"For over thirty years," writes author and recovering alcoholic Kathleen FitzGerald, "the American Medical Association has recognized alcoholism as a disease with identifiable and progressive symptoms that, if untreated, lead to mental damage, physical incapacity and early death. Yet still do not treat alcoholism as a disease, but as a sin, a social stigma, a moral aberration.

This book takes you on a journey through not only understanding alcoholism and drug addiction, but also addresses the emotional, physical and biological effects of this disease. If you are looking for a way to understand, overcome and recover alcoholism, you must read this book.

Author: Kathleen Whalen Fitzgerald
Paperback: 265 pages
Company: Whales Tales Pr (2002-08-01)
ISBN: 1882195019
List Price: $14.95
Amazon Price: $60.96
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It was once taken for granted that peer-assisted groups such as Alcoholics Anonymous had no “real” value in recovery from addiction. More recently, evidence-based medicine is recognizing a spiritual component in healing—especially when it comes to addiction. The newest edition of Recent Developments in Alcoholism reflects this change by focusing on the 12-step model of recovery as well as mindfulness meditation and other spiritually oriented activity. More than thirty contributors bring together historical background, research findings, and clinical wisdom to analyze the compatibility of professional treatment and nonprofessional support, day-to-day concepts of relapse prevention, the value of community building in recovery, and much more.

Among the topics covered: (1) How and why 12-step groups work. (2) The impact of the spiritual on mainstream treatment. (3) The impact of AA on other nonprofessional recovery programs. (4) AA outcomes for special populations. (5) Facilitating involvement in 12-step programs. (6) Methods for measuring religiousness and spirituality in alcohol research.

Whether one is referring clients to 12-step programs or seeking to better understand the process, this is a unique resource for clinicians and social workers. Developmental psychologists, too, will find Volume 18—Research on Alcoholics Anonymous and Spirituality in Addiction Recovery a worthy successor to the series.

Twelve Jewish Steps to Recovery explains how the Twelve Steps of Alcoholics Anonymous is relevant for Jewish people. Many Jewish people see the Twelve Steps as "Christian" and have difficulty relating to the Steps as Jews. The authors present the Twelve Steps in a Jewish context.

In a spiritually supportive way, Rabbi Olitzky and Dr. Copans resolve questions such as: Why are Jews uncomfortable with the Twelve Steps? How does the Jewish understanding of the material differ from the Christian understanding of it? Which Jewish sources explore the concepts of recovery and renewal? They present a Jewish perspective on the Twelve Steps and offer consolation, inspiration, and motivation for recovery through drawing on traditional Jewish sources and quoting from what recovering Jewish people say about their experiences.

Artist Maty Grünberg's illustrations of the gates of the Old City of Jerusalem open each chapter of Twelve Jewish Steps to Recovery as the reader is welcomed into another stage of a Jewish Twelve Steps experience. These illustrations were selected to emphasize the relationship between heavenly and earthly in all our lives through the prism of Jerusalem.

Author: Kerry M. Olitzky, Stuart A. Copans
Paperback: 136 pages Bargain Price
Company: Jewish Lights Publishing (1991-09)
List Price: $15.99
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Hope and Healing for Children
Hurt by Addiction in the Family

'I have spent my adult life in the company of children who have been my teachers. We got to know each other because someone in each child's life was addicted to alcohol or other drugs.

For thirty years I have had a front-row seat in group watching, learning, and helping these youngest victims of addicted families, children who live with a legacy that can break hearts and destroy souls--one they certainly did not choose. They arrive carrying secrets, confusion, and pain. But almost all find their voice. These children can and do heal.'

Understanding Addiction and Recovery Through a Child's Eyes shares the poignant and profound healing journeys of children who have found their voice and reclaimed their sense of self-worth. Each story reminds us that children have a unique way of viewing the world and shows how, with help, they can build upon strengths and deepen their resilience in spite of living in the shadow of addiction. In addition to the life-affirming stories, esteemed children's counselor Jerry Moe reveals how the healing process transcends the children and has a dramatic impact on the entire family system--especially their parents, giving them a new, deeper commitment to break the multigenerational legacy of addiction.

The Handbook of Alcoholism Treatment Approaches is a comprehensive, results-based guide to alcohol treatment methods. This handbook surveys the various models that have been used to define alcoholism, ending with a discussion of what the authors call "an informed eclecticism." Using this approach, clinicians develop a spectrum of treatment approaches that have proved effective in practice, then match specific clients with the treatment methods that offer the greatest opportunities for success in these specific circumstances. This new edition of this handy reference provides both practitioners and researchers with a rich source of information on treatment interventions demonstrated to be the most successful. Clinical Psychologists and Alcohol Treatment Specialists.

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
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Book 1 in The Vitamin Cure Series
Most people_s diets are woefully inadequate for providing proper nutrition. Even good diets fail to deliver sufficient levels of nutrients. The Vitamin Cure book series highlights the safe and clinically effective use of vitamin supplements for a variety of illnesses. Research continues to prove the immense value of vitamins for maintaining health and fighting disease. The Vitamin Cure books, written by authors who are recognized experts in their field, offer authoritative, up-to-date, and practical information on taking vitamins for particular health problems.

The Vitamin Cure for Alcoholism can help those who suffer from alcohol addiction, their friends and loved ones, and those in the relevant helping professions. Its central message is that alcoholism is primarily a metabolic disease that should be treated nutritionally first. The person called an _alcoholic_ suffers from nutrient deficiency, especially vitamin B3, and seeks relief by consuming alcohol. Megavitamin therapy is not only more effective than drugs or counseling, it is cheaper and safer. Behavioral and psychological treatment approaches have lacked long-term success, largely because they pay little attention to the nutritional needs of alcoholics. In fact, Bill W., the man who cofounded Alcoholics Anonymous (AA), promoted the concept of megavitamin therapy.

Nutrition can cure alcohol addiction.


Author: Abram Hoffer, Andrew W. Saul
Paperback: 144 pages
Company: Basic Health Publications (2009-05-15)
ISBN: 159120254X
List Price: $14.95
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These are people who are alternately amazed, appalled, delighted, depressed, illuminated, disturbed, or simply thrown by their first days, weeks, and months of sobriety. Kettelhack explores the challenges all seem to face: learning to break through loneliness, isolation, and fear; finding ways to deal with anger, depression, and resentment; and learning how to deal with a new and sometimes overwhelming happiness.

Guy Kettelhack has written seven books on recovery. He is completing a Master's degree in psychoanalysis, and is an analyst-in-training at the Boston and New York Centers for Modern Psychoanalytic Studies. A graduate of Middlebury College, Kettelhack has also done graduate work in English literature at Bread Loaf School of English at Oxford University. He lives in New York City.

Author: Guy Kettelhack
Paperback: 142 pages
Company: Hazelden (1998-09-30) (1998-09-30)
ISBN: 1568382308
List Price: $12.95
Amazon Price: $6.01
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Intended primarily for counsellors working with alcoholics, addicts and their families, this text describes three treatment approaches to anger - ventilation, reduction and management - along with their advantages and disadvantages for different types of patients.

When The Natural History of Alcoholism was first published in 1983, it was acclaimed in the press as the single most important contribution to the literature on alcoholism since the first edition of Alcoholic Anonymous's Big Book. George Vaillant took on the crucial questions of whether alcoholism is a symptom or a disease, whether it is progressive, whether alcoholics differ from others before the onset of their alcoholism, and whether alcoholics can safely drink. Based on an evaluation of more than 600 individuals followed for over forty years, Vaillant's monumental study offered new and authoritative answers to all of these questions.

In this updated version of his classic book Vaillant returns to the same subjects with the perspective gained from fifteen years of further follow-up. Alcoholics who had been studied to age 50 in the earlier book have now reached age 65 and beyond, and Vaillant reassesses what we know about alcoholism in light of both their experiences and the many new studies of the disease by other researchers. The result is a sharper focus on the nature and course of this devastating disorder as well as a sounder foundation for the assessment of various treatments.

"The addiction field has long needed a comprehensive set of exercises counselors could use to guide patients through good treatment. The workbooks developed by Dr. Perkinson take the patient from the beginning of treatment to the end. They are written in such a manner that Dr. Perkinson is your mentor and is conversing with you, sharing with you his vast area of expertise and knowledge about recovery. These patient exercises meet the highest standards demanded by accrediting bodies."
--Dr. Bob Carr, Director Substance Abuse Program and Mental Health Services, Sioux Falls V.A. Regional Medical Center, South Dakota

"I have been in the chemical dependency field for over 28 years. I have worked as a counselor, clinical supervisor and executive director in a number of treatment centers. These are the best exercises for alcoholics, drug addicts and problem gamblers that I have ever seen. I have used them for years and patients find them easy to understand. The material covers everything an addict needs to know to enter a stable recovery. I highly recommend these patient handbooks. Patients love them and they make the counselor's job easy. The book makes the job easy as all you will need to help your patient is in one place."
--Bob Bogue, CCSII, CCDC III, Clinical Supervisor

"Dr. Perkinson does and excellent job of bringing together and individualizing 12 step treatment for addicts and gamblers including identifying character defects and relapse prevention. Comments from patients include, 'it has opened my eyes to my gambling and behaviors associated with it' and 'I feel it is easy to work and very self explanatory.'"
--Ron Scherr, CCDC II, Certified Chemical Dependency Counselor, Avera St. Lukes, Worthmore Treatment Center

"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.

Melanie Solomon's book compares and contrasts many different self-help programs so the client can better choose which one best suits his or her needs, as well as contact information for licensed professionals and treatment facilities throughout the U.S. and abroad. "This book is ideal for any addiction professional's waiting room, treatment process, or as an integral part of the client's continuing care plan." (NAADAC-The Association for Addiction Professionals).

"AA-Not the Only Way fills an important niche in the recovery literature. It offers a compact but wide-ranging guide to addiction support and treatment options. The author's recovery story will also be an inspiration to those who find themselves battling a one-size-fits-all system that is supposed to be helping them." (Dr. Tom Horvath, President of SMART Recovery).

Author: Melanie Solomon
Paperback: 106 pages
Company: Capalo Press (2008-11-28)
ISBN: 0976247992
List Price: $24.95
Amazon Price: $15.92
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Whether it's called 'dry drunk' or 'white knuckle sobriety,' it's that stage in recovery when we realize that 'putting the plug in the jug' isn't enough. The next step is taking responsibility for the emotional immaturity that fuels our addictive personality and has a tremendous impact on ourselves and others.

In 12 Smart Things to Do When the Booze and Drugs Are Gone, Allen Berger, Ph.D., draws on the teachings of Bill W. and psychotherapy pioneers to offer twelve hallmarks of emotional sobriety that, when practiced, give people the confidence to be accountable for their behavior, ask for what they want and need, and grow and develop a deeper trust in the process of life. These 'smart things' include:

It is in these practices that we find release from what Bill W. described as an 'absolute dependency' on people or circumstances, and develop the tools to find prestige, security, and belonging within.

Are you sabotaging your own recovery?

To grow in recovery, we must grow up emotionally. This means getting honest with ourselves and facing up to the self-defeating thoughts and actions that put our sobriety at risk. Although there are as many ways to mess up recovery as there are alcoholics and addicts, some general themes exist, which include:

• confusing self-concern with selfishness
• not making amends
• using the program to try to become perfect
• not getting help for relationship troubles
• believing that life should be easy

In simple, down-to-earth language, Allen Berger explores the twelve most commonly confronted beliefs and attitudes that can sabotage recovery. He then provides tools for working through these problems in daily life. This useful guide offers fresh perspectives on how the process of change begins with basic self-awareness and a commitment to working a daily program.

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.

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.

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.

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 (

Ugeskr Laeger. 2012 Jan 31; 174(5): 280-281
Risum M, Ellekvist P

Capnocytophaga canimorsus is a gram-negative bacterial species hosted in the oral cavity of dogs. C. canimorsus can cause sepsis, meningitis and endocarditis. Penicillin is the drug of choice. However, the species is a slow-grower and sometimes missed in blood cultures. Patients with a history of alcoholism, splenectomy or immunodeficiency are at an increased risk of contracting serious infections with C. canimorsus following dog bites. We report a case story of C. canimorsus meningitis contracted after a dog bite.

Dev Psychopathol. 2012 Feb; 24(1): 157-65
Spinelli S, Schwandt ML, Lindell SG, Heilig M, Suomi SJ, Higley JD, Goldman D, Barr CS

The short allele of the serotonin transporter linked polymorphic region (5-HTTLPR) moderates the effects of stress on vulnerability to mood and anxiety disorders. The mechanism by which this occurs may relate to differential sensitivity to stressful life events. Here we explored whether 5-HTTLPR and sex affected behavioral responses to repeated maternal separation in infant rhesus macaques. Behaviors were collected during the acute (Day 1) and the chronic (Days 2-4) phases of the separation, and the effects of duration of separation (acute vs. chronic), genotype (long/long vs. short allele), and sex (male vs. female) on behavioral responses were analyzed across four successive separations. Males increased their levels of locomotion with repeated maternal separation, whereas females exhibited an increase in frequency of self-directed behavior, a measure of "depression-like" behavior. The short-allele predicted increased environmental exploration, particularly during the chronic phase of social separation, indicative of higher arousal. In addition, the short-allele carriers were more likely to increase their levels of self-directed behavior during the chronic phase of separation, as a function of repeated exposures. These findings suggest that the short allele may increase reactivity to repeated, chronic stressors, leaving them more vulnerable to affective psychopathology, with females particularly vulnerable.

Ultrastruct Pathol. 2012; 36(1): 40-7
Skuja S, Groma V, Smane L

Alcohol-induced damage causes dysfunction of selected brain regions. Multidisciplinary studies have provided an extensive description of changes observed in neurons and glia following alcohol consumption. In this study the authors have elucidated preferential cellular vulnerability in three different brain regions. Autopsy material of the prefrontal cortex, striatum, and substantia nigra obtained from the brain tissue of alcoholic subjects was used in this study. We found that dendritic tree and astroglial damage is irreversible, while neuronal somata and most axons do not display irreversible changes.

Seishin Shinkeigaku Zasshi. 2011; 113(10): 1055-7
Takeda M

Biol Psychiatry. 2012 Jan 28;
Urban NB, Slifstein M, Thompson JL, Xu X, Girgis RR, Raheja S, Haney M, Abi-Dargham A

BACKGROUND: Low striatal dopamine 2/3 receptor (D(2/3)) availability and low ventrostriatal dopamine (DA) release have been observed in alcoholism and cocaine and heroin dependence. Less is known about the dopaminergic system in cannabis dependence. We assessed D(2/3) availability and DA release in abstinent cannabis users compared with control subjects and explored relationships to cannabis use history using [(11)C]raclopride positron emission tomography and an amphetamine challenge paradigm. METHODS: Sixteen recently abstinent, psychiatrically healthy cannabis-using participants (27.3 ± 6.1 years, 1 woman, 15 men) and 16 matched control subjects (28.1 ± 6.7 years, 2 women, 14 men) completed two positron emission tomography scans, before and after injection of intravenous d-amphetamine (.3 mg/kg). Percent change in [(11)C]raclopride binding after amphetamine (change in nondisplaceable binding potential, ΔBP(ND)) in subregions of the striatum was compared between groups. Correlations with clinical parameters were examined. RESULTS: Cannabis users had an average consumption of 517 ± 465 estimated puffs per month, indicating mild to moderate cannabis dependence. Neither baseline BP(ND) nor ΔBP(ND) differed from control subjects in any region of interest, including ventral striatum. In cannabis-dependent subjects, earlier age of onset of use correlated with lower [ΔBP(ND)] in the associative striatum when controlling for current age. CONCLUSIONS: Unlike other addictions, cannabis dependence of mild to moderate severity is not associated with striatal DA alterations. However, earlier or longer duration of use is related to lower DA release in the associative striatum. These observations suggest a more harmful effect of use during adolescence; more research is needed to distinguish effects of chronicity versus onset.

Rev Prat. 2011 Dec; 61(10): 1381-5
Balester Mouret S

Inpatient treatment has long been considered the reference in the treatment of alcoholism. It may indeed have many conceptual advantages, but practically it is a method of treatment with high costs and long waiting period. Moreover, reviews of studies evaluating effectiveness of treatment settings for alcohol dependence suggest that no significant differences exist between inpatient and outpatient programs. Therefore, it seems useful to determine indications of inpatient detoxification programs. As we may see, the choice of inpatient detox should be primarily guided by the contra-indications of outpatient detox. However, it also depends very much on patients' preference, essential to success, since they are the lead actors. Some other situations require urgent residential care, regardless of readiness to change or type of alcohol disorder underlying.

Arkh Patol. 2011 Sep-Oct; 73(5): 27-30

The comparative histologic, morphometric and immunohistochemical investigation of a right ventricular myocardium from 3 groups of patients has been carried out. The first group has included 12 patients with an arrythmogenic right ventricular dysplasia (ARVD) confirmed by an endomyocardial biopsy. The second group has consisted of 7 healthy people died a violent death. The third group has included 7 patients with a chronic alcoholism died from an acute alcoholic intoxication. The patients with ARVD and a chronic alcoholism have had an evident adiposis, a moderate fibrosis, and muscle atrophy with only 65% of cardiac hystiocytes. The patients with a chronic alcoholism have had only dystonia of intramural arteries. The cardiac hystiocytes of patients with ARVD have infected by enteroviruses (100%), parvoviruses B19 (58%), adenoviruses (25%), and hepatitis virus C (16%). 83% of observations have had a mixed viral infections.

Transfus Apher Sci. 2012 Jan 25;
Kulaksizoglu M, Gonen MS, Kebapcilar L, Sahin F, Acikgoz B, Demir T, Dincturk E

A 41-year-old man with a history of hyperthyroidism had been treated with methimazole and propranolol for the past 2months. He developed multiorgan dysfunction with acute liver failure, severe lactic acidosis, disseminated intravascular coagulation, heart failure and acute pulmonary edema with rapid deterioration of renal function. The patient had no history of alcoholism, drug abuse, blood transfusion, or exposure to hepatitis A, B, or C. Extrahepatic obstruction was ruled out with an abdominal ultrasonogram. Serologic studies and immunologic tests were negative. This case illustrates the sudden and abrupt deterioration of multiorgan dysfunction due to antithyroid drug administration and thyroid storm. The thyroid storm score of Burch and Wartofsky was 90/140. The multiorgan dysfunction was reversed by discontinuation of the methimazole and treat with hemodialysis, steroids, cholestyramine, nonselective beta-blocker, fresh frozen plasma infusion and supportive management in the intensive care unit. The patient was discharged from the hospital with normal coagulation parameters, renal and liver function tests.

Alcohol Clin Exp Res. 2012 Feb; 36(2): 193-6
Thiele TE

The goals of this commentary are to discuss the important contributions of the work by Kaur and colleagues titled "Corticotropin-releasing factor acting on corticotropin-releasing factor receptor type 1 is critical for binge alcohol drinking in mice," published in this issue of Alcoholism: Clinical and Experimental Research, and to highlight the importance of preclinical research aimed at identifying the neurobiology of binge ethanol drinking.The work by Kaur and colleagues provides an important extension of previous pharmacological evidence implicating the corticotropin-releasing factor (CRF) type-1 receptor (CRF1R) in binge-like ethanol drinking by verifying the role of the CRF1R using genetic tools, and by establishing that CRF, but not urocortin 1 (Ucn1), is the primary neuropeptide associated with the CRF system that modulates binge-like ethanol drinking in C57BL/6J mice.It is suggested that the evidence for a critical role of the CRF1R in excessive ethanol intake observed in both models of binge-like ethanol drinking and dependence-like ethanol intake indicates that overlapping mechanisms may be involved, and that studies that employ models of binge-like ethanol drinking may provide insight into the neurobiological mechanisms that underlie the transition to ethanol dependence.

J Marital Fam Ther. 2012 Jan; 38(1): 122-44
O'Farrell TJ, Clements K

This review of controlled studies of marital and family therapy (MFT) in alcoholism treatment updates the earlier review by O'Farrell and Fals-Stewart (2003). We conclude that, when the alcoholic is unwilling to seek help, MFT is effective in helping the family cope better and motivating alcoholics to enter treatment. Specifically, both Al-Anon facilitation and referral and spouse coping skills training (based on new findings) help family members cope better, and CRAFT promotes treatment entry and was successfully transported to a community clinic in a new study. Once the alcoholic enters treatment, MFT, particularly behavioral couples therapy (BCT), is clearly more effective than individual treatment at increasing abstinence and improving relationship functioning. New BCT studies showed efficacy with women alcoholics and with gay and lesbian alcoholics, and BCT was successfully transported to a community clinic, a brief BCT version was tested, and BCT was adapted for family members other than spouses. Future studies should evaluate the following: MFT with couples where both members have a current alcohol problem and with minority patients, mechanisms of change, transportability of evidence-based MFT approaches to clinical practice settings, and replication of MFT outcomes of reduced partner violence and improved child functioning.