Anomie, alcohol abuse and alcohol consumption: a prospective-analysis

Cross-sectional and 36-month prospective analyses of the relationships among anomie and both alcohol abuse and alcohol consumption patterns provided little support that anomie was directly associated with ethanol ingestion patterns in a sample of 302 male air traffic controllers. This lack of association was observed for self-reported alcohol consumption, interview-established alcohol abuse and biochemical markers of alcohol intake. In addition, anomie was not predictive of change in alcohol use/abuse over 36 months, controlling for baseline levels of alcohol use and abuse and for relevant demographic factors. Measurement of anomie and alcohol use/abuse, the relative importance of anomie in various socioeconomic groups and issues related to prospective research on this topic are discussed.     

Changes in alcohol problems as a result of changing alcohol consumption: a natural experiment

Alcohol consumption declined by about 10.5% in Quebec and 2.5% in Ontario but increased by 9.5% in Alberta in the years 1974-1983. This created a 'natural experiment' in which the effects of various changes in alcohol consumption on alcohol problems could be assessed. Declines in rates of most alcohol problems were found in Quebec and Ontario despite their different rates of decrease in consumption. However, there were declines in alcoholism rates, and deaths from liver disease and the alcohol dependency syndrome in Alberta. Some problems such as impaired driving and toxic or accidental deaths from alcohol increased in Alberta, probably because of its relatively youthful population compared to Ontario and Quebec. Changes in alcohol consumption appeared to be an unreliable indicator of how various problems are changing.     

Low alcohol alternatives: a promising strategy for reducing alcohol related harm

BackgroundLess than 1% of the beer market in British Columbia comprises beers with an alcohol content below 4%, despite the success of low alcohol beers in other countries, e.g. Australia. A small experimental study is described in which male students were given either unmarked low alcohol beer (3.8%) or regular strength beer (5.3%) to investigate their enjoyment and subjective intoxication.MethodsThirty-four male students who reported drinking 5 or more beers in 1 day at least once in the last month volunteered for the study. In each drinking session, small groups of between 6 and 10 students consumed two servings of beer while playing dominoes. Each subject was his own control in the experiment by attending two group-drinking sessions, drinking a different beverage each time. The different beers were given in balanced order with half the subjects in each group drinking each type of beer. Standard measures of subjective intoxication and enjoyment were used. Blood alcohol levels were tested before, during and after drinking.ResultsAlthough significantly higher blood alcohol levels were obtained with the higher strength beer (means of 0.026 versus 0.033 mg/100 ml at the end of the study, p < 0.001), (i) most participants reported enjoying the two sessions equally or preferred the low alcohol beer session, (ii) most did not report feeling different between the two sessions and (iii) only about half correctly guessed which was the higher alcohol content beer. There was a preference, however, for the taste of the stronger beer.ConclusionWe conclude beer drinkers cannot readily distinguish low and regular strength beers and can enjoy socializing equally with either. We recommend taxation strategies to create incentives for the manufacture, marketing and consumption of low alcohol alternatives.     

Delayed access to alcohol accelerates self-administration of alcohol on a progressive ratio schedule

In a previous report, we found that a 5-min. delay in alcohol access increases ethanol intake in rats trained to self-administer 5% ethanol. To assess the effects of this delay on the motivation to self-administer ethanol, Wistar rats were trained on a progressive ratio schedule of reinforcement and presented with the 5-min. delay. There was no change in break point (6 presses/delivery), active (125 presses/30 min.) or inactive (10 presses/30 min.) lever presses after the 5-min. delay compared to baseline. However, response cessation occurred 10 min. earlier in this delay session compared to baseline indicating that consumption was accelerated by delayed access to alcohol.     

The relation of initial alcohol experiences to current alcohol consumption in a college population

Male and female undergraduate college students were surveyed to examine whether age and circumstances of initial taste and intoxication experiences with alcohol would be predictive of current alcohol usage. Age of initiation, nature of the experience (pleasant vs unpleasant), social setting and type of beverage were examined. Only age of initial experience was found to be minimally predictive of subsequent heavier alcohol use. The negative effects of early experiences with alcohol were predictive for abstinence in both sexes, but did not differentiate between moderate and heavy alcohol users in either.     

Attitudes about alcohol: a general review

This paper reviews 266 articles relating to attitudes towards alcohol use and misuse. It is concluded that adults typically regard themselves as moderate drinkers and disapprove of excessive drinking by others, expressed attitudes vary in accordance with respondent characteristics, drinker characteristics, beverage and amount, setting and time, the term 'alcoholism' has pejorative connotations, but there is no public consensus about etiology or treatment, and alcohol-related attitudes are generally poor predictors of behaviour (but need not be so). It is suggested that a pool of items relating to topic areas of continuing interest be created in order to increase comparability between surveys and further research using more complex attitudinal models be undertaken.     

Price as a determinant of alcohol consumption

The formulation and execution of alcohol policy is considered, particularly in relation to the impact of economic variables, such as price, on consumption of alcohol. Trends in consumption levels and their effects are outlined. Available econometric evidence suggests that price has a significant impact on consumption, with other influential variables being income and access, and to a lesser extent, advertising.     

An alcohol policy for a banana republic

This paper was originally presented at the 8th National AMSAD Conference, Thursday, 11 August, 1988.     

Fetal alcohol syndrome: a cautionary note

Fetal alcohol syndrome (FAS) is a pattern of anomalies occurring in children born to alcoholic women. The main features of this pattern are pre and/or postnatal growth retardation, characteristic facial abnormalities, and central nervous system dysfunction, including mental retardation. Since its clinical recognition in 1973 it has progressed from an unrecognized condition to a major public health concern with exaggerated and unfounded claims as to causality and impact. This review summarizes some of the basic facts about fetal alcohol syndrome with respect to terminology, prevalence, and mechanisms, in the context of exposure risk.     

Adolescent alcohol use and adult alcohol disorders: a two-part random-effects model with diagnostic outcomes

Alcohol use is often analyzed by treating the behavior as a single dimension, such as focusing on frequency of use. Based on data from a longitudinal study, this report considers two distinct aspects of semi-continuous alcohol use data. A two-part random-effects model was used to evaluate change in the log-odds and frequency of use from about age 13 to about age 18 years. Change features were then related to the log-odds of later alcohol disorders. Results suggested differences in the two aspects of use over time and their relationships with later disorders. Most important for the purposes of this study, different methods of analyzing antecedents and consequences of alcohol use trajectories were shown to generate both similar and disparate findings.     

Very young adolescents and alcohol: evidence of a unique susceptibility to peer alcohol use

Aim

The aim of this study is to examine the susceptibility of very young adolescents (10–12 years of age) to peer alcohol-related influences, compared to older adolescents (13–14 years of age).

Methods

The analysis sample consisted of 7064 adolescents in grade 6 (modal age 11) or grade 8 (modal age 13) from 231 schools in 30 communities across three Australian States. Key measures were adolescent reports of alcohol use (past 30 days) and the number of peers who consume alcohol without their parent's awareness. Control variables included parent alcohol use, family relationship quality, pubertal advancement, school connectedness, sensation seeking, depression, length of time in high school, as well as age, gender, father/mother education, and language spoken at home. A multi-level model of alcohol use was used to account for school-level clustering on the dependent variable.

Results

For both groups, the number of peers who consumed alcohol was associated with alcohol use, but Grade 6 students showed a unique susceptibility to peripheral involvement with peer drinking networks (having one friend who consumed alcohol).

Conclusion

The results point to the importance of monitoring and responding to comparatively minor shifts in the proportion of peers who use alcohol, particularly among very young adolescents.     

Central nervous system effects of alcohol at a pseudo-steady-state concentration using alcohol clamping in healthy volunteers

AIM

In determining the acute effects of alcohol, it is helpful if alcohol concentrations are maintained at stable levels, to facilitate the interpretation of the results. Recently, an alcohol clamping method was developed that resulted in stable alcohol concentrations for hours. The aim of this study was to test a range of central nervous system (CNS) effects under pseudo-steady-state conditions.

METHODS

To achieve a pseudo-steady state of 0.6 g l⁻¹, breath alcohol concentrations (BrAC) were frequently measured and fed back into a spreadsheet-based program to guide intravenous dosing. CNS effects were frequently measured throughout the clamp.

RESULTS

The clamping paradigm resulted in a pseudo-steady-state BrAC of 0.61 g l⁻¹ (coefficient of variation 6.2%). A plateau was maintained from 25 to 300 min and caused significant effects on smooth pursuit eye movements [−9.7%, 95% confidence interval (CI) −12.4, −7.1], adaptive tracking (−3.4%, 95% CI −4.5, −2.2), visual analogue scale (VAS) alertness (−13 mm, 95% CI −20, −6), VAS alcohol effects (16 mm, 95% CI 7, 25) and body sway (21.3%, 95% CI 1.8, 45). Some effects (like smooth pursuit eye movements) closely followed the relatively stable alcohol concentrations, whereas others (such as body sway and VAS alcohol effects) fluctuated during the plateau phase.

CONCLUSIONS

Most CNS effects of alcohol showed a trend to change over time, despite stable concentrations. Other variables remained stable under pseudo-steady-state conditions. The intravenous clamping method provides precise control over BrAC levels and allows frequent repetition of different CNS measurements. These features make this technique eminently suitable to study the complex pharmacodynamic effects of acute alcohol administration.     

Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder

Alcohol use disorder (AUD) and depressive disorders often co-occur. Findings on the effects of major depressive disorder (MDD) or depressive symptoms on posttreatment alcohol relapse are controversial. The study's aim is to examine the association of MDD and depressive symptoms with treatment outcomes after residential AUD programs. In a naturalistic-prospective, multisite study with 12 residential AUD treatment programs in the German-speaking part of Switzerland, 64 patients with AUD with MDD, 283 patients with AUD with clinically significant depressive symptoms at admission, and 81 patients with AUD with such problems at discharge were compared with patients with AUD only on alcohol use, depressive symptoms, and treatment service utilization. MDD was provisionally identified at admission and definitively defined at discharge. Whereas patients with MDD did not differ from patients with AUD only at 1-year follow-up, patients with AUD with clinically significant depressive symptoms had significantly shorter time-to-first-drink and a lower abstinence rate. These patients also had elevated AUD indices and treatment service utilization for psychiatric disorders. Our results suggest that clinically significant depressive symptoms are a substantial risk factor for relapse so that it may be important to treat them during and after residential AUD treatment programs.     

Women with alcohol problems: a psycho-social perspective

In this paper, women's alcohol use and related problems are examined and special reference is given to the various psycho-social factors involved. The need for a special treatment approach for women is discussed and the lack of knowledge in this area highlighted. The areas of alcohol relapse and women-only groups are explored as possible areas for future development and research.     

Progression of alcohol problems in a Navajo sample

OBJECTIVE: This study tested the cross-cultural applicability of Jellinek's progression in a sample of Navajo men and women. Jellinek (1952) described a predictable progression of alcoholism that continues to be used widely in treatment, but it is unclear whether this pattern is consistent across cultures and genders. METHOD: The sample consisted of 99 Navajo (67 men and 32 women) who were undergoing detoxification in a secure facility. Participants were asked about the quantity and frequency of their drinking as well as other drinking experiences. Their level of cultural identification was also assessed. RESULTS: Of the 46 events established by Jellinek, the order of progression for the Navajo sample was modestly correlated (r(s) = .41, p = .005, 17% shared variance) with that for Jellinek's white men. The correlation of Jellinek's sample with the Navajo men was slightly larger (r(s) = .48, p = .001, 23% shared variance) than that of the whole sample; however, the comparison with Navajo women resulted in a near zero correlation (r(s) = .06, p = .705, 4% shared variance). CONCLUSIONS: In the context of studies from other cultures, these data suggest convergence decreases as the studied sample deviates culturally from Jellinek's sample of U.S. white men. These data question the cross-cultural applicability of this popular model of progression of alcoholism.     

The effects of alcohol and alcohol expectancies on subjective reports and physiological reactivity: a meta-analysis

The balanced placebo design (BPD) has been used to understand the etiology and maintenance of alcohol consumption. The utility of this design lies in its ability to examine both actual alcohol consumption and the expectation of alcohol consumption. A meta-analysis of the BPD literature was conducted in the context of cue-reactivity, which may be characterized as an experimental phenomenon observed in studies utilizing alcohol. Sixty-four studies were obtained in literature searches and coded for type of experimental setting and cues present during the actual beverage consumption. Lab setting was a moderator for both pharmacological (alcohol) and expectancy effects with the largest effects (in the same direction) noted in natural environment labs (i.e., an easy chair and casual environment). Contrary to predictions, the bar lab produced the smallest effects. Cues present during alcohol consumption served as a moderator of pharmacological effect, with the largest effect observed when alcohol was placed on the rim of the glass. Implications of these findings for cue-reactivity studies and the treatment of alcohol abuse are discussed.     

Evaluating a brief alcohol intervention with fraternities.

OBJECTIVE: The current study tested the efficacy of a brief intervention designed to reduce drinking and drinking-related consequences among first-year fraternity members. METHOD: Twelve fraternities were randomly assigned to receive either a motivational enhancement intervention with individual and housewide feedback components (n = 6 houses) or a treatment-as-usual control condition (n = 6 houses). Individual feedback was delivered either by peer interviewers or professional research staff. Participants were assessed during their pledge (first) year of house membership and during a follow-up period 1 year later. RESULTS: Of the participants who completed follow-up (N = 120), fraternity members who received the brief intervention reported significant reductions in alcohol use (total average consumption) and typical peak blood alcohol concentrations when compared with fraternity members in the control condition. No differences in drinking-related consequences were observed. Fraternity members who received their individualized feedback from peer interviewers and professional members of the research staff reported similar outcomes. CONCLUSIONS: Results provide support for the efficacy of a brief motivational enhancement intervention in reducing drinking within this high-risk population. The cost-effective use of peer interviewers appears to be a promising strategy for delivering individualized prevention programming in college populations.     

Peritoneal dialysis in alcohol intoxication in a child

Our case dealt with an alcohol intoxication of a 6 years and 2 months old girl (asphyctical stage). The blood alcohol level was 4.98 It was caused by child abuse whereby the father forced his daughter to drink a cup of Brandy. The therapy of this severe alcohol intoxication consists of treatment of shock, warming, mechanical ventilation after cessation of spontaneous respiration and for a quicker elimination of the blood alcohol peritoneal dialysis was performed during a period of 18 h.