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The hypothalamic pituitary adrenal axis and dopamine have a key role in transition from alcohol social use to addiction. The medial prefrontal cortex was shown to modulate dopaminergic activity and cortisol releasing factor (CRF) release in hypothalamic and extra-hypothalamic systems. The recent advancements in non-invasive neurostimulation technologies has enabled stimulation of deeper brain regions using H-coil transcranial magnetic stimulation (TMS) in humans. This randomized double-blind placebo-controlled pilot study aims to evaluate H-coil efficacy in stimulating the medial prefrontal cortex. Cortisolemia and prolactinemia were evaluated as effectiveness markers. Alcohol intake and craving were considered as secondary outcomes. Eighteen alcoholics were recruited and randomized into 2 homogeneous groups: 9 in the real stimulation group and 9 in the sham stimulation group. Repetitive TMS (rTMS) was administered through a magnetic stimulator over 10 sessions at 20 Hz, directed to the medial prefrontal cortex. rTMS significantly reduced blood cortisol levels and decreased prolactinemia, thus suggesting dopamine increase. Craving visual analogic scale (VAS) in treated patients decreased, as well as mean number of alcoholic drinks/day and drinks on days of maximum alcohol intake (DMAI). In the sham group there was no significant effect observed on cortisolemia, prolactinemia, mean number of alcoholic drinks/day, or drinks/DMAI. Thus, deep rTMS could be considered a potential new treatment for alcoholism. Key words: alcohol, prefrontal cortex, transcranic magnetic stimulation, cortisol, prolactin. L'axe hypothalamo-hypophyso-surrenalien et la dopamine jouent un role cle dans la transition d'une consommation sociale d'alcool vers une dependance a l'alcool. Le cortex prefrontal interne module l'activite dopaminergique et la liberation de corticoliberine (CRF) dans les systemes hypothalamique et extra-hypothalamique. Un progres recent sur le plan des technologies de neurostimulation non-invasive permet de stimuler ces regions profondes du cerveau a l'aide de la stimulation magnetique trans-cranienne (SMT) chez l'humain. Cet essai pilote aleatoire a double aveugle comparatif avec placebo visait a evaluer l'efficacite de stimulation du cortex prefrontal interne de la bobine solenoide. La cortisolemie et la prolactinemie ont ete evaluees en tant que marqueurs d'efficacite. La consommation d'alcool et l'etat de besoin ont ete consideres comme resultats secondaires. Dix-huit personnes alcooliques ont ete recrutees et reparties de maniere aleatoire en deux groupes homogenes, 9 personnes avec stimulation reelle et 9 personnes avec stimulation simulee. La STM repetitive (STMr) a ete appliquee au moyen d'un stimulateur magnetique en 10 sessions de 20 Hz, et dirigee sur le cortex prefrontal interne. La STMr pouvait reduire significativement le niveau de cortisol sanguin et la prolactinemie, suggerant ainsi un accroissement de la dopamine. L'echelle visuelle de l'etat de besoin chez les patients traites diminuait, de meme que le nombre moyen de consommations par jour et le nombre de consommations lors des jours de consommation d'alcool maximale. Chez le groupe simule, aucun effet significatif n'etait observe sur la cortisolemie, la prolactinemie, le nombre moyen de consommations par jour et le nombre de consommations lors des jours de consommation maximale. Le STMr profonde pourrait etre consideree comme un outil supplementaire pour traiter l'alcoolisme. [Traduit par la Redaction] Mots-cles : alcool, cortex prefrontal, stimulation magnetique trans-cranienne, cortisol, prolactine., Introduction Background Impulse-control disorders and antisocial personality disorders are very common in patients affected by substance dependence, particularly alcoholics (Hasin et al. 2011; Lewis 2011). In the context of alcohol [...]

A study was conducted to examine the occurrence of erosive tooth lesions in patients with alcoholism and to analyze the influence of salivary flow rates and pH levels on their appearance. The study found a higher number of erosive lesions in participants in the test group who had a pH range of 5 to 6, compared with a range of 6 to 7.

The study aims to investigate the association between a "Housing First" intervention for chronically homeless persons with severe alcohol problems and a relative decrease in health care use and costs. The results indicate that such a program did result in a relative decrease in costs after 6 months.

As many studies show, Americans tend to think that an illness has a morally weaker claim to medical care when it is caused by personal conduct that is known to [...]

Objective: Alcohol may have psychomotor stimulant properties during the rising limb of the blood alcohol curve at commonly self-administered doses. Increased heart rate (HR) immediately after alcohol consumption may serve [...]

A study examining the epidemiology, diagnosis, medical treatment, orofacial findings among geriatric patients with alcoholism, is presented.

Previous studies that have examined the effects of specific aspects of 12-step participation and social network composition on abstinence have focused mostly on alcohol-related outcomes and have screened out drug dependent persons. This article explores whether these predictors differentially affect abstinence based on DSM-III-R substance dependence disorder (alcohol dependence, drug dependence, and both alcohol and drug dependence). A heterogeneous community sample of treatment seekers (N=302) randomized to day treatment programs were followed at 6 and 12 months. Bivariate and multivariate regression models were used to test whether engagement in 12-step practices and social network influences to drink or use drugs predicted total abstinence from alcohol and drugs differentially by dependence disorder. Chi-square automatic interaction detector (CHAID) segmentation analyses were then conducted to identify the specific 12-step activities and social network thresholds that best distinguished higher rates of abstinence in each dependence category. Results showed that the number of 12-step meetings attended and number of prescribed 12-step activities engaged in similarly predicted abstinence for alcoholics, drug addicts, and those dependent on both alcohol and drugs. However, specific activities were associated with abstinence differentially by dependence disorder. While many activities differentiated abstinence for drug addicts and those dependent on both alcohol and drugs, for alcoholics only two Alcoholics Anonymous (AA) activities distinguished abstinence (having a sponsor and doing service). Key predictors of abstinence (CHAID) varied by follow-up and dependence disorder, except for doing service in AA and/or Narcotics Anonymous, which was the only specific 12-step activity that was a best predictor of abstinence in all three categories one year following treatment. Thus, 'giving back' to one's peer community through service work, an important 12-step belief, seems to be universally valuable later in recovery. As for social network influences, a multivariate regression model showed that having a higher proportion of abstinent individuals in the network was associated with abstinence for alcoholics at 6 months only and for drug dependent persons at 12 months only. CHAID models supported these results and provided specific thresholds for 12-step measures (e.g., >20 meetings for alcoholics, 2 or more nondrinkers in the social network, 3 or more persons supporting reduction for those dependent on both alcohol and drugs, and having 2 or more nondrinkers for those dependent on drugs only). These results support the value of treatment providers prioritizing certain 12-step-related practices and social network changes based on their client dependence profiles. Early on, those with an alcohol diagnosis need to make a commitment to meetings and obtain a sponsor; also, they need to place themselves in a network that encourages sobriety. Early on, those who are drug-dependent-only especially need to become connected with 12-step programs to the extent that they consider themselves a member, and, later, saturate themselves in a highly supportive and predominantly nondrinking environment. Alcohol and drug dependent clients need more intense ongoing 12-step involvement (sponsor and meetings) as well as having nondrinking individuals and people supportive of abstinence in their network. For all clients, doing service is especially important at the longer 12-month posttreatment timeframe. Keywords; DSM-III-R disorders, drug dependence disorder, alcohol dependence disorder, polysubstance use disorder, social networks, friendship networks, Alcoholics Anonymous, Narcotics Anonymous, Cocaine Anonymous, 12-step activities, 12-step involvement, abstinence, INTRODUCTION Accumulating evidence suggests that participation in Alcoholics Anonymous (AA) is associated with alcohol abstinence for alcohol dependent individuals (1-9), but it is less clear if findings for alcoholics and [...]

Over the past 12 years, a university research team has been involved in a collaborative action research project with a community-based, self-run, residential substance abuse recovery program called Oxford House. Success of the project has been dependent on the development of trust, respect for the personal experiences of community members and group processes, commitment to serve the community, collaborative development of research and action agendas and techniques, efforts to validate findings with organization members, and accountability. In this article, we review this collaborative effort and examine the distinct opportunities and constraints in adopting this less conventional method of inquiry and action. We highlight a number of practical and theoretical issues that have been raised as we have strived to maintain a mutually beneficial alliance throughout the research endeavor. Keywords: Substance abuse, mutual help, collaborative research, Oxford House, In 1992, a conference devoted to discussing research on Alcoholics Anonymous (AA) was held at the Rutgers Center on Alcohol Studies in New Brunswick, New Jersey (1). A group of [...]

Acetaldehyde, a toxic metabolite of ethanol oxidation, is suggested to play a role in the increased risk for gastrointestinal cancers in alcoholics. In the present study, the effect of acetaldehyde on tyrosine phosphorylation, immmunofluorescence localization, and detergent-insoluble fractions of the tight junction and the adherens junction proteins was determined in the human colonic mucosa. The role of EGF and L-glutamine in prevention of acetaldehyde-induced effects was also evaluated. Acetaldehyde reduced the protein tyrosine phosphatase activity, thereby increasing the tyrosine phosphorylation of occludin, E-cadherin, and [beta]-catenin. The levels of occludin, zonula occludens-1, E-cadherin, and [beta]-catenin in detergent-insoluble fractions were reduced by acetaldehyde, while it increased their levels in detergent-soluble fractions. Pretreatment with EGF or L-glutamine prevented acetaldehyde-induced protein tyrosine phosphorylation, redistribution from intercellular junctions, and reduction in the levels of detergentin-soluble fractions of occludin, zonula occludens-1, E-cadherin, and [beta]-catenin. These results demonstrate that acetaldehyde induces tyrosine phosphorylation and disrupts tight junction and adherens junction in human colonic mucosa, which can be prevented by EGF and glutamine. alcohol; barrier function; human colon; epidermal growth factor

The readiness for mental health treatment of patients with comorbid psychiatric and alcohol disorders who may be ready to change one behavior to the other is discussed. Confirmatory factor analysis suggests that separate levels of patient motivation exist for mental health treatment and changing alcohol use.

This study examined the utility of Cloninger's tridimensional personality theory (1986, 1987a) in predicting preferred substance of abuse and self-reported motivations for use among a sample of 200 adolescent substance abusers and 200 matched community control adolescents. Two primary hypotheses were tested: (1) Cloninger's type II profile is more strongly associated with stimulant use, and his type I profile is more strongly associated with substances having sedative-hypnotic effects; and 2) type II individuals will report motivations for use that focus primarily on obtaining positive rewards, whereas type I individuals will report motivations primarily concerning negative reinforcement or the avoidance of problems and negative life experiences. Our results did not show strong associations between Cloninger's Harm Avoidance and Reward Dependence dimensions and preferred substance or motivations for use. However, in partial support of the hypotheses examined here, we did find that individuals low in novelty seeking (NS) tended to prefer alcohol and marijuana, whereas those high in NS endorsed a wider range of preferred substances. High NS was associated with significantly greater stimulant use and motivations focused on obtaining positive rewards, whereas low NS was associated with greater sedative use and motivations related to avoiding negative emotions or negative life experiences. Key Words: Substance abuse; Personality; Adolescence., INTRODUCTION There is accumulating evidence to suggest that substance abusers are a heterogeneous group (e.g., Refs. 1-13). Understanding the multiple pathways to substance abuse may have important implications for treatment [...]

This paper analyzes the variation of suicide by day of the week in alcohol dependence, with public holidays taken into consideration. From 1949 through 1969, 1,312 patients with alcohol dependence were admitted to the Department of Psychiatry in Lund. By 1997, a total of 102 (99 men) alcoholic patients had taken their own life. Suicide victims with severe depression and other diagnoses were compared. There was a suicide peak on the first two days after weekends and holidays in patients with alcohol dependence (p < .05). Alcohol withdrawal is proposed as a contributor to the suicide peak.

Little is known about the perceived barriers to quitting smoking among alcohol abusers. In addition to the usual barriers perceived by smokers, alcohol dependent smokers may have a few barriers unique to their addictive lifestyle. The Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) was administered to 96 alcohol dependent smokers in residential substance abuse treatment. The BQS-SAT is designed to assess perceived barriers to quitting smoking among alcohol abusers using eleven true-false items. One open-ended item was included to gather information about potential additional barriers. The majority of respondents reported withdrawal-related barriers such as expecting to feel irritable, anxious, restless, and about half expected intolerable urges to smoke if they were to quit smoking, as most smokers do. However, concerns about effects on sobriety and needing cigarettes to cope with feeling down were also endorsed by almost half of the patients. Total number of perceived barriers was significantly related to smoking history, expected effects from smoking, and smoking temptation but was not associated with severity of alcohol use or dependence on admission. Providing corrective feedback about these barriers could be useful when addressing smoking with patients who have alcohol abuse or dependence. Keywords: Barriers; Quitting smoking; Nicotine dependence; Alcohol dependences

Objective: The medical literature suggests that alcoholics may present greater challenges to achieving clinical pain control than nonalcoholics. This study was undertaken to test the hypotheses that: (1) significant differences exist between alcoholics and nonalcoholics on detection and pain thresholds during electric tooth stimulation; (2) group differences exist in the depth and time course of pulpal anesthesia; and (3) responses to tooth stimulation are associated with severity of alcoholism and/or other psychological factors. Method: Male alcoholics (n = 22) in aftercare treatment (mean length of sobriety = 113 days) and age-matched nonalcoholics (n = 22) received 1.0 ml of 3% mepivicaine at the apex of a maxillary lateral incisor and saline placebo at the apex of the contralateral incisor. Results: At baseline no group differences were found on sensory thresholds. During drug intervention significant drug and time effects for both detection threshold (p [is less than] .0001) and pain threshold (p [is less than] .0001) were found, but group differences and interactive effects were not significant. By exploratory regression analysis of alcoholic subjects, history of depression/unhappiness was significantly associated with shallower pulpal anesthesia, whereas high need for control/low actual control and frequency of treatment for detoxification were associated with deeper anesthesia. Conclusions: Our findings suggest alcoholics in recovery are not at increased risk for inadequate pain control with local anesthesia. (J. Stud. Alcohol 58: 291-296, 1997), Twenty-two recovering alcoholics, with a mean length of sobriety of 113 days, were not significantly different from a population of 22 nonalcoholics in their sensitivity to the pain-controlling effects of the local anesthesia mepivicaine, according to a dental study at the University of Washington. Prior pain management research in clinical settings suggested that alcoholics were less responsive to anesthesia and pain-controlling drugs than nonalcoholics. The study also found that psychological factors such as depression did affect alcoholics' level of response to local anesthesia., The medical literature suggests that a history of alcohol or nonalcohol drug abuse may predispose patients to achieve less effect from pharmacological methods for general anesthetics/pain control (Couderc et al., [...]

Dentists may need to exercise special care in treating patients with alcoholic liver disease (ALD). About 7% of American adults show signs of alcoholism, and ALD can be an outgrowth of alcohol abuse. Since liver damage affects how drugs are metabolized by the body, dentists should only prescribe low doses of acetaminophen and should not prescribe aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) in patients with ALD. ALD reduces the ability of blood to clot, so dentists should schedule ALD patients in the morning when blood has better clotting ability.

A positive correlation exists between cirrhosis mortality rates and the sales of alcoholic drinks. The study establishes a relationship between chronic heavy consumptions and preferences for strong drinks such as spirits. The consumption of alcoholic drinks causes both long and short term physiological effects. The study uses the data on cirrhosis mortality rates and beverage specific sales rates of 50 states in US over 12 year period to evaluate the relationship.

A study shows that a positive correlation exists between the encountered number of drinking harms and probability of involvement in treatments. Experiences of problems at work, employment and education usually get treated immediately. The self-help groups are generally consulted before seeking treatments. The study took a sample of 1954 individuals with experience of at least one harmful effect of drinking. To evaluate the relationships Chi-square tests were conducted.

The sexual behavior and drug injection habits of 802 alcoholic inpatients in New York State was studied to determine the degree of their elevated risk to HIV infection compared to other at risk groups. The alcoholic group was found to have HIV infection rates similar to or higher than other high risk groups. Study results indicated areas to be dealt with in facilitating risk reduction.

Bartonella quintana may be the cause of fever, bacteria in the blood, and endocarditis in HIV-negative, homeless, inner-city patients with chronic alcoholism. B. quintana has been identified as the cause of epidemics of trench fever among soldiers in Europe during World War I. Endocarditis is an inflammation of the lining of the heart. B. quintana was isolated from 34 blood cultures from 10 HIV-negative patients between January and June 1993 in Seattle. A retrospective case-control study of the blood samples using polymerase chain reaction-restriction-fragment-length polymorphism (PCR-RFLP) analysis suggested that the patient's cases were linked to a common source. The mode of transmission of B. quintana may have been close body contact among the patients, who were all homeless and whose chronic alcoholism and homelessness may have contributed to poor hygiene. All of the patients were nonwhite. The transmitter of B. quintana is the human body louse. Only one patient was observed to have lice upon hospitalization.

Heterosexuals who abuse alcohol appear to be at a higher risk of contracting HIV than previously thought. A total of 860 heterosexuals in alcohol treatment programs were interviewed and tested anonymously for HIV infection. Forty study participants (5%) tested positive for HIV infection. Sixty-two percent of those who were HIV positive had a history of injection drug use. Additionally, those who had a history of syphilis were more likely to be HIV positive than those who did not. No other sexually transmitted disease appeared to be associated with HIV infection. Almost 85% of participants reported heterosexual activity in the past year. Almost half had at least three sexual partners. Consistent condom use with all sexual partners was reported by 3% of participants. Few participants reported they always asked about a new partner's sexual history or HIV status., Objective.--To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcohol treatment. Design.--Cross-sectional survey. Setting.--Five public alcohol treatment centers. Subjects.--Consecutive sample of 888 heterosexual clients entering treatment between October 1990 and December 1991. Respondents were 51% black, 10% Hispanic, 33% white, and 76% male. The overall response rate was 68%. Measurements.--Structured interview and serotesting for HIV antibodies. Results.--The overall seroprevalence of HIV infection was 5% (95% confidence interval, 3% to 6%). There were no significant differences in rates of infection by age, gender, or race. The prevalence of infection in heterosexual respondents without a history of injection drug use was 3% in men and 4% in women, several times higher than published estimates from a similar community-based heterosexual sample. Unsafe sexual practices were common: 54% of respondents reported multiple sexual partners in the previous year, 97% of nonmonogamous respondents did not use condoms during all sexual encounters, and few respondents consistently asked new sexual partners about previous high-risk behaviors. Conclusions.--There is a substantial prevalence of HIV infection among heterosexual clients in San Francisco (Calif) alcohol treatment programs, much of which is not associated with injection drug use. Because of this and the high prevalence of unsafe sexual behaviors, there is a relatively high likelihood of heterosexual spread of HIV among the large population of clients seeking treatment for alcohol dependency. Interventions to prevent HIV spread should become a standard part of alcohol treatment programs. (JAMA. 1994;271:515-518)

An improvised clinical model of the influence of genetic determinants in alcohol dependence centers around lowered response to alcohol. Biological determinants could be polygenic or dominant with partial penetrance, and should work with the environment, because alcohol dependence is not the result of a particular genetic factor. The determination of a particular gene that increases the alcoholism risk is problematic.

US and Spanish emergency room admissions for injury and noninjury problems were compared on the predictive value of breath-analyzer readings, drinking prior to the event, feeling drunk at the time of the event, drinking patterns, alcohol-related problems and demographic characteristics. Results showed that quantity and frequency of drinking, time and place of injury and feeling drunk at the time of the event were predictive of alcohol-related injuries in California. On the other hand, drinking patterns were less predictive of alcohol-related injury in Spain.

Three hundred chronic alcoholic and normal subjects participated in a study to determine the correlation between diet, alcohol intake, tobacco use and other alcohol-related diseases. Results show that chronic alcoholics exhibit stronger 'oral behavior' exemplified by eating, drinking and smoking than the reference populaion. The oral behavior served as the basis for classifying the chronic alcoholics into alcohol-related diseases.

The inhibiting effect of alcohol intake on the spontaneous and nitrogen-induced interferon-gamma secretion by human peripheral blood lymphocytes of healthy donors in vitro is confirmed. Interferon-gamma has a great variety of immuno-stimulating effects, thus its inhibition renders patients who chronically abuse alcohol vulnerable to more frequent and to more serious infections and to certain malignancies, particularly cancers of the head and neck.

Mortality rates in alcoholics who abstain from alcohol for long periods of time are no higher than those in the general population. Of 199 alcoholics enrolled in a treatment program who were followed up to 11 years, 101 relapsed and 98 achieved long-term abstinence. At 11 years, the mortality rate in the abstainers was similar to that in a control group of 92 non-alcoholics, but the rate in the relapsed alcoholics was five times higher than would be expected in the general population. The mortality rate was especially high in relapsed alcoholics between the ages of 20 and 45; there were nine times as many deaths as would be expected in the general population. Smoking did not appear to be associated with increased mortality in relapsed alcoholics, since abstainers smoked as much as relapsers, and both groups smoked more than the non-alcoholics., Objectives.-To determine if alcoholic men who achieved stable abstinence experienced fewer deaths than those who relapsed and to develop a model predictive of premature mortality. Design. -A cohort of alcoholic men recruited into a prospective study of neurocognitive effects of alcoholism was followed up from 1 through 11 years. A demographically equated group of nonalcoholic men was also followed up. Alcoholics were classified as stable abstainers or relapsers. Setting.-Alcoholics were patients or ex-patients from a Department of Veterans Affairs Alcoholism Treatment Program and/or members of local chapters of Alcoholics Anonymous. Participants.-There were 234 alcoholic men who met the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, criteria for alcohol dependence. Follow-up status regarding relapse and mortality was obtained for 199 alcoholic subjects (85%). Of these, 101 had relapsed and 98 had abstained. Ninety-eight nonalcoholic controls equated for age, education, and sex also participated. Mortality status was obtained for 92 subjects in this group (94%). Exclusions.-Major medical and psychiatric illness and history of nonalcoholic drug abuse. Main Outcome Measure. - Death during a follow-up period of 1 through 11 years. Death was ascertained through the National Death Index, the California State Department of Health and Vital Statistics, the State Department of Motor Vehicles, and through personal contact with informants, relatives, and significant others of the subjects. Results.-There were 19 deaths among relapsed alcoholics compared with the expected number of 3.83 (99% confidence interval (CI), 9.64 to 33.38). Among abstinent alcoholics there were four deaths (expected = 3.21; 99% Cl, 0.67 to 12.59). The standardized mortality ratio for relapsed alcoholics was 4.96, which significantly exceeded the expected ratio P Conclusions. Alcoholic men who achieve stable abstinence do not differ from nonalcoholic men in mortality experience; however, alcoholics who relapse die at a rate 4.96 times that of an age-, sex-, and race-matched representative sample from the US Bureau of the Census. JAMA, 1992;267:668-672)

The publication in 1988 of a study showing that patients with alcohol-related end-stage liver disease (ARESLD) could survive as long after liver transplantation as patients with other terminal liver diseases raised important questions regarding the appropriate use of the very short supply of donated livers. These issues are particularly pressing since the Health Care Financing Administration decided to extend Medicare coverage for liver transplantation to patients with alcoholic cirrhosis (liver disease caused by alcoholism) who stop drinking. The authors take exception to this position. Liver transplantation is different from other lifesaving treatments for several reasons. Donor livers are extremely scarce, and including people with ARESLD, who represent more than half of the ESLD patients, as potential recipients would increase competition for the few (fewer than 2,000 in 1989) liver transplantation operations performed. While hearts are also in short supply, no one main cause for the type of heart disease requiring transplantation can be identified. Liver transplantation has been targeted for cost containment, and public support is needed if donor programs are to be successful. A proposal is presented to rank candidates for liver transplantation that would give the highest priority to those who develop ESLD through no fault of their own (because of congenital conditions or cirrhosis due to causes other than alcohol). The scarcity of donated livers dictates that ARESLD patients be judged differently than other patients. It is deemed fairer to give a child dying of biliary atresia (failure of the biliary system to develop) a first healthy liver than to give an ARESLD patient a second healthy one. The proposal does not discriminate against the poor, because alcoholism is present at all socioeconomic levels. The public, which holds lifesaving care for alcoholics in low regard, represents a force that must be considered in formulating health policy. Several other articles and editorials on this issue appear in the March 13, 1991 issue of The Journal of the American Medical Association. (Consumer Summary produced by Reliance Medical Information, Inc.)

A 3-mo. follow-up was made of 64 male veterans who were discharged from a 21-day Alcohol Detoxification Treatment Program at the Veterans Affairs Medical Center at Lyons, NJ. Scores on the Router I-E and Alcohol Responsibility Scales were significantly correlated with tendencies toward a more external direction among the 13% who relapsed, significant on the I-E scale and nonsignificant on the Alcohol Responsibility Scale. When tests were compared as possible predictor variables of alcoholic relapse, the difference in favor of the I-E scale was statistically nonsignificant.

ABSTRACT Background: Alcohol consumption can have a variety of cutaneous manifestations. Awareness of the cutaneous changes of alcohol abuse can allow early detection and intervention in an attempt to limit [...]