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Clites BL, Hofmann HA, Pierce JT. The Promise of an Evolutionary Perspective of Alcohol Consumption. Neurosci Insights 2023; 18:26331055231163589. [PMID: 37051560 PMCID: PMC10084549 DOI: 10.1177/26331055231163589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 02/27/2023] [Indexed: 04/07/2023] Open
Abstract
The urgent need for medical treatments of alcohol use disorders has motivated the search for novel molecular targets of alcohol response. Most studies exploit the strengths of lab animals without considering how these and other species may have adapted to respond to alcohol in an ecological context. Here, we provide an evolutionary perspective on the molecular and genetic underpinnings of alcohol consumption by reviewing evidence that alcohol metabolic enzymes have undergone adaptive evolution at 2 evolutionary junctures: first, to enable alcohol consumption accompanying the advent of a frugivorous diet in a primate ancestor, and second, to decrease the likelihood of excessive alcohol consumption concurrent with the spread of agriculture and fermentation in East Asia. By similarly considering how diverse vertebrate and invertebrate species have undergone natural selection for alcohol responses, novel conserved molecular targets of alcohol are likely be discovered that may represent promising therapeutic targets.
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Affiliation(s)
- Benjamin L Clites
- Department of Neuroscience, University of Texas at Austin, Austin, TX, USA
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA
- Institute for Cellular & Molecular Biology, University of Texas at Austin, Austin, TX, USA
- Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA
| | - Hans A Hofmann
- Institute for Cellular & Molecular Biology, University of Texas at Austin, Austin, TX, USA
- Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA
- Department of Integrative Biology, University of Texas at Austin, Austin, TX, USA
| | - Jonathan T Pierce
- Department of Neuroscience, University of Texas at Austin, Austin, TX, USA
- Waggoner Center for Alcohol and Addiction Research, University of Texas at Austin, Austin, TX, USA
- Institute for Cellular & Molecular Biology, University of Texas at Austin, Austin, TX, USA
- Institute for Neuroscience, University of Texas at Austin, Austin, TX, USA
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Metz VE, Leibowitz A, Satre DD, Parthasarathy S, Jackson-Morris M, Cocohoba J, Sterling SA. Effectiveness of a pharmacist-delivered primary care telemedicine intervention to increase access to pharmacotherapy and specialty treatment for alcohol use problems: Protocol for the alcohol telemedicine consult cluster-randomized pragmatic trial. Contemp Clin Trials 2022; 123:107004. [PMID: 36379437 PMCID: PMC9729439 DOI: 10.1016/j.cct.2022.107004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Alcohol use problems are associated with serious medical, mental health and socio-economic consequences. Yet even when patients are identified in healthcare settings, most do not receive treatment, and use of pharmacotherapy is rare. This study will test the effectiveness of the Alcohol Telemedicine Consult (ATC) Service, a novel, personalized telehealth intervention approach for primary care patients with alcohol use problems. METHODS This cluster-randomized pragmatic trial, supplemented by qualitative interviews, will include adults with a primary care visit between 9/10/21-3/10/23 from 16 primary care clinics at two large urban medical centers within Kaiser Permanente Northern California, a large, integrated healthcare system. Clinics are randomized to the ATC Service (intervention), including alcohol pharmacotherapy and SBIRT (screening, MI (Motivational Interviewing)-based brief intervention and referral to addiction treatment) delivered by clinical pharmacists, or the Usual Care (UC) arm that provides systematic alcohol SBIRT. Primary outcomes include a comparison of the ATC and UC arms on 1) implementation outcomes (alcohol pharmacotherapy prescription rates, specialty addiction treatment referrals); and 2) patient outcomes (medication fills, addiction treatment initiation, alcohol use, healthcare services utilization) over 1.5 years. A general modeling approach will consider clustering of patients/providers, and a random effects model will account for intra-class correlations across patients within providers and across clinics. Qualitative interviews with providers will examine barriers and facilitators to implementation. DISCUSSION The ATC study examines the effectiveness of a pharmacist-provided telehealth intervention that combines pharmacotherapy and MI-based consultation. If effective, the ATC study could affect treatment models across the spectrum of alcohol use problems. CLINICAL TRIALS REGISTRATION This study has been registered on ClinicalTrials.gov (NCT05252221).
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Affiliation(s)
- Verena E Metz
- Kaiser Permanente Northern California Division of Research, Center for Addiction and Mental Health Research, 2000 Broadway, Oakland 94612, CA, USA.
| | - Amy Leibowitz
- Kaiser Permanente Northern California Division of Research, Center for Addiction and Mental Health Research, 2000 Broadway, Oakland 94612, CA, USA
| | - Derek D Satre
- Kaiser Permanente Northern California Division of Research, Center for Addiction and Mental Health Research, 2000 Broadway, Oakland 94612, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco 94107, CA, USA
| | - Sujaya Parthasarathy
- Kaiser Permanente Northern California Division of Research, Center for Addiction and Mental Health Research, 2000 Broadway, Oakland 94612, CA, USA
| | - Melanie Jackson-Morris
- Kaiser Permanente Northern California Division of Research, Center for Addiction and Mental Health Research, 2000 Broadway, Oakland 94612, CA, USA
| | - Jennifer Cocohoba
- School of Pharmacy, University of California, San Francisco, 521 Parnassus Avenue, San Francisco 94117, CA, USA
| | - Stacy A Sterling
- Kaiser Permanente Northern California Division of Research, Center for Addiction and Mental Health Research, 2000 Broadway, Oakland 94612, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco 94107, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, 98 South Los Robles Avenue, Pasadena 91101, CA, USA.
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Jewett DC, Liyanagamage DSNK, Avond MAV, Anderson MAB, Twaroski KA, Marek MA, James KF, Pal T, Klockars A, Olszewski PK, Levine AS. Chronic Intermittent Sucrose Consumption Facilitates the Ability to Discriminate Opioid Receptor Blockade with Naltrexone in Rats. Nutrients 2022; 14:nu14050926. [PMID: 35267900 PMCID: PMC8912831 DOI: 10.3390/nu14050926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 12/20/2022] Open
Abstract
The opioid antagonist naltrexone (NTX) decreases intake of preferred diets in rats at very low doses relative to doses needed to decrease intake of "bland" laboratory chow. In the absence of an opioid agonist, NTX is not discriminable using operant techniques. In the current study, we found that rats given intermittent access to a 25% sucrose solution learned to discriminate between various naltrexone doses and saline. None of the rats given only water learned to discriminate between naltrexone and saline. When access to the sucrose solution was discontinued for 14 days, the rats lost the ability to discriminate between NTX and saline. We also studied the changes of c-Fos IR in selected brain regions in rats treated with saline versus NTX that were drinking water or 25% sucrose. An injection of NTX or saline resulted in a significant drug, diet, and interaction effect in various brain regions associated with feeding behavior, particularly the amygdala, accumbens, and hypothalamic sites. Thus, we found that ingestion of a sucrose solution results in the ability of rats to reliably discriminate naltrexone administration. In addition, sucrose and naltrexone altered c-Fos IR in an interactive fashion in brain regions known to be involved in ingestion behavior.
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Affiliation(s)
- David C. Jewett
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (D.C.J.); (M.A.V.A.); (M.A.B.A.); (K.A.T.); (M.A.M.); (K.F.J.)
| | - Donisha S. N. K. Liyanagamage
- Faculty of Science and Engineering, University of Waikato, Hamilton 3240, New Zealand; (D.S.N.K.L.); (T.P.); (A.K.); (P.K.O.)
| | - Mark A. Vanden Avond
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (D.C.J.); (M.A.V.A.); (M.A.B.A.); (K.A.T.); (M.A.M.); (K.F.J.)
| | - Molly A. B. Anderson
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (D.C.J.); (M.A.V.A.); (M.A.B.A.); (K.A.T.); (M.A.M.); (K.F.J.)
| | - Kyleigh A. Twaroski
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (D.C.J.); (M.A.V.A.); (M.A.B.A.); (K.A.T.); (M.A.M.); (K.F.J.)
| | - Morgan A. Marek
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (D.C.J.); (M.A.V.A.); (M.A.B.A.); (K.A.T.); (M.A.M.); (K.F.J.)
| | - Kimberly F. James
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, WI 54701, USA; (D.C.J.); (M.A.V.A.); (M.A.B.A.); (K.A.T.); (M.A.M.); (K.F.J.)
| | - Tapasya Pal
- Faculty of Science and Engineering, University of Waikato, Hamilton 3240, New Zealand; (D.S.N.K.L.); (T.P.); (A.K.); (P.K.O.)
| | - Anica Klockars
- Faculty of Science and Engineering, University of Waikato, Hamilton 3240, New Zealand; (D.S.N.K.L.); (T.P.); (A.K.); (P.K.O.)
| | - Pawel K. Olszewski
- Faculty of Science and Engineering, University of Waikato, Hamilton 3240, New Zealand; (D.S.N.K.L.); (T.P.); (A.K.); (P.K.O.)
- Department of Integrative Biology and Physiology, Medical School, University of Minnesota, Minneapolis, MN 55414, USA
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108, USA
| | - Allen S. Levine
- Department of Food Science and Nutrition, University of Minnesota, St. Paul, MN 55108, USA
- Correspondence:
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