An Article By Terence T. Gorski
GORSKI-CENAPS Web Publications
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Published On:
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Updated On: August 07, 2001
© Terence T. Gorski, 2001 |
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NIAAA 10th
Special Report
To The U.S. Congress
On Alcohol and Health
Secretary of Health and Human Services
Donna E. Shalala has announced the availability of the 10th Special
Report to the U.S. Congress on Alcohol and Health, produced by the
National Institute on Alcohol Abuse and Alcoholism (NIAAA). The report
highlights recent research advances on the causes, consequences,
treatment, and prevention of alcohol addiction (alcoholism) and alcohol
abuse.
The 492-page report, available in print and
on the internet, documents the scope of alcohol’s impact on society. The
effects range from violence to traffic crashes to lost productivity to
illness and premature death—all of which, combined, cost our nation an
estimated $184.6 billion per year. The report also conveys the rapid
progress of research into the genetic and environmental factors that can
lead to alcohol addiction. Scientists are using these insights to develop
and test new ways of preventing and treating this disease. "Alcohol
problems can yield to scientific investigation and medical intervention in
the same way as other health conditions," writes DHHS Secretary Donna
Shalala in the foreword.
The new report presents advances in alcohol
research since 1997, when the last edition of Alcohol and Health
was published. "This report reflects the tremendous growth in the
scope of alcohol research," according to NIAAA Director Enoch Gordis,
M.D. Contemporary alcohol research spans all life stages—from prenatal
alcohol exposure to drinking problems in the elderly—and applies the
latest methods of basic, epidemiological, clinical, behavioral, and social
sciences research, often in multidisciplinary collaborations. The
following research areas are among those detailed in the 10th
Report:
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Genetics
of alcoholism. Two studies have found evidence of genes on
specific chromosomes influencing susceptibility to alcoholism. The
ongoing Collaborative Study on the Genetics of Alcoholism (COGA),
which involves 987 individuals from high-risk families, reported
suggestive evidence of genes on chromosomes 1 and 7 involved in
alcoholism. An early report from the study also reported weaker
evidence of such a gene on chromosome 2. Another study from
NIAAA’s Laboratory of Neurogenetics, based on 152 members of a
southwestern Native American tribe, reported suggestive evidence for
a gene influencing susceptibility to alcoholism on chromosome 11.
Both studies reported finding evidence of a gene that was protective
against alcoholism in a region of chromosome 4.
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Heavy
drinking during pregnancy and fetal brain development. Applying
advances in neuroimaging and cellular and molecular biology, alcohol
researchers are gaining an increasingly clear picture of the
physical nature of alcohol-induced damage to the developing brain
and the mechanisms that cause the damage. Imaging studies have
demonstrated structural abnormalities in certain brain regions,
whereas other regions seem to be spared. Research also shows that a
number of deficits in cognitive and motor functions are linked to
prenatal alcohol exposure, while other functions appear to remain
intact. These studies, as well as basic research on the mechanisms
of prenatal alcohol damage, support the notion that alcohol has
specific, rather than global, effects on the developing brain.
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Preventing
underage drinking. One major study, the Community Trials
Project, found that sales clerks in alcoholic beverage outlets were
half as likely to sell alcohol to minors in communities with
programs that trained clerks, enforced underage sales laws, and
raised awareness of increased enforcement through the media. Another
large study, Project Northland, showed that a multi-year program
involving schools, parents, peers, policy-makers, and businesses can
effectively reduce underage drinking—if the intervention begins before
adolescents begin to use alcohol. The 10th Report also
describes the search for the roots of alcohol problems in
adolescence and later life stages, through multidisciplinary
research on social, cultural, psychological, and biological
influences.
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Reducing
alcohol-related traffic crashes. The 10th Report
presents many studies on the effectiveness of laws, public policies,
community programs, and individual actions to deter drunk driving. A
number of studies have focused on State laws that make it a criminal
offense to drive with a blood alcohol concentration (BAC) over a
certain limit, which in most States is 0.10 percent. New research
shows that States that reduce the legal BAC limit to 0.08 percent
experience a significant drop in fatal crashes related to alcohol,
and that this decrease is distinct from the effects of other drunk
driving measures.
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Chronic
alcohol use and the brain. Studies in animal models are
revealing how changes in the brain from chronic alcohol consumption
underlie such features of alcoholism as tolerance (lowered
sensitivity to the intoxicating effects of alcohol), withdrawal, and
craving. This work is helping scientists understand the biological
basis for the motivation to drink too much and the mechanisms
through which alcohol causes lasting damage to the brain in some
individuals who consume alcohol heavily.
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Damage
to body organs. Research on how alcohol damages body organs is
providing information that may be used in developing novel
treatments. For example, a variety of evidence suggests that liver
damage results from changes in immune function, suggesting the
potential of immune-based treatments.
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Helping
patients to reduce alcohol use and related problems. When
patients are found to be at-risk or problem drinkers, but not
alcohol dependent, health care providers can significantly reduce
alcohol use and related problems by providing a quick form of
counseling called "brief intervention." Research shows
that brief interventions delivered in primary care settings can
decrease alcohol use for at least a year in persons who drink above
recommended limits.
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Medications
for treating alcoholism. Advances in neuroscience have paved the
way for medications that operate at the molecular level of brain
processes that influence alcohol addiction. Studies show that the
medication naltrexone and a similar compound, nalmefene, help reduce
the chance of heavy drinking when abstinent individuals relapse;
that a medication called acamprosate may prevent relapse; and that
when patients with co-existing depression take antidepressants,
their alcoholism treatment outcomes improve. |
The report contains eight chapters:
Chapter 1: Drinking Over the Life Span:
Issues of Biology, Behavior and Risk,
Chapter 2: Alcohol and the Brain:
Neuroscience and Neurobehavior,
Chapter 3: Genetic and Psychosocial
Influences,
Chapter 4: Medical Consequences,
Chapter 5: Prenatal Exposure to
Alcohol,
Chapter 6: Economic and Health Services
Perspectives,
Chapter 7: Prevention, and
Chapter 8: Treatment.
Each chapter is divided into two to six
subsections that can be downloaded individually in PDF format from the
NIAAA website (http://www.niaaa.nih.gov).
Bound copies of the entire 492-page report can also be ordered by writing
to: National Institute on Alcohol Abuse and Alcoholism, Publications
Distribution Center, P.O. Box 10686, Rockville, MD 20849-0686.
The NIAAA produced the 10th
Special Report to the U.S. Congress on Alcohol and Health with
guidance from a distinguished editorial advisory board and contributions
from some of the world’s leading alcohol researchers. A component of the
National Institutes of Health, NIAAA funds more than 90 percent of the
alcohol abuse and alcohol addiction (alcoholism) research in the United
States. |
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