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Yale University researchers say that alcoholics who display abnormal activity in the prefrontal cortex during an MRI brain scan are as much as 8 times more likely to relapse.

Recovering alcoholic? Worried about relapse?

Well, you might find this interesting then - researchers at Yale University say that after scanning your brain in an MRI machine they can predict your odds of relapse.

Apparently, people who show excessive brain activity in parts of the prefrontal cortex during a relaxation exercise are as much as 8 times more likely to relapse within 3 months as people with more normal activation in that area.

The Study

• The Yale team recruited 45 alcoholics about to start a residential treatment program and 30 non-alcoholic control subjects.
• Each subject was given an MRI scan, and during the scan each was asked to imagine recent very stressful situations, as well as to imagine themselves in a very serene and relaxing situation, such as on a tropical beach.
• The researchers then followed the study subjects for three months after the successful completion of treatment.

The Results

• Subjects who displayed high activity in certain areas of the prefrontal cortex experienced more alcohol cravings after the completion of treatment than subjects with more normal relaxation responses and this translated into an 8.5 fold greater likelihood of relapse and an 8.7  fold greater likelihood of a return to heavy drinking.

Commentary

Chronic alcohol abuse can damage the prefrontal cortex, and since this area of the brain manages decision making, emotional regulation and impulse control, it is unsurprising that abnormal prefrontal cortex functioning increases a person’s risk of relapse.

Lead researcher Rajita Sinha, Ph.D commented on the significance of the study findings, saying, "The patterns of brain activity we observed may one day serve as a neural marker that could help clinicians identify alcohol-dependent patients in recovery who are most at risk of relapse. Our findings may also have implications for the use of medications and behavioral treatments that restore prefrontal function, as they could potentially benefit people at high risk of relapse."

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A Canadian study shows that raising the costs of the cheapest alcohol by 10% cuts alcohol related deaths by as much as a third.

So what if that beer costs a few cents more…could a small price increase really affect people’s drinking habits?

Well, according to researchers at The University of Victoria’s Centre for Addictions Research, between 2002 and 2009 in British Columbia, Canada, a 10% increase in average minimum alcohol pricing resulted in a 32% drop in alcohol related deaths.

To come to this conclusion, the researchers sifted through provincial death medical records over the 7 year study period to identify people who died wholly or partly because of alcohol consumption, and they grouped these people into one of three categories:

1. Completely Alcohol Caused Deaths – people who died from alcohol poisoning, fetal alcohol syndrome, alcoholic gastritis, alcohol psychosis, alcoholic pancreatitis and alcoholic cardiomyopathy
2. Acute Alcohol Attributable Deaths – Alcohol related suicides and accidental injuries leading to death
3. Chronic Alcohol Attributable Death – Deaths caused by chronic alcohol related diseases, such as cirrhosis of the liver and stomach, mouth, esophagus and breast cancers

Key Study Findings

Raising the average minimum price by 10%:

• Caused a 32% reduction in completely alcohol caused deaths
• Caused a substantial decrease in chronic alcohol deaths, though the death rate here didn’t start to go down until a couple of years following the introduction of raised minimum pricing

Commentary

A common argument raised against upping average minimum alcohol pricing is that it punishes healthy consumers while failing to dissuade problem drinkers.

The researchers argue, however, that by raising the costs of the cheapest alcoholic drinks you decrease consumption most among the heaviest drinkers, who tend to buy these better ‘value’ alcoholic drinks. 

Commenting on the findings, lead researcher Dr. Tim Stockwell notes, "This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia."

Read the full study results in the journal, Addiction.

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A new study shows that Nalmefene helps alcoholics who can’t quit, or aren’t ready to quit, to reduce their consumption.

Alcoholics who just can’t or won’t stop drinking entirely might find the drug Nalemfene helpful.

Nalemfene is an opiate antagonist that works similarly to Naltrexone. If you take Nalemfene, and then go drinking, you don’t get that same pleasurable buzz and you don’t have much of an incentive to continue with it. This way, in theory, it helps people cut down.

But how well does it work? To find out, researchers at the Central Institute of Mental Health in Germany recruited 604 alcoholics for a 24 week experiment on the medication’s usefulness.

The Study

• The study subjects (alcoholics) were divided into 2 groups. Half received Nalemfene and half received a visually identical placebo medication.
• The subjects were instructed to take a pill (either Nalemfene or a placebo) on any day they felt like they might be at risk of drinking, on an as needed basis.
• Results were measured by self reports of alcohol consumption and liver enzyme testing.

The Results

• Subjects taking Nalemfene reduced their alcohol consumption significantly more than subjects taking a placebo.
• Subjects taking Nalemfene showed greater improvements in liver functioning (as measured by liver enzymes)
• Subjects reported few or no mild side effects.

Commentary

The study authors wrote, “Our new findings may mark a true paradigm shift in the treatment of men and women who suffer from alcohol related disorders. While abstinence should be the best bet, a reduction in consumption may be a valuable alternative for the many patients who cannot attain abstinence or are not (yet) capable of doing so.”

Read the full study findings in Biological Psychology

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Heavy drinkers given Nalmefene to take as needed reduced the amount they consumed by 66%.

Need some medicine to help you drink less? Well, through Nalmefene isn’t yet approved for use, based on the results of phase 3 clinical trials, it might be exactly what you’re looking for.

Nalmefene is an experimental drug which can be taken as needed and which takes the fun out of drinking - and in doing so, it helps heavy drinkers consume less alcohol.  

The Study

According to research presented at the 2012 European Conference of Psychiatry, 600 people who were given access to Nalmefene to be used as needed for 6 months (as well as motivational counseling and support) were able to reduce their drinking by 66% by the 6^th month of the study.

The researchers say that not everyone wants or is able to maintain abstinence but there are still significant harm reduction benefits associated with a substantial reduction in the amount of alcohol consumed by someone with an alcohol dependence problem.

Commenting on the findings, study researcher Dr. David Collier said that the medication could fill a treatment need to help people who are suffering from their alcohol use but who can’t achieve or sustain abstinence, saying, “The people volunteering for these trials had real problems with alcohol dependence, most had never sought help before, and others had tried and failed with abstinence strategies - stopping drinking for good. Abstinence is the right option for many people, but not everyone wants to do that, and in those that do try, it helps only about half of them.”

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Though alcohol helps you to fall asleep, it disrupts total REM sleep and causes sleep disruptions in the second half of the night. In summary – it does more harm than good.

A lot of people use a drink or two (or more) as a way to ease into sleep. But though alcohol helps you to fall asleep more quickly, it probably makes you more tired the next day.

Researchers at The London Sleep Center have consolidated the findings of more than 20 studies to come up with an overview report on what we know so far about alcohol’s impact on sleep quality.

All studies accepted into the review were methodologically sound and were performed on healthy individuals (people without mental or physical health concerns that might compromise sleep quality).

Here’s what they found out:

Findings - How Alcohol Affects Sleep Quality

At all dosages, Alcohol:

1. Decreases the amount of time it takes to fall asleep
2. Causes deeper sleep in the first half of the night
3. Causes more disrupted sleep in the second half of the night

and:

• Alcohol increases the amount of slow wave sleep we get during the first half of the night. During slow wave sleep the body repairs tissue, strengthens the immune system and builds bone and muscle.
• Because alcohol causes deeper sleep in the first part of the night it can increase problems with sleep apnea and sleepwalking, among people susceptible to these problems
• At low doses, alcohol causes little disruption to REM sleep. At high doses, alcohol causes a reduction in the amount of REM sleep you get in the first and second half of a night’s sleep. At moderate doses, you get disrupted REM sleep in the second half of the night only. (So both moderate and high doses cause a reduction in total REM sleep)
• Insufficient REM sleep leads to a non-restful night’s rest. Other consequences of insufficient REM sleep include memory and motor problems and impaired concentration abilities

In Summary

Lead researcher Irshaad Ebrahim notes that although many people believe that alcohol helps with sleep, that, “alcohol on the whole is not useful for improving a whole night's sleep. Sleep may be deeper to start with, but then becomes disrupted. Additionally, that deeper sleep will probably promote snoring and poorer breathing. So, one shouldn't expect better sleep with alcohol."

The full results will be available in the study April 2013 edition of Alcoholism: Clinical & Experimental Research

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Reversing alcohol induced liver damage: Researchers gain a better understanding of how the metabolism of alcohol damages the liver, at the cellular level, and say their study findings may help doctors narrow their therapeutic focus.

Everyone knows that alcohol damages the liver…

But no one knows, at the cellular level, exactly how it wreaks this damage.

Fortunately, scientists at the Keck School of Medicine at USC say they’re one step closer to understanding this process and they hope their study findings may lead to more effective treatments to reverse alcohol induced liver damage.

Study: The Role of the Mitochondria

Mitochondria provide the energy necessary for liver cells to metabolize alcohol. Alcohol stresses the liver. Does chronic alcohol use change the functioning of the mitochondria in liver cells?

• Mitochondria generate energy for cellular processes and as they do this they metabolize oxygen.
• As they metabolize oxygen they create reactive oxygen (free radicals) that can do cellular damage.

In a clinical study, USC researchers fed mice alcohol for four weeks. As they did this they observed liver mitochondria to see what effect the alcohol would have on the metabolism of oxygen.

The Results

• Chronic alcohol use caused an increase in the number of liver cell mitochondria and an increase in mitochondrial oxygen consumption.
• Mice fed more alcohol showed greater increases

Commentary

Lead researcher Derick Han, Ph.D explained that mitochondrial plasticity helps the liver deal with a sudden stress load – such as a sudden increase in alcohol use.

With long term chronic alcohol abuse, however, the liver’s ability to increase mitochondrial numbers may lead to a considerable increase in free radical release and to cellular damage and liver diseases.

Read the full study findings in the Dec 7th edition of the Journal of Biological Chemistry.

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Your brain heals quickly once you stop drinking and after a couple of weeks people start to see big improvements. Researchers say alcohol treatment needs to be at least this long to take advantage of this return of function.

How does the brain heal from alcohol damage and what are the implications of brain healing for alcohol addiction treatment?

• Chronic alcohol abuse causes brain shrinkage and consequences like memory loss, increased impulsivity, motor coordination deficits and problems with attention and concentration.
• Irreversible brain-cell death causes some of the reduction, but some volume loss happens as a result of cell shrinkage - which is reversible with alcohol abstinence - and as brain volume increases with abstinence there is a concordant improvement in some brain functions.

 Researchers at Stanford University wanted to know how long it takes for different brain functions to improve and whether varying rates of function return have any implications for things like minimum length of addiction treatment.

The Study

To find out they did brain scans 49 on alcohol dependent study subjects who were going through an inpatient addiction treatment program. Each subject was scanned within 24 hours of detoxification and again after 2 weeks of abstinence.

For comparison, 42 non alcoholic age and gender matched control subjects were also scanned over the same time periods.

The Results

• 2 weeks of alcohol abstinence resulted in a substantial improvement in brain volume
• The cerebellum, which is responsible for coordinating motor movements, showed an almost complete recovery after 2 weeks of abstinence. This likely explains how alcoholics can make such rapid improvements in movement and coordination with prolonged abstinence.
• Areas of the brain responsible for higher cognitive functions, like attention and memory, are slower to recover than areas responsible for motor movements

Implications

The study authors say that while many people pass through 3 day detoxification programs, 3 days does not give the brain enough time to recover and after 3 days people may not have the cognitive abilities necessary to maintain abstinence. They write, "Based on the current study and others, suggesting that a minimum set of cognitive abilities is necessary to conquer alcohol addiction, clinicians should consider recovery programs that provide support for the recovering addict for a minimum of two weeks.”

The full study results are published in Alcoholism: Clinical and Experimental Research, Early View

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AA study - Researchers say that while attending meetings improves your recovery odds, it’s helping others in the program that really makes the difference.

A lot of research shows that staying actively involved with AA increases your odds of maintaining sobriety, but going beyond that, is there any one aspect of the program that seems to help people the most?

That’s what Dr. Maria Pagano of Case Western Reserve University School of Medicine wanted to know, and to find out, she studied data from Project MATCH, which was a 10 year long NIAAA sponsored study of alcoholism treatment outcomes across multiple sites.

She found that while simply showing up for AA meetings helped, people that got involved in helping others reaped the greatest benefits from their participation.

Helping Others Helps a Lot – The Results

• People who got involved in AA helping activities, such as sponsoring and/or sharing experiences with others and 2 month service positions were less likely to be drinking and more likely to be interested in others at each follow up period over the 10 year study duration.
• In addition to having more sober time, people involved in helping others within AA also attended more meetings, did more step work and felt a stronger connection to the program.

Commentary

Speculating on why helping others has such a beneficial effect, Dr. Pagano wrote, “Being interested in others keeps you more connected to your program and pulls you out of the vicious cycle of extreme self-preoccupation that is a posited root of addiction.”

The full research results of the study, Helping Others are published in the Journal Substance Abuse.

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People trying to reduce their alcohol consumption may want to pay attention to their glassware. Researchers at the University of Bristol say that people drinking alcohol out of curved glasses drink about twice as fast as people drinking alcohol out of straight-sided glassware.

Slowing your drinking rate decreases the amount you’ll likely consume in a single session, reduces the odds of drunkenness and reduces the chances of alcohol abuse problems.

It’s all good stuff, but for a lot of us, it’s easier said than done!

Fortunately, researchers in the UK may have stumbled upon a solution – drink out of the right types of glass and you’ll naturally drink much slower.

The Experiment

To see what influence glassware might exert over rate of consumption, the researchers had 160 social drinkers between the ages of 18 and 40 come in for 2 sessions to drink alcoholic and non alcoholic drinks in different types of glassware.  

• In one session the subjects drank our of straight sided glasses
• In the next session, they drank out of curved sided glassware

The Results

• People consume alcoholic drinks out of curved-sided glassware almost twice as quickly as they do out of straight-sided glasses
• When shown pictures of straight-sided and curved-sided glasses holding varying quantities of liquid, the subjects were far less able to accurately determine when curved-sided  glasses were half-full, although they had little difficulty on this task with straight-sided glasses.

Commentary

The researchers suggest that people’s inability to accurately gauge how much they’re drinking when using curved-sided glasses may account for the increase in drinking rate seen with this type of glassware.

Commenting on the take-home message of the results, lead study author Dr Angela Attwood said, “People often talk of 'pacing themselves' when drinking alcohol as a means of controlling levels of drunkenness, and I think the important point to take from our research is that the ability to pace effectively may be compromised when drinking from certain types of glasses."

The full study findings are published in the journal, PLoS One

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Researchers at the University of Pittsburgh Medical Center say having gastric bypass surgery raises a person’s risk of developing an alcohol abuse problem by 50%.

The Study

The research team followed 2000 patients scheduled for obesity surgery at 30 days pre-op and at one and two years post surgery, and asked patients to fill out questionnaires on alcohol habits at each interval.

The Results

• Roughly 25% of the patients had laparoscopic adjustable gastric banding surgery. Alcohol abuse rates among this population remained steady at about 5% pre and post surgery (this is lower than the roughly 8% abuse rate among the general population).
• 70% had gastric bypass surgery. Abuse rates among this population rose from 7% pre surgery to almost 11% two years post surgery – a more than 50% jump.

The Explanation

So why does gastric bypass cause such a significant increase in alcohol abuse problems?

Lead researcher Professor Mary King says it has to do with the way post surgery alcohol gets absorbed into the bloodstream, explaining, “if you give gastric bypass patients a standard amount of alcohol, they reach a higher peak alcohol level, they reach the level more quickly, and they take longer to return to a sober state – they’re experiencing alcohol differently after surgery.”

Knowing this, she said, they weren’t really surprised when they observed such a large post gastric bypass surgery increase in alcohol abuse problems among the study participants.

King says say that while gastric bypass is still going to be a valid option for a lot of people, that doctors need to do a better job educating people about some of the peripheral risks, such as the risk of increased drinking post surgery, saying “This is really something that needs to be a part of patients’ discussions with their surgeons…Patients need to hear information when it’s applicable to them.  They need to be reminded at annual follow-up screenings as a part of clinical care, so referrals to counseling can be given, if needed.”

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Harvard University Medical School researchers say that an extract taken from the kudzu root may help alcohol abusers drink less.

The researchers looked at the isoflavone puerarin, which is extracted from kudzu root. Puerarin was selected for study based on previous research which indicated its possible utility in the treatment of alcohol addiction and due its long track record of safe use in China, where it is approved for intravenous use in the treatment of angina, myocardial infarction and coronary heart disease.

The Harvard team wanted to know how taking an extract of puerarin would affect binge drinking patterns, and to find out, they developed a study modeled around afternoon binge drinking sessions.

The Study

A group of regular heavy drinking men and women in their 20s were invited to participate in a study on binge drinking.

The research team set up an apartment with a TV and DVD player and a refrigerator stocked with favorite beers.

• During the first week of the study each subject spent 90 minutes alone in the apartment, drinking as many beers as they wanted to.
• After the first session, subjects were given either puerarin to take daily or a placebo. Each subject then returned at weeks 2 and 3 of the experiment to repeat their afternoon binge drinking in the research apartment.
• For the last week of the study, subjects who had been taking a placebo were given puerarin and puerarin subjects switched to taking a placebo, and at the end of the week each subject revisited the apartment for a last session of afternoon drinking.

The Results

• Subjects using puerarin drank significantly less than subjects on the placebo pills . In an average session, subjects on puerarin drank 2.4 beers compared to the 3.5 beers consumed by those taking the placebo pills.
• Subjects on puerarin took more sips to finish a beer and drank a beer over a longer period of time.

Commentary

Commenting on the significance of the study results, Lead study author David Penetar, PhD, said, "Our study is further evidence that components found in kudzu root can reduce alcohol consumption and do so without adverse side effects. Further research is needed, but this botanical medication may lead to additional methods to treat alcohol abuse and dependence."

The full study results have been published in the current edition of Drug and Alcohol Dependence

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In a recent study, the common anti smoking drug varenicline (Chantix) helped heavy drinkers reduce consumption by 36%.

Researchers at the Ernest Gallo Clinic and Research Center at the University of California say that the commonly used smoking cessation medication varenicline, sold under the brand name Chantix, may also work to help heavy drinkers cut down on their consumption.

The Study

Heavy smoking study subjects were assigned to one of 2 groups:

1. A group that was given varenicline
2. A group that was given a placebo medication

Study participants were looking to quit smoking but were not seeking to reduce their alcohol consumption.

The Results

At the end of the study, the researchers looked at how well varenicline helped people beat tobacco addiction and at how the medication affected drinking habits.

They found that:

• Study participants using varenicline reduced the number of alcoholic drinks they consumed per week by an average of 36%
• People on varenicline did not reduce the frequency of their drinking sessions but drank fewer drinks per session

Commentary

The researchers say that the medication might work to help drinkers cut down as it helps smokers quit because alcohol and nicotine stimulate similar reward pathways in the brain. Varenicline blocks some of this reward pathway activation.

Commenting on the implications of the research, study leader Jennifer Mitchell, PhD argued that a medication that helped people reduce their overall consumption could have enormous health and social benefits, saying, “If you currently drink seven drinks a night, and we can turn that into two or three, then you're not only drinking at a level that's going to harm you less, you're less likely to harm others, as well. If we could lower the rates of drunk driving, spousal and child abuse and other secondary effects of alcoholism, that would be tremendous."   

The full research results can be found in the journal, Psychopharmacology.

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It won’t work once you’re dependent, but a new study says that for heavy and binge drinkers who haven’t yet crossed that line, recording the amount consumed each day is an effective way to cut down.

Sometimes, a bit of well timed advice from a trusted health authority is all that's needed to help a person make a change in their drinking habits.

Doctors who council possibly at risk patients on healthier drinking perform a service called the brief intervention, and studies show that brief interventions at the general practitioner level are one of the most effective and cost effective ways to reduce harmful drinking at the societal level.

But after broaching the subject of harmful drinking, what’s the best advice for a general practitioner (GP) to give?

That’s what researchers at University College London wanted to know and to find out they looked back at clinical trials on brief interventions and compared different types of advice given to see which resulted in the greatest reduction in drinking by patients.

Some advice commonly given by GPs in brief interventions included:

• Advising people on how to improve self confidence without needing to use alcohol
• Advice on maintaining motivation to drink less
• Advice on avoiding triggers to excessive drinking
• Advice on monitoring daily consumption – patients were advised to write down how much they drank on a daily basis

The Results

The researchers found that people counseled to maintain a daily written record of their consumption made the largest reductions in harmful drinking.

Lead study author Susan Michie commented on the significance of the findings, saying, "In brief interventions, it's important to advise people how to reduce their drinking rather than just saying they ought to drink less. Getting patients to record how much alcohol they drink each day provides a concrete, easy task that raises their awareness of their behaviour and how well they are doing in staying within limits that they set themselves.”

The full results can be found in the journal, Addiction.

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Researchers at Yale University School of Medicine say that compared to moderate drinkers, heavier drinkers show less activation in areas of the brain which modulate risk management.

In an experiment that further erodes simplistic or moralistic explanations for the development of alcoholism, Yale University researchers say that heavier drinking young people have less neural activity in areas of the brain which control risk taking. This lessened risk aversion contributes to heavier drinking in young adulthood and increases a person’s risk to develop an alcohol abuse problem later in life.

The Experiment

There are many psychological and behavioral processes which combine to increase a person’s risk for alcohol abuse and dependence; two of which are a willingness to engage in risky behaviors and heavier drinking, particularly during adolescence and young adulthood.

To see whether these processes might intersect, the researchers recruited a sample of college aged students and divided this sample into 2 cohorts:

1. Those who engaged in heavier drinking as measured by total number of drinks consumed per month
2. Those who drank at low risk levels

All subjects were then observed through MRI scans as they performed a risk taking test (simulated speeding) and a risk aversion test (simulated slowing).

The Results

• Compared to the low-risk drinkers, heavier drinkers showed less activation in the caudate nucleus and frontal cortex during the risk taking task. These areas of the brain are associated with the modulation of risk taking activities.
• Although young men are more likely to engage in problem drinking, the differences in risk taking neural activity were seen most strongly among heavier drinking women and the women who had least neural response to risk were the likeliest to drink frequently.

The full research results will be published in the May 2012 edition of Alcoholism: Clinical and Experimental Research.

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Want to understand why you have such a hard time staying sober? Researchers at Harvard Medical School say they have the answer based on the results of a recent brain imaging experiment – The very areas of the brain you need most to maintain abstinence are the areas most damaged by excessive alcohol use!

Why do some people struggle to control their drinking while others manage effortless moderation?

In an attempt to answer this question, researchers at Harvard Medical School rolled out their high resolution brain imaging equipment and took a good look inside the brains of a group of alcohol abusers and a group of non alcohol abusing control subjects.

What Did They Find?

After comparing the high resolution brain images of 31 people with a history of alcohol abuse problems and 34 people without such a history, the scientists say that alcohol abuse leads to brain atrophy in certain areas of the brain and that the areas of the brain most damaged by heavy alcohol consumption are the areas most necessary for controlling behavior (such as controlling drinking!)

• Heavy drinking led to atrophy in the frontal and temporal lobes of the cerebral cortex
  
• Study subjects with greater alcohol use histories showed greater levels of brain damage
  
• Fortunately, prolonged alcohol abstinence leads to some neural recovery

Brain atrophy in the frontal and temporal regions of the cortex can cause memory problems and language problems, reduced self control and a reduced ability to plan and reason. Such deficits, obviously, make maintaining sobriety all that much more difficult.

Commenting on the significance of the research, Terence M. Keane, Assistant Dean of Research at  Boston University School of Medicine, wrote, "This study documents, for the first time, the dynamic nature of the neuropathology associated with chronic heavy alcohol use. The results may explain why alcoholism may be so difficult to treat: alcohol damages the very neural systems that are critical to achieving and maintaining abstinence."

The full study results can be read in the December 2011 edition of Alcoholism: Experimental and Clinical Research