Alcohol Dependence in General Medical Settings

Summary

Principal Investigator: Scott H Stewart
Abstract: Alcohol dependence is common in general medical settings. While controlled clinical trials have demonstrated the effectiveness of brief advice from medical providers in decreasing consumption for non-dependent heavy drinkers, there is no evidence for effective treatments for alcohol dependence in this setting. This application proposes a five-year period of support for the candidate, providing him with sufficient time and resources to develop as an independent researcher conducting trials of treatments for alcohol dependence in general medical settings. The candidate is currently an Assistant Professor of Medicine at the University at Buffalo, State University of New York. His research background has focused on alcohol-related medical issues, and he has performed several epidemiologic analyses in this area. The career award will allow him to develop additional skills in health-related behavior modification, the use of diagnostic and measurement instruments commonly used in studies evaluating alcohol use and alcoholism, and in conducting trials of treatments for alcohol dependence within a general medical model. Such treatments will be aimed at complementing or providing alternative treatment options to more established standards of care such as referral to self-help groups or addiction specialists. A variety of formal and informal didactics during the early portion of the career development period are planned to facilitate completion of the research objectives. However the majority of the award period will be devoted to the supervised completion of a pilot trial. This trial will evaluate a primary care treatment model for alcohol dependence that includes brief, patient-centered, motivational counseling with optional naltrexone. This will be compared with a traditional medical model based on assessment and expert advice, and also including optional naltrexone. Outcomes will include various measures of medication use, alcohol consumption, and drinking-related adverse consequences. Activities during the award period will be supervised by senior research scientists from the Research Institute on Addictions and and the Department of Social and Preventive Medicine at the University at Buffalo, who have agreed to mentor the candidate over the five-year period.
Funding Period: 2004-05-15 - 2009-06-30
more information: NIH RePORT

Top Publications

  1. ncbi Exploration of the relationship between drinking intensity and quality of life
    Scott H Stewart
    Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
    Am J Addict 15:356-61. 2006
  2. pmc Preliminary evaluation of phosphatidylethanol and alcohol consumption in patients with liver disease and hypertension
    Scott H Stewart
    Medical University of South Carolina, Charleston, 29425, USA
    Alcohol Alcohol 44:464-7. 2009
  3. pmc COMT genotype influences the effect of alcohol on blood pressure: results from the COMBINE study
    Scott H Stewart
    Department of Psychiatry and Behavioral Sciences, Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina, USA
    Am J Hypertens 22:87-91. 2009
  4. pmc Blood pressure reduction during treatment for alcohol dependence: results from the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study
    Scott H Stewart
    Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
    Addiction 103:1622-8. 2008
  5. pmc Ethnicity, alcohol drinking and changes in transaminase activity among heavy drinkers
    Scott H Stewart
    Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
    J Natl Med Assoc 99:564-9. 2007
  6. ncbi Alcoholics in acute medical settings have increased risk for other drug, mood, and personality disorders
    Scott H Stewart
    Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston 29425, USA
    Int J Psychiatry Med 37:59-67. 2007
  7. ncbi Interest in pharmacotherapy and primary care alcoholism treatment among medically hospitalized, alcohol dependent patients
    Scott H Stewart
    Psychiatry and Medicine, Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, SC 29425, USA
    J Addict Dis 26:63-9. 2007
  8. ncbi Ethnicity and gamma-glutamyltransferase in men and women with alcohol use disorders
    Scott H Stewart
    Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, NY 14260, USA
    Alcohol Alcohol 42:24-7. 2007
  9. ncbi Perceived health status, alcohol-related problems, and readiness to change among medically hospitalized, alcohol-dependent patients
    Scott H Stewart
    Center for Drug and Alcohol Programs, Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina 29425, USA
    J Hosp Med 2:372-7. 2007
  10. pmc Phosphatidylethanol and alcohol consumption in reproductive age women
    Scott H Stewart
    Charleston Alcohol Research Center and Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina, USA
    Alcohol Clin Exp Res 34:488-92. 2010

Detail Information

Publications10

  1. ncbi Exploration of the relationship between drinking intensity and quality of life
    Scott H Stewart
    Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
    Am J Addict 15:356-61. 2006
    ..Each quality of life indicator improved with decreased DDD. Gender and ethnicity modified the DDD effect for some outcomes, with DDD exerting a greater influence on quality of life in women and non-Hispanic whites...
  2. pmc Preliminary evaluation of phosphatidylethanol and alcohol consumption in patients with liver disease and hypertension
    Scott H Stewart
    Medical University of South Carolina, Charleston, 29425, USA
    Alcohol Alcohol 44:464-7. 2009
    ..The goal of this preliminary study was to evaluate the relationship between blood phosphatidylethanol (PEth) and recent drinking in patients with liver disease and hypertension...
  3. pmc COMT genotype influences the effect of alcohol on blood pressure: results from the COMBINE study
    Scott H Stewart
    Department of Psychiatry and Behavioral Sciences, Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina, USA
    Am J Hypertens 22:87-91. 2009
    ..Catechol- O-methyltransferase (COMT) inactivates catecholamines, and a G to A substitution in codon 108 in the soluble COMT mRNA (or codon 158 in the membrane-bound form) substitutes methionine for valine and alters enzyme activity...
  4. pmc Blood pressure reduction during treatment for alcohol dependence: results from the Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) study
    Scott H Stewart
    Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
    Addiction 103:1622-8. 2008
    ..Heavy drinking is associated with hypertension. This study evaluated blood pressure changes occurring during treatment for alcohol dependence...
  5. pmc Ethnicity, alcohol drinking and changes in transaminase activity among heavy drinkers
    Scott H Stewart
    Center for Drug and Alcohol Programs, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
    J Natl Med Assoc 99:564-9. 2007
    ..Some studies suggest alcohol sensitivity may contribute to this finding. This analysis evaluated if alcohol-associated changes in aspartate aminotransferase (AST) and alanine transaminase (ALT) differed by ethnicity among heavy drinkers...
  6. ncbi Alcoholics in acute medical settings have increased risk for other drug, mood, and personality disorders
    Scott H Stewart
    Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston 29425, USA
    Int J Psychiatry Med 37:59-67. 2007
    ..To explore this possibility, this study evaluated the prevalence of mental health disorders in the U.S. population stratified by alcoholism and recent hospitalization or emergency room use...
  7. ncbi Interest in pharmacotherapy and primary care alcoholism treatment among medically hospitalized, alcohol dependent patients
    Scott H Stewart
    Psychiatry and Medicine, Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, SC 29425, USA
    J Addict Dis 26:63-9. 2007
    ..Medically hospitalized patients with alcohol dependence were interested in effective medication for relapse prevention, but primary care follow-up alone may not adequately address patients' perceived treatment needs...
  8. ncbi Ethnicity and gamma-glutamyltransferase in men and women with alcohol use disorders
    Scott H Stewart
    Department of Medicine, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, NY 14260, USA
    Alcohol Alcohol 42:24-7. 2007
    ..This study evaluated the associations of gender and ethnicity with GGT in a large sample of patients with DSM-IV alcohol abuse or dependence, as well as modification of alcohol's effects on GGT by gender and ethnicity...
  9. ncbi Perceived health status, alcohol-related problems, and readiness to change among medically hospitalized, alcohol-dependent patients
    Scott H Stewart
    Center for Drug and Alcohol Programs, Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina 29425, USA
    J Hosp Med 2:372-7. 2007
    ..This study evaluated the correlations of readiness to change drinking behavior with perceived physical and mental health status and specific alcohol-related consequences of medical inpatients...
  10. pmc Phosphatidylethanol and alcohol consumption in reproductive age women
    Scott H Stewart
    Charleston Alcohol Research Center and Center for Drug and Alcohol Programs, Medical University of South Carolina, Charleston, South Carolina, USA
    Alcohol Clin Exp Res 34:488-92. 2010
    ..Biomarkers represent an alternative method for assessing alcohol use, and this study evaluated the relationship between blood phosphatidylethanol (PEth) and alcohol use in a sample of reproductive age women...