The short of it: Exposure to things normally associated with your alcohol intake
("alcohol cue exposure") without actual alcohol intake taking place
significantly decreases cravings and relapses when done repeatedly. This works
as a therapy procedure that is effective alone and is likely to be a valuable
complement to more traditional approaches like coping skills training or group
support network (like AA).

A typical session of "extinguishing conditioned response to alcohol cues" is
based on a classic Pavlovian model (see
http://www.ucs.louisiana.edu/~cgc2646/LRN/Chap2.html and
http://www.as.wvu.edu/~sbb/comm221/chapters/pavlov.htm , for example) goes like
this:

Take one drink in the ideal surrounding - your favorite kind, in your favorite
glass with your favorite music in the background. (This is "priming" - the drug
can be a cue for itself; effects of the first drink are associated with the
subsequent drinks; I imagine priming is not included for those with the goal
of total abstinence). Then you are served another, identical drink and you are
urged to refuse it. Refusing at this point is essential. If you succeed and do
this kind of thing (preferably incorporating all kind of cue associated for you
with alcohol) many times, eventually you’ll have no urges to drink when exposed
to the cues.

I suppose it can be said that there is nothing new to it - one can describe this
procedure as an act of "training the will", "acquiring strength by resisting
temptation", etc. Doesn’t matter as long as it works. And it seems to work
equally well for those with the goal of abstinence and those with the goal of
moderation.

Here are some references:

http://www.niaaa.nih.gov/publication...-2/107-115.pdf
(Somewhat outdated but not too "scientific").


Siegel S. Ramos BM.
Department of Psychology, McMaster University, Hamilton, Ontario, Canada.
siegel@mcmaster.ca
Applying laboratory research: drug anticipation and the treatment of drug
addiction. [Review] [175 refs]
Experimental & Clinical Psychopharmacology. 10(3):162-83, 2002 Aug.
Abstract
Basic research concerning drug tolerance and withdrawal may inform clinical
practice, and vice versa. Three areas that integrate the work of the laboratory
and the clinic are discussed: (a) drug overdose, (b) cue exposure treatment of
addiction, and (c) pharmacological treatment of withdrawal symptoms. The areas
are related in that they indicate the contribution of drug-paired cues to the
effects of addictive drugs and the role of Pavlovian conditioning of drug
effects in drug tolerance and withdrawal symptoms. [References: 175]
[GREAT REVIEW!]


Dawe S. Rees VW. Mattick R. Sitharthan T. Heather N.
School of Applied Psychology, Griffith University, Brisbane, Queensland,
Australia. s.dawe@mailbox.gu.edu.au
Efficacy of moderation-oriented cue exposure for problem drinkers: a randomized
controlled trial.
Journal of Consulting & Clinical Psychology. 70(4):1045-50, 2002 Aug.
Abstract
The effectiveness of cue exposure following a priming dose was compared with
cognitive-behavioral intervention in a community sample of problem drinkers.
Participants were randomly allocated to 1 of the 2 conditions and received a
mean of 5.84 (SD = 2.69) sessions. A psychologist blind to treatment condition
conducted an 8-month follow-up. Compared with pretreatment levels, significant
decreases in alcohol consumption were evident posttreatment and maintained at
follow-up for both groups. Reductions in severity of dependence, impaired
control, and alcohol-related problems were also evident for both groups at
follow-up. No differences in outcome associated with initial severity of alcohol
dependence were apparent. The results raise the issue of the appropriateness of
reserving a goal of controlled drinking for those with relatively mild alcohol
problems and low alcohol dependence.


Heather N. Brodie J. Wale S. Wilkinson G. Luce A. Webb E. McCarthy S.
Centre for Alcohol and Drug Studies, Newcastle City Health NHS Trust, Newcastle
upon Tyne, United Kingdom.
A randomized controlled trial of Moderation-Oriented Cue Exposure.
Journal of Studies on Alcohol. 61(4):561-70, 2000 Jul.
Abstract
OBJECTIVE: A randomized controlled trial was conducted to examine the
effectiveness of Moderation-Oriented Cue Exposure (MOCE) in comparison to
Behavioral Self-Control Training (BSCT). The main hypothesis was that MOCE would
be more effective than BSCT among a sample of problem drinkers aiming at
moderate drinking. A subsidiary hypothesis was that MOCE would be relatively
more effective than BSCT among problem drinkers with higher levels of alcohol
dependence. METHOD: Clients (N = 91; 75% men) were randomly allocated to either
MOCE or BSCT. Treatment was delivered in weekly sessions by two trained
therapists, in a nested design in which therapists switched to the alternative
treatment modality approximately halfway through the trial. Follow-up was
carried out 6 months following posttreatment assessment, with 85% successful
contact. RESULTS: There was no evidence for the general superiority of MOCE over
BSCT. The subsidiary hypothesis was not confirmed. A subsample of clients (n =
14) showing levels of dependence at baseline above the commonly accepted
cut-point for a moderation goal (Severity of Alcohol Dependence Questionnaire
[SADQ] > 29) showed outcomes at least as favorable as those below the cut-point.
The validity of self-reports of alcohol consumption and problems was supported
by significant relationships with liver function tests (gamma-glutamyl
transferase and alanine transferase). CONCLUSIONS: These results provide no
grounds for the replacement of BSCT by MOCE in routine, moderation-oriented
treatment practice. Assuming they prefer it to abstinence and that it is not
contra-indicated on other grounds, there seems no reason why clients showing a
higher level of dependence (SADQ = 30-45) should not be offered a moderation
goal.


Havermans RC. Jansen AT.
University of Maastricht, Maastricht, The Netherlands.
r.havermans@psychology.unimaas.nl
Increasing the efficacy of cue exposure treatment in preventing relapse of
addictive behavior.
Addictive Behaviors. 28(5):989-94, 2003 Jul.
Abstract
Theoretically, cue exposure treatment should be able to prevent relapse by
extinguishing conditioned drug responding (e.g. cue-elicited craving). According
to contemporary learning theory, though, extinction does not eliminate
conditioned responding. Analogous cue exposure with response prevention (CERP)
as a treatment of addictive behavior might not eliminate the learned relation
between drug-related cues and drug use. This does not necessarily mean that cue
exposure cannot successfully prevent relapse. Various suggestions for increasing
the efficacy of cue exposure treatment are being discussed from a contemporary
learning theory perspective. It is suggested that cue exposure treatment
incorporating retrieval cues can be a beneficial treatment in preventing relapse
of addictive behavior.

Monti PM. Rohsenow DJ. Swift RM. Gulliver SB. Colby SM. Mueller TI. Brown RA.
Gordon A. Abrams DB. Niaura RS. Asher MK.
Providence VA Medical Center, and the Center for Alcohol and Addiction Studies,
Brown University, Providence, Rhode Island 02912, USA. peter_monti@brown.edu
Naltrexone and cue exposure with coping and communication skills training for
alcoholics: treatment process and 1-year outcomes.
Alcoholism: Clinical & Experimental Research. 25(11):1634-47, 2001 Nov.
Abstract
BACKGROUND: Promising treatments for alcoholics include naltrexone (NTX), cue
exposure combined with urge-specific coping skills training (CET), and
communication skills training (CST). This study investigated the effects of
combining these elements as treatment adjuncts. METHODS: A 2 x 2 design
investigated the effects of CET combined with CST, as compared with an education
and relaxation control treatment, during a 2-week partial hospital program (n =
165) followed by 12 weeks of NTX (50 mg/day) or placebo during aftercare (n =
128). Drinking outcomes were assessed at 3, 6, and 12 months after discharge
from the partial hospital. Process measures included urge, self-efficacy
(confidence about staying abstinent in risky situations), and self-reported
coping skills. Medically eligible alcohol-dependent patients were recruited.
RESULTS: Among those compliant with medication on at least 70% of days, those
who received NTX had significantly fewer heavy drinking days and fewer drinks on
days that they drank than those receiving placebo during the medication phase
but not during the subsequent 9 months. CET/CST-condition patients were
significantly less likely to report a relapse day and reported fewer heavy
drinking days at the 6- and 12-month follow-ups than patients in the control
treatment. Interactions of medication with behavioral treatments were not
significant. Process measures showed that NTX resulted in lower weekly urge
ratings, and those in CET/CST used more of the prescribed coping skills after
treatment, reported fewer cue-elicited urges, and reported more self-efficacy in
a posttest role-play test. Drinking reductions at 3, 6, and 12 months correlated
with more use of coping skills, lower urge, and higher self-efficacy.
CONCLUSIONS: The results suggest the probable value of keeping alcoholics on NTX
for longer periods of time and the importance of increasing compliance with NTX.
They also support the earlier promising effects of CET and CST as adjuncts to
treatment programs for alcoholics by maintaining treatment gains over at least a
year. The value of the urge-specific and general coping skills and of
self-efficacy and urge constructs was demonstrated in their association with
drinking outcomes.


Sitharthan T. Sitharthan G. Hough MJ. Kavanagh DJ.
Western Sydney Area Drug and Alcohol Services, University of Sydney, Australia.
Cue exposure in moderation drinking: a comparison with cognitive-behavior
therapy.
Journal of Consulting & Clinical Psychology. 65(5):878-82, 1997 Oct.
Abstract
To date, the published controlled trials on exposure to alcohol cues have had an
abstinence treatment goal. A modification of cue exposure (CE) for moderation
drinking, which incorporated priming doses of alcohol, could train participants
to stop drinking after 2 to 3 drinks. This study examined the effects of
modified CE within sessions, combined with directed homework practice.
Nondependent problem drinkers who requested a moderation drinking goal were
randomly allocated to modified CE or standard cognitive-behavior therapy (CBT)
for alcohol abuse. Both interventions were delivered in 6 90-min group sessions.
Eighty-one percent of eligible participants completed treatment and follow-up
assessment. Over 6 months, CE produced significantly greater reductions than CBT
in participants' reports of drinking frequency and consumption on each occasion.
No pretreatment variables significantly predicted outcome. The modified CE
procedure appears viable for nondependent drinkers who want to adopt a moderate
drinking goal.

---------------------------
HP-G

'Scuse me! That's a very old therapy that's been tested by all alcoholics.
In fact, I think we invented it. Never knew anybody it worked for.
However, it's a wonderful, scientific rationalization for getting drunk.
Unfortunately, the results are always the same. Many have died testing that
approach. Linda



"H.P. Gawd" <hpgawd@non-anonymous.org> wrote in message
news:g8g1g0t7lnf918eavsgvtgemd7068gql7d@4ax.com...
> The short of it: Exposure to things normally associated with your alcohol
intake
> ("alcohol cue exposure") without actual alcohol intake taking place
> significantly decreases cravings and relapses when done repeatedly. This
works
> as a therapy procedure that is effective alone and is likely to be a
valuable
> complement to more traditional approaches like coping skills training or
group
> support network (like AA).
>
> A typical session of "extinguishing conditioned response to alcohol cues"
is
> based on a classic Pavlovian model (see
> http://www.ucs.louisiana.edu/~cgc2646/LRN/Chap2.html and
> http://www.as.wvu.edu/~sbb/comm221/chapters/pavlov.htm , for example) goes
like
> this:
>
> Take one drink in the ideal surrounding - your favorite kind, in your
favorite
> glass with your favorite music in the background. (This is "priming" - the
drug
> can be a cue for itself; effects of the first drink are associated with
the
> subsequent drinks; I imagine priming is not included for those with the
goal
> of total abstinence). Then you are served another, identical drink and you
are
> urged to refuse it. Refusing at this point is essential. If you succeed
and do
> this kind of thing (preferably incorporating all kind of cue associated
for you
> with alcohol) many times, eventually you'll have no urges to drink when
exposed
> to the cues.
>
> I suppose it can be said that there is nothing new to it - one can
describe this
> procedure as an act of "training the will", "acquiring strength by
resisting
> temptation", etc. Doesn't matter as long as it works. And it seems to work
> equally well for those with the goal of abstinence and those with the goal
of
> moderation.
>
> Here are some references:
>
> http://www.niaaa.nih.gov/publication...-2/107-115.pdf
> (Somewhat outdated but not too "scientific").
>
>
> Siegel S. Ramos BM.
> Department of Psychology, McMaster University, Hamilton, Ontario, Canada.
> siegel@mcmaster.ca
> Applying laboratory research: drug anticipation and the treatment of drug
> addiction. [Review] [175 refs]
> Experimental & Clinical Psychopharmacology. 10(3):162-83, 2002 Aug.
> Abstract
> Basic research concerning drug tolerance and withdrawal may inform
clinical
> practice, and vice versa. Three areas that integrate the work of the
laboratory
> and the clinic are discussed: (a) drug overdose, (b) cue exposure
treatment of
> addiction, and (c) pharmacological treatment of withdrawal symptoms. The
areas
> are related in that they indicate the contribution of drug-paired cues to
the
> effects of addictive drugs and the role of Pavlovian conditioning of drug
> effects in drug tolerance and withdrawal symptoms. [References: 175]
> [GREAT REVIEW!]
>
>
> Dawe S. Rees VW. Mattick R. Sitharthan T. Heather N.
> School of Applied Psychology, Griffith University, Brisbane, Queensland,
> Australia. s.dawe@mailbox.gu.edu.au
> Efficacy of moderation-oriented cue exposure for problem drinkers: a
randomized
> controlled trial.
> Journal of Consulting & Clinical Psychology. 70(4):1045-50, 2002 Aug.
> Abstract
> The effectiveness of cue exposure following a priming dose was compared
with
> cognitive-behavioral intervention in a community sample of problem
drinkers.
> Participants were randomly allocated to 1 of the 2 conditions and received
a
> mean of 5.84 (SD = 2.69) sessions. A psychologist blind to treatment
condition
> conducted an 8-month follow-up. Compared with pretreatment levels,
significant
> decreases in alcohol consumption were evident posttreatment and maintained
at
> follow-up for both groups. Reductions in severity of dependence, impaired
> control, and alcohol-related problems were also evident for both groups at
> follow-up. No differences in outcome associated with initial severity of
alcohol
> dependence were apparent. The results raise the issue of the
appropriateness of
> reserving a goal of controlled drinking for those with relatively mild
alcohol
> problems and low alcohol dependence.
>
>
> Heather N. Brodie J. Wale S. Wilkinson G. Luce A. Webb E. McCarthy S.
> Centre for Alcohol and Drug Studies, Newcastle City Health NHS Trust,
Newcastle
> upon Tyne, United Kingdom.
> A randomized controlled trial of Moderation-Oriented Cue Exposure.
> Journal of Studies on Alcohol. 61(4):561-70, 2000 Jul.
> Abstract
> OBJECTIVE: A randomized controlled trial was conducted to examine the
> effectiveness of Moderation-Oriented Cue Exposure (MOCE) in comparison to
> Behavioral Self-Control Training (BSCT). The main hypothesis was that MOCE
would
> be more effective than BSCT among a sample of problem drinkers aiming at
> moderate drinking. A subsidiary hypothesis was that MOCE would be
relatively
> more effective than BSCT among problem drinkers with higher levels of
alcohol
> dependence. METHOD: Clients (N = 91; 75% men) were randomly allocated to
either
> MOCE or BSCT. Treatment was delivered in weekly sessions by two trained
> therapists, in a nested design in which therapists switched to the
alternative
> treatment modality approximately halfway through the trial. Follow-up was
> carried out 6 months following posttreatment assessment, with 85%
successful
> contact. RESULTS: There was no evidence for the general superiority of
MOCE over
> BSCT. The subsidiary hypothesis was not confirmed. A subsample of clients
(n =
> 14) showing levels of dependence at baseline above the commonly accepted
> cut-point for a moderation goal (Severity of Alcohol Dependence
Questionnaire
> [SADQ] > 29) showed outcomes at least as favorable as those below the
cut-point.
> The validity of self-reports of alcohol consumption and problems was
supported
> by significant relationships with liver function tests (gamma-glutamyl
> transferase and alanine transferase). CONCLUSIONS: These results provide
no
> grounds for the replacement of BSCT by MOCE in routine,
moderation-oriented
> treatment practice. Assuming they prefer it to abstinence and that it is
not
> contra-indicated on other grounds, there seems no reason why clients
showing a
> higher level of dependence (SADQ = 30-45) should not be offered a
moderation
> goal.
>
>
> Havermans RC. Jansen AT.
> University of Maastricht, Maastricht, The Netherlands.
> r.havermans@psychology.unimaas.nl
> Increasing the efficacy of cue exposure treatment in preventing relapse of
> addictive behavior.
> Addictive Behaviors. 28(5):989-94, 2003 Jul.
> Abstract
> Theoretically, cue exposure treatment should be able to prevent relapse by
> extinguishing conditioned drug responding (e.g. cue-elicited craving).
According
> to contemporary learning theory, though, extinction does not eliminate
> conditioned responding. Analogous cue exposure with response prevention
(CERP)
> as a treatment of addictive behavior might not eliminate the learned
relation
> between drug-related cues and drug use. This does not necessarily mean
that cue
> exposure cannot successfully prevent relapse. Various suggestions for
increasing
> the efficacy of cue exposure treatment are being discussed from a
contemporary
> learning theory perspective. It is suggested that cue exposure treatment
> incorporating retrieval cues can be a beneficial treatment in preventing
relapse
> of addictive behavior.
>
> Monti PM. Rohsenow DJ. Swift RM. Gulliver SB. Colby SM. Mueller TI. Brown
RA.
> Gordon A. Abrams DB. Niaura RS. Asher MK.
> Providence VA Medical Center, and the Center for Alcohol and Addiction
Studies,
> Brown University, Providence, Rhode Island 02912, USA.
peter_monti@brown.edu
> Naltrexone and cue exposure with coping and communication skills training
for
> alcoholics: treatment process and 1-year outcomes.
> Alcoholism: Clinical & Experimental Research. 25(11):1634-47, 2001 Nov.
> Abstract
> BACKGROUND: Promising treatments for alcoholics include naltrexone (NTX),
cue
> exposure combined with urge-specific coping skills training (CET), and
> communication skills training (CST). This study investigated the effects
of
> combining these elements as treatment adjuncts. METHODS: A 2 x 2 design
> investigated the effects of CET combined with CST, as compared with an
education
> and relaxation control treatment, during a 2-week partial hospital program
(n =
> 165) followed by 12 weeks of NTX (50 mg/day) or placebo during aftercare
(n =
> 128). Drinking outcomes were assessed at 3, 6, and 12 months after
discharge
> from the partial hospital. Process measures included urge, self-efficacy
> (confidence about staying abstinent in risky situations), and
self-reported
> coping skills. Medically eligible alcohol-dependent patients were
recruited.
> RESULTS: Among those compliant with medication on at least 70% of days,
those
> who received NTX had significantly fewer heavy drinking days and fewer
drinks on
> days that they drank than those receiving placebo during the medication
phase
> but not during the subsequent 9 months. CET/CST-condition patients were
> significantly less likely to report a relapse day and reported fewer heavy
> drinking days at the 6- and 12-month follow-ups than patients in the
control
> treatment. Interactions of medication with behavioral treatments were not
> significant. Process measures showed that NTX resulted in lower weekly
urge
> ratings, and those in CET/CST used more of the prescribed coping skills
after
> treatment, reported fewer cue-elicited urges, and reported more
self-efficacy in
> a posttest role-play test. Drinking reductions at 3, 6, and 12 months
correlated
> with more use of coping skills, lower urge, and higher self-efficacy.
> CONCLUSIONS: The results suggest the probable value of keeping alcoholics
on NTX
> for longer periods of time and the importance of increasing compliance
with NTX.
> They also support the earlier promising effects of CET and CST as adjuncts
to
> treatment programs for alcoholics by maintaining treatment gains over at
least a
> year. The value of the urge-specific and general coping skills and of
> self-efficacy and urge constructs was demonstrated in their association
with
> drinking outcomes.
>
>
> Sitharthan T. Sitharthan G. Hough MJ. Kavanagh DJ.
> Western Sydney Area Drug and Alcohol Services, University of Sydney,
Australia.
> Cue exposure in moderation drinking: a comparison with cognitive-behavior
> therapy.
> Journal of Consulting & Clinical Psychology. 65(5):878-82, 1997 Oct.
> Abstract
> To date, the published controlled trials on exposure to alcohol cues have
had an
> abstinence treatment goal. A modification of cue exposure (CE) for
moderation
> drinking, which incorporated priming doses of alcohol, could train
participants
> to stop drinking after 2 to 3 drinks. This study examined the effects of
> modified CE within sessions, combined with directed homework practice.
> Nondependent problem drinkers who requested a moderation drinking goal
were
> randomly allocated to modified CE or standard cognitive-behavior therapy
(CBT)
> for alcohol abuse. Both interventions were delivered in 6 90-min group
sessions.
> Eighty-one percent of eligible participants completed treatment and
follow-up
> assessment. Over 6 months, CE produced significantly greater reductions
than CBT
> in participants' reports of drinking frequency and consumption on each
occasion.
> No pretreatment variables significantly predicted outcome. The modified CE
> procedure appears viable for nondependent drinkers who want to adopt a
moderate
> drinking goal.
>
> ---------------------------
> HP-G
>

On Fri, 23 Jul 2004 08:49:09 -0400, "Linda" <lodum@alltel.net> wrote:

>'Scuse me! That's a very old therapy that's been tested by all alcoholics.
>In fact, I think we invented it. Never knew anybody it worked for.

I am sure that if you never knew anybody it worked for then it
definitely means it does not. I am also sure that there is
a vast international conspiracy by medical professionals to
fool alcoholics and lure them into treatments that everyone
knows does not work. And I am sure that you definitely
know better than scores of people whose job is to try to
find better ways of helping alcoholics. Finally, I am sure
that those relapsing AA members need not to know about
alternative/complementary approaches that may help.

>However, it's a wonderful, scientific rationalization for getting drunk.
>Unfortunately, the results are always the same. Many have died testing that
>approach. Linda

Perhaps you can consider reading the messages you reply to.
Nobody's talking about "getting drunk".

HP-G


>
>"H.P. Gawd" <hpgawd@non-anonymous.org> wrote in message
>news:g8g1g0t7lnf918eavsgvtgemd7068gql7d@4ax.com.. .
>> The short of it: Exposure to things normally associated with your alcohol
>intake
>> ("alcohol cue exposure") without actual alcohol intake taking place
>> significantly decreases cravings and relapses when done repeatedly. This
>works
>> as a therapy procedure that is effective alone and is likely to be a
>valuable
>> complement to more traditional approaches like coping skills training or
>group
>> support network (like AA).
>>
>> A typical session of "extinguishing conditioned response to alcohol cues"
>is
>> based on a classic Pavlovian model (see
>> http://www.ucs.louisiana.edu/~cgc2646/LRN/Chap2.html and
>> http://www.as.wvu.edu/~sbb/comm221/chapters/pavlov.htm , for example) goes
>like
>> this:
>>
>> Take one drink in the ideal surrounding - your favorite kind, in your
>favorite
>> glass with your favorite music in the background. (This is "priming" - the
>drug
>> can be a cue for itself; effects of the first drink are associated with
>the
>> subsequent drinks; I imagine priming is not included for those with the
>goal
>> of total abstinence). Then you are served another, identical drink and you
>are
>> urged to refuse it. Refusing at this point is essential. If you succeed
>and do
>> this kind of thing (preferably incorporating all kind of cue associated
>for you
>> with alcohol) many times, eventually you'll have no urges to drink when
>exposed
>> to the cues.
>>
>> I suppose it can be said that there is nothing new to it - one can
>describe this
>> procedure as an act of "training the will", "acquiring strength by
>resisting
>> temptation", etc. Doesn't matter as long as it works. And it seems to work
>> equally well for those with the goal of abstinence and those with the goal
>of
>> moderation.
>>
>> Here are some references:
>>
>> http://www.niaaa.nih.gov/publication...-2/107-115.pdf
>> (Somewhat outdated but not too "scientific").
>>
>>
>> Siegel S. Ramos BM.
>> Department of Psychology, McMaster University, Hamilton, Ontario, Canada.
>> siegel@mcmaster.ca
>> Applying laboratory research: drug anticipation and the treatment of drug
>> addiction. [Review] [175 refs]
>> Experimental & Clinical Psychopharmacology. 10(3):162-83, 2002 Aug.
>> Abstract
>> Basic research concerning drug tolerance and withdrawal may inform
>clinical
>> practice, and vice versa. Three areas that integrate the work of the
>laboratory
>> and the clinic are discussed: (a) drug overdose, (b) cue exposure
>treatment of
>> addiction, and (c) pharmacological treatment of withdrawal symptoms. The
>areas
>> are related in that they indicate the contribution of drug-paired cues to
>the
>> effects of addictive drugs and the role of Pavlovian conditioning of drug
>> effects in drug tolerance and withdrawal symptoms. [References: 175]
>> [GREAT REVIEW!]
>>
>>
>> Dawe S. Rees VW. Mattick R. Sitharthan T. Heather N.
>> School of Applied Psychology, Griffith University, Brisbane, Queensland,
>> Australia. s.dawe@mailbox.gu.edu.au
>> Efficacy of moderation-oriented cue exposure for problem drinkers: a
>randomized
>> controlled trial.
>> Journal of Consulting & Clinical Psychology. 70(4):1045-50, 2002 Aug.
>> Abstract
>> The effectiveness of cue exposure following a priming dose was compared
>with
>> cognitive-behavioral intervention in a community sample of problem
>drinkers.
>> Participants were randomly allocated to 1 of the 2 conditions and received
>a
>> mean of 5.84 (SD = 2.69) sessions. A psychologist blind to treatment
>condition
>> conducted an 8-month follow-up. Compared with pretreatment levels,
>significant
>> decreases in alcohol consumption were evident posttreatment and maintained
>at
>> follow-up for both groups. Reductions in severity of dependence, impaired
>> control, and alcohol-related problems were also evident for both groups at
>> follow-up. No differences in outcome associated with initial severity of
>alcohol
>> dependence were apparent. The results raise the issue of the
>appropriateness of
>> reserving a goal of controlled drinking for those with relatively mild
>alcohol
>> problems and low alcohol dependence.
>>
>>
>> Heather N. Brodie J. Wale S. Wilkinson G. Luce A. Webb E. McCarthy S.
>> Centre for Alcohol and Drug Studies, Newcastle City Health NHS Trust,
>Newcastle
>> upon Tyne, United Kingdom.
>> A randomized controlled trial of Moderation-Oriented Cue Exposure.
>> Journal of Studies on Alcohol. 61(4):561-70, 2000 Jul.
>> Abstract
>> OBJECTIVE: A randomized controlled trial was conducted to examine the
>> effectiveness of Moderation-Oriented Cue Exposure (MOCE) in comparison to
>> Behavioral Self-Control Training (BSCT). The main hypothesis was that MOCE
>would
>> be more effective than BSCT among a sample of problem drinkers aiming at
>> moderate drinking. A subsidiary hypothesis was that MOCE would be
>relatively
>> more effective than BSCT among problem drinkers with higher levels of
>alcohol
>> dependence. METHOD: Clients (N = 91; 75% men) were randomly allocated to
>either
>> MOCE or BSCT. Treatment was delivered in weekly sessions by two trained
>> therapists, in a nested design in which therapists switched to the
>alternative
>> treatment modality approximately halfway through the trial. Follow-up was
>> carried out 6 months following posttreatment assessment, with 85%
>successful
>> contact. RESULTS: There was no evidence for the general superiority of
>MOCE over
>> BSCT. The subsidiary hypothesis was not confirmed. A subsample of clients
>(n =
>> 14) showing levels of dependence at baseline above the commonly accepted
>> cut-point for a moderation goal (Severity of Alcohol Dependence
>Questionnaire
>> [SADQ] > 29) showed outcomes at least as favorable as those below the
>cut-point.
>> The validity of self-reports of alcohol consumption and problems was
>supported
>> by significant relationships with liver function tests (gamma-glutamyl
>> transferase and alanine transferase). CONCLUSIONS: These results provide
>no
>> grounds for the replacement of BSCT by MOCE in routine,
>moderation-oriented
>> treatment practice. Assuming they prefer it to abstinence and that it is
>not
>> contra-indicated on other grounds, there seems no reason why clients
>showing a
>> higher level of dependence (SADQ = 30-45) should not be offered a
>moderation
>> goal.
>>
>>
>> Havermans RC. Jansen AT.
>> University of Maastricht, Maastricht, The Netherlands.
>> r.havermans@psychology.unimaas.nl
>> Increasing the efficacy of cue exposure treatment in preventing relapse of
>> addictive behavior.
>> Addictive Behaviors. 28(5):989-94, 2003 Jul.
>> Abstract
>> Theoretically, cue exposure treatment should be able to prevent relapse by
>> extinguishing conditioned drug responding (e.g. cue-elicited craving).
>According
>> to contemporary learning theory, though, extinction does not eliminate
>> conditioned responding. Analogous cue exposure with response prevention
>(CERP)
>> as a treatment of addictive behavior might not eliminate the learned
>relation
>> between drug-related cues and drug use. This does not necessarily mean
>that cue
>> exposure cannot successfully prevent relapse. Various suggestions for
>increasing
>> the efficacy of cue exposure treatment are being discussed from a
>contemporary
>> learning theory perspective. It is suggested that cue exposure treatment
>> incorporating retrieval cues can be a beneficial treatment in preventing
>relapse
>> of addictive behavior.
>>
>> Monti PM. Rohsenow DJ. Swift RM. Gulliver SB. Colby SM. Mueller TI. Brown
>RA.
>> Gordon A. Abrams DB. Niaura RS. Asher MK.
>> Providence VA Medical Center, and the Center for Alcohol and Addiction
>Studies,
>> Brown University, Providence, Rhode Island 02912, USA.
>peter_monti@brown.edu
>> Naltrexone and cue exposure with coping and communication skills training
>for
>> alcoholics: treatment process and 1-year outcomes.
>> Alcoholism: Clinical & Experimental Research. 25(11):1634-47, 2001 Nov.
>> Abstract
>> BACKGROUND: Promising treatments for alcoholics include naltrexone (NTX),
>cue
>> exposure combined with urge-specific coping skills training (CET), and
>> communication skills training (CST). This study investigated the effects
>of
>> combining these elements as treatment adjuncts. METHODS: A 2 x 2 design
>> investigated the effects of CET combined with CST, as compared with an
>education
>> and relaxation control treatment, during a 2-week partial hospital program
>(n =
>> 165) followed by 12 weeks of NTX (50 mg/day) or placebo during aftercare
>(n =
>> 128). Drinking outcomes were assessed at 3, 6, and 12 months after
>discharge
>> from the partial hospital. Process measures included urge, self-efficacy
>> (confidence about staying abstinent in risky situations), and
>self-reported
>> coping skills. Medically eligible alcohol-dependent patients were
>recruited.
>> RESULTS: Among those compliant with medication on at least 70% of days,
>those
>> who received NTX had significantly fewer heavy drinking days and fewer
>drinks on
>> days that they drank than those receiving placebo during the medication
>phase
>> but not during the subsequent 9 months. CET/CST-condition patients were
>> significantly less likely to report a relapse day and reported fewer heavy
>> drinking days at the 6- and 12-month follow-ups than patients in the
>control
>> treatment. Interactions of medication with behavioral treatments were not
>> significant. Process measures showed that NTX resulted in lower weekly
>urge
>> ratings, and those in CET/CST used more of the prescribed coping skills
>after
>> treatment, reported fewer cue-elicited urges, and reported more
>self-efficacy in
>> a posttest role-play test. Drinking reductions at 3, 6, and 12 months
>correlated
>> with more use of coping skills, lower urge, and higher self-efficacy.
>> CONCLUSIONS: The results suggest the probable value of keeping alcoholics
>on NTX
>> for longer periods of time and the importance of increasing compliance
>with NTX.
>> They also support the earlier promising effects of CET and CST as adjuncts
>to
>> treatment programs for alcoholics by maintaining treatment gains over at
>least a
>> year. The value of the urge-specific and general coping skills and of
>> self-efficacy and urge constructs was demonstrated in their association
>with
>> drinking outcomes.
>>
>>
>> Sitharthan T. Sitharthan G. Hough MJ. Kavanagh DJ.
>> Western Sydney Area Drug and Alcohol Services, University of Sydney,
>Australia.
>> Cue exposure in moderation drinking: a comparison with cognitive-behavior
>> therapy.
>> Journal of Consulting & Clinical Psychology. 65(5):878-82, 1997 Oct.
>> Abstract
>> To date, the published controlled trials on exposure to alcohol cues have
>had an
>> abstinence treatment goal. A modification of cue exposure (CE) for
>moderation
>> drinking, which incorporated priming doses of alcohol, could train
>participants
>> to stop drinking after 2 to 3 drinks. This study examined the effects of
>> modified CE within sessions, combined with directed homework practice.
>> Nondependent problem drinkers who requested a moderation drinking goal
>were
>> randomly allocated to modified CE or standard cognitive-behavior therapy
>(CBT)
>> for alcohol abuse. Both interventions were delivered in 6 90-min group
>sessions.
>> Eighty-one percent of eligible participants completed treatment and
>follow-up
>> assessment. Over 6 months, CE produced significantly greater reductions
>than CBT
>> in participants' reports of drinking frequency and consumption on each
>occasion.
>> No pretreatment variables significantly predicted outcome. The modified CE
>> procedure appears viable for nondependent drinkers who want to adopt a
>moderate
>> drinking goal.
>>
>> ---------------------------
>> HP-G
>>
>
>

"H.P. Gawd" <hpgawd@non-anonymous.org> wrote in message
news:g8g1g0t7lnf918eavsgvtgemd7068gql7d@4ax.com...
> The short of it: Exposure to things normally associated with your alcohol
intake
> ("alcohol cue exposure") without actual alcohol intake taking place
> significantly decreases cravings and relapses when done repeatedly. This
works
> as a therapy procedure that is effective alone and is likely to be a
valuable
> complement to more traditional approaches like coping skills training or
group
> support network (like AA).
>
> A typical session of "extinguishing conditioned response to alcohol cues"
is
> based on a classic Pavlovian model (see
> http://www.ucs.louisiana.edu/~cgc2646/LRN/Chap2.html and
> http://www.as.wvu.edu/~sbb/comm221/chapters/pavlov.htm , for example) goes
like
> this:
>
> Take one drink in the ideal surrounding - your favorite kind, in your
favorite
> glass with your favorite music in the background. (This is "priming" - the
drug
> can be a cue for itself; effects of the first drink are associated with
the
> subsequent drinks; I imagine priming is not included for those with the
goal
> of total abstinence). Then you are served another, identical drink and you
are
> urged to refuse it. Refusing at this point is essential. If you succeed
and do
> this kind of thing (preferably incorporating all kind of cue associated
for you
> with alcohol) many times, eventually you'll have no urges to drink when
exposed
> to the cues.
>
> I suppose it can be said that there is nothing new to it - one can
describe this
> procedure as an act of "training the will", "acquiring strength by
resisting
> temptation", etc. Doesn't matter as long as it works. And it seems to work
> equally well for those with the goal of abstinence and those with the goal
of
> moderation.
>
> Here are some references:
>
> http://www.niaaa.nih.gov/publication...-2/107-115.pdf
> (Somewhat outdated but not too "scientific").
>
>
> Siegel S. Ramos BM.
> Department of Psychology, McMaster University, Hamilton, Ontario, Canada.
> siegel@mcmaster.ca
> Applying laboratory research: drug anticipation and the treatment of drug
> addiction. [Review] [175 refs]
> Experimental & Clinical Psychopharmacology. 10(3):162-83, 2002 Aug.
> Abstract
> Basic research concerning drug tolerance and withdrawal may inform
clinical
> practice, and vice versa. Three areas that integrate the work of the
laboratory
> and the clinic are discussed: (a) drug overdose, (b) cue exposure
treatment of
> addiction, and (c) pharmacological treatment of withdrawal symptoms. The
areas
> are related in that they indicate the contribution of drug-paired cues to
the
> effects of addictive drugs and the role of Pavlovian conditioning of drug
> effects in drug tolerance and withdrawal symptoms. [References: 175]
> [GREAT REVIEW!]
>
>
> Dawe S. Rees VW. Mattick R. Sitharthan T. Heather N.
> School of Applied Psychology, Griffith University, Brisbane, Queensland,
> Australia. s.dawe@mailbox.gu.edu.au
> Efficacy of moderation-oriented cue exposure for problem drinkers: a
randomized
> controlled trial.
> Journal of Consulting & Clinical Psychology. 70(4):1045-50, 2002 Aug.
> Abstract
> The effectiveness of cue exposure following a priming dose was compared
with
> cognitive-behavioral intervention in a community sample of problem
drinkers.
> Participants were randomly allocated to 1 of the 2 conditions and received
a
> mean of 5.84 (SD = 2.69) sessions. A psychologist blind to treatment
condition
> conducted an 8-month follow-up. Compared with pretreatment levels,
significant
> decreases in alcohol consumption were evident posttreatment and maintained
at
> follow-up for both groups. Reductions in severity of dependence, impaired
> control, and alcohol-related problems were also evident for both groups at
> follow-up. No differences in outcome associated with initial severity of
alcohol
> dependence were apparent. The results raise the issue of the
appropriateness of
> reserving a goal of controlled drinking for those with relatively mild
alcohol
> problems and low alcohol dependence.
>
>
> Heather N. Brodie J. Wale S. Wilkinson G. Luce A. Webb E. McCarthy S.
> Centre for Alcohol and Drug Studies, Newcastle City Health NHS Trust,
Newcastle
> upon Tyne, United Kingdom.
> A randomized controlled trial of Moderation-Oriented Cue Exposure.
> Journal of Studies on Alcohol. 61(4):561-70, 2000 Jul.
> Abstract
> OBJECTIVE: A randomized controlled trial was conducted to examine the
> effectiveness of Moderation-Oriented Cue Exposure (MOCE) in comparison to
> Behavioral Self-Control Training (BSCT). The main hypothesis was that MOCE
would
> be more effective than BSCT among a sample of problem drinkers aiming at
> moderate drinking. A subsidiary hypothesis was that MOCE would be
relatively
> more effective than BSCT among problem drinkers with higher levels of
alcohol
> dependence. METHOD: Clients (N = 91; 75% men) were randomly allocated to
either
> MOCE or BSCT. Treatment was delivered in weekly sessions by two trained
> therapists, in a nested design in which therapists switched to the
alternative
> treatment modality approximately halfway through the trial. Follow-up was
> carried out 6 months following posttreatment assessment, with 85%
successful
> contact. RESULTS: There was no evidence for the general superiority of
MOCE over
> BSCT. The subsidiary hypothesis was not confirmed. A subsample of clients
(n =
> 14) showing levels of dependence at baseline above the commonly accepted
> cut-point for a moderation goal (Severity of Alcohol Dependence
Questionnaire
> [SADQ] > 29) showed outcomes at least as favorable as those below the
cut-point.
> The validity of self-reports of alcohol consumption and problems was
supported
> by significant relationships with liver function tests (gamma-glutamyl
> transferase and alanine transferase). CONCLUSIONS: These results provide
no
> grounds for the replacement of BSCT by MOCE in routine,
moderation-oriented
> treatment practice. Assuming they prefer it to abstinence and that it is
not
> contra-indicated on other grounds, there seems no reason why clients
showing a
> higher level of dependence (SADQ = 30-45) should not be offered a
moderation
> goal.
>
>
> Havermans RC. Jansen AT.
> University of Maastricht, Maastricht, The Netherlands.
> r.havermans@psychology.unimaas.nl
> Increasing the efficacy of cue exposure treatment in preventing relapse of
> addictive behavior.
> Addictive Behaviors. 28(5):989-94, 2003 Jul.
> Abstract
> Theoretically, cue exposure treatment should be able to prevent relapse by
> extinguishing conditioned drug responding (e.g. cue-elicited craving).
According
> to contemporary learning theory, though, extinction does not eliminate
> conditioned responding. Analogous cue exposure with response prevention
(CERP)
> as a treatment of addictive behavior might not eliminate the learned
relation
> between drug-related cues and drug use. This does not necessarily mean
that cue
> exposure cannot successfully prevent relapse. Various suggestions for
increasing
> the efficacy of cue exposure treatment are being discussed from a
contemporary
> learning theory perspective. It is suggested that cue exposure treatment
> incorporating retrieval cues can be a beneficial treatment in preventing
relapse
> of addictive behavior.
>
> Monti PM. Rohsenow DJ. Swift RM. Gulliver SB. Colby SM. Mueller TI. Brown
RA.
> Gordon A. Abrams DB. Niaura RS. Asher MK.
> Providence VA Medical Center, and the Center for Alcohol and Addiction
Studies,
> Brown University, Providence, Rhode Island 02912, USA.
peter_monti@brown.edu
> Naltrexone and cue exposure with coping and communication skills training
for
> alcoholics: treatment process and 1-year outcomes.
> Alcoholism: Clinical & Experimental Research. 25(11):1634-47, 2001 Nov.
> Abstract
> BACKGROUND: Promising treatments for alcoholics include naltrexone (NTX),
cue
> exposure combined with urge-specific coping skills training (CET), and
> communication skills training (CST). This study investigated the effects
of
> combining these elements as treatment adjuncts. METHODS: A 2 x 2 design
> investigated the effects of CET combined with CST, as compared with an
education
> and relaxation control treatment, during a 2-week partial hospital program
(n =
> 165) followed by 12 weeks of NTX (50 mg/day) or placebo during aftercare
(n =
> 128). Drinking outcomes were assessed at 3, 6, and 12 months after
discharge
> from the partial hospital. Process measures included urge, self-efficacy
> (confidence about staying abstinent in risky situations), and
self-reported
> coping skills. Medically eligible alcohol-dependent patients were
recruited.
> RESULTS: Among those compliant with medication on at least 70% of days,
those
> who received NTX had significantly fewer heavy drinking days and fewer
drinks on
> days that they drank than those receiving placebo during the medication
phase
> but not during the subsequent 9 months. CET/CST-condition patients were
> significantly less likely to report a relapse day and reported fewer heavy
> drinking days at the 6- and 12-month follow-ups than patients in the
control
> treatment. Interactions of medication with behavioral treatments were not
> significant. Process measures showed that NTX resulted in lower weekly
urge
> ratings, and those in CET/CST used more of the prescribed coping skills
after
> treatment, reported fewer cue-elicited urges, and reported more
self-efficacy in
> a posttest role-play test. Drinking reductions at 3, 6, and 12 months
correlated
> with more use of coping skills, lower urge, and higher self-efficacy.
> CONCLUSIONS: The results suggest the probable value of keeping alcoholics
on NTX
> for longer periods of time and the importance of increasing compliance
with NTX.
> They also support the earlier promising effects of CET and CST as adjuncts
to
> treatment programs for alcoholics by maintaining treatment gains over at
least a
> year. The value of the urge-specific and general coping skills and of
> self-efficacy and urge constructs was demonstrated in their association
with
> drinking outcomes.
>
>
> Sitharthan T. Sitharthan G. Hough MJ. Kavanagh DJ.
> Western Sydney Area Drug and Alcohol Services, University of Sydney,
Australia.
> Cue exposure in moderation drinking: a comparison with cognitive-behavior
> therapy.
> Journal of Consulting & Clinical Psychology. 65(5):878-82, 1997 Oct.
> Abstract
> To date, the published controlled trials on exposure to alcohol cues have
had an
> abstinence treatment goal. A modification of cue exposure (CE) for
moderation
> drinking, which incorporated priming doses of alcohol, could train
participants
> to stop drinking after 2 to 3 drinks. This study examined the effects of
> modified CE within sessions, combined with directed homework practice.
> Nondependent problem drinkers who requested a moderation drinking goal
were
> randomly allocated to modified CE or standard cognitive-behavior therapy
(CBT)
> for alcohol abuse. Both interventions were delivered in 6 90-min group
sessions.
> Eighty-one percent of eligible participants completed treatment and
follow-up
> assessment. Over 6 months, CE produced significantly greater reductions
than CBT
> in participants' reports of drinking frequency and consumption on each
occasion.
> No pretreatment variables significantly predicted outcome. The modified CE
> procedure appears viable for nondependent drinkers who want to adopt a
moderate
> drinking goal.
>
> ---------------------------
> HP-G
>
hp
Tell me, since you spent some time reading these studies, what group of
people are they dealing with. The population in whole (drinkers in general),
alcohol abusers (various and sundry people who drink too much), or just
diagnosed alcoholics (we the damned)?
John

On - Fri, Jul 23, 2004, 4:19pm (EDT+4) jhdroge@earthlink.net
(John*Droge) wrote:

>> BACKGROUND: Promising treatments for
>> alcoholics include naltrexone (NTX),

> Tell me, since you spent some time reading these
> studies, what group of people are they dealing
> with. The population in whole (drinkers in
> general), alcohol abusers (various and sundry
> people who drink too much), or just diagnosed
> alcoholics (we the damned)?

Excerpt: New England Journal of Medicine. 2001

"Naltrexone failed to improve drinking behavior, and the authors
concluded that they could not support its use in the treatment of
chronic alcoholic patients." (The medication was given in addition to
standard psychosocial supports, including 12-step facilitation
counseling and attendance at AA meetings)

http://www.csam-asam.org/naltrexone_in_the_treatmen.htm


"Naltrexone, which was approved to treat the disease in 1994, failed to
prevent drinking relapses in a study that left its chief author
"flabbergasted."

The study, appearing in the Dec. 13 issue of The New England Journal of
Medicine, says naltrexone fails to prevent drinking relapses as well as
previously believed, and, in fact, is no better than sugar pills at
keeping hardened alcoholics on the wagon.

It has small to medium effects and works in many but not all
[alcoholics]. We're trying to figure out which ones it works best in,"
Litten says.
The fact that the study subjects were such hard-core drinkers might have
warranted using more of the drug, perhaps double or triple the 50
milligram dose, Litten says."

http://www.twilightbridge.com/thetimes/alcohol.htm

In news:g8g1g0t7lnf918eavsgvtgemd7068gql7d@4ax.com,
H.P. Gawd <> quoted
> The short of it: Exposure to things normally associated with your
> alcohol intake ("alcohol cue exposure") without actual alcohol
> intake taking place significantly decreases cravings and relapses
> when done repeatedly. This works as a therapy procedure that is
> effective alone and is likely to be a valuable complement to more
> traditional approaches like coping skills training or group support
> network (like AA).

I can give it to you in 1 kb,,,

Alcoholics drink.

Non-alcoholics do and don't drink

Paper never refused ink. People have to make a living

Cheers
Tommy

In news:yUaMc.10906$mL5.9631@newsread1.news.pas.earth link.net,
John Droge <> quoted
> "H.P. Gawd" <hpgawd@non-anonymous.org> wrote in message

nother thread marked 'read'

12 plus 12 plus 13 kb

I guess netiquette rules / not
TOmmy

On Fri, 23 Jul 2004 02:41:09 -0500, H.P Gawd <hpgawd@non-anonymous.org> wrote:

> The short of it: Exposure to things normally associated with your alcohol intake
> ("alcohol cue exposure") without actual alcohol intake taking place
> significantly decreases cravings and relapses when done repeatedly. This works
> as a therapy procedure that is effective alone and is likely to be a valuable
> complement to more traditional approaches like coping skills training or group
> support network (like AA).

If true, it implies doing some things contrary to the typical AA
approach. I doubt most AA sponsors would smile upon going to the bar
you always hang out at, even if you didn't drink. This sounds very much
like the 'just put the plug in the jug' mentality that AA (and others)
often disparage. If you just stop drinking, but maintain the same
environment, you'll reverse condition yourself. The little nod to AA
therefore sounds a little odd - perhaps the author doesn't understand AA
well (a 'group support network' .. weeelll, sorta).

Myself, I still spend a good deal of time in and around the places I
used to drink. One is a pub, where I like to have lunch, but most of my
drinking was outside of the bar, at places I really can't avoid (e.g. my
home). Have I reverse conditioned myself? I dunno, but I'm not
drinking..

--
AB5DB9CC

On Sat, 24 Jul 2004 00:15:34 +0100, "Tommy" <tormyleprechaun@indigo.ie> wrote:

>In news:g8g1g0t7lnf918eavsgvtgemd7068gql7d@4ax.com,
>H.P. Gawd <> quoted
>> The short of it: Exposure to things normally associated with your
>> alcohol intake ("alcohol cue exposure") without actual alcohol
>> intake taking place significantly decreases cravings and relapses
>> when done repeatedly. This works as a therapy procedure that is
>> effective alone and is likely to be a valuable complement to more
>> traditional approaches like coping skills training or group support
>> network (like AA).
>
>I can give it to you in 1 kb,,,
>
>Alcoholics drink.
>
>Non-alcoholics do and don't drink
>
>Paper never refused ink. People have to make a living

You are so amazingly smart! I am sure if you were to move
to alt.support.cancer, you'd also solve all the problems
about concerning cancer it in less than 1 kb. After all,
"Paper never refused ink. People have to make a living"
- this gotta be an explanation for hundreds of journals
that publish results of studies worth many billions
dollars. Umm, would that be something like this: "Cancer
patients have too many cancerous cells and die. Non-cancer
patients don't"?

Keep up the good work - humankind needs you.

HP-G

In news:moa3g09k54f97inuocgjn36u9tm14a2omp@4ax.com,
H.P. Gawd <> quoted
> On Sat, 24 Jul 2004 00:15:34 +0100, "Tommy"
> You are so amazingly smart! I am sure if you were to move
> to alt.support.cancer, you'd also solve all the problems
> about concerning cancer it in less than 1 kb. After all,
> "Paper never refused ink. People have to make a living"
> - this gotta be an explanation for hundreds of journals
> that publish results of studies worth many billions
> dollars. Umm, would that be something like this: "Cancer
> patients have too many cancerous cells and die. Non-cancer
> patients don't"?

> Keep up the good work - humankind needs you.

> HP-G

Vast difference between malignant cancers and abusive drinking habits mate.

You wouldn't know this, nor expected to know it, but I am a survivor of
cancer among other things. So go right ahead and show how terribly
smart-arsed you are.

I agree with your findings that many billions of dollars/pounds/euros are
wasted annually on ridiculously funded studies. I'd vote that this money
might be better spent on finding cures for diseases and/or palliative care
for sufferers.

But then you'd have no trumpet to sound, would you? Or ink to waste....
Cheers
Tommy