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.
Friday, September 7, 2007
Addiction 102 (10), 1531–1532.
The paper by Li et al. reminds us that the publication of ‘Alcohol dependence: provisional description of a clinical syndrome’ by Edwards & Gross was a watershed event for understanding alcohol and drug dependence.
We may forget that prior to this publication, definitions ofdependence were vague and idiosyncratic. For example, at that time the existing World Health Organization definition was ‘a compulsion to take the drug . . . in order to experience its psychic effects and sometimes to avoid the discomfort of its absence’. The existing Diagnostic and Statistical Manual (DSM) definition for substance dependence was tolerance and withdrawal and for alcohol dependence was ‘pathological use . . . that causes impairment in social or occupational functioning’. The National Council of Alcoholism definition was ‘tolerance and physical dependency; or pathological organ changes’.
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Addiction 102 (10), 1515–1521.
When the Labour government came to power in the UK in 1997, it took over high and rising levels of alcohol consumption and alcohol-related harm. Contrary to ‘old Labour’'s views on alcohol policy, New Labour did nothing to reverse this trend, and, if anything, exacerbated it.
Since New Labour has been in power, alcohol has become 40% more affordable; consumption has increased by 14% and alcohol-related deaths have increased by over 40%.
New Labour viewed alcohol-related harm as a question of individual responsibility and, as expressed in its long awaited 2004 alcohol harm reduction strategy (commonly known as AHRSE), viewed partnerships with the alcohol industry as the solution to reducing harm.
Ten years on we have safe, sensible and social, the 3Ss, AHRSE's next steps. On first reading it would seem that the government has learnt nothing from its mistakes of the previous ten years, and in its approach to alcohol policy continues to disable the public interest.
Nevertheless, there remain areas where science might inform policy, including health sector policy where there is an emphasis on early diagnosis and treatment, and transport policy, where reducing the legal blood alcohol level to the European Commission maximum recommended level of 0.5g/L is again on the agenda. The 3Ss propose an independent review of the evidence of the relationship between alcohol price, promotion and harm.
However, unless this fully reviews the international evidence of the relationship between the economic and physical availability of alcohol, the marketing of alcohol and alcohol related harm, AHRSE and its successor will continue to be a recipe for ineffectiveness.
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Addiction 102 (10), 1513–1514.
This issue's News and Notes describes an ambitious new strategy to combat addiction in France. It involves a major reorganization to implement a workable hospital pathway dedicated to addictions care with specialized units, departments and a university discipline: ‘addictology’.
Thus, within 5 years every university hospital should have its own university addictology unit. This new health care organization is a concrete manifestation of a conceptual change which shifted social and medical orientation from ‘the fight against alcoholism’ to the implementation of addictology in the primary care and hospital settings and at the university level, and to recognize addiction as a disease, and not as a ‘vice’.
Of course, the majority of harmful use does not correspond in the strict sense of the term with an addiction conceived of as a ‘brain disease’.
However, the concept of ‘early detection and brief intervention’ is fully consistent with this model and the shift from a moral model to a medical model is a major step in public health policy.
This editorial analyses the historical elements of this change and its implications.
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The Canadian Foundation on Fetal Alcohol Research (CFFAR) is an independent, non-profit foundation created to promote interest and fund research related to the short and long-term bio-medical, psychological and social effects of alcohol consumption during pregnancy, and the prevention of fetal alcohol spectrum disorders (FASD).
CFFAR awards research grants to eligible Canadian researchers annually in conjunction with International FASD day and the annual Fetal Alcohol Canadian Expertise (FACE) Research Roundtable.
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International Journal of Cancer Early View Published Online: 31 Aug 2007
The role of alcohol intake in the etiology of endometrial cancer is unclear.
We examined the impact of alcohol intake on endometrial cancer risk among 41,574 postmenopausal African-American, Japanese-American, Latina, Native-Hawaiian and White women recruited to the prospective Multiethnic Cohort Study in 1993-1996.
Increased alcohol consumption was associated with increased risk Compared to nondrinkers, women consuming 2 drinks/day had a multivariate RR of 2.01 . There was no increase in risk associated with <1 drink/day and 1 to <2 drinks/day. There was no clear effect modification by body mass index, postmenopausal hormone use, parity, oral contraceptive use or smoking status, though our power to detect such interactions was limited.
Our results suggest that only alcohol consumption equivalent to 2 or more drinks per day increases risk of endometrial cancer in postmenopausal women.
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Alcohol, Other Drugs, and Health: Current Evidence
Current Issue: September-October 2007
- Alcohol Use Disorders: Chronic or Not?
- Risk Factors for Nonfatal Drug Overdose
- The Effects of Alcohol Use on Blood Pressure: Does Gender Matter?
- What Predicts Harmful Alcohol Use After Liver Transplantation?
- Estimating the Impact of Alcohol Use on Survival Among Veterans With HIV
- Divorce: Grounds for Substance Use Screening
- Drinking May Lower Postprandial Glycemia
Assessments and Interventions
- Does Methadone Treatment Change Alcohol Consumption?
- Antiretroviral Medication Affects Dose of Methadone
- Do Mortality Rates Differ by Type of Pharmacotherapy for Opioid Dependence?
- A Simplified Method to Assess Alcohol Use Disorders
- Who Receives and Remains in Office-Based Buprenorphine Treatment?
- Health Plans’ Requirements for Mental Health and Substance Use Screening
- HAART and Drug Treatment May Improve Survival in People With HIV Who Inject Drugs
Capitol event celebrates triumph over drug, alcohol addiction
By Peter Hecht - Bee Capitol Bureau
Published 12:00 am PDT Thursday, September 6, 2007
Danna Jensen went back to school a decade ago to earn a community college degree in addiction studies. It seemed only appropriate, Jensen joked Wednesday, "after my field work for 25 years."
At the Capitol on Wednesday, it was a day of celebration for the 50-year-old Jensen. The drug and alcohol counselor in Merced County has been clean and sober for 13 years and three months after a prolonged struggle with substance abuse, ranging from inhaling PCP to dropping LSD to shooting heroin.
Jensen, her husband, Christopher Jensen, and their 25-year-old son, Christopher Jr. -- all recovering addicts -- joined thousands of others at a "Recovery Happens!" rally celebrating their collective triumph over drugs and alcohol.
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Thursday, September 6, 2007
The European Parliament rejected calls from its own Health Committee to introduce standardised EU-wide health warnings on alcoholic drinks, as is currently the case on tobacco products, in what some MEPs denounced as 'strong lobbying' from alcohol producers.
The non-binding resolution adopted by a large majority gives MEPs' views on the consumption of alcopops and binge-drinking by minors and young people, how to reduce accidents caused by drinking and driving and the warning labels on products.
The MEPs removed from the resolution a note from the House's Health Committee stating that "health warnings on alcohol may require European harmonisation similar to health warnings on tobacco" as well as the request for the Commission to publish by 2010 either a legislative proposal to introduce health warnings on alcoholic beverages, or a communication to explain why in contrast to health warnings on tobacco, the introduction or harmonisation of health warnings on alcohol is not necessary.
Instead, MEPs asked the Commission to initiate "a comparative study on the impact and effectiveness of various information and communication means, including labelling and advertising, applied in member states" and to publish the results by 2010.
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Published: 6th September 2007 15:17 CET
The current laws ban the serving of alcohol at any establishment that doesn't serve food and that does not have full kitchen facilities capable of preparing warm food. This means that many sushi restaurants cannot get alcohol licences. Larsson said the current rules were outdated, but argued that the link between food and alcohol should remain.
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Addictive Behaviors Volume 32, Issue 11, November 2007, Pages 2439-2468
This paper serves to update a prior review of the literature on individual-focused prevention and treatment approaches for college drinking [Larimer, M.E. & Cronce, J.M. (2002). Identification, prevention and treatment: A review of individual-focused strategies to reduce problematic alcohol consumption by college students. Journal of Studies on Alcohol Suppl. 14, 148–163.], and covers the period from late 1999 through 2006.
No support was found for information/knowledge approaches alone, or for brief values clarification approaches alone or with other informational content.
Evidence was found in support of skills-based interventions and motivational interventions that incorporated personalized feedback, with or without an in-person intervention. Normative re-education interventions received mixed support, though personalized normative feedback was associated with positive outcomes.
Significant advances have been made over the past seven years with respect to mailed and computerized feedback interventions, and interventions with mandated students.
Much of the research reviewed suffered from significant limitations, particularly small sample sizes, attrition, and lack of appropriate control groups.
More research is needed to determine the best methods for disseminating such interventions on college campuses, as well as additional research on interventions with high-risk groups of students.
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Alcoholism: Clinical and Experimental Research 31 (1), 1–10.
The μ-opioid receptor gene (OPRM1) codes for the μ-opioid receptor, which binds β-endorphin. The A118G polymorphism in this gene affects β-endorphin binding such that the Asp40 variant (G allele) binds β-endorphin 3 times more tightly than the more common Asn40 variant (A allele).
This study investigated the influence of the A118G polymorphism on cue reactivity after exposure to an alcoholic beverage in male heavy drinkers.
G allele carriers reported significantly more craving for alcohol than the A allele participants (as indicated by the within-subject difference in craving after beer vs after water exposure). No differences were found for subjective arousal and saliva. Both groups did not differ in family history of alcoholism. Participants with the G allele reported a significantly higher lifetime prevalence of drug use than participants homozygous for the A allele.
A stronger urge to drink alcohol after exposure to an alcoholic beverage might contribute to a heightened risk for developing alcohol-related problems in individuals with a copy of the G allele. The G allele might also predispose to drug use in general.
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Progress in Neuro-Psychopharmacology and Biological Psychiatry
Volume 31, Issue 7, 1 October 2007, Pages 1526-1534
Cloninger had proposed a psychobiological model suggesting that three main personality dimensions distinguish the alcoholism into two subtypes (type I and type II). However, the classification was equivocal for clinical diagnosis.
Recently, anxiety–depressive alcohol dependence (ANX/DEP ALC) has been posited as a genetically specific subtype of alcoholism. Its clinical characteristics were similar to individuals with type I alcoholism [Cloninger, C.R. 1987. Neurogenetic adaptive mechanisms in alcoholism. Science 236: 410–6.] such as having a high comorbidity with mood disorder, late-onset and more anxious/depressed traits.
We attempted to investigate whether the dopamine D2 receptor (DRD2) and the serotonin transporter promoter region (5-HTTLPR) genes were involved in Novelty Seeking (NS) and Harm Avoidance (HA) of ANX/DEP ALC.
Both NS and HA were high in ANX/DEP ALC . The association between NS and ANX/DEP ALC only existed in subjects with DRD2 TaqI A1+ allele (A1/A1 or A1/A2 genotypes) and in those with S/S genotype of 5-HTTLPR . With the stratification of DRD2 TaqI A1+ allele, high NS of ANX/DEP ALC existed only in carriers of 5-HTTLPR S/S genotype . Moreover, ANX/DEP ALC was related to high HA only in samples carrying 5-HTTLPR S/L or L/L genotype .
These findings provided the empirical genetic characterization of the specific personality traits in ANX/DEP ALC among Han Chinese population in Taiwan.
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Efforts to halt underage drinking often focus on peer pressure and the prevention of risky behaviors, but the American Association for the Advancement of Science (AAAS) is undertaking a new federally funded project to give middle-school children a science-based understanding of what can happen to them if they use alcohol.
The three-year project, called The Science Inside Alcohol, will incorporate recent advances in neuroscience that have been shedding new light on how alcohol affects the body. It is funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) with an initial grant of $253,000 and an anticipated total of $831,000.
The project will draw on AAAS's long experience in developing standards and benchmarks for effective science education. It is getting underway as a new study in the September issue of the journal Prevention Science suggests that teachers and parents should pay attention to alcohol prevention as early as the fourth grade. The analysis, by psychiatrist John E. Donovan of the University of Pittsburgh, cited one national survey in which 6.9 percent of fourth graders and 12.9 percent of sixth graders reported alcohol use during the past 12 months.
While prevention messages, including warnings that alcohol can make youngsters do things they ordinarily would not do, are an important part of the effort to stop underage drinking, the new AAAS project will go beyond a purely prevention approach. It will offer students, and their adult teachers, a look at key scientific concepts related to alcohol use and abuse in simple, direct language.
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- Slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2006 survey (50.9 percent). This translates to an estimated 125 million people, which is similar to the 2005 estimate of 126 million people (51.8 percent).
- More than one fifth (23.0 percent) of persons aged 12 or older participated in binge drinking (having five or more drinks on the same occasion on at least 1 day in the 30 days prior to the survey) in 2006. This translates to about 57 million people, similar to the estimate in 2005.
- In 2006, heavy drinking was reported by 6.9 percent of the population aged 12 or older, or 17 million people. This rate is similar to the rate of heavy drinking in 2005 (6.6 percent). Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days.
- In 2006, among young adults aged 18 to 25, the rate of binge drinking was 42.2 percent, and the rate of heavy drinking was 15.6 percent. These rates are similar to the rates in 2005.
- The rate of current alcohol use among youths aged 12 to 17 was 16.6 percent in 2006. Youth binge and heavy drinking rates were 10.3 and 2.4 percent, respectively. These rates are essentially the same as the 2005 rates.
- Underage (persons aged 12 to 20) past month and binge drinking rates have remained essentially unchanged since 2002. In 2006, about 10.8 million persons aged 12 to 20 (28.3 percent of this age group) reported drinking alcohol in the past month. Approximately 7.2 million (19.0 percent) were binge drinkers, and 2.4 million (6.2 percent) were heavy drinkers.
- Among persons aged 12 to 20, past month alcohol use rates were 18.6 percent among blacks, 19.7 percent among Asians, 25.3 percent among Hispanics, 27.5 percent among those reporting two or more races, 31.3 percent among American Indians or Alaska Natives, and 32.3 percent among whites. The 2006 rate for American Indians or Alaska Natives is higher than the 2005 rate of 21.7 percent.
- Among pregnant women aged 15 to 44, binge drinking in the first trimester dropped from 10.6 percent in 2003-2004 combined data to 4.6 percent in 2005-2006 combined data.
- In 2006, an estimated 12.4 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. This percentage has decreased since 2002, when it was 14.2 percent. The 2006 estimate corresponds to 30.5 million persons.
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J Epidemiol Community Health 2007;61:902–907.
The aim of the study was to determine outcomes in adult life of binge drinking in adolescence in a national birth cohort.
17.7% of participants reported binge drinking in the previous 2 weeks at the age of 16 years. Adolescent binge drinking predicted an increased risk of adult alcohol dependence, excessive regular consumption , illicit drug use , psychiatric morbidity , homelessness , convictions , school exclusion , lack of qualifications , accidents and lower adult social class, after adjustment for adolescent socioeconomic status and adolescent baseline status of the outcome under study. These findings were largely unchanged in models including both adolescent binge drinking and habitual frequent drinking as main effects.
Adolescent binge drinking is a risk behaviour associated with significant later adversity and social exclusion. These associations appear to be distinct from those associated with habitual frequent alcohol use. Binge drinking may contribute to the development of health and social inequalities during the transition from adolescence to adulthood.
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Contributor: Don Phillips
12th E.F.T.C European Conference on Rehabilitation and Drug Policy
Date: 2 - 5 June 2009.
Venue: The Hague, The Netherlands.
Venue: The World Forum Convention Center
The European Federation of Therapeutic Communities (EFTC) is delighted to invite you to the European Conference on Rehabilitation and Drug Policy.
The 12 th conference will be held in The Hague, the centre of political power of the Netherlands. The conference will be hosted by two Dutch institutions for addiction care: Brijder Verslavingszorg and Verslavingszorg Noord Nederland (VNN).
• Investigate and find Evidence and Best Practices
• Look for innovation and new target groups
• Debate: Integrate old tradition and new visions
More information is available from the Conference Website:
|September 2007||vol. 8 issue 9|
|Abstinent Alcoholics can have Reduced Brain Activation without Apparent Structural Damage|
|Online/Correspondence Course: Using Patient Placement Criteria (ASAM PPC-2R)|
|NREPP: National Registry of Evidence-based Programs & Practices|
Wednesday, September 5, 2007
|Written by Ebrima Jaw Manneh|
| Sep 05, 2007 at 08:32 AM |
“The harmful use of alcohol in the African region is rising and the situation will worsen, if appropriate action is not taken to address the problem,” a report transmitted by the WHO Country Office in Banjul warned.This call was contained in a report by Dr Luis Sambo, WHO Regional Director for Africa, at the 57th session of the WHO Regional Committee for Africa, in Brazzaville, Congo.
“Episodic or binge is a significant characteristic pattern of consumption in the region,” Dr Sambo said in the report.
According to a 2006 report by a WHO Expert Committee on Problems Related to Alcohol Consumption, the estimated proportion of deaths attributable to alcohol consumption in Africa shows a burden of 2.1% in 2000 and 2.2% in 2002.
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Addictive Behaviors Volume 32, Issue 11, November 2007, Pages 2573-2585
There is a need for novel, theory-based approaches to reduce heavy drinking on college campuses. Behavioral economics has guided basic laboratory research on drug administration for over 30 years and has recently been applied to human substance use in naturalistic and clinical settings.
This paper provides an introduction to behavioral economics, reviews applications of behavioral economics to college student drinking, and describes prevention and intervention strategies that are consistent with behavioral economic theory.
Behavioral economic theory predicts that college students' decisions about drinking are related to the relative availability and price of alcohol, the relative availability and price of substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drinking.
Measures of problem severity are based on resource allocation towards alcohol and the relative value of alcohol compared to other reinforcers.
Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including strategies for increasing the behavioral and monetary price of alcohol, increasing engagement in rewarding alternatives to substance use, and counteracting student drinkers' tendency to overvalue immediate relative to delayed rewards.
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We invite you to join your friends and neighbors this September in rallying for new attitudes and policies that will increase public understanding of addiction and the reality of long-term recovery.
As we saw in HBO's Addiction, it's time to end the silence and speak out!
Parents, friends and neighbors will Rally for Recovery! on September 15th as part of National Alcohol and Drug Addiction Recovery Month.
Hundreds of organizations across the country are hosting picnics, walks, concerts and forums as part of this annual observance that now engages tens of thousands of people, including elected and law enforcement officials, community leaders, families and friends.
You can make a difference!
People are getting the word out that effective health responses to addiction that prevent and treat problems and support people in long-term recovery will safeguard our nation’s health and build safer communities. They're calling on decision makers to take action!
We hope that you will join us in experiencing the joy and the spirit of recovery from addiction this September and speak out so that more people can get the help that they need.
We encourage you to find out more about activities in your community and to continue using HBO's ADDICTION Series to get the word out about the hope and reality of long-term recovery from addiction.
By Stacy Teicher Khadaroo | Staff writer of The Christian Science Monitor
from the September 6, 2007 edition
Researcher finds that exposure to alcohol in middle school raises the risk of social problems later in life.
For six years, John Donovan's "hobby" was to dig up hard-to-find data on children's use of alcohol. With so much attention paid to binge drinking by high-schoolers and college students, he wanted to shine a light on what was happening with kids even before junior high.
"The younger that people are when they start to drink," says Mr. Donovan, an associate professor of psychiatry and epidemiology at the University of Pittsburgh Medical Center, "the more likely they are to have problems with alcohol in adolescence and in later life, and the more likely they are to be involved in a whole variety of other problematic behaviors," like absence from school, delinquency, use of illicit drugs, drunken driving, and risky sexual activity.
By eighth grade, about 40 percent of American students say they've had some alcohol, but Donovan looked at an even younger set in a report just published in the September issue of Prevention Science. He found that between fourth and sixth grades, the prevalence of alcohol use increases significantly. In one national survey, for instance, about 10 percent of fourth-graders and 29 percent of sixth-graders said they'd had more than a sip of alcohol. In a survey in New York State, 21 percent of fifth- and sixth-graders reported having had a drink of alcohol at some point, including 7 percent who had drunk liquor, as distinct from beer or wine.
Broad conclusions can't yet be drawn, because the data are scattered in various substance-use and behavior surveys that span more than a decade, but Donovan's hope is to impel people to examine an age group that's been largely overlooked in alcohol studies. The data suggest that prevention might best be timed around fifth-grade, he says. Such efforts would be most effective, he and others say, if they involve not just schools, but families and whole communities as well.
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The Guardian Thursday September 6, 2007
John Carvel, social affairs editor
· Much higher likelihood of crime and drug use
· Research based on 11,000 who were born in 1970
Children who have begun binge drinking by the age of 16 are more likely to use drugs as adults, become alcoholics and acquire a string of criminal convictions, researchers at the Institute of Child Health in London said today. In a long-term study of the lives led by 11,000 British children born in 1970, they found those who drank heavily in their mid-teens encountered a wide range of social and medical problems by the age of 30.
Children who were binge drinkers at 16 were 60% more likely to be alcoholic at 30 and 70% more likely to be regular heavy drinkers. They were 40% more likely to use illegal drugs, 40% more likely to suffer mental health problems and 60% more likely to be homeless.
The research found they were 40% more likely to have suffered accidents, almost four times as likely to have been excluded from school, and 30% more likely to have gained no qualifications. The binge drinkers were also 90% more likely to have criminal convictions.
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Social Work Education, Volume 26, Issue 7 October 2007 , pages 697 - 707
This paper argues that social work education in the UK has persistently failed to equip its social workers with the knowledge to work effectively with people with alcohol and drug problems.
In spite of continuing criticism of the profession's unwillingness or inability to engage with substance use issues, social work education has failed to respond to the calls for better training on this subject, even when specific guidance has been issued about course content. This results in a failure to meet the needs of our service users as well as social work staff who remain frustrated at their inability to intervene.
The paper explores the historical and current debate about social work training in relation to alcohol and drugs and identifies the barriers to its inclusion in qualifying and post-qualifying (PQ) curricula.
Finally it offers a strategy for improving social work training as well as an overview of programme content requirements.
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Contributor: Don Phillips
Addiction (OnlineEarly Articles). 3 Sep 2007
To evaluate the effect of receiving one of two brief interventions in reducing alcohol consumption among general hospital patients compared with usual care.
To assess whether a brief intervention of self-efficacy enhancement was superior to a self-help booklet in reducing alcohol consumption.Compared to the usual care group the self-efficacy enhancement group and the self-help booklet group had greater reductions in self-reported weekly alcohol consumption. There was no evidence that self-efficacy enhancement was superior to the self-help booklet.
Brief interventions delivered in hospital offer simple means of helping heavy drinkers to reduce their alcohol consumption.
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Journal of Psychiatric Research Article in Press, 31 August 2007
Conduct disorder (CD) and attention deficit hyperactivity disorder (ADHD) may be more prevalent in relatives of alcoholics and may predict alcohol and drug problems, but not all studies agree. This paper evaluates these questions in well-educated families of alcoholics and controls.
Data from 165, 14–25-year-old offspring in the San Diego Prospective Study were used to create Group 1 with CD or ADHD and Group 2 with no such diagnoses. Correlations and hierarchical logistic regressions evaluated characteristics associated with these disorders, comparing the impact of CD and ADHD.
The rates of CD and of ADHD were not strikingly elevated, and did not relate to the family history of alcohol or drug use disorders. Group 1 offspring were more likely to have divorced parents, a relative with bipolar disorder, a higher intake of alcohol and illicit substances, and associated problems.
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Tuesday, September 4, 2007
J Am Coll Cardiol, 2007; 50:1009-1014,
Light to moderate alcohol consumption (up to 1 drink daily for women and 1 or 2 drinks daily for men) is associated with cardioprotective benefits, whereas increasingly excessive consumption results in proportional worsening of outcomes. Alcohol consumption confers cardiovascular protection predominately through improvements in insulin sensitivity and high-density lipoprotein cholesterol.
The ethanol itself, rather than specific components of various alcoholic beverages, appears to be the major factor in conferring health benefits. Low-dose daily alcohol is associated with better health than less frequent consumption. Binge drinking, even among otherwise light drinkers, increases cardiovascular events and mortality.
Alcohol should not be universally prescribed for health enhancement to nondrinking individuals owing to the lack of randomized outcome data and the potential for problem drinking.
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Report by Virginia Berridge et al. on the history and culture of binge drinking and current concerns and trends. Keywords: binge drinking, alcohol history, public drunkenness.
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