Journal of studies on alcohol and drugs最新文献

Objective: Withdrawal syndrome stands out as the strongest risk factor for prescription opioid-use disorder (POUD) and is related to psychological and pain impairment in the chronic pain population. This study aimed to identify profiles of chronic pain patients with opioid withdrawal based on psychological factors and to explore the association between the classes and demographic, clinical, and substance use variables.

Method: This cross-sectional descriptive study involved 391 patients, 221 with interdose withdrawal (mean age = 57.91±13.61 years; 68.3% female). Latent class analysis and bivariate and logistic regression analyses were performed.

Results: Two latent classes were identified (Bayesian information criterion = 4020.72, entropy = .70, likelihood ratio tests p < .01): Withdrawal syndrome with No Psychological Distress (WNPD; 45.2%, n = 100) and Withdrawal syndrome with Psychological Distress (WPD; 54.8%, n = 121). The WPD class was more likely to experience craving, anxiety, and depression and to report higher levels of pain intensity and interference (p < .01). Patients in this class were younger, visited a higher number of specialists, and showed higher rates of high-dose opioid use, misuse, moderate-severe POUD, and tobacco and anxiolytics use (p < .05). Only moderate-severe POUD (odds ratio [OR] = 2.64) and tobacco use (OR = 2.28) increased the risk of WPD class membership.

Conclusions: Although it is common for chronic pain patients to experience withdrawal symptoms during opioid treatment, more than half of the participants reported concomitant psychological distress. Establishing differential profiles can help to improve withdrawal syndrome management during the treatment of chronic pain with opioids.

Objective: There is considerable variability in how young adults (YAs) perceive drinking-related consequences, and some researcher-identified "negative" consequences are viewed by YAs as neutral or even somewhat positive. Little is known about individual difference factors that may influence subjective evaluations of alcohol consequences.

Method: We tested whether endorsement and subjective evaluation ("extremely negative" to "extremely positive") of 24 alcohol-related negative consequences differed by age (18-20, 21-27), past-3-month drinking frequency (three times/month or less, weekly or more), and current undergraduate status (4-year undergraduate, nonstudent). YAs were recruited for a longitudinal ecological momentary assessment study on cognitions and alcohol use. Participants in the analytic sample (N = 640; 48.1% White non-Hispanic/Latinx, 50.0% female, M age = 22.2 years, SD = 2.3) reported past-3-month drinking. Past-3-month drinking frequency, negative consequences (total and item-level), and subjective evaluations of consequences were assessed cross-sectionally.

Results: Compared with YAs age 18-20, YAs 21 and older experienced fewer total consequences, were significantly less likely to endorse experiencing physical/behavioral consequences, and rated these consequences more negatively if they were endorsed. YAs who drank weekly or more reported experiencing more consequences and were significantly more likely to experience all 24 consequences in comparison with YAs who drank three times/month or less. Subjective evaluation ratings did not significantly differ by drinking frequency. There were few differences between 4-year undergraduates and non-undergraduates; non-undergraduates rated several health/responsibility-related consequences more negatively.

Conclusions: Findings highlight the importance of identifying individual difference factors that contribute to subjective evaluation ratings and may be useful for tailoring brief, personalized alcohol interventions for YAs.

Objective: The COVID-19 pandemic has affected the availability of and access to medications for opioid dependence (OD). We examined the monthly trends in new buprenorphine/naloxone (BNX) treatment episodes, number of clinical visits for BNX, BNX dispensed per person, and BNX prescription over 56 months, which included the pre-pandemic period and the early and later parts of the pandemic (January 2017 to August 2022).

Method: Research data were collected from the pharmacy database of a large publicly funded treatment center in India. A flexible, low-threshold service was adopted in April 2020 in response to the lockdown implemented on March 25, 2020. Change point analyses were performed to examine monthly trends visually and statistically. We used autoregressive integrated moving averages to forecast trends from April to August 2020 and March to August 2022, using January 2017 to March 2020 and March 2020 to February 2022 as training data sets.

Results: A total of 993 patients were started on BNX treatment; 40,452 BNX clinic attendances were made; 1,401,393 BNX tablets were dispensed; and 6,795 new patients with OD were registered. The observed data for clinic attendance for BNX was significantly lower than the projected estimates in April to August 2020; however, observed new treatment episodes and monthly BNX prescriptions were within the 95% projected estimates; BNX dispensed per person was significantly more than the projected estimate. In contrast, observed BNX prescription trends surpassed the upper limit of the 95% confidence interval in March to August 2022.

Conclusions: A low-threshold and flexible-treatment service could mitigate the unintended consequences of pandemic-induced restrictions.

Objective: Ellagic acid (EA) exerts neuroprotective, mitoprotective, anti-oxidative, and anti-inflammatory effects. We evaluated the protective effect of EA on ethanol-induced fetal alcohol spectrum disorders (FASD).

Method: A total of 35 newborn male rats were used, divided into five groups, including control (normal saline), ethanol (5.25 g/kg per day), ethanol (5.25 g/kg per day) + EA (10 mg/kg), ethanol (5.25 g/kg per day) + EA (20 mg/kg), and ethanol (5.25 g/kg per day) + EA (40 mg/kg). Thirty-six days after birth, behavioral tests (Morris water maze and Elevated Plus Maze), tumor necrosis factor-alpha (TNF-alpha) levels, oxidative markers (malondialdehyde, glutathione, and superoxide dismutase), and mitochondrial examination such as succinate dehydrogenases activity, mitochondrial swelling, mitochondrial membrane potential, and reactive oxygen species formation were analyzed.

Results: The results revealed that ethanol exposure adversely affected cognitive and mitochondrial functions and induced oxidative stress and inflammation in brain tissue. However, EA (20 and 40 mg/kg) administration effectively prevented the toxic effects of ethanol in the FASD model.

Conclusions: These findings demonstrate that ethanol application significantly impairs brain development via mitochondrial dysfunction and induction of oxidative stress. These data indicate that EA might be a useful compound for the prevention of alcohol-induced FASD.

Objective: This study examined whether the cumulative experience of elevated depressive symptoms from ages 19 to 23 was associated with cannabis use disorder (CUD) at age 26 and whether the association varied by perceived ease of access to cannabis and perceived risk for harms from cannabis use.

Method: Data were from 4,407 young adults participating in the Community Youth Development Study. Cumulative experience of elevated depressive symptoms was calculated by summing the number of times a participant scored ≥10 on the 9-item Patient Health Questionnaire across three biennial survey waves (ages 19 to 23). To assess CUD, the Diagnostic Interview Schedule was used. Participants also self-reported their ease of access to cannabis and the perceived harm of regular cannabis use at the age 19, 21, and 23 waves. Marginal structural modeling was used to account for multiple time-varying and time-fixed covariates using inverse probability weights.

Results: In the final weighted models, a greater number of time points (i.e., study waves) showing elevated depressive symptoms was associated with an increased likelihood of CUD at age 26 (prevalence ratio = 1.46, 95% CI [1.20, 1.77]). There was no strong evidence for moderation of this association by perceived ease of access or perceived risk for harms because of regular cannabis use.

Conclusions: Persistent experience of elevated depressive symptoms may place young adults at risk for CUD. Strategies to reduce the burden of depressive symptoms among young adults may lead to downstream effects such as reducing the prevalence of cannabis-related problems.

Objective: This follow-up study examines whether a multi-component, high-visibility alcohol enforcement intervention implemented in 12 California cities had long-term effects on alcohol-related motor vehicle crashes beyond the period of the original study. Previous results indicated a significant reduction in single-vehicle night-time (SVN) crashes among 15- to 30-year-olds in intervention cities relative to controls.

Method: A randomized trial was conducted with 24 randomly chosen California cities from 2012 to 2017 to evaluate a multi-component intervention to reduce excessive drinking and driving while impaired among adolescents and young adults. Twelve of the cities were randomly assigned to the intervention condition and implemented high-visibility alcohol enforcement operations and other components from April 2013 to March 2016. Multi-level negative binomial regression analyses were conducted with motor vehicle crash data from 2010 to 2021 to examine whether SVN crashes among 15- to 30-year-olds decreased in intervention cities relative to controls after the multi-component intervention was implemented. Analyses controlled for community sociodemographic characteristics, the overall time trend, the COVID pandemic, and pre-intervention levels of SVN crashes and adjusted for correlation of repeated observations within cities over time.

Results: Regression analyses indicated a significantly lower level of monthly SVN crashes among 15- to 30-year-olds in intervention cities during post-intervention months through 2021 relative to control cities (incidence rate ratio [95% CI] = 0.88 [0.79, 0.98], p < .05) when controlling for community sociodemographic characteristics, the overall time trend, COVID, and pre-intervention levels of SVN crashes.

Conclusions: Study findings suggest that a multi-component, high-visibility alcohol enforcement intervention can have long-term effects on alcohol-related motor vehicle crashes and related injuries and fatalities among adolescent and young adult drivers.

Objective: Alcohol contributes to a large number of deaths annually, in terms of both deaths fully attributed to alcohol (e.g., alcohol poisoning) and deaths where alcohol is a contributing cause (e.g., motor vehicle accidents). Nationally, alcohol-involved deaths are increasing. This study examines alcohol's role in substance-involved deaths and factors that are associated with alcohol involvement in the St. Louis, Missouri region.

Method: The present study examined 7,641 substance-involved deaths that occurred in the St. Louis, Missouri region. Data were provided by city and county medical examiner offices and comprised all substance-involved deaths between 2011 and 2022. We examined the prevalence of alcohol stratified by manner of death, sex, and race. We conducted logistic regression predicting odds of alcohol involvement based on demographic factors, presence of medical conditions, involvement of other substances, and year of death.

Results: Overall, 26.29% (2,009/7,671) of substance-involved deaths involved alcohol, and annual alcohol-involved deaths increased by 54.33% from 2011 to 2022. Most substance-involved deaths were overdose deaths (82.54%; 6,307/7,641). Alcohol-involved overdose deaths increased by 60.76% from 2011 to 2022. Prevalence of alcohol was higher for overdose deaths involving opioids and benzodiazepines (18%-24%) than for other drug classes (7%-16%). Odds of alcohol involvement in overdose deaths increased with age (odds ratio = 1.02, 95% CI [1.01, 1.02]) and were higher for males (odds ratio = 1.67, 95% CI [1.43, 1.96]).

Conclusions: The St. Louis metropolitan area saw increases in alcohol-involved fatalities for all manner of deaths, particularly overdose deaths and deaths among Black men. To improve prevention strategies for alcohol fatalities, further research is needed to investigate the role of alcohol in polysubstance overdose deaths.

Objective: People who use both alcohol and combustible tobacco have an increased risk of developing cancer. Few interventions have been developed to inform people about the risks of co-use. This study developed and tested messages about the risks of alcohol and combustible tobacco co-use among adults.

Method: In June to July 2021, we surveyed 1,300 U.S. adults who had used both alcohol and combustible tobacco products within the past 30 days. After reporting their awareness of diseases caused by tobacco and alcohol co-use, participants were randomly assigned to four between-subjects experiments that manipulated specific cancer health effects versus the word cancer; cancer health effects versus noncancer health effects; different descriptions of co-use (e.g., using alcohol and tobacco…, drinking alcohol and smoking tobacco…); and co-use versus single-use messages. Participants saw one message for each experiment and rated each message using a validated perceived message effectiveness (PME) scale.

Results: Awareness of health effects caused by alcohol and tobacco co-use ranged from moderately high for throat cancer (65.4%) to moderately low for colorectal cancer (23.1%). Messages about cancer health effects increased PME more than messages about noncancer health effects (B = 0.18, p = .01). Messages about some specific cancers, including oral cancer (B = -0.20, p = .04) and colorectal cancer (B = -0.22, p = .02), decreased PME more than messages with only the word cancer. No significant differences were identified for descriptions of co-use or co-use versus single-use messages.

Conclusions: Messages about some cancer health effects of co-using alcohol and tobacco may be effective when communicating the harms of both drinking alcohol and using tobacco.

Objective: Epidemiologic surveys aim to estimate the population prevalence of cannabis use and cannabis use disorder. Prevalence 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 (age 12 and older). 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 the validity and reliability of these estimates are offered.