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

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


Saturday, December 20, 2008

Age of Onset and Temporal Sequencing of Lifetime DSM-IV Alcohol Use Disorders Relative to Comorbid Mood and Anxiety Disorders
Drug Alcohol Depend. 2008 April 1; 94(1-3): 234–245.

Understanding the temporal sequencing of alcohol use disorders (AUDs) nd comorbid mood and anxiety disorders may help to disentangle the etiological underpinnings of comorbidity. Methodological limitations of previous studies, however, may have led to inconsistent or inconclusive findings.

To describe the temporal sequencing of the onset of AUDs relative to the onset of specific comorbid mood and anxiety disorders using a large, nationally representative survey.

AUD onset tended to follow the onset of 2 of the 9 mood and anxiety disorders (specific and social phobia). The onset of alcohol abuse tended to precede the onset of 5 of the 9 mood and anxiety disorders (GAD, panic, panic with agoraphobia, major depression, and dysthymia), whereas the onset of alcohol dependence tended to precede the onset of only 2 of the 9 mood and anxiety disorders (GAD and panic). Lag times between primary and subsequent disorders generally ranged from 7–16 years. Comorbid individuals whose alcohol dependence came after panic with agoraphobia, hypomania, and GAD had increased risk of persistent alcohol dependence.

Alcohol abuse, but not dependence, precedes many mood and anxiety disorders. If the primary disorder does in fact play a causative or ontributing role in the development of the subsequent disorder, this role can best be described as “temporally distal.” However, in assessing the risk for persistent alcohol dependence, clinicians should not only consider the type of comorbid mood/anxiety disorder, but also the temporal ordering of these disorders.

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Association of NFKB1, which encodes a subunit of the transcription factor NF-[kappa]B, with alcohol dependence.
Human Molecular Genetics. 17(7):963-970, April 1, 2008.

A broad region on chromosome 4q has been linked to alcohol dependence (alcoholism). We hypothesized that such broad linkage regions represent the combined action of multiple genes.
Seeking to identify genes within that region that are associated with alcoholism, we have tested the association of NFKB1, located at 4q24, with alcoholism. NFKB1 encodes a 105 kDa transcription inhibitor that is cleaved to the 50 kDa DNA-binding subunit of the ubiquitous transcription factor NF-B. NF-B regulates many genes relevant to brain function, and its actions can be potentiated by ethanol; thus, NFKB1 is an excellent candidate gene for alcoholism.
Nineteen SNPs in and near NFKB1 were analyzed in a sample of 219 multiplex alcoholic families of European American descent. Family-based association analyses detected significant evidence of association with eight SNPs and marginal evidence for five more. The association was driven by the affected individuals with earlier onset of alcoholism (55% of the sample with onset 21 years). Further analysis of the age of onset as a quantitative variable provided evidence for the association of 12 SNPs in this gene.
Thus, variations in NFKB1 appear to affect the risk for alcoholism, particularly contributing to an earlier onset of the disease.

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News Release - UCSF Researchers Shed Light on Genetic Factors Behind Alcohol Dependence

By Robin Hindery

Understanding the genetic factors behind alcohol dependence — and using that information to improve treatment — has been the goal of many scientific studies. Now, a group of UCSF researchers has moved one step closer to unraveling what one called the “complicated web” of components that determine an individual’s response to alcohol and likelihood to abuse it.

In a recently published study, scientists from UCSF’s Ernest Gallo Clinic and Research Center took 367 white siblings with a family history of alcohol abuse and had each consume three alcoholic drinks over a 10-minute period at 10 a.m. . . . . .

Molecular Genetics of Alcohol-Related Brain Damage
Alcohol and Alcoholism Advance Access published online on December 18, 2008

In the scientific literature it has been repeatedly hypothesized that there is a heritable susceptibility to thiamine deficiency comparable to other hereditary metabolic disorders.

The aim of this paper is to review the most recent knowledge on the genetic susceptibility to the development of alcohol-related Wernicke–Korsakoff syndrome (WKS).

A literature review was carried out looking at the molecular genetics studies performed in alcohol-dependent patients affected by WKS.

A genetic component in the pathogenesis of WKS has been postulated since the late seventies. Since then, very few genetic studies have been carried out on candidate genes such as thiamine-dependent enzymes, alcohol-metabolizing enzymes and GABA receptors. The findings are controversial and not conclusive. Several authors reported the important role of the thiamine transporters in the pathogenesis of the thiamine deficiency disorders. Our findings on SLC19A2 and SLC19A3 suggest a potential role of these two genes in the pathophysiology of alcohol-related thiamine deficiency but further studies need to be carried out.

The WKS may be a very complex, multifactorial disorder where the interaction of multiple genes and environment plays an important role in the pathogenesis. However, it is still plausible that megaphenic gene effects are responsible for WKS susceptibility and the thiamine transport genes are good candidates for having such a role. Further genetic studies are definitely needed to investigate the association with candidate genes or linkage with hot spot areas.

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Involvement of A2A receptors in anxiolytic, locomotor and motivational properties of ethanol in mice
Genes, Brain and Behavior Volume 7 Issue 8, Pages 887 - 898

We have shown previously that mice lacking the adenosine A2A receptor (A2AR) generated on a CD1 background self-administer more ethanol and exhibit hyposensitivity to acute ethanol.
We aimed to investigate if the increased propensity of A2A−/− mice to consume ethanol is associated with an altered sensitivity in the motivational properties of ethanol in the conditioned place preference (CPP) and conditioned taste aversion (CTA) paradigms and with an altered development of sensitization to the locomotor effects of ethanol. We also tested their sensitivity to the anxiolytic effects of ethanol.
Our results show that A2A−/− mice produced on a CD1 background displayed a reduced ethanol-induced CPP and an increased sensitivity to the anxiolytic and locomotor-stimulant effects of ethanol, but they did not show alteration in ethanol-induced CTA and locomotor sensitization.
Ethanol-induced CPP, ethanol consumption and the locomotor effects of ethanol were also tested in A2A−/− mice produced on a C57BL/6J background.
Our results emphasized the importance of the genetic background because alteration in ethanol consumption and preference, ethanol-induced CPP and locomotor-stimulant effects were not found in knockout mice produced on the alcohol-preferring C57BL/6J genetic background. Finally, the A2AR agonist, 2-p-(2-carboxyethyl)-phenylethylamino-5'-N-ethylcarboxamidoadenosine hydrochloride (CGS 21680), reduced ethanol consumption and preference in C57BL/6J mice.
In conclusion, A2AR deficiency in mice generated on a CD1 background leads to high ethanol consumption that is associated with an increased sensitivity to the locomotor-stimulant/anxiolytic effects of ethanol and a decrease in ethanol-induced CPP.
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Children admitted to hospital due to alcohol increasing

By Rebecca Smith, Medical Editor
17 Dec 2008

The number of children admitted to hospital due to alcohol has risen with those living in rural and isolated areas worst affected, official figures have revealed.

Almost 8,000 children under the age of 18 were admitted to hospital in 2006/7 a rise of more than five per cent in three years.

The data from the North West Public Health Observatory has calculated the alcohol-related health problems for each local authority area and found despite awareness campaigns and warnings from doctors illnesses and deaths caused by drinking continue to rise.

Areas with the highest child admissions due to drink are in rural places such as Copeland in Cumbria, the Isle of Wight, Rossendale in Lancashire, Wirral, and Halton in Cheshire.

The highest adult admissions though tended to be in major towns and cities, especially in the North West. . . . . .

Changes in the Episodic Memory and Executive Functions of Abstinent and Relapsed Alcoholics Over a 6-Month Period
Alcoholism: Clinical and Experimental Research Published Online: 16 Dec 2008

It is still unclear whether episodic memory and executive functions capacities can return to normal in abstinent patients over a 6-month period. Furthermore, the role of interim drinking in cognitive recovery is still not well known. Finally, further research is required to specify the predictive value of cognitive abilities at initial testing in the treatment outcome (abstinence or relapse).

The aims of the present study were therefore to measure changes in episodic memory and executive functions over a 6-month period in abstinent and relapsed alcoholics and to ascertain whether neuropsychological results at treatment entry can predict treatment outcome at follow-up.

Results showed that over the 6-month interval, the abstainers' episodic memory and executive performances had returned to normal, whereas the relapsers performed lower than before in the flexibility task. Episodic memory and executive functions recovery was correlated, in abstainers, with drinking history and age respectively. Finally, there was no significant difference regarding neuropsychological scores at baseline between abstainers and relapsers.

Over the 6-month interval, abstainers normalized episodic memory and executive performances whereas relapsers obtained executive results which were more severely impaired, emphasizing the influence of interim drinking on cognitive changes. Episodic memory, executive functions, the slave systems of working memory and attentional abilities did not appear to be reliable predictors of treatment outcome over a 6-month interval.

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Middle class over 45-year-olds now the most frequent drinkers

By Kate Devlin Medical Correspondent
17 Dec 2008

The middle class people over the age of 45 are now the most frequent drinkers in England, new NHS figures show.

Middle aged people who are on high incomes are the most likely to drink five or more nights a week, according to the statistics.

The findings add to growing concern over middle class drinkers and the damage their habits are doing to their bodies.

Earlier this year a report by the National Audit Office, the Government watchdog, warned that 10 million Britons were now drinking to "hazardous" levels. . . . . .

Chronic voluntary ethanol intake hypersensitizes 5-HT1A autoreceptors in C57BL/6J mice
Journal of Neurochemistry Volume 107 Issue 6, Pages 1660 - 1670

Alcoholism is a complex disorder involving, among others, the serotoninergic (5-HT) system, mainly regulated by 5-HT1A autoreceptors in the dorsal raphe nucleus. 5-HT1A autoreceptor desensitization induced by chronic 5-HT reuptake inactivation has been associated with a decrease in ethanol intake in mice.

We investigated here whether, conversely, chronic ethanol intake could induce 5-HT1A autoreceptor supersensitivity, thereby contributing to the maintenance of high ethanol consumption. C57BL/6J mice were subjected to a progressive ethanol intake procedure in a free-choice paradigm (3–10% ethanol versus tap water; 21 days) and 5-HT1A autoreceptor functional state was assessed using different approaches.

Acute administration of the 5-HT1A receptor agonist ipsapirone decreased the rate of tryptophan hydroxylation in striatum, and this effect was significantly larger (+75%) in mice that drank ethanol than in those drinking water. Furthermore, ethanol intake produced both an increased potency (+45%) of ipsapirone to inhibit the firing of 5-HT neurons, and a raise (+35%) in 5-HT1A autoreceptor-mediated stimulation of [35S]GTP-γ-S binding in the dorsal raphe nucleus.

These data showed that chronic voluntary ethanol intake in C57BL/6J mice induced 5-HT1A autoreceptor supersensitivity, at the origin of a 5-HT neurotransmission deficit, which might be causally related to the addictive effects of ethanol intake,

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Does Low to Moderate Alcohol Intake Protect Against Cognitive Decline in Older People?
Journal of the American Geriatrics Society Volume 56 Issue 12, Pages 2217 - 2224
To determine whether low to moderate alcohol intake is protective against cognitive decline in older people.

Forty-two percent of women and 71% of men were alcohol drinkers. Cognitive performance was better for female drinkers than nondrinkers for all cognitive domains over the 3.2-year follow-up; no significant effects were seen for men (linear mixed model, including adjusting for possible confounders). The rate of cognitive decline was similar for drinkers and nondrinkers for all cognitive domains, except for MMSE, which declined significantly less in female drinkers than nondrinkers (linear mixed model attenuated rate of decline=0.05 MMSE units per annum, P=.001).

Drinking low to moderate amounts of alcohol may delay age-associated cognitive decline in older women (including slowing deterioration in global cognitive function), but these apparent benefits were not clearly seen in older men.

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Mandatory drinks code closer to reality

19 December, 2008
By James Wilmore

But details of conditions not specified in Policing and Crime Bill

Government plans to introduce a national mandatory code of practice for the industry took a step closer yesterday with the official tabling of a new Bill.

If passed, the Policing and Crime Bill, first announced in the Queen’s Speech, will give Home Secretary Jacqui Smith the power to impose mandatory conditions on on-trade and off-trade premises. . . . .

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Limited Competition: Collaborative Study on the Genetics of Alcoholism (COGA) (U10)

This Funding Opportunity Announcement (FOA) issued by the National Institute on Alcoholism and Alcohol Abuse (NIAAA), National Institutes of Health, is a limited competition FOA soliciting a cooperative agreement (U10) application from investigators currently supported under an existing study, entitled “Collaborative Study of the Genetics of Alcoholism (COGA)” to (i) identify genetic variants that affect the susceptibility to develop alcohol dependence in adult and adolescent populations, (ii) determine molecular and functional mechanisms of these variants, (iii) identify and characterize gene x gene and gene x environment interactions leading to alcoholism, (iv) develop and refine phenotypes that will facilitate genetic analysis. (v) perform prospective studies of COGA probands.

The Collaborative Study of the Genetics of Alcoholism (COGA) is a joint multi-disciplinary project that has been supported by the National Institute of Alcohol Abuse and Alcoholism (NIAAA) since 1989 and more recently also by the National Institute on Drug Abuse (NIDA). It seeks to identify the role of genes in susceptibility to (or protection from) developing alcohol dependence and related phenotypes. The ultimate goal is to understand the functional effects of variation at genes identified in these studies, including effects on expression, at the molecular and cellular level. Investigators with complementary expertise in molecular and cellular biology, neurophysiology, and psychiatry have collaborated over the years to identify genes in which nucleotide sequence variation affects the risk for alcoholism and related disorders. This approach was built on linkage and association studies in severely affected individuals within families. COGA collected data from more than 300 extended families consisting of more than 3,000 individuals. This dataset is a rich resource for alcohol researchers and for investigators interested in determining the genetic basis of other complex disorders that frequently influence the development of alcoholism, such as anxiety and major depression. The COGA dataset has also served the larger research community as a resource for examining functionally-based endophenotypes and in testing new analytical approaches


Friday, December 19, 2008

Some Explorations in the Sociology of Alcohol

Ron Roizen
Wallace, Idaho

History of Scientific Ideas:

Overlooking Terris (1999)

Wartime Paris, cirrhosis mortality, and the ceteris paribus assumption (2002)

Some notes on the new paradigmatic environment of "natural remission" studies in alcohol research (2001)

The coming crisis in alcohol social science (2000) -- pdf downloae, go to p. 91

Stalking the origins of historical U.S. per capita alcohol consumption statistics (1993)

The strange case of the Jellinek Formula's sex ratio (1980)

Ascription of problems to drinking (1975)
Some Explorations in the Sociology of Alcohol

Ron Roizen
Wallace, Idaho

Epidemiology & Cross Cultural Studies:

Some Explorations in the Sociology of Alcohol

Ron Roizen
Wallace, Idaho

Historical Change in Problem Definition, Problem Ownership, and Scientific Paradigms:

Indonesia drinkers face alcohol shortage

By Lucy Williamson
BBC News, Jakarta

They call it "the Bitching Session". Once a week, in the hushed cocktail lounge of Jakarta's Dharmawangsa Hotel, Miranti and her girlfriends gather.

They come for a proper gossip, and several glasses of the hotel's legendary chocolate martini.

We can bitch about work, boys, whatever we feel like, Miranti explained. But it is always at the Dharmawangsa because of that delicious chocolate martini.

Miranti is part of a growing class in Indonesia. She is 34, single, an architect.

Like her friends, she knows how to run a business, deal with jet-lag, and how to mix a margarita.

What she does not know is that she is at the heart of a battle being fought here in Jakarta - over alcohol. . . . . .

MillerCoors Voluntarily Agrees to Reformulate Sparks

MillerCoors today said it has reached an agreement with a coalition of state attorneys general to voluntarily reformulate Sparks to remove caffeine, taurine, guarana and ginseng from the product. The brewer also agreed not to produce caffeinated alcohol beverages in the future.

While the formulation, labeling, marketing and selling of Sparks was approved by federal regulatory authorities numerous times, the company decided to reformulate the product based on concerns expressed by the attorneys general.

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Wednesday, December 17, 2008

The Language of Intoxication: Preliminary Investigations
Alcoholism: Clinical and Experimental Research Published Online: 16 Dec 2008

The extensive vocabulary individuals use to describe alcohol's subjective effects has largely gone unexamined in contemporary alcohol research. The present study examined the language drinkers use to describe their own intoxication. It is argued that this language can provide a more complete characterization of alcohol's subjective effects than is available from existing objective and subjective measures of alcohol use and can inform future self-report research.

Exploratory factor analyses using data from the first sample and confirmatory factor analyses using data from the second sample similarly showed that commonly used terms loaded onto 2 factors, which directly reflected the number of drinks required to be considered moderately or heavily intoxicated, respectively. Gender differences were also found in the familiarity and self-use of some terms across both samples.

The findings suggest that alcohol researchers include multiple intoxication-related terms in future self-report research, and to periodically assess current intoxication-related vocabulary considering demographic, generational, and socio-cultural differences.

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Dopamine Enhances Fast Excitatory Synaptic Transmission in the Extended Amygdala by a CRF-R1-Dependent Process
The Journal of Neuroscience, December 17, 2008, 28(51):13856-13865

A common feature of drugs of abuse is their ability to increase extracellular dopamine levels in key brain circuits. The actions of dopamine within these circuits are thought to be important in reward and addiction-related behaviors.

Current theories of addiction also posit a central role for corticotrophin-releasing factor (CRF) and an interaction between CRF and monoaminergic signaling. One region where drugs of abuse promote robust rises in extracellular dopamine levels is the bed nucleus of the stria terminalis (BNST), a CRF-rich component of the extended amygdala.

We find that dopamine rapidly enhances glutamatergic transmission in the BNST through activation of a combination of D1- and D2-like receptors. This enhancement is activity-dependent and requires the downstream action of CRF receptor 1 (CRF-R1), suggesting that dopamine induces CRF release through a local network mechanism.

Furthermore, we found that both in vivo and ex vivo cocaine induced a dopamine receptor and CRF-R1-dependent enhancement of a form of NMDA receptor-dependent short-term potentiation in the BNST. These data highlight a direct and rapid interaction between dopamine and CRF systems that regulates excitatory transmission and plasticity in a brain region key to reinforcement and reinstatement.

Because a rise in extracellular dopamine levels in the BNST is a shared consequence of multiple classes of drugs of abuse, this suggests that the CRF-R1-dependent enhancement of glutamatergic transmission in this region may be a common key feature of substances of abuse.

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Early Release of Selected Estimates Based on Data From the January-June 2008 National Health Interview Survey

In this release, the National Center for Health Statistics (NCHS) updates estimates for 15 selected health measures based on data from the January-June 2008 National Health Interview Survey (NHIS) and presents estimates from 1997 through 2007 for comparison.

The 15 Early Release measures are being published prior to final data editing and final weighting to provide access to the most recent information from NHIS.

The estimates will be updated on a quarterly basis as each new quarter of the NHIS data becomes available.

Alcohol consumption
Figure 9.1. Percentage of adults aged 18 years and over who had 5 or more drinks in 1 day at least once in the past year: United States, 1997-June 2008

Figure 9.2. Percentage of adults aged 18 years and over who had 5 or more drinks in 1 day at least once in the past year, by age group and sex: United States, January-June 2008

Figure 9.3. Age-sex-adjusted percentage of adults aged 18 years and over who had 5 or more drinks in 1 day at least once in the past year, by race/ethnicity: United States, January-June 2008

Data tables for Figures 9.1-9.3

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Effects of MAOA-Genotype, Alcohol Consumption, and Aging on Violent Behavior

Alcoholism: Clinical and Experimental Research Published Online: 16 Dec 2008

Environmental factors appear to interact with a functional polymorphism (MAOA-LPR) in the promoter region of the monoamine oxidase A gene (MAOA) in determining some forms of antisocial behavior. However, how MAOA-LPR modulates the effects of other factors such as alcohol consumption related to antisocial behavior is not completely understood.

The risk for committing new acts of violence increased by 2.3% for each kilogram of increase in yearly mean alcohol consumption (p = 0.004) and decreased by 7.3% for every year among offenders carrying the high activity MAOA genotype. In contrast, alcohol consumption and aging failed to affect violent behavior in the low activity MAOA genotyped offenders. MAOA-LPR showed no main effect on the risk for recidivistic violence.

Violent offenders carrying the high activity MAOA genotype differ in several ways from carriers with the low activity MAOA risk allele previously associated with antisocial behavior. Finnish high activity MAOA genotyped risk alcoholics exhibiting antisocial behavior, high alcohol consumption, and abnormal alcohol-related impulsive and uncontrolled violence might represent an etiologically distinct alcohol dependence subtype.

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Gene expression profiling in blood: new diagnostics in alcoholism and addiction?
Neuropsychopharmacology (2009) 34, 250–251;

The successful treatment of most diseases relies heavily upon early detection. Biomarkers with diagnostic and prognostic value are critical to the addiction field. Most individuals with alcohol or drug dependence or use problems evade detection until severe medical, legal, or social consequences arise. The short half-life of alcohol in the blood after cessation of drinking eliminates the feasibility for using blood alcohol as a iomarker. Carbohydrate- deficient transferrin (CDT) is currently the most specific serum marker of chronic, heavy alcohol use (Reynaud et al, 2000), but the low sensitivity of the CDT test in the general population makes it an unreliable candidate for predicting either heavy alcohol use or for diagnosing alcohol abuse and/or dependence (Alte et al, 2004). Except for the drugs and their metabolites, there are not biomarkers for addiction.

Advances in the field of genomics offer new diagnostic and screening potential for complex genetic diseases like addiction. The ability to simultaneously measure the level of all possible transcripts (mRNAs) provides an unbiased view of potential biomarkers. The importance of understanding gene expression changes in alcohol and drug dependence can be appreciated by the impact of expression profiling in other diseases, most notably cancer, where studies have led to improved pharmacotherapies and to a molecular classification of disease.
. . . . . .
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Neuroscience: Pathways to Alcohol Dependence Part 1 — Overview of the Neurobiology of Dependence
Alcohol Research & Health Volume 31, Number 3, 2008

Strategies to Study the Neuroscience of Alcoholism: Introduction [PDF] Robert Hitzemann and Denesa Oberbeck
Positron Emission Tomography As a Tool for Studying Alcohol Abuse [PDF] Panayotis K. Thanos, Gene-Jack Wang,and Nora D. Volkow
From Event-Related Potential to Oscillations: Genetic Diathesis in Brain (Dys)Function and Alcohol Dependence [PDF] Madhavi Rangaswamy and Bernice Porjesz
The Use of Magnetic ResonanceSpectroscopy and Magnetic ResonanceImaging in Alcohol Research [PDF] Bonnie J. Nagel and Christopher D. Kroenke
Magnetic Resonance Imaging Approachesfor Studying Alcoholism Using Mouse Models [PDF] Eilis A. Boudreau, Gang Chen, Xin Li, andChristopher D. Kroenke
Laser-Assisted Microdissection [PDF] Denesa Oberbeck
Proteomic Solutions for Analytical ChallengesAssociated With Alcohol Research [PDF] Michael J. MacCoss and Christine C. Wu
On the Use of Short-Interfering RNAto Study Alcohol-Related Genes [PDF] Christopher A. Adams and W. Michael Zawada

Viral Delivery of Small-Hairpin RNAsfor Reducing Gene Expression in theRodent Brain [PDF]Amy W. Lasek and Ulrike Heberlein
Quantitative Trait Locus Analysis: MultipleCross and Heterogeneous Stock Mapping [PDF] Robert Hitzemann, John K. Belknap, andShannon K. McWeeney
Interval-Specific Congenic Animals for High-Resolution Quantitative Trait Loci Mapping [PDF] Deaunne L. Denmark, Lauren C. Milner,and Kari J. Buck
Single-Nucleotide Polymorphism Masking [PDF]Nicole A.R. Walter, Shannon K. McWeeney,Sandra T. Peters, John K. Belknap, RobertHitzemann, and Kari J. Buck
Expression Quantitative Trait Loci and thePhenoGen Database [PDF]Laura Saba, Paula L. Hoffman, CherylHornbaker, Sanjiv V. Bhave, and Boris Tabakoff
Integrative Genetic Analysis of AlcoholDependence Using the GeneNetworkWeb Resources [PDF]Robert W. Williams and Lu Lu
Conclusions [PDF]Robert Hitzemann and Denesa Oberbeck
Glossary [PDF]

VANCOUVER – British Columbia’s provincial health officer today released the findings of his alcohol policy report, revealing that per capita alcohol consumption in the province has increased eight per cent since 2002.

The 2008 report, Public Health Approach to Alcohol Policy, is an update to Dr. Perry Kendall’s 2002 alcohol policy report and indicates the rapid expansion in the number of liquor stores has likely contributed to an increase in consumption and revenues, but also to an increase in harms to health. The report also reviews government’s current alcohol policy and makes recommendations to reduce the health and social harms of alcohol while maintaining the economic and social benefits.

“While we recognize alcohol is part of many people’s social agenda, data clearly indicate the health and social costs of present patterns of alcohol consumption measurably outweigh the benefits,” said Kendall. “I encourage government to undertake a cross-ministry approach to addressing the role of alcohol in our society. The development of the government’s 10-year plan for mental health and addictions provides an opportunity for attention to our most costly substance use problem.”

In order to reverse the negative impacts of alcohol, Kendall also recommends government continues to monitor alcohol consumption patterns, focus on initiatives to reduce harmful alcohol use by youth, commit to reducing alcohol-impaired driving, increase resources for Fetal Alcohol Spectrum Disorder, and implement a small levy on high alcohol content drinks.

“Reports like this present useful information on patterns and trends that allow senior policy makers to discuss beneficial changes,” said Tim Stockwell from the Centre for Addictions Research of BC (CARBC), who co-authored the report.

The Public Health Approach to Alcohol Policy report is available at . . . . . .

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Tuesday, December 16, 2008

Health Survey for England 2007 Latest trends [NS]

The Health Survey for England is a series of annual surveys designed to measure health and health-related behaviours in adults and children living in private households in England. The survey was commissioned originally by the Department of Health and, from April 2005 by The NHS Information Centre for health and social care. Since 1994, the survey has been carried out by the National Centre for Social Research and the Department of Epidemiology at University College Medical School.

The trend tables focus upon key changes in core topics and measurements. The number estimates presented here for the first time convert the prevalences in the key trend tables into estimates of the numbers of people in the population in England that they represent
  • Trends in alcohol consumption between 1998 and 2007 are shown in Table 9, based on the heaviest drinking day in the last week. . . . . .


Health Survey for England 2007 Latest Trends (0.31MB)

Adult Trend Tables 2007 (0.53MB)

Children Trend Tables 2007 (0.49MB)

Population Number Estimate Tables 2007 (0.31MB)

Population Number Estimates - user guide (0.28MB)

Pre-release access list (0.03MB)


Health Survey for England 2007: Healthly lifestyles: knowledge, attitudes and behaviour [NS]

The Health Survey for England is a series of annual surveys designed to measure health and health-related behaviours in adults and children living in private households in England. The survey was commissioned originally by the Department of Health and, from April 2005 by The NHS Information Centre for health and social care. Since 1994, the survey has been carried out by the National Centre for Social Research and the Department of Epidemiology at University College Medical School.

The 2007 Health Survey for England focuses on knowledge, attitudes and behaviour on key aspects of lifestyle - smoking, drinking, eating and physical activity. Both adults and children were asked about their views on what constitutes healthy behaviour, their knowledge of government recommendations and the factors that may encourage or discourage healthy behaviour.

  • approximately nine in ten adults had heard of units of alcohol. However, fewer adults knew what the recommended maximum daily intake was - 35 per cent of men and 43 per cent of women had heard of units but said that they didn't know what the recommendations were for their sex. Only 14 per cent of men thought that four units was the recommended daily maximum for a man and 6 per cent of women thought that three units was the recommended daily maximum for a woman. A further 15 per cent of men and 23 per cent of women thought the recommendation was three units and two units respectively.
Summary of key findings
2 Introduction
5 Hypertension
6 Anthropometric measures, overweight and obesity
8 Physical activity: knowledge and attitudes
9 Diet and healthy eating
10 Cigarette smoking
11 Alcohol consumption
14 BMI, overweight and obesity
15 Physical activity: behaviour, knowledge and attitudes
16 Diet and healthy eating
17 Cigarette smoking and exposure to others’ smoke
18 Experience of alcohol: behaviour and attitudes
19 Reports on the 2007 Health Survey
19 Contact points


Monday, December 15, 2008

Effects of alcoholism severity and smoking on executive neurocognitive function
Addiction Volume 104 Issue 1, Pages 38 - 48

Neurocognitive deficits in chronic alcoholic men are well documented. Impairments include memory, visual–spatial processing, problem solving and executive function. The cause of impairment could include direct effects of alcohol toxicity, pre-existing cognitive deficits that predispose towards substance abuse, comorbid psychiatric disorders and abuse of substances other than alcohol. Cigarette smoking occurs at higher rates in alcoholism and has been linked to poor cognitive performance, yet the effects of smoking on cognitive function in alcoholism are often ignored.

We examined whether chronic alcoholism and chronic smoking have effects on executive function.

Both alcoholism and smoking were correlated negatively with a composite executive function score. For component measures, alcoholism was correlated negatively with a broad range of measures, whereas smoking was correlated negatively with measures that emphasize response speed. In regression analyses, both smoking and alcoholism were significant predictors of executive function composite. However, when IQ is included in the regression analyses, alcoholism severity is no longer significant.

Both smoking and alcoholism were related to executive function. However, the effect of alcoholism was not independent of IQ, suggesting a generalized effect, perhaps affecting a wide range of cognitive abilities of which executive function is a component. On the other hand, the effect of smoking on measures relying on response speed were independent of IQ, suggesting a more specific processing speed deficit associated with chronic smoking

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Systematic review of the literature on Fetal Alcohol Spectrum Disorders (FASD)

This systematic review of the literature on Fetal Alcohol Spectrum Disorders (FASD) evaluates the relative effectiveness of various prevention strategies aimed at reducing the burden of FASD.
The document also provides a less detailed review of the diagnosis and management literature, and provides information on the economic burden of FASD.
The review was commissioned by the Ministry of Health to inform development of an action plan to address FASD in New Zealand.

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Report highlights efficacy of pricing measures on alcohol consumption and harm

The second part of the University of Sheffield report, the 'Independent Review of the Effects of Alcohol Pricing and Promotion' was released last week as new measures were announced by the Home Secretary to tackle irresponsible drinks deals. The findings largely detail that alcohol pricing policies are effective in reducing alcohol related health, crime and social costs, yet will not be implemented by the government.
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Policy implications of the widespread practice of 'pre-drinking' or 'pre-gaming' before going to public drinking establishments—are current prevention strategies backfiring?
Addiction Volume 104Issue 1, Pages 4 - 9

To describe the research, policy and prevention implications of pre-drinking or pre-gaming; that is, planned heavy drinking prior to going to a public drinking establishment.

Heavy drinking prior to going out has emerged as a common and celebrated practice among young adults around the world. Apparent motivations are: (i) to avoid paying for high priced drinks at commercial drinking establishments; (ii) to achieve drunkenness and enhance and extend the night out; and (iii) to socialize with friends, reduce social anxiety or enhance male group bonding before going out. Limited existing research on pre-drinking suggests that it is associated with heavy drinking and harmful consequences.

We argue that policies focused upon reducing drinking in licensed premises may have the unintended consequence of displacing drinking to pre-drinking environments, possibly resulting in greater harms.

Effective policy and prevention for drinking in licensed premises requires a comprehensive approach that takes into account the entire drinking occasion (not just drinking that occurs in the licensed environment), as well as the 'determined drunkenness' goal of some young people

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Does the ‘gateway’ matter? Associations between the order of drug use initiation and the development of drug dependence in the National Comorbidity Study Replication
Psychological Medicine (2009), 39 : 157-167

The ‘gateway’ pattern of drug initiation describes a normative sequence, beginning with alcohol and tobacco use, followed by cannabis, then other illicit drugs. Previous work has suggested that ‘violations’ of this sequence may be predictors of later problems but other determinants were not considered.

We have examined the role of pre-existing mental disorders and sociodemographics in explaining the predictive effects of violations using data from the US National Comorbidity Survey Replication (NCS-R).

Gateway violations were largely unrelated to later dependence risk, with the exception of small increases in risk of alcohol and other illicit drug dependence for those who initiated use of other illicit drugs before cannabis. Early-onset internalizing disorders were predictors of gateway violations, and both internalizing and externalizing disorders increased the risks of dependence among users of all drugs.

Drug use initiation follows a strong normative pattern, deviations from which are not strongly predictive of later problems. By contrast, adolescents who have already developed mental health problems are at risk for deviations from the normative sequence of drug initiation and for the development of dependence.

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Alcohol and illicit drug dependence among parents: associations with offspring externalizing disorders
Psychological Medicine (2009), 39:149-155

Previous research indicates that alcohol and drug dependence constitute aspects of a general vulnerability to externalizing disorders that accounts for much of the parent-offspring resemblance for these and related disorders.

This study examined how adolescent offspring risk for externalizing psychopathology varies with respect to parental alcoholism and illicit drug dependence.

Data from the Minnesota Twin Family Study, a community-based investigation of adolescents (age 17 years, n=1252) and their parents, were used. Lifetime diagnoses of alcohol and drug dependence (among both parents and offspring) and offspring attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, adult antisocial behavior, and nicotine dependence were assessed via structured interviews.

Parental alcohol dependence and parental drug dependence were similarly associated with increased risk for nearly all offspring disorders, with offspring of alcohol and drug-dependent parents having approximately 2–3 times the odds for developing a disorder by late adolescence compared to low-risk offspring. Compared to parental dependence on other illicit drugs, parental cannabis dependence was associated with weaker increased risk for offspring externalizing disorders.

Both parental alcohol and drug dependence are independently associated with an increased risk for a broad range of externalizing psychopathology among late-adolescent offspring.

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Query for Aging Patients: How Much Do You Drink?

Published: December 15, 2008

Is alcohol a tonic or a toxin? The question is especially critical to older people, whose overall medical picture gives alcohol the potential to be a health benefit or a life-shortening hazard.

Yet experts say that doctors rarely ask older patients how much and how often they drink. Not knowing the answers to these questions can result in misdiagnosis, medical complications and life-threatening accidents. Doctors may also fail to recognize the symptoms of alcohol abuse, a problem that is expected to become increasingly common as baby boomers, who have been found to drink more than previous generations, reach age 65 and beyond.

At the same time, older people who are in good health should know that moderate drinking under the right conditions may improve their health in several important ways. In a comprehensive review in the October issue of The Journal of the American Dietetic Association, Maria Pontes Ferreira and M. K. Suzy Weems described the myriad health benefits and risks of alcohol consumption by aging adults.
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Alcohol Consumption by Aging Adults in the United States: Health Benefits and Detriments
Journal of the American Dietetic Association VColume 108, Issue 10, Pages 1668-1676 (October 2008)

The most rapidly growing segment of the US population is that of older adults (≥65 years). Trends of aging adults (those aged ≥50 years) show that fewer women than men consume alcohol, women consume less alcohol than men, and total alcohol intake decreases after retirement.

A U- or J-shaped relationship between alcohol intake and mortality exists among middle-aged (age 45 to 65 years) and older adults. Thus, alcohol can be considered either a tonic or a toxin in dose-dependent fashion.

Active areas of research regarding the possible benefits of moderate alcohol consumption among aging individuals include oxidative stress, dementia, psychosocial functioning, dietary contributions, and disease prevention.

Yet, due to the rising absolute number of older adults, there may be a silent epidemic of alcohol abuse in this group.

Dietary effects of moderate and excessive alcohol consumption are reviewed along with mechanisms by which alcohol or phytochemicals modify physiology, mortality, and disease burden. Alcohol pharmacokinetics is considered alongside age-related sensitivities to alcohol, drug interactions, and disease-related physiological changes. International guidelines for alcohol consumption are reviewed and reveal that many nations lack guidelines specific to older adults.

A review of national guidelines for alcohol consumption specific to older adults (eg, those offered by the National Institute on Alcohol Abuse) suggests that they may be too restrictive, given the current literature. There is need for greater quantification and qualification of per capita consumption, consumption patterns (quantity, frequency, and stratified combinations), and types of alcohol consumed by older adults in the United States.

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Tackle the alcohol problem at its source

Robin Room
December 15, 2008

THE Spaniards call it el botellón — "the big bottle" — the local teenagers' custom of congregating for noisy outdoor drinking parties in town squares. The custom and the term have spread to Switzerland where, perhaps unsurprisingly, a big concern is the litter left behind by drinkers in famously tidy streets.

There, as in other countries, it is in many ways a generational conflict that troubles municipal authorities and police.

Australia is not alone in its problem with intoxication among teenagers and young adults. But the problems caused by heavy drinking can vary from place to place. Australians, for example, are worried about the violence that accompanies intoxication. Britain also has these worries and indeed has suffered a rise in drunken violence.
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Alcohol Consumption and Risk Attitude

This study examines the effect of alcohol on individual preferences in lottery games of varying risk profiles.

The experiment was carried out in the field where the subjects were randomly sampled from a pool of visiting
adults in festive-mood who were in the natural environment for drinking and social interactions.
The results suggest that men’s risky behaviour is negatively correlated with alcohol expectancies, while women’s risky behaviour is negatively correlated with their actual alcohol consumption.
The environment seems to have an additional effect on the subject's risk preferences.

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Age–period–cohort modelling of alcohol volume and heavy drinking days in the US National Alcohol Surveys: divergence in younger and older adult trends
Addiction Volume 104 Issue 1, Pages 27 - 37

The decomposition of trends in alcohol volume and heavy drinking days into age, period, cohort and demographic effects offers an important perspective on the dynamics of change in alcohol use patterns in the United States.
Trend analyses show that while mean values of drinking measures have continued to decline for those aged 26 and older, there has been a substantial increase in both alcohol volume and 5+ days among those aged 18–25 years. Age–period–cohort models indicate a potential positive cohort effect among those born after 1975.
However, an alternative interpretation of an age–cohort interaction where drinking falls off more steeply in the late 20s than was the case in the oldest surveys cannot be ruled out. For women only, the 1956–60 birth cohort appears to drink more heavily than those born just before or after.
Models also indicate the importance of income, ethnicity, education and marital status in determining these alcohol measures.

Increased heavy drinking among young adults in recent surveys presents a significant challenge for alcohol policy and may indicate a sustained increase in future US alcohol consumption.
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CHIS 2007 Is Here!

The California Health Interview Survey (CHIS) today released its latest data on hundreds of topics affecting the health and well-being of Californians. The new 2007 survey includes nearly 200 variables on health topics that can be easily examined by state, region and county via the free AskCHIS web tool.

The 2007 survey is one of the largest CHIS surveys ever. More than 53,000 households participated, including over 51,000 adults and more than 13,000 teens and children.
A summary of key CHIS 2007 health topics by county or region can be found at: healthSNAPSHOTS.

The new survey introduced a number of innovations, including:
  • A new cell-phone-only sample to ensure participation of this growing type of household.

  • New questions about the Human Papilloma Virus (HPV) as well as new questions on mental health, health literacy, high deductible insurance plans and access to safe parks.

  • The look of the CHIS website was also updated to make navigation even easier.

Sunday, December 14, 2008

Drinks industry says no to link with drugs plan

The Sunday Times
December 14, 2008

A Government plan to include alcohol in a new national drugs strategy has angered the drinks industry

AN Irish government plan to include alcohol in its national drugs strategy is being opposed by the drinks industry.

John Curran, a junior minister in the Department of Community and Rural Affairs, wants to replace the national drugs strategy, which ran from 2001 to 2008, with one that deals with drugs and alcohol.

The Alcohol Beverage Federation of Ireland (ABF) said addressing legal alcohol consumption and illegal drug use together could be counter-productive. But Curran has defended the idea.

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