Alcohol Use Risk Research Articles

Delineating the psychiatric morbidity spectrum in congenital adrenal hyperplasia: a population-based registry study.

Clinical studies of psychiatric morbidity in patients with congenital adrenal hyperplasia (CAH) imply impaired mental health. To delineate psychiatric morbidity in a national CAH cohort by using complete data on psychiatric diagnoses from all Danish hospitals between 1977-2018 and on all psychiatric medication prescribed between 1995-2018. A registry-based cohort study. A public uniform healthcare system. Four-hundred-forty-eight patients (females: n=215) with CAH, hereof 410 with 21-hydroxylase deficiency (21-OHD) (females: n=255) and 44,527 age- and sex-matched general population controls. Diagnoses were analyzed by negative binomial regression yielding incidence rate ratios (IRR). Medication were analyzed by Cox regression yielding hazard ratios (HR). 21-OHD was associated with an increased risk of any psychiatric diagnosis; females: IRR=2.32 (confidence interval (CI) (1.48-3.64), males: IRR=2.74 (CI 1.31-5.71) as well as of medication related to psychiatric disorders; females: HR=1.74 (CI 1.42-2.13), males: HR=1.74 (CI1.30-2.33). Both females and males with 21-OHD had a significantly increased risk of alcohol use, stress- and adjustment disorders, and of suicidal behavior. For patients with more rare forms of CAH (n=24), the risk of any psychiatric diagnosis was significantly increased for males, IRR=12.85 (CI 1.78-92.87), but not for females, IRR=0.54 (CI 0.10-3.00). The risk of being prescribed psychiatric medication was not increased for neither females, HR=1.05 (CI 0.39-2.84), or males, HR=0.72 (CI 0.10-5.13), with rare forms of CAH. 21-OHD is associated with a significantly increased psychiatric morbidity. This study underlines a need for awareness of mental health in patients with 21-OHD.

Work- & family-related stress & the risk of hazardous alcohol use: role of sex and social support

Abstract Background There is a lack of longitudinal studies investigating the effect of individual stress factors on alcohol use behaviour, and how sex and social support may mitigate the effect of these stressors. We aimed to determine the association of work- and family-related stressors with developing hazardous alcohol use over time among habitual drinkers, and to examine the role of sex and social support in these associations. Methods A sample of 4,046 individuals, working and living in Stockholm, age 25-55 years, habitual drinkers, who answered the PART study (Swedish acronym for Mental Health, Work and Social Relations) questionnaire regarding work- and family-related stress (exposures) in 1998-2000 (wave1) and 2001-2003 (wave2) were followed until 2010 (wave3) regarding hazardous alcohol use (outcome) measured using Alcohol-Use-Disorder-Identification-Test (AUDIT) score ( > =8 in men, > =7 in women). Weights for selective attrition were calculated, and crude and multivariate (adjusting for sociodemographic, health- and previous stress-related factors) logistic regression models, yielding Odds Ratios (OR) with 95% Confidence Intervals (CI), were used to estimate the exposure-outcome associations. Analyses were stratified for sex and social support in general and at work. Results Job strain (a combination of high demand and low control) was not statistically significantly associated with hazardous alcohol use (OR, CI: 1.3, 0.9-1.9). Among those reporting any family-related stress, a significantly higher risk was observed (OR, CI: 1.5, 1.1-2.1), particularly among women (OR, CI: 1.7, 1.02-2.7) and those with low social support (OR, CI: 2.1, 1.2-3.6). These associations became non-significant after adjusting for previous family-related stress. Conclusions Public health measures aiming to prevent transitions from habitual to hazardous alcohol use should give special attention to individuals with family-related stress, especially among women and those with low social support. Key messages • While job stress was not significantly associated, those experiencing family-related stress had a higher risk of hazardous alcohol use, especially among women and those without social support. • Individuals experiencing family-related stress, particularly women and those lacking social support, require special attention in public health prevention strategies for risky alcohol consumption.

Risk factors associated with consumption of alcohol among Turkish older men and women

ABSTRACT Objectives This study aims to examine the factors associated with alcohol use among individuals aged 60 and above in Türkiye. Methods The microdata obtained from the Türkiye Health Survey conducted by the Turkish Statistical Institute (TSI) in 2019 and 2022 were used in this study. Binary logistic regression analysis was employed to identify variables associated with alcohol use in older adults. Results The analysis revealed that gender, age, education level, employment status, marital status, health condition, lung disease, history of heart attack, kidney disease, Alzheimer’s disease, difficulty in carrying or holding items, and tobacco use significantly influence alcohol use among older individuals. Conclusion The study concludes that older males are at a higher risk of alcohol use. It is recommended to develop preventive health programs tailored to address the specific reasons for alcohol initiation and use among men. Aging is a period characterized by reduced activity in both work and social life due to retirement, leading some older individuals to turn to alcohol consumption as a coping mechanism. To promote active aging, it is suggested that the number of senior clubs and elderly solidarity centers affiliated with municipalities should be increased.

Binge drinking trajectories across adolescence and early adulthood: Associations with genetic influences for dual-systems impulsive personality traits, alcohol consumption, and alcohol use disorder.

Binge drinking is a relatively common pattern of alcohol use among youth with normative frequency trajectories peaking in emerging and early adulthood. Frequent binge drinking is a critical risk factor for not only the development of alcohol use disorders (AUDs) but also increased odds of alcohol-related injury and death, and thus constitutes a significant public health concern. Changes in binge drinking across development are strongly associated with changes in impulsive personality traits (IPTs) which have been hypothesized as intermediate phenotypes associated with genetic risk for heavy alcohol use and AUD. The current study sought to examine the extent to which longitudinal changes in binge drinking and intoxication frequency across adolescence and early adulthood are associated with genetic influences underlying dual-systems IPTs (i.e., top-down [lack of self-control] and bottom-up [sensation seeking and urgency] constructs) alongside genetic risk for alcohol consumption and AUD. Associations were tested using conditional latent growth curve polygenic score (PGS) models in three independent longitudinal samples ( N =10,554). Results suggested consistent significant and independent associations across all samples between sensation seeking PGSs and model intercepts (i.e., higher frequency of binge drinking at first measurement occasion) and alcohol consumption PGSs and model slopes (i.e., steeper increases toward peak binge drinking frequency). Urgency PGSs were not significantly associated with changes in binge drinking or intoxication frequency. Collectively, these findings highlight the role of unique but correlated IPT and alcohol-specific genetic factors in the emergence and escalation of binge drinking during adolescence and early adulthood.

Determining the Acceptability of Targeted Apps for High-Risk Alcohol Consumption in Nurses: A Qualitative Study

Aim To determine the acceptability of targeted apps and provide recommendations for the implementation of and app addressing high risk alcohol use to nurses. Design A qualitative descriptive study design, using the Behavioural Change Wheel implementation framework. Methods Semi-structured interviews with 42 Australian nurses were subject to structural coding using the Capability, Opportunity, and Motivation (COM-B) model linked to the Behaviour Change Wheel. Qualitative data has been reported using the COREQ framework. Results Most participants agreed that targeted apps would appeal to nurses, provided specific design considerations were included. These considerations related to privacy and confidentiality, strategies to target the app to nurses across wide age and experience ranges and identified the need for a considered campaign to both launch the app and position it with existing interventions for high-risk alcohol use. Conclusions Our findings indicate that a targeted app to reduce high-risk alcohol consumption could be acceptable to nurses, however the needs to include specific components suitable for nurses. We recommend further research into specific components of a targeted app, leading to a co-design process where nurses can determine app components and function. Summary of relevance High-risk alcohol consumption has been shown to be an issue amongst nurses. Targeted apps have been shown to have an effect in addressing high-risk alcohol consumption among specific groups. However, consideration for privacy of data provided to the app must be considered, especially given the link between disciplinary action, loss of role identity, and nurse suicide. This paper indicates that nurses would accept a targeted app, subject to specific design considerations, particularly related to confidentiality.

Alcohol Use Among American Youth: Differential Susceptibility to Peer Influence on Substance Use Tied to Genetic Risk

ABSTRACT The behavior of peers is one of the most robust correlates of deviance and arguably the strongest influence on substance use; however, not all youth mirror their peers’ behavior. Understanding how youth may be differentially susceptible to peer influence has implications for both theory and substance use policy. The potential moderation of the peer behavior-youth substance use relationship by genetic risk is explored to determine if differential susceptibility to peer influence is partially tied to biological factors. A subsample of data from the first two waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) is utilized (n = 1,495). Evidence of a gene-environment interaction emerges whereby genetic risk conditions the relationship between peer substance use and early onset of alcohol use in models controlling for several risk and protective factors (e.g. poverty, self-control, victimization, social support, neighborhood dissatisfaction, religiosity). Genotype appears particularly salient when youth report a moderate degree of peer substance use (when peer substance use exceeds the mean but does not reach the extreme). This finding has implications for Burgess and Akers’ Social Learning Theory and other peer-based theories of behavior. It suggests that interventions to insulate youth from substance-using peers will be particularly impactful for those at enhanced genetic risk for early alcohol use. The identified gene-environment interaction partially explains why some youth are differentially susceptible to peer influence.

Examining the impact of daily discrimination on alcohol use among racially diverse, trauma-exposed sexually minoritized adults: A pilot study.

Identity-based stress and trauma are key drivers of alcohol use-related health inequities among minoritized people. Research on intersectional experiences of identity-based stress and alcohol use among trauma-exposed minoritized people is scant. This pilot study used a 30-day diary design to examine the effect of identity-based discrimination exposure on alcohol use in a racially diverse sample of trauma-exposed sexual minoritized (SM) adults (N = 47; 63.8% cisgender female; 65.2% Black, Indigenous, and People of Color [BIPOC]). Multilevel logistic regression models were used to evaluate whether days marked by any (vs. no) identity-based discrimination were concurrently or prospectively associated with increased likelihood of reporting a higher (vs. lower) level of drinking-and whether these associations differed by race/ethnicity. Discrimination was associated with increased likelihood of reporting a higher level of same-day drinking (B = 0.91, p = .03), but did not predict next-day drinking. BIPOC (vs. White) individuals were less likely to report a higher drinking level on or following nondiscrimination days (Bs = -2.18 to -1.52, ps ≤ .005), but more likely to do so on or following discrimination days (Bs = 1.13-1.60, ps ≤ .03). Results suggest that everyday discrimination may create insidious risk for coping-motivated alcohol use among SM BIPOC, a subgroup that otherwise exhibits resilience with respect to drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effects of isolation stress and voluntary ethanol exposure during adolescence on ethanol and nicotine co-use in adulthood using male rats

BackgroundAlcohol use in adolescence may increase susceptibility to substance use disorders (SUDs) in adulthood. This study determined if voluntary ethanol (EtOH) consumption during adolescence, combined with social isolation, alters the trajectory of EtOH and nicotine intake during adulthood, as well as activating brain neuroinflammation. MethodsAdolescent male isolate- and group-housed rats were given 0.2 % saccharin/20 % EtOH (Sacc/EtOH) or water using intermittent 2-bottle choice; controls were given water in both bottles (n=17–20 per group). Some rats from each group (n=5–6) were euthanized one week later to measure autoradiographic [3H]PK-11195 binding, an indicator of microglial reactivity, and the remainder (n=11–14 per group) were tested in adulthood in 2-bottle choice, followed by nicotine self-administration using an incremental fixed ratio (FR) schedule with Sacc/EtOH and water concurrently available. ResultsIsolation housing increased adolescent intake of Sacc/EtOH, but the increase did not produce an observable neuroimmunological response in brain. Adolescent EtOH exposure decreased adult intake of both Sacc/EtOH and unsweetened EtOH, with isolate-housed rats showing a greater effect than group-housed rats. In the co-use model, a cross-price economic demand analysis revealed a substitutional relationship between Sacc/EtOH and nicotine, but no effect of adolescent Sacc/EtOH exposure. Compared to group-housed rats, isolate-housed rats were more sensitive to the changing price of nicotine and showed greater substitutability of Sacc/EtOH for nicotine. ConclusionThe current results suggest that adolescent EtOH exposure per se, with or without isolation stress, does not likely explain the enhanced risk for either alcohol or nicotine use later in life.

Identifying Suicide-Related Predictors Using Overseas Airborne Infantry Brigade Serious Incident Reports.

Suicidal ideation and attempts are considered to be graduated risks for suicide, yet they remain under studied. Suicide is among the leading causes of death in the U.S. for all individuals between the ages of 10 and 64 years. Suicide is a critical problem in the U.S. Military. The U.S. Army suicide rates surpassed civilian rates in 2008 and continue to climb steadily; with U.S. Army soldiers at more than twice the risk than U.S. civilians, and enlisted personnel at more than twice the risk of officers. Suicidal ideation and attempts are routinely reported within U.S. Army brigades using suicide-related serious incident reports (SR-SIRs). These reports could form a useful source of information for prevention planning, but to date there have been no efforts to summary these reports. This paper analyzes SR-SIRs among enlisted personnel for a 4-year period for 1 Army brigade, to test the usefulness of this information and to explore whether risk factors for attempts compared to ideation can be identified. This report analyzes 130 de-identified reports of suicidal ideation (n = 102) and suicide attempts (n = 28) reported as SR-SIRs from August 2018 to June 2022 among enlisted personnel in an airborne infantry brigade combat team (BCT) outside the continental U.S. Analysis of de-identified data was not considered research by brigade and university human subject/IRB authorities. Fourteen soldier characteristics and context factors were examined to determine if they differentiate the two types of incidents, suicidal ideations and suicide attempts. Unit location and alcohol use at the time of the incident were strongly associated with suicide attempts compared to ideation. Attempts occurred disproportionately during off duty hours, and attempters were more likely to have had prior contact with behavioral health services than ideators; however, these differences did not attain conventional statistical significance. The study can help inform unit-specific suicide prevention and intervention strategies. Off duty hours and alcohol use are risk factors for attempts, particularly among soldiers who have sought behavioral health care. Plans to engage and support soldiers who have sought behavioral health care during off duty hours, and information regarding the risks of alcohol use, could meaningfully reduce their risk. This is the first known attempt to examine active duty U.S. Army brigade combat team SR-SIRs, and they are a potentially valuable source of health and mental health-related information.

Perceived Risk of Binge Drinking among Older Alcohol Users: Associations with Alcohol Use Frequency, Binge Drinking, Alcohol Use Disorder, and Alcohol Treatment Use.

Despite the high prevalence of alcohol use and binge drinking among older adults, little research has been conducted on the association between their alcohol risk perception and alcohol use patterns. Using data on past-year alcohol users aged 50 and older (N = 6693) in the 2022 National Survey on Drug Use and Health, we examined the (1) associations between risk perception of binge alcohol use 1-2 times a week and alcohol use frequency, binge use frequency, and alcohol use disorder (AUD), and (2) the association between alcohol treatment use and risk perception. About 40% of past-year alcohol users perceived great risk of binge alcohol use 1-2 times a week, and 27% of past-year users had binge drinking in the past month. Multivariable analyses showed the negative association between great risk perception and alcohol use frequency (IRR = 0.60, 95%CI = 0.48-0.74 for daily use) and past-month binge alcohol use (IRR = 0.33, 95%CI = 0.19-0.57 for 6-19 days of binge use). The odds of great risk perception were also lower among those with mild AUD. Risk perception was not significantly associated with alcohol treatment. The lower likelihood of risk perception among problematic alcohol users and low treatment use is concerning. Education and interventions to reduce harm from alcohol are needed.

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.

Conformity to masculine norms and its association with drinking behaviors and alcohol-related consequences among adult men: A meta-analysis

ObjectivesStudies typically show that men are at higher risk for heavy alcohol use than women. Research linking conformity to masculine norms and drinking behaviors among adult males has grown steadily during the past 10 years. We conducted the first meta-analysis that examines (a) the strength of the associations between conformity to masculine norms and alcohol use outcomes, and (b) the extent to which the strength of these associations would be affected by the specific type of drinking behavior or methodological factors. MethodsWe included 35 studies (N=32,412) in this meta-analysis that examined the association between scores on the Conformity to Masculine Norms Inventory (CMNI) and alcohol use outcomes. ResultsAcross all studies, the average correlation between conformity to masculine norms and alcohol variables was small (r = 0.17). The associations between conformity to masculine norms and specific alcohol variables were also modest: alcohol use composite score of frequency and quantity (r = 0.20), binge drinking frequency (r = 0.14), and alcohol-related consequences (r = 0.16). The mean correlation between each CMNI subscale and alcohol variables was also small (alcohol use composite, rs range from 0.07 to 0.22; alcohol-related consequences, rs range from 0.04 to 0.29; frequency of binge drinking, rs range from −0.06 to 0.22). There was a significant difference in effect size by specific type of drinking behavior (i.e., effect sizes for binge drinking were smaller than effect sizes for other alcohol variables). Methodological factors (i.e., CMNI version; sample type: university vs. adult vs. mixed samples; country where the study was conducted) did not affect the associations between masculine norms and the alcohol-outcome variables. ConclusionsConformity to masculine norms is modestly associated with drinking behaviors and alcohol-related consequences. The effect sizes reported in this meta-analysis can assist in power analyses in future studies on conformity to masculine norms and specific drinking behaviors among adult males.

Associations of alcohol and tobacco use with psychotic, depressive and developmental disorders revealed via multimodal neuroimaging

People affected by psychotic, depressive and developmental disorders are at a higher risk for alcohol and tobacco use. However, the further associations between alcohol/tobacco use and symptoms/cognition in these disorders remain unexplored. We identified multimodal brain networks involving alcohol use (n = 707) and tobacco use (n = 281) via supervised multimodal fusion and evaluated if these networks affected symptoms and cognition in people with psychotic (schizophrenia/schizoaffective disorder/bipolar, n = 178/134/143), depressive (major depressive disorder, n = 260) and developmental (autism spectrum disorder/attention deficit hyperactivity disorder, n = 421/346) disorders. Alcohol and tobacco use scores were used as references to guide functional and structural imaging fusion to identify alcohol/tobacco use associated multimodal patterns. Correlation analyses between the extracted brain features and symptoms or cognition were performed to evaluate the relationships between alcohol/tobacco use with symptoms/cognition in 6 psychiatric disorders. Results showed that (1) the default mode network (DMN) and salience network (SN) were associated with alcohol use, whereas the DMN and fronto-limbic network (FLN) were associated with tobacco use; (2) the DMN and fronto-basal ganglia (FBG) related to alcohol/tobacco use were correlated with symptom and cognition in psychosis; (3) the middle temporal cortex related to alcohol/tobacco use was associated with cognition in depression; (4) the DMN related to alcohol/tobacco use was related to symptom, whereas the SN and limbic system (LB) were related to cognition in developmental disorders. In summary, alcohol and tobacco use were associated with structural and functional abnormalities in DMN, SN and FLN and had significant associations with cognition and symptoms in psychotic, depressive and developmental disorders likely via different brain networks. Further understanding of these relationships may assist clinicians in the development of future approaches to improve symptoms and cognition among psychotic, depressive and developmental disorders.

The Impact of COVID-19 on Substance Use and Related Consequences among Patients in Office-Based Opioid Use Disorder Treatment.

The COVID-19 pandemic led to increased substance-related morbidity and mortality and transformed care for opioid use disorder (OUD). We assessed the perceived impacts of the pandemic on substance use and related consequences among patients in office-based addiction treatment (OBAT). We recruited patients with OUD on buprenorphine from July 2021 to July 2022, with data collection at baseline and 6 months. Exposures of interest were the following 6 domains potentially impacted by COVID-19: personal or family infection, difficulty accessing healthcare/medication, economic stressors, worsening physical or mental health, social isolation, and conflicts/disruptions in the home. Outcomes were past 30-day alcohol and other substance use, increased use, and substance-related consequences at baseline and 6 months. Generalized estimating equations Poisson regression models quantified associations between increasing impact domain scores and relative risks of each outcome. All participants (N = 150) reported at least one domain negatively impacted by COVID-19 at both time points. Higher "worsening physical or mental health" domain scores were associated with increased relative risk of recent alcohol or drug use (adjusted risk ratio [aRR] 1.04, 95% confidence interval [CI]: 1.01-1.07). Relative risks of experiencing substance-related consequences increased with higher scores in the domains of economic stressors (aRR 1.07, 95% CI: 1.02-1.13), difficulty accessing healthcare/medication (aRR 1.11, 95% CI: 1.04-1.19), and worsening physical or mental health (aRR 1.08, 95% CI: 1.04-1.12). Among patients with OUD, stressors from COVID-19 were common. Three life domains impacted by COVID-19 appeared to be associated with consequential substance use, highlighting opportunities to address barriers to healthcare access and economic stressors.

Paternal and maternal psychological distress and adolescent health risk behaviors: The role of sensitive periods.

Adolescent health risk behaviors are linked to poor physical and mental health outcomes. While past research shows that maternal psychological distress predicts those behaviors, we know less about the role of paternal psychological distress and the role of sensitive periods. Using 11,128 data from families (50.5% female children) from the UK's Millennium Cohort Study, we examined the role of timing of exposure to paternal and maternal psychological distress in engagement in health risk behaviors (smoking, alcohol use, binge drinking, and sexual activity) at age 14. Paternal and maternal psychological distress, measured with the Kessler-6 scale, were assessed at child ages 3, 7, and 11. We performed path analysis, adjusting for key covariates, modeling maternal distress parallel to paternal, and allowing for autoregressive paths. Paternal distress experienced at age 11 predicted a higher likelihood of smoking at age 14. Maternal distress at age 7 also predicted a higher likelihood of smoking, alcohol use, and binge drinking, but only for boys. Moreover, maternal distress at age 3 was associated with a lower risk for alcohol use. Effects were not replicated in the sensitivity analysis we performed, including only families with resident biological fathers across the study period. Instead, maternal and paternal distress at age 11 raised girls' risk for binge drinking and sexual activity, respectively. Parental distress in early childhood does not predict adolescent health risk behaviors. In late childhood, however, both paternal and maternal distress seem to influence the likelihood of engagement in such behaviors.

Cannabis use and alcohol and drug outcomes in a longitudinal sample of sober living house residents in California

IntroductionSome evidence suggests that cannabis may be a safer substitute for other drugs. Historically, sober living houses (SLHs) have been abstinence-based environments designed for individuals in recovery to live with others in recovery. However, the evolving legal landscape around cannabis use has left SLH operators and managers in a difficult position regarding policies related to cannabis use among residents. The primary aim of this study was to examine how cannabis use relates to alcohol use, other drug use, and related problems among SLH residents. MethodsBaseline (N = 557), 6-month (n = 462), and 12-month (n = 457) data came from SLH residents living in 48 houses in Los Angeles, CA from 2018 to 2021. Longitudinal generalized estimating equation models tested associations between any past six-month cannabis use and alcohol and non-cannabis drug outcomes: any use, number of days of use, and any alcohol- or drug-related problems. Final models adjusted for baseline age, sex, race-and-ethnicity, inpatient substance use treatment, and alcohol/drug use days, and time-varying 12-step attendance and percent of social network using drugs/alcohol heavily. ResultsAt baseline, 107 (19.2 %) residents reported cannabis use in the past six months. At 12 months, 80 (17.5 %) residents reported cannabis use in the past six months. Across all timepoints, any vs. no past six-month cannabis use was related to significantly (P < 0.05) higher odds of past-month alcohol use (OR = 3.85, 95 % CI: 2.65, 5.59); more drinking days in the past six months (IRR = 1.76, 95 % CI: 1.40, 2.21); higher odds of alcohol problems (OR = 2.74, 95 % CI: 1.99, 3.76); higher odds of past-month drug use (OR = 10.41, 95 % CI: 6.37, 17.00); more drug use days in the past six months (IRR = 1.86, 95 % CI: 1.40, 2.49); and higher odds of drug problems (OR = 14.99, 95 % CI: 9.91, 22.68). ConclusionsDuring each assessment period, almost one-fifth of individuals residing in sample of California sober living houses report using cannabis in the past six months. Cannabis does not appear to work as a substitute for alcohol or other drugs in this population because cannabis use is related to increased risk of alcohol and other drug use and problems. SLH managers and operators should consider potential harm that could result from house policies that fail to address cannabis use.

Assessing the feasibility, acceptability, and initial efficacy of a multiple behavior change intervention addressing alcohol use, sexual risk taking, and bystander intervention.

Prevention programs that address the intersecting health problems of risky alcohol use, unsafe sexual behaviors, and sexual violence are needed. This pilot project assessed the feasibility, acceptability, and preliminary efficacy of a two-session group-based intervention, Sex Positive Lifestyles: Addressing Alcohol & Sexual Health (SPLASH), targeting these highly interconnected risks for college students across genders. A total of 217 participants (51.6% male, ages 18-24) took part in the SPLASH intervention or a nutrition/exercise control condition. SPLASH included three approaches aimed at reducing the incidence of alcohol problems, unsafe sex, and sexual victimization: normative feedback to modify misperceptions around peers' drinking, sexual behaviors, and support of bystander intervention; drinking and sexual-related protective behavioral strategy training to enhance safer drinking and sex-risk behaviors; and bystander intervention skills training to promote bystander efficacy and engagement. Participants completed baseline and follow-up (1-month and 6-month) online assessments. SPLASH demonstrated high acceptability and feasibility, as well as preliminary efficacy. SPLASH participants reported strong acceptability of the intervention, particularly its integrated content and interactive, in-person group format. Successful enrollment (70% randomized) and retainment point to the feasibility of recruiting students to this two-session in-person intervention. Results showed sustained trends toward more accurate perceived sex-related norms and indications of increasing bystander norms among intervention but not control participants. Results demonstrate the potential for SPLASH to effectively address the interrelated health risks of risky alcohol use, unsafe sex, and sexual violence on college campuses and point to the need for larger-scale studies.

S3 - Sex Differences in Adversity and Risk for Future Alcohol Use in Youth in the ABCD Study

S3 - Sex Differences in Adversity and Risk for Future Alcohol Use in Youth in the ABCD Study

The Influence of Monochromatic Illustrations on the Attention to Public Health Messages: An Eye-Tracking Study

Past research suggests that images can be a useful tool in attracting people’s attention and improving public health communication. This is especially important for the effective transmission of health-related messages to the youth, who should be warned about risks of alcohol and tobacco use. This study explores the application of eye-tracking methodology to investigate the influence of monochromatic illustrations on youths’ visual attention to digital ads, with a particular emphasis on those presenting harmful effects of alcohol and tobacco consumption. Four digital ads were designed for the purpose of the experiment. Two ad topics (alcohol versus tobacco) and two ad contents (text-only versus text with a monochromatic illustration) were used as variables in the digital ad design. Analyses of eye fixations and viewing time revealed that more students noticed the digital ads with the illustration than the text-only ads. Furthermore, we found that the ads with illustrations had a longer viewing time and a higher number of fixations, regardless of the ad topic. The findings highlight the effectiveness of eye-tracking technology in examining the role of illustrations in digital ads, focusing on a better perception of addiction prevention campaigns whose message is targeted primarily toward young people.

Changes in alcohol consumption during the COVID-19 among first-year university students in Spain, considering the risk of problematic use – UniHcos project

The aim of this study was to evaluate the possible impact of the COVID-19 pandemic on prevalence rates and self-reported changes in patterns of alcohol use among first-year university students in Spain, considering the risk of problematic alcohol use. A serial cross-sectional study based on the uniHcos project was carried out. Data from 10 518 first-year university students (73.3% female, mean age 19 (SD = 1.6)) collected between 2012 and 2022 were analysed. The evolution of the pooled prevalence rates during the time series was analysed and the risk of problematic alcohol consumption was assessed using the AUDIT. Also, self-reported changes in alcohol use patterns during the pandemic were assessed. According to the results, during the COVID-19 pandemic, the prevalence of alcohol use in the past 30-days was reduced (76.3% in 2019 vs. 63.7% in COVID-19) increasing again in the New Normal period. Thus, a similar pattern in the practice of binge drinking was observed. Regarding the AUDIT score, 21.7% (95%CI 20.9, 22.6) of the students had harmful alcohol consumption, with a higher proportion among males. In the multivariable logistic models, a higher AUDIT score was significantly associated (p-value < 0.001) with being male and living with roommates. According to self-reported changes in consumption patterns during the COVID-19 pandemic, a higher proportion of participants with harmful use reported an increase in alcohol consumption compared to those at low-risk (43% vs 19%). Finally, despite the overall reduction in drinking prevalence during COVID-19, changes were not equal for all students and depended on their previous level of problematic drinking, highlighting that this should be considered in the development of strategies against alcohol use in this population.