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Heavy Drinkers (heavy + drinker)
Selected AbstractsBehavioral economic analysis of cue-elicited craving for alcoholADDICTION, Issue 9 2010James MacKillop ABSTRACT Aims Craving as a motivational determinant of drug use remains controversial because of ambiguous empirical findings. A behavioral economic approach may clarify the nature of craving, theorizing that subjective craving functionally reflects an acute increase in a drug's value. The current study tested this hypothesis via a multidimensional assessment of alcohol demand over the course of an alcohol cue reactivity procedure. Design One-way within-subjects design. Setting Human laboratory environment. Participants Heavy drinkers (n = 92) underwent exposures to neutral (water) cues followed by personalized alcohol cues. Assessments Participants were assessed for craving, alcohol demand, affect, and salivation following each exposure. Findings Alcohol versus neutral cues significantly increased craving and multiple behavioral economic measures of the relative value of alcohol, including alcohol consumption under conditions of zero cost (intensity), maximum expenditure on alcohol (Omax), persistence in drinking to higher prices (breakpoint) and proportionate price insensitivity (normalized Pmax). Craving was significantly correlated with demand measures at levels ranging from 0.21,0.43. Conclusions These findings support the potential utility of a behavioral economic approach to understanding the role of environmental stimuli in alcohol-related decision making. Specifically, they suggest that the behavioral economic indices of demand may provide complementary motivational information that is related to though not entirely redundant with measures of subjective craving. [source] Alcohol Consumption, Alcohol Outlets, and the Risk of Being Assaulted With a GunALCOHOLISM, Issue 5 2009Charles C. Branas Background:, We conducted a population-based case,control study to better delineate the relationship between individual alcohol consumption, alcohol outlets in the surrounding environment, and being assaulted with a gun. Methods:, An incidence density sampled case,control study was conducted in the entire city of Philadelphia from 2003 to 2006. We enrolled 677 cases that had been shot in an assault and 684 population-based controls. The relationships between 2 independent variables of interest, alcohol consumption and alcohol outlet availability, and the outcome of being assaulted with a gun were analyzed. Conditional logistic regression was used to adjust for numerous confounding variables. Results:, After adjustment, heavy drinkers were 2.67 times as likely to be shot in an assault when compared with nondrinkers (p < 0.10) while light drinkers were not at significantly greater risk of being shot in an assault when compared with nondrinkers. Regression-adjusted analyses also demonstrated that being in an area of high off-premise alcohol outlet availability significantly increased the risk of being shot in an assault by 2.00 times (p < 0.05). Being in an area of high on-premise alcohol outlet availability did not significantly change this risk. Heavy drinkers in areas of high off-premise alcohol outlet availability were 9.34 times (p < 0.05) as likely to be shot in an assault. Conclusions:, This study finds that the gun assault risk to individuals who are near off-premise alcohol outlets is about the same as or statistically greater than the risk they incur from heavy drinking. The combination of heavy drinking and being near off-premise outlets resulted in greater risk than either factor alone. By comparison, light drinking and being near on-premise alcohol outlets were not associated with increased risks for gun assault. Cities should consider addressing alcohol-related factors, especially off-premise outlets, as highly modifiable and politically feasible approaches to reducing gun violence. [source] Effects of Alcohol Consumption on Disability among the Near Elderly: A Longitudinal AnalysisTHE MILBANK QUARTERLY, Issue 4 2001Jan Ostermann Data from four waves of the Health and Retirement Study are used to analyze the effects of alcohol use on disability, mortality, and income transfers from public programs. Cross-sectional analysis reveals a complex relationship, with a history of problem drinking clearly leading to higher rates of limitations, and a nonmonotonic relationship between current drinking and disability. In longitudinal analysis, problem drinking was predictive of disability onset, but not of transfer receipt or mortality. Heavy drinkers and problem drinkers, if anything, were less likely to receive public income support than abstainers or moderate drinkers. The likelihood that heavy drinkers received public transfers did not decrease relative to others following statutory changes in 1996 that sought to limit eligibility of alcoholics and drug abusers. [source] Heavy Drinking, Alcohol Dependence, and Injuries at Work Among Young Workers in the United States Labor ForceALCOHOLISM, Issue 12 2000Mark A. Veazie Background: To determine whether heavily drinking and alcohol-dependent workers are at higher risk of occupational injury, we analyzed the nationally representative cohort of people enrolled in the National Longitudinal Survey of Youth since 1979. Methods: This analysis was restricted to the 8569 respondents in the 1989 annual interview (age 24,32) who were employed during the 6 months before the interview. We studied occupational injuries (excluding sprains or strains) reported within 6 months of the interview in 1989 (cross-sectional analysis) and 1990 (prospective analysis). Results: Among current drinkers, significant two-fold increases in the odds of injury for one or more episodes of heavy drinking were reduced to an odds ratio (OR) of 1.2 (95% confidence interval [CI] = 0.7, 2.1) in the cross-sectional analysis and an OR of 1.6 (CI 1.0, 2.8) in the prospective analysis after adjustment for confounding. No dose-response relationship with the frequency of heavy drinking was found. Alcohol-dependent respondents were not at higher risk of injury in the cross-sectional (OR = 1.1, CI 0.7, 1.8) or prospective (OR = 1.3, CI 0.8, 2.2) analyses after adjustment for confounding. Conclusions: For young U.S. workers, common occupational injuries (excluding sprains and strains) may not be strongly associated with alcohol dependence. Confounding by other risk factors may explain much of the association between being a heavy drinker and occupational injuries in this population. [source] Association between alcohol consumption and serum dehydroepiandrosterone sulphate concentration in men with Type 2 diabetes: a link to decreased cardiovascular riskDIABETIC MEDICINE, Issue 10 2005M. Fukui Abstract Aims Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with Type 2 diabetes. Both light-to-moderate alcohol consumption and higher serum concentrations of dehydroepiandrosterone (DHEA) are associated with reduced CVD mortality, raising the possibility of DHEA as a causal intermediate in CVD and alcohol consumption. Methods Relationships between alcohol consumption and serum DHEA sulphate (DHEA-S) concentration, carotid atherosclerosis as evaluated by carotid ultrasonography and major cardiovascular risk factors were investigated in 404 consecutive men with Type 2 diabetes. Patients were divided into three groups according to mean ethanol consumption per week: non-drinkers, light-to-moderate drinkers (< 210 g per week) or heavy drinkers (, 210 g per week). Results Plasma HDL-cholesterol was positively associated with the degree of alcohol consumption. Intima-media thickness (0.92 ± 0.21 vs. 1.09 ± 0.35 mm, P < 0.0001) and plaque score (3.0 ± 3.3 vs. 5.2 ± 4.9, P = 0.008) were lower in light-to-moderate drinkers than in non-drinkers. Serum DHEA-S concentrations were higher in light-to-moderate drinkers (1264.2 ± 592.2 ng/ml, P < 0.0001) and heavy drinkers (1176.2 ± 607.6 ng/ml, P = 0.0100) than in non-drinkers (956.8 ± 538.6 ng/ml). In a subgroup aged 60,75-year-old patients (n = 277), serum DHEA-S concentrations were higher in light-to-moderate drinkers (1126.8 ± 502.5 ng/ml, P = 0.0121) than in non-drinkers (937.9 ± 505.1 ng/ml). Also, in a subgroup without CVD (n = 339), serum DHEA-S concentrations were higher in light-to-moderate drinkers (1328.5 ± 593.7 ng/ml, P < 0.0001) than in non-drinkers (970.1 ± 540.7 ng/ml). Conclusions Higher serum DHEA-S concentrations in light-to-moderate drinkers may represent part of the link between light-to-moderate alcohol consumption and lower CVD mortality. [source] Towards an understanding of the high death rate among young people with diabetes in UkraineDIABETIC MEDICINE, Issue 1 2001M. Telishevka SUMMARY Aims Published rates of deaths attributed to diabetes mellitus among those aged under 50 have risen substantially in several former Soviet republics since the late 1980s. The reasons for this increase, and the situation facing patients with diabetes in these countries are poorly understood. The aim of this study was to describe the circumstances leading up to the death of individuals dying under the age of 50 years with mention of diabetes on their death certificate. Methods Interviews with surviving relatives or neighbours, combining elements of verbal autopsy and confidential enquiry. For those who had lived in the city of Lviv a random sample was taken. For those in rural areas a purposive sample was used to ensure coverage of more and less remote areas. Results Key informants were identified and agreed to be interviewed for 64 individuals out of a possible 79 with insulin-treated diabetes identified from their death certificates. The main immediate causes of death were renal failure (69%), ischaemic heart disease (9%), ketoacidosis (6%) and hypoglycaemia (3%). Over a third of men, but no women, were reported to have been heavy drinkers. Informants described many difficulties in obtaining regular supplies of insulin and related supplies since 1990. Although insulin is officially available free of charge, most had retained supplies for use in an emergency. More than half had, at some time, purchased supplies. The large number of deaths from renal failure reflects the effective absence of renal replacement therapy for patients with diabetes. Conclusions Individuals with diabetes in Ukraine face profound challenges involving access to necessary care. Their needs require significantly more attention from policy makers. [source] Injury and alcohol: a hospital emergency department studyDRUG AND ALCOHOL REVIEW, Issue 2 2001ANN M. ROCHE Abstract A pilot survey was undertaken of injury presentations to a public hospital emergency department to determine patterns of alcohol use in this population. Of the 402 injury presentations in the study period, a total of 236 injury cases were interviewed, of whom 45% (n = 107) and 29% (n = 69) had consumed alcohol 24 and 6 hours prior to injury. Mean age for all injury presentations was 35.1 years, and 32.6 years for alcohol injury cases. For both injury groups, males were significantly younger than females. Recent alcohol ingestion was three times more common among male than female injury presentations, but with females drinking at significantly lower levels. Of males who had consumed alcohol 6 hours prior to injury, nearly 70% were drinking at NHMRC harmful levels and 61% had drunk more than eight standard drinks. Overall, alcohol-involved injury cases commonly occurred among low-income, single males around 30 years of age who were regular heavy drinkers who were drinking heavily in licensed premises prior to their injury, and who sustained injury through intentional harm. In addition, one in five of the alcohol-involved injury cases were aged 15,18 years, i.e. below the legal age of purchase. The high proportion of hazardous and harmful drinkers among those who had consumed alcohol within the last 6 hours, and the injury sample overall, highlights the need for further research to explore the relationship between the occurrence of injury and the drinking patterns and environments associated with injury. Further research is also required to assess the efficacy of early and brief interventions for alcohol and drug use within the emergency ward setting. This information would enable appropriate public health interventions to be initiated. [source] Initial, habitual and compulsive alcohol use is characterized by a shift of cue processing from ventral to dorsal striatumADDICTION, Issue 10 2010Sabine Vollstädt-Klein ABSTRACT Aims During the development of drug addiction, initial hedonic effects decrease when substance use becomes habitual and ultimately compulsive. Animal research suggests that these changes are represented by a transition from prefrontal cortical control to subcortical striatal control and within the striatum from ventral to dorsal domains of the striatum, but only limited evidence exists in humans. In this study we address this hypothesis in the context of alcohol dependence. Design, setting and participants Non-abstinent heavy social drinkers (n = 21, 5.0 ± 1.5 drinks/day, 13 of them were alcohol-dependent according to DSM-IV) and light social drinkers (n = 10, 0.4 ± 0.4 drinks/day) were examined. Measurements We used a cue-reactivity functional magnetic resonance imaging (fMRI) design during which pictures of alcoholic beverages and neutral control stimuli were presented. Findings In the dorsal striatum heavy drinkers showed significant higher activations compared to light drinkers, whereas light social drinkers showed higher cue-induced fMRI activations in the ventral striatum and in prefrontal areas compared to heavy social drinkers [region of interest analyses, P < 0.05 false discovery rate (FDR)-corrected]. Correspondingly, ventral striatal activation in heavy drinkers correlated negatively with obsessive-compulsive craving, and furthermore we found a positive association between cue-induced activation in the dorsal striatum and obsessive-compulsive craving in all participants. Conclusions In line with our hypothesis we found higher cue-induced activation of the ventral striatum in social compared to heavy drinkers, and higher dorsal striatal activation in heavy drinkers. Increased prefrontal activation may indicate that social drinkers activate cortical control when viewing alcohol cues, which may prevent the development of heavy drinking or alcohol dependence. Our results suggest differentiating treatment research depending on whether alcohol use is hedonic or compulsive. [source] ADH1B*2 allele is protective against alcoholism but not chronic liver disease in the Hungarian populationADDICTION, Issue 5 2010Reka Toth ABSTRACT Background Standardized death rates from chronic liver diseases (CLDs) in Hungary are much higher than the European Union average. Carrying the alcohol dehydrogenase 1B 48His allele (rs1229984 or ADH1B*2) could decrease the risk of alcoholism, but with persistent drinking may confer a greater risk of CLDs. The aim of this study was to assess the prevalence of this polymorphism in the Hungarian population and its association with alcohol consumption and with CLDs. Methods and results A total of 278 cases with diagnosed CLDs and 752 controls without any alterations in liver function, all males aged 45,64, were screened for ADH1B Arg48His polymorphism. ADH1B*2 allele frequencies in controls and cases were 8.31% and 4.50%, respectively (,2 = 9.2; P = 0.01). Carrying the ADH1B*2 allele was associated with significantly lower odds ratio (OR) for drinking frequency (OR = 0.63; P = 0.003), the number of positive answers on CAGE (Cut-down, Annoyed, Guilt, Eye-opener) assessment (OR = 0.58; P = 0.005) and a positive CAGE status (OR = 0.55; P = 0.007). There was a significant association between ADH1B*2 and CLDs (OR = 0.50; P = 0.003), but it disappeared after adjusting for CAGE status and scores (OR = 0.67 P = 0.134; OR = 0.67 P = 0.148, respectively) and weakened after adjusting for drinking frequency (OR = 0.61; P = 0.045). Among heavy drinkers the presence of ADH1B*2 did not increase the risk of cirrhosis but there was a significant interaction between genotype and CAGE status (P = 0.003, P = 0.042), with ADH1B*2 conferring reduced risk of CLDs in CAGE negatives. Conclusion In Hungarians, the ADH1B 48His allele reduces the risk of alcoholism, but not the risk of chronic liver disease among heavy drinkers. [source] Predictors of hangover during a week of heavy drinking on holidayADDICTION, Issue 3 2010Morten Hesse ABSTRACT Aims To investigate predictors of hangover during a week of heavy drinking in young adults. Design Observational prospective study. Methods A total of 112 young Danish tourists were interviewed on three occasions during their holiday. They completed the Acute Hangover Scale and answered questions about their alcohol consumption and rest duration. The incidence of hangover was analysed as the proportion of heavy drinkers (i.e. those reporting drinking more than 12 standard units of alcohol during the night before) scoring above the 90th percentile of light drinkers (i.e. those who had consumed fewer than seven standard units the night before). We estimated the course and predictors of hangover using random effects regression. Results The incidence of hangover was 68% after drinking more than 12 standard units in the whole sample. The severity of hangover increased significantly during a week of heavy drinking and there was a time × number of drinks interaction, indicating that the impact of alcohol consumed on hangover became more pronounced later in the week. Levels of drinking before the holiday did not predict hangover. Conclusions Hangovers after heavy drinking during holidays appear to be related both to amount drunk and time into the holiday. [source] Ethyl glucuronide in hair.ADDICTION, Issue 6 2009A sensitive, specific marker of chronic heavy drinking ABSTRACT Aims This study aims to define a cut-off concentration for ethyl glucuronide in hair to determine if there was a history of heavy drinking. Settings Pavia, Italy. Participants We analysed hair samples from 98 volunteers among teetotallers, social drinkers and heavy drinkers, whose ethanol daily intake (EDI) was estimated by means of a written questionnaire. Measurements Ethyl glucuronide hair concentration (HEtG) was measured by liquid chromatography-tandem mass spectrometry (lower limit of quantification: 3 pg/mg) using a fully validated method. Findings The HEtG level providing the best compromise between sensitivity (0.92) and specificity (0.96) at detecting an EDI of 60 g or higher during the last 3 months was 27 pg/mg. None of the factors examined among those known to affect ethanol metabolism and/or the diagnostic power of other markers of ethanol use or hair analyses, including age, gender, body mass index, tobacco smoke, prevalent beverage, hair colour, cosmetic treatments and hygienic habits was found to influence marker performance significantly. However, the slight differences in HEtG performance observed for some factors (e.g. body mass index, smoke and hair treatments) require further studies on larger groups of individuals in order to assess their influence more precisely. Conclusions Our results confirm further that HEtG is a sensitive and specific marker of chronic heavy drinking. [source] Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004ADDICTION, Issue 4 2009Pia Mäkelä ABSTRACT Aims To review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average. Design A review of published research and routinely available data. Setting Finland. Measurements Prices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use. Findings Alcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004,06 compared to 2001,03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular. Conclusions Alcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland. [source] Alcohol consumption patterns and risk factors among childhood cancer survivors compared to siblings and general population peersADDICTION, Issue 7 2008E. Anne Lown ABSTRACT Aims This study describes alcohol consumption among adult survivors of pediatric cancer compared to sibling controls and a national sample of healthy peers. Risk factors for heavy drinking among survivors are described. Design, setting and participants Cross-sectional data were utilized from the Childhood Cancer Survivor Study including adult survivors of pediatric cancer (n = 10 398) and a sibling cohort (n = 3034). Comparison data were drawn from the National Alcohol Survey (n = 4774). Measurement Alcohol consumption, demographic, cancer diagnosis, treatment and psychosocial factors were measured. Findings Compared to peers, survivors were slightly less likely to be risky [adjusted odds ratio (ORadj) = 0.9; confidence interval (CI) 0.8,1.0] and heavy drinkers (ORadj = 0.8; CI 0.7,0.9) and more likely to be current drinkers. Compared to siblings, survivors were less likely to be current, risky and heavy drinkers. Risk factors for survivors' heavy drinking included being age 18,21 years (ORadj = 2.0; 95% CI 1.5,2.6), male (ORadj = 2.1; 95% CI 1.8,2.6), having high school education or less (ORadj = 3.4; 95% CI 2.7,4.4) and drinking initiation before age 14 (ORadj = 6.9; 95% CI 4.4,10.8). Among survivors, symptoms of depression, anxiety or somatization, fair or poor self-assessed health, activity limitations and anxiety about cancer were associated with heavy drinking. Cognitively compromising treatment, brain tumors and older age at diagnosis were protective. Conclusions Adult survivors of childhood cancer show only a modest reduction in alcohol consumption compared to peers despite their more vulnerable health status. Distress and poorer health are associated with survivor heavy drinking. Screening for alcohol consumption should be instituted in long-term follow-up care and interventions among survivors and siblings should be established to reduce risk for early drinking. [source] Attentional re-training decreases attentional bias in heavy drinkers without generalizationADDICTION, Issue 3 2007Tim Schoenmakers ABSTRACT Aims To examine whether alcohol-related attentional bias (AB) can be reduced by training heavy drinkers to attend to soft drinks as an alternative to alcohol. Diminishing AB is important because AB has been suggested to be a significant factor in the development, maintenance and relapse of addictive behaviours. AB was trained in a clinically relevant design, and we studied the generalization of this training. Design, participants and intervention We assigned randomly 106 heavy drinking male college and university students to the attentional re-training (AR; modified visual-probe task) or control condition (standard visual-probe task). Setting Laboratory at Maastricht University. Measurements We measured the effects of AR on the visual-probe task with stimuli that were presented in the AR and with new stimuli, and on an alternative measure of AB, the flicker paradigm. We further measured effects on craving and preference for either an alcohol beverage or a soft drink. Findings After AR, participants had learned to avoid alcohol stimuli and had developed an AB for soft drinks. This effect was restricted to stimuli used in the AR. The flicker task, where AB for alcohol was found in both the AR and control groups, was not affected by the AR. No effect was found on craving and the preference task. Conclusions Although heavy drinkers can learn to attend selectively to an alternative category for alcohol, a single AR is not sufficient to decrease symptoms of problem drinking. [source] Family members of relatives with alcohol, drug and gambling problems: a set of standardized questionnaires for assessing stress, coping and strainADDICTION, Issue 11 2005Jim Orford ABSTRACT Aims To describe a set of standard questionnaire measures for the assessment of the needs of family members of relatives with alcohol, drug or gambling problems, and to present evidence of their reliability and validity from a series of related studies. Design Includes cross-sectional and repeated-measurement studies. Setting and participants Family members affected by and concerned about the problem drinking or drug-taking of close relatives in treatment and non-treatment samples in the United Kingdom (white and Sikh) and Mexico City; family members of untreated heavy drinkers; and family members of problem gamblers. Measurements Four measures derived from a stress,strain,coping,support model of alcohol, drugs and gambling problems and the family: Family Member Impact scale (FMI), Symptom Rating Test (SRT), Coping Questionnaire (CQ), and Hopefulness,Hopelessness scale (HOPE). FMI, SRT and CQ assess stress, strain and coping, respectively. The exact role of HOPE in the model remains to be determined. The support component remains unmeasured. Findings Results from a number of studies support the internal reliability, discriminant and construct validity and sensitivity to change of the SRT and its two constituent scales (psychological and physical symptoms) and at least two subscales of the CQ (engaged and tolerant,inactive coping). Although showing evidence of satisfactory reliability and some evidence of discriminant validity, further work may be required on the CQ withdrawal coping subscale. Evidence suggests that the FMI is reliable and valid and may have a factor structure that will support future research (distinguishing worrying behaviour from active disturbance). HOPE is a new measure showing promising characteristics. Conclusions A set of standard measures is available for helping to assess the needs of concerned and affected family members, derived from an explicit model of the family in relation to excessive drinking, drug taking or gambling. It may have a role to play in correcting the current neglect of the needs of such family members, estimated to be in the region of nearly a million adults in Britain alone. [source] GENETIC STUDY: Polymorphisms of the dopamine D4 receptor gene (DRD4 VNTR) and cannabinoid CB1 receptor gene (CNR1) are not strongly related to cue-reactivity after alcohol exposureADDICTION BIOLOGY, Issue 2 2007Esther Van Den Wildenberg ABSTRACT Polymorphisms in the D4 dopamine receptor gene (DRD4) and the CB1 cannabinoid receptor gene (CNR1) have been associated with a differential response to alcohol after consumption. The goal of the present study was to investigate whether heavy drinkers with these polymorphisms would respond with enhanced cue-reactivity after alcohol exposure. Eighty-eight male heavy drinkers were genotyped for the DRD4 variable number of tandem repeats (VNTR) [either DRD4 long (L) or short (S)] and the CNR1 rs2023239 polymorphism (either CT/CC or TT). Participants were exposed to water and beer in 3-minute trials. Dependent variables of main interest were subjective craving for alcohol, subjective arousal and salivary reactivity. Overall, no strong evidence was found for stronger cue-reactivity (= outcome difference between beer and water trial) in the DRD4 L and CNR1 C allele groups. The DRD4 VNTR polymorphism tended to moderate salivary reactivity such that DRD4 L participants showed a larger beverage effect than the DRD4 S participants. Unexpectedly, the DRD4 L participants reported, on average, less craving for alcohol and more subjective arousal during cue exposure, compared with the DRD4 S participants. As weekly alcohol consumption increased, the CNR1 C allele group tended to report more craving for alcohol during the alcohol exposure than the T allele group. The DRD4 and CNR1 polymorphisms do not appear to strongly moderate cue-reactivity after alcohol cue exposure, in male heavy drinkers. [source] Alcohol inflammation and coronary heart diseaseADDICTION BIOLOGY, Issue 3 2003ARMIN IMHOF This overview summarizes the experimental and epidemiological evidence linking alcohol consumption and the immune system. It focuses on findings supporting the notion that moderate alcohol consumption exerts anti-inflammatory effects which may explain, at least in part, the reduced risk of coronary heart disease morbidity and mortality in these subjects. Alcohol consumption has been shown consistently to be associated with all-cause mortality in a J- or U-shaped manner. This is due primarily to reduced risk of coronary heart disease (CHD) mortality among moderate consumers of alcohol compared to abstainers and heavy drinkers. Several mechanisms have been suggested by which moderate alcohol consumption could lower risk of CHD. However, changes in lipids, such as increased HDL cholesterol and apolipoprotein A1 or a favourable haemostatic profile, can only partly explain the beneficial effects. Recently, anti-inflammatory effects of moderate intake of alcohol have been considered as an additional possible explanation, as inflammation has a fundamental role in the initiation, progression and the thrombotic complications of atherosclerosis. [source] Antiplatelet drug use preceding the onset of intracerebral hemorrhage is associated with increased mortalityFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2007Karine Lacut Abstract Recent studies highlight the contribution of antiplatelet therapy to clinical severity and increased mortality of intracerebral hemorrhage (ICH) but results are discrepant. The aim of this report was to evaluate the association between antiplatelet drug use preceding the onset of ICH and the mortality, assessed at regular intervals, among patients with acute ICH. We analyzed data from a randomized study which enrolled consecutive patients with a documented acute ICH to evaluate the efficacy of intermittent pneumatic compression of the legs in venous thrombosis prevention. Clinical characteristics and treatment used before the onset of ICH were checked at the time of inclusion. Mortality was assessed at regular intervals until 3 months after ICH diagnosis. Among 138 patients included in this report, 30 were current users of antiplatelet therapy at the time of ICH; they were significantly older and less frequently heavy drinkers than non-users of antiplatelet drugs. Mortality rates were 20% at 8 days, 40% at 1 month, and 47% at 3 months among antiplatelet drug users compared with 6.5%, 13% and 19% among non-users. The corresponding estimated risks for mortality related to antiplatelet drug use were 3.6 (95% CI 1.1,12), 4.5 (95% CI 1.8,11), and 3.6 (95% CI 1.5,8.6). Adjusted for age, hypertension and alcohol over use, antiplatelet therapy remained significantly associated with an increased mortality rate of acute ICH. Current antiplatelet drug use preceding the onset of ICH is associated with increased short-term ICH mortality, independently of age. [source] Rats bred for high alcohol drinking are more sensitive to delayed and probabilistic outcomesGENES, BRAIN AND BEHAVIOR, Issue 7 2008C. J. Wilhelm Alcoholics and heavy drinkers score higher on measures of impulsivity than nonalcoholics and light drinkers. This may be because of factors that predate drug exposure (e.g. genetics). This study examined the role of genetics by comparing impulsivity measures in ethanol-naive rats selectively bred based on their high [high alcohol drinking (HAD)] or low [low alcohol drinking (LAD)] consumption of ethanol. Replicates 1 and 2 of the HAD and LAD rats, developed by the University of Indiana Alcohol Research Center, completed two different discounting tasks. Delay discounting examines sensitivity to rewards that are delayed in time and is commonly used to assess ,choice' impulsivity. Probability discounting examines sensitivity to the uncertain delivery of rewards and has been used to assess risk taking and risk assessment. High alcohol drinking rats discounted delayed and probabilistic rewards more steeply than LAD rats. Discount rates associated with probabilistic and delayed rewards were weakly correlated, while bias was strongly correlated with discount rate in both delay and probability discounting. The results suggest that selective breeding for high alcohol consumption selects for animals that are more sensitive to delayed and probabilistic outcomes. Sensitivity to delayed or probabilistic outcomes may be predictive of future drinking in genetically predisposed individuals. [source] Genetic polymorphisms in the tobacco smoke carcinogens detoxifying enzyme UGT1A7 and the risk of head and neck cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 10 2009Martin Lacko MD Abstract Background. UGT1A7 is an enzyme involved in the metabolism of (pre)carcinogens present in tobacco smoke. We investigated whether genetic polymorphisms in UGT1A7, with predicted altered enzyme activity, may have a risk-modifying effect on head and neck carcinogenesis. Methods. Blood samples from 427 patients with oral, pharyngeal, and laryngeal carcinoma and 420 healthy control subjects were investigated for UGT1A7 polymorphisms. Based on these polymorphisms, patients and controls were divided according to predicted enzyme activity (low, intermediate, high). Results. Logistic regression analysis showed a significant increased distribution of predicted high activity UGT1A7 polymorphisms among the patients (OR:1.44; 95% CI: 1.07,1.93). Stratified analyses demonstrated that high activity UGT1A7 polymorphisms were even more significantly present in patients with laryngeal cancer, older patients, heavy smokers, and heavy drinkers when compared with the control subjects. Conclusions. Predicted high activity UGT1A7 polymorphisms were significantly associated with an increased risk of head and neck cancer. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Genetic polymorphisms in alcohol metabolism, alcohol intake and the risk of stomach cancer in Warsaw, PolandINTERNATIONAL JOURNAL OF CANCER, Issue 9 2007Fang Fang Zhang Abstract Genetic variations increasing blood levels of acetaldehyde, the first metabolite of alcohol, refrain their carriers from drinking alcohol but may also put them at increased risk of cancer because of the mutagenic and carcinogenic effect of acetaldehyde. In a population-based study of 305 cases and 428 controls in Warsaw, Poland, we evaluated the effect of polymorphisms in alcohol metabolizing genes, including ADH1B (Ex9+5C>T, Ex3+23A>G, Ex3+58A>T and Ex9+77A>G), ADH1C (Ex8-56A>G and Ex6-14G>A) and ALDH2 (Ex1+82A>G), on levels of alcohol drinking and susceptibility of stomach cancer. We found that among control subjects frequency of alcohol drinking varied by alcohol metabolizing genotype. In particular, the weekly consumption of individuals carrying the AA, GA and GG genotypes of ALDH2 Ex1+82A >G polymorphism were 3.75, 2.26 and 1.53 drinks, respectively (p= 0.04). However, none of the assessed polymorphisms in these 3 genes had a measurable effect on stomach cancer risk. When stratified by ALDH2 Ex1+82A>G polymorphism, alcohol-related increases in stomach cancer risk were restricted to individuals with the AG/GG genotypes, with a more than 2-fold risk among daily drinkers (OR = 2.63, 95% CI = 1.00,6.88) and 3-fold risk (OR = 3.66, 95% CI = 1.19,11.24) among those with 40 or more drink-years. In summary, our results suggested that the ALDH2 Ex1+82 G allele may be functionally deficient in eliminating acetaldehyde and discourage alcohol drinking. Furthermore, heavy drinkers of alcohol who were genetically prone to accumulate acetaldehyde may face an increased risk of stomach cancer. © 2007 Wiley-Liss, Inc. [source] Self-Deception and Responsibility for AddictionJOURNAL OF APPLIED PHILOSOPHY, Issue 2 2003Neil Levy ABSTRACT We frequently accuse heavy drinkers and drug users of self-deception if they refuse to admit that they are addicted. However, given the ways in which we usually conceptualize it, acknowledging addiction merely involves swapping one form of self-deception for another. We ask addicts to see themselves as in the grip of an irresistible desire, and to accept that addiction is an essentially physiological process. To the extent this is so, we, as much as the addicts, suffer from self-deception, and the responsibility for their state is in part ours. Conversely, since addicts are compelled to accept a self-deceptive image of themselves, they are at least partially excused from blame for their self-deception. [source] Naltrexone Selectively Elevates GABAergic Neuroactive Steroid Levels in Heavy Drinkers With the ASP40 Allele of the OPRM1 Gene: A Pilot InvestigationALCOHOLISM, Issue 8 2010Lara A. Ray Background:, Preclinical studies have implicated GABAergic neurosteroids in behavioral responses to alcohol. Naltrexone is thought to blunt the reinforcing effects of alcohol, and a few studies have found that the effects of naltrexone are moderated by the Asn40Asp polymorphisms of the OPRM1 gene. The present study seeks to integrate these lines of research by testing (i) the moderating role of the functional Asn40Asp polymorphism of the OPRM1 gene on naltrexone-induced alternations in GABAergic neurosteroid levels, namely (3,,5,)-3-hydroxypregnan-20-one (allopregnanolone, ALLO); and (ii) the combined effects of naltrexone or genotype with alcohol administration on neurosteroid levels in a sample of at-risk drinkers. Methods:, Participants were 32 (9 females) nontreatment-seeking heavy drinkers who completed a placebo-controlled laboratory study of naltrexone (50 mg/d for 3 days) and provided complete sets of serum samples for ALLO assays before and after alcohol administration under both naltrexone and placebo conditions. Results:, Naltrexone treatment raised ALLO levels among carriers of the Asp40 allele, but not homozygotes for the Asn40 allele. The Asn40Asp polymorphism did not moderate effects of naltrexone on cortisol levels. Ethanol infusion modestly reduced ALLO levels in all subjects, independent of genotype or naltrexone exposure. Conclusions:, Naltrexone increased ALLO levels among individuals with the Asn40Asp allele suggesting a potential neurosteroid contribution to the neuropharmacological effects of naltrexone among Asp40 carriers. [source] Up-Regulation and Functional Effect of Cardiac ,3 -Adrenoreceptors in Alcoholic MonkeysALCOHOLISM, Issue 7 2010Heng-Jie Cheng Background:, Recent studies link altered cardiac ,-adrenergic receptor (AR) signaling to the pathology of alcoholic cardiomyopathy (ACM). However, the alteration and functional effect of ,3 -AR activation in ACM are unknown. We tested the hypothesis that chronic alcohol intake causes an up-regulation of cardiac ,3 -AR, which exacerbates myocyte dysfunction and impairs calcium regulation, thereby directly contributing to the progression of ACM. Methods:, We compared myocyte ,3 - and ,1 -AR expression and myocyte contractile ([Ca2+]i), transient ([Ca2+]iT), and Ca2+ current (ICa,L) responses to ,- and ,3 -AR stimulation in myocytes obtained from left ventricle (LV) tissue samples obtained from 10 normal control (C) and 16 monkeys with self-administered alcohol for 12 months prior to necropsy: 6 moderate (M) and 10 heavy (H) drinkers with group average alcohol intakes of 1.5 ± 0.2 and 3.3 ± 0.2 g/kg/d, respectively. Results:, Compared with control myocytes (C), in alcoholic cardiomyocytes, basal cell contraction (dL/dtmax, ,39%, H: 69.8 vs. C: 114.6 ,m/s), relaxation (dR/dtmax, ,37%, 58.2 vs. 92.9 ,m/s), [Ca2+]iT (,34%, 0.23 vs. 0.35), and ICa,L (,25%, 4.8 vs. 6.4pA/pF) were all significantly reduced. Compared with controls, in moderate and heavy drinkers, ,1 -AR protein levels decreased by 23% and 42%, but ,3 -AR protein increased by 46% and 85%, respectively. These changes were associated with altered myocyte functional responses to ,-AR agonist, isoproterenol (ISO), and ,3 -AR agonist, BRL-37344 (BRL). Compared with controls, in alcoholic myocytes, ISO (10,8 M) produced significantly smaller increases in dL/dtmax (H: 40% vs. C: 71%), dR/dtmax (37% vs. 52%), [Ca2+]iT (17% vs. 37%), and ICa,L (17% vs. 27%), but BRL (10,8 M) produced a significantly greater decrease in dL/dtmax (H: ,23% vs. C: ,11%), [Ca2+]iT (,30% vs. ,11%), and ICa,L (,28% vs. ,17%). Conclusions:, Chronic alcohol consumption down-regulates cardiac ,1 - and up-regulates ,3 -ARs, contributing to the abnormal response to catecholamines in ACM. The up-regulation of cardiac ,3 -AR signaling enhances inhibition of LV myocyte contraction and relaxation and exacerbates the dysfunctional [Ca2+]i regulation and, thus, may precede the development of ACM. [source] Intoxication With Bourbon Versus Vodka: Effects on Hangover, Sleep, and Next-Day Neurocognitive Performance in Young AdultsALCOHOLISM, Issue 3 2010Damaris J. Rohsenow Background:, This study assessed the effects of heavy drinking with high or low congener beverages on next-day neurocognitive performance, and the extent to which these effects were mediated by alcohol-related sleep disturbance or alcoholic beverage congeners, and correlated with the intensity of hangover. Methods:, Healthy heavy drinkers age 21 to 33 (n = 95) participated in 2 drinking nights after an acclimatization night. They drank to a mean of 0.11 g% breath alcohol concentration on vodka or bourbon one night with matched placebo the other night, randomized for type and order. Polysomnography recordings were made overnight; self-report and neurocognitive measures were assessed the next morning. Results:, After alcohol, people had more hangover and more decrements in tests requiring both sustained attention and speed. Hangover correlated with poorer performance on these measures. Alcohol decreased sleep efficiency and rapid eye movement sleep, and increased wake time and next-day sleepiness. Alcohol effects on sleep correlated with hangover but did not mediate the effects on performance. No effect of beverage congeners was found except on hangover severity, with people feeling worse after bourbon. Virtually no sex differences appeared. Conclusions:, As drinking to this level affects complex cognitive abilities, safety could be affected, with implications for driving and for safety-sensitive occupations. Congener content affects only how people feel the next day so does not increase risk. The sleep disrupting effects of alcohol did not account for the impaired performance so other mechanisms of effect need to be sought. As hangover symptoms correlate with impaired performance, these might be contributing to the impairment. [source] Association Analyses of Genetic Polymorphisms of GSTM1, GSTT1, NQO1, NAT2, LPL, PRSS1, PSTI, and CFTR With Chronic Alcoholic Pancreatitis in JapanALCOHOLISM, Issue 2010Katsuya Maruyama Background:, Excessive consumption of alcohol is involved in the onset of pancreatitis. However, most of heavy drinkers do not always develop chronic pancreatitis. Various genetic factors appear to be involved in these individual differences in onset of chronic alcoholic pancreatitis. Here we investigated a possible association of alcoholic pancreatitis with polymorphisms of the various genes belong to the phase II detoxification enzymes responsible for metabolism of the oxidative compounds, and the several genes that have relevance to inherited pancreatitis. Methods:, The subjects consisted of 53 patients with chronic alcoholic pancreatitis, 54 alcoholic patients without pancreatic dysfunction, and 42 healthy individuals. DNA was extracted from the peripheral nucleated blood cells of all subjects and genetic mutations and subtypes were analyzed by the PCR and RFLP methods. We examined the correlation between chronic alcoholic pancreatitis and variants of the phase II detoxification enzymes such as Glutathione S-transferase M1 (GSTM1), glutathione S-transferase theta 1 (GSTT1), NADPH-quinone oxidoreductase 1 (NQO1), and N-acetyl transferase (NAT2). In addition, genes of lipoprotein lipase (LPL), cationic trypsinogen (PRSS1), pancreatic secretory trypsin inhibitor (PSTI), and cystic fibrosis transmembrane conductance regulator (CFTR) were also analyzed. Results:, Frequencies of the gene deletion of GSTM1 and GSTT1 in addition to the C-allele frequency of NQO1 tended to be higher in the alcoholic patients with (AlCP) or without pancreatic dysfunction (Alc) than in the healthy controls although the difference was not significant. The NAT2 gene showed no relation with Alc and AlCP patients. PSTI, LPL, PRSS1, and CFTR genes presented no association with chronic alcoholic pancreatitis. Conclusions:, All genes analyzed in the present study lacked association with chronic alcoholic pancreatitis. However, the gene deletion of GSTM1 and GSTT1, and the C-allele of NQO1 cannot be ruled out for association with alcoholism. [source] Students' Drinker Prototypes and Alcohol Use in a Naturalistic SettingALCOHOLISM, Issue 1 2010Renske Spijkerman Background:, Perceptions about the type of people who drink, also referred to as drinker prototypes, may strengthen young people's motivation to engage in alcohol use. Previous research has shown that drinker prototypes are related to alcohol consumption in both adolescents and young adults. However, the evidence for the strength of these relationships remains inconclusive. One of the caveats in former studies is that all insights about prototype relations are based on self-reported data from youngsters themselves, mostly gathered in a class situation, which may contain bias due to memory distortions and self-presentation concerns. Methods:, The present study examined the impact of drinker prototypes on young adults' drinking patterns by using a less obtrusive measure to assess alcohol consumption, i.e. ad lib drinking among friend groups in the naturalistic setting of a bar lab. Drinker prototypes, self-reported alcohol use in the past, and observed alcohol intake in the bar lab were assessed among 200 college students. Relations between participants' drinker prototypes and their self-reported and observed drinking behavior were examined by computing correlations and conducting multilevel analyses. Results:, Drinker prototypes were related to both self-reported and observed alcohol use. However, the drinking patterns of friend group members had a strong impact on participants' individual drinking rates in the bar lab. After these group effects had been controlled for, only heavy drinker prototypes showed relations with observed alcohol intake in the bar lab. Conclusions:, These findings further establish the value of drinker prototypes in predicting young adults' drinking behavior and suggest that people's motivation to drink alcohol in real-life drinking situations is related to their perceptions about heavy drinkers. [source] Immunoglobulin-E Reactivity to a Glycosylated Food Allergen (Peanuts) Due to Interference With Cross-Reactive Carbohydrate Determinants in Heavy DrinkersALCOHOLISM, Issue 8 2009C. Vidal Background:, N-glycans in plant and invertebrate glycoproteins can induce extensive IgE cross-reactivity therefore limiting the specificity of in vitro allergy tests. IgE sensitization to N-glycans (cross-reactive carbohydrate determinants, CCDs) may be increased in heavy drinkers, who therefore show IgE reactivity to aeroallergens, latex, and Hymenoptera venoms. The peanut, a CCD-bearing allergen, is the leading cause of severe food allergic reactions in many populations. Aim of the study:, To investigate the potential interference of CCDs with determinations of IgE to peanuts in heavy drinkers. Methods:, We determined IgE to peanuts and IgE to a CCD marker (MUXF3, the N-glycan from bromelain) in 41 heavy drinkers admitted to the hospital and 54 healthy controls. None of the participants reported symptoms of peanut allergy. In cases with positive (,0.35 kU/l) IgE to peanuts, we performed inhibition assays with a neoglycoprotein consisting of MUXF3 molecules coupled to bovine serum albumin (MUXF3 -BSA) and a similar neoglycoprotein lacking xylose and fucose (MM-BSA). In the same cases, we screened for IgE to a panel of recombinant nonglycosylated peanut allergens. SDS-PAGE immunoblotting and inhibition assays were performed in selected cases. Results:, The prevalence of positive IgE to peanuts was 22 and 3.7% in heavy drinkers and healthy controls, respectively (p < 0.001). Peanut-IgE positivity was closely related to the presence of IgE to CCDs. In most (8/9) heavy drinkers with positive IgE to peanuts, reactivity was inhibited by preincubation with MUXF3 -BSA, but not with MM-BSA. IgE binding to multiple bands on immunoblotting studies was also inhibited by MUXF3 -BSA preincubation. IgE to nonglycosylated recombinant peanut allergens was uniformly negative. Conclusion:, Heavy drinking is associated with clinically asymptomatic IgE reactivity to peanuts, a relevant food allergen, in relation to CCD interference. [source] Influence of Alcohol Use Experience and Motivational Drive on College Students' Alcohol-Related CognitionALCOHOLISM, Issue 8 2009Roisin M. O'Connor Background:, Cognitive processes are thought to be pivotal to risk for heavy drinking. However, few studies have examined the alcohol cue-activated positive and negative semantic memory networks that may be pivotal to drinking behavior. Moreover, much is to be understood about the influences of cognitive processes, particularly in high-risk drinking samples such as college students. The current study examines the sequential process of alcohol cues activating valenced semantic memory networks, and the influences of prior drinking experience and individual differences in motivational drive on this automatic (implicit) cognitive process. Methods:, Participants (N = 138, 52% women) were college freshmen prescreened to represent the full range of drinking experience (i.e., current abstainers, light and heavy drinkers). Participants completed self-reports of past month alcohol use, and individual differences in behavioral inhibition system (BIS) and behavioral approach/activation system (BAS). Alcohol cue-elicited positive and negative semantic memory networks were assessed using a priming task. Results:, Results from the priming task revealed that for light drinkers alcohol cues were equally as likely to activate positive and negative semantic memory networks, suggesting relatively neutral cue-elicited alcohol attitudes. Conversely, for heavy drinkers, alcohol cues more readily activated positive relative to negative semantic memory networks, suggesting relatively positive cue-elicited alcohol attitudes. Furthermore, positive alcohol cue-elicited semantic memory networks (positive attitudes) were evident for individuals characterized by a strong BAS and weak BIS (as hypothesized) and those characterized by a weak BAS and weak BIS. Conclusions:, The findings suggest that alcohol-cue elicited positive semantic memory networks may be pivotal to risk for heavy drinking. Specifically, it is via the influence on this cognitive process that prior drinking experience and individual differences in motivational drive, respectively, may maintain and predispose individuals to risk for heavy alcohol use. [source] IgA Immune Responses Against Acetaldehyde Adducts and Biomarkers of Alcohol Consumption in Patients with IgA GlomerulonephritisALCOHOLISM, Issue 7 2009Kati Kaartinen Background:, The pathogenesis of IgA glomerulonephritis (IgAGN) involves intense deposition of IgAs within the glomerulus. Although previous studies have shown that heavy drinking frequently leads to the generation of IgA antibodies against neo-antigens induced by ethanol metabolites and tissue deposition of IgAs, the associations between alcohol consumption, IgA immune responses, and kidney disease have not been examined. Methods:, A total of 158 IgAGN patients (96 men, 62 women) were classified as abstainers (n = 38), moderate drinkers (n = 114), and heavy drinkers (n = 6) based on self-reported alcohol consumption. The reference population included 143 individuals (99 men, 44 women) who were either apparently healthy abstainers (n = 31), moderate drinkers (n = 43), or heavy drinkers devoid of liver disease (n = 69). The assessments included various biomarkers of alcohol consumption: carbohydrate-deficient transferrin (CDT), glutamyl transferase, ,-CDT (combination of GGR and CDT), mean corpuscular volume (MCV), tests for liver and kidney function, serum immunoglobulin A (IgA), and specific IgA antibodies against acetaldehyde,protein adducts. Results:, In male IgAGN patients, drinking status was significantly associated with MCV, p < 0.001; CDT, p < 0.01; and , -CDT, p < 0.05. In the reference population, all biomarkers and anti-adduct IgA levels were found to vary according to drinking status. In IgAGN patients, anti-adduct IgA levels were elevated in 63% of the cases but the titers did not associate with self-reported ethanol intake. Conclusions:, These data indicate high levels of IgA antibodies against acetaldehyde-derived antigens in IgAGN patients, which may hamper the use of the immune responses as markers of alcohol consumption among such patients. Future studies on the pathogenic and prognostic significance of anti-adduct immune responses in IgAGN patients are warranted. [source] | ||||||||||||||||