Archive for December, 2012

Women and men benefit in different ways from AA

A new study finds differences in the ways that participation in Alcoholics Anonymous (AA) helps men and women maintain sobriety. Two Massachusetts General Hospital (MGH) investigators found that, while many factors are helpful to all AA participants, some were stronger in men and some in women.

For example, avoidance of companions who encourage drinking and social situations in which drinking is common had more powerful benefits for men, while increased confidence in the ability to avoid drinking while feeling sad, depressed or anxious appeared to be more important for women. Their report will appear in Drug and Alcohol Dependence and has been released online.

Benefits Different for Men, Women

“Men and women benefit equally from participation in AA, but some of the ways in which they benefit differ in nature and in magnitude,” says John F. Kelly, PhD, associate director of the MGH Center for Addiction Medicine. “These differences may reflect differing recovery challenges related to gender-based social roles and the contexts in which drinking is likely to occur.”

Kelly and his co-author Bettina B. Hoeppner, PhD, note that, while AA was founded by men, one-third of its members today are women. Studies have found that women benefit at least as much as men from participation, and many women become deeply involved in the AA program. The researchers carried out some of the first studies identifying the behavioral changes behind the success of AA participation, and this report is the first to examine whether the benefits differ between men and women.

Project MATCH Study

Kelly and Hoeppner analyzed data from more than 1,700 participants, 24 percent of whom were women, enrolled in a federally funded trial called Project MATCH that compared three approaches to alcohol addiction treatment. Participants in the trial were free to attend AA meetings along with the specific treatment program to which they were assigned. At several follow-up sessions, participants reported their success in maintaining sobriety, whether or not they were attending AA meetings, and completed specialized assessments of factors like their confidence in their ability to stay sober in particular situations and whether or not their social contacts supported or discouraged efforts to maintain abstinence.

In September 2011, Kelly, Hoeppner and colleagues reported in the journal Addiction that increased confidence in the ability to maintain abstinence in social situations and spending more time with people who supported abstinence were the behavioral changes most strongly associated with successful recovery among overall Project MATCH participants attending AA meetings. The current study reanalyzed some of the data used in the Addiction study to see if there were differences between men and women in the impact of factors included in the assessments.

High-Risk Drinking Situations

For both men and women, participation in AA increased confidence in the ability to cope with high-risk drinking situations and increased the number of social contacts who supported recovery efforts. But the effect of both of those changes on the ability to abstain from drinking was about twice as strong for men as for women.

In contrast, women benefitted much more than men from improved confidence in their ability to abstain during times when they were sad or depressed. “It is striking that this effect was virtually absent in men while it was a major contributor to women’s ability to remain abstinent and to limit the number of drinks they consumed when they did drink,” says Hoeppner. Several factors that helped to reduce the intensity of drinking in men – such as less depression and fewer friends who encouraged drinking – did not appear to be as important for helping women.

Coping With Negative Emotions

Kelly says,”AA helps both men and women stay sober following treatment by enhancing sober social networks and boosting confidence in coping with high-risk social situations. In terms of alcoholism recovery more generally, we found the ability to handle negative moods and emotions was important for women but not for men. Conversely, coping with high-risk social situations – which could be attending sports or other events where people are likely to drink – was important for men but not women. These differences suggests that, for women, finding alternative ways to cope with negative emotions may yield recovery benefits, while among men, a greater focus on coping with social occasions that feature drinking may enhance recovery.

“In terms of drinking intensity – the number of drinks consumed on days when someone does drink – because the variables we studied explained only about half of the effects of AA for women, there must be other factors involved that were not captured in our analysis,” he adds. “More work is required to fully capture the biopsychosocial effects of AA participation for enhancing alcohol addiction recovery, particularly among women.”

December 5th, 2012  in Alcoholism No Comments »

Smoking may worsen hangover after heavy drinking

People who like to smoke when they drink may be at greater risk of suffering a hangover the next morning, according to a study in the January 2013 issue of the Journal of Studies on Alcohol and Drugs.

For anyone who has ever had too much to drink, that day-after combination of headache, nausea and fatigue may be a familiar feeling. But some drinkers appear hangover-resistant: about one-quarter of people who drink enough to spur a hangover in most of us don’t actually develop one.

Smoking a Factor in Hangovers

No one is sure why that is. But the new study suggests that smoking could be one factor that boosts the hangover odds.

Researchers found that college students were more likely to report hangover symptoms after a heavy drinking episode if they smoked more heavily on the day they drank. And it wasn’t simply because they smoked more when they drank more.

“At the same number of drinks, people who smoke more that day are more likely to have a hangover and have more intense hangovers,” said researcher Damaris J. Rohsenow, Ph.D., of the Center for Alcohol and Addiction Studies at Brown University in Providence, Rhode Island.

A Direct Effect on Hangovers

Her team controlled for some other factors as well, such as whether students reported drug use in the past year. And smoking, itself, was linked to an increased risk of hangover compared with not smoking at all.

That raises the likelihood that there is some direct effect of tobacco smoking on hangovers, Rohsenow said.

The “how” isn’t fully clear. But other research has shown that nicotine receptors in the brain are involved in our subjective response to drinking, Rohsenow said. For example, smoking and drinking at the same time boosts the release of dopamine, a “feel-good” brain chemical.

So the fact that nicotine and alcohol are connected in the brain may explain why smoking is tied to hangover.

Higher Suffering

The findings are based on a Web survey of 113 college students who recorded their drinking and smoking habits, and any hangover symptoms, every day for eight weeks. Overall, when students drank heavily — the equivalent of five or six cans of beer in about an hour — those who’d smoked more on that same day had higher odds of suffering a hangover the next morning and suffered more when they did.

That leaves the question of “So what?” Hangovers may make you feel bad, but is there any more harm than that?

Reasons to Stop Smoking

There is evidence that a hangover affects your attention and reaction time in the short term, Rohsenow said. So it might be unwise to drive or work in safety sensitive occupations with a hangover, for instance. No one is sure yet whether hangovers may signal some type of damage to the brain, but smoking is already known from other studies to aggravate the ill effects on the brain caused by years of heavy drinking.

There are already plenty of reasons to avoid both smoking and heavy drinking. But Rohsenow said these findings suggest that if smokers are going to indulge in heavy alcohol use, it would be wise to at least cut down on cigarettes.

December 5th, 2012  in Tobacco No Comments »