‘Drinking a Lot’ in Denmark, Estonia, and Italy: Norms and Meanings Related to Excessive Alcohol Use

Importance of Alcohol Awareness and Issues in Curricula

The current study examined demographics, sexual orientation, gender characteristics, and gender minority stress and their association to excessive alcohol, cannabis, and illicit (noncannabis) drug use among 1210 transgender adults living in the United States. The authors conducted a secondary analysis of data that included 680 transgender women (M age=32.63, SD age=12.29) and 530 transgender men (M age=26.14, SD age=7.42). A modified version of the Risk Behavioral Assessment quantified participants' alcohol, cannabis, and illicit drug use in the past 3months. Overall, 21.5% of participants reported excessive alcohol use; no significant differences were found on the rates of excessive alcohol use between transgender women and men. Cannabis use among our sample was 24.4%; trangender men reported significantly higher rates of cannabis use compared to transgender women. Illicit drug (noncannabis) use among our sample was 11.6%; transgender men also reported significantly higher rates of illicit drug use compared to transgender women. Multivariate analyses suggested that gender dysphoria was significantly associated with: excessive alcohol use for transgender women, cannabis use among both transgender women and men, and illicit (noncannabis) drug use among transgender women. A nonheterosexual orientation was associated with increased odds of cannabis use among transgender women and men; a nonheterosexual orientation was associated with greater odds of illicit substance use among transgender men but not among transgender women. Genderminority stressors were independently associated with excessive alcohol use among transgender men and cannabis use among transgender women. The authors suggest that minority stress may only partially account for substance use among transgender people. Consequently, the authors suggest that in addition to minority stress, other biopsychosocial mechanisms should continue to be examined to identify pathways that may lead to the development of effective substance use prevention efforts and treatment programs.

Alcohol use and clinical manifestations of tuberculosis

Since chronic alcohol use suppresses the adult immune system, we tested the hypothesis that maternal alcohol ingestion increases the risk of infection in term newborns. Analysis of a large case-control study of birth weight for gestational age was performed focusing on maternal alcohol ingestion and the development of infection in term newborns > or =36 weeks gestation. After delivery, mothers were asked about alcohol and tobacco use in the 3 months prior to conception, the 1st, 2nd, and 3rd trimester of pregnancy. Eight hundred and seventy-two singleton newborns (872) > or = 36 weeks gestation were identified for analysis. A total of 51 (5.8%) had newborn infections. Gestational age, sex, and small for gestational age (SGA) were similar in the newborns with and without infection (p = NS). Infants whose mothers reported alcohol use, excessive drinking or smoking in pregnancy were more likely to have a newborn diagnosed with an infection than were mothers who reported abstaining from alcohol or cigarettes (p < 0.05). When controlling for race and smoking, SGA infants whose mothers used any alcohol had a 2.5-fold increase risk of infection, while excessive alcohol use increased the risk 3-4-fold. In a multivariable logistic regression analysis controlling for low maternal income, smoking, and SGA, excessive alcohol use during the 2 trimester increased the risk of newborn infection (OR 3.7 [1.1,12.8], p < 0.05). Excessive maternal alcohol use is associated with an increased risk of newborn infection in this patient sample. Increased awareness and further clinical investigations are warranted to address the detrimental effects of fetal alcohol exposure on the developing immune system.

There is a well-known link between attending college and engaging in excessive alcohol use. This study examines in a national sample how the association between student status and excessive alcohol use changes from late adolescence through young adulthood and whether the association of student status with excessive alcohol use is different for students residing with versus away from parents during the school year. This study used cross-sectional data from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative sample of noninstitutionalized civilian adults residing in the United States. Our analyses included nonhigh school young adults who were ages 18 to 30years (n=8,645). Excessive alcohol use included past-year (i) high-intensity drinking (men: ≥10 standard drinks; women: ≥8) and (ii) exceeding weekly drinking guidelines (men: >14 drinks per week; women: >7). Students who resided away from their parents and students who lived with their parents during the school year were compared to nonstudents. Analyses using time-varying effect modeling showed that the relationship of student status with excessive alcohol use varied as a function of age. Overall student status lost its association with excessive alcohol use in the early 20s, after controlling for demographics and other adult social roles. The association between student status and excessive alcohol use also varied considerably across age and depending on whether the student was residing with or away from parents. The association of student status with excessive alcohol use is heterogeneous in terms of both age and living arrangements, suggesting opportunities for interventions targeting problematic alcohol use. Future research should examine additional sources of heterogeneity of students in their risk for excessive alcohol use.

Alcohol Screening and Brief Intervention: A Potential Role in Cancer Prevention for Young Adults

Excess alcohol use among tuberculosis (TB) patients complicates TB control strategies. To characterize the role of excess alcohol use in TB control, we describe the epidemiology of excess alcohol use and TB in the United States among those aged ⩾15 years. Using data reported to the National Tuberculosis Surveillance System, 1997-2012, we examined associations between excess alcohol use and TB treatment outcomes and markers for increased transmission (involvement in a local genotype cluster of cases) using multivariate logistic regression. We used Cox proportional hazards regression analysis to examine the relationship between excess alcohol use and the rate of conversion from positive to negative in sputum culture results. Excess alcohol use was documented for 31 207 (15.1%) of 207 307 patients. Prevalence of excess alcohol use was greater among male patients (20.6%) and US-born patients (24.6%). Excess alcohol use was associated with a positive sputum smear result (aOR 1.23, 95%CI 1.18-1.28) and death during treatment (vs. completion of treatment) (aOR 1.16, 95%CI 1.10-1.22). The rate of culture conversion was higher among patients without excess alcohol use (adjusted hazard ratio 1.20, 95%CI 1.18-1.23). Excess alcohol use was common among patients with TB, and was associated with TB transmission, lower rates of sputum culture conversion, and greater mortality.

Binge drinking among adults, by select characteristics and state — United States, 2018

Hepatitis C virus (HCV) infection and excessive alcohol consumption are leading causes of liver disease worldwide. Direct acting antivirals (DAAs) are well-tolerated treatments for HCV infections with high sustained virologic response (SVR) rates. There are limited data assessing the influence of alcohol use on DAA uptake and cure. We performed a retrospective analysis of patients followed at The Ottawa Hospital Viral Hepatitis Program between January 2014 and May 2020 to investigate the effect of excessive alcohol use history on DAA uptake and SVR rates. Additionally, we evaluated the incidence of concurrent comorbidities and social determinants of health. Predictors of DAA uptake and SVR were assessed by logistic regression. Excessive alcohol use history was reported in 46.0% (733) of patients. Excessive alcohol use did not predict DAA uptake (OR 1.06, 95% CI 0.71 to 1.57), while employment (OR 2.10, 95% CI 1.29 to 3.42) and recreational drug use (OR 0.62, 95% CI 0.40 to 0.94) were predictors. Employment predicted SVR (OR 2.38, 95% CI 1.68 to 3.36) in those starting treatment. Excessive alcohol use history did not predict SVR. History of excessive alcohol use does not influence treatment initiation or SVR. Efforts to improve treatment uptake should shift to focus on the roles of determinants of health such as employment and recreational drug use on treatment initiation.

Addiction as a Coping Response: Hyperkatifeia, Deaths of Despair, and COVID-19.

Excessive alcohol use in the US contributes to over 88,000 deaths per year and costs over $250 billion annually. While previous studies have shown that excessive alcohol use can be detected from general patterns of social media engagement, we characterized how drinking-specific language varies across regions and cultures in the US. From a database of 38 billion public tweets, we selected those mentioning “drunk”, found the words and phrases distinctive of drinking posts, and then clustered these into topics and sets of semantically related words. We identified geolocated “drunk” tweets and correlated their language with the prevalence of self-reported excessive alcohol consumption (Behavioral Risk Factor Surveillance System; BRFSS). We then identified linguistic markers associated with excessive drinking in different regions and cultural communities as identified by the American Community Project. “Drunk” tweet frequency (of the 3.3 million geolocated “drunk” tweets) correlated with excessive alcohol consumption at both the county and state levels (r = 0.26 and 0.45, respectively, p < 0.01). Topic analyses revealed that excessive alcohol consumption was most correlated with references to drinking with friends (r = 0.20), family (r = 0.15), and driving under the influence (r = 0.14). Using the American Community Project classification, we found a number of cultural markers of drinking: religious communities had a high frequency of anti-drunk driving tweets, Hispanic centers discussed family members drinking, and college towns discussed sexual behavior. This study shows that Twitter can be used to explore the specific sociocultural contexts in which excessive alcohol use occurs within particular regions and communities. These findings can inform more targeted public health messaging and help to better understand cultural determinants of substance abuse.

Gender and age differences in the associations between family social roles and excessive alcohol use

Construct interview that correctly identifies those with alcohol use disorder have limitation, especially when the subjects are motivated to minimize the magnitude of drinking behavior. Current laboratory tests to detect excessive alcohol consumption are limited by marginal sensitivity/specificity. Excessive drinking has been shown to affect several organ systems, which may be reflected in changes in quantity of plasma proteins. Our aim was to employ novel proteomic analyses to identify potential markers for excessive alcohol use. A prospective case-control study included 49 controls and 54 excessive drinkers (discovery cohort). The serum proteomic analyses in these subjects were performed, and the results were tested in the verification cohort (40 controls and 40 excessive drinkers). Using the appropriate cutoff and confirmation with ELISA, we identified 4 proteins which were significantly elevated in the serum of excessive drinkers: AT-rich interactive domain-containing protein 4B (ARID4B), phosphatidylcholine-sterol acyltransferase (LCAT), hepatocyte growth factor-like protein (MST1), and ADP-ribosylation factor 6 (ARL6). The performance of the conventional markers (aspartate aminotransferase [AST], alanine aminotransferase [ALT], gamma-glutamyl transpeptidase [GGT], percentage of carbohydrate-deficient transferrin [%CDT], and mean corpuscular volume [MCV]) discriminating between excessive alcohol use and controls had an area under the curve (AUC) ranging from 0.21 (ALT) to 0.67 (MCV). The AUC of these novel proteins showed the improvement in the detection of excessive drinkers compared to conventional laboratory tests, ranging from 0.73 (for ARID4B) to 0.86 (for ARL6). We have identified 4 novel proteins that can discern subjects with excessive alcohol use. Further studies are needed to determine the clinical implications of these markers to detect excessive alcohol use and confirm abstinence.

The purpose of the study is to discuss the necessity of interventions on excessive alcohol use among middle-aged adult Koreans and attempt to investigate the effect of social supports including family support and friend support on excessive alcohol use. To achieve these goals, a self-administered online survey was conducted on middle-aged adult Koreans from 40 to 59 years old sampled through the convenience allocation extraction method, with responses of a total of 767 samples analyzed. The results from the analysis was that the support of the family reduced excessive alcohol use, whereas the support of friends provoked excessive alcohol use. Based on these results, the necessity of a distinction in the different types of social supports for interventions in excessive alcohol use was revealed. In addition, several practical and political implications for the alleviation of excessive alcohol use among middle-aged adults are recommended.

The aim of the study was to investigate which factors are associated with age at onset in bipolar disorder with a specific focus on excessive alcohol and cannabis use, and the sequence of the onsets of excessive substance use and bipolar disorder. We investigated a naturalistic sample of 151 patients with bipolar I and II disorder receiving psychiatric treatment. Whether the presence of excessive substance use prior to bipolar disorder onset or the type of substance used (alcohol or cannabis) was associated with differences in age at onset was investigated using hierarchical and multiple linear regression analyses, adjusting for potential confounders. Patients with excessive alcohol use had a significantly later onset compared with patients with excessive cannabis use. Excessive general substance use prior to bipolar disorder onset was associated with a later onset. However, excessive cannabis use was associated with an earlier onset whether it preceded or followed bipolar disorder onset, also after adjusting for possible confounders. Excessive use of alcohol or other substances was not independently associated with age at onset in multivariate analyses. Alcohol use was associated with a later onset compared with cannabis use, suggesting different relationships to the onset of bipolar disorder. Lifetime use of cannabis predicted an earlier onset, independent of the sequence of onsets. This indicates that an early onset may increase the risk of cannabis use and that cannabis use may trigger bipolar disorder in vulnerable individuals.