TAG: "Alcohol"

Restricting firearms access for people who misuse alcohol may prevent violence

Existing policies largely ineffective in restricting firearm access for people who misuse alcohol.

By Carole Gan, UC Davis

Restricting access to firearms for people who misuse alcohol could prevent firearm violence, but policies that more clearly define alcohol misuse should be developed to facilitate enforcement, according to a review of existing research and public policies by the UC Davis Violence Prevention Research Program.

The analysis, published online April 30 in the peer-reviewed journal Preventive Medicine, summarizes studies on binge drinking and other forms of alcohol misuse in association with firearm access and use, including firearm violence. It also describes the shortcomings of existing policies designed to restrict access to firearms among those who are at high risk for violence due to alcohol misuse — particularly people with multiple prior convictions for alcohol-related offenses such as driving while under the influence (DUI).

“Both acute alcohol intoxication and chronic alcohol misuse are strongly associated with risk for committing firearm violence, whether that violence is directed at others or at oneself,” said Garen J. Wintemute, professor of emergency medicine, founding director of the UC Davis Violence Prevention Research Program and expert on gun violence as a public health problem.

“In any given month, an estimated 8.9 million to 11.7 million firearm owners binge drink. Both binge drinking and heavy chronic drinking are more common among firearm owners than in the general population. For men, there are as many alcohol-associated deaths from firearm violence as from motor vehicle crashes,” he said.

The article cites numerous studies that link aggressive firearm behaviors and alcohol misuse. These include a nationally representative study in which people who reported threatening others with a firearm were more likely than others to meet Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria for alcohol abuse or dependence, and another that found people who misused alcohol were substantially more likely than others to exhibit a combination of angry behavior and either carry firearms outside the home or have firearms at home.

Similarly, many studies have linked suicide by firearm and alcohol intoxication, including a 2011 study that found the excessive consumption of alcohol was associated with an 86-fold increase (an increase of 8,600 percent) in the risk of firearm suicide or near-suicide.

Federal and state policies are largely ineffective in restricting firearm access for people who misuse alcohol, Wintemute writes. Federal statute prohibits individuals who are unlawful users of or addicted to any controlled substance from the purchase or possession of firearms, but the statute specifically excludes alcohol from its definition of a “controlled substance” and leaves alcohol-related restrictions for individual states to consider.

“While 37 states with jurisdiction over 65 percent of the U.S. population have some restrictions on acquiring, possessing or using firearms by those who are intoxicated or have a history of alcohol misuse, many of these policies are unenforceable because they rely on vague, inherently subjective definitions of intoxication or misuse, such as ‘habitual drunkard,’  ‘habitually in an intoxicated condition,’ ‘chronic alcoholic’ and ‘addicted to alcohol,’” Wintemute said.

Wintemute noted that in the few locations that more specifically define alcohol misuse by number of convictions for DUI or other alcohol-related offenses over time (Maryland, Pennsylvania, Indiana, and the District of Columbia), the data on enforcement are unavailable or suggest that enforcement is lacking.

“Policies that restrict firearm access by persons with other risk factors for violence have been shown to be effective,” said Wintemute, who also is the first Susan P. Baker-Stephen P. Teret Chair in Violence Prevention at UC Davis Health System.

“In California, prohibiting persons convicted of violent misdemeanors for 10 years following their convictions reduced their risk of arrest for a firearm-related or violent offense. The evidence strongly suggests that properly-crafted and well-enforced policies, like modern laws for drinking and driving, would help prevent firearm-related violence,” he said.

Research for the article, “Alcohol misuse, firearm violence perpetration, and public policy in the United States,” was funded in part by the California Wellness Foundation (grant no. 2013-159). The foundation played no role in study design or conceptualization; in the collection, analysis and interpretation of the data; in the writing of the report; or in the decision to submit the article for publication.

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Frequent drinkers are more likely to neglect supervising their children

UCLA study finds heavy drinkers more likely to leave a child unsupervised at home or in car.

Bridget Freisthler, UCLA

Adults who drink alcoholic beverages frequently are more likely to inadequately supervise their children, according to a study led by a UCLA researcher.

The research, which was published (PDF) in the peer-reviewed journal Alcohol and Alcoholism, also found that frequent drinkers were less likely than others to physically neglect their children — defined as failing to provide food, medical care and other physical needs for the child. However, the more alcohol parents consume each time they drink, the more likely they are to show behavior consistent with physical neglect, such as not keeping the house warm enough.

Put another way, frequent drinkers are more likely to fail to provide adequate care for their children, and heavy drinkers are more likely to leave a child unsupervised at home or in a car, said Bridget Freisthler, professor of social welfare at the UCLA Luskin School of Public Affairs.

The researchers write that 500,000 children were victims of neglect in 2011, citing Child Protective Services statistics, and that alcohol is a factor in more than 11 percent of child neglect cases. But they said little is known about the relationship between alcohol use and neglectful parenting.

Most research on the subject has focused on alcohol dependence, alcohol abuse and quantity of alcohol consumed, rather than on drinking frequency or social contexts. The researchers attempted to fill that gap by examining five different drinking contexts and how they do or do not contribute to child neglect.

They interviewed 2,152 California parents who had children 12 or under and who had reported drinking alcohol in the past year.

The study found that the social contexts in which parents drink played distinct roles in whether and how parents neglected their children. For example, those who drank more often with friends were more likely to leave their children home alone, while those who drank with family members were more likely to unsafely monitor their children. Frequency and continued volumes of drinking in any context were not found to be related to parents’ reports of insufficient food or heat in the house.

“We found that no single drinking context is universally problematic in terms of either supervisory or physical neglect,” Freisthler said. “To help protect children, we need more detailed research into the relationships between alcohol consumption, behavioral patterns and types of neglect.”

The study was funded by the National Institute on Alcohol Abuse and Alcoholism.

Freisthler’s co-authors were Jennifer Price Wolf of the Prevention Research Center at the Pacific Institute for Research and Evaluation, and Michelle Johnson-Motoyama at the University of Kansas School of Social Welfare.

Freisthler leads the Spatial Analysis Lab in the Department of Social Welfare and the Child Abuse and Neglect Social Ecological Models Consortium.

This news release was adapted from a UCLA Luskin School of Public Affairs report.

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Hispanics develop alcoholic liver disease at younger ages than others

The difference is between four and 12 years earlier than Caucasians or African Americans.

Valentina Medici, UC Davis

By Karen Finney, UC Davis

Hispanics develop alcoholic liver disease (ALD), a common cause of liver-disease death, between four and 12 years earlier than whites/Caucasians or African Americans, according to a new study from UC Davis Health System.

While previous research indicated that Hispanics tend to have more severe ALD than other populations, the new study — published online in the journal Alcoholism: Clinical and Experimental Research — is believed to be the first to pinpoint racial and ethnic disparities in the ages at which symptoms first appear.

“Clinicians typically evaluate older patients for liver disease when moderate or heavy alcohol use has been long term,” said senior author Valentina Medici, associate professor of internal medicine. “We should be more aggressive in counseling patients about the importance of sobriety and testing them for ALD at younger ages, especially our Hispanic patients.”

An expert on liver metabolism and physiology, Medici and the study team reviewed records of nearly 800 UC Davis Medical Center patients diagnosed between 2002 and 2010 with one of the three, progressive stages of ALD caused by alcohol consumption — alcoholic fatty liver, alcoholic hepatitis or alcoholic cirrhosis.

The team also assessed patients’ drinking patterns, laboratory data, body mass indexes and additional health conditions such as metabolic syndrome and diabetes. Patients who had diseases such as hepatitis B or who were HIV-positive were excluded from the study to avoid potential confounding effects on ALD onset and severity.

The results showed that the most striking differences were in the average ages of onset of alcoholic fatty liver: 41 for Hispanic patients, 51 for whites/Caucasians and 53 for African Americans. This is the first stage of ALD and the point at which intervention can be most successful at reversing liver damage.

The average ages of onset for alcoholic hepatitis were 41 for Hispanic patients, 47 for whites/Caucasians and 48 for African Americans. For alcoholic cirrhosis, the average ages of onset were 49 for Hispanics, 53 for whites/Caucasians and 54 for African Americans.

The team also found that Hispanics who had end-stage ALD were more likely to be obese and diabetic than White/Caucasian and African American patients in the study.

“Our findings suggest that alcoholic liver disease is caused by more than chronic alcoholism,” said Charles Halsted, a study co-author and professor emeritus of internal medicine. “Future research should focus on genetic, metabolic and environmental factors that may increase the susceptibility of Hispanics to this disease.”

Funding for the study was provided by grants to Medici from the National Institutes of Health (numbers K08DK084111 and R03DK099427) and the UC Davis Division of Gastroenterology and Hepatology. Additional contributors to the research were lead author Robert Levy, Blythe Durbin-Johnson and Andreea Catana of UC Davis.

The study — titled “Ethnic Differences in Presentation and Severity of Alcoholic Liver Disease — is available online at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1530-0277/earlyview.

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Intoxication played bigger role in suicide deaths during economic downturn

Acute alcohol use could be one of missing links between economic hardship and suicide.

People who committed suicide during the Great Recession of 2008 and 2009 were more likely to have been legally intoxicated at the time than those who committed suicide during other recent years, according to research led by UCLA professor Mark Kaplan.

Although one-third of all people who commit suicide are intoxicated at the time of their deaths, extensive research has shown that individuals who are unemployed or at risk of unemployment in a down economy are at increased risk for suicide. At the same time, people overall tend to consume less alcohol during economic recessions.

The UCLA-led study found that, consistent with other findings, the number of suicide deaths did increase during the recession. However, despite noted declines in alcohol sales during tough economic times, the researchers found a positive relationship between economic downturn and alcohol use prior to suicide.

“This contradiction can be because while overall alcohol consumption goes down during recessions, there have been increases in detrimental drinking patterns and alcohol-related problems in certain individuals, particularly those affected by the recession,” said Kaplan, a professor of social welfare at the UCLA Luskin School of Public Affairs.

For the study, which was published by the peer-reviewed journal Injury Prevention, Kaplan and his colleagues reviewed seven years of data from 16 of the states that participate in the National Violent Death Reporting System, part of the Centers for Disease Control and Prevention. The NVDRS data showed that the number of suicides involving acute intoxication was 7 percent higher during the recession than it was from 2005 to 2007, before the recession began, a finding that suggests that acute alcohol use could be one of the missing links between economic hardship and suicide, according to Kaplan.

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Study finds acute alcohol misuse among suicidal people

UCLA research highlights need to link suicide prevention and alcohol-control strategies.

One-third of all suicides in the U.S. involve acute use of alcohol before the fatal attempt, according to a study led by UCLA social welfare professor Mark Kaplan. The researchers say the findings underscore the need to link suicide prevention and alcohol-control strategies.

The study is the first to compare alcohol use among those who committed suicide with that of a nationally representative survey of non-suicidal adults in the United States. Its purpose was to provide estimates of the relative risk of suicide associated with drinking and heavy drinking occasions.

The report was published online June 12 by the Annals of Epidemiology.

The researchers found that alcohol was detected in nearly 36 percent of men and 28 percent of women who committed suicide. Additionally, a blood alcohol content at or above .08 grams per deciliter — considered legally intoxicated in many states — was a potent risk factor for suicide across the age spectrum, and that people who committed suicide were four to 20 times more likely than others to have engaged in heavy drinking at any point in their lives. High levels of alcohol consumption were also associated with the methods of suicide that are most likely to be fatal, such as shooting and hanging.

“The key finding is that the data showed alcohol misuse is common among people who are suicidal,” said Kaplan, a faculty member at the UCLA Luskin School of Public Affairs. “Those who drank, drank heavily in the hour before taking their lives. Fewer than half of those who were alcohol positive at the time of death had a history of alcohol-related problems.”

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Grant renewed for project rewarding use of designated drivers

UC Irvine’s Health Education Center will expand anti-DUI effort to 30 California campuses.

Doug Everhart, UC Irvine

Doug Everhart, UC Irvine

UC Irvine’s Health Education Center has received a grant of $673,000 from the California Office of Traffic Safety – through the National Highway Traffic Safety Administration – to promote responsible alcohol consumption and safe driving. It’s the fifth consecutive year the center has been awarded such a grant.

In partnership with RADD, “the entertainment industry’s voice for road safety,” UC Irvine has organized 19 universities into a California College DUI Awareness Project consortium over the last four years. The new funding will facilitate that work, permitting the addition of two new regions and 11 more campuses.

RADD encourages bars and restaurants to provide free nonalcoholic drinks, appetizers and other incentives to designated drivers carrying a RADD card. Participating businesses get free listings on regional websites and a RADD rewards card.

“This project continues to grow because of the powerful partnerships that are created,” said Doug Everhart, director of the Health Education Center and principal investigator on the grant project. “The participating establishments understand and value their responsibility to recognize and reward sober designated drivers, who serve a very important role in getting their friends home safely. This business/consumer relationship also contributes to a positive town-and-gown relationship between campuses and the communities in which students live and socialize.”

UC Irvine data shows that most students on campus already make good decisions when it comes to being safe after consuming alcohol, said Rosezetta Henderson, grants coordinator at the Health Education Center. “This program reinforces those positive decisions by giving students an approach they can immediately benefit from,” she said.

The project currently comprises 19 campuses in six regions: San Diego, Orange County, Los Angeles, the Inland Empire, Sacramento and San Francisco’s South Bay area. It will be expanded this grant year to include 11 new campuses in the Central Coast and Central Valley.

The California College DUI Awareness Project uses a variety of tactics to get its message across. At UC Irvine, the RADD Crew appears at campus events such as Shocktoberfest, Reggaefest and Wayzgoose and speaks to Greek leaders and athletic teams. Toyota donated a 2012 Scion xB wrapped with RADD graphics to help spread the word.

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Unsafe at any level

Very low blood alcohol content associated with causing car crashes.

Even “minimally buzzed” drivers are more often to blame for fatal car crashes than the sober drivers they collide with, reports a UC San Diego study of accidents in the United States.

Led by UC San Diego sociologist David Phillips and published in the British Medical Journal group’s Injury Prevention, the study examined 570,731 fatal collisions, from 1994 to 2011.

The researchers used the official U.S. Fatality Analysis Reporting System (FARS) database for the study, because it is nationally comprehensive and because it reports on blood alcohol content (BAC) in increments of 0.01 percent. They focus particularly on “buzzed drivers,” with BAC of 0.01 to 0.07 percent, and, within this group, the “minimally buzzed” (or BAC 0.01 percent).

Phillips and his co-authors find that drivers with BAC 0.01 percent – well below the U.S. legal limit of 0.08 – are 46 percent more likely to be officially and solely blamed by accident investigators than are the sober drivers they collide with.

The authors also find no “threshold effect” – “no sudden transition from blameless to blamed” at the legal limit for drunk driving. Instead, blame increases steadily and smoothly from BAC 0.01to 0.24 percent.

Despite this evidence, “buzzed” drivers are often not punished more severely than their sober counterparts. In practice, Phillips said, police, judges and the public at large treat BAC 0.08 percent as “a sharp, definitive, meaningful boundary,” and do not impose severe penalties on those below the legal limit. That needs to change, Phillips said. “The law should reflect what official accident investigators are seeing.”

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The role of alcohol in injuries

UC Irvine offers interactive test to help patients rate their use of alcohol.

Alcohol chartThe next time you trip over a doorjamb and find yourself sitting in the emergency room nursing a sprained ankle, don’t be surprised if someone hands you a tablet computer and asks if you’d like to take a little quiz.

The interactive test, called CASI (short for Computerized Alcohol Screening and Intervention), helps patients rate their use of alcohol; it can also help them learn whether drinking is beginning to affect their health.

But what does the test have to do with you and your sore ankle?

Accidents and alcohol are so tightly intertwined that emergency room personnel suspect drinking is involved any time someone suffers a trauma, says Dr. Shahram Lotfipour, professor of emergency medicine and public health and director of the Center for Trauma and Injury Prevention Research at UC Irvine School of Medicine.

“We have the busiest trauma center in Orange County. And much of what we see is alcohol-related.”

The list includes falls, drowning, burns, domestic violence injuries, assaults, on-the-job injuries, sports injuries and, of course, traffic accidents. In America, a person is injured in an alcohol-related crash almost every 90 seconds, according to U.S. Highway Administration statistics.

“I know it’s a pessimistic view, but we come to expect trauma cases to be alcohol-related,” says Lotfipour, who has been involved in several long-term research studies of alcohol use.

UC Irvine Health is trying to break down the trauma-and-alcohol relationship by offering the CASI test and intervention to patients, in an attempt to prevent future heartbreaking emergency room visits.

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Can a glass of wine a day keep the doctor away?

Moderate consumption of alcohol can improve immune response to vaccination.

Can a glass of wine a day keep the doctor away? (Photo credit: Wikimedia)

Can a glass of wine a day keep the doctor away? (Photo credit: Wikimedia)

It’s the time of year when many of us celebrate the holidays with festive foods and drinks, including alcohol. No better time then to ask if it is true, as is widely held, that moderate consumption of alcohol is beneficial to health.

A research team led by an immunologist at UC Riverside now has data that could put the question to rest. The researchers found that moderate alcohol consumption could bolster our immune system, and potentially our ability to fight infections.

The finding, to be published Dec. 17 in the journal Vaccine, can help lead to a better understanding of how our immune system works. It also can pave the way for potentially new interventions to improve our ability to respond to vaccines and infections, benefiting vulnerable populations, such as the elderly for whom the flu vaccine, for example, has been found to be largely ineffective.

“It has been known for a long time that moderate alcohol consumption is associated with lower mortality,” said Ilhem Messaoudi, an associate professor of biomedical sciences in the UC Riverside School of Medicine and the lead author of the research paper. “Our study, conducted on non-human primates, shows for the first time that voluntary moderate alcohol consumption boosts immune responses to vaccination.”

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Prenatal exposure to alcohol disrupts brain circuitry

Research by UC Riverside neuroscientists demonstrates severe changes that alter behavior.

Prenatal exposure to alcohol severely disrupts major features of brain development that potentially lead to increased anxiety and poor motor function, conditions typical in humans with fetal alcohol spectrum disorders (FASD), according to neuroscientists at the University of California, Riverside.

In a groundbreaking study, the UC Riverside team discovered that prenatal exposure to alcohol significantly altered the expression of genes and the development of a network of connections in the neocortex — the part of the brain responsible for high-level thought and cognition, vision, hearing, touch, balance, motor skills, language and emotion — in a mouse model of FASD. Prenatal exposure caused wrong areas of the brain to be connected with each other, the researchers found.

These findings contradict the recently popular belief that consuming alcohol during pregnancy does no harm.

“If you consume alcohol when you are pregnant you can disrupt the development of your baby’s brain,” said Kelly Huffman, assistant professor of psychology at UC Riverside and lead author of the study that appears in the Nov. 27 issue of The Journal of Neuroscience, the official, peer-reviewed publication of the Society of Neuroscience. Study co-authors are UCR Ph.D. students Hani El Shawa and Charles Abbott.

“This research helps us understand how substances like alcohol impact brain development and change behavior,” Huffman explained. “It also shows how prenatal alcohol exposure generates dramatic change in the brain that leads to changes in behavior. Although this study uses a moderate- to high-dose model, others have shown that even small doses alter development of key receptors in the brain.”

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Gallo announces awards for $20M Army-funded research program

Grants to speed discovery, development of new meds to treat alcohol, substance abuse.

John De Luca

John De Luca

The UCSF-affiliated Ernest Gallo Clinic and Research Center has issued a second round of grants to accelerate the discovery and development of new medications to treat alcohol and substance abuse in the context of post-traumatic stress and combat injury.

The U.S. Army-funded research program, known as the Institute for Molecular Neuroscience (IMN), relies on the expertise of a team of national experts who are unaffiliated with grant applicants to conduct an independent peer-review process.

The second round of pilot research grants will support a broad range of projects to investigate potential new treatments for substance abuse, traumatic brain injury and post-traumatic stress. The total funding for this round of awards is $1.25 million. Together with the $3.7 million awarded in round one, the IMN has, to date, awarded approximately $5 million in proof-of-principle grants.

“The IMN program represents an important new strategy for combating substance abuse and related post-traumatic stress or other combat injuries,” said John A. De Luca, Ph.D., chairman of the board and president of the Gallo Center. “These medical conditions are national security health issues. The IMN seeks to address these problems through its multidisciplinary, competitive national research program.”

Grant recipients in this round of funding are:

Michael E. Charness
Boston VA Research Institute (Harvard)

Lori A. Knackstedt
University of Florida

Kenneth M. Lattall
Oregon Health and Science University

Eric P. Zorilla
The Scripps Research Institute

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‘Don’t drink’ coasters urge local pregnant women to avoid alcohol

San Diego bars, restaurants take part in Fetal Alcohol Spectrum Disorders Awareness Day.

Before taking a sip of alcohol at nearly a dozen local bars and restaurants, San Diegans will be reminded of the dangers of mixing alcohol and pregnancy thanks to a beverage coaster campaign led by the new Southern California chapter of the National Organization on Fetal Alcohol Syndrome (SoCal NOFAS), in partnership with the UC San Diego School of Medicine.

Members of SoCal NOFAS, a non-profit housed at UC San Diego, will hand out “Pregnant? Don’t Drink” coasters to ten participating bars and restaurants in the San Diego region today (Sept. 9) in honor of Fetal Alcohol Spectrum Disorders (FASD) Awareness Day.

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