Alcohol craving is an antecedent and consequence of drinking. However, there is little research regarding cyclic relations between alcohol-induced craving and drinking behavior occurring during naturalistic drinking episodes. This study tested a theoretical model wherein early-episode craving predicts continued drinking and heightened reinforcing subjective effects, which then are associated with increases in craving and subsequent drinking thereafter. Young adults (N = 131) completed 21 days of ecological momentary assessment, including event-contingent reports completed after first drink, followed by assessments 60-minutes and 120-minutes later. Participants self-reported consumption quantity, alcohol craving, and subjective stimulation/relaxation. Craving during the drink initiation assessment predicted increased consumption over the next 60-minutes, which predicted increased stimulation and decreased relaxation at the 60-minute assessment. Increased stimulation (and decreased relaxation) were then associated with increased craving at the 60-minute assessment, which in turn predicted increased consumption between 60-minute and 120-minute assessments. Thus, early-episode craving predicted increased consumption 60-minutes later, which was then associated with subsequent craving and consumption another 60-minutes later indirectly via increased stimulation and decreased relaxation during the 60-minute assessment. Residual relations between craving and consumption remained. Sensitivity analyses demonstrated that cyclic indirect effects beginning with early-episode craving were only present during binge drinking episodes, and models were unchanged when accounting for early-episode subjective effects. Further, cyclic indirect effects operated through craving but not subjective effects when specified as contemporaneously correlated mediators. Relations between craving and naturalistic drinking appear to be cyclic processes in young adults, with subjective reinforcement potentially serving a mechanistic role in relations.

Chronic pain (CP) and hazardous/harmful drinking (HD) commonly co-occur. HD contributes to the onset and severity of CP, while CP severity predicts alcohol use disorder relapse. Integrated treatments for CP and HD are needed in rural areas, where CP and alcohol-related consequences occur at higher rates and treatment accessibility is lower. This study assessed the acceptability and feasibility of an app-based cognitive-behavioral intervention for CP and HD. Participants (n = 32) were rural residents reporting CP and HD (mean age = 49.81, SD = 8.79). Participants were randomized to intervention or assessment-only control. Self-report questionnaires at baseline and 12-week follow-up assessed program acceptability, pain, alcohol involvement, and functioning. Timely recruitment and low attrition (3.2%) supported procedure feasibility, while app engagement suggested intervention feasibility and acceptability. Descriptive statistics suggest reductions in pain (37% reduction in median pain in intervention group vs. 10% in control group). Changes in alcohol-related behavior were not consistent across outcomes and warrant further study (e.g., no change in median heavy drinking episodes in intervention, with 77% reduction in control; 60% reduction in alcohol consequences in intervention vs. 27% in control). This mobile intervention is feasible and acceptable for rural residents and may help address CP and functioning among those who engage in HD.

Background: Safe water is important for health, yet many people still rely on sources of water that are not adequately protected from contamination. Drinking unsafe water provides conditions that enhance the chances of contacting such waterborne illnesses as diarrhea and typhoid, especially in communities with poor sanitation measures. The study was conducted to assess water sources, handling practices, and waterborne diseases in Gyel and Du communities in Jos South Local Government Area. Methods: A total of 807 respondents participated in this community-based cross-sectional survey. The structured questionnaire focused on household drinking water sources, storage methods, hygiene behaviors, and episodes of illness in the past six months. Water samples were collected from common sources like wells, streams, and stored household water. The water samples were assayed for simple quality indicators, namely pH, turbidity, and bacterial contamination, using simple laboratory procedures. The results indicated a high reliance by households on water sources that were unsafe, with the majority being wells without protection and surface waters. The majority of households did not treat the water before drinking. Laboratory analysis indicated many samples contained unsafe levels for bacteria such as coliforms and Escherichia coli, indicative of fecal contamination. A large number of respondents reported diarrhea and typhoid within the last six months; this points to a strong association between water quality and health complaints. Conclusion: Drinking water in Gyel and Du communities is not always safe, leading to a high burden of waterborne diseases. Improvements in water supply systems are urgently needed along with the promotion of household water treatment and improved sanitation and hygiene practices in order to safeguard public health.

Acute effects of subjective alcohol effects and negative alcohol consequences on next-day positive alcohol expectancies.

Background: Adolescents face unique challenges as they transition from childhood to adulthood, which can be marked by risky behaviours such as substance use and sexual activities. The present study analyses the relationship between risky sexual behaviour and the use of psychoactive substances, namely alcohol, cannabis, and other illegal substances, among students aged 15–16 years in 23 European countries, to investigate potential between-country differences. Method: Data were extracted from the 2019 European School Survey Project on Alcohol and Other Drugs (ESPAD) cross-sectional survey. Risky sexual behaviour was defined as self-reported unprotected sex. Substance use, other individual risk behaviours, and parenting indicators were investigated as key predictors. Results: A 9.8% of 16-year-old students in Europe reported sexual intercourse without a condom in the past year, and 7.8% had unprotected sex while not using alcohol/drugs, with a higher prevalence observed among males (8.5%) than among females (7.1%). Prevalence ranged from 3.2% in Georgia to 16.0% in Sweden. The multivariate analysis revealed significantly higher odds of engaging in sexual intercourse without a condom in illicit drug users (cannabis, inhalants, cocaine, ecstasy) and heavy episodic drinkers, students who went out in the evening, and those belonging to non-traditional families. Conclusions: Unprotected sex in the past year and substance use are strongly associated amid 16-year-old students in Europe. The prevalence of risky sexual behaviours across European countries does not follow a clear geographical pattern, suggesting that simple macro-level factors, such as broad regional or cultural groupings, may only partially explain prevalence differences.

Structural brain recovery following reductions in adolescent and young adult binge drinking: A longitudinal NCANDA study

Introduction: binge drinking has increased among female university students in recent years. This pattern poses greater risks for women compared to men; however, their rate of seeking professional help remains low, and existing treatments are typically targeted at male or mixed populations. Brief interventions based on the cognitive-behavioral model have demonstrated effectiveness in modifying this risk behavior. Objective: evaluate the effect of a brief cognitive-behavioral intervention (BCBI) in undergraduate female students with binge drinking episodes. Method: a single case with an intrasubject replication design was used with six participants who reported at least one episode of binge drinking in the past 180 days. Changes in alcohol consumption (in terms of standard drinks [SD], frequency, and duration), perceived self-efficacy, and readiness to change were assessed. Data analysis included calculating level and trend for the SD variable, Nonoverlap of All Pairs (NAP) Index, Objective Clinical Change (OCC), Reliable Change Index (RCIJT), and numerical rating scales (NRS). Results: gradual reductions were observed in the amount of SD consumed and the frequency of binge drinking episodes, along with improvements in perceived self-efficacy and readiness to modify drinking habits. Discussion and conclusions: the findings suggest that BCBIs tailored to the specific needs of women are a promising strategy for preventing binge drinking and its associated risks. Brief, remote, and gender-sensitive intervention adaptations are beneficial for reducing episodes of use in this population.

The current study measured the extent to which different neurobehavioral indices of incentive-motivational salience attribution to alcohol cues predict alcohol craving and consumption in the natural environment. Laboratory study at a university in Missouri, USA, followed by a smartphone-based 21-day ecological momentary assessment (EMA) protocol. Participants were emerging adults (N = 218-268 [52-56% female], age 18-20). Participants completed an alcohol cue approach-avoidance task while their electroencephalogram (EEG) was recorded. Behavioral measures (response time) indexed the strength of cue-activated approach vs. avoidance tendency. Cue-locked event-related potentials provided EEG-based neural measures of motivated attention (P3 amplitude) and approach-avoidance conflict (N450 amplitude). From EMA, measures of alcohol consumption dynamics (as indexed by estimated blood alcohol concentration [eBAC], g/dL) during real-world drinking episodes were obtained, as were measures of alcohol craving (7-point visual analogue scale) dynamics during and outside these episodes. Different approach-avoidance task-derived behavioral and neural measures rank-ordered participants differently. Participants who approached alcohol cues more rapidly in lab subsequently showed steeper increases in craving (∆B ± standard error [SE] = 1.042 ± 0.499 point/hr), and eBAC (∆B ± SE = 0.046 ± 0.017 g/dl/hr), during real-world drinking episodes. Participants who avoided alcohol cues more slowly in lab also showed steeper increases in eBAC (∆B ± SE = 0.056 ± 0.017 g/dl/hr). Participants with larger P3 during alcohol cue approach in lab subsequently showed steeper increases in eBAC (∆B ± SE = 0.048 ± 0.017 g/dl/hr), as did those with smaller P3 during alcohol cue avoidance (∆B ± SE = 0.025 ± 0.017 g/dl/hr). Participants with smaller N450 during alcohol cue approach in lab subsequently showed steeper increases in craving during drinking episodes (∆B ± SE = 1.465 ± 0.607 point/hr). Tests examining lab-based neurobehavioral measures as predictors of craving dynamics during nondrinking moments, such as following incidental cue exposure, generally were inconclusive. Incentive salience toward alcohol may influence alcohol seeking (including craving) and alcohol consumption through distinct behavioral risk pathways in different people.

This study used ecological momentary assessment to investigate the association between unplanned drinking and alcohol-impaired driving (AID) cognitions and behavior among adults. Adults (N = 125) completed 6 weeks of morning and evening ecological momentary assessment surveys assessing plans to drink later that night, driving behavior, and AID cognitions. Mixed-effects models with moments (Level 1) nested within days (Level 2) within person (Level 3) were used to test the effect of planned (vs. unplanned) drinking intentions on perceived danger of AID and willingness to engage in AID. A separate two-level model (days nested within person) tested planned (vs. unplanned) drinking on AID behavior. A novel breath alcohol concentration biosensor accounted for alcohol consumption in all models. Unplanned drinking episodes were associated with lower perceived danger of AID, increased willingness to engage in AID, and higher odds of engaging in AID, compared to planned drinking episodes. Findings were held after controlling for alcohol consumption measured by breath alcohol concentration biosensors. Findings suggest that unplanned drinking intentions confer risk for AID-a behavior requiring significant preparation and planning to avoid. Findings highlight the need for future research investigating unplanned drinking's effect on other negative consequences requiring preparation and planning. Additionally, findings highlight the need for targeted interventions and policies to reduce unplanned drinking to prevent AID and improve public health outcomes among adults. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Thinking when I'm drinking: The interaction of mood and rumination across drinking and non-drinking days.

Alcohol hangovers can occur after a single episode of drinking and begin as blood alcohol concentration returns to zero. While hangovers are widely known for their physical symptoms, they also include psychological symptoms such as a depressed mood. These psychological impacts, particularly negative affect (e.g., anxiety, stress), remain less well understood, yet may contribute to maladaptive drinking behaviours and reinforce the cycle of excessive alcohol consumption. This systematic review, pre-registered and reported in alignment with Preferred Reporting Items for SystematicReviews and Meta-Analyses (PRISMA) and Synthesis without Meta-analysisguidelines, aimed to comprehensively examine the association between alcohol hangovers and negative affect. Searches were performed in MEDLINE, Embase, PsycNET, Scopus and CINAHL from inception to January 2025. Two independent reviewers screened articles, assessed the risk of bias and extracted data. Twenty-two studies (n = 6152; mean age 26.9 years, 57% female) demonstrated a significant association between hangovers and increased negative affect, including anxiety, stress and depression. Maladaptive emotional regulation, avoidant coping styles, repetitive negative thinking and greater baseline anxiety exacerbated these negative experiences, while social support and mental resilience offered potential protective factors. The findings highlight the clinical importance of addressing psychological factors in alcohol-related harm. The tendency to return to binge drinking despite negative hangover experiences suggests that psychological factors may perpetuate unhealthy alcohol consumption. This review supports a strong link between alcohol hangovers and heightened negative affect. Effective interventions must address both the reduction of negative affect and the underlying drivers of binge drinking to promote healthier alcohol consumption patterns.

Disclosure: Y. Abdullah: None.Addison’s disease, or primary adrenal insufficiency, is a rare yet potentially life-threatening disorder caused by the destruction or dysfunction of the adrenal cortex, leading to insufficient glucocorticoid and mineralocorticoid production. Early symptoms such as fatigue, anorexia, nausea, and abdominal pain are often subtle and nonspecific, delaying diagnosis. In acute settings, patients may develop severe hypoglycemia, hypotension, hyponatremia, and hyperkalemia, which can precipitate an adrenal crisis. Binge drinking can worsen such presentations by fueling hypoglycemia and metabolic derangements, obscuring other pathologies. While alcohol-induced metabolic encephalopathy commonly explains altered mental status in binge drinkers, adrenal insufficiency can produce similar features, including hypoglycemia-driven encephalopathy and cardiovascular compromise. Distinguishing these overlapping syndromes can be challenging, especially in adolescents lacking known comorbidities. We present an 18-year-old man who arrived with severe altered mental status after a binge drinking episode. He was profoundly hypoglycemic (blood glucose of 10 mg/dL) on admission, briefly improved with IV dextrose, yet repeated hypoglycemic episodes persisted. Further investigations showed mild hyponatremia, a baseline cortisol below 0.1 nmol/L, and a poor cortisol response to ACTH stimulation. Elevated plasma ACTH (∼122 pmol/L) and positive 21-hydroxylase antibodies confirmed primary adrenal insufficiency. MRI of the brain revealed no structural abnormality, and normal very long-chain fatty acid levels excluded adrenoleukodystrophy. The patient’s status improved significantly with glucocorticoid replacement, and he was discharged for endocrine follow-up. This case underscores the interplay between binge drinking, metabolic encephalopathy, and life-threatening hypoglycemia, highlighting the diagnostic challenge of “overshadowing,” where Addison’s disease may be overlooked in favor of an alcohol-related cause. We emphasize that adrenal insufficiency should be considered in younger, otherwise healthy individuals presenting with recurrent hypoglycemia, hyponatremia, or refractory shock. Early detection and targeted therapy remain critical to preventing adrenal crisis. Furthermore, the report illustrates how consistent use of a systematic diagnostic approach can unmask uncommon yet crucial etiologies in patients with severe metabolic derangements, ensuring that no presumed explanation prematurely ends the search for a treatable condition.Presentation: Sunday, July 13, 2025

Social context and impaired control over alcohol use during naturally occurring drinking episodes.

Binge drinking acutely induces hepatic steatosis which is readily reversible: A real-world observational study in healthy adults

Background/Objectives: University students frequently engage in risky alcohol consumption, making them a priority population for targeted interventions. Motivational interventions (MIs) have been widely implemented to address this issue, but evidence of their effectiveness remains heterogeneous. This study aimed to evaluate the efficacy of MIs in reducing alcohol consumption and related harm among university students through a systematic review and meta-analysis. Methods: A systematic search was conducted in PubMed, Scopus, and BVS Library, including randomized controlled trials (RCTs) published up to April 2025. The PRISMA and RoB-2 tools guided reporting and risk of bias assessment. Random-effects models were applied to pool effect sizes for changes in alcohol consumption patterns and related consequences. Results: Fifteen RCTs were included. MIs significantly reduced daily alcohol intake (-0.55 drinks/day; 95% CI: -0.78 to -0.32), with additional reductions in weekly consumption and binge drinking episodes, though these were not statistically significant. Positive effects were also observed in reducing alcohol-related consequences and blood alcohol concentration levels. Short, single-session formats (45-90 min) showed consistent efficacy across studies, with effects sustained at 2-3 months and, in some cases, up to one year post-intervention. Conclusions: MIs are effective, brief, and adaptable strategies for reducing harmful alcohol use and associated negative outcomes among university students. Their simplicity, feasibility, and sustained effects make them valuable tools for university health programs. Future research should focus on optimizing intervention components and evaluating their effectiveness in diverse cultural and socioeconomic contexts.

BackgroundThis study examined the association between readiness to change and reductions in unhealthy alcohol use among Latino adults in the emergency department (ED) who used the Automated Bilingual Computerized Alcohol Screening Intervention (AB-CASI), a digital behavioral health intervention tool.MethodsThe study included 310 self-identified US Latino ED patients with unhealthy drinking. The primary independent variable was baseline readiness to reduce alcohol consumption. Outcomes included binge drinking episodes in the past 28 days and average weekly drinks, assessed at baseline and 1-, 6-, and 12-month follow-ups. Alcohol severity was measured via the Alcohol Use Disorders Identification Test scores, with gender and language preference (English vs Spanish) as covariates. Generalized linear mixed models in SAS accounted for within-subject variability across time points for analysis.ResultsBinge drinking ratios comparing those “more ready” to cut down to those “less ready” were 0.61 at 1 month [95% confidence interval (CI): 0.42, 0.90; P = .013], 0.46 at 6 months (95% CI: 0.31, 0.69; P < .0001), and 0.61 at 12 months (95% CI: 0.41, 0.89; P = .011). Weekly drinks ratios were 0.60 at 1 month (95% CI: 0.40, 0.90; P = .001), 0.45 at 6 months (95% CI: 0.29, 0.71; P < .0001), and 0.63 at 12 months (95% CI: 0.41, 0.97; P = .006).ConclusionIn the original AB-CASI clinical trial, Latino ED patients more ready to reduce alcohol intake showed significant decreases in drinking after the intervention. This highlights the importance of readiness-to-change models in alcohol interventions for vulnerable ED populations. AB-CASI’s bilingual, culturally sensitive design effectively promotes behavioral health, supporting both English- and Spanish-speaking patients in reducing unhealthy drinking behaviors.

Activation of anoctamin-1 calcium-activated chloride channels reduces voluntary alcohol consumption in rats.

Egocentric social network analyses show that drinking habits of college students' friends predict personal alcohol consumption. To date, most of this research focused on between-person, cross-sectional, or long-term longitudinal designs to evaluate these effects. This study used intensive longitudinal methods to examine episode-specific effects of social networks (network drinking, network composition) on college students' drinking, comparing within-person and between-person effects on individual episodic drinking, and highlighted social network characteristics that might be targeted for intervention. College students (N = 1,151, 54% female, Mage = 19.26, 81% White) identified their ego network: five close alters (e.g., friends, family) whom they met frequently. For 30 days using an internet-based diary, participants reported their daily drinking levels, indicated whether they met with each alter the previous night, and reported how many drinks each alter consumed. Two-part multilevel models were used to examine participant drinking. At the within-person level, when a higher proportion of a participant's ego network drank and when network total drinks were higher than average, the odds that a participant drank were significantly increased, and if they did drink, they consumed more alcoholic drinks than usual. Participants were more likely to drink on days when their network was comprised of more friends and more opposite-gender alters. Findings provide preliminary evidence that daily network drinking appears to influence drinking patterns and quantities among students. Such information could be used within ecological momentary interventions to prevent harmful drinking patterns such as heavy drinking episodes and incapacitation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

There is potential to use public posts on social networking sites (SNS) to screen for problematic alcohol use. This study investigated how frequency of public posting about alcohol on SNS relates to alcohol outcomes among young adults (YA) not attending 4-year college. We also explored associations for racial/ethnic and gender subgroups. Participants were 501 non-college-attending YA, aged 18-29, living in the United States. Participants were recruited via Qualtrics Panels and completed measures of demographics, SNS use (past-3-month frequency of public posting about alcohol on Instagram, TikTok, "X"), and alcohol-related outcomes: heavy episodic drinking frequency (HED), high-intensity drinking episodes (HID), U.S. Alcohol Use Disorders Identification Test total (USAUDIT), and alcohol consequences. Regression models tested hypothesized associations between frequency of public posting and alcohol outcomes. Subsequent models assessed simple effects by race/ethnicity (Hispanic, Black, White) and gender (man, woman). Controlling for covariates, more frequent public alcohol-posting was associated with higher USAUDIT, HED frequency, and HID likelihood, not consequences. For Hispanic YA, posting was positively associated with all outcomes except consequences. For Black YA, posting was positively associated with USAUDIT and HID, not HED or consequences. For White YA, posting was positively associated with USAUDIT and HED, not HID or consequences. For women, posting was positively associated with USAUDIT total, HID, and consequences. For men, posting was positively associated with USAUDIT and HED. In conclusion, more frequent public alcohol-posting on SNS was positively associated with past-year alcohol use and problems, implying potential to screen for hazardous drinking via public SNS posts, among non-college-attending YA. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Alcohol consumption that damages health remains highly prevalent in Sweden despite macrolevel intervention measures such as availability, restrictions and taxation. As understanding of behaviour change develops, there may be an opportunity to enhance individual level interventions by targeting personal dimensions of behaviour, such as underlying motives for drinking alcohol and readiness to change behaviour. This protocol describes a randomised controlled trial aimed at estimating the effectiveness of an intervention tailored to motives and readiness to change. A three-arm, parallel groups, randomised controlled trial will be used to estimate the effects of a motives and readiness to change tailored intervention. We will use a Bayesian sequential design to decide when to stop recruitment, with target criteria for benefit, harm and futility. Recruitment will be completed via web adverts and social media. Inclusion criteria are being aged 18 or older, having access to a mobile phone and being classified as a risky drinker. Participants allocated to the two intervention groups will receive either a personalised digital intervention or an intervention with enhanced tailoring for motives and readiness to change. The personalised intervention consists of weekly screening, personalised feedback and tools for planning behaviour. The enhanced tailored version will follow the same logic but will contain materials tailored for individuals' drinking motives and readiness to change. The control group will be redirected to two national websites with information about alcohol and health. Outcome measures are weekly alcohol consumption and monthly heavy drinking episodes, which will be contrasted with regression models and estimated using Bayesian inference. Ethical approval was obtained from the Swedish Ethical Review Authority on 16 April 2024, (Dnr 2024-01630-01). The results of the study will be disseminated in academic journals and research conferences. The trial was preregistered in the ISRCTN Registry on 12 June 2024 (ISRCTN87600318).