Problematic Alcohol Use Research Articles

Psychological outpatient follow-up after hospitalization for adolescent acute alcohol intoxication.

The findings of this study demonstrate that a preventive program following acute alcohol intoxication contributes to the reduction of adolescent alcohol use and associated risk-taking behaviours. • Earlier studies showed that adolescents with problematic alcohol use reported reduced alcohol consumption and fewer alcohol-related problems after participating in a motivational interviewing intervention compared to standard care. • During the follow-up assessment of adolescents with acute alcohol intoxication it is possible to signalize mental disorders and to determine whether the patient requires referral to specialized mental healthcare. • These findings suggest that the preventive program had a short-term impact in reducing alcohol consumption among adolescents with acute alcohol intoxication, as well as a long-term impact in reducing binge-drinking behaviours. • The program's success in mitigating binge-drinking behaviours aligns with its goals of promoting safer drinking habits among adolescents.

A multi-omics Mendelian randomization study identifies new therapeutic targets for alcohol use disorder and problem drinking.

Integrating proteomic and transcriptomic data with genetic architectures of problematic alcohol use and alcohol consumption behaviours can advance our understanding and help identify therapeutic targets. We conducted systematic screens using genome-wise association study data from ~3,500 cortical proteins (N = 722) and ~6,100 genes in 8 canonical brain cell types (N = 192) with 4 alcohol-related outcomes (N ≤ 537,349), identifying 217 cortical proteins and 255 cell-type genes associated with these behaviours, with 36 proteins and 37 cell-type genes being new. Although there was limited overlap between proteome and transcriptome targets, downstream neuroimaging revealed shared neurophysiological pathways. Colocalization with independent genome-wise association study data further prioritized 16 proteins, including CAB39L and NRBP1, and 12 cell-type genes, implicating mechanisms such as mTOR signalling. In addition, genes such as SAMHD1, VIPAS39, NUP160 and INO80E were identified as having favourable neuropsychiatric profiles. These findings provide insights into the genetic landscapes governing problematic alcohol use and alcohol consumption behaviours, highlighting promising therapeutic targets for future research.

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.

An integrated alcohol and suicide intervention for adolescents in inpatient psychiatric treatment.

Despite the bidirectional relationship between alcohol use and STB, the two issues are often treated separately in adolescent inpatient psychiatric hospitals, highlighting the need for brief interventions that address both alcohol use and STB in an integrated fashion. This study tested the feasibility, acceptability, and preliminary effectiveness of a brief integrated Alcohol and Suicide Intervention for Suicidal Teens (iASIST) with a post-discharge mHealth booster for adolescents in inpatient psychiatric treatment. We conducted an RCT of iASIST relative to an attention-matched comparison condition with adolescents hospitalized following STB (N = 40). iASIST demonstrated feasibility and acceptability and mixed models indicated that both groups had significant decreases in substance use over the 3-month follow-up, but post-intervention group differences were not significant. In terms of cannabis use, however, iASIST participants significantly improved over time. Intervention group participants showed a significant decrease in suicide plans from baseline to follow-up, which was not the case for control group participants. Study findings suggest a larger RCT is warranted to test the effectiveness of the iASIST intervention. iASIST shows promise in its ability to target the public health problems of alcohol use and STB in an integrated fashion with a high-risk adolescent population receiving acute psychiatric care.

Longitudinal patterns of alcohol and cannabis use among US young adults: Correlates and implications for problematic health outcomes.

Alcohol and cannabis use are common during young adulthood. Less is known regarding correlates of alcohol-cannabis use patterns and related problematic health outcomes. Using longitudinal survey data (Fall 2018, 2019, 2020) from 2,194 young adults (YAs; ages 18-34), bivariate analyses and multivariable logistic regressions examined: (1) Wave 1 (W1) sociodemographics and psychosocial factors (i.e., adverse childhood experiences [ACEs], depressive symptoms, personality traits, parent and peer alcohol and cannabis use) in relation to W3 past-month use group (i.e., use of neither, alcohol only, cannabis only, both/co-use); and (2) W3 use group in relation to W5 problematic alcohol use (Alcohol Use Disorder Identification Test), problematic cannabis use (Cannabis Use Disorder Identification Test), and depressive/anxiety symptoms (Patient Health Questionnaire - 4 item). Overall, 42.3% reported W3 alcohol-only use, 34.9% co-use, 17.8% no use, and 5.0% cannabis-only use. Those reporting W3 co-use reported greater W1 extraversion, openness, friend alcohol/cannabis use, and were more likely to report parent cannabis use (vs. no use); reported less conscientiousness, greater friend cannabis use, and were more likely to report depressive symptoms and parent cannabis use (vs. alcohol-only use); and reported greater friend alcohol use, and were more likely to report parent alcohol use (vs. cannabis-only use). W3 co-use was associated with higher odds of W5 problematic alcohol use (vs. alcohol-only use) and problematic cannabis use (vs. cannabis-only use). Substance use messaging and interventions should consider YAs' alcohol-cannabis co-use and the unique correlates of such use.

Neurostructural features predict binge drinking in emerging adulthood: Evidence from a 5-year follow-up study

BackgroundBinge drinking (BD) involves consuming large amounts of alcohol within a short timeframe, leading to a blood alcohol concentration of 0.08g/dL or above. This pattern of alcohol consumption is prevalent among young adults and has significant implications for brain structure and subsequent drinking behaviors. MethodsIn this prospective longitudinal study, we employed zero-inflated negative binomial regression models to examine whether various neurostructural features (i.e., volume, surface area, cortical thickness) of brain regions involved in executive and emotional/motivational processes at the age of 18–19 could predict number of BD episodes five years later, at ages 23–24, once participants were expected to complete their university degree. Specifically, we recorded magnetic resonance imaging (MRI) data from 68 students who completed both the baseline MRI and follow-up alcohol use assessment, with the aim of analyzing the predictive value of these neurostructural characteristics five years later. ResultsThe analysis revealed that a larger surface area in the caudal division of the right middle frontal gyrus was significantly associated with a higher incidence rate of BD episodes (IRR = 2.24, 95 % CI = 1.28–3.91, p = 0.005). Conversely, a smaller surface area in the right caudal anterior cingulate cortex was associated with a higher incidence rate of BD episodes (IRR = 0.61, 95 % CI = 0.44–0.85, p = 0.004). ConclusionsThese findings suggest that specific neurostructural characteristics during adolescence can predict BD behaviors in young adulthood. This highlights the potential of neuroimaging to identify individuals at risk for developing problematic alcohol use.

5.Y.2. Alcohol intoxication among adolescents in Italy, Belgium and The Netherlands

Abstract Excessive drinking behavior poses a significant risk to the health of adolescents and contributes to high social and health costs. It is also well-documented that engaging in risky drinking behavior at a young age increases the likelihood of developing alcohol use disorders and other mental health disorders later in life. Therefore, the timely development of adequate interventions to prevent and reduce such behavior is an important public health task. The initial step here is to gather comprehensive data on the phenomenon. Studying alcohol intoxication data among adolescents is an important source in this context. In the Netherlands, data on alcohol intoxication in adolescents have been routinely collected for several years, leading to a successful transmural framework aimed at supporting these young individuals and their parents. As countries are at varying stages in addressing this issue, the objective of this workshop is to facilitate mutual learning about effective prevention initiatives targeting problematic alcohol use in young people. The workshop will feature presentations from four studies representing three countries: Italy, Belgium, and the Netherlands. Allegra Ferrari from Italy will discuss alcohol-related emergencies among adolescents admitted to an emergency department in Genoa, emphasizing the importance of urgent interventions to mitigate adolescent alcohol use. Hanna van Roozendaal from Belgium will present data from both retrospective and prospective studies on adolescents with acute alcohol intoxication in Antwerp hospitals, exploring the feasibility of follow-up interventions. Louise Pigeaud from the Netherlands will share data from a cohort of individuals under 18 years presented with acute alcohol intoxication symptoms at an emergency department between 2015-2023 to monitor trends in admission characteristics. Finally, Guido van Hal will focus more in depth on the differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in Italy, Belgium and The Netherlands. The workshop will conclude with an open discussion on topics such as the necessary data to be registered for minors with acute alcohol intoxication, the most effective methods for preventing/reducing alcohol intoxication in these age groups, and the potential transferability of the successful Dutch transmural framework to other countries. Key messages • Acute alcohol intoxication and problematic alcohol use in minors can lead to significant alcohol-related issues in adulthood. • Collecting and analyzing high-quality data can facilitate the development of interventions aimed at reducing and preventing alcohol-related issues in adolescents.

Characteristics of adolescents with acute alcohol intoxication in Belgium

Abstract Background Binge drinking and acute alcohol intoxication (AAI) are common in Belgian adolescents, posing a risk of serious health consequences. To develop cost-effective preventive measures for problematic alcohol use in adolescents in Belgium, more insight into the background of this group is necessary. Methods To gain more insight into the prevalence, medical characteristics and context of AAI, a retrospective multicentre hospital chart study was performed on adolescents aged 10 to 18 years with AAI in Antwerp, Belgium from 2015-2021. Furthermore, a prospective intervention study for adolescents with AAI in Antwerp was set up in 2023, of which the first results were not yet known at the time of submission. However, these results will be presented at the conference, if available. Results Over the study period, a total of 1032 admissions related to alcohol intoxication occurred in 1016 patients, with a median age of 16.6 years old and a median blood alcohol intoxication (BAC) of 1.95 g/L. There was combined drug use in 10% of the cases. Only 17% of the patients received additional care after admission. These findings did not significantly change over the study period. Multiple linear regression analyses indicated that after correcting for covariates, higher age, no combined drug use and decreased consciousness at admission were associated with more severe AAI cases (higher BAC). Conclusions AAI is prevalent among Belgian adolescents. Therefore, better-targeted preventive measures and policies are needed. Our findings could be taken into account when developing preventive measures. However, data addressing the demographics and context of AAI were mostly missing. Therefore, a prospective follow-up study was set up in Antwerp, which started in 2023 and is still ongoing. Furthermore, this study will investigate the feasibility and effectiveness of a follow-up intervention for this group of patients.

Alcohol misuse among university students before and during COVID-19: The role of mental health

Objective: Examine predictors of alcohol misuse among university students amid the COVID-19 pandemic. Participants: University students who completed the National College Health Assessment III before, during, and after the pandemic lockdown. Methods: Using multivariable logistic regression, we examined associations between psychological functioning, time spent with family and friends, and problematic alcohol use. Results: Alcohol use decreased, and psychological functioning was poorest one year after COVID-19-related university closures. While indicators of psychological functioning started to improve in the second year after the school closures, alcohol use started to increase. Overall stress, spending more time with friends, and fraternity/sorority residence significantly predicted moderate to high risk for alcohol dependence and binge drinking two years post-pandemic. Severe psychological distress (OR= 1.36, CI = 1.22, 1.52, p < 0.001) predicted moderate to high risk for alcohol dependence but not binge drinking. Conclusion: Innovative mental health interventions are needed to reduce alcohol misuse among university students.

Clinical outcomes and outcome predictors of two-year assertive community treatment in Norway: an explorative prospective pre–post study

BackgroundAssertive Community Treatment (ACT) teams have become a part of mental health services for people with severe mental illness in many high-income countries. Studies in several countries have investigated the outcomes of ACT, and knowledge is also needed about outcomes of ACT teams in Norway. Our aims were to study clinical outcomes of ACT, how the outcomes were associated with characteristics of patients and treatment, and whether they differed across ACT teams.MethodsOur explorative, prospective, pre–post multicenter study involved 142 patients who received ACT for two years from the first 12 ACT teams established in urban and rural areas of Norway. There was no control group. The primary outcome was change in clinician-rated psychiatric symptoms. Secondary outcomes were clinician-rated change in functioning and engagement and change in community tenure compared with 2 years prior to ACT. We measured fidelity to the ACT model using the Tool for Measurement of Assertive Community Treatment. We performed linear mixed-effects modeling to analyze outcomes and their associations with characteristics of patients and treatment.ResultsAfter two years, psychiatric symptoms were significantly reduced with a small effect size. Negative symptoms, anxiety and depression, and agitation and mania had significant reductions, while positive symptoms had nonsignificant changes. Functioning, engagement, and community tenure all significantly increased with small effect sizes. Age, difficulty to engage, problematic use of alcohol, frequent previous use of inpatient services, total number of sessions, and team’s fidelity to the ACT model were associated with different groups of symptoms. Less improvement in functioning was associated with team fidelity and number of sessions. Change in engagement was not associated with any predictors. Increased community tenure was greater for younger patients and patients who were on community treatment orders at treatment start.ConclusionsACT for two years led to significant positive outcomes with small effect sizes for psychiatric symptoms, functioning, engagement, and community tenure. The outcomes were associated with some potential predictors, and some team-level variance emerged. Positive significant outcomes after two years indicate that larger improvements may be achieved from longer-term treatments by ACT teams.

Preliminary Results of a Voluntary One-Month Abstinence Program on Drinking Refusal Self-Efficacy and Craving

ABSTRACT The aim of this study was to investigate how drinking refusal self-efficacy (DRSE) and craving change and are linked during the participation in the Dry November one-month voluntary abstinence-based program. The present sample consisted of 27 participants who successfully completed the program. Paired sample t-tests indicated significant increase for DRSE and non-significant change for craving by the end of the program. Higher increase in DRSE during the program was correlated with higher craving and lower pre-program DRSE. Future research is needed on a larger sample to investigate the mechanisms among DRSE, craving and alcohol use. However, the findings might indicate the relevance of DRSE in treatments targeting problem alcohol use and maintaining alcohol abstinence.

Delay discounting of rewards and losses, alcohol use, and the influence of socioeconomic factors: A cross-sectional online study in frequent drinkers.

Delay discounting describes the devaluation of future outcomes over time and is a popular behavioral construct in addiction research. Prior studies show modest yet consistent associations between problematic alcohol use and delayed reward discounting (DRD). However, the potential confounding influence of socioeconomic status (SES, e.g., income and education) is rarely addressed. In this study, we aimed to investigate the robustness of DRD as a predictor of alcohol use after controlling for socioeconomic and demographic variables. Additionally, we aimed to test the association between delayed loss discounting (DLD) and alcohol use in a sufficiently large sample. We collected data from 341 moderate-to-heavy-drinking participants (27.92 ± 21.12 g alcohol/day, 43.48 ± 11.90 years old, 49.9% female, UK residents) in a cross-sectional online study. DRD and DLD were measured using an intertemporal choice task. Questionnaires encompassed alcohol use (AUDIT, weekly alcohol consumption), education and income, subjective measures of past and present socioeconomic status, and impulsivity. DRD, but not DLD, was significantly associated with AUDIT scores (r = 0.15) and weekly alcohol consumption (r = 0.12). DRD remained a significant yet weak predictor of AUDIT scores when controlling for education and income, but not when controlling for education and age. We replicated a small but robust association between alcohol use and DRD, but not DLD. This association appeared to be confounded by education and age, but not by income. We conclude that socioeconomic and demographic variables should systematically be accounted for in future studies investigating DRD and alcohol use.

Factor structure for measures of bystander likelihood, barriers, and actions to prevent problematic alcohol use among college students

Objective There are currently no adequate measures to assess bystander intervention for problematic alcohol use (PAU). Methods We developed initial measures of bystander intervention for PAU, that include the constructs of likelihood to intervene, barriers to intervention, and actions taken in response to PAU situation. We sought to confirm the factor structure of the initial measures using confirmatory factor analysis (CFA). Participants We administered the measures in a college student sample (N = 1,270) recruited through Prime Panels. Results CFA analysis resulted in the following two scales: 1) Bystander Alcohol Likelihood to Intervene (14 items), 2) Overcoming Bystander Alcohol Barriers to Intervene (22 items). The Bystander Alcohol Actions (22 items) was formative, no CFA was conducted. We found that the hypothesized model displayed significantly superior fit to all other models. Conclusion These measures can be used to inform bystander intervention programs for PAU and as tools to evaluate bystander intervention programs.

Problematic alcohol use, jealousy, and digital dating abuse: A dyadic analysis

Young adults engage in digital dating abuse (DDA), or threatening, monitoring, and controlling behavior towards a romantic partner through technology. Alcohol use and jealousy are well-established risk factors for in-person partner abuse but have not yet been investigated in couples in the context of DDA. Jealousy might be a relevant moderator in the digital context, potentially amplifying the negative associations between problematic alcohol use and DDA. Thus, we examine dyadic associations between young adults’ problematic alcohol use and DDA perpetration, with romantic jealousy as a moderator. Participants are young adult heterosexual couples ( N = 91 couples, M age = 21.03 years, 54.4% White, 19.2% Latino, 26.3% other). Results from actor-partner interdependence models suggest that men’s jealousy significantly moderates both the actor effect for men and the partner effect for women. In contrast, women’s jealousy significantly moderates the partner effects for both men and women. Men’s problematic alcohol use is a risk factor for their own DDA perpetration at high levels of jealousy and is a risk factor for their partner’s DDA perpetration across their own or their partner’s jealousy. Women’s problematic alcohol use is a risk factor for their partner’s DDA perpetration across levels of their jealousy. These findings underscore the importance of considering individual and relational factors in understanding DDA. The study highlights the need for dyadic interventions targeting problematic alcohol use and jealousy to prevent DDA. Future research should utilize longitudinal designs and diary studies to investigate in-the-moment processes and within-person variability.

Divergent gene expression patterns in alcohol and opioid use disorders lead to consistent alterations in functional networks within the dorsolateral prefrontal cortex

Substance Use Disorders (SUDs) manifest as persistent drug-seeking behavior despite adverse consequences, with Alcohol Use Disorder (AUD) and Opioid Use Disorder (OUD) representing prevalent forms associated with significant mortality rates and economic burdens. The co-occurrence of AUD and OUD is common, necessitating a deeper comprehension of their intricate interactions. While the causal link between these disorders remains elusive, shared genetic factors are hypothesized. Leveraging public datasets, we employed genomic and transcriptomic analyses to explore conserved and distinct molecular pathways within the dorsolateral prefrontal cortex associated with AUD and OUD. Our findings unveil modest transcriptomic overlap at the gene level between the two disorders but substantial convergence on shared biological pathways. Notably, these pathways predominantly involve inflammatory processes, synaptic plasticity, and key intracellular signaling regulators. Integration of transcriptomic data with the latest genome-wide association studies (GWAS) for problematic alcohol use (PAU) and OUD not only corroborated our transcriptomic findings but also confirmed the limited shared heritability between the disorders. Overall, our study indicates that while alcohol and opioids induce diverse transcriptional alterations at the gene level, they converge on select biological pathways, offering promising avenues for novel therapeutic targets aimed at addressing both disorders simultaneously.

Substance use among Latinx youth: The roles of sociocultural influences, family factors, and childhood adversity.

Substance use among youth is associated with adverse consequences and may increase vulnerability to addiction and psychiatric disorders later in life. Sociocultural factors such as discrimination have been associated with substance use, while positive cultural resources, such as enculturation and familism, have demonstrated protective outcomes. However, few studies have highlighted how family factors influence substance use among Latinx youth during their transition from adolescence to young adulthood. This study used longitudinal data to explore the associations between sociocultural factors, family factors, childhood adversity, and substance use among Latinx youth. The data were from a longitudinal study of acculturation and substance use among Latinx youth in Southern California (n = 1257, 52.1% female, mixed socioeconomic status). The average age was 14.5 (SD = 0.39). Data collection began in 2005 and ended in 2016. Hierarchical regression models showed that discrimination was associated with higher problematic alcohol susceptibility. Childhood adversity was associated with higher odds of tobacco, alcohol, and marijuana use. Parental communication was associated with lower odds of problematic alcohol and marijuana use. To promote youth well-being, preventive efforts should prioritize reducing childhood adversity and discrimination, while fostering positive family relationships. Overall, our findings suggest the need for interventions targeting various systemic levels to effectively address substance use among Latinx youth.

Gene expression differences associated with alcohol use disorder in human brain.

Excessive alcohol consumption is a leading cause of preventable death worldwide. To improve understanding of neurobiological mechanisms associated with alcohol use disorder (AUD) in humans, we compared gene expression data from deceased individuals with and without AUD across two addiction-relevant brain regions: the nucleus accumbens (NAc) and dorsolateral prefrontal cortex (DLPFC). Bulk RNA-seq data from NAc and DLPFC (N ≥50 with AUD, ≥46 non-AUD) were analyzed for differential gene expression using modified negative binomial regression adjusting for technical and biological covariates. The region-level results were meta-analyzed with those from an independent dataset (NNAc = 28 AUD, 29 non-AUD; NPFC = 66 AUD, 77 non-AUD). We further tested for heritability enrichment of AUD-related phenotypes, gene co-expression networks, gene ontology enrichment, and drug repurposing. We identified 176 differentially expressed genes (DEGs; 12 in both regions, 78 in NAc only, 86 in DLPFC only) for AUD in our new dataset. After meta-analyzing with published data, we identified 476 AUD DEGs (25 in both regions, 29 in NAc only, 422 in PFC only). Of these DEGs, 17 were significant when looked up in GWAS of problematic alcohol use or drinks per week. Gene co-expression analysis showed both concordant and unique gene networks across brain regions. We also identified 29 and 436 drug compounds that target DEGs from our meta-analysis in NAc and PFC, respectively. This study identified robust AUD-associated DEGs, contributing novel neurobiological insights into AUD and highlighting genes targeted by known drug compounds, generating opportunity for drug repurposing to treat AUD.

The Association between Post-Traumatic Stress Disorder and Problematic Alcohol and Cannabis Use in a Multi-Ethnic Cohort in The Netherlands: The HELIUS Study.

(1) Background: Ethnic minorities exhibit a higher prevalence of post-traumatic stress disorder (PTSD), while results for problematic substance use among ethnic groups remain mixed. PTSD and problematic substance use often co-occur; however, the impact of ethnicity on this association has not yet been investigated. (2) Methods: Self-report data on problematic alcohol/cannabis use (AUDIT/CUDIT) and presence of severe PTSD symptoms (PSS-SR) of N = 22,841 participants of Dutch (n = 4610), South-Asian Surinamese (n = 3306), African Surinamese (n = 4349), Ghanaian (n = 2389), Turkish (n = 3947), and Moroccan (n = 4240) origin were available from the HELIUS study. (3) Results: We found a positive association between the presence of severe PTSD symptoms and problematic alcohol and cannabis use. Ethnicity did not moderate the association between the presence of severe PTSD symptoms and problematic alcohol/cannabis use. (4) Conclusions: We demonstrated the relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use in a multi-ethnic sample. The relationship between the presence of severe PTSD symptoms and problematic alcohol/cannabis use was similar between ethnic groups. We recommend screening for PTSD symptoms in those exhibiting problematic substance use and vice versa, regardless of ethnic background.

Addressing India’s alcohol misuse crisis: The urgent need for screening and brief intervention to bridge the healthcare gap

India faces a significant challenge with alcohol misuse, as evidenced by the national survey revealing that 57 million out of 160 million persons with alcohol use exhibit harmful or dependent patterns, necessitating professional assistance. The Global Status Report on Alcohol and Health (2018) indicates a rising per capita alcohol consumption in the Southeast Asian Region, with India contributing substantially. To address this, implementing policies and programs to curb hazardous alcohol use is crucial. Despite a shortage of mental health professionals in India, they remain the primary caregivers for those with alcohol-related issues. Only one in five individuals with problematic alcohol use can access professional help. I argue for adopting Screening and Brief Intervention (SBI) to bridge this healthcare gap. SBI is a concise, structured counseling approach that proves effective and scalable. It can be delivered by various healthcare providers, including doctors, nurses, counselors, and paramedics. Hence, it can be seamlessly integrated into primary care, emergency, and nonclinical settings. The efficacy of SBI extends to electronic formats, providing a scope of expansion through telehealth. The WHO advocates SBI by its SAFER initiative aimed at reducing negative alcohol-associated health and social consequences. SBI is effective across age groups, including adolescents and young adults, constituting most of India’s population. Emerging evidence suggests that SBI is acceptable, feasible, and effective in the Indian context. Universal or targeted SBI can be a pivotal tool in achieving the Sustainable Development Goals (2030) and global commitments for noncommunicable diseases, fortifying efforts to prevent and treat alcohol misuse.

BNST CRF receptor type 1 modulates mechanical hypersensitivity induced by adolescent alcohol exposure in adult female mice.

Alcohol exposure during adolescence has been linked to long-lasting behavioral consequences, contributing to the development of alcohol use disorder. Negative affect and chronic pain during alcohol withdrawal are critical factors influencing problematic alcohol use and relapse. Our previous research demonstrated that adolescent intermittent ethanol (AIE) vapor exposure elicits sex-specific negative affect-like behavior in adult mice following stress exposure. Additionally, AIE induces persistent mechanical hypersensitivity, which is accompanied by increased activation of corticotropin-releasing factor receptor type 1 (CRFR1) neurons in the dorsolateral bed nucleus of the stria terminalis (dlBNST). This study extends previous work by investigating plasma corticosterone levels and CRFR1 protein expression in the dlBNST following restraint stress exposure in adult mice with an AIE history. We also aim to explore the role of dlBNST CRFR1 signaling in mediating negative affect-like behavior and mechanical hypersensitivity. Female mice exhibited elevated plasma corticosterone levels compared to males following restraint stress. Moreover, females with AIE history showed higher expression of CRFR1 protein in the dlBNST compared to air controls. Antagonism of CRFR1 in the dlBNST blocked AIE-induced mechanical hypersensitivity in adult females but did not affect stress-induced negative affect-like behavior. In alcohol-naïve females, intra-dlBNST administration of a CRFR1 agonist induced mechanical hypersensitivity. These findings provide new insights into the neurobiological mechanisms underlying stress-induced negative affect and pain-related behavior, both influenced by a history of adolescent alcohol exposure. The results suggest that CRFR1 antagonists warrant further investigation for their potential in addressing alcohol-related chronic pain.