Lifetime Drinking Research Articles

Drinking patterns, dependency and life‐time drinking history in alcohol‐related liver disease

To examine the hypothesis that increases in UK liver deaths are a result of episodic or binge drinking as opposed to regular harmful drinking. A prospective survey of consecutive in-patients and out-patients. The liver unit of a teaching hospital in the South of England. A total of 234 consecutive in-patients and out-patients between October 2007 and March 2008. Face-to-face interviews, Alcohol Use Disorders Identification Test, 7-day drinking diary, Severity of Alcohol Dependence Questionnaire, Lifetime Drinking History and liver assessment. Of the 234 subjects, 106 had alcohol as a major contributing factor (alcoholic liver disease: ALD), 80 of whom had evidence of cirrhosis or progressive fibrosis. Of these subjects, 57 (71%) drank on a daily basis; only 10 subjects (13%) drank on fewer than 4 days of the week--of these, five had stopped drinking recently and four had cut down. In ALD patients two life-time drinking patterns accounted for 82% of subjects, increasing from youth (51%), and a variable drinking pattern (31%). ALD patients had significantly more drinking days and units/drinking day than non-ALD patients from the age of 20 years onwards. Increases in UK liver deaths are a result of daily or near-daily heavy drinking, not episodic or binge drinking, and this regular drinking pattern is often discernable at an early age.

Validity of the Lifetime Drinking History: A Comparison of Retrospective and Prospective Quantity-Frequency Measures

The Lifetime Drinking History (LDH) has been used to examine alcohol use throughout the life span. Given its retrospective nature, it is important to examine the validity of the assessment. Building on previous work establishing the reliability and validity of the LDH, the current study examined a sample of 1,295 men in the Vietnam Era Twin Registry. The men were assessed retrospectively with the LDH in 2000, at an average age of 51. The drinking patterns of these same men were also assessed prospectively in four prior studies, taking place in 1987, 1990, 1992, and 1995. Validity of the LDH was examined by comparing the correspondence between the prospective and retrospective quantity-frequency measures and reported age at first regular drinking. Correlations between the retrospective and prospective assessments were high for age at first regular drinking (.42-.58) and quantity-frequency measures (.47-.69), although some mean differences in the amount of consumption existed. Results support the use of the LDH in reporting phases of drinking across the life span.

School‐based alcohol education: results of a cluster‐randomized controlled trial

This study aimed to examine the effects of a school-based alcohol education intervention. Two-arm three-wave cluster-randomized controlled trial, with schools as the unit for randomization. Surveys were conducted prior to intervention implementation, then 4 and 12 months after baseline. A total of 30 public schools in Schleswig-Holstein, Germany. Participants Baseline data were obtained from 1686 7th graders. The retention rate was 85% over 12 months. Intervention The intervention consisted of four interactive lessons conducted by teachers, booklets for students and booklets for parents. Knowledge, attitudes, life-time alcohol consumption (ever use alcohol without parental knowledge, ever been drunk and ever binge drinking) and past-month alcohol use. Intention-to-treat analyses revealed that intervention status was associated with more general knowledge about alcohol and lower levels of life-time binge drinking. No effects were found with respect to students' self-reported attitudes, intentions to drink, life-time alcohol use and past-month alcohol use. The results indicate that this brief school-based intervention had a small short-term preventive effect on alcohol misuse.

Dimensionality of lifetime alcohol abuse, dependence and binge drinking

Questions relevant to DSM-V alcohol use disorders (AUD) include whether dimensional measures provide more information than categorical diagnoses, whether to combine abuse and dependence criteria, and whether to add a new diagnostic criterion, binge drinking. Binary and dimensional models of three versions of AUD criteria were investigated: (1) dependence criteria; (2) abuse and dependence criteria combined; and (3) abuse and dependence criteria combined with a binge drinking criterion added. In a national sample of lifetime drinkers ( N = 27,324), these models of AUD criteria were investigated in relation to two well-established risk factors for AUD, family history and early drinking onset. Logistic or Poisson regression modeled the relationships between the validating variables and dependence in categorical, dimensional and hybrid forms; Wald tests were used to assess differences between the dimensional, categorical and hybrid models. Alcohol dependence criteria represented a single continuum (family history Wald = 9.93, p = 0.13; early drinking Wald = 7.62, p = 0.27) with no support for a categorical or hybrid version of alcohol dependence. Adding four abuse criteria produced similar results for family history (Wald = 15.4, p = 0.12) although with early drinking, this model showed a trend towards deviating from the data (Wald = 16.7, p = 0.08). No support was found for any diagnostic threshold at 3, 4, 5, 6, or 7 criteria when abuse and dependence were combined. Adding binge drinking resulted in a significant departure from linearity for family history (Wald = 21.8, p = 0.03) and early drinking (Wald = 23.9, p = 0.01). The number of alcohol dependence and abuse criteria met should be explored further as a useful AUD severity indicator or phenotype.

The Effect of Alcohol Intake on Cardiovascular Disease and Mortality Disappeared After Taking Lifetime Drinking and Covariates Into Account

Current alcohol intake has been associated with cardiovascular morbidity and mortality. The effect of past and lifetime drinking has received less attention. In the present study, the impact of current, past and lifetime drinking on cardiovascular events and all-cause mortality has been assessed. Secondly, the effect of accounting for covariates within these relationships has been studied. The Lifestyle and Health study is a prospective cohort study in 2 regions of the Netherlands. Men and women aged 45 to 70 years registered in 34 general practices were followed over the period July 1996 to June 2001. At baseline, an extensive questionnaire had to be filled in. It included 3 questionnaires about alcohol intake: a Weekly Recall, a Quantity-Frequency about last year, and the Lifetime Drinking History questionnaire. Health problems were registered by the general practitioners. During follow-up, 679 men and 397 women had a cardiovascular event and 330 men and 204 women died. Current drinking was associated with lower risks of cardiovascular events (women) and all-cause mortality (men and women) compared with never drinkers. The relationships were strongest for alcohol intake measured with the Weekly Recall. Lifetime alcohol intake and alcohol intake in the distant past did not seem to be related to all-cause mortality or cardiovascular events. Adjustments for covariates weakened the relationships. Potential positive effects of drinking seem to be of a transient nature, as lifetime drinking and drinking in the past could not be related to all-cause mortality or cardiovascular events. The alleged benefits of current drinking at baseline diminished with increasing methodological quality and rigor.

Different drinking patterns for women and men with alcohol dependence with and without alcoholic cirrhosis

The aim of our study was to investigate if there were differences in drinking patterns in patients with alcohol dependence (AD), with or without cirrhosis. We examined three groups in regard to differences in drinking patterns. We collected information from 50 patients with alcoholic cirrhosis (AC), 50 patients with AD, and 40 patients with non-alcoholic cirrhosis (NAC). We used the structured interview Lifetime Drinking History (LDH) to measure the alcohol consumed. Information regarding the total lifetime alcohol intake (LAI), drinking days (DD), drinks per drinking day (DDD), their beverage preferences, and their binge consumption was collected during interviews. Women drank less than men. Women with AC reported 9,198 drinks as binge drinking compared to 25,890 drinks for women with AD without liver cirrhosis (P < 0.05), Women with AC reported 14,009 drinks of alcohol consumed during their lifetime compared to 45,658 drinks consumed by men with AC (P < 0.0001). Women with AD had drunk 5.8 DDD, and men had 8.5 DDD (P < 0.05). Both women and men with AC had significantly fewer DDD compared to men and women with AD without cirrhosis, 4.4 drinks for women (P = 0.046) and 6.2 for men (P = 0.048) with AC. Patients with AC seem to be predisposed to the hepatotoxic effects of alcohol- and the affected women seem to be even more sensitized. Binge drinking, rather than continuous drinking, does not seem to be especially associated with the development of cirrhosis. That women had drunk less alcohol during binge drinking further emphasizes this.

Can serotonin transporter genotype predict serotonergic function, chronicity, and severity of drinking?

Serotonin transporter (5-HTT) activity is greater in carriers of the long (L) vs. short (S) alleles of the 5-HTT-linked polymorphic region (5′-HTTLPR) among healthy control subjects but not alcohol-dependent adults. In 198 alcoholics, we determined the relationship between current or lifetime drinking and platelet 5-HTT function and density among allelic variants of the 5′-HTTLPR. SS subjects were younger than L-carriers (LL and LS) ( p < 0.0085) and had fewer years of lifetime drinking. For L-carriers, the mean of B max for paroxetine binding, but not V max for serotonin (5-HT) uptake, was lower than that for SS subjects ( p < 0.05). More L-carriers than their SS counterparts had V max for 5-HT uptake below 200 nmol/10 7 platelets-min ( p < 0.05) and B max for paroxetine binding below 600 nmol/mg protein ( p < 0.06). Current drinking (drinks per day during the past 14 days) correlated positively with K m and V max of platelet 5-HT uptake ( p < 0.05) and negatively with B max, but not K d, of paroxetine binding ( p < 0.05) for L-carriers alone. Years of lifetime drinking correlated negatively with K m and V max of platelet 5-HT uptake ( p < 0.05) and B max, but not K d, of paroxetine binding ( p < 0.05) for L-carriers alone. Among L-carriers alone, there were higher levels of platelet 5-HT uptake and lower levels of platelet paroxetine binding with increased drinking, and more lifetime drinking was associated with modestly lower levels of 5-HT uptake and paroxetine binding. Thus, 5-HTT expression varies with current and lifetime drinking in L-carriers alone.

Effects of chronic drinking on verb generation: an event related potential study

In alcohol dependent individuals, abnormalities in brain functioning have been revealed using event-related potential (ERP) methods. In the present study, we investigated whether in non-alcohol dependent drinkers functioning of the brain is also compromised as a function of recent and lifetime drinking history (LDH). An ERP verb generation task consisting of two conditions (generating verbs describing the use of visually presented nouns versus reading nouns aloud) was used; subtracting ERPs in the latter condition from those in the former should reveal the sequence of brain processes involved in verb generation. Four groups were included, consisting of individuals drinking either lightly, moderately, heavily, or excessively (overall mean age 46.6 years). Participants were sober at the time of testing. Although the excessive group had the highest per cent retrieval errors, there was no continuous relationship between this score and amount of alcohol consumption. However, number of glasses per week affected differential ERPs associated with verb generation both at short (120-220 ms, mid-frontal sites) and at longer latencies (from 700 ms on),left-temporal and right-frontal electrode sites (T7, F6). It is concluded that moderate, heavy, and excessive drinkers, compared to light drinkers, show abnormal brain potentials associated with verb generation over frontal and temporal areas. Moderate to excessive drinking alters some but not all brain processes involved in verb generation. In particular the frontal and temporal brain areas appear to be vulnerable for the effects of chronic lifetime drinking.

Nigeria: alcohol and society today

Nigeria: alcohol and society today

Impact of Lifetime Alcohol Quit Attempts and Medicated Detoxifications on Time to Relapse During an Index Alcohol Detoxification

Previous work has shown that multiple medication-treated alcohol detoxifications are associated with poorer treatment outcomes during subsequent detoxifications. Little is known about the impact of nonmedicated attempts to stop drinking outside the realm of these medically supervised detoxifications on acute detoxification outcomes. This study included 58 subjects enrolled in an outpatient detoxification study. Subjects were asked why and how often they quit alcohol for 3 days or longer during their drinking lifetime using concepts derived from the Cognitive Lifetime Drinking History. The effect of previous attempts at abstinence (both medicated and nonmedicated) on time to relapse during an index detoxification was examined. After the index detoxification, older individuals relapsed later than younger individuals and the number of previous medicated detoxifications rather than total lifetime quit attempts per se was related to quicker relapse. Contrary to expectation, those who reported fewer previous nonmedicated quit attempts tended to relapse sooner than those who reported more past quit attempts. This study supports and extends previous work that suggests that the number of previous medicated detoxifications, rather than the total number of past attempts at abstinence, predicts higher and sooner risk for early relapse drinking during outpatient alcohol detoxification.

Health Effects from Drinking: Type, Severity, and Associated Drinking Patterns Based on Qualitative and Quantitative Questions in a Methodological Survey

The specific content of reported health harms are explored in relation to heavy episodic drinking and alcohol dependence symptoms. A national telephone computer-assisted interview of U.S. adults (N = 635), was conducted in 1994. A modified National Alcohol Survey instrument assessed self-reported health harms and related economic costs and work missed. Among the 579 lifetime drinkers, 26% reported health harms from drinking. In multivariate logistic regression harms relating to intoxication, injuries or internal organs were associated with monthly heavy drinking (5+ drinks) and past dependence symptoms. Study limitations are noted. Dependence symptoms should be assessed in screening for those most at risk for alcohol-related health harms.

Reliability and Validity of the Substance Abuse Outcomes Module

Reliability and Validity of the Substance Abuse Outcomes Module

Exposure to Paternal Alcoholism Does Not Predict Development of Alcohol-Use Disorders in Offspring: Evidence From an Offspring-of-Twins Study

Using an offspring-of-twins design, we tested the hypothesis that exposure to paternal alcoholism during the child's first 12 years will increase offspring risk for subsequent alcohol-use disorders (AUD). Structured psychiatric interviews assessed history of psychiatric and substance-use disorders in Vietnam Era Twin Registry fathers (n = 512), their offspring (n = 877), and mothers of the offspring (n = 507). Exposure was defined as the fathers' endorsement of any Diagnostic and Statistical Manual of Mental Disorders (DSM), Fourth Edition, AUD symptom, according to the Lifetime Drinking History assessment (administered in 1999), at any time between off- spring ages 0-12 years; all fathers had satisfied DSM, Third Edition, Revised (DSM-III-R), criteria for alcohol dependence in a 1992 diagnostic interview. Cox proportional hazards models were fit to predict time to first symptom of abuse/dependence in offspring. Off- spring exposed to paternal alcoholism were significantly more likely to develop an AUD when compared with offspring of nonalcoholic fathers (hazard ratio [HR] = 1.51; 95% confidence interval [CI]: 1.10-2.07). Although offspring unexposed to paternal alcoholism did not significantly differ from control offspring (HR = 1.50, 95% CI: 0.93-2.41), the magnitude of association was similar to that in the exposed offspring. There were no significant differences in AUD between offspring of alcoholics who were exposed and those who were not exposed to paternal alcoholism, as long as fathers had satisfied DSM-III-R criteria for alcohol dependence at some point in their lives. There does not appear to be a relationship between exposure to paternal alcoholism during childhood and development of an AUD in offspring. Genetic and high-risk environmental factors that are correlated with lifetime paternal alcoholism may be stronger predictors of offspring AUD than fathers' problem drinking. Future research should be encouraged, using more comprehensive analyses, to examine the role of family genetic influences and other family environmental influences on offspring alcohol outcomes.

Reliability of lifetime drinking history among alcohol dependent men.

Information regarding patterns and correlates of problem drinking over the life course is important for both clinical and research purposes although few retrospective, psychometrically adequate instruments to collect data of this kind are available. In the current study, the authors report 5-year test-retest reliabilities of the Lifetime Drinking History (LDH). Analyses were based on 49 male participants with a lifetime diagnosis of alcohol dependence who were residing within intact families and who were not seeking treatment at time of initial assessment. Overall, the LDH was found to reflect adequate stability over this long retest interval for a number of relevant drinking measures, with results providing further support for the instrument's psychometric strengths. Limits on the generalizability of these findings and future research needs are discussed.

Poor Response Inhibition as a Predictor of Problem Drinking and Illicit Drug Use in Adolescents at Risk for Alcoholism and Other Substance Use Disorders

To evaluate the predictive power of executive functions, in particular, response inhibition, in relation to alcohol-related problems and illicit drug use in adolescence. A total of 498 children from 275 families from a longitudinal high-risk study completed executive function measures in early and late adolescence and lifetime drinking and drug-related ratings at multiple time points including late adolescence (ages 15-17). Multi-informant measures of attention-deficit/hyperactivity disorder and conduct disorder were obtained in early childhood (ages 3-5), middle childhood, and adolescence. In multilevel models, poor response inhibition predicted aggregate alcohol-related problems, the number of illicit drugs used, and comorbid alcohol and drug use (but not the number of drug-related problems), independently of IQ, parental alcoholism and antisocial personality disorder, child attention-deficit/hyperactivity disorder and conduct symptoms, or age. Multivariate models explained 8% to 20% of residual variance in outcome scores. The incremental predictive power of response inhibition was modest, explaining about 1% of the variance in most outcomes, but more than 9% of the residual variance in problem outcomes within the highest risk families. Other measured executive functions did not independently predict substance use onset. Models of alcoholism and other drug risks that invoke executive functions may benefit from specifying response inhibition as an incremental component.

Drinking trajectories from adolescence to the mid-forties among alcohol dependent males.

Identifying differing developmental trajectories of alcohol behavior is fundamental in building theories of alcoholism etiology and course. The purpose of this study was to identify differences in developmental pathways of alcoholism from onset of drinking into middle adulthood. Alcohol-related behaviors and psychiatric status were assessed in 330 men from the Vietnam Era Twin Registry having a lifetime diagnosis of alcohol dependence (AD). Using a modified version of Skinner's Lifetime Drinking History, distinct drinking phases were identified that differed in terms of quantity, frequency and context of drinking. Person-year data were created to indicate whether AD criteria were or were not met for each year between drinking onset and age 41. Using Latent Growth Mixture Modeling, a four-class model was identified: Severe Chronic Alcoholics; Severe Non-Chronic Alcoholics (SNCA); Late Onset Alcoholics; and Young Adult Alcoholics. Counterparts for three trajectories could be found in the larger alcoholism literature, whereas the fourth type (SNCA) has not been described, notwithstanding its seeming importance and prevalence. Present findings support the existence of different alcoholism trajectories and provide a more complete understanding of the variability of alcohol dependence over time. Findings build on the larger alcoholism literature identifying alcoholic subgroups and provide important information regarding alcoholism trajectories and associated features. Future studies are needed with regard to better understanding of the psychosocial influences related to the different alcoholism trajectories, as well as characterizing the different trajectories as individuals transition into older age.

Negative consequences and cognitions about drinking and driving.

Drinking and driving has been found to be a highly persistent behavior, even after experiencing negative consequences, such as arrest. This study tested the association between consequences of drinking and driving and cognitions related to drinking and driving (e.g., attitudes, normative beliefs). We tested whether exposure to negative consequences was associated with perceptions of risk associated with drinking and driving. Participants were 938 college students. The sample was 57% female and primarily white (86%). Questionnaire measures were used to assess alcohol use, drinking and driving behaviors, drinking and driving cognitions, and lifetime drinking and driving consequences. Results indicated that participants who had experienced consequences of drinking and driving (either as a driver or rider) reported more current drinking and driving and greater alcohol consumption. Analyses indicated that most cognition measures differentiated those reporting lifetime consequences from the rest of the sample, with the consequence groups reporting more risky cognitions. However, experiencing a personal consequence of drinking and driving was associated with perceiving negative consequences of drinking and driving to be more likely. These results provide evidence that most cognitive risk factors for drinking and driving remain high even after experiencing a negative consequence. This may contribute to the persistence of drinking and driving in prior offenders. The finding that the perception of negative consequences may be influenced by experiencing consequences may have implications for intervention and treatment efforts.

Alcohol Use Disorders Among US College Students and Their Non–College-Attending Peers

Heavy/binge drinking among college students has become a major public health problem. There is consistent evidence suggesting that young adults in college are drinking more than their non-college-attending peers, but it is still not clear whether they are more likely to suffer from clinically significant alcohol use disorders. To compare the prevalence of alcohol use disorders and alcohol use disorder symptoms in college-attending young adults with their non-college-attending peers within the same study in a large and representative US national sample. Cross-sectional survey. Civilian, noninstitutionalized US population. Young adults (n = 6352) from the 2001 National Household Survey on Drug Abuse (19-21 years of age, 51% female, 66% white, 14% African American, 14% Hispanic). Lifetime, past-year, and past-month drinking, past-year and past-month weekly drinking, past-month weekly binge drinking, past-month daily drinking, typical quantity consumed in the past month, and past-year DSM-IV alcohol dependence and abuse diagnoses. Eighteen percent of US college students (24% of men, 13% of women) suffered from clinically significant alcohol-related problems in the past year, compared with 15% of their non-college-attending peers (22% of men, 9% of women; overall odds ratio = 1.32). The association between past-year alcohol use disorder and college attendance was stronger among women (odds ratio = 1.70) than men (odds ratio = 1.14). College students were more likely to receive a diagnosis of DSM-IV alcohol abuse than their peers not attending college; despite the fact that those in college were drinking more, they were not more likely to receive a diagnosis of DSM-IV alcohol dependence. College students suffer from some clinically significant consequences of their heavy/binge drinking, but they do not appear to be at greater risk than their non-college-attending peers for the more pervasive syndrome of problems that is characteristic of alcohol dependence.

Psychosocial, cultural and genetic influences on alcohol use in Asian American youth.

Environmental and cultural factors, as well as a genetic variant of the aldehyde dehydrogenase gene (the ALDH2*2 allele) have been identified as correlates of alcohol use among Asian Americans. However, concurrent examination of these variables has been rare. The present study assessed parental alcohol use, acculturation and ALDH2 gene status in relation to lifetime, current and heavy episodic drinking among Chinese and Korean American undergraduates. Participants (N = 428, 51% women; 52% Chinese American, age 18-19 years) were first-year college students in a longitudinal study of substance use initiation and progression. Data were collected via structured interview and self-report, and participants provided a blood sample for genotyping at the ALDH2 locus. Gender, parental alcohol use and acculturation significantly predicted drinking behavior. However, none of the hypothesized moderating relationships were significant. In contrast with previous studies, ALDH2 gene status was not associated with alcohol use. Results indicate that although the variables examined influence alcohol use, moderating effects were not observed in the present sample of Asian American college students. Findings further suggest that the established association of ALDH2 status and drinking behavior in Asians may not be evident in late adolescence. It is possible that ALDH2 status is associated with alcohol consumption only following initiation and increased drinking experience.

Smoking and Drinking Patterns Among Residents of Li Ethnic Minority Villages in Hainan, China

Background. In China, approximately 67% of male adults are smokers and 64% of them are drinkers. Tobacco and alcohol use are more prevalent among many of China's 55 ethnic minority populations, but specific data are lacking for them, including the Li population.Methods. Cross-sectional data from 379 residents sampled from 12 Li villages in Hainan Province were used for this analysis. Data were collected in 2003 using a questionnaire adopted from the U.S. National Household Survey on Drug Abuse. Both lifetime and current use of tobacco and alcohol products, including prevalence, frequency and amount of use, as well as age patterns of onset of use were assessed.Findings. Eighty-five percent of the sample were Li minority and 43% were female with a mean age of 34.7 years (SD = 14.5). While fewer female subjects of the sample reported smoking (1.9% of lifetime smoking) and drinking (21.0% lifetime drinking), 84.1% of the male sample were lifetime smokers and 92.5% were lifetime drinkers; 78.1% were 30-day smokers and 88.4% were 30-day drinkers; and 58.6% were daily smokers and 15.8% were daily drinkers. In addition, 79.1% male villagers were binge drinkers, and 21.4% were intoxicated in the past month. The risk of onset of smoking and drinking increased after 10 years of age, peaked at 18–19 years (hazard = 16.0% for smoking and 19.5% for drinking), then declined until leveling off at 25 years of age. Eighty-five to 97% of the males simultaneously used alcohol and tobacco.Conclusions. The prevalence rates of tobacco and alcohol use in Li male villagers are higher than those of the national average and other ethnic minorities in China. In-depth studies are needed to obtain more detailed information regarding issues such as detailed types of tobacco and alcohol products, causes of use, as well as willingness to participate in tobacco and alcohol control interventions in order to develop and deliver substantial intervention programs.