Treatment Of Alcohol-related Problems Research Articles

A Deep Learning Algorithm to Predict Hazardous Drinkers and the Severity of Alcohol-Related Problems Using K-NHANES.

Purpose: The number of patients with alcohol-related problems is steadily increasing. A large-scale survey of alcohol-related problems has been conducted. However, studies that predict hazardous drinkers and identify which factors contribute to the prediction are limited. Thus, the purpose of this study was to predict hazardous drinkers and the severity of alcohol-related problems of patients using a deep learning algorithm based on a large-scale survey data.Materials and Methods: Datasets of National Health and Nutrition Examination Survey of South Korea (K-NHANES), a nationally representative survey for the entire South Korean population, were used to train deep learning and conventional machine learning algorithms. Datasets from 69,187 and 45,672 participants were used to predict hazardous drinkers and the severity of alcohol-related problems, respectively. Based on the degree of contribution of each variable to deep learning, it was possible to determine which variable contributed significantly to the prediction of hazardous drinkers.Results: Deep learning showed the higher performance than conventional machine learning algorithms. It predicted hazardous drinkers with an AUC (Area under the receiver operating characteristic curve) of 0.870 (Logistic regression: 0.858, Linear SVM: 0.849, Random forest classifier: 0.810, K-nearest neighbors: 0.740). Among 325 variables for predicting hazardous drinkers, energy intake was a factor showing the greatest contribution to the prediction, followed by carbohydrate intake. Participants were classified into Zone I, Zone II, Zone III, and Zone IV based on the degree of alcohol-related problems, showing AUCs of 0.881, 0.774, 0.853, and 0.879, respectively.Conclusion: Hazardous drinking groups could be effectively predicted and individuals could be classified according to the degree of alcohol-related problems using a deep learning algorithm. This algorithm could be used to screen people who need treatment for alcohol-related problems among the general population or hospital visitors.

Supporting the distributed execution of clinical guidelines by multiple agents.

Clinical guidelines (GLs) are widely adopted in order to improve the quality of patient care, and to optimize it. To achieve such goals, their application on a specific patient usually requires the interventions of different agents, with different roles (e.g., physician, nurse), abilities (e.g., specialist in the treatment of alcohol-related problems) and contexts (e.g., many chronic patients may be treated at home). Additionally, the responsibility of the application of a guideline to a patient is usually retained by a physician, but delegation of responsibility (of the whole guideline, or of a part of it) is often used\required (e.g., delegation to a specialist), as well as the possibility, for a responsible, to select the executor of an action (e.g., a physician may retain the responsibility of an action, but delegate to a nurse its execution). To manage such phenomena, proper support to agent interaction and communication must be provided, providing agents with facilities for (1) treatment continuity (2) contextualization, (3) responsibility assignment and delegation (4) check of agent "appropriateness". In this paper we extend GLARE, a computerized GL management system, to support such needs. We illustrate our approach by means of a practical case study.

Adult attachment and drinking context as predictors of alcohol problems and relationship satisfaction in college students

ABSTRACTBackground: Evidence suggests that for young adults, intimate partners influence each other’s drinking patterns. Therefore, exploration of variables related to intimate partner relationships (such as attachment style) could broaden the current understanding of risk factors for alcohol problems in this demographic. Objectives: The current study examined the role of drinking context in the relationships among insecure attachment, alcohol problems, and relationship satisfaction. A path model was hypothesized where the relationship between insecure attachment and alcohol problems would be explained via two distinct drinking contexts (i.e., drinking with one’s partner and drinking away from one’s partner). It was also hypothesized that the relationship between insecure attachment and relationship satisfaction would be explained via these same two drinking contexts. Methods: Participants were 194 undergraduate students ages 18–25 who reported being in a monogamous intimate partner relationship for at least 90 days and had also consumed alcohol in the past 90 days. The sample was comprised of 76% women and 24% men. Results: The hypothesized direct relationship from anxious attachment to alcohol problems was significant; there were also significant direct paths from both anxious and avoidant attachment to relationship satisfaction. The hypotheses regarding indirect relationships were not supported. Conclusion: The results of this study contribute to the existing literature, in that they suggest that drinking in the context of an intimate relationship may not directly affect relationship satisfaction in this population. However, relationship functioning still appears to be an important variable to consider in the prevention and treatment of alcohol-related problems affecting college students.

Internet interventions for treatment of alcohol-related problems

This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective of this review will be to assess the effect of internet and mobile phone alcohol-related interventions on reducing participants' alcohol consumption. Secondary objectives will include assessing the impact of the interventions on symptoms of alcohol-related disorders and degree of alcohol dependence, the effects on functioning, and patient acceptability. The review will also assess whether there are different outcomes for different diagnostic groups, and which intervention approaches or components (including therapeutic support) may be contributing to any positive effects.

Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample

BackgroundGay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. MethodsUsing data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. ResultsFindings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. ConclusionThese findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality.

Gender and race/ethnicity differences for initiation of alcohol-related service use among persons with alcohol dependence

BackgroundPrior studies on treatment for alcohol-related problems have yielded mixed results with respect to gender and race/ethnicity disparities. Additionally, little is known about gender and racial differences in time to first alcohol-related service contact amongst persons with alcohol dependence. This study explored gender and race/ethnicity differences for first alcohol-related service utilization in a population-based sample. MethodsPrimary analyses were restricted to Blacks, Whites and Hispanics, ages 18–44, with lifetime alcohol dependence (n=3311) in Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions. We compared time to service use among men and women within and across race/ethnicity strata using multivariable Cox proportional hazard methods. ResultsIn the sample of individuals age <45 with alcohol dependence, only 19.5% reported alcohol-related service use. Overall, women were less likely than men to receive alcohol-related services in their lifetime. However, women who did receive treatment were younger at first service utilization and had a shorter interval between drinking onset and service use than men. Gender differences were consistent across racial/ethnic groups but only statistically significant for Whites. There were no appreciable race/ethnicity differences in hazard ratios for alcohol-related service use or time from drinking initiation to first service contact. Results of sensitivity analyses for persons ≥45 years old are discussed. ConclusionsThere are important gender differences in receipt of and time from drinking initiation to service utilization among persons with alcohol dependence. Increased recognition of these differences may promote investigation of factors underlying differences and identification of barriers to services.

Consensus paper of the WFSBP task force on biological markers: Biological markers for alcoholism

Objectives. This article presents an overview of the current literature on biological markers for alcoholism, including markers associated with the pharmacological effects of alcohol and markers related to the clinical course and treatment of alcohol-related problems. Many of these studies are well known, while other studies cited are new and still being evaluated. Methods. In this paper we first describe known biomarkers of alcohol-related disorders, review their features and the problems involved in their use. We then consider future developments on biomarkers and their possible impact on the field. Results. More recent findings cited include the work on type 7 adenylcyclase (AC) polymorphism and its lower expression levels in female alcoholics. Neuroimaging studies involving biomarkers have also reported brain volume reductions of gray and white matter, including amygdala and subcortical regions in alcoholic patients, while a high association between the copy number variations (CNVs) in 6q14.1/5q13.2 and alcohol dependence has more recently been identified in genetic studies. Conclusions. In addition to their possible importance for diagnosis, biomarkers may have utility for predicting prognosis, progression of the disorder, the development of new treatments, and monitoring treatment effects. Although such findings should be verified in independent studies, the search for new biomarkers is continuing. Several potential candidate biomarkers have been found recently in blood, imaging, and genetic studies with encouraging results.

A novel treatment resource for co-occurring symptoms

Purpose – This paper describes the development of a novel integrative self-directed treatment tool which uses cognitive behavioural therapy techniques to reduce anxiety symptoms in patients presenting to treatment for alcohol-related problems. More specifically, the purpose of this paper is to explore patient and health practitioner perceptions of the booklet, in order to determine its suitability and utility in the context of existing alcohol treatment services. The extent of cross-informant agreement between patient and health practitioner responses is also examined. Design/methodology/approach – This research utilises a cross-sectional qualitative research design using semi-structured interview methods with patients presenting to hospital for alcohol-related diseases/illnesses/accidents/injuries (n=15) and practitioners (n=10) working at inpatient, outpatient and residential substance treatment facilities. Findings – The present study found that the majority of patients (80 per cent) and practitioners (90 per cent) expressed a motivation to utilise the proposed booklet, agreeing that the booklet was a practical, achievable and educational resource for patients suffering from co-occurring anxiety symptoms in substance abuse facilities. Participants outlined limitations of the resource, suggesting that the booklet would be most suitable for patients with moderate to high cognitive ability, who also exhibit a motivation to change alcohol consumption and have access to additional support. Practical implications – Findings from the present study suggest that the booklet may be most effective in improving treatment accessibility and patient treatment seeking behaviours; rather than reducing practitioner-patient contact. Originality/value – This paper focuses on the development and utility of a novel resource suitable for substance abuse treatment facilities. The findings and feedback produced from the present study can assist with modifications of the intervention and in improving the effectiveness of future trials.

Predictors of alcohol-related problems among depressed and non-depressed women

BackgroundDepression and alcohol-related problems are often comorbid in women, but not all depressed women have comorbid alcohol-related problems. The current study investigated intrapersonal (drinking expectancies), interpersonal (interpersonal pressure to drink), and familial (mother's and father's drinking history) predictors of alcohol-related problems among women with and without a major depressive episode in the past year. MethodParticipants were 853 women ages 21–90 from a U.S. national probability sample. Depression diagnosis was determined via interviewer administration of the Diagnostic Interview Schedule (DIS) depression module. Participants completed self-report measures of alcohol-related problems and intrapersonal, interpersonal, and familial predictors of drinking. ResultsRegression analyses indicated that an episode of depression in the past year, more positive drinking expectancies, greater interpersonal pressure to drink, and higher levels of maternal (but not paternal) drinking predicted alcohol-related problems; moreover, the relationships between alcohol-related problems and maternal drinking, paternal drinking, and interpersonal pressure to drink were significantly stronger among women with an episode of major depression in the past year than among women without an episode. LimitationsStudy data was cross-sectional and obtained through self-report, thus limiting causal explanations of results. ConclusionsFindings suggest that depression may enhance the impact of interpersonal and familial risk factors on women's alcohol misuse. Implications of findings for transdiagnostic models of psychopathology and for prevention and treatment of alcohol-related problems in women presenting with depressive symptoms are discussed.

Computerised assessment of alcohol use and readiness to change in Spanish-speaking emergency department patients

BackgroundThe rapid growth of the Latino population in the US requires increased attention for prevention, screening, and treatment for alcohol-related problems. We offer English and Spanish-speaking emergency department (ED) patients...

The Psychosocial Treatment Expectations Questionnaire (PTEQ) for Alcohol Problems

High dropout rates from treatment for alcohol-related problems are a problem for treatment delivery. Outcome expectations of treatment attendance are motivational aspects of treatment adherence. Since no method to put such expectations into operation has been found, we developed the Psychosocial Treatment Expectations Questionnaire (PTEQ) to assess the expectations of people receiving such psychosocial treatments. PTEQ development and early validation relied on data from 151 clients. A two-dimensional questionnaire assessing treatment purpose and atmosphere, and impact on daily life was developed, showing acceptable levels of reliability (α = 0.85 for the overall score, and 0.80 and 0.77 for the two scales, respectively). The PTEQ overall score significantly detected differences in expectations between those who remained in, and those who dropped out of treatment. On average, the dropouts had lower treatment expectations than those who remained in treatment. Validity for populations other than alcohol misusers and for treatments delivered exclusively through individual sessions, needs to be further examined.

The world of drinking: national alcohol control experiences in 18 countries

The world of drinking: national alcohol control experiences in 18 countries

Effect of Puerariae radix on c-Fos Expression in Hippocampus of Alcohol-Intoxicated Juvenile Rats.

Alcohol consumption is known to cause substantial neuronal loss in several regions of the brain. In Oriental medicine, medications based on Puerariae radix have been known to be of efficacy in the treatment of alcohol-related problems. In the present study, the effect of the aqueous extract of Puerariae radix on the expression of c-Fos, an immediate early gene whose expression is sometimes used as a marker for stimulus-induced changes in the metabolic activity of neurons, in the hippocampus of acutely alcohol-intoxicated juvenile rats was investigated via immunohistochemistry. In the first part of the experiment, Sprague-Dawley rats were divided into six groups: the control group, the alcohol-treated group, the alcohol- and 0.3 mg/kg Puerariae radix-treated group, the alcohol- and 3 mg/kg Puerariae radix-treated group, the alcohol- and 30 mg/kg Puerariae radix-treated group, and the alcohol- and 300 mg/kg Puerariae radix-treated group. In the second part of the experiment, animals were divided into four groups: the control group, the 30 mg/kg Puerariae radix-treated group, the alcohol-treated group, and the alcohol- and 30 mg/kg Puerariae radix-treated group. From the results, it was demonstrated that alcohol administration significantly decreases the number of Fos-positive cells in the various regions of the hippocampus, and Puerariae radix treatment inhibits the alcohol-induced suppression of the expression of Fos in the hippocampus in a dose-dependent manner. Puerariae radix exerted no significant effect on Fos expression in the hippocampus of normal rats. The results presented in this study suggest that Puerariae radix may alleviate alcohol-induced disruption of hippocampal functions.

Primary care and alcohol use disorders: evaluation of a faculty-development program in Venezuela

Primary care offers an opportunity to identify and treat persons who drink alcohol above permissible levels. In order to prepare primary care practitioners around the world to prevent and treat alcohol-related problems, the National Institute on Alcohol Abuse and Alcoholism of the United States of America has developed and tested a model international program for educating physicians about such problems. The model was designed to increase the clinical, teaching, and research skills of medical school faculty who work with medical students, residents, and primary care physicians. Venezuela was one of the countries selected for the initiative. During September 1999 a five-day faculty-development course consisting of 19 workshops was conducted at the University of Zulia, which is located in the city of Maracaibo, Zulia, Venezuela. Teaching strategies included class presentations, role plays, case presentations, skills-building workshops, and having each participant develop a teaching plan that he or she would use. Thirty-three faculty members from 9 of Venezuela's 10 medical schools participated in the project. The 18 female and 15 male participants had an average age of 44 years. The areas of specialization of the 33 participants were: family medicine (9 participants), psychiatry (7), pediatrics (6), obstetrics (4), internal medicine (3), and unspecified (4). Of the 33 participants, 25 of them (76%) completed a six-month follow-up interview. This group said they had significantly increased their competence in 14 clinical areas and that they had successfully implemented new teaching activities within their respective medical schools and residency programs. This model proved to be an effective strategy for increasing training for physicians in the prevention and treatment of alcohol-related problems in Venezuela. The evaluation confirms similar findings in other countries where the program has been implemented.

Criminal Justice Coercion in the Treatment of Alcohol Problems: An Examination of Two Client Subgroups

An increasing number of individuals are being referred to alcohol treatment programs under coercion from the criminal justice system. While a substantial number of investigations have addressed coercive treatment for illicit drug-related offenses, fewer studies have focused on mandated treatment for alcohol-related problems. This article examines the treatment of two subgroups of clients coerced into alcohol treatment from criminal justice institutions. The article begins with an overview of the literature on clients coerced into treatment as a result of “driving under the influence” (DUI) charges. The characteristics of a subgroup that has received less attention are then described: lower socioeconomic clients who are coerced into alcohol treatment from the courts for non-DUI offenses, such as public inebriation, disorderly conduct, trespassing, assault, and theft. This subgroup of non-DUI coerced-treatment offenders depends primarily upon underfunded public services, although their treatment requires careful assessment and triage for multiple problem areas. The article addresses some potential political and economic roadblocks to comprehensive treatment and closes with questions and recommendations for further research.

Book: Review/Commentary: The Treatment of Drinking Problems: A Guide for the Helping Professions

The Treatment of Drinking Problems: A Guide for the Helping Professions, by Griffith Edwards, E. Jane Marshall and Christopher C. Cook (Cambridge: Cambridge University Press, 1997), third edition, 368 pp., $85 cloth, $39.95 paper). I. REVIEWED BY William L. White A 1982 text by Griffith Edwards on the treatment of drinking problems was widely hailed and utilized. It went through a second edition (1987) and was eventually published in six languages. A new and significantly expanded edition of this text, titled The Treatment of Drinking Problems: A Guide for the Helping Professions, has been issued, with two coauthors, E. Jane Marshall and Christopher C. Cook. The critical praise heaped on the first two editions needs only be embellished for this latest edition. The Treatment of Drinking Problems is precisely what its title implies: a sweeping synthesis of the research and clinical literature on alcoholism and a highly useful manual for clinical practice. If anything, the authors are too humble in their statement of intent. Claimed to have been written for clinical practitioners, the book's utility easily extends to anyone who professionally encounters the personal and social consequences of excessive drinking. There are many quickly evident strengths to this book. First are its scope and objectivity. Edwards and his colleagues have presented a comprehensive survey of what we know about alcoholism and its treatment and have included balanced portrayals of some of the most controversial issues in alcoholism studies. Following a profusion of literature on addiction (much of questionable scientific merit), bringing into existence such a credible synthesis is no small feat. The text also rates high marks as a training manual. It is filled with prescriptive approaches to assessment and intervention that will be of great benefit to many helping professionals. The intent of this book is more one of helping alcoholics and their families than staking out ideological turf within the alcohol studies community. When the last page of The Treatment of Drinking Problems is turned, one is left with the clear impression that we are not only learning a great deal more about the potentially diverse and complex nature of alcohol problems but are also making significant strides in treating them. Having briefly added my own accolades to the praise that this book will surely receive as a training tool for professional helpers, it seems that this text might serve yet another purpose. The timing of this new edition offers something of a unique opportunity. Presenting itself as a comprehensive text on the treatment of alcoholism, and coming as it does at the end of the 20th century, this book affords a perfect vehicle to explore what we have learned about alcoholism and its treatment in this century. To conduct such a review requires that we define a baseline of knowledge by locating a comparable text written at the end of the l9th century. There are a number of late-19th-century texts that could serve this purpose, including Dr. Joseph Parrish's Alcoholic Inebriety (1883), Dr. T.L. Wright's Inebriism (1885), Dr. Norman Kerr's Inebriety (1894), or Dr. Charles Palmer's Inebriety: Its Source, Prevention and Cure (1898). The text I have chosen for this exercise is The Disease of Inebriety from Alcohol, Opium, and Other Narcotic Drugs (1893), compiled by Dr. T.D. Crothers. This choice is based on Crothers's international status as a late19th century addiction expert (a status comparable to that of Edwards today), the fact that Crothers's text was published by the American Association for the Study and Cure of Inebriety (an association analogous to today's American Society of Addiction Medicine), and that the text reflected the mainstream ideas of the association's central organ, The Journal of Inebriety. So, what does a comparison of these two widely acclaimed texts, written nearly 100 years apart, tell us about how the perception and treatment of alcohol-related problems have changed in the 20th century? …

Alcoholism and alcohol abuse among women: report of the Council on Scientific Affairs. American Medical Association.

We describe characteristics of women alcohol abusers, risk factors for alcoholism in women, barriers to treatment, and implications and strategies for physicians dealing with alcohol abuse in women patients, including risk assessments and intervention strategies. Alcohol abuse and alcoholism have a different physiologic effect on women than on men. Societal attitudes about women and alcohol and internal (self-perception) and external (environmental) factors can create barriers to the detection and treatment of female alcohol abusers. Physicians are in an excellent position to address the medical, psychologic, and social concomitants of alcoholism and alcohol abuse. The Council on Scientific Affairs recommends that physicians become more active in the prevention, diagnosis, and treatment of alcohol-related problems in women, including the diseases that may be associated with chronic alcohol abuse and the effect of alcohol on the developing fetus. Specific American Medical Association policy and recommendations for physician practice are included.

Gaps in the treatment for alcohol-related problems in primary care settings

Traditionally, the medical approach to the management of alcohol-related problems has been limited to the treatment of ‘alcoholism’, based on intensive medical and social rehabilitation, made by psychiatrists with a specialization in ‘addiction’, often in inpatient settings and for long periods of time. Treatment was given for those with presenting symptoms of dependence and withdrawal, several medical and psychiatric problems, asking for help or brought by the family, after a long ‘career’ of heavy alcohol consumption and numerous attempts at stopping alcohol use without any success. However, at the beginning of the 1980s, the need for a public health approach to reduce the impact of alcohol use in society led to the development of earlier and low-cost interventions which could benefit a larger number of people and be delivered before dependence and chronic disability had been established. It was realized that the burden of illness imposed on society by heavy drinkers was comparable to that imposed by al...

Using Social Indicators to Predict Addiction

Because of cost and other constraints, states often find it difficult to estimate need for treatment of alcohol-related problems from routine surveys. The social undesirability of illegal drug use makes the assessment of need for treatment of their use even more difficult. This paper uses independently obtained treatment need estimates to provide parameters for short-term prediction. We obtained the parameters by regressing the proportions of people addicted to alcohol (or drugs) in counties on social-indicator-based relative treatment need estimates for alcohol (or drugs). In addition to integrating estimates coming from independent sources, our approach presents an important tool for planning and resource allocation.

Traditional and Western Healing Practices for Alcoholism in American Indians and Alaska Natives

The American Indian and Alaska Native population is a culturally diverse population with a current census of 1,959,000. Prior to White contact, there was historically little use of alcoholic beverages except for American Indians in the Southwest. After White contact, use and misuse of alcohol escalated rapidly; however, the prevalence, patterns, and problems of drinking alcoholic beverages vary enormously even in tribes closely linked geographically. American Indians and Alaska Natives have preserved and revitalized a number of traditional healing practices and applied these to the treatment of alcohol-related problems. These healing practices include the following: nativistic movements, sacred dances, sweat lodges, talking circle, four circles, and cultural enhancement programs. Additionally, Western treatment approaches have been applied in the treatment of problems related to alcohol, such as medication for detoxification, disulfiram (Antabuse), Alcoholics Anonymous, and behavioral interventions. Several investigators have completed a small number of naturalistic follow-up studies, but no one has undertaken a randomized controlled trial looking at specific methods of alcohol treatment in American Indians or Alaska Natives. American Indian and Alaska Native communities have adapted and integrated both Traditional and Western approaches to fit their own unique sociocultural needs.