Increased Alcohol Use Research Articles

Associations of Perceived Stress and Social Support on Health Behavior Changes in Sexual Minoritized Women During the COVID-19 Pandemic.

We examined how perceived stress and social support were associated with changes in health behaviors during the COVID-19 pandemic among sexual minoritized women (SMW). In an online convenience sample of SMW (N = 501, M age = 23.6), we used multinomial logistic regression models to estimate associations of perceived stress and social support (emotional, material, virtual, in-person) with self-reported changes (increased or decreased vs. no change) in fruit and vegetable intake, physical activity, sleep, tobacco, alcohol, and substance use during the pandemic. We also tested whether social support modified associations between perceived stress and changes in health behaviors. Models controlled for sexual orientation, age, race and ethnicity, and income. Perceived stress and social support were associated with changes in health and risk behaviors. Specifically, increased perceived stress was associated with decrease (odds ratio [OR] = 1.20, p = 0.01) and increase (OR = 1.12, p = 0.04) in fruit and vegetable intake, and increase in substance use (OR = 1.19, p = 0.04). Receiving in-person social support was associated with changes in decrease (OR = 10.10, p < 0.001) and increase (OR = 7.35, p < 0.01) in combustible tobacco use and increase in alcohol use (OR = 2.63, p = 0.01). Among SMW who never received material social support during the pandemic, increased perceived stress was associated with increased alcohol use (OR = 1.25, p < 0.01). Perceived stress and social support were associated with SMW's health behavior changes during the pandemic. Future research may explore interventions to mitigate the effects of perceived stress and appropriately increase social support to promote health equity among SMW.

Changes in Alcohol Consumption during the COVID-19 Pandemic: Evidence from Wisconsin.

Alcohol consumption often increases in times of stress such as disease outbreaks. Wisconsin has historically ranked as one of the heaviest drinking states in the United States with a persistent drinking culture. Few studies have documented the impact of the COVID-19 pandemic on alcohol consumption after the first few months of the pandemic. The primary aim of this study is to identify factors related to changes in drinking at three timepoints during the first eighteen months of the pandemic. Survey data was collected from May to June 2020 (Wave 1), from January to February 2021 (Wave 2), and in June 2021 (Wave 3) among past participants of the Survey of the Health of Wisconsin. Study participants included 1290, 1868, and 1827 participants in each survey wave, respectively. Participants were asked how their alcohol consumption changed in each wave. Being younger, having anxiety, a bachelor's degree or higher, having higher income, working remotely, and children in the home were significantly associated with increased drinking in all waves. Using logistic regression modeling, younger age was the most important predictor of increased alcohol consumption in each wave. Young adults in Wisconsin may be at higher risk for heavy drinking as these participants were more likely to increase alcohol use in all three surveys.

The COVID-19 Pandemic in the Nawalparasi District of Nepal: a mixed methods assessment of increased alcohol use and violence against women

BackgroundIn Nepal and across the globe, the COVID-19 pandemic has primed an environment for increased rates of violence against women (VAW). This paper explores pandemic-driven economic insecurity and increased alcohol use as instigators of VAW and Intimate Partner Violence (IPV) within newly married households in the rural, Nawalparasi region of Nepal.MethodsThis study is a secondary analysis of data obtained from the Sumadhur Intervention pilot study that has been previously described and demonstrates successful implementation of group-based, household-level intervention for women’s empowerment and sexual and reproductive health education (1). Our three sets of data were collected before and during the COVID-19 pandemic. The first set is from a Longitudinal Cohort of 200 newly married women who were surveyed twice a year from February 2017 through July 2020. The second data set is a subset cohort of newly married women, their husbands, and their mothers-in-law (31 women, 31 husbands and 31 mothers-in-law) who participated in Sumadhur in January 2021. The third data set was obtained through in-depth interviews in July 2021 from 15 households following Sumadhur. The interviews were thematically coded, and subthemes were identified. A t-test of the January 2021 survey data set was run to look at correlations between income loss, alcohol consumption and experience of IPV among newly married women. All other survey data was analyzed for change over time.ResultsAt three months after the onset of the pandemic (July 2020), the Longitudinal Cohort survey data from newly married women reported increased rates of husbands’ alcohol use as well as personal experiences of IPV as compared to pre-pandemic averages. There was a statistically significant difference (p < 0.001) in the effects of income loss on increased alcohol use and experience of IPV. Qualitative results iterated the common theme of alcohol use and economic insecurity as upstream instigators of VAW in the community.ConclusionsIn the Nawalparasi district of Nepal, the pandemic has led to unstable economic situations that have instigated alcohol use among men, and increased rates of IPV among young, newly married women, and reports of VAW in the community. We have demonstrated a need for urgent programmatic and policy responses aimed at reducing VAW and IPV and protecting women during times of uncertainty and crisis.

Intersectional forms of racism and sexual minority stress are associated with alcohol use among Latinx sexual minority men with greater Hispanic/Latinx cultural orientation

ABSTRACT Background: Latinx sexual minorities with increased levels of acculturation report higher rates of alcohol use, and discrimination may impact this association. Yet, there is little research examining the concomitant impact of racism and sexual minority stress (i.e. intersectional discrimination) and the additive effect of acculturation on Latinx sexual minority men’s risk for hazardous alcohol consumption. Objectives: This study investigated the role of perceived stressfulness of intersectional discrimination in the relation between acculturation (US cultural orientation/Hispanic cultural orientation) and alcohol use among Latinx sexual minority men. Methods: A structural equation model was utilized to test the indirect effect of discrimination between acculturation and alcohol use with a sample of 357 Latinx sexual minority men (Mage = 28.39) recruited via Amazon MTurk. Results: The indirect effect between the Hispanic cultural orientation to alcohol use through intersectional forms of discrimination was significant and positive (b = .19, SE = .03, p < .01). The indirect effect for the US cultural orientation to alcohol use through intersectional forms of discrimination was significant and negative (b = −.10, SE = .03, p < .01). Conclusion: Contrary to previous literature, Latinx sexual minority men with a higher Hispanic cultural orientation reported higher levels of intersectional forms of discrimination, which in turn was associated with increased alcohol use. Those with a higher US cultural orientation reported lower levels of intersectional forms of discrimination, which in turn was associated with decreased alcohol use. These findings may help identify mechanisms that exacerbate health disparities for Latinx sexual minority men.

Longitudinal factors associated with increased alcohol consumption in adults during the COVID-19 pandemic

ABSTRACT Background: Alcohol is the most abused substance among adults in the United States. The COVID-19 pandemic impacted patterns of alcohol use, but data are conflicting, and previous studies are largely limited to cross-sectional analyses. Objective: This study aimed to longitudinally assess sociodemographic and psychological correlates of changes in three patterns of alcohol use (number of alcoholic drinks, drinking regularity, and binge drinking) during COVID-19. Methods: We studied changes in self-reported drinking behaviors in 222,195 Mayo Clinic patients over 21 years of age (58.1% female and 41.9% male) between April 1, 2019, and March 30, 2021. Logistic regression models were used to estimate associations between patient characteristics and change in alcohol consumption. Results: Sociodemographically younger age, White race, having a college degree, and living in a rural area were associated with increased alcohol use regularity (all p < .05). Younger age, male, White, high-school education or less, living in a more deprived neighborhood, smoking, and living in a rural area were associated with increases in number of alcohol drinks (all p ≤ .04) and binge drinking (all p ≤ .01). Increased anxiety scores were associated with increased number of drinks, while depression severity was associated with both increased drinking regularity and increased number of drinks (all p ≤ .02) independent of sociodemographic characteristics. Conclusion: Our study showed that both sociodemographic and psychological characteristics were associated with increased alcohol consumption patterns during the COVID-19 pandemic. Our study highlights specific target groups previously not described in the literature for alcohol interventions based on sociodemographic and psychological characteristics.

Alcohol Consumption and Mental Health during the COVID-19 Pandemic.

To examine the association between alcohol consumption and mental health during the COVID-19 pandemic. An anonymous online survey was distributed among US adults during May-August 2020 through social networks and ResearchMatch. We collected information on demographic, lifestyles and mental health symptoms including anxiety, depression, stress and post-traumatic stress disorder. Logistic regression models were used to examine the cross-sectional association between alcohol consumption and mental health symptoms. We also examined effect modification by race, age, gender, social support, financial insecurity and quarantine status. The analytical sample consists of 3623 adults. Stable drinking habits and regular drinking behaviors were found to co-exist with better mental health status. Participants who increased their alcohol use had higher odds of developing mental health disorders than those who maintained their pre-pandemic drinking habits. Additionally, participants who engaged in binge drinking during the pandemic had higher odds of depression and stress than those who did not. The associations regarding increased drinking and binge drinking in relation to adverse mental health outcomes were stronger among females, racial minorities, and individuals with financial concerns, poor social support and restricted quarantine status than their counterparts. During the early stage of the COVID-19 pandemic, increased alcohol use and binge drinking are cross-sectionally associated with higher odds of mental health disorders, which highlighted the need for targeted intervention to address the mental health needs of individuals who have engaged in these behaviors, especially among females, minorities, those with insecurities or with restricted quarantine status.

Associations between alcohol and cigarette use and type 1 and 2 myocardial infarction among people with HIV.

People with HIV have a higher risk of myocardial infarction (MI) than the general population, with a greater proportion of type 2 MI (T2MI) due to oxygen demand-supply mismatch compared with type 1 (T1MI) resulting from atherothrombotic plaque disruption. People living with HIV report a greater prevalence of cigarette and alcohol use than do the general population. Alcohol use and smoking as risk factors for MI by type are not well studied among people living with HIV. We examined longitudinal associations between smoking and alcohol use patterns and MI by type among people living with HIV. Using longitudinal data from the Centers for AIDS Research Network of Integrated Clinical Systems cohort, we conducted time-updated Cox proportional hazards models to determine the impact of smoking and alcohol consumption on adjudicated T1MI and T2MI. Among 13 506 people living with HIV, with a median 4 years of follow-up, we observed 177 T1MI and 141 T2MI. Current smoking was associated with a 60% increase in risk of both T1MI and T2MI. In addition, every cigarette smoked per day was associated with a 4% increase in risk of T1MI, with a suggestive, but not significant, 2% increase for T2MI. Cigarette use had a greater impact on T1MI for men than for women and on T2MI for women than for men. Increasing alcohol use was associated with a lower risk of T1MI but not T2MI. Frequency of heavy episodic alcohol use was not associated with MI. Our findings reinforce the prioritization of smoking reduction, even without cessation, and cessation among people living with HIV for MI prevention and highlight the different impacts on MI type by gender.

Do Coping Motives and Perceived Impaired Control Mediate the Indirect Links from Childhood Trauma Facets to Alcohol-Related Problems?

The Self-Medication Hypothesis suggests that individuals drink to alleviate undesirable affective states. Behavioral Economics Theory states that individuals deprived of resources (i.e., physically neglected) consume more reinforcing substances when they are available than others. Childhood trauma may indirectly increase impaired control over alcohol (IC; drinking beyond one's own intentions) and thereby increase alcohol use and problems through the employment of coping-motives. A structural equation model that included sex as a covariate examined mediated paths with 612 university students. Men were less likely to be emotionally abused and were more likely to use greater amounts of alcohol than women did. Physical neglect was directly linked to both more IC and alcohol use. Emotional and sexual abuse were directly linked to more coping motives. Both emotional and sexual abuse were indirectly linked to more alcohol use and its related problems through increased coping motives and IC. Consistent with Behavioral Economics Theory, there was a direct link between physical neglect and IC. We also found partial support for the Self-Medication Hypothesis regarding the emotional and sexual abuse trauma dimensions; they indirectly contributed to alcohol use and its related problems via the mediating mechanisms of more coping motives and IC. Our findings suggest coping motives could be a therapeutic target for intervention among those sexually or emotionally abused.

When asking ‘are you stressed?’ is not enough: Hair cortisol, subjective stress, and alcohol use during the first year of the pandemic

The onset of the COVID-19 pandemic was accompanied by an increase in alcohol use in a third of the population worldwide. To date, the literature shows that subjective reports of stress predicted increased alcohol use during the early stages of the pandemic. However, no studies have investigated the effect of physiological stress (via the stress hormone cortisol) on alcohol use during the pandemic. This study aimed to identify the predictive value of cortisol and/or subjective stress on alcohol use during the first year of the pandemic. Every three months, between June 2020 and March 2021, 79 healthy adults (19–54 years old) answered online questionnaires assessing alcohol use. In May 2020, participants reported pre-pandemic alcohol use, while in June 2020, participants reported current alcohol use, subjective stress measures, and provided a 6 cm hair sample. The latter allowed us to quantify the cumulative levels of cortisol produced in the three months prior to and following the start of the mandatory lockdown measures in March 2020 in Quebec, Canada. A relative change in hair cortisol was computed to quantify the physiological stress response. While controlling for sex, age, and psychiatric diagnoses, multilevel linear regressions revealed that alcohol use increased only among people with concomitant high subjective stress and elevated hair cortisol concentrations. Moreover, this increased alcohol use remained elevated one year later. This study documents the importance of simultaneously considering stress biomarkers and subjective stress to identify people at risk of increasing their alcohol use during major stressful life events.

Influences on change in expected and actual health behaviors among first-year university students

ABSTRACT Background First-year students often adopt health risk behaviors during their first semester such as increased consumption of unhealthy food, decreased physical activity, and increased alcohol use. Expectations, social tie's efforts to motivate behavior, and coresidence with parents can influence said behaviors. Aims We assessed how students’ health behaviors and expectations change over the first semester, and how the aforementioned factors influence the maintenance or change of behavior and expectations. Methods A longitudinal survey design was implemented. A total of N = 163 German first-year students (81% female; 18% male; 1% non-binary; M age = 21.20, SD = 2.66) completed online questionnaires, including the NCHRBS and AUDIT, during the Covid-19 pandemic at the beginning (November 2020) and after the end (May 2021) of their first semester. Results Current and expected food consumption and physical activity became healthier over time. The current and expected number of drinks consumed per month increased. Change in expectations for physical activity, number of drinks and binge drinking were predicted by the initial respective behavior. The number of drinks and expected physical activity became unhealthier in relation to reported initial parental influence to drink and to be physically inactive. Moving out of the parental home predicted an increase in current and expected number of drinks and in current and expected binge drinking. These effects of moving out were not mediated by perceived parental or peer influence. Conclusions Interventions should target these behaviors and expectations during the first semester and address parental influence on physical activity and alcohol use.

Increased alcohol use to cope with COVID-19-related anxiety one year into the coronavirus pandemic.

Background: An increase in drinking to cope with anxiety provoked by the coronavirus was observed during the first few months of the COVID-19 pandemic. Objective: In the present study, we examined the role of drinking motives in the anxiety-alcohol link one year into the pandemic. Methods: Using a cross-sectional design, we collected data between April and May 2021: 678 participants located in Romania or the Netherlands completed an online survey on alcohol consumption in the past month (assessed using a simple quantity-frequency measure), change in drinking during the past year (assessed using a single item asking whether there had been an increase, decrease or no change), drinking motives (assessed using the Revised Drinking Motives Questionnaire), drinking-related problems (assessed using the Alcohol Use Disorder Identification Test), and COVID-19-related anxiety (assessed using the Coronavirus Anxiety Scale). Results: Compared to before the pandemic, while 42% of participants had decreased their alcohol consumption, 15% reported an increase. Participants with clinically relevant COVID-19-related anxiety (11%) were more likely to drink to cope with negative affect, enhance positive affect, and conform to others. The association between COVID-19-related anxiety and drinking-related problems was specifically moderated by drinking to cope, such that the anxiety-alcohol link was stronger in participants who endorsed this drinking motive more. Conclusion: Drinking is a maladaptive coping strategy for individuals with high levels of COVID-19-related anxiety. These individuals might benefit from interventions involving the learning of healthier skills to deal with the ongoing pandemic.

Perceived discrimination enhances the association between distress and impact related to the murder of George Floyd and unhealthy alcohol use in a survey sample of U.S. Veterans who report drinking

IntroductionOn May 25, 2020, George Floyd was murdered by a Minneapolis police officer leading to increased social justice and antiracism movements (SJARM) across the United States. Vicarious exposure to racism and perceived discrimination are salient sources of distress which may lead to increased alcohol use as means of coping. The primary aim of the current study was to examine how perceived discrimination and the subjective impact and personal distress related to the SJARM following the George Floyd murder interact and relate to unhealthy alcohol use among U.S. Veterans. Methods286 Veterans were assessed for unhealthy alcohol use (AUDIT-10), perceived discrimination (EDS), and subjective impact and personal distress related to the SJARM. Two moderation analyses were performed to examine whether subjective impact and personal distress moderated relations between perceived discrimination and alcohol use. In-depth follow-up analyses were conducted to examine differences and relationships among variables. ResultsIn two different moderation models, perceived discrimination moderated the association between both subjective impact (p <.001) and personal distress (p <.001) felt by the SJARM and unhealthy alcohol use. In planned exploratory analyses, Veterans who reported perceived discrimination reported higher levels of unhealthy alcohol use (M = 14.71, SD = 9.39) than those who did not t(284) = 5.61, p <.001. In post-hoc analyses, racial/ethnic minorities were significantly more likely to report perceived racial discrimination (p <.001) while non-Hispanic Whites were more likely to report perceived discrimination based on education or income level (p <.01). ConclusionsIn the context of a socially unjust event amidst a global pandemic, perceived discrimination contributes to unhealthy alcohol use and subjective impact and personal distress associated with the SJARM following the murder of George Floyd. Results highlight the importance of addressing discrimination experiences in Veterans who seek alcohol treatment, particularly as rates of unhealthy alcohol use are on the rise.

Alcohol use in self-isolation during the COVID-19 pandemic: a cross-sectional survey in Brazil.

To assess alcohol use and perceived change in alcohol consumption (before and during the pandemic) in Brazilians during the COVID-19 pandemic, their correlates, and their associations with depressive, anxiety and co-occurring depressive and anxiety symptoms (D&A). This is a cross-sectional study comprising 992 individuals in self-isolation. A self-report questionnaire was used to assess whether participants were drinking during self-isolation and whether they changed their drinking behavior (drinking less, more, or no change) from before to during the pandemic. D&A symptoms were assessed using the Beck Depression and Anxiety Inventories (BDI and BAI). A total of 68.5% of participants reported alcohol consumption during the pandemic, and 22.7% of these reported increased alcohol use. Smoking was positively associated with alcohol consumption during the pandemic. Alcohol consumption was associated with anxiety (OR = 1.40, 95%CI 1.06-1.85, p < 0.01) and D&A (OR = 1.38, 95%CI 1.02-1.87, p = 0.033) symptoms. Drinking during self-isolation was prevalent and was associated with risk factors for alcohol use disorders. The long-term effects of high drinking rates and increased consumption should be proactively monitored and assessed.

THE STRUCTURAL AND FUNCTIONAL STATE OF THE PANCREAS AND LIVER IN CHRONIC PANCREATITIS IN COMBINATION WITH CHRONIC VIRAL HEPATITIS C DEPENDING ON THE INDEX OF THE SURVEY ACCORDING TO THE INTERNATIONAL CAGE QUESTIONNAIRE.

The aim: To conduct a comparative analysis of parameters of the structural and functional state of the liver and pancreas in patients with chronic pancreatitis in comorbidity with treated etiologically chronic viral hepatitis C, depending on the results of testing according to the international CAGE questionnaire. Materials and methods: 100 ambulatory patients with CP with concomitant HCV, treated etiotropically, were examined. All patients were examined ac-cording to generally accepted algorithms. To establish the role of alcohol on the formation of CP and the condition of patients with treated HCV, latent craving for alcohol was verified using the international CAGE questionnaire. The study of the density of the liver parenchyma and the liver of the patients was carried out not only according to the ultrasound data in the B-mode, but also with the simultaneous measurement of the shear wave elastography (SWE) method on the Ultima PA scanning ultrasound device with the further determination of the median of the parameters, which characterizes the stiffness in kilopascals (kPa). Determination of the presence and depth of pancreatic exocrine insufficiency (PEI) was carried out by the content of fecal elastase-1 (FE-1), which was determined by the enzyme immunoassay method. Results: Screening-testing of patients with CP on the background of etiotropically treated HCV using the CAGE scale made it possible to state that 65.0% of such patients had a hidden craving for alcohol, and 21.0% of this cohort were women, which needs to be taken into account in the management of such patients. It has been proven that in the group of patients with CAGE≥2.0, the level of functional and structural changes in the liver and liver was significantly more severe (according to the deepening of the PEI, a decrease in fecal α-elastase by 13.01%, according to an increase in the total index of the coprogram by 15.11% and the total US-indicator of the pancreas structure by 28.06%, and the total US-indicator of the liver structure - by 40.68% (p<0.05) and corresponded to the average degree of severity of the process in panceas according to the criteria of the Marseille-Cambridge classification, and in the group with CAGE<2.0 - only a mild degree. Conclusions: The negative effect of the factor of increased alcohol use according to CAGE was proven by increasing the density of the echostructure of the liver by 5.73% (p<0.05), and the liver by 5.16% (p<0.05). According to the results of the correlation analysis of the dependence of the structural state of the liver and PW of the studied patients on the value of the CAGE scale, which was R=0.713, p<0.05, and R=0.686, p<0.05, respectively, it was established that there is a strong direct dependence of the structural state of the liver and PW from the value of the CAGE questionnaire, which proved an independent, reliably significant role of alcohol consumption for patients with a comorbid course of CP and HCV.

Effects of ethanol on mechanical allodynia and dynamic weight bearing in male and female mice with spared nerve injury.

Men and women with chronic pain report increased alcohol use and are more likely to be diagnosed with alcohol use disorder. The relationship between alcohol use and pain is bidirectional. Alcohol is used as an analgesic, but chronic alcohol intake increases pain. Sex differences in the relationship between chronic pain and alcohol are reported in the clinical and preclinical literature, but due to this bidirectional relationship, it is challenging to investigate the mechanisms that contribute to these differences. Thus, animal models of chronic pain are needed to characterize the efficacy of ethanol as an analgesic in males and females. The current experiments tested the hypothesis that ethanol differentially reduces pain behaviors in male and female mice in chronic neuropathic pain. The spared nerve injury (SNI) model was used to investigate the analgesic effects of multiple doses of ethanol (0.5, 1, 2, g/kg i.p.) in male and female mice using von Frey and dynamic weight-bearing (DWB) assays. In both male and female mice, SNI led to robust allodynia and shifts in dynamic weight bearing. In male SNI mice, all three doses of ethanol fully reversed mechanical allodynia and shifts in DWB. In SNI females, only the highest dose (2.0g/kg) was fully antiallodynic in the von Frey assay, while shifts in weight bearing were reversed at the 1.0 and 2.0g/kg doses. The differences between male and females were not due to lower blood ethanol concentrations in female mice. These data indicate that while ethanol has antiallodynic and antinociceptive effects in male and female mice, the doses and time course of these effects are distinct. Studies investigating the relationship between pain and ethanol exposure in mice should consider sex as a key variable. These data also inform reported sex differences in rodent models of chronic pain and in chronic pain patients.

CHRONIC CONDITION DISCORDANCE AND ALCOHOL USE AMONG OLDER COUPLES: THE MODERATING EFFECTS OF MARITAL QUALITY

Abstract Chronic condition discordance (i.e., the extent that two or more conditions have non-overlapping self-management requirements that heighten self-management complexity) may be stressful and contribute to increased alcohol use over time among older adults, especially for those with greater marital stress. In this study, we examined how chronic condition discordance at the individual level (i.e., within individuals) and the couple level (i.e., between spouses) predicted alcohol use across an 8-year period, and whether these links varied by negative marital quality. The U.S. sample included 1,116 wives (M = 54 years) and husbands (M = 57 years) from five waves (2006-2014) of the Health and Retirement Study. Dyadic growth curve models controlled for age, minority status, education, and own and partner time-varying number of chronic health conditions and depressive symptoms. Wives with greater individual-level discordance reported fewer initial drinks per week. Marital quality moderated the links between chronic condition discordance and alcohol use over time. Notably, when husbands reported lower negative marital quality and had greater individual-level chronic condition discordance, they had faster decreases in their own drinks per week over time. By contrast, when husbands reported higher negative marital quality and had greater individual-level discordance, their wives had faster increases in drinks per week over time. Overall, these findings indicate that better quality marriages may protect against increased alcohol use for both wives and husbands in the context of greater chronic condition discordance among husbands.

DOES DEPRESSION IMPROVE DURING RETIREMENT AMONG BINGE DRINKERS?

Abstract Data from the Health and Retirement Study (1992-2016) was used. All non-institutionalized respondents aged 50+ were included in our sample (n=12,618). Mixed models were conducted to study the association between transitioning to retirement and depressive symptoms (CESD) among retirees, and to test the mediation effect of alcohol use. Results: Those retired for at least 6 years had increased probability of binge drinking. Additionally, binge drinking mediated the association between the retirement transition and depressive symptoms, making the effect stronger for those retired for 3 to 5 years (p&amp;lt; 0.05), and weaker and no significant for those retired for 6+ years (p&amp;gt;0.05). Thus, the decrease on depressive symptoms was higher for those retired between 3 to 5 years when being binge drinkers. Discussion and Implications: Addressing depressive symptoms and binge drinking among older adults is sorely needed. Binge drinking was associated with decreased depressive symptoms, consistent with the self-medication hypothesis. Treatment and screening for depression as well as binge drinking are especially important as both are associated with increased mortality. Treating depression would reduce the risk of increased alcohol use and its detrimental effects on health.

Association Between Bariatric Surgery and Alcohol Use–Related Hospitalization and All-Cause Mortality in a Veterans Affairs Cohort

Bariatric surgery procedures, in particular Roux-en-Y gastric bypass (RYGB), have been associated with subsequent alcohol-related complications. However, previous studies lack data to account for changes in body mass index (BMI) or alcohol use over time, which are key potential confounders. To evaluate the association between RYGB, sleeve gastrectomy, or gastric banding on subsequent alcohol use disorder (AUD)-related hospitalization and all-cause mortality as compared with referral to a weight management program alone. This cohort study included 127 Veterans Health Administration health centers in the US. Patients who underwent RYGB, sleeve gastrectomy, or gastric banding or who were referred to MOVE!, a weight management program, and had a BMI (calculated as weight in kilograms divided by height in meters squared) of 30 or greater between January 1, 2008, and December 31, 2021, were included in the study. RYGB, sleeve gastrectomy, or gastric banding or referral to the MOVE! program. The primary outcome was time to AUD-related hospitalization from the time of bariatric surgery or MOVE! referral. The secondary outcome was time to all-cause mortality. Separate propensity scores were created for each pairwise comparison (RYGB vs MOVE! program, RYGB vs sleeve gastrectomy, sleeve gastrectomy vs MOVE!). Sequential Cox regression approaches were used for each pairwise comparison to estimate the relative hazard of the primary outcome in unadjusted, inverse probability treatment weighting (IPTW)-adjusted (generated from the pairwise logistic regression models), and IPTW-adjusted approaches with additional adjustment for time-updating BMI and categorical Alcohol Use Disorders Identification Test-Concise scores. A total of 1854 patients received RYGB (median [IQR] age, 53 [45-60] years; 1294 men [69.8%]), 4211 received sleeve gastrectomy (median [IQR] age, 52 [44-59] years; 2817 men [66.9%]), 265 received gastric banding (median [IQR] age, 55 [46-61] years; 199 men [75.1%]), and 1364 were referred to MOVE! (median [IQR] age, 59 [49-66] years; 1175 men [86.1%]). In IPTW Cox regression analyses accounting for time-updating alcohol use and BMI, RYGB was associated with an increased hazard of AUD-related hospitalization vs MOVE! (hazard ratio [HR], 1.70; 95% CI, 1.20-2.41; P = .003) and vs sleeve gastrectomy (HR, 1.98; 95% CI, 1.55-2.53; P < .001). There was no significant difference between sleeve gastrectomy and MOVE! (HR, 0.76; 95% CI, 0.56-1.03; P = .08). While RYGB was associated with a reduced mortality risk vs MOVE! (HR, 0.63; 95% CI, 0.49-0.81; P < .001), this association was mitigated by increasing alcohol use over time. This cohort study found that RYGB was associated with an increased risk of AUD-related hospitalizations vs both sleeve gastrectomy and the MOVE! program. The mortality benefit associated with RYGB was diminished by increased alcohol use, highlighting the importance of careful patient selection and alcohol-related counseling for patients undergoing this procedure.

COVID-19 Concerns, Perceived Stress, and Increased Alcohol Use Among Adult Women in the United States.

The objective of this study was to assess the direct and indirect (via perceived stress) effects of different types of pandemic-related concerns and increased alcohol use among adult women in the United States (US). We conducted a secondary analysis of cross-sectional survey data from April 2020 for adult females in the US who use alcohol (n = 1,089). The indirect effect model accounted for 19% of the variance in perceived stress and 8% of the variance in reporting increased alcohol use compared to no change or decreased use. Path analysis results indicated that concerns about isolation (odds ratio [OR] = 1.027, 95% confidence interval [CI] = 1.013-1.046), job/finances (OR = 1.025, 95% CI = 1.007-1.065), basic needs (OR = 1.021, 95% CI = 1.008-1.047), and concerns about government (OR = 1.038, 95% CI = 1.014-1.179]) were significantly related to reporting increased alcohol use through perceived stress. These findings can inform timely public health interventions to minimize alcohol-related harm among women.

Association of Recreational Cannabis Legalization With Alcohol Use Among Adults in the US, 2010 to 2019

In the US, cannabis use has nearly doubled during the past decade, in part because states have implemented recreational cannabis laws (RCLs). However, it is unclear how legalization of adult-use cannabis may affect alcohol consumption. To estimate the association between implementation of state RCLs and alcohol use among adults in the US. This was a cross-sectional study of 4.2 million individuals who responded to the Behavioral Risk Factor Surveillance System in 2010 to 2019. A difference-in-differences approach with demographic and policy controls was used to estimate the association between RCLs and alcohol use, overall and by age, sex, race and ethnicity, and educational level. Data analyses were performed from June 2021 to March 2022. States with RCLs, as reported by the RAND-University of Southern California Schaeffer Opioid Policy Tools and Information Center. Past-month alcohol use, binge drinking, and heavy drinking. Of 4.2 million respondents (median age group, 50-64 years; 2 476 984 [51.7%] women; 2 978 467 [58.3%] non-Hispanic White individuals) in 2010 through 2019, 321 921 individuals lived in state-years with recreational cannabis laws. Recreational cannabis laws were associated with a 0.9 percentage point (95% CI, 0.1-1.7; P = .02) increase in any alcohol drinking but were not significantly associated with binge or heavy drinking. Increases in any alcohol use were primarily among younger adults (18-24 years) and men, as well as among non-Hispanic White respondents and those without any college education. A 1.4 percentage point increase (95% CI, 0.4-2.3; P = .006) in binge drinking was also observed among men, although this association diminished over time. This cross-sectional study and difference-in-differences analysis found that recreational cannabis laws in the US may be associated with increased alcohol use, primarily among younger adults and men.