Alcohol: Crossroads Between Nursing Research and Psychiatric Nursing Practice

Abstract

This special issue of the Journal of the American Psychiatric Nurses Association highlights research related to alcohol use and abuse and the associated adverse social, behavioral, economic, and health outcomes. Alcohol is the most commonly abused substance. The lifetime prevalence rate for alcohol use disorder is considerably higher among persons with psychiatric disorders than among persons in the general U.S. population. As such, alcohol is a topic of great concern to psychiatric nurses. In this issue, Goldstein and colleagues examined rates and types of additional psychiatric disorders among persons who had posttraumatic stress disorder (PTSD) plus antisocial personality disorder (ASPD), adult-onset antisocial behavior syndrome, or no antisocial behavior. The data for this article were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Goldstein and colleagues note that because persons with antisocial syndromes (ASPD or adult-onset antisocial behavior) had higher odds of alcohol use disorders and other psychiatric disorders compared with those with no antisocial behavior, nurses need to carefully assess persons with PTSD for co-occurring antisocial behavior and other comorbid conditions. In the article titled “Alcohol and Violence-Related Injuries Among Emergency Room Patients in an International Perspective,” Cherpitel and Ye present data substantiating the global and strong relationship between recent alcohol consumption and violence-related injuries among emergency room patients. In this article, data are reported from 15 countries comprising the Emergency Room Collaboration Alcohol Analysis Project and the World Health Organization Collaborative Study on Alcohol and Injury. The magnitude of the relative risk for alcohol drinking associated violence-related injuries varied among countries. However, the relative risk for violencerelated injury because of drinking prior to the emergency room admission was more than five times greater than risk for injuries because of other causes. These data suggest an urgent need for global educational programs to raise awareness about the strong relationship between alcohol and violence-related injuries. In a relatively new APNA initiative, Buccola, Rosedale, and Bryan wrote a “Clinical Translation” of Cherpitel and Ye’s research article. They clearly articulate that nurses bring a specialized skill set of screening, brief interventions, motivational interviewing, and crisis intervention that can help patients recognize the risks associated with alcohol use/abuse. They also highlight the role of nurses in caring for the “whole patient.” In the article titled “Early Drinking and Its Association With Adolescents’ Participation in Risky Behaviors,” Calvert and colleagues conducted a secondary data analysis using data from the first wave of the Missouri Family Study, which is an ongoing prospective community-based family study designed to examine familial influences on health compromising behaviors among adolescent offspring. Cigarette smoking and marijuana use were significantly more common among early onset drinkers (age 12 or younger) compared with later-onset drinkers. Early drinking was also associated with other adverse health behaviors including disordered eating behavior, having sex, having multiple sex partners, and having sex without a condom. These findings continue to support the need for practitioners to screen for alcohol use as well as the use of other drugs such as marijuana and tobacco among adolescents. These data also support routine screening for other adverse health behaviors. Alcohol dependence among women and alcohol use among girls are areas of growing concern. Corte, Rongmuang, and Stein review the nursing empirical literature on alcohol and women’s health published over the past 5 years. They summarize findings related to (a) determinants of alcohol use and alcohol problems; (b) patterns of use, assessment of alcohol use, and comorbidity; (c) consequences of alcohol use; and (d) the effects of treatment or specific interventions. They also propose a research agenda for nursing that addresses the most pressing issues related to alcohol use and alcohol problems in women. As can be seen in the articles in this special issue, psychiatric nurses have a particularly important role in identifying persons at risk across the lifespan, caring for persons who have alcohol use disorders and their families, educating nurses and other health care providers, and collaborating in or conducting alcohol-related nursing research.