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CORK Bibliography: Binge Drinking

77 citations. January 2009 to present

Prepared: December 2009

Aalto M; Alho H; Halme JT; Seppa K. AUDIT and its abbreviated versions in detecting heavy and binge drinking in a general population survey. Drug and Alcohol Dependence 103(1-2): 25-29, 2009. (23 refs.)

Background: The aim of this study was to define optimal cut points for the Alcohol Use Disorders Identification Test (AUDIT) and its abbreviated versions (AUDIT-C, AUDIT-QF, and AUDIT-3), and to evaluate how effectively these questionnaires detect heavy drinking in the general population. Methods: The study population consisted of a sub-sample of the National FINRISK Study. A stratified random sample of 3216 Finns, aged 25-64, was invited to a health check. Of these, 1851 (57.6%) completed the AUDIT and participated in person in the Timeline Followback (TLFB) interview regarding their alcohol consumption. The TLFB-based definition of heavy drinking was used as a primary gold standard (for males >= 16 standard drinks average in a week or >= 7 drinks at least once a month; for females, respectively, >= 10 and >= 5 drinks). Areas under receiving operating characteristics curves (AUROCs), sensitivities and specificities were used to compare the performance of the tests. Results and conclusions: The AUDIT and its abbreviated versions are valid for detecting heavy drinking also in a general population sample. However, performance seems to vary between the different versions and accuracy of each test is achieved only by using tailored cut points according to gender. The AUDIT and AUDIT-C are effective for both males and females. The optimal cut points for males were found to be >= 7 or 8 for AUDIT and >= 6 for AUDIT-C. Among females the optimal cut points were found to be >= 5 for AUDIT and >= 4 for AUDIT-C. The Study also indicates that AUDIT-QF among females and AUDIT-3 among males are relatively effective. The cut points for detecting all heavy drinkers (including binge drinkers without exceeding weekly thresholds) were lower than for detecting heavy drinkers excluding those who are only binge drinkers.

Ackleh AS; Fitzpatrick BG; Scribner R; Simonsen N; Thibodeaux JJ. Ecosystem modeling of college drinking: Parameter estimation and comparing models to data. Mathematical and Computer Modelling 50(3-4): 481-497, 2009. (31 refs.)

Recently we developed a model composed of five impulsive differential equations that describes the changes in drinking patterns (that persist at epidemic level) amongst college students. Many of the model parameters cannot be measured directly from data; thus, an inverse problem approach, which chooses the set of parameters that results in the "best'' model to data fit, is crucial for using this model as a predictive tool. The purpose of this paper is to present the procedure and results of an unconventional approach to parameter estimation that we developed after more common approaches were unsuccessful for our specific problem. The results show that our model provides a good fit to survey data for 32 campuses. Using these parameter estimates, we examined the effect of two hypothetical intervention policies: (1) reducing environmental wetness, and (2) penalizing students who are caught drinking. The results suggest that reducing campus wetness may be a very effective way of reducing heavy episodic (binge) drinking on a college campus, while a policy that penalizes students who drink is not nearly as effective.

Bakhireva LN; Young BN; Dalen J; Phelan ST; Rayburn WF. Periconceptional binge drinking and acculturation among pregnant Latinas in New Mexico. Alcohol 43(6): 475-481, 2009. (38 refs.)

Binge drinking during pregnancy might lead to the development of Fetal Alcohol Spectrum Disorders in the offspring. Latinas are often considered a low-risk group for alcohol abuse, although recent reports indicate that the prevalence of alcohol consumption ill this group is increasing due to changing cultural norms. The predictors of alcohol consumption during pregnancy among Latinas are largely unknown. We explored predictors of periconceptional drinking among Latinas (n = 155) recruited into an ongoing cohort study at the University of New Mexico. Women were interviewed by a bilingual trained interviewer about any episodes of binge drinking (>= 4 drinks/occasion) a month around their last menstrual period (LMP) and were administered a TWEAK questionnaire. Sociodemographic, lifestyle, and reproductive health characteristics were also ascertained. Predictors of binge drinking were identified by Chi-square test and logistic regression in univariate and multivariable analyses, respectively. Backward selection procedure was used to identify covariates that were independently associated with binge drinking in the final model. The mean age of participants was 27.0 +/- 5.8 years and 69% were foreign born. In the entire sample, 17.4% of pregnant Latinas admitted at least one binge-drinking episode in the month around their LMP. Results of multivariate analysis indicate that Latinas born in the United States have a much greater risk of binge drinking in the periconceptional period (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2, 8.9) compared with foreign-born Latinas. Similarly, Latinas who primarily speak English at home were at much greater risk (OR = 3.6; 95% CI: 1.3, 10.5) compared with primarily Spanish-speaking women. No other variables were identified as significant predictors in multivariable models. Our results indicate that more acculturated Latinas are at much greater risk of binge drinking before conception and in early pregnancy compared with less acculturated Latinas. Culturally sensitive interventions should be developed to address risky alcohol consumption among Latinas of reproductive age.

Balodis IM; Potenza MN; Olmstead MC. Binge drinking in undergraduates: Relationships with sex, drinking behaviors, impulsivity, and the perceived effects of alcohol. Behavioural Pharmacology 20(5/6, Special Issue): 518-526, 2009. (52 refs.)

Binge drinking on university campuses is associated with social and health-related problems. To determine the factors that may predict this behavior, we collected information on alcohol use, alcohol expectations, and impulsivity from 428 undergraduate students attending a Canadian university. The subjective effects of a binge drinking dose of alcohol were assessed in a subset of participants. In the larger sample, 72% of students reported drinking at or above binge drinking thresholds on a regular basis. Men reported alcohol consumption per drinking occasion, which was consistent with other studies, but the frequency of drinking occasions among women was higher than in earlier studies, suggesting that consumption in women may be increasing. Compared with men, women reported different expectations of alcohol, specifically related to sociability and sexuality. Self-reported impulsivity scores were related, albeit weakly, to drinking behaviors and to expectations in both the sexes. Finally, intoxicated binge drinkers reported feeling less intoxicated, liking the effects more, and wanting more alcohol than did non-binge drinkers receiving an equivalent dose of alcohol. These results have implications for sex-specific prevention strategies for binge drinking on university campuses.

Bartram DJ; Sinclair JMA; Baldwin DS. Alcohol consumption among veterinary surgeons in the UK. Occupational Medicine 59(5): 323-326, 2009. (10 refs.)

Aims To investigate alcohol consumption and the prevalence and associations of 'at-risk' drinking among vets in the UK. Methods Alcohol consumption was measured using the Alcohol Use Disorders Identification Test alcohol consumption questions (AUDIT-C) embedded in a questionnaire which included measures of mental health and psychosocial working conditions, administered to a representative sample of 1796 vets. Scores of >= 4 for women and >= 5 for men were used as an indicator of 'at-risk' drinking. Results The response rate was 56%. Five per cent of respondents were non-drinkers, 32% low-risk drinkers and 63% at-risk drinkers. The estimated odds of at-risk drinking was not significantly different for men and women. A 1-year increase in age was associated with a 2% reduction in the odds of at-risk drinking (OR 0.98, 95% CI: 0.97-0.99, P < 0.01). There was no significant difference across hours worked or on call in a typical week. Lower psychological demands at work were associated with reduced odds of at-risk drinking (OR 0.75, 95% CI: 0.63-0.90, P < 0.01). Conclusions It is estimated that vets drink more frequently than the general population, but consume less on a typical drinking day and have a prevalence of daily and weekly binge drinking that is similar to the general population. The level of alcohol consumption does not appear to be a negative influence on mental health within the profession as a whole.

Beets MW; Flay BR; Vuchinich S; Li KK; Acock A; Snyder FJ. Longitudinal patterns of binge drinking among first year college students with a history of tobacco use. Drug and Alcohol Dependence 103(1-2): 1-8, 2009. (45 refs.)

Background: Underage heavy episodic drinking is a major contributor to alcohol-related morbidity/mortality. Reports indicate underage binge drinking among college students is widespread and has remained stable over the past decade. This study describes individual characteristics and calendar-specific events associated with binge drinking episodes over the Course of freshman college academic year (2002-2003). Methods: Students (N = 827, age 18 years), with a prior history of tobacco use, attending a large Midwest university completed weekly web-based surveys on the number of drinks consumed for each of the past 7 days over the duration of 35 consecutive weeks (avg. number of weeks reported 16.0 +/- 10.5). Results: Average prevalence of binge episodes across the academic year was 17.2 +/- 14.4%, 23.6 +/- 8.3%. and 66.3 +/- 11.2% for weekdays, Thursdays, and weekend days, respectively. Two-level random effects logit survival models for repeated events indicated the prevalence of weekday and Thursday binge drinking was associated with specific university/community events (Local festival odds ratio (OR] 6.03, 95% confidence interval [CI] 4.34-8.36), holidays (New Year's Eve OR 18.48, CI 12.83-26.63), and academic breaks (Spring Break OR 6.45, CI 4.57-9.08). Expected associations of younger age of first heavy drinking, past 12-month drinking, and experiencing negative consequences from heavy drinking were observed. Conclusions: Although individual characteristics were related to engaging in a binge episode, binge episodes were strongly associated with time-specific calendar events. Effective interventions to prevent immediate and long-term health consequences associated with binge drinking should consider environmental and institutional policy-level controls to reduce high levels of binge drinking on college campuses connected with holidays and university/community events.

Bellis MA; Phillips-Howard PA; Hughes K; Hughes S; Cook PA; Morleo M et al. Teenage drinking, alcohol availability and pricing: A cross-sectional study of risk and protective factors for alcohol-related harms in school children. BMC Public Health 9(380), 2009. (48 refs.)

Background: There is a lack of empirical analyses examining how alcohol consumption patterns in children relate to harms. Such intelligence is required to inform parents, children and policy relating to the provision and use of alcohol during childhood. Here, we examine drinking habits and associated harms in 15-16 year olds and explore how this can inform public health advice on child drinking. Methods: An opportunistic survey of 15-16 year olds (n = 9,833) in North West England was undertaken to determine alcohol consumption patterns, drink types consumed, drinking locations, methods of access and harms encountered. Cost per unit of alcohol was estimated based on a second survey of 29 retail outlets. Associations between demographics, drinking behaviours, alcohol pricing and negative outcomes (public drinking, forgetting things after drinking, violence when drunk and alcohol-related regretted sex) were examined. Results: Proportions of drinkers having experienced violence when drunk (28.8%), alcohol-related regretted sex (12.5%) and forgetting things (45.3%), or reporting drinking in public places (35.8%), increased with drinking frequency, binge frequency and units consumed per week. At similar levels of consumption, experiencing any negative alcohol-related outcome was lower in those whose parents provided alcohol. Drunken violence was disproportionately associated with being male and greater deprivation while regretted sex and forgetting things after drinking were associated with being female. Independent of drinking behaviours, consuming cheaper alcohol was related to experiencing violence when drunk, forgetting things after drinking and drinking in public places. Conclusion: There is no safe level of alcohol consumption for 15-16 year olds. However, while abstinence removes risk of harms from personal alcohol consumption, its promotion may also push children into accessing drink outside family environments and contribute to higher risks of harm. Strategies to reduce alcohol-related harms in children should ensure bingeing is avoided entirely, address the excessively low cost of many alcohol products, and tackle the ease with which it can be accessed, especially outside of supervised environments.

Bezinovic P; Malatestinic D. Perceived exposure to substance use and risk-taking behavior in early adolescence: Cross-sectional study. Croatian Medical Journal 50(2): 157-164, 2009. (25 refs.)

Aim: To examine the relation between perceived exposure to parents, siblings, and peers' substance use and self-reported substance consumption among early adolescents in Primorsko-goranska county, Croatia, and between perceived exposure to substance use and risk-taking behaviors such as going out late at night, gathering at secluded places, skipping school, and gambling. Method: A self-reported cross-sectional survey was conducted in 2007 among 2219 eight-grade (14-year old) pupils in elementary schools in Primorsko-goranska county. Exposure to substance use in their immediate social environment, self-reported consumption of cigarettes, alcohol, inhalants, and marihuana, ways of spending free time, and family and peer relationships were assessed. Results There was a significant association between perceived exposure to substance use and self-reported consumption of cigarettes, alcohol, inhalants, and marihuana in both sexes (P < 0.001). Pupils whose parents, siblings, and peers used substances significantly more often developed the same behavioral patterns. Level of exposure to substance use in the immediate social environment had the strongest effect on experimenting with smoking among girls (from 26.6% in low exposure to 76.2% in high exposure group) and among boys (from 15.8% in low exposure to 69.4% in high exposure); on regular everyday smoking among girls (from 4.4% in low exposure to 45% in high exposure group) and among boys (from 2.7% in low exposure to 36.7% in high exposure group); on hard liquor consumption among girls (from 25.1% in low exposure to 79.5% in high exposure group) and among boys (from 28.1% in low exposure to 78.4% in high exposure group), as well as on binge drinking among girls (from 10.9% in low exposure to 56.6% in high exposure group) and among boys (from 15.5% in low exposure to 62.4% in high exposure group). Girls and boys exposed to substance use engaged more often in risk-taking and potentially delinquent behaviors (F-(2,F- 1180) = 166 502; P < 0.001, two-way ANOVA). Conclusion: High exposure to substance use in immediate social environment and its great impact on substance use among early adolescents indicate that there is a need for the introduction of preventive programs that would reduce inappropriate behavior among adolescents' social models.

Blazer DG; Wu LT. The epidemiology of at-risk and binge drinking among middle-aged and elderly community adults: National Survey on Drug Use and Health. American Journal of Psychiatry 166(10): 1162-1169, 2009. (24 refs.)

Objective: The purpose of this article was to estimate the prevalence, distribution, and correlates of at-risk alcohol use (especially binge drinking) among middle-aged and elderly persons in the United States and to compare at-risk alcohol use between women and men. Method: Secondary analysis of the 2005 and 2006 National Survey on Drug Use and Health was conducted for 10,953 respondents aged 50 years and older. Among respondents, 6,717 were 50 to 64 years of age and 4,236 were >= 65 years. Social and demographic variables, alcohol use (including at-risk use), binge drinking, serious psychological distress, and self-rated health were assessed. Results: Overall, 66% of male respondents and 55% of female respondents reported alcohol use during the past year. At-risk alcohol use and binge drinking were more frequent among respondents 50 to 64 years of age relative to respondents aged 65 years or older. In the >= 65 years old age group, 13% of men and 8% of women reported at-risk alcohol use, and more than 14% of men and 3% of women reported binge drinking. Among male subjects, binge drinking compared with no alcohol use was associated with higher income and being separated, divorced, or widowed, while being employed and nonmedical use of prescription drugs were associated with binge drinking compared with no alcohol use among women. For all respondents, binge drinking relative to no alcohol use was associated with the use of tobacco and illicit drugs. Among women who reported using alcohol, being African American and less educated were associated with binge drinking, but race/ethnicity and educational level were not associated with binge drinking in men who reported using alcohol. Conclusions: At-risk and binge drinking are frequently reported by middle-aged and elderly adults nationwide and are therefore of public health concern. Clinicians working with middle-aged and older adults should screen for binge drinking and coexisting use of other substances.

Blomeyer D; Laucht M. Hazardous alcohol consumption in adolesccence. Findings from the Manheim longitudinal study. (German). Psychotherapeut 54(3): 179-+, 2009. (29 refs.)

Binge drinking is common in adolescents. Externalizing behavior disorders, novelty seeking, lack of parental monitoring, delinquency and deviant peer affiliations are regarded as major risk factors. In the framework of a prospective longitudinal study, the specific explanatory power of these risk factors for variation in hazardous drinking behavior (here: maximum amount of alcohol drunk on one single occasion) of 15-year-old is determined. A stepwise linear regression analysis revealed statistically significant independent contributions to the maximum amount of alcohol drunk on one single occasion for all risk factors. This implies that each of the risk factors investigated plays a unique role for adolescent binge drinking and provides clues for the conception of preventive strategies. Possible preventive measures derived from these findings are discussed.

Blow FC; Ilgen MA; Walton MA; Czyz EK; McCammon R; Chermack ST et al. Severity of baseline alcohol use as a moderator of brief interventions in the emergency department. Alcohol and Alcoholism 44(5): 486-490, 2009. (30 refs.)

Aims: This study examines whether the severity of baseline alcohol consumption/consequences moderates the effect of an alcohol brief intervention (BI) in the emergency department (ED). Methods: Injured patients (N = 494) were recruited from an ED, randomly assigned to receive brief advice or not and completed a 12-month follow-up interview. Results: A significant interaction was found between severity of baseline alcohol consumption (i.e. average weekly, binge drinking) and receipt of a BI on alcohol consumption at 12 months. The form of this interaction indicates that the BI group tended to report lower alcohol consumption at follow-up than the untreated group especially in those who had reported high baseline consumption. Severity of alcohol consequences at baseline did not significantly impact the effect of the BI on 12-month outcomes. Conclusion: ED patients with higher alcohol consumption benefit from BI. In some cases, the BI's effects may be enhanced for patients who are heavier drinkers, perhaps due to a greater opportunity to develop a discrepancy between current behavior and future goals.

Brown SA; Mcgue M; Maggs J; Schulenberg J; Hingson R; Swartzwelder S et al. Underage alcohol use summary of developmental processes and mechanisms: Ages 16-20. Alcohol Research & Health 32(1): 41-52, 2009. (83 refs.)

Late adolescence (i.e., the age-group between 16 and 20 years) is characterized by significant changes in neurological and cognitive processes, behavioral and social functioning, and relational and physical contexts as the individual moves toward adulthood. In this age-group, major role transitions affect almost every aspect of life. Moreover, brain development continues-and with it the development of cognitive functions, working memory, emotional and behavioral self-regulation, and decisionmaking. The adolescents' social and emotional development also continues to evolve, affecting interactions with parents, siblings, peers, and first romantic relationships. All of these changes impact drinking behavior during late adolescence, and, in fact, alcohol use, binge drinking, and heavy drinking are particularly prevalent in youth ages 16-20. Determining the common trajectories of drinking behavior in this age-group is important for understanding how adolescent alcohol rise helps shape adult outcomes and for identifying risk and protective factors. It also is important to study the short- and long-term consequences of adolescent alcohol use and abuse, including alcohol effects on the developing adolescent brain and accomplishment of important developmental tasks of this age.

Campo S; Askelson NM; Mastin T; Slonske M. Using evidence-based research to redirect a conversation: Newspapers' coverage of strategies to address college binge drinking. Public Relations Review 35(4): 411-418, 2009. (38 refs.)

This study examines selected newspapers' coverage of college binge drinking while also serving as an example of evidence-based practices that can be of use to public relations practitioners and health care professionals working to draw attention to important factors that are not being addressed in either public or policy conversations related to this issue. We examine newspaper coverage in 32 newspapers from 1997 to 2006 to determine which strategies to address college binge drinking are being covered and which of those are evidence-based and implemented by colleges. The mix of individual versus environmental strategies was examined based on Social Cognitive Theory. In the 255 articles analyzed, the majority of strategies covered were environmental. The most frequently covered strategy, increasing student knowledge, is individual and not evidence-based. Strategies classified as effective were not frequently covered. Media advocacy is offered as an evidence-based practice that public relations and health care professionals can use to affect change.

Crego A; Holguin SR; Parada M; Mota N; Corral M; Cadaveira F. Binge drinking affects attentional and visual working memory processing in young university students. (review). Alcoholism: Clinical and Experimental Research 33(11): 1870-1879, 2009. (103 refs.)

Background: Binge Drinking (BD) typically involves heavy drinking over a short time, followed by a period of abstinence, and is common among young people, especially university students. Animal studies have demonstrated that this type of alcohol consumption causes brain damage, especially in the nonmature brain. The aim of the present study was to determine how BD affects brain functioning in male and female university students, during the performance of a visual working memory task. Methods: Event-related potentials (ERPs) were recorded, with an extensive set of 32 scalp electrodes, in 95 first-year university students (age range 18 to 20 years), comprising 42 binge drinkers (BD) and 53 controls, in a visual "identical pairs" continuous performance task. Principal components analysis was used to identify and analyze the N2 (negative waveform with a latency around 200 to 300 ms related to attentional processes) and P3 (positive waveform with a latency around 300 to 600 ms related to working memory processes) components of the ERPs. Results: In the matching condition of the task, the N2 component in central and parietal regions was significantly larger in the BD than in the control group. In the control group, the P3 component was larger in the matching than in the nonmatching condition in the frontal, central, and parietal regions, whereas the BD group did not show any significant differences between conditions in any region. Conclusions: The results of this study confirm the presence of electrophysiological differences between young university student binge drinkers and controls during the execution of a visual task with a high working memory load. The larger N2 in the BD group suggests higher levels of attentional effort required by this group to perform the task adequately. The absence of any differences in the P3 component in the different conditions (matching and nonmatching stimuli) in the BD group suggests a deficiency in the electrophysiological differentiation between relevant and irrelevant information, which may reflect some impairment of working memory processes.

De Genna NM; Cornelius MD; Donovan JE. Risk factors for young adult substance use among women who were teenage mothers. Addictive Behaviors 34(5): 463-470, 2009. (77 refs.)

Teenage mothers may not "mature out" of substance use during young adulthood, and this non-normative trajectory of use may contribute to negative outcomes for teenage mothers and their offspring. Pregnant teenagers (age range = 12-18 years; 68% Black) were recruited from a prenatal clinic and interviewed about their substance use, and subsequently re-interviewed six and ten years later (n = 292). Consistent with the literature, early tobacco and marijuana use were risk factors for young adult use. Other substance use. peer adolescent use and mental health indicators were more important than race and socioeconomic status (SES) in determining which teenage mothers would use tobacco, engage in binge drinking, and use marijuana as young adults. However, race and SES were significant predictors of quitting tobacco use and marijuana use by the 10-year follow-up. Depression was associated with both persistent tobacco use and marijuana use in teenage mothers. These results illustrate the long-term consequences of teenage childbearing and identify modifiable risk factors for later health risks that should be addressed among younger mothers.

Deas D; Clark A. Youth binge drinking: Progress made and remaining challenges. (editorial). Journal of the American Academy of Child and Adolescent Psychiatry 48(7): 679-680, 2009. (10 refs.)

Dodge NC; Jacobson JL; Molteno CD; Meintjes EM; Bangalore S; Diwadkar V et al. Prenatal alcohol exposure and interhemispheric transfer of tactile information: Detroit and Cape Town findings. Alcoholism: Clinical and Experimental Research 33(9): 1628-1637, 2009. (55 refs.)

Background: Previous research has demonstrated that heavy prenatal alcohol exposure affects the size and shape of the corpus callosum (CC) and compromises interhemispheric transfer of information. The aim of this study was to confirm the previous reports of poorer performance on a finger localization test (FLT) of interhemispheric transfer in a cohort of heavily exposed children and to extend these findings to a cohort of moderately exposed young adults. Methods: In Study 1, the FLT was administered to 40 heavily exposed and 23 nonexposed children from the Cape Coloured community of Cape Town, South Africa, who were evaluated for fetal alcohol syndrome (FAS) dysmorphology and growth. Anatomical images of the CC were obtained using structural MRI on a subset of these children. In Study 2, the FLT was administered to a cohort of 85 moderate-to-heavily exposed young adults participating in a 19-year follow-up assessment of the Detroit Prenatal Alcohol Exposure cohort, whose alcohol exposure had been ascertained prospectively during gestation. Results: In Study 1, children with FAS showed more transfer-related errors than controls after adjustment for confounding, and increased transfer-related errors were associated with volume reductions in the isthmus and splenium of the CC. In Study 2, transfer-related errors were associated with quantity of alcohol consumed per occasion during pregnancy. More errors were made if the mother reported binge drinking (>= 5 standard drinks) during pregnancy than if she drank regularly (M >= 1 drink/day) without binge drinking. Conclusions: These findings confirm a previous report of impaired interhemispheric transfer of tactile information in children heavily exposed to alcohol in utero and extend these findings to show that these deficits are also seen in more moderately exposed individuals, particularly those exposed to binge-like pregnancy drinking.

Donovan JE. Estimated blood alcohol concentrations for child and adolescent drinking and their implications for screening instruments. Pediatrics 123(6): e975-e981, 2009. (49 refs.)

OBJECTIVE. Blood alcohol concentrations ( BACs) in children after consumption of different numbers of standard drinks of alcohol have not been estimated previously. The goal was to determine the number of drinks at each age that led to a BAC of >= 80 mg/dL, the National Institute on Alcohol Abuse and Alcoholism criterion for binge drinking. METHODS. The updated Widmark equation to estimate BAC was modified to take account of the differing body composition (total body water) and accelerated rates of ethanol elimination of children. The modified formula was used with 1999-2002 National Health and Nutrition Examination Survey data to estimate BACs for > 4700 children and adolescents from 9 through 17 years of age, for intake levels of 1 to 5 standard drinks. RESULTS. The estimated BACs for children after consumption of just 3 standard drinks within a 2-hour period were between 80 and 139 mg/dL for boys 9 to 13 years of age and for girls 9 to 17 years of age, indicating substantial potential alcohol impairment. With 5 drinks within 2 hours ( the level used to define binge drinking among college students), children 9 to 13 years of age were estimated to have BACs 2 to 3 times the adult legal limit for intoxication of 80 mg/dL. CONCLUSION. Binge drinking should be defined as >= 3 drinks for 9- to 13-year-old children, as >= 4 drinks for boys and >= 3 drinks for girls 14 or 15 years of age, and as >= 5 drinks for boys and >= 3 drinks for girls 16 or 17 years of age.

DuMonthier WN; Haneline MT; Smith M. Survey of health attitudes and behaviors of a chiropractic college population. Journal of Manipulative and Physiological Therapeutics 32(6, Special Issue): 477-484, 2009. (30 refs.)

Objectives: We gathered information about health behaviors on a chiropractic campus, including compliance with recent guidelines for exercise as well as diet, smoking, and binge drinking. We also assessed the perceived importance of the chiropractic physician in role modeling and teaching healthy behaviors to patients. Methods: A survey instrument composed of 16 questions was designed and distributed to 279 students, faculty, and staff at a chiropractic college campus in northern California. Confidentiality was maintained throughout the process, and a response rate of 92% was obtained. Statistical analysis was performed on the data collected. Results: The levels of obesity, inactivity, and smoking on this college campus are lower than the levels reported for the metropolitan area, the state, and the nation. The level of binge drinking among our students was high but similar to the reported rates for college students generally. We found interesting and significant relationships between the behaviors of physical activity and diet (red meat consumption), obesity, and self-reported perceived health in our surveyed chiropractic college population. Without exception, all surveyed members of our campus community view doctors of chiropractic as having a responsibility to role model healthy behaviors and to educate their patients with regard to healthy behaviors; however, we also found that less importance was placed on role modeling and patient education by those who were obese or who consumed red meat in excess. Conclusions: This chiropractic college campus places a high level of importance on both educating patients and role modeling healthy behaviors. In the behavioral domain, the rates of smoking, obesity, and inactivity are lower than what is seen in the general population. However, there remains room for considerable improvement to bring actual health behaviors closer in line with evidence-informed behavioral health practices.

Eitle TM; Wahl AMG; Aranda E. Immigrant generation, selective acculturation, and alcohol use among Latina/o adolescents. Social Science Research 38(3): 732-742, 2009. (65 refs.)

Do alcohol use and binge drinking among Latina/o adolescents increase in the second and third generation? This study explores generational differences in alcohol use behaviors for three Latina/o ethnic groups. Using data from the National Longitudinal Study of Adolescent Health on 1504 Latina/o adolescents in secondary school, we found that the factors associated with alcohol use behaviors differed across the Latina/o groups. For Mexican and Cuban adolescents, but not Puerto Ricans, immigrant generation was associated with alcohol use. For Mexican, but not Cuban adolescents, acculturation mediated the effect of immigrant generation on alcohol use behaviors. Although generally social capital and a coethnic presence were protective factors against alcohol use behaviors, we found that some forms of social capital were actually risk factors for Cubans and Puerto Ricans. Our results provide support for segmented-assimilation theory.

Ekholm O; Gronbaek M; Peuckmann V; Sjogren P. Alcohol and smoking behavior in chronic pain patients: The role of opioids. European Journal of Pain 13(6): 606-612, 2009. (38 refs.)

The primary aim of this epidemiological study was to investigate associations between chronic non-cancer pain with or without opioid treatment and the alcohol and smoking behavior. The secondary aims were to investigate self-reported quality of life, sleeping problems, oral health and the use of different health care providers. The Danish health Survey of 2005 was based on a region-stratified random sample of 10.916 individuals. Data were collected via personal interviews and self-administrated questionnaires. Respondents Suffering from chronic pain were identified through the question 'Do you have chronic/long-lasting pain lasting 6 months or more?' The question concerning alcohol intake assessed the frequency of alcohol intake and binge drinking. Smoking behavior assessed the daily number of cigarettes. Individuals reporting chronic pain were stratified into two groups (opioid users and non-opioid users). In all, 7275 individuals completed a personal interview and 5552 individuals completed and returned the self-administrated questionnaire. Responders with a self-reported earlier or present cancer diagnosis were excluded from the Study. Hence, the final study population consisted of 5292 individuals. We found, that individuals suffering from chronic pain were less likely to drink alcohol. In opioid users alcohol consumption was further reduced. Cigarette smoking was significantly increased in individuals Suffering from chronic pain and in opioid users smoking was further increased. Poor oral health, quality of life and sleep were markedly associated with chronic pain and opioid use. The use of opioids was associated with significantly more contacts to healthcare care providers.

Eliasen M; Kjaer SK; Munk C; Nygard M; Sparen P; Tryggvadottir L et al. The relationship between age at drinking onset and subsequent binge drinking among women. European Journal of Public Health 19(4): 378-382, 2009. (20 refs.)

Methods: The data consisted of 68 539 women aged 1847 years randomly selected from the general population in Denmark, Iceland, Norway and Sweden. Frequency of binge drinking, defined as consuming 6 U of alcohol at the same occasion once or more per month, and age at drinking debut were assessed through a questionnaire survey. Results: Overall, 1226% reported binge drinking once or more per month in the four countries. Median age for starting drinking was 16 years in all four countries. Women who started drinking at 14 years or younger were significantly more likely to binge drink than women who started drinking at 19 years or older with adjusted odds ratios of 2.9 (95% confidence intervals 2.33.7), 2.8 (2.13.6) and 2.6 (1.93.4) for binge drinking in Denmark, Iceland and Sweden, respectively. Among Norwegian women the association was stronger with an adjusted odds ratio at 4.4 (3.55.6). The association in all four countries was more pronounced in women younger than 30 years than in older women. Conclusion: In the four Nordic countries, there is a strong relation between age at drinking onset and later binge drinking. The strong relationship found in countries with such different alcohol cultures is most likely generalizable to other Western countries.

Ernst FA; Hogan B; Vallas MA; Cook M; Fuller D. Superior self-regulatory skills in African-American college students: Evidence from alcohol and tobacco use. Journal of Black Studies 40(2): 337-346, 2009. (36 refs.)

Excessive drinking is more common among Whites (W) than African Americans (AA) on college campuses, but the reasons for this are not clear. The authors investigated demographic and personality factors in a group of 369 W and 202 AA college students, finding that alcohol consumption was significantly less prevalent among AA students (69%) than W students (78%) (p = .02) and that binge drinking was significantly less frequent in AA drinkers (42% past month, 60% past year) than W drinkers (56%, 79%) (p < .00001). Cigarette smoking was also dramatically less frequent in AA students (5%) than W students (28%) (p < .00001). AA students also scored significantly higher on Overcontrolled Hostility (M = 18.2, SEM = 0.40) than did W students (M = 15.7, SEM = 0.19) (p < .00001). The authors conclude that AA college students are a more self-selected group of high achievers who reveal evidence of superior self-regulatory skills.

fChen CM; Yi H-Y; Williams GD; Faden VB. Trends in Underage Drinking in the United States, 1991-2007. Surveillance Report #86. Bethesda MD: National Institute on Alcohol Abuse and Alcoholism, 2009. (44 refs.)

This surveillance report, prepared by the Alcohol Epidemiologic Data System (AEDS), National Institute on Alcohol Abuse and Alcoholism (NIAAA), presents data on underage drinking for 1991- 2007 . This is the third of a series of reports to be published every two years on underage drinking and related attitudes and risk behaviors. Data is derived from three separate national surveys: the National Survey on Drug Use and Health (NSDUH), the Monitoring the Future (MTF) survey, and the Youth Risk Behavior Survey (YRBS). The following are highlights of trends from 1991 through 2007. Prevalence of use: The trends across all three survey data sources show an overall decline in the prevalence of alcohol consumption of "recent" (past 30 days) between 1991 and 2007. In 2007 28.2 percent of youth ages 12-20 reported drinking in the past month. Throughout the decade, rates of underage drinking remained highest among non-Hispanic whites, followed by Hispanics and non-Hispanic blacks. Rates were also higher among youth not enrolled in school. Drinking patterns: The median age of initiating alcohol use increased slightly from 13.65 years in 1991-1993 to 14.06 years in 2005-2007. In addition, there has been a gradual decline over the decade in the proportion of youth reporting initiating drinking at age 12 years or younger. Over the course of the decade, males have maintained higher average frequency, quantity, and volume of consumption in the past 30 days than females. In 2005-2007, those ages 12-20 reported drinking on a mean of 5.84 days in the past 30 days. They consumed an average of 4.79 drinks on the days that they did drank. One survey (NSDUH) indicates that rates of binge drinking have increased among 12- to 20-year-olds between 1993 and 2002, from 12.1 to 19.1 percent, but have leveled off in the recent 5 years. Alcohol-related attitudes: There has been a gradual shift in youth attitudes towards underage drinking, with a decrease during the 1990s, particularly in the early 1990s, in the percentage of youth strongly disapproving of others regularly consuming alcohol or binge drinking, and in the percentage of those who consider regular or binge drinking a great risk (MTF). Recent data indicate these trends may be reversing. Alcohol-related risk behaviors: Between 1991 and 2007 trends from the YRBS show an overall decline in the prevalence of secondary school youth driving while under the influence of alcohol, however, the NSDUH data trends show an increase in prevalence between 1995 and 2002 . The difference is due to the large increase in rates among 18- to 20-year-olds-from 15.6 percent in 1995 to 22.2 percent in 2002-whereas rates among younger youth remained relatively stable. Data is presented in 14 tables and 34 figures.

Public Domain

Ferrier-Auerbach AG; Kehle SM; Erbes CR; Arbisi PA; Thuras P; Polusny MA. Predictors of alcohol use prior to deployment in National Guard Soldiers. Addictive Behaviors 34(8): 625-631, 2009. (38 refs.)

Frequent and heavy alcohol use is associated with negative mental and physical health consequences. Previous research has suggested that alcohol misuse is associated with demographic, personality, and mental health variables. This study examined the relative contribution of these factors in predicting drinking among National Guard soldiers prior to deployment to a combat zone. Members of a National Guard Brigade Combat Team (N = 515) completed questionnaires assessing drinking behaviors in the past year (frequency, quantity, binge, and total drinking), as well as demographic, personality, and mental health variables. As a group, demographic and personality variables significantly predicted all drinking outcomes. Negative emotionality and disconstraint were independent predictors of all drinking variables. Younger age predicted higher quantity of drinking, while being unmarried predicted greater total drinking and higher frequency of binge drinking. Once the influence of personality variables were accounted for, mental health was not associated with any drinking variable. The results of this study illustrate the role of factors associated with problematic drinking in a sample of high-risk individuals.

Gerlich MG; Kramer A; Gmel G; Maggiorini M; Luscher TF; Rickli H et al. Patterns of alcohol consumption and acute myocardial infarction: A case-crossover analysis. European Addiction Research 15(3): 143-149, 2009. (46 refs.)

Background: Alcohol consumption has been causally related to the incidence of coronary heart disease, but the role of alcohol before the event has not been explored in depth. This study tested the hypothesis that heavy drinking (binge drinking) increases the risk of subsequent acute myocardial infarctions (AMI), whereas light to moderate drinking occasions decrease the risk. Methods: Case-crossover design of 250 incident AMI cases in Switzerland, with main hypotheses tested by conditional logistic regression. Results: Alcohol consumption 12 h before the event significantly increased the risk of AMI (OR 3.1;95% CI 1.4-6.9). Separately, the effects of moderate and binge drinking before the event on AMI were of similar size but did not reach significance. In addition, AMI patients showed more binge drinking than comparable control subjects from the Swiss general population. Conclusions: We found no evidence that alcohol consumption before the event had protective effects on AMI. Instead, alcohol consumption increased the risk.

Gray MK; Brown KL. Drinking and drug use by college students: Comparing criminal justice majors and non-majors. Journal of Criminal Justice 37(3): 234-240, 2009. (41 refs.)

The current research examined drinking and drug use among college students. Using a self-report survey of students from a midwestern university, the frequency of alcohol use, binge drinking, and drug use were explored. Particular attention was paid to drinking behaviors and drug use among Criminal justice (CJ) students compared to students from other majors. Differences were found between CJ and non-CJ students especially in terms of drinking behavior; fewer differences were found between majors in terms of drug use. Issues of moral authority were examined as well as issues of employability. Implications for CJ students, faculty and advisors are discussed.

Grekin ER; Ondersma SJ. The relationship between prenatal care, personal alcohol abuse and alcohol abuse in the home environment. Drugs: Education, Prevention and Policy 16(5): 463-470, 2009. (26 refs.)

Aims: Nearly one-fourth of African-American women receive no prenatal care during the first trimester of pregnancy. The aim of the current study is to identify factors that underlie inadequate prenatal care among African-American women. Maternal alcohol abuse has been examined as one risk factor for inadequate prenatal care, but findings have been inconsistent, perhaps because (a) alcohol use during pregnancy is substantially under-reported and (b) studies have not considered the wider social network in which maternal alcohol use takes place. The current study attempts to clarify relationships between personal alcohol use, alcohol use in the home environment, and prenatal care in a sample of post-partum women. Methods: Participants were 107 low-income, primarily African-American women. All participants completed a computer-based screening which assessed personal and environmental alcohol use, prenatal care and mental health. Findings: Environmental alcohol use was related to delayed prenatal care while personal alcohol use was not. More specifically, after controlling for demographic variables, the presence of more than three person-episodes of binge drinking in a woman's home environment increased the odds of seriously compromized prenatal care by a factor of seven. Conclusions: Findings suggest the need to further assess environmental alcohol use and to examine the reliability of personal alcohol use measures.

Grucza RA; Norberg KE; Bierut LJ. Binge drinking among youths and young adults in the United States: 1979-2006. Journal of the American Academy of Child and Adolescent Psychiatry 48(7): 692-702, 2009. (35 refs.)

Objective: To evaluate trends in the past 30-day prevalence of binge drinking by age, sex, and student status, among youths and young adults in the United States between 1979 and 2006, a period that encompasses the federally mandated transition to a uniform legal drinking age of 21 years, and other policy changes aimed at curbing underage drinking. Method: Data were analyzed from 20 administrations of the National Survey on Drug Use and Health, yielding a pooled sample of more than 500,000 subjects. Trends in relative risk for four different age groups, stratified by sex, relative to the 24- to 34-year-old reference group were calculated. We also examined trends in risk for binge drinking associated with student status (among college-age students) and race/ethnicity. Results: Significant reductions in relative risk for binge drinking over time were observed for 12- to 20-year-old males, but no changes were observed for females in this age range, and binge drinking among minority females increased. Risk for binge drinking increased among 21- to 23-year-old women, with college women outpacing nonstudents in this age range. Trends also indicate that no reduction in binge drinking occurred for college men. Conclusions: Although the overall trend is toward lower rates of binge drinking among youths, likely a result of a higher legal drinking age and other changes in alcohol policy, little improvement has occurred for college students, and increases in binge drinking among women has offset improvements among youths. Understanding these specific demographic trends will help inform prevention efforts.

Hamelin C; Salomon C; Sitta R; Gueguen A; Cyr D; Lert F. Childhood sexual abuse and adult binge drinking among Kanak women in New Caledonia. Social Science & Medicine 68(7): 1247-1253, 2009

The long-term consequences of violence against women are poorly documented within the context of political domination, economic inequalities and rapid social change of indigenous communities. Using data from the first population study on violence against women and their consequences on health in New Caledonia, South Pacific, this article investigates the association between childhood sexual abuse and binge drinking among 441 adult Kanak women. Face-to-face standardised interviews were conducted in 2002-2003, among women aged 18-54 years drawn from the electoral rolls. Childhood sexual abuse before 15 years of age was reported by 11.6% of respondents. Nearly all the perpetrators (96%) were known to the victims (63% being a close relative). The rate of frequent binge drinking amongst the women within the last 12 months was 34%. After controlling for social and demographic factors, an independent association was found between childhood sexual abuse and current binge drinking. This study is the first to analyse the contribution of childhood sexual abuse to the likelihood of later heavy alcohol use in an indigenous population in the South Pacific. The findings call for improving and giving priority to care for children who are victims of violence to prevent long-term health consequences and to develop prevention programs aimed at alcohol-related behaviour in women, while taking into account simultaneous individual and collective factors.

Hart CL; Smith GD; Upton MN; Watt GCM. Alcohol consumption behaviours and social mobility in men and women of the Midspan Family Study. Alcohol and Alcoholism 44(3): 332-336, 2009. (29 refs.)

Aims: The aim of this study was to investigate relationships between alcohol consumption and social mobility in a cohort study in Scotland. Methods: 1040 sons and 1298 daughters aged 30-59 from 1477 families reported their alcohol consumption from which was derived: weekly units (1 UK unit being 8 g ethanol), exceeding daily or weekly limits, binge drinking and consuming alcohol on 5+ days per week. Own and father's social class were available enabling social mobility to be investigated. Results: More downwardly mobile men exceeded the weekly limit, the daily limit, were defined as binge drinkers and drank the most units per week of the four social mobility groups. Stable non-manual women were more likely to consume alcohol on 5+ days a week but very few were binge drinkers. Stable non-manual and upwardly mobile men and women were more likely to drink wine, and downwardly mobile men to drink beer. Conclusions: Downward mobility was associated with less favourable alcohol behaviours, especially in men. Wine consumption was more closely related to the social mobility groups than beer and spirits consumption. Drinking patterns could both influence and be influenced by social mobility.

Hasin DS; Beseler CL. Dimensionality of lifetime alcohol abuse, dependence and binge drinking. Drug and Alcohol Dependence 101(1-2): 53-61, 2009. (65 refs.)

Questions relevant to DSM-V alcohol use disorders (AUD) include whether dimensional measures pro vide more information than categorical diagnoses, whether to combine abuse and dependence criteria, and whether to add a new diagnostic criterion, binge drinking. Binary and dimensional models of three versions of AUD criteria were investigated: (1) dependence criteria; (2) abuse and dependence crite. ria combined; and (3) abuse and dependence criteria combined with a binge drinking criterion added. In a national sample of lifetime drinkers (N = 27,324), these models of AUD criteria were investigated in relation to two well-established risk factors for AUD, family history and early drinking onset. I.ogistic or Poisson regression modeled the relationships between the validating variables and dependence in categorical, dimensional and hybrid forms; Wald tests were used to assess differences between the dimensional, categorical and hybrid models. Alcohol dependence criteria represented a single continuum (family history Wald = 9.93, p = 0.13; early drinking Wald = 7.62, p = 0.27) with no support for a categorical or hybrid version of alcohol dependence. Adding four abuse criteria produced similar results for family history (Wald = 15.4, p = 0.12) although with early drinking, this model showed a trend towards deviating from the data (Wald = 16.7, p = 0.08), No support Was found for any diagnostic threshold at 3, 4, 5, 6, or 7 criteria when abuse and dependence were combined. Adding binge drinking resulted in a significant departure from linearity for family history (Wald = 21.8. p = 0.03) and early drinking (Wald = 23.9, p = 0.01). The number of alcohol dependence and abuse criteria met should be explored further is a useful AUD severity indicator or phenotype.

Jones AW; Holmgren A. Age and gender differences in blood-alcohol concentration in apprehended drivers in relation to the amounts of alcohol consumed. Forensic Science International 188(1-3): 40-45, 2009. (43 refs.)

This article reports the age, gender, and blood-alcohol concentration (BAC) of people apprehended in Sweden for driving under the influence of alcohol (DUIA) over an 8-year period (2000-2007). Duplicate determinations of ethanol were made in venous blood by headspace gas chromatography and results were reported positive at a cut-off concentration of 0.1 g/L (10 mg/100 ml or 0.01 g%). The mean, median and highest BAC was 1.74 g/L, 1.70 g/L and 5.18 g/L, respectively. The vast majority of offenders were men (89.5%) with a mean age of 39.0 +/- 14.6 y (+/- SD). The women (10.5%) were a few years older 41.8 +/- 13.6 y (p < 0.001). The mean BAC in the men (1.73 +/- 0.85 g/L) did not differ significantly (p > 0.05) from women (1.77 +/- 0.87 g/L). The youngest offenders aged 15-20 y (N = 3513) had a mean BAC of 1.30 +/- 0.60 g/L (median 1.32), which was significantly less (p < 0.001) than people aged 40-50 y (N = 6644): mean 1.90 g/L (median 2.0 g/L). In 95 individuals (89 men and 6 women) the BAC exceeded 4.0 g/L, which is a level considered to cause death by acute alcohol poisoning. The Widmark formula was used to calculate that a man (80 kg) with a BAC of 1.7 g/L has 95 g ethanol (similar to 12 units of alcohol) in the body compared with 61 g (similar to 8 units) for a woman (60 kg). This study verifies that the average drunken driver in Sweden is typically a binge drinker and education programs and treatment for alcohol-use disorder might be a more appropriate sanction than the more conventional penalties for alcohol-impaired driving.

Khaylis A; Trockel M; Taylor CB. Binge drinking in women at risk for developing eating disorders. International Journal of Eating Disorders 42(5): 409-414, 2009. (41 refs.)

Objective: To determine binge drinking rates in college-age women at risk for eating disorders and to examine factors related to binge drinking over time. Method: Participants were 480 college-age women who were at high risk for developing an eating disorder (ED) and who had a body mass index (BMI) between 18 and 32. Participants were assessed annually for 4 years. Results: Participants reported high rates of binge drinking and frequent binge drinking throughout college. Binge drinking was positively correlated with dietary restraint, coping using substances, coping using denial, and life events. Discussion: The study's findings suggest that binge drinking is highly prevalent in women at high risk for developing eating disorders. Results also indicated that binge drinking was related to dieting and maladaptive coping patterns. Intervention for women with strong weight and shape concerns should also address problematic alcohol use.

Kimbro RT. Acculturation in context: Gender, age at migration, neighborhood ethnicity, and health behaviors. Social Science Quarterly 90(5, Special Issue): 1145-1166, 2009. (67 refs.)

Objectives: This article investigates differences in smoking and binge-drinking for Latinos by nativity, stratified by their age at immigration, and tests individual- and neighborhood-level acculturation measures as determinants of those differences. Methods: Data are from the Los Angeles Families and Neighborhoods Study (N=2,023) and analyses use multilevel logistic regression. Results: The article finds that Latino immigrants are less likely to smoke or binge drink, compared to their U.S.-born peers, and that acculturation measures account for some of the immigrant gaps in health behaviors, although results differ by gender and age at migration. Additionally, living in a neighborhood with a high foreign-born concentration is associated with lower odds of binge-drinking. Conclusions: Findings suggest that both individual- and neighborhood-level measures of acculturation may contribute to immigrant health behavior advantages, and that it is important to consider these relationships within the context of gender and age at migration.

Kraus L; Baumeister SE; Pabst A; Orth B. Association of average daily alcohol consumption, binge drinking and alcohol-related social problems: Results from the German Epidemiological Surveys of Substance Abuse. Alcohol and Alcoholism 44(3): 314-320, 2009. (32 refs.)

Aims: The present study investigates the combined effect of average volume and binge drinking in predicting alcohol-related social problems and estimates the proportion of alcohol-related harms related to specific drinking patterns that could be prevented if transferred to a low-risk drinking group. Methods: Data came from the 1997 and 2000 German Epidemiological Survey of Substance Abuse (ESA) (age: 18-59 years; response rate: 65% and 51%, respectively). The pooled sample consisted of 12,668 current drinkers. By using nine categories of average daily intake and three groups of binge drinking, individuals were grouped into 22 mutual exclusive groups. Social problems were defined as the occurrence of 'repeated family quarrels', 'concern of family members or friends', 'loss of partner or friend' or 'physical fight or injury' in relation to alcohol. Results: The effect of average daily intake is modified by binge drinking frequency such that the association was strongest in those with four or more binge drinking occasions during the last 30 days. Within each binge drinking group, adjusted relative risks (aRR) increased with alcohol intake up to a certain threshold and decreased thereafter. Overall, compared to the reference group (<= 7 g ethanol/day-025EFno binge), the population-attributable fraction (PAF) related to the other drinking groups was 71.4% (95% CI: 64.4-77.1%). Conclusions: The frequency of binge drinking occasions seems to be a better predictor of alcohol-related social problems than volume. Alcohol-related social harms especially among drinkers with moderate volume per day may be reduced by targeting prevention strategies towards episodic heavy drinkers.

Kypri K; Paschall MJ; Langley J; Baxter J; Cashell-Smith M; Bourdeau B. Drinking and alcohol-related harm among New Zealand university students: Findings from a national web-based survey. Alcoholism: Clinical and Experimental Research 33(2): 307-314, 2009. (44 refs.)

Alcohol-related harm is pervasive among college students in the United States of America and Canada, where a third to half of undergraduates binge drink at least fortnightly. There have been no national studies outside North America. We estimated the prevalence of binge drinking, related harms, and individual risk factors among undergraduates in New Zealand. A web survey was completed by 2,548 undergraduates (63% response) at 5 of New Zealand's 8 universities. Drinking patterns and alcohol-related problems in the preceding 4 weeks were measured. Drinking diaries for the preceding 7 days were completed. Multivariate analyses were used to identify individual risk factors. A total of 81% of both women and men drank in the previous 4 weeks, 37% reported 1 or more binge episodes in the last week, 14% of women and 15% of men reported 2+ binge episodes in the last week, and 68% scored in the hazardous range (4+) on the AUDIT consumption subscale. A mean of 1.8 (95% confidence interval 1.4, 2.3) distinct alcohol-related risk behaviors or harmful consequences were reported, e.g., 33% had a blackout, 6% had unprotected sex, and 5% said they were physically aggressive toward someone, in the preceding 4 weeks. Drink-driving or being the passenger of a drink-driver in the last 4 weeks was reported by 9% of women and 11% of men. Risk factors for frequent binge drinking included: lower age, earlier age of drinking onset, monthly or more frequent binge drinking in high school, and living in a residential hall or a shared house (relative to living with parents). These correlates were similar to those identified in U.S. and Canadian studies. Strategies are needed to reduce the availability and promotion of alcohol on and around university campuses in New Zealand. Given the high prevalence of binge drinking in high school and its strong association with later binge drinking, strategies aimed at youth drinking are also a priority. In universities, high-risk drinkers should be identified and offered intervention early in their undergraduate careers.

Main CT. Underage drinking and the drinking age. Policy Review 2009(155): 33-46, 2009. (11 refs.)

In 2008, 135 College presidents circulated a statement, known as "The Amethyst Initiative," requesting public officials review the legal age for drinking. With that as the foreground, the author reviews the history around establishing a legal drinking age, the purported rationale, as well as the patterns of adolescent alcohol consumption in the United States. The case is made for continuing to have 21 as the legal drinking age.

Manning V; Best DW; Faulkner N; Titherington E. New estimates of the number of children living with substance misusing parents: Results from UK National Household Surveys. BMC Public Health 9(377), 2009. (38 refs.)

Background: The existing estimates of there being 250,000 - 350,000 children of problem drug users in the UK (ACMD, 2003) and 780,000 - 1.3 million children of adults with an alcohol problem (AHRSE, 2004) are extrapolations of treatment data alone or estimates from other countries, hence updated, local and broader estimates are needed. Methods: The current work identifies profiles where the risk of harm to children could be increased by patterns of parental substance use and generates new estimates following secondary analysis of five UK national household surveys. Results: The Health Survey for England (HSfE) and General Household Survey (GHS) (both 2004) generated consistent estimates - around 30% of children under-16 years (3.3-3.5 million) in the UK lived with at least one binge drinking parent, 8% with at least two binge drinkers and 4% with a lone (binge drinking) parent. The National Psychiatric Morbidity Survey (NPMS) indicated that in 2000, 22% (2.6 million) lived with a hazardous drinker and 6% (705,000) with a dependent drinker. The British Crime Survey (2004) and NPMS (2000) indicated that 8% (up to 978,000) of children lived with an adult who had used illicit drugs within that year, 2% (up to 256,000) with a class A drug user and 7% (up to 873,000) with a class C drug user. Around 335,000 children lived with a drug dependent user, 72,000 with an injecting drug user, 72,000 with a drug user in treatment and 108,000 with an adult who had overdosed. Elevated or cumulative risk of harm may have existed for the 3.6% (around 430,000) children in the UK who lived with a problem drinker who also used drugs and 4% (half a million) where problem drinking co-existed with mental health problems. Stronger indicators of harm emerged from the Scottish Crime Survey (2000), according to which 1% of children (around 12,000 children) had witnessed force being used against an adult in the household by their partner whilst drinking alcohol and 0.6% (almost 6000 children) whilst using drugs. Conclusion: Whilst harm from parental substance use is not inevitable, the number of children living with substance misusing parents exceeds earlier estimates. Widespread patterns of binge drinking and recreational drug use may expose children to sub-optimal care and substance-using role models. Implications for policy, practice and research are discussed.

Marshall EJ; Guerrini I; Thomson AD. Introduction to this issue: The seven ages of man ... (or woman) (editorial). Alcohol and Alcoholism 44(2): 106-107, 2009. (7 refs.)

Alcohol affects the brain throughtout life, from the results of prental alcohol exposure, through the binge pattern of drinking the occurs in adolescents, as well as being manifest in the presence of Wernicke-Korsakof's that results from extended heavy alcohol use. This special issue presents the latest views on alcohol-related brain damage that document the advances that have been made and give us considerable optimism for future understanding and prevention of this condition. The public should be given information about how alcohol affects the brain, so that they can make up their mind about how to drink. What is required is the political will and medical determination to educate all members of the medical and allied professions who are likely to be responsible for individuals with alcohol-related brain damage. Much has been achieved over the last 40 years in highlighting and treating the effects of alcohol on the liver. In many ways, alcohol-related brain damage is more fundamental and its effects on society more profound. It is time that equal efforts were made to protect what makes us who we are, and so allow us to 'play (our) part' at every stage in our lives.

Martyn KK; Loveland-Cherry CJ; Villarruel AM; Cabriales EG; Zhou Y; Ronis DL et al. Mexican adolescents' alcohol use, family intimacy, and parent-adolescent communication. Journal of Family Nursing 15(2): 152-170, 2009

Despite widespread adolescent alcohol use, research on individual and contextual factors among Mexican adolescents is limited. This study describes the relationship between adolescent risk/protective factors, parent-adolescent communication, and their effects on alcohol use of 14- to 17-year-old adolescents living in Mexico (N = 829; 458 girls, 371 boys). In this study, adolescents reported that 55% ever used alcohol, 24% used alcohol in the past 30 days, and 10% reported binge drinking. Adolescents with high family intimacy were less likely to report ever using alcohol and binge drinking. Regression analysis revealed that parent-adolescent communication mediated the effect of family intimacy on overall and binge drinking. Alcohol use prevention with Mexican adolescents should focus on family intimacy and parent-adolescent communication.

Mathurin P; Deltenre P. Effect of binge drinking on the liver: An alarming public health issue? Gut 58(5): 613-617, 2009. (55 refs.)

Alcohol consumers show strong variations in demographic characteristics, alcohol intake, frequency, duration and profile of consumption. Individuals consuming up to two drinks per day (men) or one drink per day (women) are defined as moderate drinkers and do not have an increased risk compared to abstainers. Conversely, a high-risk pattern, defined as daily consumption above those limits, or binge drinking episodes, cause health, personal and social problems. This definition separates chronic drinkers from binge drinkers, as their drinking patterns are different. Binge drinking implies "drinking too much too fast". well-known consequences of binge drinking include unintentional injuries, interpersonal violence, fetal alcohol syndrome, child neglect, loss of productivity, suicide, sexually transmitted diseases and unintended pregnancy. This review compiles experimental, clinical and epidemiological data on the binge drinking phenomenon. Binge drinking is a major public heath issue that can no longer be considered simply a momentary risk factor of behavioural concerns, but must now be viewed in light of long-term consequences, such as alcohol-induced liver disease. Binge drinking has a deleterious effect on the liver exacerbated by repeated episodes. The drastic increase in liver cirrhosis and mortality rates in the UK is particularly alarming. The binge phenomenon is now spreading throughout young populations in almost all Western countries. Studies specifically focusing on the risk threshold for development of alcohol cirrhosis in binge drinkers are warranted.

McCauley J; Ruggiero KJ; Resnick HS; Conoscenti LM; Kilpatrick DG. Forcible, drug-facilitated, and incapacitated rape in relation to substance use problems: Results from a national sample of college women. Addictive Behaviors 34(5): 458-462, 2009. (30 refs.)

This is the first study to examine the relation between rape and substance use problems in college women as a function of three legally recognized forms of rape: forcible, incapacitated, and substance-facilitated rape. Data were collected via structured telephone interview with a large national sample of college women aged 18-34 years (n = 1980). Lifetime prevalence of any type of rape was 11.3% in the sample. Prevalence estimates for binge drinking and substance abuse were 15.8% and 19.8%, respectively. Lifetime experience of incapacitated rape and drug-alcohol facilitated rape, but not forcible rape, were associated with increased odds of past-year binge drinking and substance abuse. Findings have implications for secondary prevention and call for continued differentiation in assessment of rape type.

McMillen BA; Hillis SM; Brown JM. College students' responses to a 5/4 drinking question and maximum blood alcohol concentration calculated from a timeline followback questionnaire. Journal of Studies on Alcohol and Drugs 70(4): 601-605, 2009. (25 refs.)

Objective: Many surveys employed to study college drinking ask whether students have had a five-drink (for men) or four-drink (for women) episode in one sitting at least once during the previous 2 weeks to indicate risky or heavy episodic drinking. However, some researchers have questioned the predictive validity of the 5/4 measure. This study tested whether such students attained extremely high blood alcohol concentrations (BACs) during the previous 30 days. Method: Freshmen students were recruited by presentation of short screening surveys in the classroom or outside the student stores. Students who reported a risky drinking episode were invited to enroll in the study and were given a lengthy survey battery that included a computerized 30-day Timeline Followback recall of their drinking. The amount of alcohol consumed was used along with each subject's gender and weight to calculate an estimated BAC (eBAC) for each event and the maximum eBAC taken for this report. Results: Fifty-five percent of the 953 students who completed the screening survey met criterion for enrollment, and 381 students entered the study. The average peak calculated eBAC was 233 mg/dl. Only 9.2% of subjects did not have an eBAC value at or above the threshold for a driving while intoxicated offense, 80 mg/dl. Conclusions: Students who report one recent risky drinking episode are very likely to have had at least one heavy drinking episode that generated a BAC in excess of the threshold for driving while intoxicated. Many report extremely high consumption levels. The 5/4 screening question is highly predictive of abusive drinking and can be used to identify students at severe risk for adverse events related to the consumption of alcohol.

McQueeny T; Schweinsburg BC; Schweinsburg AD; Jacobus J; Bava S; Frank LR et al. Altered white matter integrity in adolescent binge drinkers. Alcoholism: Clinical and Experimental Research 33(7): 1278-1285, 2009. (64 refs.)

Background: White matter integrity has been found to be compromised in adult alcoholics, but it is unclear when in the course of alcohol exposure white matter abnormalities become apparent. This study assessed microstructural white matter integrity among adolescent binge drinkers with no history of an alcohol use disorder. Methods: We used diffusion tensor imaging to examine fractional anisotropy (FA), a measure of directional coherence of white matter tracts, among teens with (n = 14) and without (n = 14) histories of binge drinking but no history of alcohol use disorder, matched on age, gender, and education. Results: Binge drinkers had lower FA than controls in 18 white matter areas (clusters >= 27 contiguous voxels, each with p < 0.01) throughout the brain, including the corpus callosum, superior longitudinal fasciculus, corona radiata, internal and external capsules, and commissural, limbic, brainstem, and cortical projection fibers, while exhibiting no areas of higher FA. Among binge drinkers, lower FA in 6 of these regions was linked to significantly greater lifetime hangover symptoms and/or higher estimated peak blood alcohol concentrations. Conclusions: Binge drinking adolescents demonstrated widespread reductions of FA in major white matter pathways. Although preliminary, these results could indicate that infrequent exposure to large doses of alcohol during youth may compromise white matter fiber coherence.

Morgenstern M; Wiborg G; Isensee B; Hanewinkel R. School-based alcohol education: results of a cluster-randomized controlled trial. Addiction 104(3): 402-412, 2009. (38 refs.)

This study aimed to examine the effects of a school-based alcohol education intervention. Two-arm three-wave cluster-randomized controlled trial, with schools as the unit for randomization. Surveys were conducted prior to intervention implementation, then 4 and 12 months after baseline. A total of 30 public schools in Schleswig-Holstein, Germany. Baseline data were obtained from 1686 7th graders. The retention rate was 85% over 12 months. The intervention consisted of four interactive lessons conducted by teachers, booklets for students and booklets for parents. Knowledge, attitudes, life-time alcohol consumption (ever use alcohol without parental knowledge, ever been drunk and ever binge drinking) and past-month alcohol use. Intention-to-treat analyses revealed that intervention status was associated with more general knowledge about alcohol and lower levels of life-time binge drinking. No effects were found with respect to students' self-reported attitudes, intentions to drink, life-time alcohol use and past-month alcohol use. The results indicate that this brief school-based intervention had a small short-term preventive effect on alcohol misuse.

Naimi TS; Nelson DE; Brewer RD. Driving after binge drinking. American Journal of Preventive Medicine 37(4): 314-320, 2009. (31 refs.)

Background: Although binge drinking is strongly associated with alcohol-impaired driving, little is known about the prevalence of or risk factors for driving after binge drinking. Purpose: The purpose of this study was to assess the prevalence of, and risk factors for, driving during or shortly after a specific binge drinking episode. Methods: The data were analyzed in 2007 and 2008 from 14,085 adults from 13 states in 2003 and 14 states in 2004 who reported binge drinking and answered an additional series of questions about binge drinking behaviors as part of the Behavioral Risk Factor Surveillance System survey. Binge drinking was defined as the consumption of five or more drinks during a drinking occasion. Results: Overall, 11.9% of binge drinkers drove during or within 2 hours of their most recent binge drinking episode. Those drinking in licensed establishments (bars, clubs, and restaurants) accounted for 54.3% of these driving episodes. Significant independent risk factors for driving after binge drinking included male gender (AOR=1.75); being aged 35-54 or >= 55 years compared to 18-34 years (AOR=1.58 and 2.37, respectively); and drinking in bars or clubs compared to drinking in the respondent's home (AOR=7.81). Drivers who drank most of their alcohol in licensed establishments consumed an average of 8.1 drinks, and 25.7% of them consumed >= 10 drinks. Conclusions: Because binge drinking and subsequent driving were common in establishments licensed to sell alcohol, and because licensing is conditional on responsible beverage service practices (i.e., not selling to intoxicated people), efforts to prevent impaired driving should focus on enforcing responsible beverage service in licensed establishments.

Nelson DE; Naimi TS; Brewer RD; Nelson HA. State alcohol-use estimates among youth and adults, 1993-2005. American Journal of Preventive Medicine 36(3): 218-224, 2009. (50 refs.)

Background: Underage drinking, particularly binge drinking, is an important public health problem that results in substantial premature mortality and morbidity. Little is known about the potential influence of the alcohol-use behaviors of adults on youth alcohol use at a population level. The purpose of this study was to examine the correlation of alcohol-use behaviors among youth with those of adults at a population level. Methods: Data were analyzed in 2007 and 2008, using biennial 1993-2005 data from state school-based Youth Risk Behavior Surveys of students in grades 9-12, and from the Behavioral Risk Factor Surveillance System for adults aged >= 18 years. Pearson correlation coefficients (r) were used to compare state prevalence estimates for youth with those of adults for several alcohol-use measures. Results: Overall and subgroup-specific state youth estimates of current drinking and binge drinking were generally moderately to strongly correlated with adult alcohol use (range of r-values for pooled estimates across all years: 0.35-0.68 for current drinking [p<0.01 for all correlations]; 0.24-0.60 for binge drinking [p<0.01 for all correlations]) and with youth and adult drinking-and-driving behaviors (range of r-values for pooled estimates: 0.12-0.52, p<0.01 for all but one correlation). Correlation coefficients were generally higher for girls with women and for youth with younger adults aged 18-34 years. The use of alcohol by youth before they were aged 13 years was not correlated with adult alcohol-use measures, and most youth alcohol-use measures were not correlated with adult heavy-alcohol use. Conclusions: Most state youth alcohol-use estimates were correlated with state adult estimates. These findings have implications for underage-drinking control strategies and suggest that efforts to address this problem need to be targeted on a broader societal level.

Nelson MC; Lust K; Story M; Ehlinger E. Alcohol use, eating patterns, and weight behaviors in a university population. American Journal of Health Behavior 33(3): 227-237, 2009. (37 refs.)

Objective: To explore associations between alcohol, alcohol-related eating, and weight-related health indicators. Methods: Cross-sectional, multivariate regression of weight behaviors, binge drinking, and alcohol-related eating, using self-reported student survey data (n=3206 undergraduates/graduates). Results: Binge drinking was associated with poor diets, unhealthy weight control, body dissatisfaction, and sedentary behavior. Neither year in school nor age modified these relationships. Alcohol-related eating was associated with increased risk of overweight/obesity. Conclusions: Binge drinking was associated with an array of adverse behaviors. These associations did not differ between undergraduate and graduate students. Initiatives are needed to assist students in overcoming campus norms promoting unhealthy alcohol and dietary patterns.

Nelson TF; Xuan ZM; Lee H; Weitzman ER; Wechsler H. Persistence of heavy drinking and ensuing consequences at heavy drinking colleges. Journal of Studies on Alcohol and Drugs 70(5): 726-734, 2009. (39 refs.)

Objective: The purpose of this study was to examine drinking levels, related harms, and secondhand effects of alcohol use at heavy drinking colleges between 1993 and 2005 at colleges with high levels of drinking in 1993. Method: Students attending 18 colleges with high levels of heavy episodic drinking (50% of students or more) from the 1993 Harvard School of Public Health College Alcohol Study were surveyed in 2005 (n = 4,518). Data collected through mailed and Web-based questionnaires were compared with responses from students at the same schools in 1993, 1997, 1999, and 2001 (N = 13,254) using time trend analyses. Results : Overall, levels of alcohol consumption, experience of problems, and levels of secondhand effects remained high among students attending heavy drinking colleges. More than four of five students at these schools drank alcohol (range: 85%-88%), and more than half engaged in heavy episodic drinking (range: 53%-58%). The stability of drinking behavior occurred among subgroups of students as well, The few statistically significant changes occurred mainly between 1993 and 1997. A decline in driving after any drinking between 1997 and 2005 was observed, but no similar decline was found in two other measures of drinking and driving. Conclusions: Heavy drinking and associated problems continue unabated, with few exceptions, at colleges that are most in need of intervention: those with high levels of heavy episodic drinking. Addressing student alcohol use at heavy drinking colleges may require stronger, more consistent, and more comprehensive approaches, with increased emphasis on the alcohol environment.

Office of Applied Studies, Substance Abuse and Mental Health Administration. Results from the 2008 National Survey on Drug Use and Health: National Findings. NSDUH Series H-36. Rockville MD: Substance Abuse and Mental Health Administration, 2009. (104 refs.)

Highlights: This report presents the first information from the 2008 National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The survey is the primary source of information on the use of illicit drugs, alcohol, and tobacco for those aged 12 years and older. Information is provided on different classes of substances, the inititiation of use, prevention efforts, and involvement or need for treatment. In 2008, an estimated 20.1 million Americans aged 12 or older were current (past month) illicit drug users, a rate of 8.0% of the population. Marijuana was the most commonly used illicit drug (15.2 million past month users), a rate of 6.1%, similar to 2007. Of note, for those using pain relievers nonmedically, the majority (55.9%) got the drug they most recently used from a friend or relative for free, who had gotten it from a single doctor. Another 18.0% got the drug from one doctor. Only 4.3% got pain relievers from a drug dealer or other stranger, and 0.4 percent bought them on the Internet. Among those who reported getting the pain reliever from a friend or relative for free, 81.7% reported in a follow-up question that the friend or relative had obtained the drugs from just one doctor. In terms of alcohol use, slightly more than half of Americans aged 12 or older reported being current drinkers of alcohol in the 2008 survey (51.6%), similar to the prior year. More than one fifth (23.3%) reported binge drinking, for those aged 18 to 25 in 2008, the rate of binge drinking was 41.0%. In 2008, 28.4% used tobacco, with a decline in the proportion of users in the 12-17 age group. Data is presented in 76 tables and 70 figures.

Public Domain

Office of Applied Studies, Substance Abuse and Mental Health Administration. The NSDUH Report: Substance Use among Women During Pregnancy and Following Childbirth. (May 21, 2009). Rockville MD: Substance Abuse and Mental Health Administration, 2009. (6 refs.)

This issue of "The NSDUH Report" examines past month use of alcohol, cigarettes, and marijuana among pregnant and parenting women aged 18 to 44 to shed light on how rapidly use of these substances resumes after childbirth. It differentiates pregnant women by trimester of pregnancy and recent mothers by age of the youngest child in the household. When compared with women in the third trimester of pregnancy, nonpregnant women with children under 3 months old in the household had much higher rates of past month alcohol use (6.2 vs. 31.9%), binge alcohol use (1.0 vs. 10.0%), cigarette use (13.9 vs. 20.4%, and marijuana use (1.4 vs. 3.8%). Consistent with other research this strongly suggests the resumption of use among mothers in the 3 months after childbirth. The increase in rates of substance use among parenting women tended to level off as the age of the youngest child increased. For alcohol, past month use increased from 31.9% for women with children under 3 months old to 43.9% for those with 3 to 5 month olds and 52.1% for those with 9 to 11 month olds. similar patterns were seen with binge alcohol use was 15.5 percent among women whose youngest children were aged 3 to 5 months and 19.7 percent for those whose youngest children were aged 18 months or older. Cigarette use among parenting women increased to 30.3 percent for those whose youngest children were aged 18 months or older. For marijuana, there was no significant increase in use among women who had children aged 3 months or older. Combined 2002 to 2007 data show that past month alcohol use among women aged 18 to 44 was highest for those who were not pregnant and did not have children living in the household (63.0 percent) but comparatively low for women in the first trimester of pregnancy (19.0 percent), and even lower for those in the second (7.8 percent) or third trimester (6.2 percent); similar patterns were seen with marijuana, cigarette, and binge alcohol use.

Public Domain

Office of Applied Studies, Substance Abuse and Mental Health Administration. The NSDUH Report: Concurrent Illicit Drug and Alcohol Use. (March 19, 2009). Rockville MD: Substance Abuse and Mental Health Administration, 2009. (4 refs.)

Concurrent use of illicit drugs and alcohol is a serious public health concern because of the potential additive or interactive effects of multiple substance use, which can lead to more severe adverse consequences than use of a single substance. Little is known about the prevalence of illicit drug use at the same time or within a few hours of alcohol use. The National Survey on Drug Use and Health (NSDUH) can help to address the need for information in this area. This issue of "The NSDUH Report" examines this topic using annual averages based on combined 2006 and 2007 NSDUH data. Among the notable findings: Illicit drug use concurrent with alcohol use (i.e., during or within 2 hours of last alcohol use) was reported by 5.6% of past month alcohol users in 2006 and 2007; this is equivalent to an estimated 7.1 million persons. The illicit drug most frequently used with alcohol was marijuana (reported by 4.8%). Among those who had used alcohol in the past month, adolescents and young adults (ages 12-17 and ages 18 to 25) had higher rates of illicit drug use along with alcohol, than older persons. Binge drinking is associated with higher rates of illicit drug use on that drinking occasion. For those who binged on alcohol during their last drinking occasion were more likely than their counterparts who did not binge to have used illicit drugs concurrent with their last alcohol use (13.9 vs. 3.8%). Data is also provided on rates of drinking and drug use by age and race/ethnicity.

Public Domain

Okamoto J; Ritt-Olson A; Soto D; Baezconde-Garbanati L; Unger JB. Perceived discrimination and substance use among Latino adolescents. American Journal of Health Behavior 33(6): 718-727, 2009. (39 refs.)

Objective: To examine perceived discrimination and substance use among Latino high school students. Methods: Latino 9(th) graders (N=1332) completed self-report measures of perceived discrimination and substance use behavior. Results: Perceived discrimination was associated with lifetime use measures of smoking (OR=1.73, P < 0.01), alcohol (OR=1.53, P < 0.01), marijuana (OR=1.70, P < 0.01), and inhalants (OR=1.50, P < 0.05); and past 30 day measures of smoking (OR=2.54, P < 0.01), alcohol (OR=1.63, P < 0.01), marijuana (OR=1.95, P < 0.01), and inhalants (OR=1.64, P < 0.01), and binge drinking (OR=1.84, P < 0.01). Conclusions: Latino adolescents who have higher perceptions of discrimination are at risk for substance use. Interventions to help Latino adolescents cope with feelings of discrimination may be a useful addition to substance use prevention programs.

O'Leary CM; Nassar N; Kurinczuk JJ; Bower C. The effect of maternal alcohol consumption on fetal growth and preterm birth. Obstetrical & Gynecological Survey 64(5): 299-300, 2009

Although numerous studies have investigated the effects of alcohol intake during pregnancy, currently available data linking prenatal alcohol exposure with abnormal fetal growth or preterm birth are inconclusive. This population-based cohort study assessed the effects of prenatal exposure to alcohol via a questionnaire given to a 10% random sample of all nonindigenous women in Western Australia who had delivered a singleton infant (n = 4719) between 1995 and 1997. The investigators examined the quantity of alcohol consumed per occasion, the frequency of consumption, and the total quantity consumed during the 3 months before and during each trimester of pregnancy. Multivariate logistic regression analysis was used to assess the possible association between alcohol consumption, both before and during pregnancy, with abnormal fetal growth (both small-for-gestational-age [SGA] and large-for-gestational-age infants [LGA]), and with preterm birth (<37 weeks of gestation). The control group consisted of infants born to abstinent women. In unadjusted analysis, moderate to heavy alcohol consumption during pregnancy was associated with an increased proportion of SGA infants born preterm. Adjustment for smoking status eliminated this effect in SGA infants. Binge drinking, defined as 5 or more drinks per occasion, in the first trimester was associated with a nonsignificant increase in the odds of preterm birth (adjusted odds ratio [aOR], 1.31; 95% confidence interval [CI], 0.67-2.58) as was binge drinking in late pregnancy (OR, 1.61; 95% CI: 0.68-3.77). Compared to the controls, women with moderate and heavy alcohol consumption had a significantly increased risk of preterm birth only if they ceased drinking before the second trimester (OR 1.78; 95% CI: 1.01-3.14). Low levels of alcohol intake during pregnancy (less than 60 gm/week or two or less standard drinks per occasion) was not associated with preterm. birth or SGA. These findings suggest that heavy and binge drinking among pregnant women may increase the likelihood of preterm birth, although the small number of patients makes the significance of these data unclear.

Paljarvi T; Koskenvuo M; Poikolainen K; Kauhanen J; Sillanmaki L; Makela P. Binge drinking and depressive symptoms: A 5-year population-based cohort study. Addiction 104(7): 1168-1178, 2009. (40 refs.)

Only few prospective population studies have been able so far to investigate depression and drinking patterns in detail. Therefore, little is known about what aspect of alcohol consumption best predicts symptoms of depression in the general population. In this prospective population-based two-wave cohort study, a cohort of alcohol-drinking men and women (n = 15 926) were followed-up after 5 years. A postal questionnaire was sent in 1998 (response proportion 40%) and again in 2003 (response proportion 80% of the baseline participants) to Finnish adults aged 20-54 years at baseline. Alcohol consumption was measured by average intake (g/week) and by measures of binge drinking (intoxications, hangovers and alcohol-induced pass-outs). Depressive symptoms were assessed with the 21-item Beck Depression Inventory. In addition, information from hospital discharge register for depression and alcohol abuse were linked to the data. This study found a positive association between baseline binge drinking and depressive symptoms 5 years later. Adjustment for several possible confounders attenuated the observed relationships only slightly, suggesting that binge drinking contributes independently to the occurrence of depressive symptoms. Binge drinking was related to symptoms of depression independently of average intake. This study supports the hypothesis that heavy drinking, and in particular a binge pattern involving intoxications, hangovers or pass-outs, produces depressive symptoms in the general population. The frequency of hangovers was the best predictor for depressive symptoms.

Paradis C; Demers A; Picard E; Graham K. The importance of drinking frequency in evaluating individuals' drinking patterns: implications for the development of national drinking guidelines. Addiction 104(7): 1179-1184, 2009. (25 refs.)

This paper examines the relationship between frequency of drinking, usual daily consumption and frequency of binge drinking, taking into consideration possible age and gender differences. Subjects were 10,466 current drinkers (5743 women and 4723 men) aged between 18 and 76 years, who participated in the GENACIS Canada (GENder Alcohol and Culture: an International Study) study. Canada. The independent variable was the annual drinking frequency. The dependent variables were the usual daily quantity consumed, annual, monthly and weekly frequency of binge drinking (five drinks or more on one occasion). Logistic regressions show (i) that those who drink less than once a week are less likely than weekly drinkers to take more than two drinks when they do drink; (ii) that the usual daily quantity consumed by weekly drinkers is not related to their frequency of drinking; but that (iii) the risk and frequency of binge drinking increase with the frequency of drinking. Given that risk and frequency of binge drinking among Canadians increases with their frequency of drinking, any public recommendation to drink moderately should be made with great caution.

Phillips WJ; Hine DW; Marks ADG. Individual differences in trait urgency moderate the role of the affect heuristic in adolescent binge drinking. (review). Personality and Individual Differences 47(8): 829-834, 2009. (39 refs.)

This study investigated the roles of the affect heuristic and outcome beliefs in explaining the relationship between negative urgency and adolescent binge drinking behaviour. The sample consisted of 391 Australian high school students, who were selected to be low or high on urgency. We hypothesised that highly urgent adolescents would be more likely than adolescents low in urgency to utilise the affect heuristic (i.e., to rely upon affective input) when making alcohol-related decisions. Multiple-group path analysis supported this prediction. Adolescents high in urgency exhibited greater use of the affect heuristic by displaying a direct path from affective associations to binge drinking; whereas adolescents low in urgency exhibited greater reliance upon rational processing by displaying an indirect path via outcome beliefs.

Pino NW; Johnson-Johns AM. College women and the occurrence of unwanted sexual advances in public drinking settings. Social Science Journal 46(2): 252-267, 2009. (28 refs.)

Using existing data from the 1999 Harvard School of Public Health College Alcohol Study, this study analyzes the social predictors of unwanted sexual advances experienced by college women and where this type of victimization occurs. Routine activities theory informed the analysis. While attendance and increased alcohol consumption at bars have a significant effect on experiences of unwanted sexual advances, attendance at parties, attendance at drink promotions, and participation in drinking games does not. Furthermore, while less satisfaction with education, having more sexual partners and friends that binge drink, and having more alcohol-related problems increase the likelihood of experiencing unwanted sexual advances, so does drinking less in general, having higher educated parents, and having a higher grade point average. These findings show that the predictors of unwanted sexual advances may differ somewhat from those that predict more serious forms of sexual victimization. Implications for future research and policy are discussed.

Ramstedt M. Fluctuations in male ischaemic heart disease mortality in Russia 1959-1998: Assessing the importance of alcohol. Drug and Alcohol Review 28(4): 390-395, 2009. (25 refs.)

Introduction and Aims. The decline in cardiovascular mortality in Russia following the Soviet anti-alcohol campaign of 1985-1988 and the subsequent increase when these extreme alcohol controls were repealed suggested that alcohol consumption is responsible for a substantial number of ischaemic heart disease (IHD) deaths in Russia. To examine whether a similar conclusion can be drawn on the basis of a time-series analysis covering a longer time period, namely 1959-1998. Design and Methods. Using ARIMA time-series analysis, the male IHD mortality rates from 1959 to 1998 were analysed in relation to three indicators of alcohol consumption: estimated per capita consumption, mortality from liver cirrhosis and alcohol poisonings. Cigarette sales and lung cancer mortality were used as indicators of smoking. Results. Each indicator of alcohol consumption had positive and statistically significant relationships with male IHD mortality in bivariate autoregressive integrated moving average models. The association was stronger in models predicting changes in premature male IHD mortality (30-54 years). At least one alcohol indicator was significantly related to IHD mortality in multivariate models, and in the case of premature IHD mortality, both mortality indicators were significant. Discussion and Conclusions. The results provide additional empirical evidence supporting alcohol's conceivable negative effects on IHD in Russia and the idea that binge drinking could be the mechanism through which this effect is mediated. There were no signs of any protective effects from alcohol among Russian men.

Rantakomi SH; Laukkanen JA; Kurl S; Kauhanen J. Binge drinking and the progression of atherosclerosis in middle-aged men: An 11-year follow-up. Atherosclerosis 205(1): 266-271, 2009. (36 refs.)

Objective: There is limited knowledge on drinking patterns and the progression of atherosclerosis. Previous studies have shown conflicting results between alcohol consumption and atherosclerotic progression. We investigated the association between the pattern of binge drinking and the 11-year progression of carotid atherosclerosis in a population-based sample of middle-aged men. Methods and results: This study is a part of the FinDrink Study, based on the Kuopio Ischemic Heart Disease Risk Factor Study. We investigated the effect of drinking patterns on the changes in maximum and mean intima-media thickness, including changes in maximum plaque height in 751 participants as measured by carotid ultrasound. The increased atherosclerosis progression was statistically significant among those men with binge drinking of >= 6 drinks per session (22.4% of total number of participants) using different covariates in different models according to the mean increase in maximum intima-media thickness (Model 1, p=0.008: Model 2, p=0.031, Model 3, p=0.037) and the mean increase in maximum plaque height (Model 1, p=0.002; Model 2, p=0.012, Model 3, p=0.017). Conclusion: Our study shows that binge drinking was associated with an increased atherosclerosis progression during an 11-year follow-up in middle-aged men, independent of the total alcohol consumption.

Razvodovsky YE. Suicide and fatal alcohol poisoning in Russia, 1956-2005. Drugs: Education, Prevention and Policy 16(2): 127-139, 2009. (33 refs.)

Background: The association between alcohol and suicide is well documented. The role of binge drinking patterns in the alcohol-suicide relationship is a very important issue today. The solid body of research and empirical evidence suggests that hazardous patterns of alcohol consumption (binge drinking) lead to a quicker and deeper intoxication, increasing the propensity for alcohol-related suicide. Purpose: To estimate the aggregate level effect of binge drinking on the suicide rate in the 'wet' Russian drinking culture. Method: Trends in age-adjusted, sex-specific suicide and fatal alcohol-poisoning rate (as a proxy for binge drinking) from 1956 to 2005 in Russia were analysed employing an ARIMA analysis in order to assess bivariate relationship between the two time series. Results: The results of the time-series analysis indicates the presence of a statistically significant association between the two time series at zero lag for male (r = 0.79; SE = 0.14), and for female (r = 0.58; SE = 0.14). Conclusion: The present study replicates previous findings from other settings that suggest positive association between alcohol and suicide at aggregate level. Support is thus provided for the hypothesis that suicide and alcohol are closely connected in cultures where intoxication-oriented drinking patterns prevail and these results add to the growing body of evidence that alcohol played a crucial role in the fluctuation in suicide mortality rate in Russia during the last decades.

Salonsalmi A; Laaksonen M; Lahelma E; Rahkonen O. Drinking habits and sickness absence: The contribution of working conditions. Scandinavian Journal of Public Health 37(8): 846-854, 2009. (27 refs.)

Aims: The main aim was to examine whether drinking habits including average, binge and problem drinking are associated with self-certified and medically confirmed sickness absence among middle-aged municipal employees. Another aim was to examine whether psychosocial and physical working conditions and work arrangements explain these associations. Methods: The data on drinking habits and working conditions of 5,119 female and 1,390 male middle-aged employees of the City of Helsinki was obtained from postal questionnaires collected in 2000-2002. The data on sickness absence (2000-2005) were derived from the employer's registers. Poisson regression analysis with self-certified (1-3 days) and medically confirmed (over 3 days) sickness absence spells as outcomes was used in performing the analyses. Results: Heavy average, binge and problem drinking were all associated with an increase in self-certified sickness absence. Both non-drinkers and heavy drinkers had excess medically confirmed sickness absence compared to moderate drinkers. Problem drinking and among women also binge drinking were associated with medically confirmed sickness absence. Psychosocial working conditions slightly attenuated the association of drinking habits and sickness absence mainly among men. Physical working conditions and work arrangements slightly explained medically confirmed sickness absence among male problem drinkers. Conclusions: All studied drinking habits were associated with both self-certified and medically confirmed sickness absence. Thus, a decrease in unhealthy drinking habits among employees is likely to prevent sickness absence. The effects of working conditions were small but psychosocial working conditions slightly explained the associations between drinking habits and sickness absence mainly among men.

Shin SH; Edwards EM; Heeren T. Child abuse and neglect: Relations to adolescent binge drinking in the national longitudinal study of Adolescent Health (AddHealth) Study. Addictive Behaviors 34(3): 277-280, 2009. (28 refs.)

The purpose of this study was to examine the relationship between child maltreatment and adolescent binge drinking. Given that many victimized children have been maltreated in multiple ways, we examine the effects of co-occurrence of multiple types of maltreatment on adolescent binge drinking. We used the National Longitudinal Study of Adolescent Health (AddHealth), which included a nationally representative sample of adolescents (n = 12,748). Adolescent binge drinking was defined as five or more drinks in a row at least 2-3 times per month in the past year. Among those reporting any maltreatment, 12.4% reported binge drinking compared to 9.9% among those reporting no maltreatment. Logistic regression models found that child maltreatment is a robust risk factor for adolescent binge drinking controlling for parental alcoholism. In particular, all types of or combinations of types of maltreatment were strongly associated with adolescent binge drinking, controlling for age, gender, race, parental alcoholism and monitoring. Research examining the effect of childhood maltreatment on later alcohol abuse needs to recognize the clustering effects of multiple types of childhood maltreatment on alcohol problems.

Sise CB; Sack DI; Sise MJ; Riccoboni ST; Osler TM; Swanson SM et al. Alcohol and high-risk behavior among young first-time offenders. Journal of Trauma, Injury, Infection and Critical Care 67(3): 498-502, 2009. (27 refs.)

Background: Underage drinking carries a high risk of injury. An important approach for reducing underage drinking is limiting youth access to alcohol. Underage drinkers obtain alcohol from multiple sources and patterns of access may vary by region. We examined patterns of access to alcohol and alcohol use among youth in a local court-ordered diversion program for first-time adolescent alcohol offenders as a basis for designing and evaluating community prevention efforts. Methods: Youth in the program completed a survey of demographic data, type of offense, source, setting, and quantity of alcohol consumed at time of offense, and 1-year alcohol-related high-risk behaviors. Significance was attributed to p <= 0.05. Results: Completed surveys were obtained from 1,158 (84.8%) of 1,366 eligible participants during the 23-month study period. There were 71% males and 29% females with a mean age of 17.2 years (range, 12-24 years). Respondents were Caucasian (64.5%), Hispanic/Latino (19.9%), Asian (3.5%), African American (2.5%), and others (9.6%). Offenses included minor in possession (55.8%), driving under the influence (21.2%), and drunk in public (20.4%). Consumption at time of offense was one or less drinks in 36.3%, two to five drinks in 31.7%, and 32.0% reported six or more drinks. Social sources of alcohol (got it from someone else) were reported by 72.9% and commercial sources (bought it or took it from a store) were reported in 11.9%. The two most common places of consumption were someone else's home (30.7%) and the beach (14.6%). Multiple 1-year high-risk behaviors were reported and 41.0% drove after drinking or rode with someone else who had been drinking. Binge drinking (5 or more drinks for males; 4 or more drinks for females) was reported by 43.1% of males and 36.7% of females. All high-risk behaviors were more common in binge drinkers (p < 0.001). Drinking and driving or riding with a drinking driver was reported in 54.2% of those who binged. Females who hinged reported a higher rate than males in 8 of 10 high-risk behaviors. Conclusions: This study revealed the predominance of social sources of alcohol among young first-time alcohol offenders. Drinking and driving or riding with a drinking driver was reported at an alarmingly high rate. Other alcohol-related high-risk behaviors were also common. Efforts to prevent alcohol-related trauma should target social access to alcohol, the resulting high-risk behaviors, and include a special focus on young females.

Song EY; Reboussin BA; Foley KL; Kaltenbach LA; Wagoner KG; Wolfson M. Selected community characteristics and underage drinking. Substance Use & Misuse 44(2): 179-194, 2009. (48 refs.)

This study assessed the relationship between community characteristics and alcohol use among 6,636 youth, aged from 14 to 20, in 2004. After adjusting for individual-level characteristics, youth from communities with a greater proportion of grandparents as caregivers, larger numbers of married couple families, and higher employment rates were significantly less likely to report past 30-day alcohol use. Youth from communities with higher median household income were significantly more likely to report past 30-day alcohol use. Adolescents in communities with a greater percentage of whites were significantly more likely to report binge drinking. The results indicate that the community context is an important predictor of alcohol use.

Stahre MA; Brewer RD; Fonseca VP; Naimi TS. Binge drinking among US active-duty military personnel. American Journal of Preventive Medicine 36(3): 208-217, 2009. (63 refs.)

Background: Binge drinking (drinking on a single occasion >= 5 drinks for men or >= 4 drinks for women) is a common risk behavior among U.S. adults that is associated with many adverse health and social consequences. However, little is known about binge drinking among active-duty military personnel (ADMP). The objectives of this study were to quantify episodes of binge drinking, to characterize ADMP who binge-drink, and to examine the relationship between binge drinking and related harms. Methods: The prevalence of binge drinking and related harms was assessed from responses to the 2005 Department of Defense Survey of Health Related Behaviors Among Military Personnel (n=16,037), an anonymous, self-administered survey. The data were analyzed in 2007 after the release of the public-use data. Results: In 2005, a total of 43.2% of ADMP reported past-month binge drinking, resulting in 29.7 episodes per person per year. In all, 67.1 % of binge episodes were reported by personnel aged 17-25 years (46.7% of ADMP), and 25.1% of these episodes were reported by underage youth (aged 17-20 years). Heavy drinkers (19.8% of ADMP) were responsible for 71.5% of the binge-drinking episodes and had the highest number of annual per-capita episodes of binge drinking (112.6 episodes). Compared to nonbinge drinkers, binge drinkers were more likely to report alcohol-related harms, including job performance problems (AOR=6.5; 95% CI=4.65, 9.15); alcohol-impaired driving (AOR=4.9; 95% CI=3.68, 6.49); and criminal justice problems (AOR=6.2; 95% CI=4.00, 9.72). Conclusions: Binge drinking is common among ADMP and is strongly associated with adverse health and social consequences. Effective interventions (e.g., the enforcement and retainment of the minimum legal drinking age) to prevent binge drinking should be implemented across the military and in conjunction with military communities to discourage binge drinking.

Stolle M; Sack PM; Thomasius R. Binge drinking in childhood and adolescence epidemiology, consequences, and interventions. (review). Deutsches Arzteblatt International 106(19): 323-I, 2009. (28 refs.)

Background: Episodic excessive alcohol consumption ("binge drinking") among children and adolescents has become a serious public health problem in Germany and is associated with a variety of risks. Methods: Selective literature search of the Ovid Medline database from 1998 to 2008. Results: Episodic excessive alcohol consumption is associated not only with somatic complications, but also with traffic accidents and other types of accident, violent behavior, and suicide. The more frequently a child or adolescent drinks to excess, and the younger he or she is, the greater is the risk of developing an alcohol-related disorder (alcohol misuse or dependence syndrome). In the USA, brief motivational interventions have been shown to have a small to medium-sized beneficial effect in reducing further binge drinking and its complications. Conclusions: The intervention HaLT ("Stop," also an acronym for Hart am Limit-"near the limit") is performed in a number of regions in Germany. Further types of brief motivating intervention should be developed and evaluated to prevent the development of alcohol-related disorders, where indicated, in children and adolescents that engage in binge drinking.

Strandberg-Larsen K; Gronbaek M; Andersen AMN; Andersen PK; Olsen J. Alcohol drinking pattern during pregnancy and risk of infant mortality. Epidemiology 20(6): 884-891, 2009. (35 refs.)

Background: The safety of small amounts of alcohol drinking and occasional binge-level drinking during pregnancy remains unsettled. We examined the association of maternal average alcohol intake and binge drinking (>= 5 drinks per sitting) with infant mortality, both in the neonatal and postneonatal period. Methods: Participants were 79,216 mothers who were enrolled in the Danish National Birth Cohort in 1996-2002, gave birth to a live-born singleton, and provided information while they were pregnant on alcohol consumption during pregnancy. Information on infant mortality and causes of death was obtained from national registries and medical records. Results: During the first year of life, 279 children (0.35%) died, 204 during the neonatal period. Infant mortality was not associated with alcohol drinking, even at a consumption level of either 4+ drinks per week or 3+ occasions of binge drinking. Postneonatal mortality was associated with an intake of 4+ drinks per week (hazard ratio = 3.56 [95% confidence interval = 1.15-8.43]) and with 3+ binge episodes (2.69 (1.27-5.69]). When restricting analyses to term births, both infant mortality and postneonatal mortality were associated with a weekly average intake of 4+ drinks or 3+ binge episodes. Conclusions: Among term infants, intake of at least 4 drinks of alcohol per week or binging on 3 or more occasions during pregnancy are associated with an increased risk of infant mortality, especially during the postneonatal period.

Sull JW; Yi SW; Nam CM; Ohrr H. Binge drinking and mortality from all causes and cerebrovascular diseases in Korean men and women: A Kangwha cohort study. Stroke 40(9): 2953-2958, 2009. (22 refs.)

Background and Purpose-The purpose of this study was to examine the association between binge drinking and risks of mortality due to all causes of death with a focus on cerebrovascular disease in Korean men and women. Methods-This study followed a cohort of 6291 residents in Kangwha County, aged >= 55 years in March 1985, for their cause-specific mortality for 20.8 years up to December 31, 2005. We calculated hazard ratio of mortality by experience or frequency of binge drinking using the Cox proportional hazard model. Binge drinking was defined as having >= 6 drinks on one occasion. Results-In men, binge drinkers who drink daily had an increased risk of mortality from all causes (hazard ratio, 1.33; 95% CI, 1.11 to 1.60) as compared with nondrinkers. They showed much increased risks of mortality from total stroke (hazard ratio, 1.86; 95% CI, 1.16 to 2.99) and hemorrhagic stroke (hazard ratio, 3.39; 95% CI, 1.38 to 8.35). Female binge drinkers also showed an increased risk of mortality from cardiovascular disease as compared with female nondrinkers, but the outcome was not statistically significant. Conclusions-The results of this study suggest that frequent binge drinking has a harmful effect on hemorrhagic stroke in Korean men. These findings need to be confirmed in further studies.

Sun YL; Strandberg-Larsen K; Vestergaard M; Christensen J; Andersen AMN; Gronbaek M et al. Binge drinking during pregnancy and risk of seizures in childhood: A study based on the Danish National Birth Cohort. American Journal of Epidemiology 169(3): 313-322, 2009. (41 refs.)

Seizures are often found in children with fetal alcohol syndrome, but it is not known whether binge drinking during pregnancy by nonalcoholic women is associated with an increased risk of seizure disorders in children. The authors conducted a population-based cohort study of 80,526 liveborn singletons in the Danish National Birth Cohort (1996-2002). Information on maternal binge drinking (intake of >= 5 drinks on a single occasion) was collected in 2 computer-assisted telephone interviews during pregnancy. Children were followed for up to 8 years. Information on neonatal seizures, epilepsy, and febrile seizures was retrieved from the Danish National Hospitalital Register. Results showed that exposure to binge drinking episodes during pregnancy was not associated with an increased risk of seizure disorders in children, except for those exposed at 11-16 gestational weeks. These children had a 3.15-fold increased risk of neonatal seizures (95% confidence interval: 1.37, 7.25) and a 1.81-fold increased risk of epilepsy (95% confidence interval: 1.13, 2.90). These findings suggest that maternal binge drinking during a specific time period of pregnancy may be associated with an increased risk of specific seizure disorders in the offspring. The results are exploratory, however, and need to be replicated.

Toriola AT; Kurl S; Laukkanen JA; Kauhanen J. Does binge drinking increase the risk of lung cancer: Results from the Findrink study. European Journal of Public Health 19(4): 389-393, 2009. (41 refs.)

Background: There are controversies on the role of alcohol in lung cancer but no studies have examined the role of alcohol consumption patterns. We examined the association between binge drinking and lung cancer. Methods: Prospective population based study of 2267 middle aged men from Finland without a history of lung cancer at baseline. Results: There were 65 cases of lung cancer during an average follow-up of 16.7 years. The relative risk (RR) of lung cancer for binge drinkers was 1.89 (95% CI 1.103.20) after adjusting for age, examination year, family history of cancer, smoking, socio-economic status (SES), leisure-time physical activity and body mass index (BMI). No increased risk was observed among non-smoking binge drinkers, RR 1.48 (95% CI 0.892.47). Binge drinking smokers had increased risks of lung cancer in all categories of daily smoking compared with non-binge drinking smokers. The RR were 2.70 (95% CI 1.614.53), 2.35 (95% CI 1.383.96) and 2.24 (95% CI 1.293.80) for those who smoked 119, 2029 and 30/day, respectively. Conclusion: Binge drinking is not associated with an increased risk of lung cancer among non-smokers but among smokers, it is associated with an increased risk irrespective of the number of cigarettes smoked daily. Even though the number of lung cancer cases among non-smokers was relatively small, the fact that the increased risk was limited to only smokers means that residual confounding by smoking may play a role. Larger studies are needed to clarify this association.

Valencia-Martin JL; Galan I; Rodriguez-Artalejo F. Alcohol and self-rated health in a mediterranean country: The role of average volume, drinking pattern, and alcohol dependence. Alcoholism: Clinical and Experimental Research 33(2): 240-246, 2009. (57 refs.)

The association between average alcohol consumption and self-rated ill-health is "J-shaped" in Scandinavian and Anglo-Saxon countries, but it has shown an inverse linear relationship in the few studies conducted in Mediterranean countries, based on average volume solely. To examine the relationship between alcohol and self-rated health in the general population of a Mediterranean country, by simultaneously taking into account average volume, drinking pattern, and alcohol abuse. From 2000 to 2005, we conducted telephone interviews on 12,037 persons, representative of the population aged 18 to 64 years in Madrid, Spain. The drinking pattern encompassed binge drinking, beverage preference, and drinking at mealtimes. Alcohol abuse was estimated by the CAGE test. The association between each alcohol-related variable and self-rated suboptimal (fair, poor, or very poor) health was estimated from logistic regression, with adjustment for the remaining alcohol-related variables and other potential confounders. In comparison with never-drinkers, suboptimal health was less frequent among occasional drinkers [odds ratio (OR) 0.72; 95% confidence interval (CI): 0.61 to 0.86], average moderate drinkers (OR 0.57; 95% CI: 0.48 to 0.69), and excessive drinkers (OR 0.51; 95% CI: 0.36 to 0.72), but more frequent among former drinkers with >= 1 year of abstinence (OR 1.30; 95% CI: 1.03 to 1.64). Frequency of suboptimal health was likewise higher in subjects with >= 3 episodes of binge drinking (OR 1.55; 95% CI: 1.12 to 2.14) or alcohol abuse (OR 1.47; 95% CI: 1.22 to 1.76). No differences were observed in suboptimal health according to beverage preference or drinking at mealtimes. Results in each gender were similar to those for total study participants. Occasional, moderate, and excessive consumption of alcohol are associated with better self-rated health, even after adjustment for drinking pattern and alcohol abuse. In contrast, former-drinking, frequent binge drinking, and alcohol abuse are all associated with suboptimal self-rated health.

Vaughn MG; Beaver KM; DeLisi M; Howard MO; Perron BE. Dopamine D4 receptor gene exon III polymorphism associated with binge drinking attitudinal phenotype. Alcohol 43(3): 179-184, 2009. (34 refs.)

Although binge drinking is a serious public health problem, relatively few studies have investigated the relationship between specific dopaminergic genes such as the dopamine D4 receptor (DRD4) and binge drinking attitudinal phenotypes. This study used the DNA subsample (N = 233, mean age 19.8, standard deviation, 0.89) of the National Longitudinal Study of Adolescent Health to investigate the association between a 48 base-pair variable number of tandem repeats in the DRD4 gene and a measure of binge drinking. Multivariate regression models indicated that the 7-repeat (7R) allele of the exon III polymorphism is significantly positively associated (beta = 0.16, P < .05) with binge drinking while controlling for low self-control and demographic variables. Findings were sturdy across race and gender. The present study provides unique evidence to the genetic underpinnings of binge drinking. Results suggest that the 7R allele may be an important contributor to the liability to binge drinking.

Ward RJ; Lallemand F; de Witte P. Biochemical and neurotransmitter changes implicated in alcohol-induced brain damage in chronic or 'binge drinking' alcohol abuse. Alcohol and Alcoholism 44(2): 128-135, 2009. (73 refs.)

The brain damage, which occurs after either chronic alcoholization or binge drinking regimes, shows distinct biochemical and neurotransmitter differences. An excessive amount of glutamate is released into specific brain regions during binge drinking (in excess of 4- to 5-fold of the normal basal concentration) that is not evident during periods of excessive alcohol consumption in chronic alcohol abusers. Increases in glutamate release are only observed during the initial stages of withdrawal from chronic alcoholism (similar to 2- to 3-fold) due to alterations in the sensitivities of the NMDA receptors. Such changes in either density or sensitivity of these receptors are reported to be unaltered by binge drinking. When such excesses of glutamate are released in these two different models of alcohol abuse, a wide range of biochemical changes occur, mediated in part by increased fluxes of calcium ions and/or activation of various G-protein-associated signalling pathways. Cellular studies of alveolar macrophages isolated from these two animal models of alcohol abuse showed enhanced (binge drinking) or reduced (chronic alcoholization) lipopolysaccharide (LPS)-stimulated NO release. Such studies could suggest that neuroadaptation occurs with the development of tolerance to alcohol's effects in both neurotransmitter function and cellular processes during chronic alcoholization that delay the occurrence of brain damage. In contrast, 'binge drinking' induces immediate and toxic effects and there is no evidence of an increased preference for alcohol as seen after withdrawal from chronic alcoholization.

Whitbeck LB; Crawford DM. Gestational risks and psychiatric disorders among indigenous adolescents. Community Mental Health Journal 45(1): 62-72, 2009. (69 refs.)

This study reports on the effects maternal prenatal binge drinking, cigarette smoking, drug use, and pregnancy and birth complications on meeting criteria for psychiatric disorders at ages 10-12 and 13-15 years among 546 Indigenous adolescents from a single culture in the northern Midwest and Canada. Adolescent DSM-IV psychiatric disorders were assessed with the Diagnostic Interview Schedule for Children-Revised (DISC-R). Results indicate that maternal behaviors when pregnant have significant effects on adolescent psychiatric disorders even when controlling for age and gender of adolescent, family per capita income, living in a single mother household, and adolescent reports of mother's positive parenting.

Xiao L; Bechara A; Grenard J; Stacy WA; Palmer P; Wei YL et al. Affective decision-making predictive of Chinese adolescent drinking behaviors. Journal of the International Neuropsychological Society 15(4): 547-557, 2009. (46 refs.)

The goal of the current investigation was to address whether affective decision making would serve as a unique neuropsychological marker to predict drinking behaviors among adolescents. We conducted a longitudinal Study of 181 Chinese adolescents in Chengdu city, China. In their 10th grade (ages 15-16), these adolescents were tested for their affective decision-making ability using the Iowa Gambling Task (IGT) and working memory capacity using the Self-Ordered Pointing Test. Self-report questionnaires were used to assess academic performance and drinking behaviors. At 1-year follow-up, questionnaires were completed to assess drinking behaviors, and the UPPS Impulsive Behavior Scale was used to examine four dimensions Of impulsivity: urgency, lack of premeditation, lack of perseverance, and sensation seeking. Results indicated that those adolescents who progressed to binge drinking or exhibited consistent binge drinking not only performed poorly on the IGT but also scored significantly higher in urgency compared to those who never or occasionally drank. Moreover, better IGT scores predicted fewer drinking problems and fewer drinks 1 year later after controlling for demographic variables, the previous drinking behaviors, working memory, and impulsivity. These findings suggest that deficits in affective decision making may be important independent determinants of compulsive drinking and potentially addictive behavior in adolescents.