Archive for the ‘ Alcoholism ’ Category

Trusting Counselor Vital to Successful Alcohol Treatment

A positive, trusting relationship between counselor and patient, known as a “therapeutic alliance,” can be key to successful treatment of alcohol use disorder, a new study finds.

Gerard Connors, PhD, senior research scientist at the University at Buffalo Research Institute on Addictions, studied more than five dozen people engaging in a 12-week program of cognitive behavior therapy for alcohol use disorder.

Patients who reported the most positive relationships with their counselors on a session-to-session basis had fewer days of drinking and fewer days of heavy drinking between treatment sessions than patients whose relationship was not as positive.

Positive Relationship Yields Better Results

The results indicate that efforts to ensure a good match between patient and counselor can have considerable benefits to the patient’s recovery, Connors says. Further research on what factors lead to strong therapeutic alliances in alcohol treatment could be warranted.

Historically, there was an expectation that the most effective process to treat alcohol use disorder involved therapists confronting their clients about their behavior. However, Connors’ work over several years, along with other emerging research, has shown a more positive relationship between therapist and client yields better results.

“Many recent studies have recognized that a positive therapeutic alliance between a therapist and client is necessary for achieving behavior change, but much less has been known about how alliances operate across a full course of treatment,” Connors says.

Risk of Dropping Out of Treatment

“By studying the alliance on a session-to-session basis, we could see how a fractured alliance at a given point in time interferes with the pursuit of treatment goals by running the risk of a client dropping out of treatment,” he says. “Therefore, it’s important for the therapist to continue assessing the alliance throughout the entire course of treatment.”

The study also showed a positive alliance was even more critical for patients who had not made changes in their drinking prior to starting treatment. “In contrast, patients who had already reduced their drinking prior to entering treatment were not as dependent on the therapeutic alliance to continue the process of behavior change,” Connors says.

January 26th, 2017  in Alcoholism No Comments »

119,000 Children With FAS Born Each Year

Worldwide, an estimated 119,000 children are born with Fetal Alcohol Syndrome (FAS) each year, a new study from the Centre for Addiction and Mental Health (CAMH) shows.

The study, published in The Lancet Global Health, provides the first-ever estimates of the proportion of women who drink during pregnancy, as well as estimates of FAS by country, World Health Organization (WHO) region and worldwide.

Globally, nearly 10 per cent of women drink alcohol during pregnancy, with wide variations by country and WHO region. In some countries, more than 45 per cent of women consume alcohol during pregnancy. In Canada, which has clinical guidelines advising abstinence during pregnancy, an estimated 10 per cent of pregnant women still drink, which is close to the estimated world average.

Prevalence of FAS Increasing

Nearly 15 per 10,000 people around the world are estimated to have FAS, the most severe form of Fetal Alcohol Spectrum Disorder (FASD). FAS is characterized by mental, behavioural and learning problems, as well as physical disabilities. In Canada, the estimate is 10.5 cases of FAS per 10,000 people.

Not every woman who drinks while pregnant will have a child with FAS. “We estimated that one in 67 mothers who drink during pregnancy will deliver a child with FAS,” says lead author Dr. Svetlana Popova, Senior Scientist in CAMH’s Institute for Mental Health Policy Research.

She notes that this figure is very conservative and does not include other types of FASD that may occur from alcohol consumption during pregnancy, including partial FAS (pFAS) and Alcohol-related Neurodevelopmental Disorders (ARND).

Safest to Completely Abstain

Although it’s well established that alcohol can damage any organ or system in the developing fetus, particularly the brain, it’s still not known exactly what makes a fetus most susceptible, in terms of the amount or frequency of alcohol use, or timing of drinking during pregnancy. Other factors, such as the genetics, stress, smoking and nutrition also contribute to the risk of developing FASD.

“The safest thing to do is to completely abstain from alcohol during the entire pregnancy,” says Dr. Popova.

The study involved comprehensive literature reviews and statistical analyses to determine the estimates, which are intended to help countries plan public health initiatives and policies, such as FAS surveillance systems and educational efforts on the risks of alcohol use during pregnancy, the researchers note.

Rates Highest in Europe

The five countries with the highest alcohol use in pregnancy were in Europe: Russia, United Kingdom, Denmark, Belarus and Ireland. As a region, Europe also had a 2.6 higher prevalence of FAS than the global average. The lowest levels of drinking and FAS were found for the Eastern Mediterranean and South East Asia regions, as there are high rates of alcohol abstinence in these regions.

The predictive model that the research team developed in this study could also be used to estimate the prevalence of other disease conditions, notes Dr. Popova. Her team is currently extending this work to study the global scale of all fetal alcohol spectrum disorders (FASD). An earlier study by Dr. Popova and her team, published in The Lancet last year, showed that more than 400 disease conditions co-occur with FASD.

January 17th, 2017  in Alcoholism No Comments »

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 »

Alcohol dependence more deadly for women

While researchers and clinicians know that the mortality rates among alcohol dependent (AD) individuals are high, most of that knowledge is based on studies of clinical populations. A new study is the first to examine excess mortality and its predictors among AD individuals in the general population throughout a 14-year span, finding that annualized death rates were 4.6-fold higher for AD females and 1.9-fold higher for AD males when compared to the general population, indicating that females with AD merit particular attention.

Results will be published in the January 2013 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Getting Treatment an Unknown Factor

“Clinical data have revealed a higher proportion of individuals who have died than among the general population of the same age,” explained Ulrich John, professor of epidemiology and social medicine, and director of the Institute of Epidemiology and Social Medicine at University Medicine Greifswald, Germany. “Gender-specific data are rare, even among clinical samples. Furthermore, these studies have two main limitations. First, we know that only a minority of AD individuals receive treatment of this disorder, but we lack knowledge about how this selection occurs. Second, we have no evidence about potential effects of specialized alcoholism treatment on mortality among people who had been diagnosed as AD. We would like to know whether treatment might enhance survival time. For ethical reasons, no controlled trials are possible. Thus, longitudinal descriptive data as in this study are helpful.”

John, the corresponding author for the study, added that Germany is well-suited for this kind of research since it is mandatory in that country for residents to provide vital status data. “Our data are also of international interest because researchers used the Composite International Diagnostic Interview (CIDI), which is an internationally and widely accepted instrument,” he said.

Cases Followed 14 Years

John and his colleagues used registration data to gather a random sample of 4,070 respondents between the ages of 18 and 64 years from a region in Germany; of these, 153 were identified as AD and, of these, 149 (119 males, 30 females) were successfully followed for 14 years. Baseline data included information garnered using the German version of the CIDI, AD diagnostic criteria from the Diagnostic and Statistical Manual of Mental Health Disorder – Fourth Edition (DSM-IV), and any other psychiatric disorders according to the DSM-IV. Possible predictors of mortality included AD treatment utilization, AD severity, alcohol-related problems, and self-rated health.

“First, we found that annualized death rates were 4.6-fold higher for females and 1.9-fold higher for males compared to the age- and gender-specific general population,” said John. “Second, we found that the mean age at death was 60 for females and 58 for males, both of which are about 20 years lower than the mean age at death among the general population. None of those deceased had reached the age of life expectancy. Third, having participated in inpatient AD treatment was not related with longer survival compared to not having taken part in treatment, meaning that it did not seem to have a sufficient protective effect against premature death.”

Death Rates Among Women

John expects that future studies will support the finding that females with AD had much higher annualized death rates compared to AD males in the general population. “We already know females tend to respond much stronger to toxins such as alcohol than males,” he said. “Women also seem to develop alcohol-attributable disease faster than men do. On the other hand we have only little knowledge about alcohol-attributable disease among women, since in most samples females constitute just one fourth to one third of the sample.”

That said, admitted John, the researchers were surprised by three findings. “One, a lack of longer survival after specialized AD treatment than after no treatment,” he said. “Here in Germany we provide very intense and specialized inpatient treatment on a long-term basis, and we expected that these patients had a better chance of longer survival than those not participating in such specialized treatment. We were also surprised by the finding that psychiatric co-morbidity did not seem to make any difference in survival time, although this is good news for those with an additional psychiatric diagnosis to AD. Third, we were surprised by the degree of the gender gap we found.”

Alcohol More Deadly Than Smoking

In short, said John, drinking seems to contribute more to very early death more than other main risk factors such as tobacco smoking.

“For example,” he said, “smoking-related death cases are more due to cancers which seem to occur later in life than many alcohol-attributable causes of death do. Furthermore, drinking can also contribute to other risky behaviours such as smoking, becoming overweight, and obesity. Alcohol is a dangerous product and should be consumed only within guidelines, no more than 12 grams for women on occasion and no more than 24 grams for men.”

October 20th, 2012  in Alcoholism No Comments »

Treatment reduces financial burden on alcoholic families

The financial effects of alcoholism on the family members of addicts can be massive, but little is known about whether treatment for alcoholism reduces that financial burden. A study of 48 German families published online today in the journal Addiction reveals that after twelve months of treatment, family costs directly related to a family member’s alcoholism decreased from an average of €676.44 (£529.91, US$832.26) per month to an average of €145.40 (£113.90, $178.89) per month. Put another way, average costs attributable to alcoholism decreased from 20.2% to 4.3% of the total pre-tax family income.

Among those 48 families, two of the largest family expenditures directly related to alcoholism were for alcoholic beverages (averaging €252.13/£197.51/$310.29 per month) and cigarettes (averaging €92.98/£72.83/$114.43 per month). Twelve months into treatment, those costs had reduced to €70.63 (£55.32, $86.92) and €64.21 (£50.29, $79.04) per month.

Financial Benefits of Treatment

Also, after twelve months of treatment, the average amount of time spent caring for the affected family member dropped from 32.2 hours per month to 8.2 hours per month. Using the minimum wage in Germany for employees in the nursing industry (€8.50 per hour), informal care provided by family members initially piled on an additional financial burden of €274.30 (£214.87, $337.66) per month, which reduced to €69.79 (£54.67, $85.88) per month after one year of treatment.

Even in cases of relapse, treatment for alcoholism still reduced the financial burden on families, but only by €65.22 (£51.09, $80.26) per month on average.

Lead author Dr. Salize (Central Institute of Mental Health, Mannheim, Germany) says, “We’re opening up an area of addiction research that doesn’t receive much attention. When they look at effects on families, addiction studies mainly focus on problems such as domestic violence and depression, not on the financial burden of caring for an alcoholic. But when health services and policymakers study the costs and benefits of treating alcoholism, they need to know that treatment has an immense financial effect not just on the alcoholic but also on his or her spouse, partner, children, and parents. The benefits of treatment reach well beyond the individual patient.”

October 1st, 2012  in Alcoholism No Comments »

Adolescents can benefit from 12-step involvement

Adolescents who misuse alcohol and other drugs to the point where they need treatment must contend with costly and limited options for youth-specific care, as well as high relapse rates following treatment. Mutual-help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are widely available but little research has addressed their benefits for adolescents. An assessment of 12-step meetings and recommended activities has found that attendance, participation, and finding a sponsor promote greater abstinence among adolescents.

Results will be published in the July 2012 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

Long-Term Recovery Support

“Most substance use disorder (SUD) treatment is short-term and relapse rates post-discharge are typically high without continued support,” explained John F. Kelly, associate director of the Center for Addiction Medicine at Massachusetts General Hospital, and associate professor in psychiatry at Harvard Medical School. “Mutual-help organizations such as AA and NA can help fill this gap, providing free and flexible long-term recovery support in the communities in which people live.”

Kelly and his co-author assessed 127 adolescent outpatients (95 males, 32 females) aged 14-19 years old – who were enrolled in a naturalistic study of treatment effectiveness – at intake as well as at three, six, and 12 months later. Effects of the youths’ attendance and active involvement in activities, such as contact with their sponsor, on their subsequent abstinence were tracked over time.

“We found that about one quarter to one third of the youth attended AA/NA throughout the year-long study period following treatment, and that more meeting attendance was associated with significantly better substance use outcomes – particularly attending meetings at least once per week or more,” said Kelly. “Importantly, youth who also were in contact with an AA or NA sponsor or who participated verbally during AA/NA meetings had an even better outcome over and above the positive effects from merely attending. These findings support the common clinical recommendation that individuals should ‘go to meetings, get a sponsor, and get active.’ This is the first evidence to support this common clinical recommendation among young people.”

Encouraging A.A. Attendance

Kelly suggested that medical practitioners, counselors, and other clinicians can enhance the likelihood that youth will attend and participate in AA/NA by encouraging or facilitating their attendance early in treatment.

“Starting an on-site NA or AA young person’s meeting is another good idea,” he added. “Not all youth will be motivated to attend, but the more severely substance-involved ones will be more likely to give meetings a try and these are the ones most likely to benefit. It is also a good idea to facilitate a good match between the patient’s primary substance, cannabis/other drugs or alcohol, and the mutual-help organization to which they are being referred, Marijuana Anonymous, NA, or AA. Not doing this can lead to a poor initial match, which can be difficult to overcome.”

Kelly said that one of the key elements to success in 12-step involvement is the creation of a personal connection between the patient and an existing community AA or NA member.

A.A. for Young People

“This community member can then make introductions, answer questions, and generally act as an initial guide and onsite facilitator,” he said. “This is probably the most significant part of ensuring that young people get to their first meeting and have a positive experience – it’s hard for anyone to walk in ‘cold’ to a large AA or NA meeting. Another possibility is for parents or counselors to take adolescents to meetings or to arrange to meet them at meetings to help facilitate attendance and engagement. Once there, young people report that they like the camaraderie and social affiliation offered at meetings; they appreciate knowing that they are not the only ones suffering from addiction problems, and they report liking the attention, care, and support they get at meetings.”

April 20th, 2012  in Alcoholism No Comments »

Nurse-delivered alcohol interventions more accepted

The U.S. Joint Commission recently approved new hospital accreditation measures related to alcohol screening, brief intervention, and referral to treatment (SBIRT) for all hospitalized patients. Yet little is known about the effectiveness of brief interventions (BIs) or inpatient acceptability of SBIRT when performed by healthcare professionals other than physicians. A new study has found high hospital-patient acceptability of and comfort with nurse-delivered SBIRT.

Results will be published in the April 2012 issue of Alcoholism: Clinical & Experimental Research.

Identifying Unhealthy Alcohol Use

“SBIRT is widely endorsed for identifying and managing unhealthy alcohol use that ranges from hazardous or ‘risky’ drinking to the more serious alcohol abuse and dependence,” explained Lauren M. Broyles, a research health scientist at the VA Pittsburgh Healthcare System, assistant professor of medicine at the University of Pittsburgh, and corresponding author for the study.

“A more recent focus has extended to identification of hazardous drinking – consumption that exceeds guidelines established by the National Institute on Alcohol Abuse and Alcoholism – as more than 14 standard drinks/week or more than four/occasion for men, and more than seven standard drinks/week or more than three/occasion for women and healthy individuals age 65 or older,” she said. “Despite [supporting] evidence, recommendations and mandates concerning SBIRT implementation, uptake by healthcare providers in real-world clinical settings is still relatively limited.”

“SBIRT is a brief conversation, about 10 to 15 minutes, about hazardous alcohol consumption,” added Deborah S. Finnell, a research nurse scientist at the VA Western New York Healthcare System and associate professor of nursing at the University at Buffalo. “Healthcare team members could easily deliver SBIRT, assuming they are qualified. Since nurses provide 24-hour care in hospitals, nurses are most likely to have contact with patients compared with other healthcare team members, such as physicians and social workers.”

High Rate of Acceptability

Broyles and her colleagues conducted a cross-sectional survey of 355 (342 males, 13 females) hospitalized medical-surgical patients at a large university-affiliated medical center that is part of the U.S. Department of Veterans Affairs.

Results indicated acceptability for nurse-delivered SBIRT was high. Patient acceptability for eight out of 10 individual nurse-delivered SBIRT tasks was greater than 84 percent. Roughly 20 percent of the patients reported some degree of personal discomfort with the discussions; in general these individuals had a lower belief in their ability to reduce their drinking risk, were older than 60 years of age, had a positive alcohol screening, and were of non-black race.

“We found, in general, that acceptability for nurse-delivered SBIRT tasks was associated with how people perceived their own alcohol-related risks,” explained Broyles. “Patients had higher acceptability if they felt that they were able to determine and reduce their own alcohol-related health risks, and if they had expressed concern about their own alcohol use. Conversely, roughly 20 percent of the patients expressed annoyance or embarrassment with the questions while also showing high levels of acceptability. While this might seem contradictory, patients might feel embarrassed or uncomfortable with the topic or discussion even though they see the discussions as a legitimate, necessary, and acceptable part of the nurse’s role.”

Alcohol and Health Risks

“This study also highlights the importance of being patient-centered,” said Finnell. “Patients are accepting of receiving information from nurses about changing their alcohol use and about self-help groups. Specifically, when patients can make the connection between their alcohol use and health risks, they may be more accepting of having the conversation with the nurse and continuing that conversation about decreasing the amount of alcohol they consume. Additionally, nurses providing patient-centered care will be sensitive to signs that the patient is uncomfortable during the conversation.”

Broyles agreed. “For hazardous drinkers, nurses and other healthcare providers can normalize alcohol screening and BI by drawing analogies, for themselves and their patients, to screening and structured health behavior advice for other health conditions,” she said. “Normalizing talk about unhealthy alcohol use and alcohol use disorders in general medical settings, by general medical providers, in general medical encounters in this way may help both providers and patients feel more comfortable.”

Finnell said she was not surprised that patients were comfortable with nurse-delivered SBIRT. “I have been amazed at what patients share with me during my interactions with them,” she said. “Americans consistently rank nurses ‘very high’ or ‘high’ on honesty and ethical standards. The concept of trust is an important element in the nurse-patient relationship.”

Appropriate Training Needed

Both Broyles and Finnell emphasized the need for appropriate training, practice, support, and pragmatic strategies for incorporating alcohol SBIRT into existing clinical practices and routines. “Our findings suggest that once trained in SBIRT and motivational interviewing techniques, providers can proceed with greater confidence in alcohol-related risk assessment and risk-reduction conversations with patients,” said Broyles.

“While this study focused on nurse-delivered SBIRT, the take-home points are highly relevant to other clinicians,” added Finnell. “Clinicians who have been asked about barriers to delivering SBIRT report concern about jeopardizing their relationship with the patient. This study shows that patients are accepting of alcohol-related discussions, particularly brief counseling about alcohol, educational materials about changing alcohol use, and information about alcohol self-help groups. The findings from this study should alert nurses, physicians, and other health care providers to be prepared to meet the needs of these patients.”

January 22nd, 2012  in Alcoholism No Comments »

Heavy drinkers have poor dietary habits

Excessive drinking and an unbalanced diet are two preventable contributors to health problems in the developed world. Different studies have found varying linkages between amounts of alcohol consumed and quality of diet. A new study of adults in Spain has found that heavy drinking, binge drinking, a preference for spirits, and drinking alcohol at mealtimes were associated with a poor adherence to major food consumption guidelines.

Results will be published in the November 2011 issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

“Drinking alcohol may reduce maintaining a healthy diet, leading to adverse metabolic effects which in turn add to those directly produced by alcohol,” said José Lorenzo Valencia-Martín, a doctor at the Universidad Autónoma de Madrid and corresponding author for the study. “The specific influence of alcohol on diet may depend upon the overall quantity of alcohol ingested, frequency of consumption, beverage preference, and whether alcohol intake takes place during the meals. Alcohol may indirectly contribute to several chronic diseases such as obesity, diabetes mellitus, cardiovascular disease, or cancer.”

Careless Dietary Habits

“Unhealthy lifestyles tend to cluster together, but this is not a ‘necessary’ association,” added Miguel A. Martínez-González, chair of the department of preventive medicine and Public Health at the University of Navarra. “On average, people who drink excessive alcohol are more likely to be careless in their dietary habits. A high alcohol intake is especially unhealthy with respect to liver disease. A high-energy food pattern rich in trans fats – such as ‘fast-foods’ or items from a commercial bakery – is also likely to be related to liver disease. In this sense, if both unhealthy lifestyles cluster together, they can act synergistically to produce very adverse effects.”

“In Spain, alcohol is frequently drunk during meals, particularly lunch and dinner,” said Valencia-Martín. “Because of this, and the lower prevalence of abstainers, our findings apply to most adults in Spain and in other Mediterranean countries in Europe. Our results are of relevance because they show that drinking at mealtimes is associated with insufficient intake of healthy foods, such as fruits and vegetables, and with excessive intake of animal protein.”

Unintended Consequences

From 2000 to 2005, the researchers carried out a telephone survey of 12,037 adults (5850 men, 6187 women) considered representative of 18-to-64-year-olds in the region of Madrid. Binge drinking was defined as equal to or more than 80 grams of alcohol for men and equal to or more than 60 grams for women during one drinking session; the threshold between moderate and heavy drinking was 40 grams of alcohol per day for men and 24 grams per day for women. Food consumption was measured using a 24-hour recall.

“Excessive drinkers, either with or without binge drinking, showed a poor adherence to dietary recommendations,” said Valencia-Martín. “Although drinking at mealtimes has traditionally been considered a safe or even a healthy behavior, our results point to some unintended consequences that the general populations should be aware of. In particular, drinking at mealtimes is associated with poor adherence to most of the food consumption guidelines. Also, not all types of alcoholic beverages are equal with regard to their dietary effects; our results suggest that a preference for spirits is associated with a poorer diet. Lastly, the above implications apply to both men and women.”

“I believe the key finding of this study is the suggestion of a harmful effect of binge drinking on healthy eating habits,” said Martínez González. “Binge drinking prevalence was found to be relatively high – greater than 10 percent – in a representative sample of Spanish population. This is very bad news. Alcohol misuse has become a priority public-health problem in Spain, especially because of rising rates of binge drinking and especially because of the abandonment of the traditional Mediterranean pattern of moderate alcohol drinking, in little amounts, generally red wine during meals. Recent changes, especially among young Spanish people, include a pattern of high amounts of spirits during weekends. This excellent study adds another unfortunate consequence of this change: the impairment of eating habits.”

Alcohol Replaces Healthy Calories

Martínez González added that both alcohol researchers and clinicians need to pay more attention to the dietary pattern of binge drinkers, and also consider that some of the detrimental effects attributed to alcohol might in fact be consequences of a poor diet.

“Don’t forget that alcohol is addictive, that it replaces healthy calories from other foods by empty calories, meaning these calories are devoid of minerals and vitamins,” said Martínez González. “Keep also in mind that the drinking pattern might be more important than the total amount consumed. The unhealthiest pattern is to consume high amounts – three to four drinks per day – of spirits or beer exclusively during the weekends. Conversely, the healthiest use of alcohol may be red wine, no more than one glass per day for women and two per day for men, and consumed during meals in a regular daily pattern.”

September 4th, 2011  in Alcoholism No Comments »

Definition of Alcoholism

In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence, Inc. (NCADD) and the American Society of Addiction Medicine (ASAM) published this definition for alcoholism:

“Alcoholism is a primary chronic disease with genetic, psychosocial and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic.”

July 27th, 2011  in Alcoholism 31 Comments »

Alcoholism 4 times more likely in mentally ill

A new report shows that alcohol dependence is four times more likely to occur among adults with mental illness than among adults with no mental illness (9.6-percent versus 2.2-percent).

Based on a nationwide survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) the report also shows that the rate of alcohol dependency increases as the severity of the mental illness increases. For example, while 7.9-percent of those with mild mental illness were alcohol dependent, 10-percent of those with moderate mental illness and 13.2-percent of those with serious mental illness were alcohol dependent.

“Mental and substance use disorders often go hand in hand. This SAMHSA study adds to the evidence of this connection,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Co-occurring mental illness and substance use disorders are to be expected not considered the exception. Unfortunately, signs and symptoms of these behavioral health conditions are often missed by individuals, their friends and family members and unnoticed by health professionals. The results can be devastating and costly to our society.”

Behavioral Health Issues

The SAMHSA Spotlight report, “Alcohol Dependence is More Likely among Adults with Mental Illness than Adults without Mental Illness” was developed as part of SAMHSA’s strategic initiative on data, outcomes, and quality – an effort to inform policy makers and service providers on the nature and scope of behavioral health issues. The report is based on data from the 2009 National Survey of Drug Use and Health – a state-of-the-art scientific survey of a large representative sample of people throughout the United States.

The full report is available on the web.

June 5th, 2011  in Alcoholism No Comments »