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.
Saturday, March 8, 2008
The 2008 Budget submission argues that a 10% rise in the price of alcohol across the board would reduce adult alcohol-related mortality by up to 37%.
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By Nic Fleming, Medical Correspondent
Teetotallers who become moderate drinkers in middle age are significantly less likely to suffer heart attacks and strokes than those who continue to abstain, according to a study published yesterday.
Researchers found that women aged between 45 and 64 who began consuming an average of one alcoholic drink per day cut their risk of developing cardiovascular disease by almost 40 per cent.
The same was true for middle-aged men who allowed themselves up to two alcoholic drinks per day.
. . . . . . .
By GLEN OWER and BRENDAN CARLIN
8th March 2008
A bidding war over "binge drinking" taxes broke out last night as duty on alcohol became a key political battleground ahead of this week's Budget.
By last night, all three parties had pledged to raise taxes on alcohol, with Chancellor Alistair Darling indicating that he will be hiking duties on wines and spirits in his debut Budget on Wednesday.
Liberal Democrat Treasury spokesman Vincent Cable added a novel contribution to the debate, telling his party's spring conference that VAT on fruit juice and smoothies should be cut from 17.5 per cent to five per cent to help encourage healthy diets, with the anticipated £225million shortfall made up by raising the tax on some alcoholic drinks.
The Conservatives promised on Friday to raise tax on super-strength beer, cider and alcopops to tackle binge-drinking, while reducing the tax on low-strength beer and cider enjoyed by 'sensible' drinkers.
. . . . . .
Human Molecular Genetics Advance Access published online on March 4, 2008
Variations in OPRK1, which encodes the -opioid receptor, are associated with the risk for alcohol dependence.
Sequencing DNAs with higher and lower risk haplotypes revealed an insertion/deletion (indel) with a net addition of 830 bp located 1986 bp upstream of the translation start site (1389 bp upstream of the transcription start site).
We demonstrated that the upstream region extending from -1647 to -10 bp or from -2312 to -10 bp (relative to the translation start site) could function as a promoter in transient transfection assays. We then determined that the presence of the indel reduced transcriptional activity by half.
We used a PCR assay to genotype individuals in 219 multiplex alcohol dependent families of European American descent for the presence or absence of this indel.
Family-based association analyses detected significant evidence of association of this insertion with alcoholism; the longer allele (with the indel), which had lower expression, is associated with higher risk for alcoholism.
This indel is, therefore, a functional regulatory variation likely to explain at least part of the association of OPRK1 with alcohol dependence.
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The Journal of Neuroscience, March 5, 2008, 28(10):2589-2600
The immediate early gene, activity-regulated cytoskeleton-associated protein (Arc), has been implicated in synaptic plasticity. However, the role of Arc in alcoholism is unknown.
Here, we report that the anxiolytic effects of acute ethanol were associated with increased brain-derived neurotrophic factor (BDNF) and tyrosine kinase B (trkB) expression, increased phosphorylation of extracellular signal-regulated kinases 1/2 (Erk1/2), Elk-1, and cAMP responsive element-binding protein (CREB), increased Arc expression, and increased dendritic spine density (DSD) in both the central amygdala (CeA) and medial amygdala (MeA) but not in the basolateral amygdala (BLA) of rats.
Conversely, the anxiogenic effects of withdrawal after long-term ethanol exposure were associated with decreased BDNF and trkB expression, decreased phosphorylation of Erk1/2, Elk-1, and CREB, decreased Arc expression, and decreased DSD in both the CeA and MeA but not in the BLA of rats.
We also showed that BDNF infusion into the CeA normalized phosphorylation of Erk1/2, Elk-1, and CREB, and normalized Arc expression, thereby protecting against the onset of ethanol withdrawal-related anxiety.
We further demonstrated that arresting Arc expression in the CeA decreased DSD, thereby increasing anxiety-like and alcohol-drinking behaviors in control rats.
These results revealed that BDNF–Arc signaling and the associated DSD in the CeA, and possibly in the MeA, may be involved in the molecular processes of alcohol dependence and comorbidity of anxiety and alcohol-drinking behaviors.
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Accident Analysis & Prevention Volume 40, Issue 2, March 2008, Pages 733-741
This paper examines rates of self-reported driving under the influence (DUI) of alcohol and 12-month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans and South/Central Americans in the U.S. population.
Using a multistage cluster sample design, a total of 5224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the U.S.: Miami, New York, Philadelphia, Houston and Los Angeles.
The survey weighted response rate was 76%. Among men, 21% of Mexican Americans, 19.9% of South/Central Americans, 11.6% of Puerto Ricans and 6.9% of Cuban Americans reported DUI. Rates were lower among women, ranging from 9.7% for Mexican Americans to 1.3% for Cuban Americans. Mexican American men had the highest 12-month arrest rate (1.6%) and the highest lifetime arrest rate (11.2%).
Drinkers who reported DUI were heavier drinkers than those not reporting DUI according to a variety of indicators. However, most DUI incidents involved non-alcohol-dependent drivers. Mexican Americans and South Central/Americans, men, younger drivers, those with less than high school education, those with higher income and higher alcohol consumption were more likely to report DUI and DUI arrests.
These findings show that Hispanic national groups in the U.S. are diverse regarding drinking and DUI-related experiences.
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Friday, March 7, 2008
The Videoconference Series provides access to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) leading scientists and the latest alcohol research. NIAAA experts offer free, accurate, and timely information on a wide range of alcohol-related topics.
Each Videoconference webscast features a real-time presentation and slideshow on a specific alcohol-research topic, followed by an online Q & A.
The first in the series featuring Dr. Mark Willenbring, Director, Division of Treatment and Recovery Research, NIAAA, may be accessed below. Additional presentations will be listed in this section as they become available.
Alcoholism Isn’t What It Used to Be: New Research on the Nature and Diagnosis of Alcohol Use Disorders
Mark Willenbring, M.D., Director, Division of Treatment and Recovery Research
National Institute on Alcohol Abuse and Alcoholism, NIH
December 12, 2007
View Archived Presentation and Slide Show
Runtime: 103 minutes
(Please note: Audio and slide presentation begins at the 45 second mark)
Thursday, March 6, 2008
Journal of Substance Abuse Treatment Volume 34, Issue 3, April 2008, Pages 263-271
This study evaluated the efficacy of an alcohol web-based personalized feedback program delivered in the workplace to young adults.
Participants (N = 124) were randomly assigned to one of three conditions: web-based feedback (WI), web-based feedback plus a 15-minute motivational interviewing session (MI), or a control group.
Results indicated that participants in the intervention group (WI and MI conditions combined) reported significantly lower levels of drinking than those in the control group at a 30-day follow-up. This was particularly true for participants classified as high-risk drinkers at the baseline assessment. Similar results were found when comparing the WI condition to the control group. No differences were found between the WI and MI conditions, indicating that the addition of a 15-minute motivational interviewing session did not increase the efficacy of the web-based feedback program.
Findings support the use of web-based feedback as a stand-alone alcohol prevention program for young adults in the workplace.Read Full Abstract
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The American Journal of Medicine Volume 121, Issue 3, March 2008, Pages 201-206
Moderate alcohol use is part of a healthy lifestyle, yet current guidelines caution nondrinkers against starting to drink alcohol in middle age. The purpose of this study was to evaluate whether adopting moderate alcohol consumption in middle age would result in subsequent lower cardiovascular risk.
This study examined a cohort of adults aged 45-64 years participating in the Atherosclerosis Risk in Communities study over a 10-year period. The primary outcome was fatal or nonfatal cardiovascular events.
Of 7697 participants who had no history of cardiovascular disease and were nondrinkers at baseline, within a 6-year follow-up period, 6.0% began moderate alcohol consumption (2 drinks per day or fewer for men, 1 drink per day or fewer for women) and 0.4% began heavier drinking. After 4 years of follow-up, new moderate drinkers had a 38% lower chance of developing cardiovascular disease than did their persistently nondrinking counterparts. This difference persisted after adjustment for demographic and cardiovascular risk factors (odds ratio 0.62, 95% confidence interval, 0.40-0.95). There was no difference in all-cause mortality between the new drinkers and persistent nondrinkers (odds ratio 0.71, 95% confidence interval, 0.31-1.64).People who newly begin consuming alcohol in middle age rarely do so beyond recommended amounts. Those who begin drinking moderately experience a relatively prompt benefit of lower rates of cardiovascular disease morbidity with no change in mortality rates after 4 years
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This report presents State estimates for 23 measures of substance use or mental health problems based on the 2005 and 2006 National Surveys on Drug Use and Health (NSDUHs).
- In 2005-2006, the rate of past month alcohol use in States among all persons aged 12 or older ranged from a low of 32.4 percent in Utah to a high of 63.1 percent in Wisconsin. Six States showed significant increases from 2004-2005 to 2005-2006 in the percentage of all persons aged 12 or older who used alcohol in the past month: Arkansas (39.6 to 42.6 percent), Maine (51.5 to 54.8 percent), Michigan (54.2 to 56.2 percent), Nevada (48.2 to 52.0 percent), Utah (30.1 to 32.4), and Wyoming (53.0 to 56.4 percent). (Tables B.9 and C.9)
- The rate of binge alcohol use among youths aged 12 to 17 decreased from 10.5 percent in 2004-2005 to 10.1 percent in 2005-2006; however, the rates among young adults aged 18 to 25 and persons aged 26 or older did not change. The highest rates of binge use of alcohol occurred among persons aged 18 to 25. North Dakota (56.5 percent) had the highest rate in this age group, about twice the highest rate among persons aged 26 or older (Wisconsin at 27.4 percent) and almost 4 times the highest rate among youths aged 12 to 17 (Montana at 15.3 percent). (Tables B.10 and C.10)
- Between 2004-2005 and 2005-2006, there was an increase in perception of the risk of binge drinking from 41.2 to 41.7 percent among persons aged 12 or older. In this age group, Wisconsin had the lowest percentage (32.9 percent) perceiving a great risk of drinking five or more drinks of alcohol on a single occasion, while New Mexico had the highest rate at 47.6 percent. Seven of the ten States (Iowa, Minnesota, Montana, North Dakota, South Dakota, Vermont, and Wisconsin) with the highest rates of binge use of alcohol in 2005-2006 among persons 12 or older also were States with the lowest perceived risk of binge drinking for the population aged 12 or older. (Tables B.11 and C.11, Figures 3.5 and 3.9)
- Past month use of alcohol among persons aged 12 to 20 (underage use of alcohol) ranged from a low of 21.5 percent in Utah to a high of 38.3 percent in Vermont. Georgia (15.2 percent) had the lowest rate for past month underage (aged 12 to 20) binge use of alcohol, and North Dakota had the highest rate for this measure, 28.5 percent. There was no significant change at the national level in underage alcohol or binge alcohol use between 2004-2005 and 2005-2006; however, there were significant changes among several States. Arkansas and Vermont had increases in both underage alcohol use and underage binge alcohol use between 2004-2005 and 2005-2006. South Dakota's and Wisconsin's rates decreased for both measures over the same time period. (Tables B.12 and C.12)
Wednesday, March 5, 2008
Journal of the American Geriatrics Society 56 (2) , 214–223
To examine the prevalence of unhealthy drinking patterns in community-dwelling older adults and its association with sociodemographic and health characteristics.
The prevalence of unhealthy alcohol use by older adults defined in relation to two parameters of recommended limits: monthly use exceeding 30 drinks per typical month and "heavy episodic" drinking of four or more drinks in any single day during a typical month in the previous year. Sociodemographic and health status variables were also included.
Nine percent of elderly Medicare beneficiaries reported unhealthy drinking, with higher prevalence in men (16%) than women (4%). In logistic regression analyses with the full sample, higher education and income; better health status; male sex; younger age; smoking; being white; and being divorced, separated, or single were associated with higher likelihood of unhealthy drinking. Among drinkers, in addition to sociodemographic variables, self-reported depressive symptoms were positively associated with unhealthy drinking. Among unhealthy drinkers, race and ethnicity variables were associated with likelihood of heavy episodic drinking.
Almost one in 10 elderly Medicare beneficiaries report exceeding recommended drinking limits. Several distinct unhealthy drinking patterns were identified and associated with sociodemographic and health characteristics, suggesting the value of additional targeted approaches within the context of universal screening to reduce alcohol misuse by older adults.
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Commenting on the results of today’s (Tuesday 4 March 2008) review of licensing laws in England and Wales, the BMA’s Head of Science and Ethics, Dr Vivienne Nathanson, says:
“It is essential that the government continues to review 24-hour licensing, not only for its effect on crime but also its impact on public health. Research has already indicated a possible link between 24-hour licensing and increases in alcohol-related cases in A&E units. If this is confirmed in larger studies, the government must act.
“We are pleased that the government is proposing tough action on alcohol sales to under-18s. But tough talk alone is not enough – penalties must be enforced. There needs to be a change in perception – if retailers knew they couldn’t get away with selling alcohol to under-18s they probably wouldn’t do it.
“On a wider issue, the government needs to look at the whole area of alcohol misuse and licensing hours are just one aspect of this issue. The BMA recently launched its report on tackling alcohol misuse, and we want the government to also focus on taxation and access to alcohol. We are also calling for increased funding for treatment centres for people with alcohol problems.”
News Release - Quantity and Frequency of Drinking Influence Mortality Risk
Embargoed for Release
Tuesday, March 4, 2008
How much and how often people drink — not just the average amount of alcohol they consume over time — independently influence the risk of death from several causes, according to a new study by researchers at the National Institutes of Health (NIH).
"Taken together, our results reinforce the importance of drinking in moderation. In drinkers who are not alcohol dependent, the majority of U.S. drinkers, alcohol quantity and frequency might be thought of as modifiable risk factors for mortality, the researchers conclude."
. . . . . .
The Journal of Pediatrics Article in Press, Corrected Proof 10 January 2008
To determine the relationship between fatty acid ethyl esters (FAEE) in meconium and neurodevelopment in infants exposed to alcohol in utero at 6.5 months, 1 year, and 2 years of age.
After controlling for prenatal visits and maternal factors, increasing concentrations of FAEE were significantly associated with poorer mental and psychomotor development (β ± standard error) at all follow-up visits: ethyl myristate (MDI −2.46 ± 1.24, P = .05; PDI −3.88 ± 1.67, P = .02), ethyl oleate (MDI −1.94 ± 0.65, P < .01; PDI −2.60 ± 0.93, P < .01), ethyl linoleate (MDI −1.92 ± 0.60, P < .01; PDI −2.28 ± 0.84, P < .01), ethyl linolenate (MDI −1.99 ± 0.74, P < .01; PDI −2.98 ± 1.04, P < .01), and ethyl arachidonate (MDI −2.40 ± 1.11, P = .03; PDI −3.32 ± 1.51, P = .03).
FAEE in meconium may be a marker for identifying newborns at risk for neurodevelopmental delay from alcohol exposure in utero.
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Tuesday, March 4, 2008
Neuroscience Article in Press, Corrected Proof 29 January 2008
Alcohol abuse is associated with sleep problems, which are often linked to circadian rhythm disturbances. However, there is no information on the direct effects of ethanol on the mammalian circadian clock. Acute ethanol inhibits glutamate signaling, which is the primary mechanism through which light resets the mammalian clock in the suprachiasmatic nucleus (SCN). Glutamate and light also inhibit circadian clock resetting induced by nonphotic signals, including 5-HT.
Thus, we investigated the effects of acute ethanol on both glutamatergic and serotoninergic resetting of the mouse SCN clock in vitro.
We show that ethanol dose-dependently inhibits glutamate-induced phase shifts and enhances serotonergic phase shifts. The inhibition of glutamate-induced phase shifts is not affected by excess glutamate, glycine or d-serine, but is prevented by excess brain-derived neurotrophic factor (BDNF). BDNF is known to augment glutamate signaling in the SCN and to be necessary for glutamate/light-induced phase shifts.
Thus, ethanol may inhibit glutamate-induced clock resetting at least in part by blocking BDNF enhancement of glutamate signaling. Ethanol enhancement of serotonergic phase shifts is mimicked by treatments that suppress glutamate signaling in the SCN, including antagonists of glutamate receptors, BDNF signaling and nitric oxide synthase.
The combined effect of ethanol with these treatments is not additive, suggesting they act through a common pathway. Our data indicate further that the interaction between 5-HT and glutamate in the SCN may occur downstream from nitric oxide synthase activation.
Thus, acute ethanol disrupts normal circadian clock phase regulation, which could contribute to the physiological and psychological problems associated with alcohol abuse.
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By Elizabeth Rigby and Jimmy Burns
Published: March 5 2008
Drinks companies, pubs and supermarkets yesterday implored the government not to take further regulatory action on alcohol sales and promotions after the government admitted that 24-hour licensing laws had produced "mixed results".
The British Pub and Beer Association told the government it was already suffering from difficult trading conditions following last year's smoking ban and fragile consumer confidence, without further regulatory or tax pressure.
Supermarket groups, under fire for aggressive drinks promotions, reminded the government that competition law made it illegal for them to take collective action on price rises.
"The industry is doing triple backwards somersaults to come to terms with shifting government criteria," said Tim Martin, chairman of Wetherspoons, the pub chain. "Pubs were repeatedly investigated in the 1970s and 1980s for over-pricing and now, having forgotten about rip-off Britain, we are being told to get our prices up."
. . . . . .
The urge to binge mindlessly, though it can strike at any time, seems to stir in the collective unconscious during the last weeks of winter. Maybe it’s the television images from places like Fort Lauderdale and Cabo San Lucas, of communications majors’ face planting outside bars or on beaches.
Or perhaps it’s a simple a case of seasonal affective disorder in reverse. Not SAD at all, but anticipation of warmth and eagerness for a little disorder.
Either way, researchers have had a hard time understanding binge behavior. Until recently, their definition of binge drinking — five drinks or more in 24 hours — was so loose that it invited debate and ridicule from some scholars. And investigators who ventured into the field, into the spray of warm backwash and press of wet T-shirts, often returned with findings like this one from a 2006 study: “Spring break trips are a risk factor for escalated alcohol use.”
Or this, from a 1998 analysis: “The men’s reported levels of alcohol consumption, binge drinking and intoxication were significantly higher than the women’s.”
In fact, the dynamics of bingeing may have more to do with personal and cultural expectations than with the number of upside-down margaritas consumed. In their classic 1969 book, “Drunken Comportment,” recently out in paperback, the social scientists Craig MacAndrew and Robert B. Edgerton wrote that the disconnect between the conventional wisdom on drunken behavior and the available evidence “is even now so scandalous as to exceed the limits of reasonable toleration.”
. . . . . .
4 March 2008
The Government will launch a crackdown on alcohol-fuelled disorder in light of the Review of the Licensing Act published today.
In a written ministerial statement, Culture Secretary Andy Burnham said that the review had produced a "mixed picture" of the impact of extended hours introduced in the Licensing Act in 2003 and that there needed to be a new focus on enforcement of police and local authority powers. Overall crime and alcohol consumption had fallen since 2003 but alcohol-related violence in the early hours of the morning had increased, he said.
In an interview with the Daily Mirror newspaper yesterday, the Prime Minister said that there needed to be tougher action on shops found to be selling alcohol to underage drinkers as well as a change in the drinking culture of the country. Any retailer caught selling to under-18s twice in a three-month period should lose its license, he said.
"We have to tighten up the penalties. Any shop that is selling to under-18s twice in three months shouold lose its license...If someone is selling to under-18s they are allowing these problems of binge drinking to grow and they are giving young people the worst possible start in life."
Mr Brown also pointed to other measures to deal with the sale of cheap alcohol and an advertising campaign to encourage responsible drinking and make being drunk in public socially unacceptable.
As well as the "two-strikes" rule for retailers, today's review also listed measures such as tougher sanctions on premises breaking the law and more instant closures of problem venues.
Appendix A: Tables and charts for the case study areas
Appendix B: Technical report
The Licensing Act 2003 came into effect on the 24th November 2005 and abolished set licensing laws in England and Wales. The aim was to liberalise a rigid system whilst reducing the problems of drinking and disorder associated with a standard closing time.
The evaluation used a multi-method approach and employed both the national and local level data. A key component of the evaluation was the temporal and spatial analysis of time-stamped recorded crime data in five case study areas. This was supplemented by survey data from local residents about their perceptions of crime and qualitative interviews with regulators and representatives from night time economy businesses.
The findings suggest the overall volume of incidents of crime and disorder remains unchanged, though there are signs that crimes involving serious violence have reduced. There is, however, temporal displacement, in that the small proportion of violent crime occurring in the small hours of the morning has increased. Police, local authorities and licensees generally welcomed the new powers and the Act’s partnership philosophy.
Appendix A: Numbers and methods
Appendix B: Levels and timing of crime and disorder
This paper examines the early experiences of the implementation of the Licensing Act 2003 in two Government Office regions, specifically a sample of market towns in the East of England and a mix of towns in the Yorkshire and the Humber region. In both regions a mixed methods approach was used including: qualitative interviews with police, licensing officers, licensees and CDRP representatives; examination of licensing applications; and quantitative data analysis of police recorded crime figures in the first six months of the Act. It discusses the take up and use of the extended licensing hours, where most of the licensees interviewed had applied for license extensions. An analysis of the police recorded crime data revealed a mixed picture in the two regions, with both increases and decreases noted in the towns examined. However, the results should be treated with caution as the crime types examined were often proxies for alcohol-related crime, the levels were small and they could be subject to fluctuation due to police activity. The main change experienced in some towns was a shift in the patterns of alcohol related crime, with peak periods flattening or moving to later in the night.
From The Times
Pubs and clubs will lose their licences after breaking the drinking laws twice and people caught drinking in public areas where it is banned will face increased fines, the Government will announce today.
Ministers will hold out the prospect of blanket licence bans in the early hours where there has been persistent trouble from rowdy drinkers but they will not reverse the 24-hour licensing laws. Two reviews from the Home Office and the Department for Culture, Media and Sport of the 30 months of operation of the 24-hour law will give it qualified backing — “a mark of seven out of ten” according to one senior official.
But at the instigation of Gordon Brown and Andy Burnham, the new Culture Secretary, measures designed to tackle binge drinking and the irresponsible minority who have abused the laws will be outlined today and later in the year.
. . . . . . .
Monday, March 3, 2008
PLoS Med 5(3): e52
Alcohol has been reported to be a common and modifiable risk factor or hypertension. However, observational studies are subject to confounding by other behavioural and sociodemographic factors, while clinical trials are difficult to implement and have limited follow-up time.
Mendelian randomization can provide robust evidence on the nature of this association by use of a common polymorphism in aldehyde dehydrogenase 2 (ALDH2) as a surrogate for measuring alcohol consumption. ALDH2 encodes a major enzyme involved in alcohol metabolism. Individuals homozygous for the null variant (*2*2) experience adverse symptoms when drinking alcohol and consequently drink considerably less alcohol than wild-type homozygotes (*1*1) or heterozygotes.
We hypothesise that this polymorphism may influence the risk of hypertension by affecting alcohol drinking behaviour.
We carried out fixed effect meta-analyses of the ALDH2 genotype with blood pressure (five studies, n = 7,658) and hypertension (three studies, n = 4,219) using studies identified via systematic review.
In males, we obtained an overall odds ratio of 2.42 (95% confidence interval [CI] 1.66–3.55, p = 4.8 × 10−6) for hypertension comparing *1*1 with *2*2 homozygotes and an odds ratio of 1.72 (95% CI 1.17–2.52, p = 0.006) comparing heterozygotes (surrogate for moderate drinkers) with *2*2 homozygotes.
Systolic blood pressure was 7.44 mmHg (95% CI 5.39–9.49, p = 1.1 × 10−12) greater among *1*1 than among *2*2 homozygotes, and 4.24 mmHg (95% CI 2.18–6.31, p = 0.00005) greater among heterozygotes than among *2*2 homozygotes.
These findings support the hypothesis that alcohol intake has a marked effect on blood pressure and the risk of hypertension.
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Journal of Traumatic Stress Volume 20, Issue 6 , Pages 1041 - 1051
Recent studies show a high prevalence of traumatic events in samples of patients with a substance use disorder.
In the present study, the lifetime exposure to potentially traumatic events (PTEs) was
estimated in a sample of 458 patients recruited at 17 randomly chosen alcohol-dependence treatment units in the public healthcare sector in Poland.
Eighty percent of the patients reported a history of at least one potentially traumatic event. Sixty percent of them reported experiencing more than one probable trauma. However, only the patients who experienced physical assault reported worse clinical severity in posttraumatic stress and alcohol-use related symptomatology.
The findings confirm the importance of trauma assessment in alcohol-dependent patients and the inclusion of trauma-related issues in the treatment of alcohol dependence.
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Neuropsychopharmacology advance online publication 20 February 2008
Although ethanol has been shown to impair acquisition of memory, its effect on consolidated memories is not clear. Recent reports revealed that memory retrieval converted consolidated memory into a labile state and initiated the reconsolidation process.
In the present study, we have demonstrated the effect of ethanol on reactivated fear memory. We used contextual fear conditioning where rats were conditioned with mild footshock, re-exposed to the training context for 2 min, immediately injected with ethanol or saline, and finally tested 48 h after re-exposure.
Ethanol-treated groups demonstrated longer freezing and the effect lasted for 2 weeks. Reactivation is necessary for this effect. Injection of ethanol itself did not induce a fearful response. Reactivated and ethanol-treated rats exhibited longer freezing than non-reactivated controls, suggesting that ethanol does not inhibit the memory decline but facilitates the fear memory. Two minute re-exposures induced no or little extinction.
The effect of ethanol was specific for 2-min reactivation, which induces reconsolidation. Moreover, we found that picrotoxin inhibited the memory enhancement that was produced by ethanol administered just after the reactivation.
These studies demonstrate that ethanol enhances reactivated contextual fear memories via activation of GABAA receptors.
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Alan Travis and Nicholas Watt
The Guardian,Tuesday March 4 2008
· Antisocial behaviour still a problem, says Home Office
· Crackdown on shops and off-licences also unveiled
The package comes with the publication of the official Culture Department review of the impact of the changes in the licensing laws, which receive a verdict of "7/10 - good but could do better".
Ministers believe the relaxation in the opening hours has given the responsible majority greater freedom. But that has been matched by only a patchy improvement in the enforcement of the laws to curb underage drinking and antisocial behaviour.
A Home Office study of the impact of the licensing changes on crime and disorder also to be published today will confirm that later closing times have led to a spike in incidents of drink-related disorder which have been displaced to between 3am and 6am. Ministers hope the new measures will tackle this problem.
But there will not be any announcements today of action to legislate over cheap supermarket alcohol promotions, which have led to police complaints that lager is sold cheaper than bottled water.
Instead ministers will make clear that the industry will be expected to stop such irresponsible promotions. An internal government review under way into possible links between pricing promotions and crime and disorder is not due to report until June. It may well lead to changes the licensing laws and competition laws later in the year if self-regulation proves to fail one last time.
. . . . . . .
Arch Gen Psychiatry. 2008;65(3):310-318.
Twin studies provide compelling evidence that alcohol and drug dependence, childhood conduct disorder, adult antisocial behavior, and disinhibitory personality traits share an underlying genetic liability that contributes to a spectrum of externalizing behaviors.
However, this information has not been widely used in gene identification efforts, which have focused on specific disorders diagnosed using traditional psychiatric classification systems.
To test the utility of using a multivariate externalizing phenotype in (1) linkage analyses and (2) association analyses to identify genes that contribute broadly to a spectrum of externalizing disorders.
Principal component analyses indicated that the 6 individual variables loaded on a single externalizing factor. Linkage analyses using the resultant component scores identified a region on chromosome 7 consistent with a gene that broadly predisposes individuals to externalizing behavior. Association analyses of a candidate gene, CHRM2, previously of interest in the Collaborative Study on the Genetics of Alcoholism, suggest that it is involved in a general externalizing phenotype.
Broader conceptualizations of psychiatric disorders, such as studying a spectrum of externalizing psychopathology, may aid in identifying susceptibility genes and understanding the pathways through which genetic factors affect vulnerability for a variety of poor outcomes.
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Asked about the Licensing Review being published tomorrow, the PMS said that it was important to see the review as a staging post in terms of the action the Government was taking, rather than being the final word on the matter. There would be announcements from DCMS and the Home Office, looking at the way in which the new licensing laws were operating and how they were being enforced.
It was important to remember alongside this, the Action Plan on young people and alcohol from DCSF and a Department of Health Review of evidence on the relationship between pricing, promotion and harm being published later in the year. So it was more of an ongoing process, rather than a definitive final conclusion one way or the other.
Put that the Chancellor had said in an interview in February that he didn't think putting up taxes on alcohol was the best way to tackle binge-drinking and was that a view shared by the Prime Minister, the PMS replied that the view of the Prime Minister was that tax was a matter for the Chancellor in the Budget. Asked if the Prime Minister was putting pressure on the Chancellor to change his views on the subject, the PMS said he did not know where the journalist was going with that line of questioning and suggested that all questions in regards to the Chancellor should be addressed to the Treasury.
Asked when the reviews from the Department of Health and DCSF were expected to report back, the PMS said a bit later in the year.
Asked whether the Government thought the Licensing Act had worked or not, the PMS said people would find out tomorrow.
Asked whether the term staging post meant that it was too early to make a definitive statement as to how well the Licensing Act had gone, the PMS said it was a reflection of the fact that it was a complex issue. It affected a whole range of Government departments and affected different parts of the country in different ways. It was a very complex piece of legislation with a complex social impact. There would be an assessment of it tomorrow, but what we were saying was that this was not necessarily the final word on the matter.
Asked if the Government was opening itself up to the charge of dithering, the PMS replied that that was not the case. It was a reflection of the fact that this was a complex piece of legislation with a very complex impact.
Asked of the Prime Minister would be meeting with representatives of Tesco, the PMS replied that the Prime Minister had met with representatives of the retail industry, including Tesco, regarding alcohol back in November. We welcomed any further positive contributions to taking this issue forward. There were reviews ongoing into the relationship between pricing and alcohol drinking habits, but in the interim, any progress that we could make with all those involved was to be welcomed.
Asked about the time frame regarding this subject, without pre-empting the Budget, the PMS replied that the Budget was a matter for the Chancellor but that there were various elements to this. There was a review due quite shortly into the Licensing Act as a whole, which had been looking across impacts in terms of local councils, health and policing; there were several elements to this and we could expect various Government business on this in the upcoming weeks/months.
Current Psychiatry Vol. 7, No. 3 / March 2008
Children of alcoholics have a 40% to 60% increased risk of developing severe alcohol-related problems1—a harsh legacy recognized for >30 years. Now, as the result of rapidly growing evidence, we can explain in greater detail why alcoholism runs in families when discussing alcohol dependence with patients.
Individuals vary in response to medications and substances of abuse, and genetic research is revealing the heritable origins. Numerous genetic variations are known to influence response to alcohol, as well as alcoholism’s pathophysiology, clinical manifestations, and treatment. Pieces are still missing from this complex picture, but investigators are identifying possible risk factors for alcoholism and matching potential responders with treatments such as naltrexone and acamprosate.
This article provides a progress report on contemporary genetic research of alcoholism. Our goal is to inform your clinical practice by describing:
new understandings of the genetics of alcoholism
how researchers identify relationships between genetic variations and clinical/behavioral phenomena
practical implications of this knowledge.
Open Alcohol Forum
Within the framework of the European Alcohol and Health Forum, the Commission services will organise an 'Open Forum' on Thursday, 17 April 2008 in Brussels (25 KB)
European Alcohol and Health Forum: commitments for action by Forum members
The members of the European Alcohol and Health Forum have made a series of commitments aimed at reducing alcohol-related harm. A complete overview of the 78 commitments introduced so far under the process described in the Charter establishing the European Alcohol and Health Forum is contained in the following document (580 KB)
Ten years ago, Harlem community activists and Bill Perkins, Harlem's representative to the New York City Council, led a successful campaign to rid Harlem of malt liquor ads that they called
pornographic and disrespectful (1). Several years earlier, legal action had forced malt liquor advertisers to remove similar ads. In the ensuing decades, activists launched comparable campaigns against the advertising and distribution of malt liquor in Portland, Oregon; Chicago; Philadelphia; Washington, D.C. and many other cities, often in the African-American neighborhoods targeted by malt liquor manufactures.
Now, major U.S. breweries are facing declining revenues due to decreased demand for mass market product lines such as Budweiser and a trend toward increased wine consumption and specialty and imported beers (2,3). For the beer industry, young consumers who have not yet established brand and drink preferences are an obvious target for the more aggressive marketing of malt liquor products (2,3).
This story of marketing malt liquor and the resistance to it illustrates some of the ways that free markets can collide with public health. It also demonstrates both the potential and limits of community activism to resist the promotion of unhealthy products. This Corporations and Health Watch report summarizes the health risks associated with malt liquor consumption and describes the marketing of newer flavored malt liquors and caffeinated energy malt liquors to young people. It reviews actions by community activists to restrict the sale and advertisement of malt liquor products in low-income urban communities, and concludes with policy recommendations designed to better protect young people from the risks associated with malt liquor.
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Sunday, March 2, 2008
J. Stud. Alcohol Drugs 69: 259-265, 2008
This article examines the association between birthplace, acculturation, and self-reported driving under the influence of alcohol (DUI), 12-month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans in the U.S. population.
Using a multistage cluster sample design, 5,224 adults (18 years of age or older) were interviewed from households in five metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles.
Birthplace was not associated with DUI, 12-month DUI arrest rates, or lifetime DUI arrest rates. Mexican Americans in the medium- and high-acculturation groups were more likely to engage in DUI. A higher proportion of U.S.-born than foreign-born respondents as well as those in the high-acculturation group, irrespective of national origin, reported having been stopped by police when driving. U.S.-born Cuban Americans, Mexican Americans, and South/Central Americans thought they could consume a higher mean number of drinks before their driving is impaired compared with those who are foreign born.
There are considerable differences in DUI-related behavior across Hispanic national groups. U.S.-born Hispanics and those born abroad, but not those at different levels of acculturation, have equal risk of involvement with DUI.
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Request Reprint E-Mail: raul.caetano@UTSouthwestern.edu
J. Stud. Alcohol Drugs 69: 251-258, 2008
Self-monitoring is recommended following brief alcohol intervention (BI). We have previously demonstrated that self-monitoring with an automated telephone system (interactive voice response; IVR) is associated with a steady reduction in alcohol consumption in the absence of BI.
In this study we explore the feasibility and efficacy of IVR as a possible therapeutic enhancement for BI.
We updated all providers (N = 112) in 15 primary care clinics about BI and encouraged them to do a BI with their patients whenever appropriate and to invite those patients to participate in the research project. Interested patients (N = 338) were randomized to one of four study conditions including no IVR and three groups who self-monitored for 6 months using an IVR: no feedback, feedback, and feedback plus a monetary calling incentive.
The IVR proved to be a feasible method for self-monitoring. Of those invited to use the IVR, 90% initiated use and made 95% of the calls while they remained engaged with the system; more than half continued calling for the entire 6 months. Reported impact of the IVR and associated feedback on drinking awareness was high. Therapeutic results were mixed. Overall, the IVR groups reported higher consumption on the Timeline Followback (TLFB) at the 3- and 6-month follow-ups than did the no IVR group. However, because of a potential measurement confound, the TLFB may not have operated in an unbiased fashion across the four study conditions. A comparison of the feedback and no feedback IVR groups, which is independent of this confound, shows a significant therapeutic advantage of IVR with feedback.
IVR is a feasible technology for behavioral self-monitoring in primary care clinics. IVR with regular feedback may be an effective therapeutic enhancement to BI.
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Request Reprint E-Mail: John.Helzer@vtmednet.org
J Korean Med Sci. 2008 Feb;23(1):1-9
To determine the effects of excessive drinking and alcohol dependency on mortality and chronic health problems in a rural community in South Korea, this study represents a nested case-control study.
In 1998, we conducted the Alcohol Dependence Survey (ADS), a population survey of a village in Korea. To measure the effects of alcohol on chronic health conditions and mortality over time, in 2004, we identified 290 adults from the ADS sample (N=1,058) for follow-up.
Of those selected, 145 were adults who had alcohol problems, either alcohol dependence as assessed in the ADS by the Severity of Alcohol Dependence Questionnaire (N=59), or excessive drinking without dependency (N=86). Further 145 nondrinkers were identified, matching those with alcohol problems in age and sex.
We revisited the village in 2004 and completed personal interviews with them. In multivariate logistic regressions, the rates of mortality and morbidity of chronic health conditions were three times greater for alcohol dependents compared with the rate for nondrinkers.
Importantly, however, excessive drinking without dependency was not associated with the rates of either mortality or morbidity.
Future investigations would benefit by attending more specifically to measures for alcohol dependence as well as measures for alcohol consumption.
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