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ABSTRACT Problem drinkers account for a large proportion of those convicted of driving while intoxicated (DWI). Nevertheless, specific rates of problem drinking among D WI offenders have been shown to [...]

Polymorphisms of the [mu]-opioid receptor (OPRM1) and dopamine D4 receptor (DRD4) genes are associated with subjective responses to alcohol and urge to drink under laboratory conditions. This study examined these associations in the natural environment using ecological momentary assessment. Participants were non-treatment-seeking heavy drinkers (n = 112, 52% female, 61% alcohol dependent) who enrolled in a study of naltrexone effects on craving and drinking in the natural environment. Data were culled from 5 consecutive days of drinking reports prior to medication randomization. Analyses revealed that, alter drinking, carriers of the Asp40 allele of the OPRM1 gene reported higher overall levels of vigor and lower levels negative mood, as compared to homozygotes for the Asn40 variant. Carriers of the long allele (i.e., [greater than or equal to] 7 tandem repeats) of the DRD4 endorsed greater urge to drink than homozygotes for the short allele. Effects of OPRMI and DRD4 variable-number-of-tandem-repeats genotypes appear to be alcohol dose-dependent. Specifically, carriers of the DRD4-L allele reported slight decreases in urge to drink at higher levels of estimated blood alcohol concentration (eBAC), and Asp40 carriers reported decreases in vigor and increases in negative mood as eBAC rose, as compared to carriers of the major allele for each gene. Self-reported vigor and urge to drink were positively associated with alcohol consumption within the same drinking episode. This study extends findings on subjective intoxication, urge to drink, and their genetic bases from controlled laboratory to naturalistic settings. Keywords: OPRM1, DRD4, urge to drink, alcohol, EMA DOI: 10.1037/a0017550

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2006.03.003 Byline: Pim Cuijpers, Bas Steunenberg, Annemieke van Straten Keywords: Children of problem drinkers; Children of alcoholics; Major depression; Older adults; Residential homes Abstract: It is well established that children of problem drinkers have an increased risk of developing mental health problems, not only during childhood but also when they grow up into adolescents and adults. However, it has not been examined whether this risk is also present during the old age of these children. In this study, we examine the question whether this increased risk is present in inhabitants of eleven residential homes (mean age 85 years). A total of 355 residents indicated whether one of their parents ever had problems with alcohol. We also used the MINI diagnostic interview to assess the presence of mental disorders. We found that parental problem drinking was significantly associated with having a major depression (current and lifetime), and with the number of drinks in the past week. No significant relationship was found with alcohol-related disorders and anxiety disorders. It was already known that parental problem drinking results in mental health problems in children. We found clear indications that these problems do not disappear when these children grow old. Author Affiliation: Department of Clinical Psychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.04.001 Byline: Kenneth M. Carpenter (a), Xinhua Liu (b), Deborah S. Hasin (c) Keywords: Alcohol dependence; Type I-Type II; Subtype Abstract: The Type A-Type B multidimensional classification model has been useful for identifying a subgroup of alcohol dependent drinkers with more severe psychosocial problems and a poor prognosis. Evidence suggests its dimensions may be useful for identifying problem drinkers in the general population at risk for developing alcohol dependence. To date, the model has not yet been investigated for this purpose. The present study investigated the Type A/Type B distinction in a community sample of problem drinkers as well as its predictive validity among problem drinkers with no history of alcohol dependence. Author Affiliation: (a) Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, 1051 Riverside Drive, Box 120, New York, NY 10032, United States (b) Joseph L. Mailman School of Public Health, Columbia University, New York State Psychiatric Institute, United States (c) Joseph L. Mailman School of Public Health and College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, United States

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.07.004 Byline: Michael A. Dawes (a), Bankole A. Johnson (b), Jennie Z. Ma (a), Nassima Ait-Daoud (b), Suzanne E. Thomas (c), Jack R. Cornelius (d) Keywords: Adolescence; Alcohol dependence; Ondansetron; Open-label trial; Craving; Obsessive-compulsive drinking Abstract: Recently, we reported that ondansetron (a 5-HT.sub.3 antagonist) as an adjunct to cognitive behavioral therapy (CBT) produced significant within-group decreases (improvement) in drinking in adolescents with alcohol dependence. We previously have hypothesized that the mechanism of ondansetron treatment response in adolescents with alcohol dependence should be similar to early onset adult alcoholics, wherein blockade of serotonin-3 receptors may decrease dopamine release and subsequent alcohol consumption and craving. We now suggest that one mechanism by which ondansetron diminishes drinking in adolescents with alcohol dependence is through a reduction in 'craving' as measured by the Adolescent Obsessive-Compulsive Drinking Scale (A-OCDS). We conducted an 8-week, prospective, open-label study of ondansetron (4 [mu]g/kg b.i.d.) in 12 adolescents (age 14-20 years) who had alcohol dependence. Results showed that 'irresistibility' and total scores as measured by the A-OCDS were correlated significantly with drinking indices (drinks/day, percent days abstinent) at the end of treatment, and that 'irresistibility' and total A-OCDS scores decreased significantly by the end of treatment. These preliminary results suggest that the A-OCDS can be useful as an outcome measure in clinical studies of adolescents with alcohol dependence. Author Affiliation: (a) START Center, Division of Alcohol and Drug Addiction, Department of Psychiatry, The University of Texas Health Science Center at San Antonio (UTHSCSA), The South Texas Addiction Research and Technology Center, 3939 Medical Drive, Suite 100, San Antonio, TX 78229-3900, United States (b) Department of Psychiatric Medicine, Box 800623, UVA Health Services Center, Charlottesville, Virginia 22908, United States (c) Center for Drug and Alcohol Programs, Institute of Psychiatry, Medical University of South Carolina, 67 President Street, Charleston, SC 29452, United States (d) Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PAARC Suite, 3811 O'Hara Street, Pittsburgh, PA 15213, United States

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.07.018 Byline: Suzanne E. Thomas, Deborah Deas Keywords: Adolescents; Alcohol; Craving; Cue reactivity Abstract: Adolescents with alcohol dependence may experience marked craving and physiologic reactivity in the presence of alcohol cues which could undermine treatment gains. The Adolescent Obsessive Compulsive Drinking Scale (A-OCDS) was developed to help quantify the severity of alcohol craving in adolescents with alcohol use disorders. The A-OCDS is a relatively new instrument, and empirical data are needed to support its value in clinical trials. The present investigation uses data collected as part of a clinical laboratory study examining alcohol craving and cue reactivity in adolescents with and without alcohol dependence. A-OCDS total and subscale scores from adolescent alcoholics (N =28) were examined regarding their relationship to drinking and several indices of craving and alcohol cue reactivity. In addition, regression analyses were performed to characterize the predictive ability of A-OCDS total scores and drinking indices (drinks per drinking day and percent days abstinent) on two measures of alcohol craving and cue reactivity. Results showed that the A-OCDS total scores, but not drinks per drinking day or percent days abstinent, predicted scores on both indices of craving. The study uses a small but well-defined sample of adolescents with alcohol dependence and supports the construct validity of the A-OCDS and suggests that, as in adults, alcohol craving and drinking behavior are related but separate elements of alcohol dependence. The results are intended to guide future studies in which the A-OCDS may be employed to measure craving and changes in craving over the course of treatment for adolescents with alcohol dependence. Author Affiliation: Center for Drug and Alcohol Programs, Institute of Psychiatry, Medical University of South Carolina, 67 President Street, MUSC, Charleston, SC 29425, United States

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.02.006 Byline: John A. Cunningham (a), T. Cameron Wild (b), Anja Koski-Jannes (c) Keywords: Alcohol; Motivation; Life events; Autoremission; Natural history Abstract: A prospective natural history study was conducted of problem drinkers who were thinking about quitting or reducing their alcohol consumption. Two primary constructs, cognitive appraisals and life events, were measured in a mailed-out baseline survey. A one-year follow-up survey identified those who had made reductions in drinking. Partial correlations controlling for baseline drinking severity revealed some support for both cognitive appraisal and life events explanations of change. Author Affiliation: (a) Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada, M5S 2S1 (b) Centre for Health Promotion Studies, University of Alberta, Centre for Addiction and Mental Health, Canada (c) University of Tampere, Jarvenpaa Addiction Hospital, Finland

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.03.003 Byline: John A. Cunningham (a)(b), Keith Humphreys (c)(d), Anja Koski-Jannes (e), Joanne Cordingley (a) Abstract: The objective of this study was to conduct a preliminary evaluation of an Internet-based intervention for problem drinkers, comparing changes in drinking between respondents who only received the intervention to those who also received a self-help book. After receiving a personalized feedback summary on the Internet, 83 respondents provided complete baseline information and volunteered to participate in a 3-month follow-up survey. Half of the respondents were randomized to receive an additional self-help book. The follow-up was returned by 48 respondents (69% female). Repeated measures ANOVAs were conducted to compare drinking levels at baseline and 3-month follow-up among respondents who only received the Internet-based intervention. There was minimal support for an impact of the Internet intervention alone. In addition, hierarchical regression analyses were conducted to compare respondents in the two intervention conditions on their drinking at follow-up, controlling for baseline consumption. Respondents who received the additional self-help book reported drinking less and experiencing fewer consequences at follow-up as compared to respondents who received only the Internet-based intervention. While the results are promising, they cannot be taken as evidence of the efficacy of Internet-based personalized feedback as a stand-alone intervention because of the absence of a control group that did not receive the intervention. Further research on this topic should be a priority because of the potential for Internet-based interventions to reach problem drinkers underserved by traditional treatment. Author Affiliation: (a) Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario, Canada M5S 2S1 (b) University of Toronto, Toronto, Canada (c) Center for Health Care Evaluation, Veterans Affairs, United States (d) Stanford University, United States (e) University of Tampere, Finland

Few prospective studies have examined older problem-drinkers not currently in treatment to determine the stability in alcohol problems over time. Seventy-eight currently drinking, older adults meeting a diagnosis of alcohol abuse or dependence were recruited via advertising to complete a health interview; 48 were reinterviewed approximately 3 years later. Participants were categorized based on alcohol consumption (risk) and alcohol-related diagnostic symptoms (problem) at baseline and follow-up. At follow-up, few older adults (11.4%) were resolved using both risk and problem criteria. Alcohol risk/problem groups were not significantly stable between baseline and follow-up. Health problems was the most common reason for changing drinking habits. Average and maximum consumption at baseline and follow-up were significant markers of follow-up risk group and follow-up alcohol-related consequences, respectively, with maximum consumption being more robust. The course of alcohol problems among older adults fluctuates over time, and heavy drinking appears to be the best indicator of problem continuation.

It may be a common pattern for alcohol dependent individuals to exhibit periods of abstinence of three or more months. Of a total of 1,853 alcohol dependent subjects, 56% reported at least one period of nondrinking lasting 3 months or longer. Some predictors of periodic abstinence could be related to a greater life stability, while others could indicate more severe drinking difficulties, with a greater awareness of alcohol problems. A association between life stability and the probability of a long-term dry period of five or more years was also seen. Alcoholics Anonymous attendance improved abstinence., ABSTRACT. Objective: Data from both laboratory experiments and retrospective histories of alcoholics indicate alternations between periods of abstinence and heavy drinking are common in the course of alcoholism. This article [...]

Nearly 14 million Americans abuse alcohol (Grant et al. 1994) and an estimated 100,000 deaths each year stem from alcohol abuse and dependence (National Institute on Alcohol Abuse and Alcoholism [...]