Substance Abuse News

Regular beer—but not light beer or other types of alcohol—appears to be associated with an increased risk of developing psoriasis, according to a report posted online that will be published in the Archives of Dermatology.

“Psoriasis is a common immune-mediated skin disease,” the authors write as background information in the article. “The association between alcohol consumption and increased risk of psoriasis onset and psoriasis worsening has long been suspected. For example, individuals with psoriasis drink more alcohol than individuals without psoriasis, and alcohol intake may exacerbate psoriasis severity.”

Alcohol and Psoriasis

For other diseases, type of alcoholic beverage has been shown to influence risk—for instance, beer confers a larger risk for gout than wine or spirits. To evaluate the association between different types of alcohol and psoriasis risk, Abrar A. Qureshi, M.D., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School, Boston, assessed data from 82,869 women who were age 27 to 44 years in 1991. The women, participants in the Nurses’ Health Study II, reported the amount and type of alcohol they consumed on biennial questionnaires. They also reported whether they had received a diagnosis of psoriasis.

Through 2005, 1,150 cases of psoriasis developed, 1,069 of which were used for analysis. Compared with women who did not drink alcohol, the risk of psoriasis was 72 percent greater among women who had an average of 2.3 drinks per week or more. When beverages were assessed by type, there was an association between non-light beer drinking and psoriasis, such that women who drank five or more beers per week had a risk for the condition that was 1.8 times higher. Light beer, red wine, white wine and liquor were not associated with psoriasis risk.

When only confirmed psoriasis cases—those in which women provided more details about their condition on a seven-item self-assessment—were considered, the risk for psoriasis was 2.3 times higher for women who drank five or more beers per week than women who did not drink beer.

Increased Risk of Psoriasis

“Non-light beer was the only alcoholic beverage that increased the risk for psoriasis, suggesting that certain non-alcoholic components of beer, which are not found in wine or liquor, may play an important role in new-onset psoriasis,” the authors write. “One of these components may be the starch source used in making beer. Beer is one of the few non-distilled alcoholic beverages that use a starch source for fermentation, which is commonly barley.” Barley and other starches contain gluten, to which some individuals with psoriasis show a sensitivity. Lower amounts of grain are used to make light beer as compared with non-light beer, potentially explaining why light beer was not associated with psoriasis risk, they note.

“Women with a high risk of psoriasis may consider avoiding higher intake of non-light beer,” the authors conclude. “We suggest conducting further investigations into the potential mechanisms of non-light beer inducing new-onset psoriasis.”

Given that Whites are the majority population in the United States, drinking trends for this group tend to determine overall trends in drinking for the country and simultaneously minimize trends and possible risks among Black and Hispanic populations. A study of trends in drinking patterns and amounts drank among Whites, Blacks, and Hispanics from 1992 to 2002 has found a rise in the proportion of drinkers across all three ethnic groups and both genders.

Results will be published in the journal Alcoholism: Clinical & Experimental Research.

Drinking Trends in Ethnic Groups

“Trend analysis is an important part of epidemiological monitoring of drinking and problems in the general population,” said Raul Caetano, professor of epidemiology and regional dean (Dallas) at The University of Texas School of Public Health, as well as the study’s corresponding author. “However, different population groups, such as ethnic groups, can present different trends in drinking and problems and so it is important to investigate trends in different groups and not only in the U.S. general population as a whole.”

“This is the first cross-ethnic alcohol trend analysis to … examine whether alcohol consumption – such as use and heavy drinking – has increased, decreased, or remained stable among Whites, Blacks, and Hispanics in the U.S. from 1992 to 2002,” noted Rhonda Jones-Webb, associate professor in the division of epidemiology and community health at the University of Minnesota School of Public Health.

“Alcohol studies on racial/ethnic minorities such as this are much needed,” Jones-Webb added. “Blacks and Hispanics live in communities where alcohol availability is higher, where there is more exposure to outdoor alcohol advertising, where they have been targeted by special advertising of higher alcohol content beverages – all with fewer personal and community resources to respond to these challenges. Additionally, Blacks and Hispanics are at greater risk for alcohol-related problems such as homicide, which is on the rise in some cities.”

Researchers used data from the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey (n=42,862) and the 2001-2002 National Epidemiologic Study on Alcohol and Related Conditions (n=43,093); both surveys selected respondents 18 years of age and older from the U.S. household population.

Increase in Binge Drinking

“Whites increased their mean number of drinks while Blacks and Hispanics did not,” said Caetano. “There was also a rise in drinking five or more drinks in a day across all three ethnic groups and drinking to intoxication among Whites and Blacks, but this was limited to those reporting such drinking at least once a month. This suggests a polarization in drinking between the two surveys, with those who drank more in 1992 reporting an increase in their drinking in 2002.”

“The results also suggest that while the proportion of Black and Hispanic drinkers increased, the amount of alcohol consumed did not increase among Blacks and Hispanics across the 10-year period,” added Jones-Webb.

“Trends in drinking are linked to a complex web of factors that include how individual drinking is influenced by the drinking of the group to which the individual belongs, as well as personal and other societal changes,” said Caetano. “Changes in the sociodemographic composition of the population such as aging, the influx of immigrant groups, and a decline in mean income level because of economic recessions can all influence trends in drinking and problems.”

In addition, said Jones-Webb, norms regarding drinking seemed to have become more liberal during the 10-year period examined. “This might explain why groups that traditionally do not drink – for example, women and African Americans – may have started to do so.”

Changes in Drinking Trends

“The results in the paper provide a detailed view of how drinking and binge drinking changed in the U.S. between 1992 and 2002,” said Caetano. “National studies such as this are important because they provide information that serves as a backdrop against which the results of other national or local studies can be compared, aiding in the interpretation of findings from these other studies. Trend analyses at the national level can also alert health professionals at the federal level to trends developing in the country, providing a ‘broad-stroke’ national level picture against which many other trends … can be viewed and understood.”

“While there are more drinkers in the population, the rise in the proportion of drinkers does not seem to be triggering a rise in the mean number of drinks consumed per month, at least among Blacks and Hispanics,” added Jones-Webb. “This finding suggests that a diversity of public-health policies are needed to reduce alcohol-related problems among Blacks and Hispanics, including restrictions on alcohol advertising, limiting the overconcentration of liquor stores in poor and minority neighborhoods, regulating high alcohol content beverages, increasing taxes on alcohol, as well as treatment and brief interventions.”

Few colleges and college communities have taken steps to implement recommendations to reduce college student drinking, according to a new study released by researchers from the University of Minnesota School of Public Health. Alcohol consumption by U.S. college students remains a major issue despite a report by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) that detailed the problems associated with student drinking. That report, released in 2002, also outlined strategic recommendations based on the best available science that were designed to help colleges curtail the problem.

Few Colleges Offer Intervention

Toben Nelson, Sc.D., lead author of the study, said the latest research found that only half of the 351 colleges surveyed offered brief intervention programs with documented evidence of effectiveness for students at high risk for alcohol problems. Only a small number (33 percent) of colleges reported that they collaborated with their community on effective alcohol control strategies such as compliance checks to monitor illegal sales, responsible beverage service training, restrictions on alcohol outlets or interventions to address access to low-cost alcohol.

Nearly all colleges offered educational programs, even though the NIAAA report found that by themselves these efforts are ineffective. More than one in five college administrators said they were not familiar with the 2002 NIAAA recommendations.

Curbing Binge Drinking

The latest research – funded by the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation – in the journal Alcoholism: Clinical and Experimental Research, and comes less than 12 months after University of Minnesota researchers published findings that showed colleges previously identified as “heavy-drinking” have shown little improvement in curbing the binge drinking habits of their students.

“In 2002, there was a great deal of research available to show that heavy drinking was a problem on college campuses. The NIAAA recommendations were designed to help colleges and college communities address that problem,” Nelson said. “Unfortunately, what we’ve found is that little progress in the implementation of the recommendations has been made since they were released.”

Nelson identified a number of possible reasons for the lack of implementation, including strained relationships between communities and college campuses over student drinking, a lack of resources, and staff who are either untrained in the development of community partnerships, or who lack the authority to take meaningful steps forward.

Difficulties Due to Drinking

According to co-author Traci Toomey, Ph.D., a contributor to the development of the 2002 NIAAA recommendations, the latest findings are a source of frustration. “We certainly would have hoped to see more progress among colleges, considering that the NIAAA identified strategies and actions that could lower drinking on college campuses more than six years prior to this study.”

Binge drinking across college campuses remains a problem with a host of associated risks. According to the NIAAA, nearly 600,000 students between the ages of 18 and 24 are unintentionally injured while under the influence of alcohol each year, and 97,000 students are victims of alcohol-related sexual assault or date rape. Nearly one in four college students report academic difficulties that result from their drinking.

A new national study reveals that the rate of past month alcohol use (i.e., at least one drink in the past 30 days) among American Indian or Alaska Native adults is significantly lower than the national average for adults (43.9 percent versus 55.2 percent). The study, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), also shows that American Indian or Native Alaska adults have a rate of past month binge alcohol drinking (i.e., five or more drinks on the same occasion – on at least one day in the past 30 days) well above the national average (30.6 percent versus 24.5 percent). The level of past month illicit drug use was also found to be higher among American Indian or Alaska Native adults than the overall adult population (11.2 percent versus 7.9 percent).

Alcohol Treatment Needed

Among the study’s other significant findings:

• Eighteen percent of American Indian or Alaska Native adults needed treatment for an alcohol or illicit drug use problem in the past year, nearly twice the national average (9.6 percent).
• 1 in 8 (12.6 percent) American Indian or Alaska Native adults who were in need of alcohol or illicit drug treatment in the past year received it at a specialty facility – about the same as the national average (10.4 percent).
• American Indian or Alaska Native adults’ past month substance use rates drop significantly in older age groups – for example, illicit drug use levels drop from 25.4 percent in the 18 to 25 age group to 4.1 percent in those 50 and older. This pattern is also seen in the general adult population.

The study was developed as part of the agency’s strategic initiative on data, outcomes, and quality – an effort to create an integrated data strategy that informs policy makers and service providers on the nature and scope of behavioral health issues. It is one in a series of studies designed to provide more detailed information on substance abuse patterns and treatment needs existing within a wide range of population groups.

Support Services Needed

“Patterns of substance abuse vary somewhat among different segments of our society,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Prevention, treatment and recovery support services are vitally needed within every community. We are using these studies along with on the ground experience to design and provide these services in a way that is accepted by the community and appropriate for individual needs.”

“We appreciate SAMHSA’s support of this study, which provides valuable findings that can be used for more targeted treatment programs and patient screening,” said Dr. Yvette Roubideaux, the Director of the Indian Health Service.

Summertime and the living is easy. But not too easy for parents whose children will head to college in the fall.

University of Rhode Island Psychology Professor Mark Wood, a nationally recognized alcohol researcher, wants parents to be aware that this is a time when teens tend to increase their alcohol consumption.

The URI expert advises parents to monitor their children–know where they are, whom they are with and what they are doing.

Monitoring Means Less Drinking

“This type of monitoring, particularly in combination with an emotionally supportive parenting style, is associated with less drinking and fewer alcohol-related problems across numerous studies,” Wood said.

“It is also important for parents to express clear disapproval of alcohol use and to provide clear and fair consequences associated with breaking the rules. Research shows this combination of factors decreases alcohol use and problems through adolescence and into college,” continued Wood who helps create interventions to reduce alcohol related-harm, particularly among college-age students. Results of his recent study bear this out.

Is Wood advocating that parents become helicopter parents–ones who hover over their children and their problems or experiences, especially when they are in college?

“We live in a era when students are texting and talking to parents, sometimes many times a day. Although the term helicopter parent does have a negative connotation, I think conversations about drinking are good whenever and wherever they occur,” said the researcher.

But is it too late for parents to begin monitoring teenagers after they have already graduated from high school?

“Most American teenagers begin to drink by age 15. By the time they go off to college, most have considerable drinking experience,” explained Wood. “Ideally, parents should be having conversations about alcohol throughout high school. But it’s never too late to begin an ongoing dialogue about drinking with teens.”

There is good reason to be concerned. It’s estimated that more than 1,800 college students die each year in car accidents and more than 750,000 are involved in alcohol related physical or sexual assaults.

Adolescents tend to increase their alcohol use the summer before entering college and during their first semester at college. This is also true of children who have been consistently monitored and emotionally supported. However, these children don’t increase consumption to the levels of kids who didn’t have that kind of parental involvement in high school.

Values, Attitudes and Expectations

“The protective effects that parents exert in high school continue to be influential into college even at a time when the kids have left the home. It’s the internalization of those values, attitudes, expectations that seem to continue to exert an effect,” said Wood.

Wood and his team applied some of their research findings to an intervention to reduce the increases in drinking and the negative consequences that typically occur during matriculation and into college. Results of the study were published in the June 2010 issue of the Journal of Consulting and Clinical Psychology.

In this study, which began in 2004, they recruited and randomly assigned 1,000 incoming freshmen to receive either a Brief Motivational Intervention (BMI) or a parent-based intervention, both, or an assessment-only control. The motivational intervention is considered to be the most effective individual alcohol prevention approach with college students.

In contrast to other BMI studies that have focused on heavier drinkers, the URI study recruited students whether they drank or not. In fact, about 28 percent of the 1,000 students in the study didn’t drink when they came to college.

Students met with an intervention provider who went over a tailored report compiled from information provided by the students about a range of factors, including their alcohol use patterns, consequences associated with use, and family history of alcohol problems. Students were recognized as responsible adults, and weren’t preached to or told not to drink.

Among other things, the report showed the student how his or her drinking compared to others of the same age and gender, correcting misperceptions students have about how much other students are drinking. For example, students often overestimate how much their peers are drinking, and correcting these misconceptions as part of motivational interventions has resulted in lower levels of alcohol use and problems.

Family History of Alcoholism

“A message that we would give a student who told us her father was an alcoholic is that we know that alcohol problems run in families. But it’s also important for you to know that this doesn’t mean that you’re destined to become an alcoholic. It just means that you have an increased risk of drinking problems based on family history,” says Wood.

The message is different with non-drinkers: “Congratulations, you’ve made the safest choice in terms of alcohol use at this point. One of the things we want to tell you is that there are more students like you than you think. We’d like to talk to you about ways that you can continue to make the safe choice around drinking now that you’re in an environment where there is more drinking.”

URI researchers followed up with the students in the spring of their freshman and sophomore years. The team found the intervention was successful for non-drinkers and drinkers. Students who received the BMI were significantly less likely to transition into heavy drinking or begin experiencing alcohol-related problems. For those who were already drinking, the BMI reduced heavy drinking and alcohol problems indirectly by altering students’ misperceptions about alcohol use.

An African study has found a link between a difficult childhood and alcohol consumption as a teenager. Researchers writing in BioMed Central’s open access journal Child and Adolescent Psychiatry and Mental Health studied the association between adverse childhood experiences and drunkenness among 9,189 adolescents aged 12-19 years living in Burkina Faso, Ghana, Malawi, and Uganda.

Dr. Caroline Kabiru and a team of researcher from the African Population and Health Research Center , Nairobi, Kenya conducted the study.

Childhood Drinkers

They noted, “Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. In general, respondents who had lived in a food-insecure household, lived with a problem drinker, been physically abused, or been coerced into having sex were more likely to report drunkenness”.

There has previously been little research into the determinants of alcohol use among adolescents in sub-Saharan Africa. The researchers’ work is supported by similar studies in other parts of the world, which also draw a link between adverse childhood experiences and future drinking. Speaking about the findings, Dr. Kabiru said, “Early treatment for traumatic childhood experiences may be an essential component of interventions designed to prevent alcohol abuse among adolescents”.

Parents may be surprised, even disappointed, to find out they don’t influence whether their teen tries alcohol.

But now for some good news: Parenting style strongly and directly affects teens when it comes to heavy drinking – defined as having five or more drinks in a row – according to a new Brigham Young University study.

The researchers surveyed nearly 5,000 adolescents between the ages of 12 and 19 about their drinking habits and their relationship with their parents. Specifically, they examined parents’ levels of accountability – knowing where they spend their time and with whom – and the warmth they share with their kids.

Less Likely to Binge Drink

Here’s what they found:

• The teens least prone to heavy drinking had parents who scored high on both accountability and warmth.
• So-called “indulgent” parents, those low on accountability and high on warmth, nearly tripled the risk of their teen participating in heavy drinking.
• “Strict” parents – high on accountability and low on warmth – more than doubled their teen’s risk of heavy drinking.

Prior research on parenting style and teen drinking was a mixed bag, showing modest influence at best. Unlike previous research, this study distinguished between any alcohol consumption and heavy drinking.

“While parents didn’t have much of an effect on whether their teens tried alcohol, they can have a significant impact on the more dangerous type of drinking,” said Stephen Bahr, a professor in BYU’s College of Family, Home and Social Sciences.

Bahr, along with co-author John Hoffmann, will publish the study in the July issue of the Journal of Studies on Alcohol and Drugs.

The statistical analysis also showed that religious teens were significantly less likely to drink any alcohol. The effect of religiosity mirrors findings from this 2008 study Bahr and Hoffmann conducted on teens’ marijuana use.

Non-Drinking Friends

Not surprisingly, a teen’s peers play an important role on whether a teen drinks. The BYU researchers note that teens in this new study were more likely to have non-drinking friends if their parents scored high on warmth and accountability.

“The adolescent period is kind of a transitional period and parents sometimes have a hard time navigating that,” Bahr said. “Although peers are very important, it’s not true that parents have no influence.”

For parents, the takeaway is this:

“Realize you need to have both accountability and support in your relationship with your adolescent,” Hoffmann said. “Make sure that it’s not just about controlling their behavior – you need to combine knowing how they spend their time away from home with a warm, loving relationship.”

Recovering addicts who avoid coping with stress succumb easily to substance use cravings, making them more likely to relapse during recovery, according to behavioral researchers.

“Cravings are a strong predictor of relapse,” said H. Harrington Cleveland, associate professor of human development, Penn State. “The goal of this study is to predict the variation in substance craving in a person on a within-day basis. Because recovery must be maintained ‘one day at a time,’ researchers have to understand it on the same daily level.”

Craving Triggers

Cleveland and his colleague Kitty S. Harris, director, Center for the Study of Addiction and Recovery, Texas Tech University, used data from a daily diary study of college students who are recovering addicts to identify the processes that trigger cravings and prevent some addicts from building a sustained recovery.

The researchers found that how addicts cope with stress — either by working through a problem or avoiding it — is a strong predictor of whether they will experience cravings when faced with stress and negative mood.

Coping Skills Important

“Whether you avoid problems or analyze problems not only makes a big difference in your life but also has a powerful impact on someone who has worked hard to stay away from alcohol and other drugs,” explained Cleveland. “When faced with stress, addicts who have more adaptive coping skills appear to have a better chance of staying in recovery.” The findings appeared in a recent issue of Addictive Behaviors.

Researchers supplied Palm Pilots to 55 college students who were in recovery from substance abuse ranging from alcohol to cocaine and club drugs. The students were asked to record the their daily cravings for alcohol and other drugs, as well as the intensity of negative social experiences — hostility, insensitivity, interference, and ridicule — and their general strategies for coping with stress.

“We looked at variations in the number of cravings across days and found that these variations are predicted by stressful experiences,” said Cleveland. “More importantly, we found that the strength of the daily link between experiencing stress and the level of cravings experienced is related to the participants’ reliance on avoidance coping.”

Stress Doubles Cravings

Statistical analyses of the survey data suggests that the magnitude of the link between having a stressful day and experiencing substance use cravings doubles for recovering addicts who cope with stress by avoiding it.

“We found that addicts who deal with stress by avoiding it have twice the number of cravings in a stressful day compared to persons who use problem solving strategies to understand and deal with the stress,” explained Cleveland. “Avoidance coping appears to undercut a person’s ability to deal with stress and exposes that person to variations in craving that could impact recovery from addiction.”

According to Cleveland, the findings suggest the impulse to avoid stress is never going to help recovering addicts because stressful experiences cannot be avoided.

“If your basic life strategy is to avoid stress, then your problems will probably end up multiplying and causing you more problems,” he added.

While alcohol in the form of a “night cap” may be able to help an individual fall asleep, its pharmacological properties later disrupt the rapid eye movement (REM) and deeper, more restorative stages of sleep. Sleep problems also predict the onset of alcohol abuse in healthy adults and relapse in abstinent alcoholics. A new study of associations among pubertal development, sleep preferences and problems, and alcohol use in early adolescence has found that puberty is related to sleep problems and later bedtimes, which were in turn associated with alcohol use.

Results will be published in Alcoholism: Clinical & Experimental Research.

Early Puberty Predicts Alcohol Use

“Pubertal timing has been found to predict adolescent alcohol use, with early maturing adolescents being more likely to drink,” explained Sara Pieters, a doctoral student in neuropsychology at the University Nijmegen and corresponding author for the study. “Adolescent alcohol use has also been linked to sleep problems, such as trouble falling asleep, maintaining sleep, and perceived tiredness. This study combines these two separate lines of research by examining the impact of pubertal maturation on the relation between sleep problems and alcohol use.”

Comparatively speaking, added Carmen Van Der Zwaluw, a doctoral student in neuropsychology at the University Nijmegen linkages between sleep problems and alcohol use by adolescents have received little scientific attention. “A few studies have shown … that adolescents who experience sleep problems tend to use more alcohol than those without sleep difficulties,” she said. “This has been mainly shown for late adolescents and young adults, but not yet for young adolescents, [however,] adolescent developmental changes such as puberty onset and different circadian rhythms take place [during] early adolescence.”

Puberty and Sleep Problems

Pieters and her colleagues used data collected from a larger study of 725 children in grades one through six in five participating Dutch schools. For this study, questionnaire data from 431 adolescents (236 girls, 195 boys) aged 11 to 14 years of age were analyzed for associations, if these associations changed vis-à-vis adolescent internalizing and externalizing problems, and if they were influenced by gender.

“Our results indicated that puberty was related to sleep problems and more evening-type tendencies such as favoring later bedtimes, which in turn were positively related to early adolescent alcohol use,” said Pieters. “Underlying psychopathology, gender, and educational level did not change these relationships, meaning that these factors are not the explanatory mechanism behind this relation. From this study, it can be concluded that both puberty and sleep regulation are important factors in explaining alcohol use in early adolescence.”

Favoring Later Bedtimes

“[The finding that] puberty was related to alcohol use, via sleep problems and delayed circadian preference,” said Van Der Zwaluw, “means that: [one,] early-maturing adolescents, in terms of puberty, tend to have more ‘owl-like’ tendencies such as favoring later bedtimes, and experience more sleep problems; [and two,] adolescents who have more owl-like tendencies and who experience more sleep problems also report higher levels of alcohol consumption.”

“This study has shown that puberty-dependent sleep regulation is an important aspect of explaining alcohol use in early adolescence,” said Pieters. “Our advice to clinicians would be to better screen for sleep problems when adolescents seem to have other psychosocial or behavioral problems. To parents it is recommended that they monitor their offspring’s sleep, keeping in mind that sleep has an effect on so many other health domains, including risky behaviors such as alcohol consumption.”

It’s long been known that alcohol use in pregnancy can lead to children with mental retardation and birth defects, but researchers who study fetal alcohol syndrome (FAS) have not made definitive progress on preventing the disorder, detecting it early, or effectively treating it, say researchers from Georgetown University Medical Center.

In the journal Developmental Neuroscience, four first-year medical students at Georgetown University School of Medicine looked into the science and clinical treatment of FAS, and found that although there is much ongoing study, no new medical strategies exist to change the grim outcome that can occur when a fetus is exposed to alcohol.

Lack of Diagnosis Tools

“Although there is a lot of research in the field to determine how alcohol acts on the developing brain, there is not much translation into the clinic,” says Sahar Ismail, now a second year medical student. “What surprised us the most was the lack of sensitive and specific diagnostic tools to identify children with FAS, given its prevalence and harmful effects on the child, family, and society.”

Working with her on the study were medical students Stephanie Buckley, Ross Budacki, and Ahmad Jabbar – each student contributed equally. Their study was a project for the Sexual Development and Reproduction Module under directorship of G. Ian Gallicano, PhD, an associate professor in the Department of Biochemistry and Molecular & Cellular Biology.

“This is a very important review, because it combed the research literature on FAS, and concluded that nothing has changed clinically,” Gallicano says. “Not every woman who drinks alcohol will have a child with FAS, but because so much remains unknown, women are still advised not to drink any time during pregnancy.”

Even the question of whether alcohol is a teratogen (a chemical that causes nervous system abnormalities) in the first days or weeks of pregnancy – when a woman may not know she is pregnant – has not been answered fully, says Ismail. Mouse studies show alcohol can have detrimental effects at any stage of fetal development, but “only so much can be concluded about humans from mouse studies,” she says. “All we can say now is that there is no safe period to drink.”

Preventable Mental Retardation

What is clear, however, is that alcohol is the leading cause of preventable mental retardation, the researchers say. FAS is relatively uncommon, affecting .2 to 1.5 live births in every 1,000, but fetal alcohol spectrum disorders (FASD), the less severe form of FAS, is much more common and has a broad range of the same symptoms, they say. “Taken together, both FAS and FASD, are more common than the public realizes but are entirely preventable,” Ismail says.

The study authors say FAS research shows:

Effects of Alcohol

Alcohol can have a range of effects on the baby but the fetal brain is particularly at risk because of its complex blood networks. Alcohol is carried from the mother to the child through blood that flows through the umbilical cord.

Many factors influence the severity of alcohol’s effects, such as maternal genetics, increased maternal age, history of alcohol abuse, poor prenatal care. In the genetics realm, for example, researchers have found that women with a more efficient enzyme that breaks down alcohol have a decreased risk of giving birth to a child with FAS.

Alcohol can cause dramatic and irreversible effects on the fetus, such as developmental delay, head and facial irregularities, seizures, hyperactivity, attention deficits, cognitive deficits, learning and memory impairments, poor psychosocial functioning, facial irregularities, and motor coordination deficits. However, the exact developmental phases in which alcohol has these specific effects on the fetus are not entirely known

Based on animal studies, consumption of alcohol during the times in animals that correspond to the first 2-3 weeks in human brain growth are detrimental to the brain. But much remains unknown about alcohol’s vast mechanism in growth development in humans, most importantly on neurogenesis.

It is very important to identify FAS early in life in order to provide the child with the appropriate counseling and guidance as early as possible. But, at this point, there is no treatment or specific and sensitive diagnostic tools to diagnose FAS early in pregnancy or early after birth. Still, the authors say there is ongoing research aimed at devising better diagnostic tools for FAS. These include a panel of genes that are altered in a developing fetus and a kit to examine a newborn’s stool for telltale chemicals.

Detecting Alcohol Use

Research is underway to find biomarkers that can inform physicians if a pregnant woman is using, or chronically abusing, alcohol. One marker, for example, can be detected in a woman’s bloodstream for at least 28 days after alcohol use. Other researchers are studying biomarkers in amniotic fluid that can distinguish between high-risk and low-risk pregnancies. Still, the authors say there is comparatively little investigation on these ideas.

Prevention of FAS is an important goal primarily because so little is understood about the adverse effects that alcohol has on the developing fetus. Current prevention programs focus on educating potential mothers at risk for conceiving a child with FAS. However, potentially powerful approaches are being studied in animals, such as the use of agents to protect the developing brain early in pregnancy or to treat brain malformations caused by alcohol exposure. Although there is vast research in this area, clinical strategies to reverse the effects of alcohol are not foreseeable in the near future, the authors say.