Journal of studies on alcohol and drugs最新文献

Objective: To identify latent classes of substance use behaviors (i.e., alcohol and illicit drug use) and their correlates among transgender women and transfeminine nonbinary adults.

Method: Baseline data (March 2018 to August 2020; n=1,614) from [blinded] were used to identify latent substance use classes and report latent class membership probabilities (γ) and item-response probabilities (ρ). We assigned participants to the class with their highest probability of class membership and assessed associations with socioeconomic conditions. We reported adjusted odds ratios (aOR) and 95% confidence intervals (CI) for each correlate.

Results: Mean age was 33.0 years old (standard deviation=12.1), and 45.3% were Non-Latina/e, White. We identified four classes: no illicit drug use (γ=0.63), alcohol misuse and cannabis use (γ=0.26), polysubstance use (γ=0.062), and opioid and cannabis use (γ=0.046). Compared to the no illicit drug use class, met need for medical gender affirmation was associated with lower odds of being in the polysubstance use and opioid and cannabis use classes, and housing security and lack of arrest were associated with lower odds of being in the alcohol misuse and cannabis use, polysubstance use, and opioid and cannabis use classes. For example, compared to those food insecure most or all of the time, never food insecure had lower odds of being in the polysubstance use class (aOR=0.22, 95%CI=0.09-0.52) versus the no illicit drug use class. Living with HIV was associated with greater odds of polysubstance use.

Conclusions: Met need for medical gender affirmation and better socioeconomic conditions may be protective for alcohol misuse and/or polysubstance use. Interventions aimed at improving socioeconomic conditions among transgender women and transfeminine nonbinary adults may improve substance use outcomes.

Objective: Experimentation with alcohol and other substances during the early adolescent period is associated with a myriad of potentially deleterious health outcomes. The present analysis utilized data from the Adolescent Brain and Cognitive Development^SM Study (ABCD Study®) to investigate the relationships between risk perception, susceptibility to peer influence, and substance use in early adolescence.

Method: Participants completed a Social Influence Task (SIT) in which they were asked to rate the riskiness of various hypothetical scenarios. They were then presented with a risk rating that had ostensibly been provided by their peers and were asked to rate each scenario a second time. Mixed effects logistic regression models were used to evaluate the relationship between risk perception (initial risk rating), susceptibility to peer influence (risk rating change), and future substance use.

Results: Higher initial risk perception was associated with lower odds of future substance use. Greater susceptibility to peer influence in the positive direction (i.e., being more swayed by peers to say that a scenario was more risky than the participant had originally decided) was associated with lower odds of future substance use as well.

Conclusions: These findings highlight the potential importance of leveraging positive peer influence as a means for affecting substance use outcomes.

Objective: Alcohol misuse and sexual assault are prevalent in the U.S. military, including in military service academies. As these behaviors frequently co-occur, there is an urgent need to develop and test prevention programs that address risk factors for both and that are also appropriately tailored for military cadets. The purpose of this study was to compare the efficacy of a combined alcohol misuse and sexual assault prevention program to those of an alcohol misuse prevention program plus a healthy skills program, a stand-alone sexual assault prevention program, and a stand-alone healthy skills program.

Method: A four-arm quasi-experimental study was conducted at the U.S. Air Force Academy with two incoming classes of cadets (N = 1,985). Participants completed pre- and posttest surveys to assess alcohol misuse- and sexual assault-related knowledge and attitudes. Mixed-effects multilevel models tested changes over time by condition; interactions were examined to determine whether program effects were moderated by sex or prior alcohol use.

Results: Several significant differences between conditions in pre- to posttest changes were observed, with most results indicating greater improvements for the combined condition than for other conditions. Alcohol readiness to change improved in the combined program compared to the alcohol misuse prevention and healthy skills program (p < 0.05); knowledge regarding sexual assault and self-efficacy to resist unwanted sexual advances increased significantly more in the combined program than in all others (p < 0.05).

Conclusions: This study provides initial evidence to support combined, tailored alcohol misuse and sexual assault training in military academy settings.

Objective: Suicidal thoughts and behaviors (STB) are elevated among individuals with Alcohol Use Disorder (AUD) and posttraumatic stress disorder (PTSD). The highest STB prevalences occur among those with comorbid AUD-PTSD. STB interferes with AUD and PTSD recovery outcomes. However, no research has examined the impact of STB on recovery trajectories among those with dual AUD-PTSD - a comorbidity with a chronic and difficult-to-treat clinical profile.

Method: Data from a randomized controlled trial with 141 (84.4% male) treatment-seeking Veterans with comorbid AUD-PTSD were used to compare the 12-week recovery trajectories for alcohol consumption (percent drinking days; percent heavy drinking days) and PTSD symptoms between the following groups: (1) Veterans with (n = 90) versus without (n = 51) lifetime STB and (2) Veterans with (n = 46) versus without (n = 95) current STB.

Results: Compared to respective groups without STB, veterans with lifetime and current STB had similar severity of drinking consumption over 12 weeks and similar reductions in drinking consumption and PTSD symptoms over the study period. Veterans with (versus without) current STB reported significantly higher PTSD symptom levels throughout the 12 weeks.

Conclusions: Results suggest that the presence of lifetime and current STB does increase the severity of PTSD but does not appear to impact the rates of symptom recovery across a 12-week period. Results add important context to cross-sectional research which emphasizes the greater severity of AUD-PTSD. Our longitudinal analyses indicate that Veterans can achieve symptom improvements in AUD and PTSD, even in the context of co-occurring STB.

Objectives: Parents play a role in shaping their children's beliefs and behaviors around substance use. When faced with unfamiliar or challenging situations, many parents turn to peers for advice. This study characterized the substance use-related advice parents sought from peers in an online parenting forum.

Method: We conducted a content analysis of substance use-related posts from the r/parenting subreddit. Among the advice-seeking posts included in this study (n=156), thematic coding assessed the presence (yes/no) of seven themes: (1) general communication with children about alcohol and drugs, (2) parental substance use, (3) responding to a child's substance use, (4) permissiveness of a child's substance use under adult supervision, (5) pregnancy or breastfeeding and substance use, (6) nicotine and tobacco use around children, and (7) dealing with an adult family member who is using substances or getting help for substance use problems. Posts could be coded into multiple themes. Two coders independently annotated posts (κ = 0.75).

Results: Parents asked about responding to a child's substance use (67/156; 42.9%), parental substance use in parenting contexts (54/156; 34.6%) and navigating other adult family members' substance use (54/156; 34.6%). Parents sought advice about general communication with children about alcohol and drugs (21/156; 13.5%), nicotine and tobacco use around children (19/156; 12.2%), permissiveness of adolescent substance use under adult supervision (18/156; 11.5%), and substance use during pregnancy or breastfeeding (4/156; 2.6%).

Conclusions: Findings may inform the development of targeted resources, guide public health messaging, and support the use of social media data in ongoing research relevant to family development.

Public health significance: This study shows that parents turn to online forums like Reddit for advice related to substance use and their children. Understanding the kinds of questions parents have can help shape educational resources and public health messaging that directly addresses these concerns.

Objective: Longitudinal patterns of alcohol use among older couples may have important implications for health. This study identified trajectories of alcohol use among different-sex couples and their associations with health over 24 years.

Method: Participants included 9,823 older married/cohabiting different-sex couples from the Health and Retirement Study (HRS), in which participants complete surveys every 2 years. We included couples with at least three waves of alcohol and health data between 1996 and 2020.

Results: Dual-trajectory latent class growth analysis revealed five longitudinal couple-level trajectories of alcohol use: concordant infrequent/abstaining, concordant light, concordant moderate, discordant husband heavy wife light, and discordant husband moderate wife infrequent/abstaining. Self-rated health was higher on average but decreased more rapidly over time for concordant moderate compared with concordant infrequent/abstaining husbands and wives. On average, chronic health conditions were higher for concordant infrequent/abstaining than for concordant light and concordant moderate couples. The number of conditions increased more rapidly over time for concordant infrequent/abstaining and discordant husband heavy wife light compared with concordant light and discordant husband moderate wife infrequent/abstaining couples.

Conclusions: These findings reveal the importance of considering couple patterns of drinking amount and drinking concordance to understand the impact of alcohol use on health among older couples.

Objective: Research shows that a high proportion of college seniors experience alcohol problems repeatedly. The present study examined associations between behavioral willingness to experience alcohol consequences, protective behavioral strategies (PBS) to reduce harmful drinking, drinking, and repeated alcohol problems (RAP) early in the senior year, and how these constructs influenced behavioral willingness, PBS, drinking, and RAP later in the senior year.

Method: The sample included randomly selected first-year students from a large northeastern university who met the inclusion criterion of consuming alcohol before enrollment. Students were followed each semester across 4 years. The study (N = 1,753; 58% female) focused on the assessments in the fall (Time 1 [T1]) and spring (T2) semesters of their senior year (mean age = 21). A longitudinal path model examined associations among behavioral willingness, PBS, drinking, and RAP at both waves.

Results: Behavioral willingness, drinking, and PBS had direct, concurrent associations with RAP at T1 and T2. The nature of the associations was positive for behavioral willingness and drinking and negative for PBS. Prospective analyses revealed significant independent, positive associations between T1 RAP and T2 behavioral willingness, drinking, and RAP, whereas a negative independent association between T1 RAP and PBS was observed at T2.

Conclusions: Findings show evidence for a cycle of alcohol use behavior between behavioral willingness, drinking, and RAP. Based on the findings, interventions targeting college seniors seem warranted to reduce the development of further alcohol problems in adulthood.

Objective: The prevalence of binge drinking among U.S. college students has decreased over the last two decades but remains high. We examined the extent to which state-level alcohol policies and drinking environments are associated with excessive and underage alcohol use among college students.

Method: Repeated cross-sectional surveys were administered to 902,486 college students ages 18-24 years from 591 4-year institutions in 47 states biannually from 2008 to 2019. Time-varying, state-level Alcohol Policy Scale (APS) scores and population-level binge drinking and alcohol consumption rates were examined in relation to students' 30-day alcohol use (1+ days) and frequent use (20+ days), and 2-week binge drinking (5+ drinks in a sitting).

Results: More restrictive state-level policy environments were associated with lower odds of students' alcohol use, frequent use, and binge drinking; for a 10-point increase in APS, odds ratios [95% confidence interval] were .92 [.88, .95], .91 [.87, .96], and .94 [.91, .98], respectively (p < .01). Associations were significant for underage students (ages 18-20 years) but significantly stronger for older students (ages 21-24 years). State population levels of binge drinking and alcohol consumption were only positively associated with drinking outcomes for students age 21 years and older.

Conclusions: Alcohol use and binge drinking were less prevalent among young adults attending college in states with more restrictive alcohol policies and among students age 21 and older in states with lower state rates of binge drinking and alcohol consumption. Lifelong patterns of alcohol use can begin in college, and findings indicate that state alcohol policies are a foundation on which community- and campus-level preventive efforts can build.

Objective: Psychosocial stress increases the risk for subsequent episodes of alcohol use disorder (AUD) and drug use disorder (DUD), with most studies assessing stress exposure by questionnaire or interview methods. We developed an environmental risk score (ERS) using multiple classes of stressful life events (SLEs) obtained from national Swedish registries.

Method: We assessed, in the entire adult population of Sweden (N = 7,105,712), the occurrence of 51 categories of SLEs derived from registry information for the 6 months before September 1, 2010, and the risk for AUD and DUD registration over the subsequent 18 months. Weights for these two ERSs were obtained from a random half of our sample, and the relationship of ERS to AUD and DUD was evaluated in the second half.

Results: The ERS strongly predicted subsequent AUD and DUD episodes. Men were more sensitive to the pathogenic effect of the ERS than women. Those with prior episodes of AUD and DUD had larger absolute increases in ERS-associated AUD and DUD risk than those without previous episodes. Genetic risk for AUD and DUD was associated with greater sensitivity to the pathogenic effects of the ERS. A co-sibling control analysis suggested that a large proportion of the ERS-AUD and ERS-DUD associations were causal.

Conclusions: Valid measures of environmental risks that predispose to AUD and DUD can be assessed from SLEs obtained from high-quality national registry data. Importantly, this method avoids prior assessment problems of accurate dating and recall bias and can be performed in large samples.

Objective: This article describes the development of an online and text-messaging intervention aimed at augmenting protective behavioral strategies (PBS) utilization at the daily level among young adults engaged in alcohol and cannabis use. PBS, encompassing tips and strategies to moderate alcohol and cannabis use and reduce associated risks, have been integral components of personalized feedback interventions. The quality and consistency of PBS use have been underexplored in intervention frameworks.

Method: We describe six initial focus groups and 13 cognitive interviews that were conducted with young adults who use alcohol and cannabis to learn the motivations underpinning alcohol and cannabis PBS utilization, barriers impeding PBS use, and PBS use with high quality and consistency. This step served as the cornerstone for crafting targeted intervention strategies. Drawing from the insights from the focus groups and cognitive interviews, we developed an interactive online intervention and text message platform. We then conducted three additional focus groups and nine cognitive interviews with young adults who use alcohol and cannabis to gain insight into intervention content, and we implemented any needed changes.

Results: We present the final iteration of the intervention, which consisted of a brief, web-based intervention followed by text messages 3 days a week for 8 consecutive weeks, as well as two monthly daily-level summaries of behaviors reported across 8 weeks.

Conclusions: This article shares our process for designing an intervention using daily-level data, aimed at reducing alcohol and cannabis use among young adults and fostering quality and consistent use of PBS.