Search

The article presents the authors' views on the previously published article "Phosphatidylethanol Is Superior to CDT and GGT as an Alcohol Marker and Is a Reliable Estimate of Alcohol Consumption Level," by Walther L. and colleagues.

Background: The use of pejorative or stigmatizing language to describe individuals with alcohol and drug use disorders adversely affects treatment seeking, quality of care, and treatment outcomes. In 2015, the International Society of Addiction Journal Editors released terminology guidelines that recommended against the use of words that contribute to stigma against individuals with an addictive disorder. This study examined the use of stigmatizing language in National Institutes of Health (NIH)‐funded research and reviews published by the journal, Alcoholism: Clinical and Experimental Research (ACER) from 2010 to 2020, with the goal of sharing the results with the alcohol research community to enhance awareness. Methods: The search for stigmatizing language in ACER was limited to NIH‐funded articles made publicly available on PubMed Central (PMC). Though ACER is not an open‐access journal, original research and reviews directly funded by NIH are published to PMC for open access to the public as required by the conditions of NIH funding. ACER articles published on PMC were searched from 2010 to 2020 with specific queries for individual terms of interest including those considered pejorative ("alcoholic," "addict," and "abuser") and outdated ("alcohol dependent," "alcohol abuse," and "alcoholism"). The number of articles containing a term of interest for a given year was divided by the total number of articles published in that year to determine the percent use of each term per year. Results: Our search of research and reviews (n = 1903) published in ACER on PMC determined that although the use of pejorative and outdated terminology has decreased over time, there is continued use of the term "alcoholic" over the last decade. Specifically, in 2020, over 40% of articles searched for in PMC still included "alcoholic." The results of a separate manual search (n = 110) on the Wiley Online Database showed that approximately 30% of articles used the term "alcoholic" in a stigmatizing manner. Conclusions: Stigmatizing language can perpetuate negative biases against people with alcohol use disorder. We encourage researchers to shift away from language that maintains discriminatory conceptions of alcohol use disorder. Reducing stigma has the potential to increase rates of treatment seeking and improve treatment outcomes for individuals with alcohol use disorder. [ABSTRACT FROM AUTHOR]

Background: This commentary discusses the importance of the recent article by Suffoletto and colleagues (in press), from the perspective of the developing role that technology such as text-messaging is serving as a means of increasing the reach of brief interventions for harmful alcohol use. Results: This study is important as it offers evidence from a well-designed study that text-messaging can be used to survey young adults about their alcohol use shows promising results for the potential efficacy of this technology to reduce alcohol use, including risky heavy episodic use. There are ethical and clinical considerations around text-messaging that need to be examined. Conclusions: Future adequately powered randomized studies are needed to show the comparative effect of new technologies, such as text-messaging, in comparison with more traditional methods of providing interventions in reducing harmful alcohol use. [ABSTRACT FROM AUTHOR]

An introduction to the issue is presented in which the author discusses articles in this issue on state-of-the-art alcohol consumption biochemical markers, the development of new biochemical markers and knowledge enhancement regarding known biochemical markers.

Background: Patients with severe alcohol use disorder (SAUD) demonstrate multifaceted impairments in social cognition abilities, including emotional decoding or Theory of Mind. Such impairments are associated with real‐life interpersonal difficulties, which in turn could contribute to the persistence of SAUD. However, little is known regarding how patients with SAUD make decisions in a social context and this literature has not been comprehensively reviewed. Objectives: The main aim of this paper was to conduct the first review specifically focusing on social decision‐making abilities in SAUD. Following PRISMA guidelines for scoping reviews, we describe existing knowledge regarding the difficulties experienced by patients with SAUD during social interactions. Our second objective was to propose perspectives for future research, based on the shortcomings identified in the available literature. Design: We searched three online databases (PubMed, PsycINFO, and Scopus) and identified 14 papers using behavioral tasks to assess social decision making in patients with SAUD. Results: Included studies assessed social decision making through three paradigms: (1) economic games (four papers), (2) moral dilemmas (four papers), and (3) interpersonal problem‐solving (six papers). Results indicated that patients with SAUD behave differently from controls in all three paradigms. Conclusions: Previous studies suggested large‐scale social decision‐making impairments or biases in SAUD. However, in light of the limited number of studies available and of the restricted set of processes measured, we call for the extension of this field through more ecologically relevant and model‐based paradigms in order to elucidate the underlying mechanisms of these effects. [ABSTRACT FROM AUTHOR]

The equivalence of paper-and-pencil-administered and computer-administered versions of the Self-Administered Alcoholism Screening Test (SAAST) was investigated with alcoholic inpatients and nonalcoholic psychiatric outpatients. When the two formats were administered in counterbalanced order, total score mean differences were nonsignificant. In addition, mean differences on a short-form version were also nonsignificant. Equivalence was also determined by comparing the two formats in terms of classification agreement (i.e., classification of subjects into alcoholic and nonalcoholic categories). Agreement between the two formats was 95% in both the total score and short-form versions. Implications of these results as well as the advantages and disadvantages of using computer-administered alcoholism screening tests are discussed. [ABSTRACT FROM AUTHOR]

The article offers an overview of research paper that discussed the women-focused topics including the epidemiology of alcohol use among women, health and behavioral consequences of drinking, prenatal alcohol use and interventions, and enhanced alcohol treatment services. It also mentions the objectives of research to examine the harmful physiological and behavioral effects of alcohol in women.

Background: Interactive voice response (IVR) technology integrates touch-tone telephones with computer-automated data processing. IVR offers a convenient, efficient method for remote collection of self-report data. Methods: Twenty-six subjects recruited from an outpatient alcohol treatment center completed IVR and paper/pencil versions of a demographic and drinking history questionnaire, Stages of Change Readiness and Treatment Eagerness Scale, Drinker Inventory of Consequences, Obsessive-Compulsive Drinking Scale, Alcohol Dependence Scale, and two numerical rating scales of craving and desire to drink during the prior week. Administration of the instruments in both formats was repeated 1 week later. The order of administration method was counterbalanced between subjects and reversed across data collection sessions. Scale and subscale scores from both methods were correlated within sessions. Test-retest correlations were also calculated for each method. A criterion of α= 0.01 was used to control type I statistical error. Results: Intermethod correlations within each session were significant for all of the instruments administered. Test-retest correlations for both methods were also significant, except for the numerical ratings. Scores on the Alcohol Dependence Scale obtained via IVR were significantly lower than those collected by paper/pencil. Other differences between the data collection methods or across the sessions were inconsistent. The average IVR call length was 34 min and 23 sec. Paper/pencil forms required an average of 18 min and 38 sec to complete and an additional 10 min and 17 sec for data entry. Conclusions: IVR technology provides a convenient alternative to collecting self-report measures of treatment outcomes. Both paper/pencil and IVR assessments provide highly convergent data and demonstrate good test-retest reliability. Alcohol Dependence Scale score differences between methods highlight special considerations for IVR adaptation of existing paper/pencil instruments. Benefits of IVR include procedural standardization, automatic data scoring, direct electronic storage, and remote accessibility from multiple locations. [ABSTRACT FROM AUTHOR]

Background: Knowledge of how drinking motives are differentially associated with alcohol use (e.g., frequency, quantity) and drinking problems is critical in understanding risky drinking and the development of alcohol use disorder. The purpose of this paper was to use meta‐analytic techniques to answer 2 overarching questions: (a) Which types of drinking motives (i.e., enhancement, coping, social, conformity) are most strongly associated with alcohol use and drinking problems? and (b) What are the most likely mechanisms (alcohol use or drinking problems) through which motives may be indirectly associated with outcomes? Method: A comprehensive literature search identified 229 studies that met inclusion criteria (254 samples; N = 130,705) with a subset containing longitudinal data (k = 5; N = 6283). Data were analyzed using 2‐stage meta‐analytic structural equation modeling. Results: Results showed that both enhancement and coping motives were the strongest predictors of drinking problems, but only enhancement motives were the strongest predictor of alcohol use. Enhancement and social motives were indirectly associated with alcohol use through drinking problems and with drinking problems through alcohol use, whereas coping motives were only indirectly associated with alcohol use through drinking problems, although the results differed for cross‐sectional and longitudinal data. Conclusion: Overall, findings from this meta‐analysis provide evidence that drinking motives differentially predict alcohol use outcomes through unique direct and indirect pathways. [ABSTRACT FROM AUTHOR]

The article focuses on Clinical and Experimental Research (ACER), the journal of the Research Society on Alcoholism (RSA) and the International Society for Biomedical Research on Alcoholism (ISBRA), has pleased to announce awards for an outstanding paper has published in ACER by an early career investigator. Topics include the role of the early career investigator in the project and write-up of the manuscript, and the potential impact of the research report on the field.

This paper summarizes the proceedings of a symposium presented at the 2005 Research Society on Alcoholism meeting in Santa Barbara, California, that spans the interval from toddlerhood to early middle adulthood and addresses questions about how far ahead developmentally we can anticipate alcohol problems and related substance use disorder and how such work informs our understanding of the causes and course of alcohol problems and alcohol use disorder. The context of these questions both historically and developmentally is set by Robert Zucker in an introductory section. Next, Maria Wong and colleagues describe the developmental trajectories of behavioral and affective control from preschool to early adolescence in a high risk for alcoholism longitudinal study and demonstrate their ability to predict alcohol and drug outcomes in adolescence. Duncan Clark and Jack Cornelius follow with a report on the predictive utility of parental disruptive behavior disorders in predicting onset of alcohol problems in their adolescent offspring in late adolescence. Next, Kenneth Leonard and Gregory Homish report on adult development study findings relating baseline individual, spouse, and peer network drinking indicators at marriage onset that distinguish different patterns of stability and change in alcohol problems over the first 2 years of marriage. In the final paper, John Schulenberg and colleagues, utilizing national panel data from the Monitoring the Future Study, which cover the 18- to 35-year age span, show how trajectories of alcohol use in early adulthood predict differential alcohol abuse and dependence outcomes at age 35. Finally, Robert Zucker examines the degree to which the core symposium questions are answered and comments on next step research and clinical practice changes that are called for by these findings. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption and problems are increasing among older adults, who are at elevated risk for alcohol‐related accidents and medical problems. This paper describes a pilot follow‐up of older adults with a history of alcohol dependence that was designed to determine the feasibility of conducting a more extensive investigation. Methods: The sample consisted of previously assessed subjects in the Collaborative Studies on the Genetics of Alcoholism who: (i) were age 50+; (ii) had lifetime DSM‐IV AD; and (iii) had DNA available. Individuals were located through family contacts, Internet searches, and death registries. A brief telephone interview assessed demographics, health, and alcohol involvement. Results: Of the total sample (N = 2,174), 36% were contacted, 24% were deceased, and 40% were not yet located. Most (89%) contacted subjects were interviewed, and 99% of them agreed to future evaluation. Thirty percent of interviewed subjects reported abstinence for 10+ years, 56% reported drinking within the past year, and 14% last drank between >1 and 10 years ago. There were no age‐related past‐year differences in weekly consumption (overall sample mean: 16 drinks), number of drinking weeks (30.8), maximum number of drinks in 24 hours (8.1), or prevalence of weekly risky drinking (19%). Among those who drank within the past 5 years, the 3 most common alcohol‐related problems were spending excessive time drinking or recovering (49%), drinking more/longer than intended (35%), and driving while intoxicated (35%); and about a third (32%) received some form of treatment. Conclusions: Over a 1‐year period, we located 60% of individuals last seen an average of 23 years ago. The majority of contacted individuals were interviewed and willing to be evaluated again. Although the proportion of individuals currently drinking diminished with age, subjects exhibited troublesome levels of alcohol consumption and problems. Our findings suggest the importance and feasibility of a more comprehensive follow‐up. [ABSTRACT FROM AUTHOR]

Background: Peer selection and socialization influences for alcohol and other substance use have been a prominent area of research especially, though not exclusively, across adolescence. This study used 4‐wave prospective data from 1,004 young adults to evaluate selection and socialization influences for young adults' alcohol use and friends' alcohol use from late adolescence to later young adulthood, and incorporated the time‐varying predictors of marital and parental status. In addition, sex differences in peer selection and socialization processes were tested. Methods: Participants were recruited from high schools, and assessments were based on self‐reports initially collected in adolescence (at age 17.0 years) via paper‐and‐pencil surveys and in young adulthood at ages 23.8, 28.9, and 33.5 years via computer‐based individual interviews (computer‐assisted personal interview and audio computer‐assisted self‐interviewing). Initial sampling included a 76% participation rate, and the retention rate was 83%. Cross‐lagged panel regression models were used to evaluate hypotheses about peer selection and socialization. Results: Findings indicated that friend selection processes were stronger than socialization processes across adolescence to young adulthood. Adopting marital and (especially) parental roles was negatively associated with young adults' alcohol use and percentage of friends using alcohol, and the magnitude of these relationships was stronger and more consistent for females. Conclusions: These findings indicated that across the adolescence‐to‐young adulthood transition, peer selection processes were more influential than peer socialization. Marital and parental roles were associated with both lower young adult alcohol use and a lower percentage of friends using alcohol, with stronger role‐related effects for females relative to males. Do you select friends who drink similarly (selection effect) or does your shared drinking with friends increase your alcohol use (socialization effect)? Longitudinal data from 1004 young adults were used to evaluate these effects for young adults' and friends' alcohol use from adolescence to young adulthood. Friend selection effects were stronger than socialization effects. Adopting marital and parental roles was associated with a decrease in young adults' and friends' alcohol use; findings were stronger for females than males. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss how prenatal ethanol alcohol (EtOH) exposure (PEE) can be used as a sign of EtOH involvement among adolescent people. Also cited are the association of PEE with various neuropsychological deficits and mental disorders like fetal alcohol spectrum disorders (FASD), mental retardation, and autism spectrum disorder, the generator of alcoholism hypothesis, and the double hit exposure protocols.

Background: Subjective response to alcohol (SR), which reflects individual differences in sensitivity to the pharmacological effects of alcohol, may be an important endophenotype in understanding genetic influences on drinking behavior and alcohol use disorders (AUDs). SR predicts alcohol use and problems and has been found to differ by a range of established risk factors for the development of AUDs (e.g., family history of alcoholism). The exact pattern of SR associated with increased risk for alcohol problems, however, remains unclear. The Low Level of Response Model (LLR) suggests that high-risk individuals experience decreased sensitivity to the full range of alcohol effects, while the Differentiator Model (DM) asserts that high risks status is associated with increased sensitivity to alcohol's positive effects but decreased sensitivity to negative effects. Aims: The current paper (1) reviews two prominent models of subjective response, (2) reviews extant laboratory-based research on subjective response, (3) highlights remaining gaps in our understanding and assessment of subjective response, and (4) encourages collaborative efforts to address these methodological and conceptual concerns. Methods: This paper reviews studies which employed placebo-controlled and non-placebo-controlled alcohol challenge paradigms to assess a range of alcohol effects including impairment, stimulation, and sedation. Results: The research literature provides at least partial support for both the LLR and DM models. High-risk individuals have been shown to have a reduced response to alcohol with respect to sedative or impairing effects, particularly on the descending limb of the blood alcohol curve (BAC). There is also evidence that ascending limb stimulant effects are more pronounced or operate differently for high-risk individuals. Discussion: Despite commendable advances in SR research, important questions remain unanswered. Inconsistent results across studies may be attributable to a combination of an inadequate understanding of the underlying construct and methodological differences across studies (e.g., number and timing of assessments across the BAC, inclusion of a placebo condition). With respect to the underlying construct, existing measures fail to adequately distinguish between cognitive/behavioral impairment and sedation, aspects of which may be perceived positively (e.g., anxiolysis) due to their ability to act as negative reinforcers. Conclusions: Addressing the concerns raised by the current review will be integral to making meaningful scientific progress in the field of subjective response. [ABSTRACT FROM AUTHOR]

This program calls attention to the upcoming timetable for the revision of the Diagnostic and Statistical Manual (DSM)-IV and the publication of DSM-V. It is vitally important for Research Society of Alcoholism members to be aware of the current discussions of the important scientific questions related to the next DSM revision and to use the opportunity for input. The title of the symposium highlights 1 key question, i.e., whether the DSM definitions should remain strictly categorical as in the past or whether a dimensional component should be included in this revision. Two substantive and 1 conceptual paper are included in this portion of the symposium. The fourth and final presentation detailing the revision timetable and the opportunities for input is by Dr. Darrel Regier. Dr. Regier is the director of American Psychiatric Institute for Research and Education the research and education branch of the American Psychiatric Association and the organization within the APA that will oversee the DSM revision. The discussion is by Marc Schuckit, who was chair of the Substance Use disorders (SUD) Committee for DSM-IV and cochair of the international group of experts reviewing the SUD definitions for DSM-V. [ABSTRACT FROM AUTHOR]

This article summarizes a symposium organized and cochaired by Maria Testa and presented at the 2005 Annual Meeting of the Research Society on Alcoholism, in Santa Barbara, California. The symposium explored issues relevant to understanding the function of placebo conditions and to interpreting placebo effects. Cochair Mark Fillmore began with an overview of the use of placebo conditions in alcohol research, focusing on methodological issues. Jeanette Norris and her colleagues conducted a review of studies examining placebo conditions among women. They conclude that expectancy effects are limited to a few domains. Maria Testa and Antonia Abbey presented papers suggesting that placebo manipulations may result in unanticipated compensatory effects in actual or hypothetical social situations. That is, placebo participants may compensate for anticipated cognitive impairment through vigilant attention to situational cues. John Curtin's research suggests that the compensatory strategies of placebo participants appear to involve a sensitization of evaluative control, resulting in improved performance. Kenneth Leonard provided concluding remarks on the meaning of placebo effects and the value of placebo conditions in research. [ABSTRACT FROM AUTHOR]

Based on a selective review of the occupational alcoholism literature, a number of difficulties with the research regarding the effects of the workplace on problem drinking were identified. The identification of these difficulties led to an alternative model being proposed. The alternative emphasizes interactions between predispositional factors and the workplace and does not advocate continuing to search for main effects of the workplace on problem drinking. The paper closes with 10 recommendations for future research. [ABSTRACT FROM AUTHOR]

Background Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems ( CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. Methods CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. Results CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing ( MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. Conclusions CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India. [ABSTRACT FROM AUTHOR]

This commentary discusses a study by Karahanian and colleagues (2011) on the role of central nervous system acetaldehyde in the reinforcing effects of ethanol. The goal is to emphasize the importance of the study and to discuss future directions. This important paper solidifies the idea that the levels of acetaldehyde in the central nervous system have profound effects in mediating the reinforcing actions of ethanol. This is accomplished by manipulating the brain levels of acetaldehyde produced from ethanol by the injection of lentivirus containing either an anti-catalase shRNA construct or a rat liver alcohol dehydrogenase into the central nervous system and observing the effects on alcohol preference by high ethanol-consuming rats. A factor not directly considered is that acetaldehyde is further metabolized to acetate, which also has some behavioral actions. The efficacy of lentivirus injections of enzyme inhibitors or enzymes themselves to alter a behavioral response to ethanol is clearly demonstrated here. The many other actions of ethanol that are postulated to be a result of the production of acetaldehyde in the brain remain to be investigated by similar techniques. Possible 'therapeutic avenues to reduce chronic alcohol use' are envisioned. [ABSTRACT FROM AUTHOR]

Background This paper examines the prevalence, the symptom profile, and the drinking and sociodemographic predictors of current (past 12 months) DSM- IV alcohol abuse and dependence among Mexican Americans living along the U. S.- Mexico border and those living in metropolitan areas away from the border. Methods Respondents in the non-border areas (primarily Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288) of these areas, interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey ( HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results Although bivariate analyses revealed no overall differences between border and non-border locations, (negative) age trends were more pronounced on the border for male abuse and for dependence among both genders. Among females aged 18 to 29, border residence was linked to significantly higher rates of dependence. In multivariable analyses, the prevalence of male abuse declined more rapidly with age on the border than off the border. Other unique predictors of male abuse were Jewish/other religion and weekly volume of alcohol consumption. Being married or out of the workforce, attaining a higher education, having no religious preference, and weekly volume uniquely predicted female dependence. Age and weekly volume uniquely predicted male dependence. Conclusions The prevalence of alcohol use disorders among Mexican Americans on and off the U. S.- Mexico border largely mirrors previously documented patterns of alcohol consumption in these areas. For young Mexican American women in particular, border residence is linked to heightened vulnerability to alcohol dependence. [ABSTRACT FROM AUTHOR]

In their paper ' Copy number variations in 6q14.1 and 5q13.2 are associated with alcohol dependence' Lin and colleagues report on the association between alcohol dependence and 2 duplication CNVs in the genome sequence, one containing 8 genes within its boundaries and another that contains no genes. In this commentary, I point out some of the opportunities and challenges that arise from such a finding. [ABSTRACT FROM AUTHOR]

Background: This paper examines differences in drinking and binge drinking between Mexican Americans living along the U.S.-Mexico border and those living in 2 metropolitan areas away from the border (Houston, Texas and Los Angeles, California). Methods: Respondents in the non-border area (Houston and Los Angeles) constitute a multistage probability sample ( N = 1,288), who were interviewed as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS). Respondents in the border area ( N = 1,307) constitute a household probability sample of Mexican Americans living on the U.S.-Mexico border. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The HABLAS and the border sample response rates were 76 and 67%, respectively. Results: There were no differences between border and non-border Mexican American men in the proportion of drinkers, the proportion who binge drink at least once a year, and volume of alcohol consumption. However, within each location, there were significant differences in drinking by age, indicating that younger men drank more than men who were older. Border women showed significant differences across age-groups in the proportion of drinkers, in binge drinking, and volume of alcohol consumption, which were not seen among non-border women. Conclusions: Women's drinking seems to be more affected than men's by their residence on or off the U.S.-Mexico border. This is seen most clearly among young women 18 to 29 years old, and it is associated with an increased proportion of drinkers, a higher volume of drinking, and an increased proportion of women who report binge drinking. Increased drinking in this group of younger women seems to be associated with drinking in Mexico. [ABSTRACT FROM AUTHOR]

The endogenous opioid system has been implicated in the pathophysiology of alcoholism as it modulates the neurobehavioral effects of alcohol. A variant in the mu opioid receptor gene ( OPRM1), the Asn40Asp polymorphism, has received attention as a functional variant that may influence a host of behavioral phenotypes for alcoholism as well as clinical response to opioid antagonists. This paper will review converging lines of evidence on the effect of the Asn40Asp SNP on alcoholism phenotypes, including: (i) genetic association studies; (ii) behavioral studies of alcoholism; (iii) neuroimaging studies; (iv) pharmacogenetic studies and clinical trials; and (v) preclinical animal studies. Together, these lines of research seek to elucidate the effects of this functional polymorphism on alcoholism etiology and treatment response. [ABSTRACT FROM AUTHOR]

Background: Imaging techniques have been in widespread use in the scientific community for more than 3 decades. They facilitate noninvasive, in vivo studies of the human brain in both healthy and diseased persons. These brain-imaging techniques have contributed significantly to our understanding of the effects of alcohol abuse and dependence on structural and functional changes in the human brain. A systematic review summarizing these contributions has not previously been conducted, and this is the goal of the current paper. Methods: The databases PubMed, PsycINFO, and PSYNDEX were searched using central key words. Fulfilling the inclusion criteria were 140 functional and structural imaging studies, together comprising data from more than 7,000 patients and controls. The structural imaging techniques we considered were cranial computerized tomography and various magnetic resonance imaging-based techniques, including voxel-based morphometry, deformation-based morphometry, diffusion tensor magnetic resonance imaging, and diffusion-weighted magnetic resonance imaging. The functional methods considered were magnetic resonance spectroscopy, positron emission tomography, single photon emission computed tomography, and functional magnetic resonance imaging. Results: Results from studies using structural imaging techniques have revealed that chronic alcohol use is accompanied by volume reductions of gray and white matter, as well as microstructural disruption of various white matter tracts. These changes are partially reversible following abstinence. Results from functional imaging methods have revealed metabolic changes in the brain, lower glucose metabolism, and disruptions of the balance of neurotransmitter systems. Additionally, functional imaging methods have revealed increased brain activity in the mesocorticolimbic system in response to alcohol-themed pictures relative to nondrug-associated stimuli, which might be of predictive value with regard to relapse. Conclusions: There has been tremendous progress in the development of imaging technologies. Use of these technologies has clearly demonstrated the structural and functional brain abnormalities that can occur with chronic alcohol use. The study of the alcoholic brain provides an heuristic model which furthers our understanding of neurodegenerative changes in general, as well as their partial reversibility with sustained abstinence. Additionally, functional imaging is poised to become an important tool for generating predictions about individual brain functioning, which can then be used as a basis for personalized medicine. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for 'hazardous use.' which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic 'orphans.' These respondents reported 1 or 2 indicators of alcohol dependence as present. Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic 'orphans' to better design interventions to address their problems. [ABSTRACT FROM AUTHOR]

The 'prevention paradox,' a notion that most alcohol-related problems are generated by nonheavy drinkers, has significant relevance to public health policy and prevention efforts. The extent of the paradox has driven debate over the type of balance that should be struck between alcohol policies targeting a select group of high-risk drinkers versus more global approaches that target the population at-large. This paper examines the notion that most alcohol problems among 4 Hispanic national groups in the United States are attributable to moderate drinkers. A general population survey employing a multistage cluster sample design, with face-to-face interviews in respondents' homes was conducted in 5 metropolitan areas of the United States. Study participants included a total of 2,773 current drinkers 18 years and older. Alcohol consumed in the past year (bottom 90% vs. top 10%), binge drinking (binge vs. no binge), and a 4-way grouping defined by volume and binge criteria were used. Alcohol-related harms included 14 social and dependence problems. Drinkers at the bottom 90% of the distribution are responsible for 56 to 73% of all social problems, and for 55 to 73% of all dependence-related problems reported, depending on Hispanic national group. Binge drinkers are responsible for the majority of the social problems (53 to 75%) and dependence-related problems (59 to 73%), also depending on Hispanic national group. Binge drinkers at the bottom 90% of the distribution are responsible for a larger proportion of all social and dependence-related problems reported than those at the top 10% of the volume distribution. Cuban Americans are an exception. The prevention paradox holds when using volume-based risk groupings and disappears when using a binge-drinking risk grouping. Binge drinkers who drink moderately on an average account for more harms than those who drink heavily across all groups, with exception of Cuban Americans. [ABSTRACT FROM AUTHOR]

Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR = 3.5; 95% CI 2.6 to 4.8) and dependence (OR = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "The relationships of the level of response to alcohol and additional characteristics to alcohol use disorders across adulthood: a Discrete-Time Survival Analysis,” by Trim and others in a previous issue.

Background: We have previously identified suggestive linkage for alcohol consumption in a community-based sample of Australian adults. In this companion paper, we explore the strength of genetic linkage signals for alcohol dependence symptoms. Methods: An alcohol dependence symptom score, based on DSM-IIIR and DSM-IV criteria, was examined. Twins and their nontwin siblings (1,654 males, 2,518 females), aged 21 to 81 years, were interviewed, with 803 individuals interviewed on 2 occasions, approximately 10 years apart. Linkage analyses were conducted on datasets compiled to maximize data collected at either the younger or the older age. In addition, linkage was compared between full samples and truncated samples that excluded the lightest drinkers (approximately 10% of the sample). Results: Suggestive peaks on chromosome 5p (LODs >2.2) were found in a region previously identified in alcohol linkage studies using clinical populations. Linkage signal strength was found to vary between full and truncated samples and when samples differed only on the collection age for a sample subset. Conclusions: The results support the finding that large community samples can be informative in the study of alcohol-related traits . [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the articles “Complete and Prolonged Suppression of Symptoms and Consequences of Alcohol-Dependence Using High-Dose Baclofen: A Self-Case Report of a Physician,” by O. Ameisen in a 2005 issue of "Alcohol and Alcoholism" and "Efficacy and Safety of Baclofen for Alcohol Dependence: A Randomized, Double Blind, Placebo-Controlled Trial," by J. C. Garbutt and colleagues in a 2010 issue of "Alcoholism: Clinical & Experimental Research."

Background: Two different measures have been used to establish a person’s level of response (LR) to alcohol as a risk factor for alcohol use disorders. LR values established by the alcohol challenge protocol and the Self-Report of the Effects of Ethanol (SRE) questionnaire usually correlate at 0.3 to 0.4, up to 0.6. However, it is not clear how this correlation relates to the ability of each measure to predict alcohol outcomes. This paper evaluates that overlap. Methods: Sixty-six Caucasian males (mean age = 22 years) from 2 protocols participated in alcohol challenges with 0.75 ml/kg of ethanol, filled out the SRE, and were followed with a structured interview ∼5 years later. The relationship between the subjective feelings of intoxication at the time of peak breath alcohol levels from the alcohol challenge and the SRE score for a time early in the drinking career were evaluated regarding predicting the drinks per occasion in the 6 months prior to follow-up. Results: Cross-sectional correlations between alcohol challenge and SRE LR’s ranged from −0.25 ( p < 0.05) to −0.32 ( p = 0.02) for the full sample, and the 2 LR measures correlated with drinking at follow-up (−0.26 and 0.41, respectively). The SRE measure was more robust than the challenge in a regression analysis predicting the outcome in the context of other baseline predictors (e.g., drinking at baseline). As much as 60% of the ability of the more well established (gold standard) alcohol challenge LR to predict outcome was shared with the SRE. The alcohol challenge accounted for as much as 44% of the ability of the SRE to predict outcome. Conclusions: The SRE-generated LR overlapped considerably with the alcohol challenge LR in the ability to predict future heavier drinking. [ABSTRACT FROM AUTHOR]

Background: U.S. Hispanics come from many countries in Latin America, which can lead to different beverage preferences in the United States. This paper examines choice for drinking wine, beer, and liquor across 4 Hispanic national groups: Mexican Americans, Puerto Ricans, Cuban Americans, and South/Central Americans. Methods: A sample of 5,224 individuals 18 years of age and older was selected using multistage cluster procedures from the household population in 5 metropolitan areas of the United States: Miami, New York, Philadelphia, Houston, and Los Angeles. The survey weighted response rate was 76%. Face-to-face interviews lasting 1 hour on average were conducted in the respondents’ homes either in English or Spanish. Results: Among men, beer drinkers consume the highest mean number of drinks per week in all national groups. Among women, this is true only of Puerto Ricans and Mexican Americans. Among men who drink beer, beer drinking constitutes 52 to 72% of total alcohol consumption. Among women who drink beer, beer consumption is associated with 32 to 64% of total consumption. Beer is the beverage most associated with binge drinking among Puerto Rican and Mexican American women, while among Cuban Americans and South/Central Americans this is seen for wine. Regression analyses showed no significant differences by national group in the likelihood of drinking 2 or fewer drinks (vs. no drinks) of wine, beer, or liquor. Puerto Ricans were more likely (OR = 1.47; 95% CI = 1.00–2.14) than Cuban Americans to drink 3 or more drinks (compared with no drinks) of beer. There was no association between the likelihood of binge drinking and Hispanic national group. Conclusions: Beverage preference across Hispanic national groups is similar. Beer is the preferred beverage. Alcohol control policies such as taxation and control of sales availability should apply equally to beer, liquor, and wine. Prevention interventions directed at different Hispanic national groups in the United States can be relatively uniform in their focus on the dangers associated with drinking different types of alcoholic beverages. [ABSTRACT FROM AUTHOR]

Background: Within the alcoholism field, there is mounting evidence supporting an important relationship between medication adherence and drinking outcomes. Little is known however, about the complex relationships between medication and treatment variables and drinking outcomes. The present paper reports on the differential impact of medication adherence and treatment factors on drinking outcomes. Data derived from the COMBINE Study was used to investigate the interrelationships between medication adherence, combination treatments and drinking outcomes. Methods: Twelve hundred and twenty-six patients were randomized to 1 of 8 different combination treatments involving 2 medications—naltrexone and acamprosate and placebo, and 2 behavioral treatments—medical management (MM) and combined behavioral intervention (CBI). Two primary drinking outcomes were percent days abstinent (PDA) and time to first heavy drinking day. Medication adherence was defined as a proportion that reflects the number of pills taken by the maximum number of pills expected to be taken over the course of the trial. A generalized linear mixed model was used to estimate the effects of adherence on PDA while proportional hazards model was used to examine similar co-variate effects on time to first heavy drinking day. Results: Concerning time to first heavy drinking day, a significant three-way interaction was found between medication adherence, CBI and naltrexone ( p = 0.0160). Within the MM only plus placebo group (no CBI), significant differences were found in “recovery” (i.e., no heavy drinking days) rates between adherers and nonadherers (40% vs. 10%, p < 0.0001). Such differences became nonsignificant ( p = 0.12) when CBI was introduced into the relationship. CBI did not add any such advantage to naltrexone-treated patients. Conclusions: CBI might serve a protective function for nonadherers in the placebo group; the median relapse time was reduced when these nonadherers were exposed to the alcohol specialty intervention. CBI offered little additional benefit to nonadherers in the naltrexone group. Among nonadherers in the naltrexone group, relapse rates appear to be more a function of inadequate exposure to the active medication and less influenced by CBI. [ABSTRACT FROM AUTHOR]

Background: Given today’s telecommunications environment, random digit dial (RDD) telephone surveys face declining response rates and coverage, and increasing costs. As an alternative to RDD, we surveyed participants in a randomly recruited standing Internet panel supplemented with a randomly sampled telephone survey of nonpanel members for a study of associations between onset of alcohol use and later alcohol-related problems. The purpose of this paper was to compare results from our survey with results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a face-to-face probability sample survey of 43,093 adults, with a focus on associations between demographics, age of drinking onset, and alcohol dependence. Methods: Demographic and drinking characteristics from our survey of 4,021 ever-drinkers between the ages of 18 and 39 years were compared with the characteristics of 11,549 similarly aged ever-drinkers from the NESARC. Weighted analyses accounting for sampling design compared these 2 samples on drinking characteristics over the past year and during a respondent’s heaviest period of drinking, and in multivariate models examining associations between demographics, age of drinking onset, and lifetime alcohol dependence. Results: Participants in the supplemented Internet panel were similar to the national population of 18- to 39-year-old ever drinkers on gender, education, and race/ethnicity, while adults who were aged 18 to 25 years were under-represented in the Internet panel. The supplemented Internet panel reported higher rates of moderate risk drinking over the past 12 months, lifetime high-risk drinking, and lifetime (ever) alcohol dependence. Estimates of the associations between alcohol dependence and age of drinking onset, risky drinking, and family history of alcohol problems did not significantly differ between the supplemented Internet sample and the NESARC survey. Conclusions: Randomly recruited Internet-based panels may provide an alternative to random digit dial telephone surveys and in-person surveys for some studies of factors associated with alcohol-related problems. [ABSTRACT FROM AUTHOR]

Background: In light of the inconsistent evidence associating acculturation with drinking outcomes among Latinos in the United States, the current paper comprehensively reviews the literature on this topic. Methods: Studies were eligible for review if they (1) were published in a refereed journal, (2) were published in English, (3) sampled Latino/Hispanic adults aged 18+, (4) examined self-reported drinking behavior, alcohol-related problems, and/or alcohol abuse/dependence, and (5) reported original results or unique analyses from a larger dataset. The review includes only studies using composite scales of acculturation. Studies were identified via electronic databases (i.e., PSYCHINFO, ETOH, and PUBMED) using search terms, and combinations thereof, including “acculturat*,”“alcohol*,”“Latino,” and “Hispanic.” This search was supplemented by recursive checking and author searches. Thirty-two articles were identified and coded on methodological characteristics; results from 24 disaggregating genders and using appropriate outcomes were summarized. Results: Higher acculturation was very consistently associated with higher odds of drinking among women, even controlling for demographic covariates. The evidence for women also suggested associations between higher acculturation and heavier drinking on other outcomes, including total volume, drinking frequency, typical quantity, heavy/problem drinking, drinking problems, and abuse/dependence, despite some null results. Relationships were weaker and ambiguous among men. Some evidence suggested that highly acculturated men are (compared with peers low on acculturation) more prone to drink, and perhaps as a result, can show higher consumption and problems. However, results also implied that, among male drinkers, higher acculturation may be associated with a lighter drinking pattern. Important study limitations were identified, including low power, aggregation of nondrinkers with drinkers, restrictive sampling, measurement issues, and analytical issues. Conclusions: The pattern of results suggests important associations between acculturation and drinking outcomes—particularly for women—but conclusions are tempered by serious methodological limitations. The review urges further research, particularly large-scale, longitudinal studies, addressing these limitations. [ABSTRACT FROM AUTHOR]

Background: The decision among young people to drink is complex and reflects multiple domains of influence. This paper applies the results from a previous test of an externalizing-based model predicting heavy drinking and alcohol problems in the probands from the San Diego Prospective Study to evaluate how similar characteristics relate to the decision to drink in their offspring. Methods: Data were generated from multiple sources for 152 offspring with a mean age of 17.2 years. Information on the family histories, personal alcohol and other substance use, socioeconomic stratum, the child’s gestational problems, and additional characteristics were gathered from face-to-face interviews with a parent approximately every 5 years between their mid-20s and mid-40s. Data regarding the drinking status and additional variables applicable to the offspring were extracted from the 25-year (T25) epoch of the family evaluations using data supplied directly by the offspring. The relationships of variables to the drinking status in that generation were determined through correlations, regression analyses, and an AMOS-based structural equation model (SEM). Results: Significant correlations to the drinking status in offspring were observed for age, but not for sex. Using age-adjusted backgrounds and data supplied by the offspring at T25, the most robust correlations to the drinking status were seen for a disinhibition measure, peer drinking, expectations of the effects of alcohol, and the history of having worked outside the home. When placed into an SEM, the former 3 variables performed in a manner similar to that observed in the original probands in the prediction of the drinking status, in a model with good fit characteristics. Conclusions: These data from a prospective study support the importance of similar domains across 2 generations in characterizing age-appropriate alcohol-related outcomes. [ABSTRACT FROM AUTHOR]

Thiamine deficiency has been specifically linked to the development of Wernicke–Korsakoff syndrome (WK)—a degenerative brain disorder that is typically associated with alcoholic drinking. Alcoholism-related thiamine deficiency is a major cause of WK. However, an inherited abnormality in thiamine utilization has been identified in some WK patients that may predispose heavy drinkers to this severe neurological syndrome. Individuals who possess this variant require more thiamine throughout their lives to prevent them from experiencing thiamine deficiency. Recent prospective studies have implicated early childhood nutritional and environmental influences in the etiology of alcoholism in adults. These studies have suggested that developmental abnormalities involving brain white matter growth might precipitate the later development of alcoholism possibly by altering the emerging reward-related brain systems. Brain white matter growth is highly sensitive to nutritional deficiency (including thiamine deficiency) and oxidative injury, especially during the perinatal period. The proposed model of familial alcoholism hypothesizes that an inherited insensitivity to thiamine can precipitate brain abnormalities very early in life that will greatly increase the risk of developing alcoholism in adulthood. This paper offers a heuristic model of a possible mechanism by which both inherited and environmental factors related to thiamine utilization might coaggregate to cause alcoholism. [ABSTRACT FROM AUTHOR]

Background: Tracking the dynamic course of human alcoholism brain pathology can be accomplished only through naturalistic study and without opportunity for experimental manipulation. Development of an animal model of alcohol-induced brain damage, in which animals consume large amounts of alcohol following cycles of alcohol access and deprivation and are examined regularly with neuroimaging methods, would enable hypothesis testing focused on the degree, nature, and factors resulting in alcohol-induced brain damage and the prospects for recovery or relapse. Methods: We report the results of longitudinal magnetic resonance imaging (MRI) studies of the effects of free-choice chronic alcohol intake on the brains of 2 cohorts of selectively bred alcohol-preferring (P) rats. In the companion paper, we described the MRI acquisition and analysis methods, delineation of brain regions, and growth patterns in total brain and selective structures of the control rats in the present study. Both cohorts were studied as adults for about 1 year and consumed high doses of alcohol for most of the study duration. The paradigm involved a 3-bottle choice with 0, 15 (or 20%), and 30% (or 40%) alcohol available in several different exposure schemes: continuous exposure, cycles of 2 weeks on followed by 2 weeks off alcohol, and binge drinking in the dark. Results: Brain structures of the adult P rats in both the alcohol-exposed and the water control conditions showed significant growth, which was attenuated in a few measures in the alcohol-exposed groups. The region with the greatest demonstrable effect was the corpus callosum, measured on midsagittal images. Conclusion: The P rats showed an age–alcohol interaction different from humans, in that normal growth in selective brain regions that continues in adult rats was retarded. [ABSTRACT FROM AUTHOR]

This article summarizes a symposium organized by Dr. Elizabeth DʼAmico and presented at the 2004 Annual Meeting of the Research Society on Alcoholism in Vancouver, Canada. The four presentations illustrate the importance of creating substance use interventions that are developmentally appropriate for youth. They represent innovative approaches to working with preteens, teenagers, and young adults. Dr. DʼAmicoʼs paper describes her research on the development of a voluntary brief intervention targeting alcohol use among middle school students. Findings indicated that by using school and community input, she was able to obtain a diverse a sample of youth across grades, sex, ethnicity, and substance use status. Dr. Ellicksonʼs paper describes her research on Project ALERT, a school-based prevention program for middle school youth. Her findings indicate that Project ALERT worked for students at all levels of risk (low, moderate, and high) and for all students combined. Dr. Wagnerʼs Teen Intervention Project was a randomized clinical trial to test the efficacy of a standardized Student Assistance Program for treating middle and high school students with alcohol and other drug problems. The study provided a unique opportunity to begin to examine how development may impact response to an alcohol or other drug intervention. Dr. Turrisiʼs paper examined processes underlying the nature of the effects of a parent intervention on college student drinking tendencies. Findings suggested that the parent intervention seems to have its impact on student drinking by reducing the influence of negative communications and decreasing the susceptibility of influences from closest friends. Dr. Kim Fromme provided concluding remarks. [ABSTRACT FROM AUTHOR]

This article summarizes a symposium that was organized by Dr. Kim Fromme and presented at the 2003 annual meeting of the Research Society on Alcoholism in Ft. Lauderdale, Florida. The four presentations illustrate the emerging technologies and methods that are now being used to investigate the genetic basis of differential sensitivity to alcohol and their behavioral manifestations. Combining human genotyping with laboratory measures of behavior and subjective reports, these presentations represent state-of-the-art approaches to crossing the bridge from the Decade of the Brain to the Decade of Behavior. Dr. De Wit’s paper describes her research on the neurobiological basis for individual differences in sensitivity to the stimulant and sedative effects of alcohol. Evidence suggests that activity of the dopaminergic and GABAergic neurotransmitters underlie these stimulant and sedative effects, respectively. Both Drs. Hutchison’s and Corbin’s papers describe their research on polymorphisms for the serotonin transporter (SLC6A4) as a determinant of the subjective effects of alcohol challenge. Dr. Hutchinson’s and Ms. Ray’s findings indicate that individuals with the short form of the SLC6A4 alleles (S) demonstrated a low level of response to alcohol, thus supporting previous research that the S allele may be associated with increased risk for alcohol dependence. In contrast, Dr. Corbin did not find a reliable association between the SLC6A4 genotype and subjective response to alcohol. Mr. Cook’s and Dr. Wall’s paper adds another dimension to this article by presenting research on both the aldehyde dehydrogenase (ALDH2) and alcohol dehydrogenase (ADH2) genetic variants and their association with the alcohol-related flushing response that is prevalent in Asian populations. Dr. David Goldman provides concluding remarks. [ABSTRACT FROM AUTHOR]

Background: This study examined the effect of fathers' alcoholism and associated risk factors on toddler compliance with parental directives at 18 and 24 months of age. Methods: Participants were 215 families with 12-month-old children, recruited through birth records, who completed assessments of parental substance use, family functioning, and parent-child interactions at 12, 18, and 24 months of child age. Of these families, 96 were in the control group, 89 families were in the father-alcoholic-only group, and 30 families were in the group with two alcohol-problem parents. Child compliance with parents during cleanup situations after free play was measured at 18 and 24 months. The focus of this paper is on four measures of compliance: committed compliance, passive noncompliance, overt resistance, and defiance. Results: Sons of alcohol-problem parents exhibited higher rates of noncompliance compared with sons of nonalcoholic parents. Sons in the two-alcohol-problem parent group seemed to be following a trajectory toward increasing rates of noncompliance. Daughters in the two-alcohol-problem parent group followed an opposite pattern. Other risk factors associated with parental alcohol problems also predicted compliance, but in unexpected ways. Conclusions: Results indicate that early risk for behavioral undercontrol is present in the toddler period among sons of alcoholic fathers, but not among daughters. [ABSTRACT FROM AUTHOR]

Background: There is strong evidence for the role of the endogenous opioid system in alcohol reinforcement and consumption; however, recent human laboratory studies and clinical trials have reported mixed effects of naltrexone (a nonselective opioid antagonist) on alcohol-related behaviors. This paper reports a secondary data analysis of a human laboratory study that examines the relationship between serum levels of 6-beta-naltrexol, the major, biologically active metabolite of naltrexone, and subjective effects of alcohol. Methods: The study used a within-subjects design to examine the effects of naltrexone (0, 50, and 100 mg/day) on subjective responses to alcohol (none, moderate, and high dose) in heavy drinkers ( n= 23). Each subject received three doses of naltrexone in random order; each naltrexone dose was administered over an 8 day period on an inpatient unit, with a 1 week outpatient washout between doses. After stabilization at each of the naltrexone doses, subjects participated in three alcohol challenge sessions (none, moderate, and high dose) in random order; thus, each subject participated in a total of nine alcohol administration sessions. Results: Doubling the naltrexone dose (50 vs. 100 mg/day) doubled the mean serum 6-beta-naltrexol levels. At each naltrexone dose, there was a 4-fold range in 6-beta-naltrexol levels across subjects. Before alcohol administration, higher 6-beta-naltrexol levels were associated with higher ratings of sedation. After high-dose alcohol administration, higher 6-beta-naltrexol levels were associated with significantly lower ratings of liking and best effects. Conclusions: These findings provide further evidence of the involvement of the opioid system in the modulation of alcohol effects and suggest that serum 6-beta-naltrexol concentrations may be important in predicting therapeutic response to naltrexone. [ABSTRACT FROM AUTHOR]

Background: This paper focuses on the co-occurrence of alcoholism and eating disorders and the clinical implications for treating this comorbidity in women with alcohol use disorders. There is substantial literature that supports higher than expected rates of co-occurrence of these two disorders. In addition, there is evidence that the co-occurrence of alcoholism and eating disorders is more likely to occur in the presence of other psychiatric disorders. A critical analysis of the studies on the comorbidity of these disorders is conducted along with a review of the possible etiologic association between the two disorders. Crucial questions related to pharmacological and behavioral treatments for this subgroup of alcoholic women with eating disorders are raised from a health services research perspective. Conclusions: There is substantial evidence that alcoholism and eating disorders co-occur at high rates. However, as this review points out, several important research questions remain regarding both the clinical manifestations of each problem in women who are comorbid for both disorders and the treatment implications. [ABSTRACT FROM AUTHOR]

Drawing upon data from the National Longitudinal Survey of young adults, this paper examines the effects of family history of alcoholism and current alcohol use by the young adults. A multivariate analysis of the data from the study indicates that there are both main and interaction effects of family history and current alcohol use on dependence symptoms among the young adults. [ABSTRACT FROM AUTHOR]

The article announces that the Clinical and Experimental Research (ACER), the journal of the Research Society on Alcoholism (RSA) and the International Society for Biomedical Research on Alcoholism (ISBRA), is pleased to announce awards for outstanding papers published in ACER by early career investigators. It mentions that these awards recognize outstanding scientific papers published in ACER between January 1, 2020 and December 31, 2020 by students or postdoctoral fellows.

Background Alcohol is a common target of counterfeiting in Russia. Counterfeit alcohol is defined here as the manufacture, distribution, unauthorized placement (forgery) of protected commodity trademarks, and infringement of the exclusive rights of the registered trademark holders of alcoholic beverages. It is often argued that the expansion of the counterfeit product market is due to the steady demand of economically disadvantaged people for low-priced goods. The situation becomes more complicated once deceptive and nondeceptive forms of counterfeiting are taken into account. This study aimed to identify markers of risky behavior associated with the purchase of counterfeit alcohol in Russia. Methods The analysis relied on consumer self-reports of alcohol use and purchase collected nationwide by the Russia Longitudinal Monitoring Survey (RLMS-HSE) in 2012 to 2014. I used a generalized linear mixed-model logistic regression to identify predictors of risky behavior by consumers who purchased counterfeit alcohol, either knowingly or unknowingly, during the 30 days preceding the survey. Results Purchases of counterfeit alcohol declined slightly from 2012 to 2014, mainly due to a decrease in consumers mistakenly purchasing counterfeit products. Predictors of counterfeit alcohol purchases differed between consumers who knowingly and unknowingly purchased counterfeit products. Nondeceptive purchase of counterfeit alcohol was related primarily to an indifference to alcohol brands. Consumers with social networks that include drinkers of nonbeverage alcohol and producers of homemade alcohol were highly likely to consume counterfeit alcohol deliberately. Problem drinking was significantly associated with a higher risk of both deceptive and nondeceptive purchases of counterfeit alcohol. Poverty largely contributed to nondeceptive counterfeiting. Conclusions The literature has overestimated the impact of low prices on counterfeit alcohol consumption. Problem drinking and membership in social networks of consumers of surrogate alcohol (i.e., nonbeverage) are more influential in explaining why people purchase counterfeit alcohol. Further research on these 2 factors is needed to more fully understand the purchase and consumption of counterfeit alcoholic beverages. [ABSTRACT FROM AUTHOR]

Background: High alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts of alcohol. Methods: We obtained information from the UK Biobank on approximately 500,000 participants aged 40–70 years at baseline assessment in 2006–2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported consuming ≥80 or ≥50 g/day, respectively, were used in survival analysis. Results: Mortality hazard ratios for these excessive drinkers, compared to all other participants, were 2.02 (95% CI 1.89–2.17) for all causes, 1.89 (1.69–2.12) for any cancer, 1.87 (1.61–2.17) for any circulatory disease, and 9.40 (7.00–12.64) for any liver disease. Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake; diagnosed alcohol dependence, harmful use, or withdrawal syndrome; and current smoking at assessment. Conclusions: People with chronic excessive alcohol intake experience decreased average survival, but there is substantial variation in their mortality, with liver abnormality and alcohol dependence or other alcohol use disorders associated with a worse prognosis. Clinically, patients with these risk factors and high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality. [ABSTRACT FROM AUTHOR]

Background: In a previous study, ondansetron, a serotonin 5‐HT3 receptor antagonist, reduced drinking intensity (drinks/drinking day [DPDD]) among European‐ancestry (EA) participants with moderate‐to‐severe alcohol use disorder (AUD) and variants in genes encoding the serotonin transporter (SLC6A4) and 5‐HT3A (HTR3A), and 5‐HT3B (HTR3B) receptors. We tested whether (1) ondansetron reduces DPDD among individuals of either European or African ancestry (AA), and (2) that reductions in DPDD are greatest among ondansetron‐treated individuals with population‐specific combinations of genotypes at SLC6A4, HTR3A, and HTR3B. Methods: In this 16‐week, double‐blind, placebo‐controlled, parallel‐group clinical trial, adults with AUD were randomized to receive low‐dose oral ondansetron (0.33 mg twice daily) or placebo stratified by "responsive" versus "nonresponsive" genotype defined using population‐specific genotypes at the three genetic loci. Generalized estimating equation regression models and a modified intent‐to‐treat analysis were used to compare the treatment groups on the primary outcome—DPDD—and two secondary outcomes—heavy drinking days per week [HDD] and drinks per day [DPD] across the 16 weeks of treatment. Results: Of 296 prospective participants screened, 95 (58 EA and 37 AA) were randomized and received at least one dose of study medication. In the modified intent‐to‐treat analysis, the ondansetron group averaged 0.40 more DPDD (p = 0.51), 1.35 times as many HDD (p = 0.16), and 1.06 times as many DPD (p = 0.59) as the placebo group. There were no significant interactions with genotype. There were no study‐related serious adverse events (AEs) and similar proportions of participants in the two treatment groups experienced AEs across organ systems. Conclusions: We found no evidence that low‐dose oral ondansetron is beneficial in the treatment of AUD, irrespective of genotype, thus failing to confirm prior study findings. However, the study was underpowered to identify medication by genotype interactions. [ABSTRACT FROM AUTHOR]