Alcohol and Alcoholism - current issue

Alterations of serum brain-derived neurotrophic factor levels in early alcohol withdrawal

2008-05-03

Aims: Alcohol withdrawal-enhanced neurotoxicity contributes to the addictive process. Brain-derived neurotrophic factor (BDNF) plays an important role in neuronal plasticity and learning. In this study, we explored the changes of serum BDNF levels in alcoholic patients at baseline and after one-week alcohol withdrawal. Methods: Twenty-five alcoholic patients were admitted for alcohol detoxification treatment, and 22 healthy control subjects were also enrolled. We collected blood samples of the patient group on the first and seventh day of alcohol withdrawal, and measured serum BDNF level with sandwich enzyme-linked immunosorbent assay. The severity of withdrawal symptoms was evaluated by the Clinical Institute Withdrawal Assessment-Alcohol, Revised every eight hours. Results: Serum BDNF levels did not differ significantly between alcoholic patients and control subjects. But BDNF levels were found to be significantly increased one week after alcohol withdrawal (from 13.9 ± 3.8 ng/ml to 15.4 ± 3.8 ng/ml, P = 0.03). A significant positive correlation was found between baseline BDNF level and baseline withdrawal severity (r = 0.45, P = 0.03). Conclusions: The present study suggests that elevated serum BDNF levels were found in early alcohol withdrawal, implying that BDNF may involve in neuroadaptation during the period.

Protective effects of sericin protein on alcohol-mediated liver damage in mice

Li, Y.-G., Ji, D.-F., Chen, S., Hu, G.-Y. — 2008-05-03

Aims: The purpose of this study was to investigate the protective effects of sericin protein (SP) on alcohol-induced hepatic injury in mice and the possible mechanisms. Methods: SP (0.375, 0.75 and 1.50 g/kg body weight) was dissolved in distilled water and given to mice by gavage 1 hour before the alcohol (56% wt/vol, 14.2 ml/kg b.w.) treatment for 30 days, then blood, urine and liver were collected, processed and used for alcohol concentration mensuration, various biochemical estimations and histopathological examination. Results: The concentration of alcohol evidently decreased in serum and increased in urine in SP treated mice as compared to alcohol-administered animals. Chronic alcohol administration resulted in significantly increase in the levels of transaminase (AST and ALT) and malondialdehyde (MDA) but decrease of glutathione (GSH), glutathione peroxidase (GSH-PX), catalase (CAT) and superoxide dismutase (SOD) in the serum and liver. Hepatic triglyceride (TG) also increased. When mice ingested high doses of SP (0.75 and 1.50 g/kg b.w.) the levels of antioxidant enzymes in the serum were restored to normal. However, hepatic CAT and GSH were still below normal, although a trend of significant increases was observed in comparison with alcohol treatment group. Conclusions: The results indicated that SP was able to hasten the alcohol elimination through urine directly and enhance the ethanol oxidation rate in liver. Simultaneously, SP may exert a protective effect against lipid peroxidation by scavenging reactive oxygen species and elevating the activity of antioxidant enzymes, in consequence prevented the peroxidative deterioration of structural lipids in membranous organelles, especially mitochondria and karyon.

Chronic alcohol feeding induces biochemical, histological, and functional alterations in rat retina

2008-05-03

Aims: Ethanol consumption originates a wide spectrum of disorders, including alteration of visual function. Oxidative stress is included among the mechanisms by which alcohol predisposes nervous tissue to injury. Retina, which is the neurosensorial eye tissue, is particularly sensitive to oxidative stress. Methods: In this study we analyze the effect of long-term alcohol consumption on oxidative stress parameters of the rat retina, and its correlation to retinal function, as well as to the expression of the antiapoptotic protein Bcl-2. We also study the protective effect of ebselen, a synthetic selenoorganic antioxidant. Results: Herein we show that ethanol has a toxic effect on rat retina associated with oxidative stress. Decreases in retina glutathione concentration and increases in malondialdehyde content in whole eye homogenate significantly correlate with ERG b-wave decrease and Bcl-2 overexpression. We also show how ebselen is able to prevent all the alterations observed. Conclusion: Chronic ethanol consumption induces oxidative stress in rat retina associated with an impairment of ERG and Bcl-2 overexpression, suggesting a role for glial cells. All these alterations in the rat allow the proposal of an alcoholic retinopathy in this species.

Alcohol exposure alters cell cycle and apoptotic events during early neurulation

Anthony, B., Zhou, F. C., Ogawa, T., Goodlett, C. R., Ruiz, J. — 2008-05-03

Background: Fetal alcohol exposure causes growth deficits, microencephaly, and neurological abnormalities. Although the effects of alcohol on developmental delay and growth-related deficits have been hypothesized, little is understood about how alcohol alters, in particular, the cyclin pathway within the cell cycle, which is critical to proliferation and apoptotic control. In this study, we examined cell cycle proteins pertinent to the G1–S phase transition and apoptosis, to determine if cell cycle misregulation can be attributed to apoptotic induction and growth defects. Methods: We examined cell cycle regulation during G1 and S-phase, and DNA fragmentation damage, using E14 dorsal root ganglia neural stem cells (DRG-NC), and cultured mouse embryos exposed to 200 and 400 mg/dl ethanol. Results: Alcohol-exposed DRG-NC demonstrated a dose-dependent increase in cells expressing increased cyclin D1 protein, and increased DNA fragmentation. Western blot analysis, using embryos, demonstrated an overexpression of cyclin D1, D2, and E2F1, key G1 to S-phase cell cycle regulatory components, and increases in p53, linking the cell cycle and apoptotic pathways. Bromodeoxyuridine incorporation indicated reduced DNA synthesis and growth in several embryonic regions. Propidium iodide staining demonstrated decreases in DNA content and increases in DNA fragmentation in several embryonic tissues. Conclusions: This study indicated that retarded growth of DRG-NC and embryos, induced by alcohol, is associated with altered expression of cell cycle and apoptotic proteins and concurrent inhibition of proliferation and increased DNA fragmentation. We suggest that alcohol induces an increase in cyclin D1 expression, premature S-phase entry, and disjointed DNA synthesis with increased apoptosis.

Associations of alcohol drinking and cigarette smoking with serum lipid levels in healthy middle-aged men

Wakabayashi, I. — 2008-05-03

Aims: The aim of this study is to determine whether influences of drinking alcohol on serum lipid levels are different in smokers and non-smokers. Methods: Subjects were 25,689 healthy male workers aged 40 to 59 years. Serum total and HDL cholesterol and triglyceride concentrations were measured and LDL cholesterol concentrations were estimated by using the Friedewald formula. The subjects were divided into three groups by average daily consumption of cigarettes (non-smokers; light smokers, less than 20 cigarettes per day; heavy smokers, 20 or more cigarettes per day) and by average daily alcohol consumption (non-drinkers; light drinkers, less than 30 g of ethanol per day; heavy drinkers, 30 g or more of ethanol per day). Results: In overall subjects, serum HDL, LDL and total cholesterol were significantly lower and triglyceride was significantly higher in heavy smokers than in non-smokers. In the smoker groups, serum total cholesterol was significantly lower in heavy drinkers than in non-drinkers, while no difference in total cholesterol was observed in non- and heavy drinkers of the non-smoker group. Both in the smoker and non-smoker groups, HDL cholesterol was higher and LDL cholesterol was lower in drinkers than in non-drinkers. The difference in LDL cholesterol between non-drinkers and drinkers was more prominent in smokers than in non-smokers. The above associations were not altered after the adjustment for age, body weight and alcohol intake. Conclusions: The results suggest that smoking increases the lowering effect of alcohol drinking on LDL cholesterol, but does not affect the relationship of alcohol drinking with HDL cholesterol.

Kinetics and isoforms of serum glutamate dehydrogenase in alcoholics

Kravos, M., Malesic, I. — 2008-05-03

Aims: The goal of this paper was to determine Glutamate dehydrogenase's (GLDH) increased activity and rapid decrease in alcoholics according to last consumption of alcohol as well as to confirm that quick normalisation cannot be a sign of hepatocyte necrosis and that GLDH from rough endoplasmic reticulum exists in the serum of alcoholics. Methods: GLDH activity was assed in 238 alcoholics admitted to hospital. A blood sample was taken from every subject three times: on admission to hospital, after 24 hours and after 7 days. We established our own reference activities for GLDH in serum, i.e., up to 124.0 nkat/l in males and 64.5 nkat/l in females. Results: Alcoholics were ascertained to have statistically significantly higher mean GLDH serum activities (men 351.53 nkat/L, women 296.08 nkat/L); the higher the level, the less elapsed time there was after the latest alcohol intake. There was an increased GLDH activity in 65.5% of alcoholics; furthermore, the percentage rose sharply to 72.2% with those who had last consumed alcohol within 48 hours. In the serum of alcoholics, it was found that, on average, it was 32.4% thermo-stable and 67.6% thermo-labile GLDH, which means that almost one third of GLDH serum originates from rough endoplasmic reticulum and rest from mitochondria. This is a completely new finding. Conclusions: A statistically significant fast decrease of GLDH serum activity after a break in alcohol consumption has been confirmed. It is estimated that increased GLDH activity in the sera of alcohol dependents and its fast decrease after total abstinence has been restored are specific for alcohol addiction.

Pathways to substance-related disorder: a structural model approach exploring the influence of temperament, character, and childhood adversity in a national cohort of prisoners

Lukasiewicz, M., Neveu, X., Blecha, L., Falissard, B., Reynaud, M., Gasquet, I. — 2008-05-03

Aims: Using Cloninger's model of personality, we aimed to specify the relative influence of the more biologically determined variables, temperament and character and more environmentally driven influence, childhood adversity in the development of addiction; and to compare patterns found among alcoholics with those found among drug addicts. Methods: We studied a group of prisoners, at a high risk of substance abuse and past history of childhood adversity. Using a stratified random strategy we selected (i) 23 prisons among the different types of prison in France, (ii) 998 prisoners. Each prisoner was assessed by two psychiatrists—one junior, using a structured interview (MINI 5 plus), and one senior, completing the procedure with an open clinical interview. At the end of the interview the clinicians met and agreed on a list of diagnoses. Cloninger's Temperament and Character Inventory was used to measure personality. Structural equations models, which have been advocated to disentangle the respective influence of complex risk factors, were used. Results: the "novelty seeking" temperament was a crucial vulnerability factor, for both alcoholics and drug addicts, in the same proportion. Character and childhood adversity played a significant part only in the development of drug abuse. Conclusions: In a prison population, a common biological loaded factor, novelty seeking is found both at the core of alcohol- and drug-related disorder whereas environmentally loaded factors play a greater role in drug problems.

Hippocampal volume loss in patients with alcoholism is influenced by the consumed type of alcoholic beverage

2008-05-03

Aims: The individual extent of structural brain tissue changes in patients with alcohol dependence is influenced by genetic factors, gender, age and possibly a dose/duration-effect. Aim of the present study was to investigate different types of alcoholic beverages with regard to hippocampal volume loss in patients suffering from alcoholism. Methods: We included 52 patients with alcohol dependence and divided them according to their preferred type of beverage consumption (beer, wine, and spirits). Hippocampal volumes were determined using volumetric high-resolution MR imaging. Results: There was a significant difference in hippocampal volumes between patients consuming different beverages (ANOVA: F = 7.454; df = 2; P = 0.0015) with the smallest volumes in the wine group, followed by the spirits group. Furthermore, patients with a preferred spirits consumption showed significantly higher plasma homocysteine levels (ANOVA: F = 3.39; df = 2; P = 0.042). Linear regression analyses revealed an association of homocysteine and hippocampal volume only in the group of patients preferring spirits (R² = 0.364; P = 0.008). Conclusions: Homocysteine-mediated excitotoxicity may be an important pathophysiological mechanism in ethanol-related brain damage, particularly in patients consuming wine and spirits. The extent of brain atrophy in beer consuming patients seems to be more moderate.

Comorbidity of alcohol and substance dependence with attention-deficit/hyperactivity disorder (ADHD)

2008-05-03

Aims: Attention-deficit/hyperactivity disorder (ADHD) is of great clinical importance not only because of its high prevalence but also due to the frequent comorbid illnesses that are connected with this disorder. Several studies were able to demonstrate that ADHD constitutes a significant risk factor for the exacerbation of habit-forming illnesses, i.e. addictions. Methods: We conducted a study on 152 adult patients with alcohol dependence (n = 91) or multiple substance addiction (n = 61) to determine whether or not these patients were affected by ADHD. For retrospective assessment of childhood ADHD, the WURS-k was used as well as the DSM-IV symptom checklist for ADHD. The CAARS was used to assess the persisting symptoms of ADHD in adults. Results: 20.9% (WURS-k) or 23.1% (DSM-IV diagnostic criteria) of the alcohol-dependent patients showed evidence of retrospective ADHD affliction in childhood. With the help of CAARS, ADHD was proved to be persistent in 33.3% of the adult patients. In the group of substance-addicted patients 50.8% (WURS-k) and 54.1% (DSM-IV) presented with diagnostic criteria for ADHD in childhood and 65.5% (CAARS) showed evidence of ADHD persisting in adulthood. Conclusions: These results reveal that habit-forming illnesses can be associated with a high comorbidity with ADHD, expressed in the form of alcohol abuse and also in consumption of illegal drugs. The results underline the great importance of early and adequate diagnostics and therapy of ADHD for the prevention of habit-forming illnesses.

Complaints about sleep in trauma patients in an emergency department in respect to alcohol use

Neumann, T., Neuner, B., Weiss-Gerlach, E., Spies, C. — 2008-05-03

Among other lifestyle problems, sleeping problems have been related to alcohol use. Aim: The aim of this study was to evaluate complaints about sleep in trauma patients in an emergency department and its relation to alcohol use disorders (AUD). Method: In an emergency department, trauma patients (1014 females, 1680 males) were screened using a computerized questionnaire addressing AUD (AUD identification test, AUDIT), smoking, drug and medication use, and sleep (presence of difficulties in falling asleep and/or sleeping through). Age, BMI, income, employment, partner status, and "feeling fit" were additionally assessed. Results: An AUDIT score ≥8 points was found in 24.2% of the males and 8.3% of the females. Complaints about sleep were reported by 28% and 34% of the patients, respectively. These complaints about sleep were more likely in males at-risk drinkers (AUDIT ≥ 8 versus 1–4 points (Adjusted odds ratio: AOR = 1.60, P = 0.001) or abstainers (AUDIT = 0 versus 1–4 points, AOR = 1.55, P = 0.029), and with increasing age (AOR = 1.01, P = 0.010), in patients not feeling "fit" (AOR = 2.15, P < 0.001), and users of pain (AOR = 2.24, P < 0.001) and sleep medication (AOR = 8.03, P < 0.001). In females, complaints about sleep were more likely with higher age (AOR = 1.04, P = 0.023), higher BMI (AOR = 1.04, P = 0.023), with not-feeling-fit (AOR = 1.87, P < 0.001) and sleep medication (AOR = 5.24, P < 0.001), and less likely in patients with a higher education (AOR = 0.57, P < 0.001). Conclusion: Complaints about sleep were reported frequently by trauma patients. There was an association between AUDs and sleep complaints (mainly problems about sleeping through) in males, but not in females.

Prognostic value of nutritional status in alcoholics, assessed by double-energy X-ray absorptiometry

2008-05-03

Objectives: This study was performed in order to assess nutritional status of 77 alcoholic patients. Methods: Patients underwent a total body double-energy X-ray absorptiometry (DEXA) analysis, with estimation of lean and fat mass at different parts of the body. Results: Lean mass, but not fat mass, was significantly reduced among alcoholics, compared to 31 age-matched controls, especially at right arm, legs, and total body. Lean mass at both arms was significantly related to liver function parameters (albumin, prothrombin activity, bilirubin) and, inversely, with ethanol consumption. The 24 patients who died during a follow-up period of 88 months showed less lean mass at both arms, trunk, and left leg, and also less fat at the left arm, than survivors. When right and left arm lean mass were classified in quartiles, Kaplan–Meier curves showed significant differences between dead and survivors. Left arm lean mass was the parameter which was independently related to mortality when encephalopathy was not included in a stepwise Cox regression analysis, but was displaced by this last parameter when it was also introduced in the analysis. Conclusion: lean mass is reduced in alcoholics, is related to liver function derangement and ethanol consumption, and is related to mortality.

Improving alcohol and tobacco history taking by junior medical officers

Proude, E. M., Conigrave, K. M., Britton, A., Haber, P. S. — 2008-05-03

Aims: We aimed to determine the effectiveness of individual feedback and group feedback in improving recording, assessment, and management of risky alcohol use and of tobacco smoking by Junior Medical Officers (JMOs). Method: Medical records of patients admitted by JMOs were examined for recording of alcohol use, alcohol withdrawal, intervention for alcohol, a consultation with the Drug and Alcohol team, tobacco use, and prescription of nicotine replacement therapy (NRT). In year 1, JMOs from hospital 1 received printed individual feedback on their own and their group's performance, while JMOs at hospital 2 attended a presentation of their group feedback. The following year, they reversed roles. Results: A total of 3025 patient records were examined for 130 JMOs. After individual feedback, the percentage of alcohol histories that were quantified rose significantly, from 69% to 82%. More smokers were detected, and NRT prescribing rates rose significantly. Group feedback showed no change. Logistic regression showed that JMOs were significantly more likely to record an alcohol history if located at the smaller hospital and in first year of hospital practice, if the patient was admitted during business hours, was male, and/or was younger than the median age of 70 years; JMOs were significantly more likely to quantify alcohol consumption after individual feedback, but this had no effect on tobacco history recording. Conclusion: Our study suggests that individual feedback on performance with education about desired standards is effective in improving the quality of recording of alcohol histories by Junior Medical Officers.

The latent structure of alcohol use disorders: A taxometric analysis of structured interview data obtained from male federal prison inmates

Walters, G. D. — 2008-05-03

Aims: Archival data from structured interviews of 1193 male prison inmates were subjected to taxometric analysis to determine the latent structure of the alcohol use disorder construct. Methods: Analyses were performed using three taxometric procedures: mean above minus below a cut (MAMBAC), maximum eigenvalue (MAXEIG), and latent mode factor analysis (L-Mode). Results: The outcomes were based on three indicators: (1) DSM-IV alcohol dependence criteria 1 and 2 (tolerance/withdrawal), (2) DSM-IV alcohol dependence criteria 3, 4, and 5 and DSM-IV alcohol abuse criterion 3 (loss of control), and (3) DSM-IV alcohol dependence criteria 6 and 7 and DSM-IV alcohol abuse criteria 1, 2, and 4 (negative social/psychological consequences). The outcomes revealed consistent support for a taxonic (categorical) interpretation of alcohol use disorders. Conclusions: There may be a taxonic boundary separating those who do and do not qualify for a diagnosis of alcohol dependence or abuse with important implications for diagnosis and treatment.

Gender differences in the efficacy of brief interventions with a stepped care approach in general practice patients with alcohol-related disorders

Reinhardt, S., Bischof, G., Grothues, J., John, U., Meyer, C., Rumpf, H.-j. — 2008-05-03

Aim: To analyse gender differences in the efficacy of stepped care brief interventions for general practice patients with alcohol problems. Methods: Data are part of "Stepped Interventions for Problem Drinkers," in which 10,803 patients from 85 general practitioners were screened using alcohol related questionnaires; 408 patients were randomized (32% were female) to a control (booklet only) or two different intervention groups: stepped care (feedback, manual, and up to three counselling sessions depending on the success of the previous intervention) and fixed care (four sessions). Response rate for the 12 months follow-up was 91.7%. Results: Regression analysis revealed a significant effect size only in women (P = 0.039). After excluding alcohol dependents and binge drinkers, an effect size (R²) of 0.031 (P = 0.050) in women and an effect size (R²) of 0.069 (P = 0.057) in men was obtained. Among the patients in stepped care who, by the first assessment point, had reduced drinking to within safe-drinking limits, there was a tendency for females to have achieved this more often than males (40% vs. 24%; P = 0.089). Conclusions: In a heterogeneous sample, the intervention was only effective for women. Women tended to profit more from the first, less intensive intervention than men. When analysis was limited to those reporting "at risk" average daily consumption and "alcohol abuse," the gender differences in efficacy appeared to be less, but the study was not sufficiently powered to affirm that.

Neurobiology and treatment in alcoholism--recent findings regarding lesch's typology of alcohol dependence

Hillemacher, T., Bleich, S. — 2008-05-03

Subtyping in alcohol dependence has become an important issue as studies have proposed different neurobiological mechanisms in alcoholism in the recent years. Studies have shown that alcohol dependence reflects a wide range of different phenotypes, including psychological, social, and neurobiological factors. Different ways of subtyping have been proposed in the last decades, one of them being Lesch's typology of alcohol dependence. Recent investigations have shown that different subtypes of Lesch's typology are associated with specific neurobiological factors which may have important implications for clinical practice. This applies in particular for genetic and neuroendocrinological factors, differences in the regulation of NMDA receptor-mediated glutamatergic neurotransmission, and in response to acamprosate and naltrexone treatment.

Improvement of knowledge, attitude, and behavior about oral health in a population of alcohol addicted persons

Barbadoro, P., Lucrezi, D., Prospero, E., Annino, I. — 2008-05-03

Aims: To improve knowledge, attitude, and behavior about oral health and oral cancer prevention in a population of alcohol-addicted persons involved in a residential rehabilitation program in Italy. Methods: A questionnaire was administered to obtain socioeconomic and oral risk factors data, and a complete dental examination was performed. A lecture on oral health risk factors and healthy behaviors was delivered. A pre–post test questionnaire was used to assess the short-term effectiveness of the intervention. Long-term effectiveness was assessed by a follow-up interview at 1 year from the intervention. The independent effect of several covariates on oral health at baseline and on the outcome of the intervention was evaluated. Results: Seventy-six individuals from the residential alcohol rehabilitation program participated in our study. About half had been addicted to alcohol for more than 10 years; 81.6% smoked at the time of survey; 31.0% declared that they never used toothbrushes or that they brushed less than once/day. We found an improvement of 25.0% in exact answers between the pre–post test questionnaire. At 1 year from the intervention, the 42 participants who reached follow up showed a great improvement in knowledge and attitude towards oral health. In particular, toothbrushing had become a daily routine after every meal for 67.1% of participants. Conclusions: Education of alcohol-dependent individuals in a rehabilitation setting may contribute to their attention to oral health and willingness to change habits.

Hazardous alcohol drinking in the former soviet union: a cross-sectional study of eight countries

Pomerleau, J., McKee, M., Rose, R., Haerpfer, C. W., Rotman, D., Tumanov, S. — 2008-05-03

Background: Hazardous consumption of large quantities of alcohol is a major cause of ill-health in the former Soviet Union (fSU). The objective of this study was to describe episodic heavy drinking and other hazardous drinking behaviors in eight countries of the fSU. Methods: Data from national surveys of adults conducted in Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine in 2001 were used (overall sample size 18,428; response rates 71–88%). Heavy episodic drinking, high alcohol intake, drinking alcohol during the working day, and using illegally produced strong spirits were examined. Results: On average, 23% of men and 2% of women were defined as heavy episodic drinkers (≥2 l of beer or ≥750 g bottle of wine or ≥200 g strong spirits at least once every 2–3 weeks). This was more common in young males, women who are single or who are divorced/separated/widowed, in smokers, and in frequent alcohol drinkers. About half the respondents who drank strong spirits obtained at least some alcohol from private sources. Among drinkers, 11% of males and 7% of women usually took their first drink before the end of working day. Conclusions: Heavy episodic alcohol drinking is frequent in males throughout the region—although prevalence rates may have been affected by underreporting—but is still relatively rare in women. Alcohol policies in the region should address hazardous drinking patterns and the common use of illegally produced alcohol.

Prevalence and the factors associated with binge drinking, alcohol abuse, and alcohol dependence: a population-based study of chinese adults in Hong Kong

Kim, J. H., Lee, S., Chow, J., Lau, J., Tsang, A., Choi, J., Griffiths, S. M. — 2008-05-03

Aims: To examine the patterns of drinking, the relationship between binge drinking, alcohol abuse, and dependence, and the sociodemographic factors associated with problem drinking among Hong Kong Chinese. Method: An anonymous, random telephone survey was conducted on 9860 Hong Kong Chinese adults from April to June, 2006. Results: The age-adjusted prevalence amongst men for binge drinking was 14.4% with 5.3% of males being alcohol abusers and 2.3% dependent on alcohol. The corresponding figures for women were all lower at 3.6%, 1.4%, and 0.7%, respectively. Younger age groups showed the highest prevalence of these drinking problems. Among male binge drinkers, 18.7% were also alcohol abusers and 12.3% were alcohol dependent. Among female binge drinkers, 16% reported alcohol abuse and 9.9% reported dependence. Male binge drinkers were less likely to be older, less likely to be students but more likely to be employed in the service industry. Female binge drinkers were less likely to be over 60 years of age or married but more likely to be smokers. In both genders, smoking was significantly associated with the likelihood of binge drinking (OR = 3.6–12.3), alcohol abuse (OR = 3.0–12.1), and dependence (OR = 5.2–20.6). Conclusions: Although binge drinking has been well tolerated in Chinese culture, it is strongly associated with alcohol abuse and dependence in both genders in Hong Kong. Our findings suggest that prevalence of problematic alcohol consumption warrants greater promotion of alcohol harms awareness. Higher rates of heavy drinking in younger-aged individuals may reflect changing lifestyle behaviors and herald higher future levels of alcohol-related health and social problems.

Association between smoking and the risk of heavy drinking among young women: a prospective study

Morgen, C. S., Bove, K. B., Larsen, K. S., Kjaer, S. K., Gronbaek, M. — 2008-05-03

Aim: To address the association between smoking habits and the risk of later heavy drinking among young women. Methods: Repeated assessments of alcohol and smoking habits were obtained in 1991–93 and 1999–2000 in a Danish representative cohort in Copenhagen. A total of 6369 non- to moderate-drinking Danish women, aged 20–29 years at baseline, attended a follow-up examination and were included in the study. The risk of becoming a heavy drinker (more than 14 drinks per week) 8 years after enrolment was analyzed by means of logistic regression. Results: A total of 177 women became heavy drinkers during follow-up. Daily smoking at baseline was associated with an increased risk of becoming a heavy drinker 8 years later. Relative to nonsmokers, the adjusted odds ratios (OR) for becoming a heavy drinker associated with smoking 1–14, 15–24, or more than 24 cigarettes per day were 1.6 (95% confidence intervals (CI) 1.1–2.4), 1.7 (CI 1.1–2.6), and 2.3 (CI 0.9–5.9), respectively. Age at sexual debut modified the effect of smoking, and women with a debut before the age of 15 years had an adjusted OR of 2.9 (CI 1.1–3.9) compared to never-smokers while there seemed to be no effect among women with a sexual debut after the age of 18. In addition, relative to nondrinkers, all of the moderate (1–5 units per week), medium (6–10 units), and large (10–14 units) alcohol consumption at baseline were associated independently with becoming a heavy drinker 8 years later. Conclusions: This study suggests that smoking is an important predictor of later heavy drinking among young women and that this relatively elevated risk is most pronounced among women with an early sexual debut.

Alcohol consumption, abstaining, health utility, and quality of life - a general population survey in finland

2008-05-03

Aims: To examine the associations between alcohol consumption and utility-based health-related quality of life (HRQoL), subjective quality of life (QoL), self-rated health (SRH), and mental distress. Methods: Representative general population survey in Finland, with 5871 persons aged 30–64 years. HRQoL was measured with two health utility instruments (15D and EQ-5D), QoL and SRH were measured with RATING scales, and mental distress with a General Health Questionnaire (GHQ-12). Past alcohol problems were diagnosed with a structured psychiatric interview known as the composite international diagnostic interview (CIDI). Alcohol consumption was examined with a self-report questionnaire. Results: Negative associations between alcohol and well-being were observed on several measures for women consuming more than 173 g and men more than 229 g per week. Former drinkers scored worst on most measures, even in comparison to the highest drinking decile. For men, all statistically significant associations between moderate drinking and well-being disappeared when sociodemographic factors and former drinkers were controlled for. For women, moderate alcohol use associated with better SRH and EQ-5D as compared to abstainers. However, the possible health utility benefits associated with moderate alcohol consumption were of clinically insignificant magnitude. Conclusions: Failure to separate former drinkers and other abstainers produces a significant bias favoring moderate drinkers. As the possible health utility benefits of moderate alcohol use were clinically insignificant, it suffices to investigate mortality, when estimating the public health impact of moderate alcohol consumption using quality-adjusted life years.

Evidence-Based Treatments for Alcohol and Drug Abuse: A Practitioner's Guide to Theory, Methods and Practice. By Paul M. G. Emmelkamp and Ellen Vedel

Hore, B. D. — 2008-05-03

Alcohol Use Disorders. By Stephen A. Maisto, Gerard J. Connors and Ronda L. Dearing

Paton, A. — 2008-05-03