Abi Rose

The effects of a priming dose of alcohol and drinking environment on snack food intake

Alcohol consumption is a potential risk factor for being overweight. We aimed to investigate the effects of an alcohol priming dose and an alcohol-related environment on snacking behaviour. One hundred and fourteen social drinkers completed one of four experimental sessions either receiving a priming dose of alcohol (.6 g/kg) or soft drink in a bar-lab or a sterile lab. Participants provided ratings of appetite, snack urge, and alcohol urge before and after consuming their drinks. Participants completed an ad libitum snack taste test of savoury and sweet, healthy and unhealthy foods before completing the self-reports a final time. Appetite and snack urge increased more following alcohol consumption, and decreased to a lesser extent following the taste test relative to the soft drink. Total calories (including drink calories) consumed were significantly higher in the alcohol groups. There was a marginal effect of environment; those in the bar-lab consumed a higher proportion of unhealthy foods. These effects were more pronounced in those who were disinhibited. While alcohol may not increase food consumption per se, alcohol may acutely disrupt appetite signals, perhaps via processes of reward and inhibitory control, resulting in overall greater calorie intake. Individuals who are generally disinhibited may be more vulnerable to the effects of alcohol and drinking environments on eating behaviour.

The effect of beliefs about alcohol’s acute effects on alcohol priming and alcohol-induced impairments of inhibitory control

Acute alcohol administration can lead to a loss of control over drinking. Several models argue that this ‘alcohol priming effect’ is mediated by the effect of alcohol on inhibitory control. Alternatively, beliefs about how alcohol affects behavioural regulation may also underlie alcohol priming and alcohol-induced inhibitory impairments. Here two studies examine the extent to which the alcohol priming effect and inhibitory impairments are moderated by beliefs regarding the effects of alcohol on the ability to control behaviour. In study 1, following a priming drink (placebo or .5g/kg of alcohol), participants were provided with bogus feedback regarding their performance on a measure of inhibitory control (stop-signal task; SST) suggesting that they had high or average self-control. However, the bogus feedback manipulation was not successful. In study 2, before a SST, participants were exposed to a neutral or experimental message suggesting acute doses of alcohol reduce the urge to drink and consumed a priming drink and this manipulation was successful. In both studies craving was assessed throughout and a bogus taste test which measured ad libitum drinking was completed. Results suggest no effect of beliefs on craving or ad lib consumption within either study. However, within study 2, participants exposed to the experimental message displayed evidence of alcohol-induced impairments of inhibitory control, while those exposed to the neutral message did not. These findings do not suggest beliefs about the effects of alcohol moderate the alcohol priming effect but do suggest beliefs may, in part, underlie the effect of alcohol on inhibitory control.

Baclofen : Maintenance of Abstinence in Alcohol Dependent Patients Attending a Joint Liver and Alcohol Treatment Clinic

Introduction Alcohol induced liver disease (ALD) is the predominant cause of alcohol-related mortality in the UK. Therefore helping patients with ALD to quit is a primary treatment goal. Aims/Objectives The primary aim of this study was to measure the effectiveness and tolerability of Baclofen in maintaining abstinence, and to determine if this resulted in a reduction in standard measures of liver damage. Methods An observational prospective clinical audit was performed. Patients with ALD were commenced on Baclofen titrated according to tolerability and response up to 30 mg TDS. Primary outcome measures were severity of physical dependence (SADQ score) and biochemical markers of liver damage GGT, ALT, Bilirubin fibroelastography. These were compared at baseline, and 1 year. Results Of the 243 patients commenced on Baclofen, 151 (85 female 66 male) have completed 1 year follow-up (F/U) of which 130 (86%) have remained engaged. 10 have died. Comparison of baseline (B/L) and 1 year biochemical markers showed a reduction in GGT (c2= 66.8 P Conclusion Baclofen is well tolerated in this very difficult to treat, high risk patient group. It has a positive impact on alcohol consumption, and overall measures of liver function and harm. A RCT is needed to confirm the benefit of Baclofen in this patient group.

PTU-118 Baclofen As An Adjunct Pharmacotherapy For The Maintenance Of Abstinence In Alcohol Dependent Patients With Liver Disease

Introduction Alcohol induced liver disease is the predominant cause of alcohol-related mortality in the UK. Therefore abstinence-based treatments are essential. Upto 70% of patients receiving alcohol treatment relapse within 6 months,1 NICE attribute much of this failure of treatment to underutilisation of pharmacotherapy and recommend this be made available.2 However, current licensed pharmacotherapies are contraindicated for patients with ALD. Baclofen has shown efficacy in the promotion of abstinence in patients with severe alcohol dependence3,4 including those with ALD,5 without exhibiting any of the complications or side effects elicited by current pharmacotherapies. Therefore the primary aim of this study was to measure the effectiveness of Baclofen in maintaining abstinence in this difficult to treat group. Methods An observational prospective clinical audit was performed. Patients with liver disease and concomitant alcohol use were commenced on Baclofen at 10 mg three times daily (TDS), and titrated according to tolerability and response up to 30 mg TDS. Primary outcome measures were severity of physical dependence, as determined by SADQ score, and weekly alcohol consumption. These were compared at baseline, and 6 months. Setting Acute Hospital Trust Participants 149 patients referred to Hepatology for investigation of abnormal liver function and heavy drinking Results Of the 149 patients commenced on Baclofen 100 (67.1%) remained engaged in treatment for 6 months. There was a significant reduction in alcohol consumption (P < 0.0001 95% CI for difference 18 to 20) with 81 of the 149 patients (54.3%) maintaining total abstinence, 20 (13.4%) continued to drink and 48 (32.2%) were lost to follow-up and assumed to have returned to drinking. There was a significant reduction in the presence of physical dependence (c2 = 77.4 P < 0.0001) as categorised by SADQ, and a non-significant improvement of liver biochemistry. Conclusion Baclofen has a positive impact on alcohol consumption in this very difficult to treat, high risk patient group. A RCT is needed to confirm the benefit of baclofen in this patient group. References Raistrick, D. 2006, NTA NICE, Alcohol Use Disorders: CG115, 2011 Addolorato, G. 2012 Muzyk, A. 2012 Leggio, L. 2010 Disclosure of Interest None Declared.

Reward expectancy promotes generalised increases in attentional bias for rewarding stimuli

Expectations of drug availability increase the magnitude of attentional biases for drug-related cues. However, it is unknown if these effects are outcome-specific, or if expectation of aspecific reinforcer produces a general transfer effect and increases attentional bias for other types of rewarding cues. In the present study, 31 social drinkers completed an attentional bias task in which attentional bias for alcohol- and chocolate-related cues was assessed while the expectation of receiving alcohol and chocolate was manipulated on a trial-by-trial basis. Participants showed attentional bias for alcohol and chocolate cues (relative to neutral cues) overall. Importantly, these effects were magnified when participants expected to receive alcohol and chocolate, but effects were not outcome-specific: the expectation of receiving either alcohol or chocolate increased attentional bias for both alcohol and chocolate cues. Results suggest that anticipation of reward produces a general rather than an outcome-specific enhancement of attentional bias for reward-related stimuli. Funded by a research grant from Alcohol Research UK.