Journal of studies on alcohol and drugs最新文献

Objective: Heavy drinking is common among men who have sex with men (MSM) and significantly increases HIV acquisition risk. MSM who report heavy drinking also report higher cannabis use, which has also been associated with sexual behaviors known to elevate HIV transmission risk. Despite evidence of associations at the between-subjects level, the effects of alcohol and cannabis use on sexual risk behavior among MSM who engage in heavy drinking are largely unknown. The current study used ecological momentary assessment to examine the between- and within-subject associations of heavy drinking, cannabis use, and sexual behavior.

Method: This is a secondary data analysis of a study on alcohol intoxication and sexual decision making that included 115 MSM who reported cannabis use and were not using pre-exposure prophylaxis (PrEP) at baseline. Participants reported daily alcohol and cannabis use and sexual activities over 6 weeks. Multilevel multinomial regression was used to evaluate how alcohol and cannabis use were associated with sexual behaviors.

Results: Higher alcohol use was associated with higher rates of intercourse at the between-persons level and a higher likelihood of all sexual behaviors at the event level. In contrast, cannabis use at the between-person level was associated with an increased rate of condomless anal intercourse relative to both anal intercourse with a condom as well as no sex. At the within-person level, cannabis was associated with an increased likelihood of anal sex with or without a condom relative to no sex.

Conclusions: Cannabis and alcohol may have independent effects on sexual risk behavior among MSM. Interventions addressing sexual health among MSM who engage in heavy drinking should also consider the additive risks of cannabis use.

Objective: We investigated risk for alcohol use disorder (AUD) and drug use disorder (DUD) in offspring of parents with major depression (MDD) or bipolar disorder (BD), including how parent and offspring sex impact familial transmission.

Method: Offspring born in Sweden 1970-1990 in intact families with parental MDD or BD (n=1,218,920) were examined using Swedish population registries. Hazard ratios (HRs) for AUD and DUD risk among offspring were calculated using Cox models.

Results: Offspring of one parent with MDD or BD had higher risks of AUD (HR=1.34; HR=1.50) and DUD (HR=1.32; HR=1.43) than offspring of unaffected parents. Maternal MDD (HR=1.38) had a stronger effect on offspring DUD than paternal MDD (HR=1.26), and maternal BD (HR=1.67) more strongly influenced offspring AUD than paternal BD (HR=1.34). Parental MDD had stronger effects on daughters than sons for AUD (HR=1.40 vs. HR=1.32) and DUD (HR=1.44 vs. HR=1.27), while no sex differences were found for parental BD. Among daughters, maternal MDD had stronger effects than paternal MDD for AUD (HR=1.48 vs. 1.32) and DUD (HR=1.56 vs. 1.33); for sons, maternal MDD had greater impact on DUD (HR=1.31 vs. 1.23). Maternal BD had greater effects in daughters, both versus sons for DUD (HR=1.92 vs. HR=1.37) and versus paternal BD for AUD (HR=1.82 vs. HR=1.30) and DUD (HR=1.92 vs. HR=1.31).

Conclusions: Findings demonstrate familial transmission of MDD and BD in parents to AUD and DUD in offspring. Affected mothers may be particularly influential. When sex-specific transmission occurred, it was consistently strongest from mother to daughter.

Objective: Buprenorphine is a high affinity partial agonist that can displace full opioid agonists and could be used to reverse opioid induced respiratory depression. There is scant evidence to support the use of buprenorphine in an acute opioid overdose to reverse respiratory depression in the era of high fentanyl prevalence in the drug supply. This is a case series of four patients with signs and symptoms of an opioid overdose who showed clinical improvement after receiving intravenous buprenorphine.

Methods: A case series of adult emergency department (ED) patients treated at a single urban academic medical center. Cases were reviewed by authors and determined by consensus whether there was evidence of an acute opioid overdose and if those signs and symptoms were improved after receiving intravenous buprenorphine.

Results: All four cases were male patients with a history of opioid use disorder (OUD) and were treated in the ED after an opioid overdose and had signs of respiratory depression. Three of the four cases received naloxone prior to receiving intravenous buprenorphine. Initial doses of intravenous buprenorphine ranged from 0.1 mg to 0.15 mg. None of the patients developed buprenorphine precipitated withdrawal. All of the cases were discharged from the ED with a prescription for sublingual buprenorphine.

Conclusion: In this case series patients who received intravenous buprenorphine after an acute opioid overdose had some clinical improvement and did not develop buprenorphine precipitated withdrawal. Further research should be performed to determine the safety and efficacy of intravenous buprenorphine as an opioid overdose reversal agent.

Objective: Latino/as comprise nearly 20% of the US population; 25% report past month binge drinking, and disparities in care persist. Culturally adapted interventions may improve outcomes and access. We tested the efficacy of a culturally adapted behavioral intervention to reduce unhealthy alcohol use, delivered in Spanish to Latino/a adults.

Method: We conducted a parallel, two-group, randomized controlled trial with 12- and 26-week follow-ups to test a 3-session intervention delivered by community health workers (CHWs) from a community-based agency in Los Angeles, California. The intervention combined culturally-adapted Motivational Enhancement Therapy and Strengths Based Case Management (CA-MET/SBCM) and was compared to the "Rethinking Drinking" booklet. Participants were 236 non-treatment seeking Latino/a adults who exceeded NIAAA low risk drinking limits. The primary outcome was percentage of heavy drinking days (≥ 5 drinks for men, ≥ 4 drinks for women) in the past 90 days at 26 weeks. Secondary outcomes were average number of drinks per week and alcohol-related problems.

Results: The CA-MET/SBCM group had greater reductions in heavy drinking days and average drinks per week at week 26 compared to the Rethinking Drinking group (-21.7 vs -12.9 for percent heavy drinking days; -15.9 vs -9.8 for average drinks per week). At week 12, heavy drinking days were also significantly reduced in the CA-MET/SBCM group (-18.5 vs -10.3).

Conclusions: A culturally adapted behavioral intervention, combining MET and SBCM, delivered by Spanish-speaking CHWs significantly reduced unhealthy alcohol use among Latino/as. These results are promising in addressing health disparities, though continued research is essential to further reduce unhealthy drinking and advance health equity for Latino/as.

Objective: This pilot micro-randomized trial (MRT) evaluated feasibility of the MRT design and compared acceptability and preliminary impacts of drinking-focused and maternal-focused text messages to inform development of a tailored just-in-time adaptive text messaging intervention for postpartum at-risk alcohol use.

Method: Postpartum mothers (n = 65) participated in a 28-day MRT. Participants completed ecological momentary assessment (EMA) surveys upon waking (morning survey) at two random times daily (hourly surveys), with an optional night survey (night survey). After each hourly and night survey, participants were randomized to receive either a maternal-focused message, a drinking-focused message, or no message. Check-in surveys assessed intermediate (motivation, maternal self-efficacy, drinking self-efficacy, self-regulation, and craving) and primary (alcohol use) outcomes 15 minutes later.

Results: Compliance rates for all survey types exceeded 70%, except for optional night surveys. Participants reported low burden associated with the MRT. Participants were more likely to rate maternal-focused messages as helpful and evoking positive feelings compared to drinking-focused messages. A significant effect of receiving an intervention message (vs. no message) was found for drinking self-efficacy (DSE), with those who received a message reporting higher DSE compared to those who received no message, with no difference between message types. Significant time by condition interactions revealed that the effect of maternal messages decreased over time, while DSE increased over time for the control condition.

Conclusions: Findings support feasibility and acceptability of the MRT design in postpartum mothers with at-risk drinking histories and inform the development of a tailored text messaging intervention for this population.

Objective: Involvement in mutual-help groups (MHGs) is associated with positive alcohol recovery outcomes. Attendance is a first step to involvement, but barriers to attendance remain poorly understood, especially among second-wave (non-12-step) MHGs. This study aimed to describe the most common barriers to MHG attendance, describe variation in barriers across diverse MHG types, and identify attendance barrier domains associated with MHG involvement over a 12-month period.

Method: Data were from the Peer Alternatives (PAL) Study 2021 Cohort, a longitudinal, online survey of second-wave and 12-step MHG participants (n=531) with follow-ups at 6 and 12 months. Surveys measured MHG attendance barriers (11-items, 3 domains) and MHG involvement (5-items). We employed adjusted Generalized Estimating Equations to examine lagged associations between barrier subscale scores and MHG involvement at 6 and 12 months.

Results: Social anxiety and psychiatric concerns were overall more highly endorsed than low motivation/perceived need and dislike of meeting attendees and content in the total sample and for each MHG except LifeRing. The most highly endorsed individual barrier to attendance was "I don't like crowds or large groups." Higher social anxiety and psychiatric concerns domain scores predicted lower MHG involvement at 6- and 12-month follow-ups in adjusted models (β=-0.09 (-0.18, -0.01), p<0.01), and this was the only barrier domain associated with MHG involvement.

Conclusions: Social anxiety and psychiatric concerns are salient barriers to attending a variety of MHG groups and to MHG involvement. Efforts to enhance MHG social experiences and the availability of groups for people with psychiatric concerns could improve MHG involvement.

Background: High-level commitments to engage the private sector in governance and limited attention to managing conflict of interest (COI) have enabled alcohol industry actors to engage with policy development processes. This is recognised as a key barrier to developing effective alcohol policy, and as important to the industry's efforts to position itself as contributing to sustainable development. This paper examines alcohol industry perspectives on governance, particularly with respect to partnerships and COI, submitted during the development of the WHO Global Alcohol Action Plan.

Methods: A frame analysis of 111 submissions from alcohol industry actors to two public consultations held in the development of the WHO Global Alcohol Action Plan 2022-2030.

Results: Alcohol industry actors engaged with two broad frames in their submissions, collaborative and adversarial. Industry submissions overwhelmingly employed the collaborative frame, positioning the alcohol industry as a partner by claiming alignment with policy goals and referencing forms of governance that prioritise industry involvement. Respondents also engaged with a contrasting adversarial frame, most commonly articulated by public health actors, by rejecting the relevance of COI; resisting restriction of the industry's role in governance; and dismissing a potential binding global instrument for alcohol.

Conclusion: The alcohol industry places significant value on participating in policy initiatives and is resistant to challenges to its engagement. The WHO Action Plan's continued ambivalence towards the alcohol industry may point towards a challenging environment for effective policy. This underscores a need for stronger norms around COI and a more cautious approach to the alcohol industry.

Background: Bisexual individuals consistently report higher levels of alcohol use and are at greater risk for developing alcohol use disorder compared to heterosexual, gay, or lesbian individuals. According to the Minority Stress Model, this disparity may be attributed to bisexual-specific stressors such as experienced binegativity-discrimination or prejudice targeting bisexual identity-and internalized binegativity, or the internal adoption of such stigma.

Methods: The current study tested whether an acute experience of binegativity would influence internalized binegativity and alcohol-related cognitions. We hypothesized that bisexual individuals exposed to a binegative event would (1) report higher internalized binegativity and (2) demonstrate more positive, salient alcohol expectancies compared to a control group. Participants (N=60) were adults aged 21-35 who explicitly self-identified as bisexual. Participants were randomly assigned to either an experimental condition involving a face-to-face binegative comment delivered by a confederate interviewer, or a control condition with no discriminatory statement. Participants then completed post-manipulation measures of internalized binegativity and a free-association alcohol expectancy task, which asked them to generate and rate anticipated effects of drinking.

Results: Results showed that participants in the experimental condition endorsed more positive and emotionally salient alcohol expectancies than those in the control group (p=.039), though no differences were observed in internalized binegativity (p > .50).

Conclusion: These findings suggest that even brief discriminatory experiences may influence alcohol-related cognitions among bisexual individuals. This study also introduces a novel experimental method for modeling the proximal psychological effects of binegativity, with implications for minority stress research and substance use interventions.