Alcohol Binge Drinking Research Articles

Burnout in Secondary School Athletic Trainers, Part II: Correlations With Substance Use

Burnout has been associated with increased energy drink consumption and increased occurrence of binge drinking of alcohol in collegiate athletic trainers (ATs), but this has not been examined in ATs in other work settings. The purpose of this study was to examine the relationship between burnout and use of various substances in secondary school ATs. Statistical analyses found a significant direct relationship between emotional exhaustion and energy drink consumption, but no other findings were statistically significant. These findings suggest that other factors besides burnout are contributing to a high rate of binge drinking of alcohol in secondary school ATs.

NLRP3 deficiency decreases alcohol intake controlling anxiety-like behavior via modification of glutamatergic transmission in corticostriatal circuits

BackgroundAlcohol use disorders result from repeated binge and chronic alcohol consumption followed by negative effects, such as anxiety, upon cessation. This process is associated with the activation of NLRP3 inflammasome-mediated responses. However, whether and how inhibition of the NLRP3 inflammasome alters alcohol intake and anxiety behavior remains unclear.MethodsA combination of drinking-in-the-dark and gavage was established in NLRP3-knockout and control mice. Behavior was assessed by open-field and elevated plus maze tests. Binge alcohol drinking was measured at 2 h and 4 h. A 2 h/4 h/24 h voluntary drinking was determined by a two-bottle choice paradigm. Western blotting and ELISA were applied to examine the levels of the NLRP3 inflammasome and- inflammatory factors, such as IL-1β and TNF-α. Nissl staining was used to measure neuronal injury. The electrophysiological method was used to determine glutamatergic transmission in corticostriatal circuits. In vivo optogenetic LTP and LTD were applied to control the function of corticostriatal circuits on the behavior of mice. MCC950 was used to antagonize the NLRP3 inflammasome.ResultsThe binge alcohol intake was decreased in NLRP3 KO mice compared to the control mice. During alcohol withdrawal, NLRP3 deficiency attenuated anxiety-like behavior and neuronal injury in the mPFC and striatum. Moreover, we discovered that glutamatergic transmission to striatal neurons was reduced in NLRP3 KO mice. Importantly, in vivo optogenetic induction of long-term potentiation (LTP) of corticostriatal circuits reversed the effects of NLRP3 deficiency on glutamatergic transmission and anxiety behavior. We also demonstrated that optogenetic induction of LTD decreased anxiety-like behavior and caused a reduction in glutamatergic transmission. Interestingly, NLRP3 deficiency or inhibition (MCC950 injection) attenuated the anxiety-like behavior, but it did not prevent DID + gavage paradigm-induced a persistent enhancement of drinking in a two-bottle choice at 2 and 4 days into withdrawal.ConclusionOur results demonstrate that NLRP3 deficiency decreases binge alcohol intake and anxiety-like behavior through downregulation of glutamatergic transmission in corticostriatal circuits, which may provide an anti-inflammatory target for treating alcohol use disorders.

Binge alcohol drinking alters the differential control of cholinergic interneurons over nucleus accumbens D1 and D2 medium spiny neurons.

Animals studies support the notion that striatal cholinergic interneurons (ChIs) play a central role in basal ganglia function by regulating associative learning, reward processing, and motor control. In the nucleus accumbens (NAc), a brain region that mediates rewarding properties of substance abuse, acetylcholine regulates glutamatergic, dopaminergic, and GABAergic neurotransmission in naïve mice. However, it is unclear how ChIs orchestrate the control of these neurotransmitters/modulators to determine the synaptic excitability of medium spiny neurons (MSNs), the only projecting neurons that translate accumbens electrical activity into behavior. Also unknown is the impact of binge alcohol drinking on the regulation of dopamine D1- and D2 receptor-expressing MSNs (D1- and D2-MSNs, respectively) by ChIs. To investigate this question, we optogenetically stimulated ChIs while recording evoked and spontaneous excitatory postsynaptic currents (sEPSCs) in nucleus accumbens core D1- and D2-MSN of ChAT.ChR2.eYFPxDrd1.tdtomato mice. In alcohol-naïve mice, we found that stimulating NAc ChIs decreased sEPSCs frequency in both D1- and D2-MSNs, presumably through a presynaptic mechanism. Interestingly, ChI stimulation decreased MSN synaptic excitability through different mechanisms in D1- vs. D2-MSNs. While decrease of ChI-mediated sEPSCs frequency in D1-MSNs was mediated by dopamine, the same effect in D2-MSNs resulted from a direct control of glutamate release by ChIs. Interestingly, after 2 weeks of binge alcohol drinking, optogenetic stimulation of ChIs enhanced glutamate release in D1-MSNs, while its effect on D2-MSNs remained unchanged. Taken together, these data suggest that cholinergic interneurons could be a key target for regulation of NAc circuitry and for alcohol consumption.

The intersection of internalizing symptoms and alcohol use during the COVID-19 pandemic: A prospective cohort study

Given the well-established relationship between alcohol and internalizing symptoms, potential increases in depression and anxiety during the COVID-19 pandemic may lead to increases in alcohol consumption and binge drinking. This study examines this association from before to during two phases of the pandemic in a cohort of Canadian youth. We used linked data from a sub-sample of 1901 secondary school students who participated in three consecutive school years of the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study between 2018/19 and 2020/21. Separate multilevel logistic regression models examined the association between depression and anxiety symptoms with odds of escalation and reduction (vs. maintenance) and initiation (vs. abstinence) of alcohol consumption. Results show that depression and anxiety symptoms significantly increased over the three years, and these changes were moderated by changes in alcohol consumption and binge drinking. Students with increased depression symptoms were less likely to reduce their alcohol consumption in the early pandemic (Adjust odds ratio [AOR] 0.94, 95% CI:0.90–0.98), more likely to initiate alcohol consumption in the ongoing pandemic period (AOR 1.03, 95% CI: 1.01–1.05), and more likely to initiate binge drinking in both periods. The depression-alcohol use association was stronger among females than males. This study demonstrates a modest association between internalizing symptoms and alcohol use, particularly for depression symptoms and in females. The identified depression-alcohol use association suggests that preventing or treating depression might be beneficial for adolescent alcohol use and vice versa.

Mitochondrial optic neuropathies (MON)

AbstractWhen we first proposed the term, Mitochondrial Optic Neuropathies (MON) (Sadun AA. Mitochondrial optic neuropathies. J Neurol Neurosurg Psychiatry. 2002 Apr;72(4):423–5.), it may have seemed odd. The paradigm before then was that many things could injure the optic nerves, and genetic, nutritional and many toxic causes made the list alongside tumours, infections, inflammations, etc. Our experiences in Cuba changed this mode of thinking. There, an epidemic of optic neuropathy (CEON) was found to exist among those consuming small amounts of methanol in the presence of folic acid deficiency. This demonstrated the convergence of toxic and nutritional causes that affected the same (oxidative‐phosphorylation) systems. Several publications have demonstrated that certain metabolic optic neuropathies are more likely in the setting of genetic predispositions. In short, asymptomatic carriers of well characterized genetic disorders such as Leber's Hereditary Optic Neuropathy (LHON), may lose vision when additionally stressed by exposures to certain drugs like ethambutol or to nutritional deficiencies. Several studies have revisited the original diagnosis of tobacco‐alcohol amblyopia (their term) and found about 20% harboured LHON mtDNA mutations (Cullom, et al., Arch Ophthalmol. 1993 Nov;111(11):1482–5).We hereby present a framework for seeing many forms of metabolic (hereditary, nutritional and toxic) optic neuropathies as related. One unifier is the stereotypic clinical presentation. These patients have, after a while, very symmetric visual losses. The loss of visual acuity, colour vision, and high spatial frequency contrast sensitivity, reflects a pair of symmetrical central or cecocentral scotomas. These aforementioned functional defects are to be expected by the equally characteristic anatomical loss of the small fibres of the papillo‐macular bundle (PMB) which also explains the temporal optic disc pallor. The other unifier is that the molecular injuries cause impairments of mitochondria, and specifically oxidative phosphorylation (Ox‐Phos). We and others have further demonstrated that this especially entails the accumulation of reactive oxygen species (ROS) more than a problem with bioenergetics. This also explains the particular predilection for injury of the smallest and unmyelinated fibres of the PMB.Several drugs are causes or additional risk factors in MON. Remarkably, most drugs that are best demonstrated to injure the optic nerve are also understood to impair mitochondria and Ox‐Phos. These include ethambutol and linezolid, chloramphenicol, streptomycin, and some antivirals (Wang and Sadun, J Neuroophthalmol. 2013 Jun;33(2):172–8). These drugs can also be regarded, in addition to heavy smoking and binge drinking of alcohol, as exogenous sources of ROS that are likely to bring out Type II LHON (vs Type I LHON which is apt to be genetic/genetic, and occurs at an early age more acutely).In general, MON represent the unique susceptibility of the optic nerve, and most specifically, the small fibres of the PMB, to the ROS that are generated when mitochondrial Ox‐Phos is defective. When the ROS threshold is exceeded, these fibres are the first to decompensate and this leads to a remarkably consistent phenotype.

Drinking history dependent functionality of the dorsolateral striatum on gating alcohol and quinine-adulterated alcohol front-loading and binge drinking.

After an extended alcohol-drinking history, alcohol use can transition from controlled to compulsive, causing deleterious consequences. Alcohol use can be segregated into two distinct behaviors, alcohol seeking and alcohol taking. Expression of habitual and compulsive alcohol seeking depends on the dorsolateral striatum (DLS), a brain region thought to engage after extended alcohol access. However, it is unknown whether the DLS is also involved in compulsive-like alcohol taking. The purpose of this experiment was to identify whether the DLS gates compulsive-like binge alcohol drinking. To ask this question, we gave adult male and female C57BL/6J mice a binge-like alcohol-drinking history, which we have previously demonstrated to produce compulsive-like alcohol drinking (Bauer, McVey, & Boehm, 2021), or a water-drinking history. We then tested the involvement of the DLS on gating binge-like alcohol drinking and compulsive-like quinine-adulterated alcohol drinking via intra-DLS AMPA receptor antagonism. We hypothesized that pharmacological lesioning of the DLS would reduce compulsive-like quinine-adulterated alcohol (QuA) drinking, but not non-adulterated alcohol drinking, in male and female C57BL/6J mice. Three important findings were made. First, compulsive-like alcohol drinking is significantly blunted in cannulated mice. Because of this, we conclude that we were not able to adequately assess the effect of intra-DLS lesioning on compulsive-like alcohol drinking. Second, we found that the DLS gates binge-like alcohol drinking initially, which replicates findings in our previous work (Bauer, McVey, Germano, Zhang, & Boehm, 2022). However, following an extended alcohol history, the DLS no longer drives this behavior. Finally, alcohol and QuA front-loading is DLS-dependent in alcohol-history mice. Intra-DLS NBQX altered these drinking behaviors without altering ambulatory locomotor activity. These data demonstrate the necessity of the DLS in binge-like alcohol drinking before, but not following, an extended binge-like alcohol-drinking history and in alcohol front-loading in alcohol-history mice.

The temporality and accessibility of message types (TAMT) model: Examining social media message types and the associations between exposure to alcohol and binge drinking

Scholars have indicated that social media contribute to various health-related behaviors (e.g., substance use, body dissatisfaction) among adolescents. This study adds to the literature on health-related social media effects through theoretical advances supported by empirical evidence. First, we introduce the TAMT model, in which we assess the media environment along a continuum of two dimensions: the temporality (from ephemeral to persistent) and accessibility (from private to public) of message types. By combining these dimensions, we argue that there are four message types: ephemeral private, persistent private, ephemeral public, and persistent public. Second, we draw on the TAMT model to advance our knowledge of the role of social media in alcohol-related behaviors. We expected that, due to the distinctive characteristics of the four message types, they would be differently related to alcohol references and binge drinking. Based on cross-sectional data (N = 1,636, Mage = 15, SD = 1.17), we found that moderate alcohol references are encountered across all message types, while more extreme references are more likely to be prevalent in ephemeral public and ephemeral private messages. We show that exposure to moderate and extreme alcohol use references in ephemeral private and persistent private messages was associated with a higher probability of engaging in binge drinking, whereas exposure to ephemeral public and persistent public messages was not. Ephemeral private messages played the most crucial role in the association with binge drinking. These findings illustrate the importance of broadening the scope of research to ephemeral private environments when studying health-related behaviors. While we have illustrated the usefulness of the TAMT model against the background of two specific types of alcohol references, this new model can be extended to other behaviors (e.g., sexual risk-taking behaviors, cyberbullying).

Association of Recreational Cannabis Legalization With Alcohol Use Among Adults in the US, 2010 to 2019

In the US, cannabis use has nearly doubled during the past decade, in part because states have implemented recreational cannabis laws (RCLs). However, it is unclear how legalization of adult-use cannabis may affect alcohol consumption. To estimate the association between implementation of state RCLs and alcohol use among adults in the US. This was a cross-sectional study of 4.2 million individuals who responded to the Behavioral Risk Factor Surveillance System in 2010 to 2019. A difference-in-differences approach with demographic and policy controls was used to estimate the association between RCLs and alcohol use, overall and by age, sex, race and ethnicity, and educational level. Data analyses were performed from June 2021 to March 2022. States with RCLs, as reported by the RAND-University of Southern California Schaeffer Opioid Policy Tools and Information Center. Past-month alcohol use, binge drinking, and heavy drinking. Of 4.2 million respondents (median age group, 50-64 years; 2 476 984 [51.7%] women; 2 978 467 [58.3%] non-Hispanic White individuals) in 2010 through 2019, 321 921 individuals lived in state-years with recreational cannabis laws. Recreational cannabis laws were associated with a 0.9 percentage point (95% CI, 0.1-1.7; P = .02) increase in any alcohol drinking but were not significantly associated with binge or heavy drinking. Increases in any alcohol use were primarily among younger adults (18-24 years) and men, as well as among non-Hispanic White respondents and those without any college education. A 1.4 percentage point increase (95% CI, 0.4-2.3; P = .006) in binge drinking was also observed among men, although this association diminished over time. This cross-sectional study and difference-in-differences analysis found that recreational cannabis laws in the US may be associated with increased alcohol use, primarily among younger adults and men.

Changes in emerging adults' alcohol and cannabis use from before to during the COVID-19 pandemic: Evidence from a prospective birth cohort.

Prospective research is needed to better-understand changes in substance use from before to during the coronavirus disease (COVID-19) pandemic, among emerging adults (18-25 years), a high-risk group for substance use. N = 1,096 (weighted sample N = 1,080; 54% female) participants enrolled in the Québec Longitudinal Study of Child Development, who completed prepandemic (2019; 21 years) and COVID-19 (mid-March to mid-June 2020) surveys. COVID-19-related and preexisting factors were examined as moderators of change in substance use. Full sample analyses revealed decreased binge drinking (p < .001, Bayes factor [BF] = 22, Cohen's f² = 0.02), but no changes in alcohol and cannabis use. Stratified analyses revealed emerging adults who reported < monthly use prepandemic increased their alcohol use (p < .001, BF > 150, f² = 0.05) and binge drinking (p < .001, BF = 27, f² = 0.01), but not their cannabis use. Conversely, emerging adults who reported >monthly use prepandemic decreased their binge drinking (p < .001, BF > 150, f² = .12) and cannabis use (p < .001, BF > 150, f² = .06), but did not change their alcohol use frequency. Several factors moderated change in substance use, including employment loss (p = .005, BF > 39, f² = .03) and loneliness (p = .018, BF > 150, f² = .10) during COVID-19. Changes in alcohol and cannabis use frequency among emerging adults in the first 3 months of COVID-19 largely differed according to prepandemic substance use, COVID-19-related factors, and preexisting factors. While some youth with preexisting vulnerabilities (e.g., more frequent substance use prepandemic) remained stable or decreased their substance use during COVID-19, emerging adults who experienced employment loss, loneliness, and financial concerns during COVID-19 increased their substance use, highlighting the need for increased supports for vulnerable populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Measurement invariance of the Young Adult Alcohol Consequences Questionnaire across college status, race, and childhood SES in a diverse community sample.

The Young Adult Alcohol Consequences Questionnaire (YAACQ) was designed to measure the various domains of alcohol-related problems experienced by emerging adults (EAs), but has primarily been used in college samples and it remains unclear whether the psychometric properties of the YAACQ function similarly in racially and economically diverse populations. The present study assessed the factor structure and evaluated measurement invariance, latent mean differences, and correlates of the 48-item eight-factor YAACQ across college status, race, and childhood socioeconomic status (SES). EAs ages 21.5-25 (N = 602; 57.3% female, 47.0% White, 41.5 % Black, 35.4% noncollege EAs) who consumed 3/4 + alcoholic beverages (for women/men) at least twice in the previous month completed measures of alcohol use, alcohol-related consequences and demographics. Confirmatory factor analysis (CFA) supported the 48-item eight-factor structure across the entire sample. However, one item related to academic achievement was predictably endorsed by few noncollege EAs and thus, was dropped. Multiple-group CFA demonstrated measurement invariance of a revised 47-item eight-factor YAACQ across college status, race, and childhood SES. Assessment of latent mean differences revealed that noncollege EAs reported more alcohol-related consequences overall, compared to college students, including greater endorsement of severe problem domains. White EAs reported more total alcohol-related consequences relative to Black EAs, and EAs of low childhood SES reported more total alcohol-related consequences compared to those of high childhood SES. Furthermore, all eight alcohol consequence factors demonstrated concurrent associations with weekly alcohol use, binge drinking, and high intensity drinking within each subgroup. Findings suggest that the YAACQ is a psychometrically robust measure of alcohol-related consequences across demographic groups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does state repeal of alcohol exclusion laws increase problem drinking?

For decades, alcohol exclusion laws (AELs) have allowed insurance companies to reject claims for physical injuries caused by alcohol consumption, including injuries from impaired driving. A central premise of AELs is that they function as a deterrent to risk-taking behaviors, such as excessive drinking. If this assumption is correct, state repeal of these laws should result in increased drinking. This study examines whether the repeal of AELs by some states affects drinking behaviors. Data were obtained from the 1993 to 2017 Behavioral Risk Factor Surveillance System nationwide survey. Exploiting the natural experiment presented by state repeal of AELs, we assessed the impact on current drinking and binge drinking. We used a rigorous quasi-experimental difference-in-differences analysis and conducted a battery of sensitivity analyses to assure robust findings. Overall, the study found no discernable impact of state repeal of AELs on alcohol consumption. While the repeal of AELs significantly decreased the odds of reporting drinking in the past 30 days compared to those living in states with AELs or that never had AELs, the effects were small (aOR=0.98, 95% CI=0.96, 0.99). Likewise, there were higher odds of binge drinking among individuals living in states that repealed AELs compared to those living in states without AELs, yet with small effects (aOR=1.03, 95% CI=1.01, 1.05). After additionally adjusting for state-varying characteristics and state-specific time trends, no significant effects were identified regarding current and binge drinking. Findings from the sensitivity analyses were largely consistent with the main analysis. This study found no evidence supporting the idea that repealing AELs increased alcohol consumption or binge drinking. Future studies should consider other state-specific dimensions within the Uniform Accident and Sickness Policy Provision Law.

LBSUN290 A Rare, Sordid Tale Of The Two Most Dreaded Adverse Effects Of SGLT-2 Inhibitors Occurring Concurrently - Acute Pancreatitis And Euglycemic Diabetic Ketoacidosis - Within Days Of Initiating Empagliflozin Therapy.

Abstract Introduction Empagliflozin is an anti-diabetic agent belonging to the class of SGLT-2 inhibitors, which was approved by the U. S. Food and Drug Administration (FDA) in 2013. It has emerged as a popular choice of second line diabetic therapy owing to benefits of reduction in cardiovascular adverse events and delayed progression of kidney disease. However, in 2015, FDA issued a safety warning in connection to its use with euglycemic ketoacidosis and subsequently in 2016, started investigating its link with pancreatitis. We present a case of a type 2 diabetic started on Empagliflozin therapy 4 days prior to his presentation to the ER with nausea, vomiting and diarrhea when he was found to have concurrent euglycemic DKA and acute pancreatitis. Case presentation A 49 year old male with a history of diabetes mellitus type 2 presented to the ER with nausea, vomiting, diarrhea and fatigue. He reported these symptoms since starting a new anti-diabetic agent Empagliflozin four days ago. He denied fever, chills, chest pain, shortness of breath, abdominal pain, and urinary symptoms. He denied heavy alcohol use or binge drinking. Lab tests showed: WBC count 18.7 k/mm cu (4 -11), Glucose 229 mg/dL (70 - 99), Bicarbonate 7 mmol/L (21 - 31), Anion gap 30 mmol/L (6 -14), Lactate 1.8 mmol/L (0.7 - 2.5), Serum beta hydroxybutyrate level &amp;gt;4 mM (0. 02 - 0.27), Lipase 866 IU/L (11 - 82) and Venous blood pH 6.98 (7.30 - 7.45). Repeat blood glucose measurements remained &amp;lt; 250 mg/dl. Urinalysis showed &amp;gt; 500 mg/dl glucose. CT abdomen and pelvis showed moderate fat stranding consistent with acute pancreatitis. He was started on insulin infusion and admitted to the intensive care unit. He was subsequently discharged on a basal-bolus regimen with instructions to discontinue Empagliflozin. Discussion Acute pancreatitis and euglycemic DKA are grave clinical entities, associated with significant mortality. Our patient presented with nausea, vomiting, diarrhea and fatigue; he denied the characteristic abdominal pain yet was noted to have pancreatitis by laboratory and imaging studies. It is extremely important that pancreatitis be considered and ruled out in patients presenting with non-specific symptoms while on SGLT-2 inhibitor therapy. In addition, a high radar of suspicion should be maintained in both inpatient and outpatient settings for euglycemic DKA in patients on SGLT-2 inhibitor therapy presenting with non-specific symptoms, even in the absence of a classic identifiable triggering event, especially as there is evidence to suggest that pancreatitis may actually serve as a triggering factor for euglycemic DKA suggesting that, due to a cause-effect phenomenon, these two conditions may co-exist more often than expected. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

Changes in alcohol beliefs mediate the effects of a school-based prevention program on alcohol use among Brazilian adolescents

ObjectiveTo investigate the mechanisms of the #Tamojunto2.0 program that mediated the prevention of lifetime alcohol and drug use, including drug knowledge, behavioral beliefs, attitudes, decision-making skills, and refusal skills. MethodsA cluster-randomized controlled trial was conducted in 73 public middle schools in three Brazilian cities. The sample included 5208 students (49.4 % girls; Mage = 13.2 years). The intervention group attended twelve #Tamojunto2.0 lessons conducted by their previously trained teachers. The control group did not receive any intervention. Data were collected pre-intervention and at the 9-months follow-up. We performed multiple mediation models (for the whole sample, users, and non-users) with a post-estimation adjustment to standard errors to account for nesting. We analyzed all available mediators simultaneously according to each drug: alcohol, binge drinking, tobacco, marijuana, and inhalant lifetime use. To handle missing data, we used the “full-information maximum-likelihood” paradigm. ResultsOutcomes in the whole sample and among non-users showed that #Tamojunto2.0 indirectly prevented lifetime alcohol use and binge drinking by increasing negative and non-positive alcohol beliefs. Only the direct effect on decreasing lifetime alcohol consumption was statistically significant. However, an indirect increase in binge drinking was observed through knowledge about alcohol, but the direct effect was not statistically significant. No effects were reported for marijuana, tobacco, or inhalants. Among users, no statistically significant effects were found for alcohol or drug use. ConclusionsThe results suggest that the #Tamojunto2.0 program was only effective in delaying alcohol consumption via increasing negative and non-positive alcohol beliefs. It seems that mediating mechanisms vary depending on contextual characteristics, differences in socializing among adolescents, features of the educational systems, psychosocial conditions, or, fidelity issues of program implementation.

Weight misperception and substance use: Brazilian Study of Cardiovascular Risks in Adolescents (ERICA)

BackgroundAdolescence is a crucial period for body image formation. Weight misperception is the discrepancy between individuals’ body weight perception and their actual nutritional status. Both weight concerns and substance use are common among adolescents, and there is evidence of an associations between these two variables. Thus, the aim of this study was to assess the association between weight misperception and substance use (smoking and alcohol) in a national sample of normal weight Brazilian adolescents.MethodsData were obtained from the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, multicenter, national, school-based survey, carried out in 124 municipalities with more than 100,000 inhabitants from Brazil. The sample included adolescents aged 12–17 years, classified as normal weight by nutritional status evaluation. The following measures were collected: weight underestimation and overestimation (exposure); having tried cigarette smoking, current smoking, current alcohol consumption, binge drinking and current smoking and alcohol consumption(outcomes); macro-region, sex, type of school, and excessive screen time (confounders). The frequency of variables was calculated with 95% confidence intervals (CI). Poisson regression models were used to estimate prevalence ratios (PR).ResultsIn total, data from 53,447 adolescents were analyzed. Weight misperception was present in a third of the adolescents, with similar prevalence of weight underestimation and overestimation. In adolescents aged 12–14 years, weight underestimation and overestimation were associated with having tried cigarette smoking (PR: 1.18 and 1.43, respectively), current alcohol consumption (PR: 1.33 for both weight misperception categories), and binge drinking (PR: 1.96 and 2.01, respectively). Weight underestimation was associated with both having tried cigarette smoking and current alcohol consumption in boys (PR: 1.14 and 1.16, respectively) and girls (PR: 1.32 and 1.15, respectively). In girls, weight overestimation was associated with all substance use variables (PR between 1.19 and 1.41).ConclusionsOur results showed an association between weight misperception and having tried cigarette smoking, alcohol consumption, and binge drinking in younger adolescents. In addition, weight overestimation was associated with all substance use indicators in girls. Based on our findings, interventions aimed to improve weight perception in normal weight adolescents may contribute to the reduction of substance use in this population.

Heavy weekly alcohol consumption versus binge drinking after an acute coronary syndrome and risk of major adverse cardiovascular events at one year follow up

Abstract Background The association between heavy weekly alcohol consumption or binge drinking and the risk of major adverse cardiovascular events (MACE) after acute coronary syndromes (ACS) is still unclear. Purpose To determine the risks of MACE at one year follow up according to baseline alcohol consumption, especially in patients with heavy weekly alcohol consumption or binge drinking. Methods We analyzed data of 6053 patients hospitalized in 4 Swiss centres for an ACS and followed over 12 months. Data on alcohol consumption were collected at baseline and at one year follow up after ACS. Binge drinking was defined as the consumption of ≥6 units of alcohol on one occasion, for the 12-months period preceding the one-year follow up. We defined MACE as a composite of cardiac death, myocardial infarction, stroke or clinically indicated target vessel coronary revascularization. We applied Cox regression to assess the risk of MACE associated with heavy alcohol weekly consumption (&amp;gt;14 standard units/week) compared to light consumption (&amp;lt;1 standard unit/week) or abstinence, as well as the risk with binge drinking, compared to no binge drinking, adjusting for baseline differences (age, sex, body-mass index, smoking, diabetes, peripheral artery disease, stroke, hypertension, use of aspirin, anticoagulation, statin, beta-blocker, ACE-inhibitor or ATII receptor blocker). Results At baseline, 817 (13.4%) patients reported heavy weekly alcohol consumption and 717 (11.8%) reported to have at least one episode of binge drinking per month. The risk for MACE at one year follow up was not increased in those with heavy weekly consumption compared to light consumption (8.7% vs. 8.5%, HR 0.96, 95% CI 0.69–1.33, P=0.80) or no consumption (8.7% vs. 10.3%, HR 1.26, 95% CI 0.88–1.80, P=0.21). However, the risk of MACE was higher in those reporting binge drinking with less than one episode a month (9.4% vs. 7.7%, HR 1.67, 95% CI 1.32–2.12, P&amp;lt;0.001), as well as in those with at least one episode of binge drinking per month (13.4% vs. 7.7%, HR 2.07, 95% CI 1.62–2.65, P&amp;lt;0.001), when compared to no binge drinking. Conclusion In contrast to regular heavy alcohol consumption, binge drinking behavior is associated with significant increased risk of MACE 12 months after ACS. Funding Acknowledgement Type of funding sources: None.

S3590 Emphysematous Gastritis

Introduction: Emphysematous gastritis is a rare and severe condition characterized by the presence of air and bacteria in the gastric wall. It usually presents with severe abdominal pain and diagnosed by presence of gas within the gastric wall on imaging. It has a high mortality rate of about 60-80%. Conservative management is the mainstay of treatment. Case Description/Methods: A 36-year-old male with a past medical history of alcohol use disorder and major depressive disorder presented with severe diffuse abdominal pain with post-prandial worsening, intractable nausea, and vomiting. This was preceded by binge drinking of alcohol. He reported poor appetite over one month associated with 17lb weight loss and early satiety. No history of liver disease, peptic ulcer disease, excessive NSAID or aspirin use. He was tachycardic and normotensive. No signs or symptoms of overt GI bleeds. Physical exam was negative for guarding or tenderness. Labs were remarkable for lactic acidosis of 3.6 mmol/L with an anion gap of 21. Lipase and LFTs were normal. CT abdomen showed gastric emphysema and mild diffuse circumferential thickening with fat deposition through the cecum and sigmoid colon, suggestive of emphysematous gastritis. General surgery was consulted but recommended no acute surgical intervention. He was started on a clear liquid diet, pantoprazole drip, empiric IV Piperacillin-Tazobactam, pain medications, and IV fluids. EGD showed moderate gastritis, no necrosis, mild duodenitis. Biopsy showed mild chronic gastritis. Patient improved clinically and repeat CT abdomen in 2 days showed improvement in gastric emphysema. He was discharged with a 7-day course of oral Amoxicillin-Clavulanate and indefinite pantoprazole 40mg BID (Figure). Discussion: Emphysematous gastritis starts with disruption of the integrity of gastric mucosa with secondary infection. Isolated organisms include Streptococci, S. Aureus Enterococci, Clostridium, Klebsiella, Pseudomonas, E.Coli, Enterobacter. Ischemia is an inciting event as seen in volvulus, SMA occlusion, acute gastric dilation. Mechanical causes include forceful emesis, gastric outlet obstruction, malignancy, and iatrogenic causes like gastrostomy or NG tube insertion, myotomy and biliary stents. Risk factors are alcohol use, NSAID and steroid use, cytotoxins, diabetes, abdominal surgery, and burns. Optimal conservative management with diet management, IV fluids, antibiotics has good outcomes as demonstrated by the above case and additional recent cases in literature.Figure 1.: A- Gastric emphysema and mild diffuse circumferential thickening with fat deposition through the cecum and sigmoid colon, suggestive of emphysematous gastritis B- Significantly decreased air locules along the periphery of the proximal gastric mucosa.

CONSUMPTION PATTERNS OF TOBACCO AND INTOXICANTS IN INDIA

Tobacco smoking and binge alcohol drinking are two of the leading risk factors for premature mortality worldwide. In India, studies have examined the geographic distributions of tobacco smoking and alcohol drinking only at the state-level; sub-state variations and the spatial association between the two consumptions are poorly understood. We analyze the consumption patterns, socio-economic distribution and the household choice of a variety of harmful tobacco and alcohol products across India.

Physical Activity as a Mediator for Health Outcomes Among Sexual Minority Adults.

Purpose: This study aimed to examine physical activity (PA) as a protective measure of health outcomes among sexual minority (SM) and heterosexual adults. Methods: Using data from the 2018 National Health Interview Survey, differences in key health outcomes between three groups (heterosexual, SM, and "other") and the mediating effects of PA were explored. Chi-square tests were used to examine group differences. Multinomial logistic regression models were fit to examine associations between PA and health outcomes (body mass index [BMI], psychological distress, health status, and use of alcohol, cigarettes, and e-cigarettes). Results: Compared with heterosexual respondents, "other" adults had higher levels of BMI above 24.9 and were less active; SM respondents had elevated levels of alcohol use, smoking, binge drinking, and psychological distress, and reported worse overall health status. Unadjusted models showed that PA served as a protective factor for BMI above 30 and health status for all groups. PA was also protective for BMI below or above 18.5-24.9, smoking, psychological distress, and health status for both heterosexual and SM groups. Alternatively, PA behaved as a risk factor for alcohol use and binge drinking for all groups. Adjusted modeling removed PA as a risk factor for light alcohol use and binge drinking for SM respondents and added a protective factor for e-cigarette use for heterosexual respondents. Conclusion: This study adds to current literature on health disparities affecting SM populations and the health benefits associated with PA. Further research is needed to explore tailored PA intervention for SM populations and those who mark "other," "something else," "don't know," or refuse to answer questions on sexual orientation.

Alcohol binge drinking in adolescence and psychological profile: Can the preclinical model crack the chicken-or-egg question?

During adolescence, internal and external factors contribute to engaging with alcohol binge drinking (ABD), putting at risk the neurodevelopment of brain regions crucial for emotional control and stress coping. This research assessed the prevalence of ABD in late adolescent students of Southern Italy and characterized their psychological profile and drinking motives. Translational effects of alcohol binge drinking in the animal model were also studied. Seven hundred and fifty-nine high school students of both sexes (aged 18–20) were recruited. Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), Drinking Motives Questionnaire-Revised Short Form, Millon Clinical Multiaxial Inventory-Third Ed., State-Trait Anxiety Inventory, Connor-Davidson Resilience Scale, and Basic Self-Esteem Scale identified alcohol habits, drinking motives, and psychopathological profile. Eighty-five percentage of the students drank alcohol and 28% of them engaged in ABD; AUDIT-C correlated with enhancement, coping, and conformity motives. ABD was related to a greater likelihood of presenting clinical syndromes and personality disorders, as well as low resilience and self-esteem. Thereafter, in the pre-clinical model, adolescent male rats were exposed to alcohol (3.5 g/kg) in an intermittent binge-like paradigm and tested during prolonged abstinence. Rats were evaluated for anxiety-like behavior, motivated behaviors, resilience, and stress response following a psychosocial challenge. Binge-like alcohol-exposed adolescent rats displayed high integrated z-score for social- and novelty-induced anxiety, altered motivation-driven output, decreased resilience, and a blunted HPA axis response to psychosocial stress, with respect to respective controls. Our data confirm that ABD is the chosen pattern of drinking in a significant percentage of high school students in Southern Italy, and highlights AUDIT-C score as a relevant parameter able to predict the occurrence of affective disturbances. The evidence from the preclinical model shows that ABD produces detrimental consequences in the adolescent rat brain, resulting in negative affect, emotional dysregulation, and aberrant stress response, pointing to decreasing excessive alcohol drinking as a primary goal for the global act for brain health.

Social stress under binge-like alcohol withdrawal in adolescence: evidence of cannabidiol effect on maladaptive plasticity in rats.

Alcohol binge drinking may compromise the functioning of the nucleus accumbens (NAc), i.e. the neural hub for processing reward and aversive responses. As socially stressful events pose particular challenges at developmental stages, this research applied the resident-intruder paradigm as a model of social stress, to highlight behavioural neuroendocrine and molecular maladaptive plasticity in rats at withdrawal from binge-like alcohol exposure in adolescence. In search of a rescue agent, cannabidiol (CBD) was selected due to its favourable effects on alcohol- and stress-related harms. Binge-like alcohol exposed intruder rats displayed a compromised defensive behaviour against the resident and a blunted response of the stress system, in addition to indexes of abnormal dopamine (DA)/glutamate plasticity and dysfunctional spine dynamics in the NAc. CBD administration (60 mg/kg) was able to: (1) increase social exploration in the binge-like alcohol exposed intruder rats, at the expenses of freezing time, and in control rats, which received less aggressive attacks from the resident; (2) reduce corticosterone levels independently on alcohol previous exposure; (3) restore DA transmission and (4) facilitate excitatory postsynaptic strength and remodelling. Overall, the maladaptive behavioural and synaptic plasticity promoted by the intersection between binge-like alcohol withdrawal and exposure to adverse social stress can be rescued by a CBD détente effect that results in a successful defensive strategy, supported by a functional endocrine and synaptic plasticity. The current data highlight CBD's relevant therapeutic potential in alcohol- and stress-related harms, and prompt further investigation on its molecular targets.