Aims

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.

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Friday, January 11, 2013

Alcohol Policy UK news 10.1.13




This is a digest of news and information for the UK alcohol harm reduction field,
brought to you by Alcohol Policy UK, courtesy of the Alcohol Academy. For more information, visit Alcohol Policy UK at www.alcoholpolicy.net or visit www.alcoholacademy.net.

Read Full Digest   (PDF)

Thursday, January 10, 2013

NIAAA Newsletter Winter 2012 • Issue 25



>> BREAKING NEWS: NIAAA/NIDA Merger Announcement <<
On Friday November 16, National Institutes of Health (NIH) Director, Dr. Francis Collins, announced that NIH will support a trans-NIH substance use, abuse, and addiction functional integration, enhancing NIH Institute and Center (IC) collaborations around this important scientific and public health topic. This approach is being taken in place of founding a new NIH Institute on addiction—which would have included a merger of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and addiction-related research from other NIH Institutes.

Dr. Kenneth Kendler
Mark Keller Honorary Lecture Series 2012

Photo of Dr. Kenneth Kendler
Kenneth Kendler, M.D., delivered the 17th Annual Mark Keller Honorary Lecture on November 15, 2012, at the Clinical Center on the National Institutes of Health campus in Bethesda, Maryland. Dr. Kendler, a world-renowned expert on the genetics of psychiatric and substance abuse disorders, gave an insightful and sweeping lecture entitled, “The Genetic Epidemiology of Alcohol Use Disorders: A Current Perspective.”
Dr. Kendler set up his talk by saying he would attempt to “review the field of alcohol use disorders through the lens of genetic epidemiology—in one hour.”

Special Issue on Health Status of American Indians and Alaska Natives

The National Institute on Alcohol Abuse and Alcoholism’s (NIAAA’s) Judith Arroyo, Ph.D., Minority Health and Health Disparities Coordinator, and Marcia Scott, Ph.D., Project Officer, Division of Epidemiology and Prevention Research, were guest editors of a special issue of The American Journal of Drug and Alcohol Abuse (Volume 38, Issue 5, 2012). The special edition contains 24 research papers covering many of the most important and urgent issues surrounding alcohol and substance use among American Indian and Alaska Native communities, including how it affects high-risk groups such as adolescents and pregnant women.

Preview of the NIAAA College Drinking Intervention Decision Tool

On July 9, 2012, Dr. Vivian Faden, director of the Office of Science Policy and Communications and associate director of Behavioral Research at NIAAA, spoke during the National College Health Improvement Projects’ (NCHIP) third meeting in Washington, D.C. NCHIP, a national collaborative that works to improve student health, launched an initiative on high-risk college drinking prevention in 2011.

NIAAA Sponsors AACAP Symposium and Residents in Alcohol Research

Steven Szabo, M.D., Ph.D., Ashley Rutter, Shannon Gulliver, M.D., M.Phil., Cecilia Johnson, and Shivana Naidoo, M.D.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recently sponsored a symposium on Alcohol and Teens Research during the American Academy of Child and Adolescent Psychiatry annual meeting in San Francisco. According to Howard Moss, NIAAA Associate Director for Clinical and Translational Research, the symposium shared important new research that has implications for practitioners.

NIAAA on the Road: Delivering a Message on Risky Drinking and Summer Safety

Photo of Risky Drinking billboard
Last summer, NIAAA embarked on an extensive outreach campaign to highlight the harmfulness of risky drinking and to promote summer safety. In July and early August, NIAAA ran a series of outdoor billboard ads in select locations across the Mid-Atlantic region. These billboards carried the themes, and matched the colorful graphics, of the Institute’s summer safety fact sheets, which have been widely distributed.

Dr. Samir Zakhari Retires

Photo of Dr. Sam Zakhari
Dr. Samir Zakhari, director of the Division of Metabolism and Health Effects (DMHE), retired from NIAAA on September 28, 2012. His retirement marks a more than 25-year history with the Institute.
Dr. Zakhari joined NIAAA in 1986 as a scientific review officer, becoming chief of the Biomedical Research Branch in the Division of Basic Research in 1990. In 1998, he was appointed director of the Division of Basic Research, and, in 2003, he took on his current responsibilities in the DMHE.

Students from the Jeter’s Leaders Program visit NIAAA

Photo of participant
NIAAA’s 10-year collaboration with the Jeter’s Leaders Program continued this past July when more than 100 students visited the Institute—the largest group yet.
Founded by New York Yankees team captain Derek Jeter, Jeter’s Leaders is a youth development program that seeks to instill the value of leadership and mentoring in high school students to encourage healthy lifestyles for them and their broader communities.

Project Match Monograph Series

Photo of Dr. Sam Zakhari
The Project Match manuals are a series of publications designed to disseminate methodology developed by the investigators of the multi-site clinical trial Project MATCH (1990–1997), an initiative funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).
The Institute developed these materials with the hope that they would fill a gap in the published literature and provide a resource for alcohol treatment researchers and clinicians. That prediction has proven to be accurate. Since the initial publication, the manuals have been reprinted many times and requested by users both in the United States and abroad.

Two NIAAA Researchers Receive Neuroscience Awards

Andrew Holmes, Ph.D.
The Society for Neuroscience (SfN) recently awarded Andrew Holmes, Ph.D., chief of NIAAA’s Laboratory of Behavioral and Genomic Neuroscience, the 2012 Jacob P. Waletzky Award. That award specifically recognizes research in the field of neuroscience and substance abuse. Dr. Holmes received the $25,000 prize at the SfN annual meeting in New Orleans in recognition of his innovative research on the effects of alcohol and stress on cognitive functioning and emotional regulation.
Rui M.  Costa, D.V.M., Ph.D.
Also recognized at the SfN meeting was Rui M. Costa, D.V.M., Ph.D., a guest researcher in the NIAAA Laboratory for Integrative Neuroscience. Dr. Costa works at the Champalimaud Center for the Unknown in Lisbon, Portugal. He received the $15,000 SfN Young Investigator Award, which is given to notable neuroscientists who have earned their advanced degree in the past 10 years to recognize and foster the growth of talented young neuroscientists.

Wednesday, January 9, 2013

Are Some Individuals Diagnosed With ADHD Prone to Alcohol Abuse? Consideration of Two Possible Mediating Factors for This Susceptibility



Some studies conducted on ADHD have found a statistically significant relationship between those diagnosed with the disorder and a higher susceptibility to abuse alcohol. However, other studies have found no such correlation, or have found this to be true of only a nonstatistically significant subset of the population of individuals with ADHD.

This research found an answer to what may be causing these discrepancies in findings. Various studies on ADHD have discovered both biological and cognitive differences in some individuals with ADHD that may be responsible for this predisposition toward alcohol abuse found in a subset of the ADHD population. 


It is proposed that those individuals diagnosed with ADHD who also have a mutation in the dopamine receptor D4 (DRD4) and who possess a deficiency in functionality of the prefrontal area of the brain designed for planning and reasoning may be more likely to develop alcohol abuse.


Read Full Abstract

Request Reprint E-Mail:   amaxwel2@connect.carleton.ca

Relationship between alcohol mangement plans and injury reductions in a remote Australian community



Alcohol management plans have been introduced in several remote communities in Australia to address a high rate of alcohol-related harm

To evaluate the impact on injury of the alcohol management plan in Bourke NSW (population 2175; 33% Aboriginal) following introduction of takeaway alcohol restrictions in February 2009.

Community and stakeholder interviews were conducted at 12 (n=29) and 24 months (n=19) post-restrictions. Hospital emergency presentations, admissions and police crime databases were analysed to compare injury at 12 months pre- and post-restrictions.

Contested views were provided; however, the majority of interviewees reported visible and tangible benefits, such as reduced public drunkeness and violence. Police reported a 22% decrease in assaults. Hospital presentations (N=714) showed no change in the proportion involving injury (6%) but a significant decline in the proportion of injury presentations involving alcohol (negative binomial regression p=0.016). Injury admissions were low (N=229), with few significant findings detected; however, head injuries decreased by 1.5 times.

Despite limitations of small numbers and alcohol status likely under-enumerated in hospital data, the results collectively indicate reductions in alcohol-related injury, supporting the increasing uptake of alcohol management plans.



Request Reprint E-Mail:   t.senserrick@unsw.edu.au

GDNF is a novel ethanol-responsive gene in the VTA: implications for the development and persistence of excessive drinking



Glial cell line-derived neurotrophic factor (GDNF) is a potent inhibitor of ethanol consumption and relapse, and GDNF heterozygous knockout mice display increased reward sensitivity to ethanol and consume more ethanol after a period of abstinence than their wild-type littermates. 

Here, we tested whether ethanol alters GDNF expression in the ventral tegmental area (VTA; GDNF's site of action) and/or the nucleus accumbens (NAc; the main source of GDNF), and if so, determine the role of the endogenous growth factor in the regulation of ethanol consumption. 

Systemic administration of ethanol increased GDNF expression and protein levels in the VTA, but not the NAc. Additionally, GDNF levels were elevated after an ethanol-drinking session in rats that consumed ethanol in the intermittent-access two-bottle choice procedure for 1 week, but not 7 weeks. Deprivation following 7 weeks of excessive ethanol intake reduced GDNF levels, while a short ethanol binge drinking period following deprivation upregulated GDNF expression. Importantly, knockdown of GDNF within the VTA using adenovirus expressing short hairpin RNA facilitated the escalation of ethanol drinking by ethanol-naïve rats, but not by rats with a history of excessive ethanol consumption. 

These results suggest that during initial ethanol-drinking experiences, GDNF in the VTA is increased and protects against the development of excessive ethanol intake. However, the growth factor's protective response to ethanol breaks down after protracted excessive ethanol intake and withdrawal, resulting in persistent, excessive ethanol consumption.


Read Full Abstract

Request Reprint E-Mail:   dron@gallo.ucsf.edu

Population pharmacokinetics of multiple alcohol intake in humans





The objective of this study was to determine population-based pharmacokinetics parameters for ethanol following multiple intake and to identify the factors influencing the pharmacokinetics. 

Three different solutions of alcoholic liquor (ethanol 55.39 ± 0.45 g) with different dissolved oxygen concentrations were administered, and blood alcohol concentration was determined in 59 healthy subjects using a breath analyzer. Samples (n = 2955) were collected at various time points. Population pharmacokinetic modeling was performed to describe the pharmacokinetics of ethanol. The influence of individuals' demography and dissolved oxygen concentration was investigated, and Visual Predictive Check and bootstrapping were conducted for internal evaluation. The developed model was used to perform simulations to visualize the effects of covariates on individuals. A one-compartment model with Michaelis–Menten elimination kinetics described the multiple ethanol intake data. 

Population pharmacokinetic estimates of Vmax and Km were 3.256 mmol min−1 and 0.8183 mmol L−1, respectively. Vd/F was estimated to be 77.0 L, and Ka was 0.0767 min−1. Body weight, age, and the dissolved oxygen concentration were confirmed to be significant covariates. The mean estimates from the developed population pharmacokinetic model were very similar to those from 500 bootstrap samples, and Visual Predictive Check showed that approximately 94% of the observed data fit well within the 5th–95th percentile. 

A one-compartment model with nonlinear elimination kinetics for multiple ethanol intake was developed and the significant covariates were determined. The robustness of the developed model was evaluated by bootstrap and Visual Predictive Check. 

The final model and implanted covariates explained well the variability and underlying mechanism of ethanol PK.


Read Full Abstract

Request Reprint E-Mail:    kwon@cnu.ac.kr

Genetic and Environmental Influences on the Relationship Between Mastery and Alcohol Dependence






Sense of mastery, a personal resource, is likely to have an inverse association with alcohol dependence. Previous evidence, however, is sparse. In addition, the extent to which an association is due to genetic or environmental factors is unknown.

Data were from 3,983 male twins and 2,630 female twins who had ever used alcohol, interviewed in the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Mastery was measured by a 6-item scale. Lifetime diagnosis of alcohol dependence was based on DSM-IV criteria assessed in a structured diagnostic interview. Univariate analyses modeled the relative contributions of genetic and environmental factors to mastery and alcohol dependence using Mx software. Bivariate Cholesky models were fit to the mastery and alcohol dependence raw data

In the best-fitting model of mastery, genetic factors accounted for about 33% of the observed variance. Nonshared environmental factors, including random measurement error, accounted for the remaining 67%. Fifty-six percent of the variance in liability to alcohol dependence was genetic, and the other 44% was explained by the nonshared environment. The phenotypic polychoric correlation between mastery and alcohol dependence of −0.18 was primarily (67% in the best-fitting model) explained by genes common to both low mastery and alcohol dependence; the rest was explained by nonshared environmental factors.

The findings indicate that genetic risk for alcohol dependence overlaps with genetic factors that influence sense of mastery. Key challenges for future research are to identify the genes that influence mastery and alcohol dependence, as well as the environmental pathways by which they come to be linked.


Read Full Abstract

Request Reprint E-Mail:   kiecolt@vt.edu

Fibrosis Progression in HCV Carriers with Mild Hepatitis Who Possess the High-Repetition Variant of the DRD4 Gene, a Genetic Marker for Binge-Drinking and Risk-Seeking Behavior: A Longitudinal Study






Alcohol is a major determinant of the outcome of chronic hepatitis C virus (HCV) infection, but self-reported drinking habits lack reliability. We hypothesized that carriage of high-repetition variants (HRV) of the variable number of tandem repeats (VNTR) in exon III of the dopamine receptor D4 gene, linked to binge-drinking and risk-seeking behavior, might be a proxy measure of alcohol consumption, and aimed to verify whether it may affect histologic outcome.

A cohort of HCV patients with normal or near-normal aminotransferases (N = 128) underwent a liver biopsy as part of diagnostic work-up. None admitted to exceed low-risk alcohol consumption; most (90/128, 70%) described themselves as teetotalers. They received advice on abstaining from alcohol, but not antiviral treatment. After a median follow-up period of 10 years, all underwent a second liver biopsy. HRV allele frequencies were compared with those of a group of healthy blood donors (N = 128) and related to liver histology.

HRV allele frequencies were 0.19 in patients and 0.16 in controls (p = 0.182). In the subgroup of patients who admittedly had consumed alcohol, 20/38 (53%) carried HRV, in comparison with 27/90 patients (30%) who had denied to consume alcohol (p = 0.026 by Fisher's exact test). Carriage of HRV was associated with higher histologic grade (p = 0.002) and stage (p = 0.009) at the final biopsy. At multivariate analysis, among a set of variables also including viral genotype, viral load, body mass index, gender, and history of alcohol consumption, only age (OR = 1.06, 95% CI 1.02 to 1.11) and HRV (OR = 3.13, 95% CI 1.28 to 7.68) were independent predictors of significant fibrosis at the end of follow-up.

The link between HRV carriage and histologic outcome in a subgroup of HCV patients at low risk of progression underlines the need for intense scrutiny of alcohol habits in hepatitis C.


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Request Reprint E-Mail:    mario.pirisi@med.unipmn.it

Similar Ethanol Drinking in Adolescent and Adult C57BL/6J Mice After Chronic Ethanol Exposure and Withdrawal






Increasing evidence shows that excessive alcohol consumption during adolescence increases vulnerability to alcohol use disorders in adulthood. The aim of this study was to examine differences between adolescent and adult C57BL/6J mice in drinking behavior and blood ethanol (EtOH) concentrations (BECs) after chronic EtOH exposure and withdrawal.


Male adolescent (PND = 28 to 30) and adult (PND = 70) C57BL/6J mice were allowed to consume EtOH in a 2-bottle choice paradigm (15% EtOH vs. water) for 3 weeks (Baseline drinking, Test 1, and Test 2), which were interspersed with 2 cycles (Cycles I and II) of chronic EtOH vapor or air inhalation (16 hours) and withdrawal (8 hours). BECs were determined during both cycles.

Chronic EtOH exposure led to increased EtOH intake during Test 1 and Test 2 in both adolescent and adult mice compared with air-exposed controls, and no differences between age groups were observed. During Cycle I adult mice showed higher BECs compared with adolescents. During Cycle II, BECs were lower in adult mice as compared to Cycle I, and BECs in adolescent mice did not change between the 2 cycles.

Chronic EtOH exposure followed by withdrawal periods increases EtOH consumption similarly in both adolescent and adult mice, despite differences in BECs.


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Request Reprint E-Mail:    camarini@icb.usp.br

Trends in Gastrectomy and ADH1B and ALDH2 Genotypes in Japanese Alcoholic Men and Their Gene–gastrectomy, Gene–gene and Gene–age Interactions for Risk of Alcoholism



The life-time drinking profiles of Japanese alcoholics have shown that gastrectomy increases susceptibility to alcoholism. We investigated the trends in gastrectomy and alcohol dehydrogenase-1B (ADH1B) and aldehyde dehydrogenase-2 (ALDH2) genotypes and their interactions in alcoholics. 

This survey was conducted on 4879 Japanese alcoholic men 40 years of age or older who underwent routine gastrointestinal endoscopic screening during the period 1996–2010. ADH1B/ALDH2 genotyping was performed in 3702 patients. 

 A history of gastrectomy was found in 508 (10.4%) patients. The reason for the gastrectomy was peptic ulcer in 317 patients and gastric cancer in 187 patients. The frequency of gastrectomy had gradually decreased from 13.3% in 1996–2000 to 10.5% in 2001–2005 and to 7.8% in 2006–2010 (P < 0.0001). ADH1B*1/*1 was less frequent in the gastrectomy group than in the non-gastrectomy group (age-adjusted prevalence: 20.4 vs. 27.6%, P = 0.006). ALDH2 genotype distribution did not differ between the two groups. The frequency of inactive ALDH2*1/*2 heterozygotes increased slightly from 13.0% in 1996–2000 to 14.0% in 2001–2005 and to 15.4% in 2006–2010 (P < 0.08). Two alcoholism-susceptibility genotypes, ADH1B*1/*1 and ALDH2*1/*1, modestly but significantly tended not to occur in the same individual (P = 0.026). The frequency of ADH1B*1/*1 decreased with ascending age groups. 

The high frequency of history of gastrectomy suggested that gastrectomy is still a risk factor for alcoholism, although the percentage decreased during the period. The alcoholism-susceptibility genotype ADH1B*1/*1 was less frequent in the gastrectomy group, suggesting a competitive gene–gastrectomy interaction for alcoholism. A gene–gene interaction and gene–age interactions regarding the ADH1B genotype were observed.


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Request Reprint E-Mail:    a_yokoyama@kurihama1.hosp.go.jp

Serum Sclerostin in Alcoholics: A Pilot Study




Sclerostin is an endogenous inhibitor of the Wnt/β-catenin pathway secreted by osteocytes, which inhibits osteoblast function, differentiation and survival. As a consequence, sclerostin tends to decrease bone mass. Alcoholics frequently present osteoporosis, mainly due to decreased bone synthesis. The behaviour of sclerostin in these patients is unknown. The aim of this work was to analyse the relationship between serum sclerostin levels and bone mineral density (BMD), ethanol consumption, nutritional status, liver function derangement and biomarkers of bone homeostasis in alcoholic patients. 

We included 31 alcoholic patients, of whom 11 were infected with Hepatitis C virus (HCV) and 7 age and sex-matched controls. All underwent densitometry, and serum sclerostin, osteocalcin, collagen telopeptide, parathyroid hormone (PTH), vitamin D, cortisol and testosterone were determined. 

Sclerostin levels were significantly higher in patients (30.95 ± 18.91 pmol/l) than controls (t = 4.4; P < 0.001), especially in non-HCV patients; they showed an inverse correlation with osteocalcin, prothrombin activity and serum albumin, and a direct correlation with bilirubin and telopeptide, but not with BMD, nutritional status or ethanol intake. 

Serum sclerostin was raised in alcoholic patients, and it correlated with decreased markers of bone synthesis and increased markers of bone breakdown. The elevation in sclerostin levels was clearly related with liver function, but not with ethanol intake, nutritional status or concomitant HCV infection.


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Request Reprint E-Mail:   egonrey@ull.es

Alcohol Consumption and Mortality in Russia since 2000: Are there any Changes Following the Alcohol Policy Changes Starting in 2006?





To elucidate the possible effects of Russian alcohol control policy on alcohol consumption and alcohol-related mortality for the period 2000–2010. 

Narrative review including statistical analysis. Trends before and after 2006 are compared, 2006 being the date of implementation of the Russian government's long-term strategy to reduce alcohol-related harms. Mortality data were taken from the World Health Organization (WHO) database ‘Health for All’. Data on recorded alcohol consumption were taken from the WHO, based on the Russian Statistical Service (Rosstat). For unrecorded consumption, the calculations of Alexandr Nemtsov were used. Russian public opinion surveys on drinking habits were utilized. Treatment data on alcohol dependence were obtained from the Moscow National Research Centre on Addictions. Information on alcohol policy was obtained from official reports.

Marked fluctuations in all-cause and alcohol-associated mortality in the working-age population were observed during the reviewed period. A decrease in total consumption and mortality was noted since the end of 2005, when the Russian government initially adopted the regulation of alcohol production and sale. The consumption changes were driven by decreases in recorded and unrecorded spirit consumption, only partly compensated for by increases in beer and wine consumption. 

Alcohol is a strong contributor to premature deaths in Russia, with both the volume and the pattern of consumption being detrimental to health. The regulations introduced since 2006 seem to have positive effects on both drinking behavior and health outcomes. However, there is an urgent need for further alcohol-control strategies to reduce alcohol-related harm.                


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Request Reprint E-Mail:    jtrehm@gmail.com

Comparison of Systematic Versus Targeted Screening for Detection of Risky Drinking in Primary Care





To compare two identification methods for risky drinking in primary health care centres (PHCs). 

Sixteen PHCs from three Swedish counties were randomized into strands: consultation-based early identification (CEI) or systematic screening early identification (SS). Measurements took place at baseline and during two intervention periods. Patients filled in questionnaires including gender, age, if they had the issue of alcohol brought up during the consultation and the AUDIT-C (a three item screening tool). The intervention periods were preceded by training sessions for clinicians. The AUDIT-C was used for categorization of risky drinking with cut-offs for risky drinking set at ≥5 for men and ≥4 for women. In the SS strand, clinicians were supposed to give AUDIT-C to all patients for the identification of risky drinking. In the CEI strands, they were encouraged to use early clinical signs to identify risky drinking. 

The proportions of patients having the issue of alcohol brought up are higher during the intervention periods than baseline. A higher proportion of all patients and of risk drinkers in SS, than in CEI, had the issue of alcohol brought up. A higher mean score of AUDIT-C was found among patients having the issue of alcohol brought up in CEI than in SS, and this was also true after adjusting for age and gender. 

More patients are asked about alcohol in the SS strand and thus have the possibility of receiving brief interventions. CEI identifies risk drinkers with higher AUDIT-C scores which might indicate more severe problems. No comparison of the effectiveness of a brief intervention following these alternative identification procedures is reported here.


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Request Reprint E-Mail:    hanna.reinholdz@gu.se

Demos re-iterates importance of parenting style in preventing problem drinking



The think-tank Demos has produced a follow up report further emphasising the influence of parenting style on children’s drinking as teenagers and later in life. Demos claim that ‘tough love’ parenting – a parenting style that combines warmth with consistent discipline – is the best protection against young people developing later life alcohol problems.

Download Feeling the Effects and see a summary blog piece by one of the authors. An NHS Choices review of the report is also available. > > > >  Read More

Tuesday, January 8, 2013

January 2013 Vital Signs Issue: Binge Drinking



Binge drinking is a dangerous behavior but is not widely recognized as a women’s health problem. Drinking too much – including binge drinking* - results in about 23,000 deaths in women and girls each year. Binge drinking increases the chances of breast cancer, heart disease, sexually transmitted diseases, unintended pregnancy, and many other health problems. Drinking during pregnancy can lead to sudden infant death syndrome and fetal alcohol spectrum disorders.


Read Full Issue  (PDF)

Blacks And Hispanics Are Less Likely Than Whites To Complete Addiction Treatment, Largely Due To Socioeconomic Factors



More than one-third of the approximately two million people entering publicly funded substance abuse treatment in the United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute approximately 40 percent of the admissions in publicly funded substance abuse treatment programs, may be particularly at risk for poor outcomes. 

 Using national data, we found that blacks and Hispanics were 3.5–8.1 percentage points less likely than whites to complete treatment for alcohol and drugs, and Native Americans were 4.7 percentage points less likely to complete alcohol treatment. Only Asian Americans fared better than whites for both types of treatment. 

Completion disparities for blacks and Hispanics were largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability. However, the alcohol treatment disparity for Native Americans was not explained by socioeconomic or treatment variables, a finding that warrants further investigation.
The Affordable Care Act could reduce financial barriers to treatment for minorities, but further steps, such as increased Medicaid funding for residential treatment and better cultural training for providers, would improve the likelihood of completing treatment and increase treatment providers’ cultural competence.




Read Full Abstract

Request Reprint E-Mail:     saloner@wharton.upenn.edu

FASD News - 1/2013





NEWS and ARTICLES
Sky News (South Africa) - South Africa: Women Drinking To Harm Babies
Mothers in one of South Africa's poorest areas are drinking heavily to deliberately damage their unborn babies - just so they can claim disability benefit.
Globe and Mail - Unplanned parenthood: how drinking while pregnant changes lives forever
Crystal Piquette is 31 and ripped, her biceps and flat tummy a testament to the rigours of her factory job. Her life seems ordinary – she has a boyfriend and five cats, does handicrafts and dreams of buying a home – but it’s a quantum leap for someone who ran away from home at 17 to live on the street.
Globe and Mail (Canada) - Educating Austin: supporting kids with fetal alcohol syndrome
School can be a problem for children like Austin Layte. He was in Grade 3 last year, but spent most of May and June, not in class but in the principal’s office – visits that mystified a boy who always seem to have a storm brewing inside.
Scientific American - How Much Alcohol Is Safe for Expectant Mothers?
On the night of my 32nd birthday, my husband and I enjoyed a delicious dinner while on vacation in Orvieto, Italy. To complement my pasta, I enjoyed a single glass of red wine, my first since learning I was pregnant four months earlier. Even now my indulgence inspires periodic pangs of guilt: Did I stunt my son’s potential by sipping that Sangiovese?
Wadena Pioneer Journal (USA) - Public Health Matters: January is National Birth Defects Prevention Month
Wadena County Public Health wants to let you know that January is National Birth Defects Prevention Month. Together, with the National Birth Defects Prevention Network (NBDPN), we work to make information available on how to prevent birth defects and also give support to families who are dealing with a child born with a birth defect.
Glasgow Evening Times (Wales) - 88% of pregnant women who tried to quit smoking started again within 4 weeks
Figures show the message is still not getting through to women about the dangers of prenatal smoking. A total of 1270 women were referred to NHS Greater Glasgow and Clyde's Smokefree Pregnancy Service from From April 1 to September 30 this year.
U.S. News & World Report (USA) - Thousands of U.S. Babies Born With Cleft Lip, Palate Each Year
It's not clear exactly what causes oral clefts, according to the March of Dimes. Some factors that have been associated with an increased risk for cleft lip and palate include changes in some genes, a deficiency of folic acid before pregnancy, taking certain medications while pregnant, drinking alcohol during pregnancy and having certain infections during pregnancy.
The Delta Discovery - The Difference Between FAS and FAE
Originally, FAS was an acronym for Fetal Alcohol Syndrome and FAE for Fetal Alcohol Effect. In the early years of research on the effects of alcohol on the developing fetus, the terms FAS and FAE were used to distinguish between a syndrome that could be detected by observation and less noticeable effects from the alcohol upon the developing nervous system.
USA TODAY - Parents plead for easier route to help mentally ill kids
Starting at age 7, Teddy Shuman would transform at a moment's notice from a sweet-natured boy who struggled with developmental disabilities to a child driven by uncontrollable rages.
Health-e (South Africa) - Headway in the fight against FAS
A far-flung Northern Cape town has been making world headlines over the last few years. Unfortunately for the wrong reasons - a 2002-study revealed that more than one in 10 (12.2%) children in the De Aar community had foetal alcohol syndrome (FAS), giving the town the highest reported rate in the world.
The Observer - Drinking While Pregnant: Her Baby, Your Problem?
It’s your first day as a waiter or waitress. You walk up to one of your customers, a woman with an oddly familiar glow to her skin. She looks up, smiling, and orders a glass of pinot noir. Seems normal, right? Until you look down and notice something odd: the woman is pregnant. What do you do?
Pix11 (USA) - Outrage as hospitals test pregnant moms for drugs near low-income neighborhoods
Expecting moms in New York are being drug tested in hospitals near low income neighborhoods. But pregnancy advocates are calling the practice racist and discriminatory.

UPCOMING
FASD Throughout the Lifespan: from prevention to lifelong support
The FASD Association of Newfoundland & Labrador is inviting you to the FACE Research Roundtable and our conference FASD Throughout the Lifespan.
FASD Learning series 2012-2013
Sessions are available via live webcast.
College of New Caledonia - FASD Advanced Diploma Online / FASD Online Courses
This post-diploma program is designed for professionals who are working with individuals or families affected by FASD. Classes are provided in a supportive, fully online environment. Join our team of nationally recognized experts in this field and gain university credits that can be used toward social, justice, education and health professions.
MOFAS - Video Project Night for Young Adults Affected by an FASD
We invite young adults affected by an FASD to join us in creating short videos that feature you, talking about your experiences. You can talk about what services have been beneficial for you, what is most frustrating or what would have been more helpful in making you feel supported and successful. The videos will be short, easy and fun to make.

MATERIALS
Community Living - Supporting Success for Adults with FASD
CLBC’s new Fetal Alcohol Spectrum Disorder (FASD) Resource Supporting Success for Adults with FASD is designed to be used by CLBC staff, service providers, community members, family members and others who work with adults with FASD.

RESEARCH
Annals of Neurology - Prenatal Alcohol Exposure Affects Vasculature Development in the Neonatal Brain
In mice, prenatal alcohol exposure induced a reduction of cortical vascular density, loss of the radial orientation of microvessels, and altered expression of VEGF receptors. Time-lapse experiments performed on brain slices revealed that ethanol inhibited glutamate-induced calcium mobilization in endothelial cells, affected plasticity, and promoted death of microvessels.
Alcoholism - Investigating the Influence of Prenatal Androgen Exposure and Sibling Effects on Alcohol Use and Alcohol Use Disorder in Females from Opposite-Sex Twin Pairs
There are robust sex differences for alcohol phenotypes, with men reporting more drinking and alcohol use disorder (AUD) symptoms than women. However, the sources of these effects are not completely understood. Sex hormones, a substantial biological sex difference, exert neurobehavioral influences and are candidates for influencing sex differences in alcohol phenotypes. This study investigated the effects of prenatal androgens based on the hypothesis of prenatal hormone transfer, which posits that hormones from one twin influence the development of a cotwin.


Monday, January 7, 2013

The 2008–2009 Recession and Alcohol Outcomes: Differential Exposure and Vulnerability for Black and Latino Populations





We examined whether race/ethnicity was related to exposure to acute economic losses in the 2008–2009 recession, even accounting for individual-level and geographic variables, and whether it influenced associations between economic losses and drinking patterns and problems.

Data were from the 2010 National Alcohol Survey (N = 5,382). Surveys assessed both severe losses (i.e., job and housing loss) and moderate losses (i.e., reduced hours/pay and trouble paying the rent/mortgage) attributed to the 2008–2009 recession. Alcohol outcomes included total annual volume, monthly drunkenness, drinking consequences, and alcohol dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). 


Compared with Whites, Blacks reported significantly greater exposure to job loss and trouble paying the rent/mortgage, and Latinos reported greater exposure to all economic losses. However, only Black–White differences were robust in multivariate analyses. Interaction tests suggested that associations between exposure to economic loss and alcohol problems were stronger among Blacks than Whites. Given severe (vs. no) loss, Blacks had about 13 times the odds of both two or more drinking consequences and alcohol dependence, whereas the corresponding odds ratios for Whites were less than 3. Conversely, associations between economic loss and alcohol outcomes were weak and ambiguous among Latinos. 

Results suggest greater exposure to economic loss for both Blacks and Latinos (vs. Whites) and that the Black population may be particularly vulnerable to the negative effects of economic hardship on the development and/or maintenance of alcohol problems. Findings extend the economic literature and signal policy makers and service providers that Blacks and Latinos may be at special risk during economic downturns.


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Role of Tobacco Smoking in Hangover Symptoms Among University Students





Although hangover results from excessive alcohol consumption, the specific pathways through which hangover symptoms arise have not been elucidated. Research on predictors of hangover sensitivity may provide clues about such mechanisms. The present study investigated whether tobacco smoking on days of heavy drinking affects next-day hangover incidence and severity. 

The study drew on diary data from a study on smoking and drinking among 113 students at a midwestern university in the United States. Participants completed a daily, web-based, 26-item survey for 8 weeks to assess prior-day alcohol and tobacco use as well as current-day hangover symptoms. Hierarchical linear modeling was used to test the hypothesis that amount of smoking is related to hangover, controlling for amount of alcohol consumed, sex, and other individual characteristics. Analyses were conducted after selecting only days with alcohol consumption levels that typically elicit hangover, then repeated on lighter drinking days for comparison. Validity of the hangover items was checked by comparing reports after such heavy drinking days with days of lighter drinking. 

Across all possible person-days, 92% of daily reports were obtained. When selecting only events where an estimated blood alcohol concentration of 110 mg/dl was attained, smoking significantly increased the odds of hangover incidence and hangover severity while controlling for number of drinks consumed and sex. Additional analyses controlling for age first smoked regularly, frequency of drug use, type of drug involvement, or smoking status resulted in findings that were unchanged.

Smoking more on heavy drinking days affects hangover sensitivity and severity, possibly because of acute pharmacological effects.



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Varying Impacts of Alcohol Outlet Densities on Violent Assaults: Explaining Differences Across Neighborhoods





Groups of potentially violent drinkers may frequent areas of communities with large numbers of alcohol outlets, especially bars, leading to greater rates of alcohol-related assaults. This study assessed direct and moderating effects of bar densities on assaults across neighborhoods. 

We analyzed longitudinal population data relating alcohol outlet densities (total outlet density, proportion bars/pubs, proportion off-premise outlets) to hospitalizations for assault injuries in California across residential ZIP code areas from 1995 through 2008 (23,213 space-time units). Because few ZIP codes were consistently defined over 14 years and these units are not independent, corrections for unit misalignment and spatial autocorrelation were implemented using Bayesian space-time conditional autoregressive models. 

Assaults were related to outlet densities in local and surrounding areas, the mix of outlet types, and neighborhood characteristics. The addition of one outlet per square mile was related to a small 0.23% increase in assaults. A 10% greater proportion of bars in a ZIP code was related to 7.5% greater assaults, whereas a 10% greater proportion of bars in surrounding areas was related to 6.2% greater assaults. The impacts of bars were much greater in areas with low incomes and dense populations. 

The effect of bar density on assault injuries was well supported and positive, and the magnitude of the effect varied by neighborhood characteristics. Posterior distributions from these models enabled the identification of locations most vulnerable to problems related to alcohol outlets.



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