Injury Risk Highest Among Binge Drinkers

Binge drinkers have a higher risk of alcohol-related injury than chronic, heavy drinkers, the Health Behavior News Service reported Feb. 22.

Binge-drinking women who otherwise drink in moderation had seven times the risk of injury as nondrinkers, while binge-drinking men increased their injury risk sixfold.

"It’s not only the amount of alcohol consumed that shapes the risk for injury, but also the usual consumption pattern," said study author Gerhard Gmel of the Swiss Institute for the Prevention of Alcohol and Drug Problems. "At highest risk are those who usually consume moderately but sometimes binge drink. This is true for both sexes."

The study was based on records from 8,736 people admitted to hospital emergency departments; researchers examined the relationship of injuries to average weekly alcohol consumption, binge-drinking episodes, and the amount of alcohol consumed prior to admission.

Gmel warned against prevention that focuses only on chronic drinkers, saying that many binge drinkers will be missed.

The research appears in the March 2006 issue of the journal Alcoholism: Clinical and Experimental Research.

From; Join Together Online

Increase in Nicotine Receptors Makes Quitting Harder

Smokers have more nicotine receptors in their brains than nonsmokers, making it more difficult for them to quit, according to researchers at Yale University.

Researchers used brain-scanning technology to compare the nicotine receptors of 16 smokers who had abstained for four days with scans from a group of 16 nonsmokers. They found that the density of common nicotine receptors was higher among smokers during early abstinence, contributing to withdrawal symptoms.

"Nicotine craving is an important factor associated with relapse," said lead author Julie Staley. "This study paves the way for determining whether medications normalize the number of receptors and why some smokers, such as women and those with neuropsychiatric disorders, have more difficulty quitting smoking."

Research report: Staley, J. K., et al. (2006) Human Tobacco Smokers in Early Abstinence Have Higher Levels of Nicotinic Acetylcholine Receptors than Nonsmokers. J. Neurosci., 26: 8707-8714.

From; Join Together Online

Drug commonly used for alcoholism craving curbs urges of pathological gamblers

A drug commonly used to treat alcohol addiction has a similar effect on pathological gamblers – it curbs the urge to gamble and participate in gambling-related behavior, according to a new research at the University of Minnesota.

Seventy-seven people participated in the double-blind, placebo controlled study. Fifty-eight men and women took 50, 100, or 150 milligrams of naltrexone every day for 18 weeks.

• Forty percent of the 49 participants who took the drug and completed the study, quit gambling for at least one month.
• Their urge to gamble also significantly dropped in intensity and frequency.

The other 19 participants took a placebo. But, only 10.5 percent of those who took the placebo were able to abstain from gambling.

Study participants were aged 18 to 75 and reported gambling for 6 to 32 hours each week.

Dosage did not have an impact on the results, naltrexone was generally well tolerated, and men and women reported similar results.

“This is good news for people who have a gambling problem,” said Jon Grant, M.D., J.D., M.P.H., a University of Minnesota associate professor of psychiatry and principal investigator of the study. “This is the first time people have a proven medication that can help them get their behavior under control.”

The research is published in the June 2008 issue of the Journal of Clinical Psychiatry.

Compulsive gamblers are unable to control their behavior, and the habit often becomes a detriment in their lives, Grant said. He estimates between 1 to 3 percent of the population has a gambling problem.

While the drug is not a cure for gambling, Grant said it offers hope to many who are suffering from addiction. He also said the drug would most likely work best in combination with individual therapy.

“Medication can be helpful, but people with gambling addiction often have multiple other issues that should be addressed through therapy,” he said.

See also;

• Effects of Gambling Addiction
• Gamblers Anonymous
• How can I overcome my addiction to gambling?
• Subscribe to Twelve Step Facilitation by e-Mail

Counselling for Problem Gambling (Living Therapy) by Richard Bryant-Jeffries Read more about this title…

Motivational Enhancement Therapy (MET) is a systematic intervention approach for evoking change in problem drinkers.

It is based on principles of motivational psychology and is designed to produce rapid, internally motivated change. This treatment employs motivational strategies to mobilize the client’s own change resources.

MET consists of four carefully planned and individualized treatment sessions.

The first two focus on structured feedback from the initial assessment, future plans, and motivation for change,

The final two sessions at the midpoint and end of treatment provide opportunities for the therapist to reinforce progress, encourage reassessment, and provide an objective perspective on the process of change.

The counselor seeks to develop a discrepancy in the client’s perceptions between current behavior and significant personal goal; emphasis is placed on eliciting from clients self-motivational statements of desire for and commitment to change.

The working assumption is that intrinsic motivation is a necessary and often sufficient factor in instigating change.

See also;

• Address the drinking problem directly
• Alcohol & Medication Interactions
• Alcoholic Family Roles
• Brief-TSF is designed to as adjunctive therapy for anti-craving medication.

Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment by Marc A. Schuckit Read more about this title…

Alcohol factors in suicide mortality rates in Manitoba, Canada.

OBJECTIVE: To identify alcohol-related factors that influence mortality rates from suicide.

METHOD: We examined the impact of per capita consumption of total alcohol, spirits, beer, and wine; unemployment rate; and Alcoholics Anonymous (AA) membership rate on total, male and female suicide mortality rates in Manitoba during 1976 to 1997. Time series analyses with autoregressive integrated moving average modelling were applied to total, male and female suicide rates. The analyses performed included total alcohol consumption, spirits consumption, beer consumption, and wine consumption. Missing AA membership data were interpolated with cubic splines.

RESULTS:

• Total alcohol consumption, and consumption of beer, spirits, and wine individually, were significantly and positively related to female suicide mortality rates.
• Spirits and wine were positively related to total and male mortality rates.
• AA membership rates were negatively related to total and female suicide rates.
• Unemployment rates were positively related to male and total suicide rates.

CONCLUSIONS:

The data confirm the important relations between per capita consumption measures and suicide mortality rates.

Additionally, the results for AA membership rates are consistent with the hypothesis that AA membership can exert beneficial effects observable at the population level.

Mann RE, Zalcman RF, Rush BR, Smart RG, Rhodes AE. Can J Psychiatry. 2008 Apr;53(4):243-51. Alcohol factors in suicide mortality rates in Manitoba.

see also;

• 12-Step Treatment More Effective than Alternative
• AA Offers Recovery Not Religion
• Brief-TSF can assist patients cease alcohol consumption.
• Subscribe to Twelve Step Facilitation by e-Mail

Understanding and Counselling the Alcoholic by Howard J. Clinebell Amazon books; Read more about this title…

Concept of Alcoholism

In TSF and Brief-TSF alcoholism is considered an illness that affects individuals both mentally and physically in such a way that they are unable to control their use of alcohol. Viewed from this perspective, the concept of controlled use of alcohol amounts to denial of the primary problem, that is, loss of control. Specific causative factors (ie, stress) are of less relevance in recovery than is acceptance of both the loss of control and the need for abstinence and a willingness to follow the pathway laid out in the 12-steps.

Alcoholics and Loss of control of drinking

Alcoholics and addicts can attest to their countless attempts to stop or cut back on their drinking or drugging. They learn but cannot really accept that they have no power over alcohol or drugs.

The following research of the 1970’s began to explore this phenomenon and in the process confirming a basic tenet of Alcoholics Anonymous.

We alcoholics are men and women who have lost the ability to control our drinking. We know that no real alcoholic ever recovers control. All of us felt at times that we were regaining control, but such intervals - usually brief - were inevitably followed by still less control, which led in time to pitiful and incomprehensible demoralization. We are convinced to a man that alcoholics of our type are in the grip of a progressive illness. Over any considerable period we get worse, never better. Alcoholics Anonymous, pp 30.

Abstract of research report; This study evaluates the ability of alcoholics to regulate their blood alcohol levels (BAL) within a designated range by relying primarily on interoceptive (internal) cues. Forty male alcoholics and 20 control subjects were exposed to an initial training session in which they received sufficient ethanol to maintain them within a designated BAL range over a 2 1/2-hour period.

They were then exposed to two experimental sessions, one providing "overfeedback" and one "underfeedback." During each session, subjects had ten drinking decisions to make with respect to regulation of their BAL.

The results indicated that alcoholics displayed greater "loss-of-control" than control subjects.

This finding supported the hypothesis that alcoholics may possess a neurophysiologic feedback dysfunction that contributes to their relative inability to regulate ethanol intake.

A. M. Ludwig, F. Bendfeldt, A. Wikler and R. B. Cain. Loss of control in alcoholics. Archives of General Psychiatry. Vol. 35 No. 3, March 1978.

Understanding Stress: Characteristics and Caveats

By Hymie Anisman, Ph.D. and Zul Merali, Ph.D.

Exposure to stressful situations is among the most common human experiences. These types of situations can range from unexpected calamities to routine daily annoyances.

In response to stressors, a series of behavioral, neurochemical, and immunological changes occur that ought to serve in an adaptive capacity. However, if those systems become overly taxed, the organism may become vulnerable to pathology. Likewise, the biological changes, if sufficiently sustained, may themselves adversely affect the organism’s well-being.

Several factors may dictate an individual’s response to environmental stressors, including

• characteristics of the stressor (i.e., type of stressor and its controllability, predictability, and chronicity);
• biological factors (i.e., age, gender, and genetics); and
• the subject’s previous stressor history and early life experiences.

Research on the physiological and psychological responses to different types of stressful stimuli is presented, focusing particularly on processes that may be relevant to the development of alcohol use disorders.

Stressful events may profoundly influence the use of alcohol or other drugs (AODs). For example, the resumption of AOD use after a lengthy period of abstinence may reflect a person’s attempt to self-medicate to attenuate the adverse psychological consequences of stressors (e.g., anxiety).

Alternatively, stress may increase the reinforcing effects of AODs.

Alcohol Research & Health. Vol. 23, No. 4, 1999

Models of Craving and Implications for Treatment

By Raymond F. Anton, M.D.

Although many alcoholics experience craving, researchers have not yet developed a common, valid definition of the phenomenon. Numerous models of the mechanisms underlying craving have been suggested, however. One of those models-the neuroadaptive model-suggests that the prolonged presence of alcohol induces changes in brain-cell function. In the absence of alcohol, those changes cause an imbalance in brain activity that results in craving. Furthermore, the adaptive changes generate memories of alcohol’s pleasant effects that can be activated when alcohol-related environmental stimuli are encountered, even after prolonged abstinence, thereby leading to relapse.

Similarly, stressful situations may trigger memories of the relief afforded by alcohol, which could also lead to relapse. Neurobiological and brain-imaging studies have identified numerous brain chemicals and brain regions that may be involved in craving. Psychiatric conditions that affect some of these brain regions, such as depression or anxiety, also may influence craving. A better understanding and more reliable assessment of craving may help clinicians tailor treatment to the specific needs of each patient, thereby reducing the risk of relapse.

Alcohol Research & Health Vol. 23, No. 3, 1999

Drinking and Biting

It’s a problem Mike Tyson knows well: fights that escalate into men biting other men. And researchers say that most human-bite cases involve males who have been drinking, the CanWest News Service reported June 20.

Irish researchers say that 86 percent of human-bite cases involve alcohol, and that men are bitten 12 times more often than women. Most bites occur on the face — particularly the ears, nose and cheek — as well as the fingers and forearm. Sixty-five percent of all bites involve the ear.

"I think a lot of people wouldn’t know this happens, or to the extent that it happens," said study co-author Patricia Eadie, a plastic surgeon at St. James’s Hospital in Dublin. "There’s a lot of person-on-person violence that can be due to alcohol and drugs." Many such incidents go unreported because victims don’t seek medical attention, she added.

The study was published in the July 2007 issue of the Emergency Medicine Journal.

Research Reference: Henry, F.P., Purcell, E.M., Eadie, P.A. (2007) The human bite injury: a clinical audit and discussion regarding the management of this alcohol fuelled phenomenon. Emergency Medicine Journal, 24: 455-458.