Disorders Identification Test Research Articles

Efficacy of Screening and Brief Intervention for Alcohol Misuse in Opioid Agonist Maintenance Treatment: A Randomized Clinical Trial

ABSTRACT Alcohol misuse is common in persons on opioid agonist maintenance treatment (OAMT). We tested the efficacy of screening and brief intervention (SBI) for harmful/hazardous alcohol use in buprenorphine/naloxone (BNX)-assisted OAMT. It was a double-blind, parallel-group, randomized trial, where 150 participants with alcohol misuse (Alcohol Use Disorder Identification Test – AUDIT 8–19) on BNX were allocated equally to receive either a single session SBI or screening and brief advice (control). Participants were followed up at three months. The primary outcome was the change in AUDIT; other outcomes were risk transition, change in the frequency of heavy drinking, days of abstinence from alcohol, Gamma-glutamyl transferase (GGT) levels, non-prescription opioid use, and adherence to BNX. Follow-up data was gathered from 138 participants. SBI participants had a higher reduction in AUDIT scores at the follow-up (F = 129. 173, df = 1, p < .001, ηp 2 =.469). A higher proportion of participants transitioned to a low-risk category in the SBI group. The SBI group showed a higher reduction in heavy drinking and days of alcohol abstinence. Although the proportion of persons with normal serum GGT increased in both groups, the difference was not significant at the follow-up. The SBI group performed better in non-prescription opioid use and BNX adherence.

Abstract 4136355: Investigating Changes in Hazardous and Harmful Drinking Among Young Adults Through Zoom Intervention

Introduction/Background: Hazardous drinking is a major adverse factor for young adults’ health. This study investigates the efficacy of an integrated contingency management and problem-solving Zoom intervention in addressing hazardous and harmful drinking among young adults. Research Questions/Hypothesis: Participants who receive the 8-session integrated Zoom CM-PST intervention will demonstrate a significant reduction in hazardous and harmful drinking behaviors compared to baseline measurements. Goals/Aims: The aims of this study were to evaluate the effectiveness of 8-session integrated Zoom contingency management and problem-solving Zoom intervention in reducing hazardous and harmful drinking reduction and abstinence. Methods/Approach: This pilot randomized controlled trial study employed a single-arm design with post-intervention and follow-up assessments at 12 weeks. The study targeted young adults aged 18-24 in Chicagoland who regularly consume alcohol at least once a week and have alcohol use disorder. Participants completed the Alcohol Use Disorders Identification Test (AUDIT), Drinking Motives Questionnaire-Revised (DMQ-R), and the 90-day Timeline Follow-back (TLFB) at baseline and 12 weeks after the intervention. The Zoom CM-PST intervention was administered to the participants, and a self-reported questionnaire was utilized to evaluate participants’ drinking use, severity, motivation, and hazardous drinking behavior at baseline and at the 12-week follow-up. A paired t-test, correlation, and multiple regressions were performed to investigate changes in hazardous and harmful drinking among 20 young adults aged 18-24. Results: A paired t-test showed that the participant’s level of alcohol use problem and social, coping, and enhancement motivation for alcohol use decreased from pre- to post-intervention. High drinking behaviors accounted for 40% at baseline, while 35% at post-intervention assessment. Over 12 weeks, 45% of participants demonstrated an improvement in hazardous drinking behaviors. Motivation at baseline was a significant factor affecting post-intervention alcohol use problems at 12 weeks. Conclusions: The results showed notable enhancements in alcohol use problem reduction and motivation for alcohol use at 12 weeks. The study provides useful insights into the effectiveness of web-based integrated contingency management and problem-solving Zoom interventions in mitigating hazardous and harmful drinking among young adults.

Tobacco use, cirrhosis, and age are predictors of readiness to change and continued drinking following brief alcohol intervention in Veterans.

Alcohol-use disorder (AUD) is prevalent within the Veterans Health System, especially in patients being seen in hepatology clinics, and needs a point-of-care strategy. A brief alcohol intervention based on AUDIT-C (Alcohol Use Disorders Identification Test) may be needed for management of hazardous alcohol intake, but feasibility is unclear. We aimed to define predictors of readiness to cease alcohol intake (0-10, 10 being ready to quit now) and continued drinking after using a brief alcohol intervention in Veterans seen in hepatology clinics cross-sectionally and longitudinally over 6 months. A total of 414 men with liver disease (average age of 61 years old, 48% with cirrhosis, 31% with concomitant psychiatric conditions, 44% with tobacco use, 14% with prior AUD therapy) were approached. 144 patients (35%) had a positive AUDIT-C (8.9±4.0) and were given the brief intervention. 80 of these patients (56%) had a high readiness to change, listing "wanting to improve health" and "prior success at reducing alcohol intake" as their most frequent reasoning. On regression analysis, concomitant tobacco use was associated with a significantly lower readiness to quit alcohol score. On longitudinal follow-up at 6 months, 34 (23%) patients were still drinking. These patients were older, and more likely to have concomitant diagnoses of cirrhosis and anxiety. Overall, we found that in a large cohort of Veterans seen in hepatology clinics that in routine practice,a brief intervention targeted at alcohol use is feasible. Older patients with concomitant tobacco use, cirrhosis, and anxiety may need more longitudinal attention to ensure that the initial interest in reducing problem drinking is sustained.

Effectiveness of digital screening and brief intervention for alcohol misuse among college students: A state-wide cluster randomized trial from India.

Alcohol misuse is prevalent among college students globally, including in India. Digital screening and brief interventions (DSBI) promise to address this issue. This study assesses DSBI's effectiveness in a state-wide cluster randomized trial among college students in India. We recruited 548 participants (274 in each DSBI and digital screening and brief advice-DSBA) from 40 colleges across 10 districts of Punjab, India. Colleges were selected via two-stage cluster random sampling and were allocated to groups using permuted block randomization. Participants with Alcohol Use Disorder Identification Test (AUDIT) scores between 8 and 19 were included. The digital platform directed eligible participants to their respective groups. DSBI participants received information on alcohol harms, normative and personalized feedback, a decisional balance checklist, and a menu of options. DSBA participants received screening and alcohol harm information. Follow-ups were conducted at 3- and 6-month post-intervention. reduction in AUDIT scores; secondary outcomes: frequency of drinking, drinks per drinking day, and frequency of heavy episodic drinking (HED). Baseline demographics and clinical variables did not significantly differ between groups, except for participants' age. 37.6% were women. Follow-up rates were 513/548 at 3 months and 483/548 at 6 months, with no group differences in attrition. AUDIT scores significantly decreased in both groups at 3 and 6 months (Time F = 1870.11, p < 0.001, partial η2 = 0.77), with no Group × Time effects (F = 0.160, p = 0.85). Drinking frequency, HED frequency, and drinks per drinking day decreased significantly in both groups without between-group differences. The study highlights the potential policy implications of integrating brief digital interventions for alcohol misuse into educational health initiatives.

Abstract 4128549: Feasibility and Acceptability of a Combined Contingency Management and Problem-Solving Therapy Intervention to Enhance Alcohol Abstinence: A Pilot Single-Arm Mixed Methods Randomized Controlled Trial

Introduction/Background: It is crucial to develop and implement innovative behavior-change therapies that specifically target young adults with alcohol use disorder, as the prevalence of this issue is on the rise, and it has serious long-term health consequences. Research Questions/Hypothesis: How does the newly developed Contingency Management and Problem-Solving Therapy (CM-PST) intervention impact the levels of alcohol misuse or abstinence in young adults at follow-up compared to baseline.Young adults who receive the newly developed CM-PST will have lower levels of alcohol misuse or abstain from alcohol. Goals/Aims: We aimed to examine the feasibility, acceptability, and efficacy of an integrated behavior therapy of CM-PST for young adults with alcohol use disorder. Methods/Approach: This mixed methods study employed a single-arm design with post-intervention and 12-week follow-up assessments. Young adults aged 18-24 were recruited from July 2023 to May 2024. Participants underwent the newly developed integrated CM-PST intervention for 8 weeks. The assessment of feasibility was conducted by evaluating the rates of recruitment and retention, and adherence to the intervention. Acceptability was assessed by analyzing participants’ feedback and engagement data. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and the 90-day Timeline Follow back (TLFB) at baseline and 12 weeks after the intervention. Furthermore, they participated in a twice daily breathalyzer test, post-intervention interview and completed a client satisfaction scale questionnaire. Results: A total of 28 participants were recruited, with 71.43% (20/28) completing all the study procedures. Adherence to the CM-PST was 100%, indicating strong engagement. Participant feedback highlighted the influence of CM on behavior and decision-making and the efficacy of PST in addressing life challenges as well. Alcohol consumption at 12 weeks was significantly lower than those at baseline ( t =3.042, p =.007). Overall, the newly developed intervention was well-received, and 95% of participants indicated that the interventions were acceptable. Conclusions: This study showed that the integrated CM-PST intervention to promote alcohol abstinence and reduce alcohol related problems is both feasible and acceptable. Study findings indicated that the intervention has potential as a supplementary care for individuals seeking support in reducing alcohol consumption.

Leptin and leptin receptor gene polymorphisms and depression treatment response.

Associations between leptin (LEP) and leptin receptor (LEPR) gene polymorphisms and mood disorders have been found but not yet confirmed in multiple studies. The aim of our study was to study the associations between LEP and LEPR single nucleotide polymorphisms (SNPs) and treatment response of depression. Associations between leptin levels and depression severity were also investigated. The data included 242 depressed patients in secondary psychiatric care. Symptoms of depression were assessed with the Montgomery–Åsberg Depression Rating Scale (MADRS). Previously found LEP and LEPR SNPs associated with depression and other mood disorders were studied. Furthermore, all available LEP and LEPR SNPs were clumped using proxy SNPs to represent gene areas in r2 > 0.2 linkage disequilibrium and their association with treatment response was analysed with logistic regression. Two proxy SNPs of LEPR gene, rs12564738 and rs12029311, were associated with MADRS response at 6 weeks (p adjusted = 0.024, p adjusted = 0.024). SNPs from previous studies were not associated with MADRS response, but LEPR rs12145690 from a previous study was strongly associated with rs12564738 (r2 = 0.94). The positive association between leptin levels and MADRS score at baseline after adjusting with age, sex, body mass index (BMI), Alcohol Use Disorders Identification Test score, and smoking was found (p = 0.011). Our findings suggest that LEPR polymorphisms are associated with depression treatment response. We also found associations between leptin levels and depression independently of BMI. Further studies and meta-analyses are needed to confirm the significance of found SNPs and the role of leptin in depression.

Factors Associated With Motivation to Reduce Alcohol Use Among Patients With Chronic Liver Disease.

Alcohol use is prevalent among hepatology clinic patients with chronic liver disease (CLD). We explored factors associated with the importance and confidence dimensions of motivation to reduce drinking. Participants (N = 121) with unhealthy alcohol use (i.e., over NIH guidelines) receiving care in hepatology clinics from a safety-net hospital (SN, N = 54) and two Veterans Affairs Healthcare Systems (VA, N = 67) were enrolled in an alcohol intervention trial from March 2022 through October 2023. Baseline assessments included Generalised Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), Alcohol Use Disorders Identification Test (AUDIT), COVID-19 stress; and measures of importance and confidence to decrease alcohol use (readiness rulers, scales of 1-10). Liver disease aetiology and severity were extracted from electronic health records. We performed multivariable linear regression models with forward selection to assess pre-specified variables' associations with importance and confidence. The sample was 84% male, 40% Latino, 31% White, 18% Black and 11% other races; median age was 61 years. Median (Q1-Q3) AUDIT score was 16 (12-24), importance was 9 (6-10) and confidence was 8 (5-9). On multivariable analysis, VA site (vs. SN) participants had a 0.97-point lower importance score (p = 0.02); higher symptoms of depression (PHQ-8 score ≥ 10 vs. < 10) and AUDIT scores (for each point increase) were associated with higher importance score (estimates 1.2 and 0.08, p < 0.05, respectively). Liver disease aetiology and severity were not significantly associated with outcomes. Depression, alcohol problem severity and treatment site may influence motivation to reduce alcohol use and could inform future hepatology-based interventions.

Is Alcohol Consumption Pattern Dependent on Prenatal Sex-Steroids? A Digit Ratio (2D:4D) Study Among University Students.

There is evidence that alcohol consumption is influenced by prenatal sex steroids (as measured by digit ratio [2D:4D]). Here, we clarify the effect size of the relationship in a student (rather than a patient) population. There were 258 (169 women) participants. Digit length was measured directly with calipers. Alcohol use was evaluated by the Polish version of Alcohol Use Disorders Identification Test (AUDIT) and operationalized as total AUDIT scores and grams of alcohol/week. Digit ratios were sexually dimorphic (males < females). There were negative correlations between right 2D:4D and Dr-l (right 2D:4D minus left 2D:4D) and AUDIT scores and grams of alcohol/week in both sexes. Relationships varied from small (r = -0.29) to large (r = -0.69) and they were stronger in males in comparison to females and for right 2D:4D in comparison to Dr-l. In males only, there were small (r = 0.21) to moderate (r = 0.31) positive associations with body size (height, weight, and mean right digit length) and alcohol consumption. Multiple regression analyses showed relationships between digit ratios remained significant but those for body size did not. Alcohol consumption was negatively related to 2D:4D, suggesting high prenatal testosterone and low prenatal estrogen are linked to its consumption. Correlations varied in strength from small to large with the strongest found for right 2D:4D and for males. Positive relationships between body size and alcohol were small to moderate, confined to males, and were not independent of digit ratios. Prenatal androgenization may influence alcohol drinking patterns in non-clinical individuals.

Hazardous alcohol consumption is associated with an increased occurrence of falls among people with HIV in the PROSPER-HIV Study.

Falls are a significant public health concern, particularly among older adults and people with HIV (PWH). This study examines the association between alcohol consumption and falls in PWH. The PROSPER-HIV study recruited PWH from four US sites. Participants were categorized based on Alcohol Use Disorders Identification Test Consumption (AUDIT-C) scores: none, non-hazardous, and hazardous drinking. Data collection included demographics, medical history (i.e., comorbidities, treated hypertension, eGFR), alcohol consumption using AUDIT-C, daily alcohol recall in grams, and self-reported falls over the previous year. Physical performance was measured using the Short Performance Physical Battery (SPPB). Statistical analyses included Pearson's correlation and Poisson regression models to estimate fall prevalence ratios (PR), adjusting for confounders (SPPB, comorbidities, treated hypertension, and eGFR). The study included 315 PWH, aged 52 ± 12 years, with 78% male participants. Thirty-three percent were classified as non-drinking, 50% non-hazardous, and 17% hazardous drinking. Poisson regression showed a significantly higher risk of falls (PR: 2.12, 95% CI: 1.11-4.03) and recurrent falls (PR: 3.54, 95% CI: 1.21-10.3) among hazardous drinking compared to non-hazardous drinking, even after adjusting for confounders. The PR for falls per daily intake in grams was not statistically significant. There is a significant association between hazardous alcohol consumption and increased fall risk in PWH using AUDIT-C, but not when accessing recall of alcohol consumption in grams.

Impulsivity Moderates the Association Between Hazardous Alcohol Use and Risky Sexual Behaviors Among Cisgender Bisexual Women

Bisexual women report higher rates of alcohol use and risky sexual behavior than lesbian and heterosexual women. Impulsivity (i.e., action without considering negative consequences) is a risk factor for greater alcohol use and sexual behavior, but few studies have examined the impact of impulsivity on alcohol use and sexual behavior among cisgender bisexual women. Consequently, the purpose of this study was to examine the moderating role of impulsivity on the association between hazardous alcohol use and sexual risk-taking among cisgender bisexual emerging adults. Participants were 225 self-identified cisgender bisexual women (Ma ge = 22.77, SD = 3.45) who completed an online survey about their hazardous alcohol use using the Alcohol Use Disorder Identification Test (AUDIT), impulsivity, and sexual behaviors over the past 30 days. A moderated regression model examined main effects of impulsivity and alcohol use severity, and their interaction, on sexual risk-taking. The association between alcohol use severity and sexual risk-taking was moderated by impulsivity. Simple slopes analyses revealed that greater alcohol use severity was associated with greater sexual risk-taking, but this only occurred for participants with average or high scores of impulsivity. These results suggest prevention programs that target alcohol use should address the role that impulsivity may have on risky sexual behaviors among young bisexual women. Future research would benefit from looking at various outcomes related to sexual risk to determine which are most predominantly associated with alcohol use severity and impulsivity.

Long-term effectiveness of SBIRT by outreach visits on subsequent alcohol treatment utilization among inpatients from general hospital: a 36-months follow-up

Aim To investigate the long-term effect of Screening, Brief Intervention, and Referral to Treatment (SBIRT) on alcohol treatment utilization among general hospital inpatients. Methods This 36-month follow-up of a randomized controlled trial included general hospital inpatients who were screened using the Alcohol Use Disorder Identification Test (AUDIT). Patients with an AUDIT score of 8+ were included. Patients were randomized to either SBIRT (Relay) or treatment as-usual (TAU). Outcome was attendance at a specialized outpatient treatment institution or prescription of pharmacological alcohol treatment in general practice. Using the Danish Civil Registration System, patients were followed in the Danish National Patient Registry, Danish National Alcohol Treatment Register, and the Danish National Prescription Registry. Data was collected up to 36 months after discharge. Results The study population consisted of 258 patients in the Relay group and 303 patients in the TAU group. In the Relay group, 36 (14.0%) patients received treatment versus 23 (7.6%) in the TAU group. Patients in the Relay group had higher odds for receiving treatment compared to the TAU group (OR: 1.97, 95% CI: 1.1–3.4, p = 0.01). Significantly more patients in the Relay group scored 16+ on the AUDIT and had already tried to change their alcohol consumption (both p < 0.01). Adjusted for potential confounders, the effect of the Relay intervention was reduced (OR: 1.37, 95%CI: 0.7–2.5, p = 0.31). Conclusions This study did not find evidence that SBIRT is better than TAU at sustaining significant long-term alcohol treatment utilization after discharge among inpatients from general hospital.

Cross-Sectional Associations Between Expectancies for Cannabis use and Pain in an Emerging Adult Sample.

Pain and cannabis use are highly prevalent among emerging adults but research regarding how pain is associated with cannabis-related expectancies is limited. Emerging adults who reported past three-month cannabis use (N = 173) were recruited through an online sampling platform. Participants completed the Graded Chronic Pain Scale, Cannabis Use Disorders Identification Test - Revised, and Marijuana Effect Expectancy Questionnaire. Multiple linear regressions indicated that pain intensity and disability were associated with hazardous cannabis use and expectancies for global negative effects (ps < .001). Sex did not moderate any of these relationships (ps > .14). Findings suggest that emerging adults who experience pain report greater hazardous cannabis use and may expect more negative effects of cannabis use. Researchers and clinicians should consider assessing pain in the context of cannabis studies and interventions.

The impact of alcohol consumption on the quality of life of college students: a study from three Slovak universities

Alcohol consumption can influence an individual's quality of life, with the impact varying based on several factors such as the amount of alcohol consumed, frequency of consumption, individual tolerance, and overall health. Slovakia is among the countries with the highest incidence of liver cirrhosis in the world, with alcohol representing a significant risk factor. Therefore, it is important to identify at-risk groups and the potential impact of various factors. The primary objective of this study is to examine the relationship between alcohol consumption and quality of life among college students in the Slovak Universities. A cross-sectional study was conducted in December 2021 and January 2022. The study included college students with an average age of 22.3 years. Participants were surveyed about their alcohol consumption and quality of life using the standardized Alcohol Use Disorders Identification Test (AUDIT) and EuroQol-5D (EQ-5D) questionnaires. These questionnaires were distributed through online school systems. In the study, 88.7% of the students reported drinking alcohol. A low AUDIT score was recorded for 67.1% of the total participants (2573 students). A medium score was found in 23.3% of the participants (893 students). High scores were identified in 2.4% of the participants (92 students), and very high scores were found in 2.2% of the total participants (86 students). Mild pain was reported in 33.8% of cases, while moderate pain was reported in 5.2% of cases. Mild depression and anxiety were reported in 31.1% of the cases, and moderate depression and anxiety were reported in 13.5% of the cases. There is a statistically significant relationship between AUDIT and EuroQOL variables (p < 0.001). This suggests that the association between alcohol use (measured by AUDIT) and health-related quality of life (measured by EuroQOL) is unlikely to be due to chance. Higher alcohol consumption was associated with a poorer quality of life in Slovak college students. Our results suggest a meaningful connection between alcohol consumption behaviors and overall quality of life, highlighting the potential impact of alcohol use on health outcomes. Further research is warranted to explore the nature and causality of this relationship, which could inform interventions aimed at improving health-related quality of life through alcohol use reduction strategies. The association between higher alcohol consumption and poorer quality of life in Slovak college students raises important questions about causality and the complex interplay between alcohol consumption and one’s overall well-being. The significant relationship between higher alcohol consumption and poorer quality of life suggests the need for targeted public health interventions aimed at reducing alcohol consumption among college students. Programs focusing on awareness and education about the negative impacts of excessive drinking could be implemented to promote healthier lifestyles.

Salivary Metabolic Pathway Alterations in Brazilian E-Cigarette Users.

In recent years, the use of electronic cigarettes (e-cigs) has increased. However, their long-term effects on oral health and saliva remain poorly understood. Therefore, this study aimed to evaluate the saliva of e-cig users and investigate possible biomarkers. Participants were divided into two groups: the Electronic Cigarette Group (EG)-25 regular and exclusive e-cig users-and Control Group (CG)-25 non-smokers and non-e-cig users, matched in sex and age to the EG. The clinical analysis included the following parameters: age, sex, heart rate, oximetry, capillary blood glucose, carbon monoxide (CO) concentration in exhaled air, and alcohol use disorder identification test (AUDIT). Qualitative and quantitative analyses of saliva included sialometry, viscosity, pH, and cotinine concentrations. Furthermore, the EG and CG salivary metabolomes were compared using gas chromatography coupled with mass spectrometry (GC-MS). Data were analyzed using the Mann-Whitney test. The MetaboAnalyst 6.0 software was used for statistical analysis and biomarker evaluation. The EG showed high means for exhaled CO concentration and AUDIT but lower means for oximetry and salivary viscosity. Furthermore, 10 metabolites (isoleucine, 2-hydroxyglutaric acid, 3-phenyl-lactic acid, linoleic acid, 3-hydroxybutyric acid, 1,6-anhydroglucose, glucuronic acid, valine, stearic acid, and elaidic acid) were abundant in EG but absent in CG. It was concluded that e-cig users had high rates of alcohol consumption and experienced significant impacts on their general health, including increased cotinine and CO concentration in exhaled air, decreased oximetry, and low salivary viscosity. Furthermore, they showed a notable increase in salivary metabolites, especially those related to inflammation, xenobiotic metabolism, and biomass-burning pathways.

A self-efficacy enhancement alcohol reduction intervention for men on-remand in prison: the APPRAISE feasibility pilot RCT.

As many as 70% of remand prisoners have admitted to being under the influence of alcohol when committing the crime leading to their imprisonment. Providing support and advice regarding alcohol consumption can be effective in some groups of people. There is little evidence regarding this for men on remand in prison. To pilot the study measures and evaluation methods to assess the feasibility of conducting a future definitive multicentre, pragmatic, parallel group, randomised controlled trial. A two-arm, parallel group, individually randomised pilot study of a self-efficacy-enhancing psychosocial alcohol intervention to reduce levels of alcohol consumption for males on remand in prison and on liberation. Two purposively selected prisons in Scotland and England. Adult men on remand in prison with an Alcohol Use Disorders Identification Test score of ≥8. The APPRAISE intervention delivery comprised four steps: Step 1: 1×40-minute face-to-face session, delivered by a trained practitioner from Change Grow Live in prison. Steps 2, 3 and 4: 20-minute sessions conducted by phone, on or as close as possible to days 3, 7 and 21 post liberation. Control: assessment, screening and referral onto further alcohol support options. Recruitment and retention rates, completion of follow-ups, outcome measures at 12 months and interventions delivered. The primary outcome for the pilot study was alcohol consumed in the 28 days prior to Time Point 2, assessed using the extended Alcohol Use Disorders Identification Test-C. Of 182 men on remand approached across two study sites, 132 were randomised (90 in England; 42 in Scotland) with 46 randomised to intervention and 44 to care as usual in England and 22 randomised to intervention and 20 to care as usual in Scotland. A total of 53 in-prison interventions were delivered. One day-3 post-liberation intervention was delivered, no day-7 and one day-21. At 12 months, of 132 randomised, 18 (13%) were followed up, 53 (40%) were not liberated; 47 (36%) were uncontactable and 14 (11%) had been released but could not be located. Data completeness was 96% at baseline and 8% at 12 months. The process evaluation reported good acceptability of the intervention with investment in time, capacity and space to support implementation identified. The economic study produced guidance on how to assess costs associated with implementing the APPRAISE intervention which could be applied more broadly. No adverse events or side effects were noted. A future definitive trial would be possible, but only if follow-up mechanisms can be addressed as well as full access to recidivism and health data. Collaboration with the probation service in future could offer the opportunity to develop a robust process and system to optimise follow-up post liberation. Dedicated resources to support the intervention delivery both in and out of the prison setting are recommended. Coronavirus disease discovered in 2019 impacted recruitment and follow-up, with access to prisons restricted. We were unable to deliver the post-liberation element of the intervention. We did not include probation services or other agencies in the trial. This trial is registered as Current Controlled Trials ISRCTN36066. This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: 17/44/11) and is published in full in Public Health Research; Vol. 12, No. 11. See the NIHR Funding and Awards website for further award information.

The non-linear correlation between the severity of alcohol consumption and depressive symptoms in the Chinese Wa ethnic minority.

The aim of this research was to examine the association between alcohol consumption and depressive symptoms in the Wa ethnic minority of China, a population where this relationship has been insufficiently explored. A cross-sectional analysis was conducted on a sample of 317 current drinkers from the Wa ethnic minority, a "direct fast-forward" group in Cangyuan County, between December 1, 2022, and February 28, 2023. Utilizing a multi-stage cluster sampling approach, participants were selected, each of whom exhibited an Alcohol Use Disorder Identification Test (AUDIT) score exceeding 0. Data were collected via face-to-face interviews employing a uniform questionnaire. Quantification of alcohol use was achieved through the application of the AUDIT, while the Patient Health Questionnaire (PHQ)-9 was employed to gauge depressive symptoms. The relationship between the severity of alcohol consumption and depressive symptoms was evaluated using a multivariable logistic regression model. Subsequently, potential non-linear associations were scrutinized through the application of a smoothing plot. The study included 317 current drinkers (196 males [61.83%]; mean age 41.78 ± 12.91 years), of which 94 (29.65%) exhibited comorbid depressive symptoms. Multivariable logistic regression analysis, adjusting for confounders, revealed that higher AUDIT scores were significantly associated with an increased probability of depressive symptoms (OR = 1.09, 95% CI: 1.02-1.18, p = 0.008). The risk of depressive symptoms was notably greater in the group with alcohol dependent range in contrast the group at low-risk range (OR = 7.01, 95% CI: 1.66-29.62, p = 0.008). The smoothing plot indicated a J-shaped non-linear relationship with an inflection point at an AUDIT score of 15. To the left of this inflection point, no significant relationship was observed, whereas to the right, a positive correlation emerged (OR = 1.39, 95% CI: 1.11-1.74, p < 0.001). The findings reveal a non-linear relationship between alcohol consumption and the probability of depressive symptoms within the Wa ethnic minority in China, with implications for the development of nuanced and effective treatment strategies tailored to this population.

EFFECTIVENESS OF AN ALTERNATIVE PROTOCOL TO FACE SUBSTANCE USE DISORDER AND SYMPTOMS OF COMORBID DEPRESSION

Introduction: There is scarcity of studies in the national and international literature on alternative protocols to pharmacological and psychotherapeutic intervention for the treatment of Substance Use Disorder (SUD) and symptoms of comorbid depression. This study aimed to develop a protocol based on alternative therapies through mindfulness meditation, reiki, acupuncture and auriculotherapy to improve substance use problems and symptoms of comorbid depression. Method: This is a randomized single-blind controlled study. The final sample consisted of 18 participants randomized divided into two groups of nine participants: experimental and control. Participants were evaluated by four validated instruments during the screening process and after the intervention. The instruments were: Beck Depression Scale (BDI), Depression, Anxiety and Stress Scale (DASS-21), Alcohol Use Disorders Identification Test (AUDIT), Drug Abuse Screening Test (DAST-10) and Brazilian Economic Classification Criteria (CCEB). Results: the results of the analysis indicate a significant reduction in the pattern of alcohol consumption (p &lt;0.001); other drugs related problems (p&lt;0.001); symptoms of depression (p&lt;0.001); anxiety (p&lt;0.001) and stress (p&lt;0.001) between the two distinct groups (experimental and control) after the intervention. Conclusion: The protocol proposed in this study was effective in reducing the pattern of problems related to alcohol and other drugs, in addition to being effective in reducing symptoms of depression, stress and anxiety.

The Acceptability and Feasibility of a Mobile Phone Delivered Brief Intervention for Hazardous Drinking in India

Abstract The effectiveness of Brief Interventions (BIs) for hazardous drinking is well established. However the implementation of BIs at scale in LMICs such as India is rare, primarily due to human resource related barriers. This paper describes the testing of acceptability and feasibility, and the preliminary impact, of a mobile phone delivered BI in an uncontrolled treatment cohort and nested qualitative study. Consenting adult (≥18 years) participants with an Alcohol Use Disorder Identification Test (AUDIT) score between 8 to 15 were recruited from educational institutions, workplaces, and primary care settings. The TLFB (Time-Line Follow Back) was administered to participants at baseline and 3 months post recruitment. All participants received the BI through text messages or IVR (Interactive Voice Response) over eight weeks; and in-depth interviews (IDIs) were conducted with some participants. The mean pre and post outcomes were compared using paired t-test. Qualitative data was analysed using thematic analyses. 29 participants received the intervention and 16 (55%) completed the outcome assessments. Some key qualitative findings indicated the desire from participants for fewer messages and messages that did not require interaction; and more messages with motivational content and information on practical skills to reduce drinking. The percentage days abstinent (PDA) was significantly higher at follow up than baseline in all those who had completed the TLFB at baseline and follow up. Feasibility and acceptability testing is an important component of the intervention development process to ensure that the resulting intervention is suitable for the context.

Alcohol consumption and risky sexual behaviours: consistent patterns in France and South Korea

Abstract Background Despite the concurrent increase in harmful alcohol use and risky sexual behaviours associated with STIs and HIV/AIDS among young adults, their relationship remains inconsistent due to the inherent influence of sociodemographic and cultural factors on drinking and sexual practices. This study aims to examine the relationship between alcohol consumption and risky sexual behaviours and cross-validate this relationship in France and South Korea. Methods We conducted a cross-sectional survey among young adults aged 18 to 30 in France and in South Korea in 2023-2024 (n = 998; 489 in France, 509 in Korea). A spearman partial correlation and a z-test on Fisher-transformed correlation coefficients were used to determine the relationship between alcohol use and risky sexual behaviours, as well as the consistency of this relationship across both samples. Results After controlling for age, gender, occupation, education, and perceived socioeconomic status, a positive correlation was found between the age of alcohol initiation and the age at first sexual intercourse in both samples (r=.17 in France, r=.28 in Korea; p &amp;lt; 0.001). Alcohol Use Disorder Identification Test (AUDIT) score and the frequency of drunkenness showed positive correlations with the number of sexual partners (r=.19, r=.26 in France; r=.19, r=.23 in Korea; p &amp;lt; 0.001). These two alcohol use indicators were also correlated with the frequency of inconsistent condom use (r=.15, r=.12 in France; r=.06, r=.14 in Korea; p &amp;lt; 0.001). The Z test confirmed that there is no significant difference in all correlation coefficients between the French and Korean samples. (p &amp;gt; 0.05, 95% CI). Conclusions An integrated health intervention aimed at simultaneously addressing harmful alcohol use and risky sexual behaviours is warranted to prevent high prevalence of sexually transmitted infections among young adults. Key messages • Recent data support that alcohol use is associated with risky sexual behaviours among young adults. • This relationship is consistent regardless of different sociodemographic and cultural settings.

The Feasibility and Acceptability of a Clinical Pharmacist-delivered Intervention to Reduce Bothersome Health Symptoms from Polypharmacy and Alcohol Use and Communicate Risk among People with HIV: Pilot Study Protocol.

Among persons with HIV (PWH), unhealthy alcohol use and polypharmacy contribute to bothersome symptoms (e.g., fatigue, dizziness, memory loss). However, effective risk communication targeting these associations is challenging. The HIV and Alcohol Research center focused on Polypharmacy (HARP) is conducting a pilot study that will generate feasibility and acceptability data on a clinical pharmacist-delivered counseling intervention targeting the modification of unhealthy alcohol use and polypharmacy in PWH. Counseling is guided by the Information-Motivation-Behavioral Skills-Motivational Interviewing (IMB-MI) model. Herein, we describe the study protocol. This pilot uses a one-group pre-test/post-test design. We will recruit 50 participants from those who participated in the consented cohort of the Veterans Aging Cohort Study. Participants must be prescribed ≥ 5 long-term medications, have a self-reported Alcohol Use Disorders Identification Test score > 0, and be living with HIV. We will exclude those with moderate-severe alcohol use disorder as identified by an Alcohol Symptom Checklist score ≥ 4. Data are collected using three self-administered surveys (baseline, immediately after booster intervention, and 30-days post-intervention), two PEth blood tests (baseline, 30 days post-intervention), and medication data from the electronic health record (baseline). The intervention includes a 60-minute IMB-MI-based counseling session followed by a booster session 2 weeks later. Some participants will also be asked to participate in a qualitative interview to provide feedback on the intervention. The pilot investigates the impact of an intervention on alcohol consumption and the use of multiple medications among PWH, exploring how best to reduce bothersome symptoms, communicate risk, and support behavior change in this population.