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Background: Excessive alcohol use is a leading cause of global morbidity and premature mortality. This study evaluated the effectiveness of two types of nurse‐delivered interventions to reduce excessive alcohol consumption among screened participants using the alcohol use disorders identification test (AUDIT) in the workplace. Methods: A randomized controlled trial involving AUDIT‐positive employees of five Japan‐based companies was conducted. A total of 351 participants were randomized into groups that received a patient information leaflet (PIL), 5 min of brief advice, or 15 min of brief advice and counseling. Outcomes (weekly alcohol consumption and drinking and binge drinking frequency in the previous 30 days) were evaluated at 6 and 12‐month follow‐up. Results: The follow‐up rates were 96.3% (n = 338) and 94.9% (n = 333) at 6 and 12 months, respectively. At 6 months, the mean change in weekly alcohol consumption was −38.1 g (−1.64 US fluid oz/week) in the 15‐min brief advice and counseling group, which differed significantly from the PIL group. The reduction in the advice and counseling group persisted at 12‐month follow‐up but was no longer significantly different from the PIL group. There was no significant change in alcohol consumption observed in the 5‐min brief advice group. Improvement in drinking and binge drinking frequency was observed in all three groups. Conclusions: Nurse‐delivered 15‐min brief advice and counseling was effective over a 6‐month period in reducing alcohol consumption in a workplace setting. This finding suggests that the implementation of workplace screening and brief intervention could play a useful role in preventing the burden of harmful alcohol use. [ABSTRACT FROM AUTHOR]

Background: Ibudilast, a novel neuroimmune modulator being studied to treat alcohol use disorder (AUD), was shown in a randomized controlled trial (NCT03489850) to reduce ventral striatum (VS) activation in response to visual alcohol cues. The present study extended this finding by probing the effects of ibudilast on alcohol cue–elicited functional connectivity (i.e., temporally correlated activation) with the VS seed. The study also tests the association between functional connectivity and alcohol use during the trial. Methods: Non–treatment‐seeking participants (n = 45) with current alcohol use disorder were randomized to receive twice‐daily dosing with either ibudilast (50 mg; n = 20) or placebo (n = 25). Upon reaching the target dosagee of the medication or placebo, participants completed a functional neuroimaging alcohol cue reactivity paradigm. Drinks per drinking day were assessed at baseline and daily during the 2‐week trial. Results: Ibudilast reduced alcohol cue–elicited functional connectivity between the VS seed and reward‐processing regions including the orbitofrontal and anterior cingulate cortices compared with placebo (p < 0.05). Cue‐elicited functional connectivity was correlated with drinks per drinking day (R2 = 0.5351, p < 0.001), and ibudilast reduced this association in similar reward‐processing regions compared with placebo. Conclusions: Ibudilast's effects on drinking outcomes may be related to the attenuation of functional connectivity in frontostriatal circuits related to reward processing. These results provide an important proof of concept for this novel pharmacotherapy and support the clinical utility of incorporating neuroimaging—and especially functional connectivity—analyses into medication development. [ABSTRACT FROM AUTHOR]

Background The genetic polymorphisms of alcohol dehydrogenase-1B ( ADH1B) and aldehyde dehydrogenase-2 ( ALDH2) are associated with the risk of alcoholism and upper aerodigestive tract cancer in alcoholics. Salivary ethanol ( sEtOH) levels are well correlated with blood Et OH levels. Methods To study the effects of ADH1B and ALDH2 genotypes on the alcohol elimination rate ( AER) and salivary acetaldehyde ( sAcH) levels, we measured the sEtOH and sAcH levels twice at a 1-hour intervals in 99 intoxicated Japanese alcoholic men who had stopped drinking for 4 or more hours. Results The initial sEtOH levels did not differ between the ADH1B*2 group ( n = 50) and the ADH1B*1/*1 group ( n = 49) (median: 0.617 vs. 0.762 mg/ml). The salivary AER (sAER) increased as the sEtOH levels increased ( p < 0.0001). After stratification according to the sEtOH levels (<0.4, 0.4 to 0.99, and ≥1.00 mg/ml), the median sAER of the ADH1B*2 group was 0.075, 0.188, and 0.228 mg/ml/h, respectively, and that of the ADH1B*1/*1 group was 0.037, 0.115, and 0.233 mg/ml/h, respectively. The sAER of the ADH1B*2 group was faster than that of the ADH1B*1/*1 group overall ( p = 0.001) and when the sEtOH category was 0.4 to 0.99 mg/ml ( p < 0.0001). The ADH1B genotype and the sEtOH levels had an interaction effect on the sAER ( p = 0.036). A multiple linear regression analysis with a stepwise procedure selected the ADH1B*2 allele ( p = 0.004) and the sEtOH levels ( p < 0.0001) as positive predictors of sAER. The sAER did not differ according to the ALDH2 genotype. The sAcH levels were higher than the blood AcH levels reported in alcoholics, probably because of AcH production by oral microorganisms. The sAcH of the ALDH2*1/*2 group ( n = 18) was higher than that of the ALDH2*1/*1 group ( n = 81) overall ( p = 0.0008) and when the corresponding sEtOH category was ≥1.00 mg/ml (median: 3.195 vs. 1.776 μg/ml, p = 0.009). A multiple linear regression analysis selected the ALDH2*1/*2 and the sEtOH levels as positive predictors of the sAcH levels ( p < 0.0001). Conclusions The enhanced AER in ADH1B*2 carriers and the increased sAcH levels in ALDH2*1/*2 carriers among intoxicated alcoholics provide possible mechanisms explaining how each genetic polymorphism affects the risk of alcoholism and upper aerodigestive tract cancer. [ABSTRACT FROM AUTHOR]

Background Recent evidence from alcohol and trauma studies suggests that disasters are associated with increases in the consumption of alcohol. The Great East Japan Earthquake and the associated nuclear disaster have continued to affect the mental health of evacuees from Fukushima. This study aimed to extend these findings by examining the relationship between drinking behaviors and the risk of mental illness after the compound disaster. Methods We conducted the Mental Health and Lifestyle Survey with 56,543 evacuees. Kessler's K6 was used to assess the risk of mental illness, and logistic regression models were applied to analyze how drinking behavior patterns influence the risk of serious mental illness after adjustment for confounding variables. Results Logistic regression analysis evidenced that beginning heavy and light drinkers had the highest and a higher risk of serious mental illness, respectively. Individuals who were nondrinkers pre- and postdisaster had the lowest proportional risk of mental illness. Abstainers also had some risk to their mental health after the compound disaster. Conclusions The results of this study highlight that beginning drinkers have a high risk of serious mental illness. Thus, mental health professionals should pay attention to the drinking behaviors of evacuees, which might predict increased risk of serious mental illness and consequently indicate a need for psychological intervention. [ABSTRACT FROM AUTHOR]

Background The efficacy of disulfiram in preventing an alcoholic relapse has been controversial. The aim of our study was to assess the efficacy of supervised disulfiram for the treatment of alcohol dependence with a multi-institutional study in Japan. Methods In a single-blinded, randomized placebo-controlled study, we recruited 109 patients diagnosed with alcohol dependence under ICD-10 criteria. The patients were randomly allocated to 4 treatment groups, depending on whether they took disulfiram (200 mg daily) or a placebo or whether they received adjunctive therapy consisting of mailed letters which delineated and emphasized the harmful effect of alcohol and the management of alcohol craving. The proportion of abstinence among the 4 groups at 26 weeks after discharge was the primary outcome measure. The proportion of abstinence was compared with the severity of alcohol dependence and craving. Furthermore, we examined the proportion of abstinence in patients with inactive aldehyde dehydrogenase-2 ( ALDH2). Results There were no significant differences among the 4 groups in terms of abstinent patients or study dropouts. The ratio of abstinence was not related to the severity of alcohol dependence or the degree of alcohol craving. Patients with inactive ALDH2 significantly sustained abstinence with the use of disulfiram ( p = 0.044). Conclusions Supervised oral disulfiram use followed by intervention via letters seems to be ineffective for increasing abstinence. Further studies are necessary to prove the efficacy of disulfiram for the pharmacological treatment of alcohol dependence. We indicated the effectiveness of disulfiram for the maintenance of abstinence in patients with inactive ALDH2. [ABSTRACT FROM AUTHOR]

Background To clarify the carcinogenic factors associated with steatohepatitis, we investigated the characteristic features of hepatic and extrahepatic malignancies in patients with cirrhotic nonalcoholic steatohepatitis ( NASH- LC) and cirrhotic alcoholic liver disease ( ALD- LC). Methods A total of 72 patients with NASH- LC and 85 with ALD- LC (both biopsy-proven steatohepatitis without hepatocellular carcinoma [HCC]) were assessed with regard to the development of hepatic and extrahepatic malignancies. Risk factors for HCC were analyzed. Results During follow-up, 10 NASH- LC patients and 6 ALD- LC patients developed HCC. The 5-year HCC development rate was similar for these 2 groups, being 10.5% in the NASH- LC group and 12.3% in the ALD- LC group. After adjusting for age and gender, the HCC development rates were also similar. Risk factors for HCC in the NASH- LC group were older age, higher γ- GTP level, and higher Child- Pugh score as determined by Cox hazards analysis. Regarding risk factors in the ALD- LC group, no risk factor was found by Cox hazards analysis, although diabetes mellitus led to a significantly higher HCC rate by log-rank test ( p = 0.013). Regarding extrahepatic cancer, only 1 NASH- LC patient (1.4%) developed endometrial cancer. In contrast, 7 ALD- LC patients (8.2%) had other cancers ( p = 0.052). Conclusions Comparison between NASH- LC and ALD- LC revealed similar HCC development curves. However, the risk factors for HCC and extrahepatic malignancies differed between the 2 diseases. In ALD- LC, the incidences of HCC and extrahepatic cancer are similar. When treating LC patients with NASH or ALD, the risk factors and extrahepatic malignancies associated with ALD- LC should be assessed. [ABSTRACT FROM AUTHOR]

The article presents several abstracts which were presented at the 2012 World Congress of the International Society for Biomedical Research on Alcoholism, including abstracts on alcoholic liver disease, a personalized medicine approach to alcoholism and cannabis use and psychosis.

Background: Trends in alcohol drinking prevalence were assessed among Japanese adolescents, and possible reasons for a decrease in drinking prevalence observed in 2004. Methods: Cross-sectional nationwide surveys were conducted periodically. High schools were randomly sampled from throughout Japan in 1996, 2000, and 2004. All enrolled students in sampled schools were subjects of the surveys. Self-reporting anonymous questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. Questions about drinking prevalence of students and family members, proportion of students who have no friends, and sources of alcohol were included. Students who drunk at least one day of the 30 days preceding the survey were defined as the current drinkers. Results: The drinking prevalence in 2004 was decreased in comparison to that in 1996 and 2000 in both sexes and in all school grades. The current drinking rate (monthly drinker) among junior high school boys was 29.4% in 1996, 29.0% in 2000, and 20.5% in 2004, while that among senior high school boys was 49.7%, 48.7%, and 36.2%, respectively. The respective prevalence among junior and senior girls was 24.0%, 25.5%, and 20.0% and 40.8%, 42.1%, and 34.1%. The prevalent sources of alcohol beverages were searching in home, stores (convenience store, supermarket, or gas-stand), liquor shops, and bars. An analysis of the reasons for this decrease identified a decrease in drinking prevalence in students’ families, especially by fathers and older brothers, and an increase in the proportion of students who had no friends. Conclusions: A decrease in drinking prevalence of male family members and a limitation of sources of alcoholic beverages may contribute to the decrease in adolescent drinking prevalence. [ABSTRACT FROM AUTHOR]