Concurrent Alcohol Research Articles

Longitudinal associations between minority stress, internalizing symptoms, and substance use among sexual and gender minority individuals assigned female at birth.

Sexual and gender minority individuals assigned female at birth (SGM-AFAB) are at increased risk for anxiety, depression, and substance use and problems compared with heterosexual cisgender women. Cross-sectional research has demonstrated that minority stressors are associated with anxiety, depression, and substance use. However, longitudinal research is limited and the examination of prospective associations between minority stressors, mental health, and substance use is even more sparse. We utilized 4 waves of data (6 months between waves) from a diverse (26.0% non-Latinx White; 26.2% gender minorities) longitudinal cohort of 488 SGM-AFAB (16- to 32-years-old at Wave 1) to examine concurrent and prospective associations between 3 minority stressors (internalized stigma, microaggressions, victimization) and anxiety, depression, and alcohol and cannabis use and problems. At the within-person level, results indicated that when SGM-AFAB experienced more minority stressors than usual, they reported more concurrent and prospective anxiety and depression. Additionally, when SGM-AFAB experienced more microaggressions than usual, they were more likely to use alcohol and cannabis, and when they experienced more victimization than usual, they reported more concurrent alcohol and cannabis use problems. No prospective associations between minority stressors and substance use were significant. Findings indicate that minority stressors were consistently associated with internalizing symptoms, both concurrently and prospectively, while evidence for associations between minority stressors and substance use/problems was less consistent. These findings highlight the need for interventions that that teach SGM-AFAB skills for effectively coping with minority stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Substance Use, Mental Health, and Child Welfare Profiles of Juvenile Justice-Involved Commercially Sexually Exploited Youth.

Objectives: To describe the substance use profiles of youth impacted by commercial sexual exploitation (CSE) and explore associations between substance use with mental health diagnoses and child welfare involvement. Methods: Data were systematically extracted from the court files of 364 youth who participated between 2012 and 2016 in Los Angeles County's Succeeding Through Achievement and Resilience (STAR) Court, a juvenile delinquency specialty court for youth impacted by CSE. Descriptive statistics and multivariate regression analyses were conducted to quantify associations between youths' substance use with mental health diagnoses and child welfare involvement. Results: Of the 364 youth impacted by CSE involved in the STAR Court, 265 youth had documented contact with a psychiatrist while in court-of whom, 73% were diagnosed with at least one mental health challenge. Before STAR Court participation, 74% of youth were the subject of one or more child welfare referral; of these youth, 75% had prior out-of-home care. Eighty-eight percent of youth reported substance use, the most prevalent illicit substances were marijuana (87%), alcohol (54%), and methamphetamine (33%). Controlling for age and race, youth impacted by CSE with a diagnosed general mood disorder had more than five times the odds of reporting substance use compared with those without a mood disorder diagnosis (adjusted odds ratio [AOR]: 5.80; 95% confidence interval CI: 2.22-18.52; p < 0.001); and youth impacted by CSE with prior child welfare placements had more than two times the odds of reporting substance use (AOR: 2.24; 95% CI: 1.04-4.86; p = 0.039) compared with youth without prior placements. The association between substance use and general mood disorder was significant and positive for all substance use types (AOR = 3.3, p = 0.033 marijuana; AOR = 4.01, p = 0.011 concurrent alcohol and marijuana; AOR = 9.2, p < 0.001, polysubstance use). Conclusions: High prevalence of substance use among juvenile justice-involved youth impacted by CSE combined with strong associations between substance use with both mental health diagnoses and child welfare system history underscores the need for comprehensive, specialized substance use treatment. Findings suggest an important opportunity for multidisciplinary collaboration among mental health providers, child welfare professionals, juvenile justice practitioners, and other care providers for these youth.

The Brief Situational Confidence Questionnaire for alcohol: A psychometric assessment with incarcerated youth.

The factor structure, measurement invariance, validity, reliability, and stability of scores on the Brief Situational Confidence Questionnaire (BSCQ) were evaluated for use with incarcerated youth. The BSCQ is an 8-item measure that assesses self-efficacy to resist alcohol use in tempting situations. The brevity of the measure may make it a useful tool for clinicians and researchers in a forensic setting. Analyses were conducted with 2 separate samples (N = 205 and N = 189) of incarcerated youth (M age = 16.90 and 17.12 years, respectively; 88% and 86% male). Based on prior theory and confirmatory factor analyses (CFAs), results indicated that a correlated 2-factor model best fit the data. Multisample CFAs suggested that BSCQ scores demonstrated configural and metric invariance across our 2 samples. Further, the BSCQ scores demonstrated sufficient test-retest stability in Samples 1 and 2 (Pearson's r = .66, .55) and internal consistency (Cronbach's α = .84 and .86, respectively). Negative binomial regressions showed that the overall BSCQ scores were significantly associated with concurrent alcohol use (number of drinking days, number of heavy drinking days, average drinks per week) and significantly predicted future alcohol use. Scores on the BSCQ demonstrated sufficient stability, internal consistency, and validity, and the 2-factor structure was largely invariant across 2 separate samples of incarcerated youth. Given its brevity, the BSCQ may provide valid and reliable scores to use with this population when time and resources are scarce. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Association between relationship quality and concurrent alcohol use and sedative-tranquilizer misuse in middle and later life

Objectives Mid-life adults have notably higher rates of alcohol and other substance misuse than older adults and maintain higher levels of use over time. Social isolation has been linked to higher risk use with increasing age. The purpose of this study is to examine the associations between social relationships, drinking, and misuse of sedative-tranquilizers. Methods The data for this study come from the national Midlife in the United States study wave 2 (MIDUS 2) of adults (N = 3378; 53.3% women) aged 40 and older. Past month alcohol use and past year sedative medication misuse were assessed with social support and strain. Multinomial logistic regressions evaluated the relationship of (a) support and (b) strain to use and co-use of alcohol and sedatives. Results Of the sample, 58.4% used alcohol only, 1.7% only misused sedatives, and 3.5% co-used alcohol/misused sedative-tranquilizers. Support from friends was associated with 1.18 increased risk of co-using compared to not using either substance. Source of strain was associated with co-use for middle-aged and older adults. Familial strain was associated with increased risk of co-using for middle-aged adults. Friend-related strain was associated with increased risk of co-use for older adults. Conclusion Evidence suggests that older co-users may differ from those in midlife in terms of social risk factors. As the aging population increases, elucidating the potential mechanisms by which social factors impact concurrent alcohol use and sedative-tranquilizer medication misuse aid the development of targeted interventions and prevention programs in these groups.

Development of the alcohol use discrepancy instrument (AUDI): An instrument for measuring a purported mechanism of behavior change underlying self-regulation theory

Self-regulation theory (SRT) posits that individuals make decisions regarding behavior change based on a comparison of their actual (e.g., excessive alcohol use) and desired (e.g., abstinence) behaviors. This comparison must result in a discrepancy of sufficient magnitude to motivate an individual toward behavior change. It appears that this purported mechanism of behavior change (MOBC) has not been tested with regards to alcohol use disorder (AUD) treatment. Furthermore, there seems to be no psychometrically sound instrument for assessing such discrepancies in a clinical sample. The purpose of this study was to establish the psychometric properties of an instrument developed to assess actual versus desired alcohol use discrepancies that could be used to test this purported MOBC underlying SRT. The Alcohol Use Discrepancy Instrument (AUDI) was administered to 235 individuals participating in the Clifford et al. (2007) alcohol treatment outcome study that centered on research assessment exposure reactivity effects. Principal axis factor analysis yielded a unidimensional construct (Cronbach’s α = 0.80). Baseline and six-month AUDI scores were correlated with concurrent alcohol use (proportion days abstinent, drinks per drinking day, and proportion heavy days, p < .01) in expected directions. Parallel process models provided further evidence of the AUDI’s construct validity, as well as its potential as a measure of discrepancy as a MOBC.The AUDI has good psychometric properties and is likely to prove useful for assessing discrepancies between actual and desired alcohol use behavior, which, according to the principles of SRT, is essential for behavior change and maintenance.

The relevance of macroeconomic conditions on concurrent and subsequent alcohol use – results from two Northern Swedish cohorts

Background: The aim of this study is to examine the relevance of macroeconomic conditions (boom vs. recession) and own labor market status on alcohol use in youth and midlife.Method: Two Northern Swedish cohorts, born in either 1965 (boom at age 21 years) or 1973 (recession at age 21 years), included all pupils attending the last grade of compulsory school in Luleå, in 1981 (n = 990) or 1989 (n = 686), respectively. Questionnaires were completed at ages 21 and 43/39 years. Alcohol use was measured as volume of consumption (cl/year) and heavy episodic drinking (HED).Results: Women aged 21 years during the boom (Cohort65) consumed less alcohol and were less likely to be heavy episodic drinkers at age 21 years compared to those who were exposed to recession at the same age (Cohort73). In men there were no such cohort differences. Women, and to some extent men, in Cohort65 increased their consumption at midlife, whereas this decreased for those in Cohort73. HED decreased in both cohorts, but the decrease was steeper in the recession cohort. Analyses stratified by labor market status revealed between-cohort differences in consumption among women who were either employed or students at baseline; but not for men. Alcohol use for those unemployed did not differ between the cohorts.Conclusions: In our study, comparing two cohorts that experienced either macroeconomic boom (1986) or recession (1994) at age 21 years in Sweden, the association between individual alcohol use and concurrent unemployment in youth was not affected by macroeconomic conditions.

Unequal interactions between alcohol and nicotine co-consumption: suppression and enhancement of concurrent drug intake.

Alcohol and nicotine addiction are prevalent conditions that co-occur. Despite the prevalence of co-use, factors that influence the suppression and enhancement of concurrent alcohol and nicotine intake are largely unknown. Our goals were to assess how nicotine abstinence and availability influenced concurrent alcohol consumption and to determine the impact of quinine adulteration of alcohol on aversion-resistant alcohol consumption and concurrent nicotine consumption. Male and female C57BL/6J mice voluntarily consumed unsweetened alcohol, nicotine, and water in a chronic 3-bottle choice procedure. In experiment 1, nicotine access was removed for 1week and re-introduced the following week, while the alcohol and water bottles remained available at all times. In experiment 2, quinine (100-1000μM) was added to the 20% alcohol bottle, while the nicotine and water bottles remained unaltered. In experiment 1, we found that alcohol consumption and preference were unaffected by the presence or absence of nicotine access in both male and female mice. In experiment 2a, we found that quinine temporarily suppressed alcohol intake and enhanced concurrent nicotine, but not water, preference in both male and female mice. In experiment 2b, chronic quinine suppression of alcohol intake increased nicotine consumption and preference in female mice without affecting water preference, whereas it increased water and nicotine preference in male mice. Quinine suppression of alcohol consumption enhanced the preference for concurrent nicotine preference in male and female mice, suggesting that mice compensate for the quinine adulteration of alcohol by increasing their nicotine preference.

Development of a novel alcohol and nicotine concurrent access (ANCA) self-administration procedure in baboons

BackgroundSelf-administration of either alcohol or nicotine under single-access conditions has been studied extensively in laboratory animals. Relatively few studies have examined the co-use of these substances, even though alcohol and nicotine use and abuse commonly co-occur in humans. The objectives of this study were to develop a baboon model of concurrent alcohol and nicotine self-administration, and examine effects of varenicline on alcohol and nicotine co-use. MethodsIn Experiment 1, five male baboons were trained to self-administer drinks of alcohol (4% w/v) and injections of nicotine (0.032–0.1 mg/kg) under single-access and then concurrent-access conditions, and intake of alcohol (g/kg) and nicotine (mg/kg) was compared under single- and concurrent-access conditions. In Experiment 2, three male baboons self-administered drinks of alcohol (4% w/v) and injections of nicotine (0.056 mg/kg) under concurrent-access conditions. Pretreatment with varenicline (0.32–1.0 mg/kg, s.c.) or an equal volume of its vehicle before concurrent-access sessions was repeated for 5 consecutive days. ResultsSelf-administration of nicotine and alcohol was successfully established under both single- and concurrent-access conditions that produced reliable levels of voluntary alcohol and nicotine intake. Co-self-administration of both drugs produced levels of intake similar to that produced by each drug alone. Varenicline significantly reduced intake of both alcohol and nicotine when compared to the vehicle condition. ConclusionsThis baboon model provides a valuable tool for further investigation of the behavioral and pharmacological mechanisms involved in co-use of nicotine and alcohol. A single pharmacotherapeutic agent (e.g., varenicline) may be useful in treating nicotine and alcohol co-use.

Conceptualising alcohol consumption in relation to long-term health conditions: Exploring risk in interviewee accounts of drinking and taking medications.

Alcohol use is a major contributor to the burden of disease, including long-term non-communicable diseases. Alcohol can also interact with and counter the effects of medications. This study addresses how people with long term conditions, who take multiple medications, experience and understand their alcohol use. The study objective is to explore how people conceptualise the risks posed to their own health from their concurrent alcohol and medicines use. Semi-structured interviews were conducted with a sample of 24 people in the North of England taking medication for long term conditions who drank alcohol twice a week or more often. Transcripts were analysed using a modified framework method with a constructionist thematic analysis. Alcohol was consumed recreationally and to aid with symptoms of sleeplessness, stress and pain. Interviewees were concerned about the felt effects of concurrent alcohol and medicines use and sought ways to minimise the negative effects. Interviewees associated their own drinking with short-term reward, pleasure and relief. Risky drinking was located elsewhere, in the drinking of others. People made experiential, embodied sense of health harms and did not seem aware of, or convinced by, (or in some cases appeared resigned to) future harms to their own health from alcohol use. The study has limitations common to exploratory qualitative studies. Health risk communication should be better informed about how people with long-term health conditions perceive health outcomes over time, and how they adopt experience-based safety strategies in contexts in which alcohol consumption is heavily promoted and weakly regulated, whilst medicines adherence is expected. Supporting people to make active and informed connections between medicines, alcohol and potential personal health harms requires more than a one-way style of risk communication if it is to be perceived as opening up rather than restricting choice.

Brain N-Acetyl Aspartate and associations with cognitive impairment in alcohol dependent patients

ABSTRACTIntroduction: Chronic alcohol consumption has been observed to be associated with a range of cognitive impairments that impact on treatment management. In this spectroscopy study, we examined the association of N-Acetyl Aspartate (NAA), a marker of neuronal integrity, and cognitive impairment in alcohol dependent patients.Method: Using in vivo proton magnetic resonance spectroscopy (1H-MRS), we examined brain metabolite levels in 31 alcohol dependent individuals. 1H-MRS from the parietal lobe were analyzed to yield absolute concentrations of NAA. Alcohol history, neurocognitive function including Clock Drawing Test (CDT), Mini Mental State Exam (MMSE), Trial Making Test (TMT) and Balloon Analogue Risk Task (BART) were also assessed. Covariates included concurrent medication, age and recent alcohol consumption.Results: There were statistically significant bivariate associations between NAA and the variables age, CDT and BART (r = −.45, P = 01; r = −.53, P = .01; r = .49, P = .02) respectively) but there were no statistically significant associations with other measures of cognitive function. Controlling for age, concurrent medication and recent alcohol consumption, multiple linear regression revealed a negative association between parietal NAA (Model: F = 6.96, R2 = .66, P = .001) and CDT scores (B = −.35, P = .03), a positive association with BART scores (B = .47, P = .02).Conclusion: These results demonstrate that in alcohol dependent patients lower NAA/Cr is associated with reduced cognitive functioning and increased risk-taking.

Brain activation to cannabis- and alcohol-related words in alcohol use disorder

Cannabis abuse commonly co-occurs with alcohol use disorder (AUD). With increased acceptance and accessibility to cannabis in the US, it is imperative to understand the psychological and neural mechanisms of concurrent alcohol and cannabis use. We hypothesized that neural alcohol-cue conditioning may extent to other drug-related stimuli, such as cannabis, and underwrite the loss of control over reward-driven behavior. Task-activated fMRI examined the neural correlates of alcohol- and cannabis-related word cues in 21 abstinent AUD and 18 control subjects. Relative to controls, AUD showed behavioral attentional biases and frontal hypoactivation to both alcohol- and cannabis-related words. This cue-elicited prefrontal hypoactivation was related to higher lifetime alcohol consumption (pcorrected < 0.02) and modulated by past cannabis use histories (p ≦ 0.001). In particular, frontal hypoactivation to both alcohol and cannabis cues was pronounced in AUD without prior cannabis exposure. Overall, frontal control mechanisms in abstinent AUD were not sufficiently engaged to override automatic alcohol and cannabis-related intrusions, enhancing the risk for relapse and potentially for alcohol and cannabis co-use with the increased social acceptance and accessibility in the US.

Alcohol Intoxication as a Stroke Mimic and the Incidence of Acute Alcohol Intoxication in Stroke

Background and AimAlcohol intoxication can be a posterior circulation stroke mimic as they share symptoms such as dysarthria, gait disturbances and nystagmus. We describe alcohol intoxication as a stroke mimic and the frequency of acute alcohol intoxication among stroke patients. MethodsProspective observational single-center study (2014-2017, Haga Ziekenhuis, the Hague). In all patients older than 16 years presenting as possible acute stroke less than 6 hours of onset, blood ethanol was measured; greater than 0.1 blood alcohol concentration (BAC) was considered elevated. ResultsIn total 974 patients were included: 60 (6%) had elevated blood ethanol (mean: 1.3 BAC). In 180 of 974 patients (18%) a stroke mimic was diagnosed: 12 were due to alcohol intoxication (1% of total cohort, 7% of stroke mimic, mean ethanol level: 2.2 BAC). Half of these patients denied or downplayed their alcohol consumption. Stroke and concurrent alcohol intoxication occurred in 38 of 794 strokes (5%, mean ethanol level: 1.1 BAC). Compared to other stroke patients, these 38 patients presented more often after working hours (mean 6.38pm versus 2.23pm) and received alteplase and endovascular therapy less often (24% versus 43%, P = .018 and 3% versus 10%, P = .241, respectively). ConclusionsOf all patients presenting as possible acute stroke, 6% also drank alcohol. 18% of the whole cohort was diagnosed with a stroke mimic. Acute alcohol intoxication as sole diagnosis was diagnosed in 1% of the total cohort and 7% of stroke mimics, 50% denied or downplayed their alcohol consumption. 5% of all stroke patients also drank alcohol, they were significantly less likely to receive alteplase or endovascular treatment.

573 Safety of Esophagogastroduodenoscopy in Patients With Active Cocaine Use: A Pilot Study

INTRODUCTION: The timing of when to perform endoscopy in patients with a positive cocaine urine drug screen (UDS+C) varies across institutions and is based on expert opinions and personal experience. There are no clear published guidelines or reported studies in the English literature examining the safety of endoscopy in active users of cocaine. This study aimed to describe the incidence of adverse events of esophagogastroduodenoscopy (EGD) in patients with active cocaine use in a single inner-city tertiary hospital in Chicago. METHODS: We examined consecutive records of patients who underwent an EGD at the John H. Stroger, Jr. Hospital of Cook County from October 2016 to October 2018 and identified those who had a UDS + C within 4 days. We examined the demographics and outcomes of these patients including pre- and post-procedure hemodynamics. Paired T-tests were used to analyze the periprocedural hemodynamics. RESULTS: A total of 2122 patients were identified during the study period of which 129 patients had a positive urine drug screen and 50 had a UDS + C. From these patients, we identified 20 who had a UDS + C within 4 days of an EGD. These active users were predominately male (n=16) and African-American (n = 14). The majority underwent urgent procedures (n=16) in an inpatient setting (n = 19). The average time since a UDS + C was 2.3 days (SD ± 1.26). 8 patients were ASA class II and 12 were ASA class III. 14 patients underwent monitored anesthesia care (MAC) sedation and 6 underwent general anesthesia. 12 patients had abnormal electrocardiograms. The most frequent comorbidity was concurrent drug or alcohol abuse (n = 14) followed by hypertension (n = 7). There were no adverse endoscopic or anesthesia events, but 3 patients had transient procedural events (1 with oxygen desaturation and 2 with hypotension). Pre- and post-procedure hemodynamics were within normal ranges and blood pressure showed a statistically but not clinically significant decrease from a mean of 136/79 mmHg to 129/77 mmHg (P &lt; 0.05). CONCLUSION: No major adverse events occurred in the active cocaine users undergoing EGD in our retrospective single center study. The decrease in blood pressure in our study was statistically but not clinically significant. Our study suggests that EGD with anesthesia support appears to be safe in patients with active cocaine use. More studies with larger sample sizes are needed to confirm these findings and further guide the safety and timing of endoscopy in cocaine users.

Effects of Adolescent Cannabis Use on Motivation and Depression: A Systematic Review.

This article reviews recent behavioral and neuroimaging studies to elucidate whether adolescent cannabis use is related to reduced motivation and increased risk of depression. Recent work suggests that heavy adolescent cannabis use predicts poorer educational outcomes, often presumed to reflect reduced academic motivation, as well as increased levels of depressive symptoms. However, evidence of a link between cannabis use and general motivation was lacking. Factors such as concurrent alcohol and tobacco use, trajectories of cannabis use during adolescence, and cannabis-related changes in underlying neurocircuitry may impact associations among cannabis use, motivation, and depression. Heavy adolescent cannabis use is associated with poorer educational outcomes and increased levels of depressive symptoms. The role of depression in how cannabis may affect motivation, broadly, is not yet clear, as most studies have not examined associations among all three constructs. Future work should explore possible overlap between cannabis effects on motivation and depression, and clarify the temporality of these associations.

Concurrent Daily Alcohol and Tobacco Use among Sexual Minority and Heterosexual Women

Background: Studies show that sexual minority women (SMW) report more hazardous alcohol use patterns and higher rates of tobacco use than exclusively heterosexual women. Despite the public health implications of drinking and smoking, especially when they co-occur, little is known about SMW’s daily use patterns or the factors that may facilitate concurrent use. Objectives: The present study seeks to identify patterns of daily concurrent alcohol and tobacco use among SMW and heterosexual women, including socio-environmental drinking contexts of concurrent use. Methods: Data come from a community sample of lesbian, bisexual, and heterosexual women (N = 246) who completed up to 84 consecutive days of web-based reports about substance use. Results: Participants reported 4,012 drinking days (24%), 2,019 smoking days (12%), and 769 concurrent drinking and smoking days (5%). No differences were found between SMW and heterosexual women in the proportion of drinking days; however, SMW consumed more drinks on drinking days. SMW also reported a greater proportion of smoking days, more cigarettes smoked on smoking days, and a greater proportion of concurrent drinking and smoking days. Reciprocal daily relationships between alcohol and tobacco use were identified, and these relationships were strongest for bisexual women. Socio-environmental factors—including certain locations, situations, and companions—increased the likelihood of concurrent use for all women; however, few sexual identity differences were found in concurrent use contexts. Importance: Results expand our understanding about daily concurrent alcohol and tobacco use risk among SMW, and potentially inform treatment research to better address the unique experiences of this vulnerable group.

Concurrent Alcohol and Opioid Use Among Harm Reduction Clients

BackgroundHarm reduction services infrequently address alcohol use among clients using opioids, despite the evaluated risk of overdose or medical consequences for clients with viral infections. The purpose of this study is to assess concurrent alcohol and opioid use among syringe services and overdose prevention program participants predominately in southern Ohio and northern Kentucky. MethodsThis is a cross-sectional study using self-report data (n = 1,142) pooled across regional overdose prevention programs and a mobile syringe services program. The outcome variable was concurrent use categorized as no concurrent alcohol, prescription opioid or heroin use; alcohol and heroin or prescription opioid use; and alcohol, prescription opioid and heroin use in the past three months. ResultsThe sample was predominantly white (95%), 56% were male and the mean age was 33 years old. Forty-seven percent of the clients had no concurrent use of alcohol and opioids; 20.1% reported concurrent use of alcohol and either heroin or prescription opioids; and 33.4% reported concurrent use of alcohol, heroin and prescription opioids in the past 3 months. Lifetime suicidal ideation and non-opioid drug use were associated with concurrent alcohol and opioid use in the multivariable model. ConclusionHarm reduction clients with concurrent alcohol and opioid use may warrant enhanced overdose prevention services. Syringe services and overdose prevention program participants may benefit from education or a brief intervention on alcohol consumption.

Longitudinal associations between minority stressors and substance use among sexual and gender minority individuals

BackgroundSexual and gender minority individuals (SGM) are at increased risk for substance use and substance use problems compared to heterosexual individuals. A growing cross-sectional literature has demonstrated that minority stressors are associated with higher risk for substance use among SGM individuals. However, longitudinal research in this area is limited and existing longitudinal studies have focused almost exclusively on one type of substance use (alcohol) and one minority stressor (SGM victimization). MethodsTo extend the longitudinal body of research on associations between minority stressors and substance use, we utilized seven waves of data from a longitudinal cohort study of 1091 SGM individuals assigned male at birth to examine associations between three minority stressors, general stress, and marijuana and alcohol use. ResultsAt the within-person level, results indicated that when individuals experienced more internalized stigma, microaggressions, victimization, or general stress than usual, they reported more concurrent alcohol problems. Further, when individuals experienced more microaggressions or general stress than usual, they also experienced more concurrent marijuana use problems. However, stressors were not prospectively associated with higher rates of alcohol or marijuana problems six months later. ConclusionsFindings indicate that minority stressors are consistently associated with more concurrent alcohol problems, while these associations may be less consistent for marijuana problems. The lack of prospective effects of minority stress on substance use points to the need for innovative methods for examining these effects, such as daily or weekly diary studies.

Is the Sum Greater than its Parts? Variations in Substance-Related Consequences by Conjoint Alcohol-Marijuana Use Patterns

ABSTRACTAlcohol and marijuana are the most commonly used substances for college-attending young adults. This study evaluated differences in substance-specific consequence attribution by alcohol-marijuana use patterns (concurrent alcohol and marijuana [CAM; use of both substances, not at same time] and simultaneous [SAM; use of both, at same time]) as well as alcohol-only (AO). First-year college students with prior alcohol use (N = 610, 50.9% women, 71% White, Mage = 18) completed an online assessment of past-three-month substance use, including SAM, and related consequences. Results indicated that polydrug (SAM and CAM) users reported greater alcohol involvement and earlier alcohol initiation than AO, and polydrug use was associated with more alcohol-related problems, including sexual risk taking and alcohol-related blackouts. When restricted to SAM/CAM users, logistic regressions indicated that SAM users reported an increased incidence in two marijuana-related problems relative to CAM (driving after using and academic difficulties), but lower rates of social problems. SAM users were also less likely to attribute substance-related social problems to alcohol. Overall, findings highlight variations that exist within alcohol-marijuana polydrug users and show areas to consider for intervention development and future research.

Structurally Similar and Behaviorally Unique Modafinil Analogs as Potential Pharmacotherapeutics for Psychostimulant Use Disorder

Modafinil has been used off‐label to treat psychostimulant use disorders (PSUD). However, its effectiveness in clinical trials seems limited to a subpopulation of subjects without concurrent alcohol or poly‐drug use. Since the main pharmacological target of cocaine is the dopamine transporter (DAT), recent efforts to develop more globally effective pharmacotherapies for PSUD have focused on two new DAT inhibitors and structural analogs of modafinil, JJC8‐088 and JJC8‐091, as promising lead compounds.In this study, the behavioral effects of these compounds were tested in rat models of cocaine self‐administration and reinstatement to drug seeking. Neurochemical correlates to those behaviors were assessed in microdialysis and fast‐scan cyclic voltammetry (FSCV) procedures aimed to measure extracellular dopamine levels and potential changes in dopamine dynamics in the nucleus accumbens shell (NAS).Our results show that JJC8‐088 (3, 10, 30 mg/kg, i.p.) dose‐dependently decreased the number of cocaine infusions under a fixed ratio schedule of self‐administration, while JJC8‐091 (10, 30, 56 mg/kg) failed to significantly alter cocaine self‐administration. In contrast, JJC8‐088 failed, while JJC8‐091 effectively decreased the break‐point for cocaine self‐administration under a progressive ratio schedule of behavior. JJC8‐088 maintained self‐administration behavior in both drug‐naïve and cocaine trained rats, while JJC8‐091 did not. Moreover, only priming injections of JJC8‐088 dose‐dependently reinstated drug‐seeking behavior in rats following previous cocaine extinction. Importantly, in the same rats, JJC8‐091 pretreatment blocked cocaine‐induced reinstatement of drug seeking behavior.The neurochemical assessment of JJC8‐088 and JJC8‐091 effects showed that both drugs dose‐dependently increased extracellular DA concentrations in dialysates from the NAS. However, JJC8‐088 was more potent and more efficacious in increasing DA levels compared to JJC8‐091. Indeed, the maximal changes in DA levels elicited by JJC8‐088 resemble those obtained with cocaine, in contrast to JJC8‐091.The FSCV studies showed that both JJC8‐088 and JJC8‐091 dose dependently reduced the rate of DA clearance, with JJC8‐088 producing effects greater in magnitude at lower doses than JJC8‐091. Finally, like cocaine, cumulative doses of JJC8‐088 produced a dose‐dependent increase in DAMax, while JJC8‐091 was ineffective at all doses tested.Collectively, these data show that despite sharing significant structural similarity, JJC8‐088 was cocaine‐like, while JJC8‐091 was not. Indeed, in contrast with JJC8‐088, JJC8‐091 did not elicit significant reinforcing actions and reduced or blunted the reinforcing effects of cocaine. Taken together, our data support further development of JJC8‐091, as a potential pharmacotherapy for the treatment of PSUD.Support or Funding InformationSupport for this research was provided by the Medication Development Program, National Institute on Drug Abuse ‐ Intramural Research Program, NIH/DHHSThis abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

US Emergency Department Visits for Acute Harms From Prescription Opioid Use, 2016-2017.

To estimate the number of US emergency department visits for prescription opioid harms by patient characteristics, intent, clinical manifestations, and active ingredient. We used data from medical record-based surveillance from a nationally representative 60-hospital sample. Based on 7769 cases, there were 267 020 estimated emergency department visits annually (95% confidence interval [CI] = 209 833, 324 206) for prescription opioid harms from 2016 to 2017. Nearly half of visits (47.6%; 95% CI = 40.8%, 54.4%) were attributable to nonmedical opioid use, 38.9% (95% CI = 32.9%, 44.8%) to therapeutic use, and 13.5% (95% CI = 11.0%, 16.0%) to self-harm. Co-implication with other pharmaceuticals and concurrent illicit drug and alcohol use were common; prescription opioids alone were implicated in 31.5% (95% CI = 27.2%, 35.8%) of nonmedical use visits and 19.7% (95% CI = 15.7%, 23.7%) of self-harm visits. Unresponsiveness or cardiorespiratory failure (30.0%) and altered mental status (35.7%) were common in nonmedical use visits. Gastrointestinal effects (30.4%) were common in therapeutic use visits. Oxycodone was implicated in more than one third of visits across intents. Morbidity data can help target interventions, such as dispensing naloxone to family and friends of those with serious overdose, and screening and treatment of substance use disorder when opioids are prescribed long-term.