Initiative urges thinking before drinking

Web site lets people learn what type of drinker they are

By Mary Brophy Marcus
USA Today

Many young adults socialize on weekends and weeknights at bars and parties where cocktails and beers flow, but most don't give much thought to their drinking habits, said Mark Willenbring, director of the Division of Treatment and Recovery Research at the National Institute on Alcohol Abuse and Alcoholism. If they did, he said, it's likely that fewer people would develop problems with alcohol abuse later in life.

To that end, Willenbring and other experts at NIAAA have developed a "Rethinking Drinking" Web site — Rethinking Drinking.niaaa.nih.gov — to help people who drink alcoholic beverages determine what type of drinker they are and whether they are at a risk for developing a drinking problem.

reducing risks

"Not everybody who drinks more than is medically healthy or recommended realizes they are doing it," Willenbring said. About 30 percent of Americans have too many drinks in one day at least once a year, he says.

The heaviest drinkers are primarily between the ages of 18 and 30, and they are the target population for "Rethinking Drinking," Willenbring said.

"They are a group that drinks more than is healthy, but doesn't have the health problems yet."

Willenbring likens the interactive Web site to a prevention tool. The approach is similar to how a doctor might focus on groups at risk for heart disease — those with high blood pressure or cholesterol — but who haven't had a heart attack yet. "We're really doing risk reduction," he said.

In any given year, about 4 percent of the population has alcohol dependence, or alcoholism, according to Willenbring. About 26 percent are heavy drinkers. "Even if these folks, the heavy drinkers, reduce their drinking, the public health impact is great," he said.

While many associate heavy drinking with liver problems, it can also increase the risk for heart disease, sleep disorders, depression, stroke and stomach bleeding. Consumed during pregnancy, it can cause fetal brain damage, said Fulton Crews, director of the Bowles Center for Alcohol Studies at the University of North Carolina-Chapel Hill School of Medicine. It's also linked to cancer.

"We know if you're a heavy drinker but not alcohol dependent, your risk of oral cavity cancer and also breast cancer are increased," Crews said.

at-risk drinking

The "Rethinking Drinking" site asks if visitors know what constitutes at-risk drinking. Many might be surprised to learn what does, said alcohol-abuse expert Charles O'Brien, a professor of psychiatry at the University of Pennsylvania.

"A heavy drinking day is a lot less than most people think it is," O'Brien said. "We have in college and universities many who do binge drinking and they don't even realize it. When I told my students the daily limits, they laughed at me. Many said that's barely getting started — that they have a few drinks in their dorm rooms even before going out drinking for the night."

The site provides illustrations and tables showing the amount of alcohol in a variety of drinks, including beer, wine and liquor. A calculator can help one estimate how much a typical toddy includes. Drinkers who want to make changes can find some helpful tools and resources, too.

The site isn't meant to promote abstinence, Willenbring says. It doesn't demonize alcohol. In fact, it even points out that light to moderate drinking on a regular basis can lower the risk for heart disease for some.

Schoolteacher, soccer mom, athlete, physician, husband — anyone who cares to find out if their drinking habits are risky or not can now do so on their own, Willenbring said.

Drug Research and Recovery Act of 2009

What's in the budget for addiction scientists?

Scientists were among the likely beneficiaries of President Obama’s American Recovery and Reinvestment Act of 2009.

The National Institutes of Health (NIH) is slated to receive $10 billion for use over the next two years. A yet-to-be-determined portion of the grant will end up with the National Institute on Drug Abuse (NIDA).

Here is a sampling of NIDA’s wish, or “Challenge Topics” for which the agency is seeking grant proposals. The application due date is April 27, 2009.

--Dietary treatment of substance disorders.
“There is abundant preclinical and clinical evidence that suggest dietary therapies and behavioral interventions can promote neurogenesis, diminish susceptibility to metabolic and excitotoxic injury (e.g., diets rich in antioxidants), and/or counteract stress responses within the brain. Dietary regimens or supplements can be evaluated as individual treatments or as adjuncts to FDA-approved medications.”

--Drug genetics and informed consent.
“Address ethical issues related to access to broad sharing and use of new genetic information and technologies for addiction research to improve treatment and prevention options for addicts.”

--Addiction drugs combined in treatment.
“Network biological analysis predicts that modification of a single target by a drug is not nearly as likely to affect disease outcome as would rational combinations of drugs that target multiple, complementary mechanisms. Applications will focus on combination of medication strategies for the treatment of substance use disorders.”

--Neurobiology of opioid addiction.
“There is an urgent need for research that will more thoroughly delineate the neurobiological implications of long-term opioid use. This knowledge gap is of particular concern when it comes to the developing brain - and the urgency is underscored by the fact that increasing numbers of adolescents and young adults are using opioid medications, prescribed and otherwise.”

--Research on addiction drugs for pregnant women.
“Substance abuse during pregnancy often occurs in the context of complex environmental factors and poly-drug exposure, as well as medical conditions which are associated with adverse neonatal consequences. Much is known in regard to the negative effects of substances of abuse on the pregnant/post partum women and their substance exposed neonates but relatively little is known in regard to medication treatment strategies and research methodology.”

--Internet-based prevention and treatment in rural locations.
“Many persons living in remote or rural locations have limited opportunities to obtain drug abuse treatment services, due to a lack of available service settings, the barrier of traveling long distances, and/or the perceived lack of private and confidential treatment options. This program seeks to develop web-based drug abuse treatment interventions that do not necessitate frequent in-person visits to a central facility.”

--Finding new molecular targets for addiction treatment drugs.
“Projects may utilize techniques ranging from gene knockout technologies, behavioral evaluations, assay development, and targeted library synthesis and screening that could lead to the development of medications for drug addiction treatment. The focus may be on the identification of new molecular targets, and/or the discovery of small molecule selective ligands for previously identified targets, such as muscarinic M5 antagonists, neuropeptide Y antagonists, and neurotensin agonists.”

For general information on the National Institute on Drug Abuse implementation of NIH Challenge Grants, contact:

Christine Colvis, Ph.D.
NIDA Challenge Grant Program Coordinator
National Institute on Drug Abuse
National Institutes of Health
Phone 301-443-6480
Email ccolvis@nida.nih.gov
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source: Addiction Inbox

Drunken driving connected to mental problems

Stockholm (IANS): Drunken driving is not just an indication of a deeply seated alcohol problem but is also very often connected to psychological disease and chronic criminal background, says a doctoral thesis presented at the Karolinska Institute (KI).

Psychologist Beata Hubicka has in collaboration with the Swedish traffic authority, Vagverket, and the police, carried out a nationwide study involving 1,200 drivers who were charged with drunken driving.

The suspect alcoholic offenders, along with a research group of 786 assuredly sober drivers, were called upon to answer a questionnaire on their alcohol consumption habits. The psychosocial and psychotic health condition of some of the drunken drivers was examined too.

"Earlier research in this area has mostly been undertaken in the US," Hubicka told IANS, after her dissertation at the KI. "However, it became essential to carry out an entirely Swedish study since we have different promille (alcohol in the blood permissible for driving) limits and different attitudes towards drunken driving compared to the US. Such variables have also to be taken into account when dealing with this problem in other countries."

The well-received study shows that "more than a half of the suspected alcohol abusers had earlier committed criminal offences. A large number among the abusers were also found to be suffering serious psychotic problems."

"Since such a large number have psychotic problems and a criminal background," says Hubicka, "one should not direct attention solely towards their alcohol problem in any preemptive efforts to resolve drunken driving".

Hubicka said: "The current limit for drunken driving of 0.2 promille (in Sweden, among the strictest globally) is based on physiological studies in which it has been observed and recorded that our capacity for reaction (reflexes) is dangerously impaired with such an alcohol level (in the blood). Since alcohol abuse is such a big risk factor (cause) for drunken criminality, the result of our study should perhaps form the basis for a reconsidered alcohol limit for driving. I would rather suggest that we follow the few countries that have established zero-tolerance."

One-Third of Americans Have an Addicted Relative

Nearly 1/3 of Americans have an immediate family member who has or have had an alcohol or drug abuse problem and almost half of those families have more than one member who had an addiction problem. For most of those families the most significant negative consequence of that addiction is the embarrassment or social stigma.

These finds were part of the "Attitudes Toward Addiction Survey" conducted by the Hazelden organization.

The telephone survey of 1,000 adults revealed some lingering stigma associated with alcoholism and drug addiction in spite of the fact 78% of those surveyed agreed that drug addiction is a chronic disease rather than a personal failing.

According to Hazelden, when survey participants were asked to describe people who have problems with drugs or alcohol included: "sinner," "irresponsible," "selfish, "stupid," "uncaring," "loser," "undisciplined," "pitiful," "pathetic," "weak," "criminal," "derelict," "washed up" and "crazy."

"What Hazelden's new survey brought home to me is that Americans understand addiction is a disease, yet much more work must be done to explain how effective treatment can be for addicts and to bring an end to the stigma that prevents addicts from pursuing treatment," said William Cope Moyers, executive director of Hazelden's Center for Public Advocacy in a news release.

The Prevalence of Addiction

Here are some of the survey findings about the prevalence of addiction:

* Nearly one-third of Americans reported past abuse of alcohol or drugs in their immediate family.

* Of those households with an immediate family member who had an addiction problem, 44% reported more than one family member with a drug problem.

* A third of the families which reported a drug problem in their immediate family say that a majority of their family members have problems with drugs.

* With one in six of the respondents dealing with substance abuse in their family, every member of the family has a problem with drugs or alcohol.

* When asked about extended family, virtually half of Americans surveyed reported three or more family members have experienced a problem with drugs during their lives.

Attitudes About Prevention, Treatment

The survey also revealed attitudes about prevention and treatment efforts:

* 79% percent feel the War on Drugs has not been successful.

* 83% agree that much more should be done to prevent addiction.

* 83% believe that first-time drug offenders should get chemical dependency treatment rather than prison time.

* 77 percent agree that many addicts who complete treatment go on to lead useful lives.

* 71% agree health insurance should cover addiction treatment, but most have no idea if their own insurance will pay.

As a result of the survey, Hazelden's Center for Public Advocacy will launch a public advocacy campaign in Washington, D.C. and across the United States this year.
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source: http://alcoholism.about.com

New Recovery

ALL ADDICTS ARE DIFFERENT — NOW THERE'S A TREATMENT THAT IS TOO

As a professional experienced with alcohol and drug addiction, you know those struggling with this debilitating disease face a long journey towards sobriety – one that requires a customized, leading-edge recovery program with a personalized approach. Unfortunately, there are few programs today that go above and beyond the standardized treatment formula to improve the odds for long-term sobriety. That's why Enterhealth, a premier alcohol and drug addiction recovery center, with its proven therapeutic approaches, neurology, technology, and leading anti-addiction medications, is earning a reputation as the better way to recover.

Here are just a few reasons why Enterhealth stands out from more traditional alcohol and drug addiction treatment programs. To learn more on how Enterhealth can help you and your clients, call 800.388.4601 or visit us at enterhealth.com.

Reason 1: Neuro therapy. In order to help clients overcome physical trauma to the brain caused by addiction, Enterhealth utilizes neurological therapy techniques. This integration of state-of-the-art diagnostics of the brain with clinical therapies involves an MRI to assess any damage caused to the brain by alcohol and/or drug use, an EEG to assess risk level of seizure, and a written neuro-psych test to check for cognitive brain function loss. The results of this evaluation support a personalized treatment plan.

Reason 2: Anti-addiction medications. Rather than rely on talk therapy alone, Enterhealth offers clients access to the latest, most effective anti-addiction medications such as Suboxone, Campral, and Vivitrol. This can help not only repair damage to the brain caused by alcohol and drug use, but also reduce cravings, providing them the opportunity to more fully participate and benefit from treatment.

Reason 3: Length of stay. In contrast to most residential treatment facilities that offer a typical length of stay of 28-30 days, Enterhealth recommends a customized length of stay based on the client's unique needs and recovery progress. This better ensures the client has the tools they need to continue sobriety post residential treatment.

Reason 4: Dual diagnosis. The Enterhealth facility is designed to diagnosis and treat both the addiction as well as other mental health disorders – which in most cases is what creates the desire for alcohol or drugs in the first place. By treating the mental disorder in tandem, typically with personalized, private therapy, the odds for relapse are greatly reduced.

Reason 5: Wellness emphasis. Enterhealth's personalized wellness program includes individual time with a trainer as well as a dietician to address physical and dietary patterns that are recommended for balance and healthy living.

Reason 6: Balance of group & private therapy. The Enterhealth facility is limited to 16 clients, offering an industry-low therapist-to-client ratio of 1:3. This intimate setting allows more focus to be placed on individualized, one-on-one therapy, while also supporting a menu of both small and large group therapies.

Reason 7: Post Residential Support. As your clients transitioned back to your care from the residential addiction treatment program, Enterhealth’s online Life Care program can assist them in continued recovery through access of Enterhealth's online recovery tools 24 hours a day from anywhere in the world.

We invite you to schedule a tour and meet our team. To learn more about what makes Enterhealth a better way to recovery and how it can help your clients, call 800.388.4601 or visit us at www.enterhealth.com

JOIN TOGETHER MERGES INTO CASA

NEW YORK, N.Y., January 15, 2009 – The National Center on Addiction and Substance Abuse (CASA) at Columbia University announced today that Join Togethertm will be merged into CASA and David L. Rosenbloom, Ph.D., will become the President and Chief Executive Officer of CASA on May 1, 2009, succeeding Joseph A. Califano, Jr., the former U.S. Secretary of Health, Education, and Welfare who founded CASA in 1992 and has been its Chairman and President since that time. Califano will continue to serve as CASA chairman.

“Naming David Rosenbloom CASA’s new president is the result of more than two years of work by the Board which involved an analysis of CASA’s first 16 years, discussions with 100 individuals and institutions about CASA achievements and potential, the needs of the substance abuse field, and an intensive search involving a number of qualified candidates. The Board and I are convinced that David Rosenbloom is the individual best suited to move CASA forward and increase its influence and activities,” said Califano. “Merging Join Together into CASA will greatly strengthen CASA’s ability to inform the American people of the economic and social costs of substance abuse and its impact on their lives, make CASA’s research findings and recommendations widely available to those working on the front lines to prevent and treat substance abuse and addiction, and significantly expand our nationwide advocacy capacity. The combination of CASA and Join Together will produce a total far greater than the sum of the parts.”

Rosenbloom, 64, has been Director of Join Togethertm since he founded it in 1991. He is a Professor of Public Health at the Boston University School of Public Health. For eight years, from 1973 to 1985, he was Commissioner of the Department Health and Hospitals for the city of Boston and CEO of Boston City Hospital. For several years after that he was president and CEO of Health Data Institute, a company that pioneered the clinical analysis of medical claims data and developed managed care techniques. He received his BA from Colgate University in 1965 and his Ph.D. from the Massachusetts Institute of Technology in 1970.

“Progress in addiction prevention and treatment is essential in order to reform America’s health care system and address most other critical social problems facing the nation. Combining the resources of CASA and Join Together creates the critical mass needed to focus the attention of our nation and its leaders on the need for effective prevention and treatment policies to achieve such progress. It blends the formidable research of CASA and the public and policy attention that CASA has attracted with the unique web based education and advocacy and tools of Join Together. I am excited by the opportunity to combine and lead these talented teams and work with Joe Califano,” said Rosenbloom.

Join Togethertm is the leading provider of news, information and continuing education on tobacco, alcohol and illegal, prescription and performance enhancing drugs to policy makers, community leaders, parents, and front line prevention and treatment practitioners; all free of charge to more than 50,000 subscribers and 7,000 daily users of its website http://www.jointogether.org/. Its advocacy campaigns promote adoption of prevention and treatment policies and practices that research has shown to be effective.

“CASA is the premier think/action tank in the field with the brightest group of professionals ever assembled under one roof to research and combat substance abuse and addiction. David has the right experience, talent and creativity to enhance this national asset. We are fortunate that he has accepted this challenge,” said Califano. “I look forward to working with him.”

CASA is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA and its staff of more than 50 professionals has issued 66 reports and white papers, published one book, conducted demonstration programs focused on children, families and schools at 224 sites in 87 cities and counties in 34 states plus Washington, DC and two Native American tribal reservations, held 17 conferences attended by professionals and others from 49 states, and has been evaluating the effectiveness of drug and alcohol treatment in a variety of programs and drug courts. CASA is the creator of the nationwide initiative Family Day—A Day to Eat Dinner With Your Childrentm –the fourth Monday in September—the 28th in 2009—that promotes parental engagement as a simple and effective way to reduce children’s risk of smoking, drinking and using illegal drugs. In May 2007, CASA’s Chairman Joseph A. Califano, Jr., called for a fundamental shift in the nation’s attitude about substance abuse and addiction with publication of his book, HIGH SOCIETY: How Substance Abuse Ravages America and What To Do About It. For more information visit http://www.casacolumbia.org/.
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source: http://www.casacolumbia.org

States Unleash New Ignition Lock Laws

Starting this month, drivers convicted of driving while intoxicated in at least six new states will face a hi-tech hurdle to repeat offenses: ignition interlocks. After a high profile national campaign, Mothers Against Drunk Driving and other organizations convinced several state legislatures to pass laws mandating the dashboard installation of small ignition interlock device activated by a breathalyzer.

“It’s amazingly inconvenient, “ David Malham of the Illinois MADD group told Associated Press. “But the flip side of the inconvenience is death.”

Will high technology really help keep drunk drivers off the streets and highways? Malham, quoted in the Chicago Tribune, insisted that “it’s not about changing human nature, it’s about science interfering and preventing reckless behavior.” Maltham also said he is looking forward to technology that will be able to sniff a car’s interior, scan the eyes of drivers, and test sweat on the steering wheel before allowing the driver to turn the key.

In addition to Illinois, states that passed laws requiring the use of ignition locks for drunken driving convictions of varying degrees include Nebraska, Colorado, Washington, and Alaska. Other states with similar but unevenly enforced laws on the books include South Carolina, Arizona, New Mexico, and Louisiana.

Illinois is attempting to work around the program’s most obvious flaws—the convicted drinker could drive someone else’s car, or get someone else to blow into the breath-monitoring device—by instituting heavy penalties for non-compliance if the driver is caught cheating.

Lined up in opposition to ignition lock legislation, thus far, is the American Beverage Institute, a lobby group for restaurant owners. In the AP article, the Institute’s Sarah Longwell objected to the fact that states might decide to apply the laws to people other than repeat offenders—to anyone who, on any given night, blows a 0.08 or a 0.10, the common denominators of alcohol intoxication in most states.

Sounding a bit more like the National Rifle Association (NRA) than perhaps it intended, the Beverage Institute offered a dire vision of a slippery slope: “We foresee a country in which you’re no longer able to have a glass of wine, drink a beer at a ball game or enjoy a champagne toast at a wedding. There will be a de facto zero tolerance policy imposed on people by their cars.”

My modest prediction: A tangle of state lawsuits and questions over civil liberties, the more so since many of the laws are first-pass efforts and subject to interpretation.

source: Addiction Inbox