A new study out of the University of Chicago Medicine following young adult drinkers for 10 years has found that individuals who reported the highest sensitivity to alcohol’s pleasurable and rewarding effects at the start of the trial were more likely to develop an alcohol use disorder (AUD) over the course of the study.
University of Chicago Medical Center. “Increase in pleasurable effects of alcohol over time can predict alcohol use disorder: New research challenges existing dogma that higher tolerance for stimulating and rewarding effects of alcohol leads to addiction.” ScienceDaily. http://www.sciencedaily.com/releases/2021/01/210105084649.htm (accessed January 7, 2021).
Journal Reference: Andrea King, Ashley Vena, Deborah S. Hasin, Harriet deWit, Sean J. O’Connor, Dingcai Cao. Subjective Responses to Alcohol in the Development and Maintenance of Alcohol Use Disorder. American Journal of Psychiatry, 2021; appi.ajp.2020.2 DOI: 10.1176/appi.ajp.2020.20030247
Nielsen reports alcohol sales in stores were up 54% in late March compared to that time last year, while online sales were up nearly 500% in late April. According to a Morning Consult poll of 2,200 U.S. adults conducted in early April, 16% of all adults said they were drinking more during the pandemic, with higher rates among younger adults: One in 4 Millennials and nearly 1 in 5 Gen Xers said they had upped their alcohol intake.
I stumbled upon the same AHA news article in several other websites. The entire article was reprinted in its entirety and just one website provided attribution to the source. The copyright notice and proper attribution is included above.
The binging population is of particular concern. “This is a huge problem, driven by people in their 30s and 40s,” Saab told Medscape Medical News. “It’s fascinating; with each subsequent generation, risk behavior increases. Nobody seems to know why that is. Different parenting, different life stressors, social media? Things have changed.”
In the 25- to 34-year age group, death from liver cirrhosis increased 10.5% from 2009 to 2016, according to data from the ACCELERATE-AH consortium, which is looking at alcohol use by patients before and after liver transplantation, as reported by Medscape Medical News.
Today, Washingtonians purchase more alcohol on a per capita basis than any state except New Hampshire, according to statistics from the Centers for Disease Control and Prevention (CDC).
Nearly a quarter of District residents are binge drinkers, defined as consuming more than five drinks in an evening; that is the second-highest rate in the nation, behind North Dakota. And Washington bears higher economic costs of problem drinking than any other state, according to the CDC calculations.
A part of the higher rates comes from the high-stakes nature of government jobs, and from professions with a large presence in Washington, said Aaron White, the senior scientific adviser to the director of the National Institute on Alcohol Abuse and Alcoholism. Lawyers, plentiful in Washington, tend to drink more than those in other professions.
“We know that high-powered jobs, high income, that is a risk factor for excessive drinking,” White said. “You have a lot of people in powerful, high-paying jobs downtown. People with money and stressful jobs tend to drink more.”
The retrospective analysis involving 30 million people in France shows that those with a history of alcohol use disorders had a threefold increased risk for dementia and that over half those with early-onset dementia had a history of alcohol problems. “This study used a phenomenally large database, and the result showing that half the cases of early-onset dementia were associated with alcohol use disorders is truly staggering,” Ballard told Medscape Medical News.
The researchers used diagnostic codes on hospital records to identify patients with dementia and those who had a history of alcohol use disorders. They found over a million cases of dementia, after excluding people with diseases that can lead to rare types of dementia and those with early-life mental disorders that can increase or confound dementia diagnosis. There were also 945,000 people with alcohol use disorders.
Results showed a strong association between a history of alcohol problems and dementia. This was especially noticeable in early-onset dementia, with 57% of the 57,000 patients who had developed dementia under the age of 65 years having a history of alcohol use disorders (66% of men and 37% of women).
In an analysis of just those patients in whom the first record of dementia occurred in 2011-2013 and adjusted for other risk factors found in the medical records, the risk for dementia was three times greater if the patient had a history of alcohol use disorders. The hazard ratio was 3.36 for men and 3.34 for women.
Read the Medscape article here. Or get down and dirty with the full study here.
It has been said that alcoholics exist to teach physicians humility. These patients are quite complicated, often suffering from several problems simultaneously (e.g., withdrawal, nutritional deficiencies, trauma, infection, psychiatric problems). Arguably the most important task when treating alcohol withdrawal is exclusion of alternative or superimposed problems. Phenobarbital obviously cannot be expected to solve every problem that may exist in an alcoholic patient.
Phenobarbital does, however, appear to be a uniquely effective and safe treatment for alcohol withdrawal (including withdrawal seizures and delirium tremens). Several reasons for the superiority of phenobarbital are listed above. Preliminary evidence suggests that these do indeed translate into meaningful clinical benefit (e.g. faster recovery, fewer complications).
After adjustments for variables that included sex, educational status, and year of birth, alcohol use disorder was associated with a mortality hazard ratio of 5.83 (95% confidence interval, 5.76 – 5.90). However, the hazard ratio showed an inverted U-shaped curve in accordance with age.
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