酒精中毒：临床和实验研究的范围涵盖与酒精滥用、依赖或酒精中毒的任何方面有关的动物和人类临床研究、流行病学、实验、政策和历史研究。该杂志在其范围内采用多学科方法酗酒，其原因，临床和动物影响，后果，模式，治疗和恢复，预测因素和预防。

The journal "Alcoholism: Clinical and Experimental Research" covers all aspects related to alcohol abuse, dependence, or intoxication, including clinical studies in both animals and humans, epidemiology, experimental research, policy analysis, and historical studies. It employs a multidisciplinary approach to explore the causes of alcoholism, its clinical and animal effects, consequences, patterns, treatment and recovery, predictive factors, and prevention strategies.

《Alcoholism: Clinical and Experimental Research》期刊涵盖与酒精滥用、依赖或酒精中毒相关的各个方面，包括动物和人类的临床研究、流行病学、实验研究、政策分析和历史研究。该杂志采用多学科的方法探讨酗酒的原因、临床和动物影响、后果、模式、治疗与恢复、预测因素以及预防措施。

Alcoholism: Clinical and Experimental Research

Background: In several studies, patients with alcohol dependence treated with the opioid antagonist naltrexone have shown fewer relapses to heavy drinking than those receiving placebo. An interaction between the naltrexone effect and the type of psychological therapy has been observed. Methods: A 6‐month, double‐blind, placebo‐controlled, parallel‐group study was performed at 10 different investigation sites. After a placebo run‐in period of 1 week, 118 patients were randomized into 4 treatment groups—50 mg of naltrexone daily or placebo in combination with either cognitive behavioral therapy (CBT) or supportive therapy. The CBT was performed over nine sessions according to the manual of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity). The supportive therapy was defined as “the treatment as usual.” Alcohol consumption, craving, carbohydrate‐deficient transferrin, medication compliance by tablet count, and adverse clinical events were assessed at all visits. Other liver enzymes and psychiatric symptoms were also determined. Results: Ninety‐one (77%) patients completed the study, and 92 (78%) were 80% compliant with the medication regimen. A lower percentage of heavy‐drinking days was shown in the naltrexone group ( p = 0.045) compared with the placebo group, as was a lower craving score ( p = 0.029). These results are supported by the lower levels of liver enzyme activities ( p &lt; 0.010 for aspartate aminotransferase, alanine aminotransferase, and γ‐glutamyltransferase), but not by the carbohydrate‐deficient transferrin levels, in the naltrexone group. The mean time period before the first day of heavy drinking was longer for the group treated with CBT ( p = 0.010), especially in combination with naltrexone ( p = 0.007). Naltrexone was well tolerated, and no patients discontinued the study due to side effects. Conclusions: This study supports the effect of naltrexone in outpatient treatment of alcohol dependence and suggests that a beneficial interaction effect with CBT can be expected.

J. Balldin

M. Berglund

S. Borg

Marianne Månsson

P. Bendtsen

J. Franck

L. Gustafsson

J. Halldin

L.‐ H. Nilsson

G. Stolt

A. Willander

Alcoholism Clinical and Experimental Research

A 6‐Month Controlled Naltrexone Study: Combined Effect With Cognitive Behavioral Therapy in Outpatient Treatment of Alcohol Dependence

The prevalence of alcohol misuse among older adults has grown dramatically in the past decade, yet little is known about the association of alcohol misuse with hospitalization and death in this patient population.We examined the association between alcohol use (measured by a screening instrument in primary care) and rates of all-cause and cardiovascular disease (CVD)-related 6-month hospitalization or death via electronic health records (EHRs) in a nationally representative sample of older, high-risk Veterans. Models were adjusted for sociodemographic and clinical characteristics, including frailty and comorbid conditions.The all-cause hospitalization or death rate at 6 months was 14.9%, and the CVD-related hospitalization or death rate was 1.8%. In adjusted analyses, all-cause hospitalization or death was higher in older Veterans who were nondrinkers or harmful use drinkers compared to moderate use drinkers, but CVD-related hospitalization or death was similar in all categories of drinking.These findings suggest that the complex association between alcohol and all-cause acute healthcare utilization found in the broader population is similar in older, high-risk Veteran patients. These findings do not support an association between alcohol consumption and CVD-specific hospitalizations.

Dan V. Blalock

Janet Grubber

Valerie A. Smith

Donna M. Zulman

Hollis J. Weidenbacher

Liberty Greene

Eric A. Dedert

Matthew L. Maciejewski

The association of alcohol use with all‐cause and cardiovascular disease‐related hospitalizations or death in older, high‐risk Veterans

酒精使用与老年高危退伍军人全因及心血管疾病相关住院或死亡的关系

Background Chronic, heavy alcohol use is associated with multiple health problems, including premature death. Further, the clinical presentation of alcohol dependence may differentially affect and predict the long‐term health consequences of affected individuals. Subtypes of alcohol dependence based upon treatment intake information can help identify homogenous groups of patients for treatment purposes, but have not been used to predict long‐term outcomes. The current study examined mortality in a 36‐year posttreatment interval among 4 subtypes of alcohol‐dependent patients based upon their initial intake data. Methods Extensive baseline data were collected from n = 316 male and female patients receiving inpatient treatment for alcohol dependence between 1980 and 1982. Four alcohol dependent subtypes (Del Boca &amp; Hesselbrock, Alcohol Health Res World, 20:56, 1996) derived from the baseline data were used to examine the 1‐year posttreatment drinking status and the risk of death 36 years postdischarge. Public records were used to determine patient deaths in the 36 years since discharge. Results At the 36‐year follow‐up interval since discharge, 68.4% of the sample had died. The 4 subtypes were found to be associated with different rates of resumption of regular drinking in the first year posttreatment and a differential risk of mortality. An increased risk for returning to regular drinking (once a week or more) and early death were associated with subtypes defined, in part, by conduct problems and externalizing disorders. Regardless of subtype membership, women had the highest risk of death following treatment. Conclusions This study demonstrates the clinical usefulness of subtypes of alcohol dependence for examining different alcohol use outcomes, including predicting mortality. The increased risks for returning to regular drinking once a week or more and early death posttreatment among subtypes associated with conduct problems and externalizing disorders suggest the need for continued monitoring and possible additional intervention postdischarge.

Michie N. Hesselbrock

Victor M. Hesselbrock

Grace Chan

Frances Del Boca

Karen Chartier

Subtypes of Alcohol Dependence and 36‐Year Mortality

酒精依赖亚型与36年死亡率

Background The nucleus accumbens shell is a key brain area mediating the reinforcing effects of ethanol (EtOH). Previously, it has been shown that the density of μ ‐opioid receptors in the nucleus accumbens shell is higher in alcohol‐preferring Alko Alcohol ( AA ) rats than in alcohol‐avoiding Alko Non‐Alcohol rats. In addition, EtOH releases opioid peptides in the nucleus accumbens and opioid receptor antagonists are able to modify EtOH intake, all suggesting an opioidergic mechanism in the control of EtOH consumption. As the exact mechanisms of opioidergic involvement remains to be elucidated, the aim of this study was to clarify the role of accumbal μ ‐ and κ ‐opioid receptors in controlling EtOH intake in alcohol‐preferring AA rats. Methods Microinfusions of the μ ‐opioid receptor antagonist CTOP (0.3 and 1 μ g/site), μ ‐opioid receptor agonist DAMGO (0.03 and 0.1 μ g/site), nonselective opioid receptor agonist morphine (30 μ g/site), and κ ‐opioid receptor agonist U50488H (0.3 and 1 μ g/site) were administered via bilateral guide cannulas into the nucleus accumbens shell of AA rats that voluntarily consumed 10% EtOH solution in an intermittent, time‐restricted (90‐minute) 2‐bottle choice access paradigm. Results CTOP (1 μ g/site) significantly increased EtOH intake. Conversely, DAMGO resulted in a decreasing trend in EtOH intake. Neither morphine nor U50488H had any effect on EtOH intake in the used paradigm. Conclusions The results provide further evidence for the role of accumbens shell μ ‐opioid receptors but not κ ‐opioid receptors in mediating reinforcing effects of EtOH and in regulating EtOH consumption. The results also provide support for views suggesting that the nucleus accumbens shell has a major role in mediating EtOH reward.

Johanna Uhari‐Väänänen

Atso Raasmaja

Pia Bäckström

Ville Oinio

Mikko Airavaara

Petteri Piepponen

Kalervo Kiianmaa

Accumbal <i>μ</i>‐Opioid Receptors Modulate Ethanol Intake in Alcohol‐Preferring Alko Alcohol Rats

伏隔核<i>μ</i>阿片受体调节酒精偏好Alko酒精大鼠的乙醇摄入

Many alcohol research questions require methods that take a person-centered approach because the interest is in finding heterogeneous groups of individuals, such as those who are susceptible to alcohol dependence and those who are not. A person-centered focus also is useful with longitudinal data to represent heterogeneity in developmental trajectories. In alcohol, drug, and mental health research the recognition of heterogeneity has led to theories of multiple developmental pathways.This paper gives a brief overview of new methods that integrate variable- and person-centered analyses. Methods discussed include latent class analysis, latent transition analysis, latent class growth analysis, growth mixture modeling, and general growth mixture modeling. These methods are presented in a general latent variable modeling framework that expands traditional latent variable modeling by including not only continuous latent variables but also categorical latent variables.Four examples that use the National Longitudinal Survey of Youth (NLSY) data are presented to illustrate latent class analysis, latent class growth analysis, growth mixture modeling, and general growth mixture modeling. Latent class analysis of antisocial behavior found four classes. Four heavy drinking trajectory classes were found. The relationship between the latent classes and background variables and consequences was studied.Person-centered and variable-centered analyses typically have been seen as different activities that use different types of models and software. This paper gives a brief overview of new methods that integrate variable- and person-centered analyses. The general framework makes it possible to combine these models and to study new models serving as a stimulus for asking research questions that have both person- and variable-centered aspects.

Bengt Muthén

Linda K. Muthén

Alcoholism Clin &amp;amp; Exp Res

Integrating Person‐Centered and Variable‐Centered Analyses: Growth Mixture Modeling With Latent Trajectory Classes

整合以人为中心和以变量为中心的分析：基于潜在轨迹类别的增长混合建模

This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education.United Nations Multi-Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18-49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self-reported HED of 6+ drinks in one occasion vs. non-HED and abstaining. Moderating effects of a 13-item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender-inequitable attitudes using the Gender-Equitable Men scale score. Bivariate and adjusted individual participant meta-analyses were used to determine effect estimates for each site and across all sites.Fathers' HED was associated with less positive parental involvement after adjusting for gender-equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07).Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children.

Anne‐Marie Laslett

Sandra Kuntsche

Ingrid M. Wilson

Angela Taft

Emma Fulu

Rachel Jewkes

Kathryn Graham

The relationship between fathers' heavy episodic drinking and fathering involvement in five Asia‐Pacific countries: An individual participant data meta‐analysis

父亲重度偶发性饮酒与在五个亚太国家中的父亲参与度的关系：一项个体参与者数据荟萃分析

Abstract Background Up to 15% of all visits to the Emergency Department (ED) are alcohol related. Identification of problematic alcohol use is important in this setting because it allows for intervention and prevention efforts. This study investigated the correlation between the objective phosphatidylethanol (PEth) marker and the subjective Alcohol Use Disorders Identification Test (AUDIT) and Timeline Followback Questionnaire (TLFB) as screening methods for hazardous alcohol use in the general ED population. Methods This prospective cohort study included 301 ED patients (57% male) who were seen in the ED and required to give a blood sample. The correlation between the values of PEth (PEth 16:0/18:1 and PEth 16:0/18:2) and the scores on the AUDIT and TLFB were analyzed using Spearman's rank correlation coefficient. Differences between risk categories of PEth and AUDIT were also examined. Results The Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and the AUDIT scores were moderate (PEth 16:0/18:1: 0.67, p &lt; 0.001; PEth 16:0/18:2: 0.67, p &lt; 0.001). Of the patients who scored ‘low risk drinking/abstinence’ according to the AUDIT questionnaire, respectively 1% and 4% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating excessive alcohol use, and another 10% and 12% had PEth 16:0/18:1|PEth 16:0/18:2 values indicating moderate alcohol consumption. Of the 12 (PEth 16:0/18:1) and 25 (PEth 16:0/18:2) patients with high‐risk values, respectively 25% and 40% scored in the lowest risk category on the AUDIT questionnaire. Spearman correlation coefficients between PEth 16:0/18:1|PEth 16:0/18:2 values and TLFB two‐week scores were high (PEth 16:0/18:1: 0.74, p &lt; 0.001; PEth 16:0/18:2: 0.82, p &lt; 0.001). Conclusions AUDIT scores were moderately correlated with PEth values in the general ED population. In almost all cases where there was not a good correlation, patients had high PEth values with low AUDIT scores. We conclude that PEth identifies patients with problematic alcohol use who are missed by the AUDIT questionnaire and therefore PEth could be used as an additional screening method for hazardous alcohol use in this population.

Carolien Verheij

Juanita A. Haagsma

Birgit C. P. Koch

Anne E. M. Segers

Stephanie C. E. Schuit

Pleunie P. M. Rood

Screening for hazardous alcohol use in the Emergency Department: Comparison of phosphatidylethanol with the Alcohol Use Disorders Identification Test and the Timeline Follow‐back

急诊科危险性酒精使用筛查：磷脂酰乙醇与酒精使用障碍筛查测试及时间线回溯法的比较

Abstract Background During the COVID‐19 pandemic, specialty alcohol treatment transitioned rapidly to telehealth, which may have created barriers for some patients but increased access for others. This study evaluated the impact of the COVID‐19 pandemic on alcohol treatment utilization and potential disparities. Methods We analyzed electronic health record and claims data from Kaiser Permanente Northern California for adults with alcohol use problems (alcohol use disorder or unhealthy alcohol use diagnoses) during pre‐COVID‐19 (March to December 2019, n = 32,806) and COVID‐19 onset (March to December 2020, n = 26,763). Generalized estimating equation models were fit to examine pre‐COVID‐19 to COVID‐19 onset changes in alcohol treatment initiation, engagement, and retention (days in treatment). Heterogeneity in pre‐COVID‐19 to COVID‐19 onset changes in treatment utilization by age, race, and ethnicity; neighborhood deprivation index (NDI); and comorbid medical and psychiatric disorders were also examined. Results Treatment initiation increased during the COVID‐19 onset period (adjusted odds ratio [aOR] = 1.46; 95% CI = 1.41–1.52). The increases in odds of treatment initiation during the COVID‐19 onset period compared with the pre‐COVID period were largest among patients aged 18–34 years (aOR = 1.59; 95% CI = 1.48–1.71), those without medical conditions (aOR = 1.56; 95% CI = 1.49–1.65), and those without psychiatric disorders (aOR = 1.60; 95% CI = 1.51–1.69). Patients aged 18–34 years (aOR = 5.21; 95% CI = 4.67–5.81), those with the second highest NDIs (aOR = 4.63; 95% CI = 4.12–5.19), and those without medical (aOR = 4.34; 95% CI = 4.06–4.65) or psychiatric comorbidities (aOR = 4.48; 95% CI = 4.11–4.89) had the greatest increases in telehealth treatment initiation from pre‐COVID‐19 to COVID‐19 onset. Treatment engagement and retention also increased during COVID‐19 onset, with the greatest increase among patients aged 35–49 years who initiated treatment via telehealth (engagement: aOR = 2.33; 95% CI = 1.91–2.83; retention: adjusted mean difference [aMD] = 3.3 days; 95% CI = 2.6–4.1). We found no significant variation of changes in treatment utilization by race and ethnicity. Conclusions The transition to telehealth in this healthcare system may have attracted subgroups of individuals who have historically underutilized care for alcohol use problems, particularly younger and healthier adults, without exacerbating pre‐pandemic racial and ethnic disparities in treatment utilization.

Vanessa A. Palzes

Felicia W. Chi

Verena E. Metz

Cynthia Campbell

Caroline Corriveau

Stacy Sterling

COVID‐19 pandemic‐related changes in utilization of telehealth and treatment overall for alcohol use problems

COVID‐19大流行相关远程医疗和酒精使用问题治疗的整体利用率变化

Abstract Background The U.S. Food and Drug Administration identifies abstinence and the absence of heavy drinking days as outcomes for pharmacotherapy trials for alcohol use disorder (AUD). However, many individuals with AUD struggle to achieve these outcomes, which may discourage them from seeking treatment. World Health Organization (WHO) risk drinking levels have garnered attention in the alcohol field as potential non‐abstinent outcomes for AUD medication trials. Further, testing combination pharmacotherapy for AUD represents an important direction in the field, particularly using medications such as naltrexone and varenicline, which are approved for treating AUD and smoking, respectively. The objective of the current study was to test the utility of the WHO risk drinking levels as a drinking outcome in a randomized clinical trial of combined varenicline and naltrexone for smoking cessation and drinking reduction. These analyses provide additional tests of the efficacy of this combination treatment. Methods The current study is a secondary analysis of a phase 2, randomized, double‐blind clinical trial, wherein participants ( N = 165) who were daily smokers and heavy drinkers were randomly assigned to receive either 2 mg/day of varenicline plus 50 mg/day of naltrexone or 2 mg/day of varenicline plus placebo for 12 weeks. Medication effects on 1‐ and 2‐level reductions in WHO risk drinking levels were assessed at 4, 8, and 12 weeks into the active medication period. Results In logistic growth curve models individuals receiving the combined treatment had greater reductions in WHO risk drinking levels than individuals taking varenicline alone when assessed at 4 weeks into the active medication period. Among individuals who were WHO high and very high risk drinkers at baseline, the largest effect sizes favoring combination treatment were at Week 4 for the WHO 2‐level reduction outcome (Cohen's h = 0.202) and Week 12 for the WHO 1‐level reduction outcome (Cohen's h = 0.244), although these effects did not reach statistical significance. Conclusions These findings provide evidence that combined varenicline plus naltrexone treatment is effective at reducing WHO risk drinking levels, particularly among individuals who smoke cigarettes daily and drink heavily. These results add to a growing body of literature validating reductions in WHO risk drinking levels as outcomes of alcohol medication trials.

Steven J. Nieto

Craig K. Enders

Katie Witkiewitz

Stephanie S. O'Malley

Lara A. Ray

Combination treatment with varenicline and naltrexone reduces World Health Organization risk drinking levels

联合使用伐尼克兰和纳曲酮降低世界卫生组织风险饮酒水平

Alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD) are highly comorbid, yet there is a lack of preclinical research investigating how prior ethanol (EtOH) dependence influences the development of a PTSD-like phenotype. Furthermore, the neuroimmune system has been implicated in the development of both AUD and PTSD, but the extent of glial involvement in this context remains unclear. A rodent model was developed to address this gap in the literature.We used a 15-day exposure to the 5% w/v EtOH low-fat Lieber-DeCarli liquid diet in combination with the stress-enhanced fear learning (SEFL) paradigm to investigate the effects of chronic EtOH consumption on the development of a PTSD-like phenotype. Next, we used a reverse transcription quantitative real-time polymerase chain reaction to quantify mRNA expression of glial cell markers GFAP (astrocytes) and CD68 (microglia) following severe footshock stress in EtOH-withdrawn rats. Finally, we tested the functional contribution of dorsal hippocampal (DH) astrocytes in the development of SEFL in EtOH-dependent rats using astrocyte-specific Gi designer receptors exclusively activated by designer drugs (Gi -DREADD).Results demonstrate that chronic EtOH consumption and withdrawal exacerbate future SEFL. Additionally, we found significantly increased GFAP mRNA expression in the dorsal and ventral hippocampus and amygdalar complex following the severe stressor in EtOH-withdrawn animals. Finally, the stimulation of the astroglial Gi -DREADD during EtOH withdrawal prevented the EtOH-induced enhancement of SEFL.Collectively, results indicate that prior EtOH dependence and withdrawal combined with a severe stressor potentiate future enhanced fear learning. Furthermore, DH astrocytes significantly contribute to this change in behavior. Overall, these studies provide insight into the comorbidity of AUD and PTSD and the potential neurobiological mechanisms behind increased susceptibility to a PTSD-like phenotype in individuals with AUD.

Gillian A. Barkell

Shveta V. Parekh

Jacqueline E. Paniccia

Alia J. Martin

Kathryn J. Reissner

Darin J. Knapp

Stacey L. Robinson

Todd E. Thiele

Donald T. Lysle

Chronic ethanol consumption exacerbates future stress‐enhanced fear learning, an effect mediated by dorsal hippocampal astrocytes

慢性乙醇摄入加剧未来应激增强的恐惧学习，该效应由背侧海马星形胶质细胞介导

Abbreviation	Alcoholism Clin & Exp Res
Journal Impact	3.36
Quartiles(Global)	SUBSTANCE ABUSE(Q3)

Publication Information	Publisher: John Wiley and Sons Inc，Publishing cycle: Monthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1977，Proportion of original research papers: 92.50%，Self Citation Rate:10.00%， Gold OA Rate: 23.58%
Average review cycle	网友分享经验：一般,3-6周
Average recruitment ratio	网友分享经验：较易

Alcoholism: Clinical and Experimental Research

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