Evidence-Based Treatments for Alcohol and Drug Abuse encompasses the developments in the field over the last decade, blending theory, techniques and clinical flexibility.

Research in the past decade has shown that substance abuse and substance dependence are treatable. The field has witnessed the introduction of evidence-based psychological and specific pharmacological treatments. Unfortunately, many of the empirical supported therapies for addictions are still not widely applied by practitioners. The third volume in the Practical Clinical Guidebooks Series (PCG), Evidence-Based Treatments for Alcohol and Drug Abuse, defines the characteristics, classification, and prevalence of substance use disorders, and provides the clinician with practical guidelines applicable across a variety of treatment settings and patient groups.

Drawing on the recent research in the field, the authors provide the practicing clinician and student with an up-to-date understanding of the epidemiology, etiology, course and prognosis of substance abuse disorders that would be relevant to clinical practice. In addition to describing phenomenology and etiology, the book provides a comprehensive guide to the assessment and treatment of DSM-IV-TR substance abuse disorders (SUDs), including abuse and dependence of alcohol, stimulants, opiates, hallucinogens, cannabis/marijuana, sedative, and party drugs.

This is the eBook version of the printed book.

Addiction destroys lives. In The Addicted Brain, a leading neuroscientist explains how and why this happens–and presents advances in treatment and prevention. Using breathtaking brain imagery and other research, Michael Kuhar, Ph.D., shows the powerful, long-term brain changes that drugs can cause, revealing why it can be so difficult for addicts to escape their grip.

In plain English, Kuhar describes why some people are far more susceptible to addiction than others. He illuminates striking neural similarities between drugs and other pleasures potentially capable of causing abuse or addiction–including alcohol, gambling, sex, caffeine, and even Internet overuse. Finally, he outlines the 12 characteristics most often associated with successful treatment.

Authoritative and easy to understand, The Addicted Brain offers today’s most up-to-date scientific explanation of addiction–and what addicts, their families, and society can do about it.

Weaving actual clinical examples with solid research, Substance Abuse continues to provide counseling, social work, and other students with a detailed overview of the alcohol and other drug (AOD) field. Now in its Third Edition, this text provides updated coverage and practical clinical examples to reflect the rapid changes in the field of addiction. In a reader-friendly style, the authors present balanced coverage of various treatment models as well as objective discussions of the controversies in the field. The text covers topics spanning the entire field–pharmacology, assessment and diagnosis, treatment, recovery, prevention, children, families, and other addictions–providing students with a broad view of the AOD field as well as the pervasiveness of the problem in all areas of behavioral health and general fields.

Pharmacogenomics is the basis of personalized medicine, which is said to be the medicine of the future. Understanding genetic variation in alcohol response is vital for professionals involved in alcohol rehabilitation programs. This volume focuses on how pharmacogenomic principles are applied to alcohol and drug testing and treatment and discusses the role of the clinical laboratory in the practice of personalized medicine. With contributions from a range of experts, the text presents the genetic aspects of alcohol metabolism and drugs of abuse, including marijuana, cocaine, and amphetamine. It also covers methodologies in pharmacogenomic testing.

Drowning in a Bottle is a Capstone Press publication.



Author: Gail B. Stewart
Hardcover: 48 pages
Company: Compass Point Books (2009-01)
ISBN: 0756541514
List Price: $27.99
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Each title in the Allyn & Bacon Johnson & Grant Casebook Series presents three to four in-depth cases in a different topic area, prefaced by an introduction to generalist social work practice.

Allyn & Bacon Casebook Series for Substance Abuse, First Edition by Jerry Johnson and George Grant provides students with personal and intimate glimpses into the thinking and actions of experienced practitioners working with with substance abusing clients. The contributors to this casebook combined many decades of social work experience and teaching to create a one-of-a-kind tool for students to study and analyze how practitioners think about practice. The authors move beyond the belief that practice involves finding “correct” interventions to solve client problems, and instead invite students to review and challenge the work of others to help them understand what compromises important practice decision with real clients in real practice settings.

Author: Joseph R. Gusfield
Paperback: 384 pages
Company: University of Wisconsin Press (1996-05-15)
ISBN: 029914934X
List Price: $21.95
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"An outstanding contribution to the professional well-being of the addiction field."
—Thomas McGovern, editor, Addiction Treatment Quarterly

"Forever useful."
—S. Beckett, education and training coordinator, National Association of Alcohol and Drug Abuse Counselors

Author: David J. Powell, Archie Brodsky
Kindle Edition: 451 pages Kindle eBook
Company: Jossey-Bass (1993-11-30) (1993-11-30)
List Price: $51.50
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There has been recent attention given to overcome the gulf between the treatment of alcoholism and research on alcoholism. This book is a practical step to “bridge the gap”. There is a great body of useful research on alcohol and alcoholism, which has been conducted in the past 25 years. This book includes this research for important contributions to the understanding of alcoholism and treatment.

This book gives the reader an introduction to research methods and other knowledge bases, while discussing current alcohol research and suggests clinical applications. Each subsequent chapter focuses on a specific variable and its methodology.

This timely resource provides information on all aspects of substance abuse, and focuses on its effects throughout the life span — from infants to the elderly. Coverage includes current research and epidemiology, as well as basic strategies for identification, assessment, and management of problems. For nurses in advanced practice looking for up-to-date, comprehensive information for developing management strategies and plans.

Throughout history, and across cultures, alcohol has affected the fabric of society through abuse and addiction, contributed to violence and accidents, and caused injuries and health issues. In Alcohol: Its History, Pharmacology, and Treatment, part of Hazelden's Library of Addictive Drugs Series, Cheryl Cherpitel, Dr.P.H. and Mark Rose, M.A. examine the nature and extent of alcohol use in the United States, current treatment models and demographics, and the biology of alcohol, addiction, and treatment.

In separating fact from fiction, Cherpitel and Rose give context for understanding the alcohol problem by tracing its history and different uses over time, then offer an in-depth look at

Thoroughly researched and highly readable, Alcohol offers a comprehensive understanding of medical, social, and political issues concerning this legal, yet potentially dangerous, drug.

From the origins of drinking to the use and abuse of alcohol in the present day, this global historical study draws on approaches and research from biology, anthropology, sociology and psychology. Topics covered include:

the impact of colonialism

alcohol before the world economy

industrialization and alcohol

globalization, consumer society, and alcohol.

Gina Hames argues that the production, trade, consumption, and regulation of alcohol have shaped virtually every civilization in numerous ways. It has perpetuated the development of both domestic and international trade; helped create identity and define religion; provided a tool for oppression as well as a tool for cultural and political resistance; and has supplied governments with essential revenues as well as a means of control over minority groups.

Alcohol in World History is one of the first studies to pull together such a wide range of sources in order to compare the role of alcohol throughout time and across both western and non-western civilizations.

It is the backbone of Ritalin and the “club drugs” Ecstasy, Eve and Cat. According to the DEA statistics, approximately four percent of all Americans have used clandestinely manufactured methamphetamine. In the 1960s and 1970s millions of mainstream Americans used and abused prescription amphetamines; today, anyone with a stovetop, a beaker, and a little know-how can make its derivative, methamphetamine, with chemicals purchased at the hardware store and pharmacy down the street.

American Meth is the unprecedented story of a molecule in all of its incarnations, and the deep but little-known impact it has had on American life over the course of the last century. Told from the viewpoint of author Sterling Braswell, whose life has been touched by the drug, American Meth is a deeply personal drama that illuminates the epidemic we live with today.

Since the dawn of athletic competition during the original Olympic Games in Ancient Greece, athletes, as well as their coaches and trainers, have been finding innovative ways to gain an edge on their competition. Some of those performance-enhancement methods have been within the accepted rules while other methods skirt the gray area between being within the rules and not, while still other methods break the established rules. In modern times, doping - the use of performance-enhancing drugs - has been one method athletes and their trainers have used to beat their competition. The history of sports doping during the modern era can be traced through the events and scandals of the times in which the athletes lived. From the use of amphetamines and other stimulants in the early 20th century, to the use of testosterone and steroids by both the USSR and the United States during Cold War-era Olympics games, to blood doping and EPO, to designer drugs, the history of doping in sports closely follows the medical and technological advances of our times. In the early 21st century, the possibility of genetically engineered athletes looms. The story of doping in sports over the last century offers clues to where the battle over performance enhancement will be fought in the years to come.

First, you learn five safe-drinking guidelines, then, each week you learn clinically-proven behavioral, cognitive, motivational and lifestyle strategies and techniques to help you stay within those guidelines. The result? You enjoy controlled drinking and no problems. It's an easy, commonsense moderate drinking program that works!

Learn what triggers your alcohol craving and how to manage it, how to slow down and pace your drinking, how to pre-plan for drinking occasions, how to master the art of social drinking and how to make alcohol less important in your life so you drink less naturally. Drink/Link is registered with both the California Department of Alcohol and Drug Programs and the United States Department of Health and Human Services.

Author: Donna J. Cornett
Paperback: 184 pages
Company: People Friendly Books (2011-08-05)
ISBN: 0976372002
List Price: $18.95
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New this spring, the third edition of this Hazelden best-seller has been updated to include the latest research, information about new medications, and an explanation of new diagnostic criteria.

Key features and benefits outlines the relationship between chemical dependency and psychiatric disorders contains important resources for chemically dependent individuals and their families presents practical relapse prevention strategies

Author: Dennis C Daley Ph.D., Howard B. Moss M.D.
Paperback: 499 pages
Company: Hazelden (2002-04) (2002-03-07)
ISBN: 1568388020
List Price: $32.95
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“An excellent and honest book.”—The New York Times Book Review

"Often I have been compelled to ask myself, 'Who is the civilized and who is the savage?' Their principal vices are emphatically our vices. If they get drunk it is upon our whiskey. . . . [A]nd yet we claim to be 'civilized' and freely deal out to them the epithet 'savage.'"--The Reverend William H. Goode, reflecting on his early 19th-century sojourn in Indian Country

In White Man's Wicked Water, Unrau tells the compelling story of how an alcohol-sodden society introduced drink to the Indians. That same society then instituted futile policies to control the flow of alcohol to tribes who, as one superintendent put it, "have not the moral force to resist temptation." Unrau dispels that racial-deficiency theory and debunks the belief that prohibition was carried out by well-intended reformers.

Unrau shows that, contrary to the perniciously false image of the innately "depraved savage," Indians actually learned their "uncivil" behavior by emulating--in hopes of accommodating--"civilized" men. Indian inebriation in the nineteenth century, he shows, essentially mimicked the habits of white Americans who--spurred on by prevailing attitudes and federal law--were aspiring to integrate the natives into the cultural mainstream. Prohibition zealots, intent upon soothing white anxieties, were far more concerned with this goal than with stemming the flow of alcohol.

Scholars have often viewed the sale of alcohol to Native Americans as a ploy by Euro-Americans to trick them into unfair land and trade deals. But Unrau makes it clear that alcoholic consumption by Native Americans was the inevitable consequence of cultural confluence, not of conscious white subversion.

To support his arguments, Unrau has closely examined previously neglected records pertaining to illicit alcohol trafficking, its tie to the land-cession/annuity-distribution system, and the influence of federal subsidy to non-Indian, western development. From these sources, he provides surprising new insights into alcohol use and abuse in relation to Indian removal. Unrau also sheds new light on nineteenth-century prohibition attempts in the trans-Missouri West (primarily Nebraska, Kansas, and Oklahoma) up to the absolutist prohibition law of 1892.

Author: William E. Unrau
Paperback: 180 pages
Company: Univ Pr of Kansas (1996-06)
ISBN: 0700609644
List Price: $14.95
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Debates over the use and abuse of drugs, the laws controlling drugs in this country, and the question of whether or not certain drugs should be legally available have inflamed Americans since the 19th-century, and continue to flourish as America attempts to rage its war on drugs. Students can trace the history and development of these arguments, as well as the reactions to them, through this unique collection of over 250 primary documents. Court cases, speeches, laws, opinion pieces, and other documents bring to life the controversies surrounding the issues. Explanatory introductions to documents aid users in understanding the various arguments put forth, while illuminating the significance of each document.

Belenko traces the origins and changes in the nature of drug use and abuse in this country, as well as drug policy. Students can follow the evolution of the laws that have limited access to drugs such as cocaine and opium that were once legal in this country, as well as read the differing opinions in recent history on whether or not certain drugs such as marijuana ought to be legally available. The carefully chosen documents reflect the fact that our government's decisions have not always ended public controversy about how to deal with drug related problems and the very real consequences of addiction. The introductory and explanatory text help readers understand the nature of the conflicts, the issues being litigated, the social and cultural pressures that have shaped the debates, and the manner in which the passions of individual people have affected our drug policies.

From the authors of Buzzed and Pumped, a no-nonsense guide to what kids should know to make healthy decisions.

The success or failure of drug treatment programs have long been evaluated by assessing the clients’ progress while in treatment and their status upon completion. This approach does not provide a complete assessment or an adequate picture of treatment outcomes over time. A comprehensive evaluation of the success or failure of treatment should also include client status in the years following treatment for a fair assessment of the long-term efficacy of any drug-treatment program.

What happens to former clients who left treatment? What influence did the treatment have on their lives? These are the questions that Marvin R. Burt seeks to answer with the follow-up studies included in this book. By selecting samples of former clients treated by two of the largest drug treatment agencies in the U.S. and control groups, Burt compares client behavior in terms of drug abuse, criminal activity, and socioeconomic productivity before, immediately following, and well after treatment.

The findings in this book challenge many common assumptions about drug treatment programs. Burt finds larger than expected positive behavioral changes in clients regardless of treatment duration or type, and demographic or background characteristics. Whether the results are attributable to the clients’ maturation, commitment to change, or a reduction in the availability of drugs, the positive results of treatment are encouraging. This volume provides valuable insight into the natural history of drug abuse and outcomes for client groups.

J Physician Assist Educ. 2011; 22(4): 15-22
Herman L, Shtayermman O, Aksnes B, Anzalone M, Cormerais A, Liodice C

Prescription stimulant use as academic performance enhancers is increasingly widespread among college students. The purpose of this study was to evaluate the prevalence of prescription stimulant use among health care students attending a university in the northeastern United States. The study investigated the specific stimulants being used and the frequency of usage. It also examined the rates of nicotine, alcohol, and drug abuse versus dependence.A web-based survey was administered to medical and health profession students regarding prescription stimulant use for nonprescribed purposes. Tobacco, alcohol, and recreational drug use were also surveyed.Approximately 10.4% (32) of students surveyed have either used a stimulant or are currently using prescription stimulants illegally. The most common reason for stimulant use was to focus and concentrate during studying (93.5%). Of the 308 students, 45.2% were female, 83.9% were Caucasian, and amphetamine-dextroamphetamine was the most commonly abused stimulant (71.4%).Results from this study are consistent with previous research of undergraduate students regarding prescription stimulant use for nonprescribed purposes, specifically for academic performance enhancement. Data from the study support that alcohol abuse and dependence among students is a pertinent concern, suggesting that substance abuse in general must be addressed. Substance abuse and awareness programs combined with stress management programs in an overall substance-abuse reduction strategy, including the use of prescription stimulant use beyond the originally intended purpose, may be beneficial. Because of the lack of research focusing on graduate health care students, further investigations should use similar populations.

J Health Psychol. 2012 Feb 7;
Laghi F, Baiocco R, Lonigro A, Capacchione G, Baumgartner E

Limited studies have sought to describe binge drinking among adolescents and even fewer studies have attempted to examine whether family functioning, family communication and satisfaction could be associated with alcohol abuse. Our sample was made up of 726 Italian adolescents between the ages of 16 and 18. According to previous research, adolescents were categorized into non-drinkers, social, binge and heavy drinkers. Results showed that social, binge and heavy drinkers differ in terms of some drinking variables, family functioning, family communication and satisfaction.

Qual Life Res. 2012 Feb 5;
Boakye M, Moore R, Kong M, Skirboll SL, Arrigo RT

PURPOSE: To measure the impact of spinal disorders on health-related quality of life (HRQOL) among Veterans, to describe demographic patterns of Veterans with spinal disorders, and to quantify HRQOL scores as they relate to demographics, medical comorbidities, pain severity, and depressive symptoms. METHODS: From 2009 to 2010, 112 lumbar and 56 cervical spinal disorder patients completed SF-12, Oswestry Disability Index, visual analog pain scale, and Beck Depression Inventory surveys. Multivariate analysis identified predictors of HRQOL, disability, and depressive symptoms. RESULTS: A total of 168 patients completed surveys for this study. The median age of all patients was 60. Nearly 30% of lumbar and 16% of cervical patients were aged 65 or older. Approximately 96% of patients were men. Sixty percent of patients were currently receiving or had pending disability compensation. Nearly 60% of patients were current smokers, approximately 26% reported alcoholism or intravenous drug use, and 26% self-reported post-traumatic stress disorder. The most common lumbar spine diagnoses were disk herniation (36.6%) and stenosis (34.8%), and most common cervical spine diagnoses were stenosis (50.0%) and disk herniation (23.2%). Back pain was reported by 93.8% of lumbar patients and leg pain by 83.0%. Neck pain was reported by 96.4% of cervical patients and arm pain by 69.6%. Median SF-12 physical component scores were more than two standard deviations below the US average. Ninety percent of patients had at least moderate physical disability. Sixty-four percent met criteria for depressive symptoms. Visual analog pain score was the strongest predictor of SF-12 physical (β = -1.32, P 

Psychopharmacology (Berl). 2012 Feb 4;
Jamadar S, Devito EE, Jiantonio RE, Meda SA, Stevens MC, Potenza MN, Krystal JH, Pearlson GD

RATIONALE: Individuals with a family history of alcoholism (family history positive [FHP]) show higher alcoholism rates and are more impulsive than those without such a family history (family history negative [FHN]), possibly due to altered N-methyl-D: -aspartate (NMDA) receptor function. OBJECTIVES: We investigated whether memantine, an NMDA receptor antagonist, differentially influences impulsivity measures and Go/No-Go behavior and fMRI activity in matched FHP and FHN individuals. METHODS: On separate days, participants received a single dose of 40 mg memantine or identical-appearing placebo. RESULTS: No group performance differences were observed on placebo for Go correct hit or No-Go false alarm reaction time on the Go/No-Go task. During fMRI, right cingulate activation differed for FHP vs. FHN subjects during No-Go correct rejects. Memantine had attenuated effects in FHP vs. FHN subjects: For No-Go false alarms, memantine was associated with limited reduction in subcortical, cingulate, and temporal regions in FHP subjects and reduced activity in fronto-striatal-parietal networks in FHN subjects. For No-Go correct rejects, memantine (relative to placebo) reduced activity in left cingulate and caudate in FHP but not FHN subjects. CONCLUSIONS: Lower sensitivity to the effects of memantine in FHP subjects is consistent with greater NMDA receptor function in this group.

Alcohol Clin Exp Res. 2012 Feb 6;
Koller G, Zill P, Rujescu D, Ridinger M, Pogarell O, Fehr C, Wodarz N, Bondy B, Soyka M, Preuss UW

BACKGROUND: Several lines of evidence from previous research indicate that opioid receptors play an important role in ethanol reinforcement and alcohol dependence (AD) risk. Conflicting results were reported on the role of the mu-opioid receptor (OPRM1) polymorphism A118G (Asn40Asp, rs1799971) in the development of alcoholism. METHODS: We investigated a total number of 1,845 alcohol-dependent subjects recruited from inpatient facilities in Germany and 1,863 controls for the mu-opioid receptor (OPRM1) polymorphism using chi-square statistics. RESULTS: An association between the OPRM variant and AD was detected (p = 0.022), in recessive (AA vs. GA/GG) and co-dominant (AA vs. GA) models of inheritance. An association between the OPRM variant and the DSM-IV criterion "efforts to cut down or could not" (p = 0.047) was found, but this did not remain significant after the correction for multiple testing. CONCLUSIONS: The results indicate that this functional OPRM variant is associated with risk of AD and these findings apply to more severe AD, although the association is only nominally significant.

Alcohol Clin Exp Res. 2012 Feb 6;
Plebani JG, Ray LA, Morean ME, Corbin WR, Mackillop J, Amlung M, King AC

BACKGROUND: Human laboratory studies have a long and rich history in the field of alcoholism. Human laboratory studies have allowed for advances in alcohol research in a variety of ways, including elucidating neurobehavioral mechanisms of risk, identifying phenotypically distinct subtypes of alcohol users, investigating the candidate genes underlying experimental phenotypes for alcoholism, and testing mechanisms of action of alcoholism pharmacotherapies on clinically relevant translational phenotypes, such as persons exhibiting positive-like alcohol effects or alcohol craving. Importantly, the field of human laboratory studies in addiction has progressed rapidly over the past decade and has built upon earlier findings of alcohol's neuropharmacological effects to advancing translational research on alcoholism etiology and treatment. METHODS AND RESULTS: To that end, the new generation of human laboratory studies has focused on applying new methodologies, further refining alcoholism phenotypes, and translating these findings to studies of alcoholism genetics, medication development, and pharmacogenetics. The combination of experimental laboratory approaches with the recent developments in neuroscience and pharmacology has been particularly fruitful in furthering our understanding of the impact of individual differences in alcoholism risk and in treatment response. CONCLUSIONS: This review of the literature focuses on human laboratory studies of subjective intoxication, alcohol craving, anxiety, and behavioral economics. Each section discusses opportunities for phenotype refinement under laboratory conditions, as well as its application to translational science of alcoholism. A summary and recommendations for future research are also provided.

Alcohol Clin Exp Res. 2012 Feb 6;
Nam HW, McIver SR, Hinton DJ, Thakkar MM, Sari Y, Parkinson FE, Haydon PG, Choi DS

Recent studies have demonstrated that the function of glia is not restricted to the support of neuronal function. Especially, astrocytes are essential for neuronal activity in the brain. Astrocytes actively participate in synapse formation and brain information processing by releasing or uptaking gliotransmitters such as glutamate, d-serine, adenosine 5'-triphosphate (ATP), and adenosine. In the central nervous system, adenosine plays an important role in regulating neuronal activity as well as in controlling other neurotransmitter systems such as GABA, glutamate, and dopamine. Ethanol (EtOH) increases extracellular adenosine levels, which regulates the ataxic and hypnotic/sedative (somnogenic) effects of EtOH. Adenosine signaling is also involved in the homeostasis of major inhibitory/excitatory neurotransmission (i.e., GABA or glutamate) through neuron-glial interactions, which regulates the effect of EtOH and sleep. Adenosine transporters or astrocytic SNARE-mediated transmitter release regulates extracellular or synaptic adenosine levels. Adenosine then exerts its function through several adenosine receptors and regulates glutamate levels in the brain. This review presents novel findings on how neuron-glial interactions, particularly adenosinergic signaling and glutamate uptake activity involving glutamate transporter 1 (GLT1), are implicated in alcoholism and sleep disorders.

Alcohol Clin Exp Res. 2012 Feb 6;
Dawson DA, Goldstein RB, Ruan WJ, Grant BF

BACKGROUND: Correlates of recovery from alcohol dependence have been identified through a variety of study designs characterized by different strengths and limitations. The goal of this study was to compare correlates of recovery based on a 3-year prospective design with those based on cross-sectional analyses of data from the same source. METHODS: Data from the 2001 to 2002 Wave 1 and 2004 to 2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) were used to examine baseline characteristics associated with Wave 2 recovery from alcohol dependence, among those who classified with past-year DSM-IV alcohol dependence at Wave 1 (n = 1,172). RESULTS: Abstinent recovery was significantly associated with Black/Asian/Hispanic race/ethnicity, children

Alcohol Clin Exp Res. 2012 Feb 6;
Chandrasekaran K, Swaminathan K, Mathan Kumar S, Clemens DL, Dey A

BACKGROUND: Hyperglycemia or alcoholism can lead to impaired liver functions. Cytochrome P450 2E1 (CYP2E1) is elevated in hyperglycemia or alcoholism and plays a critical role in generating oxidative stress in the cell. METHODS: In the present study, we have used VL-17A cells that overexpress the alcohol metabolizing enzymes [alcohol dehydrogenase (ADH) and CYP2E1] to investigate the toxicity due to ethanol (EtOH) plus high glucose. Toxicity was assessed through viability assay and amount of acetaldehyde adduct formation. Oxidative stress parameters included measuring reactive oxygen species (ROS) levels and malondialdehyde adduct formation. Apoptosis was determined through caspase-3 activity, Annexin V- Propidium iodide staining, and changes in mitochondrial membrane potential. The effects of antioxidants and specific inhibitors of ADH and CYP2E1 on cell viability and ROS levels were also studied. RESULTS: When present together, EtOH plus high glucose-treated VL-17A cells exhibited greater oxidative stress and toxicity than other groups. Apoptosis was observed in liver cells treated with the toxins, and the EtOH plus high glucose-treated VL-17A cells exhibited apoptosis to the largest extent. A distinct and graded increase in CYP2E1 level occurred in the different groups of VL-17A cells. Further, antioxidants or inhibitors of ADH and CYP2E1 were effective in decreasing the observed oxidative stress and toxicity. CONCLUSIONS: The combined oxidative insult due to alcohol plus high glucose leads to greater liver injury, which may prove to be a timely warning for the injurious effects of alcohol consumption in diabetics.

Addiction. 2012 Mar; 107(3): 467-77
Kaye S, Darke S

Aims  To examine the literature pertaining to the diversion and misuse of pharmaceutical stimulants. Methods   Relevant literature was identified through comprehensive MEDLINE, EMBASE and PubMed searches. Results  The evidence to date suggests that the prevalence of diversion and misuse of pharmaceutical stimulants varies across adolescent and young adult student populations, but is higher than that among the general population, with the highest prevalence found among adults with attention deficit-hyperactive disorder (ADHD) and users of other illicit drugs. Concerns that these practices have become more prevalent as a result of increased prescribing are not supported by large-scale population surveys. Information on trends in misuse in countries where there have been recent increases in prescription and consumption rates, however, is limited. Little is known about the frequency and chronicity of misuse, or the extent of associated harms, particularly among those populations, i.e. adolescents, young adult student populations, those with ADHD and illicit drug users, where abuse may be more likely to occur. Conclusions  Continued monitoring of the diversion and misuse of pharmaceutical stimulants is of major clinical importance. Despite recognition of the abuse liability of these medications, there is a paucity of data on the prevalence, patterns and harms of diversion and misuse among populations where problematic use and abuse may be most likely to occur (e.g. adolescents, young adults, illicit drug users). Comprehensive investigations of diversion and misuse among these populations should be a major research priority, as should the assessment of abuse and dependence criteria among those identified as regular users.

J Clin Psychiatry. 2012 Jan 10;
Putnins SI, Griffin ML, Fitzmaurice GM, Dodd DR, Weiss RD

BACKGROUND: Sleep problems are common in patients with bipolar disorder and have been shown to predict subsequent mood symptoms. Sleep problems have also been shown to lead to worse substance use outcomes in individuals with substance use disorder. However, the relationship between sleep and clinical outcomes in a population with co-occurring bipolar disorder and substance use disorder is unclear. METHOD: This secondary analysis included 60 outpatients (mean age = 38.1 years; recruited via advertisements, fliers, clinician referrals, and hospital treatment programs) who met DSM-IV criteria for both bipolar disorder and substance use disorder (assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders) and who participated in a randomized clinical trial comparing integrated group therapy for bipolar disorder and substance use disorder to group drug counseling for substance use disorder alone. A 12-week treatment period preceded a 24-week follow-up. Poor sleep was assessed with the Pittsburgh Sleep Quality Index, which provides 7 component subscores and an overall sleep score. Data were collected from August 2003 through April 2007. RESULTS: When analyses were controlled for baseline mood, substance use, and treatment condition, baseline sleep score predicted mood over the course of the 12-week treatment (β = 0.28; P < .05) and 24-week follow-up (β = 0.46; P < .01): worse sleep was associated with worse mood outcomes. Sleep was not associated with substance use outcomes. CONCLUSIONS: Impaired sleep is a prognostic factor for mood outcomes in patients with co-occurring bipolar and substance use disorders. Further investigation is warranted into the long-term clinical outcomes of poor sleep in this population with co-occurring bipolar disorder and substance use disorder so that appropriate interventions can be developed.

Neuroscience. 2012 Jan 21;
Alexander GM, Graef JD, Hammarback JA, Nordskog BK, Burnett EJ, Daunais JB, Bennett AJ, Friedman DP, Suomi SJ, Godwin DW

Early-life stress has been shown to increase susceptibility to anxiety and substance abuse. Disrupted activity within the anterior insular cortex (AIC) has been shown to play a role in both of these disorders. Altered serotonergic processing is implicated in controlling the activity levels of the associated cognitive networks. We therefore investigated changes in both serotonin receptor expression and glutamatergic synaptic activity in the AIC of alcohol-drinking rhesus monkeys. We studied tissues from male rhesus monkeys raised under two conditions: Male rhesus monkeys (1) "mother reared" (MR) by adult females (n=9) or (2) "Nursery reared" (NR), that is, separated from their mothers and reared as a separate group under surrogate/peer-reared conditions (n=9). The NR condition represents a long-standing and well-validated nonhuman primate model of early life stress. All monkeys were trained to self-administer ethanol (4% w/v) or an isocaloric maltose-dextrin control solution. Subsets from each rearing condition were then given daily access to ethanol, water, or maltose-dextrin for 12 months. Tissues were collected at necropsy and were further analyzed. Using real time RT-PCR we found that ethanol-naive, NR monkeys had lower AIC levels of 5-HT(1A) and 5-HT(2A) receptor mRNA compared with ethanol-naive, MR animals. Although NR monkeys consumed more ethanol over the 12-month period compared with MR animals, both MR and NR animals expressed greater 5-HT(1A) and 5-HT(2A) receptor mRNA levels following chronic alcohol self-administration. The interaction between nursery-rearing conditions and alcohol consumption resulted in a significant enhancement of both 5-HT(1A) and 5-HT(2A) receptor mRNA levels such that lower expression levels observed in nursery-rearing conditions were not found in the alcohol self-administration group. Using voltage clamp recordings in the whole cell configuration we recorded excitatory postsynaptic currents in both ethanol-naive and chronic self-administration groups of NR and MR monkeys. Both groups that self-administered ethanol showed greater glutamatergic activity within the AIC. This AIC hyperactivity in MR alcohol-consuming monkeys was accompanied by an increased sensitivity to regulation by presynaptic 5-HT(1A) receptors that was not apparent in the ethanol-naive, MR group. Our data indicate that chronic alcohol consumption leads to greater AIC activity and may indicate a compensatory upregulation of presynaptic 5-HT(1A) receptors. Our results also indicate that AIC activity may be less effectively regulated by 5-HT in ethanol-naive NR animals than in NR monkeys in response to chronic ethanol self-administration. These data suggest possible mechanisms for increased alcohol seeking and possible addiction potential among young adults who had previously experienced early-life stress that include disruptions in both AIC activity and serotonin system dynamics.

Diabetes. 2012 Feb 7;
Rajesh M, Bátkai S, Kechrid M, Mukhopadhyay P, Lee WS, Horváth B, Holovac E, Cinar R, Liaudet L, Mackie K, Haskó G, Pacher P

Endocannabinoids and cannabinoid 1 (CB(1)) receptors have been implicated in cardiac dysfunction, inflammation, and cell death associated with various forms of shock, heart failure, and atherosclerosis, in addition to their recognized role in the development of various cardiovascular risk factors in obesity/metabolic syndrome and diabetes. In this study, we explored the role of CB(1) receptors in myocardial dysfunction, inflammation, oxidative/nitrative stress, cell death, and interrelated signaling pathways, using a mouse model of type 1 diabetic cardiomyopathy. Diabetic cardiomyopathy was characterized by increased myocardial endocannabinoid anandamide levels, oxidative/nitrative stress, activation of p38/Jun NH(2)-terminal kinase (JNK) mitogen-activated protein kinases (MAPKs), enhanced inflammation (tumor necrosis factor-α, interleukin-1β, cyclooxygenase 2, intracellular adhesion molecule 1, and vascular cell adhesion molecule 1), increased expression of CB(1), advanced glycation end product (AGE) and angiotensin II type 1 receptors (receptor for advanced glycation end product [RAGE], angiotensin II receptor type 1 [AT(1)R]), p47(phox) NADPH oxidase subunit, β-myosin heavy chain isozyme switch, accumulation of AGE, fibrosis, and decreased expression of sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPase (SERCA2a). Pharmacological inhibition or genetic deletion of CB(1) receptors attenuated the diabetes-induced cardiac dysfunction and the above-mentioned pathological alterations. Activation of CB(1) receptors by endocannabinoids may play an important role in the pathogenesis of diabetic cardiomyopathy by facilitating MAPK activation, AT(1)R expression/signaling, AGE accumulation, oxidative/nitrative stress, inflammation, and fibrosis. Conversely, CB(1) receptor inhibition may be beneficial in the treatment of diabetic cardiovascular complications.

Physiol Behav. 2012 Feb 1;
Pan Y, Chaterjee D, Gerlai R

The zebrafish is becoming increasingly popular in behavior genetics because it may allow one to conduct large scale mutation and drug screens facilitating the discovery of mechanisms of complex traits. Strain differences in adult zebrafish behavior have already been reported, which may have important implications in neurobehavioral genetics. For example, we have found the AB and SF strains to differ in their behavioral responses to both acute and chronic alcohol exposure. In the current study, we further characterize these strains using semi-quantitative RT-PCR to measure the expression of ten selected genes and HPLC to measure the levels of nine neurochemicals. We chose the target genes and neurochemicals based upon their potential involvement in alcohol and other drugs of abuse related mechanisms. We quantified the expression of the genes encoding D1-R, D2a-R, D4a-R dopamine receptors, GABA(A)-R, GABA(B)-R1, GAD1, MAO, NMDA-R (NR2D subunit), 5HT-R1bd and SLC6 a4a. We found the gene encoding D1 dopamine receptor over-expressed and the genes encoding GABA(B1) receptor and solute family carrier protein 6 (SLC6) 4a under-expressed in SF compared to AB. We also found the level of all (dopamine, DOPAC, Serotonin, GABA, Glutamate, Glycine, Aspartate, Taurine) but one (5HIAA) neurochemicals tested decreased in SF as compared to AB. These results, combined with previously identified behavioral differences between the AB and SF strains, demonstrate the importance of strain characterization in zebrafish. They now also allow formulation of working hypotheses about possible mechanisms underlying the differential effects of acute and chronic alcohol treatment on these two zebrafish strains.

Aust N Z J Psychiatry. 2012 Feb; 46(2): 132-40
McLean D, Gladman B, Mowry B

Objective: Suicide and attempted suicide are common in individuals with schizophrenia, and evidence exists for a link between substance use disorders and suicidality in this disorder. However, alcohol has not been consistently implicated. We examined the relationship between substance use disorders and suicide attempts in schizophrenia. Methods: We recruited a schizophrenia sample in Australia (n = 821) for genetic analyses. We analysed demographic and clinical variables, including substance use disorders, and their relationship to suicide attempts using generalised equation modelling. Results: A significant association was identified between lifetime alcohol abuse/dependence and suicide attempts (OR = 1.66; 95% CI, 1.23 to 2.24; p= 0.001) after adjustment for potential confounders, but not between cannabis abuse/dependence and suicide attempts, nor between other illicit drug abuse/dependence and suicide attempts. Polysubstance abuse/dependence was also not implicated. Conclusions: These results suggest that the presence of alcohol abuse/dependence may be a risk factor for suicide attempts in individuals with schizophrenia, independent of comorbid substance abuse/dependence.

BJU Int. 2012 Feb 7;
Chung SD, Keller JJ, Lin HC

Study Type - Symptom prevalence (case control) Level of Evidence 3a What's known on the subject? and What does the study add? In recent years, a number of studies have reported a high prevalence of erectile dysfunction (ED) among patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Several studies have reported that the prevalence of ED ranges from 15.0 to 40.5% in men in China with CP/CPPS; however, the previous studies focusing on the prevalence of ED among patients with CP/CPPS all neglected to explore the magnitude of this association. Our study found an association between ED and previously diagnosed CP/CPPS. The odds of previous CP/CPPS were 3.62 times greater for cases than for controls, after adjusting for patient socio-demographic characteristics, comorbidities, obesity, and alcohol abuse/alcohol dependence syndrome. OBJECTIVE: •  To examine the association between erectile dysfunction (ED) and a previous diagnosis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) using a population-based dataset. PATIENTS AND METHODS: •  The data for this case-control study was obtained from the National Health Insurance database. •  A total of 3194 males, who were ≥18 years of age when they first received a diagnosis of ED, were identified and 15 970 controls were randomly selected. •  The prevalence and risk of CP/CPPS among cases and controls were calculated by using conditional logistic regression analysis. RESULTS: •  In total, 667 (3.5%) of the 19 164 sampled subjects had been diagnosed with CP/CPPS before the index date; CP/CPPS was found in 276 (8.6%) cases and in 391 (2.5%) controls (P < 0.001). •  Regression analysis indicated that cases were more likely to have had previous CP/CPPS (odd ratio 3.62, 95% confidence interval 3.07-4.26) after adjusting for patient monthly income, geographical location and urbanization level, as well as hypertension, diabetes, coronary heart disease, renal disease, obesity and alcohol abuse/alcohol dependence syndrome status, when compared with controls. CONCLUSIONS: •  We conclude that there was an association between ED and having been previously diagnosed with CP/CPPS. •  Urologists should be alert to the association between CP/CPPS and ED, and assess the erectile function of patients suffering from CP/CPPS.

Hepatology. 2012 Feb 6;
Tsuchiya M, Ji C, Kosyk O, Shymonyak S, Melnyk S, Kono H, Tryndyak V, Muskhelishvili L, Pogribny IP, Kaplowitz N, Rusyn I

Alcoholic liver injury is a major public health issue worldwide. Even though the major mechanisms of this disease have been established over the past decades, little is known about genetic susceptibility factors that may predispose individuals who abuse alcoholic beverages to liver damage and subsequent pathological conditions. We hypothesized that a panel of genetically diverse mouse strains may be used to examine the role of ER stress and one-carbon metabolism in the mechanism of inter-individual variability in alcoholic liver injury. We administered alcohol (up to 27 mg/kg/d) in high fat diet using intragastric intubation model for 28 days to male mice from 14 inbred strains (129S1/SvImJ, AKR/J, BALB/cJ, BALB/cByJ, BTBR T+tf/J, C3H/HeJ, C57BL/10J, DBA/2J, FVB/NJ, KK/HIJ, MOLF/EiJ, NZW/LacJ, PWD/PhJ, and WSB/EiJ). Profound inter-strain differences (more than 3-fold) in alcohol-induced steatohepatitis were observed among the strains in spite of consistently high levels of urine alcohol that was monitored throughout the study. We found that endoplasmic reticulum stress genes were induced only in strains with the highest liver injury. Liver glutathione and methyl donor levels were affected in all strains, albeit to a different degree. Most pronounced effects that were closely associated with the degree of liver injury were hyperhomocysteinemia and strain-dependent differences in expression patterns of one-carbon metabolism-related genes. CONCLUSION: Our data demonstrate that strain differences in alcohol-induced liver injury and steatosis are striking and independent of alcohol exposure and the most severely affected strains exhibit major differences in the expression of ER stress markers and genes of one-carbon metabolism. (HEPATOLOGY 2012.).

Matern Child Health J. 2012 Feb 4;
Meschke LL, Holl J, Messelt S

High levels of alcohol use among pregnant women have been associated with a spectrum of birth defects. Greater maternal age has been related to an increased risk of drinking during pregnancy. Although the context, process, and outcomes of pregnancy and alcohol use vary by maternal age, no studies have examined predictors of prenatal drinking by age. This study addresses this gap by examining potential risk factors associated with prenatal alcohol use (any versus none) by maternal age (

Gen Dent. 2011 Sep; 59(5): 356-9
Fung EY, Lange BM

Drug abuse and dependence are important and complex health problems, and understanding these issues is important for dental patient management. At the same time, dentists, like their patients, could abuse alcohol and other illicit drugs, which would jeopardize their ability to provide optimum dental care. This article reviews important aspects of drug abuse and dependence, risk factors for dentists, the impact of drug abuse on the dental profession, and various treatment options.

Gastroenterology. 2012 Jan 31;
Liu J, Zhou L, Xiong K, Godlewski G, Mukhopadhyay B, Tam J, Yin S, Gao P, Shan X, Pickel J, Bataller R, O'Hare J, Scherer T, Buettner C, Kunos G

BACKGROUND & AIMS: Obesity-related insulin resistance contributes to cardiovascular disease. Cannabinoid receptor-1 (CB(1)) blockade improves insulin sensitivity in obese animals and people, suggesting endocannabinoid involvement. We explored the role of hepatic CB(1) in insulin-resistance and inhibition of insulin signaling pathways. METHODS: Wild-type mice and mice with disruption of CB(1) (CB(1)(-/-)mice), or with hepatocyte-specific deletion or transgenic overexpression of CB(1)were maintained on regular chow or a high-fat diet (HFD) to induce obesity and insulin resistance. Hyperinsulinemic-euglycemic clamp analysis was used to analyze the role of the liver and hepatic CB(1) in HFD-induced insulin resistance. The cellular mechanisms of insulin resistance were analyzed in mouse and human isolated hepatocytes using small interfering or hairpin RNAs and lentiviral knock-down of gene expression. RESULTS: The HFD induced hepatic insulin resistance in wild-type mice, but not in CB(1)(-/-)mice or mice with hepatocyte-specific deletion of CB(1). CB(1)(-/-)mice that overexpressed CB(1) specifically in hepatocytes became hyperinsulinemic as a result of reduced insulin clearance due to down-regulation of the insulin degrading enzyme. However, they had increased hepatic glucose production due to increased glycogenolysis, indicating hepatic insulin resistance; this was further increased by the HFD. In mice with hepatocytes that express CB(1), the HFD diet or CB(1) activation induced the endoplasmic reticulum (ER) stress response via activation of the Bip-PERK-eIF2α protein translation pathway. In hepatocytes isolated from human or mouse liver, CB(1) activation caused ER stress-dependent suppression of insulin-induced phosphorylation of akt-2 via phosphorylation of IRS1 at serine-307 and by inducing the expression of the serine and threonine phosphatase Phlpp1. Expression of CB(1) was upregulated in samples from patients with non-alcoholic fatty liver disease. CONCLUSIONS: Endocannabinoids contribute to diet-induced insulin resistance in mice via hepatic CB(1)-mediated inhibition of insulin signaling and clearance.