In the UK, it has been proposed that alongside the current advice to abstain from alcohol completely in pregnancy, there should be increased screening of pregnant women for alcohol consumption in order to prevent instances of fetal alcohol spectrum disorder. The Scottish Intercollegiate Guidelines Network published guidelines in 2019 recommending that standardised screening questionnaires and associated use of biomarkers should be considered to identify alcohol exposure in pregnancy. This was followed in 2020 by the National (...) Institute for Health and Care Excellence Draft Quality Standard, which recommended that pregnant women should have information on their alcohol consumption recorded throughout their pregnancy and this information transferred to the child’s health records. Most recently, Public Health England has stated that the alcohol intake of all women should be recorded throughout pregnancy, not just at the initial booking appointment and that tools such as blood biomarkers and meconium testing should be researched in order to determine true prevalence rates of alcohol in pregnancy. We argue that this proposed enhanced screening undermines women’s autonomy and their legal right to be sufficiently informed to consent to screening. We argue that there is no evidence that this kind of screening will result in a reduction of fetal harm and there is a danger that undermining the autonomy of women and the trust relationship between women and healthcare professionals may even increase harm to future children. (shrink)

This paper takes a phenomenological hermeneutic orientation to explicate and explore the notion of the grey zone of health and illness and seeks to develop the concept through an examination of the case of alcohol consumption. The grey zone is an interpretive area referring to the irremediable zone of ambiguity that haunts even the most apparently resolute discourse. This idea points to an ontological indeterminacy, in the face of which decisions have to be made with regard to the (...) health of a person (e.g., an alcoholic), a system (e.g., the health system), or a society. The fundamental character of this notion will be developed in relation to the discourse on health and the limitations of different disciplinary practices. The case of alcohol consumption will be used to tease out the grey zone embedded in the different kinds of knowledge made available through the disciplinary traditions of medical science, with its emphasis on somatic well-being, and anthropology, with its focus on communal well-being. This tension or grey zone embedded in different knowledge outcomes will be shown to have a discursive parallel with the dialogue between the Athenian, the Spartan, and the Cretan in Plato’s Laws. Making use of the dialogical approach as described by Gadamer, the Athenian’s particular resolution of the tension will be explored as a case study to demonstrate the necessarily particular analysis involved in a grey zone resolution. (shrink)

BackgroundYouth substance use is a public health problem globally, where alcohol is one of the drugs most consumed by children, and youth prevention is the best intervention for drug abuse.ObjectiveReview the latest evidence of alcohol use prevention programs in empirical research, oriented to all fields of action among children and youth.MethodsA narrative and critical review was carried out within international databases in August 2021 and was limited to empirical studies that appeared in the last five years. A flow (...) diagram was used according to the PRISMA statements. Empirical research articles in English with RCTs and quasi-experimental design that included alcohol, children, and young people up to 19 years of age were included. The authors examined the results and conceptual frameworks of the Prevention programs by fields of action.ResultsTwenty-two articles were found from four fields of action: school, family, community, and web-based, representing 16 alcohol prevention programs. School-based alcohol prevention programs are clinically relevant [Theory of Planned Behavior, Refuse, Remove, Reasons, Preventure, The GOOD Life, Mantente REAL, Motivational Interviewing, Primavera, Fresh Start, Bridges/Puentes], they are effective in increasing attitudes and intentions toward alcohol prevention behavior, while decreasing social norms and acceptance of alcohol, reducing intoxication, and increasing perceptions with regards to the negative consequences of drinking.DiscussionThis narrative and critical review provides an updated synthesis of the evidence for prevention programs in the school, family, community, and web-based fields of action, where a more significant number of programs exist that are applied within schools and for which would have greater clinical relevance. However, the prevention programs utilized in the other fields of action require further investigation. (shrink)

BackgroundAlcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied.ObjectiveThe aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador.MethodsA total of 7,905 college students (...) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire. Macro Process for SPSS was used to analyze mediation and moderation effects.ResultsReported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women.DiscussionResults of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective. (shrink)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility (...) in distributive justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

BackgroundThere has been media coverage surrounding the dangers of heavy drinking and benefits of moderation, with TV and radio presenter, Adrian Chiles, documenting his experience of moderating alcohol consumption in an online article for the Guardian. By analysing the comments in response to Chiles’ article, this study aimed to explore posters’ attitudes or beliefs toward moderating alcohol and posters’ experiences of moderating or abstaining from alcohol.MethodA secondary qualitative analysis of online comments in response to an article (...) about moderating alcohol consumption. Main outcome measures: Comments in response to a United Kingdom online news article about moderating alcohol consumption were extracted and inductive thematic analysis was used.ResultsFor aim one, two themes were developed; “general attitudes toward drinking” and “general attitudes toward reducing consumption”. These themes reflect negative perceptions of alcohol and issues around changing attitudes. For aim two, three themes were developed: “moderation vs. abstention”, “reflection on past drinking behaviours”, and “current drinking behaviours”. These themes represent posters’ experiences and implications changing their drinking habits.ConclusionOur analysis provides a novel insight into perceptions and experiences of moderating or abstaining from alcohol. Alcohol is embedded within United Kingdom culture, creating difficulties for those who choose to moderate or abstain from alcohol. Our analysis highlights the need for public health to focus on shifting the current drinking culture, through clearer drinking guidelines and a wider availability of alcohol-free alternatives. (shrink)

The vast majority of studies focusing on alcohol consumption among university students are based on US and Canadian samples and employ a quantitative approach. Universities from the US and Canada also have a longer tradition in implementing alcohol policies. The alcohol policies at universities in Slovakia are mostly non-systematic and often not implemented in practice. The objective of this study was to explore Slovak university students’ experiences towards alcohol policy on their campuses using a qualitative (...) approach. Eight focus group discussions were conducted among university students (n=64; 38 female; 2011; Slovakia). The key questions were (1) “Is there a policy concerning alcohol on your campus and what are the consequences of not complying with it?”, and (2) “How should an on-campus alcohol policy be developed and what should it include?” The students knew of few, if any, rules concerning alcohol. Student participation was considered important in policy development and implementation. Slovak universities should be more active in forming alcohol policies. A preventative policy which actively involves students was emphasized as optimal. (shrink)

Several years ago, Cohen, Dearnaley, and Hansel [1] demonstrated that under the influence of alcohol drivers became more risk prone, although their risk perception remained unchanged. Research shows that ambiguity aversion is to some extent positively correlated with risk aversion, though not very highly [2]. The question addressed by the present research is whether alcohol reduces ambiguity aversion. Our research was conducted in a natural setting (a restaurant bar), where customers with differing levels of alcohol intoxication were (...) offered a choice between a risky and an ambiguous lottery. We found that alcohol reduced ambiguity aversion and that the effect occurred in men but not women. We interpret these findings in terms of the risk-as-value hypothesis, according to which, people in Western culture tend to value risk, and suggest that alcohol consumption triggers adherence to socially and culturally valued patterns of conduct different for men and women. (shrink)

Alcohol is a class 1 carcinogen, and its use, at any level, is not safe for health. Despite this, alcohol remains strongly mixed into medical culture and is often served free at medical‐community events. This presents numerous ethical concerns. First, the funding of alcohol‐centered events by the medical community reinforces alcohol consumption as a coping mechanism for stress, perpetuates the perceived need for alcohol for socialization, and falsely implies that it is a safe substance. (...) Additionally, the medical community is increasingly diverse, including Muslims, Mormons, those in recovery from substance use disorders, pregnant individuals, and individuals from homes and communities damaged by alcohol. Due to their moral or safety concerns, these individuals may miss opportunities to network and engage in professional development when alcohol is present. Therefore, alcohol acts as a barrier to diversity, equity, and inclusion efforts and can result in pernicious downstream effects for minority patient populations. (shrink)

Khalafzai, Rida Usman Harms of alcohol consumption are not limited to the consumer. For women, it poses a significant threat to their unborn child. This article discusses one type of alcohol-related harm to the fetus: the fetal alcohol spectrum disorders (FASD).

There is evidence to the effect that exposing children to alcohol consumption in the media increases the chances that they will consume alcohol as minors or as adults, and since alcohol consumption is associated with numerous public health issues, calls for stricter regulation can be heard from many quarters. This article argues that with the available research we cannot conclude that exposure to portrayals of alcohol consumption plays a genuine causal role in bringing (...) about the things with which it is associated, that the strength of the correlation is too weak to justify regulation and that the sorts of things with which it is associated only rarely count as genuine harms from a liberal point of view. This article also argues that even if genuine harms were caused, no justification for regulation would directly follow because alcohol in the media could still be protected by freedom of speech and expression. Yet, the article argues that regulation is defensible if it can be shown that the harmful consequences arise in ways that bypass autonomy, or if it can be shown that the harmful consequences are unacceptable from the point of view of so-called ‘proleptic’ autonomy. (shrink)

Alcohol use has been recognized as a challenge in eldercare and social care, and some anticipate that problems related to alcohol use will increase in the future as the current adult generation has high alcohol consumption rates. Accordingly, it is suggested that care workers are at risk of becoming passive bystanders to the destructive lifestyles of vulnerable older adults and even facilitating these lifestyles. In the present paper, we suggest that alcohol exacerbates and underscores inherent (...) difficulties in eldercare, such as finding an appropriate balance between the personal freedom of the older adult and the responsibility of the care worker to provide care. The specific focus in the paper regard the communication and interaction involving values between people in eldercare in cases of problematic alcohol‐related situations to uncover the difficulties. We found it noteworthy that the objectives and perspectives of older adults, care workers, managers and relatives have implications regarding their interactions and communications because their varying experiences involve values that are not necessarily aligned. Sometimes, care workers have no choice but to act against what, in the public sphere and to the other care workers, is ruled out by virtue of their professional ethics. It is suggested that care workers describe and judge situations where alcohol is present paradoxically by virtue of their professional ethics, yet regulate their care to preserve the dignity of older adults, even when they find the situation to be an apparent dilemma. (shrink)

The link between alcohol consumption and cancer is well established, but public awareness of the risk remains low. Mandated warning labels have been suggested as a way of ensuring “informed choice” about alcohol consumption. In this article we explore various ethical issues that may arise in connection with cancer warning labels on alcoholic beverages; in particular we highlight the potentially questionable autonomy of alcohol consumption decisions and consider the implications if the autonomy of drinking (...) behavior is substantially compromised. Our discussion demonstrates the need for the various ethical issues to be considered and addressed in any decision to mandate cancer warning labels. (shrink)

Excessive alcohol consumption can have adverse effects on health, and patients who suffer from alcohol use disorders are subject to much stigmatization. Nurses are often the first point of contact when patients enter the acute medical unit, and it is pivotal that this contact establishes the basis for future collaboration. The aim of this study is to elucidate nurses’ lived experience of providing care to patients suffering from alcohol use disorders. This present study has a qualitative (...) research design, anchored in phenomenological and hermeneutical methodology as described in reflective lifeworld research. Ten in‐depth, open‐ended interviews with nurses working in an acute medical unit were conducted. The analysis showed that providing care to patients suffering from alcohol use disorders was a highly complex task to accomplish. This required the nurse to engage with the patient in a sensitive cooperation in order to be dealing with the intricacy of the patient's life situation and balancing care between standardized procedures and the complexity of the patients. Further, a two‐sided feeling of responsibility emerged: a professional responsibility and a personal responsibility causing the provision of care as being caught between feelings of despondency and resignation. Nurses lack opportunities for being creative in determining how to provide care; instead, patients' perspectives of well‐being should be taken into account and should guide the provision of a meaningful care. Nurses must call for opportunities to deviate from the firmly established procedures restraining the care of this population. (shrink)

Resource loss, coping, alcohol expectancies and drinking in students The aim of the study was to find relationships between resource loss treated as a stress indicator, coping, alcohol expectancies and drinking in college students. Results of a group of 125 first and second year students showed that there was a strong relationship between alcohol consumption and expectancies connected with alcohol. Some coping forms were also related to drinking but no relationship was found for resource loss.

Alcohol consumption during pregnancy can lead to fetal alcohol spectrum disorders. FASD is a spectrum of structural, functional, and neurodevelopmental problems with often lifelong implications, affecting communities worldwide. It is a leading preventable form of intellectual disabilities and therefore warrants effective prevention approaches. However, well-intended FASD prevention can increase stigmatization of individuals with FASD, women who consume or have consumed alcohol during pregnancy, and non-biological parents and guardians of individuals with FASD. This narrative review surveyed the (...) literature on stigmatization related to FASD. Public stigma appears to be the most common form of stigma studied. Less is known about FASD-related self-stigma, stigma by association, and structural stigma. Accordingly, the current literature on FASD-related stigma does not appear to provide sufficient guidance for effectively reducing FASD-related stigma. However, lessons can be learned from other related health topics and the use of a systematic approach for the development of health promotion programs, namely Intervention Mapping. (shrink)

In the course of a project on European policy on media and alcohol, a series of structured deliberative discussion sessions with young people (aged 13–25 years) in Sweden were arranged, where young people could communicate and exchange ideas about risks and policy issues connected to alcohol consumption and drinking, as presented in fictional media. The objective was to understand how risks and knowledge about alcohol consumption is acquired by young people and ‘uploaded’ to peers. The (...) discussion sessions applied adapted variants of the Youth Jury approach developed to facilitate the communication of ideas for guidelines and policies stemming from young people’s own perceptions about alcohol and media consumption. When ordinary ‘matters of fact’ information about drinking and alcohol fail to engage young people of today (even if it is understood), using humor, horror and shock seems a justified way in Sweden to get the desired reaction. Many of the jury participants themselves thought so. Social network has become an important way of communication also for temperance nongovernmental organizations and public initiatives, in particular with regard to nudging through emotional engagement and attempting to inspire further ‘peer-to-peer’ communication of this type, as young people ‘click-to-connect’. (shrink)

_Reasonable Risk_ examines the concept of risk as it applies to everyday life in general and to alcohol consumption specifically. The book addresses how we assess risks, and the strategies we use to manage them. It examines the elements that shape our perceptions of risk-cultural influences, social factors, and how we are presented with information about risk. The final chapter of the book focuses on the role of risk in policy formulation, examining in particular how alcohol policies (...) are developed within the context of individual and societal responsibility. (shrink)

The diagnosis of Fetal Alcohol Spectrum Disorders is embedded in a matrix of biological, social and ethical processes, making it an important topic for crossdisciplinary social and ethical research. This article reviews different branches of research relevant to understanding how FASD is identified and defined and outlines a framework for future social and ethical research in this area. We outline the character of scientific research into FASD, epidemiological discrepancies between reported patterns of maternal alcohol consumption during pregnancy (...) and the incidence of FASD, and the social and ethical considerations that may impact on who is, and is not, diagnosed. We highlight what further research investigating FASD diagnostic processes, as well as the multi-generational impacts of FASD, is needed. Important research priorities are to: 1) enumerate the variety of stakeholders involved in seeking FASD diagnoses; 2) understand the experiences and perspectives of mothers from different backgrounds who have consumed alcohol during pregnancy and their affected children; and 3) collect health histories of maternal alcohol consumption in families to determine the effect of FASD at sub-cultural and cultural levels. (shrink)

Fetal alcohol spectrum disorders is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a (...) series of discussions with experts in the field, published literature, and medical ethicists. Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the social services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. The value for the concerned individuals of obtaining a FASD-related description of their condition – for instance, in terms of wellbeing – is not established. Nor is it established that allocating resources based on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs. (shrink)

Objective: We aimed to analyze the characteristics and psychological mechanism of depressive symptoms in elderly patients with alcohol dependence under the COVID-19 epidemic and to observe the effect of acupuncture combined with emotional therapy of Chinese medicine treatment on depressive symptoms in elderly patients with alcohol dependence.Methods: Sixty patients were randomly divided into two groups. One group was treated by a set of emotional therapy of Chinese medicine treatment for 12 weeks. One group was treated by a set (...) of acupuncture combined with emotional therapy of Chinese medicine treatment for 12 weeks. We compared the curative effect between the control group and the treatment group, the mean alcohol consumption, the SF-36 scores before and after treatment, and the scores of Hamilton Depression Scale before and after treatment of 3, 6, and 9 weeks.Results: Based on the cognitive behavior model, the characteristics and psychological mechanism of depression in elderly patients with alcohol dependence under the COVID-19 epidemic situation were summarized. The total effective rate of the control group was 60%, and that of the treatment group was 100%. After 12 weeks of treatment, there were significant differences in PF, RF, physical pain, general health status, energy, and mental health between the treatment group and the control group. Before and after treatment, there were significant differences in PF, RF, physical pain, general health, energy, emotional function, and mental health of the treatment group. The PF, energy, and mental health of the control group were significantly different before and after treatment. There was no significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale before treatment. There was significant difference between the treatment group and the control group in the scores of Hamilton Depression Scale at 3, 6, and 9 weeks after treatment.Conclusion: Attention, cognition, emotion, behavior, and physical response reinforce each other, creating a vicious cycle that reinforces and sustains the depressive symptoms of elderly alcohol dependence under the COVID-19 epidemic, and acupuncture combined with emotional therapy of Chinese medicine treatment for improving the depressive symptoms of elderly alcohol dependence during the epidemic period of COVID-19 has a brilliant therapeutic effect. (shrink)

This paper argues that social contexts of inequality are crucial to understanding the ethics of gestational harm and responsibility. Recent debates on gestational harm have largely ignored the social context of gestators, including contexts of inequality and injustice. This can reinforce existing social injustices arising from colonialism, socio‐economic inequality and racism, for example, through increased regulation of maternal behaviour. To demonstrate this, I focus on the related notions of the ‘future child’ and an obligation of easy rescue, which have been (...) used to discuss the ethics of gestational harm in the context of alcohol consumption during gestation and foetal alcohol spectrum disorder (FASD). I use a feminist perspective to evaluate these ideas and conclude that anyone concerned with remediation of social injustice has good reason to be suspicious of the notion of the future child in the context of gestational harm. (shrink)

From a gender-historical perspective, this article deals with the history of and discussions around an observed increase in female alcoholism. Since the 1950s, psychiatric, pedagogical and psychological discourses have lamented the increasing consumption of alcohol by women, and identified women’s emancipation as its cause. The article examines the male-dominated debates on female alcoholism up to 1968 and the emerging feminist counter-movement that followed. It analyzes the shifts in the social role of women as expressed in the discussions about (...) ‘the drinking woman’ as well as simultaneous scientific-patriarchal counter-movements. On the one hand, the article shows how a classic concept of addiction is eroding due to the failure of medical treatment attempts and is being replaced by new psychosocial explanatory knowledge. On the other hand, it illustrates how women’s self-help is appropriating and reinterpreting this knowledge. (shrink)

An expanding policy framework aimed at monitoring alcohol consumption during pregnancy has emerged. The primary justification is prevention of harm from what is termed ‘prenatal alcohol exposure’ (PAE), by enabling more extensive diagnosis of the disability labelled fetal alcohol spectrum disorder (FASD). Here we focus on proposals to include biomarkers as a PAE ‘screening tool’, specifically those found in meconium (the first newborn excrement), which are discussed as an ‘objective’ measure of PAE.We ask the overarching question, (...) ‘Can routine screening of meconium to establish PAE be ethically or legally justified’, and we answer, ‘No’. To reach this conclusion, we discuss three areas. First, we consider the reasons why meconium screening should not be deemed ‘typical’ within the scope of accepted screening tools. We argue that given the aim and necessary timing of the screen, it cannot achieve what it promises. Second, we outline why patient autonomy and consent are not properly accounted for and cannot be reconciled with the ‘routinisation’ of the proposed ‘screening’. Last, we outline why the benefit of such a screen is not clear, focusing on the significance of trust in healthcare professionals (HCP) for the best interests of the future child and pregnant woman.While recognising the adverse effects of heavy alcohol consumption during pregnancy, we emphasise the case for robust ethical, legal and social considerations and the central need for trust between HCP and patients in maternity care. We conclude the permissibility of meconium screening has not been proven, and it is not justified. (shrink)

Brussen, Kerri Anne In February 2009, the National Health and Medical Research Council (NHMRC) issued revised guidelines to help reduce the health risks from alcohol consumption. This report summarises these guidelines. Above all, it discusses the change of thought in these guidelines based on a greater understanding of the need to reduce both the immediate as well as the lifetime risks of alcohol consumption.

This chapter examines ethnic differences in responses to alcohol. Specifically, it discusses the subjective effects of alcohol on Asians, Native Americans, and Jews. Recent studies have shown that genetic variations in the enzymes that metabolize alcohol lead to individual differences in the subjective effects of alcohol, typically in the form of increased sensitivity to its effects. It is also recognized that these gene variations are associated with lower rates of alcohol consumption and alcohol (...) use disorders, and possibly other substance use and substance use disorders. Causes of decreased intensity or more pleasurable effects associated with alcohol or other drug use in ethnic groups, whether such variations exist, and to what extent they are genetically and environmentally influenced, remain currently unanswered questions. (shrink)

AimsAlcohol consumption could lead to a series of health problems and social issues. In the current study, we investigated the resting-state functional brain networks of healthy volunteers before and after drinking through graph-theory analysis, aiming to ascertain the effects of acute alcohol intake on topology and information processing mode of the functional brain networks.Materials and methodsThirty-three healthy volunteers were enrolled in this experiment. Each volunteer accepted alcohol breathalyzer tests followed by resting-state magnetic resonance imaging at three time (...) points: before drinking, 0.5 h after drinking, and 1 h after drinking. The data obtained were grouped based on scanning time into control group, 0.5-h group and 1-h group, and post-drinking data were regrouped according to breath alcohol concentration (BrAC) into relative low BrAC group (A group; 0.5-h data, n = 17; 1-h data, n = 16) and relative high BrAC group (B group; 0.5-h data, n = 16; 1-h data, n = 17). The graph-theory approach was adopted to construct whole-brain functional networks and identify the differences of network topological properties among all the groups.ResultsThe network topology of most groups was altered after drinking, with the B group presenting the most alterations. For global network measures, B group exhibited increased global efficiency, Synchronization, and decreased local efficiency, clustering coefficient, normalized clustering coefficient, characteristic path length, normalized characteristic path length, as compared to control group. Regarding nodal network measures, nodal clustering coefficient and nodal local efficiency of some nodes were lower in B group than control group. These changes suggested that the network integration ability and synchrony improved, while the segregation ability diminished.ConclusionThis study revealed the effects of acute alcohol intake on the topology and information processing mode of resting-state functional brain networks, providing new perceptions and insights into the effects of alcohol on the brain. (shrink)

Introduction: Alcohol approach bias, the tendency to automatically move toward alcohol cues, has been observed in people who drink heavily. However, surprisingly, some alcohol-dependent patients demonstrate an alcohol avoidance bias. This inconsistency could be explained by the clinical or demographic profile of the population studied, yet this has not been examined in approach bias modification trials to date. We aimed to determine the proportion of patients with an approach or avoidance bias, assess whether they differ on (...) demographic and drinking measures, and to examine the clinical correlates of approach bias.Method: These research questions were addressed using baseline data from 268 alcohol-dependent patients undergoing inpatient withdrawal treatment who then went on to participate in a trial of ABM.Results: At trial entry, 155 had an alcohol approach bias and 113 had an avoidance bias. These two groups did not differ on any demographic or relevant drinking measures. Approach bias was significantly and moderately associated with total standard drinks consumed in the past 30 days but no other indices of alcohol consumption or problem severity.Conclusion: Whilst the majority of alcohol-dependent patients showed an alcohol approach bias, those with an avoidance bias did not differ in demographic or clinical characteristics, and the strength of approach bias related only to recent consumption. Further research is needed to develop more accurate and personally tailored measures of approach bias, as these findings likely reflect the poor reliability of standard approach bias measures. (shrink)

In some places consumption of alcohol raises serious public health issues. One recent proposal for addressing these issues has been to set a minimum price at which a unit of alcohol can be sold. In this paper I argue that such a policy, while it may have substantial health benefits, is ethically problematic. This is primarily because it unfairly places considerable burdens on those already most disadvantaged in society. In addition, such policies are poorly targeted if our (...) concern is with preventing the harms drinkers pose to other people. (shrink)

The publication of the latest contribution to the alcohol-in-pregnancy debate, and the now customary flurry of media attention it generated, have precipitated the renewal of a series of ongoing debates about safe levels of consumption and responsible prenatal conduct. The University College London (UCL) study’s finding that low levels of alcohol did not contribute to adverse behavioural outcomes—and may indeed have made a positive contribution in some cases—is unlikely to be the last word on the subject. Proving (...) a negative correlation is notoriously difficult (technically, impossible), and other studies have offered alternative claims. The author is not an epidemiologist, and the purpose of this article is not to evaluate the competing empirical claims. However, the question of what information and advice healthcare practitioners ought to present to pregnant women, or prospectively or potentially pregnant women, in a situation of uncertainty is one to which healthcare ethicists may have a contribution to make. In this article, it is argued that the total abstinence policy advocated by the UK’s Department of Health, and even more stridently by the British Medical Association, sits uneasily with recent data and is far from ethically unproblematic. In particular, the “precautionary” approach advocated by these bodies displays both scant regard for the autonomy of pregnant and prospectively pregnant women and a confused grasp of the principles of beneficence and non-maleficence. (shrink)

The increasing presence of women, especially university women, in risky alcohol consumption such as Binge Drinking, which is associated with gender-specific biopsychosocial problems, makes it necessary to analyze the variables underlying BD in order to adjust possible interventions more in line with their reality. The motives and expectancies of this pattern of consumption, as well as the consequences derived from it, are some of the variables that are shown to have the greatest weight in the prediction of (...) BD. In the present study we analyze, on the one hand, the performance of these variables among college women with alcohol use, and on the other hand, which of these variables allow us to classify BD. A total of 501 female university consumers of alcohol were assessed. Specifically, they completed a self-report of alcohol consumption, the Expectancy Questionnaire, the Drinking Motives Questionnaire and the Alcohol Consumption Consequences Evaluation. BD female students scored significantly higher on these instruments, except for compliance motives. The logistic regression analysis carried out to estimate the probability of performing BD using the social and conformity motives, the ACCE and positive expectancies correctly estimated have a 3.55-fold increase in the probability of having BD, compared to women classified as low risk by the ACCE. On the other hand, women classified as moderate risk by the ACCE have a 4.77-fold increase in the probability of having BD. In the case of social motives and positive expectancies, their increase multiplies by 1.165 and 1.024, respectively, the probability of having BD. The results of this study highlight the importance of adapting preventive measures to the consequences experienced by BD university students, especially in relation to the social motives and positive expectancies that modulate decision-making when engaging in this pattern of consumption. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele (...) is associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

Major neurocognitive changes occur during adolescence, making this phase as one of the most critical developmental period of life. Furthermore, this phase in life is also the time in youth substance use has its onset. Several studies demonstrated the differential associations of alcohol and cannabis use concerning the neurocognitive functioning of both males and females. Past and contemporary literature on gender-specific effects in neuroscience of addiction is predominantly based on cross-sectional datasets and data that is limited in terms of (...) measurement variability. Given the importance of gender-specific effects in addiction studies, and in order to address the two above-mentioned gaps in the literature, the present study aimed to compare neurocognitive functioning of male and female adolescents in the context of cannabis and alcohol use, while employing a longitudinal design with multiple repeated measurements. Participants were 3,826 high school students (47% female; mean age, 12.7), which were recruited from 31 high schools in the greater Montreal area. Participants were requested to complete annual surveys for five consequent years, from 7th to 11th grade, assessing their alcohol/cannabis use and neurocognitive functioning (working memory, delayed recall memory, perceptual reasoning, and inhibition control). The analytical strategy was focused on the longitudinal association between each predictor (female, male) and each of the outcomes (domains of neurocognitive functioning). Multilevel linear models assessed the association of alcohol and cannabis consumption and the four domains of neurocognitive functioning. Results revealed a gender by within-subject interaction, suggesting a weaker effect of yearly fluctuation of cannabis use on working memory among males compared to females. Our findings suggest a different pattern of neurocognitive impairment of female and male working memory after using cannabis over the course of adolescence. Early initiation of cannabis use potentially results in more spatial working memory deficits in female adolescents. This may negatively influence young females’ capacity in academic settings and lead to significant impairment in adulthood, which critically decreases the individual’s quality of life. (shrink)

ContextThe recent development of “serious games” has produced encouraging results in maintaining adherence to health-related interventions. In alcohol research, several studies have shown that computerized training on attentional bias decreases alcohol consumption bias among students. However, these highly controlled experimental situations, do not allow for direct large-scale dissemination. Our objective is to evaluate an attentional bias remediation program using a gamified smartphone training procedure.MethodsFifty students from Clermont-Ferrand University were invited to participate in the study. After a cognitive (...) assessment in the laboratory, the smartphone application was installed on each Student’s smartphone. Participants were randomly assigned to either the alcohol attentional training group or the control group Each student had to complete the 2-min program at least once a day for 15 days. After 15 days, a new cognitive assessment of attention bias was conducted in the laboratory. Forty-seven students were included in the study.ResultsOur analyses did not show any effect of the cognitive remediation program on attentional bias reduction between the two group [F < 1, p = 0.87], attentional performance [F = 1.63, p = 0.20] or inhibitory abilities [F < 1, p = 0.73]. These results were confirmed by Bayesian analyses.DiscussionDespite the absence of group effects, both the alcohol and control version of this program appeared to reduce attentional bias and increase inhibition capacities in the subset of participants who had attentional bias for alcohol at baseline This pilot study identifies areas for improvement in smartphone applications for future developments. Attentional bias remediation programs remain an interesting way to explore. (shrink)

Bullying often results in negative coping in victims, including an increased consumption of alcohol. Recently, however, an increase in alcohol use has also been reported among perpetrators of bullying. The factors triggering this pattern are still unclear. We investigated the role of empathy in the interaction between bullying and alcohol use in an adolescent sample (IMAGEN) at age 13.97 (±0.53) years (baseline (BL), N = 2165, 50.9% female) and age 16.51 (±0.61) years (follow-up 1 (FU1), N (...) = 1185, 54.9% female). General empathic distress served as a significant moderator of alcohol use in perpetrators (F9, 493 = 17.978, p < 0.01), which was specific for males and FU1. Male perpetrators, who are generally less sensitive to distress, might thus be more vulnerable to alcohol abuse. (shrink)

This article examines how public health addresses alcohol use through marketing — place, product, promotion, and price. The article reviews current product trends and how restrictions on certain products designs may reduce youth consumption; how product availability may be restricted through zoning; and the current advertising landscape.

This paper presents the results of the first phase of a longitudinal study initiated during the ‘first wave’ of the COVID-19 pandemic in Montenegro. The research aimed to examine the influence of selected risk factors on the occurrence of physical violence against women by their husbands during the pandemic. Four risk factors were assessed: the husband’s job loss, the frequency of alcohol consumption by the husband, the history of family violence, and the distribution of family responsibilities. The study (...) was conducted on a sample of 500 adult female participants, age range 20 to 49 years. Binary logistic regression analysis revealed that the husband’s job loss during the COVID-19 pandemic was significantly associated with an increased likelihood of physical violence against women. Frequent alcohol consumption by husbands, as a negative coping mechanism for stress, was found to be the strongest predictor of physical violence against women. Furthermore, a prior occurrence of domestic violence was associated with an increased likelihood of physical violence perpetrated by the husband. Findings also indicated that more equitable distribution of household responsibilities between partners correlated with a lower likelihood of physical violence against women. These results underscore the need for targeted strategies in preventing this issue. (shrink)