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

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

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

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

Feasibility of Using Interactive Voice Response to Monitor Daily Drinking, Moods, and Relationship Processes on a Daily Basis in Alcoholic Couples

Daily process research on alcohol involvement has used paper-and-pencil and electronic data collection methods, but no studies have yet tested the feasibility of using Interactive Voice Response (IVR) technology to monitor drinking, affective, and social interactional processes among alcoholic (ALC) couples. This study tested the feasibility of using IVR with n  = 54 ALC couples.Participants were n  = 54 couples (probands who met criteria for a past 1-year alcohol use disorder and their partners) recruited from a substance abuse treatment center and the local community. Probands and their partners reported on their daily drinking, marital interactions, and moods once a day for 14 consecutive days using an IVR system. Probands and partners were on average 43.4 and 43.0 years old, respectively.Participants completed a total of 1,418 out of a possible 1,512 diary days for an overall compliance rate of 93.8%. ALC probands completed an average of 13.3 (1.0) diary reports, and partners completed an average of 13.2 (1.0) diary reports. On average, daily IVR calls lasted 7.8 (3.0) minutes for ALC probands and 7.6 (3.0) minutes for partners. Compliance was significantly lower on weekend days (Fridays and Saturdays) compared to other weekdays for probands and spouses. Although today’s intoxication predicted tomorrow’s noncompliance for probands but not spouses, the strongest predictor of proband’s compliance was their spouse’s compliance. Daily anxiety and marital conflict were associated with daily IVR nonresponse, which triggered automated reminder calls.Findings supported that IVR is a useful method for collecting daily drinking, mood, and relationship process data from alcoholic couples. Probands’ compliance is strongly associated with their partners’ compliance, and automated IVR calls may facilitate compliance on high anxiety, high conflict days.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79396/1/j.1530-0277.2009.01115.x.pd

Differences of Photographs Inducing Craving Between Alcoholics and Non-alcoholics

Many researchers have used cue reactivity paradigm to study alcohol craving. But the difference of craving response to drinks between alcoholic patients and social drinkers was little evaluated. To investigate characteristics of alcohol-related visual cues which induce alcohol craving in alcoholism, we examined the response of subjects to alcohol-related cues considering qualitative aspects. The authors developed 27 photographs related to alcohol as candidate visual cues. Thirty five patients with alcohol dependence, 35 heavy drinkers and 35 social drinkers were shown these pictures and asked to rate these 6 pictures in order of inducing alcohol craving the most. 'A glass of Soju' and 'A Party scene' were chosen as the alcohol-related visual cues which induced craving the most in the patients and heavy drinkers, respectively. The results suggest that the patients with alcohol dependence are more absorbed by alcohol without drinking context such as an atmosphere or situation involving drinking. Heavy drinkers may experience craving in anticipation of being in a drinking situation