Category: Alcoholism

A Cardiff University study has established a link between pub violence and happy hour-style drinking promotions. The findings also show that pub staff themselves need to do more to stop heavily intoxicated customers from continuing to drink.

The team studied pubs and nightclubs with a history of violence across five different cities and towns in the UK. Customers entering and leaving the premises were breathalysed. The team also recorded data about the price of beer and any drink promotions at each establishment. Their findings were then linked to police and hospital data about assaults inside or immediately outside the premises.

The team found that premises with the highest levels of violence were most likely to have:

• The greatest change in customers' intoxication levels between entry and exit
• Price promotions on drinks

The team also found that simple observation of customers staggering or slurring their speech was a very accurate predicator of the levels of intoxication recorded by the breathalysers.

Dr Simon Moore, of Cardiff University's award-winning Violence and Society Research Group, who led the study, said: "Our findings clearly show that alcohol misuse and violence are not simply caused by drinkers' weaknesses. The way premises are run also contributes, suggesting the industry still has more to do in playing its part.

"The legislation requiring bar staff not to serve those who are already drunk should be properly enforced. Our study shows these customers are not difficult to spot — time should be called on those who can no longer walk in a straight line or who slur their speech.

"Measures to restrict promotions and enforce sensible drinking would make night-time city centres healthier and more enjoyable spaces for everyone who uses them."

The team's findings have just been published in the journal Alcohol and Alcoholism and the Project was funded by the Medical Research Council. ENDS

---

Journal Reference:

1. S. C. Moore, I. Brennan, S. Murphy. Predicting and Measuring Premises-Level Harm in the Night-Time Economy. Alcohol and Alcoholism, 2011; DOI: 10.1093/alcalc/agr011

 Experts agree that long-term alcohol abuse is detrimental to memory function and can cause neuro-degenerative disease. However, according to a study published in Age and Ageing by Oxford University Press, there is evidence that light-to-moderate alcohol consumption may decrease the risk of cognitive decline or dementia.

Estimates from various studies have suggested the prevalence of alcohol-related dementia to be about 10% of all cases of dementia. Now researchers have found after analyzing 23 longitudinal studies of subjects aged 65 years and older that the impact of small amounts of alcohol was associated with lower incidence rates of overall dementia and Alzheimer dementia, but not of vascular dementia and cognitive decline. It is still an open question whether different alcoholic beverages, such as beer, wine, and spirits, all have a similar effect. Some studies have shown a positive effect of wine only, which may be due either to the level of ethanol, the complex mixture that comprises wine, or to the healthier life-style ascribed to wine drinkers.

A total of 3,327 patients were interviewed in their homes by trained investigators (physicians, psychologists, gerontologists) and reassessed one and a half years and three years later. Information on the cognitive status of those who had died in the interim was collected from family members, caregivers or primary care physicians.

Among the 3,327 patients interviewed at baseline, 84.8% (n=2,820) could be personally interviewed one and a half years later and 73.9% (n=2,460) three years later. For the vast majority of subjects who could not be personally interviewed, systematic assessments (follow-up 1: 482; follow-up 2: 336) focusing particularly on dementia could be obtained from GPs, relatives or caregivers. Within three years, follow-up assessments were unavailable for only 49 subjects (1.5%). Proxy information could be obtained for 98.0% (n=295) of the 301 patients who had died in the interim. Since dementia is associated with a higher mortality rate, proxy information is particularly important in order to avoid underestimation of incident dementia cases.

At baseline there were 3,202 persons without dementia. Alcohol consumption information was available for 3,180 subjects:

• 50.0% were abstinent
• 24.8% consumed less than one drink (10 grams of alcohol) per day
• 12.8% consumed 10-19 grams of alcohol per day
• 12.4% consumed 20 or more grams per day
• A small subgroup of 25 participants fulfilled the criteria of harmful drinking (>60 grams of alcohol per day for men, respectively >40 grams for women)
• One man (>120 grams of alcohol per day) and one woman (>80 grams of alcohol per day) reported an extremely high consumption of alcohol
• Among the consumers of alcohol almost half (48.6%) drank wine only
• 29.0% drank beer only
• 22.4% drank mixed alcohol beverages (wine, beer, or spirits)

Alcohol consumption was significantly associated with male gender, younger age, higher level of education, not living alone, and not being depressed.

The calculation of incident cases of dementia is based on 3,202 subjects who had no dementia at baseline. Within the follow-up period of three years:

• 217 cases of dementia (6.8%) were diagnosed, whereby 111 subjects (3.5%) suffered from Alzheimer dementia. Due to the relatively small numbers, other subgroups of dementia (vascular dementia: n=42; other specific dementia, e.g. dementia in Parkinson's disease, Lewy body dementia, alcohol dementia: n=14; dementia with unknown aetiology: n=50) were not considered in the following analyses.

Univariate and multivariate analyses revealed that alcohol consumption was significantly associated with a lower incidence of overall dementia and Alzheimer dementia. In line with a large-scale study also based on GP attenders aged 75 years and older, the study found that light-to-moderate alcohol consumption was associated with relatively good physical and mental health. This three-year follow-up study included, at baseline, only those subjects 75 years of age and older, the mean age was 80.2 years, much higher than that in most other studies.

---

Journal Reference:

1. Siegfried Weyerer, Martina Schäufele, Birgitt Wiese, Wolfgang Maier, Franziska Tebarth, Hendrik van den Bussche, Michael Pentzek, Horst Bickel, Melanie Luppa, Steffi G. Riedel-Heller for the German Agecode Study Group (German Study on Ageing, Cognition and Dementia in Primary Care Patients). Current alcohol consumption and its relationship to incident dementia: results from a 3-year follow-up study among primary care attenders aged 75 years and older. Journal of Age and Ageing, 2011; DOI: 10.1093/ageing/afr007

Alcoholism is a tough addiction to kick. Eventually, most people return to drinking. But some Dutch and German psychological scientists have tested a short-term regime that promises to help alcoholics stay sober. Their study is published in Psychological Science, a journal of the Association of Psychological Science.

Heavy drinkers tend to behave impulsively in response to temptation. Meanwhile, their "reflective," or controlled, responses — the thoughts that would help them resist drinking — are often weak. Most therapies, including Cognitive Behavior Therapy, primarily address the reflective responses. "They deal with the reasons and strategies" for sobriety, said University of Amsterdam experimental psychologist Reinout W. Wiers, the study's lead author. To boost treatment success, his team developed cognitive-bias modification, or CBM, which, for the first time, "tries to turn around those impulsive responses."

This newly developed CBM variety employs video-game-like "approach-avoidance tasks": pushing or pulling a joystick in response to images on a screen. Pulling zooms in on the image, as if the participant were "approaching" it. Pushing zooms out, in "avoidance." The team's earlier studies found that heavier drinkers, shown images of alcoholic beverages or soft drinks, are faster to "pull" the alcohol than lighter drinkers — but CBM can turn this "approach bias" into an "avoidance bias."

Could CBM help serious alcoholics? In this study Wiers and his collaborators — Carolin Eberl and Johannes Lindenmeyer of the Salus Clinic in Lindow, Germany, and Mike Rinck and Eni S. Becker of Radboud University — recruited 214 inpatients at the Salus Clinic. Three weeks after detoxification, the patients were assessed for their craving for alcohol, as well as their attraction to it, indicated by joystick and word-association tasks.

One group of patients then received CBM: they were trained to push away pictures of alcoholic drinks. The control groups either received "sham" training or none at all. Four 15-minute sessions were conducted on four consecutive days.

When retested a week later, the CBM participants' "approach bias for alcohol had changed to an avoidance bias, on a variety of tests," said Wiers. The control groups showed no such changes.

Then the patients began abstinence-based cognitive behavior therapy, a structured method that helps people identify and challenge the thinking patterns that perpetuate their self-destructive behaviors. Treatment lasted about three months. A year later, the researchers assessed the patients' success in staying sober.

As is typical, many patients had relapsed — but only 46 percent of the CBM trained group, compared with 59 percent of the others. Although the researchers cannot be absolutely sure that CBM made the difference, joystick and word tests left them "strongly confident," said Wiers, that "adding this intervention to regular treatment helps people stay abstinent."

One still-abstinent patient told a story illustrating this point. At a party, looking for a Coke, the man opened the refrigerator, but found it full of beer. "Immediately, he made the push movement" — he closed the door. "In the heat of the moment, when temptations is high, you have to take that immediate first step in the right direction or it becomes very difficult," commented Wiers. "CBM helps people take this step, before they have time to consciously think, 'Should I take a drink?'"

Reference: Retraining Automatic Action Tendencies Changes Alcoholic Patients’ Approach Bias for Alcohol and Improves Treatment Outcome

---

Journal Reference:

1. R. W. Wiers, C. Eberl, M. Rinck, E. S. Becker, J. Lindenmeyer. Retraining Automatic Action Tendencies Changes Alcoholic Patients' Approach Bias for Alcohol and Improves Treatment Outcome. Psychological Science, 2011; DOI: 10.1177/0956797611400615

A strong link between victimization experiences and substance abuse has been discovered by researchers at the University of Illinois at Chicago.

The correlation is especially prevalent among gays, lesbians and bisexuals — more so than in heterosexuals, says Tonda Hughes, professor and interim head of health systems science in the UIC College of Nursing. Hughes is lead author of the study, published in the journal Addiction.

Researchers compared victimization experiences of unwanted sexual activity, neglect, physical violence, and assault with a weapon, across four sexual-identity subgroups — heterosexual, gay or lesbian, bisexual, or "not sure." The study used data collected nationally from 34,635 adults from the National Epidemiologic Survey on Alcohol and Related Conditions.

Hughes and her research team wondered if sexual-minority women and men are at a heightened risk for victimization. The results, Hughes said, showed that they are.

Lesbian and bisexual women were more than twice as likely as heterosexual women to report any victimization over their lifetime. Lesbians, gay men and bisexual women also reported a greater number of victimization experiences than did heterosexuals. Three times as many lesbians as heterosexual women reported childhood sexual abuse.

One possible explanation for this disproportionality, Hughes said, is that lesbians are more willing to acknowledge and report this experience.

"Gays and lesbians tend to be more self-reflective," she said. "This means they are more likely to think about and report negative or stigmatizing life experiences. Heterosexuals may not be inclined to do so."

Gay men also had high rates of victimization, with about half of them reporting any lifetime victimization. They reported significantly higher rates of childhood sexual abuse, childhood neglect, partner violence and assault with a weapon than heterosexual men.

Not only are there higher rates of violence and victimization among sexual minorities, but there is also a higher rate of substance abuse, Hughes said.

Regardless of sexual identity, women who reported two or more victimization experiences had two to four times the prevalence of alcohol dependence, drug abuse or drug dependence as women who reported no victimization, she said.

The research also concluded that gay, lesbian and bisexual youth may use substances to cope with adverse psychological and interpersonal effects of victimization, increasing the risk for further victimization from others, she said.

The study was funded through grants from the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, two of the National Institutes of Health.

Other authors on the Addiction paper were Sean Esteban McCabe, Brady West and Carol Boyd of the University of Michigan and Sharon Wilsnack of the University of North Dakota.

Individuals who drink alcohol in moderation (about one drink a day or less) are 14-25% less likely to develop heart disease compared to those who drink no alcohol at all, finds research led by Professor William Ghali from the University of Calgary, published online in the British Medical Journal.

The first paper, led by Paul Ronksley from the University of Calgary, emphasises that a balance needs to be found between the public health message that consuming large amounts of alcohol is bad for you, and the one that drinking in moderation can have health benefits.

An accompanying paper led by Dr Susan Brien, also from the University of Calgary, finds that moderate consumption of alcohol (up to one drink or 15 g alcohol per day for women and up to two drinks or 30 g alcohol per day for men) is good for health. They say moderate amounts of alcohol significantly increase the levels of 'good' cholesterol circulating in the body and this has a protective effect against heart disease.

Brien and colleagues argue that their study strengthens the case that there is a causal link between alcohol consumption and reduced heart disease.

The authors of both papers acknowledge that a number of previous studies have concluded that moderate alcohol consumption has been associated with a decrease in heart disease. However, they say that the research was out-of-date and there was a need for new material. Professor Ghali says his team's research is the most comprehensive to date.

Ghali and colleagues reviewed 84 studies of alcohol consumption and heart disease. They compared alcohol drinkers with non-drinkers and their outcomes in relation to heart disease, death from heart disease, incidences of stroke and death from having a stroke.

In the companion study, Brien and colleagues reviewed 63 studies and investigated alcohol consumption with known physical markers for heart disease such as cholesterol, levels of inflammation, fat cells and the condition of blood vessels. They also assessed the impact of the type of alcohol consumed (wine, beer and spirits).

Interestingly, Brien's research concludes that it is the alcohol content that provides the health benefits not the type of alcoholic beverage (wine, beer or spirits) that is drunk.

Professor Ghali concludes that the debate between the impact of alcohol on heart disease should now centre "on how to integrate this evidence into clinical practice and public health messages."

He adds "with respect to public health messages there may now be an impetus to better communicate to the public that alcohol, in moderation, may have overall health benefits that outweigh the risks in selected subsets of patients … any such strategy would need to be accompanied by rigorous study and oversight of impacts."

---

Journal References:

1. P. E. Ronksley, S. E. Brien, B. J. Turner, K. J. Mukamal, W. A. Ghali. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ, 2011; 342 (feb22 1): d671 DOI: 10.1136/bmj.d671
2. S. E. Brien, P. E. Ronksley, B. J. Turner, K. J. Mukamal, W. A. Ghali. Effect of alcohol consumption on biological markers associated with risk of coronary heart disease: systematic review and meta-analysis of interventional studies. BMJ, 2011; 342 (feb22 1): d636 DOI: 10.1136/bmj.d636

Unlike alcohol problems and antisocial behavior, depression doesn't decline with age in addiction-prone women in their 30s and 40s — it continues to increase, a new study led by University of Michigan Health System researchers found.

The longitudinal analysis examined the influences of the women's histories, family life and neighborhood instability on their alcoholism symptoms, antisocial behavior and depression over a 12-year period covering the earlier years of marriage and motherhood.

The research, published in Development and Psychopathology, is part of the Michigan Longitudinal Study, an ongoing project focusing on families at high risk for substance abuse and associated disorders that has already collected more than 20 years worth of data.

Among the current study's other top findings:

• The women's partners' struggles with addiction and antisocial behavior, such as run-ins with the law, worsened the women's own symptoms and behaviors.
• Children's behavior also had a negative impact on their mothers. When children exhibited behaviors that included acting out and getting into trouble, their mothers' alcohol problems and antisocial behavior tended to worsen. Meanwhile, when children were sad, withdrawn or isolated,their mothers' depression increased.
• Living in an unstable neighborhood, where residents move in and out frequently, also had a significant effect on the women's alcoholism symptoms and level of depression.

"Our findings demonstrate the complexity of the factors affecting changes in alcohol problems, antisocial behavior and depression for these women," says the study's senior author Robert Zucker, Ph.D., a professor of psychiatry and psychology at the University of Michigan Medical School and director of the U-M Addiction Research Center.

The findings challenge common notions that depression, alcoholism and antisocial behavior, are either just genetic disorders, or alternatively, that they are caused by environmental factors, Zucker adds.

"It's really the network of these relationships — at the biological, social and at the community level — that influences these disorders over time," he says.

The research also shows that unlike alcoholism symptoms and antisocial behavior, depression does not, by itself, moderate over time — it actually gets worse, at least in this high risk population, Zucker notes.

"Unlike the other two disorders, biological differences appear to be more of a constant factor in depression," he says.

The research sample included 273 adult women and their families from a four-county area in the Midwest. Drunk driving convictions involving the father were used to find the highest risk portion of the sample; a blood alcohol content of .15 was required to help ensure that the men had long standing difficulties with alcohol abuse, rather than just having been out drinking heavily for one night. The remaining families were recruited from the neighborhoods where the drunk drivers lived.

The findings also underscore the relationship between alcohol abuse and antisocial behavior over long periods of time, says study lead author Anne Buu, Ph.D., Ph.D., a research assistant professor in the Substance Abuse Section of the U-M Department of Psychiatry. As a result, she notes, interventions targeting antisocial behavior could benefit by also systematically targeting addiction.

"Based on these findings, interventions for women with young children might have the most impact if they improve social supports, educational opportunities, access to family counseling and neighborhoods environments," Buu says.

---

Journal Reference:

1. Anne Buu, Wei Wang, Jing Wang, Leon I. Puttler, Hiram E. Fitzgerald, Robert A. Zucker. Changes in women's alcoholic, antisocial, and depressive symptomatology over 12 years: A multilevel network of individual, familial, and neighborhood influences. Development and Psychopathology, 2011; 23 (01): 325 DOI: 10.1017/S0954579410000830

One of the ways in which alcohol dependence (AD) may develop is through alcohol's effects on neural signaling, such as modulation of γ-aminobutyric acid type A (GABAA) receptors. Alcohol may indirectly modulate GABAA receptor function by increasing levels of neuroactive steroids in blood. A new study has found linkages between AD and single nucleotide polymorphisms (SNPs) in the genes encoding two key enzymes required for the generation of endogenous neuroactive steroids, which suggests a genetic link between neuroactive steroids and risk for AD.

Results will be published in the May 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Although alcohol's biochemical effects on the nervous system are not completely known, the immediate effect of alcohol on how we feel and function as well as the long-term development of tolerance to alcohol are thought to be mediated by neurotransmitter receptors, especially GABAA receptors," said Jonathan Covault, associate professor of psychiatry at the University of Connecticut Health Center and corresponding author for the study.

GABAA receptors are primarily responsible for dampening brain activity, Covault explained, and balance the other major class of neurotransmitter receptors — glutamate receptors — that are responsible for enhancing excitatory brain activity. Healthy brain function relies on a relative balance of these two signaling systems.

"For example," he said, "excess excitatory relative to inhibitory receptor activity can result in seizures. The acute dampening effects of alcohol, such as disinhibition and sedation, are in large part due to alcohol effects on enhancing GABAA receptor function. Changes in the production of GABAA and glutamate receptors after chronic alcohol use also contribute to withdrawal symptoms, which can be medically serious and include delirium or seizures. The mainstay of medical treatment for alcohol withdrawal is to replace the effects of alcohol on stimulating GABAA receptors with medications — valium, librium or other benzodiazapines — that have similar effects as alcohol on enhancing GABAA receptor activity but can be gradually reduced in a controlled fashion."

"Previous studies have shown that neuroactive steroids contribute to alcohol sensitivity in rats and subjective feelings produced by alcohol in humans," said A. Leslie Morrow, John Andrews Distinguished Professor in the departments of psychiatry and pharmacology, and associate director of the Bowles Center for Alcohol Studies, both at the University of North Carolina School of Medicine. "Since low alcohol sensitivity has been linked to risk for alcoholism in humans, it is possible that low neurosteroid responses to alcohol may be linked to this disease."

"The detailed mechanisms by which alcohol modulates GABAA or glutamate receptors are still not well understood," added Covault. "How the body controls the production of neuroactive steroids is poorly understood, but stress and alcohol are two triggers shown to increase neuroactive steroids in the bloodstream and brain of laboratory rats. Laboratory studies suggest that many of the immediate effects of alcohol may be the result of alcohol on the production and metabolism of neuroactive steroids."

Covault and his colleagues genotyped SNPs in the genes encoding two key enzymes — 5α-reductase, type I (5α-R) and 3α-hydroxysteroid dehydrogenase, type 2 (3α-HSD), both of which are expressed in the human brain — in 1,083 participants living in Connecticut (583 males, 500 females): 531 with AD, and 552 individuals without AD.

"Results indicate that naturally occurring common genetic variations in two key enzymes required for the production of neuroactive steroids may influence the risk of developing AD," said Covault. "This finding is among the first evidence that some behavioral effects of alcohol are related to the production of neuroactive steroids. Specifically, genetic variation in each of two genes coding neuroactive steroid biosynthetic enzymes was more common in controls than AD participants, suggesting that protective genetic variations may result in more neuroactive steroids being produced in response to alcohol, thereby increasing the acute effects of alcohol — particularly sedating effects — which tend to limit a person's use of alcohol."

"This study brings scientists one step closer to understanding genetic and biochemical factors that underlie risk for alcoholism," said Morrow. "Such advances will surely lead to better treatments for alcoholism. We now have both genetic and behavioral studies linking neuroactive steroids to alcohol effects in humans. More studies of neuroactive steroids in humans are needed.

Covault concurs. "While much more work is needed to understand how variation in neuroactive steroid metabolism may influence an individual's predisposition to alcohol use problems, this report opens the door to new avenues of investigation and the potential development of new medical interventions for alcohol use problems."

---

Journal Reference:

1. Verica Milivojevic, Henry R. Kranzler, Joel Gelernter, Linda Burian, Jonathan Covault. Variation in Genes Encoding the Neuroactive Steroid Synthetic Enzymes 5α-Reductase Type 1 and 3α-Reductase Type 2 Is Associated With Alcohol Dependence. Alcoholism: Clinical and Experimental Research, 2011; DOI: 10.1111/j.1530-0277.2010.01425.x

 Participating in community service activities and helping others is not just good for the soul; it has a healing effect that helps alcoholics and other addicts become and stay sober, a researcher from Case Western Reserve University School of Medicine reports. In a review article published in the Volume 29 issue of Alcoholism Treatment Quarterly, Maria E. Pagano, PhD, associate professor of psychiatry at the School of Medicine, sheds light on the role of helping in addiction recovery, using the program of Alcoholics Anonymous (AA) as a prime example.

She cites a growing body of research as supporting evidence. "The research indicates that getting active in service helps alcoholics and other addicts become sober and stay sober, and suggests this approach is applicable to all treatment-seeking individuals with a desire to not drink or use drugs," Dr. Pagano says. "Helping others in the program of AA has forged a therapy based on the kinship of common suffering and has vast potential." In her research, Dr. Pagano highlights the helper therapy principle (HTP), a concept embodied by AA, as a means of diminishing egocentrism or selfishness, a root cause of addiction.

The HTP is based on the theory that, when a person helps another individual with a similar condition, they help themselves. The principle is reflected in the stated purpose of AA, which is to help individuals "stay sober and help other alcoholics achieve sobriety." Helping other alcoholics is viewed as the foundation for the alcoholic helper to stay on the path to recovery, Dr. Pagano says in her overview of the AA program.

In addition to outlining the basis for AA-related helping, Dr. Pagano reviews the data to date that illustrates the health and mental health benefits derived from helping others. She likewise examines several empirical studies she conducted previously which show how helping others in 12-step programs of recovery help the recovering individual to stay sober.

The research includes a 2004 study by Dr. Pagano and her colleagues. Using data from Project MATCH, one of the largest clinical trials in alcohol research, the investigators determined that 40 percent of the alcoholics who helped other alcoholics during their recovery successfully avoided drinking in the 12 months following three months in chemical dependency treatment, whereas only 22 percent of those that did not help others stayed sober.

A subsequent study by Dr. Pagano and her colleagues in 2009, also involving data from Project MATCH, showed that 94 percent of alcoholics who helped other alcoholics, at any point during the 15-month study, continued to do so as part of their ongoing recovery, and experienced lower levels of depression.

Similarly, a study of alcoholic patients with body dysmorphic disorder (BDD), a condition in which a person is excessively preoccupied with a perceived physical defect, found that those who helped others were more likely to become sober and enjoy an improved self-image than non-helpers. "These studies indicate that among alcoholics, AA-related helping and giving general help to others has positive effects on drinking outcomes and mental health variables," Dr. Pagano says in the Alcoholism Treatment Quarterly journal.

In fact, the benefits of doing good works and helping others also extend to individuals coping with chronic conditions like depression, AIDS, and chronic pain. "When humans help others regardless of a shared condition, they appear to live longer and happier lives," she adds. The benefits of helping are significant because the costs of alcoholism and drug addiction to society are so great, Dr. Pagano says. In light of recent health care reform, resources which can reduce these costs and suffering are crucial.

However, the lack of consensus on what peer helping is in addiction recovery requires additional study to clarify what specific behaviors to encourage, to whom and what forms of service to recommend for individuals engaging in early and ongoing recovery. Dr. Pagano is presently conducting a longitudinal study examining the role of service in adolescent addiction recovery. An area of new scientific discovery, she's applying the knowledge she's accrued with adults to adolescent populations with addiction.

It's no secret that there is a lot of alcohol consumed by fans at sporting events, but is it possible to measure the blood alcohol content (BAC) of fans as they exit the stadiums? And if BAC levels can be measured, what do the results tell us?

A new study published online in the journal Alcoholism: Clinical & Experimental Research (ACER) finds that BAC levels can be measured using a breath tester on fans as they exit football and baseball events. And the results show that 60% of the fans had zero BAC, 40% had a positive BAC, and nearly 8% were legally drunk.

Darin Erickson, PhD, University of Minnesota, was an investigator on the study and was the lead author of the paper.

"Getting fans to submit to a breath test and participate in a brief survey following a football or baseball game is not an easy task. We conducted BAC tests of 362 adult attendees following 13 baseball games and three football games. This is a preliminary study, but the first one to actually attempt to measure BAC levels after professional sporting events in the US," Erickson said. A Canadian study conducted in 1992 found similar results.

"Our sample size was small, partly because of the difficulty of getting fans to submit to a BAC test after a game. But if we assume that it represents individuals attending professional events, it means that on average about 5,000 attendees leaving one National Football League (NFL) event would be above the legal BAC limit for driving. That's a lot of drunken individuals who could be involved in traffic crashes, assaults, vandalism, crime and other injuries," Erickson said.

Part of the problem can be addressed through better training of alcohol servers and several stadiums are trying to train their servers. But according to another study cited by Erickson, even as recently as 2008, individuals who appeared to be obviously intoxicated could purchase alcohol 74% of the time. Increased police patrols around sports stadiums would also help, he said.

Other results from Erickson's study found that:

• Fans under 35 years of age have nine times greater odds of having BAC levels above the limit of 0.08. And those who drink at tailgating parties have 14 times greater odds of being legally drunk, compared to fans that had not tailgated.
• Nearly one in four attendees who tailgated reported consuming five or more alcoholic beverages while tailgating.
• Those who were in the highest BAC category reported consuming, on average, 6.6 drinks while tailgating compared with 3.7 drinks and 2.8 drinks for those in the mid-range BAC category and the zero BAC category, respectively.
• Night game attendees had higher odds of having a mid-range BAC (not above the legal limit), but they were not significantly more likely to have a BAC above the legal limit.

Erickson's study was funded by the Substance Abuse Policy Research Program (www.saprp.org) of the Robert Wood Johnson Foundation. SAPRP has funded research into policies related to alcohol, tobacco and illegal drugs. The study is available online and will appear in the April 2011 issue of ACER.

---

Journal Reference:

1. Darin J. Erickson, Traci L. Toomey, Kathleen M. Lenk, Gunna R. Kilian, Lindsey E. A. Fabian. Can We Assess Blood Alcohol Levels of Attendees Leaving Professional Sporting Events?Alcoholism: Clinical and Experimental Research, 2011; DOI: 10.1111/j.1530-0277.2010.01386.x

There are many ways, both medical and traditional, that are used to treat alcohol abuse or dependence. In China, kudzu root extract has been commonly used to reduce, but not eliminate, alcohol consumption and dependence. Despite its history, the mechanism of action for kudzu extract is still unknown, and that is what the current research explores.

Results of the study will be published in the April 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

David M. Penetar, senior author of the study and assistant Professor of Psychology in the Department of Psychiatry at McLean Hospital, said that kudzu has been around for centuries to treat alcohol intoxication, hangovers and other related problems in humans. But, how kudzu manages this is still not understood. One possibility is through the different isoflavones, which are biologically active molecules that can affect physiology, contained within the kudzu extract.

"Recently, preclinical studies with animals have shown reductions in alcohol consumption when treated with isoflavones contained in the kudzu root," said Penetar. "Therefore, the next step in the research was to assess the effects of kudzu extract on different physical, behavioral and cognitive features in humans."

The researchers observed 12 men and women in a double-blind placebo-controlled study. The participants were either treated with kudzu or a placebo for nine days, and then received a medium or high alcohol challenge to determine how prominently they presented alcohol-related symptoms.

The results showed pre-treatment with kudzu extract had little to no effect on the participant's behavioral, physical or cognitive performance. However, the researchers did note that treatment with kudzu caused an increase in heart rate, skin temperature and blood ethanol levels in the participants. Based on this, the researchers hypothesized that an increase in blood ethanol levels could translate into increased effects from the first alcoholic drink and delay an individual's desire for subsequent drinks.

"The fact that participants experienced a rapid rise in blood alcohol levels when pre-treated with kudzu has no apparent explanation and therefore requires additional research," said Penetar. For the researchers, the next step is to determine if kudzu alters regional brain blood flow using an fMRI.

"If alcohol reaches the brain earlier, people might stop drinking earlier or drink less because they achieve the desired intoxication level earlier, with less alcohol," said Robert Swift, a Professor of Psychiatry and Human Behavior at Brown University and the Providence VA Medical Center.

"It is also possible that there is another, as yet undiscovered compound in the mixture that accounts for the effects. Thus, the mechanism of action of the kudzu extract remains unknown."

---

Journal Reference:

1. David M. Penetar, Robert R. MacLean, Jane F. McNeil, Scott E. Lukas. Kudzu Extract Treatment Does Not Increase the Intoxicating Effects of Acute Alcohol in Human Volunteers. Alcoholism: Clinical and Experimental Research, 2011; DOI: 10.1111/j.1530-0277.2010.01390.x