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
Amazon Price: $13.95
Used Price: $13.95

If you've ever wished you could just stop . . .
– drinking – eating – smoking – gambling – shopping (pick one)

For anyone struggling to break the cycle of addiction comes the groundbreaking approach from The Chopra Center, the world-renowned facility that has successfully helped thousands of people change their lives for the better.

Chopra Center cofounder and medical director David Simon, M.D., and bestselling author and personal-growth expert Deepak Chopra outline their revolutionary approach--one that defies outmoded beliefs about recovery, particularly that people 'are' their addictions or that they are powerless to control them. By integrating the best of Western research with Eastern traditions, Simon and Chopra give anyone the tools to uncover the true cause of their addiction and provide comprehensive steps to end it for good. Readers will discover how to:

- Recognize the purpose their habit serves and how to fill the void
- Identify triggers and avoid relapse
- Deal with disappointments, insecurities, or anger in ways that provide lasting relief, not a temporary high
- Use meditation to counter stress
- Choose foods and supplements that will detoxify the body and curb cravings

By following the path thousands have used to turn their lives around, now anyone can have access to the renowned Chopra Center's program to achieve lasting freedom from addiction.

Living Sober Sucks offers a different path that breaks the stereotype of the 12-step system. It is an inspiring, real life story, not like any other story you've heard before. Living Sober Sucks is entertaining, funny, sad, controversial and thought provoking. Written using very raw and straight forward terms. No holds barred when talking to the alcoholic. Reality is reflected on every page. Whether you're a full blown raging alcoholic or just feel like alcohol is complicating your life and relationships, you will get something out of this book. It is an uncomplicated plan for the average person. Everyone knows someone who needs to read Living Sober Sucks.

Living Sober Sucks is not an anti-alcohol book, it is a descriptive work that offers strategies, techniques and ideas to stop letting alcohol run someone's total existence. All drunks are not jerks riddled with flaws, defects and despicable characteristics. Many are genuinely good people who over indulge and make poor choices while under the influence. They do not need the program to break them down, force them into a belief system or rebuild them into something they are not. What they need is to have other viable alternatives, to believe in themselves and their own willpower.

It is true that many problem drinkers have a physical dependency and psychological addiction to alcohol, but it is still a choice to drink. Sparked by the popularity of LivingSoberSucks.com this philosophy is detailed in Living Sober Sucks. It gives readers realistic and tangible examples of how to eliminate guilt, rebuild self-esteem, discover creativity and possibly repair damaged relationships. The reader is shown ways to rid their life of chaos, unnecessary drama and avert the stigma of being titled a recovering alcoholic. They will discover how to feel like and be treated like a normal person. They are shown how to save money and amass a small fortune. Learn to enjoy a fun, fully engaged normal life - sober.

This narrative nonfiction is part memoir but mostly descriptive ideas to help you maintain and enjoy sobriety. Questions are raised on how you can become sober and realistic answers are given.

Author: Mark A. Tuschel
Paperback: 230 pages
Company: CW Media, Inc. (2009-11-18)
ISBN: 098427300X
List Price: $12.95
Amazon Price: $12.95
Used Price: $11.66

"New, scientifically-based approaches that recognize the biological basis of addiction have brought major advances in the treatment of addiction. Dr. Urschel is at the forefront of this treatment paradigm."
Dr. Larry Hanselka, Psychologist

The Proven Scientific Approach to Conquering Addiction and Defeating the Disease

Healing the Addicted Brain is a breakthrough work that focuses on treating drug and alcohol addiction as a biological disease—based on the Recovery Science program that has helped thousands of patients defeat their addictions over the past 10 years. It combines the best behavioral addiction treatments with the latest scientific research into brain functions, providing tools and strategies designed to overcome the biological factors that cause addictive behavior along with proven treatments and medications.

Using this scientific approach, you will learn to conquer the physical factors that keep people tied to drug and alcohol addiction. The proven fact is addiction is not a moral failing or an issue of not having enough willpower. It is a disease of the brain that can and must be treated like other chronic medical illnesses —such as diabetes, hypertension, or asthma—in order to defeat the disease.

This revolutionary program can triple the success rate of patients, from 20-30% to 90%

There Is Hope.

Addiction and Grace offers an inspiring and hope–filled vision for those who desire to explore the mystery of who and what they really are. May examines the "processes of attachment" that lead to addiction and describes the relationship between addiction and spiritual awareness. He also details the various addictions from which we can suffer, not only to substances like alcohol and drugs, but to work, sex, performance, responsibility, and intimacy.

Drawing on his experience as a psychiatrist working with the chemically dependent, May emphasizes that addiction represents an attempt to assert complete control over our lives. Addiction and Grace is a compassionate and wise treatment of a topic of major concern in these most addictive of times, one that can provide a critical yet hopeful guide to a place of freedom based on contemplative spirituality.

For more than a decade, Howard Clinebell's Understanding and Counseling the Alcoholic has been considered the standard work in the field. This updated edition of Clinebell's earlier book expands his work on counseling to encompass the care of persons with drug addiction, behavioral addictions, multiple addictions, and co-dependency. The volume includes a new annotated bibliography.

"This is the most comprehensive summary on understanding and counseling persons with addictions of which I am aware. The book should be part of every counselor's library." --Anderson Spickard, M.D., Professor of Medicine, Vanderbilt Internal Medicine Associates

"This invaluably revised work on addiction is inclusive and comprehensive. Building upon seminal research in alcoholism, this expansive explication of the etiology, treatment, and after-care of those afflicted and affected by addictions provides a pragmatic proposal of care for all practitioners. It gleans the best from the past, appropriates the research of the present, and provides a vision of what effective care might be in the future.--Robert H. Albers, Professor of Pastoral Theology at Luther Seminary and Editor of The Journal of Ministry

Inspiring true stories of recovery from the high-pressure world of business

They reached the pinnacle of their careers in spite of-or sometimes because of-substance abuse. They struggled with sobriety while striving for success, often risking their professional lives on the road to recovery. Now, with honesty, courage, and insight, they share their remarkable stories.

Michael Deaver, former White House deputy chief of staff, describes his recovery as “the single most powerful thing I've ever experienced”-even compared to meeting presidents and kings.

Andrew Zimmern, celebrity chef and TV personality, reveals how he applied the principles of recovery to his profession-“and that's when my career took off.”

Michael Glasser, CEO of Seven Jeans, worked hard and partied harder-until the threat of jail forced him to admit, “I needed help.”

Walter Yetnikoff, former president of CBS Records, talks about leaving the music industry to find meaningful work that enhanced-and was enhanced by--his recovery.

You'll also hear from James Abernathy of the Abernathy-MacGregor Group, bestselling author William Cope Moyers, and ten other business leaders who found newfound success through the healing power of second chances.

Author: Gary Stromberg, Jane Merrill
Paperback: 256 pages Bargain Price
Company: McGraw-Hill (2009-02-11)
List Price: $15.95
Amazon Price: $6.38
Used Price: $5.88

Part of the Wiley Series on Treating Addictions, Treating Alcohol Problems offers the latest evidence-based guidance on effectively diagnosing and treating the full spectrum of problems related to drinking. Whether you are an addictions counselor, mental health professional, or physician, you can use this all-in-one guide as a stepping-stone to seek out and develop better treatment options for your clients.

Bringing treatment approaches into harmony with scientific findings, Treating Alcohol Problems summarizes methods proven to be successful. Written in a clear and accessible style, the text focuses on presenting the information most directly useful for helping clients. This handy guide is ideal for training and continuing education, as a refresher for seasoned professionals, and as a useful primer for all who come into contact with individuals suffering from alcohol abuse.

Coverage includes:Conceptual foundations-defining alcohol problemsIdentifying alcohol problemsAssessment and treatment planningTreatment tools, programs, and theoriesWhen and how clients should be discharged to aftercareIncreasing recovery successCulture, coaching, and change-moving beyond alcohol problemsFinding and getting the best out of professional resources

Supporting this expert coverage, the reader-friendly series format features quizzes, checklists, diagrams, "Research Frontier" boxes, problem-solving scenarios, "Dos and Don'ts" lists, "Test Yourself" questions, suggested resources, and more. These tools help you reinforce your understanding and integrate this knowledge into your practice. In addition, a thorough bibliography and appendix provide lists of contacts for self-help groups, residential and outpatient treatment programs, support groups, Web sites, and reading material.

Treating Alcohol Problems is an essential resource for mental health professionals, as well as an indispensable study guide for students in psychology and social services courses.

Author: Frederick Rotgers, Beth Davis
Paperback: 176 pages
Company: Wiley (2006-04-07)
ISBN: 0471494321
List Price: $47.50
Amazon Price: $35.69
Used Price: $2.64

Finally—a road map to recovery from the nation's most original thinker on addiction

In his revolutionary book The Heart of Addiction, Dr. Lance Dodes examined the underlying emotions that drive addictive behaviors—whether drinking, gambling, sex, or eating. Now, in Breaking Addiction, Dodes presents a comprehensive guide outlining seven critical steps to overcome addiction, based on his findings.

Through his practice and research, Dodes has found that virtually every addictive act is preceded by feelings of helplessness. In his refreshingly clear style, Dodes incorporates case stories to illustrate exactly how these feelings set addiction in motion, how to recognize the path toward addiction—and then how to take back control.

Many people, discouraged by current treatments, have been hungry for an approach that digs addiction up by its roots. Since the publication of The Heart of Addiction, Dodes's ideas have been incorporated by therapists and treatment centers around the country, and are taught by universities and training centers for clinicians.

With special sections for both families and health-care professionals, Breaking Addiction is poised to be the handbook for a new, comprehensive, and in-depth understanding of addiction.

This book offers new strategies, techniques, and scripts for use with problem drinkers, alcoholism, drug addiction, and gambling addiction in an outpatient population. It also reviews old and new techniques or combinations of techniques, strategies, and scripts for other addictions. Five key addictions are addressed: alcohol abuse and dependency, drug abuse and addiction, gambling compulsions/obsessions and addictions, tobacco addiction (including cigars, pipes and chew), food addiction/compulsions.

Many of the techniques and strategies incorporate a variety of therapeutic modalities, including: cognitive-behavioral techniques, reframing and other NLP techniques, systematic desensitization, covert sensitization, 12-step-programs, guided imagery and meditation, and more. The techniques described can be employed both in and out of trance.

Chapter I is an overview of how the author does hypnosis and how he orients new patients to his approaches. Chapter II deals with alcohol abuse and problem drinking using two different models: abstinence and moderation management. Chapters III and IV focus on drug abuse and pathological gambling. Chapters V and VI deal with smoking cessation and weight loss. While much is already written in these two areas, the author presents some novel approaches to packaging the sessions, along with his own approaches to treating these problems. Chapter VII offer conclusions.

In summary, all of the strategies, techniques, and scripts herein have to do with helping clients take more effective control of their lives.

Author: Joseph Tramontana
Paperback: 160 pages
Company: Crown House Publishing (2009-08-28)
ISBN: 0982357362
List Price: $27.95
Amazon Price: $23.14
Used Price: $23.41

Working a 12-step program helps keep many recovering addicts and alcoholics sober, but not necessarily happy. They are often left with unresolved feelings of fear, anger, and grief about their lives.

Addiction and Grief looks at the emotional "bottom" of recovery. Just as one needs to hit bottom with drinking or using in order to begin recovery, eventually one will also hit an emotional bottom of fear, anger, and grief.

Recovery author Barb Rogers challenges readers in recovery to investigate the unresolved grief and loss in their lives; negative emotions that can lead back to using if not resolved.

She begins with a "Grief" list, that helps readers understand where, when, and how fear and anger took control of their lives; then she asks a set of questions to identify how these negative emotions continue to hold them back in recovery.

Addiction and Grief shows that authentic recovery is more than an attitude; it is based on emotional work that involves an honest appraisal of one's life, and the willingness to change.

With an estimated three million older Americans struggling with alcohol and drug misuse and abuse, Aging and Addiction is a much-needed resource. The authors, both experts in the field of addiction treatment and intervention, provide a respectful, definitive guide for recognizing and addressing substance abuse among older adults. Key topics include: understanding the relationship between aging and addiction, finding help for a loved one, and recognizing the treatment needs of older adults.

Key features and benefits authors are widely recognized experts in the field of addiction addresses one of the nation's most underestimated, under treated health problems provides how-to-help information for family members and friends

Author: Carol Colleran, Debra Jay
Paperback: 232 pages
Company: Hazelden (2002-03-07) (2002-03-07)
ISBN: 156838792X
List Price: $15.95
Amazon Price: $8.77
Used Price: $2.13

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.

Addiction. 2012 Mar; 107(3): 478-85
Casswell S

Aims  To review research literature and available information on the extent and impacts of marketing, current policy response and the interests engaged in the policy debate in order to inform recommendations for policy change on alcohol marketing. Methods  Relevant literature, including systematic reviews and publicly available information (websites and participant observation) is reviewed and synthesized. Results  Alcohol marketing has expanded markedly in the past 50 years and, while there remains uncertainty about the impact across the population, there is now clear evidence of its impact on the consumption of young people. Few countries have effective policy in place restricting alcohol marketing, and there is a lack of an international response to alcohol marketing which crosses national boundaries. The protection of alcohol marketing has been a major focus for vested interest groups and this has affected governmental response at national and international levels. There has been a lack of non-governmental organization engagement. The policy response to tobacco marketing provides a clear contrast to that of alcohol marketing policy and provides a model for alcohol marketing policy. Conclusion  The global exposure of young people to alcohol marketing requires an urgent policy response. The Framework Convention on Tobacco Control provides an appropriate model for global governance to control alcohol marketing. There are extant examples of national level legislation achieving comprehensive bans with France's Loi Evin providing a feasible model. Resources from philanthropic organizations to allow non-governmental organization engagement are urgently required, as is engagement by the governmental sector independent of commercial influence.

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.

Addiction. 2012 Mar; 107(3): 461-3
Hedrich D, Farrell M

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.

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 

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;
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.

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;
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;
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.

Brain Nerve. 2012 Feb; 64(2): 163-73
Tsuchida H, Nishimura I, Fukui K

Abstract In this paper, we have outlined the neurobiological basis of alcohol and drug dependence. The prevalence of drug dependence is a serious social problem in many countries, including Japan. This problem involves many background factors, including those pertaining to medical sciences, socio economics, and politics. First, we briefly describe the findings pertaining to psychotomimetic drugs as a model of schizophrenia. The biological pathogenesis of schizophrenic disorders is still unknown. The symptoms of methamphetamine (MAP) and phencyclidine (PCP) psychoses are very similar to those of schizophrenic disorders involving hallucination or delusion. PCP causes not only positive symptoms but also negative symptoms. Therefore, it has been considered as a more comprehensive model of schizophrenia than other drugs. Furthermore, amotivational syndrome, which is observed in patients with chronic cannabis and organic solvent dependence, is similar to the negative symptoms of schizophrenia. Understanding the neurobiological basis of drug dependence by using the molecular biological approach will provide an important clue for elucidating the mechanisms underlying schizophrenia and endogenous psychiatric disorders. Next, we discuss account for the neurobiological mechanisms underlying drug dependence. The reward system in the brain, which is common for all dependent drugs, has been explained, and the stages of addiction corresponding to the development of drug dependence have been discussed followed. In addition, we have discussed the epigenetics aspects of substance dependence, which is one of the hottest topics in psychiatric genetics. We expect that further studies of the mechanisms underlying drug dependence will aid in elucidating of the pathophysiology of various psychiatric diseases.

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.

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.

J Neurosci. 2012 Feb 1; 32(5): 1884-97
Ponomarev I, Wang S, Zhang L, Harris RA, Mayfield RD

Alcohol abuse causes widespread changes in gene expression in human brain, some of which contribute to alcohol dependence. Previous microarray studies identified individual genes as candidates for alcohol phenotypes, but efforts to generate an integrated view of molecular and cellular changes underlying alcohol addiction are lacking. Here, we applied a novel systems approach to transcriptome profiling in postmortem human brains and generated a systemic view of brain alterations associated with alcohol abuse. We identified critical cellular components and previously unrecognized epigenetic determinants of gene coexpression relationships and discovered novel markers of chromatin modifications in alcoholic brain. Higher expression levels of endogenous retroviruses and genes with high GC content in alcoholics were associated with DNA hypomethylation and increased histone H3K4 trimethylation, suggesting a critical role of epigenetic mechanisms in alcohol addiction. Analysis of cell-type-specific transcriptomes revealed remarkable consistency between molecular profiles and cellular abnormalities in alcoholic brain. Based on evidence from this study and others, we generated a systems hypothesis for the central role of chromatin modifications in alcohol dependence that integrates epigenetic regulation of gene expression with pathophysiological and neuroadaptive changes in alcoholic brain. Our results offer implications for epigenetic therapeutics in alcohol and drug addiction.

Am J Hypertens. 2012 Feb 2;
Chen X, Zhang ZX, George LK, Wang ZS, Fan ZJ, Xu T, Zhou XL, Han SM, Wen HB, Zeng Y

BackgroundThis birth cohort study was conducted to investigate the contribution of prenatal and antenatal environmental exposures to later-life hypertensive status.MethodsTwo thousand five hundred and three individuals born in 1921-1954 at the Peking Union Medical College Hospital (PUMCH) were targeted; 2,081 (83.1%) participated. Clinical examinations included an interview, blood pressure (BP) measurements, and laboratory assays. Statistical analyses were performed using ordinal regression models with later-life hypertensive status as the dependent variable. Similar analyses were for subpopulations divided by family history of hypertension.ResultsIn the 2,081 subjects, 449 were normotensive, 531 were prehypertensive, and 1,101 had hypertension. Three hundred and forty two hypertensive patients were classified as high-risk (BP ≥180/110 mm Hg, or accompanied with diabetes or three well-established cardiovascular risk factors); the other 759 patients were at mid-to-low risks. Lower birth weight (

Addiction. 2012 Feb 1;
Mythily S, Abdin E, Vaingankar J, Phua AM, Tee J, Chong SA

Aims:  To establish the prevalence, correlates, comorbidity, and treatment gap of alcohol use disorders in the Singapore resident population. Design:  The Singapore Mental Health Study is a cross-sectional epidemiological survey. Setting:  A nationally representative survey of the resident (citizens and permanent residents) population in Singapore. Participants:  6616 Singaporean adults aged 18 years and older. Measurements:  The diagnoses were established using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI) diagnostic modules for lifetime and 12-month prevalence of select mental illnesses including alcohol use disorders. Results:  The lifetime prevalence of alcohol abuse and alcohol dependence was 3.1% and 0.5%, while the 12-month prevalence of alcohol abuse and alcohol dependence was 0.5% and 0.3%, respectively. The lifetime and 12-month prevalence of alcohol use disorders was 3.6% and 0.8%, respectively. Those with alcohol use disorder had significantly higher odds of having major depressive disorder (OR 3.1) and nicotine dependence (OR 4.5). Compared to the rest of the population, those with an alcohol use disorder had significantly higher odds of having gastric ulcers (OR 3.0), respiratory conditions OR (2.1) and chronic pain (OR 2.1). Only 1 in 5 of those with alcohol use disorder had ever sought treatment. Conclusions:  The prevalence of alcohol use disorders is relatively low in the Singapore adult population. Comorbidity with mental and physical disorders is significant emphasizing the need to screen persons with alcohol use disorders for these comorbidities.

Addiction. 2012 Feb 1;
Friguls B, Joya X, Garcia J, Gómez-Culebras M, Pichini S, Martinez S, Vall O, Garcia-Algar O

Aims:  The study aims to estimate the prevalence of drug use by pregnant women living in Ibiza, using structured interviews and biomarkers in maternal hair In addition, the potential detrimental effects of maternal drug abuse on their newborns were investigated. Ibiza has a large international night-life resort associated with clubs, music and use of recreational drugs. Design, setting and participants:  Hair samples were prospectively collected from January to March 2010 from a cohort of consecutive mothers after giving birth in the Hospital Can Misses in Ibiza. Measurements:  Opiates, cocaine, cannabis, methadone, amphetamines, MDMA and their metabolites were detected in a 3cm. long proximal segment of maternal hair corresponding to last trimester of pregnancy by gas chromatography coupled to mass spectrometry (N = 107). Data on sociodemographic characteristics and on tobacco, alcohol, drugs of prescription and drugs of abuse consumption during pregnancy were collected using a structured questionnaire. Findings:  Hair analysis showed an overall 16% positivity for drugs of abuse in the third trimester of pregnancy, with a specific prevalence of cannabis, cocaine, MDMA and opiates use of 10.3%, 6.4%, 0.9% and 0%, respectively. In the questionnaires, only 1.9% of mothers declared using drugs of abuse during pregnancy. Gestational drug of abuse consumption was associated with active tobacco smoking, a higher number of smoked cigarettes and the mother being Spanish. Conclusions:  Illicit drug use is substantially under-reported among pregnant women living in Ibiza, particularly among Spanish nationals. Voluntary, routine objective biological toxicology screening should be considered as part of routine examinations in antenatal clinics on this Mediterranean Island.

Addiction. 2012 Feb 1;
Houben K, Havermans RC, Nederkoorn C, Jansen A

Aims Previous research showed that consistently not responding to alcohol-related stimuli in a Go/No-Go training reduces drinking behavior. This study aimed to further examine the mechanisms underlying this Go/No-Go training effect. Design, setting, and participants Fifty-seven heavy drinkers were randomly assigned to two training conditions: In the beer/no-go condition, alcohol-related stimuli were always paired with a stopping response, while in the beer/go condition, participants always responded to alcohol-related stimuli. Participants were individually tested in a laboratory at Maastricht University. Measurements Weekly alcohol intake, implicit attitudes toward beer, approach-avoidance action tendencies toward beer, and response inhibition were measured before and after the training. Findings Results showed a significant reduction in both implicit attitudes (p= .03) and alcohol intake (p= .02) in the beer/no-go condition, but not in the beer/go condition. There were no significant training effects on action tendencies or response inhibition. Conclusions Repeatedly stopping prepotent responses toward alcohol-related stimuli effectively reduces excessive alcohol use via a devaluation of alcohol-related stimuli rather than via increased inhibitory control over alcohol-related responses.

Am J Psychiatry. 2012 Jan 31;
Potenza MN, Hong KI, Lacadie CM, Fulbright RK, Tuit KL, Sinha R

OBJECTIVE: Although stress and drug cue exposure each increase drug craving and contribute to relapse in cocaine dependence, no previous research has directly examined the neural correlates of stress-induced and drug cue-induced craving in cocaine-dependent women and men relative to comparison subjects. METHOD: Functional MRI was used to assess responses to individualized scripts for stress, drug/alcohol cue and neutral-relaxing-imagery conditions in 30 abstinent cocaine-dependent individuals (16 women, 14 men) and 36 healthy recreational-drinking comparison subjects (18 women, 18 men). RESULTS: Significant three-way interactions between diagnostic group, sex, and script condition were observed in multiple brain regions including the striatum, insula, and anterior and posterior cingulate. Within women, group-by-condition interactions were observed involving these regions and were attributable to relatively increased regional activations in cocaine-dependent women during the stress and, to a lesser extent, neutral-relaxing conditions. Within men, group main effects were observed involving these same regions, with cocaine-dependent men demonstrating relatively increased activation across conditions, with the main contributions from the drug and neutral-relaxing conditions. In men and women, subjective drug-induced craving measures correlated positively with corticostriatal-limbic activations. CONCLUSIONS: In cocaine dependence, corticostriatal-limbic hyperactivity appears to be linked to stress cues in women, drug cues in men, and neutral-relaxing conditions in both. These findings suggest that sex should be taken into account in the selection of therapies in the treatment of addiction, particularly those targeting stress reduction.