Alcohol Use Dependence Research Articles

Paternal Preconceptional Alcohol Use Disorder With the Offspring's Mortality Risk

IntroductionPaternal pre-conceptional alcohol use may contribute to early pregnancy loss. However, the link between paternal pre-conceptional alcohol use disorder(AUD) and long-term offspring's mortality risk remains unclear. This study examined the association of paternal pre-conceptional AUD and recency of diagnosis with offspring's mortality, and further stratified the mortality after the first year of birth by age. MethodsThis is a nationwide cohort study with 1973174 Danish births(1980-2012), with follow-up from birth until death, emigration, or 31-December 2016. Paternal conceptional AUD was identified from Danish National Patient Register and Prescription Registry, categorizing recency of diagnosis into <1 year, 1-<4 years, 4-<8 years, ≥8 years. Logistic regression estimated odds ratios and 95% confidence intervals(CIs) for offspring mortality risk. All data were analyzed in 2023. ResultsPaternal pre-conceptional AUD was associated with a 28% increased mortality after one year of birth(95%CI=1.09-1.51), 23% increased infant mortality(95%CI=1.07-1.42), and 23% increased odds of stillbirth(95%CI=1.06-1.43). Paternal AUD diagnosed <1 year before conception was associated with an 85%-111% increased risk of mortality in offspring aged 15-40 years. More recent AUD diagnosis(i.e.,one year before conception) had a higher risks of death from infectious and circulatory diseases in offpring. ConclusionsOffspring of fathers with AUD before conception had higher mortality risk from birth to early adulthood, especially when AUD diagnosis is close to conception. Current awareness regarding paternal pre-conceptional alcohol dependence use is insufficient. Promoting alcohol dependence avoidance, including educating men on the impact of alcohol on child health during pre-pregnancy examination may help reduce or prevent long-term offspring mortality.

Hazardous, harmful, and dependent alcohol use in healthcare professionals: a systematic review and meta-analysis.

Healthcare professionals work in high-pressured and demanding environments, which has been linked to the use of alcohol as a coping strategy. This international review aimed (i) to determine the pooled prevalence of hazardous, harmful, dependent, and frequent binge drinking in healthcare professionals, and (ii) to explore factors associated with variation in these outcomes. Scopus, MEDLINE, and PsycINFO were searched from 2003 to 17th November 2022, for studies reporting a prevalence estimate for any outcome among healthcare professionals. Random-effects meta-analyses determined pooled prevalence estimates. Sub-group analyses were conducted, stratifying the meta-analyses by pandemic period vs pre-pandemic period. Meta-regressions explored factors that were associated with variation in the outcomes. PROSPERO (CRD42020173119). After screening 9,108 records, 64 studies were identified as eligible. The pooled prevalence was 19.98% [95% Confidence Intervals [CI]: 16.05-24.23%] for hazardous alcohol use (K = 52), 3.17% [95% CI: 0.95-6.58%] for harmful drinking (K = 8), 14.59% [95% CI: 7.16-25.05%] for dependent drinking (K = 7), and 17.71% [95% CI: 8.34-29.63%] for frequent binge drinking (K = 11). The prevalence of hazardous drinking was greater during the pandemic (28.19%) compared with pre-pandemic estimates (17.95%), though this was not statistically significant (p = 0.049). Studies including all hospital staff (32.04%) showed higher prevalence estimates for hazardous drinking compared with studies of doctors (16.78%) and nurses (27.02%). Approximately one fifth of healthcare professionals drink to hazardous levels, with higher prevalence estimates observed during the COVID-19 pandemic. It may be that healthcare professionals used alcohol to cope with the additional trauma and stressors. Further research is needed to investigate whether this is sustained in the post-pandemic period.

Gender differences in substance use and associated factors among urban refugees in Uganda

ABSTRACT Background: Alcohol and other substances use related problems among refugees is a global public health concern. Although there is substantial research on the use of alcohol and other substances among the refugees, little is known about gender and other factors that might be associated with the use of alcohol and other substances. Our study aimed to assess the prevalence of alcohol and substance use across gender and other specific associated factors among urban refugees living in Mbarara city, Southwestern Uganda. Methods: In a cross-sectional study, 343 refugees were interviewed on the use of alcohol and other substances using the Alcohol Use Disorder Identification Test and the Drug Abuse Screening Test. The associated factors included, age, marital status, occupation, duration (length of stay) in Uganda, educational levels, stigma and depression. Linear regression analysis was used to examine the associations between the predictor and outcome variables. Results: No significant gender difference in alcohol use was found, and the overall prevalence of hazardous, harmful or dependent alcohol use among our sample of refugees living in Mbarara city was 43%. There were however, statistically significant gender differences in the use of other substances, with a significantly higher percentage of men than women reporting intermediate, substantial, or severe substance use (45% among men, 37% among women). Higher levels of depression and being separated from one’s spouse were associated with higher levels of alcohol and substance use. In addition, higher age and being male were associated with the use of substances other than alcohol. Conclusions: Our findings indicate a high prevalence of problematic alcohol and substance use among both male and female refugees. Clinical interventions focused on the treatment and prevention of alcohol and substance use among the refugee communities may benefit from focusing on depressive symptoms as well.

Outcomes following suicidal crisis among hazardous and harmful alcohol users in the Crisis Resolution Team.

Despite associations between alcohol use and suicidal acts, little research measures prognoses of alcohol-using patients treated by Crisis Resolution Teams (CRTs), an intensive community-based intervention. We estimated the association of alcohol use amongst patients accepted following suicidal acts or ideation in four London-based Crisis Resolution Teams, with death-by-any-cause or recontact with crisis care. We analysed the electronic health records of 1615 CRT patients accepted following suicidal acts or ideation over 38 months, following STROBE guidelines. Using logistic regression we estimated the association of alcohol use (indicated by risk-assessment, AUDIT, or ICD-10 diagnosis) with death-or-recontact at (i) 30-days and (ii) 1-year after treatment start, adjusted for age, sex, ethnicity, psychiatric diagnosis, and severity of need. Hazardous, harmful, or dependent drinking was identified in 270 cases at baseline (16.7%); 73 (4.5%) were alcohol dependent. By 1-year, 622 patients (38.5%) had recontacted crisis care or died. After adjustment, alcohol use at a hazardous, harmful, or dependent level was not associated with increased odds of death-or-recontact at 30-days (AOR 1.17, 95%CI 0.73, 1.88) or 1-year (AOR 1.17, 95%CI 0.85, 1.60). Patients with hazardous, harmful, and dependent alcohol use are a small proportion of CRT patients, despite being more commonly encountered in emergency settings from which patients may be referred to CRTs, indicating a potential gap in provision. Those who are included in CRTs are not at increased risk of death-or-recontact within 1 year of treatment, suggesting that their inclusion can work, at least in a sample with predominantly hazardous or harmful alcohol use.

Alcohol use during pregnancy and motherhood: Attitudes and experiences of pregnant women, mothers, and healthcare professionals.

Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering 'grey area' drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds.

Association of Attending a High-Performing High School With Substance Use Disorder Rate and Health Outcomes in Young Adults

Interventions directly targeting social factors, such as education, may have the potential to greatly improve health. To examine the association of attending a high-performing public charter high school with rates of substance use disorder and physical and mental health. This cohort study used the random school admissions lottery system of high-performing public charter high schools in low-income neighborhoods of Los Angeles, California, to examine the health outcomes of students who applied to at least 1 of 5 of these high schools. Participants attended 147 different high schools and were randomly selected from those who won the admissions lottery (intervention group) and those who were placed on a waiting list (control group). Participants were surveyed at the end of grade 8 through transition into grade 9 and then from grade 10 through 3 years after high school completion (at age 21 years). Surveys were conducted from March 2013 through November 2021. Attendance at a high-performing public charter high school. Self-reported alcohol use disorder and cannabis misuse, delinquent behaviors, physical and mental health, and body mass index. Of the 1270 participants at baseline (mean [SD] age, 14.2 [0.47] years; 668 female individuals [52.6%]). The control group included 576 individuals (45.4%), and 694 individuals (54.6%) were in the intervention group. Both groups were similar in almost all characteristics at baseline, and the median (IQR) follow-up was 6.4 (6.0-6.7) years. Participants attending a high-performing public charter high school had a 53.33% lower rate of hazardous or dependent alcohol use disorder compared with those in the control group (5.43% vs 11.64%; difference, -6.21% [95% CI, -11.87% to -0.55%]; P = .03). Among male participants, the intervention group had a 42.05% lower rate of self-reported fair or poor physical health (13.33% vs 23.01%; difference, -9.67% [95% CI, -18.30% to -1.05%]; P = .03) and a 32.94% lower rate of obesity or overweight (29.28% vs 43.67%; difference, -14.38% [95% CI, -25.74% to -3.02%]; P = .02) compared with the control group. Among female participants, attending a high-performing public charter high school was associated with worse physical health outcomes (30.29% vs 13.47% reporting fair or poor health; difference, 16.82% [95% CI, 0.36% to 33.28%]; P = .045) and higher rates of overweight or obesity (52.20% vs 32.91%; difference, 19.30% [95% CI, 3.37% to 35.22%]; P = .02) at age 21 years. Few differences in mental health outcomes were observed. Adjusting for educational outcomes did not significantly change these findings. Results of this study suggest that attending a high-performing public charter high school was associated with lower rates of substance use disorder independent of academic achievement. Physical health and obesity outcomes were also better but only for young men; the intervention group had worse physical health outcomes among young women for unclear reasons. Schools are a potent social determinant of health and an important target for future health interventions.

The Extent of Alcohol-Related Problems Among College and University Students in Norway Prior to and During the COVID-19 Pandemic.

AimTo provide estimates of the distribution of alcohol-related problems in a national sample of college and university students in 2021, i.e., during the COVID-19 pandemic, in comparison with pre-pandemic data from 2018.DesignLongitudinal data from linkage of two recent national health surveys from 2018 to 2021.SettingStudents in higher education in Norway (the SHoT-study).Participants8,287 fulltime students (72.5% women, 27.6% men) that were 18 years or more at the time of the first survey in 2018, and 21 years or more at the time of the second survey in 2021.MeasurementsThe Alcohol Use Disorders Identification Test (AUDIT) was used to assess potential alcohol-related problems.Findings37.0% of male students and 24.1% of female students reported either risky, harmful, or dependent alcohol use in 2021, compared with 55.0% of male students and 43.6% of female students in 2018. This decrease in alcohol-related problems was most pronounced for dependent alcohol use, where we observed a 57% relative reduction among male students (from 3.5% in 2018 to 1.5% in 2021) and a 64% relative reduction among female students (from 1.4% in 2018 to 0.5% in 2021).ConclusionsThe present study demonstrated a sharp decline in alcohol-related problems among students during the COVID-19 pandemic, that were present across gender, age groups, and geographical study locations. Universal preventive measures to limit students' alcohol use should be considered when restrictions related to the pandemic is lifted.

DRUGS USE HABITS AND PERSONALITY TRAITS OF SYNTHETIC DRUGS USERS: A DESCRIPTIVE CROSS - SECTIONAL STUDY

Background and objectives: Several studies in the world showed that distinctive personality traits linked to an increased risk of substance abuse than the general population. In addition, personality also played an important role in treatment outcome in patients with substance use disorders. Objectives: 1. To describe drugs use habits of synthetic drugs users. 2. To investigate personality traits by Minnesota Multiphasic Personality Inventory - 2 in the participants. Subjects and methods: This is a descriptive cross - sectional study on 40 inpatients with using synthetic drugs at the Department of Mental Health, Hue Central Hospital and Psychiatric Hospital. Using a designed questionnaire to assess synthetic drug use habits in the participants. Minnesota Multiphasic Personality Inventory – 2 (MMPI -2) was used to investigate personality in the subjects. Using ICD – 10 diagnostic criteria to identify mental and behavioral disorders due to drug use. Results: The meanage of first drug use in the participants was 26.6 ± 5.9 years old. 85% of patients used multiple drugs, 82.5% of patients used drugs from 2 to 5 times per a week and 82.5% of patients used drugs at different locations. There were 37.5% of patients with harmful or dependent alcohol use, and 30 patients, accounting for 75%, were smokers.The personality traits in the participants were paranoia personality trait (42.5%), schizophrenic personality trait (37.5%), hypochondriasis personality trait (32.5%), psychasthenia personality trait (27.5%), deviant personality (25%), hypomanic personality (20%), hysterical personality 15%, depressive personality trait (2.5%). There were no cases of gender deviation and social introvert personality. Most of the patients had 2 or more personality disorder traits (72.5%).There were 3 patients accounting for 7.5% without any personality disorder traits. Conclusion: synthetic drug users often used multiple drugs, several times per a week and in different locations. schizophrenic and paranoia personality traits account for the highest rate in the participants. Majority of patients had combination of personality traits Key words: MMPI, personality traits, synthetic drug users, drug use habits

Prevalence and correlates of hazardous, harmful or dependent alcohol use and drug use amongst persons 15 years and older in South Africa: Results of a national survey in 2017.

BackgroundHarmful alcohol and illicit drug use significantly contribute the burden of disease.AimThis study aimed to assess the prevalence and correlates of hazardous, harmful or dependent alcohol (HHDA) use and drug use amongst persons 15 years and older in South Africa.SettingPopulation-based survey.MethodIn a national cross-sectional 2017 survey, 39 210 persons 15 years and older (Median = 34 years) responded to a questionnaire on substance and health variables. The prevalence of HHDA use was 10.3% and past 3-month drug use 8.6%.ResultsIn adjusted logistic regression analysis, men of middle age (25–34 year olds) with higher education, urban residence, drug use and psychological distress were positively associated and Indian or Asian and white population groups were negatively associated with HHDA. Women of middle age (25–34 year old) and mixed race, residing on rural farms and urban areas, with drug use and psychological distress were positively associated and older age (55 years and older) and Indians or Asians were negatively associated with HHDA. In adjusted logistic regression analysis, men, having Grade 8–11 education, mixed race, being unemployed, and the HHDA used were positively associated and middle and older age (25 years and older) and being a student or learner were negatively associated with past 3-month any drug use. Women, who were mixed race, Indians or Asians, with the HHDA use were positively associated and older age (45 years and older) were negatively associated with the past 3-month drug use.ConclusionAbout one in 10 participants with several sociodemographic and health indicators was identified to be associated with HHDA and any drug use.

Does the Fast Alcohol Screening Test Accurately Distinguish Between Harmful and Severely Dependent Tiers of Alcohol Misuse?

AimsPrimary aim: to determine the efficacy of FAST (the Fast Alcohol Screening Test) for detecting harmful and dependent levels of alcohol use. Secondary aim: to compare the performance of the FAST to two short forms of the Alcohol Use Disorder Identification Test (AUDIT): the AUDIT-C and AUDIT-3.MethodsData from 3336 individuals in South Wales, compiled from full AUDIT datasets, were examined. AUROC analysis, alongside measures of sensitivity and specificity of the FAST, AUDIT-C and AUDIT-3 were utilized for the identification of harmful and dependent alcohol use.ResultsThe FAST demonstrated efficacy in the identification of harmful and dependent levels of alcohol use, with superior performance to both the AUDIT-C and AUDIT-3.ConclusionThe present paper demonstrates the potential of the FAST as a cost- and time-effective method for appropriate screening and signposting in the stepped care model utilized by many health care and treatment services. Further studies are needed to ensure validity, both within the general population and for specific services and populations.

Neurofeedback Training versus Treatment-as-Usual for Alcohol Dependence: Results of an Early-Phase Randomized Controlled Trial and Neuroimaging Correlates

Introduction: Alcohol dependence is one of the most common substance use disorders, and novel treatment options are urgently needed. Neurofeedback training (NFT) based on real-time functional magnetic resonance imaging (rtf­MRI) has emerged as an attractive candidate for add-on treatments in psychiatry, but its use in alcohol dependence has not been formally investigated in a clinical trial. We investigated the use of rtfMRI-based NFT to prevent relapse in alcohol dependence. Methods: Fifty-two alcohol-dependent patients from the UK who had completed a detoxification program were randomly assigned to a treatment group (receiving rtfMRI NFT in addition to standard care) or the control group (receiving standard care only). At baseline, alcohol consumption was assessed as the primary outcome measure and a variety of psychological, behavioral, and neural parameters as secondary outcome measures to determine feasibility and secondary training effects. Participants in the treatment group underwent 6 NFT sessions over 4 months and were trained to downregulate their brain activation in the salience network in the presence of alcohol stimuli and to upregulate frontal activation in response to pictures related to positive goals. Four, 8, and 12 months after baseline assessment, both groups were followed up with a battery of clinical and psychometric tests. Results: Primary outcome measures showed very low relapse rates for both groups. Analysis of neural secondary outcome measures indicated that the majority of patients modulated the salience system in the desired directions, by decreasing activity in response to alcohol stimuli and increasing activation in response to positive goals. The intervention had a good safety and acceptability profile. Conclusion: We demonstrated that rtfMRI-neurofeedback targeting hyperactivity of the salience network in response to alcohol cues is feasible in currently abstinent patients with alcohol dependence.

Alcohol use and viral suppression in HIV-positive Kenyan female sex workers on antiretroviral therapy

BackgroundExcessive alcohol intake has been associated with poor adherence to antiretroviral therapy (ART). The impact of alcohol on viral suppression is particularly important among groups at high risk of HIV transmission, such as female sex workers (FSWs). Few studies have directly evaluated the association between alcohol use and HIV viral load. We hypothesized that hazardous or harmful alcohol use is associated with detectable plasma viral load among HIV-positive FSWs.MethodsA prospective cohort study was conducted among HIV-positive FSWs in Mombasa, Kenya. Hazardous or harmful alcohol use was assessed yearly and defined as an Alcohol Use Disorders Identification Test (AUDIT) score ≥7. Detectable viral load was assessed every six months and defined as ≥180 c/mL. Adherence measures were collected monthly and included late ART refill (>48 hours) and self-reported adherence, using both a validated self-rating scale of ability to take medication and visual analog scale (VAS) of ART use in the last month. Generalized estimating equations were used to estimate adjusted relative risks (aRR) and 95% confidence intervals (CI).ResultsThis analysis included 366 participants followed monthly between October 2012 and March 2018. At baseline, AUDIT scores indicated hazardous alcohol use (AUDIT 7–15) in 14.3%, harmful alcohol use (AUDIT 16–19) in 1.4%, and alcohol dependency (AUDIT ≥20) in 1.4% of participants. After adjusting for potential confounders, a combined exposure including hazardous, harmful, and dependent alcohol use was not associated with detectable viral load (aRR 1.10, 95%CI 0.63–1.92) or late ART refill (aRR 1.13, 95%CI 0.82–1.56), but was associated with lower self-rated ability to take medication (aRR 2.38, 95%CI 1.42–3.99) and a lower rate of self-reported perfect ART adherence by VAS (aRR 2.62, 95%CI 1.84–3.71).ConclusionsIn this FSW cohort, while participants reporting hazardous, harmful, or dependent alcohol use were not more likely to have a detectable viral load, they were more likely to report lower ART adherence. These results suggest that interventions targeting alcohol use among this population of FSWs may not have a large impact on viral suppression.

Tinder Use and Romantic Relationship Formations: A Large-Scale Longitudinal Study.

The current paper aims to investigate if Tinder use predicts romantic relationship formation 1 year later and to identify demographic, personality, mental health, and substance use covariates in the relationship between Tinder use and romantic relationship formation. Data were collected by online surveys (two waves) among students in Bergen, Norway. The first survey was administered during fall 2015 (T1). The follow-up took place 1 year later (fall 2016, T2). The sample consisted of the 5253 participants who reported to be single at T1. The surveys included questions about Tinder use, demographics, personality (the Five-Factor Model’s personality traits), mental health (i.e., symptoms of depression and anxiety), alcohol use, and use of illegal substances. Bivariate comparisons were conducted to assess differences in demographics, personality traits, mental health, and substance use between Tinder users and non-Tinder users. Further, crude and adjusted binary logistic regressions were employed to investigate if Tinder use at T1 predicted romantic relationship formation at T2, when controlling for relevant covariates. Tinder users differed from non-users on almost all included variables. Compared to non-users, Tinder users were younger and more likely to be men, born in Norway, childless, and non-religious. Tinder users had higher scores on extroversion and agreeableness and lower scores on openness compared to non-users. Further, compared to non-users, Tinder users reported more symptoms of anxiety and were more likely to have hazardous, harmful, or dependent alcohol use and to report use of illegal substances. Compared to non-users, Tinder users had a higher likelihood of having formed a romantic relationship at T2 in the crude model (p < 0.05) and when controlling for demographic (p < 0.05) and mental health (p < 0.05) covariates. However, when controlling for personality, substance use, and all included covariates, the difference in likelihood of romantic relationship formation was no longer significant. In conclusion, the current results suggest that Tinder users have a higher likelihood of forming romantic relationship longitudinally, but that this increased likelihood can be explained by Tinder users’ personality and substance use characteristics.

SUN-LB103 The Relationship Between Alcohol Consumption Patterns and Insulin Sensitivity in Obesity

BACKGROUNDThe effects of alcohol intake on insulin sensitivity have produced conflicting results with both beneficial and adverse effects observed. This study aimed to compare the relationship between patterns of alcohol consumption and insulin sensitivity in obese Veterans. METHODSWe performed a cross-sectional study of obese (BMI 30.0-45.0 kg/m2), nondiabetic U.S. Military Veterans without active mental health diagnoses, including no report of dependent alcohol use within the last 12 months. Alcohol exposure over the previous 12 months (mos) was assessed using a study-developed questionnaire and Michigan Alcoholism Screening Test (MAST). Fasting insulin, glucose, and a 75gm OGTT were completed to determine Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) and prediabetes (preDM) score of 0, 1, or 2 based on fulfilling 0, 1, or at least 2 of the ADA criteria for preDM, respectively. Linear regression was used to assess for associations between measures of insulin resistance and alcohol consumption; unstandardized β and p-value are reported for variable of interest. RESULTS104 Veterans participated (66% males; 44±8years (range: 25-60); BMI 36±4kg/m2 (range: 29-45); 53% White, 46% African American, 2% Alaskan/Native American, 1% Other). 83 participants reported any alcohol intake in the previous 12 mos and neither preDM score (p=0.57) nor HOMA-IR (p=0.14) were predicted by this question. PreDM score groups were similar in gender, BMI, and weight, but age predicted both preDM score (r2=0.09, β=0.025, p=0.006) and HOMA-IR (r2=0.05, β=-0.09, p=0.034); therefore, all regressions were adjusted for age. There was a negative association between the number of days of alcohol intake with HOMA-IR (β=-0.271, p=0.037) but no association occurred with preDM score (p=0.15). Fewer days of binge drinking was associated with higher HOMA-IR (β= -0.342, p=0.058) and preDM score (β=-0.075, p=0.05). There was no significant association between total quantity of alcohol intake and HOMA-IR (p=0.13) nor preDM score (p=0.15). There was no association between MAST score and HOMA-IR (p=0.7) or preDM score (p=0.3). CONCLUSIONIn our cohort of obese, non-alcohol dependent Veterans, the reported number of days of alcohol intake and days of binge drinking in the previous 12 mos were lower in those with markers of insulin resistance. These results suggest that drinking patterns among obese patients may have unique effects on insulin sensitivity that warrant further investigation.

Associations between interrelated dimensions of socio-economic status, higher risk drinking and mental health in South East London: A cross-sectional study.

AimTo examine patterns of hazardous, harmful and dependent drinking across different socio-economic groups, and how this relationship may be explained by common mental disorder.Methods and findingsBetween 2011–2013, 1,052 participants (age range 17–91, 53% female) were interviewed for Phase 2 of the South East London Community Health study. Latent class analysis was used to define six groups based on multiple indicators of socio-economic status in three domains. Alcohol use (low risk, hazardous, harmful/dependent) was measured using the Alcohol Use Disorders Identification Test and the presence of common mental disorder was measured using the revised Clinical Interview Schedule. Multinomial regression was used to explore associations with hazardous, harmful and dependent alcohol use, including after adjustment for common mental disorder.Harmful and dependent drinking was more common among people in Class 2 ‘economically inactive renters’ (relative risk ratio (RRR) 3.05, 95% confidence interval (CI) 1.07–8.71), Class 3 ‘economically inactive homeowners’ (RRR 4.11, 95% CI 1.19–14.20) and Class 6 ‘professional renters’ (RRR 3.51, 95% CI 1.14–10.78) than in Class 1 ‘professional homeowners’. Prevalent common mental disorder explained some of the increased risk of harmful or dependent drinking in Class 2, but not Class 3 or 6.ConclusionsAcross distinct socio-economic groups in a large inner-city sample, we found important differences in harmful and dependent drinking, only some of which were explained by common mental disorder. The increased risk of harmful or dependent drinking across classes which are very distinct from each other suggests differing underlying drivers of drinking across these groups. A nuanced understanding of alcohol use and problems is necessary to understand the inequalities in alcohol harms.

Alcohol-related problems among college and university students in Norway: extent of the problem.

Aims: The aim of the current study was to provide estimates of the distribution of alcohol-related problems in a large sample of college and university students. We also sought to examine trends in the distribution of alcohol-related problems from 2010 to 2018. Methods: Data stem from a recent national health survey from 2018 for higher education in Norway (the SHoT study) in which 50,054 full-time students (69.1% women; 30.9% men) aged 18-35 years participated. The Alcohol Use Disorders Identification Test (AUDIT) was used to assess potential alcohol-related problems. Data on demographic characteristics were also collected. Results: More than half of the male students (52.8%) and 4 out of 10 of the female students (40.1%) reported risky, harmful or dependent alcohol use. Compared to women, men had an increased risk of risky alcohol use (relative risk ratio (RRR) = 1.57), harmful alcohol use (RRR = 2.45) and dependent alcohol use (RRR = 2.73). Younger students had higher rates of risky and harmful alcohol use compared with older students, while rates of dependent alcohol use were similar across the age span. Several demographic variables were associated with alcohol use. The trend analyses revealed that the rates of risky, harmful and dependent alcohol use, as well as mean AUDIT scores, among the students have remained relatively stable over the past 8 years. Conclusions: Alcohol use remains an important health concern among Norwegian college and university students, and the present study confirms the high rates of alcohol-related problems, and the need to address the issue within this population.

Correlates of sedentary behaviour among adolescents and adults with hazardous, harmful or dependent drinking in South Africa.

BackgroundThere is lack of information on the correlates of sedentary behaviour among persons with alcohol use disorders. The study aimed to examine socio-demographic and health correlates among adolescents and adults with hazardous, harmful or probable dependent alcohol use (= problem drinking).MethodData from the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) 2011–12 were analysed. From a total sample of 15 085 persons aged 15 years and older, 2849 adolescents and adults (mean age = 37.1 years, standard deviation [s.d.] = 15.1) were identified as problem drinkers, based on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Multivariable logistic and linear regression were used to determine the associations between socio-demographic characteristics, health variables and high sedentary behaviour (≥8 h/day) and total minutes of sedentary behaviour a day.ResultsThe prevalence of high sedentary behaviour (≥ 8 h/day) was 11.9% overall (11.9% among men and 12.1% among women), and the mean (s.d.) duration of sedentary behaviour was 263 (169) min/day. In bivariate analysis, older age, population group, functional disability, cognitive impairment, having hypertension, having had a stroke and posttraumatic symptoms were correlated with high sedentary behaviour. In adjusted logistic regression analysis, older age and being Indian or Asian were positively, and having been diagnosed with angina was negatively, associated with high sedentary behaviour. In linear regression analysis, older age, not employed and having had a stroke were positively, and being of mixed race and having angina were negatively, associated with total minutes (up to 960 min/day) of sedentary behaviour in a day.ConclusionThe study provides socio-demographic and health correlates of sedentary behaviour among problem drinkers. This information can guide possible future interventions in reducing sedentary behaviour among problem drinkers.

Alcohol marketing and adolescent alcohol consumption: Results from the International Alcohol Control study (South Africa).

A complete ban on alcohol advertisements has been proposed for South Africa (SA), but there has been limited local research on the association between exposure to alcohol advertisements and alcohol consumption. To examine the role of demographic factors, exposure to alcohol marketing and liking of alcohol advertisements in predicting use of alcohol in the past 6 months among older adolescents in Tshwane, Gauteng Province, SA. Participants comprised the adolescent sub-sample (N=869) of the International Alcohol Control study survey that was conducted in SA. They consisted of 408 males and 461 females aged 16 and 17 years who took part in structured interviews on their alcohol consumption and various alcohol-related attitudes and behaviours. A multiple survey logistic regression analysis of the dependent variable alcohol use in the past 6 months on the independent variables age, gender, educational status, socioeconomic status, exposure to alcohol brand marketing and liking of alcohol advertisements was used. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. The prevalence of drinking in the past 6 months was 10.6% (95% CI 5.9 - 18.3). The number of modes of alcohol brand/product advertising to which the adolescents were exposed was positively associated with alcohol use in the past 6 months. An additional mode of alcohol brand/product advertising exposure led to a relative increase of 1.13 (95% CI 1.01 - 1.28) in the odds of alcohol use in the past 6 months (e.g. a participant who was exposed to advertisements via seven different channels was 2.08 times more likely to have used alcohol in the past 6 months than a participant with exposure via a single channel). Having a strong dislike of alcohol advertisements was associated negatively (protective) with alcohol use in the past 6 months, with the odds ratio being 0.35 (95% CI 0.19 - 0.64). Having only a moderate dislike or a liking of alcohol advertisements was positively associated with alcohol use in the past 6 months among the study participants (OR 2.90 and 2.84, respectively). Age, gender, educational status and socioeconomic status were not independently associated with alcohol consumption. Exposure to alcohol marketing and not being strongly averse to advertisements of alcohol brands and products were associated with alcohol use among adolescents. The results have implications for policies on alcohol marketing in SA.

A Stage-Based Mobile Intervention for Substance Use Disorders in Primary Care

Background: Over 20 million American adults meet diagnostic criteria for a substance use disorder (SUD). However, only 10-11% of individuals requiring SUD treatment receive it. Given their access to patients, primary care providers are in a unique position to perform universal screening, brief intervention, and referral to treatment (SBIRT) to fill gaps in services and make referrals to specialty treatment when indicated. While SBIRT has shown success in reducing tobacco and non-dependent alcohol use, the data on SBIRT for dependent alcohol use and illicit drug use are less promising. Major barriers to SBIRT include limited time and resources for SBIRT among providers and low motivation to change among many patients. Objective: The objective of this research was to develop and test the acceptability of a prototype of a mobile-delivered substance use risk intervention (SURI) for primary care patients and a clinical dashboard for providers that can address major barriers to SBIRT for risky drug use. To reduce provider burden, SURI delivers universal screening and feedback on SUD risk via mobile tools to patients at home or in the waiting room. For patients at risk, it also delivers a brief intervention based on the Transtheoretical Model of Change to facilitate progress through the stages of change for quitting the most problematic drug and for seeking treatment if indicated. The prototype also delivers 30 days of stage-matched text messages and four online activities addressing key topics (eg, managing cravings). For providers, the clinical dashboard summarizes the patient’s SUD risk scores and stage of change data and provides stage-matched scripts to guide in-person sessions. Methods: Feasibility test participants were 3 providers at a federally qualified health center and 5 of their patients with a known SUD. Providers completed a 45-minute webinar training session on the SURI tools, delivered dashboard-guided SBIRT session(s), and completed a brief acceptability survey. Patients completed an online SURI session and in-person SBIRT session, accessed other program components, and completed 3 acceptability surveys over 30 days. Questions in the surveys were adapted from the National Cancer Institute’s Education Materials Review Form. Response options ranged from 1=strongly disagree to 5=strongly agree. The criterion for establishing feasibility was an overall rating of 4 or higher across items. Results: For providers, mean acceptability ratings ranged from 3.7 to 5.0, with an overall mean rating of 4.3. Notably, all providers gave a rating of 5.0 for the item “The program can give me helpful information about my patient.” One patient dropped out of the study before accessing any study materials. For the remaining patients, mean acceptability ratings for the mobile- and provider-delivered SBIRT session ranged from 4.0 to 5.0, with an overall mean rating of 4.5; mean ratings of the follow-up text messages and online activities ranged from 3.6 to 4.8, with an overall rating of 4.0. One of the most highly rated items was “The program could help me make some positive changes” (4.5). Conclusions: The SURI program and clinical dashboard, developed to reduce barriers to SBIRT in primary care, were well received by care providers and patients.

Pre-deployment Alcohol Misuse Among Shipboard Active-Duty U.S. Military Personnel.

The burden of alcohol misuse is unknown among shipboard U.S. Navy and Marine Corps military personnel immediately prior to deployment and may be elevated. Anonymous survey data on hazardous, dependent, and binge alcohol misuse and involuntary drug consumption were collected during 2012-2014 among shipboard personnel within approximately 2 weeks of deployment. Using the Alcohol Use Disorders Identification Test Consumption (AUDIT-C), hazardous alcohol misuse was defined using two cut-point scoring criteria: (1) ≥3 for women and ≥4 for men; and (2) ≥4 for women and ≥5 for men; binge drinking as ≥4 drinks for women and ≥5 drinks for men on a typical day in past 30 days; and dependent alcohol misuse as an AUDIT-C score of ≥8. Demographic- and sex-stratified self-reported alcohol misuse prevalence was reported for analysis conducted during 2014-2015. Among 2,351 male and female shipboard personnel, 39%-54% screened positive for hazardous, 27% for binge, and 15% for dependent alcohol use. Seven percent reported involuntary drug consumption history. A larger proportion of those aged 17-20 years screened positive for dependent alcohol use compared with the overall study population prevalence. A large proportion of shipboard personnel screened positive for hazardous and dependent alcohol use (18% among those aged <21 years) at deployment onset. These data can inform interventions targeting shipboard personnel engaging in hazardous use before progression to dependent use and enable early identification and care for dependent users. Future studies should include more comprehensive assessment of factors associated with involuntary drug consumption.