Alcoholic Research Articles

Prevalence of Alcohol Use Disorder among Medical Students in New Delhi: A Cross-Sectional Study

Abstract Introduction: Amid the global concern over alcohol consumption’s ramifications for public health, the escalating prevalence of alcohol misuse among young individuals, especially students, is alarming. This study examines the prevalence of alcohol use disorder (AUD) among medical students, exploring its link to depression, anxiety, and socioeconomic factors. Material and Methods: We conducted this cross-sectional study at a medical college in New Delhi in the month of June, 2023. We determined a sample size of 425 using prevalence estimates for AUD, a 4% margin of error, and a 15% nonresponse rate. We selected participants using simple random sampling from the MBBS enrollment list and provided them with self-administered questionnaires. We utilized validated screening tools, including PHQ-9, GAD-7, AUDIT-C, and CAGE, to assess depression, anxiety, and AUD. Statistical analysis was performed using STATA 18. AUD prevalence was presented with 95% confidence intervals. Associations between AUD and variables were examined using Chi-square tests. Significant variables (P < 0.2) in univariate analysis were considered in multivariate logistic regression (P < 0.05). Results: In our study, 413 students participated. The prevalence of AUD was 13.6%, depression was 31.5%, and anxiety was 24.2%. Univariate and multivariate logistic regression revealed significant associations between AUD and factors such as gender, current living space, tobacco use, and anxiety. Conclusion: The current study highlights worrisome levels of AUD, depression, and anxiety among medical students in New Delhi. Our research also reveals connections between AUD and factors like gender, living situation, tobacco use, and anxiety.

Demographic and clinical characteristics associated with utilization of alcohol use disorder treatment in a multicenter study of patients with alcohol-associated cirrhosis.

Alcohol use disorder (AUD) treatment can help improve clinical outcomes among patients with alcohol-associated cirrhosis but is underutilized. Among socioeconomically disadvantaged patients with alcohol-associated cirrhosis, we examined rates of lifetime and past 12-month AUD treatment utilization and associated demographic and clinical characteristics. Racial/ethnically diverse patients with alcohol-associated cirrhosis who had at least one hepatology clinic visit in the prior 6 months were recruited from three Northern California medical centers serving veterans and safety-net populations. Participants self-reported their AUD treatment utilization, liver disease quality of life (LDQoL), history and current symptoms of anxiety and depression, and problematic drinking as measured by the Alcohol Use Disorders Identification Test (AUDIT). Clinical measures including liver disease severity were captured from medical records. Among 196 participants, the majority were male (88%) with a mean age of 62 years. Two-thirds of participants (67%) reported ever utilizing AUD treatment and 32% reported utilizing AUD treatment in the past 12 months. Compared with those who did not utilize AUD treatment, participants who utilized lifetime or past 12-month AUD treatment were younger, had lower LDQoL scores, and had higher scores on current symptoms of anxiety, depression, and problematic drinking. In multivariable analyses, the odds of ever utilizing pharmacological treatment alone or both behavioral and pharmacological treatment (vs. none) were lower with older age or higher LDQoL, and higher among those with a history of anxiety/depressive disorder. For past 12-month treatment utilization, odds were lower with older age, and higher among those with current clinically significant anxiety/depression or problematic drinking. Patients with alcohol-associated cirrhosis who were younger or had anxiety/depression and problematic drinking were more likely to utilize AUD treatment. To improve AUD treatment utilization, targeted outreach to patients less likely to receive care and the provision of integrated ALD and AUD treatment is warranted.

Type 2 Diabetes Health Care Outcomes for Patients with Alcohol Use Disorder Starting Addiction Treatment.

Alcohol use disorder (AUD) is common and may complicate type 2 diabetes (T2DM) management. Little research has examined diabetes outcomes for people with T2DM and AUD, including during the window when patients start specialty addiction treatment. To examine diabetes-related health monitoring, clinical outcomes, and acute health care use among patients with T2DM and AUD newly accessing specialty addiction treatment. This retrospective cohort study included electronic health record data from a large, integrated health care delivery system. Adults with T2DM and an index outpatient health care visit during 2016-2021 were included. Patients whose index visit was an initial AUD-related visit in specialty addiction treatment were in the AUD group. The comparison group had no AUD or addiction medicine visits. Outcomes were diabetes-related health monitoring, achievement of treatment targets, complications, and acute health care use during the 12months post-index visit. The study included 222,334 adults with T2DM, 1,998 with AUD. Relative to the comparison group, participants with AUD had elevated risk for hypoglycemia (adjusted risk ratio [aRR] = 2.14; 95% confidence interval [CI] = 1.49, 3.08), cardiovascular complications (aRR = 1.43; 95% CI = 1.34, 1.53), and neuropathy (aRR = 1.26; 95% CI = 1.14, 1.41), and were less likely to be non-smokers (aRR = 0.88; 95% CI = 0.86, 0.90), after adjusting for confounding factors. In adjusted models, the AUD versus comparison group had similar or higher rates of diabetes monitoring (e.g., any glycemic test, aRR = 1.19; 95% CI = 1.17, 1.22) and metabolic control (e.g., hemoglobin A1c < 8.0%, aRR = 1.14; 95% CI = 1.11, 1.18). Patients with co-occurring T2DM and AUD in an integrated health care delivery system are vulnerable to diabetes complications that could be addressed during the early phase of specialty addiction treatment.

Childhood trauma is associated with developmental trajectories of EEG coherence, alcohol-related outcomes, and PTSD symptoms.

Associations between childhood trauma, neurodevelopment, alcohol use disorder (AUD), and posttraumatic stress disorder (PTSD) are understudied during adolescence. Using 1652 participants (51.75% female, baseline Mage = 14.3) from the Collaborative Study of the Genetics of Alcoholism, we employed latent growth curve models to (1) examine associations of childhood physical, sexual, and non-assaultive trauma (CPAT, CSAT, and CNAT) with repeated measures of alpha band EEG coherence (EEGc), and (2) assess whether EEGc trajectories were associated with AUD and PTSD symptoms. Sex-specific models accommodated sex differences in trauma exposure, AUD prevalence, and neural development. In females, CSAT was associated with higher mean levels of EEGc in left frontocentral (LFC, ß = 0.13, p = 0.01) and interhemispheric prefrontal (PFI, ß = 0.16, p < 0.01) regions, but diminished growth in LFC (ß = -0.07, p = 0.02) and PFI (ß = -0.07, p = 0.02). In males, CPAT was associated with lower mean levels (ß = -0.17, p = 0.01) and increased growth (ß = 0.11, p = 0.01) of LFC EEGc. Slope of LFC EEGc was inversely associated with AUD symptoms in females (ß = -1.81, p = 0.01). Intercept of right frontocentral and PFI EEGc were associated with AUD symptoms in males, but in opposite directions. Significant associations between EEGc and PTSD symptoms were also observed in trauma-exposed individuals. Childhood assaultive trauma is associated with changes in frontal alpha EEGc and subsequent AUD and PTSD symptoms, though patterns differ by sex and trauma type. EEGc findings may inform emerging treatments for PTSD and AUD.

Impact of alcohol use disorder on inpatient hospitalizations: A comparison of outcomes between urban and rural Veterans Affairs hospitals.

Alcohol use disorder (AUD) is a leading cause of morbidity and mortality that disproportionately affects rural residents and Veterans. To evaluate the burden of AUD in admissions at rural and urban hospitals within the Veterans Health Administration (VHA) comparing patient characteristics, clinical outcomes, and 1-, 3-, and 5-year mortality rates. Retrospective cross-sectional study of patients admitted to VHA hospitals from 2016 to 2020, with a primary or secondary diagnosis related to AUD. Follow-up mortality data was collected through September 30, 2023. From 2.9 million qualifying admissions, AUD-related diagnoses were present in 14.3% of admitted patients (427,375 admissions among 190,152 unique patients in 129 facilities). Rural hospitals (n = 22) had a significantly higher overall admission rate for AUD-related diagnoses (21.6% vs. 14.8%, p = .011), higher 30-day readmission rates (17.8% vs. 15.3%, p < .001), but lower hospital-level average length of stay (median = 4.3 vs. 5.6, p < .001). Mortality in rural hospitals was lower than urban at 1 year (9.6% vs. 11.4%, p < .001), 3 years (20.7% vs. 23.1%, p < .001), and 5 years (30.4% vs. 32.9%, p < .001). Rural VHA hospitals have a higher proportion of patients admitted with AUD-related diagnoses and higher readmission rates, but lower mortality rates. Approximately, one in three patients admitted with an AUD-related diagnosis died within the 5-year follow-up period. The mortality rates observed are extraordinary and deserve urgent attention. A comprehensive plan to address AUD in the Veteran population, including how we approach and engage patients in treatment during hospitalizations with any primary or secondary AUD diagnoses, is needed.

Age at onset as an index of genetic heterogeneity in major psychiatric and substance use disorders.

Robust clinical indices of etiologic heterogeneity for psychiatric disorders are rare. We investigate whether age at onset (AAO) reflects genetic heterogeneity, utilizing Genetic Risk Ratios (GRR) derived from Family Genetic Risk Scores (FGRS). We examined, in individuals born in Sweden 1940-2003, whether AAO for five primary disorders -- drug use disorder (DUD), alcohol use disorder (AUD), major depression (MD), bipolar disorder (BD), and schizophrenia (SZ)-- was associated with varying levels of GRRs with a range of informative secondary disorders and traits. Our disorders displayed a varying pattern of change of GRRs with increasing AAO. At one end was SZ, where all GRRs rose with increasing AAO meaning that SZ became increasing genetically heterogeneous with later AAO. The most balanced disorder was AUD where, with increasing AAO, GRRs rose for AD, BD, and MD and declined for DUD, CB, and ADHD. That is, at young AAO, AUD had high levels of genetic risk for other externalizing disorders while at older AAO, high genetic risk for internalizing disorders were more prominent. MD was at the continuum's other end where all GRRs, except for AD, decreased with higher AAO, meaning that MD became increasingly genetically homogeneous with later AAO. Genetic heterogeneity was robustly associated with AAO across our five primary disorders with substantial inter-disorder differences in the observed patterns. In particular, young AAO was associated with maximal genetic homogeneity for SZ and DUD while older AAO had greater genetic homogeneity for MD with AUD falling in between.

Harms to children from men’s heavy drinking: A scoping review

Background: Research has examined a range of impacts of women’s drinking on children. However, fewer studies have addressed the consequences of men’s heavy drinking on children. This review aims to identify and describe the types of behaviours and actions that arise from men's drinking and are likely to cause harm to children and to identify and describe the types of harms that children experience that stem from men's drinking. Methods: Review articles from 1990 to September 2023 were included. Four health and social databases were searched for reviews that included terms relating to men, alcohol consumption, and child harms. From 1,873 identified articles, 19 articles met the criteria for inclusion. Results: Four broad topics were identified: relationships and families; violence and maltreatment; and health, social and education outcomes for children. Children may experience both direct and indirect harms associated with men’s drinking. The former includes examples where men’s drinking was linked to disinhibition, aggression, and physical assault. In the latter, men were absent resulting in being unavailable emotionally due to drinking. Internalising and externalising behaviours were common outcomes for children exposed to men’s drinking. Contextual factors such as poverty, cultural norms and patriarchal influences were interrelated and sometimes exacerbated harm to children from men’s drinking. Conclusions: This review highlights the immediate and longer-lasting consequences of men’s drinking for children, including family conflict, maltreatment, and emotional distress. Future studies should address gender disparities and consider the social factors present in cases where children are exposed to men’s drinking.

Synergistic‐like decreases in alcohol intake following combined pharmacotherapy with GLP‐1 and amylin in male rats

Background and PurposeThe limited effectiveness of current pharmacological treatments for alcohol use disorder (AUD) highlights the need for novel therapies. These may involve the glucagon‐like peptide‐1 receptor or the amylin receptor, as treatment with agonists targeting either of these receptors lowers alcohol intake. The complexity of the mechanisms underlying AUD indicates that combining agents could enhance treatment efficacy. While a combination of amylin receptor and GLP‐1 receptor agonists reduced food intake and body weight synergistic‐like, its influence on alcohol intake is unknown.Experimental ApproachEffects of a range of dose‐combinations of GLP‐1 receptor (dulaglutide) and amylin receptor (salmon calcitonin; sCT) agonists on alcohol intake were explored in male and female rats. We used dose combinations that either lowered alcohol intake as monotherapy (0.1 mg·kg−1 + 5 μg·kg−1), or that did not affect alcohol consumption per se (0.075 mg·kg−1 + 2 μg·kg−1).Key ResultsAcute administration of dulaglutide and sCT (0.1 mg·kg−1 + 5 μg·kg−1) reduced alcohol intake in males, but not in females. When higher doses were evaluated in female rats, a decrease in alcohol intake was observed. Furthermore, the low dose combination (0.075 mg·kg−1 + 2 μg·kg−1) decreased, in in a synergistic‐like manner, alcohol intake and prevented abstinence‐induced drinking without affecting kaolin intake in males. However, tolerance developed during sub‐chronic treatment.Conclusion and ImplicationsCollectively, these findings show that the combination of dulaglutide and sCT decreased, in in a synergistic‐like manner, alcohol consumption in male rats. Contrarily, higher doses are required for females.

The Roles of Endogenous D2R Dopamine and μ-opioid Receptors of the Brain in Alcohol use Disorder.

Alcohol use disorder (AUD) affects millions of people worldwide. It is characterized by a strong physiological and psychological craving to consume large amounts of alcohol despite adverse consequences. Alcohol use disorder carries a large health and economic burden on society. Despite its prevalence, AUD is still severely undertreated. The precise molecular mechanisms of how alcohol addiction forms are yet unknown. However, previous studies on animal models show that along with the μ-opioid receptors, the D2R dopamine receptors may also be involved in alcohol craving and reward pathways. Currently, there is a limited number of treatment strategies for alcohol use disorder, which include several medications and therapy. By understanding the limitations of current treatment options and exploring new potential targets, it could be possible to find more effective ways of treating AUD in the future.

Background characteristics and neuropathological findings of medico-legal autopsy cases with acute head injury and chronic alcohol use

Background characteristics and neuropathological findings of medico-legal autopsy cases with acute head injury and chronic alcohol use

Predictors of End-of-Life Care in Nonelderly Adults With Severe Traumatic Brain Injury

IntroductionOlder age is a well-established risk factor for withdrawal of life-sustaining therapy (WDLST) and discharge to hospice (DH) in traumatic brain injury (TBI). However, a paucity of data exists in identifying factors associated with end-of-life (EoL) care in younger patients with TBI. We sought to identify hospital and patient factors associated with EoL care and timing of EoL care in younger adults with severe TBI. MethodsThis is a retrospective analysis of the National Trauma Databank (2019). Adults (18-65 y) with severe TBI (GCS<9) were included in the analysis. Inclusion criteria included death, WDLST, or DH during the hospital stay. Exclusion criteria included GCS>8, death in the emergency department, and missing WDLST status. The primary outcome was EoL Care defined as those who either underwent WDLST or DH. The secondary outcome was early EoL care defined as EoL care within 72 h of admission. ResultsA total of 1239 patients were included in the study, the median age was 43 y, and the majority were males (77%) and of white race (68%). A total of 667 (54%) patients underwent EoL Care. On multivariable analysis, increasing age (aOR: 1.02; 95% CI: 1.01-1.03) and chronic alcoholism (OR: 1.78; 95% CI: 1.05-3.03) were independently associated with EoL. Conversely, patients of Black race (aOR: 0.33; 95% CI: 0.22-0.49) and those admitted to university hospitals (OR 0.51 95% CI 0.33-0.74) and level II trauma centers (OR 0.57; 95% CI 0.37-0.88) were less likely to undergo EoL care. A total of 225 (34%) patients underwent early EoL Care. On multivariable analysis, presence of nonreactive pupils and absence of intracranial pressure monitor were independently associated with early EoL care. ConclusionsSignificant variation in EoL care exists in patients presenting with severe TBI. Better understanding of patient and hospital factors that influence these complex decisions may allow for targeted interventions to reduce variability in EoL practice in TBI across institutions.

Recovery capital profiles among a heterogeneous sample of individuals in recovery from alcohol problems.

Recovery capital (RC) is a framework for conceptualizing the resources individuals use to support alcohol and other drug recovery across social, physical, human, and cultural domains. The goal of this study was to identify subgroups of individuals in recovery with distinct combinations of RC across domains and characteristics of individuals with unique RC patterns. Latent profile analyses investigated patterns in both within-domain amount and variability of RC across each of the four domains using the Multidimensional Inventory of Recovery Capital, a theoretically and psychometrically sound RC measure. The sample included U.S. participants closely reflecting 2020 Census demographics (n = 482, 49% female, 38% racial/ethnic minority, Mage = 42.57) identifying as having resolved a prior problem with alcohol (alone or with other drugs). Latent profile analyses distinguished four RC profiles: Low/Inconsistent (23%), Moderate/Consistent (43%), Moderate/Inconsistent (12%), and High/Consistent (22%). Females and individuals who were unemployed, nonabstinent, and had greater alcohol problem severity were more likely to belong to the Low/Inconsistent profile. Individuals in unassisted recovery were more likely to belong to the Moderate/Inconsistent profile. Older age and more time in recovery were associated with High/Consistent profile membership. Race/ethnicity was not associated with profile membership. These person-oriented analyses elucidate complex patterns of resources that individuals utilize during recovery and individual characteristics underpinning differences across RC patterns. The empirically derived subgroups in this heterogeneous sample highlight multiple combinations of resources that individuals leverage to achieve recovery and indicate characteristics of individuals who may need greater amounts and/or consistency of RC to continue sustaining recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is flat rate pricing for unlimited alcohol consumption associated with problematic alcohol consumption patterns? A cross-sectional study with the Japan COVID-19 and Society Internet Survey

ObjectivesThis study investigates the relationship between flat rate pricing for unlimited alcohol consumption in restaurants and bar and problematic alcohol consumption patterns identified by the Alcohol Use Disorders Identification Test...

Resting-State Functional Connectivity Predicts Attention Problems in Children: Evidence from the ABCD Study.

Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, and numerous functional and structural differences have been identified in the brains of individuals with ADHD compared to controls. This study uses data from the baseline sample of the large, epidemiologically informed Adolescent Brain Cognitive Development Study of children aged 9-10 years old (N = 7979). Cross-validated Poisson elastic net regression models were used to predict a dimensional measure of ADHD symptomatology from within- and between-network resting-state correlations and several known risk factors, such as biological sex, socioeconomic status, and parental history of problematic alcohol and drug use. We found parental history of drug use and biological sex to be the most important predictors of attention problems. The connection between the default mode network and the dorsal attention network was the only brain network identified as important for predicting attention problems. Specifically, we found that reduced magnitudes of the anticorrelation between the default mode and dorsal attention networks relate to increased attention problems in children. Our findings complement and extend recent studies that have connected individual differences in structural and task-based fMRI to ADHD symptomatology and individual differences in resting-state fMRI to ADHD diagnoses.

NLRP3 activation maintains intestinal epithelial barrier and reduces liver injury in alcoholic liver disease mice.

Alcoholic liver disease (ALD) patients with bacterial infections usually exhibit high mortality rates. Infections frequently involve bacteria such as Vibrio vulnificus and Enterococcus faecalis. Nevertheless, the mechanisms predisposing ALD patients to bacterial infections and the role of the NLRP3 inflammasome in the intestinal epithelial barrier in ALD remain unclear. We established ALD mice models of WT, Nlrp3-/- and Gsdmd-/- through chronic alcohol consumption feeding and acute alcohol induction. We compared alterations in gut microbiota, ileitis, and adhesion protein expression, to analyze the role and potential mechanism of NLRP3 in the early onset of ALD. Concurrently, we examined the changes in inflammation and liver damage in the ileum of ALD and healthy mice following foodborne infection with V. vulnificus. Compared with the control group, the expression levels of ZO-1, Claudin-1 and E-cadherin were reduced in the ileum of ALD mice, while those of NLRP3, caspase-1(p20), GSDMD-N and IL-1β were elevated. Nlrp3-/- and Gsdmd-/- ALD mice showed an increased gut bacterial load, decreased ileal expression of E-cadherin, more severe ileitis, pronounced liver damage, steatosis and higher plasma levels of FITC-dextran, D-LA and ZO-1 compared with WT mice. Notably, Nlrp3-/- ALD mice exhibited a higher presence of Deferribacterota and Enterobacteriaceae. Furthermore, ALD mice infected with V. vulnificus infection exhibited no further activation of NLRP3 in the ileum, leading to increased intestinal permeability and bloodstream infections. This study indicated that NLRP3 activation in the ileum of ALD mice stabilizes the inflammation-related gut microbiota, preserves the intestinal epithelial barrier, and diminishes inflammation and liver injury. Furthermore, the compromised immune defence in ALD mice may contribute to their heightened susceptibility to bacterial pathogens. Activation of the NLRP3-GSDMD pathway in the ileum of Alcoholic liver disease (ALD) mice. NLRP3 activation maintains homeostasis of gut microbiota and intestinal epithelial barrier in ALD mice. ALD mice infected with V. vulnificus infection exhibited no further activation of NLRP3 in the ileum, leading to increased intestinal permeability and bloodstream infections.

Late-Life Alcohol Exposure Does Not Exacerbate Age-Dependent Reductions in Mouse Spatial Memory and Brain TFEB Activity

Alcohol consumption is believed to affect Alzheimer’s disease (AD) risk, but the contributing mechanisms are not well understood. A potential mediator of the proposed alcohol-AD connection is autophagy, a degradation pathway that maintains organelle and protein homeostasis. Autophagy is regulated through the activity of Transcription factor EB (TFEB), which promotes lysosome and autophagy-related gene expression. The purpose of this study is to explore whether chronic alcohol consumption worsens the age-related decline in TFEB-mediated lysosomal biogenesis in the brain and exacerbates cognitive decline associated with aging. To explore the effect of alcohol on brain TFEB and autophagy, we exposed young (3-month-old) and aged (23-month-old) mice to two alcohol-feeding paradigms and assessed biochemical, transcriptome, histology, and behavioral endpoints. In young mice, alcohol decreased hippocampal nuclear TFEB staining but increased SQSTM1/p62, LC3-II, ubiquitinated proteins, and phosphorylated Tau. Hippocampal TFEB activity was lower in aged mice than it was in young mice, and Gao-binge alcohol feeding did not worsen the age-related reduction in TFEB activity. Morris Water and Barnes Maze spatial memory tasks were used to characterize the effects of aging and chronic alcohol exposure (mice fed alcohol for 4 weeks). The aged mice showed worse spatial memory acquisition in both tests. Alcohol feeding slightly impaired spatial memory in the young mice, but had little effect or even slightly improved spatial memory acquisition in the aged mice. In conclusion, aging produces greater reductions in brain autophagy flux and impairment of spatial memory than alcohol consumption.

Psychedelic Research for Alcohol Use Disorder with Comorbid Major Depressive Disorder: An Unmet Need.

In this narrative review, we discuss evidence for psilocybin- and LSD-assisted treatment of alcohol use disorder (AUD) and major depressive disorder (MDD). We describe limitations of psychedelic research and posit methodological considerations when designing a trial in patients with both disorders. In AUD, a growing evidence base for psilocybin treatment shows a promising beneficial and sustained effect on measures of drinking frequency. In MDD, a recent meta-analysis has demonstrated that psilocybin therapy provides a large and consistent reduction in depressive symptoms compared to no treatment. Co-occurrence of MDD and AUD is quite prevalent, and this comorbidity exacerbates symptomatology of the two individual disorders and complicates their treatment. Theoretically, patients presenting with both AUD and MDD would benefit from an integrated therapy that could treat MDD and AUD simultaneously. We believe that more research into the efficacy of psilocybin in patients with both AUD and MDD is warranted and justified.

Kratom Alkaloids for the Treatment of Alcohol Use Disorder.

Alcohol use disorder (AUD) accounts for nearly 4.7% of all deaths and imposes a huge economic burden on society. Despite the magnitude of the problem, only a few Food and Drug Administration (FDA)/European Medicines Agency (EMA)-approved drugs are currently available for AUD treatment. Despite being efficacious, these drugs are not without problems, adverse effects being a major issue. That combined with medication adherence and compliance problems, the discovery of new drugs is imperative. Kratom (Mitragyna speciosa) alkaloids and some of their semisynthetic derivatives reduce alcohol intake and alcohol-induced withdrawal symptoms in animal models. These compounds act as G-protein-biased ligands at the μ-, δ-, and κ-opioid receptors, and their effect in reducing alcohol intake is mediated through the δ-opioid receptor. This article provides a critical overview of recent preclinical studies involving kratom alkaloids for AUD treatment, with a particular focus on the pharmacology and medicinal chemistry of these alkaloids. FDA/EMA approved drugs, repurposed drugs, and plant-based compounds for the treatment of AUD are briefly mentioned. Finally, important caveats and future research directions on this topic are discussed.

Blood metabolomic profiling reveals new targets in the management of psychological symptoms associated with severe alcohol use disorder.

Alcohol use disorder (AUD) is a global health problem with limited therapeutic options. The biochemical mechanisms that lead to this disorder are not yet fully understood, and in this respect, metabolomics represents a promising approach to decipher metabolic events related to AUD. The plasma metabolome contains a plethora of bioactive molecules that reflects the functional changes in host metabolism but also the impact of the gut microbiome and nutritional habits. In this study, we investigated the impact of severe AUD (sAUD), and of a 3-week period of alcohol abstinence, on the blood metabolome (non-targeted LC-MS metabolomics analysis) in 96 sAUD patients hospitalized for alcohol withdrawal. We found that the plasma levels of different lipids ((lyso)phosphatidylcholines, long-chain fatty acids), short-chain fatty acids (i.e. 3-hydroxyvaleric acid) and bile acids were altered in sAUD patients. In addition, several microbial metabolites, including indole-3-propionic acid, p-cresol sulfate, hippuric acid, pyrocatechol sulfate, and metabolites belonging to xanthine class (paraxanthine, theobromine and theophylline) were sensitive to alcohol exposure and alcohol withdrawal. 3-Hydroxyvaleric acid, caffeine metabolites (theobromine, paraxanthine, and theophylline) and microbial metabolites (hippuric acid and pyrocatechol sulfate) were correlated with anxiety, depression and alcohol craving. Metabolomics analysis in postmortem samples of frontal cortex and cerebrospinal fluid of those consuming a high level of alcohol revealed that those metabolites can be found also in brain tissue. Our data allow the identification of neuroactive metabolites, from interactions between food components and microbiota, which may represent new targets arising in the management of neuropsychiatric diseases such as sAUD. Gut2Behave project was initiated from ERA-NET NEURON network (Joint Transnational Call 2019) and was financed by Academy of Finland, French National Research Agency (ANR-19-NEUR-0003-03) and the Fonds de la Recherche Scientifique (FRS-FNRS; PINT-MULTI R.8013.19, Belgium). Metabolomics analysis of the TSDS samples was supported by grant from the Finnish Foundation for Alcohol Studies.

Prevalence and psycho-social factors associated with alcohol use among primary school-going children aged 6 to 13 years in Mbale district, Uganda: a cross-sectional study

BackgroundAlcohol use among children in low-resource settings has received limited attention. This study investigated the prevalence of and biopsychosocial factors associated with alcohol use among children aged 6 to 13 years enrolled in primary education in Uganda.MethodsThis cross-sectional study conducted in primary schools within Mbale district, employed stratified random sampling to select 470 child-parent dyads. Screening for child alcohol consumption utilized the validated Ugandan (Lumasaaba) version of the Car, Relax, Alone, Forget, Family/Friends, Trouble (CRAFFT) tool. Alcohol Use Disorder (AUD) was diagnosed using the AUD module of the Mini International Neuropsychiatric Interview for children and adolescents (MINI KID). Logistic regression analysis explored associations between alcohol consumption (CRAFFT cut-off score: 1 or more) and biopsychosocial factors (age, sex, nutrition, family dynamics, socioeconomic indicators, and school environment). Data analysis utilized STATA-17 statistical software.ResultsThe median age of the participants was 11 years, with an interquartile range (IQR) of 9 to 12 years and a male to female ratio of 1:1.3. The screened prevalence of alcohol consumption among the children in the past 12 months was 25.2% (95% CI: 21.4–29.4) and 7.2% (95% CI: 5.1–10.0) were diagnosed with AUD. The study found a comparable prevalence of alcohol use between boys (25.0%, 95% CI: 19.4–31.5) and girls (25.4%, 95% CI: 20.0-31.1). Age-specific variations indicated that early adolescents (10 to 13 years), were more likely to consume alcohol 28.1% (95% CI: 23.5–33.3) compared to pre-adolescent children (6 to 9 years) 17.6% (95% CI: 11.9–25.1) in the past 12 months. Factors associated with alcohol use included single-parent households, lower caregiver education, low socioeconomic status, maternal drinking, food insecurity, under-weight, physical discipline by parents, peer influence, rural school attendance, and the school environment.ConclusionThe prevalence of alcohol consumption among children in Mbale district, eastern Uganda was high with one-in-four primary-school-children aged 6 to 13 years consuming alcohol in the past year, and no significant gender differences. It highlights various interconnected factors associated with alcohol use among school-aged children. We recommend awareness campaigns at all levels, stricter implementation of alcohol policies, school prevention programs, and family-focused and socio-economic interventions. Nationwide school surveys should target pre-adolescent alcohol use.