Alcohol Involvement Research Articles

Do veterans with risky substance use (RSU) use distinct pain treatment modalities?

Risky substance use (RSU) is common among people with chronic pain and is associated with worse pain treatment outcomes. Nonopioid treatment is recommended, but it is unknown whether people with RSU use different or fewer pain treatment modalities. This study describes use of different pain treatments by veterans with and without RSU and those receiving versus not receiving opioid medication. Veterans (N = 924) who filed service-connected disability claims related to musculoskeletal conditions and rated their pain four or higher on the Numeric Rating Scale, reported on 25 different pain services in the preceding 90 days. Recent RSU was identified via Alcohol, Smoking, and Substance Involvement Test (ASSIST) cutoffs and/or nail sample toxicology. Overall, RSU was not associated with number of provider-delivered or self-delivered pain modalities. Over-the-counter medications (71%), self-structured exercise (69%), and nonopioid prescription medications (38%) were the most used modalities. Veterans receiving prescribed opioids (8.4%) were more likely to see primary care, receive injections, and attend exercise and/or meditation classes, compared to those without opioid prescriptions. Opioid and nonopioid pain treatment utilization did not differ based on RSU, and those prescribed opioids were more likely to engage in other nonopioid pain treatments. Regardless of RSU, veterans appear willing to try provider-delivered (58%) and self-delivered (79%) pain treatment. In this first-ever evaluation of 25 different pain treatment modalities among veterans with and without RSU, people with RSU did not use less treatment modalities.

The Role of Spirituality on Ambivalent Behaviors Among Christian Youth Attending Selected Churches in Kajiado County, Kenya

The role of spirituality in mitigating against ambivalent behaviors among Christian youth needs to be studied, with an aim to devising efficacious intervention programs, that can be escalated to other non-Christian youth. This study aimed at investigating the relationship between ambivalent behaviors (substance use and sexual behaviors) and spirituality (strength of faith and religious coping mechanisms) among the Christian youth attending four selected Churches in Kajiado County, Kenya. Through a descriptive research design, data was collected from 145 respondents aged 14-35 years (73 male,72 female) who were regularly attending Sunday services. Data collection instruments were the Santa Clara, to assess strength of faith, the Religious Coping Questionnaire (BRIEF-COPE) to assess the religious coping mechanisms, the Compulsive Sexual Behavior Inventory (CSBI) for sexual impairment and the Alcohol, Smoking and Substance Involvement Screening Test - Lite (ASSIST-Lite) for substance use. Data was analysed quantitatively using the statistical package for social sciences (SPSS, version 29) utilizing Kendall’s tau-b, and scatter plots were generated to assess the nature of the relationship between spirituality and ambivalent behaviors. Findings pointed to a positive statistically significant relationship between sexual behaviors and negative religious coping (τb=.223, 95% C.I .117-.324, p=.008) showing that increased use of negative coping mechanism was related to increased sexual behaviors. The scatter plots showed that overally, ambivalent behaviors had a weak negative relationship with positive coping mechanisms (R2=1.1%) and strength of faith(R2=1.1%), and a weak but positive relationship with negative coping (R2=2.1%). There were several outliers in all the three scatter plots, showing a non-linear relationship implying that other factors were related to the ambivalent behaviors aside from the spirituality. The findings thus pointed to a moderate correlation between spirituality and ambivalent behaviors, where increased faith and use of positive coping mechanisms can mitigate against ambivalent behaviors, but there is also need for additional programs that could directly address the underlying causes, as well as the propagating factors. The study thus recommends a multi-faceted approach, incorporating psychological programs alongside the spiritual nurture, to address ambivalent behaviors among Christian youth. Such programs have the potential to be escalated to other non-Christian youth.

Prevalence of Alcohol/ Substance Use among Christian Youth in Selected Churches in Kajiado County, Kenya

The last decade has witnessed a sky rocketing increase in alcohol and drug use, where it is estimated that 39.5 million people have substance use disorders (UNODC, 2023). It is opined that religion in the lives of youth can mitigate against alcohol and substance use, but research indicates that in spite of the religious beliefs, there is still a significant proportion of youth in churches who are involved in alcohol and substance use (National Study of Youth & Religion, 2024). Christian youth grappling with alcohol and drug use are caught in between following that which is biblically acceptable versus the societal norms and culture (Swindell, 2010). Thus, investigating the prevalence of alcohol and substance use among Christian youth, is crucial to pinpointing the causative factors and developing targeted programs. The purpose of this study was to evaluate the prevalence of alcohol/ substance use among Christian youth in four selected churches in Kajiado County, Kenya. It employed a descriptive research design with a sample size of 145 youth (14-35 years;73 male,72 female), who were actively attending Sunday services in the four churches. Data collection utilized the Alcohol, Smoking and Substance Involvement Screening Test- ASSIST- LITE and a socio demographics questionnaire. The data was analyzed quantitatively in SPSS using frequencies and percentages. Findings from the socio demographic questionnaire inquiring on whether respondents ‘had ever used alcohol/substances’ showed that 53(36.6%) of the respondents affirmed that they had ever used alcohol, 12(8.3%) both khat and alcohol, 3(2.1%) khat, hash and alcohol while 5(3.4%) had ever used other substances and alcohol. The ASSIT-Lite inquired on alcohol and drug use in the past three months, where the most frequently used was alcohol at n=42(28.9%), then cannabis at n=27(18.6%), sedatives at n=14(9.7%), stimulants at n=10(6.9%), psychoactive substances at n=6(4.1%) and then opioids at n=3(2.1%). Of the alcohol/substance users, 12(8.3%), 7(4.8%) and 5(3.4%) were at high risk levels for alcohol, cannabis and stimulant use respectively. The study was informative in that, it revealed Christian youth were still grappling with alcohol/substance use, and hence, targeted psychological and behavioral interventions, alongside the church-based programs are necessary.

Childhood trauma, substance use and depressive symptoms in people with HIV during COVID-19.

Adverse childhood experiences (ACEs), substance use, depressive symptoms, and HIV outcomes in people living with HIV (PLWHIV) have not been comprehensively investigated within a single study. The aim of this study was to investigate the prevalence and association of ACEs, substance use, depressive symptoms and human immunodeficiency virus (HIV) outcomes in PLWHIV accessing HIV care during the coronavirus disease 2019 (COVID-19) pandemic. District hospital HIV clinic in South Africa. A total of 196 PLWHIV completed a socio-demographic and clinical questionnaire; an adapted World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test; WHO ACEs International Questionnaire, and Patient Health Questionnaire. The most common ACEs were having one or no parent, parental separation or divorce (n = 131, 66.8%), exposure to collective (n = 57, 29.1%) and community violence (n = 55, 28.1%), with 40.3% (n = 79) experiencing ≥ 3 ACEs. The most commonly used substances were alcohol (n = 34, 17.3%), tobacco (n = 33, 16.8%), and cannabis (n =13, 6.6%). The prevalence of depressive symptoms was 19.4% (n = 38). Linear regression analyses indicated greater alcohol (adj β = 2.84, p < 0.01), tobacco (adj β = 3.64, p < 0.01) and cannabis use risk scores (adj β = 2.39, p < 0.01) were associated with ≥ 3 ACEs. Logistic regression indicated depressive risk (adjusted odds ratio [OR] = 9.39, 95% confidence interval [CI] 4.78-23.51) was associated with ≥ 3 ACEs. A high prevalence of ACEs, substance use and depressive symptoms exists among PLWHIV, along with an association between cumulative ACEs and both substance use and depressive symptoms. Enhanced screening and management services are recommended to address this triple burden in PLWHIV.

Experiences of Discrimination and Alcohol Involvement Among Young Adults at the Intersection of Race/Ethnicity and Gender.

Although discrimination is an important social determinant of alcohol involvement, there is a dearth of research testing these associations across race/ethnicity and gender. This is an important research gap given that experiences of discrimination and therefore links with alcohol involvement may vary as a function race/ethnicity and gender intersectional identities. We tested for measurement invariance in discrimination and alcohol involvement and examined group differences in means and covariances. The sample consisted of n = 1187 young adults (ages 18-26; n = 193 Black women, n = 209 Latina women, n = 186 White women, n = 198 Black men, n = 203 Latino men, and n = 198 White men). We found evidence for differential item functioning for discrimination and alcohol involvement that violated assumptions needed to make manifest between-group comparisons. To model the source and degree of differential item functioning, we used partial measurement invariance and dropped a discrimination item that did not reliably overlap with the latent factor for White women. After accounting for differential item functioning, Black women and men reported the highest discrimination, followed by Latinx women and men, and then White women and men. White women reported the most alcohol involvement, followed by White men, Latina women, Latino men, Black men, and Black women. Discrimination and alcohol involvement were positively associated for all groups except White women, though effect sizes varied with Black men exhibiting the largest effect. An intersectionally valid understanding of discrimination and alcohol involvement may necessitate statistical approaches that can test for (and model) differential item functioning prior to making between-group quantitative comparisons.

Quantifying the importance of factors in predicting non-suicidal self-injury among depressive Chinese adolescents: A comparative study between only child and non-only child groups

BackgroundDepression is a major global public health concern, often co-occurring with Non-Suicidal Self-Injury (NSSI). Focused on Depressive adolescents, this study aimed to quantify the importance of factors in predicting NSSI and compare them between the only child and non-only child groups, enriching knowledge to leverage tailored intervention strategies. MethodsA large multicenter survey was conducted in China. 2510 adolescents diagnosed with Major Depressive Disorder (MDD) volunteered for the study. 36 factors were included to train random forest models for NSSI prediction in only child and non-only child groups, respectively. The SHapley Additive exPlanations (SHAP) method was utilized to compute the relative importance of each factor in two groups. ResultsAdolescents with MDD exhibited a rather high prevalence of NSSI (52.0 %), among them 66.9 % were non-only children. Self-esteem was the most significant factor for both groups, while critical disparities of factors were also found. In the only child group, factors like family support, parental overprotection, drinking alcohol, sleep conditions and romantic relationship involvement showed greater importance, while higher depression degree, anxiety level and emotional abuse were more important factors for non-only children. LimitationsThe use of cross-sectional data from Chinese adolescents may limit deeper analysis of NSSI mechanisms and the generalizability to Western cultures. ConclusionsOnly and non-only child family structures may have different influence on factors related with NSSI occurrence of adolescents with MDD. Only children were more susceptible to vulnerable family environments, alcohol abuse and romantic experience, while non-only children were more disturbed by abnormal mental states.

High prevalence of alcohol use disorder & psychiatric comorbidity among coal mine workers: Observations from a cross-sectional study in West Bengal.

Background & objectives Tobacco (30%), alcohol (21.4%) and cannabis (3%) are the three most commonly abused substances in India. Tobacco and alcohol abuse have higher prevalence rates among different occupational groups as compared to that in general population in the country. Both tobacco and alcohol lead to significant occupational harm in terms of absenteeism, injuries, sickness and lost productivity. This study estimated the patterns of substance use and associated common psychiatric comorbidity in a sample of coal mine workers. Methods Coal mine workers at the age of 18 yr or above engaged in mining activities (skilled/semi-skilled/unskilled) were recruited from the Raniganj - Asansol coal mining areas of Eastern Coalfields Limited (ECL). Participants were screened to identify patterns of substance use and other common mental health problems. All participants were administered ASSIST (The Alcohol, Smoking and Substance Involvement Screening Test); GENACIS (Gender, Alcohol and Culture: An International Study) modified questionnaire; and Hospital Anxiety and Depression Scale (HADS) for primary screening for anxiety and depression. Results Out of 202 participants 69 per cent (n=140) were found with either 'hazardous and harmful' (moderate risk); or 'dependent' (high risk) patterns of use of either tobacco or alcohol or cannabis or of more than one substance. Only 31 per cent (n=62) were 'low-risk' for all substances. Almost 65 per cent (n=132) and 49 per cent (n=99) participants out of the whole sample (n=202) belonged to 'hazardous and harmful' (moderate risk) and 'dependent' (high risk) pattern of tobacco and alcohol consumption, respectively. About 28.8 per cent (n=38) and 23.7 per cent (n=31) of all participants had anxiety and depression, respectively. Combined moderate to high use of both alcohol and tobacco use was significantly associated with the risk of having anxiety [adjusted odds ratio (AOR)=4.896, P<0.015] and depression (AOR=5.335, P<0.012). Interpretation & conclusions Alcohol and tobacco are major substance abuse problems among coal mine workers. This population requires early community and primary care based brief intervention as well as additional community-based pharmacotherapy for substance dependence problems as well as intervention for common mental health issues.

Identifying the reciprocal causation between hit-and-run behavior and crash injury severity

Objective Hit-and-run behavior is believed to exacerbate the injury severity of traffic crashes due to the delayed emergency response for the victims. However, several previous studies indicated the opposite finding that hit-and-run crashes were associated with less severe injuries. The relevant studies mainly identified the statistical associations between hit-and-run behavior and injury severity without revealing causation between them. To this end, the study aims to explore the reciprocal causation between the two variables. Method The two-stage probit model with endogenous regressors is employed to identify the reciprocal causation between hit-and-run behavior and crash injury severity for single- and two-vehicle crashes, respectively, with the use of crash data extracted from the Crash Report Sampling System and Fatality Analysis Reporting System (2016-2019). Results The results indicate that 1) for both single- and two-vehicle crashes, the fleeing behavior can significantly increase the injury severity of the victims in the crashes while the severe injury of the victims has a negative impact on the propensity of such behavior, 2) the propensity of hit-and-run behavior is influenced by various instrumental variables such as driver age, gender, alcohol involvement, weekday, area type, and light condition, and 3) crash injury severity is significantly related to the victim age, gender, and vehicle damage. Conclusions There is a reciprocal causation between hit-and-run behavior and injury severity in traffic crashes. The analytical results can provide a reasonable explanation for the counterintuitive finding on hit-an-run crashes and help mitigate the injury severity.

Male Predominance in West Virginia Unintentional Overdose Deaths is Influenced by Alcohol and Co-Intoxicants.

To examine sex differences in overdose (OD) mortality based upon substances involved. A retrospective database analysis of West Virginia OD decedents (12,666 unintentional OD deaths, 2005-early 2023). Exposures were substances judged to contribute to death. The main outcome measure was determination of male to female death ratios with varying co-intoxicant involvement, particularly related to alcohol and fentanyl. Secondary outcomes included associations of fentanyl concentrations with alcohol concentrations and male sex, including fentanyl (F) and inactive metabolite norfentanyl (N) concentration variability between sexes. Alcohol co-intoxication in OD deaths was associated with higher male:female death ratios, from 2.0 (alcohol absent) to 3.3 (alcohol present). There was a greater increase over time in alcohol involvement in recent deaths involving females compared to males (relative increases of 52% vs. 6%, respectively). Male:female ratios with alcohol and fentanyl co-involvement ranged from 5.9:1 (only two drugs involved) to 2.4:1 (= 5 substances), with females significantly more likely to have multiple substances contributing to death. Overall, males had statistically significantly larger fentanyl (F) to norfentanyl (N) median concentration ratios compared to females (8.8 vs. 6.9, respectively). Multivariable analyses found alcohol presence was associated with a statistically significant 22% reduction in predicted fentanyl concentrations. Male:female ratios in unintentional OD deaths were higher with greater alcohol involvement and lower with fewer co-intoxicants. Fentanyl and norfentanyl concentration differences by sex were observed. It is important to determine possible contributors to sex differences in OD death rates to better target prevention and treatment initiatives.

Trauma system management of adults with severe burns in Victoria, Australia.

The aim of the present study was to examine the profile, management and outcomes of adult patients with severe burns within the Victorian State Trauma System (VSTS). Data from the Victorian State Trauma Registry (VSTR) was analysed to characterise patient and injury characteristics and review pre-hospital management and clinical outcomes of adult patients with severe burns. There were 421 cases over 13 years of the study. Approximately 80% of cases were flame burns, and 5% were associated with other significant trauma. Approximately 75% were male; with 83% of patients under 65 years old, 40% of lower socioeconomic status, 25% having pre-existing drug and alcohol involvement, and 36% living with associated comorbidities. All but 11 patients (of 421) were managed definitively at the burns service. Around one-third of patients had interhospital transfer, with median (interquartile range (IQR)) time spent in the primary hospital 3.0 (1.9-4.3) h. Only five patients had multiple interhospital transfers. Nearly 75% of patients were admitted to an ICU. The median (IQR) length of definitive hospital stay was 27.2 (11.2-44.9) days. The mortality rate was 23.8%. Severe burns are uncommon injuries with high mortality. There is a high rate of adherence to VSTS guidelines for managing patients with severe burns, and a decrease in patients requiring transfer associated with an increase in acceptable time to a trauma-receiving hospital. The VSTS operates to deliver almost all patients with severe burns to the definitive burns service efficiently.

Cm(III) speciation in the presence of citrate from neutral to hyperalkaline conditions and the effect of calcium

We investigated the binary Cm-citrate system using time-resolved laser fluorescence spectroscopy (TRLFS), parallel factor analysis (PARAFAC), and quantum chemical calculations. Evidence collectively suggests the stepwise coordination and deprotonation of citrate alcohol groups in Cm-cit complexes with two bound citrate moieties upon increasing pH, which is supported by a bathochromic shift in emission spectra, an observed increase in lifetime measurements, and lower energy minima for citrate alcohol involvement versus hydrolysis of the Cm-citrate species. Our PARAFAC results agree with a 3-component model for the Cm-citrate system and offer pure component decompositions, yielding fraction species across the studied pH range that have a correlated slope = 1 as a function of pH. For the first time, evidence of ternary Ca-Cm-citrate complexes was revealed by TRLFS with increasing calcium concentration at fixed pHm. The formation of these ternary complexes was substantiated with density functional theory (DFT) calculations on simple model systems of the complexes. Shared citrate carboxylate groups between calcium and curium were proposed for all three ternary Ca-Cm-cit complexes based on DFT-determined Ca–O and Cm–O distances. Moreover, we found that the ternary complex with both alcohol groups deprotonated is most stable when it shares both two carboxylate and two alcohol groups between Ca and Cm. The presence of shared functional groups highlights the enhanced stability of these ternary complexes. Additional work is warranted to further constrain the stoichiometry, stability constants and dependence on ionic strength of these complexes for purposes of thermodynamic modeling of repository settings.

Patterns and sociodemographic characteristics of substance abuse among hepatitis C virus-infected patients in Iraq: a cross-sectional study

BackgroundSubstance use disorders are a widely recognized problem among hepatitis C-infected patients; moreover, substance abuse by intravenous injection is a common mode of transmission of the hepatitis C virus worldwide. The frequency of substance use disorders and their relation to hepatitis C infection are still unknown in Iraq. This cross-sectional study, conducted among a sample of hepatitis C- infected patients attending the Gastrointestinal Tract Center in Baghdad Medical City, aimed to examine the prevalence of substance use disorders, the sociodemographic characteristics of the abusers, and the relation between intravenous drug abuse and hepatitis C virus infection. All participants were subjected to an Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) questionnaire and a data form to determine sociodemographic characteristics and hepatitis C virus-related risk factors.ResultsIn a total of 300 hepatitis C virus-infected patients, the prevalence of substance use disorders was 53.6%. Among these patients, 43.6% abused nicotine, 6% abused licit drugs, and 4% abused alcohol. No one reported illicit drug abuse. Intravenous drug abuse was rare, and there was no relationship found between intravenous drug abuse and hepatitis C infection. Cupping (23%) and blood transfusion (20.3%) were both significantly associated with hepatitis C transmission in this study (p > 0.001).ConclusionThis study revealed a high prevalence (53.6%) of substance abuse in this sample of hepatitis C-infected patients, with nicotine being the most commonly abused substance. However, there was no relationship between hepatitis C infection and intravenous drug abuse. Common risk factors that might contribute to hepatitis C transmission among this population include cupping and blood transfusion.

Prevalence and factors associated with opioid use disorder among adolescents with sickle cell disease in Mulago hospital, Uganda

BackgroundOpioid use disorder (OUD) among adolescents with sickle cell disease (SCD) patients increases their risk of complications from sickle cell disease, such as infections, stroke, acute chest syndrome, sudden death, and organ failure. This negatively impacts families, communities, the national health system, and the economy. This study aimed to determine the prevalence and factors associated with opioid use disorder among adolescents with SCD at Mulago Hospital Uganda.MethodsThis study was carried out at the Sickle Cell Clinic of Mulago Hospital, the national referral hospital in Uganda. The study participants were adolescents aged 10 to 19 years. Following informed consent/ assent, a sociodemographic questionnaire, the WHO Alcohol, Smoking and Substance Involvement Screening Test - Young (ASSIST-Y), the Beck Depression Inventory-II (BDI II), and Generalized Anxiety Disorder − 7 (GAD-7) questionnaires were used to collect data. Data was entered in EpiInfo and analyzed in STATA 15.ResultsThe prevalence of opioid use disorder was 5.3%. The significant risk factor was increasing depressive score AOR: 1.11(95% CI: 1.01–1.22, p = 0.035), while living with a family was protective against opioid use disorders AOR: 0.01; (95% CI: 0.0004, 0.27, p = 0.007).ConclusionThere was a significant problem of OUD among adolescents with SCD. There is, therefore, needed to integrate screening of OUD and mental illnesses like depression among adolescents with SCD and to emphasize the importance of family support in their care.

A Geospatial Drug Abuse Risk Assessment and Monitoring Dashboard Tailored for School Students: Development Study With Requirement Analysis and Acceptance Evaluation.

The enormous consequences of drugs include suicides, traffic accidents, and violence, affecting the individual, family, society, and country. Therefore, it is necessary to constantly identify and monitor the drug abuse rate among school-going youth. A geospatial dashboard is vital for the monitoring of drug abuse and related crime incidence in a decision support system. This paper mainly focuses on developing MyAsriGeo, a geospatial drug abuse risk assessment and monitoring dashboard tailored for school students. It introduces innovative functionality, seamlessly orchestrating the assessment of drug abuse usage patterns and risks using multivariate student data. A geospatial drug abuse dashboard for monitoring and analysis was designed and developed in this study based on agile methodology and prototyping. Using focus group and interviews, we first examined and gathered the requirements, feedback, and user approval of the MyAsriGeo dashboard. Experts and stakeholders such as the National Anti-Drugs Agency, police, the Federal Department of Town and Country Planning, school instructors, students, and researchers were among those who responded. A total of 20 specialists were involved in the requirement analysis and acceptance evaluation of the pilot and final version of the dashboard. The evaluation sought to identify various user acceptance aspects, such as ease of use and usefulness, for both the pilot and final versions, and 2 additional factors based on the Post-Study System Usability Questionnaire and Task-Technology Fit models were enlisted to assess the interface quality and dashboard sufficiency for the final version. The MyAsriGeo geospatial dashboard was designed to meet the needs of all user types, as identified through a requirement gathering process. It includes several key functions, such as a geospatial map that shows the locations of high-risk areas for drug abuse, data on drug abuse among students, tools for assessing the risk of drug abuse in different areas, demographic information, and a self-problem test. It also includes the Alcohol, Smoking, and Substance Involvement Screening Test and its risk assessment to help users understand and interpret the results of student risk. The initial prototype and final version of the dashboard were evaluated by 20 experts, which revealed a significant improvement in the ease of use (P=.047) and usefulness (P=.02) factors and showed a high acceptance mean scores for ease of use (4.2), usefulness (4.46), interface quality (4.29), and sufficiency (4.13). The MyAsriGeo geospatial dashboard is useful for monitoring and analyzing drug abuse among school-going youth in Malaysia. It was developed based on the needs of various stakeholders and includes a range of functions. The dashboard was evaluated by a group of experts. Overall, the MyAsriGeo geospatial dashboard is a valuable resource for helping stakeholders understand and respond to the issue of drug abuse among youth.

Associations between mental health & substance use treatment and alcohol use progression and recovery among US women drinkers.

Alcohol use has profound public health impact on women; however, modifiable factors that may influence alcohol use progression/recovery, including health service utilization, are understudied in women. To investigate the association between mental health (MH) and substance use (SU) treatment with alcohol use progression and recovery among women who currently use alcohol or have in the past. This study is a secondary data analysis of prospective data from waves 1 (2001-2002) and 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; a US-nationally representative sample of adults). The analytic sample was limited to women who reported past or current alcohol use at wave 1 (N = 15,515). Latent transition analysis (LTA) examined whether receiving SU/MH treatment in the year prior to wave 1 was associated with transitioning between three empirically-derived stages of alcohol involvement (no, moderate, and severe problems classes), between Waves 1 and 2 adjusting for possible confounders using propensity score weight. Compared to White female drinkers, female drinkers who were from Black, Hispanic, or other races were less likely to receive SU/MH treatment (p-values ≤. 001). SU/MH treatment in the year prior to wave 1 was associated with transitioning from the moderate problems class to the no problems class between Waves 1 and 2 (p-value = .04). Receipt of SU or MH treatment among women, was associated with a higher likelihood of remission from moderate alcohol use problems to no problems over time. Future research, including investigation into treatment characteristics (e.g., frequency, duration, type) should further explore why women initially experiencing severe alcohol use problems did not experience similar remission.

Prevalence and Correlates of Substance Use and the Effects on the Young People in a Southwestern State of Nigeria

In 2015, psychoactive substance use led to the deaths of 72 young people within a month across Ondo, Edo, and Rivers states in Nigeria, with Ondo being the most affected. The youth attributed these deaths to the wrath of the gods (Malokun) rather than alcohol consumption. This study aims to identify demographic factors influencing youth substance use in Ondo State. Using a cross-sectional, descriptive community study design, 500 participants aged 10 to 24 years were recruited. Data collected through a socio-demographic questionnaire and the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) were analyzed with Statistical Package for Social Science (SPSS) version 16. The findings revealed that alcohol was the most used substance, with a lifetime use prevalence of 69.6%, likely due to the availability and cultural acceptability of local alcoholic products like ogogoro and palm wine. Substance use was found to negatively impact social life. Significant correlates of substance use included gender, age, religion, and father’s relationship. Males had higher lifetime use than females (p = 0.008), and substance use prevalence was higher among late adolescents (p = 0.0034). Christian respondents reported higher lifetime use compared to Muslims (p = 0.010). These results highlight that alcohol is the predominant substance used by young people in Ondo State, with key correlates being male gender, religion, less friendly father relationships, and late adolescence, informing public health strategies to mitigate harmful effects of substance use.

Changes in cannabis involvement in emergency department visits for anxiety disorders after cannabis legalization: a repeated cross-sectional study

An increasing number of countries have or are considering legalizing cannabis. One concern is that legalization of cannabis will result in increased cannabis use and in turn a higher prevalence of anxiety disorders. We examined changes in emergency department (ED) visits for anxiety disorders with cannabis involvement in Ontario, over a period that involved medical and non-medical cannabis legalization. This repeated cross-sectional population-based study identified all ED visits for anxiety disorders from residents of Ontario, Canada aged 10-105 between 2008 and 2022 (n=15.7 million individuals). We used interrupted time series analyses to examine immediate and gradual changes in cannabis-involvement and alcohol-involvement (control condition) over four policy periods: medical cannabis legalization (January 2008-November 2015), expanded medical access (December 2015-September 2018), non-medical cannabis legalization with restrictions (October 2018-February 2020), and commercialization which overlapped with the COVID-19 pandemic (March 2020-December 2022). Poisson models were used to generate incidence rate ratios with 95% confidence intervals. Over the 14-year study, there were 438,700 individuals with one or more ED visits for anxiety disorders of which 3880 (0.89%) individuals had cannabis involvement and 6329 (1.45%) individuals had alcohol involvement. During the commercialization/COVID-19 period monthly rates of anxiety disorders with cannabis-involvement were 156% higher (0.11 vs 0.29 per 100,000 individuals) relative to the pre-legalization period, compared to a 27% increase for alcohol-involvement (0.27 vs 0.35 per 1100,000 individuals). Rates of anxiety ED visits with cannabis involvement per 100,000 individuals increased gradually over the study period with no immediate or gradual changes after expanded medical access, legalization with restrictions or commercialization/COVID-19. However, during the commercialization/COVID-19 period there were large declines in total anxiety disorder ED visits and anxiety disorder ED visits with alcohol-involvement. Consequently, during this period there was an immediate 31.4% relative increase in the proportion of anxiety visits with cannabis-involvement (incidence rate ratio [IRR], 1.31; 95% CI 1.05-1.65). We found large relative increases in anxiety disorder ED visits with cannabis involvement over a 14-year period involving medical and non-medical cannabis legalization. These findings may reflect increasing anxiety disorder problems from cannabis use, increasing self-medication of anxiety disorders with cannabis use, or both. The proportion of anxiety ED visits with cannabis involvement increased during the final period of the study but could have been the results of the market commercialization, COVID-19 or both and ongoing monitoring is indicated. Canadian Institutes of Health Research (grant #452360).

Head injuries related to bicycle collisions and helmet use – an observational study

Objectives In Denmark, the use of bicycles is widespread, and head injuries are often seen in cyclists involved in collisions. Despite the well-known effects of using a helmet to reduce head injuries, using helmets is not mandatory in Denmark. The primary objective of this study was to provide data regarding injury outcomes and helmet usage. Methods Participants were bicyclists who sustained head injuries in bicycle collisions and were assessed by the Copenhagen Emergency Medical Services between 1 January 2016; and 15 June 2019. Patients with suspected head injury were identified in an electronic prehospital patient record. Data were linked to the Danish National Patient Registry to retrieve the diagnosis and were categorized into head injury or no head injury based on the diagnosis. Adjusted logistic regression analyses were reported with odds ratios and corresponding confidence intervals to assess the risk of head injury while adjusting for risk factors like age, sex, alcohol consumption, occurrence during weekends and traumatic brain injury. Results A total of 407 patients were included in this study. Within this entity, 247 (61%) had sustained a head injury. The use of a helmet was reported in one-third of the included patients. Among the head-injured patients, 13% sustained moderate to severe head injuries. Patients with suspected alcohol involvement were significantly less likely to report the use of a helmet. Helmet use reduced the risk of head injury with an odds ratio of 0.52, (95% CI 0.31 − 0.86). In high-energy trauma, the use of a helmet showed a significant reduction in the risk of sustaining a head injury with an odds ratio of 0.28, (95% CI 0.12 − 0.80). Conclusions In this study, using a helmet was associated with a significantly decreased risk of head injury; this association was even more significant in high-energy trauma.

Comparing alcohol involvement among injured pedalcycle and motorcycle riders across three national public-use datasets

Background Annually since 2008; over 38% of fatally injured motorcycle riders and 20% of pedalcyclists involved in traffic crashes were under the influence of alcohol, yet public health surveillance of alcohol involvement in these injuries is underdeveloped. This study determined alcohol involvement among fatally and non-fatally injured pedalcycle and motorcycle riders and compared findings across three national public-use datasets. Methods Using the 2019 National Emergency Medical Services Information System (NEMSIS), the Fatality Analysis Reporting System (FARS), and National Electronic Injury Surveillance System (NEISS) datasets, we identified alcohol involvement in fatal and non-fatal injuries to pedalcycle and motorcycle riders (≥21 years). Alcohol involvement was positive based on the clinician’s evaluation of alcohol at the scene (NEMSIS) or within the ED record (NEISS); or when Blood Alcohol Content (BAC) values were ≥.01 (FARS). Pedalcycle and motorcycle injuries were identified across datasets using: 1) ICD10 codes for pedalcycle (V10-V19) or motorcycle (V20-V29) within the cause of injury and EMS respondent’s impression of the encounter variables (NEMSIS); 2) product codes for bicycles or moped/power-assisted cycle/minibike/two-wheeled, powered, off-road vehicles (NEISS); and 3) American National Standard Institute’s classifications for pedalcycle and motorcycle in the person and vehicle type variables (FARS). The descriptive epidemiology was compared across datasets. Results There were 26,295 pedalcyclist and 50,122 motorcycle rider injuries resulting in an EMS response within NEMSIS data; 10.2% and 8.5% of these injuries respectively involved alcohol. These estimates were greater than the 7.3% of pedalcyclist and 6.1% of moped/power-assisted cycle/minibike/two-wheeled, powered, off-road vehicle injuries involving alcohol among patients who presented to an ED within the NEISS dataset. Based on FARS data, alcohol was involved in 27.0% of pedalcyclist and 42.0% of motorcyclist fatal injuries. Regardless of the data source, pedalcyclist and motorcycle fatal and non-fatal injuries were more likely to involve alcohol among middle-aged adults compared to older and early aged adults, and for men compared to women, with proportions that were generally 3-8% higher for men. Conclusions Measures for pedalcycle and motorcycle injuries and alcohol involvement vary substantially across national public-use datasets. Standardized, valid, and feasible methods are needed to accurately inform injury prevention efforts.

Disaggregating trends in alcohol involvement among Hispanic, Black, and White female and male U.S. adolescents: 2002 to 2019.

Alcohol involvement is declining among U.S. adolescents, however studies examining population-level trends in alcohol involvement among females and males from diverse racial and ethnic backgrounds are scarce. Therefore, the current study examined alcohol involvement from 2002 to 2019 among Hispanic, Black, and White U.S. adolescent females and males. Data were from the National Survey on Drug Use and Health, years 2002-2019. Participants were between 12 to 17 years old and Hispanic, non-Hispanic Black, or non-Hispanic White. Annualized change estimates within each subgroup were analyzed separately for four alcohol variables: 1) lifetime alcohol use; 2) age at alcohol initiation; 3) past-year drinking days; 4) respondent's perceived risk of alcohol misuse. Lifetime alcohol use decreased for all groups, and the decrease was strongest for Hispanic males. Age at alcohol initiation similarly increased for Hispanic and White females and males, with no change in age at alcohol initiation for Black adolescents. Past-year drinking days declined for all groups but was not significant for Black females. Perceiving alcohol misuse as a "great risk" increased only for Hispanic males and females. Although alcohol involvement is declining among U.S. adolescents, results from this study highlight that engaging with alcohol is normative among many adolescent groups. Also, when considering sex as well as race and ethnicity, there are important distinctions in patterns of decline in alcohol involvement that should be accounted for to inform future research and screening.