Reported Alcohol Use Research Articles

Alcohol, Tobacco and Illicit Drug Use During Pregnancy in the Longitudinal BELpREG Cohort in Belgium Between 2022 and 2024.

Background/Objectives: Substance use during pregnancy is associated with adverse outcomes for both mother and child. This study aimed to determine the prevalence and determinants of alcohol, tobacco and illicit drug use before and during pregnancy in Belgium. Methods: An observational study was conducted using data from the longitudinal BELpREG registry. The study included women aged 18 years or older who completed at least one questionnaire on substance use during pregnancy between 2022 and 2024. Data were analyzed using descriptive statistics and logistic regressions. Results: In total, 1441 women were included. Preconception prevalences of alcohol, tobacco and illicit drug use were 82.2%, 10.0% and 4.2%. These self-reported prevalences dropped in the first trimester to 12.9%, 4.1% and 0.6%, respectively. Considering the rates of substance use in pregnancy but before pregnancy awareness, the overall prevalence of alcohol, tobacco and illicit drug use in the first trimester was 41.0%, 6.6% and 1.2%, respectively. Women with a higher education (aOR (adjusted odds ratio), 2.12; 95% CI (confidence interval): 1.14-3.96), unplanned pregnancies (aOR, 2.88; 95% CI: 1.77-4.67), spontaneous pregnancies (aOR, 2.94; 95% CI: 1.51-5.75), cohabitants drinking alcohol daily (aOR, 2.01; 95% CI: 1.09-3.70), and those using tobacco in the first trimester (aOR, 5.37; 95% CI: 2.70-10.66) were more likely to report alcohol use. In addition, women with a lower education (aOR, 7.67; 95% CI: 3.76-15.67), unplanned pregnancies (aOR, 3.31; 95% CI: 1.53-7.15), cohabitants using tobacco (aOR, 9.11; 95% CI: 4.48-18.52), and those who used alcohol (aOR, 6.67; 95% CI: 3.07-14.64) or illicit drugs (aOR, 39.03; 95% CI: 3.72-409.83) in the first trimester were more likely to report tobacco use. Conclusions: Despite a significant reduction in substance use in pregnancy compared to before pregnancy, a relevant portion of women continue to use substances, particularly in the early stages before pregnancy awareness. Targeted public health interventions and (more) awareness among caregivers are needed to further promote substance use cessation before conception.

Comparing two large data repositories to understand the differences in demographics, health history, and behavioral attributes in populations.

This study conducted a comparative analysis between two large data repositories, the All of Us (AoU) medical data and BigMouth dental data repositories. The comparison analysis includes variables related to behavioral and systemic health, health literacy, and overall health status across race, ethnicity, and gender. The analytic approach used descriptive statistics, Chi-square, odds ratio, and 95% confidence intervals; significant comparisons were measured with Cohen's D effect sizes. In the AoU dataset, 80.6% of Hispanic or Latino participants reported alcohol use compared to 16.8% in the BigMouth data repository. The female cohort in AoU showed 87.9% alcohol use, a contrast to BigMouth's 26.0%. Additionally, the diabetes prevalence among females was 8.8% in AoU vs. 21.6% in BigMouth. Differences in health literacy were observed, with 49.2% among Hispanic or Latino participants in AoU, in contrast to BigMouth's 3.2%. Despite this, 70.1% of Hispanic or Latino respondents in AoU reported satisfactory health status, while BigMouth indicated a much higher figure at 98.3%. These variations highlight the importance of targeted health interventions addressing racial/ethnic and gender influences. Differences may arise from recruitment approaches, participant demographics, and healthcare access. There is a need for collaboration, standardized data collection, and inclusive recruitment to remedy these discrepancies. Further research is imperative to understand the underlying causes, facilitate interventions that address the disparities, and advocate for a more inclusive healthcare system.

Prototype Specificity Matters When Predicting Later Alcohol-Related Content Posting and Alcohol Use Among Adolescent and Young Adults

Background: Drinking prototypes (i.e., images of the type of individual who engages in specific alcohol use behaviors) are associated with alcohol use, with self-identified similarity to the prototype possibly driving this connection more than one’s favorability of the prototype. Alcohol-related content (ARC; posts featuring alcohol or drinking) posting prototype favorability is also associated with ARC posting and drinking. However, the effects of ARC posting prototype similarity on posting or drinking behavior are unexamined. Prior research suggests specificity of antecedents (e.g., attitudes, prototypes) matters in predicting subsequent behavior. The current study examined which types of prototype similarity (e.g., drinking, ARC posting) are most strongly associated with later ARC posting and drinking behavior, respectively. Methods: Adolescents and young adults who reported alcohol use (N = 274) were recruited to complete two online surveys at baseline and 1-month later. Results: Controlling for abstaining, heavy episodic drinking (HED), and ARC posting prototype similarity, only greater baseline ARC posting prototype similarity was associated with posting ARC 1-month later. Zero-inflated negative binomial regressions revealed greater abstaining prototype similarity was associated with lower drinking frequency 1-month later. Higher HED prototype similarity was associated with likely drinking on at least one day in the past month (i.e., drinking frequency). Higher ARC posting prototype similarity was associated with likely reporting no negative alcohol consequences. Conclusions: Findings suggest that interventions targeting reductions in ARC posting should aim to change ARC posting prototype similarity whereas drinking prototype similarity should be highlighted in alcohol interventions.

Nonabstinence among US Adults in Recovery from an Alcohol or Other Drug Problem.

Most US treatment and recovery services are abstinence-based. However, many people in recovery from an alcohol or other drug (AOD) use problem do not abstain completely. This study estimated the prevalence of and characteristics associated with nonabstinence among US adults in recovery. Nonabstinence-operationalized as past-month use of alcohol, illicit drugs, or nonmedical use of prescription drugs-was estimated among a sample of 3763 US adults in self-identified recovery from the 2022 National Survey on Drug Use and Health, weighted to be nationally representative. Multivariable logistic regression identified factors associated with nonabstinence. An estimated 65.2% (95% confidence interval [CI] = 62.6-67.8) of adults in self-identified recovery reported past-month AOD use. Half (50.8%) reported alcohol use, and one-third (33.2%) reported cannabis use. Females had lower odds of use than males (adjusted odds ratio [AOR] = 0.73, 95% CI = 0.54-0.99), and lesbian/gay-identified individuals had greater odds of use than heterosexual/straight-identified individuals (AOR = 2.39, 95% CI = 1.13-5.07). Greater religiosity (AOR = 0.90, 0.84-0.96) and mutual aid attendance (AOR = 0.16, 95% CI = 0.06-0.27) were associated with lower odds of use. Significant differences were not detected for self-reported health, psychological distress, and other measures of functioning. However, relative to those without a past-year substance use disorder (SUD), odds of nonabstinence were greater among those with one mild (AOR = 14.60, 9.05-23.55), one moderate or severe (AOR = 13.05, 7.06-24.14), and multiple (AOR = 23.33, 10.59-51.37) past-year SUDs. Most US adults who self-identified as in recovery from an AOD use problem were nonabstinent. Treatment and recovery services may improve engagement and outcomes by supporting nonabstinent goals.

EGS SO34 - Idiopathic pancreatitis - a myth or a reality?

Abstract Background Acute pancreatitis is characterized by frequent episodes of inflammation in the pancreas.The most common causes are alcohol abuse and gallstones but approximately 30% of cases are defined as idiopathic because initial evaluation fails to detect the aetiology.This study aims to investigate the aetiology and the reasons for the incorrect labelling of patients with pancreatitis as idiopathic. Method This is a retrospective study and included patients with a diagnosis of idiopathic pancreatitis (IP) between 1 May 2019 and 31 April 2023.Cases were eligible for inclusion if they had been discharged as IP. Data were collected following review of patient notes into Microsoft Excel. Results A total of 129 patients were identified of whom the majority of patients did not find to have gallstones (88%), did not report alcohol use (91%), and did not experience trauma (87%). However, MRCP and EUS were not performed in all patients before they are labelled as idiopathic. Ultrasound was the most commonly performed diagnostic procedure (98%), while MRCP (40%) and EUS (8%) were less frequently utilized. Surprisingly, a quarter of patients underwent a laparoscopic cholecystectomy. Nutritional referrals were lacking in a significant portion of cases and the readmission rates were high (65%). Conclusion The most surprising elements in the data include the high incidence of unperformed diagnostic procedures to exclude the common causes of pancreatitis.Also,the underutilization of nutritional referrals and the high readmission rates suggest potential areas for improvement in the diagnostic workup and management of IP, as well as raising questions about the current clinical practices and their efficacy in this cohort.

The relationship between young people, social media use and alcohol use: A prospective cohort study

Background and aimsSocial media use is now a significant part of modern daily life. Little is known about how social media impacts young peoples’ drinking behaviours and drinking-related consequences. This cohort study aims to explore the prospective relationship between social media use and future drinking. Methods1473 alcohol naïve young people, who at Wave 5 (aged 12–13 years) reported no lifetime alcohol use, were included (social media use, peer alcohol use, and covariates were also reported at Wave 5). At Wave 8 (aged 17–18 years), participants reported alcohol use outcomes, including age of drinking initiation, past month and past week risky consumption (>10 drinks/week), and problem drinking (alcohol-related troubles, injuries, and fights). ResultsAfter controlling for factors known to be associated with alcohol use in young people and applying a conservative significance level (α =.01), results revealed that children who engaged in almost daily social media use at ages 12–13 later reported a younger age of drinking onset (β = −0.56, 95 % CI = −0.74, −0.39, p <.001) and greater problem drinking (β = 0.48, 95 % CI = 0.13, 0.83, p =.008) at ages 17–18, compared to those who never used social media at ages 12–13. Early social media use was not associated with odds of subsequent past-month alcohol use or risky alcohol consumption. ConclusionYoung peoples’ social media use was associated with future drinking behaviours, prompting the need for preventative measures to acknowledge the salient impacts of social media.

Smoking, alcohol, substance, technology, and gambling addiction among university students

Abstract Background University students turn to addictive substances to cope with the anxiety and stress caused by separation from family, adaptation to a new environment, as well as many economic and social problems. This study aimed to examine smoking, alcohol, substance, technology, and gambling addiction among university students. Methods The data of this cross-sectional study were collected between February and March 2024. The study population consisted of 23,446 people studying at Ä°nonu University, and the sample size was calculated as 346 based on a smoking rate of 35.6% among university students. A stratified sampling method was adopted according to the faculty of study, and 366 people were approached regarding the study. The independent variables were age, gender, faculty of study, and smoking status, while the dependent variables were alcohol and substance use status. Descriptive data were expressed in numbers and percentages, and a Chi-square test was used in the statistical analysis. Results Of the students in the research group, 56.8% were female, 54.4% were 22 years of age or older, 30.1% reported smoking cigarettes, 7.7% reported drinking alcohol in the last 30 days, 39.2% reported using the internet for five hours or more per day, 3% reported playing various casino games on the internet once a week or more, and 1.4% stated that they used substances. There was no statistically significant difference between alcohol and substance use according to smoking status (p &amp;gt; 0.05). Conclusions Approximately one-third of the students in the research group reported smoking cigarettes, and one-tenth reported alcohol use, which is quite high. The high percentage of students who use the internet for five hours or more per day and the low rate of online gambling should be considered in relation to these addictions. Key messages • Multidimensional interventions and intersectoral cooperation are required to prevent smoking, alcohol, substance use, technology, and gambling addictions among university students. • In addition, precautions should be taken to protect students against the risks associated with internet addiction and online gaming.

The profile and aberrant driving behavior of juvenile traffic law violators in Greece

Abstract The majority of juvenile offenses in Greece are related to road traffic violations. Juveniles in Crete region are required to attend an educational program offered by LaHeRS lab (HMU), in collaboration with the Prosecutor’s Office as part of reformative measures. The current presentation reports on the profile and aberrant driving behavior of juvenile offenders who attended the program between 2023-2024. The Driver Behavior Questionnaire (DBQ) was administered to 181 juvenile offenders. Participants were males (97.8), with a mean age 18.6 (SD = 1.2), resided in rural settings (51.8%) and secondary students 60.7%. The mean age of the first offence was 15.8 (SD = 1.1, min 13 - max 18). Participants scored low in all DBQ scales (covered violations mean=6.1, sd = 7.5; unintentional violations mean=0.9, sd = 1.6; lapses mean=8.9, sd = 10.5). No statistically significant difference was found in DBQ scores between those who had and did not have a driver’s license, as well as between those from urban or rural areas. The three DBQ subscales significant correlated (p &amp;lt; .001). Among other risky behaviors, 54.9% reported exceeding the legal speed limit, 66.3% reported aggression feelings when driving behind a slow vehicle, 34.5% used mobile phones while driving, 17.7% reported alcohol use while driving. Surprisingly, 85.5% stated high confidence addressing risks on the roads. Key messages • Early interventions on aberrant driving behavior among adolescents is crucial. • Educational programs should be tailored to address the unique needs of juvenile traffic law violators.

6898 A Case Report Of Drug-Induced Liver Injury Secondary To Sublingual Estradiol In A Transgender Woman

Abstract Disclosure: F. Manas: None. E. Davydov: None. A. Caines: None. K. Estrada: None. J.E. Shill: None. Drug-induced liver injury (DILI), the leading cause of acute liver failure in the United States, occurs in response to a medication or natural compound. Estrogens can lead to idiosyncratic DILI. According to LiverTox [livertox.nih.gov], estrogen has a likelihood score of A (highly likely) to cause DILI, whereas spironolactone has a likelihood score of D (rare). The current formulations of estrogens usually produce a mixed or cholestatic pattern of liver enzyme elevations, however very early, the ALT levels can be markedly elevated (5- to 20-fold). One can be asymptomatic. Often the liver injury resolves after removing the offending agent. We present a case of DILI with elevations of both alanine transferase (ALT) and aspartate transferase (AST), secondary to sublingual estradiol (E2). A 23-year-old transgender female presented for feminizing gender-affirming care. She was started on sublingual E2 2 mg once daily and spironolactone 100 mg orally twice daily. Approximately 14 weeks later, sublingual E2 was increased to 2 mg twice daily for a below-target E2 level, and spironolactone was decreased to 50 mg twice daily due to gas and nausea. Routine blood work three weeks later showed elevated liver function tests (LFTs) in a hepatocellular pattern with ALT of 216 IU/L (normal:&amp;lt;52IU/L), AST of 223 IU/L (normal:&amp;lt;35 IU/L), with normal total bilirubin and alkaline phosphatase. LFTs were normal six months prior. At the time of liver injury, she had consumed six alcoholic beverages in the previous fourteen days, and two doses of acetaminophen. She had no personal history of autoimmunity and no family history of liver disease. Acute hepatitis screen was normal. Abdominal US with liver Doppler was unremarkable. E2 and spironolactone were discontinued. Evaluation by hepatology lead to a diagnosis of DILI from sublingual E2, based on the temporal relationship between initiation of E2 and LFT elevation. Other potential causes of elevated LFTs were excluded. Although she reported alcohol use, the AST/ALT elevation was not in a classic 2:1 pattern. Three weeks after cessation of E2 and spironolactone, her LFTs normalized. Spironolactone was resumed along with E2 by patch, but due to skin-adherence issues she was transitioned to injectable E2 valerate. Her LFTs have remained normal since. This case illustrates a rare but potentially dangerous adverse event of DILI secondary to sublingual E2. Due to the low incidence of liver injury in various studies of individuals with gender incongruence on hormone therapy, current evidence does not support routine liver enzyme monitoring. Clinicians should be aware of the potential risk of liver injury and counsel patients accordingly. As in this case, patients may be successfully rechallenged with the offending DILI medication. Further studies on different formulations of hormone therapy and their effects on the liver would be beneficial in this unique population. Presentation: 6/2/2024

Healthcare service utilisation among adults with coronary artery disease in rural Aluva, South India: a community-based cross-sectional study

ObjectivesTo assess the pattern and determinants of healthcare service utilisation among adults with coronary artery disease (CAD) in a rural setting in Kerala, India.DesignA community-based cross-sectional analysis conducted within a...

Alcohol use and intimate partner violence victimization among young adults with a history of perpetration: An ecological momentary assessment study.

Intimate partner violence (IPV) is a major public health concern among young adults and has shown a consistent association with alcohol use. However, previous research has used cross-sectional and daily diary designs that may fail to pinpoint the effects of alcohol use within several hours of IPV occurring. The present study used novel ecological momentary assessment (EMA) methods to investigate the bidirectional effect of alcohol use and IPV victimization among young adults with a history of IPV perpetration. One hundred and sixty-eight young adults (age 18-25 years) in a dating relationship who reported IPV perpetration in the past year completed 28 days of randomly prompted EMA surveys (four surveys daily). The effect of alcohol use on IPV victimization and the effect of IPV victimization on alcohol use were examined. The results indicated that alcohol use co-occurs with psychological and physical IPV victimization. Further, alcohol use significantly increased the odds of physical (OR = 4.94; 95% CI = 2.24-10.87) and sexual (OR = 4.66; 95% CI = 1.64-13.22) IPV victimization, but not psychological IPV victimization, in the subsequent EMA survey. Finally, IPV victimization did not significantly increase the odds of reporting alcohol use in the subsequent EMA survey. Using alcohol is proximally related to IPV victimization among those with a history of IPV perpetration. Intervention efforts would benefit from adapting EMA methods to provide resources the moment they are needed.

Using risk terrain modeling and geographically-explicit ecological momentary assessments to examine alcohol use in adults experiencing homelessness

ABSTRACT Adults experiencing homelessness (AEH) are more likely to engage in risky alcohol use compared to adults in the general population. Nonetheless, relatively little is known about the naturalistic settings of alcohol use among AEH. We integrate risk terrain modeling (RTM) with geographically-explicit ecological momentary assessments (GEMAs) to identify the environmental characteristics of drinking locations among AEH in Dallas, Texas. Participants were given a study-provided smartphone pre-installed with the InsightTM application and instructed to self-initiate a GEMA when they were about to consume their first drink of the day over the duration of four weeks. Participants who used this app feature to report alcohol use were included in the analytic sample (N = 22). RTMs estimated the spatial influence of environmental features associated with alcohol availability and risky community features located in the city limits of Dallas, as well as in downtown Dallas. Across the City-Wide and Central Division analyses, proximity to food banks/shelters and public libraries are spatially associated with event locations of AEH alcohol use. Clusters of liquor stores and grocery stores are also significantly related to alcohol event locations. Findings provide insight into the geographical context of alcohol use among AEH and have implications for researchers and practitioners.

Ecological Momentary Assessment of Alcohol Marketing Exposure, Alcohol Use, and Purchases Among University Students: Prospective Cohort Study.

The relationships between alcohol marketing exposure, alcohol use, and purchase have been widely studied. However, prospective studies examining the causal relationships in real-world settings using mobile health tools are limited. We used ecological momentary assessment (EMA) to examine both the within-person- and between-person-level effects of alcohol marketing exposure on any alcohol use, amount of alcohol use, any alcohol purchase, and frequency of alcohol purchase among university students. From January to June 2020, we conducted a prospective cohort study via EMA among university students in Hong Kong who reported current drinking. Over 14 consecutive days, each participant completed 5 fixed-interval, signal-contingent EMAs daily via a smartphone app. Each EMA asked about the number and types of alcohol marketing exposures, the amount and types of alcohol used, and whether any alcohol was purchased, all within the past 3 hours. We used 2-part models, including multilevel logistic regressions and multilevel gamma regressions, to examine if the number of alcohol marketing exposure was associated with subsequent alcohol use and alcohol purchase. A total of 49 students participated, with 33% (16/49) being male. The mean age was 22.6 (SD 2.6) years. They completed 2360 EMAs (completion rate: 2360/3430, 68.8%). Participants reported exposure to alcohol marketing in 5.9% (140/2360), alcohol use in 6.1% (145/2360), and alcohol purchase in 2.4% (56/2360) of all the EMAs. At the between-person level, exposure to more alcohol marketing predicted a higher likelihood of alcohol use (adjusted odd ratio [AOR]=3.51, 95% CI 1.29-9.54) and a higher likelihood of alcohol purchase (AOR=4.59, 95% CI 1.46-14.49) the following day. Exposure to more alcohol marketing did not increase the amount of alcohol use or frequency of alcohol purchases the following day in participants who used or purchased alcohol. At the within-person level, exposure to more alcohol marketing was not associated with a higher likelihood of alcohol use, amount of alcohol use, higher likelihood of alcohol purchase, or frequency of alcohol purchases the following day (all Ps>.05). Each additional exposure to alcohol marketing within 1 week predicted an increase of 0.85 alcoholic drinks consumed in the following week (adjusted B=0.85, 95% CI 0.09-1.61). On days of reporting alcohol use, the 3 measures for alcohol marketing receptivity were not associated with more alcohol use or purchase (all Ps>.05). By using EMA, we provided the first evidence for the effect of alcohol marketing exposure on initiating alcohol use and purchase in current-drinking university students. Our findings provide evidence of the regulation of alcohol marketing for the reduction of alcohol use and purchase among young adults.

Hepatitis B prevalence and risk factors among adults living with HIV in South Africa: a clinic-based cohort study

BackgroundPeople living with HIV (PLHIV) may have concurrent Hepatitis B Virus (HBV) infection, and certain antiretroviral therapies are recommended for HBV-HIV co-infected individuals. Routine screening for Hepatitis B virus may influence management of antiretroviral therapy for PLHIV, but risk factors for co-infection have not been well defined. The objective of this study was to identify risk factors for HBV infection among PLHIV in South Africa.MethodsWe conducted a cross-sectional analysis of a prospective, clinic-based cohort study of adults seeking HIV testing from 2013–2017 in Umlazi township, South Africa. Patients newly diagnosed with HIV were enrolled and subsequently tested for Hepatitis B surface antigen positive (HBsAg +). We used a Poisson linear regression model to assess which factors, pertaining to sociodemographic status, medical history, clinical symptoms, mental health were associated with HBV.ResultsAmong 3,105 PLHIV participants in South Africa, 6% were positive for HBV. Males had a higher HBV prevalence (10.4%) than females (5.2%). Within the HBV-positive group, the mean age was 33.2 years, with 38.3% females and 43.9% having completed high school or higher. About 39.9% reported alcohol use, 24.7% had a smoking history, and 8.3% reported substance use in the past year. Older participants born before 1995, when routine infant HBV vaccination was introduced, were more likely to have HBV. In multivariable analyses, smoking history increased HBV risk in females (aPR = 2.58; 95% CI 1.47–2.52), while alcohol use decreased HBV risk in males (aPR = 0.36; 95% CI 0.19–0.70).ConclusionsIn a South African cohort, roughly one in 16 PLHIV had HBV co-infection, and this rate was higher in males. The most prominent risk factors for HBV infection in PLHIV were alcohol use, higher income, and smoking history, which may help inform targeted treatment and prevention strategies. Creating HBV-specific screening and prevention strategies for PLHIV may be useful for reducing HBV infections.

A Population-Based Study on Women Who Used Alcohol during Pregnancy and Their Neonates in Ontario, Canada.

Data from birth registries can be studied to assess the prevalence of prenatal alcohol use and associated maternal and neonatal outcomes. Linked maternal and neonatal data (2015-2018) for alcohol-exposed pregnancies were obtained from the Better Outcomes Registry and Network (BORN) Ontario. Descriptive statistics were generated for maternal demographics, prenatal substance use, mental health/substance use history, and neonatal outcomes. Logistic regression models were performed to assess the odds of prenatal heavy (binge or weekly) alcohol and other substance use based on mental health/substance use history and other maternal demographics, and the impacts of heavy alcohol use and other prenatal substance exposures on neonatal outcomes. A total of 10,172 (2.4%) women reported alcohol use during pregnancy. One-third had pre-existing or current mental health and/or substance use problems, which was associated with significantly higher odds of heavy alcohol use during pregnancy. Prenatal exposure to heavy alcohol use was associated with increased odds of neonatal abstinence syndrome (2.5 times); respiratory distress syndrome (2.3 times); neonatal intensive care unit (NICU) admission (58%); and hyperbilirubinemia (57%). Prenatal exposure to one or more substances in addition to alcohol was associated with significantly higher odds of fetal/maternal/placental pregnancy complications; preterm birth; NICU admission; low APGAR scores; one or more confirmed congenital anomalies at birth; respiratory distress syndrome; and intrauterine growth restriction. It is crucial to routinely screen childbearing-age and pregnant women for alcohol and other substance use as well as mental health problems in order to prevent adverse maternal and neonatal outcomes.

Age-related Changes in Past-Month Alcohol, Cannabis, and Simultaneous Use in a Statewide Sample of Young Adults in Washington State.

It is unknown whether age-related decreases in substance use (maturing out) are observed in the legalized cannabis context. This study evaluated age-related changes in past-month alcohol use frequency, cannabis use frequency, and any simultaneous alcohol and marijuana/cannabis (SAM) use among young adults who engaged in the respective substance use behavior. Young adults, residing in Washington State at enrollment (N=6,509; 68.3% female; ages 18-25), provided 3-5 years of annual data in a longitudinal, cohort-sequential design from 2015 to 2019, a period after nonmedical cannabis was legalized and implemented. Multilevel growth models were conducted; post-stratification weights were applied to make the sample more similar to the Washington young adult general population in demographic characteristics. Among those who reported alcohol use at 1+ timepoints, days of alcohol use increased from age 18 to approximately age 25 and then decreased until age 30. Among those who reported cannabis use at 1+ timepoints, days of cannabis use increased from age 18 until approximately age 23 and then decreased until age 30. Among those who reported SAM use at 1+ timepoints, the probability of SAM use increased from age 18 until approximately age 24 and then decreased until age 30. Age-related changes in SAM use were largely explained by concurrent changes in alcohol and cannabis use frequency. Maturing out was observed for alcohol, cannabis, and SAM use among those who used each respective substance, with evidence that age-related changes in SAM use were tied to alcohol and cannabis use frequency.

Prevalence of alcohol use by gender and HIV status in rural Uganda.

Alcohol use is a major contributor to mortality and morbidity worldwide. Uganda has a high level of alcohol use per capita. Compared to men, women are less likely to consume alcohol globally; however, women who drink have increased risks for co-occurring conditions, including depression, intimate partner violence, and HIV. This study assessed the prevalence of alcohol use and correlates of harmful alcohol use by gender and HIV status in rural Uganda. We used cross-sectional data from a study among women and men aged 15-59 residing in rural, central Uganda and accepting home-based HIV testing (Nov 2017 to Dec 2020). We estimated the prevalence of levels of alcohol use (categorized as no alcohol use (score 0), low (score 1-3 for men; 1-2 for women), medium (score 4-5 for men; 3-5 for women), high (score 6-7), and very-high (score 8-12) use with the AUDIT-C), stratified by gender and HIV status. We assessed correlates of harmful alcohol use using multivariable logistic regression models for women and men. Among 18,460 participants, 67% (95% CI: 66-67%) reported no alcohol use, 16% (95% CI: 16-17%) reported low, 5% (95% CI: 4.8-5%) reported medium, 5% (95% CI: 4-5%) reported high, and 3% (95% CI: 2.8-3) reported very high alcohol use. Compared to women, men were more likely to report alcohol use (Chi-squared p-value<0.0001). People diagnosed with HIV (both newly diagnosed and previously aware of their status prior to home-based HIV testing) were more likely to report low, medium, high, and very high alcohol use compared to those who were HIV negative (Chi-squared p-value<0.0001). Among women, those who were newly diagnosed were more likely report alcohol use, compared to those who were HIV negative. In multivariable models, being newly diagnosed with HIV (compared to HIV negative) increased the odds of harmful alcohol use among women, but not men. While alcohol use was higher among men and people living with HIV, being newly diagnosed with HIV had a stronger relationship with harmful alcohol use among women than men. More research is needed to understand how alcohol use may increase the risks of HIV acquisition among women and to identify gender-responsive services to address harmful alcohol use and increase access to HIV testing and linkage to care for women who use harmful levels of alcohol.

Strategies for isoniazid preventive therapy in HIV-positive patients who consume alcohol.

<sec><title>BACKGROUND</title>WHO guidance to defer isoniazid preventive therapy (IPT) among those with regular alcohol use because of hepatotoxicity concerns may exclude many people living with HIV (PLWH) at high TB risk in these settings.</sec><sec><title>OBJECTIVE</title>To evaluate hepatotoxicity during TB preventive therapy (TPT) in PLWH who report alcohol use in Uganda over 10 years.</sec><sec><title>METHODS</title>We developed a Markov model of latent TB infection, isoniazid preventive therapy (IPT - a type of TPT), and TB disease using data from the Alcohol Drinkers' Exposure to Preventive Therapy for TB (ADEPTT) study. We modeled several treatment scenarios, including no IPT, IPT with liver enzyme monitoring (AST/ALT) during treatment, and IPT with pre-screening using the tuberculin skin test (TST).</sec><sec><title>RESULTS</title>The no IPT scenario had 230 TB deaths/100,000 population over 10 years, which is more than that seen in any IPT scenario. IPT, even with no monitoring, was preferred over no IPT when population TB disease incidence was >50 in 100,000.</sec><sec><title>CONCLUSIONS</title>For PLWH who report alcohol use in high TB burden settings, IPT should be offered, ideally with regular AST/ALT monitoring. However, even if regular monitoring is not possible, IPT is still preferable to no IPT in almost every modeled scenario.</sec>.

Psychometric validation of the Positive Drinking Consequences Questionnaire in adolescents.

The Positive Drinking Consequences Questionnaire (PDCQ) was developed to measure positive consequences of alcohol use endorsed by college drinkers. Efforts to assess positive drinking consequences experienced by adolescents have been much more limited. The aim of the present study was to advance the psychometric testing and evaluation of the factor structure of the PDCQ in adolescents. The current sample consisted of 173 adolescents at T1 (mean age = 15 years, range = 13-17; 61% female) who reported alcohol use in the past 12 months. Data were collected at two time points over a 12-month interval in the United States. Confirmatory factor analyses, internal consistency, test-retest reliability, and discriminant, concurrent, predictive, and incremental validity were tested. Our analyses supported four factors of positive alcohol-related consequences: sociability, liquid courage, sexual enhancement, and tension reduction. Internal consistency was moderate to high (α = 0.78-0.94, ω = 0.86-0.91 at T1; α = 0.59-0.93, ω = 0.85-0.93 at T2). Test-retest reliability was fair to good (ICC = 0.46-0.55). The PDCQ total and subscale factor scores demonstrated discriminant validity from negative alcohol expectancy. PDCQ total and subscale factor scores were positively associated with current alcohol consumption (ρs = 0.19-0.50 at T1; ρs = 0.17-0.46 at T2), indicating concurrent validity. Predictive validity analyses showed that the overall PDCQ scale score and the sociability subscale positively predicted maximum drinks 1 year later (ρs = 0.18-0.22). However, the sexual enhancement subscale was negatively predictive of typical drinking frequency 1 year later. Finally, the PDCQ showed incremental validity for concurrent alcohol consumption beyond that for alcohol expectancies and drinking motives. The present findings support for the reliability and validity of PDCQ for use in adolescents where it may have utility as an assessment tool for characterizing various aspects of positive drinking.

Booster effects and mechanisms of web-based personalised normative feedback alcohol intervention for college students: A pragmatic randomised controlled trial

BackgroundTo evaluate the effects of booster and no booster versions of web-based alcohol Personalised Normative Feedback (PNF) and whether descriptive norms mediated and/or participant motivation moderated the effectiveness of the intervention in real world conditions (i.e. no financial incentives). MethodsPragmatic randomised controlled trial with 1-, 3-, and 6-month assessments. Brazilian college students reporting alcohol use in the last 12 months (N=931) were recruited from May/2020 to December/2022 and allocated to 1) No booster/single PNF(S-PNF); 2) Booster/multiple PNF(M-PNF); or 3) Assessment-only control. We applied Helmert coding [1: Any intervention (S-PNF or M-PNF) vs. Control; and 2: S-PNF vs. M-PNF]. Primary outcomes: typical number of drinks/week and maximum number of drinks/week; secondary outcomes: drinking frequency and number of consequences. Three-months assessment was the primary interval. Descriptive norms were tested as mediator. Interest, importance, and readiness to change were examined as moderators. ResultsCompared to control, any intervention did not influence primary outcomes at 3-months or 6-months, but did at 1-month, when reduced typical drinking (IRR:0.77, 95%CI:0.66;0.90) and maximum number of drinks (IRR:0.69, 95%CI:0.58;0.82). There was an intervention effect on the consequences at 3-months. No differences were observed between S-PNF and M-PNF. No mediation effects were found at 3-months. At 6-months, there was an indirect effect on typical drinking through norms at 3-months (b=-0.82, 95%CI:-2.03;-0.12) and effects on maximum drinks through norms at 1-month (b=-0.54, 95%CI:-1.65;-0.02). No support for moderation was found. ConclusionsIntervention reduced alcohol drinking at 1 month only and was not effective thereafter. Mechanisms of effect remain unclear.