PubMed · 10715857
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C Johnstone. 1999. Effective brief interventions in problem drinking.. https://pubmed.ncbi.nlm.nih.gov/10715857/
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This study investigated the effect of chronic benzodiazepine (BZD) administration and its abrupt discontinuation on later subsequent ethanol consumption employing a free choice paradigm between water and increasing ethanol concentrations. In addition, we also studied the anxiolytic and reinforcing properties of ethanol assessed in the elevated plus maze (EPM) and in the conditioned place preference paradigm, respectively. Adult male Wistar rats were subjected to a chronic diazepam (DZM) treatment (2 mg/kg/day, i.p.) during 21 days. Twenty-four hours after that treatment and, in another experiment, 10 days after the last DZM injection, rats were subjected to an oral ethanol self-administration procedure (ethanol was increased in concentration (v/v) on 4 consecutive days as follows: 2%, 4%, 6%, 8% followed by an additional period of 8 days in which animals were offered a 10% (v/v) ethanol solution. Diazepam treated rats showed a higher ethanol intake and spontaneous signs of ethanol withdrawal when the access to ethanol was discontinued. These results were observed when ethanol was available at day 1 of withdrawal but not when DZM treated rats were initiated in the ethanol choice test 10 days after BDZ withdrawal. Furthermore, DZM treated rats exhibited an increased anxiolytic ethanol induced effect (1 g/kg, i.p.) in the EPM and a significant ethanol-induced conditioned place preference (1 g/kg, i.p.). These data suggest that early DZM treatment facilitates ethanol consumption and the development of ethanol dependence.
BACKGROUND: Fetal alcohol exposure in humans can cause a variety of brain and behavioral abnormalities. The brain abnormalities include defects in the corpus callosum that range from total absence (agenesis) to reduction in size or thickness. Determination of the critical alcohol level or time period of exposure to produce these effects is difficult because of the lack of control of possible mitigating factors. METHODS: The present study was undertaken to examine possible relationships between midsagittal corpus callosum dimensions and prenatal alcohol level as measured by blood alcohol concentration, as well as prenatal period of exposure as measured by first- or second- or first- plus second-trimester equivalents in a rat model. In addition to the corpus callosum, the hippocampal and anterior commissures were also examined. Pregnant mothers were given a single daily dose of alcohol by intragastric gavage; four different doses were tested in different mothers. Peak blood alcohol concentration was determined at one of four hourly intervals thereafter. Control pregnant mothers were pairfed to individual alcohol treated mothers and handled accordingly, but no alcohol was given. Other controls consisted of normal, untreated pregnant mothers. RESULTS: The results show all measures of corpus callosum and anterior commissure were not affected by any dose of alcohol during any time period. However, higher BAC levels during prolonged periods of alcohol exposure were associated with reduced size of the hippocampal commissure. CONCLUSIONS: The results suggest that additional experimental factors not included in the present study are responsible for the effects observed in humans.
Concerns about the quality of medical care provided by health services appear to be increasing. Deficits in care are frequently found to be associated with stress and with the apparent lack of recognition of psychological problems when they occur in doctors. This paper looks briefly at the levels and sources of stress, depression and alcoholism in doctors, and the relationship of these to the care they provide. It goes on to use the research findings on causation to propose a system of organisational and individual primary and secondary interventions to address these psychological problems. The paper focusses upon a longitudinal study which follows up 314 medical students over 11 years, but also uses other relevant recent literature to discuss the issues that arise.