Colder, Darker Climates Increase Alcohol Consumption and Liver Disease

Where you live could influence how much you drink. According to new research from the University of Pittsburgh Division of Gastroenterology, people living in colder regions with less sunlight drink more alcohol than their warm-weather counterparts.

The study, recently published online in Hepatology, found that as temperature and sunlight hours dropped, alcohol consumption increased. Climate factors also were tied to binge drinking and the prevalence of alcoholic liver disease, one of the main causes of mortality in patients with prolonged excessive alcohol use.

“It’s something that everyone has assumed for decades, but no one has scientifically demonstrated it. Why do people in Russia drink so much? Why in Wisconsin? Everybody assumes that’s because it’s cold,” said senior author Ramon Bataller, M.D., Ph.D., chief of hepatology at UPMC, professor of medicine at Pitt, and associate director of the Pittsburgh Liver Research Center. “But we couldn’t find a single paper linking climate to alcoholic intake or alcoholic cirrhosis. This is the first study that systematically demonstrates that worldwide and in America, in colder areas and areas with less sun, you have more drinking and more alcoholic cirrhosis.”

Alcohol is a vasodilator — it increases the flow of warm blood to the skin, which is full of temperature sensors — so drinking can increase feelings of warmth. In Siberia that could be pleasant, but not so much in the Sahara.

Drinking also is linked to depression, which tends to be worse when sunlight is scarce and there’s a chill in the air.

Using data from the World Health Organization, the World Meteorological Organization and other large, public data sets, Bataller’s group found a clear negative correlation between climate factors — average temperature and sunlight hours — and alcohol consumption, measured as total alcohol intake per capita, percent of the population that drinks alcohol, and the incidence of binge drinking.

The researchers also found evidence that climate contributed to a higher burden of alcoholic liver disease. These trends were true both when comparing across countries around the world and also when comparing across counties within the United States.

“It’s important to highlight the many confounding factors,” said lead author Meritxell Ventura-Cots, Ph.D., a postdoctoral researcher at the Pittsburgh Liver Research Center. “We tried to control for as many as we could. For instance, we tried to control for religion and how that influences alcohol habits.”

With much of the desert-dwelling Arab world abstaining from alcohol, it was critical to verify that the results would hold up even when excluding these Muslim-majority countries. Likewise, within the U.S., Utah has regulations that limit alcohol intake, which have to be taken into account.

When looking for patterns of cirrhosis, the researchers had to control for health factors that might exacerbate the effects of alcohol on the liver — like viral hepatitis, obesity and smoking.

In addition to settling an age-old debate, this research suggests that policy initiatives aimed at reducing the burden of alcoholism and alcoholic liver disease should target geographic areas where alcohol is more likely to be problematic.

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Materials provided by University of Pittsburgh Schools of the Health SciencesNote: Content may be edited for style and length.

Citation of page: University of Pittsburgh Schools of the Health Sciences. “Colder, darker climates increase alcohol consumption and liver disease.” ScienceDaily. ScienceDaily, 14 November 2018. <www.sciencedaily.com/releases/2018/11/181114080917.htm>.

Original article here.

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New Analysis Examines the Importance of Location in the Opioid Crisis

An age-old problem lies at the center of the opioid crisis. Is it driven by people seeking escape or relief — by a demand for drugs? Or instead, are poor prescribing practices and a cheap heroin supply responsible?

Of course, the answer is a mix of both. But to chip away at that puzzle, a team of researchers including Stanford economist Matthew Gentzkow, PhD, and MIT’s Amy Finkelstein, PhD, and Heidi Williams, PhD, a visiting professor at Stanford, has examined the role of migration in the use of opioids.

The thought was they could control for personal factors (i.e. mental health, education level, family support) by following individuals as they moved. And they found that indeed, community-level factors, such as the local availability of prescription opioids, are important and individuals are more likely  to abuse opioids if they move to a county where the opioid abuse rate is higher than at their previous home.

Both supply and demand are clearly important, Gentzkow explained in the piece. “Our results suggest that supply-side would account for about 30 percent of what’s different and the individual circumstances would account for about 70 percent,” Gentzkow says in a recent Stanford Institute for Economic Policy Research article.

The article explains:

“Their migration analysis is based on the data of a random sample of 1.5 million recipients of the Supplemental Security Disability Insurance enrolled in Medicare Part D, the federal prescription drug benefit program, from 2006 to 2014…

A main finding cited in the study: When individuals move to a county where the rate of opioid abuse is 20 percent higher than from where they moved, a migrant’s rate of abuse increases by 6 percent.

The extent of that jump suggests that 30 percent of the difference in abuse can be tied to place, according to their calculations.”

The research suggests that policies to control the supply of opioids are a key part of an overall strategy to rein in the epidemic.

“The magnitude of the opioid crisis is simply staggering, and trying to make progress on understanding the underlying causes of the crisis is — or should be — on the ‘wish list’ of many researchers,” Williams says in the article.

Original article here on scopeblog.stanford.edu/.

Stanford Medicine