Journal of studies on alcohol and drugs最新文献

Objective: Learning theories suggest an aversive learning process whereby negative consequences of alcohol use (AU) curtail drinking. Yet, the literature examining this prospective association is mixed. We aimed to clarify this aversive learning process by identifying how (mediators), for whom (moderators), and when (differences across development) such learning occurs. Negative alcohol expectancies were proposed as a mediator and sensitivity to punishment (SP) was proposed as a moderator. Negative consequences were hypothesized to lead to increases in negative expectancies and, in turn, reductions in AU. Associations were expected to be strongest at high SP. This proposed aversive learning pathway was estimated in adolescence (limited alcohol experience) and young adulthood (significant alcohol experience) to examine differences in learning across developmental period.

Method: Data from a longitudinal community sample (N=387) assessed annually for three years in adolescence (ages = 12-14) and in young adulthood (ages = 19-21) were analyzed using prospective path models.

Results: In adolescence, negative consequences were not associated with negative expectancies, but negative expectancies were inversely associated with AU. In contrast, negative consequences were positively associated with negative expectancies in young adulthood, but negative expectancies were not associated with AU. Moderation was not supported.

Conclusions: Negative consequences are uncommon among community adolescents and, as a result, may not shape negative expectancies, yet negative expectancies are protective against AU. In young adulthood, negative consequences appear salient enough to shape negative expectancies, but they no longer serve a protective function. Findings suggest a shifting role of drinking experience in the development of expectancies and the influence of expectancies on AU.

Objective: The burden of alcohol-related disease is substantial and varies across regions, age and sexes. The study used the Global Burden of Disease (GBD) 2021 data to estimate the burden, emphasizing on changes during the COVID-19 pandemic.

Methods: The study analyzed trends in prevalence, mortality, disability-adjusted life years (DALYs), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs of alcohol-related diseases [alcohol use disorder (AUD), cirrhosis due to alcohol, alcoholic cardiomyopathy and liver cancer due to alcohol use] across sex, age groups (adolescents, young adults, women of childbearing age, the working-age population, the elderly), and socio-demographic index (SDI) levels using annual percentage change (APC) and average annual percentage change (AAPC).

Results: Globally, prevalence of AUD increased by 31.44%, while the ASPR declined by 0.78% annually. China, India, United States of America bearded the higher burden. The prevalence of cirrhosis due to alcohol increased by 73.69%, alcoholic cardiomyopathy by 48.24%, and liver cancer due to alcohol use prevalence also increased. Working-age populations had the largest absolute numbers of cirrhosis due to alcohol and alcoholic cardiomyopathy, while the elderly had higher ASR of liver cancer due to alcohol use. Following 2019, improvements in most alcohol-related diseases decelerated, particularly in working-age population, potentially influenced by the COVID-19 pandemic.

Conclusions: This study emphasizes the urgent need for targeted policies on alcohol-related diseases, especially for vulnerable groups, considering regional, socio-economic, and for timely interventions to reduce the long-term health impact of the COVID-19 pandemic.

Objective: Cannabis use has increased among older adults, yet the neurocognitive effects in this demographic remain unclear. Prior work has suggested cannabis may increase brain volume in areas rich in cannabinoid (CB1) receptors, though negative effects are often reported in adolescents. This study sought to clarify the relationship between cannabis use and brain health among middle-aged and older adults.

Method: Using data from the UK Biobank, which includes health information from over 500,000 adults, associations between cannabis use, regional brain volume, and cognition in participants aged 40-70 years (mean age = 54.5) were evaluated.

Results: Lifetime cannabis use was positively associated with regional brain volume in CB1-rich regions, including the caudate, putamen, hippocampus, and amygdala. Greater lifetime use was also linked to better performance in learning, processing speed, and short-term memory. Individuals reporting use limited to adolescence also showed larger regional volumes and better cognitive performance than non-users. Sex differences in cannabis effects on brain volume and cognition were also observed.

Conclusions: Results highlight that cannabis may influence brain health differently across the lifespan, potentially offering protective effects in older age while posing risks earlier in development. Protective effects may result from endocannabinoid-mediated modulation of inflammation, immune function, and neurodegeneration. Observed sex differences likely reflect variation in the endocannabinoid system and underscore the importance of considering sex as a biological variable in studies of cannabis and brain health.

Objective: There is no externally validated instrument for predicting which children will show frequent substance use (SU) in young adulthood. This study evaluated whether an instrument previously shown to predict SU outcomes in mid-adolescence could also predict SU outcomes in young adulthood, comparing performance across ages and demographics.

Method: The Loeber Risk Score (LRS) is a 5-item, parent-completed screener indexing risk of future SU in children. We evaluated the predictive performance of the LRS in a nationally representative longitudinal birth cohort (N = 4,898, 48% female). Parents completed the LRS when the child was ∼5 and ∼9 years old. Subsequently, youth reported their SU at age ∼22 years old.

Results: The LRS at age 9 predicted several outcomes at age 22 better than chance (ps<0.05): daily cigarette use (AUROCs=0.71-0.75), cannabis use ≥3x week (AUROC=0.59), vaping ≥3x week (AUROC=0.55), and receipt of treatment for an alcohol/drug problem (AUROC=0.60). Performance was no better than chance for alcohol outcomes (AUROCs=0.47-0.50). Children with LRS scores ≥2 were 1.3-2.0 times more likely to display frequent substance use outcomes. There were no consistent performance differences when the LRS was measured at age 5 vs. age 9 or by child's sex, race, or ethnicity.

Conclusion: The LRS would be an improvement over random or ad hoc selection, but screening accuracy is generally low. Much more accurate screeners are needed.

Objective: Driving while intoxicated (DWI) remains a preventable source of morbidity and mortality in the United States. Ignition Interlock Devices (IID) are used to prevent DWI offenders from driving while intoxicated during a mandated installation period and are effective during that time. Once IIDs are removed, DWI rates are similar to levels of offenders who had no IID. This study tested the efficacy of a smartphone app (B-SMART) for DWI offenders with an IID and Concerned Family Members (CFMs), with the goal of reducing IID lockout events and alcohol consumption.

Method: Four B-SMART app modules were developed: 1) Life with Interlock, 2) Supporting Changes in Drinking, 3) Doing Things Together, and 4) Effective Communication. Participants (pairs of DWI offenders and CFMs) were randomly assigned to receive the B-SMART app (n=58) or referral to a state IID information page (Usual and Customary - UC condition, n=65) and followed for 9 months post-randomization. IID data (failed tests and lockout events) were obtained from IID providers as the primary outcome variables. Offender and CFM reports of alcohol consumption in the last 30 days prior to assessment were secondary measures.

Results: IID data were collected on 62% (N=76) of participants. B-SMART participants had significantly fewer lockout events than UC participants. B-SMART offenders and their CFMs reported significantly less likelihood of DWI offender drinking at 9-months.

Conclusions: Results suggest the B-SMART app reduced IID lockout events and DWI offender alcohol consumption. These outcomes are important because fewer IID lockout events predict lower DWI recidivism.

Objective: The public health impact of substance use (SU) is substantial, with tobacco use and excessive drinking leading as causes of death in the USA. To address this growing epidemic, governments have implemented a range of SU-related policies. The NIH's Clinical & Translational Science Awards (CTSA) program, which aims to accelerate translation of research findings into health impact, may advance translation through its impact on the policy literature that informs policymakers, health professionals, and the public. Using innovative bibliometric tools, this study evaluates how CTSA-supported research published from 2006-2023 has influenced SU-related policy literature.

Method: The authors identified 135K publications that acknowledged CTSA support. Those publications were queried in the Overton Policy database, which indexes references to research publications in global policy literature.

Results: Thus far, CTSA-supported publications have been cited in 3,451 policy documents identified as SU-related according to Overton's Topics field. SU-related Topics were classified into top categories of: Tobacco, Opioids, Cannabis, Alcohol, and General/Other SU. Policy documents came from 321 organizations across 49 countries- often governments, health agencies, or political think tanks, including the World Health Organization, Guidelines in Pubmed Central, and the RAND Corporation. The authors present case illustrations of individual research publications that have had notable influence on SU policy.

Conclusions: By elucidating ways that supported publications are applied outside academia, bibliometrics offer a useful avenue for evaluating the translational impact of programs on specific areas of policy. Our findings showcase the impact that CTSA research has had on SU-related policy literature, a critical area of health policy.

Background: Prolonged alcohol consumption is associated with immune system alterations, high blood pressure, and neurotoxicity. Alcohol use disorder (AUD) is a devastating disease worldwide that leads to several changes in the neurochemical balance within the brain. Moreover, the high incidence of certain cancers and the prevalence of infectious diseases among individuals with alcohol use disorder demonstrate how alcohol impairs immune system. Our research brings a new viewpoint to the understanding of the critical pathways and genes involved in the dynamic alterations of AUD progression.

Methods: In summary, the methods utilized in this research include microarray data collection from GEO database, functional enrichment analysis of gene sets, weighted gene co-expression network analysis to find regulated modules, and analysis of modules and identification of hub genes.

Results: The findings showed that the expression of a wide range of genes is affected by alcohol and will lead to significant changes in the regulation of biological processes and signaling pathways related to the cell cycle and cellular senescence. Some of the significantly impacted pathways are polyubiquitination, NF-κB pathway, FOXO, mTOR, P53, calcium and PPAR signaling pathways.

Conclusion: It is likely that the expression of genes associated with cellular senescence is altered by alcohol and its related disorders.

Objective: The opioid crisis remains a critical public health concern, with non-medical use of prescription opioids (NMUPO) playing a significant role. However, limited evidence exists on how adults engaging in NMUPO for subjective effects differ from those who use them for other non-medical reasons. This study aims to identify and examine factors associated with engagement in NMUPO for subjective effects.

Method: Data from the 2020 to 2024 CAMH Monitor study, a repeated cross-sectional survey of adults aged 18 and older (N=7,655). The surveys used a Qualtrics-based web survey to assess NMUPO, sociodemographic factors, substance use and mental health. Data were analyzed using multivariate multinomial logistic regression.

Results: About 3% of adults engaged in NMUPO for subjective effects/to get high, and 15% of participants engaged in NMUPO for other non-medical purposes during 2020 and 2024. These percentages remained stable over the years. The risk of NMUPO for subjective effects, compared to NMUPO for other purposes, was significantly higher among Asian people, compared to their white counterparts (Relative Risk Ratio, RRR=1.80, 95%CI: 1.08-3.01), and those with children, (RRR=2.53, 95%CI: 1.64-3.92). Similarly, individuals with low household income, current other substance use, and psychological distress exhibited a higher risk of NMUPO, after adjusting for covariates.

Conclusions: Individuals who use prescription opioids non-medically for subjective effects or other reasons differ by race/ethnicity, parental status, income, substance use, and level of psychological distress. These findings suggest the need for targeted prevention and intervention strategies to address the unique needs and behaviors of different user groups.

Objective: Reduction in alcohol craving has often been specified as an outcome for alcohol use disorder (AUD) interventions. This study evaluated changes in multiple craving measures from a randomized double-blind clinical trial (RCT) evaluating the efficacy of intermittent theta burst stimulation (iTBS) to the left dorsolateral prefrontal cortex, for treatment of AUD. We predicted Veterans in AUD residential treatment, that received active iTBS (Active; n=22), show greater reductions than sham iTBS (Sham; n=22).

Method: Twenty iTBS sessions (1200 pulses/session) were delivered over 2 weeks. Craving measures were administered prior to iTBS sessions (Baseline) and following completion of sessions (Post-Assessment). Craving measures administered were the Alcohol Craving Questionnaire Short Form-Revised Total Score, Abstinence Self-Efficacy Scale (AASE) Tempted Cravings and Urges subscale, and Obsessive Compulsive Drinking Scale (OCDS).

Results: All craving measures showed reductions in scores (time main effect), collapsed across Active and Sham groups; however, the absence of significant group x time interactions indicated active iTBS did not produce statistically greater reductions than sham. Exploratory post-hoc simple effects analyses were conducted to further examine the significant main effect of time; Active participants showed reductions on the AASE Tempted Cravings-Urges and all OCDS measures; Sham group showed no significant changes on any measure.

Conclusions: Active iTBS did not produce a statistically greater reduction in craving symptomatology than sham, given the absence of significant group by time interactions. However, the exploratory post-hoc results can guide future larger scale transcranial magnetic stimulation RCTs for AUD on the utility of the acquired craving measures.

Objective: Theories posit that acute alcohol responses predict development of future heavy alcohol use and alcohol related problems. The most prominent of these theories is the low-level response theory that purports less intense alcohol responses are associated with later development of alcohol use disorder. The counter modified differentiator model posits greater stimulant effects with lower sedative effects predict future heavy drinking. The present study provided a concurrent testing of these theories in a large-scale cohort of young adult Swiss men.

Methods: Data were derived from two waves of the Cohort Study on Substance Use Risk Factors in 2749 French-speaking, current alcohol consuming young adult men aged 25.7 years at baseline and 28.5 years at follow-up. Participants completed the 6-item Anticipated Brief Biphasic Alcohol Effects Scale with the instructions of the anticipated effects they feel after consuming five standard drinks and the stimulation and sedation subscales were used in analyses. Associations of these scores with volume of drinking and frequency of heavy episodic drinking were determined both at baseline and at 3-year follow-up. Models were adjusted for covariates including disinhibited personality and family history of alcohol problems.

Results: Results show that anticipated stimulation effects of alcohol predicted increasing alcohol consumption over time and anticipated sedative alcohol effects predicted reductions in consumption (p-values ≤ .001).

Conclusions: The present study supported the modified differentiator model in that higher anticipated stimulation and lower sedation predicted future alcohol consumption patterns. This may be useful to prevent heavy drinking and inform pharmacological interventions intended to reduce pleasurable effects.