The Co-Occurrence of Depression and Alcohol Dependence Symptoms in a Community Sample of Lesbians

Numerous studies have found an association between depression and alcohol use disorders in women.

Little is known, however, about the relationship between depression and alcohol use among lesbians.

We examined the prevalence of depression and alcohol dependence symptoms as well as the co-occurrence of these two health problems in a large community-based sample of women who self-identified as lesbian.

Past year alcohol dependence symptoms were significantly associated with both past year and lifetime depression.

Lifetime depression was higher among White and Latina lesbians than among African American lesbians.

Younger women and those not currently in a committed relationship more commonly reported past year depression.

Younger age was the strongest predictor of the co-occurrence of depression and alcohol dependence symptoms.

Research report; Wendy B Bostwick, Tonda L. Hughes & Timothy Johnson. The Co-Occurrence of Depression and Alcohol Dependence Symptoms in a Community Sample of Lesbians. Journal of Lesbian Studies, Volume: 9 Issue: 3, 2005

ARBIAS (Alcohol Related Brain Injury Australian Services)

arbias Ltd was established in 1990 to provide services for people with alcohol and other substance related brain impairment. It is a not for profit company managed by a board of directors. arbias is a specialist disability service which works together with families, support networks, employers and service providers to assist people with alcohol and other substance related brain impairments to live and function to their full potential in the community.

arbias provides the following services: Neuropsychological Assessments, Secondary Consultation, Case Management, Accommodation, Lifestyle Support Services, Information Services, Workforce Training and Development.

Membership of Friends of arbias Ltd is open to organizations or individuals who support the aims of arbias Ltd and is endorsed by the arbias Ltd Board of Directors. Friends of arbias Ltd are kept informed of activities of arbias Ltd via newsletters and special events throughout the year. Your financial contribution will greatly assist arbias in preventing a highly prevalent, yet little known disability.

For further information about arbias and that work that they do, please visit their website at www.arbias.org.au.

Spirituality religiosity promotes acceptance based responding and 12-step involvement.

BACKGROUND: Previous investigations have observed that spirituality/religiosity (S/R) is associated with enhanced 12-step involvement. However, relatively few studies have attempted to examine the mechanisms for this effect. For the present investigation, we examined whether acceptance-based responding (ABR) - awareness or acknowledgement of internal experiences that allows one to consider and perform potentially adaptive responses - accounted for the effect of S/R on 12-step self-help group involvement 2 years after a treatment episode.

METHODS: Data were collected as part of a multi-site treatment outcome study with 3698 substance-dependent male veterans recruited at baseline. Assessments were conducted at baseline, discharge, 1-year follow-up, and 2-year follow-up. We utilized structural equation modeling to examine the relationships among latent variables of S/R, ABR, and 12-step involvement over time.

RESULTS: In the final model, S/R was not directly related to 12-step involvement at 2-year follow-up. However, S/R predicted enhanced ABR at 1-year follow-up after accounting for discharge levels of ABR. In turn, ABR at 1-year follow-up predicted increased 12-step involvement at 2-year follow-up after accounting for discharge levels of 12-step involvement.

CONCLUSIONS: S/R promotes the use of post-treatment self-regulation skills that, in turn, directly contribute to ongoing 12-step self-help group involvement.

Research report; Carrico AW, Gifford EV, Moos RH. Spirituality religiosity promotes acceptance based responding and 12-step involvement Drug Alcohol Depend. 2007 Jun 15;89(1):66-73.

Conversations with God : An Uncommon Dialogue (Book 1)

Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives

Aim; The People Awakening (PA) study explored an Alaska Native (AN) understanding of the recovery process from alcohol abuse and consequent sobriety.

Design; PA utilized a cross-sectional, qualitative research design and community-based participatory research methods.

Setting and participants; The study included a state-wide convenience sample of 57 participants representing all five major AN groups: Aleut/Alutiiq, Athabascan, Inupiaq, Yup’ik/Cup’ik and Tlingit/Haida/Tsimshian. Participants were nominated and self-identified as being alcohol-abstinent at least five years following a period of problem drinking.

Measurements; Open-ended and semistructured interviews gathered extensive personal life histories. A team of university and community co-researchers analyzed narratives using grounded theory and consensual data analysis techniques.

Findings; A heuristic model of AN recovery derived from our participants’ experiences describes recovery as a development process understood through five interrelated sequences:

1. the person entered into a reflective process of continually thinking over the consequences of his/her alcohol abuse;
2. that led to periods of experimenting with sobriety, typically, but not always, followed by repeated cycling through return to drinking, thinking it over, and experimenting with sobriety; culminating in
3. a turning point, marked by the final decision to become sober. Subsequently, participants engaged in
4. Stage 1 sobriety, active coping with craving and urges to drink followed for some participants, but not all, by
5. Stage 2 sobriety, moving beyond coping to what one participant characterized as ‘living life as it was meant to be lived.

Conclusions; The PA heuristic model points to important cultural elements in AN conceptualizations of recovery.

Research; Mohatt GV, Rasmus SM, Thomas L, Allen J, Hazel K, Marlatt GA. Risk, resilience, and natural recovery: a model of recovery from alcohol abuse for Alaska Natives. Addiction. 2007 Nov 27

Brief-TSF is designed to address these issues.

My Name is Funky… and I’m An Alcoholic: A Story About Alcoholism and Recovery by Tom Batiuk Read more about this title…

Concise TSF and Brief-TSF Research Summary

All the elements of TSF have moderate to strong research support, most of which has been replicated.

NB: AA does not participate in research but individual members do. The huge volume of peripheral research supports a strong case for recommending AA participation by alcoholics.

We know: -

• that Twelve Step Facilitation reduces alcohol abuse , improves related consequences, and improves employment prospects.
• that Alcoholics Anonymous has good efficacy, and that Peer Sponsoring/social support is an essential element in AA’s success.
• that recovering people who help recovering people maintain better sobriety and have greater involvement in the general community.
• that men, women, adolescence, African-Americans, Hispanics and gay men benefit from AA. That all socio-demographic groups are represented.
• that AA is suitable for head trauma victims, and methadone patients.
• that AA has wide acceptance and is readily available in almost all communities. The current global membership of AA is approximately 2.06 million.
• that participation in Alcoholics Anonymous improves medication compliance for mental health patients, improves psychological functioning, Improves coping, reduces child abuse and domestic violence, reduces healthcare usage, reduces hospitalisation, reduces medical symptoms, reduces subsequent treatment demand, reduces mortality, and reduces associated costs.
• that healthcare workers have good success rates for substance abuse treatment and recovery from alcoholism that can be improved with AA participation.
• that alcoholics with social networks supportive of drinking have better outcomes if they initiate AA attendance while in treatment.
• that affiliation with AA is enhanced if prospects gain an awareness of the culture and methods used by AA and that sobriety is better than drinking prior to attending AA.
• that 80% of Australian, 87% of USA, and 65% of UK doctors believe that Alcoholics Anonymous is the treatment of choice for alcoholism, but overall they do not understand how AA works.
• that more than 80% of specialist alcohol and drug treatment staff support Alcoholics Anonymous treatment referral and 92% of another specialist A & D service requested training in 12 Step approaches.
• that AA Peer Sponsor contact at the healthcare worker office/institution increases initiation and sustained attendance at AA meetings.
• that active and regular AA participation is one of the more effective ways to effect lifestyle changes for alcoholics.
• that routinely engaging patients in continuing outpatient care is likely to yield better outcomes..
• that most people in the early stages of alcoholism seek help from GP’s or Community Health Centres.
• that individuals with substance abuse medical conditions benefit from integrated medical and substance abuse treatment, and approaches such as TSF can be cost-effective.
• that for every $1.00 invested in intervention $4.30 is saved in future healthcare costs.

Alcohol-dependent patients attempting and not attempting suicide: a comparison.

Background:

Alcohol dependence is a psychiatric disorder associated with an increased risk of suicidal behaviour. This is also associated with an increased number of suicide risk factors.

Objective:

The current study examined the sociodemographic and clinical characteristics of a number of alcohol-dependent patients who attempted suicide.

Methods:

We studied a consecutive series of 377 alcohol-dependent patients in our in-patient clinics. Their alcohol-use histories were assessed through semi-structured interviews. The Suicidal Behaviors Questionnaire, the Childhood Trauma Questionnaire, the Michigan Alcoholism Screening Test and the Hamilton Depression Rating Scale were administered to all patients. Serum total cholesterol levels, mean corpuscular volume, the liver enzymes gamma glutamyl transferase, aspartate aminotransferase and alanine aminotransferase were routinely measured. In the statistical analyses, Student’s t-test and chi-squared tests were applied.

Results:

• Of the 377 alcohol-dependent patients, 89 (23.6%) had histories of attempted suicide.
• Thirty-four (42.5%) of the 80 female alcohol-dependent patients and
• 55 (18.5%) of the 297 male alcohol-dependent patients had attempted suicide;
• this gender difference was statistically significant (2 = 27.7, P < 0.001).
• A greater proportion of the suicide attempters than of the non-attempters met the Diagnostic Statistical Manual IV criteria for another psychiatric disorder (60.6%, n = 54, vs. 40.6%, n = 117; 2 = 14.8; df = 6; P < 0.05).
• The difference of total cholesterol levels between female (mean = 144.0, SD = 58.3; mean = 158.0, SD = 83.9; t = 4.5; P < 0.05) and male (mean = 133.7, SD = 50.5; mean = 163.6, SD = 69.7; t = 11.7; P < 0.01) attempters and non-attempters was statistically significant.

Conclusion: These results suggest that suicide attempts in alcohol-dependent patients are associated with more profound biopsychosocial pathology and decreased serum cholesterol levels.

Research; Pektas O; Mirsal H; Kalyoncu A; Ünsalan N; Beyazyürek M. Alcohol-dependent patients attempting and not attempting suicide: a comparison. Acta Neuropsychiatrica, August 2004, vol. 16, no. 4, pp. 204-211(8). Alcohol-dependent patients attempting and not attempting suicide: a comparison.

Exhaustive Review of the Literature Reveals Even Moderate Alcohol Intake Increases Risk of Cancer

The Cancer Institute of New South Wales, Australia, has released a comprehensive analysis of current evidence for the association between alcohol consumption and risk of cancer. Limited to systematic reviews and meta-analyses of the highest methodological quality, the 194-page monograph, entitled Alcohol as a Cause of Cancer, revealed that even moderate alcohol consumption is associated with an often dramatic increase in the risk of several types of cancer.

Key findings are as follows:

Alcohol intake of approximately 2 drinks per day increases the risk of

• cancer of the oral cavity and pharynx by 75 percent,
• the risk of esophageal cancer by 50 percent, and
• the risk of laryngeal cancer by 40 percent.

Moderate intake also significantly increases the risk of colorectal cancer, liver cancer, and stomach cancer.

• Intake of approximately 4 drinks per day increases the risk of any cancer by 22 percent, while
• 8 drinks per day increases the risk by 90 percent.

The risk of breast cancer is 11 to 22 percent higher in women who drink alcohol than in women who do not.

Comments: The authors were unable to identify levels of consumption associated with no risk of cancer. Although the World Health Organization lists alcohol as a Group-1 carcinogen, as noted in the introduction to this study, few people are aware that even moderate consumption can cause cancer. These findings may be limited by possible underreporting of alcohol use or misclassification of exposure (e.g., light or ex-drinkers classified as nondrinkers).

Nonetheless, information about the association between alcohol and cancer needs to be more widely available so that the public can make informed choices about their behavior.

Richard Saitz, MD, MPH. Research Reference; Lewis S, Campbell S, Proudfoot E, et al. Alcohol as a Cause of Cancer. Sydney, Cancer Institute NSW, May 2008.

See also;

• Brief-TSF can assist patients cease alcohol consumption.
• Twelve Step Facilitation
• 12-Step Treatment More Effective than Alternative
• Subscribe to BriefTSF by e-Mail

Counselling for Alcohol Problems (Counselling in Practice series) by Richard D B Velleman Read more about this title…

Screening for Alcohol Problems in Primary Care; A Systematic Review.

Background; Primary care physicians can play a unique role in recognizing and treating patients with alcohol problems.

Objective; To evaluate the accuracy of screening methods for alcohol problems in primary care.

Methods; We performed a search of MEDLINE for years 1966 through 1998. We included studies that were in English, were performed in primary care, and reported the performance characteristics of screening methods for alcohol problems against a criterion standard. Two reviewers appraised all articles for methodological content and results.

Results; Thirty-eight studies were identified. Eleven screened for at-risk, hazardous, or harmful drinking; 27 screened for alcohol abuse and dependence. A variety of screening methods were evaluated.

The Alcohol Use Disorders Identification Test (AUDIT) was most effective in identifying subjects with at-risk, hazardous, or harmful drinking (sensitivity, 51%-97%; specificity, 78%-96%),

while the CAGE questions proved superior for detecting alcohol abuse and dependence (sensitivity, 43%-94%; specificity, 70%-97%).

These 2 formal screening instruments consistently performed better than other methods, including quantity-frequency questions. The studies inconsistently adhered to methodological standards for diagnostic test research: 3 (8%) provided a full description of patient spectrum (demographics and comorbidity), 30 (79%) avoided workup bias, 12 (of 34 studies [35%]) avoided review bias, and 21 (55%) performed an analysis in pertinent clinical subgroups.

Conclusions; Despite methodological limitations, the literature supports the use of formal screening instruments over other clinical measures to increase the recognition of alcohol problems in primary care. Future research in this field will benefit from increased adherence to methodological standards for diagnostic tests.

Research report; David A. Fiellin; M. Carrington Reid, MD; Patrick G. O’Connor. Screening for Alcohol Problems in Primary Care; A Systematic Review. Arch Intern Med. 2000;160.

Brief-TSF uses the CAGE and the AUDIT to identify alcohol use disorders.

Impulsivity May Trigger Addiction, Researchers Say

British researchers say that impulsivity seems to trigger addiction and not the other way around, Science magazine reported June 6.

People with addictions are known to be more impulsive and engage in more thrill-seeking behaviors than non-addicts, but it has been unclear whether those behaviors predated drug use or were the result of addiction.

Researchers David Belin and Barry Everitt of the University of Cambridge attempted to answer the question by studying rats known to have thrill-seeking or impulsive personalities. The researchers connected the rats to a device that delivered cocaine directly to their brains and then gave the rats control over their drug use. They found that the thrill-seeking rats tried the drug immediately and in high doses, while the impulsive rats used the drug less quickly and in greater moderation.

However, the authors found that after 40 days of access to the drug the impulsive rats had become addicted and could not stop using cocaine even when punished with an electric shock, while the thrill-seeking rats had grown tired of the drug and stopped using.

The research study is published in the June 6, 2008 edition of Science magazine.

See also;

• 12-Step Treatment More Effective than Alternative
• AA and Treatment Work Better Together
• Abstinence from Heroin Addiction Works
• Subscribe to BriefTSF by e-Mail

Theory and Practice of Group Counseling by Gerald Corey Read more about this title…

One cannabis joint is as bad as five cigarettes

RESEARCH CONFIRMS CANNABIS POSES SERIOUS HEALTH RISK TO LUNGS

The British Lung Foundation welcomes research published in the journal Thorax highlighting the dangers cannabis poses to the lungs.

“This research confirms that cannabis poses a serious health risk to the lungs and smoking a joint can be more harmful to the lungs than smoking a cigarette”, says Dr Keith Prowse, Chairman of the British Lung Foundation. “It’s important to remember, though, that tobacco continues to be more harmful overall because it is typically smoked in much higher quantities than cannabis.”

One of the reasons a cannabis joint can be more dangerous than a cigarette is that people tend to inhale the smoke more deeply as well as then holding it in for longer.

Reuters reported that smoking one cannabis joint is as harmful to a person’s lungs as having up to five cigarettes, according to research published on Tuesday.

Those who smoked cannabis damaged both the lungs’ small fine airways, used for transporting oxygen, and the large airways, which blocked air flow, the researchers said.

It meant cannabis smokers complained of wheezing, coughing, and chest tightness, the study by experts at the Medical Research Institute of New Zealand found.

The study found only those who smoked tobacco suffered from the crippling lung disease emphysema, but cannabis use stopped the lungs working properly.

"The extent of this damage was directly related to the number of joints smoked, with higher consumption linked to greater incapacity," said the authors of the report published in the medical journal Thorax.

"The effect on the lungs of each joint was equivalent to smoking between 2.5 and five cigarettes in one go."

“The danger cannabis poses to respiratory health is consistently being overlooked,” says Dame Helena Shovelton, Chief Executive of the British Lung Foundation. “Smoking a joint is more harmful to the lungs than smoking a cigarette and we have just banned people from doing that in public places because of the health risks.”

In a 2002 report, the British Lung Foundation estimated that three to four cannabis cigarettes a day were associated with the same amount of damage to the lungs as 20 or more tobacco cigarettes a day. The British Lung Foundation also called for more awareness of the issue.

The BLF are calling for:

• A public health campaign to make young people fully aware about the increased risk of lung infections and respiratory cancers
• Further research into potential links between cannabis smoking and Chronic Obstructive Pulmonary Disease (COPD) - an umbrella term for conditions including emphysema and chronic bronchitis.

Research; Sarah Aldington, Mathew Williams, Mike Nowitz, Mark Weatherall, Alison Pritchard, Amanda McNaughton, Geoffrey Robinson and Richard Beasley. THE EFFECTS OF CANNABIS ON PULMONARY STRUCTURE, FUNCTION AND SYMPTOMS. Thorax, July 2007.