Blood Alcohol Research Articles

ASSESSING THE EFFECTIVENESS OF PROANECY HEPA MILK FOR PREVENTING AN INCREASE OF BLOOD ETHANOL CONCENTRATION

Aims: This study aimed to investigate whether consuming 6ml/kg of Proanecy Hepa milk prior to alcohol consumption could limit the increase in blood alcohol concentration (BAC). Methods: A self-controlled clinical trial with 6 ethanol pharmacokinetic crossover trials was performed. Ten fasting students were divided into six groups, each receiving different substances before consuming 0.5g of ethanol/kg. The substances administered included Pure water, Alcohol antidote, Proanecy Hepa milk, Proanecy Hepa milk without Silymarin, Silymarin, and Liver support milk. BAC was measured at five-time points using gas chromatography: baseline (t0), 60 minutes (t1), 120 minutes (t2), 180 minutes (t3), and 240 minutes (t4) after alcohol intake. iAUC of blood ethanol were presented as median (interquartile range). Results: The group that consumed Proanecy Hepa demonstrated a significantly lower increase in BAC, as indicated by the incremental area under the curve (iAUC) (170.9, 50.5-470.8), compared to the other groups (p< 0.001). The median iAUC for the remaining groups were as follows: pure water 2885.1 (2405.7-3005.3), alcohol antidote 2973.9 (2744.2-3369.5), Proanecy Hepa without Silymarin 2295.9 (1222.5-2569.4), Silymarin 3411.8 (3006.2-3922), and Liver support milk 2739.4 (2431.8-3149.4). Furthermore, individuals who consumed 6ml/kg of Proanecy Hepa before alcohol intake maintained BAC below the positive threshold of 10 mg/dl at all measured time points (60, 120, 180, and 240 minutes). In contrast, individuals in the control groups exceeded the positive threshold at those time points except for minute 240. Conclusions: The study suggests that consuming 6 ml/kg of Proanecy Hepa milk 30 minutes before consuming 0.5g of ethanol/kg can help prevent blood alcohol levels from exceeding the positive threshold of 10 mg/dl.

Change in brain asymmetry reflects level of acute alcohol intoxication and impacts on inhibitory control

Alcohol is one of the most commonly used substances and frequently abused, yet little is known about the neural underpinnings driving variability in inhibitory control performance after ingesting alcohol. This study was a single-blind, placebo-controlled, randomized design with participants (N = 48 healthy, social drinkers) completing three study visits. At each visit participants received one of three alcohol doses; namely, a placebo dose [equivalent Blood Alcohol Concentration (BAC) = 0.00%], a low dose of alcohol (target BAC = 0.04%), or a moderate dose of alcohol (target BAC = 0.08%). To measure inhibitory control, participants completed a Go/No-go task paradigm twice during each study visit, once immediately before dosing and once after, while their brain activity was measured with time-domain functional near-infrared spectroscopy (TD-fNIRS). BAC and subjective effects of alcohol were also assessed. We report decreased behavioral performance for the moderate dose of alcohol, but not the low or placebo doses. We observed right lateralized inhibitory prefrontal activity during go-no-go blocks, consistent with prior literature. Using standard and novel metrics of lateralization, we were able to significantly differentiate between all doses. Lastly, we demonstrate that these metrics are not only related to behavioral performance during inhibitory control, but also provide complementary information to the legal gold standard of intoxication (i.e. BAC).

Blood alcohol concentration as a measure of risk among pedestrian fatalities in the U.S., 2016–2020

Objective In the United States, deaths among pedestrians have increased dramatically since 2009 relative to other vulnerable road users, with substance use described as an important risk factor. This study aimed to explore blood alcohol concentrations (BAC g/dL) among pedestrian fatalities in the United States between 2016 and 2020. Exploring the presence of alcohol among pedestrian cases will support targeted interventions designed to reduce risk. Methods This study utilized pedestrian fatality and alcohol screening data provided by the Fatality Analysis Reporting System (FARS). Logistic models were examined to identify statistical associations (ORs, 95% CI) by age, race, and sex relative to positive BAC exposure (BAC > 0.0 g/dL), mild exposure (BAC > 0.0 < .079 g/dL), moderate to severe alcohol exposure (BAC 0.08–.299 g/dL), and severe exposure (BAC ≥ 0.30 g/dL). Results Between 2016 and 2020, 33,375 pedestrian fatalities were reported to FARS with 75.1% of cases retained for analysis (n = 25,077). Fatalities were more likely to be White (69.3%), male (69.9%), and between 25-64 years of age (67.3%). 74.0% of fatalities were tested for alcohol, with 40.9% screening positive. Females, cases ≥ 75 years of age, and those identified as Asians reported the lowest odds of being positive for alcohol exposure. Conclusions Results suggest an ongoing threat to pedestrians due to alcohol consumption and that exposure odds vary by demographic characteristics. Unfortunately, analytical approaches to understanding the roles played by drugs and alcohol among vulnerable road users tend to be marginalized in the literature. Analytical, evidence-based investigations are needed to curtail the risk of pedestrian fatalities in the U.S.

Evaluation of the Intoxilyzer® 9000 evidential breath alcohol testing instrument

The Alcohol Test Committee (ATC) of the Canadian Society of Forensic Science sets out equipment standards and evaluation procedures for the evaluation of breath testing equipment in Canada. The Intoxilyzer® 9000 was evaluated according to the 2014 Equipment Standards and Evaluation Procedures with results demonstrating that the instrument met, or exceeded, the requirements of the ATC on all criteria including accuracy, linearity, precision, and acetone interference. Human subject testing provided a comparison of blood alcohol concentrations (BACs) determined by the Intoxilyzer® 9000 with near-simultaneous breath test results from an Intoxilyzer® 8000C, an Approved Instrument in Canada since 2007. The results of 50 paired breath samples on 10 drinking subjects were well-correlated (R2 = 0.966) and described by a linear model, y = 0.95x + 0.84. The validation of the Intoxilyzer® 9000 according to the standards of the ATC demonstrates the instrument to be an accurate and reliable means of determining breath alcohol concentrations over a range of forensically relevant BACs. The Intoxilyzer® 9000 was added to the Approved Breath Analysis Instruments Order in 2019 identifying it as suitable for the purposes of Section 320.14 of the Criminal Code of Canada.

The effects of depressed mood and 0.05 % blood alcohol concentration on risky driving in males

Males are more likely than females to use alcohol as a maladaptive coping mechanism to alleviate symptoms of depressed mood. The effects of a combination of subclinical depressed mood and doses of alcohol below the per se legal threshold of 0.08 % blood alcohol concentration (BAC) on risky driving are unclear, however. This manuscript presents a quasi-experimental, between-subjects study testing the influence of combined subclinical depressed mood and 0.05 % BAC on risky driving in a simulator and the mediation of decision-making. Following assessment of depressed mood (Beck Depression Inventory-II), a double-blinded protocol was used to randomise participants and administer either an alcohol (0.05 % BAC) or a placebo (0.00 % BAC) beverage. The Iowa Gambling Task tested decision-making and participants indicated whether they would decide to drive in the simulator. Driving simulation measured risky driving in real-time. Participants were healthy male drivers (n = 57; age M = 38.2, SD = 7.5). Using ANOVA, there were non-significant group differences in risky driving. Logistic regression revealed non-significant effects between groups in predicting the decision to drive. Mediation regression was used to explore the underlying mechanisms of decision-making on the prediction of risky driving under depressed mood. However, decision-making under risk was only identified as a significant predictor of mean merge acceleration on the highway. In addition to the limited sample size, outcomes were likely impacted by the mediation of emotion regulation. As this research area remains promising, recommendations are highlighted. One of them includes the use of a measure of depressed mood that is more sensitive to externalising behavioural symptoms in males.

Safety assessment of herbal food supplements: Ethanol and residual solvents associated risk

Availability of herbal food supplements and belief in their efficacy and safety contributed to their increased use, causing exposure to ethanol and residues of extraction solvents. Liquid herbal food supplements (103) were purchased from pharmacies (Novi Sad, Serbia) during 2021, and analysed for presence of ethanol and selected residual solvents using HSS-GC-MS method. Ethanol was not quantified in only one of 18 products for infants or toddlers less than two years old. WHO proposed requirement for ethanol content in products intended for children less than 6 years old (<0.5%) was not met by 26 samples, in products for children 6–12 years (<5%) by four samples and in products for children over 12 years (<10%) by two samples. Calculated blood alcohol concentrations exceeded the relevant toxicological levels for 37 samples following a single dose, and for 31 samples in case of accidental poisoning (entire package). Methanol was quantified in 38 samples, in one of them above the limit of 0.05%, (Ph. Eur. 9), causing exceedance of permitted daily exposure. Other residual solvents were quantified rarely and in low concentrations. Study findings confirmed a need for raising awareness of professionals and public and establishment of strict guidelines for ethanol content and labelling.

No difference in COVID-19 treatment outcomes among current methamphetamine, cannabis and alcohol users

BackgroundPoor outcomes of COVID-19 have been reported in older males with medical comorbidities including substance use disorder. However, it is unknown whether there is a difference in COVID-19 treatment outcomes between patients who are current cannabis users, excessive alcohol drinkers and those who use a known hazardous stimulant such as methamphetamine (METH).MethodsElectronic medical records (EMR) of COVID-19 patients with current METH (n = 32), cannabis (n = 46), and heavy alcohol use (n = 44) were reviewed. COVID-19 infection was confirmed by positive SARS-CoV-2 PCR test, current drug use was confirmed by positive urine drug testing, and alcohol use was identified by a blood alcohol concentration greater than 11 mg/dl.Multivariate linear regression models as well as the firth logistic regression models were used to examine the effect of substance use group (METH, cannabis, or alcohol) on treatment outcome measures.ResultsA total of 122 patients were included in this analysis. There were no significant differences found between drug groups in regards to key SARS-CoV-2 outcomes of interest including ICU admission, length of stay, interval between SARS-CoV-2 positive test and hospital discharge, delirium, intubation and mortality after adjusting for covariates. About one-fifth (21.9% in METH users, 15.2% in cannabis users, and 20.5% in alcohol users) of all patients required ICU admission. As many as 37.5% of METH users, 23.9% of cannabis users, and 29.5% of alcohol users developed delirium (P = 0.4). There were no significant differences between drug groups in COVID-19 specific medication requirements. Eight patients in total died within 10 months of positive SARS-CoV-2 PCR test. Two patients from the METH group (6.3%), two patients from the cannabis group (4.3%), and four patients from the alcohol group (9.1%) died.DiscussionThe study outcomes may have been affected by several limitations. These included the methodology of its retrospective design, relatively small sample size, and the absence of a COVID-19 negative control group. In addition, there was no quantification of substance use and many covariates relied on clinical documentation or patient self-report. Finally, it was difficult to control for all potential confounders particularly given the small sample size.ConclusionDespite these limitations, our results show that current METH, cannabis, and heavy alcohol users in this study have similar treatment outcomes and suffer from high morbidity including in-hospital delirium and high mortality rates within the first-year post COVID-19. The extent to which co-morbid tobacco smoking contributed to the negative outcomes in METH, cannabis, and alcohol users remains to be investigated.

Prior experience with flavored alcohol increases preference for flavored alcohol but flavor does not influence binge-like drinking behavior in mice

BackgroundBinge drinking can lead to various negative consequences and in non-experimental settings, alcohol usually contains flavoring, which may promote increased binge drinking. Preclinical models of binge-like drinking have been well established, however, the influence of flavor on alcohol preference and binge-like drinking has not been fully explored. MethodsMale and female C57BL/6 J mice were tested via two-bottle choice with alcohol flavored with different concentrations of unsweetened Cherry flavor Kool-Aid and water. Next, mice were tested for preference for flavored alcohol over plain alcohol. Consumption of flavored alcohol versus water was examined over 48 h. Binge-like drinking with flavored alcohol was validated via drinking in the dark (DID). A separate cohort of mice underwent chronic DID for 6 weeks with either flavored or plain alcohol. After chronic DID, mice were then tested for preference for flavored versus plain alcohol and then alcohol consumption despite adverse effects was examined using the quinine adulteration test. ResultsThe 0.1% Kool-Aid concentration was chosen to use for further testing based on intake. Mice preferred Kool-Aid flavored alcohol over plain alcohol after the concentration test, but mice with no prior exposure to plain or flavored alcohol preferred plain over flavored alcohol. Throughout all initial testing, female mice showed increased alcohol intake compared to male mice. Both male and female mice showed binge-like drinking of flavored alcohol, with females having higher intake and blood alcohol levels. Kool-Aid flavor did not increase alcohol intake during chronic binge-like drinking. Previous exposure to flavored alcohol during DID increased the preference for flavored alcohol over plain alcohol but did not influence alcohol consumption despite adverse effects. ConclusionThe present study indicates that prior experience with flavored alcohol increases preference and intake, suggesting an effect of learned safety from neophobia. However, flavor does not impact binge-like alcohol consumption or alcohol drinking despite negative consequences. Additionally, the current study shows that female mice will consume more flavored alcohol than males, similar to findings from other alcohol studies.

The impact of alcohol consumption on commercial eye blink drowsiness detection technology.

Driver drowsiness detection technology that assesses eye blinks is increasingly being used as a safety intervention in the transport industry. It is unclear how alcohol consumption to common legal driving limits impacts upon this technology. The aim of the study was to assess the impact of a blood alcohol content (BAC) of 0.05% and of 0.08% on drowsiness detection technology during simulated driving. Participants completed a 60-min driving simulation and sleepiness questionnaire under three conditions: 1-0.00% BAC, 2-0.05% BAC and 3-0.08% BAC. During the driving simulation task participants wore a commercial eye blink drowsiness detection technology (Optalert) with the drowsiness alarms silenced. Twelve participants (3 female) completed all alcohol conditions. Relative to baseline, all eye blink parameters were affected at 0.08% BAC (all p<0.05), whereas 0.05% BAC only affected the composite eye blink drowsiness measure (the Johns Drowsiness Scale). Alcohol consumption to 0.08% BAC impaired eye blink measures to a level that would be considered a moderate drowsiness risk. Therefore, employers should be aware that drowsiness alerts from these technologies may increase after alcohol consumption.

DrunkChain: Blockchain-Based IoT System for Preventing Drunk Driving-Related Traffic Accidents

Traffic accidents present significant risks to human life, leading to a high number of fatalities and injuries. According to the World Health Organization’s 2022 worldwide status report on road safety, there were 27,582 deaths linked to traffic-related events, including 4448 fatalities at the collision scenes. Drunk driving is one of the leading causes contributing to the rising count of deadly accidents. Current methods to assess driver alcohol consumption are vulnerable to network risks, such as data corruption, identity theft, and man-in-the-middle attacks. In addition, these systems are subject to security restrictions that have been largely overlooked in earlier research focused on driver information. This study intends to develop a platform that combines the Internet of Things (IoT) with blockchain technology in order to address these concerns and improve the security of user data. In this work, we present a device- and blockchain-based dashboard solution for a centralized police monitoring account. The equipment is responsible for determining the driver’s impairment level by monitoring the driver’s blood alcohol concentration (BAC) and the stability of the vehicle. At predetermined times, integrated blockchain transactions are executed, transmitting data straight to the central police account. This eliminates the need for a central server, ensuring the immutability of data and the existence of blockchain transactions that are independent of any central authority. Our system delivers scalability, compatibility, and faster execution times by adopting this approach. Through comparative research, we have identified a significant increase in the need for security measures in relevant scenarios, highlighting the importance of our suggested model.

Investigating blood alcohol concentrations in injury-related deaths before and during the COVID-19 National lockdown in Western Cape, South Africa: A cross-sectional retrospective review.

Alcohol is a significant contributor to injury-related morbidity and mortality in South Africa (SA). During the COVID-19 global pandemic, restrictions to movement and to the legal access of alcohol* were introduced in SA. This study aimed to investigate the effect of alcohol bans during the COVID-19 lockdown periods on injury-related mortality and the blood alcohol concentrations (BAC) in these deaths. A retrospective, cross-sectional analysis of injury-related deaths in Western Cape (WC) province, SA, between 1 January 2019 to 31 December 2020 was conducted. Cases where BAC testing was performed were further examined according to the periods of lockdown (AL5-1) and alcohol restrictions. A total of 16,027 injury-related cases were admitted to Forensic Pathology Service mortuaries in the WC over the two-year period. An average decrease of 15.7% injury-related deaths in 2020 compared to 2019 was noted, as well as a 47.7% decrease in injury-related deaths during hard lockdown (April -May 2020) compared to the same period in 2019. In the injury-related deaths, 12,077 (75.4%) had blood specimens collected for BAC testing. In 5,078 (42.0%) of submitted cases, a positive BAC (≥0.01g/100 mL) was reported. No significant difference was observed in the mean positive BAC between 2019 and 2020, however in April and May 2020, the mean BACs observed (0.13 g/100 mL) was less than that in 2019 (0.18 g/100 mL). A high number of positive BACs in the 12-17-year age group (±23.4%) was observed. There was a clear decrease in injury-related deaths in the WC during the COVID-19-related lockdown periods that coincided with the alcohol ban and restriction of movement and an increase following relaxation of restrictions on alcohol sales and movement. The data illustrated that mean BACs were similar between all periods of alcohol restriction compared to 2019, apart from hard lockdown in April-May, 2020. This coincided with a smaller mortuary intake during the level 5 and 4 lockdown periods. Keywords: Alcohol; blood alcohol concentration; COVID-19; injury; lockdown; South Africa; violent death; Western Cape * Alcohol refers to ethanol.

Does Alcohol Use Influence Hospitalization Outcomes in Adults Suffering Craniomaxillofacial Fractures From Street Fighting?

This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes. To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes. The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars). Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges (P < .01). Non-elective admissions added $14210 in hospital charges (P < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges (P < .01). Le Fort fractures (+$61921; P < .01), mandible fractures (+$13227, P < .01), and skull base fractures (+$22170; P < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6days to the hospital stay (P < .01) and each additional year in patient age added +.1days to the length of the hospital stay (P < .01). BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.

Audio-based Deep Learning Algorithm to Identify Alcohol Inebriation (ADLAIA).

Acute alcohol intoxication impairs cognitive and psychomotor abilities leading to various public health hazards such as road traffic accidents and alcohol-related violence. Intoxicated individuals are usually identified by measuring their blood alcohol concentration (BAC) using breathalysers that are expensive and labour-intensive. In this paper, we developed the Audio-based Deep Learning Algorithm to Identify Alcohol Inebriation (ADLAIA) that can instantly predict an individual's intoxication status based on a 12-second recording of their speech. ADLAIA was trained on a publicly available German Alcohol Language Corpus that comprises a total of 12,360 audio clips of inebriated and sober speakers (total of 162, aged 21-64, 47.7% female). ADLAIA's performance was determined by computing the unweighted average recall (UAR) and accuracy of inebriation prediction. ADLAIA was able to identify inebriated speakers-with BAC of 0.05% or higher-with an UAR of 68.09% and accuracy of 67.67%. ADLAIA had a higher performance (UAR of 75.7%) in identifying intoxicated speakers (BAC > 0.12%). Being able to identify intoxicated individuals solely based on their speech, ADLAIA could be integrated in mobile applications and used in environments (such as bars, sports stadiums) to get instantaneous results about inebriation status of individuals.

Predictors of Hangover Frequency and Severity: The Impact of Alcohol Consumption, Mental Resilience, Personality, Lifestyle, Coping and Mood.

Mental resilience is the ability to bounce back from daily life stressors such as divorce or losing a job. Extensive research has demonstrated a negative relationship between mental resilience and alcohol consumption. That is, both the quantity and frequency of alcohol consumption are greater in individuals with lower levels of mental resilience. There has, however, been little scientific attention paid to the relationship between mental resilience and alcohol hangover severity. The objective of this study was to evaluate psychological factors that may impact the frequency and severity of alcohol hangovers, including alcohol intake itself, mental resilience, personality, baseline mood, lifestyle, and coping mechanisms. An online survey was conducted among Dutch adults (N = 153) who had a hangover after their heaviest drinking occasion in the period before the start of the COVID-19 pandemic (15 January to 14 March 2020). Questions were asked about their alcohol consumption and hangover severity on their heaviest drinking occasion. Mental resilience was assessed with the Brief Mental Resilience scale, personality with the Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RSS), mood via single item assessments, and lifestyle and coping with the modified Fantastic Lifestyle Checklist. The partial correlation, corrected for estimated peak blood alcohol concentration (BAC), between mental resilience and hangover severity was not significant (r = 0.010, p = 0.848). Furthermore, no significant correlations were found between hangover severity or frequency and personality and baseline mood. For lifestyle and coping factors, a negative correlation was found between the use of tobacco and toxins (i.e., drugs, medicines, caffeine) and the frequency of experiencing hangovers. Regression analysis revealed that hangover severity after the heaviest drinking occasion (31.2%) was the best predictor of hangover frequency, and that subjective intoxication on the heaviest drinking occasion (38.4%) was the best predictor of next-day hangover severity. Mood, mental resilience, and personality were not relevant predictors of hangover frequency and severity. In conclusion, mental resilience, personality, and baseline mood do not predict hangover frequency and severity.

저체온사 진단을 위한 사후 진단마커 연구

Since the diagnosis of death due to hypothermia is pathologically non-specific and the macroscopic findings are sometimes uncertain, a biochemical diagnostic analysis method for the precision of the diagnosis of hypothermia is required. Although general hypothermic death was diagnosed as an increase in ketone body concentration, as a result of statistical analysis of the correlation between hypothermic death and ketone body concentration assessed by the National Forensic Service in recent years, the ketone body concentration of hypothermic death in the case of not drinking or drinking a little is higher than the general death rate, in the case of death due to hypothermia after drinking a large amount of alcohol, the ketone body concentration showed a tendency to be inversely proportional to the blood alcohol concentration. Therefore, there is a need for a new biochemical diagnostic marker that can replace the ketone body concentration analysis in the diagnosis of death due to hypothermia. In this study, about 30 cases of hypothermic death and 76 cases of general death control were selected. Concentration changes of biochemical diagnostic indicators such as glucose, acetone, β-hydroxybutyrate, free fatty acids, and electrolyte ions were analyzed using ion chromatography (IC) and gas chromatography-mass spectrometry (GC-MS). As a result, it showed the specificity of increasing or decreasing the concentration of electrolytes ion and free fatty acids as biochemical diagnostic markers according to changes in the body at the time of death due to hypothermia.

0655 Whose Mind after Midnight? Demographic and Clinical Variation in Nocturnal Suicide Risk

Abstract Introduction Although suicides are more prevalent during the day, the risk of suicide is highest at night when adjusted for population wakefulness. It is unclear how nighttime patterns of suicide risk vary by demographic and clinical subgroups. Methods Population wakefulness data were combined with time of fatal injury data for 78,647 suicides from 2003-2017. The primary outcome was number of suicides per hour with wakefulness as an offset/exposure term. Subgroups included sex, race, ethnicity, military service, blood alcohol category and marijuana positive on autopsy, current depressed mood or partner conflict, and prior suicidal ideation or suicide attempts. Formal interaction tests identified significant subgroup variations adjusted for age, sex, race, and ethnicity where appropriate. Groups with significant interactions were subsequently examined using robust Poisson regression models to measure incident risk ratios (IRRs). Results There were subgroup interactions for age (p &amp;lt; 0.001), ethnicity (p = 0.014), blood alcohol level on autopsy (p &amp;lt; 0.001), and current partner conflict at time of fatal injury (p &amp;lt; 0.001). There was a sharp peak in risk around 4AM for individuals aged 15 to 24 (aIRR: 3.11 [2.39, 4.05]) and 25-34 (aIRR 2.15 [1.63, 2.86]), and at 6AM for individuals aged 65 to 74 (aIRR: 1.78 [1.40, 2.25]) and 75+ (aIRR: 2.25 [1.69, 3.00]). Hispanic individuals had an elevated risk between 10PM and 3AM with a maximal 232% increase at 2am (aIRR: 2.32 [1.67, 3.23]). Current partner conflict increased risk from 8PM to11PM and from 1AM to 3AM with a peak risk at 11PM (aIRR: 1.53 [1.24, 1.89]). Individuals with a BAL &amp;lt; 0.08 mg/dL showed a sustained increased risk for suicide between 8PM and 4AM; individuals with a BAL of 0.08 mg/dL or more showed greater risk (aIRR 2.33 [1.88, 2.89] at 1AM) than those with a BAL &amp;lt; 0.08 mg/dL (aIRR: 1.68 [1.40, 2.01] at 12AM). Conclusion Nighttime suicide risk varied significantly by age, ethnicity, blood alcohol level on autopsy, and current partner conflict. Military service was not associated with greater nighttime risk, which contrasts with prior findings. Support (if any)

Impact of Alcohol and Methamphetamine Use on Burn Resuscitation.

Mortality associated with burn injuries is declining with improved critical care. However, patients admitted with concurrent substance use have increased risk of complications and poor outcomes. The impact of alcohol and methamphetamine use on acute burn resuscitation has been described in single-center studies; however, has not been studied since implementation of computerized decision support for resuscitation. Patients were evaluated based presence of alcohol, with a minimum blood alcohol level of 0.10, or positive methamphetamines on urine drug screen. Fluid volumes and urine output were examined over 48 hours. A total of 296 patients were analyzed. 37 (12.5%) were positive for methamphetamine use, 50 (16.9%) were positive for alcohol use, and 209 (70.1%) with negative for both. Patients positive for methamphetamine received a mean of 5.30 ± 2.63 cc/kg/TBSA, patients positive for alcohol received a mean of 5.41 ± 2.49 cc/kg/TBSA, and patients with neither received a mean of 4.33 ± 1.79 cc/kg/TBSA. Patients with methamphetamine or alcohol use had significantly higher fluid requirements. In the first 6 hours patients with alcohol use had significantly higher urinary output (UO) in comparison to patients with methamphetamine use which had similar output to patients negative for both substances. This study demonstrated that patients with alcohol and methamphetamine use had statistically significantly greater fluid resuscitation requirements compared to patients without. The effects of alcohol as a diuretic align with previous literature. However, patients with methamphetamine lack the increased UO as a cause for their increased fluid requirements.

Alcohol and Drug Consumption among Drivers before and during the COVID-19 Pandemic: An Observational Study

Restrictions imposed during the COVID-19 pandemic might have changed recreational habits. In this study, the results of toxicological tests for alcohol and drugs in blood were compared among drivers stopped at roadside checks in the periods before (1 January 2018 to 8 March 2020) and after the lockdown measures (9 March 2020 to 31 December 2021). A total of 123 (20.7%) subjects had a blood alcohol level above the legal limit for driving of 0.5 g/l, 21 (3.9%) subjects tested positive for cocaine, and 29 (5.4%) subjects positive for cannabis. In the COVID-19 period, the mean blood alcohol level was significantly higher than in the previous period. Cannabis use, which was more frequent among younger subjects, was statistically associated with cocaine use. There has also been a quantitative increase in alcohol levels in the population with values above the legal limits, indicative of greater use of alcohol in the population predisposed to its intake.

The New Hampshire Hospital Screening and Referral Algorithm (NHHSRA) for Substance Use in People With Serious Mental Illness

Objective: Substance use is a common co-occurrence among psychiatrically hospitalized adults, yet it is especially difficult to identify in those with serious mental illness. Existing screening instruments are not feasible for individuals with serious mental illness, as they rely heavily on subjective self-report. This study aimed to develop and validate an objective substance use screening instrument for use in seriously mentally ill patient populations.Methods: Objective elements were extracted from existing substance use screening instruments and used to develop a new, data-driven referral tool, the New Hampshire Hospital screening and referral algorithm (NHHSRA). Descriptive statistics were employed to compare NHHSRA summed score and individual patient data elements in a convenience sample of patients who were referred to the Addiction Services by expert addiction psychiatrist evaluation to those who were not referred. Pearson correlation coefficients and logistic regression models assessed the association between patient referral and the overall NHHSRA score and individual items. The NHHSRA was then piloted in a smaller convenience sample of patients against the standard clinical-based identification for substance use treatment needs.Results: The instrument consists of 5 objective items. These were tested in a sample of 302 sequentially admitted adults with serious mental illness. Three of the items were significantly associated with likelihood of benefitting from referral for substance use interventions (maximum likelihood estimate and standard deviation [SD] for positive non-tetrahydrocannabinol [non-THC] toxicology screen or > 0% blood alcohol level = 3.61 [0.6]; diagnosis of a substance use disorder = 4.89 [0.73]; and medication-assisted treatment or relapse prevention = 2.78 [0.67]), and these were prioritized in building a decision tree algorithm. The area under the receiver operating characteristic (ROC) curve for the NHHSRA was 0.96, indicating that the NHHSRA has high overall sensitivity and the algorithm was capable of distinguishing between patients needing substance use intervention versus those who do not with 96% accuracy. In the pilot implementation study of another 20 patient admissions, the NHHSRA accurately identified 100% (n = 6) of patients deemed to benefit from substance use interventions by expert addiction psychiatric evaluation. The standard clinical-based referral process identified only 33% (n = 2) and erroneously identified another 4 for referral to substance use intervention that would not have been warranted.Conclusions: The NHHSRA holds promise in its ability to improve objective and timely identification of substance use in a seriously mentally ill inpatient population, helping to facilitate treatment.

Acute and Chronic Ethanol Effects during Adolescence on Neuroimmune Responses: Consequences and Potential Pharmacologic Interventions.

Heavy ethanol consumption during adolescence has been linked to neuroimmune response dysregulation and cognitive deficits in the developing adolescent brain. During adolescence, the brain is particularly susceptible to the pharmacological effects of ethanol that are induced by acute and chronic bouts of exposure. Numerous preclinical rodent model studies have used different ethanol administration techniques, such as intragastric gavage, self-administration, vapor, intraperitoneal, and free access, and while most models indicated proinflammatory neuroimmune responses in the adolescent brain, there are various factors that appear to influence this observation. This review synthesizes the most recent findings of the effects of adolescent alcohol use on toll-like receptors, cytokines, and chemokines, as well as the activation of astrocytes and microglia with an emphasis on differences associated with the duration of ethanol exposure (acute vs. chronic), the amount of exposure (e.g., dose or blood ethanol concentrations), sex differences, and the timing of the neuroimmune observation (immediate vs. persistent). Finally, this review discusses new therapeutics and interventions that may ameliorate the dysregulation of neuroimmune maladaptations after ethanol exposure.