Aims

To support the free and open dissemination of research findings and information on alcoholism and alcohol-related problems. To encourage open access to peer-reviewed articles free for all to view.

For full versions of posted research articles readers are encouraged to email requests for "electronic reprints" (text file, PDF files, FAX copies) to the corresponding or lead author, who is highlighted in the posting.

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Wednesday, January 23, 2013

Determinants of transition across the spectrum of alcohol use and misuse in Nigeria



Many studies have examined the risk factors associated with alcohol use disorders. No information is available from developing countries about the factors that may determine the transitions across different levels of use and misuse. 

 Alcohol use and its misuse were assessed in a cohort of 2143 Nigerians using Version 3.0 of the World Health Organization Composite International Diagnostic Interview (WHO-CIDI). This generated six levels of alcohol use and related disorders. Using age of onset variables created for the purpose, analysis was done to determine rates of and risk factor for transition between the levels. 

 Lifetime prevalence estimates were 57.8% for alcohol use, 27.6% for regular use, 2.9% for abuse, and 0.3% for dependence. Whereas 47.8% transited to regular use from lifetime ever use, only 10.5% transited to abuse from regular use and 9.5% from abuse to dependence. Male sex, age 18–49 years and being never married predicted onset of alcohol use. Transition to regular use was predicted only by male sex while transition to abuse was predicted by male sex and age 35–49 years. Factors associated with recovery from abuse were female sex and a student status. Higher rates of transition occurred in the stages preceding the onset of alcohol use disorders.

Sex and age were the main determinants of transition, with male gender and middle age being risk factors for transition to problematic use of alcohol
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 Request Reprint E-Mail:   ogureje@comui.edu.ng
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NTA release national alcohol treatment statistics 2011-2012






The National Treatment Agency for Substance Misuse (NTA) have published national alcohol statistics for 2011 - 31 March 2012:
The figures are taken from the National Drug Treatment Monitoring System (NDTMS) and show:
  • 108,906 people received alcohol treatment in 2011-12, down 2% from the year before. This includes 74,353 new entrants to treatment during the year, a rise of 1% compared to 2010-11.
  • 38,174 people successfully completed their treatment, 6% more than the previous year.
  • Most people (38%) referred themselves into treatment, 19% were referred by their GP
  • 70% of all those in alcohol treatment were concentrated in the 30 to 54 age range and the average age of a person in treatment was 42. Men accounted for nearly two thirds of the treatment population during the year. By far the biggest ethnic group was white British (88%).  > > > >  Read More
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Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial




To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in primary care. The hypothesis was that more intensive intervention would result in a greater reduction in hazardous or harmful drinking.

Pragmatic cluster randomised controlled trial.

Primary care practices in the north east and south east of England and in London.

3562 patients aged 18 or more routinely presenting in primary care, of whom 2991 (84.0%) were eligible to enter the trial: 900 (30.1%) screened positive for hazardous or harmful drinking and 756 (84.0%) received a brief intervention. The sample was predominantly male (62%) and white (92%), and 34% were current smokers.

 Practices were randomised to three interventions, each of which built on the previous one: a patient information leaflet control group, five minutes of structured brief advice, and 20 minutes of brief lifestyle counselling. Delivery of the patient leaflet and brief advice occurred directly after screening and brief lifestyT.le counselling in a subsequent consultation.

Patient follow-up rates were 83% at six months (n=644) and 79% at 12 months (n=617). At both time points an intention to treat analysis found no significant differences in AUDIT negative status between the three interventions. Compared with the patient information leaflet group, the odds ratio of having a negative AUDIT result for brief advice was 0.85 (95% confidence interval 0.52 to 1.39) and for brief lifestyle counselling was 0.78 (0.48 to 1.25). A per protocol analysis confirmed these findings.

All patients received simple feedback on their screening outcome. Beyond this input, however, evidence that brief advice or brief lifestyle counselling provided important additional benefit in reducing hazardous or harmful drinking compared with the patient information leaflet was lacking.

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Increased Detection of Alcohol Consumption and At-risk Drinking with Computerized Alcohol Screening



The impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT), but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources.

To assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED.

 Retrospective review of CASI/MSE database from January 2008 through December 2009, collected in the tertiary, Level I Trauma ED was performed. Inclusion criteria included age ≥18 years, and completion of both the MSE and CASI. We analyzed the database by comparing age, gender, primary language (English, Spanish), and Alcohol Use Disorders Identification Test scores using McNemar's test.

 Data were available for 5835 patients. CASI showed a significant increase in detection of at-risk drinking over MSE across all ages, gender, and primary language (p < 0.05). MSE found 2.5% at-risk drinkers and CASI found 11.5% at-risk drinkers (odds ratio [OR] 8.88, 95% confidence interval [CI] 6.89–11.61). Similar results were found in 18- to 20-year-old patients. MSE identified 1.8% at-risk drinkers and CASI reported 15.94% (OR 19.33, 95% CI 6.30–96.47).

 CASI increased detection of at-risk alcohol drinkers compared with MSE across all ages, gender, and primary language. CASI is a promising innovative method for alcohol screening in the ED for the adult population, including under-aged drinkers.
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 Request Reprint E-Mail:      shl@uci.edu 
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Effects of Modafinil on Neural Correlates of Response Inhibition in Alcohol-Dependent Patients





Impaired response inhibition is a key feature of patients with alcohol dependence. Improving impulse control is a promising target for the treatment of alcohol dependence. The pharmacologic agent modafinil enhances cognitive control functions in both healthy subjects and in patients with various psychiatric disorders. However, very little is known about the underlying neural correlates of improvements in response inhibition following modafinil.

 We conducted a randomized, double-blind, placebo-controlled, crossover study using functional magnetic resonance imaging with a stop signal task to examine effects of a single dose of modafinil (200 mg) on response inhibition and underlying neural correlates in abstinent alcohol-dependent patients (AD) (n = 16) and healthy control subjects (n = 16).

 Within the AD group modafinil administration improved response inhibition (reflected by the stop signal reaction time [SSRT]) in subjects with initial poor response inhibition, whereas response inhibition was diminished in better performing subjects. In AD patients with initial poor response inhibition, modafinil-induced SSRT improvement was accompanied by greater activation in the thalamus and supplementary motor area (SMA) and reduced connectivity between the thalamus and the primary motor cortex. In addition, the relationship between baseline response inhibition and modafinil-induced SSRT improvement was mediated by these changes in thalamus and SMA activation.

 These findings indicate that modafinil can improve response inhibition in alcohol-dependent patients through its effect on thalamus and SMA function but only in subjects with poor baseline response inhibition. Therefore, baseline levels of response inhibition should be taken into account when considering treatment with modafinil in AD.
Read Full Abstract

 Request Reprint E-Mail:  lianschmaal@gmail.com
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Problematic drinking and physiological responses among female college students



Problematic drinking is a widespread problem among college students, and can contribute to alcohol dependence during later adulthood, particularly among females.

 The current study assessed vulnerability for alcohol-related consequences by comparing self-reported drinking with coping styles and physiological and behavioral stress responses during a challenging task. 

 Cardiovascular measurements and saliva samples were taken from 88 female students at the beginning of the experiment and after the task. Hypothalamic–pituitary–adrenal (HPA) activity was measured by assessing cortisol and dehydroepiandrosterone (DHEA) salivary levels. The behavioral task consisted of a set of three anagrams of increasing difficulty, the last of which had no possible solution, to test the distress tolerance of the participants. 

 Results showed that the majority of participants (70%) reported drinking in the six months prior to data collection, most of whom reported at least one incident of binge drinking.

 Excessive alcohol use was related to an impaired physiological response to stress during the impossible task. College students who drank to cope with stress had significantly higher basal levels of cortisol and DHEA, an indication of HPA axis over-regulation, while their stress response remained remarkably flat. 

 Self-reported consequences of drinking were related to motives for drinking and lower DHEA levels. 

Regression analysis indicated that higher cortisol levels mediated the relationship between motives for drinking and problematic drinking.
Read Full Abstract

 Request Reprint E-Mail:   bardi@marshall.edu
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Relation between corticosterone and fear-related behavior in mice selectively bred for high or low alcohol preference




Blunted cortisol responses to stress or trauma have been linked with genetic (familial) risk for both alcoholism and post-traumatic stress disorder (PTSD). 

 Mouse lines selectively bred for high (HAP) or low (LAP) alcohol preference may be a relevant model of genetic risk for co-morbid alcoholism and PTSD in humans. HAP mice show greater fear-potentiated startle (FPS), a model used to study PTSD, than LAP mice. 

 The relation between corticosterone (CORT) and FPS behavior was explored in four experiments. Naïve male and female HAP2 and LAP2 mice received fear-conditioning or control treatments, and CORT levels were measured before and immediately after fear-conditioning or FPS testing. In two other experiments, HAP2 mice received CORT (1.0, 5.0 or 10.0 mg/kg) or a glucocorticoid receptor antagonist (mifepristone; 25.0 and 50.0 mg/kg) 30 minutes before fear conditioning. 

 HAP2 mice exposed to fear conditioning and to control foot shock exposures showed lower CORT after the fear-conditioning and FPS testing sessions than LAP2 mice. A trend toward higher FPS was seen in HAP2 mice pretreated with 10.0 mg/kg CORT, and CORT levels were the lowest in this group, suggesting negative feedback inhibition of CORT release. Mifepristone did not alter FPS. 

 Overall, these results are consistent with data in humans and rodents indicating that lower cortisol/CORT levels after stress are associated with PTSD/PTSD-like behavior. 

 These findings in HAP2 and LAP2 mice suggest that a blunted CORT response to stress may be a biological marker for greater susceptibility to develop PTSD in individuals with increased genetic risk for alcoholism.
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 Request Reprint E-Mail:  jchester@psych.purdue.edu
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Tuesday, January 22, 2013

Involvement in 12-Step Activities and Treatment Outcomes




This study addresses the relative importance of specific 12-step activities to recovery, and how treatment affects participation in those activities. 

 Data were from a clinical trial testing a 12-step facilitation intervention called MAAEZ (Making AA [Alcohol Anonymous] Easier). Participants (N = 508) were recruited at treatment entry. Analyses examined 8 activities measured at baseline, 7 weeks, 6 months, and 12 months.

 In simultaneous equations, meeting attendance and having a sponsor were the only strong and consistent predictors of abstinence across time points, though other activities (i.e., use of a home group, befriending members, service work, and reading the literature) were significant in some analyses. 

 Treatment involvement had mixed effects on activity participation over time. 

 Contradicting research suggesting that meeting attendance contributes little beyond other 12-step activities, the current results highlight the importance of consistent meeting attendance and sponsorship in recovery. 

 The results suggest a need for enhanced facilitation of key activities even in typical 12-step–oriented treatment.
Read Full Abstract

 Request Reprint E-Mail:    szemore@arg.org
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The 10-Year Course of Alcoholics Anonymous Participation and Long-Term Outcomes: A Follow-Up Study of Outpatient Subjects in Project MATCH



This study investigates the 10-year course and impact of Alcoholics Anonymous (AA)-related helping (AAH), step-work, and meeting attendance on long-term outcomes. 

Data were derived from 226 treatment-seeking alcoholics recruited from an outpatient site in Project MATCH and followed for 10 years post treatment. Alcohol consumption, AA participation, and other-oriented behavior were assessed at baseline, end of the 3-month treatment period, and 1, 3, and 10 years post treatment. 

 Controlling for explanatory baseline and time-varying variables, results showed significant direct effects of AAH and meeting attendance on reduced alcohol outcomes and a direct effect of AAH on improved other-oriented interest.
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12-Step Affiliation and Attendance Following Treatment for Comorbid Substance Dependence and Depression: A Latent Growth Curve Mediation Model



Among substance-dependent individuals, comorbid major depressive disorder (MDD) is associated with greater severity and poorer treatment outcomes, but little research has examined mediators of posttreatment substance use outcomes within this population. 

 Using latent growth curve models, the authors tested relationships between individual rates of change in 12-step involvement and substance use, utilizing posttreatment follow-up data from a trial of group Twelve-Step Facilitation (TSF) and integrated cognitive-behavioral therapy (ICBT) for veterans with substance dependence and MDD. 

 Although TSF patients were higher on 12-step affiliation and meeting attendance at end-of-treatment as compared with ICBT, they also experienced significantly greater reductions in these variables during the year following treatment, ending at similar levels as ICBT. Veterans in TSF also had significantly greater increases in drinking frequency during follow-up, and this group difference was mediated by their greater reductions in 12-step affiliation and meeting attendance. 

Patients with comorbid depression appear to have difficulty sustaining high levels of 12-step involvement after the conclusion of formal 12-step interventions, which predicts poorer drinking outcomes over time. 

 Modifications to TSF and other formal 12-step protocols or continued therapeutic contact may be necessary to sustain 12-step involvement and reduced drinking for patients with substance dependence and MDD.
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 Request Reprint E-Mail:   mworley@ucsd.edu
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12-Step Participation and Outcomes Over 7 Years Among Adolescent Substance Use Patients With and Without Psychiatric Comorbidity



This study examines the associations between 12-step participation and outcomes over 7 years among 419 adolescent substance use patients with and without psychiatric comorbidities. 

 Although level of participation decreased over time for both groups, comorbid adolescents participated in 12-step groups at comparable or higher levels across time points. 

 Results from mixed-effects logistic regression models indicated that for both groups, 12-step participation was associated with both alcohol and drug abstinence at follow-ups, increasing the likelihood of either by at least 3 times. 

 Findings highlight the potential benefits of 12-step 
participation in maintaining long-term recovery for adolescents with and without psychiatric disorders.


Read Full Abstract

 Request Reprint E-Mail:   felicia.w.chi@kp.org
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Multiple Dimensions of Spirituality in Recovery: A Lagged Mediational Analysis of Alcoholics Anonymous’ Principal Theoretical Mechanism of Behavior Change



Alcoholics Anonymous (AA) states that recovery is possible through spiritual experiences and spiritual awakenings. Research examining spirituality as a mediator of AA's effect on drinking has been mixed. It is unknown whether such findings are due to variations in the operationalization of key constructs, such as AA and spirituality. 

 To answer these questions, the authors used a longitudinal model to test 2 dimensions of AA as focal predictors and 6 dimensions of spirituality as possible mediators of AA's association with drinking.
Data from the first 18 months of a 3-year longitudinal study of 364 alcohol-dependent individuals were analyzed. Structural equation modeling was used to replicate the analyses of Kelly et al. (Alcohol Clin Exp Res. 2011;35:454–463) and to compare AA attendance and AA involvement as focal predictors. Multiple regression analyses were used to determine which spirituality dimensions changed as the result of AA participation. A trimmed, data-driven model was employed to test multiple mediation paths simultaneously. 

 The findings of the Kelly et al. study were replicated. AA involvement was a stronger predictor of drinking outcomes than AA attendance. AA involvement predicted increases in private religious practices, daily spiritual experiences, and forgiveness of others. However, only private religious practices mediated the relationship between AA and drinking.
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 Request Reprint E-Mail:    amykrent@med.umich.edu
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Do Changes in Selfishness Explain 12-Step Benefit? A Prospective Lagged Analysis



12-Step attendance is associated with increased abstinence. A strong claim made in 12-step literature is that alcoholics are pathologically selfish and that working the 12 steps reduces this selfishness, which, in turn, leads to sustained alcohol abstinence. 

This study tested this assumption by investigating the linkages between 12-step attendance, pathological narcissism, and drinking.

One hundred thirty early Alcohol Anonymous (AA) affiliates with limited AA and treatment histories were recruited from treatment and community-based AA. A majority of the sample was alcohol dependent and reported illicit drug use before recruitment. Participants were interviewed at intake and at 3, 6, and 9 months. A majority of participants attended AA meetings throughout follow-up and such attendance predicted increased abstinence and reduced drinking intensity. 

 12-Step affiliates were significantly higher on pathological narcissism (PN) relative to general population samples and their PN remained elevated. Contrary to predictions, PN was unrelated to 12-step meeting attendance and did not predict later abstinence or drinking intensity. 

 The findings did not support the hypothesis that reductions in PN explain 12-step benefit. An alternative function for the emphasis placed on pathological selfishness in 12-step programs is discussed and a recommendation is made to use unobtrusive measures of selfishness in future research.
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 Request Reprint E-Mail:   jtonigan@unm.edu
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Alcoholics Anonymous and Reduced Impulsivity: A Novel Mechanism of Change



Reduced impulsivity is a novel, yet plausible, mechanism of change associated with the salutary effects of Alcoholics Anonymous (AA). 

 Here, the authors review their work on links between AA attendance and reduced impulsivity using a 16-year prospective study of men and women with alcohol use disorders (AUDs) who were initially untreated for their drinking problems.

 Across the study period, there were significant mean-level decreases in impulsivity, and longer AA duration was associated with reductions in impulsivity. In turn, decreases in impulsivity from baseline to Year 1 were associated with fewer legal problems and better drinking and psychosocial outcomes at Year 1, and better psychosocial functioning at Year 8. Decreases in impulsivity mediated associations between longer AA duration and improvements on several Year 1 outcomes, with the indirect effects conditional on participants’ age. 

 Findings are discussed in terms of their potential implications for research on AA and, more broadly, interventions for individuals with AUDs.
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 Request Reprint E-Mail:   dmblonigen@gmail.com
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Monday, January 21, 2013

Alcohol News - 3/2013







15min.lt (Lithuania) - Lithuanian parliament votes to lift beer sale restrictions
Lithuania's Seimas voted in favor of canceling beer sale restrictions for fear of sanctions from the European Commission.
Russian Radio (Estonia) - As per the statistics- maximum per capita alcohol in the world is sold in Estonia
The most per capita alcohol in the world is sold in Estonia. This is shown in the statistics published in the British magazine ‘The Economist’.
THL (Finland) - THL shares Finnish alcohol policy expertise worldwide
The National Institute for Health and Welfare is now also a World Health Organization (WHO) Collaborating Centre on alcohol policy implementation and evaluation.
habermonitor (Denmark) - Limiting alcohol ads on the agenda in Denmark
Danish Prime Minister Helle Thorning-Schmidt,"we do not want to become dependent on alcohol advertising restrictions bring our children at a young age.
The Baltic Course - Nordic-Baltic alcohol policy network urges airline companies and hotels to abandon free alcohol
Nordic Alcohol and Drug Policy Network (NordAN), with over 80 member organisations from Nordic and Baltic countries, calls airline companies to rethink their policies on alcohol and end giving out free alcohol on board as alcohol is no ordinary commodity and may cause serious problems in this extraordinary situation.
NAD (Sweden) - Information if you want it – the new Swedish public health policy
In June 2012, the Swedish right-wing government presented their new public health policy to the Parliament in a written communication.
The Independent (USA) - The economic impact of alcohol
In the last decade, local option elections have taken place in nearly every corner of the state with communities voting, more often than not, to allow or expand alcohol sales rather than to limit or prohibit them entirely.
The Australian (Australia) - Health curbs on alcohol mooted
HEALTH activists are seeking public funds to lay the groundwork for bans on alcohol advertising, minimum pricing of alcoholic drinks, restrictions on certain foods and to push the case that alcohol causes cancer.
Stuff.co.nz (New Zealand) - Changing Kiwi booze culture: Time to address the elephant in the pub
New Zealand has far too many problem alcohol users. This has been accepted as fact by most interested parties. The costs can be measured in different ways and to get a true picture of alcohol related harm, such costs should be described and measured accurately.
This is Money (UK) - Cameron looks to Scotland for legal case to underpin minimum alcohol price
Lawyers for the Government are to make David Cameron’s case for minimum pricing on alcohol in the Scottish courts this week.
China Post (Russia) - Russians warily turn to AA in battle with alcohol
One-time Russian prisoner Andrei tried to quit drinking 22 times, going for cures that lasted from one to six months. But each time, he went back to the bottle.
Medscape - Physicians Frequently Miss Alcohol Problems
Clinical intuition alone misses most patients with alcohol problems compared with a standard screening instrument, according to a study published in the January/February issue of the Annals of Family Medicine.
Telegraph.co.uk (UK) - Royal Navy alcohol policy must change, says shot submarine officer's widow
Gill Molyneux, whose husband Lt Cdr Ian Molyneux was shot dead by a drunk naval rating on a submarine, says Royal Navy alcohol policy must change.
Times of India - Liver failure: Liver damage and alcohol
And how much alcohol does one have to consume to have a liver problem? To answer our questions on liver failure and to bust myths on liver damage due to alcohol, we spoke to Dr. Rakesh Tandon, Head of Gastroenterology at Pushpawati Singhania Research Institute (PSRI Hospital).
Swindon Advertiser - Europe-wide savings cut Lidl's booze costs
LIDL has responded to a survey by the Adver showing some supermarket alcohol is cheaper than at the cash and carry. The survey also found rock-bottom alcohol prices at the main stores in the town.
Otago Daily Times (New Zealand) - 'Appalling' alcohol abuse prompts pub closure
The ''appalling'' aggravated alcohol abuse at Heffs Hotel is behind a Liquor Licensing Authority order for the South Dunedin premises to be temporarily closed for part of this week.
The Local.de (Germany/Netherlands) - Dutch invade German borderlands for beer
The flood of Germans coming back from Holland with secret stashes of cannabis has been replaced by Dutch people going in the other direction, their cars loaded with beer, the Westdeutsche Allgemeine Zeitung reported.


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Decreased GABAA benzodiazepine binding site densities in postmortem brains of Cloninger type 1 and 2 alcoholics




Ethanol modulates the GABAA receptor to cause sedative, anxiolytic and hypnotic effects that are qualitatively similar to benzodiazepines and barbiturates. 

 The aim of this study was to explore if GABAA receptor density is altered in post-mortem brains of anxiety-prone Cloninger type 1 and socially hostile type 2 alcoholic subtypes when compared to controls.

 The GABAA binding site density was measured by whole-hemisphere autoradiography with tritium labeled flunitrazepam ([3H]flunitrazepam) from 17 alcoholic (nine type 1, eight type 2) and 10 non-alcoholic post-mortem brains, using cold flumazepam as a competitive ligand. A total of eight specific brain areas were examined. 

 Alcoholics displayed a significantly (p < 0.001, bootstrap type generalizing estimating equations model) reduced [3H]flunitrazepam binding site density when compared to controls. When localized, type 2 alcoholics displayed a significantly (p ≤ 0.05) reduced [3H]flunitrazepam binding site density in the internal globus pallidus, the gyrus dentatus and the hippocampus, whereas type 1 alcoholics differed from controls in the internal globus pallidus and the hippocampus. 

 While previous reports have demonstrated significant alterations in dopaminergic and serotonergic receptors between type 1 and type 2 alcoholics among these same subjects, we observed no statistically significant difference in [3H]flunitrazepam binding site densities between the Cloninger type 1 and type 2 alcoholics.
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 Request Reprint E-Mail:  markus.storvik@uef.fi 
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Alcohol problems in the criminal justice system: an opportunity for intervention




Alcohol is linked with crime, especially violent crime. Many people are incarcerated because of alcohol-related crime. Alcohol is not permitted in prisons except in a very few cases, and illicit use of alcohol in prison is not a major problem. Nevertheless, imprisonment gives an opportunity to tackle alcohol problems in prisoners, with the potential for positive effects on their families and friends and a reduction in the risk of re-offending, the costs to society and health inequalities.

 This publication describes an integrated model of care for alcohol problems in prisoners, with elements for best practice. The model starts with assessment of the seriousness of prisoners’ alcohol problems, using a validated screening tool, the WHO Alcohol Use Disorders Identification Test (AUDIT), and calls for interventions tailored to prisoners’ specific needs.



Read Full Publication     (PDF)
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Behavior Therapy Volume 44, Issue 1, March 2013, Pages 137–151 The Relationship Between Baseline Drinking Status, Peer Motivational Interviewing Microskills, and Drinking Outcomes in a Brief Alcohol Intervention for Matriculating College Students: A Replication



The purpose of this study was to replicate and extend previous findings (Tollison et al., 2008) on the association between peer facilitator adherence to motivational interviewing (MI) microskills and college student drinking behavior. 

 This study used a larger sample size, multiple follow-up time-points, and latent variable analyses allowing for more complex models to be tested in a sample with different characteristics than Tollison et al. Matriculating students who participated in high school sports (N = 327) took part in a Brief Alcohol Screening and Intervention for College Students led by peer facilitators trained in motivational interviewing (MI). Participants were assessed pre- and immediately postintervention on contemplation to change, as well as pre-, 5 months, and 10 months postintervention on drinking quantity. Independent coders used the Motivational Interviewing Treatment Integrity scale (Moyers, Martin, Manuel, & Miller, 2003) to evaluate therapist MI adherence.

 Contrary to our previous study, results indicated that a higher number of open questions was positively related to increases in drinking, especially for heavier drinkers. Congruent with the previous study, more simple reflections was positively related to increases in drinking. 

 Finally, this study revealed that heavier baseline drinking was associated with more simple reflections. There were no significant results found for changes in contemplation. 

 Results corroborate previous findings that the excessive use of simple reflections may be indicative of countertherapeutic outcomes while raising questions about the relationship between the frequency of open questions and therapeutic outcomes.
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Request Reprint E-Mail:    seantollison@hotmail.com
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Attributions of change and self-efficacy in a randomized controlled trial of medication and psychotherapy for problem drinking





The current study examines participants’ attributions of change in a double-blind, randomized controlled trial of problem drinkers wanting to moderate their alcohol consumption.

  Participants were assigned to 12 weeks of naltrexone or placebo, which was paired with either combined motivational interviewing and cognitive behavioral therapy (MBSCT) along with an enhanced medication management intervention or enhanced medication management only. Upon treatment completion, a questionnaire assessed participants’ attributions of change along with their self-efficacy in their ability to maintain treatment gains. 

 Participants differed in strength of attributions of change and self-efficacy according to both their therapy condition and their hypothesized medication condition. 

 Specifically, those in the MBSCT condition who hypothesized that they received placebo displayed greater confidence in continuing changes without medication compared with the other groups. 

How treatment condition and attributions of change relate to self-efficacy for long-term maintenance of treatment gains are discussed.


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 Request Reprint E-Mail:    KS741289@albany.edu
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Sunday, January 20, 2013

FASD News - 2/2013







NEWS and ARTICLES
Alexandria Echo Press - Here's how women can help prevent birth defects
The Minnesota Department of Health (MDH) is joining the National Birth Defects Prevention Network (NBDPN) and the Minnesota March of Dimes to inform women about ways to prevent birth defects in Minnesota throughout January, which is National Birth Defects Prevention Month.
Daily Mail (UK) - My foster son's mother drank in pregnancy. It left him so mentally damaged he was too dangerous to live with
Looking at the little boy in front of me, I felt like howling in frustration. A big vacant grin on his face, he was hopping from one foot to the other and singing at the top of his voice, while inanely cracking his knuckles.
AllAfrica.com (South Africa) - Africa: Trouble Brewing - Africa and Alcohol Problems
With over-consumption of alcohol on the rise, governments are struggling to find suitable legislation amidst profit-hungry global corporations and illegally-produced liquor.
Today's THV (USA) - ACH: Birth defects common, costly, critical for Arkansas
A baby is born every 14 minutes in Arkansas. Every five hours a baby is born with a birth defect, and every four days a baby in the state dies from a birth defect.
Communitycare.co.uk (UK) - Why my social work experience led me to specialise on foetal alcohol spectrum disorders
After 27 years as a practising social worker Liam Curran became a certified trainer on foetal alcohol spectrum disorders. Here, he tells Community Care about the highs and lows of his new job.
Wisconsin State Journal (USA) - Dr. Dana Johnson: Some birth defects can be prevented, even before pregnancy
January is National Birth Defects Prevention Month. One out of every 33 babies in the United States is born with a birth defect. While some birth defects cannot be prevented, there are ways to reduce the risk of many others.
USA TODAY (USA) - CDC: Binge drinking is serious problem for girls, women
Binge drinking among women and girls is a health problem that is serious but under-recognized, the Centers for Disease Control and Prevention says in a report today.
The New York Times - Why No One Really Knows If Moderate Drinking Is Safe for Pregnant Women
Is moderate drinking (less than one drink a day) safe during pregnancy?
TheSouthAfrican (South Africa) - ‘No evidence’ for Sky claim that SA women drink to harm babies
According to Africa Check, there is little in the way of hard evidence to back up the claim in a Sky News report that mothers in one of South Africa’s poorest areas are drinking heavily to deliberately damage their unborn babies – just so that they can claim the disability benefit

MATERIALS
College of Caledonia - FASD Programs, Services & Training
The Lakes District community has taken a proactive role in Fetal Alcohol Spectrum Disorder (FASD) since 1991. As a result, CNC Lakes District Campus has actively supported the development of a number of programs designed by front line workers to provide supports and services to individuals affected by prenatal alcohol exposure and women at risk of alcohol and drug use during pregnancy.
The University of Sydney - Handbook for Aboriginal Alcohol and Drug Work
The Handbook for Aboriginal Alcohol and Drug Work is a practical tool written for Aboriginal drug and alcohol workers, mental health workers and others working in this field.

COMING EVENTS
SPECIAL: www.fasdedmonton2013.ca - Alcohol and Pregnancy –prevention and legal issues of FASD
During the last four years, the Institute of Health Economics, a non for profit organization in Edmonton, Canada, www.ihe.ca has made significant efforts in support of the development of policy issues related to FASD.
Carolyn Blackburn SEND Consultancy (UK) - Improving outcomes for children with Foetal Alcohol Spectrum Disorders (FASD) and other complex learning disabilities (18 April 2013, Coventry)
This will be an intensive Learning Day for educators of children and young adults who have FASD, often accompanied by other learning disabilities. Carolyn Blackburn and Raja Mukherjee are two of the UK’s leading experts in FASD.
Interprofessional Continuing Education - The 5th International Conference on Fetal Alcohol Spectrum Disorder
This conference brings together experts from many disciplines to share international research, to discuss the implications of this research, and to promote scientific/community collaboration.
NeuroDevNet (France) - 3rd International SAF France Symposium
The 3rd International SAF France Symposium will be held Thursday 30th and Friday 31st of May 2013 at the Cité Internationale Universitaire of Paris.
fasdNL (Canada) - FASD Throughout the Lifespan: from prevention to lifelong support
The fasdNL Network is inviting you to an FASD conference entitled FASD Throughout the Lifespan and the 14th Annual FACE Research Roundtable.

RESEARCH
Annals of Neurology - Prenatal Alcohol Exposure Affects Vasculature Development in the Neonatal Brain
In humans, antenatal alcohol exposure elicits various developmental disorders, in particular in the brain. Numerous studies focus on the deleterious effects of alcohol on neural cells. Although recent studies suggest that alcohol can affect angiogenesis in adults, the impact of prenatal alcohol exposure on brain microvasculature remains poorly understood.
The Journal of Neuroscience - Moderate Prenatal Alcohol Exposure Reduces Plasticity and Alters NMDA Receptor Subunit Composition in the Dentate Gyrus
Although it is well documented that heavy consumption of alcohol during pregnancy impairs brain development, it remains controversial whether moderate consumption causes significant damage. Using a limited access, voluntary consumption paradigm, we recently demonstrated that moderate prenatal alcohol exposure (MPAE) is associated with dentate gyrus-dependent learning and memory deficits that are manifested in adulthood.
Alcohol - Identification of cell-specific patterns of reference gene stability in quantitative reverse-transcriptase polymerase chain reaction studies of embryonic, placental and neural stem models of prenatal ethanol exposure
Identification of the transcriptional networks disrupted by prenatal ethanol exposure remains a core requirement to better understanding the molecular mechanisms of alcohol-induced teratogenesis.

IN OTHER LANGUAGES
Berliner Zeitung (Germany) - Jeder Schluck ist eine Gefahr
Das Projekt "Blau im Bauch" richtet sich gegen den Konsum von Alkohol in der Schwangerschaft, der dazu führen kann, dass das Kind mit dem Fetalen Alkoholsyndrom (FASD) geboren wird.
Avisen Agder (Norway) - Sørlandet sykehus HF ønsker å bli godkjent som senter for utredning av russkadde barn
Sørlandet sykehus HF har søkt om å bli godkjent som regionalt henvisningskompetansesenter for utredning av barn med skader etter mors alkoholbruk. HABU ved Barnesenteret har søkt Helse Sør-Øst om 3,1 millioner kroner til å opprette et slikt senter.
SpitsNieuws (Netherlands) - Baby gehandicapt zuipen voor bijstand
Zwangere vrouwen in Zuid-Afrika gaan over tot drastische maatregelen om aan geld te komen. De laatste trend die in het land heerst is dat vrouwen expres veel alcohol drinken, zodat hun baby gehandicapt ter wereld komt.
NEWSru.co.il (Russia) - Жительницы ЮАР пьют во время беременности – чтобы родить инвалидов
По данным Всемирной организации здравоохранения (ВОЗ) в последние годы в этом регионе резко возросло количестве новорожденных, у которых диагностировано расстройство фетального алкогольного спектра ( FASD) – наиболее часто встречающийся врожденный порок у местных младенцев.


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