Journal of studies on alcohol and drugs最新文献

Objective: University students who experience more discrimination typically report more negative consequences from alcohol use. The study aimed to assess whether drinking to cope and protective behavioral strategies for alcohol use would help explain the relationship between everyday discrimination and alcohol-related consequences among university student drinkers.

Method: Data were collected in Fall 2020, and the sample included 707 undergraduate and graduate students from a large public institution in the Northeast who reported consuming alcohol in the past month. Participants identified predominantly as women (71.7%; 24.6% men) and White (65.1%; 7.9% Black/African American; 7.2% Asian/Asian American; 7.1% Hispanic/Latinx). A cross-sectional serial mediation analysis using structural equation modeling was conducted using Mplus.

Results: When we controlled for alcohol use, results supported a serial partial mediation model. More experiences of discrimination predicted a significant increase in alcohol-related consequences, above and beyond the increase attributed to drinking to cope. More frequent use of protective behavioral strategies significantly increased the odds of reporting no alcohol-related consequences.

Conclusions: Drinking to cope and protective behavioral strategies for alcohol use may help explain why university students who report frequent discrimination are more likely to experience alcohol-related consequences, independent of how much alcohol they consume. Findings can inform clinical and prevention practice, advocacy, and training.

Objective: The shelter-in-place mandates enacted early in the COVID-19 pandemic resulted in changes in alcohol use and consequent outcomes. We assessed changes in six categories of season-specific alcohol-attributable mortality from before to during the early phases of the COVID-19 pandemic in the United States.

Method: We used logistic regression models to assess alcohol-attributable mortality in the United States from 2017 through 2020 (n = 11,632,725 decedents ages 18 and older). Outcomes included chronic fully alcohol-attributable deaths, poisonings, motor vehicle accidents, suicides, homicides, and falls. Exposure variables included year, season, the interaction between the year 2020 and season, rurality, the interaction between the year 2020 and rurality, decedent age, sex, race, ethnicity, marital status, and education.

Results: Compared with 2019, season-specific mortality age-adjusted rates of chronic fully alcohol-attributable deaths, homicides, poisonings, and falls increased during the COVID-19 pandemic. Suicide rates decreased in most 2020 seasons relative to the same seasons in 2019. Motor vehicle deaths decreased in spring 2020 versus 2019. Relative to dying by any other cause, the odds of death by chronic fully alcohol-attributable causes and poisonings were higher across seasons in 2020 versus 2019. The odds of death by suicide were higher among residents of rural counties in spring 2020 versus 2019.

Conclusions: There were distinct temporal changes in six types of alcohol-attributable deaths during the early phases of the COVID-19 pandemic.

Objective: The National Survey on Drug Use and Health (NSDUH), as the primary source of epidemiological substance use data in the United States, could illuminate trends in fentanyl use behaviors contributing to the opioid overdose crisis. We hypothesized that the trend in NSDUH prevalence of lifetime fentanyl injection would match the direction and magnitude of the trend in synthetic opioid overdose deaths.

Method: Using logistic regression, we modeled the 2015-2020 trend in synthetic opioid overdose deaths as a proportion of all deaths. We modeled contemporary trends from cross-sectional NSDUH data for (a) lifetime fentanyl injection, (b) past-year prescription fentanyl misuse, (c) prescription tramadol misuse (the other synthetic opioid counted alongside fentanyl in the overdose deaths category), and (d) combined prescription fentanyl or tramadol misuse. The average annual NSDUH weighted sample size was 272,519,038 (51.5% female, 48.5% male).

Results: Synthetic opioid overdose deaths increased from 2015 to 2020 (odds ratio = 3.39, meaning that the odds of a death being from synthetic opioid overdose in 2020 were 3.39 times the odds of death from that cause in 2015, 95% CI [3.34, 3.44]). None of the substance use trends significantly increased.

Conclusions: Per NSDUH data, the prevalence of fentanyl misuse did not significantly increase in tandem with synthetic opioid overdose deaths from 2015 to 2020. Scrutiny of NSDUH's approach to assessing fentanyl misuse casts doubt on the utility of NSDUH fentanyl data collection. We acknowledge recent changes to the survey and recommend two further changes to optimize a vital source of data on behaviors related to the opioid overdose crisis.

Objective: Pregaming is common among college students and is associated with heavy drinking and negative alcohol-related consequences. The use of cannabis on pregaming days may exacerbate negative alcohol-related consequences, and the ordering of when cannabis is used on these days may buffer against or intensify these consequences. Considering the growing rates of simultaneous use of cannabis and alcohol among college students, it is necessary to examine the role of pregaming behaviors in the context of cannabis use and its effects on alcohol-related consequences.

Method: In the present study, college students (N = 485) completed a baseline survey and 14 days of daily surveys, reporting on daily alcohol and cannabis use and alcohol-related negative consequences. Multilevel structural equation models were fit to evaluate cannabis outcomes on pregaming versus non-pregaming drinking days and ordering effects on alcohol-related consequences, controlling for number of drinks, age, and sex.

Results: Across all drinking days, pregaming on that day as well as cannabis use during drinking on that day were associated with a greater risk for alcohol-related consequences. On days that did not involve pregaming, the use of cannabis before drinking was associated with a greater risk for negative alcohol-related consequences, whereas cannabis use after drinking was associated with less risk for consequences. These effects were observed on non-pregaming days only and not on days with pregaming.

Conclusions: Findings have implications for brief interventions with students, as analyses suggested that both cannabis use and pregaming--independent of number of drinks consumed--are risky behaviors associated with alcohol-related consequences.

Objective: Perception of others' approval of alcohol use (i.e., injunctive drinking norms) is strongly predictive of alcohol use, particularly among young adults. Although between-person injunctive norms predict alcohol use, there is evidence of within-person fluctuations in the relationship between norms and drinking. The current study used ecological momentary assessment (EMA) to test within-person, day-level associations between injunctive norms and alcohol use and to test whether social context moderated this association.

Method: Participants (n = 83, M age = 24.0 years, 50.9% female) completed a 2-week EMA protocol using a smartphone application. Injunctive norms, social context (type and gender of companions), and number of drinks consumed were assessed each morning following a drinking event. Multilevel models with repeated measures nested within participants tested main effects and interactions of between- and within-person injunctive norms, type of drinking companions, and gender of drinking companions on the number of drinks consumed.

Results: Day-level injunctive norms were positively associated with drinking quantity over and above baseline norms. The effect of norms differed by social context, such that norms were only positively related to drinking quantity when drinking with a friend or romantic partner (vs. drinking alone). The gender of friends with whom participants drank did not moderate the effect of norms on quantity.

Conclusions: This study provides one of the first examinations of daily fluctuations in injunctive drinking norms. Because norms represent a malleable target for intervention, results offer new information regarding possible intervention targets.

Objective: Recent research has shown potential for psychedelic therapeutics as addiction treatments; however, some academic institutions, commercial entities, and individuals are attempting to monopolize psychedelic compounds through exploiting the patent process.

Method: This Perspective article describes efforts that have been devised to mitigate exclusionary patent practices pertinent to psychedelic therapeutics for addiction.

Results: The nonprofit Porta Sophia has identified 170 patent documents focused on treating addiction through psychedelics, and many of these patents could threaten to privatize public domain knowledge and severely limit or increase the cost of research if granted. Patent examiners who determine if a patent application should be granted must negate false claims to innovation. Yet, given the unique history of psychedelics, prior knowledge can be difficult to find. As a result, overreaching patents may be granted, causing dramatic shifts in access to addiction-focused psychedelic research, treatments, and funding.

Conclusions: As the field of psychedelics approaches this crucial inflection point of U.S. Food and Drug Administration decisions, it is imperative for all stakeholders--including university investigators, academic and commercial patent seekers, and policymakers--to use available tools for determining prior knowledge. Maintaining an informed awareness of legal patent eligibility and limitations is crucial for establishing an ethical patent landscape and ensuring subsequent access to these potential life-altering psychedelic therapeutics for addiction.