ALCOHOL REPORTS

Tuesday, July 23, 2013

Cortical activation of accumbens hyperpolarization-active NMDARs mediates aversion-resistant alcohol intake

Compulsive drinking despite serious adverse medical, social and economic consequences is a characteristic of alcohol use disorders in humans. Although frontal cortical areas have been implicated in alcohol use disorders, little is known about the molecular mechanisms and pathways that sustain aversion-resistant intake.

Here, we show that nucleus accumbens core (NAcore) NMDA-type glutamate receptors and medial prefrontal (mPFC) and insula glutamatergic inputs to the NAcore are necessary for aversion-resistant alcohol consumption in rats. Aversion-resistant intake was associated with a new type of NMDA receptor adaptation, in which hyperpolarization-active NMDA receptors were present at mPFC and insula but not amygdalar inputs in the NAcore. Accordingly, inhibition of Grin2c NMDA receptor subunits in the NAcore reduced aversion-resistant alcohol intake. None of these manipulations altered intake when alcohol was not paired with an aversive consequence.

Our results identify a mechanism by which hyperpolarization-active NMDA receptors under mPFC- and insula-to-NAcore inputs sustain aversion-resistant alcohol intake.

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Request Reprint E-Mail: woody@gallo.ucsf.edu

Nicotine Decreases Ethanol-Induced Dopamine Signaling and Increases Self-Administration via Stress Hormones

Tobacco smoking is a well-known risk factor for subsequent alcohol abuse, but the neural events underlying this risk remain largely unknown. Alcohol and nicotine reinforcement involve common neural circuitry, including the mesolimbic dopamine system.

We demonstrate in rodents that pre-exposure to nicotine increases alcohol self-administration and decreases alcohol-induced dopamine responses.

The blunted dopamine response was due to increased inhibitory synaptic transmission onto dopamine neurons. Blocking stress hormone receptors prior to nicotine exposure prevented all interactions with alcohol that we measured, including the increased inhibition onto dopamine neurons, the decreased dopamine responses, and the increased alcohol self-administration.

These results indicate that nicotine recruits neuroendocrine systems to influence neurotransmission and behavior associated with alcohol reinforcement.

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Request Reprint E-Mail: jdani@bcm.edu

Initial Evidence that OPRM1 Genotype Moderates Ventral and Dorsal Striatum Functional Connectivity During Alcohol Cues

Endogenous opioids and striatal dopamine have been implicated in cue-induced alcohol craving and have been hypothesized to play a role in goal-directed, as opposed to habitual, alcohol use. This initial study examines dorsal and ventral striatal functional connectivity during alcohol-cue processing as a function of the A118G single-nucleotide polymorphism of the mu-opioid receptor (OPRM1) gene.

Seventeen individuals with alcohol dependence (6 females; 90% Caucasian; mean age = 29.4) underwent blood oxygen level-dependent functional magnetic resonance imaging, while performing an alcohol taste-cues task. Psychophysiological interaction analyses investigated associations of the OPRM1 genotype with ventral and dorsal striatum functional connectivity, using the ventral striatum and the caudate as the seed region, respectively.

Compared to A-allele homozygotes, G-allele carriers of the OPRM1 gene showed (i) greater activation of the insula and orbitofrontal cortex and (ii) stronger negative fronto-striatal functional connectivity for both ventral and dorsal striatal seed regions during processing of alcohol versus water cues.

These preliminary findings suggest that, relative to A-allele homozygotes, G-allele carriers show unstable frontal regulation over reward and/or habit-driven inputs from the striatum resulting from greater reward sensitivity combined with limited self-control resources.

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Request Reprint E-Mail: lararay@psych.ucla.edu

Combining Naltrexone and Prazosin in a Single Oral Medication Decreases Alcohol Drinking More Effectively Than Does Either Drug Alone

Naltrexone (NTX) is underutilized in clinical treatment settings because its efficacy is modest, and it is not effective for all alcoholics and, when it is effective, a significant number of alcoholics fail to maintain initial treatment gains and subsequently relapse to heavy drinking. This has slowed acceptance of NTX by the treatment community, and there is a clear need for additional treatments for alcoholism and alcohol use disorders. Given that NTX and prazosin can each reduce alcohol drinking in rats selectively bred for alcohol preference and high voluntary alcohol drinking (alcohol-preferring “P” rats), we tested whether a combination of NTX + prazosin is more effective in decreasing alcohol drinking than is either drug alone.

P rats were given access to a 15% (v/v) alcohol solution for 2 hours daily. Rats were fed NTX and prazosin, alone or in combination, prior to onset of the daily 2-hour alcohol access period for 4 weeks and the effect of drug treatment on alcohol and water intake was assessed.

During the first week of treatment, neither a low dose of NTX, nor prazosin, was effective in decreasing alcohol intake when each drug was administered alone, but combining the 2 drugs in a single medication significantly reduced alcohol intake. The combination was as effective as was a higher dose of NTX. Using a low dose of NTX in combination with prazosin may reduce the potential for undesirable side effects early in treatment which, in turn, may improve patient compliance and result in a more successful outcome when NTX is used for treating alcoholism and alcohol use disorders.

Combining low-dose NTX and prazosin in a single medication may be more useful than is either drug alone for treating both inpatient and outpatient alcoholics and heavy drinkers early in the treatment process.

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Request Reprint E-Mail: jcfroehl@iupui.edu

Monday, July 22, 2013

Alcohol News - 29/2013

Copenhagen Post (Denmark) - Enhedslisten calls for ban

on alcohol advertising

Nearly 3,000 people die of alcohol-related causes in Denmark each year, leading members of the far-left party Enhedslisten (EL) to argue that it is time for alcohol to join tobacco and other products on the list of items not allowed to be advertised.

The Local (Sweden) - 'Government must act on alcohol tax': minister

The government must fulfil its pre-election promise to raise taxes on alcohol by 2014, said Health Minister Maria Larsson on Thursday, adding that time is ticking on the matter to be resolved before its second terms draws to a close.

TNP (Norway) - Norwegian Wine Monopoly Sets Eye on Alcohol Sales at Airports

Alcoholic beverage sales in the Wine Monopoly (Vinmonopolet) stores falls, while there is an increase in duty free shops. So, the Wine Monopoly (Vinmonopolet) wants to take over alcohol sales at airports.

The Local (Norway) - Liquor monopoly wants tax-free licence

The Norwegian state liquor monopoly wants to take over the sale of wine and spirits in tax-free, saying that airport sales threaten the alcohol vendor's legitimacy and financing.

Baltic News Network (Latvia) - New set of rules for alcoholic drinks adverts comes into force in Latvia

Friday, July 19 marks the coming into force of amendments to the Law on the Circulation of Alcoholic Drinks. These amendments provide a set of rules that will reduce alcohol consumption rates, especially in regard to underage persons, says Ilze Zunde, head of the consumers information and communication department of the Consumers’ Rights Protection Centre (CRPC).

YLE.fi (Finland) - FINLAND OPINION: DO IMMIGRANTS DARE SPEAK UP ABOUT ALCOHOLISM?

Finland’s worst enemy at this time is not Russia, nor is it immigrants, Islamists or even extremists. It is alcohol, according to freelance journalist and opinion writer Wali Hashi. The following is an English version of Hashi's most recent opinion piece.

WHO (Estonia) – Case study on socially determined inequities in alcohol consumption patterns in Estonia

This alcohol and equity case study focuses on examining socially determined inequities in alcohol consumption patterns in Estonia. That is, it focuses on analysis of differences or differentials in social determinants that are considered to be avoidable, unfair and remediable – namely inequities.

The Baltic Course (Estonia) - Alcohol-caused mortality rate in Estonia is highest in EU

Leading statistician of the Statistics Board Marianne Leppik wrote in the board’s blog entry that alcohol-related mortality rate in Estonia is the highest among all EU countries, writes LETA/National Broadcasting.

Huffington Post UK (UK) - Alcohol Is Killing An Increasing Number Of Women In Their 30s And 40s, Study Suggests

There has been a "worrying" increase in the number of women in their 30s and 40s who are dying from alcohol misuse, research suggests.

Scotsman (Scotland) - Pregnant women in alcohol warning after quiz

Thousands of pregnant women have been quizzed about their drinking habits, amid concerns about the effects of alcohol on their health and their babies, figures reveal.

Telegraph.co.uk (UK) - Health advisers quit over scrapping of minimum alcohol price

A group of government advisers has resigned in protest at David Cameron’s decision not to introduce a minimum price for alcohol.

Cordis News (EU) - Toward evidence-based public policy for alcohol

Europeans are the world's heaviest drinkers. Per capita consumption is equivalent to each EU citizen aged 15 years or older drinking around 12 litres of pure alcohol per year, or just under three standard drinks per day in most European countries.

Zambia Daily Mail (Zambia) - Productivity and alcohol abuse by youths

PRODUCTIVITY has now become an everyday watchword. It is crucial to the welfare of industrial firms as well as for the community, social and economic progress of the country.

The Local.es (Spain) - Spaniards outstrip expats in smoking spend

Spaniards are among the world's heaviest smokers and spend more per person on both alcohol and tobacco than foreign residents in the country.

NHS Choices (UK) - Media blames 'ladettes' as alcohol-related deaths rise

"More young women dying of alcohol abuse," The Times reports, with much of the media covering the story that the risk of death from an alcohol-related health condition has increased for women in their 30s and 40s.

Toronto NewsFIX - Alcohol increases haemorrhagic stroke risk

Heavy drinkers run an increased risk of having the kind of stroke caused by bleeding into the brain.

Otago Daily Times (New Zealand) - Alcohol poisoning rates rise 10% yearly for 5 years

Alcohol poisoning rates in the South have risen an average of 10% annually for the past five years, a new Southern District Health Board alcohol report says.

Northampton Herald and Post (UK) - New approach to alcohol related violence paying dividends

THE new approach by police to dealing with anti-social behaviour linked to alcohol is paying dividends. The force is pleased with the results of their new approach in Northampton town centre last Friday and Saturday nights.

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Latest Findings alcohol bulletins: naltrexone finds favour for treatment; acamprosate as effective for womean; engaging in treatment; street drinkings 'bans' reviewed

Recent bulletins from the

drug and alcohol bank:

Largest US study yet favours naltrexone as alcoholism medication
Reanalyses of major US study confirmed that either naltrexone or psychological therapy improved outcomes more than medical care and placebos, while the two in combination or acamprosate added little. They also revealed previously invisible benefits when certain types of patients received certain treatments – and some hidden negatives, including a suggestion that acamprosate is counterproductive for the most needy but also most motivated alcoholics.

Acamprosate as effective for alcohol-dependent women as for men
First comprehensive analysis of whether acamprosate treatment works as well for alcohol-dependent women as for men definitively concludes that across 22 mainly European trials it had a virtually identical impact. The analysis also offers an updated and extended assessment of the drug's overall impact, finding that it helps prevent heavy drinking as well as fostering abstinence.
Clinicians can learn how to help alcohol patients stay in treatment and take medication
Getting patients to take their medication is a major issue across medicine. This US alcohol treatment study enhanced compliance with treatment through a novel and manageable approach combining brief motivational interviewing with structured clinical counselling involving feedback on the patient's real-time pill-taking record.

Winners and losers from street drinking bans
So-called 'alcohol-free zones' have proliferated across the UK, preventing an individual drinking in public if police believe their drinking is causing a problem. This review finds such measures do reassure communities, but at the expense of further marginalising street drinkers.

Efficacy of As-Needed Nalmefene in Alcohol-Dependent Patients with at Least a High Drinking Risk Level: Results from a Subgroup Analysis of Two Randomized Controlled 6-Month Studies

The aim of the study was to investigate the efficacy and safety of as-needed use of nalmefene 18 mg versus placebo in reducing alcohol consumption in patients who did not reduce their alcohol consumption after an initial assessment, i.e. the pooled subgroup of patients with at least a high drinking risk level (men: >60 g/day; women: >40 g/day) at both screening and randomization from the two randomized controlled 6-month studies ESENSE 1 (NCT00811720) and ESENSE 2 (NCT00812461).

Nalmefene 18 mg and placebo were taken on an as-needed basis. All the patients also received a motivational and adherence-enhancing intervention (BRENDA). The co-primary outcomes were number of heavy drinking days (HDDs) and mean total alcohol consumption (g/day) in Month 6 measured using the Timeline Follow-back method. Additionally, data on clinical improvement, liver function and safety were collected throughout the study.

The pooled population consisted of 667 patients: placebo n = 332; nalmefene n = 335. There was a superior effect of nalmefene compared with placebo in reducing the number of HDDs [treatment difference: −3.2 days (95% CI: −4.8; −1.6); P < 0.0001] and total alcohol consumption [treatment difference: −14.3 g/day (−20.8; −7.8); P < 0.0001] at Month 6. Improvements in clinical status and liver parameters were greater in the nalmefene group compared with the placebo group. Adverse events and adverse events leading to dropout were more common with nalmefene than placebo.

As-needed nalmefene was efficacious in reducing alcohol consumption in patients with at least a high drinking risk level at both screening and randomization, and the effect in this subgroup was larger than in the total population.

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Discriminant Profile of Young Adulthood Driving Behavior among Brazilian Drivers.Discriminant Profile of Young Adulthood Driving Behavior among Brazilian Drivers.

The aim of this article was to describe the driving behavior profile of drivers aged 18 to 25 years old.

Four hundred young adults were interviewed, 320 (80%) of them male and 80 (20%) female.

Cluster analysis identified a group characterized by sensation-seeking behavior (Cluster 1), a group that did not show any risky driving behavior (Cluster 2), and a group engaged in transgressive behavior and driving under the influence of alcohol and/or drugs (Cluster 3).

Discriminant analysis classified successfully and correctly 81.3% of the young adults into their original profiles. Function 1 distinguished cluster 1 from clusters 2 and 3, on the basis of the following factors: higher frequency of alcohol consumption, intrusive behavior, and motorcycle riding, as well as younger age, more aggressive behavior, and lower education level. Function 2 distinguished cluster 3 from cluster 1 and 2, especially as to higher amounts of alcohol consumption, higher frequency of marijuana use and delinquent behavior, larger number of traffic tickets and motor vehicle accidents, higher paternal education level, which were the variables with discriminant values above .20.

Characteristics of vulnerability were identified, especially those related to alcohol consumption, drug use, and externalizing issues.

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Request Reprint E-Mail: renata.dotta@uol.com.br

Gender differences in drinking patterns are potentially important for public policies, especially policies that rely extensively on higher alcohol taxes and prices.

This paper presents a systematic review of alcohol prices and gender differences in drinking and heavy drinking by adults and young adults.

Starting with a database of 578 studies of alcohol demand and other outcomes, 15 studies are reviewed of adult drinking including discussion of samples, measurement issues, econometric models, special variables, and key empirical results. A similar discussion is presented for eight studies of drinking by young adults, ages 18–26 years.

Four conclusions are obtained from the review. First, adult men have less elastic demands compared with women. Second, there is little or no price response by heavy-drinking adults, regardless of gender. Third, although the sample is small, price might be important for drinking participation by young adults. Fourth, the results strongly suggest that heavy drinking by young adults, regardless of gender, is not easily dissuaded by higher prices.

Policy implications, primary study limitations, and suggestions for future research are discussed.

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Request Reprint E-Mail: jpn@psu.edu

Alcohol dependence and health care utilization in African Americans.

Ethnic and cultural differences in patterns of alcohol use disorders must be understood in order to address improvement in prevention of such disorders and accessibility to health care services. The purpose of this study was to evaluate factors that influence the utilization of medical and mental health services among alcohol-dependent and non-alcohol-dependent African Americans.

A cohort of 454 African Americans was evaluated. Alcohol-dependent participants were recruited from various inpatient treatment facilities in the Washington, DC, metropolitan area and through advertisement and word of mouth. Non-alcohol-dependent participants were recruited by advertisements. Each participant was administered the Semi-Structured Assessment for the Genetics of Alcoholism to assess alcohol dependency and the Family History Assessment module to access family history of alcoholism. Xl Test and analysis of variance were used to analyze the data.

Alcohol dependence was more prevalent among men, those with lower income, those with less education, and they utilized mental health counseling as opposed to medical-based therapy. Increased reports of medical conditions such as migraine (p<.001), loss of consciousness (p=.001), and sexually transmitted diseases: (p<.001) were also associated with alcohol dependency. Other factors, including visits to inpatient treatment programs, were directly related to incidence of alcohol dependency regardless of gender status (p<.001).

This study suggests an association exists among alcohol dependence, medical conditions, health care, and mental care utilization among African Americans. Future research may benefit from investigating if an association exists between alcohol use disorders and health care utilization for other ethnic groups.

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Request Reprint E-Mail: vjmarshall@howard.edu

Trace amine associated receptor 1 modulates behavioral effects of ethanol.

Few treatment options for alcohol use disorders (AUDs) exist and more are critically needed. Here, we assessed whether trace amine associated receptor 1 (TAAR1), a modulator of brain monoamine systems, is involved in the behavioral and reinforcement-related effects of ethanol and whether it could potentially serve as a therapeutic target.

Wild-type (WT) and TAAR1 knockout (KO) mice (75% C57J/BL6 and 25% 129S1/Sv background) were compared in tests of ethanol consumption (two-bottle choice [TBC]), motor impairment (loss of righting reflex, [LORR], locomotor activity) and ethanol clearance (blood ethanol level [BEL]).

As compared with WT mice, KO mice displayed (1) significantly greater preference for and consumption of ethanol in a TBC paradigm (3%–11% vol/vol escalating over 10 weeks), with no significant difference observed in TBC with sucrose (1%–3%); (2) significantly greater sedative-like effects of acute ethanol (2.0 or 2.5 g/kg, intraperitoneal [i.p.]) manifested as LORR observed at a lower dose and for longer time, with similar BELs and rates of ethanol clearance; and (3) lower cumulative locomotor activity over 60 minutes in response to an acute ethanol challenge (1.0–2.5 g/kg, i.p.).

The present findings are the first to implicate TAAR1 in the behavioral and reinforcement-related effects of ethanol and raise the question of whether specific drugs that target TAAR1 could potentially reduce alcohol consumption in humans with AUDs.

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Characterization of Suicidal Behaviour with Self-Organizing Maps

The study of the variables involved in suicidal behavior is important from a social, medical, and economical point of view. Given the high number of potential variables of interest, a large population of subjects must be analysed in order to get conclusive results.

In this paper, we describe a method based on self-organizing maps (SOMs) for finding the most relevant variables even when their relation to suicidal behavior is strongly nonlinear. We have applied the method to a cohort with more than 8,000 subjects and 600 variables and discovered four groups of variables involved in suicidal behavior.

According to the results, there are four main groups of risk factors that characterize the population of suicide attempters: mental disorders, alcoholism, impulsivity, and childhood abuse.

The identification of specific subpopulations of suicide attempters is consistent with current medical knowledge and may provide a new avenue of research to improve the management of suicidal cases.

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Sunday, July 21, 2013

FASD News - 28/2013

NEWS and ARTICLES

Scotsman (Scotland) - Pregnant women quizzed on alcohol intake

Thousands of pregnant women have been quizzed about their drinking habits amid concerns about the effects of alcohol on their health and their babies, figures reveal.

Science World Report - Maternal Alcohol Consumption During Pregnancy Affects Learning and Memory Function in Offspring

A latest study highlights the association between maternal alcohol consumption during pregnancy and its effect on the learning and memory function of the infant.

HealthCanal.com - Pre-pregnancy alcohol consumption affects alcohol use among pregnant women, suggests new study

Most women who consume alcohol pre-pregnancy will continue to consume alcohol throughout their pregnancy even when healthcare guidelines promote abstinence, suggests a new study published today in BJOG: An International Journal of Obstetrics and Gynaecology.

WebMD.Boots.com - Regular drinkers 'more likely to continue when pregnant'

Women who drink alcohol each week before conceiving are 50% more likely to carry on drinking when pregnant, according to a study.

Stroud News and Journal (UK) - No change in advice to avoid alcohol in pregnancy say midwives

RESPONDING to research to be published tomorrow, in BJOG on pre-pregnancy alcohol consumption among pregnant women, Janet Fyle, professional policy advisor at the Royal College of Midwives, said: “This is very useful research that supports our advice to women about alcohol and pregnancy.

Medical Xpress - Study explores fetal alcohol impact at molecular level

While some physicians tell women a small amount of alcohol is OK during pregnancy, Ben Laufer vehemently disputes any such advice – and he has the research to back it up.

American Academy of Pediatrics - Joint Call to Action on Alcohol and Pregnancy

Through its cooperative agreement with the Centers for Disease Control and Prevention (CDC) National Center on Birth Defects and Developmental Disabilities (NCBDDD) the AAP Division of Children with Special Needs Fetal Alcohol Spectrum Disorders (FASD) program staff convened an FASD Risk Communication Workshop from July 30–31, 2012.

Chicago Tribune (USA) - Raising a child with profound birth defect

Sometimes, the best expert isn't someone with a long list of credentials, but a parent, especially when the child has a disability. The relentless demands of caring for a child with profound birth defects is its own graduate school and can rarely be described to someone who hasn't "been there."

MATERIALS and VIDEOS
The Knowledge Network (Scotland) - NHS' first on-line course/resource on fetal alcohol harm

The resource has been developed to support a range of activity led by the Scottish Government to substantially reduce the harm caused by alcohol consumption in pregnancy across Scotland.

Atlantic Intergovernmental Fetal Alcohol Spectrum Disorder (FASD) Partnership Update

Women and Alcohol in the EU

The European Institute of Women’s Health has published a new policy brief called “Women and Alcohol in the EU.”

THE CULTURAL POLITICS OF FETAL ALCOHOL SPECTRUM DISORDERS AND THE DIAGNOSIS OF DIFFERENCE

This dissertation is based on an ethnographic study of Fetal Alcohol Spectrum Disorders (FASD) and the racial, cultural and political considerations that shape the meaning of diagnosis for Alaska Native individuals and families in Anchorage, Alaska.

Variety Charity - Variety - the Children's Charity & Kimberley Diamond Company - supporting the Marulu Strategy

RESEARCH

Pediatrics - Prenatal Alcohol Exposure and Educational Achievement in Children Aged 8–9 Years

This study examines the relationships between the dose, pattern, and timing of prenatal alcohol exposure and achievement in reading, writing, spelling, and numeracy in children aged 8 to 9 years.

IN OTHER LANGUAGES

Luxemburger Wort (Luxembourg) - Null Prozent Alkohol während der Schwangerschaft oder der Stillzeit

Ständig warnen Mediziner und Wissenschaftler vor den Gefahren von Alkoholkonsum während der Schwangerschaft oder nach der Geburt. Der Genuss kann zu fetalen Alkoholspektrumstörungen (FASD) mit körperlichen Missbildungen, Gehirnschäden oder geistigen Behinderungen führen.