Happy families? Equipping practitioners to tackle alcohol misuse issues in families

25th April 2013, Mary Sumner House, Westminster, London
Alcohol Concern in association with Adfam

Parental substance misuse has a damaging effect on children and families. The problem is knowing what to do about it.

Many experienced professionals still feel powerless when faced with working with a family affected by substance misuse. This conference looks at how parental substance misuse affects families, what the lessons learned from supporting practitioners on the frontline are, and how professionals can be equipped to work effectively with children, parents and families.

Key speakers will outline the current policy context and the case for improving practitioners’ skills and confidence in this area. Alcohol Concern and Adfam will share lessons learned from working with practitioners on the frontline, along with the problems faced when working with these clients.  > > > >  Read More

Socioeconomic Position and Adolescent Trajectories in Smoking, Drinking, and Psychiatric Distress

 

Smoking, drinking, and psychiatric distress are inter-related and may also be associated with socioeconomic position (SEP). This paper investigates the role of SEP in adolescent development across all three of these outcomes.

Data were self-reported by adolescents in the Twenty-07 Study (N = 1,515) at ages 15, 17, and 18 years. Latent class analysis was used to identify homogeneous subgroups of adolescents with distinct developmental patterns. Associations between developmental patterns and a range of socioeconomic indicators were then tested.

Five classes were identified. A Low Risk class had low levels for all outcomes. A High Distress class had persistently high levels of distress, but was otherwise similar to the Low Risk group. A High Drinking class drank alcohol earlier and more heavily but also had higher levels of distress than the Low Risk group. Smokers were grouped in two classes, Early Smokers and Late Smokers, and both also had raised levels of drinking and distress. Early Smokers tended to begin earlier and smoke more heavily than Late Smokers. Relative to the Low Risk class, adolescents in a disadvantaged SEP were more likely to be Early Smokers and somewhat less likely to be in the High Drinking class. SEP was not consistently associated with membership in the High Distress or Late Smokers classes.

Associations with SEP are evident in opposing directions or absent depending on the combination and timing of outcomes, suggesting that a disadvantaged SEP is not a simple common cause for all three outcomes.


Read Full Abstract

Request Reprint E-Mail:    michael-g@sphsu.mrc.ac.uk

Should we train alcohol-dependent patients to avoid alcohol? Commentary on Spruyt et al “On the predictive validity of automatically activated approach/avoidance tendencies in abstaining alcohol-dependent patients”

Spruyt et al. [1] report an interesting study in which they compared an alcohol approach-bias, as measured with the Relevant-feature Stimulus Response Compatibility task (R-SRC) in 40 abstaining alcohol-dependent patients and 40 non-dependent controls. While controls had an approach-bias for alcohol as compared to matched control-pictures like water, alcohol-dependent patients showed a relative avoidance bias for alcohol. In the patients group, an avoidance-bias was associated with an increased risk for relapse 3 months later. The authors discuss the relationship of these findings with our training-results, in which alcohol-dependent patients trained to avoid alcohol did better at a one-year follow-up: “Although initial findings suggest that alcohol-avoidance training could help reduce relapse rates in abstaining-alcohol dependent patients [2], it is still unclear whether changes in automatically approach/avoidance tendencies are directly responsible for the observed changes in treatment outcome. Our findings suggest that actually inducing an avoidance orientation towards alcohol might have harmful effects, at least in a clinical population.”    > > > >   Read More

On the predictive validity of automatically activated approach/avoidance tendencies in abstaining alcohol-dependent patients

Prominent addiction models posit that automatically activated approach/avoidance tendencies play a critical role in addiction. Nevertheless, only a limited number of studies have actually documented the relationship between relapse and automatically activated approach/avoidance tendencies. We compared automatically activated approach/avoidance tendencies towards alcohol in 40 abstaining alcohol-dependent patients and 40 controls. We also examined whether individual differences in automatically activated approach/avoidance tendencies towards alcohol are predictive of relapse in patients.

A Relevant Stimulus Response Compatibility task was used to measure relative approach/avoidance tendencies. In one block of trials, participants were asked to approach alcohol-related pictures and to avoid alcohol-unrelated pictures (i.e., compatible block). In a second block of trials, participants were asked to approach alcohol-unrelated pictures and to move away from alcohol-related pictures (i.e., incompatible block). Patients were tested between 18 and 21 days after they quit drinking. Relapse was assessed 3 months after patients were discharged from the hospital.

Whereas abstaining alcohol-dependent patients were faster to respond to incompatible trials as compared to compatible trials, participants in the control group showed the exact opposite pattern. Within the patient group, the likelihood of relapse increased as participants were faster to respond to incompatible trials relative to compatible trials.

Unlike controls, abstaining alcohol-dependent patients revealed a relative avoidance bias rather than relative approach bias. Moreover, relapse rates were found to increase as the relative tendency to avoid alcohol increased. This finding suggests that an avoidance orientation towards alcohol can potentially be harmful in clinical samples.


Read Full Abstract

Request Reprint E-Mail:   Adriaan.Spruyt@UGent.be

Differential Effects of Chronic and Chronic-Intermittent Ethanol Treatment and Its Withdrawal on the Expression of miRNAs

Chronic and excessive alcohol misuse results in changes in the expression of selected miRNAs and their mRNA targets in specific regions of the human brain. These expression changes likely underlie the cellular adaptations to long term alcohol misuse.

In order to delineate the mechanism by which these expression changes occur, we have measured the expression of six miRNAs including miR-7, miR-153, miR-152, miR-15B, miR-203 and miR-144 in HEK293T, SH SY5Y and 1321 N1 cells following exposure to ethanol. These miRNAs are predicted to target key genes involved in the pathophysiology of alcoholism.

Chronic and chronic-intermittent exposure to ethanol, and its removal, resulted in specific changes in miRNA expression in each cell line suggesting that different expression patterns can be elicited with different exposure paradigms and that the mechanism of ethanol’s effects is dependent on cell type.

Specifically, chronic exposure to ethanol for five days followed by a five day withdrawal period resulted in up-regulation of several miRNAs in each of these cell lines similar to expression changes identified in post mortem human brain.

Thus, this model can be used to elucidate the role of miRNAs in regulating gene expression changes that occur in response to ethanol exposure.


Read Full Article   (PDF)

Awareness Week on Alcohol Related Harm

 

 

 

 

 

 

Time for action: The need for an integrated EU alcohol strategy

 

Awareness Week on Alcohol Related Harm

 

POLICY DEBATE HOSTED BY NESSA CHILDERS MEP

15 MAY 2013

12:00 – 14:00

 

EUROPEAN PARLIAMENT

 

Alcohol-related harm costs Europe around €155bn each year. It damages people’s health, relationships and careers. It is time to take action. This event – part of the first Awareness Week on Alcohol Related Harm
(13–17 May 2013) – will explore how EU policies can continue to tackle alcohol-related harm and will see the launch of the ‘Conclusions of the EU Roundtable on an Integrated Approach to Alcohol Related Harm’.

Click here to register for the event.

Click here to read the entire text of the Conclusions of the EU roundtable on an integrated approach to alcohol related harm.

The Role of Acidemia in Maternal Binge Alcohol-Induced Alterations in Fetal Bone Functional Properties

Heavy alcohol consumption during pregnancy negatively impacts the physical growth of the fetus. Although the deleterious effects of alcohol exposure during late gestation on fetal brain development are well documented, little is known about the effect on fetal bone mechanical properties or the underlying mechanisms. The purpose of this study was to investigate the effects of late gestational chronic binge alcohol consumption and alcohol-induced acidemia, a critical regulator of bone health, on functional properties of the fetal skeletal system.

 

Suffolk ewes were mated and received intravenous infusions of saline or alcohol (1.75 g/kg) over 1 hour on 3 consecutive days per week followed by 4 days without treatment beginning on gestational day (GD) 109 and concluding on GD 132 (term = 147 days). The acidemia group was exposed to increased inspired fractional concentrations of CO₂ to closely mimic the alcohol-induced decreases in maternal arterial pH seen in the alcohol group.

 

Fetal femurs and tibias from the alcohol and acidemia groups were ~3 to 7% shorter in length compared with the control groups (p < 0.05). Three-point bending procedure demonstrated that fetal femoral ultimate strength (MPa) for the alcohol group was decreased (p < 0.05) by ~24 and 29%, while the acidemia group exhibited a similar decrease (p < 0.05) of ~32 and 37% compared with the normal control and saline control groups, respectively. Bone extrinsic and intrinsic mechanical properties including maximum breaking force (N) and normalized breaking force (N/kg) of fetal bones from the alcohol and acidemia groups were significantly decreased (p < 0.05) compared with both control groups.

 

We conclude that late gestational chronic binge alcohol exposure reduces growth and impairs functional properties of the fetal skeletal system and that the repeated episodes of alcohol-induced maternal acidemia may be at least partially responsible for these effects.


Read Full Abstract

Request Reprint E-Mail:      swashburn@cvm.tamu.edu

Rehabilitation Training Using Complex Motor Learning Rescues Deficits in Eyeblink Classical Conditioning in Female Rats Induced by Binge-Like Neonatal Alcohol Exposure

Effective treatments for the behavioral and cognitive deficits in children with fetal alcohol spectrum disorders (FASD) are lacking, and translational approaches using animal models can help develop rational interventions. One such model, binge-like alcohol exposure in neonatal rats during the period of brain development comparable with that of the human third trimester, causes structural and functional damage to the cerebellum and disrupts cerebellar-dependent eyeblink classical conditioning. The eyeblink conditioning deficits first demonstrated in this rat model predicted the similar deficits subsequently demonstrated in children with FASD.

 

The current study extends this translational approach by testing the hypothesis that rehabilitation training involving 20 days of training on traversal of an obstacle course (complex motor learning) would ameliorate the deficits on classical conditioning of eyeblink responses produced by the neonatal alcohol exposure. We have previously shown that this training stimulates cerebellar synaptic plasticity and improves alcohol-induced deficits on motor coordination tasks.

 

The current studies found that rehabilitation training significantly attenuated alcohol-induced deficits in acquisition of eyeblink conditioning in females but not in males. These results are consistent with normalization of cerebellar-dependent learning, at least in alcohol-exposed females.

 

These findings extend previous studies in this model suggesting that rehabilitation of adolescents with FASD using training with complex motor learning tasks could be effective in ameliorating functional impairments associated with cerebellar damage. Eyeblink classical conditioning deficits are now well documented in children with FASD and could serve as an evaluation measure to continue to develop therapeutic interventions such as complex motor learning.



Read Full Abstract

Request Reprint E-Mail:   jyellig@iupui.edu

Healthcare Utilization in Medical Intensive Care Unit Survivors with Alcohol Withdrawal

 

Rehospitalization is an important and costly outcome that occurs commonly in several diseases encountered in the medical intensive care unit (ICU). Although alcohol use disorders are present in 40% of ICU survivors and alcohol withdrawal is the most common alcohol-related reason for admission to an ICU, rates and predictors of rehospitalization have not been previously reported in this population.

 

We conducted a retrospective cohort study of medical ICU survivors with a primary or secondary discharge diagnosis of alcohol withdrawal using 2 administrative databases. The primary outcome was time to rehospitalization or death. Secondary outcomes included time to first emergency department or urgent care clinic visit in the subset of ICU survivors who were not rehospitalized. Cox proportional hazard models were adjusted for age, gender, race, homelessness, smoking, and payer source.

 

Of 1,178 patients discharged from the medical ICU over the study period, 468 (40%) were readmitted to the hospital and 54 (4%) died within 1 year. Schizophrenia (hazard ratio 2.23, 95% CI 1.57, 3.34, p < 0.001), anxiety disorder (hazard ratio 2.04, 95% CI 1.30, 3.32, p < 0.01), depression (hazard ratio 1.62, 95% CI 1.05, 2.40, p = 0.03), and Deyo comorbidity score ≥3 (hazard ratio 1.43, 95% CI 1.09, 1.89, p = 0.01) were significant predictors of time to death or first rehospitalization. Bipolar disorder was associated with time to first emergency department or urgent care clinic visit (hazard ratio 2.03, 95% CI 1.24, 3.62, p < 0.01) in the 656 patients who were alive and not rehospitalized within 1 year.

 

The presence of a psychiatric comorbidity is a significant predictor of multiple measures of unplanned healthcare utilization in medical ICU survivors with a primary or secondary discharge diagnosis of alcohol withdrawal. This finding highlights the potential importance of targeting longitudinal multidisciplinary care to patients with a dual diagnosis.


Read Full Abstract

Request Reprint E-Mail:     brendan.clark@ucdenver.edu
 

Temporal and Behavioral Variability in Cannabinoid Receptor Expression in Outbred Mice Submitted to Ethanol-Induced Locomotor Sensitization Paradigm

There is a close relationship between the endocannabinoid system and alcoholism. This study investigated possible differential expression of cannabinoid receptors CB1 (CB1R) and CB2 (CB2R) in an outbred mice strain displaying behavioral variability to ethanol (EtOH)-induced locomotor sensitization.

 

Male adult Swiss mice treated chronically with EtOH (2 g/kg, i.p., daily for 21 days) were classified as “EtOH_High” or “EtOH_Low” according to their locomotor activity after the 21st EtOH injection. A control group was similarly injected with saline. Temporal analysis of CB1R and CB2R immunoreactivity was performed in 3 different occasions: (i) at the end of chronic EtOH treatment, (ii) on the fifth day of EtOH withdrawal, and (iii) after EtOH challenge.

 

Overall, no differences were seen between experimental groups regarding the CB1R at the end of acquisition. However, there were decreases in CB2R in the prefrontal cortex and the hippocampus in EtOH_Low mice. On the fifth day of withdrawal, only EtOH_High mice presented increase in CB1R. Nonetheless, CB2R up-regulation was observed in both EtOH_High and EtOH_Low mice. EtOH challenge counteracted CB1R and CBR2 up-regulation, mainly in the EtOH_High, in structures related to emotionality, such as prefrontal cortex, ventral tegmental area, amygdala, striatum, and hippocampus.

 

There are different patterns of cannabinoid receptor expression during locomotor sensitization paradigm, at both temporal and behavioral perspectives. We hypothesize that CB2R down-regulation might be related to resilience to develop locomotor sensitization, while CB1R up-regulation relates to withdrawal aspects in sensitized mice.


Read Full Abstract

Request Reprint E-Mail:   guilherme.stos.jr@gmail.com

Repeated Cycles of Binge-Like Ethanol (EtOH)-Drinking in Male C57BL/6J Mice Augments Subsequent Voluntary EtOH Intake But Not Other Dependence-Like Phenotypes

Recently, procedures have been developed to model specific facets of human alcohol abuse disorders, including those that model excessive binge-like drinking (i.e., “drinking-in-the-dark,” or DID procedures) and excessive dependence-like drinking (i.e., intermittent ethanol [EtOH] vapor exposure). Similar neuropeptide systems modulate excessive EtOH drinking stemming from both procedures, raising the possibility that both paradigms are actually modeling the same phenotypes and triggering the same central neuroplasticity. Therefore, the goal of this present project was to study the effects of a history of binge-like EtOH drinking, using DID procedures, on phenotypes that have previously been described with procedures to model dependence-like drinking.

 

Male C57BL/6J mice first experienced 0 to 10 four-day binge-like drinking episodes (3 days of rest between episodes). Beginning 24 hours after the final binge-like drinking session, mice were tested for anxiety-like behaviors (with elevated plus maze [EPM] and open-field locomotor activity tests), ataxia with the rotarod test, and sensitivity to handling-induced convulsions (HICs). One week later, mice began a 40-day 2-bottle (water vs. EtOH) voluntary consumption test with concentration ranging from 10 to 20% (v/v) EtOH.

 

A prior history of binge-like EtOH drinking significantly increased subsequent voluntary EtOH consumption and preference, effects most robust in groups that initially experienced 6 or 10 binge-like drinking episodes and completely absent in mice that experienced 1 binge-like drinking episode. Conversely, a history of binge-like EtOH drinking did not influence anxiety-like behaviors, ataxia, or HICs.

 

Excessive EtOH drinking stemming from DID procedures does not initially induce phenotypes consistent with a dependence-like state. However, the subsequent increases in voluntary EtOH consumption and preference that become more robust following repeated episodes of binge-like EtOH drinking may reflect the early stages of EtOH dependence, suggesting that DID procedures may be ideal for studying the transition to EtOH dependence.


Read Full Abstract

Request Reprint E-Mail:

Drinkaware independent review raises questions for industry funded alcohol charity

The industry funded alcohol education charity Drinkaware has released an independent review of its activities, with mixed findings over its effectiveness to date. Download the report here [pdf] or appendices.  > > > >  Read More

Predicting stubborn alcohol addiction: mood, motive may hold keys

It doesn't take stacks of research to demonstrate that medicating painful feelings with alcohol or drugs is a dangerous and ultimately futile strategy (although those studies do exist). But the relationship between emotional difficulties and alcohol addiction has always been a complex one, in a chicken-and-egg way: does alcohol -- a depressive agent -- make people who use it become depressed? Or are depressed people more likely to drink heavily to self-medicate, and then to become dependent on alcohol?

Two new studies explore the links between mood and alcoholism in an effort to predict who becomes alcohol-dependent and which alcoholics are most likely to relapse.

One of those studies -- published online this week by the journal JAMA Psychiatry -- uses brain scanners to help tease out a possible "biomarker" for the most stubborn forms of alcoholism, and finds one that implicates mood as a key factor.

The other, published in JAMA Psychiatry, is much more low-tech: In face-to-face interviews, researchers asked people who were at higher than usual risk of alcoholism whether they drank to improve their mood or to calm down, and then went back two to four years later and looked at who had become, or stayed, alcohol-dependent.  > > > >  Read More

Editorial - Brain Imaging Biomarkers to Predict Relapse in Alcohol Addiction

 

Nearly 15 million Americans 12 years of age and older were dependent on or abused alcohol in 2010.¹ The high prevalence of problem alcohol use worldwide has been estimated to cause 2.5 million deaths each year,² not to mention the exorbitant costs associated with excess morbidity³ and loss of productivity.⁴ The chronic and relapsing nature of alcoholism, just like that of every other substance use disorder, is one of the major obstacles to its successful treatment. This is why the search for predictive biomarkers to help clinicians select and monitor a therapeutic course of action and to help researchers evaluate new therapeutic interventions is so urgent.

 

It is well established that the risk for alcohol relapse is tied to static (eg, severity index, marital status, psychiatric symptoms, and genetics) and dynamic (eg, craving and stress) factors. The latter offer particularly useful metrics whose magnitudes correlate quite closely with different disease trajectories⁵ and can consistently predict alcohol relapse risk.^{6- 7} Thus, a better understanding of a patient's response to stress and/or alcohol cues is bound to contribute to the design of more personalized and, therefore, effective treatment strategies. The findings reported by Seo et al⁸ in the current issue of JAMA Psychiatry represent an important step forward for they manage to map the relationship between relapse risk and specific neural substrates, advancing the feasibility of a brain biomarker for predicting relapse into alcohol drinking.  > > > >  Read More

Disrupted Ventromedial Prefrontal Function, Alcohol Craving, and Subsequent Relapse Risk

                 


Alcohol dependence is a chronic relapsing illness; stress, alcohol-related cues, and neutral-relaxing states significantly influence craving and relapse risk. However, neural mechanisms underlying the association between these states and alcohol craving and relapse risk remain unclear.

To identify neural correlates associated with alcohol craving and relapse outcomes in 45 treatment-engaged, 4- to 8-week abstinent alcohol-dependent (AD) patients, and to compare brain responses of 30 demographically matched AD patients and 30 healthy control subjects during stress, alcohol, and neutral-relaxing cues.

 Functional magnetic resonance imaging study while participants were engaging in brief individualized script-driven imagery trials of stress, alcohol cues, and neutral-relaxing scenarios, and a prospective clinical outcome design to assess alcohol relapse 90 days postdischarge from inpatient treatment in the AD group.

Inpatient treatment setting in a community mental health center and hospital-based research unit.

Forty-five recovering AD patients in inpatient treatment for examining relapse, and 30 healthy control subjects demographically matched to 30 AD patients (subgroup of the relapse sample) for group comparisons.

Twelve-step recovery–based addiction treatment for the patient group.

Brain response, alcohol craving, and relapse outcome measures (time to relapse and relapse severity).

Increased ventromedial prefrontal cortex (vmPFC) and anterior cingulate cortex (ACC) activation during neutral-relaxing trials was correlated with high alcohol cue–induced and stress-induced craving in early recovering AD patients (x = 6, y = 43, z = −6; P < .01, whole-brain corrected). This vmPFC/ACC hyperactivity significantly predicted subsequent alcohol relapse, with a hazards ratio greater than 8 for increased relapse risk. Additionally, vmPFC/ACC hyperactivation during neutral trials and reduced activity during stress trials were each predictive of greater days of alcohol used after relapse (P < .01, whole-brain corrected). In contrast, matched control subjects showed the reverse pattern of vmPFC/ACC responses to stress, alcohol cues, and relaxed trials (F = 6.42; P < .01, whole-brain corrected).

Findings indicate that disrupted vmPFC/ACC function plays a role in jeopardizing recovery from alcoholism and may serve as a neural marker to identify those at risk for alcohol relapse.


Read Full Article   (PDF)

A Prospective Assessment of Reports of Drinking to Self-medicate Mood Symptoms With the Incidence and Persistence of Alcohol Dependence

 Mood disorders and alcohol dependence frequently co-occur. Etiologic theories concerning the comorbidity often focus on drinking to self-medicate or cope with affective symptoms. However, there have been few, if any, prospective studies in population-based samples of alcohol self-medication of mood symptoms with the occurrence of alcohol dependence. Furthermore, it is not known whether these associations are affected by treatment or symptom severity.

To evaluate the hypothesis that alcohol self-medication of mood symptoms increases the probability of subsequent onset and the persistence or chronicity of alcohol dependence.

Prospective study using face-to-face interviews—the National Epidemiologic Survey on Alcohol and Related Conditions.

Nationally representative survey of the US population.

 Drinkers at risk for alcohol dependence among the 43 093 adults surveyed in 2001 and 2002 (wave 1); 34 653 of whom were reinterviewed in 2004 and 2005 (wave 2).

Association of alcohol self-medication of mood symptoms with incident and persistent DSM-IV alcohol dependence using logistic regression and the propensity score method of inverse probability of treatment weighting.

The report of alcohol self-medication of mood symptoms was associated with an increased odds of incident alcohol dependence at follow-up (adjusted odds ratio [AOR], 3.10; 95% CI, 1.55-6.19; P = .002) and persistence of dependence (AOR, 3.45; 95% CI, 2.35-5.08; P < .001). The population-attributable fraction was 11.9% (95% CI, 6.7%-16.9%) for incident dependence and 30.6% (95% CI, 24.8%-36.0%) for persistent dependence. Stratified analyses were conducted by age, sex, race/ethnicity, mood symptom severity, and treatment history for mood symptoms.

Drinking to alleviate mood symptoms is associated with the development of alcohol dependence and its persistence once dependence develops. These associations occur among individuals with subthreshold mood symptoms, with DSM-IV affective disorders, and for those who have received treatment. Drinking to self-medicate mood symptoms may be a potential target for prevention and early intervention efforts aimed at reducing the occurrence of alcohol dependence.


Read Full Abstract

Request Reprint E-Mail:    rcrum@jhsph.edu

Evidence of psychosocial and behavioral effects related to the intention to quit alcohol in South Korea.

This study examined psychosocial and behavioral characteristics and factors that influenced certain subjects within a population-based sample of Korean drinkers to quit alcohol consumption (N = 8910).

Explored were various factors of psychosocial behaviors such as socioeconomic reasons, health behavior, cues to action, and self-control related to the intentions of alcohol abstinence. Using path analysis, it was found that, for men, self-control (B = 0.51), health behavior (B = 0.78), and health literacy (B = 0.58) were positively associated with cues to action which in turn positively induced them to quit drinking. This pattern of results appeared to apply only to men and not to women.

In conclusion, this study reveals that men who do not smoke, regularly exercise, have high self-control, and look for health information are likely to be active in acquiring cues for behavioral changes and making themselves motivated. However, conventions of alcohol consumption in the female population are more dependent on social factors in comparison to those of men.


Read Full Abstract

Request Reprint E-Mail:   minsoo_jung@dfci.harvard.edu

Role of a genetic polymorphism in the corticotropin-releasing factor receptor 1 gene in alcohol drinking and seeking behaviors of Marchigian Sardinian alcohol-preferring rats

Marchigian Sardinian alcohol-preferring (msP) rats exhibit innate preference for alcohol, are highly sensitive to stress and stress-induced alcohol seeking. Genetic analysis showed that over-expression of the corticotropin-releasing factor (CRF) system of msP rats is correlated with the presence of two single nucleotide polymorphisms (SNPs) occurring in the promoter region (position −1836 and −2097) of the CRF1 receptor (CRF1-R) gene.

Here we examined whether these point mutations were associated to the innate alcohol preference, stress-induced drinking, and seeking. We have recently re-derived the msP rats to obtain two distinct lines carrying the wild type (GG) and the point mutations (AA), respectively. The phenotypic characteristics of these two lines were compared with those of unselected Wistar rats.

Both AA and GG rats showed similar patterns of voluntary alcohol intake and preference. Similarly, the pharmacological stressor yohimbine (0.0, 0.625, 1.25, and 2.5 mg/kg) elicited increased operant alcohol self-administration under fixed and progressive ratio reinforcement schedules in all three lines. Following extinction, yohimbine (0.0, 0.625, 1.25, and 2.5 mg/kg) significantly reinstated alcohol seeking in the three groups. However, at the highest dose this effect was no longer evident in AA rats. Treatment with the CRF1-R antagonist antalarmin (0, 5, 10, and 20 mg/kg) significantly reduced alcohol-reinforced lever pressing in the AA line (10 and 20 mg/kg) while a weaker or no effect was observed in the Wistar and the GG group, respectively.  Finally, antalarmin significantly reduced yohimbine-induced increase in alcohol drinking in all three groups.

In conclusion, these specific SNPs in the CRF1-R gene do not seem to play a primary role in the expression of the msP excessive drinking phenotype or stress-induced drinking but may be associated with a decreased threshold for stress-induced alcohol seeking and an increased sensitivity to the effects of pharmacological blockade of CRF1-R on alcohol drinking.


Read Full Article    (PDF)

Short term alcohol consumption may have detrimental effect on fibrinolysis and endothelial function - a preliminary report of prospective randomized study.

The study was designed to clarify the impact of short-term consumption of different types of alcoholic beverages on haemostatic factors, C-reactive protein (hsCRP) and endothelin-1 (E-1) plasma levels.

The study group consisted of 57 healthy male volunteers, aged 20-29 years. Subjects were randomized to consume 300 ml of either: red wine, white wine, 12% ethanol, blackcurrant juice or water for five days. Blood samples were collected for C-reactive protein, tissue type plasminogen activator antigen (t-PA:Ag), plasminogen activator inhibitor antigen (PAI-1:Ag) and endothelin-1 at baseline, on day 2, and on day 6.

Significant increase in PAI-1:Ag concentration was observed in red wine drinking group (day 1 - 44.98; day 2 - 56.86; day 6 - 47.44 ng/ml; p 0.05). Similar increase of endothelin level was found in 12% ethanol group (day 1 - 0,53 day 2 - 1,65 day 6 - 1,11 fmol/ml; p 0.01). Dividing the whole study group according to ethanol content of consumed beverages revealed significant changes in tPA:Ag, PAI-1:Ag and endothelin levels. In the alcohol drinking group significant increase of PAI-1:Ag (day 1 - 44.75; day 2 - 54.07; day 6 - 44.80 ng/ml; p.


Read Full Abstract

Request Reprint E-Mail:     joannna@op.pl.

The association of alcohol drinking pattern and self-inflicted intentional injury in Korea: a cross-sectional WHO collaborative emergency room study

Self-inflicted intentional injuries are increasing at an alarming rate in the Republic of Korea, yet few reports describe their relationship with alcohol consumption. The aim of this study was to characterise the association of alcohol drinking patterns and self-inflicted intentional injury in Korean emergency departments (EDs) using WHO collaborative study protocol.

 

Cross-sectional study.

 

Data were collected from four general hospital EDs in four geographically diverse regions of Korea: Seoul, Suwon, Chuncheon and Gwangju.

 

Information was collected on 1989 patients aged 18 and above. A representative probability sample was drawn from patients admitted to each ED for the first time within 6 h of injury.

 

Alcohol-related non-fatal injuries.

 

Among 467 persons with alcohol-related injuries, 33 (7.1%), were self-inflicted intentional injuries and 137 (29.3%) were intentional injuries caused by someone else. The adjusted odds of self-inflicted intentional injury verses unintentional injury were calculated for heavy (OR 1.764; 95% CI 0.783 to 3.976), binge (OR 2.125; 95% CI 0.930 to 4.858) and moderate drinking (OR 3.039; 95% CI 1.129 to 8.178) after controlling for demographic variables. Similar odds were reported for pooled intentional injury data (self-inflicted and caused by someone else) and drinking patterns.

 

These data show a strong association between all patterns of acute alcohol consumption and self-inflicted intentional injury in the Republic of Korea.


Read Full Article   (PDF)