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, May 5, 2012

The predictive validity of the Drinking-Related Cognitions Scale in alcohol-dependent patients under abstinence-oriented treatment

Cognitive factors associated with drinking behavior such as positive alcohol expectancies, self-efficacy, perception of impaired control over drinking and perception of drinking problems are considered to have a significant influence on treatment effects and outcome in alcohol-dependent patients. However, the development of a rating scale on lack of perception or denial of drinking problems and impaired control over drinking has not been substantial, even though these are important factors in patients under abstinence-oriented treatment as well as participants in self-help groups such as Alcoholics Anonymous (AA). The Drinking-Related Cognitions Scale (DRCS) is a new self-reported rating scale developed to briefly measure cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment, including positive alcohol expectancies, abstinence self-efficacy, perception of impaired control over drinking, and perception of drinking problems. Here, we conducted a prospective cohort study to explore the predictive validity of DRCS.

Participants in this study were 175 middle-aged and elderly Japanese male patients who satisfied the DSM-IV Diagnostic Criteria for Alcohol Dependence. DRCS scores were recorded before and after the inpatient abstinence-oriented treatment program, and treatment outcome was evaluated one year after discharge.

Of the 175 participants, 30 were not available for follow-up; thus the number of subjects for analysis in this study was 145. When the total DRCS score and subscale scores were compared before and after inpatient treatment, a significant increase was seen for both scores. Both the total DRCS score and each subscale score were significantly related to total abstinence, percentage of abstinent days, and the first drinking occasion during the one-year post-treatment period. Therefore, good treatment outcome was significantly predicted by low positive alcohol expectancies, high abstinence self-efficacy, high perception level of impaired control over drinking, and high perception level of drinking problems measured by DRCS.

The DRCS was considered to have satisfactory predictive validity, which further supports our previous findings. It was suggested that DRCS is a promising rating scale for evaluating multidimensional cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment.

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Relationship between drinking patterns and the risk of type 2 diabetes: the Kansai Healthcare Study

Moderate alcohol consumption is associated with a decreased risk of type 2 diabetes. However, the relationship between drinking patterns, such as the weekly frequency of alcohol consumption and the quantity per drinking day, and the incidence of type 2 diabetes has not been sufficiently addressed.

Study participants included 10 631 Japanese men aged 40–55 years without type 2 diabetes at entry. Type 2 diabetes was diagnosed if a fasting plasma glucose level was ≥7.0 mmol/l or if participants were taking diabetes medications. Data on alcohol consumption were obtained from questionnaires.

During the 37 172 person-years of follow-up, we confirmed 878 cases of type 2 diabetes. Frequent alcohol consumption was associated with a low risk of type 2 diabetes. Compared to non-drinkers, the multiple-adjusted HR for those who drank 4–7 days weekly was 0.76 (95% CI, 0.63 to 0.92). To assess the association between drinking pattern and type 2 diabetes, we examined the joint association of the weekly frequency and the quantity per drinking day with type 2 diabetes. Men who consumed 0.1–2.0 or 2.1–4.0 US standard drinks per drinking day on 4–7 days weekly had a lower risk of type 2 diabetes (HR 0.74, 95% CI 0.58 to 0.95; HR 0.74, 95% CI 0.60 to 0.91, respectively) compared to non-drinkers.

More frequent alcohol consumption lowered the risk of type 2 diabetes. Light to moderate alcohol consumption per drinking day on 4–7 days weekly lowered the risk of type 2 diabetes compared to non-drinkers.

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Drinking in context: the influence of gender and neighbourhood deprivation on alcohol consumption

Findings from contextual studies have shown that living in both poor and affluent neighbourhoods increases the risk of drinking and drug use, but few studies have examined the connection between neighbourhood context and drinking from a gender perspective.

We investigated the association between gender, neighbourhood deprivation and weekly drinking behaviour (number of drinks) in a national sample of 93 457 Canadians using multilevel zero-inflated Poisson regression. A cross-level interaction between gender and neighbourhood deprivation was examined while controlling for other potential risk factors.

53% of Canadians reported having at least one drink in the last year (men=61%; women=46%). Among respondents who were drinkers, the average number of drinks per week was 6.4 with male drinkers reporting an average of 7.9 and female drinkers reporting an average of 4.6. Neighbourhood material deprivation was independently associated with weekly drinking. Findings from multilevel analysis showed a u-shaped curve between neighbourhood deprivation and drinking, but only for men. Men living in the poorest neighbourhoods drank more weekly (8.5 drinks) than men living in neighbourhoods of wealthy (4.5 drinks) and mid-range deprivation (3.7 drinks). No difference in drinking by neighbourhood material deprivation was observed among women.

Men, like women, experience gender-specific health difficulties (eg, alcohol-related problems) suggesting the need for a gendered focus on policies and services related to women's and men's health. The challenge for public health and primary care is to work together to target risk-taking behaviours among men through treatment, prevention and cultural/educational messages aimed at building healthy lifestyles.

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Selected papers by Robin Room

At this website you may read 172 full text documents written by Robin Room, plus 284 abstracts.


Ethanol protects from injury due to ischemia and reperfusion by increasing vascularity via vascular endothelial growth factor

The cardioprotective effects of moderate ethanol consumption have been known for years and have generally been ascribed to long-term effects of alcohol on blood lipids. However, other mechanisms, particularly ethanol-induced increase in blood vessel density, may also be involved.

Our goal was to understand the relationship between ethanol consumption, new blood vessel formation
in vivo and protection from injury due to ischemia and ischemia/reperfusion.

Using paired ethanol fed and control rats, we assessed capillary density in the heart, brain and skeletal muscle by immunostaining and quantified expression of vascular endothelial growth factor (VEGF) by Western blot analysis and immunocytochemistry.

Numbers of vessels were significantly increased in the brain, heart and skeletal muscle of animals fed ethanol-rich diets. VEGF (and its receptors) were upregulated in these organs. These effects were very rapid: highly significantly increased vascularization was seen within 2 weeks of commencing alcohol feeding. A neutralizing VEGF antibody, bevacizumab, inhibited new blood vessel formation induced by moderate doses of ethanol. Ethanol consumption increased vascularization and promoted skeletal muscle regeneration following hindlimb ischemia; these effects were prevented by bevacizumab. Finally, ethanol consumption protected myocardium following experimental ischemia/reperfusion.

Experimental ethanol ingestion rapidly increases VEGF production, significantly increasing the capillary bed in the heart, brain, and skeletal muscle. Moreover, the ethanol-induced increase of blood vessel density is protective against ischemic events (i.e., hindlimb ischemia and myocardium ischemia/reperfusion) and promotes skeletal muscle regeneration.

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The interaction of chronic restraint stress and voluntary alcohol intake: Effects on spatial memory in male rats

Alcohol consumption and exposure to stressful life events activate similar neural pathways and thus result in several comparable physiological and behavioral effects. Alcoholics in treatment claim that life stressors are the leading cause of continued drinking or relapse. However, few studies have investigated the interactive effects of stress and alcohol on cognitive behavior.

The effects of restraint stress, alcohol, and stress in combination with alcohol were examined on a spatial memory test, the object placement (OP) task. In addition, intake levels were measured to determine if stress altered general consumption of alcohol. Male Sprague-Dawley rats were assigned to one of four conditions: no alcohol/no stress control (CON), stress alone (STR), alcohol alone (ALC), and STR
+alcohol (STR+ALC). Following each restraint stress bout, the STR+ALC and the ALC groups were given access to 8% alcohol for 1h using the two-bottle choice limited access paradigm.

As predicted, the STR
+ALC group significantly increased alcohol consumption, while the ALC group had consistent drinking over the 10-day treatment. On the OP task, STR and ALC groups performed at chance levels, whereas the CON and STR+ALC groups significantly discriminated between objects in the new and old locations.

These data show that stress increases alcohol intake and the intake of alcohol is associated with reduction of the stress-induced impairment of spatial memory. The data have important implications for the development of alcohol abuse and its treatment.

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Gamma-aminobutyric acid A receptor, [alpha]-2 (GABRA2) variants as individual markers for alcoholism: a meta-analysis

The available evidence from the genetic association studies (GAS) published to date on the association between variants in the GABRA2 gene and alcoholism has produced inconclusive results. To interpret these results, a meticulous meta-analysis of all available studies was carried out.

The PubMed database and the HuGE Navigator were searched for published GAS-related variants in the GABRA2 gene with susceptibility to alcoholism. Then, the GAS were synthesized to decrease the uncertainty of estimated genetic risk effects. The risk effects were estimated on the basis of the odds ratio (OR) of the allele contrast and the generalized odds ratio (ORG), a model-free approach. Cumulative and recursive cumulative meta-analyses (CMA) were also carried out to investigate the trend and stability of effect sizes as evidence accumulates.

Fourteen variants investigated in eight studies were analyzed. Significant associations were derived for four variants either for the allele contrast or for the ORG. In particular, the variants rs279858 and rs279845 showed marginal significance for ORG: ORG=1.27 (1.01-1.60) and ORG=1.49 (1.02-2.19), respectively. Also, the variants rs567926 and rs279844 showed significance for the allele contrast: OR=1.24 (1.06-1.46) and OR=1.23 (1.08-1.43), respectively; the ORG produced similar results. The variant rs279858 produced a large heterogeneity between studies. CMA showed a trend of an association only for the variant rs567926. Recursive CMA indicated that more evidence is needed to conclude on the status of significance of all variants.

There is evidence that variants in the GABRA2 gene are associated with alcoholism. However, the present findings should be interpreted with caution.

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Jersey’s Public Health Department has published the first volume of a new health profile of the Island.

The document summarises data collected in 2008 and 2009, and mirrors a similar health profile which has been collated by Guernsey’s Public Health Department. Each island has produced their own report, but the work is the result of collaborative working between the Health Intelligence teams in Jersey and Guernsey.

pg. 46 Alcohol Consumption

pg 48 Alcohol-Attributable Hospital Admissions

pg 49 Alcohol Specific Hospital Admissions

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Friday, May 4, 2012

Statistics on alcohol - Commons Library Standard Note

Statistics on alcohol by Rachael Harker (SN/SG/3311) presents statistical information on aspects of drinking. The Note examines trends and patterns in drinking among adults and young people. It also includes information on alcohol-related ill health, NHS hospital activity and the cost of alcohol misuse.

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Positive allosteric modulation of the GABAB receptor by GS39783 attenuates the locomotor stimulant actions of ethanol and potentiates the induction of

Acute ethanol-induced locomotor stimulation and ethanol-induced locomotor sensitization are two behavioral assays thought to model the rewarding effects of ethanol. Recent evidence suggests that GS39783, a GABAB positive allosteric modulator, may be effective at reducing both the rewarding and reinforcing effects of several drugs of abuse, including ethanol.

The goal of this study was to determine if GS39783 was capable of altering acute ethanol-induced stimulation, and the induction and expression of ethanol-induced locomotor sensitization, without effecting basal locomotion levels.

Several doses of GS39783 (ranging from 0 to 100 mg/kg, depending on experiment) were tested on adult male DBA/2J mice in four experiments using 3-day basal locomotion and acute ethanol stimulation paradigms, and 14-day induction and expression of ethanol sensitization paradigms.

The results of experiment 1 are in agreement with current literature, suggesting that 30 mg/kg doses of GS39783 and lower do not alter basal locomotor activity.

In experiment 2, we found that GS39783 significantly decreased acute ethanol stimulation, but only at the 30 mg/kg dose, supporting our hypothesis and other publications suggesting that GABA
B receptors modulate acute ethanol stimulation.

Contrary to our hypothesis, GS39783 did not alter the expression of locomotor sensitization. Additionally, repeated administration of GS39783 in conjunction with ethanol unexpectedly
potentiated ethanol-induced locomotor sensitization.

Further study of GS39783 is warranted as it may be a more tolerable treatment for alcoholism than full agonists, due to its behavioral efficacy at doses that lack sedative side effects.

Our results add to current literature suggesting that the GABA
B receptor system is indeed involved in the modulation of ethanol-induced locomotor stimulation and sensitization.

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A comparison of Val81Met and other polymorphisms of alcohol metabolising genes in patients and controls in Northern Spain

The aim of this paper is to study polymorphism in the TH, ADH1B, ADH1C, ALDH2 and CYP2E1 genes so as to ascertain whether it is associated with excessive consumption of alcohol.

The SNPs rs6356 of
TH, rs1229984, rs2066702 of ADH1B; rs698, rs1693482 of ADH1C; rs671 of ALDH2; rs72559710, rs55897648, rs6413419, rs3813867, rs2031920, rs6413432 of CYP2E1 were studied in a sample of 172 high-level patients and 150 fully non-drinkers controls.

Genotyping was performed using Rt-PCR with Taqman probes. SNPs located at
ALDH2 and CYP2E1 showed no heterozygosity. Frequency distribution showed significant differences between the two groups studied for loci TH and ADH1B. The genotype Val/Val of TH locus increased in risk 1.988 times (95% CI: 1.006–3.930) that the subjects carrying the genotype Met/Met; and the genotype ADH1B*1/*1 of ADH1B locus increased in risk 3.811 times (CI: 1.660–8.749) that the subjects carrying the genotype ADH1B*1/*2.

Val and ADH1B*1 may therefore increase the risk of the onset and development of this illness.

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Evaluation of the Impact of the Image Used in a Communication Campaign to Raise Awareness about the Effects of Alcohol Use During Pregnancy

To assess the impact of the advertising image used in the health communication campaign ‘Mummy Drinks Baby Drinks’, aimed to raise awareness about the effects of drinking alcohol during pregnancy in the childbearing-aged population of the Local Health Authority of Treviso (Italy). The image depicted a foetus inside a glass of a local alcoholic drink.

A survey using a semi-structured self-reported questionnaire was carried out. The questionnaire was administered to a consecutive series of 690 parents or caregivers who accompanied children aged 0–2 years in the vaccination clinics of the Local Health Unit, during a 30-day period 1 year after the start of the campaign. The questionnaire measured the level of exposure to the image, emotional reactions and awareness of the health messages conveyed by the image.

Overall, 84% of the respondents said that they remembered the image. Almost all (93%) recalled the warning message and 53% recalled the health behaviours suggested by the campaign. The image generally seemed to arouse a high emotive impact: 38% indicated distress and 40% liking as a general opinion, while ∼50% expressed distress emotions and 13% were pleasantly affected when reflecting on the feelings evoked. We did not find unequivocal relationships between the level and kind of emotional reactions and the recalling of the health behaviours.

The image obtained a high level of visibility. It was effective in spreading the health message conveyed by the campaign, regardless of the level and kind of emotive impact evoked.

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Psychosocial Factors and Beliefs Related to Intention to Not Binge Drink Among Young Adults

The objective of the study was to identify psychosocial factors and salient beliefs associated with the intention of young people to not binge drink in the next month, applying an extended version of the theory of planned behavior.

Among 200 youths randomly recruited from adult education centers in the province of Quebec, Canada, 150 completed a questionnaire. Of these, 141 youths reported having used alcohol in the last year—analyses were performed on this sub-sample.

The prediction model demonstrated that perceived behavioral control (odds ratio, OR = 2.60, 95% confidence interval, CI 1.59–4.23; P = 0.0001), attitude (OR = 2.49, 95% CI 1.14–5.43; P = 0.02) and moral norm (OR = 1.88, 95% CI 1.23–2.88; P = 0.004) are three determinant variables of intention to not binge drink in the next month. The intention is also related to cannabis use in the last month (OR = 0.17 95% CI 0.05–0.53; P = 0.002). Young people who believe that if they do not binge drink in the next month, they will have a lower risk of getting depressed (OR = 1.53, 95% CI 1.23–1.90; P = 0.0001), and those who believe they will be able to not binge drink even if they are at a party (OR = 1.58, 95% CI 1.29–1.94; P < 0.0001), are more likely to have a positive intention.

Despite some methodological limitations, this study revealed several options for helping young people to not binge drink during their school career.

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Screening for Alcohol Use in Criminal Justice Settings: An Exploratory Study

To examine the feasibility and acceptability of alcohol screening and delivery of brief interventions within criminal justice settings.

A quantitative survey of those aged 18 or over in English criminal justice settings (three custody suites within police stations, three prisons and three probation offices).

The Fast Alcohol Screening Test (FAST) and a modified version of the Single Alcohol Screening Question (M-SASQ) were compared with the Alcohol Use Disorders Identification Test (AUDIT) as the ‘gold standard’. Participants completed a health status questionnaire (EQ5D), questions on service utilization and the Readiness to Change Questionnaire. Questions relating to the acceptability and feasibility of delivering brief interventions and about perception of coercion were included.

Five hundred and ninety-two individuals were approached and 251 were eligible. Of these, 205 (82%) consented to take part in the study. The mean AUDIT score was 19.9 (SD 13.5) and 73% scored 8 or more on AUDIT. A higher percentage of those approached in the probation setting consented to take part (81%: prison 36%, police setting 10%). Those scoring AUDIT positive were more likely to be involved in violent offences (36.5 vs 9.4%; P < 0.001) and less likely to be involved in offences involving property (27.7 vs 45.3%; P = 0.03). Three quarters of the sample (74%) reported that they would not feel coerced to engage in an intervention about their alcohol use. FAST and M-SASQ had acceptable screening properties when compared with AUDIT with area under the curves of 0.97 and 0.92, respectively.

The results confirm that there is a major problem with alcohol use in the criminal justice system and this impacts on health and criminal behaviour. Of the three criminal justice settings, probation was found to be the most suitable for screening. Participants were positive about receiving interventions for their alcohol use in probation settings.

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NIAAA NEWS Spring 2012 • Issue 24

Thursday, May 3, 2012

Patterns of Public Support for Price Increases on Alcohol in the Former Soviet Union

To measure levels of public support for price increases on beer and spirits in nine former Soviet Union countries and to examine the characteristics influencing such support.

Cross-sectional surveys were conducted in 2010 with 18,000 respondents aged 18+ in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Descriptive and multivariate logistic regression analyses were used.

The lowest level of support for price increases on beer were in Georgia (men 5%, women 9%) and Armenia (men 5%, women 11%); and the highest were in Kyrgyzstan (men 30%, women 38%), Azerbaijan (men 27%, women 37%) and Russia (men 23%, women 34%). The lowest levels of support for price increases on spirits were Armenia (men 8%, women 14%) and Georgia (men 14%, women 21%); and the highest were in Kyrgyzstan (men 38%, 47% women) and Moldova (men 36%, women 43%). Characteristics associated with supporting price increases included gender (women), higher education, good economic situation, lower alcohol consumption and greater knowledge of harmful alcohol behaviour.

Alcohol price increases are an effective means to reduce hazardous alcohol use. Despite opposition in some groups, there is evidence of public support for alcohol price increases in the study countries.

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Media Release - Australians drinking less

Apparent consumption of alcohol decreased by 1.1% in 2010-11 to 182.0 million litres, according to figures released today by the Australian Bureau of Statistics (ABS).

In 2010-11 there were 182.0 million litres of pure alcohol available for consumption, compared with 184.0 million litres in 2009-10. This was the first decrease recorded since 2001-02, and was due to decreases in the volume of pure alcohol from beer (down 3.4%) and wine (down 0.6%).

Over the past year, apparent consumption of spirits increased 4.8%, while Ready to Drink (pre-mixed) (RTDs) beverages have remained stable.

The changes in consumption patterns meant that beer accounted for 42% of all pure alcohol available for consumption in 2010-11 (down from 43% in 2009-10), wine 37% (unchanged), and spirits and RTDs 20% (up from 19% in 2009-10).

Overall, there were 10.0 litres of pure alcohol available for consumption per person aged 15 years and over in 2010-11, down 2.6% from 2009-10. This equates to around 2.2 standard drinks per person per day in 2010-11. > > > > Read More

Register for Free Recovery Support Services Training Session

Exploring the Dimensions of Recovery and Recovery Support Services

June 9, 2012 | 8:30 a.m.–5:15 p.m. Pacific Time | La Quinta Resort & Club | Palm Springs, CA

This special, free, in-person training session will precede the 74th Annual Meeting of the College on Problems of Drug Dependence, which will be held June 9–14, 2012.

Sponsored by SAMHSA, the training will provide peer specialists, clinicians, clinical supervisors, and administrators with the most up-to-date information and practices on recovery and recovery support services, including:
  • Research on the efficacy of recovery support services and information on evidence-based services
  • The role of peer recovery coaches and recovery community organizations in the system of care
  • Information on specific recovery support services and financing of recovery support services

Participants will have the opportunity to discuss how they can implement recovery support services in their organizations.

Training Features

  • Presentations from experts in the field of recovery and recovery support services
  • Access to leading recovery community service providers and researchers
  • Free continuing education units (CEUs) from NAADAC, the Association for Addiction Professionals
  • Free National Board for Certified Counselors CEUs
  • Access to online training materials (presentations will be posted following the training)

Learn More | Register Now

FTC Orders Alcoholic Beverage Manufacturers to Provide Data for Agency's Fourth Major Study on Alcohol Advertising

The Federal Trade Commission has required 14 major alcoholic beverage advertisers to provide information for the agency’s fourth major study on the effectiveness of voluntary industry guidelines for reducing advertising and marketing to underage audiences by beer, wine, and distilled spirits manufacturers.

For the first time, the agency will request information on Internet and digital marketing and data collection practices. As in previous studies, the FTC also will seek advertising expenditure and placement data, and background information about the advertisers’ business practices. > > > > Read More

Press Release - Treatment of addictive disorders: (Not) an issue for medical education?

A survey among German medical students investigated whether future physicians in Germany received adequate training to treat various diseases during undergraduate education. The main conclusion was that German medical students did learn how to treat hypertension and diabetes; however, treatment of alcohol use disorders and smoking was hardly covered during undergraduate study. The survey was co-ordinated at Göttingen University (Germany); various researchers from Charité – University Medical Centre, Hamburg Medical School as well as the University of Birmingham and University College London contributed to the paper published online in Addiction today.

A total of almost 20,000 medical students were surveyed regarding their preparation for clinical practice. Thus, the sample comprised half of all medical students enrolled at 27 medical schools participating in the study. Only one in five fifth-year students thought they knew how to treat alcohol use disorders and smoking, and only 7% of students felt they were able to counsel a smoker willing to quit. Over half of fifth-year students wished to learn more about these addictive disorders during undergraduate medical education. > > > > Read More

Family-based Genome-wide Association Study of Frontal Theta Oscillations Identifies Potassium Channel Gene KCNJ6

Event-related brain oscillations (EROs) represent highly heritable neuroelectric correlates of cognitive processes that manifest deficits in alcoholics and in offspring at high risk to develop alcoholism. Theta ERO to targets in the visual oddball task has been shown to be an endophenotype for alcoholism.

A family-based genome-wide association study (GWAS) was performed for the frontal theta ERO phenotype using 634,583 autosomal single nucleotide polymorphisms (SNPs) genotyped in 1,560 family members from 117 families densely affected by alcohol use disorders, recruited in the Collaborative Study on the Genetics of Alcoholism (COGA).

Genome-wide significant association was found with several SNPs on chromosome 21 in KCNJ6 (a potassium inward rectifier channel; KIR3.2/GIRK2), with the most significant SNP at p = 4.7 × 10−10). The same SNPs were also associated with EROs from central and parietal brain regions, but with less significance, suggesting that the association is frontally focused. One imputed synonymous SNP in exon 4, highly correlated with our top three SNPs, was significantly associated with the frontal theta ERO phenotype.

These results suggest KCNJ6 or its product GIRK2 account for some of the variations in frontal theta band oscillations. GIRK2 receptor activation contributes to slow inhibitory postsynaptic potentials that modulate neuronal excitability, and therefore influence neuronal networks.

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Alcohol IBA blog aims to share news, info and links related for alcohol brief interventions

A new Alcohol IBA blog has been set up to help promote the delivery of 'Identification and Brief Advice' (IBA), also known as alcohol brief interventions.

The blog, available at, aims to promote learning, understanding and the delivery of IBA amongst all roles that have the opportunity to deliver it.

IBA is a cost-effective simple intervention that proven to reduce risky drinking. It is a key part of the national effort to reduce alcohol-related harm, but it needs widespread delivery to achieve this.

The blog aims to support the IBA agenda by sharing information and learning relating to IBA, and sign-posting to key resources. It should also offer a space for new ideas about improving the delivery or implementation of IBA, particularly in settings or organisations facing challenges to delivery. > > > > Read More

Press Release - Tax reform for a healthier and competitive society

The Makati Business Club welcomes the initiative to reform excise taxes on tobacco and alcohol products, which would allow the government to optimize its revenue potential and create a strong disincentive for excessive tobacco and alcohol use.

We especially support the restructuring of the excise tax system from a multi-tiered structure to a unitary excise tax structure for tobacco and alcohol. This will effectively improve equity across cigarette and alcohol brands, promote market-based pricing in the industry, and encourage the entry of legitimate competition. It will also demonstrate the country’s commitment to open and fair competition, as well as its respectful compliance to international agreements.

We further push for the elimination of the price classification freeze so the government is free to levy competitive excise tax rates on tobacco and alcohol products. We believe that the current system has eroded the tax base, costing the Philippine government a substantial amount of foregone revenue. To address this loophole, we urge lawmakers to raise the excise tax rates and burden of tobacco and alcohol products, taking inflation into account yearly, to adequately reflect the negative externalities of consuming these goods.

More importantly, MBC joins the medical community in expressing concern over the increasing number of smokers among our youth; the large percentage of preventable deaths and disabilities due to smoking-related diseases; and the fact that the Philippines is the 15th-largest market for tobacco in the world, with one of the lowest taxes imposed on tobacco products. The flawed tax structure governing tobacco and alcohol products has allowed the abuse of their consumption and has failed to curb the growth of new smokers and drinkers, particularly from the youth and the poor. It is the society that carries the burden, as evidenced by the annual increase of economic and productivity losses tied to excessive drinking and smoking. > > > > Read More

Wednesday, May 2, 2012


The 10th Plenary meeting of the European Health Forum (EAHF) took place on 26 April 2012 in Brussels. The topic of the forum was responsible marketing.

The session focussed on responsible marketing
started with a brief overview of ongoing activities
and commitments to action under the Forum.
Results from three studies financed from the EU
Health Programme were then presented. > > > > Read More

Interaction between Serotonin Transporter and Serotonin Receptor 1 B genes polymorphisms may be associated with antisocial alcoholism

Several studies have hypothesized that genes regulating the components of the serotonin system, including serotonin transporter (5-HTTLPR) and serotonin 1 B receptor (5-HT1B), may be associated with alcoholism, but their results are contradictory because of alcoholism's heterogeneity. Therefore, we examined whether the 5-HTTLPR gene and 5-HT1B gene G861C polymorphism are susceptibility factors for a specific subtype of alcoholism, antisocial alcoholism in Han Chinese in Taiwan.

We recruited 273 Han Chinese male inmates with antisocial personality disorder (ASPD) [antisocial alcoholism (AS-ALC) group (n = 120) and antisocial non-alcoholism (AS-N-ALC) group (n = 153)] and 191 healthy male controls from the community. Genotyping was done using PCR-RFLP.

There were no significant differences in the genotypic frequency of the 5-HT1B G861C polymorphism between the 3 groups. Although AS-ALC group members more frequently carried the 5-HTTLPR S/S, S/LG, and LG/LG genotypes than controls, the difference became non-significant after controlling for the covarying effects of age. However, the 5-HTTLPR S/S, S/LG, and LG/LG genotypes may have interacted with the 5-HT1B G861C C/C polymorphism and increased the risk of becoming antisocial alcoholism.

Our study suggests that neither the 5-HTTLPR gene nor the 5-HT1B G861C polymorphism alone is a risk factor for antisocial alcoholism in Taiwan's Han Chinese population, but that the interaction between both genes may increase susceptibility to antisocial alcoholism.

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Protective factors of substance use in youth subcultures

Youth subcultures, characterized by a distinctive lifestyle, music preference, shared values and behaviors, are associated with substance use. The aim of this study was to explore whether protective factors such as parental monitoring, parental bonding and parental substance abstinence affect the association between subculture affiliation and adolescents’ substance use.

We used data from 15-year-old elementary school pupils (N = 1,380; mean age = 15.47; response 79.5%) who participated in the Health Behaviour in School aged Children 2009/2010 study. The association between subculture affiliation and substance use (smoking, drinking alcohol, drunkenness, and cannabis use) was adjusted for parental monitoring, parental bonding and parental substance abstinence for boys and girls separately using logistic regression.

Adolescents affiliated to one of the selected youth subcultures were significantly more likely to use substances than other 15-years-olds, except for cannabis use in girls. Adjustment for parental monitoring reduced the association between subculture affiliation and substance use by 31-64% in girls and by 10-23% in boys. Adjustment for parental bonding and parental substance abstinence led to no changes or minor changes.

After adjustments for protective factors, subculture affiliation remained significantly associated with substance use. The role of protective factors in adolescents with a subculture affiliation regarding substance use is rather limited.

Our findings imply that preventive strategies targeting youth subcultures should take protective factors into account and be gender-specific.

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Use of Treatment Strategies in a Moderated Drinking Program for Women

Little is known about the extent to which individuals participating in drinking reduction interventions use the drinking reduction strategies presented during treatment. In consideration of this issue, we advanced hypotheses about the impact of baseline drinking patterns on strategy use and the relationship of strategy use to drinking patterns over time.

One hundred forty-four women who participated in a 10-week drinking reduction program were monitored over an 18-month posttreatment follow-up period.

Results indicated that the frequency of baseline heavy drinking days and the frequency of baseline abstinent/light drinking days negatively predicted drinking reduction strategy use during treatment.

Over follow-up, strategy use decreased; however, participants who received booster sessions had higher strategy use during the initial phase of follow-up.

Although cross-lagged panel analysis revealed that strategy use during treatment predicted abstinent/light days at the 6-month follow-up assessment, this effect was moderated by baseline drinking patterns.

These data indicated that the use of drinking reduction strategies is predictive of subsequent reduced drinking only in the early posttreatment period and only for baseline heavier drinkers.

Future research is needed to further specify the interplay of strategy use and drinking outcomes and to develop interventions designed to encourage the continued use of strategies over extended periods of time.

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STRIVE: Research on structural drivers behind the spread of HIV/AIDS

The starting point of STRIVE is that despite over two decades of concerted action, the global health community has been largely unable to reverse the tide of the HIV epidemic, and new infections continue to outstrip the number of people newly put on HIV treatment. “Prevention efforts that have succeeded - like Thailand’s 100 percent condom use program - have targeted not only individual behaviour change, but have addressed the policy and economic environment in which health-related decisions are made.
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New report on intimate partner violence and alcohol use

The title of the new report is “What works to prevent partner violence: An evidence overview”. In the Executive summary Lori Heise calls for a shift in focus in strategies to prevent intimate partner violence: “The review focuses on efforts to prevent partner violence, rather than evaluating services that are available for victims. In focusing on prevention rather than mitigation or response, the review concentrates on interventions designed to reduce the overall level of violence in the medium to long term, rather than on interventions to meet the immediate needs of victims. This shifts the focus of inquiry away from interventions designed to improve services towards programmes and policies designed to influence the underlying determinants of partner violence”. > > > > Read More

The Malawi Alcohol Policy Alliance established

Malawian civil society organizations have since 2008 worked together with government partners to develop a new national policy for Malawi. See reports here and here and here. A number of policy drafts were produced, these were discussed at a series of regional consultations meetings and finally a national validation meeting was held in June 2011. After that a final national alcohol policy draft was presented to the Malawian government for their consideration and further handling.

Early in this process a Task Force Committee was established in order to secure a steady progress of the drifting process as well as to ensure broad participation of both NGOs and government institutions. When the draft policy was handed over to the government late in 2011, the role of the Task Force Committee had come to an end. The alcohol policy cooperation among civil society organizations will now be continued through a newly established Malawi Alcohol Policy Alliance (MAPA). > > > > Read More

Preventing Alcohol Abuse and Alcoholism— An Update

Drinking too much alcohol can take a heavy toll, not only on a person’s health but also on his or her family relationships and work or school performance. Alcohol consumption can lead to alcohol dependence and abuse, contribute to a number of diseases and mental and behavioral disorders, and may lead to a range of injuries. In addition, drinkers and their families are subject to social harm, such as family disruption, problems at the workplace (including unemployment), criminal convictions, and financial problems. They also encounter higher health care and related costs.

Drinking produces immense costs to society in terms of health care expenses, lost productivity, and lost years of lives. One of the most effective ways to lessen the costs associated with alcohol abuse and alcoholism is to prevent people from starting abusive drinking patterns. Because people drink for different reasons and under a wide variety of circumstances, prevention efforts must address an array of problems associated with that breadth of drinking experience.

This Alert explores some of the most effective prevention approaches in use today, aimed at a variety of groups—especially youth, their families, and the communities in which they live and work. It reviews laws and policies that can curtail access to alcohol or curb its use, protecting society as a whole and reducing the social, legal, and monetary costs of alcohol abuse and dependence.

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The Virtuous Tax: Lifesaving and Crime-Prevention Effects of the 1991 Federal Alcohol-Tax Increase

On January 1, 1991, the federal excise tax on beer doubled, and the tax rates on wine and liquor increased as well. These changes are larger than the typical state-level changes that have been used to study the effect of price on alcohol abuse and its consequences.

In this paper, we develop a method to estimate some important effects of those large 1991 changes, exploiting the interstate differences in alcohol consumption. We demonstrate that the relative importance of drinking in traffic fatalities is closely tied to per capita alcohol consumption across states.

As a result, we expect that the proportional effects of the federal tax increase on traffic fatalities would be positively correlated with per capita consumption. We demonstrate that this is indeed the case, and infer estimates of the price elasticity and lives saved in each state.

We repeat this exercise for other injury-fatality rates, and for nine categories of crime. For each outcome, the estimated effect of the tax increase is negatively related to average consumption, and that relationship is highly significant for the overall injury death rate, the violent crime rate, and the property crime rate. A conservative estimate is that the federal tax reduced injury deaths by 4.7%, or almost 7,000, in 1991.

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Global Actions: May 2, 2012

Key Recent Milestones:

· Vietnam: In April, Global Actions held the first noncommercial alcohol workshop in Vietnam in Hanoi, “Production, Consumption, and Use of Noncommercial Alcohol.”

Global Actions in Focus: Self-Regulation in India Update

India’s self-regulatory organization, the Advertising Standards Council of India (ASCI) presented the winners of the “ASCI Mobile Movie Challenge” during the closing event of the annual advertising festival Goa Fest 2012. The competition was conducted in line with the agreed strategic objectives of the Global Actions India project, developed in cooperation with the World Federation of Advertisers (WFA) to encourage responsible creativity and promote cross-industry self-regulation in advertising.

To enter the competition, young creative professionals in teams of three were asked to create short movies (30-60 seconds) using only their mobile handsets. The movies had to reflect one of the four tenets of the ASCI cross-industry advertising code:

1. Honesty and truthfulness in advertising

2. Decency in advertising

3. Safety and avoiding exploitation of vulnerable sections of society, especially children

4. Fair competition

The competition received a total of 120 registered participants and 40 movies from across India. The films were showcased at Goafest 2012 and uploaded on YouTube and select online portals. Videos such as Team iamonstage / Brief 1 Misleading Ads, Team Therefore / Brief 4 Competitive Advertising, and Team Wandererz / Brief 1 Misleading Ads inspire professionals to understand the importance of self-regulation in advertising.

“Through this competition, we wanted to inspire young professionals to abide by the guidelines set by ASCI and implement the same in their work,” said ASCI board member Subhash Kamath. “We’re extremely happy with the kind of response we’ve received and thankful for all the support. Next year, we hope to make this initiative larger and stronger by reaching out to more media and advertising professionals.”

What’s Happening Next:

· Denmark: ICAP will be attending the annual SAO meeting in Copenhagen on May 10-11. ICAP’s Ashley Adrian will speak on development at the international level, including the upcoming Global Actions conference

Alcohol Justice Calls Out "Drink Responsibly" Charade in New Report

Alcohol Justice, the U.S.-based industry watchdog, just released a new report debunking Big Alcohol’s cynical “Drink Responsibly” messages. How Big Alcohol Abuses “Drink Responsibly” to Market Its Products outlines many dangers of “drink responsibly” messages, and emphasizes the evidence that promoting “drink responsibly” messages is not effective policy to reduce alcohol-related harm. Yet Big Alcohol corporations continue to tout their voluntary messages as a useful public health measure, even while they include their brand names in the messages. “Alcohol producers and marketers are more interested in their public relations than public health,” said Sarah Mart, MS, MPH, director of research and co-author of the new report. “So it’s not surprising that they hide behind a vague, ineffective slogan that does nothing to reduce the annual catastrophe of harm caused by their products.” > > > > Read More

Cigarette Smoking Predicts Differential Benefit from Naltrexone for Alcohol Dependence

Identifying factors that modify responsiveness to pharmacotherapies for alcohol dependence is important for treatment planning. Cigarette smoking predicts more severe alcohol dependence and poorer treatment response in general. Nevertheless, there is limited research on cigarette smoking as a potential predictor of differential response to pharmacological treatment of alcoholism.

We examined the association between cigarette smoking and drinking outcomes in the COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) study, a randomized, double-blind placebo-controlled 16-week trial comparing combinations of medications (i.e., acamprosate and naltrexone) and behavioral interventions (i.e., medical management, combined behavioral therapy) in 1383 alcohol-dependent individuals.

Smokers (i.e., more than one half the sample) significantly differed from nonsmokers on several demographic and drinking-related variables at baseline and generally had poorer treatment outcomes than nonsmokers. However, smokers who received naltrexone had better drinking outcomes than smokers who received placebo, whereas alcohol use among nonsmokers did not vary by naltrexone assignment. This pattern of findings occurred independent of whether patients received combined behavioral intervention or medical management and remained after controlling for alcoholism typology and baseline demographic differences. Approximately 9% of smokers quit smoking, and an additional 10% reduced their cigarette intake during treatment. Reductions in smoking did not vary by treatment assignment.

These results suggest that naltrexone might be particularly beneficial for improving alcohol use outcomes in alcohol-dependent smokers.

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Inhibition of the Casein-Kinase-1-Epsilon/Delta Prevents Relapse-Like Alcohol Drinking

During the past decade, it has been shown that circadian clock genes have more than a simple circadian time-keeping role. Clock genes also modulate motivational processes and have been implicated in the development of psychiatric disorders such as drug addiction. Recent studies indicate that casein-kinase 1ε/δ (CK1ε/δ)—one of the components of the circadian molecular clockwork—might be involved in the etiology of addictive behavior.

The present study was initiated to study the specific role of CK1
ε/δ in alcohol relapse-like drinking using the ‘Alcohol Deprivation Effect’ model. The effect of CK1ε/δ inhibition was tested on alcohol consumption in long-term alcohol-drinking rats upon re-exposure to alcohol after deprivation using a four-bottle free-choice paradigm with water, 5%, 10%, and 20% ethanol solutions, as well as on saccharin preference in alcohol-naive rats.

The inhibition of CK1
ε/δ with systemic PF-670462 (0, 10, and 30mg/kg) injections dose-dependently decreased, and at a higher dosage prevented the alcohol deprivation effect, as compared with vehicle-treated rats. The impact of the treatment was further characterized using nonlinear regression analyses on the daily profiles of drinking and locomotor activity.

We reveal that CK1
ε/δ inhibition blunted the high daytime alcohol intake typically observed upon alcohol re-exposure, and induced a phase shift of locomotor activity toward daytime. Only the highest dose of PF-670462 shifted the saccharin intake daily rhythm toward daytime during treatment, and decreased saccharin preference after treatment.

Our data suggest that CK1 inhibitors may be candidates for drug treatment development for alcoholism.

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Drinking in the Age of the Great Recession

The United States has been experiencing the most severe economic crisis since the Great Depression.

This article presents the Life Change Consequences of the Great Recession (LCCGR), an instrument depicting work and personal life-related stressors reflecting the enduring effects of the Great Recession.

A national sample of 663 respondents completed a mail survey including this instrument and measures of drinking outcomes. Multiple regression analyses addressed the links between the LCCGR and drinking.

Economy-related stressors manifested significant effects on both male and female consumptions patterns, but most LCCGR subscales were more clearly related to problematic drinking patterns in men compared with women.

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