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, August 27, 2011

Russians need good wine, not vodka - Medvedev

Russia’s winemaking industry should be developed to help tackle widespread alcohol abuse, President Dmitry Medvedev said on Monday.

“Winemaking is one of the branches that should be developed and contribute to the eradication of alcoholism. Countries where this branch is strong, have no problems with alcohol abuse,” the president said at a meeting with the governor of Russia’s southern Krasnodar Territory, Alexander Tkachev.

Medvedev said problems with alcohol abuse stem from “other drinks.” > > > > Read More

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Russians still scoff at Mikhail Gorbachev’s anti-alcohol campaign that saw Soviet troops tearing down vineyards – but which only drove hardened drinkers’ determination to concoct their own booze.

A quarter of a century later the Kremlin is considering subtler, market-oriented methods to fight alcoholism that could give a boost to the domestic wine industry even if they fail to modify Russians’ excessive drinking habits.

“Wine making is one of the sectors that should be developed to help contribute to the eradication of alcoholism,” Dmitry Medvedev said during a visit to Krasnodar, one of Russia’s main wine producing region this week. Alcohol abuse stemmed from “other drinks,” the Russian president added in an apparent reference to his people’s love of vodka. > > > > Read More

Neuropeptide Y Signaling in the Central Nucleus of Amygdala Regulates Alcohol-Drinking and Anxiety-Like Behaviors of Alcohol-Preferring Rats

The neuropeptide Y (NPY) system of the central nucleus of amygdala (CeA) has been shown to be involved in anxiety and alcoholism. In this study, we investigated the molecular mechanisms by which NPY in the CeA regulates anxiety and alcohol drinking behaviors using alcohol-preferring (P) rats as an animal model.

P rats were bilaterally cannulated targeting the CeA and infused with aCSF or NPY. Alcohol drinking and anxiety-like behaviors were assessed by the two-bottle free-choice paradigm and light/dark box (LDB) exploration test, respectively. The levels of NPY and related signaling proteins were determined by the gold immunolabeling procedure. The mRNA levels of NPY were measured by in situ RT-PCR. Double-immunofluorescence labeling was performed to observe the colocalization of NPY and Ca2+/calmodulin dependent protein kinase IV (CaMK IV).

We found that NPY infusion into the CeA produced anxiolytic effects, as measured by the LDB exploration test, and also decreased alcohol intake in P rats. NPY infusion into the CeA significantly increased protein levels of CaMK IV and phosphorylated CREB (pCREB), and increased mRNA and protein levels of NPY, but produced no changes in protein levels of CREB or the catalytic α-subunit of protein kinase A (PKA-Cα) in the CeA. We also observed that alcohol intake produced anxiolytic effects in P rats in the LDB test and also increased NPY expression and protein levels of pCREB and PKA-Cα without modulating protein levels of CREB or CaMK IV, in both the CeA and medial nucleus of amygdala (MeA). In addition, we found that CaMK IV-positive cells were co-localized with NPY in amygdaloid structures of P rats.

These results suggest that NPY infusion may increase the expression of endogenous NPY in the CeA, which is most likely attributable to an increase in CaMK IV-dependent CREB phosphorylation and this molecular mechanism may be involved in regulating anxiety and alcohol-drinking behaviors of P rats.

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Opiate-Induced Dopamine Release Is Modulated by Severity of Alcohol Dependence: An [18F]Fallypride Positron Emission Tomography Study

Preclinical data implicate the reinforcing effects of alcohol to be mediated by interaction between the opioid and dopamine systems of the brain. Specifically, alcohol-induced release of β-endorphins stimulates μ-opioid receptors (MORs), which is believed to cause dopamine release in the brain reward system. Individual differences in opioid or dopamine neurotransmission have been suggested to be responsible for enhanced liability to abuse alcohol.

In the present study, a single dose of the MOR agonist remifentanil was administered in detoxified alcohol-dependent patients and healthy control subjects to mimic the β-endorphin-releasing properties of ethanol and to assess the effects of direct MOR stimulation on dopamine release in the mesolimbic reward system.

Availability of D2/3 receptors was assessed before and after single-dose administration of the MOR agonist remifentanil in 11 detoxified alcohol-dependent patients and 11 healthy control subjects with positron emission tomography with the radiotracer [18F]fallypride. Severity of dependence as assessed with the Alcohol Use Disorders Identification Test was compared with remifentanil-induced percentage change in [18F]fallypride binding (Δ%BPND).

The [18F]fallypride binding potentials (BPNDs) were significantly reduced in the ventral striatum, dorsal putamen, and amygdala after remifentanil application in both patients and control subjects. In the patient group, ventral striatum Δ%BPND was correlated with the Alcohol Use Disorders Identification Test score.

The data provide evidence for a MOR-mediated interaction between the opioid and the dopamine system, supporting the assumption that one way by which alcohol unfolds its rewarding effects is via a MOR-(γ-aminobutyric acid)-dopamine pathway. No difference in dopamine release was found between patients and control subjects, but evidence for a patient-specific association between sensitivity to MOR stimulation and severity of alcohol dependence was found.

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Strong Association of the Alcohol Dehydrogenase 1B Gene (ADH1B) with Alcohol Dependence and Alcohol-Induced Medical Diseases

The alcohol dehydrogenase 1B gene (ADH1B) is hypothesized to affect predisposition to alcohol dependence (AD) and abuse. A variant of the ADH1B gene (rs1229984 or Arg48His; previously referred to as Arg [*1] and His [*1]) has been reported to be associated with reduced rates of alcohol and drug dependence. Different studies have produced inconclusive results regarding association between rs1229984 (or rs2066702) and substance dependence.

Using the cumulative association study literature from the past 21 years from both English- and Chinese-language publications, this meta-analysis seeks to clarify the contradictory findings and to examine whether the aggregate data provide new evidence of significant association.

The results, based on a large sample size (9638 cases and 9517 controls), suggested strong associations with alcohol dependence and abuse as well as alcohol-induced liver diseases, with an allelic (Arg vs. His) p value being 1 × 10−36 and odds ratio (OR) (95% confidence intervals [CI]) 2.06 (1.84–2.31) under the random effects model. The dominant and recessive models produced larger ORs of 2.17 and 3.05, respectively. When more stringent criteria and subgroup analyses were imposed, the associations remained consistent and were strongest in various Asian groups (allelic p = 7 × 10−42 and OR (95% CI) = 2.24 [1.99–2.51] with ORs of 2.16 and 4.11 for dominant and recessive models, respectively).

Our findings provide further strong evidence for the involvement of the ADH1B gene in the pathogenesis of alcohol dependence and abuse as well as for some alcohol-induced medical diseases in the multiple ethnic populations—in particular, certain Asian populations.

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News Release - Poor parenting increases likelihood of binge drinking at ages 16 and 34

A study of over 15,000 children by the think tank Demos shows parenting style is one of the most important and statistically reliable influences on whether a child will drink responsibly in adolescence and adulthood.

Demos found that ‘tough love’ parenting, combining consistent warmth and discipline, was the most effective parenting style to prevent unhealthy relationships with alcohol right into the mid-thirties age range.

The report Under the Influence found that:

- Bad parenting at age 10 makes the child twice as likely to drink excessively at age 34

- Bad parenting at age 16 makes the child over eight times more likely to drink excessively at that age

- Bad parenting at age 16 makes the child over twice as likely to drink excessively at age 34

The report also found that high levels of parental warmth and attachment at an early age and strict discipline at the age of 16 are the best parenting styles to reduce the likelihood that a child will binge-drink in adolescence and adulthood. > > > > Read More

News Release - UK alcohol consumption in 2010 far lower than 2004 peak – new industry stats bible

• It’s time the alcohol consumption debate caught up with the facts, says BBPA Chief Executive Brigid Simmonds

• British pay more and more in alcohol taxes – and the tax gap with other countries is widening

• New BBPA Statistical Handbook has over 100 pages of all the latest facts

UK alcohol consumption in 2010 remains far lower than it was six years ago, with consumption continuing to flat-line - this and a wealth of other key statistics are contained in the latest annual edition of the British Beer & Pub Association’s Statistical Handbook 2011.
> > > > Read More

Chronically Homeless Women Report High Rates of Substance Use Problems Equivalent to Chronically Homeless Men

The U.S. federal government recently committed itself to ending chronic homelessness within 5 years. Women constitute one out of four chronically homeless adults and represent a particularly vulnerable group, but have been little studied. To identify potentially unique needs in this group, we report characteristics and 2-year outcomes in a large sample of male and female chronically homeless adults participating in a multisite, supportive

Men and women participating in the outcome evaluation of the 11-site Collaborative Initiative on Chronic Homelessness (n = 714) supportive housing program and who received at least one follow-up assessment were compared on baseline characteristics and up to 2-year follow-up outcomes. Mixed model multivariate regression adjusted outcome findings for baseline group differences.

Few significant baseline differences existed between males and females, with both sexes self-reporting very high rates of lifetime mental health (83% women, 74% men) and substance use (68% women, 73% men) problems. Throughout the 2-year follow-up, both men and women dramatically increased the number of days housed, showed minimal changes in substance use patterns, and had modest improvements in mental health outcomes, without significant differences between genders.

Unlike other U.S. populations, chronically homeless adults do not demonstrate substantial gender differences on mental health or addiction problems. Policy and service delivery must address these remarkably high rates of substance use and mental illness.

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Friday, August 26, 2011

Alcohol services condemn fines

SPECIALIST drug and alcohol workers should be deployed with police targeting public drunks, and new fines of up to $1100 should be used to boost treatment services, the Victorian Alcohol and Drug Association says.

The chief executive of the group that represents drug and alcohol services, Sam Biondo, said the Victorian government's new regime of higher fines for people found drunk in public ignored the complex needs of such people and had potential to drive alcohol-fuelled violence behind closed doors.

He said the state government should deploy trained drug and alcohol workers to deal with intoxicated people so they could be cared for and connected with specialist treatment when they sobered up. These workers should also be put in emergency departments instead of security guards as proposed by the government, Mr Biondo said. > > > > Read More

The practise and practice of Bourdieu: The application of social theory to youth alcohol research

Some years ago Australian anthropologist David Moore criticised the predominant form of understanding youth alcohol consumption for residing with biomedical approaches that individualise and ultimately stigmatise drinking behaviour and ‘ignore’ the social context of consumption. Of interest here is the ongoing insufficient integration of alternative approaches to understanding young people's drinking.

This paper presents theoretically informed qualitative research that investigates why young Australian females (aged 14–17) drink and how social and cultural context form the basis, rather than the periphery, of their drinking experience.

We demonstrate the utility of Pierre Bourdieu's sociological framework for delving beyond the dichotomy of young people's drinking decisions as either a determination of their cultural environment or the singular result of a rational individual's independent decision-making. The paper is presented in two parts. First, we provide the interpretation, or ‘practise’, of Bourdieu's concepts through an outline and application of his complex theoretical constructs. Specifically, the concept of symbolic capital (or social power) is applied. Second, our explication of Bourdieu's ‘practice’, or epistemological contributions, offers a methodologically grounded example to other researchers seeking to attain more complete understandings of the social processes underpinning youth alcohol consumption.

A sociological approach to exploring the complex relationship between drinking and contextual social factors amongst young Australian females is an unchartered area of enquiry. We contribute new theoretically supported insights to create a more complete picture of young females’ drinking behaviours.

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Substance use and recessions: What can be learned from economic analyses of alcohol?

In this paper, I conduct a review of the economics literature examining the relationship between alcohol use and the macro economy comparing methods, measures and findings.

Like illicit drug consumption, the relationship between alcohol use and economic conditions is not entirely straightforward since there are various theoretical explanations for why they might be positively or negatively related.

Empirical findings suggest that the relationship between drinking and the economy depends on the type of user and whether use is examined in developing or developed countries.

In developed countries, heavy drinkers consume less in a downturn, while light drinkers consume more. This pro-cyclical relationship found for heavy drinking does not hold for developed countries where disposable income is low.

The implications for researchers interested in understanding how illicit drug consumption varies with the business cycle are that they must be careful to consider differential responses across user types as well as expensive and inexpensive drugs.

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Where harm reduction meets housing first: Exploring alcohol's role in a project-based housing first setting

Housing first (HF) programmes provide low-barrier, nonabstinence-based, immediate, supportive and permanent housing to chronically homeless people who often have co-occurring substance-use and/or psychiatric disorders. Project-based HF programmes offer housing in the form of individual units within a larger housing project. Recent studies conducted at a specific project-based HF programme that serves chronically homeless individuals with alcohol problems found housing provision was associated with reduced publicly funded service utilisation, decreased alcohol use, and sizable cost offsets. No studies to date, however, have qualitatively explored the role of alcohol use in the lives of residents in project-based HF.

We collected data in a project-based HF setting via naturalistic observation of verbal exchanges between staff and residents, field notes taken during staff rounds, and audio recorded staff focus groups and resident interview sessions. Qualitative data were managed and coded using a constant comparative process consistent with grounded theory methodology. The goal of the analysis was to generate a conceptual/thematic description of alcohol's role in residents’ lives.

Findings suggest it is important to take into account residents’ motivations for alcohol use, which may include perceived positive and negative consequences. Further, a harm reduction approach was reported to facilitate housing attainment and maintenance. Residents and staff reported that traditional, abstinence-based approaches are neither desirable nor effective for this specific population. Finally, elements of the moral model of alcohol dependence continue to pervade both residents’ views of themselves and the community's perceptions of them.

Findings suggest it is necessary to set aside traditional models of alcohol use and approaches to better understand, align with, and address this population's needs. In doing so, we might gain further insights into how to enhance the existing project-based HF approach by applying more tailored, alcohol-specific, harm reduction interventions.

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Latest LAPE alcohol figures hit headlines over rising hospital admissions

Updated Local Alcohol Profiles for England (LAPE 2011) figures have been released, drawing media attention to areas with highest rates of harm and a continuing upwards national trend. Total alcohol-related admissions for England reached over one million in 2009/10; an increase of 879 alcohol-related admissions per day compared to five years ago.

The figures indicate that over the five years to 2009/10 there has been a 24.6% increase in the number of people being admitted to hospital due to alcohol specific conditions. However LAPE now includes data indicating there are more than six million people over 16 in England who do not drink alcohol. Patterns of abstention relate strongly to ethnicity as estimates range from 6.4% of adults in Mid Devon to 48.0% in London's Newham borough.
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Client–Provider relationship in comprehensive substance abuse treatment: Differences in residential and nonresidential settings

As the substance abuse service system shifts from primarily residential to primarily nonresidential settings, it becomes important to understand how substance abuse treatment processes and outcomes may vary across service setting. Research increasingly indicates that, along with specific treatment and service strategies, client–provider relationship is an important ingredient in effective substance abuse treatment.

This study uses a moderator–mediator analysis of a comprehensive service model to examine how the relation between client–provider relationship and substance abuse treatment outcomes may differ in residential and nonresidential settings.

The study used data collected for the National Treatment Improvement Evaluation Study, a prospective, cohort-based study of U.S. substance abuse treatment programs and their clients, with an analytic sample of 59 publicly funded service delivery units and 3,027 clients.

Structural equation modeling is used to assess the structural relations and causal connections between treatment process and treatment outcome variables.

Results indicate that for nonresidential settings, a better client–provider relationship is directly related to improved outcomes of treatment duration and reduced posttreatment substance use and is indirectly related to both outcomes through provision of services matched to client needs.

In residential settings, the quality of the client–provider relationship is unrelated to process or outcome variables.

The findings point to the importance of the client–provider relationship in all settings but particularly in outpatient settings where there are limited physical constraints on the treatment process.

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Thursday, August 25, 2011


The UK Recovery Federation (UKRF) are delighted to announce the 2nd annual UKRF Recovery Summit (Friday 9th September 2011) and the 3rd UK Recovery Walk (Saturday 10th September 2011)

‘Many Pathways to Recovery: Building on our Strengths’


‘Creating a UK-wide Recovery Consensus: Lessons from the US’
Keith Humphreys (Professor of Psychiatry at Stanford University)


'Building a Recovery Movement : Faces & Voices of Recovery'
Carol McDaid (Out-going Chair FAVOR)


'Building a Recovery-Oriented Integrated System (ROIS)'
John Strang (National Addictions Centre, King's College, London)


'Rolls ROIS: What is one & How do we get there?'
Colin Wilkie-Jones (Chief Executive EATA)


‘Harm Reduction and Recovery: What’s our future?’
Neil Hunt (University of Kent, UK Harm Reduction Alliance)


‘Recovery in the community: The challenges & opportunities’
Brian Morgan (SU Coordinator W.Sussex DAAT, EXACT, Whole Person Recovery Project)

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News Release - Alcohol select committee continues to disappoint communities

The Drug Foundation today expressed surprise that the Justice and Electoral Committee recommended only tinkering to the Alcohol Reform Bill, saying that many thousands of submitters had expected much greater improvements to the Bill.

The Committee received an unprecedented 8,822 written submissions, and in-fact had to split themselves in half in order to hear from the more than 352 oral submitters.

“The vast majority of submitters urged the Committee to strengthen the Bill, particularly asking for tougher controls over alcohol advertising and an increase to the price of alcohol, which were measures first recommended by Sir Geoffrey Palmer’s Law Commission report,” said Drug Foundation executive director Ross Bell.

“The modest amendments suggested by a Select Committee majority will be a blow to the many communities and concerned individuals who made the effort to have their say on this Bill and who expected much more from the Committee,” said Mr Bell. > > > > Read More

Govt considers further alcohol restrictions

The Government will set up an expert forum to look into further restrictions on alcohol advertising and sponsorship, as its refusal to budge on higher alcohol prices comes under fire.

The Alcohol Reform Bill was reported back from the justice and electoral select committee today. Most of the major elements were unchanged, including:

# A split alcohol purchase age of 18 for bars and restaurants and 20 for liquor shops and supermarkets

# Making it illegal to supply under 18s with alcohol without parental consent

# National trading hours of 7am-11pm for liquor outlets and 8am-4am for bars and clubs, though these can be altered by local authorities

# Empowering local authorities to grant licences based on the concentration, location and hours of alcohol outlets > > > > Read More

Alcohol Reform Bill

This bill implements the Government's decisions on the reform of alcohol legislation; decisions made in response to the Law Commission's 2010 report on alcohol.

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Hangover Predicts Residual Alcohol Effects on Psychomotor Vigilance the Morning After Intoxication

Both hangover and performance deficits have been documented the day after drinking to intoxication after breath alcohol concentration (BrAC) has returned to near zero. But few studies have examined the relationship between hangover and post-intoxication performance.

We performed secondary analyses of data from a previously reported controlled cross-over laboratory study to assess the relationship of hangover incidence and severity to sustained attention/reaction time the morning after drinking to about 0.11 g% BrAC. Relationships were investigated while controlling for gender, type of alcoholic beverage (bourbon or vodka), and neurocognitive performance after placebo.

Hangover severity and neurocognitive performance were significantly correlated. Participants reporting stronger hangover were more impaired than those reporting little or no hangover. Comparing any to no hangover showed a trend in the same direction of effect.

More intense hangover may indicate less fitness for duty in workers in certain safety-sensitive occupations, with implications for occupational alcohol policies.

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Hangover sensitivity after controlled alcohol administration as predictor of post-college drinking

Predicting continued problematic levels of drinking after the early 20's could help with early identification of persons at risk.

This study investigated whether hangover insensitivity could predict postcollege drinking and problems beyond the variance due to drinking patterns.

In a preliminary study, 134 college seniors from a laboratory study of hangover (Time 1) were contacted and assessed 1–4 years (M = 2.3) later (Time 2). Hangover severity was studied after controlled alcohol administration to a specific dose while controlling sleep and environmental influences. Hangover severity at Time 1 was used to predict Time 2 drinking volume and problems while controlling for relevant demographics and Time 1 drinking volume.

Hangover insensitivity at Time 1 tended to predict a clinical level of alcohol problems with a large statistical effect size. Hangover sensitivity also correlated positively with sensitivity to alcohol intoxication. Hangover severity did not predict future drinking volume.

Hangover insensitivity correlates with insensitivity to intoxication and might predict more serious alcohol problems in the future, suggesting that a future larger study is warranted.

Hangover insensitivity could result from physiological factors underlying low sensitivity to alcohol or risk for alcoholism

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Olfactory Impairment Is Correlated with Confabulation in Alcoholism: Towards a Multimodal Testing of Orbitofrontal Cortex

Olfactory abilities are now a flourishing field in psychiatry research. As the orbitofrontal cortex appears to be simultaneously implicated in odour processing and executive impairments, it has been proposed that olfaction could constitute a cognitive marker of psychiatric states. While this assumption appears promising, very few studies have been conducted on this topic among psychopathological populations.

The present study thus aimed at exploring the links
between olfaction and executive functions. These links were evaluated using two tasks of comparable difficulty, one knownto rely on orbitofrontal cortex processing (i.e., a confabulation task), and one not associated with this area (i.e., Stop-Signal task).

Twenty recently detoxified alcoholic individuals and twenty paired controls took part in an experiment evaluating olfactory abilities and executive functioning (i.e., Stop-Signal task and confabulation task). Comorbidities and potential biasing variables were also controlled for. Alcoholic individuals exhibited impaired performance for high-level olfactory processing and significant confabulation problems as compared to controls (but no deficit in Stop-
Signal task), even when the influence of comorbidities was taken into account. Most importantly, olfactory abilities and confabulation rates were significantly correlated in both groups.

Alcoholism jointly leads to olfactory and memory source impairments, and these two categories
of deficits are associated. These results strongly support the proposition that olfactory and confabulation measures both index orbitofrontal functioning, and suggest that olfaction could become a reliable cognitive marker in psychiatric
disorders. Moreover, it underlines the need to take into account these olfactory and source memory impairments in a clinical context.

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Investigating Mechanisms Linking Social Relationships to Health: Socialization, Coping Strategies, and Abstinence in Alcoholics Anonymous

Research has long documented the association between social relationships and health; for over 30 years, however, the literature has consistently called attention to the need to explain how social relationships have their effects.

The present research brings a cultural sociology approach to this gap, exploring socialization processes underlying the emergence of coping strategies.

Analysis relies on a qualitative study of Alcoholics Anonymous. Initially, I find that two types of groups, “structured” and “social,” exist and that members of structured groups tend to have higher levels of long-term abstinence.

I then explore underlying processes in the socialization of members of structured groups that might account for this discrepancy.

My research suggests that a key reason for the discrepancy lies in the fact that structured groups transmit a repertoire of problem-focused coping strategies to their members, which are used as resources to moderate the stressors that lead to compulsive drinking.

My research therefore begins to shed light on a significant and long-standing gap in the health and illness literature by explicating underlying processes through which socialization patterns moderating resources in the stress process.

In doing so, it lends additional weight to the growing emphasis on cultural sociology as a means to better specify explanatory mechanisms and suggests the need for a wealth of future research investigating cultural mechanisms underlying the stress process.

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Community organization moderates the effect of alcohol outlet density on violence

There is growing evidence from multiple disciplines that alcohol outlet density is associated with community levels of assault.

Based on the theoretical and empirical literatures on social organization and crime, we tested the hypothesis that the association between alcohol outlet density and neighborhood violence rates is moderated by social organization.

Using geocoded police data on assaults, geocoded data on the location of alcohol outlets, controlling for several structural factors thought to be associated with violence rates, and accounting for any spatial autocorrelation, we tested this hypothesis employing negative binomial regression with our sample of 302 block groups in Cincinnati.

Our results revealed direct effects of alcohol outlet density and social organization on assault density, and these effects held for different outlet types (i.e., off-premise, bars, restaurants) and levels of harm (i.e., simple and aggravated assaults).

More importantly, we found that the strength of the outlet-assault association was significantly weaker in more socially organized communities. Subsequent analyses by level of organization revealed no effects of alcohol outlet density on aggravated assaults in organized block groups, but significant effects in disorganized block groups. We found no association between social (dis)organization and outlet density.

These results clarify the community-level relationship between alcohol outlets and violence and have important implications for municipal-level alcohol policies.

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Alcohol Outlets and Community Levelsof Interpersonal Violence: Spatial Density, Outlet Type, and Seriousness of Assault

This study examined the association between alcohol outlets and violence. Employing Cincinnati block groups as units of analysis, the authors estimated spatially lagged regression models to determine if the variation in spatial density of alcohol outlets is related to the spatial density of simple and aggravated assaults.

The authors estimated separate models for off-premise outlets, bars, and restaurants.

The results revealed a positive and significant association between outlet density and assault density. This association held for simple and aggravated assaults and for total outlet density and the density of each type of outlet.

Further tests showed the outlet-violence association to be stronger for off-premise outlets relative to bars and restaurants and for simple relative to aggravated assaults.

Estimation of attributable fractions (AFs) showed that off-premise outlets may account for approximately one-quarter and one-third of simple and aggravated assaults, respectively.

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Amount and type of alcohol consumption and missing teeth among community-dwelling older adults: findings from the Copenhagen Oral Health Senior study

To study if an association between total weekly intake of alcohol, type-specific weekly alcohol intake, alcoholic beverage preference, and the number of teeth among older people exists.

A cross-sectional study including a total of 783 community-dwelling men and women aged 65-95 years who were interviewed about alcohol drinking habits and underwent a clinical oral and dental examination. Multiple regression analyses were applied for studying the association between total weekly alcohol consumption, beverage-specific alcohol consumption, beverage preference (defined as the highest intake of one beverage type compared with two other types), and the number of remaining teeth (≤20 versus >20 remaining teeth).

The odds ratio (OR) of having a low number of teeth decreased with the total intake of alcohol in women, with ORs for a low number of teeth of 0.40 [95 percent confidence interval (CI) 0.22-0.76] in women drinking 1-14 drinks per week and 0.34 (95 percent CI 0.16-0.74) in women with an intake of more than 14 drinks per week compared with abstainers. Similar relations could also be obtained for type-specific alcohol intake of wine and for wine and spirits preference among women. Men who preferred beer showed a decreased risk for a low number of teeth compared with men with other alcohol preferences.

In this study, alcohol consumption, wine drinking, and wine and spirits preference among women were associated with a higher number of teeth compared with abstainers. Among men, those who preferred beer also had a higher number of teeth.

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Twelve-month follow-up of aftercare for adolescents with alcohol use disorders

Adolescents with alcohol use disorders (AUDs) previously completed a randomized controlled outpatient aftercare study (Y. Kaminer, J. A. Burleson, & R. H. Burke, 2008) in which they were randomly assigned to in-person, brief telephone, or no-active aftercare. Youth were assessed at end of aftercare and at 3-, 6-, and 12-month follow-up on frequency and quantity of alcohol use.

It was predicted that active aftercare (in-person and brief telephone) would be superior to no-active aftercare in reducing alcohol use, as shown in the original study.

No subject or therapy group attributes were significant moderators of outcome.

Active aftercare in general maintained short-term favorable effects by reducing relapse in youth with AUD and should be considered as part of standard procedures in therapeutic interventions for all alcohol and other substance use.

In-person and the brief telephone procedures did not differ in their effectiveness.

Structured communications with AUD youth during and after treatment by use of electronic technology rather than in-person contact might therefore be more fully investigated.

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Non-alcoholic Beer Reduces Inflammation And The Incidence Of Upper Respiratory Tract Infections After A Marathon

Strenuous exercise significantly increases the incidence of upper respiratory tract infections (URTI) caused by transient immune dysfunction. Naturally occurring polyphenolic compounds present in food such as non-alcoholic beer (NAB) have strong anti-oxidant, anti-pathogenic, and anti-inflammatory properties.

To determine whether the ingestion of non-alcoholic beer polyphenols for three weeks prior to the Munich Marathon would attenuate post-race inflammation and decrease URTI incidence.

Healthy male runners (N=277, age 42±9 y) were randomly assigned to 1-1.5 L/day NAB or placebo (PL) beverage (double-blinded design) for three weeks before and two weeks after the Munich Marathon. Blood samples were collected 4- and 1-week pre-race, and immediately-, 24-h-, and 72-h-post-race, and analyzed for inflammation measures (IL-6 and total blood leukocyte counts). URTI rates, assessed by the Wisconsin Upper Respiratory Symptom Survey (WURSS-21), were compared between groups during the 2-week period following the race.

Change in IL-6 was significantly reduced in NAB compared to PL immediately post-race [median (interquartile range): ng/L 23.9 (15.9 - 38.7) ng/L vs. 31.6 (18.5 - 53.3), p = 0.03]. Total blood leukocyte counts were also reduced in NAB versus PL by approximately 20% immediately- and 24-h-post-race (p=0.02). Incidence of URTI was 3.25-fold lower (95%-CI 1.38-7.66) (p=0.007) in NAB compared to PL during the 2-week post-marathon period.

Consumption of 1-1.5 L/day non-alcoholic beer for three weeks before and two weeks after marathon competition reduces post-race inflammation and URTI incidence.

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Conditioned Tolerance to the Effects of Alcohol on Inhibitory Control in Humans

To test whether the repeated consumption of alcohol in a particular environment leads to the emergence of a context-specific conditioned compensatory response (CCR) that can counter alcohol's impairment of inhibitory processes.

Twenty-four participants consumed an alcoholic drink (males: 0.65 g/kg; females: 0.57 g/kg) in one context on three sessions and a matched placebo drink in a different context on three other sessions. At test, participants were split into two groups and consumed a novel alcoholic drink either in the context previously paired with alcohol or the placebo-paired context. On all sessions, participants were tested on two computer-based tasks that measured response inhibition: an affective go/no-go task and a stop-signal task (SST).

Over the conditioning trials, tolerance developed to alcohol's disinhibitory effects on the go/no-go task; moreover, on the test for conditioned responding, performance was less impaired for participants in the alcohol-paired versus the placebo-paired context. No tolerance was evident on the SST, and no CCR.

Repeated consumption of alcohol in a particular environment can lead to the emergence of a context-specific CCR that counters some of alcohol's disinhibitory effects. Therefore, consuming alcohol in an unfamiliar context might produce stronger disinhibitory effects than would be apparent in a familiar drinking environment.

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Wednesday, August 24, 2011

Topography of Drinking Behaviours in England

Previous research has demonstrated that a sizable proportion of England population
drink alcohol at a level associated with a range of health, crime and economic outcomes. Men who regularly drink over 50 units per week (or eight units per day) and women who regularly drink over 35 units per week (or six units per day) are most at risk of developing alcohol-related illness or injuries or being admitted to hospital. Levels of alcohol consumption (and associated harms) have changed over the last decade and so updated estimates are necessary to understand the current situation.

This report presents updated model-based figures (known as synthetic estimates) for
the numbers and proportions of abstainers, lower risk (sensible), increasing risk (hazardous) and higher risk (harmful) drinkers for all local authorities in England for 2008 (see Table 1 for definitions of abstainers and different drinking levels). These estimates, commissioned by the Department of Health and produced by the North West Public Health Observatory, replace the harmful and hazardous drinking estimates based upon data for 2000/02.

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The Big Drink Debate: perceptions of the impact of price on alcohol consumption from a large scale cross-sectional convenience survey in north west En

A large-scale survey was conducted in 2008 in north west England, a region with high levels of alcohol-related harm, during a regional 'Big Drink Debate' campaign. The aim of this paper is to explore perceptions of how alcohol consumption would change if alcohol prices were to increase or decrease.

A convenience survey of residents (>18 years) of north west England measured demographics, income, alcohol consumption in previous week, and opinions on drinking behaviour under two pricing conditions: low prices and discounts and increased alcohol prices (either 'decrease', 'no change' or 'increase'). Multinomial logistic regression used three outcomes: 'completely elastic' (consider that lower prices increase drinking and higher prices decrease drinking); 'lower price elastic' (lower prices increase drinking, higher prices have no effect); and 'price inelastic' (no change for either).

Of 22,780 drinkers surveyed, 80.3% considered lower alcohol prices and discounts would increase alcohol consumption, while 22.1% thought raising prices would decrease consumption, making lower price elasticity only (i.e. lower prices increase drinking, higher prices have no effect) the most common outcome (62%). Compared to a high income/high drinking category, the lightest drinkers with a low income (adjusted odds ratio AOR=1.78, 95% confidence intervals CI 1.38-2.30) or medium income (AOR=1.88, CI 1.47-2.41) were most likely to be lower price elastic. Females were more likely than males to be lower price elastic (65% vs 57%) while the reverse was true for complete elasticity (20% vs 26%, P<0.001).

Lower pricing increases alcohol consumption, and the alcohol industry's continued focus on discounting sales encourages higher drinking levels. International evidence suggests increasing the price of alcohol reduces consumption, and one in five of the surveyed population agreed; more work is required to increase this agreement to achieve public support for policy change. Such policy should also recognise that alcohol is an addictive drug, and the population may be prepared to pay more to drink the amount they now feel they need.

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'New media, new problem'-children exposed to online alcohol marketing says Alcohol Concern

A new report from Alcohol Concern looks at how children and young people are at risk of being exposed to alcohol marketing and pro-drinking messages via the internet. Download New Media, New Problem

'The report reveals the growing importance to alcohol companies of social networking sites (SNSs) like Facebook and video sharing sites such as YouTube as a means of promoting their products, and the inadequacies of online age verification pages aimed at preventing under 18s from accessing content intended for adults.

It also highlights the frequent practice of users of SNSs posting pictures and descriptions of themselves drinking and being drunk, and asks why so many of us choose to publicise our alcohol consumption in this way.' > > > > Read More

How Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) Work: Cross-Disciplinary Perspectives

Evidence from multiple lines of research supports the effectiveness and practical importance of Alcoholics Anonymous and Narcotics Anonymous.

Conference presenters discussed the relationship between 12-Step participation and abstinence among various populations, including adolescents, women, and urban drug users. Insight from the arts and humanities placed empirical findings in a holistic context.

This article summarizes the conference presentations including recommendations for treatment and further research.

The original presentations can be streamed online at

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Tuesday, August 23, 2011

Global Actions August 23, 2011

Global Actions Spotlight: Enhanced Enforcement Workshop in Da Nang

ICAP and the National Traffic Safety Committee (NTSC) held the Global Actions Drink Driving Enhanced Enforcement Program on August 16 through 18 in Da Nang. Participants received field training in drink driving enforcement and developed action plans for future enforcement strategies. “Effective law enforcement is a critical aspect of drink driving prevention initiatives,” said Global Actions Vietnam Country Manager Lan Huong Nguyen. Local law enforcement received guidance on effective methods of addressing drink driving and road safety issues.

The program was led by members of NTSC, Da Nang Police Department, and Da Nang Traffic Safety Committee (TSC). International road safety specialist Ray Shuey served as the program trainer. Ray’s experience includes 41 years of police work and expertise in developing capacity-building programs specifically for drink driving enforcement in Vietnam and China. “Our biggest success was enabling the officers to understand the big picture approach to drink driving enforcement strategies,” said Shuey. “It is important to create a highly visible and active police enforcement program that is intrinsically combined with community education and awareness programs.” Participants formed checkpoint groups to enforce and apply real penalties. Traffic police trainees received breathalyzer training. “The donation of breathalyzer testing equipment combined with the training program enabled the officers to be totally professional in the field,” said Shuey. “Most of the participants confirm that it is easy to use the ICAP funded breathalyzers,” said Nguyen. “Before the workshop, most of them said that using the breathalyzers was very complicated and difficult.” Nguyen reports that 30 police participants are currently working on enforcement, applying the skills and knowledge gained from this program into their daily work.

What’s Happening Next

· Colombia: August 30-31, PACTOS seminar in Bogotá.
· Mexico: September, Drink Drive launch event in Mexico City.
· Argentina: September 14-17, Self-Regulation CONARED conference.
· China: September 16-18, Drink Drive training workshop for local staff in Xi’an.
· China: September 20-22, Drink Drive training workshop for local staff in Nanjing.
· Nigeria: September 20-21, Capacity-building program for the Lagos-Apapa intervention at the Protea Maryland Hotel, Lagos.

The rise of binge drinking in China

Peter Chi knows he has to cut back on his drinking. It is not much fun at the best of times, and the worst have included hospitalisation – after drinking fake alcohol – and the numerous evenings where he has passed out at the table.

"No one likes binge drinking, but it's not under your control," he complains. "Of course I don't like it, but there's nothing I can do."

Chi, from north-eastern Liaoning province, is not an alcoholic. Nor is he a party animal, despite his four-times-a-week binges. But as a respectable headteacher in his 40s, he feels he has little choice but to indulge – or risk harming his career. In the west, binge drinking is associated with young men and women spilling out of pubs and clubs in the early hours of the mornings. But in China drinkers are older and – in many cases – drinking not just for fun but for career reasons.

"If I drink, it doesn't necessarily help me get promoted. But if I don't, it's less likely that I will be. So I must drink, even if it's not pleasant at all," Chi explains. "People want to show they are forthright and try to get along with others … It's very normal to get an order to drink from bosses." > > > > Read More

Portman Group will monitor Responsibility Deal labelling pledge

The Portman Group, the industry's social responsibility body, is to monitor and report on the industry’s progress on the voluntary labelling pledge.

The pledge to provide responsible drinking information on 80 per cent of alcohol labels on UK shelves by 2013 was set out as part of the Government's controversial Responsibilty Deal earlier this year. > > > > Read More

Assessing State Substance Abuse Prevention Infrastructure Through the Lens of CSAP's Strategic Prevention Framework

Although the organizational structures and operating procedures of state substance abuse prevention systems vary substantially across states, there is scant empirical research regarding approaches for rigorous assessment of systems attributes and which attributes are most conducive to overall effectiveness.

As one component of the national cross-site evaluation of the SPF State Incentive Grant Program (SPF SIG), an instrument was developed to assess state substance abuse prevention system infrastructure in order to measure infrastructure change and examine the role of state infrastructure in achieving prevention-related outcomes.

In this paper we describe the development of this instrument and summarize findings from its baseline administration.

As expected, states and territories were found to vary substantially with respect seven key characteristics, or domains, of state prevention infrastructure. Across the six domains that were assessed using numeric ratings, states scored highest on data systems and lowest on strategic planning. Positive intercorrelations were observed among these domains, indicating that states with high capacity on one domain generally have relatively high capacity on other domains as well.

The findings also suggest that state prevention infrastructure development is linked to both funding from state government and the presence of a state interagency coordinating body with decision-making authority.

The methodology and baseline findings presented will be used to inform the ongoing national cross-site evaluation of the SPF SIG and may provide useful information to guide further research on state substance abuse prevention infrastructure.

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Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost–benefit analysis of the program.

Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration.

Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant.

Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs.

The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.

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Cognitive Processes in Alcohol Binges: A Review and Research Agenda

Alcohol abuse is associated with a cluster of long-term changes in cognitive processes, as predicted by contemporary models of addiction.

In this paper we review evidence which suggests that similar changes may occur during an alcohol binge, and as such they may play an important role in explaining the loss of control over alcohol consumption that occurs during alcohol binges.

As a consequence of both acute alcohol intoxication (alcohol ‘priming’ effects) and exposure to environmental alcohol-related cues, we suggest that a number of changes in cognitive processes are likely. These include increased subjective craving for alcohol, increased positive and arousing outcome expectancies and implicit associations for alcohol use, increased attentional bias for alcohol-related cues, increased action tendencies to approach alcohol, increased impulsive decision-making, and impaired inhibitory control over drives and behaviour.

Potential reciprocal relationships between these different aspects of cognition during an alcohol binge are discussed.

Finally, we discuss the relationship between the current model and existing models of cognitive processes in substance abuse, and we speculate on the implications of the model for the reduction binge drinking and its consequences.

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