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The impact of a family empowerment intervention on juvenile offender heavy drinking: a latent growth model analysis.

We report the results of a growth model analysis of the impact of a Family Empowerment Intervention (FEI) on the heavy drinking over a 36-month follow-up period among youths processed at the Hillsborough County Juvenile Assessment Center. Families involved in the project were randomly assigned to either receive an Extended Services Intervention (ESI) or the FEI. Families in the ESI group received monthly phone contacts and, if indicated, referral information; FEI families received three one-hour, home-based meetings per week for approximately 10 weeks from a clinician-trained paraprofessional. By seeking to improve family functioning by empowering parents, it was hypothesized that target youths' behavior and psychosocial functioning would improve. Although the difference between FEI and ESI was not significant, the reported frequency of getting very high or drunk on alcohol declined more over time for FEI completers than FEI noncompleters. The results provide support for the impact of the FEI services.

Adolescent↗

Heavy drinking decreases plasma met-enkephalin concentrations.

Plasma met-enkephalin immunoreactive material (ME-IR) concentration was measured in 175 aged subjects (68 males, 107 females). Heavy drinking (1 liter of red or white wine a day, equivalent roughly to greater than 110 g ethanol) was associated with reduced ME-IR concentrations. On the other hand, no correlation was found between plasma ME-IR and other parameters such as blood pressure, age or body weight. These data favor the hypothesis of an involvement of ME-IR in the mechanisms of ethanol action.

Aged↗

Association of moderate consumption of alcohol with rates of heavy drinking and abstinence in Spain.

BACKGROUND: Moderate consumption of alcohol reduces general mortality among middle-aged and elderly persons through a reduction in cardiovascular risk. Furthermore, higher consumption of wine is associated with lower cardiovascular mortality in northern Spain. This information may be used to promote moderate consumption of alcoholic beverages in Spain. However, alcohol consumption is influenced by the drinking habits of the individual's social environment. Therefore, we examine the relation between average consumption of alcohol and the prevalence of heavy drinkers, who most often have adverse effects from alcohol, and the prevalence of abstainers, who do not benefit from alcohol, in Spain. METHODS: Spain's 17 administrative regions are the units of analysis. Alcohol consumption data were taken from the 1993 National Health Survey. Data were analyzed using weighted correlation coefficients and linear regression. RESULTS AND CONCLUSIONS: Mean alcohol consumption among moderate drinkers showed a positive correlation with the proportions of men (r = 0.63; p = 0.007) and women (r = 0.58; p = 0.015) whose alcohol intake was above the 90th percentile of consumption distribution. Similar results were yielded when median rather than mean consumption was used, and when heavy drinking was defined as the consumption of 210 g and 140 g of alcohol per week, in men and women, respectively. The association also was observed across all ages and all types of beverages. However, no statistically significant association was seen between mean and median alcohol consumption and the proportion of abstainers. SIGNIFICANCE: Moderate consumption of alcohol is associated with the prevalence of heavy drinkers in all regions of Spain. Therefore, promotion of moderate consumption of alcohol in Spain might be associated with a rise in the prevalence of heavy drinkers, those who most frequently suffer the harmful effects of alcohol.

Adult↗

Increased blood acetate: a new laboratory marker of alcoholism and heavy drinking.

Blood acetate concentration of 51 intoxicated patients was measured and compared to conventional laboratory markers of chronic alcoholism. Mean blood acetate concentration of 23 chronic alcoholics and 17 heavy drinkers was significantly (p less than 0.0005) higher than that of 53 nonalcoholic volunteers or 11 occasional drinkers. Blood acetate level was completely independent of blood ethanol concentration ranging from 0.20 to 2.90 promille. Blood acetate was elevated in 65% of both chronic alcoholics and heavy drinkers. Gammaglutamyltransferase was abnormal only in 35%, aspartate aminotransferase in 21% and mean corpuscular volume in 12% of heavy drinkers. Combination (acetate + gammaglutamyltransferase) correctly detected 87% of alcoholics and 71% of heavy drinkers. During ethanol oxidation the upper normal limit of blood acetate is 0.75 mM. The specificity of increased blood acetate is as high as 92%. Increased blood acetate is indicative for metabolic tolerance to alcohol and it may be so far the most sensitive and specific laboratory marker of chronic alcoholism and heavy drinking.

Acetates↗

College students' early cessation from episodic heavy drinking: prevalence and correlates.

The author surveyed 788 undergraduates at a large public university (overall response rate 54%) to (1) estimate the proportion of college students who cease engaging in a pattern of episodic heavy drinking (EHD) and (2) identify individual and contextual factors associated with early cessation. He used a staging algorithm to classify respondents into 4 stages of EHD cessation. Of the 60% who had engaged in EHD, 64% continued to drink heavily with no intention of stopping, 12% continued to drink heavily but were thinking about stopping, 14% had ceased temporarily, and 9% had ceased permanently. Students who had stopped EHD perceived more risks and fewer benefits associated with alcohol misuse, but they did not differ in their perceptions of normative alcohol use on campus. Many collegiate heavy drinkers cease EHD before graduation, and others may be predisposed to moderate their alcohol use. Tailored interventions that alter alcohol expectancies may facilitate early cessation from EHD.

Adolescent↗

The development of heavy drinking and alcohol-related problems from ages 18 to 37 in a U.S. national sample.

OBJECTIVE: The purpose of this study is to add to the understanding of the development of heavy alcohol use and alcohol-related problems by examining data from the National Longitudinal Survey of Youth (NLSY), a general population sample that contains information on alcohol use for the ages 18-37. A key question in this study is how background characteristics of the individual influence this development and whether the influence of these background characteristics changes over time. METHOD: The data used in this study are a general population sample (N = 7,859) from the National Longitudinal Survey of Youth (NLSY). This study uses a multivariate outcome approach that focuses on individual variation in trajectories over age. The statistical analysis uses random coefficients in a latent variable framework. Across-age changes in the importance of the influence of background variables on the outcomes are modeled using varying centering points. RESULTS: A key finding is that dropping out of high school has no effect on alcohol-related problems for individuals in their mid-twenties, but is associated with significantly increased levels of alcohol-related problems for individuals in their mid-thirties. In contrast, going on to college is associated with lower levels of heavy drinking when individuals reach their late twenties and their thirties. Strong gender and ethnicity effects seen in the twenties diminish when individuals reach their thirties. CONCLUSIONS: The trajectory analysis expands the knowledge of problematic alcohol development for individuals in their late twenties and thirties. The increasing detrimental effect of dropping out of high school up to the age 37 endpoint of the study raises questions about the effects in later life of dropping out of high school.

Achievement↗

[Disappearance of Mallory bodies in the liver of autopsy cases with a history of heavy drinking].

Mallory bodies, the intra-cytoplasmic inclusions in hepatocytes, are thought to be a pathognomonic feature of alcoholic liver disease, particularly of alcoholic hepatitis. The presence of Mallory bodies is considered as a reflection of serious illness in alcoholic liver disease. Mallory bodies are thought to disappear relatively rapidly with the use of therapeutic agents after giving up alcohol drinking. However, histological vicissitudes of Mallory bodies have not been studied extensively. In the present study, 19 autopsied cases with a history of heavy drinking were clinicopathologically evaluated. All patients were admitted to our hospital, and stopped alcohol drinking. These period of non-drinking ranged from one day to 150 days (group A: 1-7 days, group B: 8-30 days, group C: 31-150 days). Histological evaluation was performed by hematoxylin and eosin staining, Luxol Fast blue staining and chromotrope aniline blue staining of formalin-fixed paraffin-embedded liver sections. Hepatocytes including Mallory bodies were counted. The incidence of Mallory body formation was as follows: Group A (50%), group B (100%), and group C (100%) respectively. Average count of Mallory bodies: Group A (12.3/10 fields), group B (141.4/10 fields), and group C (188.3/10 fields). Fatty change was more significant in group A than in group B or C, and bile stasis was more significant in group B or C than in group A. These findings suggest that Mallory bodies may remain for several months after giving up drinking.

Adult↗

Heavy drinking, alcohol-dependent vs. nondependent methadone-maintenance clients: a follow-up study.

This study of methadone-maintenance clients interviewed approximately 1 year after discharge from treatment revealed that outcomes differed between heavy-drinking clients who are alcohol dependent and those who are not. Alcohol-dependent clients seem to benefit more from treatment but continue to have severe cocaine-use problems, suggesting they also may be cocaine dependent. The results emphasized the value in differentiating between these types of drinking clients, and they suggest that failure to do so may account for earlier contradictory results about the role alcohol consumption has in treatment outcomes for methadone-maintenance clients.

Adolescent↗

Heavy drinking among Norwegian male drunken drivers: a study of gamma-glutamyltransferase.

The distributions of blood alcohol concentrations (BACs) of different age groups of drunken drivers suggested that a large number of the drunken drivers above 29 years of age had high tolerance to alcohol, and many of these might be heavy drinkers. In order to study the extent of heavy drinking, gamma-glutamyltransferase (GGT) activities were measured in 269 blood samples from male drunken drivers using a new method suitable for hemolyzed blood samples. Of the drunken drivers above 29 years of age, 40% had elevated GGT activities, indicating that roughly one-third of these drivers might be heavy drinkers (consuming more than 80 g of alcohol/day). Of the drunken drivers above 29 years of age with BACs above 55 mmol/liter (250 mg/100 ml), 63% had elevated GGT, indicating that a large majority of these drivers were heavy drinkers. Fewer of the younger drivers had elevated GGT activities. The GGT activities of the repeating offenders indicated that the percentage of heavy drinkers in this group was approximately the same as in the total population of apprehended drunken drivers.

Adult↗

Acute pancreatic injury in asymptomatic individuals after heavy drinking over the long-term.

Recently, high-dose short-term alcohol exposure has been observed not to induce acute pancreatic damage, as evaluated by serum pancreatic enzyme activities. In this study the effect of high-dose, long-term alcohol exposure on the pancreas was investigated in 32 consecutive alcoholics admitted to a unit to treat the problems of withdrawal after a long period of heavy drinking. None of the alcoholics complained of abdominal symptoms. The signs of clinical acute pancreatitis (pain, increased serum C-reactive protein concentration or blood white cell count) were not observed in any of the alcoholics. A significant increase in serum total amylase, pancreatic isoamylase and lipase activities developed by the second day after termination of alcohol intake. These enzyme activities remained significantly increased for one week after cessation of drinking. Seven alcoholics had signs of chronic pancreatitis at ultrasonography (pancreatic calcification, pseudocyst). These results suggest that heavy alcohol intake over the long term may frequently induce subclinical pancreatic injury.

Acute Disease↗

The effect of past-year heavy drinking on alcohol-related aggression.

OBJECTIVE: The primary goal of this study was to determine the moderating effect of a history of heavy episodic drinking on the alcohol-aggression relation in men and women. METHOD: Participants were 310 (152 men and 158 women) healthy social drinkers between 21 and 35 years of age. Drinking history was operationalized as participants' average number of alcoholic drinks consumed per drinking occasion during the past year. Following the consumption of either an alcohol or a placebo beverage, participants were tested on a modified version of the Taylor Aggression Paradigm in which mild electric shocks were received from, and administered to, a fictitious opponent during a competitive task. Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent under conditions of low and high provocation. RESULTS: Alcohol increased aggression only among highly provoked men who reported a history of heavy episodic drinking. A history of high-frequency drinking did not moderate the alcohol-aggression relation. CONCLUSIONS: These findings highlight the importance of considering a history of heavy episodic drinking in the prediction of intoxicated aggression.

Adult↗

Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24-60 months of long-term study with randomized controls.

In a continuing screening and intervention programme in Malmó, elevated serum-gamma-glutamyltransferase (GGT) values were used for selection of heavy drinkers. The study population consisted of 585 individuals born 1926-1933 with two consecutive GGT values in the upper decile of the GGT distribution, randomly allocated either to an intervention group of to a control group. The subjects in the intervention group were further investigated and 75% of them were judged to have elevated GGT values caused by alcohol consumption. These individuals were repeatedly encouraged to lower their overall alcohol consumption and GGT measurements were used as biofeedback method in the treatment program. The controls were informed by letter to be restrictive with their alcohol consumption and that they should receive new invitations for measurements of their liver enzymes after 2, 4, and 6 years. The intervention and control groups were well matched and followed over a 2-6-year period. Two and 4 years after the screening investigation, the GGT values in both groups were significantly decreased. There were differences, however, between the two groups with regard to sick absenteeism, hospitalization, and mortality. A significant reduction was found in sick absence during 4 years by 80%, in hospital days during 5 years by 60%, and in mortality during 6 years by 50% in the intervention group compared with the control group. Thus, the intervention program was effective in preventing medico-social consequences of heavy drinking.

Absenteeism↗

Development of a chinese version of the Yale-Brown obsessive compulsive scale for heavy drinking.

BACKGROUND: Measurement of craving is an important component in the investigation of the etiology and clinical pictures of alcoholism and dependence of other substances in different cultures. The aim of this study was to develop a Chinese version of the Yale-Brown Obsessive Compulsive Scale for heavy drinking (YBOCS-hd-C), the instrument most frequently used in assessing the severity of alcohol craving in Taiwan. METHODS: Four hundred twenty Han Chinese (220 with alcohol use disorders) and 218 Bunun aborigines (150 with alcohol use disorders) in Taiwan were interviewed by mental health professionals with the YBOCS-hd-C and a Chinese version of the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry to establish the psychiatric diagnosis. Validity and reliability of the YBOCS-hd-C were examined. RESULTS: The YBOCS-hd-C was found to have acceptable interrater reliability (intraclass correlation, 0.89-0.96), internal consistency (Cronbach's alpha = 0.99), construct validity, concurrent validity, and cross-cultural validity. The correlations between 10 items of the YBOCS-hd-C and 11 items of the World Health Organization Schedules for Clinical Assessment in Neuropsychiatry adjusted for age, gender, and ethnicity ranged from 0.39 to 1.00. The YBOCS-hd-C also discriminated effectively among individuals with alcohol dependence, alcohol abusers, and normal drinkers. CONCLUSIONS: This study demonstrated that the YBOCS-hd-C is a reliable and valid instrument for assessing the extent of craving for alcohol in Taiwanese Han and Bunun individuals.

Adult↗

A comparison of the Yale-Brown Obsessive Compulsive Scale for "heavy drinking" with a single item craving measure: construct validity and clinical utility.

The measurement of alcohol "craving" began with single-item scales. Multifactorial scales developed with the intention to capture more fully the phenomenon of craving. This study examines the construct validity of a multifactorial scale, the Yale-Brown Obsessive Compulsive Scale for heavy drinking (Y-BOCS-hd). The study compares its clinical utility with a single item visual-analogue craving scale. The study includes 212 alcohol dependent subjects (127 males, 75 females) undertaking an outpatient treatment program between 1999-2001. Subjects completed the Y-BOCS-hd and a single item visual-analogue scale, in addition to alcohol consumption and dependence severity measures. The Y-BOCS-hd had strong construct validity. Both the visual-analogue alcohol craving scale and Y-BOCS-hd were weakly associated with pretreatment dependence severity. There was a significant association between pretreatment alcohol consumption and the visual-analogue craving scale. Neither craving measure was able to predict total program abstinence or days abstinent. The relationship between obsessive-compulsive behavior in alcohol dependence and craving remains unclear.

Adult↗

Perceptions of another person's heavy drinking as a function of one's relationship to the drinker a pilot study.

Of 301 participants in a telephone survey, 201 could identify a problem drinker within their social networks. In 67 cases the drinker was a partner, in 45 another family member, in 61 a friend, and in 28 a work colleague. Another person's heavy drinking was reported as most disrupting to one's life when that person was a partner or other family member or if one was living in the same residence as the drinker. The exception to this was that reported disruption to respondents' work life was greatest when the drinker was a work colleague. While there appear to be problems for friends and work colleagues, partners and other family members appear to report the most disruption so providing services to family members seems appropriate.

Adult↗

Alcohol use and abuse: heavy drinking among methadone clients.

This paper discusses alcohol use among methadone maintenance clients and narcotics users not in treatment. The data are derived from the Tri-State Ethnographic Project, a study of four methadone maintenance clinics in three states. Data indicate that methadone clients consume more alcohol than comparable age groups in the general population, but not more alcohol than narcotics users not in treatment. For a portion of the treatment population, however, heavy drinking presents significant problems. Sixteen percent of the treatment sample were found to be abusive pattern drinkers; that is, persons who report not only drinking heavily but also spending a great deal of time hanging out on the street, getting high, and consuming many other additional drugs. These abusive pattern drinkers reflect a pattern of polydrug use which began in their early teens and report multiple unsuccessful treatment attempts.

Adult↗

A genetic linkage study of the D2 dopamine receptor locus in heavy drinking and alcoholism.

BACKGROUND: Reports of an association between restriction fragment length polymorphisms (RFLPs) at the dopamine D2 receptor (DRD2) locus and alcoholism have suggested involvement of that locus in the aetiology of alcoholism. METHOD: Sib pair linkage analyses were conducted in families multiply affected by alcoholism, using both the Taql 'A' RFLP and a microsatellite repeat polymorphism at the DRD2 locus. RESULTS: The 'Identical By Descent' analysis provided significant evidence of an effect of the DRD2 locus on the liability to develop heavy drinking (P < 0.0016) and Research Diagnostic Criteria alcoholism (P < 0.0003) in the first sample of families studied. However, this result was explicable by the segregation of alleles in a single large sibship, and it was not replicated in a second sample of families. CONCLUSIONS: The results do not support linkage between the DRD2 locus and alcoholism in most of the families studied. It remains possible that this locus influences the predisposition to alcoholism in some families.

Alcoholism↗

Therapy of heavy drinking during pregnancy.

A survey of patients registering at the Boston City Hospital Prenatal Clinic had demonstrated that 9 percent were heavy drinkers. To reduce the health hazards to mothers and children, treatment of heavy alcohol use was integrated with prenatal care. A pediatric neurologist independently examined 322 offspring, including 42 whose mothers were heavy drinkers. Frequency of congenital anomalies, growth retardation, or functional abnormalities among these 42 was twice that of infants born to abstinent or moderate drinking mothers P less than .001). Within that group of 42, there were 15 whose mothers were able to abstain or reduce alcohol intake during the third trimester. These 15 demonstrated fewer abnormalities than those 27 whose mothers had continued heavy drinking (P less than .001). Since pregnant women can be motivated to reduce heavy drinking, treatment programs can benefit both mothers and infants.

Abnormalities, Drug-Induced↗