Alcohol-related Disabilities Research Articles

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EFFECT OF NARINGENIN (CITRUS FLAVANONE) ON LIPID PROFILE IN ETHANOL-INDUCED TOXICITY IN RATS

ABSTRACT Our aim was to investigate the effect of naringenin on hyperlipidemia induced by ethanol. Groups 1 and 2 rats received isocaloric glucose and 0.5% carboxymethyl cellulose (CMC); groups 3 and 4 received 20% (6 g/kg body weight p.o.) ethanol everyday for 60 days. Groups 2 and 4 rats received naringenin (50 mg/kg body weight/day in 0.5% CMC) everyday during the last 30 days of the experiment. There were increased levels of plasma total cholesterol (TC), triglycerides (TG), free fatty acids (FFA), very low density lipoproteins (VLDL), low density lipoproteins (LDL) and tissue TC, TG, FFA, HMG CoA reductase and alterations in collagen content of ethanol-fed rats, which on naringenin supplementation showed decreased levels of plasma and tissue TC, TG and FFA, HMG CoA reductase and collagen content. There was a significant decrease in the levels of plasma high density lipoprotein (HDL), lipoprotein lipase (LPL) and lecithin cholesterol acyltransferase (LCAT) of ethanol-fed rats, which on naringenin supplementation showed an increase in the levels of HDL and LPL with ethanol alone–fed rats. Naringenin can efficiently prevent the accumulation of plasma lipids and lipoproteins. PRACTICAL APPLICATIONS Alcohol abuse, alcohol intolerance, alcohol dependence and other alcohol related disabilities are some of the most challenging public health problems. A phytotherapeutic approach in the new drug development can provide many valuable drugs from traditional plant sources. The use of herbal medicines for the treatment of hepatotoxicity has gained importance throughout the world. Renewed attention to alternative medicine and natural therapies has stimulated new wave of research interest in traditional practice, and there is a need to look for more potent agents with lesser side effects. The present study is aimed to identify the efficacy of naringenin by uncovering its underlying mechanism of action against alcohol-induced liver disease for effective therapy. Naringenin, an important flavonoid, is widely present in fruits and vegetables. Naringenin is known to possess a number of significant beneficial properties. If the biochemical and histological findings are positive, indicating the marked hepatoprotective efficacy of naringenin, it could be subjected to human trials in the future.

Social Welfare Policy and Public Assistance for Low-Income Substance Abusers: The Impact of 1996 Welfare Reform Legislation on the Economic Security of Former Supplemental Security Income Drug Addiction and Alcoholism Beneficiaries

Prior to January 1, 1997, individuals with drug- or alcohol-related disabilities could qualify for federal public assistance through the Supplemental Security Income (SSI) program. During the welfare reforms of the Clinton administration, this policy was changed, resulting in lost income and health care benefits for many lowincome substance abusers. This paper examines the historical underpinnings to the elimination of drug addiction and alcoholism (DA&A) as qualifjing impairments for SSI disability payments. Following this, empirical evidence is presented on the effect this policy change had on the subsequent economic security of former SSI DA&A beneficiaries. Findings indicate that study participants who lost SSI benefits suffered increased economic hardship folloving the policy change. These findings have important implications for future social welfare policymaking decisions.

How the 1977 World Health Organization report on alcohol‐related disabilities came to be written: a provisional analysis

In 1977 the World Health Organization (WHO) published a report entitled 'Alcohol-Related Disabilities'. The crucial contribution of this report was to differentiate between alcohol dependence, on one hand, and alcohol-related disabilities (or problems) on the other hand. Essentially, it offered a bi-axial mapping of the field of concern. This paper seeks to identify the multiple influences which shaped the evolution of this report. Use is made of unpublished archival material and recall of personal involvement, together with relevant published material. Three major influences made it possible to move beyond the confines of previous WHO thinking on alcohol: the multi-disciplinary nature of the input; the internationality of the enterprise; and the expectations set that the concepts developed should speak to the practical world. The arena of drug and alcohol policy has, for more than a century, been rich in its reports. This case study, although limited in its immediate content, points to the need for further analysis of the history of such reports.

Fetal Alcohol Spectrum Disorders: Understanding the Effects of Prenatal Alcohol Exposure and Supporting Students

Fetal Alcohol Spectrum Disorders (FASD) affect a significant number of children in this country. This article addresses diagnostic issues related to fetal alcohol syndrome (FAS) and other alcohol-related disabilities, discusses associated features and behaviors of FASD, and introduces interventions to support children with FASD in school settings. A comprehensive review of FAS and FASD literature as it relates to school functioning was conducted. Prenatal alcohol exposure can result in a broad range of negative developmental consequences, including deficits in cognitive and academic functioning, psychological disorders, behavioral problems, and difficulties with independent living. Children with prenatal alcohol exposure are at risk for a spectrum of difficulties at school. This topic is of considerable relevance to all professionals in a school setting, including teachers, administrators, school psychologists, special education providers, special service providers, and school nurses who interact with children who may be prenatally exposed to alcohol. Successful interventions will need to balance the use of environmental modifications, immediate and meaningful positive and negative consequences for behaviors, and opportunities to teach children skills to monitor and modify their behavior.

Motives for Fostering Children with Alcohol-Related Disabilities

A sample of 63 licensed foster parents was asked, “What motivates you to foster a child who has a fetal alcohol spectrum disorder?” The responses to this question were grouped together by licensed foster parents. The grouped data were subjected to multidimensional scaling and cluster analysis. Results indicated that foster parents were motivated to care for children with alcohol-related disabilities by witnessing positive changes in the children in their care, helping children focus on their strengths, using their own parenting experience, earning an income, assisting children who have disabilities, and helping children stay connected to their families and communities. Foster parents who foster children with alcohol-related disabilities foster for similar reasons to those who foster children with special needs in general. Differences between the literature on foster parent motives and study results were described. Foster parents who are caring for children with alcohol-related disabilities see their care as specialized, see their roles as long-term helpers facilitators to children, their birth families and home communities, and emphasize positive experiences of fostering.

Are Attempts at Moderate Drinking by Patients with Alcohol Dependency a Form of Russian Roulette?

In 1962, Davies reported on 7 male patients who showed habits, out of a total of 93 addicts as defined by the WHO at the time (1). All 7 patients had achieved a period of complete abstinence ranging from a few months to a year before taking up normal for a period ranging from 7 to 11 years. Follow-up included outpatient attendances, contact by a social worker, and correspondence with relatives. Davies' paper received 17 critical commentaries the same journal. They included the following statements: in many years of practice, we never encountered a true alcoholic recovering the ability to drink normally, drinking resumption was a freak anomaly of human biochemistry or psychopathology, these patients may have been genuine alcoholics but not genuine drinkers, and was simply a prelude to full relapse. While Davies was not the first to report this phenomenon, he was the first to give it prominence the paper's title, hence, the widespread reaction. In 1981, Heather and Robinson marshalled the related evidence their book Controlled Drinking (2). The notion of by previously identified individuals with alcoholism essentially contradicted the dominant concept of alcoholism as an irreversible disease characterized by loss of control, that is, by the inability to stop once commenced, as described by Alcoholics Anonymous (AA, 3)-a trait later adopted by Jellinek as a characteristic of the gamma alcoholic (4). In Heather and Robinson's view, loss of control described rather than explained alcoholic drinking. Throughout, a conceptual dichotomy differentiated between individuals suffering from the disease of alcoholism and those whose might be abnormal quantity and harmful but who were not diseased. Modern versions of this dichotomy have been adopted by Edwards and others their delineation of the alcohol dependence syndrome as part of a range of alcohol-related disabilities (5). In its criteria for alcohol dependence vs alcohol abuse, the DSM-IV TR nosology reflects a similar range (6), as does the ICD-IO differentiation between dependence and harmful use (7). The Debate Today Fast-forwarding some 25 years, the professional debate the field does not, my opinion, seem to elicit as much passion as it once did, owing to several developments. The first development is recognition that the terms used required further definition. Heather and Tebbutt proposed that the definition of controlled (CD) should include some limit on the amount and frequency of consumption (that is, a maximum of 3 oz of alcohol daily) and the condition that the does not result signs of dependence (that is, withdrawal syndrome) or social, legal, and health problems (8). At present, the term drinker is increasingly replaced by the nosological dichotomies (based on DSM and ICD criteria) of abuse or harmful use and dependence. The second development is increased consensus that abstinence remains the preferred, safer outcome for individuals with alcohol dependency. However, several studies report resumption of controlled drinking, with prevalence estimates ranging from 2% to 30%, depending on definitions. Miller undertook a comparative analysis of 4 samples (n = 140) of media-recruited problem drinkers who self-referred for behavioural self-control training (9). Of the original 140 cases, 99 (71%) were accounted foras follows: at 3.5,5.0,7.0, and 8.0 years, respectively, 23 were abstinent, 14 reported controlled and asymptomatic drinking, 22 were improved but still impaired, 35 were unremitted, and 5 were deceased. Most of the long-term controlled drinkers had established their pattern within the first year of follow-up, but maintenance of this pattern could not be reliably predicted (9). Related to abstinence is the so-called dry syndrome. Dry drunk is a lay term used by AA to describe an individual with alcoholism who has stopped but who may still be suffering many of the emotional symptoms common to actively alcoholism sufferers (3). …

Fetal exposure to alcohol as evidenced by fatty acid ethyl esters in meconium in the absence of maternal drinking history in pregnancy.

The detection of fatty acid ethyl esters (FAEE) in neonatal meconium has been proposed as a novel screening method for intrauterine exposure to alcohol. We investigated the potential use of meconium FAEE screening in a high-risk neonatal population in the absence of maternal drinking history. One hundred forty-two meconium samples of neonates suspected of intrauterine illicit substance exposure and referred to the Motherisk Laboratory were analyzed for the existence of drugs by enzyme-linked immunosorbent assay (ELISA) and FAEE by gas chromatography-flame ionization detection (GC-FID). A positive FAEE test was previously defined as a cumulative measurement of 7 individual FAEE > or = 2 nmol/g. Seventy-one percent of the samples tested positive for at least 1 illicit drug, with cannabis being the most prevalent (52.3%). Fourteen percent of all samples tested positive for prenatal alcohol exposure, as evidenced by cumulative meconium FAEE > or = 2 nmol/g. Ethyl oleate, linoleate, palmitate, and arachidonate were detected most often and at the highest levels. At least 3 individual FAEE were detected in 95% of all positive samples, and none could be identified by the use of 1 selected FAEE. Significantly elevated levels of FAEE above the baseline and the presence of multiple FAEE species in meconium are exclusive to neonates who have likely been exposed to excessive amounts of alcohol in utero. Babies born to mothers who are suspected to use illicit drugs in pregnancy are at elevated risk for exposure also to alcohol in utero. Meconium FAEE are emerging biologic markers that can potentially facilitate earlier diagnosis and intervention for less apparent forms of alcohol-related disabilities that cannot be confirmed in the absence of maternal drinking history.

Disabling the public interest: alcohol strategies and policies for England.

Disabling the public interest: alcohol strategies and policies for England.

Alcohol abuse: prevalence and detection in a general hospital

Despite a high prevalence of alcohol-related disabilities and the availability of cost-effective interventions, alcohol abuse and dependence commonly go undetected in hospital inpatients. In a university teaching hospital we compared three well validated screening methods for sensitivity and specificity-the Alcohol Use Disorders Identification Test (AUDIT, with various cut-off scores), CAGE (a four-question screening tool), and a 10-question version of the Michigan Alcoholism Screening Test (BMAST). A subset of patients also completed the DSM IV structured clinical interview for diagnosis. 1133 adult patients were randomly selected from all hospital admissions, with exclusion of day cases and patients too ill to be interviewed. Two-thirds of the patients were interviewed, most of the remainder being unavailable at the time. 30% of the men and 8% of the women met the DSM IV criteria for alcohol abuse or dependence. Sensitivities and specificities of the screening tools were as follows: AUDIT (with cut-off score >8) 89% and 91%; CAGE 77% and 99%; BMAST 37% and 100%. 255 case records of patients scoring above the cut-off on one or more questionnaires were subsequently reviewed. The admitting team recognized an alcohol problem in only 46, of whom 17 were referred for appropriate follow up. As in previous hospital surveys, alcohol abuse and dependence was not receiving proper attention. The most efficient screening tool was the CAGE questionnaire.

Variable Structure/ Variable Performance

Families of children with alcohol-related disabilities report difficulty choosing the most appropriate educational support services for their children. A case study of a school-age boy with a diagnosis of fetal alcohol syndrome is presented to explore the parent's and teacher's viewpoints about the best educational program for him. During open-ended interviews, the child's mother and teacher described his strengths and challenges differently, ultimately leading to disagreement about the most appropriate educational placement and supports for this child. Analysis of these interviews indicated that differences in environmental structure and adult expectations for child behavior across the home and school settings are one likely source for these diverse viewpoints. These results suggest that intervention planning must take into account this child's variations in performance across contexts. Recommendations for positive behavioral supports are provided to facilitate the child's performance across home and school settings.

The prevention paradox revisited.

The contribution of heavy and moderate drinkers, respectively, to the rate of alcohol problems in society is evaluated for different types of risk functions. It is demonstrated that if the risk function is linear, the moderate drinkers will be responsible for the bulk of the problems. When the risk function is curved upwards, the heavy drinkers contribute a larger share of the problem. However, the risk function needs to be quite strongly curved before the majority of the problems can be attributed to the heavy drinkers. These calculations are based on certain empirically motivated assumptions about the distribution of the consumers along the consumption scale. The results suggest that the validity of the prevention paradox depends very much on the shape of the risk function, and hence that the role of the moderate drinkers may vary a lot across the spectrum of alcohol-related disabilities. For disabilities where the risk curve has a pronounced threshold-like form, the prevention paradox cannot be expected to apply. However, the role of the moderate drinker could be expected to be more significant for disabilities with a smoother and less convex risk curve. Accidents and social problems seem to fulfil the latter qualification, because the causal mechanism underlying such problems are connected to rates of acute intoxication, rather than to annual intake per se.

Psychiatric Emergencies: The Check Effect Revisited

Federal income support to persons with alcohol and drug related disabilities was ended in 1997. The argument for ending the programs was that recipients were using their benefits to purchase drugs and alcohol. This supposedly led to the "check effect," an increase in psychiatric emergencies in American communities in the days following the receipt of disability benefits. We test two hypotheses implied by this argument. The first is that psychiatric emergencies are elevated in the fourth through eighth day of the month. The second is that the excess of emergencies in these days was significantly reduced when benefits were ended. The tests are based on 35,500 psychiatric emergencies in San Francisco, California occurring over 1,551 days. Results support the first hypothesis but not the second. The implications are that there is a general check effect and that it was not reduced by ending benefits to persons with drug and alcohol related disabilities.

The changes in the social class distribution of moderate and high alcohol consumption and of alcohol-related disabilities over time in Stockholm County and in Sweden

The changes in the social class distribution of moderate and high alcohol consumption and of alcohol-related disabilities over time in Stockholm County and in Sweden

The changes in the social class distribution of moderate and high alcohol consumption and of alcohol-related disabilities over time in Stockholm County and in Sweden

The purpose of this paper was to analyse the role of social class concerning changes in alcohol consumption and severe alcohol-related problems from the end of the 1960s to the 1990s in Stockholm County, and in the whole of Sweden for consumption. Survey data showed that the prevalence of moderate and/or high alcohol consumption in adults of both sexes was highest among non-manual employees at medium and high level, in 1967 as well as in 1980 in the whole of Sweden. After 1980, an equalization occurred. A similar change in the social class pattern of alcohol consumption was noted in young people. We analysed all 36,404 male and 10,648 female hospitalizations and all the 3175 male and 713 female deaths with a diagnosis of alcoholism, alcohol psychosis or alcohol intoxication in Stockholm County during 1970-86 (1970-84 for mortality) linked to individual census data. There was a greater increase in rates among women than among men, especially among women outside the labour market. We found pronounced social class differences between manual and non-manual employees, which widened up to 1986 (1984 for mortality)-a period with an initial increase and a subsequent decrease in alcohol consumption. Thus, the changes in consumption and alcohol-related problems developed differently in principal social classes over time, suggesting that an expanded theory on alcohol consumption in the population should take socio-economic factors into account.

Alcohol dependence: is carbohydrate-deficient transferrin a marker for alcohol intake?

We investigated %CDT (carbohydrate-deficient transferrin) in 92 ethanol-intoxicated alcohol-dependent patients after consecutive admission to hospital and followed the for 28 days under controlled conditions. At admission, 63% (58 patients) showed elevated CDT (> 2.5%) and 34 patients (37%) had normal CDT levels (< 2.5%). No correlation of the %CDT values to alcohol-related disabilities, severity of the withdrawal syndrome, alcohol-drinking pattern before admission, or several other factors was found. The sensitivity of GGT (gamma-glutamyl transferase) was 58% for the same group of patients. Levels of %CDT decreased during the 28 days following abstinence, whereby we could separate four statistically different groups of "CDT decrease'. In two of these groups, comprising most of the cases studied, normal %CDT levels were reached after 14 days of abstinence. Those patients with %CDT levels exceeding the upper normal level after 14 days of sobriety, showed a decrease during the following 14 days to levels of 2.55-2.61%.

Structure of the MAST with an Australian sample of alcoholics

The dimensionality of the Michigan Alcoholism Screening Test (MAST) was examined utilizing an Australian sample (n = 196) of alcoholics. This study was specifically designed to overcome some of the problems with sampling and analytic techniques used in previous studies. Three moderately intercorrelated factors were revealed which covered (a) alcohol-related disabilities; (b) help-seeking behaviour and (c) recognition of a drinking problem. These factors were found to be internally consistent as shown by moderate to high alpha coefficients. Results indicate that the additive system of scoring all 24 items may result in an underestimation of the information afforded by the MAST.

Six Horsemen ride out: WHO initiates a new programme on substance abuse

British Journal of AddictionVolume 86, Issue 11 p. 1387-1390 Free Access Six Horsemen ride out: WHO initiates a new programme on substance abuse First published: November 1991 https://doi.org/10.1111/j.1360-0443.1991.tb01716.xCitations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References Arif, A. (1990) Interview, in: G. Edwards, (Ed.) Addictions: Personal Influences and Scientific Movements, pp. 25– 36 ( New Brunswick , Transaction Publishers). Eddy, N. B., Halbach, H., Isbell, H. & Servers, M. A. (1965) Drug Dependence: its significance and characteristics, Bulletin of the World Health Organization, 32, pp. 721– 733. G. Edwards, M. M. Gross, M. Keller, J. Moser & R. Room, (Eds) (1977) Alcohol-related Disabilities, Offset Publication No. 32 ( Geneva , WHO). Edwards, G. & Arif, A. (1980) Drug Problems in the Sociocultural Context: a basis for policies and programme planning ( Geneva , WHO). Ghodse, H. & Khan, I. (1988) Psychoactive Drugs: improving prescribing practices ( Geneva , WHO). Lowes, P. D. (1966) The Genesis of International Narcotics Control ( Geneva , Libraire Drog). Moser, J. (1974) Problems and Programmes Related to Alcohol and Drug Dependence in 33 countries, Offset Publication No. 6 ( Geneva , WHO). Moser, J. (1990) Interview, in: G. Edwards, (Ed.) Addictions: Personal Influences and Scientific Movements, pp. 3– 24 ( New Brunswick , Transaction Publishers). Porter, L., Arif, A. E. & Curran, W. J. (1986) The Law and Treatment of Drug and Alcohol-dependent Persons: a comparative study of existing legislation ( Geneva , WHO). Ritson, E. B. (1985) Community Response to Alcohol-related Problems ( Geneva , WHO). Ritson, B. (1988) Who publications provide a very useful service, British Journal of Addiction, 83, pp. 241– 243. Who (1967) Services for the Prevention and Treatment of Dependence on Alcohol, Technical Report Series No. 363 ( Geneva , WHO). Who (1981) Nomenclature and classification of alcohol- related problems, Bulletin of the World Health Organization, 59, pp. 225– 242. Who (1990) Programme on Substance Abuse, Draft 2 ( Geneva , WHO). Citing Literature Volume86, Issue11November 1991Pages 1387-1390 ReferencesRelatedInformation

The effect of financial management on alcohol-related hospitalization

Treatment-unresponsive alcoholics in New Zealand who are unable to care for themselves tend to be hospitalized for lengthy periods of time. The author examined the effect of adding financial management to the therapeutic management of such patients. The null hypothesis was that this would have no effect on the duration of alcohol-related hospitalization. All 61 alcoholic patients registered with an alcohol outpatient clinic who received financial management over a period of 6 years were included in the study. Their alcohol-related disabilities were so severe that they had resulted or were likely to result in lengthy or frequent periods of hospitalization. The financial management involved putting each patient's income into a checking account for which a budget advisory officer was cosignatory for withdrawals. The advisor saw to it that patients' basic living requirements were being met and that expenditure on alcohol was not having a detrimental effect. Participation was voluntary for voluntary patients and involuntary for committed patients. The durations of each patient's alcohol-related hospitalizations were compared for two equal periods of time before and after financial management was instituted. The null hypothesis was not supported. The duration of alcohol-related hospitalizations after financial management was instituted was 86% less than it was before such management. For the patient who is struggling in the face of excessive drinking to cope with the tasks of daily living, including the provision of adequate shelter and nutrition, the benefits of adding financial management to other therapeutic strategies should be considered.

Michigan Alcoholism Screening Test (MAST) — Its possibilities and shortcomings as a screening device in a pre-selected non-clinical population

A statistical analysis of the MAST scores obtained by its administration to industrial workers, hospitalized alcoholics and persons arrested driving while intoxicated has been performed. The author discusses the modalities and possibilities of improving the test reliability which will increase its efficiency in the screening of alcohol related disabilities. A further study of the inconsistencies in the administration of the MAST along with its validation is planned.