Journal of studies on alcohol and drugs最新文献

Objective: Chronic heavy alcohol use increases risk for developing alcohol use disorder (AUD), leading to adverse health outcomes. Evidence suggests patient demographics are used to make treatment decisions, which contributes to barriers to AUD treatment experienced by Hispanic/Latino (H/L) individuals. This study characterized the use of ethnicity in alcohol use assessment and treatment referral among medical (MT) and dental trainees (DT).

Method: Current MT (n=54) and DT (n=59) reviewed thirty-two vignettes varying systematically in sex, age, ethnicity, and alcohol concern cues. Trainees used 0-100 visual analog scales (VASs) to rate likelihood of discussing the patient's alcohol use (VAS1), likelihood the patient has AUD (VAS2), comfort discussing alcohol use with the patient (VAS3), and likelihood of referring to AUD-related treatment (VAS4). Idiographic regressions characterized individuals' decision-making policies. Group-level analysis determined the influence of trainee ethnicity and trainee type on patient ethnicity cue use.

Results: Almost all (96-100%) trainees reliably used the alcohol concern cue when providing ratings. 25-56% of trainees used ethnicity as a cue. Trainee ethnicity did not significantly affect ethnicity cue use when evaluating vignettes (t<1.37, p>.17, d<.56). Analyses indicated MT weighed the alcohol concern cue more heavily than DT for VAS1.

Conclusions: Results suggested that a substantial proportion of trainees reliably used patient ethnicity to make alcohol treatment-related decisions, consistently to the potential detriment of H/L patients. Finally, lower weighting of alcohol concern among DT than MT in all but one judgment suggests DT may not view alcohol screening as part of their professional role as strongly as MT.

Objective: Lower education is a risk factor for alcohol-related deaths, but it is unknown if the impact of education varies by race/ethnicity. We evaluated the interaction between education and race/ethnicity on the odds of alcohol use disorder (AUD) and the significance of employment and poverty as potential mediators.

Method: The 2016-19 National Survey on Drug Use and Health was used to obtain weighted prevalence of AUD in participants 26+ years. Using AUD as the outcome, multivariable logistic regression analyses were performed, stratified by four levels of education, ranging from less than high school (|10%| change implying significant mediating or confounding effect.

Results: AUD prevalence was highest among American Indian/Native Alaskans (AI/ANs) (8.06%), and similar among non-Hispanic Whites (5.37%) and Blacks (5.09%). When stratified by education, the odds of AUD among Blacks and AI/ANs increased with decreasing education [(OR 1.45, 95% CI 1.07-1.96) for Blacks v. Whites with

Conclusions: Lower education significantly increased the odds of AUD among Blacks and AI/ANs. Employment and poverty did not significantly change the association, implying there are likely other mechanisms accounting for racial/ethnic disparities in AUD.

Background: Media alcohol exposure is a modifiable environmental risk factor for adolescent drinking behavior. Shifts in teen media use have made social media engagement nearly ubiquitous among this population. TikTok, a short video-sharing social media platform, is the fastest growing platform among teens. 98% of the most viewed videos tagged "#alcohol" on TikTok portray alcohol positively. TikTok also offers a search function that provides algorithmically identified "Top Videos", for which alcohol-related content has yet to be characterized. Alcohol-naïve and curious youth may be more susceptible to encountering content this way.

Methodology: A Python script utilizing a newly created account was used to download the 100 "Top Videos" for five alcohol-related search terms: #alcohol, #beer, #wine, #vodka, #tequila. Videos were qualitatively coded for context, setting, and positive/negative sentiment of alcohol depiction. 20% of videos were double-coded with a total percent agreement of 95.8% (Cohen's κ = .81).

Results: For terms related to specific alcohol types (e.g., #beer), videos were overwhelmingly alcohol-positive (96.9%), rarely depicted alcohol problems, and frequently were humorous and depicted alcohol recipes and games. For the "#alcohol" search term, nearly half of videos (41.8%) were identified as being alcohol-negative and more often depicted alcohol problems and dependence.

Conclusions: In contrast with the most viewed videos on TikTok for "#alcohol," videos returned via the search function included significantly more alcohol-negative content. Content returned by all other search terms remained alcohol-positive. Understanding content delivery algorithms may be a beneficial route for mitigating risk of alcohol exposure on digital/social media platforms.

Objective: Increasing engagement in evidence-based treatment for opioid use disorder during pregnancy is pressing. Generative artificial intelligence large language model conversational agents may support clinicians in delivering safe, accurate, and relevant information to this population. The central aim of this study was an exploratory evaluation of the steerability of GPT-4 (generative pre-trained transformer) for the provision of trustworthy treatment-related information to pregnant people with opioid use disorder.

Methods: The model was tuned using evidence-based guidelines and tenets of motivational interviewing. A rubric was developed to evaluate the safety, accuracy, and relevance of the tuned model's responses to user messages from the persona of a pregnant woman with an opioid use disorder. Two advanced practice registered nurses with more than 10 years of experience treating people with opioid use disorder independently evaluated the model-persona dialogs (n = 30) using the rubric and qualitative methodology.

Results: Responses were rated as safe, accurate, and relevant in 96.7% of cases. Qualitative analysis identified four increasing connection subthemes, including three related to client-centered communication. In 100% of cases, the model identified congruence with opioid use disorder criteria and located the person within the transtheoretical model's stages of change.

Conclusion: The tuned model generated clinically safe, accurate, and relevant responses about opioid use disorder treatment during pregnancy. Consistent with the progression of informatics study typology, before this model could be embedded in an application to allow direct public access, additional lab- and field-based testing is indicated, including with people with this use disorder.

Objective: We investigate offspring alcohol use outcomes as a function of unremitted and remitted parental alcohol use disorder (AUD).

Methods: Self-report data of participants in the Collaborative Study on the Genetics of Alcoholism (COGA) were used. Offspring (n=2244, mean age 16.3 at baseline, 26.9 years at follow-up, 50.8% female) were linked to parent data. Time-varying associations of parental AUD and remission with offspring age at first drink, years from first drink to AUD onset, and years from AUD onset to first remission were tested in Cox models adjusted for polygenic risk for problematic alcohol use (PGSPAU). Analyses were stratified by genetically inferred continental groups of European (EA, 65.9%) and African (AA, 34.1%) Americans due to sociocultural factors that can contribute to differences in alcohol use and problems.

Results: In EA, maternal remission was associated with increased risk for offspring AUD; neither maternal nor paternal remission was associated with other outcomes. In AA, maternal and paternal remission were associated with increased likelihood of early drinking; the association with maternal drinking varied as a function of whom offspring lived with during adolescence. Paternal, but not maternal, remission was associated with heightened risk for AUD onset. Parental status had no association with offspring remission in EA or AA.

Conclusions: Evidence that parental remission can help mitigate the risk associated with parental AUD and increase likelihood of remission in affected offspring was limited and mixed based on continental group and sex. These nuanced outcomes highlight the complex interplay of parental AUD status and offspring's alcohol-related behaviors.

Objective: The purpose of the study was to investigate factors contributing to the decline in the number of passengers riding with alcohol-impaired drivers involved in fatal crashes since 1982, and to examine the impact of simulated interventions on this group through 2050.

Method: Historical data were obtained from the Fatality Analysis Reporting System. We applied linear regression to analyze changes in the average numbers of passengers per alcohol impaired young driver involved in fatal crashes between 1982 and 2020 by age and sex. We also extended our existing system dynamics simulation model developed to examine driving while impaired (DWI) behaviors of U.S. male and female drivers aged 15 to 24 and explored riding with an impaired driver (RWI) behaviors and corresponding interventions. We conducted sensitivity analyses to examine the likely trajectories of alcohol impaired drivers' passengers in fatal crashes across multiple scenarios through 2050.

Results: Our findings show that the decline in passengers of alcohol impaired drivers in fatal crashes primarily stems from a decrease in the number of impaired drivers, rather than a change in average number of passengers per impaired drivers. The simulation model replicated historical trends from 1982 to 2020, and the sensitivity analyses show that the policies reducing DWI trips also decrease RWI trips.

Conclusions: Wide adoption of a comprehensive strategy, combining increased enforcement, an alcohol truth campaign, the provision of alternative transportation, and the enactment of a new DWI restrictive law, could significantly reduce the number of passengers in fatal crashes involving alcohol-impaired drivers, while minimizing possible unintended consequences.

Introduction: Despite a decline in cigarette use, the dual use of cigarettes and electronic vaping products (EVPs) is a concerning pattern of nicotine consumption in the United States (US). Anxiety, a risk factor for tobacco use, may contribute to dual use patterns; however, the association between daily anxiety symptoms and dual use of cigarettes and EVPs is not known. This study investigated associations between daily anxiety symptoms and dual cigarette and EVP use overall, and by sex, race, and ethnicity.

Method: Data are from the 2020-2022 National Health Interview Survey (n=83,544). Multinomial logistic regression models adjusted for sociodemographic factors, tobacco use, mental health services and medication characteristics examined the relationship between daily anxiety and current exclusive/dual cigarette and EVP use. Stratified analyses explored effect modification by sex, race, and ethnicity.

Results: Among the sample, 13.0% reported daily anxiety symptoms, and 1.3% reported dual cigarette and EVP use. Daily anxiety was associated with increased odds of exclusive cigarette (OR=1.54, 95% CI: 1.42-1.68), exclusive EVP (OR=1.44, 95% CI: 1.23-1.68), and dual use (OR=2.16, 95% CI: 1.77-2.63). Stratified analyses showed significant associations for dual use with daily anxiety across Hispanic, Non-Hispanic White, Non-Hispanic Black, and Non-Hispanic Asian adults. Notably, Hispanic males and females, Non-Hispanic White males and females, Black females, Non-Hispanic Asian males, and females of another race/ethnicity had higher odds of dual use, while Asian females had lower odds.

Conclusion: This study highlights heterogeneous relationships between daily anxiety and dual cigarette and EVP use at the intersection of sex, race, and ethnicity. Tailored interventions addressing persistent mental health symptoms are crucial for reducing tobacco use and associated disparities.

Objective: The purpose of the current study was to assess preliminary efficacy from a randomized controlled trial of the Promoting Resilient Youth with Strong Hearts and Mind (PRYSHM) Program. PRYSHM is an online, live-facilitated, nine-session group program for sexual and gender minority youth (SGMY) ages 15 to 18. The program focuses on reducing proximal forms of minority stress, promoting positive identity development, building LGBTQ+ community, developing social-emotional skills, and providing alcohol use (AU) and teen dating violence (TDV) prevention skills.

Method: Participants (recruited predominantly via social media) included 304 recently dating SGMY (ages 15 to 18) from across the U.S. who were randomized to treatment or waitlist after completing a baseline survey. Participants completed post-test and 3-month follow-up surveys.

Results: Relative to waitlist, participants in the PRYSHM condition had reduced AU and TDV perpetration. Dosage analyses supported that youth who attended six or more PRYSHM sessions had better outcomes compared to the control group, and more so than youth who attended 0-2 sessions or 3-5 sessions.

Conclusion: These data provide preliminary support for PRYSHM as an efficacious intervention to reduce TDV, AU, and alcohol consequences among SGMY. Dosage analyses provided additional nuance in understanding program effects, with promising findings for those receiving a higher dosage of intervention content. Research is needed using larger samples of SGMY, including SGMY with identities underrepresented in the current trial (e.g., SGMY assigned male at birth), as well as work seeking to evaluate mechanisms of change and identify the optimum program dosage. There is also a need for studies with a longer-term follow-up to evaluate the intervention's durability and if additional booster sessions are needed.