Alcohol-related Experiences Research Articles

Sleep and Alcohol Use Among Veterans Living With Long COVID.

Study objectives were to: (1) better understand sleep experiences and unhealthy alcohol use among Veterans with long COVID and (2) explore providers' perceptions of barriers and facilitators to delivering evidence-based care for sleep problems and unhealthy alcohol use in patients with long COVID. VA electronic health records were used to conduct chart reviews (n = 57) of patients evaluated in a VA COVID-19 Recovery Clinic during 1 calendar year; semi-structured interviews were completed with Veterans (n = 5) and clinicians (n = 7) recruited from the clinic. Veteran participants also completed quantitative, self-report measures assessing sleep- and alcohol-related experiences and behaviors. Data from chart reviews and interviews suggested that Veterans with long COVID often had pre-existing sleep problems that were exacerbated during long COVID. Patients and providers agreed that sleep interventions would be beneficial and acceptable in the COVID-19 Recovery clinic. Conversely, few Veterans with long COVID had a pre-existing alcohol use disorder (AUD) diagnosis; alcohol use occurred less frequently and was less often discussed between patients and providers. Providers had mixed viewpoints on delivering alcohol-related care in the clinic; some were highly amenable, others were unsure whether patients would be receptive. This study is among the first to take a mixed-method approach to understanding experiences of sleep-wake behaviors and unhealthy alcohol use in Veterans with long COVID. Characterizing sleep and alcohol-related experiences, examining associations with functioning, and exploring perspectives on treatment approaches is critical to support efforts to refine, personalize, and optimize evidence-based sleep and alcohol care for Veterans living with long COVID.

Incorporating Social Networks and Event-Specific Information in a Personalized Feedback Intervention to Reduce Drinking Among Young Adults.

To correct risky alcohol use among young adults, current personalized feedback interventions (PFIs) use social influence information related to distal referent groups. Although current PFIs have been effective, little consideration has been given to strategies applying more concrete sources of social influence, namely the influence of specific people within one's social network during actual drinking contexts. The current study evaluated a novel PFI, providing feedback regarding the presence or absence of particular individuals within a participant's close network along with the number of drinks consumed and consequences experienced during several specific drinking occasions. TurkPrime users (N = 338) identified five close others with whom they sometimes drank. They also provided details about their five most recent drinking occasions and noted which of their network members were present. Participants were then randomized to receive or not receive feedback consisting of a list of drinking events, negative consequences and who was present. Feedback participants intended to consume fewer drinks over the next month relative to control (b = -0.25, P = 0.001). Analyses were inconclusive as to whether this effect was stronger for those who received more feedback (b = -0.01, P = 0.857). Results provide preliminary support for the efficacy of a novel social influence-based intervention, which provides personalized feedback indicating social contexts that are more and less likely to lead to negative alcohol-related experiences.

Alcohol risk perception and the risk target. Results from a survey among the Polish adult population

Employing a nationally representative sample (n = 2,000), this research investigated how specific beliefs about alcohol along with alcohol-related experiences relate to personal and general alcohol risk perceptions in Poland. Multiple hierarchical logistic regression models were performed to assess the impact of demographic and alcohol-related variables including alcohol consumption and beliefs about the benefits and hazards of drinking. In order to understand how the risks associated with alcohol consumption are viewed, we draw on the concept of ‘risk target’. Respondents tended to perceive the level of general alcohol risk to be higher than the personal risk. We were able to confirm that drinkers tend to be clearly overoptimistic towards alcohol risks, and that those who consume more alcohol rate the personal risks to be higher. Individuals who experienced the need to cut down their drinking were more concerned by alcohol risks. The same was true for people who have known someone with an alcohol problem, in terms of general risk. We also found that risk perceptions were affected by beliefs about the harmful and protective functions of drinking which shows the importance of providing substantive knowledge on alcohol risk to individuals expected to make informed choices about their drinking. All in all, most of the explanatory variables significantly influenced general risk perception while the analyses of personal risk perception yielded only a few significant results; the latter did have, however, stronger effects than general risk perception.

Childhood social context in relation to alcohol expectancy through early adolescence: A latent profile approach

BackgroundThe present study aims to (i) identify patterns in the changes of endorsed positive alcohol expectancies (AEs) through early adolescence and (ii) examine associated childhood social context predictors of such profiles. MethodsWe used three waves of longitudinal data from the Alcohol-Related Experiences among Children. The baseline sample comprised 928 6th graders from 17 elementary schools in northern Taiwan (response rate = 60 %); subsequent follow-up was conducted at 7th and 8th grade (follow-up rate = 88 %). Data concerning three domains of positive AEs (i.e., global positive transformation, enhancing social behaviors, and promoting relaxation), social context, and alcohol drinking were collected by self-administered questionnaires. Longitudinal latent profile and survey multinomial logistic regression analyses were used to evaluate the association estimates, stratified by childhood alcohol initiation. ResultsThree distinct profiles (decreasing, stable, and increasing) of positive AEs were identified for the alcohol-naïve children (n = 466); observing paternal drinking and watching TV more than two hours per day at baseline were strongly linked with the stable and increasing AE profiles (aOR = 1.96–4.80). For the alcohol-experienced children, four profiles (low decreasing, low increasing, high decreasing, and high increasing) emerged; observing maternal drinking was predictive for the high-increasing profile (aOR = 2.94). Regardless of childhood alcohol initiation, recent alcohol use appeared to be the strongest predictor for the increasing profiles of positive AEs. ConclusionsStrategies addressing pro-alcohol social contexts that facilitate a prominent increase in positive AEs should be considered when devising preventive programs targeting underage drinking behaviors and problems.

Family and school social capitals in late childhood predict youthful drinking behaviors and problems

BackgroundThe present study aims to investigate the connection linking late childhood’s family- and school- social capitals with subsequent alcohol drinking and problems. MethodsData were obtained from the Alcohol-Related Experiences among Children survey in Taiwan. A total of 928 6th graders (age 11–12) were recruited from 17 elementary schools in an urban region in 2006 (response rate = 61.0%wt); follow-ups were conducted at 8th grade (n = 783, follow-up rate = 82.6%wt) and young adulthood (age 18–19; n = 645, follow-up rate = 68.0%wt). Information concerning family social capital, alcohol drinking, and teacher–student relationship was collected by self-administered questionnaires; school social capitals were assessed via questionnaires and official statistics. Multilevel logistic regression analyses were used to evaluate relationship estimates. ResultsAt 8th grade, nearly one in ten reported having drunk alcohol on four or more occasions (i.e., occasional drinking) in the past year; and 14% reported past-month binge drinking in young adulthood. Effects of family social capital differed by developmental stage; parental involvement appeared prominent in reducing occasional drinking only in adolescence (adjusted Odds Ratio [aOR] = 0.54). School social capital (e.g., teacher–student ratio) was salient in shaping alcohol involvement in adolescence (occasional drinking: aOR = 0.80, 95% CI = 0.63–0.98) and young adulthood (binge drinking: aOR = 0.71, 95% CI = 0.67–0.86). ConclusionsOur findings warrant future research on social capitals at family- and school- levels in late childhood, and inform preventive strategies targeting alcohol drinking and problems in young people.

Media alcohol advertising with drinking behaviors among young adolescents in Taiwan

ObjectivesTo investigate potential effects of alcohol ads in six major marketing channels on drinking behaviors among young adolescents in Taiwan. MethodsThe data were derived from the Alcohol-Related Experiences among Children study. The baseline sample was comprised of 1926 seventh-eighth graders from 11 public middle schools in Taipei in 2010; follow-up was conducted one year later (follow-up rate=97%). Information concerning individual sociodemographics, family characteristics, exposure to media portrayals of drinking and alcohol ads on major marketing channels, and drinking experience was collected through web-based self-administered questionnaires. Complex survey analyses were used to evaluate the association estimates, with stratification by prior drinking experiences in childhood. ResultsTelevision, in-store displays, and websites are the three most common marketing channels for young adolescents to report past-month alcohol advertising exposure. With statistical adjustment for potential confounders and six market channels, exposure to alcohol ads on television was associated with subsequent increased drinking initiation (adjusted odds ratio [aOR]=2.62; 95% CI=1.14–6.02). For those who have initiated alcohol use in childhood, the exposure to ads on the web (aOR=1.50; 95% CI=1.04–2.15) and radio (aOR=2.58; 95% CI=1.60–4.15) may elevate subsequent risk of occasional drinking. Exposure to media drinking portrayals was not related to subsequent drinking behaviors in this sample. ConclusionsOur results demonstrated that the effects of alcohol advertising on drinking behaviors in early adolescence may differ by marketing channels. Preventive strategies targeting underage drinking should consider restraining marketing channels (e.g., websites and radio) from certain advertising content and placement.

Reluctance to Accept Alcohol Treatment by Alcoholic Liver Disease Transplant Patients: A Qualitative Study.

BackgroundLiver transplantation (LT) is the optimum treatment for patients with end-stage alcoholic liver disease (ALD). However, despite a recognized risk of relapse to harmful drinking, ALD transplant patients are reluctant to use speciality alcohol treatment to support their abstinence, even when offered within the LT context. This study aimed to understand and identify factors contributing to alcohol treatment reluctance by ALD patients undergoing transplantation.MethodsWe conducted an in-depth qualitative study of ALD transplant patients. Minimally structured face-to-face interviews explored participants' alcohol-related experiences and their reasons for not using alcohol treatment during the course of their transplantation. Thematic analysis was used to analyze and interpret interview data to understand treatment reluctance based on participants' experiences.ResultsFive major themes were identified among 3 subgroups of patients (pretransplant and posttransplant abstainers and posttransplant relapsers): (i) the “contract” of mandatory abstinence, (ii) the “gap in the program” involving the lack of candour between patient and staff about alcohol-related matters and the lack of addiction services, (iii) a preference by participants to self-manage their alcohol use disorder, (iv) social support as a facilitator of abstinence and the risk of relapse when social support is diminished, and (v) the fear of stigmatization. Each of these factors were dynamically interrelated and differed slightly for each subgroup.ConclusionsThe LT services may benefit from the inclusion of integrated specialist addiction services in their model of care. Such an approach may enhance the acceptability of alcohol treatment and reduce the risk of relapse among ALD transplant participants, especially for those whose social supports have diminished.

Negative evaluations of negative alcohol consequences lead to subsequent reductions in alcohol use.

Alcohol use during young adulthood may reflect a learning process whereby positive and negative alcohol-related experiences and interpretations of those experiences drive subsequent behavior. Understanding the effect of consequences and the evaluation of consequences could be informative for intervention approaches. The objective of this study was to examine the extent to which the number of positive and negative alcohol consequences experienced and the evaluation of those consequences predict subsequent alcohol use and consequences in college students. Students at 3 colleges (N = 679) completed biweekly web-based surveys on alcohol use, positive and negative consequences, and consequence evaluations for 2 academic years. Hierarchical linear modeling tested whether consequences and evaluations in a given week predicted changes in alcohol use and consequences at the next assessment. Moderation by gender and class year were also evaluated. Evaluating past-week negative consequences more negatively than one's average resulted in decreases in alcohol use at the next assessment. More negative evaluation of negative consequences was followed in the subsequent observation by a higher number of positive consequences for females but not for males. A higher number of positive consequences in a given week was followed by a higher number of both positive and negative consequences in the subsequent observation. Number of negative consequences experienced and evaluation of positive consequences had no effect on later behavior. Salient negative consequences may drive naturalistic reductions in alcohol use, suggesting the possible efficacy of programs designed to increase the salience of the negative effects of alcohol.

A prospective study of alcohol advertisement on alcohol experiences among adolescents in Taiwan

Aims: Alcohol advertisement has been indicated as an important factor shaping youngster’s decision to drink. This study aims to investigate the association between alcohol ads with drinking intention and behaviors among adolescents in Taiwan. Methods: The data were derived from the Alcohol-Related Experiences among Children II. The baseline sample comprised 1926 7th to 8th graders from 11 public middle schools in Taipei by multi-stage sampling; follow-up was conducted in 9th grade (follow-up rate =97%). Data concerning sociodemographic and family characteristics, exposure to alcohol ads on eight marketing channels, and drinking experiences were collected by web-based self-administratedquestionnnaires. Complex survey analyseswere used to evaluate the predictors for drinking behaviors in 9th grade, with stratification by prior drinking experiences in childhood. Results: Approximately 45% students had tried alcoholic beverages at least once in 7th grade. Annual incidence of alcohol initiation was estimated 18%. 90% of adolescents were exposed to alcohol ads on television in 7th grade, and the estimates for pamphlets andwebsite was 27% and 68%, respectively. After statistical adjustment for potential confounders at baseline, exposure to alcohol ads on pamphlets, television, website, and stores was significantly linkedwith subsequent alcohol initiation (aOR=1.3–3.4); continued drinking was only linked with pamphlet ads (aOR=1.2). Website alcohol ads exposure may increase future drinking intention in noncurrent drinkers by 46–50%. Conclusions: Our results demonstrate that alcohol advertisement on marketing channels may have differential effects on youngsters’ involvement of drinking behaviors and intention through early adolescence. Preventive strategies targeting underage drinking should consider restrain marketing channels from certain advertising content (e.g., website). Financial support: This work was supported by the Ministry of Science and Technology to Chen, C.

Evidence for anhedonia in early recovery from prescription opiate addiction: Affect modulated startle response suggests blunted hedonic responses to natural reward cues

Aims: Alcohol advertisement has been indicated as an important factor shaping youngster’s decision to drink. This study aims to investigate the association between alcohol ads with drinking intention and behaviors among adolescents in Taiwan. Methods: The data were derived from the Alcohol-Related Experiences among Children II. The baseline sample comprised 1926 7th to 8th graders from 11 public middle schools in Taipei by multi-stage sampling; follow-up was conducted in 9th grade (follow-up rate =97%). Data concerning sociodemographic and family characteristics, exposure to alcohol ads on eight marketing channels, and drinking experiences were collected by web-based self-administratedquestionnnaires. Complex survey analyseswere used to evaluate the predictors for drinking behaviors in 9th grade, with stratification by prior drinking experiences in childhood. Results: Approximately 45% students had tried alcoholic beverages at least once in 7th grade. Annual incidence of alcohol initiation was estimated 18%. 90% of adolescents were exposed to alcohol ads on television in 7th grade, and the estimates for pamphlets andwebsite was 27% and 68%, respectively. After statistical adjustment for potential confounders at baseline, exposure to alcohol ads on pamphlets, television, website, and stores was significantly linkedwith subsequent alcohol initiation (aOR=1.3–3.4); continued drinking was only linked with pamphlet ads (aOR=1.2). Website alcohol ads exposure may increase future drinking intention in noncurrent drinkers by 46–50%. Conclusions: Our results demonstrate that alcohol advertisement on marketing channels may have differential effects on youngsters’ involvement of drinking behaviors and intention through early adolescence. Preventive strategies targeting underage drinking should consider restrain marketing channels from certain advertising content (e.g., website). Financial support: This work was supported by the Ministry of Science and Technology to Chen, C.

Adult Binge Drinking: Childhood Sexual Abuse, Gender and the Role of Adolescent Alcohol-Related Experiences.

This study examines gender differences in the pathway from childhood sexual abuse (CSA) to adult binge drinking. Using longitudinal data on 313 males and females (31-41 years old, mean = 36.21) in the Lehigh Longitudinal Study, we test for gender differences in the pathway from CSA to adolescent drinking, norms and pro-alcohol peers, to adult binge drinking. Controlling for family history of alcohol problems, socioeconomic status (SES) and ethnicity, we found that for females there was a significant direct effect of CSA on adult binge drinking. For males there was no significant direct or indirect effect. Significant effects of family alcohol problems and SES were also moderated by gender. There are gender differences in the impact of CSA on adult binge drinking. Service providers and program developers should pay special attention to the possibility that their female clients may have a history of sexual abuse which could have implications for the course of prevention and treatment services related to binge drinking. Early intervention could prevent alcohol-related risk in adolescence which in turn could reduce, but not eliminate, the binge drinking consequences of CSA for females.

Peers and social network on alcohol drinking through early adolescence in Taiwan

ObjectivesThis study aims to identify peers and social network characteristics associated with drinking occasions through early adolescence. MethodsThe study sample of 1808 middle school students (aged 13–15 years) in northern Taiwan was collected via a two-wave longitudinal study of the Alcohol-Related Experiences among Children (AREC). Data concerning individual sociodemographics, family characteristics, peer influence, and alcohol drinking behaviors were collected via web-based self-administered questionnaire. Building upon the maximum of five friends nominated by young respondents at 7th grade, class-based social network was first constructed via the UCINET and Pajek; the network position (i.e., member, bridge, and isolate) for each student was subsequently ascertained. Complex surveys analyses and negative binominal regression models were used to evaluate concurrent and prospective relationship estimates. ResultsEffects of peers and social network were found to operate differentially by childhood alcohol experience. For the alcohol naïve youngsters, receiving higher peer's nomination at baseline was linked with subsequent increased drinking occasions (adjusted Incidence Rate Ratio [aIRR]=1.06; 95% CI=1.01–1.10), whereas having peers against alcohol drinking may reduce drinking occasions at 9th grade (aIRR=0.59; 95% CI=0.41–0.87). For the alcohol experienced youngsters, having parental alcohol offer, drinking peers, and attending classes of higher drinking norms may increase future drinking occasions by 90%, 80% and 44%, respectively. ConclusionsOur results demonstrated that parental alcohol offer, peer norms, and social network may affect adolescent drinking occasions differentially depending on childhood drinking experience. The findings have implications for the interventions to reduce alcohol consumption in underage population.

What Do Dutch College Students Talk about When They Talk about Alcohol?

OBJECTIVES: Interpersonal communication about alcohol influences alcohol consumption, yet evidence is scarce about the content and valence of alcohol-related conversations and how these concepts predict alcohol consumption. METHODS: By employing a correlational design among Dutch undergraduate students (N = 133), this study measured alcohol consumption predictors and conversational valence and occurrence regarding three topics (personal alcohol-related experiences; alcohol-related experiences of others; and alcohol-related media messages). RESULTS: Results showed that people talk more often and more positively about (personal) alcohol-related experiences than about alcohol-related media messages. In contrast to media messages, whether and how positively people talk about alcohol-related experiences was related to several alcohol consumption determinants. CONCLUSIONS: Health promotion attempts should elicit negative conversations about alcohol-related experiences, thereby resulting in more healthy alcohol consumption predictors. Language: en

NON-RESPONSE BIAS IN A COMMUNITY SURVEY OF DRINKING, ALCOHOL-RELATED EXPERIENCES AND PUBLIC OPINION ON ALCOHOL POLICY

BackgroundThe continuing decline in response rates to household surveys is a concern for the health and social sciences as it increases the risk of selective non-response biasing the estimates of...

Non-response bias in a community survey of drinking, alcohol-related experiences and public opinion on alcohol policy

BackgroundThe continuing decline in response rates to household surveys is a concern for the health and social sciences as it increases the risk of selective non-response biasing the estimates of interest. MethodsWe analysed non-response bias in a postal survey measuring drinking behaviour, experience of harm and opinion on local government alcohol policies among residents in six New Zealand communities. The Continuum of Resistance model, which suggests that late respondents to a survey are most similar to non-respondents on the measures of interest, was used to guide our investigation. ResultsMen, younger people, those of Māori descent and those living in more deprived areas were less likely to respond to our survey than women, older people, those not of Māori descent and those living in comparatively affluent areas. Late respondents more closely resembled non-respondents demographically than early respondents. The prevalence of binge drinking and experience of assault was higher, and support for restrictive local government alcohol policies lower, among late respondents. Assuming the drinking behaviour and alcohol-related experiences of non-respondents were the same as those of late respondents, prevalence was under-estimated by 3.4% (relative difference: 13%) and 2.1% (relative difference: 21%) for monthly binge drinking and assault respectively. Policy support was not over-estimated. ConclusionThe findings add to a growing body of evidence suggesting that surveys under-estimate risk behaviour because of selective non-response and this bias increases as response rates fall. Notably, public opinion may not be subject to such misestimation.

MISSED CALL? A REEXAMINATION OF SPORT FANS' AND NONFANS' ALCOHOL USAGE AND ALCOHOL-RELATED EXPERIENCES

The current investigation attempted to replicate and extend Nelson and Weschler's (2003) research that indicated that college student sport fans were more likely to report problematic alcohol usage and more negative alcohol-related experiences in comparison to nonfans. In addition to utilizing the original study's operational definition of fan (spectator-based), 323 college students were categorized according to more traditional measures of fandom, specifically levels of fan and team identification. Contrary to the previous research, the results indicated that fans' and nonfans' alcohol usage and experiences of negative alcohol-related events were not significantly different. Additionally, both forms of identification (fan and team) failed to predict problematic alcohol usage and negative alcohol-related experiences. Although the results were unaffected by the operational definitions of fan, distinguishing certain subgroups of fans may be important in regards to clarifying and advancing our understanding of the potential relationship between sport and alcohol usage. These distinctions could guide efforts to reduce problematic alcohol usage.

The International society for developmental psychobiology 39th annual meeting symposium: Alcohol and development: beyond fetal alcohol syndrome.

As has been repeatedly demonstrated, alcohol can exert deleterious morphological and physiological effects during early stages in development. The present review examines nonteratological links existing between alcohol and ontogeny. Human and animal studies are taken into consideration for the analysis of fetal, neonatal, infantile, adolescent, and adult responsiveness to the drug. Sensitivity to alcohol's chemosensory and postabsorptive properties, as well as learning and memory processes mediated by such properties, are examined from this developmental perspective. The studies under discussion indicate that, within each stage in development, we can trace alcohol-related experiences capable of determining or modulating alcohol seeking and intake patterns.

Disruption of maternal behavior by alcohol intoxication in the lactating rat: a behavioral and metabolic analysis.

Preweanling rats exhibit clear behavioral signs of distress after interacting with an alcohol-intoxicated dam. Interestingly, behavioral reactivity of infants to the experience of alcohol in the nursing context decreases as a function of repeated alcohol administrations to the mother. In this study, maternal activities were examined when dams were exposed to repeated administrations of a subnarcoleptic alcohol dose. Maternal changes in alcohol metabolism were also analyzed as a function of repeated exposures to the drug. During postpartum days 3, 5, 7, 9, 11, and 13, nursing dams received an intragastric administration of either 2.5 g/kg of alcohol or water. Maternal behaviors were evaluated (experiment 1). Blood alcohol levels (BALs) of the dams were determined on postpartum day 16 after all mothers received either an intragastric (experiment 2) or an intraperitoneal (experiment 3) dose of alcohol. The doses used (2.5 g/kg intragastrically and 1.5 g/kg intraperitoneally) were chosen because they promote similar peak BALs in dams naive to alcohol. Maternal behaviors were strongly affected by the state of intoxication. Nevertheless, these disruptions clearly subsided with progression of alcohol-related experiences (experiment 1). Chromatographic analysis of alcohol metabolism indicated the development of tolerance in dams that had prior experience with alcohol (experiment 2). Changes in BALs as a function of prior experience with alcohol seemed related to first-pass alcohol metabolism rather than hepatic oxidative processes of the drug (experiments 2 and 3). When the dam first experiences a moderate state of alcohol intoxication, maternal behaviors are uniformly disrupted. Subsequent exposures to alcohol lead to maternal metabolic tolerance. In conjunction with previous studies, these data indicate that infantile reactivity to alcohol is dependent on how the members of the dam/pup dyad express or perceive ethanol's postabsorptive effects.

ICAP's LATEST REPORT ON ALCOHOL EDUCATION – A FLAWED PROCESS

I applaud Professor Foxcroft (Foxcroft 2005) in his move to make visible concerns over quality and process in a publication from the International Center for Alcohol Policies (ICAP). His appropriate critiques of the ICAP document (International Center for Alcohol Policies 2004) are largely focused on coverage of alcohol education delivered to young people. The ICAP document also falls well short of adequate scientific standards in its review of ‘Alcohol Education for the General Public’. For example, the paragraph devoted to evidence of effectiveness of public service announcements cites, in support of the statement ‘that such measures can be successful and should be used more widely’ (International Center for Alcohol Policies 2004, p. 2), the authoritative review Alcohol: No Ordinary Commodity (Babor et al. 2003). In fact Babor et al. (2003) assessed the substantial research on public service announcements as showing no evidence of effectiveness. The ICAP paragraph goes on to suggest that ‘while they [PSAs] may not be as useful for young people, there is evidence that they may be helpful in educating parents’ (International Center for Alcohol Policies 2004, p. 2). However, the one reference cited (Hornik et al. 2002) refers to an illicit drug campaign. While Foxcroft fulfils an important task by drawing attention to the scientific inadequacies in the ICAP report, he fails to contextualise the reasons for these inadequacies and therefore concludes optimistically that a significant change is likely to occur in the ICAP publishing operation. However, seen in the broader context of the purpose of ICAP and its publishing agenda, this is not so likely. After analysing previous publications in this series as well as other activities of ICAP, McCreanor et al. (2000; p. 180) argued ‘from a study of its publications and funding . . . ICAP has taken on a specialised (and legitimate task)—the promotion of an industry-favourable alcohol ideology’. The ICAP publication Alcohol Education and Its Effectiveness (International Center for Alcohol Policies 2004) is a further example of this. Looking at the broader picture it appears that ICAP's intention is not, in fact, to publish a robust review of the evidence but rather to produce and disseminate a brief, easily digested, apparently credible, review document which supports the use of an ineffective but popular response to alcohol-related harm. Such a document is of particular value, one imagines, in emerging economies where the race is on to assist the development of a strong drinking culture, by means of ‘consumer education’ by the alcohol industry. The ICAP report rightly acknowledges that ‘an individual's alcohol education encompasses all of the alcohol-related experiences of a lifetime’ (International Center for Alcohol Policies 2004; p. 1). It is regrettable therefore that this review did not deal with the ‘consumer education’ which is taking place throughout the world, using the most sophisticated technologies and creative approaches available (Casswell 2004), calling on enormous financial resources, and successfully increasing the likelihood that young people will begin to drink earlier and drink more (Babor et al. 2003). Ignoring this commercial involvement in alcohol education while reviewing school, family and community programmes and concluding ‘some alcohol education measures have been found to be highly effective . . .’ (International Center for Alcohol Policies 2004; p. 9) seems, not surprisingly, well in keeping with ICAP's ongoing industry-favourable agenda.

Factors affecting entry into substance abuse treatment: Gender differences among alcohol-dependent Alaska Natives

This article reports the results of an investigation of alcohol treatment among Alaska Natives admitted to treatment in Anchorage, Alaska. The time between the age at which they were diagnosed as alcohol dependent and first treatment was similar for men and women. Women were more likely to be parents and reported more contact with health and mental health providers, but these factors were not associated with elapsed time to alcoholism treatment; type of health care professional consulted about problems was associated with elapsed time to treatment for women. Among men, acting as a parent, lifetime depression, and type of professional consulted were significantly associated with elapsed time to treatment. The effect of lifetime depression and parenting on elapsed time to treatment for men raises important questions about the significance of these two factors among other racial and ethnic groups. Key words: access; Alaska Natives; alcoholism; gender differences; treatment ********** Epidemiological studies indicate that alcohol abuse and dependence occur about twice as often among men as among women (Chang, 1997; Weisner & Schmidt, 1992). However, women are underrepresented among individuals entering treatment for alcohol abuse, dependency, and related problems (Beckman, 1994; Dawson, 1996). Although there is some indication that the underutilization of alcohol treatment by women is changing, men have persistently outnumbered women in treatment by a ratio of almost 4:1 (Chang; Weisner & Schmidt). Among individuals in treatment for alcoholism, the proportion of women increased from 22 percent in 1982 to 29 percent in 1993 (U.S. Department of Health and Human Services [DHHS], 1997). This coincided with a similar national increase in specialized treatment services for women (DHHS). Several explanations have been postulated to account for differences in treatment utilization between men and women. Some have focused on the male-oriented characteristics of treatment services that may discourage female participation (Schober & Annis, 1996; Walitzer & Connors, 1997), whereas others have identified gender-specific intrapersonal and social barriers that can impede treatment access (Beckman, 1994; Vogeltanz & Wilsnack, 1997; Weisner & Schmidt, 1992). Research indicates that women are less likely than men to recognize drinking as the source of problems encountered (Beckman; Chang, 1997), and they are more likely than men to seek medical or mental health services where their problems with alcohol are underrecognized (Amodei, Williams, Seale, & Alvarado, 1996; Mendelson & Mello, 1998; Vogeltanz & Wilsnack; Weisner & Schmidt). Fear of stigmatization, shame, and guilt related to drinking and concerns about leaving or losing their children to obtain treatment are additional obstacles more likely confronted by women than men (Beckman). Conversely, men are more likely to be identified for treatment through the criminal justice system (O'Connor, Horwitz, Gottlieb, Kraus, & Segal, 1993) and employee assistance programs (Blume, 1990), to have an alcohol history taken and be identified as alcoholic when seen in medical settings (Amodei et al., 1996; Chang, 1997; Dawson, Dadheech, Speroff, Smith, & Schubert, 1992), and to engage a broader range of helping services for their drinking problems (Weisner & Schmidt, 1992). The differences notwithstanding, men and women are similar in their need for and ability to benefit from treatment. A high degree of consistency has been found across genders in the timing and appearance of alcohol-related life experiences, among treated and untreated alcohol-dependent individuals (Schuckit, Anthenelli, Bucholz, Hesselbrock, & Tipp, 1995). Although women, typically, are reported to initiate drinking at later ages than men (Brady & Randall, 1999), contradictory evidence exists as to whether they also enter treatment earlier (Brady & Randall) or after approximately the same length of drinking history as men (M. …