WorldWideScience

Sample records for public alcohol treatment

  1. Elderly alcoholics in outpatient treatment

    DEFF Research Database (Denmark)

    Nielsen, Bent; Nielsen, Anette Søgaard; Lolk, Anette

    2010-01-01

    In Denmark, the treatment of alcoholics is provided by public outpatient alcohol clinics. The purpose of this study was to investigate whether elderly patients differ from younger patients with regards to sociodemographic data, drinking pattern and psychiatric comorbidity which may affect...

  2. Hispanic Alcoholic Treatment Considerations.

    Science.gov (United States)

    Costello, Raymond M.

    1987-01-01

    A path analytic model for Hispanic alcoholics relating socioclinical prognostic variables to outcome following treatment in a therapeutic community differs markedly from that fitted to Anglo alcoholics. The differential relationship of education to alcoholism severity and outcome was noted specifically as reflecting different racial-ethnic paths…

  3. Alcohol Use Disorder (AUD) Treatment

    Science.gov (United States)

    ... provide ideas that may help you make a change. Is treatment for alcohol use disorder effective? For most people, treatment for an AUD is helpful. But overcoming an alcohol use disorder is an ongoing process, ...

  4. Alcohol, diabetes, and public health in the Americas.

    Science.gov (United States)

    Babor, Thomas; Rehm, Jurgen; Jernigan, David; Vaeth, Patrice; Monteiro, Maristela; Lehman, Hallie

    2012-08-01

    This article describes epidemiological evidence on the association between alcohol use and diabetes, and the implications for clinical management and public health policies in the Americas. Heavy alcohol use is a risk factor for both diabetes and poor treatment adherence, despite evidence that moderate drinking can protect against type 2 diabetes under some circumstances. The burden of disease from diabetes associated with excessive alcohol consumption warrants both clinical and public health measures. On the clinical level, research on early interventions to prevent hazardous drinking shows that new screening, brief intervention, and referral techniques are effective ways to manage hazardous drinking in primary care settings. On the population level, restrictions on alcohol marketing and other alcohol control policies reduce the frequency and intensity of alcohol consumption in at-risk populations. These policy actions are recommended within the context of the World Health Organization's global strategy to reduce the harmful use of alcohol.

  5. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  6. Delivering Service Quality in Alcohol Treatment: A Qualitative Comparison of Public and Private Treatment Centres by Service Users and Service Providers

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2012-01-01

    In the UK, quality of care has now been placed at the centre of the National Health Service (NHS) modernisation programme. To date, there has been little research on the service quality delivery of alcohol treatment services from the perspective of both the service user and service provider. Therefore, this qualitative study explored the…

  7. Caffeinated alcohol beverages: a public health concern.

    Science.gov (United States)

    Attwood, Angela S

    2012-01-01

    Consumption of alcohol mixed with caffeinated energy drinks is becoming popular, and the number of pre-mixed caffeinated alcohol products on the worldwide market is increasing. There is public health concern and even occasional legal restriction relating to these drinks, due to associations with increased intoxication and harms. The precise nature and degree of the pharmacological relationship between caffeine and alcohol is not yet elucidated, but it is proposed that caffeine attenuates the sedative effects of alcohol intoxication while leaving motor and cognitive impairment unaffected. This creates a potentially precarious scenario for users who may underestimate their level of intoxication and impairment. While legislation in some countries has restricted production or marketing of pre-mixed products, many individuals mix their own energy drink-alcohol 'cocktails'. Wider dissemination of the risks might help balance marketing strategies that over-emphasize putative positive effects.

  8. Economic issues and public alcohol abuse prevention policies in France

    Science.gov (United States)

    Spach, Miléna

    2016-10-19

    Objective: To analyse the impact of the alcohol market on the implementation of strong-willed public alcohol abuse prevention policies based on a critical review of the literature. Method: Documentary research and analysis of the alcohol market economic data were performed. An overview of public alcohol abuse prevention policies was conducted from a historical perspective by distinguishing drunkenness control policies, protection of vulnerable populations, and the fight against drink driving and drinking in the workplace. Results: Public alcohol abuse prevention policies are primarily designed to reduce the harmful consequences of alcohol occurring as a result of a drinking episode (motor vehicle accident, highway accidents, etc.), while neglecting the long-term consequences (cancer, cirrhosis, etc.). Moreover, while taxation is one of the major public health tools used to reduce the costs of alcohol-related damage on society, the State exercises legislative and tax protection for alcoholic beverages produced in France. In particular, wine benefits from a lower tax rate than other stronger forms of alcohol (spirits, liquors, etc.). The economic weight of the alcohol market can provide an explanation for these public alcohol abuse prevention policies. Conclusion: In view of the mortality caused by alcohol abuse, France must implement a proactive public policy. An alcohol taxation policy based on the alcohol content, a minimum unit pricing for alcohol, or higher taxes on alcohol are public policies that could be considered in order to reduce alcohol-related mortality.

  9. Antabuse treatment for excessive users of alcohol

    DEFF Research Database (Denmark)

    Hardt, F

    1992-01-01

    Antabuse treatment has mostly been applied to alcohol dependent patients although the heavy users of alcohol are responsible for the major parts of alcohol related problems in our societies. The heavy users of alcohol should be identified both by the general practitioners and the hospital doctors...... in any field and the first intervention should be a health interview connected with a biological monitoring of alcohol damages and thereby many patients would be motivated for moderate drinking. If this is not the case, heavy users should be encouraged to a 6 or better a 12 months supervised treatment...... with Antabuse. This treatment has especially been effective in employees with work-related alcohol problems....

  10. A review of public opinion towards alcohol controls in Australia

    Directory of Open Access Journals (Sweden)

    Livingstone Charles

    2011-01-01

    Full Text Available Abstract Background Increasing concern about the negative impact of alcohol on the Australian community has renewed calls for tighter regulatory controls. This paper reviews levels of and trends in public support for liquor control regulations, regulation of alcohol promotions, and alcohol pricing and taxation reforms in Australia between 1998 and 2009. Methods Six electronic databases and twenty public health and alcohol organisation websites were searched for research literature, reports and media releases describing levels of public support for alcohol controls. Only studies which randomly selected participants were included. Results Twenty-one studies were included in the review. The majority of the Australian public support most proposed alcohol controls. Levels of support are divided between targeted and universal controls. Conclusions Implementation of targeted alcohol policies is likely to be strongly supported by the Australian public, but universal controls are liable to be unpopular. Policy makers are provided with insights into factors likely to be associated with higher public support.

  11. Alcohol abuse and related disorders treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Yu. P. Sivolap

    2014-01-01

    Full Text Available Alcohol abuse and alcoholism are the leading causes of worse health and increased mortality rates. Excessive alcohol consumption is the third leading cause of the global burden of diseases and a leading factor for lower lifespan and higher mortality. Alcohol abuse decreases working capacity and efficiency and requires the increased cost of the treatment of alcohol-induced disorders, which entails serious economic losses. The unfavorable medical and social consequences of excessive alcohol use determine the importance of effective treatment for alcoholism. The goals of rational pharmacotherapy of alcohol dependence are to enhance GABA neurotransmission, to suppress glutamate neurotransmission, to act on serotonin neurotransmission, to correct water-electrolyte balance, and to compensate for thiamine deficiency. Alcoholism treatment consists of two steps: 1 the prevention and treatment of alcohol withdrawal syndrome and its complications (withdrawal convulsions and delirium alcoholicum; 2 antirecurrent (maintenance therapy. Benzodiazepines are the drugs of choice in alleviating alcohol withdrawal and preventing its convulsive attacks and delirium alcoholicum. Diazepam and chlordiazepoxide are most commonly used for this purpose; the safer drugs oxazepam and lorazepam are given to the elderly and patients with severe liver lesions. Anticonvulsants having normothymic properties, such as carbamazepine, valproic acid, topiramate, and lamotrigine, are a definite alternative to benzodiazepines. The traditional Russian clinical practice (clearance detoxification has not a scientific base or significant impact on alcohol withdrawal-related states in addicts. Relapse prevention and maintenance therapy for alcohol dependence are performed using disulfiram, acamprosate, and naltrexone; since 2013 the European Union member countries have been using, besides these agents, nalmefene that is being registered in Russia. Memantine and a number of other

  12. Pharmacogenomics of alcohol addiction: Personalizing pharmacologic treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Ragia Georgia

    2014-01-01

    Full Text Available Alcohol dependence is a serious psychiatric disorder with harmful physical, mental and social consequences, and a high probability of a chronic relapsing course. The field of pharmacologic treatment of alcohol dependence and craving is expanding rapidly; the drugs that have been found to reduce relapse rates or drinking in alcohol-dependent patients and are approved for treatment of alcohol dependence are naltrexone, acamprosate and disulfiram, whereas also topiramate appears as a promising therapy. For many patients, however, these treatments are not effective. Evidence from a number of different studies suggests that genetic variation is a significant contributor to interindividual variation of clinical presentation of alcohol problems and response to a given treatment. The aim of the present review is to summarize and discuss the findings on the association between gene polymorphisms and the response to alcohol dependence treatment medications. It is anticipated that future implementation of pharmacogenomics in clinical practice will help personalize alcohol dependence drug treatment, and development personalized hospital pharmacology.

  13. Recent developments in alcoholism: inpatient treatment.

    Science.gov (United States)

    Nace, E P

    1993-01-01

    The historical role of inpatient treatment for alcoholism is reviewed in terms of its advantages and disadvantages. The factors that have forced a change in the utilization of inpatient treatment include increasing recognition of the heterogeneity of alcoholic patients, negative outcome studies, and cost-containment efforts. The clinical domains that warrant inpatient treatment are outlined, and decisions of treatment placement are necessarily guided by the factors of acuteness, ability, safety, and stabilization.

  14. From alcohol toxicity to treatment

    NARCIS (Netherlands)

    Seitz, HK; Salaspuro, M; Savolainen, M; Haber, P; Ishii, H; Teschke, R; Moshage, H; Lieber, CS

    This article presents the proceedings of a symposium held at the meeting of the International Society for Biomedical Research on Alcoholism in Mannheim, Germany, in October 2004. This symposium was dedicated to Charles S. Lieber in recognition of his contribution in alcohol research over the last 50

  15. From alcohol toxicity to treatment

    NARCIS (Netherlands)

    Seitz, HK; Salaspuro, M; Savolainen, M; Haber, P; Ishii, H; Teschke, R; Moshage, H; Lieber, CS

    2005-01-01

    This article presents the proceedings of a symposium held at the meeting of the International Society for Biomedical Research on Alcoholism in Mannheim, Germany, in October 2004. This symposium was dedicated to Charles S. Lieber in recognition of his contribution in alcohol research over the last 50

  16. Alcohol industry influence on UK alcohol policy: A new research agenda for public health

    OpenAIRE

    2012-01-01

    : The British government has been criticised for according industry interests too much weight in alcohol policy-making. Consequently, it has been argued that alcohol strategy in the UK is built around policies for which the evidence base is weak. This has clear implications for public health. The purpose of this commentary is to map recent developments in UK alcohol policy and related debates within the alcohol policy literature, thus laying the foundations for a systematic examination of the...

  17. A randomized controlled trial of Minnesota day clinic treatment of alcoholics

    DEFF Research Database (Denmark)

    Grønbaek, Morten; Nielsen, Bent

    2007-01-01

    AIM: To compare the Minnesota day clinic treatment with the traditional public psychosocial treatment. DESIGN: Randomized controlled trial. SETTING: Public out-patient alcohol clinic and privately funded Minnesota day clinic in Denmark. PARTICIPANTS: A total of 148 individuals with alcohol...

  18. The Alcohol Mandatory Treatment Act: evidence, ethics and the law.

    Science.gov (United States)

    Lander, Fiona; Gray, Dennis; Wilkes, Edward

    2015-07-01

    The Northern Territory Alcohol Mandatory Treatment Act 2013 (AMT Act) permits mandatory residential alcohol rehabilitation for up to 3 months. International guidelines and human rights law confirm that mandatory rehabilitation should only be used for short periods. Evidence concerning the efficacy of long-term mandatory alcohol rehabilitation is lacking, and minimal data concerning the efficacy of the scheme have been released. Specific legal issues also arise concerning the AMT Act, including its potentially discriminatory application to Aboriginal and Torres Strait Islander peoples. The program only permits referral by police, despite the fact that it is ostensibly a medical intervention. Use of a treatment as a method of effectively solving a public intoxication problem is highly dubious, and should be of concern to the medical community. Given that more cost-effective and proven measures exist to combat alcohol dependence, the utility of the AMT Act is questionable.

  19. [Misuse of alcohol and new drug treatments].

    Science.gov (United States)

    Paille, François

    2011-12-01

    Three drugs are currently marketed in France in the prevention of relapse in alcohol-dependent patients. Their efficacy though real remains limited and it is useful to develop other molecules. Some products are at present under evaluation, and are already or could be used in the near future in the treatment of alcohol dependence: baclofene, oxybate de sodium (GHB), nalmefene, topiramate, ondansetron and aripiprazole. The available studies on these molecules are still limited and the results sometimes clinically modest. Nevertheless, some of them open interesting future prospects. If there is no big revolution to wait in the short term in the treatment of alcohol dependence, we can consider some interesting orientations: better effectiveness on alcohol consumption, but also change of paradigm concerning the objectives and the methods of this treatment: reduction of consumption versus abstinence, treatment on request, choice of the molecule guided by objective criteria (psychosocial, biological, genetic...).

  20. Alcoholism in Southeast Asia. Prevalence and treatment.

    Science.gov (United States)

    McGovern, M P

    1982-01-01

    A pilot, field investigation of the prevalence and treatment of alcoholism in Southeast Asia (Singapore, Indonesia, Malaysia, Burma, and Thailand) and conducted. The methodology combined an informant study, interviewing leading alcohol and drug abuse authorities; utilising existing data; and clinical and naturalistic observation. The effects of modernisation, multiracial culture, and the unilateral focus on opiates are discussed; recommendations on treatment, education, and research are presented.

  1. Treatment of alcohol withdrawal with gabapentin.

    Science.gov (United States)

    Bozikas, Vasilis; Petrikis, Petros; Gamvrula, Katerina; Savvidou, Ioanna; Karavatos, Athanasios

    2002-01-01

    Gabapentin is an anticonvulsant agent, also effective in the treatment of mood disorders and anxiety disorders. Three cases of alcohol withdrawal treated with gabapentin are presented. All patients received gabapentin 400 mg tid for 3 days, 400 mg bid for 1 day, and finally 400 mg for 1 day. Withdrawal symptoms subsided and no adverse effects were observed. The possible effectiveness of gabapentin in the treatment of alcohol withdrawal warrants further investigation by systematic and well-designed studies.

  2. Psychoanalytic treatment of psychological addiction to alcohol (alcohol abuse).

    Science.gov (United States)

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments.

  3. Treatment of alcohol withdrawal syndrome with gabapentin.

    Science.gov (United States)

    Bonnet, U; Banger, M; Leweke, F M; Maschke, M; Kowalski, T; Gastpar, M

    1999-05-01

    Four in-patients with moderate alcohol-withdrawal syndromes benefited from treatment with gabapentin administered in an add-on fashion to clomethiazole. In comparison with the amount of clomethiazole required as estimated using a specially developed score during previous detoxifications of these patients at our hospital, gabapentin (400 mg q.i.d.) clearly reduced the amount of clomethiazole needed now Gabapentin, an anticonvulsant with favorable pharmacokinetic properties and tolerability, and with no known risk of dependence, may therefore be a useful new drug in the treatment of alcohol withdrawal. We believe that the potential value of gabapentin in alcohol withdrawal deserves further controlled studies.

  4. Alcohol and Public Health: Frequently Asked Questions

    Science.gov (United States)

    ... problem? What health problems are associated with excessive alcohol use? I’m young. Is drinking bad for my health? Is it ... health? Yes. 8,9 Studies have shown that alcohol use by adolescents and young adults increases the risk of both fatal and ...

  5. The New Alcoholics: Teenagers. Public Affairs Pamphlet No. 499.

    Science.gov (United States)

    Saltman, Jules

    This brief pamphlet on teenage alcoholism is one in a series published by the Public Affairs Committee. It was designed to give concise and useful information on teenage alcohol problems, and was written for both adults and youth. Statistics are offered as proof that large numbers of American teenagers are already problem drinkers. The current…

  6. Public Policy and the Child of the Alcoholic.

    Science.gov (United States)

    O'Gorman, Patricia A.

    1982-01-01

    Outlines historical development of the concept of children of alcoholics as a high-risk population in need of protection. Highlights recent efforts on the behalf of such children by public and private agencies. (CMG)

  7. [Ambulant treatment of alcohol withdrawal].

    Science.gov (United States)

    Nüstedt, Volker

    2016-07-01

    Most of the patients addicted to alcohol are socially well integrated. The offer of a low threshold ambulant withdrawal therapy opens an opportunity to build a sustainable therapeutic relationship. The so started empathic addiction therapy will be well accepted and will lead to a satisfying outcome. Using Clomethiazole or Oxazepam in a daily reduced dose and with daily personal contacts, the ambulant withdrawal in patients without seizures or delir in medical history is a secure and successful therapeutic option.

  8. Effectiveness of public health programs for decreasing alcohol consumption

    Directory of Open Access Journals (Sweden)

    Kelly-Weeder S

    2011-05-01

    Full Text Available Susan Kelly-Weeder, Kathryn Phillips, Shannon RounsevilleWilliam F Connell School of Nursing, Boston College, Chestnut Hill, MA, USAAbstract: Excessive alcohol consumption and the associated negative consequences are a major public health concern in the United States and throughout the world. Historically, there have been numerous attempts to develop policies and prevention programs aimed at decreasing high-risk alcohol use. Policy initiatives have demonstrated considerable effectiveness and include changes in the minimum legal drinking age, reductions in acceptable legal limits for blood alcohol concentration while operating a motor vehicle, as well as decreasing availability and access to alcohol for underage individuals. Primary prevention programs that have used exclusively educational approaches have received mixed results. Increasing effectiveness has been associated with prevention programs that have utilized a multi-component approach and have included educational initiatives with environmental changes.Keywords: alcohol abuse, underage, public health, programs, binge drinking

  9. Motivation to change drinking behavior: the differences between alcohol users from an outpatient gastroenterology clinic and a specialist alcohol treatment service

    Directory of Open Access Journals (Sweden)

    Neliana Buzi Figlie

    Full Text Available CONTEXT AND OBJECTIVE: For some patients who have developed significant alcohol-related physical disease, total abstinence from alcohol may offer the best chance of survival. The aim of this study was to investigate motivation for treatment in two groups of alcohol users: outpatients from the gastroenterology clinic and outpatients from the specialist alcohol treatment service. DESIGN AND SETTING: Cross-sectional study, at a federally funded public teaching hospital. METHODS: The sample studied was 151 outpatients from the gastroenterology clinic and 175 from the specialist alcohol treatment service. The interview was conducted in the outpatient clinics at the first appointment, and consisted of demographic questions and scales for measuring quality of life, alcohol dependence, pattern of alcohol, motivation for treatment and consequences of alcohol consumption. RESULTS: The results suggested that outpatients from the gastroenterology clinic were less dependent on alcohol, had suffered fewer consequences from alcohol and had fewer emotional and mental health problems than did the outpatients from the alcohol treatment service. In relation to their stages of change, the gastroenterology outpatients presented high precontemplation scores at the beginning of treatment while outpatients of alcohol treatment service showed higher scores in contemplation, action and maintenance. CONCLUSION: The medical treatment may be a reason for the temporary alcohol abstinence behavior among the gastroenterology outpatients.

  10. Korean public opinion on alcohol control policy: a cross-sectional International Alcohol Control study.

    Science.gov (United States)

    Seo, Seonwha; Chun, Sungsoo; Newell, Maxine; Yun, Mieun

    2015-01-01

    To examine Korean public opinions toward alcohol control measures on availability, advertisement, drink-driving and pricing policy, and how the views on alcohol control policy vary by demographics, drinking patterns and attitude to drinking environments. The study used national-based, cross-sectional data collected in 2012 as part of the International Alcohol Control study. 2510 people (M: 1163, F: 1261) aged 15-65 and living in geographically diverse regions of Korea completed the questionnaire asking the support of 12 alcohol control measures. Generally, targeted measures (purchase age of 20 and drink-driving) were more popular than universal (availability, advertisement and price) among Koreans. Gender, age, marital status, drinking patterns and attitude to drinking environments related to alcohol use of young and heavy drinkers were strong predictors of the opinions on most of the alcohol control measures. It was daily/weekly drinkers who opposed most restrictions on alcohol availability and price and the support from individuals who are more aware of problems with drinking in public place was outstanding in every control measure. These findings should be taken into account by Korean policy-makers as they formulate an alcohol policy for the country. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. Cannabis use during treatment for alcohol use disorders predicts alcohol treatment outcomes.

    Science.gov (United States)

    Subbaraman, Meenakshi Sabina; Metrik, Jane; Patterson, Deidre; Swift, Robert

    2017-04-01

    To compare post-treatment alcohol use between those who use cannabis and those who abstain during treatment for alcohol use disorders (AUD); and to examine potential cannabis use thresholds by comparing post-treatment alcohol use between four frequency groups of cannabis users relative to abstainers. Secondary analyses of the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) Study, a randomized control trial of AUD treatments. The current study compares longitudinal drinking data between those who used cannabis versus those who abstained during COMBINE treatment. The COMBINE Study treatments were delivered on an out-patient basis for 16 weeks. The current analyses include 206 cannabis users and 999 cannabis abstainers. All participants met diagnosis of primary alcohol dependence (n = 1383). Primary exposures were any cannabis use and quartiles of cannabis use (Q1: 1-4 use days during treatment, Q2: 5-9 days, Q3: 10-44 days, Q4: 45-112 days). Outcomes were percentage of days abstinent from alcohol (PDA), drinks per drinking day (DPDD) and percentage of heavy drinking days (PHD), all measured at treatment end and 1 year post-treatment. Compared with no cannabis use, any cannabis use during treatment was associated with 4.35% [95% confidence interval (CI) = -8.68, -0.02], or approximately 4 fewer alcohol abstinent days at the end of treatment. This association weakened by 1 year post-treatment (95% CI = -9.78, 0.54). Compared with no cannabis use, only those in the second quartile of cannabis use (those who used once or twice per month during treatment) had 8.81% (95% CI = -17.00, -0.63), or approximately 10 fewer days alcohol abstinent at end of treatment, and 11.82% (95% CI = -21.56, -2.07), or approximately 13 fewer alcohol abstinent days 1 year post-treatment. Neither any cannabis use nor quartiles were associated with DPDD or PHD at either time-point. Among individuals in alcohol treatment, any cannabis use (compared with none) is

  12. Public sentiment towards alcohol and local government alcohol policies in New Zealand.

    Science.gov (United States)

    Maclennan, Brett; Kypri, Kypros; Langley, John; Room, Robin

    2012-01-01

    In many countries, including New Zealand, alcohol availability and promotion have increased markedly in the last three decades as a result of liberalised central and/or state government alcohol policies. Accordingly, communities are increasingly relying on local government to manage alcohol-related problems. New Zealand's Local Government Act (2002) states the purpose of local government as facilitating public decision-making and promoting community well-being. We sought to describe public sentiment towards alcohol and local government alcohol policies. A cross-sectional survey was conducted in 2007 with a sample of 2337 residents aged 18 years and over in a diverse set of New Zealand communities. Data were collected via a self-administered pen-and-paper questionnaire. There were responses from 1372 individuals (response: 59%). Problem drinking amongst youth (vandalism, dangerous driving and traffic crashes. Fifty-eight percent of respondents agreed that "it is up to local government to make sure alcohol does not become a problem in the community". There was strong support for local governments to restrict the hours of operation of on-licenced premises, to use liquor bans to control drinking in public places, and for local governments and police to be stricter in their enforcement of drinking laws. There is strong support for local government alcohol policies that restrict the availability and promotion of alcohol. The study findings are important in light of the stated purpose of local government in New Zealand and the recently completed "once in a generation" review of alcohol laws and policies. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Proteasome inhibitor treatment in alcoholic liver disease

    Institute of Scientific and Technical Information of China (English)

    Fawzia Bardag-Gorce

    2011-01-01

    Oxidative stress, generated by chronic ethanol consumption, is a major cause of hepatotoxicity and liver injury. Increased production of oxygen-derived free radicals due to ethanol metabolism by CYP2E1 is principally located in the cytoplasm and in the mitochondria, which does not only injure liver cells, but also other vital organs, such as the heart and the brain. Therefore, there is a need for better treatment to enhance the antioxidant response elements. To date, there is no established treatment to attenuate high levels of oxidative stress in the liver of alcoholic patients. To block this oxidative stress, proteasome inhibitor treatment has been found to significantly enhance the antioxidant response elements of hepatocytes exposed to ethanol. Recent studies have shown in an experimental model of alcoholic liver disease that proteasome inhibitor treatment at low dose has cytoprotective effects against ethanol-induced oxidative stress and liver steatosis. The beneficial effects of proteasome inhibitor treatment against oxidative stress occurred because antioxidant response elements (glutathione peroxidase 2, superoxide dismutase 2, glutathione synthetase, glutathione reductase, and GCLC) were upregulated when rats fed alcohol were treated with a low dose of PS-341 (Bortezomib, Velcade(r)). This is an important finding because proteasome inhibitor treatment up-regulated reactive oxygen species removal and glutathione recycling enzymes, while ethanol feeding alone down-regulated these antioxidant elements. For the first time, it was shown that proteasome inhibition by a highly specific and reversible inhibitor is different from the chronic ethanol feeding-induced proteasome inhibition. As previously shown by our group, chronic ethanol feeding causes a complex dysfunction in the ubiquitin proteasome pathway, which affects the proteasome system, as well as the ubiquitination system. The beneficial effects of proteasome inhibitor treatment in alcoholic liver disease

  14. California Drug and Alcohol Treatment Assessment (CALDATA-1991-1993)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The California Drug and Alcohol Treatment Assessment (CALDATA) was designed to study the costs, benefits, and effectiveness of the state's alcohol and drug treatment...

  15. Pathogenetic aspects of alcoholic encephalopathy treatment

    Directory of Open Access Journals (Sweden)

    Shchetinin S.G.

    2010-12-01

    Full Text Available Alcohol is considered to be the most common exogenous toxins, causing encephalopathy. The defeat of almost all parts of the nervous system should be assigned to the special features of ethanol. Neurophysiological mechanisms of development of substance dependence are based in the stem and limbic structures of the brain that are involved in ensuring the regulation of emotional state, mood, motivation sphere, psychophysical tone of human behavior in general and its adaptation to the environment. Stress or disruption of the normal functioning of these structures can lead to the formation of abstinence syndrome, affective disorders in remission and craving for alcohol. Dopaminergic and opioid (endorphin system play an important role in the genesis of various mental and motor disorders. In some way alcohol dependence can be regarded as an endorfinodefitsitnoe disease with a pathogenetic point of view. Activating of opioidereal system by trans-cranial electrical stimulation promotes the restoration of disturbed emotional, cognitive and autonomic functions, reduces craving for alcohol and in that way increases the effectiveness of rehabilitation treatment

  16. Public and professional attitudes to transplanting alcoholic patients.

    Science.gov (United States)

    Neuberger, James

    2007-11-01

    The discrepancy between the number of people who might benefit from liver transplantation continues to exceed the availability of donor livers available, so rationing of grafts must occur. Alcoholic liver disease (ALD) is an excellent indication for liver transplantation, with outcomes at least as good as for other indications.ALD remains a controversial indication for liver transplantation. There is no robust evidence that public disquiet over distribution of donor livers to those with ALD (even if they return to alcohol) greatly affects organ donation, although this does not mean there is no consequence of such disquiet. Numerous surveys of the general public, patients, and health care professionals indicate the these patients are thought to have lower priority for access to available liver grafts. Public education is required to demonstrate that patients with ALD are carefully selected for liver transplantation and available grafts are used with attention to equity, justice, and utility.

  17. Effects of Treatment Type on Alcohol Consumption Partially Mediated by Alcoholics Anonymous Attendance.

    Science.gov (United States)

    Karriker-Jaffe, Katherine J; Klinger, Jamie L; Witbrodt, Jane; Kaskutas, Lee Ann

    2017-09-14

    As insurance coverage, funding sources and venues for drug and alcohol treatment evolve in the United States, it is important to assess how the type of treatment received may impact long-term outcomes. The current study aims were to examine effects of treatment type on alcohol consumption in the year after treatment intake and to test mediators of effects of treatment type on later alcohol use. Longitudinal data from clients in inpatient and outpatient alcohol treatment programs in California (n = 560) were used in ordinary least squares path analysis adjusting for respondent characteristics typically associated with both treatment completion and alcohol use. The primary outcome was amount of alcohol consumed in the 12 months after treatment entry; hypothesized mediators were treatment duration and participation in Alcoholics Anonymous (AA). Despite higher baseline problem severity and a shorter treatment duration, inpatient clients consumed less alcohol after treatment than outpatient clients (B [95% CI] = -0.95 [-1.67, -0.23]). AA involvement was a significant mediator of the relationship between treatment type and alcohol consumption, with inpatient clients being more involved in AA and also drinking less after treatment than outpatient clients; the bias-corrected bootstrap 95% confidence interval for the indirect effect (B = -0.20) was entirely below zero (-0.43 to -0.05). Outpatient clients may benefit from customized posttreatment recommendations to identify additional resources to assist in the recovery process during the first year after treatment.

  18. Suicidal behaviour among alcohol-dependent Danes attending outpatient treatment

    DEFF Research Database (Denmark)

    Bjørk Petersen, Christina; Grønbæk, Morten; Bussey Rask, Marie;

    2009-01-01

    . Characteristics of, predictors for and outcome among suicidal patients were studied. Alcohol-dependent patients with a history of suicide attempts were found to constitute a highly selected group in alcohol abuse treatment as they often had a more severe course of alcohol dependence, were unemployed, younger......, were more often lowly educated, and had more physical and psychiatric problems. Traumatic childhood experience related to physical or sexual abuse was found as a major predictor for suicidal behaviour among alcohol-dependent patients. We found no significant difference in the effect of treatment...... that suicidal patients in treatment for alcohol abuse are treated effectively within the present treatment settings....

  19. Treatment for Alcohol Problems: Finding and Getting Help

    Science.gov (United States)

    ... new and better treatments for alcohol problems. By studying the underlying causes of alcoholism in the brain and body, NIAAA is working to identify key cellular or molecular structures — called “ ...

  20. Alcohols as hydrogen-donor solvents for treatment of coal

    Science.gov (United States)

    Ross, David S.; Blessing, James E.

    1981-01-01

    A method for the hydroconversion of coal by solvent treatment at elevated temperatures and pressure wherein an alcohol having an .alpha.-hydrogen atom, particularly a secondary alcohol such as isopropanol, is utilized as a hydrogen donor solvent. In a particular embodiment, a base capable of providing a catalytically effective amount of the corresponding alcoholate anion under the solvent treatment conditions is added to catalyze the alcohol-coal reaction.

  1. [Treatment processes of pre-alcoholism and alcohol dependence targeted towards drinking reduction].

    Science.gov (United States)

    Yoshimura, Atsushi; Maesato, Hitoshi; Hisatomi, Nobuko; Higuchi, Susumu

    2013-02-01

    Since the 1990s, we have suggested the concept of pre-alcoholism which encompasses patients who have drunk a great deal of alcohol leading to alcohol related problems such as health issues, domestic violence, drunken driving and black-outs. Pre-alcoholism excludes alcohol-dependent patients who have experienced continuous drinking or withdrawal symptoms. We have treated many outpatients with pre-alcoholism for several years. Our regimen demands that the patients must be abstinent for half a year at the beginning of their treatment. After half a year they can choose whether they will continue to be abstinent or they will resume drinking with the aim of reducing their total alcohol consumption. The study clarified the character of pre-alcoholism by investigation of the patients' background and re-diagnosis of the patients based on the International Classification of Diseases, 10th Revision (ICD-10). A remarkable ratio of pre-alcoholic patients was diagnosed with alcohol dependence under ICD-10. We classified pre-alcoholic patients into two groups, one diagnosed as having ICD-10-classed alcohol dependence and the other which did not fulfill the ICD-10 diagnostic criteria of alcohol dependence, and examined the therapeutic processes of the two groups. It was shown that most pre-alcoholic patients could finally take required courses of treatment by themselves without regard to diagnosis under ICD-10, even if they chose any treatment and made alcohol related mistakes on the way. Our findings suggested that pre-alcoholic patients, a portion of whom may have exhibited mild alcohol dependence, could select drinking reduction as a primary goal of treatment after a certain period of abstinence.

  2. Changes in alcohol policies and public opinions in Finland 2003-2013.

    Science.gov (United States)

    Österberg, Esa; Lindeman, Mikaela; Karlsson, Thomas

    2014-05-01

    There is a constant and ongoing interplay between public opinions and public policies, alcohol policies being no exception. This article describes the development of public opinions regarding alcohol policy in Finland during a 10-year period between 2003 and 2013. Fluctuations in the alcohol policy opinion climate are put in context by looking at concurrent changes in alcohol policies and in total alcohol consumption. The study is based on data from opinion surveys on alcohol policies commissioned by the National Institute for Health and Welfare and the Finnish Social and Health Association. The opinion polls include questions about the general acceptance of prevailing alcohol policies, appropriate sales channels of different alcoholic beverage categories and opinions about the legal age limits and prices of alcoholic beverages. In the study, changes in alcohol policy during 2003-2013 are surveyed, and their relationship with changes in alcohol policy opinion is examined. There seem to be a strong positive correlation during the study period between the level of alcohol consumption and the share of those wanting a more restrictive alcohol policy in Finland. It seems that an increased level of awareness of alcohol-related issues among the general public created a more restrictive opinion climate on alcohol policy issues after the big alcohol excise duty decrease in 2004. The reverse seems to happen but in a lesser degree when alcohol excise duties has been increased after the year 2007. © 2014 Australasian Professional Society on Alcohol and other Drugs.

  3. The current situation of treatment systems for alcoholism in Korea.

    Science.gov (United States)

    Kim, Jee Wook; Lee, Boung Chul; Kang, Tae-Cheon; Choi, Ihn-Geun

    2013-02-01

    Alcoholism is becoming one of the most serious issues in Korea. The purpose of this review article was to understand the present status of the treatment system for alcoholism in Korea compared to the United States and to suggest its developmental direction in Korea. Current modalities of alcoholism treatment in Korea including withdrawal treatment, pharmacotherapy, and psychosocial treatment are available according to Korean evidence-based treatment guidelines. Benzodiazepines and supportive care including vitamin and nutritional support are mainly used to treat alcohol withdrawal in Korea. Naltrexone and acamprosate are the drugs of first choice to treat chronic alcoholism. Psychosocial treatment methods such as individual psychotherapy, group psychotherapy, family therapy, cognitive behavior therapy, cue exposure therapy, 12-step facilitation therapy, self-help group therapy, and community-based treatment have been carried out to treat chronic alcoholism in Korea. However, current alcohol treatment system in Korea is not integrative compared to that in the United States. To establish the treatment system, it is important to set up an independent governmental administration on alcohol abuse, to secure experts on alcoholism, and to conduct outpatient alcoholism treatment programs and facilities in an open system including some form of continuing care.

  4. Current concepts and controversies in the treatment of alcoholic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Catherine Rongey; Neil Kaplowitz

    2006-01-01

    The treatment of alcoholic hepatitis remains one of the most debated topics in medicine and a field of continued research. In this review, we discuss the evolution of scoring systems, including the recent development of the Glasgow alcoholic hepatitis score, role of liver biopsy and current treatment interventions. Studies of treatment interventions with glucocorticoids, pentoxifylline,infliximab, s-adenosyl-methionine, and colchicine are reviewed with discussion on quality. Glucocorticoids currently remain the mainstay of treatment for severe alcoholic hepatitis.

  5. Personality dimensions and psychiatric treatment of alcoholics' wives.

    Science.gov (United States)

    Grubisić-Ilić, M; Ljubin, T; Kozarić-Kovacić, D

    1998-03-01

    To investigate the basic personality dimensions of the wives of alcoholics in comparison to the wives of non-alcoholics, and to compare these two groups according to psychiatric treatment frequency. The group of alcoholics' wives (N=100) was compared to a group of non-alcoholics' wives (N=90). The groups were identical with respect to their age, working and marital status. Eysenck Personality Questionnaire was used for measuring the main personality dimensions. A structured psychiatric interview based on ICD-10 and DSM-III-R, and self-assessment of behavior before marriage (extraverted vs. introverted) were also used. The wives of alcoholics were less extraverted than the wives of non-alcoholics. There were no differences in neuroticism and psychoticism. According to the self-assessment of their behavior before marriage, wives of alcoholics also manifested less extraverted behavior before marriage. The wives of alcoholics were psychiatrically treated more often during their marriage than the wives of non-alcoholics. Moreover, the group of the wives of non-alcoholics had fewer psychiatric treatments during than before marriage. The wives of alcoholics were less extraverted than the wives of non-alcoholics, but they did not differ in two other main personality dimensions, neuroticism and psychoticism. More psychiatric treatments during marriage of the wives of alcoholics can be interpreted in accordance with the "stressed wife" theory.

  6. Reductions in Alcohol Craving Following Naltrexone Treatment for Heavy Drinking.

    Science.gov (United States)

    Helstrom, Amy W; Blow, Frederick C; Slaymaker, Valerie; Kranzler, Henry R; Leong, Shirley; Oslin, David

    2016-09-01

    The role of craving for alcohol as a response to alcohol treatment is not well understood. We examined daily diary ratings of craving over the course of 28 days among individuals participating in an inpatient substance abuse treatment program. Participants were alcohol dependent patients (n = 100) in the Hazelden residential treatment program who were offered and agreed to take naltrexone and an age- and gender-matched comparison group (n = 100) of alcohol-dependent patients in the same program who declined the offer of treatment with naltrexone. Changes in craving over time were compared between the two groups. The naltrexone-treated group reported a more rapid decrease in craving than the usual care group. The change in the trajectory of craving is consistent with prior reports suggesting that craving reduction is a mechanism of naltrexone's efficacy in treating alcohol dependence. Providing naltrexone to individuals seeking treatment for alcohol dependence may accelerate a reduction in their craving, consistent with a primary target of many addiction treatment programs. Craving ratings by 100 residential patients taking naltrexone for alcohol dependence were compared to ratings by 100 patients who did not take naltrexone. Craving for alcohol decreased more rapidly in the patients taking naltrexone. Providing naltrexone to individuals seeking treatment for alcohol dependence may accelerate a reduction in craving, which may benefit treatment efforts. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  7. Thai men’s experiences of alcohol addiction and treatment

    Science.gov (United States)

    Hanpatchaiyakul, Kulnaree; Eriksson, Henrik; Kijsompon, Jureerat; Östlund, Gunnel

    2014-01-01

    Background Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men’s experiences with addiction and alcohol treatment programs in Thailand. Objective The aim of this study was to explore men’s experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years) were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results Through men’s descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking. PMID:24845212

  8. Thai men's experiences of alcohol addiction and treatment

    Directory of Open Access Journals (Sweden)

    Kulnaree Hanpatchaiyakul

    2014-05-01

    Full Text Available Background: Men are overrepresented with regard to alcohol addiction and in terms of alcohol treatment worldwide. In Thailand, alcohol consumption continues to rise, but few of those afflicted with alcohol addiction attend alcohol treatment programs, even though there is universal care for all. No comprehensive studies have been done on men's experiences with addiction and alcohol treatment programs in Thailand. Objective: The aim of this study was to explore men's experiences in terms of the ‘pros and cons of alcohol consumption’ in order to identify the barriers that exist for Thai men with regard to alcohol addiction and the decision to stop drinking. Design: Purposive sampling was applied in the process of recruiting participants at an alcohol clinic in a hospital in Thailand. Thirteen men with alcohol addiction (aged 32–49 years were willing to participate and were interviewed in thematic interviews. The analysis of the data was done with descriptive phenomenology. Results: Through men's descriptions, three clusters of experiences were found that were ‘mending the body’, ‘drinking as payoff and doping related to work’, and ‘alcohol becoming a best friend’ as ways of describing the development of addiction. Conclusions: The results highlight the importance of addressing concepts of masculinity and related hegemonic ideas in order to decrease the influence of the barriers that exist for Thai men with alcohol addiction with regard to entering treatment and to stop drinking.

  9. Implementation of public policy on alcohol and other drugs in Brazilian municipalities: comparative studies.

    Science.gov (United States)

    Mota, Daniela Belchior; Ronzani, Telmo Mota

    2016-07-01

    One of the challenges with respect to public health and the abuse of alcohol and other drugs is to implement policies in support of greater co-ordination among various levels of government. In Brazil, policies are formulated by the Secretaria Nacional de Políticas sobre Drogas (SENAD - State Department for Policies on Drugs) and the Ministério da Saúde (MS - Ministry of Health). This study aims to compare implementation of policies adopted by SENAD and MS at the municipal level. Three municipalities were intentionally selected: Juiz de Fora having a larger network of treatment services for alcohol and drug users; Lima Duarte, a small municipality, which promotes the political participation of local actors (COMAD - Municipal Council on Alcohol and Drugs); and São João Nepomuceno, also a small municipality, chosen because it has neither public services specialised to assist alcohol and other drugs users, nor COMAD. Data collection was conducted through interviews with key informants (n = 19) and a review of key documents concerned with municipal policies. Data analysis was performed using content analysis. In Juiz de Fora, there are obstacles regarding the integration of the service network for alcohol and other drug users and also the articulation of local actors, who are predominant in the mental health sector. In Lima Duarte, while there is a link between local actors through COMAD, their actions within the local service network have not been effective. In São João Nepomuceno, there were no public actions in the area of alcohol and drugs, and consequently insufficient local debate. However, some voluntary, non-governmental work has been undertaken. There were weaknesses in the implementation of national-level policies by SENAD and the MS, due to the limited supply of available treatment, assistance and the lack of integration among local actors. © 2015 John Wiley & Sons Ltd.

  10. Alcohol tax, consumption and mortality in tsarist Russia: is a public health perspective applicable?

    Science.gov (United States)

    Norström, Thor; Stickley, Andrew

    2013-04-01

    The public health perspective on alcohol comprises two main tenets: (i) population drinking impacts on alcohol-related harm and (ii) population drinking is affected by the physical and economic availability of alcohol, where alcohol taxes are the most efficient measure for regulating consumption. This perspective has received considerable empirical support from analyses of contemporary data mainly from Europe and North America. However, as yet, it has been little examined in a historical context. The aims of the present article are to use data from tsarist Russia to explore (i) the relation between changes in the tax on alcohol and per capita alcohol consumption and (ii) the relation between per capita alcohol consumption and alcohol mortality. The material comprised annual data on alcohol taxes, alcohol consumption and alcohol mortality. The tax and alcohol consumption series spanned the period 1864-1907 and the mortality data covered the period 1870-94. The data were analysed by estimating autoregressive integrated moving average models on differenced data. Changes in alcohol taxes were significantly associated with alcohol consumption in the expected direction. Increases in alcohol consumption, in turn, were significantly related to increases in alcohol mortality. This study provides support for the utility of the public health perspective on alcohol in explaining changes in consumption and alcohol-related harm in a historical context. We discuss our findings from tsarist Russia in the light of experiences from more recent alcohol policy changes in Russia.

  11. Pharmacological aversion treatment of alcohol dependence. I. Production and prediction of conditioned alcohol aversion.

    Science.gov (United States)

    Howard, M O

    2001-08-01

    Eighty-two hospitalized alcoholics receiving pharmacological aversion therapy (PAT) over a 10-day treatment interval completed cognitive, behavioral, and psychophysiological measures evaluating conditioned aversion to alcohol. Pre-post assessments provided convergent support for the efficacy of PAT vis-à-vis production of conditioned aversion to alcohol. Positive alcohol-related outcome expectancies were significantly reduced, whereas confidence that drinking could be avoided in various high-risk situations for consumption was increased following PAT. Behavioral and cardiac rate assessments revealed significant changes following PAT that were specific to alcoholic beverages and potentially reflective of conditioned alcohol aversion. Patients with more extensive pretreatment experiences with alcohol-associated nausea and greater involvement in antisocial conduct appeared to be less susceptible to the PAT conditioning protocol.

  12. Molecular Basis and Current Treatment for Alcoholic Liver Disease

    Directory of Open Access Journals (Sweden)

    Juan Armendariz-Borunda

    2010-04-01

    Full Text Available Alcohol use disorders and alcohol dependency affect millions of individuals worldwide. The impact of these facts lies in the elevated social and economic costs. Alcoholic liver disease is caused by acute and chronic exposure to ethanol which promotes 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 broad approach of alcohol use disorders, and a more specific assessment of the pathophysiologic molecular basis, and genetics, as well as clinical presentation and current modalities of treatment for alcoholic liver disease.

  13. Phenobarbital compared to benzodiazepines in alcohol withdrawal treatment

    DEFF Research Database (Denmark)

    Askgaard, Gro; Hallas, Jesper; Fink-Jensen, Anders

    2016-01-01

    Background: Long-acting benzodiazepines such as chlordiazepoxide are recommended as first-line treatment for alcohol withdrawal. These drugs are known for their abuse liability and might increase alcohol consumption among problem drinkers. Phenobarbital could be an alternative treatment option......, possibly with the drawback of a more pronounced acute toxicity. We evaluated if phenobarbital compared to chlordiazepoxide decreased the risk of subsequent use of benzodiazepines, alcohol recidivism and mortality. Methods: The study was a register-based cohort study of patients admitted for alcohol...... withdrawal 1998-2013 and treated with either phenobarbital or chlordiazepoxide. Patients were followed for one year. We calculated hazard ratios (HR) for benzodiazepine use, alcohol recidivism and mortality associated with alcohol withdrawal treatment, while adjusting for confounders. Results: A total...

  14. Treatment of alcoholism and concomitant drugs of abuse.

    Science.gov (United States)

    Zeiner, A R; Stanitis, T; Spurgeon, M; Nichols, N

    1985-01-01

    It has been proposed that concomitant substances of abuse may have additive or synergistic properties such that alcoholics using other substances of abuse concurrently may have a harder time giving up alcohol than alcoholics abusing only alcohol. The present study surveyed 291 alcoholics in an alcohol treatment program and 86 social drinker controls matched on age, education, SES and gender. Alcohol consumption, smoking, coffee intake, other substances of abuse. Beck depression and Spielberger Anxiety (State) were measured. Alcoholics drank significantly more alcohol than did social drinkers per day (350.19 cc versus 28.08 cc, p less than 0.001), consumed more caffeine/day (486.3 mg versus 339.9 mg, p less than 0.002), smoked more cigarettes/day (27.8 versus 12.8, p less than 0.001), were more depressed (16.8 versus 4.4 (Beck), p less than 0.0001), had lower internal locus of control scores (37.6 versus 39.7, p less than 0.005), had higher scores on control by chance (22.7 versus 20.2, p less than 0.03) and were significantly more anxious (52.5 versus 33.9 on Spielberger's State Inventory p less than 0.0001). Some patients used stimulants, tranquilizers, depressants, narcotics or toluene. Only 3/258 abused alcohol without using other drugs. Results support earlier studies showing strong associations between alcohol and smoking and between alcohol and caffeine consumption. The alcoholic abusing only alcohol is very rare. Treatment programs need to pay attention to concomitant drugs of abuse.

  15. Treatment for alcohol-related problems: special populations: research opportunities.

    Science.gov (United States)

    Gomberg, Edith S Lisansky

    2003-01-01

    efficacy of treatment for patients in elder-specific and mixed age groups, etc. MINORITIES: Each of the federally mandated minority groups in the United States is heterogeneous. The epidemiology of use and abuse of alcohol and other drugs is well studied, but treatment issues are not. AMERICAN INDIANS: There are more than 200 tribes; each has its own customs and culture. Some tribes are abstinent; others have big problems with abuse of alcohol, and other drugs. Orthodox treatment methods, used by professional counselors and therapists, have not worked very well. study of traditional Indian forms of healing practices combined with other treatment; this would be a culture-sensitive model. BLACK AMERICANS: This includes not only African-Americans but people from the Caribbean, Central and South America, etc. Among African-Americans, there is a history of ambivalence toward alcohol: on the one hand, a tolerant "nightclub culture" and on the other, church beliefs in temperance and abstinence. There is "respectable drinking" and "problem drinking," most often defined as solitary or public drinking. The primary source of support is considered familial, so people tend to be distrustful of therapy from "strangers." They are anonymous in promoting sobriety and study of subcultural norms and the history of slavery. Earlier ethnographic works (Liebow, 1967) were of "street-corner men," slum dwellers, ghetto norms; recommended: studies of middle-class African-American life and drinking behaviors. ASIAN-AMERICANS: A study in Los Angeles reports differences among Chinese, Japanese, Filipinos, and Koreans in drinking beliefs and behavior. Of these groups, the Japanese in Japan and the Japanese-Americans report the largest number of heavy drinkers. It is, however, considered a private matter, even when associated with social problems. Interestingly, there is an organization called the All Nippon Sobriety Association (like Alcoholics Anonymous). RECOMMENDATIONs: studies of generational

  16. Public support for alcohol policies associated with knowledge of cancer risk.

    Science.gov (United States)

    Buykx, Penny; Gilligan, Conor; Ward, Bernadette; Kippen, Rebecca; Chapman, Kathy

    2015-04-01

    Several options are advocated by policy experts to mitigate alcohol-related harms, although the most effective strategies often have the least public support. While knowledge of tobacco-related health risks predicts support for relevant public health measures, it is not known whether knowledge of alcohol health risks is similarly associated with the acceptability of policies intended to reduce alcohol consumption and related harms. This study aims to gauge public support for a range of alcohol policies and to determine whether or not support is associated with knowledge of a long-term health risk of alcohol consumption, specifically cancer. 2482 adults in New South Wales (NSW), Australia, participated in an online survey. Logistic regression analysis was used to examine the association between demographic data, alcohol consumption, smoking status, knowledge of alcohol as a risk factor for cancer and support for alcohol-related policies. Most participants were supportive of health warnings, restricting access to internet alcohol advertising to young people, and requiring information on national drinking guidelines on alcohol containers. Almost half of participants supported a ban on sport sponsorship, while less than 41% supported price increases, volumetric taxation, or reducing the number of retail outlets. Only 47% of participants identified drinking too much alcohol as a risk factor for cancer. Knowledge of alcohol as a risk factor for cancer was a significant predictor of support for all policies, while level of alcohol consumption had a significant inverse relationship with policy support. The finding that support for alcohol management policies is associated with awareness that drinking too much alcohol may contribute to cancer could assist in the planning of future public health interventions. Improving awareness of the long term health risks of alcohol consumption may be one avenue to increasing public support for effective alcohol harm-reduction policies

  17. Pharmacologically induced alcohol craving in treatment seeking alcoholics correlates with alcoholism severity, but is insensitive to acamprosate.

    Science.gov (United States)

    Umhau, John C; Schwandt, Melanie L; Usala, Julie; Geyer, Christopher; Singley, Erick; George, David T; Heilig, Markus

    2011-05-01

    Modulation of alcohol craving induced by challenge stimuli may predict the efficacy of new pharmacotherapies for alcoholism. We evaluated two pharmacological challenges, the α(2)-adrenergic antagonist yohimbine, which reinstates alcohol seeking in rats, and the serotonergic compound meta-chlorophenylpiperazine (mCPP), previously reported to increase alcohol craving in alcoholics. To assess the predictive validity of this approach, the approved alcoholism medication acamprosate was evaluated for its ability to modulate challenge-induced cravings. A total of 35 treatment seeking alcohol dependent inpatients in early abstinence were randomized to placebo or acamprosate (2997 mg daily). Following two weeks of medication, subjects underwent three challenge sessions with yohimbine, mCPP or saline infusion under double blind conditions, carried out in counterbalanced order, and separated by at least 5 days. Ratings of cravings and anxiety, as well as biochemical measures were obtained. In all, 25 subjects completed all three sessions and were included in the analysis. Cravings were modestly, but significantly higher following both yohimbine and mCPP challenge compared with saline infusion. The mCPP, but not yohimbine significantly increased anxiety ratings. Both challenges produced robust ACTH, cortisol and prolactin responses. There was a significant correlation between craving and the degree of alcoholism severity. Acamprosate administration did not influence craving. Both yohimbine and mCPP challenges lead to elevated alcohol craving in a clinical population of alcoholics, and these cravings correlate with alcoholism severity. Under the experimental conditions used, alcohol cravings induced by these two stimuli are not sensitive to acamprosate at clinically used doses.

  18. A Case of Psychosis in Disulfiram Treatment for Alcoholism

    Science.gov (United States)

    de Melo, Raquel Calvão; Lopes, Rui; Alves, José Carlos

    2014-01-01

    Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine-β-hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis. Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence. Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day) for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic. Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account. PMID:24818034

  19. A Case of Psychosis in Disulfiram Treatment for Alcoholism

    Directory of Open Access Journals (Sweden)

    Raquel Calvão de Melo

    2014-01-01

    Full Text Available Background. Disulfiram, a drug used in the treatment of alcohol dependence, is an inhibitor of dopamine-β-hydroxylase causing an increase in the concentration of dopamine in the mesolimbic system. In addition to the physical symptoms associated with concomitant use of alcohol, disulfiram may lead to adverse events, when used alone, including psychosis. Aims. To report a case of a rare complication when using disulfiram for alcoholism treatment in a patient in alcoholic abstinence. Case Report. We describe the case of a 42-year-old male patient, who developed psychotic symptoms 3 weeks after initiating treatment with disulfiram for alcohol dependency. The patient had a history of chronic alcoholism for 12 years and was under disulfiram treatment (250 mg/day for 1 month, with no other past history of psychiatric illness. The symptoms worsened after he initiated alcohol consumption, while taking disulfiram. The patient was hospitalized and disulfiram was suspended. After 4 days he was asymptomatic and at 6-week follow-up remained asymptomatic. Conclusion. Treatment with disulfiram can lead to the appearance of psychosis in patients with increased vulnerability. In clinical practice, psychosis in the context of alcoholism with disulfiram therapy is often neglected and should be taken into account.

  20. Selected Publications on Teenagers and Alcohol. Grouped Interest Guide No. 8-2.

    Science.gov (United States)

    National Inst. on Alcohol Abuse and Alcoholism (DHEW/PHS), Rockville, MD.

    This brief bibliography is part of a series produced by the Current Awareness Services of the National Clearinghouse for Alcohol Information, and informational service of the National Institute on Alcohol Abuse and Alcoholism. The publications provide readers with regularly codified bibliographic references to recent, topical literature in…

  1. Hypnosis in the Treatment of Alcoholism: A Theoretical Perspective.

    Science.gov (United States)

    Steffenhagen, R. A.

    1983-01-01

    Reviews the history and theory of alcoholism and hypnosis and proposes a theoretical model of alcholism based on self-esteem. Suggets that hypnosis may be an effective tool in the treatment of alcoholism with cure as the goal, and calls for more consistency in theory and practice. (JAC)

  2. Hypnosis in the Treatment of Alcoholism: A Theoretical Perspective.

    Science.gov (United States)

    Steffenhagen, R. A.

    1983-01-01

    Reviews the history and theory of alcoholism and hypnosis and proposes a theoretical model of alcholism based on self-esteem. Suggets that hypnosis may be an effective tool in the treatment of alcoholism with cure as the goal, and calls for more consistency in theory and practice. (JAC)

  3. Alcohol and acetaldehyde in public health: from marvel to menace.

    Science.gov (United States)

    Guo, Rui; Ren, Jun

    2010-04-01

    Alcohol abuse is a serious medical and social problem. Although light to moderate alcohol consumption is beneficial to cardiovascular health, heavy drinking often results in organ damage and social problems. In addition, genetic susceptibility to the effect of alcohol on cancer and coronary heart disease differs across the population. A number of mechanisms including direct the toxicity of ethanol, its metabolites [e.g., acetaldehyde and fatty acid ethyl esters (FAEEs)] and oxidative stress may mediate alcoholic complications. Acetaldehyde, the primary metabolic product of ethanol, is an important candidate toxin in developing alcoholic diseases. Meanwhile, free radicals produced during ethanol metabolism and FAEEs are also important triggers for alcoholic damages.

  4. Alcohol and Acetaldehyde in Public Health: From Marvel to Menace

    Directory of Open Access Journals (Sweden)

    Rui Guo

    2010-03-01

    Full Text Available Alcohol abuse is a serious medical and social problem. Although light to moderate alcohol consumption is beneficial to cardiovascular health, heavy drinking often results in organ damage and social problems. In addition, genetic susceptibility to the effect of alcohol on cancer and coronary heart disease differs across the population. A number of mechanisms including direct the toxicity of ethanol, its metabolites [e.g., acetaldehyde and fatty acid ethyl esters (FAEEs] and oxidative stress may mediate alcoholic complications. Acetaldehyde, the primary metabolic product of ethanol, is an important candidate toxin in developing alcoholic diseases. Meanwhile, free radicals produced during ethanol metabolism and FAEEs are also important triggers for alcoholic damages.

  5. Effects of Depression on Treatment Motivation in Male Alcohol Dependence

    Science.gov (United States)

    CENGİSİZ, Cengiz; DEVECİ, Artuner; YAPICI, Aslıhan

    2015-01-01

    Introduction Treatment motivation in alcohol dependents is usually viewed as a strong predictor of seeking treatment and treatment success. The conditions affecting motivation in alcohol dependence, however, has not been clarified. In this study, it is aimed to determine the effects of depression on treatment motivation in male alcohol dependence. Methods The present study included 34 male alcohol dependents presenting to outpatient clinics in Manisa Hospital of Mental Disorders and Hospital of Celal Bayar University. The patients underwent evaluation using the socio-demographic and clinical information form, DSM-IV SCID-I Clinical Version, Treatment Motivation Questionnaire (TMQ), and Hamilton Depression Rating Scale (HDRS). Results A significant relationship was found between the total score of TMQ and HDRS (p=.039). Conclusion We believe that the present study, in which we examined the relationship between treatment motivation in male alcohol dependence and depression, would provide a significant contribution to literature. It is also important to investigate other factors that may affect treatment motivation in male alcohol dependence. Studies with larger samples are needed on this topic.

  6. Pharmacological treatment of insomnia in alcohol recovery: a systematic review

    National Research Council Canada - National Science Library

    Kolla, Bhanu Prakash; Mansukhani, Meghna Prabhdas; Schneekloth, Terry

    2011-01-01

    .... In accordance with the Quorum statement, we searched PubMed, EMBASE, Psych Info and Medline databases using the terms alcohol, insomnia/sleep and treatment/management with no year/language restrictions...

  7. Nalmefene: a new approach to the treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Paille F

    2014-08-01

    Full Text Available François Paille, Hervé Martini Department of Addiction Treatment, University Hospital, Vandœuvre-lès-Nancy, France Abstract: Reduction of alcohol consumption is not yet a widely accepted treatment objective for alcohol-dependent patients, as abstinence is often considered to be the only possible objective in this situation. However, various studies have demonstrated the value of proposing these two options to such patients. Firstly, reduction of alcohol consumption very significantly reduces the risk of alcohol-related damage, and also modifies the patient's and the doctor's perception of the disease, resulting in improved access to care and better patient adherence with the proposed treatment objective and consequently better clinical results. Recent studies have shown that some medicinal products can help patients reduce their alcohol consumption. One such product, nalmefene, has been granted European marketing authorization and is now being released onto the market in various countries. The ESENSE 1 and 2 studies in alcohol-dependent patients showed that, in combination with BRENDA, a psychosocial intervention focusing on reinforcement of motivation and treatment adherence, nalmefene significantly reduced the number of heavy drinking days and mean daily total alcohol consumption versus placebo. This reduction was more marked in the marketing authorization target population, ie, patients with a high or very high drinking risk level according to World Health Organization criteria. Another original feature of this molecule is that it can be used as needed if the patient perceives a risk of drinking, which is a more flexible approach and more likely to ensure the patient's active involvement in the treatment of his/her disease. This molecule opens up interesting and original therapeutic prospects in the treatment of alcohol dependence. Keywords: alcohol dependence, reduction, consumption, damage reduction, drug therapy, nalmefene

  8. The role of expectation in the therapeutic outcomes of alcohol and drug addiction treatments.

    Science.gov (United States)

    Spagnolo, Primavera A; Colloca, Luana; Heilig, Markus

    2015-05-01

    Throughout history, patient-physician relationships have been acknowledged as an important component of the therapeutic effects of any pharmacological treatment. Here, we discuss the role of physicians' expectations in influencing the therapeutic outcomes of alcohol and drug addiction pharmacological treatments. As largely demonstrated, such expectations and attitudes may contribute to produce placebo and nocebo effects that in turn affect the course of the disease and the response to the therapy. This article is aimed at discussing the current insights into expectations, placebo and nocebo mechanisms and their impact on the therapeutic outcomes of alcohol and drug addiction treatments; with the goal of informing physicians and other health care providers about the potentially widespread implications for clinical practice and for a successful treatment regimen. Published by Oxford University Press on behalf of Medical Council on Alcohol 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  9. Outpatient treatment of alcohol use disorders among subjects 60+ years

    DEFF Research Database (Denmark)

    Andersen, Kjeld; Bogenschutz, Michael P; Bühringer, Gerhard

    2015-01-01

    disorders (AUD). We present the rationale and design of a multisite, multinational AUD treatment study for subjects aged 60+ years. METHODS/DESIGN: 1,000 subjects seeking treatment for AUD according to DSM-5 in outpatient clinics in Denmark, Germany, and New Mexico (USA) are invited to participate in a RCT......, including the Form-90, Alcohol Dependence Scale, Penn Alcohol Craving Scale, Brief Symptom Inventory and WHO Quality of Life. Enrolment will be completed by April 2016 and data collection by April 2017. The primary outcome is the proportion in each group who are abstinent or have a controlled use of alcohol...

  10. Alcohol use disorder: pathophysiology, effects, and pharmacologic options for treatment

    Directory of Open Access Journals (Sweden)

    Wackernah RC

    2014-01-01

    Full Text Available Robin C Wackernah,1 Matthew J Minnick,1 Peter Clapp2 1Department of Pharmacy Practice, 2Department of Pharmaceutical Sciences, School of Pharmacy, Rueckert-Hartman College for Health Professions, Regis University, Denver, CO, USA Abstract: Alcohol use disorders (AUD continue to be a concerning health issue worldwide. Harmful alcohol use leads to 2.5 million deaths annually worldwide. Multiple options exist for the management of dependence on alcohol, not all of which are approved by drug-regulating agencies. Current practice in treating AUD does not reflect the diversity of pharmacologic options that have potential to provide benefit, and guidance for clinicians is limited. Few medications are approved for treatment of AUD, and these have exhibited small and/or inconsistent effects in broad patient populations with diverse drinking patterns. The need for continued research into the treatment of this disease is evident in order to provide patients with more specific and effective options. This review describes the neurobiological mechanisms of AUD that are amenable to treatment and drug therapies that target pathophysiological conditions of AUD to reduce drinking. In addition, current literature on pharmacologic (both approved and non-approved treatment options for AUD offered in the United States and elsewhere are reviewed. The aim is to inform clinicians regarding the options for alcohol abuse treatment, keeping in mind that not all treatments are completely successful in reducing craving or heavy drinking or increasing abstinence. Keywords: abuse, alcohol, alcoholism, craving, dependence, relapse

  11. Differences between Alcoholics and Cocaine Addicts Seeking Treatment.

    Science.gov (United States)

    López-Goñi, José J; Fernández-Montalvo, Javier; Arteaga, Alfonso

    2015-03-03

    This study explored the characteristics of a representative sample of patients who were addicted to either alcohol or cocaine, comparing the profiles of both types of drug users. A sample of 234 addicted patients (109 alcoholics and 125 cocaine addicts) who sought outpatient treatment in a Spanish clinical centre was assessed. Data on socio-demographic, consumption, psychopathological and maladjustment characteristics were collected using the European Addiction Severity Index (EuropASI), the Symptom Checklist-90-Revised (SCL-90-R) and the Millon Clinical Multiaxial Inventory (MCMI-II). Demographically, differences were observed with regard to age (alcoholics were older than cocaine addicts; t = 12.2, p = .001), employment (the alcoholic group had more labor problems; χ 2 = 6.2, p = .045) and family consequences (worse in alcoholics; t = 2.3, p = .025). The EuropASI results showed statistically significant differences in addiction severity, with alcoholics showing a greater severity than cocaine addicts. In terms of psychopathology, alcoholics presented more associated symptomatology than cocaine addicts. According to these results, patients with alcohol dependence have a different profile from patients with cocaine dependence, resulting in different repercussions for important areas of their lives. These differences should be taken into account when standard treatments for addiction are implemented.

  12. The moderating role of social networks in the relationship between alcohol consumption and treatment utilization for alcohol-related problems

    Science.gov (United States)

    Mowbray, Orion

    2014-01-01

    Many individuals wait until alcohol use becomes severe before treatment is sought. However, social networks, or the number of social groups an individual belongs to, may play a moderating role in this relationship. Logistic regression examined the interaction of alcohol consumption and social networks as a predictor of treatment utilization while adjusting for sociodemographic and clinical variables among 1,433 lifetime alcohol-dependent respondents from wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC). Results showed that social networks moderate the relationship between alcohol consumption and treatment utilization such that for individuals with few network ties, the relationship between alcohol consumption and treatment utilization was diminished, compared to the relationship between alcohol consumption and treatment utilization for individuals with many network ties. Findings offer insight into how social networks, at times, can influence individuals to pursue treatment, while at other times, influence individuals to stay out of treatment, or seek treatment substitutes. PMID:24462223

  13. The moderating role of social networks in the relationship between alcohol consumption and treatment utilization for alcohol-related problems.

    Science.gov (United States)

    Mowbray, Orion

    2014-01-01

    Many individuals wait until alcohol use becomes severe before treatment is sought. However, social networks, or the number of social groups an individual belongs to, may play a moderating role in this relationship. Logistic regression examined the interaction of alcohol consumption and social networks as a predictor of treatment utilization while adjusting for sociodemographic and clinical variables among 1,433 lifetime alcohol-dependent respondents from wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC). Results showed that social networks moderate the relationship between alcohol consumption and treatment utilization such that for individuals with few network ties, the relationship between alcohol consumption and treatment utilization was diminished, compared to the relationship between alcohol consumption and treatment utilization for individuals with many network ties. Findings offer insight into how social networks, at times, can influence individuals to pursue treatment, while at other times, influence individuals to stay out of treatment, or seek treatment substitutes.

  14. Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

    Directory of Open Access Journals (Sweden)

    Jinhee Lee

    2015-01-01

    Full Text Available Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

  15. Pharmacotherapeutic Treatment of Alcohol Dependence: An Overview

    Science.gov (United States)

    Graves, Erin; Goodwin, Lloyd R., Jr.

    2008-01-01

    Pharmacotherapy medications can reduce the likelihood of relapse, decrease craving intensity and severity of withdrawal symptoms, and bolster the likelihood of achieving and maintaining recovery goals for many individuals seeking recovery from alcohol dependence. An overview of the benefits and concerns of integrating pharmacotherapeutic…

  16. Anticonvulsants for the treatment of alcohol withdrawal syndrome and alcohol use disorders.

    Science.gov (United States)

    Hammond, Christopher J; Niciu, Mark J; Drew, Shannon; Arias, Albert J

    2015-04-01

    Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

  17. Varenicline in the treatment of alcohol use disorders.

    Science.gov (United States)

    Erwin, Beth L; Slaton, Rachel M

    2014-11-01

    To summarize the efficacy and safety data for the use of varenicline in the treatment of alcohol use disorders. A literature search was conducted in PubMed, International Pharmaceutical Abstracts, and Cochrane Library (through May 2014). Key search terms included varenicline, alcohol, alcohol dependence, alcoholism, ethanol, and nicotinic acetylcholine receptor. Additional references were identified from literature citations. Results were limited to clinical trials and case reports that discussed either the use of varenicline in alcohol drinking patients or adverse effects experienced with its use. Only English language studies in humans were reviewed. In all, 7 randomized, placebo-controlled clinical trials and 1 open-label study were identified that evaluated the impact of varenicline on various drinking-related end points. The studies were conducted in patients dependent on alcohol (n=4), non-alcohol-dependent patients (n=3), and patients with a history of alcohol dependence but who had been abstinent for at least 6 months (n=1). The majority of the studies classified their participants as heavy drinkers; however, this definition varied across studies. Most studies included smokers, but 2 trials included both smokers and nonsmokers. Evidence supports the use of varenicline for the reduction of alcohol craving as well as for the reduction of overall alcohol consumption in patients with alcohol use disorders. However, it is not likely to improve abstinence rates. Although most of the data were derived from patients with concurrent nicotine dependence, the effects of varenicline appear to occur independent of baseline smoking status. © The Author(s) 2014.

  18. Public attitudes towards alcohol control policies in Scotland and England: Results from a mixed-methods study.

    Science.gov (United States)

    Li, Jessica; Lovatt, Melanie; Eadie, Douglas; Dobbie, Fiona; Meier, Petra; Holmes, John; Hastings, Gerard; MacKintosh, Anne Marie

    2017-03-01

    The harmful effects of heavy drinking on health have been widely reported, yet public opinion on governmental responsibility for alcohol control remains divided. This study examines UK public attitudes towards alcohol policies, identifies underlying dimensions that inform these, and relationships with perceived effectiveness. A cross-sectional mixed methods study involving a telephone survey of 3477 adult drinkers aged 16-65 and sixteen focus groups with 89 adult drinkers in Scotland and England was conducted between September 2012 and February 2013. Principal components analysis (PCA) was used to reduce twelve policy statements into underlying dimensions. These dimensions were used in linear regression models examining alcohol policy support by demographics, drinking behaviour and perceptions of UK drinking and government responsibility. Findings were supplemented with a thematic analysis of focus group transcripts. A majority of survey respondents supported all alcohol policies, although the level of support varied by type of policy. Greater enforcement of laws on under-age sales and more police patrolling the streets were strongly supported while support for pricing policies and restricting access to alcohol was more divided. PCA identified four main dimensions underlying support on policies: alcohol availability, provision of health information and treatment services, alcohol pricing, and greater law enforcement. Being female, older, a moderate drinker, and holding a belief that government should do more to reduce alcohol harms were associated with higher support on all policy dimensions. Focus group data revealed findings from the survey may have presented an overly positive level of support on all policies due to differences in perceived policy effectiveness. Perceived effectiveness can help inform underlying patterns of policy support and should be considered in conjunction with standard measures of support in future research on alcohol control policies.

  19. The importance of psychoeducation in systemic family therapy alcoholic treatment

    Directory of Open Access Journals (Sweden)

    Dragišić-Labaš Slađana

    2010-01-01

    Full Text Available The main goal of the paper was to analyze the impact of psychoeducation in alcoholism therapy treatment on initial motivation and comprehension, change in attitudes to alcoholism, and beginning of creating a new value system. The sample consisted of 166 respondents (83 married couples that had been involved in one-year systemic group family therapy alcoholic treatment (with the man being alcoholic. A questionnaire on knowledge about alcoholism was used. The respondents were tested three times - at the beginning of the treatment, after 6 months, and after one year. The results showed that the level of education had increased through three phases of the treatment, that motivation changed from initial to substantial, that the comprehension had also changed, turning family system into a more functional model of living. Statistically significant difference in level of education between phase 1 and phase 3 of the family therapy was confirmed. In conclusion, the authors argue for the importance of psychoeducation as a method in treating alcoholism.

  20. Agnihotra in the treatment of alcoholism.

    Science.gov (United States)

    Golechha, G R; Sethi, I G; Deshpande; Rani, U

    1991-01-01

    Agnihotra is a Vedic ritual of litting fire in a copper pyramid pot with use of Mantras at sunrise and sunset time. It is found to have neurophysiological effect on human body and brain. Clinically it produces mental tranquility and reported to have useful adjunct effect on deaddiction. In our present study effect of Agnihotra was studied on 18 cases of alcoholism. It is found that it leads to total abstinence without other restrain after 2 weeks of continuous Agnihotra practice. An obsessive compliance to perform Agnihotra develops. After discontinuing, its effect last for another few weeks. Though relapse may develop on discontinuing Agnihotra, a sizeable number of cases i.e. 55%, continued to remain abstinent for more than 8 weeks. Agnihotra is not a total cure for alcoholism, but it may serve as an useful adjunct.

  1. Using public health and community partnerships to reduce density of alcohol outlets.

    Science.gov (United States)

    Jernigan, David H; Sparks, Michael; Yang, Evelyn; Schwartz, Randy

    2013-04-11

    Excessive alcohol use causes approximately 80,000 deaths in the United States each year. The Guide to Community Preventive Services recommends reducing the density of alcohol outlets - the number of physical locations in which alcoholic beverages are available for purchase either per area or per population - through the use of regulatory authority as an effective strategy for reducing excessive alcohol consumption and related harms. We briefly review the research on density of alcohol outlets and public health and describe the powers localities have to influence alcohol outlet density. We summarize Regulating Alcohol Outlet Density: An Action Guide, which describes steps that local communities can take to reduce outlet density and the key competencies and resources of state and local health departments. These include expertise in public health surveillance and evaluation methods, identification and tracking of outcome measures, geographic information systems (GIS) mapping, community planning and development of multisector efforts, and education of community leaders and policy makers. We illustrate the potential for partnerships between public health agencies and local communities by presenting a contemporary case study from Omaha, Nebraska. Public health agencies have a vital and necessary role to play in efforts to reduce alcohol outlet density. They are often unaware of the potential of this strategy and have strong potential partners in the thousands of community coalitions nationwide that are focused on reducing alcohol-related problems.

  2. Pathogenetic aspects of alcoholic encephalopathy treatment

    OpenAIRE

    Shchetinin S.G.; Barylnik Yu.B.; Lim V.G.

    2010-01-01

    Alcohol is considered to be the most common exogenous toxins, causing encephalopathy. The defeat of almost all parts of the nervous system should be assigned to the special features of ethanol. Neurophysiological mechanisms of development of substance dependence are based in the stem and limbic structures of the brain that are involved in ensuring the regulation of emotional state, mood, motivation sphere, psychophysical tone of human behavior in general and its adaptation to the environment....

  3. Pharmacogenetically driven treatments for alcoholism: are we there yet?

    Science.gov (United States)

    Arias, Albert J; Sewell, R Andrew

    2012-06-01

    Pharmacogenetic analyses of treatments for alcohol dependence attempt to predict treatment response and side-effect risk for specific medications. We review the literature on pharmacogenetics relevant to alcohol dependence treatment, and describe state-of-the-art methods of pharmacogenetic research in this area. Two main pharmacogenetic study designs predominate: challenge studies and treatment-trial analyses. Medications studied include US FDA-approved naltrexone and acamprosate, both indicated for treating alcohol dependence, as well as several investigational (and off-label) treatments such as sertraline, olanzapine and ondansetron. The best-studied functional genetic variant relevant to alcoholism treatment is rs1799971, a single-nucleotide polymorphism in exon 1 of the OPRM1 gene that encodes the μ-opioid receptor. Evidence from clinical trials suggests that the presence of the variant G allele of rs1799971 may predict better treatment response to opioid receptor antagonists such as naltrexone. Evidence from clinical trials also suggests that several medications interact pharmacogenetically with variation in genes that encode proteins involved in dopaminergic and serotonergic neurotransmission. Variation in the DRD4 gene, which encodes the dopamine D(4) receptor, may predict better response to naltrexone and olanzapine. A polymorphism in the serotonin transporter gene SLC6A4 promoter region appears related to differential treatment response to sertraline depending on the subject's age of onset of alcoholism. Genetic variation in SLC6A4 may also be associated with better treatment response to ondansetron. Initial pharmacogenetic efforts in alcohol research have identified functional variants with potential clinical utility, but more research is needed to further elucidate the mechanism of these pharmacogenetic interactions and their moderators in order to translate them into clinical practice.

  4. Service Quality in Alcohol Treatment: A Qualitative Study

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2010-01-01

    The objective of the study was to qualitatively evaluate the managerial and organisational issues associated with service quality in a privately funded alcohol treatment centre in the UK. Two different groups of participants at a private treatment clinic were interviewed. The first group comprised 25 of its patients. The second group comprised 15…

  5. Service Quality in Alcohol Treatment: A Qualitative Study

    Science.gov (United States)

    Resnick, Sheilagh M.; Griffiths, Mark D.

    2010-01-01

    The objective of the study was to qualitatively evaluate the managerial and organisational issues associated with service quality in a privately funded alcohol treatment centre in the UK. Two different groups of participants at a private treatment clinic were interviewed. The first group comprised 25 of its patients. The second group comprised 15…

  6. Alcohol Use. Adolescent Health Highlight. Publication #2012-34

    Science.gov (United States)

    Murphey, David; Vaughn, Brigitte; Barry, Megan; Terzian, Mary

    2012-01-01

    A substantial proportion of high school students consume alcohol, with nearly a quarter of 12th grade students reporting binge drinking in the past two weeks. Drinking alcohol in adolescence is associated with a variety of other risky behaviors, as well as with an increased likelihood of long-term problems reaching into adulthood. This "Adolescent…

  7. The Effectiveness of Alcohol Policies in 4-Year Public Universities

    Science.gov (United States)

    Walter, Gayle T.

    2010-01-01

    A problem facing American universities is heavy drinking by the student body which results in unintentional injuries and deaths, illegal offenses, sexual assault, altercations, and academic demise. The relationship between the type of alcohol policy enacted on campus and alcohol consumption among undergraduate students attending 4-year public…

  8. The Effectiveness of Alcohol Policies in 4-Year Public Universities

    Science.gov (United States)

    Walter, Gayle T.

    2010-01-01

    A problem facing American universities is heavy drinking by the student body which results in unintentional injuries and deaths, illegal offenses, sexual assault, altercations, and academic demise. The relationship between the type of alcohol policy enacted on campus and alcohol consumption among undergraduate students attending 4-year public…

  9. Culture clash: alcohol marketing and public health aspirations.

    Science.gov (United States)

    Munro, Geoffrey; de Wever, Johanna

    2008-03-01

    It is of no coincidence that a number of recent Harm Reduction Digests have addressed the issue of the reduction of alcohol-related harm. Despite the dominant focus on illicit drug use in the popular discourse, alcohol remains Australia's number one drug problem, as it is in many other developed countries. In this Digest Munro and de Wever use the 'four Ps' of marketing: product, price, place and promotion, to critique the two decades industry self-regulation of alcohol marketing. They conclude that if we are going to develop policies which effectively change Australian drinking culture to reduce alcohol-related harm, we need first to accept that the alcohol industry and the health field have separate and conflicting interests.

  10. Public Attitudes to and Awareness of Fetal Alcohol Syndrome in Young Adults.

    Science.gov (United States)

    Oei, Tian P. S.; And Others

    1986-01-01

    Assessed public attitude toward, and awareness of possible problems and risks associated with, the consumption of alcohol during pregnancy. Results indicated a high awareness of the problem, knowledge of the specific effects to the offspring, and of quantities and frequency of consumption of alcohol which would have teratogenic effects were…

  11. Alcohol Consumption in Russia and Some Aspects of Public Health

    Directory of Open Access Journals (Sweden)

    Jargin

    2016-02-01

    Full Text Available Context The problem of alcohol misuse in Russia is immense; but nonetheless there is a tendency to exaggerate it, which is evident for inside observers. Such exaggeration tends to veil shortcomings of the health care system with responsibility shifted onto the patients, that is, self-inflicted diseases caused by excessive alcohol consumption. The aim of this report is to draw attention to the above-mentioned and other problems related to the alcohol consumption in Russia, not clearly perceptible from the literature, e.g. toxicity of some legally sold alcoholic beverages. Evidence Acquisition This report is based on a review of literature and observations by the author during the period 1970 - 2014. Results Predictable increase of alcohol consumption after the anti-alcohol campaign facilitated the economical reforms of the early 1990s: workers and some intelligentsia did not oppose privatizations of state-owned enterprises partly due to their drunkenness, involvement in workplace theft and use of equipment for profit, which was often tolerated by the management at that and earlier time. Conclusions Last time, a gradual change of the alcohol consumption pattern in Russia has been noticed: less heavy binge drinking of vodka, fortified wine and surrogates; more moderate consumption of beer.

  12. Magnesium treatment in alcoholics: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Poikolainen Kari

    2008-01-01

    Full Text Available Abstract Background Magnesium (Mg deficiency is common among alcoholics. Earlier research suggests that Mg treatment may help to normalize elevated enzyme activities and some other clinically relevant parameters among alcoholics but the evidence is weak. Methods The effect of Mg was studied in a randomized, parallel group, double-blind trial. The patients were first treated for alcohol withdrawal symptoms and then received for 8 weeks either 500 mg of Mg divided into two tablets or matching placebo. Measurements were made at the beginning and in the end of the Mg treatment period. The primary outcome was serum gamma-glutamyltransferase (S-GGT activity; secondary outcomes included aspartate-aminotransferase (S-AST and alanine-aminotransferase (S-ALT activity. Results The number of randomized patients (completers was 64 (27 in the treatment and 54 (31 in the control group. In intention-to-treat-analyses and in most analyses of study completers, there were no significant differences between the Mg-treated and placebo groups in the outcome variables. When baseline serum Mg level, coffee intake, and the number of unused Mg tablets were controlled for in a multivariate regression model, after-treatment serum Mg levels were found to be higher among the Mg-treated group than in the placebo group (t-test 3.334, df = 53, p = 0.002. After controlling for age, body weight, baseline alcohol intake, subsequent change in alcohol intake and baseline S-AST, the after-treatment S-AST levels were found to be lower among the Mg-treated group than in the placebo group (t-test 2.061, df = 49, p = 0.045. Conclusion Mg treatment may speed up the S-AST decrease in compliant patients. This might decrease the risk of death from alcoholic liver disease. Trial Registration ClinicalTrials.gov ID NCT00325299

  13. Exploring Treatment Options for Alcohol Use Disorders

    Science.gov (United States)

    ... public payers such as States are willing to finance. 49 One thing, however, that influences payers is ... In: Longabaugh, R., and Wirtz, P.W., Eds. Project MATCH Hypotheses: Results and Causal Chain Analyses (Project ...

  14. Alcohol Alert

    Science.gov (United States)

    ... main content National Institute on Alcohol Abuse and Alcoholism (NIAAA) Main Menu Search Search form Search Alcohol & ... on a single aspect of alcohol abuse and alcoholism. Please click on the desired publication for full ...

  15. Predicting Post-Treatment-Initiation Alcohol Use among Patients with Severe Mental Illness and Alcohol Use Disorders

    Science.gov (United States)

    Bradizza, Clara M.; Maisto, Stephen A.; Vincent, Paula C.; Stasiewicz, Paul R.; Connors, Gerard J.; Mercer, Nicole D.

    2009-01-01

    Few investigators studying alcohol abuse among individuals with a severe mental illness (SMI) have examined predictors of posttreatment alcohol outcomes. In the present study, a multivariate approach based on a theoretical model was used to study the relationship between psychosocial factors and post-treatment-initiation alcohol use. Predictors of…

  16. Alcoholics Anonymous and Relapse Prevention as Maintenance Strategies After Conjoint Behavioral Alcohol Treatment for Men: 18-Month Outcomes

    Science.gov (United States)

    McCrady, Barbara S.; Epstein, Elizabeth E.; Kahler, Christopher W.

    2004-01-01

    Ninety men with alcohol problems and their female partners were randomly assigned to 1 of 3 outpatient conjoint treatments: alcohol behavioral couples therapy (ABCT), ABCT with relapse prevention techniques (RP/ABCT), or ABCT with interventions encouraging Alcoholics Anonymous (AA) involvement (AA/ABCT). Couples were followed for 18 months after…

  17. [Burnout in Residential Drug- and Alcohol Treatment

    Science.gov (United States)

    Härtel, Roland; Limmer, Uwe; Schiller, Martin; Wolfersdorf, Manfred

    2003-05-01

    OBJECTIVE: The study aimed at comparing burnout in staff members at residential drug and alcohol detoxification wards with and without teamsupervision. METHOD: 4 times in a period of 18 month all staff members (n = 44) were assessed for burnout using a german version (Checkliste Burnoutmerkmale) of the Maslach Burnout Inventory (MBI, Maslach u. Jackson 1986) to asses the severity and the CBE (Checkliste Burnoutentstehungsmerkmale) for associated burnout risc-factors. RESULT: There was no statistical differences between the mean scores of the 3 different wards due to extreme SDs. The interpersonal differences among staff on the 4 occasions were remarkably. On repeated measurements the intraindividual changes were high. Higher scores were correlated with high workload (seen as frequent admissions). CONCLUSION: Work-related variables (admissions) turned out to be of more importance than supervision in times of chronic staff-shortage.

  18. Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

    Science.gov (United States)

    Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz

    2015-11-01

    There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley

  19. In silico models of alcohol dependence and treatment

    Directory of Open Access Journals (Sweden)

    Boris eKovatchev

    2012-02-01

    Full Text Available In this paper we view alcohol dependence and the response to treatment as a recurrent bio-behavioral process developing in time and propose formal models of this process combining behavior and biology in silico. The behavioral components of alcohol dependence and treatment are formally described by a stochastic process of human behavior, which serves as an event generator challenging the metabolic system. The biological component is driven by the biochemistry of alcohol intoxication described by deterministic models of ethanol pharmacodynamics and pharmacokintetics to enable simulation of drinking addiction in humans. Derived from the known physiology of ethanol and the literature of both ethanol intoxication and ethanol absorption, the different models are distilled into a minimal model (as simple as the complexity of the data allows that can represent any specific patient. We use these modeling and simulation techniques to explain responses to placebo and ondansetron treatment observed in clinical studies. Specifically, the response to placebo was explained by a reduction of the probability of environmental reinforcement, while the effect of ondansetron was explained by a gradual decline in the degree of ethanol-induced neuromodulation. Further, we use in silico experiments to study critical transitions in blood alcohol levels after specific average number of drinks per day, and propose the existence of two critical thresholds in the human - one at 5 and another at 11 drinks/day - at which the system shifts from stable to critical and to super critical state indicating a state of alcohol addiction. The advantages of such a model-based investigation are that 1 the process of instigation of alcohol dependence and its treatment can be deconstructed into meaningful steps, which allow for individualized treatment tailoring, and 2 physiology and behavior can be quantified in different (animal or human studies and then the results can be integrated

  20. Treating Alcohol Problems | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Alcohol Treating Alcohol Problems Past Issues / Winter 2015 Table of Contents ... offers treatment options The new publication, Treatment for Alcohol Problems: Finding and Getting Help , complements the information ...

  1. Fetal Alcohol Spectrum Disorders (FASDs): Treatments

    Science.gov (United States)

    ... alternative treatments used for people with FASDs include: Biofeedback Auditory training Relaxation therapy, visual imagery, and meditation (especially for sleep problems and anxiety) Creative art ...

  2. Alcohol-Adapted Anger Management Treatment: A Randomized Controlled Trial of an Innovative Therapy for Alcohol Dependence.

    Science.gov (United States)

    Walitzer, Kimberly S; Deffenbacher, Jerry L; Shyhalla, Kathleen

    2015-12-01

    A randomized controlled trial for an innovative alcohol-adapted anger management treatment (AM) for outpatient alcohol dependent individuals scoring moderate or above on anger is described. AM treatment outcomes were compared to those of an empirically-supported intervention, Alcoholics Anonymous Facilitation treatment (AAF). Clients in AM, relative to clients in AAF, were hypothesized to have greater improvement in anger and anger-related cognitions and lesser AA involvement during the 6-month follow-up. Anger-related variables were hypothesized to be stronger predictors of improved alcohol outcomes in the AM treatment condition and AA involvement was hypothesized to be a stronger predictor of alcohol outcomes in the AAF treatment group. Seventy-six alcohol dependent men and women were randomly assigned to treatment condition and followed for 6 months after treatment end. Both AM and AAF treatments were followed by significant reductions in heavy drinking days, alcohol consequences, anger, and maladaptive anger-related thoughts and increases in abstinence and self-confidence regarding not drinking to anger-related triggers. Treatment with AAF was associated with greater AA involvement relative to treatment with AM. Changes in anger and AA involvement were predictive of posttreatment alcohol outcomes for both treatments. Change in trait anger was a stronger predictor of posttreatment alcohol consequences for AM than for AAF clients; during-treatment AA meeting attendance was a stronger predictor of posttreatment heavy drinking and alcohol consequences for AAF than for AM clients. Anger-related constructs and drinking triggers should be foci in treatment of alcohol dependence for anger-involved clients. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. The Effects of Drinking Goal on Treatment Outcome for Alcoholism

    Science.gov (United States)

    Bujarski, Spencer; O'Malley, Stephanie S.; Lunny, Katy; Ray, Lara A.

    2013-01-01

    Objective: It is well known to clinicians and researchers in the field of alcoholism that patients vary with respect to drinking goal. The objective in this study was to elucidate the contribution of drinking goal to treatment outcome in the context of specific behavioral and pharmacological interventions. Method: Participants were 1,226…

  4. Public health, academic medicine, and the alcohol industry's corporate social responsibility activities.

    Science.gov (United States)

    Babor, Thomas F; Robaina, Katherine

    2013-02-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.

  5. Public Health, Academic Medicine, and the Alcohol Industry’s Corporate Social Responsibility Activities

    Science.gov (United States)

    Robaina, Katherine

    2013-01-01

    We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry’s economic interests. PMID:23237151

  6. Conditioned learning in alcohol dependence: implications for cue exposure treatment.

    Science.gov (United States)

    Drummond, D C; Cooper, T; Glautier, S P

    1990-06-01

    A review of the literature pertinent to cue exposure treatment in alcohol dependence is presented. Psychological models of relapse, based on conditioning and social learning theories, are critically evaluated. In particular, attention is drawn to the potential implications for cue exposure research and treatment of an interaction between Pavlovian and operant conditioning, problems with the application of the concepts of arousal and craving and the importance of a systems model to understand physiological responses. It is concluded that no study has so far demonstrated a link between conditioned responses to alcohol-related cues and relapse, an assumption on which cue exposure treatment is based. Further, the evidence for the effectiveness of cue exposure as a treatment is lacking. Promising research directions are identified.

  7. Alcohol misuse, firearm violence perpetration, and public policy in the United States.

    Science.gov (United States)

    Wintemute, Garen J

    2015-10-01

    Firearm violence is a significant public health problem in the United States, and alcohol is frequently involved. This article reviews existing research on the relationships between alcohol misuse; ownership, access to, and use of firearms; and the commission of firearm violence, and discusses the policy implications of these findings. Narrative review augmented by new tabulations of publicly-available data. Acute and chronic alcohol misuse is positively associated with firearm ownership, risk behaviors involving firearms, and risk for perpetrating both interpersonal and self-directed firearm violence. In an average month, an estimated 8.9 to 11.7 million firearm owners binge drink. For men, deaths from alcohol-related firearm violence equal those from alcohol-related motor vehicle crashes. Enforceable policies restricting access to firearms for persons who misuse alcohol are uncommon. Policies that restrict access on the basis of other risk factors have been shown to reduce risk for subsequent violence. The evidence suggests that restricting access to firearms for persons with a documented history of alcohol misuse would be an effective violence prevention measure. Restrictions should rely on unambiguous definitions of alcohol misuse to facilitate enforcement and should be rigorously evaluated. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Client Evaluation of Treatment for Alcohol Use Disorder in COMBINE.

    Science.gov (United States)

    Kirouac, Megan; Witkiewitz, Katie; Donovan, Dennis M

    2016-08-01

    Practitioners and researchers across disciplines have been interested in identifying variables that act as indicators of treatment success or failure and one straightforward approach to measuring treatment success is to assess client satisfaction with treatment. Existing measures of treatment satisfaction do not address the specific aspects relevant to alcohol use disorder (AUD) treatment. Researchers in the COMBINE Study developed a new measure of treatment satisfaction to assess satisfaction in AUD treatment: The Evaluation of Treatment (EOT) measure. The aims of the present study were to examine the factor structure of items from the EOT measure and to examine the association between the EOT measure and other measures of client engagement, as well as AUD treatment outcomes. We also extended the model to test for possible mediation effects of treatment evaluation on the relationship between client treatment engagement components and AUD treatment outcomes. Confirmatory factor analyses indicated a 6-factor model with a higher order treatment satisfaction factor provided an excellent fit to the data (χ2 (246)=499.44, p<0.001, CFI=0.99, TLI=0.98, RMSEA =0.040 (90% CI: 0.035, 0.045). Overall, the latent factor of treatment satisfaction was significantly associated with client engagement predictors and treatment evaluation significantly mediated the associations between both working alliance and treatment expectations in the prediction of alcohol-related problems and global severity. Findings suggest that client evaluations of treatment play a substantial role in predicting AUD treatment outcomes and should be considered in future treatment and research.

  9. Subjective response as a consideration in the pharmacogenetics of alcoholism treatment.

    Science.gov (United States)

    Roche, Daniel Jo; Ray, Lara A

    2015-01-01

    Currently available pharmacological treatments for alcoholism have modest efficacy and high individual variability in treatment outcomes, both of which have been partially attributed to genetic factors. One path to reducing the variability and improving the efficacy associated with these pharmacotherapies may be to identify overlapping genetic contributions to individual differences in both subjective responses to alcohol and alcoholism pharmacotherapy outcomes. As acute subjective response to alcohol is highly predictive of future alcohol related problems, identifying such shared genetic mechanisms may inform the development of personalized treatments that can effectively target converging pathophysiological mechanisms that convey risk for alcoholism. The focus of this review is to revisit the association between subjective response to alcohol and the etiology of alcoholism while also describing genetic contributions to this relationship, discuss potential pharmacogenetic approaches to target subjective response to alcohol in order to improve the treatment of alcoholism and examine conceptual and methodological issues associated with these topics, and outline future approaches to overcome these challenges.

  10. Personality disorders among Danish alcoholics attending outpatient treatment

    DEFF Research Database (Denmark)

    Nordholm, Dorte; Nielsen, Bent

    2007-01-01

    The aim of the present study was firstly to describe the characteristics of alcoholic outpatients (A) suffering from co-morbid personality disorder (PD) of either the cluster B (A+PDB) or cluster C (A+PDC) type. Secondly, to investigate the effect of various kinds of treatment to be able to single...... out the most beneficial therapy. Thirdly, to identify the most beneficial treatment. The patients were offered the following outpatient treatments: cognitive behaviour therapy, family therapy and supportive consultations. The material consisted of 363 patients who started psychosocial treatment...

  11. Native American women in alcohol and substance abuse treatment.

    Science.gov (United States)

    Peterson, Sara; Berkowitz, Gale; Cart, Courtney Uhler; Brindis, Claire

    2002-08-01

    Alcohol and other drug use is a serious problem among American Indian and Alaska Native women. However, information about their needs for treatment is lacking. In response, a study was conducted to document the life experiences and perceived recovery needs of American Indian and Alaska Native women at nine treatment centers nationwide. The data show that most of these women have experienced various forms of abuse and neglect from childhood into adulthood and have been exposed to alcohol and other drugs from an early point in their lives. Most of these women have made multiple attempts to recover from their addictions, often for the sake of their children. The information derived from this study can be used as the foundation for further research about the treatment needs of American Indian and Alaska Native women.

  12. Participation in Alcoholics Anonymous and post-treatment abstinence from alcohol and other drugs.

    Science.gov (United States)

    Kingree, J B; Thompson, Martie

    2011-08-01

    This study examined associations between two types of AA participation (i.e., meeting attendance, having a sponsor) and two types of post-treatment abstinence (i.e., abstinence from alcohol, abstinence from drugs). Respondents completed measures that assessed their demographic characteristics, the severity of their substance use, and their motivation to change when they enrolled in treatment (T1). They completed measures of AA participation at T1 and a 3-month follow-up assessment (T2), and measures of recent abstinence at T1 and a 6-month follow-up assessment (T3). T2 sponsor was associated prospectively with T3 abstinence from alcohol. Having a sponsor served as a marker for subsequent abstinence. Future research can examine factors that may mediate or moderate the associations between having a sponsor and subsequent abstinence. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Pediatric non-alcoholic fatty liver disease: an increasing public health issue.

    Science.gov (United States)

    Berardis, S; Sokal, E

    2014-02-01

    Non-alcoholic fatty liver disease (NAFLD) is a multifactorial condition that encompasses a wide spectrum of liver abnormalities ranging from simple liver steatosis to steatohepatitis (non-alcoholic steatohepatitis), which may be associated with fibrosis and progress to cirrhosis and end-stage liver disease. NAFLD has recently become the most common cause of chronic liver disease in children and adolescents. NAFLD prevalence, alongside obesity, continues to increase among pediatric patients. Obesity is believed to represent a major risk factor for NAFLD, which is considered to be the liver presentation of the metabolic syndrome. Although the pathogenesis of NAFLD is not fully understood, the notion that multiple factors affect disease development and progression is widely accepted. Both genetic background and environmental factors contribute to NAFLD development. A more complete understanding of the pathogenesis may aid in developing non-invasive diagnostic tools and identifying new therapeutic targets. Liver biopsy currently remains the gold standard for NAFLD diagnosis and staging. Although lifestyle and diet modifications are key in NAFLD treatment, the development of new pharmacological therapies is crucial for patients who are unresponsive to first-line therapy. Pediatric NAFLD is an increasing public health issue that remains underdiagnosed. A large-scale screening in the high-risk population, especially among the overweight pediatric patients, should be considered, including measurement of serum transaminases and liver ultrasound. It is crucial to treat this condition as soon as possible in order to avoid the progression to end-stage liver disease.

  14. Alcohol and older people from a public health perspective

    Directory of Open Access Journals (Sweden)

    Peter Anderson

    2012-01-01

    Full Text Available OBJECTIVES AND METHODS: As part of the European project VINTAGE, a systematic review of scientific literature was undertaken to document the evidence base on the impact of alcohol on the health and well-being of older people, and on effective policies and preventive approaches to face the problem in this steadily increasing segment of the population. RESULTS: 369 references were identified, from which 78 papers were selected. CONCLUSIONS: The review confirms the paucity of data on this topic and the need for more specific research. Although there is scarce evidence, the elderly seems to respond equally well to alcohol policy, screening instruments and brief interventions as do younger adults. According to a lifecycle approach, a future focus on the middle aged is also recommended.

  15. Alcohol

    Science.gov (United States)

    ... that's how many accidents occur. continue What Is Alcoholism? What can be confusing about alcohol is that ... develop a problem with it. Sometimes, that's called alcoholism (say: al-kuh-HOL - ism) or being an ...

  16. Alcohol

    Science.gov (United States)

    If you are like many Americans, you drink alcohol at least occasionally. For many people, moderate drinking ... risky. Heavy drinking can lead to alcoholism and alcohol abuse, as well as injuries, liver disease, heart ...

  17. Pharmacologically induced alcohol craving in treatment seeking alcoholics correlates with alcoholism severity, but is insensitive to acamprosate

    OpenAIRE

    Umhau, John C.; Schwandt, Melanie L.; Usala, Julie; Geyer, Christopher; Singley, Erick; George, David T.; Heilig, Markus

    2011-01-01

    Modulation of alcohol craving induced by challenge stimuli may predict the efficacy of new pharmacotherapies for alcoholism. We evaluated two pharmacological challenges, the α2-adrenergic antagonist yohimbine, which reinstates alcohol seeking in rats, and the serotonergic compound meta-chlorophenylpiperazine (mCPP), previously reported to increase alcohol craving in alcoholics. To assess the predictive validity of this approach, the approved alcoholism medication acamprosate was evaluated for...

  18. Implementation of a clinical pathway may improve alcohol treatment outcome

    DEFF Research Database (Denmark)

    Nielsen, Anette Søgaard; Nielsen, Bent

    2015-01-01

    This article describes the design, implementation, and evaluation of a clinical pathway system in a two-cohort quasi-experimental study before and after implementation, controlling for confounders. The main outcome measures were retention in care and sensible alcohol use (defined as abstinent...... a structured intake, a referral and independent follow-up system, checklists, audit, and feedback, there was no change in length of stay, but significantly more patients had a good clinical outcome (stopped or moderated their consumption) at the end of treatment (OR = 1.9; 1.2–3.1). The study documents...... the feasibility of using a clinical pathway framework, incorporating a local monitoring system, checklists, audit, and feedback to enhance treatment quality and improve outcomes for alcohol use disorders...

  19. The Lesch alcoholism typology - psychiatric and psychosocial treatment approaches.

    Science.gov (United States)

    Schlaff, Golda; Walter, Henriette; Lesch, Otto Michael

    2011-01-01

    In the past three decades, researchers have been attempting to replace the obsolete concept of homogeneity of alcohol dependence, by classifying these patients into specific heterogeneous subtypes. Based on 30 years of experience and research, the Lesch Typology has proved to be very useful in clinical daily routine. The aim of the Lesch Typology is to provide targeted subtype-specific treatments to patients, thereby increasing their probability of long-term abstinence and hence improving their prognosis. The Lesch Typology is based on data from a longitudinal prospective study (with follow ups even 19 years later) on alcohol dependent patients (n=436). By observing the long term development of these patients, four distinct courses could be identified. In the meantime, a computerized version of the Lesch Typology had been created and translated into many languages, and is currently being employed in numerous psychiatric institutions while assisting clinicians in quickly determining a patient's subtype (www.lat-online.at). Based on the patients' drinking patterns and origin of substance craving, hence according to the Lesch Typology, four subtypes of alcohol dependent patients can be distinguished: 1. the "allergy model" (craving caused by alcohol); 2. the "conflict resolution and anxiety model" (craving caused by stress); 3. the "depressive model" (craving caused by mood); and 4. the "conditioning model" (craving caused by compulsion). Pharmacological treatments are not always the most effective way of preventing relapses in alcohol dependent patients. Many times, a combination with psychosocial as well as psychotherapeutic approaches is necessary and essential for helping patients to stay sober. Depending on the patient's Lesch Type, certain therapeutic approaches are more appropriate and subsequently lead to better results and higher chances of lasting abstinence.

  20. Antidotes for alcohol and glycol toxicity: translating mechanisms into treatments.

    Science.gov (United States)

    McMartin, K E

    2010-09-01

    Translational toxicology can be defined as the movement of potential antidotes for the treatment of poisonings from basic mechanistic research to the marketplace. Because poisonings are infrequent, the clinical development of antidotes is fraught with trials and tribulations. Academic scientists often conduct basic mechanistic work with antidotes but are infrequently involved in further drug development. This article presents the development of 4-methylpyrazole (4MP) (fomepizole) as an antidote against toxic alcohol poisonings, particularly by methanol and ethylene glycol (EG).

  1. Severe alcoholic hepatitis-current concepts, diagnosis and treatment options

    Institute of Scientific and Technical Information of China (English)

    Won; Kim; Dong; Joon; Kim

    2014-01-01

    Alcoholic hepatitis(AH) is an acute hepatic manifesta-tion occurring from heavy alcohol ingestion. Alcoholic steatohepatitis(ASH) is histologically characterized by steatosis, inflammation, and fibrosis in the liver. Despite the wide range of severity at presentation, those with severe ASH(Maddrey’s discriminant function ≥ 32) typically present with fever, jaundice, and abdominal tenderness. Alcohol abstinence is the cornerstone of therapy for AH and, in the milder forms, is sufficient for clinical recovery. Severe ASH may progress to multi-or-gan failure including acute kidney injury and infection. Thus, infection and renal failure have a major impact on survival and should be closely monitored in patients with severe ASH. Patients with severe ASH have a re-ported short-term mortality of up to 40%-50%. Severe ASH at risk of early death should be identified by one of the available prognostic scoring systems before consid-ering specific therapies. Corticosteroids are the main-stay of treatment for severe ASH. When corticosteroids are contraindicated, pentoxifylline may be alternatively used. Responsiveness to steroids should be assessed at day 7 and stopping rules based on Lille score should come into action. Strategically, future studies for pa-tients with severe ASH should focus on suppressing inflammation based on cytokine profiles, balancing he-patocellular death and regeneration, limiting activation of the innate immune response, and maintaining gut mucosal integrity.

  2. Molecular targets in the treatment of alcoholic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Ashwin D Dhanda; Richard WL Lee; Peter L Collins; C Anne McCune

    2012-01-01

    Alcohol related costs to health and society are high.One of the most serious complications of alcohol misuse to the individual is the development of alcoholic hepatitis (AH),a clinical syndrome of jaundice and progressive inflammatory liver injury in patients with a history of recent heavy alcohol use.It has a poor outcome and few existing successful therapies.The use of glucocorticoids in patients with severe AH is still controversial and there remains a group of patients with glucocorticoid-resistant disease.However,as our understanding of the pathogenesis of the condition improves there are opportunities to develop new targeted therapies with specific actions to control liver inflammation without having a detrimental effect on the immune system as a whole.In this article we review the molecular mechanisms of AH concentrating on the activation of the innate and adaptive immune response.We consider existing treatments including glucocorticoids,anti-tumor necrosis factor therapy and pentoxifylline and their limitations.Using our knowledge of the disease pathogenesis we discuss possible novel therapeutic approaches.New targets includepro-inflammatory cytokines such as interleukin (IL)-17,chemokines and their receptors (for example IL-8,CXCL9 and CXCR3) and augmentation of anti-inflammatory molecules such as IL-10 and IL-22.And there is also future potential to consider combination therapy to selectively modulate the immune response and gain control of disease.

  3. Merging public relations with health communication in the context of university alcohol prevention.

    Science.gov (United States)

    Brummette, John

    2015-01-01

    The scope of this study is to determine whether social norms marketing should be further evaluated according to its ability to serve as a public relations tactic for universities. Based on a framework of social norms theory and strategic issues management, this study uses a web-based survey with university parents (N = 173) to identify relationships among exaggerated parental misperceptions of student binge drinking, parental awareness of alcohol prevention programs, and parental perceptions of organizational legitimacy. Findings from this study are used to make the argument that health communication and public relations should be viewed as interrelated concepts in the context of university alcohol prevention.

  4. A total ban on alcohol advertising: presenting the public health case.

    Science.gov (United States)

    Parry, Charles; Burnhams, Nadine Harker; London, Leslie

    2012-05-28

    Evidence from burden of disease and economic costing studies amply indicate that the public health burden from hazardous and harmful use of alcohol in South Africa warrants drastic action. Evidence that banning alcohol advertising is likely to be an effective intervention is reflected in WHO strategy documents on non-communicable diseases and harmful use of alcohol. Studies on young people furthermore support arguments refuting the claim that advertising only influences brand choice. Given the weakness of relying on industry self-regulation, the government is considering legislation to ban alcohol advertising, resulting in heated debate. Tobacco control and studies investigating the effect of alcohol advertising bans on consumption and alcohol-related deaths point to the effectiveness of such action - ideally supplemented by other policy interventions. Arguments against an advertising ban include possible communication sector job losses, but these are likely to have been exaggerated. Banning alcohol advertising will necessitate greater scrutiny of digital media, satellite television and merchandising to reduce the likelihood of subverting the ban.

  5. Sodium valproate in the treatment of the alcohol withdrawal syndrome.

    Science.gov (United States)

    Lambie, D G; Johnson, R H; Vijayasenan, M E; Whiteside, E A

    1980-09-01

    The value of sodium valproate in the management of patients during withdrawal from alcohol dependence has been assessed. Alcoholic inpatients were randomly allocated to two groups - one treated with sodium valproate and the other acting as a control. All patients received multivitamins and fluid and electrolyte replacement, and some received chlormethiazole or other tranquillisers. Treatment with sodium valproate (1200 mg daily) was continued for one week. The occurrence of seizures and other withdrawal symptoms (tremulousness, nausea, sweating, disorientation) were noted daily. Forty-nine episodes of withdrawal have been included in the trial - 22 in the sodium valproate group and 27 in the control group. Five patients, all in the control group, had seizures. Other withdrawal symptoms disappeared more quickly in the sodium valproate group even though fewer patients were receiving chlormethiazole.

  6. Probiotics and Alcoholic Liver Disease: Treatment and Potential Mechanisms

    Directory of Open Access Journals (Sweden)

    Fengyuan Li

    2016-01-01

    Full Text Available Despite extensive research, alcohol remains one of the most common causes of liver disease in the United States. Alcoholic liver disease (ALD encompasses a broad spectrum of disorders, including steatosis, steatohepatitis, and cirrhosis. Although many agents and approaches have been tested in patients with ALD and in animals with experimental ALD in the past, there is still no FDA (Food and Drug Administration approved therapy for any stage of ALD. With the increasing recognition of the importance of gut microbiota in the onset and development of a variety of diseases, the potential use of probiotics in ALD is receiving increasing investigative and clinical attention. In this review, we summarize recent studies on probiotic intervention in the prevention and treatment of ALD in experimental animal models and patients. Potential mechanisms underlying the probiotic function are also discussed.

  7. Barriers to successful treatment of alcohol addiction as perceived by healthcare professionals in Thailand – a Delphi study about obstacles and improvement suggestions

    Directory of Open Access Journals (Sweden)

    Kulnaree Hanpatchaiyakul

    2016-08-01

    Full Text Available Background: Many Thai people experiencing alcohol addiction do not seek help, and those who do often have inadequate access to treatment. There are few research studies focusing on alcohol addiction treatment in Thailand. Objective: The purpose of the current study was to identify barriers to the treatment of alcohol addiction and to collect experts’ suggestions for improving treatment in Thailand. The Delphi technique was used to achieve consensual agreement among an expert panel within the field of alcohol addiction and treatment. Design: Three rounds of a Delphi survey were completed by a panel of experts in alcohol addiction, including physicians, nurses, social workers, psychologists, healthcare officers, and an Alcoholics Anonymous member. The open-ended answers provided by 34 experts in the first round resulted in 60 statements, which were later grouped into three themes. After three rounds of questionnaires, 51 statements were accepted as consensus. Results: Thirty-two experts participated in all three Delphi rounds. Over 80% of participants were particularly concerned about five obstacles to alcohol addiction treatment. The majority of suggestions from the expert panel were related to patients’ right to treatment and the national policy for reducing the negative effects of alcohol. According to the results of the present study, the experts suggested that the treatment of alcohol addiction should be continuous from primary care to tertiary care, and convenient pathways should be established in healthcare services. The experts would also like to increase the number of healthcare providers and improve their knowledge and skills in working with people experiencing alcohol addiction. Conclusions: Equal rights to health and treatment for people experiencing alcohol addiction in Thailand require policy improvements, as well as acceptance and awareness of alcohol addiction from both the public and policymakers.

  8. The role of topiramate and other anticonvulsants in the treatment of alcohol dependence: a clinical review.

    Science.gov (United States)

    De Sousa, Avinash

    2010-03-01

    Alcohol dependence is a major health problem worldwide. Various pharmacological agents have been used in the management of alcohol dependence. This review looks at the role of topiramate and other anticonvulsants in the management of alcohol dependence. Topiramate is the most widely used anticonvulsant in the treatment of alcohol dependence. The literature on topiramate is reviewed and critically analyzed, along with its proposed mechanism of action in alcohol dependence. A review of data available on other anticonvulsants like carbamazepine, oxcarbazepine, sodium valproate, gabapentin and levetiracetam are presented and their potential in the treatment of alcohol dependence is considered, together with future research directions.

  9. Western Australian Public Opinions of a Minimum Pricing Policy for Alcohol: Study Protocol.

    Science.gov (United States)

    Keatley, David A; Carragher, Natacha; Chikritzhs, Tanya; Daube, Mike; Hardcastle, Sarah J; Hagger, Martin S

    2015-11-18

    Excessive alcohol consumption has significant adverse economic, social, and health outcomes. Recent estimates suggest that the annual economic costs of alcohol in Australia are up to AUD $36 billion. Policies influencing price have been demonstrated to be very effective in reducing alcohol consumption and alcohol-related harms. Interest in minimum pricing has gained traction in recent years. However, there has been little research investigating the level of support for the public interest case of minimum pricing in Australia. This article describes protocol for a study exploring Western Australian (WA) public knowledge, understanding, and reaction to a proposed minimum price policy per standard drink. The study will employ a qualitative methodological design. Participants will be recruited from a wide variety of backgrounds, including ethnic minorities, blue and white collar workers, unemployed, students, and elderly/retired populations to participate in focus groups. Focus group participants will be asked about their knowledge of, and initial reactions to, the proposed policy and encouraged to discuss how such a proposal may affect their own alcohol use and alcohol consumption at the population level. Participants will also be asked to discuss potential avenues for increasing acceptability of the policy. The focus groups will adopt a semi-structured, open-ended approach guided by a question schedule. The schedule will be based on feedback from pilot samples, previous research, and a steering group comprising experts in alcohol policy and pricing. The study is expected to take approximately 14 months to complete. The findings will be of considerable interest and relevance to government officials, policy makers, researchers, advocacy groups, alcohol retail and licensed establishments and organizations, city and town planners, police, and other stakeholder organizations.

  10. Influence of public alcohol and tobacco use on general practitioners' advice: an international comparative study.

    NARCIS (Netherlands)

    Pas, L.; Boerma, W.; Spreeuwenberg, P.; Saunders, J.B.; Zee, J. van der

    2002-01-01

    Background: Efficacy of advice for substance use is proven in general practice. Studies show high variability of perfomance. Especially intercountry variability has rarely been taken into account. Aim: To study the influence of public tobacco and alcohol use and health service characteristics on the

  11. Alcohol and the American College Campus: A Report from the Harvard School of Public Health.

    Science.gov (United States)

    Wechsler, Henry

    1996-01-01

    A Harvard School of Public Health survey of 17,592 college students concerning alcohol consumption found 84% reported drinking during the school year, with 19% frequent binge drinkers. Half of these were binge drinkers in high school. Also investigated were other drug use, dangerous behavior, secondhand binge effects, and gender effects. A 12-step…

  12. Trends in Alcohol Consumption among Undergraduate Students at a Northeastern Public University, 2002-2008

    Science.gov (United States)

    Bulmer, Sandra Minor; Irfan, Syed; Mugno, Raymond; Barton, Barbara; Ackerman, Louise

    2010-01-01

    Objective: This study examined alcohol consumption patterns and trends at a public university in the Northeast from 2002 to 2008. Participants: Stratified random sampling was used to select undergraduate students enrolled in courses during spring semesters in 2002, 2004, 2006, and 2008. Methods: Data were collected during regularly scheduled…

  13. Family Life and Alcohol Consumption: The Transmission of "Public" and "Private" Drinking Cultures

    Science.gov (United States)

    Jayne, Mark; Valentine, Gill; Gould, Myles

    2012-01-01

    This article considers the transmission of drinking cultures within families. In particular, we highlight the differential and discursive construction of the home as a space where parents/carers are happy to introduce children to alcohol in a "safe" environment in opposition to public spaces which they consider to be locations where…

  14. Trends in Alcohol Consumption among Undergraduate Students at a Northeastern Public University, 2002-2008

    Science.gov (United States)

    Bulmer, Sandra Minor; Irfan, Syed; Mugno, Raymond; Barton, Barbara; Ackerman, Louise

    2010-01-01

    Objective: This study examined alcohol consumption patterns and trends at a public university in the Northeast from 2002 to 2008. Participants: Stratified random sampling was used to select undergraduate students enrolled in courses during spring semesters in 2002, 2004, 2006, and 2008. Methods: Data were collected during regularly scheduled…

  15. Drug, Sex and Age Differentials in the Use of Australian Publicly Funded Treatment Services

    Directory of Open Access Journals (Sweden)

    Jane Anne Fischer

    2012-01-01

    Full Text Available Context Little is known about the proportion of the Australian population using alcohol or other drugs who may seek treatment. There is a need to have some additional estimates of population morbidity which reflect harms associated with use. Objective To determine Australian population rates of publicly funded community based specialised alcohol and other drug treatment and in-patient hospital care by those ‘at risk’, by drug type, sex and age. Design and setting The design is secondary data analysis of publicly available datasets. We use the latest available complete data on Australian general population incidence of alcohol, cannabis amphetamines and ecstasy use (2007 National Drug Strategy Household Survey and nationally collected administrative data on publicly funded specialised alcohol and other drug treatment services (2006–2007 Alcohol and Other Drug Treatment Services National Minimum Dataset and public hospitals (2006–2007 National Hospital Morbidity Minimum Dataset to calculate rates of drug treatment and in-patient hospital care per 1000 Australians. ‘At risk’ for alcohol is defined as being at risk of short term harm, as defined by the National Health and Medical Research Council (2001. ‘At risk’ for illicit drugs is defined as those exposed to potential harm through at least weekly use of cannabis, amphetamines and ecstasy use. Results Risky alcohol consumption followed by recent cannabis use appears to lead to most harm. Greater harm seems to be experienced by males rather than females. Younger adults (15–19 years and older adults (40+ years seem also to experience the highest rates of harm. Conclusions It is possible to derive population estimates of harms associated with licit and illicit drugs use. Treatment rates vary across drug type, gender and age. Alcohol and cannabis are the substances whose use leads to the greatest demand for services. Ecstasy appears to generate few presentations for treatment

  16. Treatment Seeking for Alcohol Use Disorders : Treatment Gap or Adequate Self-Selection?

    NARCIS (Netherlands)

    Tuithof, Marlous; Ten Have, Margreet; Van Den Brink, Wim; Vollebergh, Wilma; De Graaf, Ron

    2016-01-01

    Background/Aims: This study examines whether it is harmful that subjects with an alcohol use disorder (AUD) in the general population rarely seek treatment. Methods: Baseline and 3-year follow-up data from the Netherlands Mental Health Survey and Incidence Study-2 were used. Treatment utilization

  17. Benzodiazepines should still be first-line treatment for alcohol withdrawal

    DEFF Research Database (Denmark)

    Askgaard, Gro; Pottegård, Anton; Fink-Jensen, Anders

    2017-01-01

    In this review, we summarize the evidence for benzodiazepines and barbiturates as alcohol withdrawal treatment and outline a treatment guideline. A number of randomized controlled trials (RCTs) indicate that benzodiazepine treatment decreases alcohol withdrawal seizures and is safe....... For barbiturates, only a few RCTs have been undertaken, and barbiturates were not found to be superior to benzodiazepines. Consequently, we suggest that benzodiazepines should still be first-line treatment for alcohol withdrawal....

  18. Influence of pretreatment coping strategies on the outcome of outpatient treatment of Danish alcohol abusers

    DEFF Research Database (Denmark)

    Bussey Rask, Marie; Jørgensen, Tina; Pinnerup Jensen, Jeanette

    2006-01-01

    An important issue regarding treatment for alcohol abuse is the high rate of relapse following treatment. In the research on treatment of alcohol abuse, the concept of coping has been proposed as a relevant factor in the relationship between relapse crises and treatment outcome. The present study...

  19. Alcoholics Anonymous and the Minnesota Model of treatment in Iceland.

    Science.gov (United States)

    McMenamin, Daniel; Warren, Matthew; Tyrfingsson, Thornorarinn; Hansdóttir, Ingunn; Dermatis, Helen; Galanter, Marc; McMahon, Caitlin

    2011-01-01

    This study was undertaken to provide an initial characterization of the current status of patients admitted to an alcoholism treatment program in Iceland. Consistent with the Minnesota Model, 12-step facilitation has been a central component of the program since its inception. Of the 94 patients assessed in this study, 67% were male and 40% had attended over 90 AA meetings prior to admission. The mean number of drinking days during the month prior to admission was 15.51 days and the mean length of hospital stay was 12.32 days. At time of hospital discharge, 39% were referred to residential treatment. Significant predictors of referral to residential treatment included having attended less than 90 AA meetings prior to admission and length of stay.

  20. Patient-Treatment Matching Improves Compliance of Alcoholics in Outpatient Treatment

    DEFF Research Database (Denmark)

    Nielsen, Anette Søgaard; Nielsen, Bent; Wraae, Olaf

    1998-01-01

    In chronic medical disorders, patient compliance is very poor and often less than 50%. The purpose of this investigation was to determine whether the proper matching of patient, treatment, and therapist would improve patient compliance in the outpatient treatment of alcoholics. We randomly placed...... curves. The consequence of compliance for long-term prognosis was described by means of the Addiction Severity Index. The form of treatment in itself had no importance for compliance. However, correct matching of a patient and a treatment structure resulted in a compliance rate of 63% as opposed to 38......% compliance among mismatched patients. Twenty-four months after the initiation of treatment, patients in the compliance group had a significantly higher level of function than those in the noncompliance group. Our investigation of alcoholics involved in outpatient treatment shows that the correct matching...

  1. Cognitive Dysfunction, Locus of Control and Treatment Outcome among Chronic Alcoholics.

    Science.gov (United States)

    Abbott, Max W.

    While alcoholism is no longer regarded as a unitary disorder, conventional measures of congition and personality have yet to be shown capable of consistently predicting clinical outcomes. To investigate cognitive dysfunction and locus of control as predictors of post treatment outcome in a large sample of alcoholics, 106 alcoholics (74 men, 32…

  2. Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Jong, C.A.J. de; Buitelaar, J.; Verkes, R.J.

    2015-01-01

    INTRODUCTION: Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized

  3. Co-morbid anxiety disorders predict early relapse after inpatient alcohol treatment

    NARCIS (Netherlands)

    Schellekens, A.F.A.; Jong, C.A.J. de; Buitelaar, J.K.; Verkes, R.J.

    2015-01-01

    Introduction Alcohol dependence and anxiety disorders often co-occur. Yet, the effect of co-morbid anxiety disorders on the alcohol relapse-risk after treatment is under debate. This study investigated the effect of co-morbid anxiety disorders on relapse rates in alcohol dependence. We hypothesized

  4. Drinking Distilled. Onset, course and treatment of alcohol use disorders in the general population

    NARCIS (Netherlands)

    Tuithof, M.

    2015-01-01

    Although most people in Western society drink alcohol and regard this to be harmless and normal, some people drink excessively and develop an alcohol use disorder. This thesis examined the onset, course and treatment of alcohol use disorders in the general population using 3-year longitudinal data f

  5. Risk factors for treatment failure in smokers: relationship to alcohol use and to lifetime history of an alcohol use disorder.

    Science.gov (United States)

    Leeman, Robert F; McKee, Sherry A; Toll, Benjamin A; Krishnan-Sarin, Suchitra; Cooney, Judith L; Makuch, Robert W; O'Malley, Stephanie S

    2008-12-01

    Little is known about the impact of alcohol involvement on smoking cessation relapse or possible mechanisms for these associations. We addressed these issues using data from a randomized clinical trial of two types of framed messages (gain vs. loss) in conjunction with open label sustained-release (SR) bupropion (Toll et al., 2007) (N = 249). Participants were categorized according to whether or not they were diagnosed with a lifetime alcohol use disorder (AUD; i.e., current or past alcohol abuse or past alcohol dependence) and according to three levels of alcohol use: abstinence, moderate, or hazardous use. Alcohol use categories were established for drinking at baseline, during the 6-week treatment period and through 12 weeks post-quit. There were few significant differences by baseline alcohol use level or AUD history for a series of predictors of smoking cessation failure (e.g., depressive symptoms). During treatment and follow-up, the probability of any smoking on heavy drinking days was significantly higher than the probability of smoking on moderate drinking or abstinent days. AUD history did not predict smoking cessation relapse in any analysis, nor were any alcohol usexAUD history interactions significant. Moderate alcohol users and, to a lesser extent, abstainers from alcohol at baseline were less likely than hazardous drinkers to have relapsed at 12 weeks post-quit. Based on these findings, it appears that risk of any smoking and of relapse was associated primarily with heavy drinking days and a hazardous pattern of use respectively, rather than with moderate drinking.

  6. Pregabalin in the treatment of alcohol and benzodiazepines dependence.

    Science.gov (United States)

    Oulis, Panagiotis; Konstantakopoulos, George

    2010-01-01

    We review all available studies on the use of the newer anticonvulsant drug pregabalin (PGB) in the treatment of both alcohol dependence (AD) and benzodiazepine dependence (BD). In AD, the available evidence includes one open-label and one double-blind randomized studies, whereas in BD, only a few case reports and one open-label study are as yet available. In both conditions, PGB was found efficacious with significant improvement in withdrawal symptoms at the dosage ranges of 150-450 mg/day (AD) and 225-900 mg/day (BD). Moreover, its side effects were mild and transient. Despite the limited quality of the studies design, their findings suggest that PGB might constitute a novel efficacious and safe option in the treatment of both AD and BD.

  7. [Screening, Brief Intervention, Referral to Treatment(SBIRT) model for alcohol use disorder in Japan].

    Science.gov (United States)

    Isono, Hiroki; Yoshimoto, Hisashi

    2015-09-01

    The prevalence of alcohol dependence in Japan was 0.9% in 2013, but up to 16% adults drink alcohol at levels of unhealthy use. Primary care physicians play an important role in recognizing alcohol use disorder, helping patients change their behavior, and preventing its medical complications. The Screening, Brief Intervention, Referral to Treatment (SBIRT) model is an evidence-based, cost-effective intervention implemented worldwide to reduce alcohol use disorder.

  8. Ego Identity of Adolescent Children of Alcoholics

    Science.gov (United States)

    Gavriel-Fried, Belle; Teichman, Meir

    2007-01-01

    The study examines the issue of ego identity among adolescent sons of alcoholic fathers. Forty-four adolescent sons of alcoholic fathers, age of 15-18, constituted the sample. They were drawn from public alcohol treatment center in Israel. The control group included 60 adolescents none of their parents is known as an alcoholic, sampled from…

  9. Public awareness of the link between alcohol and cancer in England in 2015: a population-based survey.

    Science.gov (United States)

    Buykx, Penny; Li, Jessica; Gavens, Lucy; Hooper, Lucie; Lovatt, Melanie; Gomes de Matos, Elena; Meier, Petra; Holmes, John

    2016-11-30

    Public knowledge of the association between alcohol and cancer is reported to be low. We aimed to provide up-to-date evidence for England regarding awareness of the link between alcohol and different cancers and to determine whether awareness differs by demographic characteristics, alcohol use, and geographic region. A representative sample of 2100 adults completed an online survey in July 2015. Respondents were asked to identify which health outcomes, including specific cancers, may be caused by alcohol consumption. Logistic regressions explored whether demographic, alcohol use, and geographic characteristics predicted correctly identifying alcohol-related cancer risk. Unprompted, 12.9% of respondents identified cancer as a potential health outcome of alcohol consumption. This rose to 47% when prompted (compared to 95% for liver disease and 73% for heart disease). Knowledge of the link between alcohol and specific cancers varied between 18% (breast) and 80% (liver). Respondents identified the following cancers as alcohol-related where no such evidence exists: bladder (54%), brain (32%), ovarian (17%). Significant predictors of awareness of the link between alcohol and cancer were being female, more highly educated, and living in North-East England. There is generally low awareness of the relationship between alcohol consumption and cancer, particularly breast cancer. Greater awareness of the relationship between alcohol and breast cancer in North-East England, where a mass media campaign highlighted this relationship, suggests that population awareness can be influenced by social marketing.

  10. The use of alcohol by Miami's adolescent public school students 1992: peers, risk-taking, and availability as central forces.

    Science.gov (United States)

    Yarnold, B M

    1998-01-01

    This analysis examines the use of alcohol by 535 adolescents in Dade County Public Schools during 1992. Statistically significant factors which tend to increase the probability of alcohol use by adolescents include: the fact that their friends drink, their awareness of the risks associated with the use of alcohol, and their ease in obtaining alcohol. Hence, the typical adolescent who uses alcohol seems to be a risk-taker, who may enjoy the dangers involved with alcohol use; friends are also users of alcohol. Not significantly related to alcohol use are a number of other variables, including family-related variables (whether adolescents live with their mothers, fathers, or alone; and whether someone in the family has a problem with drugs or alcohol). Similarly, early cigarette smoking did not serve as a gateway to later alcohol use. Religion, gender, race, academic performance, and extracurricular school activities (athletics, music, school clubs, and other activities) were all unrelated to the use of alcohol by adolescents. Although the typical adolescent who consumed alcohol was older (in grades 9 through 12), this was not a significant variable.

  11. The prevalence of alcohol consumption among the students newly enrolled at a public university.

    Science.gov (United States)

    Brandão, Yuri Silva Toledo; Correia, Divanise Suruagy; de Farias, Maria Stella Jakeline Alves; Antunes, Thallyta Maria Tavares; da Silva, Laís Alves

    2011-07-01

    Alcohol is the number one toxic substance consumed by people of all age groups, which makes its use a public health problem. The overall trend shows that university students are those who suffer the most pressure. To assess the prevalence of alcohol use among students newly enrolled at a public university in Alagoas, Brazil. We conducted an analytical sectional study at the Federal University of Alagoas, with 1435 (44% of total) newly enrolled students of all courses in 2006. They answered a questionnaire based on the CAGE. Some points such as sex, age, marital status, course, housing, family characteristics and how drugs fit into in the student life were studied with the resources of EpiInfo version 3.3.2. The survey was approved by the Research Ethics Committee of the Federal University of Alagoas (number 000878/2005-17). Of the group studied, 95.9% lived with family and 87.6% reported ever drinking alcohol at some time in their life. Of all the respondents, 55.4% of men reported having the habit of drinking with friends or colleagues (Odds = 0.71; CI = 0.58-0.88; P-value = 0.00088). Among all respondents, 17.7% of male students and 9.8% females skipped class after using alcohol (Odds = 0.52; CI = 0.38-0.72; P-value = 0.000023). The transition from adolescence to youth and study time at university is marked by greater vulnerability to alcohol abuse. The family is decisive for the initiation of alcohol use, and the university is a factor that increases the possibility of maintaining the practice. The fact that not all students were present in the classroom at the time of the application questionnaire may have limited the search because this was a sectional study. Alcohol consumption in this university is similar to that in other higher education institutions in the world, which is a cause for concern, since the external lesions are accentuated with the practice of using alcohol, characterizing the risk of violence.

  12. The prevalence of alcohol consumption among the students newly enrolled at a public university

    Directory of Open Access Journals (Sweden)

    Yuri Silva Toledo Brandão

    2011-01-01

    Full Text Available Background : Alcohol is the number one toxic substance consumed by people of all age groups, which makes its use a public health problem. The overall trend shows that university students are those who suffer the most pressure. Objective : To assess the prevalence of alcohol use among students newly enrolled at a public university in Alagoas, Brazil. Materials and Methods : We conducted an analytical sectional study at the Federal University of Alagoas, with 1435 (44% of total newly enrolled students of all courses in 2006. They answered a questionnaire based on the CAGE. Some points such as sex, age, marital status, course, housing, family characteristics and how drugs fit into in the student life were studied with the resources of EpiInfo version 3.3.2. The survey was approved by the Research Ethics Committee of the Federal University of Alagoas (number 000878/2005-17. Results : Of the group studied, 95.9% lived with family and 87.6% reported ever drinking alcohol at some time in their life. Of all the respondents, 55.4% of men reported having the habit of drinking with friends or colleagues (Odds = 0.71; CI = 0.58-0.88; P -value = 0.00088. Among all respondents, 17.7% of male students and 9.8% females skipped class after using alcohol (Odds = 0.52; CI = 0.38-0.72; P -value = 0.000023. The transition from adolescence to youth and study time at university is marked by greater vulnerability to alcohol abuse. The family is decisive for the initiation of alcohol use, and the university is a factor that increases the possibility of maintaining the practice. The fact that not all students were present in the classroom at the time of the application questionnaire may have limited the search because this was a sectional study. Conclusion : Alcohol consumption in this university is similar to that in other higher education institutions in the world, which is a cause for concern, since the external lesions are accentuated with the practice of using

  13. Identifying Alcoholism in Families Seeking Mental Health Treatment.

    Science.gov (United States)

    Bayer, Gregory A.; Bayer, Marilyn A.

    A family system is intimately affected by the presence of an alcoholic within the system. One symptom of alcoholism is the development of elaborate defenses. In response to the defense of the alcoholic, each family member develops individual well established and unique defenses. The diagnosis of the defenses is essential in determining the nature…

  14. Alcohol

    NARCIS (Netherlands)

    Hendriks, H.F.; Tol, A. van

    2005-01-01

    Alcohol consumption affects overall mortality. Light to moderate alcohol consumption reduces the risk of coronary heart disease; epidemiological, physiological and genetic data show a causal relationship. Light to moderate drinking is also associated with a reduced risk of other vascular diseases an

  15. A common public health-oriented policy framework for cannabis, alcohol and tobacco in Canada?

    Science.gov (United States)

    Kirst, Maritt; Kolar, Kat; Chaiton, Michael; Schwartz, Robert; Emerson, Brian; Hyshka, Elaine; Jesseman, Rebecca; Lucas, Philippe; Solomon, Robert; Thomas, Gerald

    2016-03-16

    Support for a public health approach to cannabis policy as an alternative to prohibition and criminalization is gaining momentum. Recent drug policy changes in the United States suggest growing political feasibility for legal regulation of cannabis in other North American jurisdictions. This commentary discusses the outcomes of an interdisciplinary policy meeting with Canadian experts and knowledge users in the area of substance use interventions. The meeting explored possibilities for applying cross-substance learning on policy interventions for alcohol, tobacco and cannabis, towards the goal of advancing a public health framework for reducing harms associated with substance use in Canada. The meeting also explored how the shift in approach to cannabis policy can provide an opportunity to explore potential changes in substance use policy more generally, especially in relation to tobacco and alcohol as legally regulated substances associated with a heavy burden of illness. Drawing from the contributions and debates arising from the policy meeting, this commentary identifies underlying principles and opportunities for learning from policy interventions across tobacco, alcohol and cannabis, as well as research gaps that need to be addressed before a public health framework can be effectively pursued across these substances.

  16. Nearly Half of College Student Treatment Admissions Were for Primary Alcohol Abuse. Data Spotlight

    Science.gov (United States)

    Substance Abuse and Mental Health Services Administration, 2012

    2012-01-01

    Many students, and the public in general, believe that drinking alcohol is a normal part of the college experience. Unfortunately, students' efforts to "be sociable" or "fit in" can escalate into substance use behavior that puts their health and well-being at risk: One in four full-time college students have experienced past year alcohol abuse or…

  17. New drug treatments for alcohol problems: a critical appraisal.

    Science.gov (United States)

    Moncrieff, J; Drummond, D C

    1997-08-01

    This review considers the novel drug treatments that have been suggested to help prevent relapse or attenuate drinking in people with alcohol problems. The evidence from randomized controlled trials for the efficacy of some of the main candidates: acamprosate, naltrexone, bromocriptine, selective serotonin re-uptake inhibitors and buspirone, was examined. Important methodological problems which may have introduced bias were detected in many of the trials. These included failure to test the integrity of the double blind, excluding or estimating outcome in early withdrawals and the comparison of groups on multiple outcome measures with selective reporting of results. In addition, the generalizability of some studies was limited by the procedures used for sample selection. In view of the potential adverse effects of drug treatment it is concluded that the evidence is not strong enough to support the introduction of any of these substances into routine clinical practice at present. The review also emphasizes the importance of methodological rigour to maximize objectivity in treatment evaluation research.

  18. Readiness for Change and Treatment Outcome among Individuals with Alcohol Dependency.

    Science.gov (United States)

    Hewes, Robert L.; Janikowski, Timothy P.

    1998-01-01

    Uses the Addiction Severity Index and Stage of Change Readiness and Treatment Eagerness Scale to evaluate individuals with primary alcohol-abuse problems involved in treatment programs. Results indicate that participants showed significant improvement in problems related to alcohol use. No significant differences were found between participants…

  19. Selected Publications on Teenagers and Alcohol. National Clearinghouse for Alcohol Information Grouped Interest Guide No. 8-5. Cumulative Issue.

    Science.gov (United States)

    National Clearinghouse for Alcohol Information (DHEW/PHS), Rockville, MD.

    This Grouped Interest Guide is published by the National Institute on Alcohol Abuse and Alcoholism. Its purpose is to provide the reader with a regularly published set of bibliographic references for recent, topical literature in designated areas. Topics included in this guide are Youth, Children of Alcoholic Parents, and Social Forces. A wide…

  20. Alcohol

    Science.gov (United States)

    ... changes that come from drinking alcohol can make people do stupid or embarrassing things, like throwing up or peeing on themselves. Drinking also gives people bad breath, and no one enjoys a hangover. ...

  1. Dynamic Association between Negative Affect and Alcohol Lapses following Alcohol Treatment

    Science.gov (United States)

    Witkiewitz, Katie; Villarroel, Nadia Aracelliz

    2009-01-01

    Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the…

  2. Retraining automatic action tendencies changes alcoholic patients’ approach bias for alcohol and improves treatment outcome

    NARCIS (Netherlands)

    R.W. Wiers; C. Eberl; M. Rinck; E.S. Becker; J. Lindenmeyer

    2011-01-01

    This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or implicitly trained to make avoidance movements

  3. Retraining Automatic Action Tendencies Changes Alcoholic Patients’ Approach Bias for Alcohol and Improves Treatment Outcome

    NARCIS (Netherlands)

    Wiers, R.W.H.J.; Eberl, C.M.; Rinck, M.; Becker, E.S.; Lindenmeyer, J.

    2011-01-01

    This study tested the effects of a new cognitive-bias modification (CBM) intervention that targeted an approach bias for alcohol in 214 alcoholic inpatients. Patients were assigned to one of two experimental conditions, in which they were explicitly or implicitly trained to make avoidance movements

  4. Effect of variations in treatment regimen and liver cirrhosis on exposure to benzodiazepines during treatment of alcohol withdrawal syndrome

    OpenAIRE

    Gershkovich, Pavel; Wasan, Kishor M.; Ribeyre, Charles; Ibrahim, Fady; McNeill, John H

    2015-01-01

    Purpose: Benzodiazepines (BDZs) are the drugs of choice to prevent the symptoms of alcohol withdrawal syndrome (AWS). Various treatment protocols are published and have been shown to be effective in both office-managed and facility-managed treatment of AWS. The aim of this scientific commentary is to demonstrate the differences in the expected exposure to BDZs during AWS treatment using different treatment regimens available in the literature, in patients with or without alcoholic liver cirrh...

  5. Prazosin for Treatment With PTSD And Comorbid Alcohol Dependence

    Science.gov (United States)

    2010-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD and alcohol dependence . The objective of this study is to evaluate the efficacy of prazosis (16mg

  6. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder

    OpenAIRE

    Fang Wang; Ya Li; Yu-Jie Zhang; Yue Zhou; Sha Li; Hua-Bin Li

    2016-01-01

    Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the pro...

  7. 3 R's in the Marital Treatment of Alcohol Abuse.

    Science.gov (United States)

    Schlesinger, Stephen E.

    Alcohol abuse imposes financial, social, and emotional burdens on drinkers and their families. Couples suffering from alcohol-related problems who seek therapy often have expectations of retribution, restitution, and refuge. Although thoughts of retribution are difficult to elicit in therapy, non-drinking spouses often expect to inflict pain on…

  8. Alcohol and Drug Abusers Entering Treatment: How Different Are They?

    Science.gov (United States)

    Seraganian, Peter; And Others

    A major shift in drug abuse epidemiology has been witnessed in North America over the past decade. Although alcohol continues to be widely abused, usage of other substances has proliferated. While addicted individuals share some attributes, certain demographic, psychological, and cognitive characteristics may distinguish alcoholics from those who…

  9. Efficacy of a combination of flumazenil and gabapentin in the treatment of alcohol dependence: relationship to alcohol withdrawal symptoms.

    Science.gov (United States)

    Anton, Raymond F; Myrick, Hugh; Baros, Alicia M; Latham, Patricia K; Randall, Patrick K; Wright, Tara M; Stewart, Scott H; Waid, Randy; Malcolm, Robert

    2009-08-01

    Improved treatment of alcohol dependence is a high priority, including defining subtypes that might respond differently. We evaluated a medication combination of intravenous flumazenil (FMZ) and oral gabapentin (GBP) in alcoholics who did and did not exhibit pretreatment alcohol withdrawal (AW) symptoms. Sixty alcohol-dependent individuals (44 with low AW and 16 with high AW) were randomized to receive FMZ (2 mg of incremental bolus for 20 minutes for 2 consecutive days) and GBP (up to 1200 mg nightly for 39 days) or their inactive placebos. Alcohol withdrawal was measured for the first 2 days, and drinking, sleep parameters, and adverse events were monitored during weekly evaluations, along with behavioral counseling sessions. Percent days abstinent (PDA) during treatment and time to first heavy drinking (TFHD) day were primary outcome variables. There was an interaction between the pretreatment AW status and the medication group on PDA (P = 0.0006) and TFHD (P = 0.06). Those in the high AW group had more PDA and more TFHD if treated with active medications, whereas those in the low AW group had more PDA and more TFHD if treated with placebo. This interaction remained for those totally abstinent (P = 0.03) and was confirmed by percent carbohydrate-deficient transferrin values. In addition, the pattern of response remained up to 8 weeks after treatment. In addition, in those with high AW, greater improvement in AW symptoms was observed in the active medication group compared with the placebo group. These results suggest a differential response to FMZ/GBP treatment, depending on pretreatment AW status that should be taken into account during future treatment trials.

  10. "Kitchen cupboard drinking": a review of South African women's secretive alcohol addiction, treatment history, and barriers to accessing treatment.

    Science.gov (United States)

    Pretorius, Liezille; Naidoo, Av; Reddy, S P

    2009-01-01

    How Black women are represented, conceptualized, and researched in the field of psychology has dramatic and far-reaching effects on arriving at an understanding of personality and psychopathology. This point becomes especially salient as researchers try to develop alternative strategies for researching gendered experiences and for generating meaningful information about African women's experiences of alcohol misuse. On the African continent, there is a paucity of research on Black women's access to alcohol treatment. Therefore, this review has implications for research and practice with the potential to stimulate future health disparities research affecting Black African women. The article focuses on a South African population and explores the importance of theorizing alcohol misuse and sex by discussing the history of alcohol misuse in South Africa, women and alcohol misuse in South Africa, and women's treatment history; interpreting women's experiences of treatment; and addressing recommendations for future research.

  11. Alcohol Use, Psychopathology, and Treatment Utilization in a University Mental Health Clinic

    Science.gov (United States)

    Seigers, Danielle K. L.; Carey, Kate B.

    2010-01-01

    In the general population, alcohol use disorders and psychiatric disorders co-occur. Despite ample evidence of the adverse effects of alcohol use on treatment outcomes, these relationships have not been examined among college students presenting at counseling centers. The purpose of this study was to assess the prevalence of hazardous drinking…

  12. Alcohol Education Provided to Opioid Treatment Program Patients: Results of a Nationwide Survey

    Science.gov (United States)

    Strauss, Shiela M.; Harris, Gavin; Katigbak, Carina; Rindskopf, David M.; Singh, Sheena; Greenblum, Ilana; Brown, Lawrence S.; Kipnis, Steven; Kritz, Steven A.; Parrino, Mark W.

    2010-01-01

    Alcohol-related problems are especially common among opioid treatment program (OTP) patients, suggesting that educating OTP patients about alcohol and its harmful effects needs to be a priority in OTPs. Using data collected in interviews with a nationwide U.S. sample of OTP directors (N = 200) in 25 states, we identified factors that differentiate…

  13. The Use of Gestalt Interventions in the Treatment of the Resistant Alcohol-Dependent Client.

    Science.gov (United States)

    Ramey, Luellen

    1998-01-01

    Reviews ethical and practical dilemmas associated with clients who have hidden alcohol dependencies, and proposes an approach rooted in Gestalt counseling theory which confronts these issues and is compatible with a current emerging alcohol-treatment model. Suggests specific activities for addressing client resistance to revealing a hidden alcohol…

  14. Longitudinal Risk Factors for Intimate Partner Violence among Men in Treatment for Alcohol Use Disorders

    Science.gov (United States)

    Taft, Casey T.; O'Farrell, Timothy J.; Doron-Lamarca, Susan; Panuzio, Jillian; Suvak, Michael K.; Gagnon, David R.; Murphy, Christopher M.

    2010-01-01

    Objective: This study examined static and time-varying risk factors for perpetration of intimate partner violence (IPV) among men in treatment for alcohol use disorders. Method: Participants were 178 men diagnosed with alcohol abuse or dependence and their partners. Most (85%) of the men were European American; their average age was 41.0 years.…

  15. Alcohol Use, Psychopathology, and Treatment Utilization in a University Mental Health Clinic

    Science.gov (United States)

    Seigers, Danielle K. L.; Carey, Kate B.

    2010-01-01

    In the general population, alcohol use disorders and psychiatric disorders co-occur. Despite ample evidence of the adverse effects of alcohol use on treatment outcomes, these relationships have not been examined among college students presenting at counseling centers. The purpose of this study was to assess the prevalence of hazardous drinking…

  16. [Identification and treatment of psychiatric comorbidity associated with alcoholism].

    Science.gov (United States)

    Davidson, C

    1999-10-14

    The importance of psychiatric comorbidity has been recently recognized. It may help to understand why a similar chronic disease has several clinical presentations. Concurrent psychiatric disorders associated with alcohol dependence worsen the prognosis for the patient. Depression and anxiety are frequently the consequence of chronic alcohol consumption; however, these disorders have been clearly identified, also as the primary disorder, which may be complicated secondarily by alcohol dependence. Therefore, the evaluation of concurrent psychiatric disorders is important because it allows for better therapeutic strategies, adjusted to specific problems of the patient. Cognitivo-behavioural therapies are thus more effective if they are combined with a specific approach to concurrent disorders.

  17. GABAB receptor ligands for the treatment of alcohol use disorder: preclinical and clinical evidence

    Directory of Open Access Journals (Sweden)

    Roberta eAgabio

    2014-06-01

    Full Text Available The present paper summarizes the preclinical and clinical studies conducted to define the anti-alcohol pharmacological profile of the prototypic GABAB receptor agonist, baclofen, and its therapeutic potential for treatment of alcohol use disorder (AUD. Numerous studies have reported baclofen-induced suppression of alcohol drinking (including relapse- and binge-like drinking and alcohol reinforcing, motivational, stimulating, and rewarding properties in rodents and monkeys. The majority of clinical surveys conducted to date – including case reports, retrospective chart reviews, and randomized placebo-controlled studies – suggest the ability of baclofen to suppress alcohol consumption, craving for alcohol, and alcohol withdrawal symptomatology in alcohol-dependent patients. The recent identification of a positive allosteric modulatory binding site, together with the synthesis of in vivo effective ligands, represents a novel, and likely more favorable, option for pharmacological manipulations of the GABAB receptor. Accordingly, data collected to date suggest that positive allosteric modulators of the GABAB receptor reproduce several anti-alcohol effects of baclofen and display a higher therapeutic index (with larger separation – in terms of doses – between anti-alcohol effects and sedation.

  18. Opioid Receptor Antagonists in the Treatment of Alcoholism.

    Science.gov (United States)

    Serecigni, Josep Guardia

    2015-09-29

    Objetivos: A partir de los recientes progresos en la farmacoterapia del alcoholismo, hemos efectuado una revisión sobre los fármacos antagonistas de los receptores opioides, que tienen aprobada la indicación para el tratamiento del alcoholismo, como son naltrexona y nalmefeno. Metodología: Hemos revisado más de 100 publicaciones sobre péptidos y receptores opioides, el efecto de los fármacos antagonistas de los receptores opioides sobre el consumo de alcohol, tanto en animales como en humanos, tanto en el laboratorio como para el tratamiento del alcoholismo. También se describen las características farmacológicas de naltrexona y de nalmefeno y su utilidad en la práctica clínica. Resultados: Múltiples evidencias han demostrado la eficacia de naltrexona y nalmefeno para reducir el consumo de alcohol, tanto en animales de laboratorio como también en personas estudiadas en situación de bar experimental, aunque debido al diferente perfil receptorial, nalmefeno ha sido relacionado con una mayor eficacia para la reducción del consumo de alcohol, en ratas que presentan dependencia del alcohol. Además, un gran número de ensayos clínicos controlados han demostrado la eficacia de naltrexona para la prevención de recaídas, en personas que presentan un trastorno por dependencia del alcohol. Ensayos clínicos controlados recientes han demostrado la eficacia de nalmefeno “a demanda” para reducir el consumo de alcohol, en personas que presentan un trastorno por dependencia del alcohol de baja gravedad. Conclusiones: Tanto naltrexona como nalmefeno han demostrado ser fármacos seguros, bien tolerados, de manejo sencillo, y eficaces para el tratamiento del trastorno por dependencia del alcohol, (actualmente llamado trastorno por consumo de alcohol). A partir de recientes ensayos clínicos controlados se ha comprobado que nalmefeno produce una reducción significativa del consumo de alcohol, lo cual supone un nuevo objetivo que amplía las posibilidades de

  19. Developing policy analytics for public health strategy and decisions-the Sheffield alcohol policy model framework.

    Science.gov (United States)

    Brennan, Alan; Meier, Petra; Purshouse, Robin; Rafia, Rachid; Meng, Yang; Hill-Macmanus, Daniel

    This paper sets out the development of a methodological framework for detailed evaluation of public health strategies for alcohol harm reduction to meet UK policy-makers needs. Alcohol is known to cause substantial harms, and controlling its affordability and availability are effective policy options. Analysis and synthesis of a variety of public and commercial data sources is needed to evaluate impact on consumers, health services, crime, employers and industry, so a sound evaluation of impact is important. We discuss the iterative process to engage with stakeholders, identify evidence/data and develop analytic approaches and produce a final model structure. We set out a series of steps in modelling impact including: classification and definition of population subgroups of interest, identification and definition of harms and outcomes for inclusion, classification of modifiable components of risk and their baseline values, specification of the baseline position on policy variables especially prices, estimating effects of changing policy variables on risk factors including price elasticities, quantifying risk functions relating risk factors to harms including 47 health conditions, crimes, absenteeism and unemployment, and monetary valuation. The most difficult model structuring decisions are described, as well as the final results framework used to provide decision support to national level policymakers in the UK. In the discussion we explore issues around the relationship between modelling and policy debates, valuation and scope, limitations of evidence/data, how the framework can be adapted to other countries and decisions. We reflect on the approach taken and outline ongoing plans for further development.

  20. A minimum price per unit of alcohol: A focus group study to investigate public opinion concerning UK government proposals to introduce new price controls to curb alcohol consumption

    Directory of Open Access Journals (Sweden)

    Lonsdale Adam J

    2012-11-01

    Full Text Available Abstract Background UK drinkers regularly consume alcohol in excess of guideline limits. One reason for this may be the high availability of low-cost alcoholic beverages. The introduction of a minimum price per unit of alcohol policy has been proposed as a means to reduce UK alcohol consumption. However, there is little in-depth research investigating public attitudes and beliefs regarding a minimum pricing policy. The aim of the present research was to investigate people’s attitudes and beliefs toward the introduction of a minimum price per unit of alcohol policy and their views on how the policy could be made acceptable to the general public. Methods Twenty-eight focus groups were conducted to gain in-depth data on attitudes, knowledge, and beliefs regarding the introduction of a minimum price per unit of alcohol policy. Participants (total N = 218 were asked to give their opinions about the policy, its possible outcomes, and how its introduction might be made more acceptable. Transcribed focus-group discussions were analysed for emergent themes using inductive thematic content analysis. Results Analysis indicated that participants’ objections to a minimum price had three main themes: (1 scepticism of minimum pricing as an effective means to reduce harmful alcohol consumption; (2 a dislike of the policy for a number of reasons (e.g., it was perceived to ‘punish’ the moderate drinker; and (3 concern that the policy might create or exacerbate existing social problems. There was a general perception that the policy was aimed at ‘problem’ and underage drinkers. Participants expressed some qualified support for the policy but stated that it would only work as part of a wider campaign including other educational elements. Conclusions There was little evidence to suggest that people would support the introduction of a minimum price per unit of alcohol policy. Scepticism about the effectiveness of the policy is likely to represent the most

  1. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder

    Directory of Open Access Journals (Sweden)

    Fang Wang

    2016-01-01

    Full Text Available Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s and related mechanism(s of action.

  2. Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder.

    Science.gov (United States)

    Wang, Fang; Li, Ya; Zhang, Yu-Jie; Zhou, Yue; Li, Sha; Li, Hua-Bin

    2016-01-07

    Alcoholic beverages such as beer, wine and spirits are widely consumed around the world. However, alcohol and its metabolite acetaldehyde are toxic and harmful to human beings. Chronic alcohol use disorder or occasional binge drinking can cause a wide range of health problems, such as hangover, liver damage and cancer. Some natural products such as traditional herbs, fruits, and vegetables might be potential dietary supplements or medicinal products for the prevention and treatment of the problems caused by excessive alcohol consumption. The aim of this review is to provide an overview of effective natural products for the prevention and treatment of hangover and alcohol use disorder, and special emphasis is paid to the possible functional component(s) and related mechanism(s) of action.

  3. WILL FLUOROTELOMER ALCOHOL BASED POLYMER FORMULATIONS BIODEGRADE DURING AEROBIC BIOLOGICAL WASTEWATER TREATMENT?

    Science.gov (United States)

    The release of fluorotelomer alcohol (FTOH) based polymer formulations (PFs) to wastewater treatment plants (WWTPs) may be an important source of the perfluoroalkyl carboxylic acids (PFCAs) observed in many environmental matrices. Working with the Office of Pollution, Prevention,...

  4. Participation in Treatment and Alcoholics Anonymous: A 16-Year Follow-Up of Initially Untreated Individuals

    Science.gov (United States)

    Moos, Rudolf H.; Moos, Bernice S.

    2007-01-01

    This study focused on the duration of participation in professional treatment and Alcoholics Anonymous (AA) for previously untreated individuals with alcohol use disorders. These individuals were surveyed at baseline and 1 year, 3 years, 8 years, and 16 years later. Compared with individuals who remained untreated, individuals who obtained 27 weeks or more of treatment in the first year after seeking help had better 16-year alcohol-related outcomes. Similarly, individuals who participated in AA for 27 weeks or more had better 16-year outcomes. Subsequent AA involvement was also associated with better 16-year outcomes, but this was not true of subsequent treatment. Some of the association between treatment and long-term alcohol-related outcomes appears to be due to participation in AA.* PMID:16538654

  5. Clinical effectiveness of baclofen for the treatment of alcohol dependence: a review

    Directory of Open Access Journals (Sweden)

    Brennan JL

    2013-07-01

    Full Text Available Jessica L Brennan,2 Jonathan G Leung,1 Jane P Gagliardi,3 Sarah K Rivelli,3 Andrew J Muzyk4 1Department of Hospital Pharmacy Services, Mayo Clinic, Rochester, MN, 2Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, 3Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, 4Department of Pharmacy Practice, Campbell University School of Pharmacy and Health Sciences, Buies Creek, NC, USA Abstract: Baclofen, an agonist at the B subunit of gaba-aminobutyric acid receptor, possesses pharmacologic properties that may confer utility for the treatment of alcohol dependence. Research suggests that not only can it be useful in promoting maintenance of alcohol abstinence but also it may play a key role in decreasing alcohol cravings and anxiety often associated with alcohol dependence. To assess the benefit of baclofen for alcohol dependence, a review of the literature was conducted to identify published data investigating this off-label treatment. Four randomized controlled trials to date have been published and were included in this review. Although primary outcomes differ between studies, patients randomized to baclofen experience higher rates of abstinence from alcohol than those taking placebo in two of the trials. Secondary analyses indicate that baclofen is safe in patients with alcohol dependence, including those with moderate to severe liver cirrhosis, and may provide beneficial anxiolytic effects. Despite some positive data, the largest available randomized controlled trial failed to find any differences between baclofen and placebo. In all studies, individuals with severe medical comorbidities, seizure disorders, and psychiatric disorders were excluded from trials, which may limit external validity. In summary, there may be beneficial effects from using baclofen for the treatment of alcohol dependence; however, limited conclusions can be drawn from the small number of studies

  6. No effect of oral testosterone treatment on sexual dysfunction in alcoholic cirrhotic men

    DEFF Research Database (Denmark)

    Gluud, C; Wantzin, P; Eriksen, J

    1988-01-01

    The prevalence and course of sexual dysfunction was evaluated in 221 alcoholic cirrhotic men participating in a double-blind, placebo-controlled study on the effect of oral testosterone treatment on liver disease. At entry, 67% (95% confidence limits, 61%-74%) complained of sexual dysfunction....... In conclusion, oral testosterone treatment does not significantly influence the type or course of sexual dysfunction in alcoholic cirrhotic men. However, sexual function improved after reduction of ethanol consumption in these patients....

  7. Posttraumatic stress disorder, depression, and alcohol and tobacco use in public health workers after the 2004 Florida hurricanes.

    Science.gov (United States)

    Fullerton, Carol S; McKibben, Jodi B A; Reissman, Dori B; Scharf, Ted; Kowalski-Trakofler, Kathleen M; Shultz, James M; Ursano, Robert J

    2013-02-01

    We examined the relationship of probable posttraumatic stress disorder (PTSD), probable depression, and increased alcohol and/or tobacco use to disaster exposure and work demand in Florida Department of Health workers after the 2004 hurricanes. Participants (N = 2249) completed electronic questionnaires assessing PTSD, depression, alcohol and tobacco use, hurricane exposure, and work demand. Total mental and behavioral health burden (probable PTSD, probable depression, increased alcohol and/or tobacco use) was 11%. More than 4% had probable PTSD, and 3.8% had probable depression. Among those with probable PTSD, 29.2% had increased alcohol use, and 50% had increased tobacco use. Among those with probable depression, 34% indicated increased alcohol use and 55.6% increased tobacco use. Workers with greater exposure were more likely to have probable PTSD and probable depression (ORs = 3.3 and 3.06, respectively). After adjusting for demographics and work demand, those with high exposure were more likely to have probable PTSD and probable depression (ORs = 3.21 and 3.13). Those with high exposure had increased alcohol and tobacco use (ORs = 3.01 and 3.40), and those with high work demand indicated increased alcohol and tobacco use (ORs = 1.98 and 2.10). High exposure and work demand predicted increased alcohol and tobacco use, after adjusting for demographics, work demand, and exposure. Work-related disaster mental and behavioral health burden indicate the need for additional mental health interventions in the public health disaster workforce.

  8. 20 CFR 416.1725 - Effect of your failure to comply with treatment requirements for your drug addiction or alcoholism.

    Science.gov (United States)

    2010-04-01

    ... treatment requirements for your drug addiction or alcoholism. 416.1725 Section 416.1725 Employees' Benefits... Persons Eligible for Supplemental Security Income to Other Agencies Referral for Treatment of Alcoholism... drug addiction or alcoholism. (a) Suspension of benefits. Your eligibility for benefits will...

  9. 20 CFR 416.1326 - Suspension for failure to comply with treatment for drug addiction or alcoholism.

    Science.gov (United States)

    2010-04-01

    ... treatment for drug addiction or alcoholism. 416.1326 Section 416.1326 Employees' Benefits SOCIAL SECURITY....1326 Suspension for failure to comply with treatment for drug addiction or alcoholism. (a) Basis for suspension. If you are disabled and drug addiction or alcoholism is a contributing factor material to...

  10. Psychoanalytic treatment of psychological addiction toalcohol (alcohol abuse

    Directory of Open Access Journals (Sweden)

    Brian eJohnson

    2011-12-01

    Full Text Available AbstractThe DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (DSM5.org. The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson 2003. In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery.Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9 year followup.

  11. Alcoholics Anonymous attendance following 12-step treatment participation as a link between alcohol-dependent fathers' treatment involvement and their children's externalizing problems.

    Science.gov (United States)

    Andreas, Jasmina Burdzovic; O'Farrell, Timothy J

    2009-01-01

    We investigated longitudinal associations between alcohol-dependent fathers' 12-step treatment involvement and their children's internalizing and externalizing problems (N = 125, M(age) = 9.8 +/- 3.1), testing the hypotheses that fathers' greater treatment involvement would benefit later child behavior and that this effect would be mediated by fathers' posttreatment behaviors. The initial association was established between fathers' treatment involvement and children's externalizing problems only, whereas Structural Equation Modeling (SEM) results supported mediating hypotheses. Fathers' greater treatment involvement predicted children's lower externalizing problems 12 months later, and fathers' posttreatment behaviors mediated this association: Greater treatment involvement predicted greater posttreatment Alcoholics Anonymous attendance, which in turn predicted greater abstinence. Finally, fathers' abstinence was associated with lower externalizing problems in children. Theoretical and practical implications of these findings are discussed.

  12. Representations of minimum unit pricing for alcohol in UK newspapers: a case study of a public health policy debate.

    Science.gov (United States)

    Patterson, Chris; Katikireddi, Srinivasa Vittal; Wood, Karen; Hilton, Shona

    2015-03-01

    Mass media influence public acceptability, and hence feasibility, of public health interventions. This study investigates newsprint constructions of the alcohol problem and minimum unit pricing (MUP). Quantitative content analysis of 901 articles about MUP published in 10 UK and Scottish newspapers between 2005 and 2012. MUP was a high-profile issue, particularly in Scottish publications. Reporting increased steadily between 2008 and 2012, matching the growing status of the debate. The alcohol problem was widely acknowledged, often associated with youths, and portrayed as driven by cheap alcohol, supermarkets and drinking culture. Over-consumption was presented as a threat to health and social order. Appraisals of MUP were neutral, with supportiveness increasing slightly over time. Arguments focused on health impacts more frequently than more emotive perspectives or business interests. Health charities and the NHS were cited slightly more frequently than alcohol industry representatives. Emphases on efficacy, evidence and experts are positive signs for evidence-based policymaking. The high profile of MUP, along with growing support within articles, could reflect growing appetite for action on the alcohol problem. Representations of the problem as structurally driven might engender support for legislative solutions, although cultural explanations remain common. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health.

  13. Acamprosate for treatment of alcohol dependence: mechanisms, efficacy, and clinical utility

    Directory of Open Access Journals (Sweden)

    Witkiewitz K

    2012-02-01

    Full Text Available Katie Witkiewitz, Kimber Saville, Kacie HamreusDepartment of Psychology, Washington State University Vancouver, Vancouver, WA, USAAbstract: Acamprosate, or N-acetyl homotaurine, is an N-methyl-D-aspartate receptor modulator approved by the Food and Drug Administration (FDA as a pharmacological treatment for alcohol dependence. The exact mechanism of action of acamprosate is still under investigation, but the drug appears to work by promoting a balance between the excitatory and inhibitory neurotransmitters, glutamate and gamma-aminobutyric acid, respectively, and it may help individuals with alcohol dependence by reducing withdrawal-associated distress. Acamprosate has low bioavailability, but also has an excellent tolerability and safety profile. In comparison with naltrexone and disulfiram, which are the other FDA-approved treatments for alcohol dependence, acamprosate is unique in that it is not metabolized by the liver and is also not impacted by alcohol use, so can be administered to patients with hepatitis or liver disease (a common comorbid condition among individuals with alcohol dependence and to patients who continue drinking alcohol. Acamprosate has demonstrated its efficacy in more than 25 placebo-controlled, double-blind trials for individuals with alcohol dependence, and has generally been found to be more efficacious than placebo in significantly reducing the risk of returning to any drinking and increasing the cumulative duration of abstinence. However, acamprosate appears to be no more efficacious than placebo in reducing heavy drinking days. Numerous trials have found that acamprosate is not significantly more efficacious than naltrexone or disulfiram, and the efficacy of acamprosate does not appear to be improved by combining acamprosate with other active medications (eg, naltrexone or with psychosocial treatment (eg, cognitive-behavioral therapy. In this review, we present the data on acamprosate, including its pharmacology

  14. The impact of alcohol on HIV prevention and treatment for South Africans in primary healthcare

    Directory of Open Access Journals (Sweden)

    Michelle Schneider

    2014-02-01

    Full Text Available Background: Antiretroviral treatment (ART has substantially reduced morbidity and mortality for HIV patients. In South Africa, with the largest ART programme globally, attention is needed not only on the further expansion of ART coverage, but also on factors which undermine its effectiveness, such as alcohol use.Objective: Given the decentralised approach of nurse-initiated and -sustained ART in the South African primary health sector, it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV.Method: This study comprised a narrative review of relevant literature.Results: Alcohol acts through both behavioural and physiological pathways to impact on the acquisition, further transmission and then progression of HIV disease. Besides links to risky sex, alcohol undermines the immune system, raising susceptibility to contracting and then countering HIV and other infections. There are important drug interactions between alcohol and ART, or therapies for opportunistic infections and other co-morbidities. Moreover, alcohol undermines adherence to the medication which is essential for effective ART.Conclusion: Primary healthcare clinic attendees need evidence-based information on the detrimental effects of alcohol consumption on HIV infection, which ensue throughout the clinical course of HIV. This spans the role of alcohol consumption as a risk factor for HIV infection, HIV replication in infected individuals, a person’s response to HIV infection and HIV treatment. Primary healthcare workers, especially nurses and HIV counsellors, require training in order to screen for and provide appropriate interventions for HIV-positive patients, those on treatment and treatment-naïve patients, who will benefit from reduced alcohol consumption or the cessation thereof.

  15. [Work and alcohol: considerations on a caseload of patients undergoing treatment].

    Science.gov (United States)

    Biscaldi, G; Vittadini, G; Giorgi, I; Fonte, R; Maglio, R; Nervi, O

    1999-01-01

    An enquiry into alcohol dependent subjects admitted to the clinical wards of the first section of Occupational Medicine belonging to Medicina Preventiva Occupazionale e di Comunità of University of Pavia for an alcohol disaddiction treatment has been performed through a phone interview. 289 patients have been contacted and time elapsed from admission to interview was one to three years. The questions focused alcohol abstinence, occupational position before and after admission, any improvement in the work sphere (relationship with the collegues), any feeling of empowerment of the work abilities and any increase in the responsibilities load. From our results we can conclude that alcohol disaddiction carried on during admission has positively contributed to the reinstatement of alcoholics patients.

  16. The Uniform Alcoholism and Intoxication Treatment Act: Law Enforcement Guidelines.

    Science.gov (United States)

    International Association of Chiefs of Police, Inc., Washington, DC.

    This text has been prepared in an effort to explain what the Uniform Act contains, intends to do, and cannot do. It also examines mehtods by which the Act can be implemented as well as the manner in which implementation can be accomplished most effectively. Working within the parameters of the overall alcohol problem, it also addresses the major…

  17. Publicly Owned Treatment Works General Permit (POTW GP) ...

    Science.gov (United States)

    2017-04-10

    The Notice of Availability of the final National Pollutant Discharge Elimination System (NPDES) General Permits for the Discharge of Wastewater from Certain Publicly Owned Treatment Works Treatment Plants (POTW Treatment Plants) and Other Treatment Works Treating Domestic Sewage in the Commonwealth of Massachusetts and the State of New Hampshire was published in the Federal Register on July 6, 2011.

  18. Alcohol

    Science.gov (United States)

    ... Disease (Nephropathy) Gastroparesis Mental Health Step On Up Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ... us get closer to curing diabetes and better treatments for those living with diabetes. Other Ways to ...

  19. Developing an alternative alcohol advertising complaint review system: lessons from a world-first public health advocacy initiative

    Directory of Open Access Journals (Sweden)

    Hannah L Pierce

    2017-07-01

    Full Text Available Young people in Australia are frequently exposed to alcohol marketing. Leading health organisations recommend legislative controls on alcohol advertising as part of a comprehensive approach to reduce alcohol-related harm. However, Australia relies largely on industry self-regulation. This paper describes the development and implementation of the Alcohol Advertising Review Board (AARB, a world-first public health advocacy initiative that encourages independent regulation of alcohol advertising. The AARB reviews complaints about alcohol advertising, and uses strategies such as media advocacy, community engagement and communicating with policy makers to highlight the need for effective regulation. In 4 years of operation, the AARB has received more complaints than the self-regulatory system across a similar period. There has been encouraging movement towards stronger regulation of alcohol advertising. Key lessons include the importance of a strong code, credible review processes, gathering support from reputable organisations, and consideration of legal risks and sustainability. The AARB provides a unique model that could be replicated elsewhere.

  20. Vested interests in addiction research and policy. Alcohol industry use of social aspect public relations organizations against preventative health measures.

    Science.gov (United States)

    Miller, Peter G; de Groot, Florentine; McKenzie, Stephen; Droste, Nicolas

    2011-09-01

    It has been proposed that alcohol industry 'social aspects/public relations' organizations (SAPROs) serve the agenda of lending credibility to industry claims of corporate responsibility while promoting ineffective industry-friendly interventions (such as school-based education or TV advertising campaigns) and creating doubt about interventions which have a strong evidence base (such as higher taxes on alcoholic beverages). This paper investigated whether submissions to Australia's National Preventative Health Taskforce (NPHT) from alcohol industry bodies regarding the Australian SAPRO, Drinkwise, have used this organization to demonstrate corporate responsibility while promoting industry-friendly interventions. Submissions to the Australian National Preventative Health Taskforce (NPHT) discussion paper Australia, the healthiest country by 2020 (n = 375) were examined to identify those with primary alcohol content. A thematic analysis of the resulting 33 submissions was conducted to determine which organization, institution or individual discussed Drinkwise. Australia. Nine of the 33 submissions discussed Drinkwise; all were submitted by the alcohol industry or its affiliates. Every industry submission referred to Drinkwise either as providing evidence of social responsibility or by suggesting the industry-friendly actions of Drinkwise as alternatives to those recommended by the NPHT report. Drinkwise has been used by the alcohol industry to create an impression of social responsibility while promoting interventions that maintain profits and campaigning against effective interventions such as higher taxes on alcohol. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

  1. Hazardous and Harmful Alcohol Use and Associated Factors in Tuberculosis Public Primary Care Patients in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-09-01

    Full Text Available The aim of this study was to assess the prevalence of hazardous and harmful alcohol use and associated factors among patients with tuberculosis in South Africa. In a cross-sectional survey new tuberculosis (TB and TB retreatment patients were consecutively screened using the Alcohol Use Disorder Identification Test (AUDIT within one month of anti-tuberculosis treatment. The sample included 4,900 (54.5% men and women 45.5% tuberculosis patients from 42 primary care clinics in three districts. Results indicate that, overall 23.2% of the patients were hazardous or harmful alcohol drinkers, 31.8% of men and 13.0% of women were found to be hazardous drinkers, and 9.3% of men and 3.4% of women meet criteria for probable alcohol dependence (harmful drinking as defined by the AUDIT. Men had significantly higher AUDIT scores than women. In multivariable analyses it was found that among men poor perceived health status, tobacco use, psychological distress, being a TB retreatment patient and not being on antiretroviral therapy (ART, and among women lower education, tobacco use and being a TB retreatment patient were associated with hazardous or harmful alcohol use. The study found a high prevalence of hazardous or harmful alcohol use among tuberculosis primary care patients. This calls for screening and brief intervention and a comprehensive alcohol treatment programme as a key component of TB management in South Africa.

  2. Acamprosate in the treatment of alcoholism: a budget impact analysis for the National Health Service in Italy

    Directory of Open Access Journals (Sweden)

    Colombo GL

    2012-07-01

    Full Text Available Giorgio L Colombo,1,2 Sergio Di Matteo,2 Giacomo Bruno21Department of Drug Sciences, School of Pharmacy, University of Pavia, Pavia, Italy; 2S.A.V.E. – Studi Analisi Valutazioni Economiche, Milan, ItalyObjective: Alcohol dependence is a common condition associated with high direct and indirect health care costs. The purpose of this analysis was to estimate the economic consequences of acamprosate used as adjuvant therapy in the treatment of alcoholism, defining a budget impact analysis (BIA from the point of view of the Italian National Health Service (NHS.Methods: We developed a model of disease evolution related to alcoholism using data from the PRAMA study. The hypothetical population included in the decision model was obtained from data from the Ministry of Health. We compared the following treatment strategies: no treatment, standard care (psychotherapy, sodium oxybate (sodium salt-4-hydroxybutyric acid, and acamprosate. The time horizon of the model was 10 years. The costs were evaluated from the NHS perspective.Results: We simulated the path for 69,348 patients treated at the outpatient clinics of the Addiction Services (SerT, and 38,911 patients discharged from hospital. Patients in the acamprosate group had lower alcohol-related events, with a reduction of the total cost. The BIA shows that the increase in the use of acamprosate was associated with a progressive decrease of total costs, calculated as the sum of the diagnosis-related groups (DRG, rehabilitation, and drug costs. The increasing use of acamprosate instead of standard care and sodium oxybate would generate cost savings up to over €6 million over 10 years of simulation.Conclusion: The estimates in the model are based on hypothetical situations; the assumptions of the model as well as their specific impact on treatment effect estimations and clinical implications should be validated in real life. Public health care authorities would benefit from mathematical models

  3. Facts about Alcohol and Alcoholism.

    Science.gov (United States)

    Hall, Leonard C.

    Recognition of alcoholism as a treatable illness is a result of public education based on scientific facts. This publication, a digest of a more detailed survey of research about drinking and alcoholism, presents information about alcohol and its effects on individuals and society. It provides facts about the short-term and long-term effects of…

  4. Comorbid psychiatric diagnoses among individuals presenting to an addiction treatment program for alcohol dependence.

    LENUS (Irish Health Repository)

    Lyne, John Paul

    2011-01-01

    A retrospective patient record review was conducted to examine comorbid psychiatric diagnoses, and comorbid substance use, among 465 patients below 45 years of age, presenting to a national alcohol addiction treatment unit in Dublin, between 1995 and 2006. Rates were high for depressive disorder (25.3%) particularly among females (35.4%). Lifetime reported use of substances other than alcohol was 39.2%, and further analysis showed significantly higher rates of deliberate self-harm among this group. Lifetime reported use of ecstasy was also significantly associated with depression in this alcohol-dependent population using logistic regression analysis. Implications and limitations of the findings are discussed.

  5. Gamma Hydroxybutyric Acid (GHB for the Treatment of Alcohol Dependence: A Review

    Directory of Open Access Journals (Sweden)

    Mauro Bernardi

    2009-06-01

    Full Text Available Gamma-hydroxybutyric acid (GHB is a short-chain fatty acid structurally similar to the inhibitory neurotransmitter γ-aminobutyric acid. Clinical trials have demonstrated that 50-100 mg/kg of GHB fractioned into three or six daily doses is able to suppress alcohol withdrawal symptoms and facilitates the maintenance of abstinence from alcohol. These studies have also shown that GHB craving episodes are a very limited phenomenon (about 10-15%. Thus, physicians with access should consider the clinical efficacy of GHB as a valid pharmacological tool for the treatment of alcohol addiction.

  6. Alcohol and Hepatitis

    Science.gov (United States)

    ... code here Enter ZIP code here Daily Living: Alcohol for Veterans and the Public Alcohol and Hepatitis: Entire Lesson Overview Alcohol is one ... related to choices you make about your lifestyle . Alcohol and fibrosis Fibrosis is the medical term for ...

  7. Changing the public perception of physiotherapeutic treatment.

    Science.gov (United States)

    Sheppard, L

    1994-01-01

    Market research was undertaken to establish the public perception of physiotherapy. Using this market research strategic recommendations for the future marketing of physiotherapy are made within the professional context. Marketing will be used to contribute to changing the public perception of physiotherapy. The market research involved a qualitative study of five focus groups of the general public and one focus group of physiotherapists. The responses from the focus groups were used to construct an appropriate questionnaire for the qualitative study. A random sample of 510 members of the general public were then surveyed. The market research results yielded the following key features: The best known conditions treated by physiotherapists are musculoskeletal. The least known are women and children. Client-centered care is sought. The importance of location gives potential for physiotherapists to capitalise on tailoring to clients in their area. Doctors are important for referral and communication about physiotherapy. Marketing should be used to inform doctors of what physiotherapy has to offer. A marketing orientation has begun within physiotherapy; however, it must 'fit' the culture initially to be successful. A marketing strategy should be developed on national, state and individual levels based on a strategic intent. At the state level, strategies must be responsive to area or regional needs. Marketing needs to target identified market segments such as workers compensation organisations. Individual physiotherapists must promote themselves within their region, particularly to doctors and clients with the use of relationship marketing. Informal presentations to community groups and school students about physiotherapy will increase their profile.

  8. Alcoholic pancreatitis: New insights into the pathogenesisand treatment

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Acute pancreatitis is a necro-inflammatory disease of theexocrine pancreas that is characterized by inappropriateactivation of zymogens, infiltration of the pancreas byinflammatory cells, and destruction of the pancreaticexocrine cells. Acute pancreatitis can progress to asevere life-threatening disease. Currently there is nopharmacotherapy to prevent or treat acute pancreatitis.One of the more common factors associated withacute pancreatitis is alcohol abuse. Although commonlyassociated with pancreatitis alcohol alone is unableto cause pancreatitis. Instead, it appears that alcoholand its metabolic by-products predispose the pancreasto damage from agents that normally do not causepancreatitis, or to more severe disease from agentsthat normally cause mild pancreatic damage. Over thelast 10 to 20 years, a tremendous amount of work hasdefined a number of alcohol-mediated biochemicalchanges in pancreatic cells. Among these changesare Sustained levels of intracellular calcium, activationof the mitochondrial permeability transition pore,endoplasmic reticulum stress, impairment in autophagy,alteration in the activity of transcriptional activators,and colocalization of lysosomal and pancreatic digestiveenzymes. Elucidation of these changes has led to adeeper understanding of the mechanisms by whichethanol predisposes acinar cells to damage. This greaterunderstanding has revealed a number of promisingtargets for therapeutic intervention. It is hoped thatfurther investigation of these targets will lead to thedevelopment of pharmacotherapy that is effective in treatingand preventing the progression of acute pancreatitis.

  9. A randomized, open-label, controlled trial of gabapentin and phenobarbital in the treatment of alcohol withdrawal.

    Science.gov (United States)

    Mariani, John J; Rosenthal, Richard N; Tross, Susan; Singh, Prameet; Anand, Om P

    2006-01-01

    Gabapentin was compared with phenobarbital for the treatment of alcohol withdrawal in a randomized, open-label, controlled trial in 27 inpatients. There were no significant differences in the proportion of treatment completers between treatment groups or the proportion of patients in each group requiring rescue medication for breakthrough signs and symptoms of alcohol withdrawal. There were no significant treatment differences in withdrawal symptoms or psychological distress, nor were there serious adverse events. These findings suggest that gabapentin may be as effective as phenobarbital in the treatment of alcohol withdrawal. Given gabapentin's favorable pharmacokinetic profile, further study of its effectiveness in treating alcohol withdrawal is warranted.

  10. Dexmedetomidine for the treatment of alcohol withdrawal syndrome: rationale and current status of research.

    Science.gov (United States)

    Muzyk, Andrew J; Kerns, Suzanne; Brudney, Scott; Gagliardi, Jane P

    2013-11-01

    Dexmedetomidine is currently used in the US in the treatment of alcohol withdrawal syndrome (AWS) in the intensive care unit (ICU) setting, although data to support this practice are limited. Dexmedetomidine targets the noradrenergic system, an important but frequently overlooked secondary mechanism in the development of AWS, and, in doing so, may reduce the need for excessive benzodiazepine use which can increase the risk of γ-aminobutyric acid (GABA)-mediated deliriogenesis and respiratory depression. The purpose of this narrative review is to evaluate available literature reporting on the safety and efficacy of dexmedetomidine for AWS in the ICU setting. An English-language MEDLINE search (1966 to July 2013) was performed to identify articles evaluating the efficacy and safety of dexmedetomidine for AWS. Case series, case reports and controlled trials were evaluated for topic relevance and clinical applicability. Reference lists of articles retrieved through this search were reviewed to identify any relevant publications. Studies focusing on the safety and efficacy of dexmedetomidine for AWS in humans were selected. Studies were included if they were published as full articles; abstracts alone were not included in this review. Eight published case studies and case series were identified. Based on a limited body of evidence, dexmedetomidine shows promise as a potentially safe and possibly effective adjuvant treatment for AWS in the ICU. Prospective, well-controlled studies are needed to confirm the safety and efficacy of the use of dexmedetomidine in AWS.

  11. Questioning the Value of Realism: Young Adults' Processing of Messages in Alcohol-Related Public Service Announcements and Advertising.

    Science.gov (United States)

    Andsager, Julie L.; Austin, Erica Weintraub; Pinkleton, Bruce E.

    2001-01-01

    Finds that: (1) perceived realism and themes that students could identify with are important factors in increasing the salience and persuasiveness of alcohol-related public service announcements (PSAs) among undergraduate students; (2) realistic but logic-based PSAs were not as effective as unrealistic but enjoyable ads; and (3) low production…

  12. Alcoholism and its treatment approach from a citizen perspective.

    Science.gov (United States)

    Gual, Antoni; Arbesú, José Ángel; Zarco, José; López Pelayo, Hugo; Miquel, Laia; Bobes, Julio

    2016-06-14

    Introducción: El objetivo del estudio es describir el consumo de alcohol de la población general española, conocer la opinión que tienen los ciudadanos de su consumo, del alcoholismo y de su abordaje terapéutico.Métodos: Estudio descriptivo transversal mediante encuesta telefónica  que se realizó en mayo de 2015. Se seleccionó una muestra representativa de la población adulta española a quien se le preguntó acerca de su patrón de consumo de alcohol, percepción de riesgo, opinión acerca del alcoholismo,  y consecuencias del consumo, y abordaje terapéutico. Se diseñó un cuestionario ad hoc utilizando el AUDIT-C para determinar el patrón de consumo. Se realizó un análisis descriptivo e inferencial según las características socio-demográficas.Resultados:  El 22,1% presentan un consumo de riesgo, siendo mayor en los hombres y los jóvenes. Mayoritariamente el alcoholismo es considerado una enfermedad y más del 75% de los ciudadanos coinciden que el alcohol tiene consecuencias negativas en la salud  a nivel sociolaboral y familiar. La percepción de riesgo que tienen los ciudadanos de su consumo es mayor de lo esperado (37,6%). El 67,7% considera  al médico de familia capacitado para atender los problemas relacionados con el consumo de alcohol, sobre todo entre las mujeres y los ciudadanos de mayor edad.Conclusiones: El consumo de riesgo es muy prevalente entre los ciudadanos españoles sobre todo entre los  jóvenes (31,8%). Existe una alta autopercepción de riesgo del consumo de alcohol. La mayoría de ciudadanos coinciden que el médico de familia está capacitado para tratar el alcoholismo.

  13. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    Science.gov (United States)

    Jiménez-Murcia, Susana; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Hakänsson, Anders; Tárrega, Salomé; Valdepérez, Ana; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Sauvaget, Anne; Romeu, Maria; Steward, Trevor; Menchón, José M.

    2016-01-01

    Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10–14 patients attending 16 weekly outpatient sessions lasting 90 min each. Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment. PMID:27065113

  14. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use

    Directory of Open Access Journals (Sweden)

    Susana eJiménez-Murcia

    2016-03-01

    Full Text Available Aims: The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT program.Methods: The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD= 12.2. All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10-14 patients attending 16 weekly outpatient sessions lasting 90 min each.Results: The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes.Conclusions: Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment.

  15. Treatment Outcome in Male Gambling Disorder Patients Associated with Alcohol Use.

    Science.gov (United States)

    Jiménez-Murcia, Susana; Del Pino-Gutiérrez, Amparo; Fernández-Aranda, Fernando; Granero, Roser; Hakänsson, Anders; Tárrega, Salomé; Valdepérez, Ana; Aymamí, Neus; Gómez-Peña, Mónica; Moragas, Laura; Baño, Marta; Sauvaget, Anne; Romeu, Maria; Steward, Trevor; Menchón, José M

    2016-01-01

    The primary objective of this study was to analyze the association between alcohol consumption and short-term response to treatment (post intervention) in male patients with gambling disorder enrolled in a group cognitive behavioral therapy (CBT) program. The sample consisted of 111 male individuals with a diagnosis of Gambling Disorder, with a mean age of 45 years (SD = 12.2). All participants were evaluated by a comprehensive assessment battery and assigned to CBT groups of 10-14 patients attending 16 weekly outpatient sessions lasting 90 min each. The highest mean pre- and post-therapy differences were recorded for the alcohol risk/dependence group on the obsessive/compulsive and anxiety dimensions of the SCL-90-R. As regards the presence of relapses and dropouts over the course of the CBT sessions, the results show a significant association with moderate effect size: patients with risk consumption or alcohol dependence were more likely to present poor treatment outcomes. Alcohol abuse was frequent in GD, especially in patients with low family income and high accumulated debts. High levels of somatization and high overall psychopathology (measured by the SCL-90-R) were associated with increased risk of alcohol abuse. Alcohol abuse was also associated with poor response to treatment.

  16. Gait and Balance in Treatment-Naive Active Alcoholics with and without a Lifetime Drug Codependence

    Science.gov (United States)

    Fein, George; Smith, Stan; Greenstein, David

    2012-01-01

    Background Disturbed gait and balance are among the most consistent sequelae of chronic alcoholism. However, although a majority of alcoholics have never sought treatment, most investigations showing ataxia in alcohol dependent individuals have relied on samples drawn from treated populations. In addition, few studies have addressed the associations of codependence on other drugs with alcoholic gait and balance disturbance. Methods The present study employed the Walk-a-line Ataxia Battery (Fregly et al. 1972) to assess gait and balance in treatment-naive, actively drinking alcohol dependent men and women (TNA; n = 69) who were dependent on alcohol only (ALC; n = 43), or who also had a lifetime drug dependence (ALC+DRG; n = 26; i.e., methamphetamine, cocaine, opiates, and/or marijuana), compared with non-substance abusing controls (NSAC; n = 74). We also examined associations between lifetime alcohol use and age with gait and balance measures. Results Our main findings were 1) no evidence of disturbed gait and balance in ALC vs. NSAC and 2) significantly disturbed gait and balance in ALC+DRG, relative to both NSAC and ALC, along with steeper age-associated decline in gait and balance performance in ALC vs. ALC+DRG. Conclusions Our results provide evidence consistent with previous studies that TNA (without a lifetime drug codependence) may represent a population that is different and less impaired (including in gait and balance) than treated alcoholics. Additionally, we provide evidence that ALC+DRG, with greater alcohol use and family drinking density than ALC, have an accelerated effect of age on gait and balance disturbance compared to both NSAC and ALC. The ALC+DRG group likely represents a subset of TNA with different characteristics than ALC. PMID:22390787

  17. 20 CFR 416.936 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Science.gov (United States)

    2010-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 416.936... AGED, BLIND, AND DISABLED Determining Disability and Blindness Drug Addiction and Alcoholism § 416.936 Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material...

  18. 20 CFR 404.1536 - Treatment required for individuals whose drug addiction or alcoholism is a contributing factor...

    Science.gov (United States)

    2010-04-01

    ... addiction or alcoholism is a contributing factor material to the determination of disability. 404.1536... Treatment required for individuals whose drug addiction or alcoholism is a contributing factor material to... alcoholism is a contributing factor material to the determination of disability (as described in §...

  19. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Science.gov (United States)

    2010-07-01

    ... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Alcohol and...

  20. Attitudes to publicly funded obesity treatment and prevention

    DEFF Research Database (Denmark)

    Lund, Thomas Bøker; Sandøe, Peter; Lassen, Jesper

    2011-01-01

    , the perceived controllability of obesity, self-reported BMI, and additional attitudinal and sociodemographic characteristics. Public funding of some obesity treatments, such as weight-loss surgery, attracted only limited public support. A majority of the Danish public did support ‘softer’ treatment......The aim of this study was to investigate the Danish public’s support for publicly funded obesity treatment and prevention. It was also examined whether levels of support could be explained by dislike of obese people and / or the belief that those who are obese are personally responsible...... interventions and preventive initiatives. Attitudes to the treatment of obesity were clearly best predicted by the belief that individuals are personally responsible for their own obesity. Dislike of obese persons had no direct effect on the preference for collective treatment initiatives and only a small...

  1. Alcohol Treatment and Cognitive-Behavioral Therapy: Enhancing Effectiveness by Incorporating Spirituality and Religion

    Science.gov (United States)

    Hodge, David R.

    2011-01-01

    Cognitive-behavioral therapy (CBT) is an effective modality for the treatment of alcoholism. Given widespread interest in incorporating spirituality into professional treatment, this article orients practitioners to spiritually modified CBT, an approach that may enhance outcomes with some spiritually motivated clients. More specifically, by…

  2. Medicaid-Covered Alcohol and Drug Treatment Use among People with Intellectual Disabilities: Evidence of Disparities

    Science.gov (United States)

    Slayter, Elspeth

    2010-01-01

    For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for…

  3. Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment

    Science.gov (United States)

    Ong, Lee Za; Cardoso, Elizabeth; Chan, Fong; Chronister, Julie; Chou, Chih Chin

    2007-01-01

    Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their…

  4. Successful treatment of polydipsia, water intoxication, and delusional jealousy in an alcohol dependent patient with clozapine.

    Science.gov (United States)

    Margetić, Branimir; Aukst-Margetić, Branka; Zarković-Palijan, Tija

    2006-09-30

    The beneficial effect of clozapine on polydipsia and water intoxication in patients with schizophrenia has been demonstrated many times. The authors report a successful clozapine treatment of polydipsia, intermittent water intoxication, and delusional jealousy of an alcoholic. This is a rare case of clozapine treatment of a non-schizophrenic patient affected by polydipsia.

  5. Multi-modal MRI classifiers identify excessive alcohol consumption and treatment effects in the brain.

    Science.gov (United States)

    Cosa, Alejandro; Moreno, Andrea; Pacheco-Torres, Jesús; Ciccocioppo, Roberto; Hyytiä, Petri; Sommer, Wolfgang H; Moratal, David; Canals, Santiago

    2017-09-01

    Robust neuroimaging markers of neuropsychiatric disorders have proven difficult to obtain. In alcohol use disorders, profound brain structural deficits can be found in severe alcoholic patients, but the heterogeneity of unimodal MRI measurements has so far precluded the identification of selective biomarkers, especially for early diagnosis. In the present work we used a combination of multiple MRI modalities to provide comprehensive and insightful descriptions of brain tissue microstructure. We performed a longitudinal experiment using Marchigian-Sardinian (msP) rats, an established model of chronic excessive alcohol consumption, and acquired multi-modal images before and after 1 month of alcohol consumption (6.8 ± 1.4 g/kg/day, mean ± SD), as well as after 1 week of abstinence with or without concomitant treatment with the antirelapse opioid antagonist naltrexone (2.5 mg/kg/day). We found remarkable sensitivity and selectivity to accurately classify brains affected by alcohol even after the relative short exposure period. One month drinking was enough to imprint a highly specific signature of alcohol consumption. Brain alterations were regionally specific and affected both gray and white matter and persisted into the early abstinence state without any detectable recovery. Interestingly, naltrexone treatment during early abstinence resulted in subtle brain changes that could be distinguished from non-treated abstinent brains, suggesting the existence of an intermediate state associated with brain recovery from alcohol exposure induced by medication. The presented framework is a promising tool for the development of biomarkers for clinical diagnosis of alcohol use disorders, with capacity to further inform about its progression and response to treatment. © 2016 Society for the Study of Addiction.

  6. Testing Public Anxiety Treatments against a Credible Placebo Control

    Science.gov (United States)

    Duff, Desiree C.; Levine, Timothy R.; Beatty, Michael J.; Woolbright, Jessica; Park, Hee Sun

    2007-01-01

    Research investigating public speaking anxiety treatments is subject to demand effects. This study tests the relative effectiveness of systematic desensitization (SD) and multiple treatment method (MT) containing visualization therapy against no-treatment and credible placebo controls. Data (N = 238) were collected at six points in a public…

  7. Metabotropic and ionotropic glutamate receptors as potential targets for the treatment of alcohol use disorder.

    Science.gov (United States)

    Goodwani, Sunil; Saternos, Hannah; Alasmari, Fawaz; Sari, Youssef

    2017-02-24

    Emerging evidence indicates that dysfunctional glutamate neurotransmission is critical in the initiation and development of alcohol and drug dependence. Alcohol consumption induced downregulation of glutamate transporter 1 (GLT-1) as reported in previous studies from our laboratory. Glutamate is the major excitatory neurotransmitter in the brain, which acts via interactions with several glutamate receptors. Alcohol consumption interferes with the glutamatergic signal transmission by altering the functions of these receptors. Among the glutamate receptors involved in alcohol-drinking behavior are the metabotropic receptors such as mGluR1/5, mGluR2/3, and mGluR7, as well as the ionotropic receptors, NMDA and AMPA. Preclinical studies using agonists and antagonists implicate these glutamatergic receptors in the development of alcohol use disorder (AUD). Therefore, the purpose of this review is to discuss the neurocircuitry involving glutamate transmission in animals exposed to alcohol and further outline the role of metabotropic and ionotropic receptors in the regulation of alcohol-drinking behavior. This review provides ample information about the potential therapeutic role of glutamatergic receptors for the treatment of AUD.

  8. The role of the glutamatergic system in the patogenesis and treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Karina Łukasik

    2010-10-01

    Full Text Available The lack of satisfactory results of alcohol dependence treatment has necessitated the search for new directions of studies. One of them is connected with glutamatergic transmission. The influence of alcohol on this transmission is very complex and relates to changes including at the molecular level. However, the diversity of glutamatergic receptors creates a new possibility of modulation of its activity. It leads to decrease of alcohol reward abilities, prolongs abstinence time and reduces the incidence of acute alcohol intoxication in alcohol addicts. The use of acamprosate – a glutamatergic transmission modulator drug – and naltrexone (an opioid receptor antagonist improves therapy effectiveness of acamprosate alone. Satisfactory results were achieved in the studies of topiramate – an antagonist of AMPA and KA receptors. Its effectiveness was proved in clinical studies. Topiramate reduced alcohol craving and prolonged abstinence time, which decreased the probability of relapse. There are promising preclinical results of groups I and II metabotropic receptor antagonists. However, further studies are necessary to elucidate precisely their role in alcohol dependence.

  9. Real or perceived impediments to minimum pricing of alcohol in Australia: public opinion, the industry and the law.

    Science.gov (United States)

    Chalmers, Jenny; Carragher, Natacha; Davoren, Sondra; O'Brien, Paula

    2013-11-01

    A burgeoning body of empirical evidence demonstrates that increases in the price of alcohol can reduce per capita alcohol consumption and harmful drinking. Taxes on alcohol can be raised to increase prices, but this strategy can be undermined if the industry absorbs the tax increase and cross-subsidises the price of one alcoholic beverage with other products. Such loss-leading strategies are not possible with minimum pricing. We argue that a minimum (or floor) price for alcohol should be used as a complement to alcohol taxation. Several jurisdictions have already introduced minimum pricing (e.g., Canada, Ukraine) and others are currently investigating pathways to introduce a floor price (e.g., Scotland). Tasked by the Australian government to examine the public interest case for a minimum price, Australia's peak preventative health agency recommended against setting one at the present time. The agency was concerned that there was insufficient Australian specific modelling evidence to make robust estimates of the net benefits. Nonetheless, its initial judgement was that it would be difficult for a minimum price to produce benefits for Australia at the national level. Whilst modelling evidence is certainly warranted to support the introduction of the policy, the development and uptake of policy is influenced by more than just empirical evidence. This article considers three potential impediments to minimum pricing: public opinion and misunderstandings or misgivings about the operation of a minimum price; the strength of alcohol industry objections and measures to undercut the minimum price through discounts and promotions; and legal obstacles including competition and trade law. The analysis of these factors is situated in an Australian context, but has salience internationally.

  10. Psychometric Properties of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) in Public First Responders.

    Science.gov (United States)

    Jeong, Hyeonseok S; Park, Shinwon; Lim, Soo Mee; Ma, Jiyoung; Kang, Ilhyang; Kim, Jungyoon; Kim, Eui-Jung; Choi, Yejee J; Lim, Jae-Ho; Chung, Yong-An; Lyoo, In Kyoon; Yoon, Sujung; Kim, Jieun E

    2017-03-21

    Problematic alcohol consumption is prevalent among first responders because alcohol is commonly used to cope with occupational stress and frequent exposure to traumatic incidents, making them an at-risk population for alcohol use disorders (AUD). This study investigated the psychometric properties of the Korean version of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) among public first responders. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision (SCID), AUDIT-C, AUDIT, and CAGE were administered to 222 public first responders, who were recruited by convenience sampling. One-week test-retest reliability was evaluated in a subsample (n = 24). Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the diagnostic accuracy and estimate the optimal cut-off scores for any AUD and alcohol dependence. Three different analytic criteria were utilized to calculate the cut-off scores. The AUDIT-C demonstrated good test-retest reliability (intraclass correlation coefficient for test-retest reliability = 0.91) and satisfactory convergent validity. The areas under the ROC curves for any AUD and alcohol dependence of the AUDIT-C were 0.87 and 0.93, respectively. For any AUD, all three criteria suggested a cut-off score of 7.5 (sensitivity = 81.8%, specificity = 79.8%), whereas for alcohol dependence, a cut-off score of 8.5 (sensitivity = 85.7%, specificity = 86.1%) was derived from two criteria. In conclusion, the AUDIT-C demonstrated good reliability and validity and proved to be a brief and effective screening test for AUD among first responders.

  11. Prediction of treatment outcome in a clinical sample of problem drinkers: self-efficacy, alcohol expectancies, and readiness to change

    Directory of Open Access Journals (Sweden)

    Demmel, Ralf

    2003-10-01

    Full Text Available Cognitive processes related to client motivation are important mediators of alcoholism treatment outcome. The present study aimed to expand previous research on client motivation and treatment outcome by establishing the predictive utility of self-efficacy, alcohol expectancies, and readiness to change in a sample of alcohol-dependent inpatients (N = 83. Treatment outcome was assessed three months following discharge. According to self-reported alcohol use, 22 clients were classified as abstainers and 41 clients as relapsers. Twenty participants were lost to follow-up. Readiness to change and anticipated reinforcement from alcohol predicted abstinence at follow-up. Client motivation was unrelated to both frequency and quantity of alcohol use. In accordance with social learning theory, self-efficacy was inversely correlated with alcohol expectancies. The results of the present study suggest that once abstinence has been violated factors other than pretreatment motivation determine drinking behavior.

  12. Pentoxifylline: A first line treatment option for severe alcoholic hepatitis and hepatorenal syndrome?

    Institute of Scientific and Technical Information of China (English)

    Stelios F Assimakopoulos; Konstantinos C Thomopoulos; Chrisoula Labropoulou-Karatza

    2009-01-01

    Although favourable results of pentoxifylline (PTX) used in treatment of severe alcoholic hepatitis patients with a Maddrey discriminant function score ≥ 32 have been previously reported, it is not currently recommended as a first line treatment for alcoholic hepatitis owing to lack of evidence for its efficacy as compared to the standard treatment with corticosteroids. In a very recent issue of World Journal of Gastroenterology, Dr. De BK and colleagues compared for the first time the two treatment modalities head to head in a randomized controlled study, demonstrating the advantage of PTX over corticosteroids in terms of patients' survival and risk-benefit profile. The advantage of PTX over corticosteroids in survival of patients with severe alcoholic hepatitis was found to be related to the prevention of hepatorenal syndrome in their study. This study raises the question of the use of PTX as a standard treatment for severe alcoholic hepatitis. Considering the fact that PTX presented a spectacular efficiency in prevention of hepatorenal syndrome in their study as well as that previous studies have shown that this effect is possibly related to a primary renoprotective action because it is irrelevant of tumor necrosis factor-α synthesis inhibition or improved liver function, we tempted to speculate that PXT might be an effective option for prevention and/or treatment of hepatorenal syndrome complicating other forms of advanced liver disease. This attractive theory remains to be elucidated by pressing future studies in view of the lack of effective treatment modalities for hepatorenal syndrome.

  13. Prevalence of problem alcohol use among patients attending primary care for methadone treatment

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2009-06-11

    Abstract Background Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed todetermine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. Methods We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. Results We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28–41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. Conclusion Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make

  14. Prevalence of problem alcohol use among patients attending primary care for methadone treatment.

    LENUS (Irish Health Repository)

    Ryder, Niamh

    2012-02-01

    BACKGROUND: Problem alcohol use is associated with adverse health outcomes among current or former heroin users and primary care is providing methadone treatment for increasing numbers of this population. This study aimed to determine the prevalence of problem alcohol use among current or former heroin users attending primary care for methadone treatment and to describe the socio-demographic characteristics and health service utilisation characteristics associated with problem alcohol uses. METHODS: We conducted a cross sectional survey of patients sampled from a national database of patients attending general practice for methadone treatment. Participants were recruited by their general practitioner and data was collected using an interviewer-administered questionnaire, which included the Alcohol Use Disorders Identification Test (\\'AUDIT\\'), with a score of >7 considered abnormal (ie \\'AUDIT positive cases\\') and socio-demographic, medical and substance use characteristics. RESULTS: We interviewed 196 patients (71% of those invited, 31% of those sampled, 11% of the national database). The median age was 32 years, 55% were hepatitis C positive, 79% had used illicit drugs in the previous month and 68% were male. Sixty-eight \\'AUDIT positive\\' cases were identified (prevalence of 35%, 95% CI = 28-41%) and these were more likely to have attended a local Emergency Department in the previous year (p < 0.05) and less likely to have attended a hospital clinic in the previous year (p < 0.05). Twenty-seven (14%) scored 20 or higher indicating possible alcohol dependence. CONCLUSION: Problem alcohol use has a high prevalence among current or former heroin users attending primary care for methadone treatment and interventions that address this issue should be explored as a priority. Interventions that address problem alcohol use in this population should be considered as a priority, although the complex medical and psychological needs of this population may make this

  15. Unemployment Is a Risk Factor for Hospitalization Due to Alcohol Problems: A Longitudinal Study Based on the Stockholm Public Health Cohort (SPHC).

    Science.gov (United States)

    Backhans, Mona Christina; Balliu, Natalja; Lundin, Andreas; Hemmingsson, Tomas

    2016-11-01

    This study examined the associations between unemployment and alcohol-related hospitalization or mortality and to what extent these associations may be confounded by alcohol consumption and alcohol problems before unemployment. The study was based on the Stockholm Public Health Cohort (SPHC), a population-based stratified random sample with a baseline questionnaire in 2002/2003 and record linkages up to year 2011. The final sample in the study consists of 15,841 people aged 18-60 years. Unemployment was defined as any registration at the public employment services during 2003-2005. The outcome was alcohol-related hospitalization and alcohol-related mortality during 2006-2011. Confounders were age, sex, and education, and we further adjusted for baseline alcohol consumption and alcohol-related hospitalization before the study period. Cox proportional hazard models were fit, and associations were expressed as hazard ratios (HRs). In the fully adjusted model, unemployment was associated with an increased risk of alcohol-related hospitalization or mortality, with a more than threefold hazard (HR = 3.38, 95% CI [1.81, 6.31]) compared with no unemployment during the exposure period. There was a moderate attenuating effect of prior alcohol consumption and alcohol-related hospitalization. Any unemployment in 2003-2005 was highly related to having experienced an alcohol-related diagnosis during the 6-year follow-up, even after controlling for risky use of alcohol and prior hospitalization.

  16. Is it time for baclofen to be included in the official recommendations concerning the treatment of alcoholism?

    Directory of Open Access Journals (Sweden)

    Masternak Sebastian

    2016-06-01

    Full Text Available Alcohol dependence and its treatment is not an exactly resolved problem. Based on the EZOP [Epidemiology of Mental Disorders and Accessibility of Mental Health Care] survey, which included a regular analysis of the incidence of mental disorders in the population of adult Polish citizens, we were able to estimate that the problem of alcohol abuse in any period of life affects even 10.9% of the population aged 18-64 years, and those addicted represent 2.2% of the country’s population. The typical symptoms of alcohol dependence according to ICD-10, include alcohol craving, impaired ability to control alcohol consumption, withdrawal symptoms which appear when a heavy drinker stops drinking, alternating alcohol tolerance, growing neglect of other areas of life, and persistent alcohol intake despite clear evidence of its destructive effect on life. At the moment, the primary method of alcoholism treatment is psychotherapy. It aims to change the patient’s habits, behaviours, relationships, or the way of thinking. It seems that psychotherapy is irreplaceable in the treatment of alcoholism, but for many years now attempts have been made to increase the effectiveness of alcoholism treatment with pharmacological agents. In this article we will try to provide a description of medications which help patients sustain abstinence in alcoholism therapy with particular emphasis on baclofen.

  17. Treatment, Alcoholics Anonymous, and 16-Year Changes in Impulsivity and Legal Problems Among Men and Women With Alcohol Use Disorders*

    Science.gov (United States)

    Blonigen, Daniel M.; Timko, Christine; Moos, Bernice S.; Moos, Rudolf H.

    2009-01-01

    Objective: The link between impulsive personality traits and alcohol use disorders (AUDs) is well established. No studies, however, have investigated whether receipt of help for AUDs predicts change in impulsivity or whether such change is associated with relevant outcomes such as legal problems. The present study examined predictive associations between the duration of help for AUDs (Alcoholics Anonymous [AA], professional treatment) and impulsivity and legal problems over 16 years in men and women with AUDs. Method: Participants who were initially untreated for their AUDs (n men = 332, n women = 296) completed follow-up telephone interviews at 1 and 16 years after their baseline assessment. Results: Impulsivity and legal problems declined between baseline and the 1-year and 16-year follow-ups among both women and men. A longer duration of participation in AA predicted a decline in impulsivity at both follow-up assessments, and, in turn, a decline in impulsivity predicted a decline in legal problems at Years 1 and 16. In addition, a longer duration of participation in AA predicted fewer legal problems at Year 1, and this association was moderated by gender (significant in men) and impulsivity (significant for individuals with higher baseline scores). Conclusions: The results highlight the potential for AA and professional treatment to reduce the expression of impulsivity and related disinhibitory traits and legal problems in individuals with AUDs. PMID:19737496

  18. Treatment, alcoholics anonymous, and 16-year changes in impulsivity and legal problems among men and women with alcohol use disorders.

    Science.gov (United States)

    Blonigen, Daniel M; Timko, Christine; Moos, Bernice S; Moos, Rudolf H

    2009-09-01

    The link between impulsive personality traits and alcohol use disorders (AUDs) is well established. No studies, however, have investigated whether receipt of help for AUDs predicts change in impulsivity or whether such change is associated with relevant outcomes such as legal problems. The present study examined predictive associations between the duration of help for AUDs (Alcoholics Anonymous [AA], professional treatment) and impulsivity and legal problems over 16 years in men and women with AUDs. Participants who were initially untreated for their AUDs (n(men) = 332, n(women) = 296) completed follow-up telephone interviews at 1 and 16 years after their baseline assessment. Impulsivity and legal problems declined between baseline and the 1-year and 16-year follow-ups among both women and men. A longer duration of participation in AA predicted a decline in impulsivity at both follow-up assessments, and, in turn, a decline in impulsivity predicted a decline in legal problems at Years 1 and 16. In addition, a longer duration of participation in AA predicted fewer legal problems at Year 1, and this association was moderated by gender (significant in men) and impulsivity (significant for individuals with higher baseline scores). The results highlight the potential for AA and professional treatment to reduce the expression of impulsivity and related disinhibitory traits and legal problems in individuals with AUDs.

  19. Facilitating involvement in Alcoholics Anonymous during out-patient treatment: a randomized clinical trial.

    Science.gov (United States)

    Walitzer, Kimberly S; Dermen, Kurt H; Barrick, Christopher

    2009-03-01

    This study evaluated two strategies to facilitate involvement in Alcoholics Anonymous (AA)--a 12-Step-based directive approach and a motivational enhancement approach--during skills-focused individual treatment. Randomized controlled trial with assessments at baseline, end of treatment and 3, 6, 9 and 12 months after treatment. PARTICIPANTS, SETTING AND INTERVENTION: A total of 169 alcoholic out-patients (57 women) assigned randomly to one of three conditions: a directive approach to facilitating AA, a motivational enhancement approach to facilitating AA or treatment as usual, with no special emphasis on AA. Self-report of AA meeting attendance and involvement, alcohol consumption (percentage of days abstinent, percentage of days heavy drinking) and negative alcohol consequences. Participants exposed to the 12-Step directive condition for facilitating AA involvement reported more AA meeting attendance, more evidence of active involvement in AA and a higher percentage of days abstinent relative to participants in the treatment-as-usual comparison group. Evidence also suggested that the effect of the directive strategy on abstinent days was mediated partially through AA involvement. The motivational enhancement approach to facilitating AA had no effect on outcome measures. These results suggest that treatment providers can use a 12-Step-based directive approach to effectively facilitate involvement in AA and thereby improve client outcome.

  20. Facilitating Involvement in Alcoholics Anonymous During Outpatient Treatment: A Randomized Clinical Trial

    Science.gov (United States)

    Walitzer, Kimberly S.; Dermen, Kurt H.; Barrick, Christopher

    2009-01-01

    AIM This study evaluated two strategies to facilitate involvement in Alcoholics Anonymous (AA) – a 12-step-based directive approach and a motivational enhancement approach – during skills-focused individual treatment. DESIGN Randomized controlled trial with assessments at baseline, end of treatment, and 3, 6, 9, and 12 months after treatment. PARTICIPANTS, SETTING, and INTERVENTION 169 alcoholic outpatients (57 women) randomly assigned to one of three conditions: a directive approach to facilitating AA, a motivational enhancement approach to facilitating AA, or treatment as usual with no special emphasis on AA. MEASUREMENTS Self-report of AA meeting attendance and involvement, alcohol consumption (percent days abstinent, percent days heavy drinking), and negative alcohol consequences. FINDINGS Participants exposed to the 12-step directive condition for facilitating AA involvement reported more AA meeting attendance, more evidence of active involvement in AA, and a higher percent days abstinent relative to participants in the treatment-as-usual comparison group. Evidence suggested also that the effect of the directive strategy on abstinent days was partially mediated through AA involvement. The motivational enhancement approach to facilitating AA had no effect on outcome measures. CONCLUSIONS These results suggest that treatment providers can use a 12-step-based directive approach to effectively facilitate involvement in AA and thereby improve client outcome. PMID:19207347

  1. The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving.

    Science.gov (United States)

    Kaczkurkin, Antonia N; Asnaani, Anu; Alpert, Elizabeth; Foa, Edna B

    2016-04-01

    Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD.

  2. Treatment with neuropeptides attenuates c-fos expression in a mouse model of fetal alcohol syndrome.

    Science.gov (United States)

    Incerti, Maddalena; Vink, Joy; Roberson, Robin; Abebe, Daniel; Spong, Catherine Y

    2010-10-01

    Fetal alcohol syndrome (FAS) is the most common nongenetic cause of mental retardation and is characterized by neurodevelopmental anomalies. C-FOS is a cellular marker of transcriptional activity in the stress-signal pathway. Previously, we showed the treatment with NAP (NAPVSIPQ) + SAL (SALLRSIPA) reversed the learning deficit after prenatal alcohol exposure in FAS. Our objective was to evaluate if the mechanism of actions of NAP + SAL involves the stress-signal pathway differentiating C-FOS expression in mouse brains after prenatal alcohol exposure. C57Bl6/J mice were treated with alcohol (0.03 mL/g) or placebo on gestational day 8. On postnatal day 40, in utero alcohol-exposed males were treated via gavage with 40 μg D-NAP and 40 μg D-SAL ( N = 6) or placebo ( N = 4); controls were gavaged with placebo daily ( N = 12). After learning evaluation, hippocampus, cerebellum, and cortex were isolated. Calibrator-normalized relative real-time polymerase chain reaction and Western blot analysis were performed. Statistics included analysis of variance and post hoc Fisher analysis. Adult treatment with NAP + SAL restored the down-regulation of C-FOS in the hippocampus after prenatal alcohol exposure ( P < 0.05), but not in the cerebellum. There was no difference in C-FOS expression in the cortex. Adult treatment with NAP + SAL restored the down-regulation of C-FOS expression in hippocampus attenuating the alcohol-induced alteration of the stress-signal pathway.

  3. Alcohol in Primary Care. Differential characteristics between alcohol-dependent patients who are receiving or not receiving treatment.

    Science.gov (United States)

    Barrio, Pablo; Miquel, Laia; Moreno-España, Jose; Martínez, Alicia; Ortega, Lluisa; Teixidor, Lidia; Manthey, Jakob; Rehm, Jürgen; Gual, Antoni

    2016-03-02

    primary health care services for other reasons. The aim of the present study is to describe the differential characteristics of AD patients in primary care, distinguishing between those who receive treatment and those who do not, and their reasons for not seeking it. In a cross-sectional study patients were evaluated by their general practitioner (GP) and interviewed by a member of the research team. Sociodemographic, diagnostic and clinical data were collected. From 1,372 patients interviewed in Catalonia, 118 (8.6%) were diagnosed as AD. These patients showed a lower socioeconomic status (48.3% vs 33.3%, odds ratio 2.02), higher unemployment rates (32.2% vs 19.2 %, odds ratio 2.11), and greater psychological distress and disability. Patients with AD receiving treatment (16.9%), were older (44 vs 36 years of age), reported higher unemployment rates (66% vs 25.5%, odds ratio 6.32) and higher daily alcohol consumption (61.5 vs 23.7 grams), suggesting a more advanced disease. Patients with AD in general showed a higher degree of comorbidity compared to other patients, with patients in treatment showing the most elevated level. The main reasons given for not seeking treatment were shame, fear of giving up drinking and barriers to treatment. Taken together, the data suggest the need to implement earlier strategies for the detection and treatment of AD.

  4. Dropout among patients in qualified alcohol detoxification treatment: the effect of treatment motivation is moderated by Trauma Load.

    Science.gov (United States)

    Odenwald, Michael; Semrau, Peter

    2013-03-21

    Motivation to change has been proposed as a prerequisite for behavioral change, although empirical results are contradictory. Traumatic experiences are frequently found amongst patients in alcohol treatment, but this has not been systematically studied in terms of effects on treatment outcomes. This study aimed to clarify whether individual Trauma Load explains some of the inconsistencies between motivation to change and behavioral change. Over the course of two months in 2009, 55 patients admitted to an alcohol detoxification unit of a psychiatric hospital were enrolled in this study. At treatment entry, we assessed lifetime Trauma Load and motivation to change. Mode of discharge was taken from patient files following therapy. We tested whether Trauma Load moderates the effect of motivation to change on dropout from alcohol detoxification using multivariate methods. 55.4% dropped out of detoxification treatment, while 44.6% completed the treatment. Age, gender and days in treatment did not differ between completers and dropouts. Patients who dropped out reported more traumatic event types on average than completers. Treatment completers had higher scores in the URICA subscale Maintenance. Multivariate methods confirmed the moderator effect of Trauma Load: among participants with high Trauma Load, treatment completion was related to higher Maintenance scores at treatment entry; this was not true among patients with low Trauma Load. We found evidence that the effect of motivation to change on detoxification treatment completion is moderated by Trauma Load: among patients with low Trauma Load, motivation to change is not relevant for treatment completion; among highly burdened patients, however, who a priori have a greater risk of dropping out, a high motivation to change might make the difference. This finding justifies targeted and specific interventions for highly burdened alcohol patients to increase their motivation to change.

  5. Polypharmacy Treatment of Hypertensionin Public Health Centers

    Directory of Open Access Journals (Sweden)

    Vasanthi A/P Nayagam

    2016-12-01

    Full Text Available Background: Hypertension is one of the most prominent global diseases. Despite the availability of effective therapies, hypertension remains poorly controlled in Indonesia. In many cases, patient’s noncompliance may be attributable to the low patients’ knowledge, attitude, and life-style practices such as polypharmacy. Polypharmacy is defined as the administration of many drugs at in one prescription. Polypharmacy increases expenses, possible adverse reaction to a single agent, incidence of drug interactions, and decreases patient’s compliance This study aimed to identify the practice of polypharmacy in hypertension treatment in primary health centers. Methods: A cross-sectional descriptive observational study was carried out on 60 patients from two primary health centers in Jatinangor, West Java, Indonesia in October 2013. Sociodemographic profile, degree of hypertension, types of antihypertensive drugs, concomitant drugs given together with antihypertensive drugs, and treatment compliance data were collected and presented in tables and figures. Results: The incidence of hypertension was more common among male patients compared to female patients. Thirty-three patients (55% have low compliance to their medication. Twenty-nine patients (48% received single drug and 31 patients (52% received more than one drugs. Conclusions: The percentage of polypharmacy practice in treating hypertension in primary health centers is 52%. The most frequently prescribed anti-hypertensive are angiotensin-converting enzyme (ACE inhibitors and calcium-channel blockers (CCB. Most of hypertensive patients have low compliance to therapy.

  6. Álcool e alcoolismo entre adolescentes da rede estadual de ensino de Cuiabá, Mato Grosso Alcohol and alcoholism among Brazilian adolescent public-school students

    Directory of Open Access Journals (Sweden)

    Delma P Oliveira de Souza

    2005-08-01

    Full Text Available OBJETIVO: Estimar a prevalência de consumo de álcool e do alcoolismo entre estudantes adolescentes trabalhadores e não trabalhadores. MÉTODOS: Estudo transversal, realizado por amostragem estratificada sistemática, composta por 993 adolescentes trabalhadores e 1.725 não-trabalhadores. Foram incluídos os estudantes matriculados em 1998, na rede estadual de ensino de Cuiabá, MT. Aplicou-se, em sala de aula, um questionário de auto-preenchimento anônimo. Utilizou-se as análises univariada, bivariada e regressão logística. RESULTADOS: Verificaram-se prevalências de 71,3% para o consumo de álcool e 13,4% para alcoolismo na amostra total, sendo maior entre os estudantes trabalhadores (81,0% e 14,9% comparativamente aos não-trabalhadores (65,8% e 12,6%. Além da associação do uso de álcool com o trabalho, observou-se tanto semelhanças quanto diferenças entre os dois grupos. O alcoolismo não está associado ao trabalho, mas ao sexo masculino (RO=1,61; IC 95%: 1,18-2,19 e história de álcool na família tanto entre os não-trabalhadores (RO=2,19; IC 95%: 1,60-2,99 quanto entre trabalhadores (RO=2,10; IC 95%: 1,42-3,12. CONCLUSÕES: Os resultados indicam alta prevalência de consumo de álcool e alcoolismo, sendo maior entre os adolescentes trabalhadores. Os fatores sociodemográficos, familiares e relacionados a trabalho devem ser considerados na implementação de ações educativas nessa população, visando a mudanças de comportamento relacionadas ao consumo de álcool.OBJECTIVE: To estimate the prevalence of alcohol consumption and alcoholism among working and non-working adolescents. METHODS: Cross-sectional study with a systematic, stratified sample 993 working adolescents and 1,725 non-working adolescents. The study included students enrolled in 1998 in the state public network schools of a city in Center-Western Brazil. An anonymous, self-administered questionnaire was completed by subjects in the classroom. Univariate and

  7. Scientific publications and research groups on alcohol consumption and related problems worldwide: authorship analysis of papers indexed in PubMed and Scopus databases (2005 to 2009).

    Science.gov (United States)

    González-Alcaide, Gregorio; Castelló-Cogollos, Lourdes; Castellano-Gómez, Miguel; Agullo-Calatayud, Víctor; Aleixandre-Benavent, Rafael; Alvarez, Francisco Javier; Valderrama-Zurián, Juan Carlos

    2013-01-01

    The research of alcohol consumption-related problems is a multidisciplinary field. The aim of this study is to analyze the worldwide scientific production in the area of alcohol-drinking and alcohol-related problems from 2005 to 2009. A MEDLINE and Scopus search on alcohol (alcohol-drinking and alcohol-related problems) published from 2005 to 2009 was carried out. Using bibliometric indicators, the distribution of the publications was determined within the journals that publish said articles, specialty of the journal (broad subject terms), article type, language of the publication, and country where the journal is published. Also, authorship characteristics were assessed (collaboration index and number of authors who have published more than 9 documents). The existing research groups were also determined. About 24,100 documents on alcohol, published in 3,862 journals, and authored by 69,640 authors were retrieved from MEDLINE and Scopus between the years 2005 and 2009. The collaboration index of the articles was 4.83 ± 3.7. The number of consolidated research groups in the field was identified as 383, with 1,933 authors. Documents on alcohol were published mainly in journals covering the field of "Substance-Related Disorders," 23.18%, followed by "Medicine," 8.7%, "Psychiatry," 6.17%, and "Gastroenterology," 5.25%. Research on alcohol is a consolidated field, with an average of 4,820 documents published each year between 2005 and 2009 in MEDLINE and Scopus. Alcohol-related publications have a marked multidisciplinary nature. Collaboration was common among alcohol researchers. There is an underrepresentation of alcohol-related publications in languages other than English and from developing countries, in MEDLINE and Scopus databases. Copyright © 2012 by the Research Society on Alcoholism.

  8. The search for mechanisms of change in behavioral treatments for alcohol use disorders: a commentary.

    Science.gov (United States)

    Longabaugh, Richard

    2007-10-01

    Definitive results from efforts to identify mechanisms of change in behavioral treatments for alcohol use disorders have been elusive. The working hypothesis guiding this paper is that one of the reasons for this elusiveness is that the models we hypothesize to account for treatments effectiveness are unnecessarily restricted and too simple. This paper aims to accomplish 3 things. First, a typography for locating potential mediators of change will be presented. In the course of doing so, a nomenclature will be proposed with the hope that this will facilitate communications among alcohol treatment researchers studying mechanisms of change. Second, alternatives to the classic test of mediation of alcohol treatment effects will be considered and one such alternative described. Third, alternative ways of conceptualizing, constructing and analyzing variables to measure mediators will be suggested. It is hoped that this commentary will facilitate research on mechanisms of change in behavioral treatments for alcohol use disorders. Behavioral change is a complex process, and the models that we develop to account for this process need to reflect this complexity. Advances in statistical approaches for testing mediation, along with a better understanding as to how to use these tools should help in moving toward this goal.

  9. ADH and ALDH polymorphisms among Alaska Natives entering treatment for alcoholism.

    Science.gov (United States)

    Segal, B

    1999-01-01

    The alcohol dehydrogenase (ADHs) and aldehyde dehydrogenases (ALDHs) involved in alcohol metabolism are polymorphic. Different alleles encode subunits of the enzymes that are related to differences in alcohol metabolism with different ethnic groups. This study examined the allele frequencies at the ADH1, ADH2, ADH3 and ALDH2 loci in Alaska Natives entering treatment for alcoholism to determine if allele frequencies at these loci differ among five distinct Alaska Native groups: Yupik and Inupiat Eskimos, Athabascan, Tlingit and Aleut. It was found that all persons were homozygous for the ADH1*1, ADH2*1 and ALDH2*1 alleles. Variations, however, were found for the allele distribution of the ADH3 genotype. Comparison with a general population sample found no differences in allele distributions for ADHs and ALDH2*1, but differences were found when comparisons were made with four Asian Groups. The study's findings suggest that the Alaska Natives are not protected from the risk of alcoholism in the same way that Asians who possess the ALDH2*2 genotype are considered to have a negative risk factor. Nor, does there appear to be any generalized differences between Alaska Native alcoholics and members of the general population with respect to the ALDH and ADH polymorphisms studied herein.

  10. Are the effects of gamma-hydroxybutyrate (GHB) treatment partly physiological in alcohol dependence?

    Science.gov (United States)

    Ameisen, Olivier

    2008-01-01

    It has been hypothesized that the therapeutic effects of Gamma-hydroxybutyrate (GHB) in alcohol dependence could be related to ethanol-mimicking action of the drug and that GHB could reduce alcohol craving, intake and withdrawal by acting as a "substitute" of the alcohol in the central nervous system. Nevertheless, alcohol being the strongest trigger of craving and intake, it is difficult to ascribe reduction of craving and intake to ethanol-mimicking activity of GHB. I have recently proposed that alcohol/substance dependence could result from a GHB-deficiency-related dysphoric syndrome in which alcohol/substances would be sought to "substitute" for insufficient GHB effect. GHB is the sole identified naturally occurring gamma-aminobutyric acid B (GABA (B)) receptor agonist. Here, I propose that exogenous GHB might in fact "substitute" for deficient endogeneous GHB and represent true substitutive treatment for GHB-deficiency. And that baclofen and GHB could both compensate for deficient effect of the physiological GABA (B) receptor agonist(s).

  11. Alcohol consumption, illicit substances, and intimate partner violence in a sample of batterers in psychological treatment.

    Science.gov (United States)

    Redondo Rodríguez, Natalia; Graña Gómez, José Luis

    2015-03-01

    The purpose of this study is to analyze the alcohol and illicit substance consumption characteristics in a sample of 572 batterers in treatment by court order. The results indicate that the prevalence of alcohol consumption in the past year was 89.3%, whereas within illicit substances, the prevalences were higher for cannabis (27.8%), followed by cocaine 20.3%). In order to analyze the possible effect of consumption on levels of perpetration and victimization of partner-aggression, the sample was divided into 4 groups: nonconsumers (16.3%), alcohol consumers (58.6%), illicit drug consumers (3.5%), and consumers of alcohol and illicit drugs (21.7%), finding that the groups of nonconsumers and alcohol consumers presented the lowest level of perpetration of psychological, physical, and sexual aggression and of victimization of psychological and physical aggression, whereas the group of consumers of alcohol and illicit drugs presented the highest levels. The results reveal the need to assess substance consumption when designing intervention protocols with batterers.

  12. Phenobarbital compared to benzodiazepines in alcohol withdrawal treatment: A register-based cohort study of subsequent benzodiazepine use, alcohol recidivism and mortality.

    Science.gov (United States)

    Askgaard, Gro; Hallas, Jesper; Fink-Jensen, Anders; Molander, Anna Camilla; Madsen, Kenneth Grønkjær; Pottegård, Anton

    2016-04-01

    Long-acting benzodiazepines such as chlordiazepoxide are recommended as first-line treatment for alcohol withdrawal. These drugs are known for their abuse liability and might increase alcohol consumption among problem drinkers. Phenobarbital could be an alternative treatment option, possibly with the drawback of a more pronounced acute toxicity. We evaluated if phenobarbital compared to chlordiazepoxide decreased the risk of subsequent use of benzodiazepines, alcohol recidivism and mortality. The study was a register-based cohort study of patients admitted for alcohol withdrawal 1998-2013 and treated with either phenobarbital or chlordiazepoxide. Patients were followed for one year. We calculated hazard ratios (HR) for benzodiazepine use, alcohol recidivism and mortality associated with alcohol withdrawal treatment, while adjusting for confounders. A total of 1063 patients treated with chlordiazepoxide and 1365 patients treated with phenobarbital were included. After one year, the outcome rates per 100 person-years in the phenobarbital versus the chlordiazepoxide cohort were 9.20 vs. 5.13 for use of benzodiazepine, 37.9 vs. 37.9 for alcohol recidivism and 29 vs. 59 for mortality. Comparing phenobarbital to chlordiazepoxide treated, the HR of subsequent use of benzodiazepines was 1.56 (95%CI 1.05-2.30). Similarly, the HR for alcohol recidivism was 0.99 (95%CI 0.84-1.16). Lastly, the HR for 30-days and 1 year mortality was 0.25 (95%CI 0.08-0.78) and 0.51 (95%CI 0.31-0.86). There was no decreased risk of subsequent benzodiazepine use or alcohol recidivism in patients treated with phenobarbital compared to chlordiazepoxide. Phenobarbital treatment was associated with decreased mortality, which might be confounded by somatic comorbidity among patients receiving chlordiazepoxide. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Addressing the intersection between alcohol consumption and antiretroviral treatment: needs assessment and design of interventions for primary healthcare workers, the Western Cape, South Africa.

    Science.gov (United States)

    Schneider, M; Chersich, M; Temmerman, M; Parry, C D

    2016-10-26

    At the points where an infectious disease and risk factors for poor health intersect, while health problems may be compounded, there is also an opportunity to provide health services. Where human immunodeficiency virus (HIV) infection and alcohol consumption intersect include infection with HIV, onward transmission of HIV, impact on HIV and acquired immunodeficiency syndrome (AIDS) disease progression, and premature death. The levels of knowledge and attitudes relating to the health and treatment outcomes of HIV and AIDS and the concurrent consumption of alcohol need to be determined. This study aimed to ascertain the knowledge, attitudes and practices of primary healthcare workers concerning the concurrent consumption of alcohol of clinic attendees who are prescribed antiretroviral drugs. An assessment of the exchange of information on the subject between clinic attendees and primary healthcare providers forms an important aspect of the research. A further objective of this study is an assessment of the level of alcohol consumption of people living with HIV and AIDS attending public health facilities in the Western Cape Province in South Africa, to which end, the study reviewed health workers' perceptions of the problem's extent. A final objective is to contribute to the development of evidence-based guidelines for AIDS patients who consume alcohol when on ARVs. The overall study purpose is to optimise antiretroviral health outcomes for all people living with HIV and AIDS, but with specific reference to the clinic attendees studied in this research. Overall the research study utilised mixed methods. Three group-specific questionnaires were administered between September 2013 and May 2014. The resulting qualitative data presented here supplements the results of the quantitative data questionnaires for HIV and AIDS clinic attendees, which have been analysed and written up separately. This arm of the research study comprised two, separate, semi-structured sets of

  14. Situational drinking in private and public locations: A multilevel analysis of blood alcohol level in Finnish drinking occasions.

    Science.gov (United States)

    Mustonen, Heli; Mäkelä, Pia; Lintonen, Tomi

    2016-11-01

    The first aim was to estimate the extent to which the variation in alcohol use across specific drinking occasions arises from variation at the occasion level and from variation at the drinker level. The second aim was to identify characteristics of drinking situations that moderate or increase situational alcohol use beyond the influence of drinker-level characteristics. The general population aged 15-69 years in Finland was sampled randomly in 2008. The multilevel analysis was based on data from 1511 drinkers and 2933 drinking occasions that occurred in the 7 days before the interview. Alcohol use was operationalised as estimated blood alcohol level (BAL). Characteristics of drinking occasions included location, circumstance, company and timing. Drinker-level data included demographic and drinking pattern variables. Fifty-three percent of the variance in BAL was between occasions and 47% between respondents, for both women and men. With drinking patterns and demographic characteristics controlled for, the dominant characteristics of drinking occasions predisposing to greater intoxication were late-night drinking, across locations and for both genders. For private locations, predisposing characteristics included drinking on weekends for both genders and drinking with friends for men. Situational and drinker levels are equally important in determining the BAL in drinking occasions; therefore, prevention efforts should be targeted at both risky individuals and risky drinking occasions. Occasions occurring late at night, often at home and with friends, are a central challenge for targeting preventive efforts related to situational drinking.[Mustonen H, Mäkelä P, Lintonen T. Situational drinking in private and public locations: A multilevel analysis of blood alcohol level in Finnish drinking occasions. Drug Alcohol Rev 2016;35:772-784]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  15. Assertive Community Treatment For People With Alcohol Dependence: A Pilot Randomized Controlled Trial

    Science.gov (United States)

    Gilburt, Helen; Burns, Tom; Copello, Alex; Crawford, Michael; Day, Ed; Deluca, Paolo; Godfrey, Christine; Parrott, Steve; Rose, Abigail; Sinclair, Julia; Coulton, Simon

    2017-01-01

    Abstract Aims A pilot randomized controlled trial (RCT) to assess the feasibility and potential efficacy of assertive community treatment (ACT) in adults with alcohol dependence. Methods Single blind, individually randomized, pilot RCT of 12 months of ACT plus treatment as usual (TAU) versus TAU alone in adults (age 18+ years) with alcohol dependence and a history of previous unsuccessful alcohol treatment attending specialist community alcohol treatment services. ACT aimed to actively engage participants for 12 months with assertive, regular, minimum weekly contact. ACT was combined with TAU. TAU comprised access to the full range of services provided by the community teams. Primary outcome is mean drinks per drinking day and percent days abstinent at 12 months follow up. Analysis of covariance was conducted using 80% confidence intervals, appropriate in the context of a pilot trial. Results A total of 94 participants were randomized, 45 in ACT and 49 in TAU. Follow-up was achieved with 98 and 88%, respectively at 12 months. Those in ACT had better treatment engagement, and were more often seen in their homes or local community than TAU participants. At 12 months the ACT group had more problems related to drinking and lower quality of life than TAU but no differences in drinking measures. The ACT group had a higher percentage of days abstinent but lower quality of life at 6 months. The ACT group had less unplanned healthcare use than TAU. Conclusions An trial of ACT was feasible to implement in an alcohol dependent treatment population. Trial registration ISRCTN22775534 PMID:27940571

  16. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  17. Relationship of Depression, Sociopathy, and Locus of Control to Treatment Outcome in Alcoholics

    Science.gov (United States)

    Caster, David U.; Parsons, Oscar A.

    1977-01-01

    Depression, sociopathy, and Levenson's tridimensional locus of control orientation were studied in four groups of veteran male alcoholics, who varied as to degree of benefit from therapeutic programs, and a group of controls. Higher depression scores were found in those groups that appeared to benefit less from treatment. (Author)

  18. The level of alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment.

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    BACKGROUND: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was hyp

  19. The Level of Alexithymia in Alcohol-Dependent Patients Does Not Influence Outcomes after Inpatient Treatment

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was hyp

  20. Alcohol Withdrawal Syndrome: Symptom-Triggered versus Fixed-Schedule Treatment in an Outpatient Setting

    DEFF Research Database (Denmark)

    Elholm, B.; Larsen, Klaus; Hornnes, N.

    2011-01-01

    , time to relapse and patient satisfaction were measured. Patients assessed their symptoms using the Short Alcohol Withdrawal Scale (SAWS). Patient satisfaction was monitored by the Diabetes Treatment Satisfaction Questionnaire. We used the Well-Being Index and the European addiction severity index...... of AWS. The SAWS is a powerful monitoring tool, because it is brief and permits the subject to log the withdrawal symptoms....

  1. Liver haemodynamics and function in alcoholic cirrhosis. Relation to testosterone treatment and ethanol consumption

    DEFF Research Database (Denmark)

    Gluud, C; Henriksen, J H

    1987-01-01

    Liver haemodynamics and liver function were measured in 34 alcoholic cirrhotic men before entry and after 12 months (median) in a double-blind, placebo-controlled study on the effect of oral testosterone treatment (200 mg t.i.d.). Comparing data at entry with those at follow-up in the total patie...

  2. Marital Therapy and Spouse Involvement in the Treatment of Depression, Agoraphobia, and Alcoholism.

    Science.gov (United States)

    Jacobson, Neil S.; And Others

    1989-01-01

    Examines literature on marital therapy and spouse involvement as treatments for major psychopathology, focusing on depression, agoraphobia, and alcoholism. For each disorder, examines relation between marital dynamics and disorder and discusses empirical efforts to evaluate impact of marital therapy or spouse involvement on disorder. Summarizes…

  3. The level of alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment.

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    BACKGROUND: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  4. The level of Alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment

    NARCIS (Netherlands)

    de Haan, Hein A.; Schellekens, Arnt F.A.; van der Palen, Jacobus Adrianus Maria; Verkes, Robbert-Jan; Buitelaar, Jan K.; de Jong, Cor A.J.

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  5. The Level of Alexithymia in Alcohol-Dependent Patients Does Not Influence Outcomes after Inpatient Treatment

    NARCIS (Netherlands)

    Haan, H.A. de; Schellekens, A.F.A.; Palen, J. van der; Verkes, R.J.; Buitelaar, J.K.; Jong, C.A.J. de

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was

  6. The level of Alexithymia in alcohol-dependent patients does not influence outcomes after inpatient treatment

    NARCIS (Netherlands)

    Haan, de Hein A.; Schellekens, Arnt F.A.; Palen, van der Job; Verkes, Robbert-Jan; Buitelaar, Jan K.; Jong, de Cor A.J.

    2012-01-01

    Background: The inability of individuals with Alcohol Use Disorders (AUD) to recognize and describe their feelings and cravings may be due to alexithymia. Previous researches have shown evidence for a negative influence of alexithymia on treatment outcomes in patients with AUD. Therefore, it was hyp

  7. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    Science.gov (United States)

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  8. Does Oxidative Stress Induced by Alcohol Consumption Affect Orthodontic Treatment Outcome?

    Science.gov (United States)

    Barcia, Jorge M.; Portolés, Sandra; Portolés, Laura; Urdaneta, Alba C.; Ausina, Verónica; Pérez-Pastor, Gema M. A.; Romero, Francisco J.; Villar, Vincent M.

    2017-01-01

    HIGHLIGHTS Ethanol, Periodontal ligament, Extracellular matrix, Orthodontic movement. Alcohol is a legal drug present in several drinks commonly used worldwide (chemically known as ethyl alcohol or ethanol). Alcohol consumption is associated with several disease conditions, ranging from mental disorders to organic alterations. One of the most deleterious effects of ethanol metabolism is related to oxidative stress. This promotes cellular alterations associated with inflammatory processes that eventually lead to cell death or cell cycle arrest, among others. Alcohol intake leads to bone destruction and modifies the expression of interleukins, metalloproteinases and other pro-inflammatory signals involving GSKβ, Rho, and ERK pathways. Orthodontic treatment implicates mechanical forces on teeth. Interestingly, the extra- and intra-cellular responses of periodontal cells to mechanical movement show a suggestive similarity with the effects induced by ethanol metabolism on bone and other cell types. Several clinical traits such as age, presence of systemic diseases or pharmacological treatments, are taken into account when planning orthodontic treatments. However, little is known about the potential role of the oxidative conditions induced by ethanol intake as a possible setback for orthodontic treatment in adults. PMID:28179886

  9. Onset of Alcohol or Substance Use Disorders Following Treatment for Adolescent Depression

    Science.gov (United States)

    Curry, John; Silva, Susan; Rohde, Paul; Ginsburg, Golda; Kennard, Betsy; Kratochvil, Christopher; Simons, Anne; Kirchner, Jerry; May, Diane; Mayes, Taryn; Feeny, Norah; Albano, Anne Marie; Lavanier, Sarah; Reinecke, Mark; Jacobs, Rachel; Becker-Weidman, Emily; Weller, Elizabeth; Emslie, Graham; Walkup, John; Kastelic, Elizabeth; Burns, Barbara; Wells, Karen; March, John

    2012-01-01

    Objective: This study tested whether positive response to short-term treatment for adolescent major depressive disorder (MDD) would have the secondary benefit of preventing subsequent alcohol use disorders (AUD) or substance use disorders (SUD). Method: For 5 years, we followed 192 adolescents (56.2% female; 20.8% minority) who had participated in…

  10. The application of Bandura's self-efficacy theory to abstinence-oriented alcoholism treatment.

    Science.gov (United States)

    Rollnick, S; Heather, N

    1982-01-01

    This paper explores the relevance of self-efficacy theory (Bandura, 1977b) to the process of abstinence treatment and the phenomenon of relapse. By distinguishing between the particular efficacy and outcome expectations created in treatment it is possible to clarify some of the problems encountered between clinicians and alcoholics. Bandura's theory also explains why some treatment methods might be more effective than others. Analysis of relapse suggests that while some of the expectations created in treatment might serve to promote abstinence, others might unwittingly precipitate relapse. The understanding of abstinence treatment could be enhanced by the testing of hypotheses which emerge from this analysis.

  11. [Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part I: Screening, Early Detection and Risk Factors in Patients with Alcohol Abuse or Dependence].

    Science.gov (United States)

    de la Espriella Guerrero, Ricardo; de la Hoz Bradford, Ana María; Gómez-Restrepo, Carlos; Zárate, Alina Uribe-Holguín; Menéndez, Miguel Cote; Barré, Michelle Cortés; Rentería, Ana María Cano; Hernández, Delia Cristina

    2012-12-01

    Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. 70 % of people under risk of having alcohol problems go undetected in medical practice, a fact that underlines the need for specific screening measures allowing early detection leading to timely treatment. This article presents evidence gathered by alcohol abuse and dependence screening as well as by risk factor identification and screening. It also presents evidence concerning withdrawal symptoms, delirium tremens and Wernicke's encephalopathy in order to promote early detection and timely treatment. Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Evidence was found and recommendations were made for the pertinent screening and search of risk factors, in order to perform a diagnosis and carry out a timely management of alcohol abuse, dependence and ensuing complications: withdrawal syndrome, delirium tremens and Wernicke's encephalopathy. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  12. [Clinical Practice Guide for Early Detection, Diagnosis and Treatment of the Acute Intoxication Phase in Patients with Alcohol Abuse or Dependence: Part II: Evaluation and Management of Patients with Acute Alcohol Intoxication].

    Science.gov (United States)

    de la Espriella Guerrero, Ricardo; de la Hoz Bradford, Ana María; Zárate, Alina Uribe-Holguín; Lee, Patricia Rodríguez; Menéndez, Miguel Cote; Rentería, Ana María Cano; Hernández, Delia Cristina; Cardeño, Carlos; Barré, Michelle Cortés; Kunzel, Gabriel Hernández; Gómez-Restrepo, Carlos

    2012-12-01

    Worldwide, alcohol is the second most-used psychotropic substance and the third risk factor for early death and disability. Its noxious use is a world public health problem given its personal, labor, family, economic and social impact. The identification of acute alcohol intoxication is extremely important, as well as the alcohol withdrawal syndrome and its complications, such as delirium tremens and Wernicke's encephalopathy in order to grant a timely treatment for those patients. This article introduces the evidence found so as to face and treat these clinic manifestations. Systematic revision of the evidence available together with an evaluation of pertinent guidelines found in literature so as to decide whether to adopt or adapt the existing recommendation for each question or to develop de novo recommendations. For de novo recommendations as well as those adapted, it was carried out an evidence synthesis, together with evidence tables and formulation of recommendations based on the evidence. Evidence was found and recommendations were made for the diagnosis and treatment of acute alcohol intoxication, withdrawal syndrome, delirium tremens and Wernicke's encephalopathy. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  13. [The effectiveness of psychosocial treatment approaches for alcohol dependence--a review].

    Science.gov (United States)

    Bottlender, M; Köhler, J; Soyka, M

    2006-01-01

    Treatment approaches which are used in the context of inpatient alcoholism treatment are frequently neither theoretically justified nor empirically examined. In view of the enormous method variety the necessity exists for the development of treatment guidelines in order to offer indicators of promising treatment achievement for practitioners and pension funds. In a first step, it must be examined which treatments are effective, which are ineffective and which are possibly even counter-productive. This article aims to give a comprehensive review of randomized-controlled studies/meta-analysis on the efficacy of different treatment approaches. This article reporting the literature review is part of a larger programme to develop clinical practice guidelines for rehabilitation which is supported in form, content and finance by the German Pension Institute for Salaried Employees (Bundesversicherungsanstalt für Angestellte, BfA). Summing up, treatment is effective compared to no treatment. Cognitive behavioural therapy included in a multimodal treatment program is effective. There are a number of treatment protocols for which controlled research has consistently found positive results like social skills training, community reinforcement approaches, behaviour contracting, motivation-enhancing treatment, and family/marital therapy. There is also a number of commonly used treatment approaches that brought neither a positive result or were counter productive like relapse prevention, non-behavioural marital therapy, and insight psychotherapy, confrontational counseling, education, relaxation training, and milieu therapy. Support for matching to a specific treatment is weak, but interventions against alcohol problems should be differentiated according to the severity of the alcohol problem. Since treatment evaluation is mainly accomplished in the US and supplying structures with respect to the US and Germany are substantially different, a generalized transmission of US

  14. The positive and negative health effects of alcohol- and the public health implications

    DEFF Research Database (Denmark)

    Grønbaek, M

    2009-01-01

    In this paper, the negative and the positive effects of alcohol on health are reviewed. It is first of all established facts that a high alcohol intake implies an increased risk of a large number of health outcomes, such as dementia, breast cancer, colorectal cancer, cirrhosis, upper digestive...

  15. Alcohol and the Workplace. WHO Regional Publications, European Series, No. 67.

    Science.gov (United States)

    Henderson, Marion; Hutcheson, Graeme; Davies, John

    Alcohol is the most widely used drug in the world and its use in the workplace can have serious consequences on safety, productivity, working relationships, and absenteeism. Some of the effects of alcohol consumption on the workplace, along with the types of responses that companies can make, are covered in this review. The text opens with a…

  16. Parenting Manuals on Underage Drinking: Differences between Alcohol Industry and Non-Industry Publications

    Science.gov (United States)

    Lindsay, Gordon B.; Merrill, Ray M.; Owens, Adam; Barleen, Nathan A.

    2008-01-01

    Background: There is some debate over the efficacy of alcohol industry parenting manuals. Purpose: This study compares the content and focus of alcohol industry and non-industry "talk to your child about drinking" parenting manuals. Methods: Parenting manuals from Anheuser-Busch and Miller Brewing Company were compared to federal government and…

  17. Boarding and Public Schools: Navajo Educational Attainment, Conduct Disorder, and Alcohol Dependency.

    Science.gov (United States)

    Henderson, Eric; Kunitz, Stephen J.; Gabriel, K. Ruben; McCright, Aaron; Levy, Jerrold E.

    1998-01-01

    Interviews with over 1,000 Navajos aged 21-67 in 1992-95 found that alcohol dependency was less common among high school graduates than dropouts but was also disproportionately low among older men with no schooling. Despite abusive conditions that prevailed in some Indian boarding schools, alcohol dependency rates did not differ by type of school…

  18. The Efficacy of Disulfiram for the Treatment of Alcohol Use Disorder

    DEFF Research Database (Denmark)

    Jørgensen, Charlotte H; Pedersen, Bolette; Tønnesen, Hanne

    2011-01-01

    Background: Alcohol use disorders (AUD) involving hazardous, harmful, and addictive misuse of alcohol are widespread in most parts of the world. The aim of this study was to review the effect of disulfiram in the treatment of patients with AUD. The effect of disulfiram was evaluated according...... Register of Controlled Trials (CENTRAL). Results: Eleven randomized controlled trials were included with a total of 1,527 patients. They compared disulfiram treatment with placebo, none or other abstinence-supportive treatments. Overall, 6 studies reported of a significant better effect on abstinence......-analyses, but valid results were found regarding the effect of disulfiram versus placebo over 12 months and unsupervised disulfiram versus other or no treatment. The vast majority of significant studies were of shorter duration, while only 3 studies of 12 months were significant regarding more days until relapse and...

  19. Is there any progress in the treatment of non-alcoholic fatty liver disease?

    Institute of Scientific and Technical Information of China (English)

    Emmanuel; A; Tsochatzis; George; V; Papatheodoridis

    2011-01-01

    Despite the fact that non-alcoholic fatty liver disease(NAFLD) and its severe clinical form,non-alcoholic steatohepatitis,are becoming increasingly prevalent in the industrialised countries,there are no licensed pharmacological treatments for them.Weight loss and life modifications,antioxidant therapies and insulin-sensitising agents are the current treatment strategies and have all been tested with inconclusive results.Low sample numbers,inadequate treatment duration and invalid surrogate markers for treatment response might all account for these results.As NAFLD is a systemic rather than a liver disease,future trials should address the patient as a whole and also address cardiovascular risk factors.

  20. [SEMERGEN positioning for the treatment of alcohol disorders in primary care].

    Science.gov (United States)

    Arbesú, José Ángel; Gual, Antoni; Casquero, Rafael; Bobes, Julio; Ortega, Patricia

    2015-12-01

    The present manuscript is based on the recommendations of a panel of health care professionals, including several experts in primary health care, psychiatry and addictions. The participants are recognized specialists in the treatment of alcohol use disorder. The panel met in Barcelona on 2015 April 22 with the aims of evaluating the current management of alcohol use disorder in primary health care and developing a strategy to address this problem, basing on the evidence and the recommendations of the scientific societies and national and international organizations. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Rural y Generalista (SEMERGEN). All rights reserved.

  1. Dexmedetomidine as an adjuvant in the treatment of alcohol withdrawal delirium: a case report.

    Science.gov (United States)

    Rovasalo, Aki; Tohmo, Harri; Aantaa, Riku; Kettunen, Eija; Palojoki, Riitta

    2006-01-01

    In this case report, even a moderate dose of dexmedetomidine, a very selective alpha(2)-adrenergic agent, resulted in a rapid response to alcohol withdrawal delirium after the standard treatment. Psychiatrists should be aware of this relatively new drug that provides advantages over clonidine, heavy sedation and secondary restraints. Dexmedetomidine should be further evaluated in the treatment of specific forms of aggressive behavior and complicated withdrawal states.

  2. A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse

    OpenAIRE

    Millie J. Darvell; Kavanagh, David J; Connolly, Jennifer M.

    2015-01-01

    Background: Many Internet-based treatments for depression and for alcohol misuse have a positive impact, yet little is known about how these treatments work. Most research on web-based interventions involves efficacy trials which, while important, offer little explanation about how people perceive and use online programs. Objective: This study aimed to undertake a qualitative exploration of participants' experience, perceived impact and use of an integrated web-based program for comorbid d...

  3. Assessment and treatment of insomnia in adult patients with alcohol use disorders.

    Science.gov (United States)

    Brower, Kirk J

    2015-06-01

    Insomnia in patients with alcohol dependence has increasingly become a target of treatment due to its prevalence, persistence, and associations with relapse and suicidal thoughts, as well as randomized controlled studies demonstrating efficacy with behavior therapies and non-addictive medications. This article focuses on assessing and treating insomnia that persists despite 4 or more weeks of sobriety in alcohol-dependent adults. Selecting among the various options for treatment follows a comprehensive assessment of insomnia and its multifactorial causes. In addition to chronic, heavy alcohol consumption and its effects on sleep regulatory systems, contributing factors include premorbid insomnia; co-occurring medical, psychiatric, and other sleep disorders; use of other substances and medications; stress; environmental factors; and inadequate sleep hygiene. The assessment makes use of history, rating scales, and sleep diaries as well as physical, mental status, and laboratory examinations to rule out these factors. Polysomnography is indicated when another sleep disorder is suspected, such as sleep apnea or periodic limb movement disorder, or when insomnia is resistant to treatment. Sobriety remains a necessary, first-line treatment for insomnia, and most patients will have some improvement. If insomnia-specific treatment is needed, then brief behavioral therapies are the treatment of choice, because they have shown long-lasting benefit without worsening of drinking outcomes. Medications work faster, but they generally work only as long as they are taken. Melatonin agonists; sedating antidepressants, anticonvulsants, and antipsychotics; and benzodiazepine receptor agonists each have their benefits and risks, which must be weighed and monitored to optimize outcomes. Some relapse prevention medications may also have sleep-promoting activity. Although it is assumed that treatment for insomnia will help prevent relapse, this has not been firmly established. Therefore

  4. Who Is Using What in the Public Schools: The Interrelationships among Alcohol, Drug and Tobacco Use by Adolescents in New Brunswick Classrooms.

    Science.gov (United States)

    Grobe, Cary; Campbell, Elaine

    1990-01-01

    Attempted to discover patterns of alcohol, drug, and tobacco use among public school children in New Brunswick using Provincial School Drug Survey (PSDS), an existing large-scale assessment. Recoded variables in PSDS dataset to derive profiles of typical tobacco, cannabis, and alcohol users. Found increase in predictive accuracy of regression…

  5. Impact of binge alcohol on mortality among people who inject drugs

    Directory of Open Access Journals (Sweden)

    Cheyenne Johnson

    2015-12-01

    Conclusions: Binge alcohol use was associated with time to all-cause mortality among PWID in this setting. Since alcohol use is often overlooked as a risk factor for mortality among this population, these findings highlight the continued need to incorporate addiction treatment and public health interventions and policies that address binge alcohol use to reduce alcohol related-harms.

  6. An empirical description of phases of maintenance following treatment for alcohol dependence.

    Science.gov (United States)

    Murphy, S A; Hoffman, A L

    1993-01-01

    This article reports two longitudinal prospective studies conducted sequentially to describe participants' maintenance of abstinence experiences up to 36 months posttreatment. Study 1 reports responses of 102 subjects who maintained alcohol abstinence following treatment and who were assessed for duration and intensity of symptoms associated with postacute withdrawal at baseline, 3, 6, and 12 months. A decreasing linear trend of symptoms was found as time of alcohol abstinence increased. Study 2 obtained interview and survey data from 23 successful abstainers from Study 1 at 12, 18, and 36 months posttreatment to describe coping strategies, perceptions of relapse risk, extent and duration of "aftercare," and substitute addictions as these phenomena developed and changed over time. Multiple occasions of data collection supported the description of three phases of maintenance: symptom stabilization/management accompanied by a cognitive paradigm shift, distancing self from alcohol-dependent behavior, and normalization of life processes.

  7. Add on dexmedetomidine in the treatment of severe alcohol withdrawal in a patient of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Roshan Madan Shende

    2015-09-01

    Full Text Available According to American statistics 90% of people drink alcohol at some time in life. The estimated prevalence of alcohol abuse among hospitalized in patients is 20 % and 10- 33 % in patients admitted to the ICU. Approximately 18% of these patients will develop alcohol withdrawal syndrome (AWS whose symptoms can include physical and psychological manifestations that range from mild to life threatening. Although AWS has been reported in literature in post-operative periods and in intensive care unit, there is less information on treatment and preparing of a patient with AWS, coming for emergency surgical procedure. The surgical stress and deranged liver functions possess an additional challenge to the anesthesiologist. Here we are reporting the successful management of a case of delirium tremens by using Dexmedetomidine in pre, intra and post-operative period in a patient with hollow viscous perforation for emergency laparotomy. [Int J Res Med Sci 2015; 3(9.000: 2446-2449

  8. Health issues in the Arab American community. Arab Americans in publicly financed substance abuse treatment.

    Science.gov (United States)

    Arfken, Cynthia L; Kubiak, Sheryl Pimlott; Koch, Alison L

    2007-01-01

    To determine the characteristics of Arab Americans receiving treatment and to compare them with individuals of other ethnic groups. We used admission data (FY2005) for Michigan publicly funded substance abuse treatment (N=69,989). Arab American ethnicity (n=224 or 0.3% of admissions) was defined by codes for race, ethnicities or primary language of Arabic (n=21). Other ethnicities examined were American Indian, Hispanic, African American, and White. The number of Arab American admissions was lower than expected for the population (RR=0.25). Admissions were concentrated (81%) in metropolitan Detroit as is the community (82%, RR=.99), unlike other ethnicities. Primary drugs of abuse were alcohol (34.8%), marijuana (17.9%), heroin (17.4%) and crack cocaine (15.6%). Mean duration of use (11.2 yrs) was significantly lower than for other ethnicities. Arab American admissions were predominately male (76.3%), unemployed (62.1%) and with criminal justice involvement (58%), similar to other ethnicities. Using administrative database has its limits and may misclassify ethnicities. Based upon the available data, it appears that Arab Americans accounted for a small percentage of admissions to publicly funded substance abuse treatment in Michigan. Most of the admissions listed English as the primary language, raising concern that language may be a barrier to entry. Admission profiles were generally similar across ethnicities, except that Arab Americans were entering treatment after shorter duration of use. These data can inform development of treatment programs and outreach efforts.

  9. Hazardous use of alcohol among undergraduate students at a public university

    Directory of Open Access Journals (Sweden)

    Amilton Santos Jr

    2014-01-01

    Full Text Available Background The potentially harmful consequences of alcohol use among undergraduates have become a growing concern in recent years. Objectives This study aimed to determine the prevalence of hazardous use of alcohol in this population and to identify demographic and psychosocial factors associated with this pattern of consumption. Methods This was a cross-sectional study using an anonymous and self-completed questionnaire in the classroom. The questionnaire was administered to 1,290 enrolled male and female students, which comprised a proportional sample of the main areas of knowledge at University of Campinas. The questionnaire produced sociodemographic and psychosocial profiles and the Alcohol Use Disorders Identification Test was used to detect hazardous use of alcohol. Results The prevalence of hazardous use of alcohol among the study participants was 24%. Male gender, subjective perceived social support in case of difficulties, being sexually active, not dating, having smoked tobacco cigarettes or marijuana, and having used other illicit psychoactive substances were associated with hazardous use of alcohol. Discussion Variables related to gender, sexuality, affective partnerships, and consumption of other psychoactive substances were associated with hazardous use of alcohol, which was identified in a quarter of the evaluated students, and indicate the need for strategies to prevent and to treat problems.

  10. Within-session communication patterns predict alcohol treatment outcomes.

    Science.gov (United States)

    Houck, Jon M; Moyers, Theresa B

    2015-12-01

    Within-session client speech is theorized to be a key mechanism of behavior change in motivational interviewing (MI), a directional, client-centered approach to behavior change. Client change talk (CT: speech indicating movement toward changing a problematic health behavior) and sustain talk (ST: speech supporting continuing a problematic health behavior) have each shown relationships with outcomes. However, it may be the case that patterns of within-session client speech, rather than counts of client speech, are important for producing change. Recorded initial MI/MET psychotherapy sessions from Project MATCH had been previously rated using the Motivational Interviewing Sequential Code for Observing Process Exchange (MI-SCOPE), a mutually exclusive and exhaustive sequential coding system. From these existing data, session conditional probabilities for transitions of interest (the transition from CT to more CT, and the transition from reflections of CT to CT) were analyzed as empirical Bayes estimates of log-normalized odds ratios. CT frequencies and these log-normalized odds ratios were entered as independent variables into longitudinal generalized estimating equation (GEE) models predicting within-treatment and post-treatment drinking. While all variables were significant predictors of within-treatment drinking, only the CT-CT transition emerged as a significant predictor of decreased drinking after treatment. The momentum of a client's speech about change during an MI session may be a better predictor of outcome than is a simple frequency count of it. Attending not only to the mere occurrence of CT, but also recognizing the importance of consecutive client statements of CT, may improve treatment outcomes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Current Findings and Mechanisms of Action of Disulfiram in the Treatment of Alcohol Dependence.

    Science.gov (United States)

    Mutschler, J; Grosshans, M; Soyka, M; Rösner, S

    2016-07-01

    As an alcohol-aversive agent, disulfiram occupies an exceptional position in the pharmacological relapse prevention of alcohol dependence. In contrast to anti-craving drugs, disulfiram does not modulate neurobiological mechanisms of addiction, but rather works by producing an aversive reaction when combined with alcohol. Therapeutic and adverse effects are therefore closely related: On the one hand, the aversiveness of the disulfiram ethanol reaction has the potential to support abstinence in a subgroup of alcohol-dependent patients, while on the other hand it becomes a health threat if the patient fails to maintain complete abstinence. The exceptional position of disulfiram is also related to the role that expectations play in the mediation of therapeutic effects. These are not determined by the pharmacological effects or the actual occurrence of a disulfiram-ethanol reaction, but are attributable to patient awareness that the drug was consumed and the corresponding anticipation of an aversive reaction if combined with alcohol. This is in line with the findings of a recent meta-analysis that only showed significant effects for disulfiram in open-label trials. The authors of the meta-analysis conclude that due to expectations induced in both the treatment and placebo groups, blinded studies are incapable of distinguishing a difference between groups. The mediation of therapeutic effects through expectation has a number of consequences for clinical practice and future research on disulfiram.

  12. The Effects of Boys & Girls Clubs on Alcohol and Other Drug Use and Related Problems in Public Housing. Final Research Report.

    Science.gov (United States)

    Schinke, Steven P.; And Others

    This comparative study evaluates the effects of Boys and Girls Clubs and related SMART Moves drug prevention programs on children and adolescents living in public housing and on the quality of life in public housing. The study involves 15 public housing developments in a representative sample of American cities and focuses on alcohol and other…

  13. The Effects of Boys & Girls Clubs on Alcohol and Other Drug Use and Related Problems in Public Housing. Final Research Report.

    Science.gov (United States)

    Schinke, Steven P.; And Others

    This comparative study evaluates the effects of Boys and Girls Clubs and related SMART Moves drug prevention programs on children and adolescents living in public housing and on the quality of life in public housing. The study involves 15 public housing developments in a representative sample of American cities and focuses on alcohol and other…

  14. [Early detection, negotiation and treatment of alcohol use disorders in primary care].

    Science.gov (United States)

    Reimer, J; Cimander, K F; Reimer, C

    2014-05-01

    Subjects with alcohol dependence or alcohol-related health problems frequently use the primary care system without receiving the correct diagnosis or specific interventions. Stigma, lack of knowledge and know-how with regards to diagnosis and treatment of alcohol-related disorders on the site of the health care professionals may contribute to the treatment gap. General anamnesis, clinical evaluation, and laboratory parameters can serve as indicators, and validated screening tests can further corroborate the hypothesis. However, a diagnosis should only be made according to ICD-10 criteria. Adequate counselling techniques substantially contribute to successful physician-patient interaction. Motivational Interviewing combines a positive, appreciative attitude with communicative techniques to create a motivation to change. It includes general approaches as open questions, appreciation of the patient, active listening, summarizing results as well as specific approaches such as change and confidence talk and dealing with resistance. Within a positive relationship, the conversation can lead to change. Brief interventions cover four to five sessions with a duration between five and sixty minutes. Brief interventions based on an empathic attitude und reflection of findings, a brief advice leaving the responsibility on the patient's side and supporting self-efficacy can improve alcohol-related disorders. The transtheoretical model of change may help the health care provider to adapt intervention strategies to the patient's state. Primary health care provides an adequate framework for screening, diagnosis and intervention for alcohol-related disorders with the aim of reduction or abstinence. Further institutions in addiction treatment such as self-help and clinical institutions may complement the treatment system.

  15. Public, official, and industry submissions on a Bill to increase the alcohol minimum purchasing age: A critical analysis.

    Science.gov (United States)

    Kypri, Kypros; Wolfenden, Luke; Hutchesson, Melinda; Langley, John; Voas, Robert

    2014-07-01

    In 2005 a Bill was introduced to the New Zealand parliament to increase the alcohol minimum purchasing age (MPA) from 18 to 20 years and submissions were invited from interested parties. We sought to characterise and critique the arguments tendered for and against the proposal. We used template analysis to study written submissions on the Bill from 178 people and organisations in New Zealand. Independent raters coded submissions according to the source, whether for or opposed, and the arguments employed. The most common sources of submissions were members of the public (28%), the alcohol industry (20%), and NGOs (20%). Overall, 40% opposed increasing the MPA, 40% were in favour, 4% supported a split MPA (18 years for on-premise, 20 years for off-premise), 7% were equivocal, and 8% offered no comment. The most common proponents of increasing the MPA were NGOs (36%) and members of the public (30%) and their arguments concerned the expected positive effects on public health (36%) and public disorder/property damage (16%), while 24% argued that other strategies should be used as well. The most common sources of opposition to increasing the MPA were the alcohol industry (50%) and the public (20%). It was commonly claimed that the proposed law change would be ineffective in reducing harm (22%), that other strategies should be used instead (16%), that it would infringe adult rights (15%), and that licensed premises are safe environments for young people (14%). There were noteworthy examples of NGOs and government agencies opposing the law change. The alcohol industry maximised its impact via multiple submissions appealing to individual rights while neglecting to report or accurately characterise the scientific evidence. Several health and welfare agencies presented confused logic and/or were selective in their use of scientific evidence. In contrast to the fragmented and inconsistent response from government and NGOs, the alcohol industry was organised and united, with

  16. Priorities for policy research on treatments for alcohol and drug use disorders.

    Science.gov (United States)

    McCarty, Dennis; McConnell, K John; Schmidt, Laura A

    2010-09-01

    The Robert Wood Johnson Foundation's Substance Abuse Policy Research Program (SAPRP) supported 368 awards for nearly $60 million to complete policy research related to alcohol, tobacco, and illicit drug use and abuse. As part of its closure in 2009, SAPRP commissioned four papers that articulated policy research priorities for tobacco cessation and control, alcohol prevention, drug prevention, and addiction treatment. The papers were released at a Congressional Briefing on October 2, 2009 and are available on the SAPRP Web site (http://www.saprp.org/Research_Agenda.cfm). An abridged version of the treatment policy paper summarizes what we know, what we need to know, and research recommendations. The paper examines five categories of policy concerns that are likely to affect addiction treatment services over the next 5 years: (a) organization and delivery of care, (b) quality of care, (c) evidence-based practices, (d) access to care, and (e) financing, costs, and value of care. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Acardiac twin pregnancy: successful intrauterine ablative treatment with alcohol at 14 weeks of gestation.

    Science.gov (United States)

    Guven, M A; Koc, O; Bodur, H; Erkanli, S; Bagis, T; Usal, D

    2016-01-01

    Twin reversed arterial perfusion (TRAP) sequence is a serious condition of monochorionic twin pregnancy, occurring in approximately one in 35,000 cases. First trimester treatment of TRAP sequence is controversial with higher incidence of procedure related complications. Present case demonstrates a TRAP sequence that was managed by intrauterine treatment with one-ml 100% pure alcohol injection into the abdominal part of the umbilical artery and obliteration of the acardiac twin at 14 weeks of gestation. Antenatal follow-up was uneventful and elective cesarean section was performed at 39 weeks' gestation. Postnatal outcome of the pump twin was excellent at 30 months after birth. Early second trimester elective ablation by alcohol injection can be an inexpensive, alternative, and reasonable minimal invasive treatment option to prevent fetal loss of pump twin before mid and late second trimester in perinatology centers where intrafetal cord occlusive methods are not available.

  18. A smartphone application of alcohol resilience treatment for behavioral self-control training.

    Science.gov (United States)

    Yu, Fei; Albers, Jörg; Gao, Tian; Wang, Minghao; Bilberg, Arne; Stenager, Elsebeth

    2012-01-01

    High relapse rate is one of the most prominent problems in addiction treatment. Alcohol Resilience Treatment (ART), an alcohol addiction therapy, is based on Cue Exposure Treatment, which has shown promising results in preliminary studies. ART aims at optimizing the core area of relapse prevention, and intends to improve patients' capability to withstand craving of alcohol. This method emphasizes the interplay of resilience and resourcefulness. It contains 6 sessions with different topics according to the stage of treatment circuit, and each session consists of 6 steps. Due to the purity and structure of the treatment rationale, it is realistic, reasonable and manageable to transform the method into a smartphone application. An ART app in Android system and an accessory of bilateral tactile stimulation were developed and will be used in a study with behavioral self-control training. This paper presents the design and realization of the smartphone based ART application. The design of a pilot study, which is to examine the benefits of a smartphone application providing behavioral self-control training, is also reported in this paper.

  19. Social stability on admission and success of in-patient treatment for alcoholism.

    Science.gov (United States)

    Williams, R J

    1977-03-01

    The pre-treatment social stability score (combined economic-familial-residential scales), indicating whether the patients were comparatively integrated or disintegrated socially, was found to be of greater prognostic value regarding post-treatment drinking than was information about whether they received full, part or "no" treatment. There was a differential treatment effect for the first 3 months of the 12-month period only. Of the overall sample, one-third of the patients could be considered to have improved following treatment, but two-thirds drank as much, if not more, than they did prior to treatment. These two groups were significantly different in terms of social stability and different types of treatment appear necessary to accommodate these differences. Social integration/disintegration is most readily seen in terms of the number of previous treatments (or institutionalisations) the subject has received for alcohol-related problems.

  20. Self-regulation, daily drinking, and partner violence in alcohol treatment-seeking men.

    Science.gov (United States)

    Schumacher, Julie A; Coffey, Scott F; Leonard, Kenneth E; O'Jile, Judith R; Landy, Noah C

    2013-02-01

    This study builds on research identifying deficits in behavioral self-regulation as risk factors for intimate partner violence (IPV). It also builds on alcohol administration research identifying these deficits as moderators of the association between acute alcohol consumption and aggression in laboratory paradigms. Participants analyzed were 97 men seeking residential treatment for alcohol dependence who were involved in a current or recent heterosexual relationship of at least 1 year. Participants completed a self-report measure of impulsivity, neuropsychological tests of executive function, and computerized delay discounting and behavioral inhibition tasks. With the exception of the self-report measure of impulsivity, performance on measures of behavioral self-regulation was not associated with the occurrence or frequency of past year IPV in this sample. Similarly, self-reported impulsivity moderated the association between daily drinking and IPV in multivariate models controlling for daily drug use, but deficits in performance on other measures did not. Performance on a tower task moderated the association between daily drinking and the occurrence of IPV, but contrary to hypotheses, better task performance was associated with greater likelihood of IPV on drinking days. These results suggest that self-perceived impulsivity is a better predictor of IPV in alcohol treatment seeking men than deficits in performance on behavioral measures of delay discounting, behavioral inhibition, and executive function.

  1. Hitting rock bottom? Resource loss as a predictor of alcoholism treatment completion.

    Science.gov (United States)

    Gruszczyńska, Ewa; Kaczmarek, Małgorzata; Chodkiewicz, Jan

    2016-07-01

    Background Efforts to better understand the phenomenon of the 'bottom', the beginning of the process of turning away from alcohol, are important for both theoretical and practical goals. The conservation of resources theory by Hobfoll may represent a suitable framework to base these attempts around. Aim The aim of the study was to examine the role of resource loss in completing alcoholism treatment on the basis of Hobfoll's conservation of resources theory. Methods The study included 86 patients undergoing inpatient alcoholism treatment. An assessment of resource loss and gain during the previous year, as well as of the decisional balance regarding the pros and cons of drinking alcohol, took place at the beginning of therapy. Results The results of hierarchical binary logistic regression confirmed that resource loss was the only significant predictor of therapy completion, after adjustment for decisional balance, demographics and basic clinical data. Additionally, gender moderated the relationship between resource gain and therapy completion: while an increase in gain was related to a decreased chance of completing therapy in men, the opposite effect was noted in women. Conclusions Resource loss has more influence than decisional balance in predicting therapy completion, which can be translated into clinically valid recommendations based on gender differences.

  2. The contribution of emotional maltreatment to alcohol dependence in a treatment-seeking sample.

    Science.gov (United States)

    Potthast, Nadine; Neuner, Frank; Catani, Claudia

    2014-05-01

    Studies reporting a link between child maltreatment and addiction have typically focused on physical and sexual abuse. In contrast, emotional maltreatment has rarely been studied in substance-abusing samples although it is associated with a wide range of dysfunction. The current study aimed to determine the specific impact of different types of maltreatment and peer victimization on alcohol dependence and to examine the potentially mediating role of psychopathology. A sample of treatment seeking adults with alcohol dependence (N=72) underwent an extensive clinical examination including both a standardized interview and self-report measures. Child maltreatment, peer victimization, severity of alcohol dependence, and general psychopathology were assessed. Regression analyses revealed that emotional maltreatment was the strongest predictor of alcohol dependence severity whereas a unique contribution of peer victimization was not found. Our findings suggest that emotional maltreatment might have a major role in the etiology of AD that seems to exceed the contribution of other abuse and victimization experiences. Thereby, the study underscores the need for considering child maltreatment experiences in the prevention and treatment of AD.

  3. Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems.

    Science.gov (United States)

    Orwat, John; Saitz, Richard; Tompkins, Christopher P; Cheng, Debbie M; Dentato, Michael P; Samet, Jeffrey H

    2011-10-01

    This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19-0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29-0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45-0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR = 3.37, CI = 2.24-5.06), physical or sexual abuse (AOR = 2.12, CI = 1.22-3.69), social supports that help with sobriety (AOR = 1.92, CI = 1.28-2.87), homelessness (AOR = 2.40, CI = 1.60-3.62), drug dependence diagnosis (AOR = 2.64, CI = 1.88-3.70), and clinically important depressive symptoms (AOR = 1.52, CI = 1.08-2.15). While reassuring that factors indicating need for SAT among people with HIV and alcohol problems (e.g., drug dependence) are associated with receipt, nonneed factors (e.g., sexual orientation, age) that should not decrease likelihood of receipt of treatment were identified.

  4. EXPERIENCE OF ORNITHINE ASPARTATE (HEPA-MERZ AND PROBIOTICS BIOFLORUM FORTE IN THE TREATMENT OF NON-SEVERE FORMS OF ALCOHOLIC AND NON-ALCOHOLIC FATTY LIVER DISEASE

    Directory of Open Access Journals (Sweden)

    L. Yu. Ilchenko

    2016-01-01

    Full Text Available Aim: to evaluate the efficacy and tolerability of ornithine aspartate, probiotic Bioflorum Forte and their combination with steatosis and steatohepatitis in patients  with alcohol and non-alcoholic  fatty  liver disease. Materials and methods.  An open, randomized,  comparative  clinical study, which included 30 outpatients and inpatients with a diagnosis of steatosis, steatohepatitis. We analyzed the clinical symptoms, functional state of the liver. With the help of questionnaires  (Grids LeGo and post intoxication alcohol syndrome have established the presence of chronic alcohol intoxication. Test transmissions of numbers used to characterize the cognitive function, as well as detection  of minimal hepatic encephalopathy. Quality of life was assessed by questionnaire for patients with chronic liver disease — CLDQ (The chronic liver disease questionnaire. The duration of treatment was4 weeks. Results: all three treatment regimens have demonstrated therapeutic  efficacy: clinical improvement, recovery of liver function and results in cognitive function. When combined therapy also produced a significant improvement  in patients’ quality of life. It is shown that  the safety and tolerability of the means employed, adverse events were not reported. Conclusion: the results obtained allow us to recommend the use of ornithine aspartate (Hepa-Merz, both as monotherapy and as part of complex therapy of steatosis,  steatohepatitis with probiotic Bioflorum Forte in patients with alcoholic and non-alcoholic fatty liver disease.

  5. Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation

    Energy Technology Data Exchange (ETDEWEB)

    Akhlaghpoor, S. [Noor Medical Imaging Center, Tehran (Iran, Islamic Republic of)]. E-mail: akhlaghpoor@nmri-ir.com; Tomasian, A. [Noor Medical Imaging Center, Tehran (Iran, Islamic Republic of); Arjmand Shabestari, A. [Noor Medical Imaging Center, Tehran (Iran, Islamic Republic of); Ebrahimi, M. [Noor Medical Imaging Center, Tehran (Iran, Islamic Republic of); Alinaghizadeh, M.R. [Noor Medical Imaging Center, Tehran (Iran, Islamic Republic of)

    2007-03-15

    Aim: To assess the efficacy of percutaneous osteoid osteoma treatment using a combination of radiofrequency ablation (RFA) and alcohol ablation with regard to technical and long-term clinical success. Materials and methods: From December 2001 to November 2004, RFA and subsequent alcohol ablation was performed on 54 patients with osteoid osteoma, diagnosed clinically using radiography, computed tomography (CT) and symptoms. Under general anaesthesia, treatment was performed via percutaneous access under thin section (2 mm) spiral CT guidance in all cases with an 11 G radiofrequency-compatible coaxial needle and 2 mm coaxial drill system and 1.0 cm active tip 17 G non-cooled radiofrequency needle. RFA was performed at 90 {sup o}C for a period of 6 min. After needle removal, 0.5-1.0 ml absolute alcohol (99.8% concentration) was injected directly into the nidus using a 20 G needle. Patients were discharged within 24 h and followed up clinically (at 1 week, 1 month and every 3 months thereafter). Results: The technical success rate was 100%. Complications occurred in two patients consisting of local mild cellulitis in entry site and peripheral small zone paresthesia on the anterior part of leg. The follow-up period range was 13-48 months (mean {+-} SD, 28.2 {+-} 7.4 months). Prompt pain relief and return to normal activities were observed in 52 of 54 patients. Recurrent pain occurred in two patients after a 1 and 3 months period of being pain free, respectively; a second RFA and alcohol ablation was performed achieving successful results. Primary and secondary clinical success rates were 96.3% (52/54 patients) and 100% (2/2 patients), respectively. Conclusion: Percutaneous osteoid osteoma treatment with combination of radiofrequency and alcohol ablation is safe, effective and minimally invasive with high primary and secondary success rates. Persistent or recurrent lesions can be effectively re-treated.

  6. Neural activation during processing of aversive faces predicts treatment outcome in alcoholism.

    Science.gov (United States)

    Charlet, Katrin; Schlagenhauf, Florian; Richter, Anne; Naundorf, Karina; Dornhof, Lina; Weinfurtner, Christopher E J; König, Friederike; Walaszek, Bernadeta; Schubert, Florian; Müller, Christian A; Gutwinski, Stefan; Seissinger, Annette; Schmitz, Lioba; Walter, Henrik; Beck, Anne; Gallinat, Jürgen; Kiefer, Falk; Heinz, Andreas

    2014-05-01

    Neuropsychological studies reported decoding deficits of emotional facial expressions in alcohol-dependent patients, and imaging studies revealed reduced prefrontal and limbic activation during emotional face processing. However, it remains unclear whether this reduced neural activation is mediated by alcohol-associated volume reductions and whether it interacts with treatment outcome. We combined analyses of neural activation during an aversive face-cue-comparison task and local gray matter volumes (GM) using Biological Parametric Mapping in 33 detoxified alcohol-dependent patients and 33 matched healthy controls. Alcoholics displayed reduced activation toward aversive faces-neutral shapes in bilateral fusiform gyrus [FG; Brodmann areas (BA) 18/19], right middle frontal gyrus (BA46/47), right inferior parietal gyrus (BA7) and left cerebellum compared with controls, which were explained by GM differences (except for cerebellum). Enhanced functional activation in patients versus controls was found in left rostral anterior cingulate cortex (ACC) and medial frontal gyrus (BA10/11), even after GM reduction control. Increased ACC activation correlated significantly with less (previous) lifetime alcohol intake [Lifetime Drinking History (LDH)], longer abstinence and less subsequent binge drinking in patients. High LDH appear to impair treatment outcome via its neurotoxicity on ACC integrity. Thus, high activation of the rostral ACC elicited by affective faces appears to be a resilience factor predicting better treatment outcome. Although no group differences were found, increased FG activation correlated with patients' higher LDH. Because high LDH correlated with worse task performance for facial stimuli in patients, elevated activation in the fusiform 'face' area may reflect inefficient compensatory activation. Therapeutic interventions (e.g. emotion evaluation training) may enable patients to cope with social stress and to decrease relapses after detoxification.

  7. Effect of variations in treatment regimen and liver cirrhosis on exposure to benzodiazepines during treatment of alcohol withdrawal syndrome

    Science.gov (United States)

    Gershkovich, Pavel; Wasan, Kishor M; Ribeyre, Charles; Ibrahim, Fady; McNeill, John H

    2015-01-01

    Purpose: Benzodiazepines (BDZs) are the drugs of choice to prevent the symptoms of alcohol withdrawal syndrome (AWS). Various treatment protocols are published and have been shown to be effective in both office-managed and facility-managed treatment of AWS. The aim of this scientific commentary is to demonstrate the differences in the expected exposure to BDZs during AWS treatment using different treatment regimens available in the literature, in patients with or without alcoholic liver cirrhosis. Methods: Diazepam and lorazepam AWS protocols were examined and reviewed in the literature, and blood plasma levels were examined and compared, respectively. Results: Considerable variation in the blood levels with the different dosing schedules was found. Because the drugs are metabolized differently, we have also shown that liver disease affects the blood levels of diazepam, but not of lorazepam. Conclusions: Differences in treatment regimens, the choice of BDZ, as well as the presence of liver cirrhosis can substantially alter the exposure of patients to drugs used for AWS treatment. Outpatient treatment of AWS has been shown to be relatively safe and effective for the treatment of AWS but patients should be carefully monitored. PMID:26322116

  8. Risk Factors for Treatment Failure in Smokers: Relationship to Alcohol Use and to Lifetime History of an Alcohol Use Disorder

    OpenAIRE

    Leeman, Robert F.; McKee, Sherry A.; Toll, Benjamin A.; Krishnan-Sarin, Suchitra; Cooney, Judith L.; Makuch, Robert W.; O’Malley, Stephanie

    2008-01-01

    Little is known about the impact of alcohol involvement on smoking cessation relapse or possible mechanisms for these associations. We addressed these issues using data from a randomized clinical trial of 2 types of framed messages (gain vs. loss) in conjunction with open label sustained-release (SR) bupropion (Toll et al., 2007) (N = 249). Participants were categorized according to whether or not they were diagnosed with a lifetime alcohol use disorder (AUD; i.e., current or past alcohol abu...

  9. Waste water treatment through public-private partnerships

    DEFF Research Database (Denmark)

    Carpintero, Samuel; Petersen, Ole Helby

    2014-01-01

    This paper analyses the experience of the regional government of Aragon (Spain) that has extensively used public-private partnerships for the construction and operation of waste water treatment plants. The paper argues that although overall the implementation of this PPP program might be considered...

  10. Crucial factors influencing public acceptance of fuels treatments

    Science.gov (United States)

    Sarah. McCaffrey

    2009-01-01

    An important component of the wildland fire problem in the United States is the growing number of people living in high fire hazard areas. How people in these areas contribute to fire risk--or potentially decrease it--will be shaped by their attitudes and beliefs toward different fuel treatment approaches. Understanding the issues and concerns that influence public...

  11. Public opinion of drug treatment policy: exploring the public's attitudes, knowledge, experience and willingness to pay for drug treatment strategies.

    Science.gov (United States)

    Matheson, C; Jaffray, M; Ryan, M; Bond, C M; Fraser, K; Kirk, M; Liddell, D

    2014-05-01

    Research evidence is strong for opiate replacement treatment (ORT). However, public opinion (attitudes) can be at odds with evidence. This study explored the relationships between, attitudes, knowledge of drugs and a range of socio-demographic variables that potentially influence attitude. This is relevant in the current policy arena in which a major shift from harm reduction to, rehabilitation is underway. A cross sectional postal questionnaire survey in Scotland was conducted where the drug, treatment strategy has changed from harm-reduction to recovery-based. A random sample (N=3000), of the general public, >18 years, and on the electoral register was used. The questionnaire was largely structured with tick box format but included two open questions for qualitative responses. Valuation was measured using the economic willingness-to-pay (WTP) method. The response rate was 38.1% (1067/2803). Less than 10% had personal experience of drug, misuse but 16.7% had experience of drug misuse via a friend/acquaintance. Regression modelling revealed more positive attitudes towards drug users in those with personal experience of drug misuse, (p£50,000 per, annum compared to public attitudes and evidence regarding drug treatment. Findings suggest a way forward might be to develop and evaluate treatment that integrates ORT with a community rehabilitative approach. Evaluation of public engagement/education to improve knowledge of drug treatment effectiveness is recommended. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Efficacy of Qianggan capsule in treatment of non-alcoholic fatty liver disease complicated with hyperlipidemia

    Institute of Scientific and Technical Information of China (English)

    Zhi-Jun He; Meng-Xian Wang; Min-Man Ning

    2016-01-01

    Objective:To observe the clinical effects of Qianggan capsule and silibinin capsule in the treatment of non-alcoholic fatty liver disease complicated with hyperlipidemia. Methods:A total of 112 patients with non-alcoholic fatty liver disease were included in the study and divided into the control group (n=50) and the observation group (n=62). The patients in the control group were given silibinin capsule, while the patients in the observation group were given Qianggan capsule. The patients in the two groups were treated for 24 weeks. The liver/spleen CT was performed before and after treatment. BMI was measured. The liver function, serum lipid, and leptin were detected. Results:TG, LDL-C, BMI, and liver/spleen CT ratio in the observation group were significantly reduced when compared with the control group. The levels of HDL-C and adiponectin in the observation group were significantly elevated when compared with the control group. The differences of ALT, GGT, and AST after treatment between the two groups were not statistically significant. Conclusions:Qianggan capsule and silibinin capsule has an accurate efficacy and high safety in the treatment of non-alcoholic fatty liver disease complicated with hyperlipidemia.

  13. Cognitive control network function in alcohol use disorder before and during treatment with lorazepam.

    Science.gov (United States)

    Wilcox, Claire E; Mayer, Andrew R; Bogenschutz, Michael P; Ling, Josef; Dekonenko, Charlene; Cumbo, Heather

    2015-01-01

    Individuals with alcohol use disorders (AUDs) have deficits in cognitive control, but how they change with treatment is unclear. Seven patients with AUD and anxiety from an open-label trial of disulfiram plus lorazepam performed a multisensory Stroop task during fMRI (both pre and post initiation of treatment), and were compared to nine healthy controls (HCs) (n = 16; Albuquerque, NM; years 2009-2012). Evoked BOLD signal and resting state functional connectivity were compared (HC vs. AUD; Scan 1 vs. Scan 2). AUD demonstrated hyperactivity and altered connectivity in the cognitive control network compared to HC, but treatment did not normalize function.

  14. Alcohol use and implications for public health: Patterns of use in four communities

    Directory of Open Access Journals (Sweden)

    Girish N

    2010-01-01

    Full Text Available Background: Alcohol is one of the leading causes of death and disability globally and in India. Information on quantum and pattern of consumption is crucial to formulate intervention programs. Objectives: To identify the extent and pattern of alcohol use in urban, rural, town and slum populations using a uniform methodology. Materials and Methods: Door-to-door survey was undertaken and simple random sampling methodology was adopted; households were the primary sampling unit. One respondent in each alcohol-user household was randomly chosen for detailed interview. Results: Overall, 13% of males and females consumed alcohol. Proportion of users was greater in town (15.7% and among 26-45 years (67.4%. Whisky (49% and arrack (35% were the preferred types and the preferences differed between rural (arrack and urban (beer areas. Nearly half (45% of rural population were very frequent users (consuming daily or every alternate-days as against users in town (23% or slum (20%. Two-thirds were long-term users and the proportions were greater in the rural and town areas. While, overall 17% of the users were heavy-users, frequent-heavy-drinking was more in slum and rural areas. Nearly two-thirds consumed alcohol in liquor-shops, restaurants, bars and pubs. Habituation and peer-pressure were the key reasons for alcohol use. Conclusions: The study documented alcohol use and patterns of use in four different communities particularly in transitional areas using similar methodology. Many of the patterns identified are detrimental to health both immediate and over the long period of time.

  15. Evaluation of tendered prices of natural mineral water, juice and non-alcoholic beer (public procurement research

    Directory of Open Access Journals (Sweden)

    Nataša Pomazalová

    2011-01-01

    Full Text Available The purpose of this paper is to evaluate tender prices of chosen beverages according to public procurement based on secondary data analysis. The empirical results of analysis (t-test and F-test show that average annual prices of these beverages are different and collected data are not included in the same sample. Tender prices are different in each year of observed years, although are based on public tender. Important evidence is that for the public tenders in the abroad is obligatory use of the Czech public procurement law. According to this act the base evaluation criterion is the lowest offered price. Data were collected during the years 2005–2009. This study deals with empirical approach, variability of prices of chosen beverages based on public tenders between the Czech Republic (Ministry of Defence and local suppliers in Kosovo. Results show low variability of prices, which are based on public tender and legal approach, regulated public procurement. The research conclusion is the fact, that tender prices for piece of non-alcoholic beverage are less than 10 % from annual mean (pcs./CZK of tendered prices.

  16. Internet Therapy versus Internet Self-Help versus No Treatment for Problematic Alcohol Use: A Randomized Controlled Trial

    Science.gov (United States)

    Blankers, Matthijs; Koeter, Maarten W. J.; Schippers, Gerard M.

    2011-01-01

    Objective: Problematic alcohol use is the third leading contributor to the global burden of disease, partly because the majority of problem drinkers are not receiving treatment. Internet-based alcohol interventions attract an otherwise untreated population, but their effectiveness has not yet been established. The current study examined the…

  17. Alcohol policy enforcement and changes in student drinking rates in a statewide public college system: a follow-up study

    Directory of Open Access Journals (Sweden)

    Harris Sion K

    2010-08-01

    Full Text Available Abstract Background Heavy alcohol use among U.S. college students is a major contributor to young adult morbidity and mortality. The aim of this study was to examine whether college alcohol policy enforcement levels predict changes in student drinking and related behaviors in a state system of public colleges and universities, following a system-wide change to a stricter policy. Methods Students and administrators at 11 Massachusetts public colleges/universities completed surveys in 1999 (N of students = 1252, one year after the policy change, and again in 2001 (N = 1074. We calculated policy enforcement scores for each school based on the reports of deans of students, campus security chiefs, and students, and examined the correlations between perceived enforcement levels and the change in student drinking rates over the subsequent two year period, after weighting the 2001 data to adjust for demographic changes in the student body. Results Overall rates of any past-30-days drinking, heavy episodic drinking, and usual heavy drinking among past-30-days drinkers were all lower in 2001 compared to 1999. School-level analyses (N = 11 found deans' baseline reports of stricter enforcement were strongly correlated with subsequent declines in heavy episodic drinking (Pearson's r = -0.73, p = 0.011. Moreover, consistently high enforcement levels across time, as reported by deans, were associated with greater declines in heavy episodic drinking. Such relationships were not found for students' and security chiefs' reports of enforcement. Marijuana use did not rise during this period of decline in heavy drinking. Conclusions Study findings suggest that stronger enforcement of a stricter alcohol policy may be associated with reductions in student heavy drinking rates over time. An aggressive enforcement stance by deans may be an important element of an effective college alcohol policy.

  18. Meta-analysis of supplemental treatment for depressive and anxiety disorders in patients being treated for alcohol dependence.

    Science.gov (United States)

    Hobbs, Jennifer D J; Kushner, Matt G; Lee, Susanne S; Reardon, Sean M; Maurer, Eric W

    2011-01-01

    Approximately half of those receiving treatment for an alcohol use disorder (AUD) also suffer with an anxiety or depressive (internalizing) disorder. Because all internalizing disorders mark a poor alcohol treatment outcome, it seems reasonable to supplement AUD treatment with a psychiatric intervention when these disorders co-occur with AUD. However, this conclusion may be faulty given that the various possible interrelationships between AUD and internalizing disorders do not uniformly imply a high therapeutic yield from this approach. Unfortunately, the studies conducted to date have been too few and too small to resolve this important clinical issue with confidence. Therefore, we used a meta-analytic method to synthesize the effects from published randomized controlled trials examining the impact of supplementing AUD treatment with a psychiatric treatment for co-occurring internalizing disorder (N = 15). We found a pooled effect size (d) of .32 for internalizing outcomes and .22 for a composite of alcohol outcomes; however, the alcohol outcomes effect sizes were greater than this for some specific outcome domains. Subgroups that differed in terms of internalizing outcomes included treatment type (medication vs. cognitive behavioral therapy) and treatment focus (anxiety vs. depression). There was also a trend for the studies with better internalizing disorder outcomes to have better alcohol outcomes. These results indicate that clinical outcomes (both psychiatric and alcohol-related) could be somewhat improved by supplementing AUD treatment with psychiatric treatment for co-occurring internalizing disorder.

  19. Do women differ from men on Alcoholics Anonymous participation and abstinence? A multi-wave analysis of treatment seekers.

    Science.gov (United States)

    Witbrodt, Jane; Delucchi, Kevin

    2011-12-01

    Given the widespread use of Alcoholics Anonymous (AA) and other similar groups in the United States and the increasing membership of women, this study compares women with men on their meeting attendance and AA-prescribed behaviors, factors associated with that AA participation, and tests how these relate to women's and men's abstinence across time. All consecutive new admissions (age ≥ 18) from county-wide public and private treatment programs representing the larger population of treatment seekers were approached to be in the study at treatment entry. Those consenting at baseline (n = 926) were sought for follow-up interviews 1, 3, 5, and 7 years later. Generalized linear models were used to test whether various help-seeking factors were associated with AA participation differentially by gender and, controlling for AA and other confounders, whether women differ from men on abstinence. At each follow-up interview, women and men attended AA at similar rates and similarly practiced specific AA behaviors, and they were alike on most factors associated with AA participation and abstention across time including abstinence goal, drink volume, negative consequences, prior treatment, and encouragement to reduce drinking. Relative to men, women with higher drug severity were less likely to participate in AA. Although higher AA participation was a predictor of abstinence for both genders, men were less likely to be abstinent across time. Men were also more likely to reduce their AA participation across time. These findings add to an emerging literature on how women compare with men on factors related to AA participation and subsequent drinking outcomes across time. Findings have clinical implications for service providers referring clients to such groups. Copyright © 2011 by the Research Society on Alcoholism.

  20. The appropriateness of the treatment setting for the inpatient post-acute treatment of alcohol dependence disorders in Switzerland

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    Odenwald Michael

    2009-07-01

    Full Text Available Abstract Background In Switzerland, a total of 1'000 patients a year are treated for alcohol-dependence in specialized institutions. Though the current literature suggests favoring outpatient treatment, whether outpatient or inpatient treatment is more efficient cannot be answered generally. For Germany, "AWMF"-treatment guidelines were formulated in order to treat patients with substance use disorders in the appropriate treatment settings. The aim of the present study was to test the hypothesis that the majority of patients treated in the largest specialized institution for alcohol abuse treatment in Switzerland were treated in the appropriate setting. Methods All completed treatments conducted in the Forel-Hospital – the largest clinic of its kind in Switzerland – between the 1st of January 2004 and the 20th of December 2006 were included in the investigation (n = 915. Patient and treatment characteristics were gathered using the information from the PSYREC and act-info questionnaire. The AWMF criteria were operationalized on the basis of the questionnaire. Results Applying the AWMF criteria resulted in the emergence of three groups: 73.7% of the study sample could clearly be assigned to the inpatient treatment group, and for 7.5% there was evidence supporting the allocation to an outpatient treatment setting. In 18.8% of the cases, however, the AWMF criteria did not allow an assignment to either of the treatment settings. Of the total sample, 18.5% of all patients apparently did not profit from the inpatient treatment setting, whereas for the vast majority (81.5%, a therapeutic progress was documented. In those patients who, according to the AWMF guidelines, did not need an inpatient setting, a larger proportion improved than in the group of the patients who needed an inpatient treatment in a specialized hospital. Furthermore, the logistic regression analyses revealed that the less severe the clinical state of a patient upon admittance

  1. Similarities and Differences between Individuals Seeking Treatment for Gambling Problems vs. Alcohol and Substance Use Problems in Relation to the Progressive Model of Self-stigma

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    Belle Gavriel-Fried

    2017-06-01

    Full Text Available Aims: People with gambling as well as substance use problems who are exposed to public stigmatization may internalize and apply it to themselves through a mechanism known as self-stigma. This study implemented the Progressive Model for Self-Stigma which consists four sequential interrelated stages: awareness, agreement, application and harm on three groups of individuals with gambling, alcohol and other substance use problems. It explored whether the two guiding assumptions of this model (each stage is precondition for the following stage which are trickle-down in nature, and correlations between proximal stages should be larger than correlations between more distant stages would differentiate people with gambling problems from those with alcohol and other substance use problems in terms of their patterns of self-stigma and in terms of the stages in the model.Method: 37 individuals with gambling problems, 60 with alcohol problems and 51 with drug problems who applied for treatment in rehabilitation centers in Israel in 2015–2016 were recruited. They completed the Self-stigma of Mental Illness Scale-Short Form which was adapted by changing the term “mental health” to gambling, alcohol or drugs, and the DSM-5-diagnostic criteria for gambling, alcohol or drug disorder.Results: The assumptions of the model were broadly confirmed: a repeated measures ANCOVA revealed that in all three groups there was a difference between first two stages (aware and agree and the latter stages (apply and harm. In addition, the gambling group differed from the drug use and alcohol groups on the awareness stage: individuals with gambling problems were less likely to be aware of stigma than people with substance use or alcohol problems.Conclusion: The internalization of stigma among individuals with gambling problems tends to work in a similar way as for those with alcohol or drug problems. The differences between the gambling group and the alcohol and other

  2. Treatment in hospital for alcohol-dependent patients decreases attentional bias

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    Flaudias V

    2013-05-01

    Full Text Available Valentin Flaudias,1,2 Georges Brousse,1,2 Ingrid De Chazeron,1,2 François Planche,2 Julien Brun,2 Pierre-Michel Llorca1,2 1Clermont Université, EA 7280 NPsy-Sydo, Clermont-Ferrand, France; 2Pôle Psychiatrie B, CHU Gabriel-Montpied, Clermont-Ferrand, France Background and objectives: Previous studies in alcohol-dependent patients have shown an attentional bias (AB under related substance cues, which can lead to relapse. This AB can be evaluated by the alcohol Stroop test (AST. The AST is a modified Stroop task in which participants have to name the color of an alcohol-related word or a neutral word. AB is the response-time difference between these two types of words. The goal of the current study was to examine modification of AB during specialized hospitalization for alcohol dependence, with the suppression of a training bias that could be present in within-subject design. Methods: Individuals with alcohol-dependence disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th edition and admitted for withdrawal in the addiction unit of the University Hospital of Clermont-Ferrand (test group, n = 42 and persons with no alcohol or psychiatric disorder (control group, n = 16, recruited among colleagues and friends of the staff, performed the AST. A subgroup of the test group performed the AST in admission (admission group, n = 19, and another subgroup undertook the test immediately before discharge (discharge group, n = 23. Results: Results showed an AB only for patients seen at admission (F[1,55] = 3.283, P = 0.075. Moreover, we observed that the AB in the admission group (mean = 34 ms, standard deviation [SD] = 70.06 was greater than the AB in the control group (mean = 23 ms, SD = 93.42, itself greater than the AB in the discharge group (mean = −12 ms, SD = 93.55 (t[55] = −1.71; P = 0.09. Conclusion: Although the results are preliminary, the present study provides evidence for changes in the AB during alcohol-addiction treatment

  3. Pharmacological interventions for alcoholic liver disease (alcohol-related liver disease)

    DEFF Research Database (Denmark)

    Buzzetti, Elena; Kalafateli, Maria; Thorburn, Douglas

    2017-01-01

    trials (irrespective of language, blinding, or publication status) including participants with alcohol-related liver disease. We excluded trials that included participants who had previously undergone liver transplantation and those with co-existing chronic viral diseases. We considered any...... and follow-up of one to two years in order to compare the benefits and harms of different treatments in people with alcoholic hepatitis. Randomised clinical trials should include health-related quality of life and report serious adverse events separately from adverse events. Future randomised clinical trials......BACKGROUND: Alcohol-related liver disease is due to excessive alcohol consumption. It includes a spectrum of liver diseases such as alcohol-related fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Mortality associated with alcoholic hepatitis is high. The optimal pharmacological treatment...

  4. Polyhydric alcohol protective effect on Rhizomucor miehei lipase deactivation enhanced by pressure and temperature treatment.

    Science.gov (United States)

    Noël, Marilyne; Lozano, Pedro; Combes, Didier

    2005-10-01

    The influence of polyhydric alcohols (sorbitol, xylitol, erythritol, glycerol) on the thermal stability of Rhizomucor miehei lipase has been studied at high hydrostatic pressure (up to 500 MPa). In the absence of additives, a protective effect (PE) (the ratio between the residual activities determined at 480 MPa for the enzyme in the presence or absence of polyhydric alcohols) of low-applied pressures (from 50 MPa to 350 MPa) against thermal deactivations (at 50 degrees C and 55 degrees C) has been noticed. In the presence of additives, a strong correlation between PE and the total hydroxyl group concentration has been obtained, for the first time, under treatments of combining denaturing temperatures and high hydrostatic pressures. This relationship does not seem to be dependent on the nature polyhydric alcohols as the same effect could be observed with 1 M sorbitol and 2 M glycerol. This PE, against thermal and high pressure combined lipase deactivation, increases with polyhydric alcohol concentrations, and when temperature increases from 25 degrees C to 55 degrees C.

  5. Experimental study of osthole on treatment of hyperlipidemic and alcoholic fatty liver in animals

    Institute of Scientific and Technical Information of China (English)

    Fang Song; Mei-Lin Xie; Lu-Jia Zhu; Ke-Ping Zhang; Jie Xue; Zhen-Lun Gu

    2006-01-01

    AIM: To evaluate the effects of osthole on fatty liver,and investigate the possible mechanism.METHODS: A quail model with hyperlipidemic fatty liver and rat model with alcoholic fatty liver were set up by feeding high fat diet and alcohol, respectively. These experimental animals were then treated with osthole 5-20 mg/kg for 6 wk, respectively. Whereafter, the lipid in serum and hepatic tissue, and coefficient of hepatic weight were measured.RESULTS: After treatment with osthole the levels of serum total cholesterol (TC), triglyceride (TG), lower density lipoprotein-cholesterol (LDL-C), coefficient of hepatic weight, and the hepatic tissue contents of TC and TG were significantly decreased. The activity of superoxide dismutase (SOD) in liver was improved.In alcohol-induced fatty liver rats, the level of malondialdehyde (MDA) in liver was decreased. In high fat-induced fatty liver quails, glutathione peroxidase (GSH-PX) in liver was significantly improved. The histological evaluation of liver specimens demonstrated that the osthole dramatically decreased lipid accumulation.CONCLUSION: These results suggested that osthole had therapeutic effects on both alcohol and high fatinduced fatty liver. The mechanism might be associated with its antioxidation.

  6. Problemas laborales en pacientes dependientes del alcohol: Evolución en un año de tratamiento Work-related problems among alcohol-dependent patients: Development a year of alcohol treatment

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    Mª Trinidad Gómez-Talegón

    2009-09-01

    Full Text Available Objetivo: El objetivo de este estudio es analizar la prevalencia de problemas laborales debidos al consumo de alcohol en una muestra de dependientes del alcohol y su evolución durante un año de tratamiento. Material y Método: Se realizó un estudio prospectivo de una cohorte de 93 pacientes, que realizaron tratamiento durante un año, diagnosticados de dependencia del alcohol según criterios DSM-IV. Se obtuvo información de los siguientes problemas laborales debidos al consumo de alcohol: absentismo, llamadas de atención, sanciones, accidentes laborales, despidos, desempleo o paro, ocurridos en tres momentos: durante toda la vida, el año anterior al inicio del tratamiento y durante un año de tratamiento. Resultados: El 57% tuvieron problemas laborales a lo largo de su vida, el 35,5% el año anterior al inicio del tratamiento, y el 23,7% durante el año de tratamiento. Los problemas mas frecuentes fueron el absentismo y el desempleo. Los problemas laborales disminuyeron (pObjetive: The aim of this study is to analyse the prevalence of work-related problems due to the consumption of alcohol in a sample of alcohol-dependent patients and their evolution over twelve months of treatment. Method: A prospective study was carried out on a cohort of 93 patients diagnosed as alcohol-dependent according to DSM-IV criteria, who underwent treatment over a 12 month period. Information concerning the following work-related problems due to the consumption of alcohol was obtained: absenteeism, warnings, sanctions, accidents at work, dismissals and unemployment, that occurred within three different time scales: the patient's lifetime, the 12 months prior to the start of the treatment and during the 12 months of the treatment. Results: 57% had had work-related problems during their lifetime, 35.5% in the 12 months prior to starting treatment and 23,7% during the year of treatment. The most frequent problems during the year of treatment were absenteeism and

  7. Treatment of acute alcohol withdrawal with gabapentin: results from a controlled two-center trial.

    Science.gov (United States)

    Bonnet, Udo; Banger, Markus; Leweke, F Markus; Specka, Michael; Müller, Bernhard W; Hashemi, Thilo; Nyhuis, Peter W; Kutscher, Sven; Burtscheidt, Wilhelm; Gastpar, Markus

    2003-10-01

    A few case reports and data from animal experiments point to a possible efficacy of gabapentin (GP) in the treatment of alcohol withdrawal syndrome (AWS). Because of ethical considerations, the efficacy of GP in acute AWS was tested in an add-on fashion to clomethiazole (CLO). Given that the symptom-triggered amount of CLO required to limit AWS within the first 24 hours is related to the severity of AWS, we tested this amount of CLO during placebo (P) or GP (400 mg qid) under double blind, randomized conditions. Sixty-one patients (P = 29/GP = 32) suffering from alcohol dependence (ICD-10) and without any other psychiatric condition or psychotropic medication were included. The groups were not significantly different in baseline characteristics (eg, demographic data, severity of AWS). Both ITT and completer analyses revealed no significant differences between the groups considering the primary effectiveness measure: amount of CLO required in the first 24 hours (P = 6.1 +/- 5.4/GP = 6.2 +/- 4.7 capsules). In addition, premature discontinuations (P = 3/GP = 2) and decreases in Mainz Alcohol Withdrawal Scores were not significantly different in the first 48 hours of AWS (secondary effectiveness measures). Tolerability of combined CLO/GP was studied throughout the whole treatment comprising a 5-day lasting reduction part subsequent to the first 48 hours. Throughout the whole 7-day treatment a total of 5 and 2 patients dropped out and 6 and 5 patients reported adverse clinical events in the P and GP groups, respectively. All together, GP (400 mg qid) was no better than P in saving initial consumption of CLO or decreasing initial Mainz Alcohol Withdrawal Scores suggesting that GP was ineffective in the management of acute AWS in this model. The combination of GP and CLO was safe.

  8. Phobic anxiety and depression as predictor variables for treatment outcome. A LISREL analysis on treated female alcoholics.

    Science.gov (United States)

    Haver, Brit; Gjestad, Rolf

    2005-01-01

    The study focuses on the relationship between phobic anxiety and depression, alcohol abuse, treatment and drinking outcome in female alcoholics. A structural equation analysis (LISREL) was used to test the strength and direction of predictor variables, enabling the development of models for the process of change taking place following treatment. Participants were patients attending a specific treatment programme for women with alcohol problems at Karolinska Hospital, Stockholm, Sweden. One hundred and twenty female alcoholics consecutively admitted during 1991-1993 were followed up 2 years after treatment. The Alcohol Use Inventory (AUI) and Symptom Check List-90 were used at intake and follow-up. Duration of problem drinking and depression at follow-up affected drinking outcome directly and negatively, whereas duration of treatment affected drinking outcome directly and positively in all our models. Phobic anxiety on the other hand affected drinking outcome negatively and indirectly, via shorter treatment duration and higher depression at follow-up. Using different outcome variables as an end product resulted in only minor changes. Thus, the model presented is viewed as robust and clinically meaningful. The results underscore the importance of phobic anxiety and recurrent or sustained depression--in addition to the pre-treatment duration of problem drinking--for the drinking outcome among female alcoholics.

  9. Use (and Misuse) of the Responsible Drinking Message in Public Health and Alcohol Advertising: A Review

    Science.gov (United States)

    Barry, Adam E.; Goodson, Patricia

    2010-01-01

    The objective is to present a comparative analysis examining the alcohol industry's and scholarly researchers' use of the concept "responsible drinking." Electronic databases associated with health, education, sociology, psychology, and medicine were the date sources. Results were limited to English, peer-reviewed articles and commentaries…

  10. 2015 Copyright © 2015, CRISA Publications alCOHOl usE RElaTED ...

    African Journals Online (AJOL)

    alCOHOl usE RElaTED INJuRy IN NORTHwEsT ETHIOpIa: ... 1College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. 2Institute ... lence between inebriated young people. .... of poor school performance and school.

  11. Alcohol: A Description and Comparison of Recent Scientific vs. Public Knowledge.

    Science.gov (United States)

    Buckalew, L. W.

    1979-01-01

    After noting recent research on the nature, effects, and consequences of alcohol use/abuse, this article describes the results of a survey of high school and college students on that issue. Implications of the low overall knowledge level; specific informational deficits; and age, sex, and racial variables are discussed. (SJL)

  12. Fetal Alcohol Spectrum Disorders: When Science, Medicine, Public Policy, and Laws Collide

    Science.gov (United States)

    Warren, Kenneth R.; Hewitt, Brenda G.

    2009-01-01

    Historically, alcohol has been used for different purposes including as a part of religious observances, as a food, at times as a medicine and its well-known use as a beverage. Until relatively recently these purposes have not changed and have at times been at odds with one another, resulting in collisions among policies and practices in science,…

  13. 2013 Copyright © 2013, CRISA Publications tABoo of Alcohol AnD ...

    African Journals Online (AJOL)

    tABoo of Alcohol AnD roAD SAfetY PolicieS in AlgeriA houria Bencherifa ... driving while drunk and road preventive actions undertaken to fight against this risk factor. We first .... concentration for driving the vehicle is set at 0.80 g/l of blood.

  14. Guided and Unguided Internet-Based Treatment for Problematic Alcohol Use - A Randomized Controlled Pilot Trial.

    Directory of Open Access Journals (Sweden)

    Christopher Sundström

    Full Text Available The Internet has increasingly been studied as mode of delivery for interventions targeting problematic alcohol use. Most interventions have been fully automated, but some research suggests that adding counselor guidance may improve alcohol consumption outcomes.An eight-module Internet-based self-help program based on cognitive behavioral therapy (CBT was tested among Internet help-seekers. Eighty participants with problematic alcohol use according to the Alcohol Use Disorders Identification Test (AUDIT; scores of ≥ 6 for women and ≥ 8 for men were recruited online from an open access website and randomized into three different groups. All groups were offered the same self-help program, but participants in two of the three groups received Internet-based counselor guidance in addition to the self-help program. One of the guidance groups was given a choice between guidance via asynchronous text messages or synchronous text-based chat, while the other guidance group received counselor guidance via asynchronous text messages only.In the choice group, 65% (13 of 20 participants chose guidance via asynchronous text messages. At the 10-week post-treatment follow-up, an intention-to-treat (ITT analysis showed that participants in the two guidance groups (choice and messages reported significantly lower past week alcohol consumption compared to the group without guidance; 10.8 (SD = 12.1 versus 22.6 (SD = 18.4; p = 0.001; Cohen's d = 0.77. Participants in both guidance groups reported significantly lower scores on the AUDIT at follow-up compared to the group without guidance, with a mean score of 14.4 (SD = 5.2 versus 18.2 (SD = 5.9; p = 0.003; Cohen's d = 0.68. A higher proportion of participants in the guidance groups said that they would recommend the program compared to the group without guidance (81% for choice; 93% for messages versus 47% for self-help.Self-help programs for problematic alcohol use can be more effective in reducing alcohol

  15. Comorbid Psychopathology and Alcohol Use Patterns among Methadone Maintenance Treatment Patients

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    Georgios Moussas

    2015-01-01

    Full Text Available 130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R and Alcohol Use Disorders Identification Test (AUDIT self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was 6.9±7.9. 63.0% of our participants scored below cut-off and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serious abuse/addiction. Scores on AUDIT scale were positively correlated with length of time on methadone treatment, but not with length of time on drug use or age of our participants. Positive correlations were observed among AUDIT and SCL-90R scores, namely, with global severity index score, positive symptom distress index, positive symptom total, and all primary symptom dimensions subscales except phobic anxiety.

  16. Alcohol detoxification completion, acceptance of referral to substance abuse treatment, and entry into substance abuse treatment among Alaska Native people.

    Science.gov (United States)

    Running Bear, Ursula; Beals, Janette; Novins, Douglas K; Manson, Spero M

    2017-02-01

    Little is known about factors associated with detoxification treatment completion and the transition to substance abuse treatment following detoxification among Alaska Native people. This study examined 3 critical points on the substance abuse continuum of care (alcohol detoxification completion, acceptance of referral to substance abuse treatment, entry into substance abuse treatment following detoxification). The retrospective cohort included 383 adult Alaska Native patients admitted to a tribally owned and managed inpatient detoxification unit. Three multiple logistic regression models estimated the adjusted associations of each outcome separately with demographic/psychosocial characteristics, clinical characteristics, use related behaviors, and health care utilization. Seventy-five percent completed detoxification treatment. Higher global assessment functioning scores, longer lengths of stay, and older ages of first alcohol use were associated with completing detoxification. A secondary drug diagnosis was associated with not completing detoxification. Thirty-six percent accepted a referral to substance abuse treatment following detoxification. Men, those with legal problems, and those with a longer length of stay were more likely to accept a referral to substance abuse treatment. Fifty-eight percent had a confirmed entry into a substance abuse treatment program at discharge. Length of stay was the only variable associated with substance abuse treatment entry. Services like motivational interviewing, counseling, development of therapeutic alliance, monetary incentives, and contingency management are effective in linking patients to services after detoxification. These should be considered, along with the factors associated with each point on the continuum of care when linking patients to follow-up services. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Alcoholism and Alcohol Abuse

    Science.gov (United States)

    ... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... groups. NIH: National Institute on Alcohol Abuse and Alcoholism

  18. 7-year trajectories of Alcoholics Anonymous attendance and associations with treatment.

    Science.gov (United States)

    Kaskutas, Lee Ann; Bond, Jason; Avalos, Lyndsay Ammon

    2009-12-01

    Although many members of Alcoholics Anonymous (AA) are introduced to AA during treatment, the relationship between treatment and AA attendance over time is unknown. This paper describes four latent classes of AA attendance among 586 dependent alcoholics interviewed by telephone 1, 3, 5 and 7 years after baseline, and models the relationship between treatment exposure and AA attendance in each class. There was a low AA group (averaging fewer than 5 meetings at most follow-ups), a medium AA group (about 50 meetings a year at each follow-up), a descending AA group (about 150 meetings year 1, then decreasing steeply), and a high AA group (about 200 meetings at 1 year, then decreasing gradually by year 7). Declines in meeting attendance were not always accompanied by decreases in abstinence. After accounting for the effect of time on AA attendance (i.e., the "ups-and-downs" that occur over time), treatment exposure was minimally related to AA attendance in all but the descending AA group, where it was negatively associated (p<0.001). Considering AA patterns over time highlights a different role for treatment in AA attendance than what is gleaned from analyses at single timepoints.

  19. Gait and balance in treatment-naïve active alcoholics with and without a lifetime drug codependence.

    Science.gov (United States)

    Fein, George; Smith, Stan; Greenstein, David

    2012-09-01

    Disturbed gait and balance are among the most consistent sequelae of chronic alcoholism. However, although a majority of alcoholics have never sought treatment, most investigations showing ataxia in alcohol-dependent individuals have relied on samples drawn from treated populations. In addition, few studies have addressed the associations of codependence on other drugs with alcoholic gait and balance disturbance. This study employed the Walk-a-Line Ataxia Battery (Fregly et al. Alcohol Clin Exp Res 1972;43:395-399) to assess gait and balance in treatment-naïve, actively drinking alcohol-dependent men and women (TNA; n = 69) who were dependent on alcohol only (ALC; n = 43), or who also had a lifetime drug dependence (ALC + DRG; n = 26; i.e., methamphetamine, cocaine, opiates, and/or marijuana), compared with nonsubstance abusing controls (NSAC; n = 74).We also examined associations between lifetime alcohol use and age with gait and balance measures. Our main findings were (i) no evidence of disturbed gait and balance in ALC versus NSAC and (ii) significantly disturbed gait and balance in ALC + DRG, relative to both NSAC and ALC, along with steeper age-associated decline in gait and balance performance in ALC versus ALC + DRG. Our results provide evidence consistent with previous studies that TNA (without a lifetime drug codependence) may represent a population that is different and less impaired (including in gait and balance) than treated alcoholics. Additionally, we provide evidence that ALC + DRG, with greater alcohol use and family drinking density than ALC, have an accelerated effect of age on gait and balance disturbance compared with both NSAC and ALC. The ALC + DRG group likely represents a subset of TNA with different characteristics than ALC. Copyright © 2012 by the Research Society on Alcoholism.

  20. [Pharmacological treatment in alcohol-, drug- and benzodiazepine-dependent patients - the significance of trazodone].

    Science.gov (United States)

    Funk, Sándor

    2013-06-01

    Currently detoxification of drug and alcohol dependent patients is pharmacologically unresolved, and long-term treatment following the acute phase is also not very successful including a high number of relapses. We would need medications that on the short term cease: the severe vegetative symptoms, the pain, the extremely distressing psychosyndrome characterised by restlessness, anxiety or acute depressive symptoms, and the craving. The optimal would be if there was one medication capable of simultaneously alleviating or diminishing all the above symptoms without causing dependency and preventing relapse in the long-term. Dependency is almost all cases accompanied by primary and/or secondary mood disorder or sleep disorder which should also be treated. It should be considered, however, that following withdrawal of the agent benzodiazepine dependency often develops. The serotonin antagonist and reuptake inhibitor (SARI) trazodone is effective in the treatment of depression accompanied by sleeping disorder and it has also shown efficacy in alcohol and benzodiazepine-dependency. Its administration may improve the efficacy of detoxification and treatment of following conditions, may decrease medication load and the risk of the development of benzodiazepine dependency. In our clinical practice we frequently use this agent to treat our patients simultaneously suffering from depression and addiction problems, gaining experience comparing it to other pharmacotherapies (benzodiazepines or other antidepressants). The medication is not approved for alcohol and drug dependence, however, treatment t of comorbid conditions is not against to the official recommendations. Our aim was, in addition to reviewing the literature, to share our experience which, although cannot be considered an evidence based study, we deemed worthy of publishing. We cannot, at this point, put forward a protocol addressing all related scientific problems and problems of off-label treatment, and we could

  1. Sex-Dependent Decrease of Sphingomyelinase Activity During Alcohol Withdrawal Treatment

    Directory of Open Access Journals (Sweden)

    Christiane Mühle

    2014-06-01

    Full Text Available Background: In vitro and in vivo studies have demonstrated the role of the acid sphingomyelinase (ASM in pathophysiological processes and alterations in response to ethanol exposure. Cellular and plasmatic ASM activities are increased in male alcohol dependent patients and decrease during physical withdrawal. Methods: Here, we analyzed the time course of ASM in male and also female acutely intoxicated patients during alcohol withdrawal and compared the activity levels to those under long-term maintenance treatment. Craving and further psychometric parameters were assessed by questionnaires. Results: The gradual decrease of serum ASM was confirmed in males (pConclusion: These data support the potential of ASM as a biomarker for the course of withdrawal therapy in males and provide the first associations of this enzyme with psychological variables such as craving and depression.

  2. Anger, Sadness and Fear in Response to Breaking Crime and Accident News Stories: How Emotions Influence Support for Alcohol-Control Public Policies via Concern about Risks.

    Science.gov (United States)

    Solloway, Tyler; Slater, Michael D; Chung, Adrienne; Goodall, Catherine

    2013-01-01

    Prior research shows that discrete emotions, notably anger and fear, can explain effects of news articles on health and alcohol-control policy support. This study advances prior work by coding expressed emotional responses to messages (as opposed to directly manipulated emotions or forced responses), incorporating and controlling for central thoughts, including sadness (a particularly relevant response to tragic stories), and examining concern's mediating role between emotion and policy support. An experiment with a national online adult panel had participants read one of 60 violent crime or accident news stories, each manipulated to mention or withhold alcohol's causal contribution. Multi-group structural equation models suggest that stories not mentioning alcohol had a direct effect on policy support via fear and central thoughts, unmediated by concern. When alcohol was mentioned, sadness and anger affects alcohol-control support through concern. Findings help confirm that emotional responses are key in determining news story effects on public support of health policies.

  3. Effectiveness of alcohol treatment interventions integrated into routine tuberculosis care in Tomsk, Russia.

    Science.gov (United States)

    Shin, Sonya; Livchits, Viktoria; Connery, Hilary Smith; Shields, Alan; Yanov, Sergei; Yanova, Galina; Fitzmaurice, Garrett M; Nelson, Adrianne K; Greenfield, Shelly F

    2013-08-01

    To test the feasibility and effectiveness of brief counseling intervention (BCI) and naltrexone integrated into tuberculosis (TB) care in Tomsk, Russia. Using a factorial randomized controlled trial design, patients were randomized into: naltrexone (NTX), brief behavioral compliance enhancement therapy (BBCET), treatment as usual (TAU) and BCI. In the Tomsk Oblast, hospitalized TB patients diagnosed with alcohol use disorders (AUDs) by the DSM-IV were referred at the start of TB treatment. Of the 196 participants, the mean age was 41 years and 82% were male. Severe TB (84.7% had cavitary disease) and smoking (92.9%) were common. The majority had a diagnosis of an AUD (63.0%); 27.6% reported nearly daily drinking and consumed a median of 16 standard drinks per day. Primary outcomes were 'favorable' TB outcome (cured, completed treatment) and change in mean number of abstinent days in the last month of study compared with baseline. Change in mean number of heavy drinking days, defined as four drinks per day and five drinks per day for women and men, respectively, and TB adherence, measured as percentage of doses taken as prescribed under direct observation, were secondary outcomes. Analysis based on 'intention-to-treat' was performed for multivariable analysis. Primary TB and alcohol end-points between naltrexone and no-naltrexone or BCI and no-BCI groups did not differ significantly. TB treatment adherence and change in number of heavy drinking days also did not differ significantly among treatment arms. Among individuals with a prior quitting attempt (n = 111), naltrexone use was associated with an increased likelihood of favorable TB outcomes (92.3% versus 75.9%, P = 0.02). In Tomsk Oblast, Russia, tuberculosis patients with severe alcohol use disorders who were not seeking alcohol treatment did not respond to naltrexone or behavioral counselling integrated into tuberculosis care; however, those patients with past attempts to quit drinking had improved

  4. The application of machine learning techniques as an adjunct to clinical decision making in alcohol dependence treatment.

    Science.gov (United States)

    Connor, J P; Symons, M; Feeney, G F X; Young, R McD; Wiles, J

    2007-01-01

    With few exceptions, research in the addictive sciences has relied on linear statistics and methodologies. Addiction involves a complex array of nonlinear behaviors. This study applies two machine learning techniques, Bayesian and decision tree classifiers, in the assessment of outcome of an alcohol dependence treatment program. These nonlinear approaches are compared to a standard linear analysis. Seventy-three alcohol-dependent subjects undertaking a 12-week cognitive-behavioral therapy (CBT) program and 66 subjects undertaking an identical program but also prescribed the relapse prevention agent Acamprosate were employed in this study. Demographic, alcohol use, dependence severity, craving, health-related quality of life, and psychological measures at baseline were used to predict abstinence at 12 weeks. Decision trees had a 77% predictive accuracy across both data sets, Bayesian networks 73%, and discriminant analysis 42%. Combined with clinical experience, machine learning approaches offer promise in understanding the complex relationships that underlie treatment outcome for abstinence-based alcohol treatment programs.

  5. [Parenteral S-adenosylmethionine compared to placebos in the treatment of alcoholic liver diseases].

    Science.gov (United States)

    Diaz Belmont, A; Dominguez Henkel, R; Uribe Ancira, F

    1996-01-01

    The improvements in the knowledge of the action of ethanol over the hepatic cell, its direct action over the cell, and the intracytoplasmatic structures membranes, point out the possibilities of use of sulfo-adenosil-L-metionina (SAMe); as an util drug inn the treatment of the altered metilation reactions, that take place in those membranes, facilitating their physiological functions. The primary end point in this study was to demonstrate the therapeutic worth os SAMe, by parenteral route in 45 patients with alcoholic liver disease, which were determined by clinical laboratory and hepatic function test, label qith 32 points or more of the discriminatory function index. Divided into two groups, placebo-SAMe, randomized, double blind. As well as total plasmatic and reduced glutation and lipoperoxidation index, indirect form as malondehaldehyde. Were determined at the first visit anf after 8 and 15 days of treatment. Comparing the results of both groups there were a significative favorable results for the group treatment with SAMe and this confirms the utility of this drug in the treatment of patients with alcoholic liver disease with a discriminatory function index (Maddrey index), of 32 points or more.

  6. Long-Term γ-Hydroxybutyric Acid (GHB) and Disulfiram Combination Therapy in GHB Treatment-Resistant Chronic Alcoholics

    Science.gov (United States)

    Maremmani, Angelo Giovanni Icro; Pani, Pier Paolo; Rovai, Luca; Pacini, Matteo; Dell’Osso, Liliana; Maremmani, Icro

    2011-01-01

    Leading Italian studies support the use of γ-hydroxybutyric acid (GHB), not only in the treatment of the alcohol withdrawal syndrome, but also in maintaining alcohol abstinence. GHB gives a better result than naltrexone and disulfiram in maintaining abstinence, and it has a better effect on craving than placebo or disulfiram. The problem is that about 30–40% of alcoholics are non-responders to GHB therapy. In our clinical practice, we speculate that by combining disulfiram with GHB treatment we may be able to achieve a kind of ‘antagonist’ effect by using the ‘psychological threat’ of disulfiram (adversative effect) while taking advantage of the anticraving effect of GHB, despite the limitation of its ‘non-blockade’ effect on alcohol. In this context, to improve the outcome in GHB long-term treated alcoholics, we added disulfiram to GHB in the management of GHB treatment-resistant alcoholics. In this study we compared retention in treatment of 52 patients who were treated with the GHB-disulfiram combination for up to six months, with retention for the same subjects considering their most recent unsuccessful outpatient long-term treatment with GHB only. An additional comparison was carried out on the days of complete abstention from alcohol. Thirty four patients (65.4%) successfully completed the protocol and were considered to be responders; 18 (34.6%) left the programme, and were considered to be non-responders. Considering the days of complete abstinence from alcohol, 36 patients stayed in treatment longer with the GHB-Disulfiram combination, 12 stayed for a shorter time and four for the same time. The results of this study seem to indicate a higher efficacy of the GHB-disulfiram association compared with GHB alone. Randomized controlled trials are now needed to verify this hypothesis. PMID:21845160

  7. Long-Term γ-Hydroxybutyric Acid (GHB and Disulfiram Combination Therapy in GHB Treatment-Resistant Chronic Alcoholics

    Directory of Open Access Journals (Sweden)

    Icro Maremmani

    2011-07-01

    Full Text Available Leading Italian studies support the use of γ-hydroxybutyric acid (GHB, not only in the treatment of the alcohol withdrawal syndrome, but also in maintaining alcohol abstinence. GHB gives a better result than naltrexone and disulfiram in maintaining abstinence, and it has a better effect on craving than placebo or disulfiram. The problem is that about 30–40% of alcoholics are non-responders to GHB therapy. In our clinical practice, we speculate that by combining disulfiram with GHB treatment we may be able to achieve a kind of ‘antagonist’ effect by using the ‘psychological threat’ of disulfiram (adversative effect while taking advantage of the anticraving effect of GHB, despite the limitation of its ‘non-blockade’ effect on alcohol. In this context, to improve the outcome in GHB long-term treated alcoholics, we added disulfiram to GHB in the management of GHB treatment-resistant alcoholics. In this study we compared retention in treatment of 52 patients who were treated with the GHB-disulfiram combination for up to six months, with retention for the same subjects considering their most recent unsuccessful outpatient long-term treatment with GHB only. An additional comparison was carried out on the days of complete abstention from alcohol. Thirty four patients (65.4% successfully completed the protocol and were considered to be responders; 18 (34.6% left the programme, and were considered to be non-responders. Considering the days of complete abstinence from alcohol, 36 patients stayed in treatment longer with the GHB-Disulfiram combination, 12 stayed for a shorter time and four for the same time. The results of this study seem to indicate a higher efficacy of the GHB-disulfiram association compared with GHB alone. Randomized controlled trials are now needed to verify this hypothesis.

  8. Long-term γ-hydroxybutyric acid (GHB) and disulfiram combination therapy in GHB treatment-resistant chronic alcoholics.

    Science.gov (United States)

    Maremmani, Angelo Giovanni Icro; Pani, Pier Paolo; Rovai, Luca; Pacini, Matteo; Dell'Osso, Liliana; Maremmani, Icro

    2011-07-01

    Leading Italian studies support the use of γ-hydroxybutyric acid (GHB), not only in the treatment of the alcohol withdrawal syndrome, but also in maintaining alcohol abstinence. GHB gives a better result than naltrexone and disulfiram in maintaining abstinence, and it has a better effect on craving than placebo or disulfiram. The problem is that about 30-40% of alcoholics are non-responders to GHB therapy. In our clinical practice, we speculate that by combining disulfiram with GHB treatment we may be able to achieve a kind of 'antagonist' effect by using the 'psychological threat' of disulfiram (adversative effect) while taking advantage of the anticraving effect of GHB, despite the limitation of its 'non-blockade' effect on alcohol. In this context, to improve the outcome in GHB long-term treated alcoholics, we added disulfiram to GHB in the management of GHB treatment-resistant alcoholics. In this study we compared retention in treatment of 52 patients who were treated with the GHB-disulfiram combination for up to six months, with retention for the same subjects considering their most recent unsuccessful outpatient long-term treatment with GHB only. An additional comparison was carried out on the days of complete abstention from alcohol. Thirty four patients (65.4%) successfully completed the protocol and were considered to be responders; 18 (34.6%) left the programme, and were considered to be non-responders. Considering the days of complete abstinence from alcohol, 36 patients stayed in treatment longer with the GHB-Disulfiram combination, 12 stayed for a shorter time and four for the same time. The results of this study seem to indicate a higher efficacy of the GHB-disulfiram association compared with GHB alone. Randomized controlled trials are now needed to verify this hypothesis.

  9. Pharmacologic Treatment of Alcoholic Hepatitis: Examining Outcomes Based on Disease Severity Stratification.

    Science.gov (United States)

    Owens, Ryan E; Snyder, Heather S; Twilla, Jennifer D; Satapathy, Sanjaya K

    2016-12-01

    Maddrey discriminant function (MDF) score is a measure of disease prognosis in alcoholic hepatitis (AH) used to identify patients at highest risk of mortality and determine the need for initiation of pharmacologic treatment. The purpose of this study was to evaluate the effects of pharmacologic therapy for hospitalized AH patients as stratified by MDF score. A retrospective review of patients with an AH diagnosis admitted to a Methodist LeBonheur Healthcare adult hospital between 06/2009 and 06/2014 was conducted. Patients ≥18 years of age with an ICD-9 code for AH were evaluated. Of the 493 patients screened, 234 met the inclusion criteria, comprised of 62 patients with an MDF ≥ 32 (treatment, n = 42 vs. no treatment, n = 20) and 172 patients with an MDF MDF ≥ 32, there was no statistically significant difference between the treatment group vs. non-treatment group regarding 28-day mortality (31% vs. 11%, respectively; P = 0.18) and 6-month mortality (45% treatment vs. 38% non-treatment; P = 0.75). For the patients with an MDF  0.99) and 6-month mortality (11% treatment vs. 13% non-treatment; P > 0.99). There was no difference in incidence of acute kidney injury, hepatorenal syndrome, development of infection or hepatic encephalopathy between the treatment vs. non-treatment groups. Pharmacologic treatment showed no survival benefit, regardless of disease severity. Given the mortality risk seen in mild-moderate AH patients not receiving treatment and concern for a possible treatment ceiling effect in severe AH patients, more data are needed to adequately assess the utility of MDF in selecting appropriate candidates for AH treatment.

  10. Intensive lifestyle treatment for non-alcoholic fatty liver disease in children with severe obesity: inpatient versus ambulatory treatment.

    Science.gov (United States)

    Koot, B G P; van der Baan-Slootweg, O H; Vinke, S; Bohte, A E; Tamminga-Smeulders, C L J; Jansen, P L M; Stoker, J; Benninga, M A

    2016-01-01

    Lifestyle intervention is the only established therapy for non-alcoholic fatty liver disease (NAFLD). The optimal treatment schedule and predictors of response of this treatment have not been established in children. We aimed to evaluate the 2-year efficacy of an inpatient versus ambulatory intensive lifestyle intervention for treating NAFLD in children with severe obesity. A cohort study of 51 severely obese non-diabetic children (mean age 14.7 (±2.4) years; BMI-z-score 3.5 (±0.5)) with liver steatosis were non-randomly allocated to inpatient treatment (2 or 6 months), ambulatory treatment or usual care. Proton Magnetic Resonance Spectroscopy determined liver steatosis and serum alanine aminotransferase (ALT) at 6 months were the primary outcome measures. Baseline variables were evaluated as predictors of treatment response. Liver steatosis had disappeared in 43, 29 and 22% and serum ALT normalized in 41, 33 and 6% at the end of 6 months in the inpatient, ambulatory or usual care treatment groups, respectively. Only the proportions of ALT normalization in inpatient and ambulatory treatment compared with usual care were significantly higher. Treatment effects of inpatient and ambulatory treatment were sustained at 1.5 years follow-up. No baseline characteristic, including PNPLA3 polymorphism or leptin, was consistently predictive for treatment response. A 6-month intensive inpatient and ambulatory lifestyle treatment in children with severe obesity reverses NAFLD in a minority of patients. This study suggests that inpatient compared with ambulatory intensive treatment does not importantly increase treatment success. Further efforts to optimize and individualize lifestyle interventions and additional treatments options are needed particular for children with severe obesity resistant to conventional lifestyle interventions.

  11. Molecular Mechanisms and New Treatment Strategies for Non-Alcoholic Steatohepatitis (NASH

    Directory of Open Access Journals (Sweden)

    Akinobu Takaki

    2014-04-01

    Full Text Available Non-alcoholic steatohepatitis (NASH is a severe form of non-alcoholic fatty liver disease (NAFLD, in which most patients exhibit non-progressive, non-alcoholic fatty liver (NAFL attributable to simple steatosis. Multiple hits, including genetic differences, fat accumulation, insulin resistance and intestinal microbiota changes, account for the progression of NASH. NAFLD is strongly associated with obesity, which induces adipokine secretion, endoplasmic reticulum (ER and oxidative stress at the cellular level, which in turn induces hepatic steatosis, inflammation and fibrosis. Among these factors, gut microbiota are acknowledged as having an important role in initiating this multifactorial disease. Oxidative stress is considered to be a key contributor in the progression from NAFL to NASH. Macrophage infiltration is apparent in NAFL and NASH, while T-cell infiltration is apparent in NASH. Although several clinical trials have shown that antioxidative therapy with vitamin E can effectively control hepatitis pathology in the short term, the long-term effects remain obscure and have often proved to be ineffective in many other diseases. Several long-term antioxidant protocols have failed to reduce mortality. New treatment modalities that incorporate current understanding of NAFLD molecular pathogenesis must be considered.

  12. Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions.

    Science.gov (United States)

    Kelly, Peter J; Leung, Joanne; Deane, Frank P; Lyons, Geoffrey C B

    2016-11-01

    Despite clinical recommendations that further treatment is critical for successful recovery following drug and alcohol detoxification, a large proportion of clients fail to attend treatment after detoxification. In this study, individual factors and constructs based on motivational and volitional models of health behaviour were examined as predictors of post-detoxification treatment attendance. The sample consisted of 220 substance-dependent individuals participating in short-term detoxification programs provided by The Australian Salvation Army. The Theory of Planned Behaviour and Implementation Intentions were used to predict attendance at subsequent treatment. Follow-up data were collected for 177 participants (81%), with 104 (80%) of those participants reporting that they had either attended further formal treatment (e.g. residential rehabilitation programs, outpatient counselling) or mutual support groups in the 2 weeks after leaving the detoxification program. Logistic regression examined the predictors of further treatment attendance. The full model accounted for 21% of the variance in treatment attendance, with attitude and Implementation Intentions contributing significantly to the prediction. Findings from the present study would suggest that assisting clients to develop a specific treatment plan, as well as helping clients to build positive perceptions about subsequent treatment, will promote greater attendance at further treatment following detoxification. [Kelly PJ, Leung J, Deane FP, Lyons GCB. Predicting client attendance at further treatment following drug and alcohol detoxification: Theory of Planned Behaviour and Implementation Intentions. Drug Alcohol Rev 2016;35:678-685]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  13. Treatment of public lice infestation: a comparison of two agents.

    Science.gov (United States)

    Smith, D E; Walsh, J

    1980-12-01

    Bulletins issued by both the United States Public Health Service and the Pan American Health Organization have noted a sharp increase in the incidence of public lice infestation (pediculosis pubis) in this country. At the Haight-Ashbury Free Medical Clinic we conducted a controlled, open study comparing the efficacy and safety of Kwell Shampoo (gamma benzene hexachloride; lindane) with RID, an over-the-counter, pyrethrin-based pediculicide. The results showed the two treatments to be equally effective and safe. All adult lice, nymphs, and nits were eradicated at the one week follow-up in fifteen patients treated with single applications of either product. Two patients in each group experienced very slight and transient erythema.

  14. Disulfiram Efficacy in the Treatment of Alcohol Dependence: A Meta-Analysis

    Science.gov (United States)

    Skinner, Marilyn D.; Lahmek, Pierre; Pham, Héloïse; Aubin, Henri-Jean

    2014-01-01

    Background Despite its success with compliant or supervised patients, disulfiram has been a controversial medication in the treatment of alcoholism. Often, study designs did not recognize a pivotal factor in disulfiram research, the importance of an open-label design. Our objectives are: (1) to analyze the efficacy and safety of disulfiram in RCTs in supporting abstinence and (2) to compare blind versus open-label studies, hypothesizing that blinded studies would show no difference between disulfiram and control groups because the threat would be evenly spread across all groups. Methods and Findings We searched PubMed, EMBASE and the Cochrane Central Register for RCTs on disulfiram use with alcoholics in comparison to any alcoholic control group. The primary outcome was defined by the authors of each trial. Additional analyses included: blind vs. open-label, with or without supervision, cocaine study or not, and type of control. Overall, the 22 included studies showed a higher success rate of disulfiram compared to controls Hedges'g = .58 (95%CI = .35–.82). When comparing blind and open-label RCTs, only open-label trials showed a significant superiority over controls g = .70 (95%CI = .46–.93). RCTs with blind designs showed no efficacy of disulfiram compared to controls. Disulfiram was also more effective than the control condition when compared to naltrexone g = .77, 95%CI = .52–1.02, to acamprosate g = .76, 95%CI = .04–1.48, and to the no disulfiram groups g = .43, 95%CI = .17–.69. Limits include: (1) a population of 89% male subjects and (2) a high but unavoidable heterogeneity of the studies with a substantial I-square in most subgroups of studies. Conclusions Blinded studies were incapable of distinguishing a difference between treatment groups and thus are incompatible with disulfiram research. Based on results with open-label studies, disulfiram is a safe and efficacious treatment compared to other abstinence

  15. Disulfiram efficacy in the treatment of alcohol dependence: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Marilyn D Skinner

    Full Text Available BACKGROUND: Despite its success with compliant or supervised patients, disulfiram has been a controversial medication in the treatment of alcoholism. Often, study designs did not recognize a pivotal factor in disulfiram research, the importance of an open-label design. Our objectives are: (1 to analyze the efficacy and safety of disulfiram in RCTs in supporting abstinence and (2 to compare blind versus open-label studies, hypothesizing that blinded studies would show no difference between disulfiram and control groups because the threat would be evenly spread across all groups. METHODS AND FINDINGS: We searched PubMed, EMBASE and the Cochrane Central Register for RCTs on disulfiram use with alcoholics in comparison to any alcoholic control group. The primary outcome was defined by the authors of each trial. Additional analyses included: blind vs. open-label, with or without supervision, cocaine study or not, and type of control. Overall, the 22 included studies showed a higher success rate of disulfiram compared to controls Hedges'g = .58 (95%CI = .35-.82. When comparing blind and open-label RCTs, only open-label trials showed a significant superiority over controls g = .70 (95%CI = .46-.93. RCTs with blind designs showed no efficacy of disulfiram compared to controls. Disulfiram was also more effective than the control condition when compared to naltrexone g = .77, 95%CI = .52-1.02, to acamprosate g = .76, 95%CI = .04-1.48, and to the no disulfiram groups g = .43, 95%CI = .17-.69. LIMITS INCLUDE: (1 a population of 89% male subjects and (2 a high but unavoidable heterogeneity of the studies with a substantial I-square in most subgroups of studies. CONCLUSIONS: Blinded studies were incapable of distinguishing a difference between treatment groups and thus are incompatible with disulfiram research. Based on results with open-label studies, disulfiram is a safe and efficacious treatment compared to other abstinence supportive

  16. [Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse].

    Science.gov (United States)

    Nilsson, Maria; Sonne, Charlotte

    2013-04-01

    Wernicke-Korsakoff syndrome is a condition with high morbidity and mortality and occurs as a consequence of thiamine deficiency. Clinical symptoms are often ambiguous and post-mortem examinations show that the syndrome is underdiagnosed and probably undertreated. There is sparse clinical evidence concerning optimal dosage and duration of treatment. This article reviews the current literature and concludes that all patients with a history of alcohol abuse should be treated with high dosage IV thiamine for an extended period of time, albeit further research is needed.

  17. Consumption of alcohol and depression in students of a public school of Coatzacoalcos, Veracruz, Mexico

    OpenAIRE

    Brenda Alicia Hernández-Cortaza; Leticia Cortaza-Ramírez; Moacyr Lobo da Costa Junior

    2012-01-01

    Estudio descriptivo y transversal cuyo objetivo fue analizar la relación entre el nivel de depresión y el padrón de consumo de alcohol en alumnos de una preparatoria pública de Coatzacoalcos, Veracruz, México. La muestra trabajó con 175 estudiantes de ambos los sexos, entre 15 y 19 años, seleccionados por muestreo aleatorio simple. Se utilizó, un documento con datos personales, la escala Auto aplicada de Zung, y la prueba AUDIT. Se encontró 96,6% de los participantes presentando algún nivel d...

  18. Waste water treatment through public-private partnerships

    DEFF Research Database (Denmark)

    Carpintero, Samuel; Petersen, Ole Helby

    2014-01-01

    This paper analyses the experience of the regional government of Aragon (Spain) that has extensively used public-private partnerships for the construction and operation of waste water treatment plants. The paper argues that although overall the implementation of this PPP program might be considered...... allocation of some tasks. The paper also illustrates two features of this PPP program that arguably have strongly influenced its successful implementation: The mitigation of demand risk and the rigorous estimations of demand carried out by the regional government...

  19. Changing policy framing as a deliberate strategy for public health advocacy: a qualitative policy case study of minimum unit pricing of alcohol.

    Science.gov (United States)

    Katikireddi, Srinivasa Vittal; Bond, Lyndal; Hilton, Shona

    2014-06-01

    Scotland is the first country in the world to pass legislation introducing a minimum unit price (MUP) for alcohol in an attempt to reduce consumption and associated harms by increasing the price of the cheapest alcohol. We investigated the competing ways in which policy stakeholders presented the debate. We then established whether a change in framing helped explain the policy's emergence. We conducted a detailed policy case study through analysis of evidence submitted to the Scottish parliament, and in-depth, one-to-one interviews (n = 36) with politicians, civil servants, advocates, researchers, and industry representatives. Public- and voluntary-sector stakeholders tended to support MUP, while industry representatives were more divided. Two markedly different ways of presenting alcohol as a policy problem were evident. Critics of MUP (all of whom were related to industry) emphasized social disorder issues, particularly among young people, and hence argued for targeted approaches. In contrast, advocates for MUP (with the exception of those in industry) focused on alcohol as a health issue arising from overconsumption at a population level, thus suggesting that population-based interventions were necessary. Industry stakeholders favoring MUP adopted a hybrid framing, maintaining several aspects of the critical framing. Our interview data showed that public health advocates worked hard to redefine the policy issue by deliberately presenting a consistent alternative framing. Framing alcohol policy as a broad, multisectoral, public health issue that requires a whole-population approach has been crucial to enabling policymakers to seriously consider MUP, and public health advocates intentionally presented alcohol policy in this way. This reframing helped prioritize public health considerations in the policy debate and represents a deliberate strategy for consideration by those advocating for policy change around the world and in other public health areas. © 2014

  20. No effect of long-term oral testosterone treatment on liver morphology in men with alcoholic cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Christoffersen, Pernille Yde; Eriksen, J

    1987-01-01

    duration of 30 months demonstrated a significant (p less than 0.01) increase in the prevalence of macronodular cirrhosis (from 6 to 51%) and a significant (p less than 0.01) decrease in the prevalence of alcoholic hepatitis (to 21%) and of fatty liver (to 52%). Testosterone treatment did not significantly...... Budd-Chiari's syndrome. The degree of fatty liver and of alcoholic hepatitis in follow-up liver specimens were significantly (p less than 0.002) higher among patients who consumed ethanol during follow-up than in patients who abstained (76 versus 22% and 30 versus 6%). In conclusion, this study does......The effect of oral testosterone treatment (200 mg tid) on liver morphology was examined in a double-blind, placebo controlled study including men with alcoholic cirrhosis (n = 126). Liver biopsies obtained before randomization showed micronodular cirrhosis in 119 patients (94%), alcoholic hepatitis...

  1. Alcoholic cardiomyopathy

    Institute of Scientific and Technical Information of China (English)

    Gonzalo; Guzzo-Merello; Marta; Cobo-Marcos; Maria; Gallego-Delgado; Pablo; Garcia-Pavia

    2014-01-01

    Alcohol is the most frequently consumed toxic substance in the world. Low to moderate daily intake of alcohol has been shown to have beneficial effects on the cardiovascular system. In contrast, exposure to high levels of alcohol for a long period could lead to progressive cardiac dysfunction and heart failure. Cardiac dysfunction associated with chronic and excessive alcohol intake is a specific cardiac disease known as alcoholic cardiomyopathy(ACM). In spite of its clinical importance, data on ACM and how alcohol damages the heart are limited. In this review, we evaluate available evidence linking excessive alcohol consumption with heart failure and dilated cardiomyopathy. Additionally, we discuss the clinical presentation, prognosis and treatment of ACM.

  2. Automatic activation of alcohol cues by child maltreatment related words: a replication attempt in a different treatment setting

    OpenAIRE

    Potthast, Nadine; Neuner, Frank; Catani, Claudia

    2017-01-01

    Background A growing body of research attempts to clarify the underlying mechanisms of the association between emotional maltreatment and alcohol dependence (AD). In a preceding study, we found considerable support for a specific priming effect in subjects with AD and emotional abuse experiences receiving alcohol rehabilitation treatment. We concluded that maltreatment related cues can automatically activate an associative memory network comprising cues eliciting craving as well as alcoho...

  3. Intraprostatic injection of alcohol gel for the treatment of benign prostatic hyperplasia: preliminary clinical results.

    Science.gov (United States)

    Larson, Benjamin T; Netto, Nelson; Huidobro, Christian; de Lima, Marcelo Lopez; Matheus, Wagner; Acevedo, Cristian; Larson, Thayne R

    2006-09-06

    Benign prostatic hyperplasia (BPH) is one of the most common diseases ailing older men. Office-based procedures offer the advantage of being more effective than medications, while limiting the adverse effects, cost, and recovery of surgery. This study presents preliminary data on a new procedure that utilizes intraprostatic alcohol gel injection to ablate prostatic tissue. The purpose of this study is to evaluate the feasibility of using this gel as a treatment for BPH. A total of 65 patients with lower urinary tract symptoms (LUTS) due to BPH were treated with intraprostatic injections of alcohol gel. The gel is composed of 97% denatured alcohol and a patented polymer to cause viscosity. Three different methods of injection were utilized: transrectal (TR) injections (8), transurethral (TU) injections (36), and transperineal (TP) injections guided by biplaned ultrasound (21). Each method provided easy access to the center of the prostate, where a volume of gel, approximately 20-30% of the prostatic volume, was injected. Follow-up was based on changes in peak urinary flow (Qmax), IPSS scores, quality of life scores (QoL), adverse effects, and failures. Data are available at 3 and 12 months. The procedure was well tolerated with only local or no anesthesia in the TR and TP groups; the TU group received spinal anesthesia. All groups showed statistically significant (p gel injected was 8.05 ml, representing 21.56% of the prostatic volume. Qmax increased from a baseline mean of 8.50 to 12.01 ml/s at 3 months, and to 11.29 ml/s at 12 months. IPSS scores improved from a baseline mean of 21.12 to 10.00 at 3 months, and to 11.84 at 12 months. QoL scores were only available for 55 patients. QoL scores improved from a baseline of 3.93 to 1.98 at 3 months, and to 2.18 at 12 months. No extraprostatic injury or adverse effects were reported due to treatment. This preliminary study presents significant results showing that intraprostatic injection of alcohol gel could be an

  4. Lactobacillus rhamnosus CCFM1107 treatment ameliorates alcohol-induced liver injury in a mouse model of chronic alcohol feeding.

    Science.gov (United States)

    Tian, Fengwei; Chi, Feifei; Wang, Gang; Liu, Xiaoming; Zhang, Qiuxiang; Chen, Yongquan; Zhang, Hao; Chen, Wei

    2015-12-01

    Lactobacillus rhamnosus CCFM1107 was screened for high antioxidative activity from 55 lactobacilli. The present study attempted to explore the protective properties of L. rhamnosus CCFM1107 in alcoholic liver injury. A mouse model was induced by orally feeding alcohol when simultaneously treated with L. rhamnosus CCFM1107, the drug Hu-Gan- Pian (HGP), L. rhamnosus GG (LGG), and L. plantarum CCFM1112 for 3 months. Biochemical analysis was performed for both serum and liver homogenate. Detailed intestinal flora and histological analyses were also carried out. Our results indicated that the administration of L. rhamnosus CCFM1107 significantly inhibited the increase in the levels of serum aminotransferase and endotoxin, as well as the levels of triglyceride (TG) and cholesterol (CHO) in the serum and in the liver. Glutathione (GSH), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were elevated while the levels of malondialdehyde (MDA) were decreased. The enteric dysbiosis caused by alcohol was restored by increasing the numbers of both lactobacilli and bifidobacteria and decreasing the numbers of both enterococci and enterobacter. Histological analysis confirmed the protective effect of L. rhamnosus CCFM1107. Compared with the other lactobacilli and to the drug Hu-Gan-Pian, there is a high chance that L. rhamnosus CCFM1107 provides protective effects on alcoholic liver injury by reducing oxidative stress and restoring the intestinal flora.

  5. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    Science.gov (United States)

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  6. Strains toward convergence in the consumption of alcoholic beverages: the Canadian case and implications for public health.

    Science.gov (United States)

    Whitehead, P C; Macdonald, S

    1987-05-01

    Sulkunen's observations that international trends in the consumption of alcoholic beverages involve quantitative as well as qualitative homogenization of drinking practices are tested against the experience of Canada and its provinces from the mid 1960s to late 1970s. Per capita consumption of spirits, beer, and wine, and the contribution of each of these types of alcoholic beverages to total consumption are examined for each province for the fiscal years 1966, 1972, and 1978. On the whole, the findings are consistent with worldwide trends. Per capita consumption is increasing generally and there is a trend toward greater similarity in per capita consumption across the provinces (quantitative homogenization). Consumption of different types of beverages is becoming more similar (qualitative homogenization) and increases in the beverage with the lowest share of the market (i.e., wine) appear to be additive to overall consumption. The observation that increases in consumption of the traditional types of beverages have the most impact on overall consumption is not observed for beer, but is observed in the case of spirits. Implications for public health and social policy are discussed.

  7. Level of risk for alcohol consumption among the drivers of an urban public transportation company in Medellín

    Directory of Open Access Journals (Sweden)

    Carlos F. Molina C

    2011-11-01

    Full Text Available Objective: to study the level of risk for alcohol consumption among drivers from a public transportation company. Methodology: a cross-sectional observational study with a sample of 145 drivers from a transportation company in Medellin, Colombia. A self-survey was used that included socio-demographic data, work organization data, and the audittest to measure the level of risk for alcohol consumption. Results: the socio-demographic and work organization profiles, together with the risk level values are consistent with the findings of previous national and international studies. The audit test results showed that 12.5% of the subjects had a score greater than or equal to 8. This is a global indicator of risky and harmful consumption. Furthermore, the score of 17% of the subjects suggested probable dependence. Conclusions: this study’s findings suggest that further research is required in order to establish the grounds for designing a coordinated proposal integrating the actions of each of the Social Security System’s actors. Such proposal should be based on the policy for decreasing consumption of psychoactive substances in the working population

  8. Betaine treatment decreased oxidative stress, inflammation, and stellate cell activation in rats with alcoholic liver fibrosis.

    Science.gov (United States)

    Bingül, İlknur; Başaran-Küçükgergin, Canan; Aydın, A Fatih; Çoban, Jale; Doğan-Ekici, Işın; Doğru-Abbasoğlu, Semra; Uysal, Müjdat

    2016-07-01

    The aim of this study was to investigate the effect of betaine (BET) on alcoholic liver fibrosis in rats. Fibrosis was experimentally generated with ethanol plus carbon tetrachloride (ETH+CCl4) treatment. Rats were treated with ETH (5% v/v in drinking water) for 14 weeks. CCl4 was administered intraperitoneally (i.p.) 0.2mL/kg twice a week to rats in the last 6 weeks with/without commercial food containing BET (2% w/w). Serum hepatic damage markers, tumor necrosis factor-α, hepatic triglyceride (TG) and hydroxyproline (HYP) levels, and oxidative stress parameters were measured together with histopathologic observations. In addition, α-smooth muscle-actin (α-SMA), transforming growth factor-β1 (TGF-β1) and type I collagen (COL1A1) protein expressions were assayed immunohistochemically to evaluate stellate cell (HSC) activation. mRNA expressions of matrix metalloproteinase-2 (MMP-2) and its inhibitors (TIMP-1 and TIMP-2) were also determined. BET treatment diminished TG and HYP levels; prooxidant status and fibrotic changes; α-SMA, COL1A1 and TGF-β protein expressions; MMP-2, TIMP-1 and TIMP-2 mRNA expressions in the liver of fibrotic rats. In conclusion, these results indicate that the antifibrotic effect of BET may be related to its suppressive effects on oxidant and inflammatory processes together with HSC activation in alcoholic liver fibrosis.

  9. Treatment of Cutaneous Leishmaniasis in Murine Model by Alcoholic Extract of Berberis vulgaris

    Directory of Open Access Journals (Sweden)

    Jalalianfard A

    2006-08-01

    Full Text Available In order to evaluate the effect of Berberis vulgaris extract on the experimental ulcers of cutaneous leishmaniasis (CL on Balb/c mice, a study was undertaken over a 12 months period. Forty Balb/c mice were divided into 2 main groups A and B. Each main group in turn was divided into 5 sub groups of 4 mice and each sub group were inoculated subcutaneously by 0.1ml liquid phase culture containing promastigotes of Leishmania major. After 2-3 weeks, nodules and ulcers appeared on 37 of 40 inoculated mice. Ethanol extract of the stem and leaves as well as roots of Berberis vulgaris in different concentrations, were used topically on CL lesions of 4 sub groups A and B, respectively. Ethanol alone was used on the lesions of control mice. The surface area of lesions were measured before and 1-2 weeks after treatment. Direct Geimsa stained smear prepared 20 days after treatment. The results showed that after 2 weeks, a statistically significant decrease of ulcer size of treated mice observed, while in the control group the lesion growth continued. The examinations showed that using higher concentration of the extract caused more decrease in surface area of CL lesions on day 15 and negative direct smear on day 20. Alcoholic extract of B.vulgaris root was more effective than leaves and stem extract. Alcoholic extract of B vulgaris might be further used in animal model.

  10. Syngas production by plasma treatments of alcohols, bio-oils and wood

    Science.gov (United States)

    Arabi, K.; Aubry, O.; Khacef, A.; Cormier, J.-M.

    2012-12-01

    Exploitation of forest resources for energy production includes various methods of biomass processing. Gasification is one of the ways to recover energy from biomass. The Syngas produced from biomass can be used to power internal combustion engines, or, after purification, to supply fuel cells. The paper is summarizing results obtained through a non thermal arc plasma reactor at laboratory scale. A stationary discharge (I = 150mA) is used to perform physical diagnostics and also chemical analysis. The arc is formed between two electrodes made of graphite. We first present results on plasma-steam reforming of alcohols and bio-oils mixed in water. The outlet gas compositions are given from various alcohols and-bio-oils obtained at different experimental conditions. The second part of the paper is dedicated to a direct plasma treatment of wood (beech) at laboratory scale. One of the electrodes is surrounded by wood. The final part of the paper is a general discussion about efficiencies and comparisons of plasma treatments presented. The results obtained are discussed by considering the steam reforming reactions and the water gas shift reaction.

  11. HIV Treatment for Alcohol and Non-Injection Drug Users in El Salvador.

    Science.gov (United States)

    Dickson-Gomez, Julia; Bodnar, Gloria; Petroll, Andy; Johnson, Kali; Glasman, Laura

    2015-12-01

    Since the mid-1990 s, many developing countries have introduced and expanded the availability of combination antiretroviral therapy (cART) to persons living with HIV (PLH). However, AIDS-related mortality continues to be high particularly among drug users. In this article, we present results from in-depth interviews with 13 HIV medical providers and 29 crack cocaine and alcohol using PLH in El Salvador. Providers endorsed negative attitudes toward substance using PLH and warned PLH that combining cART with drugs and alcohol would damage their livers and kidneys resulting in death. Upon diagnosis, PLH received little information about HIV treatment and many suffered depression and escalated their drug use. PLH reported suspending cART when they drank or used drugs because of providers' warnings. Substance using PLH were given few strategies and resources to quit using drugs. Messages from medical providers discourage drug users from initiating or adhering to antiretroviral therapy (ART) and may contribute to treatment abandonment.

  12. Non-alcoholic fatty liver disease and diabetes: from physiopathological interplay to diagnosis and treatment.

    Science.gov (United States)

    Leite, Nathalie C; Villela-Nogueira, Cristiane A; Cardoso, Claudia R L; Salles, Gil F

    2014-07-14

    Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in patients with diabetes mellitus and increasing evidence suggests that patients with type 2 diabetes are at a particularly high risk for developing the progressive forms of NAFLD, non-alcoholic steatohepatitis and associated advanced liver fibrosis. Moreover, diabetes is an independent risk factor for NAFLD progression, and for hepatocellular carcinoma development and liver-related mortality in prospective studies. Notwithstanding, patients with NAFLD have an elevated prevalence of prediabetes. Recent studies have shown that NAFLD presence predicts the development of type 2 diabetes. Diabetes and NAFLD have mutual pathogenetic mechanisms and it is possible that genetic and environmental factors interact with metabolic derangements to accelerate NAFLD progression in diabetic patients. The diagnosis of the more advanced stages of NAFLD in diabetic patients shares the same challenges as in non-diabetic patients and it includes imaging and serological methods, although histopathological evaluation is still considered the gold standard diagnostic method. An effective established treatment is not yet available for patients with steatohepatitis and fibrosis and randomized clinical trials including only diabetic patients are lacking. We sought to outline the published data including epidemiology, pathogenesis, diagnosis and treatment of NAFLD in diabetic patients, in order to better understand the interplay between these two prevalent diseases and identify the gaps that still need to be fulfilled in the management of NAFLD in patients with diabetes mellitus.

  13. Underage College Students' Drinking Behavior, Access to Alcohol, and the Influence of Deterrence Policies: Findings from the Harvard School of Public Health College Alcohol Study.

    Science.gov (United States)

    Wechsler, Henry; Lee, Jae Eun; Nelson, Toben F.; Kuo, Meichun

    2002-01-01

    Used data from college alcohol surveys conducted between 1993-01 to compare underage students' and older students' drinking behaviors, access to alcohol, and exposure to prevention. While underage drinking rates decreased, binge drinking rates remained constant. Underage students' frequent binge drinking and related problems increased. College…

  14. 38 CFR 17.81 - Contracts for residential treatment services for veterans with alcohol or drug dependence or...

    Science.gov (United States)

    2010-07-01

    ... treatment services for veterans with alcohol or drug dependence or abuse disabilities. 17.81 Section 17.81... dependence or abuse disabilities. (a) Contracts for treatment services authorized under § 17.80(a) may be... Department of Veterans Affairs sponsored residents to adjust to and maintain freedom from dependence on...

  15. The internet trade of counterfeit spirits in Russia – an emerging problem undermining alcohol, public health and youth protection policies? [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Maria Neufeld

    2017-04-01

    Full Text Available Counterfeit alcohol belongs to the category of unrecorded alcohol not reflected in official statistics. The internet trade of alcoholic beverages has been prohibited by the Russian Federation since 2007, but various sellers still offer counterfeit spirits (i.e., forged brand spirits over the internet to Russian consumers, mostly in a non-deceptive fashion at prices up to 15 times lower than in regular sale. The public health issues arising from this unregulated trade include potential harm to underage drinkers, hazards due to toxic ingredients such as methanol, but most importantly alcohol harms due to potentially increased drinking volumes due to low prices and high availability on the internet. The internet sale also undermines existing alcohol policies such as restrictions of sale locations, sale times and minimum pricing. The need to enforce measures against counterfeiting of spirits, but specifically their internet trade should be implemented as key elements of alcohol policies to reduce unrecorded alcohol consumption, which is currently about 33 % of total consumption in Russia.

  16. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: effective treatments for post-amputation pain

    Science.gov (United States)

    Zhang, Xin; Xu, Yongming; Zhou, Jin; Pu, Shaofeng; Lv, Yingying; Chen, Yueping; Du, Dongping

    2017-01-01

    Background Post-amputation pain (PAP) is highly prevalent after limb amputation, and stump neuromas play a key role in the generation of the pain. Presently, PAP refractory to medical management is frequently treated with minimally invasive procedures guided by ultrasound, such as alcohol neurolysis and radiofrequency ablation (RFA). Objective To record the immediate and long-term efficacy of alcohol neurolysis and RFA. We first used alcohol neurolysis and then, when necessary, we performed RFA on PAP patients. Study design Prospective case series. Setting Pain management center. Methods Thirteen subjects were treated with ultrasound-guided procedures. Results All patients were treated with neurolysis using alcohol solutions guided by ultrasound. Seven (54%) of 13 subjects achieved pain relief after 1–3 alcohol injection treatments. The remaining 6 subjects obtained pain relief after receiving 2 administrations of ultrasound-guided RFA. After a 6-month follow-up evaluation period, pain quantities were also assessed. Both stump pain (including intermittent sharp pain and continuous burning pain) and phantom pain were relieved. The frequency of intermittent sharp pain was decreased, and no complications were noted during the observation. Conclusion The use of ultrasound guidance for alcohol injection and RFA of painful stump neuromas is a simple, radiation-free, safe, and effective procedure that provides sustained pain relief in PAP patients. In this case series, RFA was found to be an effective alternative to alcohol injection. PMID:28223839

  17. Corticosteroids or non-corticosteroids:a fresh perspective on alcoholic hepatitis treatment

    Institute of Scientific and Technical Information of China (English)

    FeiWang; Bing-YuanWang

    2011-01-01

    BACKGROUND: Alcoholic hepatitis (AH) is a necrotizing inflammatory process caused by alcoholic liver injury. It carries a significant short-term mortality. The management of AH is challenging. Although corticosteroids have been demonstrated to exert anti-inflammatory and antifibrotic effects, their efficacy for the treatment of AH remains debatable. DATA  SOURCES: A literature search was performed of MEDLINE, ScienceDirect, SpringerLink and Wiley InterScience usingthekey words"alcoholichepatitis","alcoholicliverdisease", and "corticosteroids". The available data reported in the relevant literaturewereanalyzed. RESULTS: More than 17 controlled trials and at least 13 meta-analyses have reported the efficacy of corticosteroids in the treatment of AH in the past 40 years. Many were poorly designed and used different inclusion/exclusion criteria, making it difficult to reach a consensus. In this review, we summarized all the controversial data in the past decade and analyzed the potential causes for the varying therapeutic effects of corticosteroids in AH. The focus of the controversy has changed from "whether steroids are beneficial or harmful for AH patients" to "how to accurately identify responders to steroids early and rationalize corticosteroid treatment". An early response to glucocorticoids, as determined by calculating the Lille score after 7 days of treatment, has been shown to be a clinically useful indicator. Moreover, down-regulation of steroid sensitivity, risk of infection, and a rational therapeutic strategy of corticosteroids in AH patients are all crucial for therapeutic effect. CONCLUSIONS: An early and accurate determination of steroid sensitivity is important. Besides, we need to overcome the down-regulation of steroid sensitivity, reduce the infection risk and rationalize the therapeutic strategy of corticosteroids. A fresh perspective is needed on the use of corticosteroids in AH patients.

  18. Access to treatment for those with alcohol, crack or other drug dependency problems--a case study in the municipality of Rio de Janeiro, Brazil.

    Science.gov (United States)

    Ribeiro, José Mendes; Moreira, Marcelo Rasga; Bastos, Francisco I; Inglez-Dias, Aline; Fernandes, Fernando Manuel Bessa

    2016-01-01

    Changes in psychiatric policies has meant more emphasis on the protection of the individual's rights, tougher regulations and disincentives regarding involuntary patient admissions, and the creation of a community network to support individuals needing help. The differing socioeconomic status of those requiring treatment coupled with guidelines issued by the Health Ministry has meant that more support and care is now being directed towards individuals and families. The rise in public awareness of the problems in these areas has aided in the changes that have taken place. Due to a lack of community public services, this has led to the proliferation of different types of services all with differing standards of care and has fueled the public debate surrounding involuntary patient admissions. Our analysis in relation to treatment for those with alcohol, crack and other drugs problems in the municipality of Rio de Janeiro, states that there are gaps related to access for all-day public services and a lack of psychiatrists in multi-disciplinary teams. There are many new and untried serviced offered by the private sector, religious bodies and public shelters which have arisen in the wake of the rise in people that need help. We took note of the development and progress of these new projects as well as the policy recommendations from the Government.

  19. Chronic disease and recent addiction treatment utilization among alcohol and drug dependent adults

    Directory of Open Access Journals (Sweden)

    Samet Jeffrey

    2011-10-01

    Full Text Available Abstract Background Chronic medical diseases require regular and longitudinal care and self-management for effective treatment. When chronic diseases include substance use disorders, care and treatment of both the medical and addiction disorders may affect access to care and the ability to focus on both conditions. The objective of this paper is to evaluate the association between the presence of chronic medical disease and recent addiction treatment utilization among adults with substance dependence. Methods Cross-sectional secondary data analysis of self-reported baseline data from alcohol and/or drug-dependent adults enrolled in a randomized clinical trial of a disease management program for substance dependence in primary care. The main independent variable was chronic medical disease status, categorized using the Katz Comorbidity Score as none, single condition of lower severity, or higher severity (multiple conditions or single higher severity condition, based on comorbidity scores determined from self-report. Asthma was also examined in secondary analyses. The primary outcome was any self-reported addiction treatment utilization (excluding detoxification in the 3 months prior to study entry, including receipt of any addiction-focused counseling or addiction medication from any healthcare provider. Logistic regression models were adjusted for sociodemographics, type of substance dependence, recruitment site, current smoking, and recent anxiety severity. Results Of 563 subjects, 184 (33% reported any chronic disease (20% low severity; 13% higher severity and 111 (20% reported asthma; 157 (28% reported any addiction treatment utilization in the past 3 months. In multivariate regression analyses, no significant effect was detected for chronic disease on addiction treatment utilization (adjusted odds ratio [AOR] 0.88 lower severity vs. none, 95% confidence interval (CI: 0.60, 1.28; AOR 1.29 higher severity vs. none, 95% CI: 0.89, 1.88 nor for

  20. The effect of co-morbid depression and anxiety on the course and outcome of alcohol outpatient treatment

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Nielsen, Bent; Stenager, Elsebeth

    2015-01-01

    Background: Studies examining the effect of alcohol treatment among patients with alcohol use disorders (AUD) and co-morbid depression and/or anxiety are few and show inconsistent, but mainly negative drinking outcomes. Aims: To describe the prevalence of anxiety and depression among Danish...... of the Addiction Severity Index at treatment start and 276 (76%) followed up after 1 year. Results: 15.7% of the patients suffered from depression and 12.7% from anxiety at baseline. Both patients with or without co-morbidity had improved on drinking outcome measures at follow-up with medium to large effect sizes....... No difference was found between patients with and without co-morbidity. Conclusion: In contrast to the majority of prior studies, this study provides evidence that depression and anxiety do not have an effect on alcohol treatment. However, because of the naturalistic setting, a number of limitations should...

  1. High-dose baclofen for the treatment of alcohol dependence (BACLAD study): a randomized, placebo-controlled trial.

    Science.gov (United States)

    Müller, Christian A; Geisel, Olga; Pelz, Patricia; Higl, Verena; Krüger, Josephine; Stickel, Anna; Beck, Anne; Wernecke, Klaus-Dieter; Hellweg, Rainer; Heinz, Andreas

    2015-08-01

    Previous randomized, placebo-controlled trials (RCTs) assessing the efficacy of the selective γ-aminobutyric acid (GABA)-B receptor agonist baclofen in the treatment of alcohol dependence have reported divergent results, possibly related to the low to medium dosages of baclofen used in these studies (30-80mg/d). Based on preclinical observations of a dose-dependent effect and positive case reports in alcohol-dependent patients, the present RCT aimed to assess the efficacy and safety of individually titrated high-dose baclofen for the treatment of alcohol dependence. Out of 93 alcohol-dependent patients initially screened, 56 were randomly assigned to a double-blind treatment with individually titrated baclofen or placebo using dosages of 30-270mg/d. The multiple primary outcome measures were (1) total abstinence and (2) cumulative abstinence duration during a 12-week high-dose phase. More patients of the baclofen group maintained total abstinence during the high-dose phase than those receiving placebo (15/22, 68.2% vs. 5/21, 23.8%, p=0.014). Cumulative abstinence duration was significantly higher in patients given baclofen compared to patients of the placebo group (mean 67.8 (SD 30) vs. 51.8 (SD 29.6) days, p=0.047). No drug-related serious adverse events were observed during the trial. Individually titrated high-dose baclofen effectively supported alcohol-dependent patients in maintaining alcohol abstinence and showed a high tolerability, even in the event of relapse. These results provide further evidence for the potential of baclofen, thereby possibly extending the current pharmacological treatment options in alcohol dependence.

  2. Assessment of motivation for treatment in alcohol dependent patients who sought treatment at a specialized medical service

    Directory of Open Access Journals (Sweden)

    Oliveira Júnior Hercílio Pereira de

    2003-01-01

    Full Text Available INTRODUCTION: Motivation is deemed a critical component for interventions intended to change behaviors related to the use of alcohol and other drugs. The classification of patients in 'stages of change' can be a useful tool for the organization and improvement of treating programs. METHODS: This study assessed the stages of change using the scales URICA and SOCRATES in patients who attended two different treating programs for alcohol dependence in a specialized medical service. We performed an analysis of the association between stages of change and demographic aspects. After three months of treatment, patients were reassessed to evaluate their outcome. RESULTS: In the assessments using URICA, there was an association between stages of change and monthly income and age. There was no evidence that patients move across the stages of change. Using the scale SOCRATES, we found an association between stages of change and monthly income. In the reassessment, there was a significant movement across the stages of change. CONCLUSION: Patients who attend two different treating programs may have different motivation profiles. There was no movement congruent with the stage of change model, suggesting that patients may need more than 3 months to obtain significant changes in their motivation.

  3. The predictive validity of the Drinking-Related Cognitions Scale in alcohol-dependent patients under abstinence-oriented treatment

    Directory of Open Access Journals (Sweden)

    Sawayama Toru

    2012-05-01

    Full Text Available Abstract Background Cognitive factors associated with drinking behavior such as positive alcohol expectancies, self-efficacy, perception of impaired control over drinking and perception of drinking problems are considered to have a significant influence on treatment effects and outcome in alcohol-dependent patients. However, the development of a rating scale on lack of perception or denial of drinking problems and impaired control over drinking has not been substantial, even though these are important factors in patients under abstinence-oriented treatment as well as participants in self-help groups such as Alcoholics Anonymous (AA. The Drinking-Related Cognitions Scale (DRCS is a new self-reported rating scale developed to briefly measure cognitive factors associated with drinking behavior in alcohol-dependent patients under abstinence-oriented treatment, including positive alcohol expectancies, abstinence self-efficacy, perception of impaired control over drinking, and perception of drinking problems. Here, we conducted a prospective cohort study to explore the predictive validity of DRCS. Methods Participants in this study were 175 middle-aged and elderly Japanese male patients who met the DSM-IV Diagnostic Criteria for Alcohol Dependence. DRCS scores were recorded before and after the inpatient abstinence-oriented treatment program, and treatment outcome was evaluated one year after discharge. Results Of the 175 participants, 30 were not available for follow-up; thus the number of subjects for analysis in this study was 145. When the total DRCS score and subscale scores were compared before and after inpatient treatment, a significant increase was seen for both scores. Both the total DRCS score and each subscale score were significantly related to total abstinence, percentage of abstinent days, and the first drinking occasion during the one-year post-treatment period. Therefore, good treatment outcome was significantly predicted by low

  4. Cost-effectiveness of home visits in the outpatient treatment of patients with alcohol dependence.

    Science.gov (United States)

    Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos B

    2010-01-01

    The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure - abstinent cases at the end of treatment. There were 51.8% abstinent cases for HV and 43.1% for CT, a clinically relevant finding. Other outcome measures, such as quality of life, also showed significant improvements that favored HV. The baseline scenario presented an ICER of USD 1,852. Sensitivity analysis showed an ICER of USD 689 (scenario favoring HV) and USD 2,334 (scenario favoring CT). The HV treatment was found to be cost-effective according to the WHO Commission on Macroeconomics and Health. 2009 S. Karger AG, Basel.

  5. A Literature Review of Cost-Benefit Analyses for the Treatment of Alcohol Dependence

    Directory of Open Access Journals (Sweden)

    Satya Mohapatra

    2011-08-01

    Full Text Available The purpose of this study was to conduct a literature review of cost-benefit studies on pharmacotherapy and psychotherapy treatments of alcohol dependence (AD. A literature search was performed in multiple electronic bibliographic databases. The search identified seven psychotherapy studies from the USA and two pharmacotherapy studies from Europe. In the psychotherapy studies, major benefits are typically seen within the first six months of treatment. The benefit-cost ratio ranged from 1.89 to 39.0. Treatment with acamprosate was found to accrue a net benefit of 21,301 BEF (528 € per patient over a 24-month period in Belgium and lifetime benefit for each patient in Spain was estimated to be Pta. 3,914,680 (23,528 €. To date, only a few studies exist that have examined the cost-benefit of psychotherapy or pharmacotherapy treatment of AD. Most of the available treatment options for AD appear to produce marked economic benefits.

  6. Effect of acid concentration and treatment time on acid-alcohol modified jackfruit seed starch properties.

    Science.gov (United States)

    Dutta, Himjyoti; Paul, Sanjib Kumar; Kalita, Dipankar; Mahanta, Charu Lata

    2011-09-15

    The properties of starch extracted from jackfruit (Artocarpus heterophyllus Lam.) seeds, collected from west Assam after acid-alcohol modification by short term treatment (ST) for 15-30min with concentrated hydrochloric acid and long term treatment (LT) for 1-15days with 1M hydrochloric acid, were investigated. Granule density, freeze thaw stability, solubility and light transmittance of the treated starches increased. A maximum decrease in the degree of polymerisation occurred in ST of 30min (2607.6). Jackfruit starch had 27.1±0.04% amylose content (db), which in ST initially decreased and then increased with the severity of treatment; in LT the effect was irregular. The pasting profile and granule morphology of the treated samples were severely modified. Native starch had the A-type crystalline pattern and crystalline structure increased on treatment. FTIR spectra revealed slight changes in bond stretching and bending. Colour measurement indicated that whiteness increased on treatment. Acid modified jackfruit seed starch can have applications in the food industry.

  7. Suicidal ideation among adolescents with alcohol use disorders during treatment and aftercare.

    Science.gov (United States)

    Kaminer, Yifrah; Burleson, Joseph A; Goldston, David B; Burke, Rebecca H

    2006-01-01

    The objectives of this study are to assess the magnitude and course of suicidal ideation during outpatient treatment and aftercare for adolescents with alcohol use disorders (AUD). One hundred seventy-seven adolescents meeting eligibility criteria, including no past 30-day suicidal behavior, participated in 9 weeks of outpatient cognitive-behavioral group therapy. Treatment completers were randomized into: (1) No-Active, (2) In-Person, or (3) Telephone aftercare conditions for a period of 12 weeks. No specific intervention for suicidal behavior was provided during the study. The Suicide Ideation Questionnaire (SIQ-JR, Reynolds, 1988) was administered at baseline, end of treatment, and end of aftercare. The results are as follows, a higher baseline suicidal ideation was associated with higher retention at the end of treatment and through aftercare. The In-Person Aftercare condition showed a significant decrease in suicidal ideation, relative to the No-Active Aftercare condition. There was a trend for similarly reduced severity of suicidal ideation in the Telephone Aftercare condition. In conclusion, the type of aftercare and resulting decrease in AUD may play a role in the reduction in suicidal ideation. The mechanism of change by which suicidal ideation is reduced in adolescents in treatment for AUD needs to be further explored.

  8. Public scandal about the nuclear waste treatment industry. Der Atommuellskandal

    Energy Technology Data Exchange (ETDEWEB)

    1988-01-01

    The events leading to the public scandal are summarized into three main items: (1) Accusation for taking bribe in the form of money and in kind. (2) Suspicion of false labelling of radioactive waste. (3) Suspicion of offense against the Non-Proliferation Treaty. The survey in hand is intended to prepare a sober judgement of the situation by: stating the facts and their significance in terms of safety; explaining the various types of radioactive wastes, their treatment and the quantities involved; explaining the legal provisions for transport of radioactive materials; discussing the problem of nuclear waste management in terms of quantity. The lesson to be drawn is that controls and further means of quality assurance are required to make the pathways of radioactive wastes are pellucid and verifiable. (orig./HSCH).

  9. Implementing a Public Health Objective for Alcohol Premises Licensing in Scotland: A Qualitative Study of Strategies, Values, and Perceptions of Evidence

    Science.gov (United States)

    Fitzgerald, Niamh; Nicholls, James; Winterbottom, Jo; Katikireddi, Srinivasa Vittal

    2017-01-01

    The public health objective for alcohol premises licensing, established in Scotland in 2005, is unique globally. We explored how public health practitioners engaged with the licensing system following this change, and what helped or hindered their efforts. Semi-structured interviews were conducted with 13 public health actors, audio-recorded, and analysed using an inductive framework approach. Many interviewees viewed the new objective as synonymous with reducing population-level alcohol consumption; however, this view was not always shared by licensing actors, some of whom did not accept public health as a legitimate goal of licensing, or prioritised economic development instead. Some interviewees were surprised that the public health evidence they presented to licensing boards did not result in their hoped-for outcomes; they reported that licensing officials did not always understand or value health data or statistical evidence. While some tried to give “impartial” advice to licensing boards, this was not always easy; others were clear that their role was one of “winning hearts and minds” through relationship-building with licensing actors over time. Notwithstanding the introduction of the public health objective, there remain significant, and political, challenges in orienting local premises licensing boards towards decisions to reduce the availability of alcohol in Scotland. PMID:28241512

  10. Dietary sodium, potassium, and alcohol: key players in the pathophysiology, prevention, and treatment of human hypertension.

    Science.gov (United States)

    Koliaki, Chrysi; Katsilambros, Nicholas

    2013-06-01

    Western industrialized societies are currently experiencing an epidemic expansion of hypertension (HTN), which extends alarmingly even to children and adolescents. HTN constitutes an independent risk factor for cardiorenal disease and represents an extremely common comorbidity of diabetes and obesity. Numerous randomized clinical trials and meta-analyses have provided robust scientific evidence that reduced dietary salt intake, increased dietary potassium intake, moderation of alcohol consumption, optimal weight maintenance, and the adoption of "heart-friendly" dietary patterns such as the Dietary Approaches to Stop Hypertension or the Mediterranean diet can effectively lower blood pressure. Interestingly, the susceptibility of blood pressure to nutritional interventions is greatly variable among individuals, depending on age, race, genetic background, and comorbidities. The purpose of this review is to provide a comprehensive overview of currently available scientific evidence in the constantly evolving field of diet and HTN, placing particular emphasis on the key role of dietary sodium, dietary potassium, and alcohol intake in the pathophysiology, prevention, and treatment of human hypertension. © 2013 International Life Sciences Institute.

  11. [The treatment received by public health services users in Mexico].

    Science.gov (United States)

    Puentes Rosas, Esteban; Gómez Dantés, Octavio; Garrido Latorre, Francisco

    2006-06-01

    To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users' socioeconomic status. The data were obtained by means of a survey of 18 018 users who visited 73 health services in 13 states within Mexico. They were asked to grade the way the institution had performed in seven of the eight domains that define appropriate user treatment (autonomy, confidentiality, communication, respectful manner, condition of basic facilities, access to social assistance networks, and free user choice). The questionnaire included some vignettes to help determine user expectations. A composite ordinal probit model was applied; the perception of quality in connection with each of the appropriate treatment domains was the independent variable, whereas gender, educational level, age, type of provider, and user expectations were used as control variables. The type of provider was the main factor that determined users' perceptions regarding the treatment they received when visiting health services in Mexico. Institutions belonging to the social security system performed the worst, while the services provided under the program targeting the rural population (IMSS Oportunidades) received the highest scores. Overall, the domain that was most highly ranked was respectful manner, whereas the lowest score was given to the ability to choose the provider. Men felt they had been able to communicate better than women, while respectful manner, communication, and social support showed a significant negative association with educational level (P < 0.05). Differences were noted in the way different public health service providers in Mexico treat their users, regardless of the latter's socioeconomic status. Social security system providers showed the greatest deficiencies in this respect. Respectful manner was the domain that received the highest scores in the case of all providers. Organizational

  12. Gender Differences in Early Maladaptive Schemas in a Treatment-Seeking Sample of Alcohol-Dependent Adults

    Science.gov (United States)

    Shorey, Ryan C.; Anderson, Scott E.; Stuart, Gregory L.

    2012-01-01

    The current study examined early maladaptive schemas among alcohol-dependent men and women and sought to determine whether men and women differed in their early maladaptive schemas. Using preexisting patient records of adults diagnosed with alcohol dependence from a residential treatment center in the Southeastern United States, from 2005 to 2010 (N = 854), results showed that women scored significantly higher than men on 14 of the 18 early maladaptive schemas assessed. Both women and men endorsed having a number of early maladaptive schemas, with four schemas being particularly prevalent across gender. Study limitations are noted and implications of these findings for treatment and future research are discussed. PMID:22060801

  13. The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK.

    Science.gov (United States)

    Rice, Peter; Drummond, Colin

    2012-09-01

    The UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.

  14. Changes in concentration of visfatin during four weeks of inpatient treatment of alcohol dependent males

    Directory of Open Access Journals (Sweden)

    Damian Czarnecki

    2015-09-01

    Conclusions: The dynamic of change in the concentration of visfatin during four weeks of abstinence is not associated with a reduction in craving for alcohol at the time and is associated with alcohol drinking and liver functioning.

  15. Removal and environmental exposure of alcohol ethoxylates in US sewage treatment.

    Science.gov (United States)

    Morrall, S W; Dunphy, J C; Cano, M L; Evans, A; McAvoy, D C; Price, B P; Eckhoff, W S

    2006-05-01

    Alcohol ethoxylates (AE) are a common nonionic surfactant employed in consumer and industrial detergents worldwide. Commercial AE are typically complex mixtures composed of > 100 homologous compounds with varying alkyl chain lengths and varying numbers of ethylene oxide (EO) units. Recent improvements in analytical methodology have enabled accurate measurement of the entire AE mixture in sewage treatment plant (STP) influents and effluents, including alkyl chain lengths from 12 to 18 carbons with a range of ethoxylation from 0 to 18 EO units. These improved analytical methods were used to measure AE concentrations at nine sites representative of sewage treatment processes and geographical locations. These new data will make possible a more accurate assessment of environmental risk for AE in the United States. The results indicate that all AE homologues are effectively removed (> 99%) in the most common treatment types. Individual STP total AE effluent concentrations ranged from a low of 0.92 microg/L for activated sludge to a high of 15.6 microg/L for a trickling filter process. For the purpose of representing a national average distribution, an average-flow-weighted wastewater treatment plant effluent concentration was determined for each AE component. The total-flow-weighted average AE effluent concentration was 3.64 microg/L.

  16. Practitioner Review: Adolescent Alcohol Use Disorders--Assessment and Treatment Issues

    Science.gov (United States)

    Perepletchikova, Francheska; Krystal, John H.; Kaufman, Joan

    2008-01-01

    Background: Alcohol use disorders in adolescents are associated with significant morbidity and mortality. Over the past decade, there has been a burgeoning of research on adolescent alcohol use disorders. Methods: A summary of the alcohol assessment tools is provided, and randomized studies reviewed and synthesized to provide an overview of state…

  17. The Influence of Parental Emotional Neglect on Assault Victims Seeking Treatment for Depressed Mood and Alcohol Misuse: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Kylie A. Bailey

    2016-10-01

    Full Text Available This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS, depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220 with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation identified the two assault factors of sexual assault (SA and physical assault (PA. A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.

  18. A randomized comparative trial in the management of Alcohol Dependence: Individualized Homoeopathy versus standard Allopathic Treatment

    Directory of Open Access Journals (Sweden)

    Raj K Manchanda

    2016-01-01

    Full Text Available Objectives: This study was undertaken to compare the effects of IH with standard allopathic (SA treatment. Methods: A randomized controlled, open-label, comparative trial, was conducted, in which alcohol dependents were screened verbally using the CAGE scale. The participants 80 patients fulfilling the inclusion criteria were randomized either IH (n=40 or SA (n=40 and treated cum followed up for 12 months. The primary outcome was more than 50% reduction in the Severity of Alcohol Dependence Questionnaire [SADQ] rating scale at 12 th month. Data analysis was done for both intention-to-treat (ITT and per-protocol (PP populations. Results: ITT analysis reflected 80% (n = 32 of the patients in IH and 37.5% (n = 15 of the patients in the SA responding to CI before 2.4 treatment with absolute difference was 42.5% (42.5 [95% confidence interval [CI]: 23.0, 61.6] and estimated effect: 6.6 (95% C.I: 2.4, 18.2, P = 0.0002. A significant difference favoring IH was also observed in three out of four domains of WHO QOL-BREF. Statistically significant difference was found in the number of drinking days (median difference: −24.00; CI: −39.0-−8.0; P = 0.001 and number of drinks per drinking day (median difference: −6.3 [95% CI: −11.3-−1.9]; P = 0.004, favoring IH. The results showed a similar trend in PP analysis. Medicines found useful were Sulphur, Lycopodium clavatum, Arsenicum album, Nux vomica, Phosphorus, and Lachesis. Conclusion: The results conclude that IH is not inferior to SA in the management of AD patients. More rigorous studies with large sample size are however desirable.

  19. Metamorphoses of alcohol addiction’s pathomorphism and the new approaches to its treatment

    Directory of Open Access Journals (Sweden)

    Константин Дмитриевич Гапонов

    2015-07-01

    Full Text Available Aim: to elaborate the differentiated system of medical and rehabilitation accompaniment of patients from the position of biopsychosocial   approach to the modern pathomorphism of alcohol addiction (AA.Methods: retrospective analysis of medical documentation, clinical and anamnestic, social and demographic, clinical and psychopathologic, psychodiagnostic, statistical.Results. In the research it was proved an existence of such phenomenon as pathomorphism of AA in the modern period, identified its meaning content and marked out its psychosocial, clinical and therapeutic forms that can exist separately or turn from the one to another causing the complication of medical and social effects of AA.  It was also established the specificity of clinical and psychopathologic and social peculiarities of AA that were systematized as indicators of intensity of the harmful effects of AA that were united into clusters of signs in aspect of optimization of its complex treatment: minimal, apparent and heavy harmful effects. It was proved the necessity of its detection as a criterion of differentiation of the choice of content and volume of measures of medical and rehabilitation accompaniment of patients with AA depending on heaviness of the harmful effects of an alcohol disease. It was detected the peculiarities of an ability to perception of the social support in persons with alcoholic addiction.  Compromise of emotional and volitional features of person and the low communicative and emotional competence that form a personal resource of perception of the social support and also the negative dynamics of the aforesaid phenomenon in patients with AA in progression of disease were defined as the main impact factors on the process of perception of the social support.On the base of analysis and generalization of received data there was elaborated an algorithm of assessment of rehabilitation potential (RP of patients with AA as a criterion of differentiation of the

  20. The fate of linear alcohol ethoxylates during activated sludge sewage treatment.

    Science.gov (United States)

    Battersby, N S; Sherren, A J; Bumpus, R N; Eagle, R; Molade, I K

    2001-10-01

    Model continuous activated sludge (CAS) plants (Husmann units) were used to study the fate of two commercial, alcohol ethoxylate (AE) surfactants during aerobic sewage treatment. The surfactants were produced by the ethoxylation of an essentially linear C(12-15) alcohol (NEODOL 25) with an average of 7 (C(12-15)EO7) or 3 (C(12-15)EO3) moles of ethylene oxide (EO). Recent analytical developments made it possible to measure levels of AE that included the free alcohol and EO1 oligomers across the CAS system, from the influent feed, on the activated sludge, through to the effluent. Measured concentrations of AE (as C(12-15)EO(0-20)) in the synthetic sewage feeds to the test CAS plants lay in the range 11-13 mg/l. During stable operation at 20 degrees C, an average of 5 microg/l AE were present in the C(12-15)EO7 CAS plant effluent, giving a removal (bioelimination) of >99.9%. When levels of AE on the sludge, and polyethylene glycols (PEGs--an expected biodegradation intermediate) in the effluent and on the sludge were also taken into account, biodegradation was considered to be responsible for >98.7% of the observed removal. During operation at a winter temperature (10 degrees C), an average of 26 microg/l AE were present in the C(12-15)EO7 CAS plant effluent, giving a removal of 99.8%. Biodegradation was estimated to be responsible for >97.2% of the observed removal. During operation at 20 degrees C, an average of 7 microg/l AE were present in the C(12-15)EO3 CAS plant effluent, giving a removal of >99.9%. No analysis for PEG was performed in this case but the low level of AE on the sludge (0.2 mg/g dry solids) suggested that biodegradation was responsible for most of the observed removal. Neither surfactant had any adverse effect on the sewage treatment efficiencies of the CAS plants in terms of dissolved organic carbon (DOC) removal, nitrification or biomass levels.

  1. Ultrasound-guided alcohol neurolysis and radiofrequency ablation of painful stump neuroma: effective treatments for post-amputation pain

    Directory of Open Access Journals (Sweden)

    Zhang X

    2017-02-01

    Full Text Available Xin Zhang, Yongming Xu, Jin Zhou, Shaofeng Pu, Yingying Lv, Yueping Chen, Dongping Du Pain Management Center, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, People’s Republic of China Background: Post-amputation pain (PAP is highly prevalent after limb amputation, and stump neuromas play a key role in the generation of the pain. Presently, PAP refractory to medical management is frequently treated with minimally invasive procedures guided by ultrasound, such as alcohol neurolysis and radiofrequency ablation (RFA.Objective: To record the immediate and long-term efficacy of alcohol neurolysis and RFA. We first used alcohol neurolysis and then, when necessary, we performed RFA on PAP patients.Study design: Prospective case series.Setting: Pain management center.Methods: Thirteen subjects were treated with ultrasound-guided procedures.Results: All patients were treated with neurolysis using alcohol solutions guided by ultrasound. Seven (54% of 13 subjects achieved pain relief after 1–3 alcohol injection treatments. The remaining 6 subjects obtained pain relief after receiving 2 administrations of ultrasound-guided RFA. After a 6-month follow-up evaluation period, pain quantities were also assessed. Both stump pain (including intermittent sharp pain and continuous burning pain and phantom pain were relieved. The frequency of intermittent sharp pain was decreased, and no complications were noted during the observation.Conclusion: The use of ultrasound guidance for alcohol injection and RFA of painful stump neuromas is a simple, radiation-free, safe, and effective procedure that provides sustained pain relief in PAP patients. In this case series, RFA was found to be an effective alternative to alcohol injection. Keywords: post-amputation pain, neuroma, ultrasound-guided, alcohol neurolysis, radiofrequency ablation

  2. Anxiety and Art Therapy: Treatment in the Public Eye

    Science.gov (United States)

    Chambala, Amanda

    2008-01-01

    Anxiety is one of the most common mental health problems in the United States today. It is the number one mental health problem among American women and ranks as a close second to substance abuse among men. In fact, alcoholism is the only other disorder that affects a greater number of people throughout the county. Fifteen percent of the American…

  3. Medical cost-offset following treatment referral for alcohol and other drug use disorders in a group model HMO.

    Science.gov (United States)

    Polen, Michael R; Freeborn, Donald K; Lynch, Frances L; Mullooly, John P; Dickinson, Daniel M

    2006-07-01

    The purpose of this study was to determine whether specialty alcohol and other drug (AOD) treatment is associated with reduced subsequent medical care costs. AOD treatment costs and medical costs in a group model health maintenance organization (HMO) were collected for up to 6 years on 1,472 HMO members who were recommended for specialty AOD treatment, and on 738 members without AOD diagnoses or treatment. Addiction Severity Index measures were also obtained from a sample of 293 of those recommended for treatment. Changes in medical costs did not differ between treatment and comparison groups. Nor did individuals with improved treatment outcomes have greater reductions in medical costs. AOD treatment costs were not inversely related to subsequent medical costs, except for a subgroup with recent AOD treatment. In the interviewed sample, better treatment outcomes did not predict lower subsequent medical costs. Multiple treatment episodes may hold promise for producing cost-offsets.

  4. Behavioural profile of drug users attending public drug-treatment centres in Sicily: the role of social context

    Directory of Open Access Journals (Sweden)

    Francesco Vitale

    2007-12-01

    Full Text Available

    Objective: Investigations of injecting drug users (IDUs have suggested that the social context may influence high-risk behaviours in this population. The aim of this study was to describe knowledge, attitudes and behaviours of IDUs attending public drug-treatment centres in our area.

    Study design and methods: A cross-sectional survey was conducted between July 2002 and February 2004, enrolling 607 drug users attending four public drug-treatment centres in the Palermo area. Two of them were located inside the urban area, whereas the other two were in rural districts near the city. All participants answered an anonymous questionnaire concerning social and demographic characteristic and potential high-risk behaviours.

    Results: IDUs living in urban context have a higher educational level, higher number of sexual partners, as well as a lower prevalence of exchanging sex for drugs. Conversely, IDUs living in suburban/rural context are less likely to share syringes and more likely to have used light drugs in the past. Suburban/rural IDUs drink more alcohol but smoke less cigarettes/day, although both groups are strong smokers.

    Conclusions: The results suggest that public drug-treatment centres should take in consideration the adoption of specific programs targeting specific groups, in line with the profile and needs of the subjects in each context in order to promote approaches leading to risk reduction.

  5. Alcoholic dogs and glory for all: the Anti-Saloon League and public relations, 1913.

    Science.gov (United States)

    Lamme, Margot Opdycke

    2007-01-01

    In 1913, the Anti-Saloon League of America declared its intention to pursue national prohibition. While it continued to adhere to its core principles of agitation, it expanded its communication efforts and entered a partnership with the Scientific Temperance Federation, a spin-off of the education arm of the Woman's Christian Temperance Union. The League's tactics were not necessarily new to the temperance movement -- or even to other reform movements of the time. What did set it apart was its single-minded focus on stopping the liquor traffic. Tracing through archival artifacts the League's communication strategies and tactics during 1913, then, this study contributes to a larger body of work that seeks to expand on the traditional model of public relations history.

  6. Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease

    Institute of Scientific and Technical Information of China (English)

    Matteo Nicola Dario Di Minno; Anna Russolillo; Roberta Lupoli; Pasquale Ambrosino; Alessandro Di Minno; Giovanni Tarantino

    2012-01-01

    Non-alcoholic fatty liver disease (NAFLD) has been recognized as a major health burden.It is the most important cause of chronic liver disease and a major independent cardiovascular risk factor.Lacking a definite treatment for NAFLD,a specific diet and an increase in physical activity represent the most commonly used therapeutic approaches.In this review,major literature data about the use of omega-3 polyunsaturated fatty acids (n-3 PUFAs) as a potential treatment of NAFLD have been described.n-3 PUFAs,besides having a beneficial impact on most of the cardio-metabolic risk factors (hypertension,hyperlipidemia,endothelial dysfunction and atherosclerosis) by regulating gene transcription factors [i.e.,peroxisome proliferator-activated receptor (PPAR)α,PPARγ,sterol regulatory element-binding protein-1,carbohydrate responsive element-binding protein],impacts both lipid metabolism and on insulin sensitivity.In addition to an enhancement of hepatic beta oxidation and a decrease of the endogenous lipid production,n-3 PUFAs are able to determine a significant reduction of the expression of pro-inflammatory molecules (tumor necrosis factor-α and interleukin-6) and of oxygen reactive species.Further strengthening the results of the in vitro studies,both animal models and human intervention trials,showed a beneficial effect of n-3 PUFAs on the severity of NAFLD as expressed by laboratory parameters and imaging measurements.Despite available results provided encouraging data about the efficacy of n-3 PUFAs as a treatment of NAFLD in humans,well-designed randomized controlled trials of adequate size and duration,with histological endpoints,are needed to assess the long-term safety and efficacy of PUFA,as well as other therapies,for the treatment of NAFLD and non-alcoholic steatohepatitis patients.It is worthwhile to consider that n-3 PUFAs cannot be synthesized by the human body and must be derived from exogenous sources (fish oil,flaxseeds,olive oil) which are typical foods

  7. Recovery Poetry 101: The Use of Collaborative Poetry in a Dual-Diagnosis Drug and Alcohol Treatment Program.

    Science.gov (United States)

    Gillispie, Charles

    2001-01-01

    Presents a practice report that profiles the use of collaborative writing techniques in a dual-diagnosis drug and alcohol treatment program. Provides examples of typical patient-generated collaborative poems. Concludes that collaborative group poetry, when effectively facilitated, can generate a meaningful process-discussion toward values…

  8. Unhealthy behaviors during pregnancy : who continues to smoke and consume alcohol, and is treatment of anxiety and depressive symptoms effective?

    NARCIS (Netherlands)

    Beijers, Chantal

    2014-01-01

    This thesis investigated continued smoking and alcohol consumption during pregnancy, and treatment of anxiety and depressive symptoms during pregnancy using cognitive behavioral therapy. Data from a large prospective population-based cohort study and a randomized controlled trial were used. Regardin

  9. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... Enter ZIP code here PTSD and Problems with Alcohol Use Public This section is for Veterans, General Public, Family, & Friends PTSD and Problems with Alcohol Use PTSD and alcohol use problems are often ...

  10. Aerobic exercise training in the treatment of non‐alcoholic fatty liver disease related fibrosis

    Science.gov (United States)

    Linden, Melissa A.; Sheldon, Ryan D.; Meers, Grace M.; Ortinau, Laura C.; Morris, E. Matthew; Booth, Frank W.; Kanaley, Jill A.; Vieira‐Potter, Victoria J.; Sowers, James R.; Ibdah, Jamal A.; Thyfault, John P.; Laughlin, M. Harold

    2016-01-01

    Key points Physiologically relevant rodent models of non‐alcoholic steatohepatitis (NASH) that resemble the human condition are limited.Exercise training and energy restriction are first‐line recommendations for the treatment of NASH.Hyperphagic Otsuka Long–Evans Tokushima fatty rats fed a western diet high in fat, sucrose and cholesterol for 24 weeks developed a severe NASH with fibrosis phenotype.Moderate intensity exercise training and modest energy restriction provided some improvement in the histological features of NASH that coincided with alterations in markers of hepatic stellate cell activation and extracellular matrix remodelling.The present study highlights the importance of lifestyle modification, including exercise training and energy restriction, in the regulation of advanced liver disease. Abstract The incidence of non‐alcoholic steatohepatitis (NASH) is rising but the efficacy of lifestyle modifications to improve NASH‐related outcomes remain unclear. We hypothesized that a western diet (WD) would induce NASH in the Otsuka Long–Evans Tokushima Fatty (OLETF) rat and that lifestyle modification would improve this condition. Eight‐week‐old Long–Evans Tokushima Otsuka (L) and OLETF (O) rats consumed a control diet (10% kcal fat, 3.5% sucrose) or a WD (45% kcal fat, 17% sucrose, 1% cholesterol) for 24 weeks. At 20 weeks of age, additional WD‐fed OLETFs were randomized to sedentary (O‐SED), food restriction (O‐FR; ∼25% kcal reduction vs. O‐SED) or exercise training (O‐EX; treadmill running 20 m min–1 with a 15% incline, 60 min day–1, 5 days week–1) conditions for 12 weeks. WD induced a NASH phenotype in OLETFs characterized by hepatic fibrosis (collagen 1α1 mRNA and hydroxyproline content), as well as elevated inflammation and non‐alcoholic fatty liver disease activity scores, and hepatic stellate cell activation (α‐smooth muscle actin) compared to Long–Evans Tokushima Otsuka rats. FR and EX modestly

  11. Physical exercise as a supplement to outpatient treatment of alcohol use disorders – design and preliminary results of a randomized controlled trial

    DEFF Research Database (Denmark)

    Sari, Sengül; Bilberg, Randi Marie; Roessler, Kirsten Kaya

    . The aim of this study is to investigate the effect of physical exercise on alcohol intake, cardio-respiratory fitness and socio-psychological outcomes. Methods and design The study is a randomized controlled trial with three arms: (A) Standard treatment alone, (B) Standard treatment and physical exercise...... the study and inform about the first preliminary results. Perspectives If this study detects a positive relationship between exercise as a supplement to alcohol treatment and patients’ alcohol intake, quality of life, fitness, well-being, anxiety, depression and interpersonal problems......Background and aim Alcohol use disorder is a widespread problem in Denmark and has severe impacts on health and quality of life of each individual. The clinical treatment of alcohol use disorder involves evidence-based knowledge on medical treatment, physical training, and psychological management...

  12. Involvement of the TAGE-RAGE system in non-alcoholic steatohepatitis: Novel treatment strategies

    Institute of Scientific and Technical Information of China (English)

    Masayoshi; Takeuchi; Jun-ichi; Takino; Akiko; Sakasai-Sakai; Takanobu; Takata; Tadashi; Ueda; Mikihiro; Tsutsumi; Hideyuki; Hyogo; Sho-ichi; Yamagishi

    2014-01-01

    Non-alcoholic fatty liver disease(NAFLD)is a major cause of liver disease around the world.It includes a spectrum of conditions from simple steatosis to non-alcoholic steatohepatitis(NASH)and can lead to fibrosis,cirrhosis,liver failure,and/or hepatocellular carcinoma.NAFLD is also associated with other medical conditions such as obesity,diabetes mellitus(DM),metabolic syn-drome,hypertension,insulin resistance,hyperlipidemia,and cardiovascular disease(CVD).In diabetes,chronic hyperglycemia contributes to the development of both macro-and microvascular conditions through a variety of metabolic pathways.Thus,it can cause a variety of metabolic and hemodynamic conditions,including upregulated advanced glycation end-products(AGEs)synthesis.In our previous study,the most abundant type of toxic AGEs(TAGE);i.e.,glyceraldehyde-derived AGEs,were found to make a significant contribution to the pathogenesis of DM-induced angiopathy.Furthermore,accumulating evidence suggests that the binding of TAGE with their receptor(RAGE)induces oxidative damage,promotes inflammation,and causes changes in intracellular signaling and the expression levels of certain genes in various cell populations including hepatocytes and hepatic stellate cells.All of these effects could facilitate the pathogenesis of hypertension,cancer,diabetic vascular complications,CVD,dementia,and NASH.Thus,inhibiting TAGE synthesis,preventing TAGE from binding to RAGE,and downregulating RAGE expression and/or the expression of associated effector molecules all have potential as therapeutic strategies against NASH.Here,we examine the contributions of RAGE and TAGE to various conditions and novel treatments that target them in order to prevent the development and/or progression of NASH.

  13. Implications for alcohol minimum unit pricing advocacy: what can we learn for public health from UK newsprint coverage of key claim-makers in the policy debate?

    Science.gov (United States)

    Hilton, Shona; Wood, Karen; Patterson, Chris; Katikireddi, Srinivasa Vittal

    2014-02-01

    On May 24th 2012, Scotland passed the Alcohol (Minimum Pricing) Bill. Minimum unit pricing (MUP) is an intervention that raises the price of the cheapest alcohol to reduce alcohol consumption and related harms. There is a growing literature on industry's influence in policymaking and media representations of policies, but relatively little about frames used by key claim-makers in the public MUP policy debate. This study elucidates the dynamic interplay between key claim-makers to identify lessons for policy advocacy in the media in the UK and internationally. Content analysis was conducted on 262 articles from seven UK and three Scottish national newspapers between 1st May 2011 and 31st May 2012, retrieved from electronic databases. Advocates' and critics' constructions of the alcohol problem and MUP were examined. Advocates depicted the problem as primarily driven by cheap alcohol and marketing, while critics' constructions focused on youth binge drinkers and dependent drinkers. Advocates justified support by citing the intervention's targeted design, but critics denounced the policy as illegal, likely to encourage illicit trade, unsupported by evidence and likely to be ineffective, while harming the responsible majority, low-income consumers and businesses. Critics' arguments were consistent over time, and single statements often encompassed multiple rationales. This study presents advocates with several important lessons for promoting policies in the media. Firstly, it may be useful to shift focus away from young binge drinkers and heavy drinkers, towards population-level over-consumption. Secondly, advocates might focus on presenting the policy as part of a wider package of alcohol policies. Thirdly, emphasis on the success of recent public health policies could help portray the UK and Scotland as world leaders in tackling culturally embedded health and social problems through policy; highlighting past successes when presenting future policies may be a valuable

  14. Effects of herbal infusions, tea and carbonated beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity.

    Science.gov (United States)

    Li, Sha; Gan, Li-Qin; Li, Shu-Ke; Zheng, Jie-Cong; Xu, Dong-Ping; Li, Hua-Bin

    2014-01-01

    Various alcoholic beverages containing different concentrations of ethanol are widely consumed, and excessive alcohol consumption may result in serious health problems. The consumption of alcoholic beverages is often accompanied by non-alcoholic beverages, such as herbal infusions, tea and carbonated beverages to relieve drunk symptoms. The aim of this study was to supply new information on the effects of these beverages on alcohol metabolism for nutritionists and the general public, in order to reduce problems associated with excessive alcohol consumption. The effects of 57 kinds of herbal infusions, tea and carbonated beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity were evaluated. Generally, the effects of these beverages on alcohol dehydrogenase and aldehyde dehydrogenase activity are very different. The results suggested that some beverages should not be drank after excessive alcohol consumption, and several beverages may be potential dietary supplements for the prevention and treatment of problems related to excessive alcohol consumption.

  15. Recent Advances in the Herbal Treatment of Non-Alcoholic Fatty Liver Disease

    Directory of Open Access Journals (Sweden)

    Jia Xiao

    2013-04-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD is one of the leading causes of chronic liver injury across the world. It is also strongly related to other pathological conditions, including obesity, diabetes, cardiovascular diseases, and symptoms of metabolic syndrome. Pathogenesis of NAFLD remains not fully characterized but is generally attributed to the occurrence of insulin resistance, lipid metabolism dysfunction, oxidative stress, inflammation, and necro-apoptosis. Every potential therapeutic strategy should target one or some of these pathological events in the liver. Over the past decades, application of herbal treatment for NAFLD has received increasing attention due to its wide availability, low side effects, and proven therapeutic mechanisms and benefits. In recent years, some monomers and certain functional mixtures of herbs have been extensively examined for their potential uses in NAFLD treatment. In the present review, we selected several herbal derivatives under intense basic and/or clinical investigations by carrying out a PubMed search of English language articles relevant to herbal derivatives and NAFLD, such as polysaccharide portion of wolfberry, garlic-derived monomers, red grape–derived resveratrol, and milk thistle–derived substances. They have been shown to target the pathological events during NAFLD initiation and progression both in pre-clinical studies and clinical trials. Although more detailed mechanistic researches and long-term clinical evaluations are needed for their future applications, they offer unanticipated and great health benefits without obvious adverse effects in NAFLD therapy.

  16. Pathogenesis, diagnosis and treatment of non-alcoholic fatty liver disease

    Directory of Open Access Journals (Sweden)

    Verónica Martín-Domínguez

    2013-08-01

    Full Text Available Non-alcoholic fatty liver disease (NAFLD includes a broad spectrum of alterations that go from simple steatosis to steatohepatitis and cirrhosis. Type 2 diabetes mellitus (DM-2 and obesity are the principle factors associated to NAFLD. A 20-30 % prevalence in general population has been described. The survival of this type of patient is lower than the general population's, showing a higher incidence of hepatic and cardiovascular complications. The aetiopathogenesis is still unclear, but we know the intervention of different factors that produce fatty-acid accumulation in hepatic parenchyma, causing oxidative stress, oxygen-free radicals and the synthesis of an inflammatory cascade, that determine the progression of this disease from steatosis up to advanced fibrosis. The diagnostic gold-standard is still the liver biopsy, even though the development of newer non-invasive techniques, like serological and imaging (radiology, have opened a new field for research that allows bloodless testing of these patients and better study of the natural history of this disease. Nowadays, there is still no specific treatment for NAFLD. The development of healthy life habits and moderate exercise continue to be the pillars of treatment. Different pharmacological approaches have been studied and applied, such as the control of insulin resistance, lowering cholesterol levels, antioxidants, and other alternatives in experimental trials.

  17. Non-alcoholic fatty liver disease in children now: lifestyle changes and pharmacologic treatments.

    Science.gov (United States)

    Alisi, Anna; Nobili, Valerio

    2012-07-01

    Over the past decade, non-alcoholic fatty liver disease (NAFLD) has become one of most common chronic liver diseases in children. A greater understanding about the risk factors and molecular pathogenesis of NAFLD suggests that lifestyle interventions aiming to decrease obesity/body mass index and metabolic derangement are the first line of treatments adopted in children affected by this disease. However, because these therapeutic options are often at the beginning misjudged by the patients and their parents, the use of pharmacologic agents may help to protect the liver and other organs from further irreversible tissue damage. Pharmacologic therapies against one or more specific factors and/or molecules involved in the development of NAFLD (i.e., insulin resistance, free fatty acid lipid toxicity, and oxidative stress) also might slow the progression of this increasingly prevalent pediatric disorder. On this basis, insulin sensitizers, antioxidants, cytoprotective agents, and dietary supplementations have been evaluated in pediatric clinical trials. In this review, we discuss the efficacy of the dietary approaches, possibly coupled with regular exercise, on decreasing the metabolic and histologic damage in pediatric NAFLD. We also emphasize several advantages of the pharmacologic treatments adopted or adoptable in combination with lifestyle interventions in children with NAFLD. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2013-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD, and alcohol dependence . Objective: The objective of this study is to evaluate the efficacy of

  19. A Brief Up-Date of the Use of Sodium Oxybate for the Treatment of Alcohol Use Disorder.

    Science.gov (United States)

    Caputo, Fabio; Vignoli, Teo; Tarli, Claudia; Domenicali, Marco; Zoli, Giorgio; Bernardi, Mauro; Addolorato, Giovanni

    2016-03-05

    The treatment of alcohol use disorder (AUD) with sodium oxybate (SMO) or gamma-hydroxybutyric acid (GHB) was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS) and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA), exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as "street drug"; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD.

  20. Probiotics as a novel treatment for non-alcoholic Fatty liver disease; a systematic review on the current evidences.

    Science.gov (United States)

    Kelishadi, Roya; Farajian, Sanam; Mirlohi, Maryam

    2013-04-01

    Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease, with 5-10% of liver having extra fat. Increase in its prevalence in all age groups is linked with obesity and Type II diabetes. The treatment of NAFLD remains controversial. A growing body of evidence suggests a relation between overgrowth of gut microbiota with NAFLD and non-alcoholic steatohepatitis (NASH). The objective of this review is to provide an overview on experimental and clinical studies assessing all positive and negative effects of probiotics. We made a critical appraisal on various types of documents published from 1999 to March 2012 in journals, electronic books, seminars, and symposium contexts including Medline, PubMed, and Cochrane Central Register of Controlled Trials databases. We used the key words: "non-alcoholic fatty liver disease, probiotics, non-alcoholic steatohepatitis, liver disease, and fatty liver". Probiotics, as biological factors, control the gut microbiota and result in its progression. It is in this sense that they are suggestive of a new and a natural way of promoting liver function. Correspondingly, limited evidence suggests that probiotics could be considered as a new way of treatment for NAFLD. Various experimental studies and clinical trials revealed promising effects of probiotics in improving NAFLD; however given the limited experience in this field, generalization of probiotics as treatment of NAFLD needs substantiation through more trials with a larger sample sizes and with longer-term follow up.

  1. A Brief Up-Date of the Use of Sodium Oxybate for the Treatment of Alcohol Use Disorder

    Directory of Open Access Journals (Sweden)

    Fabio Caputo

    2016-03-01

    Full Text Available The treatment of alcohol use disorder (AUD with sodium oxybate (SMO or gamma-hydroxybutyric acid (GHB was introduced in Italy and Austria more than 20 years and 15 years ago, respectively, and it is now widely employed to treat alcohol withdrawal syndrome (AWS and to maintain alcohol abstinence. These indications derive from its similar structure to the inhibitory neurotransmitter γ-amino-butyric acid (GABA, exerting an ethanol-mimicking effect, because it binds to GABAB receptors. Craving for, and abuse of, SMO remain a controversial issue; even though these unfavorable effects are evident in poly-drug addicted patients and in those with psychiatric diagnosis of borderline personality disorder. In addition, despite cases of severe intoxication and deaths being widely documented when GHB is used as “street drug”; its clinical use remains safe. Thus, the aim of the present review is to examine the role of SMO in the treatment of AUD, its possible implications in reducing alcohol consumption, and cases of abuse, and severe intoxication due to SMO during its clinical use in the treatment of AUD.

  2. Psychiatric comorbidity and plasma levels of 2-acyl-glycerols in outpatient treatment alcohol users. Analysis of gender differences.

    Science.gov (United States)

    García Marchena, Nuria; Araos, Pedro; Pavón, Francisco Javier; Ponce, Guillermo; Pedraz, María; Serrano, Antonia; Arias, Francisco; Romero-Sanchiz, Pablo; Suárez, Juan; Pastor, Antoni; De la Torre, Rafael; Torrens, Marta; Rubio, Gabriel; Rodríguez de Fonseca, Fernando

    2016-09-29

    Alcohol addiction is associated with high psychiatric comorbidity. Objective stratification of patients is necessary to optimize care and improve prognosis. The present study is designed to gain insights into this challenge by addressing the following objectives: a) to estimate the prevalence of psychiatric comorbidities in a sample of outpatients seeking treatment for alcohol use disorder, b) to describe the existence of gender differences and c) to validate 2-acyl-glycerols as biomarkers of alcohol use disorder and/or psychiatric comorbidity. One hundred and sixty-two patients were recruited and evaluated with the semi-structured interview PRISM. The presence of psychopathology was associated with a greater number of criteria for alcohol abuse and dependence according to DSM-IV-TR. We found gender differences in psychiatric comorbidity, e.g., mood disorder, as well as in comorbid substance use disorders. The prevalence of lifetime psychiatric comorbidity was 68.5%, with mood disorders the most frequent (37%), followed by attention deficit disorder (24.7%) and anxiety disorders (17.9%). Substance-induced disorders were more frequent in mood and psychotic disorders, whereas the primary disorders were more prevalent in patients with comorbid anxiety disorders. We found that 2-acyl-glycerols were significantly decreased in comorbid anxiety disorders in alcohol dependent patients in the last year, which makes them a potential biomarker for this psychopathological condition.

  3. The glucagon-like peptide-1 receptor as a potential treatment target in alcohol use disorder: evidence from human genetic association studies and a mouse model of alcohol dependence.

    Science.gov (United States)

    Suchankova, P; Yan, J; Schwandt, M L; Stangl, B L; Caparelli, E C; Momenan, R; Jerlhag, E; Engel, J A; Hodgkinson, C A; Egli, M; Lopez, M F; Becker, H C; Goldman, D; Heilig, M; Ramchandani, V A; Leggio, L

    2015-06-16

    The hormone glucagon-like peptide-1 (GLP-1) regulates appetite and food intake. GLP-1 receptor (GLP-1R) activation also attenuates the reinforcing properties of alcohol in rodents. The present translational study is based on four human genetic association studies and one preclinical study providing data that support the hypothesis that GLP-1R may have a role in the pathophysiology of alcohol use disorder (AUD). Case-control analysis (N = 908) was performed on a sample of individuals enrolled in the National Institute on Alcohol Abuse and Alcoholism (NIAAA) intramural research program. The Study of Addiction: Genetics and Environment (SAGE) sample (N = 3803) was used for confirmation purposes. Post hoc analyses were carried out on data from a human laboratory study of intravenous alcohol self-administration (IV-ASA; N = 81) in social drinkers and from a functional magnetic resonance imaging study in alcohol-dependent individuals (N = 22) subjected to a Monetary Incentive Delay task. In the preclinical study, a GLP-1R agonist was evaluated in a mouse model of alcohol dependence to demonstrate the role of GLP-1R for alcohol consumption. The previously reported functional allele 168Ser (rs6923761) was nominally associated with AUD (P = 0.004) in the NIAAA sample, which was partially replicated in males of the SAGE sample (P = 0.033). The 168 Ser/Ser genotype was further associated with increased alcohol administration and breath alcohol measures in the IV-ASA experiment and with higher BOLD response in the right globus pallidus when receiving notification of outcome for high monetary reward. Finally, GLP-1R agonism significantly reduced alcohol consumption in a mouse model of alcohol dependence. These convergent findings suggest that the GLP-1R may be an attractive target for personalized pharmacotherapy treatment of AUD.

  4. Screening and Treatment for Alcohol, Tobacco and Opioid Use Disorders: A Survey of Family Physicians across Ontario.

    Directory of Open Access Journals (Sweden)

    Genane Loheswaran

    Full Text Available As a primary point of contact within the health care system, family physicians are able to play a vital role in identifying individuals with substance use disorders and connecting them to the appropriate treatment. However, there is very little data available on whether family physicians are actively screening for and treating substance use disorders. The objective of the current survey was to assess whether family physicians in Ontario are screening for alcohol, opioid and tobacco use disorders, using validated tools and providing treatment.An online survey consisting of a series of 38 primarily close-ended questions was circulated to family physicians in Ontario. Rates of screening for alcohol, opioid and tobacco dependence, use of validated tools for screening, providing treatment for dependent individuals and the current barriers to the prescription of pharmacotherapies for these drug dependences were assessed.The use of validated screening tools was limited for all three substances. Screening by family physicians for the substance use disorders among adolescents was much lower than screening among adults. Pharmacotherapy was more commonly used as an intervention for tobacco dependence than for alcohol and opioid dependence. This was explained by the lack of knowledge among family physicians on the pharmacotherapies for alcohol and opioid dependence.Findings from the current study suggest there is a need for family physicians to integrate screening for substance use disorders using validated tools into their standard medical practice. Furthermore, there is a need for increased knowledge on pharmacotherapies for alcohol and opioid use disorders. It is important to note that the low response rate is a major limitation to this study. One possible reason for this low response rate may be a lack of interest and awareness among family physicians on the importance of screening and treatment of substance use disorders in Ontario.

  5. Breastfeeding women under medication treatment in the public health network

    Directory of Open Access Journals (Sweden)

    Viviane Muniz da Silva Fragoso

    2014-06-01

    Full Text Available Objective: To analyse the medications used by breastfeeding women treated in the public health network, and correlated actions. Methods: Cross-sectional, quantitative and descriptive study carried out with 100 breastfeeding women, recruited through nonprobabilistic convenience sampling, at the Municipal Hospital of Duque de Caxias, RJ, in 2012. A questionnaire was applied containing the following variables: prescribed medications, unwanted effects in nursing infants, and professionals involved in guidance on the edication. The data was analysed through descriptive statistics, based on absolute and relative frequencies. Results: It was found that 46% (n=46 of the breastfeeding women were aged 21 to 30 years, 54% (n=54 were primiparae, 52% (n=52 had complete fundamental level, and 72% (n=72 received prenatal care. It was verified that 78% (n = 78 of the sample were receiving some type of medicine and, among these, a significant percentage of nonsteroidal analgesic/anti-inflammatory medication, with 61.54% (n=48 of the breastfeeding women. All the prescribed medicines were in the category of compatible use with breastfeeding. The incidence of some unwanted symptoms was evidenced in 19.2% (n=15 of the breastfeeding women. Among the women undergoing medication therapy, 76.92% (n=60 received guidance during treatment, 55% (n=33 by doctors and 45% (n=27 by nurses. In this research, 100% of the breastfeeding women were satisfied with the acquired knowledge. Conclusion: It was noted a high percentage of breastfeeding women in the sample taking medicines, all compatible with breastfeeding. It stands out the limited engagement of the multidisciplinary team in the orientations. doi:10.5020/18061230.2014.p283

  6. Experience in the treatment of some complications of portal hypertension in alcoholic liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Savić Željka

    2011-01-01

    Full Text Available Background/Aim. Portal hypertension (PH is hemodynamical abnormality associated with the most serious complications of alcoholic liver cirrhosis (ALC: ascites, varices and variceal bleeding. The aim of this study was to determine characteristics of portal hypertension, especially of upper gastrointestinal bleedings in patients with alcoholic liver cirrhosis (ALC. Methods. A total of 237 patients with ALC were observed in a 3-year period. Results. A total of 161 patients (68% were hospitalized because of PH elements: 86 (36.3% had upper gastrointestinal bleeding, 75 (31.7% were decompensated. Only 76 (32% of the patients had icterus. General mortality was 85 (36%. According to the source of bleeding, 61 (71% patients bled from varices, and 25 (29% from other sources with existing varices but non-incriminated for bleeding in 16 (64% of those patients. Active bleeding or stigmata of recent bleeding were found in 63 (73% cases. Endoscopic treatment of variceal bleeding along with octreotide applied in 20 (32.78% patients, just octreotide in 32 (52.46%, and octreotid plus balloon tamponade in 9 (14.75%. According to Child-Pugh classification, 25 (29% of the bleeding patients were in class A, score 5.4; 43 (50% in class B, score 7.8; and 18 (21% in class C, score 10.9. Average hemoglobin level was 93 g/L, hematocrit 0.27, AST 71.52 U/L (normal to 37 U/L, ALT 37.74 U/L (normal to 40 U/L. Until this bleeding episode, 41 (47% of the patients already bled. In the decompensated patients 3 (4% were in Child Pugh class A, score 6; 42 (56% in class B, score 8.3; and 30 (40% in class C, score 10.6. Until this decompensation episode, 7 (9.3% patients already bled. Conclusion. Patients with ALC need early detection of varices, primary and secondary profilaxis of variceal bleeding and adequate therapy of ascites. When bleeding occurs, patients need urgent upper endoscopy and intensive treatment.

  7. [Experience in the treatment of some complications of portal hypertension in alcoholic liver cirrhosis].

    Science.gov (United States)

    Savić, Zeljka; Vracarić, Vladimir; Hadnadjev, Ljiljana; Petrović, Zora; Damjanov, Dragomir

    2011-11-01

    Portal hypertension (PH) is hemodynamical abnormality associated with the most serious complications of alcoholic liver cirrhosis (ALC): ascites, varices and variceal bleeding. The aim of this study was to determine characteristics of portal hypertension, especially of upper gastrointestinal bleedings in patients with alcoholic liver cirrhosis (ALC). A total of 237 patients with ALC were observed in a 3-year period. A total of 161 patients (68%) were hospitalized because of PH elements: 86 (36.3%) had upper gastrointestinal bleeding, 75 (31.7%) were decompensated. Only 76 (32%) of the patients had icterus. General mortality was 85 (36%). According to the source of bleeding, 61 (71%) patients bled from varices, and 25 (29%) from other sources with existing varices but non-incriminated for bleeding in 16 (64%) of those patients. Active bleeding or stigmata of recent bleeding were found in 63 (73%) cases. Endoscopic treatment of variceal bleeding along with octreotide applied in 20 (32.78%) patients, just octreotide in 32 (52.46%), and octreotid plus balloon tamponade in 9 (14.75%). According to Child-Pugh classification, 25 (29%) of the bleeding patients were in class A, score 5.4; 43 (50%) in class B, score 7.8; and 18 (21%) in class C, score 10.9. Average hemoglobin level was 93 g/L, hematocrit 0.27, AST 71.52 U/L (normal to 37 U/L), ALT 37.74 U/L (normal to 40 U/L). Until this bleeding episode, 41 (47%) of the patients already bled. In the decompensated patients 3 (4%) were in Child Pugh class A, score 6; 42 (56%) in class B, score 8.3; and 30 (40%) in class C, score 10.6. Until this decompensation episode, 7 (9.3%) patients already bled. Patients with ALC need early detection of varices, primary and secondary profilaxis of variceal bleeding and adequate therapy of ascites. When bleeding occurs, patients need urgent upper endoscopy and intensive treatment.

  8. Gambling and Early Maladaptive Schemas in a Treatment Seeking Sample of Male Alcohol Users: A Preliminary Investigation.

    Science.gov (United States)

    Shorey, Ryan C; Anderson, Scott; Stuart, Gregory L

    2012-12-01

    Gambling problems are overrepresented among men seeking treatment for substance use problems, including alcohol dependence. Early maladaptive schemas are overrepresented among substance users, although no known study has examined the early maladaptive schemas of men with potential gambling problems. The current study examined the relations among potential gambling problems and early maladaptive schemas among a sample of alcohol dependent men seeking treatment at a residential substance use facility (N = 628). Using pre-existing patient records of self-report measures for early maladaptive schemas and potential gambling problems, results showed that a number of early maladaptive schemas were associated with gambling. Men with potential gambling problems scored significantly higher than non-problem gamblers on a number of early maladaptive schemas. These results suggest that early maladaptive schemas may be an important underlying characteristic for gambling problems, and that substance use treatment programs should considering screening for and targeting gambling problems and early maladaptive schemas.

  9. Assessment of antiretroviral treatment outcome in public hospitals ...

    African Journals Online (AJOL)

    Bernt Lindtjørn

    2School of Public Health, Addis Ababa University, Cell phone: 0911-405652, P.O. Box: 14 575, Addis Ababa, ... Method: A historical retrospective cohort study design was used for patients ... Low CD4 cell count, gender and timing of ARV regimen combinations had ... chronic care and retention of physicians in the public.

  10. Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): A Pilot Study in Alcohol-dependent Women.

    Science.gov (United States)

    Persson, Anna; Back, Sudie E; Killeen, Therese K; Brady, Kathleen T; Schwandt, Melanie L; Heilig, Markus; Magnusson, Åsa

    Posttraumatic stress disorder (PTSD) and substance use disorders are highly comorbid. Effective treatments are largely lacking. This pilot study evaluated the safety and feasibility of a novel intervention, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), in preparation for a randomized controlled trial. Twenty-two treatment-seeking women with current DSM-IV-TR PTSD and alcohol dependence (AD) were recruited. Participants received COPE. Safety and feasibility were evaluated, as were efficacy-related outcomes: PTSD and depression symptom severity, alcohol use, craving, and dependence severity. No adverse events occurred. COPE was implemented in routine clinical practice. Among the assessed women, 95.8% were eligible to participate. Treatment attendance and completion were higher than in previous studies. Post treatment, all efficacy-related outcomes, including PTSD and depression symptom severity, alcohol use, craving, and dependence severity, were significantly reduced. COPE was safe and feasible to use. Concerns that trauma-focused, exposure-based therapy might promote relapse in this population appear unwarranted. Our findings provide initial evidence suggestive of COPE efficacy for comorbid PTSD and AD in women. These results provide a strong rationale for investigating the efficacy of COPE for comorbid PTSD and AD in women in a randomized controlled trial.

  11. A qualitative study of patients' knowledge and views of about oral health and acceptability of related intervention in an Australian inpatient alcohol and drug treatment facility.

    Science.gov (United States)

    Cheah, Alison Li Sun; Pandey, Ram; Daglish, Mark; Ford, Pauline J; Patterson, Sue

    2017-01-20

    Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare; most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.

  12. Alcohol and Breastfeeding

    DEFF Research Database (Denmark)

    Haastrup, Maija Bruun; Pottegård, Anton; Damkier, Per

    2014-01-01

    While the harmful effects of alcohol during pregnancy are well-established, the consequences of alcohol intake during lactation have been far less examined. We reviewed available data on the prevalence of alcohol intake during lactation, the influence of alcohol on breastfeeding......, the pharmacokinetics of alcohol in lactating women and nursing infants and the effects of alcohol intake on nursing infants. A systematic search was performed in PubMed from origin to May 2013, and 41 publications were included in the review. Approximately half of all lactating women in Western countries consume...... alcohol while breastfeeding. Alcohol intake inhibits the milk ejection reflex, causing a temporary decrease in milk yield. The alcohol concentrations in breast milk closely resemble those in maternal blood. The amount of alcohol presented to nursing infants through breast milk is approximately 5...

  13. A Research Study of Casa Del Sol: A Viable Chicano Bilingual-Bicultural Alcoholism Treatment Modality.

    Science.gov (United States)

    Bueno, Domingo

    Alcoholism among Chicanos is principally due to structural deficiencies in the surrounding society. The frustrations and limitations brought on by the social structure constitute the principal cause of Chicano alcoholism. These include the major causative factors of poverty, racism and acculturation. In an attempt to address the problem of…

  14. Alcohol Services for Mexican Americans: A Review of Utilization Patterns, Treatment Considerations and Prevention Activities.

    Science.gov (United States)

    Gilbert, M. Jean; Cervantes, Richard C.

    1986-01-01

    Synthesizes available literature that addresses: (1) utilization patterns of alcohol-related services by Mexican Americans; (2) existing therapeutic approaches which take into account cultural factors; and (3) existing approaches to alcohol abuse education and prevention for this population. Discusses research needs and the need for…

  15. Intervention for Individuals with Fetal Alcohol Spectrum Disorders: Treatment Approaches and Case Management

    Science.gov (United States)

    Paley, Blair; O'Connor, Mary J.

    2009-01-01

    Exposure to alcohol in utero is considered to be the leading cause of developmental disabilities of known etiology. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of characteristic facial anomalies, growth retardation, and central nervous system (CNS) dysfunction. Some…

  16. Alcoholic Pancreatitis: Pathogenesis, Incidence and Treatment with Special Reference to the Associated Pain

    Directory of Open Access Journals (Sweden)

    Antonio M. Morselli-Labate

    2009-11-01

    Full Text Available Alcoholic pancreatitis continues to stir up controversy. One of the most debated points is whether from onset it is a chronic disease or whether it progresses to a chronic form after repeated episodes of acute pancreatitis. Histological studies on patients with alcoholic pancreatitis have shown that the disease is chronic from onset and that alcoholic acute pancreatitis occurs in a pancreas already damaged by chronic lesions. Genetic factors may also play a role in the pathogenesis of alcoholic disease. The incidence of chronic alcoholic pancreatitis seems to have decreased in the last twenty years. Finally, recent therapeutic studies which have shown medical or surgical approaches capable of reducing the pain episodes in chronic pancreatitis patients will be described.

  17. A new treatment for cognitive disorders related to in utero exposure to alcohol

    Institute of Scientific and Technical Information of China (English)

    Shuang Li; Yan Zhang; Feng Zhu; Bin Zhang; Jianying Lin; Chunyang Xu; Wancai Yang; Wei Hao; Ruiling Zhang

    2013-01-01

    Maternal alcohol consumption during pregnancy has detrimental effects on fetal central nervous system development. Maternal alcohol consumption prior to and during pregnancy significantly affects cognitive functions in offspring, which may be related to changes in cyclin-dependent kinase 5 because it is associated with modulation of synaptic plasticity and impaired learning and memory. In this study, we examined adult offspring in a maternal alcohol consumption model in rats. Y-maze test results showed that in utero exposure to alcohol impairs learning and memory capacities. Cyclin-dependent kinase 5 mRNA and protein expressions in the hippocampus of the offspring were significantly elevated, as assayed by quantitative real-time PCR and reverse transcription-PCR, immunofluorescence, and immuno-precipitation. Our experimental findings strongly suggest that altered cyclin-dependent kinase 5 may mediate impaired learning and memory in adult rats that were exposed to alcohol by maternal consumption while in utero.

  18. 酒精性肝病治疗进展%Progress in treatment of alcoholic liver disease

    Institute of Scientific and Technical Information of China (English)

    徐亮(综述); 宓余强(审校)

    2014-01-01

    酒精性肝病是影响人们健康的常见肝病之一。积极预防、合理治疗可以有效地控制病情进展。过量酒精摄入是导致人体疾患的主要原因,重症酒精性肝病的治疗为该病治疗的重点和热点。 Child-Pugh分级、Maddrey判别函数、MELD模型、GAHS评分、年龄-胆红素-INR-肌酐(ABIC)评分及Lille评分可较好地预测预后,评判疗效。肝移植仍为终末期酒精性肝病的主要治疗手段。%Alcoholic liver disease (ALD) is one of the most common liver diseases. The treatment of severe alcoholic hepatitis(SAH)and the control of alcohol abuse are the hot spots in this field. Child-Pugh class,Maddrey discriminate function, the model of end-stage liver disease(MELD),Glasgow alcoholic hepatitis score,age/bilirubin/INR/creatinine(ABIC)score,and Lille score systems can be used to predict the prognosis of patients with SAH. Liver transplantation is still the major treatment for patients with ALD at end-stage illness.

  19. TiO2 and polyvinyl alcohol (PVA) coated polyester filter in bioreactor for wastewater treatment.

    Science.gov (United States)

    Liu, Lifen; Zhao, Chuanqi; Yang, Fenglin

    2012-04-15

    Prepared by coating TiO(2)/polyvinyl alcohol (PVA) on a low cost polyester filter cloth (22 μm), a composite membrane (10 μm pore size) was successfully used in an anoxic/oxic membrane bioreactor (A/O-MBR) for treating a simulate wastewater in removing nitrate/ammonium for water reuse in a polyester fiber production plant. Its permeate flux and the anti-fouling properties against extracellular polymeric substances (EPS) were studied. Comparing with a commercial (0.1 μm) PVDF (polyvinylidene fluoride) membrane, similar effluent qualities were achieved, meeting the basic COD requirements for reuse. Anti-EPS accumulation, the TiO(2)/PVA Polyester composite membrane had higher sustained permeability and required less frequent cleaning. Its filtration time was 4 times longer when operated at a higher flux than the PVDF membrane. The nano-TiO(2) enhances the interaction between PVA and polyester, forms a more hydrophilic surface, drastically reduces the contact angle with water and reduces EPS fouling. The slow (trans-membrane pressure) TMP rise, loose cake layer, the low filtration resistances, and the EPS, SEM analysis confirmed the advantage of the composite membrane. Potential in lowering the membrane cost, the operation and maintenance cost, and in enhancing MBR waste water treatment efficiency is expected by the use of this new composite membrane.

  20. Non-alcoholic fatty liver disease and cardiovascular risk: metabolic aspects and novel treatments.

    Science.gov (United States)

    Scorletti, E; Calder, P C; Byrne, C D

    2011-12-01

    Non-alcoholic fatty liver disease (NAFLD) is usually a silent disease that occurs in a very high proportion of people with features of the metabolic syndrome, including overweight, insulin resistance and type 2 diabetes. Because obesity and type 2 diabetes are now extremely common in Westernised societies, it is likely that the prevalence of NAFLD increases markedly in the future. Although previously it was thought that NAFLD was harmless, it is now recognised that NAFLD can be a progressive liver condition that increases risk of cirrhosis, end-stage liver disease and hepatocellular carcinoma. Additionally, liver fat accumulation causes insulin resistance and increases risk of type 2 diabetes. Increasing evidence now shows NAFLD is a risk factor for cardiovascular disease (CVD). The purpose of this review is to briefly discuss the pathogenesis of NAFLD, to describe the relationship between NAFLD and CVD and the mechanisms linking both conditions and to discuss some of the treatment options (including lifestyle, nutrition and drugs) that may influence both NAFLD and risk of CVD.

  1. Post-Heat Treatment and Mechanical Assessment of Polyvinyl Alcohol Nanofiber Sheet Fabricated by Electrospinning Technique

    Directory of Open Access Journals (Sweden)

    Mahir Es-saheb

    2014-01-01

    Full Text Available Polyvinyl alcohol (PVA sheets based nanofibers were produced by electrospinning technique. Postheat treatment of the produced PVA sheets with temperatures both below and above Tg to improve the mechanical properties of this material is conducted. The morphology, microstructures, and thermal degradation of the nanofibers sheets produced were investigated using scanning electron microscopy (SEM, transmission electron microscope (TEM, and thermal gravimetric analysis (TGA. Produced nanofibers are compact, and entangled with each other, with diameters from around 150 to 210. Some mechanical characteristics of the successfully produced PVA sheets, and heat-treated, are then conducted and assessed employing uniaxial tensile tests at different speeds ranging from 1 mm/min to 100 mm/min. The tensile test results obtained show that the PVA sheets are strain rate sensitive with increasing strength as the speed (i.e., strain rate increases. The yield tensile stress ranges from 2.411 to 6.981 MPa, the ductility (i.e., elongation percent from ∼21 to 60%, and Young modulus ranges from 103 to 0.137 KPa. However, for heat-treated samples, it is found that the yield strength increases almost by ∼35–40% more than the values of untreated cases with values reaching up to about 3.627–9.63 MPa.

  2. How Different Stakeholders in Two Public School Systems Perceived the Ability of Their Drug and Alcohol Policies to Protect the Needs of the School, the Community, and/or the Student

    Science.gov (United States)

    Stamm, Mark; Frick, William C.

    2009-01-01

    Student drug and alcohol policies often impose consequences on students that may place the child at greater risk of delinquent behavior. The project described in this article sought to explore how different stakeholders in two public school systems perceived the ability of their drug and alcohol policies to protect the needs of the school, the…

  3. Short-term treatment with alcohols causes hepatic steatosis and enhances acetaminophen hepatotoxicity in Cyp2e1(-/-) mice.

    Science.gov (United States)

    Sinclair, J F; Szakacs, J G; Wood, S G; Walton, H S; Bement, J L; Gonzalez, F J; Jeffery, E H; Wrighton, S A; Bement, W J; Sinclair, P R

    2000-10-15

    CYP2E1 has been reported to have an essential role in alcohol-mediated increases in hepatic steatosis and acetaminophen hepatotoxicity. We found that pretreatment of Cyp2e1(-/-) mice with ethanol plus isopentanol, the predominant alcohols in alcoholic beverages, for 7 days resulted in micro- and macrovesicular steatosis in the livers of all mice, as well as a dramatic increase in acetaminophen hepatotoxicity. In Cyp2e1(-/-) mice administered up to 600 mg acetaminophen/kg alone and euthanized 7 h later, there was no increase in serum levels of ALT. In Cyp2e1(-/-) mice pretreated with ethanol and isopentanol, subsequent exposure to 400 or 600 mg acetaminophen/kg resulted in centrilobular necrosis in all mice with maximal elevation in serum levels of ALT. Acetaminophen-mediated liver damage was similar in males and females. Hepatic microsomal levels of APAP activation in untreated females were similar to those in males treated with the alcohols. However, the females, like the males, required pretreatment with the alcohols in order to increase APAP hepatotoxicity. These findings suggest that, in the Cyp2e1(-/-) mice, the alcohol-mediated increase in acetaminophen hepatotoxicity involves the contribution of other factors, in addition to induction of CYP(s) that activate acetaminophen. Alternatively, CYP-mediated activation of acetaminophen measured in vitro may not reflect the actual activity in vivo. Our findings that a 7-day treatment with ethanol and isopentanol causes extensive hepatic steatosis and increases acetaminophen hepatotoxicity in Cyp2e(-/-) mice indicate that CYP2E1 is not essential for either response.

  4. Lessons learned from the deadly sisters: drug and alcohol treatment disruption, and consequences from Hurricanes Katrina and Rita.

    Science.gov (United States)

    Maxwell, Jane Carlisle; Podus, Deborah; Walsh, David

    2009-01-01

    This paper reports on the effects of Hurricanes Katrina and Rita on drug and alcohol treatment in Texas in 2005-2006. Findings are based on a secondary analysis of administrative data on 567 hurricane-related admissions and on interview data from a sample of 20 staff in 11 treatment programs. Katrina evacuees differed from Rita clients in terms of demographics and primary problem substances and treatment needs, while the experiences of program staff and needed changes to improve disaster readiness were more similar. Additional systematic research is needed to document the intermediate and long-term impacts of the storms in these and other affected areas.

  5. Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment.

    LENUS (Irish Health Repository)

    Field, Catherine Anne

    2013-01-01

    Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients\\' experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care.

  6. A 9-month follow-up of a 3-month web-based alcohol treatment program using intensive asynchronous therapeutic support.

    NARCIS (Netherlands)

    Postel, Marloes Gerda; ter Huurne, E.D.; de Haan, H.A.; van der Palen, Jacobus Adrianus Maria; de Jong, Cor A.J.

    2015-01-01

    Background: Web-based alcohol interventions have demonstrated efficacy in randomized controlled trials. However, most studies have involved self-help interventions without therapeutic support. Objectives: To examine the results of a 3-month web-based alcohol treatment program using intensive,

  7. A 9-month follow-up of a 3-month web-based alcohol treatment program using intensive asynchronous therapeutic support

    NARCIS (Netherlands)

    Postel, M.G.; Huurne, E.D. ter; Haan, H.A. de; Palen, J.A.M. van der; Jong, C.A.J. de

    2015-01-01

    Background: Web-based alcohol interventions have demonstrated efficacy in randomized controlled trials. However, most studies have involved self-help interventions without therapeutic support. Objectives: To examine the results of a 3-month web-based alcohol treatment program using intensive,

  8. A 9-month follow-up of a 3-month web-based alcohol treatment program using intensive asynchronous therapeutic support.

    NARCIS (Netherlands)

    Postel, M.G.; Huurne, ter E.D.; Haan, de H.A.; Palen, van der Job; Jong, de Cor A.J.

    2015-01-01

    Background: Web-based alcohol interventions have demonstrated efficacy in randomized controlled trials. However, most studies have involved self-help interventions without therapeutic support. Objectives: To examine the results of a 3-month web-based alcohol treatment program using intensive, asynch

  9. Cost Benefit Analyses of Behavioral Marital Therapy with and without Relapse Prevention Sessions for Alcoholics and Their Wives.

    Science.gov (United States)

    O'Farrell, Timothy J.; And Others

    Several studies have indicated that costs of alcoholism treatment are partially or completely offset by monetary benefits of reduced health and legal system costs after such treatment, although most of these studies have been conducted in the private rather than the public alcoholism treatment system. This study examined the health and legal…

  10. 40 CFR 117.13 - Applicability to discharges from publicly owned treatment works and their users.

    Science.gov (United States)

    2010-07-01

    ... publicly owned treatment works and their users. 117.13 Section 117.13 Protection of Environment... SUBSTANCES Applicability § 117.13 Applicability to discharges from publicly owned treatment works and their users. (a) (b) These regulations apply to all discharges of reportable quantities to a POTW, where the...

  11. 26 CFR 1.883-2T - Treatment of publicly-traded corporations (temporary).

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Treatment of publicly-traded corporations... (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Foreign Corporations § 1.883-2T Treatment of publicly-traded corporations (temporary). (a) through (e)(1) . For further guidance, see § 1.883-2(a) through (e)(1)....

  12. 26 CFR 1.883-2 - Treatment of publicly-traded corporations.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Treatment of publicly-traded corporations. 1.883...) INCOME TAX (CONTINUED) INCOME TAXES Foreign Corporations § 1.883-2 Treatment of publicly-traded corporations. (a) General rule. A foreign corporation satisfies the stock ownership test of § 1.883-1(c)(2)...

  13. Tuberculosis treatment managed by providers outside the Public Health Department: lessons for the Affordable Care Act.

    Directory of Open Access Journals (Sweden)

    Melissa Ehman

    Full Text Available INTRODUCTION: Tuberculosis (TB requires at least six months of multidrug treatment and necessitates monitoring for response to treatment. Historically, public health departments (HDs have cared for most TB patients in the United States. The Affordable Care Act (ACA provides coverage for uninsured persons and may increase the proportion of TB patients cared for by private medical providers and other providers outside HDs (PMPs. We sought to determine whether there were differences in care provided by HDs and PMPs to inform public health planning under the ACA. METHODS: We conducted a retrospective, cross-sectional analysis of California TB registry data. We included adult TB patients with culture-positive, pulmonary TB reported in California during 2007-2011. We examined trends, described case characteristics, and created multivariate models measuring two standards of TB care in PMP- and HD-managed patients: documented culture conversion within 60 days, and use of directly observed therapy (DOT. RESULTS: The proportion of PMP-managed TB patients increased during 2007-2011 (p = 0.002. On univariable analysis (N = 4,606, older age, white, black or Asian/Pacific Islander race, and birth in the United States were significantly associated with PMP care (p<0.05. Younger age, Hispanic ethnicity, homelessness, drug or alcohol use, and cavitary and/or smear-positive TB disease, were associated with HD care. Multivariable analysis showed PMP care was associated with lack of documented culture conversion (adjusted relative risk [aRR] = 1.37, confidence interval [CI] 1.25-1.51 and lack of DOT (aRR = 8.56, CI 6.59-11.1. CONCLUSION: While HDs cared for TB cases with more social and clinical complexities, patients under PMP care were less likely to receive DOT and have documented culture conversion. This indicates a need for close collaboration between PMPs and HDs to ensure that optimal care is provided to all TB patients and TB transmission is

  14. Comparison of Chinese and Foreign Urban Public Security Treatment Mechanisms and Analysis of Policy References

    Institute of Scientific and Technical Information of China (English)

    Li Xuejun; Zhang Mingyu

    2007-01-01

    From the viewpoint of disaster prevention in the urban areas, this paper analyzes the value of urban public security system, selects typical cases to make a comparison of Chinese and foreign public security treatment mechanisms, and makes systematic summarization of the Chinese and foreign historic experiences. Then, the paper puts forward some designs on structure of the Chinese urban public security system structure. This paper is of the opinion that at present the management of urban public security concerning unexpected incidents should be strengthened. The effective way is to set up the sound urban public security system, urban public security mechanism and related laws and regulations.

  15. Prazosin Augmentation of Outpatient Treatment of Alcohol Use Disorders in Active Duty Soldiers with and without PTSD

    Science.gov (United States)

    2016-10-01

    treatment and 2) to determine if the presence of PTSD affects prazosin efficacy for AUD. AUD are major causes of behavioral, medical, family , and...debilitating problem in active duty Service Members and is a frequent comorbidity of posttraumatic stress disorder (PTSD). Our pilot placebo...durability of prazosin effect on AUD in those randomized to prazosin in the RCT. 2. KEYWORDS: alcohol use disorder, prazosin, Service Member , PTSD

  16. Fighting alcoholism among railway workers in the light of early 20th Century Polish-language temperance publications

    Directory of Open Access Journals (Sweden)

    Izabela Krasińska

    2016-12-01

    Discussion and conclusions: The Polish-language temperance periodicals provide, among other things, valuable information referring to as yet unknown though essential problem of fighting alcoholism among railway workers in Europe, USA and the Polish territories of the Three Partitions.

  17. Evidence from regression-discontinuity analyses for beneficial effects of a criterion-based increase in alcohol treatment.

    Science.gov (United States)

    Flam-Zalcman, Rosely; Mann, Robert E; Stoduto, Gina; Nochajski, Thomas H; Rush, Brian R; Koski-Jännes, Anja; Wickens, Christine M; Thomas, Rita K; Rehm, Jürgen

    2013-03-01

    Brief interventions effectively reduce alcohol problems; however, it is controversial whether longer interventions result in greater improvement. This study aims to determine whether an increase in treatment for people with more severe problems resulted in better outcome. We employed regression-discontinuity analyses to determine if drinking driver clients (n = 22,277) in Ontario benefited when they were assigned to a longer treatment program (8-hour versus 16-hour) based on assessed addiction severity criteria. Assignment to the longer16-hour program was based on two addiction severity measures derived from the Research Institute on Addictions Self-inventory (RIASI) (meeting criteria for assignment based on either the total RIASI score or the score on the recidivism subscale). The main outcome measure was self-reported number of days of alcohol use during the 90 days preceding the six month follow-up interview. We found significant reductions of one or two self-reported drinking days at the point of assignment, depending on the severity criterion used. These data suggest that more intensive treatment for alcohol problems may improve results for individuals with more severe problems.

  18. Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled Trial.

    Science.gov (United States)

    Rahmani, Sepideh; Asgary, Sedigheh; Askari, Gholamreza; Keshvari, Mahtab; Hatamipour, Mahdi; Feizi, Awat; Sahebkar, Amirhossein

    2016-09-01

    Non-alcoholic fatty liver disease (NAFLD) is a global health problem. Although many aspects of NAFLD pathogenesis have been understood, there is a paucity of effective treatments to be used as the second line when lifestyle modification is insufficient. Curcumin, a natural polyphenol from turmeric, has been shown to be effective against development of hepatic steatosis and its progression to steatohepatitis, yet these beneficial effects have not been explored in clinical practice. The aim of this study is to investigate the effects of curcumin on hepatic fat content as well as biochemical and anthropometric features of patients with NAFLD. In this randomized double-blind placebo-controlled trial, patients with ultrasonographic evidence of NAFLD were randomly assigned to receive an amorphous dispersion curcumin formulation (500 mg/day equivalent to 70-mg curcumin) or matched placebo for a period of 8 weeks. Liver fat content (assessed through ultrasonography), glycemic and lipid profile, transaminase levels, and anthropometric indices were evaluated at baseline and at the end of follow-up period. The clinical trial protocol was registered under the Iranian Registry of Clinical Trials ID: IRCT2014110511763N18. Compared with placebo, curcumin was associated with a significant reduction in liver fat content (78.9% improvement in the curcumin vs 27.5% improvement in the placebo group). There were also significant reductions in body mass index and serum levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase, alanine aminotransferase, glucose, and glycated hemoglobin compared with the placebo group. Curcumin was safe and well tolerated during the course of trial. Findings of the present proof-of-concept trial suggested improvement of different features of NAFLD after a short-term supplementation with curcumin. Copyright © 2016 John Wiley & Sons, Ltd.

  19. Alcoholism between Fiction and Reality.

    Science.gov (United States)

    Carota, Antonio; Calabrese, Pasquale

    2013-01-01

    Alcoholism has always been emphasized in literature, narratives, and theater as its prevalence and related disability are very high, is found throughout the world, and affects women and men of all ages and social classes. There is a tragic or romantic fascination in the deep sense of personal failure that drinking is able to relieve and in the uncontrollable inability to stop drinking. These aspects have been portrayed well by fictional alcoholics in movies and novels. It has become evident that biological traits together with a complex series of psychosocial factors (e.g. negative life events, depression, anxiety, and other psychiatric or personality disorders), which are also well represented in novels and movies, can lead to alcohol addiction. Behavioral (euphoria, disinhibiting behaviors, aggressiveness) and neurological changes (confusion, bradypsychism, slurred speech, ataxia, blackouts) related to alcohol intoxication are also well portrayed by fictional characters. Delirium tremens, epilepsy, alcohol dementia, and Wernicke-Korsakoff disease, however, find less representation in literature and on the stage and screen. The treatment of alcoholic dependence is very difficult (as often reported by fictional and real stories), but should never be considered hopeless. It should be initiated at any stage of the disease. The support offered by Alcoholics Anonymous has always had great appeal for the public. Fictional works can portray alcohol addiction superbly and show some dark sides of human nature (negative emotions and autodestructive thoughts and behaviors), and, at the same time, the severity and pervasiveness of mental illnesses. The psychiatric and psychosocial aspects of alcohol addiction in movies and novels could be an inspiring source for new psychological studies and rehabilitation programs.

  20. Use of Poly glutamic acid PGA {alpha}21 in the treatment of vinasse from an alcohol distillery

    Energy Technology Data Exchange (ETDEWEB)

    Carbajal Zarrabal, O.; Nolasco Hipolito, C.; Robles Olvera, V.; Waliszewski, S.

    2009-07-01

    Vinasse is the residue generated from ethyl alcohol production via fermentation and subsequent distillation. Its high organic content makes it an extremely polluting effluents. Vinasse has an acid pH (3.5-4) and is characterized by an elevated chemical oxygen demand (COD) in the range of 10,000 to 50,000 mg/L. it is common practice for these effluents to be discharged into public sewers or poured into evaporation tanks or even used in irrigation water in agricultural fields. (Author)

  1. Possible new ways in the pharmacological treatment of bipolar disorder and comorbid alcoholism

    Directory of Open Access Journals (Sweden)

    Jean-Michel Azorin

    2010-03-01

    Full Text Available Jean-Michel Azorin1, Charles L Bowden2, Ricardo P Garay3, Giulio Perugi4, Eduard Vieta5, Allan H Young61Department of Psychiatry, CHU Sainte Marguerite, Marseilles, France; 2Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA; 3CNRS-UMR 8162, Université Paris-Sud, and Hôpital Marie Lannelongue, Le Plessis-Robinson, France; 4Vincent P Dole Dual Diagnosis Team, Santa Chiara and University Hospital, Department of Psychiatry, University of Pisa, Italy; 5Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBER -SAM, Barcelona, Spain; 6Institute of Mental Health, University of British Columbia, Vancouver, CanadaAbstract: About half of all bipolar patients have an alcohol abuse problem at some point of their lifetime. However, only one randomized, controlled trial of pharmacotherapy (valproate in this patient population was published as of 2006. Therefore, we reviewed clinical trials in this indication of the last four years (using mood stabilizers, atypical antipsychotics, and other drugs. Priority was given to randomized trials, comparing drugs with placebo or active comparator. Published studies were found through systematic database search (PubMed, Scirus, EMBASE, Cochrane Library, Science Direct. In these last four years, the only randomized, clinically relevant study in bipolar patients with comorbid alcoholism is that of Brown and colleagues (2008 showing that quetiapine therapy decreased depressive symptoms in the early weeks of use, without modifying alcohol use. Several other open-label trials have been generally positive and support the efficacy and tolerability of agents from different classes in this patient population. Valproate efficacy to reduce excessive alcohol consumption in bipolar patients was confirmed and new controlled studies revealed its therapeutic benefit to prevent relapse in newly abstinent alcoholics and to improve alcohol hallucinosis. Topiramate

  2. Differences in Characteristics and Treatment Received among Depressed Adolescent Psychiatric Outpatients with and without Co-Occuring Alcohol Misuse: A 1-Year Follow-Up Study

    Directory of Open Access Journals (Sweden)

    Tiia Pirkola

    2011-01-01

    Full Text Available Objectives. We aimed at examining the differences between depressed psychiatric adolescent outpatients with and without cooccurring alcohol misuse in psychosocial background, clinical characteristics, and treatment received during one-year followup. Furthermore, we investigated factors related to nonattendance at treatment. Materials and Methods. Consecutive 156 adolescent (13–19 years psychiatric outpatients with a unipolar depressive disorder at baseline were interviewed using structured measures at baseline and at 12 months. Alcohol misuse was defined as having an AUDIT score of 8 or more points. The outpatients received “treatment as usual” of clinically defined duration. Results. Among depressive outpatients, poor parental support, parental alcohol use and decreased attendance at treatment associated with alcohol misuse. The severity of alcohol use as measured by AUDIT-score was the strongest factor independently predicting nonattendance at treatment in multivariate analysis. Conclusions. Alcohol misuse indicates family problems, has a deleterious effect on treatment attendance, and should be taken into account when managing treatment for depressive adolescent outpatients.

  3. MicroRNA profiles following metformin treatment in a mouse model of non-alcoholic steatohepatitis.

    Science.gov (United States)

    Katsura, Akiko; Morishita, Asahiro; Iwama, Hisakazu; Tani, Joji; Sakamoto, Teppei; Tatsuta, Miwa; Toyota, Yuka; Fujita, Koji; Kato, Kiyohito; Maeda, Emiko; Nomura, Takako; Miyoshi, Hisaaki; Yoneyama, Hirohito; Himoto, Takashi; Fujiwara, Shintaro; Kobara, Hideki; Mori, Hirohito; Niki, Toshiro; Ono, Masafumi; Hirashima, Mitsuomi; Masaki, Tsutomu

    2015-04-01

    Non-alcoholic steatohepatitis (NASH) is one of the most common causes of chronic liver disease and is considered to be a causative factor of cryptogenic cirrhosis and hepatocellular carcinoma. microRNAs (miRNAs) are small non-coding RNAs that negatively regulate messenger RNA (mRNA). Recently, it was demonstrated that the aberrant expression of certain miRNAs plays a pivotal role in liver disease. The aim of the present study was to evaluate changes in miRNA profiles associated with metformin treatment in a NASH model. Eight-week-old male mice were fed a methionine- and choline-deficient (MCD) diet alone or with 0.08% metformin for 15 weeks. Metformin significantly downregulated the level of plasma transaminases and attenuated hepatic steatosis and liver fibrosis. The expression of miRNA-376a, miRNA‑127, miRNA-34a, miRNA-300 and miRNA-342-3p was enhanced among the 71 upregulated miRNAs, and the expression of miRNA-122, miRNA-194, miRNA-101b and miRNA-705 was decreased among 60 downregulated miRNAs in the liver of MCD-fed mice when compared with control mice. Of note, miRNA profiles were altered following treatment with metformin in MCD-fed mice. miRNA-376a, miRNA‑127, miRNA-34a, miRNA-300 and miRNA-342-3p were downregulated, but miRNA-122, miRNA-194, miRNA‑101b and miRNA-705 were significantly upregulated in MCD-fed mice treated with metformin. miRNA profiles were altered in MCD-fed mice and metformin attenuated this effect on miRNA expression. Therefore, miRNA profiles are a potential tool that may be utilized to clarify the mechanism behind the metformin-induced improvement of hepatic steatosis and liver fibrosis. Furthermore, identification of targetable miRNAs may be used as a novel therapy in human NASH.

  4. Maintaining Treatment Fidelity of Mindfulness-Based Relapse Prevention Intervention for Alcohol Dependence: A Randomized Controlled Trial Experience

    Directory of Open Access Journals (Sweden)

    Aleksandra E. Zgierska

    2017-01-01

    Full Text Available Background. Treatment fidelity is essential to methodological rigor of clinical trials evaluating behavioral interventions such as Mindfulness Meditation (MM. However, procedures for monitoring and maintenance of treatment fidelity are inconsistently applied, limiting the strength of such research. Objective. To describe the implementation and findings related to fidelity monitoring of the Mindfulness-Based Relapse Prevention for Alcohol Dependence (MBRP-A intervention in a 26-week randomized controlled trial. Methods. 123 alcohol dependent adults were randomly assigned to MM (MBRP-A and home practice, adjunctive to usual care; N=64 or control (usual care alone; N=59. Treatment fidelity assessment strategies recommended by the National Institutes of Health Behavior Change Consortium for study/intervention design, therapist training, intervention delivery, and treatment receipt and enactment were applied. Results. Ten 8-session interventions were delivered. Therapist adherence and competence, assessed using the modified MBRP Adherence and Competence Scale, were high. Among the MM group participants, 46 attended ≥4 sessions; over 90% reported at-home MM practice at 8 weeks and 72% at 26 weeks. They also reported satisfaction with and usefulness of MM for maintaining sobriety. No adverse events were reported. Conclusions. A systematic approach to assessment of treatment fidelity in behavioral clinical trials allows determination of the degree of consistency between intended and actual delivery and receipt of intervention.

  5. Amino acid content in red wines obtained from grapevine nitrogen foliar treatments: consumption during the alcoholic fermentation

    Directory of Open Access Journals (Sweden)

    Javier Portu

    2014-12-01

    Full Text Available Nitrogen is an important element for grapevine and winemaking which affects the development of the plant and yeast, and therefore it is important for wine quality. The aim of this work was to study the influence of foliar application to vineyard of proline, phenylalanine and urea and two commercial nitrogen fertilizers, without and with amino acids in their formulation, on the wine amino acid content and their consumption during the alcoholic fermentation. The results showed that these treatments did not affect the amino acid composition in wines. The differences observed for certain amino acids were so small that the concentration of total amino acids was not significantly different among wines. Moreover, it was observed that the higher the content of amino acids in the medium, the greater their consumption during the alcoholic fermentation.

  6. [Interrupted alcohol treatment and liver: free radical homeostasis, nitric oxide, adaptive mechanisms].

    Science.gov (United States)

    Miskevich, D A; Borodinskiĭ, A N; Petushok, N E; Konovalenko, O V; Lelevich, V V

    2006-01-01

    Alcohol administration can result in liver damage. Reactive oxygen species (ROS), nitric oxide (NO) and their interaction are crucial factors in this process. The aim of work was to investigate, free radical state and mechanisms of adaptation of the antioxidant system (AOS) to stress, caused by interrupted alcohol intake. Repeated cycles of alcoholization caused an imbalance between production and utilization of various ROS. This imbalance was due to impairments in the system superoxide dismutase/catalase. Nevertheless, in most experimental groups there was clear reduction of lipid peroxidation (LPO) products evaluated by thiobarbituric acid reactive substances. This might be attributed to the antioxidant effect of NO. However, there was an increased level of transaminases in blood plasma. After 28 days of this experimental scheme all the parameters studied normalized.

  7. The Role of Drinking Alcohol, Coffee, Tea Habits, Fear of Gaining Weight and Treatment Methods in Smoking Cessation Success

    Directory of Open Access Journals (Sweden)

    İzzet Fidancı1

    2016-04-01

    Full Text Available Objective: We aimed to evaluate the role of drinking alcohol, coffee and tea habits, fear of gaining weight and treatment methods in smoking cessation success. Methods: In our study, we applied a questionnaire and Fagerström Test for Nicotine Dependence to 128 participants consulting Family Medicine Smoking Cessation Outpatient Clinic of Ankara Training and Research Hospital. Among participants, 67 of them were people quitted smoking while the other 61 did not. With questionnaire, we investigated factors possibly affecting smoking cessation success like drinking alcohol, coffee and tea habits and also marital status and occupations of participants. By adding Fagerström Test for Nicotine Dependence to questionnaire we defined the dependence status of participants. Results: Study comprised of 128 participants, 50 of them being female and 78 being male. Mean age of participants was 34.01 (±12.24 in patients quitted smoking and 32.82 (±13.45 in patients still smoking. Tea and alcohol drinking habits were found to be higher in smoking group and difference was statistically significant (p<0,05. When examining smoking cessation success according to occupational groups, civil servants and unemployed people were more successful than other occupational groups, but there was no statistically significant difference. People having coffee drinking habits quitted smoking in a significantly higher rate (p<0,05. Among given treatments, although statistically insignificant, the most effective one was varenicline. Conclusion: According to our results, smoking cessation success is lower among people having tea and alcohol drinking habits. In smokers, we should investigate the relationship with additional substance usage and aim to decrease these additional substance usage habits for increasing smoking cessation success.

  8. 酒精性肝病临床诊治分析%Clinical Analysis of Diagnosis and Treatment of Alcoholic Liver Disease

    Institute of Scientific and Technical Information of China (English)

    柴玉萍

    2015-01-01

    目的 分析酒精性肝病临床诊治方法.方法 对2014年1~12月我院收治的62例酒精性肝病患者的临床资料进行回顾性分析,总结其临床诊断及治疗措施.结果 本次研究的62例酒精性肝病患者中,酒精性脂肪肝8例,酒精性肝炎45例,酒精性肝硬化9例.入院后经戒酒、护肝等综合治疗,总有效率为95.2%(59/62例);治疗后患者ALT、AST、GGT等肝功能指标与治疗前比较,差异有统计学意义(P<0.05).结论 酒精性肝病主要有酒精性肝炎、酒精性肝硬化及酒精性脂肪肝等,其肝脏损害程度与饮酒时间、饮酒量及饮酒方式关系密切,临床常给予患者戒酒、保肝治疗及营养支持治疗,可有效促进患者恢复.%Objective To analyze diagnosis and treatment methods of alcoholic liver disease.Methods From January to December 2014 of our hospital,clinical data of 62 patients with alcoholic liver disease were retrospectively analyzed and summarized the clinical diagnosis and treatment measures.Results The study of 62 patients with alcoholic liver disease,8 cases of alcoholic fatty liver,alcoholic hepatitis 45 cases, 9 cases of alcoholic liver cirrhosis. After giving up drinking, protecting liver,and other comprehensive treatment,the total effective rate was 95.2%(59/62). Patients after treatment of ALT, AST,GGT liver function index compared with before treatment,the difference was statisticaly significant(P<0.05).Conclusion Alcoholic liver disease basicaly have alcoholic hepatitis,alcoholic liver cirrhosis and alcoholic fatty liver. And the degree of liver damage is closely related to alcohol and alcohol drinking time. Clinical often give patients giving up drinking,protecting liver treatment and nutritional support treatment,which can effectively promote patients recover.

  9. We-Language and Sustained Reductions in Drinking in Couple-Based Treatment for Alcohol Use Disorders.

    Science.gov (United States)

    Hallgren, Kevin A; McCrady, Barbara S

    2016-03-01

    Couple-based treatments for alcohol use disorders (AUDs) produce higher rates of abstinence than individual-based treatments and posit that active involvement of both identified patients (IPs) and significant others (SOs) is partly responsible for these improvements. Separate research on couples' communication has suggested that pronoun usage can indicate a communal approach to coping with health-related problems. The present study tested whether communal coping, indicated by use of more first-person plural pronouns ("we" language), fewer second-person pronouns ("you" language), and fewer first-person singular pronouns ("I" language), predicted improvements in abstinence in couple-based AUD treatment. Pronoun use was measured in first- and mid-treatment sessions for 188 heterosexual couples in four clinical trials of alcohol behavioral couple therapy (ABCT). Percentages of days abstinent were assessed during treatment and over a 6-month follow-up period. Greater IP and SO "we" language during both sessions was correlated with greater improvement in abstinent days during treatment. Greater SO "we" language during first- and mid-treatment sessions was correlated with greater improvement in abstinence at follow-up. Greater use of IP and SO "you" and "I" language had mixed correlations with abstinence, typically being unrelated to or predicting less improvement in abstinence. When all pronoun variables were entered into regression models, only greater IP "we" langue and lower IP "you" language predicted improvements in abstinence during treatment, and only SO "we" language predicted improvements during follow-up. Most pronoun categories had little or no association with baseline relationship distress. Results suggest that communal coping predicts better abstinence outcomes in couple-based AUD treatment. © 2015 Family Process Institute.

  10. A study of gabapentin in the treatment of tonic-clonic seizures of alcohol withdrawal syndrome.

    Science.gov (United States)

    Rustembegovic, Avdo; Sofic, Emin; Tahirović, Ismet; Kundurović, Zlata

    2004-01-01

    In this study for thirty (30) patients with alcohol withdrawal syndrome, the response to anticolvusant gabapentin was assessed. Thirty (30) patients with median age of 57.0 years and median body weight of 79.1 kg were treated with gabapentin 3 x 300 mg daily for up 30 days. The preliminary findings of this study suggest that gabapentin is very effective against tonic-clonic seizures in alcohol withdrawal syndrome. Gabapentin was safe and well tolerated. For twenty (20) patients no side effect were observed.

  11. Public Health Aspects of Paediatric Dental Treatment under General Anaesthetic

    Directory of Open Access Journals (Sweden)

    William Murray Thomson

    2016-06-01

    Full Text Available Early childhood caries (ECC has negative psychosocial effects on children, with chronic pain, changed eating habits, disrupted sleep and altered growth very common, and it disrupts the day-to-day lives of their families. The treatment of young children with ECC places a considerable burden on health systems, with a considerable amount having to be provided under general anaesthesia (GA, which is resource-intensive. Justifying its use requires evidence of the efficacy of treatment in improving the lives of affected children and their families. This paper discusses the available evidence and then makes some suggestions for a research agenda.

  12. The Combination of Marketed Antagonists of α1b-Adrenergic and 5-HT2A Receptors Inhibits Behavioral Sensitization and Preference to Alcohol in Mice: A Promising Approach for the Treatment of Alcohol Dependence.

    Directory of Open Access Journals (Sweden)

    Fabrice Trovero

    Full Text Available Alcohol-dependence is a chronic disease with a dramatic and expensive social impact. Previous studies have indicated that the blockade of two monoaminergic receptors, α1b-adrenergic and 5-HT2A, could inhibit the development of behavioral sensitization to drugs of abuse, a hallmark of drug-seeking and drug-taking behaviors in rodents. Here, in order to develop a potential therapeutic treatment of alcohol dependence in humans, we have blocked these two monoaminergic receptors by a combination of antagonists already approved by Health Agencies. We show that the association of ifenprodil (1 mg/kg and cyproheptadine (1 mg/kg (α1-adrenergic and 5-HT2 receptor antagonists marketed as Vadilex ® and Periactine ® in France, respectively blocks behavioral sensitization to amphetamine in C57Bl6 mice and to alcohol in DBA2 mice. Moreover, this combination of antagonists inhibits alcohol intake in mice habituated to alcohol (10% v/v and reverses their alcohol preference. Finally, in order to verify that the effect of ifenprodil was not due to its anti-NMDA receptors property, we have shown that a combination of prazosin (0.5 mg/kg, an α1b-adrenergic antagonist, Mini-Press ® in France and cyproheptadine (1 mg/kg could also reverse alcohol preference. Altogether these findings strongly suggest that combined prazosin and cyproheptadine could be efficient as a therapy to treat alcoholism in humans. Finally, because α1b-adrenergic and 5-HT2A receptors blockade also inhibits behavioral sensitization to psychostimulants, opioids and tobacco, it cannot be excluded that this combination will exhibit some efficacy in the treatment of addiction to other abused drugs.

  13. Effect of pulsed electric field treatment during cold maceration and alcoholic fermentation on major red wine qualitative and quantitative parameters.

    Science.gov (United States)

    El Darra, Nada; Rajha, Hiba N; Ducasse, Marie-Agnès; Turk, Mohammad F; Grimi, Nabil; Maroun, Richard G; Louka, Nicolas; Vorobiev, Eugène

    2016-12-15

    This work studies the effect of pulsed electric field (PEF) treatment at moderate and high field strengths (E=0.8kV/cm & 5kV/cm) prior and during alcoholic fermentation (AF) of red grapes on improving different parameters of pre-treated extracts: pH, °Brix, colour intensity (CI), total polyphenols content (TPI) of Cabernet Sauvignon red wine. Similar trends were observed for treating grapes using moderate and high electric field strength on the enhancement of CI and TPI of the wine after AF. The application of PEF using moderate strengths at different times during cold maceration (CM) (0, 2 and 4days) was more efficient for treatment during CM. The treatment during AF showed lower extraction rate compared to treating during CM and prior to AF. Our results clearly show that the best time for applying the PEF-treatment through the red fermentation is during the CM step.

  14. Relationships among adaptive and maladaptive emotion regulation strategies and psychopathology during the treatment of comorbid anxiety and alcohol use disorders.

    Science.gov (United States)

    Conklin, Laren R; Cassiello-Robbins, Clair; Brake, C Alex; Sauer-Zavala, Shannon; Farchione, Todd J; Ciraulo, Domenic A; Barlow, David H

    2015-10-01

    Both maladaptive and adaptive emotion regulation strategies have been linked with psychopathology. However, previous studies have largely examined them separately, and little research has examined the interplay of these strategies cross-sectionally or longitudinally in patients undergoing psychological treatment. This study examined the use and interplay of adaptive and maladaptive emotion regulation strategies in 81 patients receiving cognitive-behavioral interventions for comorbid alcohol use and anxiety disorders. Patients completed measures of emotion regulation strategy use and symptoms of psychopathology pre- and post-treatment. Cross-sectionally, higher use of maladaptive strategies (e.g., denial) was significantly related to higher psychopathology pre- and post-treatment, whereas higher use of adaptive strategies (e.g., acceptance) only significantly related to lower psychopathology post-treatment. Prospectively, changes in maladaptive strategies, but not changes in adaptive strategies, were significantly associated with post-treatment psychopathology. However, for patients with higher pre-treatment maladaptive strategy use, gains in adaptive strategies were significantly associated with lower post-treatment psychopathology. These findings suggest that psychological treatments may maximize efficacy by considering patient skill use at treatment outset. By better understanding a patient's initial emotion regulation skills, clinicians may be better able to optimize treatment outcomes by emphasizing maladaptive strategy use reduction predominately, or in conjunction with increasing adaptive skill use. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US

    Science.gov (United States)

    Zeng, Lily; Alongkronrusmee, Doungkamol; van Rijn, Richard M

    2017-01-01

    Neuropathic pain (NeuP) is a syndrome that results from damaged nerves and/or aberrant regeneration. Common etiologies of neuropathy include chronic illnesses and medication use. Chronic disorders, such as diabetes and alcoholism, can cause neuronal injury and consequently NeuP. Certain medications with antineoplastic effects also carry an exquisitely high risk for neuropathy. These culprits are a few of many that are fueling the NeuP epidemic, which currently affects 7%–10% of the population. It has been estimated that approximately 10% and 7% of US adults carry a diagnosis of diabetes and alcohol disorder, respectively. Despite its pervasiveness, many physicians are unfamiliar with adequate treatment of NeuP, partly due to the few reviews that are available that have integrated basic science and clinical practice. In light of the recent Centers for Disease Control and Prevention guidelines that advise against the routine use of μ-opioid receptor-selective opioids for chronic pain management, such a review is timely. Here, we provide a succinct overview of the etiology and treatment options of diabetic and alcohol- and drug-induced neuropathy, three different and prevalent neuropathies fusing the combined clinical and preclinical pharmacological expertise in NeuP of the authors. We discuss the anatomy of pain and pain transmission, with special attention to key ion channels, receptors, and neurotransmitters. An understanding of pain neurophysiology will lead to a better understanding of the rationale for the effectiveness of current treatment options, and may lead to better diagnostic tools to help distinguish types of neuropathy. We close with a discussion of ongoing research efforts to develop additional treatments for NeuP. PMID:28176937

  16. Research progress of treatment of alcoholic liver disease%酒精性肝病治疗的研究进展

    Institute of Scientific and Technical Information of China (English)

    管文婕; 吕雄文; 杨万枝; 代雪飞; 李俊

    2011-01-01

    Alcoholic liver disease( ALD )is caused by the liver damage and a series of changes of pathology which are attributed to longterm excessive drinking. The incidence of the disease tends to escalate year by year. ALD includes alcoholic fatty liver( AFL ), alcoholic hepatitis( AH ), alcoholic hepatic fibrosis( AHF ), alcoholic cirrhosis( AC ), etc. On the basis of the different treatments for different conditions,in this paper,the research progress of treatment of alcoholic liver disease is summarized, including abstinence, nutrition therapy,drug therapy, complications of treatment, and liver transplantation, etc.%酒精性肝病(alcoholic liver disease,ALD)是由于长期过量摄入酒精导致的肝脏损害及其一系列病变,其发病率在我国呈逐年上升趋势.ALD包括酒精性脂肪肝(AFL)、酒精性肝炎(AH)、酒精性肝纤维化(AHF)、酒精性肝硬化(AC)等.该文综述了ALD治疗方面的研究进展,根据不同病情进行不同治疗,包括:戒酒;营养治疗;药物治疗;并发症治疗;肝移植等.

  17. Self-Administered Treatments of Public Speaking Anxiety.

    Science.gov (United States)

    Auerbach, Alan

    1981-01-01

    Reports on two do-it-yourself treatment programs for dealing with stage fright. One program followed a systematic desensitization paradigm; the other was a handout listing 16 strategies for understanding stage fright. Higher ratings were given to the handout strategy. A list of the 16 strategies is included. (Author/RC)

  18. Ending Discrimination against People with Alcohol and Drug Problems.

    Science.gov (United States)

    Join Together, Boston, MA.

    People with alcohol or other drug disease face public and private policies that restrict their access to appropriate health care, employment, and public benefits, discouraging them from seeking treatment, robbing them of hope for recovery, and costing society millions of dollars. Join Together, a project of Boston University School of Public…

  19. Clinical impacts of hazardous alcohol use and obesity on the outcome of entecavir therapy in treatment-naïve patients with chronic hepatitis B infection

    Directory of Open Access Journals (Sweden)

    Won Gil Chung

    2012-06-01

    Full Text Available Background/AimsThe aim of this study was to analyze the clinical impacts of obesity and hazardous alcohol use on the outcome of entecavir (ETV therapy in chronic hepatitis B (CHB patients.MethodsThe medical records of 88 treatment-naïve patients who were diagnosed with CHB and received ETV between March 2007 and September 2009 were analyzed retrospectively. Body mass index (BMI values and Alcohol Use Disorders Identification Test (AUDIT scores were obtained at 6 months after the initiation of ETV (0.5 mg daily treatment.ResultsA BMI of 25 kg/m2 or more was recognized as an indicator of obesity, and a total AUDIT score of 8 or more was recognized as an indicator of hazardous alcohol use. Of the cohort, 24 patients (27.3% were obese and 17 (19.3% were hazardous alcohol users. The rate of seroconversion, alanine aminotransferase (ALT normalization, and hepatitis B virus (HBV-DNA negativity (<300 copies/mL at 3, 6, and 12 months of treatment did not differ significantly between the normal-BMI and high-BMI groups. Moreover, the rate of seroconversion and HBV-DNA negativity at 3, 6, and 12 months of treatment did not differ significantly between the nonhazardous and hazardous alcohol users. However, the frequency of ALT normalization at 12 months was significantly lower among hazardous alcohol users (91.5% vs. 70.6%; P=0.033.ConclusionsObesity and hazardous alcohol drinking have no significant impact on the outcome of ETV treatment. However, the ALT normalization rate at 12 months after initiation of ETV treatment was significantly lower among the hazardous alcohol users.

  20. Preventing Alcohol Problems among Young People: Californians Support Key Public Policies. Growing Up Well. Focus on Prevention.

    Science.gov (United States)

    Mosher, James F.

    This report, fourth in a series of eight, highlights the views of Californians about policies local communities and the state can establish to reduce the potential for alcohol problems among young people. In the California Center for Health Improvement (CCHI) "Children and Youth Survey," 51% of the adults surveyed said that they were…

  1. Oxidative Mineralization and Characterization of Polyvinyl Alcohol Solutions for Wastewater Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Oji, L.N.

    1999-08-31

    The principal objectives of this study are to identify an appropriate polyvinyl alcohol (PVA) oxidative mineralization technique, perform compatibility and evaporation fate tests for neat and mineralized PVA, and determine potential for PVA chemical interferences which may affect ion exchange utilization for radioactive wastewater processing in the nuclear industry.

  2. A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

    Science.gov (United States)

    2016-10-01

    significantly reduced in the placebo group in some measures of alcohol use and NSI symptoms, suggesting some possible benefit for TOP. However, the TOP...after the Wenchuan earthquake: an ERP study. PloS One 2012; 7: e40316. 53. Lovallo WR, Farag NH, Sorocco KH, Acheson A, Cohoon AJ, Vincent AS: Early

  3. EXPLORING THE BIOTRANSFORMATION POTENTIAL OF FLUOROTELOMER ALCOHOL-BASED POLYMER FORMULATIONS DURING AEROBIC BIOLOGICAL WASTEWATER TREATMENT

    Science.gov (United States)

    Fluorotelomer alcohols have been widely used over the past 50 years in surface protection products for paper, packaging, textile, and carpet goods; in industrial surfactant mixtures; in aqueous fire-fighting foams, and as processing aids during the production of fluoropolymer pla...

  4. Prazosin for Treatment of Patients with PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2014-12-01

    as high as those in the general population. In addition, alcohol dependence is the most ommon comorbid condition in men with PTSD. Despite this...participants with a current iagnosis of AD and PTSD will be enrolled in a 13-week trial. They will be assigned, in a double-blind fashion , to either

  5. The Potential of Flavonoids in the Treatment of Non-alcoholic Fatty Liver Disease

    NARCIS (Netherlands)

    van de Wier, B.; Koek, Ger H.; Bast, Aalt; Haenen, Guido R.M.

    2015-01-01

    The contemporary pathophysiological model of non-alcoholic fatty liver disease (NAFLD) consists of multiple parallel pathways with a dynamic cross talk that cumulate in steatosis and inflammation and ultimately fibrosis, cirrhosis, liver failure and hepatocellular carcinoma. So far, no pharmacologic

  6. EXPLORING THE BIOTRANSFORMATION POTENTIAL OF FLUOROTELOMER ALCOHOL-BASED POLYMER FORMULATIONS DURING AEROBIC BIOLOGICAL WASTEWATER TREATMENT

    Science.gov (United States)

    Fluorotelomer alcohols have been widely used over the past 50 years in surface protection products for paper, packaging, textile, and carpet goods; in industrial surfactant mixtures; in aqueous fire-fighting foams, and as processing aids during the production of fluoropolymer pla...

  7. Public Views on Food Addiction and Obesity: Implications for Policy and Treatment

    OpenAIRE

    Natalia M Lee; Jayne Lucke; Wayne D Hall; Carla Meurk; Boyle, Frances M; Adrian Carter

    2013-01-01

    BACKGROUND: According to their advocates, neurobiological explanations of overeating, or "food addiction", have the potential to impact public understanding and treatment of obesity. In this study, we examine the public's acceptance of the concept of food addiction as an explanation of overeating and assess its effects upon their attitudes toward obese persons and the treatment of obesity. METHODS AND FINDINGS: We conducted an online survey of 479 adults from the US (n = 215) and Australia (n...

  8. Alcohol withdrawal.

    Science.gov (United States)

    Manasco, Anton; Chang, Shannon; Larriviere, Joseph; Hamm, L Lee; Glass, Marcia

    2012-11-01

    Alcohol withdrawal is a common clinical condition that has a variety of complications and morbidities. The manifestations can range from mild agitation to withdrawal seizures and delirium tremens. The treatments for alcohol withdrawal include benzodiazepines, anticonvulsants, beta-blockers and antihypertensives. Although benzodiazepines are presently a first-line therapy, there is controversy regarding the efficacies of these medications compared with others. Treatment protocols often involve one of two contrasting approaches: symptom-triggered versus fixed-schedule dosing of benzodiazepines. We describe these protocols in our review and examine the data supporting symptom-triggered dosing as the preferred method for most patients in withdrawal.The Clinical Institute Withdrawal Assessment for Alcohol scoring system for alcohol withdrawal streamlines care, optimizes patient management, and is the best scale available for withdrawal assessment. Quality improvement implications for inpatient management of alcohol withdrawal include increasing training for signs of withdrawal and symptom recognition, adding new hospital protocols to employee curricula, and ensuring manageable patient-to-physician and patient-to-nurse ratios.

  9. Immunohistochemistry Study on Androgen and Estrogen Receptors of Rat Seminal Vesicle Submitted to Simultaneous Alcohol-Nicotine Treatment

    Directory of Open Access Journals (Sweden)

    Mohsen Basiri

    2016-09-01

    Full Text Available Objective: Alcohol consumption is habitually accompanied by the use of other psychoactive substances, mostly tobacco. Nicotine and alcohol affect male accessory reproductive glands function. Most studies have been done on pathologic features of prostate, but there has been no systematic study on the seminal vesicle. Therefore, the aim of current study was to investigate the distribution of androgen receptor (AR and estrogen receptors-beta (ER-β immune reactivities following long-term treatment of alcohol, nicotine or a combination of both substances. Materials and Methods: In this experimental study, a total of 40 adult Wistar rats, nine weeks of age, were used. Animals were randomly divided into four groups, including: i. Control group receiving normal saline 0.09%, ii. Ethanol group receiving ethanol 20% (2 ml/kg, via gavage, iii. Nicotine group receiving nicotine (0.1 mg/kg, subcutaneous injection, and iv. Ethanol-nicotine group receiving simultaneous ethanol 20% (2 ml/kg and nicotine (0.1 mg/kg treatment. All treatment lasted for eight weeks. Prior to intracardiac perfusion, blood sample was collected from left ventricle. The seminal vesicles were isolated and processed for paraffin blocking. The sample tissues were then studied for distribution of AR and ER-β immunereactivities using immunohistochemical (IHC staining method. One way analysis of variance (ANOVA and Tukey’s test were performed for data analysis. A value of P<0.05 was considered significant. Results: Our results revealed that the lowest mean number of positive cells belonged to the animals of ethanol-nicotine group that was followed by the ethanol, nicotine, and control groups, respectively. However, there was no significant difference regarding serum testosterone level among experimental groups. Conclusion: It was concluded that combination of both ethanol and nicotine may be a crucial factor in the expression levels of AR and ER-β.

  10. Cognitive Training and Work Therapy for the Treatment of Verbal Learning and Memory Deficits in Veterans With Alcohol Use Disorders.

    Science.gov (United States)

    Bell, Morris D; Vissicchio, Nicholas A; Weinstein, Andrea J

    2016-01-01

    This study focused on the efficacy of cognitive training for verbal learning and memory deficits in a population of older veterans with alcohol use disorders. Veterans with alcohol use disorders, who were in outpatient treatment at VA facilities and in early-phase recovery (N = 31), were randomized to receive a three-month trial of daily cognitive training plus work therapy (n = 15) or work therapy alone (n = 16), along with treatment as usual. Participants completed assessments at baseline and at three- and six-month follow-ups; the Hopkins Verbal Learning Task (HVLT) was the primary outcome measure. Participants were primarily male (97%) and in their mid-50s (M = 55.16, SD = 5.16) and had been sober for 1.64 (SD = 2.81) months. Study retention was excellent (91% at three-month follow-up) and adherence to treatment in both conditions was very good. On average, participants in the cognitive training condition had more than 41 hours of cognitive training, and both conditions had more than 230 hours of productive activity. HVLT results at three-month follow-up revealed significant condition effects favoring cognitive training for verbal learning (HVLT Trial-3 T-score, p learning compared with a premorbid estimate of verbal IQ. At three-month follow-up there was a significant reduction in the number of participants in the cognitive training condition with clinically significant verbal memory deficits (p learning deficits, which was not sustained at six-month follow-up. This National Institute on Drug Abuse-funded pilot study demonstrates that cognitive training within the context of another activating intervention (work therapy) may have efficacy in remediating verbal learning and memory deficits in patients with alcohol use disorder. Findings indicate a large effect for cognitive training in this pilot study, which suggests that further research is warranted. This study is registered on ClinicalTrials.gov (NCT 01410110).

  11. Metagenomic analyses of alcohol induced pathogenic alterations in the intestinal microbiome and the effect of Lactobacillus rhamnosus GG treatment.

    Directory of Open Access Journals (Sweden)

    Lara Bull-Otterson

    Full Text Available Enteric dysbiosis plays an essential role in the pathogenesis of alcoholic liver disease (ALD. Detailed characterization of the alterations in the gut microbiome is needed for understanding their pathogenic role in ALD and developing effective therapeutic approaches using probiotic supplementation. Mice were fed liquid Lieber-DeCarli diet without or with alcohol (5% v/v for 6 weeks. A subset of mice were administered the probiotic Lactobacillus rhamnosus GG (LGG from 6 to 8 weeks. Indicators of intestinal permeability, hepatic steatosis, inflammation and injury were evaluated. Metagenomic analysis of the gut microbiome was performed by analyzing the fecal DNA by amplification of the V3-V5 regions of the 16S rRNA gene and large-scale parallel pyrosequencing on the 454 FLX Titanium platform. Chronic ethanol feeding caused a decline in the abundance of both Bacteriodetes and Firmicutes phyla, with a proportional increase in the gram negative Proteobacteria and gram positive Actinobacteria phyla; the bacterial genera that showed the biggest expansion were the gram negative alkaline tolerant Alcaligenes and gram positive Corynebacterium. Commensurate with the qualitative and quantitative alterations in the microbiome, ethanol caused an increase in plasma endotoxin, fecal pH, hepatic inflammation and injury. Notably, the ethanol-induced pathogenic changes in the microbiome and the liver were prevented by LGG supplementation. Overall, significant alterations in the gut microbiome over time occur in response to chronic alcohol exposure and correspond to increases in intestinal barrier dysfunction and development of ALD. Moreover, the altered bacterial communities of the gut may serve as significant therapeutic target for the prevention/treatment of chronic alcohol intake induced intestinal barrier dysfunction and liver disease.

  12. Advances in alcoholic liver disease treatment%酒精性肝病治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    魏玲; 张小莉; 何正; 武会娟

    2015-01-01

    目前,长期过度摄入酒精而引发的酒精性肝病已经成为一个社会性的健康问题,给患者、家庭及社会带来了极大的经济负担。酒精性肝病包括酒精性脂肪肝、酒精性肝炎、肝硬化以及肝癌等。酒精性肝病的诊断一般基于临床上的症状,如饮酒史、肝病指标及临床化验指标等。目前酒精性肝病的治疗最重要的是戒酒,再根据病情采取相应的治疗措施,主要的治疗手段包括药物治疗、精神治疗及外科肝移植治疗等。严重的酒精性肝病临床上推荐使用皮质类固醇或己酮可可碱。干细胞治疗是肝硬化患者的一个可能的治疗措施。肝移植除了合适的肝脏供体,移植后使用的免疫抑制剂可能导致新的癌症的发生。新型的安全高效的病理生理主导的治疗方法是治疗酒精性肝病的必然趋势,可能的靶点包括CXC细胞因子、IL-22、TNF受体超家族、补体和脂多糖(LPS)等。%Alcoholic liver diseases (ALD) which is associated with excess consumption of alcohol, is a major healthcare problem and brings great economic burden to patients’ family and society. ALD include alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is according to the clinical features, such as history of excess alcohol consume, evidence of liver disease, and laboratory findings. The most important and effective treatment for ALD is abstinence, and according to the stage of the disease the treatment plan varies. Now, the treatments for alcoholic liver diseases include abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and liver transplantation. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. The suitable donor is essential for liver transplantation, and immunosuppressive drugs that are used after transplantation may cause new

  13. The use of very high-doses of baclofen for the treatment of alcohol-dependence: a case series.

    Directory of Open Access Journals (Sweden)

    Renaud ede Beaurepaire

    2014-10-01

    Full Text Available Baclofen, particularly high-dose baclofen, has recently emerged as a treatment of major interest for alcohol-dependence. However, baclofen has many potentially dangerous side effects, and the maximal dose of baclofen that may be used is a matter of discussion. Here, the author analyses the medical charts of the last 100 patients seen in his clinic, 17 of whom have been taking a very high dose of baclofen, that is to say, more than 300mg per day. The analysis of the charts shows that the very high doses baclofen were justified in almost all the cases. Side effects are analyzed.

  14. Formation of inorganic nanofibers by heat-treatment of poly(vinyl alcohol-zirconium compound hybrid nanofibers

    Directory of Open Access Journals (Sweden)

    Nakane K.

    2013-01-01

    Full Text Available Poly(vinyl alcohol-zirconium compound hybrid nanofibers (precursors were formed by electrospinning employing water as a solvent for the spinning solution. The precursors were converted into oxide (ZrO2, carbide (ZrC or nitride (ZrN nanofibers by heating them in air, Ar or N2 atmospheres. Monoclinic ZrO2 nanofibers with high-specific surface area were obtained by heat-treatment of the precursors in air. ZrC and ZrN nanofibers could be obtained below theoretical temperatures calculated from thermodynamics data.

  15. Two-year prognosis after residential treatment for patients with alcohol dependence: three chief guidelines for sobriety in Japan

    Science.gov (United States)

    Cho, Tetsuji; Negoro, Hideki; Saka, Yasuhiro; Morikawa, Masayuki; Kishimoto, Toshifumi

    2016-01-01

    Background In Japan, the three chief traditional guidelines for sobriety (3CGS) are regular medical checkups, participation in self-help groups, and pharmacotherapy with antidipsotropics. However, the official record of the origins of 3CGS is not clear. The aim of this current study was to assess 3CGS by an examination of the prognosis of patients with alcohol dependence 2 years after their discharge from a residential treatment program. Subjects and methods The association between subjects’ abstinence from alcohol and their regular medical checkups, participation in self-help groups, and treatment with antidipsotropics were prospectively examined. Two years after discharge, the relationship between the 3CGS compliance and abstinence rates was investigated as the primary outcome. In addition, the following were examined as secondary outcomes: the time taken till the first drink after discharge, whether the participants were readmitted to residential treatment, the number of days to readmission, the number of heavy drinking days, and recovery. Results A total of 98 patients participated. The perfect and partial abstinence rates for patients who followed all the principles of 3CGS were significantly higher than those for patients who followed no guidelines (P<0.05 and P<0.01, respectively). The perfect abstinence rates for patients who had continued attending checkup sessions (P<0.001) and who were taking antidipsotropics (P<0.05) were significantly higher than those for patients who did not follow these components of 3CGS. However, the perfect abstinence rates were not higher for patients who had continued to participate in self-help groups. In addition, the perfect abstinence rate was statistically associated with regular medical checkups (adjusted odds ratio =5.33, 95% confidence interval =1.35–21.0) and participation in self-help groups (adjusted odds ratio =3.79, 95% confidence interval =1.17–12.3). Conclusion This study, reports the effectiveness of 3CGS

  16. Evaluation of Public Awareness about Orthodontic Treatments in Two Cities of Iran

    Directory of Open Access Journals (Sweden)

    Rafighi Ali

    2015-01-01

    Full Text Available Objective: Most orthodontic patients are children or adolescents. In recent years, orthodontic treatment in adults, also has gained social and professional acceptance. Adults have undoubtable effect on overall treatment demand. Parents are the most powerful single factor in children motivation for treatment. Therefore, parents and other members of the society are expected to have proper knowledge about orthodontic problems. The purpose of this study was to determine and compare public awareness about orthodontic treatment in two cities of Iran. Materials and Methods: A questionnaire consisting of 17 questions, including general information, suitable age, and costs of orthodontic treatment, was given to 384 subjects. The questionnaire was given to healthcare centers in different districts of both cities in order to justify a homogeneous study sample. The public awareness in two cities was analyzed and compared with independent t-test. Results: There was no significant difference between the two cities in general information and their opinion about the costs of the orthodontic treatment. The difference in public awareness about the proper age for orthodontic treatment was statistically significant between the two cities (p= 0.002. Conclusion: General awareness of people about orthodontic treatment in both cities was not adequate, and in the two cities, high costs of orthodontic treatment were the main problems causing treatment demand reduction. Knowledge of people in Tabriz about proper age of orthodontic treatment was higher.   Key words: Health Care Costs; Health Knowledge; Health Service Needs and Demands; Orthodontics

  17. Aerobic Exercise for Alcohol Recovery: Rationale, Program Description, and Preliminary Findings

    Science.gov (United States)

    Brown, Richard A.; Abrantes, Ana M.; Read, Jennifer P.; Marcus, Bess H.; Jakicic, John; Strong, David R.; Oakley, Julie R.; Ramsey, Susan E.; Kahler, Christopher W.; Stuart, Gregory; Dubreuil, Mary Ella; Gordon, Alan A.

    2009-01-01

    Alcohol use disorders are a major public health concern. Despite the demonstrated efficacy of a number of different treatments for alcohol dependence, relapse remains a major problem. Healthy lifestyle changes may contribute to long-term maintenance of recovery, and interventions targeting physical activity, in particular, may be especially…

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

    Science.gov (United States)

    Gossop, Michael; Stewart, Duncan; Marsden, John

    2008-01-01

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

  19. Outpatient treatment of alcohol use disorders among subjects 60+ years: design of a randomized clinical trial conducted in three countries (Elderly Study).

    Science.gov (United States)

    Andersen, Kjeld; Bogenschutz, Michael P; Bühringer, Gerhard; Behrendt, Silke; Bilberg, Randi; Braun, Barbara; Ekstrøm, Claus Thorn; Forcehimes, Alyssa; Lizarraga, Christine; Moyers, Theresa B; Nielsen, Anette Søgaard

    2015-11-14

    The proportion of 60+ years with excessive alcohol intake varies in western countries between 6-16 % among men and 2-7 % among women. Specific events related to aging (e.g. loss of job, physical and mental capacity, or spouse) may contribute to onset or continuation of alcohol use disorders (AUD). We present the rationale and design of a multisite, multinational AUD treatment study for subjects aged 60+ years. 1,000 subjects seeking treatment for AUD according to DSM-5 in outpatient clinics in Denmark, Germany, and New Mexico (USA) are invited to participate in a RCT. Participants are randomly assigned to four sessions of Motivational Enhancement Treatment (MET) or to MET plus an add-on with eight sessions based on the Community Reinforcement Approach (CRA), which include a new module targeting specific problems of older adults. A series of assessment instruments is applied, including the Form-90, Alcohol Dependence Scale, Penn Alcohol Craving Scale, Brief Symptom Inventory and WHO Quality of Life. Enrolment will be completed by April 2016 and data collection by April 2017. The primary outcome is the proportion in each group who are abstinent or have a controlled use of alcohol six months after treatment initiation. Controlled use is defined as maximum blood alcohol content not exceeding 0.05 % during the last month. Total abstinence is a secondary outcome, together with quality of life andcompliance with treatment. The study will provide new knowledge about brief treatment of AUD for older subjects. As the treatment is manualized and applied in routine treatment facilities, barriers for implementation in the health care system are relatively low. Finally, as the study is being conducted in three different countries it will also provide significant insight into the possible interaction of service system differences and related patient characteristics in predictionof treatment outcome. Clinical Trials.gov NCT02084173 , March 7, 2014.

  20. A Preliminary Investigation of Continuous and Intermittent Exposures in the Treatment of Public Speaking Anxiety

    Science.gov (United States)

    Seim, Richard W.; Waller, Stacey A.; Spates, C. Richard

    2010-01-01

    It is often argued that exposure-based treatments for anxiety disorders are only effective if the exposures are presented continuously until a marked decrement in anxiety is achieved (e.g. Foa & Kozak, 1986). However, the data supporting this conclusion is limited. This study compared two treatments for public speaking anxiety: one requiring…