Sociodemographics, lifestyle factors and health status indicators associated with alcohol consumption and related behaviours: a Brazilian population-based analysis.

OBJECTIVES: To investigate how various alcohol-drinking behaviours are associated with sociodemographics, lifestyle factors and health status indicators in Brazil. STUDY DESIGN: This study is based on a household survey of 53,034 adults aged 18 + years from all 26 Brazilian capitals and the Federal District conducted in 2017. METHODS: Sex-stratified relationships were modelled using logistic regressions and controlled for capital-specific effects. Main outcome measures included regular alcohol use, weekly alcohol use, heavy episodic drinking (HED), frequent HED and drinking and driving. RESULTS: Overall (unadjusted) prevalence of regular alcohol consumption is 41%. Among drinkers, approximately 70% drink on a weekly basis, and 46% are heavy episodic drinkers. Among this latter group, close to 44% are frequent heavy episodic drinkers (i.e. at least four times in a month). Among regular drinkers who also are drivers, the prevalence of drinking and driving is 28%. These prevalences are considerably higher in men. The relationships investigated vary by drinking behaviour and sex, with some factors consistently associated with various behaviours, when present. Population (men or women) at greatest risk include (largely) younger individuals (up to 700% increase in odds) who are single or divorced, those who are less health conscious and watch television or use mobile devices during leisure time 4 + hours per day and do not have diabetes. For drinking and driving, the additional risk factors include speeding behaviour, the use of mobile devices while driving and HED. Education, race/ethnicity and other health status indicators are differently associated with various drinking behaviours. For women, in particular, the results also show differences in odds of up to 360% and 1430% across cities for frequent HED and drinking and driving, respectively. Similarly, indigenous women are at greatest risk of weekly alcohol use and HED. CONCLUSIONS: HED and drinking and driving are problematic, as the association with other factors suggests a clustering of risky behaviours that may exacerbate the consequences of drinking behaviours.

Biological markers of alcohol consumption in nondrinkers, drinkers, and alcohol-dependent Brazilian patients.

BACKGROUND: The purpose of this study was to compare the sensitivity and specificity of some new and traditional biological markers and indicators of health among Brazilian nondrinkers, drinkers, and alcohol-dependent patients. MATERIAL AND METHODS: We evaluated 130 nondrinkers, 167 drinkers, and 183 alcohol-dependent drinkers from Brazil who participated in the WHO/ISBRA Study on State and Trait Markers of Alcohol Use and Dependence. A standardized WHO/ISBRA Interview Schedule provided background information on the subjects' characteristics including reported health problems and alcohol consumption. Blood samples were analyzed for aspartate aminotransferase (AST), carbohydrate deficient transferrin (CDT), gamma-glutamyltransferase (GGT), blood alcohol levels (BAL), and platelet adenylate cyclase activity (basal levels [AC] and levels after stimulation with Gpp(NH)p, cesium fluoride, and forskolin). RESULTS: The alcohol-dependent drinkers presented higher levels of AST, GGT, AC, CDT, and BAL than the nondrinkers and drinkers, whose levels were similar. Sex differences in the sensitivity of CDT and AC were found. The alcohol-dependent women presented a lower prevalence of abnormal values of CDT and Gpp(NH)p-stimulated AC than the alcohol-dependent men, despite the fact that they presented similar alcohol consumption levels. The alcohol-dependent drinkers presented a higher prevalence of clinical disorders than the nondrinkers and drinkers. The drinkers and alcohol-dependent patients presented significantly higher rates of gastritis than the nondrinkers. CONCLUSIONS: Sex differences in the sensitivity of CDT and AC suggest that these markers are not as sensitive at detecting excessive alcohol use in women as they are in men. If data from this Brazilian sample are compared with those reported for international samples, relevant differences are detected, which suggests that genetic and cultural differences should be considered in the selection of biological markers of heavy alcohol consumption.

A World Health Organization perspective on alcohol and illicit drug use and health.

Alcohol and illicit drug use has a significant impact on global health. Alcohol consumption is increasing worldwide, particularly in developing countries and countries in transition, leading to an increasing number of health and social problems, both acute and chronic. Illicit drug use is also increasing, particularly injection drug use, followed by an epidemic spread of HIV and other blood-borne infections. Alcohol and illicit drug use are related to key determinants of population health and are also an outcome of poor health. Globalized marketing and trade, and rapid social changes and development in the absence of strong policies and investments in public health have led to an increased availability, use and problems related to alcohol and other substance use. Public health policies and substantial investments in effective prevention and treatment approaches are needed in order to reduce the negative impact of alcohol and other drug use at national and global levels.

MK-801 blocks the development of behavioral sensitization to the ethanol.

BACKGROUND: Studies have indicated that MK-801 (a noncompetitive N-methyl-D-aspartate receptor antagonist) participates in the long-term neural changes responsible for sensitization to stimulant drugs. It is known that repeated administration of low doses of ethanol sensitizes animals to its stimulant effect. In this work we investigated whether MK-801 alters the development of behavioral sensitization to ethanol. METHODS: Groups of male Swiss mice were treated with saline or ethanol (2.0 g/kg) plus saline or MK-801 (0.25 mg/kg) for 21 days. On day 25, all animals received an ethanol challenge injection (2.0 g/kg). We measured locomotor activity on days 1, 7, 14, 21) and 25. In addition, we assessed the effects of different doses of MK-801 on the response to a low dose of ethanol (2.0 g/kg). RESULTS: Ethanol-treated mice developed sensitization to the locomotor-stimulating effect of the drug, whereas those concomitantly receiving ethanol and MK-801 did not. All doses of MK-801 that were used stimulated the locomotor activity of both ethanol and saline-treated animals. CONCLUSIONS: The findings support the hypothesis that N-methyl-D-aspartate receptors have an important role in the development of sensitization to drugs of abuse.

A review of biological indicators of illicit drug use, practical considerations and clinical usefulness.

AIMS: To examine a range of biological indicators of illicit drug use, including blood, urine, hair and saliva, addressing both technological and practical issues relating to their application and interpretation. METHODS: The review process involved an examination of key reference texts and literature from the scientific fields of analytical and clinical toxicology. FINDINGS: Urine remains the biological tool of choice for qualitative detection of illicit drug use in a clinical setting, while quantitative accuracy remains strictly the domain of blood. The growing sophistication of laboratory analysis may additionally make possible the routine use of hair sampling which can provide a much longer time frame for assessment. Breath, saliva, sweat or breast milk remain possibilities in the future. CONCLUSIONS: Accurate interpretation of the screening tests within a clinical setting alongside other relevant information remains the key to the usefulness of any test.

Allele frequency of ADH2 and ALDH2 among Brazilians of different ethnic groups.

We determined the genotypes of the alcohol dehydrogenase (ALDH) and aldehyde dehydrogenase (ALDH2) loci of different ethnic groups living in Brazil, using saliva DNA amplified by PCR and allele-specific oligonucleotides. Self-reports of flushing reaction after drinking were also studied. The allelic frequencies of ADH2 and ALDH2 were found to be lower than those reported other authors, which might be a result of the admixture origin of the Brazilian population. Variability in facial flushing reaction suggests that other factors play a role in the expression of alcohol-induced flushing.

Studies on the sensitivity to alcohol and alcohol dependence.

The role of genetic and environmental factors in the development of alcohol dependence is beginning to be investigated in Brazil. This paper reviews recent studies on genetic aspects of alcohol use and alcohol dependence, with emphasis on those carried out in Brazilian populations. Most findings replicated studies in developed countries, while some indicate new possible venues for investigation in the future. They underscore the need for a cross-cultural and interethnic approach to biomedical aspects of alcohol use and dependence.

Comparison between subjective feelings to alcohol and nitrogen narcosis: a pilot study.

Nitrogen narcosis is often compared to alcohol intoxication, but no actual studies have been carried out in humans to test the comparability of these effects. If a common mechanism of action is responsible for the behavioral effects of these substances, biological variability of response to alcohol should correlate to that of nitrogen in the same individual. To test this hypothesis, subjective feelings were assessed in two separate occasions in 14 adult male, healthy volunteers, nonprofessional divers. In one occasion, each subject received 0.75 ml/kg (0.60 g/kg) alcohol 50% (v/v PO) and in another day underwent a simulated dive at 50 m for 30 min in a hyperbaric chamber. There was a significant correlation between reported feelings in the two sessions; subjects who felt less intoxicated after drinking also felt less nitrogen narcosis during the simulated dive. The results, although preliminary, raise the hypothesis that ethanol and nitrogen may share the same mechanisms of action in the brain and that biological differences might account for interindividual variability of responses to both ethanol and nitrogen.

Family history of alcoholism and psychiatric co-morbidity in Brazilian male alcoholics and controls.

The present study was aimed at replicating, in a sample of Brazilian subjects, findings generated mostly in developed countries on the relative prevalence of alcohol problems, associated psychiatric disorders, family history of alcoholism and other familial psychiatric disorders in alcoholics and controls. A group of Brazilian male alcoholics (n = 103) and controls (n = 63) at first admission to ambulatory or inpatient treatment were interviewed individually using sections of the Structured Clinical Interview for DSM-III-R. Information on demographic characteristics, alcohol-related problems, psychiatric problems and family history of alcoholism and depression were collected from all subjects. Alcoholics had a higher prevalence of a family history of alcoholism, a family history of depression and of a personal history of other psychiatric disorders when compared to controls. Comparisons between FHP and FHN alcoholics, although preliminary, showed few significant differences between these subgroups. Comparisons between FHP and FHN control showed a non-significant trend towards a higher prevalence of psychiatric problems and towards antisocial behaviours among those with a positive family history of alcoholism. The findings point to the importance of cross-cultural studies on genetic and environmental factors related to alcohol dependence.

Prolonged treatment with carbamazepine increases the stimulatory effects of ethanol in mice.

Carbamazepine (CBZ) has been used in the treatment of alcohol withdrawal (AW). However, cases of induction of euphoric feelings when mixed with alcohol have been reported. We verified whether CBZ could potentiate ethanol stimulatory effects in animals. Two groups of mice were injected with saline (group I) or 2 g/kg ethanol (group II) IP, for 20 days. On the next day, each group was divided into two subgroups that received either a single dose of CBZ (10 mg/kg) or vehicle IP, followed, 30 min later, by saline or ethanol injection. Locomotor activity was measured. Acute CBZ did not change locomotor activity of ethanol-treated mice. Treatment with CBZ or vehicle continued for 6 days. Finally, on the 28th day, 30 min after the last CBZ or vehicle injection, an ethanol challenge was given to group II and a saline injection to group I. The results showed a significant potentiation of ethanol stimulatory effects by chronic CBZ treatment. Data indicated that CBZ should be cautiously administered to alcohol-dependent patients.

Alcohol flushing, patch test, and ADH and ALDH genotypes in Brazilian ethnic groups.

Self reports of flushing reaction after drinking, cutaneous sensitivity to alcohol (patch test), and genotypic determination of ADH2, ADH3, and ALDH2 were studied in 53 Brazilian volunteers of different ethnic groups. Genotypes were determined using single-strand conformation polymorphism in discontinuous buffer electrophoresis. Analysis of the results indicated several cases of a reported flushing reaction among ALDH2 1/1 individuals, while all but 2 cases of ALDH2 heterozygotes reported a flushing reaction. The latter subjects also had a negative result in the patch test. These preliminary results indicate that variability in the facial flushing reaction to alcohol seems to be a phenomenon resulting not only from the presence of a deficient ALDH2*2 allele, but also from other polymorphisms of alcohol-metabolizing enzymes.

Alcohol flushing, patch test, and ADH and ALDH genotypes in Brazilian ethnic groups

Self reports of flushing reaction after drinking, cutaneous sensitivity to alcohol (patch test), and genotypic determination of ADH2, ADH3, and ALDH2 were studied in 53 Brazilian volunteers of different ethnic groups. Genotypes were determined using single strand conformation polymorphism in discontinous buffer electrophoresis. Analysis of the results indicated several cases of a reported flushing reaction among ALDH2 1/1 individuals, while all but 2 cases of ALDH2 heterozygotes reported a flushing reaction. The latter subjects also had negative result in the patch test. These preliminary results indicate that variability in the facial flushing reaction to alcohol seems to be a phenomenon resulting not only from the presence of a deficient ALDH2*2 allele, but also from other polymorphism of alcohol-metabolizing enzymes

Long-lasting effects of chronic ethanol administration on the activity of antioxidant enzymes.

The aim of this study was to investigate the long-lasting effects of prolonged administration of ethanol doses on oxidative processes of aged rats. We determined the activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) in erythrocytes of rats 15, 20, and 24 months old treated with an average daily dose of 1.5 g/Kg of ethanol or saline administered intraperitoneally for 13 weeks and after a 2 month period of withdrawal from treatment. The activity of all three enzymes decreased significantly with aging in the controls, while no age-related changes were found among treated rats. These findings are important since they are the first to show a long-lasting toxic effect of low ethanol doses observed in association with the aging process.

Pharmacological treatment of alcoholism.

This paper presents an overview on pharmacologic treatment of alcoholism. A wide range of drugs have been tested over the years, some showing a reduction of alcohol drinking in alcoholics. However, at present, there is little evidence that pharmacotherapy is effective in the rehabilitation of alcoholics. Although research in this area still has several methodological problems and much needs to be done, a greater understanding of the neuropharmacology and neurobiology of alcohol use and abuse will certainly open new avenues for investigation and drug development. Patient-treatment matching and the combination of two or more modalities of intervention may also help increase overall effectiveness of alcohol treatment.

Subjective feelings and changes in body sway following diazepam in sons of alcoholics and control subjects.

The possible generalization to diazepam of the dampened response to ethanol in sons of alcoholic fathers was evaluated in 62 sons of alcoholics (family history positive [FHP] subjects) and 62 family history negative (FHN) controls (124 men). Following challenges with placebo, .12 and .2 mg/kg of diazepam in three separate sessions, evaluation of subjective feelings and increases in body sway revealed no decreased reaction for FHPs.

High levels of sensitivity to alcohol in young adult Jewish men: a pilot study.

This article compares the intensity of response to ethanol in 15 men who reported having Jewish mothers and fathers with the responses of 15 non-Jews who have a close alcoholic relative (FHP) and 15 non-Jews who have no such family history (FHN). After matching the three groups on demography and drinking history, there were no differences on their expectations of the effects of alcohol, nor on the blood alcohol concentrations following the consumption of 0.75 ml/kg of ethanol. However, the men who considered themselves as having a Jewish heritage evidenced significantly more intense subjective feelings after the alcohol challenge, with a similar but nonsignificant trend observed for their level of postdrinking body sway.

Antiulcerogenic effects of two Maytenus species in laboratory animals.

Leaves of Maytenus species are commonly used in Brazil for the treatment of gastric ulcers, dyspepsias and other gastric problems. The present study evaluated the antiulcerogenic potential of a boiling water extract of equal parts of M. aquifolium and M. ilicifolia leaves against ulcer lesions induced by indomethacin and cold-restraint stress in rats. Ranitidine and cimetidine were used as reference drugs. The oral and intraperitoneal administration of the extract had a potent antiulcerogenic effect against both types of ulcers. The extract was shown to cause an increase in volume and pH of gastric juice of the animals with the pH effects comparable to those of cimetidine. The results tend to confirm the popular use of the plant.