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Alcohol Abstinence (alcohol + abstinence)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Environmental Cues, Alcohol Seeking, and Consumption in Baboons: Effects of Response Requirement and Duration of Alcohol Abstinence

ALCOHOLISM, Issue 12 2006
Elise M. Weerts
Background: Environmental stimuli (cues) that have been paired with alcohol drinking may evoke classically conditioned states that in turn influence alcohol consumption and relapse to heavy drinking. Animal models using chained schedules of alcohol reinforcement may be useful for examining such complex interactions. Methods: Alcohol drinking was established in 4 baboons. A sequence of lights and tones was presented during daily 3-hour sessions. First, cues were presented alone and no programmed contingencies were in effect. Second, cues were paired with 3 linked components consisting of different behavioral contingencies leading to and concluding with access to alcohol for self-administration in the last component (i.e., a chained schedule of alcohol reinforcement). Third, the effects of withholding alcohol access (i.e., forced abstinence) and increasing the number of lever responses required per drink were evaluated. Results: Cues paired with a chained schedule of alcohol reinforcement engendered behaviors that brought baboons into contact with alcohol-related cues and occasioned operant responding that facilitated access to alcohol (alcohol seeking) during components that preceded alcohol access. Increasing the response requirement for each drink decreased the number of drinks and volume of alcohol consumed, but did not alter alcohol seeking. On the first session after 14 days of alcohol abstinence, latency to complete the operant requirement that produced alcohol access was decreased while both alcohol self-administration and volume of alcohol consumed were increased. Conclusions: Alcohol self-administration and consumption were sensitive to increases in response requirement and duration of alcohol abstinence, while seeking was only enhanced by duration of alcohol abstinence. This animal model may be useful to further examine the interactions between environmental cues and behaviors associated with seeking and consumption of alcohol and to evaluate the efficacy of potential alcohol treatment drugs on these behaviors. [source]

Clinical Practice Characteristics and Preconception Counseling Strategies of Health Care Providers Who Recommend Alcohol Abstinence During Pregnancy

ALCOHOLISM, Issue 11 2004
Suzanne C. Tough
Objective: National initiatives on fetal alcohol syndrome in Canada and the United States aimed at prevention, identification, and treatment of individuals who are affected by alcohol exposure in utero recommend that women abstain from consuming alcohol during pregnancy. Health care providers are key educators regarding appropriate alcohol use. The objective of this study was to describe characteristics of physicians who recommend alcohol abstinence during pregnancy with regard to knowledge of fetal alcohol syndrome and preconception counseling strategies. Methods: A survey was mailed to Canadian physicians and midwives between 2001 and 2002. Participants consisted of a national random sample of 1090 Canadian obstetricians and gynecologists, midwives, and family physicians who were current members of provincial and national professional organizations. The main outcome measure was questionnaire responses to knowledge, prevention, and diagnosis of issues related to alcohol use during pregnancy. Results: Response rates ranged from 31.1% among family physicians to 63.5% among midwives. Overall, 91.2% of providers recommended abstinence from alcohol during pregnancy. These providers were significantly more likely to believe that there is sufficient information about alcohol use and that clients were interested in discussing alcohol (p < 0.05). They were also significantly more likely to discuss depression, personal alcohol use, partner's use of alcohol, and family history of alcohol misuse with women of childbearing age (p < 0.05). Once a patient became pregnant, fewer practice differences were noted, although those who recommended alcohol abstinence were significantly more likely to take clinical action when pregnant patients were consuming moderate amounts of alcohol (p < 0.05). Conclusions: It is encouraging that almost 90% of Canadian health care providers recommend abstinence from alcohol during pregnancy. However, differences in clinical practice exist between providers who recommend alcohol abstinence during pregnancy as compared with those who recommend a "glass in moderation." [source]

Review article: the diagnosis and management of alcoholic hepatitis

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2009
S. M. COHEN
Summary Background, Alcoholic hepatitis is a severe, cholestatic liver disease occurring in patients with alcohol abuse. Mortality is substantial; however, therapies may improve clinical outcomes. Aim, To provide an updated review of the epidemiology, diagnosis, staging and treatment of alcoholic hepatitis. Methods, A MEDLINE literature search was performed to identify pertinent articles. Relevant clinical abstracts were also reviewed. Results, Severe alcoholic hepatitis occurs in a small fraction of patients who abuse alcohol. The 28-day mortality ranges from 30% to 50% in most series. Diagnosis is generally based on clinical features, with a limited role for liver biopsy. Beneficial treatment options include alcohol abstinence and nutritional therapy. Despite variable results in clinical trials, corticosteroids and pentoxifylline appear to provide moderate survival benefit. Anti-tumour necrosis factor agents and antioxidants have not proven beneficial, and should be limited to clinical trials. Liver transplant is not a frequent option given the active or recent alcohol use. Conclusions, Severe alcoholic hepatitis is a clinically-diagnosed condition associated with significant mortality. Alcohol abstinence and nutritional therapy have been associated with improved clinical parameters and should be considered in all patients. Corticosteroid therapy and pentoxifylline therapy appear to show moderate survival benefit and should be considered as first-line therapeutic agents. [source]

The importance of family management, closeness with father and family structure in early adolescent alcohol use

ADDICTION, Issue 10 2010
Cherine Habib
ABSTRACT Aims To examine the importance of family management, family structure and father,adolescent relationships on early adolescent alcohol use. Design Cross-sectional data was collected across 30 randomly selected Australian communities stratified to represent a range of socio-economic and regional variation. Setting Data were collected during school time from adolescents attending a broad range of schools. Participants The sample consisted of a combined 8256 students (aged 10,14 years). Measurements Students completed a web-based survey as part of the Healthy Neighbourhoods project. Findings Family management,which included practices such as parental monitoring and family rules about alcohol use,had the strongest and most consistent relationship with alcohol use in early adolescence. Adolescents reporting higher family management were less likely to have drunk alcohol in their life-time, less likely to drink alcohol in the preceding 30 days and less likely to have had an alcohol binge. Adolescents reporting emotionally close relationships with their fathers were less likely to have drunk alcohol in their life-time and less likely to have had an alcohol binge in the preceding fortnight. Conclusions Findings indicate that family management practices may contribute to alcohol abstinence in adolescents. Furthermore, emotionally close father,adolescent relationships may also foster abstinence; however, fathers' drinking behaviours need to be considered. [source]

Attendance at Narcotics Anonymous and Alcoholics Anonymous meetings, frequency of attendance and substance use outcomes after residential treatment for drug dependence: a 5-year follow-up study

ADDICTION, Issue 1 2008
Michael Gossop
ABSTRACT Aims This study investigates the relationship between frequency of attendance at Narcotics Anonymous and Alcoholics Anonymous (NA/AA) meetings and substance use outcomes after residential treatment of drug dependence. It was predicted that post-treatment NA/AA attendance would be related to improved substance use outcomes. Methods Using a longitudinal, prospective cohort design, interviews were conducted with drug-dependent clients (n = 142) at intake to residential treatment, and at 1 year, 2 years and 4,5 years follow-up. Data were collected by structured interviews. All follow-up interviews were carried out by independent professional interviewers. Findings Abstinence from opiates was increased throughout the 5-year follow-up period compared to pre-treatment levels. Clients who attended NA/AA after treatment were more likely to be abstinent from opiates at follow-up. Abstinence from stimulants increased at follow-up but (except at 1-year follow-up) no additional benefit was found for NA/AA attendance. There was no overall change in alcohol abstinence after treatment but clients who attended NA/AA were more likely to be abstinent from alcohol at all follow-up points. More frequent NA/AA attenders were more likely to be abstinent from opiates and alcohol when compared both to non-attenders and to infrequent (less than weekly) attenders. Conclusions NA/AA can support and supplement residential addiction treatment as an aftercare resource. In view of the generally poor alcohol use outcomes achieved by drug-dependent patients after treatment, the improved alcohol outcomes of NA/AA attenders suggests that the effectiveness of existing treatment services may be improved by initiatives that lead to increased involvement and engagement with such groups. [source]

Headache prevalence related to smoking and alcohol use.

EUROPEAN JOURNAL OF NEUROLOGY, Issue 11 2006
The Head-HUNT Study
The aim of this study was to examine a possible association between smoking, alcohol and headache in a large population-based cross-sectional study. A total of 51 383 subjects completed a headache questionnaire and constituted the ,Head-HUNT' Study. Questionnaire-based information on smoking was available in 95% and on alcohol in 89% of the individuals. Associations were assessed in multivariate analyses, estimating prevalence odds ratios (ORs) with 95% confidence intervals (CI). Prevalence rates for headache were higher amongst smokers compared with never smokers, most evident for those under 40 years smoking more than 10 cigarettes per day (OR 1.5, 95% CI 1.3,1.6). Passive smoking was also associated with higher headache prevalence. For alcohol use, there was a tendency of decreasing prevalence of migraine with increasing amounts of alcohol consumption compared with alcohol abstinence. Only with regard to symptoms indicating alcohol overuse, a positive association with frequent headache was found. The association between headache and smoking found in the present study raises questions about a causal relationship, e.g. that smoking causes headache or that it allays stress induced by headache. The observed negative association between migraine and alcohol consumption is probably explained by the headache precipitating properties of alcohol. [source]

Preclinical and clinical pharmacology of alcohol dependence

FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 1 2007
Sophie Tambour
Abstract In recent years, advances in neuroscience led to the development of new medications to treat alcohol dependence and especially to prevent alcohol relapse after detoxification. Whereas the earliest medications against alcohol dependence were fortuitously discovered, recently developed drugs are increasingly based on alcohol's neurobiological mechanisms of action. This review discusses the most recent developments in alcohol pharmacotherapy and emphasizes the neurobiological basis of anti-alcohol medications. There are currently three approved drugs for the treatment of alcohol dependence with quite different mechanisms of action. Disulfiram is an inhibitor of the enzyme aldehyde dehydrogenase and acts as an alcohol-deterrent drug. Naltrexone, an opiate antagonist, reduces alcohol craving and relapse in heavy drinking, probably via a modulation of the mesolimbic dopamine activity. Finally, acamprosate helps maintaining alcohol abstinence, probably through a normalization of the chronic alcohol-induced hyperglutamatergic state. In addition to these approved medications, many other drugs have been suggested for preventing alcohol consumption on the basis of preclinical studies. Some of these drugs remain promising, whereas others have produced disappointing results in preliminary clinical studies. These new drugs in the field of alcohol pharmacotherapy are also discussed, together with their mechanisms of action. [source]

Understanding and Treating Patients With Alcoholic Cirrhosis: An Update

ALCOHOLISM, Issue 7 2009
Giovanni Addolorato
Alcoholic cirrhosis represents the terminal stage of alcoholic liver disease (ALD) and one of the main causes of death among alcohol abusers. The aim of this review was to provide an update on alcoholic cirrhosis, with an emphasis on recent findings. Increased alcohol consumption in developing countries is expected to increase cirrhosis mortality. There is a need, therefore, to develop new approaches to the prevention of ALD, including more attention to co-factors that may increase risk of ALD (i.e., obesity and diabetes, chronic HCV infection, and smoking). Furthermore, a better understanding of the pathological mechanisms on the basis of alcohol cirrhosis represents a cornerstone in order to develop new pharmacological treatments. Inflammatory and immune responses along with oxidative stress and alterations in adipokine secretion might contribute in different ways to the evolution of alcohol-induced fibrosis/cirrhosis. As of this date, patients with severe alcoholic hepatitis with a Maddrey Discriminant Factor (MDF) 32 should be offered pentoxifylline and/or corticosteroids unless contraindications exist. For ambulatory patients, S-adenosylmethionine (SAMe) may be considered in a motivated patient with nutritional support. Current studies do not support use of anti-tumor necrosis factor (TNF)-alpha antibody. Finally, achieving total alcohol abstinence should represent the main aim in the management of patients affected by any stage of cirrhosis. In the last decades, several drugs able to increase abstinence and prevent alcohol relapse have been evaluated and some of them have obtained approval for alcohol dependence. Patients with alcoholic cirrhosis; however, are usually excluded from such treatments. A recent study demonstrated the efficacy and safety of baclofen in inducing and maintaining alcohol abstinence in cirrhotic alcohol-dependent patients with cirrhosis. All together the information available suggests the need of a multimodal approach in the clinical management of these patients. [source]

Abstinence From Moderate Alcohol Self-Administration Alters Progenitor Cell Proliferation and Differentiation in Multiple Brain Regions of Male and Female P Rats

ALCOHOLISM, Issue 1 2009
Jun He
Background:, Acute and chronic ethanol exposure has been found to decrease hippocampal neurogenesis, reduce dendritic differentiation of new neurons, and increase cell death. Interestingly, abstinence from such treatment increases hippocampal neurogenesis and microglial genesis across several brain regions. The goal of the current investigation was to study cellular alterations on neuro- and cell-genesis during abstinence following alcohol self-administration using alcohol-preferring rats (P rats). Methods:, Male and female P rats were given the choice of drinking 10% alcohol in water or pure water for 7 weeks. Social interaction behavioral assessments were conducted at 5 hours upon removal of alcohol, followed by bromo-deoxyuridine (BrdU, 150 mg/kg × 1/d × 14 d) injections to label proliferating cells. Animals were then killed 4 weeks later to conduct immunohistochemical and confocal analyses using antibodies against BrdU and other phenotypic markers (NeuN for mature neurons; Iba-1 for microglia; GFAP for astrocytes; and NG2 for oligodendrocyte progenitors). Results:, Mild alcohol withdrawal anxiety was detected by reduction in social interactions. The number of hippocampal BrdU+ cells was increased approximately 50% during alcohol abstinence (26 ± 2.8 in controls vs. 39 ± 4 in alcohol group). BrdU+ cells were also increased in the substantia nigra (SN) approximately 65% in the alcohol abstinent group (12 ± 1 in controls vs. 19 ± 1.5 in alcohol group). No gender differences were found. Confocal analyses indicated that approximately 75% of co-localization of BrdU+ cells with NeuN in the hippocampal dentate gyrus (DG) resulting a net increase in neurogenesis in the alcohol abstinent group compared to controls. In cingulum, greater proportion of BrdU+ cells were co-localized with NG2 in the alcohol abstinent group indicating increased differentiation toward oligodendrocyte progenitors in both genders. However, the phenotype of the BrdU+ cells in SN and other brain regions were not identified by NeuN, Iba-1, GFAP, or NG2 suggesting that these BrdU+ cells probably remain in a nondifferentiated stage. Conclusions:, These data indicate that abstinence from moderate alcohol drinking increases hippocampal neurogenesis, cingulate NG2 differentiation, and SN undifferentiated cell proliferation in both males and females. Such cellular alteration during abstinence could contribute to the spontaneous partial restoration of cognitive deficits upon sobriety. [source]

Coffee and Cigarette Consumption and Perceived Effects in Recovering Alcoholics Participating in Alcoholics Anonymous in Nashville, Tennessee

ALCOHOLISM, Issue 10 2008
Michael S. Reich
Background:, Alcoholics Anonymous (AA) members represent an important and relatively understudied population for improving our understanding of alcohol dependence recovery as over 1 million Americans participate in the program. Further insight into coffee and cigarette use by these individuals is necessary given AA members' apparent widespread consumption and the recognized health consequences and psychopharmacological actions of these substances. Methods:, Volunteers were sought from all open-AA meetings in Nashville, TN during the summer of 2007 to complete a questionnaire (n = 289, completion rate = 94.1%) including timeline followback for coffee, cigarette, and alcohol consumption; the Alcoholics Anonymous Affiliation Scale; coffee consumption and effects questions; the Fagerstrom Test for Nicotine Dependence (FTND); and the Smoking Effects Questionnaire. Results:, Mean (±SD) age of onset of alcohol consumption was 15.4 ± 4.2 years and mean lifetime alcohol consumption was 1026.0 ± 772.8 kg ethanol. Median declared alcohol abstinence was 2.1 years (range: 0 days to 41.1 years) and median lifetime AA attendance was 1000.0 meetings (range: 4 to 44,209 meetings); average AA affiliation score was 7.6 ± 1.5. Most (88.5%) individuals consumed coffee and approximately 33% of coffee consumers drank more than 4 cups per day (M = 3.9 ± 3.9). The most common self-reported reasons for coffee consumption and coffee-associated behavioral changes were related to stimulatory effects. More than half (56.9%) of individuals in AA smoked cigarettes. Of those who smoked, 78.7% consumed at least half a pack of cigarettes per day (M = 21.8 ± 12.3). Smokers' FTND scores were 5.8 ± 2.4; over 60% of smokers were highly or very highly dependent. Reduced negative affect was the most important subjective effect of smoking. Conclusions:, A greater proportion of AA participants drink coffee and smoke cigarettes in larger per capita amounts than observed in general U.S. populations. The effects of these products as described by AA participants suggest significant stimulation and negative affect reduction. Fundamental knowledge of the quantitative and qualitative aspects of coffee and cigarette consumption among AA members will enable future research to discern their impact on alcohol abstinence and recovery. [source]

Antiglutamatergic Strategies for Ethanol Detoxification: Comparison With Placebo and Diazepam

ALCOHOLISM, Issue 4 2007
Evgeny M. Krupitsky
Background: Benzodiazepines are the standard pharmacotherapies for ethanol detoxification, but concerns about their abuse potential and negative effects upon the transition to alcohol abstinence drive the search for new treatments. Glutamatergic activation and glutamate receptor up-regulation contribute to ethanol dependence and withdrawal. This study compared 3 antiglutamatergic strategies for ethanol detoxification with placebo and to the benzodiazepine, diazepam: the glutamate release inhibitor, lamotrigine; the N -methyl- d -aspartate glutamate receptor antagonist, memantine; and the AMPA/kainite receptor inhibitor, topiramate. Methods: This placebo-controlled randomized single-blinded psychopharmacology trial studied male alcohol-dependent inpatients (n=127) with clinically significant alcohol withdrawal symptoms. Subjects were assigned to 1 of 5 treatments for 7 days: placebo, diazepam 10 mg TID, lamotrigine 25 mg QID, memantine 10 mg TID, or topiramate 25 mg QID. Additional diazepam was administered when the assigned medication failed to suppress withdrawal symptoms adequately. Results: All active medications significantly reduced observer-rated and self-rated withdrawal severity, dysphoric mood, and supplementary diazepam administration compared with placebo. The active medications did not differ from diazepam. Conclusions: This study provides the first systematic clinical evidence supporting the efficacy of a number of antiglutamatergic approaches for treating alcohol withdrawal symptoms. These data support the hypothesis that glutamatergic activation contributes to human alcohol withdrawal. Definitive studies of each of these medications are now needed to further evaluate their effectiveness in treating alcohol withdrawal. [source]