Coping and alcohol use and abuse disorder

One hundred and forty-one (141) heroin users were interviewed at the time of their most recent overdose of which 34% returned for in-depth interviews within seven days. Subjects were predominantly male (77%), aged between 18 and 29 (53%), highly dependent, and unlikely to be (8%) or to have ever been (68%) in MMT. Poly-drug use was prevalent (54%) at the time of overdose despite most subjects' awareness of the association between poly-drug use and overdose. Subjects consumed other drugs with heroin in order to increase the pleasurable effects of drug use rather than to medicate symptoms of withdrawal or depression. The overdose did not appear to change subjects' low level of concern about overdosing - only a minority (11 %) said they would seek treatment following overdose. Experience of overdose therefore does not appear to be a motivating factor for entry into treatment. A variety of harm reduction initiatives needs to be supported in order to reduce the frequency and hazards of overdose.     

The Great Recession, somatic symptomatology and alcohol use and abuse

While most research has examined the long-term effects of alcohol consumption on health, the current study examines how health status impacts on drinking behavior. Using data from a national study conducted between 2010 and 2011 to assess the impact of the recession on drinking behavior, this study examines how economic hardships linked to the recent economic recession affect physical health, and how physical health may in turn affect alcohol use. Structural equation models were used to test the predicted associations. The data demonstrate that many of the economic stressors linked to the recession are associated with increased somatic symptoms. Somatic symptoms are also associated with increased drinking for men, but not for women. These findings suggest that men may use alcohol to self medicate somatic symptomatology. The current findings are consistent with gender role-based explanations that account for gender disparities in the utilization of medical care.     

Neurobiology of alcohol abuse.

Excessive consumption of beverage alcohol (ethanol) is a major health concern worldwide. Understanding the mechanisms by which ethanol affects neural functioning, after both acute and chronic exposure, has become a major goal in the study of alcoholism. With such an understanding, we should be able to institute more effective treatments and preventative measures for alcohol abuse problems. Recent studies have found, contrary to earlier assumptions, that ethanol has selective, dose-dependent effects on various neurotransmitter systems within the CNS. These effects are observed at all levels of analysis, from molecular to behavioral. This review by Herman Samson and Adron Harris covers these recent findings, with the intent of generating questions that will focus further research efforts.     

Age at onset of alcohol use and DSM-IV alcohol abuse and dependence: A 12-year follow-up

Purpose: The purpose of this study was to examine the relationship between age at drinking onset and the development of DSM-IV alcohol abuse and dependence in a 12-year prospective study of youth in the United States. Methods: Logistic regression analyses were used to quantify the relationship between age at drinking onset and the development of alcohol abuse and dependence controlling for sociodemographic factors and problem indicators. Results: The odds of alcohol dependence decreased by 5% in 1989 and 9.0% in 1994 for each year drinking onset was delayed. In 1994, the odds of alcohol abuse increased by 7.0% with each decreasing year of age at drinking onset, while age at drinking onset was not related to alcohol abuse in 1989. Several other risk factors were found to be strong and consistent predictors of abuse and dependence in 1989 and 1994, including being male, divorced, separated or never married, younger, and having an early history antisocial behaviors and marijuana use. Implications: Implications of the results of this study are discussed in terms of other factors that may impact on the onset-abuse and onset-dependence relationship and the need to focus future prevention efforts.     

5-HT and alcohol abuse.

Recent experimental data, both in animals and the clinic, suggest that drugs selectively interacting with the 5-HT system may reduce alcohol intake. Although the precise mechanisms underlying these drug effects are unknown, it seems that there are at least two pharmacological strategies available, described in this review by Edward Sellers and colleagues. The first is enhancement of 5-HT neuronal activity using compounds that will release 5-HT, block 5-HT reuptake, or act as selective 5-HT receptor agonists. A second approach involves selective 5-HT3 receptor antagonists. If the initial research findings with these drugs are confirmed and extended, they may present useful therapies for the treatment of alcohol abuse, especially if used in conjunction with psychosocial therapy.     

Alcohol abuse in a rural community in India. Part II: characteristics of alcohol users

This part of the study dealt with the analysis of the characteristics of alcohol users. About 50% of both male and female users were between 20 and 39 years of age; 8.1% of males and only 1.3% of females used alcohol daily or several times in a week. Desi (country) liquor was the beverage used by more than 85% of the users; 77.5% of males and 96.5% of females consumed less than one quarter of a bottle of alcohol, and 65.3% of males and 93.6% of females were taking alcohol at their houses only. The reasons given for drinking by the majority of users were 'for pleasure', 'for celebration of an event' and 'status symbol'. The quantity/frequency index analysis showed that the percentage of alcoholics was 4.2 and the remaining were social drinkers. Physical, economic and social problems were reported by a significantly higher percentage of alcoholics than social drinkers. The importance of consideration of these factors in formulating a strategy of social policy in the field of alcohol use is emphasised.     

DSM-III: alcohol abuse and alcohol dependence--inter-rater diagnostic reliability

In the DSM-III field trials, measures of inter-rater diagnostic agreement were obtained only for major diagnostic categories. Two diagnoses subsumed under the major diagnostic category of Substance Use Disorders are Alcohol Abuse and Alcohol Dependence. The purpose of the present study was to obtain inter-rater reliability estimates among raters given identical clinical information for the two diagnoses, for the separate criteria for each diagnosis and for the definitional components of each criterion. Intra-class correlation coefficients were obtained with results ranging from 0.07 to 0.85. The need for further statistical studies examining the specificity of definitions for the diagnostic criteria within DSM III is addressed.     

Phosphatidylethanol in blood (B-PEth): a marker for alcohol use and abuse

Phosphatidylethanol (PEth) represents a group of glycerophospholipid homologues where ethanol by phospholipase D has been bound at the position that normally contains an amino-alcohol. Since the formation of PEth is specifically dependent on ethanol, the diagnostic specificity of PEth as an alcohol biomarker is theoretically 100%. The half-life of PEth in blood is approximately 4 days. The amount of alcohol consumed correlates to blood concentration of PEth and PEth has been shown to be a more sensitive indicator of alcohol consumption than traditional alcohol markers, such as CDT (carbohydrate-deficient transferrin), GGT (γ-glutamyl transferase), and MCV (mean corpuscular volume) or a combination of these. Almost all clinical data so far available are based on a high performance liquid chromatography (HPLC) method with limited analytical sensitivity. With the advent of methods with considerably higher analytical sensitivity (e.g. mass spectrometric methods), clinical sensitivity will increase correspondingly. The possibility of determining very low concentrations of PEth by new sensitive analytical techniques may, however, have both ethical and legal consequences that have to be considered.     

Deaf culture and alcohol and substance abuse.

Alcohol and substance abuse problems are now of concern among persons who are deaf. The problems of cultural influence, prevalence of the problem, and factors contributing to isolation and denial are addressed in this article. In addition, the issues of accessibility and service delivery are explored. Current programs that are accessible and provide alcohol and substance abuse recovery are identified.     

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.     

The relationship between prenatal care,personal alcohol abuse and alcohol abuse in the home environment

Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been inconsistent, perhaps because (a) alcohol use during pregnancy is substantially under-reported and (b) studies have not considered the wider social network in which maternal alcohol use takes place. The current study attempts to clarify relationships between personal alcohol use, alcohol use in the home environment, and prenatal care in a sample of post-partum women.

Methods: Participants were 107 low-income, primarily African-American women. All participants completed a computer-based screening which assessed personal and environmental alcohol use, prenatal care and mental health.

Findings: Environmental alcohol use was related to delayed prenatal care while personal alcohol use was not. More specifically, after controlling for demographic variables, the presence of more than three person-episodes of binge drinking in a woman's home environment increased the odds of seriously compromized prenatal care by a factor of seven.

Conclusions: Findings suggest the need to further assess environmental alcohol use and to examine the reliability of personal alcohol use measures.     

Drinking to cope, emotional distress and alcohol use and abuse: a ten-year model

OBJECTIVE: This study examines the ability of baseline drinking to cope to predict drinking behavior across an ensuing 10-year period. In addition, it examines whether a propensity to consume alcohol to cope with stressors strengthens the link between emotional distress and drinking behavior. METHOD: The study uses survey data from a baseline sample of 421 adults (54% women) assessed four times over a 10-year period (i.e., baseline and 1-, 4- and 10-year follow-ups). RESULTS: Baseline drinking to cope was associated with more alcohol consumption and drinking problems at all four observations across the 10-year interval. Baseline drinking to cope also predicted increases in both alcohol consumption and drinking problems in the following year. Moreover, change in drinking to cope was positively linked to changes in both alcohol consumption and drinking problems over the interval. Individuals who had a stronger propensity to drink to cope at baseline showed a stronger link between both anxiety and depressive symptoms and drinking outcomes. CONCLUSIONS: Findings demonstrate the power of alcohol-related coping strategies in predicting long-term drinking behavior and they illustrate one way in which such coping is linked to alcohol use and abuse. More broadly, they underscore the importance of considering individual differences in emotion-based theories of drinking behavior.