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CORK Bibliography: Alcohol (Acute Effects)

54 citations. January 2010 to present

Prepared: June 2011

Anderson KG; Brown SA. Middle school drinking: Who, where, and when. Journal of Child & Adolescent Substance Abuse 20(1): 48-62, 2011. (34 refs.)

The goal of this research was to describe the most common drinking situations for young adolescents (N=1171; 46.6% girls), as well as determine predictors of their drinking in the seventh and eighth grades. Middle school students most frequently drank at parties with three to four teens, in their home or at a friend's home, and reported alcohol-related problems including conflicts with friends or parents, memory loss, nausea, and doing things they would not normally do. Differences emerged in predicting higher levels of drinking on the basis of sex, race, grade, positive alcohol expectancies, impulsivity, and peer drinking. These findings suggest both specific and general factors are implicated in drinking for middle school students. Contextual factors, including drinking alone, in public places, and at or near school, are characteristic of the most problematic alcohol involvement in middle school and may have utility in prevention and early intervention.

Bacon AK; Ham LS. Attention to social threat as a vulnerability to the development of comorbid social anxiety disorder and alcohol use disorders: An avoidance-coping cognitive model. Addictive Behaviors 35(11): 925-939, 2010. (137 refs.)

Despite the frequent comorbidity of social anxiety disorder and alcohol use disorders, no theoretical model currently exists to explain the specific mechanisms underlying the comorbidity between these two disorders. An integration of existing theoretical models and empirical evidence across the social anxiety and alcohol use literatures is presented as the Avoidance-Coping Cognitive Model, which proposes that socially anxious individuals may be particularly vulnerable to the anxiolytic effects of alcohol through reductions in attention biases to social threat. The disproportionate reduction in anxiety may then make alcohol an attractive method of avoidance coping. Gaps in the empirical literature are reviewed in light of this model as future directions are suggested.

Ballard ME; de Wit H. Combined effects of acute, very-low-dose ethanol and delta(9)-tetrahydrocannabinol in healthy human volunteers. Pharmacology, Biochemistry and Behavior 97(4): 627-631, 2011. (48 refs.)

Rationale: Previous studies examining the combined effects of ethanol and cannabis, or its primary psychoactive ingredient, Delta(9)-tetrahydrocannabinol (THC), have provided mixed results. Data from an in vitro study suggests that combined, sub-threshold doses of these drugs may interact to produce synergistic effects. Very low doses of the two drugs in combination have not been tested in humans. Materials and methods: This study assessed whether combinations of acute, very low doses of ethanol and THC produce synergistic effects on subjective, cognitive, and physiological measures. Healthy volunteers (n = 11) received capsules containing placebo or THC (2.5 mg), and beverages containing placebo or ethanol (0.1 and 0.2 g/kg) alone, and in combination, across separate sessions, in a within-subjects, randomized, double-blind design. During each session, participants completed measures of working memory, psychomotor ability, and simple reaction time, and provided subjective mood and drug effect ratings. Cardiovascular measures were obtained at regular intervals. Results: As intended, when administered alone, these very low doses of ethanol and THC had only moderate effects on isolated measures. The combined effects of these drugs were not synergistic, and in some cases appeared to be less-than-additive. Conclusions: Our data provide no evidence for synergistic effects of acute combinations of very-low-dose ethanol and THC on subjective or physiologic response, or on cognitive performance.

Barnes MJ; Mundel T; Stannard SR. Acute alcohol consumption aggravates the decline in muscle performance following strenuous eccentric exercise. Journal of Science and Medicine in Sport 13(1): 189-193, 2010. (21 refs.)

This study investigated the effects of acute moderate alcohol intake on muscular performance during recovery from eccentric exercise-induced muscle damage. Eleven healthy males performed 300 maximal eccentric contractions of the quadriceps muscles of one leg on an isokinetic dynamometer. They then consumed a beverage containing 1 g/kg bodyweight ethanol (as vodka and orange juice) (ALC). On another occasion they performed an equivalent bout of eccentric exercise on the contralateral leg after which they consumed an isocaloric quantity of orange juice (OJ). Measurement of maximal isokinetic (concentric and eccentric) and isometric torque produced across the knee, plasma creatine kinase (CK) concentrations and muscle soreness were made before and at 36 and 60 h following each exercise bout. All measures of muscle performance were significantly reduced at 36 and 60h post-exercise compared to pre-exercise measures (all p<0.05). The greatest decreases in peak strength were observed at 36 h with losses of 12%, 28% and 19% occurring for OJ isometric, concentric, and eccentric contractions, respectively. However, peak strength loss was significantly greater in ALC with the same performance measures decreasing by 34%, 40% and 34%, respectively. Post-exercise plasma creatine kinase activity and ratings of muscle soreness were not different between conditions (both p > 0.05). These results indicate that consumption of even moderate amounts of alcohol following eccentric-based exercise magnifies the normally observed losses in dynamic and static strength. Therefore, to minimise exercise related losses in muscle function and expedite recovery, participants in sports involving eccentric muscle work should avoid alcohol-containing beverages in the post-event period.

Beckerleg S. 'Idle and disorderly' khat users in Western Uganda. Drugs: Education, Prevention and Policy 17(4): 303-314, 2010. (23 refs.)

Aims: To describe and analyse patterns of khat consumption and the response of the authorities to such drug use in Western Uganda. Methods: Participant-observation and key informant interviews were carried out in Western Uganda during 2007, 2008 and 2009. Findings: Khat is legal in Uganda but its use, especially when combined with alcohol and cannabis, is linked with violent crime by many Ugandans. In Western Uganda local government authorities have attempted to crack down on khat: in Bushenyi District they have introduced a by-law; in other districts khat traders and consumers face arrest and charges of being 'idle and disorderly'. Conclusion: The authorities, by clamping down on khat, because they perceive it to be a cause of violent crime, are targeting a substance that is widely reported in the academic literature to cause apathy, not violence.

Birak KS; Terry P; Higgs S. Effect of cues associated with an alcoholic beverage on executive function. Journal of Studies on Alcohol and Drugs 71(4): 562-569, 2010. (29 refs.)

Objective: To investigate whether alcohol-associated drink cues can elicit conditioned compensatory responses that counter alcohol's effects on cognition. Method: A between-subjects design was used in which participants were randomly assigned to one of three drink groups: an alcohol-associated drink (lager based) or one of two drinks not usually associated with alcohol (a fruit squash-flavored drink or an apple schnapps-flavored drink; n = 15 per group). The amount of alcohol in each was the same: 0.65 g/kg body weight for men and 0.57 g/kg for women. Executive functions of inhibition, updating of working memory, and attentional set shifting were measured using the CANTABeclipse computerized test battery before and after alcohol consumption. Self-reported mood was measured, and participants provided ratings of the drinks' sensory and hedonic properties. Results: Participants in the lager drink group showed less disinhibitory responding in an affective go/no-go task and less of a reduction in alertness than participants in the two other groups. The lager group was also faster to respond in the set-shifting task than the group given the "squash" (nonassociated) drink. There were no significant differences between the groups in how they evaluated the drinks' sensory/hedonic properties. Conclusions: These data provide provisional evidence to suggest that cues previously associated with alcohol in lager drinkers (particularly the taste and smell of lager) can elicit compensatory responses that counter alcohol's cognitive effects and its effects on alertness.

Carhart-Harris RL; Nutt DJ. User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study. Journal of Substance Use 15(4): 283-300, 2010. (32 refs.)

This study used a web-based questionnaire to investigate user perceptions of the benefits and harms of hallucinogenic drug use. Over 600 forms were submitted. Users were asked to comment on the acute and prolonged effects of different drugs and to provide more specific information on how particular drugs have harmed and/or helped them. Subjects reported relatively less harm associated with the classic hallucinogens, LSD and psilocybin, than other drugs specifically focused on in the questionnaire (MDMA, cannabis, ketamine and alcohol). A wide-range of benefits was reported, including: help with mood disorders, addictions and migraine as well as more general long-term improvements in wellbeing. Symptoms of hallucinogen persisting perceptual disorder were reported by a number of subjects and these were most closely associated with use of LSD; however, few users regarded these effects as troubling. Eighty-one per cent of users reported having had a 'spiritual experience' on a hallucinogenic drug and over 90% considered 'access to the unconscious mind' to be a specific property of the classic hallucinogens. With caution, these findings support recent calls for a systematic investigation of the therapeutic potential of the classic hallucinogens and highlight the scope for empirical investigations of spiritual and psychodynamic phenomena.

Chan DCN; Wu AMS; Hung EPW. Invulnerability and the intention to drink and drive: An application of the theory of planned behavior. Accident Analysis and Prevention 42(6): 1549-1555, 2010. (46 refs.)

The present study aims at an examination, based on the theory of planned behavior (TPB), of the psychological antecedents of young Chinese people's intentions to drive after drinking. One hundred and twenty-four licensed drivers (aged from 19 to 35 years) successfully completed an online questionnaire. Using path analysis, we found the most proximal predictors of intention to be attitudes and perceived behavioral control, whereas invulnerability as well as subjective norms indirectly influenced intention by promoting favorable attitudes toward and greater perceived behavioral control over driving after alcohol use. The total explained variances in the intention to drink and drive reached 79%. The present findings highlight irrational beliefs of invulnerability and the three TPB components as potentially valid targets for prevention and intervention efforts against drinking and driving among young Chinese drivers.

Cheng SY; Lee HY; Lee JC; Tsai SY. Comparing the effects of light alcohol consumption on human response to auditory and visual stimuli. Perceptual and Motor Skills 111(2): 589-607, 2010. (44 refs.)

The purpose of this study is to examine the effects of various levels of alcohol consumption on human response to auditory and visual stimuli in terms of reaction time movement time total reaction time and error rate Placebo level and three low level alcohol doses were randomly assigned to 20 male university student volunteers 30 mm after consuming the alcohol or placebo participants responded to either auditory or visual stimuli Total reaction time increased significantly at the mid-low dose of alcohol (0 3 g/kg) For alcohol doses less than 5 g/kg the change in total reaction time was confined to reaction time i e the processing time between onset of stimulus and onset of movement Effects of alcohol were significantly more pronounced in the choice type tests Notably the effects of alcohol on total reaction time and error rate were significant for auditory but not visual stimuli.

Chermack ST; Grogan-Kaylor A; Perron BE; Murray RL; De Chavez P; Walton MA et al. Violence among men and women in substance use disorder treatment: A multi-level event-based analysis. Drug and Alcohol Dependence 112(3): 194-200, 2010. (49 refs.)

Background: This study examined associations between acute alcohol and drug use and violence towards others in conflict incidents (overall partner and non-partner conflict incidents) by men and women recruited from substance use disorder (SUD) treatment Methods: Semi-structured interviews were used to obtain details about Interpersonal conflict incidents (substance use whether specific conflicts were with intimate partners or non-partners) in the 180 days pre-treatment Participants for this study were selected for screening positive for past-year violence (N = 160 77% men 23% women) Results: Multi-level multinomial regression models showed that after adjusting for clustering within individual participants the most consistent predictors of violence across models were acute cocaine use (significant for overall intimate partner and non-partner models) acute heavy alcohol use (significant for overall and non-partner models) and male gender (significant in all models) Conclusions: This study was the first to explicitly examine the role of acute alcohol and drug use across overall partner and non-partner conflict incidents. Consistent with prior studies using a variety of methodologies alcohol cocaine use and male gender was most consistently and positively related to violence severity (e g resulting in injury). The results provide important and novel event-level information regarding the relationship between acute alcohol and specific drug use and the severity of violence in interpersonal conflict incidents.

Ehlers CL; Gizer IR; Schuckit MA; Wilhelmsen KC. Genome-wide scan for self-rating of the effects of alcohol in American Indians. Psychiatric Genetics 20(5): 221-228, 2010. (87 refs.)

Objective: This study's aims were to map loci linked to self-rating of the effects of alcohol and to determine if there was overlap with loci mapped earlier for other substance dependence phenotypes in an American Indian community at high risk for substance dependence. Methods: Each participant gave a blood sample and completed a structured diagnostic interview using the Semi Structured Assessment for the Genetics of Alcoholism. Retrospective report of responses to alcohol during the FIRST FIVE TIMES they had ever drank alcohol was estimated from the Self-Rating of the Effects of Alcohol (SRE) questionnaire for each participant. Genotypes were determined for a panel of 791 micro-satellite polymorphisms in 381 members of multiplex families using SOLAR. Results Analyses of multipoint variance component Log of Odds (LOD) scores, for the FIRST FIVE TIMES phenotype, revealed two loci that had a LOD score greater than 3.0 on chromosomes 6 and 9. In addition, three locations were identified with LOD scores above 2.0 on chromosomes 10, 12, 17. Conclusion: These results corroborate the importance of regions on chromosome 6 and 9 highlighted in earlier segregation studies in this and other populations for substance dependence-related phenotypes, as well as an area on chromosome 10 earlier identified for the FIRST FIVE TIMES phenotype in the collaborative study on the genetics of alcoholism. These studies additionally lend further support the construct that the SRE may represent an important endophenotype associated with alcohol and other substance dependence.

Gmel G; Kuntsche E; Wicki M; Labhart F. Measuring alcohol-related consequences in school surveys: Alcohol-attributable consequences or consequences with students' alcohol attribution. American Journal of Epidemiology 171(1): 93-104, 2010. (53 refs.)

In alcohol epidemiology surveys, there is a tradition of measuring alcohol-related consequences using respondents' attribution of alcohol as the cause. The authors aimed to compare the prevalence and frequency of self-attributed consequences to consequences without self-attribution using alcohol-attributable fractions (AAF). In 2007, a total of 7,174 Swiss school students aged 13-16 years reported the numbers of 6 alcohol-related adverse consequences (e.g., fights, injuries) they had incurred in the past 12 months. Consequences were measured with and without attribution of alcohol as the cause. The alcohol-use measures were frequency and volume of drinking in the past 12 months and number of risky single-occasion (>= 5 drinks) drinking episodes in the past 30 days. Attributable fractions were derived from logistic (>= 1 incident) and Poisson (number of incidents) regression analyses. Although relative risk estimates were higher when alcohol-attributed consequences were compared with nonattributed consequences, the use of AAFs resulted in more alcohol-related consequences (10,422 self-attributed consequences vs. 24,520 nonattributed consequences determined by means of AAFs). The likelihood of underreporting was higher among drinkers with intermediate frequencies than among either rare drinkers or frequent drinkers. Therefore, the extent of alcohol-related adverse consequences among adolescents may be underestimated when using self-attributed consequences, because of differential attribution processes, especially among infrequent drinkers.

Greenstein JE; Kassel JD; Wardle MC; Veilleux JC; Evatt DP; Heinz AJ et al. The separate and combined effects of nicotine and alcohol on working memory capacity in nonabstinent smokers. Experimental and Clinical Psychopharmacology 18(2): 120-128, 2010. (63 refs.)

Research indicates that nicotine and alcohol are often used on the same occasion. However, the reasons for their concurrent use are not well understood. We hypothesized that one reason smokers use tobacco when they drink alcohol is to compensate for alcohol's negative effects on processing capacity with nicotine's enhancement of processing capacity. As such, the present study tested this theory by using an independent groups design to examine the separate and combined acute effects of alcohol and nicotine on working memory (WM) capacity. Nonabstinent daily smokers (n = 127) performed the counting span task (CSPAN) after consuming either an alcohol (men: 0.8 g/kg; women: 0.7 g/kg) or placebo beverage and smoking either nicotinized (1.14 mg nicotine, 15.9 mg tar) or denicotinized (.06 mg nicotine, 17.9 mg tar) cigarettes. Analyses revealed that smokers who smoked the nicotinized cigarettes performed significantly worse on the CSPAN task than smokers who smoked the denicotinized cigarettes. Although there was no main effect of alcohol on WM performance, women exhibited better WM performance than men after consuming alcohol whereas men performed better than women on the WM task after consuming the placebo beverage. Findings also revealed no interaction between the two substances on WM performance. Taken together, results suggest that nicotine impairs nonabstinent smokers' verbal WM capacity and that gender moderates the effects of alcohol on WM. Furthermore, the present findings failed to support the notion that nicotine compensates for alcohol-related decrements in working memory capacity.

Gruenewald PJ; Johnson FW; Ponicki WR; LaScala EA. A dose-response perspective on college drinking and related problems. Addiction 105(2): 257-269, 2010. (27 refs.)

Aims: In order to examine the degree to which heavy drinking contributes to risks for problems among college drinkers this paper develops and tests a dose-response model of alcohol use that relates frequencies of drinking specific quantities of alcohol to the incidence of drinking problems. Methods: A mathematical model was developed that enabled estimation of dose-response relationships between drinking quantities and drinking problems using self-report data from 8698 college drinkers across 14 campuses in California, USA. The model assumes that drinking risks are a direct monotone function of the amount consumed per day and additive across drinking days. Drinking problems accumulate across drinking occasions and are the basis for cumulative reports of drinking problems reported by college drinkers. Results: Statistical analyses using the model showed that drinking problems were related to every drinking level, but increased fivefold at three drinks and more gradually thereafter. Problems were associated most strongly with occasions on which three drinks were consumed, and more than half of all reported problems were related to occasions on which four or fewer drinks were consumed. There were some important differences in dose-responsiveness between men and women and between different groups of 'light', 'moderate' and 'heavier' drinkers. Conclusion: Many problems among college students are associated with drinking relatively small amounts of alcohol (two to four drinks). Programs to reduce college drinking problems should emphasize risks associated with low drinking levels.

Haberstick BC; Zeiger JS; Corley RP; Hopfer CJ; Stallings MC; Rhee SH et al. Common and drug-specific genetic influences on subjective effects to alcohol, tobacco and marijuana use. Addiction 106(1): 215-224, 2011. (49 refs.)

Aim: To examine variation in positive and negative subjective effects to alcohol, tobacco and marijuana and covariation between these three drugs and each effect. Design: Retrospective self-reports of subjective effects were collected to estimate the genetic and environmental influences and the extent of their specificity across three drugs. Participants: Data were drawn from 1299 adolescent and young adult same- and opposite sex twin- and sibling-pairs participating in the Colorado Center for Antisocial Drug Dependence (CADD). Setting: A large, collaborative, longitudinal study of substance use and antisocial behavior in community and clinical adolescents. Measurement: Subjective effects were assessed using a 13-item questionnaire that included positive and negative responses to alcohol, tobacco and marijuana. Findings: Heritable influences contributed moderately (additive genetic effects 16-56%) to positive and negative subjective effects to all three drugs and did not differ for males and females. Genetic and environmental contributions to positive and negative subjective effects are largely non-overlapping for tobacco and marijuana. Multivariate genetic modeling indicated that subjective effects to alcohol, tobacco and marijuana share a common, heritable etiology and that drug-specific genetic influences were an important contributor to individual differences in drug response. Conclusions: Results from our genetic analyses suggest that subjective effects to these commonly used and misused drugs are heritable and that the genetic and environmental influences on effects to one drug also influence subjective effects to other drugs.

Halsey LG; Huber JW; Bufton RDJ; Little AC. An explanation for enhanced perceptions of attractiveness after alcohol consumption. Alcohol 44(4): 307-313, 2010. (29 refs.)

Acute alcohol consumption increases ratings of attractiveness to faces. This may help to explain increased frequencies of sexual encounters during periods of alcohol intoxication. At least in part, such increased attraction may be the result of alcohol consumption decreasing ability to detect bilateral asymmetry, presumably because of the reductions in the levels of visual function. We tested the hypotheses that acute alcohol consumption decreases ability to detect asymmetry in faces and reduces preference for symmetrical faces over asymmetrical faces. Twenty images of a pair of faces and then 20 images of a single face were displayed on a computer, one at a time. Participants were instructed to state which face of each of the face pairs displayed was most attractive and then whether the single face being displayed was symmetrical or not. Data were collected near campus bars at Roehampton University. Sixty-four self-selecting students who undertook the study were classified as either sober (control) or intoxicated with alcohol. For each face pair or single face displayed, participant response was recorded and details of the alcohol consumption of participants that day were also obtained. Sober participants had a greater preference for symmetrical faces and were better at detecting whether a face was symmetrical or otherwise, supporting the hypotheses. A further, unexpected finding was that males made fewer mistakes than did females when determining whether individual faces were asymmetrical. The reduced ability of inebriated people to perceive asymmetry may be an important mechanism underlying the higher ratings of facial attractiveness they give for members of the opposite sex and hence their increased frequency of mate choice.

Howland J; Rohsenow DJ; Arnedt JT; Bliss CA; Hunt SK; Calise TV et al. The acute effects of caffeinated versus non-caffeinated alcoholic beverage on driving performance and attention/reaction time. Addiction 106(2): 335-341, 2011. (37 refs.)

Aims: Marketing that promotes mixing caffeinated 'energy' drinks with alcoholic beverages (e.g. Red Bull with vodka) targets young drinkers and conveys the expectation that caffeine will offset the sedating effects of alcohol and enhance alertness. Such beliefs could result in unwarranted risk taking (e.g. driving while intoxicated). The aim of this study was to assess the acute effects of caffeinated versus non-caffeinated alcoholic beverages on a simulated driving task and attention/reaction time. Design: We conducted a 2 x 2 between-groups randomized trial in which participants were randomized to one of four conditions: beer and non-alcoholic beer, with and without caffeine added. Caffeine was added in the same proportion as found in a commercially available caffeinated beer (69 mg/12 oz of beer at 4.8% alc. by vol). Participants: Participants were 127 non-dependent, heavy episodic, young adult drinkers (age 21-30) who were college students or recent graduates. The target breath alcohol level was 0.12 g%. Measures: Driving performance was assessed with a driving simulator; sustained attention/reaction with the Psychomotor Vigilance Task (PVT). Findings: Across the driving and attention/reaction time we found main effects for alcohol, with alcohol significantly impairing driving and sustained attention/reaction time, with mainly large statistical effects; however, the addition of caffeine had no main or interaction effects on performance. Conclusion: The addition of caffeine to alcohol does not appear to enhance driving or sustained attention/reaction time performance relative to alcohol alone.

Jayne M; Valentine G; Holloway SL. Emotional, embodied and affective geographies of alcohol, drinking and drunkenness. Transactions of The Institute of British Geographers 35(4): 540-554, 2010. (54 refs.)

This paper develops dialogue between geographers' engagement with emotion, embodiment and affect, and geographical research on alcohol, drinking and drunkenness. In doing so, we focus on the long-running 'moral panic' relating to alcohol-related violence, disorder and drunken behaviour in urban public space. We argue there has been an ontological and epistemological impasse in 'alcohol studies' between approaches that have considered the biological, physiological and psychological impacts of alcohol consumption and those focused on social and cultural practices. While there has been an artificial separation, and hence under-theorisation of the relationships between emotions, embodiment, affect and everyday uses of alcohol, we develop an argument that signals the possibilities of a more nuanced and sophisticated approach. We present empirical research from the UK and offer theoretical, methodological and policy-relevant conclusions.

Joslyn G; Ravindranathan A; Brush G; Schuckit M; White RL. Human variation in alcohol response is influenced by variation in neuronal signaling genes. Alcoholism: Clinical and Experimental Research 34(5): 800-812, 2010. (67 refs.)

Background: Alcohol use disorders (AUD) exhibit the properties shared by common conditions and diseases classified as genetically complex. The etiology of AUDs is heterogeneous involving mostly unknown interactions of environmental and heritable factors. A person's level of response (LR) to alcohol is inversely correlated with a family history and the development of AUDs. As an AUD endophenotype, alcohol LR is hypothesized to be less genetically complex and closer to the primary etiology of AUDs. Methods: A genome wide association study (GWAS) was performed on subjects characterized for alcohol LR phenotypes. Gene Set Enrichment Analysis (GSEA) of the GWAS data was performed to determine whether, as a group, genes that participate in a common biological function (a gene set) demonstrate greater genetic association than would be randomly expected. Results: The GSEA analysis implicated variation in neuronal signaling genes, especially glutamate signaling, as being involved in alcohol LR variability in the human population. Conclusions: These data, coupled with cell and animal model data implicating neuronal signaling in alcohol response, support the conclusion that neuronal signaling is mechanistically involved in alcohol's cellular and behavioral effects. Further, these data suggest that genetic variation in these signaling pathways contribute to human variation in alcohol response. Finally, this concordance of the cell, animal, and human findings supports neuronal signaling, particularly glutamate signaling, as a prime target for translational studies to understand and eventually modulate alcohol's effects.

Kaminer Y. Problematic use of energy drinks by adolescents. Child and Adolescent Psychiatric Clinics of North America 19(3): 643-+, 2010. (38 refs.)

Energy drinks (EDs) are caffeine-based beverages that commonly contain large doses of sugar, carbohydrates, and a variety of legal stimulants and supplements, such as guarana, taurine, ginseng, and vitamin B complex. These drinks are marketed for young people as natural alternatives that increase fun and improve physical and cognitive performance such as concentration, attention, and alertness. There are commonly held false perceptions that the consumption of EDs can reverse alcohol-related impairment, including motor coordination and visual reaction time, which are crucial for driving safety. This article reviews the literature on EDs and examines problematic use and potential negative consequences in young people. Special emphasis is devoted to safety concerns following combination of EDs with alcohol, which gives the user a false sense of control.

Kareken DA; Liang TB; Wetherill L; Dzemidzic M; Bragulat V; Cox C et al. A polymorphism in GABRA2 is associated with the medial frontal response to alcohol cues in an fmri study. Alcoholism: Clinical and Experimental Research 34(12): 2169-2178, 2010. (63 refs.)

Background: Significant evidence has accumulated to suggest an association between single-nucleotide polymorphisms (SNPs) in the GABRA2 gene and alcoholism. However, research has yet to show an association between these polymorphisms and the human brain's reward system function. In this study, we stratified subjects who had participated in an fMRI study of alcohol cue responses according to their genotype at a SNP in GABRA2 (rs279871) shown to be associated with alcohol dependence (Edenberg et al, 2004). Methods: Genotyping showed 13 subjects to be homozygous for the high-risk allele (AA), and 23 subjects to be heterozygous (AG). In fMRI, subjects were exposed to the aromas of their preferred alcoholic drink odors (AO), as well as to appetitive control odors (ApCO) under both alcohol intoxication and placebo control conditions. Results: Homozygous AA subjects had a larger [AO > ApCO] response than did AG subjects in medial frontal cortical areas thought to code reward value. However, AG subjects had a larger [AO > ApCO] effect in the ventral tegmental area. Alcohol intoxication did not alter these group differences. Conclusions: These are the first data to suggest that GABRA2 genotype could affect the brain's responses to cues associated with alcohol.

Manzo-Avalos S; Saavedra-Molina A. Cellular and mitochondrial effects of alcohol consumption. (review). International Journal of Environmental Research and Public Health 7(12): 4281-4304, 2010. (168 refs.)

Alcohol dependence is correlated with a wide spectrum of medical, psychological, behavioral, and social problems. Acute alcohol abuse causes damage to and functional impairment of several organs affecting protein, carbohydrate, and fat metabolism. Mitochondria participate with the conversion of acetaldehyde into acetate and the generation of increased amounts of NADH. Prenatal exposure to ethanol during fetal development induces a wide spectrum of adverse effects in offspring, such as neurologic abnormalities and pre- and post-natal growth retardation. Antioxidant effects have been described due to that alcoholic beverages contain different compounds, such as polyphenols as well as resveratrol. This review analyzes diverse topics on the alcohol consumption effects in several human organs and demonstrates the direct participation of mitochondria as potential target of compounds that can be used to prevent therapies for alcohol abusers.

Maraj S; Figueredo VM; Morris DL. Cocaine and the heart. (review). Clinical Cardiology 33(5): 264-269, 2010. (39 refs.)

The use of cocaine may be associated with either acute or chronic toxicity, and approximately 5% to 10% of emergency department visits in the United States are believed to be secondary to cocaine usage. Chest pain is the most common cocaine-related medical problem, leading to the evaluation of approximately 64000 patients annually for possible myocardial infarction, of which approximately 57% are admitted to the hospital, resulting in an annual cost greater than $83 million. There is a plethora of cocaine-related cardiovascular complications, including acute myocardial ischemia and infarction, arrhythmias, sudden death, myocarditis, cardiomyopathy, hypertension, aortic ruptures, and endocarditis. There is no evidence to suggest that preexisting vascular disease is a prerequisite for the development of a cocaine-related cardiovascular event, although it may be a potentiating factor, as may be nicotine and alcohol.

Marmorstein NR; White H; Chung T; Hipwell A; Stouthamer-Loeber M; Loeber R. associations between first use of substances and change in internalizing symptoms among girls: Differences by symptom trajectory and substance use type. Journal of Clinical Child and Adolescent Psychology 39(4): 545-558, 2010. (44 refs.)

This study examined how girls' initial use of alcohol, cigarettes, and marijuana related to changes in depressive, generalized anxiety, and social anxiety symptoms, and whether these changes varied based on which internalizing symptom trajectories the girls were on. Data came from the Pittsburgh Girls Study, a community-based study of girls assessed at ages 5 to 8 and followed for 6 years. Growth mixture modeling was used to identify trajectory groups. The results indicated that for girls on a high depressive symptom trajectory, initial use of marijuana was related to further increases in depressive symptoms. Initial uses of alcohol and cigarettes were associated with overall increases in depressive symptoms, and the initial use of cigarettes was associated with an overall increase in generalized anxiety symptoms. Initial use of all substances was related to change in social anxiety, but the direction of change varied by trajectory group and substance. Links between initial use and internalizing symptoms depended on the type of substance, type of internalizing symptom, and trajectory group.

Miranda R; Ray L; Justus A; Meyerson LA; Knopik VS; McGeary J et al. Initial evidence of an association between OPRM1 and adolescent alcohol misuse. Alcoholism: Clinical and Experimental Research 34(1): 112-122, 2010. (87 refs.)

Background: Considerable research efforts have attempted to identify genes associated with alcoholism among adults, yet few studies have examined adolescents. Identifying genes associated with alcohol misuse in youth is important given that the relative contribution of genetic and environmental influences on alcoholism varies across development. The purpose of this study was to examine the association between a polymorphism of the mu-opioid receptor gene (OPRM1) and alcohol misuse in a sample of youth and to test whether heightened sensitivity to the reinforcing effects of alcohol mediated this relationship. Methods: Adolescents (n = 187; mean age = 15.4 years; 47.6% female) were genotyped for A118G (i-sl799971), a single-nucleotide polymorphism (SNP) of the OPRM1 gene, and assessed for alcohol use disorder (AUD) diagnoses and other psychopathology. Alcohol misuse was also measured continuously to maximize detection of drinking problems in youth. Drinking motives were used to capture the extent to which youth consumed alcohol to enhance positive affect. Results: AUD groups differed significantly in terms of allelic distributions of the A118G SNP. 51.9%, of youth with an AUD carried at least one copy of the G allele compared to 16.3% of non-AUD controls. Those who carried the G allele endorsed drinking to enhance positive affect more strongly than those who were homozygous for the A allele and drinking to enhance positive affect mediated the association between OPRM1 and alcohol-related problems. Conclusions: These data build on findings from adult studies and provide the first evidence that a polymorphism of the OPRM1 reccptor gene is associated with the development of early-onset alcohol-related problems during adolescence, in part, by heightening sensitivity to the reinforcing effects of alcohol.

Morean ME; Corbin WR. Subjective response to alcohol: A critical review of the literature. (review). Alcoholism: Clinical and Experimental Research 34(3): 385-395, 2010. (93 refs.)

Background: Subjective response to alcohol (SR), which reflects individual differences in sensitivity to the pharmacological effects of alcohol, may be an important endophenotype in understanding genetic influences on drinking behavior and alcohol use disorders (AUDs). SR predicts alcohol use and problems and has been found to differ by a range of established risk factors for the development of AUDs (e.g., family history of alcoholism). The exact pattern of SR associated with increased risk for alcohol problems, however, remains unclear. The Low Level of Response Model (LLR) suggests that high-risk individuals experience decreased sensitivity to the full range of alcohol effects, while the Differentiator Model (DM) asserts that high risks status is associated with increased sensitivity to alcohol's positive effects but decreased sensitivity to negative effects. Aims: The current paper (1) reviews two prominent models of subjective response, (2) reviews extant laboratory-based research on subjective response, (3) highlights remaining gaps in our understanding and assessment of subjective response, and (4) encourages collaborative efforts to address these methodological and conceptual concerns. Methods: This paper reviews studies which employed placebo-controlled and non-placebo-controlled alcohol challenge paradigms to assess a range of alcohol effects including impairment, stimulation, and sedation. Results: The research literature provides at least partial support for both the LLR and DM models. High-risk individuals have been shown to have a reduced response to alcohol with respect to sedative or impairing effects, particularly on the descending limb of the blood alcohol curve (BAC). There is also evidence that ascending limb stimulant effects are more pronounced or operate differently for high-risk individuals. Discussion: Despite commendable advances in SR research, important questions remain unanswered. Inconsistent results across studies may be attributable to a combination of an inadequate understanding of the underlying construct and methodological differences across studies (e.g., number and timing of assessments across the BAC, inclusion of a placebo condition). With respect to the underlying construct, existing measures fail to adequately distinguish between cognitive/behavioral impairment and sedation, aspects of which may be perceived positively (e.g., anxiolysis) due to their ability to act as negative reinforcers. Conclusions: Addressing the concerns raised by the current review will be integral to making meaningful scientific progress in the field of subjective response.

Moss AC; Dyer KR; Albery IP; Allsop S; Kypri K; Erskine J et al. Alcohol pharmacokinetics, decision making and folk wisdom: A reply to Moxnes and Jensen (2009) (editorial). Drug and Alcohol Dependence 109(1-3): 1-3, 2010. (19 refs.)

Moxnes and Jensen (2009) present a study of decision making under conditions of uncertainty using a computerised simulation of alcohol pharmacokinetics. In their article, they conclude that their findings challenge the 'folk wisdom' that advises against drinking on an empty stomach. We contend that this is a problematic conclusion for three reasons: (1) the study and findings presented in their paper are simply not sufficient to allow one to, even tentatively, draw such a conclusion; (2) the conclusion is contrary to basic pharmacological knowledge concerning alcohol absorption, metabolism and the implications for peak blood alcohol concentration: and (3) the implications for understanding the process of decision making while alcohol intoxicated are not considered in the study. The Moxnes and Jensen (2009) study did not involve alcohol administration and is therefore an examination of decision making in situations of uncertainty rather than a specific exploration of drinking-related decision making. Recent formulations of the effects of alcohol on cognitive processing would lead to different conclusions than those presented by Moxnes and Jensen (2009). We conclude by suggesting our understanding of the implications of the study.

Moxnes E; Jensen L. Complex alcohol pharmacokinetics: A response to Moss et al. (editorial). Drug and Alcohol Dependence 109(1-3): 4-5, 2010. (0 refs.)

The commentary by Moss et al. (2010) disagrees with policy recommendations we did not give. Our main conclusions were that "Our study warrants further studies... [and]... implies a modification of the 'folk wisdom' of not drinking on an empty stomach." Our conclusions were based on a laboratory experiment where we found that juvenile subjects behaved according to a simple feedback rule when making drinking decisions. This rule led them to overshoot intended levels of drunkenness. For further research we suggested a diagnostic information treatment to test effects on real drinking behavior. Moss et al. misinterpret our discussion of the 'folk wisdom' and their comments strengthen our claim that this is a complex issue that requires further studies.

Noel X; Bechara A; Brevers D; Verbanck P; Campanella S. Alcoholism and the loss of willpower: A neurocognitive perspective. Journal of Psychophysiology 24(4): 240-248, 2010. (66 refs.)

Like other addictions, alcoholism reflects the continuation of alcohol use despite negative consequences (e. g., an ulcer or family problems made worse by alcohol consumption). Recent cognitive theories suggest that optimal information processing related to the capacity to make decisions under uncertainty conditions is impaired either prior to the initiation of alcohol use, or it is related to the consequence of its repeated utilization. In this paper, we suggest that alcoholism may be the product of an imbalance between two separate, but interacting, cognitive registers that contribute to decision making: a reactive/automatic attentional and memory system for signaling the presence of alcohol cues in the environment and for attributing to such cues pleasure and/or excitement; and a reflective/nonautomatic system for regulating the dominant reactive/automatic response. Hyperactivity within the reactive system can override the reflective system and brain/cognitive changes induced by ethanol could lead to the disruption of self-regulation. We finally develop the idea that different patterns of imbalance between reactive and reflective systems could lead to distinct patterns of clinical impulsivity involved in the vulnerability to, the development of, and the relapse into alcoholism.

Noel X; Campanella S; Pelc I; Verbanck P. Acute and chronic effects of alcohol: Some insights from cognitive sciences. Acta Clinica Belgica 65(Supplement 1): 68-74, 2010. (38 refs.)

Alcohol consumption may alter the behaviour of a drinker through several different mechanisms that lead to transient changes in the cognitive functioning of the drinker. In some cases, alcohol users and abusers begin to suffer from a disorder characterised by a certain "myopia" for future consequences, where the negative consequences associated with drinking (e.g., relationships, medical problems, etc.) do not lead to drinking moderation or cessation. Interestingly, this abnormal cognitive functioning is often seen in these individuals even when they are sober. This paper reviews evidence in support of the notion that the acute effects of alcohol disrupt primarily at least three key cognitive processes that are critical for flexible interaction with a changing environment: (1) the response to alcohol cues, which acquire new properties of quickly grasping attention and generating strong motivation to have a drink; (2) the individual's ability to exert control over this tendency to seek reward, and to volitionally inhibit or suppress a prepotent responding to alcohol cues; and (3) the individual's ability to detect an error when an incorrect response is initiated, or to detect action slips, so that for instance when driving a car is intended, the stopping of alcohol consumption becomes difficult. Finally, cognitive and brain electrophysiological aspects of binge drinking are discussed. In order to improve prevention, the identification of susceptibility factors to these alcohol effects should be challenged in further investigations.

Ostafin BD; Marlatt GA; Troop-Gordon W. Testing the incentive-sensitization theory with at-risk drinkers: Wanting, liking, and alcohol consumption. Psychology of Addictive Behaviors 24(1): 157-162, 2010. (24 refs.)

Motivational models of addiction typically propose that alcohol and drugs are desired because of their hedonic effects (i.e., increasing pleasure or reducing distress). In contrast, the incentive-sensitization theory proposes that wanting motivation and liking motivation are separable and that after repeated substance use, motivation shifts from liking to wanting. Using a sample of 85 at-risk drinkers (as defined by the National Institute on Alcohol Abuse and Alcoholism), in the current study we examined the separability of liking motivation and wanting motivation for alcohol and whether years of drinking experience was associated with an increased role for wanting motivation and a decreased role for liking motivation. Consumption was measured with a free-drinking task. Wanting motivation was assessed immediately before drinking, and liking was assessed immediately after drinking had begun. The results indicated that (a) wanting motivation predicted variance of consumption unique from that accounted for by liking motivation, (b) longer drinking experience was associated with a decreased relation between liking motivation and consumption, and (c) longer drinking experience was not associated with an increased relation between wanting motivation and consumption. The results provide partial support for the incentive-sensitization theory.

Quinn PD; Fromme K. Predictors and outcomes of variability in subjective alcohol intoxication among college students: An event-level analysis across 4 years. Alcoholism: Clinical and Experimental Research 35(3): 484-495, 2011. (45 refs.)

Background: Individual differences in subjective alcohol intoxication, as measured by laboratory-based alcohol challenge, have been identified as a phenotypic risk factor for alcohol use disorders. Further, recent evidence indicates that subjective alcohol response is also associated with event-level physiological consequences among college students, including blackouts and hangovers. Methods: The current investigation tested predictors of and outcomes associated with subjective intoxication in the natural drinking environment. In a preliminary laboratory alcohol-challenge study (n = 53), we developed a brief measure of subjective alcohol intoxication for use in event-level research. Participating students in the principal study (n = 1,867; 63% women; 54% Caucasian) completed 30 days of Web-based self-monitoring in each of the 4 college years. Results: In the principal study, generalized estimating equation analyses revealed that both lighter drinking and a family history of alcohol problems predicted greater subjective intoxication after accounting for estimated blood alcohol concentration (eBAC). Moreover, greater subjective intoxication during a given drinking episode was associated with negative alcohol-related consequences, illicit drug use, and unsafe sex, and at higher eBACs, was associated with aggression, sex, and property crime. Students who on average experienced greater subjective intoxication were also more likely to experience negative consequences and engage in illicit drug use, sex, unsafe sex, and aggression. Conclusions: These findings suggest that both within-person variability and between-person individual differences in subjective intoxication may be risk factors for adverse drinking outcomes at the event level. Intervention efforts aimed at reducing problems associated with collegiate drinking may benefit from consideration both of who experiences greater subjective intoxication and of the situations in which they are more likely to do so.

Ralevski E; Perrino A; Acampora G; Koretski J; Limoncelli D; Petrakis i. Analgesic effects of ethanol are influenced by family history of alcoholism and neuroticism. Alcoholism: Clinical and Experimental Research 34(8): 1433-1441, 2010. (50 refs.)

Background: Although personality factors and family history of substance abuse influence how individuals experience pain and respond to analgesics, the combined effects of those factors have not been extensively studied. The objective of this study was to consider the possible role of personality trait of neuroticism and family history of alcoholism on the experience of pain and their role in the analgesic response to an ethanol challenge. Methods: Forty-eight healthy subjects participated in this study; thirty-one had a positive family history of alcoholism (FHP), seventeen had a negative family history of alcoholism (FHN). They were also categorized based on their neuroticism (N) scores (low N = 28, and high N = 20). This was a double-blind, placebo-controlled, randomized, within-subject design study of intravenous administration of three doses of ethanol. The testing consisted of 3 separate test days scheduled at least 3 days apart. Test days included a placebo day (saline solution), low-exposure ethanol day (targeted breathalyzer = 0.040 g/dl), and high-exposure ethanol day (targeted breathalyzer = 0.100 g/dl). Noxious electrical stimulation and pain assessments were performed prior to start of infusion and at the 60-minute infusion mark. Results: The analgesic effect of ethanol was mediated by an interaction between the personality trait of neuroticism and family history. Individuals with family history of alcoholism and high N scores reported significantly more analgesia on low dose of ethanol than those with low N scores. There was no difference in the analgesic response to ethanol among FHNs with low and high N scores. Conclusion: These findings support the conclusion that neuroticism and family history of alcoholism both influence the analgesic response of alcohol. Individuals with high N scores and FHP have the strongest response to ethanol analgesia particularly on the low exposure to alcohol.

Ray LA; Hart EJ; Chin PF. Self-Rating of the Effects of Alcohol (SRE): Predictive utility and reliability across interview and self-report administrations. Addictive Behaviors 36(3): 241-243, 2011. (24 refs.)

The Self-Rating of the Effects of Alcohol (SRE) is a widely used and well-established measure of the level of response to alcohol. Although the SRE has been successfully used in studies of alcoholism etiology, including genetics, studies to date have not compared the self-report and interview formats. The objectives of this study are to: (a) test the predictive utility of the subscales of the SRE in relation to alcohol problems; and (b) test the reliability of the SRE in interview versus self-report formats. A sample of college drinkers (n = 446) completed the SRE in a self-report format along with the Alcohol Use Disorders Identification Test (AUDIT). A subset of participants (n = 34) returned to the laboratory and completed the SRE in a face-to-face interview format. All subscales of the SRE were robust predictors of alcohol problems accounting for as much as 25% of the variance in AUDIT scores. In addition, scores obtained via self-report and interview-based SRE were highly correlated (r = .70 to .80). Results support the predictive utility of the SRE and provide initial evidence that the self-report and interview formats produce reliable results and may be combined and/or used interchangeably.

Ray LA; Mackillop J; Monti PM. Subjective responses to alcohol consumption as endophenotypes: Advancing behavioral genetics in etiological and treatment models of alcoholism. Substance Use & Misuse 45(11): 1742-1765, 2010. (105 refs.)

Individual differences in subjective responses to alcohol consumption represent genetically mediated biobehavioral mechanisms of alcoholism risk (i.e., endophenotype). The objective of this review is three-fold: (1) to provide a critical review the literature on subjective response to alcohol and to discuss the rationale for its conceptualization as an endophenotype for alcoholism; (2) to examine the literature on the neurobiological substrates and associated genetic factors subserving individual differences in subjective response to alcohol; and (3) to discuss the treatment implications of this approach and to propose a framework for conceptualizing, and systematically integrating, endophenotypes into alcoholism treatment.

Rehm J; Kanteres F; Lachenmeier D. Unrecorded consumption, quality of alcohol and health consequences. (review). Drug and Alcohol Review 29(4): 426-436, 2010. (129 refs.)

Issues. This contribution aims to examine systematically the evidence on the impact of the quality of unrecorded alcohol products on health consequences. Approach. Systematic computer assisted review of the literature. Key Findings. There are a number of pathways related to alcohol quality that may lead to acute or chronic health problems. The following constituents and contaminants of alcoholic beverages were identified as likely contributors to these problems: (i) toxic metals (e.g. lead) from contaminated water sources or unsuitable distillation equipment; (ii) volatile constituents, such as acetaldehyde or higher alcohols, which may be produced in significant amounts due to faults in production technology or microbiological spoilage; (iii) ethyl carbamate (urethane), a carcinogenic contaminant with major occurrence in certain fruit and sugarcane spirits; (iv) biologically active flavour compounds (e.g. coumarin in cosmetics used as non-beverage alcohol); (v) toxic compounds used to denature alcohol (e.g. methanol or diethyl phthalate). In addition, the often higher ethanol content may have detrimental health effects. These pathways should not be assumed as present for all subcategories of unrecorded alcohol, but are more relevant to certain types and geographic regions. Implications. A health impact of unrecorded alcohol over and above the effect of ethanol cannot be excluded. More research is urgently needed, especially with respect to liver disease and alcohol poisoning as endpoints. Conclusion. A feasible approach for new research on the effects of unrecorded alcohol could be based on a representative sample from low socioeconomic regions with high prevalence of unrecorded consumption.

Roche DJO; King AC. Alcohol impairment of saccadic and smooth pursuit eye movements: Impact of risk factors for alcohol dependence. Psychopharmacology 212(1): 33-44, 2010. (60 refs.)

While persons at risk for alcohol dependence by virtue of heavy drinking patterns or family history (FH) of alcohol use disorders have exhibited differential alcohol responses on a variety of measures, few studies have examined alcohol's effects on eye movements in these subgroups. The purpose of this study was to (1) conduct a placebo-controlled, dose-ranging study of alcohol's effects on eye movements and (2) examine the impact of these risk factors on oculomotor response to alcohol. A within-subject, double-blind laboratory study was conducted in N = 138 heavy (HD; n = 78) and light social drinkers (LD; n = 60) with self-reported positive (FH+) or negative (FH-) family history. Subjects participated in three laboratory sessions in which they consumed a beverage containing a high (0.8 g/kg) or low (0.4 g/kg) dose of alcohol or placebo. Smooth pursuit, pro-saccadic, and anti-saccadic eye movements were recorded before and at two intervals after alcohol consumption. Alcohol significantly impaired smooth pursuit gain and pro- and anti-saccade latency, velocity, and accuracy in a dose and time specific matter. HD and LD showed similar impairment on smooth pursuit gain and anti-saccade measures, but HD were less impaired in pro-saccade latency, velocity, and accuracy. FH+ and FH- subjects were equally impaired in nearly all pro- and anti-saccade measures, but FH+ were less impaired in smooth pursuit gain. In sum, alcohol produced systematic impairment on oculomotor functioning, even at a non-intoxicating dose. Furthermore, high- and low-risk drinkers may be vulnerable to select performance deficits relative to eye movement task.

Roh S; Matsushita S; Hara S; Maesato H; Matsui T; Suzuki G et al. Role of GABRA2 in moderating subjective responses to alcohol. Alcoholism: Clinical and Experimental Research 35(3): 400-407, 2011. (54 refs.)

Background: Human twin studies have shown that certain responses to alcohol, including subjective perceptions, are genetically influenced. Previous studies have provided evidence that a low level of response to alcohol predicts future alcohol use disorders in humans. Recent genetic studies suggest an association between alcohol dependence and genetic variation in the gamma-aminobutyric acid A (GABA(A)) receptor alpha 2 subunit gene (GABRA2). Based on a haplotypic association of alcohol dependence with GABRA2, we investigated whether GABRA2 alleles are associated with the subjective responses to clamped alcohol concentration. Methods: One hundred and ten healthy social drinkers (53 men) underwent the alcohol clamp. Fifteen minutes after the start of an intravenous infusion of alcohol, the breath alcohol concentration was clamped at a target of 50 +/- 5 mg/dl for 165 minutes. Subjective physiologic responses to alcohol and stimulant and sedative effects of alcohol were measured repeatedly during the alcohol clamp. Because aldehyde dehydrogenase 2 (ALDH2) has been shown to have a great impact on the subjective responses to alcohol, we divided subjects by ALDH2 genotype for further analyses. To examine the role of genetic variation in GABRA2, 7 single nucleotide polymorphisms (SNPs) that were informative in association studies were included as factors in the analysis. Results: Among these 7 SNPs, 3 SNPs (rs279869, rs279858, and rs279837) located in the middle of the GABRA2 gene showed significant associations with subjective effects of alcohol. Subjects with 1 or 2 copies of the more common allele showed greater subjective responses to alcohol than did individuals homozygous for the alcohol dependence associated allele regardless of ALDH2 genotype. Conclusions: These findings confirm and extend the observation that the GABRA2 alleles affect the subjective responses to alcohol, and suggest that the genetic variations in GABRA2 might play a role in the risk of alcohol use disorders by moderating the subjective effects of alcohol.

Rose AK; Hobbs M; Klipp L; Bell S; Edwards K; O'Hara P et al. Monitoring drinking behaviour and motivation to drink over successive doses of alcohol. Behavioural Pharmacology 21(8): 710-718, 2010. (46 refs.)

The objective of this study was to compare alcohol urge, drinking behaviour and mood across two beverage conditions (alcohol/soft drink), over multiple drinks. Forty-five (22 men) participants completed two conditions (alcohol/soft-drink). Baseline alcohol urge and mood was measured before an initial drink consumed (0.2 g/kg alcohol or lemonade). Four drinking phases, which provided alcohol and lemonade, followed. Alcohol urge, mood and liking/enjoyment of beverages were measured. Participants' typical drinking habits were recorded, allowing comparisons across drinking factors. Alcohol urge was greater in the alcohol condition (P < 0.03), which positively correlated with liking and drinking enjoyment of the alcohol beverage (P < 0.04). Binge drinking and weekly alcohol consumption positively related to alcohol urge during the first half of the alcohol condition (P < 0.02). Feeling stimulated was positively related to alcohol urge (P < 0.01). Sip latency was quickest for alcohol in the alcohol condition (P < 0.001) and did not increase over time as in the soft-drink condition (P < 0.001). This study presents a paradigm in which alcohol motivation can be assessed within more typical drinking occasion parameters. Urge related to alcohol's positive reinforcing effects. As more alcohol was consumed, a disassociation of liking and wanting alcohol occurred, indicating that different processes may underlie behaviour during different periods of a drinking occasion.

Rose ME; Grant JE. Alcohol-induced blackout phenomenology, biological basis, and gender differences. (review). Journal of Addiction Medicine 4(2): 61-73, 2010. (149 refs.)

Blackouts from acute alcohol ingestion are defined as the inability to recall events that occurred during a drinking episode and are highly prevalent in both alcoholic and nonalcoholic populations. This article reviews the clinical manifestations, epidemiology, risk factors, cognitive impairment, and neurobiology associated with alcohol-induced blackout, with special emphasis on the neurochemical and neurophysiological basis, and gender differences. Two types of blackout have been identified: en bloc, or complete inability to recall events during a time period, and fragmentary, where memory loss is incomplete. The rapidity of rise in blood alcohol concentration is the most robust predictor of blackout. Alcohol impairs different brain functions at different rates, and cognitive and memory performance are differentially impaired by ascending versus descending blood alcohol concentration. Cognitive and memory impairment occurs before motor impairment, possibly explaining how a drinker appearing fully functional can have little subsequent memory. Blackouts are caused by breakdown in the transfer of short-term memory into long-term storage and subsequent retrieval primarily through dose-dependent disruption of hippocampal CA1 pyramidal cell activity. The exact mechanism is believed to involve potentiation of gamma-aminobutyric acid-alpha-mediated inhibition and interference with excitatory hippocampal N-methyl-D-aspartate receptor activation, resulting in decreased long-term potentiation. Another possible mechanism involves disrupted septohippocampal theta rhythm activity because of enhanced medial septal area gamma-aminobutyric acid-ergic neurotransmission. Women are more susceptible to blackouts and undergo a slower recovery from cognitive impairment than men, due in part to the effect of gender differences in pharmacokinetics and body composition on alcohol bioavailability.

Schoenmakers TM; Wiers RW. Craving and attentional bias respond differently to alcohol priming: A field study in the pub. European Addiction Research 16(1): 9-16, 2010. (41 refs.)

Background: Several experimental laboratory studies have shown that subjective craving for alcohol increases as a result of low-to-moderate levels of alcohol consumption. Less is known about alcohol prime effects on relatively automatic appetitive motivational processes such as attentional bias (AB). Also, it is not known whether the effects from laboratory studies can be generalized to real-life drinking environments, and whether effects change after higher alcohol doses than those that have been administered in lab studies. Method: In two pubs, we investigated alcohol prime dose effects in self-reported craving and AB, measured by a modified Flicker Paradigm. We included an opportunistic sample of 72 social drinkers who had been drinking various amounts of alcohol. Results: Self-reported craving was positively predicted by dose of alcohol consumed, from one up to 16 drinks. In contrast, AB was negatively predicted by dose consumed in participants who had been binge drinking. Conclusion: This field study validates earlier experimental research on alcohol prime effects in a real drinking situation. Further, it demonstrates prime effects up to much higher alcohol doses than in previous lab studies.

Schuckit MA; Smith TL; Trim RS; Tolentino NJ; Hall SA. Comparing structural equation models that use different measures of the level of response to alcohol. Alcoholism: Clinical and Experimental Research 34(5): 861-868, 2010. (50 refs.)

Background: The two measures of a low level of response (LR) to alcohol, an alcohol challenge and the retrospective Self-Report of the Effects of Alcohol questionnaire (SRE), each identify individuals at high risk for heavy drinking and alcohol problems. These measures also perform similarly in identifying subjects with unique functional brain imaging characteristics. However, few data are available regarding whether alcohol challenge-based and SRE-based LRs operate similarly in structural equation models (SEMs) that search for characteristics, which help to mediate how LR impacts alcohol outcomes. Methods: Two hundred and ninety-four men from the San Diego Prospective Study were evaluated for their LR to alcohol using alcohol challenges at similar to age 20. At similar to age 35, the same subjects filled out the SRE regarding the number of drinks needed for effects 15 to 20 years earlier. The two different LR scores for these men were used in SEM analyses evaluating how LR relates to future heavy drinking and to drinking in peers (PEER), alcohol expectancies (EXPECT), and drinking to cope (COPE) as potential mediators of the LR to drinking pattern (ALCOUT) relationships. Results: While the 2 LR measures that were determined 15 years apart related to each other at a modest level (r = 0.17, p < 0.01), the SEM results were similar regardless of the LR source. In both alcohol challenge-based and SRE-based LR models, LR related directly to ALCOUT, with partial mediation from PEER and COPE, but not through EXPECT in these 35-year-old men. Conclusions: Consistent with the > 60% overlap in prediction of outcomes for the 2 LR measures, and with results from functional brain imaging, alcohol challenge- and SRE-based LR values operated similarly in SEM models in these men.

Schuckit MA; Smith TL. Onset and course of alcoholism over 25 years in middle class men. Drug and Alcohol Dependence 113(1): 21-28, 2011. (77 refs.)

Background: Patterns of drinking and alcohol problems change with age. However, few studies use multiple data points and detailed history spanning early adulthood to middle age. This study reports such data from 373 men in the San Diego Prospective Study. Methods: Data were generated at baseline (T1) at similar to age 20, and through face-to-face followup interviews similar to every 5 years in >90% of these eligible Caucasian and relatively higher educated men. Subjects were placed into 4 groups regarding their course: 62.5% with no alcohol use disorder (AUD); 17.2% with AUD onset = age 30 and no recovery; and 13.7% with AUD onset 5 years before the 25-year followup. Results: On a univariate level, low level of response (LR) to alcohol, family history of AUDs, and higher Novelty Seeking at age similar to 20 predicted AUDs with onset before age 30 (mean age similar to 25), but among these only LR predicted later onset (mean age 38) as well. Additional predictors of AUDs included demography (lower education), and greater involvement with alcohol, drugs, and nicotine prior to T1. Sustained remission from AUDs among alcoholics was predicted by lower T1 and T10 drinking frequencies, and being separated or divorced at T10, along with a trend for higher Reward Dependence. Conclusion: These data indicate that information available in ages of the late teens to early twenties can help predict the future onset and course of AUDs, and underscore the importance of longitudinal studies in substance use disorders.

Shin E; Hopfinger JB; Lust SA; Henry EA; Bartholow BD. Electrophysiological evidence of alcohol-related attentional bias in social drinkers low in alcohol sensitivity. Psychology of Addictive Behaviors 24(3): 508-515, 2010. (52 refs.)

Low sensitivity to the acute effects of alcohol is a known risk factor for alcoholism. However, little is known concerning potential information-processing routes by which this risk factor might contribute to increased drinking. We tested the hypothesis that low-sensitivity (LS) participants would show biased attention to alcohol cues, compared with their high-sensitivity (HS) counterparts. Participants performed a task in which alcoholic and nonalcoholic beverage cues were presented bilaterally followed by a target that required categorization by color. Response times were faster for targets appearing in alcohol-cued than non alcohol-cued locations for LS but not for HS participants. Event-related potential markers of early attention orienting (P1 amplitude) and subsequent attention reorienting (ipsilateral invalid negativity amplitude) indicated preferential selective attention to alcohol-cued locations among LS individuals. Controlling for recent drinking and family history of alcoholism did not affect these patterns, except that among HS participants, relatively heavy recent drinking was associated with difficulty reorienting attention away from alcohol-cued locations. These findings suggest a potential information-processing bias through which low sensitivity could lead to heavy alcohol involvement.

Sumnall H; Bellis MA; Hughes K; Calafat A; Juan M; Mendes F. A choice between fun or health? Relationships between nightlife substance use, happiness, and mental well-being. Journal of Substance Use 15(2): 89-104, 2010. (75 refs.)

Objective: To examine the substance use behaviours of young adults in Europe and to explore the association with self reported indices of mental well being, and the relative value of health. Method: 1341 16-35-year-olds, representing youth and young adults who routinely engage in nightlife, were surveyed in nine European cities. Participants self-completed questionnaires, designed to gather demographic, social, and behavioural data on historic and current substance use, risk behaviours, and mental well being. Results: Controlling for inter-country differences, we found that early initiation and frequency of use of a range of substances was associated with poorer life satisfaction, suicidal ideation, and hopelessness. Younger, more frequent substance users placed greater value on having fun than maintaining long-term health. Bi/homosexual participants were more likely to report hopelessness, suicidal thoughts, dissatisfaction with life, and preferring fun to health. Younger cocaine initiates were more likely to report considering suicide in the last 12 months than older initiates. Conclusions: These findings confirm the importance of early intervention for young substance users. Whilst our study does not make assumptions on causality, identification of substance use in nightclub attendees may be a good marker of comorbid disorders. It is important to recognize that negative mental states may also partly be a product of lifestyle and socioeconomic factors. Prevention and harm reduction interventions should recognize that the most at risk young people may discount future health gains from reducing their substance use.

Thompson I; Williams G; Caldwell B; Aldington S; Dickson S; Lucas N et al. Randomised double-blind, placebo-controlled trial of the effects of the 'party pills' BZP/TFMPP alone and in combination with alcohol. Journal of Psychopharmacology 24(9): 1299-1308, 2010. (34 refs.)

The objective of this study was to determine the clinical effects of party pills containing benzylpiperazine (BZP) and trifluoromethylphenylpiperazine (TFMPP) when taken alone and in combination with alcohol. The study was a randomised, double-blind, placebo-controlled trial conducted in a hospital-based clinic in Wellington, New Zealand. Thirty-five volunteers who had previously used party pills containing BZP were included in this trial. Participants received one of the following four treatments: 300 mg/74 mg BZP/TFMPP and placebo, 300 mg/74 mg BZP/TFMPP and 57.6 g (6 units) alcohol, placebo and 57.6 g (6 units) alcohol and double placebo. The primary outcome variable was a measure of driving performance, the standard deviation of lateral position (SDLP) measured at 6.5 h. Secondary measures included adverse events, cardiovascular effects, psychological function and delayed effects on sleep. The study was stopped early, after 35 of the planned 64 subjects had undertaken testing, because of severe adverse events that occurred in four of 10 BZP/TFMPP-only subjects, three of seven combined BZP/TFMPP and alcohol subjects, none of the 6 placebo subjects, and none of the 12 alcohol-only subjects. The overall rate of severe adverse events (defined as causing considerable interference with usual activity and/or rated by subject as severe) in those receiving BZP/TFMPP was seven of 17 (41.2%, 95% CI 18.4-67.1). The severe events included agitation, anxiety, hallucinations, vomiting, insomnia and migraine. BZP/TFMPP significantly improved the driving performance, decreasing SDLP at -4.2 cm (95% CI-6.8 to -1.6, P = 0.002). The effect of alcohol was to increase SDLP: 2.3 cm (95% CI-0.3 to 4.9, P = 0.08). BZP/TFMPP also resulted in increased heart rate and blood pressure and in difficulty in getting to sleep. BZP/TFMPP alone or with alcohol carries a significant risk of severe adverse events when taken in similar doses to those recommended by manufacturers. [Note: BZP, despite being described as a natural product or herbal preparation is a synthetic drug, a stimulant with amphetamine-like properties. In is banned in the US Schedule I controlled substanance and over the past decade has been similarly banned in other countries. Canada is an exception.] Copyright 2010, Sage Publication

Vaughn MG; Fu QA; Perron BE; Bohnert ASB; Howard MO. Is crack cocaine use associated with greater violence than powdered cocaine use? Results from a national sample. American Journal of Drug and Alcohol Abuse 36(4): 181-186, 2010. (18 refs.)

Background: The question of whether crack cocaine use is associated with increased violence compared to powdered cocaine use has not been adequately explored in large nationally representative general population samples. Methods: This study used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) to 1) determine the comparative prevalences of violent behaviors among crack cocaine users and powdered cocaine users, 2) examine these differences while controlling for sociodemographic variables, lifetime psychiatric, alcohol and drug use disorders (a majority of cocaine users use other substances), and levels of crack cocaine and powdered cocaine use. Results: The likelihood of violence associated with crack cocaine users was greater compared to powdered cocaine users at the bivariate level. However, these differences were almost uniformly statistically nonsignificant when demographic, mood and non-cocaine substance use disorders were controlled for. Conclusions: The substantial attenuation of the association of crack cocaine use with violence after adjustment suggests that the sociodemographic characteristics, psychiatric variables, and non-cocaine substance use disorders that make some individuals more likely to use crack cocaine than powder cocaine are responsible for the increased prevalence of violence observed among crack users, rather than crack itself.

Vollstadt-Klein S; Hermann D; Rabinstein J; Wichert S; Klein O; Ende G et al. increased activation of the ACC during a spatial working memory task in alcohol-dependence versus heavy social drinking. Alcoholism: Clinical and Experimental Research 34(5): 771-776, 2010. (35 refs.)

Background: Activation of the anterior cingulate cortex (ACC) in a spatial working memory task has been associated with risk factors for alcohol use disorders such as low alcohol effects and positive alcohol expectations in adolescents. To transfer these results into adults, we used the same task in adults. Methods: During functional magnetic resonance imaging, 12 light social, 7 heavy social, and 11 non-abstinent-dependent alcohol drinkers performed a spatial working memory task and completed measures of automatic alcohol-related thoughts and behavior (Obsessive-Compulsive Drinking Scale-OCDS), alcohol use of the last 90 days, and general intelligence. Results: Behavioral performance in the spatial working memory task was not significantly different in all 3 groups. Controlling for differences in general intelligence alcohol-dependent participants showed a higher task-related activation of the dorsal ACC (dACC) in comparison with light and heavy social drinkers. Measures of the OCDS were positively correlated with the activation in the left hippocampus and right thalamus in all participants. Conclusions: Our results support the findings of increased dACC activation during a spatial working memory task as a risk factor for alcohol dependence. Increased task-related activation in the dACC was only observed in alcohol-dependent participants and not in heavy social drinkers with comparable alcohol consumption. Furthermore, the absence of behavioral performance differences between groups as well as an association between dACC activation and working memory performance indicates subtle working memory deficits. Low capacity of working memory has been linked to more automatic and less self-regulated behavior in studies on natural reward processing. Therefore, additional neural activation during performance of the non-alcohol-related working memory task in participants with higher OCDS values in the left hippocampus and the right thalamus may be a consequence of decreased neural capacity because of distracting alcohol-related thoughts.

Webb A; Lind PA; Kalmijn J; Feiler HS; Smith TL; Schuckit MA et al. The investigation into CYP2E1 in relation to the level of response to alcohol through a combination of linkage and association analysis. Alcoholism: Clinical and Experimental Research 35(1): 10-18, 2011. (50 refs.)

Background: A low level of response to alcohol during an individual's early experience with alcohol is associated with an increase risk of alcoholism. A family-based genome-wide linkage analysis using sibling pairs that underwent an alcohol challenge where the level of response to alcohol was measured with the Subjective High Assessment Scale (SHAS) implicated the 10q terminal (10qter) region. CYP2E1, a gene known for its involvement with ethanol metabolism, maps to this region. Methods: Variance component multipoint linkage analysis was performed on a combined map of single-nucleotide polymorphism (SNP) and microsatellite data. To account for the heterogeneity evident in the dataset, a calculation assuming locus heterogeneity was made using the Heterogeneity Log of Odds (HLOD) score. Association between SNP marker allele counts and copy number and SHAS scores were evaluated using a logistic regression model. Results: Linkage analysis detected significant linkage to CYP2E1, which was diminished because of apparent locus heterogeneity traced to a single family with extreme phenotypes. In retrospect, circumstances recorded during testing for this family suggest that their phenotype data are likely to be unreliable. Significant allelic associations were detected for several CYP2E1 polymorphisms and the SHAS score. DNA sequencing from families that contributed the greatest evidence for linkage did not detect any changes directly affecting the primary amino acid sequence. With the removal of a single family, combined evidence from microsatellites and SNPs offers significant linkage between the level of response to alcohol and the region on the end of chromosome 10. Conclusion: Combined linkage and association indicate that sequence changes in or near CYP2E1 affect the level of response to alcohol providing a predictor of risk of alcoholism. The absence of coding sequence changes indicates that regulatory sequences are responsible. Implicating CYP2E1 in the level of response to alcohol allows inferences to be made about how the brain perceives alcohol.

Weldy DL. Risks of alcoholic energy drinks for youth. Journal of the American Board of Family Medicine 23(4): 555-558, 2010. (42 refs.)

Ingesting alcohol and energy drinks together is associated with a decreased awareness of the physical and mental impairment caused by the alcohol without reducing the actual impairment. This is of particular concern for youth who have a baseline of less mature judgment. Adding energy drinks to alcohol tends to increase the rate of absorption through its carbonation and dilution of the alcohol, and keep a person awake longer allowing ingestion of a greater volume of alcohol. At low blood alcohol levels, caffeine appears to decrease some of the impairment from the alcohol, but at higher blood alcohol levels, caffeine does not appear to have a modifying effect on either the physical or mental impairment induced by the alcohol. Obtaining this combination is made easier and more affordable for under aged persons by manufacturers of premixed alcoholic energy drink combination beverages. Awareness by medical and educational personnel and parents of this activity and its potential for harm is unknown.

Wester AE; Verster JC; Volkerts ER; Bocker KBE; Kenemans JL. Effects of alcohol on attention orienting and dual-task performance during simulated driving: An event-related potential study. Journal of Psychopharmacology 24(9): 1333-1348, 2010. (73 refs.)

Driving is a complex task and is susceptible to inattention and distraction. Moreover, alcohol has a detrimental effect on driving performance, possibly due to alcohol-induced attention deficits. The aim of the present study was to assess the effects of alcohol on simulated driving performance and attention orienting and allocation, as assessed by event-related potentials (ERPs). Thirty-two participants completed two test runs in the Divided Attention Steering Simulator (DASS) with blood alcohol concentrations (BACs) of 0.00%, 0.02%, 0.05%, 0.08% and 0.10%. Sixteen participants performed the second DASS test run with a passive auditory oddball to assess alcohol effects on involuntary attention shifting. Sixteen other participants performed the second DASS test run with an active auditory oddball to assess alcohol effects on dual-task performance and active attention allocation. Dose-dependent impairments were found for reaction times, the number of misses and steering error, even more so in dual-task conditions, especially in the active oddball group. ERP amplitudes to novel irrelevant events were also attenuated in a dose-dependent manner. The P3b amplitude to deviant target stimuli decreased with blood alcohol concentration only in the dual-task condition. It is concluded that alcohol increases distractibility and interference from secondary task stimuli, as well as reduces attentional capacity and dual-task integrality.

White HR; Marmorstein NR; Crews FT; Bates ME; Mun EY; Loeber R. Associations between heavy drinking and changes in impulsive behavior among adolescent boys. Alcoholism: Clinical and Experimental Research 35(2): 295-303, 2011. (38 refs.)

Background: Impulsive behavior in humans predicts the onset of drinking during adolescence and alcohol use disorders (AUDs) in adulthood. It is also possible, however, that heavy drinking may increase impulsive behavior by affecting the development of brain areas that support behavioral control or through other associated mechanisms. This study examined whether drinking heavily during adolescence is related to changes in impulsive behavior with a specific focus on how the association differs across individuals, contingent on the developmental course of their impulsiveness. Method: Data came from a sample of boys (N = 503) who were followed annually from approximate age 8 to age 18 and again at approximate age 24/25. Heavy drinking was defined as experiencing a blood alcohol concentration (BAC) level of 0.08% or higher. At each assessment, the parent and child each reported whether the child was impulsive. Results: First, group-based trajectory analysis was used to identify 4 groups differing in the level and slopes of their trajectories of impulsive behavior from age 9 to age 17: low (13.9%), early adolescence-limited (18.7%), moderate (60.8%), and high (6.6%). These trajectory groups differed in their prevalence of any heavy drinking, peak BACs, and rates of alcohol dependence in adolescence and AUD in early adulthood, with the less impulsive groups being lower on these measures than the more impulsive groups. Heavy drinking was then entered into the model as a time-varying covariate; this measure was lagged so that the results represent change in impulsive behavior the year following heavy drinking. Among boys on the moderate trajectory, those who drank heavily were rated as significantly more impulsive the following year compared to those who did not drink heavily. Conclusions: The association between heavy drinking and impulsive behavior may depend on earlier levels of impulsive behavior with those who are moderately impulsive appearing to be at greatest risk for increased impulsive behavior following heavy drinking. Further research is needed to clarify this association.

Wiers RW; Stacy AW. Are alcohol expectancies associations? Comment on Moss and Albery (2009). (editorial). Psychological Bulletin 136(1): 12-16, 2010. (45 refs.)

Moss and Albery (2009) presented a dual-process model of the alcohol-behavior link, integrating alcohol expectancy and alcohol myopia theory. Their integrative theory rests on a number of assumptions including, first, that alcohol expectancies are associations that can be activated automatically by an alcohol-relevant context, and second, that alcohol selectively reduces propositional reasoning. As a result, behavior comes under the control of associative processes after alcohol consumption. We agree with the second but not with the first assumption, based on theoretical and empirical arguments. Although in some cases expectancies may involve a simple association, they are propositional in nature. We demonstrate that this assertion is supported by existing literature cited in Moss and Albery. Moreover, 6 recent studies consistently demonstrated that under circumstances in which executive control is impaired (either as a stable individual difference or under the acute influence of alcohol), associative processes, over and above expectancies, predict alcohol-related behavior. Taken together, the evidence strongly suggests a fundamental distinction between expectancies and associations in memory: Effects of propositional expectancies and executive functions are impaired under the acute influence of alcohol, but memory associations are not. This difference in perspective not only has theoretical implications but also leads to different predictions regarding acute alcohol effects in society.

Yeomans MR. Short term effects of alcohol on appetite in humans. Effects of context and restrained eating. Appetite 55(3): 565-573, 2010. (45 refs.)

The present study examined further the short-term effects of alcohol on food intake and appetite in women volunteers, testing the extent to which the apparent appetizing effects of alcohol depend on (a) expectations that alcohol had been consumed and (b) disinhibition of dietary restraint. Twenty restrained and 20 unrestrained women consumed a drink preload 30 min before a test meal on four different days, with preloads varying in alcohol content (alcohol or energy-matched control) and drink context (alcohol-related - beer or alcohol unrelated - juice). Significantly more energy was consumed following alcohol than no-alcohol, but this effect depended on the drink consumed: least was eaten after the alcohol-free juice drink, and most after the same juice drink with added alcohol. There was no evidence that the effect of alcohol on intake was due to disinhibition of restrained eating, nor did alcohol increase liking for the test foods. The change in energy intake at lunch was mainly due to greater intake of energy-rich foods on days when alcohol had been consumed. Alcohol also increased rated appetite once food had been tasted, suggesting alcohol may increase food-related reward. Overall these data suggest that effects of alcoholic drinks represent a complex interaction between physiological effects of alcohol and expectations and associations generated by past experience of alcoholic drinks.