September 07, 2017

About 137 Million Americans Drink Alcohol

The National Survey on Drug Use and Health (NSDUH) results for 2016 have been release by the Substance Abuse and Mental Health Services Administration indicating that 136.7 million American report themselves to be current alcohol drinkers.




In addition, 7.3 million American under the age of 21 reported past-month alcohol use and 4.5 million of those underage drinkers reported that they binge drink.

NSDUH asks respondents aged 12 or older about their alcohol use in the 30 days before the interview. Current alcohol use is defined as any use of alcohol in the past 30 days.

In addition to asking about any alcohol use, NSDUH collects information on binge alcohol use and heavy alcohol use. Until the 2015 NSDUH, the threshold for binge drinking was defined the same for male and females. Consistent with federal definitions and other federal data collections, the NSDUH definition for binge alcohol use since 2015 differs for males and females.

Binge drinking for males is defined as drinking five or more drinks on the same occasion on at least 1 day in the past 30 days, which is unchanged from the threshold prior to 2015.

Since 2015, binge alcohol use for females has been defined as drinking four or more drinks on the same occasion on at least 1 day in the past 30 days. Heavy alcohol use is defined as binge drinking on 5 or more days in the past 30 days based on the thresholds that were described previously for males and females.

136.7 Million Americans Drink Alcohol

Any alcohol use, binge drinking, and heavy drinking are not mutually exclusive categories of use; heavy use is included in estimates of binge and current use, and binge use is included in estimates of current use.

Because of the 2015 changes to the definition of binge alcohol use in NSDUH, overall estimates of binge and heavy alcohol use in 2016 are presented in this report, but these 2016 estimates are not comparable with estimates prior to 2015.

In 2016, 136.7 million Americans aged 12 or older reported current use of alcohol, 65.3 million reported binge alcohol use in the past month, and 16.3 million reported heavy alcohol use in the past month. Thus, nearly half of current alcohol users reported binge alcohol use (47.8 percent), and 1 in 8 current alcohol users reported heavy alcohol use (11.9 percent). Among binge alcohol users, about 1 in 4 (24.9 percent) were heavy users.

Any Alcohol Use

The estimate of 136.7 million current alcohol users aged 12 or older in 2016 (Figure 9) corresponds to alcohol use in the past month by slightly more than half (50.7 percent) of people aged 12 or older. The 2016 estimate of past month alcohol use was similar to the estimates in most years between 2002 and 2008, but it was lower than the estimates in 2009 to 2015.

Aged 12 to 17

The percentage of adolescents aged 12 to 17 who were current alcohol users was 9.2 percent in 2016, which corresponds to 2.3 million adolescents in 2016 who drank alcohol in the past month. The percentage of adolescents who were current alcohol users in 2016 was lower than the percentages in 2002 through 2014, but it was similar to the percentage in 2015.

Although the estimate of current alcohol use among adolescents decreased between 2002 and 2016, about 1 in 11 adolescents were current alcohol users in 2016.

Aged 18 to 25

In 2016, 57.1 percent of young adults aged 18 to 25 were current alcohol users, which corresponds to about 19.8 million young adults. The percentage of young adults in 2016 who drank alcohol in the past month was similar to the percentage in 2015.

Although the 2016 estimate was lower than the estimates in 2002 through 2014, about three fifths of young adults were current alcohol users in each year between 2002 and 2016 (ranging from 57.1 to 62.0 percent).

Aged 26 or Older

More than half (54.6 percent) of adults aged 26 or older in 2016 were current alcohol users. This percentage corresponds to about 114.7 million adults in this age group who drank alcohol in the past month.

The percentage of adults aged 26 or older in 2016 who were current alcohol users was similar to the percentages in most years from 2002 to 2015. In each year between 2002 and 2016, slightly more than half of adults aged 26 or older were current alcohol users (ranging from 52.5 to 56.5 percent).

Binge Alcohol Use

In 2016, an estimated 65.3 million people aged 12 or older were binge alcohol users in the past 30 days. This number of people who were current binge drinkers corresponds to about 1 in 4 people aged 12 or older (24.2 percent).

About 1.2 million adolescents aged 12 to 17 were past month binge alcohol users, which corresponds to 4.9 percent of adolescents. Thus, about 1 in 20 adolescents aged 12 to 17 in 2016 were current binge drinkers.

An estimated 38.4 percent of young adults aged 18 to 25 were binge alcohol users in the past month, which corresponds to about 13.3 million young adults. Stated another way, about 2 out of 5 young adults in 2016 were current binge alcohol users.

About a quarter (24.2 percent) of adults aged 26 or older were current binge alcohol users. This percentage corresponds to about 50.9 million adults in this age group who were binge drinkers.

Heavy Alcohol Use

The estimate of 16.3 million people aged 12 or older in 2016 who were heavy alcohol users in the past month represents 6.0 percent of the population aged 12 or older.

In 2016, 191,000 adolescents aged 12 to 17 were current heavy alcohol users. Stated another way, about 1 out of 125 adolescents (0.8 percent) engaged in binge drinking on 5 or more days in the past 30 days.

About 1 out of every 10 young adults aged 18 to 25 (10.1 percent) were heavy alcohol users in the past month, which corresponds to 3.5 million young adults.

An estimated 6.0 percent of adults aged 26 or older in 2016 were current heavy alcohol users. This percentage corresponds to about 12.6 million adults aged 26 or older who were heavy alcohol users in the past month.

Underage Alcohol Use

All 50 states and the District of Columbia currently prohibit possession of alcoholic beverages by individuals younger than 21, and most prohibit underage consumption (i.e., consumption of alcoholic beverages prior to the age of 21).

In 2016, about 7.3 million people aged 12 to 20 reported drinking alcohol in the past month, including 4.5 million who reported binge alcohol use and 1.1 million who reported heavy alcohol use. Thus, about three fifths of underage current drinkers (62.5 percent) were binge alcohol users, and about 1 in 7 were heavy alcohol users (14.7 percent).

About one fourth of underage binge alcohol users (23.5 percent) were heavy drinkers.

The estimate of 7.3 million underage people in 2016 who reported current alcohol use represents 19.3 percent of 12 to 20 year olds. Among people aged 12 to 20 in 2016, 12.1 percent were binge drinkers, and 2.8 percent were heavy drinkers.

The percentage of underage individuals who reported current alcohol use in 2016 was lower than the percentages in 2002 through 2014, but it was similar to the percentage in 2015 (Figure 14). Despite these declines over time, about 1 in 5 individuals aged 12 to 20 in 2016 drank alcohol in the past month.

Posted by Webmaster at 02:21 PM

August 16, 2017

Early Brain Injury Linked to Alcoholism

Researchers at Ohio State University have surveyed previous studies to investigate the relationship between traumatic brain injuries and alcohol abuse. They found evidence that traumatic brain injuries in children and adolescents could be a risk-factor for alcohol abuse in later life.

When we think of the link between alcohol and traumatic brain injuries, we probably think of a person's increased risk of injury while drunk. Alcohol intoxication is indeed a significant risk factor for traumatic brain injuries, and one study has reported that alcohol use is involved in as many as 50% of emergency department admissions for traumatic brain injuries in the US.

More Susceptible to Alcohol Abuse

Intriguingly, an animal study conducted by Zachary Weil, a researcher at Ohio State University, made him suspect that the converse might also be true, particularly in young people. "We recently reported that mice that experience a traumatic brain injury as juveniles drink significantly more alcohol as adults," says Weil. "When we started to look at the human literature it became clear that alcohol and traumatic brain injuries were very connected. There were some hints that brain injuries might actually make someone more susceptible to alcohol abuse."

Weil was inspired to look more closely at the past literature, and what he and his team found was recently published in Frontiers in Behavioral Neuroscience. The researchers found that it was difficult to tell if their hypothesis was true in adults. "So many adults that have brain injuries are already heavy drinkers and therefore it's really hard to tell for sure if a brain injury has affected their drinking," explains Weil.

Brain Injury Affects Other Factors

However, for people who suffer a traumatic brain injury in childhood or adolescence, there was a clearer link to alcohol abuse problems in later life. For example, children under 5 years of age who suffer a traumatic brain injury are over 3.6 times more likely to exhibit substance abuse as teenagers, compared with uninjured children.

So, why would a traumatic brain injury potentially lead to alcohol abuse? The team found evidence in the literature that brain injury can negatively affect factors that are associated with reducing alcohol abuse. For example, forming stable romantic relationships, getting involved in extracurricular activities and maintaining full-time employment are all associated with a reduced risk of substance abuse, but all are less likely in brain injury survivors.

More Impulsive, Less Aware

Traumatic brain injuries can also make people more impulsive and less aware of the consequences of their actions, and there is also evidence that brain injury survivors may use alcohol to help deal with the negative consequences of their injury.

Beyond its psychological effects, traumatic brain injury can cause significant inflammation in the brain. Alcohol also generates neuroinflammation, and evidence from animal studies suggests that this inflammation might drive further drinking.

Other Potential Factors in Alcohol Abuse

Finally, traumatic brain injuries can damage specific neurochemical systems in the brain that are vulnerable during childhood development, such as the dopaminergic system. A dysfunctional dopaminergic system is a risk factor for substance abuse, suggesting another potential link between childhood brain injury and alcohol abuse in adulthood.

So, how can we address the problem? "This is an important issue because drinking after brain injury is associated with health problems and poorer outcomes. Specifically targeting substance abuse problems in the brain-injured population could do a lot of good," says Weil.

The researchers caution that the link between brain injuries and alcohol abuse has not yet been completely established and more work is needed. "This has not been completely confirmed in humans, but there is a lot of suggestive evidence," explains Weil.

Posted by Webmaster at 07:51 AM

August 13, 2017

Teens Can Benefit From 12-Step Involvement

Adolescents who misuse alcohol and other drugs to the point where they need treatment must contend with costly and limited options for youth-specific care, as well as high relapse rates following treatment. Mutual-help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are widely available but little research has addressed their benefits for adolescents. An assessment of 12-step meetings and recommended activities has found that attendance, participation, and finding a sponsor promote greater abstinence among adolescents.

Results will be published in Alcoholism: Clinical & Experimental Research.

Long-Term Recovery Support

"Most substance use disorder (SUD) treatment is short-term and relapse rates post-discharge are typically high without continued support," explained John F. Kelly, associate director of the Center for Addiction Medicine at Massachusetts General Hospital, and associate professor in psychiatry at Harvard Medical School. "Mutual-help organizations such as AA and NA can help fill this gap, providing free and flexible long-term recovery support in the communities in which people live."

Kelly and his co-author assessed 127 adolescent outpatients (95 males, 32 females) aged 14-19 years old – who were enrolled in a naturalistic study of treatment effectiveness – at intake as well as at three, six, and 12 months later. Effects of the youths' attendance and active involvement in activities, such as contact with their sponsor, on their subsequent abstinence were tracked over time.

"We found that about one quarter to one third of the youth attended AA/NA throughout the year-long study period following treatment, and that more meeting attendance was associated with significantly better substance use outcomes – particularly attending meetings at least once per week or more," said Kelly. "Importantly, youth who also were in contact with an AA or NA sponsor or who participated verbally during AA/NA meetings had an even better outcome over and above the positive effects from merely attending. These findings support the common clinical recommendation that individuals should 'go to meetings, get a sponsor, and get active.' This is the first evidence to support this common clinical recommendation among young people."

Encouraging A.A. Attendance

Kelly suggested that medical practitioners, counselors, and other clinicians can enhance the likelihood that youth will attend and participate in AA/NA by encouraging or facilitating their attendance early in treatment.

"Starting an on-site NA or AA young person's meeting is another good idea," he added. "Not all youth will be motivated to attend, but the more severely substance-involved ones will be more likely to give meetings a try and these are the ones most likely to benefit. It is also a good idea to facilitate a good match between the patient's primary substance, cannabis/other drugs or alcohol, and the mutual-help organization to which they are being referred, Marijuana Anonymous, NA, or AA. Not doing this can lead to a poor initial match, which can be difficult to overcome."

Kelly said that one of the key elements to success in 12-step involvement is the creation of a personal connection between the patient and an existing community AA or NA member.

A.A. for Young People

"This community member can then make introductions, answer questions, and generally act as an initial guide and onsite facilitator," he said. "This is probably the most significant part of ensuring that young people get to their first meeting and have a positive experience – it's hard for anyone to walk in 'cold' to a large AA or NA meeting. Another possibility is for parents or counselors to take adolescents to meetings or to arrange to meet them at meetings to help facilitate attendance and engagement. Once there, young people report that they like the camaraderie and social affiliation offered at meetings; they appreciate knowing that they are not the only ones suffering from addiction problems, and they report liking the attention, care, and support they get at meetings."

Posted by Webmaster at 06:49 PM

Heavy Drinkers Have Poor Dietary Habits

Excessive drinking and an unbalanced diet are two preventable contributors to health problems in the developed world. Different studies have found varying linkages between amounts of alcohol consumed and quality of diet. A study of adults in Spain has found that heavy drinking, binge drinking, a preference for spirits, and drinking alcohol at mealtimes were associated with a poor adherence to major food consumption guidelines.

Results were published in Alcoholism: Clinical & Experimental Research.

"Drinking alcohol may reduce maintaining a healthy diet, leading to adverse metabolic effects which in turn add to those directly produced by alcohol," said José Lorenzo Valencia-Martín, a doctor at the Universidad Autónoma de Madrid and corresponding author for the study. "The specific influence of alcohol on diet may depend upon the overall quantity of alcohol ingested, frequency of consumption, beverage preference, and whether alcohol intake takes place during the meals. Alcohol may indirectly contribute to several chronic diseases such as obesity, diabetes mellitus, cardiovascular disease, or cancer."

Careless Dietary Habits

"Unhealthy lifestyles tend to cluster together, but this is not a 'necessary' association," added Miguel A. Martínez-González, chair of the department of preventive medicine and Public Health at the University of Navarra. "On average, people who drink excessive alcohol are more likely to be careless in their dietary habits. A high alcohol intake is especially unhealthy with respect to liver disease. A high-energy food pattern rich in trans fats – such as 'fast-foods' or items from a commercial bakery – is also likely to be related to liver disease. In this sense, if both unhealthy lifestyles cluster together, they can act synergistically to produce very adverse effects."


"In Spain, alcohol is frequently drunk during meals, particularly lunch and dinner," said Valencia-Martín. "Because of this, and the lower prevalence of abstainers, our findings apply to most adults in Spain and in other Mediterranean countries in Europe. Our results are of relevance because they show that drinking at mealtimes is associated with insufficient intake of healthy foods, such as fruits and vegetables, and with excessive intake of animal protein."

Unintended Consequences

From 2000 to 2005, the researchers carried out a telephone survey of 12,037 adults (5850 men, 6187 women) considered representative of 18-to-64-year-olds in the region of Madrid. Binge drinking was defined as equal to or more than 80 grams of alcohol for men and equal to or more than 60 grams for women during one drinking session; the threshold between moderate and heavy drinking was 40 grams of alcohol per day for men and 24 grams per day for women. Food consumption was measured using a 24-hour recall.

"Excessive drinkers, either with or without binge drinking, showed a poor adherence to dietary recommendations," said Valencia-Martín. "Although drinking at mealtimes has traditionally been considered a safe or even a healthy behavior, our results point to some unintended consequences that the general populations should be aware of. In particular, drinking at mealtimes is associated with poor adherence to most of the food consumption guidelines. Also, not all types of alcoholic beverages are equal with regard to their dietary effects; our results suggest that a preference for spirits is associated with a poorer diet. Lastly, the above implications apply to both men and women."

"I believe the key finding of this study is the suggestion of a harmful effect of binge drinking on healthy eating habits," said Martínez González. "Binge drinking prevalence was found to be relatively high – greater than 10 percent – in a representative sample of Spanish population. This is very bad news. Alcohol misuse has become a priority public-health problem in Spain, especially because of rising rates of binge drinking and especially because of the abandonment of the traditional Mediterranean pattern of moderate alcohol drinking, in little amounts, generally red wine during meals. Recent changes, especially among young Spanish people, include a pattern of high amounts of spirits during weekends. This excellent study adds another unfortunate consequence of this change: the impairment of eating habits."

Alcohol Replaces Healthy Calories

Martínez González added that both alcohol researchers and clinicians need to pay more attention to the dietary pattern of binge drinkers, and also consider that some of the detrimental effects attributed to alcohol might in fact be consequences of a poor diet.

"Don't forget that alcohol is addictive, that it replaces healthy calories from other foods by empty calories, meaning these calories are devoid of minerals and vitamins," said Martínez González. "Keep also in mind that the drinking pattern might be more important than the total amount consumed. The unhealthiest pattern is to consume high amounts – three to four drinks per day – of spirits or beer exclusively during the weekends. Conversely, the healthiest use of alcohol may be red wine, no more than one glass per day for women and two per day for men, and consumed during meals in a regular daily pattern."

Posted by Webmaster at 06:24 PM

Parental Alcoholism Linked to Offspring's Alcoholism

Researchers know that there is a strong link between parental alcohol use disorders and the risk for developing an alcohol use disorders among their offspring. This study looked at the risk of alcohol use disorders in the offspring of a large population-based sample of Danish parents. Findings confirmed that parental alcohol use disorders were associated with an increased risk of alcohol use disorders among the offspring.

"Few studies have used a broad population-based approach to examine associations between a parental history of alcohol use disorders and risk of an alcohol use disorders in offspring," said Erik Lykke Mortensen, associate professor in medical psychology at the University of Copenhagen and corresponding author for the study. "Longitudinal population studies are both expensive and take a long time to complete. In some countries it may also be a problem to follow several generations through decades. But in Denmark we have personal identification numbers and national health registries."

Population Based Study

Mortensen and his colleagues gathered data on 7,177 individuals (3,627 men, 3,550 women) born in Copenhagen between October 1959 and December 1961: information on alcohol use disorders was gathered from three Danish health registers, and information on other psychiatric disorders (OPDs) was gathered from the Danish Psychiatric Central Register. Offspring registration with an alcohol use disorders was analyzed in relation to parental registration with an alcohol use disorders and/or OPD. The gender of the offspring and parental social status were also noted.

Results showed that parental alcohol use disorders were associated with an increased risk of alcohol use disorders among the offspring, independent of other significant predictors such as gender, parental social status, and parental psychiatric hospitalization with other diagnoses.

"Furthermore, this association appeared to be stronger among female than male offspring, which suggests that inherited factors related to alcohol use disorders are at least as important among daughters as among sons," said Mortensen. "This finding is important because some early studies suggested that a genetic load played a stronger role in males than in females."

Increased Risk for Alcoholism

One of the important aspects of this study, added Mortensen, is that contrary to a number of previous adoption and twin studies – often based on relatively small and selected samples – these findings represent risk estimates from a population-based study.

"The key message for the general public is that there is an increased risk associated with parental alcoholism," said Mortensen, "but obviously many other factors determine whether an individual develops an alcohol use disorder."

Results were published in Alcoholism: Clinical & Experimental Research.

Posted by Webmaster at 11:54 AM

Helping Others Helps Alcoholics Stay in Recovery

Participating in community service activities and helping others is not just good for the soul; it has a healing effect that helps alcoholics and other addicts become and stay sober, a researcher from Case Western Reserve University School of Medicine reports.

In a review article published in the Volume 29 issue of Alcoholism Treatment Quarterly, Maria E. Pagano, PhD, associate professor of psychiatry at the School of Medicine, sheds light on the role of helping in addiction recovery, using the program of Alcoholics Anonymous (AA) as a prime example.

Service Works Helps Alcoholics

She cites a growing body of research as supporting evidence. “The research indicates that getting active in service helps alcoholics and other addicts become sober and stay sober, and suggests this approach is applicable to all treatment-seeking individuals with a desire to not drink or use drugs,” Dr. Pagano says. “Helping others in the program of AA has forged a therapy based on the kinship of common suffering and has vast potential.”

In her research, Dr. Pagano highlights the helper therapy principle (HTP), a concept embodied by AA, as a means of diminishing egocentrism or selfishness, a root cause of addiction. The HTP is based on the theory that, when a person helps another individual with a similar condition, they help themselves. The principle is reflected in the stated purpose of AA, which is to help individuals “stay sober and help other alcoholics achieve sobriety.”

Helping other alcoholics is viewed as the foundation for the alcoholic helper to stay on the path to recovery, Dr. Pagano says in her overview of the AA program. In addition to outlining the basis for AA-related helping, Dr. Pagano reviews the data to date that illustrates the health and mental health benefits derived from helping others.

Helping Others Helps You


She likewise examines several empirical studies she conducted previously which show how helping others in 12-step programs of recovery help the recovering individual to stay sober. The research includes a 2004 study by Dr. Pagano and her colleagues. Using data from Project MATCH, one of the largest clinical trials in alcohol research, the investigators determined that 40 percent of the alcoholics who helped other alcoholics during their recovery successfully avoided drinking in the 12 months following three months in chemical dependency treatment, whereas only 22 percent of those that did not help others stayed sober.

A subsequent study by Dr. Pagano and her colleagues in 2009, also involving data from Project MATCH, showed that 94 percent of alcoholics who helped other alcoholics, at any point during the 15-month study, continued to do so as part of their ongoing recovery, and experienced lower levels of depression.

Positive Effects of Helping Others


Similarly, a study of alcoholic patients with body dysmorphic disorder (BDD), a condition in which a person is excessively preoccupied with a perceived physical defect, found that those who helped others were more likely to become sober and enjoy an improved self-image than non-helpers.

“These studies indicate that among alcoholics, AA-related helping and giving general help to others has positive effects on drinking outcomes and mental health variables,” Dr. Pagano says in the journal. In fact, the benefits of doing good works and helping others also extend to individuals coping with chronic conditions like depression, AIDS, and chronic pain.

Benefits to Society


“When humans help others regardless of a shared condition, they appear to live longer and happier lives,” she adds. The benefits of helping are significant because the costs of alcoholism and drug addiction to society are so great, Dr. Pagano says.

In light of recent health care reform, resources which can reduce these costs and suffering are crucial. However, the lack of consensus on what peer helping is in addiction recovery requires additional study to clarify what specific behaviors to encourage, to whom and what forms of service to recommend for individuals engaging in early and ongoing recovery.

Dr. Pagano is presently conducting a longitudinal study examining the role of service in adolescent addiction recovery. An area of new scientific discovery, she’s applying the knowledge she’s accrued with adults to adolescent populations with addition.

Posted by Webmaster at 11:31 AM

Spirituality of A.A. Is Effective

Addictions, whether it is to drugs or alcohol, are a very difficult hurdle for individuals to overcome. But, there are ways to help people with their recovery through 12-step programs like Alcoholics Anonymous (AA). Many of these organizations, including AA, highlight spirituality as a very important factor, but the data surrounding its effectiveness have often been contested.

However, research shows that as attendance of AA meetings increase, so do the participants spiritual beliefs, especially in those individuals who had low spirituality at the beginning of the study.

Important Aspect of Recovery

John F. Kelly, lead author of the study, Associate Professor in Psychiatry at Harvard Medical School and the Associate Director of the Center for Addiction Medicine at Massachusetts General Hospital, said that while spirituality is an important aspect of AA recovery, it is not the only way they can help individuals.

"I've heard it said that AA is too spiritual, and I've also heard it said that AA is not spiritual enough for some people. Although this is not the only way that AA helps individuals recover, I think these findings support the notion that AA works in part by enhancing spiritual practices," Kelly said.

The researchers assessed more than 1,500 adults throughout their recovery process, with data being gathered at three, six, nine, 12, and 15 months. The study utilized data on their attendance to AA meetings, their individual spirituality/religiosity practices and overall alcohol-use outcomes to determine if spirituality is indeed a mechanism of behavior change.

Decrease in Alcohol Use

The results indicated that there was a robust association between an increase in attendance to AA meetings with increased spirituality and a decrease in the frequency and intensity of alcohol use over time. One of the most interesting aspects of the research was that the same amount of recovery was seen in both agnostics and atheists, which indicates that while spirituality is an important mechanism of behavioral change for AA, it is not the only method used.

"Many people will be surprised that alcoholic patients with little or no interest in spirituality attended AA and seemed to change even more than did those who had a pre-existing, strong sense of spirituality," said Keith Humphreys, a Career Research Scientist with the Veterans Health Administration and Professor of Psychiatry at Stanford University. "AA is thus much more broad in its appeal than is commonly recognized."

The researchers also noted that while spirituality is an important aspect of recovery, it is still not known how these beliefs work in complement or competition with other recovery methods, as there are multiple.

Changing Social Networks

"We have also found that AA participation leads to recovery by helping members change their social network and by enhancing individuals' recovery coping skills, motivation for continued abstinence, and by reducing depression and increasing psychological well-being," said Kelly.

"Down the road it will be important to conduct more qualitative research as well as further quantitative replication of our findings in order to understand more about how exactly spiritual practices and beliefs influence coping and behavioral change in recovery from addiction"

Posted by Webmaster at 11:28 AM

Stigma Deters Alcoholics From Seeking Treatment

Despite the existence of effective programs for treating alcohol dependencies and disorders, less than a quarter of people who are diagnosed actually seek treatment. In a study by Columbia University's Mailman School of Public Health researchers report that people diagnosed with alcoholism at some point in their lifetime were more than 60% less likely to seek treatment if they believed they would be stigmatized once their status is known.

This is the first study to address the underuse of alcohol services specifically with regard to alcohol-related stigma. Findings are published in the November issue of the American Journal of Epidemiology.

Perceived Negative Stigma

Based on a survey of 34,653 individuals in the general population (6,309 of whom had an alcohol use disorder) drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), researchers found that individuals with an alcohol use disorder who perceived negative stigma were 0.37 times less likely to seek treatment for their disorder compared to individuals with similarly serious alcohol disorders who did not perceive stigma.

In the general population, younger individuals perceived less stigma, and also were less likely to seek treatment for an alcohol disorder. Men perceived more stigma compared to women (38.1%vs. 37.7%). Non-Hispanic blacks and Hispanic adults overall reported a higher mean stigma compared to Whites (39 % vs. 37%) and were less likely to utilize alcohol services. However, the data also suggest that individuals with more severe alcohol disorders had a greater likelihood to seek treatment. Overall, perceived stigma was significantly higher for those with lower personal income, lower education, and individuals previously married compared to those who had never married.

A Barrier to Treatment

"People with alcohol disorders who perceive high levels of alcohol stigma may avoid entering treatment because it confirms their membership in a stigmatized group," said Katherine Keyes, PhD, in the Mailman School of Public Health Department Epidemiology. "Given that alcohol use disorders are one of the most prevalent psychiatric disorders in the United States, the empirical documentation of stigma as a barrier to treatment is an important public health finding. Greater attention to reducing the stigma of having an alcohol disorder is urgently needed so that more individuals access the effective systems of care available to treat these disabling conditions."

Posted by Webmaster at 11:24 AM

Energy Drink Use May Lead to Alcohol Dependence

Research indicates that individuals who have a high frequency of energy drink consumption (52 or more times within a year) were at a statistically significant higher risk for alcohol dependence and episodes of heavy drinking.

A hallmark of college life is staying up late to study for an exam the following morning, and many students stay awake by consuming an energy drink. Also increasing in popularity is the practice of mixing alcohol with energy drinks. But these drinks are highly caffeinated and can lead to other problems, in addition to losing sleep. Unfortunately, the contents of energy drinks are not regulated.

The results were published in the journal Alcoholism: Clinical & Experimental Research.

Energy Drinks Without Alcohol

Amelia M. Arria, the lead author of the study, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health, and a Senior Scientist at the Treatment Research Institute, said that prior research has highlighted the dangers of combining energy drinks with alcohol.

"We were able to examine if energy drink use was still associated with alcohol dependence, after controlling for risk-taking characteristics. The relationship persisted and the use of energy drinks was found to be associated with an increase in the risk of alcohol dependence."

The study utilized data from more than 1,000 students enrolled at a public university who were asked about their consumption of energy drinks and their alcohol drinking behaviors within the past 12 months.

More Likely to Become Dependent

The researchers found that individuals who consumed energy drinks at a high frequency were more likely to get drunk at an earlier age, drink more per drinking session, and were more likely to develop alcohol dependence compared to both non-users of energy drinks and the low-frequency users.

The results of this study confirm and extend earlier research about the risks of energy drink consumption. A major concern is that mixing energy drinks with alcohol can lead to "wide-awake drunkenness," where caffeine masks the feeling of drunkenness but does not decrease actual alcohol-related impairment. As a result, the individual feels less drunk than they really are, which could lead them to consume even more alcohol or engage in risky activities like drunk driving.

Caffeine Disguises Impairment

"Caffeine does not antagonize or cancel out the impairment associated with drunkenness—it merely disguises the more obvious markers of that impairment," says Kathleen Miller, a research scientist from the Research Institute on Addictions at the University at Buffalo. According to her, the next steps in this research include identifying links between energy drinks and other forms of substance abuse, as well assessing the overall prevalence of energy drink use by adolescents and young adults.

"Also needed is research that directly assesses students' reported reasons for mixing alcohol and energy drinks. Anecdotal reports suggest that part of this phenomenon may be driven by the perpetuation of myths (e.g., mixing alcohol and caffeine reduces drunkenness, prevents hangovers, or fools a breathalyzer test) that could be debunked through further education."

Arria agrees, adding that further research and regulations are needed to curb this disturbing trend.

"The fact that there is no regulation on the amount of caffeine in energy drinks or no requirements related to the labeling of contents or possible health risks is concerning."

Posted by Webmaster at 11:18 AM

Stress Hormone Impacts Alcohol Recovery

Scientists at the University of Liverpool have found that high levels of a stress hormone in recovering alcoholics could increase the risk of relapse. The study showed that cortisol, a hormone produced by the adrenal gland in response to stress, is found in high levels in chronic alcoholics, as well as those recovering from the condition. Researchers found that this could result in impaired memory, attention and decision-making functions, which could decrease the patient's ability to engage with treatment.

Chronic alcoholism is a disabling addictive disorder, characterised by compulsive and uncontrolled consumption of alcohol despite the negative effects it has on health, relationships and social standing. Alcohol damages almost every organ of the body including the brain where it causes memory loss and impairs decision-making and attention span.

Cortisol and Recovery

Cortisol plays an important role in the regulation of emotion, learning, attention, energy utilization, and the immune system. The research showed that high levels of this hormone are present in alcoholic patients and continue to be elevated during withdrawal from alcohol and after long periods of abstinence.

Dr Abi Rose (lead author of the review), in the School of Psychology, Health and Society at the University of Liverpool, said: "Both drinking and withdrawal from alcohol can affect cortisol function in humans. Cortisol dysfunction, including the high levels of cortisol observed during alcohol withdrawal, may contribute to the high rates of relapse reported in alcohol dependence, even after many months of abstinence. Drugs targeting the effects of cortisol in the brain might reduce the chances of relapse and reduce the cognitive impairments that interfere with treatment."

Posted by Webmaster at 10:47 AM

Naltrexone Reduces Brain's Response to Craving

Researchers at Harvard-affiliated McLean Hospital have produced the first evidence that the opioid blocker extended-release injectable naltrexone (XR-NTX) is able to reduce the brain's response to cues that may cause alcoholics to relapse. In data presented at the annual meeting of the American Psychiatric Association, Scott Lukas, PhD, director of the Neuroimaging Center at McLean, located in Belmont, Mass., said the findings help in the understanding of how XR-NTX works in reducing the craving for alcohol and may potentially help predict which people will respond best to the drug.

Less Likely to Relapse

"These data are quite important since relapse remains a significant challenge in treating patients with alcohol dependence," Lukas said. "It looks to us that XR-NTX can help people remain abstinent by reducing the importance of these cues so they are less likely to relapse."

XR-NTX works by blocking opioid receptors in the brain and was approved for the treatment of alcohol dependence in 2006. XR-NTX is commercially available as Vivitrol®.

Reducing Alcohol Consumption

"We were trying to better understand the biological basis of how XR-NTX reduces alcohol consumption," Lukas said. "These data clearly demonstrate that XR-NTX reduced craving response in the brain when patients were presented with alcohol cues."

In the study, which has not yet been published, the researchers used brain imaging as a tool to document how XR-NTX works when a person is placed in a situation deemed risky for alcohol relapse.

A total of 28 alcohol-dependent individuals were tested with a BOLD (Blood Oxygen Level Dependent) fMRI scan while shown pictures of bottles or glasses of alcoholic beverages and exposed to odors of their particular alcoholic beverage of choice.

Testing Naltrexone Injections

Under double-blind conditions, fifteen of the subjects were given an injection of a XR-NTX and thirteen subjects were given a placebo injection. The study did not test the older form of naltrexone, which is taken daily in pill form.

Initially, the subjects were asked to self-report their cravings for alcohol after being exposed to the alcohol cues. All subjects reported that their cravings increased in the first few minutes after exposure to the cues.

Alcohol Cravings Diminished

However, those on XR-NTX reported that their cravings started to diminish after a few minutes, while those on placebo injection reported no such decrease in craving levels.

fMRI images also revealed that the pictures and odors induced sharply contrasting brain blood flow activation patterns. Scans were taken at baseline and again two weeks after the injection. Scans of subjects on placebo were virtually unchanged after two weeks. But those subjects on XR-NTX showed significant reductions in activation patterns in areas of the brain having to do with cognitive and emotional processing and reward circuitry on the second scan following exposure to the alcohol cues.

Responded Less to Alcohol Cues

"The areas in the brain associated with craving did not light up nearly as much in patients treated with XR-NTX compared to patients on placebo," Lukas said. "These data suggest that those patients on XR-NTX were responding less strongly to the alcohol cues after being on the drug for only two weeks," he added.

Lukas cautioned, "There is no single magic bullet, but having a choice of medications at our disposal gives physicians an increased chance to better treat a wide range of addictions."

Understanding cravings and how medication can play a role in controlling them will help to improve treatment for patients with alcohol dependence.

Posted by Webmaster at 09:55 AM

Heavy Alcohol Use Hikes Risk of Pancreatic Cancer

Heavy alcohol use and binge drinking could increase the risk of pancreatic cancer in men, research from UT Southwestern Medical Center suggests. In a study available online in Cancer Causes and Control, researchers found that the more alcohol a man consumed, the higher his risk of pancreatic cancer compared with those who drank little or no alcohol.

Important to Reduce Drinking

"If this relationship continues to be confirmed, reducing heavy and binge drinking may be more important than we already know," said Dr. Samir Gupta, assistant professor of internal medicine at UT Southwestern and lead author of the study, which was conducted at the University of California, San Francisco.

Researchers found that men who consumed alcohol increased their risk of pancreatic cancer by 1.5 to 6 times compared with those who didn't consume alcohol or who had less than one drink per month. The increased risk depended on the amount and frequency of alcohol consumption. Researchers found that the risk was greater no matter when in the past heavy drinking occurred.

Binge Drinking a Risk Factor

They also found that men who engaged in binge drinking had a 3.5 times greater likelihood of developing pancreatic cancer. Their risk also was greater regardless of when the binge episodes occurred.

Researchers defined one drink as a can, bottle or 12 ounces of beer; a 4-ounce glass of wine; or one shot of liquor. Each of these servings contains about 14 grams of alcohol. The heaviest drinkers consumed 21 to 35 drinks per week. Binge drinking was defined as consuming five or more drinks during one drinking episode.

Researchers did not find the association among women, possibly due to the lower proportion of women who reported heavy or binge drinking, said Dr. Gupta, who also is affiliated with the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern.

Deadly Pancreatic Cancer

"Pancreatic cancer is one of the deadliest cancers, so any risk factor that can be identified and addressed may save lives," Dr. Gupta said. "Our research found that large and frequent amounts of alcohol consumption may be risk factors for pancreatic cancer."

Previous studies inconsistently have linked alcohol and pancreatic cancer. Dr. Gupta said his study is different, however, because the researchers collected more detailed information on alcohol consumption and binge drinking than other studies and because the researchers were able to analyze the data for multiple factors that previously hadn't been considered in great detail.

532 Cases Reviewed

In the current study, researchers used structured questionnaires to interview pancreatic cancer patients in the San Francisco area diagnosed between 1995 and 1999 and compared those results with those of control participants matched by sex, age and county of residence.

The 532 cancer patients ranged in age from 21 to 85, with the majority between 60 and 80 years of age. Fifty-five percent of study participants were men; 83 percent of them were Caucasian; and most of them were of normal weight with some college education. The 1,701 control participants were of similar demographics.

Dr. Gupta said more research is needed to understand the differences in pancreatic cancer risk between men and women and to understand why heavy alcohol use and binge drinking may increase the risk of pancreatic cancer in men.

Low Survival Rate Cancer

The next step, Dr. Gupta said, will be to see if other studies with detailed information on alcohol consumption and binge drinking have similar results.

Cancer of the pancreas, an organ important for digestion and production of hormones, has the lowest overall five-year survival rate of all specific cancers. Early signs of pancreatic cancer are difficult to diagnose, partly because the organ is located deep in the upper abdomen. Mortality rates have changed little in the past three decades, according to the National Cancer Institute.

Dr. Elizabeth Holly, who was the principal investigator, and Drs. Paige Bracci and Furong Wang also were involved in the UCSF study.

Posted by Webmaster at 09:43 AM

Risky Drinkers Less Likely to Seek Medical Care

Women and men who engage in frequent heavy drinking report significantly worse health-related practices, according to a Kaiser Permanente Center for Health Research study in the journal Addiction Research & Theory. For the study, researchers surveyed 7,884 members of the Kaiser Permanente Northwest integrated health plan in Oregon and Washington.

They found that risky drinkers have attitudes and practices that may adversely affect their long-term health and that people who drink at hazardous levels were less likely than other categories of drinkers to seek routine medical care.

At-Risk Drinkers

Risky drinking was defined in three different ways to account for both short and long-term alcohol-related risks: 1) those who, on average, drank three or more drinks per day, 2) women who consumed four or more drinks during one sitting, or men who drank five or more drinks during one sitting, or 3) people identified as at-risk drinkers using a commonly used screening tool.

"The main finding here is that risky drinkers also engage in other behaviors--such as relieving stress with alcohol and cigarettes, not wearing seatbelts, unhealthy eating and not regularly seeing their doctors--that put their health at risk," said study lead author Carla Green, a senior investigator at the Kaiser Permanente Center for Health Research. "Physicians should not only be concerned about patients' heavy drinking, but also these other health-related practices."

The study, funded by the National Institute on Alcohol Abuse and Alcoholism, is the first to examine the relationship between drinking patterns and health while taking into account a wide-range of other factors that might influence that relationship.

Drinking Patterns and Health

Those factors include diet, exercise, stress management, sleep practices, seat belt use, income, education, obesity, as well as feelings about seeing the doctor, skepticism toward medical care, and attitudes about personal ability to influence health.

"Our study found that men and women who drank the most had less collaborative relationships with their doctors and were more likely to dislike going to the doctor. They were also less confident they could change their own health-related practices and more likely to think health is a matter of good fortune," Green said.

While the study clearly showed a negative relationship between health and daily, heavy drinking, it also found that moderate drinking was associated with better health. In fact, on a standard health status survey, people who drank one-to-three drinks daily reported slightly better health than all other categories of drinkers, including life-long abstainers, former drinkers, light drinkers (less than one drink a day) and heavier drinkers (three or more drinks per day). People who drank moderately were also more likely to have better health-related attitudes and practices, and more likely to seek routine medical care.

Moderate Drinkers Healthier

"Even after taking these other health-related attitudes and practices into account, there was still a small but independent relationship between moderate drinking and better self-assessed health," said Michael Polen, study co-investigator at the Kaiser Permanente Center for Health Research. "Previous research has linked moderate alcohol drinking with cardiovascular benefits, so that might be the underlying reason moderate drinkers report better health. It's also possible that there are additional factors we didn't measure that account for this positive relationship."

The study was conducted by reviewing mail-survey responses of 7,884 Kaiser Permanente members from 2002 and 2003. The survey was linked to two years of electronic health records and service use data to study how drinking patterns affect willingness to seek health care. Each of the members, aged 18 to 64, responded to a survey that measured physical and mental health as well as health-related attitudes and practices.

Posted by Webmaster at 08:52 AM