A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R EFERENCES J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS ii ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright Ó2003 by ICON Group International, Inc. Copyright Ó2003 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1 Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Alcohol Abuse: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83685-X 1. Alcohol Abuse-Popular works. I. Title. iii Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication. Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: iconedit@san.rr.com). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book. iv Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on alcohol abuse. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support. v About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications. vi About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes & Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health vii Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON ALCOHOL ABUSE ...................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Alcohol Abuse ............................................................................... 6 E-Journals: PubMed Central ....................................................................................................... 70 The National Library of Medicine: PubMed ................................................................................ 71 CHAPTER 2. NUTRITION AND ALCOHOL ABUSE .......................................................................... 157 Overview.................................................................................................................................... 157 Finding Nutrition Studies on Alcohol Abuse ............................................................................ 157 Federal Resources on Nutrition ................................................................................................. 161 Additional Web Resources ......................................................................................................... 162 CHAPTER 3. ALTERNATIVE MEDICINE AND ALCOHOL ABUSE .................................................... 165 Overview.................................................................................................................................... 165 National Center for Complementary and Alternative Medicine................................................ 165 Additional Web Resources ......................................................................................................... 172 General References ..................................................................................................................... 177 CHAPTER 4. DISSERTATIONS ON ALCOHOL ABUSE...................................................................... 179 Overview.................................................................................................................................... 179 Dissertations on Alcohol Abuse ................................................................................................. 179 Keeping Current ........................................................................................................................ 190 CHAPTER 5. CLINICAL TRIALS AND ALCOHOL ABUSE ................................................................ 191 Overview.................................................................................................................................... 191 Recent Trials on Alcohol Abuse ................................................................................................. 191 Keeping Current on Clinical Trials ........................................................................................... 201 CHAPTER 6. PATENTS ON ALCOHOL ABUSE ................................................................................ 203 Overview.................................................................................................................................... 203 Patents on Alcohol Abuse .......................................................................................................... 203 Patent Applications on Alcohol Abuse ...................................................................................... 228 Keeping Current ........................................................................................................................ 237 CHAPTER 7. BOOKS ON ALCOHOL ABUSE .................................................................................... 239 Overview.................................................................................................................................... 239 Book Summaries: Federal Agencies............................................................................................ 239 Book Summaries: Online Booksellers......................................................................................... 241 The National Library of Medicine Book Index ........................................................................... 246 Chapters on Alcohol Abuse ........................................................................................................ 248 Directories.................................................................................................................................. 248 CHAPTER 8. MULTIMEDIA ON ALCOHOL ABUSE ......................................................................... 251 Overview.................................................................................................................................... 251 Video Recordings ....................................................................................................................... 251 Audio Recordings....................................................................................................................... 255 Bibliography: Multimedia on Alcohol Abuse............................................................................. 257 CHAPTER 9. PERIODICALS AND NEWS ON ALCOHOL ABUSE ...................................................... 259 Overview.................................................................................................................................... 259 News Services and Press Releases.............................................................................................. 259 Newsletter Articles .................................................................................................................... 262 Academic Periodicals covering Alcohol Abuse........................................................................... 263 CHAPTER 10. RESEARCHING MEDICATIONS................................................................................. 265 Overview.................................................................................................................................... 265 U.S. Pharmacopeia..................................................................................................................... 265 Commercial Databases ............................................................................................................... 267 viii Contents APPENDIX A. PHYSICIAN RESOURCES .......................................................................................... 271 Overview.................................................................................................................................... 271 NIH Guidelines.......................................................................................................................... 271 NIH Databases........................................................................................................................... 273 Other Commercial Databases..................................................................................................... 279 The Genome Project and Alcohol Abuse .................................................................................... 279 APPENDIX B. PATIENT RESOURCES ............................................................................................... 283 Overview.................................................................................................................................... 283 Patient Guideline Sources.......................................................................................................... 283 Finding Associations.................................................................................................................. 291 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 293 Overview.................................................................................................................................... 293 Preparation................................................................................................................................. 293 Finding a Local Medical Library................................................................................................ 293 Medical Libraries in the U.S. and Canada ................................................................................. 293 ONLINE GLOSSARIES ................................................................................................................ 299 Online Dictionary Directories ................................................................................................... 301 ALCOHOL ABUSE DICTIONARY ............................................................................................ 303 INDEX .............................................................................................................................................. 377 1 FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with alcohol abuse is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about alcohol abuse, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to alcohol abuse, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on alcohol abuse. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to alcohol abuse, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on alcohol abuse. The Editors 1 From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know. 3 CHAPTER 1. STUDIES ON ALCOHOL ABUSE Overview In this chapter, we will show you how to locate peer-reviewed references and studies on alcohol abuse. The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and alcohol abuse, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “alcohol abuse” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: · Relationship of Acute Transfusion-Associated Hepatitis to the Development of Cirrhosis in the Presence of Alcohol Abuse Source: Annals of Internal Medicine. 134(2): 120-124. January 16, 2001. Contact: Available from American College of Physicians. American Society of Internal Medicine. 190 North Independence Mall West, Philadelphia, PA 19106-1572. Website: www.acponline.org. Summary: Although concomitant (occurring at the same time) alcoholism is widely believed to enhance liver disease progression in persons with hepatitis C virus (HCV) infection, this relationship has not been well quantified. This article reports on a study undertaken to quantify the relationship of transfusion associated HCV infection and history of heavy alcohol abuse to the development of cirrhosis (liver scarring). The 4 Alcohol Abuse retrospective cohort study featured extensive followup of 1,030 patients in prospective investigations of transfusion associated viral hepatitis conducted in the United States between 1968 and 1980. Development of cirrhosis and history of heavy alcohol abuse were determined from review of interviews with patients or their proxies, medical records, death certificates, and autopsy and biopsy reports. The absolute risk for cirrhosis was 17 percent among patients with transfusion associated HCV; 3.2 percent among patients with transfusion associated nonA, nonB, nonC hepatitis; and 2.8 percent among controls. A history of heavy alcohol abuse was associated with a fourfold increased risk for cirrhosis. Hepatitis C virus infection plus a history of heavy alcohol abuse led to a substantial increase in risk for cirrhosis, compared with controls without such a history. The authors stress that this finding emphasizes the need to counsel such patients about their drinking habits. 2 tables. 19 references. · Neuropsychiatric Aspects of Alcohol Abuse in the Elderly Source: Geriatric Medicine Today. 9(7): 60-67. July 1990. Summary: The number of elderly persons who abuse alcohol is estimated at four million in the United States. Medical morbidity and mortality associated with alcohol abuse in the elderly is significantly higher than that associated with a younger cohort or with those elderly who do not abuse alcohol. Elderly persons who abuse alcohol may experience an acceleration of the aging process, depression, and dementia. Primary-care physicians need to be educated about the prevalence of this problem and its signs and symptoms and must routinely screen their elderly patients for its presence. Treatment involves breaking through the patient's denial, followed by detoxification and rehabilitation. Treatment is easier to carry out in elderly than in younger patients. 29 references. (AA). · Clinical Significance of Hepatitis C Virus Infection to Alcoholics with Cirrhosis in Korea Source: Journal of Gastroenterology and Hepatology. 15(11): 1282-1286. November 2000. Contact: Available from Blackwell Science. 54 University Street, Carlton South 3053, Victoria, Australia. +61393470300. Fax +61393475001. E-mail: Rob.Turner@blacksciasia.com.au. Website: www.blackwell-science.com. Summary: This article reports on a study undertaken to investigate the prevalence and clinical significance of hepatitis C virus (HCV) infection and its relationship with the development of hepatocellular carcinoma (HCC, liver cancer). In the study, 162 consecutive alcoholic Korean patients with cirrhosis were studied. Alcohol intake and parenteral risk factors were investigated by interview using a questionnaire. All patients had consumed at least 80 grams of alcohol per day for at least the past 5 years. Patients were categorized into 3 groups: anti HCV or HBsAg (group A); cases with HBsAg only (group B), and cases with anti HCV only (group C). Anti-HCV was present in 17 cases (10.5 percent) and HBsAg was present in 47 cases (29 percent). No patient had both antiHCV and HBsAg. Group C subjects were the oldest, but the duration of drinking in this group was similar to that of group A. There was no significant difference in the daily alcohol intake among the three groups of patients. Previous surgical operations and tattooing were more frequent in group C. Only one patient in group C was an intravenous drug user. The combined rate of HCC was significantly higher in groups B and C than in group A (34 percent, 23.5 percent, and 6.1 percent, respectively). Laboratory data showed a higher platelet count, higher albumin level, lower bilirubin lever. and lower aspartate amino transferase or alanine aminotransferase ratio in group Studies 5 C patients than in the other two groups. The authors conclude that hepatitis C virus infection is frequent in alcoholic patients with cirrhosis in Korea. Hepatitis C virus, as well as hepatitis B virus, infection may have a synergistic effect on the development of HCC in alcoholic patients. 1 figure. 3 tables. 28 references. · Assessing Alcoholism as a Risk Factor for Acquired Immunodeficiency Syndrome (AIDS) Source: Social Science & Medicine; Vol. 27, No. 11. Contact: Pergamon Press, 660 White Plains Rd, Tarrytown, NY, 10591, (914) 524-9200. Summary: This article reviews alcohol abuse as feature of the homosexual experience, suggesting it may merit consideration as a risk factor in relation to AIDS. The presumably high prevalence of alcohol abuse among homosexuals and the damaging effects of alcohol on the immune system are discussed as a basis for linking alcoholism, homosexuality, and AIDS. The implications of the potential effects of alcohol misuse are presented in terms of high risk populations and the need for additional preventive measures and research. The authors also cite studies linking intravenous drug abuse with alcohol use in AIDS patients, leading them to suggest further investigation of these cofactors. · The genetics of alcoholism Source: Alcohol Alert. no. 18: 1-4. October 1992. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686. Available at no charge. (DHHS PH 328). Summary: This issue of 'Alcohol Alert' discusses current research on the genetics of alcoholism, describing research methods such as twin studies and adoption studies. An accompanying 2-page supplement describes genetic research conducted and sponsored by the National Institute on Alcohol Abuse and Alcoholism. Topics covered include family (pedigree) studies, genetics and alcohol metabolism, studies on women, the genetics of alcohol's health effects, animal studies on susceptibility and neurochemistry, and mapping genes in diseases that have complex genetic origins. · Children of alcoholics: Are they different? Source: Alcohol alert. no. 9: 1-4. July 1990. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686. Available at no charge. (DHHS PH288). Summary: This issue of 'Alcohol Alert' summarizes current research and findings about children of alcoholics (COAs). The publication focuses on the following three major research questions: 1) What contributes to resilience in some COAs; 2) Do COAs differ from children of nonalcoholics; and 3) Are the differences specifically related to parental alcoholism, or are they similar to characteristics observed in children whose parents have other illnesses?. 6 Alcohol Abuse · Comparison of the Michigan Alcoholism Screening Test and the Michigan Alcoholism Screening Test-Geriatric Version in Screening for Higher Alcohol Use Among Dementia Caregivers Source: Journal of Mental Health and Aging. 1(2): 147-155. 1995. Summary: This journal article focuses on the identification of alcohol abuse among family caregivers of people with dementia. The Michigan Alcoholism Screening Test (MAST) and the Michigan Alcoholism Screening Test-Geriatric Version (MAST-G) were developed and validated as screening tools to identify alcohol abuse in adults and older adults, respectively. Many studies of alcohol problems in older adults have focused on hospital and medical clinic populations. This investigation compares the MAST and the MAST-G in a sample of 60 community dwelling caregivers (75 percent of whom over age 50) of older adults with dementia. The authors found the MAST-G to have acceptable levels of reliability and validity and to be more reliable and valid with this population than the MAST. The MAST-G appears useful for determining alcohol abuse by caregivers of people with dementia. 5 tables, 1 figure, 21 references. (AA-M). · Alcohol Abuse and Alzheimer's Disease Source: Hospital and Community Psychiatry. 45(10): 1040-1041. October 1994. Summary: This study examined the relationship between alcohol abuse and Alzheimer's disease (AD). It explored the coexistence of the two disorders and developed a descriptive classification based on questionnaire responses from family caregivers of patients with AD. Drinking was studied in 64 patients (97 percent male) enrolled in an outpatient dementia study. All patients were diagnosed with probable AD. Caregivers responded to a series of structured questions to learn the extent of the patient's alcohol use and whether it presented a problem, either currently or in the past. Family caregivers answered a questionnaire assessing activities of daily living to provide information on patient performance in six functional areas. Alcohol abuse was found in about one-third of the of outpatients. Although Type I and Type II dementia could be the result of alcohol abuse, the clinical picture was that of AD rather than of WernickeKorsakoff disease, Marchiafavia Bignami disease, or alcoholic dementia. Type II problem drinkers had a long period of abstinence before the development of dementia symptoms. Problem drinkers rated as less impaired in activities of daily living and consequently required less assistance, but burden scores did not differ significantly between the family caregivers of the two groups. For clinicians, these findings suggest that alcohol abuse should be a factor in assessing, treating, and managing patients with AD. 10 references. Federally Funded Research on Alcohol Abuse The U.S. Government supports a variety of research studies relating to alcohol abuse. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. 2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH). Studies 7 Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to alcohol abuse. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore alcohol abuse. The following is typical of the type of information found when searching the CRISP database for alcohol abuse: · Project Title: ADH GENOTYPE, ALC ABUSE & CELL RESPONSE TO V VULNIFICUS Principal Investigator & Institution: Powell, Jan L.; Epidemiology and Prev Medicine; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2001; Project Start 21-AUG-2000; Project End 31-JUL-2005 Summary: (Taken from the Investigator's Abstract) The purpose of the Mentored Research Scientist Award in Molecular Epidemiology is to provide career development in the field of molecular epidemiology of environmentally induced diseases. The interactions between environmental host pathogen are extremely complex, and require a multi-disciplinary approach to understand the interrelationships within this paradigm at a mechanistic level. The candidate, an environmental microbiologist, proposes to fully integrate didactic training in molecular and applied epidemiology with mentored basic research. It is the goal of the candidate to gain the necessary training to allow, not only the investigation of specific parts of these interactions through applied research, but to develop a career path that will allow a vision of the paradigm as a whole. Through the Masters Degree program in the Department of Epidemiology and Preventive Medicine at the University of Maryland, Baltimore, the candidate will gain new and enhanced skills in molecular and applied epidemiology, biostatistics, clinical study design, and data analysis. The commitment and participation of three mentors, together with strong institutional support ensures that the candidate is in the ideal environment for career development through completion of the proposed training and by conducting highly relevant environmental biomedical research. In the research component of the proposal the candidate will use molecular epidemiology techniques to investigate whether there is an association between host alcohol dehydrogenase (ADH) genotype, alcohol abuse, immune status and cellular response to environmental food-borne pathogen Vibrio vulnificus. Individuals that abuse alcohol are at increased risk of developing septicemia and cytokine-mediated shock following exposure to V. vulnificus in raw oysters. However, not all individuals with the same (perceived) risk factors develop disease from exposure to V. vulnificus. Differences in host susceptibility may lie at the genetic level, as suggested for other infectious diseases such as HIV. Alcohol metabolites, particularly acetaldehyde, can directly affect immune cells, cause immunosuppression and therefore affect the response to pathogens. Alcohol metabolism is controlled by ADH whose gene polymorphisms have been shown to affect alcohol metabolic rates. The investigators hypothesize that particular ADH genotypes are associated with cellular oxidative stress in the presence of alcohol abuse, an increased inflammatory cytokine response, and an adverse response to V. vulnificus. Studies will include both genetic and cellular endpoints to investigate the effects of an environmental exposure on host immune response and susceptibility to an environmental bacterial pathogen. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 8 Alcohol Abuse · Project Title: ADOLESCENT ALCOHOL ABUSE, PTSD & HIPPOCAMPAL DEVELOPMENT Principal Investigator & Institution: De Bellis, Michael D.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2001; Project Start 01-JUL-2001; Project End 31-MAR-2004 Summary: This is the second submission of a proposal which was initially reviewed in response to an RFA entitled "Neurobiological Mechanisms of Adolescent Alcohol Abuse" (AA-99-002). We propose a 3 year cross sectional investigation to non-invasively examine the effects of alcohol use disorders (AUD) (defined as DSM-IV alcohol dependence or abuse) and posttraumatic stress disorder (PTSD) on hippocampal development in adolescents. The developing hippocampus may be particularly vulnerable to the toxic effects of alcohol. We have recently published our pilot investigation comparing medically healthy adolescents and young adults with AUD and age and sex matched controls on hippocampal volumes. We found a decrease in total hippocampal volume in AUD subjects compared with matched controls. A substantial percentage of adolescents with AUD are comorbid with PTSD secondary to a history of childhood physical and sexual abuse. Previous studies have suggested that childhood traumatic experiences, which lead to a diagnosis of PTSD, may have adverse effects of brain development. This study will therefore examine the main effect of AUD, the main effect of PTSD and the interaction of AUD and PTSD on adolescent hippocampal development. We hypothesize that AUD and PTSD both adversely effect hippocampal volume and hippocampal function. Recruitment, assessment, and administration of this investigation will occur primarily through the Pittsburgh Adolescent Alcohol Research Center (PAARC), an NIAAA Alcohol Research Center. Four adolescent groups will be compared: 1) AUD adolescents with PTSD (n=36), 2) AUD adolescents with PTSD (n=36), 3) adolescents with PTSD and with or without a current of lifetime diagnosis of AUD (n=36), and 4) age, sex, and sociodemographically matched healthy community control adolescents (n=3 6). This design will determine the effects of AUD while controlling for the effects of PTSD and environmental variables. In addition to examining the differences among these groups, the effects of AUD age of onset, AUD severity, as well as alcohol consumption quantity, frequency, and duration, on adolescent hippocampal development will also be examined. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ADOLESCENT ALCOHOL ABUSE: A TWIN-STUDY PERSPECTIVE Principal Investigator & Institution: Rose, Richard J.; Professor Emeritus; Psychology; Indiana University Bloomington P.O. Box 1847 Bloomington, in 47402 Timing: Fiscal Year 2001; Project Start 01-JUN-2000; Project End 31-MAY-2005 Summary: Submitted in response to RFA AA-99-003, this application requests five years' support to study consequences and mechanisms of adolescent alcohol abuse in adult and adolescent twin pairs. The research proposal builds on two ongoing twin-family studies conducted in Finland. One study, FinnTwin16, has ascertained 2,800 twin pairs, born 1975-79, and assessed them, and their parents, with questionnaires, in 1991-1995, as the twins reached age 16; follow-up questionnaire assessments of the twins were made at ages 17 and 18 1/2. We propose a fourth questionnaire assessment of all these Finnish twins, at ages 22-25, to evaluate their adult use/abuse of alcohol and their social, educational, occupational and interpersonal competencies. From the adolescent questionnaire assessments, we have identified >200 dizygotic twin pairs for intensive follow-up; the targeted co- twins were selected for extreme concordance or extreme Studies 9 discordance for adolescent alcohol abuse. At ages 22-25, we will interview them with the Semi-Structured Assessment for Genetics of Alcoholism (SSAGA), access them with a neuropsychological test battery and evaluate their electrophysiological function with ERP paradigms. These within-family comparisons of co-twins discordant for adolescent alcohol abuse will robustly test for its consequences. To compliment this appraisal of early adult consequences of adolescent problem drinking, we propose intensive study of two birth cohorts from a second on-going study, FinnTwin12; 485 twin pairs, born 198687, are selected for intensive study in that project with 50% at elevated familial risk for alcoholism. At age 14, in years 2000-01, these twin pairs will be interviewed with the adolescent SSAGA (with other funding), and as part of this proposal, we will append to the interview an enriched neuropsychological test battery and assay testosterone and cortisol from saliva. Jointly, these neurophysiological, neuropsychological, and neuroendocrine studies of targeted Finnish twins, for whom risk-relevant data have been collected earlier, will offer incisive analyses of neurobiological mechanisms and consequences of alcohol abuse in adolescence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: AFTERCARE FOR ADOLESCENTS WITH SUBSTANCE USE DISORDERS Principal Investigator & Institution: Kaminer, Yifrah; Associate Professor; Psychiatry; University of Connecticut Sch of Med/Dnt Bb20, Mc 2806 Farmington, Ct 060302806 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2007 Summary: (provided by applicant): Adolescent Alcohol and Other Substance Use Disorders (AOSUD) continue to present as a major public health problem. Regional studies reveal that between 7-10%of adolescents are in need of treatment. Little is known empirically about the effectiveness of various treatment methods and techniques for adolescents with AOSUD, mainly due to restricted resources including a limited number of clinical investigators in this area. There is a pressing need to mentor more clinical investigators who will concentrate on effective treatment and aftercare for adolescents. This proposal to meet three complementary objectives, 1) develop and implement a mentor ship program for new clinical investigators interested in the treatment and aftercare of adolescents with AOSUD; 2) conduct a clinical trial focusing on treatment and aftercare for adolescents with AOSUD; and 3) further advance the applicant's skills in research methodology and data analysis in order to become both a better independent clinical investigator and a more effective mentor. The applicant is an experienced child and adolescent psychiatrist who has demonstrated 1) a long-term commitment as a career clinical scientist in the assessment and treatment of adolescent AOSUD; 2) academic productivity by publishing, teaching, and training in this domain nationally and internationally; and 3) an ability to obtain research funding. This award will allow the applicant protected time to pursue quality mentoring of future clinical investigators while conducting clinical research that will optimize long-term scientific contributions of both the mentor and trainees. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL ABUSE AND TREATMENT UTILIZATION Principal Investigator & Institution: Gruskin, Elisabeth; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, Ca 94612 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 10 Alcohol Abuse Summary: (Revised) (provided by applicant): Dr. Gruskin's career goal is to understand the underlying dynamics of alcohol problems so as to improve alcohol treatment services and their evaluation for women. As part of her progression toward becoming an independent investigator she plans to: Educational Training: 1. Design an advanced didactic educational program including qualitative methodology courses in the sociology departments at the University of California at San Francisco (UCSF) and Berkeley (UCB) and advanced quantitative methodology and programming courses at the SAS Institute 2. Work individually with researchers, statisticians and programmers at UCSF and the Division of Research at Kaiser Permanente (KP). 3. Attend seminars, grand rounds, and conferences in pertinent areas. Research: 4. Conduct a comprehensive literature review on alcohol abuse and treatment services. 5. Conduct two studies that build upon each other. The first is a cross-sectional study which will compare drinking patterns and problems and substance abuse treatment utilization among groups of women. This study will use data collected as part of a survey at KP linked to the participants' automated medical records. The second study, will consist of qualitative interviews and focus groups that will explore the relationships between drinking, culture, stress/distress and the function that alcohol plays in the lives of women. 6. Design and test the reliability and validity of measurements that she will use in an R01 proposal to conduct a prospective cohort study on women and alcohol, that she will submit in the last year of the grant. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL COMPARISON AND HOMELESS YOUTH: A LONGITUDINAL Principal Investigator & Institution: Toro, Paul A.; Associate Professor; Psychology; Wayne State University 656 W. Kirby Detroit, Mi 48202 Timing: Fiscal Year 2002; Project Start 01-JUL-1997; Project End 31-MAR-2007 Summary: The proposed 5-year continuation research project will assess longitudinal outcomes during the transition from adolescence into early adulthood for a large 2group sample of 401 at-risk urban youth: (1) a probability sample of 251 homeless adolescent from throughout the Detroit metropolitan area and (2) 150 initially housed adolescents matched on gender, age, race, and SES. Measures assessed longitudinally include family and contextual factors, psychological processes (e.g., competence, selfefficacy), homelessness and stress, peer relations, and outcomes that often begin in late adolescence and coalesce in early adulthood (e.g., alcohol and drug use/abuse, criminal behavior, education and employment, mental and physical health, HIV-risk behaviors). The proposed research builds on the original study by extending the follow-up period from adolescence (initial-final mean ages= 15.5-17.0) into early adulthood (initial-final mean ages=19.5- 21.5). We believe that is during this period of early adulthood that the consequences of problematic experiences in adolescence will become most clearly visible. Relatively few studies have tracked at-risk youth through the important transition. Specifically we will: (1) investigate risk and protective factors predicting longitudinal outcomes and test theoretical models on longitudinal pathways in our atrisk sample; (2) improve understanding of family dynamics among at-risk urban youth during the transition to early adulthood; (3) assess the impact of peer relationships; and (4) assess longitudinal differences in outcomes for African-vs. European-Americans and for girls vs. boys. In the original 4- year project, the rate of attrition has been low and we expect that 179 (81%) of the initially homeless and 141 (94%) of the housed ill receive at least one follow-up interview during early adulthood in the continuation project. Preliminary findings over 1.5 years suggest that our at-risk youth show some short-term Studies 11 improvements (perhaps due to service, family, or other factors) but are beginning to show signs of negative longitudinal outcomes (e.g., alcohol and drug problems) as they turn 16-17. W e are also finding some support for out theoretical perspectives. For example, supporting a social learning perspective, we have found that family relations, school problems, and deviant peers all have roles in the development of alcohol use/abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL AND INTENTIONAL INJURY IN THE U.S ARMY Principal Investigator & Institution: Bell, Nicole S.; Social Sectors Develop Strategies Strategies, Inc. (Ssds) Natick, Ma 01760 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2005 Summary: Alcohol use has been linked to family violence, assaults, and suicides. Some studies suggest that all these forms of intentional injury may result from a similar constellation of risk factors, such as alcohol abuse, depression, impulsivity, and aggression. The factors that may mediate the role of alcohol and those that may determine whether the endpoint is violence against others versus violence against self are less clear. Long-term health and occupational experiences of perpetrators and victims of violence are not clear, nor have potential modifying factors for these outcomes been elucidated. Specific Aims: This study uses a large linked database to identify fixed and time-varying factors that modify the relationship between alcohol use and perpetrating or experiencing violence or suicide. Factors can be measured prior to the event as well as during the event. In addition, we will follow perpetrators and victims of violence subsequent to the violent episode to document long-term health and occupational experiences of these individuals. Methods: This study uses data from the Total Army Injury and Health Outcomes Database (TAIHOD). Data are available on almost 3 million unique soldiers who were on active duty 1980-1998, including personnel records (occupation, hazardous duty pay, gender, age, rank, education, marital status, dependents, overseas assignments-all updated every 6 months), hospitalization (including ICD-9-CM codes, cause of injury codes indicating mechanism and intentionality), disability evaluations, health habit surveys (including typical alcohol use, the CAGE, drinking and driving, and, other health behaviors, and satisfaction with one's life and family), occupational surveys (job satisfaction, harassment on the job) and outpatient data. In addition, Spouse Abuse Registry Data have recently been added to the TAIHOD, which include information on victims and perpetrators as well as severity of the assault. Most questions will be addressed using a retrospective cohort design. Standard time-to-event statistical techniques will be employed (e.g., Cox Proportional Hazards Models). MIMIC models (i.e., confirmatory factor analyses with background variables) will be used to investigate more complex relationships where there may be multiple possible outcomes (e.g., different levels of severity of assault; or violence against self versus others). Conclusions: This study offers a number of advantages over prior research. This population is fully employed and has full access to healthcare and housing, controlling many potential socioeconomic confounders. Data are very complete with little lost information. Data for both victims and perpetrators regarding the incident of violence, precursors to the event, and longrange health and occupational outcomes are available. This study will allow us to costeffectively assess the role of alcohol in intentional injuries, for a large diverse population encompassing a wide range of occupational, racial, and gender groups. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 12 Alcohol Abuse · Project Title: ALCOHOL HEALTH DISPARITIES IN 2 INDIAN POPULATIONS Principal Investigator & Institution: Novins, Douglas K.; Associate Professor; Psychiatry; University of Colorado Hlth Sciences Ctr P.O. Box 6508, Grants and Contracts Aurora, Co 800450508 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-JUL-2005 Summary: (provided by applicant): The use and abuse of alcohol among American Indians (AI) is a major public health concern. To date, the best information derives from adolescent populations. Compared to their non-AI counterparts, AI youth are more likely to use alcohol, more likely to become problem drinkers, more likely to meet diagnostic criteria for alcohol abuse and dependence, more likely to use alcohol in combination with drugs, and more likely to have both an alcohol use disorder and a psychiatric disorder. From service system data and vital statistics, we know that AIs generally are more likely to develop a variety of physical health conditions that are related to alcohol use and to die from alcohol-related causes. Research to date also suggests that rates of the alcohol-related health disparities (ARHDs) vary substantially across AI tribes. Despite the compelling nature of these disparities, surprisingly little is known regarding key aspects of their descriptive and analytical epidemiology. Indeed, the specific relationships of alcohol use, abuse, and dependence with co morbid drug, psychiatric, and physical health conditions among AI adults are largely unexplored. Yet findings from studies focused on the US general population suggest that these interrelationships are critical for understanding ARHDs. The goal of this project is to analyze data from the recently completed American Indian Service Utilization, Psychiatric Epidemiology, and Risk/Protective Factors Project - the first large-scale, population-based study of AIs between the ages of 15 and 54. The specific aims for this project are as follows: 1) to describe disparities in the epidemiology of alcohol use across 2 AI population-based samples of 15-54 year-olds as well as between these 2 AI samples and samples representative of the US general population; 2) to conduct a parallel investigation regarding disparities in the epidemiology of alcohol abuse and dependence in these same samples; 3) to extend this line of inquiry to explore disparities in the epidemiology of drug use, abuse, and dependence co morbid with alcohol use, abuse and dependence; 4) to depict disparities in the epidemiology of non-substance use psychiatric disorders co morbid with alcohol use, abuse, and dependence; and 5) to investigate disparities in the epidemiology of physical health conditions co morbid with alcohol use, abuse, and dependence across these 2 AI tribes and between these tribes and the US general population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL IN MEXICAN-ORIGIN GROUPS: US AND MEXICAN SURVEYS Principal Investigator & Institution: Greenfield, Thomas K.; Center Director and Senior Scientist; Public Health Institute 555 12Th St, 10Th Fl Oakland, Ca 94607 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2005 Summary: (provided by applicant): Based on the 2000 census, over 32.8 million Hispanics in the US represent 12% of the county's total population. People of Mexican origin constitute the largest, fastest growing subgroup. They are now two-thirds of all US Hispanics, and this subgroup has grown 53% since 1990. Numerous indicators show that such alcohol-related problems as alcohol dependence and such adverse social and health consequences as cirrhosis disproportionately affect Mexican Americans- health disparities that NIAAA is committed to addressing. This research will conduct a Studies 13 secondary analysis of three datasets, two drawn from existing Alcohol Research Group US National Alcohol Surveys (NASs), each including large Hispanic oversamples, and the 1998 Mexican National Survey of Addictions (ENA) conducted by our collaborators at the National Institute of Psychiatry, Mexico City. Questionnaires for the ENA (n = approximately 5,712) used NAS alcohol items and scales, so assuring considerable comparability. The US surveys were conducted in 1995 (N9) as face-to-face interviews (n = 4,925; 1,589 Hispanics; 964 of Mexican descent), and in 2000 (N10+Supplement) as telephone surveys (n = 8,980; 1,132 Hispanics; est. 679 of Mexican descent) of adults 18 or older. Following preliminary analyses, we plan to pool the Mexican-descent NAS samples, limiting age range to 18-65 (pooled n = 1,542) for comparison with the ENA. Specific Aims include (1) comparing and contrasting the prevalence, predictors and correlates of heavy drinking, alcohol use disorders (AUD), and other alcohol-related problems among men and women of Mexican descent living in the two countries (US and Mexico); (2) analyzing and comparing the comorbidity of AUD and drug abuse, and AUD and depression, among these groups; (3) investigating the risk curves between key parameters of drinking pattern (volume and frequency of heavy drinking) and AUD and a range of alcohol-related health and social harms in the two Mexican- origin populations, considering the role of demographic mediators such as gender, age and (for the US) acculturation; and (4) exploring the association of alcohol treatment in relation to AUD and other alcohol-related problems, health harms, drug abuse, and depression among Mexican Americans in the US. This research accords with the NIAAA strategic action plan for addressing health disparities: using a rigorous study design, it aims to provide critically needed knowledge in detail about drinking patterns and alcohol-related consequences of a key ethnic minority population-Mexican descent Hispanic individuals-known to be at risk for alcohol dependence and other health harms from drinking. Results will inform provision of culturally appropriate health services and prevention program planning. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL PSYCHOSOCIAL FACTORS AND ADOLESCENT DEVELOPMENT Principal Investigator & Institution: Bray, James H.; Psychiatry and Behavioral Scis; Baylor College of Medicine 1 Baylor Plaza Houston, Tx 77030 Timing: Fiscal Year 2001; Project Start 10-JAN-2001; Project End 31-MAR-2001 Summary: (Adapted from investigator's abstract): The main objective of the proposed project is to test a developmental model of older adolescent alcohol use and abuse that extends current psychosocial interaction models of usage. The model incorporates adolescent individuation, a key aspect of development, in the context of individual, family, and peer factors, perceived stress, and externalizing behaviors to further understand alcohol use during later adolescence and with heavy drinkers. The proposed model hypothesizes causal sequences between variables that effect individuation and subsequently usage, both directly and indirectly. The model will be explored with three ethnic groups, African American, Mexican American and non-Hispanic White adolescents, with the expectation that ethnic differences in individuation and family dynamics will have a unique bearing on the role of individuation in substance use. A sample of 3500 adolescents, starting with 9th graders, will be surveyed 7 times over 4 years concerning substance use and these psychosocial factors. In addition, assessment of school grades and behavior will be collected from schools. The proposed project will examine five specific aims. First, the investigators propose to examine individuation in the context of family factors, such as conflict, cohesion, communication and parenting; 14 Alcohol Abuse individual factors, such as impulsivity and affectivity; stress; and externalizing behaviors that are influential for alcohol use and abuse. Second, they will examine the influence of peer relations on alcohol use in the context of individual, family, stress, and developmental factors. Third, they will investigate the moderating role of individuation on the relationships between family factors, individual factors, stress, and peer factors and alcohol use. Fourth, they propose that over time there are reciprocal and bidirectional effects of individual family, peer, stress, externalizing behaviors, and individuation factors on subsequent drinking, and that drinking then impacts these psychosocial factors. Fifth, it is expected that the influence of developmental, individual, family, and peer factors will vary based on ethnicity and gender of the adolescents. Multivariate longitudinal methods including structural equation modeling and hierarchical linear modeling will be used to examine these aims. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL, GLUTATHIONE, AND ALVEOLAR MACROPHAGE FUNCTION Principal Investigator & Institution: Burnham, Ellen L.; Internal Medicine; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2008 Summary: (provided by applicant): Each year in the United States, there are an estimated 4 million cases of pneumonia, accounting for 600,000 hospitalizations with an annual cost of $23 billion. Alcohol is a common risk factor for the development of both community-acquired and nosocomial pneumonia. Presently, the mechanisms by which chronic alcohol abuse alters human pulmonary immunity and increases the likelihood of developing pneumonia are essentially unknown. We hypothesize that increased oxidative stress via glutathione (GSH) depletion leads to abnormal function and viability of human alveolar macrophages (AM), and subsequently impairs alveolar clearance of infectious particles leading to pulmonary infections. In this proposal, the impact of alcohol abuse on the development of pneumonia will be explored by examining the function and viability of AM obtained from two patient cohorts: individuals with a prior history of chronic alcohol abuse and critically ill patients with acute lung injury. Additionally, we will determine the efficacy of oral antioxidant replacement therapy on AM function in individuals with a prior history of chronic alcohol abuse. The goal of this research endeavor is effective medical therapy to decrease the risk of community-acquired and nosocomial pneumonia in the millions of individuals who chronically abuse alcohol. Dr. Ellen Burnham is presently a fellow in Pulmonary and Critical Care Medicine at Emory University. During the next five years, she will work with several investigators in the Emory Alcohol and Critical Care Clinical Research Program in order to develop necessary clinical and basic research skills. With the support of this proposal, Dr. Burnham will not only receive personal supervision from these established clinical and basic investigators, but will also enroll in the Clinical Research Curriculum Award (CRCA) program at Emory University and the Rollins School of Public Health, and obtain a Masters of Science in Clinical Research to further enhance her ability to perform high-quality research. The ultimate goal of this award is to develop an independent research career in "translational" investigation for Dr. Burnham, examining the systemic effects of alcohol abuse as it relates to pulmonary and critical care medicine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen Studies · 15 Project Title: ALCOHOL, HIV, AND THE BRAIN Principal Investigator & Institution: Pfefferbaum, Adolf; Director; Sri International 333 Ravenswood Ave Menlo Park, Ca 94025 Timing: Fiscal Year 2001; Project Start 29-SEP-2001; Project End 31-AUG-2006 Summary: The longevity of HIV infected individuals (HIV+) has been extended by new therapies, but the disease still follows a progressive course with significant deleterious effects on the brain. High comorbidity with alcohol abuse among HIV+ individuals puts dually afflicted patients at risk for additive or synergistic effects, especially in frontostriatal brain systems that control executive and motor functions. Recent advances in magnetic resonance (MR) imaging, such as MR spectroscopy, MR diffusion tensor imaging, provide new opportunities to study, in vivo, the macrostructural, microstructural, and biochemical bases of the pathophysiology of HIV infection and alcohol abuse. Further, these techniques enable the observation of disease-induced changes over time, and the degree to which these changes relate to clinical state and cognitive and motor performance. In balanced four group, we will compare high and low alcohol consuming HIV+ patients with low-alcohol consuming HIV- subjects over a three year period in a naturalistic design to model the cumulative and progressive deleterious effects on the brain of combined HIV infection and alcohol abuse. We will test dual model of their comorbidity: interactive effects on structures disrupted by both disease (e.g., basal ganglia in HIV+). Three specific aims are proposed: Specific Aim 1: To use neuroimaging and neuropsychological measures to establish patterns of normality and abnormality in HIV+ alone, alcohol abuse alone, and HIV+ with alcohol abuse. Specific Aim 2: To track in neuroimaging measures at 1 and 3 year follow-up sessions. Specific Aim 3: To establish cross-sectional and longitudinal within-subject relationships among nueroimaging, neuropsychological, and clinical measures. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOL, SLEEP AND CIRCADIAN RHYTHMS IN YOUNG HUMANS Principal Investigator & Institution: Carskadon, Mary A.; Director; Emma Pendleton Bradley Hospital East Providence, Ri 02915 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2006 Summary: (Provided by applicant): Studies of adults with alcohol dependence indicate a close relation between sleep disturbances and alcohol use and abuse. Few studies have examined these relations in young humans; fewer have examined the role of the circadian timing or sleep/wake homeostatic systems in alcohol utilization and metabolism; and none has attempted to determine association of family history of alcoholism with sleep of offspring. This project includes three studies aimed at assessing these associations. Study 1 provides the first attempt to examine sleep patterns, sleep architecture, and a marker of the circadian timing system (melatonin onset phase) in children ages 9 and 10, adolescents ages 15 and 16, and young adults ages 21 and 22 with (PH+) or without (PH-) parental history of alcohol abuse/dependence (N = 200). A subset of older participants have moderate to high prior experience with alcohol (etoh+). We will test hypotheses that sleep is more disturbed in (1) PH+ participants, (2) etoh+ participants, (3) and in older participants at an initial assessment. We also predict that participants with both PH+ and etoh+ will show most disruption. A 2.5-yr longitudinal component in a subgroup of 80 low alcohol-experience children and adolescents will test the hypotheses that (1) pre-existing sleep disruptions predict amount of alcohol use in the 2.5-year follow up and (2) alcohol use during 16 Alcohol Abuse follow-up predicts changes in sleep between the initial and the 2.5- year in-lab assessments. In Study 2, effects of a moderate evening dose of alcohol on sleep, waking performance, and circadian phase will be studied in 64 adolescents and young adults with low alcohol exposure and PH+ or PH-. We will test the hypothesis that alcohol will alter sleep architecture and waking performance in predictable ways and that the effects will be blunted in PH+ offspring relative to PH- offspring. Additionally, we will assess whether alcohol- induced alterations in SWS are associated with slope of the decline in core body temperature following alcohol ingestion. Study 3 uses the forced desynchrony paradigm, in which participants will live in the laboratory for nearly weeks on a 20-hour day, to determine the independent and interactive contributions of the circadian timing system and sleep/wake homeostatic processes to the effects of moderate doses of alcohol on sleep, sleepiness, and waking performance. Study 3 involves a total of 24 FHparticipants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ALCOHOLISM: GENETIC EPIDEMIOLOGIC TWIN STUDY Principal Investigator & Institution: Heath, Andrew C.; Director; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2001; Project Start 01-MAR-1994; Project End 31-MAR-2005 Summary: This resubmission seeks continued funding for the Missouri Adolescent Female Twin Study (MOAFTS), a prospective genetic-epidemiologic survey of alcohol use and abuse/dependence and co-morbid psychopathology in adolescent and young adult women. During the first five years of the project, using a cohort-sequential sampling design, cohorts of 13.5, 15.5, 17.5 and 19.5 year-old twins have been ascertained from birth records over a 2-year period, with continued recruitment of new cohorts of 13 year-olds and 11 year-olds. The twins, together with at least one parent information, have been assessed using telephone diagnostic interviews (N-1730 pairs, including 249 minority pairs; N=3651 parents), with brief 1-year follow up interventions and self-report questionnaire assessments of twin pairs (N=1378 pairs to date) and 2year follow-up interview assessments of twin pairs (N=477 pairs to date) and a parent informant (N=796 parents to date) still in progress. Detailed assessments of history of psychopathology (childhood inattention and hyperactivity, suicidality, lifetime histories of DSM-IV oppositional defiant and conduct disorders, major depression, social phobia and panic disorder) and alcohol and other substance use disorders (DSM-V alcohol dependence or abuse, nicotine dependence, illicit drug abuse/dependence), as well as other behavioral and environmental risk- factors (including parental psychopathology and perceived peer and sibling behaviors) have been made. In this competing continuation, we seek to continue detailed telephone diagnostic interview assessments with twin cohorts at ages 175, 19.5, 21.5, 23.5, and 25.5, as well as repeat assessments of mothers of 19-year olds, plus assessment of those fathers who have not previously been interviewed. Following these twin pairs through their period of highest risk for onse5t of alcohol dependence will provide a powerful basis for identifying mediators and riskmodifiers of genetic and environmental influences on alcohol dependence and harmful alcohol use in young women (see heuristic models in Figures a1 and bla- blc), including effects of partner influences and influences of peers at college or work, occupation and work environment and transitions to adult roles (full-time employment, marriage, parenthood) on drinking behavior and problems. It will provide preliminary data on genetic and environmental predictors of course and remission versus persistence on alcohol problems, issues that can be addressed with greatest power when the youngest cohorts are followed up in a proposal as they reach their mid to late 20s. Studies 17 Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: BIPOLAR DISORDER & ALCOHOL ABUSE COMORBIDITY Principal Investigator & Institution: Frye, Mark A.; Psychiatry & Biobehav Sciences; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2001; Project Start 16-AUG-2001; Project End 31-JUL-2007 Summary: The applicant proposes to acquire new training in magnetic resonance spectroscopy and neuroendocrinology. These two areas of investigation will expand his clinical research expertise and further his research endeavors in attempting to better understand the neuroanatomic and neuroendocrinological underpinnings of bipolar disorder. The research training will then be used to translate these potential research gains into clinical applications to better understand and ultimately treat major psychiatric illnesses. This study will examine the impact of alcohol on the biochemistry, neuroendocrinology, and neuropsychological functioning of bipolar illness. The lifetime prevalence rate of alcohol abuse comorbidity in bipolar disorder is the highest of all Axis I diagnoses; furthermore, the presence of alcohol abuse in bipolar disorder is associated with a decreased response rate to the gold standard treatment lithium carbonate. Thus, by prevalence data and inadequate treatment response, this represents an enormous public health problem. In a cross-sectional analysis, patients with bipolar disorder and comorbid alcohol abuse or dependence, patients with bipolar illness without comorbid alcohol abuse or dependence, and age matched healthy controls will undergo 1 H-MR spectroscopy, Dexamethasone/CRH neuroendocrine challenge, and neuropsychological evaluation assessing executive function, verbal memory, and working memory. This study will evaluate whether there are differences amongst the three groups and if there is a relationship between N-acetylaspartate (NAA), hypothalamic-pituitary adrenal axis function, and neuropsychological functioning. These variables will also be evaluated as to their predictive potential for relapse under naturalistic follow-up where mood stability, alcohol craving and relapse, medication compliance, and functional capacity will be monitored. This naturalistic follow-up period may identify preliminary neurobiological factors associated with relapse and provide direction for further controlled interventional study. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: BRIEF INTERVENTION TO REDUCE INJURY IN MINORITIES Principal Investigator & Institution: Caetano, Raul; Professor of Epidemiology and Assistant; None; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 26-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Injuries are not isolated events or one time occurrences and injury has been identified as an important public health problem. Among the risk factors associated with injury and injury recidivism, the most widely recognized is alcohol use with approximately 50% of all injuries associated with alcohol. In general, alcohol use and drinking patterns vary by ethnicity, with frequent heavy drinking and associated problems more common among Blacks and Hispanics. Blacks, in general, suffer a disproportionate level of alcohol problems, despite having higher rates of abstention than Whites and Hispanics. Hispanics also generally suffer more alcohol-related problems than whites. Overall, injury recidivism is higher among poorer, minority populations and among individuals who abuse alcohol. The efficacy of brief alcohol interventions in the emergency care setting such as hospital emergency 18 Alcohol Abuse departments and trauma care centers is a relatively new area of research. Brief alcohol interventions appear to reduce alcohol intake and rates of injury following hospitalization; however, there is a need to evaluate the efficacy of these brief interventions in various ethnic groups. The proposed research involves a randomized controlled trial of a brief alcohol intervention based upon motivational interviewing and harm reduction to reduce alcohol consumption and injury following admission to an emergency room or trauma department for treatment of an injury. The primary aim of the proposed project is to determine the efficacy of this intervention as applied in the trauma care and emergency room setting among Whites, Blacks and Hispanics. The three outcomes of interest include 1) Alcohol consumption as measured by number of standard drinks consumed per week and frequency of drinking five or more drinks per occasion engagement in injury related risk behaviors and 3) injury recidivism rates. It is hypothesized that the brief alcohol intervention will have a greater impact on alcohol consumption, injury related risk behaviors and injury recidivism among Whites than Blacks and Mexican Americans. In addition, it is hypothesized that the that the brief alcohol intervention will have less of an impact on alcohol consumption, injury related risk behaviors and injury recidivism among Mexican Americans born in the United States than among those born in Mexico after controlling for acculturation, acculturation stress and sociodemographic characteristics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: BRIEF INTERVENTIONS FOR BINGE DRINKING COLLEGE STUDENTS Principal Investigator & Institution: Carey, Kate B.; Associate Professor; Psychology; Syracuse University Syracuse, Ny 13210 Timing: Fiscal Year 2001; Project Start 26-SEP-2000; Project End 31-JUL-2005 Summary: The long-term goal of this research is to reduce the risks associated with binge drinking among college students. Approximately 40% of college students are binge drinkers, defined as consuming 5 or more drinks at a single occasion for men (4 or more drinks for women) at least once in the last 2 weeks. Binge drinking is associated with a variety of academic, social, and health-related problems. Preliminary findings support the use of brief, motivational interventions (BMIs) to reduce binge drinking and its' negative consequences. BMIs used with college students often consist of an initial assessment session followed by an individualized feedback session. The latter includes personalized feedback (PF) with normative comparisons, and alcohol education (AE) with tips for reducing risk, delivered in a client-centered, motivational style. This proposal describes two related studies designed to evaluate the efficacy of BMIs with binge drinking college students. All BMIs will be enhanced with feedback related to the co-occurrence of drinking and risky sexual behavior, and each study will determine whether adding a decisional balance (DB) exercise to the "basic" BMI enhances outcomes. In Study l, 411 binge drinkers will be recruited from the general population of college students. Participants will be randomly assigned to an assessment only condition, a basic BMI (PF and AE), or an enhanced BMI (PF, AB and DB). All participants will provide data regarding drinking and related problems at 1, 6, and 12 months post-intervention. In Study 2, 411 binge drinkers will be recruited from among the students referred to a campus substance abuse agency. In this study, all participants will receive an intervention; they will be randomly assigned to AE, basic BMI (PF and AB), or enhanced BMI (PF, AB and DB). Analyses will determine (a) the effects of BMIs on drinking behavior and alcohol-related consequences, (b)the incremental utility of the DB exercise, and (c) the mediational role of hypothesized mechanisms of change (e.g., Studies 19 changes in norm perception and decisional balance). Findings will help to establish the efficacy of BMIs for reducing binge drinking and related problems in college students, and the generalizability of BMIs to students who have come to the attention of campus authorities because of alcohol-related infractions. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: CAREER TRAINING IN ADOLESCENT ALCOHOL TREATMENT RESEARCH Principal Investigator & Institution: Deas, Deborah V.; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 01-AUG-1997; Project End 31-JUL-2003 Summary: APPLICANT'S ABSTRACT: The current proposal is a request for a K08 Mentored Clinical Scientist Development Award. The candidate, Dr. Deborah DeasNesmith, is a child/adolescent psychiatrist in the field of adolescent substance abuse at the Medical University of South Carolina, Center for Drug and Alcohol Programs. In order for the candidate to develop into a sophisticated, independent researcher, she must receive additional didactic and experiential research training in treatment research which is not possible in her current faculty position due to the vast amount of clinical and teaching responsibilities required. The long-term objectives of the proposal are to: acquire expertise in research-related skills as well as acquire skills in theory, development and execution of manual-guided therapies for adolescents; and to gain expertise in the delivery of an assessment battery, and cognitive behavioral (CBT) and 12-step facilitation (TSF) therapy to adolescent substance abusers in a clinical trial. The proposed research plan addresses the need for systematic exploration of the effectiveness of psychosocial interventions in the treatment of adolescent substance abusers. The project integrates the ~candidate's skills and expertise in the area of adolescent substance abuse with a training plan designed to develop skill in nonpharmacologic treatment interventions and in adolescent treatment outcome research. The proposed research is a randomized clinical trial which will compare two standard approaches used in the treatment of adult alcoholics (CBT and TSF), in treatmentseeking adolescents who abuse alcohol. The hypothesis being tested is that treatmentseeking adolescent alcohol abusers will have better treatment outcome over a six month period with cognitive behavioral therapy intervention than with a 12-step facilitation therapy intervention. The specific aims are to modify existing CBT and TSF therapy manuals to suit adolescent alcohol abusers as well as gain training in the use of these manuals; to pilot test and revise manuals if necessary and conduct a 12-week randomized trial of weekly individual CBT or TSF in 84 (42/group) adolescents presenting for outpatient treatment of alcohol abuse/dependence. The study involves a randomized clinical trial assigning substance abusing adolescents to one of two 12-week individual psychotherapy groups. The proposed research is divided into several phases which will take place over the 5 year training period. Phase I will consist of manual development/revision for substance abusing adolescents; in Phase 2, the manual and research assessment battery will be pilot tested for feasibility and acceptability; and in Phase 3, the subjects will be randomly assigned to one of the two treatment conditions, and treatment will begin. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 20 Alcohol Abuse · Project Title: CHILDHOOD COMORBIDITY TRAUMA, PARENTAL ALCOHOLISM,AND Principal Investigator & Institution: Nelson, Elliot C.; Assistant Professor; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 05-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This revised new investigator ROl application proposes an assessment of adult twin pairs, their full siblings, and parents ascertained via twins' participation in a recently completed survey of the Australian National Health and Medical Research Council '1989 cohort. The target sample will be: (1) a "childhood abuse" (CA) group (N=500 families) in which at least one twin reported having experienced childhood sexual abuse (CSA), physical abuse (PA), or both; and (2) a "control" group (N=500 families) in which neither twin reported a history of abuse, matched to the CA group on the basis of gender. zygosity, and age. The specific aims of this investigation are: AIM1 To examine parental alcoholism and other parental predictors of offspring CSA and PA, and the routes by which these associations are mediated. AIM2 To use data from non-abused co-twins and siblings to control for family background risk factors to permit: (i) improved estimation of the risks for negative outcomes associated with CSA and PA; (ii) examination of routes by which these risks are mediated and moderated. AIM3 To more comprehensively determine the contributions of CSA and PA, cluster B personality disorders, depression, and anxiety disorders, to the inheritance of alcohol dependence risk and to identify critical intervening variables. These aims will be accomplished by better assessing childhood abuse and neglect history and additional Axis I and II diagnoses in previously interviewed adult twin pairs and by obtaining comprehensive assessments of parents and other siblings (Axis I and H psychopathology as well as childhood abuse and neglect). Despite the limitations of retrospective data, this study population offers important advantages: 1) data available from the recently completed, extensive assessment of twins including history of early home environment, traumatic events, drug use, and parental alcohol problems in addition to psychiatric diagnostic assessments; 2) families with a demonstrated history of cooperation including the twins' willingness to allow telephone assessment of questions about CSA and PA history; 3) an established relationship between twin reports of childhood abuse and parental alcohol problems; 4) very low frequency of abstinence and high mean levels of alcohol consumption suggest that hypothesized relationships are likely to be expressed; 5) a powerful twin sibship design; 6) an ability to generalize findings to the twin panel as a whole. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: CLINICAL INVESTIGATION OF DRUG ABUSE DISORDERS Principal Investigator & Institution: Brady, Kathleen T.; Professor of Psychiatry; Psychiatry and Behavioral Scis; Medical University of South Carolina 171 Ashley Ave Charleston, Sc 29425 Timing: Fiscal Year 2001; Project Start 15-AUG-1999; Project End 31-JUL-2004 Summary: This mid-career investigator award application is designed to support the continued efforts of Dr. Kathleen T. Brady, M.D., Ph.D. in conducting and mentoring patient-oriented drug abuse research. Dr. Brady has been continuously funded to conduct patient-oriented research with substance abusing individuals since completing her psychiatric residency training in 1989. Her particular areas of interest are in psychiatric comorbidity with substance use disorders and the pharmacotherapy of Studies 21 substance use disorders. She is currently funded as the PI on four (Concurrent Treatment of PTSD and Cocaine Dependence, Naltrexone Use in a Community Setting, Sertraline Treatment of Comorbid Alcoholism and PTSD, and Valproate in Relapse Prevention) and the Co-PI on two (Amlodipine in Cocaine Dependence and Buspirone in Methadone Maintained Individuals with GAD) patient-oriented substance abuse research projects. Dr. Brady has a strong track record in mentoring beginning clinical researchers. She is currently the director of the Addiction Psychiatry Fellowship Program and the co-director of a NIDA-funded post-doctoral research fellowship training program. Dr. Brady is a faculty member in the Center for Drug and Alcohol Programs (CDAP) which is an active and productive clinical and research training environment. CDAP provides a variety of education and training-related activities to faculty and students. There are currently eleven faculty at CDAP conducting eighteen funded, patient oriented research projects. The candidate's immediate career goals include the initiation of pilot work to support the competing renewals of existing projects and assisting two junior faculty with the submission of K awards. Her longterm career goals are to continue work in patient-oriented substance abuse research in new directions which build on existing studies. Investigation of CRF antagonists in the treatment of substance use disorders in a clinical setting and the development of a human laboratory model for the measurement of risk-tasking and impulsivity are two areas of preliminary investigation which would be developed during the award period. The candidate would also use the time and funding provided through this award to expand her activities in mentoring fellows and junior faculty in patient-oriented research. This award will allow Dr. Brady to be relieved from a number of clinical and administrative duties in order to refocus her career to center on clinical research and clinical research training activities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COCAINE, ALCOHOL, AND COCAETHYLENE--CLINICAL EFFECTS Principal Investigator & Institution: Mccance-Katz, Elinore F.; Associate Professor; Montefiore Medical Center (Bronx, Ny) Bronx, Ny 104672490 Timing: Fiscal Year 2001; Project Start 20-MAR-1996; Project End 31-JUL-2003 Summary: Epidemiological studies have shown that at least 62% of cocaine abusers and possibly up to 90% in some populations are concomitant alcohol abusers. We conducted a study which investigated the effects of simultaneous consumption of cocaine and alcohol in humans and prospectively demonstrated the formation of cocaethylene, a metabolite formed by ethyl esterification of cocaine which appears to have pharmacological properties similar to cocaine. Subjects experienced prolonged and increased euphoria relative to cocaine or alcohol alone administration and had significant increases in heart rate following cocaine-alcohol administration leading to speculation regarding the role of cocaethylene. Our pilot study in which intranasal cocaethylene was administered to 8 subjects showed it to be similar to cocaine, but with an elimination half-life about twice that of cocaine. our pilot study of acute disulfiram 250 mg treatment followed by cocaine administration showed decreased cocaine craving and increased dysphoria in some subjects. In our open pilot study, outpatients randomized to disulfiram 250 mg daily had a significant decrease in cocaine use as compared to subjects treated with naltrexone. This FIRST application is composed of a series of pharmacologic challenge (study drug administration) studies designed to test the hypothesis that cocaethylene plays a significant role in behavioral and physiological responses during cocaine- alcohol abuse. The 5 proposed studies will each enroll 28 subjects for a total of 140 subjects over 5 years. The studies have been designed to 22 Alcohol Abuse include an analysis of gender differences in responses to study drug administration which may be important to the pathoetiology of cocaine- alcohol abuse and could have important implications for treatment. Study 1 will explore the effects of multiple doses of cocaine in the presence of a steady state of ethanol. Studies 2 and 3 will determine the behavioral, physiological and pharmacokinetic properties of cocaethylene in humans using cocaine as a comparator. Studies 4A and 4B will test the hypothesis that disulfiram is an efficacious pharmacotherapy for cocaine and alcohol abuse using a double-blind, placebo-controlled, limited randomization, dose-response study design. Cocaethylene has been shown to have mush greater selectivity for the dopamine transporter than does cocaine and does not block serotonin reuptake. One hypothesis regarding the high incidence of comorbid cocaine and alcohol abuse is that cocaethylene, with its lack of serotonin reuptake inhibition, alleviates acute abstinence symptoms and dysphoria associated with binge cocaine use. Cocaethylene may be used as a tool to sort out the role of serotonin versus dopamine in mediating the actions of disulfiram on cocaine effects. Cocaethylene will be utilized in Study 4B as a pharmacologic probe in an attempt to deuterium the relative contribution of dopamine and serotonin to cocaine effects and to develop an understanding of possible mechanisms by which disulfiram modifies drug effects. Findings from this study could be important to the development of new pharmacotherapies for cocaine-alcohol abuse. In total, these studies should provide significant contributions to the current state of knowledge regarding the epidemiology of cocaine-alcohol abuse and treatment of these disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COGNITIVE MECHANISMS OF ALCOHOL ABUSE Principal Investigator & Institution: Fillmore, Mark T.; Assistant Professor; Psychology; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2001; Project Start 01-SEP-2001; Project End 31-MAY-2004 Summary: (provided by applicant): Excessive alcohol use during a drinking episode (i.e., a binge) contributes to many adverse health and social consequences. Binge drinkers are more likely to drive while intoxicated and to suffer blackouts and hangover. A continued pattern of binge drinking poses immediate health risks (e.g., alcohol poisoning, acute alcoholic hepatitis), and long-term consequences, such as alcohol dependence and liver cirrhosis. Given that even mild doses of alcohol impair cognitive processes that control behavior, it is important to understand how such disturbances also can reduce control over alcohol intake once a drinking episode has begun. The proposed project aims to determine how the inability to curtail alcohol consumption during a drinking episode is linked to alcohol-induced impairment of cognitive processes involved in the self-control and regulation of behavior. The research will examine acute alcohol impairment of cognitive functions in young non-dependent drinkers. The project combines measures of alcohol effects on cognitive inhibitory processes with traditional abuse liability indices based on subjective rewarding effects of the drug and its ability to reinforce self-administration. Studies will determine the degree to which alcohol abuse potential is influenced by two mechanisms of drug action: 1) reward-enhancing effects (i.e., elevation of an approach "go" mechanism); and 2) impairment of cognitive inhibitory processes (i.e., suppression of an avoidance "stop" mechanism). Multiple strategies will test the role of acute cognitive impairment in the abuse liability of alcohol. A drug-reinforcement model will test the degree to which preload alcohol doses "prime" subsequent drug self-administration by impairing inhibitory control processes that regulate behavior. The research also will test an indirect Studies 23 alcohol antagonist drug. caffeine, and an approved medication for alcohol abuse, naltrexone, for their ability to reduce alcohol self-administration by blocking its impairing effects on inhibitory control. The research has several long-term objectives. The findings will provide an understanding of how drinkers' susceptibility to alcohol's acute cognitive-impairing effects can pose an early-onset risk factor for later alcohol dependence by promoting a continued pattern of abusive binge drinking. The research strategies also will provide methods for testing the role of cognitive mechanisms in the treatment efficacy of existing pharmacotherapies. such as naltrexone, as well as some investigational medications that might operate via cognitive mechanisms (e.g., acamprosate). Finally, the proposed experiments will provide initial methods and protocols for studying alcohol use in combination with other drugs of abuse that also disrupt cognitive functions, such as cocaine, for which binge use is also a common pattern of drug-taking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COLLEGE DRINKING AND ITS LONG-TERM CONSEQUENCES Principal Investigator & Institution: Klepinger, Daniel H.; Battelle Centers/Pub Hlth Res & Evaluatn Health Research & Evaluation Seattle, Wa 98105 Timing: Fiscal Year 2002; Project Start 25-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Despite implementation of a variety of policies and programs designed to reduce under-age and excessive drinking on college campuses, alcohol abuse among college students remains a serious problem. Recent figures indicate that 62% of young adults aged 18 to 22 enrolled in college report using alcohol in the last month, 41% report binge drinking in the last month, and 16% report heavy use of alcohol in the last month. These figures for college students are higher than those observed for same-age peers who are not in college, and have remained fairly stable over the past two decades. Given that alcohol abuse can have serious health and social consequences, the high rate of alcohol abuse in college is an important public health concern. We currently do not know the extent to which alcohol abuse during college is associated with subsequent adult alcohol abuse or with experiencing the long-term health and social consequences typically associated with alcohol abuse. Further, we do not know whether alcohol abuse during college is more or less detrimental than alcohol use among college-age young adults who do not attend college. To fully understand the importance and long-term consequences of drinking during college it is essential to place college drinking within the more general context of drinking both in and outside of college during the college-age years. If patterns of lifetime alcohol use are established during the college-age years, then it is important to examine college-age drinking in general, and determine whether college drinking is especially relevant for subsequent patterns of alcohol use and for experiencing the long-term effects of college-age drinking. There is also insufficient information about the risk factors associated with college and college-age drinking, and whether the college experience exacerbates their influence on alcohol abuse. The proposed research will examine longitudinally from high school to college-age to midlife the evolution and health and social consequences of college and college-age drinking using non-drinkers and individuals who do not attend college as comparison groups. The analytic approach we propose to use permits us to control for unobserved differences among these groups and college drinkers that may bias the estimated effects of college and college-age drinking. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 24 Alcohol Abuse · Project Title: COMBINATION NICOTINE REPLACEMENT FOR ALCOHOLIC SMOKERS Principal Investigator & Institution: Cooney, Ned L.; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-AUG-1997; Project End 31-JUL-2006 Summary: (provided by applicant): This is a competitive renewal of a grant entitled "Field Study of Smoking Cessation in Alcohol Treatment." Tobacco use among alcoholics is a major public health problem. The broad objective of this study is to develop recommendations for empirically supported smoking cessation treatment for alcoholic smokers in the initial phase of outpatient alcoholism treatment. In a double blind, placebo controlled clinical trial; a sample of 175 alcohol dependent cigarette smokers will be recruited from the community and treated in a six month outpatient alcohol and tobacco treatment protocol. All subjects will be offered a total of 15 individual treatment sessions with a goal of abstinence from alcohol and tobacco. They will also be randomized to one of two levels of nicotine replacement therapy (NRT). One group will receive Combination INRT consisting of active nicotine patch and active nicotine gum, while a comparison group will receive Single NRT consisting of active nicotine patch and placebo nicotine gum. Smoking and drinking outcome will be assessed across one year from the onset of treatment. In addition to the outcome assessment, Ecological Momentary Assessment (EMA) methodology will be used to examine treatment process. EMA data will be collected using cellular telephones combined with Interactive Voice Response technology to randomly sample each subject's experience in the natural environment during two week periods before smoking cessation, immediately after smoking cessation, and two months after smoking cessation. This methodology will be used (a) to compare the overall effects of Single versus Combination NRT on frequency and intensity of urge to smoke and urge to drink; (b) to determine the immediate impact of nicotine gwn self administration on subsequent momentary urge to drink and urge to smoke; and (e) to determine the momentary effect of urges to drink and urges to smoke on subsequent nicotine gum self administration. The results of these process analyses will lead to improved understanding of the effects of nicotine replacement on alcoholic smokers and factors affecting their compliance with nicotine gum. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COMBINING HIV AND ALCOHOL INTERVENTIONS IN STD CLINICS Principal Investigator & Institution: Weinhardt, Lance S.; Assistant Professor; Psychiatry and Behavioral Med; Medical College of Wisconsin Po Box26509 Milwaukee, Wi 532264801 Timing: Fiscal Year 2001; Project Start 28-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant): This application is in response to RFA AA-01-004 "RESEARCH ON ALCOHOL AND AIDS," and proposes a four-year project to evaluate the efficacy of a HIV-risk reduction intervention that combines motivationalenhancement based treatment for alcohol problems with HIV counseling and testing. Our central premise is that people with alcohol use disorders (i.e., abuse and dependence), particularly those in inner-city communities with elevated HIV seroprevalence rates, are at heightened risk for infection with HIV and other STDs and benefit less from HIV-risk reduction interventions than other participants, and that theory-based clinic-delivered interventions targeting alcohol use and HIV risk behavior Studies 25 can be effective in reducing risk behavior in this population. We will randomly assign people recruited at an urban STD clinic to one of three time-matched conditions: (1) standard information-based pre-test counseling and HIV antibody testing, followed in two weeks by the test result and information-based post-test counseling; (2) clientcentered theory-based pre-test counseling and HIV antibody testing, followed in two weeks by the test result notification and client-centered theory-based post-test counseling; or (3) client-centered, theory-based based pre-test counseling and HIV antibody testing, followed in two weeks by test result notification and post-test counseling (as implemented in Condition 2) and a 45-minute alcohol use disorder intervention based on motivational interviewing principles. We will assess participants' sexual and substance use behavior at baseline, post-intervention, and in 3-, 6-, 9-, and 12month follow-up interviews. We will test the hypothesis that participants in the HIV counseling and testing intervention (HIV-CT) plus alcohol treatment condition will exhibit greater sexual risk behavior reduction and maintain these reductions longer than participants in either of the other conditions. We will also examine whether the alcohol treatment in this setting leads to reductions in alcohol use and whether theory-based HIV-CT alone led to greater risk behavior reduction than the information-based HIVCT. In addition, the design of the proposed study will provide data with which to examine theory-based variables that may mediate intervention outcomes, factors involved in maintenance of risk behavior reduction, and the association of alcohol use with sexual risk behavior. Combining these interventions for HIV risk reduction and alcohol use problems at STD clinics and other HIV testing sites may result in an efficient HIV-prevention intervention package with enhanced effectiveness that is feasible in real-world settings and has the potential to be used with many people each year. Findings derived from the study can also guide future efforts to develop combined alcohol/HIV interventions for groups at risk for HIV infection and the use of brief motivational interventions for alcohol problems among non-treatment seeking problem drinkers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COMORBID MENTAL DISORDERS IN PERIODS OF SOCIAL DISRUPTIO Principal Investigator & Institution: Bromet, Evelyn J.; Professor; Psychiatry and Behavioral Scis; State University New York Stony Brook Stony Brook, Ny 11794 Timing: Fiscal Year 2001; Project Start 25-SEP-2000; Project End 31-AUG-2005 Summary: (Applicant's abstract): This proposal seeks support to obtain nationally representative data for Ukraine in the years 2000-2001 in conjunction with the World Health Organization's (WHO) World Mental Health (WMH2000) Initiative in order to study the lifetime and 12-month prevalence of alcoholism, substance abuse and mental illness, concomitant role impairments and disability, the availability of adequacy of treatment, and the socio-demographic correlates of alcohol and mental disorder, impairment, treatment, and treatment adequacy. The Ukraine study will also generate data on the prevalence and correlates of extreme stress in the general population. The international portrait will be used by the WHO to increase recognition among health policy makers of mental disorders and alcoholism as a priority area in public health prevention and intervention efforts throughout the world. A representative sample of 5,000 people 18 years and older will be interviewed with the CIDI, supplemented by other measures of stress (including material deprivation), drinking behavior, social desirability, social support, mastery, family history of alcohol problems, and self-report symptomatology. Five hundred individuals will be re-interviewed by psychiatrists with 26 Alcohol Abuse the SCAN in order to examine the reliability of the CIDI diagnoses. Ukraine provides a unique epidemiologic laboratory for studying alcoholism and mental illness, and both the process and fruits of this study will be of great benefit there. While the cross-national measurement issues are challenging and will not be perfectly resolved in the near future, the data generated from the proposed study will nevertheless deepen our understanding of the rates and risk factors of alcoholism and mental illness in Ukraine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: CONTROL OF ALCOHOL INTAKE BY BRAIN-GUT PEPTIDES Principal Investigator & Institution: Geary, Norcross D.; Professor; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 01-AUG-2001; Project End 31-JUL-2004 Summary: Abuse of alcohol is a major social, economic and medical problem, accounting this year for 20-40% of hospitalizations, $167 billion in costs, and over 100,000 deaths according to the NIAAA (1999). The current very imperfect understanding of the physiological mechanisms involved in alcohol use and abuse is an important impediment to the development of effective therapies. Therefore, this application proposes a new direction in the analysis of the physiological control of alcohol ingestion in laboratory animals. That is to investigate the potential roles in alcohol intake of several peripheral and central regulatory peptides and of estradiol, all of which contribute to the regulation of food intake. The rationale of this proposal is that in addition to its central pharmacological effects, alcohol produces oropharyngeal, gastrointestinal and systemic stimuli similar to those occurring after food ingestion. Behavioral techniques that have been extremely useful in the investigation of the control of food intake will be applied to the analysis of the control of alcohol ingestion for the first time. These include the measurement of the microstructural organization of bouts of alcohol ingestion and the gastric sham feeding technique. Most work will be done in a genetic model of alcohol abuse, the Marchigian Sardinian alcohol-preferring (msP) rat. The msP rat prefers alcohol to water in a free-choice situation and chronically ingests intoxicating amounts of alcohol. In addition, we propose to investigate the control of alcohol intake in fa/fa and db/db mice that have mutations of the leptin receptor that lead to syndromes of hyperphagia and obesity. Finally, we propose to determine if any effects on alcohol ingestion in these mutant animals can be reversed by tissue-specific transgenic reinsertion of the normal gene. In order to increase the effectiveness and productivity of this program, work will proceed at two sites. The PI and his colleagues at the Bourne Behavioral Research Laboratory, Weill Medical College of Cornell University, have a long record of progress in the analysis of peripheral peptidergic mechanisms of the control of ingestion as well as the influence of estradiol on this control in females. The co-PI and his colleagues at the University of Camerino are experts in the analysis of alcohol ingestion and reward in alcohol-preferring rats, with special emphasis on central peptidergic controls of behavior. The work will be closely coordinated, and we expect this cooperative effort to be very productive. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: CONTROL OF ETHANOL INTAKE BY MGLUR5-PKCEPSILON PATHWAY Principal Investigator & Institution: Olive, M Foster.; Associate Investigator; Ernest Gallo Clinic and Research Center 5858 Horton St, Ste 200 Emeryville, Ca 94608 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2008 Studies 27 Summary: (provided by applicant): Recent evidence suggests that the epsilon isoform of protein kinase C (PKCepsilon) plays a critical role in ethanol-seeking behavior. We recently demonstrated that mice lacking PKCepsilon and consume 50-75% less ethanol than their wildtype counterparts in two separate self-administration paradigms. We also demonstrated that PKCepsilon null mutant mice demonstrate reduced ethanol intake following deprivation (a model of relapse), reduced ethanol withdrawal severity, and a lack of ethanol-stimulated mesolimbic dopamine release. These data suggest that selective pharmacological inhibition of PKCepsilon activity may be a novel therapeutic avenue for the treatment of various aspects of alcoholism. However, given the high degree of structural homology between PKC isoforms, to date there are no specific CNSpenetrant pharmacological compounds that selectively inhibit PKC activity. An alternative approach to directly inhibiting PKCepsilon activity is to pharmacologically modulate a specific neurotransmitter receptor system that is directly coupled to PKCepsilon. Our preliminary data show that the type 5 metabotropic glutamate receptor (mGluR5) may be functionally linked to PKCepsilon activity. We show that the selective mGluR5 antagonist MPEP reduces ethanol self-administration and enhances ethanol-stimulated locomotor activity in a PKCepsilon-dependent manner. We also show that PKCepsilon and mGluR5 immunoreactivity are highly co-localized in brain regions known to be involved in ethanol consumption and reinforcement. Finally, MPEP reduces the rewarding effects of ethanol as measured by the conditioned place preference paradigms. Taken together, these data indicate that the mGluR5 receptor may be functionally coupled to PKCepsilon, and that selective mGluR5 antagonists may be useful in treating excessive alcohol consumption, relapse following detoxification, and withdrawal symptom severity. The following Specific Aims describe preclinical experiments designed to investigate the functional coupling between mGluR5 and PKCepsilon, and to evaluate the ability of mGluR5 antagonists to reduce ethanolstimulated mesolimbic dopamine release, relapse to drinking following deprivation, and withdrawal severity. The first specific aim will be to biochemically characterize the functional coupling between the mGluR5 receptor and PKCepsilon activity. The second specific aim will determine if mGluR5 antagonists inhibit ethanol-stimulated mesolimbic dopamine release, a phenomenon thought to contribute to the reinforcing properties of ethanol. The third specific aim will determine if mGluR5 antagonists reduce relapse to ethanol self-administration following deprivation in both wildtype and PKCepsilon null mutant mice. Finally, the fourth specific aim will determine if mGluR5 antagonism attenuates ethanol withdrawal severity in both wildtype and PKCepsilon null mutant mice. Together, these proposed preclinical studies will attempt to delineate a novel pharmacological target that may be used to treat various aspects of alcohol abuse and alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COST EFFECTIVENESS OF ALCOHOL TREATMENT Principal Investigator & Institution: Zarkin, Gary A.; Director; Research Triangle Institute Box 12194, 3040 Cornwallis Rd Research Triangle Park, Nc 27709 Timing: Fiscal Year 2001; Project Start 02-AUG-2000; Project End 31-JUL-2005 Summary: Alcohol and drug abuse impose significant costs on society. In 1992, the economic cost of alcohol and drug abuse was estimated to be 246 billion dollars. The majority of these costs arise from alcohol abuse (148 billion dollars). Partly in response to these costs, new pharmacotherapies have recently been developed to treat alcohol abuse and alcoholism. Likewise, important advances have been made in the development of behavioral interventions designed to treat alcohol abuse. While new 28 Alcohol Abuse alcohol abuse therapies have been developed over the last several years, pressures have been developing to identify therapies that are not only efficacious but also cost-effective. Much of this pressure has been driven by managed care, which has placed a premium on economic studies that assess whether the clinical and economic outcomes of new pharmaceutical and behavioral therapies justify their costs. To increase the understanding of the efficacy of two pharmacotherapies (naltrexone and acamprosate) and psychotherapy, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recently funded Project COMBINE, a multi-site, randomized control trial (RCT). This trial is one of the most ambitious clinical trials ever undertaken for the treatment of alcoholism. However, in spite of the importance of economic analysis of clinical trials, the Project COMBINE protocol does not include cost or cost-effectiveness studies. The purpose of this study is to examine the costs and cost-effectiveness of behavioral and pharmacotherapies for alcoholism (and their combination) included in Project COMBINE. Our proposed project builds on Project COMBINE's RCT design, which will provide great credibility of our results in the scientific community. Because of the number of therapies studied, the strength of the study design, and the limited existing literature on the cost and cost-effectiveness of alcohol treatments, the proposed study represents a major advance in the cost and cost-effectiveness analysis of alcohol treatment; our results should have a profound effect on the choice of alcohol treatment in the United States. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: COSTS INTERVENTIONS AND BENEFITS OF ALCOHOL SERVICES & Principal Investigator & Institution: French, Michael T.; Professor of Health Economics; None; University of Miami Box 016159 Miami, Fl 33101 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2006 Summary: Despite considerable methodological and empirical developments in economic assessment of primary health care programs, economic evaluation techniques are not systematically adopted in studies of behavioral health care, especially addiction interventions. Compared to other health care areas, evaluation of addiction interventions is also particularly complex due to the diversity of delivery systems, the perplexity of the financing schemes, and the wide spectrum of social and economic outcomes. With the continuing need for more and improved economic evaluation findings for alcohol abuse services and interventions, the present project will address the following three broad aims: 1. Examine whether recently developed methods to estimate the economic costs and benefits of drug abuse services and interventions can be utilized in evaluation studies of alcohol abuse services and interventions; 2. Make any modifications and/or enhancements to customize these earlier developed methodologies and instruments for use in current studies of alcohol abuse services and interventions; 3. Test the practicality and scientific integrity of using these contemporary economic evaluation methods for alcohol abuse services and interventions by adding (or supplementing) an economic evaluation component to several NIAAA-funded services research and intervention projects in Arkansas, California, Florida, Illinois, New Mexico, Pennsylvania, and Wisconsin. The proposed study will complement and extend an existing research grant with the National Institute on Drug Abuse (NIDA), which focuses on developing and testing economic evaluation methods for drug abuse interventions, including the application of clinical and financial instruments in economic evaluation (e.g., ASI, DATCAP, TSR) (1R01 DA11506). Since the start of the grant in September 1998, various economic evaluation methods have been developed, Studies 29 empirically tested, and implemented. Presumably, most of the methods can be applied to alcohol abuse services and interventions as well. To provide an empirical laboratory for testing these methods, the investigative team for the proposed study has assembled an impressive group of NIAAA grantees that have offered access to outcome and other data from their current projects for the purposes of adding (or improving) an economic evaluation component to their research studies. Since the demand for economic evaluation studies of alcohol abuse services and interventions is increasing in the U.S. as well as abroad, the proposed study holds important potential to assist researchers, policymakers, and program directors with economic evaluation guidelines and "real world" applications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: CRA AND ENHANCED JOB TRAINING FOR HOMELESS WOMEN Principal Investigator & Institution: Smith, Jane E.; Associate Professor; Psychology; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2001; Project Start 27-SEP-2001; Project End 31-JUL-2005 Summary: Women and families now comprise about 30 percent of the homeless population and they are viewed as the fastest rising subgroup. Alcoholism is their most widespread health problem It is unfortunate, then, that despite the availability of efficacious treatment programs, women enter and remain in them at much lower rates than do men. Some suggest that women will only seek treatment if women's issues are addressed or when they have options other than predominantly male programs. Since the proposed study will attempt to recruit a large sample of homeless women, an allfemale program will be conducted utilizing a treatment that has been modified to take women's issues into consideration. Ninety-nine alcohol-dependent or alcohol-abusive homeless women will be randomly assigned to one of three conditions: case management (CM), the Community Reinforcement Approach (CRA), or an enhanced CRA program called CREATE (Community Reinforcement, Employment, and Training Enhancement). It is considered essential to investigate a CM program, both due to its widespread popularity, and the fact that it has only inconsistent empirical backing. The behavioral intervention, CRA, has proven to be efficacious for treating alcoholics and was listed as the most cost-effective treatment in the latest meta- analytic review. In its recent successful application to a homeless population, promising preliminary outcomes were detected for the small sample of female participants. However, two limitations were apparent. First, a considerable number of women relapsed when both their treatment and their stay in the abstinence-contingent, free housing ended. Consequently, the current proposal is an attempt to provide aftercare services during this high-risk period. It also will specifically address critical issues for these women (e.g. sexual victimization) from the start. A second problem was the high rate of unemployment posttreatment. In response, this project will offer basic computer skills training to the CREATE group through an empirically-based contingency management (voucher) program proven to enhance job-training attendance. The CREATE condition also will receive motivational CRA procedures called Systematic Encouragement to bolster job-training attendance and to make the work environment a reinforcing community. It is predicted that both of the CRA conditions will result in significant improvement in alcohol use, employment, and housing stability compared to CM, and that the CREATE group will obtain employment outcomes superior to the regular CRA group. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 30 Alcohol Abuse · Project Title: DIFFUSING A PC-BASED INTERVENTION FOR PROBLEM DRINKERS Principal Investigator & Institution: Squires, Daniel D.; Psychology; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2002; Project Start 20-SEP-2002; Project End 31-JUL-2003 Summary: (provided by applicant): The overall goal of this research is to evaluate relevant issues confronting the integration of research findings into clinical practice, and to outline the perceived benefits of an automated, multi-use computer program for the assessment and treatment of alcohol abuse, and associated outcome and program evaluation functions. This multi-site, statewide (NM) randomized trial utilizes an automated computer-based assessment, treatment, and follow-up evaluation program to examine two empirical questions. First, does the program effectively disseminate the use of clinical (brief) interventions known to be efficacious for the treatment of alcohol and/or drug abuse across a variety of treatment settings? Second, how useful do treatment providers find an automated intervention and data management program to be, and what, if any, issues arise with respect to the diffusion of such an innovation? Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: DISADVANTAGED YOUTH AND ALCOHOL ABUSE PREVENTION Principal Investigator & Institution: Schinke, Steven P.; Professor; None; Columbia Univ New York Morningside 1210 Amsterdam Ave, Mc 2205 New York, Ny 10027 Timing: Fiscal Year 2001; Project Start 01-APR-1999; Project End 31-MAR-2004 Summary: This study will develop and test intervention strategies to prevent alcohol and other substance abuse among high-risk youth. The study has three aims: 1) Develop intervention strategies to prevent alcohol and other substance abuse among high-risk youth. 2) Test the strategies in a randomized trial with high-risk youth in community settings. 3) Develop and deliver booster sessions to extend and expand intervention effects. 4) Longitudinally evaluate the strategies through follow-up data collections. 5) Analyze relationships among individual-level variables for youth and parent participants. The proposed study will occur in three phases. In a 10-month preparation phase, the investigators will develop intervention and measurement protocols, draw a representative sample of community organizations for study participation, and recruit and train intervention delivery agents. A 12-month implementation phase will initiate field operations of a clinical trial, including pretesting, intervention delivery, process data collection, and posttesting. A follow-up phase in the last years of the study will involve follow-up testing, booster session delivery, and data analysis. The study's alcohol and other substance abuse prevention strategy includes skills interventions that will engage groups of high-risk youths in community settings, and parent-enhanced skills intervention that will help family members sustain youths' risk reduction efforts. By engaging parents in the skills-based intervention, the prevention protocol will tap natural resources in youths' environments to nurture and sustain their efforts to avoid problems with alcohol and other substance abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: DOMESTIC VIOLENCE AMONG FEMALE ALCOHOLICS IN TREATMENT Principal Investigator & Institution: O'farrell, Timothy J.; Associate Chief of Psychology; Psychiatry; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Studies 31 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Domestic violence and alcohol problems are closely linked. Men who drink heavily are more likely to perpetrate wife abuse and women who abuse alcohol are more likely to be victims of violence. Fifty to 60% of male alcoholics have been violent toward a female partner in the year before alcoholism treatment, and two-thirds or more of women alcoholic patients have been the victims of violence from a male partner. We have been studying the natural history of domestic violence before and after alcoholism treatment under the hypothesis that violence is reduced after treatment and nearly eliminated with abstinence. Two recent studies with male alcoholics and an initial pilot study with female alcoholics showed that male-tofemale domestic violence decreased substantially after behavioral couples therapy. Despite these initial findings, virtually nothing is known about changes in domestic violence after more typical individual treatment for alcoholism. In addition, models designed to explain the occurrence of domestic violence and variations in violence before and after treatment have received very little attention. Our ongoing NIAAA grant examines violence among male alcoholics in individual treatment, and we propose to extend this work to female alcoholic patients. This study will examine a sample of 320 married or cohabiting female alcoholics as they enter traditional individual treatment for alcoholism, along with a demographically similar comparison group of 320 couples without current alcohol problems from the community. We will follow both samples for 18 months in a multi-wave longitudinal design. PROJECT OBJECTIVES are to describe the natural history and to explore explanations of male-to- female violence among female alcoholics and their male partners by addressing 2 aims: (1) to find out if violence is reduced relative to a comparison sample as a function of treatment and associated reductions in drinking; and (2) to explore explanatory models that consider alcohol use and other risk factors for violence. This project will provide clinically important and policy-relevant information about whether treatment for female alcoholics is associated with meaningful reductions in the risk of their violent victimization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: DOSE RESPONSE EFFECTS OF ALCOHOL ON BONE METABOLISM Principal Investigator & Institution: Turner, Russell T.; Professor; Mayo Clinic Rochester 200 1St St Sw Rochester, Mn 55905 Timing: Fiscal Year 2002; Project Start 29-SEP-1996; Project End 31-JAN-2007 Summary: (provided by applicant): Chronic alcohol abuse is the most important "life style" risk factor for osteoporosis. The long-term goal of the proposed research is to understand the cellular and molecular mechanisms responsible for mediating alcohol's detrimental actions on the skeleton and, with this improved understanding, to develop effective countermeasures. Research performed during the current funding interval provides strong evidence that alcohol-induced bone loss is due to a disturbance in the bone remodeling cycle. Specifically, an imbalance in the coupling of bone formation to the prevailing rate of bone resorption creates inadequate new bone to compensate for bone resorption, resulting in net bone loss. At the molecular level, we have established a clear positive association between bone formation and insulin-like growth factor-I (IGF1) gene expression in bone tissue. Furthermore, the architectural, cellular and gene expression changes in tibiae of rats fed alcohol are strikingly similar to those that follow hypophysectomy (HYPOX), suggesting that the underlying mechanisms for the skeletal response to alcohol abuse and growth hormone (GH) deficiency are similar. Because most of the effects of GH on bone cells are mediated by locally produced IGF-1, the 32 Alcohol Abuse detrimental skeletal effects of alcohol abuse and GH deficiency may share disturbed IGF-1 signaling as a common pathway. The antagonistic effects of HYPOX on bone formation can be reversed with parathyroid hormone (PTH), which up-regulates IGF-1 expression by bone cells. Based on these findings, our working hypotheses are that alcohol-induced osteoporosis is largely due to decreased IGF-1 expression by osteoblasts, and can be prevented or reversed by treatment with PTH. We propose to test these hypotheses in adult and adolescent female rat models for chronic alcohol abuse by determining changes in bone and mineral metabolism in: (1) HYPOX and intact rats fed alcohol; (2) HYPOX and intact rats fed alcohol and treated with GH; (3) HYPOX and intact rats fed alcohol and treated with IGF-1; and (4) HYPOX and intact rats simultaneously fed alcohol and treated with PTH; and (5) intact rats fed alcohol to induce bone loss and then treated with PTH. A suite of complementary techniques will be employed in these experiments to evaluate the skeletal changes, including dynamic and static bone histomorphometry, bone densitometry, micro-CT, biochemical markers, mechanical testing, immunohistochemistry, radioautography and RNA analysis by Northern blots and RNase protection assays. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: DWI PREVENTION--STATEWIDE RANDOMIZED TRIAL OF INTERLOCKS Principal Investigator & Institution: Rauch, William J.; Researcher; Westat, Inc. 1650 Research Blvd Rockville, Md 208503195 Timing: Fiscal Year 2002; Project Start 01-AUG-1998; Project End 31-JUL-2004 Summary: The primary purpose of the proposed study is to conduct a rigorous outcome evaluation of a statewide randomized trial of alcohol interlock systems in the State of Maryland as a means of preventing recidivism in first-time DWI (Driving While Intoxicated) offenders. All first-time DWI offenders in Maryland will complete a State mandated diagnostic evaluation by the investigative team. Then all alcohol dependent/ abusive DWI offenders (estimated at 6,450 individuals) will be randomly assigned to Standard Treatment (T) or to an Ignition Interlock plus Treatment (IIT) condition that will be mandated by the Maryland Department of Motor Vehicles for 12 months. In addition to examining rates of DWI recidivism and interlock tampering and false start data, the current project will include confidential assessments of DWI risk behavior, alcohol use, social and psychological functioning at each of the three data collection points. Study participants will be assessed at baseline and at 12-month and 24-month follow-ups. The current project will be the first randomized Statewide trial of alcohol interlocks ever to be conducted, and is the second truly randomized trial of interlocks ever to be conducted (including any studies that are currently underway, such as Voas et al. in Canada). The first randomized trial of interlocks, also conducted by the proposed PI, was with multiple offenders in the State of Maryland (see Preliminary Studies section). This project is also the first study ever to assess the effects of treatment and treatment plus interlock on other variables such as alcohol use, self-reported rates of driving after drinking, and levels of psychological and social functioning over time as well as conventional outcomes such as re-arrest for DWI. In general, the proposed study will provide the first efficacy information available on utilizing ignition interlock systems with first time DWI offenders, and will allow for a detailed examination of which individuals respond best to the treatment conditions examined. The study will also be the first to provide an extensive description of first-time DWI offenders. It is also the first study to investigate possible unintended negative consequences of introducing alcohol interlocks (e.g., an increase in drinking when not driving, an increase in riding Studies 33 with intoxicated drivers, and a decrease in social functioning). It is also the first study to investigate the effects of interlocks as an adjunct to treatment in various racial/ethnic subpopulations, and in other subgroups. The proposed project takes advantage of a unique opportunity where State officials are willing to randomly assign all first-time "problem drinker", DWI offenders to participate in such a longitudinal study. If the project produces the anticipated effect in reducing DWI recidivism in first-time DWI offenders, this program could be immediately adopted by the State of Maryland, and could serve as a national model for DWI prevention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: ECONOMIC ASPECTS OF ALCOHOL USE AND ABUSE Principal Investigator & Institution: Alexandre, Pierre K.; Epidemiology and Public Health; University of Miami Box 016159 Miami, Fl 33101 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): This application proposes a five-year research program for the Mentored Research Scientist Development Award (K01) from the National Institute on Alcohol Abuse and Alcoholism for Pierre K. Alexandre, Ph.D. The Principal Investigator is an ideal candidate for this award given his limited training in epidemiology of alcohol addiction and treatment, alcohol research methods, and research ethics, his desire for advanced training in health and labor economics, and the economics of addiction; the solid infrastructure available to him at the University of Miami, and the exceptional group of collaborators that have agreed to work on this project. The proposed career development and research program will enable Dr. Alexandre to establish a strong training and research foundation in the economics of alcohol use and abuse, to achieve important accomplishments in technical writing and presentations, and to develop as an independent alcohol researcher. Dr. Alexandre (PI), Dr. French (mentor), and a team of multidisciplinary collaborators will use the U- or Jshaped alcohol-mortality relationship of the medical literature as a guide to examine economic aspects of alcohol use and abuse as they relate to labor markets, health care utilization and cost, and crime. The empirical analysis will use national surveys, particularly the National Household Survey on Drug Abuse and the National Longitudinal Surveys of Youth, to pursue the following specific aims: (1) Determine the relationship between alcohol consumption and labor market measures such as earnings, labor force participation, employment, and number of weeks worked, (2) Determine the relationship between alcohol consumption and the utilization and cost of medical care, and (3) Determine the relationship between alcohol consumption and the prevalence and cost of crimes. The main outcomes of this Mentored Research Scientist Development Award (K01) will be (1) Training in epidemiology of alcohol addiction and treatment, (2) advanced health economies, labor economics, and economics training for Dr. Alexandre, (3) training in research ethics, (4) multidisciplinary research on the economics of alcohol use and abuse, (5) conference presentations on alcohol research findings, (6) several publications in peer-reviewed professional journals, and (7) developing R03, R01, or other grant applications to function as an independent researcher at the end of the award. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: EFFECTIVENESS OF ASSERTIVE AFTERCARE FOR YOUTH Principal Investigator & Institution: Godley, Mark D.; Chestnut Health Systems 1003 Martin Luther King Dr Bloomington, Il 61701 34 Alcohol Abuse Timing: Fiscal Year 2001; Project Start 01-JUN-1997; Project End 31-MAY-2002 Summary: APPLICANT'S ABSTRACT: The majority of adolescents entering residential treatment programs already have chronic and relapsing problems with alcohol abuse and dependence as well as multiple comorbid problems that complicate treatment. Two thirds relapse to alcohol use within 90 days after discharge from residential programs, a fifth returning to weekly use. While all are referred to an outpatient program at discharge, in some counties as many as 60% never get any treatment and only a fraction of these stay in aftercare treatment for even four sessions. The primary goal of this research is to evaluate the effectiveness of an Assertive Aftercare Protocol (AAP) in increasing successful transfer and decreasing relapse and other problems relative to the current system's Status Quo (SQ) level of aftercare. AAP is designed to ensure a specified quantity and quality of aftercare services are provided including assessment, aftercare planning, frequent community-based contacts, linkages between systems, relapse prevention, problem solving, social skill building; family/social support and other forms of case management. The specific aims are to evaluate two core hypotheses: Hl. Following discharge from residential treatment, clients randomly assigned to the experimental assertive aftercare protocol will have improved intermediate outcomes (treatment participation, self-efficacy We will test these hypotheses for both immediate and long-term effects in a blocked randomized field experiment. Over a 3-year period approximately 250 clients will be interviewed at intake to residential care, discharge from residential care, and then quarterly post-discharge for a year. At the point of discharge from residential services, half the clients will be randomly assigned to the experimental Assertive Aftercare Protocol (AAP) and the other half to receive the current Status Quo aftercare. Data will include self-reports, collateral reports, service records, and urine tests for alcohol, marijuana and cocaine. Additional comparisons will be possible with a pre-experimental baseline group of another 80 clients and a separate state-wide study we are currently conducting with 38 treatment units serving approximately 7200 clients per year. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: EFFECTS OF ALCOHOL ABUSE ON THE AGING BRAIN Principal Investigator & Institution: Fein, George; President; Neurobehavioral Research, Inc. Corte Madera, Ca 94925 Timing: Fiscal Year 2001; Project Start 25-SEP-1997; Project End 31-AUG-2005 Summary: (Adapted from the Investigator's Abstract) The primary goal of the proposed research is to test two opposing models of why the CNS morbidity due to alcohol abuse is greatest in the elderly alcoholic. The generally accepted age-related vulnerability model postulates a greater vulnerability of the older brain to the toxic effects of alcohol. An alternative model, the cumulative effects model, postulates the duration and amount of abusive drinking (regardless of when in the lifespan it took place) and the aging process as the only factors underlying the greater CNS morbidity in the older alcoholic. In the cumulative effects model, the younger brain is able to compensate for the damage done by alcohol abuse/dependence until cognitive losses associated with normal aging undermine these compensatory mechanisms and the CNS morbidity due to alcohol abuse/dependence (earlier in life) becomes apparent. There is no data in the literature to test the differential predictions of these models (e.g., data on the CNS status of elderly individuals who were alcoholic into late middle age, but who have been abstinent for 10 years or more) because research to date has focused only on recently abstinent individuals. We will test these two opposing models of how age modulates chronic alcohol abuse effects on CNS structure and function using state-of-the-art methods. Studies 35 Structural brain imaging will be used to assess regional morphological brain changes; electrophysiological and neuropsychological testing will assess functional changes in information processing abilities. The study will use a cross-sectional design with five groups, each group consisting of 30 males and 30 females. The secondary goal of this project is to determine whether there are gender differences in the effects of chronic alcohol abuse on CNS function, and the matter in which age modulates these effects. Our final goal in the project is to examine other factors (e.g., brain "functional reserve," presence of the APOE-epsilon4 allele) that may modulate the effects of chronic alcohol abuse/dependence and age on brain structure and function. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: EFFECTS OF ALCOHOL ON MESOACCUMBAL DOPAMINE LEVELS Principal Investigator & Institution: Kirstein, Cheryl L.; Director, Cognitive and Neurosciences; Psychology; University of South Florida 4202 E Fowler Ave Tampa, Fl 33620 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2002 Summary: The role of the mesolimbic dopaminergic pathway (specifically the nucleus accumbens septi, NAcc) in reward has been well-documented in ,adult animals. Dnigs of abuse, such as alcohol increase dopamine (DA) levels in the NAcc of adult rats. Similarly, in many studies drug ,expectancy has been shown to increase DA in the adult NAcc. As a result, several studies have implicated this pathway as a potential neural substrate for drug abuse. In humans, drug abuse patterns are often established in adolescence, not adulthood; this is especially true of alcohol. A limited number of studies have examined changes in the NAcc in response to alcohol during development. The establishment of an animal model to study this reward system during early development and adolescence is critical. The data show that drug use begins around adolescence and continues into adulthood. Moreover, development of the brain is still ongoing during this period and this may be critical in elucidating the development of addiction. To this end, we modified and adapted the in vivo micro dialysis procedure to enable us to effectively and reliably recover DA from the NAcc of young rat pups. The dialysis procedure allows measurement of the neurochemical changes resulting from drug administration. The present studies propose to use in vivo micro dialysis to examine: 1. the effects of ethanol on the NAcc in preadolescent rats (postnatal day 25; PND 25) and 2. the function of the mesolimbic pathway in periadolescent (PND 35, 45) and adult animals (PND 60) after repeated ethanol exposure (n=bidaily injections for 4 days at each age) during these different periods of development. The principal goals of these proposed studies are: first, to isolate the dose-response effects of ethanol exposure on the mesolimbic DA pathway in male and female preadolescent rats to determine appropriate low and high doses for use in the repeated administration experiments; second, to examine the acute vs. repeated effects of ethanol on the mesolimbic DA pathway in preadolescent, periadolescent and adult animals; third to see how these processes are altered in periadolescent and adult animals following repeated administration of ethanol during adolescence and adulthood; and fourth to determine the effects of ethanol expectancy on the function of the mesolimbic DA system in preadolescent, pefiadolescent and adult animals. We will examine how this system responds to ethanol administration, how these responses differ between preadolescent, periadolescent and adult animals, and whether drug expectancy following repeated administration is sufficient to elicit the same neurochemical responses (ie., whether there are "expectancy-induced" increases in accumbal DA in response to saline alone after repeated ethanol). These studies will provide insight as to alterations in mesolimbic DA 36 Alcohol Abuse function following repeated exposure during a time when the brain reward system is developing. We have previously reported ethanol-induced increases in DA efflux in the NAcc of preadolescent rats. The proposed studies will allow us to examine the underlying mechanism of ethanol's effects in young animals which is critical in order to understand how these processes control the initiation of drug use. Moreover, we will be able to compare these responses across ages which is critical to understand the mechanisms which may underlie the continued maintenance of ethanol abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: EMERGENCY PHYSICIAN BRIEF INTERVENTIONS FOR ALCOHOL Principal Investigator & Institution: D'onofrio, Gail; Associate Professor; Surgery; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 13-SEP-2001; Project End 31-JUL-2004 Summary: Patients with hazardous and harmful alcohol consumption are at increased risk for adverse health consequences and have frequent visits to the Emergency Department (ED). Despite research that has demonstrated the prevalence of alcohol problems in ED patients, there are limited data on the effectiveness of brief intervention (BI) strategies for patients in this setting. The purpose of the current study is to evaluate the effectiveness of a brief intervention, termed Brief Negotiation Interview (BNI), provided by emergency practitioners (EPs-emergency physicians and physician assistants), in reducing alcohol consumption in ED patients with hazardous and harmful drinking. In a controlled (randomized clinical trial of 500 patients with hazardous and harmful drinking, BNI will be compared to scripted discharge instructions (DI). Three hypotheses will be tested: BNI is superior to DI in: 1) reducing alcohol consumption; 2) reducing the number of binge drinking episodes; and 3) increasing utilization of primary care or alcohol-related services. Alcohol consumption and utilization of primary care or alcohol-related services will be measured by self-report at 1,6 and 12 months. An additional benefit to changing patterns of consumption and utilization of health services may be decreased ED visits and alcohol-related hospitalizations. These will be assessed utilizing a statewide database. In order to facilitate real- world application of BNI in the ED, the project will result in a BNI manual for EPs and an adherence and competence scale. Unique features of the current project as compared to earlier studies include: 1)use of a credible control condition; 2) enrollment of a heterogeneous population; 3)use of a manual-guided intervention by existing ED staff; 4)systematic assessment of adherence and competence to ensure quality administration and discriminability of interventions; 5)monitoring of use of ancillary treatments; and 6)monitoring of repeat ED visits and alcohol-related hospitalizations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: EMORY ALCOHOL AND LUNG BIOLOGY CENTER Principal Investigator & Institution: Guidot, David M.; Associate Professor of Medicine; Internal Medicine; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-DEC-2007 Summary: REVISED ABSTRACT The alcohol research group at Emory University has determined that alcohol abuse increases the risk 3-fold of developing the Acute Respiratory Distress Syndrome (ARDS), a severe form of lung injury that kills tens of thousands of Americans each year. In fact, the Center's studies in nearly 600 patients indicate that ~50% of all patients who develop ARDS have a significant history of alcohol abuse. In addition, the Center's investigators have determined that ethanol- Studies 37 mediated depletion of the critical antioxidant glutathione produces specific defects in lung structure and function that render the lung susceptible to acute injury. ARDS is part of a spectrum of tissue injury in critically ill patients that has been termed the 'multiple organ dysfunction syndrome'. This syndrome produces devastating consequences in terms of mortality and prolonged morbidities in survivors. However, it does not arise de novo but rather in response to a variety of acute insults, such as trauma and sepsis. The important question is how does alcohol abuse render the lung and other organs susceptible to injury and failure in critically ill patients? The Center investigators hypothesize that alcohol abuse produces chronic oxidative stress within the lung, and that an array of consequent defects in lung structure and function render patients susceptible to respiratory failure and associated multiple organ dysfunction. Further, this mechanism affects infants born prematurely to mothers with a significant alcohol abuse history in addition to adults admitted to intensive care units for treatment of sepsis, trauma, or other critical illnesses. The proposed Emory Alcohol and Lung Biology Center will extend this previous work and dissect the clinical associations as well as the fundamental mechanisms underlying alcohol abuse and multiple organ dysfunction. Capitalizing on established collaborations as well as the talents of recently recruited faculty, the Center will test the central hypothesis in a comprehensive set of related projects that include in vitro and in vivo animal models, as well as clinical studies in pediatric and adult intensive care unit settings. The Center will conduct six collaborative research projects that examine the effects of ethanol on lung epithelial, endothelial, and matrix biology. In parallel, the Pilot Component will facilitate novel pilot projects that will identify new aspects of alcohol-mediated tissue injury in basic and clinical projects. Finally, the Center will nurture the training of scientists for careers in alcohol research. The work proposed by this Center has enormous implications for the understanding of the diagnosis and prognosis of hundreds of thousands of patients in intensive care units throughout the U.S., and could lead to the development of novel therapies for those patients at greatest risk for multiple organ dysfunction as a consequence of chronic alcohol abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: FACTORS AFFECTING USE OF MEDICATION TO TREAT ALCOHOLISM Principal Investigator & Institution: Mark, Tami L.; Medstat Group, Inc. 777 E Eisenhower Pky Ann Arbor, Mi 48108 Timing: Fiscal Year 2001; Project Start 01-JUL-2000; Project End 31-OCT-2003 Summary: In January 1995, naltrexone, marketed under the name REVIATM became the first medication approved by the Food and Drug Administration for alcoholism treatment in almost 50 years. The ifficacy of naltrexone, as an adjunct to therapy, in decreasing the mean number of drinking days per week, the frequency of relapse, and subjective craving for alcohol with few side effects has been shown in double blind randomized clinical trials. Despite the evidence of its efficacy, reports of its use indicate that it is not as widespread as might be expected. Total prescription of Revia in 1998 (including prescription for narcotic treatment) were 13,000 per month, only slightly more than the number of prescriptions in 1996. The 1992 National Longitudinal Alcohol Epidemiologic Survey estimated that 13.7 million adults met the criteria for alcohol abuse and alcohol dependence during the year preceding the interview (Grant, 1995). The one-day census of specialty substance abuse providers (NDATUS) indicates that in 1996, there were 677,000 clients in treatment for alcoholism. This figure excludes persons receiving treatment for alcoholism in institutions specializing in mental health 38 Alcohol Abuse care and in primary care settings. Thus, perhaps only 2 percent of persons receiving alcoholism treatment are being treated with naltrexone. Given the low utilization of naltrexone in the face of its apparent efficacy, it is critical to understand the barriers to the adoption of this important new pharmacological tool. The goal of this proposed research is to identify the factors that are influencing the use of naltrexone and to gain insight into its perceived efficacy among practitioners. Towards this end, the primarily aims of this study are: (1) to identify factors influencing use of naltrexone and their relative importance; (2) to determine whether other new medications to treat alcoholism are likely to face barriers to prescribing; (3) to identify methods that physicians used to overcome barriers to prescribing naltrexone; (4) to collect information on the types of patients being prescribed naltrexone and the circumstances under which it is being prescribed. We propose to collect this information through experts panels and a national survey of physicians specialized in treating substance abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: FAMILY MOTIVATIONAL INTERVIEWS FOR ETOH+ TEENS IN THE ER Principal Investigator & Institution: Spirito, Anthony; Professor of Psychiatry; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): The long-term objectives of this research program are to develop effective interventions in health care settings for reducing problem drinking and associated problems among adolescents and to further enhance intervention approaches by identifying effective elements of treatment. The major purpose of this study is to compare a brief integrated individual and family intervention designed to reduce alcohol use and related problems to an enhanced standard care condition (standard care plus family assessment). The targeted population is underage drinkers (13 - 17 years old) who have been treated in an Emergency Department following an alcohol-related event. It is important to intervene with this population because alcohol-involved adolescents may be at higher risk for having continuing alcohol problems. The intervention is conceptualized as using a "teachable moment" (i.e., shortly after a salient event) to increase family interest in reducing harmful drinking. The experimental intervention integrates an individual Motivational Interview (MI) for the adolescent, based on our research group?s prior work with this intervention, with a brief family intervention, the Family Check-Up. The experimental condition will be compared to standard care plus family assessment. This design allows us to test the added benefit of the brief intervention compared to the benefits often derived from assessment without added treatment. Follow-up interviews will be conducted at 3, 6, and 12 months after the baseline intervention to assess outcome. The specific aims of this proposal are to test the effectiveness of the experimental intervention in reducing alcohol- related problems, alcohol consumption, and other behavior problems compared to the enhanced standard care condition. Second, we will examine whether depressed mood and behavior problems at baseline moderate the effects of the treatment conditions. We will also test whether individual factors (motivation to change behavior) and environmental factors (parent/family influence and peer influence) mediate the relation between the treatment condition and outcomes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen Studies · 39 Project Title: FAMILY RELIGIOSITY ON YOUNG ADULT ALCOHOL PROBLEMS Principal Investigator & Institution: Ensminger, Margaret E.; Professor and Chair; Health Policy and Management; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-JAN-2004 Summary: (provided by applicant): The proposed developmental epidemiological study is focused upon the paths leading to alcohol use and abuse and how religiosity influences these paths. The intent of this study is to assess the buffering effect of religiosity during adolescence and adulthood on a variety of identified risk factors for alcohol use and abuse. These risk factors include parental alcohol use, a background of family disadvantage, early (first grade) aggressive and shy-aggressive behavior, poor parental monitoring, low educational attainment, depression, delinquency, and unemployment. The analysis will be conducted using data from a panel study of African Americans from the Woodlawn community in Chicago. This group has been assessed at three data points: first grade (1966-67), adolescence (1975-76) and young adulthood (1992-94). The population consists of a total cohort (N= 1242) of African American adults first studied in 1966 when they were in first grade in Woodlawn, an inner city neighborhood of Chicago. They were assessed three times in first grade, in third grade, during adolescence and most recently in 1993-94 when they were young adults. The overall aim of this research is to gain an understanding of the role that religious affiliation, attendance and participation, and religious salience play in the development of alcohol use, abuse, and alcoholism problems]. The first specific aim focuses on the concurrent relationships between religiosity and alcohol problems in young adulthood. The second aim examines the role of childhood and adolescent factors which may influence the development of alcohol problems and how these factors may moderate or mediate the pathways of religiosity to alcohol problems. The third aim brings together the findings of the first two aims to examine how childhood, adolescent, and young adult risk and protective factors work with religiosity over the life course to influence young adult alcohol problems. Mothers' religiosity is measured at the time of first grade and adolescence; the study "child's" religiosity is measured during adolescence and again in young adulthood. Alcohol problems were measured during adolescence and again in adulthood. We will use several different approaches, including descriptive statistics of prevalence, odds ratios, and mean differences, and multivariate logistic regression, survival analysis, and causal modeling. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: HIV PREVENTION PARTNERSHIP IN RUSSIAN ALCOHOL TREATMENT Principal Investigator & Institution: Samet, Jeffrey H.; Professor of Medicine; Boston Medical Center Gambro Bldg, 2Nd Fl, 660 Harrison Ave, Ste a Boston, Ma 02118 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 31-AUG-2006 Summary: (provided by applicant): Russia's per capita alcohol consumption is one of the highest of any country. Since 1996, Russia has witnessed a dramatic increase in HIVinfected citizens. Alcohol use is known to increase HIV risk behaviors in general and in drug users in particular. The rapid spread of HIV infection among drug users and the early appearance of HIV in alcohol dependent individuals in Russia raise concern for the spread of HIV among the sizable Russian alcohol-dependent population. While Regional Narcology Hospitals play a central role in Russia's efforts to address alcohol and drug dependence, these treatment centers have not aggressively addressed the 40 Alcohol Abuse current Russian HIV epidemic. The objective of this proposal, Russian-Partnership to Reduce the Epidemic via Engagement in Narcology Treatment (Russian PREVENT) is to expand on an existing international research collaboration to develop and test the feasibility of adapting and implementing an efficacious US HIV prevention intervention, RESPECT, in a Russian substance abuse treatment center. In this study, American researchers will mentor, train, and collaborate with Russian researchers in the areas of data management, biostatistical methods, HIV prevention interventions, and study implementation in order to lay the groundwork for future testing of the efficacy of a culturally adapted HIV prevention intervention. The study will randomize 180 alcohol and drug dependent patients in substance abuse treatment to one of two adapted interventions, assessing at baseline and 6-months HIV risk behaviors and substance use. Data will be collected, managed, and analyzed by Russian researchers under the tutelage of American collaborators. We hypothesize that data from the pilot trial will indicate that Russian subjects with primary diagnoses of alcohol dependence will have greater risk behaviors than those with primary diagnoses of drug dependence. Further, we anticipate that alcohol use in Russians with primary diagnoses of drug dependence will be common and associated with increased high-risk and drug use behaviors. This investigation will allow the adaptation of an HIV prevention intervention to a Russian setting. It will provide data to further define alcohol use and HIV risk behaviors in the narcology hospital population, more clearly identifying the optimal population for a Russian HIV prevention intervention study. Many will be HIV infected. Thus, the successful implementation of this study will provide a critical foundation for future prevention efforts to address the explosion of HIV infection in Russia. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: HMO TREATMENT OF DEPRESSION & SUBSTANCE ABUSE Principal Investigator & Institution: Clarke, Gregory N.; Senior Investigator; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, Ca 94612 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 31-MAR-2003 Summary: Previous research has shown that depression is frequently comorbid with alcohol abuse and/or dependence, and that it is predictive of poorer short- and longterm drinking outcomes. Efficacy studies suggest that alcohol and other drug (AOD) treatment outcomes improve when comorbid depression is successfully treated. However, these efficacy studies are limited in their generalizability to real-world clinical settings, and their results require replication in effectiveness trials. Further, little is known regarding the cost- effectiveness of the treatment of depression comorbid with AOD problems. This randomized, controlled trial will test whether concurrent treatment for depression and AOD disorders improves drinking outcomes (percent days abstinent from alcohol, and mean standard drinks per possible drinking day) and depression. Adult HMO members entering an intensive, 5-week outpatient AOD treatment program will be administered a depression screening scale (the Beck Depression Inventory; BDI) as part of their standard intake assessment. Members scoring 16 or greater on the BDI will be contacted and invited to participate in the study. Consenting members will be administered an intensive intake battery, assessing drug, alcohol and psychiatric history, life functioning, and other psychosocial constructs of interest. Two hundred and twelve (212) subjects will be randomized to either: (a) "usual care" AOD treatment, or (b) usual care AOD treatment plus 8 individual sessions of cognitive-behavioral treatment for depression (CBT-D). All subjects will be re-assessed for AOD and depression outcomes at post-treatment, and at 3,6 and 12- months follow-up points. HMO databases will be employed to examine health services utilization and costs outcomes. Studies 41 Principal outcomes analyses will examine whether (a) AOD outcomes are better in the CBT-D condition; (b) depression outcomes are better in the CBT-D condition; (c) better AOD outcomes are mediated by improved depression outcomes: and (d) CBT-D is a cost effective adjunctive treatment for AOD with comorbid depression. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: HOMELESS PERSONS' USE OF ADDICTION TREATMENT SERVICES Principal Investigator & Institution: Kertesz, Stefan G.; Medicine; University of Alabama at Birmingham Uab Station Birmingham, Al 35294 Timing: Fiscal Year 2002; Project Start 03-DEC-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Stefan G. Kertesz, M.D. is an academic physician in general internal medicine with five years of clinical experience caring for homeless persons addicted to drugs and alcohol, and drug abuse research training experience. As part of his K23 career development award, he will seek to identify factors associated with addiction treatment utilization and addiction outcomes among homeless persons who abuse drugs and/or alcohol (Aim 1). Given the heterogeneity of the homeless population, in particular the ways in which the duration of homelessness can vary from a few nights to many years, the proposed research also seeks to determine whether factors associated with addiction treatment utilization differ according to the persistence of homelessness (Aim 2). The research program will use two existing datasets to address these aims. In Part 1, data from the 1996 National Survey of Homeless Assistance Providers and Clients will permit evaluation of factors associated with treatment utilization in a nationally representative cross-sectional survey of homeless persons. In Part 2, data from a completed 2-year prospective follow-up study of 470 homeless and housed persons addicted to drugs and/or alcohol will permit evaluation of factors associated with sustained treatment utilization, and evaluation of the relationship between treatment utilization and addiction outcomes. The value of treatment itself has been documented in the context of clinical trials. The importance of this proposed research lies in its potential to assist policymakers and treatment planners who wish to understand how to improve actual treatment access and treatment utilization by homeless persons who are addicted to drugs and/or alcohol. Career development activities for this career development award include the research itself, mentoring by individuals with extensive research experience in addiction and homelessness, and coursework to develop methodological expertise pertinent to the use of large and complex datasets, content expertise in the areas of addiction, addiction treatment theory, housing policy and homeless sociology, and research ethics. Completion of the proposed work will prepare Dr. Kertesz to independently investigate the treatment of drug and alcohol abuse in the homeless. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: IMPACT OF SUBSTANCE ABUSE TREATMENT ON MARITAL VIOLENCE Principal Investigator & Institution: Stuart, Gregory L.; Butler Hospital (Providence, Ri) 345 Blackstone Blvd Providence, Ri 02906 Timing: Fiscal Year 2001; Project Start 30-SEP-2000; Project End 31-AUG-2005 Summary: APPLICANT'S ABSTRACT: This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) from NIAAA. I am strongly committed to a career in patient-oriented research. I believe that the 42 Alcohol Abuse educational opportunities in which I will be able to participate as a result of a K23 award will lead to further development of the skills necessary to become a productive, independent researcher. The proposed training experiences will include: collaboration with excellent mentors (Dr. Richard Brown"Dr. Kenneth Leonard, and Dr. Robert Stout), active participation in the Brown University Center for Alcohol and Addiction Studies academic activities, advanced courses in multivariate statistics, and regular presentations at national conferences. The reduction of marital violence is a health priority for the US. There is extensive theoretical and empirical evidence linking alcohol and drug abuse and marital violence. Marital violence is over represented in individuals seeking treatment for alcohol and drug abuse. The efficacy of treatments designed to address marital violence is questionable, with research suggesting that treatment for marital violence is relatively ineffective. It has been suggested that maritally violent individuals who abuse alcohol and drugs require substance abuse treatment before addressing their violent behavior. However, the extent to which treatment for alcohol and drug abuse (which does not include interventions specifically targeting marital violence) will ameliorate subsequent marital violence is currently unknown. Given the high comorbidity of marital violence and alcohol and drug abuse, it is critical to assess the extent to which substance abuse treatment for alcohol dependent patients impacts marital violence. The proposed study assesses the impact of substance abuse treatment for alcohol dependent patients on marital violence and psychological abuse. Alcohol and drug use and abuse, marital violence, psychological abuse, and marital satisfaction will be assessed in a sample of alcohol dependent patients receiving substance abuse treatment. These variables will be assessed at pretreatment and at 6-month and 12month follow-up. At each assessment point we will also contact the patients' partners to obtain collateral data regarding the patients' use of substances, marital violence, and psychological abuse, as well as to collect data on these variables in the partners. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: INIA: GENETIC ANALYSIS OF ALCOHOL CONSUMPTION AND STRESS Principal Investigator & Institution: Goldowitz, Daniel; Professor; Anatomy and Neurobiology; University of Tennessee Health Sci Ctr Health Science Center Memphis, Tn 38163 Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 31-DEC-2006 Summary: (provided by applicant): The genetic basis of the neuroadaptive response to stress and anxiety relative to alcohol abuse is poorly understood. In this Research Component of the INIA, a wide net will be cast to identify genes important to neuroadaptation and alcohol abuse by using ethyl nitrosourea (ENU)-induced mutations of male mouse germ cells and subsequent breeding to screen for dominant and homozygous recessive mutations that result in aberrant alcohol-related phenotypes. Microarray and gene mapping studies are proposed to chart the molecular pathways and the specific genes that are involved in alcohol-related phenotypes. In addition, specially constructed congenic lines of mice will be used as reagents to better map loci responsible for quantitative trait loci (QTLS) and serve as reagents for gene identification in an ENU-mutagenesis program. In Aim, 1, ongoing NIH-supported mutagenesis program will be identifying mutants with abnormal fear conditioning behavior and a wide range of aberrant alcohol phenotypes and these mutants will be further explored for a) corticosterone levels following acute ethanol administration and b) stress-induced reinstatement of ethanol consumption. A concerted effort will be made in Aim 2 to identify the genetic basis of quantitative trait (QTLS) for alcohol-related Studies 43 behaviors by targeted mutagenesis of mouse chromosomes 1 and 4. Male congenic or consomic mice that span the withdrawal and drinking QTLs on Chr 1 and 4 will mutagenized with ENU. Test class mice, identified by molecular markers, will be phenotyped for 2-bottle choice, withdrawal or corticosterone levels following ethanol administration. Mice that show aberrant behavior in any of these tasks would be candidates to bear a mutation in a gene responsible for the relevant QTL. These studies should provide insights into the genetic bases of stress-alcohol interactions, and provide molecular clues to rational therapeutic approaches to curing alcoholism. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: INTERACTION OF HUMAN IMMUNE CELLS, ALCOHOL & HIV Principal Investigator & Institution: Douglas, Steven D.; Professor and Medical Director; Children's Hospital of Philadelphia 34Th St and Civic Ctr Blvd Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 28-SEP-2001; Project End 31-AUG-2006 Summary: (provided by applicant): Acute and chronic alcohol abuse alters many specific immune functions and has been implicated as a cofactor in HIV/AIDS disease. Our overarching hypothesis is that alcohol affects HIV infection of human immune cells through modulation of the function of the cells, including microglia, macrophages and T cells that are primary targets for HIV in the blood tissues and central nervous system (CNS). We will use immune cells isolated from healthy donors and from HIV-infected individuals with and without alcohol abuse to investigate these relationships. We will explore whether chronic alcohol abuse increases immune cell susceptibility to the HIV infection and determine whether chronic alcohol use by HIV-infected individuals increases HIV replication and leads to events that could promote HIV disease progression. We will investigate four specific aims: 1) we will determine whether alcohol affects the expression of HIV receptors (CD4, CCR3, CCR5 and CXCR5), production of beta-chemokines (RANTES, MIP-1alpha and MIP-1beta), and cytokines in immune cells derived from healthy individuals; 2) we will determine whether alcohol, through alteration of the functions of the immune cells, modulates replication of HIV in macrophages (including microglial cells) and CD4+ T lymphocytes. We will study effects of alcohol on HIV entry, viral replication and the molecular mechanism of alcohol-mediated HIV replication in macrophages, including viral entry, transcription and LTR promotor; 3) we will determine whether alcohol has the ability to activate and enhance HIV replication in latently infected immune cells; and 4) we will measure the levels of HIV RNA and beta-chemokines (MIP-1alpha, beta and RANTES) in the plasma from HIV-infected patients with or without alcohol abuse. We also will use peripheral blood mononuclear cells (PBMCs) from these subjects to analyze the expression of HIV co-receptors and numbers and ratio of T cell subsets. We will isolate PBMCs to determine the effect of chronicalcohol dependence on recovery of latent HIV. These studies may provide new mechanistic insights related to the role of alcohol in the pathogenesis of HIV disease and AIDS and toward design of new therapeutic approaches. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: INTERVENTIONS FOR HIV+ MOTHERS WITH DRINKING PROBLEMS Principal Investigator & Institution: Gwadz, Marya; Scientist; National Development & Res Institutes Research Institutes, Inc. New York, Ny 10010 Timing: Fiscal Year 2001; Project Start 22-SEP-2000; Project End 31-MAY-2005 44 Alcohol Abuse Summary: (adapted from the applicant's abstract): Increasing numbers of women are infected with HIV, particularly ethnic minority mothers. Mothers living with HIV (MLH) must sustain high quality parenting while coping with a chronic or terminal illness. At least 30 percent of MLH experience problem drinking, which will significantly impair their abilities to meet parenting challenges, including those associated with HIV infection, and to negotiate safer sex and manage drug use. Building on successful intervention research; namely, a study we conducted with parents with AIDS (Rotheram, Lee & Gwadz, in submission); cognitive-behavioral interventions for alcohol abuse (NIAAA, 1995), and a project for families with alcohol-abusing parents of children aged 6-12 years (Aktan. Kumpfer, & Turner, 1996), the goal of this proposal is to design, implement, and evaluate over 24 months the "Family First" program, an intervention for MLH with problem-drinking who are raising adolescent children (aged 12-18 years). MLH (n=150) will be recruited from two clinical sites in New York City and randomly assigned to either: 1) the "Family First," intervention or 2) a Brief Video Intervention. Based on the Social Action Model (Ewart, 1991), the "Family First" intervention will be conducted in individual sessions with the MLH over two modules (total 17 sessions) that target: a) reducing or eliminating problem drinking/drug use; b) improving the quality of parenting, and secondarily, c) reducing sexual risk behavior. To evaluate the effectiveness of the intervention, the MLH will be assessed at 3, 6, 12, 18, and 24 months following recruitment. The intervention is anticipated to improve parenting monitoring, skills, and bonds; therefore, the adolescent children of the MLH (n=210) will also be assessed at recruitment, 6, 18, and 24 months. The project will contribute to the field in five major areas: I) a gender-tailored and culturally-appropriate intervention will be developed for MLH with alcohol problems, a group at higher risk for the negative effects of alcohol than men, and typically with sole responsibility for their children; 2) individual intervention sessions will be conducted which include only MLH and not their children (many of whom cannot attend an intervention because they have not been informed about the MLHs diagnosis); 3) the intervention targets mothers of adolescents and provides MLH with an opportunity to delay/prevent problem drinking, drug use, and risk behavior among their teens; 4) the impact of the theoretical constructs in the Social Action Model will be evaluated; and 5) the cost-effectiveness of the intervention will be assessed. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: DISORDERS INTERVENTIONS FOR WELFARE CLIENTS WITH AOD Principal Investigator & Institution: Morgenstern, Jonathan; Associate Professor; National Ctr on Addiction & Subst Abuse Substance Abuse New York, Ny 10017 Timing: Fiscal Year 2002; Project Start 12-SEP-2002; Project End 31-AUG-2007 Summary: (provided by applicant): Beginning in 1996, legislation has been enacted to move those with alcohol and other drug use (AOD) problems off public assistance and into self-sufficiency by requiring work and limiting the time period of welfare receipt. The impact of change in welfare on substance abusers receiving public assistance and the publicly funded treatment system could be profound. Unfortunately, the inherent difficulty of examining this area has limited the number of high quality research studies looking at the treatment of alcohol problems in the context of welfare reform. This application capitalizes on a unique opportunity to test the effectiveness of three intervention approaches for welfare recipients who have been identified in a welfare setting as requiring substance abuse treatment. Participant will be randomly assigned to three conditions: 1) triage and referral to a treatment program (usual care); 2) referral to Studies 45 a treatment program and case management services designed to link them with auxiliary services (case management); and 3) case management services and referral to a substance abuse program that provides integrated medical, mental health, family, employment, and child care services (case management with integrated services). Participants (N=450) will be assessed in-person at baseline and months 1, 3, 6, and 12. In addition, administrative data on labor and welfare outcome will be available for outcomes up to three years following recruitment. Biological and collateral verification will be used to verify self-report of substance use. HLM will be used to test the impact of the interventions on substance use, employment, and other psychosocial outcomes. The grant money we are requesting will fund the evaluation of these conditions as well as the substance abuse program in the integrated services condition. Funding for the usual care group and all case management has already been provided for by Human Resources Administration (HRA). Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: LEARNING NEWER WAYS TO ANALYZE TREATMENT RESEARCH DATA Principal Investigator & Institution: Maisto, Stephen A.; Professor; Psychology; Syracuse University Syracuse, Ny 13210 Timing: Fiscal Year 2001; Project Start 24-SEP-2001; Project End 31-AUG-2006 Summary: (Provided by applicant): This application requests support for (KO2) Award for Stephen A. Maisto. His overall career goal is to contribute to the advancement of knowledge about alcohol treatment through the achievement of three specific career goals: (1) to advance his progress in becoming a leader in the scientific study of outcomes and mechanisms of interventions for alcohol problems, (2) to increase his expertise in the study of new statistical methods and accompanying computer technology that are becoming important in intervention research, and (3) to continue to mentor junior colleagues. This proposal describes two currently funded projects that are part of the research plan. Project 1 has two substudies designed to evaluate the effectiveness of an enhanced brief motivational intervention (BMI) for binge drinking in college students. In substudy 1, participants identified as binge drinkers are randomly assigned to receive a basic BMI, an enhanced BMI that adds a decisional balance exercise, or an assessment only control group. Substudy 2 replicates the first substudy but is done with individuals presenting to a campus substance abuse counseling program. All participants provide data on drinking and related problems at 1, 6, and 12 months post-intervention. Project 2 is designed to investigate subject reactivity to assessment protocols. Participants will be recruited from an outpatient AOD treatment service and will be randomly assigned to one of four conditions formed by the combination of frequency and Comprehensiveness of assessment. Participants will be evaluated at admission to treatment and over the course of 1 year. These and, future research projects form part of the applicant's program of research and is dedicated to the study of the effectiveness of BIs for alcohol problems and the mechanisms of their action. The applicant's career development plans and include acquiring knowledge of new developments in statistical methods, continuing mentoring of junior colleagues, and continuing the conduct of programmatic research. The K02 award would allow the applicant protected time to continue to develop his skills in and to conduct a program of research on alcohol treatment. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 46 Alcohol Abuse · Project Title: LONG-TERM COURSE OF TREATED AND UNTREATED ALCOHOL ABUSE Principal Investigator & Institution: Moos, Rudolf H.; Professor; Psychiatry; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2001; Project Start 21-SEP-2000; Project End 31-JUL-2005 Summary: APPLICANT'S ABSTRACT: The purpose of this project is to describe the long-term course of treated and untreated alcohol abuse, and to examine how participation in professional treatment, and/or self-help groups, and life history and life context factors, influence the process of remission and relapse. The objectives are to: (1) compare alcohol-related, and psychological/social outcomes among individuals with alcohol use disorders who enter professional treatment with outcomes among untreated individuals; (2) focus on the outcome of participation in self-help groups with and without professional treatment; and examine the role of (3) stress and coping processes, life history factors, and (4) gender differences in the course of treated and untreated alcohol abuse. To pursue these objectives, the project involves a 16-year follow-up of individuals with alcohol use disorders who were previously studied at baseline and at 1-, 3-, and 8-year follow-ups. The plan is to (1) compare the 16-year course of treated and untreated alcohol abuse; (2) examine 16-year patterns of participation in self-help groups, with and without involvement in professional treatment, and relate these patterns to the process of remission and relapse; (3) examine stress and coping processes and life history factors among treated and untreated individuals, and (4) examine gender differences in the predictors and course of alcohol abuse. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: TREATMENT MEDICAID MANAGED CARE & ACCESS TO ALCOHOL Principal Investigator & Institution: Mcfarland, Bentson H.; Associate Professor; Oregon Research Institute 1715 Franklin Blvd Eugene, or 97403 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2005 Summary: (provided by applicant): This project has been completely re-designed to have both descriptive and analytical components addressing treatment utilization by Medicaid clients with alcohol problems. This topic remains significant since Medicaid has undergone substantial change in the last decade as states have replaced fee for service programs with managed care systems such as capitation. Early studies in individual states indicate that these changes may have had considerable impact on Medicaid clients' use of alcohol and drug abuse treatment services. However, there are no published national studies pertaining to these issues. The project will make use of information contained in the Treatment Episode Data Set, Medicaid Eligibility file, Uniform Facility Data System, the Substance and Mental Health Services Administration's Managed Care Tracking System, the National Association of State Alcohol and Drug Abuse Directors annual surveys, and other national data sets. The national data will be combined so as to obtain information on a state by state and year by year basis. Tables and graphs will be produced describing changes in state substance abuse treatment policies for and use of services by Medicaid clients with alcohol problems. In the analytic phase of the project the researchers will generate statistical models of access to alcohol and drug abuse treatment services by Medicaid clients that adjust for state by state and year by year variation in Medicaid enrollment, treatment program availability, and prevalence of alcohol problems in the Medicaid population, among other covariates. Hypotheses pertaining to changes over time in service use, Studies 47 client severity, and treatment modality will be tested. The investigators will explore application of hierarchical models and latent variable growth curves to the national data sets. The results will be of considerable interest to state Medicaid and alcohol drug abuse program directors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: MEDICATIONS FOR COMORBID COCAINE AND ALCOHOL DEPENDENCE Principal Investigator & Institution: Johnson, Rolley E.; Associate Professor; Psychiatry and Behavioral Scis; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-OCT-2003 Summary: (provided by applicant): Cocaine abuse and dependence continues to be a major public health problem with up to 3 million people in need of treatment. Over the past decade, medications including dopamine agonists, antagonists, tricyclic antidepressants, selective serotonin reuptake inhibitors, opiate mixed agonistantagonists, and opioid antagonist have been studied for thetreatment of this disorder. No efficacious medication has been found to treat cocaine abusing or dependent patients. The lack of a efficacious medication for cocaine dependence has led to the proposal to treat co-morbid disorders found with high frequency in cocaine abusing patients, especially when these disorders are thought to enhance or perpetuate the use of cocaine. Alcohol abuse/dependence is the most common co-morbid condition found in cocaine abusing patients; as many as 85% of patients with cocaine dependence also have a diagnosis of alcohol abuse or dependence. Since alcohol use is common among cocaine abusers, it is possible that treatment of co-morbid alcohol use could lead to decreases in cocaine use. Disulfiram is approved for the treatment of alcohol abuse. Thus, it is possible to test the hypothesis that treatment of alcoholism in cocaine abusing patients will lead to improvements in cocaine use, as well as alcohol use. Disulfiram inhibits the enzyme that breaks down acetaldehyde (the first metabolite of alcohol) thus causing an increase in acetaldehyde which produces unpleasant aversive effects. It also inhibits opamine P-hydroxylase causing an increase in dopamine and decrease in norepinephrine that may result in attenuation of cocaine craving and euphoria and thus decrease the desire to use cocaine. This may explain the reported reduction in cocaine use in opioid dependent patients treated with disulfiram. Thus, disulfiram appears to have potential for impacting significantly on the treatment of cocaine addicts. This study assesses the efficacy of disulfiram at two different doses levels (62.5 mg and 250 mg) to treat cocaine dependent patients with a dual diagnosis of cocaine dependence and alcohol abuse or dependence. A randomized, placebo controlled, parallel 3-group design is utilized in conjunction with manual-guided Cognitive-Behavioral Therapy (CBT). Primary outcome measures include: 1) continuous cocaine (qualitative and quantitative) and alcohol abstinence, 2) retention time in treatment, and 3) frequency and quantity of cocaine and alcohol use. Secondary measures include: 1) use of other illicit drugs, 2) side effects data, 3) safety data, 4) self- and observer global reports and 5) other subjective measures (e.g., psychosocial adjustment, time spent in use, reduction in time spent in use, severity of withdrawal, etc.). This study will utilize rigorous clinical trials methodology to provide critical scientific and safety data for assessing disulfiram as a treatment for primary cocaine dependence and associated alcohol abuse and dependence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 48 Alcohol Abuse · Project Title: MET FOR ALCOHOL PROBLEMS IN PARTNER VIOLENT MEN Principal Investigator & Institution: Murphy, Christopher M.; Associate Professor; Psychology; University of Maryland Balt Prof School Baltimore, Md 21201 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): This revised application involves a controlled clinical trial of Motivational Enhancement Therapy (MET) for alcohol problems among partner violent men. Prior research has indicated that alcohol problems are common among partner violent men, alcohol problems impede compliance with and response to partner violence interventions, and unresolved alcohol problems are a major risk factor for continued partner abuse in this population. In the proposed study, 278 individuals who present for domestic violence counseling at a community-based treatment agency, and who screen positive for risky alcohol consumption or alcohol involvement in domestic violence incidents, will be randomly assigned to receive either 4 weekly sessions of MET, or a control condition consisting of 4 weekly sessions of Alcohol Education (AE). MET involves extensive personalized feedback on alcohol consumption and related risks and problems. MET is designed to stimulate a self-directed change process. Subsequent to completing one of these interventions, all participants will be assigned to agency treatment-as-usual for domestic abuse, and participants with severe substance use disorders, as assessed by the agency program staff, will be referred for additional substance use treatment at a community agency. Outcomes will be assessed through self-report and collateral partner report of alcohol and drug consumption, partner abuse, and related variables, with assessments conducted at baseline, post- 4 session intervention, and quarterly follow-ups for one year after the alcohol interventions. The investigation will examine the efficacy of MET in reducing alcohol consumption, reducing physical and emotional abuse of relationship partners, and enhancing subsequent treatment participation and help seeking. Additional analyses will test explanatory models of the effect of MET on partner violence that include alcohol use and involvement in domestic violence treatment as mediating variables. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: MILITARY WORK AND DRINKING--RISKS AND PREVENTION Principal Investigator & Institution: Ames, Genevieve M.; Associate Director; Pacific Institute for Res and Evaluation Calverton, Md 207053102 Timing: Fiscal Year 2001; Project Start 01-FEB-1999; Project End 31-JAN-2004 Summary: The overall goal of this study is to gain an understanding of the influence of the military workplace on this drinking beliefs, behaviors, and problems of enlisted personnel and officers. Building on recent theoretical developments, we seek to continue our focus on the work environment and workplace culture with the following objectives: to observe both work- and nonwork-related drinking patterns among an enlisted and officer work force; 2. to observe the effects of alcohol consumption on alcohol-related problems both at work and generally; 3. to examine the drinking and drinking problems in relation to individual background characteristics and psychosocial factors; 4. to analyze the relationship between drinking and work environments with guidance from a theoretical model that includes conceptual areas of social control, alcohol availability, and stress factors; 5. to study the effect of social and cultural characteristics of military life on alcohol beliefs, expectancies, and behaviors; and 6. to examine how gender and ethnicity influence drinking and drinking problems within the context of military and occupational culture, and conversely, how individual and/or group drinking is related to behavior that may be defined as harassing or abusive. The Studies 49 research design calls for a five-year study of the United States Navy, using a mixed method approach of ethnography, survey, and archival data collection. We will conduct a minimum of 100 semistructured, in- person interviews; multiple observations among regular enlisted and officer personnel in geographically dispersed work settings; administer a survey to approximately 3,500 regular enlistees and officers, with an oversampling of women and minorities in order to improve statistical power; and collect archival data on relevant problem areas within the entire Navy population. The Navy offers full cooperation and support. We have the opportunity to assess drinking and drinking problems in an occupational culture that encompasses a combination of military and public safety work. Therefore, our research findings and strategies for prevention will be generalizable to both civilian and military populations. Guidelines for prevention will be provided to the Navy annually. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: MOOD MANAGEMENT VS MOOD TOLERANCE IN ALCOHOL TREATMENT Principal Investigator & Institution: Gulliver, Suzy B.; Psychiatry; Boston University Medical Campus 715 Albany St, 560 Boston, Ma 02118 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2004 Summary: The long-term objective of this research project is to contrast the effectiveness of cognitive behavioral skills training (Mood Management- MM) and exposure-based therapy (Mood Tolerance-MT) in the treatment of individuals diagnosed with alcohol abuse or dependence. Specific Aims include: 1) evaluating the relatively efficacy of MM and MT in helping problem drinkers to maintain abstinence from alcohol, and 3) to examine the relationship between mood dysregulation and relapse. Mood dysregulation has become a prominent factor in many theories of alcohol abuse/dependence with widespread use of treatment modules designed to improve mood regulation. Few studies have been conducted to evaluate the efficacy of therapies designed to improve mood regulation among alcohol dependent patients, and no studies have directly compared the efficacy of cognitive behavioral and exposure-based treatment approaches targeting negative mood. 128 participants with no more than three-months sobriety will be recruited for the present study. Participants will be assessed and randomly assigned to either MM or MT. Participants in both treatment conditions will complete twiceweekly 90 minute groups for a total of five weeks. Between group (MM vs. MT) differences in alcohol use, affective regulation, and current affective state are expected at a one- week, three-month, and six-month follow-up assessment. This project will provide pilot data to inform an RO1 application with a planned submission in the year 2001. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: MOTHERS VICTIMIZATION ALCOHOL PROBLEMS AND CHILDRENS Principal Investigator & Institution: Miller, Brenda A.; Senior Scientist; None; State University of New York at Buffalo 402 Crofts Hall Buffalo, Ny 14260 Timing: Fiscal Year 2001; Project Start 01-SEP-1988; Project End 31-DEC-2002 Summary: This competitive renewal builds on findings generated by our previous research, "Mothers' Alcohol Use and Children's Victimization, (hereafter, "Mothers" study) and involves interviewing mother and child pair. This study identifies women with current high alcohol involvement and adds a specific aim to the prior study. Prior 50 Alcohol Abuse finding indicated that mothers with histories of high alcohol involvement had higher levels of punitiveness toward their children and lower levels of protectiveness than mothers with histories of lower alcohol involvement. The proposed project investigates 1) how levels of mothers' current alcohol involvement affect their punitiveness and protectiveness of their children; 2) whether changes in their alcohol involvement over time affect their punitiveness and protectiveness; 3) whether mothers' behaviors (alcohol involvement, punitiveness, and protectiveness) affect their children's alcohol-related expectancies and/or children's level of alcohol/drug involvement. Women, along with one of their children between the ages of 10 and 16, will be interviewed. The following sources will be used for recruitment; a) alcoholism treatment programs (n=220); b) newspaper advertisements for (heavy) alcohol drinkers with children (n=165); and c) a randomly selected, matched (on age and geographic region) community comparison group (n=165, half matched to each group). These samples will identify women who decrease, increase, and maintain their level of alcohol involvement over the course of the study. Interviews will be conducted at six month intervals for a total of three interviews (over one year) to investigate how changes in mothers' level of alcohol involvement impact mothers' punitiveness and protectiveness. Both increases and decreases in level of mothers' alcohol involvement, and changes in the child's alcohol/drug involvement and expectancies are expected over the course of the year. Structural equation modeling (SEM) will be utilized to examine the relevant pathways between mothers alcohol involvement and their punitiveness and protectiveness. SEM will also be employed to examine the relationship among mothers alcohol involvement, punitiveness, protectiveness and children's alcohol/drug involvement. Further, mediating and moderating variables that have been conceptualized for each pathway in the model will be examined. This study addresses the lack of information out the complexities of the intergenerational transmission of alcohol involvement and family violence. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: MOTIVATIONAL INTERVIEWS FOR INCARCERATED TEENS Principal Investigator & Institution: Stein, Lynda a R.; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2001; Project Start 16-AUG-2000; Project End 31-JUL-2004 Summary: A significant proportion of teens involved in the juvenile justice system abuse substances. Multiple drug use increases the likelihood of remaining a youth involved in crime. Many teens involved in crime use alcohol or drugs prior to the commission of delinquent acts. A substantial number of delinquent youths who are offered treatment are unmotivated for intervention. The objective of this research is to investigate ways to enhance motivation for treatment and effectively reduce substance abuse among juvenile offenders. Motivational intervention (MI) as preparation for residential treatment and for persons (including teens) with little motivation to change has been effective in reducing substance abuse. Thus, MI designed for delinquent youths who are required to attend substance abuse treatment may prove efficacious. In this proposed randomized trial, a one-way design (MI + Standard Care [SC] vs. Attention Control [AC] + SC) will be used to determine whether MI enhances subsequent treatment participation and reduces substance-related problems post discharge in substance using, delinquent youths. Teens will also receive a booster session of MI or AC prior to discharge. SC includes skills training and psycho-educational components; AC provides relaxation training. Participants will be followed at 3 months post discharge. Primary outcome variables include alcohol and marijuana use, as well as related behaviors (illegal activity, sex or injures while drunk or high). It is hypothesized that in Studies 51 comparison to teens receiving AC, youths receiving MI will participate more (by therapist and teen ratings) in SC and will show the lowest levels of heavy substance use and related problems after discharge. It is hypothesized that effects found post discharge will be mediated by stage of change, drug effect expectancies, self-efficacy and treatment participation. This study will extend previous research by evaluating the use of MI with ethnically diverse substance abusing teens in a correctional facility, and by expanding outcome measures to include alcohol and marijuana-related risk behavior (such as injuries and illegal activity when drunk or high) in this population. The development of effective interventions for substance using juvenile offenders has the potential to reduce substance abuse and crime in this population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: EDUCATION MOTIVATIONAL INTERVIEWS FOR MANDATED ETOH Principal Investigator & Institution: Barnett, Nancy P.; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2001; Project Start 01-APR-2000; Project End 31-MAR-2004 Summary: A significant proportion of young adults drink heavily and consequently are at risk for a variety of problems such as alcohol-related motor vehicle crashes, injury, and behavioral and academic problems. The objective of this research is to investigate ways to effectively reduce harmful drinking in college students who have been identified by college authorities as having had an alcohol-related incident. Whereas mandated alcohol education or treatment for alcohol violations on college campuses is ubiquitous, the efficacy of such interventions has not been studied. Motivational approaches with hazardous drinking college students have shown promise. Thus, a motivation-based intervention designed for those who are required to attend alcohol counseling may prove efficacious. Intensifying the intervention by adding a booster session might further enhance efficacy. Additionally, the common association between alcohol and sexual activity among young adults suggests that including risky sexual behavior as an avoidable alcohol-related problem could be successful as well. In this proposed randomized trial, a 2 (Motivational Interview vs. Standard Education) X 2 (2week booster vs. none) factorial design will be used to determine whether MI and a booster session separately, and in conjunction, are effective in reducing alcohol-related consequences and alcohol use in college students mandated to an alcohol intervention following an alcohol-related emergency or infraction. The Standard Education condition will be based on college standards for alcohol education. Subjects will be followed at 3 and 12 months after the baseline intervention. Primary outcome variables include alcohol consumption, and alcohol-related injuries and consequences including unprotected sexual behavior. It is hypothesized that: 1) groups receiving MI will show the lowest levels of heavy drinking and alcohol problems, with the groups receiving MI plus booster showing the greatest effect, and that 2) intervention effects will be mediated by alcohol expectancies, stage of change, use of behavioral alcohol-reduction strategies, and treatment seeking. This study will extend previous research by evaluating the use of MI with individuals who are mandated to treatment, by including a booster session, and by expanding the focus to include alcohol-related sexual risk behavior. The development of effective interventions for young adults who are engaging in harmful drinking should reduce the chronicity of alcohol-related problems and injuries in this population. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen 52 Alcohol Abuse · Project Title: MULTIMEDIA SMOKING CESSATION FOR ALCOHOLIC CLIENTS Principal Investigator & Institution: Butler, Steve; Inflexxion, Inc. Newton, Ma 02464 Timing: Fiscal Year 2001; Project Start 01-MAY-1999; Project End 31-JUL-2003 Summary: This application proposes development of an interactive multimedia program called, "On the Air: A Smoking Education Program for Alcoholics," designed to reduce smoking of clients in alcohol treatment. The program will be offered through inpatient, residential and outpatient treatment programs to help those struggling with alcohol addiction to understand, reduce and stop smoking. The program utilizes multimedia technology to tailor intervention material to clients' stage of change with respect to smoking. Based on the metaphor of a television network, users are able to access their own personal "channel" broadcasting a selection of "shows," each of which represents an entertaining, educational oriented intervention tailored to the user's stageof-change, concerns about smoking and smoking cessation, and other key variables. Phase I involved the gathering of feedback from interviews, focus groups with professionals, interviews with experts, and acceptance and satisfaction testing to develop the "On the Air" prototype. Phase II will involve the completion of the "On the Air" CD-ROM, acceptance and satisfaction testing, and implementation of a comprehensive field test of the program. If "On the Air" were shown to demonstrably increase clients' motivation to actively quit smoking, the national commercial potential would be significant. PROPOSED COMMERCIAL APPLICATION: The proposed program will provide a targeted, computer-administered intervention to facilitate smoking cessation for alcoholic clients. Despite extremely high proportions of alcoholics who smoke (as much as 90%), and the growing evidence of addictive and even synergistic health consequences of abusing both alcohol and tobacco, few alcohol treatment programs directly address client smoking. Limited financial and staff resources and a general lack of reimbursement for smoking interventions are some of the barriers to integrating smoking cessation efforts into ongoing treatment programs. If a computerized, affordable smoking cessation program can be shown, in field trials, to have demonstrable efficacy, the commercial potential can be extraordinary. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: MYOCARDIAL INTOXICATION PROTEIN SYNTHESIS AFTER ALCOHOL Principal Investigator & Institution: Vary, Thomas C.; Professor; Cellular/Molecular Physiology; Pennsylvania State Univ Hershey Med Ctr 500 University Dr Hershey, Pa 17033 Timing: Fiscal Year 2001; Project Start 22-SEP-2000; Project End 31-AUG-2005 Summary: The objective of the studies described herein are to gain a better understanding of the mechanisms by which chronic alcohol feeding induces derangements in myocardial protein metabolism. Alcoholism remains the most common form of drug abuse in the United States. Alcohol abuse is associated with an increased premature mortality. A leading etilogy of mortality is the development of a cardiomyopathy, diagnosed in approximately 35% of whose individuals who chronically abuse alcohol. The degree of cardiac dysfunction is proportional to the duration and severity of the alcohol consumption. Histological examination of biopsy specimens obtained from humans reveals a thinning of the ventricular wall, myocyte degeneration, loss of striations, and myofilament dissolution, consistent with alterations in structural and myofibrillar proteins. The underlying mechanisms responsible for these alterations remain unknown. It is our hypothesis that chronic alcohol consumption Studies 53 induces specific defects in the regulation of protein synthesis in cardiac muscle that ultimately are responsible for the histologic changes of the alcoholic cardiomyopathy. Preliminary studies have shown a 25% loss of cardiac protein/heart from animals consuming alcohol for 12 weeks. The loss of protein mass resulted, in part, from a diminished (30%) rate of protein synthesis. The block in protein synthesis occurred through an inhibition of translational efficiency, rather than a loss of ribosomes. Furthermore, the diminished translational efficiency is a result of proportional decreases in both peptide-chain initiation and elongation. Currently, there is no information concerning the biochemical loci or mechanism responsible for the inhibition of translational efficiency and hence protein synthesis following chronic ethanol intoxication. The experimental design addresses the following Specific Aims: (1) to determine the mechanism by which chronic alcohol consumption reduces peptide-chain initiation in heart; (2) to determine the mechanism by which chronic alcohol consumption reduces myocardial peptide-chain elongation; 3) to determine the mechanism by which acute alcohol consumption reduces translational efficiency for protein synthesis in heart.; (3) to investigate the expression of specific myocardial proteins following chronic alcohol consumption; and 4) to determine if there is a differential response in protein metabolism to chronic alcohol consumption between male and female rats. Overall, the research design will establish the processes by which myocardial protein synthesis is reduced following long and short term alcohol intoxication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: NALTREXONE AND CBT FOR PATIENTS WITH ALCOHOLISM AND PTSD Principal Investigator & Institution: Foa, Edna B.; Professor; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2001; Project Start 19-SEP-2000; Project End 31-JUL-2005 Summary: APPLICANT'S ABSTRACT: This proposed investigation extends prior research efforts by Edna Foa and Joseph Volpicelli in the evaluation of pharmacological and cognitive-behavioral treatments for alcohol dependence (AD) and post- traumatic stress disorder (PTSD), and capitalizes on their combined expertise in evaluating a comprehensive treatment program developed for patients with comorbid AD and PTSD. The comorbidity of AD and PTSD is a significant public mental health problem because the risk for AD dramatically increases among individuals with trauma history or PTSD and vice versa. The two disorders are thought to form a vicious cycle in which PTSD leads to abuse of alcohol; alcohol abuse impedes recovery from the traumatic experience thus contributing to the maintenance of PTSD; and PTSD in turn further escalates and entrenches alcohol abuse. Although promising treatments for AD and PTSD have been identified, comprehensive programs that address both disorders simultaneously have not been empirically tested. Specifically, the opiate antagonist naltrexone has been well established as an efficacious treatment for AD, but research has not specifically addressed its efficacy in patents with PTSD, who are especially prone to treatment attrition and noncompliance. Similarly, cognitive- behavioral treatment of PTSD by prolonged exposure (PE) is the most validated psychosocial treatment for PTSD; however, its efficacy in patients who abuse alcohol is unknown because AD is typically an exclusion criterion in such research. In the proposed study we will evaluate the efficacy of combining these empirically validated treatments for a group of patients who exhibit comorbid AD and PTSD. The proposed study compares four, 6-month treatment conditions in a 2 (naltrexone vs. placebo) by 2 (PE vs. No PE) research design. 54 Alcohol Abuse The four conditions are: 1) 100mg. naltrexone with PE; 2) naltrexone alone; 3) pill placebo with PE; 4) pill placebo alone. An enhanced medication management intervention will accompany all treatment conditions. PE will be provided by experienced psychologists trained in manual protocols. The study will include 200 patients (50/group) diagnosed with AD and comorbid PTSD. Symptoms will be evaluated before, during, and at the end of treatment, and at 9 and 12 months following study entry. Our primary study objective is to compare the short and long term effects of the combined treatments to those of each treatment in isolation on symptoms of AD and of PTSD. This study offers a model for combining and evaluating interventions in diverse treatment modalities for addressing comorbidity in AD, in a major step toward the development of theoretically driven and empirically validated treatments for difficult to treat populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: NALTREXONE TREATMENT FOR ALCOHOLISM Principal Investigator & Institution: Krishnan-Sarin, Suchitra; Assistant Professor; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001; Project Start 04-JUN-2001; Project End 31-MAY-2006 Summary: Evidence from both preclinical studies and retrospective data from clinical trials indicate that opioid antagonists reduce alcohol drinking, especially continued alcohol drinking following lapse in drinking, as well as reduce craving for alcohol. However, the cascade of events that mediates this efficacy of opioid antagonists is still unknown. Increased knowledge of this mechanism may help to further understanding of the processes mediating continued alcohol drinking and result in the development of more effective treatments of alcohol dependence. Family history of alcoholism is known to be a significant risk factor for development of heavy alcohol drinking and understanding the biological basis of developing this genetic risk would also advance our ability to develop better treatments for this disorder. Our group has prospectively demonstrated using a laboratory paradigm of alcohol self-administration that naltrexone does indeed reducer alcohol consumption during an ad-libitum alcohol selfadministration period following exposure to a priming drink of alcohol. We would now like to extend these findings to a laboratory model of relapse to alcohol that includes an alcohol deprivation period prior to the self-administration session. The results from this laboratory paradigm would more closely model evidence from clinical trials of naltrexone for alcohol dependence which indicate that one of the most important effects of naltrexone is to prevent relapse following a lapse of abstinence. The results of our self- administration paradigm also indicate that naltrexone induces HPA activation as evidenced by increased cortisol levels, that could either mediate naltrexone's effects or be a marker of naltrexone's efficacy. Recent evidence indicates that a genetic risk of alcoholism results in an attenuated release of cortisol in response to the opioid antagonist naloxone suggesting that the sensitivity of the endogenous opioid system to alcohol is altered by increased genetic risk. Therefore, we will conduct this study in heavy drinkers with or without a family history of alcoholism and address the following specific aims: 1) To evaluate the efficacy of six days of pretreatment with one of three doses of naltrexone (o,50 and 100 mg/day) using a laboratory model consisting of four days of alcohol deprivation following by exposure to a priming drink of alcohol and subsequent ad-libitum drinking and 2) To evaluate the influence of family history of alcoholism on the efficacy of naltrexone using a laboratory model consisting of four days of alcohol deprivation followed by exposure to a drinking drink of alcohol and subsequent ad- libitum alcohol drinking. Studies 55 ABUSE IN Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: NALTREXONE SCHIZOPHRENIA TREATMENT OF ALCOHOL Principal Investigator & Institution: Batki, Steven L.; Professor and Director of Research; Psychiatry and Behavioral Scis; Upstate Medical University Research Administration Syracuse, Ny 13210 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2007 Summary: (provided by applicant): The long-term goal of the proposed project is to improve the treatment of alcohol abuse and dependence in patients with schizophrenia and schizoaffective disorder. Alcohol use disorders are common among patients with severe mental illness. It is estimated that there may be as many as 750,000 individuals in the United States with comorbid schizophrenia and alcohol disorders. Alcohol disorder comorbidity requires treatment because it is associated with adverse consequences such as increased rates of hospitalization. Yet, to date, there are no reports of controlled trials testing the efficacy of pharmacological treatments for alcohol abuse or dependence in this population. Naltrexone pharmacotherapy is an effective treatment for alcohol dependence, but it has not been systematically applied to the care of patients with schizophrenia. The specific aims of this study are: To test the efficacy of naltrexone in reducing alcohol use among individuals with schizophrenia and schizoaffective disorder who also have alcohol abuse or dependence. We will test hypothesis 1: Naltrexone will be more effective than placebo in reducing alcohol use. Our primary outcome measure will be the number of drinking days over the course of the treatment trial. To test naltrexone's efficacy in reducing psychiatric symptom severity and medical utilization by reducing alcohol use. We will test hypothesis 2: Patients responding to naltrexone by reducing alcohol use will also show reductions in severity of psychiatric symptoms and utilization of inpatient and emergency psychiatric services. To determine the relationship between a) changes in alcohol use, and b) psychiatric symptom severity and inpatient and emergency service utilization. We will test hypothesis 3: Severity of psychiatric symptoms and amount of service utilization will correlate positively with alcohol use. The proposed research will study a cohort of 150 subjects in a double-blind, randomized, placebo-controlled trial of naltrexone using three times per week directly observed administration of medication. The study will be 6 months in duration, consisting of a 12-week course of naltrexone or placebo plus 3 monthly follow-up interviews after discontinuation of medication. Voucher incentives contingent on attendance will be provided to all subjects to ensure attendance for medication administration. Weekly motivational enhancement counseling sessions will also be provided to all subjects. Study outcomes will consist of self-report and biological measures of alcohol use as well as measures of psychiatric symptom severity and medical service utilization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: NEIGHBORHOOD, TRAJECTORIES RACE AND ALCOHOL USE /ABUSE Principal Investigator & Institution: Buka, Stephen L.; Associate Professor; Epidemiology; Harvard University (Sch of Public Hlth) Public Health Campus Boston, Ma 02460 Timing: Fiscal Year 2002; Project Start 30-SEP-2002; Project End 31-AUG-2005 56 Alcohol Abuse Summary: (provided by applicant): Many studies have considered how personal background and family functioning are linked to alcohol use, progression, and desistance. The proposed study is novel in its potential to reveal the ways in which broader social contexts-neighborhoods and schools-contribute to the etiology of alcohol use and abuse. Data are drawn from a prospective, longitudinal study of 3000 youth living in 80 neighborhoods of Chicago. Subjects were surveyed on three occasions over 6 years, and range in age from 9 to 23. The study was designed to include 1) large numbers of three major race/ethnic subgroups (white, black and Hispanic); 2) substantial socioeconomic variation and overlap within each of these race/ethnic subgroups; and 3) substantial variation in the socioeconomic, racial, and ethnic composition of the study neighborhoods. Considerable information collected through surveys, observations, and other sources enable the research team to characterize the social processes in the neighborhoods in which the study participants have resided and in the schools that they have attended. The proposed work follows our previous findings, based on cross-sectional data, that neighborhood context accounted for roughly 50% of the observed black-white disparity in adolescent annual alcohol use rates. The disparity in alcohol use between a black and white youth living in the same neighborhood is roughly half that observed between the average black and white youth in the city of Chicago. Given this evidence of the strong association between neighborhood context and alcohol use, this study aims to 1) describe race/ethnic differences in alcohol use from age 9-23; 2) examine the extent to which these can be accounted for by group differences in socioeconomic status and immigrant generational status; 3) examine the extent to which these differences can be attributed to racial, ethnic, and socioeconomic segregation of groups into different residential and/or school contexts; and 4) determine whether a set of theoretically indicated characteristics of schools and neighborhoods explain these contextual effects. In addition, this study will also support the development of advanced statistical techniques needed to simultaneously estimate school and neighborhood contributions to race/ethnic disparities in alcohol use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: NEURONAL SIGNALING IN ALCOHOL PREFERENCE Principal Investigator & Institution: Pandey, Subhash C.; Associate Professor of Biochemistry in p; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2001; Project Start 29-SEP-2001; Project End 31-AUG-2005 Summary: (provided by applicant): There is increasing evidence to suggest that genetic factors play an important role in the development of alcohol drinking behavior. It has also been suggested that innate anxiety level is an important factor in the initiation of alcohol consumption. Animal lines, such as alcohol-preferring (P) and nonpreferring (NP) rats, appear to be suitable models to investigate the neurobiological basis of genetic vulnerability to anxiety and alcohol abuse. P rats are more anxious and also consume larger amounts of alcohol than NP rats. Neuropeptide Y (NPY) has been shown to play a crucial role in anxiety and alcohol abuse. The levels of NPY are lower in the central amygdala of P rats than of NP rats. The mechanisms by which NPY are regulated in the neurocircuitry of the central amygdala of P rats and also how NPY is involved in anxiety and alcohol drinking behavior of P rats are unknown. The cAMP-responsive elementbinding protein (CREB), which represents a common intracellular target for the action of a number of neurotransmitters, has been found to be decreased in the amygdala of P rats compared with NP rats. The proposal is based on the hypothesis that decreased Studies 57 expression of the CREB and CREB-related target genes, i.e., NPY, in the central amygdala, is responsible for the genetic predisposition to anxiety and to alcohol drinking behavior. This hypothesis will be tested by the following Specific Aims: 1) To compare a) the expression and phosphorylation of CREB, and b) mRNA and protein levels of NPY, and c) the expression and activity of PKA in the amygdala of alcoholnaive P rats and NP rats; 2) To examine a) if the increased phosphorylation of CREB and the increased expression of NPY elicited by PKA activator infusion into the central amygdala attenuate anxiety and alcohol preference in P rats; and b) if the decreased phosphorylation of CREB and the decreased expression of NPY elicited by PKA inhibitor infusion into the central amygdala provoke anxiety and also increase alcohol preference in NP rats; 3)To evaluate if the decreased expression of NPY due to decreased CREB expression caused by CREB anti-sense oligonucleotide infusion into the central amygdala, provokes anxiety and also increases alcohol preference in NP rats; 4)To examine if the increased phosphorylation of CREB and the increased levels of NPY due to NPY infusion into the central amygdala attenuate anxiety and alcohol preference in P rats. Thus, the proposed studies will provide evidence that a downregulation of PKA - CREB - NPY signaling in the central amygdala acts as a genetic vulnerability factor to induce anxiogenic and desperate alcohol-drinking behaviors of P rats. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: NEUROPHYSIOLOGY IN CHILDREN AT HIGH RISK FOR ALCOHOLISM Principal Investigator & Institution: Porjesz, Bernice; Associate Professor; Psychiatry; Suny Downstate Medical Center 450 Clarkson Ave New York, Ny 11203 Timing: Fiscal Year 2001; Project Start 01-JUL-1982; Project End 31-AUG-2006 Summary: (provided by applicant): For the past twenty years it has been repeatedly observed that the P3(00) component of the event-related potential (ERP) is not only significantly lower in alcoholics, but also in young offspring of alcoholics at high risk (HR) for developing alcoholism. These observations suggested that reduced amplitudes of the P3 component in HR individuals might antecede the development of alcohol dependence. There is some evidence that reduced P3 voltage in childhood and adolescence in HR individuals is associated with externalizing disorders (conduct disorder, attention deficit hyperactivity, oppositional defiant disorder and adult antisocial behavior) and increased substance use, and may predict later substance and alcohol abuse. A meta-analysis of all HR studies concluded that the low amplitude P3 in HR individuals provides a reliable phenotypic marker of alcoholism, and it has been postulated to be indicative of increased Central Nervous System (CNS) disinhibition. Thus P3 as a potential vulnerability marker may provide insight into some causative pathophysiology process involved in the development of alcohol dependence. Here it is hypothesized that the P3 amplitude may index some CNS vulnerability (e.g. disinhibition) which may result in any one of a number of adverse conditions, such as alcohol dependence, drug abuse, antisocial personality, attention deficit hyperactivity disorder, conduct disorder, oppositional disorder, etc. The research strategy used to date has been based on a familial high-risk model, because it is well known that children of alcoholics are at high risk to develop alcohol dependence. In the present renewal a complementary strategy is proposed based on a "neurophysiological high-risk" model. In this model, individuals are hypothesized to be at high-risk based solely on their extreme scores on neurophysiological features (e.g. visual P3 amplitude), well established to be associated with a number of clinical conditions such as alcohol dependence, substance abuse, etc. Several scientific issues will be examined with the use 58 Alcohol Abuse of this novel approach, using innovative neurophysiological assays and methods. Specifically, electrophysiological measures (P3 and other measures) will be recorded in a large randomly ascertained sample of adolescents (15-17). The P3b amplitude provides a quantitative variable that typically yields a normal distribution in the general population. This distribution will be divided into the lower, upper and middle third. These three groups based on P3b amplitude will provide the basis for subsequent dependent variables, such as other EEG/ERP experiments, the clinical data to be collected (externalizing symptoms, other psychiatric symptoms, alcohol use, drug use, family history of psychiatric disorders, etc.). It is hypothesized that those individuals at the low end of the P3 amplitude distribution will manifest more evidence of electrophysiological disinhibition, externalizing traits, and substance use. Moreover, it is proposed that individuals with low P3b amplitude will manifest significantly greater prevalence of externalizing traits, alcohol and drug abuse compared to subjects with high P3b amplitude when retested four years later (ages 19-21). Retesting will begin in the last year of this application, and will continue in the future. The identification of individuals with neuroelectric deficits will have great utility in prevention initiatives. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: OUTCOME AND COST OF DAY HOSPITAL VS OUTPATIENT CARE Principal Investigator & Institution: Weisner, Constance M.; Professor; Langley Porter Psychiatric Institute; University of California San Francisco 500 Parnassus Ave San Francisco, Ca 94122 Timing: Fiscal Year 2001; Project Start 20-SEP-1994; Project End 31-MAY-2004 Summary: As increasing numbers of individuals enter treatment for alcohol dependence and abuse, an era of cost containment in health care challenges the cost effectiveness of traditional in patient treatment. Clinical evidence suggests that outpatient treatment for alcohol dependence and abuse may be as effective as in patient treatment, but the effectiveness and cost of various levels of intensity of outpatient treatment has not been assessed. Thus, given the range and severity of problems commonly found among alcohol treatment clients, a question remains of what is the optimum intensity of services for rehabilitation and whether this differs by gender, by ethnicity, and by mental health status. This submission proposes a controlled, random assignment comparison of day hospital outpatient treatment and traditional outpatient treatment in a heterogeneous population (N=1214; 34% women, 12% African American, and 10% Hispanic) of a large health maintenance organization's (HMO) substance abuse program. The HMO setting is an important "real world" environment in which to conduct such a study; it has a heterogeneous patient population, and such managed care settings are increasingly becoming the most common form of service delivery. The study compares the effects of day hospital treatment and traditional outpatient treatment during the course of the care provided, such as length of stay, completion rates, and during- treatment alcohol use. It compares post treatment outcome and improvement rates in the areas of alcohol consumption, levels of psychosocial functioning, and medical care utilization of the two regimens, and attempts to specify patient characteristics associated with successful treatment outcomes in each setting. Finally, it compares the costs of day hospital and traditional outpatient treatment, and assesses cost effectiveness and cost offsets of the two programs. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen Studies · 59 Project Title: PERSONAL COMPETENCE SKILLS AND ADOLESCENT ALCOHOL USE Principal Investigator & Institution: Griffin, Kenneth W.; Public Health; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2001; Project Start 01-JUN-2001; Project End 31-MAY-2003 Summary: APPLICANT'S ABSTRACT: School-based drug abuse prevention programs that combine refusal skills training with social and personal competence enhancement have been shown to reduce adolescent drug and alcohol use. Etiology research has begun to clarify how the components of effective prevention programs work. Social competence appears to play a protective role by helping young people resist peer influences to use alcohol. Less is known about the role of personal competence skills in the etiology of adolescent alcohol use. Although research has shown that personal competence skills such as cognitive and behavioral self-management strategies are associated with less alcohol use among adolescents, the etiological mechanisms remain unclear. In addition, little is known about how personal competence skills protect youth from important risk factors for alcohol use, particularly youth in high-risk settings. Research has shown that rates of alcohol use differ among ethnic and gender subgroups of adolescents. Thus, it is important to determine whether competence-based etiological models can explain alcohol use among various subgroups of adolescents. A primary goal of the proposed research is to develop, test, and refine several etiologic models that focus on personal competence skills and adolescent alcohol use, and to examine these models among two longitudinal samples of middle school students: a predominantly white, suburban sample (N=3,549), and a largely minority, inner-city sample (N=2,229). This goal will be accomplished through secondary analysis of control group participants from two school-based drug abuse prevention trials. The proposed research aims to elucidate how personal competence skills influence the initiation and escalation of adolescent alcohol use. Mediational analyses will test the hypothesis that personal competence skills reduce alcohol use by enhancing psychological well-being or reducing distress; moderational analyses will test whether personal competence skills buffer the effects of other risk factors for alcohol use (e.g., peer influences). Models will be crossvalidated among ethnic and gender subgroups, and differences in the prediction of experimental versus heavy alcohol use will be tested. The long-term goal is to improve our understanding of how alcohol use develops among youth of different backgrounds and to improve prevention intervention for ethnically diverse populations. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: PET IMAGING OF BRAIN OPIOID RECEPTORS IN ALCOHOLISM Principal Investigator & Institution: Frost, J James.; Professor; Radiology; Johns Hopkins University 3400 N Charles St Baltimore, Md 21218 Timing: Fiscal Year 2001; Project Start 01-JUL-1999; Project End 31-MAR-2003 Summary: Alcohol abuse and alcoholism is a major public health problem in the United States, but little is known of the neurochemical pathways in the human brain that mediate the reinforcing and other properties of ethanol. The brain's endogenous opioid system is known to play an important role in reward mechanisms and recently it has been targeted in treatment efforts using the opiate antagonist naltrexone. The rationale for using opioid blockade in the treatment of alcoholism is well founded in experimental animal models of human alcohol use and abuse, but we know little about the underlying differences in the endogenous opioid system between healthy individuals and alcoholics. Positron emission tomography (PET) is a non-invasive 60 Alcohol Abuse imaging method that can be used to image and quantitate a number of neuromarkers and mu opioid receptors can be imaged in the human brain by PET using the wellvalidated ligand C-11 carfentanil. Our long-term goal is to better understand the function of the endogenous brain opioid system in alcohol use and abuse, and determine if it is involved in increasing the risk of alcoholism. The use of PET to measure regional mu opioid receptors is an approach that could provide new insight into the role of the endogenous opioid system in alcoholism. The specific aims of this study are: l) Measure regional mu opioid receptor binding by PET in non-alcoholic men and women with a positive family history of alcoholism.; 2) Measure regional brain mu opioid receptor binding by PET in FHP and FHN alcoholic men and women and relate regional binding to behavioral measures of alcohol abuse; and 3) Measure the change in regional mu opioid receptor binding during one month controlled abstinence from ethanol in alcoholic men and women. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: PILOT--THE LUNG AS AN ETHANOL METABOLIZING ORGAN Principal Investigator & Institution: Polavarapu, Giri; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-DEC-2007 Summary: This Center is focused on the mechanisms by which alcohol abuse produces chronic oxidative stress within the lung and renders it susceptibile to acute injury in response to insults such as sepsis and trauma. Studies in alcoholic liver disease demonstrate that ethanol is metabolized through phase I and phase II enzymes like alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH), and cytochrome P450EI, leading to accumulation of electrophiles, reactive oxygen species (ROS), and ultimately, oxidative stress. However, endogenous metabolism of ethanol and the subsequent oxidative stress within the lung has not been examined. We hypothesize that during chronic alcohol abuse, ethanol-metabolizing enzymes are induced within the lung and contribute to the oxidative stress and glutathione depletion that characterize the ?alcoholic lung'. In pilot experiments on rat lung tissue analyzed with state-of-theart Gene Chip technology, we determined that chronic ethanol ingestion increases expression of members of the alcohol, aldehyde dehydrogenases and P450 superfamilies (ADH I and IV, ALDH I & P4502EI). Ethanol-metabolizing enzyme induction correlated with levels of thiobarbituric acid reactive substances (TBARS), a marker of oxidative stress, and with induction of antioxidant enzymes including catalase, superoxide dismutase, and enzymes involved in glutathione homeostasis. Therefore, endogenous metabolism of ethanol within the lung may exert profound effects on lung function via mechanisms that are quite similar to its toxic effects in other tissues. To test this hypothesis we propose to first identify the specific isoforms of ADH, ALDH, cytochrome P4502EI, and catalase that are induced in the lung by chronic ethanol ingestion in rats using cytochemical, molecular biological, enzymatic and gene chip microarray methods. We will then study the regulation of selected phase II genes that are responsible for electrophile formation as well as ROS scavening, particularly within the alveolar epithelial microenvironment that our collaborators in this Center have shown to be a target of alcohol toxicity. Finally, based on our findings and collaborative studies with other investigators within the Center, we can use microarray technology to identify novel candidate genetic targets of alcohol abuse within the lung. Further, we can assess the potential therapeutic actions of treatments such as glutathione replacement and angiotensin II blockade that have been identified as a result of studies by our collaborators within the Center. Studies 61 Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: PREDICTING DRINKING USING A COPING SKILLS TAXONOMY Principal Investigator & Institution: Mackinnon, Selene M.; Ctr for Alcohol & Addict Studs; Brown University Providence, Ri 02912 Timing: Fiscal Year 2002; Project Start 27-SEP-2002; Project End 31-MAY-2005 Summary: (provided by applicant): Relapse rates among individuals treated for alcohol abuse continue to be high, ranging from 35% to 90%. Effective cognitive and behavioral anticipatory, immediate, and restorative coping strategies have been identified; however, little is known about risk appraisal as a cognitive process for identifying the level of risk of a potentially high-risk situation. Failure to appraise a high-risk situation as dangerous will likely result in failure to implement coping responses. There is also a paucity of research examining the effectiveness of sobriety-related lifestyle coping strategies in reducing the frequency and severity of alcohol relapse. An alternative taxonomy of coping skills is presented to incorporate these understudied areas of coping and to enhance our knowledge of coping and relapse. The long-term objective of this research is to improve alcohol treatment by increasing our understanding of coping strategies that are effective in decreasing relapse rates among individuals treated for alcohol abuse. The major goal of this assessment study is to evaluate the ability to predict subsequent drinking severity by assessing the use of two understudied dimensions of coping: (1) cognitive risk appraisal of potentially high- risk situations and (2) sobriety-related lifestyle coping strategies that may be used on an ongoing basis outside of high-risk situations. Individual differences in coping strategies will be assessed in males and females as they complete residential substance abuse treatment and transfer to outpatient treatment. Participants will be followed for one year, with assessments conducted at baseline (start of outpatient therapy), and at 3, 6 and 12 months post baseline assessment. Self-reported use of coping strategies at the baseline, 3-month and 6-month follow-up assessment points will be used to predict drinking quantity, frequency, and status (relapsed versus abstinent) during the subsequent 3- and 6-month follow-up intervals. Results of this study will expand work completed to date by prospectively predicting drinking severity based on use of previously understudied dimensions of coping. This information will enhance the coping skills component of CBT alcohol intervention and reduce the frequency of heavy alcohol consumption and its associated harmful effects. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: PREVENTING HARM FROM ALCOHOL USE IN OLDER ADULTS Principal Investigator & Institution: Moore, Alison A.; Medicine; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2007 Summary: (provided by applicant): Up to 40 percent of older persons who drink may be at-risk for harm. This risk is due to age-related physiological changes that increase the effects of a given dose of alcohol and age-associated increases in comorbidity and medication use that may cause adverse effects when even small amounts of alcohol are consumed. Most trials of brief advice to reduce drinking among primarily younger populations have reduced subjects' alcohol use by 10-20 percent. These trials have focused on drinkers who are at risk because of the amount they drink, or because they have symptoms of alcohol abuse or dependence. No trials have yet focused on older drinkers who are at risk because of the interaction of alcohol use and co-morbidity (e.g., 62 Alcohol Abuse diabetes, hypertension) and medication use (e.g., anticoagulants, nonprescription antihistamines). To test whether a screening and brief advice preventive intervention targeted to older persons may reduce such at-risk drinking and prevent subsequent harm, we propose a 12-month, randomized, controlled trial involving 880 subjects attending primary care clinics at two non-academic sites. Our intervention will consist of advice given to both at-risk drinkers and their physicians personalized to address the particular reasons a subject is identified as an at-risk drinker. We will identify at-risk drinkers using a new screening measure, the Short Alcohol-Related Problems Survey (shARPS). Respondents may be identified as at-risk drinkers because they have a single risk (e.g., drinking and using benzodiazepines) or multiple risks (e.g., drinking and using narcotics, drinking and having depression). At-risk drinkers will be randomized to either receive brief advice about at-risk drinking (intervention) or a booklet on healthy behaviors (control). To assess the efficacy of the intervention, subjects will undergo assessments of their alcohol-associated risks at recruitment, and 3 and 12 months later. Our analyses will assess the effect of the intervention on the prevalence of at-risk drinking, the amount of drinking, and the numbers of risks identifying those subjects still considered at-risk drinkers. This study will be the first to assess a preventive intervention to reduce risks of alcohol use, alone or in conjunction with comorbidity and medication use among older adults in primary care. If such an intervention is successful, potentially hundreds of thousands of older persons may benefit from a reduction in their risks associated with alcohol use and prevention of harm. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: PRIMARY CARE INTERVENTION FOR ALCOHOL PROBLEMS Principal Investigator & Institution: Baca, Catherine; None; University of New Mexico Albuquerque Controller's Office Albuquerque, Nm 87131 Timing: Fiscal Year 2003; Project Start 01-SEP-2003; Project End 31-AUG-2008 Summary: (provided by applicant): The University of New Mexico (UNM) submits this new application for career retraining of Catherine Baca, MD, to focus on patientoriented alcohol research. Dr. Baca is a preventive medicine specialist with 21 years of clinical experience in treating alcohol and drug dependence among Hispanic and other populations in the American Southwest. For the past eight years she has worked at UNM's Center on Alcoholism, Substance Abuse, and Addictions (CASAA), treating patients with alcohol and other drug use disorders. Through her work in clinical trials at CASAA, she has become increasingly interested in a research career, with particular focus on Hispanic substance use and disorders. Her career development plan emphasizes three areas for expanded expertise: (1) statistics and design methodology, (2) alcohol clinical and prevention research, and (3) scientific writing and research development. The primary resources for her research training will be at CASAA, in UNM's Public Health Program, and in the Department of Psychology. Her primary mentor will be Dr. William R. Miller, Distinguished Professor of Psychology and Psychiatry, with secondary mentorship from Dr. J. Scott Tonigan in the design and analysis of addiction research, and additional support from other CASAA units and investigators. The five-year training plan is designed to prepare Dr. Baca to become an independent investigator, focusing her primary career efforts on patient-oriented clinical and prevention research in alcohol and drug abuse. As part of her training, her initial research plan focuses on motivational interviewing with Hispanic and non-Hispanic patients seen in a primary care setting. Dr. Baca will focus 80% time on research training during this five-year period, relieved of other clinical and administrative duties. To Studies 63 remain clinically attuned, she would retain 20% time (one day per week) devoted to patient care at the V.A. Medical Center where she also treats patients with alcohol and other drug use disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: REACHING TEENAGE DRINKERS VIA THE INTERNET Principal Investigator & Institution: Cauffiel, Lowell; Indepthlearning.Com, Inc. 123 N Ashley, Ste 14 Ann Arbor, Mi 48104 Timing: Fiscal Year 2003; Project Start 18-JUN-2003; Project End 31-MAY-2006 Summary: (provided by applicant): The goal of this project is to bridge the gap between scientific knowledge about alcohol use and its associated risks, and contemplation of that knowledge in ways that promote awareness, prevention, and behavioral change. To accomplish this objective, we will create a website that 1) explains what research tells us about the medical, biological, and behavioral ramifications and risks of alcohol use, abuse, and dependency, 2) presents the personal stories of individual teenage and young adult alcoholics and alcohol abusers, and 3) integrates these two types of knowledge in ways designed to promote changes in attitude and behavior. The technology for creating this website will be based on the inDepthLearning System, a set of web-based, interactive learning tools that we previously developed to address the educational needs of people with varying backgrounds and skills (use Internet Explorer to see http://indepthlearning.org for an example of this approach). Each page will be prepared at three levels of complexity with popup definitions in multiple languages and incorporate a built-in feedback learning system known to promote learning. When appropriate, the personal stories of alcoholics and alcohol abusers will be accessible by clicking on phrase-associated icons. This innovative system addresses the needs of individuals with varying interests, backgrounds, and reading skills. An e-mail-based encouragement system will foster repeated, anonymous access of the resulting website. To evaluate effectiveness, we will utilize assessment instruments designed to monitor changes in alcohol usage, behavior, and attitudes at intervals of one, three, eight, and fourteen months. Subjects for this preliminary evaluation will consist of a random group of young adult, web users who have just graduated from high school. Assessment information and feedback will guide improvements in our materials. We will then disseminate the website with its periodic encouragement system in ways designed to make it an important intervention resource that promotes awareness, prevention, and behavioral change. This proposal is made possible by a partnership that brings together scientists, educators, media experts, computer programmers, community outreach leaders, social workers, physicians, nurses, treatment experts, individuals in the recovery community, and leading researchers in the field of alcoholism and alcohol abuse by late teenage and young adult drinkers. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: REDUCING INJURY, ETOH & THC USE AMONG ED PATIENTS Principal Investigator & Institution: Woolard, Robert H.; Rhode Island Hospital (Providence, Ri) Providence, Ri 02903 Timing: Fiscal Year 2003; Project Start 08-AUG-2003; Project End 31-JUL-2007 Summary: (provided by applicant): Injuries are the leading cause of injury into the 3rd decade of life. Alcohol, and dual alcohol and marijuana use are associated with increased risk of injuries. Prior study by this research group (Longabaugh et. Al., 2001) has shown that the combination of a brief motivational interview in the ED followed by 64 Alcohol Abuse a booster session significantly reduces alcohol-related injuries and negative consequences for sub-critically injured harmful/hazardous drinkers more than does either standard treatment or brief intervention by itself. However, hazardous drinkers who also used marijuana had poorer outcomes than did those who did not use marijuana, irrespective of experimental treatment condition. Moreover, Marijuana use was not reduced by the intervention. The implication is that an intervention addressing both alcohol and marijuana use for dual users will be effective in reducing marijuana related injuries and negative consequences as well. The aims of the present study are three: 1) to test whether two sessions of motivational interviewing for dual users will reduce both alcohol and marijuana related injuries and negative consequences more than will standard ED care, 2) to identify the active ingredients of treatment that mediate the effectiveness of the motivational intervention. 3) to identify patient factors that moderate the strength of this relationship between intervention and outcomes]. 600 sub-critically injured dual users will be randomly assigned to motivational treatment vs. standard care, assessed at three months to identify response to treatment, and at one year to measure distal clinical outcomes. Causal chain analyses will be conducted to identify the mediators and moderators of treatment effects. Identification of active ingredients of the treatment will facilitate the generalizeability of the intervention's effects to other ED settings using a brief motivational intervention. [Identification of patient variables that moderate treatment effectiveness will facilitate selection of patients most and least likely to benefit from the intervention. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: RELAPSE AMONG SEVERELY MENTALLY ILL ALCOHOL ABUSERS Principal Investigator & Institution: Bradizza, Clara M.; None; State University of New York at Buffalo 402 Crofts Hall Buffalo, Ny 14260 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2006 Summary: The long-term goal of this proposed research is to develop effective methods for reducing posttreatment alcohol involvement among severely mentally ill (SMI) alcohol-abusing individuals. The specific aims of this research proposal are to test specific hypotheses summarized in a conceptual path model: 1. To examine the direct and indirect effects of psychiatric symptomatology on posttreatment alcohol involvement in schizophrenic individuals. Alcohol involvement outcome will be assessed by several variables including relapse to alcohol use, percent days abstinent, drinks per drinking day, and negative consequences due to alcohol use. It is anticipated that psychiatric symptoms will have both a direct influence on posttreatment alcohol involvement and an indirect effect through the dual-diagnosis treatment and coping skills factors. 2. To examine the direct and indirect effects of alcohol and other substance use problems on posttreatment alcohol involvement. It is predicted that alcohol and other substance use problems will have both a direct influence on alcohol involvement outcomes and an indirect effect through the dual- diagnosis treatment and coping skills factors. 3. To examine the direct and indirect effects of dual-diagnosis treatment on posttreatment alcohol involvement outcomes. It is predicted that dual-diagnosis treatment will have a direct influence on alcohol involvement outcomes and also an indirect effect through the coping skills factor. 4. To examine the direct influence of general and alcohol- specific coping skills on posttreatment alcohol involvement outcomes. It is predicted that poorer coping skills will lead to worse alcohol involvement outcomes. 5. To conduct exploratory analyses examining the moderating effects of gender, ethnic background, antipsychotic medications, and alcohol medications on the association between predictor variables derived from our Studies 65 mediational path model and alcohol involvement outcomes. A longitudinal design will be used to assess multiple measures of key constructs at treatment entry, and every two months thereafter for a period of six months. Key constructs include background characteristics, psychiatric symptomatology, alcohol and other substance use problems, treatment, coping skills, and alcohol involvement outcomes. Importantly, the results of this study will be used to gain an understanding of factors leading to posttreatment alcohol involvement among SMI individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: SOCIAL DEVELOPMENT INFLUENCES ON ADOLESCENT ALCOHOL USE Principal Investigator & Institution: Duncan, Susan C.; Research Scientist; Oregon Research Institute 1715 Franklin Blvd Eugene, or 97403 Timing: Fiscal Year 2003; Project Start 08-SEP-1998; Project End 31-AUG-2008 Summary: (provided by applicant): This proposal is a continuation of a current research project studying the development of alcohol use among White and African-American youth and their families. Within a developmental social contextual model personal, family, peer, school and neighborhood influences on the development of alcohol use, and other drug use, among children and adolescents, as well as relations between alcohol use and other problem behaviors over time, are assessed. The design of the study is multilevel. Approximately 400 target children from three cohorts (9, 11, and 13 years of age) and their families were recruited from 58 different neighborhoods, thus allowing research questions to be examined across multiple contexts and multiple levels of the hierarchy (individual, family, and neighborhood levels). In addition, the recruitment of relatively equal numbers of African-American and White male and female target children from the three cohorts allows for the examination of developmentally and contextually significant research questions across both ethnic groups, at multiple levels of analysis. The continuation study proposes an additional 4 years of data collection, which would provide information from ages 9-20 years. Until recently, psychological research has had few tools to accommodate the interdependence of data collected across multiple contexts and multiple levels of the hierarchy (e.g., family, neighborhood). Fortunately, new analysis techniques are now available that are more suited to the study of hierarchical and longitudinal data. The proposed study will continue to use recent statistical methods for analyzing development and change, and multilevel data, allowing us to examine research questions at the individual, family, and neighborhood levels, using multi-method, multi-informant data. This longitudinal study of the dynamic interplay of multiple social contexts from pre-adolescence through adolescence and beyond is likely to lead to a greater understanding and identification of malleable risk and protective factors to be targeted for prevention and intervention programs for African-American and White youth and their families. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: TELEPHONE & MAIL INTERVENTION FOR ALCOHOL USE DISORDERS Principal Investigator & Institution: Brown, Richard L.; Family Medicine; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2001; Project Start 24-SEP-2001; Project End 31-JUL-2005 Summary: Medical setting offer unique opportunities to screen and intervene for patients with alcohol use disorders (AUD's), but few medical settings have incorporated 66 Alcohol Abuse these services into their clinical routines. Barriers to the management of AUD's in medical settings are the lack of data on interventions beyond brief interventions for alcohol abusers, the lack of data on interventions for alcohol dependent patients who decline specialized treatment, difficulty engaging primary health care providers in alcohol screening and intervention, and cost constraints. A randomized controlled trial will assess the efficacy of a counselor-administered, telephone and mail intervention (TAMI) compared to a health lifestyles pamphlet; all subjects will receive usual medical care. 22,500 patients will be systematically screened in 9 primary care and managed care clinics in Madison and Milwaukee, Wisconsin, to identify 900 subjects. Subjects will be of ages 21 to 59, able to speak English, not pregnant, and not suicidal, with AUDIT scores of greater than or equal to 8 and DSM-IV diagnoses of alcohol abuse or dependence. The experimental intervention is based on Prochaska and DiClemente's stages of readiness to change and Miller and Rollnick's model of motivational interviewing. It will include six 30-minute, structured telephone counseling sessions and post-session summary letters. Primary outcome measures, to be assessed at baseline, 3-, 6-, and 12-months, are total alcohol consumption and days of heavy drinking (greater than 4 drinks for men, greater than 3 drinks for women) over the past 28 days. An intention-to-treat analysis will use a generalized estimation equation approach. A benefit-cost analysis will be performed using 12-months of pre- and post-TAMI data on health care utilization and criminal justice and motor vehicle events. Additional analyses will focus on the predictors of efficacy, the subjects' satisfaction with TAMI, and pre- and post-TAMI pharmaceutical use. This study has the potential to establish an efficient, cost-effective, convenient intervention for AUD's in primary and managed care settings. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: TESTING DRINKING/DRIVING EXPLICIT THEORETICAL MODELS OF Principal Investigator & Institution: Lapham, Sandra C.; Research Scientist; Behavioral Health Research Ctr-Southwest Center of the Southwest Albuquerque, Nm 87102 Timing: Fiscal Year 2003; Project Start 01-APR-2003; Project End 31-MAR-2005 Summary: (provided by applicant): This R03 proposal seeks two years of funding to conduct secondary analyses on an important longitudinal dataset examining predictors of high-risk drinking and driving in a select sample of DWI offenders (N=1396). Secondary analyses provide a fruitful and cost-effective means of testing and refining theory and can augment existing knowledge using recently developed and innovative statistical techniques. Prior work examining alcoholic subtypes and classification of high-risk drinkers has emphasized the role of personality factors and driving-related attitudes as efficient proximal predictors. However, this body of knowledge has neglected examining the etiologic role of cognitive processes and psychiatric symptoms as they contribute to vulnerability. An accumulation of empirical evidence based on prospective alcohol-related studies highlights that cognitive and psychiatric factors play a prominent generative role in the early stages of drinking and contribute to heavy and more problematic abuse. However, more detailed studies are required that clarify whether specific risk factors moderate or mediate high-risk drinking and driving. The present application extends previous empirical findings and theoretical knowledge in several ways: (1) by including a wider set of demographic, cognitive, behavioral, attitudinal, and psychological (including diagnostic) predictors than previously considered; (2) by using a high-risk sample of convicted DWI offenders, with adequate representation of women and minorities, which provides a unique opportunity to learn Studies 67 more about etiology and consequences of problematic alcohol use in an offender population; (3) by examining 5-year histories of substance abuse treatment and its relation to the progression of alcohol and drug dependence symptoms; and (4) by implementing state-of-the-art multivariate statistical analysis methods including confirmatory factor analysis and structural equation modeling (SEM) to examine theoretical models of high-risk drinking. Participants were convicted drunk drivers referred to the Lovelace Comprehensive Screening Program from the municipal court system in Bernalilto County, New Mexico, contacted and interviewed five years after referral for screening. Data collection protocols included structured in-person interviews coupled with research diagnostic criteria for alcohol and drug, and other psychiatric disorders. This study has the potential to elucidate important risk mechanisms that contribute to high-risk drinking and driving and presence of psychiatric symptoms in the five years following a first DWI conviction, as well as elucidate a theoretically consistent foundation on which to construct clinically useful screening methods, develop valid prevention approaches, and design efficient treatment approaches. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: THE BIOLOGICAL BASIS OF ALCOHOL INDUCED BRAIN DAMAGE Principal Investigator & Institution: Meyerhoff, Dieter J.; Associate Professor; Northern California Institute Res & Educ San Francisco, Ca 941211545 Timing: Fiscal Year 2001; Project Start 01-AUG-1996; Project End 31-JUL-2006 Summary: (Provided by applicant): Long-term chronic alcohol abuse is associated with structural brain changes and neuro-cognitive impairment. Few studies have shown a convincing correlation between these phenomena and it appears likely that neurosubstrates other than structural alterations underlie the cognitive changes associated with heavy drinking and recovery. The overall goal of this project is to test the hypothesis that axonal/dendritic and membrane phospholipid ( and possibly perfusion) changes in white matter underlie the reversible structural and neurocognitive changes associated with long-term chronic alcohol abuse and recovery. Subjects: 50 light drinkers (LD) and 100 heavy drinkers. LD will be studied at baseline and 9-12 months later, HD will be studied at entry into alcohol abuse treatment (to capture the full extent of brain damage due to heavy drinking), at 2-4 weeks of abstinence, and at 912 months after treatment entry during abstinence or relapse. Measurements: Cognition by neuropsychological testing; brain structures by MRI, axonal/dendritic and neuronal viability by 1H MR spectroscopic imaging (N-acetyl aspartate, a putative neuronal/axonal marker); lipids by choline-containing compounds (Cho) and myoinositol (ml) and by phosphorus-31 MRS (via membrane phospholipids and their breakdown products and precursors); regional cerebral blood flow will be measured with exploratory spin-tagged perfusion MRI. The specific focus of the study will be on white matter, but cortical and subcortical gray matter, cerebellum, hippocampus, corpus callosum, and brain stem, intracranial volume and volumes of various brain nuclei will also be assessed. We expect that initially low regional NAA and phospholipid measures and initially high Cho and mI measures correlate with specific measures of cognitive impairment and that these outcome measures will recover during abstinence in association with cognitive improvements; relapse will arrest structural, metabolic, and cognitive improvements. The significance of these results is several fold: First, this project will develop non invasive outcome measures which provide objective quantitative measurements of alcohol-induced brain damage. This may be useful in future clinical trials in which drugs or treatments are used to reduce drinking, or to 68 Alcohol Abuse monitor effects of drugs aimed at reducing brain damage, or facilitating recovery. Second, these results may also provide information, which can lead to the development of specific drug treatments, aimed at preventing brain damage at the neuron or membrane or at facilitating recovery. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: THE EPIDEMIOLOGY OF ALCOHOL ABUSE AND CRITICAL ILLNESS Principal Investigator & Institution: Moss, Marc Marc.; Assistant Professor; Emory University 1784 North Decatur Road Atlanta, Ga 30322 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Alcohol is the most commonly abused drug in the world. In the intensive care unit (ICU), patients with a history of alcohol abuse are common, and their rate of mortality and ICU-related morbidity are significantly higher when compared to non-alcoholics. Though ICU patients are a heterogeneous group, Acute Respiratory Distress Syndrome (ARDS) is one of the more frequent diagnoses among these critically ill patients, and its course is characterized by several stages, including an acute and recovery phase. Our group has pioneered the clinical research concerning the association between alcohol abuse and ARDS. We have determined that chronic alcohol abuse significantly increases the risk of developing ARDS. This association is a common phenomenon as 50% of all ARDS patients had a prior history of alcohol abuse in our patient population. Based upon the extensive evidence implicating the depletion of glutathione in the pathogenesis of alcohol mediated liver disease, we have focused on the possibility that alterations in pulmonary and systemic glutathione homeostasis may increase susceptibility to ARDS. We have reported that chronic alcohol abuse in humans was associated with decreased glutathione concentrations in the epithelial lining fluid of the lung. In the first part of this project, we will determine the diagnostic ability of alcohol-related alterations in glutathione homeostasis on the initial development of ARDS (acute effects). In the second part of this project, we will also examine the effects of alcohol abuse that only become apparent during the recovery phase of ARDS. As the number of ARDS survivors continues to increase, it is evident that our understanding of their physical impairment and dysfunction in health related quality of life is limited. Though ARDS survivors begin to improve after 3 months, patients who remain impaired have more difficulty with general medical health issues and neuromuscular problems than specific pulmonary dysfunction. Presently, the impact of prior medical conditions, such as chronic alcohol abuse, on ARDS survivors is unknown. Therefore we will determine the effects of chronic alcohol abuse on the development of neuromuscular dysfunction and subsequent long term health-related quality of life (late effects) in ARDS survivors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: TREATMENT OF ALCOHOL PROBLEMS FOR VIOLENCE PRONE YOUTH Principal Investigator & Institution: Gil, Andres G.; Associate Professor and Associate Direct; School of Social Work; Florida International University Division of Sponsored Research and Training Miami, Fl 33199 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): "Treatment of Alcohol Problems for Violence Prone Youth" is a five-year research project designed to develop and test a school-based Studies 69 alcohol abuse/violent behavior intervention with a multicultural sample of violence prone alternative school youth with alcohol and substance use problems. Adolescent alcohol and drug use/abuse and juvenile violence are pressing social problems in America. Moreover, an extensive literature has documented significant associations between substance use/abuse and juvenile violence. Compared with the general population of adolescents, juvenile offenders are more likely to use alcohol, tobacco, and other drugs, are more likely to have substance use problems, and use substances at earlier ages. The proposed study is a randomized clinical trial evaluating the efficacy of a school-based intervention (Guided Self-Change). Key features of the study include manualized treatments, theory-driven hypotheses, a randomized controlled trial design, and a culturally/ethnically diverse sample of youth with co-occurring problems of substance abuse and violent behaviors. Participants (n=800) will be randomly assigned to two conditions: a brief intensive school-based intervention (GSC) or standard care (SC and referral] provided by Communities in Schools of Miami. The school-based intervention will consist of 5-7 weekly individual sessions of GSC. Participants will be assessed immediately before and after intervention and at 3- and 6-month follow-up. Primary hypotheses include: 1) adolescents assigned to GSC will demonstrate significantly greater reductions in alcohol and other drug involvement thanadolescents assigned to SC; and 2) adolescents assigned to GSC will demonstrate significantly greater reductions in violent behavior and attitudes than those assigned to SC. Our second aim is to examine processes of change associated with response to the GSC intervention. Analyses will involve: 1) measuring the degree to which participants demonstrate pretreatment/post-treatment changes in selected domains (i.e., stresscoping skills, social skills, adolescent-parent communication skills, motivation to change) directly reflecting each of the intervention components; and 2) examining whether changes in these domains predict participants? ultimate response to intervention. A third aim is to examine contextual variables, representing significant subgroups of adolescents that may predict differential treatment. These include family and neighborhood substance use and violence, and peer and adult social support. Finally, the fourth aim is to examine treatment response by factors related to race/ethnicity and gender. These factors include acculturation level, acculturation stress, discrimination, and cultural mistrust for race/ethnic factors, and psychopathology and abuse experiences for gender factors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen · Project Title: TRENDS IN ALCOHOL PROBLEMS UNDER WELFARE REFORM Principal Investigator & Institution: Schmidt, Laura A.; Research Scientist; Public Health Institute 555 12Th St, 10Th Fl Oakland, Ca 94607 Timing: Fiscal Year 2001; Project Start 01-JUL-1981; Project End 31-DEC-2005 Summary: Research Component 5 speaks to timely concerns about the changing circumstances of low-income people with alcohol problems in the 1990s, a period of important changes in the economy and in federal policies under welfare reform. The project tracks change in alcohol and drug problems, and their socioeconomic correlates, by comparing an existing sample of welfare recipients interviewed in 1989 with a new, comparable sample collected in 2001. Both samples are representative of welfare recipients in a large California county interviewed at intake for federally-funded Temporary Aid to Needy Families (TANF, formerly Aid to Families with Dependent Children [AFDC]) and county-funded General Assistance (GA). Analyses examine trends in the burden of alcohol and drug problems on AFDC/TANF and GA to better understand secular changes in who welfare programs have to work with, in terms of the 70 Alcohol Abuse functional capacities and substance-related disabilities of their clientele. The study also examines the impact of changing substance-related client eligibility criteria, or "gatekeeping" policies, on the characteristics of the AFDC/TANF and GA caseloads over time. By incorporating both quantitative and qualitative methods, we investigate the hypothesis that more punitive federal welfare reform gatekeeping policies around substance abuse have contributed to reductions in rates of alcohol and drug problems in the TANF population, while increasing the burden of alcohol and drug problems on local GA -- the welfare program of last resort for substance abusers unable to obtain federal aid through TANF. Component 5 builds on the Center?s past services research on the public agency response to alcohol problems in communities, and on the Center?s track record of research on alcohol and drug problems in the welfare population. At the same time, it expands those agendas by tracking change over time in the social handling of a large, special population of problem drinkers in America, and by examining how this population is being affected by major social policies occurring outside the narrow field of alcohol policy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “alcohol abuse” (or synonyms) into the search box. This search gives you access to full-text articles. The following is a sample of items found for alcohol abuse in the PubMed Central database: · Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial. by Tonnesen H, Rosenberg J, Nielsen HJ, Rasmussen V, Hauge C, Pedersen IK, Kehlet H.; 1999 May 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=27867 · Harm-reduction initiative provides alcohol to Ottawa's street alcoholics. by Hass J.; 2001 Oct 2; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=81514 · Influence of the endogenous opioid system on high alcohol consumption and genetic predisposition to alcoholism. by Gianoulakis C.; 2001 Sep; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=167184 3 4 Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html. With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. Studies 71 · Nonhuman Primate Model of Alcohol Abuse: Effects of Early Experience, Personality, and Stress on Alcohol Consumption. by Higley JD, Hasert MF, Suomi SJ, Linnoila M.; 1991 Aug 15; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=abstr act&artid=52274 · What treatment options exist for alcohol abuse? by Dongier M.; 2003 Jan; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&rendertype=exter nal&artid=161728 The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with alcohol abuse, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “alcohol abuse” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for alcohol abuse (hyperlinks lead to article summaries): · A comparison of correlates of DSM-IV alcohol abuse or dependence among more than 400 sons of alcoholics and controls. Author(s): Schuckit MA, Smith TL. Source: Alcoholism, Clinical and Experimental Research. 2001 January; 25(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11198703&dopt=Abstract · A demonstration of attentional bias, using a novel dual task paradigm, towards clinically salient material in recovering alcohol abuse patients? Author(s): Waters H, Green MW. Source: Psychological Medicine. 2003 April; 33(3): 491-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12701669&dopt=Abstract · A new approach to student alcohol abuse at Georgetown University. Author(s): Minto SD, Bennett RE 2nd, Keltner BR, Porterfield DR. Source: Journal of American College Health : J of Ach. 2002 September; 51(2): 81-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416940&dopt=Abstract 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication. 72 Alcohol Abuse · A statewide model detection and prevention program for geriatric alcoholism and alcohol abuse: increased knowledge among service providers. Author(s): Coogle CL, Osgood NJ, Parham IA. Source: Community Mental Health Journal. 2000 April; 36(2): 137-48. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10800863&dopt=Abstract · A structural equation model of the effect of poverty and unemployment on alcohol abuse. Author(s): Khan S, Murray RP, Barnes GE. Source: Addictive Behaviors. 2002 May-June; 27(3): 405-23. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12118628&dopt=Abstract · Adverse childhood experiences and personal alcohol abuse as an adult. Author(s): Dube SR, Anda RF, Felitti VJ, Edwards VJ, Croft JB. Source: Addictive Behaviors. 2002 September-October; 27(5): 713-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12201379&dopt=Abstract · Age at onset of alcohol use and DSM-IV alcohol abuse and dependence: a 12-year follow-up. Author(s): Grant BF, Stinson FS, Harford TC. Source: Journal of Substance Abuse. 2001; 13(4): 493-504. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11775078&dopt=Abstract · Alcohol abuse and alcoholism: an overview. Author(s): Volpicelli JR. Source: The Journal of Clinical Psychiatry. 2001; 62 Suppl 20: 4-10. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11584874&dopt=Abstract · Alcohol abuse and crime: a fixed-effects regression analysis. Author(s): Fergusson DM, Horwood LJ. Source: Addiction (Abingdon, England). 2000 October; 95(10): 1525-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11070528&dopt=Abstract · Alcohol abuse and dependence among U.S. college students. Author(s): Knight JR, Wechsler H, Kuo M, Seibring M, Weitzman ER, Schuckit MA. Source: J Stud Alcohol. 2002 May; 63(3): 263-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12086126&dopt=Abstract · Alcohol abuse and dependence in a national sample of psychiatric patients. Author(s): Svikis DS, Zarin DA, Tanielian T, Pincus HA. Source: J Stud Alcohol. 2000 May; 61(3): 427-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10807214&dopt=Abstract Studies 73 · Alcohol abuse and dependence in Latinos living in the United States: validation of the CAGE (4M) questions. Author(s): Saitz R, Lepore MF, Sullivan LM, Amaro H, Samet JH. Source: Archives of Internal Medicine. 1999 April 12; 159(7): 718-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10218752&dopt=Abstract · Alcohol abuse and dependence: psychopathology, medical management and dental implications. Author(s): Friedlander AH, Marder SR, Pisegna JR, Yagiela JA. Source: The Journal of the American Dental Association. 2003 June; 134(6): 731-40. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839410&dopt=Abstract · Alcohol abuse and dilated cardiomyopathy in men. Author(s): Gavazzi A, De Maria R, Parolini M, Porcu M. Source: The American Journal of Cardiology. 2000 May 1; 85(9): 1114-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10781762&dopt=Abstract · Alcohol abuse and dysfunctional eating in adolescent girls: the influence of individual differences in sensitivity to reward and punishment. Author(s): Loxton NJ, Dawe S. Source: The International Journal of Eating Disorders. 2001 May; 29(4): 455-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11285583&dopt=Abstract · Alcohol abuse and economic conditions: evidence from repeated cross-sections of individual-level data. Author(s): Dee TS. Source: Health Economics. 2001 April; 10(3): 257-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11288191&dopt=Abstract · Alcohol abuse and liver enzymes (AALE): results of an intercompany study of mortality. Author(s): Titcomb C, Braun R, Roudebush B, Mast J, Woodman H; Mortality and Morbidity Liaison Committee of the Society of Actuaries, American Academy of Insurance Medicine, Academy of Life Underwriting. Source: J Insur Med. 2001; 33(3): 277-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11558411&dopt=Abstract · Alcohol abuse and mortality: a 40-year prospective study of Norwegian conscripts. Author(s): Rossow I, Amundsen A. Source: Social Science & Medicine (1982). 1997 January; 44(2): 261-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9015878&dopt=Abstract 74 Alcohol Abuse · Alcohol abuse and postoperative complications. Do we ask the right questions? Author(s): Eklund J. Source: Acta Anaesthesiologica Scandinavica. 1996 July; 40(6): 647-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8836255&dopt=Abstract · Alcohol abuse and psychopathic deviance in noncustodial parents as predictors of child-support payment and visitation. Author(s): Dion MR, Braver SL, Wolchik SA, Sandler IN. Source: The American Journal of Orthopsychiatry. 1997 January; 67(1): 70-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9034023&dopt=Abstract · Alcohol abuse and stage of HIV disease in intravenous drug abusers. Author(s): Lake-Bakaar G, Grimson R. Source: Journal of the Royal Society of Medicine. 1996 July; 89(7): 389-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8774537&dopt=Abstract · Alcohol abuse and suicidal behaviour in young and middle aged men: differentiating between attempted and completed suicide. Author(s): Rossow I, Romelsjo A, Leifman H. Source: Addiction (Abingdon, England). 1999 August; 94(8): 1199-207. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10615735&dopt=Abstract · Alcohol abuse and the burden on the NHS. Author(s): Donkin J, Mitchison H, Cowlam S. Source: Journal of the Royal College of Physicians of London. 2000 July-August; 34(4): 402. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11005084&dopt=Abstract · Alcohol abuse and the burden on the NHS--time for action. Author(s): Pirmohamed M, Gilmore IT. Source: Journal of the Royal College of Physicians of London. 2000 March-April; 34(2): 161-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10816872&dopt=Abstract · Alcohol abuse and the risk of pancreatic cancer. Author(s): Ye W, Lagergren J, Weiderpass E, Nyren O, Adami HO, Ekbom A. Source: Gut. 2002 August; 51(2): 236-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12117886&dopt=Abstract Studies 75 · Alcohol abuse and the risks of violence. Author(s): Donath S. Source: Aust N Z J Public Health. 2002 October; 26(5): 411-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413281&dopt=Abstract · Alcohol abuse as a risk factor for and consequence of child abuse. Author(s): Widom CS, Hiller-Sturmhofel S. Source: Alcohol Research & Health : the Journal of the National Institute on Alcohol Abuse and Alcoholism. 2001; 25(1): 52-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11496967&dopt=Abstract · Alcohol abuse exaggerates autonomic dysfunction in chronic liver disease. Author(s): Lindgren S, Lilja B, Verbaan H, Sundkvist G. Source: Scandinavian Journal of Gastroenterology. 1996 November; 31(11): 1120-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8938907&dopt=Abstract · Alcohol abuse in individuals exposed to trauma: a critical review. Author(s): Stewart SH. Source: Psychological Bulletin. 1996 July; 120(1): 83-112. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8711018&dopt=Abstract · Alcohol abuse in older persons: implications for critical care. Author(s): Ruppert SD. Source: Critical Care Nursing Quarterly. 1996 August; 19(2): 62-70. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8718047&dopt=Abstract · Alcohol abuse in social phobic patients: is there a bipolar connection? Author(s): Perugi G, Frare F, Madaro D, Maremmani I, Akiskal HS. Source: Journal of Affective Disorders. 2002 February; 68(1): 33-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11869780&dopt=Abstract · Alcohol abuse or dependence among Mexican American women who report violence. Author(s): Lown AE, Vega WA. Source: Alcoholism, Clinical and Experimental Research. 2001 October; 25(10): 1479-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11696668&dopt=Abstract · Alcohol abuse, alcoholism, and damage to the immune system--a review. Author(s): Cook RT. Source: Alcoholism, Clinical and Experimental Research. 1998 December; 22(9): 1927-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9884135&dopt=Abstract 76 Alcohol Abuse · Alcohol abuse, cognitive impairment, and mortality among older people. Author(s): Thomas VS, Rockwood KJ. Source: Journal of the American Geriatrics Society. 2001 April; 49(4): 415-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11347785&dopt=Abstract · Alcohol abuse. Author(s): Wootton JC. Source: Journal of Women's Health / the Official Publication of the Society for the Advancement of Women's Health Research. 1999 April; 8(3): 417-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10326996&dopt=Abstract · Alcohol abuse. Author(s): O'Farrell TJ, Fals-Stewart W. Source: J Marital Fam Ther. 2003 January; 29(1): 121-46. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616803&dopt=Abstract · Alcohol abuse/dependence in motor vehicle crash victims presenting to the emergency department. Author(s): Maio RF, Waller PF, Blow FC, Hill EM, Singer KM. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1997 April; 4(4): 256-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9107322&dopt=Abstract · Alcohol abuse: adding content to category. Author(s): Lagenbucher JW. Source: Alcoholism, Clinical and Experimental Research. 1996 November; 20(8 Suppl): 270A-275A. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8947279&dopt=Abstract · Alcohol abuse: an important cause of severe hyperhomocysteinemia. Author(s): Carmel R, James SJ. Source: Nutrition Reviews. 2002 July; 60(7 Pt 1): 215-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12144201&dopt=Abstract · Alcohol abuse: managing the heavy drinker. Author(s): Latcham R. Source: The Practitioner. 1998 January; 242(1582): 16-8, 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10492936&dopt=Abstract Studies 77 · Alcohol abuse: medical effects of heavy drinking in late life. Author(s): Gambert SR. Source: Geriatrics. 1997 June; 52(6): 30-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9194788&dopt=Abstract · Alcohol abuse: prevalence and detection in a general hospital. Author(s): Hearne R, Connolly A, Sheehan J. Source: Journal of the Royal Society of Medicine. 2002 February; 95(2): 84-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11823551&dopt=Abstract · Alcohol abuse: the hidden diagnosis. Author(s): Coldwell B. Source: Occup Health (Lond). 1996 November; 48(11): 392-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9283470&dopt=Abstract · Alcohol abuse--common or garden? Author(s): Koffman J. Source: The British Journal of General Practice : the Journal of the Royal College of General Practitioners. 2001 May; 51(466): 408-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11360715&dopt=Abstract · An explorative, population-based study of female disability pensioners: the role of childhood conditions and alcohol abuse/dependence. Author(s): Upmark M, Thundal KL. Source: Scandinavian Journal of Public Health. 2002; 30(3): 191-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12227975&dopt=Abstract · Anxiety and alcohol abuse disorders: a common role for CREB and its target, the neuropeptide Y gene. Author(s): Pandey SC. Source: Trends in Pharmacological Sciences. 2003 September; 24(9): 456-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12967770&dopt=Abstract · Applications of health services research in the treatment and prevention of alcohol abuse. Introduction. Author(s): McCarty D, Weisner C, Huebner RB. Source: The Journal of Behavioral Health Services & Research. 2001 May; 28(2): 115-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11338323&dopt=Abstract 78 Alcohol Abuse · Association of 5HT2A receptor gene polymorphism and alcohol abuse with behavior problems. Author(s): Hwu HG, Chen CH. Source: American Journal of Medical Genetics. 2000 December 4; 96(6): 797-800. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11121184&dopt=Abstract · Attitudes and knowledge concerning alcohol abuse: curriculum implications. Author(s): Giannetti VJ, Sieppert JD, Holosko MJ. Source: Journal of Health & Social Policy. 2002; 15(1): 45-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12212932&dopt=Abstract · Band-aids in the ER. A missed opportunity to treat alcohol abuse. Author(s): Shute N. Source: U.S. News & World Report. 2000 January 17; 128(2): 51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11184571&dopt=Abstract · Bartenders: an untapped resource for the prevention of alcohol abuse? Author(s): Waring ML, Sperr I. Source: Int J Addict. 1982 July; 17(5): 859-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7129701&dopt=Abstract · Behavioral factors related to elderly alcohol abuse: research and policy issues. Author(s): Gurnack AM, Thomas JL. Source: Int J Addict. 1989 July; 24(7): 641-54. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2689359&dopt=Abstract · Behavioural therapy for the treatment of alcohol abuse and dependence. Author(s): Sher L. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 August; 47(6): 586. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12211893&dopt=Abstract · Being female and less deviant: the direct and indirect effects of gender on alcohol abuse and tobacco smoking. Author(s): DeFronzo J, Pawlak R. Source: The Journal of Psychology. 1993 November; 127(6): 639-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8301617&dopt=Abstract · Benzodiazepines and the treatment of alcohol abuse. Author(s): Newsom JA, Seymour RB. Source: J Psychoactive Drugs. 1983 January-June; 15(1-2): 97-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6136576&dopt=Abstract Studies 79 · Between despair and hope: health services research on treatment of alcohol abuse. Author(s): McCarty D. Source: Addiction (Abingdon, England). 2000 November; 95 Suppl 3: S439-47. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11132367&dopt=Abstract · Biased cohort studies on alcohol abuse and mortality. Author(s): Poikolainen K. Source: Addiction (Abingdon, England). 1997 July; 92(7): 903-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9293048&dopt=Abstract · Binge drinking among underage college students: a test of a restraint-based conceptualization of risk for alcohol abuse. Author(s): Collins RL, Koutsky JR, Morsheimer ET, MacLean MG. Source: Psychology of Addictive Behaviors : Journal of the Society of Psychologists in Addictive Behaviors. 2001 December; 15(4): 333-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11767266&dopt=Abstract · Biochemical detection and monitoring of alcohol abuse and abstinence. Author(s): Sharpe PC. Source: Annals of Clinical Biochemistry. 2001 November; 38(Pt 6): 652-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11732647&dopt=Abstract · Biochemical identification of alcohol abuse. Author(s): Rosalki SB. Source: Int J Clin Pract. 1999 March; 53(2): 138-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10344050&dopt=Abstract · Biochemical markers of alcohol abuse. Author(s): Sharpe PC, McBride R, Archbold GP. Source: Qjm : Monthly Journal of the Association of Physicians. 1996 February; 89(2): 137-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8729555&dopt=Abstract · Biological correlates and detection of alcohol abuse and alcoholism. Author(s): Eckardt MJ, Rawlings RR, Martin PR. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 1986; 10(2): 135-44. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2875489&dopt=Abstract 80 Alcohol Abuse · Biomarkers to assess the genetic damage induced by alcohol abuse in human lymphocytes. Author(s): Maffei F, Forti GC, Castelli E, Stefanini GF, Mattioli S, Hrelia P. Source: Mutation Research. 2002 February 15; 514(1-2): 49-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11815244&dopt=Abstract · Biomedical causes of alcohol abuse. Author(s): Freund G. Source: Alcohol (Fayetteville, N.Y.). 1984 March-April; 1(2): 129-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6152650&dopt=Abstract · Blood count and hematologic morphology in nonanemic macrocytosis: differences between alcohol abuse and pernicious anemia. Author(s): Seppa K, Sillanaukee P, Saarni M. Source: Alcohol (Fayetteville, N.Y.). 1993 September-October; 10(5): 343-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8216878&dopt=Abstract · Blood phosphatidylethanol as a marker of alcohol abuse: levels in alcoholic males during withdrawal. Author(s): Hansson P, Caron M, Johnson G, Gustavsson L, Alling C. Source: Alcoholism, Clinical and Experimental Research. 1997 February; 21(1): 108-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9046381&dopt=Abstract · Bone and mineral metabolism and chronic alcohol abuse. Author(s): Lalor BC, France MW, Powell D, Adams PH, Counihan TB. Source: The Quarterly Journal of Medicine. 1986 May; 59(229): 497-511. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3763813&dopt=Abstract · Bone changes after alcohol abuse. Author(s): Schnitzler CM, Solomon L. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1984 November 10; 66(19): 730-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6495122&dopt=Abstract · Bone disease in alcohol abuse. Author(s): Sosa Henriquez M, Betancor Leon P, Font The Mora Turon A, Navarro Rodriguez MC. Source: Annals of Internal Medicine. 1986 June; 104(6): 893. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3706946&dopt=Abstract Studies 81 · Bone disease in alcohol abuse. Author(s): Bikle DD, Genant HK, Cann C, Recker RR, Halloran BP, Strewler GJ. Source: Annals of Internal Medicine. 1985 July; 103(1): 42-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2988390&dopt=Abstract · Bone marrow disturbances of iron utilisation: cytomorphological diagnostic in chronic alcohol abuse. Author(s): Boewer C. Source: Acta Haematologica. 1986; 76(2-3): 141-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3101353&dopt=Abstract · Booze and blood: the effects of acute and chronic alcohol abuse on the hematopoietic system. Author(s): Heermans EH. Source: Clin Lab Sci. 1998 July-August; 11(4): 229-32. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10182111&dopt=Abstract · Borderline personality and alcohol abuse. Author(s): Vaccani JM. Source: Archives of Psychiatric Nursing. 1989 April; 3(2): 113-9. 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Source: Drug and Alcohol Dependence. 1991 August; 28(2): 113-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1935563&dopt=Abstract · Urine melatonin in alcoholic patients: a marker of alcohol abuse? Author(s): Murialdo G, Filippi U, Costelli P, Fonzi S, Bo P, Polleri A, Savoldi F. Source: J Endocrinol Invest. 1991 June; 14(6): 503-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1774447&dopt=Abstract · Use of computer-assisted instruction in the prevention of alcohol abuse. Author(s): Meier ST, Sampson JP. Source: Journal of Drug Education. 1989; 19(3): 245-56. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2677296&dopt=Abstract · Usefulness of microheterogeneity of serum alpha 1-acidglycoprotein as a marker for alcohol abuse. Author(s): Tsutsumi M, Takase S. Source: Alcohol (Fayetteville, N.Y.). 2001 November; 25(3): 181-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11839463&dopt=Abstract · Using focus group interviews to identify salient issues concerning college students' alcohol abuse. Author(s): Emery EM, Ritter-Randolph GP, Strozier AL, McDermott RJ. Source: Journal of American College Health : J of Ach. 1993 March; 41(5): 195-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8482757&dopt=Abstract · Validity of children's reports of parental alcohol abuse. Author(s): Roosa MW, Michaels M, Groppenbacher N, Gersten J. Source: J Stud Alcohol. 1993 January; 54(1): 71-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8355502&dopt=Abstract · Validity of integrity tests for predicting drug and alcohol abuse: a meta-analysis. Author(s): Schmidt FL, Viswesvaran V, Ones DS. Source: Nida Res Monogr. 1997; 170: 69-95. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9154252&dopt=Abstract Studies 153 · Variables associated with alcohol abuse among self-identified collegiate COAs and their peers. Author(s): Havey JM, Dodd DK. Source: Addictive Behaviors. 1993 September-October; 18(5): 567-75. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8310875&dopt=Abstract · Vasopressin inhibition via combined head-out water immersion and a prostaglandin E-1 precursor in the treatment of male reproductive failure due to chronic alcohol abuse. Author(s): Backon J. Source: Medical Hypotheses. 1989 June; 29(2): 81-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2755369&dopt=Abstract · Verbal learning and memory in alcohol abusers and polysubstance abusers with concurrent alcohol abuse. Author(s): Bondi MW, Drake AI, Grant I. Source: Journal of the International Neuropsychological Society : Jins. 1998 July; 4(4): 319-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9656605&dopt=Abstract · Vitamin B6 metabolism in chronic alcohol abuse The effect of ethanol oxidation on hepatic pyridoxal 5'-phosphate metabolism. Author(s): Vech RL, Lumeng L, Li TK. Source: The Journal of Clinical Investigation. 1975 May; 55(5): 1026-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1168205&dopt=Abstract · Vitamin B6 metabolism in chronic alcohol abuse. Pyridoxal phosphate levels in plasma and the effects of acetaldehyde on pyridoxal phosphate synthesis and degradation in human erythrocytes. Author(s): Lumeng L, Li TK. Source: The Journal of Clinical Investigation. 1974 March; 53(3): 693-704. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4359937&dopt=Abstract · Voluntary health risks and public policy. 3. Alcohol abuse in the Soviet Union. Author(s): Field MG, Powell DE. Source: The Hastings Center Report. 1981 October; 11(5): 40-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7309499&dopt=Abstract · Waging the war against alcohol abuse. Author(s): Skirrow J. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1986 September 1; 135(5): 434. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3742382&dopt=Abstract 154 Alcohol Abuse · Waging the war against alcohol abuse. Author(s): Korcok M. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1986 June 15; 134(12): 1401-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3708492&dopt=Abstract · Warning patients about alcohol abuse. Author(s): Volk RJ, Cantor SB, Steinbauer JR. Source: Jama : the Journal of the American Medical Association. 1992 June 17; 267(23): 3153. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1593733&dopt=Abstract · Washington Report: National Institute on Alcohol Abuse and Alcoholism. Author(s): Noble EP. Source: J Stud Alcohol. 1978 March; 39(3): 578-89. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=206788&dopt=Abstract · What can we expect from treatment of adolescent drug and alcohol abuse? Author(s): Peele S. Source: Pediatrician. 1987; 14(1-2): 62-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3615303&dopt=Abstract · What if Americans drank less? The potential effect on the prevalence of alcohol abuse and dependence. Author(s): Archer L, Grant BF, Dawson DA. Source: American Journal of Public Health. 1995 January; 85(1): 61-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7832263&dopt=Abstract · What treatment options exist for alcohol abuse? Author(s): Dongier M. Source: Journal of Psychiatry & Neuroscience : Jpn. 2003 January; 28(1): 80. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587852&dopt=Abstract · Women and alcohol abuse in primary care. Identification and intervention. Author(s): Chang G, Behr H, Goetz MA, Hiley A, Bigby J. Source: The American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions. 1997 Summer; 6(3): 183-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9256984&dopt=Abstract Studies 155 · Women and alcohol abuse--factors involved in successful interventions. Author(s): Robinson SD. Source: Int J Addict. 1984 September; 19(6): 601-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6511135&dopt=Abstract · Youthful precursors of alcohol abuse in physicians. Author(s): Moore RD, Mead L, Pearson TA. Source: The American Journal of Medicine. 1990 April; 88(4): 332-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2327420&dopt=Abstract 157 CHAPTER 2. NUTRITION AND ALCOHOL ABUSE Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and alcohol abuse. Finding Nutrition Studies on Alcohol Abuse The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: ods@nih.gov). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “alcohol abuse” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field. 7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture. 158 Alcohol Abuse The following is a typical result when searching for recently indexed consumer information on alcohol abuse: · Adverse effects of paclitaxel in patients with alcohol abuse histories. Source: Henderson Martin, B Clin-J-Oncol-Nurs. 2000 Jan-February; 4(1): 11-4 1092-1095 · Alcohol abuse among general hospital inpatients according to the Munich Alcoholism Test (MALT). Author(s): Department of Psychiatry, University Hospital Rotterdam-Dijkzigt, The Netherlands. Source: Smals, G L van der Mast, R C Speckens, A E Schudel, W J Gen-Hosp-Psychiatry. 1994 March; 16(2): 125-30 0163-8343 · Alcohol abuse: an important cause of severe hyperhomocysteinemia. Author(s): Department of Medicine, New York Methodist Hospital, Brooklyn, NY 11215, USA. Source: Carmel, R James, S J Nutr-Revolume 2002 July; 60(7 Pt 1): 215-21 0029-6643 · Alcoholism-induced bone necrosis. Source: Jacobs, B N-Y-State-J-Med. 1992 August; 92(8): 334-8 0028-7628 · Booze and blood: the effects of acute and chronic alcohol abuse on the hematopoietic system. Source: Heermans, E H Clin-Lab-Sci. 1998 Jul-August; 11(4): 229-32 0894-959X · Central pontine myelinolysis associated with low potassium levels in alcoholism. Author(s): Department of Neurology, University of Tubingen, Federal Republic of Germany. Source: Bahr, M Sommer, N Petersen, D Wietholter, H Dichgans, J J-Neurol. 1990 July; 237(4): 275-6 0340-5354 · Effects of chronic alcohol abuse on duodenal mononuclear cells in man. Author(s): Department of Internal Medicine I, Robert-Bosch-Hospital, Stuttgart, Germany. Source: Maier, A Bode, C Fritz, P Bode, J C Dig-Dis-Sci. 1999 April; 44(4): 691-6 01632116 · Evaluation of the prevalence of drug and alcohol abuse in motor vehicle trauma in south western Sydney. Author(s): Department of Trauma, Liverpool Hospital, Sydney, New South Wales, Australia. Source: Sugrue, M Seger, M Dredge, G Davies, D J Ieraci, S Bauman, A Deane, S A Sloane, D Aust-N-Z-J-Surg. 1995 December; 65(12): 853-6 0004-8682 · Free radicals and not acetaldehyde influence the circulating levels of glutathione after acute or chronic alcohol abuse: in vivo and in vitro studies. Author(s): Second University of Naples, Italy. Source: Loguercio, C Clot, P Albano, E Argenzio, F Grella, A De Girolamo, V Delle Cave, M Del Vecchio Bianco, C Nardi, G Ital-J-Gastroenterol-Hepatol. 1997 April; 29(2): 168-73 1125-8055 · Jesus, peyote, and the holy people: alcohol abuse and the ethos of power in Navajo healing. Author(s): University of Kentucky College of Medicine, USA. Source: Garrity, J F Med-Anthropol-Q. 2000 December; 14(4): 521-42 0745-5194 Nutrition 159 · Morphology of the seminal vesicle of Calomys callosus submitted to experimental chronic alcoholism. Author(s): Department of Morphology and Pathology, Federal University of Sao Carlos, SP, Brazil. martinez@power.ufscar.br Source: Martinez, M Mattos, E C Mello, W J Cagnon, V H Martinez, F E J-SubmicroscCytol-Pathol. 2001 October; 33(4): 453-61 1122-9497 · Neuromodulatory role of the endocannabinoid signaling system in alcoholism: an overview. Author(s): Division of Analytical Psychopharmacology, New York State Psychiatric Institute, New York, NY, USA. Basavaraj@nki.rfmh.org Source: Basavarajappa, B S Hungund, B L Prostaglandins-Leukot-Essent-Fatty-Acids. 2002 Feb-March; 66(2-3): 287-99 0952-3278 · New-onset amnestic syndrome in AIDS patients with past history of alcohol abuse. Author(s): State University of New York Health Science Center at Brooklyn 11203, USA. Source: Viswanathan, R Pilman, M Hasaj, M Psychosomatics. 1998 Nov-December; 39(6): 551-3 0033-3182 · Optic neuropathy from folic acid deficiency without alcohol abuse. Author(s): Neuro-Ophthalmology Unit, Johns Hopkins Medical Institutions, Baltimore, Md., USA. Source: Hsu, Cynthia T Miller, Neil R Wray, Misty L Ophthalmologica. 2002 JanFebruary; 216(1): 65-7 0030-3755 · Safe withdrawal from acute alcohol abuse in the aged. Source: Ketcham, M L Hayner, G N Geriatr-Nurs. 1992 Sep-October; 13(5): 281-3 01974572 · Studies on the oxidative stress in alcohol abusers in China. Author(s): The Second Affiliated Hospital, Medical College of Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China. Source: Zhou, J F Chen, P Biomed-Environ-Sci. 2001 September; 14(3): 180-8 0895-3988 · The biochemistry of alcohol and alcohol abuse. Source: Palmer, T N Sci-Prog. 1989; 73(289 Pt 1): 1-15 0036-8504 · The role of alcohol abuse in the etiology of heroin-related deaths. Evidence for pharmacokinetic interactions between heroin and alcohol. Author(s): Department of Legal Medicine and Public Health, University of Pavia, Italy. apole@unipv.it Source: Polettini, A Groppi, A Montagna, M J-Anal-Toxicol. 1999 Nov-December; 23(7): 570-6 0146-4760 · Vasopressin inhibition via combined head-out water immersion and a prostaglandin E-1 precursor in the treatment of male reproductive failure due to chronic alcohol abuse. Author(s): Mount Pleasant Hospital Addiction Studies Foundation, Lynn, Massachusetts. Source: Backon, J Med-Hypotheses. 1989 June; 29(2): 81-3 0306-9877 The following information is typical of that found when using the “Full IBIDS Database” to search for “alcohol abuse” (or a synonym): · Adverse effects of paclitaxel in patients with alcohol abuse histories. Source: Henderson Martin, B Clin-J-Oncol-Nurs. 2000 Jan-February; 4(1): 11-4 1092-1095 160 Alcohol Abuse · Alcohol abuse among general hospital inpatients according to the Munich Alcoholism Test (MALT). Author(s): Department of Psychiatry, University Hospital Rotterdam-Dijkzigt, The Netherlands. Source: Smals, G L van der Mast, R C Speckens, A E Schudel, W J Gen-Hosp-Psychiatry. 1994 March; 16(2): 125-30 0163-8343 · Alcohol abuse: an important cause of severe hyperhomocysteinemia. Author(s): Department of Medicine, New York Methodist Hospital, Brooklyn, NY 11215, USA. Source: Carmel, R James, S J Nutr-Revolume 2002 July; 60(7 Pt 1): 215-21 0029-6643 · Alcoholism-induced bone necrosis. Source: Jacobs, B N-Y-State-J-Med. 1992 August; 92(8): 334-8 0028-7628 · Booze and blood: the effects of acute and chronic alcohol abuse on the hematopoietic system. Source: Heermans, E H Clin-Lab-Sci. 1998 Jul-August; 11(4): 229-32 0894-959X · Central pontine myelinolysis associated with low potassium levels in alcoholism. Author(s): Department of Neurology, University of Tubingen, Federal Republic of Germany. Source: Bahr, M Sommer, N Petersen, D Wietholter, H Dichgans, J J-Neurol. 1990 July; 237(4): 275-6 0340-5354 · Effects of chronic alcohol abuse on duodenal mononuclear cells in man. Author(s): Department of Internal Medicine I, Robert-Bosch-Hospital, Stuttgart, Germany. Source: Maier, A Bode, C Fritz, P Bode, J C Dig-Dis-Sci. 1999 April; 44(4): 691-6 01632116 · Evaluation of the prevalence of drug and alcohol abuse in motor vehicle trauma in south western Sydney. Author(s): Department of Trauma, Liverpool Hospital, Sydney, New South Wales, Australia. Source: Sugrue, M Seger, M Dredge, G Davies, D J Ieraci, S Bauman, A Deane, S A Sloane, D Aust-N-Z-J-Surg. 1995 December; 65(12): 853-6 0004-8682 · Free radicals and not acetaldehyde influence the circulating levels of glutathione after acute or chronic alcohol abuse: in vivo and in vitro studies. Author(s): Second University of Naples, Italy. Source: Loguercio, C Clot, P Albano, E Argenzio, F Grella, A De Girolamo, V Delle Cave, M Del Vecchio Bianco, C Nardi, G Ital-J-Gastroenterol-Hepatol. 1997 April; 29(2): 168-73 1125-8055 · Jesus, peyote, and the holy people: alcohol abuse and the ethos of power in Navajo healing. Author(s): University of Kentucky College of Medicine, USA. Source: Garrity, J F Med-Anthropol-Q. 2000 December; 14(4): 521-42 0745-5194 · Morphology of the seminal vesicle of Calomys callosus submitted to experimental chronic alcoholism. Author(s): Department of Morphology and Pathology, Federal University of Sao Carlos, SP, Brazil. martinez@power.ufscar.br Source: Martinez, M Mattos, E C Mello, W J Cagnon, V H Martinez, F E J-SubmicroscCytol-Pathol. 2001 October; 33(4): 453-61 1122-9497 Nutrition 161 · Neuromodulatory role of the endocannabinoid signaling system in alcoholism: an overview. Author(s): Division of Analytical Psychopharmacology, New York State Psychiatric Institute, New York, NY, USA. Basavaraj@nki.rfmh.org Source: Basavarajappa, B S Hungund, B L Prostaglandins-Leukot-Essent-Fatty-Acids. 2002 Feb-March; 66(2-3): 287-99 0952-3278 · New-onset amnestic syndrome in AIDS patients with past history of alcohol abuse. Author(s): State University of New York Health Science Center at Brooklyn 11203, USA. Source: Viswanathan, R Pilman, M Hasaj, M Psychosomatics. 1998 Nov-December; 39(6): 551-3 0033-3182 · Optic neuropathy from folic acid deficiency without alcohol abuse. Author(s): Neuro-Ophthalmology Unit, Johns Hopkins Medical Institutions, Baltimore, Md., USA. Source: Hsu, Cynthia T Miller, Neil R Wray, Misty L Ophthalmologica. 2002 JanFebruary; 216(1): 65-7 0030-3755 · Safe withdrawal from acute alcohol abuse in the aged. Source: Ketcham, M L Hayner, G N Geriatr-Nurs. 1992 Sep-October; 13(5): 281-3 01974572 · Studies on the oxidative stress in alcohol abusers in China. Author(s): The Second Affiliated Hospital, Medical College of Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China. Source: Zhou, J F Chen, P Biomed-Environ-Sci. 2001 September; 14(3): 180-8 0895-3988 · The biochemistry of alcohol and alcohol abuse. Source: Palmer, T N Sci-Prog. 1989; 73(289 Pt 1): 1-15 0036-8504 · The role of alcohol abuse in the etiology of heroin-related deaths. Evidence for pharmacokinetic interactions between heroin and alcohol. Author(s): Department of Legal Medicine and Public Health, University of Pavia, Italy. apole@unipv.it Source: Polettini, A Groppi, A Montagna, M J-Anal-Toxicol. 1999 Nov-December; 23(7): 570-6 0146-4760 · Vasopressin inhibition via combined head-out water immersion and a prostaglandin E-1 precursor in the treatment of male reproductive failure due to chronic alcohol abuse. Author(s): Mount Pleasant Hospital Addiction Studies Foundation, Lynn, Massachusetts. Source: Backon, J Med-Hypotheses. 1989 June; 29(2): 81-3 0306-9877 Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: · healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0 · The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov 162 Alcohol Abuse · The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov · The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/ · The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/ · Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/ · Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/ · Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/ Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: · AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats · Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html · Google: http://directory.google.com/Top/Health/Nutrition/ · Healthnotes: http://www.healthnotes.com/ · Open Directory Project: http://dmoz.org/Health/Nutrition/ · Yahoo.com: http://dir.yahoo.com/Health/Nutrition/ · WebMDÒHealth: http://my.webmd.com/nutrition · WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html The following is a specific Web list relating to alcohol abuse; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: · Vitamins Folic Acid Source: Healthnotes, Inc.; www.healthnotes.com Folic Acid Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,887,00.html Nutrition 163 Pantothenic Acid Source: Healthnotes, Inc.; www.healthnotes.com Thiamine Source: Integrative Medicine Communications; www.drkoop.com Vitamin a Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B Complex Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,962,00.html Vitamin B1 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B1 Source: Prima Communications, Inc.www.personalhealthzone.com Vitamin B1 (thiamine) Source: Integrative Medicine Communications; www.drkoop.com Vitamin B12 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B2 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin B6 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin C Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,904,00.html Vitamin D Source: Healthnotes, Inc.; www.healthnotes.com Vitamin E Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,906,00.html Vitamin K Source: Prima Communications, Inc.www.personalhealthzone.com · Minerals Biotin Source: Healthnotes, Inc.; www.healthnotes.com 164 Alcohol Abuse Carnitine (l-carnitine) Source: Integrative Medicine Communications; www.drkoop.com Chromium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10018,00.html L-carnitine Source: Integrative Medicine Communications; www.drkoop.com Lecithin and Choline Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10040,00.html Magnesium Source: Healthnotes, Inc.; www.healthnotes.com Magnesium Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,890,00.html Zinc Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Integrative Medicine Communications; www.drkoop.com Zinc Source: Prima Communications, Inc.www.personalhealthzone.com · Food and Diet Cancer Prevention and Diet Source: Healthnotes, Inc.; www.healthnotes.com Coffee Source: Healthnotes, Inc.; www.healthnotes.com Diabetes Source: Healthnotes, Inc.; www.healthnotes.com High Cholesterol Source: Healthnotes, Inc.; www.healthnotes.com 165 CHAPTER 3. ALTERNATIVE MEDICINE AND ALCOHOL ABUSE Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to alcohol abuse. At the conclusion of this chapter, we will provide additional sources. National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to alcohol abuse and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “alcohol abuse” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to alcohol abuse: · A pilot study: locus of control and spiritual beliefs in alcoholics anonymous and smart recovery members. Author(s): Li EC, Feifer C, Strohm M. Source: Addictive Behaviors. 2000 July-August; 25(4): 633-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10972457&dopt=Abstract · A survey of the current clinical practice of psychiatrists and accident and emergency specialists in the United Kingdom concerning vitamin supplementation for chronic alcohol misusers. Author(s): Hope LC, Cook CC, Thomson AD. Source: Alcohol and Alcoholism (Oxford, Oxfordshire). 1999 November-December; 34(6): 862-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10659721&dopt=Abstract 166 Alcohol Abuse · Abstinence and well-being among members of Alcoholics Anonymous: personal experience and social perceptions. Author(s): Kairouz S, Dube L. Source: The Journal of Social Psychology. 2000 October; 140(5): 565-79. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11059202&dopt=Abstract · Acceptance of pharmacotherapy for relapse prevention by chronic alcoholics. Author(s): Wetterling T, Veltrup C, Junghanns K, Kromer-Olbrisch T, Schneider U. Source: Pharmacopsychiatry. 2001 July; 34(4): 142-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11518475&dopt=Abstract · Acute neurologic complications of drug and alcohol abuse. Author(s): Brust JC. Source: Neurologic Clinics. 1998 May; 16(2): 503-19. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9537972&dopt=Abstract · Adverse effects of paclitaxel in patients with alcohol abuse histories. Author(s): Henderson-Martin B. Source: Clinical Journal of Oncology Nursing. 2000 January-February; 4(1): 11-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10865578&dopt=Abstract · Alcoholics Anonymous affiliation during early recovery. Author(s): Caldwell PE, Cutter HS. Source: Journal of Substance Abuse Treatment. 1998 May-June; 15(3): 221-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9633034&dopt=Abstract · Alcoholics Anonymous and 12-step alcoholism treatment programs. Author(s): Humphreys K. Source: Recent Dev Alcohol. 2003; 16: 149-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12638636&dopt=Abstract · Alcoholics Anonymous and nursing. Lessons in holism and spiritual care. Author(s): McGee EM. Source: Journal of Holistic Nursing : Official Journal of the American Holistic Nurses' Association. 2000 March; 18(1): 11-26. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11847688&dopt=Abstract · Alcoholics Anonymous and the use of medications to prevent relapse: an anonymous survey of member attitudes. Author(s): Rychtarik RG, Connors GJ, Dermen KH, Stasiewicz PR. Alternative Medicine 167 Source: J Stud Alcohol. 2000 January; 61(1): 134-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10627107&dopt=Abstract · Alcoholics anonymous involvement and positive alcohol-related outcomes: cause, consequence, or just a correlate? A prospective 2-year study of 2,319 alcoholdependent men. Author(s): McKellar J, Stewart E, Humphreys K. Source: Journal of Consulting and Clinical Psychology. 2003 April; 71(2): 302-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12699024&dopt=Abstract · Are the Twelve Steps more acceptable to drug users than to drinkers? A comparison of experiences of and attitudes to Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) among 200 substance misusers attending inpatient detoxification. Author(s): Best DW, Harris JC, Gossop M, Manning VC, Man LH, Marshall J, Bearn J, Strang J. Source: European Addiction Research. 2001 July; 7(2): 69-77. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11455172&dopt=Abstract · Attitudes towards alcoholics anonymous by dually diagnosed psychiatric inpatients. Author(s): Pristach CA, Smith CM. Source: Journal of Addictive Diseases : the Official Journal of the Asam, American Society of Addiction Medicine. 1999; 18(3): 69-76. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10507583&dopt=Abstract · Can recovering alcoholics help hospitalized patients with alcohol problems? Author(s): Blondell RD, Looney SW, Northington AP, Lasch ME, Rhodes SB, McDaniels RL. Source: The Journal of Family Practice. 2001 May; 50(5): 447. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11350721&dopt=Abstract · Controlling for selection bias in the evaluation of Alcoholics Anonymous as aftercare treatment. Author(s): Fortney J, Booth B, Zhang M, Humphrey J, Wiseman E. Source: J Stud Alcohol. 1998 November; 59(6): 690-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9811090&dopt=Abstract · Core heritable personality characteristics and relapse in alcoholics. Author(s): Janowsky DS, Fawcett J, Meszaros K, Verheul R. Source: Alcoholism, Clinical and Experimental Research. 2001 May; 25(5 Suppl Isbra): 94S-98S. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11391056&dopt=Abstract 168 Alcohol Abuse · Cyanocobalamin absorption abnormality in alcoholics is improved by oral supplementation with a fermented papaya-derived antioxidant. Author(s): Marotta F, Tajiri H, Barreto R, Brasca P, Ideo GM, Mondazzi L, Safran P, Bobadilla J, Ideo G. Source: Hepatogastroenterology. 2000 July-August; 47(34): 1189-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11020912&dopt=Abstract · Does Alcoholics Anonymous work? The results from a meta-analysis of controlled experiments. Author(s): Kownacki RJ, Shadish WR. Source: Substance Use & Misuse. 1999 November; 34(13): 1897-916. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10540977&dopt=Abstract · Effects of alcohol detoxification on dopamine D2 receptors in alcoholics: a preliminary study. Author(s): Volkow ND, Wang GJ, Maynard L, Fowler JS, Jayne B, Telang F, Logan J, Ding YS, Gatley SJ, Hitzemann R, Wong C, Pappas N. Source: Psychiatry Research. 2002 December 30; 116(3): 163-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12477600&dopt=Abstract · Effects of coping skills training, group support, and information for spouses of alcoholics: a controlled randomized study. Author(s): Zetterlind U, Hansson H, Aberg-Orbeck K, Berglund M. Source: Nordic Journal of Psychiatry. 2001; 55(4): 257-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11839116&dopt=Abstract · Essential fatty acids predict metabolites of serotonin and dopamine in cerebrospinal fluid among healthy control subjects, and early- and late-onset alcoholics. Author(s): Hibbeln JR, Linnoila M, Umhau JC, Rawlings R, George DT, Salem N Jr. Source: Biological Psychiatry. 1998 August 15; 44(4): 235-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9715354&dopt=Abstract · Evaluation of medical student attitudes toward alcoholics anonymous. Author(s): Fazzio L, Galanter M, Dermatis H, Levounis P. Source: Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse. 2003 September; 24(3): 175-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12913366&dopt=Abstract · Family--opinions and expectations of alcoholics from AA (Anonymous Alcoholics) groups. Author(s): Rudnicka-Drozak E, Kulik TB. Alternative Medicine 169 Source: Ann Univ Mariae Curie Sklodowska [med]. 2000; 55: 377-81. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11482101&dopt=Abstract · Fostering client connections with Alcoholics Anonymous: a framework for social workers in various practice settings. Author(s): Caldwell PE. Source: Social Work in Health Care. 1999; 28(4): 45-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10425671&dopt=Abstract · Gender differences in help-utilization and the 8-year course of alcohol abuse. Author(s): Timko C, Moos RH, Finney JW, Connell EG. Source: Addiction (Abingdon, England). 2002 July; 97(7): 877-89. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133127&dopt=Abstract · Improvement of hemorheological abnormalities in alcoholics by an oral antioxidant. Author(s): Marotta F, Safran P, Tajiri H, Princess G, Anzulovic H, Ideo GM, Rouge A, Seal MG, Ideo G. Source: Hepatogastroenterology. 2001 March-April; 48(38): 511-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11379344&dopt=Abstract · Intercessory prayer in the treatment of alcohol abuse and dependence: a pilot investigation. Author(s): Walker SR, Tonigan JS, Miller WR, Corner S, Kahlich L. Source: Alternative Therapies in Health and Medicine. 1997 November; 3(6): 79-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9375433&dopt=Abstract · Jesus, peyote, and the holy people: alcohol abuse and the ethos of power in Navajo healing. Author(s): Garrity JF. Source: Medical Anthropology Quarterly. 2000 December; 14(4): 521-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11224979&dopt=Abstract · Long-term treatment careers and outcomes of previously untreated alcoholics. Author(s): Timko C, Moos RH, Finney JW, Moos BS, Kaplowitz MS. Source: J Stud Alcohol. 1999 July; 60(4): 437-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10463799&dopt=Abstract · Matching alcohol treatment to patient social support and the effects of participation in Alcoholics Anonymous. Author(s): Longabaugh R. 170 Alcohol Abuse Source: Medicine and Health, Rhode Island. 1999 April; 82(4): 122. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10228335&dopt=Abstract · Mutual help groups, perceived status benefits, and well-being: a test with adult children of alcoholics with personal substance abuse problems. Author(s): Kingree JB, Thompson M. Source: American Journal of Community Psychology. 2000 June; 28(3): 325-42. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10945120&dopt=Abstract · Network support for drinking, Alcoholics Anonymous and long-term matching effects. Author(s): Longabaugh R, Wirtz PW, Zweben A, Stout RL. Source: Addiction (Abingdon, England). 1998 September; 93(9): 1313-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9926538&dopt=Abstract · Outcome of treatment for alcohol abuse and involvement in Alcoholics Anonymous among previously untreated problem drinkers. Author(s): Timko C, Moos RH, Finney JW, Moos BS. Source: J Ment Health Adm. 1994 Spring; 21(2): 145-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10133776&dopt=Abstract · Participation in alcoholics anonymous: intended and unintended change mechanisms. Author(s): Owen PL, Slaymaker V, Tonigan JS, McCrady BS, Epstein EE, Kaskutas LA, Humphreys K, Miller WR. Source: Alcoholism, Clinical and Experimental Research. 2003 March; 27(3): 524-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12658120&dopt=Abstract · Polydrug use in adolescent drinkers with and without DSM-IV alcohol abuse and dependence. Author(s): Martin CS, Kaczynski NA, Maisto SA, Tarter RE. Source: Alcoholism, Clinical and Experimental Research. 1996 September; 20(6): 10991108. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8892534&dopt=Abstract · Predictors of drinking outcomes among alcoholics. Author(s): Staines G, Magura S, Rosenblum A, Fong C, Kosanke N, Foote J, Deluca A. Source: The American Journal of Drug and Alcohol Abuse. 2003; 29(1): 203-18. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731689&dopt=Abstract · Prior Alcoholics Anonymous (AA) affiliation and the acceptability of the Twelve Steps to patients entering UK statutory addiction treatment. Author(s): Harris J, Best D, Gossop M, Marshall J, Man LH, Manning V, Strang J. Alternative Medicine 171 Source: J Stud Alcohol. 2003 March; 64(2): 257-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12713200&dopt=Abstract · Psychiatric co-morbidity and aftercare among alcoholics: a prospective study of a nationwide representative sample. Author(s): Tomasson K, Vaglum P. Source: Addiction (Abingdon, England). 1998 March; 93(3): 423-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10328049&dopt=Abstract · Research on spirituality and Alcoholics Anonymous. Author(s): Galanter M. Source: Alcoholism, Clinical and Experimental Research. 1999 April; 23(4): 716-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10235308&dopt=Abstract · Shared ideology in Alcoholics Anonymous: a grounded theory approach. Author(s): Wright KB. Source: Journal of Health Communication. 1997 April-June; 2(2): 83-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10977242&dopt=Abstract · Social networks as mediators of the effect of Alcoholics Anonymous. Author(s): Kaskutas LA, Bond J, Humphreys K. Source: Addiction (Abingdon, England). 2002 July; 97(7): 891-900. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12133128&dopt=Abstract · Stimulus-induced craving and startle potentiation in abstinent alcoholics and controls. Author(s): Grusser SM, Heinz A, Raabe A, Wessa M, Podschus J, Flor H. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2002 July; 17(4): 188-93. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12231263&dopt=Abstract · Synthesis of daidzin analogues as potential agents for alcohol abuse. Author(s): Gao GY, Li DJ, Keung WM. Source: Bioorganic & Medicinal Chemistry. 2003 September 1; 11(18): 4069-81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927869&dopt=Abstract · The Alcoholics Anonymous Affiliation Scale: development, reliability, and norms for diverse treated and untreated populations. Author(s): Humphreys K, Kaskutas LA, Weisner C. 172 Alcohol Abuse Source: Alcoholism, Clinical and Experimental Research. 1998 August; 22(5): 974-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9726265&dopt=Abstract · The physiological effects of alcohol misuse. Author(s): Roberts C. Source: Prof Nurse. 1996 July; 11(10): 646-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8718369&dopt=Abstract Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: · Alternative Medicine Foundation, Inc.: http://www.herbmed.org/ · AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats · Chinese Medicine: http://www.newcenturynutrition.com/ · drkoop.comÒ: http://www.drkoop.com/InteractiveMedicine/IndexC.html · Family Village: http://www.familyvillage.wisc.edu/med_altn.htm · Google: http://directory.google.com/Top/Health/Alternative/ · Healthnotes: http://www.healthnotes.com/ · MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine · Open Directory Project: http://dmoz.org/Health/Alternative/ · HealthGate: http://www.tnp.com/ · WebMDÒHealth: http://my.webmd.com/drugs_and_herbs · WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html · Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/ The following is a specific Web list relating to alcohol abuse; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: · General Overview Alcohol Withdrawal Source: Healthnotes, Inc.; www.healthnotes.com Amenorrhea Source: Integrative Medicine Communications; www.drkoop.com Alternative Medicine 173 Bone Loss Source: Integrative Medicine Communications; www.drkoop.com Cardiomyopathy Source: Healthnotes, Inc.; www.healthnotes.com Cirrhosis Source: Integrative Medicine Communications; www.drkoop.com Congestive Heart Failure Source: Integrative Medicine Communications; www.drkoop.com Dementia Source: Integrative Medicine Communications; www.drkoop.com Depression Source: Healthnotes, Inc.; www.healthnotes.com Dysmenorrhea Source: Healthnotes, Inc.; www.healthnotes.com Erectile Dysfunction Source: Healthnotes, Inc.; www.healthnotes.com Gastritis Source: Healthnotes, Inc.; www.healthnotes.com Heart Attack Source: Healthnotes, Inc.; www.healthnotes.com Hepatitis Source: Healthnotes, Inc.; www.healthnotes.com High Blood Pressure Source: Integrative Medicine Communications; www.drkoop.com High Triglycerides Source: Healthnotes, Inc.; www.healthnotes.com Hypertension Source: Integrative Medicine Communications; www.drkoop.com Hypothyroidism Source: Healthnotes, Inc.; www.healthnotes.com Liver Cirrhosis Source: Healthnotes, Inc.; www.healthnotes.com Liver Disease Source: Integrative Medicine Communications; www.drkoop.com 174 Alcohol Abuse Low Back Pain Source: Healthnotes, Inc.; www.healthnotes.com Meningitis Source: Integrative Medicine Communications; www.drkoop.com Osteoporosis Source: Integrative Medicine Communications; www.drkoop.com Pancreatic Insufficiency Source: Healthnotes, Inc.; www.healthnotes.com Peptic Ulcer Source: Integrative Medicine Communications; www.drkoop.com Premenstrual Syndrome Source: Healthnotes, Inc.; www.healthnotes.com Senile Dementia Source: Integrative Medicine Communications; www.drkoop.com Tuberculosis Source: Integrative Medicine Communications; www.drkoop.com Vitamin B12 Deficiency Source: Healthnotes, Inc.; www.healthnotes.com · Alternative Therapy Art Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,671,00.html Bach Flower Remedies Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,673,00.html Biofeedback Source: Integrative Medicine Communications; www.drkoop.com Biofeedback Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,675,00.html Native American Medicine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,721,00.html Alternative Medicine 175 Relaxation Techniques Source: Integrative Medicine Communications; www.drkoop.com Twelve Steps Alternative names: 12-Step path 12 program 12 way Source: The Canoe version of A Dictionary of Alternative-Medicine Methods, by Priorities for Health editor Jack Raso, M.S., R.D. Hyperlink: http://www.canoe.ca/AltmedDictionary/t.html Urine Therapy Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,744,00.html · Herbs and Supplements Alpha Lipoic Acid Source: Healthnotes, Inc.; www.healthnotes.com Beta-carotene Source: Healthnotes, Inc.; www.healthnotes.com Beta-carotene Source: Prima Communications, Inc.www.personalhealthzone.com Dandelion Alternative names: Taraxacum officinale Source: Healthnotes, Inc.; www.healthnotes.com Dehydroepiandrosterone (dhea) Source: Healthnotes, Inc.; www.healthnotes.com Fentanyl Source: Healthnotes, Inc.; www.healthnotes.com Gamma-linolenic Acid (gla) Source: Integrative Medicine Communications; www.drkoop.com Gla Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: Integrative Medicine Communications; www.drkoop.com Glutamine Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10030,00.html Guaraná Alternative names: Paullinia cupana Source: Healthnotes, Inc.; www.healthnotes.com 176 Alcohol Abuse Kava Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,798,00.html Kudzu Alternative names: Pueraria lobata Source: Healthnotes, Inc.; www.healthnotes.com Kudzu Source: Prima Communications, Inc.www.personalhealthzone.com Kudzu Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,858,00.html Lipotropic Combination Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,861,00.html Milk Thistle Alternative names: Silybum marianum, Carduus marianus Source: Healthnotes, Inc.; www.healthnotes.com Milk Thistle Source: Prima Communications, Inc.www.personalhealthzone.com Milk Thistle Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10044,00.html Nac (n-acetylcysteine) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,809,00.html Nadh Source: Healthnotes, Inc.; www.healthnotes.com Pueraria Alternative names: Kudzu; Pueraria lobata Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Same Source: Healthnotes, Inc.; www.healthnotes.com Silybum Alternative names: Milk Thistle; Silybum marianum (L.) Gaertn. Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Alternative Medicine 177 Soy Isoflavones Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10057,00.html St. John's Wort Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,824,00.html Taurine Source: Prima Communications, Inc.www.personalhealthzone.com Valerian Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10064,00.html General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources. 179 CHAPTER 4. DISSERTATIONS ON ALCOHOL ABUSE Overview In this chapter, we will give you a bibliography on recent dissertations relating to alcohol abuse. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “alcohol abuse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on alcohol abuse, we have not necessarily excluded non-medical dissertations in this bibliography. Dissertations on Alcohol Abuse ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to alcohol abuse. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: · A Case Control Study of Acoa Problems in an Employee Assistance Program (adult Children of Alcoholics, Alcoholism) by Martin, Patricia Ann, Edd from The Johns Hopkins University, 1992, 234 pages http://wwwlib.umi.com/dissertations/fullcit/9229372 · A Case Study: the Role of the School, Parents, and Other Agencies in Two Contrasting Cases of Alcohol Abuse by Hopson, Linda, Edd from Columbia University Teachers College, 1993, 208 pages http://wwwlib.umi.com/dissertations/fullcit/9525487 · A Community Approach to the Primary Identification of Alcohol Abuse by Mckirnan, David James; Phd from Mcgill University (canada), 1978 http://wwwlib.umi.com/dissertations/fullcit/NK39741 180 Alcohol Abuse · A Comparative Study of the Attitudes and Perceptions of Alabama College Officials Regarding Student Alcohol Abuse by Mccloskey, Frank Jordan, Edd from The University of Alabama, 1995, 99 pages http://wwwlib.umi.com/dissertations/fullcit/9534250 · A Critical Assessment of the National Institute on Alcohol Abuse and Alcoholism (niaaa) Funding Policies and Practices of Alcoholism Research by Bovelle, Elliott Irving, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1980, 370 pages http://wwwlib.umi.com/dissertations/fullcit/8024550 · A Descriptive Study of Alcohol and Other Drug Abuse Elements in Nursing Curricula (alcohol Abuse Education, Drug Abuse Education) by Parrott, Thena Elizabeth, Phd from Texas A&m University, 1993, 123 pages http://wwwlib.umi.com/dissertations/fullcit/9410846 · A Descriptive Study of Oregon Schools/school Districts to Investigate How They Planned to Implement Oregon Administrative Rule 581-22-413 (drug Abuse, Alcohol Abuse) by Denevan, James P., Edd from Oregon State University, 1990, 108 pages http://wwwlib.umi.com/dissertations/fullcit/9125141 · A Diagnostic Assessment of Alcohol Abuse and Dependence and Personality Variables of First Offender Dui Participants by Lank, Brigitte Lee; Phd from California Institute of Integral Studies, 2002, 231 pages http://wwwlib.umi.com/dissertations/fullcit/3068742 · A Formative Evaluation of a Program for Primary Prevention of Drug and Alcohol Abuse. by Dempsey, Hugh Michael, Ded from Indiana University of Pennsylvania, 1979, 224 pages http://wwwlib.umi.com/dissertations/fullcit/8000945 · A Longitudinal Study of the Psychosocial Risk Factors Associated with Adolescent Alcohol Abuse: a Family Systems Perspective (at Risk) by Kalman, David Wayne, Phd from Simmons College School of Social Work, 1994, 254 pages http://wwwlib.umi.com/dissertations/fullcit/9514937 · A Socioeconomic Study of the Drinking and Labor Force Behavior of Alcoholics in Treatment (unemployment, Employment) by Forcier, Michael Walkow, Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1984, 146 pages http://wwwlib.umi.com/dissertations/fullcit/8422727 · A Study of Self-monitoring and Consultation Model Strategies for Alcohol Abuse Prevention in High-risk College Males by Smith, Davis Arnold, Phd from The University of Southern Mississippi, 1985, 88 pages http://wwwlib.umi.com/dissertations/fullcit/8611247 · A Study of the Relationship between Taverngoing and Alcohol Abuse. by Pearson, David Charles, Phd from Washington State University, 1979, 113 pages http://wwwlib.umi.com/dissertations/fullcit/7923509 · A Study to Assist Administrators of Public, Four-year Colleges and Universities in Establishing Alcohol and Other Drug Abuse Prevention and Education Programs (alcohol Abuse Prevention) by Woods, Brenda Ann, Edd from Texas Tech University, 1993, 161 pages http://wwwlib.umi.com/dissertations/fullcit/9416636 · A Study to Determine the Increase in Knowledge of Drugs and Drug Abuse by Fourth-graders As a Result of the 'here's Looking at You Two' Drug and Alcohol Dissertations 181 Abuse Education Curriculum by Mahaffey, James Michael, Phd from University of South Carolina, 1988, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8910267 · Adolescent Alcohol Abuse and Social Control. by Swart, Jane Carol, Phd from University of Washington, 1979, 288 pages http://wwwlib.umi.com/dissertations/fullcit/7927876 · Alcohol Abuse among High School Students in Benin City, Nigeria by Oshodin, Osayuki Godwin, Edd from Columbia University Teachers College, 1980, 192 pages http://wwwlib.umi.com/dissertations/fullcit/8105891 · Alcohol Abuse among the Homeless by Knight, Janet Wilson, Phd from University of Massachusetts, 1987, 210 pages http://wwwlib.umi.com/dissertations/fullcit/8805938 · Alcohol Abuse and Occupational Stress: the Case of Middle-level Managers by Vinyard, John L., Phd from Southern Illinois University at Carbondale, 1987, 156 pages http://wwwlib.umi.com/dissertations/fullcit/8817255 · Alcohol Abuse and the Greek System: an Exploration of Fraternity and Sorority Drinking by Larimer, Mary E., Phd from University of Washington, 1992, 147 pages http://wwwlib.umi.com/dissertations/fullcit/9223015 · Alcohol Abuse and Violent Crime: a Contemporary Examination and Comparison of Adult Male and Female Violent and Nonviolent Criminal Offenders by Haley, Don Randall; Phd from Louisiana State University and Agricultural & Mechanical College, 2000, 203 pages http://wwwlib.umi.com/dissertations/fullcit/9998678 · Alcohol Abuse in the Elderly in Southern Illinois: Examination of Psycho-social and Knowledge Aspects As Perceived by the Elderly in Selected Settings by Litherland, Barbara Ann, Phd from Southern Illinois University at Carbondale, 1992, 187 pages http://wwwlib.umi.com/dissertations/fullcit/9305382 · Alcohol Abuse Prevention in the Navy and Marine Corps: a Practical Approach to Alcohol Abuse Prevention in the Sea Services by Asparro, James Vito, Dmin from School of Theology at Claremont, 1992, 110 pages http://wwwlib.umi.com/dissertations/fullcit/9303454 · Alcohol Abuse Prevention in the Workplace: the Development and Evaluation of an Individualized Approach by Anderson, Britt Katherine; Phd from University of Washington, 2002, 121 pages http://wwwlib.umi.com/dissertations/fullcit/3053471 · Alcohol Abuse: an Alternative to Dissociation As a Psychological Coping Strategy of Adult Female Incest Survivors (women Survivors) by Ostendorf, Carole G., Phd from The University of Wisconsin - Milwaukee, 1995, 88 pages http://wwwlib.umi.com/dissertations/fullcit/9617056 · Alcohol, Women's Alcohol Abuse and Attitudes toward Women: an Assessment of Knowledge and Attitudes among Care Service Professionals and Pre-professionals by Avallone, Ernest J., Edd from Boston University, 1983, 153 pages http://wwwlib.umi.com/dissertations/fullcit/8401864 · Alcoholism and Marital Consent by Morris, Patrick S.; Phd from University of Ottawa (canada), 1999, 389 pages http://wwwlib.umi.com/dissertations/fullcit/NQ45188 182 Alcohol Abuse · Alcoholism and Mortality in Poland and Eastern Europe: the Social Consequences of Democratization by Zimny, Mark Joseph; Phd from Yale University, 2000, 192 pages http://wwwlib.umi.com/dissertations/fullcit/9973802 · Alcoholism Counseling, Intervention, and Prevention: Aspects of Pastoral Care for the U.s. Navy Chaplain (united States) by Latty, Allan Robert, Dmin from Fuller Theological Seminary, School of Theology, 1984, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8425173 · Alcoholism Prevention in the Local Community by the Spiritual Means of Agape Love by Shields, Doyle Ellsworth, Dmin from School of Theology at Claremont, 1980, 177 pages http://wwwlib.umi.com/dissertations/fullcit/8018700 · Alcoholism Treatment and Its Effect on Subsequent Health Care Costs: a Medicaid Study of Cost Differences by Treatment Setting by Kemp, Edmund Paul, Dpa from Western Michigan University, 1987, 123 pages http://wwwlib.umi.com/dissertations/fullcit/8721473 · Alcoholism: the Influence of Gender on Its Clinical Course by Romness, Sharon Lee, Phd from Northwestern University, 1986, 47 pages http://wwwlib.umi.com/dissertations/fullcit/8621863 · American Indian Youth Alcohol Abuse and Alcoholism Prevention Project (maryland) by White, Jack Chapman, Phd from The Union for Experimenting Colleges and Universities, 1982, 764 pages http://wwwlib.umi.com/dissertations/fullcit/8309714 · An Analysis of the Relationship between Control Discrimination Accuracy and Alcohol Abuse in the United States Air Force by Newsome, Richard Dowell, Phd from The Florida State University, 1986, 260 pages http://wwwlib.umi.com/dissertations/fullcit/8626805 · An Analysis of the Relationships among Selected Attitudinal, Demographic, and Behavioral Variables and the Self-reported Intent to Use and Actual Use of Alcohol and Other Drugs by Adolescents with Learning Disabilities (alcohol Abuse, Drug Abuse, Middle S by Rodeheffer, Beverly Pinder, Phd from The Ohio State University, 1995, 237 pages http://wwwlib.umi.com/dissertations/fullcit/9612266 · An Investigation of the Relationship between Student Nurses' Causal Attributions for Alcohol Abuse and Their Affect and Helping Behavior toward Persons Who Abuse Alcohol (attitude) by Kahn, Arlene Judy, Edd from University of San Francisco, 1986, 144 pages http://wwwlib.umi.com/dissertations/fullcit/8614595 · An Investigation of Three Models for Training Paraprofessionals to Confront Alcohol Abuse. by O'hara, Dennis Joseph, Phd from Michigan State University, 1979, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8001573 · Analysis of Specific Alcohol Risk Characteristics of Participants in the United States Air Force Supervisor Alcohol Abuse Education Program by Shoemaker, Gary L., Edd from The George Washington University, 1983, 203 pages http://wwwlib.umi.com/dissertations/fullcit/8324490 Dissertations 183 · Anxiety and Career Maturity As Seen in Three Groups of Alcohol Abusers by Mckeown, Suzanne Loring Murphy, Edd from University of Northern Colorado, 1982, 169 pages http://wwwlib.umi.com/dissertations/fullcit/8221870 · Attitudes toward Alcohol: Implications for Alcohol Abuse Prevention Programs by Edmundson, Elizabeth Walston, Phd from The University of Texas at Austin, 1990, 151 pages http://wwwlib.umi.com/dissertations/fullcit/9031562 · Attitudinal and Social Normative Factors As Predictors of Intended Alcohol Abuse among Fifth- and Seventh-grade Students by London, Florence Betty, Edd from Columbia University Teachers College, 1980, 108 pages http://wwwlib.umi.com/dissertations/fullcit/8207353 · Black Adolescent Alcohol Abusers: Severity of Alcohol Use, History of Child Abuse and Current Level of Depression by London, Dyanne Patricia, Phd from Boston University, 1990, 124 pages http://wwwlib.umi.com/dissertations/fullcit/9001154 · Client Participation in and Response to an Employee Assistance Program in One Major Corporation (alcohol Abuse Treatment) by Smith, Marjorie Lee, Dsw from Columbia University, 1983, 219 pages http://wwwlib.umi.com/dissertations/fullcit/8406553 · College Student Alcohol Abuse Prevention: Using Social Norms Within a Health Communication Campaign by Bailey, Kelley Christine Walter; Phd from Purdue University, 2000, 190 pages http://wwwlib.umi.com/dissertations/fullcit/3017774 · Coordination and Centralization in a Drug and Alcohol Abuse Treatment Network by Chuse, Michael Howard, Phd from Bryn Mawr College, the Grad. Sch. of Social Work and Social Research, 1979, 193 pages http://wwwlib.umi.com/dissertations/fullcit/8007654 · Determinants of Advertising Regulation Attitudes: the Alcoholism Field and Alcohol Advertising by Witkowski, Terrence Henry, Phd from University of California, Berkeley, 1980, 293 pages http://wwwlib.umi.com/dissertations/fullcit/8029632 · Development of a Coping Skill Treatment Programme for Relapse Prevention with Alcoholics by Langley, Mervin John, Dphil from University of South Africa (south Africa), 1987 http://wwwlib.umi.com/dissertations/fullcit/f4311364 · Domestic Violence and Alcoholism: a Study of Service Providers' Attitudes and Beliefs by Lester, Lois Butterworth, Dsw from City University of New York, 1989, 220 pages http://wwwlib.umi.com/dissertations/fullcit/9000042 · Drinking and Sobriety in Japan (alcoholism) by Smith, Stephen Richard, Phd from Columbia University, 1988, 304 pages http://wwwlib.umi.com/dissertations/fullcit/8815701 · Drinking Practices, Problem Drinking, and Alcoholism among Urban Puerto Rican Men by Garrido, Pedro Jose, Phd from Boston College, 1984, 245 pages http://wwwlib.umi.com/dissertations/fullcit/8512599 184 Alcohol Abuse · Early Treatment of Alcohol Abuse Through a Brief Program of Covert Sensitization and Aversive Olfactory Conditioning. by Hout, Mary Carolyn Newton, Phd from University of Oregon, 1977, 179 pages http://wwwlib.umi.com/dissertations/fullcit/7726449 · Employee Assistance Programs Aimed at Alcohol Abuse: Evaluating the Evaluations by O'mara Mccabe, Eileen Julia, Edd from Fairleigh Dickinson University, 1985, 240 pages http://wwwlib.umi.com/dissertations/fullcit/8607365 · Evaluation Problems in Alcohol Abuse Policies in New York State School Districts by Chen, Chuan-cheng, Edd from State University of New York at Albany, 1987, 275 pages http://wwwlib.umi.com/dissertations/fullcit/8805391 · Factors Associated with Assessment of High Risk of Recidivism, Alcohol Abuse, or Traffic Accident in a Population of Offenders Convicted of Driving While Intoxicated by Osbon, Sue Brunning, Phd from University of New Orleans, 1995, 214 pages http://wwwlib.umi.com/dissertations/fullcit/9717085 · Familial, Academic, and Behavioral Differences in Juvenile Delinquent Alcohol and Substance Abusers (familial Differences, Academic Differences, Alcohol Abusers) by Barnes, Earl Glenn, Edd from Peabody College for Teachers of Vanderbilt University, 1992, 50 pages http://wwwlib.umi.com/dissertations/fullcit/9224295 · Gender Correlates of Alcohol Abuse in a University Population by Griffin, Laura Sullivan, Phd from University of South Carolina, 1996, 111 pages http://wwwlib.umi.com/dissertations/fullcit/9637122 · Gender Role Conflict and Help-seeking Attitudes among Males Referred for Alcohol Abuse Treatment: a Comparison of Self Vs. Mandatory Referral by Generali, Margaret Mary; Phd from The University of Connecticut, 2002, 96 pages http://wwwlib.umi.com/dissertations/fullcit/3054238 · Helping the Alcoholic: Education, Stigma and Social Control in Alcoholism Treatment by Neeley, Beverly Evon, Phd from University of California, San Diego, 1983, 205 pages http://wwwlib.umi.com/dissertations/fullcit/8319133 · Interpersonal Matching and Compliance (alcohol Abuse, Drug Abuse) by Luongo, Peter Felice, Phd from University of Maryland at Baltimore, 1990, 192 pages http://wwwlib.umi.com/dissertations/fullcit/9019879 · Intervention Strategies for the Treatment of Alcohol-abusers and Alcoholics among the Papago Indians: an Ethnographic Needs Assessment by Callahan, Kathy Lynn, Phd from Purdue University, 1981, 236 pages http://wwwlib.umi.com/dissertations/fullcit/8123616 · Lack of Trust, Fear of Disapproval and Potential for Addiction in Adult Children of Alcoholics and Adults from Dysfunctional Families (alcoholics) by Lundberg, Kelly J., Phd from The University of Iowa, 1990, 118 pages http://wwwlib.umi.com/dissertations/fullcit/9103236 · 'lady Lushes': Women Alcoholics and American Society, 1880--1960 by Mcclellan, Michelle Lee; Phd from Stanford University, 2000, 378 pages http://wwwlib.umi.com/dissertations/fullcit/9986485 Dissertations 185 · Law/alcoholism in Black S. Africa (alcoholism, South Africa) by Sithole, Rejoice Dorothy Thokozile, Phd from Washington University, 1990, 374 pages http://wwwlib.umi.com/dissertations/fullcit/9103171 · Leadership Styles of Official Leaders of Interdisciplinary Teams and Teams' Work Performance in Drug and Alcohol Abuse Treatment Programs by Lawental, Eliezer, Dsw from University of Pennsylvania, 1987, 219 pages http://wwwlib.umi.com/dissertations/fullcit/8715319 · Legal Aspects of Dealing with Alcoholism/alcohol Abuse of Professional Employees in the Public School Setting by Warburton, Kathleen Carol, Phd from Kent State University, 1987, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8919798 · Life Space Crisis: Alcohol Abuse among American College Students by Schroeder, Ruth Mae, Phd from Walden University, 1995, 114 pages http://wwwlib.umi.com/dissertations/fullcit/9608115 · Male Client Self-reports of Domestic Violence Reduction Following Employee Assistance Program Intervention for Alcohol Abuse by Maiden, R. Paul, Phd from University of Maryland at Baltimore, 1994, 145 pages http://wwwlib.umi.com/dissertations/fullcit/9819190 · Meditation, Flow, and Heavy Social Alcohol Use among College Students (alcohol Abuse) by Francis, Timothy Lewis, Phd from University of Maryland College Park, 1992, 128 pages http://wwwlib.umi.com/dissertations/fullcit/9315641 · Memory Impairment Related to Ethanol Abuse: a Study of Detoxified Male Alcoholics in an Inpatient Chemical Dependency Treatment Unit by Lewis, Carolyn Victoria, Phd from University of Missouri - Kansas City, 1988, 87 pages http://wwwlib.umi.com/dissertations/fullcit/8905085 · Meta-analysis: Comparison of the Coprevalence of Alcohol Abuse in Eating Disorders and a Family History of Alcohol Abuse As a Risk Factor by Mcginnes, Diane E.; Psyd from Carlos Albizu University, 2002, 71 pages http://wwwlib.umi.com/dissertations/fullcit/3070510 · Pastoral Gatekeeper Participation in Community Alcohol Abuse Prevention by Merrigan, Daniel Michael, Edd from Boston University School of Education, 1983, 306 pages http://wwwlib.umi.com/dissertations/fullcit/8319921 · Patterns of Group Development and Leadership Style in Involuntary Psychotherapy Groups for Alcohol Abusers by O'connell, David Francis, Phd from Temple University, 1986, 168 pages http://wwwlib.umi.com/dissertations/fullcit/8627493 · Personal and Social Perceptions of College Drinking: Implications for Alcohol Abuse Prevention by Nofz, Michael Paul, Phd from University of Illinois at Urbanachampaign, 1990, 265 pages http://wwwlib.umi.com/dissertations/fullcit/9021736 · Personality Characteristics of Alcoholics Related to Age and Employment by Wilson, Lindsay Edward, Phd from University of Florida, 1982, 122 pages http://wwwlib.umi.com/dissertations/fullcit/8226446 186 Alcohol Abuse · Planning in a Developing Health Sector: State Level Planning for Alcoholism Services by Staff, Clarice Ann, Dsw from Columbia University, 1989, 253 pages http://wwwlib.umi.com/dissertations/fullcit/9005940 · Power, Support and Conflict Resolution in the Marriages of Male Alcoholics by De Mahy, Michael Douglas, Phd from Kansas State University, 1980, 124 pages http://wwwlib.umi.com/dissertations/fullcit/8111816 · Practitioners' Attitudes toward Current Conceptions of Alcoholism: Policy Implications for Treatment and Control by Bermas, Neal F., Phd from Brandeis U., the F. Heller Grad. Sch. for Adv. Stud. in Soc. Wel., 1980, 128 pages http://wwwlib.umi.com/dissertations/fullcit/8112860 · Predicting Risk for Alcohol Abuse among Adolescents with Behavior Disorders, Learning Disabilities, and No Disability by Marchbanks, Scott Griffith, Phd from University of Georgia, 1998, 139 pages http://wwwlib.umi.com/dissertations/fullcit/9908626 · Primary Prevention of Alcoholism: Interorganizational Coordination Approach by Earle, Richard Miller, Phd from Washington University, 1980, 374 pages http://wwwlib.umi.com/dissertations/fullcit/8103676 · Problem Attribution, Leadership and Community Mobilization for Addressing Alcohol Abuse by Leek, Kenneth Mark, Phd from University of Washington, 1995, 154 pages http://wwwlib.umi.com/dissertations/fullcit/9616635 · Project C.a.r.e. Substance Abuse Prevention Program: an Evaluation of Program Effectiveness (alcohol Abuse) by Hostetler, Michelle Louise, Phd from The Pennsylvania State University, 1995, 153 pages http://wwwlib.umi.com/dissertations/fullcit/9612756 · Psychological and Psychosocial Correlates That Identify Subgroups of Africanamerican College Student Drinkers (alcohol Abuse, Black Studies) by Sly, Kaye Francis, Phd from Southern Illinois University at Carbondale, 1995, 190 pages http://wwwlib.umi.com/dissertations/fullcit/9536592 · Psychosocial Outcomes among University Student Offspring of Alcohol-abusing Fathers (children of Alcoholics) by Moreas, Robert, Phd from Michigan State University, 1990, 194 pages http://wwwlib.umi.com/dissertations/fullcit/9117846 · Rhetorical Dimensions of Institutional Language: a Case Study of Women Alcoholics by Hallberg, Lillian Mae, Phd from The University of Iowa, 1988, 179 pages http://wwwlib.umi.com/dissertations/fullcit/8913180 · Rural and Urban Youth Drinking and Driving Knowledge, Attitudes, and Behaviors (drunk Driving, Alcohol Abuse) by Owen, Jill Deanna, Phd from Southern Illinois University at Carbondale, 1995, 357 pages http://wwwlib.umi.com/dissertations/fullcit/9536578 · School-based Alcohol Abuse Prevention Programs by Weissman, Eric N., Psyd from State University of New York at Albany, 1992, 128 pages http://wwwlib.umi.com/dissertations/fullcit/9228989 · Sex-role Identity and Alcohol Abuse in Women by Lindeman, Roberta Fae S., Edd from University of Nevada, Reno, 1992, 84 pages http://wwwlib.umi.com/dissertations/fullcit/9233455 Dissertations 187 · Specializations and Clinical Judgments of Social Workers in Cases of Children of Alcohol Abusers by Levy, Alan J., Dsw from Columbia University, 1988, 236 pages http://wwwlib.umi.com/dissertations/fullcit/8827607 · Spiritual Experiences of Recovering Alcoholics (constructivism, Alcoholics Anonymous, William James) by Turner, Colleen, Phd from University of California, Los Angeles, 1993, 408 pages http://wwwlib.umi.com/dissertations/fullcit/9521866 · State Dependent Learning the Effects of Alcohol on Learning and Recall of Information about Alcohol Abuse and Its Consequences among Light and Heavy Social Drinkers by Goulet, Robert John; Phd from The University of Manitoba (canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK43074 · Students' Perceptions of Alcohol Abuse Prevention Programs at Two-year and Fouryear Institutions by Adams, Heidi-christa (rieger); Edd from Arizona State University, 2000, 196 pages http://wwwlib.umi.com/dissertations/fullcit/9963122 · Teenage Children of Alcohol Abusers: Risk Outcomes and Resiliency Factors (alcoholics) by Chandy, Joseph Mulakara, Phd from University of Minnesota, 1990, 176 pages http://wwwlib.umi.com/dissertations/fullcit/9112672 · Temptation to Use Alcohol among University Students with a High Risk for Alcohol Abuse by Iuraduri, Cristina D.; Ma from Southern Connecticut State University, 2002, 40 pages http://wwwlib.umi.com/dissertations/fullcit/1412199 · The Demand for Health, Alcohol Abuse, and Labor Market Outcomes: a Longitudinal Study by Keng, Shao-hsun, Phd from Iowa State University, 1998, 159 pages http://wwwlib.umi.com/dissertations/fullcit/9911610 · The Development of the Children of Alcoholics Risk Scale and Its Utility with School and Clinical Samples by Anderson, Lee, Phd from University of Delaware, 1994, 136 pages http://wwwlib.umi.com/dissertations/fullcit/9500640 · The Difference between Shame-prone and Guilt-prone Persons on Measures of Anxiety, Depression and Risk of Alcohol Abuse by Schaefer, Daniel Albert; Phd from The University of Toledo, 1999, 107 pages http://wwwlib.umi.com/dissertations/fullcit/9936341 · The Effect of an Alcoholism Education Program on Student Nurses' Attitudes toward Alcoholism by Long, Patricia, Edd from St. John's University (new York), 1985, 205 pages http://wwwlib.umi.com/dissertations/fullcit/8526102 · The Effect of Intake Procedures on Dropout Rate from Treatment of Alcohol Abuse by Shanklin, Henry Davis, Phd from Indiana State University, 1989, 161 pages http://wwwlib.umi.com/dissertations/fullcit/8921063 · The Effect of Parental Symptoms, Parental Relationships, and Parenting Practices on the Intergenerational Transmission of Alcoholism and Depression by Holmes, Sandra Johnson, Phd from Washington University, 1989, 220 pages http://wwwlib.umi.com/dissertations/fullcit/8924396 188 Alcohol Abuse · The Effectiveness of a Model Drug and Alcohol Abuse Prevention Program on Lowrisk Students by Klee, Thomas Earl, Phd from Temple University, 1982, 414 pages http://wwwlib.umi.com/dissertations/fullcit/8311605 · The Effects of a Leisure Counseling Program on the Leisure Attitudes of Adult Alcohol Abusers in an Inpatient Treatment Program by Smith, Carol Ann, Edd from Texas Southern University, 1989, 94 pages http://wwwlib.umi.com/dissertations/fullcit/9029527 · The Effects of Childhood Trauma on Drug and Alcohol Abuse in College Students by Jelley, Harvey Henry; Phd from Fordham University, 2002, 247 pages http://wwwlib.umi.com/dissertations/fullcit/3061335 · The Effects of Covert Modeling and Progressive Relaxation on the Locus of Control Orientation and Drinking Behavior of Inpatient Alcohol Abusers by Goodman, Ronald Willis, Edd from The College of William and Mary, 1981, 134 pages http://wwwlib.umi.com/dissertations/fullcit/8205149 · The Effects of Family History of Alcoholism on the Pattern of Motivation for Drinking and the Level of Consumption in Young Adult Offspring by Khazrai, Farzaneh S. A., Phd from Syracuse University, 1994, 206 pages http://wwwlib.umi.com/dissertations/fullcit/9516435 · The Effects of Intimate Exposure to Alcohol Abuse on the Acquisition of Knowledge about Drinking by Rainer, Jackson Patten, Phd from Georgia State University, 1986, 127 pages http://wwwlib.umi.com/dissertations/fullcit/8703968 · The Effects of Parental Alcohol Abuse on the Career Interests of Entering Students at an Urban University (alcohol Abuse) by Sinacola, Richard Samuel, Phd from Wayne State University, 1990, 98 pages http://wwwlib.umi.com/dissertations/fullcit/9118931 · The Effects of Peer Alcohol Abuse Education on College Students' Drinking Behavior by Turner, Sally Christopherson, Edd from University of South Dakota, 1996, 113 pages http://wwwlib.umi.com/dissertations/fullcit/9708468 · The Effects of the Beginning Alcohol and Addictions Basic Education Studies (babes) Prevention Curriculum on the Self-esteem and Attitudes of Junior High School Students (alcohol Abuse Prevention, Addiction Prevention) by Garcia-mcdonnell, Catherine Linda, Phd from Wayne State University, 1993, 143 pages http://wwwlib.umi.com/dissertations/fullcit/9418161 · The Impact of Structured Controversy Versus Concurrence-seeking in Aids, Alcohol Abuse and Cigarette Smoking Education by Mitchell, James Michael, Phd from University of Minnesota, 1997, 141 pages http://wwwlib.umi.com/dissertations/fullcit/9804742 · The Interplay between Alcohol Abuse Episodes and Intrapersonal or Interpersonal Problems: the Functions Served by Heavy Drinking by Merikallio, Annukka, Edd from University of San Francisco, 1994, 240 pages http://wwwlib.umi.com/dissertations/fullcit/9433227 · The Level and Extent of Rehabilitation Needs of Black Alcohol Abuse Clients in an Outpatient Treatment Program by Smith, Edward Robert, Rhd from Southern Illinois University at Carbondale, 1988, 170 pages http://wwwlib.umi.com/dissertations/fullcit/8922396 Dissertations 189 · The Neuropsychological Outcome of Community Alcoholics: Psychiatric Disorders, Neuromedical Problems, and Drinking History by Poon, Edwin; Phd from Michigan State University, 2002, 98 pages http://wwwlib.umi.com/dissertations/fullcit/3075064 · The Perceptions of Drug and Alcohol Workers and School Personnel about Drug and Alcohol Abuse Prevention/education: a Case Study by Dirienzo, Patricia Marie, Edd from Temple University, 1986, 143 pages http://wwwlib.umi.com/dissertations/fullcit/8611835 · The Politics of Temperance: Nicholas Ii's Campaign against Alcohol Abuse (russia) by Schulkin, Marc Lee, Phd from Harvard University, 1985, 339 pages http://wwwlib.umi.com/dissertations/fullcit/8602266 · The Propensity for Alcohol Misuse among Collegiate Football Players: Its Relationship to Athletic Success, Psychological Profile, and Family of Origin by Sweeney, Michael Richard, Phd from University of Missouri - Kansas City, 1987, 144 pages http://wwwlib.umi.com/dissertations/fullcit/8800644 · The Relation of Observation of Parental Violence in Family of Origin, Support Network Variables, Social Support, and Alcohol Abuse in Male Spouse Abusers by Johnson, Judith Lynn, Phd from Loyola University of Chicago, 1989, 130 pages http://wwwlib.umi.com/dissertations/fullcit/8923137 · The Relationship between Adult Children of Alcoholics, Psychotherapy, and Problems with Interpersonal Relationships by Stollman, Gary D., Phd from University of Southern California, 1991 http://wwwlib.umi.com/dissertations/fullcit/f1394068 · The Relationship between Reported Alcohol Abuse and Self-perceived Jewishness among Adolescents by Garfinkle, Martin I., Dsw from Adelphi University, School of Social Work, 1989, 181 pages http://wwwlib.umi.com/dissertations/fullcit/8917187 · The Relationship between the School Resource Officer and Patterns of Suspensions from School due to Violence, Gang Activity and Substance/alcohol Abuse by Wilkerson, Deborah Marie Holt; Edd from Saint Louis University, 2001, 86 pages http://wwwlib.umi.com/dissertations/fullcit/3051857 · The Relationship of Certain Demographic, Personality, and Environmental Variables to College Students' Alcohol Abuse (demographic Variables) by Sherman, Nancy Elizabeth, Phd from The Ohio State University, 1992, 115 pages http://wwwlib.umi.com/dissertations/fullcit/9227377 · The Role of Alcohol Abuse in Career Decision-making Readiness among High School Students by Pendorf, James Edward, Phd from The Pennsylvania State University, 1986, 105 pages http://wwwlib.umi.com/dissertations/fullcit/8615233 · The Role of Cultural Traditions in Alcohol and Drug Abuse Prevention: a Native American Study (alcohol Abuse Prevention) by Parker, Linda Ann, Phd from Brown University, 1990, 152 pages http://wwwlib.umi.com/dissertations/fullcit/9101819 · Training in Peer Counseling for the Prevention of High School Alcohol Abuse by Scovil, James Stewart, Dmin from Hartford Seminary, 1986, 197 pages http://wwwlib.umi.com/dissertations/fullcit/8621944 190 Alcohol Abuse · Twelve Steps to Serenity: the Stress Management Aspect of Alcoholics Anonymous by Zlotnick, Robert; Phd from Temple University, 2001, 124 pages http://wwwlib.umi.com/dissertations/fullcit/3014494 · Women in Transition: a Time of Potential Alcohol Abuse (prevention) by Baldwin, Janice Irene, Phd from University of California, Santa Barbara, 1985, 401 pages http://wwwlib.umi.com/dissertations/fullcit/8609695 Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations. 191 CHAPTER 5. CLINICAL TRIALS AND ALCOHOL ABUSE Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning alcohol abuse. Recent Trials on Alcohol Abuse The following is a list of recent trials dedicated to alcohol abuse.8 Further information on a trial is available at the Web site indicated. · Behavioral Counseling for Alcohol Dependent Smokers (nicotine patch) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is to evaluate the effectiveness of a mood management intervention on abstinent alcoholic smokers with a history of major depression. The second aim is to determine the effect of smoking treatments on alcohol abstinence and to identify factors associated with smoking and alcohol outcomes (e.g., more days of abstinence). A randomized, two-group design will be used to evaluate the added benefit of mood management compared to a state-of-the-art smoking cessation treatment. Treatment will consist of 8 weekly group sessions and 1, 3, 6, and 12-month follow-up. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004551 · Behavioral Therapy Plus Naltrexone for Alcoholism Condition(s): Alcoholism Study Status: This study is currently recruiting patients. 8 These are listed at www.ClinicalTrials.gov. 192 Alcohol Abuse Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare cognitive behavioral therapy with a timelimited motivational enhancement therapy to which naltrexone (Revia) or placebo medication is added. In this randomized clinical trial, 160 alcohol-dependent outpatients, after 5 days of abstinence, will receive one of the two psychosocial therapies and either naltrexone (Revia) or placebo for a 12-week treatment period. Abstinence rates, alcohol use, and time to alcohol relapse will be evaluated in all four groups along with measures of alcohol craving, biological measures of alcohol consumption, drinking consequences, changes in self-confidence for avoiding alcohol, and medication compliance. All study participants will be assessed for measures of outcome variables at 3 and 6 months after completing the treatment protocol. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000456 · Behavioral/Drug Therapy for Alcohol-Nicotine Dependence (naltrexone/nicotine patch) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will develop a behavioral and drug relapse prevention program for individuals who are dependent on both alcohol and tobacco. The study's goal is to show that individuals receiving nicotine replacement therapy and naltrexone (Revia) with behavior therapy will have higher rates of abstinence from both smoking and drinking than individuals who do not receive the drug therapies. Individuals will be placed in a 12-week outpatient treatment program with followup assessments 1, 3, and 6 months after treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000447 · Bupropion as a Smoking Cessation Aid in Alcoholics Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to test the use of time-released bupropion (Wellbutrin) in patients receiving treatment for alcohol abuse/dependence as an aid to stop smoking. Patients will receive either a time-released bupropion or placebo. Both groups will receive nicotine replacement therapy during the 9 week study. A final followup assessment will be conducted 6 months from the start of treatment. Phase(s): Phase IV Study Type: Interventional Clinical Trials 193 Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00044434 · Combination Nicotine Replacement for Alcoholic Smokers Condition(s): Smoking; Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The overall objective of the study is to develop recommendations for treatment programs to help alcoholic smokers to stop smoking. A sample of 175 alcohol dependent cigarette smokers will be recruited from the community and treated in a 6month outpatient alcohol and tobacco treatment program. The 175 patients will be divided into two groups. One group will receive an active nicotine patch and active nicotine gum. The other group will receive an active nicotine patch and placebo nicotine gum. Followup assessments will be conducted for 1-year from the beginning of treatment. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00064844 · Combined Pharmacotherapies for Alcoholism (naltrexone/odansetron) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare the effectiveness of ondansetron (Zofran) and naltrexone (ReVia) both alone and in combination in treating Early Onset Alcoholics versus Late Onset Alcoholics. All subjects will received standardized Cognitive Behavioral Therapy. Followup assessments will be completed at 1, 3, 6, and 9 months after treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027079 · Comparing Gabapentin and Lorazepam for Treating Alcohol Withdrawal Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will evaluate a safe and useful medication for outpatient detoxification that is as effective as benzodiazepines in the short-term, and more effective in the protracted withdrawal period. Gabapentin (Neurontin) will be compared to a standard benzodiazepine, lorazepam (Ativan), for its effectiveness in treating alcohol withdrawal. 194 Alcohol Abuse Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011297 · Drug Therapy for Alcohol Dependence in Alaska Natives (naltrexone/sertraline) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will assess the ability of naltrexone (Revia) to reduce the risk of relapse in Alaska natives with alcohol dependence. The study will also examine whether a combination of naltrexone and sertraline (Zoloft) yields better abstinence rates than naltrexone used alone. Alaska Native individuals will be recruited into a 16 week outpatient study. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000451 · Drug Treatment for Alcoholism (ondansetron) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is to determine if alcoholics who differ on genetic variations of serotonin activity respond differently to ondansetron (Zofran) treatment. Subjects will receive one week of single-blind placebo lead-in followed by randomization to 11 weeks of double-blind treatment with ondansetron or placebo. All subjects will receive weekly cognitive behavioral therapy and have brain imaging and genetic testing. Participants will be scheduled for followup assessments at 1, 2, 3, 6, and 9 months after treatment. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006205 · Drug Treatment for Depressed Alcoholics (naltrexone/fluoxetine) Condition(s): Alcoholism; Depression Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will examine the effects of combing naltrexone and fluoxetine (Prozac) versus fluoxetine and placebo in alcoholics with co-occurring major depression. Both groups will actively participate in the 6-month study, which includes Clinical Trials 195 weekly individual Dual Disorders Recovery Counseling during the first month and every two weeks during the second through sixth months, plus the naltrexone and fluoxetine or fluoxetine and placebo. Subjects will complete follow-up assessments at 9 and 12 months. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006204 · Genetic Factors and Interrelationships for Sexual Orientation, Susceptibility to HIV and Kaposi's Sarcoma, Alcoholism and Psychological Traits, and Histocompatibility Antigens Condition(s): Alcoholism; HIV Infection; Homosexuality; Kaposi's Sarcoma Study Status: This study is currently recruiting patients. Sponsor(s): National Cancer Institute (NCI) Purpose - Excerpt: We propose to test, by DNA linkage analysis of family pedigree members, the following interrelated hypotheses: 1) that sexual orientation is genetically influenced; 2) that the development of Kaposi's sarcoma and other outcomes of HIV infection in male homosexuals is affected by host susceptibility genes, circulating sex hormone levels, or HLA haplotype; and 3) that alcoholism and other psychobehavioral conditions are associated with homosexuality on a genetic basis and/or influenced by candidate behavioral loci. The subjects for these studies will be self-identified male and female homosexual probands and their relatives from families in which there are at least two individuals with homosexual orientation. All subjects will be adults, and will be referred through NIH physicians, private practitioners, and gay and lesbian organizations. Subjects will undergo a sexual orientation and behaviors interview, a psychiatric interview, and phlebotomy for HIV testing, HLA determination, endocrine measurements, and preparation of DNA from cultured lymphocytes. The DNA samples will be analyzed for a series of genetic markers that span the human genome and for candidate loci chosen for function. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00001294 · Improving Substance Abuse Treatment Aftercare Adherence and Outcome Condition(s): Substance Abuse; Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Purpose - Excerpt: Although substance abuse treatment aftercare participation is strongly related to positive treatment outcomes, aftercare participation rates are low and relatively few interventions have been developed that improve aftercare adherence and outcome. We have shown in preliminary studies that contracting, prompting with feedback, and providing social reinforcement independently increase aftercare participation and improve treatment outcome. We propose a randomized clinical trial to examine a behaviorally based substance abuse treatment adherence intervention. We have 3 goals: 1) to compare the effectiveness of an aftercare intervention consisting of a 196 Alcohol Abuse participation contract, attendance prompts with feedback, and attendance reinforcers (CPR) to a standard treatment (STX) on adherence to aftercare therapy; 2) to assess the effects of this intervention on treatment outcome; and 3) to understand the process by which this intervention works. Over a 1.5-year period, we will recruit 160 veterans seeking residential or intensive outpatient treatment at the Salem VAMC's Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) who can participate in aftercare therapy. Our population is highly similar to those in SARRTP's throughout the VAMC (95% male, 52% Caucasian, 48% minority, 44 years mean age, 47% alcohol dependent, 16% drug dependent, 37% both alcohol and drug dependent, and 36% dual diagnosis). In this randomized clinical trial, participants will be assigned to the STX or the CPR condition. Treatment adherence and outcome will be measured 3-, 6- and 12months after participants enter treatment and will be compared to baseline levels using structured interviews, questionnaires, urine alcohol and drug screens, VAMC databases, medical records, and therapist ratings. The basic study design is a repeated measures nested cohort design, with an intervention group and a standard care group. The primary outcome, abstinence rate, will be analyzed using a logistic regression model in which the parameters of interest are estimated using Generalized Estimating Equations (GEE). We will analyze secondary outcomes using both marginal and linear mixedeffects models. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00057187 · Naltrexone, Craving, and Drinking Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This 5-week study will examine the effects of naltrexone on alcohol craving, drinking rates, and reaction to drinking-related triggers, or cues, in participants' everyday environment and in laboratory sessions. Participants will monitor and record their daily desires to drink, environmental circumstances in which urges occur, and drinking behavior using a palm top computer. Participants will receive naltrexone or a placebo. One week after receiving medication, all participants will be asked to respond to alcohol-related cues that may or may not arouse the desire to drink. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006203 · Pharmacological Intervention Project (fluoxetine) Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This is a large scale study involving fluoxetine (Prozac) versus a placebo in the treatment of adolescents with alcohol use disorder and major depression. Clinical Trials 197 All individuals will receive treatment for 12 weeks with a followup phase lasting 9 months. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027378 · Post-Treatment Effects of Naltrexone Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The aims of this protocol are to compare 3 and 6 months of naltrexone treatment coupled with two psychotherapies that differ in scope and intensity. The effect of these treatments will be assessed with patients who differ in their psychosocial need and resources at their disposal, and in their level of cravings for alcohol. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006449 · Serotonin in Alcoholism Condition(s): Alcoholism; Healthy Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study uses positron emission tomography (PET) scanning to study how serotonin works in alcoholics. Serotonin is a chemical that allows brain cells to communicate. There is evidence that people with alcoholism have altered serotonin; their brains begin to make and break down serotonin more slowly than people who do not drink. PET scans use radioactive substances injected into the body. A special camera detects the radiation emitted by the radioactive fluid and a computer processes the radioactivity into images of the brain, which show the activity of brain chemicals like serotonin. People with alcohol dependency may participate in this study. Candidates are screened with a medical history, including questions about alcohol and drug use, physical examination, blood tests, breath alcohol tests, electrocardiogram (ECG), urine test for illicit drugs and, for women, a pregnancy test, and a stool test for hidden blood. They also undergo magnetic resonance imaging (MRI) scan of the brain and complete questionnaires on their alcohol and drug history. Participants undergo the following tests and procedures: - Diet low in tryptophan. Tryptophan is an amino acid from which serotonin is made. - Brain MRI before starting the study to make sure brain structure is normal. - Lumbar puncture (spinal tap) to collect a small sample of cerebrospinal fluid (CSF). A local anesthetic is given and a needle is inserted in the space between the bones (vertebrae) in the lower back. About 2 tablespoons of fluid is collected through the needle. - Arterial catheter (plastic tube) placed in an artery in the wrist area for drawing blood samples. The skin is numbed with a local anesthetic for placement of the catheter. 198 Alcohol Abuse - Intravenous (IV) catheter placed in a vein for injecting the radioactive isotope used in the PET scan. - Two PET scans - baseline and active. - Amino acid drink (orange flavored) before the active PET scan. The drink lowers tryptophan levels. - Amino acid capsules - 23 amino acid capsules are taken with the orange drink. - Genetic analysis to help understand serotonin and alcoholism. A blood sample is collected for DNA testing and possibly establishment of a cell line (collection of cells that are grown in the laboratory from an original tissue specimen) for other genetic studies. Patients are admitted to the intensive care unit for the lumbar puncture and arterial line procedures. After these procedures are complete, the patient is transferred by stretcher to the PET suite for scanning. During the two scans, blood samples are drawn from the artery and a small amount of CSF is collected each hour of the study. Each PET scanning session lasts about 3 hours. The study lasts 36 hours, during which time the subject remains in bed. Study Type: Observational Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011752 · Timing of Smoking Intervention in Alcohol Treatment (nicotine patch) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will attempt to determine the best time to begin a smoking cessation program in individuals who undergo intensive treatment for alcohol dependence. The goal of this trial is to determine whether a smoking cessation program is more effective if it occurs at the same time as or after treatment for alcohol dependence. The study also will attempt to determine the effect of smoking cessation programs on the outcome of treatment for alcohol dependence. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000444 · Tobacco Dependence in Alcoholism Treatment (nicotine patch/naltrexone) Condition(s): Alcoholism; Smoking Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: The purpose of this study is to determine the effectiveness of naltrexone (Revia) in reducing drinking and smoking in patients with both nicotine and alcohol dependence. Individuals will be randomly assigned to a 12-week trial of a fixed daily dose of either naltrexone (Revia) and nicotine replacement patch or placebos. All individuals will receive weekly coping skills and smoking-cessation behavioral therapy. Followup interviews will be conducted 3 and 6 months after treatment to determine smoking and drinking status and persistence of any dependence symptoms. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Clinical Trials 199 Web Site: http://clinicaltrials.gov/ct/show/NCT00000437 · Trazodone for Sleep Disturbance in Early Alcohol Recovery Condition(s): Alcoholism Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study is a randomized, double-blind clinical trial comparing trazodone (Desyrel) and placebo among sleep-disturbed, alcohol-dependent individuals shortly after discharge from an inpatient detoxification program. Subjects will undergo a baseline assessment and random assignment to trazodone or identical placebo for 12 weeks. All persons completing the alcohol detoxification at Stanley Street Treatment and Resources (SSTAR) will be screened. (SSTAR of Rhode Island provides detoxification services to non/underinsured persons of Rhode Island.) Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00027053 · Treating Alcohol Use In Older Adults With Depression Condition(s): Alcoholism; Depression Study Status: This study is currently recruiting patients. Sponsor(s): Department of Veterans Affairs Medical Research Service Purpose - Excerpt: The purpose of this study is to test the efficacy combining a treatment for depression with a treatment for alcohol dependence. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00018824 · Treatment for Alcoholism and Post-Traumatic Stress Disorder (naltrexone) Condition(s): Alcoholism; Post-Traumatic Stress Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will evaluate naltrexone and cognitive-behavioral therapy treatments for alcohol dependence and post-traumatic stress disorder (PTSD). Subjects will be randomly assigned a 6-month treatment of either: 1) naltrexone alone, 2) naltrexone with PTSD psychosocial therapy, 3) a placebo with PTSD psychosocial therapy, or 4) placebo alone. An enhanced medication management intervention will accompany all treatment conditions. Followup assessments will be completed at 9 and 12 months after treatment. Phase(s): Phase IV Study Type: Interventional 200 Alcohol Abuse Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006489 · Treatment of Adolescents with Comorbid Alcohol Use and Attention Deficit Hyperactivity Disorder (bupropion) Condition(s): Alcoholism; Attention Deficit Hyperactivity Disorder Study Status: This study is currently recruiting patients. Sponsor(s): National Institute on Alcohol Abuse and Alcoholism (NIAAA) Purpose - Excerpt: This study will compare the effectiveness of sustained release bupropion (Wellbutrin) versus a placebo in the treatment of adolescents with comorbid alcohol use disorder and attention deficit hyperactivity disorder. Adolescents, ages 1418 will be recruited from community treatment programs for a 16-week trial with follow-up assessments. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00029614 · Preliminary Human Trial of NPI-028 Condition(s): Alcoholism Study Status: This study is not yet open for patient recruitment. Sponsor(s): National Center for Complementary and Alternative Medicine (NCCAM) Purpose - Excerpt: This research will determine whether the Chinese herbal medicine (NPI-028) can make a significant contribution to the management of withdrawal and to follow-up treatment aimed at preventing or managing relapse in both women and men alcoholics. The herbal preparation has been used historically in the treatment of alcohol intoxication and is still prescribed in China and Southeast Asia. Efficacy has been documented but awaits the application of current research methods to establish efficacy, safety, and probable mechanisms of action. Preclinical studies have been carried out in alcohol-preferring rats and vervet monkeys to test efficacy in reducing voluntary alcohol intake, measure tolerance effects, and toxicological affects. The proposed human trial will develop a placebo, establish quality control, test methods of administration, and examine compliance issues. Following these preliminary steps, a placebo controlled trial will be conducted using 160 subjects (80 subjects per treatment condition with 40 of each gender). Alcohol use, craving, health status, psychological status, and at rates will be assessed using established measures that are current in addiction research. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00010907 Clinical Trials 201 Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “alcohol abuse” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials: · For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/ · For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html · For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/ · For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm · For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm · For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm · For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp · For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm · For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/ · For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm · For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm · For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm · For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm 202 Alcohol Abuse · For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm · For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials 203 CHAPTER 6. PATENTS ON ALCOHOL ABUSE Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “alcohol abuse” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on alcohol abuse, we have not necessarily excluded non-medical patents in this bibliography. Patents on Alcohol Abuse By performing a patent search focusing on alcohol abuse, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We will tell you how to obtain this information later in the chapter. The following is an 9Adapted from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 204 Alcohol Abuse example of the type of information that you can expect to obtain from a patent search on alcohol abuse: · 3-(Diarylmethylene)-8-azabicyclo[3.2.1]octane derivatives Inventor(s): Neilson; Lou Anne (Sellersville, PA), Wu; Wu-Nan (Landsdale, PA), Boyd; Robert E. (Horsham, PA), Coats; Steven J. (Quakertown, PA), Pitis; Philip M (North Wales, PA), Carson; John R. (Norristown, PA) Assignee(s): Ortho-McNeil Pharmaceutical, Inc. (Raritan, NJ) Patent Number: 6,552,036 Date filed: February 22, 2001 Abstract: This invention is directed to 3-(diarylmethylene)-8-azabicyclo[3.2.1]octane derivatives useful as.delta.-opioid or.mu.-opioid receptor modulators. Depending on their agonist or antagonist effect, the compounds are useful analgesics, immunosuppressants, antiinflammatory agents, agents for the treatment of neurological and psychiatric conditions, medicaments for drug and alcohol abuse, agents for treating gastritis and diarrhea, cardiovascular agents and agents for the treatment of respiratory diseases. Excerpt(s): The present invention is directed to compounds useful as delta-opioid and mu-opioid receptor modulators. More particularly, the present invention is directed to 3-(diarylmethylene)-8-azabicyclo[3.2.1]octane derivatives useful as delta-opioid or muopioid receptor modulators. wherein R is hydrogen, methyl, propyl, hexyl, 2-ethylbutyl, allyl, 3,3-dimethallyl, cyclohexylmethyl, phenethyl, phenylpropyl, 2,2-diphenylethyl, 3,4-dimethoxyphenethyl, 4-fluorophenethyl, 2-furylmethyl, 3,4-methylenedioxybenzyl, cyano and X is N,N-dimethylamino, N,N-diethylamino, N,N-dipropylamino, N-methylN-ethylamino, N-methyl-N-propylamino, N-methyl-N-phenylamino, N-ethyl-N-(4methyl)benzylamino, N-butyl-N-ethylamino, N-butyl-N-propylamino, [N-ethyl-N-(2methyl)allyl]amino, hydroxy, O-t-butyl and 1-pyrrolidinyl; and, Y is hydrogen, methoxy and methylthio. Other selective 4-[(8-alkyl-8-azabicyclo[3.2.1] octyl-3-yl)-3-arylanilino]N,N-diethylbenzamide.delta.-opioid ligands have also been described (Thomas, J. B., Atkinson, R. N., Rothman, R. B., Burgess, J. P., Mascarella, S. W., Dersch, C. M., Xu, H. and Carroll, F. I., Biorg. Med. Chem. Lett., 2000, 10: 1281-1284). Web site: http://www.delphion.com/details?pn=US06552036__ · 3-[4-[4-substituted-1-piperazinyl]-1-butyl]-1H-2,3-dihydroindoles Inventor(s): Perregaard; Jens (Jaegerspris, DK), Stenberg; John W. (Copenhagen, DK) Assignee(s): H. Lundbeck A/S (Copenhagen-Valby, DK) Patent Number: 5,002,948 Date filed: December 26, 1989 Abstract: The present invention relates to novel piperazinylbutylindoles, -indazoles, the corresponding 2,3-dihydro derivatives and 2-indolones which have been found to have central serotonin activity with preference for the serotonin 5-HT.sub.lA receptor.Compared to the anxiolytic drug buspirone, and other clinically investigated compounds such as ipsapirone and gepirone, most of the present compounds have lower efficacy at the 5-HT.sub.lA receptor which implies less side effects related to activation of the receptors.The invention also includes acid addition salts, methods of Patents 205 preparation, pharmacetical compositions and method of treating CNS disorders occuring in anxiety, depression, aggression and in alcohol abuse, or in states of disease related to the cardiovascular, gastrointestinal and renal systems, by administering the aforementioned derivatives.Separation and use of the stereo isomers of the 2,3-dihydro derivatives and 2-indolones are also part of this invention. Excerpt(s): as well as pharmaceutically acceptable acid addition salts and stereo isomers thereof. 4-Phenyl-1-piperazinylalkyl-3-indoles have previously been disclosed in the following patents: Fr. No. 1,551082 (Sterling Drug Inc.--1968); U.S. Pat. No. 3,135,794 (Sterling Drug Inc.--1964); GB No. 944,443 (Sterling Drug Inc.--1963) and in the following papers as well: Med. Pharm. Chem. 5, 932-943 (1962), Arch. intern. Pharmacodyn. 157 (1) 67-89 (1965). These patents and papers have focused on 4-phenyl-1-piperazinylethyl-3indoles with antihistaminergic, sedative, hypotensive and tranquilizing activity, however, without mentioning of serotonergic activity and the diseases where deficits in this neurotransmitter system are involved. The only butyl derivative included in our invention specifically mentioned in the above patents and papers was 3-[1-(2methoxyphenyl)-4-piperazinyl]-4-butylindole (Compound 2a). In the compounds of formula I the preferred compounds are dihydroindoles, 2-indolones and indazoles with R.sup.2 being preferably hydrogen or methyl and R.sup.1 hydrogen, halogen or trifluoromethyl. The aromatic substituent Ar is preferably 2-lower alkoxyphenyl, 1,4benzodioxan-5-yl, or 2,3-dihydro-7-benzofuranyl. Web site: http://www.delphion.com/details?pn=US05002948__ · 4-[aryl(8-azabicyclo[3.2.1]octan-3-yl)]aminobenzoic acid derivatives Inventor(s): Boyd; Robert E. (Horsham, PA), Carson; John R. (Norristown, PA), Neilson; Lou Anne (Sellersville, PA) Assignee(s): Ortho-McNeil Pharmaceutical, Inc. (Raritan, NJ) Patent Number: 6,306,876 Date filed: December 4, 2000 Abstract: 4-[aryl(8-azabicyclo[3.2.1]octan-3yl)]aminobenzoic acid derivatives are deltaopioid receptor modulators. As delta-opioid receptor agonists, such compounds are useful as analgesics. Depending on their antagonist effect, such compounds may also be useful immunosuppressants, antiinflammatory agents, agents for the treatment of neurological and psychiatric conditions, medicaments for drug and alcohol abuse, agents for treating gastritis and diarrhea, cardiovascular agents and agents for the treatment of respiratory diseases. Excerpt(s): The present invention is directed to delta-opioid receptor modulators. More particularly, the present invention is directed to 4-[aryl(8-azabicyclo[3.2.1]octan-3yl)]aminobenzoic acid derivatives which are delta-opioid receptor modulators useful as effective analgesics. The foregoing reference compounds have been described as either delta- or mu-opioid receptor agonists or antagonists. It is an object of the present invention to provide delta-opioid receptor modulators. It is another object of the present invention to provide delta-opioid receptor selective agonists as analgesics having reduced side-effects. It is also another object of the present invention to provide deltaopioid receptor antagonists as immunosuppressants, antiinflammatory agents, agents for the treatment of neurological and psychiatric conditions, medicaments for drug and alcohol abuse, agents for treating gastritis and diarrhea, cardiovascular agents and agents for the treatment of respiratory diseases, having reduced side-effects. It is a 206 Alcohol Abuse further object of the present invention to provide a method for treating a disorder modulated by the delta-opioid receptor. Web site: http://www.delphion.com/details?pn=US06306876__ · 4-[aryl(piperidin-4-yl)]aminobenzamides Inventor(s): Fitzpatrick; Louis J. (Souderton, PA), Carson; John R. (Norristown, PA), Carmosin; Richard J. (late of Quakertown, PA), Jetter; Michele C. (Norristown, PA), Reitz; Allen B. (Lansdale, PA) Assignee(s): Ortho-McNeil Pharmaceutical, Inc. (Raritan, NJ) Patent Number: 6,436,959 Date filed: December 23, 1998 Abstract: 4-[aryl(piperidin-4-yl)]aminobenzamides are delta-opioid receptor agonists/antagonists. As delta-opioid receptor agonists, such compounds are useful as analgesics. Depending on their agonist/antagonist effect, such compounds may also be useful immunosuppressants, antiinflammatory agents, agents for the treatment of mental illness, medicaments for drug and alcohol abuse, agents for treating gastritis and diarrhea, cardiovascular agents, and agents for the treatment of respiratory diseases. Excerpt(s): The present invention relates to delta-opioid receptor agonists/antagonists. More particularly, the present invention relates to 4-[aryl(piperidin-4yl)]aminobenzamides which are delta-opioid receptor agonists useful as analgesics. which are mu-opioid antagonists. which are delta-opioid agonists/antagonists. Web site: http://www.delphion.com/details?pn=US06436959__ · Allelic association of the human dopamine (D.sub.2) receptor gene in compulsive disorders such as alcoholism Inventor(s): Sheridan; P. J. (San Antonio, TX), Blum; Kenneth (San Antonio, TX), Noble; E. P. (Los Angeles, CA) Assignee(s): Regents of the University of California (Berkeley, CA), Board of Regents, The University of Texas System (Austin, TX) Patent Number: 5,210,016 Date filed: January 23, 1992 Abstract: In an important embodiment, the present invention concerns a method for diagnosing compulsive disease predisposition of an individual. The method comprises initially obtaining a DNA sample of said individual and then determining the presence or absence of a particular human D.sub.2 receptor gene allele in said sample. Detection of said allele in the sample is indicative of predilection to compulsive disease. A most preferred embodiment is to detect predisposition to alcoholism, particularly because said allele has been found to be present in a majority of clinically diagnosed alcoholics. The human D.sub.2 receptor gene A1 allele is most preferably detected in said sample. Excerpt(s): The present invention relates to the first molecular genetic evidence, through the use of RFLP analysis, that an allele in the human dopamine (D.sub.2) receptor gene is more significantly associated with human brain tissue from alcoholics than with brain tissue obtained from nonalcoholics. The occurrence of this disease-associated Patents 207 polymorphism has a high predictive value in the classification of, at least, one probable subtype of alcoholics. The identification of a genetic marker that is closely linked to alcoholism means that the gene's inheritance can be followed, leading to simple tests for diagnosing carriers and future disease victims, and potential gene therapy. Some authors believe that dopaminergic cells are implicated in the rewarding action of alcohol (23) and of opiates (2). In contrast, others (3) argue that at least alcohols/opiates and alcohol reinforcing effects are mediated primarily by nonadrenergic and not dopaminergic systems in the brain. Whether or not multiple systems exist, the question of several parallel reward mechanisms, or a very few, even one, is yet to be fully resolved. The cause and effect of compulsive behavior diseases, including alcoholism, appears to be biogenic. Regardless of the number of systems involved, the ability to identify an allelic gene segment associated with specific compulsive behavior is a significant step forward in developing predictive tests for compulsive behavior patterns. Web site: http://www.delphion.com/details?pn=US05210016__ · Bromocriptine for the treatment of alcoholics diagnosed with the D.sub.2 dopamine receptor DRD2 A1 allele Inventor(s): Noble; Ernest P. (South Laguna, CA) Assignee(s): The Regents of the University of California (Los Angeles, CA) Patent Number: 6,001,848 Date filed: March 24, 1997 Abstract: Disclosed are dopamine agonist and opioidergic compositions and methods for their use in the treatment of alcoholism. The invention discloses compounds and therapeutic kits useful in the treatment of alcoholics having the A1 allele of the dopamine receptor D2 gene. Also disclosed are methods of treating alcoholics having the A1/A1 or A1/A2 DRD2 genotype comprising administration of dopamine agonists such as aporphines, ergolines, related compounds, and their analogs, in combination with opioidergic compounds such as naloxone. Excerpt(s): The present invention relates generally to the field of molecular biology. More particularly, certain embodiments comprise dopamine agonist compositions and methods for their use in the treatment of alcoholism and related compulsive disorders. In preferred embodiments methods and compositions are disclosed for the treatment of patients having the A1 allele of the D.sub.2 dopamine receptor (DRD2) gene. A variety of effective drugs are now available in the treatment of many mental afflictions including schizophrenia, anxiety reactions and affective disorders. In contrast, with the recent exception of naltrexone, vide infra, no current accepted pharmacotherapy exists for decreasing alcohol consumption and relapse in alcoholics (for reviews see Noble, 1984; Liskow and Goodwin, 1987; Litten and Allen, 1991; Gorelick, 1992). A variety of methods have been described in the literature in recent years relating to treatment of chronic alcoholism. Such methods have included stimulating electroacupuncture of zones in the ears (Soviet Pat. No. SU 1,757,671, 1992); intramuscular injection of meksidol (Soviet Pat. No. SU 1,777,878, 1992); oral compositions which contain vitamin, protein, fat and carbohydrate compounds (Soviet Pat. No. SU 1,717,069, 1992); visual stimulation using pulsed red light (Soviet Pat. No. SU 1,699,467, 1991); peroral administration of vitamin complexes and honey (Soviet Pat. No. SU 1,697,802, 1991); intravenous injection of cholecystokinin (Soviet Pat. No. SU 1,463,302, 1989); administration of phenylalkanoyl amines (European Pat. No. EP 424,528, 1992); administration of opiod antagonists (Intl. Pat. Appl. Publ. No. WO 960947, 1996); 208 Alcohol Abuse administration of spiroindane derivatives (U.S. Pat. No. 5,298,622, 1994); application of low frequency alternating currents to reflect reflexogenic zones (Russian Pat. No. RU 2,056,110, 1996); a variety of homeopathic compositions including sulfur and rattlesnake venom (Russian Pat. No. RU 2,039,561, 1995); -apomorphine-teturam administration (Soviet Pat. No. SU 1,806,743, 1993); and a variety of treatment methods involving acute negative reaction and somatic disturbance (Soviet Pat. No. SU 170,148; 1968). Each of the aforementioned patents is specifically incorporated herein by reference in its entirety. Web site: http://www.delphion.com/details?pn=US06001848__ · Composition for suppressing withdrawal symptoms and craving for alcohol in alcoholics and preventing the abuse of alcohol in healthy subjects Inventor(s): Cavazza; Claudio (Rome, IT), Fassi; Aldo (Pomezia, IT) Assignee(s): Sigma-Tau Industrie Farmaceutiche Riunite S.p.A. (Rome, IT) Patent Number: 6,255,346 Date filed: June 6, 2000 Abstract: A combination composition comprising L-carnitine, acetyl L-carnitine and propionyl L-carnitine or the pharmacologically acceptable salts thereof is disclosed which can be used as a pharmaceutical composition for suppressing withdrawal symptoms and craving for alcohol in alcoholics, and as a dietary supplement, health food, medical food or nutraceutical for preventing the abuse of alcohol in substantially healthy subjects, particularly in young individuals. Excerpt(s): The present invention relates to a combination composition of L-carnitine and lower alkanoyl L-carnitines or the pharmacologically acceptable salts thereof for the treatment of alcoholism. The use of the combination composition suppresses withdrawal symptoms (such as tremors, perspiration, hyperreflexia, nausea, anxiety and convulsions) and the craving for alcohol. All the drugs used to date for the treatment of alcoholism present substantial drawbacks. A number of the drugs commonly used in the treatment of alcohol withdrawal syndrome are similar to this with regard to their pharmacological effects. In fact, the most useful of those currently used are those with which alcohol develops a cross-tolerance. All patients treated for withdrawal syndromes are potential candidates for SNC depressants though not all of them need them. Web site: http://www.delphion.com/details?pn=US06255346__ · Detection of novel carbohydrates directly associated with chronic alcoholism Inventor(s): Raguthu; Simhachalam (Staten Island, NY), Pullarkat; Raju K. (Staten Island, NY), Pullarkat; Premila S. (Staten Island, NY) Assignee(s): Research Foundation for Mental Hygiene, Inc. (Albany, NY) Patent Number: 5,747,346 Date filed: May 27, 1994 Abstract: Chronic or long-term alcohol consumption is detected and monitored by determining the level of a newly-observed, alcohol-specific carbohydrate in body fluids (e.g. urine) of subjects by calorimetric reaction using qualitative and quantitative assay methods. The alcohol-specific carbohydrate have been identified as a novel ethyl glucuronide. Ethyl glucuronide is observed and detected in direct response to alcohol Patents 209 consumption in body fluids, and can be isolated and purified. Simple, economical, and reproducible assay methods, such as a spot assay and an ascending or thin layer chromatography assay, provide reliable, objective, and sensitive methods for detecting and monitoring a chronic alcoholic condition. Both the presence of the alcohol-specific ethyl glucuronide and a substantial increase in its levels are indicative of chronic alcoholism. Since the novel ethyl glucuronide is produced and appears as a direct response to chronic alcohol intake, the novel carbohydrate is considered to be a unique biomarker for the detection of alcoholism, with virtually no possibility of false positive results. Excerpt(s): The present invention describes the isolation and characterization of a novel carbohydrate biomarker of alcohol consumption and relates generally to improvements in detecting and monitoring chronic alcoholism. Alcoholism is a major health and economic problem which imposes broad reaching concerns not only to the afflicted individuals, but to society at large. In the United States alone, at least ten to twenty million people are classified as chronic alcoholics and long-term alcohol abusers. In addition, other countries have serious problems with chronic alcohol consumption as well as with the objective diagnosis and detection of long-term alcohol use. It is known that chronic (i.e. over a period of weeks, months, or longer) alcoholic and long-term alcohol users rarely admit their excessive consumption of alcohol. In spite of attempts to standardize the diagnosis of alcohol abuse and chronic alcoholism based on operational and functional criteria, many problems exist in the detection and diagnosis of alcoholrelated disorders. One major problem is that patient cooperation is required, and often, alcoholics do not approach their physicians to ask for help specifically to stop their excessive or pathological drinking. Unfortunately, even when questioned directly by their physicians, alcoholics rarely disclose the true extent of their alcohol consumption, and often deny and minimize any association between their use of alcohol and their other symptoms or problems. Because it is difficult to detect and diagnose alcoholism and alcohol abuse in patients, physicians frequently misdiagnose or underdiagnose alcohol-related disorders. Web site: http://www.delphion.com/details?pn=US05747346__ · Hemoglobin marker of alcoholism Inventor(s): Hoberman; Henry D. (New Rochelle, NY) Assignee(s): Albert Einstein College of Medicine of Yeshiva University a Division of (Bronx, NY) Patent Number: 4,463,098 Date filed: October 3, 1983 Abstract: An in vitro method for identifying alcoholism and alcohol abuse in humans is disclosed which comprises the isolation and measurement of a unique and stable form of glycosylated hemoglobin. Excerpt(s): This invention relates to a method for measuring alcohol intake in humans. This invention further relates to a method for providing a dose-time record of alcohol consumption. To the present time, efforts to identify markers of alcoholism have relied chiefly on evaluating changes in liver biochemistry reflected in the blood by changes in the concentrations of certain amino acids. See Shaw, et al, 1976, Plasma a-amino-nbutyric acid to leucine ratio: An empirical biochemical marker of alcoholism, Science, 194: 1057. Accumulating evidence indicates, however, that probes that depend on the 210 Alcohol Abuse development of abnormalities of liver function lack the specificity required of a test that, in principle, should do no more than reflect a dose-time record of alcohol consumption. See Morgan, M. Y., et al, 1977, Ratio of plasma a-amino-n-butyric acid to leucine as an empirical marker of alcoholism: Diagnostic value, Science, 197: 1183; Eriksson, S., et al, 1979, Plasma a-amino-n-butyric acid/leucine ratio in alcoholism, N. Eng. J. Med. 300L 93; Kristensson, H., et al, 1977, Serum glutamyl-transferase in alcoholism, Lancet, 1: 609; and Whitehead, T. P., et al, 1978, Biochemical and hematological markers of alcohol intake, Lancet, 1: 978. Web site: http://www.delphion.com/details?pn=US04463098__ · Hormone and growth factor phosphoglycokine mimetics from mycobacterium Inventor(s): Caro; Hugo N. (London, GB), Rademacher; Thomas W. (London, GB), Rook; Graham A. W. (London, GB) Assignee(s): University College of London (London, GB) Patent Number: 6,106,822 Date filed: February 2, 1998 Abstract: A hormone or growth factor mimetic second messenger is derived from a microorganism of the genus Mycobacterium, suitably M. vaccae. The mimetic second messenger may mimic the action of insulin, ACTH, NGF, EGF, FGF, TGF.beta. or HGF. Further, methods of treating type I or type II diabetes mellitus, polycystic ovary syndrome, central nervous system damage, hepatic damage, alcohol abuse, drug sensitivity, tissue damage, adrenal atrophy, etc., are also disclosed. The methods are carried out by administering the mimetic second messenger to a patient in need thereof. Excerpt(s): The present invention relates to second messengers which mimic the action of insulin and other mammalian growth factors and hormones. Non insulin-dependent diabetes mellitus is one of the most common metabolic disorders in the industrial world. Associated with the disorder are dyslipidemias, atherosclerosis, hypertension, cardiovascular disorders and renal dysfunction. Obesity constitutes the greatest risk factor for the disease. Two physiological defects that lead to the development of diabetes are tissue resistance to the effects of insulin and altered secretion of insulin. (i) substitute for insulin either as a parenteral or oral treatment in patients with diabetes where the primary pathology relates either to decreased synthesis (type I diabetes) or lack of bioavailable insulin (defects in conversion of proinsulin to insulin or in the formation of anti-insulin antibodies). Web site: http://www.delphion.com/details?pn=US06106822__ · Identification of individuals predisposed toward alcohol abuse Inventor(s): Tabakoff; Boris (2952 S. Haven Dr., Annapolis, MD 21401) Assignee(s): none reported Patent Number: 4,770,996 Date filed: June 12, 1986 Abstract: A method and an assay for ascertaining individuals likely to be predisposed to alcohol abuse is disclosed. The contemplated method ascertains the relative adenylate cyclase and monoamine oxidase activities of blood platelets and includes the steps of Patents 211 isolating platelets from the blood of an individual, assaying the isolated platelets for adenylate cyclase and monoamine oxidase activities, and comparing the observed activities. Excerpt(s): The present invention relates to clinical assays and in particular to assays related to identification of individuals predisposed toward alcoholism. One of the major means of reducing the damage due to a pathologic process is early intervention. In this regard, diagnostic tools would have considerable value to the physician. The development of a diagnostic criterion to identify individuals at risk for becoming alcoholic is currently based upon the clear demonstration that genetic factors are important to the development of alcohol-related problems in a significant portion of the alcoholic population, Schuckit, in Medical and Social Aspects of Alcohol Abuse, B. Tabakoff et al., (eds.), p. 31, Plenum Press, N.Y. (1983). Thus, gene products which predispose an individual to alcohol-related problems, or closely linked gene products, could be used as "markers" to identify individuals potentially at risk for developing alcohol-related health and social problems. Early identification of "predisposed" individuals could allow primary intervention and prevention efforts to be instituted. Although substantial work has been directed at exploring biochemical or physiological candidates for "markers," the quest is far from complete. Such studies have included examination of blood groups, Hill et al., J. Stud. Alc. 36:981 (1972), color blindness, Cruze-Coke et al., Lancet 2:1281 (1966), and enzymes related to the metabolism of ethanol, Agarwal et al., Pharmacol. Biochem. Behav. 18(Suppl. 1):89 (1983). These approaches have not proved to be successful. More recently, Schuchkit, Pharmacol. Biochem. Behav. 13(Supp. 1):9 (1980), has reported that sons of alcoholics ("family history-positive" individuals) generate, ethanol-derived blood acetaldehyde levels twice those generated by matched family history-negative individuals. Since these studies have been criticized with regard to methods employed for measurement of acetaldehyde, Eriksson, Science 207:1383 (1980), the utility of this measure must await the resolution of this controversy. Also, Von Knorring et al., Acta Psychiatrica Scandinavia 72:51 (1985) have suggested that platelet monoamine oxidase activity measures could be of value in identifying particular subgroups of alcoholics. However, examination of the presented data casts doubt that monoamine oxidase activity, in and of itself, is a distinguishing parameter for identifying individuals predisposed to alcoholism. Web site: http://www.delphion.com/details?pn=US04770996__ · Immunoassay for identifying alcoholics and monitoring alcohol consumption Inventor(s): Makhlouf; Samar (Chicago, IL), Bean; Pamela (Los Angeles, CA), Anderson; Byron E. (Norton Grove, IL), Pankow; Mark L. (Chicago, IL) Assignee(s): Immtech International, Inc. (Evanston, IL), Northwestern Univeristy (Evanston, IL) Patent Number: 5,702,904 Date filed: July 8, 1994 Abstract: The invention provides an antibody which reacts selectively with a transferrin homolog found in alcoholics but not in non-alcoholics. The invention also provides methods of making the antibody and hybridomas producing the antibody. Finally, the invention provides an immunoassay which utilizes the antibody to detect or quantitate the alcoholic transferrin homolog and a kit for an immunoassay which comprises a container of the antibody. 212 Alcohol Abuse Excerpt(s): The invention relates to an immunoassay useful for identifying alcoholics and monitoring alcohol consumption. In particular, the invention relates to the detection and quantitation of transferrin homologs found in alcoholics but not found in nonalcoholics. The magnitude of alcohol-related problems in the United States alone is enormous. Currently, over 200,000 deaths per year (1 of every 10 deaths) are attributable to alcoholism, and 20% of our total medical expenditures for hospital care are alcoholrelated (West, L. T., Maxwell, D. S., Noble, E. P. and Solomon, D. H., Ann. Int. Med., 100, 405-416, 1984). In the United States, the annual cost of lost productivity and health care expenses related to alcoholism is estimated to be $117 billion (Sixth Special Report to Congress on Alcohol and Health, Rockville, Md., Dept. Health and Human Services, NIAAA, 1987:21-23. (DHHS Publication No. ADM 87-1519)). Approximately 18 million Americans are considered to be alcohol dependent. Current tests used to diagnose alcoholism are not specific for the condition. Hence, multiple tests are performed and evaluated to arrive at a diagnosis of alcoholism. Severity indices based on multiple tests are used to monitor treatment of alcohol-related liver disease (Blake, J. and Orrego, H., Clin. Chem., 37, 5-13, 1991). In alcoholism, the serum gamma-glutamyl transferase is often elevated (Rollason, J., Pincherly, G. and Robinson, D., Clin. Chim. Acta, 39, 75-80, 1972; Rosalki, S. and Rau, D., Clin. Chim. Acta, 39, 41-47, 1972). Elevations also have been observed in alpha-lipoprotein (Johansson, B. and Medhus, A., Acta Med. Scand., 195, 273-277, 1974) and serum iron (Hillman, R., Ann. N.Y. Acad. Sci., 252, 297-306, 1975; Herbert, V. and Tisman, G., Ann. N.Y. Acad. Sci., 252, 307-315, 1975). Because alcoholics often have various forms of anemias and blood clotting disorders, other abnormal laboratory results may include elevated prothrombin time and thrombocytopenia (Gitlow, S. and Peyser, H. S. in "Alcoholism, A Practical Treatment Guide," Grune and Stratton, Inc., Philadelphia, Pa. p.218, 1988). Blake and Orrego recently discussed the various indices of prognostic significance to the treatment of alcohol-related liver disease and concluded that functional variables (mainly blood tests) are more important than histological abnormalities (Blake, J. and Orrego, H., Clin. Chem., 37, 5-13, 1991). Regardless, a high level of clinical expertise is necessary in evaluating clinical data from alcoholic patients. Web site: http://www.delphion.com/details?pn=US05702904__ · Injectable fomulations of disulfiram for the treatment of alcoholism Inventor(s): Phillips; Michael (1740 Hinman Ave., Apt. 3B, Evanston, IL 60201) Assignee(s): none reported Patent Number: 4,678,809 Date filed: February 1, 1985 Abstract: The disclosure is of the use of an injectable formulation of disulfiram for the treatment of alcoholism. One formulation comprises disulfiram and a biodegradable polymer. Another formulation comprises a slurry of disulfiram in normal saline. After injection, disulfiram is released from the injection site in a sustained-release manner. Excerpt(s): The present invention concerns an improved injectable formulation of the drug disulfiram, for use in the treatment of alcoholism. Disulfiram (DSF) is a drug widely used in the treatment of alcoholism. Anyone who consumes ethyl alcohol after pretreatment with DSF (taken orally) will experience the subjectively unpleasant Disulfiram-Ethanol Reaction (DER) characterized by nausea, palpitations, flushing, hyperventilation and hypotension. In theory, treatment of an alcoholic patient with DSF should discourage a relapse into impulsive drinking. In practice, DSF therapy often ends Patents 213 in failure when the patient stops taking the drug and resumes drinking after the effects have worn off. An alternative approach, parenteral therapy with subcutaneous implants of sterile DSF tablets has been widely practiced for many years but it is now clear that these implants are inactive placebos which can not elicit a true DER in alcoholic humans. Alcoholics implanted with DSF tablets do not experience a DER after drinking alcohol, nor do they drink significantly less alcohol than those implanted with an inactive placebo. These failures of therapy are probably due to subtherapeutic dosage as well as the poor bioavailability of DSF tablets in the subcutaneous milieu where they often become encapsulated by fibrotic tissue. The following references describe relevant prior art methods: Bergstrom et al., Lancet 1:49-50, 1982; Kline and Kingstone, Can Med Assoc. J. 116:1382-1383, 1977; Lewis et al., Can Psychiatr. Assoc J. 20:283-286, 1975. Detoxification of an alcoholic induces a remission of the disease which may be followed by an acute relapse into abusive drinking at any time; treatment with an effective sustained-release formulation of DSF is likely to prolong the duration of the initial remission and lengthen the period between subsequent relapses. Web site: http://www.delphion.com/details?pn=US04678809__ · Marker for individuals susceptible to alcoholism Inventor(s): Park; David (New York, NY), Ricketts; Michael (Somerset, NJ), Poretz; Ronald D. (Marlboro, NJ), Manowitz; Paul (East Brunswick, NJ) Assignee(s): Algene LLC (East Brunswick, NJ) Patent Number: 5,736,325 Date filed: August 31, 1994 Abstract: The present invention relates to methods for diagnosis of susceptibility to alcoholism or the pathological effects of alcoholism based on detection of a genetic marker in an individual. The present invention is directed generally to methods and associated compositions and kits for detecting the presence of arylsulfatase A (ASA) pseudodeficiency (PD) mutations in humans. Detection of these mutations has been surprisingly found to be a strong indicator for susceptibility to alcoholism and/or susceptibility to alcohol's pathological effects, as well as an important marker in evaluating the likelihood of metachromatic leukodystrophy (MLD). Excerpt(s): The present invention relates to methods for diagnosis of susceptibility to alcoholism or the pathological effects of alcoholism based on detection of a genetic marker in an individual. A large number of adoption and twin studies indicate that there is a genetic factor or factors to at least some forms of alcoholism (Goodwin, 1979, Arch. Gen. Psychiatry 36:57-61). However, to date, the only genetic factor that has been clearly identified in alcoholism is a deficiency in aldehyde dehydrogenase activity. This deficiency leads to a reduction, not an increase, in the rate of alcoholism. Earlier studies showed that arylsulfatase A (ASA) electrophoresed in native polyacrylamide gels and stained for enzymatic activity exhibited a variety of electrophoretic patterns, some of which were more likely to be found in alcoholic patients than in non-alcoholic psychiatric and normal control subjects (Hulyalkar et al., 1984, Alcoh.: Clin. Exp. Res. 8:337-341). However, lacking any biochemical explanation for these observations, no correlation with a genetic basis or marker for alcoholism was possible. Web site: http://www.delphion.com/details?pn=US05736325__ 214 Alcohol Abuse · Method and means for treating alcoholism by extinguishing the alcohol-drinking response using a transdermally administered opiate antagonist Inventor(s): Sinclair; John D. (Espoo, FI) Assignee(s): Alko Ltd. (Helsinki, FI) Patent Number: 5,096,715 Date filed: November 20, 1989 Abstract: A method for treating alcoholism by extinguishing the alcohol-drinking response in which an opiate antagonist is transdermally administered to a subject and a device for transdermally administering the antagonist. The device is a package containing a fixed dose of opiate antagonist, a vehicle and a permeation enhancer. Excerpt(s): This invention relates to the treatment of alcoholism and particularly to an extinction method of treating alcoholism using a transdermally administered opiate antagonist. The invention also relates to a device for the rapid, transdermal administration or delivery of a fixed dose of the opiate antagonist. A method for treating alcoholism by extinguishing the alcohol-drinking response is described in copending United States patent application Ser. No. 205,758, the disclosure of which is incorporated herein in its entirety by reference. In this extinction method, an opiate antagonist is administered to a subject suffering from alcoholism in a daily dosage sufficient to block the stimulatory effect of alcohol and, while the amount of antagonist in the subject's body is sufficient to block the stimulatory effect of alcohol, the subject is made to drink an alcoholic beverage. The steps of administration of the opiate antagonist and drinking of an alcoholic beverage are continued until the alcohol-drinking response is extinguished. Existing methods for administering opiate antagonists, however, are inadequate for use in the extinction of the alcohol-drinking response. Web site: http://www.delphion.com/details?pn=US05096715__ · Method for determining the consumption rate of alcohol by a human subject Inventor(s): Harasymiw; James W (1272 Balmoral Ct., Brookfield, WI 53005) Assignee(s): none reported Patent Number: 5,126,271 Date filed: July 16, 1991 Abstract: An improved method for determining the approximate consumption rate of alcohol by a human subject includes the steps of using are blood sample from such subject to develop a subject serum panel. Such serum panel includes at least twelve constituents, preferably more. Two of the constituents are HDL and magnesium. The subject blood serum panel is then statistically compared with a reference panel providing categories of rates of alcohol consumption such as light-to-moderate, moderate-to-heavy and very heavy. The reference panel also includes HDL and magnesium as constituents. That category of alcohol consumption which best characterizes such subject is then identified, thereby diagnosing the approximate alcohol consumption rate and, therefore, the presence or absence of probable alcohol abuse. Selenium, copper and/or zinc may also be included as constituents. Reference and subject panels may also be developed to include considerations of gender and ranges of age. Patents 215 Excerpt(s): This invention is related generally to methods for making medical diagnoses and, more particularly, to a method for diagnosing alcoholism. Alcoholism is a serious human health issue and it has been predicted that it will affect about 16% of the population. Mortality rates among alcoholics are two to three times the rate for the general population and it has been suggested that it is one of the leading preventable causes of death, injury, illness and impaired functioning. In 1987, the National Institute on Alcoholism and Alcohol Abuse cited reports estimating the total societal costs for alcoholism in 1983 of about $116 billion dollars. There are four known, major techniques for diagnosing alcoholism or excessive drinking. One of these involves the examination of blood serum variables and the remaining three involve psychological assessment. Web site: http://www.delphion.com/details?pn=US05126271__ · Method for the inhibition of ALDH-I useful in the treatment of alcohol dependence or alcohol abuse Inventor(s): Keung; Wing-Ming (Wayland, MA), Vallee; Bert L. (Brookline, MA), Keung; Wing-Ming (Wayland, MA), Vallee; Bert L. (Brookline, MA) Assignee(s): The Endowment for Research in Human Biology, Inc. (Cambridge, MA), The Endowment for Research in Human Biology, Inc. (Cambridge, MA) Patent Number: 6,255,497 Date filed: November 12, 1998 Abstract: Methods and compounds for inhibiting aldehyde dehydrogenase are disclosed. The compounds are useful as pharmaceutical compositions in methods for therapeutically treating alcohol consumption in a human. Excerpt(s): Alcohol abuse and alcohol dependence (i.e., alcoholism) are serious public health problems of modern society. In the United States alone, an estimated 13 million adults exhibit symptoms of alcohol dependence due to excessive alcohol intake, and an additional 7 million abuse alcohol without shoving symptoms of dependence according to U.S. Government projections from studies conducted in the mid-1980s. Alcohol dependence and abuse are very expensive: in economic and medical terms, it will cost the U.S. well over $200 billion in 1991 with no prospect of falling or leveling off. The social and psychological damages inflicted on individuals as a consquence of alcohol abuse, e.g., children born with fetal alcohol syndrome (FAS) and victims of alcoholrelated accidental death, homicide, suicide, etc., are immense. Alcohol abuse and alcohol dependence (i.e., alcoholism) are serious public health problems of modern society. In the United States alone, an estimated 13 million adults exhibit symptoms of alcohol dependence due to excessive alcohol intake, and an additional 7 million abuse alcohol without shoving symptoms of dependence according to U.S. Government projections from studies conducted in the mid-1980s. Alcohol dependence and abuse are very expensive: in economic and medical terms, it will cost the U.S. well over $200 billion in 1991 with no prospect of falling or leveling off. The social and psychological damages inflicted on individuals as a consquence of alcohol abuse, e.g., children born with fetal alcohol syndrome (FAS) and victims of alcohol-related accidental death, homicide, suicide, etc., are immense. While it is generally accepted that alcoholism and alcohol abuse are afflictions with staggering international economic, social, medical, and psychological repercussions, success in preventing or otherwise ameliorating the consequences of these problems has been an elusive goal. Only very recently the public view that alcoholism and alcohol abuse are remediable solely by moral imperatives has been changed to include an awareness of alcoholism and alcohol abuse as physiological 216 Alcohol Abuse aberrations whose etiology may be understood and for which therapy may be found through scientific pursuits. Both alcohol abuse and dependence arise as a result of different, complex, and as yet incompletely understood processes. At present, alcohol research is in the mainstream of scientific efforts. While it is generally accepted that alcoholism and alcohol abuse are afflictions with staggering international economic, social, medical, and psychological repercussions, success in preventing or otherwise ameliorating the consequences of these problems has been an elusive goal. Only very recently the public view that alcoholism and alcohol abuse are remediable solely by moral imperatives has been changed to include an awareness of alcoholism and alcohol abuse as physiological aberrations whose etiology may be understood and for which therapy may be found through scientific pursuits. Both alcohol abuse and dependence arise as a result of different, complex, and as yet incompletely understood processes. At present, alcohol research is in the mainstream of scientific efforts. Prior to our research (for example, see Blair and Vallee, 1966, Biochemistry 5: 2026-2034), ADH in man was thought to exist in but one or two forms, primarily in the liver, where it was considered the exclusive enzyme for the metabolism of ethanol. Currently, four different classes of ADH encompassing over twenty ADH isozymes have been identified and isolated from human tissues. There is no reason to believe that all of these ADH isozymes are necessary to catalyze the metabolism of a single molecule, ethanol, even though all of them can interact with it. We have proposed that the normal function of these isozymes is to metabolize other types of alcohols that participate in critical, physiologically important processes, and that ethanol interferes with their function (Vallee, 1966, Therapeutic Notes 14: 71-74). Further, we predicted that individual differences in alcohol tolerance might well be based on both qualitative and quantitative differences in isozyme endowment (Vallee, 1966, supra). Prior to our research (for example, see Blair and Vallee, 1966, Biochemistry 5: 2026-2034), ADH in man was thought to exist in but one or two forms, primarily in the liver, where it was considered the exclusive enzyme for the metabolism of ethanol. Currently, four different classes of ADH encompassing over twenty ADH isozymes have been identified and isolated from human tissues. There is no reason to believe that all of these ADH isozymes are necessary to catalyze the metabolism of a single molecule, ethanol, even though all of them can interact with it. We have proposed that the normal function of these isozymes is to metabolize other types of alcohols that participate in critical, physiologically important processes, and that ethanol interferes with their function (Vallee, 1966, Therapeutic Notes 14: 71-74). Further, we predicted that individual differences in alcohol tolerance might well be based on both qualitative and quantitative differences in isozyme endowment (Vallee, 1966, supra). Web site: http://www.delphion.com/details?pn=US06255497__ · Method for the inhibition of ALDH-I useful in the treatment of alcohol dependence or alcohol abuse Inventor(s): Keung; Wing-Ming (Wayland, MA), Vallee; Bert L. (Brookline, MA), Keung; Wing-Ming (Wayland, MA), Vallee; Bert L. (Brookline, MA) Assignee(s): The Endowment for Research in Human Biology, Inc. (Cambridge, MA), The Endowment for Research in Human Biology, Inc. (Cambridge, MA) Patent Number: 6,255,497 Date filed: November 12, 1998 Patents 217 Abstract: Methods and compounds for inhibiting aldehyde dehydrogenase are disclosed. The compounds are useful as pharmaceutical compositions in methods for therapeutically treating alcohol consumption in a human. Excerpt(s): Alcohol abuse and alcohol dependence (i.e., alcoholism) are serious public health problems of modern society. In the United States alone, an estimated 13 million adults exhibit symptoms of alcohol dependence due to excessive alcohol intake, and an additional 7 million abuse alcohol without shoving symptoms of dependence according to U.S. Government projections from studies conducted in the mid-1980s. Alcohol dependence and abuse are very expensive: in economic and medical terms, it will cost the U.S. well over $200 billion in 1991 with no prospect of falling or leveling off. The social and psychological damages inflicted on individuals as a consquence of alcohol abuse, e.g., children born with fetal alcohol syndrome (FAS) and victims of alcoholrelated accidental death, homicide, suicide, etc., are immense. Alcohol abuse and alcohol dependence (i.e., alcoholism) are serious public health problems of modern society. In the United States alone, an estimated 13 million adults exhibit symptoms of alcohol dependence due to excessive alcohol intake, and an additional 7 million abuse alcohol without shoving symptoms of dependence according to U.S. Government projections from studies conducted in the mid-1980s. Alcohol dependence and abuse are very expensive: in economic and medical terms, it will cost the U.S. well over $200 billion in 1991 with no prospect of falling or leveling off. The social and psychological damages inflicted on individuals as a consquence of alcohol abuse, e.g., children born with fetal alcohol syndrome (FAS) and victims of alcohol-related accidental death, homicide, suicide, etc., are immense. While it is generally accepted that alcoholism and alcohol abuse are afflictions with staggering international economic, social, medical, and psychological repercussions, success in preventing or otherwise ameliorating the consequences of these problems has been an elusive goal. Only very recently the public view that alcoholism and alcohol abuse are remediable solely by moral imperatives has been changed to include an awareness of alcoholism and alcohol abuse as physiological aberrations whose etiology may be understood and for which therapy may be found through scientific pursuits. Both alcohol abuse and dependence arise as a result of different, complex, and as yet incompletely understood processes. At present, alcohol research is in the mainstream of scientific efforts. While it is generally accepted that alcoholism and alcohol abuse are afflictions with staggering international economic, social, medical, and psychological repercussions, success in preventing or otherwise ameliorating the consequences of these problems has been an elusive goal. Only very recently the public view that alcoholism and alcohol abuse are remediable solely by moral imperatives has been changed to include an awareness of alcoholism and alcohol abuse as physiological aberrations whose etiology may be understood and for which therapy may be found through scientific pursuits. Both alcohol abuse and dependence arise as a result of different, complex, and as yet incompletely understood processes. At present, alcohol research is in the mainstream of scientific efforts. Prior to our research (for example, see Blair and Vallee, 1966, Biochemistry 5: 2026-2034), ADH in man was thought to exist in but one or two forms, primarily in the liver, where it was considered the exclusive enzyme for the metabolism of ethanol. Currently, four different classes of ADH encompassing over twenty ADH isozymes have been identified and isolated from human tissues. There is no reason to believe that all of these ADH isozymes are necessary to catalyze the metabolism of a single molecule, ethanol, even though all of them can interact with it. We have proposed that the normal function of these isozymes is to metabolize other types of alcohols that participate in critical, physiologically important processes, and that ethanol interferes with their function (Vallee, 1966, Therapeutic Notes 14: 71-74). Further, we predicted that individual differences in 218 Alcohol Abuse alcohol tolerance might well be based on both qualitative and quantitative differences in isozyme endowment (Vallee, 1966, supra). Prior to our research (for example, see Blair and Vallee, 1966, Biochemistry 5: 2026-2034), ADH in man was thought to exist in but one or two forms, primarily in the liver, where it was considered the exclusive enzyme for the metabolism of ethanol. Currently, four different classes of ADH encompassing over twenty ADH isozymes have been identified and isolated from human tissues. There is no reason to believe that all of these ADH isozymes are necessary to catalyze the metabolism of a single molecule, ethanol, even though all of them can interact with it. We have proposed that the normal function of these isozymes is to metabolize other types of alcohols that participate in critical, physiologically important processes, and that ethanol interferes with their function (Vallee, 1966, Therapeutic Notes 14: 71-74). Further, we predicted that individual differences in alcohol tolerance might well be based on both qualitative and quantitative differences in isozyme endowment (Vallee, 1966, supra). Web site: http://www.delphion.com/details?pn=US06255497__ · Method for treating alcohol abuse and alcoholism Inventor(s): Reid; Larry D. (65 23rd St., Troy, NY 12180) Assignee(s): none reported Patent Number: 5,366,990 Date filed: November 14, 1991 Abstract: A method for decreasing appetite for alcohol in humans which comprises the steps of providing an effective dosage of an alpha-2-adrenergic antagonist to the subject. Excerpt(s): Alcohol abuse and alcoholism and their consequences are considered by many Nations to be their most serious health problem. Proven methods for treating and preventing alcohol abuse and alcoholism have not been found to date. Any treatment method which ameliorated the effects of alcohol abuse and/or alcoholism would be beneficial. Attempts have been made to develop pharmaceutical agents to treat alcohol abuse and alcoholism. For instance, the approach of using an agent which would cause nausea upon the event of alcohol consumption has been discussed and attempted. These agents, however, have not been shown to be clinically effective in well-controlled clinical trials. Another approach has been premised on the notion that alcohol abuse and alcoholism are manifestations of anxiety and/or depression and have attempted to treat alcohol abuse or alcoholism with pharmocotherapies used in treating severe anxiety and/or depression. Generally, these treatments, and particularly antianxiety medications, have not been found to be clinically effective in well-controlled clinical trials. Web site: http://www.delphion.com/details?pn=US05366990__ · Method for treating alcohol intoxication and alcohol abuse Inventor(s): Lee; David (Cambridge, MA), Lukas; Scott (Boxborough, MA) Assignee(s): McLean Hospital (Belmont, MA) Patent Number: 6,465,436 Date filed: May 31, 2001 Patents 219 Abstract: Treatment for alcohol dependence or intoxication that involves administering a pharmaceutical composition containing an extract of the kudzu plant, Pueraria lobata. Excerpt(s): The present invention relates to methods of treating alcohol intoxication and alcohol abuse with an extract from the Kudzu plant, Puararia lobata. Ethyl alcohol is the most widely used psychoactive drug in the world. Alcohol abuse and alcohol related diseases represent a serious threat to human health and pose major medical, social, and economic problems. In the United States alone, an estimated 10% of the population is affected by alcoholism. The problems associated with alcohol abuse are very costly, both to the individuals affected and to society at large. The physical, social and psychological harm which can result from alcohol abuse and dependence, such as fetal alcohol syndrome, cirrhosis of the liver, alcohol-related accidental death, homicide, suicide, etc., can be devastating. Thus, there remains a strong need to develop safe and effective therapeutic agents for treating alcohol abuse and dependence. As public awareness of the problems associated with alcohol abuse has increased in recent years, greater efforts have been devoted to the development of treatments for alcoholism. Much of the current research in this area has focused on methods for treating the effects of alcohol withdrawal through the clinical use of various drugs, such as benzodiazepines and the antidipsotropic agent disulfuram (ANTABUSE.TM.). Recent research has also led to the development of new therapeutic agents which suppress alcohol drinking in humans. For instance, dopamine agonists and antagonists, serotonergic agents, glutamate antagonists, opiate antagonists, ALDH inhibitors, and calcium blockers have been reported to reduce self administration of alcohol in alcoholic humans and alcoholpreferring rats (Banys, 1988; Lawrin et al., 1986; McBride et al., 1989; Naranjo et al., 1990; Rezvani et al., 1990, 1991; Sellers et al., 1992). Also, naltrexone (REVIA.TM.), an opioid receptor antagonist, when combined with psychotherapy, has shown encouraging results in several clinical trials (Berg et al., 1990; O'Malley et al., 1992a,b; Volpicelli et al., 1990, 1992). Unfortunately, many of these current drug treatments are toxic, exhibit low efficacy and patient compliance, have many adverse side effect, and are unsuitable for use with adolescents and pregnant women. Thus, despite these recent advancements, developing effective treatments for alcohol dependence remains a challenging goal. Web site: http://www.delphion.com/details?pn=US06465436__ · Method for treating alcoholism and eliminating and preventing alcohol intoxication Inventor(s): Revici; Emanuel (1111 Park Ave., New York, NY 10028) Assignee(s): none reported Patent Number: 4,368,206 Date filed: December 21, 1979 Abstract: The invention relates to a method of treating alcoholism and for aiding in controlling alcohol intoxication in humans by the internal administration of a composition produced by heating certain allylically unsaturated compounds sufficient to substantially increase the peroxide titer. The incorporation of sulfur in the composition during the heating has been found to be particularly advantageous. Excerpt(s): There has been much recent interest in the study of alcoholism involving biological, psychological, and sociological investigations. Publications such as the various "Proceedings of the. Annual Alcoholism Conference" and "Recent Advances in Studies of Alcoholism", obtainable from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402, indicate the rather intensive 220 Alcohol Abuse scientific investigations in this area. Some of these studies are concerned with the effect on a host produced by certain chemicals in combination with alcohol. An article by E. B. Truitt and M. J. Walsh appearing at p. 100 et sequa of "Proceedings of the First Annual Alcoholism Conference of the National Institute on Alcohol Abuse and Alcoholism", DHEW Publication No. (NIH) 74-675 (1973) discloses a number of chemicals and drugs which have been reported to have anti-alcohol effects. Included in this list are disulfiram (tetraethylthiuram disulfide--see also U.S. Pat. No. 2,567,814 Jacobsen et al), calcium carbimide (see also U.S. Pat. No. 2,998,350 de Grunigen et al), and thiocyanates which are used specifically for their anti-alcohol properties. U.S. Pat. No. 3,860,719 Marshall discloses the use of 2-[(3,4-dichlorophenoxy)methyl]-2-imidazoline hydrochloride (fenmetozole HCl) for combating ethanol intoxication in mammals. Web site: http://www.delphion.com/details?pn=US04368206__ · Method for treating alcoholism with nalmefene Inventor(s): Sinclair; John D. (Espoo, FI), Scheinin; Harry (Piispanristi, FI), Lammintausta; Risto (Turku, FI) Assignee(s): Alko Ltd. (Helsinki, FI), Orion-Yhtyma Oy (Espoo, FI) Patent Number: 5,086,058 Date filed: June 4, 1990 Abstract: A method for treating alcoholism. The alcohol-drinking response of alcoholics is extinguished by having them drink alcoholic beverages while nalmefene, an opiate antagonist, blocks the positive reinforcement effect of ethanol in the brain. Excerpt(s): The present invention relates to a treatment for alcohol abuse in which the alcohol-drinking response is extinguished over a limited number of sessions by being emitted while reinforcement from alcohol is blocked with nalmefene. U.S. Pat. No. 4,882,335 discloses a method for treating alcoholism in which the learned response of alcohol drinking is extinguished by being emitted while the reinforcement from alcohol in the brain is blocked with an opiate antagonist. The antagonists disclosed for use in the method described in U.S. Pat. No. 4,882,335, however, have various disadvantages. Of the antagonists specifically disclosed, i.e., naloxone, naltrexone, cycloazocine, diprenorphine, etazocine, levalorphan, metazocine, nalorphine and salts thereof, only naloxone and naltrexone are approved for general use. Naloxone cannot be taken orally. Naltrexone can be taken orally but because of a high first-pass metabolism, its oral availability is only 5%. Variability in first-pass metabolism also makes oral dosing with naltrexone less predictable than desired. Web site: http://www.delphion.com/details?pn=US05086058__ · Method for treating patients suffering from anxiety neurosis and anxietylike neurosis, and alcoholism Inventor(s): Pepplinkhuizen; Lolke (Rotterdam, NL), Bruinvels; Jacques (DE Bilt, NL) Assignee(s): Erasmus Universiteit Rotterdam (Rotterdam, NL) Patent Number: 4,156,013 Date filed: June 9, 1978 Abstract: Patients suffering from anxiety neurosis and anxietylike neurosis often accompanied by alcoholism are treated by administration of medicine containing Patents 221 a.beta.-(p-halogen phenyl)-.GAMMA.-aminobutyric acid as active compound. As a result these patients were totally freed from the above mentioned complaints. Excerpt(s): The invention relates to a process for the preparation of a medicine having anti-anxiety neurosis and anti-anxietylike neurosis activity and to a medicine having such activity. From clinical trials it appeared that patients having anxiety neurosis, as defined by Woodruff, R. A., Goodwin, D. W. and Guze, S. B. and Wheeler, E. O., White, P. D., Reed, E. W. and Cohen, M. E., did not show any amelioration upon administration of known anxiolytics. The symptoms of anxiety neurosis, as defined by Woodruff and Wheeler, are in decreasing significancy: palpitation, tires easily, breathlessness, nervousness, chest pain, sighing, dizziness, faintness, apprehensiveness, headache, paresthesias, weakness, trembling, breath unsatisfactory, insomnia, unhappiness, shakiness, fatigued all the time, sweating, fear of death, smothering, syncope, urinary frequency, vomiting and diarrhea and anorexia. Web site: http://www.delphion.com/details?pn=US04156013__ · Method for treatment of alcohol abuse Inventor(s): Shrotryia; Rajesh (Woodbridge, CT), Casten; George P. (Evansville, IN) Assignee(s): Bristol-Myers Company (New York, NY) Patent Number: 4,777,173 Date filed: March 25, 1987 Abstract: Buspirone and its pharmaceutically acceptable salts are useful in the treatment of alcohol abuse. Excerpt(s): This invention is concerned with a drug bioaffecting body-treating process which employs the pyrimidine compound 8-[4-[4-(2-pyrimidinyl)-1-piperazinyl]butyl]8-azaspiro [4.5]decane-7,9-dione or a pharmaceutically acceptable acid addition salt thereof. The synthesis of the compound and the disclosure of its psychotropic properties are described in the following patents and publications. 1. Y. H. Wu, et al., J. Med. Chem., 15.477 (1972). Web site: http://www.delphion.com/details?pn=US04777173__ · Method of employing therapeutic composition comprising ammonium or substituted ammonium compounds for treatment of alcoholism Inventor(s): Revici; Emanuel (New York, NY) Assignee(s): The Vinoxen Company (New York, NY) Patent Number: 4,346,082 Date filed: February 27, 1981 Abstract: This invention relates to a method of treating alcoholism and for eliminating, reducing or preventing alcohol intoxication or the manifestations of alcohol intoxication in humans by administering thereto a therapeutic composition comprising an ammonium compound or compounds, said compounds and each of said compounds having a pH greater than 5.0 when in aqueous solution at a concentration of 5 grams per 100 grams of solution (5 weight percent), and particularly ammonium salt compounds containing ammonium cations and sulfur anions. 222 Alcohol Abuse Excerpt(s): Various pharmaceutical uses of ammonium compounds have long been recognized. For example, the following ammonium compounds (as listed in Hackh's Chemical Dictionary, 4th Ed. McGraw-Hill, New York pages 37-40) have the following medicinal uses as indicated therein. Ammonium acetate is used as an antipyretic and diaphoretic antidote in formaldehyde poisoning; ammonium benzoate has been used as an antipyretic, diuretic and alternative; ammonium bromide is used to treat neuralgia; ammonium carbamate is used as a stimulant; ammonium carbonate carbamate (Hartshorn salt) is used as a heart stimulant; ammonium chloride is used as an expectorant, stimulant diuretic or disphoretic, as well as externally; ammonium formate is used as an antiseptic; ammonium hypophosphite is a nerve tonic; ammonium thiosulfate can be used as an antiseptic, ammonium iodide is used to treat syphilis and leprosy; ammonium persulfate is used as a disinfectant; ammonium phosphate can be used as an antirheumatic; ammonium salicylate is used as an antirheumatic, antipyretic, expectorant, and bactericide; and ammonium valerate is a hypnotic, sedative, and tonic. Ammonium thiosulfate has long been a standard industrial commodity, and U.S. Pat. No. 3,350,168 to Ziegler indicates that U.S. consumption of ammonium thiosulfate totaled 30,000 tons per year at the time of such patent. U.S. Pat. No. 3,890,428 to Jayawant and U.S. Pat. No. 3,973,793 to Netzger et al. indicates that ammonium thiosulfate has long been employed as a photographic fixer. A publication entitled "Testing for a `Sobering Pill`," DOT HS-801 208 (1974), available from National Technical Information Service, Springfield, Va. 22151, discloses that a number of compounds, including ammonium chloride, were investigated to determine their potential for blocking or neutralizing the effect of alcohol on a human brain. While the most effective amethystic agent (a preventive antidote of drunkenness) found was L-dopa, with respect to ammonium chloride, which has a relatively low molar pH in aqueous solution, the publication concludes that ammonium chloride does not appear to act as an amethystic agent. None of the reference teaches the use of the compositions of the present invention as a treatment for alcoholism or eliminating and preventing alcohol intoxication or the manifestations of alcohol intoxication. Web site: http://www.delphion.com/details?pn=US04346082__ · Method of preparing and using isoflavones for the treatment of alcoholism Inventor(s): Gugger; Eric (Latham, IL), Empie; Mark (Forsyth, IL) Assignee(s): Archer Daniels Midland Company (Decatur, IL) Patent Number: 6,399,072 Date filed: July 13, 2000 Abstract: A composition is prepared by extracting phytochemicals from plant matter for treatment of alcohol dependency. This composition is enriched preferably with two or more fractions of plant matter, namely: isoflavones, lignans, saponins, sapogenins, catechins and phenolic acids. Soy is the preferred source of these chemicals; however, other plants may also be used, such as wheat, psyllium, rice, oats, red clover, kudzu, alfalfa, flax, and cocoa. The composition is a dietary supplement for treatment of alcoholism. The isoflavone may be any in a group including malonyl, acetyl, glucoside, and aglycone. The composition is in a concentrated form to be delivered in an easy to consume dosage, such as a pill, tablet, liquid, capsule, or a food supplement including a health bars. Excerpt(s): This invention relates to compositions extracted from vegetable matter and more particularly to phytochemicals, including saponogenins and saponins, lignans, Patents 223 phenolic acids, catechins and isoflavones, and especially those extracted from a family of plants including soy, flax, tea, and cocoa and methods of using these compositions as nutritional supplements or food additives. As used herein, the term "isoflavone" includes malonyl, acetyl, glucoside, and aglycone forms of the isoflavones. Alcoholism is, perhaps, the most widespread addiction which is responsible for more deaths than the rest of the addictive drugs combined. It is also one of the addictions which is the most difficult to overcome. It is thought that one of the more successful treatments for helping recovering alcoholics is a use of a phytochemicals, especially isoflavones, as a source of supplemental hormones. However, it is also thought that there are superior results when a plurality of such phytochemicals are consumed in combinations. Web site: http://www.delphion.com/details?pn=US06399072__ · Methods of measuring isozymes and isozyme classes of alcohol dehydrogenase Inventor(s): Vallee; Bert L. (Brookline, MA) Assignee(s): President and Fellows of Harvard College (Cambridge, MA) Patent Number: 5,162,203 Date filed: September 7, 1989 Abstract: The present invention provides fluorescence-based methods for sensitively detecting total ADH activity in human sera and selectively measuring the activity of different classes of ADH in human sera and other body fluids and tissues. The present invention also provides highly purified Class I, Class II, and Class III isozymes, and methods for their purifiation. The class of substrates consisting of various naphthaldehydes and quinoline aldehydes provide the requisite sensitivity and selectivity for measurements of the activity of ADH and individual ADH classes. These fluorescence-based methods may serve as a diagnostic aid in disease assessment, in particular, diagnosis of alcohol abuse, alcoholism, alcohol consumption, altered alcohol sensitivity or tolerance. Excerpt(s): Human alcohol dehydrogenase (ADH, EC 1.1.1.1) is the primary enzyme responsible for ethanol metabolism in humans. ADH exists as 3 classes, Class I, II, III, that can be isolated from liver and have been differentiated on the basis of their electrophoretic (Vallee et al., 1983, Isozymes: Current Topics in Biological & Medical Research pp. 219-244, Liss, New York), immunological (Montavon et al., 1989, Anal Biochem 176 48-56), catalytic (Wagner, et al, 1983, Biochemistry 22: 1857-1863; Wagner et al., 1984. Biochemistry 23: 2193-2199; Ditlow et al., 1984, Biochemistry 23: 6363-6368), and structural (Strydom et al., 1982, Anal. Biochem. 123: 422-429; Kaiser et al, 1988, Biochemistry 27: 1132-1140) differences. The ADH classes further contain isozymes, particularly Class I ADH. Class I isozymes include homodimers and heterodimers composed of.alpha.,.beta. and.gamma. subunits, for example,.alpha.beta.sub.1,.alpha.gamma.sub.1,.beta.sub.1.beta.sub.1,.beta.sub.1.gamma. 1,.beta.sub.1.gamma.2 and.sub.gamma.1.gamma.1. The occurrence of particular isozymes in some tissues is remarkably selective For example, Class III (.chi.) ADH is the only isozyme in brain and placenta and virtually the only isozyme in testis, while Class II (.eta.) has only been observed in liver homogenates. Vallee et al., 1983, supra. Since liver ADH isozymes are clearly responsible for the oxidation of most of the ethanol ingested, their involvement in the physiological and pathological consequences of human ethanol consumption is of considerable interest. The classes of ADH, as well as individual isozymes differ in their substrate and inhibitor specificities. Wagner et al , 1983, Biochemistry 22: 1857-63; Deetz et al., 1984, Biochemistry 23 6822-28; Ditlow et al., 224 Alcohol Abuse 1984, Biochemistry 23: 6863-68; Mardh et al., 1985, Proc. Natl. Acad. Sci. USA 83: 283640. For example differences in activity toward a number of aromatic alcohols and aldehydes in norepinephrine (Mardh et al., 1986, Proc. Natl. Acad Sci. USA 83: 8908-12; Mardh et al., 1985, Proc. Natl. Acad. Sci. USA, 82: 4979-4982), dopamine (Mardh et al., 1986, Biochemistry, 25: 7279-7282) and serotonin metabolism (Consalvi et al., 1986, Biochem. Biophys. Res. Commun., 139: 1009-1016) have been observed. However, these or other substrates capable of measuring ADH activity cannot differentiate among classes, isozymes, or phenotypic ADH variants of isozymes. For this reason, investigations of the function of human ADH have long been hindered by the lack of sensitive and specific assays to detect the activity of and characterize the individual forms of ADH in human body fluids and tissues. The capacity to accomplish this would advance studies of their distribution and regulation and might help to elucidate genetic factors underlying alcohol use and abuse. Vallee, 1966, Therap. Notes 73: 71-4. There is increasing evidence of a genetic predisposition to certain forms of chronic alcoholism (Bohman. 1978, Arch. Gen. Psychiat. 35: 269-276). Little is known at present regarding the genetics and distribution of the three ADH classes let alone the manner in which any differences between them might be manifested metabolically. It would clearly be advantageous if their existence, preponderance and variability could be ascertained in vivo from accessible tissues and body fluids The detection of ADH activity in such tissues or fluids has proven exceedingly difficult. Web site: http://www.delphion.com/details?pn=US05162203__ · Pharmaceutic formulation for the treatment of alcoholism Inventor(s): Opitz; Klaus (Munster, DE) Assignee(s): LTS Lohmann Therapie-Systeme GmbH + Co. KG (Neuwied, DE), HefaFrenon Arzneimittel GmbH & Co. KG (Werne, DE) Patent Number: 5,519,017 Date filed: May 5, 1994 Abstract: Galanthamine and the pharmaceutically suitable acid addition salts thereof can be used for the treatment of alcoholism; these compounds are released from adequate pharmaceutic formulations which are administered, e.g., orally, transdermally, or otherwise parenterally, in a continuous and controlled manner. Excerpt(s): The present invention relates to the use of galanthamine as well as the pharmaceutically suitable acid addition salts thereof for the treatment of alcoholism. These compounds are released in a continuous and controlled manner from adequate pharmaceutical formulations which are administered, e.g., orally, transdermally or otherwise parenterally. The present invention in particular provides pharmaceutical formulations which release suitable compounds in a controlled manner to treat alcoholism. Whereas today the acute withdrawal and the treatment of the perilous alcoholic delirium in special wards do not constitute medical problems, there is still no satisfying treatment of chronic alcoholism. About 80% of the treated alcoholics get a relapse within the term of one year. They are in need of a remedy against the alcohol desire resulting in the relapse, which remedy is reliably effective and well tolerated. Web site: http://www.delphion.com/details?pn=US05519017__ Patents 225 · Pharmaceutical composition containing desoxypeganine for the treatment of alcoholism Inventor(s): Asmussen; Bodo (Bendorf, DE), Opitz; Klaus (Munster, DE), Hoffmann; Hans-Rainer (Neuwied, DE), Hille; Thomas (Neuwied, DE) Assignee(s): LTS Lohmann Therapie-Systeme AG (Andernach, DE), He Arzneimittelforschung GmbH (Werne, DE) Patent Number: 6,627,631 Date filed: July 25, 2001 Abstract: Desoxypeganine and its pharmaceutically acceptable acid addition salts can be used in the treatment of alcoholism. Said substances are administered preferably in a continuos and controlled manner. The pharmaceutical administration form enables controlled release, e.g. for oral, transdermal or another route of parenteral administration. Excerpt(s): Deoxypeganine and its pharmaceutically acceptable acid addition salts can be used for the treatment of alcoholism. These substances are preferably administered in a continuous and controlled manner. The pharmaceutical administration form makes controlled release possible for, for example, oral, transdermal or alternatively parenteral administration. The invention relates to the use of deoxypeganine and its pharmaceutically suitable acid addition salts for the treatment of alcoholism. These compounds are released in a continuous and controlled manner from appropriate pharmaceutical formulations, which are administered, for example, orally, transdermally or otherwise parenterally. In particular, the present invention makes pharmaceutical formulations available which release suitable compounds for the treatment of alcoholism in a controlled manner. Web site: http://www.delphion.com/details?pn=US06627631__ · Prevention and treatment of alcoholism by the use of dietary chromium Inventor(s): Dobbins; John P. (615 Allen Ave., San Marino, CA 91108) Assignee(s): none reported Patent Number: 5,013,752 Date filed: April 16, 1990 Abstract: Prevention of or therapeutically curing the disease of alcoholism comprises supplementing the diet with biologically available chromium, such as naturally occurring chelated chromium. A food bar containing chromium picolinate is also disclosed. Excerpt(s): This invention relates generally to the treatment of alcoholism, and more particularly, to supplementing the diet with assimilable chelated chromium, for this purpose. The assimilation of an adequate quantity of physiologically important micronutrients is essential to the health of both humans and animals. Failure of the body to ingest and absorb the necessary amounts of essential micronutrients (e.g., vitamins and/or minerals) can lead to improper functioning of the metabolic processes as well as to a variety of diseases and associated symptoms. For example, anemia is correlated with an iron deficiency, and goiter is correlated with an iodine deficiency. Dr. Walter Merz of the Human Nutrition Laboratory in Bethesda, Md., was the first scientist to describe the occurrence and function of chromium in biological systems (Physiological 226 Alcohol Abuse Rev. 49:163, 1969). This was followed in 1970 by the proclamation of Dr. Henry A. Schroeder, Professor of Physiology Emeritus at the Darmouth Medical School, that chromium deficiency was a factor in atherosclerosis (Jour. Chronic Diseases 23:123). Regrettably, this knowledge was not then recognized, accepted, and applied to medical practice. Most recently, Gary W. Evans, PhD, and Muriel B. Gilman at Bemidji State University, Mont. 56601, have prepared a paper (for 1989 publication in one of the journals of the American Chemical Society) titled "Anabolic Effect of Chromium Picolinate". Therein they identify metabolic mechanisms showing how ingestion of naturally occurring chromium beneficially decreases LD ("bad") cholesterol and increases HD ("good") cholesterol in blood serum. They link these observations to "death from heart disease" and to treatment and prevention of diabetes. Web site: http://www.delphion.com/details?pn=US05013752__ · Safe pharmaceutical composition for treating and preventing alcohol abuse and increasing immune function Inventor(s): Liu; Yaguang (67-08 168th St., Flushing, NY 11365) Assignee(s): none reported Patent Number: 5,834,605 Date filed: July 7, 1997 Abstract: The safe pharmaceutical composition and processed are provided for treating and preventing alcohol abuse and increasing immune function. The pharmaceutical composition is composed of Puerarin derivatives, which includes Puerarin, Daidzein or Genistia. Excerpt(s): This invention relates to a safe and natural pharmaceutical composition for treating and preventing alcohol abuse and increasing immune function contains Puerarin derivatives. The processes for producing Puerarin derivatives and related pharmacological effect are provided. Alcohol abuse (alcoholism) is a major medical and public health problem in many societies. About 10% of all deaths in the United States may be directly alcohol-related. Alcohol abuse leads to increase risk especially by motor vehicle and fire and other accidents. Alcohol abuse is also leads work and family problems and associated with brain damage, cancer, heart attacks and high blood pressure. Antabuse (disulfiram) and tranquilizers are sometimes used for treating alcohol abuse. However, they are neither an instant solution to the problems of alcoholism, nor a complete therapy. Also, they have side effects. Web site: http://www.delphion.com/details?pn=US05834605__ · Use of dibenz(CD,F)indoles Inventor(s): Vigouret; Jean-Marie (Alle, CH) Assignee(s): Sandoz Ltd. (Basel, CH) Patent Number: 4,795,759 Date filed: July 23, 1986 Abstract: 4,5,5a,6-tetrahydro-dibenz[cd,f]indole derivatives having at least one oxy substitutent in one or both of the fused benzene rings, for the prevention of alcohol abuse. Patents 227 Excerpt(s): The present invention relates to a new pharmaceutical use of dibenz[cd,f]indoles. More particularly the present invention relates to a new pharmaceutical use for 4,5,5a,6-tetrahydro-dibenz[cd,f]indole derivatives having at least one oxy substituent in one or both of the fused benzene rings and pharmaceutically acceptable acid addition salts thereof, hereinafter referred to as compounds for use according to the invention. In accordance with the present invention it has now surprisingly been found that compounds for use according to the invention are useful for preventing alcohol abuse. Web site: http://www.delphion.com/details?pn=US04795759__ · Use of gamma-hydroxybutyric acid amides in the treatment of drug addiction and in particular of alcoholism Inventor(s): Loche; Antonella (Sanremo, IT), Cacciaglia; Roberto (Ospedaletti, IT), Perlini; Vincenzo (Matelica, IT), Guano; Lorenza (Sanremo, IT) Assignee(s): Laboratoric Farmaceutico C.T. S.r.l. (Sanremo, IT) Patent Number: 6,436,998 Date filed: September 2, 1999 Abstract: The present invention relates to the use of.gamma.-hydroxybutyric acid amides in the treatment of drug addiction and alcoholism, more particularly in reducing chronic alcoholics' desire for and habit of consuming alcoholic drinks and in the treatment of the syndrome of abstinence from alcohol. Excerpt(s): The present invention relates to the use of amides of.gamma.-hydroxybutyric acid, herein referred to as GHB, in the treatment of drug addiction, such as heroine, cocaine and, in particular, in the treatment of alcoholism, and more particularly in reducing chronic alcoholics desire for and habit of consuming alcoholic drinks and in the treatment of abstinence syndrome. The salts of 4-hydroxybutyric acid, e.g. the sodium salt, proved to be effective both in the treatment of the syndrome of abstinence from alcohol and in reducing the desire for and addiction to alcohol in alcoholic patients and disclosed in EP-A-344,704 and in the treatment of drug addiction, as reported in WO 93/00083. One of the advantages of said salts is that they do not cause the inconveniences of Disulfiram (Antabuse.RTM.), a drug having several untoward effects, such as for example the symptoms known as the "acetaldehyde syndrome", which may also result in fatality. The sodium salt of GHB is absorbed very quickly by the gastroenteric apparatus with a maximum concentration peak already at about 35-40 min after administration. However, it presents a half-life time of about 20-25 min, its elimination from the body being rather quick [EP-A-635,265]. Web site: http://www.delphion.com/details?pn=US06436998__ 228 Alcohol Abuse · Use of sulbutiamine in the treatment of Parkinson's disease, schizophrenia, alcoholism, and dysthymia Inventor(s): Le Ridant; Alain (Neuilly sur Seine, FR), Perret; Laurent (Paris, FR), Ollat; Helene (Nesle la Gilberde, FR) Assignee(s): Adir et Compagnie (Courbevoie, FR) Patent Number: 5,863,925 Date filed: October 3, 1997 Abstract: The invention relates to the use of sulbutiamine and pharmaceutical compositions thereof for the treatment of Parkinson's Disease, Schizophrenia, alcoholism, and dysthymia. Excerpt(s): The present invention relates to the use of sulbutiamine and pharmaceutical compositions thereof for the treatment of certain psychomotor and psychointellectual disorders, characterized by the delay, the slowing and the depression of behavioral and intellectual responses demanding the strategic mobilization of percepts and mental concepts. These disorders are observed in particular in Parkinson's patients, deficient schizophrenics, alcoholics, major depressives and dysthymics. Sulbutiamine is an active principle which is already known and described in the literature. The special medicament patent 5921 M has described this product as an agent having the activity of vitamin B.sub.1, capable of causing a raised vitamin B.sub.1 blood level and able to exert effects with respect to all the symptoms of B.sub.1 avitaminosis. The special medicament patent 5921 M likewise mentions that for these therapeutic ends, the product is used in the form of tablets containing 5 to 50 mg of product per unit dose. Web site: http://www.delphion.com/details?pn=US05863925__ Patent Applications on Alcohol Abuse As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to alcohol abuse: · 3-(Diarylmethylene)-8-azabicyclo[3.2.1]octane derivatives Inventor(s): Boyd, Robert E.; (Horsham, PA), Carson, John R.; (Norristown, PA), Coats, Steven J.; (Quakertown, PA), Neilson, Lou Anne; (Sellersville, PA), Pitis, Philip M.; (North Wales, PA), Wu, Wu-Nan; (Lansdale, PA) Correspondence: Philip S. Johnson, Esq.; Johnson & Johnson; One Johnson & Johnson Plaza; New Brunswick; NJ; 08933-7003; US Patent Application Number: 20030181447 Date filed: February 7, 2003 Abstract: This invention is directed to 3-(diarylmethylene)-8-azabicyclo[3.2.1]octan- e derivatives useful as.delta.-opioid or.mu.-opioid receptor modulators. Depending on their agonist or antagonist effect, the compounds are useful analgesics, immunosuppressants, antiinflammatory agents, agents for the treatment of neurological 10 This has been a common practice outside the United States prior to December 2000. Patents 229 and psychiatric conditions, medicaments for drug and alcohol abuse, agents for treating gastritis and diarrhea, cardiovascular agents and agents for the treatment of respiratory diseases. Excerpt(s): This application is a continuation of U.S. patent application Ser. No. 09/791,246, filed Feb. 22, 2001 which application is fully incorporated herein by reference. This application claims the benefit of U.S. Provisional Application No. 60/186,778 filed Mar. 3, 2000. The present invention is directed to compounds useful as delta-opioid and mu-opioid receptor modulators. More particularly, the present invention is directed to 3-(diarylmethylene)-8-azabicyclo[3.2.1]o- ctane derivatives useful as delta-opioid or mu-opioid receptor modulators. wherein R is hydrogen, methyl, propyl, hexyl, 2-ethylbutyl, allyl, 3,3-dimethallyl, cyclohexylmethyl, phenethyl, phenylpropyl, 2,2-diphenylethyl, 3,4-dimethoxyphenethyl, 4-fluorophenethyl, 2furylmethyl, 3,4-methylenedioxybenzyl, cyano and X is N,N-dimethylamino, N,Ndiethylamino, N,N-dipropylamino, N-methyl-N-ethylamino, N-methyl-N-propylamino, N-methyl-N-phenylamino, N-ethyl-N-(4-methyl)benzylamino, N-butyl-N-ethylamino, N-butyl-N-propylamino, [N-ethyl-N-(2-methyl)allyl]amino, hydroxy, O-t-butyl and 1pyrrolidinyl; and, Y is hydrogen, methoxy and methylthio. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Aminomethyl-phenyl-cyclohexanone derivatives Inventor(s): Buschmann, Helmut; (Aachen, DE), Koegel, Babette-Yvonne; (LangerweheHamich, DE), Puetz, Claudia; (Dueren, DE) Correspondence: CROWELL & MORING LLP; INTELLECTUAL PROPERTY GROUP; P.O. BOX 14300; WASHINGTON; DC; 20044-4300; US Patent Application Number: 20030096811 Date filed: July 5, 2002 Abstract: Aminomethyl-phenyl-cyclohexanone derivatives of formula I or Ia, 1their diastereomers, enantiomers and salts formed with a physiologically tolerated acid. Also disclosed are processes for preparing the same, pharmaceutical compositions comprising the same, and methods of using the same for the treatment of pain, inflammatory reaction, allergic reactions, depression, drug abuse, alcohol abuse, gastritis, cardiovascular disease, respiratory tract disease, coughing, mental illness, epilepsy, urinary incontinence, itching, and diarrhoea. Excerpt(s): The present application is a continuation of international patent application no. PCT/EP00/13282, filed Dec. 27, 2000, designating the United States of America, the entire disclosure of which is incorporated herein by reference. Priority is claimed based on Federal Republic of Germany patent application no. 100 00 311.7, filed Jan. 5, 2000. The present invention relates to aminomethyl-phenyl-cyclohexanone derivatives and processes for their preparation, the use of aminomethyl-phenyl-cyclohexanone derivatives for the preparation of medicaments and medicaments comprising aminomethyl-phenyl-cyclohexanone derivatives. Treatment of chronic and non-chronic states of pain is of great importance in medicine. There is a worldwide need for pain treatments with a good action for target-orientated treatment of chronic and non-chronic states of pain appropriate for the patient, by which is to be understood successful and satisfactory pain treatment for the patient. This manifests itself in the large number of scientific works which have been published in the field of applied analgesia and basic research in nociception in recent years. 230 Alcohol Abuse Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Benzamidine derivatives Inventor(s): Reitz, Allen B.; (Lansdale, PA), Nortey, Samuel O.; (Elkins Park, PA), Baxter, Ellen W.; (Glenside, PA) Correspondence: AUDLEY A. CIAMPORCERO JR.; JOHNSON & JOHNSON; ONE JOHNSON & JOHNSON PLAZA; NEW BRUNSWICK; NJ; 08933-7003; US Patent Application Number: 20020123489 Date filed: December 11, 2001 Abstract: Benzamidine derivatives are useful delta-opioid receptor modulators, agonists useful as analgesics and antagonists useful as immunosuppressants, antiinflammatory agents, agents for the treatment of neurological and psychiatric conditions, medicaments for drug and alcohol abuse, agents for treating gastritis and diarrhea, cardiovascular agents and agents for the treatment of respiratory diseases. Excerpt(s): The present invention is directed to delta-opioid receptor modulators and methods for use thereof. More particularly, the present invention is directed to benzamidine derivatives which are delta-opioid receptor agonists or antagonists and methods for use thereof. The foregoing reference compounds have been described as either.delta.-opioid or.mu.-opioid receptor agonists or antagonists. wherein R and R' are hydrogen, lower alkyl, hydroxy, lower alkoxy, halogen or trifluoromethyl and may be the same or different; R" is lower alkyl, lower alkenyl, cycloalkyl, or phenyl, and R'" is hydrogen, lower alkyl, lower alkenyl, carboalkoxy, carboalkoxyalkyl, formyl, phenyl, halophenyl, cinnamyl, benzyl or benzhydryl as having hypoglycemic activity. The lower alkyl, lower alkoxy and lower alkenyl groups may be branched or straight chained and contain up to 6 carbon atoms. The cycloalkyl groups contain from 3 to 7 carbon atoms in the ring which may also carry a lower alkyl substituent. The carboalkoxy groups contain alkyl groups having from 1 to 5 carbon atoms and include carbomethoxy, carbethoxy, carbopropoxy, carbobutoxy and the like. Desirably, R and R' are lower alkyl, preferably methyl, or halogen, preferably chloro; R may be hydrogen and R' is then chloro, lower alkyl, preferably methyl, or trifluoromethyl; R" is lower alkyl, preferably isobutyl, and R'" is carbethoxy. Exemplified compounds include those wherein R is selected from hydrogen, chlorine, fluorine or methyl; R' is selected from hydrogen, chlorine, fluorine, methyl, methoxy, hydroxy or trifluoromethyl; R" is selected from hydrogen, chlorine, fluorine, methyl, ethyl, n-propyl, n-butyl, i-butyl, i-amyl, n-hexyl, allyl, cyclohexyl, phenyl or 3,4-dimethylphenyl; R'" is selected from hydrogen, methyl, ethyl, n-hexyl, allyl, phenyl, 4-Cl-phenyl, benzhydryl, benzyl, 2,4-Cl.sub.2-benzyl, 2,3,4-(MeO).sub.3benzyl, COOEt or CHO. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Combination treatment for alcoholism and alcohol dependence Inventor(s): Howard, Harry R. JR.; (Bristol, CT) Correspondence: PFIZER INC; 150 EAST 42ND STREET; 5TH FLOOR - STOP 49; NEW YORK; NY; 10017-5612; US Patent Application Number: 20030130322 Date filed: May 22, 2002 Patents 231 Abstract: The present invention relates to a method of treating alcoholism or alcohol dependence in a mammal, including a human, by administering to the mammal a monoamine reuptake inhibitor in combination with an opioid antagonist. It also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a monoamine reuptake inhibitor and an opioid antagonist. Excerpt(s): The present invention relates to a method of treating alcoholism or alcohol dependence in a mammal, including a human, by administering to the mammal a biaryl ether derivative, as described below, in combination with an opioid antagonist. This invention also relates to pharmaceutical compositions containing a pharmaceutically acceptable carrier, a biaryl ether derivative, as described below, and an opioid antagonist. The biaryl ether derivatives referred to above that are employed in the methods and pharmaceutical compositions of this invention exhibit activity as monoamine (e.g., serotonin, dopamine, norepinephrine) reuptake inhibitors. These biaryl ether derivatives are referred to in U.S. patent application Ser. No. 09/692,335, filed Oct. 19, 2000, and in International Patent Application No. WO 00150380, published Aug. 31, 2000. each Z is selected independently from hydrogen, halo (i.e., chloro, fluoro, bromo or iodo), (C.sub.1-C.sub.4)alkyl optionally substituted with from one to three fluorine atoms, and (C.sub.1-C.sub.4)alkoxy; and (c) a pharmaceutically acceptable carrier; wherein the active agents "a" and "b" above are present in amounts that render the composition effective in treating alcoholism or alcohol dependence. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Compositions and methods for increasing compliance with therapies using aldehyde dehydrogenase inhibitors and treating alcoholism Inventor(s): Lederman, Seth; (New York, NY) Correspondence: Pillsbury Winthrop LLP; 1600 Tysons Boulevard; McLean; VA; 22102; US Patent Application Number: 20030087814 Date filed: November 4, 2002 Abstract: Compositions and methods for treating, preventing, or reducing alcoholism, in particular methods for increasing patient compliance with therapies that require the intake of an ALDH inhibitor comprising the step of administering a monoamine oxidase B inhibitor. Excerpt(s): This patent application claims the benefit of the filing date of U.S. Patent Application No. 60/338,901 filed on Nov. 5, 2001, the entire contents of which are hereby expressly incorporated by reference. The present invention relates to compositions and methods for increasing patient compliance with therapies comprising the administration of aldehyde dehydrogenase inhibitors, and for preventing, ameliorating or treating alcoholism. Such compositions and methods may be used to facilitate alcohol cessation, and may comprise a combination of aldehyde dehydrogenase inhibitors and monoamine oxidase inhibitors. Alcohol is a commonly abused drug. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), problematic alcohol use is divided into alcohol abuse and alcohol dependence. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html 232 Alcohol Abuse · Heteroaryl derivatives as superior ligands for nociceptin receptor ORL-1 Inventor(s): Ho, Ginny D.; (Murray Hill, NJ), Ng, Fay W.; (New York, NY), Tulshian, Deen; (Lebanon, NJ) Correspondence: SCHERING-PLOUGH CORPORATION; PATENT DEPARTMENT (K6-1, 1990); 2000 GALLOPING HILL ROAD; KENILWORTH; NJ; 07033-0530; US Patent Application Number: 20030119847 Date filed: November 6, 2002 Abstract: Novel compounds of the formula 1whereinR is optionally substituted heteroaryl or 2R.sup.1 is H or C.sub.1--C.sub.6 alkyl; andR.sup.2 and R.sup.3 are -CH.sub.3, --OCH.sub.3 or halo;or a pharmaceutically acceptable salt or solvate thereof, pharmaceutical compositions therefore, and the use of said compounds in the treatment of pain, anxiety, cough, asthma, depression and alcohol abuse are disclosed. Excerpt(s): This application claims the benefit of U.S. Provisional Application 60/333,284, filed Nov. 7, 2001. The present invention relates to nociceptin receptor ORL1 agonist 8-(bis-(halophenyl) methyl)-3-heteroaryl-8-azabicyclo-[3.2.1]octan-3-ols and derivatives thereof useful in treating cough, pain, anxiety, asthma, alcohol abuse or depression. Pharmaceutical compositions comprising the compounds and combinations of the claimed compounds with other agents for treating cough, allergy or asthma symptoms are also disclosed. 8-(bis-(halophenyl)methyl)-3-heteroaryl-8-azabicyclo[3.2.1]octan-3- -ols were generically, but not specifically, disclosed in U.S. Pat. No. 6,262,066 B1 and WO 01/07050 as being useful in the treatment of cough, pain, anxiety, asthma, alcohol abuse or depression. Compounds of the present invention represent a selection invention over U.S. Pat. No. 6,262,066 B1 and WO 01/07050. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · High affinity ligands for nociceptin receptor ORL-1 Inventor(s): Bercovici, Ana; (West Orange, NJ), Ho, Ginny D.; (Murray Hill, NJ), McLeod, Robbie L.; (Branchburg, NJ), Chapman, Richard W.; (Somerville, NJ), Cuss, Francis M.; (Basking Ridge, NJ), Hey, John A.; (Nutley, NJ), Matasi, Julius J.; (Scotch Plains, NJ), Silverman, Lisa S.; (Edison, NJ), Tulshian, Deen; (Lebanon, NJ) Correspondence: SCHERING-PLOUGH CORPORATION; PATENT DEPARTMENT (K6-1, 1990); 2000 GALLOPING HILL ROAD; KENILWORTH; NJ; 07033-0530; US Patent Application Number: 20030073690 Date filed: May 23, 2002 Abstract: Novel compounds of the formula 1or a pharmaceutically acceptable salt or solvate thereof, wherein:the dotted line represents an optional double bond;X.sup.1 is optionally substituted alkyl, cycloalkyl, aryl, heteroaryl or heterocycloalkyl;X.sup.2 is -CHO, --CN, optionally substituted amino, alkyl, or aryl;or X.sup.1 is optionally substituted benzofused heterocyclyl and X.sup.2 is hydrogen;or X.sup.1 and X.sup.2 together form an optionally benzofused spiro heterocyclyl groupR.sup.1, R.sup.2, R.sup.3 and R.sup.4 are independently H and alkyl, or (R.sup.1 and R.sup.4) or (R.sup.2 and R.sup.3) or (R.sup.1 and R.sup.3) or (R.sup.2 and R.sup.4) together can form an alkylene bridge of 1 to 3 carbon atoms;Z.sup.1 is optionally substituted alkyl, aryl, heteroaryl, cycloalkyl or heterocycloalkyl, or --CO.sub.2(alkyl or substituted amino) or CN; Z.sup.2 is H or Z.sup.1; Z.sup.3 is H oralkyl; or Z.sup.1, Z.sup.2 and Z.sup.3, Patents 233 together with the carbon to which they are attached, form bicyclic saturated or unsaturated rings; pharmaceutical compositions therefore, and the use of said compounds as nociceptin receptor inhibitors useful in the treatment of pain, anxiety, cough, asthma, depression and alcohol abuse are disclosed. Excerpt(s): The nociceptin receptor ORL-1 has been shown to be involved with modulation of pain in animal models. ORL-1 (the nociceptin receptor) was discovered as an "orphan opioid-like receptor" i.e. a receptor whose ligand was unknown. The nociceptin receptor is a G protein coupled receptor. While highly related in structure to the three classical opioid receptors, i.e. the targets for traditional opioid analgesics, it is not activated by endogenous opioids. Similarly, endogenous opioids fail to activate the nociceptin receptor. Like the classical opioid receptors, the nociceptin receptor has a broad distribution in the central nervous system. In late 1995, nociceptin was discovered and shown to be an endogenous peptide ligand that activates the nociceptin receptor. Data included in the initial publications suggested that nociceptin and its receptor are part of a newly discovered pathway involved in the perception of painful stimuli. Subsequent work from a number of laboratories has shown that nociceptin, when administered intraspinally to rodents, is an analgesic. The efficacy of nociceptin is similar to that of endogenous opioid peptides. Recent data has shown that nociceptin acts as an axiolytic when administered directly into the brain of rodents. When tested in standard animals models of anxiety, the efficacy of nociceptin is similar to that seen with classical benzodiazapine anxiolytics. These data suggest that a small molecule agonist of the nociceptin receptor could have significant analgesic or anxiolytic activity. Additional recent data (Rizzi, et al, Life Sci., 64, (1999), p.157-163) has shown that the activation of nociceptin receptors in isolated guinea pig bronchus inhibits tachykinergic non adrenergic-non cholinergic contraction, indicating that nociceptin receptor agonists could be useful in the treatment of asthma. Also, it has been reported (Ciccocioppo et al, Physchpharmacology, 141 (1999), p. 220-224) nociceptin reduces the rewarding properties of ethanol in msP alcohol preferring rats, suggesting that intervention of nociceptin could be useful in the treatment of alcohol abuse. In EP 856,514, 8-substituted 1,3,8-trazaspiro[4,5]decan-4-on derivatives were disclosed as agonists and/or antagonists of orphanin FQ (i.e., nociceptin) useful in the treatment of various disorders, including depression; 2-oxoimidazole derivatives disclosed in WO98/54168 were described as having similar utility. Earlier, benzimidazolyl piperidines were disclosed in U.S. Pat. No. 3,318,900 as having analgesic activity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Method and device for detecting and monitoring alcoholism and related diseases using microarrays Inventor(s): Harris, Adron; (Austin, TX), Lewohl, Joanne; (Brisbane, AU), Dodd, Peter; (Brisbane, AU), Mayfield, Dayne; (Austin, TX) Correspondence: CHALKER FLORES, LLP; 12700 PARK CENTRAL, STE. 455; DALLAS; TX; 75251; US Patent Application Number: 20030104457 Date filed: November 7, 2002 Abstract: A device and method for detecting, diagnosing, and or monitoring alcoholism and related disease states is disclosed. The device includes a substrate and one or more alcoholism-specific nucleic acids attached to the substrate. The substrate is contacted by a sample collected from a person with alcoholism or alcohol abuse or an alcohol related 234 Alcohol Abuse disease state, wherein contact occurs under pre-selected binding conditions that provides information that can be collected and recorded by a computer. Excerpt(s): The present invention relates in general to the method and device for detecting, monitoring or diagnosing alcoholism and related disease states, and more particularly, to the method and device for analyzing the progression of alcoholism and related disease states in a subject, preferably a human patient, using microarrays. Without limiting the scope of the invention, its background is described in connection with the method of detecting, diagnosing or monitoring alcoholism and its progression in a person using nucleic acid microarrays, as an example. Heretofore, in this field, the diagnosis and or detection of alcoholism or alcohol abuse and related behaviors has in practice depended on interviews, review of past records, or clinical impression. (Allen, J P, Columbus M, and Fertig J. 1995. Assessment in Alcoholism Treatment: An Overview. In: NIAAA Treatment Handbook Series 4, Assessing Alcohol Problems: A Guide for Clinicians and Researchers. NIH Publication No. 95-3745. pp. 1-9) Generally, items from the medical history and clinical signs are combined to form a diagnostic index. In addition, these items can be compared with the alcohol consumption history, CAGE questionnaire, and early indicator questionnaires that also form part of the index. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Method for treating alcohol intoxication and alcohol abuse Inventor(s): Lee, David; (Cambridge, MA), Lukas, Scott; (Boxborough, MA) Correspondence: CLARK & ELBING LLP; 176 FEDERAL STREET; BOSTON; MA; 02110-2214; US Patent Application Number: 20020022634 Date filed: May 31, 2001 Abstract: Treatment for alcohol dependence or intoxication that involves administering a pharmaceutical composition containing an extract of the kudzu plant, Pueraria lobata. Excerpt(s): The present invention relates to methods of treating alcohol intoxication and alcohol abuse with an extract from the Kudzu plant, Puararia lobata. Ethyl alcohol is the most widely used psychoactive drug in the world. Alcohol abuse and alcohol related diseases represent a serious threat to human health and pose major medical, social, and economic problems. In the United States alone, an estimated 10% of the population is affected by alcoholism. The problems associated with alcohol abuse are very costly, both to the individuals affected and to society at large. The physical, social and psychological harm which can result from alcohol abuse and dependence, such as fetal alcohol syndrome, cirrhosis of the liver, alcohol-related accidental death, homicide, suicide, etc., can be devastating. Thus, there remains a strong need to develop safe and effective therapeutic agents for treating alcohol abuse and dependence. As public awareness of the problems associated with alcohol abuse has increased in recent years, greater efforts have been devoted to the development of treatments for alcoholism. Much of the current research in this area has focused on methods for treating the effects of alcohol withdrawal through the clinical use of various drugs, such as benzodiazepines and the antidipsotropic agent disulfuram (ANTABUSE.TM.). Recent research has also led to the development of new therapeutic agents which suppress alcohol drinking in humans. For instance, dopamine agonists and antagonists, serotonergic agents, glutamate antagonists, opiate antagonists, ALDH inhibitors, and calcium blockers have been reported to reduce self administration of alcohol in alcoholic humans and alcohol- Patents 235 preferring rats (Banys, 1988; Lawrin et al., 1986; McBride et al., 1989; Naranjo et al., 1990; Rezvani et al., 1990, 1991; Sellers et al., 1992). Also, naltrexone (REVIA.TM.), an opioid receptor antagonist, when combined with psychotherapy, has shown encouraging results in several clinical trials (Berg et al., 1990; O'Malley et al., 1992a,b; Volpicelli et al., 1990, 1992). Unfortunately, many of these current drug treatments are toxic, exhibit low efficacy and patient compliance, have many adverse side effect, and are unsuitable for use with adolescents and pregnant women. Thus, despite these recent advancements, developing effective treatments for alcohol dependence remains a challenging goal. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Methods for reducing alcohol cravings in chronic alcoholics Inventor(s): Ma, Chunrong; (San Diego, CA), Cook, James M.; (Whitefish Bay, WI), June, Harry L.; (Indianapolis, IN) Correspondence: DANN, DORFMAN, HERRELL & SKILLMAN; 1601 MARKET STREET; SUITE 2400; PHILADELPHIA; PA; 19103-2307; US Patent Application Number: 20030176456 Date filed: December 23, 2002 Abstract: Methods are provided to reduce the anxiety associated with alcohol withdrawal in chronic alcoholics. Excerpt(s): This application claims priority of U.S. provisional application serial No. 60/345,417, filed Dec. 21, 2001. This invention relates to methods for the treatment of alcoholism. More specifically, the invention provides methods for reducing the anxiety associated with alcohol withdrawal. Various scientific articles and patents are cited throughout the specification. Full citations for the references and patents are found within the specification and are incorporated by reference herein to describe the state of the art to which this invention pertains. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Salts of bicyclic, N-acylated imidazo-3-amines and imidazo-5-amines Inventor(s): Sundermann, Corinna; (Aachen, DE), Gerlach, Matthias; (Brachttal, DE) Correspondence: CROWELL & MORING LLP; INTELLECTUAL PROPERTY GROUP; P.O. BOX 14300; WASHINGTON; DC; 20044-4300; US Patent Application Number: 20030119842 Date filed: October 18, 2002 Abstract: Salts of a bicyclic, N-acylated imidazo-3-amine or an imidazo-5-amine of the formula: 1addition products thereof with acids, and methods for preparing the salts and addition products. Also disclosed are pharmaceutical compositions comprising the same and methods using the pharmaceutical compositions for the treatment or prophylaxis of pain, drug or alcohol abuse, diarrhoea, gastritis, ulcers, urinary incontinence, depression, narcolepsy, overweight, asthma, glaucoma, tinnitus, itching, hyperkinetic syndrome, epilepsy, or schizophrenia, for inducing anesthesia, and for anxiolysis. Excerpt(s): The present application is a continuation of international patent application no. PCT/EP01/03772, filed Apr. 3, 2001, designating the United States of America, and 236 Alcohol Abuse published in German as WO 01/81344, the entire disclosure of which is incorporated herein by reference. Priority is claimed based on Federal Republic of Germany patent application no. 100 19 714.0, filed Apr. 20, 2000. The present invention relates to salts of bicyclic, N-acylated imidazo-3-amines and imidazo-5-amines, to a process for producing them, to their use for producing pharmaceutical compositions and to pharmaceutical compositions containing these compounds. Individual compounds from the category of non-acylated bicyclic imidazo-3-amines and imidazo-5-amines which form the basis of the compounds according to the present invention are known to have interesting pharmacological properties. Thus, certain imidazo[1,2-a]pyridines are described as blood pressure-reducing active ingredients (GB-B-1,135,893), as anthelmintics and antimycotics (J. Med. Chem. 1972, 15, 982-985) and as anti-secretory active ingredients for the treatment of inflammatory diseases (EP-A-0 068 378). EP-A-0 266 890 and J. Med. Chem. 1987, 30, 2031-2046 also describe an effect of individual imidazopyridines against inflammatory diseases, in particular of the stomach. Further pharmacological effects described for individual representatives of the category of non-acylated imidazo-3amines and imidazo-5-amines are antibacterial properties (Chem. Pharm. Bull. 1992, 40, 1170), antiviral properties (J. Med. Chem. 1998, 41 5108-5112) and the effect as benzodiazepine-receptor antagonist (J. Heterocyclic Chem. 1998, 35, 1205-1217). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Substituted pyrrole mannich bases to combat pain and allergic reactions Inventor(s): Maul, Corinna; (Aachen, DE), Gerlach, Matthias; (Brachttal, DE) Correspondence: OBLON SPIVAK MCCLELLAND MAIER & NEUSTADT PC; FOURTH FLOOR; 1755 JEFFERSON DAVIS HIGHWAY; ARLINGTON; VA; 22202; US Patent Application Number: 20030023100 Date filed: June 25, 2002 Abstract: The invention relates to substituted pyrrole Mannich bases of general formula (I), wherein R.sup.1=H, a C.sub.1-10-alkyl-, aryl, a heteroaryl- or an aryl, heteroaryl-, CN, Br--, Cl or OH radical bound by a C.sub.1-6 alkylene group, R.sup.2=CH(R.sup.4)N(R.sup.5)(R.sup.6), R3, R3', R3" identically or individually represent H, F, Cl, Br, CF.sub.3, CN, NO.sub.2, SO.sub.2NH.sub.2, NHR', SR.sup.8, OR.sup.9, CO(OR.sup.10), CH.sup.2CO(OR.sup.11), COR.sup.15, a C.sub.1-10-alkyl-, aryl-, heteroaryl- aryl radical or a heteroalkyl radical bound by a C.sub.1-6 alkylene group, R.sup.4=an unsubstituted phenyl radical or a phenyl radical substituted at least with C.sub.1-4 alkyl, C.sub.1-3-alkoxy-, halogen-, a method for the production of the above-mentioned compounds, medicaments containing said compounds, and the use of said compounds in the production of medicaments. Said active ingredients are particularly suitable for pain therapy, and for treating inflammatory and allergic reactions, drug or alcohol abuse, diarrhoea, gastritis, ulcers, cardiovascular diseases, urinary incontinence, depressions, states of shock, migranes, narcolepsy, overweight, asthma, glaucoma, hyperkinetic syndrome, lack of drive, bulimia, anorexia, catalepsia, anxiolysis increasing vigilance and/or increasing libido. Excerpt(s): The invention relates to substituted pyrrole Mannich bases, processes for their preparation, medicaments comprising these compounds and the use of these compounds for the preparation of medicaments. Pain is one of the basic clinical symptoms. There is a worldwide need for effective pain treatments. The urgent need for action for target-orientated treatment of chronic and non-chronic states of pain appropriate for the patient, by which is to be understood successful and satisfactory Patents 237 pain treatment for the patient, is documented in the large number of scientific works which have been published in the field of applied analgesia and basic research in nociception in recent years. Conventional opioids, such as e.g. morphine, are effective in the treatment of severe to very severe pain. However, they have as undesirable concomitant symptoms, inter alia, respiratory depression, vomiting, sedation, constipation and development of tolerance. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html · Use of y-hydroxybutyric acid amides in the treatment of drug addiction and in particular of alcoholism Inventor(s): Perlini, Vincenzo; (Matelica, IT), Cacciaglia, Roberto; (Ospedaletti, IT), Loche, Antonella; (Sanremo, IT), Guano, Lorenza; (Sanremo, IT) Correspondence: James V. Costigan, Esq.; HEADMAN & COSTIGAN, P.C.; Suite 2003; 1185 Avenue of the Americas; New York; NY; 10036-2646; US Patent Application Number: 20020165224 Date filed: December 11, 2001 Abstract: Gamma-hydroxybutryic acid amides are used in the treatment of drug addiction and especially in the treatment of alcoholism. Excerpt(s): The present invention relates to the use of amides of.gamma.-hydroxybutyric acid, herein referred to as GHB, in the treatment of drug addiction, such as heroine, cocaine and, in particular, in the treatment of alcoholism, and more particularly in reducing chronic alcoholics desire for and habit of consuming alcoholic drinks and in the treatment of abstinence syndrome. The salts of 4-hydroxybutyric acid, e.g. the sodium salt, proved to be effective both in the treatment of the syndrome of abstinence from alcohol and in reducing the desire for and addiction to alcohol in alcoholic patients and disclosed in EP-A- 344,704 and in the treatment of drug addiction, as reported in WO 93/00083. One of the advantages of said salts is that they do not cause the inconveniences of Disulfiram (Antabuse.RTM.), a drug having several untoward effects, such as for example the symptoms known as the "acetaldehyde syndrome", which may also result in fatality. The sodium salt of GHB is absorbed very quickly by the gastroenteric apparatus with a maximum concentration peak already at about 35-40 min after administration. However, it presents a half-life time of about 20-25 min, its elimination from the body being rather quick [EP-A-635,265]. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html Keeping Current In order to stay informed about patents and patent applications dealing with alcohol abuse, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “alcohol abuse” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on alcohol abuse. 238 Alcohol Abuse You can also use this procedure to view pending patent applications concerning alcohol abuse. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above. 239 CHAPTER 7. BOOKS ON ALCOHOL ABUSE Overview This chapter provides bibliographic book references relating to alcohol abuse. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on alcohol abuse include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan. Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “alcohol abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on alcohol abuse: · AIDS and Alcoholism: The Parallels Source: Acquired Immune Deficiency Syndrome and Chemical Dependency. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: AIDS and alcoholism are seen as similar public health problems because they both involve moral as well as medical considerations. Some may see AIDS as a threat to the public health from a deviant minority and propose prohibition-style measures while others see the central issue as a threat to at-risk groups from a bigoted majority. The conflict must be resolved in order to protect the health and rights of the public. · Alcohol Abuse, Suicidal Behavior, and AIDS Source: Acquired Immune Deficiency Syndrome and Chemical Dependency. 240 Alcohol Abuse Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: Suicidal tendencies appear to be common among AIDS patients, aggravated by substance abuse. In addition, self-destructive substance abusers have, in a few cases, selected AIDS as the form of suicide. A priority must be the education of staff in addressing counter-transference issues in order to effectively identify and treat patients at risk of self-destructive behavior. · Barriers to the Recognition of Links Between Drugs and Alcohol Abuse and AIDS Source: Acquired Immune Deficiency Syndrome and Chemical Dependency. Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Summary: The lack of a coordinated program to deal with AIDS infection and substance abuse appears to reduce the effectiveness of treatment programs because health care providers are reluctant to discuss sexual practice histories and may fear that inquiring about a patient's drug and alcohol use patterns will elicit a sense of rejection. Another reason is since the patient is going to die anyway, there is no point in bothering about drug and alcohol use, ignoring the possibility that medical and psychological problems may be remedied if a drug or alcohol abuse problem is recognized and treated. Concern for the health care provider's own safety is also a contributing factor. · The Response of State Agencies to AIDS, Addiction, and Alcoholism Source: AIDS and Substance Abuse. Contact: Haworth Press, Incorporated, Harrington Park Press, Incorporated, 12 W 32 St, New York, NY, 10001, (212) 563-4247. Summary: This book chapter advocates that reducing the spread of Acquired immunodeficiency syndrome (AIDS) within Intravenous drug users (IVDU's) would not only reduce the overall toll of the disease but also limit its spread to the population at large. Human immunodeficiency virus (HIV) infection can be minimized by reducing or eliminating certain high-risk activities. Primary strategies include educating IV drug users about the hazards of sharing needles, enrolling them in treatment programs, promoting use of new or sterilized syringes and needles, and discouraging high-risk sexual activity among HIV-infected persons. · Neurocognitive Impairment in Alcoholics: Review and Comparison With Cognitive Impairment Due to AIDS Source: AIDS and Substance Abuse. Contact: Haworth Press, Incorporated, Harrington Park Press, Incorporated, 12 W 32 St, New York, NY, 10001, (212) 563-4247. Summary: This book chapter discusses cognitive dysfunction and dementia, specifically caused by chronic alcohol use, consisting of subtle changes in cognition which are easily missed and/or forgotten. The nature of the dysfunction and specific neuropsychiatric and neurodiagnostic tests are reviewed and important treatment implications regarding these subtle changes in mental function are summarized. A comparison is made between the cognitive impairment experienced by patients infected with Human immunodeficiency virus (HIV) with that experienced by alcoholics. Books · 241 Encyclopedia of Alcoholism. 2nd ed Source: New York, NY: Facts on File, Inc. 1991. 346 p. Contact: Available from Facts on File, Inc. 460 Park Avenue South, New York, NY 10016. (212) 683-2244. PRICE: $45. Shipping and handling free if prepaid. ISBN: 081601955X. Summary: This volume presents a dictionary approach to information about alcoholism. With more than 600 entries, the encyclopedia defines and explains all facets of alcoholism: biological, medical and psychological areas, its social and economic impact, legal implications, terminology used in the treatment of the disease, slang, organizations that deal with alcoholism, various theories on the causes of the disease, and the prevalence of alcohol abuse around the world and what different countries have tried to do about controlling it. Entries of interest to those in the field of digestive diseases include those about alcoholic hepatitis, alcoholic liver disease, alcoholic myopathy, black Americans, blood sugar, cirrhosis, diabetes, diseases, gastrointestinal tract, hemochromatosis, hypoglycemia, intestine, liver, Mallory-Weiss syndrome, nutrition, pancreas, post-necrotic cirrhosis, stomach, and Switzerland. Appendices include tables and figures and sources of information. A subject index is included. 620 references. Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in PrintÒ). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “alcohol abuse” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “alcohol abuse” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “alcohol abuse” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): · A Handbook on Drug and Alcohol Abuse: The Biomedical Aspects by Gail Winger, et al (1992); ISBN: 019506397X; http://www.amazon.com/exec/obidos/ASIN/019506397X/icongroupinterna · A History of Alcoholism by Jean-Charles Sournia, et al; ISBN: 0631160264; http://www.amazon.com/exec/obidos/ASIN/0631160264/icongroupinterna · A Woman Like You: Life Stories of Women Reovering from Alcoholism and Addiction by Rachel V; ISBN: 006250701X; http://www.amazon.com/exec/obidos/ASIN/006250701X/icongroupinterna · Adolescent Drug & Alcohol Abuse: How to Spot It, Stop It, and Get Help for Your Family by Nikki Babbit; ISBN: 1565927559; http://www.amazon.com/exec/obidos/ASIN/1565927559/icongroupinterna · Adolescent Drug and Alcohol Abuse Handbook: For Parents and Professionals by Deborah L. Sherouse; ISBN: 0398051682; http://www.amazon.com/exec/obidos/ASIN/0398051682/icongroupinterna · Alcohol Abuse: Straight Talk Straight Answers by Pippa Sales; ISBN: 1884633048; http://www.amazon.com/exec/obidos/ASIN/1884633048/icongroupinterna 242 Alcohol Abuse · Alcohol and the Addictive Brain: New Hope for Alcoholics from Biogenetic Research by Kenneth Blum, James E. Payne; ISBN: 0029037018; http://www.amazon.com/exec/obidos/ASIN/0029037018/icongroupinterna · Alcohol Misuse; A European Perspective by Timothy J. Peters (Editor); ISBN: 3718658143; http://www.amazon.com/exec/obidos/ASIN/3718658143/icongroupinterna · Alcoholics Anonymous As a Mutual-Help Movement: A Study in Eight Societies by Klaus Makela (Editor), et al; ISBN: 0299150003; http://www.amazon.com/exec/obidos/ASIN/0299150003/icongroupinterna · Alcoholism & Violence: Epidemiology, Neurobiology, Psychology, Family Issues by Marc Galanter (Editor), et al; ISBN: 0306453584; http://www.amazon.com/exec/obidos/ASIN/0306453584/icongroupinterna · Alcoholism and Women: The Background and the Psychology (Studies in Jungian Psychology by Jungian Analysts, 11) by Jan Bauer; ISBN: 0919123104; http://www.amazon.com/exec/obidos/ASIN/0919123104/icongroupinterna · Alcoholism in the Professions by Leclair Bissell, Paul W. Haberman (Contributor); ISBN: 0195034597; http://www.amazon.com/exec/obidos/ASIN/0195034597/icongroupinterna · Alcoholism/Chemical Dependency and the College Student by Timothy M. Rivinus, et al (1988); ISBN: 0866568123; http://www.amazon.com/exec/obidos/ASIN/0866568123/icongroupinterna · Alcoholism: Reducing Your Risk (If It Runs in Your Family) by Ronald L. Rogers, C. Scott McMillin (Contributor); ISBN: 055335163X; http://www.amazon.com/exec/obidos/ASIN/055335163X/icongroupinterna · Alcoholism: the Facts by Donald W. Goodwin; ISBN: 019263061X; http://www.amazon.com/exec/obidos/ASIN/019263061X/icongroupinterna · Alternatives to Abstinence: A New Look at Alcoholism and the Choices in Treatment by Heather Ogilvie, et al (2001); ISBN: 1578260817; http://www.amazon.com/exec/obidos/ASIN/1578260817/icongroupinterna · Anger, Alcoholism, and Addiction: Treating Individuals, Couples, and Families by Ronald T. Potter-Efron, Patricia S. Potter-Efron (Contributor) (1992); ISBN: 0393701263; http://www.amazon.com/exec/obidos/ASIN/0393701263/icongroupinterna · Beware the First Drink!: The Washington Temperance Movement and Alcoholics Anonymous by Leonard U. Blumberg, William L. Pittman (Contributor); ISBN: 0934125228; http://www.amazon.com/exec/obidos/ASIN/0934125228/icongroupinterna · Beyond the Influence: Understanding and Defeating Alcoholism by Katherine Ketcham, et al; ISBN: 0553380141; http://www.amazon.com/exec/obidos/ASIN/0553380141/icongroupinterna · Big Book Unplugged: A Young Person's Guide to Alcoholics Anonymous by R. John, John R (2003); ISBN: 1592850383; http://www.amazon.com/exec/obidos/ASIN/1592850383/icongroupinterna · Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson by Francis Hartigan; ISBN: 0312200560; http://www.amazon.com/exec/obidos/ASIN/0312200560/icongroupinterna Books 243 · Bill W.: A Different Kind of Hero: The Story of Alcoholics Anonymous by Tom White (2003); ISBN: 1590780671; http://www.amazon.com/exec/obidos/ASIN/1590780671/icongroupinterna · Clinical Case Studies in the Behavioral Treatment of Alcoholism by William H. Hay (Editor), Peter E. Nathan (Editor) (1982); ISBN: 0306409402; http://www.amazon.com/exec/obidos/ASIN/0306409402/icongroupinterna · Cognitive-Behavioral Coping Skills Therapy Manual: A Clinical Research Guide for Therapists Treating Individuals With Alcohol Abuse & Dependence by Ronald Kadden (Editor) (1994); ISBN: 0788108999; http://www.amazon.com/exec/obidos/ASIN/0788108999/icongroupinterna · Containing the Uncontainable: Alcohol Misuse and the Personal Choice Community Programme by Barbara Elliott (2003); ISBN: 186156368X; http://www.amazon.com/exec/obidos/ASIN/186156368X/icongroupinterna · Desire and Craving: A Cultural Theory of Alcoholism (Suny Series in New Social Studies on Alcohol and Drugs) by Pertti Alasuutari; ISBN: 0791410978; http://www.amazon.com/exec/obidos/ASIN/0791410978/icongroupinterna · Diagnosis of Alcohol Abuse by Ronald Ross Watson, et al; ISBN: 0849363810; http://www.amazon.com/exec/obidos/ASIN/0849363810/icongroupinterna · Drug and Alcohol Abuse: A Clinical Guide to Diagnois and Treatment by Marc Alan Schuckit; ISBN: 0306462303; http://www.amazon.com/exec/obidos/ASIN/0306462303/icongroupinterna · Drug and Alcohol Abuse: The Authoritative Guide for Parents, Teachers, and Counselors (The Language of Science) by H. Thomas, Jr. Milhorn; ISBN: 0306446405; http://www.amazon.com/exec/obidos/ASIN/0306446405/icongroupinterna · Dying for a Drink: A Pastor and a Physician Talk About Alcoholism by Alexander Dejong, Martin Doot (1999); ISBN: 080284622X; http://www.amazon.com/exec/obidos/ASIN/080284622X/icongroupinterna · Effective Outpatient Treatment for Alcohol Abusers and Drinking Drivers by John S. Crandell; ISBN: 0669149292; http://www.amazon.com/exec/obidos/ASIN/0669149292/icongroupinterna · Elderly Alcoholism: Intervention Strategies by Michael Henry Beechem (2002); ISBN: 039807285X; http://www.amazon.com/exec/obidos/ASIN/039807285X/icongroupinterna · Family therapy of drug and alcohol abuse; ISBN: 0470263857; http://www.amazon.com/exec/obidos/ASIN/0470263857/icongroupinterna · Family Therapy of Drug and Alcohol Abuse (2nd Edition) by Edward Kaufman, Pauline Kaufman (Editor); ISBN: 0205134300; http://www.amazon.com/exec/obidos/ASIN/0205134300/icongroupinterna · Fetal Alcohol Abuse Syndrome by Ernest L. Abel (1998); ISBN: 0306456664; http://www.amazon.com/exec/obidos/ASIN/0306456664/icongroupinterna · Gay Men, Drinking, and Alcoholism by Thomas S. Weinberg, Jacqueline P. Wiseman (Designer) (1994); ISBN: 0809318571; http://www.amazon.com/exec/obidos/ASIN/0809318571/icongroupinterna 244 Alcohol Abuse · Getting Better: Inside Alcoholics Anonymous by Nan Robertson, Thomas Congdon (Editor); ISBN: 0688068693; http://www.amazon.com/exec/obidos/ASIN/0688068693/icongroupinterna · Handbook of Alcoholism Treatment Approaches (3rd Edition) by Reid K. Hester (Author), et al; ISBN: 0205360645; http://www.amazon.com/exec/obidos/ASIN/0205360645/icongroupinterna · Hurting on the Inside: Children's Experiences of Parental Alcohol Abuse by Ann Laybourn, et al (1996); ISBN: 1859723195; http://www.amazon.com/exec/obidos/ASIN/1859723195/icongroupinterna · Last Call for Alcohol: Healing a Marriage Harmed by Alcohol Abuse by Susan Erling Martinez (2002); ISBN: 0971607605; http://www.amazon.com/exec/obidos/ASIN/0971607605/icongroupinterna · Liver Pathology and Alcohol (Drug and Alcohol Abuse Reviews) by Ronald R. Watson (Editor) (1991); ISBN: 089603206X; http://www.amazon.com/exec/obidos/ASIN/089603206X/icongroupinterna · Manual of Drug and Alcohol Abuse: Guidelines for Teaching in Medical and Health Institutions by Awni Arif, Joseph Westermeyer (Editor) (1988); ISBN: 0306428903; http://www.amazon.com/exec/obidos/ASIN/0306428903/icongroupinterna · Medical and Social Aspects of Alcohol Abuse by Boris Tabakhoff (1983); ISBN: 0306412217; http://www.amazon.com/exec/obidos/ASIN/0306412217/icongroupinterna · Ministering to Alcoholics by John E. Keller; ISBN: 0806625406; http://www.amazon.com/exec/obidos/ASIN/0806625406/icongroupinterna · Neurobiology of Alcohol Abuse by William H. Light; ISBN: 0398051976; http://www.amazon.com/exec/obidos/ASIN/0398051976/icongroupinterna · Opioids, Bulimia, and Alcohol Abuse & Alcoholism by Larry D. Reid (Editor); ISBN: 0387972420; http://www.amazon.com/exec/obidos/ASIN/0387972420/icongroupinterna · Our Children Are Alcoholics: Copying With Children Who Have Addictions by Sally B., et al (1997); ISBN: 1888461020; http://www.amazon.com/exec/obidos/ASIN/1888461020/icongroupinterna · Our Secret Feelings: Activities for Children of Alcoholics in Support Groups by Deborah Sharp Molchan (1988); ISBN: 1556910207; http://www.amazon.com/exec/obidos/ASIN/1556910207/icongroupinterna · Preventing Alcohol Abuse: Alcohol, Culture, and Control by David J. Hanson (Author) (1995); ISBN: 0275949265; http://www.amazon.com/exec/obidos/ASIN/0275949265/icongroupinterna · Prevention of Alcohol Abuse by Peter M. and Nirenberg, Ted D. Miller (Editor), Ted D. Nirenberg (Editor) (1984); ISBN: 0306413280; http://www.amazon.com/exec/obidos/ASIN/0306413280/icongroupinterna · Psychological Theories of Drinking and Alcoholism, Second Edition by Kenneth E. Leonard (Editor), Howard T. Blane (Editor); ISBN: 1572304103; http://www.amazon.com/exec/obidos/ASIN/1572304103/icongroupinterna · Recent Developments in Alcoholism: Combined Alcohol and Drug Abuse, Typologies of Alcoholics, the Withdrawal Syndrome, Renal and Electrolyte Consequ Books 245 by Marc Galanter (Editor) (1986); ISBN: 0306421704; http://www.amazon.com/exec/obidos/ASIN/0306421704/icongroupinterna · Seeds of Grace: A Nun's Reflections on the Spirituality of Alcoholics Anonymous by Molly Monahan; ISBN: 1573221759; http://www.amazon.com/exec/obidos/ASIN/1573221759/icongroupinterna · Seven Weeks to Sobriety: The Proven Program to Fight Alcoholism Through Nutrition by Joan Mathews-Larson, Joan Mathews Larson; ISBN: 0449908968; http://www.amazon.com/exec/obidos/ASIN/0449908968/icongroupinterna · Storytelling in Alcoholics Anonymous: A Rhetorical Analysis by George H. Jensen (2000); ISBN: 0809323303; http://www.amazon.com/exec/obidos/ASIN/0809323303/icongroupinterna · Subject Examination in Drug and Alcohol Abuse by Jack Rudman (2001); ISBN: 083736678X; http://www.amazon.com/exec/obidos/ASIN/083736678X/icongroupinterna · Teen Alcoholism (Teen Issues) by Hayley R. Mitchell, Barbara Sheen (1997); ISBN: 1560065141; http://www.amazon.com/exec/obidos/ASIN/1560065141/icongroupinterna · Teens Talk About Alcohol and Alcoholism by Paul Dolmetsch (Editor), Gail Mauricette (Editor) (1987); ISBN: 0385230842; http://www.amazon.com/exec/obidos/ASIN/0385230842/icongroupinterna · The Alcoholics Anonymous Experience: A Close-Up View for Professionals by Milton A. Maxwell; ISBN: 007040996X; http://www.amazon.com/exec/obidos/ASIN/007040996X/icongroupinterna · The Consequences of Alcoholism: Medical Neuropsychiatric Economic Cross-Cltural by Marc Galanter (Editor); ISBN: 0306457474; http://www.amazon.com/exec/obidos/ASIN/0306457474/icongroupinterna · The Courage to Change: Hope and Help for Alcoholics and Their Families by Dennis Wholey; ISBN: 0395359775; http://www.amazon.com/exec/obidos/ASIN/0395359775/icongroupinterna · The Economic Cost of Alcohol Abuse by Ralph E. Berry, James P. Boland; ISBN: 0029030803; http://www.amazon.com/exec/obidos/ASIN/0029030803/icongroupinterna · The Facts About Drinking: Coping With Alcohol Use, Abuse and Alcoholism by Gail Gleason Milgram; ISBN: 0890432341; http://www.amazon.com/exec/obidos/ASIN/0890432341/icongroupinterna · The invisible alcoholics : women and alcohol abuse in America by Marian Sandmaier; ISBN: 0070546606; http://www.amazon.com/exec/obidos/ASIN/0070546606/icongroupinterna · The Invisible Alcoholics: Women and Alcohol Abuse by Marian Sandmaier, Human Services Institute; ISBN: 0830638431; http://www.amazon.com/exec/obidos/ASIN/0830638431/icongroupinterna · Twelve Jewish Steps to Recovery: A Personal Guide to Turning from Alcoholism and Other Addictions by Kerry M. Olitzky, et al (1992); ISBN: 1879045095; http://www.amazon.com/exec/obidos/ASIN/1879045095/icongroupinterna 246 Alcohol Abuse · Under the Influence: A Guide to the Myths and Realities of Alcoholism by James Robert Milam; ISBN: 0914842692; http://www.amazon.com/exec/obidos/ASIN/0914842692/icongroupinterna · Under the Weather: Coping with Alcohol Abuse and Alcoholism by John G. Cooney, Bruce Ritson (2003); ISBN: 0717134245; http://www.amazon.com/exec/obidos/ASIN/0717134245/icongroupinterna · Up and Down the Mountain: Helping Children Cope With Parental Alcoholism by Gail Zawacki (Illustrator), Pamela Leib Higgins (1994); ISBN: 0882821334; http://www.amazon.com/exec/obidos/ASIN/0882821334/icongroupinterna · Visions of Addiction: Major Contemporary Perspectives on Addiction and Alcoholism by Stanton Peele (Editor) (1988); ISBN: 0669130923; http://www.amazon.com/exec/obidos/ASIN/0669130923/icongroupinterna · White Knuckles & Wishful Thinking: Learning From the Moment of Relapse in Alcoholism and Other Addictions by George Manter Duwors, et al; ISBN: 0889372241; http://www.amazon.com/exec/obidos/ASIN/0889372241/icongroupinterna · Women Married to Alcoholics: Help and Hope for Nonalcoholic Partners by Morris Kokin, Ian W. Walker (Contributor); ISBN: 0688081541; http://www.amazon.com/exec/obidos/ASIN/0688081541/icongroupinterna · Work and Alcohol Abuse : An Annotated Bibliography by John J. Miletich (Author) (1987); ISBN: 0313256896; http://www.amazon.com/exec/obidos/ASIN/0313256896/icongroupinterna The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “alcohol abuse” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 · A handbook on drug and alcohol abuse; the biomedical aspects. [By] Frederick G. Hofmann in collaboration with Adele D. Hofmann. Author: Hofmann, Frederick G.; Year: 1975; New York, Oxford University Press, 1975 · Alcohol abuse and alcoholism prevention, treatment, and rehabilitation; hearings. Ninety-first Congress, second session on S. 3835. May 21 and 25, 1970. Author: United States. Congress. Senate. Committee on Labor and Public Welfare. Special Subcommittee on Alcoholism and Narcotics.; Year: 1970; Washington, For sale by the Supt. of Docs., U. S. Govt. Print. Off., 1970 11 In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books. Books 247 · Alcohol abuse and alcoholism. Hearing. Ninety-third Congress, first session on H. R. 10019. and H. R. 6160. Sept 26, 1973. Author: United States. Congress. House. Committee on Interstate and Foreign Commerce. Subcommittee on Public Health and Environment.; Year: 1974; Washington, U. S. Govt. Print. Off., 1974 · Alcohol abuse. Author: Office of Health Economics (London, England); Year: 1970; London [c1970]; ISBN: 901387118 · Alcoholism - what are we going to do about it?: coordinator's guide for developing a plan for the hospital care of the alcoholic patient Author: American Hospital Association.; Year: 1972; Chicago: The Association, 1972 · Alcoholism and treatment Author: Armor, David J.; Year: 1976; Santa Monica, Calif.: Rand, 1976 · Alcoholism treatment & rehabilitation; selected abstracts [1960-71]. Author: National Institute of Mental Health (U.S.); Year: 1972; Rockville, Md. [For sale by the Supt. of Docs., U. S. Govt. Print. Off., Washington. 1972] · Community resources in programs for drug and alcohol abuse and delinquency prevention Author: Ries, J. C.; Year: 1972; Los Angeles: Institute of Government and Public Affairs, University of California, 1972 · Comprehensive alcohol abuse and alcoholism prevention, treatment, and rehabilitation act of 1974; report to accompany H. R. 11387. Author: United States. Congress. House. Committee on Interstate and Foreign Commerce.; Year: 1976; [Washington] 1974 · Directory of state and local alcoholism services. Author: National Institute on Alcohol Abuse and Alcoholism (U.S.); Year: 1972; Rockville, Md., National Institute of Mental Health, 1972 · How to get money for arts and humanities, drug and alcohol abuse, and health. Compiled and edited by Stephen E. Nowlan [et al. Author: Human Resources Network.; Year: 1975; Radnor, Pa., Chilton [c1975] · Oversight on prevention activities of the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, 1982: hearing before the Subcommittee on Alcoholism and Drug Abuse of the Committee on Labor and Human Resources, United States Senate, Ninety-seventh Congress, second session. February 24, 1982. Author: United States. Congress. Senate. Committee on Labor and Human Resources. Subcommittee on Alcoholism and Drug Abuse.; Year: 1982; Washington: U.S. G.P.O., 1982 · Research on alcoholism: clinical problems and special populations: proceedings of the first annual Alcoholism Conference of the National Institute on Alcohol Abuse and Alcoholism, June 25-26, 1972 [i.e. 1971] Washington D. C. Author: Alcoholism Conference 1st, Washington, D. C., 1971.; Year: 1973; Rockville, Md.: National Institute of Mental Health, National Institute on · Research, treatment, and prevention: proceedings of the fourth annual Alcoholism Conference of the National Institute on Alcohol Abuse and Alcoholism, June 12-14, 1974, Washington, D. C. Author: Alcoholism Conference 4th, Washington, D. C., 1974.; Year: 1975; Rockville, Md.: National Institute on · Staff report on drug and alcohol abuse among U. S. military personnel and dependents in Germany. Author: United States. Congress. Senate. Committee on Armed Services. Subcommittee on Drug Abuse in the Military.; Year: 1972; Washington, U. S. Govt. Print. Off., 1972 248 Alcohol Abuse Chapters on Alcohol Abuse In order to find chapters that specifically relate to alcohol abuse, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and alcohol abuse using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “alcohol abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on alcohol abuse: · Deafness and Alcohol Abuse Source: in Lala, F.J.J., Jr. Counseling the Deaf Substance Abuser. Chicago, IL: Adams Press. 1998. p. 76-138. Contact: Available from Midas Management Company. P.O. Box 27740, Las Vegas, NV 89126-1740. PRICE: $28.95 plus shipping and handling. ISBN: 0966375300. Summary: This chapter on deafness and alcohol abuse is from a book intended to focus attention on the problem of substance abuse in the Deaf community. It attempts to help people affected by addiction, and provide preventive information and incentives to preclude the development of alcoholism and substance abuse in the next generation. Originally published as the author's dissertation, the book states that up to 35 percent of people with significant hearing impairment have abused substances, including alcohol. This is almost double the estimated rate of comparable abuse among people who do not have impaired hearing. This chapter presents a broad overview on alcoholism as it relates to deafness. The author discusses basic information about alcoholism; reviews both short and long term physical, mental, emotional, and social effects of alcohol abuse; outlines current thought regarding the etiology and epidemiology of alcoholism, including predisposing influences, such as genetics; discusses sociocultural and psychological interweaving factors which can contribute to or maintain alcohol abuse; and provides a listing of some variables that may influence an individual's willingness to seek treatment for alcohol addiction. 2 tables. Directories In addition to the references and resources discussed earlier in this chapter, a number of directories relating to alcohol abuse have been published that consolidate information across various sources. The Combined Health Information Database lists the following, which you may wish to consult in your local medical library:12 · Public funding resources for alcohol and other drug programs Source: Piscataway, NJ: New Jersey Alcohol/Drug Resource Center and Clearinghouse. 1993. 28 pp. 12 You will need to limit your search to “Directory” and “alcohol Abuse” using the "Detailed Search" option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find directories, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Select your preferred language and the format option “Directory.” Type “alcohol Abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. Books 249 Contact: Available from Judy Shepps Battle, Coordinator, New Jersey Alcohol/Drug Resource Center and Clearinghouse, Rutgers, The State University of New Jersey, Smithers Hall, Busch Campus, Piscataway, NJ 08855. Telephone: (908) 932-0787. $14.95 includes shipping and handling. Summary: The directory is designed to help those unfamiliar with funding research find possible public resources for developing programs for education, prevention, and treatment programs in higher education settings related to alcohol and other drugs. It explains the process of using the 'Federal Register' and the 'Catalog of Federal Domestic Assistance' to find sources of public funding. It also lists public program and public research resources from those sources that were effect in 1993. Excerpts from the DrugFree Schools and Communities Act Amendments of 1989 that mandated establishing certification of drug and alcohol abuse prevention programs in schools and campuses are included in an appendix. · Family planning: Reaching out to substance abusing clients: Educational materials and program descriptions Source: Seattle, WA: Center for Health Training. 1992. 36 pp. Contact: Available from Center for Health Training, 400 Tower Building, 1809 Seventh Avenue, Seattle, WA 98101-1313. Telephone: (206) 447-9538 / fax: (206) 447-9539. Summary: This bibliography contains brief descriptions of education brochures and project /training center descriptions offered to clients of federally funded family planning programs who need help with substance abuse. The educational materials includes general information on alcohol, drugs, and smoking, as well as brochures focusing on adolescent or prenatal aspects of substance or alcohol abuse. The project/training center descriptions are arranged by federal region and include workshops and conferences. · Hispanic Americans Source: Rockville, MD: National Clearinghouse for Alcohol and Drug Information. 1992. 26 pp. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail: info@health.org / Web site: http://www.health.org. Summary: This bibliography contains materials on drug abuse, alcohol abuse, smoking, and AIDS among the American Hispanic population. Many of the references are for Spanish language publications. There is also a directory of organizations and groups for Hispanic Americans. The Center for Substance Abuse Prevention plans to update this bibliography regularly. 251 CHAPTER 8. MULTIMEDIA ON ALCOHOL ABUSE Overview In this chapter, we show you how to keep current on multimedia sources of information on alcohol abuse. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine. Video Recordings An excellent source of multimedia information on alcohol abuse is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “alcohol abuse” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “alcohol abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on alcohol abuse: · Understanding the Symptoms and Causes of Dementia Source: Tuscaloosa, AL: Dementia Education and Training Program. 1993. (videocassette). Contact: Alabama Department of Public Health. Bureau of Geriatric Psychology. Dementia Education and Training Program. 200 University Boulevard, Tuscaloosa, AL 35401. (800) 457-5679; (205) 759-0820; FAX (205) 759-0891. PRICE: $15.00. Summary: In this videotape, Dr. Richard Powers gives a basic overview of dementia. The video is one of a series directed to home health nurses. However, it may be useful to a variety of professionals. Among the topics discussed are historical perspectives of dementia, 'hardening of the arteries,' cognitive and psychiatric clinical manifestations, current theories of etiology, and methods of treatment. Also included are descriptions of the risk factors for vascular dementia, syndromes associated with head trauma, and organic mental disorders related to alcohol abuse. 252 Alcohol Abuse · The Party's Over: Sex, Alcohol and Pregnancy Contact: TMW Media Group, 2321 Abbot Kinney Blvd, Venice, CA, 90291, (800) 2628862, http://www.tmwmedia.com. Summary: This live-action video presents information about the relationship between alcohol abuse, adolescent sex, and adolescent pregnancy and sexually transmitted diseases (STDs). It tells the story of three adolescent couples dealing with various sexual health and relationship issues, presented within the context of a party. The video examines how alcohol abuse contributes to unsafe sexual behavior among teens leading to adolescent pregnancy and STDs. The video includes information about state laws regarding responsibilities of noncustodial parents and child support, the realities of unplanned sexual activity, and sexual abstinence. · Research: Perspectives and Issues - Prevention & Beyond: A National Conference on HIV Infection and AIDS Among Racial and Ethnic Populations Summary: This videocassette recording begins with Dr. Ernestine Vanderween, Associate Director of Alcohol Research Center, National Institute on Alcohol Abuse and Alcoholism (NIAAA), introducing Dr. Lawrence Brown, Senior Vice-President of Addiction Research and Treatment Corporation. Dr. Brown delivers a presentation on issues that relate to research perspectives specifically concerning AIDS. He summarizes the obstacles to research, types of research investigations, and issues of methodology. Dr. Brown evaluates why people of color should participate in research, charts principles of collaboration, and describes a model protocol. The remainder of the workshop is devoted to questions from selected audience participants. · AIDS: Your Teenagers Don't Have to Get It Contact: Health Watch Information and Promotion Service Incorporated, 3020 Glenwood Rd, Brooklyn, NY, 11210, (718) 434-5411, http://www.hwatch.com. Summary: This videorecording addresses how parents can talk to their children or adolescents about Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome (AIDS). Some suggestions include: Getting the facts straight about HIV/AIDS; planning follow-up talks; never saying no without saying why; not giving mixed messages; always listening carefully; and ending on a positive note. It is also suggested that alcohol abuse and drug abuse put an individual at a high risk for contracting HIV. It points out that keeping the lines of communication open at all times is important. · AIDS: Another Way Drugs Can Kill Contact: US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on Drug Abuse, Center on AIDS and Other Medical Consequences of Drug Abuse, Rm 5213 MSC 9561, 6001 Executive Blvd, Bethesda, MD, 20892-9561, (301) 443-1124, http://www.nida.nih.gov. Summary: This videorecording contains seven public service announcements (PSA's) that warn adolescents of the dangers associated with drug and alcohol abuse and Acquired immunodeficiency syndrome (AIDS). The messages convey the possibility of impaired judgment resulting from substance abuse, and leading to Human immunodeficiency virus (HIV) transmission. Individual titles include the following, soem in varying lengths: Horror Show, Roof, Car, and Ocean. Multimedia 253 · Addiction. and Now AIDS - Prevention & Beyond: A National Conference on HIV Infection and AIDS Among Racial and Ethnic Populations Contact: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA, 30333, (404) 6393311. Summary: This videorecording presents a conference session on major issues concerning substance abuse and AIDS, taped at a congress on HIV/AIDS among racial and ethnic populations. Dr. Beny Prim moderates a slide presentation on addiction, covering definitions, theories, paraphernalia, physical symptoms, and tobacco and alcohol abuse. He calls for increased funding for treatment, and more effective drug policies. Dr. Elaine Johnson emphasizes the need for comprehensive services backed by collective efforts on the part of Federal agencies, and discusses progress that has been made in this area. Dr. German Maisonet of the Van Ness Recovery House in San Francisco, CA, stresses that AIDS is a complication and disease of addiction as he traces the effects and causes of addiction. Cyd Hupa, a Native American recovered addict, builds on her personal experiences to illustrate the high rate of substance abuse and lack of treatment services for addicts on reservations. At this point, the session is interrupted for several minutes by a protest demonstration by ACT UP and others. Several unscheduled speakers direct negative remarks at the organizers of the conference and express their views on several subjects, such as the lack of inclusion of women in clinical trials and power distribution in U.S. society. Two final scheduled speakers close the session: Dr. Davis Ja addresses the Asian connection with substance abuse; and Alberto Mata from the National Institute on Drug Abuse sums up the need for collaborative models and community response. · Teens, Sex and AIDS Contact: Films for the Humanities and Sciences, PO Box 2053, Princeton, NJ, 08543, (800) 257-5126. Summary: This videorecording presents a discussion among teens on their concerns about AIDS, combined with two dramatizations of teens dealing with decisions about sex. The first scenario involves a sexually active young couple who have been using contraceptives but are uncertain how to proceed when they start to consider the possibility of AIDS. The second scenario consists of two high school girls discussing a really "gorgeous guy" a third friend has a date with; one of the girls reveals she also went out with him but refused to have sex with him when he would not use a condom. The discussion part of the program is hosted by "Too Close for Comfort Star" Jim J. Bullock and Rebecca Street of "The Young and the Restless". During the discussion, the teens address the topics of abstinence, condom use, the window period, drug and alcohol abuse, resisting peer pressure, past partners, and respect in relationships. They emphasize that AIDS can happen to anyone. · Taking a Stand Contact: Comprehensive Health Education Foundation, 22419 Pacific Hwy S, Seattle, WA, 98198-5104, (206) 824-2907, http://www.chef.org. Summary: This videorecording uses three dramatizations to make points about withstanding peer pressure, avoiding alcohol abuse, and maintaining safe sexual conduct. The stories focus on Joanne, who doesn't want to have intercourse with her boyfriend, Lenny; Rosa, who wants to continue seeing Tony, but doesn't want to drink with his friends; and Mike, who feels his relationship with Alicia has grown too serious. 254 Alcohol Abuse The videorecording urges viewers to make informed choices, to present alternatives, and to stand their ground in the face of pressure. Using these skills can help decrease the chances of contracting Acquired immunodeficiency syndrome (AIDS). · Now That You Know: Living Healthy With HIV; Part 3 - Lifestyle Choices and Changes Contact: Kaiser Permanente, National Video Communications, 825 Colorado Blvd Ste 301, Los Angeles, CA, 90041, (323) 259-4776, http://www.kaiserpermanente.org/locations/index.html. Summary: This videorecording, part of a series, deals with the lifestyle changes made necessary by a diagnosis of Human immunodeficiency virus (HIV) infection. Co-hosts Bob Goen and Susan Campos provide narration, interspersed with presentations by experts in various fields and short-burst interviews with infected persons. The videorecording starts by saying that stress is the biggest problem in life today, and that it can suppress the immune system. Viewers are told to become aware that not all stress is caused by bad events, and are urged to learn how to cope with and reduce all types of stress. Different people have different ways of dealing with stress, and it's important for each person to determine what is right. Next, the videorecording discusses primary goals for nutrition. The importance of vitamins, minerals, calories, and protein is emphasized. Questions of supplements and dealing with illness, such as diarrhea, are addressed. Next, the videorecording looks at the importance of exercise, particularly aerobic exercise. Viewers are cautioned not to overexercise. Examples of the best types are given, and the importance of having a positive attitude is stressed. The theme then switches to drug and alcohol abuse as an escape mechanism that is harmful to the body. The videorecording points out how smoking suppresses the immune system; the narrators point out that risky sex may be a consequence of getting high. Signs of addiction are listed. The final portion of the videorecording looks at the ramifications of sexuality, including safer sexual conduct, abstinence, and loss of desire. The possibility that other Sexually transmitted diseases (STD's) may be co-factors in progression from HIV infection to full-blown Acquired immunodeficiency syndrome (AIDS), is pointed out. The videorecording discusses condom use and how to overcome the initial awkwardness of using a condom. It also examines the difficulty of telling potential partners about HIV status. · Tracy's Choices Contact: M V P Productions, P O Box 4126, Rockford, IL, 61110, (815) 877-1514. Summary: This videotape chronicles the life and death of Tracy Eichman, the first person in Illinois to be arrested, tried, convicted, and incarcerated for the knowing attempt to transmit HIV. Through interviews and news excerpts, the video sketches Tracy's involvement with alcohol and illegal drugs. Drug addiction led Tracy to prostitution at the age of 17. Following her arrest and conviction Tracy became a "born again Christian." The video emphasizes the role that spirituality and Christianity played in Tracy's recovery from drug addiction and influencing her decision to become a spokesperson for a lifestyle free of illegal drug use, alcohol abuse, and premarital sex. The video contains interviews with Tracy's arresting officer, a doctor, and a dentist. Each speaker underscores the importance of sexual and drug abuse abstinence, good decision making skills, personal responsibility, and adhering to Christian ethics, morals, and doctrine. Multimedia 255 · AIDS: Will You Risk It? Contact: AIDS Project of Central Iowa, 730 E 4th St Ste 100, Des Moines, IA, 50309-1850, (515) 284-0245. Summary: This videotape is a documentary featuring personal anecdotes of three young adults with AIDS. Each of the subjects explains the behaviors that put him/her at risk for HIV/AIDS, including unprotected sex, multiple sex partners, the use of illegal substances and alcohol, and engaging in sex while under the influence of drugs or alcohol. The video also includes an interview with a young girl who explains her experiences with sex, drug and alcohol abuse, and her sense of fatalism regarding HIV infection. Sexual abstinence is encouraged and the use of condoms is advised for those who do engage in sexual relations. · Healthy Liver-A Happier Life! Source: Cedar Grove, NJ: American Liver Foundation. 199x. Contact: Available from American Liver Foundation. 1425 Pompton Avenue, Cedar Grove, NJ 07009. (800) 223-0179 or (201) 256-2550. PRICE: $45 for video; $10 for resource packet; $50 if both are ordered. Summary: This videotape, produced by the American Liver Foundation, highlights lifegiving functions of the liver and ways to take care of it. The focus of the videotape is on prevention, describing how the liver can be seriously damaged, without warning, by viruses, drugs, alcohol, and other chemicals. Topics include liver cirrhosis and how it affects liver function; hepatitis viruses, notably hepatitis A, B, and C; the impact of vitamins and food supplements on the liver; and diagnostic tests. The video and accompanying printed materials are designed as supplements to existing substance and alcohol abuse prevention programs in schools, clinics, and businesses encouraging the adoption of healthier lifestyles. (AA-M). Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “alcohol abuse” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on alcohol abuse: · About AIDS; Read - Along Tapes Contact: Laubach Literacy International, Publishing Division, New Readers Press, PO Box 888, Syracuse, NY, 13210-0131, (800) 448-8878. Summary: These audiocassettes provide comprehensive HIV and AIDS education for the low-literacy individual. Designed to be used with or without an accompanying book, the tapes discuss what HIV is, how HIV infection differs from AIDS, how HIV is transmitted, and how HIV transmission can be prevented. The tapes also discuss home care, personal care, medications and treatments, and health care providers. Myths about casual contact transmission are discussed. Special attention is given to infants and children with HIV, their care, and their normal childhood experiences. The risks faced by injection drug users are enumerated, and information is provided on disinfecting 256 Alcohol Abuse injection equipment. Employment concerns are addressed and confidentiality issues are explored. Mental health, both of HIV-positive individuals and their caregivers, is examined. The tapes also discuss volunteer opportunities, either as part of an organization or on a personal one-to-one level. The tapes provide national toll-free numbers for further information on HIV and AIDS, drug and alcohol abuse, employment discrimination, and prescription pharmacies. · Working With Substance Abusers - Intervention Contact: Health Impact, PO Box 9443, Seattle, WA, 98109-9443, (206) 284-3865, http://www.healthimpact.org/. Summary: This sound recording deals with intervention to change and eliminate patterns of drug or alcohol abuse. Such abuse is associated with high rates of infection with the Human immunodeficiency virus (HIV), which is the etiologic agent of Acquired immunodeficiency syndrome (AIDS). A variety of intervention strategies are presented, generally based on explaining the risks associated with continuing abuse. Barriers to behavioral modification are also discussed, along with suggestions for surmounting these barriers. Of paramount importance in all these methods is the need to establish a trusting, nonjudgemental relationship with the clients. References and a post-test questionnaire are given in the booklet that accompanies this sound recording. · Working With Substance Abusers - Identification and Assessment Contact: Health Impact, PO Box 9443, Seattle, WA, 98109-9443, (206) 284-3865, http://www.healthimpact.org/. Summary: This sound recording deals with the relationship between Acquired immunodeficiency syndrome (AIDS) and drug and alcohol abuse. For several reasons, both drug and alcohol abusers seem to become infected more frequently with the Human immunodeficiency virus (HIV) and to respond less favorably to treatment. Needle-use practices and decreased sexual inhibitions while under the influence of drugs or alcohol are probably the major risks involved. Debilitated physical conditions and suppressed immune systems, which are common to addicts, are also contributing factors. Treatment may be complicated by drug and alcohol interaction with medication and by the lack of personal stability of the addicts. Drug and alcohol abusers and their children, especially Blacks and Hispanics, are the fastest-growing group of HIV-positive persons in the United States, and meeting their needs will be the challenge in the future. A list of symptoms of substance abusers is given at the end of the recording to assist health professionals in identifying these people, even when they may not themselves be aware of their problem. References and a post-test questionnaire are given in the booklet that accompanies this sound recording. · AIDS and Risk Reduction in Drug Abuse Treatment Settings Contact: Audio Visual, Incorporated, 5542 Tuxedo Rd, Cheverly, MD, 20781, (301) 3225600. Summary: This sound recording of a National Institute on Drug Abuse Conference session held January 14, 1991, presents a panel discussion of various types of treatment for drug and alcohol abuse, and how risk reduction for Human immunodeficiency virus (HIV) transmission can be modeled on these, or integrated into them. The first speaker discusses a variety of treatment programs and what types of tactics work. Programs for adolescents require special consideration. The second speaker describes personality disorders frequently found in drug and alcohol abusers which affect Multimedia 257 treatment outcome. The third speaker explains the health-belief model as an Acquired immunodeficiency syndrome (AIDS) preventive measure. Bibliography: Multimedia on Alcohol Abuse The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in alcohol abuse (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on alcohol abuse: · Alcohol abuse and alcoholism [electronic resource]. Year: 1988; Format: Electronic resource; [Kansas City, Mo.: Evaluation Resource Center, University of Missouri-Kansas City, School of Medicine, 1988] · Alcoholism: a family problem [videorecording] Source: Joseph V. Fisher, in cooperation with Office of Educational Services; Year: 1978; Format: Videorecording; Chapel Hill, N. C.: Health Sciences Consortium, c1978 · Co-morbidity of alcohol abuse and anxiety [videorecording] Source: produced by the College of Medicine and the Health Communications Network; Year: 1992; Format: Videorecording; Charleston, S.C.: Medical University of South Carolina, c1992 · Pathophysiology of alcohol abuse [slide] Source: Lauraine A. Thomas; produced by Robert J. Brady Co; Year: 1977; Format: Slide; Bowie, Md.: The Company, c1977 · Teenage alcohol abuse [videorecording] Source: produced through the facilities of Biomedical Communications Television Services, the Ohio State University, School of Allied Medical Professions; Year: 1987; Format: Videorecording; [S.l.: s.n.], c1987 · The Physician's role [videorecording]: diagnosis and management of alcoholism and alcohol related disorders Source: University of Tennessee Research Corporation, Southern Area Alcohol Education and Training Program, inc., Memphis Mental Health Institute; Year: 1977; Format: Videorecording; Memphis: The Corporation; [Atlanta: for sale by The Program], c1977 · Updating estimates of the economic costs of alcohol abuse in the United States [electronic resource]: estimates, update methods, and data. Source: Harwood, Henrick J; Year: 2000; Format: Electronic resource; [Bethesda, Md.]: U.S. Dept. of Health and Human Services, Public Health Service, National Institutes of Health, National Institute on 259 CHAPTER 9. PERIODICALS AND NEWS ON ALCOHOL ABUSE Overview In this chapter, we suggest a number of news sources and present various periodicals that cover alcohol abuse. News Services and Press Releases One of the simplest ways of tracking press releases on alcohol abuse is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “alcohol abuse” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to alcohol abuse. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “alcohol abuse” (or synonyms). The following was recently listed in this archive for alcohol abuse: · Long-term alcohol abuse affects hormones Source: Reuters Health eLine Date: May 21, 2003 · Long term hormone effects of alcoholism revealed Source: Reuters Medical News Date: May 20, 2003 260 Alcohol Abuse · Czar's freak show helps fight Russian alcoholism Source: Reuters Health eLine Date: April 28, 2003 · Alcohol industry says study on alcohol abuse flawed Source: Reuters Health eLine Date: February 26, 2003 · Minors and adult alcohol abusers purchase half of the alcohol in the US Source: Reuters Medical News Date: February 25, 2003 · High alcoholism, low stress seen among rescuers Source: Reuters Health eLine Date: May 10, 2002 · Drug for alcohol abuse may curb urge to steal Source: Reuters Health eLine Date: May 07, 2002 · Forest files NDA for drug to treat alcoholism Source: Reuters Industry Breifing Date: February 27, 2002 · Brief physician intervention reduces alcohol abuse over long term Source: Reuters Medical News Date: January 28, 2002 · Drug, alcohol abuse on rise in US after Sept. 11 Source: Reuters Health eLine Date: December 05, 2001 · Alcoholics may reverse brain damage by quitting Source: Reuters Health eLine Date: November 14, 2001 · Alcohol abuse takes major toll on college students Source: Reuters Health eLine Date: October 24, 2001 · Forest licenses US rights to Merck KgaA alcoholism drug Source: Reuters Industry Breifing Date: October 23, 2001 · Alcoholism associated with a decreased risk of endometrial cancer Source: Reuters Medical News Date: August 02, 2001 · Brain imbalance linked to alcoholism Source: Reuters Health eLine Date: March 21, 2001 · Women report more disability from alcoholism than men Source: Reuters Medical News Date: March 15, 2001 · Women report being more disabled by alcoholism Source: Reuters Health eLine Date: March 15, 2001 Periodicals and News · Brain scans show impairments in young alcoholics Source: Reuters Health eLine Date: February 15, 2001 · Women's brains are more vulnerable to alcoholism Source: Reuters Health eLine Date: February 08, 2001 · Adolescent alcohol abuse linked to increased psychopathology in adulthood Source: Reuters Medical News Date: January 15, 2001 · Alcoholism changes brain's genetic wiring Source: Reuters Health eLine Date: December 14, 2000 · Alcohol abuse undermines ability to focus Source: Reuters Health eLine Date: December 14, 2000 · Anxiety-linked drinking ups alcoholism risk Source: Reuters Health eLine Date: November 20, 2000 · Alcoholics more susceptible to nicotine's draw Source: Reuters Health eLine Date: November 16, 2000 · Laboratory marker of alcohol abuse useful for clinical practice Source: Reuters Medical News Date: October 11, 2000 261 The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to 262 Alcohol Abuse Market Wire’s home page at http://www.marketwire.com/mw/home, type “alcohol abuse” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “alcohol abuse” (or synonyms). If you know the name of a company that is relevant to alcohol abuse, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “alcohol abuse” (or synonyms). Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “alcohol abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on alcohol abuse: · Adverse Drug Reactions Source: The Beacon. 9,12-13. Summer 1997. Contact: Available from Scleroderma Foundation. 12 Kent Way, Suite 101, Byfield, MA 01922. (800) 722-4673 or (978) 463-5843. Fax (978) 463-5809. E-mail: sfinfo@scleroderma.org. Website: www.scleroderma.org. Summary: This newsletter article for individuals with scleroderma presents information about drug interactions. Topics discussed include side effects, drug-drug interactions, alcohol abuse, drug-nicotine interactions, and drug effects on laboratory tests. Examples of how food can interact with drugs are provided. Information that patients should share with their physician concerning their medications is highlighted, and questions that patients should ask their physician about prescribed medications are outlined. Guidelines for reading a prescription are provided. Sources of additional information about prescription and nonprescription medications are identified. In addition, suggestions for obtaining the best results from prescription drugs are offered. Periodicals and News 263 Academic Periodicals covering Alcohol Abuse Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to alcohol abuse. In addition to these sources, you can search for articles covering alcohol abuse that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.” 265 CHAPTER 10. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources. U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for alcohol abuse. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a non-profit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DIÒ Advice for the PatientÒ can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with alcohol abuse. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The 266 Alcohol Abuse following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to alcohol abuse: Ascorbic Acid (Vitamin C) · Systemic - U.S. Brands: Ascorbicap; Cecon; Cee-500; Cemill; Cenolate; Cetane; Cevi-Bid; Flavorcee; Ortho/CS; Sunkist http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202071.html Disulfiram · Systemic - U.S. Brands: Antabuse http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202603.html Folic Acid (Vitamin B 9 ) · Systemic - U.S. Brands: Folvite http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202250.html Naltrexone · Systemic - U.S. Brands: ReVia http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202388.html Niacin (Vitamin B 3 ) · Systemic - U.S. Brands: Endur-Acin; Nia-Bid; Niac; Niacels; Niacor; Nico-400; Nicobid Tempules; Nicolar; Nicotinex Elixir; Slo-Niacin http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202405.html Paraldehyde · Systemic - U.S. Brands: Paral http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202440.html Pyridoxine (Vitamin B 6 ) · Systemic - U.S. Brands: Beesix; Doxine; Nestrex; Pyri; Rodex http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202493.html Thiamine (Vitamin B 1 ) · Systemic - U.S. Brands: Biamine http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202560.html Vitamin B 12 · Systemic - U.S. Brands: Alphamin; Cobex; Cobolin-M; Crystamine; Crysti-12; Cyanoject; Cyomin; Hydrobexan; Hydro-Cobex; Hydro-Crysti-12; HydroxyCobal; LA-12; Nascobal; Neuroforte-R; Primabalt; Rubramin PC; Shovite; Vibal; Vibal LA; Vitabee 12 http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202596.html Vitamin D and Related Compounds · Systemic - U.S. Brands: Calciferol; Calciferol Drops; Calcijex; Calderol; DHT; DHT Intensol; Drisdol; Drisdol Drops; Hectorol; Hytakerol; Rocaltrol; Zemplar http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202597.html Researching Medications 267 Zinc Supplements · Systemic - U.S. Brands: Orazinc; Verazinc; Zinc 15; Zinc-220; Zinca-Pak; Zincate http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202622.html Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library. Mosby’s Drug ConsultÔ Mosby’s Drug ConsultÔ database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov. 269 APPENDICES 271 APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience. NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute13: · Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm · National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/ · National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html · National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25 · National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm · National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm · National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375 · National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/ 13 These publications are typically written by one or more of the various NIH Institutes. 272 Alcohol Abuse · National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm · National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/ · National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm · National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm · National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/ · National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/ · National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm · National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html · National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm · National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm · National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm · National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html · National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm · Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp · National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/ · National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp · Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html · Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm Physician Resources 273 NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.14 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:15 · Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html · HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html · NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html · Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/ · Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html · Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html · Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/ · Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html · Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html · Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html · MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html 14 Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 15 See http://www.nlm.nih.gov/databases/databases.html. 274 Alcohol Abuse · Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html · Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “alcohol abuse” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “alcohol abuse” (or synonyms) into the “For these words:” box. The following is a sample result: · Medical Consequences Source: in Seventh Special Report to the U.S. Congress on Alcohol and Health. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism. 1990. p. 107-138. Contact: Available from National Clearinghouse for Alcohol and Drug Information. 6000 Executive Boulevard, P.O. Box 2345, Rockville, MD 20852. (800) 729-6686. PRICE: Single copy free. Summary: Alcohol affects almost every organ system in the body either directly or indirectly. This chapter, from a special report on alcohol and health, discusses the medical consequences of alcohol use and abuse. Topics include alcohol-induced liver disorders; effects of alcohol on the gastrointestinal tract; nutritional and metabolic disorders; effects on the cardiovascular system, including the heart, the vascular system, and coronary heart disease; effects on the immune system; alcohol and cancer; effects on endocrine and reproductive functions; and neurologic disorders. The authors conclude that new concepts and technological advances have great potential to accelerate progress in understanding the biomedical consequences of alcohol dependence and in developing improved methods to treat and prevent the consequences of alcohol dependence and alcohol abuse. 6 figures. 256 references. · Adolescent Substance Abuse: Risk Factors and Prevention Strategies Contact: National Center for Education in Maternal and Child Health, 2000 Fifteenth St N Ste 701, Arlington, VA, 22201-2617, (703) 821-8955, http://www.ncemch.org. Summary: This article reviews information concerning the prevalence of adolescent alcohol and drug abuse and related health problems. A survey of research shows drug and alcohol abuse is related to many of the problems affecting adolescents, including accidents, suicides, sexual activity, and inadequate use of contraception. The article details associated psychological and behavioral issues, risk factors, and prevention strategies. The conclusion indicates the most effective prevention strategies utilize a social influence approach or emphasize personal and social skills teaching; the largest effects are produced by programs combining features of both. The author suggests that if drug-using behavior is not learned during adolescence due to infrequent exposure to Physician Resources 275 risk, the chances are better that drugs will never be used. He argues this implies that drug prevention programs should focus on reducing exposure to risk factors and modifying factors already present, including disrupted family environments and nonconformist attitudes. · Toward a state of esteem: The final report of the California Task Force to Promote Self-esteem and Personal and Social Responsibility Source: Sacramento, CA: California Department of Education. 1990. 144 pp. Contact: Available from Bureau of Publications, California Department of Education, 560 J Street, Suite 270, Sacramento, CA 95814. Telephone: (916) 445-0850. $4.25 each plus sales tax for California residents (includes shipping and handling). Summary: This final report from the California Task Force to Promote Self-Esteem and Personal and Social Responsibility discusses the importance of nurturing self-esteem and personal and social responsibility among children and adolescents. The task force identifies key principles of building self-esteem which are grounded in family, schools, and the workplace. The task force points to a lack of self-esteem as a factor in drug and alcohol abuse, crime and violence, and poverty. Recommendations are provided for the state for implementation in schools, and for promotion to families. · A Technical Assistance Manual on the Employment Provisions (Title I) of the Americans With Disabilities Act. Translated title Contact: US Government Printing Office, PO Box 371954, Pittsburgh, PA, 15250-7954, (202) 512-1800, http://www.access.gpo.gov. Recording for the Blind, 20 Roszel Rd, Princeton, NJ, 08540, (609) 452-0606. Summary: This manual provides guidance on the practical application of legal requirements established in the statute and Equal Employment Opportunity Commission (EEOC) regulations. This manual is designed to be updated periodically with supplements as the EEOC develops further policy guidance and identifies additional resources. The information is presented in 10 chapters that are designed to explain the American with Disabilities Act (ADA) basic employment nondiscrimination requirements. The first three chapters provide an overview of ADA and Title I legal requirements, and discuss in detail the basic requirement not to discriminate against a qualified individual with a disability. This section includes the requirement for reasonable accommodation. The following chapters apply these legal requirements to specific employment practices and activities such as medical examinations, preemployment inquiries, recruitment, drug and alcohol abuse, and work-related injuries. (Persons with the Human immunodeficiency virus (HIV) and Acquired immunodeficiency syndrome are protected under the ADA). · Delta Alcohol, Drug Abuse and AIDS Community Education Project; National Training Manual Contact: Delta Sigma Theta Sorority, Alcohol, Drug Abuse, and AIDS Community Education Project, 1707 New Hampshire Ave, Washington, DC, 20009, (202) 483-5460. Summary: This manual was developed in response to the epidemic of Acquired immunodeficiency syndrome (AIDS) among young people. It identifies the broad relationship among alcohol and drug abuse, and the spread of Human immunodeficiency virus (HIV) infection. It also draws upon African American heritage that calls on indivuduals to take responsiblity for the present and future of other African 276 Alcohol Abuse Americans. The curriculum portion of the manual looks at the project background and its key concepts and objectives. After explaining the manual content and processes, it then turns to five training models. They include setting the stage; alcohol abuse, drug abuse, Acquired immunodeficiency syndrome (AIDS) and conceptualizing the African American context; knowledge and attitudes for healthy living; behavior for healthy living; and contemporary concerns regarding violence and victimization, and safer sex. It concludes with trainer and educator tips. · Women Don't Get AIDS: They Just Die From It. Part II (Prevention Education) Source: HIV / AIDS Ministries Network Focus Paper; No. 18. Contact: General Board of Global Ministries, United Methodist Church, Health and Welfare Ministries Program Department, 475 Riverside Dr Rm 330, New York, NY, 10115, (212) 870-3909, http://gbgm-umc.org/units/hwmin/. Summary: This paper focuses on prevention education project models demonstrating community-based efforts and actions that can be undertaken by churches. It discusses the need for culturally sensitive programs, the impact of sexism and sexual violence, and the needs of different communities of women in terms of HIV/AIDS education/prevention programs. It summarizes these five key areas identified by the World Health Organization (WHO) as a "framework for intervention": public policy initiatives to foster greater equity, environments supporting access to condoms, community action to introduce legislation, individual involvement, and integrated health services. The paper describes the women and AIDS project sponsored by the New York State Division for Women and the New York State Division of Alcoholism and Alcohol Abuse, the South Carolina AIDS Education Network (SCAEN), Project REACH, the Colombian Red Cross, Hospital Audiences Inc. (HAI), and the D.C. Women's Council on AIDS. It addresses the connection between safer sex and spirituality, as well as indicating actions churches can take related to HIV prevention education, activities to build self-esteem, and ways to oppose the sexual abuse of women. · Sex, Drugs & Remote Control: A Series of Humorous Sketches Performed Live! Contact: University of Iowa, Health Iowa, Iowa City, IA, 52242, (319) 335-8392. Summary: This program contains two sets of questionnaires. College students who watch a performance are asked to take a test on condom use, drug and alcohol abuse, and Human immunodeficiency virus (HIV) prevention before the performance, then repeat the same test after the performance. · Florida's Response to AIDS and Substance Abuse Contact: Florida Department of Health and Rehabilitative Services, Alcohol, Drug Abuse and Mental Health Program Office, AIDS Unit, 1317 Winewood Blvd, Tallahassee, FL, 32399, (904) 487-2478. Summary: This report details the efforts of the Florida Alcohol and Drug Abuse Program to respond to the Acquired immunodeficiency syndrome (AIDS) epidemic. The early portion of the report describes six projects: HIV-Antibody Counseling and Testing Services; Primary Care and Substance Abuse Integrated Treatment; Comprehensive Substance Abuse/AIDS Training Program; HIV and Substance Abuse Outreach Services; Risk Assessment Survey Analysis; and Knowledge, Attitudes, Behaviors, and Beliefs (KABB) Survey. The remaining four sections consist of research papers on Physician Resources 277 various aspects of the AIDS epidemic in Florida: They examine the topics of women and AIDS, substance abuse and AIDS, program evaluation, and recovery for the family affected by alcohol abuse. · Alcohol research: Promise for the decade Source: Rockville, MD: National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services. 1991. 72 pp. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail: info@health.org / Web site: http://www.health.org. Summary: This report provides an overview of current research in alcohol dependence syndrome. Chapters focus on the neurochemistry of alcohol use, genetic and environmental factors in the development of alcohol abuse, the clinical effects of alcoholism, fetal alcohol syndrome, prevention and treatment, and the development of new drugs from treating alcoholism. · Costs of underage drinking. [Updated ed.] Source: Calverton, MD: Pacific Institute for Research and Evaluation. 1999. 22 pp. Contact: Available from Pacific Institute for Research and Evaluation, Underage Drinking Enforcement Training Center, 11710 Beltsville Drive, Suite 300, Calverton, MD 20705. Telephone: (301) 755-2700 or (877) 335- 1287 toll-free / fax: (301) 586-9214 / Web site: http://www.udetc.org. Available at no charge; also available from the Web site at no charge. Summary: This report, prepared for the U.S. Office of Juvenile Justice and Delinquency Prevention, Underage Drinking Laws program, provides information about the range of serious health and social problems and economic costs associated with underage drinking. Topics include the costs of alcohol use by youth, problems such as traffic crashes, interpersonal violence, unintentional drownings and burns, suicides, fetal alcohol syndrome, alcohol poisonings, alcohol dependence, and alcohol abuse treatment. The appendices contain definitions and values, and tables on 1998 state costs for alcohol-attributable youth traffic crashes, violence, and other problems. Endnotes, statistics, costs are also provided. The NLM Gateway16 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.17 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “alcohol abuse” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. 16 17 Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x. The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 278 Alcohol Abuse Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total Items Found 49638 3794 974 212 194 54812 HSTAT18 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.19 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.20 Simply search by “alcohol abuse” (or synonyms) at the following Web site: http://text.nlm.nih.gov. Coffee Break: Tutorials for Biologists21 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.22 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.23 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/. 18 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 19 The HSTAT URL is http://hstat.nlm.nih.gov/. 20 Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 21 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 22 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 23 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process. Physician Resources 279 Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: · CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/. · Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/. The Genome Project and Alcohol Abuse In the following section, we will discuss databases and references which relate to the Genome Project and alcohol Abuse. Online Mendelian Inheritance in Man (OMIM) The Online Mendelian Inheritance in Man (OMIM) database is a catalog of human genes and genetic disorders authored and edited by Dr. Victor A. McKusick and his colleagues at Johns Hopkins and elsewhere. OMIM was developed for the World Wide Web by the National Center for Biotechnology Information (NCBI).24 The database contains textual information, pictures, and reference information. It also contains copious links to NCBI’s Entrez database of MEDLINE articles and sequence information. To search the database, go to http://www.ncbi.nlm.nih.gov/Omim/searchomim.html. Type “alcohol Abuse” (or synonyms) into the search box, and click “Submit Search.” If too many results appear, you can narrow the search by adding the word “clinical.” Each report will have additional links to related research and databases. In particular, the option “Database Links” will search across technical databases that offer an abundance of information. The following is an example of the results you can obtain from the OMIM for alcohol Abuse: · Alcoholism Web site: http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?103780 Genes and Disease (NCBI - Map) The Genes and Disease database is produced by the National Center for Biotechnology Information of the National Library of Medicine at the National Institutes of Health. This Web site categorizes each disorder by system of the body. Go to http://www.ncbi.nlm.nih.gov/disease/, and browse the system pages to have a full view of important conditions linked to human genes. Since this site is regularly updated, you may wish to revisit it from time to time. The following systems and associated disorders are addressed: Adapted from http://www.ncbi.nlm.nih.gov/. Established in 1988 as a national resource for molecular biology information, NCBI creates public databases, conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information--all for the better understanding of molecular processes affecting human health and disease. 24 280 Alcohol Abuse · Cancer: Uncontrolled cell division. Examples: Breast and ovarian cancer, Burkitt lymphoma, chronic myeloid leukemia, colon cancer, lung cancer, malignant melanoma, multiple endocrine neoplasia, neurofibromatosis, p53 tumor suppressor, pancreatic cancer, prostate cancer, Ras oncogene, RB: retinoblastoma, von Hippel-Lindau syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Cancer.html · Immune System: Fights invaders. Examples: Asthma, autoimmune polyglandular syndrome, Crohn’s disease, DiGeorge syndrome, familial Mediterranean fever, immunodeficiency with Hyper-IgM, severe combined immunodeficiency. Web site: http://www.ncbi.nlm.nih.gov/disease/Immune.html · Metabolism: Food and energy. Examples: Adreno-leukodystrophy, atherosclerosis, Best disease, Gaucher disease, glucose galactose malabsorption, gyrate atrophy, juvenile-onset diabetes, obesity, paroxysmal nocturnal hemoglobinuria, phenylketonuria, Refsum disease, Tangier disease, Tay-Sachs disease. Web site: http://www.ncbi.nlm.nih.gov/disease/Metabolism.html · Muscle and Bone: Movement and growth. Examples: Duchenne muscular dystrophy, Ellis-van Creveld syndrome, Marfan syndrome, myotonic dystrophy, spinal muscular atrophy. Web site: http://www.ncbi.nlm.nih.gov/disease/Muscle.html · Nervous System: Mind and body. Examples: Alzheimer disease, amyotrophic lateral sclerosis, Angelman syndrome, Charcot-Marie-Tooth disease, epilepsy, essential tremor, fragile X syndrome, Friedreich’s ataxia, Huntington disease, Niemann-Pick disease, Parkinson disease, Prader-Willi syndrome, Rett syndrome, spinocerebellar atrophy, Williams syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Brain.html · Signals: Cellular messages. Examples: Ataxia telangiectasia, Cockayne syndrome, glaucoma, male-patterned baldness, SRY: sex determination, tuberous sclerosis, Waardenburg syndrome, Werner syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Signals.html · Transporters: Pumps and channels. Examples: Cystic fibrosis, deafness, diastrophic dysplasia, Hemophilia A, long-QT syndrome, Menkes syndrome, Pendred syndrome, polycystic kidney disease, sickle cell anemia, Wilson’s disease, Zellweger syndrome. Web site: http://www.ncbi.nlm.nih.gov/disease/Transporters.html Entrez Entrez is a search and retrieval system that integrates several linked databases at the National Center for Biotechnology Information (NCBI). These databases include nucleotide sequences, protein sequences, macromolecular structures, whole genomes, and MEDLINE through PubMed. Entrez provides access to the following databases: · 3D Domains: Domains from Entrez Structure, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo Physician Resources · Books: Online books, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=books · Genome: Complete genome assemblies, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Genome · NCBI’s Protein Sequence Information Survey Results: Web site: http://www.ncbi.nlm.nih.gov/About/proteinsurvey/ · Nucleotide Sequence Database (Genbank): Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Nucleotide · OMIM: Online Mendelian Inheritance in Man, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=OMIM · PopSet: Population study data sets, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Popset · ProbeSet: Gene Expression Omnibus (GEO), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=geo · Protein Sequence Database: Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Protein · PubMed: Biomedical literature (PubMed), Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed · Structure: Three-dimensional macromolecular structures, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Structure · Taxonomy: Organisms in GenBank, Web site: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Taxonomy 281 To access the Entrez system at the National Center for Biotechnology Information, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=genome, and then select the database that you would like to search. The databases available are listed in the drop box next to “Search.” Enter “alcohol Abuse” (or synonyms) into the search box and click “Go.” Jablonski’s Multiple Congenital Anomaly/Mental Retardation (MCA/MR) Syndromes Database25 This online resource has been developed to facilitate the identification and differentiation of syndromic entities. Special attention is given to the type of information that is usually limited or completely omitted in existing reference sources due to space limitations of the printed form. At http://www.nlm.nih.gov/mesh/jablonski/syndrome_toc/toc_a.html, you can search across syndromes using an alphabetical index. Search by keywords at http://www.nlm.nih.gov/mesh/jablonski/syndrome_db.html. Adapted from the National Library of Medicine: http://www.nlm.nih.gov/mesh/jablonski/about_syndrome.html. 25 282 Alcohol Abuse The Genome Database26 Established at Johns Hopkins University in Baltimore, Maryland in 1990, the Genome Database (GDB) is the official central repository for genomic mapping data resulting from the Human Genome Initiative. In the spring of 1999, the Bioinformatics Supercomputing Centre (BiSC) at the Hospital for Sick Children in Toronto, Ontario assumed the management of GDB. The Human Genome Initiative is a worldwide research effort focusing on structural analysis of human DNA to determine the location and sequence of the estimated 100,000 human genes. In support of this project, GDB stores and curates data generated by researchers worldwide who are engaged in the mapping effort of the Human Genome Project (HGP). GDB’s mission is to provide scientists with an encyclopedia of the human genome which is continually revised and updated to reflect the current state of scientific knowledge. Although GDB has historically focused on gene mapping, its focus will broaden as the Genome Project moves from mapping to sequence, and finally, to functional analysis. To access the GDB, simply go to the following hyperlink: http://www.gdb.org/. Search “All Biological Data” by “Keyword.” Type “alcohol Abuse” (or synonyms) into the search box, and review the results. If more than one word is used in the search box, then separate each one with the word “and” or “or” (using “or” might be useful when using synonyms). 26 Adapted from the Genome Database: http://gdbwww.gdb.org/gdb/aboutGDB.html - mission. 283 APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on alcohol abuse can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them. Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to alcohol abuse. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to alcohol abuse. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “alcohol abuse”: 284 Alcohol Abuse · Other guides Alcohol and Youth http://www.nlm.nih.gov/medlineplus/alcoholandyouth.html Alcohol Consumption http://www.nlm.nih.gov/medlineplus/alcoholconsumption.html Alcoholism http://www.nlm.nih.gov/medlineplus/alcoholism.html Fetal Alcohol Syndrome http://www.nlm.nih.gov/medlineplus/fetalalcoholsyndrome.html Pregnancy and Substance Abuse http://www.nlm.nih.gov/medlineplus/pregnancyandsubstanceabuse.html Prescription Drug Abuse http://www.nlm.nih.gov/medlineplus/prescriptiondrugabuse.html Within the health topic page dedicated to alcohol abuse, the following was listed: · General/Overview Alcoholism Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=DS00340 Alcoholism Source: National Clearinghouse for Alcohol and Drug Information http://store.health.org/catalog/facts.aspx?topic=3 · Diagnosis/Symptoms Knowing the Signs of Alcoholism Can Save Lives Source: National Clearinghouse for Alcohol and Drug Information http://www.ncadi.samhsa.gov/newsroom/rep/212.aspx Problem Drinking -- How to Recognize It Source: American Academy of Family Physicians http://familydoctor.org/handouts/755.html · Treatment Alcohol Alert: New Advances in Alcoholism Treatment Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa49.htm Naltrexone for Alcoholism Source: American Academy of Family Physicians http://familydoctor.org/handouts/130.html Understanding Alcohol Use Disorders and Their Treatment Source: American Psychological Association http://helping.apa.org/therapy/alcohol.html Patient Resources · 285 Coping If Someone Close.Has a Problem with Alcohol or Other Drugs Source: National Clearinghouse for Alcohol and Drug Information http://www.health.org/govpubs/ph317/ · Specific Conditions/Aspects Alcohol Impairment Chart Source: National Clearinghouse for Alcohol and Drug Information http://ncadi.samhsa.gov/nongovpubs/bac-chart/ Alcohol Withdrawal Syndrome Source: American Academy of Family Physicians http://familydoctor.org/handouts/007.html Driving Safely by Avoiding Alcohol Source: American Medical Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZUHGJ928C &sub_cat=465 Post-Traumatic Sress Disorder (PTSD) and Problems with Alcohol Use Source: Dept. of Veterans Affairs, National Center for PTSD http://www.ncptsd.org/facts/specific/fs_alcohol.html Smoking Cessation in Recovering Alcoholics Source: American Academy of Family Physicians http://familydoctor.org/handouts/269.html What Are the Myths Vs. Facts About Alcohol and the Liver? Source: American Liver Foundation http://www.liverfoundation.org/cgibin/dbs/articles.cgi?db=articles&uid=default&ID=1009&view_records=1 What Recovering Alcoholics Need to Know About Osteoporosis Source: Osteoporosis and Related Bone Diseases-National Resource Center http://www.osteo.org/newfile.asp?doc=r804i&doctitle=What%2BRecovering%2B Alcoholics%2BNeed%2Bto%2BKnow%2BAbout%2BOsteoporosis&doctype=HTML %2BFact%2BSheet · Children Alcohol Alert: Children of Alcoholics: Are They Different? Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa09.htm Children of Alcoholics: Important Facts Source: National Association for Children of Alcoholics http://www.nacoa.net/impfacts.htm Facts 4 You Source: National Association for Children of Alcoholics http://www.nacoa.net/facts4u.htm Kids and Alcohol Source: Nemours Foundation http://kidshealth.org/kid/stay_healthy/body/alcohol.html 286 Alcohol Abuse Questions and Answers about Addiction: Alcoholism Source: National Association for Children of Alcoholics http://www.nacoa.net/addictqa.htm · From the National Institutes of Health Genetics of Alcoholism Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa60.htm · Latest News Most Substance Abuse Programs Ignore the Elderly Source: 10/17/2003, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_14340 .html · Men What About Men's Health? Alcohol and Drug Abuse Source: National Women's Health Information Center http://www.4women.gov/mens/index.cfm?page=110&text=no · Organizations Al-Anon/Alateen Source: Al-Anon, Alateen http://www.al-anon.alateen.org/ Alcoholics Anonymous http://www.alcoholics-anonymous.org/ American Council for Drug Education http://www.acde.org/ National Association for Children of Alcoholics http://www.nacoa.net/index.htm National Clearinghouse for Alcohol and Drug Information Source: Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration http://www.health.org/ National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/ · Research Alcohol Alert: Craving Research, Implications for Treatment Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa54.htm Alcohol Alert: Economic Perspectives in Alcoholism Research Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa51.htm Patient Resources 287 Finding and Treating Alcohol Problems in Primary Care Source: American College of Physicians http://www.annals.org/cgi/content/full/138/5/I-49 Mouse Model Links Alcohol Intake to Marijuana-Like Brain Compounds: New Pathway Presents Target for Medication Development Source: National Institute on Alcohol Abuse and Alcoholism http://www.nih.gov/news/pr/jan2003/niaaa-20.htm · Statistics 22 Million in U.S. Suffer from Substance Dependence or Abuse Source: Dept. of Health and Human Services http://www.hhs.gov/news/press/2003pres/20030905.html FASTATS: Alcohol Use Source: National Center for Health Statistics http://www.cdc.gov/nchs/fastats/alcohol.htm · Teenagers Coping with an Alcoholic Parent Source: Nemours Foundation http://kidshealth.org/teen/your_mind/families/coping_alcoholic.html · Women Alcohol Abuse and Treatment Source: National Women's Health Information Center http://www.4woman.gov/faq/sa-alcoh.htm Alcohol Alert: Are Women More Vulnerable to Alcohol's Effects? Source: National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/publications/aa46-text.htm Alcohol and Women Source: American College of Obstetricians and Gynecologists http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZPU8DH97C &sub_cat=2008 You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on alcohol abuse. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general 288 Alcohol Abuse Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: · Treatment options for alcohol abuse: Information for health care purchasers Source: Washington, DC: Washington Business Group on Health. 1991. 24 pp. Contact: Available from Quality Resource Center, Washington Business Group on Health, 777 North Capitol Street, N.E., Suite 800, Washington, DC 20002. Telephone: (202) 408-9320. $30.00. Summary: This booklet is intended to help companies appropriately manage alcohol abusing employees at the worksite and purchase high quality, cost-effective alcoholism treatment for their employees who require such care. The report provides an introduction and overview of alcoholism; discusses appropriate worksite intervention strategies; summarizes the state of the art regarding patient assessment; outcomes measurement and clinical guidelines research; draws implications of the information for purchasers and their employees in terms of benefit design and patient-centered systems of delivery; provides corporate examples of innovative programs addressing alcohol treatment; and gives resources for further information. · Alcoholism Source: Rochester, NY: Substance and Alcohol Intervention Services for the Deaf (SAISD), Rochester Institute of Technology (RIT). 1996. 2 p. Contact: Available from Substance and Alcohol Intervention Services for the Deaf (SAISD). Rochester Institute of Technology (RIT), Hale-Andrews Student Life Center, 115 Lomb Memorial Drive, Rochester, NY 14623-5608. Voice/TTY (716) 475-4978; Fax (716) 475-7375; E-mail: SPCGRL@RIT.EDU. PRICE: Single copy free. Summary: This brochure provides basic information for deaf people about alcoholism. The brochure defines alcoholism, lists the symptoms of alcohol abuse, describes the physical damage that can be caused by alcohol, and discusses relapses. The brochure also includes a section listing places and organizations where readers can get help, including interpreted Alcoholics Anonymous meetings, hospitals, employee assistance programs, doctors, alcoholism counselors, the National Council on Alcoholism and Drug Dependency (NCADD), and Substance and Alcohol Intervention Services for the Deaf (SAISD). The front cover of the brochure is illustrated with the sign for alcohol. · The fact is: Alcoholism tends to run in families Source: Rockville, MD: Alcohol, Drug Abuse, and Mental Health Administration, U.S. Department of Health and Human Services. 1992. 2 pp. Contact: Available from National Clearinghouse for Alcohol and Drug Information, P.O. Box 2345, Rockville, MD 20847-2345. Telephone: (301) 468-2600 or (800) 729-6686 or (800) 487-4889 TDD / fax: (301) 468-6433 / e-mail: info@health.org / Web site: http://www.health.org. Available at no charge. Summary: This brochure provides questions and answers about children of alcoholics (COAs). The common characteristics of COAs, their risks and problems, and how to help COAs are discussed. A list of organizations able to provide information and referrals is included. Patient Resources · 289 Catalog of Selected Federal Publications on Illegal Drug and Alcohol Abuse Contact: National Clearinghouse for Alcohol and Drug Information, Substance Abuse and Mental Health Service Administration, PO Box 2345, Rockville, MD, 20852-2345, (301) 468-2600, http://www.health.org. Summary: This catalog helps policymakers from State and local governments select information that is useful in confronting community problems related to alcohol and drug abuse. It includes a section of materials on Acquired immunodeficiency syndrome (AIDS) that mentions four items. Other sections deal with statistics, community initiatives, drug testing, education, general treatment, housing, law enforcment, pregnancy, special populations, treatment programs for offenders, youth, and the workplace. Spanish publications are included. The National Guideline Clearinghouse™ The National Guideline Clearinghouse™ offers hundreds of evidence-based clinical practice guidelines published in the United States and other countries. You can search this site located at http://www.guideline.gov/ by using the keyword “alcohol abuse” (or synonyms). The following was recently posted: · Naltrexone and alcoholism treatment Source: Substance Abuse and Mental Health Services Administration (U.S.) - Federal Government Agency [U.S.]; 1998; 94 pages http://www.guideline.gov/summary/summary.aspx?doc_id=1565&nbr=791&am p;string=alcohol+AND+abuse Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: · Alcoholism: Getting the Facts Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3207 · Calendar and Events - National Institute on Alcohol Abuse and Alcoholism Summary: Browse this page for an up-to-date listing of upcoming conferences and national meetings relevant to this Institute's services and programs. Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3802 290 Alcohol Abuse · FAQ' s on Alcohol Abuse and Alcoholism Summary: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) provides answers online to some of the most commonly asked questions received at the agency about alcoholism. Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3803 · Growing Up Drug-Free - A Parent's Guide to Prevention Summary: Schools, churches, synagogues, community groups, law enforcement--all can help to turn the tide on drug and alcohol abuse, but none can take a parent's place. Source: National Clearinghouse for Alcohol and Drug Information, Center for Substance Abuse Prevention http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=106 · How Are Alcohol and Drugs Affecting Your Life? – A Self-Test For Teenagers Summary: This online self-test can help teens decide if they are at risk for developing alcoholism and/or dependence on another drug. Source: National Council on Alcoholism and Drug Dependence, Inc. http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=5667 · National Institute on Alcohol Abuse and Alcoholism Publications Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=329 · NIAAA Alcohol and Alcohol Problems Science Database (ETOH) Summary: The Alcohol and Alcohol Problems Science Database, commonly referred to as ETOH, is the most comprehensive online resource covering all aspects of alcohol abuse and alcoholism. Source: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6298 · Overcoming Drug and Alcohol Abuse Summary: healthfinder® — your guide to reliable health information health library just for you health care organizations search: go help | about healthfinder® Overcoming Drug and Source: American Occupational Therapy Association http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=7341 Patient Resources · 291 Substance Abuse Facility Locator Summary: The Substance Abuse and Mental Health Services Administration (SAMHSA) has provided this online service to help you locate a drug and alcohol abuse treatment program near you. Source: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=6225 The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to alcohol abuse. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: · AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats · Family Village: http://www.familyvillage.wisc.edu/specific.htm · Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/ · Med Help International: http://www.medhelp.org/HealthTopics/A.html · Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/ · Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/ · WebMDÒHealth: http://my.webmd.com/health_topics Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to alcohol abuse. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with alcohol abuse. 292 Alcohol Abuse The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about alcohol abuse. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “alcohol abuse” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “alcohol abuse”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “alcohol abuse” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “alcohol abuse” (or a synonym) into the search box, and click “Submit Query.” 293 APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area. Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.27 Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657. Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of 27 Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html. 294 Alcohol Abuse libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)28: · Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/ · Alabama: Richard M. Scrushy Library (American Sports Medicine Institute) · Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm · California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html · California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html · California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html · California: Gateway Health Library (Sutter Gould Medical Foundation) · California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/ · California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp · California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html · California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/ · California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/ · California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/ · California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html · California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/ · Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/ · Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/ · Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/ 28 Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html. Finding Medical Libraries 295 · Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml · Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm · Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html · Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm · Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp · Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/ · Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm · Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html · Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/ · Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm · Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/ · Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/ · Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/ · Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm · Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html · Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm · Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/ · Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/ · Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10 · Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/ 296 Alcohol Abuse · Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html · Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp · Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp · Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/ · Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html · Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm · Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp · Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/ · Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html · Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/ · Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm · Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/ · Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html · Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm · Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330 · Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula) · National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html · National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/ · National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/ Finding Medical Libraries 297 · Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm · New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/ · New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm · New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm · New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/ · New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html · New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/ · New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html · New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/ · Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm · Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp · Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/ · Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/ · Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml · Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html · Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html · Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml · Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp · Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm · Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/ 298 Alcohol Abuse · South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp · Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/ · Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/ · Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72 299 ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: · ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html · MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp · Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/ · Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html · On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/ · Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp · Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on alcohol abuse: · Basic Guidelines for Alcohol Abuse Alcoholism Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000944.htm Alcoholism - resources Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002199.htm · Signs & Symptoms for Alcohol Abuse Abdominal pain Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003120.htm Anxiety Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Cessation of menses Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003149.htm 300 Alcohol Abuse Confusion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003205.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm High blood pressure Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003082.htm Insomnia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003210.htm Nausea Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Nausea and vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm Numbness and tingling Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003206.htm Seizures Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm Tension Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm · Diagnostics and Tests for Alcohol Abuse Erosion Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003225.htm Liver function tests Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003436.htm Toxicology screen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003578.htm · Nutrition for Alcohol Abuse Balanced diet Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002449.htm Vitamins Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002399.htm · Background Topics for Alcohol Abuse Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Online Glossaries 301 Alcohol consumption Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Alcohol use Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001944.htm Alcoholism - support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002199.htm Bleeding Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000045.htm Cardiovascular Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002310.htm Chronic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002312.htm Drug dependence - resources Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002169.htm Hepatic Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002378.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Self-help group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm Support group Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002150.htm Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: · Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical · MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html · Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/ · Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine 303 ALCOHOL ABUSE DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Abscess: Accumulation of purulent material in tissues, organs, or circumscribed spaces, usually associated with signs of infection. [NIH] Absolute risk: The observed or calculated probability of an event in a population under study, as contrasted with the relative risk. [NIH] Acatalasia: A rare autosomal recessive disorder resulting from the absence of catalase activity. Though usually asymptomatic, a syndrome of oral ulcerations and gangrene may be present. [NIH] Acceptor: A substance which, while normally not oxidized by oxygen or reduced by hydrogen, can be oxidized or reduced in presence of a substance which is itself undergoing oxidation or reduction. [NIH] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acculturation: Process of cultural change in which one group or members of a group assimilates various cultural patterns from another. [NIH] Acetaldehyde: A colorless, flammable liquid used in the manufacture of acetic acid, perfumes, and flavors. It is also an intermediate in the metabolism of alcohol. It has a general narcotic action and also causes irritation of mucous membranes. Large doses may cause death from respiratory paralysis. [NIH] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acitretin: An oral retinoid effective in the treatment of psoriasis. It is the major metabolite of etretinate with the advantage of a much shorter half-life when compared with etretinate. [NIH] Activities of Daily Living: The performance of the basic activities of self care, such as dressing, ambulation, eating, etc., in rehabilitation. [NIH] Acyl: Chemical signal used by bacteria to communicate. [NIH] Adaptation: 1. The adjustment of an organism to its environment, or the process by which it enhances such fitness. 2. The normal ability of the eye to adjust itself to variations in the intensity of light; the adjustment to such variations. 3. The decline in the frequency of firing of a neuron, particularly of a receptor, under conditions of constant stimulation. 4. In dentistry, (a) the proper fitting of a denture, (b) the degree of proximity and interlocking of restorative material to a tooth preparation, (c) the exact adjustment of bands to teeth. 5. In microbiology, the adjustment of bacterial physiology to a new environment. [EU] 304 Alcohol Abuse Adduct: Complex formed when a carcinogen combines with DNA or a protein. [NIH] Adenocarcinoma: A malignant epithelial tumor with a glandular organization. [NIH] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adenylate Cyclase: An enzyme of the lyase class that catalyzes the formation of cyclic AMP and pyrophosphate from ATP. EC 4.6.1.1. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Affinity Chromatography: In affinity chromatography, a ligand attached to a column binds specifically to the molecule to be purified. [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and Dictionary 305 stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Alanine: A non-essential amino acid that occurs in high levels in its free state in plasma. It is produced from pyruvate by transamination. It is involved in sugar and acid metabolism, increases immunity, and provides energy for muscle tissue, brain, and the central nervous system. [NIH] Albumin: 1. Any protein that is soluble in water and moderately concentrated salt solutions and is coagulable by heat. 2. Serum albumin; the major plasma protein (approximately 60 per cent of the total), which is responsible for much of the plasma colloidal osmotic pressure and serves as a transport protein carrying large organic anions, such as fatty acids, bilirubin, and many drugs, and also carrying certain hormones, such as cortisol and thyroxine, when their specific binding globulins are saturated. Albumin is synthesized in the liver. Low serum levels occur in protein malnutrition, active inflammation and serious hepatic and renal disease. [EU] Alcohol Dehydrogenase: An enzyme that catalyzes reversibly the final step of alcoholic fermentation by reducing an aldehyde to an alcohol. In the case of ethanol, acetaldehyde is reduced to ethanol in the presence of NADH and hydrogen. The enzyme is a zinc protein which acts on primary and secondary alcohols or hemiacetals. EC 1.1.1.1. [NIH] Alcohol Drinking: Behaviors associated with the ingesting of alcoholic beverages, including social drinking. [NIH] Alcohol-Related Disorders: Disorders related to or resulting from abuse or misuse of alcohol. [NIH] Aldehyde Dehydrogenase: An enzyme that oxidizes an aldehyde in the presence of NAD+ and water to an acid and NADH. EC 1.2.1.3. Before 1978, it was classified as EC 1.1.1.70. [NIH] Aldehydes: Organic compounds containing a carbonyl group in the form -CHO. [NIH] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Alfalfa: A deep-rooted European leguminous plant (Medicago sativa) widely grown for hay and forage. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU] Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alpha Particles: Positively charged particles composed of two protons and two neutrons, i.e., helium nuclei, emitted during disintegration of very heavy isotopes; a beam of alpha 306 Alcohol Abuse particles or an alpha ray has very strong ionizing power, but weak penetrability. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveolar Process: The thickest and spongiest part of the maxilla and mandible hollowed out into deep cavities for the teeth. [NIH] Ameliorated: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Ameliorating: A changeable condition which prevents the consequence of a failure or accident from becoming as bad as it otherwise would. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Alcohols: Compounds possessing both a hydroxyl (-OH) and an amino group (NH2). [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ammonium Chloride: An acidifying agent that is used as an expectorant and a diuretic. [NIH] Ammonium Compounds: Inorganic and organic compounds that contain the hypothetical radical NH4. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH] Anaemia: A reduction below normal in the number of erythrocytes per cu. mm., in the quantity of haemoglobin, or in the volume of packed red cells per 100 ml. of blood which occurs when the equilibrium between blood loss (through bleeding or destruction) and Dictionary 307 blood production is disturbed. [EU] Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Anaphylatoxins: The family of peptides C3a, C4a, C5a, and C5a des-arginine produced in the serum during complement activation. They produce smooth muscle contraction, mast cell histamine release, affect platelet aggregation, and act as mediators of the local inflammatory process. The order of anaphylatoxin activity from strongest to weakest is C5a, C3a, C4a, and C5a des-arginine. The latter is the so-called "classical" anaphylatoxin but shows no spasmogenic activity though it contains some chemotactic ability. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anemia: A reduction in the number of circulating erythrocytes or in the quantity of hemoglobin. [NIH] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anode: Electrode held at a positive potential with respect to a cathode. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or company. [NIH] Anovulation: Suspension or cessation of ovulation in animals and humans. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthelmintics: Agents destructive to parasitic worms. They are used therapeutically in the treatment of helminthiasis in man and animal. [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] 308 Alcohol Abuse Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antidote: A remedy for counteracting a poison. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antigen-Antibody Complex: The complex formed by the binding of antigen and antibody molecules. The deposition of large antigen-antibody complexes leading to tissue damage causes immune complex diseases. [NIH] Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects Dictionary 309 (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipyretic: An agent that relieves or reduces fever. Called also antifebrile, antithermic and febrifuge. [EU] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Antiviral: Destroying viruses or suppressing their replication. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiety Disorders: Disorders in which anxiety (persistent feelings of apprehension, tension, or uneasiness) is the predominant disturbance. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Apathy: Lack of feeling or emotion; indifference. [EU] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Apolipoproteins: The protein components of lipoproteins which remain after the lipids to which the proteins are bound have been removed. They play an important role in lipid transport and metabolism. [NIH] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Approximate: Approximal [EU] Aqueous: Having to do with water. [NIH] Arachidonic Acid: An unsaturated, essential fatty acid. It is found in animal and human fat as well as in the liver, brain, and glandular organs, and is a constituent of animal phosphatides. It is formed by the synthesis from dietary linoleic acid and is a precursor in the biosynthesis of prostaglandins, thromboxanes, and leukotrienes. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Aspartate: A synthetic amino acid. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) 310 Alcohol Abuse is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrioventricular: Pertaining to an atrium of the heart and to a ventricle. [EU] Atrium: A chamber; used in anatomical nomenclature to designate a chamber affording entrance to another structure or organ. Usually used alone to designate an atrium of the heart. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Attenuation: Reduction of transmitted sound energy or its electrical equivalent. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autoantigens: Endogenous tissue constituents that have the ability to interact with autoantibodies and cause an immune response. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Autopsy: Postmortem examination of the body. [NIH] Axonal: Condition associated with metabolic derangement of the entire neuron and is manifest by degeneration of the distal portion of the nerve fiber. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Physiology: Physiological processes and activities of bacteria. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bactericide: An agent that destroys bacteria. [EU] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance Dictionary 311 whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH] Benzene: Toxic, volatile, flammable liquid hydrocarbon biproduct of coal distillation. It is used as an industrial solvent in paints, varnishes, lacquer thinners, gasoline, etc. Benzene causes central nervous system damage acutely and bone marrow damage chronically and is carcinogenic. It was formerly used as parasiticide. [NIH] Benzodiazepines: A two-ring heterocyclic compound consisting of a benzene ring fused to a diazepine ring. Permitted is any degree of hydrogenation, any substituents and any Hisomer. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Bile Acids: Acids made by the liver that work with bile to break down fats. [NIH] Bile Acids and Salts: Steroid acids and salts. The primary bile acids are derived from cholesterol in the liver and usually conjugated with glycine or taurine. The secondary bile acids are further modified by bacteria in the intestine. They play an important role in the digestion and absorption of fat. They have also been used pharmacologically, especially in the treatment of gallstones. [NIH] Bile Ducts: Tubes that carry bile from the liver to the gallbladder for storage and to the small intestine for use in digestion. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Bilirubin: A bile pigment that is a degradation product of heme. [NIH] Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU] Bioavailable: The ability of a drug or other substance to be absorbed and used by the body. Orally bioavailable means that a drug or other substance that is taken by mouth can be absorbed and used by the body. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biogenic Monoamines: Biogenic amines having only one amine moiety. Included in this group are all natural monoamines formed by the enzymatic decarboxylation of natural amino acids. [NIH] Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc. [NIH] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some 312 Alcohol Abuse cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biological Transport: The movement of materials (including biochemical substances and drugs) across cell membranes and epithelial layers, usually by passive diffusion. [NIH] Biopsy: Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body. [NIH] Biopsy specimen: Tissue removed from the body and examined under a microscope to determine whether disease is present. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blastocyst: The mammalian embryo in the post-morula stage in which a fluid-filled cavity, enclosed primarily by trophoblast, contains an inner cell mass which becomes the embryonic disc. [NIH] Blood Cell Count: A count of the number of leukocytes and erythrocytes per unit volume in a sample of venous blood. A complete blood count (CBC) also includes measurement of the hemoglobin, hematocrit, and erythrocyte indices. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Coagulation Factors: Endogenous substances, usually proteins, that are involved in the blood coagulation process. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Groups: The classification systems (or schemes) of the different antigens located on erythrocytes.The antigens are the phenotypic expression of the genetic differences characteristic of specific blood groups. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists Dictionary 313 mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Remodeling: The continuous turnover of bone matrix and mineral that involves first, an increase in resorption (osteoclastic activity) and later, reactive bone formation (osteoblastic activity). The process of bone remodeling takes place in the adult skeleton at discrete foci. The process ensures the mechanical integrity of the skeleton throughout life and plays an important role in calcium homeostasis. An imbalance in the regulation of bone remodeling's two contrasting events, bone resorption and bone formation, results in many of the metabolic bone diseases, such as osteoporosis. [NIH] Bone Resorption: Bone loss due to osteoclastic activity. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH] Breakdown: A physical, metal, or nervous collapse. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the trachea. [NIH] Bronchial: Pertaining to one or more bronchi. [EU] Bronchus: A large air passage that leads from the trachea (windpipe) to the lung. [NIH] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Burns: Injuries to tissues caused by contact with heat, steam, chemicals (burns, chemical), electricity (burns, electric), or the like. [NIH] Burns, Electric: Burns produced by contact with electric current or from a sudden discharge of electricity. [NIH] Buspirone: An anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. Its structure is unrelated to those of the benzodiazepines, but it has an efficacy comparable to diazepam. [NIH] Butyric Acid: A four carbon acid, CH3CH2CH2COOH, with an unpleasant odor that occurs in butter and animal fat as the glycerol ester. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central 314 Alcohol Abuse nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium blocker: A drug used to relax the blood vessel and heart muscle, causing pressure inside blood vessels to drop. It also can regulate heart rhythm. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbohydrate-Deficient Glycoprotein Syndrome: An inborn error of carbohydrate metabolism manifesting as a genetic multisystem disorder of autosomal recessive inheritance. A predominant feature is severe central and peripheral nervous system involvement resulting in psychomotor retardation, seizures, cerebellar ataxia, and other symptoms which include growth retardation, retinitis pigmentosa, hypothyroidism, and fatty liver. The notable biochemical feature is the deficiency of a large number of blood glycoproteins and decreased activities of various blood coagulation factors. [NIH] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinogens: Substances that increase the risk of neoplasms in humans or animals. Both genotoxic chemicals, which affect DNA directly, and nongenotoxic chemicals, which induce neoplasms by other mechanism, are included. [NIH] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH] Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart Dictionary 315 and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Cardiovascular System: The heart and the blood vessels by which blood is pumped and circulated through the body. [NIH] Carnitine: Constituent of striated muscle and liver. It is used therapeutically to stimulate gastric and pancreatic secretions and in the treatment of hyperlipoproteinemias. [NIH] Carotene: The general name for a group of pigments found in green, yellow, and leafy vegetables, and yellow fruits. The pigments are fat-soluble, unsaturated aliphatic hydrocarbons functioning as provitamins and are converted to vitamin A through enzymatic processes in the intestinal wall. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catalase: An oxidoreductase that catalyzes the conversion of hydrogen peroxide to water and oxygen. It is present in many animal cells. A deficiency of this enzyme results in acatalasia. EC 1.11.1.6. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cause of Death: Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell membrane: Cell membrane = plasma membrane. The structure enveloping a cell, enclosing the cytoplasm, and forming a selective permeability barrier; it consists of lipids, proteins, and some carbohydrates, the lipids thought to form a bilayer in which integral proteins are embedded to varying degrees. [EU] Cell proliferation: An increase in the number of cells as a result of cell growth and cell division. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and 316 Alcohol Abuse adaptability. [NIH] Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Central Nervous System Infections: Pathogenic infections of the brain, spinal cord, and meninges. DNA virus infections; RNA virus infections; bacterial infections; mycoplasma infections; Spirochaetales infections; fungal infections; protozoan infections; helminthiasis; and prion diseases may involve the central nervous system as a primary or secondary process. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebrospinal: Pertaining to the brain and spinal cord. [EU] Cerebrospinal fluid: CSF. The fluid flowing around the brain and spinal cord. Cerebrospinal fluid is produced in the ventricles in the brain. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chemokines: Class of pro-inflammatory cytokines that have the ability to attract and activate leukocytes. They can be divided into at least three structural branches: C (chemokines, C), CC (chemokines, CC), and CXC (chemokines, CXC), according to variations in a shared cysteine motif. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced oxygen content, and reflexly increases both respiration and blood pressure. [EU] Chemotactic Factors: Chemical substances that attract or repel cells or organisms. The concept denotes especially those factors released as a result of tissue injury, invasion, or immunologic activity, that attract leukocytes, macrophages, or other cells to the site of infection or insult. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chest Pain: Pressure, burning, or numbness in the chest. [NIH] Child Care: Care of children in the home or institution. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of Dictionary 317 chlorinated lime, which is used in fabric bleaching. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Cholesterol: The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. [NIH] Cholesterol Esters: Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromium: A trace element that plays a role in glucose metabolism. It has the atomic symbol Cr, atomic number 24, and atomic weight 52. According to the Fourth Annual Report on Carcinogens (NTP85-002,1985), chromium and some of its compounds have been listed as known carcinogens. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic renal: Slow and progressive loss of kidney function over several years, often resulting in end-stage renal disease. People with end-stage renal disease need dialysis or transplantation to replace the work of the kidneys. [NIH] Chylomicrons: A class of lipoproteins that carry dietary cholesterol and triglycerides from the small intestines to the tissues. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic 318 Alcohol Abuse engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coal: A natural fuel formed by partial decomposition of vegetable matter under certain environmental conditions. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaethylene: Hard drug formed by cocaine and alcohol. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Colloidal: Of the nature of a colloid. [EU] Color blindness: A form of defective color vision requiring only two primary colors, mixed in various proportions, to match all other colors. [NIH] Colorectal: Having to do with the colon or the rectum. [NIH] Colorectal Surgery: A surgical specialty concerned with the diagnosis and treatment of disorders and abnormalities of the colon, rectum, and anal canal. [NIH] Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood. [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols Dictionary 319 C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complete remission: The disappearance of all signs of cancer. Also called a complete response. [NIH] Compulsive Behavior: The behavior of performing an act persistently and repetitively without it leading to reward or pleasure. The act is usually a small, circumscribed behavior, almost ritualistic, yet not pathologically disturbing. Examples of compulsive behavior include twirling of hair, checking something constantly, not wanting pennies in change, straightening tilted pictures, etc. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computer-Assisted Instruction: A self-learning technique, usually online, involving interaction of the student with programmed instructional materials. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Conception: The onset of pregnancy, marked by implantation of the blastocyst; the 320 Alcohol Abuse formation of a viable zygote. [EU] Concomitant: Accompanying; accessory; joined with another. [EU] Condoms: A sheath that is worn over the penis during sexual behavior in order to prevent pregnancy or spread of sexually transmitted disease. [NIH] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraception: Use of agents, devices, methods, or procedures which diminish the likelihood of or prevent conception. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Control group: In a clinical trial, the group that does not receive the new treatment being studied. This group is compared to the group that receives the new treatment, to see if the new treatment works. [NIH] Controlled clinical trial: A clinical study that includes a comparison (control) group. The comparison group receives a placebo, another treatment, or no treatment at all. [NIH] Convulsions: A general term referring to sudden and often violent motor activity of cerebral or brainstem origin. Convulsions may also occur in the absence of an electrical cerebral discharge (e.g., in response to hypotension). [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Cor: The muscular organ that maintains the circulation of the blood. c. adiposum a heart that has undergone fatty degeneration or that has an accumulation of fat around it; called also fat or fatty, heart. c. arteriosum the left side of the heart, so called because it contains oxygenated (arterial) blood. c. biloculare a congenital anomaly characterized by failure of formation of the atrial and ventricular septums, the heart having only two chambers, a single atrium and a single ventricle, and a common atrioventricular valve. c. bovinum (L. 'ox heart') a greatly enlarged heart due to a hypertrophied left ventricle; called also c. taurinum and bucardia. c. dextrum (L. 'right heart') the right atrium and ventricle. c. hirsutum, c. villosum. c. mobile (obs.) an abnormally movable heart. c. pendulum a heart so movable that it seems to be hanging by the great blood vessels. c. pseudotriloculare biatriatum a congenital cardiac anomaly in which the heart functions as a three-chambered heart because of tricuspid atresia, the right ventricle being extremely small or rudimentary and the right atrium greatly dilated. Blood passes from the right to the left atrium and thence disease due to pulmonary hypertension secondary to disease of the lung, or its blood vessels, with hypertrophy of the right ventricle. [EU] Dictionary 321 Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Corpus: The body of the uterus. [NIH] Corpus Callosum: Broad plate of dense myelinated fibers that reciprocally interconnect regions of the cortex in all lobes with corresponding regions of the opposite hemisphere. The corpus callosum is located deep in the longitudinal fissure. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Corticotropin-Releasing Hormone: A neuropeptide released by the hypothalamus that stimulates the release of corticotropin by the anterior pituitary gland. [NIH] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Coumarins: Synthetic or naturally occurring substances related to coumarin, the deltalactone of coumarinic acid. Coumarin itself occurs in the tonka bean. The various coumarins have a wide range of proposed actions and uses including as anticoagulants, pharmaceutical aids, indicators and reagents, photoreactive substances, and antineoplastic agents. [NIH] Crack Cocaine: The purified, alkaloidal, extra-potent form of cocaine. It is smoked (freebased), injected intravenously, and orally ingested. Use of crack results in alterations in function of the cardiovascular system, the autonomic nervous system, the central nervous system, and the gastrointestinal system. The slang term "crack" was derived from the crackling sound made upon igniting of this form of cocaine for smoking. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Criterion: A standard by which something may be judged. [EU] Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis. [NIH] Critical Illness: A disease or state in which death is possible or imminent. [NIH] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Cultural Characteristics: Those aspects or characteristics which identify a culture. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] 322 Alcohol Abuse Cutaneous: Having to do with the skin. [NIH] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cystathionine beta-Synthase: A multifunctional pyridoxal phosphate enzyme. In the second stage of cysteine biosynthesis it catalyzes the reaction of homocysteine with serine to form cystathionine with the elimination of water. Deficiency of this enzyme leads to hyperhomocysteinemia and homocystinuria. EC 4.2.1.22. [NIH] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH] Cystitis: Inflammation of the urinary bladder. [EU] Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytokine: Small but highly potent protein that modulates the activity of many cell types, including T and B cells. [NIH] Cytotoxic: Cell-killing. [NIH] Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] De novo: In cancer, the first occurrence of cancer in the body. [NIH] Deamination: The removal of an amino group (NH2) from a chemical compound. [NIH] Death Certificates: Official records of individual deaths including the cause of death certified by a physician, and any other required identifying information. [NIH] Decarboxylation: The removal of a carboxyl group, usually in the form of carbon dioxide, from a chemical compound. [NIH] Decidua: The epithelial lining of the endometrium that is formed before the fertilized ovum reaches the uterus. The fertilized ovum embeds in the decidua. If the ovum is not fertilized, the decidua is shed during menstruation. [NIH] Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. [NIH] Dictionary 323 Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Dendritic: 1. Branched like a tree. 2. Pertaining to or possessing dendrites. [EU] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Deprivation: Loss or absence of parts, organs, powers, or things that are needed. [EU] Derealization: Is characterized by the loss of the sense of reality concerning one's surroundings. [NIH] 324 Alcohol Abuse Dermatitis: Any inflammation of the skin. [NIH] Detoxification: Treatment designed to free an addict from his drug habit. [EU] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Developed Countries: Countries that have reached a level of economic achievement through an increase of production, per capita income and consumption, and utilization of natural and human resources. [NIH] DHEA: Dehydroepiandrosterone. A substance that is being studied as a cancer prevention drug. It belongs to the family of drugs called steroids. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diaphragm: The musculofibrous partition that separates the thoracic cavity from the abdominal cavity. Contraction of the diaphragm increases the volume of the thoracic cavity aiding inspiration. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Diarrhoea: Abnormal frequency and liquidity of faecal discharges. [EU] Diastole: Period of relaxation of the heart, especially the ventricles. [NIH] Diastolic: Of or pertaining to the diastole. [EU] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Dilatation: The act of dilating. [NIH] Dilated cardiomyopathy: Heart muscle disease that leads to enlargement of the heart's chambers, robbing the heart of its pumping ability. [NIH] Diploid: Having two sets of chromosomes. [NIH] Diprenorphine: A narcotic antagonist similar in action to naloxone. It is used to remobilize animals after etorphine neuroleptanalgesia and is considered a specific antagonist to etorphine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disability Evaluation: Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Dictionary 325 Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Disparity: Failure of the two retinal images of an object to fall on corresponding retinal points. [NIH] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Disulfiram: A carbamate derivative used as an alcohol deterrent. It is a relatively nontoxic substance when administered alone, but markedly alters the intermediary metabolism of alcohol. When alcohol is ingested after administration of disulfiram, blood acetaldehyde concentrations are increased, followed by flushing, systemic vasodilation, respiratory difficulties, nausea, hypotension, and other symptoms (acetaldehyde syndrome). It acts by inhibiting aldehyde dehydrogenase. [NIH] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Dizziness: An imprecise term which may refer to a sense of spatial disorientation, motion of the environment, or lightheadedness. [NIH] Domestic Violence: Deliberate, often repetitive, physical abuse by one family member against another: marital partners, parents, children, siblings, or any other member of a household. [NIH] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Agonists: Drugs that bind to and activate dopamine receptors. [NIH] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] 326 Alcohol Abuse Drug Evaluation: Any process by which toxicity, metabolism, absorption, elimination, preferred route of administration, safe dosage range, etc., for a drug or group of drugs is determined through clinical assessment in humans or veterinary animals. [NIH] Drug Evaluation, Preclinical: Preclinical testing of drugs in experimental animals or in vitro for their biological and toxic effects and potential clinical applications. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenum: The first part of the small intestine. [NIH] Dynorphins: A class of opioid peptides including dynorphin A, dynorphin B, and smaller fragments of these peptides. Dynorphins prefer kappa-opioid receptors (receptors, opioid, kappa) and have been shown to play a role as central nervous system transmitters. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysphoria: Disquiet; restlessness; malaise. [EU] Dyspnea: Difficult or labored breathing. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Effector cell: A cell that performs a specific function in response to a stimulus; usually used to describe cells in the immune system. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Elective: Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent. [EU] Electroacupuncture: A form of acupuncture using low frequency electrically stimulated needles to produce analgesia and anesthesia and to treat disease. [NIH] Electrocardiogram: Measurement of electrical activity during heartbeats. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. Dictionary 327 [NIH] Electrophysiological: Pertaining to electrophysiology, that is a branch of physiology that is concerned with the electric phenomena associated with living bodies and involved in their functional activity. [EU] Elementary Particles: Individual components of atoms, usually subatomic; subnuclear particles are usually detected only when the atomic nucleus decays and then only transiently, as most of them are unstable, often yielding pure energy without substance, i.e., radiation. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emergency Medicine: A branch of medicine concerned with an individual's resuscitation, transportation and care from the point of injury or beginning of illness through the hospital or other emergency treatment facility. [NIH] Emergency Treatment: First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. [NIH] Emetic: An agent that causes vomiting. [EU] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encapsulated: Confined to a specific, localized area and surrounded by a thin layer of tissue. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endometrial: Having to do with the endometrium (the layer of tissue that lines the uterus). [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Endorphins: One of the three major groups of endogenous opioid peptides. They are large peptides derived from the pro-opiomelanocortin precursor. The known members of this group are alpha-, beta-, and gamma-endorphin. The term endorphin is also sometimes used to refer to all opioid peptides, but the narrower sense is used here; opioid peptides is used for the broader group. [NIH] Endoscopic: A technique where a lateral-view endoscope is passed orally to the duodenum for visualization of the ampulla of Vater. [NIH] Endotoxemia: A condition characterized by the presence of endotoxins in the blood. If endotoxemia is the result of gram-negative rod-shaped bacteria, shock may occur. [NIH] Endotoxins: Toxins closely associated with the living cytoplasm or cell wall of certain microorganisms, which do not readily diffuse into the culture medium, but are released upon lysis of the cells. [NIH] End-stage renal: Total chronic kidney failure. When the kidneys fail, the body retains fluid and harmful wastes build up. A person with ESRD needs treatment to replace the work of the failed kidneys. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Enflurane: An extremely stable inhalation anesthetic that allows rapid adjustments of anesthesia depth with little change in pulse or respiratory rate. [NIH] 328 Alcohol Abuse Enhancer: Transcriptional element in the virus genome. [NIH] Enkephalins: One of the three major families of endogenous opioid peptides. The enkephalins are pentapeptides that are widespread in the central and peripheral nervous systems and in the adrenal medulla. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Exposure: The exposure to potentially harmful chemical, physical, or biological agents in the environment or to environmental factors that may include ionizing radiation, pathogenic organisms, or toxic chemicals. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH] Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Enzyme Induction: An increase in the rate of synthesis of an enzyme due to the presence of an inducer which acts to derepress the gene responsible for enzyme synthesis. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epidemiologic Studies: Studies designed to examine associations, commonly, hypothesized causal relations. They are usually concerned with identifying or measuring the effects of risk factors or exposures. The common types of analytic study are case-control studies, cohort studies, and cross-sectional studies. [NIH] Epidemiological: Relating to, or involving epidemiology. [EU] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermal Growth Factor: A 6 kD polypeptide growth factor initially discovered in mouse submaxillary glands. Human epidermal growth factor was originally isolated from urine based on its ability to inhibit gastric secretion and called urogastrone. epidermal growth factor exerts a wide variety of biological effects including the promotion of proliferation and differentiation of mesenchymal and epithelial cells. [NIH] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epilepticus: Repeated and prolonged epileptic seizures without recovery of consciousness between attacks. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Dictionary 329 Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Erythropoietin: Glycoprotein hormone, secreted chiefly by the kidney in the adult and the liver in the fetus, that acts on erythroid stem cells of the bone marrow to stimulate proliferation and differentiation. [NIH] Escalation: Progressive use of more harmful drugs. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH] Esterification: The process of converting an acid into an alkyl or aryl derivative. Most frequently the process consists of the reaction of an acid with an alcohol in the presence of a trace of mineral acid as catalyst or the reaction of an acyl chloride with an alcohol. Esterification can also be accomplished by enzymatic processes. [NIH] Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estriol: (16 alpha,17 beta)-Estra-1,3,5(10)-triene-3,16,17-triol. A metabolite of estradiol and usually the predominant estrogenic metabolite in urine. During pregnancy, large amounts of estriol are produced by the placenta. It has also been obtained from plant sources. The 16 beta-isomer has also been isolated from the urine of pregnant women. [NIH] Estrogen: One of the two female sex hormones. [NIH] Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Etorphine: A narcotic analgesic morphinan used as a sedative in veterinary practice. [NIH] Etretinate: An oral retinoid used in the treatment of keratotic genodermatosis, lichen planus, and psoriasis. Beneficial effects have also been claimed in the prophylaxis of epithelial neoplasia. The compound may be teratogenic. [NIH] Eukaryotic Cells: Cells of the higher organisms, containing a true nucleus bounded by a nuclear membrane. [NIH] Euphoria: An exaggerated feeling of physical and emotional well-being not consonant with apparent stimuli or events; usually of psychologic origin, but also seen in organic brain disease and toxic states. [NIH] Evacuation: An emptying, as of the bowels. [EU] Evaluation Studies: Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, clinical trials, drug evaluation, and drug evaluation, preclinical are available. [NIH] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Excitability: Property of a cardiac cell whereby, when the cell is depolarized to a critical level (called threshold), the membrane becomes permeable and a regenerative inward current causes an action potential. [NIH] 330 Alcohol Abuse Exhaustion: The feeling of weariness of mind and body. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Expectorant: 1. Promoting the ejection, by spitting, of mucus or other fluids from the lungs and trachea. 2. An agent that promotes the ejection of mucus or exudate from the lungs, bronchi, and trachea; sometimes extended to all remedies that quiet cough (antitussives). [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Exudate: Material, such as fluid, cells, or cellular debris, which has escaped from blood vessels and has been deposited in tissues or on tissue surfaces, usually as a result of inflammation. An exudate, in contrast to a transudate, is characterized by a high content of protein, cells, or solid materials derived from cells. [EU] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Factor V: Heat- and storage-labile plasma glycoprotein which accelerates the conversion of prothrombin to thrombin in blood coagulation. Factor V accomplishes this by forming a complex with factor Xa, phospholipid, and calcium (prothrombinase complex). Deficiency of factor V leads to Owren's disease. [NIH] Faecal: Pertaining to or of the nature of feces. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family. [NIH] Family Relations: Behavioral, psychological, and social relations among various members of the nuclear family and the extended family. [NIH] Fat: Total lipids including phospholipids. [NIH] Fathers: Male parents, human or animal. [NIH] Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fermentation: An enzyme-induced chemical change in organic compounds that takes place in the absence of oxygen. The change usually results in the production of ethanol or lactic acid, and the production of energy. [NIH] Fetal Alcohol Syndrome: A disorder occurring in children born to alcoholic women who continue to drink heavily during pregnancy. Common abnormalities are growth deficiency (prenatal and postnatal), altered morphogenesis, mental deficiency, and characteristic facies - small eyes and flattened nasal bridge. Fine motor dysfunction and tremulousness are Dictionary 331 observed in the newborn. [NIH] Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fibrinogen: Plasma glycoprotein clotted by thrombin, composed of a dimer of three nonidentical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. [NIH] Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fibrotic tissue: Inflamed tissue that has become scarred. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH] Fluorescence: The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis. [NIH] Fluorine: A nonmetallic, diatomic gas that is a trace element and member of the halogen family. It is used in dentistry as flouride to prevent dental caries. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Flushing: A transient reddening of the face that may be due to fever, certain drugs, exertion, stress, or a disease process. [NIH] Focus Groups: A method of data collection and a qualitative research tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions. [NIH] Folate: A B-complex vitamin that is being studied as a cancer prevention agent. Also called folic acid. [NIH] Fold: A plication or doubling of various parts of the body. [NIH] Folic Acid: N-(4-(((2-Amino-1,4-dihydro-4-oxo-6-pteridinyl)methyl)amino)benzoyl)-Lglutamic acid. A member of the vitamin B family that stimulates the hematopoietic system. It is present in the liver and kidney and is found in mushrooms, spinach, yeast, green leaves, and grasses. Folic acid is used in the treatment and prevention of folate deficiencies and megaloblastic anemia. [NIH] Food Additives: Substances which are of little or no nutritive value, but are used in the processing or storage of foods or animal feed, especially in the developed countries; includes antioxidants, food preservatives, food coloring agents, flavoring agents, anti-infective agents (both plain and local), vehicles, excipients and other similarly used substances. Many of the same substances are pharmaceutic aids when added to pharmaceuticals rather than to foods. [NIH] Food Coloring Agents: Natural or synthetic dyes used as coloring agents in processed foods. [NIH] Food Preservatives: Substances capable of inhibiting, retarding or arresting the process of fermentation, acidification or other deterioration of foods. [NIH] 332 Alcohol Abuse Forearm: The part between the elbow and the wrist. [NIH] Fossa: A cavity, depression, or pit. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Galanthamine: A cholinesterase inhibitor. It has been used to reverse the muscular effects of gallamine and tubocurarine and has been studied as a treatment for Alzheimer's disease and other central nervous system disorders. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gamma-Glutamyltransferase: An enzyme that catalyzes reversibly the transfer of a glutamyl group from a glutamyl-peptide and an amino acid to a peptide and a glutamylamino acid. EC 2.3.2.2. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gas exchange: Primary function of the lungs; transfer of oxygen from inhaled air into the blood and of carbon dioxide from the blood into the lungs. [NIH] Gasoline: Volative flammable fuel (liquid hydrocarbons) derived from crude petroleum by processes such as distillation reforming, polymerization, etc. [NIH] Gastric: Having to do with the stomach. [NIH] Gastric atrophy: A condition in which the stomach muscles shrink and become weak. The digestive (peptic) glands may also shrink, resulting in a lack of digestive juices. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH] Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH] Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Genetic Code: The specifications for how information, stored in nucleic acid sequence (base sequence), is translated into protein sequence (amino acid sequence). The start, stop, and order of amino acids of a protein is specified by consecutive triplets of nucleotides called codons (codon). [NIH] Genetic Markers: A phenotypically recognizable genetic trait which can be used to identify a genetic locus, a linkage group, or a recombination event. [NIH] Genetic testing: Analyzing DNA to look for a genetic alteration that may indicate an increased risk for developing a specific disease or disorder. [NIH] Genetic transcription: The process by which the genetic information encoded in the gene, Dictionary 333 represented as a linear sequence of deoxyribonucleotides, is copied into an exactly complementary sequence of ribonucleotides known as messenger RNA. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Germ Cells: The reproductive cells in multicellular organisms. [NIH] Gestation: The period of development of the young in viviparous animals, from the time of fertilization of the ovum until birth. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glomerular: Pertaining to or of the nature of a glomerulus, especially a renal glomerulus. [EU] Glomeruli: Plural of glomerulus. [NIH] Glomerulonephritis: Glomerular disease characterized by an inflammatory reaction, with leukocyte infiltration and cellular proliferation of the glomeruli, or that appears to be the result of immune glomerular injury. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Glutamic Acid: A non-essential amino acid naturally occurring in the L-form. Glutamic acid (glutamate) is the most common excitatory neurotransmitter in the central nervous system. [NIH] Glycerol: A trihydroxy sugar alcohol that is an intermediate in carbohydrate and lipid metabolism. It is used as a solvent, emollient, pharmaceutical agent, and sweetening agent. [NIH] Glycerophospholipids: Derivatives of phosphatidic acid in which the hydrophobic regions are composed of two fatty acids and a polar alcohol is joined to the C-3 position of glycerol through a phosphodiester bond. They are named according to their polar head groups, such as phosphatidylcholine and phosphatidylethanolamine. [NIH] Glycoside: Any compound that contains a carbohydrate molecule (sugar), particularly any such natural product in plants, convertible, by hydrolytic cleavage, into sugar and a nonsugar component (aglycone), and named specifically for the sugar contained, as glucoside (glucose), pentoside (pentose), fructoside (fructose) etc. [EU] Glycosylation: The chemical or biochemical addition of carbohydrate or glycosyl groups to other chemicals, especially peptides or proteins. Glycosyl transferases are used in this biochemical reaction. [NIH] Goiter: Enlargement of the thyroid gland. [NIH] Gonad: A sex organ, such as an ovary or a testicle, which produces the gametes in most multicellular animals. [NIH] 334 Alcohol Abuse Gonadal: Pertaining to a gonad. [EU] Gonadotropin: The water-soluble follicle stimulating substance, by some believed to originate in chorionic tissue, obtained from the serum of pregnant mares. It is used to supplement the action of estrogens. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Grade: The grade of a tumor depends on how abnormal the cancer cells look under a microscope and how quickly the tumor is likely to grow and spread. Grading systems are different for each type of cancer. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Gram-negative: Losing the stain or decolorized by alcohol in Gram's method of staining, a primary characteristic of bacteria having a cell wall composed of a thin layer of peptidoglycan covered by an outer membrane of lipoprotein and lipopolysaccharide. [EU] Gram-positive: Retaining the stain or resisting decolorization by alcohol in Gram's method of staining, a primary characteristic of bacteria whose cell wall is composed of a thick layer of peptidologlycan with attached teichoic acids. [EU] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Habitat: An area considered in terms of its environment, particularly as this determines the type and quality of the vegetation the area can carry. [NIH] Half-Life: The time it takes for a substance (drug, radioactive nuclide, or other) to lose half of its pharmacologic, physiologic, or radiologic activity. [NIH] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Haploid: An organism with one basic chromosome set, symbolized by n; the normal condition of gametes in diploids. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Headache Disorders: Common conditions characterized by persistent or recurrent Dictionary 335 headaches. Headache syndrome classification systems may be based on etiology (e.g., vascular headache, post-traumatic headaches, etc.), temporal pattern (e.g., cluster headache, paroxysmal hemicrania, etc.), and precipitating factors (e.g., cough headache). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Policy: Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Helminthiasis: Infestation with parasitic worms of the helminth class. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemochromatosis: A disease that occurs when the body absorbs too much iron. The body stores the excess iron in the liver, pancreas, and other organs. May cause cirrhosis of the liver. Also called iron overload disease. [NIH] Hemoglobin: One of the fractions of glycosylated hemoglobin A1c. Glycosylated hemoglobin is formed when linkages of glucose and related monosaccharides bind to hemoglobin A and its concentration represents the average blood glucose level over the previous several weeks. HbA1c levels are used as a measure of long-term control of plasma glucose (normal, 4 to 6 percent). In controlled diabetes mellitus, the concentration of glycosylated hemoglobin A is within the normal range, but in uncontrolled cases the level may be 3 to 4 times the normal conentration. Generally, complications are substantially lower among patients with Hb levels of 7 percent or less than in patients with HbA1c levels of 9 percent or more. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH] Hepatic: Refers to the liver. [NIH] Hepatitis: Inflammation of the liver and liver disease involving degenerative or necrotic alterations of hepatocytes. [NIH] Hepatitis A: Hepatitis caused by hepatovirus. It can be transmitted through fecal contamination of food or water. [NIH] Hepatitis Viruses: Any of the viruses that cause inflammation of the liver. They include both DNA and RNA viruses as well viruses from humans and animals. [NIH] Hepatitis, Alcoholic: An acute or chronic degenerative and inflammatory lesion of the liver in the alcoholic which is potentially progressive though sometimes reversible. It does not necessarily include steatosis, fibrosis, or cirrhosis of alcoholics, although it is frequently associated with these conditions. It is characterized by liver cell necrosis, infiltration by polymorphonuclear leukocytes and lymphocytes, and Mallory bodies. The morphologic changes of chronic alcoholic hepatitis are not likely to be confused with chronic hepatitis. 336 Alcohol Abuse [NIH] Hepatocellular: Pertaining to or affecting liver cells. [EU] Hepatocellular carcinoma: A type of adenocarcinoma, the most common type of liver tumor. [NIH] Hepatocytes: The main structural component of the liver. They are specialized epithelial cells that are organized into interconnected plates called lobules. [NIH] Hepatovirus: A genus of Picornaviridae causing infectious hepatitis naturally in humans and experimentally in other primates. It is transmitted through fecal contamination of food or water. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heritability: The proportion of observed variation in a particular trait that can be attributed to inherited genetic factors in contrast to environmental ones. [NIH] Heterodimers: Zippered pair of nonidentical proteins. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH] Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histidine: An essential amino acid important in a number of metabolic processes. It is required for the production of histamine. [NIH] Homeless Persons: Persons who have no permanent residence. The concept excludes nomadic peoples. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homicide: The killing of one person by another. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Homosexuality: Sexual attraction or relationship between members of the same sex. [NIH] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hybridomas: Cells artificially created by fusion of activated lymphocytes with neoplastic cells. The resulting hybrid cells are cloned and produce pure or "monoclonal" antibodies or T-cell products, identical to those produced by the immunologically competent parent, and continually grow and divide as the neoplastic parent. [NIH] Dictionary 337 Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hyperhomocysteinemia: An inborn error of methionone metabolism which produces an excess of homocysteine in the blood. It is often caused by a deficiency of cystathionine betasynthase and is a risk factor for coronary vascular disease. [NIH] Hyperphagia: Ingestion of a greater than optimal quantity of food. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hyperventilation: A pulmonary ventilation rate faster than is metabolically necessary for the exchange of gases. It is the result of an increased frequency of breathing, an increased tidal volume, or a combination of both. It causes an excess intake of oxygen and the blowing off of carbon dioxide. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypoglycemia: Abnormally low blood sugar [NIH] Hypoglycemic: An orally active drug that produces a fall in blood glucose concentration. [NIH] Hypotension: Abnormally low blood pressure. [NIH] Hypotensive: Characterized by or causing diminished tension or pressure, as abnormally low blood pressure. [EU] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Hypothyroidism: Deficiency of thyroid activity. In adults, it is most common in women and is characterized by decrease in basal metabolic rate, tiredness and lethargy, sensitivity to cold, and menstrual disturbances. If untreated, it progresses to full-blown myxoedema. In infants, severe hypothyroidism leads to cretinism. In juveniles, the manifestations are intermediate, with less severe mental and developmental retardation and only mild symptoms of the adult form. When due to pituitary deficiency of thyrotropin secretion it is called secondary hypothyroidism. [EU] Hypoxemia: Deficient oxygenation of the blood; hypoxia. [EU] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate 338 Alcohol Abuse perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Imaging procedures: Methods of producing pictures of areas inside the body. [NIH] Immersion: The placing of a body or a part thereof into a liquid. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunity: Nonsusceptibility to the invasive or pathogenic microorganisms or to the toxic effect of antigenic substances. [NIH] effects of foreign Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunoassay: Immunochemical assay or detection of a substance by serologic or immunologic methods. Usually the substance being studied serves as antigen both in antibody production and in measurement of antibody by the test substance. [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunologic: The ability of the antibody-forming system to recall a previous experience with an antigen and to respond to a second exposure with the prompt production of large amounts of antibody. [NIH] Immunology: The study of the body's immune system. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] Implantation: The insertion or grafting into the body of biological, living, inert, or radioactive material. [EU] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incisive: 1. Having the power or quality of cutting. 2. Pertaining to the incisor teeth. [EU] Incisor: Anything adapted for cutting; any one of the four front teeth in each jaw. [NIH] Incontinence: Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Individuation: A process of differentiation having for its goal the development of the individual personality. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a Dictionary 339 specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU] Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Infusion: A method of putting fluids, including drugs, into the bloodstream. Also called intravenous infusion. [NIH] Ingestion: Taking into the body by mouth [NIH] Inhalation: The drawing of air or other substances into the lungs. [EU] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Insulin-like: Muscular growth factor. [NIH] Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility. [NIH] 340 Alcohol Abuse Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Intervertebral: Situated between two contiguous vertebrae. [EU] Intervertebral Disk Displacement: An intervertebral disk in which the nucleus pulposus has protruded through surrounding fibrocartilage. This occurs most frequently in the lower lumbar region. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intramuscular: IM. Within or into muscle. [NIH] Intramuscular injection: IM. Injection into a muscle. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU] Iodine: A nonmetallic element of the halogen group that is represented by the atomic symbol I, atomic number 53, and atomic weight of 126.90. It is a nutritionally essential element, especially important in thyroid hormone synthesis. In solution, it has anti-infective properties and is used topically. [NIH] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionizing: Radiation comprising charged particles, e. g. electrons, protons, alpha-particles, etc., having sufficient kinetic energy to produce ionization by collision. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Isoenzyme: Different forms of an enzyme, usually occurring in different tissues. The isoenzymes of a particular enzyme catalyze the same reaction but they differ in some of their properties. [NIH] Isoflavones: 3-Phenylchromones. Isomeric form of flavones in which the benzene group is attached to the 3 position of the benzopyran ring instead of the 2 position. [NIH] Dictionary 341 Isozymes: The multiple forms of a single enzyme. [NIH] Job Satisfaction: Personal satisfaction relative to the work situation. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Labile: 1. Gliding; moving from point to point over the surface; unstable; fluctuating. 2. Chemically unstable. [EU] Lactation: The period of the secretion of milk. [EU] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Least-Squares Analysis: A principle of estimation in which the estimates of a set of parameters in a statistical model are those quantities minimizing the sum of squared differences between the observed values of a dependent variable and the values predicted by the model. [NIH] Lectin: A complex molecule that has both protein and sugars. Lectins are able to bind to the outside of a cell and cause biochemical changes in it. Lectins are made by both animals and plants. [NIH] Length of Stay: The period of confinement of a patient to a hospital or other health facility. [NIH] Leprosy: A chronic granulomatous infection caused by Mycobacterium leprae. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Leucine: An essential branched-chain amino acid important for hemoglobin formation. [NIH] Leukocytes: White blood cells. These include granular leukocytes (basophils, eosinophils, and neutrophils) as well as non-granular leukocytes (lymphocytes and monocytes). [NIH] Leukopenia: A condition in which the number of leukocytes (white blood cells) in the blood is reduced. [NIH] Levo: It is an experimental treatment for heroin addiction that was developed by German scientists around 1948 as an analgesic. Like methadone, it binds with opioid receptors, but it is longer acting. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Libido: The psychic drive or energy associated with sexual instinct in the broad sense (pleasure and love-object seeking). It may also connote the psychic energy associated with instincts in general that motivate behavior. [NIH] Library Services: Services offered to the library user. They include reference and circulation. 342 Alcohol Abuse [NIH] Ligaments: Shiny, flexible bands of fibrous tissue connecting together articular extremities of bones. They are pliant, tough, and inextensile. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Likelihood Functions: Functions constructed from a statistical model and a set of observed data which give the probability of that data for various values of the unknown model parameters. Those parameter values that maximize the probability are the maximum likelihood estimates of the parameters. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Linear Models: Statistical models in which the value of a parameter for a given value of a factor is assumed to be equal to a + bx, where a and b are constants. The models predict a linear regression. [NIH] Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lipoprotein: Any of the lipid-protein complexes in which lipids are transported in the blood; lipoprotein particles consist of a spherical hydrophobic core of triglycerides or cholesterol esters surrounded by an amphipathic monolayer of phospholipids, cholesterol, and apolipoproteins; the four principal classes are high-density, low-density, and very-lowdensity lipoproteins and chylomicrons. [EU] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH] Lithium Carbonate: A lithium salt, classified as a mood-stabilizing agent. Lithium ion alters the metabolism of biogenic monoamines in the central nervous system, and affects multiple neurotransmission systems. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver cancer: A disease in which malignant (cancer) cells are found in the tissues of the liver. [NIH] Liver Cirrhosis: Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Dictionary 343 Liver Transplantation: The transference of a part of or an entire liver from one human or animal to another. [NIH] Local Government: Smallest political subdivisions within a country at which general governmental functions are carried-out. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Lorazepam: An anti-anxiety agent with few side effects. It also has hypnotic, anticonvulsant, and considerable sedative properties and has been proposed as a preanesthetic agent. [NIH] Low Back Pain: Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous sprains and strains; intervertebral disk displacement; and other conditions. [NIH] Low-density lipoprotein: Lipoprotein that contains most of the cholesterol in the blood. LDL carries cholesterol to the tissues of the body, including the arteries. A high level of LDL increases the risk of heart disease. LDL typically contains 60 to 70 percent of the total serum cholesterol and both are directly correlated with CHD risk. [NIH] Lumbar: Pertaining to the loins, the part of the back between the thorax and the pelvis. [EU] Lumbar puncture: A procedure in which a needle is put into the lower part of the spinal column to collect cerebrospinal fluid or to give anticancer drugs intrathecally. Also called a spinal tap. [NIH] Lutein Cells: The cells of the corpus luteum which are derived from the granulosa cells and the theca cells of the Graafian follicle. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH] 344 Alcohol Abuse Lymphadenitis: Inflammation of the lymph nodes. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Magnetic Resonance Spectroscopy: Spectroscopic method of measuring the magnetic moment of elementary particles such as atomic nuclei, protons or electrons. It is employed in clinical applications such as NMR Tomography (magnetic resonance imaging). [NIH] Malaise: A vague feeling of bodily discomfort. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH] Malondialdehyde: The dialdehyde of malonic acid. [NIH] Mandible: The largest and strongest bone of the face constituting the lower jaw. It supports the lower teeth. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mannich Bases: Ketonic amines prepared from the condensation of a ketone with formaldehyde and ammonia or a primary or secondary amine. A Mannich base can act as the equivalent of an alpha,beta unsaturated ketone in synthesis or can be reduced to form physiologically active amino alcohols. [NIH] Marital Status: A demographic parameter indicating a person's status with respect to marriage, divorce, widowhood, singleness, etc. [NIH] Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] Medical Records: Recording of pertinent information concerning patient's illness or illnesses. [NIH] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Megaloblastic: A large abnormal red blood cell appearing in the blood in pernicious anaemia. [EU] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, Dictionary 345 (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Mental deficiency: A condition of arrested or incomplete development of mind from inherent causes or induced by disease or injury. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mesenchymal: Refers to cells that develop into connective tissue, blood vessels, and lymphatic tissue. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Metabotropic: A glutamate receptor which triggers an increase in production of 2 intracellular messengers: diacylglycerol and inositol 1, 4, 5-triphosphate. [NIH] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microcirculation: The vascular network lying between the arterioles and venules; includes capillaries, metarterioles and arteriovenous anastomoses. Also, the flow of blood through this network. [NIH] Micronutrients: Essential dietary elements or organic compounds that are required in only small quantities for normal physiologic processes to occur. [NIH] Microorganism: An organism that can be seen only through a microscope. Microorganisms include bacteria, protozoa, algae, and fungi. Although viruses are not considered living organisms, they are sometimes classified as microorganisms. [NIH] Microtubules: Slender, cylindrical filaments found in the cytoskeleton of plant and animal 346 Alcohol Abuse cells. They are composed of the protein tubulin. [NIH] Midazolam: A short-acting compound, water-soluble at pH less than 4 and lipid-soluble at physiological pH. It is a hypnotic-sedative drug with anxiolytic and amnestic properties. It is used for sedation in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. Because of its short duration and cardiorespiratory stability, it is particularly useful in poor-risk, elderly, and cardiac patients. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH] Mobilization: The process of making a fixed part or stored substance mobile, as by separating a part from surrounding structures to make it accessible for an operative procedure or by causing release into the circulation for body use of a substance stored in the body. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Mononuclear: A cell with one nucleus. [NIH] Morals: Standards of conduct as right or wrong. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Morphogenesis: The development of the form of an organ, part of the body, or organism. [NIH] Morphological: Relating to the configuration or the structure of live organs. [NIH] Dictionary 347 Morphology: The science of the form and structure of organisms (plants, animals, and other forms of life). [NIH] Motility: The ability to move spontaneously. [EU] Motion Sickness: Sickness caused by motion, as sea sickness, train sickness, car sickness, and air sickness. [NIH] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Mycobacterium: A genus of gram-positive, aerobic bacteria. Most species are free-living in soil and water, but the major habitat for some is the diseased tissue of warm-blooded hosts. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Myopathy: Any disease of a muscle. [EU] N-acetyl: Analgesic agent. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Nalorphine: A narcotic antagonist with some agonist properties. It is an antagonist at mu opioid receptors and an agonist at kappa opioid receptors. Given alone it produces a broad spectrum of unpleasant effects and it is considered to be clinically obsolete. [NIH] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Narcosis: A general and nonspecific reversible depression of neuronal excitability, produced by a number of physical and chemical aspects, usually resulting in stupor. [NIH] 348 Alcohol Abuse Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neoplastic: Pertaining to or like a neoplasm (= any new and abnormal growth); pertaining to neoplasia (= the formation of a neoplasm). [EU] Nephropathy: Disease of the kidneys. [EU] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Nervousness: Excessive excitability and irritability, with mental and physical unrest. [EU] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuralgia: Intense or aching pain that occurs along the course or distribution of a peripheral or cranial nerve. [NIH] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroendocrinology: The study of the anatomical and functional relationships between the nervous system and the endocrine system. [NIH] Neuroleptanalgesia: A form of analgesia accompanied by general quiescence and psychic indifference to environmental stimuli, without loss of consciousness, and produced by the combined administration of a major tranquilizer (neuroleptic) and a narcotic. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Dictionary 349 Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neuropeptide: A member of a class of protein-like molecules made in the brain. Neuropeptides consist of short chains of amino acids, with some functioning as neurotransmitters and some functioning as hormones. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotic: 1. Pertaining to or characterized by neurosis. 2. A person affected with a neurosis. [EU] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not acting at synapses. [NIH] Neutrons: Electrically neutral elementary particles found in all atomic nuclei except light hydrogen; the mass is equal to that of the proton and electron combined and they are unstable when isolated from the nucleus, undergoing beta decay. Slow, thermal, epithermal, and fast neutrons refer to the energy levels with which the neutrons are ejected from heavier nuclei during their decay. [NIH] Niacin: Water-soluble vitamin of the B complex occurring in various animal and plant tissues. Required by the body for the formation of coenzymes NAD and NADP. Has pellagra-curative, vasodilating, and antilipemic properties. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Normal Distribution: Continuous frequency distribution of infinite range. Its properties are as follows: 1) continuous, symmetrical distribution with both tails extending to infinity; 2) arithmetic mean, mode, and median identical; and 3) shape completely determined by the mean and standard deviation. [NIH] Nosocomial: Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after 350 Alcohol Abuse admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire nosocomial infection. [EU] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through the kidneys. [NIH] Nuclear Family: A family composed of spouses and their children. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite struct