Journal of studies on alcohol and drugs最新文献

Objective: There is a substantial literature indicating brief interventions (BIs) for alcohol use disorder (AUD) are as effective as more extensive treatments. The research assessment reactivity literature, however, suggests that the protocols used to study AUD treatments can have clinical efficacy, which may account for the observed findings. The purpose of this research was to experimentally investigate the moderation of AUD treatment effects by AUD assessment protocols.

Method: Participants were recruited from the community via advertisements (e.g., Facebook, mail advertisements, posting of flyers). Eligible participants, providing informed consent, were randomized to one of four research conditions resulting from a two (Intervention: Motivational Enhancement Therapy (MET) or Cognitive Behavioral Coping Skills Therapy (CBT)) by two (Assessment: infrequent-alcohol/drug focused or frequent-comprehensive) factorial design and followed for 15 months post baseline assessment.

Results: Across the entire sample, the proportion of abstinence days increased from 21.6% at baseline to 62.4% during follow-up months 13-15, and the proportion of heavy drinking days decreased from 64.9% at baseline to 18.1% during follow-up months 13-15. Although the hypothesized interaction 'intervention by assessment condition' was not supported, main effects were detected for assessment condition such that individuals assigned to the alcohol/drug focused assessment conditions reported greater abstinence and fewer heavy drinking days than their counterparts assigned to the comprehensive assessment conditions.

Conclusions: Robust BIs, such as MET, appear to yield drinking outcomes that are comparable to that of more extensive AUD treatments such as CBT. In addition, reactivity to research assessments contributed to reduced alcohol use and these effects appear to be contingent upon intervention and participant characteristics.

Objective: Understanding the relationship between people's lifetime alcohol use and their awareness of the risk of common chronic diseases from alcohol use is important for informing health messaging efforts. This paper aimed to 1) assess the level of awareness that alcohol use increases the risk of cancer, diabetes, hypertension, and 2) examine the association between lifetime drinking patterns and levels of awareness.

Method: We used data from the 2019-2020 National Alcohol Survey (NAS) that included awareness that cancer, hypertension and diabetes could result from drinking too much alcohol (yes/no/unsure), past-year alcohol use, and lifetime alcohol use operationalized as peak lifetime drinking pattern and ever having 2+ symptoms of alcohol use disorder (AUD). We conducted multinomial regressions to examine associations between lifetime alcohol use and awareness of alcohol as a risk factor for each health outcome, controlling for past-year use.

Results: Overall, 42.1% acknowledged the link between alcohol use and cancer, 52.2% between alcohol use and diabetes, and 61.3% between alcohol use and hypertension. Nearly all peak lifetime drinking pattern levels were associated with a lower likelihood of awareness of the alcohol-cancer link. Conversely, nearly all levels were associated with a higher likelihood of awareness of the link between alcohol use and hypertension, and only one level was associated with awareness of the alcohol-diabetes link.

Conclusions: Awareness of alcohol's effects on chronic diseases varies by type of disease. Lifetime alcohol use is a relevant factor for understanding levels of awareness of alcohol's health effects.

Objective: Participation in 12-step groups (TS), such as Alcoholics Anonymous, confers benefits among individuals with alcohol use disorder (AUD), and one candidate mechanism underlying these effects is reductions in impulsivity. Using a multidimensional assessment of impulsivity, the current study examined delay discounting (DD) and impulsive personality traits in a longitudinal cohort of adults with AUD initiating a significant recovery attempt.

Methods: A prospective matched-sample cohort study design compared participants who reported a clinically meaningful increase in TS attendance (i.e., increase of ≥1 meetings/week; n=77) from enrollment to 6 weeks to a matched control group who did not increase attendance (n=77). Drinking was assessed using the Timeline Followback (% drinking days [%DD], % heavy drinking days [%HDD]); impulsivity was assessed using the 5-trial DD task and five UPPS-P subscales. Mediation models evaluated whether impulsivity explained the relationship between increased TS attendance and alcohol outcomes.

Results: Compared to matched controls, participants who increased TS significantly exhibited reduced %DD and %HDD (ps < 0.001), as well as Negative Urgency (i.e., acting out due to negative emotions) and Lack of Perseverance (i.e., failure to persist in tasks) (ps = 0.03) after their recovery attempt. Reductions in impulsivity, however, did not mediate the association between increased TS attendance and drinking.

Conclusions: Increased TS attendance was associated with significant reductions in drinking and certain impulsivity traits in early AUD recovery. However, while the changes were contemporaneous, impulsivity did not explain the benefits of TS effects. Future research should evaluate this hypothesis in larger samples and over longer follow-up periods.

Background: The multistage model of substance use proposes that reinforcement mechanisms and motives for use change as individuals develop substance use disorders, with positive reinforcement driving substance use when substance use disorder symptoms are absent/mild and negative reinforcement becoming dominant when substance use disorder symptoms are more severe. We aimed to determine whether event-level associations between affect, cannabis use, motives for use, and heaviness of use were moderated by cannabis use problem severity, consistent with the multistage model of substance use.

Methods: We used EMA data (2 observations per day for 14 days) from 571 young adult females who regularly used cannabis. The sample included a majority sexual minority women and gender diverse individuals (77.6%).

Results: Elevated anxious affect was concurrently associated with coping motives for cannabis use and longer duration of intoxication at the event-level but only among those with more severe CU problems. Further, positive affect was concurrently associated with a higher likelihood of endorsing enhancement motives for the full sample, but this association was stronger for those with fewer CU problems. However, many other associations between affect and cannabis use outcomes were not moderated by severity of CU problems.

Discussion: Some findings were consistent with what would be expected based on the multistage model. However, results also suggest that positive reinforcement may continue to drive cannabis use among those with more severe CU problems which is not consistent with what would be expected based on the multistage model.

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.