Frequency Of Alcohol Use Research Articles

Understanding the Role of Alcohol in Metabolic Dysfunction and Male Infertility

Purpose: Over the past 40–50 years, demographic shifts and the obesity epidemic have coincided with significant changes in lifestyle habits, including a rise in excessive alcohol consumption. This increase in alcohol intake is a major public health concern due to its far-reaching effects on human health, particularly on metabolic processes and male reproductive function. This narrative review focuses on the role of alcohol consumption in altering metabolism and impairing testicular function, emphasizing the potential damage associated with both acute and chronic alcohol intake. Conclusion: Chronic alcohol consumption has been shown to disrupt liver function, impair lipid metabolism, and dysregulate blood glucose levels, contributing to the development of obesity, metabolic syndrome, and related systemic diseases. In terms of male reproductive health, alcohol can significantly affect testicular function by lowering testosterone levels, reducing sperm quality, and impairing overall fertility. The extent of these effects varies, depending on the frequency, duration, and intensity of alcohol use, with chronic and abusive consumption posing greater risks. The complexity of alcohol’s impact is further compounded by individual variability and the interaction with other lifestyle factors such as diet, stress, and physical activity. Despite growing concern, research on alcohol’s effects remains inconclusive, with significant discrepancies across studies regarding the definition and reporting of alcohol consumption. These inconsistencies highlight the need for more rigorous, methodologically sound research to better understand how alcohol consumption influences metabolic and reproductive health. Ultimately, a clearer understanding is essential for developing targeted public health interventions, particularly in light of rising alcohol use, demographic changes, and the ongoing obesity crisis.

Impact of Interhospital Transfer on Outcomes in Acute Pancreatitis: Implications for Healthcare Quality

Background/Objectives: Effective management of acute pancreatitis (AP) hinges on prompt volume resuscitation and is adversely affected by delays in diagnosis. Given diverse clinical settings (tertiary care vs. community hospitals), further investigation is needed to understand the impact of the initial setting to which patients presented on clinical outcomes and quality of care. This study aimed to compare outcomes and quality indicators between AP patients who first presented to the emergency department (ED) of a tertiary care center and AP patients transferred from community hospitals. Methods: This study included AP patients managed at our tertiary care hospital between 2008 and 2018. We compared demographics and outcomes, including length of stay (LOS), intensive care unit (ICU) admission, rates of local and systemic complications, re-admission rates, and one-year mortality in transferred patients and those admitted from the ED. Quality indicators of interest included duration of volume resuscitation, time until advancement to enteral feeding, pain requiring opioid medication [measured in morphine milliequivalent (MME) dosing], and surgical referrals for cholecystectomy. Categorical variables were analyzed by chi-square or Fisher’s exact test; continuous variables were compared using Kruskal–Wallis tests. Regression was performed to assess the impact of transfer status on our outcomes of interest. Results: Our cohort of 882 AP patients comprised 648 patients admitted from the ED and 234 patients transferred from a community hospital. Transferred patients were older (54.6 vs. 51.0 years old, p < 0.01) and had less frequent alcohol use (28% vs. 39%, p < 0.01). Transferred patients had a significantly greater frequency of gallstone AP (40% vs. 23%), but a lower frequency of alcohol AP (16% vs. 22%) and idiopathic AP (29% vs. 41%) (p < 0.001). Regarding clinical outcomes, transferred patients had significantly higher rates of severe AP (revised Atlanta classification) (10% vs. 2% severe, p < 0.001) and ICU admission (8% vs. 2%, p < 0.001) and longer median LOS (5 vs. 4 days, p < 0.001). Regarding quality indicators, there was no significant difference in the number of days of intravenous fluid administration, or days until advancement to enteral feeding, pain requiring opioid pain medication, or rates of surgical referral for cholecystectomy. Conclusions: Though the quality of care was similar in both groups, transferred patients had more severe AP with higher rates of systemic complications and ICU admissions and longer LOS, with no difference in quality indicators between groups.

Exploring the dynamics of alcohol use, poverty and the role of social context in Athens, Greece

Abstract Background A body of research conducted across diverse national context, including the United Kingdom, Russia, Denmark and Norway, shows a robust link between poverty and increased alcohol related harm, even after accounting for different drinking patterns. This paper examines the unexplored relationship between poverty and alcohol use in Athens, Greece, focusing on alcohol’s impact related to the familial and social life of individuals and whether this system is affected by poverty. Methods This is a 2021 cross-sectional study, with 300 adult participants of mean age 45.8. We administered four questionnaires. The participants were equally distributed above and below the poverty threshold, sampled randomly. The latter were beneficiaries of social services. The data analysis established two scoring variables: the level of dysfunction from alcohol use and the level of strength of family ties. We computed their correlation and multiple linear regressions to assess their relationships. Results Individuals not residing in poverty exhibit a higher frequency of alcohol use (81.9%) than their counterparts (57.1%), however, those living in poverty tend to consume greater quantities of alcohol per occasion (p < 0.001) and reported elevated levels of dysfunction within familial and social interactions. Conclusions This study indicates that different consumption patterns are tied to diverse socioeconomic strata, with binge drinking behaviours specifically linked to financial hardship. Also, alcohol related dysfunction and family and social dynamics are affected by poverty. Our findings show that as dysfunction attributed to alcohol use increases, participants socialize less and report lower levels of well-being. In contrast those with balanced family ties and social encounters exhibit the opposite trend. This study warrants further exploration in cities in Southern Europe. Key messages • To mitigate alcohol use, policies empowering social and familial connections are of high importance. • Uncovering poverty as a factor for binge drinking can inform prevention strategies.

Income inequality and risky health behaviors of affluent adolescents in the post-Communist Europe

Abstract Background We aim to study the “golden youth” hypothesis and examine the risky behaviors of adolescents with high socioeconomic position (SEP) in post-Communist countries of Europe (PCCE) in relation to income inequality. Methods Adolescents aged 11-15 years from 14 PCCE participating in the Health Behavior in School-aged Children survey 2017/18 were included. A K-means cluster analysis was conducted to group adolescents based on tobacco smoking, alcohol use, binge drinking, and bullying perpetration. Generalized linear mixed models were fitted. Results Four clusters of adolescents were identified. The percentage of high-SEP adolescents in Cluster 1 (low risky behaviors) was slightly less compared to middle and low-SEP groups (70.9% vs 73.1% vs 73.9%, respectively). High-SEP adolescents were more likely to be in Cluster 2, characterized by frequent alcohol consumption but moderate binge drinking (14.3% vs 12.6% vs 10.7%). The prevalence of risky behaviors was similar between high and low-SEP adolescents in Cluster 3 (high smoking, frequent alcohol use, binge drinking, and moderate bullying) (8.0% vs 7.7% vs 8.2%) and Cluster 4 (high levels of bullying perpetration) (6.7% vs 6.5% vs 7.2%). Countries with higher Gini index were at a greater risk of reporting risky behaviors. High-SEP adolescents were more likely to engage in risky behaviors in countries with high income inequality. The odds ratios comparing high- vs. low-SEP adolescents ranged from 0.89 in the least unequal to 1.67 in the most unequal countries for multiple risky behaviors (Cluster 3: P-interaction = 0.042) and from 0.61 to 1.19 for bullying perpetration (Cluster 4: P-interaction = 0.030). Conclusions High-SEP adolescents in PCCE might be at an increased risk for unhealthy and vicious behaviors, especially in countries with high income inequality. This study highlights the need for policies that address income inequality to ensure the well-being of adolescents across socioeconomic strata in PCCE. Key messages • High-SEP adolescents might be at an increased risk for unhealthy behavior in PCCE. • Wide income inequality might contribute to risky behaviors among high-SEP adolescents.

Is harmonizing to social drinking norms associated with alcohol use in Danish high school students?

Abstract Background Alcohol use is positively linked with perceived drinking norms within the peer group and the social plasticity hypothesis proposes that youth are very good at harmonizing to social norms (social attunement). Youth with high social attunement may adjust their drinking habits to the perceived drinking norms of the peer group to a higher extent potentially leading to a larger impact on personal alcohol use. This study examined if frequency of personal alcohol use was associated with perceived peer approval of drinking and the role of social attunement in Danish high school students aged 15-19 years. Methods An online survey was administered to 2977 first-year students from 16 public high schools in Denmark. Students reported past month alcohol use (drinking days, using TLFB) and perceived approval of alcohol use among peers of their grade. Social attunement was calculated as a sum score of the 11-item Dutch Social Attunement Questionnaire (SAQ) (range: 11-77; α = 0.81). Number of drinking days was analysed as dependent variable, with age, gender, perceived peer approval and SAQ-score as independent variables. Results Older students were more likely to perceive peers to approve drinking (β = 0.25; p = 0.004) and getting drunk (β = 0.22; p = 0.003). More females (83.2%) than males (81.8%; p = 0.003) perceived peers to approve youth getting drunk. Multilevel regressions showed increased drinking days for students perceiving peers to approve of drinking (β = 1.68; p < 0.001) and getting drunk (β = 1.80; p < 0.001). We found interaction between SAQ-score and perceived drinking norms (β=-0.10; p < 0.001) indicating that perceived peer approval had less effect on drinking days for students with high SAQ-score. Conclusions Social attunement explained additional variance in the association between personal alcohol use and perceived drinking norms. Our findings stress the importance of addressing the influence of behavioural adaptation in e.g. school-based health promotion programs. Key messages • Students perceiving peers to approve of youth alcohol use drink more frequent, but the link is weakened when the need to harmonize to perceived drinking norms are high. • Social attunement needs to be considered when examining the link between individual alcohol consumption and perceived drinking norms and should be addressed in e.g. school health programs.

The Impact of Pleasure and Pain on Frequent Substance Use During Receptive Anal Intercourse

ABSTRACT Sexualized drug use (SDU) describes use of any psychoactive substance before or during planned sexual activity to facilitate, intensify, or prolong intercourse. The impact of pain, pleasure, and other mediators on SDU is not well characterized. This study aimed to distinguish the motivations behind different classes and frequencies of substance use during receptive anal intercourse (RAI). Data were from an internet-based survey conducted between July 2022-January 2023. We measured the frequency of SDU for five substances: poppers, alcohol, marijuana, methamphetamine, and nicotine. Satisfaction with pleasurable sensations during RAI and any type of pain bother during RAI were assessed on a 5-point scale. Multivariable logistic regression was performed for 1,119 respondents. Our results showed a strong association between bothersome pain during RAI and frequent alcohol (aOR 2.1), marijuana (aOR 2.4), nicotine (aOR 3.1), and meth (aOR 5.9) use. None of the five substance classes studied was correlated with dissatisfaction with pleasure during RAI. Frequent popper use was associated with increasing lifetime RAI experience and number of sexual partners. The mechanism behind SDU during RAI is substance-specific and multifactorial. Bothersome pain during RAI is highly associated with frequent SDU. Inquiring about pain during RAI may offer avenues for intervention.

Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder

BackgroundChronic pain and non-prescribed substance use are associated with lower retention in opioid use disorder (OUD) treatment. We examined the associations of perceived capacity to tolerate uncomfortable physical sensations (discomfort intolerance and discomfort avoidance) and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for OUD. MethodsThis study utilizes baseline data from 163 persons with chronic pain receiving prescription buprenorphine for OUD enrolled in the Treating Opioid use, Persistent Pain, and Sadness (TOPPS) intervention trial. We used negative-binomial regression models, adjusted for age, education, gender, race/ethnicity, pain interference, depression, generalized anxiety disorder, and average cigarettes smoked/day to estimate the associations of discomfort tolerance and discomfort avoidance with frequency of cannabis and alcohol use. ResultsParticipants (n=163) were on average 45 years old (standard deviation=10.6) and predominantly White (86%, n=141). Forty-one percent (n=66) used cannabis and 24% (n=30) used alcohol use in the past 30 days. In adjusted models, discomfort intolerance was positively associated with days of cannabis use (IRR = 1.11, p =.016) and days of alcohol use (IRR = 1.14, p =.022). Discomfort avoidance was not associated with cannabis or alcohol use. ConclusionIndividuals with chronic pain receiving prescribed buprenorphine for treatment of OUD with lower tolerance for physical discomfort may augment pain management with cannabis and alcohol. Given the intersections between substance use and retention in care for OUD, future work should extend this preliminary work by exploring these relationships over time and in experimental settings.Clinical Trial # NCT03698669

Brief Report: a Cross-Sectional Comparison of the Alcohol Use Disorders Identification Test with a Single Question to Assess Alcohol Use in Fishing Communities of Uganda

AbstractRapid assessment for alcohol use in clinical practice and research is key to improved health and study participation. We assessed the correlation between Alcohol Use Disorders Identification Test (AUDIT) score and responses from a single question on frequency of alcohol use among people living in fishing communities of Uganda. Four hundred nineteen participants screened for a simulated vaccine efficacy trial completed the AUDIT and single question. Spearman’s correlation coefficients compared the two tools. There was significant correlation between the AUDIT score and the single question (rho = 0.824, P < 0.001). The single question can be used as an alternative to the full AUDIT during screening.

Associations of tobacco and alcohol use with sexual behaviors among adolescents in 59 countries: a population-based study

BackgroundSexual behaviors, particularly risky sexual behavior, has become a serious public health concern among adolescents worldwide, presenting a substantial obstacle to the prevention of sexually transmitted infections, including human immunodeficiency virus (HIV). However, there is limited research using consistent and standardized methodology to examine associations between tobacco and alcohol use frequency and both total and risky sexual behaviors among adolescents. We aimed to examine the association between tobacco and/or alcohol use with both total and risky sexual behaviors among adolescents worldwide.MethodsData were collected from the Global School-based Student Health Survey, which comprised 211,847 adolescents aged 12–17 years from 59 countries. The frequency of tobacco or alcohol use during the past 30 days was categorized as 0, 1–2, 3–5, 6–9, or ≥ 10 days. Tobacco and alcohol use were also categorized as non-use, tobacco use alone, alcohol use alone, and combined use. Multi-variable logistic regression analysis was used to examine both the independent and combined associations of tobacco and alcohol use with total and risky sexual behaviors.ResultsCompared with no tobacco use, the odds ratio of engaging in sexual intercourse increased with the frequency of tobacco use from 1 to 2 days to ≥ 10 days (total: 2.03 [95% confidence interval 1.47–2.81] to 3.98[2.63–6.03]; risky: 2.43[1.75–3.38] to 4.21[3.26–5.42]), as well as with the frequency of alcohol use. Overall, combined users had greater likelihood of both total and risky sexual behaviors than tobacco users alone, alcohol users alone, and non-users. Similarly, the association between risky sexual behaviors and tobacco use alone was more pronounced among adolescent girls (vs. adolescent boys), as were those of risky sexual behaviors with alcohol use alone among younger adolescents aged 12–14 years (vs. aged 15–17 years) and with tobacco and/or alcohol use among adolescents in the Western Pacific region (vs. Regions of Africa and Americas).ConclusionsOur findings suggest independent and combined associations between tobacco and/or alcohol use with sexual behaviors among adolescents, with variations across age, sex, and WHO region.

Adolescent predictors of substance use in young adulthood among individuals with childhood-onset chronic pain: Afollow-up study.

Adolescent chronic pain is a substantial public health problem, and pain symptoms often persist into adulthood. Young adults with chronic pain are at elevated risk for more frequent tobacco, alcohol and cannabis use, and cross-sectional research highlights the importance of psychosocial vulnerability factors. Limited research has examined how adolescent predictors, including mental health symptoms, pain, sleep and family functioning, impact later, young adult substance use. A prospective cohort of 229 young adults (77.3% female; Mage = 21.0, SD = 1.6) with childhood-onset chronic pain completed measurements in adolescence and a follow-up assessment in young adulthood of past 3-month substance use frequency. Adolescent sleep quality and male sex were associated with more frequent tobacco use; adolescent depression was associated with more frequent alcohol use, and adolescent pain severity was associated with less frequent, and male sex was associated with more frequent cannabis use. Adolescent predictors of young adult substance use among youth with childhood-onset chronic pain represent important factors that may inform assessment, prevention and treatment of substance use in this population. Identifying and testing psychological interventions that target these vulnerability factors may reduce overall substance use risk in young adulthood. This prospective observational study of young adults with childhood-onset chronic pain identified adolescent depression and sleep quality as vulnerability factors associated with substance use. Given the increasing risk for substance use during adolescence and young adulthood, these findings highlight the potential importance of early intervention to reduce substance use among young adults with childhood-onset chronic pain.

Positive Childhood Experiences are Associated With Alcohol Use in Adolescent and Emerging Adult Females by Adverse Childhood Experiences Dimension

PurposeExperiencing multiple adverse childhood experiences (ACEs) is associated with alcohol use in female adolescents and emerging adults. Protective and compensatory experiences (PACEs) have been theorized to off-set the health and behavioral consequences from the accumulation of ACEs throughout childhood. This study examines the association between protective experiences and subsequent alcohol and binge alcohol use frequency over one month among female adolescent and emerging adults reporting high and low levels of two ACE dimensions (household dysfunction and emotional abuse/neglect). MethodsOne hundred 43 females between the ages of 15–24 who indicated at least one binge episode in the past two weeks completed the six-item ACEs scale, the PACEs scale, and demographics at baseline. Alcohol consumption was measured prospectively over the next month during weekly appointments using the timeline follow back approach. ResultsTwo PACEs factors had significant direct associations, a source of unconditional love was associated with less frequent alcohol use (β = −0.437, 95% confidence interval [CI] -0.744, −0.131, exp(β) = 0.65, p = .005) in the context of high household dysfunction; and having a trusted adult to count on for help and advice (β = −1.373, 95% CI -2.283, −0.464, exp(β) = 0.25, p = .003) predicted fewer binge occasions in the context of high emotional abuse/neglect. Regardless of ACE dimension exposure, nonsport social group membership was associated more frequent alcohol use over the month across all ACE dimensions (β = 0.11-0.74, 95% CI -0.11, 0.74, exp(β) = 1.37 – 1.62, p ≤ .002); and having a trusted adult to count on for help and advice was associated with a 5.7 times more frequent of alcohol use among those with low household dysfunction (β = 1.74, 95% CI 0.83, 2.65, exp(β) = 5.70, p < .001). DiscussionFew PACE items are associated with direct reductions in alcohol outcomes. Indeed, there is consistently heightened risk associated with nonsport group membership for alcohol use frequency, regardless of experiences of childhood adversity. Future research should identify which protective factors have the most potential to off-set alcohol use by ACE dimension.

Parental Patterns of Alcohol Consumption During the COVID-19 Pandemic: Scoping Review.

The declaration of the COVID-19 pandemic led to public health restrictions that impacted the lives of people across the globe. Parents were particularly burdened with balancing multiple responsibilities, such as working from home while caring for and educating their children. Alcohol use among parents is an area that warrants further exploration. This study aimed to investigate patterns of parental alcohol consumption during the COVID-19 pandemic, focusing on relative changes in the frequency and quantity of alcohol use compared to prepandemic use, nonparent adult samples, or both. A scoping review informed by the methodology of Arksey and O'Malley explored patterns of parental alcohol consumption during the COVID-19 pandemic. Searches were conducted in CINAHL, Ovid MEDLINE, PsycINFO, and Web of Science. Search terms were created using the Joanna Briggs Institute framework of Population, Concept, and Context, with the population being parents and the concept being alcohol consumption during the COVID-19 pandemic. The database search yielded 3568 articles, which were screened for eligibility. Of the 3568 articles, 40 (1.12%) met the inclusion criteria and were included in the scoping review. Findings indicated the following: (1) having children at home was a factor associated with parental patterns of alcohol use; (2) mixed findings regarding gender-related patterns of alcohol consumption; and (3) linkages between parental patterns of alcohol use and mental health symptoms of stress, depression, and anxiety. This scoping review revealed heterogeneous patterns in parental alcohol use across sociocultural contexts during the COVID-19 pandemic. Given the known harms of alcohol use, it is worthwhile for clinicians to assess parental drinking patterns and initiate conversations regarding moderation in alcohol use.

Effects of Substance Use on Condomless Anal Sex in a Large Sample of Adolescent Men Who Have Sex with Men: A Within and Between Relationship Design.

Substance use is a significant risk factor for HIV infection among adolescent men who have sex with men (AMSM). Substance use may reduce the use of HIV prevention measures or increase the likelihood of engaging in activities with a higher risk of HIV transmission, but there is a lack of studies dedicated to analyzing these mechanisms in adolescents and young MSM. This study aimed to explore the impact of substance use on condomless anal sex (CAS) in a large, racially diverse sample of AMSM. Additionally, we investigated how an individual's general level of substance use moderated the association between substance use before sex and CAS at the partnership level. Baseline data for an HIV prevention intervention were collected through online surveys from April 2018 to June 2020. The sample consisted of 1624 AMSM (M age, 16.69 years) who reported at least one sexual partner in the previous 3months. Participants provided information about their three most recent sexual partners, including their relationship to the partner, PrEP use, frequency of alcohol, marijuana, and non-prescription drug use before sex, and the number of CAS acts. Participants also completed measures of their substance use frequency. Multilevel modeling in Mplus was used for data analysis, accounting for sexual partnerships nested within participants. All models controlled for PrEP use and relationship status. Results revealed a significant positive association between the frequency of non-prescription drug use before sex and CAS at the partnership level. This indicates that higher non-prescription drug use frequency before sex was associated with a greater number of CAS acts with partners. Moreover, the cross-level interaction between alcohol frequency and non-prescription drug use before sex was statistically significant. Specifically, for participants with high alcohol frequency scores, there was a significant positive association between non-prescription drug use before sex and CAS at the partnership level. AMSM with higher average alcohol consumption were more likely to engage in CAS when using non-prescription drugs prior to sex with a partner, compared to those with lower alcohol consumption. This study's use of multilevel data analysis contributes innovatively to the field by shedding light on how substance use operates within sexual relationships and different partnership dynamics. Tailored interventions targeting substance use should be developed to reduce HIV risk among AMSM.

Associations Between Divorce Histories and Unhealthy Alcohol Use Among Middle Aged and Older Adults

Background: Unhealthy alcohol use has been considered a coping strategy related to stressful and traumatic life events such as relationship loss. Yet, the effects of marital status on health behaviors are generally studied cross-sectionally or over one transition. We explored associations between the frequency and quantity of alcohol use with the number of episodes and duration of separation/divorce events across adulthood among English adults in mid to later life. Methods: This study used life history data from wave 3 (2006/07) of the English Longitudinal Study of Aging to compute marital sequences based on marital status at each year of age from 18 years of 6,355 adults aged 50–80 years. These sequences were used to compute the portion of adulthood spent separated/divorced and the number of episodes of divorce. These variables were used as predictors in logistic regressions predicting unhealthy alcohol use, while also controlling for current marital status. Results: We found that the number of episodes of separation/divorce increased the odds of drinking ≥5 days/week and binge drinking (≥6 drinks/occasion for women; ≥8 drinks/occasion for men), whereas the portion of adulthood spent divorced was not associated with drinking frequency or binge drinking. Some nuances by gender were also noted. Conclusions: Recurrent transitions into separation/divorce over adulthood appears to increase risk of unhealthy alcohol use in mid to later life beyond the risks associated with current marital status.

Driving under the influence: An analysis of second-time offenders and intervention success, Turkey sample

Objectives Driving under the influence (DUI) of alcohol is a major public health issue that results in significant mortality, morbidity, and economic costs. Despite various penalties and interventions, DUI remains prevalent. This study examines the demographic characteristics, educational status, and involvement in motor vehicle accidents of second-time DUI offenders, aiming to identify factors influencing the success of educational interventions. Methods Between 2018 and 2023, 151 individuals whose driver’s licenses were suspended for a second DUI offense participated in this study. All participants applied to the Adıyaman Provincial Health Directorate, located in the southeast region of Turkey, to regain their licenses. Data were collected from application documents and digital records during and after the educational program, which included identity information, demographic characteristics, reasons for alcohol consumption, license duration, education level, educational success, frequency of alcohol use, and behavior under the influence. Penalties and traffic accidents in the last 5 years were also recorded. Results Participants with a high school education and above had a significantly higher success rate in the educational program (P = .03). Those without penalties (P = .001) and those not involved in traffic accidents (P = .006) also showed higher success rates. Conclusion Despite its limitations, this study shows that second-time DUI offenders who have previous traffic tickets or accidents are less likely to succeed in educational interventions. These findings suggest the need for tailored training programs, extended durations, and personalized evaluations to improve outcomes for these high-risk groups. Future research should explore prospective studies to confirm these results and guide intervention strategies.

Association between adolescent alcohol use and cognitive function in young adulthood: A co-twin comparison study.

Studies on adolescent alcohol use and cognition are often unable to separate the potential causal effects of alcohol use on cognition from shared etiological influences, including genetic influences or other substance use comorbidities also known to be associated with cognition, such as nicotine use. The present study aimed to fill this gap and clarify the relationship between adolescent alcohol use and young adult cognition by accounting for both measured and unmeasured confounders. A random effects model accounting for nesting in families was used to control for measured confounders. Next, co-twin comparisons were conducted within the full sample and in monozygotic twin pairs (MZ) to control for unmeasured genetic and environmental confounders shared by co-twins. Participants were 812 individuals (58.6% female, 361 complete pairs, 146 MZ pairs) from the longitudinal FinnTwin12 study in Finland. Adolescent alcohol use was indexed with measures of frequency of use and intoxication averaged across ages 14 and 17. Cognitive outcomes were measured at average age 22 and included Trail Making Test, California Stroop test, Wechsler Adult Intelligence subtests (Vocabulary, Block Design, Digit Symbol), Digit Span subtest of Wechsler Memory Scale, Mental Rotation Test and Object Location Memory test. Covariates included sex, parental education, general cognitive ability, current alcohol use and nicotine use. Greater frequency of alcohol use and frequency of intoxication across adolescence was associated with decreased vocabulary scores in the co-twin control [freq: stnd beta = -0.12, 95% confidence interval (CI) = -0.234, -0.013] and MZ only co-twin control models (freq: stnd beta = -0.305, 95% CI = -0.523, -0.087; intox: stnd beta = -0.301, 95% CI = -0.528, -0.074). In Finland, there appears to be little evidence that adolescent alcohol use causes cognitive deficits in young adulthood, except modest evidence for association of higher adolescent alcohol use with lower young adult vocabulary scores.

Creatine monohydrate use is prospectively associated with muscle dysmorphia symptomatology

This study aimed to determine the prospective association between creatine monohydrate use and muscle dysmorphia symptomatology among adolescents and young adults in Canada. Data from 912 adolescents and young adults from the Canadian Study of Adolescent Health Behaviors were analyzed. Creatine monohydrate use in the past 12 months was assessed at Wave 1, and muscle dysmorphia symptomatology was measured using the Muscle Dysmorphic Disorder Inventory (MDDI) at Wave 1 and Wave 2. The prospective associations between creatine monohydrate use and the MDDI total score and subscale scores were determined using linear regression analyses. Regression analyses controlled for relevant demographic identifiers, prior substance use, and the corresponding Wave 1 MDDI variable. Creatine monohydrate use at Wave 1 was prospectively associated with both total muscle dysmorphia symptomatology (B 1.34, 95 % CI 0.27, 2.42) and greater Appearance Intolerance (B 0.52, 95 % CI 0.02, 1.03) at Wave 2. Importantly, these findings were independent of prior muscle dysmorphia symptomatology, lifetime anabolic-androgenic steroid use, lifetime cigarette use, and frequency of alcohol use. Creatine monohydrate is commonly used among adolescents and young adults. Findings from this study are among the first to document that creatine monohydrate use may be a risk factor for the development of muscle dysmorphia symptomatology among adolescents and young adults. Health and mental health care professionals may consider assessing for both creatine monohydrate use and muscle dysmorphia symptomatology among adolescents and young adults.

Family meals are associated with lower substance use in female adolescents.

Adolescents, especially female youth, who have more family meals tend to be at lower risk for substance use. The present study tested whether family meals relate to substance use count and frequency during high school, whether associations differ by gender, and whether other family-related variables explain these associations. A community sample of 316 adolescents (Mage = 16.40, SD = 0.74; 56.96% female; 41.77% Latine, 23.10% Asian American, 29.11% European American, 6.01% from other ethnic backgrounds including Middle Eastern and African American) reported the number of substances they have ever used and how often they used alcohol, marijuana, and cigarettes, and completed measures of parental support and family cohesion. Across 15 days, they reported whether they had a family meal, got along with parents, and spent leisure time with their family each day. Regression models tested associations between frequency of family meals and substance use, whether associations differed by gender, and whether associations were explained by other family-related variables. Results indicated that more frequent family meals were associated with lower substance use count and less frequent alcohol, marijuana, and cigarette use among female adolescents but not male adolescents. Other daily family experiences were unrelated to substance use, and family meal frequency was independently related to lower substance use after accounting for parental support and family cohesion. Taken together, more frequent family meals in high school may reduce substance use risk for female adolescents, and interventions could consider promoting family meals in addition to other positive family values.

Sleep-related impairment among people who use opioids: The critical role of structural vulnerability

ObjectivePeople who use opioids are vulnerable to sleep disturbances due to a range of factors, including the substances they use and the various structural vulnerabilities they face. We aimed to understand the burden of sleep-related impairment and problems pertaining to sleep context and schedule among people who use opioids. MethodsWe explored sleep quality and problems among a suburban sample of people who use opioids experiencing extensive structural vulnerabilities (N = 170). Participants reported their most urgent concern in the past week (e.g., sleep, drug use, housing), their sleep context, sleep problems, sleep schedules, and scores on the PROMIS Sleep-Related Impairment measure. We then quantified associations between Sleep-Related Impairment scores and sociodemographics and substance use. ResultsParticipants were primarily men (66%) and non-Hispanic Black (67%) with a mean age of 42 (SD: 12.1). Many experienced hunger (44%) and literal homelessness (40%). One-quarter (28%) reported that sleep was their most urgent concern in the past week. The most common problems when falling or staying asleep were mental health-related symptoms (81%) and pain/discomfort (32%). Literal homelessness (β = 2.2, 95% CI: 0.6, 3.7), hunger (β = 2.3, 95% CI: 1.0, 3.6), and frequent alcohol use (β = 1.5, 95% CI: 0.2, 2.7) were significantly associated with Sleep-Related Impairment scores. ConclusionsHomelessness and hunger are associated with sleep-related impairment in people who use opioids. Poor sleep quality, substance use, structural vulnerability, and mental health problems are all interrelated sources of functional impairment in this population. Interventions that address poverty as an underlying cause of sleep-related impairment and provide safe sleeping environments are needed.

Heavy episodic drinking among French adolescents between 2005 and 2022: decreasing prevalence rates and increased risks.

To study the prevalence of alcohol use among French adolescents over time and factors associated with heavy episodic drinking (HED) among drinkers. Our analysis relies on six waves of a standardized cross, sectional survey conducted in mainland France between 2005 and 2022. The overall sample size comprises 179905 adolescents aged 17 (90166 males and 89739 females). Two outcomes were considered: declaring past month HED (at least one) and repeated HED (at least three) in the past month between 2005 and 2022. Relative risks and probabilities according to years of survey, gender and frequency of alcohol use (past 30 days) were estimated using modified Poisson regressions controlling for grade retention, schooling, living out of parental household, socioeconomic status, and other substance (tobacco, cannabis, other illicit substances) use. Despite a steady decline in alcohol use among French adolescents over the past two decades, the prevalence of HED still concerned one, third of 17-year-olds in 2022. The reduction in alcohol use conceals an increased likelihood of HED among occasional drinkers (<10 times a month). Moreover, the probability of HED among females is similar to that of males, or even higher depending on the frequency of use. HED is becoming an increasingly common behavior among adolescent drinkers. The decline in prevalence conceals a homogenization of behavior between genders. Our results also question underage access to alcohol, despite increasing legal restrictions. These results support general prevention in early adolescence aimed at all drinkers, and not only at the most frequent or "at-risk" drinkers.