Researchers from the Departments of Psychiatry (PTM, RAD, MNP) and Child Study Center (MNP) at Yale University’s School of Medicine examined data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to assess the prevalence of multiple psychiatric disorders—including alcohol abuse, nicotine dependence, mania, schizoid personality disorder, panic disorder—in both male and female children. Lead researcher Peter Morgan and his team studied 23,006 males and 17,368 females who grew up with and without an alcohol abusing mother or father, and measured the occurrence of disorders based on gender and maternal or paternal alcoholism.

As a result, researchers found a higher prevalence of psychiatric disorders in children of alcoholic parents than children without a history of familial alcohol abuse, regardless of their gender and the gender of the alcoholic parent. However, the gender of the alcohol abusing parent and their child created differing increases in the pervasiveness of specific disorders. For example, sons of alcoholic fathers were associated with an increased risk of mania, but sons of alcoholic mothers were at higher risk of panic disorder. Female offspring showed the greatest disparity among psychiatric risks. Daughters of alcoholic fathers were associated with an increased risk of alcohol abuse, but daughters of alcoholic mothers were associated with increased risk of nicotine dependence, alcohol abuse, mania, and schizoid personality disorder. Female children of alcohol abusing mothers were at the greatest risk of adulthood psychiatric illness than any other child-parent ratio.

Alcohol use disorders may directly affect the health, behavior, and productivity of the individual experiencing it, but ultimately alcoholism is a family disease. Not only does the alcoholic’s behavior affect their relationships with family members, causing various behavioral and developmental problems, but their dependencies have shown to cause specific effects on their offspring’s psychopathology that otherwise could have been prevented. During adolescence, children of alcoholic parents are susceptible to the negative effects of a parent’s drinking problem, and as adults these children face the greatest risk of essentially every type of chronic mental illness. Based on the finding from this new study, specialized intervention and prevention strategies can be implemented that target the psychiatric disorders that are specific to gender-related influences between parents and their offspring. The greater occurrence of multiple psychiatric disorders among daughters of alcoholic mothers, for example, can help families, medical professionals, and policymakers identify individuals that are at highest risk and encourage preventative strategies to aid these families.

The Yale’s research team’s study is available online and in the October 2010 print issue of Alcoholism: Clinical & Experimental Research.

Sources: Morgan, Peter T., Rani A. Desai, and Marc N. Potenza. October, 2010. Gender-Related Influences of Parental Alcoholism on the Prevalence of Psychiatric Illnesses: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions. Alcoholism: Clinical & Experimental Research. Published online July 20, 2010. DOI: 10.1111/j.1530-0277.2010.01263.x.

HealthDay News, Mom’s Alcoholism Especially Tough on Daughter’s Mental Health, July 20, 2010

The Russian government has declared an anti-alcohol campaign and aims to halve consumption by 2020 and root out illegal production and sales.

Under the bill, those found guilty of producing alcohol not registered with Russia’s Unified State Automated Information System (EGAIS), will face a fine of up to 200,000 rubles ($6,735) or a prison term of up to three years and a fine of up to 80,000 rubles ($2,700).

If the production was carried out by an organized group or in especially large quantities, it will entail a fine from 100,000 to 300,000 rubles ($3,370-$10,000). It can also be punished with a prison term from two to six years and a possible fine of up to a million rubles ($33,700).

Official statistics in Russia show more than 23,000 people die of alcohol poisoning annually. In an effort to fight counterfeit alcohol production, Russia introduced on January 1 a minimum price for vodka.

Alcohol consumption in Russia per capita is currently about 18 liters a year, twice the critical norm set by WHO.

Freeman, an assistant professor of pharmacology at Penn State College of Medicine, said the challenge in determining alcohol abuse versus substance abuse (such as cocaine, heroin, or PCP) is that alcohol is a legal substance for those over 21.

"Unlike routine testing for illicit drugs, you can’t just look for a trace of alcohol because many people enjoy a drink in a responsible manner, and alcohol is very quickly metabolized. Discriminating between excessive and responsible levels of drinking makes this a greater challenge," said Freeman, the lead investigator.

Penn State Hershey researchers have been working for two-and-a-half years with Kathleen A. Grant at the Oregon National Primate Research Center on the project and have identified a set of 17 proteins in the blood that accurately predict alcohol usage 90 percent of the time in the primates.

Freeman said the team is interested in learning how the brain works, especially when it comes to alcohol abuse and drug addiction.

"What is it that changes in the brain with substance abuse, addiction, that makes it so hard for people to stay sober or stay clean to achieve that goal," he said. Freeman said tests that are currently available, such as breathalyzers, are used for acute intoxication at the time a person is given the test. Because alcohol quickly metabolizes, the current tests are not sensitive or specific enough to serve as diagnostics, he said.

"It (the tests) won’t tell us what people did yesterday or over the past two weeks or the past three months," he said, adding that researchers have been able to measure a set of 17 proteins in monkeys’ blood for alcohol use and separate usage into three categories: no alcohol use, drinking up to two drinks per day, and drinking at least six drinks per day.
"What we want to be able to do is take someone who is in treatment and make sure they have not relapsed," he said.

Most of the proteins they looked at relate to liver, immune and nervous system functions in the body, he said. "Alcohol is this little tiny molecule, and it binds to all sorts of stuff throughout the body. It’s not like a lot of other drugs. Long periods of heavy drinking are known to have adverse impacts on the liver, the heart, on the nervous system and on immune function," he said.

Freeman said the team found that the levels of some proteins increased or decreased with as little as one or two drinks a day. "These same changes occurred with heavier levels of drinking. We also found other proteins that responded only to heavy levels of drinking. Combined, these proteins allow us to classify subjects into non-drinking, alcohol-using and alcohol-abusing groups," he said.

Freeman said the next step in the research is to do blood tests on humans. "We’re working with a few different centers around the U.S. that have inpatient treatment facilities for alcoholism," he said. "We’ll collect blood throughout their stay to see if the patients’ protein pattern reverts from an excessive drinking pattern to a pattern that’s indicative of alcohol abstinence."

The researchers also are trying to determine whether the changes measured return to normal levels with cessation of drinking, and looking for additional proteins to both increase accuracy and provide alternates if some of the initial 17 do not work in humans.

He said the goal is to create a diagnostic test for alcohol consumption that may be used in areas of public safety, such as aviation or national security, for parole conditions or for helping physicians determine if a patient may have an alcohol-abuse problem.

The findings have been published in Biological Psychiatry, the journal of the Society of Biological Psychiatry.

Others working on the project are Kent Vrana, chairman, Department of Pharmacology; Anna C. Salzberg, Penn State Hershey Cancer Institute; and Steven W. Gonzales, Biotic Micro Inc.

The research project is funded by the National Institutes of Health and the National Institute on Alcohol Abuse and Alcoholism.

"The challenge in alcohol abuse as opposed to substance abuse—things like cocaine or heroin or PCP—is that alcohol is a perfectly legal substance for those over 21," said Willard M. Freeman, Ph.D., department of pharmacology and lead investigator. "Unlike routine testing for illicit drugs, you can’t just look for a trace of alcohol because many people enjoy a drink in a responsible manner and alcohol is very quickly metabolized. Discriminating between excessive and responsible levels of drinking makes this a greater challenge."

Penn State Hershey researchers, working for two-and-a-half years in cooperation with Kathleen A. Grant, Ph.D., at the Oregon National Primate Research Center, identified a set of 17 proteins in the blood that accurately predicted alcohol usage 90 percent of the time in non-human primates. Researchers were able to separate usage into three categories—no alcohol use, drinking up to two drinks per day, and drinking at least six drinks per day. Protein levels rose and declined depending on alcohol consumption.

"We observed that the levels of some proteins increased or decreased with as little as one or two drinks a day," Freeman said. "These same changes occurred with heavier levels of drinking. We also found other proteins that responded only to heavy levels of drinking. Combined, these proteins allow us to classify subjects into non-drinking, alcohol-using, and alcohol-abusing groups."

The researchers are continuing their work, first by determining whether the changes measured return to normal levels with cessation of drinking. Second, they are looking for additional proteins to both increase accuracy and provide alternates if some of the initial 17 do not work in humans.

Working with groups around the world, Penn State Hershey researchers—led by Freeman and Kent Vrana, chair, department of pharmacology—plan to collect blood from people undergoing inpatient treatment for alcohol abuse.

"We’ll collect blood throughout their stay to see if the patients’ protein pattern reverts from an excessive drinking pattern to a pattern that’s indicative of alcohol abstinence," Freeman said.

The goal is to create a diagnostic test for alcohol consumption that may be used in areas of public safety like aviation or national security, for parole conditions and for helping physicians determine if a patient may have an alcohol abuse problem. Currently there are tests that try to address this issue, but Freeman said these tests are not sensitive and specific enough to serve as diagnostics.
"Many of these tests rely on just one protein," he said. "The limitation to this approach is that these tests often look at proteins produced by the liver. While these proteins increase with excessive alcohol intake, they also increase with any type of injury to the liver. For example, a lot of prescription drugs are hard on the liver. These tests let us know that the liver is being stressed but can’t discriminate between excessive drinking and other conditions, which therefore reduces the utility of these tests.

"That’s where we see the promise in this panel of proteins. The proteins are produced by a number of organs including the liver, the muscle, and the brain. This unique fingerprint that is indicative of alcohol abuse is less likely to be produced by unrelated conditions."
Freeman stresses, a diagnostic test would not be testing for alcoholism, but rather, alcohol intake.

"In a strictest use of the words, alcoholism is a psychological diagnosis as opposed to a level of drinking," he said. "The Diagnostic and Statistical Manual really classifies alcohol abuse and alcoholism based on how alcohol is interfering with your life. Obviously we can’t use a blood test to say yes, your drinking is interfering with your home life. But the amount of drinking and the amount of problems it causes in your life are tightly correlated.

"We envision, a number of years down the line if this becomes a diagnostic test, that if the test indicates that you’re drinking a lot, it would prompt a referral to a specialist in alcohol abuse and alcoholism. This test could provide an objective indicator to help people begin addressing what may really be a problem in their lives."

Also contributing to this research are Anna C. Salzberg, Penn State Hershey Cancer Institute and Steven W. Gonzales, Biotic Micro, Inc. The researchers’ findings are published online in Biological Psychiatry. The National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism supported this work.

The UK’s Times Online reports that 34 percent of 11-year-olds in Milan had problems with alcohol, according to Milan’s city council. Letizia Moratti, the mayor of Milan, said that the measure—the first of its kind in Italy—was in “response to an emergency.”

An Italian law already bans the sale of alcohol to those under 16 in bars but is rarely enforced. Many young people buy hard alcohol from supermarkets. The ban reflects a radical change in a culture in which children traditionally drink wine at mealtimes. In the past decade pubs have sprung up in Italian towns, often brining with them a previously unknown culture of heavy drinking.

The Health Ministry said that most Italians had their first encounter with alcohol at the age of 12, two or three years earlier than in most European countries. A sixth of hospital admissions for alcohol abuse involved youth under age 14. Pollsters recently discovered that six out of ten young people said they have set out to “drink themselves into a stupor.”

The new measure will have a trial period of 120 days. The fine, which increases to 500 Euros if not paid within five days, also applies to people who supply alcohol to children.

The Italian Prime Minister, Silvio Berlusconi, encouraged other cities to follow Milan’s “excellent example.” The Pope also urged young people to “overcome the temptation of an easy and illusory life.”
 

Similarly, many recent studies are suggesting that alcohol in moderation may promote heart health and even ward off diabetes and dementia. But according to an article in the New York Times, some scientists contend that no study has ever proven a casual relationship between moderate drinking and lower risk of death, but instead that the two go together. Instead, it may be that moderate drinking is something healthy people do—not something that makes people healthy.

Some researchers are worried that these alcohol-promoting studies may have been done in exchange for money from the alcoholic beverage industry to pay for research, train students, and promote findings. These questions were raised after financial relationships started springing up between the alcoholic beverage industry and many academic centers.

“The bottom line is there has not been a single study done on moderate alcohol consumption and mortality outcomes that is a ‘gold standard’ kind of study — the kind of randomized controlled clinical trial that we would be required to have in order to approve a new pharmaceutical agent in this country,” said Dr. Tim Naimi, an epidemiologist with the Centers for Disease Control and Prevention.

Avid supporters of moderate drinking still warn about the dangers of alcohol, which is linked to breast cancer and other types of cancer, liver disease, heart damage, and strokes when consumed in large amounts.

“It’s very difficult to form a single-bullet message because one size doesn’t fit all here, and the public health message has to be very conservative,” said Dr. Arthur L. Klatsky, a cardiologist in Oakland, CA, who wrote a study in the early 1970s finding that members of the Kaiser Permanente health care plan who drank in moderation were less likely to be hospitalized for heart attacks than those who abstained from alcohol.. He has received grants financed by an alcohol industry foundation, but has also published a study that found that alcohol increases the risk of hypertension.

“People who would not be able to stop at one to two drinks a day shouldn’t drink, and people with liver disease shouldn’t drink,” Dr. Klatsky said. However, “the man in his 50s or 60s who has a heart attack and decides to go clean and gives up his glass of wine at night — that person is better off being a moderate drinker.”

The association between moderate alcohol consumption and health benefits was first made in 1924, when a Johns Hopkins biologist published a graph that showed that moderate drinkers had the lowest death rates, particularly with respect to heart disease.

Alcohol is believed to reduce coronary disease because it has been found to increase the “good” cholesterol and have anticlotting effects. A small study in China found that cognitively impaired elderly patients who drank in moderation did not deteriorate as quickly as abstainers, and researchers have reported that moderate drinkers are less likely than abstainers to develop diabetes, and that people with Type 2 diabetes who drink moderately are less likely to develop heart disease.

But some scientists are asking who these abstainers are and why they avoid alcohol. Some suggest that abstainers might have stopped drinking because they already had heart disease. In addition, people tend to cut down on drinking as they age, making the average abstainer older and more susceptible to disease than the average moderate drinker.

In addition, two central question remain unanswered: are abstainers and moderate drinkers fundamentally different, and if so, is it these differences that make moderate drinkers live longer? Dr. Naimi of the CDC says the two groups are so different that they simply can’t be compared. Moderate drinkers are healthier, wealthier, and more educated, and they have better health care.

Some scientists say that large, long-term randomized controlled clinical trials should be conducted, like the ones performed for new drugs. One method might be to randomly assign a large group of abstainers to either to get a daily dose of alcohol or not, and then closely follow them for several years; another might be to recruit people who are at risk for coronary disease. But large randomized trials are expensive and they might lack credibility unless they are financed by the government, which could create controversy.

“The last thing we want to do as researchers and physicians is expose people to something that might harm them, and it’s that fear that has prevented us from doing a trial,” said Dr. Sei Lee of the University of California, San Francisco, who recently proposed a large trial on alcohol and health.

“But this is a really important question,” he added. “Because here we have a readily available and widely used substance that may actually have a significant health benefit — but we just don’t know enough to make recommendations.”
 

In addition to dopamine and serotonin, neurotransmitters that are important in brain functioning also include histamine, which is well known for regulating allergies and stomach functioning. The extensive histamine system in the brain is also important in regulating the sleep-waking system.

In the study, conducted by Professor Pertti Panula of the Substance Use and Addictions research program of the Academy of Finland, it was observed that the brain histamine content of rats that liked to drink alcohol was higher compared with other rats. The alcohol consumption of the rats was reduced by giving them a drug that blocks the histamine-3 receptor that was discovered in the study. These findings show that the histamine system in the brain is part of the mechanism that regulates alcohol consumption.

Researchers also tested mice that lacked histamine and the histamine-3 receptor, and found that they did not become livelier after consuming alcohol, as did the histamine-containing mice. On the other hand, the rewarding pleasure effect of alcohol was stronger in the histamine-lacking mice compared with normal mice.

The study also found that transmitter histamine also contributes to the transmitting of the stimulating, pleasurable effect of alcohol in the brain. This was determined when the effects of alcohol that cause liveliness and pleasure changed noticeably when a histamine-3 receptor was blocked. This could help scientists develop a drug for alcohol addicts that would help reduce the pleasure received from alcohol.

“Whether these histamine-3 receptor drugs help in the treatment of human alcoholism will probably be clear when the results of the currently ongoing clinical trials become public. The drugs are currently being tested for the treatment of conditions such as observation disorders, sleep disorders and narcolepsy,” said Panula.
 

Although fewer women drink heavily than men, women have as many or more problems associated with their drinking. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholic women have death rates 50 percent to 100 percent higher than men, including deaths from liver disease, cancer, heart disease, alcohol-related accidents, brain diseases, and suicide. Heavy drinking also raises a woman’s risk for being a victim of sexual assault and other acts of violence, and teenage girls who drink have a higher risk of unprotected sex and unplanned pregnancy.

Drinking is more likely to damage a woman’s health than a man’s, even if she has been drinking less alcohol for a shorter time. In addition, drinking while pregnant can result in fetal alcohol syndrome, a birth defect that can cause problems with learning, memory, attention, and problem-solving.

Women who have two or more drinks per day also raise their risk for breast cancer, especially if breast cancer runs in the family. Recent data from a study of one million middle-aged women in the United Kingdom showed that moderate drinking increased the risk for many types of cancer. Fifteen out of 1,000 women were diagnosed with cancer in the moderate drinking group, and eleven of the fifteen had breast cancer.

According to the NIAAA, moderate alcohol use is one drink per day for women and two for men. Women who have more than seven drinks per week or more than four on any given day are more likely to develop alcohol dependency. One drink is equal to a 5-ounce glass of wine, 12 ounces of beer, or 1.5 ounces of hard liquor.
 

Alcohol has been shown to cause chronic pancreatitis, which can lead to pancreatic cancer, but previous studies had been unable to confirm the association between drinking and pancreatic cancer. However, a recent study published in the journal Cancer Epidemiology, Biomarkers, and Prevention suggests that men and women who consume more than two alcoholic beverages a day could increase their risk of developing the cancer.

Unlike previous studies, the current research pools data collected from 14 research studies, which included 862,664 people. The data was collected prospectively, which means that information about dietary and environmental exposures was collected prior to the pancreatic cancer diagnosis. Of the 862,664, 2,187 were diagnosed with pancreatic cancer during the study.

If an individual consumed approximately two drinks per day (compared with no alcohol per day), their risk of pancreatic cancer was slightly increased. Researchers defined one drink as 12 ounces of beer, 4 ounces of wine, or 1.5 ounces of 80-proof distilled liquor.

Although there was no significant difference between men and women when comparing alcohol intake with the risk of cancer, the association was seen in women at two or more drinks per day. The researchers also observed a higher risk among men who consumed three or more drinks a day.

In addition to chronic pancreatitis and diabetes, smoking is still considered the strongest risk factor for pancreatic cancer. In 2008, there were about 18,910 new cases of pancreatic cancer reported and 34,290 deaths from pancreatic cancer.

"Despite being a deadly disease, there are few known risk factors for developing pancreatic cancer," explains lead author Jeanine M. Genkinger, PhD, an assistant professor at Georgetown University’s Lombardi Comprehensive Cancer Center. She continues, "At this point, it’s important to understand any protective or risk factors for this dangerous disease even if the risks are weak or modest."

Researchers at the University of Sussex have found that alcohol influences the brain’s ability to form memories, making memories before a drink stronger and memories of things that happen while under the influence weaker. Professor Theodora Duka of the department of experimental psychology at Sussex said that while it’s not entirely clear how alcohol changes the way memories are made, it could be altering the neurotransmitters that form memories.

In Professor Duka’s study, she asked volunteers to recall a series of images when they had been given either an alcoholic drink or a non-alcoholic drink. The findings showed that alcohol increased the memory for images seen before taking the drink and impaired memory for the images seen after taking the drink. The volunteers were also more likely to remember the images they saw before taking a drink if the images triggered strong emotions such as joy, but were less likely to remember emotional images viewed after drinking.

“This bias towards positive memories means that people are more likely to drink heavily the next time they go out because they only remember the good memories about the last time,” Duka said.