Risk For Alcohol Use Disorder Research Articles

Integrating Theory with Education about Genetic Risk for Alcohol Use Disorder: The Effects of a Brief Online Educational Tool on Elements of the Health Belief Model

Introduction: The utility of genetic risk information relies on the assumption that individuals will use the information to change behavior to reduce risk of developing health problems. Educational interventions designed to target elements of the Health Belief Model have shown to be effective in promoting behaviors for positive outcomes. Methods: A randomized controlled trial (RCT) was conducted in 325 college students to assess whether a brief, online educational intervention altered elements of the Health Belief Model that are known to be associated with motivations and intentions to change behavior. The RCT included a control condition, an intervention condition that received information about alcohol use disorder (AUD), and an intervention condition that received information about polygenic risk scores and AUD. We used t tests and ANOVA methods to compare differences in beliefs related to the Health Belief Model across study conditions and demographic characteristics. Results: Providing educational information did not impact worry about developing AUD, perceived susceptibility and severity of developing alcohol problems, or perceived benefits and barriers of risk-reducing actions. Individuals in the condition that received educational information about polygenic risk scores and AUD reported higher perceived chance of developing AUD than individuals in the control condition (adj. p < 0.01). Sex, race/ethnicity, family history, and drinking status were associated with several components of the Health Belief Model. Conclusion: Findings from this study demonstrate the need to better design and refine the educational information intended to accompany the return of genetic feedback for AUD to better promote risk-reducing behaviors.

Associations between family history and polygenic score of problematic alcohol use, incentive salience, and risk for alcohol use disorder

Associations between family history and polygenic score of problematic alcohol use, incentive salience, and risk for alcohol use disorder

Testing Phenotypic Models of Posttraumatic Stress Disorder and Alcohol Use Disorder Comorbidity Using Longitudinal Registry Data.

Two predominant phenotypic models of causality exist to explain the high co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD): the self-medication and susceptibility models. Population-based longitudinal studies that simultaneously examine both models are needed. Thus, the goal of the present study is to test these models using the Swedish National Registries. Registries were used to conduct longitudinal Cox proportional hazard models (n ≈ 1.5 million) and cross-lagged panel models (N ≈ 3.8 million) with follow-up periods of ~23 years. Covarying for cohort and socioeconomic status, Cox proportional hazards model results found strong support for the self-medication model. Results showed that PTSD predicted increased risk for AUD among both men (HR = 4.58 [4.42, 4.74]) and women (HR = 4.14 [3.99, 4.30]), significantly more so for men (interaction HR = 1.11 [1.05, 1.16]). Support was also found for the susceptibility model, although the effects were lower in magnitude than those for the self-medication model. AUD increased risk for PTSD among men (HR = 2.53 [2.47, 2.60]) and women (HR = 2.06 [2.01, 2.12]), and significantly more so for men (interaction term HR = 1.23 [1.18, 1.28]). Cross-lagged model results of simultaneously testing both models found support for bidirectionality. The PTSD-to-AUD paths and the AUD-to-PTSD paths were of modest effect for men and women. The results from both complementary statistical approaches demonstrate that the models of comorbidity are not mutually exclusive. Although the Cox model results evidenced more support for the self-medication pathway, the cross-lagged model results suggest that the prospective relationships between these disorders are nuanced across development.

Association Between Fatty Acid Amide Hydrolase and Alcohol Response Phenotypes: A Positron Emission Tomography Imaging Study With [11C]CURB in Heavy-Drinking Youth

BackgroundReductions in fatty acid amide hydrolase (FAAH), the catabolic enzyme for the endocannabinoid anandamide, may play a role in drinking behavior and risk for alcohol use disorder. We tested the hypotheses that lower brain FAAH levels in heavy-drinking youth are related to increased alcohol intake, hazardous drinking, and differential response to alcohol. MethodsFAAH levels in the striatum, prefrontal cortex, and whole brain were determined using positron emission tomography imaging of [11C]CURB in heavy-drinking youth (N = 31; 19–25 years of age). C385A FAAH genotype (rs324420) was determined. Behavioral (n = 29) and cardiovascular (n = 22) responses to alcohol were measured during a controlled intravenous alcohol infusion. ResultsLower [11C]CURB binding was not significantly related to frequency of use but was positively associated with hazardous drinking and reduced sensitivity to the negative effects of alcohol. During alcohol infusion, lower [11C]CURB binding related to greater self-reported stimulation and urges and lower sedation (p < .05). Lower heart rate variability was related to both greater alcohol-induced stimulation and lower [11C]CURB binding (p < .05). Family history of alcohol use disorder (n = 14) did not relate to [11C]CURB binding. ConclusionsIn line with preclinical studies, lower FAAH in the brain was related to a dampened response to the negative, impairing effects of alcohol, increased drinking urges, and alcohol-induced arousal. Lower FAAH might alter positive or negative effects of alcohol and increase urges to drink, thereby contributing to the addiction process. Determining whether FAAH influences motivation to drink through increased positive/arousing effects of alcohol or greater tolerance should be investigated.

Adverse Outcomes among Veterans who Screen Positive for TBI/do not Complete a TBI Evaluation

<h3>Research Objectives</h3> To examine whether Veterans who screened positive for mild traumatic brain injury (mTBI), but did not complete a Veterans Health Administration (VHA) Comprehensive TBI Evaluation (CTBIE), were at higher risk for adverse outcomes compared to Veterans who screened negative for TBI. <h3>Design</h3> Retrospective longitudinal study that included data from Department of Veterans Affairs (VA), Department of Defense (DoD), and National Death Index. DoD data ranged from October 1, 1999, to September 30, 2019 (Fiscal Years [FYs]2000-2019) and VHA data ranged from October 1, 2001, to September 30, 2019 (FYs2002-2019). The follow-up review period was within 3 years of TBI screening. <h3>Setting</h3> Veterans Health Administration. <h3>Participants</h3> Post-9/11 Veterans who were screened for deployment-related mTBI. <h3>Interventions</h3> None. <h3>Main Outcome Measures</h3> Incident diagnoses of substance use disorder (SUD), alcohol use disorder (AUD), opioid use disorder (OUD), overdose, and homelessness within 3 years of TBI screening. <h3>Results</h3> Compared to Veterans who screened negative for TBI, Veterans who screened positive for mTBI but never completed a CTBIE were at increased risk for incident SUD (HR=1.40, 95% CI=1.27-1.54), AUD (HR=1.32, 95% CI=1.19-1.45), OUD (HR=1.68, 95% CI=1.35-2.09), overdose (HR=1.39, 95% CI=1.13-1.70), and homelessness (HR=1.47, 95% CI=1.32-1.65) within 3 years following their TBI screening, after controlling for demographic, military, and regional covariates. <h3>Conclusions</h3> Veterans who screened positive for mTBI but did not receive a CTBIE were at increased risk for incident SUD, AUD, OUD, overdose, and homelessness relative to Veterans who screened negative for TBI. This potentially represents missed opportunities for access to interdisciplinary care to identify and address mTBI history and/or other conditions that can diminish health, safety, and quality of life. Prior to military discharge, the DoD should increase educational efforts to discuss the importance of follow-up health care. In VHA, there should be similar messaging, as well as targeted outreach to Veterans who screen positive for mTBI but do not complete a CTBIE within 30 days of screening to minimize the risk of adverse outcomes. <h3>Author(s) Disclosures</h3> The authors have no conflicts to disclose.

Rehabilitation Science Graduate Students’ Attitudes Toward Working With People at Risk For Substance Use Disorders

<h3>Research Objectives</h3> To evaluate graduate occupational therapy and counseling students' attitudes toward treating individuals at risk for substance use disorders (SUD) before and after Screening, Brief Intervention, Referral to Treatment-Plus (SBIRT-Plus), a didactic and standardized patient simulation training. We hypothesized that students' attitudes toward individuals at risk for SUDs would improve after training. <h3>Design</h3> One-group pretest-posttest study design. <h3>Setting</h3> Academic setting. <h3>Participants</h3> Our sample included 90 students from rehabilitation science graduate programs. <h3>Interventions</h3> The SBIRT-Plus training teaches universal screenings for identifying individuals at risk for substance use disorders, providing harm reduction brief interventions, and /or making referrals as necessary. The SBIRT-Plus training includes twelve modules to inform students about alcohol, opioid, and methamphetamine drug use. <h3>Main Outcome Measures</h3> We administered the Alcohol and Alcohol Perceptions Questionnaire (AAPPQ) and the Drug and Drug Perceptions Questionnaire (DDPPQ) pre- and post-training. Each questionnaire includes six subscales: role adequacy, legitimacy, and support (prepared to work with, responsibility to intervene, and support from colleagues), task specific self-esteem (confidence), motivation, and work satisfaction. We compared pre-post scores with SPSS (v.28) software using Wilcoxon signed-rank tests with an alpha of .05. <h3>Results</h3> Students' responses on five of six of the AAPPQ and DDPPQ subscales moved in the positive direction, with significant changes in role adequacy, role legitimacy, role support, task self-esteem, and work satisfaction. Students' motivation for working with individuals at risk for alcohol use disorders did not improve (p=.252, AAPPQ); however, motivation for working with individuals at risk for drug use disorders was significantly more positive after training (p=.044, DDPPQ). <h3>Conclusions</h3> Our findings demonstrate improved attitudes toward working with people at risk for SUD. This is consistent with prior studies of traditional SBIRT that showed positive improvement on all AAPPQ and DDPPQ subscales, except for the motivation subscale. The current study provides evidence that SBIRT-Plus is effective in increasing rehabilitation science graduate students' positive attitudes toward individuals at risk for a SUD. <h3>Author(s) Disclosures</h3> All authors declare no disclosures.

Genetic risk of AUDs and childhood impulsivity: Examining the role of parenting and family environment.

This study examined the independent and interactive effects of genetic risk for alcohol use disorder (AUD), parenting behaviors, and family environment on childhood impulsivity. Data were drawn from White (n = 5,991), Black/African American (n = 1,693), and Hispanic/Latino (n = 2,118) youth who completed the baseline assessment (age 9-10) and had genotypic data available from the Adolescent Brain Cognitive Development Study. Participants completed questionnaires and provided saliva or blood samples for genotyping. Results indicated no significant main effects of AUD genome-wide polygenic scores (AUD-PRS) on childhood impulsivity as measured by the UPPS-P scale across racial/ethnic groups. In general, parental monitoring and parental acceptance were associated with lower impulsivity; family conflict was associated with higher impulsivity. There was an interaction effect between AUD-PRS and family conflict, such that family conflict exacerbated the association between AUD-PRS and positive urgency, only among Black/African American youth. This was the only significant interaction effect detected from a total of 45 tests (five impulsivity dimensions, three subsamples, and three family factors), and thus may be a false positive and needs to be replicated. These findings highlight the important role of parenting behaviors and family conflict in relation to impulsivity among children.

Triangulation of evidence on immigration and rates of alcohol use disorder in Sweden: Evidence of acculturation effects.

This study aimed to determine the robustness of the impact of immigration on risk for alcohol use disorder (AUD) using different measures, designs, and immigrant regional cohorts. The analytic sample included all individuals born between 1950 and 1990 and registered in Sweden from 1973 to 2017. Using Cox regression models, we examined the risk for AUD from Swedish nationwide registries in immigrants to Sweden from seven geographical regions: Africa, Asia and Oceania, Eastern Europe, Finland, Latin America and the Caribbean, Middle East/North Africa, and Western countries. We assessed greater exposure to Swedish culture, which we interpreted as increasing acculturation, by (i) comparing first-generation immigrants and their children with no and one native Swedish parent and (ii) examining age at immigration. The baseline comparison group was the native Swedish population. We also examined AUD risk in first-generation sibling pairs discordant for their age at immigration. In nearly all immigrant cohorts in Sweden, increasing degrees of acculturation, as assessed by both our variables, were associated with rates of AUD that approached those of the Swedish population. These findings occurred in both men and women and both regional cohorts whose first-generation immigrants had lower and higher levels of AUD than native-born Swedes. For most cohorts, the rates of change with acculturation were greater in women than in men. In sibling pairs from most regions, the sibling who was younger at immigration had a higher rate of AUD. An examination of both sexes and two different proxies for acculturation provides consistent support for socio-cultural influences on AUD risk. Our co-sibling analyses suggest that a meaningful proportion of this effect is likely to be causal in nature.

A Prospective Cohort of Alcohol Use and Alcohol-related Problems Before and After Metabolic and Bariatric Surgery in Adolescents.

To describe alcohol use, alcohol-related harm, and alcohol-related problems preoperatively and up to 8 years following metabolic and bariatric surgery (MBS) in adolescents. Risk for alcohol use and alcohol use disorders (AUD) increases post-Roux-en-Y gastric bypass and vertical sleeve gastrectomy in adults. However, data are lacking in adolescents who undergo MBS. This study includes 217 adolescents (aged 13-19y) enrolled in a 5-center prospective cohort study who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy (2007-2011) and reported alcohol use preoperatively and annually postoperatively for up to 8 years. Time to elevated Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score, alcohol-related harm, and alcohol-related problems were analyzed with Kaplan-Meier estimates of cumulative incidence. Preoperatively, the median age was 17 years; the median body mass index was 51kg/m 2 . Alcohol use frequency and average quantity of drinks per drinking day increased postoperatively (2% consumed alcohol 2-4 times/month 6 months versus 24% 8 years postoperatively, P <0.001; 2% consumed≥3 drinks per drinking day 6 months versus 35% 8 years postoperatively, P <0.001). Cumulative incidence of postoperative onset elevated AUDIT-C score, alcohol-related harm, and alcohol-related problems at year 8 were 45% (95% CI:37-53), 43% (95% CI:36-51), and 47% (95% CI:40-55), respectively. Nearly half of those who underwent MBS as adolescents screened positively for AUD, symptoms of alcohol-related harm, or alcohol-related problems 8 years post-MBS, highlighting the risk for alcohol use and AUD after MBS in adolescents. AUD evaluation and treatment should be integrated into routine long-term care for adolescents undergoing MBS.

Gender Moderates the Association Between Cognitive Reappraisal and Alcohol-Related Problems Among Adolescents.

Alcohol use typically begins in adolescence, and the risk of later alcohol use disorders increases with earlier age of onset. Emotion dysregulation in adolescence has been linked to alcohol use. The present study seeks to extend previous findings by examining whether gender moderates the association between emotion regulation strategies (suppression and cognitive reappraisal) and alcohol-related problems in a longitudinal sample of adolescents. Data were collected as part of an ongoing study of high school students from the south-central region of the USA. The sample included 693 adolescents who participated in a study on suicidal ideation and risk behaviors. The majority of participants were girls (54.8%), white (85%) and heterosexual (87.7%). Baseline (T1) and 6-month follow-up (T2) data were analyzed for the present study. Negative binomial moderation analyses revealed that gender moderated the association between cognitive reappraisal and alcohol-related problems, such that the association between reappraisal and alcohol-related problems was significantly stronger for boys than for girls. Gender did not moderate the association between suppression and alcohol-related problems. The results suggest that emotion regulation strategies may be a particularly useful target for prevention and intervention efforts. Future research should consider tailoring adolescent alcohol prevention and intervention efforts focused on emotion regulation strategies by gender to bolster cognitive reappraisal skills and decrease suppression.

Cutaneous Fungal Infections in Patients Experiencing Homelessness and Treatment in Low-Resource Settings: A Scoping Review.

Patients experiencing homelessness (PEH) suffer from a high burden of cutaneous fungal infections. Preventative treatment is important as such infections can lead to harmful complications such as cellulitis and even osteomyelitis. There are sparse data regarding cutaneous fungal infections of homeless populations and management in low-resource settings. A MEDLINE search was conducted using the key terms "cutaneous," "fungal," "infections," "dermatophytes," and "homeless." The search included case-control, cohort, and randomized controlled trials published in the English language. This scoping review of studies yielded information with regard to practical treatment advice for providers in low-resource settings, including medical, hygiene, prevention, and treatment options for PEH with cutaneous fungal infections, the most common of which were tinea pedis (3-38%) and onychomycosis (1.6-15.5%). Few studies have been conducted on the differences between sheltered and unsheltered homeless patients, which can have treatment implications. Systemic antifungal therapy should be carefully considered for diffuse, refractory, or nail-based cutaneous fungal infections if there is a history of alcohol use disorder or liver disease. While PEH have a high risk of alcohol use disorder, this can make definitive treatment challenging.

Alcohol use in firefighters: A network model of behaviors and transdiagnostic risk

Background and aimsFirefighters are at heightened risk for developing alcohol use disorder (AUD), possibly due to chronic stress and exposure to potentially traumatic events. Daily trauma experiences and transdiagnostic risk factors (i.e., anxiety sensitivity and distress intolerance) are related to posttraumatic stress and depressive symptoms, as well as alcohol use severity and alcohol as a coping strategy. Although alcohol use has been identified as a key target for addressing mental health in firefighters, prior research has not fully integrated transdiagnostic vulnerabilities, internalizing symptoms, posttraumatic stress symptoms, alcohol coping, and overall alcohol use into a dynamic network model. MethodsWe assessed the symptom structure of overall alcohol use in firefighters with a likely AUD and transdiagnostic risk factors in all firefighters using network analysis. ResultsFailing to meet expectations (Expected Influence [EI]: 1.32), morning dependence (EI: 1.07), and guilt about drinking (EI: 1.10) were most central to the network model developed for firefighters with a likely AUD. In a transdiagnostic model of use in firefighters overall, anxiety sensitivity cognitive concerns (EI: 1.48) and negative alterations to cognitions and mood related to trauma (EI: 1.87) had the highest influence on the network. Notable correlations were also identified between trauma arousal and overall alcohol use, between depression and alcohol coping motives, and between trauma avoidance and alcohol coping motives. ConclusionsAlcohol use behaviors may follow a unique etiologic pathway in firefighters and intervention strategies should target factors found to be more central to symptom networks.

Acute sensitization of the P3 event-related potential response to beverage images and the risk for alcohol use disorder

Previous research suggests the amplitude of the P3 event-related potential (ERP) response reflects the incentive value of the eliciting stimulus, and that individuals with trait-like lower sensitivity (LS) to the acute effects of alcohol, a potent risk factor for alcohol use disorder (AUD), tend to show exaggerated P3 ERP responses to alcohol beverage cues (compared to their peers with higher sensitivity; HS). No prior research has examined trajectories of the cue-elicited P3 response across repeated trials of nonreinforced cue presentations. Characterizing these trajectories can be informative as to potential mechanisms linking LS with increased AUD risk. Here, we tested whether individual differences in alcohol sensitivity are associated with different trial-by-trial trajectories of the P3 elicited by alcohol and nonalcohol reward cues (infrequent oddball/target stimuli) using a large sample of emerging adults (Mage= 19.53; N = 287; 55% female; 86% White; 90% right-handed) stratified for alcohol sensitivity. Multilevel models adjusted for age, sex, handedness, and alcohol use indicated that: (i) the P3 response to alcohol and nonalcohol reward cues alike sensitized (i.e., increased) across trials; (ii) across the task, the P3 response to alcohol cues was larger for the LS than the HS phenotype; and (iii) the P3 difference score (alcohol - nonalcohol) was larger for the LS than HS phenotype only across the first half of task. Findings suggest that whereas incentive value attribution may be a mechanism for alcohol cue-triggered attentional biases for both LS and HS individuals, LS individuals more consistently over-attribute incentive value to alcohol cues.

Screening and brief intervention for alcohol use disorder risk in three middle-income countries

BackgroundThis study examined the prevalence of screening and brief intervention (SBI) for alcohol use disorder (AUD) risk in samples of adult drinkers in three middle-income countries (Brazil, China, South Africa), and the extent to which meeting criteria for AUD risk was associated with SBI.MethodsCross-sectional survey data were collected from adult samples in two cities in each country in 2018. Survey measures included past-year alcohol use, the CAGE assessment for AUD risk, talking to a health care professional in the past year, alcohol use screening by a health care professional, receiving advice about drinking from a health care professional, and sociodemographic characteristics. The prevalence of SBI was determined for past-year drinkers in each country and for drinkers who had talked to a health care professional. Logistic regression analyses were conducted to examine whether meeting criteria for AUD risk was associated with SBI when adjusting for sociodemographic characteristics.ResultsAmong drinkers at risk for AUD, alcohol use screening rates ranged from 6.7% in South Africa to 14.3% in Brazil, and brief intervention rates ranged from 4.6% in South Africa to 8.2% in China. SBI rates were higher among drinkers who talked to a health care professional in the past year. In regression analyses, AUD risk was positively associated with SBI in China and South Africa, and with brief intervention in Brazil.ConclusionAlthough the prevalence of SBI among drinkers at risk for AUD in Brazil, China, and South Africa appears to be low, it is encouraging that these drinkers were more likely to receive SBI.

Role of multiple risk factors in mental disorders diagnosed in middle-aged women: A population-based follow-up study

The aims of the study were 1). to investigate the association between the potential risk factors including socio-demographic, lifestyle and DNA methylation and mental disorders in middle-aged women from a large population-based follow-up study, and 2). to estimate the risk score by combining the potential risk factors to examine the mental disorder's incidence. A total of 6461 women, aged 50–65 years, were included in the study. After a median follow-up of 17 years, 2026 (31%) women were diagnosed with mental disorders. The association between these factors and the risk of mental disorders was analyzed using Cox regression models. Harrell's concordance index (C-index) was used to quantify models' predictive performance for future mental disorders. Blood-based global DNA methylation was assessed by an enzyme-linked immunosorbent assay. We found that smoking (HR = 1.38, 95% CI: 1.24–1.54), less physical activity (HR = 1.33, 95% CI: 1.10–1.60), being single (HR = 1.16, 95% CI: 1.04–1.29) and unemployment (HR = 1.50, 95% CI: 1.33–1.70) were independently associated with an increased risk of overall mental disorders. Risk score models combining all these observed factors showed an increased risk, but the prediction ability was low, except for the risk of alcohol use disorders (AUD) and drug use disorders (DUD) (C-index = 0.8). Finally, women who developed MDD/anxiety during follow-up had significantly higher global DNA methylation at baseline than women who did not develop MDD/anxiety (p = 0.005). In conclusion, our results indicate that the studied risk factors were associated with mental disorders in a type-specific manner. The predictive model showed that smoking, alcohol consumption, education and physical activity may predict future AUD/DUD. Global DNA methylation may be a potential risk factor for MDD/anxiety incidence.

Allelic variations in alcohol metabolism genes (ADH1B, ADH1C, CYP2E1) and alcohol use disorder (AUD) in northeastern Brazil

Alcohol use disorder (AUD) is a multifactorial disease caused by environmental and genetic factors. Genetic polymorphisms of the enzymes involved in alcohol metabolism influence the susceptibility to alcohol dependence. The distribution of the genetic variants varies depending on ethnicity. The aim of this study was to evaluate the effects of the polymorphisms of the three genes responsible for the degradation of ethanol, ADH1B, ADH1C, and CYP2E1 to examine the influence of these mutations on the risk for alcohol use disorder in a population from northeastern Brazil. In addition, the allelic distribution of the northeastern population will be compared with that obtained for other populations. The allelic and genotypic frequencies were determined in 163 alcoholic patients and 182 control subjects. Genotyping was performed by PCR-RFLP. The allele frequencies in the northeastern population were similar to those reported in studies in Mexico but differed significantly from those reported in studies of a Chinese population. The polymorphic variants of CYP2E1 were associated with a higher risk for alcohol use disorder [odds ratio (OR) = 2.80; 95% confidence interval (CI) = 1.35-5.83, p = 0.0072]. No significant result was obtained from the analyses of the ADH1C gene. A significant protective effect against alcohol dependence was observed in individuals carrying allelic and genotypic variations of the ADH1B gene, as determined through the combined analysis of homozygous and heterozygous variant forms of the gene in controls and alcoholics (P = 0.03). Furthermore, the combination of ADH1B*2 with ADH1C*1 and CYP2E1 (c1/c1) may confer protection against alcohol use disorder.

Embryonic ethanol exposure induces ectopic Hcrt and MCH neurons outside hypothalamus in rats and zebrafish: Role in ethanol-induced behavioural disturbances.

Embryonic exposure to ethanol increases the risk for alcohol use disorder in humans and stimulates alcohol-related behaviours in different animal models. Evidence in rats and zebrafish suggests that this phenomenon induced by ethanol at low-moderate concentrations involves a stimulatory effect on neurogenesis and density of hypothalamic neurons expressing the peptides, hypocretin/orexin (Hcrt) and melanin-concentrating hormone (MCH), known to promote alcohol consumption. Building on our report in zebrafish showing that ethanol induces ectopic expression of Hcrt neurons outside the hypothalamus, we investigated here whether embryonic ethanol exposure also induces ectopic peptide neurons in rats similar to zebrafish and affects their morphological characteristics and if these ectopic neurons are functional and have a role in the ethanol-induced disturbances in behaviour. We demonstrate in rats that ethanol at a low-moderate dose, in addition to increasing Hcrt and MCH neurons in the lateral hypothalamus where they are normally concentrated, induces ectopic expression of these peptide neurons further anterior in the nucleus accumbens core and ventromedial caudate putamen where they have not been previously observed and causes morphological changes relative to normally located hypothalamic neurons. Similar to rats, embryonic ethanol exposure at a low-moderate dose in zebrafish induces ectopic Hcrt neurons anterior to the hypothalamus and alters their morphology. Notably, laser ablation of these ectopic Hcrt neurons blocks the behavioural effects induced by ethanol exposure, including increased anxiety and locomotor activity. These findings suggest that the ectopic peptide neurons are functional and contribute to the ethanol-induced behavioural disturbances related to the overconsumption of alcohol.

Prevalence of Substance Use Disorders in Sickle Cell Disease Compared to Other Chronic Conditions: a Population-Based Study of Black American Adults.

Sickle cell disease (SCD) is a heritable chronic health condition characterized by pain symptoms throughout the life course that are routinely treated with opioids. This study examined differences in substance use disorders in Black American adults with SCD compared to those with other chronic conditions or with no chronic conditions. Data from a population-representative sample of Black Americans with SCD, other chronic conditions, and no chronic conditions were obtained from the National Survey of American Life (NSAL) database. Diagnosis of substance use disorder was determined by structured clinical interview. Hierarchical models controlling for covariates (demographics, socioeconomic status, self-rated health, and mood disorders) compared odds of diagnosis between the three groups. The sample included 4238 African-American and Black Caribbean participants from the NSAL study who were 18 years of age or older. Measures included age, sex, income, education, marital status, employment, possession of health insurance, health conditions, and substance use disorders diagnosed by structured clinical interview. Controlling for age, sex, and socioeconomic status, there were no differences in odds of a drug use disorder when comparing individuals with SCD to Black adults with other chronic conditions (OR = 1.12; p = 0.804) or no chronic condition (OR = 2.09; p = 0.102). SCD was, however, associated with greater odds of alcohol use disorders when compared to the groups with other chronic conditions (OR = 2.15; p = 0.01) and no chronic conditions (OR = 5.11; p < 0.001). This effect was not better accounted for by socioeconomic status, marital status, self-rated physical health, or the presence of a mood disorder. SCD was not a risk factor for drug use disorders. Further data will be needed to understand the factors contributing to increased risk of alcohol use disorders in SCD and the role uncontrolled pain symptoms may have in driving substance use.

Chemosensory Alterations and Impact on Quality of Life in Persistent Alcohol Drinkers.

Heavy alcohol consumption-associated chemosensory dysfunction is understudied, and early detection can help predict disease-associated comorbidities, especially those related to four quality of life (QOL) domains (physical, psychological, social and environment). We examined self-reports of chemosensory ability of individuals with different alcohol drinking behaviors and their association with changes in QOL domains. Participants (n = 466) were recruited between June 2020 and September 2021 into the NIAAA COVID-19 Pandemic Impact on Alcohol study. Group-based trajectory modeling was used to categorize participants without any known COVID-19 infection into three groups (non-drinkers, moderate drinkers and heavy drinkers) based on their Alcohol Use Disorders Identification Test consumption scores at four different time points (at enrollment, week 4, week 8 and week 12). Linear mixed models were used to examine chemosensory differences between these groups. The associations between chemosensory abilities and QOL were determined in each group. We observed significant impairment in self-reported smell ability of heavy drinking individuals compared to non-drinkers. In contrast, taste ability showed marginal impairment between these groups. There were no significant differences in smell and taste abilities between the moderate and non-drinking groups. Heavy drinkers' impairment in smell and taste abilities was significantly associated with deterioration in their physical, psychological, social and environmental QOL. Persistent heavy drinking was associated with lower chemosensory ability. Heavy drinkers' reduced smell and taste function and association with poorer QOL indicate that early assessment of chemosensory changes may be crucial in identifying poorer well-being outcomes in heavy drinkers at risk for alcohol use disorder.

COVID and college: how the pandemic impacted alcohol use disorder status among students

Objective: Alcohol consumption patterns during the COVID-19 pandemic have varied notably. Participants: We examined the acute impact of the pandemic on alcohol use disorder (AUD) in a generalizable sample of college students who were surveyed pre-pandemic and re-surveyed in May 2020. Method: Items assessed pre-pandemic included DSM-5 AUD and mental health symptoms. A COVID-19 impacts questionnaire was administered, and alcohol and mental health items re-assessed. Results: AUD symptoms decreased from pre-pandemic to during the pandemic, demonstrating a change in trajectory compared to prior cohorts. Students with persistent AUD reported greater concurrent symptoms of PTSD, depression, and alcohol consumption than those with remitted AUD (ps ≤ .02), but not increased COVID-19 impact. Persistent AUD status was predicted by higher sensation seeking and alcohol consumption. Conclusions: Students with concurrent mental health problems are at continued risk for persistent AUD. Findings highlight the impact of the college environment and social context for drinking on AUD.