Breath alcohol concentrations in men 7–8 hours after prolonged, heavy drinking: influence of habitual alcohol intake

IntroductionAlcohol consumption represents a significant factor for mortality in the world: 6.3% in men and 1.1% in women. Alcohol use disorder is also very common: 5.4% in men and 1.5% in women. Despite its high frequency and the seriousness of this disorder, only 8% of all alcohol-dependents are ever treated. One potentially interesting treatment option is oriented toward reducing alcohol intake.AimsTo describe one case who has improved his alcohol consumption after starting treatment with nalmefene, an opioid receptor antagonist related to naltrexone.MethodsA 35-year-old male with alcohol use disorder since 2001 came to our consult in November 2015. He was in trouble with his family and he had a liver failure. We offer a new treatment option with nalmefene 18 mg to reduce alcohol consumption.ResultsBefore to start nalmefene he drank 21 drinks/week. Six-month later, he decreased alcohol intake until 5 drinks/week with better family relationship and liver function. After starting nalmefene he complained of nausea, so we recommend to take the middle of the pill for next 7 days. After this time he returned to take one pill with good tolerance and no more side effects or withdrawal syndrome.ConclusionsNalmefene appears to be effective and safe in reducing heavy drinking and in preventing alcohol withdrawal syndrome due to its opioid receptor antagonism. This case suggests nalmefene is a potential option to help patients, who do not want or cannot get the abstinence, in reducing their alcohol consumption.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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When at risk? Drinking contexts and heavy drinking in the Montreal adult population

Contemporary Drug Problems ◽

10.1177/009145099702400303 ◽

1997 ◽

Vol 24 (3) ◽

pp. 449-471 ◽

Cited By ~ 18

Author(s):

Andrée Demers

Keyword(s):

Alcohol Intake ◽

Telephone Survey ◽

Adult Population ◽

Heavy Drinking ◽

Situational Characteristics ◽

Contextual Characteristics ◽

Logistic Regressions ◽

Alcohol Related Problems ◽

Drinking Occasion ◽

Contextual Characteristic

The purpose of this study is to identify the characteristics of contexts associated with heavier alcohol intake. Data come from a telephone survey carried out in April 1993 with a random sample of the metropolitan Montreal adult population (Quebec, Canada). Drinking contexts were investigated with regard to the situational setting (circumstances, time and location) and the relational setting (drinking partners’ relationship and sociodemographic similarity) characterizing the drinking occasion. Having five or more drinks per occasion, linked by many studies to alcohol-related problems, was deemed to be heavy drinking. The results of the logistic regressions performed reveal that for men under 25 years old, drinking with other men is the only contextual characteristic associated positively with heavy drinking, while for men age 25 and over, situational characteristics as well as relational characteristics are associated positively with heavy drinking. For women, heavy drinking is only weakly associated with contextual characteristics.

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Interaction of Heavy Drinking Patterns and Depression Severity predicts Efficacy of Quetiapine Fumarate XR in lowering Alcohol Intake in Alcohol Use Disorder Patients

10.1101/2020.07.01.20144311 ◽

2020 ◽

Author(s):

Vatsalya Vatsalya ◽

Maiying Kong ◽

Luis M. Marsano ◽

Zimple D Kurlawala ◽

Kan V Chandras ◽

...

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Alcohol Intake ◽

Rating Scale ◽

Heavy Drinking ◽

Depression Symptoms ◽

Drinking Patterns ◽

Quetiapine Fumarate ◽

Heavy Alcohol ◽

Depression Ratings

Background: Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression. We investigated the role of depression ratings and patterns of heavy drinking on the treatment efficacy of Quetiapine fumarate XR in lowering alcohol intake in alcohol use disorder (AUD) patients. Methods: One hundred and eight male and female heavy drinking AUD patients in the age range of 18 to 64 yrs. received 12 weeks of active treatment. Participants were grouped by the severity grading of depression using Montgomery Asberg Depression Rating Scale (MADRS) (clinically relevant≥8 [CR], clinically non-relevant≤7 [CNR]) at baseline. Drinking history and depression ratings were assessed at the patients visits. Results: Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD and AvgD) and MADRS scores by the end of the treatment course. Conclusions: Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR.

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Update on the Neurobiology of Alcohol Withdrawal Seizures

Epilepsy Currents ◽

10.1111/j.1535-7511.2005.00071.x ◽

2005 ◽

Vol 5 (6) ◽

pp. 225-230 ◽

Cited By ~ 41

Author(s):

Michael A. Rogawski

Keyword(s):

Alcohol Withdrawal ◽

Alcohol Intake ◽

Heavy Drinking ◽

Alcohol Exposure ◽

Rodent Models ◽

Inhibitory Function ◽

Cellular Events ◽

Generalized Seizures ◽

Clonic Seizures ◽

Severe Type

Abrupt cessation of alcohol intake after prolonged heavy drinking may trigger alcohol withdrawal seizures. Generalized tonic–clonic seizures are the most characteristic and severe type of seizure that occur in this setting. Generalized seizures also occur in rodent models of alcohol withdrawal. In these models, the withdrawal seizures are triggered by neuronal networks in the brainstem, including the inferior colliculus; similar brainstem mechanisms may contribute to alcohol withdrawal seizures in humans. Alcohol causes intoxication through effects on diverse ion channels and neurotransmitter receptors, including GABAA receptors—particularly those containing δ subunits that are localized extrasynaptically and mediate tonic inhibition—and N-methyl-D-aspartate (NMDA) receptors. Alcohol dependence results from compensatory changes during prolonged alcohol exposure, including internalization of GABAA receptors, which allows adaptation to these effects. Withdrawal seizures are believed to reflect unmasking of these changes and may also involve specific withdrawal-induced cellular events, such as rapid increases in α4 subunit–containing GABAA receptors that confer reduced inhibitory function. Optimizing approaches to the prevention of alcohol withdrawal seizures requires an understanding of the distinct neurobiologic mechanisms that underlie these seizures.

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Cerebral Hemorrhage and Alcohol Exposure: A Review

Alcohol and Alcoholism ◽

10.1093/alcalc/agz087 ◽

2019 ◽

Vol 55 (1) ◽

pp. 20-27 ◽

Cited By ~ 2

Author(s):

Jialing Peng ◽

Hongxuan Wang ◽

Xiaoming Rong ◽

Lei He ◽

L Xiangpen ◽

...

Keyword(s):

Blood Pressure ◽

Alcohol Intake ◽

Literature Search ◽

Heavy Drinking ◽

Alcohol Exposure ◽

Chronic Alcohol ◽

Chronic Alcohol Abuse ◽

Pubmed Database ◽

The Impact ◽

The Relationship

Abstract Aims To investigate the dose–response relationships between alcohol and intracerebral hemorrhage (ICH), the impact of alcohol on the outcome of ICH and possible mechanisms underlying hypertensive ICH (HICH) caused by heavy drinking. Methods Literature search from 1985 to August 2019 in the PubMed database. Results The relationship between low-middle alcohol consumption and ICH remains controversial for various reasons, whereas chronic heavy drinking increases the incidence of ICH and exerts worse outcome. More attention is needed to clarify the characteristics of chronic alcohol intake and binge drinking. Chronic alcohol abuse tends to elevates blood pressure, resulting in increased occurrence of HICH and exaggerated HICH-contributed brain injury. Conclusion It is important to develop strategies to promote reasonable intake categories, prevent alcoholism and thus reduce the risk of ICH.

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Dose–Response Characteristics of the Alcohol Biomarker Phosphatidylethanol (PEth)—A Study of Outpatients in Treatment for Reduced Drinking

Alcohol and Alcoholism ◽

10.1093/alcalc/agz064 ◽

2019 ◽

Vol 54 (6) ◽

pp. 567-573 ◽

Cited By ~ 6

Author(s):

Anders Helander ◽

Ulric Hermansson ◽

Olof Beck

Keyword(s):

Liquid Chromatography ◽

Whole Blood ◽

High Performance ◽

Alcohol Intake ◽

Heavy Drinking ◽

High Sensitivity ◽

Response Characteristics ◽

Alcohol Biomarker ◽

Carbohydrate Deficient Transferrin ◽

Reduced Drinking

AbstractAimMeasurement of whole-blood phosphatidylethanol (PEth) offers high sensitivity and specificity as alcohol biomarker. A remaining issue of importance for the routine application is to better establish the relationship between PEth concentration and amount and duration of drinking.MethodsThe study included 36 subjects (32–83 years) voluntarily attending outpatient treatment for reduced drinking. At ~ 3- to 4-week intervals, they provided a diary on their daily alcohol intake and gave blood samples for measurement of PEth and carbohydrate-deficient transferrin (CDT). Whole-blood PEth 16:0/18:1 was measured by liquid chromatography-tandem mass spectrometry and serum CDT (%disialotransferrin) by high-performance liquid chromatography.ResultsAt start, the self-reported past 2-week alcohol intake ranged 0–1260 (median 330) g ethanol, the PEth 16:0/18:1 concentration ranged 0.05–1.20 (median 0.23) μmol/L, and the CDT value ranged 0.7–13.0% (median 1.5%). At the final sampling after 5–20 (median 12) weeks, neither reported alcohol intake nor PEth and CDT levels differed significantly from the starting values. The PEth concentration showed best association with past 2-week drinking, followed by for intake in the next last week. The changes in PEth concentration vs past 2-week alcohol intake between two successive tests revealed that an increased ethanol intake by ~ 20 g/day elevated the PEth concentration by on average ~ 0.10 μmol/L, and vice versa for decreased drinking.ConclusionsThe PEth concentration correlated well with past weeks alcohol intake, albeit with a large inter-individual scatter. This indicates that it is possible to make only approximate estimates of drinking based on a single PEth value, implying risk for misclassification between moderate and heavy drinking.

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783Lifetime alcohol intake and stomach cancer risk: a pooled analysis of two prospective cohort studies

International Journal of Epidemiology ◽

10.1093/ije/dyab168.320 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Harindra Jayasekara ◽

Robert MacInnis ◽

Yi Yang ◽

Allison Hodge ◽

Hazel Mitchell ◽

...

Keyword(s):

Alcohol Consumption ◽

Cancer Risk ◽

Cohort Studies ◽

Stomach Cancer ◽

Alcohol Intake ◽

Cox Regression ◽

Heavy Drinking ◽

Inverse Association ◽

Cardia Cancer ◽

Increased Risk

Abstract Background Alcohol consumption is causally linked to several cancer sites but the evidence for stomach cancer is still inconclusive. We aimed to quantify the association between alcohol intake and risk of stomach cancer, including subtypes. Methods We pooled data from two cohort studies including 452,958 individuals enrolled in the European Prospective Investigation into Cancer in 1992-98 and 38,756 Australians enrolled in the Melbourne Collaborative Cohort Study in 1990-94. Adjusted hazard ratios (HR) and 95% confidence intervals (CI) for incident stomach cancer were estimated using Cox regression. Results 1,225 incident stomach cancers were diagnosed over 7,094,637 person-years. Alcohol intake was not associated with overall stomach cancer risk. We observed a weak positive dose-response association for lifetime intake with non-cardia stomach cancer (HR = 1.03, 95% CI: 1.00-1.06/per 10 g/day increment), which is the more common type (77.6% of cases), and a weak inverse association with cardia cancer (HR = 0.93, 95% CI: 0.87-1.00) (phomogeneity=0.006). These associations did not differ appreciably by smoking or Helicobacter pylori infection status. Differences in HRs between diffuse-type and intestinal-type cancer were minimal (phomogeneity=0.97). HRs of 1.50 (95% CI: 1.12-2.01) for non-cardia and 0.53 (95% CI: 0.27-1.02) for cardia cancer were observed for a life course trajectory characterised by sustained heavy drinking compared with light drinking (phomogeneity=0.01). Conclusions Lifetime alcohol intake was associated with increased risk of non-cardia stomach cancer. The inverse association for cardia cancer indicates aetiologic differences between subsites. Key messages Limiting long-term alcohol consumption, and avoiding heavy use in particular, might be beneficial in preventing non-cardia stomach cancer.

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The associations between alcohol intake and cardiometabolic risk in African-origin adults spanning the epidemiologic transition

BMC Public Health ◽

10.1186/s12889-021-12128-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Danny Baghdan ◽

Lara R. Dugas ◽

Candice Choo-Kang ◽

Jacob Plange-Rhule ◽

Pascal Bovet ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Alcohol Consumption ◽

Alcohol Intake ◽

Heavy Drinking ◽

Hdl Cholesterol ◽

High Density ◽

Elevated Blood ◽

African Origin ◽

Epidemiologic Transition

Abstract Background Cardiometabolic (CM) risk affects approximately 25% of adults globally, and is diagnosed by meeting 3 out of 5 of the following CM risk factors: elevated blood pressure, high triglycerides, elevated blood sugar, low high-density lipoprotein (HDL) level, and abdominal obesity. Adults with CM risk are approximately 22% more likely to have higher mortality rates, and alcohol consumption may be associated with higher CM risk. While previous studies have investigated this potential connection, the majority of them did not include African-origin adults. Therefore, the study aimed to explore the association between alcohol intake and CM risk in 5 African-origin cohorts, spanning the epidemiologic transition in Ghana, South Africa, Jamaica, Seychelles and the United States of America. Methods Measurements included clinical measures for CM risk and self-reported alcohol consumption. Each participant was categorized into one of three drinking categories: non-drinker, light drinker (1–3 drinks daily for men and 1–2 drinks daily for women) and heavy drinker (4 or more drinks every day for men and 3 or more drinks per day for women). Using non-drinker status as the reference, the association between alcohol consumption status and prevalence of each of the five CM risk factors and overall elevated CM risk (having 3 out of 5 risk factors) was explored, adjusting for site, age and sex. Associations were explored using logistic regression and significance was determined using odds ratios (OR) and 95% confidence intervals. Results Neither light nor heavy drinking was associated with increased odds for having higher CM risk compared to nondrinkers (OR = 1.05, p = 0.792 and OR = 1.11, p = 0.489, respectively). However, light drinking was associated with lower odds for having low high density lipoproteins (HDL) cholesterol (OR = 0.69, p = 0.002) and increased risk for high triglycerides (OR = 1.48, p = 0.030). Heavy drinking was associated with elevated blood pressure (OR = 1.59, p = 0.002), high triglycerides (OR = 1.73, p = 0.006) and decreased risk of low HDL-cholesterol (OR = 0.621, p < 0.0005). Finally, country-specific analyses indicated that the relationship between heavy drinking and elevated CM risk varied widely across sites. Conclusion While several CM risk factors were associated with alcohol consumption, the associations were inconsistent and varied widely across five international cohorts of African-origin. Future studies should focus on understanding the individual site-related effects.

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Estimation of Alcohol Intake from Laboratory Results

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456327801500172 ◽

1978 ◽

Vol 15 (1-6) ◽

pp. 304-306 ◽

Cited By ~ 12

Author(s):

J. B. Whitfield ◽

W. J. Hensley ◽

D. Bryden ◽

H. Gallagher

Keyword(s):

Mean Corpuscular Volume ◽

Alcohol Intake ◽

Heavy Drinking ◽

Test Results ◽

Gamma Glutamyl Transpeptidase ◽

Drinking Habits ◽

Quantitative Estimates ◽

Laboratory Results ◽

Glutamyl Transpeptidase ◽

Clear Increase

Subjects with abnormalities in a number of laboratory tests were shown to have higher than usual probabilities of being heavy drinkers. Quantitative estimates have been made of the probabilities of heavy drinking from the results of the following tests: gamma-glutamyl transpeptidase, mean corpuscular volume, uric acid, triglyceride, and aspartate aminotransferase. In men, but not in women, there was a clear increase in this probability with increasing test results for these five tests, which may prove useful in the detection of individuals who are at risk from their drinking habits.

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