Browsing by Subject "Alcoholism"

Now showing 1 - 4 of 4
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    Alcoholism is Treatable
    (2009-09-16) Welle, Nicole
    For individuals with alcoholism also known as “alcohol dependency”, meeting with a health care provider and the addition of naltrexone, combined behavioral intervention (CBI), or both naltrexone and CBI improved sobriety. Acamprosate, with or without CBI, was not shown to be effective at improving sobriety. Naltrexone or CBI alone while meeting with a health care provider produced better sobriety than any combination of acamprosate, naltrexone and CBI therapies. Meeting with a medical provider in a primary care setting and the addition of naltrexone could greatly improve effective treatment of alcohol dependence. For individuals who prefer counseling rather than medication, CBI provided by a therapist and the addition of meeting with a medical provider could also improve sobriety.
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    Characterizing specific henetic and environmental influences on alcohol use
    (2012-09) Irons, Daniel Edward
    Although both genetic and environmental influences, as well as the interplay between them, are clearly important to the development of alcohol use and related psychopathology, the effects of many of the particular genetic variants and environmental risk factors responsible have not yet been confirmed. We conducted three studies with the goal of moving beyond abstract estimates of genetic and environmental variance to the assessment of whether specified risk factors were causally implicated in the development of alcohol-related behaviors and problems. First, in a longitudinally assessed sample of 356 adopted adolescents and young adults of East Asian descent, we examined the progression over time of the relationship between a functional polymorphism in the alcohol metabolism gene aldehyde dehydrogenase 2 (ALDH2) and multiple measures of drinking behavior. We found that the protective effect of the less-functional ALDH2 variant increased between mid-adolescence and early adulthood, and that non-biological parental alcohol use, but not sibling alcohol use, nor deviant peer affiliation, moderated the effect of the gene. In a second study, using a community-based sample of 7224 individuals assessed in early and middle adulthood, we employed multiple methods to conduct a comprehensive examination of the effects of markers in GABA system genes on measures of alcohol use and related symptomatology. We tested not only the potential effects of individual markers, but also their effects in aggregate, and at the whole-gene and system-wide levels. None of these methods produced results indicative of an effect of GABA system variants on measures of alcohol use or misuse. We conducted a third study with a sample of 1512 twins, longitudinally assessed from early adolescence into adulthood, to determine whether adult alcohol use and misuse, as well as other adult outcomes, could be attributed to the causal effect of alcohol exposures in early adolescence. We used two separate techniques to adjust for potentially confounding factors. First, we used a propensity score design to adjust for the potentially confounding effects of a number of measured background covariates. Second, we used the cotwin control design to adjust for confounding due to unmeasured factors (including genetic influences) shared between twins in pairs discordant for early alcohol exposure. The results of both methods applied in this third study were generally consistent with there being a causal effect of early alcohol exposures on the later development of adult alcohol problems and other related adult outcomes, but contrasting the two methods indicated that exposure effect estimates from the propensity score application were likely to be biased by unmeasured confounding variables. In summary, we have first substantially elaborated upon the effects of a genetic variant known to influence alcohol-related behaviors (in the ALDH2 gene); next, despite thorough investigation, we have found no evidence for the effects of a second set of purported genetic influences (GABA system genes); and finally, we provided evidence that early alcohol exposure likely exerts a genuinely causal influence on later alcohol-related problems and other adult outcomes.
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    Drug Regimes: Addiction, Biopolitics, American Literature, 1820-1940
    (2019-07) McGillicuddy, Brendan
    "Drug Regimes" traces the development of the disease concept of addiction from the early American Republic into the inter-war period. In this work, struggles against alcoholism, both individual and social, are used to frame and explore larger issues of national conflict occurring around race, gender, and political economy. Each chapter discusses a literary text that exemplifies a particular "drug regime" - a mode of the governance of health, both individual and public - and analyzes this text as a mode of extrapolating a political theory of drug conflict.
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    Shelter for good?: examining the ethical issues of housing first for homeless substance abusers
    (2013-08) Barrett, Tyler Dane
    In the past fifteen years, the guiding philosophies used in addressing chronic homelessness have undergone a radical shift in approach. Whereas nearly all shelters once stipulated substance addicted or mentally ill residents must undergo treatment for chemical dependency and mental illness prior to admittance, in recent years many cities across the United States and abroad have adopted a "housing first" model. This approach treats housing as a basic human right and allows homeless individuals immediate and indefinite access to shelter and related resources without requirements of treatment, sobriety, or abstinence. This paper examines the establishment, proliferation, and evolution of housing first programs, their efficacy and the empirical research that has been collected in recent years, and the persisting ethical dilemmas and considerations that need to be addressed.