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PubMed2004

Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories.

AIMS: To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies. PARTICIPANTS: One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993. DESIGN: Longitudinal follow-up across five waves of data collection. SETTING: Post high school in Victoria, Australia. MEASUREMENTS: Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour. FINDINGS: Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. FINDINGS: revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21. CONCLUSIONS: Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

Adolescent↗
PubMed2004

An addiction agency's collaboration with the drinks industry: Moo Joose as a case study.

AIM: This paper analyses a partnership between an addiction agency and the drinks industry in Australia, with special reference to concerns held by public health advocates for such projects. METHOD: Public health anxieties regarding collaboration between the drugs sector and the drinks industry are identified. A projected partnership between the Alcohol and Drug Foundation--Queensland (ADFQ) and the liquor industry in Australia is reviewed. The partnership involves the creation of a new organization, Alcohol Education Australia Ltd. (AEA), which states as its aim the education of consumers in responsible drinking. In order to assess the impact of the partnership an examination is undertaken of the AEA's stated mission and objectives, of relevant policy development by ADFQ and of ADFQ's intervention in support of an alcohol manufacturer which was putting a case to a licensing authority. FINDINGS: The results indicate the partnership advances the interests of the drinks industry rather than public health. The mission and objectives of Alcohol Education Australia Ltd subordinate public health goals to industry aims and the host organization, the ADFQ, has changed its policy and practice to accommodate the drinks industry. CONCLUSION: The partnership between the ADFQ and the drinks industry indicates the difficulty faced by addiction organizations in maintaining an uncompromising public health orientation when in partnership with the alcohol industry.

Alcohol Drinking↗
PubMed2005

Drinking pattern among adolescents with immigrant and Norwegian backgrounds: a two-way influence?

AIMS: To assess the association between drinking behaviour among adolescents with both immigrant and native backgrounds with aspects of acculturation. DESIGN: Cross-sectional school survey among 15-16 year olds. SETTING AND PARTICIPANTS: All students, a total of 8361, in 10th grade during spring 2000 and 2001 in Oslo, Norway with response rate 88.3%. The sample consisted of 1213 students with an immigrant background and 4627 students with a Norwegian background. MEASUREMENTS: Indicators of the length of the acculturation process were assessed as first versus second generation and in terms of length of stay in Norway. The proportion of Muslim students in school was an indicator of social environment 'dryness'. Drinking behaviour was assessed as drinking alcohol ever, drinking frequency and intoxication frequency. FINDINGS: A smaller proportion of immigrant students were current drinkers, frequent drinkers and drank to intoxication compared with adolescents with a Norwegian background. Adjusted two-level analyses showed that alcohol drinking was less common among immigrant students with a short stay in Norway and with a large proportion of Muslim students in school. In those with a Norwegian background there was a larger proportion of abstainers, and those who drank did so less frequently and were less frequently intoxicated the larger the proportion of Muslim students there was in their school. CONCLUSION: Drinking behaviour among adolescents in a multicultural and heterogeneous society seems to reflect a bi-directional acculturation process where the majority population tend to adapt to the behaviours of the immigrant population which in turn, to a varying degree, tends to adapt to the behaviour of the majority population.

Acculturation↗
PubMed1991

The effect of drinking on atrial natriuretic peptide, vasopressin and thirst appreciation in hyperosmolar man.

OBJECTIVES: To assess whether drinking and oropharyngeal stimuli mediate the release of plasma atrial natriuretic peptide (ANP) in man. DESIGN: Hypertonic saline was infused into male volunteers to stimulate thirst. In order to avoid any effect of volume change on ANP release, the studies were performed with the subject in the seated position. SUBJECTS: Seated normal male volunteers (n = 6) were infused with hypertonic saline at a rate of 0.06 ml/kg/min for 90 min on two separate occasions. After a 15-min equilibrium period, subjects were allowed to drink for the following 45-min period on one occasion, but no drinking was permitted on the other occasion. MEASUREMENTS: Aliquots of blood were withdrawn at 30-min intervals for 90 min during hypertonic saline infusion, and +3, 6, 9, 12, 15, 30 and 45 min during the drinking/control period for the measurement of plasma ANP, plasma vasopressin, plasma osmolality, serum sodium and haematocrit; thirst was assessed at the same time points using a visual analogue scale. Blood pressure was measured at 15-min intervals. RESULTS: Hypertonic saline infusion induces increases in plasma vasopressin, plasma osmolality, serum sodium and thirst appreciation (P less than 0.005), and blood volume (P less than 0.05) on both study days; there was no increase in plasma ANP during hypertonic saline infusion. During the drinking period there was the expected decrease in plasma vasopressin (P less than 0.01), plasma osmolality (P less than 0.05), serum sodium (P less than 0.05) and thirst appreciation (P less than 0.01); no significant changes occurred in plasma atrial natriuretic peptide, mean arterial blood pressure or haematocrit during either the drinking or the control period. CONCLUSIONS: The drinking-mediated inhibition of thirst appreciation and plasma vasopressin is not associated with any change in plasma ANP concentrations; it does not appear that oropharyngeal stimuli contribute to the release of ANP in man.

Adult↗
PubMed2004

Effect of oxygen on survival of faecal pollution indicators in drinking water.

AIMS: The aim of this study was to determine the effect of oxygen on the survival of faecal pollution indicators including Escherichia coli in nondisinfected drinking water. METHODS AND RESULTS: Aerobic and anaerobic drinking water microcosms were inoculated with E. coli ATCC 25922 or raw sewage. Survival of E. coli was monitored by membrane filtration combined with cultivation on standard media, and by in situ hybridization with 16S rRNA-targeted fluorescent oligonucleotide probes. Anaerobic conditions significantly increased the survival of E. coli in drinking water compared with aerobic conditions. Escherichia coli ATCC 25922 showed a biphasic decrease in survival under aerobic conditions with an initial first-order decay rate of -0.11 day(-1) followed by a more rapid rate of -0.35 day(-1). In contrast, the first-order decay rate under anaerobic conditions was only -0.02 day(-1). After 35 days, <0.01% of the initial E. coli ATCC 25922 population remained detectable in aerobic microcosms compared with 48% in anaerobic microcosms. A poor survival was observed under aerobic conditions regardless of whether E. coli ATCC 25922 or sewage-derived E. coli was examined, and regardless of the detection method used (CFU or fluorescent in situ hybridization). Aerobic conditions in drinking water also appeared to decrease the survival of faecal enterococci, somatic coliphages and coliforms other than E. coli. CONCLUSIONS: The results indicate that oxygen is a major regulator of the survival of E. coli in nondisinfected drinking water. The results also suggest that faecal pollution indicators other than E. coli may persist longer in drinking water under anaerobic conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: The effect of oxygen should be considered when evaluating the survival potential of enteric pathogens in oligotrophic environments.

Aerobiosis↗
PubMed2004

Exploring the effects of psychosocial and acculturation factors on drinking behavior among aboriginal adolescents in Taiwan.

The purpose of this study was to examine the effects of psychosocial and acculturation factors on drinking behavior among Taiwanese aboriginal teenagers. Stratified random sampling was used to select six of the 19 aboriginal schools in Taipei, Pingtung, Hualien, and Taitung counties. A total of 495 student subjects were enrolled in the study, including 290 boys and 205 girls, with classification by tribe of 206 Amis, 97 Atayal, 94 Paiwan, 47 Bunun, 19 Rukai, 15 Yami, 10 Puyuma, two Saisiyat, one Tsou, and four unknown. The analysis indicated that the psychosocial and acculturation factors that directly influenced drinking behaviors of aboriginal teenagers were: self-efficacy, drinking behaviors of parents, peer alcohol use, social assimilation, social attitude, and territorial attitude. In this model, peer alcohol use had the most prominent impact on drinking behavior among aboriginal teenagers. The findings suggest that parents' behaviors play a significant role in the development of problematic drinking behavior in the aboriginal teenager through observation and imitation, and also that self-efficacy and the level of acculturation influences drinking behavior in aboriginal teenagers.

Acculturation↗
PubMed1982

Maternal drinking behavior and decreased intrauterine growth.

Reduced intrauterine growth has been a widely observed effect of maternal alcohol use during pregnancy in both animals and humans, although results in studies of humans have been inconsistent. The goal of this prospective study was to evaluate the relative importance of volume, frequency, and beverage source of alcohol as determinants of infant birthweight, while adjusting for other known determinants using multivariate techniques. In a sample of 5,093 maternal-infant pairs, 44 potential determinants of intrauterine growth were evaluated. The frequency of beer drinking, controlled for wine drinking, liquor drinking, and other variables, was found to contribute independently to a reduction of intrauterine growth, as measured by birthweight adjusted for gestational age. Of the variables explored, 11, including cigarette smoking and caffeine intake, were found to contribute significantly (R2 = 32%; p less than 0.001) to the variance. The effect of beer drinking was most apparent in the most frequently drinking 3% of gravidas. These results appear to confirm a previous suggestion that heavy beer drinking during pregnancy is related to decreased intrauterine growth, but should be interpreted cautiously since there are several alternative explanations for the finding. Thus, these results suggest several areas for further investigation.

Adult↗
PubMed1986

Monitoring drinking behavior with the alcohol dipstick during treatment.

The present communication is the first report on the clinical use of the alcohol dipstick to continuously monitor alcoholics' drinking during treatment. Daily urine samples from 34 alcoholics were tested for alcohol by the clinical staff using the alcohol dipstick. The patients also provided self-reports of drinking daily. Patients' compliance for submitting urine samples and for completing daily monitoring sheets (DMS) was 93 and 95%, respectively. Over 75% of the patients drank on at least one occasion; about half of these patients denied drinking detected by the urine tests. Drinking was confirmed by both methods in 39% of the patients who drank, and by the urine testing alone in 54%. The patients in treatment for less than 2 months were abstinent on 85% of the days compared to 98% for those in treatment for 6 months or longer. Seventy-two percent of all alcohol-positive urine samples were submitted by patients on days when they denied drinking. Monitoring of patients' drinking was useful in their clinical management. The alcohol dipstick was a simple, inexpensive, and rapid alcohol measuring procedure that could be used by the clinical staff in the treatment setting.

Adult↗
PubMed1988

Drinking patterns and problems associated with injury status in emergency room admissions.

A study of emergency room admissions at San Francisco General Hospital was undertaken to analyze the association of drinking patterns and problems with injury status. A 20% probability sample of patients admitted to the emergency room around-the-clock over a 60-day period was interviewed. Interviews were completed on 75% of those sampled (N = 1896). Of these, 29% (N = 555) were admitted to the emergency room for injuries, with drinkers more likely than abstainers to be admitted for injuries. Differences were found in the quantity and frequency of usual drinking and frequency of drunkenness for type and cause of injury and for prior alcohol-related accidents. Little differences was found between the injured and noninjured on social consequences of drinking or experiences associated with alcohol dependence and loss of control over drinking. Both injured and noninjured in this population reported much higher rates of frequent heavy drinking and alcohol-related problems than that found in the general population which may have masked additional associations of drinking patterns and problems with injury status.

Adult↗
PubMed1992

Sedating effects of ethanol and time of drinking.

Ethanol (0.5 g/kg) was administered to 12 healthy, normal-sleeping men, aged 21 to 45, at two different times of the day (0900 and 1700 hr). The Multiple Sleep Latency Test (MSLT) was conducted at 1000, 1200, 1400, and 1600 hr in the day drinking condition and at 1800, 2000, 2200, and 2400 hr in the evening drinking condition. On placebo, sleepiness was greater in the daytime testing hours than in the evening, replicating findings on the circadian rhythm of sleepiness/alertness. There was a time of drinking (day versus evening) by ethanol interaction. An ethanol effect on sleep latency was found in the daytime hours, when alertness was relatively low. Ethanol failed to have a significant effect on sleep latency during the evening hours when alertness levels were increasing. Performance on a divided attention task, administered 1 hr postconsumption, was impaired by ethanol consumption, but did not vary as a function of time of drinking (day versus evening). However, at 5 hr postconsumption, mean reaction time on the first 20 min of a 40-min auditory vigilance task was slowed by ethanol to a greater extent after day drinking then after evening drinking.

Adult↗
PubMed1993

Use of the TWEAK test in screening for alcoholism/heavy drinking in three populations.

TWEAK is an acronym for Tolerance (T1 number of drinks to feel high; T2, number of drinks one can hold), Worry about drinking, Eye-opener (morning drinking), Amnesia (blackouts), and Cut down on drinking (K/C). In this study, two versions (T1 and T2) of the TWEAK were part of a questionnaire used to detect alcoholism or heavy alcohol intake in three populations, namely, alcoholics in treatment, patients in two outpatient clinics, and the general population. Similar to the CAGE and the 10-item brief MAST, the TWEAK identified most known alcoholics, but the TWEAK had a higher sensitivity and specificity than the CAGE and B-MAST in detecting alcoholism/heavy drinking in the clinical and general populations. Different cut-off values for tolerance (T1 and T2) are recommended for screening different populations.

Adolescent↗
PubMed1994

Drinking outcomes of alcohol abusers diagnosed as antisocial personality disorder.

Clinical research and wisdom suggest that alcoholics with antisocial personality (ASPs) disorders have poorer drinking outcomes after treatment than alcoholics without this disorder. The present study challenges this wisdom, suggesting that poor prognosis and response to treatment have been confounded by not covarying on pretreatment drinking measures. Thirty-one ASPs are compared with 118 non-ASPs randomly assigned to extended cognitive behavioral and relationship enhancement treatments. Thirteen to 18 months after treatment initiation, ASPs average more abstinent days than do non-ASPs. Drinking intensity is a function of a patient-treatment matching effect: ASPs treated with cognitive behavioral treatment (CB) drink less/drinking day than do either non-ASPs treated in CB or ASPs treated in relationship enhancement. This finding is supportive of a comparable matching effect for CB and ASP found by Kadden et al. (1989). Examination of the process indicates that, irrespective of drinking index, ASPs respond poorly when they experience high posttreatment support for abstinence, whereas non-ASPs respond better with support. We conclude that early pessimism for successful treatment of ASP alcoholic drinking outcome may be unwarranted.

Adult↗
PubMed1994

Alcohol norms, expectancies, and reasons for drinking and alcohol use in a U.S. versus a Japanese college sample.

Two hundred eighty-two students at Arizona State University in the U.S. and 339 students at Okayama University in Japan completed a questionnaire on their alcohol use, expectancies of the effects of alcohol on their own and others' moods and behaviors, the desirability of these effects, norms of significant others for levels of alcohol use and the subject's desire to comply with these norms, and reasons for drinking and not drinking alcohol. Although frequencies of current drinkers versus abstainers did not differ between the two samples, the U.S. students began regular alcohol use at a significantly earlier age, currently drank more alcohol, had higher alcohol expectancies for emotional responses, and endorsed more celebratory reasons for drinking than their Japanese counterparts. U.S. students, however, had lower expectancies for flushing and lower perceived norms for drinking. Hierarchical multiple regressions performed using data from the current drinkers indicated that expectancies of disinhibition and especially aggressiveness after alcohol use, alcohol norms, celebratory (but not pathological) reasons for drinking, and reasons for not drinking were more predictive of reported levels of alcohol use among the U.S. students as compared with the Japanese students.

Adolescent↗
PubMed1995

High-risk drinking across the transition from high school to college.

Alcohol use and related problems were studied from the senior year in high school to the first autumn in college for 366 heavy drinking students. Four risk factors-subject sex, family history of drinking problems, prior conduct problems, and type of college residence-were evaluated as predictors of: (1) differential changes in drinking rates, (2) differential changes in alcohol-related problems, and (3) alcohol dependence symptoms during the first college term. Results suggest that both dispositional and environmental factors are associated with changes in drinking rates and the existence of dependence symptoms. Increases in the frequency of drinking were specifically and strongly associated with residence in a fraternity (men) or sorority (women). Three risk factors were associated with increased quantity of drinking: male gender, residence in a fraternity or sorority, and a history of conduct problems. Prior conduct problems were also consistently associated with dependence symptoms during the first term in college. A family history of alcohol problems was not consistently related to changes in use rates or problems, although some analyses suggest interactive effects. Early interventions on college campuses should target individuals using additive risk profiles.

Adolescent↗
PubMed1996

Naltrexone increases the latency to drink alcohol in social drinkers.

We investigated the effects of naltrexone (NTX) on alcohol drinking, urge to drink alcohol, and alcohol-induced sensations and mood states in social drinkers consuming alcohol ad libitum in a cocktail bar. Sixteen college-age men and women participated in a double-blind, placebo-controlled, within-subjects, cross-over study. Subjects were tested during each of three drug conditions: NTX, 50 mg/ day, po; inactive placebo; and no drug. Each treatment condition lasted 8 to 11 days. Small groups of subjects consumed alcohol ad libitum during three 2-hr evening drinking sessions, separated by approximately-2 weeks. NTX treatment significantly increased the latency (time in seconds) to first sip the first (p < 0.05) and second alcoholic beverages consumed (p < 0.01). Moreover, the mean blood alcohol concentration at the end of the session was significantly lower when subjects were treated with NTX (p < 0.05). No differences were found on self-report urge to drink alcohol. Subjects reported more fatigue and tension on the Profile of Mood States (p < 0.05), before drinking, and increases in nausea on the Alcohol Sensation Scale (p < 0.05) when treated with NTX. The increase in the latency to sip the first and second alcoholic beverages may reflect the capacity of NTX to block urge for alcohol elicited from external cues (before consuming alcohol), as well as urge for alcohol after priming from ingested alcohol. Thus, the effectiveness of NTX for reducing drinking behaviors of alcoholics may be partially caused by anticraving properties of NTX.

Adult↗
PubMed1998

How do physicians define "light," "moderate," and "heavy" drinking?

Although widely used, terms associated with consumption of alcohol--such as "light," "moderate," and "heavy"--are unstandardized. Physicians conveying health messages using these terms therefore may impart confusing information to their patients or to other physicians. As an initial attempt to assess if informal standardization exists for these terms, the present study surveyed physicians for their definitions of such terms. Physicians operationally defined "light" drinking as 1.2 drinks/day, "moderate" drinking as 2.2 drinks/day, and "heavy" drinking as 3.5 drinks/day. Abusive drinking was defined as 5.4 drinks/day. There was considerable agreement for these operational definitions, indicating there is indeed an informal consensus among physicians as to what they mean by these terms. Gender and age did not influence these definitions, but self-reported drinking on the part of physicians was a factor. We also asked physicians for their opinions regarding the effects of "light," "moderate," and "heavy" drinking on health in general and specifically on health-related implications for pregnant women, and whether they felt their patients shared these beliefs.

Adolescent↗
PubMed1999

Drinking patterns and problems: a comparison of two black primary care samples in two regions.

This paper explores the effect of regional ("wet" vs. "dry") variation in drinking patterns and problems on the prevalence of alcohol-related problems among those seeking care in primary care settings. A sample of black primary care patients interviewed in Hinds County, MS (n = 740) and in Contra Costa County, CA (n = 93) are compared on quantity and frequency of usual drinking, drunkenness, consequences of drinking, and alcohol dependence. Controlling for demographic differences in logistic regression analysis, drinkers in Contra Costa, while no more likely to report heavy drinking, were four times more likely to report alcohol-related consequences, more than five times more likely to report alcohol dependence experiences, and more than nine and a half times more likely to report ever having had treatment for an alcohol problem than those in Hinds County. Data suggest that regional variations in drinking patterns may be reflected in alcohol involvement in primary care caseloads, and that the large variation in the prevalence of alcohol-related problems found in primary care settings may, in part, be attributable to this. All primary care settings do not appear to hold equal promise for screening for and intervening with problem drinking, and further research is needed in determining those settings that provide the greatest potential for targeting prevention efforts.

Adult↗
PubMed2006

Targeted versus daily naltrexone: secondary analysis of effects on average daily drinking.

BACKGROUND: To extend our previous findings that naltrexone reduced the likelihood of heavy drinking on a given day among problem drinkers, while targeted administration reduced the likelihood of any drinking, we examined the effects of naltrexone and targeted administration on the continuous outcome of drinks/day. Because treatment response may differ by gender, we also compared the effects on this factor. METHODS: In a double-blind, placebo-controlled study, problem drinkers (n=150, 58% men) were randomly assigned to 8 weeks of treatment with naltrexone (50 mg/day) or placebo, either daily or on a targeted schedule. All subjects also received brief coping skills therapy. To complement the traditional regression analysis conducted previously, a zero-inflated Poisson regression model was used to examine the effects of medication, schedule of administration, and gender on the number of standard drinks consumed daily. RESULTS: Targeted naltrexone, and to a lesser extent targeted placebo, yielded a greater reduction in daily drinking than did daily placebo, an effect that did not differ by gender and that was greater than that seen for daily naltrexone treatment. Relative to daily placebo, daily naltrexone reduced the number of drinks/day only among men, at the level of a nonsignificant trend. CONCLUSIONS: Although in both genders, targeted treatments appeared to reduce the volume of drinking, treatment with targeted naltrexone was somewhat better. In contrast, heavy drinking women showed no benefit from daily naltrexone treatment. Further evaluation of the efficacy of targeted treatments and of daily naltrexone and the relationship of these treatments with gender is warranted.

Adolescent↗