Robert Wood Johnson Foundation Ends Addiction Funding Program

This news isn't as bad as the headline makes it sound. RWJF is going stop having a special program area for addiction and addiction related programs will be funded in thier Vulnerable Populations program area.

While this isn't a disaster, it's disappointing and reflects a larger trend toward the erosion of categorical segregation of addiction services. They are most frequently being rolled into mental health, but also into criminal justice, public health, traditional medicine, etc.

Here are a few thoughts from Bill White on the topic from Slaying the Dragon and some Counselor articles:

On problem ownership:

Whether we define alcoholism as a sin, a crime, a disease, a social problem, or a product of economic deprivation determines whether this society assigns that problem to the care of the priest, police officer, doctor, addiction counselor, social worker, urban planner, or community activist. The model chosen will determine the fate of untold numbers of alcoholics and addicts and untold numbers of social institutions and professional careers.

The existence of a “treatment industry” and its “ownership” of the problem of addiction should not be taken for granted. Sweeping shifts in values and changes in the alignment of major social institutions might pass ownership of this problem to another group.

On the segregation-integration pendulum:

American history is replete with failed efforts to integrate the care of alcoholics and addicts into other helping systems. These failed experiments are followed by efforts to move such care into a categorically segregated system that, once achieved, is followed with renewed proposals for service integration. After fighting 40 years to be born as an autonomous field of service, addiction treatment is once again in the throes of service-integration mania. This cynical evolution in the organization of addiction treatment services seems to be part of two broader pendulum swings in the broader culture, between specialization and generalization and between centralization and decentralization. Once we have destroyed most of the categorically segregated addiction treatment institutions in America, a grassroots movement will likely arise again to recreate them.

On the historical essence of addiction counseling:

If AOD problems could be solved by physically unraveling the person-drug relationship, only physicians and nurses trained in the mechanics of detoxification would be needed to address these problems. If AOD problems were simply a symptom of untreated psychiatric illness, more psychiatrists, not addiction counselors would be needed. If these problems were only a reflection of grief, trauma, family disturbance, economic distress, or cultural oppression, we would need psychologists, social workers, vocational counselors, and social activists rather than addiction counselors. Historically, other professions conveyed to the addict that other problems were the source of addiction and their resolution was the pathway to recovery. Addiction counseling was built on the failure of this premise. The addiction counselor offered a distinctly different view: “All that you have been and will be flows from the problem of addiction and how you respond or fail to respond to it.”

Addiction counseling as a profession rests on the proposition that AOD problems reach a point of self-contained independence from their initiating roots and that direct knowledge of addiction, its specialized treatment, and the processes of long-term recovery provide the most viable instrument for healing and wholeness. If these core understandings are ever lost, the essence of addiction counseling will have died even if the title and its institutional trappings survive. We must be cautious in our emulation of other helping professions. We must not forget that the failure of these professions to adequately understand and treat addiction constituted the germinating soil of addiction counseling as a specialized profession.

On the soul of the field and its future:

In the face of such threats (managed care, facility closures, merger mania & integration into behavioral health systems), the field is experiencing a strange phenomenon. As the core of the addiction treatment field shrinks, the field is growing at the periphery. Where the total amount allocated to residential and inpatient treatment services is shrinking, the numbers of outpatient services is actually increasing, as is a growing number of new specialty programs that extend addiction treatment services into allied fields. The growth zone of the addiction treatment industry is not at the traditional core but in the delivery of addiction treatment services into the criminal justice system, the public health system (particularly AIDS related projects), the child welfare system, the mental health system, and the public-welfare system. If one looks at these trends as a whole, what is emerging in the 1990s is a treatment system less focused on the goal of long-term personal recovery than on social control of the addict. The goal of this evolving system is moving from a focus on the personal outcome of treatment to an assurance that the alcoholic and addict will not bother us and will cost us as little as possible.

The fate of the field will be determined by its ability to redefine its niche in an increasingly turbulent health-care and social-service ecosystem. That fate will also be dictated by more fundamental issues – the ability of the field to: 1) reconnect with the passion for service out of which it was born; 2) re-center itself clinically and ethically; 3) forge new service technologies in response to new knowledge and the changing characteristics of clients, families, and communities; and 4) the ability of the field to address the problem of leadership development and succession.

The Politics Of Addiction

I don't share the author's rush to embrace William Cope Moyers, but, politics aside, this commentary makes some good points about attitudes toward alcoholism and the war on drugs:

The broader Clinton kerfuffle aside, what struck me about the spurious implication of a spirit-enhanced performance was how casually and often cruelly people joke about alcohol. Both its pervasiveness and the social stigma attached to alcoholism--treating it as symptom of moral turpitude rather than the disease it is--are writ large in the political world.

The war on drugs must shift from an obsessive focus on trying to reduce the supply through interdiction and criminal justice to what works the best--—recovery. Perhaps someday that will happen. In the meantime, people addicted to alcohol and other drugs, their loved ones and the communities where they live, are desperate for help.

The federal government is spending about $20 billion a year on the war on drugs. Currently, only about 18 percent of that money goes for recovery programs, prevention, addiction research and education.

WHO AIDS treatment resolution withdrawn because of U.S. opposition to needle exchanges

I hate that any critic of any needle exchange is accused of "moral panic", but this kind of stuff makes it easy for them.

Heavy Drinking Might Hasten HIV Progression

For those of you who follow politics, keep the macaca jokes to yourself:

"There are two key findings," said Bagby. "First, chronic binge alcohol consumption accelerated time to AIDS of rhesus macaques infected with SIV, a virus that mimics what happens to humans infected with HIV. The average time to end-stage disease was decreased from 900 days in control animals to 374 days in the alcohol-treated rhesus monkeys. Second, animals receiving alcohol had higher viral loads in the blood in the early months after being infected with the virus. This higher viral load is associated with more rapid disease progression in both SIV-infected rhesus macaques and HIV-infected humans. Because SIV infection in rhesus macaques is so similar to what happens in HIV infected humans, we can expect that alcohol would have similar consequences in humans."

Menthol cigarettes prove harder to quit

What I found especially interesting in this article is that menthol smokers have a harder time quitting in spite of the fact that, on average, they smoke less and drink less.

New drug may heal liver

Good news for alcoholics with liver disease:

SCIENTISTS have discovered a drug that they predict could prevent liver disease, even in alcoholics.

Tests on the drug, which is already used to treat inflammatory bowel disease, found that it prevented scarring of the liver and even reversed liver damage.

Christopher Day, a liver specialist from Newcastle University in Britain who led the research, said sulphasalazine could provide an alternative to liver transplants.

...and some revealing statements about the state of stigmatization of addicts and alcoholics in the medical professions:

"This drug is not a finite resource. You are not stealing [emphasis added] it from someone else, which is always a worry in public opinion," Professor Day said. "People are dying on the transplant list."

and

Sulphasalazine may also relieve the ethical dilemma of giving donated livers to people whose illness was self-inflicted through excessive consumption of alcohol or poor diet and obesity.

Pregnant Drug Addicts Aren't Child Abusers

I'm not sure whether this is a new problem of an old problem with new attention being brought to it:

In recent months, pregnant women have been arrested and jailed in South Carolina, New Mexico, Arizona, Alabama, Colorado, Georgia, Missouri, North Dakota and New Hampshire, among other states, based on the claim that pregnant women can be considered child abusers even before they have given birth.

Women targeted for these arrests are usually those with untreated drug or alcohol problems.

Early successful alcohol treatment pays dividends

Grim news for alcoholics:

Some studies have found a nearly five-fold greater risk of death for alcoholics compared to people without drinking problems, Timko and her colleagues note in the medical journal Alcoholism: Clinical and Experimental Research. However, it's not clear whether getting help early might reduce this risk.

To investigate, the team followed up on 628 people who had entered treatment 16 years previously.

Sixty-eight percent had died of alcohol-related causes in that time. Overall, the researchers found, study participants were 40% more likely to die over the course of follow-up than would have been expected in the general population.

Older people, those with more symptoms of alcohol dependence, and those who were unmarried had an even greater mortality risk.

But, there's good news for those who stick with treatment:

Among those who were not drinking one year after they started treatment, the likelihood of dying was much lower, the researchers found. Risk of death also was reduced for those who spent eight weeks or longer in outpatient treatment during that year and also did not have drinking problems at one year. Spending more than four months attending Alcoholics Anonymous meetings, along with better drinking outcomes at one year, also cut death risk.

This is your ass on drugs

Slate reviews the latest anti-drug ad.

Alcoholics Anonymous may prevent murders

It's official. To criticize AA is to support murder. (Warning: that was a joke.)

Lawmakers push for better treatment of addiction

Jim Ramstad and Patrick Kennedy are starting another push for parity. The legislation has been introduced every year since 2001. In order to build enough support to pass, they drop the substance abuse provisions and limit the bill to mental health care. It has enough votes to pass, but House of Representatives leadership won't allow a vote. Hopefully the changes in house leadership will create an opening.

Co-occurring Disorder Prevalence

Two more studies (here and here) that will be cited and contribute to the underlying assumptions of professional helpers who interact with addicts and their loved ones. No clinical significance standard, no attempt to determine primary/secondary diagnoses, and no obvious attempt to assess people over a period of time.

The best studies that address these issues and find that addict come into contact with helping systems with high rates of psychiatric symptoms and that most of these will improve significantly with abstinence and no psychiatric treatment. While the rates of symptoms are very high, secondary psych disorders are less prevelant and primary psych disorders are lower yet.

One Book at a Time

A story on the glut of addiction memoirs being published in the coming months. All appear to to violate the 12 tradition of AA - some in the name of stigma reduction and others for the money. How badly would some high profile relapses, or even ugly gaffes, harm the recovery advocacy movement? I'm of the opinion that this is a movement that is better off without any stars.

Social Support, Spiritual Program, and Addiction Recovery

Surprise, surprise.

Random testing of teenagers would inform drugs debate

From Scotland, an argument in favor of teen drug testing.

The author takes an academic (rather than hysterical) approach and acknowledges the ethical issues involved, but the seems to dodge them:

Drug testing, though, raises complex ethical issues. For example, whether young people can give their informed consent to be tested, whether testing impinges negatively on the teacher-pupil relationship and, perhaps most crucially, how you respond when a young person tests positive for illegal drugs. There are difficult questions to answer, but they are not so difficult as to rule out even trying to see if drug testing is an effective method of drug prevention. And if drug testing were effective would that mean we should mount a national scheme of regular testing? The answer to that question is no. What it would mean is that we could then begin a debate as to whether the ends justify the means, knowing that drug testing is at least one way of reducing teenage drug use.

I share his concern about heroin use among teens, particularly with the recent surge in fatal overdoses. However, I suspect that in most cases there are a lot of people maintaining an uncomfortable code of silence and others refusing to see something that frightens them. Part of the problem is that nobody knows what to do if they have a friend or loved on with a drug problem. Treatment has been decimated over the last decade or so. I can't help but believe that teachers, parents, friends, etc. would be much more attentive and responsive if they knew that high quality help was easily available for anyone who needed it. It might make random testing of teens unnecessary.

Should we convert smokers to snuff?

The Wall Street Journal ran a story about snuff and its potential use to reduce smoking and tobacco related illness. William Saletan from Slate Magazine runs down the pros and cons:

Arguments for it: 1) Smoking has stopped declining in the U.S. 2) Most attempts to quit fail, even with counseling and nicotine gums or patches. 3) Studies suggest low-carcinogen varieties of snuff (smokeless tobacco) are 90 percent safer than cigarettes. 4) People are entitled to know this. 5) Switching to snuff appears to have helped Sweden cut smoking to a record low. Arguments against it: 1) Snuff is still bad for you. 2) If we suggest it's safe, more kids will take it up. 3) Tobacco companies want us to embrace snuff because it's their new business plan. 4) Without giving in to snuff, California has nearly matched Sweden's reduction in smoking. (WSJ link requires subscription) (For Human Nature's take on the crusades against smoking and junk food, click here.)

Soft approach of letting-off drug takers is a success, say police

England reclassified marijuana a couple of years ago so that possession was a less serious offense. The London police reported that of the people they caught with marijuana, 67% were given a warning, 17% were cautioned and 15% were charged.

They are getting criticized on two fronts. First, because of the disproportionate arrests of blacks and second, for making the police appear impotent.

I'm not sure that reclassifying marijuana is not a bad idea, but it does seem silly to intervene and simply hand out warnings.

Democrat, Republican and a Bond of Addiction

A nice story about recovery and politicians. (Free registration required) Hat tip - Jim B.

New Research on ADHD Cases in U.S. Kids

About one-third of attention deficit cases among U.S. children may be linked with tobacco smoke before birth or to lead exposure afterward, according to provocative new research.

Suicidal thoughts, suicide attempts, major depressive episode, and substance use among adults

A new SAMHSA report on substance use and suicide. Highlights below:

Among adults who experienced a major depressive episode in the past year, 56.3% thought during their worst or most recent episode that it would be better if they were dead, 40.3% thought about committing suicide, 14.5% made a suicide plan, and 10.4% made a suicide attempt.

Adults with a past year major depressive episode who reported past month binge alcohol or illicit drug use were more likely to report suicidal thoughts and suicide attempts than their counterparts with past year depression who had not did not binge drink or use an illicit drug in the past month.

A psychiatric condition was diagnosed in 41% (43,176) of the drug-related suicide attempts treated in the emergency departments. The most frequent psychiatric diagnosis was depression.

Substance abuse treatment and psychiatric comorbidity: do benefits spill over?

This study looked at homeless cocaine addicts with an independent mental illness. They recieved addiction treatment but no psychiatric treatment:

There was a 32% reduction in the prevalence of comorbid nonaddiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32%) and anxiety-related disorders (-20%) (p=0.12).

New Study Links Suicide Mortality Rates to Alcohol-related Factors

Alcohol consumption has long been established as a risk factor for suicide. However, this is the first time I've anyone study the effect of AA participation:

Lead by Dr. Robert Mann, Senior Scientist at CAMH, this study aimed to identify alcohol-related factors that influence suicide mortality rates in Ontario. Researchers examined the impact of: per capita or average consumption of total alcohol; per capita consumption of distilled spirits, beer, and wine; unemployment rates; and Alcoholics Anonymous (AA) membership on suicide rates in Ontario between 1968 and 1991. They investigated the impact of these factors on suicide rates for the total population, and for males and females separately.

...Said Dr. Mann, “these results suggest that a 1-litre increase in alcohol consumption led to an increase of 11% to 39% in suicides. This observation is consistent with individual-level studies that show that heavy drinking, alcohol abuse and alcohol dependence increase a person’s risk of suicide substantially. Similarly, increasing unemployment rates increased suicide rates as well. However, it was heartening to see that increasing AA membership was related to reduced suicide mortality rates.”

A Vaccine Against Narcotics

This article provides a good explanation of how vaccines for addiction would work and some potential problems associated with them.

Former Texas Governor Ann Richards overcame addictions that influenced her life, death

She was a wonderful example of the contributions that recovering people make everyday.

Broad Drug Testing Adopted in Kansas Town

The wrong response to teen drug use.

Why geniuses are less prone to hangovers

I would like to retract any stories I've told about excruciating hangovers.

Choice and Free Will: Beyond the Disease Model of Addiction

Interesting commentary on choice and stigma:

...of course what's meant by personal weakness and bad choices, when stigmatizing addicts, is that the addict should have risen above his weakness; he could have chosen otherwise at the time addiction took hold. There's an implicit assumption of contra-causal agency: no matter what influences and factors came to bear, the addict could have done otherwise, but simply chose not to.

...The key point, though, on an enlightened understanding of the moral dimension of addiction, is that it is specific behavior that's the potential target of sanctions, not the mythical moral core. Once bad choices are seen as outcomes of causes and conditions, not free will, then we won't imagine that there's any virtue in the blanket condemnation of the addict as a bad person, even though we must still judge some behavior as wrong.

Nonsmokers' Depression Lifted by Nicotine

Therapeutic nicotine?

Interesting, but I'm suspicious of the leap from identifying the drug as mood-enhancing to characterizing tobacco use as self-medication.
With all of the faith in self-medication theories reguarding illicit and harmful drugs, why do they have high rates of noncompliance with psychotropic drugs intended to treat depression? Why isn't there a big black market for drugs intended to treat psychological problems?

New Curriculum Promotes Recovery Community Model

Texas Tech University’s Center for the Study of Addiction and Recovery has developed and is distributing the nation’s first curriculum to establish recovery communities on college campuses.

The students in the program stay sober at really high rates and, on average, get better grades than the rest of the student body. I'd love to hear more about whether a strong program like this impacts the drinking behavior of other students by influencing campus norms.

Teen Drinking Over the Pond

England and France struggle with teen drinking too.

A White House drug deal gone bad

Problems in another prevention campaign. This article is about the commercials with this smushed kid, the flat kid and the kids with his fist in his mouth:

Instead of reducing the likelihood that kids would smoke marijuana, the ads increased it. Westat found that 'greater exposure to the campaign was associated with weaker anti-drug norms and increases in the perceptions that others use marijuana.' More exposure to the ads led to higher rates of first-time drug use among certain groups, like 14- to 16-year-olds and white kids.

HIV and hep C on the rise among Montreal drug users

Bad news from Montreal. Their hepatitis C infection rate is scary. Not a word about facilitating recovery.

Reuters Health Information (2006-09-07): US drug use falls, except among older adults

Good news from the National Survey on Drug Use and Health. The full report is here:

'The news today is there is a fundamental shift in drug use among young people in America,' said Assistant Surgeon General Eric Broderick, who is SAMHSA Acting Deputy Administrator.

'We first saw this shift towards healthier decisions when rates of tobacco use among young people began to go down. Now, we see a sustained drop in rates of drug use. We will see if the decline in drinking among 12-to 17-year-olds becomes a continued pattern as well,' he said.

But certain dangerous patterns of alcohol use did not change -- nearly 23 percent of all people aged 12 and older admitted to binge drinking.

DEA to change rules on addictive prescriptions

Good news for pain patients. I seems to be the right thing to do. Hopefully it won't increase street supply much.

The Swedish drug control model

Sweden has taken a different approach to drug control than the rest of Europe for some time and it appears to be paying dividends.

A New Form of Tolerance?

From The Onion:

Chris Becker, bartender at the Silver Nickel tavern, said he was growing increasingly worried about his growing tolerance for alcoholics. 'A little used to go a long way, you know? I could last all night on one long, drawn-out tale of self pity, with maybe a brawl between two patrons as a nightcap,' said Becker, who has been taking in at least four alcoholics a night since getting his license in 1996. 'But lately, it's been taking nine, 10, sometimes 15 of them to make me feel anything at all.' Alcoholism tolerance has long been recognized as a problem in the hospitality industry, and experts warn it can lead to bartenders developing unhealthy tolerances for smokers, drug users, and sex addicts.

Reducing harm in our society

Here's a pretty good primer on harm reduction from an advocate.

Efforts to aid addicts redouble after deaths

This article talks about the efforts of a Delaware HR program to get their clients into recovery. I've read dozens and dozens of articles on responses to the fentanyl overdoses and this is the first one with this tenor.

This is what I had in mind when I referred to recovery-oriented HR in an earlier post. This program appears to be taking advantage of a window of opportunity and using their relationship to help the addict into recovery.

After a spring and summer of at least 30 reported heroin overdoses in Delaware and nine deaths, they are sending a different message.

"We never used to tell them 'You've got to get clean now,' " said Basha Closic, program director of HIV Prevention Services at Brandywine. "Now we're telling them 'OK, we never used to harp on you guys before about getting clean, but it's time. It's not fun right now, it's deadly.' "

Closic wants those who do seek treatment to feel proud of that choice, rather than ashamed of admitting their addiction. She says that's where a series of barbecues, open houses and marches planned for this month come into play.

"It's saying not only did we have the courage to go to treatment but we're here and it's working or we went and it worked," Closic said. "There's nothing to be embarrassed about."

CU Student Recovery Center Admitting Fall 2006 Students

A replication of a very successful program at Texas Tech:

The University of Colorado at Boulder is in the process of admitting a small group of clean and sober undergraduates recovering from addictive disorders to participate in its new Center for Students in Recovery starting this fall.

All participating students are at least six months clean and sober and actively involved in structured recovery programs and community outreach efforts and meet the standard academic requirements of the university, Lavino said. 'We are providing them support wherever they need it,' he said. 'It may come in the form of academics, life skills issues or whatever it is they need to maintain their recoveries and succeed at CU-Boulder.'

Addicts are not criminals

An opinion piece arguing for more harm reduction and legalization:

...The answer is to stop treating any of them like criminals.

Decriminalizing or legalizing possession of hard drugs is not a decision to be taken lightly. We're not talking about marijuana, a substance that should be legalized because it does little harm to anyone. But it's explicitly because of the harm it currently does users that we need to reform our approach to heroin.

Study after study tells us that we can't force junkies to clean up; they have to be willing and able to do so themselves. In those cases, the best we can do is harm reduction. And that means pulling them out from underground - from flophouses with dirty shared needles, and back alleys where there's no one to help them when they overdose -- and into places like Insite [Vancouver's supervised injection center].

Reasonable people can disagree on these matters. However, while a few studies support his statement about coerced treatment, most do not. Proposition 36 in California appears to be reasonable compromise.

Vancouver has shortchanged treatment in it's response to drug problems, and Victoria, B.C. is looking at a supervised injection site when it's treatment system is in shambles.

Even if I accept that their motives are based on concern for the welfare of addicts themselves, I have a difficult time believing that there isn't an equal dose of pessimism about their ability to recover.

Most of the addicts we come in contact with would love to recovery. Their biggest barrier is lack of hope. What do we communicate to them when we're willing to invest in a supervised injection site but only give lip service to treatment and recovery support services?

Effects of substance use spans generations

A new study reaffirming the importance of intergenerational transmission of substance use problems:

In a long-term study conducted across three generations, researchers found that substance use in one generation was associated with problem behaviors and later substance use in the following generation. In turn, the substance use in the second generation was related to problem behaviors in the third generation.

The findings suggest that 'not only does parent's substance use affect their children but it also can affect their grandchildren,' study co-author Jennifer A. Bailey, of the University of Washington, in Seattle, Washington, told Reuters Health.

On the other hand, 'the benefits of successful intervention may also echo across generations,' Bailey and her co-authors write, so the findings highlight the importance of interrupting the intergenerational cycle.

Early Alcohol Dependence Linked to Reduced Treatment Seeking and Chronic Relapse

A new study with important implications for early onset alcoholism:

Individuals who become alcohol dependent before age 25 are less likely to ever seek treatment than those who become alcohol dependent at age 30 or older.... They also are more likely to have multiple dependence episodes, of longer duration, and to meet more dependence diagnostic criteria than those who become alcohol dependent later in life.

Study Offers Clues To Brain's Protective Mechanisms Against Alcoholism

A new study offers some possible insight into why some high risk people develop alcoholism and others don't:

In this study, researchers compared the number of dopamine D2 receptors in two groups: 16 nonalcoholic individuals with no family history of alcoholism and 15 nonalcoholic individuals who had a positive family history of alcoholism — an alcoholic biological father with early onset of alcoholism and at least two other first or second degree relatives (parent, child, sibling, grandparent, grandchild, cousin, aunt, uncle) with alcoholism. The latter group was at a very high risk of developing alcoholism. The researchers studied high-risk individuals rather than looking at people with drinking disorders because chronic alcohol abuse reduces the number of dopamine receptors, making comparisons difficult. Participants were scanned with positron emission tomography (PET) and were given two radioactive tracers to assess their dopamine D2 receptor levels and brain glucose — a marker of brain function.

The scans demonstrated high levels of dopamine D2 receptors in the brains of participants with a family history of alcoholism, particularly in their frontal regions — 10 percent higher, on average, than in the brains of those with no family history. These areas of the brain — including the caudate and ventral striatum — are involved in emotional reactions to stress and cognitive control of decisions about drinking.

At Least 17 People Have Died From Fentanyl Drug Overdose In New York City

The tragedies continue. Good to see that NYC heroin addicts are being urged to seek treatment.

For the geeks

First, a study identifying central nervous system proteins affected by alcohol exposure:

Researchers at the University at Buffalo studying the effects of alcohol on the brain, using zebrafish as a model, have identified several novel central nervous system proteins that are affected by chronic alcohol exposure...

"Identification of proteins that show selective changes in abundance after alcohol exposure has the potential to unlock new pathways both for understanding the mechanisms of alcoholism and alcohol toxicity, as well as its amelioration," said Richard A. Rabin, Ph.D., professor in the UB Department of Pharmacology and Toxicology and senior author on the study.

Next, a study exploring the interactions between certain genes and alcohol response:

"These findings suggest that there indeed might be a genetically influenced factor of a possible mildly increased LR to alcohol associated with the two genes that we studied," said Schuckit, "and that may decrease some people's risk for alcoholism slightly."

Schuckit said that these findings will likely change how he approaches his own research in the future. "In the kind of work that I'm doing, I had better evaluate people with those two gene forms of ADH separately, because I think they may wash out the effects of some of the other genes that I'm trying to look for. For the field in general, it's important for researchers to know that there are milder effects of alcohol-metabolizing enzymes similar to what's seen in Asians that might have an effect of slightly decreasing the risk for alcoholism."

He added that the implications of these findings go beyond significance for just researchers. "This is the sort of finding that reinforces the fact that genes impact on your response to alcohol, and impact on your risk for alcoholism," he said. "There are some people who think it's hard to see behavioral problems like alcoholism being impacted by genes, but of course it is, because genes affect what you were like before you took the alcohol, and also genes absolutely impact on how the alcohol will affect you. The clearest example we have of this are the alcohol-metabolizing genes."

Third, a study looking neurocognitive damage from alcohol consumption and the degree to which those problems are resolved with abstinence:

Alcoholism can cause neuropsychological deficits, that much is clear. There is much less clarity, however, concerning to what degree recovery may occur with abstinence from alcohol. New findings indicate that long-term abstinence from alcohol can resolve many - but not all - neurocognitive deficits.