Addiction Rehab: Alcohol Intoxication in the Context of Major Public Holidays, Sporting and Social Events: A Time-Series Analysis in Melbourne, Australia, 2000-2009.
Alcohol intoxication in the context of major public holidays, sporting and social events: A time-series analysis in Melbourne, Australia, 2000-2009.
Filed under: Addiction Rehab
Addiction. 2012 Nov 8;
Lloyd B, Matthews S, Livingston M, Jayasekara H, Smith K
AIMS: To assess the relationship between ambulance attendances, emergency department (ED) presentations and hospital admissions for acute alcohol intoxication and the timing of public holidays, sporting and social events. DESIGN: Time series analysis was used to explore trends in intoxication in the context of major events. SETTING: Population of Melbourne, Victoria, Australia between 2000 and 2009. PARTICIPANTS: All patients attended by ambulance, presenting to hospital EDs, or admitted to hospital who were classified as acutely alcohol intoxicated. MEASUREMENT: Analysis of daily numbers of presentations for acute alcohol intoxication associated with major events were undertaken, including lead and lag effects. Analyses controlled for day of week and month of year to address temporal and seasonal variations. FINDINGS: Alcohol intoxication presentations were significantly elevated the day before all public holidays, with intoxication cases on the day of public holidays only higher on New Year’s Day (ambulance 6.57, 95% confidence intervals (CI) 3.4- 9.74; ED 3.34, 95% CI 1.28-5.4) and ANZAC Day (ambulance 3.71, 95% CI 0.68-6.75). The Australian Football League (AFL) Grand Final (ED 2.37, 95% CI 0.55-4.19), Commonwealth Games (ED 2.45, 95% CI 0.6-4.3) and Melbourne Cup Day (ambulance 6.14, 95% CI 2.42-9.85) represented the sporting events with significant elevations in acute intoxication requiring medical attention. The last working day before Christmas was the only social event where a significant increase in acute intoxication occurred (ambulance 8.98, 95% CI 6.8-11.15). Conclusions: Acute alcohol intoxication cases requiring ambulance, emergency department and hospital inpatient treatment increase substantially on the day preceding public holidays and other major social events.
HubMed – addiction
The use of epidemiology in alcohol research.
Filed under: Addiction Rehab
Addiction. 2012 Nov 7;
Rossow I, Norström T
AIMS: This paper presents examples to illustrate the utility and limitations in the use of epidemiology in alcohol research and discusses some promising new directions. METHODS: Review of literature, concentrating on epidemiological alcohol research with relevance to public health. FINDINGS AND CONCLUSION: Epidemiology offers tools for assessment of causes and effects of alcohol consumption as well as the effects of efforts to prevent alcohol consumption and its consequences. Epidemiological studies have made significant contributions to alcohol research with respect to public health and public policy. Fixed-effects modelling, difference-in-differences estimation and integrated qualitative and epidemiological methods are promising but underused methods in epidemiological studies. Many epidemiological studies have limited transferability of knowledge to other cultures and jurisdictions.
HubMed – addiction
Efficacy of Acamprosate for Alcohol Dependence in a Family Medicine Setting in the United States: A Randomized, Double-Blind, Placebo-Controlled Study.
Filed under: Addiction Rehab
Alcohol Clin Exp Res. 2012 Nov 7;
Berger L, Fisher M, Brondino M, Bohn M, Gwyther R, Longo L, Beier N, Ford A, Greco J, Garbutt JC
BACKGROUND: Acamprosate has been found to enhance rates of complete abstinence and to increase percent days abstinent (PDA) from alcohol relative to placebo treatment. As most U.S. clinical trials of acamprosate have been conducted in alcohol and other drug specialty clinics, there is a need to examine the efficacy of acamprosate in generalist settings. This study tested the efficacy of acamprosate versus placebo on the primary study outcome of PDA in the treatment of alcohol-dependent patients in a family medicine setting. Secondary study outcomes included percent heavy drinking days (%HDD) and gamma glutamyltransferase level (normal or high). METHODS: A randomized, double-blind, placebo-controlled, parallel group design of acamprosate was conducted in 2 family medicine settings (North Carolina and Wisconsin). One hundred volunteers were recruited primarily by advertisement, and participants were assigned to 666 mg (2 pills) oral acamprosate 3 times daily (1,998 mg/d) or matching placebo over a 12-week period. All participants concomitantly received 5 sessions of a brief behavioral intervention from a family/primary care physician. RESULTS: No significant treatment effect of acamprosate was found on PDA or the secondary outcomes. Significant treatment goal by time interaction effects was found on PDA and %HDD. Participants who had an initial goal of abstinence versus a reduction in alcohol use improved on average over time in PDA and had less %HDD from baseline to the end of treatment. CONCLUSIONS: This clinical trial did not find evidence of efficacy for acamprosate compared to placebo among alcohol-dependent individuals recruited primarily by advertisement as studied in a primary care setting. Drinking outcomes significantly improved regardless of medication condition. A goal of abstinence was significantly associated with improved drinking outcomes, suggesting that alcohol-dependent patients with such a goal may do particularly well with counseling in a family medicine setting.
HubMed – addiction
Immune function genes, genetics, and the neurobiology of addiction.
Filed under: Addiction Rehab
Alcohol Res. 2012; 34(3): 355-61
Crews FT
The neuroimmune system (i.e., the immune system and those components of the nervous system that help regulate immune responses), and in particular the innate immune system, play a role in the development of addictions, including alcoholism, particularly in the context of stressful situations. Certain cells of the neuroimmune system are activated both by stress and by environmental factors such as alcohol, resulting in the induction of genes involved in innate immunity. One of the molecules mediating this gene induction is a regulatory protein called nuclear factor-?B, which activates many innate immune genes. Innate immune gene induction in certain brain regions (e.g., the frontal cortex), in turn, can disrupt decision making, which is a characteristic of addiction to alcohol and other drugs. Likewise, altered neuroimmune signaling processes are linked to alcohol-induced negative affect and depression-like behaviors and also regulate alcohol-drinking behavior. Moreover, the expression of several genes and proteins involved in innate immunity is enhanced in addicted people. Finally, specific variants of multiple innate immune genes are associated with the genetic risk for alcoholism in humans, further strengthening the connection between increased brain innate immune gene expression and alcohol addiction.
HubMed – addiction
Alcohol Dependence and Genes Encoding ?2 and ?1 GABAA Receptor Subunits: Insights from Humans and Mice.
Filed under: Addiction Rehab
Alcohol Res. 2012; 34(3): 345-53
Borghese CM, Harris RA
One approach to identifying the causes of alcoholism, particularly without crossing ethical boundaries in human subjects, is to look at the person’s genome (and particularly at the variations that naturally arise in the DNA) to identify those variations that seem to be found more commonly in people with the disease. Some of these analyses have focused on the genes that encode subunits of the receptor for the brain chemical (i.e., neurotransmitter) ?-aminobutyric acid (GABA). Different epidemiological genetic studies have provided evidence that variations in certain GABAA receptor (GABAA-R) subunits, particularly subunits ?2 and ?1, are correlated with alcohol dependence. Manipulations of these genes and their expression in mice and rats also are offering clues as to the role of specific GABAA-Rs in the molecular mechanisms underlying alcoholism and suggest possibilities for new therapeutic approaches.
HubMed – addiction
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