Journal of studies on alcohol and drugs最新文献

Objective: To assess the viability of regional brain metabolite levels of individuals with alcohol use disorder (AUD) at treatment entry as a biomarker of post-treatment levels of alcohol use, categorized according to the World Health Organization risk drinking levels (WHO-RDL).

Method: Eighty-five individuals initiating treatment for AUD (16 ± 13 days after last alcohol consumption), and 45 light/non-drinking controls (LN) completed a 1.5T proton multislice magnetic resonance spectroscopic imaging study. N-acetylaspartate (NAA), a marker of neuronal viability, and other metabolites were quantitated for cortical gray matter (GM), white matter (WM) and select subcortical regions. Individuals with AUD were classified according to their post-treatment alcohol consumption, as abstainers (AB, n=42), low risk (RL, n=20), or higher risk (RH, n=23), based on the WHO-RDL taxonomy.

Results: Within frontal GM, RH exhibited significantly lower NAA levels than LN and AB but did not differ from RL. RH had significantly lower NAA concentration in frontal WM than all groups who did not significantly differ from one another. RH showed significantly lower parietal WM NAA than LN and AB; RL and RH did not differ from one another. Across RH and RL, lower frontal GM and WM NAA was related to shorter period of abstinence before first post-treatment alcohol consumption and longer post-treatment duration of alcohol resumption. There were no significant group differences in myo-inositol or choline- or creatine-containing compound concentrations.

Conclusions: Frontal and parietal lobar NAA concentrations, near treatment entry, are associated with WHO-RDL categorized post-treatment alcohol consumption levels and may serve as predictive biomarkers of clinical outcomes following treatment for AUD.

Objective: To examine how alcohol availability, overserving, and enforcement in recreational and social settings are related to alcohol misuse and alcohol-impaired driving among young adults in Victoria, Australia and Washington State, United States.

Method: Longitudinal data came from 1,430 participants in Victoria (n = 757; 52% female) and Washington (n = 673; 53% female), surveyed in 2014 (age 25) and 2018 (age 29) from the International Youth Development Study, a population-based, cross-national study to examine factors influencing substance use. Path modeling tested associations between age 25 perceptions of the alcohol environment, age 25 social alcohol consumption, and age 31 alcohol-related harms. Multiple-group modeling examined differences in parameter estimates across both states.

Results: Age 25 perceptions of the alcohol environment (alcohol availability, overservice in evening social venues, legal enforcement) and alcohol consumption in evening social settings were similar between the two states. Higher alcohol availability and perceived tendency of evening social venues to overserve were associated with higher alcohol consumption in these contexts. In turn, higher alcohol consumption in these settings was associated with more problematic alcohol use and an increased likelihood of alcohol-impaired driving 4 years later. Perceived likelihood of legal enforcement in evening social settings was not related to alcohol consumption in these contexts.

Conclusions: The recreational and social settings commonly frequented by young adults can influence drinking behaviors and alcohol-related harms. Reducing alcohol availability and over-servicing in settings where young adults often congregate and socialize could reduce problematic alcohol use and alcohol-impaired driving.

Objective: It is unknown whether age-related decreases in substance use (maturing out) are observed in the legalized cannabis context. This study evaluated age-related changes in past-month alcohol use frequency, cannabis use frequency, and any simultaneous alcohol and marijuana/cannabis (SAM) use among young adults who engaged in the respective substance use behavior.

Method: Young adults, residing in Washington State at enrollment (N=6,509; 68.3% female; ages 18-25), provided 3-5 years of annual data in a longitudinal, cohort-sequential design from 2015 to 2019, a period after nonmedical cannabis was legalized and implemented. Multilevel growth models were conducted; post-stratification weights were applied to make the sample more similar to the Washington young adult general population in demographic characteristics.

Results: Among those who reported alcohol use at 1+ timepoints, days of alcohol use increased from age 18 to approximately age 25 and then decreased until age 30. Among those who reported cannabis use at 1+ timepoints, days of cannabis use increased from age 18 until approximately age 23 and then decreased until age 30. Among those who reported SAM use at 1+ timepoints, the probability of SAM use increased from age 18 until approximately age 24 and then decreased until age 30. Age-related changes in SAM use were largely explained by concurrent changes in alcohol and cannabis use frequency.

Conclusions: Maturing out was observed for alcohol, cannabis, and SAM use among those who used each respective substance, with evidence that age-related changes in SAM use were tied to alcohol and cannabis use frequency.

Objective: Sexual and gender diverse (SGD) individuals are at heightened risk for intimate partner aggression (IPA) perpetration relative to their heterosexual and cisgender peers. Alcohol is a well-established cause of IPA perpetration in cisgender, heterosexual couples; however, minimal research has investigated the alcohol-IPA perpetration link in SGD couples. The relative lack of work in this area is a major barrier to addressing this health disparity. SGD individuals experience unique stressors related to their and/or their partner's intersecting minoritized identities that are critical to understanding alcohol-IPA etiology and informing culturally affirming intervention programming.

Method: We advance prior work by members of the authorship team (see Parrott et al., 2023a; Shorey et al., 2019) to propose an integrative theoretical model that invokes (1) the I³ Model to organize risk and resilience factors at the individual and dyadic level, and (2) Alcohol Myopia Theory to explain the mechanism by which proximal alcohol use facilitates IPA as a function of individual differences in those factors.

Results: This integrative model provides a framework to understand how the confluence of stigma, minority stressors, proximal alcohol use, and other factors contribute to IPA perpetration in SGD couples.

Discussion: Application of this integrative model has potential to facilitate more rigorous research (e.g., intensive longitudinal designs, dyadic analysis) focused on putative risk and resilience factors across the social ecology. Further, the model provides guidance for intervention development by identifying how individual (e.g., minority stress), relationship (e.g., relationship functioning), and structural factors (e.g., SGD stigma) interactively contribute to alcohol-facilitated IPA perpetration.

Objective: Bisexual women experience disparities in alcohol use outcomes compared to both lesbian and heterosexual women. Bisexual women also experience higher rates of sexual violence (SV) and alcohol use following SV. We examined whether coping drinking motives mediate the link between adult SV severity and alcohol use and whether dimensions of binegativity (i.e., hostility, instability, irresponsibility) moderate the effects of SV.

Method: The sample consisted of 355 young (ages 18-35) cisgender bisexual women drinkers (Mage=25.8, 84.2% White) recruited via MTurk. Measures included: Sexual Experiences Survey-Short Form Victimization (Koss et al., 2007), Anti-Bisexual Experiences Scale (Brewster & Moradi, 2010), Modified Drinking Motives Questionnaire-Revised (Grant et al., 2007), and Alcohol Use Disorders Identification Test Consumption subscale (Babor et al., 2001). The PROCESS macro for SPSS was used.

Results: There was an interaction between SV severity and irresponsibility stereotypes in predicting coping motives. SV severity related to greater coping motives at mean and high, but not low, levels of irresponsibility stereotypes. Indirect effects of SV severity on alcohol use via coping motives were significant at mean and high, but not low, levels of irresponsibility stereotypes. Hostility and instability dimensions of binegativity did not interact with SV severity in predicting coping motives.

Conclusions: Results identified SV severity and irresponsibility stereotypes as compounding experiences that may explain greater alcohol use. Bisexual women exposed to this dimension of binegativity may be particularly vulnerable to drink alcohol to cope with distress following SV. Interventions for alcohol use may be enhanced by helping bisexual women cope with SV-related distress and irresponsibility stereotypes.

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 time period of the original study. Previous results indicated a significant reduction in single vehicle nighttime (SVN) crashes among 15 to 30-year-olds in intervention cities relative to controls (Saltz et al., 2021).

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 single vehicle nighttime (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 [Event 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: Pregnancy-specific alcohol policies are widely adopted yet have limited effectiveness and established risks. It is unknown whether general population alcohol policies are effective during pregnancy. This study investigated associations between general population policies and alcohol treatment admission rates for pregnant people specifically.

Method: Data are from the Treatment Episodes Data Set: Admissions and state-level policy data for 1992-2019 (n=1,331 state-years). The primary outcome was treatment admissions where alcohol was the primary substance, and the secondary outcome included admissions where alcohol was any substance. There were five policy predictors: 1) Government spirits monopoly, 2) Ban on Sunday sales, 3) Grocery store sales, 4) Gas station sales, and 5) Blood alcohol concentration (BAC) laws. Covariates included poverty, unemployment, per capita cigarette consumption, state and year fixed effects, and state-specific time trends.

Results: In models with alcohol as the primary substance, prohibiting spirits sales in grocery stores (vs. allowing heavy beer and spirits) had lower treatment admission rates [IRR=0.88, 95% CI: 0.78-0.99, p=0.028]. States with BAC laws at 0.10% (vs. no law) had higher treatment admission rates [IRR=1.24, 95% CI: 1.08-1.43, p=0.003]. When alcohol was any substance, prohibiting spirits sales in grocery stores (vs. allowing heavy beer and spirits) was again associated with lower treatment admission rates [IRR=0.89, 95% CI: 0.80-0.98, p=0.021], but there was no association for BAC laws.

Conclusions: Restrictions on grocery store spirits sales and BAC laws were associated with lower and higher alcohol treatment admission rates among pregnant people, respectively, suggesting general population alcohol policies are relevant for pregnant people's treatment utilization.

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 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 of them with interdose withdrawal (mean age=57.91±13.61 years; 68.3% female). Latent Class Analysis (LCA) and bivariate and logistic regression analyses were performed.

Results: Two latent classes were identified (BIC=4020.72, entropy=0.70, LRTs p<0.01): 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<0.01). 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<0.05). Only moderate-severe POUD (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 a 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: Previous research has demonstrated different cannabis-related outcomes depending on the goal of cannabis use (i.e., recreational, medical, hybrid of both), underscoring the need to identify variables associated with specific goals of use, particularly in understudied populations.

Method: This report utilized data from a national survey of menopausal individuals using non-probability sampling. Respondents reporting current regular (≥1x/month) cannabis use (medical n=35, recreational n=61, and hybrid n=102) were included in multivariate logistic regression analyses examining demographic, clinical (e.g., menopause-related symptomatology), and cannabis-related variables associated with goal of cannabis use.

Results: Overall, increased number of medical conditions was associated with medical and hybrid use relative to recreational use (ps≤.047), and greater menopause-related symptomatology was associated with medical relative to hybrid use (p=.001). Lower education level was associated with hybrid relative to recreational use (p=.010). Lastly, increased number of modes of use was associated with hybrid use relative to medical and recreational use (ps≤.001).

Conclusions: Results suggest medical and hybrid consumers with more medical conditions and more severe clinical symptoms that are not sufficiently alleviated by conventional treatments may be more open to cannabinoid-based therapies. Additionally, as lower education level is often associated with recreational cannabis use, results suggest hybrid consumers may begin as recreational consumers who then expand their use for medical purposes. Further, more varied modes of use for hybrid consumers may reflect different product selection based on goal of use. Future research should investigate the etiology of hybrid cannabis use and predictors of long-term outcomes associated with goals of use.

Objective: Prevention programs that address the intersecting health problems of risky alcohol use, unsafe sexual behaviors, and sexual violence are needed. This pilot project assessed the feasibility, acceptability, and preliminary efficacy of a two-session group-based intervention, Sex Positive Lifestyles: Addressing Alcohol & Sexual Health (SPLASH), targeting these highly interconnected risks for college students across genders.

Method: A total of 217 participants (51.6% male, ages 18-24) took part in the SPLASH intervention or a nutrition/exercise control condition. SPLASH included three approaches aimed at reducing the incidence of alcohol problems, unsafe sex, and sexual victimization: normative feedback to modify misperceptions around peers' drinking, sexual behaviors, and support of bystander intervention; drinking and sexual-related protective behavioral strategy training to enhance safer drinking and sex-risk behaviors; and bystander intervention skills training to promote bystander efficacy and engagement. Participants completed baseline and follow-up (1-month and 6-month) online assessments.

Results: SPLASH demonstrated high acceptability and feasibility, as well as preliminary efficacy. SPLASH participants reported strong acceptability of the intervention, particularly its integrated content and interactive, in-person group format. Successful enrollment (70% randomized) and retainment point to the feasibility of recruiting students to this two-session in-person intervention. Results showed sustained trends toward more accurate perceived sex-related norms and indications of increasing bystander norms among intervention but not control participants.

Conclusions: Results demonstrate the potential for SPLASH to effectively address the interrelated health risks of risky alcohol use, unsafe sex, and sexual violence on college campuses and point to the need for larger-scale studies.