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Background: Naltrexone is a Food and Drug Administration (FDA)-approved anti-craving agent for the long-term treatment of alcohol dependence syndrome (ADS). However, it may not be equally effective in all patients. This study aims to assess naltrexone treatment response over four weeks in a national-level tertiary care setting. Methods: Male patients with ADS (n = 100) who were initiated on naltrexone were included in the study. The clinical data, including the drinking pattern and craving, were recorded at baseline. At the end of the one-month follow-up, the drinking status and compliance with naltrexone were recorded. Findings: At the end of one month, more than half of the patients (n = 53) were retained in the study. All the treatment-retained patients (n = 53) reported naltrexone consumption for more than 24 days in the last month. Those who retained in the study reported significantly less craving among 72% of patients, while an almost 50% reduction in alcohol use was observed. Conclusion: This study adds to the evidence of outcomes with naltrexone in terms of reduced craving and alcohol use. [ABSTRACT FROM AUTHOR]

Background. Untreated co-occurring substance use and substance use disorders (SUDs) in patients with medical conditions may be associated with unfavourable medical outcomes. Understanding the prevalence of substance use and SUDs among patients admitted to hospital for medical illness may help in developing appropriate strategies to manage SUDs in this population and improve the outcomes of medical illness. We assessed the prevalence of substance use and SUDs among patients admitted for medical illnesses and the association between substance use and medical illness. Methods. This cross-sectional study was done in an inpatient setting in a multidisciplinary teaching medical institution in India. Using systematic sampling, adult patients admitted in various departments for at least 24 hours were interviewed using standard instruments by psychiatrists trained in the study methodology. Results. Two hundred and ninety patients participated. Their mean (SD) age was 42.2 (15.6) years. One hundred and nine participants (37.6%) reported lifetime use of any psychoactive substance, with tobacco being the most common substance used (91, 31.4%), followed by alcohol (69, 23.8%) and cannabis (12, 4.1%). Lifetime alcohol use was significantly associated with diseases of the circulatory system. Lifetime use of any substance or of alcohol, and current use of any substance or tobacco were significantly associated with injuries, poisoning and other consequences of external causes. Conclusions. A large proportion of patients hospitalized for medical illness reported the use of psychoactive substances or had SUDs. The use of some of these substances was also associated with injuries as well as diseases of the circulatory system. [ABSTRACT FROM AUTHOR]

Background: Opioid-dependent patients undergoing opioid substitution therapy (OST) consume alcohol in a hazardous pattern which adversely affects their treatment outcome. This study aims to measure alcohol biomarkers to screen for secondary alcohol use in OST patients. Methods: A pilot study was planned to measure alcohol biomarkers (AST, ALT, GGT, and CDT) to assess alcohol use in OST patients from three community clinics. The biomarkers were categorized based on the reported frequency of alcohol use. The association of the biomarkers with the frequency of alcohol consumption was determined using the post hoc (Mann-Whitney) test. Results: Forty-five patients with a mean (SD) age of 37.04 (10.7) years were included in the study. Alcohol intake was reported in daily, weekly, and monthly patterns by 22, 63, and 16% of the patients, respectively. High levels of ALT, GGT, and CDT were measured in patients with daily use of alcohol. Serum CDT levels significantly differentiate daily and weekly use from monthly consumption of alcohol. Conclusions: Alcohol biomarkers significantly predict the pattern of alcohol use among OST patients. These results can be prudent in low-resource community clinics to improve the overall outcomes of OST in India. [ABSTRACT FROM AUTHOR]

Introduction: Exposure to alcohol in popular movies during adolescence is associated with higher rates of alcohol use. We aimed to assess the extent and pattern of depiction of alcohol in Bollywood movies, and to analyze the trends in portrayal of alcohol over three decades selected for the study. Materials and Methods: We selected the top five grossing movies for each year of the three decades selected (1961–1970; 1981–1990; and 2001–2010). Content analysis was conducted for each scene depicting alcohol in the movie. We compared quantitative variables across the three decades to assess for any changes in the portrayal of alcohol and performed qualitative content analysis for the text description of the context, in which alcohol was depicted in each movie. Results: Of the total 150 movies analyzed, 135 (90%) movies contained at least one scene depicting alcohol. Alcohol scenes comprised 7% of the total movie time. Majority of the scenes (92.2%, n = 976) showed the substance (alcohol) itself. Spirits were the most common alcohol beverages depicted (75.1%, n = 733). Only 7.9% of scenes (n = 84) depicted alcohol brands. About 67% (n = 709) of scenes showed characters consuming alcohol or appeared intoxicated. Most scenes portrayed hero (n = 253, 35.7%) consuming alcohol. Female characters were depicted in 7.5% (n = 53) alcohol scenes. The third decade (2001–2010) had the least proportion of scenes depicting Spirits and the highest proportion of scenes depicting beer and wine. Decade three also had the most proportion of scenes set in clubs, bars, discotheques or restaurants, scenes with characters of "positive" shade depicting alcohol use, and the scenes portraying heroine with alcohol use. Conclusion: There is an increasing trend toward alcohol depiction by positive characters for fun and relaxation, and toward depiction of low-concentration alcohol such as beer in recent decades. The impact of changing trend of alcohol depiction on the Indian viewers, especially young audience, needs further study. [ABSTRACT FROM AUTHOR]

Background: Pattern of drinking has a strong bearing on alcohol-related negative consequences. Very few studies from India have assessed this relationship using any standardized instrument. Aim: The current study aims to assess the relationship between pattern of alcohol use and negative consequences among problem alcohol users using a standardized instrument. Materials and Methods: This cross-sectional, observational study using snowball sampling technique was conducted among 75 participants in an urban slum of a metropolitan city of India. Screening of the participants was done by the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (WHO-ASSIST). Alcohol use details and alcohol-related adverse consequences were obtained by a semi-structured questionnaire and Drinker Inventory of Consequences (DrInC) inventory, respectively. Descriptive statistics, Chi-square test, and logistic regression test were used to analyze the data. Results: There was a significant association between high total DrInC score and ≥3 subscale scores with employment status, percentage of total family income spent on alcohol, source of income to procure alcohol, amount of alcohol, morning drinking, alcohol use for relaxation, and drinking throughout the day (Chi-square test). Age ≤35 years, current unemployment/part-time employment state, spending ≥25% of total family income on alcohol, family history, and drinking throughout the day were more likely to have high total DrInC score and ≥2 subscale scores (logistic regression analysis). Conclusion: A large proportion of the participants were suffering significantly from alcohol-related consequences but still were not receiving any treatment. It emphasizes the need for more epidemiological studies in this area for its treatment and policy-level implication. [ABSTRACT FROM AUTHOR]

Background: Harmful Alcohol use is frequent among opioid dependents patients undergoing agonist maintenance treatment. The objective assessment of harmful alcohol use can be done using laboratory measures of serum biomarkers. For community-based patients, there is often a requirement of an alternative method due to lack of onsite laboratory services. The aim of the study was to examine filter paper as a matrix to measure serum biomarkers of harmful alcohol use. Methods: The initial phase involved standardization of the filter-paper-based assay. Conditions were optimised for extraction and estimation of alcohol biomarkers (Aspartate Aminotransferase; AST, Alanine Aminotransferase; ALT, Gamma Glutamyl transferase; GGT and Carbohydrate Deficient Transferrin; CDT) from the filter paper. For clinical validation, serum samples were collected from community clinics. Biomarker levels obtained from both the methods were correlated using linear regression analysis. Limits of agreement between the two methods was estimated using the Intraclass Correlation Coefficient (ICC). Results: The extraction of enzymes (AST, ALT and GGT) from filter paper was carried out using the substrate buffer available with the reagent kit (Randox, UK). CDT was readily extracted from filter paper using deionised water. Serum biomarker levels measured from samples collected from community clinics correlated well with filter paper extracted levels (ICC 0.97-0.99). More than 90% of alcohol biomarker levels were recovered from the filter paper matrix using this method. Conclusion: Filter paper has the potential to be used as a matrix to objectively measure alcohol biomarkers among opioid-dependent patients from community settings lacking onsite laboratory facilities. [ABSTRACT FROM AUTHOR]

Aim: Ethyl glucuronide (EtG) in hair is a direct biomarker proven to be useful for the detection of chronic excessive alcohol use. This study investigated the association of self-reported alcohol consumption with traditional biomarkers: GGT, AST, ALT, CDT and MCV in blood and a direct biomarker hair EtG in a total of 122 patients with alcohol dependence syndrome. The diagnostic accuracy of the biomarkers to differentiate heavy from non-heavy drinkers was also evaluated.Method: GGT, AST, ALT in serum was measured by Automated Chemistry Analyzer; MCV in blood was measured by Haematology Analyzer; serum CDT was analysed by ELISA and EtG in hair was evaluated by gas chromatography-mass spectrometry. The association between the biomarkers and the amount of alcohol consumed (self-reported) was determined using Spearman's rank correlation.Results: All participants showed EtG level above the cut-off (0.03 ng ⁄mg). Hair EtG showed a statistically significant linear and positive correlation with the amounts (in grams) of alcohol consumed (r = 0.60; p < 0.001). No correlation was observed among the traditional biomarkers and the quantity of alcohol consumed. Also, EtG showed an excelled ROC curve (98%) with good sensitivity (85%) and specificity (60%) to classify heavy drinkers among individuals with alcohol dependence syndrome.Conclusion: Hair EtG can be helpful to estimate retrospective alcohol consumption in long-term chronic alcohol consumption cases. Hair EtG also provides a reliable diagnostic test to detect heavy drinkers among individuals with alcohol dependence syndrome. [ABSTRACT FROM AUTHOR]