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, June 16, 2012

The Fallacy of the ‘Hijacked Brain’

Of all the philosophical discussions that surface in contemporary life, the question of free will — mainly, the debate over whether or not we have it — is certainly one of the most persistent.

That might seem odd, as the average person rarely seems to pause to reflect on whether their choices on, say, where they live, whom they marry, or what they eat for dinner, are their own or the inevitable outcome of a deterministic universe. Still, as James Atlas pointed out last month, the spate of “can’t help yourself” books would indicate that people are in fact deeply concerned with how much of their lives they can control. Perhaps that’s because, upon further reflection, we find that our understanding of free will lurks beneath many essential aspects of our existence.

One particularly interesting variation on this question appears in scientific, academic and therapeutic discussions about addiction. Many times, the question is framed as follows: “Is addiction a disease or a choice?”

The argument runs along these lines: If addiction is a disease, then in some ways it is out of our control and forecloses choices. A disease is a medical condition that develops outside of our control; it is, then, not a matter of choice. In the absence of choice, the addicted person is essentially relieved of responsibility. The addict has been overpowered by her addiction.

The counterargument describes addictive behavior as a choice. People whose use of drugs and alcohol leads to obvious problems but who continue to use them anyway are making choices to do so. Since those choices lead to addiction, blame and responsibility clearly rest on the addict’s shoulders. It then becomes more a matter of free will. > > > > Read More

Tobacco Quitlines Need to Assess and Intervene with Callers' Hazardous Drinking

Based on published data showing that daily smokers have high rates of hazardous drinking and higher rates of smoking relapse, we hypothesized that New York State Smokers' Quitline (NYSSQL) callers would exhibit elevated rates of risky drinking and risky drinking callers would report lower rates of smoking cessation.

We assessed rates of hazardous drinking among 88,479 callers to the NYSSQL using modified NIAAA guidelines. Using 2 routine NYSSQL short-term follow-up interviews (n = 14,123 and n = 24,579) and a 3-month follow-up interview (n = 2,833), we also compared smoking cessation rates for callers who met criteria for hazardous drinking compared to moderate drinkers and nondrinkers.

At baseline, 56% of callers reported drinking, and 23% reported hazardous drinking using modified NIAAA guidelines. Hazardous drinkers did not differ on measures of smoking cessation outcomes compared to nondrinkers but did have lower smoking cessation rates compared to persons who reported moderate alcohol consumption for the enhanced services program 1-week follow-up (adjusted OR [95% CI] = 1.09 [1.01, 1.17], p = 0.04) and the standard 2-week follow-up (adjusted OR [95% CI] = 1.17 [1.07, 1.29], p = 0.001.

Nearly a quarter of smokers calling the NYSSQL reported a hazardous drinking pattern, which was associated with lower cessation outcomes compared to those who reported a moderate drinking profile. Given the large number of high-risk drinkers who can be identified through a quitline, tobacco quitlines may provide a venue for providing brief alcohol interventions to these high-risk drinkers. Future studies should evaluate whether a brief alcohol intervention would result in improved smoking cessation rates for hazardous drinking smokers.

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Friday, June 15, 2012

Researchers find a strong association between alcohol dependence and chromosome 5q13.2

  • There is a strong genetic influence on the risk of developing alcohol dependence (AD).
  • Copy number variations (CNVs) refer to a class of genetic variation that can delete and duplicate whole genes, leading to powerful genetic effects.
  • A first-of-its-kind study has found a significant association between AD and CNVs on chromosome 5q13.2.

Excessive drinking is not only the third leading cause of preventable death in the United States, there is also a very strong genetic influence on the risk of developing alcohol dependence (AD). Given its serious public-health impact, as well as strong evidence for genetic influence, a new study has examined links between AD and genetic variations called common copy number variations (CNVs), finding a significant association between AD and CNVs on chromosome 5q13.2.

Results will be published in the September 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.> > > > Read More

Copy Number Variations in 6q14.1 and 5q13.2 are Associated with Alcohol Dependence

Excessive alcohol use is the third leading cause of preventable death and is highly correlated with alcohol dependence, a heritable phenotype. Many genetic factors for alcohol dependence have been found, but many remain unknown. In search of additional genetic factors, we examined the association between Diagnostic and StatisticalManual of Mental Disorders, Fourth Edition (DSM-IV) alcohol dependence and all common copy number variations (CNVs) with good reliability in the Study of Addiction: Genetics and Environment (SAGE).

All participants in SAGE were interviewed using the Semi-Structured Assessment for the Genetics of Alcoholism, as a part of 3 contributing studies. A total of 2,610 non-Hispanic European American samples were genotyped on the Illumina Human 1M array. We performed CNV calling by CNVPartition, PennCNV, and QuantiSNP, and only CNVs identified by all 3 software programs were examined. Association was conducted with the CNV (as a deletion/duplication) as well as with probes in the CNV region. Quantitative polymerase chain reaction (qPCR) was used to validate the CNVs in the laboratory.

CNVs in 6q14.1 (p = 1.04 × 10−6) and 5q13.2 (p = 3.37 × 10−4) were significantly associated with alcohol dependence after adjusting multiple tests. On chromosome 5q13.2, there were multiple candidate genes previously associated with various neurological disorders. The region on chromosome 6q14.1 is a gene desert that has been associated with mental retardation and language delay. The CNV in 5q13.2 was validated, whereas only a component of the CNV on 6q14.1 was validated by qPCR. Thus, the CNV on 6q14.1 should be viewed with caution.

This is the first study to show an association between DSM-IV alcohol dependence and CNVs. CNVs in regions previously associated with neurological disorders may be associated with alcohol dependence.

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Reduced Subjective Response to Acute Ethanol Administration Among Young Men with a Broad Bipolar Phenotype

Elevated lifetime prevalence rates of alcohol use disorders (AUDs) are a feature of bipolar disorder (BD). Individuals at-risk for AUDs exhibit blunted subjective responses to alcohol (low levels of response), which may represent a biomarker for AUDs. Thus, individuals at-risk for BD may exhibit low responses to alcohol.

Participants were 20 unmedicated adult males who reported high rates of hypomanic experiences (bipolar phenotype participants; BPPs), aged 18 to 21 years, and 20 healthy controls matched on age, gender, IQ, BMI, and weekly alcohol intake. Subjective and pharmacokinetic responses to acute alcohol (0.8
g/kg) vs placebo administration were collected in a randomized, double-blind, cross-over, placebo-controlled, within-subjects design.

BPP participants reported significantly lower subjective intoxication effects (‘feel high’: F
=14.2, p=0.001; ‘feel effects’: F=8.1, p=0.008) across time, but did not differ in their pharmacokinetic, stimulant, or sedative responses.

Paradoxically, however, the BPP participants reported significantly
higher expectations of the positive effects of alcohol than controls.

Our results suggest that unmedicated young males with previous hypomanic experiences exhibit diminished subjective responses to alcohol. These blunted alcohol responses are not attributable to differences in weekly alcohol intake, pharmacokinetic effects (eg, absorption rates), or familial risk of AUDs.

These observations suggest that the dampened intoxication may contribute to the increased rates of alcohol misuse in young people at-risk for BD, and suggest possible shared etiological factors in the development of AUDs and BD.

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Validation of the Substance Abuse Screener in American Sign Language (SAS--ASL).

The study objectives were to adapt and validate a substance use disorder (SUD) screening instrument in American Sign Language (ASL) to be used to identify those deaf individuals who have a high probability of having an SUD. The goal was to develop an accurate screening instrument that balanced sensitivity and specificity while imposing minimal response burden on respondents.

A sample of 198 deaf participants in behavioral health, family social service, and educational programs that provide specialized services for deaf individuals was interviewed to obtain clinical diagnoses for current (past 12 months) SUD according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and completed a 42-item version of the Substance Abuse Screener in American Sign Language (SAS−ASL). We used Rasch and discriminant function analyses to reduce the instrument to 28 items, then divided the sample into a development subsample, used to formulate a scoring routine, and a validation subsample to assess correspondence with clinical diagnoses. To provide validation data on the shortened SAS−ASL, an independent sample of 62 respondents was diagnosed and completed the screener.

The SAS−ASL instrument demonstrated good person reliability (.85), sensitivity (.90), and specificity (.84) in the primary validation sample, and 100% screening accuracy with 62 respondents in the second validation sample.

The SAS−ASL provides a standardized SUD screening for the deaf population. The adaptability of the instrument to electronic administration lends itself to a continuum of technologically supported services for a high-risk population that is disenfranchised for most community-based behavioral health services.

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Thursday, June 14, 2012

New open-access journal fills niche for addictions research

A new open-access journal dedicated to international perspectives on substance use and addictions research was launched at the annual meeting of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol.

The International Journal of Alcohol and Drug Research (IJADR), the Society’s official peer-reviewed publication, was created with support from Canada’s Centre for Addiction and Mental Health (CAMH) and funding from the U. S. National Institute on Drug Abuse (NIDA).

Although there are other addictions journals, this publication serves several important new functions, notes CAMH Scientist and Editor-in-Chief Dr. Kathryn Graham.

“Access to many journals is often limited for researchers in low-and middle-income countries, as most have costs either for readers or authors,” says Dr. Graham. “This journal is free for both readers and researchers, and will increase access to papers of the highest scientific standard on cross-cultural research on substance use.”

In a joint editorial with Co-Editor-in-Chief Dr. John C. Clapp of San Diego University, she also notes, “We are particularly interested in papers that examine drug use from an international perspective and that explore how issues related to drug use and the social and health-related consequences of such use impact nations, regions and cultures.”

The first issue is based on research presented at a thematic meeting of the Kettil Bruun Society in Uganda. Papers include:

  • Global perspectives on alcohol research: Facilitating interdisciplinary and international collaborations to address prevailing challenges.
  • Alcohol and the process of economic development: Contributions from ethnographic research
  • Socio-economic determinants for alcohol consumption in a Ugandan student population.
  • Community-based prevention of alcohol-related injuries: Possibilities and experiences.
  • Distress and drinking: Cross-cultural connections and contexts.
> > > > Read More

Press Release - DSM-5 to Include Controversial Changes to Criteria for Substance Use Disorders

Every new edition of the Diagnostic and Statistical Manual of Mental Disorders stirs up a host of questions and controversies, and the next DSM—the DSM-5, to be published in 2013—is no exception. The diagnoses related to alcohol and other substance use disorders have had their own share of the controversy, according to Marc A. Schuckit, M.D., editor of the Journal of Studies on Alcohol and Drugs and a member of the Substance Use Disorder Work Group for the DSM-5. An ed
itorial from Schuckit in the July issue of JSAD, as well as letters from three experts, highlights the debate. > > > > Read More

Descriptive Characteristics and Cluster Analysis of Male Veteran Hazardous Drinkers in an Alcohol Moderation Intervention

Current efforts underway to develop the fifth edition of the Diagnostic and Statistical Manual (DSM-5) have reignited discussions for classifying the substance use disorders.

This study's aim was to contribute to the understanding of abusive alcohol use and its validity as a diagnosis. Cluster analysis was used to identify relatively homogeneous groups of hazardous, nondependent drinkers by using data collected from the Prevention and Treatment of Hypertension Study (PATHS), a multisite trial that examined the ability of a cognitive–behavioral-based alcohol reduction intervention, compared to a control condition, to reduce alcohol use. Participants for this study (N = 511) were male military veterans. Variables theoretically associated with alcohol use (eg, demographic, tobacco use, and mental health) were used to create the clusters and a priori, empirically based external criteria were used to assess discriminant validity. Bivariate correlations among cluster variables were generally consistent with previous findings in the literature.

Analyses of internal and discriminant validity of the identified clusters were largely nonsignificant, suggesting meaningful differences between clusters could not be identified.

Although the typology literature has contributed supportive validity for the alcohol dependence diagnosis, this study's results do not lend supportive validity for the construct of alcohol abuse.

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Dopamine Transporter (DAT1) VNTR Polymorphism and Alcoholism in Two Culturally Different Populations of South India

It is well established that the central dopaminergic reward pathway is likely involved in alcohol intake and the progression of alcohol dependence. Dopamine transporter (DAT1) mediates the active re-uptake of DA from the synapse and is a principal regulator of dopaminergic neurotransmission. The gene for the human DAT1 displays several polymorphisms, including a 40-bp variable number of tandem repeats (VNTR) ranging from 3 to 16 copies in the 3′-untranslated region (UTR) of the gene.

To assess the role of this gene in alcoholism, we genotyped the VNTR of DAT1 gene in a sample of 206 subjects from the Kota population (111 alcohol dependence cases and 95 controls) and 142 subjects from Badaga population (81 alcohol dependence cases and 61 controls). Both populations inhabit a similar environmental zone, but have different ethnic histories. Phenotype was defined based on the DSM-IV criteria. Genotyping was performed using PCR and electrophoresis. The association of DAT1 with alcoholism was tested by using the Clump v1.9 program which uses the Monte Carlo method. In both Kota and Badaga populations, the allele A10 was the most frequent allele followed by allele A9. The genotypic distribution is in Hardy–Weinberg equilibrium in both cases and control groups of Kota and Badaga populations.

The DAT1 VNTR was significantly associated with alcoholism in Badaga population but not in Kota population.

Our results suggest that the A9 allele of the DAT gene is involved in vulnerability to alcoholism, but that these associations are population specific.

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Prenatal ethanol exposure leads to greater ethanol-induced appetitive reinforcement

Prenatal ethanol significantly heightens later alcohol consumption, but the mechanisms that underlie this phenomenon are poorly understood. Little is known about the basis of ‘this effect of prenatal ethanol on the sensitivity to ethanol’s reinforcing effects. One possibility is that prenatal ethanol exposure makes subjects more sensitive to the appetitive effects of ethanol or less sensitive to ethanol’s aversive consequences.

The present study assessed ethanol-induced second-order conditioned place preference (CPP) and aversion and ethanol-induced conditioned taste aversion (CTA) in infant rats prenatally exposed to ethanol (2.0
g/kg) or vehicle (water) or left untreated. The involvement of the κ opioid receptor system in ethanol-induced CTA was also explored.

When place conditioning occurred during the ascending limb of the blood–ethanol curve (Experiment 1), the pups exposed to ethanol
in utero exhibited greater CPP than untreated controls, with a shift to the right of the dose–response curve. Conditioning during a later phase of intoxication (30–45min post-administration; Experiment 2) resulted in place aversion in control pups exposed to vehicle during late gestation but not in pups that were exposed to ethanol in utero. Ethanol induced a reliable and similar CTA (Experiment 3) in the pups treated with vehicle or ethanol during gestation, and CTA was insensitive to κ antagonism.

These results suggest that brief exposure to a moderate ethanol dose during late gestation promotes ethanol-mediated reinforcement and alters the expression of conditioned aversion by ethanol.

This shift in the motivational reactivity to ethanol may be an underlying basis of the effect of prenatal ethanol on later ethanol acceptance.

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Higher Levels of Hair Ethyl Glucuronide in Patients with Decreased Kidney Function

Hair levels of ethyl glucuronide (EtG) are often used to differentiate social drinking from heavy drinking. Patients with decreased kidney function have delayed excretion of EtG, and increased incorporation into hair could be suspected. The aim of this study was to compare hair EtG levels in patients with decreased kidney function to those seen in healthy volunteers.

Twelve patients with renal disease were included. The levels of EtG in hair were adjusted to estimated daily intake of ethanol (EDI) and compared to 21 previously published healthy individuals.

The levels of hair EtG in the 12 patients ranged between < limit of detection and 134 pg/mg, and the EDI ranged between 0.1 and 12 g. The levels of EtG in hair were significantly higher in the patients compared to healthy volunteers (p = 0.009).

These preliminary results indicate that hair levels of EtG in a population of patients with decreased kidney function should be interpreted with caution.

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Drinking habits and disability retirement

To examine associations between drinking habits and disability retirement, and to find out whether the associations differ between all-cause disability retirement and the main causes of disability retirement, i.e. musculoskeletal diseases and mental disorders.

A prospective cohort study with a mean follow-up time of 8.0 years.

Middle-aged employees of the City of Helsinki, Finland.

6275 municipal employees (78% women) who were 40–60 years old at baseline.

Data on drinking habits i.e. quantity and frequency of drinking, binge drinking and problem drinking were derived from the baseline questionnaire. The data on disability retirement and its diagnoses came from the Finnish Centre for Pensions. The analyses were made using Cox regression analysis.

Heavy average and frequent drinking were not associated with all-cause disability retirement, but increased the risk of disability retirement due to mental disorders even after adjusting for all covariates (Hazard ratios [HR] and 95% confidence intervals [CI] 2.54 (1.26-5.12) and 2.10 (1.23-3.61) respectively). Binge and problem drinking were both associated with all-cause disability retirement in the base models adjusted for age, gender and marital status. Problem drinking more than doubled the risk of disability retirement due to mental disorders even after all adjustments (HR 2.17, CI 1.53-3.08). Non-drinkers had an increased risk for disability retirement due to all, mental and musculoskeletal diagnoses.

Adverse drinking habits may contribute to disability retirement among the middle-aged working population. Tackling unhealthy drinking habits may lessen the likelihood of early retirement due to poor mental health.

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Wednesday, June 13, 2012


Dr. Lemoine’s account demonstrates how much knowledge about the toxic fetal effects of alcohol was published and known in Europe in the early 1900’s, half a century before it became public knowledge and a public health issue.

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Paul Lemoine

Dr Paul Lemoine was the Chief of the Pediatric Service at the Centre Hospitalier Universitaire (CHU) in Nantes, France.

During this time he noted the effects of parental alcoholism on offspring outcome. Here we publish his personal account of researching the cause of a strange dystrophy around the 1960's with certain children and alcoholism in their mothers.

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Acute alcohol effects on impulsivity: Associations with drinking and driving behavior

Although drink drivers exhibit higher levels of trait impulsivity, no studies have tested the hypothesis that drink drivers experience increased impulsivity while intoxicated. We tested this hypothesis for two impulsivity constructs: delay discounting and behavioral inhibition.

A within-subjects study comparing performance of drink drivers and non-drink drivers on behavioral measures of impulsivity in alcohol and no-beverage sessions.

A laboratory setting at the University of Missouri.

Twenty-nine young adults who were at least moderate drinkers were recruited from the local community and the University of Missouri.

Impulsivity was assessed using the Two Choice Impulsivity Paradigm (TCIP) and the Stop-Signal Task. Participants also completed self-report measures of binge drinking and trait impulsivity.

In the no-beverage session, TCIP impulsive choices did not differ between drinking and driving groups (p =.93). In the alcohol session, drink drivers made more TCIP impulsive choices on both the ascending (p <.01) and descending limb (p <.01) of the blood alcohol concentration curve than their peers who did not drink and drive. Drinking and driving groups did not differ on the Stop-Signal Task. Supplementary analyses indicated that effects for the TCIP were not explained by individual differences in trait impulsivity.

Individuals who report having three or more drinks before driving show greater impulsivity when under the influence of alcohol than those who do not report heavy drinking before driving.

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Association of alcohol dehydrogenase polymorphisms and lifestyle factors with excessive alcohol intake within the Spanish population (EPIC-Spain)

To analyse associations between alcohol dehydrogenase (ADH) polymorphisms and alcohol intake in Spanish men and women.

We analyzed the relationship between 21 genetic variants in ADH genes and excessive alcohol intake in both men and women. Single nucleotide polymorphisms (SNPs) were genotyped using a customized array and sex-stratified analysis was performed.

Ethanol intake was calculated using a validated dietary history questionnaire.

Heavy consumers of alcohol (≥70 g/day in men, ≥42 g/day in women) (653 cases) and very low or non-consumers (<2 g/day) (880 controls) from the Spanish cohort of the European Prospective Investigation into Cancer (EPIC).

We found statistically significant associations between alcohol intake and known lifestyle factors, namely, smoking and food energy intake (meat and fruit/seeds) in both men and women; as well as with physical activity in women and educational level in men. Additionally, we found that a non-synonymous coding SNP in ADH1B (rs1229984) is inversely associated with excessive alcohol intake in men (OR= 0.19, 95%CI=0.11-0.33; p=4.8E-10) and women (OR= 0.48, 95%CI=0.27-0.83; p=0.0067). Furthermore, ADH6 rs3857224 was found associated with heavy alcohol intake in women (OR=1.61, 95%CI=1.21-2.14; p=1.01E-3), but not in men.

In the Spanish population, the single nucleotide polymorphism of alcohol dehydrogenase ADH1B, rs1229984, is inversely associated with alcohol intake in both men and women. Another polymorhphism of ADH6, rs3857224, is associated with heavy alcohol intake, in women

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Government’s alcohol strategy

HoC Health Committee Tuesday 12 June 2012

Committee Room 5 Meeting started on Tuesday 12 June at 10.32am. Ended at 12.27pm


  1. Anne Milton MP, Parliamentary Under Secretary for Public Health, Chris Heffer, Deputy Director, Alcohol and Drugs, and Dr Mark Prunty, Senior Medical Officer, Alcohol and Drugs programme, Department of Health

Visit the Committee's homepage.

Consultation on alcohol-related hospital admissions data - the end of 'alcohol-related' figures?

Consultation on the methods used to estimate alcohol-related hospital admissions for England has been opened by the North West Public Health Observatory (NWPHO).

Download the consultation document here [pdf] and response form.

It was announced that the hospital admissions data would be reviewed when the Public Health Outcomes Framework was released earlier this year, stating 'the preferred option is for an indicator based on just alcohol-related primary diagnoses, to minimise the risk of perverse consequences from any changes in coding practice so the indicator rewards local areas for good performance.'

Hosptial admissions data was formerly used to monitor 'National Indicator (NI) 39' performance under 'Local Area Agreements' (LAA). However LAAs were scrapped under the Government's Localism agenda, although areas can still monitor hospital admissions data through the Local Alcohol Profiles for England (LAPE) site and are reviewed in the annual national alcohol statistics. > > > > Read More

The International Journal of Alcohol and Drug Research Vol 1, No 1 (2012)

Special issue of papers presented at an international Kettil Bruun Society thematic meeting on alcohol epidemiology and policy held in Kampala, Uganda. November 15-18, 2010. Alcohol Epidemiology and Evidence-Based Policy: Translating Research into Effective Prevention, Treatment and Policy

Table of Contents


Welcome to the International Journal of Alcohol and Drug ResearchPDF
Kathryn Graham, John D. Clapp, Editors-in-Chief
More than just another addiction journal: KBS and social epidemiology come of age
Thomas F. Babor, IJADR Advisory Board
A call to support the new KBS journalPDF
Charles D.H. Parry, IJADR Advisory Board
Why do we need yet another journal?PDF
Jürgen Rehm, IJADR Advisory Board Chair, Bruce G. Pollock, VP Research, CAMH
Toward new comparative understandingsPDF
Kerstin Stenius, IJADR Advisory Board

Introduction to the Special Issue

Global perspective on alcohol research: Facilitating interdisciplinary and international collaborations to address prevailing challengesPDF
Monica H. Swahn, Nazarius M. Tumwesigye, Special Issue Consulting Editors


Psycho-spatial predictors of alcohol use among motor drivers in Ibadan, Nigeria: Implications for preventing vehicular accidentsPDF
Gboyega E. Abikoye
Community-based prevention of alcohol-related injuries: Possibilities and experiencesPDF
Marja Holmila, Katariina Warpenius
Alcohol and inequity in the process of development: Contributions from ethnographic researchPDF
Laura A. Schmidt, Robin Room
Socio-economic determinants for alcohol consumption and heavy episodic drinking in a Ugandan student populationPDF
Martin Stafström
Intoxication before last sexual encounter and HIV risk behavior among men and women in Uganda: Evidence from a nationwide surveyPDF
Nazarius M. Tumwesigye, Rhoda K. Wanyenze, Tom K. Greenfield
Distress and drinking: Cross-cultural connections and contextsPDF
Richard Wilsnack, Arlinda F. Kristjanson, Sharon C. Wilsnack, Perry W. Benson

Longitudinal Analysis of Papers Presented at Past Kettil Bruun Society Meetings

Social and epidemiological research on alcohol: Research presented at meeting of the Kettil Bruun Society between between1983 and 2010.PDF
Henk Garretsen, Miranda Audenaerdt, Ien van de Goor, Dike van de Mheen, Diana Roeg, Rosalie van der Sar, Tim Schoenmakers

Global Actions June 13, 2012

Key Recent Milestones:

· China: Global Actions met with the China Alcoholic Drinks Industry Association (CADIA) and Chinese Association of National Advertisers (CANA) to support the drafting of a self-regulation code on beverage alcohol marketing communications which CADIA is developing for endorsement of its members. Also in China, the Jiangsu Institute for Health Education has completed the report on drink driving survey results in Nanjing.

Global Actions in Focus: Drink Drive Mexico

Global Actions progress continues in Mexico with the launch of “Towards zero drink driving deaths in Puebla.” The campaign was announced with a press event held at the Dirección de Vialidad del Estado (Puebla Police Office).

The drink driving awareness campaign is a combined effort of the Puebla State Police, municipal police departments of Cuautlancingo, Amozoc, San Pedro, Cholula, and San Andres Cholula, Benemerita Univeridad Autonoma de Puebla, Universidad de las Americas de Puebla, the Youth Institute of Puebla Municipality, and Global Actions.

A comprehensive campaign with the goal of reducing alcohol-related road traffic crashes, the project focuses on three main areas: enforcement, prevention/education, and communications.

“We are looking to enhance enforcement with drink drive checkpoints and efforts to detect and apprehend drink drivers,” said Global Actions country manager Mariana Guerra Rendon. “Regarding prevention, we are looking to educate Puebla’s youth about the dangers of drink driving. And regarding communications, we are looking to widely publicize these efforts to the general public.”

At the press event, Global Actions announced plans to donate breath testing equipment to the Puebla Police to enhance checkpoints.

What’s Happening Next:

· Rwanda: Global Actions Rwanda is hosting the official signing ceremony of the Rwanda Code of Commercial Communication for Alcohol Beverages on June 13 in Kigali.

Role of phenylthiocarbamide as a genetic marker in predicting the predisposition of disease traits in humans

The main objective of this study is to find out the genetic variation and predisposition of overweight/obese, smoking/alcoholism and thyroid disease traits among tasters and non-tasters in Mysore population, South India.

Bitter-taste perception for phenylthiocarbamide (PTC) is a classically variable trait both within and between human populations. Many studies have reported that in world population, approximately 30% of them are PTC non-tasters and 70% are tasters.

This investigation was conducted during the year 2009-2010 involving a total 1352 study subjects and divided into three different groups, considering the age ranging from 13 to 50 years. Phenylthiocarbamide taste sensitivity was measured by administering a freshly prepared 0.025% of phenylthiocarbamide solution using the Harris and Kalmus method with a slight modification and the results were recorded.

In the first group of 100 obese/overweight children, 28% are taster and 72% are non-taster and among 100 control group 67% are tasters and 43% are non-tasters.

In second group, out of 1152 individuals 710 (61.63%) are tasters and 442 (38.37%) are non-tasters including both males and females.

In the third group, out of each 100 thyroid patients and the control group, tasters are significantly more frequent (61.41%) than the non-tasters (38.58%) in the control group, but a higher proportion of non-tasters are recorded among individuals with thyroid problems (68%) compared to tasters (32%).

There is a significant higher incidence of PTC tasters than non-tasters among general population in this study.

As phenotypic variation in PTC sensitivity is genetic in origin, this may represent a surrogate risk factor for the development of multifactorial disease and disorders

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The Links Between Ethnicity, Cultural Identity and Alcohol Use, Abuse and Dependence in a New Zealand Birth Cohort

To examine the role of ethnicity and cultural identity in alcohol use and misuse in a birth cohort of over 1000 young people.

Data on ethnicity, cultural identification, alcohol use, alcohol abuse/dependence (AAD), socio-economic factors and childhood adversity were gathered as part of a longitudinal study of a New Zealand birth cohort (the Christchurch Health and Development Study).

Those reporting Māori ethnicity had rates of alcohol use and AAD that were 1.47–1.63 times higher than the rates found in the non-Māori people. However, there was little evidence to suggest that rates of alcohol use and AAD differed according to Māori cultural identity. Generalized estimating equation regression analyses adjusting for socio-economic disadvantage and childhood adversity slightly reduced the magnitude of these associations, but they remained statistically significant [AAD: odds ratio = 1.52; 95% confidence interval (CI): 1.11–2.10; consumption: incidence rate ratio = 1.31; 95% CI: 1.13–1.52].

(a) Māori ethnicity was found to be associated with modestly increased risks of alcohol use and AAD (b) the higher rates of alcohol use and AAD among the Māori members of the cohort could not be explained by a combination of socio-economic factors and greater exposure to environmental factors known to influence the risk of alcohol use and misuse.

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Suicide Attempts During Heavy Drinking Episodes Among Individuals Entering Alcohol Treatment in Warsaw, Poland

Acute alcohol intoxication itself may act as a trigger for suicidal thoughts and attempts among individuals at risk and may influence the potential lethality of the suicide attempt. This study in alcohol-dependent patients compared the correlates of suicide attempts during a heavy drinking episode with those of suicide attempts during relative sobriety.

In two outpatient and two residential alcohol treatment programs in Warsaw, Poland, 113 patients who reported a suicide attempt during their lifetime were interviewed. The analyses focused on the patients' most serious suicide attempts and on whether these occurred during a heavy drinking episode.

Over two-thirds of the patients reported that their most serious suicide attempt occurred during a period of heavy drinking. A multivariable logistic model indicated that the following factors significantly distinguished those patients whose most serious suicide attempt occurred during a heavy drinking episode: male gender, younger current age, greater severity of alcohol dependence and the attempt being unplanned.

Among the patients in treatment for alcohol dependence who made a suicide attempt, the most serious attempt was likely to have been unplanned and committed by men when it occurred during a heavy drinking episode.

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Tuesday, June 12, 2012

Stress and development of depression and heavy drinking in adulthood: moderating effects of childhood trauma

Studies suggest that childhood trauma is linked to both depression and heavy drinking in adulthood, and may create a lifelong vulnerability to stress. Few studies have explored the effects of stress sensitization on the development of depression or heavy drinking among those who have experienced traumatic childhood events. This study aimed to determine the effect of childhood trauma on the odds of experiencing depression or heavy drinking in the face of an adult life stressor, using a large population-based Canadian cohort.

A total of 3,930 participants were included from the National Population Health Survey. The associations among childhood trauma, recent stress and depression/heavy drinking from 1994/1995 to 2008/2009 were explored using logistic regression, as were interactions between childhood trauma and recent stress. A generalized linear mixed model was used to determine the effects of childhood trauma and stressful events on depression/heavy drinking. Analyses were stratified by sex.

Childhood trauma significantly increased the odds of becoming depressed (following 1 event: OR = 1.66; 95 %CI 1.01, 2.71; 2+ events, OR = 3.89; 95 %CI 2.44, 6.22) and drinking heavily (2+ events: OR = 1.79; 95 %CI 1.03, 3.13). Recent stressful events were associated with depression, but not heavy drinking. While most interaction terms were not significant, in 2004/2005 the association between recent stress and depression was stronger in those who reported childhood trauma compared to those with no childhood trauma.

Childhood trauma increases risk for both depression and heavy drinking. Trauma may moderate the effect of stress on depression; the relationship among trauma, stress and heavy drinking is less clear.

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Drinking, Socioemotional Functioning, and Academic Progress in Secondary School

Secondary schools are sites of academic instruction but also contexts of socioemotional development, and the intertwining of these two functions has consequences for adolescents’ future health and education.

Drawing on nationally representative data from the National Longitudinal Study of Adolescent Health (
n = 8,271), this study explored the bidirectional associations among indicators of adolescents’ alcohol use and their feelings of social integration at school.

Socioemotional problems did not predict increased drinking over time, but drinking predicted declining socioemotional functioning, with negative implications for adolescents’ academic grades by the end of high school.

These associations, however, were conditioned by aspects of school context, with drinkers feeling more marginalized in schools characterized by dense networks with low rates of drinking.

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Association Between Alcohol Screening Scores and Mortality in Black, Hispanic, and White Male Veterans

Scores on the Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questionnaire are associated with mortality, but whether or how associations vary across race/ethnicity is unknown.

Self-reported black (n = 13,068), Hispanic (n = 9,466), and white (n = 182,688) male Veterans Affairs (VA) outpatients completed the AUDIT-C via mailed survey. Logistic regression models evaluated whether race/ethnicity modified the association between AUDIT-C scores (0, 1 to 4, 5 to 8, and 9 to 12) and mortality after 24 months, adjusting for demographics, smoking, and comorbidity.

Adjusted mortality rates were 0.036, 0.033, and 0.054, for black, Hispanic, and white patients with AUDIT-C scores of 1 to 4, respectively. Race/ethnicity modified the association between AUDIT-C scores and mortality (p = 0.0022). Hispanic and white patients with scores of 0, 5 to 8, and 9 to 12 had significantly increased risk of death compared to those with scores of 1 to 4; Hispanic ORs: 1.93, 95% CI 1.50 to 2.49; 1.57, 1.07 to 2.30; 1.82, 1.04 to 3.17, respectively; white ORs: 1.34, 95% CI 1.29 to 1.40; 1.12, 1.03 to 1.21; 1.81, 1.59 to 2.07, respectively. Black patients with scores of 0 and 5 to 8 had increased risk relative to scores of 1 to 4 (ORs 1.28, 1.06 to 1.56 and 1.50, 1.13 to 1.99), but there was no significant increased risk for scores of 9 to 12 (ORs 1.27, 0.77 to 2.09). Post hoc exploratory analyses suggested an interaction between smoking and AUDIT-C scores might account for some of the observed differences across race/ethnicity.

Among male VA outpatients, associations between alcohol screening scores and mortality varied significantly depending on race/ethnicity. Findings could be integrated into systems with automated risk calculators to provide demographically tailored feedback regarding medical consequences of drinking.

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Acute Alcohol Exposure Impairs Fracture Healing and Deregulates β-Catenin Signaling in the Fracture Callus

Alcohol abuse is a risk factor for bone damage and fracture-related complications. Through precise β-catenin signaling, canonical Wnt signaling plays a key role in fracture repair by promoting the differentiation of new bone and cartilage cells. In this study, we examined the effects of alcohol on the Wnt pathway in injured bone using a murine model of alcohol-induced impaired fracture healing.

Male C57Bl/6 or T cell factor (TCF)-transgenic mice were administered 3 daily intraperitoneal doses of alcohol or saline. One hour following the final injection, mice were subjected to a stabilized, mid-shaft tibial fracture. Injured and contralateral tibias were harvested at 6, 9, or 14 days post-fracture for the analysis of biomechanical strength, callus tissue composition, and Wnt/β-catenin signaling.

Acute alcohol treatment was associated with a significant decrease in fracture callus volume, diameter, and biomechanical strength at day 14 post-fracture. Histology revealed an alcohol-related reduction in cartilage and bone formation at the fracture site, and that alcohol inhibited normal cartilage maturation. Acute alcohol exposure caused a significant 2.3-fold increase in total β-catenin protein at day 6 and a significant decrease of 53 and 56% at days 9 and 14, respectively. lacZ staining in β-galactosidase-expressing TCF-transgenic mice revealed spatial and quantitative differences in Wnt-specific transcriptional activation at day 6 in the alcohol group. Days 9 and 14 post-fracture showed that acute alcohol exposure decreased Wnt transcriptional activation, which correlates with the modulation of total β-catenin protein levels observed at these time points.

Acute alcohol exposure resulted in significant impairment of fracture callus tissue formation, perturbation of the key Wnt pathway protein β-catenin, and disruption of normal Wnt-mediated transcription. These data suggest that the canonical Wnt pathway is a target for alcohol in bone and may partially explain why impaired fracture healing is observed in alcohol-abusing individuals.

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Gait and Balance Deficits in Chronic Alcoholics: No Improvement from 10 Weeks Through 1 Year Abstinence

Disturbed gait and balance are common and important sequelae of chronic alcoholism. We present longitudinal data on recovery of gait and balance in alcoholics 6 to 15 weeks abstinent at baseline assessment through follow-up assessment 4 to 16 months after baseline.

We performed a follow-up assessment (4 to 16 months after baseline) of gait and balance functioning in 37 short-term (6 to 15 weeks) abstinent alcoholics (STAA), 25 of whom remained abstinent through the follow-up period. Fourteen non-substance-abusing controls (NSAC) were also brought back for a follow-up assessment to examine practice effects.

Alcoholics showed gait and balance impairment versus controls at both the initial and follow-up assessments, showing no improvement in gait and balance measures over the follow-up period. At follow-up, NSAC showed improvement on the Walk on Floor eyes closed measure, possibly representing a practice effect not present in STAA.

This study finds no improvement from about 10 weeks to about 1 year of abstinence in chronic alcoholics. The study is silent with regard to gait and balance recovery that occurs prior to 10 weeks abstinence, and after the first year of abstinence. Other studies suggest some recovery of gait and balance prior to 10 weeks abstinence, and our recent cross-sectional study (Smith and Fein, 2011, Alcohol Clin Exp Res 35:2184–2192) suggests that significant additional recovery occurs in the ensuing years.

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Collective amnesia: reversing the global epidemic of addiction library closures

Special libraries in the addiction field have been downsized or closed at an alarming rate during the past decade. This editorial describes what is happening, why, and what can be done to prevent further erosion of
contemporary and historical records so vital to an
interdisciplinary field
. > > > > Read More

Monday, June 11, 2012

Absence of P300 Reduction in South African Treatment-Naïve Adolescents with Alcohol Dependence

Event-related potential studies show reduced P300 amplitudes in alcohol use disorders (AUDs). Alcohol exposure, genetic vulnerability to alcoholism, and comorbid psychopathology may contribute to this reduction. Most previous research has studied treated adult AUD samples, which have more severe alcoholism, a greater family history of AUDs, and more comorbidity than untreated samples. Untreated AUD samples tend to have little or no P300 amplitude reduction. We compared P300 between treatment-naïve alcohol-dependent (TNAD) adolescents with no diagnosable substance abuse or psychiatric comorbidity and nonsubstance-abusing control (NSAC) adolescents.

Individuals between the ages of 13 and 18 years were recruited into either TNAD (n = 45) or NSAC (n = 64) groups. Alcohol use variables, family history density of alcohol problems, and psychiatric symptom counts were assessed in a clinician-administered evaluation. EEGs were recorded during performance of a 3-condition visual target detection task.

P300 amplitudes were of comparable size in TNAD adolescents and NSAC adolescents. Boys demonstrated larger P3a and P3b amplitudes than girls. Within TNAD, P3b amplitude was reduced in those who drank more frequently, and P3a latency was more prolonged in subjects with higher internalizing symptom counts.

The P300 deficit was not present in TNAD adolescents without comorbidities. In comparison to results of reduced P300 in treated adolescent AUD samples, this finding likely reflects moderate alcohol exposure, lower genetic vulnerability to alcoholism, and lack of comorbidity in our sample. Further work is needed to determine the relative contributions of these factors to changes in the P300.

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Expression Pattern, Ethanol-Metabolizing Activities, and Cellular Localization of Alcohol and Aldehyde Dehydrogenases in Human Small Intestine

Alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) are principal enzymes responsible for metabolism of ethanol (EtOH). Functional polymorphisms of ADH1B, ADH1C, and ALDH2 genes occur among racial populations. This study aimed to systematically determine the functional expressions and cellular localization of ADH and ALDH family members in human small bowel.

One hundred and seventeen surgical specimens of duodenal mucosae, 34 jejunal mucosal specimens, and 14 paired specimens of stomach, duodenum, and jejunum from same individuals were investigated. The isozyme/allozyme expression patterns of ADH and ALDH were identified by isoelectric focusing, and the ADH/ALDH activities were assayed spectrophotometrically. The protein contents of ADH/ALDH isozymes were determined by immunoblotting using the corresponding purified class-specific antibodies, and the cellular localizations were detected by immunohistochemistry and histochemistry.

The activities of ADH1C*1/*1 allelotype were significantly higher than those of the ADH1C*1/*2 allelotype in duodenum (p < 0.001) and in jejunum (p < 0.05); and the activity of ADH2-expressing phenotype was significantly higher than that of the ADH2-missing phenotype in duodenum (p < 0.05). The activities of ALDH2-inactive phenotype were not significantly different from those of the ALDH2-active phenotype in duodenum and jejunum. Stomach exhibited significantly lower ADH activity (p < 0.05), and duodenum displayed significantly lower ALDH activity (p < 0.001) comparing the paired gastric, duodenal, and jejunal mucosae of same individuals. Gender and age did not significantly influence the ADH and ALDH activities in duodenum. The isozyme protein contents in duodenum and jejunum were in the following decreasing order: ALDH1A1, ADH1/ALDH2, ADH3, ADH2, and ALDH3A1. Villous epithelial cells, cryptic Paneth cells, and Brunner's gland ductal cells revealed a greater immunostaining intensity with ADH1, ALDH1A1, and ALDH2

ADH and ALDH isozymes are differentially expressed in the various cell types of duodenum and jejunum. The results suggest that proximal small intestine can substantively contribute to first-pass metabolism of EtOH under certain conditions and that cytotoxic acetaldehyde and EtOH perturbation of retinol metabolism might play an etiological role in the pathogenesis of small bowel.

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Impact of Medical Comorbidity and Risk of Death in 680 Patients with Alcohol Use Disorders

The association between alcohol use disorders and increased risk of mortality is well known; however, there have been few systematic evaluations of alcohol-related organ damage and its impact on survival in younger alcoholics. Therefore, we assessed medical comorbidity with a clinical index to identify subgroups of alcoholic patients at high risk of premature death.

Hospital-based cohort of alcohol-dependent patients admitted for detoxification between 1999 and 2008 in Barcelona, Spain. At admission, sociodemographic characteristics and a history of alcohol dependence and abuse of illegal drugs were obtained through clinical interviews and questionnaires. Medical comorbidity was assessed with the Cumulative Illness Rating Scale (Substance Abuse) (CIRS-SA). Dates and causes of death were obtained from clinical records and death registers. Survival was analyzed using Kaplan–Meier methods, and Cox regression models were used to analyze the risk factors for premature death.

Median age of the patients (686 total, 79.7% men) was 43.5 years (interquartile range [IQR], 37.8 to 50.4), average alcohol consumption was 200 g/d (IQR, 120 to 280 g/d), and duration of alcohol use disorder was 18 years (IQR, 11 to 24). Medical comorbidity by CIRS-SA at admission showed that the organs/systems most affected were liver (99%), respiratory (86%), and cardiovascular (58%). After median follow-up of 3.1 years (IQR, 1.5 to 5.1), 78 (11.4%) patients died with a mortality rate of 3.28 × 100 person-years; according to Kaplan–Meier estimates, 50% (95% confidence interval [95% CI], 24 to 69%) of patients with severe medical comorbidity died in the first decade after treatment. In multivariate analysis, severe medical comorbidity (hazard ratio [HR], 5.5; 95% CI, 3.02 to 10.07) and being treated with methadone at admission (HR, 2.60; 95% CI, 1.50 to 4.51) were independent risk factors for premature death.

Systematic assessment of alcohol-related organ damage is relevant for the identification and treatment of those at increased risk of death.

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