Timeline Followback Research Articles

Effects of Gabapentin on Dorsal Anterior Cingulate Cortex GABA and Glutamate Levels and Their Associations With Abstinence in Alcohol Use Disorder: A Randomized Clinical Trial.

Although gabapentin has demonstrated efficacy in mitigating alcohol withdrawal symptoms and preventing relapse drinking in individuals with alcohol use disorder (AUD), the neurobiological mechanisms of action underlying these therapeutic effects remain unknown. The present study evaluated changes in GABA and glutamate levels in the dorsal anterior cingulate cortex (dACC) as candidate mechanisms of action. In a 16-week randomized clinical trial, 68 adults with AUD, including a history of alcohol withdrawal syndrome, received 1,200 mg/day of gabapentin (N=37) or placebo (N=31) and nine medical management visits after ≥72 hours of abstinence. Proton MR spectroscopy (1H-MRS) estimates of dACC levels of GABA (N=67) and glutamate (N=64) were acquired before start of treatment and again approximately 14 days after randomization. Percent days abstinent was reported via timeline followback interview. The effects of gabapentin on GABA and glutamate levels were significantly associated with participants' percent days abstinent during early treatment. Specifically, gabapentin was associated with greater increases in glutamate and greater decreases in GABA levels in participants who remained mostly or entirely abstinent, and yet the opposite in participants who drank on more than half of the days preceding the second scan. Furthermore, gabapentin-treated participants with greater increases in glutamate levels during early treatment had significantly more percent days abstinent across the remainder of the study, relative to placebo-treated participants. In addition to providing insight into the mechanisms through which gabapentin may promote abstinence in individuals with AUD, this study also provides evidence for a biomarker of efficacious treatment that may be used to evaluate other glutamatergic or GABAergic medications for AUD and related conditions.

N-acetylcysteine (NAC) for methamphetamine dependence: A randomised controlled trial.

BackgroundMethamphetamine dependence is a significant global health concern for which there are no approved medications. The cysteine prodrug, N-acetylcysteine (NAC), has been found to ameliorate glutamate dysregulation in addiction, and to reduce craving for methamphetamine and other drugs. We evaluated the efficacy and safety of NAC as a pharmacotherapy for methamphetamine dependence.MethodsA parallel double-blind randomised placebo-controlled trial of people dependent on methamphetamine recruited from Geelong, Melbourne and Wollongong, Australia, between July 2018 and December 2019. Participants were randomised to receive either 12 weeks of oral NAC (2400 mg/day) or matched placebo, delivered as a take-home medication. The primary outcome was methamphetamine use, measured in two ways: (a) change in days of use in the past 4 weeks from baseline to weeks 4, 8 and 12, assessed using the Timeline Followback; and (b) methamphetamine-positive oral fluid samples taken weekly. Analyses were intention-to-treat and based on imputed data. Secondary outcomes were craving, severity of dependence, withdrawal severity and psychiatric symptoms (depression, suicidality, hostility and psychotic symptoms). Significance levels were p < 0.025 for primary outcomes and p < 0.01 for secondary outcomes. Adverse events were compared between groups by system organ class. The study was prospectively registered, ACTRN12618000366257.ResultsParticipants (N = 153; 59% male, mean [SD] age 38 [8]) were randomised to placebo (n = 77) or NAC (n = 76). Both groups had a median (IQR) of 24 (15–28) days of methamphetamine use in the 4 weeks prior to baseline. Both groups significantly reduced methamphetamine use (mean [SE] reduction of 7.3 [1.2]) days for placebo, 6.8 [1.2] for NAC) but NAC did not reduce days of methamphetamine use more than placebo (group difference of 0.5 days, 97.5% CI -3.4–4.3). There was no significant effect of NAC on methamphetamine-positive oral fluid samples (placebo 79%, NAC 76%; mean difference -2.6, 97.5% CI -12.6–7.4). NAC did not significantly reduce craving, severity of dependence, withdrawal, suicidality, depression, hostility or psychotic symptoms relative to placebo. Adverse events did not differ significantly between placebo and NAC groups.InterpretationThese findings suggest that take-home oral NAC has no significant effect on methamphetamine use or most clinically related outcomes amongst people who are dependent on the drug.

Daily associations between cannabis use and alcohol use in young adults: the moderating role of self-report and behavioral measures of impulsivity

Although impulsivity has been implicated in cannabis and alcohol use, its role in alcohol and cannabis co-use behavior requires further study. We examined the moderating role of self-report and behavioral measures of impulsivity in the daily-level relationships between cannabis use and both (a) likelihood of same-day alcohol use and (b) the number of drinks consumed on the same day. Young adults (n = 153) completed a 90-day Timeline Follow Back assessing the amount of cannabis smoked (in grams), other forms of cannabis (e.g. oils, edibles), and the number of standard drinks consumed each day. Participants also completed a structured interview of Alcohol and Cannabis Use Disorders (AUD/CUD), and both self-report (UPPS impulsivity scales) and behavioral (behavioral disinhibition and delay discounting) measures of impulsivity. Zero-inflated multilevel modeling revealed that negative urgency, delay discounting, and disinhibition were significant, unique moderators of the daily relationship between cannabis and alcohol consumption, after controlling for AUD/CUD symptoms and other covariates. Specifically, individuals high (but not low) on negative urgency and delay discounting showed a positive association between grams of cannabis used on a given day and same-day number of standard drinks consumed. Contrary to expectations, individuals low on negative urgency and low in disinhibition showed a stronger relationship between grams of cannabis consumed and odds of engaging in any drinking on the same day. Results extend research on moderators of within-person, daily-level associations between cannabis and alcohol use, suggesting that several impulsivity-related constructs may contribute to complementary use of cannabis and alcohol among young adults.

Computer delivered intervention for alcohol and sexual risk reduction among women attending an urban sexually transmitted infection clinic: A randomized controlled trial

ObjectiveWe sought to determine if a computer delivered brief alcohol intervention (CBI) with or without interactive voice response counseling and text messages (CBI-IVR-TM), reduced alcohol use and sexual risk behaviors compared to attention control. MethodsWe conducted a 3-arm RCT among women (n = 439) recruited from Baltimore City Sexually Transmitted Infection (STI) Clinics. Eligibility included: 1) consumption of >7 drinks per week or 2) ≥2 episodes of heavy episodic drinking or ≥2 episodes of sex under the influence of alcohol in the prior three months. Research assessments conducted at baseline, 3, 6 and 12 months included a 30-day Timeline Followback querying daily alcohol use, drug use, and sexual activity. We used the MINI International Neuropsychiatric Interview-DSM-IV to ascertain drinking severity. Primary alcohol outcomes included: drinking days, heavy drinking days, drinks per drinking day. Secondary sexual risk outcomes included number of sexual partners, days of condomless sex, and days of condomless sex under the influence of drugs and alcohol. ResultsMedian age was 31 (IQR 25–44 years), 88% were African American, 65% reported current recreational drug use, and 26% endorsed depressive symptoms. On the MINI 66% met criteria for alcohol use disorder (49% alcohol dependence, 18% abuse). At follow-up, all three groups reduced drinking days, heavy drinking days, drinks per drinking day and drinks per week with no significant differences between study arms. There was no difference in sexual risk outcomes among the groups. ConclusionsAmong women attending an urban STI clinic single session CBI with or without IVR and text message boosters was insufficient to reduce unhealthy alcohol use or sexual risk behaviors beyond control. The high severity of alcohol use and the prevalence of mental health symptoms and other substance use comorbidity underscores the importance of developing programs that address not only alcohol use but other determinants of STI risk among women.

Psychological distress, obsessive-compulsive thoughts about drinking, and alcohol consumption in young adult drinkers

ABSTRACT Background Psychological distress is an important predictor of heavy drinking, especially among lower-income drinkers. The mechanisms underlying this effect are not well understood. One possibility is that distressed individuals are more vulnerable to obsessive and compulsive thoughts about drinking. We hypothesized that: 1) distress would predict obsessive and compulsive thoughts about alcohol, which in turn would predict drinking and 2) effects would be particularly pronounced among lower-income drinkers. Methods Young adults (n = 105) were recruited from an urban university and completed the Brief Symptoms Index (BSI), the Obsessive-Compulsive Drinking Scale (OCDS), and a 90-day timeline follow-back (TLFB) drinking interview. Results Consistent with the hypotheses, drinkers with higher distress (BSI) exhibited greater obsessive and compulsive drinking-related thoughts, which in turn predicted drinking over the past 90 days (p < .0001). Path analyses revealed that the BSI had a significant indirect effect on drinking outcomes through increased OCDS. Furthermore, conditional process analyses revealed that effects were particularly pronounced among drinkers with lower household incomes. Conclusions Findings highlight the importance of psychological distress as a predictor of obsessive and compulsive thoughts about alcohol, as well as drinking behavior, and underscore the critical need to address psychological functioning among lower-income drinkers in particular.

Infant neurodevelopmental outcomes of prenatal opioid exposure and polysubstance use

BackgroundPrenatal opioid exposure has been linked to adverse birth outcomes and delays in infant development. Existing literature is limited by a simple group-differences approach as well as inadequate controls for sociodemographic factors and polysubstance exposure co-occurring with prenatal opioid use. MethodThe current study assessed cumulative opioid exposure (duration of prescribed and illicit opioid use) as a predictor of infant birth outcomes and mother-reported developmental status at three and six months of age, controlling for polysubstance exposure. Participants were predominantly low-income pregnant and peripartum women, oversampled for mothers receiving medication-assisted treatment (MAT) for opioid use disorder. Prenatal opioid and non-opioid substance use were reported by mothers using a Timeline Follow-Back Interview completed during the third trimester and updated postnatally (infant age six months). ResultsDevelopmental scores were in the normal range. However, total opioid exposure was positively related to premature birth and inversely related to mother-reported developmental status in specific domains. Associations with three-month fine motor skills and six-month communication skills were robust to controls for polysubstance exposure and sociodemographic covariates. ConclusionsResults suggest unique effects of prenatal opioid exposure on the early development of fine motor and communication skills. Similar findings were obtained for prescribed and illicit opioid use, underscoring developmental risks of both MAT and untreated substance use. Exploratory analyses investigating type and timing of MAT suggest directions for future research.

Mindfulness-based relapse prevention for cannabis regular users: Preliminary outcomes of a randomized clinical trial

Mindfulness-based approaches have shown their effectiveness in caring for patients with substance use disorders (SUD). Mindfulness-based relapse prevention (MBRP) integrates practices from mindfulness-based interventions and cognitive-behavioral relapse prevention (RP) approaches. This article presents the preliminary results of a study that measures the effectiveness of an MBRP protocol for volunteer cannabis users willing to reduce or stop their consumptions. Twenty cannabis users were randomly assigned to either receive an eight-week outpatient MBRP program or treatment as usual (TAU). Cannabis use was assessed weekly through the timeline follow back (TLFB). Eighty percent of individuals received MBRP treatment and 60% of individuals received TAU completed treatment. Preliminary results did not find significant difference at the end of treatment (week 8) regarding the number of joints smoked. Despite the absence of any significant difference between the two groups, the contribution of mindfulness in the caring of SUD seems encouraging and promising. Many MBRP group participants reported qualitative changes in the way they consumed. This study will be continued in order to evaluate the effectiveness of MBRP on a larger number of subjects.

The role of reward and reinforcement in understanding alcohol use among adults living with HIV in South Africa.

Most research investigating reinforcement in alcohol use is from high-income countries. The current study sought to understand the association of different reinforcement types (alcohol-specific reward, environmental reward, behavioral activation) with multiple measures of alcohol use and cravings among individuals living with HIV in South Africa. Baseline data were obtained from a substance use clinical trial in Cape Town (N = 65). Unhealthy alcohol use was measured using the biomarker phosphatidylethanol (PEth), Alcohol Use Identification Test (AUDIT-C), average number of drinks from the timeline follow back (TLFB), and self-reported cravings. Reinforcement was measured using the proportion of income spent on alcohol (alcohol-specific reward), both subscales of the Reward Probability Index (environmental reward), and the Behavioral Activation Depression Scale (activation). Poisson and linear regression analyses were conducted. Each percentage point increase in income spent on alcohol was significantly associated with PEth, RR = 1.004 [95% CI (1.001, 1.007)], which translates to a 13.6% increase in the relative risk of unhealthy alcohol use for the average person in the study. More alcohol-specific reward was significantly associated with higher scores on the AUDIT-C, higher average number of drinks on the TLFB, and more cravings. Higher activation was associated with lower scores on the AUDIT-C. Neither subscale of environmental reward was associated with model outcomes. Greater alcohol-specific reward and less behavioral activation were associated with more frequent and unhealthy alcohol use in this setting, but not environmental reward. Findings highlight how different reinforcement types potentially influence alcohol use in a low-resource global setting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Comparison of Survey and Interview Methods for Collecting Recent Caffeine and Alcohol Use Data in College Students

Background: The present study collected benchmark data on alternative methods for collecting quantity and frequency information about caffeine, alcohol, and caffeine and alcohol combined (CAFF+ALC) use. Materials and Methods: Participants were N = 50 college students who completed computer-administered survey (COMPSURVEY) and Timeline Followback (TLFB) interviews in randomized order. COMPSURVEY and TLFB data were compared using t-tests, McNemar's tests, and Spearman's correlations. Results: For alcohol, COMPSURVEY underestimated quantity consumed compared to TLFB. Similar patterns were found for caffeine, with every participant having ≥1 COMPSURVEY-TLFB self-report difference and 65.5% having a CAFF+ALC inconsistency. Over half (56%) of participants had ≥1 caffeine misreport, with 46% misclassifying a beverage as containing/not containing caffeine. Moderate to strong relationships were found for caffeine and alcohol quantity and frequency of use, but associations for CAFF+ALC were weak. Conclusions: The largest inconsistencies were found for CAFF+ALC use, indicating that more research is needed to identify methods for collecting reliable and valid CAFF+ALC use data.

Project Khanya: results from a pilot randomized type 1 hybrid effectiveness-implementation trial of a peer-delivered behavioural intervention for ART adherence and substance use in HIV care in South Africa.

IntroductionSouth Africa (SA) has the highest number of people living with HIV (PLWH) globally, and a significant burden of alcohol and other drug use (AOD). Although integrating AOD treatment into HIV care may improve antiretroviral therapy (ART) adherence, this is not typically routine practice in SA or other low‐resource settings. Identifying interventions that are feasible and acceptable for implementation is critical to improve HIV and AOD outcomes.MethodsA pilot randomized hybrid type 1 effectiveness‐implementation trial (N = 61) was conducted to evaluate the feasibility and acceptability of Khanya, a task‐shared, peer‐delivered behavioral intervention to improve ART adherence and reduce AOD in HIV care in SA. Khanya was compared to enhanced treatment as usual (ETAU), a facilitated referral to on‐site AOD treatment. Implementation outcomes, defined by Proctor’s model, included feasibility, acceptability, appropriateness and fidelity. Primary pilot effectiveness outcomes were ART adherence at post‐treatment (three months) measured via real‐time electronic adherence monitoring, and AOD measured using biomarker and self‐report assessments over six months. Data collection was conducted from August 2018 to April 2020.Results and discussionNinety‐one percent of participants (n = 56) were retained at six months. The intervention was highly feasible, acceptable, appropriate and delivered with fidelity (>90% of components delivered as intended by the peer). There was a significant treatment‐by‐time interaction for ART adherence (estimate = −0.287 [95% CI = −0.507, −0.066]), revealing a 6.4 percentage point increase in ART adherence in Khanya, and a 22.3 percentage point decline in ETAU. Both groups evidenced significant reductions in alcohol use measured using phosphatidylethanol (PEth) (F(2,101) = 4.16, p = 0.01), significantly decreased likelihood of self‐reported moderate or severe AOD (F(2,104) = 7.02, p = 0.001), and significant declines in alcohol use quantity on the timeline follow‐back (F(2,102) = 21.53, p < 0.001). Among individuals using drugs and alcohol, there was a greater reduction in alcohol use quantity in Khanya compared to ETAU over six months (F(2,31) = 3.28, p = 0.05).ConclusionsResults of this pilot trial provide initial evidence of the feasibility and acceptability of the Khanya intervention for improving adherence in an underserved group at high risk for ongoing ART non‐adherence and HIV transmission. Implementation results suggest that peers may be a potential strategy to extend task‐sharing models for behavioral health in resource‐limited, global settings.

Nonsuicidal Self-injury, Suicide Planning, and Suicide Attempts Among High-risk Adolescents Prior to Psychiatric Hospitalization.

The purpose of this study was to understand the trajectories of nonsuicidal self-injury (NSSI) and suicide plans (SP) in the 90days prior to inpatient hospitalization, understand the role of NSSI and SP in predicting suicide attempts (SA) on a given day, and to test the interaction between NSSI and SP in predicting same-day SA. Participants included 69 adolescents (77% female, 65% white, 77% Non-Hispanic/Latinx, Mage = 15.77 SDage = 1.00) from an inpatient psychiatric unit. Past 90day NSSI, SP, and SA were measured using the Columbia Suicide Severity Rating Scale and Timeline Follow Back. First, mixed effect models were conducted to assess trajectories of NSSI and SP leading up to inpatient hospitalization. The odds of NSSI remained relatively stable prior to hospitalization (OR = 1.01, 95% CI [1.00,1.02]). The odds of SP increased in the 90days prior to hospitalization (OR = 1.04, 95% CI [1.02,1.05]) with each day associated with a 4% increase in the odds of making a SP. Second, random effect models were conducted to predict the odds of same-day SA from NSSI and SP. When adolescents endorsed either NSSI (OR = 2.99, p < .001) or a SP (OR = 77.13, p < .001) there was elevated odds of same-day SA. However, the presence of both NSSI and SP on a given day did not increase risk of SA on that same day. For this high-risk clinical sample of suicidal adolescents who drink alcohol, odds of SP increased in the days leading up to psychiatric hospitalization, but NSSI remained stable. On days when adolescents reported NSSI or SP, they had an increased odds of same-day SA. These results underscore the importance of frequent monitoring of NSSI and SP among high-risk adolescents who drink alcohol to prevent suicide attempts.

Cognitive insight, medication adherence and methamphetamine cessation in people enrolled in a pharmacotherapy trial for methamphetamine use

BackgroundThe current study examined correlates of cognitive insight in people enrolled in a methamphetamine pharmacotherapy trial; whether cognitive insight at the start of the trial predicted medication adherence and reductions in methamphetamine use during the trial; and, whether insight would remain stable over the trial or improve with reductions in methamphetamine use. MethodsA subset of people enrolled in a 12-week randomised placebo-controlled pharmacotherapy trial for methamphetamine dependence completed the Beck Cognitive Insight Scale, comprising subscales for Self-Reflection and Self-Certainty, at baseline (n = 152) and at week 12 (n = 79). Medication adherence was expressed as the percentage of non-missed doses measured using eCAP™ technology. Methamphetamine use days were assessed using the Timeline Followback. ResultsAt baseline, greater Self-Reflection was correlated with more severe methamphetamine withdrawal, and hostility, whereas Self-Certainty was correlated with less education and longer duration of methamphetamine use. No relationship was found between BCIS subscales at baseline and medication adherence (Self-Reflection b[SE] = −0.73 [0.43] p = .09; Self-Certainty b[SE] = −0.31 [0.48] p = .52,). Neither BCIS subscale was predictive of reduced methamphetamine use at 12 weeks (Self-Reflection b[SE] = 0.001 [0.01] p = .95 Self-Certainty b[SE] = −0.003 [0.01], p = .74). Self-Reflection decreased over the trial (t = 3.42, p = .001) but this was unrelated to change in methamphetamine use (Self-Reflection, b[SE] = −1.68 [1.16] p = .15) Change in methamphetamine use was found to be a significant predictor of Self-Certainty at 12 weeks (b [SE] = −2.71 [1.16] p = .02). ConclusionsWe found no evidence that cognitive insight predicted medication adherence or methamphetamine reduction in people engaged in this trial. Ongoing or increased methamphetamine use predicted increased Self-Certainty at 12 weeks.

Validation of an Online Version of the Alcohol Use Disorders Identification Test (AUDIT) for Alcohol Screening in Spanish University Students.

Online alcohol screening may be helpful in preventing alcohol use disorders. We assessed psychometric properties of an online version of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish university students. We used a longitudinal online survey (the UNIVERSAL project) of first-year students (18–24 years old) in five universities, including the AUDIT, as part of the WHO World Mental Health International College Student (WMH-ICS) initiative. A reappraisal interview was carried out with the Timeline Followback (TLFB) for alcohol consumption categories and the Mini International Neuropsychiatric Interview (MINI) for alcohol use disorder. Reliability, construct validity and diagnostic accuracy were assessed. Results: 287 students (75% women) completed the MINI, of whom 242 also completed the TLFB. AUDIT’s Cronbach’s alpha was 0.82. The confirmatory factor analysis for the one-factor solution of the AUDIT showed a good fit to the data. Significant AUDIT score differences were observed by TLFB categories and by MINI disorders. Areas under the curve (AUC) were very large for dependence (AUC = 0.96) and adequate for consumption categories (AUC > 0.7). AUDIT cut-off points of 6/8 (women/men) for moderate-risk drinking and 13 for alcohol dependence showed sensitivity/specificity of 76.2%/78.9% and 56%/97.5%, respectively. The online version of the AUDIT is useful for detecting alcohol consumption categories and alcohol dependence in Spanish university students.

Shifts in behavioral allocation patterns as a natural recovery mechanism: Postresolution expenditure patterns.

Behavioral economics predicts that recovery from Alcohol Use Disorder involves shifts in resource allocation away from drinking, toward valuable nondrinking rewards that reinforce and stabilize recovery behavior patterns. Further, these shifts should distinguish nonproblem drinking (moderation) outcomes from outcomes involving abstinence or relapse. To evaluate these hypotheses, 5 prospective studies of recent natural recovery attempts were integrated to examine changes in monetary spending during the year following the initial cessation of heavy drinking as a function of 1-year drinking outcomes. Problem drinkers from Southeastern U.S. communities (N=493, 67% male, 65% white, mean age=46.5years) were enrolled soon after stopping heavy drinking without treatment and followed prospectively for a year. An expanded Timeline Followback interview assessed daily drinking and monetary spending on alcohol and nondrinking commodities during the year before and after recovery initiation. Longitudinal associations between postresolution drinking and spending were evaluated using MPlus v.8. Initial models evaluated whether changes in spending at 4-month intervals predicted drinking outcomes at 1 year and showed significant associations in 6 commodity categories (alcohol, consumable goods, gifts, entertainment, financial/legal affairs, housing/durable goods/insurance; ps<0.05). Cross-lagged models showed that the moderation outcome group shifted spending mid-year to obtain large rewards with enduring benefits (e.g., housing), whereas the abstinent and relapsed groups spent less overall and purchased smaller rewards (e.g., consumable goods, entertainment, and gifts) throughout the year. Dynamic changes in monetary allocation occurred during the postresolution year. As hypothesized, compared to the groups who abstained or relapsed, the moderation group shifted spending in ways that, overall, yielded higher value alcohol-free reinforcement that should reinforce recovery while they enjoyed some limited nonproblem drinking below heavy drinking thresholds. These findings add to evidence that moderation entails different behavioral regulation processes than abstinent and relapse outcomes, which were more similar to one another.

Effects of At‐Risk and Recent Alcohol Use on Diet Quality among People Living with HIV (PLWH)

People living with HIV (PLWH) have increased rates of alcohol use, increased survival rates with the use of ARTs and are at an increased risk for the development of metabolic comorbidities, including obesity and insulin resistance. Alcohol use is associated with decreased diet quality and individuals consuming large quantities of alcohol often have the poorest diet quality and overconsume calories. The goal of this study was to test the hypothesis that at-risk alcohol use, as well as recent alcohol use, is associated with poor diet quality in PLWH. Diet quality was determined in a subset of adult, in-care PLWH enrolled in the New Orleans Alcohol Use in HIV (NOAH) Study (n=222). Participants completed a single 24-hour dietary recall using the Automated Self-Administered 24-hour (ASA-24) Dietary Recall Tool and values were compared to the U.S. Dietary Guidelines and Dietary Reference Intakes. At-risk alcohol use was determined by the Alcohol Use Disorders Identification Test (AUDIT). An AUDIT score ≥ 8 was defined as at-risk alcohol use (n=67) and an AUDIT score of < 8 (n=155) was considered low-risk. Recent alcohol use was determined by Timeline Followback (TLFB), which assessed the previous 30-day alcohol intake. PLWH with at-risk alcohol use had lower body mass index (BMI), consumed a lower percentage of calories from carbohydrates, consumed more total calories, more calories from protein, more cholesterol and sodium and had a higher total calorie/body weight (kg) than PLWH with low-risk alcohol use. PLWH with at-risk alcohol use also consumed more calories from alcohol than PLWH with low-risk alcohol use. Calories from alcohol accounted for the difference in total caloric intake between the two groups. Cured meat intake (oz. equivalent) was higher in PLWH with at-risk alcohol use, which likely contributed to the increased sodium, cholesterol and protein intake in this group. AUDIT score and recent alcohol use (TLFB) were positively correlated with each other and total caloric consumption and calories from alcohol. Additionally, recent alcohol use (TLFB) was positively correlated with calories consumed from protein, fat, and carbohydrates. Both AUDIT score and recent alcohol use (TLFB) were negatively correlated with BMI and waist circumference. Overall, PLWH consumed lower than recommended dietary amounts of carbohydrates (43.6% ± 11.2) and higher than recommended amounts of fat (36.0% ± 9.1). The Healthy Eating Index (HEI), a measure of diet quality based on Dietary Guidelines for Americans was not affected by alcohol use in PLWH, however average HEI in PLWH was 44.5/100, compared to the national average in adults, 59/100. These preliminary analyses suggest that at-risk and recent alcohol use significantly affect diet quality in PLWH and that overall, PLWH in this South Louisiana cohort are not meeting U.S Dietary Guidelines. The development and implementation of nutritional and alcohol-reducing interventions may be appropriate strategies to improve food selection and diet quality and decrease the risk of developing metabolic comorbidities in PLWH.

Python Package abstcal: An Open-Source Tool for Calculating Abstinence From Timeline Followback Data.

In smoking cessation clinical trials, timeline followback (TLFB) interviews are widely used to track daily cigarette consumption. However, there are no standard tools for calculating abstinence based on TLFB data. Individual research groups have to develop their own calculation tools, which is not only time- and resource-consuming but might also lead to variability in the data processing and calculation procedures. To address these issues, we developed a novel open-source Python package named abstcal to calculate abstinence using TLFB data. This package provides data verification, duplicate and outlier detection, missing-data imputation, integration of biochemical verification data, and calculation of a variety of definitions of abstinence, including continuous, point-prevalence, and prolonged abstinence. We verified the accuracy of the calculator using data derived from a clinical smoking cessation study. To improve the package's accessibility, we have made it available as a free web app. The abstcal package is a reliable abstinence calculator with open-source access, providing a shared validated online tool to the addiction research field. We expect that this open-source abstinence calculation tool will improve the rigor and reproducibility of smoking and addiction research by standardizing TLFB-based abstinence calculation. Abstinence calculation is an essential task in any smoking intervention study. However, there have not been standard open-source tools available to the researchers. This commentary describes a Python-based package called abstcal that can calculate abstinence from TLFB data, a common methodology to collect smoking consumption data in research settings. The package supports the calculation of point-prevalence, prolonged, and continuous abstinence. Importantly, the package has a web app interface that allows researchers to use the tool without any coding experience. This tool will facilitate smoking research by providing a standardized and easy-to-use abstinence calculation tool.

Limited Evidence of Associations Between Executive Functioning and Alcohol Involvement In UK Adolescents.

AimsDeficits in motor inhibitory control and working memory have been hypothesized to be both a cause and consequence of heavy alcohol use. Adolescence is a critical developmental stage for inhibitory control and working memory, and it is also a stage when individuals are most likely to initiate alcohol use. This study aimed to examine whether inhibitory control and working memory would predict alcohol use and involvement in a group of UK adolescents.MethodsWe recruited 220 (N = 178, female) adolescents, aged between 16 and 18, from eight higher education settings in the Merseyside region of the UK. Alcohol use was examined using the Timeline Follow-Back and involvement (and related problems) using the Adolescent Alcohol Involvement Scale. A reward-based inhibitory control task (Go/No-Go) was used to examine the inhibition and reward sensitivity, and a self-ordered pointing task was used to measure working memory.ResultsMultiple regression demonstrated that neither inhibitory control (b = 0.02 (95% confidence interval (CI): −0.21, 0.24)) nor working memory (b = −0.12 (95% CI: −0.30, 0.07)) were significant predictors of alcohol use (units consumed). Inhibitory control (b = 0.61 (95% CI: 0.12, 1.09), specifically, in the no reward condition and school deprivation (b = 0.67 (95% CI: 0.06, 1.28) significantly predicted alcohol-related problems.ConclusionsOur findings demonstrated limited evidence that deficits in specific mechanisms of executive functioning (i.e. motor inhibition and working memory) were associated with alcohol-related problems in UK adolescents. This study adds to an increasing body of literature suggesting weak or non-existent links between inhibitory control, working memory and alcohol use.

COVID-19 Pandemic Influence on Healthcare Professionals.

During the pandemic, many healthcare professionals (HCPs) are overburdened by work and stress. The aim of the study was to examine alcohol intake, sleep disorders, and depressive symptoms of HCPs during the pandemic in comparison with the pre-pandemic period. Another goal was to indicate risk factors for mental state deterioration and an increase in alcohol use. A cross-sectional survey study was conducted from 1 April to 15 May 2020. HCPs (n = 158) completed questionnaires that probed for symptoms during and prior to the pandemic, including the Beck depression inventory (BDI), Social Support Scale (MOS-SSS), Athens insomnia scale (AIS), and Alcohol Timeline Followback (TLFB) calendar of alcohol consumption. Gender, age, education, marital status, work situation, income, participants’ and relatives’ COVID-19 diagnosis as correlates were analyzed. Depressive symptoms and insomnia became more severe during the pandemic among HCPs, while social support increased. The increase in depressive symptoms was even higher among women (OR 2.78, 95% CI 1.05–7.36; p = 0.04) and was also positively correlated with work reduction (p = 0.02); the presence of sleep disorders was correlated with female gender. Alcohol consumption increased during the pandemic, and was correlated with both more time spent at work and income increase. HCPs involved in the treatment of COVID-19 need support and attention due to the excessive stress load during pandemics, resulting in depression, insomnia, and increased alcohol intake.

Cannabis and Alcohol Co-Use and Condomless Anal Sex Among Men Who have Sex with Men Living with HIV: An Event-Level Analysis.

Men who have sex with men (MSM) account for more than two thirds of new HIV diagnoses annually. Sexual behavior that increases risk for onward transmission of HIV is associated with both alcohol and cannabis use. However, little is known about the influence of cannabis and alcohol co-use on engagement in condomless anal sex (CAS). The current study explored daily associations between substance use and CAS among HIV-positive MSM using a 42-day timeline followback interview (N = 101). Generalized estimating equation (GEE) logistic regression models were used to examine the association between cannabis and alcohol co-use and CAS at the sexual event while controlling for study site, condition, adherence to antiretroviral therapy, sex-related alcohol expectancies, and partner type. Participants provided data for 1052 sexual activity days, 60.7% of which involved CAS. Of 638 CAS days, 9.1% involved no substances, 72.0% involved either cannabis or alcohol use, and 18.9% involved cannabis and alcohol co-use. Results indicated that the odds of engaging in CAS were higher for sexual events in which cannabis and alcohol co-use occurred (aOR 2.98; 95% CI 1.27, 6.97) compared to events in which no substance use occurred (p = 0.012), but this relationship was no longer significant when cannabis and alcohol co-use was compared to single substance use (aOR 1.57; 95% CI 0.85, 2.90; p = 0.15). Future research should identify specific substance use (e.g., quantity) and partner characteristics (e.g., level of intoxication) that may uniquely influence the relationship between cannabis and alcohol co-use and condomless sex.

Changes in Alcohol Use and Drinking and Driving Outcomes From Before Arrest for Driving Under the Influence to After Interlock Removal.

Half of the offenders convicted of impaired driving in the United States are sentenced to install alcohol ignition interlock devices (IIDs), which prevent them from starting their vehicles if they have been drinking. No research has yet explored offenders' patterns of alcohol consumption and driving under the influence of alcohol (DUI) from the time before the arrest to the time period after the IID is installed. This study aims to fill that gap in knowledge. Using the Timeline Follow-back interview procedure, we assessed the daily drinking of 153 convicted DUI offenders' self-reported total alcohol consumption and rates of self-reported driving after drinking over 4 phases: before DUI arrest, between arrest and IID installation, during the phase on the interlock, and after the interlock is removed. Because information about behaviors in each period was not available for every participant, comparisons were made using paired-sample contrasts. Compared with before the arrest, total alcohol use decreased by 50% in the 4-month phase following arrest and before IID installation, though it did not change much afterward. The frequency of drinking and driving decreased sharply after the arrest (-82%), with further decrease upon installation of the interlock (-58%, p=0.05). The frequency of drinking and driving after the IID was removed returned to preinstallation drinking and driving status (+58%, p=0.01). Participants made significant adjustments to their drinking behavior by adhering to the traditional DUI driving restrictions in the postarrest phase. Although installation of an IID was not associated with a significant change in drinking, it further reduced the frequency of drinking and driving. Evaluations of the IID experience should take into account information on an individual's drinking and DUI behaviors not only before the IID was installed, but before the individual was arrested.