2009 Worldwide Brewing Alliance and Global Brewers Forum Members Briefing Session
College and Underage Drinking in the U.S.
Kim Fromme, Ph.D., The University of Texas at Austin, “Underage and college drinking: what do we know and where should we go?”
Panel discussion by Kim Fromme, Ph.D., Helene White, Ph.D., Rutgers—The State University of New Jersey, and Sherry Stewart, Ph.D., Dalhousie University.
Medication Development for Alcohol Use Disorders
Ivan Diamond, M.D., Ph.D., University of California—San Francisco, “Experience developing a novel medication for alcoholism: from academia to the private sector."
Raymond Anton, Jr., M.D., Medical University of South Carolina, “Medication development for alcohol dependence: promises and pitfalls.”
Fatty Liver Disease in 2010
Mack C. Mitchell, Jr., M.D., Johns Hopkins Bayview Medical Center, “The role of alcohol in fatty liver disease and cirrhosis.”
Panel discussion by David Crabb, M.D., Indiana University, and Laura Nagy, Ph.D., Cleveland Clinic.
Research Highlights
On October 27, ABMRF/The Foundation for Alcohol Research held an abbreviated International Medical Advisory Group research symposium for the Worldwide Brewing Alliance (WBA) and Global Brewers Forum in Alexandria, Virginia. Members of the Foundation’s Board of Trustees and Advisory Council presented on relevant alcohol health topics and provided panel discussions for each of three research areas: underage and college drinking, the development of medications to treat alcoholism and fatty liver disease and cirrhosis.
Kim Fromme, Ph.D., a former Foundation grantee, a member of the Foundation’s Behavioral and Social Advisory Council (BSAC) and professor at The University of Texas at Austin, opened the session with her presentation “Underage and college drinking: What do we know and where should we go?” The presentation focused on the research showing the differences in the consumption patterns between underage and adult drinkers. She examined the alcohol-related consequences among underage and college drinkers, where binge drinking is associated with social, academic and behavioral problems. Fromme suggests that binge drinking is attributed to the socialization at college that encourages students to adapt to their new environments and friends. Once at college, students alter their drinking habits to meet social expectations and match the drinking rates of their friends.
To discourage underage drinking, Fromme suggests the benefits of applying social norms campaigns to students to correct peer norms. Educating college students about social norms in their community and highlighting media messages about light drinking allows students to understand accurately the drinking habits of their peers and promotes light drinking as the norm. Motivational based interventions are also successful solutions to binge drinking by underage students, where the focus is on determining why youth drink and why they might change their drinking behaviors. Multi-component cognitive-behavioral skills training uses moderation strategies and stress management skills to further curb binge drinking at colleges.
Three members of the Foundation's Behavioral and Social Behavioral Council served on the panel for discussion on underage drinking: Kim Fromme, Ph.D., Helene White, Ph.D., and Sherry Stewart, Ph.D. Members of the WBA had the opportunity to ask the Foundation’s experts about the consequences of underage drinking and guidance on the appropriate legal drinking age.
Ivan Diamond, M.D., Ph.D., a member of the Foundation’s Board of Trustees and former Medical Advisory Council member presented “Experience developing a novel medication for alcoholism: From academia to the private sector” to the WBA. Diamond offered from his experience spanning both academia at the Ernest Gallo Research Center, University of California, San Francisco and the private sector in his work at Gilead Sciences to develop medication to treat alcoholism. With 7-10% of Americans considered alcoholics, there is an unmet medical need for the treatment of alcoholism. The goal for a novel alcoholism medication is to suppress excessive drinking to prevent harm without affecting moderate drinking.
Diamond shared his experience at CV Therapeutics (now Gilead Sciences) developing CVT-10216, a new generation of medication for treating alcoholism. CVT-10216 inhibits desire for heavy drinking without appearing to affect moderate drinking, reduces relapse, and the effectiveness of the medication increases with greater urges for alcohol. Because stress often precipitates relapse in alcoholics, another success of CVT-10216 is its effectiveness as an anti-anxiety medication. Diamond emphasized that the development of CVT-10216 demonstrates that most successful medications have their origins in patents in universities. Supporting academic research is the most cost effective way to accelerate the development of new medications for alcoholism.
Raymond F. Anton, M.D., vice-chair of the Foundation’s Board of Trustees, former chair of the Behavioral and Social Advisory Council and professor of Psychiatry and director of Center for Drug and Alcohol Programs at the Medical University of South Carolina presented “Medication development for alcohol dependence: promises and pitfalls.” The presentation highlighted the medical research showing that alcohol dependence develops over years with concomitant brain and neurochemistry adaptations. Dopamine, opiate, GABA and glutamate neurotransmission play a crucial role in alcohol dependence. Medications are important for reversing or stabilizing the effects of alcohol on these circuits and thus reduce drinking and promoting abstinence. Most importantly, Anton emphasized that not every medication works for every individual and most medications are only moderately effective. An increased understanding of the roles of genes and environment on alcohol dependence is important for the development of novel medications for alcoholism.
Mack C. Mitchell, Jr., M.D., president of the Foundation and director of the Division of Digestive Diseases at Johns Hopkins Bayview Medical Center chaired the session on “The role of alcohol in fatty liver disease and cirrhosis.” The presentation explored the consequences of alcohol and food on the development of fatty liver disease and cirrhosis. Non-alcoholic fatty liver (NAFL) is the most common cause of abnormal liver tests. NAFL development is associated with obesity, type 2 diabetes and dyslipidemia (low HDL, elevated triglycerides). Fatty infiltration can be associated with inflammation and/or formation of scar tissue. Steatosis, acute alcoholic hepatitis and cirrhosis appear more common in those alcoholic patients who had been obese for greater than 10 years. Most interestingly, Mitchell explains that the mechanisms of liver injury from alcohol and obesity may overlap, particularly at the molecular level from cytokine-mediated injury. Medical research may suggest that weight loss is the best treatment for those patients with simple steatosis without nonalcoholic steatohepatitis, while abstinence is important in alcoholic liver disease.
Mitchell also discussed the role of alcohol in diabetes. Several studies may show a lower incidence of type 2 diabetes in moderate drinkers because moderate alcohol intake may improve sensitivity to insulin that reduces demand on the pancreas. Lower insulin levels may also be beneficial in reducing risks of cardiovascular disease.
Three members of the Foundation's Medical Behavioral Council served on the panel for discussion on fatty liver disease and cirrhosis: Mack C. Mitchell, Jr., M.D., David Crabb, M.D., and Laura Nagy, Ph.D. Briefing session attendees had the opportunity to ask the Foundation’s experts about the consequences of obesity and alcohol on the health of the liver.