Special Issue "Alcohol and Public Health"

Guest Editor
Prof. Dr. David J. Hanson
State University of New York College at Potsdam, Department of Sociology, 112 Breckenridge Place, Chapel Hill, NC 27514, USA
Website: http://www.alcoholinformation.org/
E-Mail:
Interests: impact of drinking beverage alcohol on health; effective ways to reduce alcohol abuse in a population

Editorial Advisor
Dr. Joris Cornelis Verster
Utrecht Institute for Pharmaceutical Sciences, Utrecht University, PoBox 80082, 3508TB Utrecht, The Netherlands
E-Mail:
Interests: effects of drugs on driving and traffic safety; drug abuse and addiction; sleep and sleep disorders

Dear Colleagues,

The light and moderate consumption of alcohol (beer, wine and distilled spirits) is associated with better health and greater longevity than is either abstention from alcohol or the immoderate consumption of alcohol. However, the abusive consumption of alcoholic beverages contributes to serious health and safety problems. In addition to pain, suffering and loss of life, these problems also place an enormous and unnecessary financial burden on the victims and on society. A major problem faced in crafting public policy is to strike the optimum balance between promoting societal abstinence on one hand and the immoderate consumption of alcohol on the other.

This goal typically includes objectives such as reducing alcohol-related motor vehicle crash deaths and injuries, reducing cirrhosis deaths associated with alcohol abuse, reducing heavy episodic or binge drinking, and increasing treatment for alcohol abuse.

The proposed means of achieving such objectives are often controversial and may include raising or lowering minimum legal drinking ages, tax increases, restrictions on time and place of purchase, issuance of drinking learner permits to adults under the age of 21, promoting harm reduction, changing the content of alcohol education, and mandating vehicle interlock systems on all motor vehicles.

Prof. Dr. David J. Hanson
Guest Editor

Related Special Issue:
Environmental Research on Alcohol: Public Health Perspectives

Submission

The Int. J. Environ. Res. Public Health (ISSN 1660-4601) was launched in 2004 and is an Open Access journal, with the main Editorial Office located in Basel, Switzerland. It has been accepted for coverage in Science Citation Index Expanded, available as the Web of Science and in Current Contents/Agriculture, Biology, and Environmental Sciences. Coverage will begin with the 2009 issues. This journal is also abstracted and indexed very rapidly by Chemical Abstracts, MedLine/PubMed and EMBASE. The IJERPH maintains a rapid editorial procedure and a rigorous peer-review system. Well written papers have been peer-reviewed and published in less than 4 weeks from manuscript submission. All papers published in IJERPH have DOI numbers.

All papers should be submitted to ijerph@mdpi.org with copy to the guest editor. To be published continuously until the deadline and papers will be listed together at this special issue website.

Please visit the Instructions for Authors page before submitting a paper. Open Access publication fees are 300 CHF per paper. English correction fees (250 CHF) will be added in certain cases (550 CHF per paper for those papers that require extensive additional formatting and/or English corrections.).

• alcohol
• public
• health
• policy
• deaths
• injuries
• treatment
• consumption
• control
• problems

Type of Paper: Review
Title: Alcohol and Crime
Author: Douzenis Athanasios
Affiliation: Athens University Medical School, 2nd Psychiatry Department, Attikon Hospital; E-Mail: thandouz@med.uoa.gr
Abstract: Alcohol addiction is an ever-expanding problem in the world that results in great loss of life, health and expenditure. Individuals addicted to alcohol are prone to violent acts. Violent crimes are often committed under the influence of alcohol. Alcohol’s relation to violence is not simple or linear. The theories attempting to explain this relationship will be mentioned. Alcohol and the typology of alcohol addiction is discussed in order to further elucidate its association with crime. The concept of athological intoxication is evaluated in the light of recent research. Adolescence is a crucial developmental period as well as the period where individuals start their “alcohol career”. Adolescence is the period where alcohol addiction and abuse prevention is most important. Adolescents use alcohol in order to overcome feelings of anxiety and this use can be dangerous, harmful and violent. Adulthood and its association with alcohol abuse and crime is well established. This review will present some data for violent crimes underlying this relationship. The issues of alcohol addiction abuse and violence in the workplace and in the family will be discussed. Alcohol is firmly related to abuse and violence in the family setting. Concluding, it should always be borne in mind that alcohol is not only associated with violence towards others but even more importantly with violence against the self. Alcohol’s association with self-destructive behaviour is stronger that the association of alcohol and crime.

Type of Paper: Review
Title: Motivational Interviewing for Alcoholism
Author: Geir Smedslund
Affiliation: Norwegian Knowledge Centre for the Health Services
E-Mail: Geir.Smedslund@kunnskapssenteret.no
Abstract: Motivational interviewing (MI) is a client-centred, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence. MI is supposed to work through its four main principles: (1) express empathy, (2) support self-efficacy, (3) roll with resistance, and (4) develop discrepancy. We conducted a systematic review of randomised controlled trials about the effects of MI on alcohol abuse. Studies were critically appraised for methodological quality, and the level of documentation was graded. We report meta-analyses on outcomes such as number of drinks per drinking day and proportion who quit drinking.

Type of Paper: Article
Title: Epistasis between IL1A, I1LB, TNF, HTR2A, 5HTT and TPH2 Variations Does Not Impact Alcohol Dependence Disorder Features
Authors: Antonio Drago (a), Ioannis Liappas (b), Carmine Petio(a,f), Diego Albani (c), Gianluigi Forloni (c), Petros Malitas (d), Christina Piperi (e), Antonis Politis (f), Elias O. Tzavellas (b), Katerina K. Zisaki (g), Francesca Prato (c), Sara Batelli (c), Letizia Polito (c), Diana De Ronchi (a), Thomas Paparrigopoulos (b), Anastasios Kalofoutis (d, e, h), Alessandro Serretti (a)
Affiliations: a) Institute of Psychiatry, University of Bologna, Italy
b) Department of Psychiatry, Eginition Hospital, University of Athens Medical School, Athens, Greece
c) Neuroscience Department. Istituto di ricerche Farmacologiche "Mario Negri", Milan, Italy
d) European Centre for the Quality of Life – E.C.Qua.L., Athens, Greece
e) Laboratory of Biological Chemistry University of Athens Medical School, Greece
f) Division of Geriatric Psychiatry Department of Psychiatry, Eginition Hospital, University of Athens Medical School, Athens, Greece
f) Dept. of Mental Health, Azienda USL di Bologna, Bologna, Italy
g) Department of Pharmacology, University of Athens Medical School, Athens, Greece
h) Biomedical Research Foundation of Academy of Athens, Greece
E-Mail: alessandro.serretti@unibo.it
Abstract: We assessed a set of biological (HDL, LDL, SGOT,SGPT, GGT, HTc, Hb and T levels) and psychometric variables (investigated through HAM-D, HAM-A, GAS, Liebowitz Social Anxiety Scale, Mark & Mathews Scale, Leyton scale, and Pilowski scale) in a sample of 64 alcohol dependent patients, at baseline and after a detoxification treatment. Moreover, we recruited 47 relatives who did not suffer alcohol related disorders and underwent the same tests. In both groups we genotyped 11 genetic variations (rs1800587; rs3087258; rs1799724; 5HTTPR; rs1386493; rs1386494; rs1487275; rs1843809; rs4570625; rs2129575;rs6313) located in genes whose impact on alcohol related behaviors and disorders has been hypothesized (IL1A, IL1B, TNF, 5HTT, TPH2 and HTR2A). We analyzed the epistasis of these genetic variations upon the biological and psychological dimensions in the cases and their relatives. Further on, we analyzed the effects of the combined genetic variations on the short – term detoxification treatment efficacy. Finally, being the only not yet investigated variation within this sample, we analyzed the impact of the rs6313 alone on baseline assessment and treatment efficacy. We detected the following results: the couple rs6313 + rs21295 affected the Leyton -Trait at admission (p=0.01) (obsessive-compulsive trait), whilst rs1800587 + 5HTTPR impacted the Pilowski test at admission (p=0.01) (hypochondriac symptoms). These results did not survive Bonferroni correction (p set at 0.004). This lack of association may depend on the incomplete gene coverage or on the small sample size which limited the power of the study. On the other hand, it may reflect a substantial absence of relevance of the genotype variants toward the alcohol related investigated dimensions. Nonetheless, the marginal significance we detected could witness an informative correlation worth investigating in larger samples.
Keywords: gene, alcohol dependence, IL1A, IL1B, TNF, 5HTPR, HTR2A, TPH2, association.

Type of Paper: Review
Title: Children of Problem Drinkers
Authors: Claus Vögele and Catherine Gilvarry
Affiliation: Director Clinical and Health Psychology Research Centre, School of Human and Life Sciences, Roehampton University, Whitelands College, Holybourne Avenue, London SW15 4JD; E-Mail: C.Vogele@roehampton.ac.uk
Abstract: Over the past several decades much research has focussed on describing the outcome for children of problem drinkers. While the outcome is not by definition poor, these children have a significantly higher risk of developing a range of mental health problems, including substance misuse. Notwithstanding, very little progress has been made in identifying these individuals at an early age, or developing interventions with a view to changing or altering their developmental course. Moss (2007) showed that only a minority of problem drinkers actually approach services for help, indicating that the numbers of affected children are significantly underestimated. We would like to review the studies that have been done (almost exclusively in the US) to help these children, and based on the psychological literature bring together appropriate interventions that can be delivered outside of clinical settings, for example in schools.

Type of Paper: Article
Title: See My Suffering: Women with Alcohol Use Disorders and Their Primary Care Experiences
Authors: Roxanne Vandermause and Mary Wood
Affiliation: Washington State University College of Nursing, PO Box 1495, Spokane, WA 99210-1495; E-Mail: rvandermause@wsu.edu
Abstract: Nearly five million women in the United States suffer from alcohol use disorders (AUD). Although primary health care settings are an access to care, there is insufficient knowledge about the primary care experience. This hermeneutic phenomenological study of “the primary care visit” of women with AUD, led to unanticipated findings about their depth of suffering. Analyses of 6 intensive interviews uncovered the patterns, Presenting my Damaged Self and Wanting, offering a new way of looking at the primary care experience. An explication of the phenomenon of suffering is offered, along with intervention implications for practitioners in primary care settings.
Keywords: alcohol-related disorders, alcoholism, suffering, women, hermeneutics, phenomenology, primary health care.

Type of Paper: Review
Title: Drunk and Disorderly Sleep: Implications for Public Health
Authors: Kirk J. Brower and colleagues
Affiliation: University of Michigan Medical School, Ann Arbor, MI USA
E-Mail: kbrower@med.umich.edu
Abstract: Each year in the U.S. alone, alcohol use disorders affect approximately 8.5% of adults, claim 85,000 lives, and cost $185 billion. Primary sleep disorders conservatively affect 6-12% of the population, also increase the risk for premature mortality, and cost the U.S. an estimated $109 billion per year. Both sets of disorders are strongly associated with motor vehicle accidents and suicidality, and together may be synergistic. Yet little attention has been paid to the public health impact of the comorbidity between these two sets of disorders, even though they commonly co-occur. This article reviews the epidemiology of these two types of disorders, their co-occurrence, and their shared adverse health consequences, particularly on mood, cognition, performance, cardiovascular health, and injuries. Next the bidirectional relationships between alcohol use and sleep disturbances are discussed. Not only can moderate amounts of alcohol disrupt the sleep of healthy individuals and worsen the performance of sleep-deprived individuals, but alcohol is reinforcing in many individuals, resulting in self-medication by approximately 18-28% of people with insomnia. In addition, sleep disturbances can influence the onset and course of alcohol use disorders; and patients with alcohol use disorders have increased risks for sleep-disordered breathing, periodic limb movements, parasomnias such as sleepwalking, and insomnia. Potential mechanisms, moderators, and mediators of these relationships are explored, with an emphasis on common neurobiology. Finally, guidelines for assessment and treatment of alcohol-dependent patients with sleep disorders are provided.

Type of Paper: Article
Title: A Review and Meta-Analysis of the Relationship between Emotional Intelligence and Problem Drinking
Author: John Malouff
Affiliation: University of New England, Armidale, New South Wales, Australia; E-Mail: jmalouff@une.edu.au
Abstract: A number of studies have examined the relationship between emotional intelligence and alcohol problems. This article will review these studies and summarize their findings by means of a meta-analysis. The meta-analysis will provide information regarding the overall effect size of the relationship between lower emotional intelligence and alcohol problems. Possible moderators of the relationship between emotional intelligence and alcohol problems include whether emotional intelligence is assessed as an ability or a trait, how alcohol problems are operationalized, and characteristics of the study participants.

Title: Laboratory Paradigms of Impulsivity and Alcohol Dependence: A Review
Authors: María Aragües, Rosa Jurado, Rafael Quinto, Gabriel Rubio
Affiliation: Department of Psychiatry, Complutense University, Hospital Universitario 12 de Octubre, Madrid, Spain
Abstract: Impulsivity is one of the primary personality traits that have been linked to alcohol dependence. However, impulsivity is not a homogeneous construct and studies from behabioural measures where used are agree to consider two broad categories of laboratory paradigms have been used to measure impulsivity and identify two behavioural processes. The first category is related to behavioural inhibition and denotes an individual’s ability to appropriately inhibit thoughts or actions. For this paradigm, several subtypes of tasks have been used: the Continuous Performance Test (CPT), go/no-go tasks, such as the Stop-Signal task (SST) and the Information Sampling Task (IST). The second category refers to the degree to which immediate (rewarding) consequences have more control over an individual’s behaviour than consequences that are delayed (delay of reward dimension). For this paradigm, the Card-Playing Task, the Risk-Taking Task (RTT), and the Differential Reinforcement for Low-Rate Responding (DRLR) have been used. Studies conducted in subjects with alcohol use disorders where theses tasks were used have been reviewed. The main results of our review are the following: alcohol misuers displayed significant impairments on the CPT, SST, DRLR, preference for small-immediate reward and higher scores on Risk Taking Task. Taken results from cross-sectional and longitudinal studies we propose a model in which the paradigm related to delay of gratification might be a marker for early consumption and/or abuse of alcohol, whereas impairment in behavioural inhibition might be a marker for maintenance of consumption and, therefore, for progression towards alcohol dependence. The review will also consider the importance of assessing different types of behavioural impulsivity in therapeutic and preventive programs, and discuss such thinking can benefit efforts for early intervention and future research.

Type of Paper: Review
Authors: Katie Witkiewitz, Nadia Villarroel
Email: kate19@u.washington.edu
Abstract: Alcohol use disorders (AUDs) affect nearly 125 million individuals worldwide (WHO 2004). Alcohol dependence is not isolated to a specific population and is, therefore, a significant and universal public health issue that warrants considerable attention. A number of ethnic minority groups are disproportionately affected by AUDs and related consequences, but research on implementing culturally competent treatments for AUDs among ethnic minorities is lacking. Currently, most studies on alcohol treatment include a sample minority population, but often these trials are designed such that cultural sensitivity is not prioritized. This review examines research on AUDs among distinct ethnic groups and offers insight on how to improve future research, aspiring to ultimately enhance treatment outcomes in these groups and reduce health disparities in alcohol treatment.

Type: Article
Title: Ethanol Consumption by Dams Affects Selenium Bioavailability and Antioxidant Balance in Their Progeny
Authors: María Luisa Ojeda, Beatriz Vázquez, Fátima Nogales, María Luisa Murillo and Olimpia Carreras *
Affiliation: Department of Physiology and Zoology, Faculty of Pharmacy, Seville University / C/ Tramontana s/n. C.P. 41012. Seville, Spain
E-Mails: ojedamuri11@us.es (M.L.O.); beatriz_vazqueza@hotmail.com (B.V.); fnogales@us.es (F.N.); taravillo@us.es (M.L.M.)
* Author to whom correspondence should be addressed: E-Mail: olimpia@us.es; Tel. + 954 556 518, Fax: + 954 233 765
Abstract: Ethanol consumption affects maternal nutrition, the mothers’ antioxidant balance and the future health of their progeny. Selenium (Se) is a trace element with an antioxidant activity .We will study the effect of ethanol on Se bioavailability in dams and in their progeny. We have used three experimental groups of dams: control, chronic ethanol and pair-fed; and three groups of pups. Se levels were measured by graphite-furnace atomic absorption spectrometry. Serum and hepatic GPx activity was determined by spectrometry. We have concluded that ethanol decreased Se retention in dams, affecting their tissue Se deposits and those of their offspring, while also compromising their progeny’s weight and oxidation balance. These effects of ethanol are caused by a reduction in Se intake and a direct alcohol-generated oxidation action.
Keywords: wistar rats, selenium bioavailability, ethanol, gestation, lactation, glutathione peroxidase.

Type of Paper: Article
Title: Alcohol and HCV Chronic Infection Are Risk Cofactors of Type 2 Diabetes Mellitus for Hepatocellular Carcinoma in Italy
Authors: V. Donadon, A. Perciaccante, M. Balbi, M. Dal Mas, P. Casarin and G. Zanette
Affiliation: 3rd Internal Medicine and Diabetic Clinic, Pordenone Hospital, Italy; E-Mail: valter.donadon@aopn.fvg.it
Abstract: Background and Aims: diabetes mellitus has been associated with increased risk of solid tumours and particularly with hepatocellular carcinoma (HCC).
Methods: to study this relationship, we enrolled 465 consecutive patients with HCC (78.3% males, mean age 68.5+8.9 yrs). As comparison groups, matched by age, sex and time of hospital admission, we selected 490 control subjects without liver diseases and 618 cirrhotic patients.
Results: every subject with abnormal glucose tolerance in the HCC, cirrhotic and control groups of our study, had the clinical and metabolic characteristics of type 2 DM (DM2). Remarkably, there was nobody with type 1 DM in the three groups of subjects studied. Prevalence of DM2 was significantly higher in HCC patients compared to the control group and cirrhotic patients (31.2% vs 12.6% and 23.3% respectively). This difference was statistically significant with an odds ratio (OR) of 3.12 between the HCC vs control cases (P <0.001) and 2.09 between cirrhotic patients vs controls (P <0.001), higher in males than in females HCC patients (3.14 vs 3.11). Insulin treated patients are significantly more frequent between HCC males. DM2 pre-exists to HCC for a total mean period of 141.5 months and the mean duration of DM2 was higher in HCC cases treated with insulin than in those treated with oral antidiabetic agents. In the HCV positive subgroup, the frequency of DM2 is significantly higher in HCC patients than in cirrhotic cases (28.7% vs 22.5%). Compared to controls, HCC with DM2 patients infected with HCV, showed an OR of 2.78. In subjects with chronic alcohol abuse, the frequency of DM2 is the highest in HCC patients (35.2%;OR=3.75) compared to controls.Finally, when HCV infection has been associated with alcohol abuse, HCC in our patients develops earlier (mean age 67.7+9.3 in HCV infection plus alcohol abuse vs 71.5+7.3 years in HCV infection alone; P <0.001) and the multivariate analysis shows that the abuse of alcohol (OR =121.2) is an independent risk factor for HCC, more than HCV infection (OR =106.5).
Conclusions: DM2 in our patients is associated with a 3-fold increased risk for HCC. Insulin treatment is more frequent in DM2 males patients with HCC and DM2 pre-exists to the development of HCC. Our results suggest that DM2, and the associated endogenous and exogenous hyperinsulinism, is only partially related to liver cirrhosis and is more likely a concourse rather than merely a consequence of the chronic liver disease and hepatocarcinoma. Moreover, our study shows that in our population the risk for HCC is more evident when DM2 is associated with alcohol abuse than with HCV chronic infection.

Title: European Aalcohol Treatment Policy
Authors: Vanesa Carral, Antoni Gual, Joan Colom and Peter Anderson; E-Mails: vanesacarral@gmail.com (V.A.); TGUAL@clinic.ub.es (A.G.); joan.colom@gencat.cat (J.C.); peteranderson.mail@gmail.com (P.A.)
Abstract: The construction of the European Union is a complex and slow process, which is often jeopardized by the tremendous diversity of European communities and the reluctance of State Members to transfer power and resources to the Union. In the Health area, State Members agreed to maintain the control of health care delivery at a national level. Hence, the only existing European policy on alcohol deals with prevention, not with treatment. Recent collaborative research projects have studied the state of the art of alcohol treatment policy in most of the EU countries. Under the umbrella of the PHEPA Project (Primary Health Care European Project on Alcohol), a questionnaire has been developed to assess the availability of services for the management of hazardous and harmful alcohol consumption (HHAC). Data were obtained from 17 European countries in the areas of: a) health care infrastructures; b) support for treatment provision; c) intervention and treatment availability and accessibility; d) health care providers (clinical accountability and treatment provision); and e) health care users (knowledge, awareness, and help seeking behaviour). Overall, data show low levels of integration in Health systems and wide heterogeneity between and within countries. Only 57% of the Member States had an official written policy on the management of HHAC, and 50% reported specific funding allocation for the provision of treatment for HHAC. Clinical guidelines for the management of hazardous and harmful alcohol consumption were available in 64% of the countries, and 71% of General Practitioners had access to CME courses on the management of HHAC. Ongoing research (e.g. Amphora project) aims at deepening our knowledge of the inequalities faced by European citizens in the availability of services to manage HHAC, and also intends to identify the gap between needs and service provision at a European level.

Type of Paper: Review
Title: to be added
Author: Timothy C. Durazzo
Affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, USA; E-Mail: Timothy.Durazzo@ucsf.edu
Abstract: The designation of an alcohol use disorder (AUD) refers to the constellation of symptoms manifested by individuals afflicted with alcohol abuse or dependence. The adverse effects of AUD on human brain morphology, blood flow, metabolism, and neurocognition are well documented in the biomedical literature. In AUD, the concurrent use of other substances, such as psychostimulants (e.g., cocaine and methamphetamine) and tobacco, is common, with tobacco products being the most frequently consumed substances in this population. The majority of individuals with AUD smoke regularly and high percentages are nicotine dependent. Chronic cigarette smoking alone is associated with abnormalities in brain structure, brain perfusion and neurocognition that are similar in type and pattern to those reported in AUD. However, despite the high percentage (50-90%) of chronic cigarette smokers in AUD, the combined effects of smoking and chronic and excessive alcohol consumption on central nervous system function have received little attention. Thus, the brain injury and the neurocognitive and/or motor dysfunction seen in AUD may be mediated, in part, by chronic cigarette smoking. In this review, we first separately present the research literature on the neurobiological (emphasizing magnetic resonance-based neuroimaging research) and neurocognitive findings in both AUD and chronic cigarette smoking, and subsequently review the literature on the effects of comorbid cigarette smoking on neurobiology and neurocognition in AUD. The potential genetic contributions (i.e., gene polymorphisms) to the development and maintenance of both AUD and cigarette smoking will also be briefly reviewed. This review addresses “uncomplicated” AUD, that is, AUD without a history of Wernike-Korsakoff Syndrome (WKS) or significant chronic hepatic disease, as uncomplicated AUD represents the vast majority of individuals with AUD.

Type of Paper: Article
Title: Detection of Alcohol-Related Stimuli in Late Adolescents: Moderation by Drinking Behavior
Author: Charlotte Boettiger; E-Mail: cab@email.unc.edu
Abstract: There is much laboratory-based evidence that people with alcohol use disorders (AUDs) or heavy alcohol consumers exhibit heightened reactivity towards alcohol-related stimuli (e.g. citations). However, little is known about how this heightened reactivity is instantiated in the brain. One possibility is that excess alcohol consumption modifies the brain’s object detection circuitry. These circuits are generally divided into two interacting pathways, the “bottom-up” parvocellular pathway to the visual identification areas of the inferior temporal lobe, and one “top-down” magnocellular pathway which first reaches the frontal lobe and sends a biasing “guess” to the inferior temporal lobe. This latter pathway may be especially useful for detection of desired objects in the environment. One hypothetical explanation then for the heightened response to alcohol stimuli is that the magnocellular pathway has been modified such that the frontal regions swiftly detects alcohol-related stimuli and sends the biasing information to the object recognition areas in the temporal lobe. This modification is expected to result from repeated rewarding experiences with alcohol. The current study examined whether either the top-down or bottom-up processes of object recognition show evidence of biased processing of alcohol-related objects in college-aged heavy alcohol consumers. The data do not appear consistent with the hypothesis that top-down signals from the frontal lobe bias recognition of alcohol-related stimuli in heavy drinkers. Instead, we found evidence for enhanced processing of alcohol stimuli by the parvocellular pathway. Moreover, our data suggest that heavy alcohol consumption among college-aged persons is associated with greater susceptibility to visual priming for alcohol-related stimuli. These results have implications for the sensitivity of this population to visual exposure to alcohol content, including advertising.

Type of Paper: Article
Title: to be added
Author: Jeffrey Abracen
Affiliation: Community Correctional Research, Research Branch, Correctional Service of Canada, Canada; E-Mail: AbracenJA@csc-scc.gc.ca
Abstract: The present article will summarize the available literature with reference to alcohol and drug abuse in relation to sexual assault against adults and children. Emphasis will be placed on research with convicted sexual offenders. The use of offender populations allows for the examination of data relevant to the question of whether treatment designed to address issues associated with substance abuse/sexual offending results in long term reductions in sexual or violent recidivism at least among relatively high risk groups (i.e., those with a history of being convicted of sexual offences). This question is critical from a public health perspective. Although evidence from a variety of sources indicates that there is a clear association between alcohol and sexual offending, such data do not address the question of whether treatment reduces the risk of future recidivism. Data from the Regional Treatment Centre (Ontario) Sex Offender Treatment Program (RTCSOTP) will be reviewed. These data indicate that lifetime history of substance abuse is related to the prediction of sexual offence recidivism even after actuarial risk estimates have been accounted for. Further, additional evidence indicating that appropriate treatment related to substance abuse reduces the risk of future sexual offences over and above sexual offender treatment alone will also be discussed. Suggestions for the assessment and treatment of substance abuse with offender populations will be provided.

Type of Paper: Article
Title: Feelings of Guilt and Shame in Alcoholics in Turkey
Authors: Ayhan Kalyoncu, Hasan Mırsal, Özkan Pektaş, et al.
Affiliation: Balıklı Rum Hastanesi Vakfı, Anatolia Klinikleri, BelgradKapı Yolu No:2 Zeytinburnu, Istanbul, Turkey; E-Mail: hmirsal@superonline.com
Abstract: Aim: Feelings of shame and guilt are prevalent in communities. They are prevelant in alcoholics, also. The aim of this study was to determine the feelings of guilt and shame in alcoholics in remission. Methods: The study included 204 patients who met DSM-IV criteria for alcohol dependence and the control group consisting of 144 voluntary subjects. A socio-demographic and clinical data form, SCID-I (Structured Clinical Interview for Axis I Disorders), Guilt Shame Scale (GSS), Rotter's Internal-External Locus of Control Scale (RIELCS) and the Hamilton Depression Rating Scale (HDRS) were applied to both groups. Results: There were significant statistical differences in the scores of GSS, RIELCS, and HDRS between two groups. Conclusion: The patient group suffered feelings of guilt and shame more intensely than the control group.
Keywords: alcoholics; shame; guilt; psychopathology

Type of Paper: Article
Title: Binge Drinking Effects on EEG in Young Adult Humans
Authors: Kelly Courtney and John Polich
Affiliation: Cognitive Electrophysiology Laboratory, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA 92037, USA; E-Mails: kellyc@scripps.edu (K.C.); polich@scripps.edu (J.P.)
Abstract: Binge drinking can be defined as a pattern of drinking alcohol that brings the blood alcohol concentration (BAC) to 0.08 gram percent or above, which implies five or more drinks for males or four or more drinks for females in two hours, on more than one occasion within the past six months. The neurocognitive effects of binge drinking in humans have been little studied. The present study assessed young adult undergraduates who varied in their binge drinking history by recording their electroencephalography (EEG) while they passively viewed a fixation point. Drinking groups consisted of alcohol consuming non-binge drinkers (1-5/4 drinks in under two hours), low-binge drinkers (5/4-6 drinks in under two hours), and high-binge drinkers (≥10 drinks in under two hours), with equal numbers of each sex in each group (n = 16/binge/sex for a total of N = 96) assessed. Participants were excluded for presence of alcoholism in the individual or family, recent excessive recreational drug use, tobacco smoking, psychological disorders, use of psychiatric medication, and serious health problems. The primary binge group effects were found in the delta (0-4 Hz) and fast beta (25-35 Hz) bands, such that non- and low-binge drinkers exhibited less mean spectral power than the high-binge drinkers. These findings suggest that binge drinking may affect central nervous system function in young adults, even after length of sobriety and binge drinking frequency are taken into account. Theoretical implications are discussed.

Type of Paper: Article
Title: to be added
Author: Thorsten Kienast; E-Mail: thorsten.kienast@charite.de
Abstract: Purpose of study: Psychotherapy with patients suffering from borderline personality disorder (BPD) and concomitant alcoholism requires an integrative approach. Dialectical Behavioral Therapy (DBT) is an evaluated and effective program for patients with BPD, whereas behavior therapy, commitment therapy and self-help groups have all been found to be effective in the treatment of alcoholism. In this pilot study, we give an initial report of the concept and efficacy of an eight week inpatient therapy program integrating an evaluated therapy of alcoholism with standard DBT. The changes of symptoms were evaluated using the Borderline Symptom List (BSL), the European Addiction Severity Index (EuropASI), Lifetime Parasuicide Count (LPC), and Beck-Depression-Inventory. Findings: Seven cases were included. All show improvements in various subscores of BSL and EuropASI, and had a decrease in the LPC score. Summary: With this pilot study we test the efficacy of an extended DBT program for inpatients with BPD and alcoholism who failed outpatient treatment, and found significant improvements in the study in all outcome measures. This promising result points to the necessity for clinical trials that compare standard care with extended DBT in larger cohorts.
Keywords: DBT; alcohol dependence; Pilot study; borderline

Type of Paper: Review
Title: to be added
Author: Ernest Abel; E-Mail: ad6042@wayne.edu
Abstract: While genetic factors are known to influence the risk for alcoholism, there is no known mechanism for inducing these genetic factors. The continued existence of a genetic influence on alcoholism implies an hereditary genotype pervasive in evolution. This poses some interesting questions: What possible survival value could this genotype have had? Or to use the evolutionary expression, why has it not been selected against in the survival of the fittest? This article further develops Dudley’s “Drunken Monkey Hypothesis,” that the “alcoholism genotype” evolved as a consequence of “optimal foraging” for energy and resulted in a craving for calorically dense substances such as alcohol-rich foods, refinement of sensory mechanisms for recognizing and detecting them, and cognitive mechanisms for remembering their location. This extension of the evolutionary hypothesis explains the hedonic reaction to alcohol, the preference of alcoholics for sweet tasting substances, the “J” shaped function relating alcohol consumption and various health related outcomes, and challenges the “no safe limit” advice regarding drinking during pregnancy.

Type of Paper: Article
Title: Does the Degree of Gender Equality between Fathers and Mothers Associate with Alcohol-Related Morbidity and Mortality? A Registry Study of the Swedish Parental & Child Cohort of 1988/89
Author: Anna Månsdotter
Affiliation: Health, Economics, and Gender, Karolinska Institutet, Public Health Sciences, SE-171 76 Stockholm, Sweden; E-Mail: anna.mansdotter@ki.se
Abstract: INTRODUCTION & AIM: The male excess of risky alcohol consumption is a global phenomenon. One potential reason is ideals and practices leading men to breadwinning duties and women to caring duties; that is, drinking alcohol requires freedom and resources, and interferes with practical and emotional childcare responsibilities. The aim of this paper was to examine the relationship between the degree gender equality during early parenthood and future alcohol-related morbidity and mortality.
MATERIAL & METHODS: The study population consists of all Swedish fathers and mothers who had their first child together in 1988 and 1989 (N=118 595). The parental couples were divided into five categories of gender (in)equality based on their division of income and occupational position (breadwinner indicators), and parental leave and temporary child care (caring indicators) during 1988-1990. The outcome was non-institutional care, in-patient care, and mortality caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication 1991-2008. The statistical method used was multiple logistic regressions with odds ratios as estimates of relative risks.
HYPOTHESIS (RESULTS): The hypothesized result is that fathers who take on a gender equal position in breadwinning and caring duties have decreased risks for alcohol-related morbidity and mortality compared to unequal (traditional) fathers; opposing, mothers who take on a gender equal position are hypothesized to run increased risks compared to unequal (traditional) mothers.

Type of Paper: Review
Title: Beer and Its Non-Alcoholic Compounds: Role in Pancreatic Exocrine Secretion, Alcoholic Pancreatitis and Pancreatic Carcinoma
Authors: Andreas Gerloff, Manfred V. Singer and Peter Feick
Affiliation: University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany; E-Mail: manfred.v.singer@umm.de
Abstract: Many studies have shown that non-alcoholic compounds of alcoholic beverages mediate biological effects on the stomach and on the pancreas. On gastric acid secretion it was conclusive demonstrated that alcoholic beverages produced by fermentation like beer and wine strongly stimulate gastric acid secretion, whereas those produced by destillation (e.g. whisky, gin) have no stimulatory effect. In this article we provide an overview about the newest in vivo and in vitro data concerning the effect of non-alcoholic constituents of alcoholic beverages, especially of beer, on pancreatic secretion and their possible role in alcoholic pancreatitis and pancreatic carcinoma. The present data indicate that pancreatic enzyme secretion in humans is stimulated by non-alcoholic constituents of beer and that this effect is mediated, at least in part, by direct actions of the substances on pancreatic acinar cells. Selected non-alcoholic compounds of beer, such as quercetin, resveratrol, ellagic acid or catechins have been shown to be protective against experimentally induced pancreatitis by inhibition of pancreatic secretion, stellate cell activation or reduction of oxidative stress. In addition, quercetin, ellagic acid and resveratrol show anti-carcinogenic potential in vitro and in vivo. However, beer contains much more non-alcoholic ingredients. Their relevance in beer-induced functional alterations pancreatic cells that may have an impact on the development of pancreatitis and pancreatic cancer in humans needs to be further evaluated.

Type of Paper: Article
Title: to be added
Author: Olimpia Carreras
Affiliation: Dpto. Fisiología y Zoología, Facultad Farmacia, Universidad Sevilla, Spain; E-Mail: olimpia@us.es
Abstract: Aim: Ethanol causes significant foetal zinc deficiency. Zinc is an essential nutrient required for normal development and growth. Maternal ethanol exposure effects duodenum kinetic parameters in vivo offspring rat zinc absorption at 21d postpartum was carried out.
Method: Pups were divided into five groups: CO, control offspring; GO, offspring exposed to ethanol during gestation only; LO: offspring exposed to ethanol during lactation only; PFO, pair-fed offspring and EO, offspring exposed to ethanol during gestation and lactation. Duodenal loop transport studies were performed using an in vivo perfusion at a flow rate of 3 ml/min for 5 min. Zinc concentrations of 25, 50, 75 and 150 µM were used. The absorption values were determined by the difference between the initial and final substrate amounts in the perfusate.
Results: The results indicated that ethanol consumption by dams during gestation and/or lactation led to significant changes in Vmax with no significant changes in apparent Km.
Conclusion: These findings suggest that exposure to ethanol during gestation and suckling periods produced a double effect, upregulation of zinc absorption consequence of a less zinc intake in suckling rats and dehydration. This effect is higher in EO groups, when the ethanol exposure and serum zinc levels were higher. Further studies are needed for a better understanding of ethanol effects on zinc turnover during pregnancy and/or lactation.

Type of Paper: Review
Title: Alcohol and Risk for Gastrointestinal, Hepatobiliary and Pancreatic Cancer
Authors: Sousana Amptoulach¹ and Evangelos Kalaitzakis²
Affiliations: ¹ Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden; E-Mails: sousana.amptoulach@vgregion.se, drsouzana@yahoo.gr
² Institute of Internal Medicjne, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; E-Mail; evangelos.kalaitzakis@medicine.gu.se
Abstract: Excessive alcohol consumption is considered to increase the risk of cancer. Both retrospective and prospective epidemiological studies indicate the association between lifetime consumption of alcoholic beverages and various types of cancer including those of the gastrointestinal tract, the liver, the biliary tree, and the pancreas. A dose-response relationship seems to exist between the amount of alcohol ingested as well as the type of alcoholic beverage and the risk of developing cancer. The mechanism by which alcohol consumption exerts its carcinogenic effect is still unclear, but a causal link has been established between alcohol consumption and cancers of the esophagus, liver, colon, rectum and an association is suspected for cancer of the pancreas and stomach. In this review article we attempt to summarize the most important published epidemiological data on the association between alcohol and gastrointestinal, hepatobiliary and pancreatic cancer.

Type of Paper: Article
Title: to be added
Author: Yann Benoist; E-Mail: yannbenoist@wanadoo.fr
Abstract: In this article, we will deal with the social consequences of alcoholism among homeless people. The text will be based on a three years ethnographic study carried out among homeless people, users of an emergency housing centre. In a first part, I will set out to describe these addictive behaviours. Among the target, they are particularly acute and are due to or strengthened by the harshness of living in the street. In a second part, I will draw the direct consequences of these behaviours, as on the social field as on the sanitary one. In a third part, I will demonstrate that, more than a lifestyle, alcoholism or on the contrary, abstinence, is the way homeless people have to shape their own personality. Finally, I will describe the answers proposed by institutions and I will analyse their consequences. While doctors and social workers both define alcoholism as a disease, they reproachfully look down at homeless people. Through institutional rules, they adopt a normative behaviour which often leads to a therapeutic failure and the incapacity to help homeless people out of destitution.

Type of Paper: Article
Title: Three Intervention Models Regarding Reducing the Consumption of Alcohol in Taiwan’s Indigenous Communities
Author: Mei Yu Yeh
Affiliation: Chang Gung Institute of Technology, Tao-Yuan, Taiwan; E-Mail: yehdiana@mail.cgit.edu.tw
Abstract: Objectives: Because the consumption of alcohol is prevalent among indigenous in Taiwan, alcohol related deaths among these people is significantly higher than in Han Taiwanese. Three intervention models were used to try to reduce the consumption of alcohol in three indigenous communities.
Method: The intervention program in three indigenous communities was sponsored by Taiwan’s government. Three institutions (a hospital, a university and a community organization) developed their own strategy regarding reducing the consumption of alcohol among indigenous over a three year period (from 2006 to 2008). Ten criteria were used to determine which the most effective strategy was.
Results: Over a three period, indigenous reduced their consumption of alcohol by 6.9%. In addition, about 30 % of problematic drinkers reduced their consumption of alcohol or entirely quit drinking. The program was successful because the three indigenous communities admitted they had a alcohol problem, and volunteers in the community as well as religious leaders counseled problem drinkers.
Conclusion: Although reducing the consumption of alcohol in Taiwan’s indigenous communities was extremely difficult, we accomplished this goal by first establishing an internal consensus in the indigenous community. In addition, other organizations supported the program. The long-term goal is to help indigenous change their attitude toward alcohol and thus reduce their consumption of alcohol.

Type of Paper: Article
Title: The Effectiveness of a Program to Reduce the Consumption of Alcohol in Taiwan’s Indigenous Communities
Author: Mei Yu Yeh
Affiliation: Chang Gung Institute of Technology, Tao-Yuan, Taiwan; E-Mail: yehdiana@mail.cgit.edu.tw
Abstract: Objectives: In Taiwan, indigenous face an inordinate amount of medical problems due to their consumption of alcohol. The objective of this study was to evaluate the effectiveness of intervention models to reduce the consumption of alcohol in Taiwan’s indigenous communities.
Method: Taiwan’s government sponsored the intervention program to reduce the consumption of alcohol in ten indigenous communities. Effective intervention programs were implemented in ten indigenous communities based on different characteristics and resources. Ten criteria were used to evaluate the effectiveness regarding the reduction of the consumption of alcohol in ten indigenous communities.
Results: Due to this program, indigenous in ten communities reduced their consumption of alcohol by an average of 6.5%. We used ten criteria to determine how effectively the ten communities helped people reduce their consumption of alcohol. Based on the ten criteria, five communities effectively helped people reduce their consumption of alcohol by establishing an internal consensus, recruiting and empowering volunteers, targeting people who have a drinking problem, encouraging the whole community to participate in this program, and counseling drinkers.
Conclusion: There is sufficient evidence to conclude that the intervention program regarding the reduction of the consumption of alcohol was effectively implemented in ten indigenous communities; however, we need to continue to help indigenous change their attitude toward drinking.

Title: Adolescent Alcohol Use and Cigaratee Smoking in Reykjavik, Sofia and St. Petersburg: What Are the Risk and Protective Factors?
Authors: Inga Dora Sigfusdottir¹, Alfgeir Logi Kristjansson¹, Jon Fridrik Sigurdsson², Gisli H. Gudjonsson³
Affiliations: ¹ Centre for Social Research and Analysis, School of Health and Education, Reykjavik University, IS-103 Reykjavik, Iceland
² Division of Psychiatry/Faculty of Medicine/School of Health and Education, Landspitali-University Hospital/University of Iceland/Reykjavik University, IS-101 Reykjavik, Iceland
³ Department of Psychology, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK; E-Mail: gisli.gudjonsson@kcl.ac.uk
Abstract: The aim of this paper is to examine the prevalence of alcohol use and cigarette smoking in a population of adolescents in three European cities; Reykjavik in Iceland, Sofia in Bulgaria and St.Petersburg in Russia. The study also seeks to establish the risk and protective factors for alcohol use and cigarette smoking in the three cities. We investigate the association between alcohol use and cigarette smoking on the one hand and factors within the family, peer-group and leisure time activities on the other hand. The study draws on the 2006 Youth in Europe data collection that was carried out through representative cross-sectional surveys of 14- to 15-year-old adolescents in 9 cities across Europe in October 2006. A total of 5,100 students in the 1991 cohort in the local secondary school systems in these three cities participated in the study. The highest prevalence of any alcohol consumption, intoxication and cigarette smoking was in Sofia. The lowest prevalence of intoxication was in St.Petersburg. The lowest prevalence of cigarette smoking and any alcohol use was in Reykjavik, where systematic effort has been carried out for the last 12 years to decrease the likelihood of substance use among adolescents. The study reveals that risk and protective factors for alcohol and cigarette use are similar in the three cities, which implies that similar prevention work that has been carried out in Reykjavik may also decrease the likelihood of alcohol use and cigarette smoking by youth in the other two respective cities.

Type of Paper: Review
Title: Binge Drinking in European Youth : A Review
Authors: Laurent Karila, Amine Benyamina, François Beck, Amandine Lebert, Henri Jean Aubin, Michel Reynaud; E-Mails: laurent.karila@gmail.com, amine.benyamina@pbr.aphp.fr, francois.beck@inpes.sante.fr, henri-jean.aubin@pbr.aphp.fr;, michel.reynaud@pbr.aphp.fr
Abstract: Binge drinking has been used most commonly to describe the drinking behaviours of college students. It is usually defined in terms of quantities of alcohol consumed within a limited duration (four - five or more drinks consumed in a single occasion). Binge drinking among youth is a growing public health problem in the major part of European Countries. Economic costs associated with binge drinking include those related to the healthcare system, the legal and criminal justice systems.
A comprehensive search from a range of electronic databases was conducted for the period from 1983 to September 2009. Searches were conducted from PubMed, EMBASE, PsycInfo using the following key words alone or in combination: binge drinking, adolescent, risk factors, health, behavioural consequences, policy.
A variety of personal and social/environmental characteristics have been described. Drinking at binge levels worsens performance of mental and physical tasks. Data show that there is an increased risk for mental health problems, cognitive impairment, somatic complications, violence, impaired driving, unsafe sex and alcohol related harm such as alcohol misuse or dependence. Therapeutic approaches include brief interventions and prevention. Binge drinking has become a focus of acute policy concern, turning it into a public health priority in many European countries.
Keywords: binge drinking; adolescent: risk factors; health; behavioural consequences; policy

Type of Paper: Review
Title: Controlled-Drinking: Beliefs and Evidences
Authors: A. Luquiens, M. Reynaud, L. Karila, A. Benyamina and H.J. Aubin; E-Mail: henri-jean.aubin@erx.aphp.fr
Abstract: What are we talking about? Controlled-drinking does not have a consensual definition. It is a general term used for public health purposes, or as an outcome in alcohol use disorders. Quantitative norms of alcohol consumption are difficult to determine and their exclusive use for recommendations or for comparison in research presents some limitations. In the alcohol use disorders field, controlled-drinking can be understood in different ways. First, controlled-drinking is a response to the harm reduction model. Secondly, controlled-drinking can be understood as a maximal alcohol consumption quantity. Thirdly, it has been proposed to integrate the two latter definitions.
Dawn and evolution of the debate opposing controlled-drinking and abstinent therapeutic goals. After the publication of the first case-report in the 1940’s, several studies supporting controlled-drinking created a violent debate within specialist alcohol workers. Clinical impact of this publication remained weak, even if later publications reported lack of accessibility to treatment for patients who are reluctant to consider abstinence. Arguments against controlled-drinking rely on the extended neural sensitization theory, supporting the ideas that loss of control is a permanent characteristic of alcohol dependent patients even after a prolonged period of abstinence, and that abstinence is the only stable outcome. On the other hand, letting patients choosing their own therapeutic goal could have a major prognostic impact, whatever the goal. Emerging data aim to target patients having the best chance of success with controlled-drinking.
Measure of success in alcohol use disorder treatment. Non-drinking outcomes (quality of life, for example) have an increasing place in clinical trials. However, regarding the assessment of outcome, the gap between clinical trials and practice remains a problem. This gap could explain poor impact of trials on clinical practice. Furthermore, alcohol treatment models seem to be largely influenced by political, economical and cultural factors.

Type of Paper: Review
Title: Molecular Basis and Current Treatment for Alcoholic Liver Disease
Authors: Alejandra Miranda-Mendez ¹, Alejandro Lugo-Baruqi ^1,2 and Juan Armendariz-Borunda ^1,2
Affiliations: ¹ Institute for Molecular Biology in Medicine and Gene Therapy, University of Guadalajara, Jalisco, Mexico; E-Mails: alemirme@hotmail.com (A.M.M.); alecslugo@yahoo.com (A.L.B.); armendbo@cucs.udg.mx (J.A.B.)
² OPD Hospital Civil de Guadalajara, Jalisco, Mexico
Abstract: Alcohol use disorders and alcohol dependency affect millions of individuals worldwide. The impact of the spectrum of these entities has an elevated social and economic. Alcoholic liver disease is caused by acute and chronic exposure to ethanol promoting oxidative stress and inflammatory response. Chronic consumption of ethanol implies liver steatosis which is the first morphological change in the liver followed by liver fibrosis and cirrhosis. This review comprises a general assessment of this disorder including physiopathology, molecular and genetic basis as well as clinical presentation and current modalities of treatment.
Keywords: alcohol; alcoholism; fibrosis; cirrhosis; alcoholic liver disease

Type of Paper: Review
Title: Ethanol and Cognition: Indirect Effects, Neurotoxicity and Neuroprotection: A Review
Author: John C.M. Brust
Affiliation: Department of Neurology, Harlem Hospital Center and Columbia University College of Physicians & Surgeons, New York, NY 10037, USA; E-Mail: jcb2@columbia.edu
Abstract: Ethanol affects cognition in a number of ways. Indirect effects include intoxication, withdrawal, brain trauma, central nervous system infection, hypoglycemia, hepatic failure, and Marchiafava-Bignami disease. Nutritional deficiency can cause pellagra and Wernicke-Korsakoff disorder. Additionally, ethanol is a direct neurotoxin and insufficient dosage can cause lasting dementia. However, ethanol also has neuroprotectant properties and in low-to-moderate dosage reduces the risk of dementia, including Alzheimer type. In fetuses ethanol is teratogenic, and whether there exists a safe dose during pregnancy is uncertain and controversial.
Keywords: Wernicke-Korsakoff; alcoholic dementia; glutamate

Type of Paper: Review
Title: Impact of Remission of Parental Alcoholism on Children of Alcoholic Parents: A Review
Author: Daniel J. Pilowsky
Affiliation: Departments of Epidemiology and Psychiatry, Mailman School of Public Healtjh at Columbia University, and New York State Psychiatric Institute, New York City, NY, USA; E-Mail: dp14@coulmbia.edu
Abstract: Children of alcoholic parents are known to have a higher prevalence of psychiatric symptoms and impaired social functioning compared to children of non-alcoholic parents. There is some evidence that a remission of paternal alcoholism may benefit these children. The scant available research has significant limitations, most prominently, the almost exclusive focus on alcoholic fathers, even though a remission of maternal alcoholism might have a similar or greater impact on children. The extant literature suggest that children of alcoholic fathers experience a decrease of psychiatric symptoms when their fathers become abstinent, and that preadolescents are more likely than adolescents to benefit from a remission of paternal alcoholism..
Keywords: children of alcoholic parents; COA; alcohol-remission; vulnerable children; alcoholic parents; impaired parents; parental alcohol treatment; alcoholism, alcohol abuse, alcohol dependence

Type of Paper: Article
Title: Drinking Pattern and Coronary Heart Disease Risk in Brazil
Authors: Maria Cristina Pereira Lima ¹, Florence Kerr-Corrêa ¹, Janaina Barbosa de Oliveira ², and Jürgen Rehm ^3,4
Affiliations: ¹ Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Sao Paulo State University (UNESP) CP 540, 18618-970, Botucatu, São Paulo, Brazil; E-Mails: mclima@fmb.unesp.br (M.C.P.L.); correaf@fmb.unesp.br (F.K.C.)
² Graduate Program in Mental Health, University of São Paulo (USP) Brazil; E-Mail: janabtc@yahoo.com.br
³ Centre for Addiction and Mental Health, Toronto, Canada; E-Mail: jtrehm@aol.com
⁴ Dalla Lana School of Public Health, University of Toronto, Canada
Abstract: A population-based cross-sectional study was conducted in Metropolitan Sao Paulo, Brazil. A representative sample of adults (30 years or older) was selected (n=1,501). The heart disease risk was assessed using the WHO Rose Angina questionnaire. Logistic Regression analysis showed that lifetime abstainers and former-drinkers had greater coronary heart disease risk than those who had drunk less than 20g pure alcohol per day, with no binge. Among those who reported binge there was a tendency toward higher risk. Our findings suggest an elevated risk for coronary heart disease among binge drinkers and claims for effective public polices to reduce harmful drinking.
Keywords: alcohol; patterns of consumption; coronary heart disease