Alcoholic Research Articles

A meta-analysis on racial discrimination and alcohol use among Asian Americans.

Racial discrimination has been identified as a contributing risk factor for alcohol use among racially minoritized individuals. The aims of this study were to quantify the relationship between racial discrimination and alcohol use among Asian Americans, examine gender, age and generational status as moderators, and characterize ethnic group representation across the literature. A systematic literature search was conducted using PsycINFO, CINAHL, Web of Science, PubMed, Embase, and OpenDissertations. A random effects model using Pearson's r effect sizes was conducted on separate alcohol outcomes. Meta-regression analyses tested for moderating effects, and heterogeneity was examined by identifying outliers and subgroup differences. Risk of bias was assessed using a funnel plot and Egger's regression test. Twenty-two effect sizes were extracted from 18 studies, representing 8926 participants. A significant positive association was found between racial discrimination and alcohol consumption (k = 9, r = 0.13, 95% CI = [0.07, 0.19], I2 = 80.7%, p = 0.002) and problematic alcohol use (k = 12, r = 0.27, 95% CI = [0.12, 0.40] I2 = 93.7%, p = 0.002), but not binge use (k = 3, r = 0.08, 95% CI = [-0.49, 0.60], I2 = 95.0%, p = 0.64). Age, gender, and generational status were not significant moderators (p's > 0.10). When ethnic groups were reported, Chinese Americans were most represented (36.9%), while Indian Americans were notably underrepresented (1.18%). There is a small positive association between racial discrimination and alcohol consumption and problematic alcohol use among Asian Americans. Research should seek to fill gaps identified by this review, including the dearth of longitudinal work needed to establish temporal precedence, the limited understanding of racial discrimination on binge use and underrepresented ethnic groups in this field of research, and reducing heterogeneity between studies.

Silent Devastation: Acute Marchiafava-Bignami Disease Unmasked by Chronic Alcoholism in a 24-Year-Old Male: A Case Report

Marchiafava-Bignami disease (MBD) is an uncommon condition that is mainly linked to prolonged alcoholism and nutritional deficits. It is characterised by necrosis and demyelination of the corpus callosum. Due to its rarity and vague clinical signs, this disorder can frequently be misdiagnosed. It manifests as a range of neurological symptoms, from altered awareness to motor impairments. We present a 24-year-old man in this case report who has a history of intravenous drug use, chronic alcohol intake, and recent binge drinking.He presented with a 10-day history of constipation, vomiting, and a high-grade continuous fever. Over two days, the patient’s condition deteriorated into a drowsy state with abdominal pain.On examination, the patient was drowsy but arousable, with stable vital signs except for hypertension. Neurological findings indicated reduced deep tendon reflexes, hypotonia, and neck stiffness. A systemic workup revealed normal brain CT findings, however, diffusion limitation was seen in the corpus callosum's splenium on MRI, along with mild oedema and T2/FLAIR hyperintensity. The lumbar puncture showed lymphocytic predominance, low CSF glucose, and elevated protein levels suggestive of a possible CNS infection. The differential diagnosis included Marchiafava-Bignami disease (MBD) and cytotoxic lesions of the corpus callosum (CLOCCs).The patient was managed with intravenous steroids, empirical antitubercular therapy (ATT), broad-spectrum antibiotics, and supportive care, including airway protection via intubation. Despite the late diagnosis, the clinical history of chronic alcoholism, recent binge, and imaging findings confirmed MBD. Early recognition and treatment of this disorder can improve neurological outcomes. The present study emphasises how crucial it is to take MBD into account when making a differential diagnosis for alcohol-related encephalopathies, especially in individuals who have neurological decline and prolonged alcohol consumption.

A Cross-Sectional Study Investigating the Role of Meaning and Purpose in Life Among Older Individuals (≥50-Years Old) in Recovery from Alcohol Use Disorder/Problem Drinking

ABSTRACT Meaning and purpose in life (MPL) is an important domain of the recovery capital model. Yet, this important recovery support mechanism has received scant attention, particularly in relation to older individuals recovering from alcohol use disorder (AUD)/problem drinking. Framed within Viktor Frankl’s theory of meaning, the study used two measures, the Purpose in Life Test and the Meaning in Life Questionnaire, to collect the data of 381 older individuals (≥50-years old) in recovery. The data was analyzed against four independent variables: onset age of problem drinking (early- and late-onset), gender, continuous years in recovery and recovery pathways. The study found a significant relationship between MPL and continuous years in recovery, suggesting that as the length of time in recovery increases, so too, do levels of MPL.

Pellagra in chronic alcoholism: An underdiagnosed condition in modern clinical practice.

Pellagra in chronic alcoholism: An underdiagnosed condition in modern clinical practice.

Polygenic risk for alcohol use disorder affects cellular responses to ethanol exposure in a human microglial cell model.

Polygenic risk scores (PRSs) assess genetic susceptibility to alcohol use disorder (AUD), yet their molecular implications remain underexplored. Neuroimmune interactions, particularly in microglia, are recognized as notable contributors to AUD pathophysiology. We investigated the interplay between AUD PRS and ethanol in human microglia derived from iPSCs from individuals with AUD high-PRS (diagnosed with AUD) or low-PRS (unaffected). Ethanol exposure induced elevated CD68 expression and morphological changes in microglia, with differential responses between high-PRS and low-PRS microglial cells. Transcriptomic analysis revealed expression differences in MHCII complex and phagocytosis-related genes following ethanol exposure; high-PRS microglial cells displayed enhanced phagocytosis and increased CLEC7A expression, unlike low-PRS microglial cells. Synapse numbers in cocultures of induced neurons with microglia after alcohol exposure were lower in high-RPS cocultures, suggesting possible excess synapse pruning. This study provides insights into the intricate relationship between AUD PRS, ethanol, and microglial function, potentially influencing neuronal functions in developing AUD.

Promoting Race and Ethnic Diversity in a Hospital-Based Randomized Clinical Trial to Address Untreated Alcohol Use Disorder: Initial Lessons Learned.

This study aimed to describe initial experiences and lessons learned conducting a trial focused on recruiting racially and ethnically diverse hospitalized patients with untreated alcohol use disorder (AUD). The parent trial is comparing the effectiveness of strategies including Brief Negotiation Interview (BNI), facilitated initiation of medications for AUD, and computer-based training for cognitive behavioral therapy (CBT4CBT) on AUD treatment engagement post-hospitalization. Guided by the Framework for Reporting Adaptations and Modifications-Enhanced, we catalogued protocol changes and evaluated outcomes using study and electronic medical record data during the first 18 months of recruitment. Recipients: (1) Selected entry criterion to intentionally include individuals most likely impacted by structural racism, (2) developed multipronged recruitment approaches, and (3) selected bilingual, multicultural, and ethnically diverse research staff. Intervention: (1) Added scripts in the BNI to consider how cultural factors influence and how racism may impact, alcohol use, and AUD treatment engagement, (2) offered tablets as a compensation alternative with support for CBT4CBT initiation (as relevant), and (3) anticipate and troubleshoot internet access challenges. Setting: (1) Identified community-based AUD treatment options with Spanish-speaking services and (2) identified resources to address social determinants of health. Study: (1) Audited data to monitor whether diverse enrollment is occurring. Among n = 132 randomized as of March 1, 2024, 25% endorsed Black, 24% endorsed Latine, 58% endorsed White, 1% endorsed Indigenous, and 15% endorsed race not listed or declined to disclose. We observed no difference by race or ethnicity in recruitment or retention experiences. Multilevel practices within a hospital-based AUD-focused trial can promote recruitment and retention of a racially and ethnically diverse sample.

The effectiveness of antidepressant therapy against anhedonia in patients with alcohol dependence

The article presents the results of a scientific study aimed at determining the effectiveness of the drug Vortioxetine (Brintellix) in the treatment of affective spectrum disorders in patients with alcohol dependence in a drug treatment hospital, since the drug is promising for widespread use in the drug therapy of a number of mental disorders and in the future could be included in the standard of medical care in the field of psychiatry-addictology. It is known that anhedonia is one of the mental disorders in withdrawal syndrome, which provokes relapses of an addictive disorder and negatively affects the duration and quality of remissions of patients with an addiction profile. At the same time, the study of antidepressant therapy in the treatment of alcohol dependence remains relevant, since poor tolerance, side effects, and deterioration of the patient's general condition may affect adherence to drug therapy. In the present study, anhedonia was assessed on the Snaith-Hamilton SHAPS scale, anxiety-depressive manifestations using the HADS hospital anxiety and depression scale and quality of life according to the SF-36 questionnaire during 24 weeks of follow-up.The result of drug therapy with Vortioxetine was the relief of affective disorders in alcohol dependence, which contributed to the improvement of overall subjective well-being, the degree of satisfaction with the quality of life and a decrease in anxiety-depressive tendencies and anhedonia. In addition, minimal and minor adverse reactions when taking Vortioxetine affected the increased adherence of the examined patients to medical prescriptions and recommendations.Conclusions. The use of Vortioxetine in the treatment of affective disorders among patients suffering from alcohol dependence provides new opportunities to help people suffering from alcohol addiction. Vortioxetine can be recommended both at the stage of inpatient care and outpatient treatment, since when it was taken, stable positive dynamics of antidepressant, anti-anxiety and antiangedonic effects were recorded.

Deciphering the role of LncRNA in alcoholic liver disease: Mechanisms and therapeutic potential.

Alcoholic liver disease (ALD) is a spectrum of liver damage caused by chronic alcohol consumption. The disease progresses in stages, starting with simple fatty liver, progressing to alcoholic hepatitis and potentially leading to fibrosis and cirrhosis. The pathophysiology of ALD is complex and involves several cellular and molecular mechanisms. Recent research has highlighted the role of long non-coding RNAs (LncRNAs) as critical regulators in the development and progression of ALD. This article reviews the current understanding of LncRNAs in ALD, focusing on their functions in key pathological processes and their potential as diagnostic markers and therapeutic targets.

The Interaction of Apical Periodontitis, Cigarette Smoke, and Alcohol Consumption on Liver Antioxidant Status in Rats

This study aimed to investigate the impact of alcohol (A), secondhand cigarette smoking (ShS), and their combined effect on liver antioxidant activity and hepatic damage in rats with induced apical periodontitis (AP). Thirty-five female Wistar rats were randomly allocated into five groups (n = 7): (1) control (rats without ShS, alcoholic diet, or AP), (2) control-AP (induced AP only), (3) ShS-AP (ShS exposure and induced AP), (4) A-AP (alcoholic diet and induced AP), and (5) A+ShS-AP (alcoholic diet, ShS exposure, and induced AP). Alcohol was administered through semi-voluntary intake, while ShS exposure involved the daily inhalation of cigarette smoke. The experimental period lasted 8 weeks, with AP induction occurring in the 4th week following molar pulp exposure. Liver samples were collected post-euthanasia for histomorphometric and antioxidant marker analyses. All AP-induced groups exhibited increased liver sinusoidal dilation compared to the control group (p < 0.05). AP significantly reduced total antioxidant capacity (FRAP) across all groups (p < 0.05). In AP-induced groups, FRAP levels were further decreased in ShS-AP and A+ShS-AP compared to control-AP (p < 0.05). AP also led to a decrease in the glutathione defense system (p < 0.05). Rats with alcohol exposure (A-AP and A+ShS-AP) showed reduced glutathione peroxidase activity (p < 0.05). Glutathione reductase activity was comparable in the control and control-AP groups (p > 0.05), but significantly decreased in the alcohol and ShS-exposed groups (p < 0.05). Apical periodontitis can relate to morphological changes in the liver’s sinusoidal spaces and impairment of liver’s antioxidant capacity of rats, particularly when combined with chronic alcohol consumption and exposure to cigarette smoke.

One Third of Alcohol Use Disorder Diagnoses are Missed by ICD Coding.

Alcohol use carries significant morbidity and mortality, yet accurate identification of alcohol use disorder (AUD) remains a multi-layered problem for both researchers and clinicians. To fine-tune a language model to AUD in the clinical narrative and to detect AUDs not accounted for by ICD-9 coding in the MIMIC-III database. We applied clinicalBERT to unique patient discharge summaries. For classification, patients were divided into nonoverlapping groups stratified by the presence/absence of AUD ICD diagnosis for model training (80%), validation (10%), and testing (10%). For detection, the model was trained (80%) and validated (20%) on 1:1 positive/negative patients, then applied to remaining negative patient population. Physicians adjudicated 600 samples from the full model confidence spectrum to confirm AUD by Diagnostic and Statistical Manual of Mental Disorders-V criteria. The model exhibited the following characteristics (mean, standard deviation): precision (0.9, 0.02), recall (0.65, 0.03), F-1 (0.75, 0.02), area under the receiver operating curve (0.97, 0.01), and area under the precision-recall curve (0.86, 0.01). Adjudication produced an estimated 4% under-documentation rate for the total study population. As model confidence increased, AUD under-documentation rate rose to 30% of the number of patients identified as positive by ICD-9 coding. Our model improves the identification of patients meeting AUD criteria, outperforming ICD codes in detecting cases of AUD. Detection discrepancy between ICD and free-text highlights clinician under documentation, not under recognition. Adjudication revealed model over-sensitivity to language around substance use, withdrawal, and chronic liver disease; future study requires application to a broader set of patient age and acuity. This model has the potential to improve rapid identification of patients with AUD and enhance treatment allocation.

A behavioral choice analysis of the role of life events during early nonabstinent natural recovery from alcohol use disorder.

Prior research supported a behavioral choice analysis of the role of life events in posttreatment drinking among abstinence-seeking inpatients with alcohol use disorder (AUD). This study investigated the generality of those relationships among persons attempting "natural" recovery involving moderation drinking. We had two hypotheses: (1) The likelihood of drinking after an event would be related to the degree of alcohol-related disruption in the life-health area of the event. (2) Event-related drinking episodes would be quantitatively greater than event-unrelated episodes. Participants (N = 83) were from a larger integrated data set of prospective natural recovery studies of persons with AUD who had stopped heavy drinking and had 6-month follow-up reports of drinking and events; abstainers were excluded. Alcohol-related disruption before resolution was assessed in four domains (relationships, vocational/financial, living arrangements/legal, physical health). As predicted, postresolution event-related drinking was positively correlated with preresolution vocational/financial disruption (p < .01) and negatively correlated with preresolution physical health problems (p = .06). Event-related drinking episodes involved heavier drinking than event-unrelated episodes (p < .001). These findings indicate strong support for the generality of the latter relationship and qualified support for the generality of the former relationship. The different results in the two samples are attributed to differences in the evolution of their AUD recovery process and the decoupling of the event-drinking relationships. The behavioral choice framework suggests ways to improve the characterization of environmental variables in future recovery research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-Worth Through Expertise: Experiences of Prime-Age Men Who are Out of the Formal Labor Force

ABSTRACT Research on masculinity finds that men who are socioeconomically excluded or otherwise marginalized may create subcultures that eschew the values of mainstream society, such as by valuing and engaging in heavy drinking, fighting, bar culture, sports, and crime, as well as rejecting school success; recent discussions have also examined the rejection of expertise and experts as a related backlash to mainstream institutions. Using in-depth interview data, the present study examines how rural, prime-age men (n = 61) who are out of the labor force develop a sense of their own value without formal employment and the role expertise plays in them doing so. Most claim expertise and do so constructively, as they assert a positive sense of their own worth through their knowledge and skills (“I am a person who can … ”). Men make claims to the dignity of holding expertise while outside institutionalized employment roles. This suggests the portability of this cultural tool and that its use is not contingent on institutional endorsements. Men’s self-identity of expertise could be challenged in formal employment settings, making formal work less attractive to them. To understand labor force participation, our focus must go beyond compensation to attend to how work opportunities are aligned or in conflict with men’s identities.

Examining the Utility of the Theory of Planned Behavior in Studying Intention to Reduce Drinking Among High-Risk College Students in the U.S.

ABSTRACT Background Alcohol consumption remains a significant public health issue among U.S. college students. Though prior research has examined behavioral and theoretical factors that predict heavy drinking, less attention has focused on exploring factors concerning alcohol reduction. Purpose The current study identified Theory of Planned Behavior (TPB) constructs associated with high-risk college students’ intent to reduce alcohol use. Methods High-risk college students (n = 822) from a large U.S. public university completed an online survey assessing their alcohol behaviors and the following TPB constructs: attitude, norms, perceived behavioral control, and intention to reduce alcohol use. Results After accounting for important covariates, a multivariate regression demonstrated that students’ attitude and norms were significantly associated with their intention to reduce alcohol use, while perceived behavioral control was not. Altogether, the TPB model explained 61% of the variance in their intention. Discussion The findings underscore the significant role theory, more specifically student’s attitudes and norms, can play in influencing intention to reduce alcohol use. Translation to Health Education Practice Incorporating norms and TPB communication strategies into campus alcohol intervention programs and aligning these efforts with competencies from the National Commission for Health Education Credentialing Inc. can enhance the design, implementation, and evaluation of theory-driven interventions.

Anticancer Effects of New Disulfiram Analogs.

Disulfiram (DSF), an irreversible aldehyde dehydrogenase 2 (ALDH2) inhibitor, is an U.S. Food and Drug Administration (FDA)-approved drug for the treatment of chronic alcoholism. Recent studies have reported an interesting antitumor activity of DSF against a wide range of human malignancies, while a growing number of ongoing and completed clinical trials have provided evidence supporting the repurposing of DSF as an anticancer treatment. Nevertheless, despite its current clinical indications and potential future therapeutic applications for treating various diseases, DSF is associated with serious side effects attributed to the inhibition of ALDH2. We have recently synthesized DSF analogs (2a-v) with limited inhibition of ALDH2. Here, we report the anticancer activity of these molecules by highlighting their effects on cell signaling in Jurkat cells. DSF and two DSF analogs, 2g and 2r, all stimulated apoptotic signaling pathways, although the 2g analog activated more apoptosis-related genes and induced higher levels of apoptosis in vitro. Differential gene expression data suggested that compounds 2g and 2r specifically reprogram target cells to downregulate pathways related to cell growth and division, while upregulating pathways related to apoptosis or differentiation. Interestingly, both compounds 2g and 2r had more differentially expressed genes related to DNA damage pathways (including those related to apoptosis) when compared to DSF, which may offer insights into their mechanisms of action.

Effects of Alcohol on EEG Activity: A Systematic Review Focused on Sex-Related Differences in Youth.

Most electroencephalographic (EEG) investigations on alcohol have focused on adults, and scarce data is available about the potential of EEG measurements to detect young people at high-risk, as well as, to understand possible sex differences in alcohol impact on the brain. This systematic review aimed to explore sex-related differences in EEG among young people with alcohol misuse, alcohol use disorder (AUD), and offspring of families with AUD. A systematic review of the literature was conducted following PRISMA guidelines. Review protocol was registered in Prospero (ID: CRD42024511471). After article selection process and quality assessment, 25 studies were included in our review. The search included participants between 12 and 30 years old with problematic alcohol consumption, as defined by DSM, AUDIT, or specific alcohol misuse questionnaires. It seems that beta was generally higher in young males with AUD, and they usually exhibited greater interhemispheric connectivity (interHC), whereas young females with AUD tended towards enhanced intraHC. P3 appears to be particularly sensitive to alcohol misuse, with males typically exhibiting a lower amplitude than young females. Other event related potentials (ERPs) such as N415, P640, and the error-related negativity (ERN) lacked sufficient methodological support to draw conclusions regarding sex differences, N340 and P540 suggested avenues for expanding research on memory processing, indicating differences in amplitude between males and females. Considering sex variables in clinical research will enhance our understanding of alterations in brain function and structure with the goal of tailoring treatment strategies for AUD.

Supporting multidrug-resistant or rifampicin-resistant TB treatment adherence in people with harmful use of alcohol through person-centred care.

TB is concentrated in populations with complex health and social issues, including alcohol use disorders (AUD). We describe treatment adherence and outcomes in a person-centred, multidisciplinary, psychosocial support and harm reduction intervention for people with multidrug-resistant or rifampicin-resistant TB (MDR/RR-TB) with harmful alcohol use. An observational cohort study, including multilevel mixed-effects logistic regression and survival analysis with people living in Minsk admitted with MDR/RR-TB and AUD during January 2019-November 2021 who received this person-centred, multidisciplinary, psychosocial support and harm reduction intervention, was conducted. There were 89 participants enrolled in the intervention, with a median follow-up of 12.2 (IQR: 8.1-20.5) mo. The majority (n=80; 89.9%) of participants had AUD, 11 (12.4%) also had a dependence on other substances, six (6.7%) a dependence on opioids and three (3.4%) a personality disorder. Fifty-eight had a history of past incarceration (65.2%), homelessness (n=9; 10.1%) or unemployment (n=55; 61.8%). Median adherence was 95.4% (IQR: 90.4-99.6%) and outpatient adherence was 91.2% (IQR: 65.1-97.0%). Lower adherence was associated with hepatitis C, alcohol plus other substance use and outpatient facility-based treatment, rather than video-observed treatment, home-based or inpatient treatment support. This intervention led to good adherence to MDR/RR-TB treatment in people with harmful use of alcohol, a group usually at risk of poor outcomes. Poor outcomes were associated with hepatitis C, other substance misuse and outpatient facility-based treatment support.

Distinct Chrna5 mutations link excessive alcohol use to types I/II vulnerability profiles and IPN GABAergic neurons

Genome wide association and animal studies have implicated genetic variations in CHRNΑ5, encoding the α5 subunit-containing nicotinic acetylcholine receptors (α5*nAChRs), as a risk factor for developing alcohol use disorders (AUDs). To understand how α5*nAChR mutations may influence alcohol (EtOH) drinking behavior, we used a two-bottle choice procedure with intermittent access to alcohol in male and female transgenic mice expressing either the highly frequent human single nucleotide polymorphism (α5SNP/rs16969968) or a deletion of the Chrna5 gene (α5KO). AUDs-related preconsommatory traits (anxiety, sensation-seeking and impulsivity) were assessed with a battery of relevant tasks (elevated-plus maze, novel place preference and step-down inhibitory avoidance). The implication of the α5-expressing IPN GABAergic neurons in AUDs and related behavioral traits was verified using neurospecific lentiviral (LV)-induced reexpression of the α5 subunit in α5KOxGAD-Cre mice. Both α5SNP and α5KO mice showed over-consumption of EtOH, but displayed opposite vulnerability profiles consistent with Cloninger’s subtypes of human AUDs. α5SNP mice showed Type I-like characteristics, i.e., high anxiety, novelty avoidance, whereas α5KOs exhibited Type II-like features such as low anxiety and high impulsivity. LV re-expression of the α5 subunit in IPN GABAergic neurons restored the control of EtOH intake and improved the impulsive phenotype. We demonstrate that the SNP (rs16969968) or null mutation of Chrna5 result in increased volitional EtOH consumption but opposite effects on anxiety, novelty-seeking and impulsive-like behaviors that match Cloninger type I and II of AUDs, including sex-related variations. IPN GABAergic neurons expressing α5*nAChRs play a key role in limiting both EtOH drinking and motor impulsivity.

Examining Between- and Within-subjects Effects of Posting and Exposure to Alcohol-Related Social Media Content on Drinking Over Time.

Social media content featuring alcoholic beverages is posted and viewed by college students. Limited longitudinal research suggests that increased alcohol-related content (ARC) posting and exposure is associated with increased alcohol consumption among college students over time. Emerging evidence suggests this association may be bidirectional, with drinking predicting later ARC posting. The current study examined longitudinal bidirectional associations between alcohol consumption and: posting ARC (aim 1) and friend ARC exposure (aim 2). College students engaging in heavy or problematic drinking (N = 384; Mage = 20.04; 74.2% female; 79.6% White) completed four surveys (baseline, 1-month, 3-month, 6-month). Each survey assessed social media use (including ARC posting) and alcohol use, along with ARC posting behaviors of their social network (i.e., important friends). Random-intercept cross-lagged panel models revealed significant large associations only at the within-subjects level for posting ARC, but significant medium-large between- and within-subjects associations for ARC exposure. Within-subjects, greater alcohol consumption predicted posting 1 month later, and posting at the 3-month follow-up predicted increased drinking at 6-months (aim 1). Between-subjects, individuals who reported greater social network ARC exposure were more likely to report greater alcohol consumption. Within-subjects, greater-than-average ARC exposure at 1-month predicted decreased alcohol consumption at 3-months (aim 2). Results suggest the relationship between alcohol consumption and alcohol posting (self and ARC exposure) is complex and not necessarily bidirectional, with associations between posting and drinking fluctuating within subjects, while between- and within-subjects associations were observed for exposure and drinking. Associations between posting and drinking vary within individuals over time, while associations between exposure and drinking exist for groups, indicating the more people are exposed, the more alcohol they consume.

Plasma neurofilament light chain levels are associated with delirium tremens in patients with alcohol use disorder

Delirium tremens (DT) is the most severe and life-threatening manifestation of alcohol withdrawal. Prompt identification and treatment are crucial in the clinical management of DT, but laboratory markers in this context are still lacking. Neurofilament light chain (NfL) has been proposed as a novel blood marker of neuroaxonal pathology. Therefore, we investigated the association between plasma NfL levels on admission and the occurrence of DT in patients with alcohol use disorder (AUD). NfL levels were measured on admission in 224 patients with AUD undergoing alcohol withdrawal treatment and in 116 healthy individuals. We monitored patients with AUD during the following 2 weeks of hospitalization and categorized them according to the prospective occurrence of DT (n = 25) or not (n = 199). Plasma NfL levels at admission were highest in patients who later developed DT, compared to AUD patients without DT, and healthy individuals (63.1 ± 47.2, 24.0 ± 22.4, 11.8 ± 6.1 pg/mL, respectively, p < 0.001). Receiver operating characteristic analysis revealed that a cut-off NfL level of 27.2 pg/mL could discriminate AUD patients who later developed DT (sensitivity: 80.0 %; specificity: 72.4 %; area under the curve: 0.84, p < 0.001), with an odds ratio of 9.43 (95 % CI 3.26–27.32; p < 0.001) for the risk of developing DT. Our findings suggest that NfL levels at admission may predict DT occurrence in patients with AUD and implicate neuroaxonal pathology in the pathophysiology of DT. Further research is needed to validate these findings and to explore the underlying neurobiological mechanisms.

Binge drinking in American Indian Alaskan Native college attending students

ABSTRACT Objectives American Indian and Alaskan Native (AIAN) populations have the highest rate of alcohol use disorder (AUD). Binge drinking is a known predecessor of AUD and is prevalent in college-attending populations. However, little is known about the prevalence and risk factors related to AIAN college student binge drinking. The current study examines prevalence of binge drinking and association with socio-demographic features, other substance use, exposure to discrimination and feelings of belonging within collegiate institutions. Design Data were collected by the Healthy Minds Study. Present analyses were restricted to 2- and 4-year college attending students in the 2021–2022 academic year who identified as AIAN (n = 1383). We used descriptive, bivariate and multivariate Poisson weighted models to evaluate distributions and associations of binge drinking, age, gender, socioeconomic status, degree program, military experience, substance use, sexual assault, discrimination, and feelings of belonging within the institution. Results In the prior 2 weeks, 26.3% of AIAN students reported binge drinking. Binge drinking commonly overlapped with other substance use. AIAN students aged 21–34 reported the highest rates of binge drinking, as did students pursuing bachelor’s degrees. AIAN students who identified as trans or queer gender were less likely to report binge drinking, while across gender identities those reporting sexual assault or racial discrimination were more likely to report binge drinking in multivariate analyses. Conclusion There are multiple factors associated with binge drinking, representing individual and contextual influences on AIAN students. Developing prevention and intervention activities to address overlap in substance use and high concurrence of sexual assault and binge drinking are critical. Additionally, colleges must make concerted efforts to reduce racial discrimination and be more inclusive of AIAN students to reduce institutional-based features that exacerbate risk.