Alcoholism in MMT Patients

Alcohol use problem among patients in methadone maintenance treatment in Taiwan. J Subst Abuse Treat. 2011 Mar;40(2):142-9.

http://www.ncbi.nlm.nih.gov/pubmed/21036515

PARTICIPANTS:

Study population included 438 patients who underwent more than 6 months of MMT.

MEASUREMENTS:

Demographic and clinical characteristics were collected for each patient prior to treatment, and treatment-related variables were collected during treatment process. Hazardous drinking, alcohol abuse, and dependence were measured using a Chinese version of the Alcohol Use Disorders Identification Test (AUDIT) and by measuring breath alcohol concentration.

FINDINGS:

The prevalence rates of alcohol use problems, indicated by hazardous drinking are 31.4%. The protective predictors of alcohol use problems among MMT patients include an attendance rate of more than 90% (odds ratio [OR] = 0.54, 95% confidence interval [CI] = 0.30-0.97) and being older than 36 years (OR = 0.48, 95% CI = 0.27-0.86), and alcohol drinking problem at intake of study is a risk factor (OR = 5.30, 95% CI = 2.87-9.76).

alcohol gene fMRI

• rs3771863, rs3755459, and rs1106855 predicted BOLD activation in response to alcohol cues in those same reward and reinforcement brain areas, especially in the medial prefrontal cortex, striatum, and insula.
•  rs3771863 also predicted AD symptom count in the SAGE data set and BOLD activation in the mesocorticolimbic pathway response to alcohol cues.

TACR1 Genotypes Predict fMRI Response to Alcohol Cues and Level of Alcohol Dependence.
Blaine S, Claus E, Harlaar N, Hutchison K.
Alcohol Clin Exp Res. 2012 Oct 18. doi: 10.1111/j.1530-0277.2012.01923.x. [Epub ahead of print]

Why We Like to Drink

• Alcohol robustly activated striatal reward circuits while attenuating response to fearful stimuli in visual and limbic regions.
• Self-ratings of intoxication correlated with striatal activation, suggesting that activation in this area may contribute to subjective experience of pleasure and reward during intoxication.
• These results show that the acute pharmacological rewarding and anxiolytic effects of alcohol can be measured with fMRI.

Why We Like to Drink: A Functional Magnetic Resonance Imaging Study of the Rewarding and Anxiolytic Effects of Alcohol. The Journal of Neuroscience, April 30, 2008 • 28(18):4583– 4591 • 4583