Journal of studies on alcohol and drugs最新文献

Objective: The relationship between mental health and substance use among military populations is well established, and evidence suggests that these risks may be greater for those who have left the military. However, it is less clear what independent effects leaving the military may have on substance use behaviors. This study examined the longitudinal relationship between leaving the military and substance use outcomes (hazardous drinking, frequent heavy drinking, nonmedical use of prescription drugs, illicit drug use) in a cohort of Reserve and National Guard (R/NG) soldiers. Further, we examined whether mental health symptoms moderate the relationship between leaving the military and substance use.

Method: Analyses used data (N = 485 soldiers) from the first four annual waves of Operation: SAFETY, an ongoing prospective cohort study of U.S. Army R/NG soldiers and their spouses. We used generalized estimating equations (GEEs) to examine the relationships between military status (former vs. current soldier) and substance use outcomes over 4 years. Last, we examined interactions between military status and mental health indicators (anxiety, anger, depression, and posttraumatic stress disorder) on substance use over time.

Results: After we controlled for sex, age, race, years of military service, sleep problems, bodily pain, and substance use norms, being a former soldier, compared with being a current soldier, was associated with greater odds of current illicit drug use (adjusted odds ratio = 2.86, 95% CI [1.47, 5.57]; p < .01). Mental health symptomatology did not moderate the relationship between leaving the military and current drug use.

Conclusions: Leaving the military in and of itself may result in increased drug use for some individuals, regardless of mental health symptomatology.

Objective: Assumptions about alcohol's health benefits profoundly influence global disease burden estimates and drinking guidelines. Using theory and evidence, we identify and test study characteristics that may bias estimates of all-cause mortality risk associated with low-volume drinking.

Method: We identified 107 longitudinal studies by systematic review with 724 estimates of the association between alcohol consumption and all-cause mortality for 4,838,825 participants with 425,564 recorded deaths. "Higher-quality" studies had a mean cohort age of 55 years or younger, followed up beyond 55 years, and excluded former and occasional drinkers from abstainer reference groups. "Low-volume" alcohol use was defined as between one drink per week (>1.30 g ethanol/day) and two drinks per day (<25 g ethanol/ day). Mixed linear regression was used to model relative risks (RRs) of mortality for subgroups of higher- versus lower-quality studies.

Results: As predicted, studies with younger cohorts and separating former and occasional drinkers from abstainers estimated similar mortality risk for low-volume drinkers (RR = 0.98, 95% CI [0.87, 1.11]) as abstainers. Studies not meeting these quality criteria estimated significantly lower risk for low-volume drinkers (RR = 0.84, [0.79, 0.89]). In exploratory analyses, studies controlling for smoking and/or socioeconomic status had significantly reduced mortality risks for low-volume drinkers. However, mean RR estimates for low-volume drinkers in nonsmoking cohorts were above 1.0 (RR = 1.16, [0.91, 1.41]).

Conclusions: Studies with lifetime selection biases may create misleading positive health associations. These biases pervade the field of alcohol epidemiology and can confuse communications about health risks. Future research should investigate whether smoking status mediates, moderates, or confounds alcohol-mortality risk relationships.

Objective: The current study used U.S. national data to examine trends in cannabis use from 2013 to 2021, focusing on changes in cannabis prevalence during young and middle adulthood and whether trends differed by sociodemographic characteristics.

Method: Data from 2013 to 2021 from 21,182 respondents ages 19-30 and 29,871 ages 35-55 in the national Monitoring the Future panel study (followed since they were in 12th grade in 1976-2020) were used to model historical trends in cannabis prevalence (any 12-month use, any 30-day use, and near-daily use [≥20 occasions in the past 30 days]).

Results: Prevalence of 12-month, 30-day, and near-daily cannabis use significantly increased from 2013 to 2021 for both young and middle adults. Trends for all three behaviors indicated either consistent linear increases or two-slope increases in which the slope estimate was larger in more recent years. Historical increases in 12-month and 30-day use were similar for young and middle adulthood; the historical increase in near-daily use among middle adults had some evidence for a possible pandemic-related deviation. Historical trends did not differ by race/ethnicity or college degree. Trends for 12-month and 30-day use differed by sex, with women increasing more than men over time, especially during middle adulthood.

Conclusions: Significant increases in the prevalence of cannabis use have occurred over the past decade for young and middle adults across sociodemographic groups, with some indication that near-daily use increased among middle adults at the onset of the pandemic. Although men continue to have a higher prevalence than women, the gap has narrowed, with greater increases in cannabis use among women.

Objective: Neighborhood characteristics have been shown to influence lifestyle behaviors. Here we characterized alcohol outlet density in Los Angeles County, CA, and Hawaii and assessed the association of alcohol outlet density with self-reported alcohol intake in the Multiethnic Cohort.

Method: Participants (n = 178,977) had their addresses geocoded at cohort entry (1993-1996) and appended to block group-level alcohol outlet densities (on- and off-premises). Multinomial logistic regression was performed to assess the association between self-reported alcohol intake and on- and off-premise alcohol outlet densities by each state. Stratified analysis was conducted by sex, race, and ethnicity.

Results: Overall, we did not find associations between alcohol outlet density and self-reported alcohol intake in Los Angeles County, but we found that on-premise alcohol outlets were associated with 59% (odds ratio [OR] = 1.59, 95% CI [1.29, 1.96]) increased odds of consuming more than two drinks per day in Hawaii. Women living in neighborhoods with a high density of on-premise alcohol outlets (Los Angeles County: OR = 1.15, 95% CI [0.95, 1.40]; Hawaii: OR = 2.07, 95% CI [1.43, 3.01]) had an increased odds of more than two drinks per day.

Conclusions: This study suggests that neighborhood factors are associated with individual-level behaviors and that multilevel interventions may be needed.

Objective: These analyses use data from a 40-year prospective study to extend information into the sixth and seventh decades of life regarding latent trajectory classes of cannabis use and predictors of those classes.

Method: Data from the San Diego Prospective Study were analyzed for 329 men of European and Hispanic ethnicity who had used cannabis at about age 23 at study entry (Time 1) and who were interviewed about every 5 years through about age 60 to 70. Latent classes of cannabis use trajectories were evaluated using latent class growth analyses, baseline predictors of class membership were determined, and significant predictors of each class were established using logistic regression analyses.

Results: Four latent classes were identified ranging from 12.5% with cannabis use at every follow-up to 25.8% with no use after Time 1. Eight of 14 Time 1 predictors differed significantly across the trajectory classes, including five (age, marital status, religious identity, intensity of cannabis use, and sensation seeking) that significantly contributed to regression analyses when all significant predictors were considered together.

Discussion: Forty-two percent of participants continued using cannabis long-term, including one in eight who used it at every follow-up. Predictors of continued use and identification of those most likely to stop required gathering information on a range of demographic, prior substance use, and personality characteristics.

Conclusions: Considering the potential enhanced dangers of cannabis use in later life, the high rate of continued use over four decades implies that clinicians should ask all older patients about recent cannabis use, especially if they had used it in their 20s.

Objective: Impaired control over alcohol is a hallmark of addiction relevant to young adults, but additional prospective findings are needed, particularly in samples reporting heavy drinking. Further, we lack understanding of how attempts and failed efforts to control drinking relate to each other in predicting outcomes. We hypothesized that attempted and failed control would prospectively predict outcomes, with endorsement of both being especially problematic.

Method: We used data from young adults reporting heavy drinking who enrolled in laboratory alcohol self-administration studies (n = 109). Mixed-effects models were used to predict drinks per drinking day, heavy drinking, and negative consequences across baseline and 6- and 12-month follow-ups. Interactions by time and between attempted and failed control were tested.

Results: Higher failed control was associated with steeper declines in consequences and heavy drinking over time compared with lower failed control. However, higher attempted or failed control was still associated with more consequences and alcohol use than lower impaired control at multiple time points. A significant interaction indicated that the combination of higher attempted and failed control was associated with the most drinks per drinking day. There was also a significant Attempted × Failed Control interaction for heavy drinking.

Conclusions: These findings provide further evidence supporting impaired control over alcohol use as a risk factor among young adults. Those reporting both higher attempted and failed control drank the most per day. Either attempted or failed control was associated with negative consequences. Those reporting both higher attempted and failed control may be in greatest need of intensive intervention.

Objective: World Health Organization (WHO) risk drinking levels (i.e., low, moderate, high, or very high risk) have been used as a drinking-reduction endpoint in clinical trials. Yet, prior work has not attempted to quantify reductions in WHO risk levels among mandated students, who may also benefit from reduced drinking. We sought to validate WHO risk drinking levels in differentiating students' alcohol-related outcomes, depressive symptoms, and academic performance. Defining risk via typical drinks per drinking day versus drinks per day was compared, and gender differences were examined.

Method: Baseline data were drawn from three intervention trials for students mandated to intervention and who were not abstinent (N = 1,436). Sex-specific WHO risk levels were generated and dummy coded, with low risk as the reference. Regression models examined associations of risk levels with positive Alcohol Use Disorders Identification Test (AUDIT) scores, peak drinking, consequences, depressive symptoms, and grade point average.

Results: Defining WHO risk via drinks per drinking day evenly dispersed students across categories, whereas drinks per day categorized most students as low risk. More women than men were classified as very high risk across definitions. Students classified as low risk differed from those classified as moderate, high, and very high risk in screening positive on the AUDIT, peak drinking, and consequences. WHO risk levels did not differentiate depressive symptoms. Differences in grade point average were inconsistent across risk definitions.

Conclusions: WHO risk drinking levels differentiated alcohol use and consequences and, therefore, hold promise for clinical use and for quantifying drinking reductions among mandated college students.

Objective: Epidemiologic surveys aim to estimate the population prevalence of cannabis use and cannabis use disorder. Prevalences estimates are important for understanding trends, such as the impact of policy change. Existing epidemiologic surveys have produced discrepant and potentially unreliable estimates. The current meta-analysis (PROSPERO CRD42022364818) aims to identify potential sources of unreliability in prevalence estimates of cannabis use and use disorder among the general population (aged 12+). There was no specific hypothesis about overall prevalence estimate, but we expected significant variability (i.e., heterogeneity) in estimates based on factors such as country, year of data collection, and specific methodological factors (e.g., diagnostic instrument).

Method: Systematic searches identified manuscripts and reports documenting nationally representative lifetime or past-year cannabis use disorder prevalence estimates. Meta-analysis was used to synthesize prevalence estimates, evaluate heterogeneity, and test moderators.

Results: There were 39 manuscripts/reports included in analyses which resulted in 259 unique prevalence estimates spanning 1980-2013 and an aggregated sample size of 973,281 individuals. Past-year and lifetime prevalence estimates for cannabis use were 12.83% (95% CI: 11.15%, 14.71%) and 38.31% (95% CI: 35.92%, 40.76%) and those for cannabis use disorder were 2.59% (95% CI:2.30%, 2.90%) and 6.77% (95% CI: 4.89%, 9.30%), respectively. There was significant heterogeneity in estimates, which was partially explained by factors such as country, year of data collection, and methodological characteristics.

Conclusions: The significant heterogeneity in prevalence estimates as a function of methodological characteristics raises concerns about the generalizability of estimates. Recommendations for enhancing validity and reliability of these estimates are offered.

Background: Five U.S. states where recreational cannabis is legal require Mandatory Warning Signs for cannabis use during pregnancy (MWS-cannabis) to be posted in cannabis dispensaries. Previous research has found adverse health consequences associated with MWS-cannabis and that people lack trust in information on signs. This qualitative study explores people's perspectives and preferences regarding MWS-cannabis.

Methods: We conducted in-depth interviews with 34 pregnant or recently pregnant individuals from multiple states with varying policy climates in the U.S. who used cannabis before and/or during pregnancy. We asked participants about their perspectives on MWS-cannabis and reactions to specific messages. We reviewed transcripts using thematic analysis.

Results: Participants reported mostly negative views on MWS-cannabis, suggesting they may have stigmatizing and negative impacts on pregnant people who use cannabis, discouraging them from seeking care. Many said that the scientific evidence is not strong enough to justify MWS-cannabis, and that they are unlikely to deter pregnant people from using cannabis. Participants asserted that vague or fear-based messages, distrust of government, and the location and timing of the signs undermine the goals of MWS-cannabis. When reacting to specific messages, participants preferred messages that are evidence-based, clear, specific, and aligned with autonomous decision-making.

Conclusions: Pregnant and recently pregnant people who use cannabis have mostly negative perceptions of MWS-cannabis and believe they have negative consequences. More work is needed to develop health information resources that meet the needs of people who use cannabis in pregnancy without increasing stigma.

Objective: Men's coercive condom use resistance (CUR) with female partners is common and is associated with greater alcohol consumption than men's noncoercive CUR engagement. Prior research indicates that emotion-related factors are relevant to alcohol-involved coercive CUR. Thus, in this alcohol administration study, we examined emotional factors as distal and proximal predictors of alcohol-involved coercive CUR among young men who have sex with women.

Method: Non-problem drinking young adult men who have sex with women (N = 282) were recruited from the local community, and as part of a larger study, completed a background survey and an in-lab alcohol administration session that included a mood induction and sexual scenario task using a 2 (sober vs. intoxicated) x 2 (positive mood vs. negative mood) experimental design.

Results: Path analysis testing a moderated mediation model revealed that for participants in the sober, positive mood, and intoxicated, negative mood conditions, there was a positive association between distal ER difficulties and motives to have sex to cope with negative emotions. Additionally, distal ER difficulties were positively associated with proximal difficulties modulating one's emotions among intoxicated participants. Among those with greater proximal difficulties modulating their emotions, state anger was positively associated with coercive CUR intentions.

Conclusions: Results demonstrate the importance of alcohol intoxication, emotions and emotion regulation, and sexual coping motives in men's coercive CUR likelihood, demonstrating potential malleable targets for prevention efforts.