Relationship between ethanol patch test and problem drinkers among dental students]

In 2000 and 2001, we carried out a drinking habit survey and the Ethanol Patch Test on 232 fourth-year dental students (128 males, 104 females). The results were statistically analyzed. For the survey, the students were asked to fill out, anonymously, the forms of the Tokyo-University ALDH2-Phenotype Screening Test (TAST), the Kurihama Alcoholism Screening Test (KAST), and the Adolescent Alcohol Involvement Scale (AAIS). The results of the subsequent Ethanol Patch test were evaluated by the students themselves. The Patch test demonstrated that 44.5% of males and 49.0% of females were positive to the test or ALDH2 deficient, the rest having the marker substance. According to the TAST results, ALDH2-deficient or TAST-positive (alcohol-intolerant) subjects accounted for 48.4% of males and 51.9% of females, the rest being ALDH2-present or TAST-negative students. Among the Patch test-positive group, the ratio of problem drinkers according to the KAST was 8.8% in males and 2.0% in females. The corresponding figures for the test-negatives group were; 22.5% in males; 7.5% in females, being higher than those for the test-positive group. Among the test-positive group, the ratio of problem drinkers scoring at least 42 points on the AAIS stood at 19.3% in males, 7.8% in females and among the test-negative group, the corresponding figures were; 21.1% in males; 13.2% in females, the difference from those for the other group being relatively small. The results of the Ethanol Patch test were related to those of the TAST and KAST, but not to the AAIS. The correlation between the Patch test and KAST indicates that the test-negatives are prone to become alcohol-dependant. Though the results of the Patch test and those of the AAIS were not related, the findings show that some alcohol-intolerant university students are drinking excessively.     

Prevalence of problem drinkers among dental students]

In 1997 and 1998 we statistically studied fourth-year dental students for their drinking and smoking habits. The subjects numbered 103 (65 males, 38 females) in 1997 and 127 (79 males, 48 females) in 1998, totaling 230. The questionnaire included the Kurihama Alcoholism Screening Test (KAST), the Adolescent Alcohol Involvement Scale (AAIS), and the Fagerstr?m Tolerance Questionnaire (FTQ). Problem drinkers as defined by KAST, scoring at least 2 points, represented 12.6% of the total in 1997 and 13.4% in 1998, exceeding 10% in both years. Alcoholic misusers, with at least 42 point on the AAIS, stood at 19.4% in 1997 and 17.3% in 1998. The incidence of students assessed as having 6 points on the Quantity-Frequency Scale (QF Scale) stood at 18.4% in 1997 and 10.2% in 1998. Compared between two sexes, KAST detected no significant difference between the two groups: 13.9% for males and 11.6% for females. Alcoholic abusers on the AAIS, however, were estimated at 22.9% in males and 9.3% in females, the ratio for males being more than twice as high as that for females. It was also found that 47.9% of the male students and 33.7% of their female counterparts drank every weekend and that 31.3% of the males and 5.8% of the females kept drinking until they were drunk. Female students thus appeared to drink more frequently, though they consumed smaller amounts of alcohol at a time. The smoking rate was lower than the average in the Japanese for both groups; nicotine dependence was also lower in dental students. It was demonstrated that dental students drink more alcohol more frequently, with a higher incidence of problem drinkers.     

Nationwide survey of alcohol drinking and alcoholism among Japanese adults]

PURPOSE: To investigate the characteristics of alcohol use among Japanese adults and prevalence of alcohol dependence in Japan, we conducted a nationwide survey on alcohol drinking behavior and alcohol dependence among Japanese adults using a representative sampling method. METHODS: We sampled 3500 adults from throughout the entire country using a stratified random sampling method with two-step stratification, and carried out a home visit interview survey. A total of 2547 people (72.8%) responded to the survey. The survey period was June, 2003. The questionnaire contained questions about the frequency and quantity of alcohol use, 'hazardous use of alcohol' and 'alcohol dependence' according to the ICD-10 definition, several screening scales on problem use of alcohol (CAGE, KAST, AUDIT), life-time prevalence of 24 alcohol related diseases, smoking status, dysgryphia, and nightcap drinking. RESULTS: The number of respondents was, 1184 males, and 1363 females. Lifetime alcohol drinking, and weekly drinking, and daily drinking rates were 95.1%, 64.4%, and 36.2% for males, 79.0%, 27.5%, and 7.5% for females, respectively. Average daily alcohol consumption was 3.7 units for males, and 2.0 units for females (1 unit = 10 g pure alcohol). The proportion of drinkers who drank alcohol 4 units or more daily was 28.9% for males, and 7.6% for females, and that for 6 units or more was 12.7% for males, and 3.4% for females. The proportion of flasher was 41.2% for males, and 35.0% for females. Among screening questions, problem drinking was most frequently identified using AUDIT (score 12 points or more, 150 persons), followed by KAST (2 points or more, 100 persons) and CAGE (2 points or more, 98 persons). The number of subjects who met the ICD-10 criteria for alcohol dependence was 24, while the number who engaged in hazardous alcohol use was 64. CONCLUSIONS: This study revealed that problem drinking and alcohol dependence are a serious problem in Japanese general population. The problem of females drinking may be growing. The government should emphasize the prevention of alcohol drinking problems in adults and continue the conduct of nationwide prevalence surveys to monitor the problem.     

Alcohol Levels Do Not Accurately Predict Physical or Mental Impairment in Ethanol-Tolerant Subjects: Relevance to Emergency Medicine and Dram Shop Laws

The human body and the central nervous system can develop tremendous tolerance to ethanol. Mental and physical dysfunctions from ethanol, in an alcohol-tolerant individual, do not consistently correlate with ethanol levels traditionally used to define intoxication, or even lethality, in a nontolerant subject. Attempting to relate observed signs of alcohol intoxication or impairment, or to evaluate sobriety, by quantifying blood alcohol levels can be misleading, if not impossible. We report a case demonstrating the disconnect between alcohol levels and generally assigned parameters of intoxication and impairment. In this case, an alcohol-tolerant man, with a serum ethanol level of 515 mg/dl, appeared neurologically intact and cognitively normal. This individual was without objective signs of impairment or intoxication by repeated evaluations by experienced emergency physicians. In alcohol-tolerant individuals, blood alcohol levels cannot always be predicted by and do not necessarily correlate with outward appearance, overt signs of intoxication, or physical examination. This phenomenon must be acknowledged when analyzing medical decision making in the emergency department or when evaluating the ability of bartenders and party hosts to identify intoxication in dram shop cases.     

Self concept and drinking problems of college students raised in alcohol-abused homes

To examine drinking problems and self concept of college students raised in homes where alcohol is abused, 148 lower division college students were given the following paper and pencil tests: The Michigan Alcoholism Screening Test, The Children of Alcoholics Screening Test, and the "Personal Self" section of The Tennessee Self Concept Scale. Students classified as children of alcoholics had a significantly lower self concept (F = 4.23, p = .04). Tabulation of the incidence of heavy drinking (31%) and lapses of memory after drinking bouts (62%) show an amount of drinking on college campuses that is truly alarming.     

The Japanese version of Substance Abuse Subtle Screening Inventory and its psychometric assessment.

OBJECTIVE: The purpose of our study was the development of the Japanese version of the Substance Abuse Subtle Screening Inventory (SASSI) and its psychometric assessment. METHOD: We translated SASSI-3 into Japanese and refined it through a back-translation technique and focus group approach. Study 1 was a preliminary study to examine the internal consistency and discriminant function of subscales, sensitivity and specificity of the Japanese version SASSI-3 (SASSI-3J). The participants were 20 drug-dependent individuals and 23 non-dependent comparison individuals. Study 2 comprised three parts. The participants were university students recruited from three classes. The first part examined the internal consistency of subscales and the relationship between the subscale Face Valid Alcohol (FVA) and the Kurihama Alcoholism Screening Test (KAST) with 269 students. The second part examined the 2-week test-retest reliability with 51 students. The third part examined the robustness of SASSI-3J against response distortion with 65 students: participants completed the SASSI-3J under standard instructions, under instructions to minimize any alcohol problems they might have (fake good), and under instructions to exaggerate any alcohol problems they might have (fake bad). They also completed the Social Desirability Scale. RESULTS: 1) SASSI-3J showed relatively high sensitivity and specificity when only the Risk Prediction Scales were used or when Rule 9 was excluded from the decision tree; 2) The Risk Prediction Scales of SASSI-3J had high internal consistency, and among them, Face Valid Alcohol (FVA) showed moderately high concurrent validity with the KAST; 3) In both Study 1 and Study 2, the internal consistencies of OAT, SAT, DEF and SAM were moderate to low (0.05 to 0.57). This may not interfere with the subscales' discriminant power but does deny sufficient uni-dimensionality of these scales; 4) SASSI-3J clinical scale scores were shown to be robust against faking good/social desirability bias.     

Randomized controlled trial on the effects of a skills‐based workshop on medical students’ management of problem drinking and alcohol dependence

The purpose of this study was to determine whether a skills‐based workshop will improve medical students' management of problem drinking and alcohol dependence in simulated patients. Seventy‐six 3rd and 4th year Ontario medical students were randomized to receive a 3‐h workshop on either problem drinking and alcohol dependence or depression (control condition). Students then completed eight simulated office visits (OSCE stations) with simulated patients presenting with depression, problem drinking or alcohol dependence. Examiners completed a checklist of the questions asked and advice given by the student, and simulated patients and examiners completed a global rating scale. Four months later, students were sent a survey on their knowledge, attitudes, and behavior towards patients with alcohol problems. The alcohol group received significantly higher assessment and management checklist scores and global rating scores than did the depression group (p < 0.01) and performed better on almost all aspects of clinical management of both problem drinking and alcohol dependence. On the follow‐up survey (n = 55) the alcohol group showed a significant increase in beliefs about self‐efficacy in managing alcohol problems (p < 0.05) and had greater knowledge of reduced drinking strategies, but the two groups did not differ on other measures. A skills‐based workshop causes marked short‐term improvements in medical students' management of problem drinking and alcohol dependence, an increase from baseline to postworkshop in self‐efficacy beliefs that was sustained through to follow‐up, and greater knowledge of reduced drinking strategies. Repeated reinforcement of clinical skills may be required for a long‐term impact on clinical behavior.     

Randomized Controlled Trial on the Effects of a Skills-Based Workshop on Medical Students' Management of Problem Drinking and Alcohol Dependence

The purpose of this study was to determine whether a ski lls-based workshop will improve medical students' management of problem drinking and alcohol dependence in simulated patients. Seventy-six 3rd and 4th year Ontario medical students were randomized to receive a 3-h workshop on either problem drinking and alcohol dependence or depression (control condition). Students then completed eight simulated office visits (OSCE stations) with simulated patients presenting with depression, problem drinking or alcohol dependence. Examiners completed a checklist of the questions asked and advice given by the student, and simulated patients and examiners completed a global rating scale. Four months later, students were sent a survey on their knowledge, attitudes, and behavior towards patients with alcohol problems. The alcohol group received significantly higher assessment and management checklist scores and global rating scores than did the depression group (p < 0.01) and performed better on almost all aspects of clinical management of both problem drinking and alcohol dependence. On the follow-up survey (n = 55) the alcohol group showed a significant increase in beliefs about self-efficacy in managing alcohol problems (p < 0.05) and had greater knowledge of reduced drinking strategies, but the two groups did not differ on other measures. A skills-based workshop causes marked short-term improvements in medical students' management of problem drinking and alcohol dependence, an increase from baseline to postworkshop in self-efficacy beliefs that was sustained through to follow-up, and greater knowledge of reduced drinking strategies. Repeated reinforcement of clinical skills may be required for a long-term impact on clinical behavior.     

Brief intervention for smoking, problem drinking and drug abuse by high school students]

Adolescent smoking, drinking and illegal drug abuse (drug-related problems) in Japan were treated as a legal model in the second prevention area. This study showed the necessity and usefulness of early intervention concerning adolescent drug-related problems as adolescent mental health problems. First, school nurses were asked if they were consulted about drug-related problems by students. Many school nurses in junior and senior high schools were consulted about drug-related problems by students, and they emphasized the need for counseling systems for drug-related problems by professionals. The second part of the study involved brief interventions by the authors in high school students with a high risk of drug-related problems. The authors went to three high schools and conducted brief interventions on students who had drug-related problems and sought advice. We prepared several screening tests for assessment of drug-related problems, such as the Fagerstr?m Test for Nicotine Dependence (FTND). Adolescent Alcohol Involvement Scale (AAIS). Quantity-Frequency Scale (QF Scale). Core Alcohol Use Disorders Identification Test (Core AUDIT), CAGE and Drug Abuse Screening Test-20 (DAST-20). In the brief interventions, the authors assessed drug-related problems of students using these scales and advised them how to revolve such problems two or three times. Twenty-two students accepted brief interventions. All of them smoked, 62% of them showed problem drinking and 33% illegal drug use. At 6 months after the brief interventions, 16 out of 21 students reported their drug-related problems. Nineteen percent of them had reduced smoking, 67% of them decreased drinking and one half of them decreased their use of illegal drugs. Results of this study revealed the necessity and the usefulness of the brief intervention for high school students with drug-related problems.     

The onset of drinking and intoxication among university students

To study the effect of the onset of drinking on subsequent alcohol use, self-administered questionnaires were completed by 856 unmarried undergraduate students from two universities in the southeastern region of the United States. The present study focuses on the 524 (61.2%) students who reported using alcohol at least occasionally. In this subsample, the strongest predictors of the extent of undergraduate intoxication are the frequency of intoxication at the onset of drinking and age at the onset. The more often an individual drinks to intoxication and the younger that individual begins to drink, the more frequently he or she will become intoxicated when a university student. Racial differences in the extent of undergraduate intoxication were also found. White students were markedly more prone to intoxication than were Black students. Sex differences, although not statistically significant, showed a tendency for drunkenness among male undergraduates to exceed that among female undergraduates. The implications of the findings for intervention and prevention strategies are discussed.     

Malt liquor use, heavy/problem drinking and other problem behaviors in a sample of community college students

OBJECTIVE: This study examined the prevalence of malt liquor use and its relationship with heavy or problem drinking, other substance use and other problem behaviors in a sample of 1,029 (58% female) students attending a community college in California. METHOD: Data were collected using anonymous surveys that were administered during daytime classes. Bivariate analyses were conducted to examine relationships between malt liquor use and demographic characteristics, heavy/problem drinking and other types of substance use and problem behaviors. Logistic regression analyses also were conducted to determine whether malt liquor use was predictive of problem drinking, drug use and other problem behavior after adjusting for background variables. RESULTS: Malt liquor use was most prevalent among male, white and Latino students. Compared with nonmalt liquor drinkers, malt liquor drinkers consumed significantly more alcohol, engaged in heavy drinking more often and experienced intoxication more often. Malt liquor drinkers scored significantly higher on the Alcohol Use Disorders Identification Test than nonmalt liquor drinkers. Malt liquor drinkers were more likely than nonmalt liquor drinkers and abstainers to report use of cigarettes, marijuana and illicit drugs and to exhibit problem behaviors. Malt liquor use was predictive of problem drinking, drug use and other problem behavior after adjusting for demographics and alcohol use in regression analyses. CONCLUSIONS: The findings of this study suggest that malt liquor use is associated with heavy and problem drinking, other drug use and behavioral problems among community college students.     

Parental problem drinking predicts implicit alcohol expectancy in adolescents and young adults

The present study aimed to investigate the influence of parental problem drinking on implicit and explicit alcohol expectancy of adolescents and young adults (12-24 years). The study was conducted via the Internet, employing a between-subjects design. We measured alcohol expectancy by means of an Implicit Association Test (IAT) and a self-report questionnaire. A short version of the Children of Alcoholics Screening Test (CAST) was used to measure alcohol-related parental problem behavior. Our results showed that increased CAST-scores were correlated with a stronger implicit association between the concepts alcohol and arousal. In contrast, no such relationship was observed between parental problem drinking and self-reported expectancy of alcohol arousal. These findings provide tentative evidence that an implicit cognitive processing bias is implicated in the intergenerational transmission of addictive behaviors.     

Alternative definitions of high risk for impaired driving: the overlap of high volume, frequent heavy drinking and alcohol dependence.

This paper examines the distributions of past-year volume of ethanol intake, frequency of drinking 5+ drinks and alcohol dependence in a representative sample of 18,352 U.S. current drinkers aged 18 years or over. Within categories defined by these three partially overlapping domains, it presents rates of self-perceived impaired driving, i.e. driving after having had too much to drink, in the year preceding interview. High volume drinkers, those with an average daily ethanol intake of 1 ounce or more, composed 19.7% of current drinkers and accounted for 66.5% of all reported ethanol consumption, 72.6% of all heavy drinking days, 49.2% of all alcohol dependence and 62.8% of all impaired driving incidents. Frequent heavy drinkers, those who drank 5+ drinks at least once a week, composed 12.3% of current drinkers and accounted for 42.9% of all reported ethanol consumption, 81.9% of all heavy drinking days, 40% of all alcohol dependence and 57% of all impaired driving incidents. Drinkers with DSM-IV alcohol dependence composed 9.9% of current drinkers and accounted for 28.9% of all reported ethanol consumption, 37% of all heavy drinking days and 56.9% of all impaired driving incidents. The overlap of these three high risk groups, each of which had a probability of at least one impaired driving incident per year, was far from complete. Of individuals who met any of these criteria for high risk drinking (i.e. high volume, frequent heavy drinking or dependence), more than half met only one criterion and only one in seven met all three. The group that did meet all three criteria had such a high rate of impaired driving incidents, an average of 5.14/year, that it accounted for 36.4% of all such incidents despite making up only 3.8% of all current drinkers. The results are discussed in terms of their implications for targeting prevention and intervention efforts, e.g. whether targeting one problematic aspect of drinking behavior will reach drinkers with other types of problem behaviors as well.     

Substance use among night high school students in Japan]

OBJECTIVE: The aim of the present study was to determine the prevalence of tobacco use, alcohol drinking, and illicit drug use among night high school students in Japan. METHOD: 247 students (180 boys and 67 girls) from 3 night high schools were asked to complete self-administered anonymous questionnaires in classrooms. The average age of the participants was 18.7 years. RESULTS: Overall, 76.0% of the participants reported lifetime alcohol use, and 44.0% reported drinking alcohol during the past 30 days. Of the former, 24.6% reported experiencing alcohol-induced blackouts and 18.9% reported drinking alcohol without adult supervision at the age of 13 years or younger. 58.3% of the participants reported experimenting with smoking cigarettes, 42.3% reported having smoked cigarettes in the past 30 days, and 34.8% reported smoking cigarettes daily. 43.0% of the participants who had experienced smoking cigarettes had started smoking at the age of 13 years or younger. The lifetime prevalence of any illicit drugs was 9.8% for boys and 5.2% for girls; overall, it was 8.6%. The most commonly used illicit drugs were marijuana (6.4%), inhalants (6.4%), butane gas (4.5%), and nitrites (3.2%). CONCLUSIONS: Although the results showed that there were no significant differences in alcohol drinking experience between night high school and general high school students, problematic drinking behavior was observed. In the case of cigarette smoking, night high school students outnumber general high school students. In previous studies in Japan, the former population showed the highest prevalence of illicit drug use. These findings provide evidence that substance use represents a problem among night high school students. Based on this evidence, health education in night high schools should include not only zero tolerance for or abstinence from substance use but also secondary and tertiary prevention approaches.     

Impact of social influences and problem behavior on alcohol use among inner-city Hispanic and black adolescents.

OBJECTIVE: Inner-city black and Hispanic adolescents might be at great risk for alcohol use. Yet the etiology of drinking among these adolescents receives little attention. The purpose of this study was to examine the impact of social influences and problem behavior on alcohol use among Hispanic and black adolescents. The impact of these factors was also tested separately for girls and boys to determine the differences in etiology of alcohol use depending on gender. METHOD: A large sample of black and Hispanic seventh-grade students (N = 4,847, 52% female) self-reported alcohol use, demographic characteristics (gender, family structure, age, ethnicity and socioeconomic status), social influences to drink (peer norms, adult norms, their friends' use, their mother's use, their father's use, their siblings' use, and perceived availability of alcohol), and problem behaviors (cigarette smoking, marijuana use, getting into trouble). Teams of three to five data collectors administered the questionnaire following standardized protocol. These data were collected in class during a regular 40-minute period. RESULTS: Logistic regressions indicated that social influences to drink from friends, peers, and family and problem behaviors including cigarette smoking and marijuana use were related to alcohol use across and within gender. Getting into trouble predicted drinking for boys but not girls. CONCLUSIONS: Based on these findings, adolescent alcohol prevention programs need to include an awareness of the many social influences to drink, modify incorrectly perceived peer norms for drinking, involve family members in the prevention program and address an array of problem behaviors within one prevention intervention.     

Performance of screening instruments for alcohol use disorders in emergency department patients in Argentina

The performance of the Alcohol Use Disorders Identification Test (AUDIT), CAGE, Brief Michigan Alcohol Screening Test (Brief MAST), Rapid Alcohol Problems Screen (RAPS), Rapid Alcohol Problems Screen-Quantity and Frequency (RAPS4-QF), and TWEAK was evaluated against a diagnosis of alcohol dependence and harmful drinking or alcohol abuse from ICD-10 and DSM-IV criteria. Data were collected from a probability sample of 779 patients admitted to the emergency department of a public general hospital in Mar del Plata, Argentina, during the year 2001. The majority of the patients sampled were male. The age range was 18 to 89 years, with a mean value of 36 years and a median of 31 years. Almost half of the sample had an elementary school education or less. All instruments were more sensitive for alcohol dependence than for harmful drinking or abuse and more sensitive for men than for women. Findings suggest the RAPS4 and RAPS4-QF may be preferred when screening for alcohol use disorders in the emergency department in Argentina. The study's limitations are noted.     

Alcohol-induced changes in body sway in women at risk for alcoholism: a pilot study

Family history of alcoholism appears to influence acute alcohol responses in young men. We report pilot data from a study designed to expand these observations by measuring blood alcohol levels (BALs), subjective intoxication effects, body sway and cognitive-motor task performance in women. Six young women with (FHP) and six without (FHN) alcoholic first degree relatives provided informed consent and were given 0.56 g/kg ethanol under double-blind conditions. Groups were matched for age, drinking history and height-weight ratio. Subjects performed tasks in random order at 90, 60 and 30 min before drinking alcohol, and 15, 30, 45, 60, 90, 120, 150 and 180 min after drinking alcohol. BALs peaked at 80 mg/dl 30 to 60 min after drinking alcohol. BALs were comparable and disappearance rates were similar for both groups. BALs and intoxication ratings for both FHP and FHN women had highly significant correlations. Alcohol decreased accuracy on an automated version of the Digit Symbol Substitution Test (DSST) for both groups, but FHN women made significantly more errors 30 min after alcohol. Significantly greater alcohol effects on body sway were apparent in FHN women 15, 30, 60, 90 and 120 min after alcohol. Compared with previous findings for men, both FHP and FHN women reported less intoxication at similar BALs, but body sway in FHN women was more affected by alcohol. Small sample size limits generalization of these findings but suggests that some effects of familial alcoholism in women are similar to those observed in men.     

Drinking as a risk factor for sustained smoking

Data from a nationally representative sample of US adults (n=42862) were used to explore the associations between drinking and smoking, on a lifetime and past-year basis, and between drinking and smoking cessation for a subsample of past-year smokers (n=12586). Smoking cessation was defined as current nonsmoking (as of the time of interview) that had lasted at least 3 months. The proportions of both lifetime and past-year smokers increased with volume of alcohol intake and frequency of heavy drinking and were greater for individuals with DSM-IV alcohol abuse or dependence than for individuals without these disorders. For example, the proportion of past-year smokers rose from 22.5% of lifetime abstainers to 53.0% of heavy drinkers, from 23.8% of those who never drank 5+ drinks on any drinking day to 61.8% of those who drank 5+ drinks weekly or more often and from 27.6% of individuals without past-year DSM-IV alcohol abuse or dependence to 55.5% of those with either of these disorders. The proportion of past-year smokers who had stopped smoking decreased from 7.8% of former drinkers to 4.6% of heavy drinkers, from 7.3% of those who never drank 5+ drinks to 3.4% of those who did so weekly or more often and from 6.7% among individuals without past-year abuse or dependence compared to 4.4% among those with either disorder. In a multivariate analysis that adjusted for background variables and smoking history, average daily ethanol intake was not significantly associated with the odds of smoking cessation, but drinking 5+ drinks at least once a month reduced the odds of cessation by 42%. Having an alcohol use disorder increased the odds of smoking cessation below the age of 30 (an effect that disappeared after adjusting for the interaction between age group and having children in the home), but had an increasingly negative effect on smoking cessation at older ages.     

Drinking patterns among individuals with and without DSM-IV alcohol use disorders

OBJECTIVE: The purpose of this study was to compare alcohol consumption patterns among individuals with and without alcohol use disorders, using a representative sample of the general population that would not exaggerate differences as a result of selection biases associated with treatment for alcohol problems. METHOD: Based on data from 18,352 past-year drinkers selected from a nationally representative sample of U.S. households, 11 measures of past-year alcohol consumption were compared for three diagnostic groups: (1) individuals who did not meet the criteria for either alcohol abuse or dependence, i.e., those without a DSM-IV alcohol use disorder (AUD); (2) those classified with abuse only; and (3) those classified with alcohol dependence, with or without abuse. RESULTS: For all measures reflecting frequency and quantity of drinking, frequency of heavy drinking and intoxication, and frequency of atypical temporal drinking patterns, the values for abusers lay midway between those for individuals without an AUD and those with dependence. Individuals with alcohol use disorders drank a greater proportion of their ethanol intake in the form of beer and a lower proportion in the form of wine than did those without an AUD. Of all the consumption measures considered, frequency of intoxication showed the strongest association with the probability of having an AUD, followed by frequency of drinking 5 + drinks, prevalence of morning drinking and total volume of intake. The ratios of consumption measures for individuals with disorders relative to those without an AUD showed relatively little significant variation across demographic subgroups of the population. CONCLUSIONS: The findings supported the distinction between the disorders of alcohol abuse and dependence, and implicated loss of control as an important element of this distinction. They also indicated that even among individuals with alcohol use disorders, demographic differentials reflecting cultural, physiological and normative forces were maintained and should be considered in approaches to treatment.     

Adolescents alcohol related traffic accidents and mortality in 1999-2000--problem and solutions]

There are a number of factors that give traffic accidents and injuries a prominent position among public health agenda. Injuries, major public health challenge throughout the world and which account for 10% of global mortality, are often ignored as a major cause of death and may require innovative strategies to reduce their toll. Traffic accidents prevention traditionally have been as the domain of law enforcement, societal responses have primarily been a repressive or containment nature. The role of the health sector has tended to be limited to one of treatment and disability prevention, or in other words, damage control. Global Status Report on alcohol use 2001 revealed that drinking has risen steadily among young people in Japan and children between the ages of 13 and 17 have drunk to intoxication or unconsciousness. It also appears that young people in Japan are beginning to drink at earlier ages, while research has found earlier initiation of alcohol use to be associated alcohol dependence and alcohol related injury in later in life. Motor vehicle traffic accidents are a leading cause of death among children, adolescents and young adults between 16 and 20 years of age even though high school students were prohibited from having drivers licenses by internal school rules, this age group was the primary responsible party for 30% of accidents and fatal accidents in 2000. This underlies the fact that how significant role they play as a contributors to the overall traffic problem in Japan. Unlike major causes of deaths such as cancer and heart diseases and despite the critical problem in public health, there are few epidemiological studies on youth involvement in traffic accidents, morbidity and mortality in Japan.