Lifelines: September-October, 1971

Lifelines is a bi-monthly educational journal on alcohol and alcoholism published by the South Carolina Commission on Alcoholism under enactment of the South Carolina General Assembly of 1957

Alcoholism: a high priority health problem

This report summarizes the problem and the historical background of alcoholism, evaluates prevention programs, and offers a reference guide for tribes and communities wishing to undertake alcoholism projects

Alcohol Research: A Lifespan Perspective

Contents: The Embryo and Fetus: Focus on Fetal Alcohol Spectrum Disorder (FASD) and Fetal Alcohol Syndrome (FAS) Midlife Focus on Detrimental Effects of Drinking and on Treatment Options Senior Adults and Alcohol: A National Health Issue Alcohol use and the risk for alcohol-related problems change over the lifespan. College students and young adults, who often drink large quantities of alcohol at one time, are more likely to experience problems such as alcohol poisoning, drunk-driving crashes, and assaults; whereas, older individuals who drink even moderately while taking certain medications run the risk of harmful drug interactions. Additionally, patterns of alcohol use may differ across the human lifespan—for example, adolescents who begin drinking prior to age 14 are more likely to develop a serious problem with alcohol later in life. Understanding how alcohol influences people across different life stages is important, especially when designing effective approaches for diagnosing, treating, and preventing alcohol abuse and dependence and their related problems. In 2006, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) published the Five-Year Strategic Plan, The NIAAA Strategic Plan for Research. The Five-Year Plan introduces a new organizing principle for alcohol research studies: A Lifespan Perspective. This new perspective gives researchers a framework within which to examine how alcohol affects people at different stages of development and how different stages of development affect drinking behaviors. The Five-Year Plan examines the current state of alcohol research—what we know about alcohol-related issues— within a Lifespan Perspective, and suggests opportunities for new research and outreach based on these findings. Since 2006, the Five-Year Plan has been revised once, and NIAAA will continue to provide updates to reflect new and emerging research opportunities. This Alcohol Alert presents some of the findings and opportunities outlined in the latest version of the Five-Year Plan

IHS Capital Financing and Health Care Reform

This document is the primary publication of a 1984-1986 management review of the Indian Health Service (IHS)-sponsored alcohol programs serving American Indians and Alaska Natives. The IHS Alcoholism/Substance Abuse Prevention Initiative: Background, Plenary Session, and Action Plan is the manifesto of the alcohol/substance abuse programs for the future. The overall purposes of the review were: 1) to define the scope of alcohol treatment and prevention efforts at all levels; 2) to identify existing program strengths; 3) to identify unique approaches to be considered for broader application; 4) to identify deficiencies; 5) to set forth the actual steps to remedy the deficiencies; and 6) to make recommendations for the mission and future direction of the IHS and alcoholism program efforts. The Background section is designed to expose the trends and issues affecting the alcoholism programs prior to 1984. The Plenary Session documents the proceedings of the second stage of the alcoholism programs management review. The Action Plan is a presentation of the recommendations developed by the contributors in the plenary session. The Action Plan was designed to address all of the relevant managerial functions, including planning, standards setting, monitoring, evaluation, resource management, operations, coordination, research, and training. The complete document provides the rationale, structures, and strategies necessary to chart a new direction that will demand enhancement of treatment program effectiveness and a realignment of resources in response to advancements in institutional knowledge and experience.This document comprises the published results of a management review of the IHS alcoholism programs that was requested by the Director of the IHS, Everett R. Rhodes, M.D., and initiated in the summer of 1984. Participants in this comprehensive program review included: 1) tribal leader representatives from each area; 2) alcohol program representatives from each area or program office; 3) IHS area alcoholism coordinators; 4) IHS line and staff officials; 5) individuals knowledgeable in the field of alcohol/substance abuse but not directly connected to IHS or tribal programs; and 6) 30 individuals from the outside who expressed interest in contributing to the process. The three major tasks of the reviewers were to: 1) develop a briefing book; 2) complete a plenary session with a set of recommendations; and 3) develop and gain the approval for an action plan based upon the recommendations coming out of the plenary session.The Director, IHS, asserted that many IHS physical plants were currently inappropriate for providing alcohol services. He concluded that these problems are solvable. In addition, he called for better horizontal and vertical communications between and within the IHS health care system and the alcohol programs. Various IHS staff, substance abuse program professionals, Federal officials, researchers, and academicians contributed their perspectives on the future direction of alcohol prevention and treatment efforts in the American Indian community. Highlights of these perspectives included: 1) community-based programs and coordination with other agencies; 2) the need for both residential and outpatient treatment services; 3) tribal leadership involvement in the recognition of alcohol as a problem; 4) good professional education for IHS doctors and nurses; 5) the importance of standardized recordkeeping for the purposes of comparison and evaluation; 6) the use of traditional healers; 7) the need to provide incentives for those programs that excel, and the continued support for those that do not function well or at all; 8) the emphasis on culture to the success and failure of different programs; 8) identification of generalizable attributes associated with the success of alcoholism prevention efforts among American Indians; and 9) the view of alcoholism as a psychosocial medical disease requiring an holistic approach to treatment.The Action Plan was developed with the assistance of the information disseminated during the Plenary Session. Specific activities, and a specific timeline for their implementation, were itemized for all nine essential management functions (listed above). Specific recommendations focused on managing scarce resources, finding additional resources, focusing on prevention, targeting youth and women for prevention activities, improving training for IHS professionals and staff to incorporate a clear understanding of alcoholism as a disease and to heighten cultural awareness. A management information system was initiated as a result of this review, and research priorities were established. Also, a plan was outlined to facilitate the monitoring of programs, and establishing a system for supporting the demands of the evaluation process. A persistent recommendation appearing throughout the review was the need to bring tribal governments into all facets of IHS involvement in alcoholism treatment and prevention, and to find ways to further involve Congressional delegates in the process

NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM Strategic Plan and Budget to Reduce and Ultimately Eliminate Health Disparities

NIAAA-supported research reveals that about one-third of Americans do not drink at all and the majority of those who do drink, do so without adverse consequences. But pressing questions still persist. Why do some people exhibit a pathological appetite for alcohol despite serious physical and social problems? Why are some individuals more vulnerable to the effects of alcohol

Effects of beverage alcohol taxes and prices on drinking: a meta-analysis of 1003 estimates from 112 studies

Aims: We conducted a systematic review of studies examining relationships between measures of beverage alcohol tax or price levels and alcohol sales or self-reported drinking. A total of 112 studies of alcohol tax or price effects were found, containing 1003 estimates of the tax/price–consumption relationship. Design: Studies included analyses of alternative outcome measures, varying subgroups of the population, several statistical models, and using different units of analysis. Multiple estimates were coded from each study, along with numerous study characteristics. Using reported estimates, standard errors, t-ratios, sample sizes and other statistics, we calculated the partial correlation for the relationship between alcohol price or tax and sales or drinking measures for each major model or subgroup reported within each study. Random-effects models were used to combine studies for inverse variance weighted overall estimates of the magnitude and significance of the relationship between alcohol tax/price and drinking. Findings: Simple means of reported elasticities are -0.46 for beer, -0.69 for wine and -0.80 for spirits. Meta-analytical results document the highly significant relationships (P < 0.001) between alcohol tax or price measures and indices of sales or consumption of alcohol (aggregate-level r = -0.17 for beer, -0.30 for wine, -0.29 for spirits and -0.44 for total alcohol). Price/tax also affects heavy drinking significantly (mean reported elasticity = -0.28, individual-level r = -0.01, P < 0.01), but the magnitude of effect is smaller than effects on overall drinking. Conclusions: A large literature establishes that beverage alcohol prices and taxes are related inversely to drinking. Effects are large compared to other prevention policies and programs. Public policies that raise prices of alcohol are an effective means to reduce drinking

Effect of Reimbursement Reductions on Bone Mineral Density Testing for Female Medicare Beneficiaries

Abstract Background: We examined whether the recent reimbursement reductions on the bone mineral density (BMD) test affected BMD testing in female Medicare beneficiaries with or without supplemental private health insurance. Methods: Retrospectively analyzing hospital administrative and clinical data on female Medicare beneficiaries (n=1320), we reviewed whether participants received BMD testing before (January 2004?December 2006) or after (January 2007?December 2009) reimbursement reductions for BMD testing. After adjusting for demographics and clinical characteristics, we performed Cox proportional hazard regression analyses of the BMD test including data from all study participants; we then performed separate regression analyses using data with or without supplemental private health insurance. Results: In those without supplemental private health insurance (n=421), less frequent BMD testing occurred after reimbursement reductions for BMD testing (hazard ratio [HR] 0.67, 95% confidence intervals [CI] 0.34-0.98; p=0.03). By contrast, in the overall participants (n=1320) and those with supplemental private health insurance (n=899), the number of BMD tests did not change significantly after reimbursement reductions for BMD testing. Conclusions: We found a significant association between reimbursement reductions and decrease in BMD tests in female Medicare beneficiaries without supplemental private health insurance.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98463/1/jwh%2E2012%2E3517.pd

A New Measure of Binge Drinking: Prevalence and Correlates in a Probability Sample of Undergraduates

A standard measure defines binge drinking as the consumption of 5 or more drinks in a row for men (4 or more drinks for women) on at least 1 occasion during the past 2 weeks. A revised operational definition of binge drinking was developed by the National Institute on Alcohol Abuse and Alcoholism in 2004 and incorporated the duration of the drinking episode in addition to the quantity of alcohol consumed. This study compares the standard and new binge measures for overall and subgroup prevalence rates; associations with gender, race/ethnicity, and age of drinking onset; and associations with negative drinking consequences. Methods : A probability sample of 4,580 randomly selected college students (50.3% female, M age=19.9, SD =2.0) at a large Midwestern university in the United States completed a Web-based survey of alcohol and other drug use. Participants reported on past 2-week binge drinking using the standard measure and past-year binge drinking using the new measure. Results : The longer past-year time frame of the new measure yielded a higher prevalence estimate of binge drinking (63.6%) compared with the 2-week standard measure (53.2%). Approximately 9.9% of those who were classified as binge drinkers using the 2-week standard measure were classified as non–binge drinkers using the new measure specification of a 2-hour duration for the drinking episode. The past-year new binge measure was positively associated with negative drinking consequences even when the 2-week measure was statistically controlled. Conclusions : Using a longer time frame and incorporating the duration of the drinking episode, the new measure of binge drinking appears to capture an important element of risky alcohol involvement in college students that is not fully assessed by the standard measure.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65718/1/j.1530-0277.2006.00234.x.pd