Alcohol Abstinence Research Articles

Association of alcohol abstinence with risk of hyperuricemia in rural Chinese adults: the Henan Rural Cohort Study

BackgroundAlcohol drinking can cause hyperuricemia (HUA), but few studies have explored alcohol abstinence’s health effects, particularly the abstinence duration on HUA. This study aimed to evaluate the associations of abstinence with HUA in rural Chinese adults.MethodsThis was a cross-sectional study of 38,855 participants (15,371 males and 23,484 females) using the baseline data (2015–2017) from the Henan Rural Cohort Study. A questionnaire survey collected information on alcohol consumption patterns. Multivariate logistic regression analyses were used to evaluate the associations of type of alcoholic beverages, abstinence status and abstinence duration with HUA, respectively. Restricted cubic spline models were applied to visualize the dose-response trend of HUA risk with increasing abstinence duration.Results3,978 cases of 38,855 participants were identified with HUA. Total alcohol intake, including beer, liquor and rice wine intake was significantly associated with the increased risk of HUA, especially for male participants. Compared with current drinkers, former drinkers and non-drinkers presented lower ORs (95%CIs) of 0.686 (0.676, 0.844) and 0.718 (0.649, 0.793) for HUA. Furthermore, the aORs (95%CIs) for those former drinkers with < 5, 6–10 and ≥ 11 years abstinence duration were 0.868 (0.693, 1.086), 0.753 (0.519, 1.092) and 0.717 (0.517, 0.990), respectively. In addition, the risk of HUA decreased with the increasing years of abstinence duration (P for trend < 0.050) and negative linear dose-response associations were observed.ConclusionFormer drinkers were associated with a reduced risk of HUA compared with current drinkers. Moreover, sustained alcohol abstinence could be beneficial for preventing HUA.Clinical Trial RegistrationThe Henan Rural Cohort Study was registered on the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06 http://www.chictr.org.cn/showproj.aspx?proj=11375.

Alcohol induces long-lasting sleep deficits in Drosophila via subsets of cholinergic neurons.

Alcohol consumption causes short- and long-term sleep impairments, which persist into recovery from alcohol use disorder (AUD). In humans, sleep quantity and quality are disturbed even after 2weeks of alcohol abstinence in as many as 72% of AUD patients. These sleep deficits are strong predictors of relapse to drinking, but their underlying biological mechanisms are poorly understood, making them difficult to treat in a targeted manner. Here, we took advantage of Drosophila melanogaster's translational relevance for human sleep and alcohol responses to model human alcohol-induced sleep deficits and determine mechanisms of these effects. While low doses of alcohol stimulate the central nervous system (CNS) in flies and in humans, high doses depress the CNS, leading to sedation. After a single, sedating alcohol exposure, flies experienced loss of nighttime sleep, increased time to fall asleep, and reduced sleep quality. These effects lasted for days but eventually recovered. Hyperactivating ethanol exposures failed to induce sleep deficits, even when repeated, suggesting that CNS-depressant effects of sedating ethanol exposures are required for long-lasting sleep deficits. By manipulating activity in neurons producing different neurotransmitters, we determined that reduced cholinergic activity synergized with a sub-sedating ethanol exposure to cause sleep deficits. We then identified subsets of cholinergic neurons mediating these effects, which included mushroom body neurons previously implicated in sleep and alcohol responses. When those neurons were excluded, sleep effects were abrogated. These data suggest that ethanol-induced suppression of cholinergic neurons induces long-lasting sleep deficits, which are conserved from Drosophila to humans.

Alcohol use and HIV suppression after completion of financial incentives for alcohol abstinence and isoniazid adherence: a randomized controlled trial

Alcohol use and HIV suppression after completion of financial incentives for alcohol abstinence and isoniazid adherence: a randomized controlled trial

New moderationism: medical discourses on alcohol and the decline of drunkenness in interwar Britain.

This article explores the significant yet underappreciated role of medical experts in consolidating the promotion of moderate drinking as a viable solution to Britain's alcohol problem during the interwar period. The country's experience with alcohol regulation in the First World War showed that widespread drunkenness could be effectively managed through policies that restricted the availability of alcohol and encouraged moderation. This realization weakened the political standing of the temperance movement, as support for alcohol prohibition and abstinence waned, leading to the liberalization of social attitudes towards drinking. Such circumstances facilitated the emergence of New Moderationism, a renewed policy approach that regarded moderate drinking as relatively benign while cautioning against the dangers of heavy consumption. Medical professionals provided the conceptual foundation for New Moderationism by reassessing several assumptions on alcohol's conflicting reputation as either a 'poison' or a 'food', its benefits to drinkers, and its potential to cause disease. These considerations led to the conclusion that alcohol policy should focus not on whether people should drink, but on how much. This study thus underscores the pivotal contribution of medical professionals in the evolution of the alcohol debate between the two world wars, revealing the transformative impact of expertise on policymaking and social change in modern Britain.

Associations of the Korean patient placement criteria matching among individuals with alcohol-related problems with treatment completion and abstinence: an observational study

BackgroundThe American Society of Addiction Medicine Patient Placement Criteria (ASAM PPC) are guidelines for matching addiction patients to an optimal level of care (LOC). South Korea lacked a systematic approach to assigning alcohol use disorder patients to suitable treatment. To address this, Park et al. translated the ASAM PPC into Korean, creating the Korean Patient Placement Criteria (KPPC). We aim to assess the efficacy of the KPPC by evaluating whether receiving KPPC-matched treatment would result in longer periods of alcohol abstinence and higher number of treatment program completion.MethodsThis is an observational, multi-site study of 225 individuals with hazardous alcohol use or alcohol dependence, defined by Alcohol Use Disorder Identification Test score of 10 or more for men, and 6 or more for women. We evaluated patients using KPPC at baseline and one-month follow-up visits and recommended a LOC at every visit. Patients freely chose to receive KPPC-matched treatment or not. We examined the duration of alcohol abstinence and number of one-month treatment program completion within a three-month period.ResultsOf the 225 participants, 47 never pursued their matched level of care treatment, 54 pursued it once, and 124 pursued it twice. Individuals who received KPPC-matched treatment once had significantly higher odds of achieving alcohol abstinence (OR = 2.23), with greater odds when they received KPPC-matched treatments twice (OR = 2.88). The association was also significant for treatment completion, with greater odds of completing treatment program for one KPPC-matched treatment (OR = 3.28) and two KPPC-matched treatments (OR = 3.19).ConclusionsIndividuals who followed the KPPC matched level of care had longer periods of alcohol abstinence and better treatment completion. Our results should encourage community addiction management centers and hospitals to adopt KPPC for classifying treatment settings for alcohol use disorder patients. Further research is warranted to maximize the potential benefits of KPPC.

Inflammation remains a dynamic component of portal hypertension in regressive alcohol-related cirrhosis.

Portal hypertension (PH) resulting from static and dynamic intrahepatic changes drives liver-related complications even after removing the underlying aetiological factor. We investigated the impact of inflammation on the dynamic component of PH during disease regression in animal models of toxin-induced cirrhosis and patients with alcohol-related cirrhosis. In mice, cirrhosis was induced via toxin application for 12weeks followed by toxin-withdrawal allowing for one or 2weeks of regression. Furthermore, 128 patients with alcohol-related cirrhosis and alcohol abstinence undergoing same-day hepatic venous pressure gradient (HVPG) and liver stiffness measurement (LSM) were included. The influence of inflammation on the dynamic PH component was assessed using linear models. Specifically, we explored proinflammatory changes in mice/patients in whom the measured portal pressure (PP)/HVPG was significantly higher than the PP/HVPG expected from the static PH component (histological collagen proportionate area [CPA; %] in mice, LSM in patients). In mice, toxin discontinuation induced a significant decrease in PP, CPA, histological hepatic inflammation and hepatic expression of proinflammatory genes (Tnfa, Il6, Cxcl1, Mcp1; all p<0.05 for one/2week regression vs. peak disease). Similarly, prolonged abstinence in alcohol-related cirrhosis was linked to lower HVPG/LSM and longer abstinence was correlated to lower C-reactive protein (CRP), IL-6, immunoglobulin A (IgA) and IgG levels (all p<0.05). Nevertheless, the persistence of a low-grade proinflammatory state during regression was linked to a higher PP/HVPG than expected from static PH components. In regressive mice, higher hepatic proinflammatory gene expression (Tnfa, Il6, Il1b; all p<0.05) was linked to higher-than-expected PP. Similarly, higher CRP, IL-6, IgA and IgG and lower complement factor C3c (all p<0.05) were associated with higher-than-expected HVPG in abstinent patients with alcohol-related cirrhosis. Although removing the underlying aetiological factor resulted in significant improvements, a persistent hepatic proinflammatory environment remained a key driver of the dynamic PH component in regressive liver disease. NCT03267615.

Genetic determinants of serum brain-derived neurotrophic factor (BDNF) after alcohol withdrawal

Peripheral brain-derived neurotrophic factor (BDNF) levels increase during alcohol abstinence in dependent subjects. Meanwhile, the genetic determinants of circulating BDNF this context are poorly understood. Studies of associations between circulating BDNF and single nucleotide polymorphisms (SNPs) of the corresponding gene are mainly restricted by the most studied BDNF SNP rs6265. A recent genome-wide association study demonstrated that the BDNF-related SNP rs75945125 is associated with serum BDNF. However, it is unknown whether this SNP is associated with changes in peripheral BDNF levels in the context of alcohol abstinence. We aimed to assess the association of the BDNF-related SNPs rs75945125 and rs6265 with changes in serum BDNF levels after alcohol withdrawal and the corresponding clinical manifestations. A total of 132 inpatients diagnosed with alcohol withdrawal syndrome were enrolled in the study. Serum BDNF levels were assessed on 2nd, 7th, and 21st days after alcohol withdrawal. Alcohol withdrawal syndrome severity, craving severity, affective symptoms, and cognitive impairment were assessed on 7th and 21st days. BDNF SNPs rs75945125 and rs6265 were genotyped using real-time PCR. BDNF concentrations in the carriers of the rs75945125 C allele on 21st day were higher as compared with TT genotype carriers. BDNF SNP rs75945125 C allele carriers had a longer duration of problem drinking, consumed a lesser volume of alcohol in the last 3 months, and had lower severity of withdrawal syndrome on 7th day compared with TT genotype carriers. BDNF levels were moderated by rs75945125 and rs6265, as well as by the interaction of rs75945125 × rs6265, whereas only the interaction of rs75945125 × rs6265 had an effect on depression scores during abstinence. Thus, the trajectory of serum BDNF changes during alcohol abstinence is determined by both rs75945125 and rs6265. Moreover, BDNF gene-related SNPs are associated with the clinical parameters of alcohol dependence and withdrawal. The longitudinal design without a control group and the relatively small sample size are the limitations of this study. Future studies on the revealed interactions are warranted.

Prevalence and characteristics of participants in Dry January 2024: findings from a general population survey in France.

Dry January is a one-month alcohol abstinence challenge for the general population running since 2013 in the United Kingdom, and 2020 in France. Dry January has gained increasing popularity among the public, but studies assessing the individual characteristics associated with awareness and participation remain sparse. Using quota sampling, a representative sample of 5,000 French adults completed an online cross-sectional survey between 8 and 17th January 2024. Chi-square tests and binary logistic regressions were used to explore demographic and alcohol-related characteristics associated with awareness of the Dry January campaign as well as participation. Among 4,075 past-year alcohol users, 2,468 (61%) were aware of the "Dry January" campaign, of whom 497 (20%) were participants (12% of all alcohol users). Extrapolated to the entire adult French population, this corresponds to an estimated 4.5 million people participating in the Dry January 2024. Awareness was comparable between genders and across age groups, but was greater among individuals with higher occupational status, and lower among those living in Eastern regions of France. Individuals aware of the campaign were more likely to self-evaluate their drinking as "at risk" and to report high-risk consumption. Participation rates did not differ by gender, occupational status, or region but decreased with age. Compared to non-participants, Dry January participants were more likely to self-identify their drinking as at-risk, to be concerned about health-related effects of alcohol, to be concerned about their control (or lack thereof) over drinking, and to report hazardous use or possible alcohol use disorder. However, no evidence was found for an association between high-risk consumption based on AUDIT-C and participation. Among participants, aiming for reduction (vs. abstinence) and official registration (vs. unofficial participation), were associated with worsened alcohol-related measures. This study indicates a stable level of awareness, but encouraging participation in Dry January in France. The results also confirm that temporary alcohol abstinence campaigns primarily attract high-risk drinkers and individuals reporting harmful consequences related to alcohol.

Blood metabolomic profiling reveals new targets in the management of psychological symptoms associated with severe alcohol use disorder.

Alcohol use disorder (AUD) is a global health problem with limited therapeutic options. The biochemical mechanisms that lead to this disorder are not yet fully understood, and in this respect, metabolomics represents a promising approach to decipher metabolic events related to AUD. The plasma metabolome contains a plethora of bioactive molecules that reflects the functional changes in host metabolism but also the impact of the gut microbiome and nutritional habits. In this study, we investigated the impact of severe AUD (sAUD), and of a 3-week period of alcohol abstinence, on the blood metabolome (non-targeted LC-MS metabolomics analysis) in 96 sAUD patients hospitalized for alcohol withdrawal. We found that the plasma levels of different lipids ((lyso)phosphatidylcholines, long-chain fatty acids), short-chain fatty acids (i.e. 3-hydroxyvaleric acid) and bile acids were altered in sAUD patients. In addition, several microbial metabolites, including indole-3-propionic acid, p-cresol sulfate, hippuric acid, pyrocatechol sulfate, and metabolites belonging to xanthine class (paraxanthine, theobromine and theophylline) were sensitive to alcohol exposure and alcohol withdrawal. 3-Hydroxyvaleric acid, caffeine metabolites (theobromine, paraxanthine, and theophylline) and microbial metabolites (hippuric acid and pyrocatechol sulfate) were correlated with anxiety, depression and alcohol craving. Metabolomics analysis in postmortem samples of frontal cortex and cerebrospinal fluid of those consuming a high level of alcohol revealed that those metabolites can be found also in brain tissue. Our data allow the identification of neuroactive metabolites, from interactions between food components and microbiota, which may represent new targets arising in the management of neuropsychiatric diseases such as sAUD. Gut2Behave project was initiated from ERA-NET NEURON network (Joint Transnational Call 2019) and was financed by Academy of Finland, French National Research Agency (ANR-19-NEUR-0003-03) and the Fonds de la Recherche Scientifique (FRS-FNRS; PINT-MULTI R.8013.19, Belgium). Metabolomics analysis of the TSDS samples was supported by grant from the Finnish Foundation for Alcohol Studies.

Impact of tobacco smoking and alcohol consumption on the treatment efficacy among psoriasis patients: A study protocol.

Psoriasis is a common skin disease. With an in-depth understanding of psoriasis, small-molecule drugs and biologics are developed and used in clinical practice, but some patients still cannot achieve a satisfactory therapeutic effect. Tobacco smoking and alcohol drinking are proven to be factors affecting psoriasis. Still, evidence of the impact of tobacco smoking and alcohol consumption on the efficacy of psoriasis treatment is limited. This study aims to understand the prevalence of tobacco smoking and alcohol drinking among patients with psoriasis in Shanghai and to examine the association between tobacco smoking as well as alcohol drinking and the therapeutic effect in patients with psoriasis. We conducted a longitudinal observational study and recruited at least 500 psoriasis patients at Shanghai Skin Disease Hospital. In this study, patients with clinically diagnosed psoriasis vulgaris, aged ≥18 years, both males and females, with informed consent were recruited. However, patients with pregnancy, serious underlying disease conditions, communication barriers, and violation of medication regulations were excluded. Patients with psoriasis in this study receive a physical examination and case record form interview. The primary outcome indicator is the proportion of patients with PASI75 achievement at Week 8. In this study, we use SAS 9.2 software to analyze the data. This study has been reviewed and approved by the Institutional Ethics Review Committee of Shanghai Skin Disease Hospital in 2021 (NO. 2021-44). It has been registered in the Chinese Clinical Trial Registry (ChiCTR2200066403). Patient recruitment began in January 2021 and is proposed to be finished in December 2024. The findings in this study will provide evidence of how tobacco smoking and alcohol drinking impact the treatment efficacy among patients with psoriasis. Therefore, the implementation of tobacco control and alcohol abstinence benefit the improvement of treatment responses.

Efficacy of Screening and Brief Intervention for Alcohol Misuse in Opioid Agonist Maintenance Treatment: A Randomized Clinical Trial

ABSTRACT Alcohol misuse is common in persons on opioid agonist maintenance treatment (OAMT). We tested the efficacy of screening and brief intervention (SBI) for harmful/hazardous alcohol use in buprenorphine/naloxone (BNX)-assisted OAMT. It was a double-blind, parallel-group, randomized trial, where 150 participants with alcohol misuse (Alcohol Use Disorder Identification Test – AUDIT 8–19) on BNX were allocated equally to receive either a single session SBI or screening and brief advice (control). Participants were followed up at three months. The primary outcome was the change in AUDIT; other outcomes were risk transition, change in the frequency of heavy drinking, days of abstinence from alcohol, Gamma-glutamyl transferase (GGT) levels, non-prescription opioid use, and adherence to BNX. Follow-up data was gathered from 138 participants. SBI participants had a higher reduction in AUDIT scores at the follow-up (F = 129. 173, df = 1, p < .001, ηp 2 =.469). A higher proportion of participants transitioned to a low-risk category in the SBI group. The SBI group showed a higher reduction in heavy drinking and days of alcohol abstinence. Although the proportion of persons with normal serum GGT increased in both groups, the difference was not significant at the follow-up. The SBI group performed better in non-prescription opioid use and BNX adherence.

Abstract 4128549: Feasibility and Acceptability of a Combined Contingency Management and Problem-Solving Therapy Intervention to Enhance Alcohol Abstinence: A Pilot Single-Arm Mixed Methods Randomized Controlled Trial

Introduction/Background: It is crucial to develop and implement innovative behavior-change therapies that specifically target young adults with alcohol use disorder, as the prevalence of this issue is on the rise, and it has serious long-term health consequences. Research Questions/Hypothesis: How does the newly developed Contingency Management and Problem-Solving Therapy (CM-PST) intervention impact the levels of alcohol misuse or abstinence in young adults at follow-up compared to baseline.Young adults who receive the newly developed CM-PST will have lower levels of alcohol misuse or abstain from alcohol. Goals/Aims: We aimed to examine the feasibility, acceptability, and efficacy of an integrated behavior therapy of CM-PST for young adults with alcohol use disorder. Methods/Approach: This mixed methods study employed a single-arm design with post-intervention and 12-week follow-up assessments. Young adults aged 18-24 were recruited from July 2023 to May 2024. Participants underwent the newly developed integrated CM-PST intervention for 8 weeks. The assessment of feasibility was conducted by evaluating the rates of recruitment and retention, and adherence to the intervention. Acceptability was assessed by analyzing participants’ feedback and engagement data. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and the 90-day Timeline Follow back (TLFB) at baseline and 12 weeks after the intervention. Furthermore, they participated in a twice daily breathalyzer test, post-intervention interview and completed a client satisfaction scale questionnaire. Results: A total of 28 participants were recruited, with 71.43% (20/28) completing all the study procedures. Adherence to the CM-PST was 100%, indicating strong engagement. Participant feedback highlighted the influence of CM on behavior and decision-making and the efficacy of PST in addressing life challenges as well. Alcohol consumption at 12 weeks was significantly lower than those at baseline ( t =3.042, p =.007). Overall, the newly developed intervention was well-received, and 95% of participants indicated that the interventions were acceptable. Conclusions: This study showed that the integrated CM-PST intervention to promote alcohol abstinence and reduce alcohol related problems is both feasible and acceptable. Study findings indicated that the intervention has potential as a supplementary care for individuals seeking support in reducing alcohol consumption.

Evaluating a 30-day alcohol abstinence challenge in heavy-drinking individuals with and without chronic pain: feasibility, safety, and perceived benefits

IntroductionTo combat high-risk alcohol consumption, we introduced a 30-day alcohol abstinence challenge targeted at heavy drinkers with and without chronic pain. Our study aimed to assess the challenge's feasibility and safety and to explore its perceived benefits. Our exploratory aim was to identify participants' coping strategies during the challenge. MethodsOur single-arm study recruited heavy drinkers from a pain clinic and a university setting (n = 34, 64.7% chronic pain). Participants underwent a modified community-based 30-day challenge, which included motivational interviewing, an individualized start date, and weekly phone check-ins. ResultsWe found the 30-day challenge was feasible and safe; 72.3% of eligible heavy drinkers participated in the challenge with no serious adverse events. Most challengers (94.1%) reported some benefit from the challenge, which included improvements in alcohol withdrawal symptoms, sleep, and alcohol abstinence self-efficacy, but not in pain. We identified 25 perceived benefits and 21 coping strategies. ConclusionOur study confirms that a 30-day alcohol abstinence challenge is a feasible and safe intervention for heavy drinkers with and without chronic pain, yielding notable health benefits. The challenge also facilitated the development of effective coping strategies. Future studies should explore the long-term benefits of such interventions in broader outpatient settings.

Preliminary Results of a Voluntary One-Month Abstinence Program on Drinking Refusal Self-Efficacy and Craving

ABSTRACT The aim of this study was to investigate how drinking refusal self-efficacy (DRSE) and craving change and are linked during the participation in the Dry November one-month voluntary abstinence-based program. The present sample consisted of 27 participants who successfully completed the program. Paired sample t-tests indicated significant increase for DRSE and non-significant change for craving by the end of the program. Higher increase in DRSE during the program was correlated with higher craving and lower pre-program DRSE. Future research is needed on a larger sample to investigate the mechanisms among DRSE, craving and alcohol use. However, the findings might indicate the relevance of DRSE in treatments targeting problem alcohol use and maintaining alcohol abstinence.

Excessive alcohol intake produces persistent mechanical allodynia and dysregulates the endocannabinoid system in the lumbar dorsal root ganglia of genetically-selected Marchigian Sardinian alcohol-preferring rats

Epidemiological data indicate a strong association between alcohol use disorder (AUD) and neuropathic pain. Genetically-selected Marchigian Sardinian alcohol-preferring (msP) rats exhibit a high preference for alcohol compared with their background strain (Wistar rats), but their sensitivity to mechanical allodynia after chronic alcohol exposure is unknown. The present study compared the development of mechanical allodynia between “low, non-pathological drinker” Wistar rats and “high drinker” msP rats using the two-bottle choice (2BC) free-access procedure. Several studies reported the involvement of endocannabinoids (eCBs) in modulating mechanical allodynia, but there are no data on their role in alcohol-related allodynia. Thus, the present study assessed eCBs and their related lipid species in lumbar dorsal root ganglia (DRG) and correlated them with mechanical allodynia in our model. We found that male and female msP rats developed persistent mechanical allodynia during protracted abstinence from alcohol, presenting no sign of recovery, as opposed to Wistar rats. This effect directly correlated with their total alcohol intake. Notably, we found a correlation between lower lumbar DRG 2-arachidonoylglycerol (2-AG) levels and the development of higher mechanical allodynia during abstinence in msP rats of both sexes but not in Wistar rats. Moreover, alcohol-exposed and abstinent msP and Wistar females but not males exhibited significant alterations of thromboxane B2 and prostaglandin E2/prostaglandin D2 compared with naive rats. These findings demonstrate that DRG 2-AG metabolism is altered in msP rats during prolonged abstinence and represents a potentially interesting pharmacological target for the treatment of mechanical allodynia during alcohol abstinence.

Post-mortem human brain analysis of the ventral pallidum in alcohol use disorder

ObjectiveAlcohol use disorder (AUD) is characterised by cycles of alcohol misuse, abstinence, and relapse. The neurobiology of AUD strongly implicates the role of the ventral pallidum (VP) in a variety of drugs of abuse, including alcohol. Pre-clinical studies have demonstrated critical role of parvalbumin and calretinin neurons in the VP in modulating relapse, mood, and motivation. However, there are a limited studies examining the VP at the cellular level in AUD in humans. MethodPost-mortem human brain tissue of AUD (n = 11), remission (n = 6), and control brains (n = 12) were processed for immunohistochemistry to examine the presence and changes in parvalbumin and calretinin neurons in the VP. ResultsSimilar to pre-clinical rodent models, parvalbumin and calretinin neurons were present in the VP, although no significant difference was found in their number or morphology across all AUD, remission, and control brains. ConclusionThe presence of parvalbumin and calretinin neurons in the VP was confirmed across all groups. This is particularly important as it supports the translatability of previous animal studies regarding the role of parvalbumin and calretinin neurons in AUD, and thus further implicates the VP in the neurobiology of AUD in humans. As there are no distinctions in the number or morphology of these neurons, their significance likely lies in their activity. The presence of both parvalbumin and calretinin in humans, particularly in both control and AUD cases supports translational capacity from preclinical findings is more feasible.

알코올중독자의 단주자기효능감과 알코올회복이 자활의지에 미치는 영향: 회복탄력성의 매개효과

This study aims to examine how abstinence self-efficacy and alcohol recovery among alcoholics affect their willingness for self-sufficiency, and to elucidate the indirect mediating role of resilience in this relationship. To achieve this, a survey was conducted from October to November 2023, targeting participants from sobriety groups, A.A(Alcoholics Anonymous) members, and patients currently hospitalized. A total of 245 responses were collected, and 217 valid responses, excluding incomplete surveys, were used for the final analysis. The raw data obtained from these surveys were analyzed using structural equation modeling with SPSS and AMOS. The results are as follows: First, abstinence self-efficacy and alcohol recovery significantly influenced willingness for self-sufficiency. Second, the mediating model, which set resilience as a mediator in the relationship between abstinence self-efficacy, alcohol recovery, and willingness for self-sufficiency, was confirmed as a suitable model. Specifically, abstinence self-efficacy and alcohol recovery had significant positive effects on resilience and willingness for self-sufficiency, and resilience significantly influenced the willingness for self-sufficiency. Third, both abstinence self-efficacy and alcohol recovery had direct effects on the willingness for self-sufficiency and had indirect effects through resilience. Based on these findings, effective and practical intervention plans for alcoholics are suggested.

Integrated Stepped Alcohol Treatment With Contingency Management for Unhealthy Alcohol Use Among People With HIV: A Randomized Controlled Trial.

We examined the impact of integrated stepped alcohol treatment with contingency management (ISAT + CM) on alcohol abstinence among people with HIV (PWH) and unhealthy alcohol use. In this multisite 24-week trial, we randomized PWH reporting untreated unhealthy alcohol use and with phosphatidylethanol (PEth) >20 ng/mL to receive ISAT+CM or treatment as usual (TAU). Intervention : Step 1 : Social worker-delivered CM; Step 2 : Addiction physician management plus motivational enhancement therapy. Participants were advanced to step 2 at week 12 if they lacked evidence of abstinence over the prior 21 days. TAU : Health handout, and for those who met criteria for alcohol use disorder, a referral to substance use treatment. Primary outcome: self-reported abstinence for the past 21 days at week 24. We enrolled 120 PWH between January 5, 2018, and March 1, 2022. Mean age was 59 years, 96% were men, and 83% were Black. Eight percent were lost to follow-up. In the ISAT+CM group, 87% were advanced to Step 2. The posterior mean proportion of participants with self-reported abstinence at 24 weeks was higher among those randomized to ISAT+CM [posterior mean proportion 9% (95% credible interval [CrI]: 0%-33%)] compared with TAU [posterior mean proportion 0.3% (95% CrI: 0%-4%)] [posterior mean treatment effect 9%, (95% CrI: 0%-32%)], the posterior probability of TAU being superior to ISAT + CM was <0.0001. ISAT + CM delivered in HIV clinics modestly increased self-reported 3-week abstinence among PWH. Our findings indicate a need for more effective treatments to promote abstinence and a potential role for ISAT + CM for reductions in alcohol use. Clinicaltrials.gov (NCT03089320).

Short-term alcohol abstinence prior to liver transplantation and impact on rejection

Background & AimsAlcohol-associated liver disease (ALD) is a leading indication for liver transplant (LT). Historically, centers implemented 6-month abstinence periods prior to LT listing; however, the impact of this abstinence time on post-transplant rejection outcomes is unclear. This study evaluated if short-term abstinence is associated with increased rejection post-LT. MethodsThis single-center, retrospective, cohort included adult LT recipients from 11/1/2015 to 7/21/2021 with a primary indication of ALD. Patients were grouped by pre-transplant abstinence time of <6 or ≥6-months. The primary endpoint was biopsy proven acute rejection (BPAR) at 12-months post-LT. Secondary endpoints were infection, alcohol relapse, patient and graft survival at 12-months. ResultsOverall, 228 LT recipients met inclusion criteria (<6-months: n = 130; ≥6-months: n = 98). Patients with <6-months of abstinence were younger, had higher MELD scores, and more renal replacement therapy needs. Incidence of BPAR within 12 months of LT was 28 % in the <6-month group vs. 18 % in the ≥6-month group (p = 0.078). Tacrolimus initiation was lower at 7 days post-LT in the <6-month group (77% vs. 89 %; p = 0.029). Delay in tacrolimus initiation past 7 days post-LT was associated with greater BPAR (35% vs. 12 %; p = 0.0001). Increased bloodstream infections (21% vs. 7 %; p = 0.04) and CMV DNAemia (31% vs. 7 %; p = 0.0008) were seen in the <6-month group. Patient and graft survival was similar between groups. ConclusionsAbstinence time of <6-months was not associated with more BPAR within 12-months post-LT. The <6-month group was sicker at time of LT, which correlates to lower tacrolimus exposure early post-LT and heightened incidence of bacteremia and CMV viremia. Given the high acuity of the <6-month abstinence group, the risk of BPAR must be closely balanced with infection risk.

Liver-specific thyroid hormone receptor-β agonism alleviates alcoholic steatohepatitis (ASH) in mice

Alcoholic steatohepatitis (ASH) represents a critical stage in alcoholic liver disease (ALD), which significantly increases the risk of developing alcoholic hepatitis and cirrhosis. Currently, corticosteroids and alcohol abstinence remain the only available strategy to prevent or reverse ASH progression with no FDA approved drug therapy till date. Given the notable pathological similarities between ASH and metabolic dysfunction-associated steatohepatitis (MASH), repurposing drugs approved for MASH presents an attractive therapeutic approach to treat ASH. In this context, we evaluated the efficacy of Resmetirom, a recently approved drug for MASH, in a mouse model of ASH. Our findings demonstrate that Resmetirom, a liver-specific thyroid hormone analog, not only reduces hepatic steatosis but also markedly alleviates liver injury, oxidative stress, and inflammation associated with ASH. In summary, this study provides a proof-of-concept for the potential use of MASH drugs in treating ASH and establishes a foundation for future testing and clinical trials of Resmetirom, in patients with ASH.