In a new target population researchers have found that alcoholics who have a particular variant of an opioid-receptor gene appear to respond better to naltrexone, an opioid antagonist that is used to reduce alcohol craving and relapse.

National Institute on Alcohol Abuse and Alcoholism (NIAAA) researchers who reviewed data from the 2001-2004 COMBINE (Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence) study found that 87 percent of patients with the OPRM1 gene variant reported good outcomes with naltrexone treatment, compared to 49 percent of those receiving placebos and 55 percent of individuals lacking the gene variant who received either a placebo or naltrexone.

The study defined good outcomes as abstinence or moderate alcohol consumption without attendant problems.

“Analysis of the large COMBINE patient population increases confidence that the OPRM1 variant is in part responsible for positive responses to naltrexone,” said Ting-Kai Li, director of NIAAA. “This study points to the promise of research on gene-medication interactions to refine treatment selection, improve clinical results, and inform ongoing medications development.”

The research was published in the Feb. 4, 2008 issue of the Archives of General Psychiatry.

See also;

• Brief-TSF can assist patients cease alcohol consumption.
• Anti-craving Naltrexone Injection Reduces Drinking

Episodes of intimate partner violence are associated with alcohol consumption. To explore this relationship further, researchers interviewed a random sample of heterosexual couples at baseline and 5 years later. They assessed alcohol use and related problems, and the incidence (new cases) and recurrence (cases at both follow-up and baseline) of male-to-female partner violence and female-to-male partner violence. Analyses included 1136 couples who were cohabitating and/or married at both baseline and follow-up. Partner violence was defined as a range of violent behaviors, such as slapping, kicking, forcing sex, and threatening with a gun or knife.

• At follow-up, the incidence of both female-to-male and male-to-female partner violence was only 6 percent. However, recurrence was more common (female-to-male violence 44 percent, male-to-female violence 39 percent).
• In unadjusted analyses, incidence and/or recurrence of partner violence was significantly associated with greater mean consumption by male perpetrators; heavy drinking (at least 5 drinks on an occasion in the past year) by male and female perpetrators; and/or alcohol problems among male and female perpetrators.
• Among these alcohol indicators, only mean consumption (among both female perpetrators and male victims) remained significantly associated with new or recurrent cases of female-to-male partner violence when analyses were adjusted for potential confounders.

Comments by Joseph Conigliaro, MD, MPH: Female-to-male partner violence was as common as male-to-female partner violence in this population-based sample, whereas male perpetration of partner violence is often the norm in clinical samples. Nevertheless, heavy episodic drinking, alcohol problems, and higher average alcohol consumption should be considered risk factors for partner violence and addressed in prevention efforts.

Reference: Caetano R, McGrath C, Ramisetty-Mikler S, et al. Drinking, alcohol problems and the five-year recurrence and incidence of male to female and female to male partner violence. Alcohol Clin Exp Res. 2005;29(1):98-106.

Reprinted with permission from “Alcohol and Health: Current Evidence”.

Healing the Trauma of Domestic Violence: A Workbook for Women (New Harbinger Self-Help Workbook) by Edward S., Ph.D. Kubany, Mari A. McCaig, Janet R. Laconsay Read more about this title…

Coping Strategies of Female Victims of Child Abuse in Treatment for Substance Abuse Relapse: Their Advice to Other Women and Healthcare Professionals,

Abstract

This study was a part of a larger qualitative descriptive study designed to explore chronic sorrow as a relapse trigger among female victims of child abuse who were currently enrolled in substance abuse treatment for relapse.

The purpose of this study was to identify coping strategies and other factors these women perceived as helpful to their recovery. A purposive sample of twelve women participated in interviews using a semistructured interview schedule.

The advice the participants offered to women in similar situations reflected interpersonal, cognitive and action-focused positive coping strategies.

They encouraged clinicians in primary care facilities to approach persons suspected of substance abuse in a nonjudgmental manner. Healthcare professionals should be more assertive in recommending resources for substance abuse treatment.

Research; Cheryl Slaughter Smith. Coping Strategies of Female Victims of Child Abuse in Treatment for Substance Abuse Relapse: Their Advice to Other Women and Healthcare Professionals, Journal of Addictions Nursing, Volume 18, Issue 2 April 2007 , pages 75 – 80

Australian Broadcasting Commission, Online, AM, 11 January 2007, journalist Anne Barker

TONY EASTLEY: It’s proven that women who drink in pregnancy risk causing life-long health problems for their unborn children.

What isn’t so well known is that there’s growing evidence that foetal alcohol disorders, as they’re known, are a major cause of crime.

A Canadian lawyer is in Darwin this week talking to judges and barristers about the impact of foetal alcohol.

Anne Barker reports.

ANNE BARKER: It’s common knowledge that women who drink when they’re pregnant can cause permanent and serious brain damage to the unborn child.

But only now is a growing body of research revealing the scale of foetal alcohol disorders in the western world.

One man who has witnessed the consequences of alcohol induced delinquency over 20 years is Canadian barrister David Boulding.

DAVID BOULDING: Alcohol acts like nail polish remover on your nails. It dissolves brain cells. And when the brain cells are not there, the brain is missing brain function.

So you get kids who are impulsive, suggestive, no abstract thinking, memory problems, learning problems, attention problems.

ANNE BARKER: David Boulding believes one to two per cent of the population has some form of life-long disability caused even before they were born. And contrary to popular belief, he says they’re more likely to come from an affluent background.

DAVID BOULDING: Rich, white stockbrokers have wives who drink while they are pregnant.

The University of California just did a huge multi-year study and they found out that women that drink the most while they are pregnant are white, with four years of university education, earning 400 per cent above the poverty line.

ANNE BARKER: Wealthy or not, youngsters with foetal alcohol disorders, whether it’s learning problems or memory loss appear to account for a staggering proportion of delinquents.

In the only study of its kind in one Canadian province, one quarter of young offenders were found to have some form of permanent foetal alcohol syndrome.

David Boulding says there’s a clear connection to crime.

DAVID BOULDING: They really are missing that little voice. That superior, frontal lobe conscience part of the brain that knows right and wrong.

But also they are alone. They don’t have friends, they’ll do anything to please people. They will confess to murder, they’ll hold the gun, they’ll drive the get away car.

ANNE BARKER: David Boulding is in the Northern Territory this week as a guest of the Aboriginal justice agency NAAJA, which represents Indigenous offenders in court.

One NAAJA lawyer Stewart O’Connell says despite the clear impact of alcohol on crime in the NT, the prevalence of foetal alcohol syndrome is virtually unknown.

STEWART O’CONNELL: We are locking Aboriginal people up in jail at a greater rate than ever before. The sentences are getting longer, and it’s not working.

And we have to ask the question – why is it not working? And one of the reasons may be because of things such as foetal alcohol syndrome.

ANNE BARKER: And David Boulding says while nothing can ever reverse foetal alcohol disorders, a recognition of the problem would lead to more effective solutions than jail.

He says it’s already working in Canada.

DAVID BOULDING: Every probation officer, every judge, every lawyer has got stories where somebody took and interest in somebody and made sure, okay he’s not going to hang out with those guys any more, he’s not going to go there any more. I’m going to get him some kind of job maybe, even if it’s volunteer work, he’s going to have new friends.

And guess what? The crime stops.

TONY EASTLEY: Canadian barrister David Boulding talking to Anne Barker in Darwin.

Link to story: http://www.abc.net.au/cgi-bin/common/printfriendly.pl?http://www.abc.net.au/am/content/2007/s2136186.htm

A healthy dentist is one of the most important ingredients in a successful dental practice. An ingredient not to be taken for granted. Professionals, dentists included, can and do experience illnesses and problems that can disrupt or impair a practice.

In addition to the vulnerabilities of the human condition–addictive disorders, psychiatric illnesses, infectious disease, family and relationship problems, or the many varieties of human misery–dentists have undergone a powerful process of socialization into their professional role that makes it difficult to seek help for themselves.

Stigma about addictive and psychiatric illnesses continues to be a problem despite significant advances in scientific understanding of these disorders.

Many people, especially those in positions of community visibility as dentists are, still struggle with shame when they associate problems with personal failure.

Dental societies are in an ideal position to provide resources and support, should they choose to take this opportunity, and the ADA has the information and expertise to help them do this.

PRACTICE IMPLICATIONS: Dentists can become more aware of their own vulnerabilities and enhance their personal and professional effectiveness, as well as evaluate ways they may support their staff and colleagues.

Research; J Am Dent Assoc. 2004 Jan;135(1):84-9. Safeguarding the health of dental professionals. Lavine SR, Drumm JW, Keating LK.

See also;

• Brief-TSF can assist people cease alcohol consumption.
• Twelve-Step Programs as an Adjunct to Psychotherapy and Psychopharmacology
• Subscribe to Twelve Step Facilitation by e-Mail

Natural Health, Natural Medicine: The Complete Guide to Wellness and Self-Care for Optimum Health by Andrew Weil Read more about this title…

Alcoholism and addiction have several common threads with reciprocal recovery principles.

In their book, “Rethinking Substance Abuse,” editors William R. Miller and Kathleen M. Carroll to sum up what has been learned about the science of addiction. These are;

• Drug Use is Chosen Behavior in the Beginning – for experimenting, peer pressure or otherwise its chosen at first.
• Drug Problems Emerge Gradually – it takes time to become addicted.
• Once Well Established, Drug Problems Tend to Become Self-Perpetuating – once the brain alters it number of drug receptor cells drug craving demands more of the same.
• Motivation is Central to Prevention and Intervention – actively doing something toward change may be more important than the particular actions that are taken.
• Drug Use Responds to Reinforcement. If you crave and use the drug use is reinforced.
• Drug Problems Do Not Occur in Isolation, but as Part of behavior clusters such as mood disorders, school or work problems, legal problems, ill-health and family problems.
• There Are Identifiable and Modifiable Risk and Protective Factors for Problem Drug Use – inherited and learned behaviour.
• Drug Problems Occur within a Family Context – either dysfunctional family culture, genetics or parental drug use.
• Drug Problems Are Affected by a Larger Social Context – social isolation is both a promoter and consequence; while bonding with someone else or a Higher Power may reverse the problem.
• Relationship Matters in rehabilitation. That’s why Alcoholics Anonymous relies on a spiritual connection with another person or a Higher Power.

See also;

• ABC’s of Recovery
• Alcohol intervention may help.
• Alcoholic Insanity
• Alcoholic Recovery for Gay and Lesbian People
• Subscribe by e-Mail to Alcohol Self-help News

Rethinking Substance Abuse: What the Science Shows, and What We Should Do about It by William R. Miller and Kathleen M. Carroll Read more about this title…

Multiple psychiatric disorder risk for families with alcohol dependence

First-degree relatives of people dependent on alcohol are not only at increased risk of becoming addicted to alcohol and other drugs such as cocaine, but also of developing psychiatric disorders such as depression and panic disorder, study findings indicate.

Noting that alcohol dependence tends to aggregate within families, John Nurnberger (Indiana University School of Medicine, Indianapolis, USA) and colleagues analyzed data from the family collection of the Collaborative Study on the Genetics of Alcoholism to assess whether other psychiatric disorders may be also be more common in families with a history of alcoholism.

Data were available for 8296 relatives of people with alcohol dependence and 1654 individuals with no family history of alcoholism.

The rate of DSM-IV alcohol dependence was 28.8% for relatives of people with the condition, compared with 14.4% for controls.

Overall, relatives of alcoholics were twice as likely to become addicted to alcohol as people without a family history of alcohol dependence.

Relatives of alcohol-dependent individuals were also at an increased risk of becoming addicted to other drugs, including cocaine, marijuana, opiates, sedatives, and stimulants. The greatest risk was for cocaine dependence, with relatives of individuals with alcoholism more than three times as likely as those without a family history of alcoholism to become dependant on the drug.

Moreover, relatives of alcoholics had a higher risk of depression, panic disorder, post-traumatic stress disorder, and antisocial personality disorder than controls.

“The aggregation of antisocial personality disorder, drug dependence, anxiety disorders, and mood disorders, suggests common mechanisms for these disorders and alcohol dependence within some families,” Nurnberger et al write in the Archives of General Psychiatry.

This represents a “shared specific genetic vulnerability,” they say, which puts people at risk of a number of psychiatric disorders if they have a family history of alcohol dependence.

Research Source: Arch Gen Psychiatry 2004; 61: 1246-1256

Alcohol hospital admissions hide individual tragedies, say doctors (issued Tuesday 22 Jul 2008)

The new government figures released today (Tuesday 22 July 2008) revealing that 811,000 people in England were admitted to hospital with alcohol misuse problems in 2006 hide the individual tragedies that hospital frontline staff see day in day out, said the British Medical Association.

The BMA’s Head of Science and Ethics, Dr Vivienne Nathanson, added:

“While this figure is rightly very frightening and shocking, it also hides the hundreds and thousands of individual tragedies that doctors witness every day. Alcohol misuse is related to over 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems – it costs the NHS millions of pounds every year and is linked to accidents and street violence.

The truth is there is nothing glamorous about drinking too much alcohol – it wrecks health, lives and families.

“The BMA will be responding in full to the government’s consultation on alcohol and we will certainly be backing tough action like introducing mandatory regulation and labelling and restricting ‘happy hours’ and irresponsible drinks promotions . There can be no more softly, softly approach. The access and affordability of alcohol must be tackled head on.”

Full story at; British Medical Association, The professional association for doctors

See also;

• If you have healthcare training this manual may help.
• Science of Addiction
• Early or Adaptive Stage of Alcoholism
• Types of Dysfunctional Families

Understanding and Counseling Persons With Alcohol, Drug, and Behaviorial Addictions by Howard Clinebell Read more about this title…

On completion of BriefTSF, you will be able to use Brief-TSF as adjunctive therapy and;

Understand and use questionnaires for assessing alcohol use.

• Separate the differences between alcoholics and problem drinkers
• Guide alcoholics to self-assessment and acceptance of their condition
• Gauge suitability of alcoholics for Alcoholics Anonymous

Understand the barriers to alcoholics acceptance of their condition

• Understand alcoholism as an illness
• Help an alcoholic to work through denial, and self defeating thinking and emotions
• Understand the stages of change in recovery from alcoholism
• Understand the impaired thinking and behaviour of alcoholics
• Foster rational and spiritual responses to dangerous drinking reminders and situations
• Help the alcoholic understand the key remedies to craving and compulsive thinking.

Understand the self help methods of Alcoholics Anonymous, Alateen and Al-anon

• Be able to work with recovering members of self help groups such as AA, Al Anon and Alateen.
• Help and support prospective members in contacting an AA or Al-anon Peer Sponsor

Understand the ‘tools of recovery’ and practices of the AA program and culture.

• Support prospective and new members of AA in their quest for sobriety using AA meetings, slogans and AA members.
• Detect the barriers to ‘doing the program’ in AA
• Discuss remedies for dangerous actions and thinking with the alcoholic
• Promote relapse prevention and better responses to relapse
• Support an alcoholic in using the tools of relapse prevention
• Help alcoholics gain new motivation, hope and action after a relapse

Partners of Alcoholics

• Understand the thinking and actions of partners, children and parents of alcoholics
• Help with understanding of alcoholic family forces and the enabling of alcoholism
• recognise symptoms of child, youth and adult abuse within alcoholic families
• Recognize impaired and healthy caring actions of significant others
• Guide partners of alcoholics to self assessment and acceptance of their condition
• Judge suitability of partners and children of alcoholics for self help groups such as Al-anon or Alateen

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