Search

The timing, rate, and quantity of gestational alcohol consumption, collectively referred to here as Maternal Drinking Patterns (MDPs), are of known importance to fetal developmental outcomes. However, few studies have directly evaluated the impact of MDPs on offspring behavior. To do so, we used specialized equipment to record the precise amount and timing of alcohol consumption in pregnant dams, and then characterized MDPs using Principle Component Analysis (PCA). We next tested offspring on behaviors we have previously identified as impacted by prenatal alcohol exposure, and evaluated them where possible in the context of MDPs. Male alcohol exposed mice exhibited longer latencies to fall on the rotarod compared to their controls, which we attribute to a delayed decrease in body weight-gain. This effect was mediated by MDPs within the first 15 min of alcohol access (i.e. alcohol frontloading), where the highest performing male offspring came from dams exhibiting the highest rate of alcohol frontloading. Female alcohol exposed mice displayed reduced locomotor activity in the open field compared to controls, which was mediated by MDPs encompassing the entire drinking session. Surprisingly, total gestational alcohol exposure alone was not associated with any behavioral outcomes. Finally, we observed allodynia in alcohol exposed mice that developed more quickly in males compared to females, and which was not observed in controls. To our knowledge, this report represents the highest resolution assessment of alcohol drinking throughout gestation in mice, and one of few to have identified relationships between specific alcohol MDPs and neurobehavioral outcomes in offspring. • Maternal gestational alcohol drinking patterns are complex and vary. • Different maternal drinking patterns lead to different neurobehavioral outcomes in offspring. • Neurobehavioral outcomes in alcohol-exposed offspring are sex-specific. [ABSTRACT FROM AUTHOR]

Background: Previous research has demonstrated the utility of subanesthetic doses of ketamine in decreasing binge (Drinking-in-the-Dark, or DID) 20% alcohol intake in female inbred (C57BL/6J) mice when administered 12 hours prior to alcohol access (Crowley et al., 2019). In the current study, we assess the efficacy of a similar ketamine pretreatment using male and female selectively bred, crossed High Alcohol Preferring (cHAP) mice, which also drink to intoxication, but are not inbred. We hypothesized that ketamine would decrease binge alcohol intake without impacting locomotor activity.Methods and Results: Subjects were 28 adult cHAP mice. Mice first received a 2-week DID drinking history using 2-h/day alcohol access. On day 12, prior to ketamine treatment, the average blood ethanol concentration (BEC) was 130 mg/dL, confirming that mice reliably reached intoxicating BECs. On day 15, mice were given 0, 3, or 10 mg/kg of ketamine 12 hours prior to the DID session. Ketamine did not decrease total (2-h) alcohol consumption or locomotion. Interestingly, the 10 mg/kg dose of ketamine did alter the drinking pattern in male mice, decreasing front-loading for a single day. We opted to then increase the doses to 32 or 100 mg/kg (i.e., an anesthetic dose) two days after the initial treatment, keeping the saline control. Mice of both sexes decreased total binge alcohol intake at the 100 mg/kg dose only, but again, the effect only lasted one day.Conclusions: The current study found that cHAP mice reached more than double the BECs observed in C57BL/6J mice during DID, but did not respond to subanesthetic ketamine. Modest efficacy was found for ketamine pretreatment at anesthetic doses. Differences in findings may be due to differential intake during DID, or genetic differences between C57Bl/6J mice and cHAP mice. Drug efficacy in multiple models is important for discovering reliable pharmacotherapies for alcoholism. [ABSTRACT FROM AUTHOR]

Background: While individual-level drinking pattern is an important risk factor for alcohol-related injury, societal-level pattern and alcohol policy are also important, and no research exists on the relationship of these variables with specific causes of injury.Methods: A probability sample of 14,142 emergency department (ED) patients from 32 ED studies in 28 countries included in the International Collaborative Alcohol and Injury Study (ICAIS) is analyzed using multilevel modeling of individual-level volume and pattern of drinking, country-level detrimental drinking pattern (DDP), and alcohol policy using the International Alcohol Policy and Injury Index (IAPII) on self-reported drinking prior to the injury event, categorized as traffic, violence, fall or other cause. The IAPII includes four domains: availability, vehicular, advertising, and drinking context.Results: Frequent heavy drinking was a strong predictor (p < .0.001) of injuries related to violence (OR = 2.57), falls (OR = 2.86), and other causes (OR = 1.71), while episodic heavy drinking was a significant predictor of injuries related to violence and falls. DDP was a significant predictor (p < 0.05) of traffic (OR = 1.54) and violence-related injuries (OR = 1.38) but lost significance when the IAPII was included. The IAPII was a significant predictor only for traffic injury (OR = 0.97, p < 0.001), and each domain with the exception of context were also significant.Conclusions: Findings here clearly point to the importance of targeted policies for specific causes of injury as well as the importance of individual and societal drinking patterns, the latter of which may be difficult to influence by preventive measures aimed to reduce alcohol-related injury. [ABSTRACT FROM AUTHOR]

Background: Older adults constitute a rapidly expanding proportion of the U.S.Population: Contemporary studies note the increasing prevalence of alcohol consumption in this group. Thus, understanding alcohol effects, consumption patterns, and associated risks in aging populations constitute critical areas of study with increasing public health relevance.Methods: Participants (n = 643; 292 women; ages 21-70) were community residing adult volunteers. Primary measures of interest included four patterns of alcohol consumption (average [oz./day]; typical quantity [oz./occasion]; frequency [% drinking days]; and maximal quantity [oz.]). Regression analyses explored associations between these measures, age, and relevant covariates. Subsequent between-group analyses investigated differences between two groups of older adults and a comparator group of younger adults, their adherance to "low-risk" guidelines, and whether alcohol-associated risks differed by age and adherence pattern.Results: Average consumption did not vary by age or differ between age groups. In contrast, markedly higher frequencies and lower quantities of consumption were observed with increasing age. These differences persisted across adherence categories and were evident even in the oldest age group. Exceeding "low-risk" guidelines was associated with greater risk for alcohol-related problems among the older groups.Conclusions: These results emphasize the utility of considering underlying constituent patterns of consumption in older drinkers. Findings highlight difficulties in identifying problem drinking among older adults and contribute to the few characterizations of "risky" drinking patterns in this group. Taken together, our data contribute to literatures of import for the design and enhancement of screening, prevention, and education initiatives directed toward aging adults. [ABSTRACT FROM AUTHOR]

Alcohol problems have variable outcomes for marital relationships depending on whether drinking patterns are concordant or discordant among the members of the dyad; however, it is unclear what impact these variations in drinking patterns have on children. The current study was designed to explore several gaps and limitations in the parent heavy drinking literature. In particular, the prospective associations over 3years between parent heavy drinking, parenting, and child externalizing behavior were investigated in an integrated model to examine the influence of concordant and discordant drinking within couples on subsequent outcomes for their children. The study consisted of 180 couples recruited by mailings with children primarily between the ages of 4 and 11years old (52% male children). Parent-report of marital conflict, parenting, alcohol use, and child externalizing behavior were measured in a longitudinal study. Actor-Partner Interdependence Model analyses were conducted. Higher levels of maladaptive parenting were associated with higher externalizing for children of concordant drinking couples as opposed to discordant drinking couples. Implications for research and practice are discussed, including investigating mediators and moderators of the current findings such as quality of the parent-child relationship. [ABSTRACT FROM AUTHOR]

Objective: to test if people with different day-to-day drinking patterns benefitted differently from two brief alcohol interventions (BAIs).Methods: A total of 1243 job-seekers with at-risk alcohol use aged 18-64 years (64% men) were randomized to (a) intervention tailored to the motivational stage (ST), (b) non-stage tailored intervention (NST), or (c) assessment only (AO). ST and NST contained individualized computer-generated feedback letters. Follow-ups were conducted at months 3, 6, and 15. Using growth mixture models, day-to-day drinking patterns were identified based on the number of drinks consumed on each day in the week prior to baseline assessment. To test drinking pattern-specific intervention effects, zero-inflated growth models were used. Outcomes were (1) the 15-month change in the likelihood of any alcohol use and (2) the 15-month change in the total number of drinks per week when alcohol was consumed.Results: Four day-to-day drinking patterns were found: daily medium use (2-4 drinks/day; 47%), daily low use (1-2 drinks/day; 29%), weekend only use (18%), and no use (6%). Only persons with daily low use benefitted from intervention, with higher odds of being abstinent after 15 months in the ST group compared to AO (odds ratio, OR=1.67, p=0.001) and NST group (OR=1.43, p=0.035). ST worked better among persons with daily low use compared to daily medium use (OR=1.91, p=0.001).Conclusions: Among at-risk drinking persons with regular low-quantity alcohol use, stage tailored BAIs may be superior over no BAI and non-stage tailored BAIs. [ABSTRACT FROM AUTHOR]

Background: Mixed ancestry populations in South Africa have amongst the highest rates of fetal alcohol syndrome (FAS) worldwide. Defining the drinking patterns of women with a FAS child guides FAS preventive interventions.Methods: Data were drawn from FAS prevalence surveys conducted in three districts: Witzenberg (Cape Winelands), Frances Baard (inland mining town) and Saldanha Bay (coastal towns). 156 mothers and 50 proxy informants of school-entry children diagnosed with FAS and partial-FAS were interviewed, and compared with 55 controls recruited in Saldanha Bay.Results: Study participants were of low socio-economic status (SES), and a majority of children were either in foster care (12%) or had been cared for by relatives for long periods (44%). Of cases, 123/160 (77%) reported current drinking, similar between sites. During pregnancy, only 35% (49/139) of cases had stopped drinking, varying between sites (from 21% to 54% in chronological order of surveys; p<0.001), while 6% (7/109) increased drinking. Though many women who stopped in pregnancy resumed postpartum, cessation in pregnancy was strongly associated with discontinuation in the long run (OR=3.3; 95%CI=1.2-8.9; p=0.005). At interview, 36% of cases (54/151) and 18% of controls (9/51) were at risk of an alcohol-exposed pregnancy (p=0.02). Median maternal mass of cases was 22kg lower than controls, with 20% being underweight and 14% microcephalic.Conclusions: Increasing rates of drinking cessation during pregnancy over time suggest rising awareness of FAS. Cessation is associated with recidivism after pregnancy but also with reduced long-term drinking. Interventions should target alcohol abstinence in pregnancy, but extend into the puerperium. [ABSTRACT FROM AUTHOR]

Background & Aims Studies assessing alcohol as a population level risk factor for cirrhosis typically focus on per capita consumption. However, clinical studies indicate that daily intake is a strong predictor of alcoholic cirrhosis. We aimed to identify the determinants of alcohol’s contribution to the global cirrhosis burden and to evaluate the influence of daily drinking on a population level. Methods We performed a comprehensive analysis of the WHO 2014 Global Status Report on Alcohol and Health. We categorized countries by heavy or moderate drinking based on daily consumption, using U.S. Department of Agriculture definitions of heavy drinking. Additional data on cirrhosis cofactors were also obtained. Uni- and multivariate models were fitted to identify independent predictors of the alcohol-attributable fraction of cirrhosis. Results The WHO 2014 Report found that half of cirrhosis mortality worldwide is attributable to alcohol, approximating 60% in North America and Europe. In an integrative multivariate model, the designation of countries by moderate or heavy daily drinking had the strongest influence on the weight of alcohol in the cirrhosis burden. The relative contribution from alcohol increased by 11% with a transition from the moderate to heavy classification ( p <0.001). Importantly, drinking patterns such as heavy episodic drinking and the type of alcohol did not independently predict the alcohol-attributable fraction of cirrhosis. Conclusions Heavy daily drinking on a population level significantly influences the weight of alcohol in the cirrhosis burden. Reducing heavy drinking should be considered as an important target for public health monitoring and policies. Lay summary We carried out an analysis of the WHO 2014 Global Status Report on Alcohol and Health, and categorized countries by their level of drinking (heavy or moderate). We found that half of the global cirrhosis cases, and 60% in both North America and Europe are associated with alcohol intake. We concluded that on a population level heavy daily drinking significantly influences the impact of alcohol on the cirrhosis burden. [ABSTRACT FROM AUTHOR]

Research indicates that nonstudent emerging adults, as compared to their college-attending peers, are at higher risk for experiencing alcohol-related problems, including alcohol use disorders. The present study sought to extend the limited research on nonstudent drinking by (1) identifying sub-groups of nonstudent drinkers based on their drinking patterns and (2) determining the extent to which social-cognitive between-person factors related to drinking (i.e., social expectancies, perceived drinking norms, social drinking motivations) distinguish these sub-groups. Participants were 195 (65.1% men) nonstudent emerging adult heavy episodic drinkers recruited from the community. Mean age was 21.88 (SD=2.08) years and 45.4% were unemployed. Latent profile analysis identified two classes based on drinking across 30days. The "moderate drinkers" group (n=143; 73.3%) reported consuming 10-11 drinks weekly and drinking two to three times per week, on average. The "heavy drinkers" class (n=52; 26.7%) reported consuming 42-43 drinks weekly and drinking six to seven days per week. Both groups exhibited a cyclic pattern of drinking whereby weekday drinking was lower, with increases on the weekend; the heavy drinkers class had stronger weekend increases starting earlier. Heavy drinkers reported greater volume, frequency, and problematic drinking behaviors, as compared to the moderate drinkers. The heavy drinkers class also endorsed stronger social motives and perceived their peers to drink more. The present study offered unique insights into nonstudent emerging adult drinking patterns by identifying sub-populations of drinkers based on their past 30-day use. Knowledge gained from this study could aide in tailoring existing alcohol interventions to nonstudents to reduce alcohol-related harms. [ABSTRACT FROM AUTHOR]

This study explores three alcohol-related databases so as to provide a comprehensive understanding of drinking patterns and the prevalence of alcohol-impaired driving in Catalonia (Spain). The rate of alcohol-impaired drivers is compared with the percentage of drinkers in this population, with a particular focus on heavy episodic drinkers. Two strategies adopted by law enforcement agents when conducting alcohol breath tests are examined: (i) non-random and (ii) random approaches to roadblock location and driver selection. We find that heavy drinker profiles (in terms of age and gender) closely match those of alcohol-impaired drivers detected at strategically located, non-random sobriety checkpoints (especially in the case of female drivers), and that they also correlate with the age-gender distribution of drivers involved in road accidents with victims. Different drink driving patterns are detected when sobriety checkpoints are located randomly and drivers are tested at random. Older drivers are identified as a risk group as they abandon the safer driving habits in relation to alcohol shown when they were middle-aged. A combination of non-random and random controls would increase driver perception of their chances of being detected when drink driving. As such, the whole population, regardless of their drinking profile, would be alerted to the serious personal, social and legal implications of alcohol-impaired driving. [ABSTRACT FROM AUTHOR]

Background: Unrecorded homemade alcohol consumption has been less examined in the literature. Previous studies of homemade alcohol in Russia have almost entirely focused upon the use of samogon (moonshine) attributed to the northern style of drinking. No systematic analysis is available regarding the production and consumption of homemade wine. This paper explores the drinking patterns demonstrated by consumers of samogon and homemade wine in Russia. The main factors affecting the consumption of these beverages are investigated.Methods: Data were collected from a 2014 nationwide survey of 14,986 respondents aged 15+ years. Beverage preferences, volume of consumed alcohol, drinking habits, and alcohol availability were the main measures reported. Demographic, socio-economic, spatial, and policy-related factors affecting homemade alcohol consumption are examined using logistic regression.Results: The percentages of samogon and homemade wine consumers were similar, although a greater volume of samogon in pure alcohol was consumed compared to homemade wine. The groups of samogon and homemade wine consumers showed very little overlap. Unlike homemade wine consumers, samogon drinkers consumed larger amounts of alcohol and were more engaged in frequent and excessive drinking, drinking without meals and drinking in marginal public settings. Gender, education, regional affiliation, and type of residence showed opposite associations with regard to the consumption of samogon and homemade wine. Availability of homemade alcohol in the neighbourhood was the most influential predictor due to respondents' own production, presence of homemade alcohol in friendship networks and at illegal market. The prices of manufactured alcohol and the consumption of homemade alcohol did not show significant relationships.Conclusion: Consumers of samogon and homemade wine demonstrate contrasting drinking patterns that are largely driven by different factors. Samogon is consumed in a more hazardous manner, whereas homemade wine is consumed in a more moderate and law-abiding way. Illegal commercial samogon should be a special concern for alcohol policy. [ABSTRACT FROM AUTHOR]

In recent years, increasing attention has been paid to the issue of driving under the influence of alcohol (DUI), especially among young people. The aims of the present study were (1) to analyse the trends of DUI, riding with a driver under influence of alcohol (RWDUI) and alcohol-related road crashes (A-rC) in a nationally representative sample of students in the period 2007–2013, (2) to assess how different drinking patterns were associated with DUI and RWDUI, (3) to evaluate other influential factors (such as gender, older siblings’ and friends’ behaviour with alcohol) on DUI and RWDUI. Data were drawn from the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) carried out annually in Italy. The sample size ranged from 25,555 to 40,390 students (15–19 years old). Results were stratified for students <18 years and ≥18 years old. Although a significant decreasing trend for alcohol consumption was observed only in the younger group, a significant decrease in DUI [APC (annual percent change) −9.7 in the younger and −6.4 in the older group] and in RWDUI (APC −6.7 in the younger and −4.8 in the older group) was detected. A significant decreasing trend of A-rC was observed only in the older group (APC −3.4). Three specific drinking patterns were identified: “Drinking to Excess” (DE), “Drinking with Intoxication” (DI) and “Drinking but Not to Excess” (DNE). In both age groups, the DE pattern significantly increased the likelihood of DUI, whereas the DI pattern was negatively associated, and the DNE pattern was not associated. Different results were found for RWDUI: the DE and DI patterns where significantly associated with RWDUI, whereas the DNE pattern was negatively associated. Overall, illegal substance use, parental monitoring, peers’ and siblings’ influence were associated with DUI and RWDUI. The change in behaviour towards DUI and RWDUI suggests a cumulative effectiveness of current alcohol policies, although further actions (greater attention to social context, law enforcement, and promotion of good practice) are needed to substantially reduce alcohol-related crashes. [ABSTRACT FROM AUTHOR]

Background Little epidemiological evidence exists on alcohol use and related problems along the U.S.–Mexico border, although the borderlands have been the focus of recent media attention related to the escalating drug/violence “epidemic”. In the present study, the relationship of proximity of living at the border and alcohol use disorders (AUDs) is analyzed from the U.S.–Mexico Study on Alcohol and Related Conditions (UMSARC). Methods Household surveys were conducted on 2336 Mexican Americans in Texas (771 in a non-border city and 1565 from three border cities located in the three poorest counties in the U.S.) and 2460 Mexicans from the states of Nuevo Leon and Tamaulipas in Mexico (811 in a non-border city and 1649 from three cities which are sister cities to the Texas border sites). Results Among current drinkers, prevalence of AUD was marginally greater ( p < 0.10) at the U.S. border compared to the non-border, but the opposite was true in Mexico ( p < 0.001), and these trends continued on both sides across volume and 5+ drinking days. Prevalence was greater in Laredo/Nuevo Laredo relative to their respective sister city counterparts on the same side. Border effects appeared greater for males than females in the U.S. and the opposite in Mexico. Conclusion The data suggest that border proximity may affect AUD in both the U.S. and Mexico, but in the opposite direction, and may be related to the relative perceived or actual stress of living in the respective communities. [ABSTRACT FROM AUTHOR]

Background Older adults are a growing segment of the European population and alcohol is an important cause of disease burden; thus, it is noteworthy that little information is available on alcohol intake among older adults in Europe. Objective The aim of this study was to examine alcohol consumption patterns and their association with demographic and clinical variables in the older population of Spain. Design This was a cross-sectional study. Participants/setting The sample included 3,058 individuals, representative of the Spanish population aged ≥60 years during 2008-2010. Main outcome measure Regular alcohol consumption was measured with a validated diet history questionnaire. The threshold between moderate and heavy drinking was ≥40 g alcohol/day in men (≥24 g in women). Binge drinking was defined as intake of ≥80 g alcohol in men (≥60 g in women) during any drinking occasion in the previous month, and problem drinking by a CAGE score ≥2. Statistical analysis performed The prevalence and 95% CI of the drinking patterns were calculated after accounting for sampling design. Results The prevalence of moderate drinking was 44.3% (95% CI 42.0% to 46.6%) and of heavy drinking was 7.8% (95% CI 6.7% to 8.9%). In total, 68.4% (95% CI 65.7% to 71.2%) of individuals obtained >80% of alcohol from wine and 61.8% (95% CI 58.9% to 64.6%) drank only with meals. Furthermore, 1% (95% CI 0.6% to 1.4%) showed binge drinking and 3.1% (95% CI 2.3% to 3.8%) showed problem drinking. Heavy alcohol consumption was significantly more frequent in men. Moderate alcohol consumption was significantly less frequent among women, persons who were not married, living alone, with a diagnosis of diabetes, receiving treatment for diabetes, and with suboptimal self-rated health. About 5% to 10% of individuals with diagnosed hypertension, diabetes, or cardiovascular disease showed heavy drinking. Among those taking sleeping pills or antidiabetes or antithrombotic treatment, 37% to 46% had moderate alcohol intake and 5% to 8% had heavy intake. Conclusions Alcohol consumption among older adults in Spain is frequent and mostly consistent with the traditional Mediterranean drinking pattern. However, a proportion of individuals were heavy drinkers and used medication that may interact with alcohol. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study examined changes in alcohol drinking patterns (DP) and associated variables in a Mediterranean country. Methods: Changes in DP between baseline (2008–2010) and follow-up (2012–2013) were examined on a Spanish population-based cohort of 2254 adults (18–59 years) using multinomial logistic regression. Heavy consumption was defined as ≥40g/day of alcohol in men (≥24g/day in women) and binge drinking (BD) as the intake of ≥80g of alcohol in men (≥60g in women) on one occasion in the previous month. Six patterns were defined: (1) non-drinkers; (2) ex-drinkers; (3) moderate drinkers without BD (MNB); (4) moderate drinkers with BD (MB); (5) heavy drinkers without BD (HNB); and (6) heavy drinkers with BD (HB). Results: Overall, 45.2% of participants changed DP during follow-up. Over 24% of non-drinkers and 19.4% of ex-drinkers at baseline qualified as MNB at follow-up. The largest flow was from HNB to MNB (57.1%). Light-drinking patterns experienced the largest gains (ex-drinkers: 37.5% and MNB: 66.7%) by absorbing individuals lost by heavy-drinking patterns (MB: 50.8% and HNB: 48.4%). Men, younger individuals, and current smokers were more likely to report heavy-drinking patterns at one or both assessments. Being married or employed increased the likelihood of reporting light-drinking patterns at both surveys (p <0.05). Improving physical quality of life and exercise were associated with a shift from light- to heavy-drinking pattern during follow-up (p <0.05). Conclusions: DP in Spain changed over 3 years with a tendency to “regress” toward moderate patterns. Repeated measures of alcohol intake may reduce classification errors and biased results when examining the impact of alcohol on health. [Copyright &y& Elsevier]

Abstract: Aims: We present methodology to identify statistically distinct patterns of daily alcohol use and classify them into categories that could be further used in monitoring of transitions between patterns such as transitions from regular to problem use. Data: The study analyzed individual patterns of adult alcohol consumption from two datasets containing short (<6 month) and long (up to 2years) daily records of drinking. These data were collected over the period between 1999 and 2003. Results: By using a non-parametric (Kolmogorov–Smirnov) test we have identified distinct drinking patterns and classified them into 8 types according to their means, percentages of non-drinking days and variances of consumed amount during drinking days. For each studied individual we calculated a transition chart that characterizes transitions between the types. Conclusions: Individual daily consumption patterns can be identified, and classified into distinct patterns. Changes between the patterns could be related to life events or environmental trends, and thus provide insights into pathways towards either heavier use or recovery. [Copyright &y& Elsevier]

Abstract: Background: Uni-dimensional measures of alcohol consumption may be unable to fully capture the complexity of adolescent drinking and experience of alcohol-related harms. Latent class analysis provides an empirical method to understand different adolescent drinking patterns. Methods: Latent class analysis was used to create typologies of drinking among the 5018 current drinkers in the national Youth ‘07 survey. Determinants of drinking patterns were identified using multinomial logistic regression. Results: Four latent classes were identified, demonstrating an overall increase in risk of alcohol-related outcomes from increasing consumption. One class strongly deviated from this pattern, having moderate consumption patterns but disproportionately high levels of alcohol-related problems. Multinomial logistic regression found that the strongest predictors of belonging to high-risk drinking typologies were having a positive attitude to regular alcohol use, buying own alcohol, peers using alcohol, and obtaining alcohol from friends and/or other adults. Other significant predictors included being male, having a strong connection to friends, having parents with a low level of knowledge of their daily activities and poor connection to school. Class membership also varied by ethnicity. Conclusion: The latent class approach demonstrated variability in alcohol-related harms across groups of students with different drinking patterns. Longitudinal studies are necessary to determine the causes of this variability in order to inform the development of targeted policy and preventative interventions. Legislative controls, such as increasing the legal purchase age and reducing the commercial availability of alcohol, will continue to be important strategies for reducing harm in young people. [Copyright &y& Elsevier]

Abstract: Background and aims: To estimate the association between patterns of alcohol consumption and biomarkers of coronary heart disease (CHD) risk. Methods and results: Cross-sectional study among 10,793 individuals representative of the Spanish population aged ≥18 years. The threshold between moderate and heavy drinking was 40 g of alcohol/day in men and 24 g/day in women. Binge drinking was defined as intake of ≥80 g of alcohol in men and ≥60 g in women at any drinking occasion in the preceding 30 days. Analyses were performed with generalized linear models with adjustment for the main confounders, and results were expressed as the percentage change in the geometric mean (PCGM). Compared to non-drinkers, moderate and heavy drinkers had progressively higher serum HDL-cholesterol, with a PCGM ranging from 4.8% (95% CI: 3.7–6.0%) in moderate drinkers without binge drinking (MNB) to 9.6% (5.1–14.2%) in heavy drinkers with binge drinking (HB). Fibrinogen decreased progressively with alcohol intake, from −2.2% (−3.1 to −1.3%) in MNB to −5.8% (−9.4 to −2.0%) in HB. Leptin, glycated hemoglobin and the HOMA-index also decreased with increasing alcohol intake, and particularly with binge drinking. Conclusions: Moderate alcohol intake is associated with improved HDL-cholesterol, fibrinogen and markers of glucose metabolism, which is consistent with the reduced CHD risk of moderate drinkers in many studies. Heavy and binge drinking were also associated with favorable levels of CHD biomarkers; since these drinking patterns produce substantial health harms, our results should not be used to promote alcohol consumption. [Copyright &y& Elsevier]

Abstract: Background: In order to successfully address excessive alcohol consumption it is essential to have a means of measuring the drinking patterns of a nation. Owing to the multi-dimensional nature of drinking patterns, usual survey methods have their limitations. The aim of this study was to make use of extremely detailed diary survey data to demonstrate a method of combining different survey measures of drinking in order to reduce these limitations. Methods: Data for 1724 respondents of the 2000/01 National Diet and Nutrition Survey was used to obtain a drinking occasion dataset, by plotting the respondent's blood alcohol content over time. Drinking frequency, level and variation measures were chosen to characterise drinking behaviour and usual behaviour was estimated via statistical methods. Results: Complex patterns in drinking behaviour were observed amongst population subgroups using the chosen consumption measures. The predicted drinking distribution combines diary data equivalent coverage with a more accurate proportion of non-drinkers. Conclusions: This statistical analysis provides a means of obtaining average consumption measures from diary data and thus reducing the main limitation of this type of data for many applications. We hope that this will facilitate the use of such data in a wide range of applications such as risk modelling, especially for acute harms, and burden of disease studies. [Copyright &y& Elsevier]

Summary: Schedules of intermittent food delivery induce excessive fluid intake, termed schedule-induced polydipsia (SIP), and hypothalamic–pituitary–adrenal (HPA) axis activation is important for the expression and maintenance of this adjunctive behavior. Previous work has focused on examining the relationship between water intake and plasma corticosterone (CORT) in rats at a single or a limited range of fixed time (FT) intervals. However, little remains known regarding SIP and the corresponding stress response (1) across the bitonic function that epitomizes adjunctive behavior, (2) when ethanol is the available fluid, and (3) when a species other than rat or multiple strains are studied. Here we report the findings from ethanol-preferring C57BL/6J (B6) and non-preferring DBA/2J (D2) mice serially exposed to progressively larger FT intervals (0→60min) and given access to either water or a 5% (v/v) ethanol solution. Following 2 weeks of experience with each schedule, blood samples were collected at the conclusion of the last 60-min session to evaluate CORT and the blood ethanol concentration (BEC) achieved. While both strains exhibited a bitonic function of ethanol intake and BEC that peaked at or near a 5-min interval, only D2 mice showed a similar response with water. In contrast, CORT levels rose monotonically with incremental increases in the FT interval regardless of the strain examined or fluid type offered, indicating that glucocorticoid release likely reflects the aversive aspects of increasing intervals between reinforcement rather than engagement in adjunctive behavior. These findings also caution against the use of a single intensity stressor to evaluate the relationship between stress and ethanol intake, as the magnitude of stress appears to affect ethanol consumption in a non-linear fashion. [ABSTRACT FROM AUTHOR]

Abstract: The food, water and sodium intake of laboratory rats fluctuates over the circadian and estrous cycles. Blood calcium and calcium-regulating hormones also wax and wane in response to these cycles, raising the possibility that the same might be true of calcium intake. To investigate this, we monitored the fluid intakes of female Long-Evans rats given a choice between water and 10mM CaCl2 solution for two consecutive estrous cycles. We found that calcium solution intake changed over the circadian cycle in a similar manner to water intake; the preference scores for CaCl2 solution remained stable. We did not detect any changes in calcium solution intake or preference scores during the estrous cycle despite a decrease in fluid intake at estrus. Thus, fluctuations in intake of calcium solution during the circadian cycle appear to be nonspecific and probably the result of changes in fluid balance. Estrous changes either do not influence calcium intake or their effects are masked by other factors, resulting in stable levels of calcium intake. [Copyright &y& Elsevier]

Abstract: Objective: To assess relationships between area level deprivation and drinking patterns among adolescents. Method: This study uses data from the national New Zealand Alcohol Survey 2004 comprising 1828, age range 12–19 years. A multilevel linear regression was conducted using NZDep2001 (a composite deprivation measure) as the exposure and alcohol use (quantity and frequency) as outcome. Results: A J-shaped association was observed between area level deprivation and quantity of adolescents’ alcohol use after controlling for age, sex, ethnicity, and individual socioeconomic position; where adolescents living in the most deprived areas consumed the heaviest quantities of alcohol. No association was found for frequency of drinking. Conclusion: This study found a J-shaped relationship between area-level disadvantage and increased quantities consumed, where adolescents living in the most deprived areas typically consumed the heaviest quantities of alcohol. However, our study has also highlighted that future research may better isolate an independent relationship between deprivation and consumption in adolescents by accounting for structural variables related to both deprivation and consumption, such as alcohol outlet density [Copyright &y& Elsevier]

Abstract: Objective: To understand patterns of alcohol consumption and baseline factors associated with favorable drinking patterns among HIV-infected patients. Methods: We studied drinking patterns among HIV-infected patients with current or past alcohol problems. We assessed drinking status in 6-month intervals. Based on National Institute on Alcohol Abuse and Alcoholism guidelines a favorable drinking pattern was defined as not drinking risky amounts at each assessment or decreased drinking over time. All other patterns were defined as unfavorable. Logistic regression models were used to identify baseline factors associated with a favorable pattern. Results: Among 358 subjects, 54% had a favorable drinking pattern with 44% not drinking risky amounts at every assessment, and 11% decreasing consumption over time. Of the 46% with an unfavorable pattern, 4% drank risky amounts each time, 5% increased, and 37% both decreased and increased consumption over time. Current alcohol dependence and recent marijuana use were negatively associated with a favorable pattern, while older age and female gender, and having a primary HIV risk factor of injection drug use were positively associated with a favorable pattern. Conclusion: Many HIV-infected adults with alcohol problems have favorable drinking patterns over time, and alcohol consumption patterns are not necessarily constant. Identifying HIV-infected adults with a pattern of risky drinking may require repeated assessments of alcohol consumption. [Copyright &y& Elsevier]

Abstract: Alcohol consumption is a function of social dynamics, environmental contexts, individuals'' preferences and family history. Empirical surveys have focused primarily on identification of risk factors for high-level drinking but have done little to clarify the underlying mechanisms at work. Also, there have been few attempts to apply nonlinear dynamics to the study of these mechanisms and processes at the population level. A simple framework where drinking is modeled as a socially contagious process in low- and high-risk connected environments is introduced. Individuals are classified as light, moderate (assumed mobile), and heavy drinkers. Moderate drinkers provide the link between both environments, that is, they are assumed to be the only individuals drinking in both settings. The focus here is on the effect of moderate drinkers, measured by the proportion of their time spent in “low-” versus “high-” risk drinking environments, on the distribution of drinkers. A simple model within our contact framework predicts that if the relative residence times of moderate drinkers are distributed randomly between low- and high-risk environments then the proportion of heavy drinkers is likely to be higher than expected. However, the full story even in a highly simplified setting is not so simple because “strong” local social mixing tends to increase high-risk drinking on its own. High levels of social interaction between light and moderate drinkers in low-risk environments can diminish the importance of the distribution of relative drinking times on the prevalence of heavy drinking. [Copyright &y& Elsevier]

Purpose: The association between alcohol consumption and breast cancer has been largely investigated, but few studies have investigated the effects of average intake when the pattern of drinking is taken into account. We sought to examine the association between drinking pattern of alcoholic beverages, particularly wine, and breast cancer using different statistical approaches. Methods: Our study included 437 cases of breast cancer, newly diagnosed in the period 2002–2004, and 922 residence- and age-matched controls. Results: Women who had an average consumption of less than 1.5 drinks per day had a lower risk (odds ratio [OR] = 0.58, 95% confidence interval [CI] = 0.34–0.97) when compared with nondrinkers. This protective effect was due substantially to wine consumption since the proportion of regular wine drinkers is predominant in our study population. Furthermore, women who consumed between 10 and 12 g/d of wine had a lower risk (OR = 0.51; 95% CI = 0.30–0.91) when compared with non–wine drinkers. Above 12 g per day of wine consumption, the risk of breast cancer increased, but the association was nonsignificant. Conclusions: Although no association between the pattern of total alcohol consumption and breast cancer was found, the type of alcoholic beverage seemed to play an important role in this association. Our results support the hypothesis that there is a threshold effect that risk decreased or was not modified for consumption under a certain threshold. Above that threshold, risk increased, however. The drinking pattern of each type of specific beverage, especially wine, seems important in terms of alcohol–breast cancer association. Low and regular wine consumption does not increase breast cancer risk. [Copyright &y& Elsevier]

Abstract: This study aimed to analyze changes in patterns of alcohol use from 1988 to 2004 amongst Polish (Warsaw) 15-year olds. Data were collected from 5 consecutive surveys, beginning in 1988 and conducted every four years. For each survey a comparable sampling approach, sample size (N ≥1461), procedures and instrument were used to ensure consistency of method across surveys. In 1988 a two-step cluster analysis was used to identify four distinct natural groups of drinkers “light”, “heavier”, “beer and wine” and “wine” drinkers. Between 1988 and 1992 the percentage of teenage infrequent drinkers decreased and the rate of heavy drinkers increased. A group of students drinking only beer appeared, whilst the group of wine drinkers disappeared. A group of students who drank alcohol to get drunk appeared in 1996. Between 2000 and 2004 drinking of various kinds of alcoholic beverages became more frequent, as did vodka abuse. Increased consumption amongst girls was also observed. The results are interpreted in the context of social change and several hypothetical causes of gender differences are discussed. [Copyright &y& Elsevier]

Abstract: This study examines relationships between country of origin, age of drinking onset, and adverse drinking outcomes among young adult Mexican Americans in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Logistic regression models estimate associations between age of drinking onset, age of onset in relation to age at immigration, and adverse drinking outcomes, controlling for sex, age, employment, education, marital status, and income. Adjusted analyses indicate the odds of adverse drinking outcomes decreased as age of drinking onset increased. Mexican Americans who initiated drinking in Mexico had significantly lower odds of current or lifetime harmful drinking than U.S. born but the odds were not significantly different between foreign-born Mexican Americans who initiated drinking in the U.S. and U.S. born. Irrespective of whether drinking onset was in Mexico or the U.S., foreign-born Mexican Americans had lower odds of alcohol abuse than U.S. born. However, odds of dependence were not significantly different between foreign-born and U.S.-born Mexican Americans. While findings suggest that being foreign born may be protective, further research on social and cultural factors impacting drinking onset and related outcomes among young Mexican Americans may help inform prevention efforts. [Copyright &y& Elsevier]

Abstract: Previous studies have suggested that college students who use protective strategies while drinking are at a lower risk for drinking-related consequences. This study evaluated the correlates of protective behavior utilization in a group of 281 heavy-drinking college students. Students who reported heavier drinking were less likely to use protective behaviors, even after adjusting for covariates. Male gender and perceived history of parental alcohol abuse also predicted lower protective behavior score. The most frequently endorsed strategies among females were “Knowing where your drink has been at all times” and “Going home with a friend,” whereas the most frequently endorsed strategies among males were “Knowing where your drink has been at all times” and “Using a designated driver.” For females, the factor structure of the protective behaviors measure was consistent with previous studies; however, for males, the results suggest a four-factor solution. Findings are discussed in terms of their implications on future research and prevention programming. [Copyright &y& Elsevier]

Abstract: This study investigated the relationship between frequency of heavy episodic drinking and nonfatal injury in four categories: environment, external cause, diagnosis, and activity at the time of injury. Data were collected over 18 months at the emergency room facility of a Swedish hospital. Injury patients aged 18–70 years answered an alcohol screening questionnaire. Heavy episodic drinking was measured as drinking six glasses (72g alcohol) or more per occasion, for both males and females. A total of 2211 patients were enrolled in the study (79.5% completion rate). Demographic and drinking characteristics for the patients were compared to those of the general population, data for which were derived from a population-based survey. The proportion of people who reported heavy episodic drinking once a month or more was nearly twice as large among the injury patients as in the general population. However, age and sex outweighed heavy episodic drinking as risk factors for most injury types. There were 11 significant associations between frequency of heavy episodic drinking and injury types in the four injury categories, yet no linear trends of increased likelihood of injury with increased frequency of heavy episodic drinking could be discerned. [Copyright &y& Elsevier]

Abstract: Although systemic allopregnanolone (ALLO; a positive modulator of GABAA receptors) has been shown to enhance ethanol-reinforced responding and to modulate drinking patterns in rodents, the effects of centrally administered ALLO on ethanol intake are not known. The current work examined the effects of intracranial ALLO on operant ethanol self-administration in food- and water-satiated mice, with a procedure designed to estimate ALLO''s influence on appetitive versus consummatory processes. Male C57BL/6J (B6) mice were trained to press an ethanol-appropriate lever by being reinforced with 30-min of continuous access to a 10% ethanol solution. Following surgical implantation of a guide cannula aimed at the lateral ventricle and subsequent habituation to vehicle infusions, ALLO (50–400ng; ICV) was delivered immediately prior to session start. ALLO doses of 100 and 400ng were further evaluated for their effects on locomotor behavior within activity chambers. ALLO selectively modulated ethanol intake patterns associated with the onset and maintenance of self-administration, while leaving appetitive (i.e., ethanol seeking) measures unaltered. The effects of ALLO on drinking patterns were dissociable from changes in locomotor behavior, as evidenced by the absence of ALLO''s influence on response frequency and horizontal distance traveled. These findings support the premise that manipulations in brain ALLO levels may influence the regulatory processes governing ethanol consumption. [Copyright &y& Elsevier]

Abstract: Ethanol reinforcement should ideally be evaluated in animals that are not food deprived to ensure that the motivation behind its consumption is pharmacological, and not caloric, in nature. The objective of this work was to assess the influence of reinforcement schedule on ethanol intake in nondeprived mice. Male C57BL/6J mice were trained to respond on an ethanol-reinforced lever on a fixed ratio 4 reinforcement schedule for 10% ethanol (10E). The appetitive and consummatory phases were then procedurally separated by changing the response requirement (RR), so that mice were permitted 30-min continuous 10E access after completion of either four (RR4) or eight (RR8) responses. Phase separation yielded a heightened appetitive drive to acquire 10E access (as indexed by a significant decrease in the latency to first active lever and a trend toward a decrease in the latency to first sipper contact) and an augmented level of drinking (twofold elevation in the ethanol dose consumed). Robust extinction responding on the ethanol-appropriate lever indicated that ethanol was effective as a behavioral reinforcer. These results suggest that the separation of appetitive and consummatory phases of ethanol self-administration may prove useful in future evaluations of the pharmacological and genetic bases of ethanol reinforcement in mice. [Copyright &y& Elsevier]

Abstract: The aim of this paper is to shed light on the nature of underage problem drinking by using an empirically based method to characterize the variation in patterns of drinking in a community sample of underage drinkers. A total of 4056 16–20-year-old current drinkers from 212 communities in the US were surveyed by telephone as part of the National Evaluation of the Enforcing Underage Drinking Laws (EUDL) Program. Latent class models were used to create homogenous groups of drinkers with similar drinking patterns defined by multiple indicators of drinking behaviors and alcohol-related problems. Two types of underage problem drinkers were identified; risky drinkers (30%) and regular drinkers (27%). The most prominent behaviors among both types of underage problem drinkers were binge drinking and getting drunk. Being male, other drug use, early onset drinking and beliefs about friends drinking and getting drunk were all associated with an increased risk of being a problem drinker after adjustment for other factors. Beliefs that most friends drink and current marijuana use were the strongest predictors of both risky problem drinking (OR=4.0; 95% CI=3.1, 5.1 and OR=4.0; 95% CI=2.8, 5.6, respectively) and regular problem drinking (OR=10.8; 95% CI=7.0, 16.7 and OR=10.2; 95% CI=6.9, 15.2). Young adulthood (ages 18–20) was significantly associated with regular problem drinking but not risky problem drinking. The belief that most friends get drunk weekly was the strongest discriminator of risky and regular problem drinking patterns (OR=5.3; 95% CI=3.9, 7.1). These findings suggest that underage problem drinking is most strongly characterized by heavy drinking behaviors which can emerge in late adolescence and underscores its association with perceptions regarding friends drinking behaviors and illicit drug use. [Copyright &y& Elsevier]

Abstract: This study assesses the degree to which sexual harassment (SH), generalized workplace abuse (GWA), and psychological workload (PWL) impact drinking behaviors in retirement. A mail survey was completed at four points in time by a cohort of 1654 employees initially drawn from a university workplace. Questionnaires assessed experiences of SH, GWA, PWL and drinking behaviors. Hypotheses were tested involving (1) the extent to which SH, GWA, and PWL experienced while working were associated with frequency and quantity of drinking in retirement, (2) the extent to which drinking levels of retirees differed from those of current employees experiencing similar stress levels, and (3) the extent to which gender moderated these relationships. Retirees reporting earlier stressful work environments report higher levels of alcohol consumption during retirement compared to those retirees reporting less stressful earlier work environments. Gender moderated these relationships. The findings of this study suggest that there may be a residual effect of workplace stress during retirement. [Copyright &y& Elsevier]

Abstract: The effect of drinker location within the farrowing crate in relation to its microenvironment and the effect of dispenser colour on drinking behaviour and water intake of newborn pigs for the first two days of their lives were studied. In the first trial, 16 sows were randomly assigned to four treatment groups with the piglet''s water dispenser placed in the front right (FR), front left (FL), back right (BR) or back left (BL) corner of the farrowing pen, respectively. In the second trial nine sows were randomly assigned to three treatment groups with the piglets’ water dispenser, placed in the front left corner of the farrowing pen, and coloured as red (CR), green (CG) or blue (CB), respectively. Trials commenced between 08:00 and 10:00h on the first morning after the litters were born and the piglets’ age was considered to be zero (“age”) by that time. The average age of the piglets at their first visit to water dispensers was 15.9±1.8h. The newborn pigs visited the drinker more frequently (P <0.001) during daytime than during night, with two peaks soon after sow feeding time. The duration of drinking time was long at the time of higher (noon) and shorter at the time of lowest (early morning) temperatures (P <0.01) in the farrowing house, respectively. The greatest attention at the drinkers occurred soon after suckling (P <0.001). The longest time spends at the drinker during the first visits and decreased as the pigs visited dispensers repeatedly. The profile of visit frequency and duration differed between piglet sexes (P <0.001). The pigs that did not visit the drinker grew slower and were lighter at 48h of age than the pigs visited the drinker. First visit and overall mean visit age were significantly shorter for BL than for FR and BR groups. Piglets visited the FL drinker for shorter time than the others. Water consumption per pig/24h was lower for FL and higher for BL groups (P <0.05). Water consumption was higher for CR and CB groups than for CG group. The overall mean visit age was shorter for CG than for CB group. Significant interactions were observed between sex and colour groups for the number of visits (P <0.05). The results of the present study revealed that water dispenser use by newborn piglets is characterised by diurnal and between two successive milk consumptions distributions. Water consumption by piglets from birth to 48h of their lives is strongly influenced by water dispenser location in the farrowing pen and the dispenser colour. It also appears that males and females behave differently to the three colour dispensers used in this study. [Copyright &y& Elsevier]

Abstract: Exogenous administration of the γ-aminobutyric acid (GABA)-ergic neurosteroid allopregnanolone (ALLO) can increase ethanol intake in rats and mice. To determine the contribution of endogenous neurosteroids (i.e., ALLO and related pregnane steroids) in the regulation of established ethanol consumption patterns in male C57BL/6J (B6) mice, the 5α-reductase (5α-R) enzyme inhibitor, finasteride (FIN), was chronically administered and then subsequently withdrawn. Mice were provided daily 2-h limited access to a 10% vol/vol ethanol solution (10E) and water in lickometer chambers during the dark phase. Following the establishment of stable 10E intake patterns, mice were injected intraperitoneally with either vehicle (20% wt/vol 2-hydroxypropyl-β-cyclodextrin; n =8) or FIN (50mg/kg; n =16) for 7 days. Effects of withdrawal from FIN treatment were subsequently assessed for an additional 7 days. Ethanol intakes were significantly decreased with acute FIN treatment (days 1–3) and during early withdrawal (days 1–3). Acute FIN treatment was also associated with an extended latency to first bout, reduced first bout size, and greatly attenuated sipper contact count during the initial 20-min interval of 10E access. These findings collectively indicated that acute FIN treatment markedly attenuated the initiation of 10E consumption during the limited access sessions. The influence of FIN on 10E intake patterns was largely dissipated with chronic treatment, suggesting that compensatory changes in neurosteroid modulation of inhibitory tone may have occurred. Thus, acute FIN treatment modulated ethanol intake patterns in a manner opposite to that previously demonstrated for a physiologically relevant, exogenous ALLO dose, consistent with the ability of a5α-R inhibitor to block ALLO biosynthesis. Manipulation of endogenous neurosteroid activity via biosynthetic enzyme inhibition or antagonism of steroid binding to the GABA type A receptor may prove to be a beneficial pharmacotherapeutic strategy in the intervention of alcohol abuse and alcoholism. [Copyright &y& Elsevier]

This study refines an empirically derived drinking pattern classification system [Addict. Behav. 20 (1995) 23] and assesses its concurrent and predictive validity in a new sample of alcohol-dependent adults in treatment. Drinking data were collected from 195 adults (133 men) at baseline and for 52 weeks postbaseline using the Timeline Follow-back (TLFB) method. Ninety-three percent of the sample were classified into one of four drinking patterns: binge (n=13, 6.5%), episodic (n=41, 21%), sporadic (n=17, 9%), or steady (n=111, 57%). The steady drinking group showed substantial variability in drinking intensity and was divided into steady/high intensity (n=67, 34%) and steady/low intensity (n=44, 23%) subgroups. With age and gender controlled, the five subgroups did not differ on baseline employment or marital status, but differed on a measure of relationship functioning. Binge and steady/high groups reported the most severe alcohol-use histories. Steady/low intensity drinkers had later age of onset of alcohol problems. The five-pattern classification demonstrated predictive validity; steady (heavy and low intensity) drinkers most dramatically reduced the frequency of their drinking at 26 weeks postbaseline, while binge drinkers reduced their drinking intensity. Binge and steady/heavy drinkers were more likely than steady/low and sporadic drinkers to be abstinent at follow up. The final classification into five pattern groups shows promise of clinical utility for treatment-seeking samples. [Copyright &y& Elsevier]

Substance abuse treatment programs have long contended that any post-treatment alcohol use is indicative of relapse. Recent studies, however, suggest more inclusive definitions. Zweben and Cisler (1996, 1999) consider both the drinking quantity and negative drinking consequences. Their proposed cutoffs integrate the 1995 NIAAA guidelines for sensible and high risk drinking levels with the objective assessment of drinking-related consequences into the definition of relapse. Our study applied this model to a group of detoxified alcoholics in a post-treatment followup project. We asked if: (1) Zweben and Cisler''s drinking categories could be found in our sample; (2) whether subgroups defined by post-treatment drinking patterns differed with respect to their pre-treatment alcohol consumption levels, years of alcoholic drinking and drinking related problems; and (3) whether post-treatment drinking patterns were associated with differential psychosocial functioning at followup. Thirteen percent of the total sample (N=61) was found to meet Zweben and Cisler''s moderate drinking category; 34% were abstinent, 27% heavy drinkers and 13 participants (26%) were unclassifiable. At treatment completion (T1), those who became moderate drinkers reported higher levels of self-confidence, but were otherwise similar to both abstainers and heavy drinkers. At followup (T2), approximately 1 year after initial testing (T1), groups differed on measures of emotional discharge, avoidance and logical coping skills and information seeking, suggesting a possible association between post-treatment drinking patterns and psychosocial functioning. [Copyright &y& Elsevier]

An inverse association between alcohol consumption and coronary heart disease (CHD) has been shown in epidemiologic studies for more than 30 years; beneficial changes in high-density lipoprotein (HDL) cholesterol, clotting factors, insulin sensitivity, and inflammation provide biological plausibility. Recently, the importance of including drinking patterns in defining “moderate drinking” has been appreciated. A recent meta-analysis raised questions about systematic misclassification error in observational studies because of inclusion among “nondrinkers” of ex-drinkers and/or occasional drinkers. However, misclassification among a small percentage of nondrinkers cannot fully explain the inverse relation, and there is substantial evidence to refute the “sick quitter” hypothesis. Furthermore, it has been shown that moderate alcohol consumption reduces CHD and mortality in individuals with hypertension, diabetes, and existing CHD. To address the issue of residual confounding by healthy lifestyle in drinkers, in a large prospective study we restricted analysis to only “healthy” men (who did not smoke, exercised, ate a good diet, and were not obese). Within this group, men who drank moderately had a relative risk for CHD of 0.38 (95% CI, 0.16–0.89) compared with abstainers, providing further evidence to support the hypothesis that the inverse association of alcohol to CHD is causal, and not confounded by healthy lifestyle behaviors. [Copyright &y& Elsevier]