Drinking Research Articles

Weizmannia coagulans BC99 Enhances Intestinal Barrier Function by Modulating Butyrate Formation to Alleviate Acute Alcohol Intoxication in Rats

Background/Objectives: Probiotics have great potential in improving acute alcohol intoxication. The aim of this study was to investigate the mitigating effect and mechanism of action of Weizmannia coagulans BC99 on acute alcohol intoxication (AAI) in SD rats. Methods: BC99 was divided into different doses administered by gavage to rats, and a rat model of acute alcohol intoxication was established by multiple gavages of excess alcohol. Results: Our study demonstrated that W. coagulans BC99 intervention significantly prolonged the latency period of intoxication; significantly attenuated alcohol-induced lipid elevation, liver injury, hepatic inflammation, and intestinal barrier damage; and lowered plasma endotoxin (LPS) levels in rats. In addition, W. coagulans BC99 could effectively restore the balance of intestinal flora, increase the abundance of Lachnospiraceae_NK4A136, Prevotellaceae_NK3B31, Parabacteroides, and Ralstonia, and thus increase the content of intestinal short-chain fatty acids (SCFAs), especially butyric acid. Moreover, we demonstrated through sodium butyrate validation experiments that butyrate could attenuate intestinal barrier damage and reduce the diffusion of LPS, thereby reducing liver inflammation. Conclusions: In conclusion, W. coagulans BC99 ameliorates acute alcohol intoxication in rats by increasing the abundance of butyrate-producing genera and thereby increasing butyrate abundance to alleviate intestinal barrier injury.

Munich cCT Rule for Patients with Recreational Drug and Ethanol Poisoning

Background: Patients with recreational drug and ethanol poisoning often present with reduced consciousness, coma, or disorientation. It is often unclear if there was recent head trauma. Algorithms to perform cranial computed tomography (cCT) like the Canadian CT Head Rule (CCHR), the National Emergency X-Radiography Utilization Study Head CT Decision Instrument (NEXUS DI), or the New Orleans Criteria (NOC) exist for patients with head trauma. It is unclear whether these algorithms can be applied to this patient collective. Methods: This is a retrospective data analysis of patients admitted to our emergency department with drug or ethanol poisoning in 2019. Minors < 16 years were excluded. The primary outcome was fracture/bleeding in cCT, the secondary outcome was neurosurgical intervention. These results were calculated: 1. Sensitivity and negative predictive value (NPV) of the CCHR, NEXUS DI, and NOC. 2. Uni- and multivariate analysis of risk factors for critical findings. 3. The Munich cCT Rule sensitivity and NPV. Results: A total of 420 patients were included. cCT was performed in 120 patients. Eight patients had fracture/bleeding in cCT, two required neurosurgical intervention. The number of patients at risk, sensitivity, and NPV for critical cCT findings were as follows: CCHR 57/25%/98.3%, NEXUS DI 239/100%/100%, NOC 420/100%/100%. The sensitivity and NPV for neurosurgical intervention were as follows: CCHR 50%/99.7%, NEXUS DI 100%/100%, NOC 100%/100%. In univariate analysis, these findings correlated significantly with the following critical findings: accident, injury, injury above clavicle, head wound, anisocoria, ethanol in serum > 2 g/L, hypotension, drug ingestion, GCS < 8, focal neurological deficit, age > 60, and cerebellar symptoms. Via chi-square recursive partitioning analysis, we created the Munich cCT Rule which is positive for intoxicated patients if both an accident and an ethanol level > 2 g/L are present. This identified 70 patients at risk. It excluded fracture/bleeding and neurosurgical intervention with a sensitivity and NPV of 100%. Conclusions: Fracture/bleeding in cCT in intoxicated patients is rare. Performing unnecessary cCTs should be avoided. The Munich cCT Rule for patients with recreational drug and ethanol poisoning may help rule out critical findings and is superior to the NEXUS DI and NOC. It also has a 100% sensitivity which the CCHR (25%) is lacking.

Effects of acute alcohol intoxication on the respiration and dehydrogenase activity of rat pancreatic acini

The exocrine function of pancreatic acini cells is a highly energy-intensive process. A cell always needs to maintain a stable level of ATP balancing between states of activation and rest. Low-energy is one of the possible mechanisms contributing to the development of pancreatic diseases. The most commonly encountered disease of the pancreas is acute pancreatitis. It is known that excessive alcohol consumption causes the development of pancreatitis. The pathogenesis of this disease is linked to the cellular loss of energy, but the mechanism of alcohol’s effect on the mitochondria in pancreatic acini is unclear. This study’s main aim is to assess the impact of acute alcohol administration on the mitochondrial function of rat pancreatic acini. Wistar rats were administered ethanol (6 g/kg body weight) by oral gavage for 3 h before the experiment. A suspension of isolated pancreatic acini was obtained following collagenase digestion. Respiration of isolated pancreatic acini was studied with a Clark electrode. The maximal respiration rate was studied at different concentrations of protonophore FCCP (0.5–2 μM) in solutions containing glucose combined with oxidative substrates (pyruvate and glutamine, monomethyl-succinate or dimethyl-α-ketoglutarate). Dehydrogenase activity was measured by colorimetric method. Ethanol administration caused a significant increase in the activity of pyruvate dehydrogenase. It was confirmed that FCCP induced an increase in the respiration rate of pancreatic acinar cells in each experimental group. The addition of 1.5 μM FCCP reduced the respiration rate of pancreatic acini during the oxidation of glucose and monomethyl succinate or dimethyl-α-ketoglutarate, but not during the oxidation of glucose, pyruvate and glutamine substrates. The administration of ethanol had no impact on the basal or FCCP-uncoupled respiration of isolated pancreatic acini. The observed data are consistent with the findings of other researchers. However, alcohol exposure is not sufficient to cause mitochondrial damage in pancreatic acinar cells. In conclusion, acute ethanol administration does not cause mitochondrial dysfunction in the pancreas of rats but causes an increase in pyruvate dehydrogenase activity.

Psychological outpatient follow-up after hospitalization for adolescent acute alcohol intoxication

Alcohol-related emergency department attendance in adolescents should be considered as a valuable opportunity to address and mitigate future alcohol consumption. Therefore, a paediatric department of a major district hospital in the Netherlands developed an outpatient preventive program targeting adolescents admitted for acute alcohol intoxication. The primary aim of this study is to evaluate how adolescent drinking patterns participating in the preventive program developed over time. This retrospective observational study involved 310 patients from the Reinier de Graaf Hospital, Delft, the Netherlands (years 2014–2022). The outpatient preventive program consists of three main components: an initial intervention, subsequent an extended counselling session and psychological interventions. The alcohol consumption was compared at three time points: before the admission for acute alcohol intoxication(T = 0), 4–6 weeks after hospital admission (T = 1) and 6–12 months after the hospital admission (T = 2). Moreover, sociodemographic variables, adolescent risk-taking behaviour and family and pedagogical factors were included in secondary analysis. Adolescents who experienced an alcohol intoxication exhibited more adolescent risk-taking behaviour (higher rates of lifetime smoking, substance use and sexual intercourse) compared to the Dutch average. Initially, these adolescents had significantly higher rates of alcohol consumption and drunkenness. Alcohol use decreased significantly in the month following intoxication, even below the Dutch average. Though 6–12 months later, their alcohol consumption increased but remained statistically lower and involved less binge drinking than the Dutch average. Conclusions: The findings of this study demonstrate that a preventive program following acute alcohol intoxication contributes to the reduction of adolescent alcohol use and associated risk-taking behaviours. What is Known:• Earlier studies showed that adolescents with problematic alcohol use reported reduced alcohol consumption and fewer alcohol-related problems after participating in a motivational interviewing intervention compared to standard care.• During the follow-up assessment of adolescents with acute alcohol intoxication it is possible to signalize mental disorders and to determine whether the patient requires referral to specialized mental healthcare.What is New:• These findings suggest that the preventive program had a short-term impact in reducing alcohol consumption among adolescents with acute alcohol intoxication, as well as a long-term impact in reducing binge-drinking behaviours.• The program’s success in mitigating binge-drinking behaviours aligns with its goals of promoting safer drinking habits among adolescents.

The Effects of a Stepped-Care Mental Health Program on Trauma Recidivism at a Level 1 Trauma Center.

This study aimed to analyze the effects of a stepped-care mental health program (TRRP) on trauma recidivism at a single institution. Designs: Retrospective review. single Level 1 trauma center. Trauma activation patients presenting at a single Level 1 trauma center between 2017-2021 were selected. Data on demographics, mechanism of injury, readmissions, and TRRP participation were recorded. Main outcomes included recidivism rates, risk factors for re-presentation, and determining if a change in readmission risk existed after participation in TRRP. 4,484 patients were included, with a mean age of 44.8 years. 65.9% were males and 34.1% were female. 14.2% (637/4,484) patients presented to the same institution having experienced an unrelated traumatic incident after their index injury. 75.6% patients identified by TRRP participated in at least one TRRP service. Patients who did not participate in TRRP were statistically significantly more likely to be recidivists (15.6%) compared to those who did (10.9%, p<0.001). Multivariable binary logistic regression analysis demonstrated statistically significant associations between increased trauma recidivism and being unmarried, Black/African American race, no use of seatbelts, alcohol intoxication at index injury, history of depression, alcohol use disorder, smoking, and government insurance (p≤0.024). The multivariable regression model predicted a decrease in trauma recidivism by 33% in privately insured patients (p=0.002), by 33% after participation in TRRP (p<0.001), and by 18% after participation in each additional step of the TRRP program (p<0.001). Results demonstrate reduced rates of trauma recidivism with involvement of the Trauma Resilience and Recovery Program. While programs focused solely on psychosocial interventions may be sufficient to reduce the risk of subsequent traumatic events, further development of trauma rehabilitation programs should address both the psychosocial consequences of traumatic injuries as well as re-injury and readmission prevention. III.

TOXIC ALCOHOL POISONING: A CASE REPORT

During the COVID-19 pandemic, toxic alcohol poisoning, notably from methanol, has emerged as a significant concern due to increased consumption of illicit liquor amidst lockdown restrictions. We present a case of a middle-aged man who developed altered consciousness, metabolic acidosis, and shock two days after ingesting hospital spirit. Although initial qualitative tests only detected ethanol, subsequent MRI findings showed classical signs of methanol poisoning, including basal ganglia abnormalities. Prompt management with dialysis, ventilatory support, and adjunctive therapy successfully addressed the acute phase despite the patient remaining delirious for seven days. This case underscores the importance of considering methanol toxicity even in the absence of direct evidence, necessitating comprehensive diagnostic approaches. Awareness and incorporating point-of-care assessments such as arterial blood gas analysis and osmolar gap evaluation in suspected cases are crucial, especially in resource-limited settings. Recognizing unexplained high anion gap metabolic acidosis with a high osmolar gap and characteristic MRI findings can aid in the early diagnosis and management of toxic alcohol poisoning

Beyond breathalyzers: AI-powered speech analysis for alcohol intoxication detection

Detecting potential alcohol inebriation or intoxication status holds paramount significance for social prevention and security. Beyond its association with long-term health effects, alcohol consumption can lead to immediate consequences, including reduced control over one’s actions, with traffic fatalities representing one of the most tragic outcomes.This study leveraged the Alcohol Language corpus, involving 162 subjects recorded both in sober and inebriated states. Participants provided 60 speech samples while sober and 30 when intoxicated, all within a realistic car setting using head-mounted microphones. Our research endeavors encompassed comprehensive stratified statistical tests to examine the impact of alcohol consumption on speech production while uncovering the influence of covariates such as age, gender, and drinking habits.Additionally, we introduced a speaker-neutral machine learning algorithm, based on the Domain-Adversarial Neural Network architecture. This approach aimed to overcome challenges posed by individual differences that often complicate intoxicated speech analysis. Notably, our findings highlighted the effectiveness of features like the RASTA-filtered auditory spectrum. Nevertheless, the results from statistical tests emphasized the need for techniques that minimize inter-subject variability.As for the automatic classification, the proposed architecture exhibited promising results, yielding a classification accuracy slightly exceeding 70% on an independent test set. Although preliminary, our research demonstrates the potential for detecting alcohol-induced speech changes, benefiting societal well-being and security. It also underscores the importance of developing strategies that account for individual differences while harnessing the power of automatic models to effectively distinguish between sober and intoxicated individuals.

A Multi-Enzyme Nanocascade to Target Disease-Relevant Metabolites.

Metabolic processes in living organisms depend on the synergistic actions of enzymes working in proximity and in concert, catalyzing reactions effectively while regulating the formation of metabolites. This enzyme synergy offers promising therapeutic application for diseases such as alcohol intoxication, cancer, and hyperinflammation. Despite their potential, the clinical translation of enzyme cascades is restricted by challenges including poor enzyme stability, short half-life, and a lack of delivery strategies that maintain enzyme proximity. In this study, multi-enzyme nanocascades synthesized are developed through in situ atom transfer radical polymerization using a zwitterionic monomer. This method markedly enhances enzyme stability and proximity, thereby prolonging their circulation half-life after systemic administration. It is demonstrated that the nanocascades of uricase and catalase effectively reduce uric acid levels without excessive hydrogen peroxide production, providing a potential antidote for hyperuricemia. Moreover, in a murine breast cancer model, the nanocascades of glucose oxidase and catalase inhibited tumor progression and enhanced the therapeutic efficacy of doxorubicin. The prolonged circulation and promoted reaction efficacy of these nanocascades underscore their substantial potential in enzyme replacement therapy and the treatment of various diseases.

Does concomitant diazepam and ethanol use modulate age-related cognitive decline in mice?

BackgroundConcomitant use of alcohol and benzodiazepines are described among elderly, raising concerns about their combined impact on memory. We aimed to evaluate the long-term impact of chronic diazepam use associated with ethanol intoxication on memory in aging mice. MethodsTwelve-month-old male C57BL6 mice were assigned into 4 groups: ethanol (OH), diazepam (DIA), diazepam + ethanol (DOH) and control (CTL). For 16 weeks, ethanol was available ad libitum and diazepam was mixed with food. Behavioral testing, performed during and after treatment cessation included working memory and visual recognition memory assessment. The second session was implemented with spatial reference learning and memory assessment in the Barnes maze test. In vivo magnetic resonance spectroscopy (MRS) acquisitions were performed to quantify hippocampal metabolites during and after cessation treatment. ResultsDuring treatment, visual recognition memory was significantly different between groups with the DIA group exhibiting the worst performance. MRS acquisition highlighted higher glutamate and choline levels in OH and DOH groups in comparison to CTL and DIA groups. After treatment wash-out, there was no difference between in the different memories evaluated. Only the learning phase of the spatial reference memory test differed significantly with worst performance in OH groups. Three months after treatment cessation, there was no remanent effect of diazepam + ethanol on hippocampal metabolites changes. ConclusionsWe did not evidence additive effect of ethanol and diazepam on memory and hippocampal metabolite levels. The disturbances observed during treatment were no remanent, highlighting the benefits of discontinuing these substances.

The effects of pretreatment oral hydration on extracorporeal shockwave lithotripsy outcomes: A randomized controlled trial.

We sought to investigate the effects of pretreatment oral hydration on the outcomes of extracorporeal shockwave lithotripsy (ESWL). Patients who undergoing ESWL for a single radio-opaque renal or proximal ureteric calculus ≤2 cm in size were randomized into two groups. The oral hydration group (OHG) administered 600 ml of water before ESWL, while the control group (CG) did not. The urine was held during ESWL to create a full bladder induced hydronephrosis. Both groups received the same ESWL protocol at four-week intervals and a maximum of three sessions. The primary outcome was stone-free rate (SFR) at 12 weeks and the secondary outcomes were the total number of shockwaves and the number of ESWL sessions. A total of 154 patients completed the study, 77 patients in each group; both groups were comparable in demographic data and stone characteristics. The SFR was 84.4% in the OHG and 68.8% in the CG group (p=0.036). Stone fragmentation in OHG was significantly higher than CG, 75.3% vs. 58.4% (p=0.040). OHG had more cases of artificial hydronephrosis (55.8% vs. 27.3%, p=0.001) and higher urine volume (375 [148] ml vs. 230 [110] ml, p<0.001). There were no statistically significant differences in the total number of shockwaves and the number of ESWL sessions. The auxiliary procedures in OHG were less than CG (15.6% vs. 31.2%, p=0.049). Pretreatment oral hydration, together with holding urine during ESWL, has increased stone disintegration and SFR. This simple and safe technique improves the ESWL outcomes.

Originalarbeiten / Original Articles. Prävention akuter Alkoholintoxikationen bei Kindern und Jugendlichen: Trinkumstände und Empfehlungen aus Sicht betroffener Eltern und Jugendlicher / Prevention of Acute Alcohol Intoxication in Children and Adolescents: Drinking Circumstances and Recommendations from the Perspective of Affected Parents and Adolescents

Prevention of Acute Alcohol Intoxication in Children and Adolescents: Drinking Circumstances and Recommendations from the Perspective of Affected Parents and Adolescents Alcohol consumption among children and adolescents in Germany is showing a downward trend. However, a significant number of minors reports risky drinking patterns that lead to alcohol intoxication requiring inpatient treatment. Findings on drinking circumstances that precede alcohol intoxication and on rules on alcohol consumption are essential for the further development of effective prevention strategies. Quantitative data analyses and qualitative interviews were used to investigate drinking circumstances that precede acute alcohol intoxication in children and adolescents as well as rules for alcohol consumption before and after the event of the intoxication. N = 201 children and adolescents took part in the survey on drinking circumstances that precede acute alcohol intoxication. While 31.3 % of respondents did not habitually consume alcohol at risk, 15.9 % reported binge drinking on a monthly basis and 15.9 % on a weekly or more frequent basis. Particular risk situations are the consumption of spirits, consumption in private settings and being found outdoors. In-depth interviews were conducted with N = 8 children and adolescents and N = 9 guardians. Young people emphasized strategies to minimize risk and communication with guardians as helpful, while parents recommended increased monitoring, communication and prohibitions. The greatest uncertainty was reported in dealing with non-compliance with rules. Preventive measures should start early, provide information about drinking circumstances that often precede intoxication and give clear recommendations for drinking rules.

Ethyl alcohol consumption characteristics of deceased individuals in Lithuania

The number of alcohol-related deaths in Lithuania has fallen by almost one-third in the last decade; however, the number of deaths has been on the rise since 2019. Data on the postmortem investigation of victims between 2018 and 2022 were obtained from the Lithuanian State Forensic Medicine Service database. This study analyzed data from 1200 autopsies. The deceased victims were categorized based on their cause of death and blood alcohol concentration (sober, legally intoxicated, mild, medium, or heavy). The causes of death were diseases (54.17 %, n = 650), suicides (12.08 %, n = 145), homicides (2.5 %, n = 30), and accidents (31.25 %, n = 375). Toxicological tests for alcohol were performed in all cases. Alcohol levels in the blood and urine were measured using gas chromatography. A significant correlation was observed between blood alcohol concentration and age (r = −0.13, p = 0.007). A statistically significant difference was observed in the proportions of men and women who were intoxicated. Among the causes of death, the group of individuals who died because of accidents exhibited the highest average blood alcohol concentration. Alcohol intoxication is undoubtedly a contributing factor to fatalities resulting from accidents and homicides. These findings assist in determining the intoxication level of victims and in assessing any potential links that may contribute to or predispose victims to lethal outcomes in cases of disease, suicide, homicide, or accident.

“Mr. Smith Has No Mealtimes”: Minimal Comfort Feeding for Patients with Advanced Dementia

While Comfort Feeding Only is appropriate for patients with advanced dementia, its emphasis on assiduous hand-feeding that may prolong life for years fails to accommodate the preferences of those who do not want to continue living with this illness. Some have proposed advance directives to completely halt the provision of oral nutrition and hydration once a person has reached an advanced stage of dementia. However, these directives may fail to address patients’ discomfort, caregivers’ obligations, or current care and regulatory standards when patients reside in facilities. In response to these dilemmas, we introduce Minimal Comfort Feeding (MCF). Rather than offering food and liquids proactively as with Comfort Feeding Only, caregivers provide nutrition and hydration only in response to signs of hunger and thirst. While further study is required to define and negotiate challenges in operationalizing this approach, MCF provides a framework that resolves competing ethical and clinical considerations in caring for those with advanced dementia.

Diverging trends in alcohol-related harms: The role of comorbid mental health, suicide and self-harm behaviors in ambulance attendances for alcohol intoxication during the COVID-19 pandemic in Victoria, Australia

BackgroundAlcohol harms changed significantly during COVID-19, but did not affect the population equally. Vulnerable groups including people with pre-existing mental health or suicidal behaviors may be at greater risk of alcohol-related harms, yet limited public health data are able to assess these. MethodsThe present study utilised a novel, statewide surveillance system to examine ambulance attendances for alcohol intoxication over a four-year period prior to, and during the strictest lockdowns in Victoria, Australia. ResultsWhile there was an overall reduction in alcohol-related attendances during lockdown (n = 15,064) compared to the 2018–19 period (n = 16,989), alcohol- intoxication attendances involving mental health symptoms increased by 40 % in Melbourne (IRR: 1.40 [1.30–1.51], p < 0.001), and by 25 % in regional Victoria (IRR: 1.25 [1.07–1.44], p = 0.005).There was also a 7 % increase in alcohol-intoxication attendances with co-morbid suicidal behaviors in Melbourne (IRR: 1.07 95%CI [1.02–1.13], p = 0.006), and a 21 % increase in regional Victoria (IRR: 1.21 [1.08–1.35], p = 0.001). ConclusionsThese findings suggest that extra services and supports for individuals with co-morbid alcohol-related harms are required to ensure their clinical care needs are being met.

Probenecid as a pharmacotherapy for alcohol use disorder: Arandomized placebo-controlled alcohol interaction trial.

This study shows the first evidence for pannexin 1 channels as a new target to develop medications for alcohol use disorder (AUD). Due to its history of long-term safe clinical use and preclinical evidence of reducing excessive alcohol intake in rodents, probenecid has clinical potential for AUD. We conducted a Phase I/IIa randomized, double-blind, placebo-controlled, crossover trial investigating the safety, tolerability, and efficacy of an oral dose of probenecid (2 g) when administered with alcohol (0.08 g/dL) in individuals who regularly consume alcohol to the 0.08 g/dL level (N = 35) and in individuals with mild to severe AUD. Alcohol pharmacokinetics and subjective responses were evaluated to assess potential interactions between probenecid and alcohol. Alcohol craving, inflammatory biomarkers, cognitive assessments, and hemodynamics were assessed as additional alcohol research domains. All outcomes were assessed both in the ascending and descending limb of alcohol intoxication using Generalized Estimating Equation. Probenecid did not exert any significant effect on alcohol pharmacokinetics and did not affect alcohol stimulation or sedation. Probenecid, compared to placebo, significantly decreased alcohol craving during the alcohol ascending limb. Inflammatory biomarkers, cognitive performance following alcohol ingestion, and hemodynamics were likewise not affected by probenecid administration. Analysis of sex as a biological variable revealed no differences of probenecid compared to placebo. Taken together, our data support the potential of probenecid for treatment of AUD and suggest that pannexin 1 channels represent a novel emerging therapeutic target for the development of new pharmacotherapies for treating AUD.

Characteristics of adolescents with acute alcohol intoxication in Belgium

Abstract Background Binge drinking and acute alcohol intoxication (AAI) are common in Belgian adolescents, posing a risk of serious health consequences. To develop cost-effective preventive measures for problematic alcohol use in adolescents in Belgium, more insight into the background of this group is necessary. Methods To gain more insight into the prevalence, medical characteristics and context of AAI, a retrospective multicentre hospital chart study was performed on adolescents aged 10 to 18 years with AAI in Antwerp, Belgium from 2015-2021. Furthermore, a prospective intervention study for adolescents with AAI in Antwerp was set up in 2023, of which the first results were not yet known at the time of submission. However, these results will be presented at the conference, if available. Results Over the study period, a total of 1032 admissions related to alcohol intoxication occurred in 1016 patients, with a median age of 16.6 years old and a median blood alcohol intoxication (BAC) of 1.95 g/L. There was combined drug use in 10% of the cases. Only 17% of the patients received additional care after admission. These findings did not significantly change over the study period. Multiple linear regression analyses indicated that after correcting for covariates, higher age, no combined drug use and decreased consciousness at admission were associated with more severe AAI cases (higher BAC). Conclusions AAI is prevalent among Belgian adolescents. Therefore, better-targeted preventive measures and policies are needed. Our findings could be taken into account when developing preventive measures. However, data addressing the demographics and context of AAI were mostly missing. Therefore, a prospective follow-up study was set up in Antwerp, which started in 2023 and is still ongoing. Furthermore, this study will investigate the feasibility and effectiveness of a follow-up intervention for this group of patients.

5.Y.2. Alcohol intoxication among adolescents in Italy, Belgium and The Netherlands

Abstract Excessive drinking behavior poses a significant risk to the health of adolescents and contributes to high social and health costs. It is also well-documented that engaging in risky drinking behavior at a young age increases the likelihood of developing alcohol use disorders and other mental health disorders later in life. Therefore, the timely development of adequate interventions to prevent and reduce such behavior is an important public health task. The initial step here is to gather comprehensive data on the phenomenon. Studying alcohol intoxication data among adolescents is an important source in this context. In the Netherlands, data on alcohol intoxication in adolescents have been routinely collected for several years, leading to a successful transmural framework aimed at supporting these young individuals and their parents. As countries are at varying stages in addressing this issue, the objective of this workshop is to facilitate mutual learning about effective prevention initiatives targeting problematic alcohol use in young people. The workshop will feature presentations from four studies representing three countries: Italy, Belgium, and the Netherlands. Allegra Ferrari from Italy will discuss alcohol-related emergencies among adolescents admitted to an emergency department in Genoa, emphasizing the importance of urgent interventions to mitigate adolescent alcohol use. Hanna van Roozendaal from Belgium will present data from both retrospective and prospective studies on adolescents with acute alcohol intoxication in Antwerp hospitals, exploring the feasibility of follow-up interventions. Louise Pigeaud from the Netherlands will share data from a cohort of individuals under 18 years presented with acute alcohol intoxication symptoms at an emergency department between 2015-2023 to monitor trends in admission characteristics. Finally, Guido van Hal will focus more in depth on the differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in Italy, Belgium and The Netherlands. The workshop will conclude with an open discussion on topics such as the necessary data to be registered for minors with acute alcohol intoxication, the most effective methods for preventing/reducing alcohol intoxication in these age groups, and the potential transferability of the successful Dutch transmural framework to other countries. Key messages • Acute alcohol intoxication and problematic alcohol use in minors can lead to significant alcohol-related issues in adulthood. • Collecting and analyzing high-quality data can facilitate the development of interventions aimed at reducing and preventing alcohol-related issues in adolescents.

Characteristics of adolescents with acute alcohol intoxication accessing emergency care in The Netherlands

Abstract Background Prevent alcohol consumption amongst minors is a major concern for national governments. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Therefore, the aim of this study is to give an overview of demographic and clinical characteristics of adolescents with an acute alcohol intoxication in the Netherlands. Methods This study was conducted using a cohort of adolescents aged 14-17 years presenting with acute alcohol intoxication symptoms at the emergency department from 2015-2023. Data were collected at the Reinier de Graaf Gasthuis in Delft in order to monitor trends in admissions for acute alcohol intoxication. Data on patients age, blood alcohol concentration, sex, combined drug use and reason of admission were collected. Results A total of 505 patients who presented themselves with symptoms of acute alcohol intoxication at the Reinier de Graaf Gasthuis were included. The mean age of patients was 15.7 years old. The mean blood alcohol concentration was 2.0‰. During the COVID-lockdown period there were statistically significant less admissions with alcohol intoxication. The distribution of sex was nearly equal with 50.3% females and 49.7% males. Combined drug use was present in 13.4% of all cases, with cannabis as the most frequent type of drugs found. The most common known reason for admission was ‘reduced consciousness’ (35.9%). Conclusions These findings are relevant for both the central government’s ongoing prevention initiatives and treatment strategies within hospitals. In the future, more countries should evaluate data on adolescent drinking patterns.

Differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in three urban regions in Italy, Belgium, and The Netherlands

Abstract Background Excessive drinking among adolescents in Western Europe is prevalent, posing significant health risks and societal costs. Early initiation of alcohol use and binge drinking are associated with adult alcohol use disorders. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Methods To gain insight into the demographic and clinical characteristics of acute alcohol intoxication (AAI), we analysed emergency department access data of adolescents aged 14-17 years presenting with AAI symptoms from 2015-2023. Three urban regions were included: the Reinier de Graaf Gasthuis in Delft (The Netherlands), eight combined hospitals in Antwerp (Belgium) and the IRCCS San Martino Hospital in Genoa (Italy). Results A total of 1841 patients with symptoms of AAI were included. The mean age of patients in the Netherlands was statistically significant younger than in Italy and Belgium (15.7 compared to 15.9 and 16.0 years old, respectively). Moreover, the blood alcohol concentration was higher in the Netherlands and Belgium compared to Italy (2.0‰ compared to 1.95‰ and 1.8‰ respectively). The distribution of sex was nearly equal in the Netherlands, while statistically significant differences were observed with a higher proportion of males in Italy (54.8%) and Belgium (56.8%). Combined drug use was lower in Belgium with 10.0%, compared to 13.4% in The Netherlands and 14.7% in Italy. The most common reason for admission was ‘reduced consciousness’ in the total population (45.2%). Conclusions This is one of the first international studies which combines data on AAI in minors. In the future, efforts should be made to establish a common European database where records of AAI can be stored and analysed more efficiently for prevention purposes.

Assessment of the effect of solid herbal extract of primula veris l on the physical performance of rats after chronic alcohol intoxication

The aim of this study was to evaluate the effect of solid herbal extract of Primula Veris L. and comparison drugs phenotropil and mildronate on the physical performance of female rats after chronic alcohol intoxication (CAI). CAI was modeled by replacing drinking water for 6 months with a 10 % solution of ethyl alcohol with sucrose (50 g/l). At the age of 16 months, the “Rotarod performance test”, “The horizontal rope walking test” and “Forced swim test with weight load” were performed. After CAI, rats show a deterioration in coordination and motor activity, a decrease in muscle strength and aerobic-anaerobic endurance. Solid herbal extract of Primula Veris L., phenotropil and mildronate contributed to an increase in the physical performance of animals after CAI.