The Association Between Toxic Exposures and Chronic Multisymptom Illness in Veterans of the Wars of Iraq and Afghanistan.

Objective: The purpose of this study was to determine if post-9/11 veterans deployed to the Iraq and Afghanistan conflicts experienced toxic exposures and whether they are related to symptoms of chronic multisymptom illness (CMI).

Methods: Data from 224 post-9/11 veterans who self-reported exposure to hazards in theater were analyzed using hierarchical regression.

Results: Of the sample, 97.

Effects of idazoxan on alcohol pharmacokinetics and intoxication: a preliminary human laboratory study.

Background: Preliminary basic and human studies suggest that the α2 -adrenergic antagonist idazoxan may represent a novel medication for alcohol dependence. The goal of this study was to evaluate the safety and tolerability of the co-administration of idazoxan with alcohol and explore whether pharmacokinetics (PK) and biobehavioral mechanisms of idazoxan may alter alcohol's effects.

Methods: This was a preliminary double-blind, single-dose, placebo-controlled, crossover, randomized human laboratory study.

Effects of alcohol availability, access to alcohol, and naltrexone on self-reported craving and patterns of drinking in response to an alcohol-cue availability procedure.

Objective: Craving has long been cited by patients and providers as a principal construct in alcohol use disorders and an essential target for treatment. The goal of the current study was to examine the effects of alcohol availability (20% vs. 80% availability), access to alcohol ("open" vs.

Family history of alcoholism mediates the frontal response to alcoholic drink odors and alcohol in at-risk drinkers.

Although a family history of alcoholism is the strongest risk factor for developing alcohol dependence, there are few studies of the association between familial alcoholism and the human brain's reward system activity. We used functional magnetic resonance imaging (fMRI) to determine how family history affects the brain's response to subjects' preferred alcoholic drink odors (AO) as compared to appetitive control odors (ApCO). Fourteen non-dependent heavy drinkers (HD) who were family history positive (FHP) participated, as did 12 HD who were family history negative (FHN).

Extended naltrexone and broad spectrum treatment or motivational enhancement therapy.

Background: Randomized clinical trials on the effectiveness of naltrexone (NTX) in the treatment of alcohol dependence have produced conflicting results. One possible explanation for these discrepancies may lie in the various psychosocial treatments for which NTX is an adjunct. The goal of this study was to examine the interplay between psychosocial treatment and duration of NTX.

Role of the HPA axis and the A118G polymorphism of the mu-opioid receptor in stress-induced drinking behavior.

Aims: The present study sought to investigate the relationship between the HPA axis reactivity to stress, the endogenous opioid system and stress-induced drinking behavior.

Methods: In the present study, 74 non-treatment-seeking alcohol-dependent subjects were tested under two mood conditions, neutral and stress, in separate testing sessions. Salivary cortisol measurements were obtained following stress induction and during the neutral control condition.

Alcohol sensitizes cerebral responses to the odors of alcoholic drinks: an fMRI study.

Background: Small, priming doses of alcohol enhance desire to drink, and thus play a role in the loss of control of alcohol consumption. Using functional magnetic resonance imaging (fMRI), we previously showed that alcoholic drink odors (AO; subjects' drinks of choice) induce greater nucleus accumbens (NAc) activity than non-appetitive odors (NApO; grass, leather) in subjects at risk for alcoholism. Here we hypothesized that priming exposure to alcohol would enhance responses to AO in the NAc and orbitofrontal cortex in comparison to NApO (grass, leather) and to the appetitive control odors (ApCO) of chocolate and grape.

Naltrexone's suppressant effects on drinking are limited to the first 3 months of treatment.

Rationale: Twelve weeks of naltrexone significantly improves drinking outcomes in alcoholics; however, the clinical benefits of naltrexone decline shortly after treatment is discontinued.

Objective: The present study investigated whether extended treatment with naltrexone significantly improved drinking outcomes.

Methods: One hundred forty-six alcohol-dependent patients received broad spectrum treatment or motivational enhancement therapy and either 12 or 24 weeks of naltrexone.

Building better cognitive-behavioral therapy: is broad-spectrum treatment more effective than motivational-enhancement therapy for alcohol-dependent patients treated with naltrexone?

Objective: The current study investigated the treatment effectiveness, during treatment, of a second-generation cognitive-behavioral therapy for alcoholism--broad-spectrum treatment (BST)--compared with motivational-enhancement therapy (MET), when both were offered in conjunction with a therapeutic dose of naltrexone (Revia).

Method: One hundred forty-nine alcohol-dependent patients completed a 3-month randomized, controlled trial of BST and naltrexone versus MET and naltrexone.

Results: Patients receiving BST had a significantly higher percentage of days abstinent than patients receiving MET.

Does participation in an alcohol administration study increase risk for excessive drinking?

It has long been thought that research protocols involving alcohol administration may exacerbate problem drinking in alcoholic subjects following their participation in such a study. However, recent studies suggest that involvement in an alcohol administration study does not, in fact, have a negative impact on subsequent drinking behavior. In the present study, 27 non-treatment-seeking alcohol-dependent subjects and 32 social drinkers participated in an alcohol administration study designed to investigate the effects of repeated doses of alcohol on craving, mood, and alcohol-seeking behavior.

The effect of olanzapine on craving and alcohol consumption.

Previous studies have indicated that olanzapine decreases craving after a priming dose of alcohol, that craving after a priming dose of alcohol is greater among individuals with the seven-repeat allele of the DRD4 variable number of tandem repeats (VNTR) polymorphism, and that the effect of olanzapine (a D2/D4 antagonist) is more pronounced among individuals with this allele. The present study tested the hypothesis that olanzapine may be differentially effective at reducing cue-elicited craving and differentially effective as a treatment for alcohol dependence over the course of a 12-week, randomized, placebo-controlled trial among individuals with and without the seven-repeat allele. Participants who met DSM IV criteria for alcohol dependence were randomly assigned to receive olanzapine (5 mg) or a placebo over the course of the trial.

Naltrexone and brief counseling to reduce heavy drinking in hazardous drinkers.

The present study examined the utility of daily naltrexone for decreasing alcohol drinking in hazardous drinkers. Forty-one participants participated in a 10-week trial and received 30 min of brief counseling on the first and second week of treatment, as well as a daily dose of 50 mg of naltrexone throughout the trial. Overall, naltrexone-treated participants did not show the same degree of improvement on drinking outcomes as placebo-treated participants.

Using the cue-availability paradigm to assess cue reactivity.

Background: A recent meta-analysis on cue-reactivity research revealed that cue-specific craving for alcohol is substantially less robust than craving measured for other drugs of abuse. The small effect sizes for alcohol underscore the need for more powerful methods of assessing cue reactivity in humans. The cue-availability paradigm is a modification of the conventional cue-reactivity paradigm and is intended to increase the sensitivity of measuring cue-reactivity to alcohol in humans.

Preclinical and clinical studies on naltrexone: what have they taught each other?

Proceedings of a symposium at the 2002 RSA/ISBRA Meeting in San Francisco, California; organized and co-chaired by Janice C. Froehlich and Stephanie O'Malley. The presentations were (1) Introduction, by Janice C.

Assessing the stimulant effects of alcohol in humans.

The stimulant effects of alcohol were assessed in humans. Twenty social drinkers were tested in dyads in the laboratory on three separate occasions, held 7 days apart. For their first session, one-third of the group consumed a dose of alcohol that was calculated to reach a target peak blood alcohol concentration (BAC) of 0.