Glutamate- and GABA-expressing neurons have long been studied in relation to alcohol drinking (Wang et al., 2022), but less is known about the importance of interneurons. Some interneurons can help synchronize and integrate activity across principal neurons in a region. GABAergic interneurons, especially fast-spiking neurons, have been implicated in such larger-scale regulation and can influence alcohol drinking (Patton et al., 2021). Another important population is the cholinergic interneurons (CINs). These are generally in low abundance (<2% of cells) and have been widely studied for their role in providing tonic acetylcholine, phasic firing increases in response to rewards, interactions with dopamine during cues, and other roles (Mallet et al., 2019). CINs have been broadly investigated in the dorsal striatum (Mallet et al., 2019), but CIN importance in nucleus accumbens (NAc) areas has received less attention.
A recent publication in Alcohol: Clinical and Experimental Research from Sharma et al. (2024) examines the importance of CINs in the nucleus accumbens shell (NAcSh) for alcohol binge drinking in mice. The NAcSh has been linked to many aspects of motivated responding. Original studies suggested the importance of the NAcSh in novel and primary experiences, rather than conditioned and motor responses (Floresco, 2015). For example, NAcSh is needed for alcohol-paired contexts, not for alcohol cues, to promote alcohol intake (Chaudhri et al., 2010). In addition, many studies find that NAcSh inhibition in mice (using a variety of methods) reduces voluntary home-cage alcohol consumption, with no consistent impact on sweet fluid intake (Lei et al., 2019). However, modulating activity in NAcSh can influence hedonic feeding for palatable foods (Castro & Bruchas, 2019). Thus, NAcSh likely plays an important role in many translationally relevant behaviors, including alcohol drinking and responding for other high-value rewards.
The present paper provides useful new findings in our understanding of how NAcSh cholinergic signaling, caused by activity of local CINs, is able to alter alcohol drinking. This study examined alcohol consumption in male mice using the Drinking in the Dark (DID) model, with 3 days of 2-h/day access, and 4-h access on the fourth day (the day of binge testing). Mice were of the ChAT-Cre line, which is on a C57 background, and showed binge-level intake (>80 mg% blood alcohol) in the 4-h drinking session.
The authors use two complementary methods to inhibit NAcSh CIN function. One involved the use of excitatory and inhibitory chemogenetics, the broadly used tool to alter neuronal activity. The other utilized virus-based expression of a toxin that leads to cell-specific lesioning, a valuable but less often used method to determine the functional importance of particular cells. To
Psychoeducation constitutes a routine therapeutic practice in most treatment settings for severe alcohol use disorder (sAUD). This technique is considered an efficient way to help patients to learn more about their disease and achieve therapeutic objectives. However, this approach capitalizes on three untested assumptions: namely, that (1) patients with sAUD possess insufficient knowledge about sAUD at treatment entry; (2) patients with sAUD have the cognitive resources to learn new information and benefit from psychoeducation; and (3) psychoeducation positively impacts clinical outcomes.
We tested these assumptions in two experimental studies. In the first experiment in 66 recently detoxified patients with sAUD and 102 matched healthy controls, we measured baseline knowledge on sAUD through self-reported questionnaires, determined whether an up-to-date psychoeducation program can improve this knowledge, explored the role of cognitive abilities in such learning, and established the impact of psychoeducation on relapse rates. In a second experiment in 23 patients and 17 healthy controls, we examined whether the increased knowledge following psychoeducation is alcohol specific, and whether the motivation to change influences the relation between psychoeducation and clinical outcomes.
At treatment entry, patients with sAUD presented with more sAUD-related knowledge than healthy controls, and were able to increase this knowledge following psychoeducation, independently of their cognitive status. However, psychoeducation did not impact either the motivation to change or relapse rates.
Psychoeducation can increase patients' knowledge about sAUD, but it does not increase the likelihood of abstinence or controlled low consumption after discharge. Thus, clinicians should question whether psychoeducation should occupy a central position in the therapeutic programs and reconsider what can be expected from psychoeducation in terms of achieving therapeutic objectives.
Although the sale of alcohol to obviously intoxicated patrons (i.e., overservice) is illegal in 48 U.S. states, the likelihood of overservice at bars and restaurants has exceeded 80% across multiple studies, states, and decades. Place of last drink (POLD) enforcement is one proposed strategy to address alcohol overservice. When law enforcement agents respond to an alcohol-related incident, they ask the individuals involved where they had their last alcoholic beverage. POLD information is recorded and ideally systematically reviewed to identify locations that are frequently places of last drink. Law enforcement or other agencies may follow up with or penalize the alcohol license holder at these locations. We compared the likelihood of overservice in communities conducting POLD with communities that did not conduct POLD in Minnesota.
Pseudo-intoxicated patrons acted out signs of obvious intoxication while attempting to purchase alcohol at 396 bars and restaurants in 26 communities conducting POLD and 26 comparison communities. We calculated rates of alcohol sales to the pseudo-intoxicated patrons overall and in POLD communities versus comparison communities.
The overall sales rate to the pseudo-intoxicated buyers was 98%. Rates of sales were 99% at establishments in POLD jurisdictions and 97% in comparison jurisdictions. There were no common characteristics, such as perceived gender/age of the server/bartender or crowdedness of the establishment, among the seven establishments that refused alcohol service.
Our study shows that, as currently implemented in Minnesota, POLD does not reduce the overservice of alcohol at a jurisdiction level. More research is needed to identify interventions that yield sustained reductions in the overservice of alcohol.
Alcohol use disorder (AUD), posttraumatic stress disorder (PTSD), and suicide are substantial public health concerns among military service members, yet the nature of their relationships is not well understood. Here, we tested the hypothesis that AUD moderates the relationship between PTSD symptom severity and suicidal ideation.
This secondary analysis uses data collected at baseline for a randomized clinical trial. The sample consists of 160 active-duty service members from three service branches (Army, Air Force, and Navy). All participants met diagnostic criteria for PTSD and were not engaged in evidence-based PTSD treatment at the time of enrollment. Zero-inflated Poisson generalized linear regression models were used to test the associations of PTSD and AUD symptom severity with the presence and severity of suicidal ideation.
Findings suggest that AUD symptom severity moderates (i.e., amplifies) the relationship between PTSD symptoms and severity of suicidal ideation among military personnel with untreated PTSD. Among service members with mild or absent AUD, we found no significant association between PTSD symptoms and the severity of suicidal ideation. However, when AUD severity was average (i.e., sample mean) or high (mean + 1SD), PTSD symptoms were significantly positively associated with the severity of suicidal ideation.
This study highlights the importance of assessing AUD and PTSD as a part of suicide risk evaluations of veterans. The results also provide strong support for the maintenance and further development in the military health system of treatment programs that simultaneously address AUD and PTSD comorbidity.
Alcohol use is declining among US adolescents/early young adults and increasing among other adults, with increases in adult binge drinking more concentrated in females than males. Reasons for drinking are historically patterned by age and sex, and if historically variant, could suggest that changes over time could in part explain age- and sex-differential cohort effects.
We analyzed longitudinal Monitoring the Future data for individuals born from 1958 to 1990. These individuals were aged 29/30 from 1987 to 2020, and first surveyed at age 18 from 1976 to 2008 (N = 14,190). Five reasons for drinking were analyzed (social, enhancement, avoid problems, relax, boredom). Drinking for social reasons and to relax were most prevalent. Total effects of birth cohort predicting past-2-week binge drinking were estimated with polynomial regression models by age; indirect effects through mediators were estimated.
Drinking reasons exhibited dynamic time trends across birth cohort and sex. Notable increases were observed in social reasons: among women aged 29/30, social reasons increased from 53% to 87% from 1987 to 2020. Social reasons to drink had prominent positive indirect effects at adult ages (age 23/24 and above among men; age 19 and above among women), indicating that binge drinking would have increased less were it not for the increase in social reasons for drinking. Social reasons also mediated adult male/female differences, indicating that part of the reason sex differences are diminishing is the more rapid increases in social reasons for drinking among women. Indirect effects were also observed for drinking to relax and for boredom, and limited indirect effects were observed for enhancement and to avoid problems.
Changing endorsement of drinking reasons, especially social reasons, among US adult drinkers mediate cohort effects in binge drinking in the US adult population and explain in part why binge drinking is converging by sex.
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