American Journal of Drug and Alcohol Abuse最新文献

Background: Unplanned drinking episodes are empirically and conceptually linked with adverse outcomes, though recent research suggests planned drinking episodes may be riskier. Mixed findings may be due to unplanned drinking being operationalized as a dichotomous representation of the phenomenon (e.g. was drinking planned or unplanned) rather than continuous (e.g. the number of drinks beyond one's intended limit). Examining a continuous representation of the number of unplanned drinks consumed (i.e. consumed minus intended drinks) would permit a more nuanced evaluation of unplanned drinking and may be more predictive of consequences.Objectives: The present study aimed to describe the occurrence of unplanned drinking and disentangle the role of dichotomous vs. continuous operationalizations in predicting consequences.Methods: Participants were 104 (81.7% female; M_age = 20.75, SD = 1.99) undergraduate drinkers recruited through a psychology subject pool. Participants completed an online baseline survey followed by 14 brief, daily online surveys. Daily reports yielded an analytic sample of 325 drinking episodes.Results: Results indicated that most drinking episodes were planned but underestimated in quantity (i.e. consumption exceeded intentions). Only the continuous estimate of unplanned drinking was associated with negative consequences after controlling for dichotomous unplanned drinking (b = 0.25, IRR = 1.28).Conclusions: Results shed light on the need for a more nuanced operationalization of unplanned drinking behaviors, as current research utilizing a dichotomous lens may not be fully capturing the risky phenomenon. Results suggest that unplanned drinking, particularly related to consuming more drinks than intended, may be a useful indicator of problematic drinking.

Background: The opioid use disorder Cascade of care (OUD Cascade) is a public health framework used by federal/state/other agencies and researchers to facilitate monitoring and evaluating responses to the opioid epidemic, including surveillance and performance evaluation. As the use of the framework proliferates, there is an urgent need to standardize stage definitions to accurately monitor and improve patient outcomes and to align interpretation of findings across settings.Objectives: Define a taxonomy to uniformly apply the OUD Cascade to improve delivery of OUD services and better compare patient outcomes across settings and populations.Methods: We conducted a narrative review and synthesis focused on research and guidelines defining and measuring four key OUD Cascade stages: OUD identification, service engagement, medication initiation, and retention. Included articles come from peer-reviewed literature and define and/or operationalize OUD Cascade stages and associated measures across six characteristics based on an adaptation of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist including: 1) settings, 2) specific population, 3) perspective, 4) time horizon, 5) assumptions, and 6) analytic method.Results: Our review (n = 27 articles) and synthesis provide an overview of how OUD Cascade definitions and framework designs have been variously applied. We found considerable heterogeneity in study approaches for all four OUD Cascade stages. We define a taxonomy to guide future research emphasizing standardized definitions to harmonize efforts across settings. In particular, we emphasize the need for clarity in defining criteria for sample construction (i.e. Identification), clear distinctions between receipt of care services generally (i.e. Engagement) from MOUD Initiation specifically, and Retention definitions that use a 30+ day gap in treatment to define discontinuation.Conclusion: Establishing a shared taxonomy for key terms specifying OUD Cascade stages will help the field advance, compare approaches and results across settings, and improve population-level patient outcomes.

Background: Alcohol-associated liver disease (ALD) results from excessive alcohol consumption, leading to liver damage such as steatosis and inflammation. Hypoxia and altered lipid metabolism contribute to ALD pathogenesis. HIF-1α, a key hypoxia regulator, and miR-185, a microRNA associated with ALD, are potential contributors to the disease.Objectives: To explore how HIF-1α and miR-185 regulate SR-BI and HDL metabolism in ethanol-exposed hepatocytes and their role in ALD-related lipid dysfunction.Methods: HL-7702 cells were treated with ethanol (25-200 mm) or hypoxia (1-2% O₂) for 24-72 hours to identify optimal conditions. miR-185 or HIF-1α inhibitors were used to assess SR-BI expression. Co-localization of HIF-1α and SR-BI was evaluated by immunofluorescence, and high-density lipoprotein cholesterol (HDL-C), which is critical in lipid metabolism, and triglyceride (TG) levels were measured by ELISA.Results: Ethanol exposure reduced cell viability in a dose- and time-dependent manner (200 mm for 72 h reduced viability by 43.7% ± 4.1%, p = .003). Exposure to 1% oxygen for 72 hours was confirmed as the optimal hypoxia model. Ethanol (200 mm) or hypoxia significantly increased HIF-1α (p = .002) and miR-185 expression (p = .001). These changes were accompanied by reduced SR-BI expression and elevated HDL-C and TG levels. miR-185 knockdown restored SR-BI expression (p = .003) and normalized HDL-C (p = .004) and TG levels (p = .005).Conclusions: Ethanol-induced HIF-1α and miR-185 upregulation disrupts HDL metabolism by suppressing SR-BI, impairing hepatic HDL uptake in ALD. Targeting this axis may offer new therapeutic strategies for ALD.

Background: Postnatal alcohol exposure impairs the development of the central nervous system, including the visual system. The behavioral consequences of such exposure on visual function remain poorly understood.Objectives: In this study, we investigated the effects of postnatal ethanol exposure on visuospatial learning and memory in C57BL/6 mice.Methods: Ethanol (3.0 g/kg) was administered via intubation on postnatal days 3-20. Controls received intubation only or no intervention. Pups were assigned to alcohol-treated (A, n = 11), intubation control (IC, n = 11), or non-intubated control (C, n = 9) groups. At three months, mice underwent the Novel Object Recognition (NOR) test and a visual water task. The NOR test measured recognition memory and exploratory behavior. The visual water task assessed visual acuity using sinusoidal gratings presented on monitors. Mice were trained over 17 days to associate a grating with a hidden platform, and visual acuity thresholds were determined based on performance at varying spatial frequencies.Results: Alcohol-exposed mice showed significant deficits in recognition memory and visual acuity. No group differences in body weight were observed. However, alcohol-treated mice displayed reduced exploration of novel objects (p = .0085, R² = 0.29) and lower visual acuity thresholds at higher spatial frequencies (p = .048, R² = 0.24).Conclusion: These findings demonstrate that early postnatal alcohol exposure can lead to lasting impairments in visual-cognitive functions. Given their similarity to deficits seen in children with Fetal Alcohol Spectrum Disorders (FASD), our results suggest the importance of early behavioral and visual assessments in children with suspected prenatal or early postnatal alcohol exposure.

Background: Although religious and cultural factors have been related to substance use in various populations, research is needed regarding associations for Arab Americans.Objectives: We examined how ethnic identity and religiosity relate to the odds and frequency of alcohol and cannabis use in Arab American college students during the COVID-19 pandemic, as well as differences by biological sex and Muslim upbringingMethods:Arab American college students (N = 173; M_age = 20.1, range 17-23; 60.7% female; 44.5% Christian upbringing, 43.9% Muslim upbringing) were recruited through electronic flyers and a psychology subject pool in California. Participants reported their ethnic identity affirmation (i.e. feeling positively about being Arab American) and search (i.e. learning about Arab culture), religiosity, and past-year alcohol and cannabis useResults: Greater ethnic identity affirmation was related to less frequent alcohol (OR = .68, p = .046) and cannabis use over the past year (OR = .58, p = .030), whereas greater ethnic identity search was related to lower odds of alcohol (OR = 0.66, p = .025) and cannabis use (OR = 0.68, p = .025). Greater ethnic identity search was also related to less frequent alcohol use among individuals from Muslim upbringings (OR = .37, p = .004). Greater religiosity was related to less frequent alcohol (OR = .61, p = .015) and cannabis use (OR = .44, p = .005). It was also related to lower odds of using alcohol and cannabis, with significantly stronger associations among individuals from Muslim upbringings (OR = .39, p = .040; OR = .40, p = .048)Conclusion: Ethnic identity and religiosity buffered substance use risk. Culturally tailored interventions and supporting cultural experiences may reduce Arab American students' substance use.

Background: Exposure to racial and ethnic discrimination (RED) is positively associated with alcohol-related outcomes among Hispanics; however, links between RED and alcohol use are poorly understood, particularly when considering RED in social media.Objectives: Study aimed to (1) examine the direct and indirect associations between RED on social media and alcohol use severity (i.e., AUDIT total score) via coping drinking motives (a form of negative reinforcement in which an individual uses alcohol to alleviate/regulate negative emotions) among Hispanic emerging adult college students, and (2) examine if psychological resilience moderates the direct and indirect associations of social media discrimination on alcohol use severity.Methods: A convenience sample of 423 (women = 300, men = 123) Hispanic college students from Texas and Florida completed a cross-sectional online survey. Data were analyzed by conducting a conditional process analysis.Results: Social media discrimination did not have a direct association with alcohol use severity (β = .05, 95% CI=[-.03, .13], p > .05), but it did have a statistically significant indirect association with alcohol use severity via coping drinking motives (β = .08, 95% CI = [.03, .13], p < .05). Further, psychological resilience functioned as a moderator that weakened the indirect association between social media discrimination and alcohol use severity (β = -.14, 95% CI=[-.23, -.05], p < .001).Conclusions: Our conditional process analysis may help guide etiological studies on RED and alcohol use. The data suggest that psychological resilience and coping drinking motives may be relevant constructs for interventions that aim to mitigate the association between RED and alcohol use.

Background: The large-scale identification of people at risk of transitioning from relatively lower-risk to higher-risk alcohol use (e.g. problem drinking) remains a public health challenge despite advances in the identification of risk and protective factors.Objective: This observational study used machine learning to identify Reddit (social media platform) posting activity associated with transitioning from lower- to higher-risk forms of alcohol use.Methods: We employed bottom-up and top-down approaches to identify lower- and higher-risk alcohol-related subreddits. Using a non-parametric negative control procedure, we estimated each of 10,006 Reddit communities' risk of progression from lower- to higher-risk alcohol-related communities and applied a random forest model to predict progression among individual Reddit members. Eligible Reddit members had posted on Reddit for two or more years before their first post in a lower-risk alcohol-related community and for three or more years after that (N = 4,160).Results: Our methodology identified 42 alcohol-related communities, four of which were suggestive of problem drinking. Five communities were significantly associated with progression. Random forests model's risk scores for individual members correlated with their progression to higher-risk communities at 0.30; the model predicted progression of individual Reddit members with a 0.92 area under the curve.Conclusions: Posting in communities dedicated to other substance use, depression, and occupation in the food service industry was associated with posting activity suggestive of problem drinking 3 years later. Posting activity on Reddit may be used for early detection of people at higher risk of transitioning from lower- to higher-risk forms of alcohol use.

Background: Ethanol consumption during pregnancy induces enduring detrimental effects in the offspring, manifesting as a spectrum of symptoms collectively termed as Fetal Alcohol Spectrum Disorders (FASD). Presently, there is a scarcity of treatments for FASD.Objectives: To analyze current literature, emphasizing evidence derived from preclinical models, that could potentially inform therapeutic interventions for FASD.Methods: A narrative review was conducted focusing on four prospective treatments: nutritional supplements, antioxidants, anti-inflammatory compounds and environmental enrichment. The review also highlights innovative therapeutic strategies applied during early (e.g. folate administration, postnatal days 4-9) or late (e.g. NOX2 inhibitors given after weaning) postnatal stages that resulted in significant improvements in behavioral responses during adolescence (a critical period marked by the emergence of mental health issues in humans).Results: Our findings underscore the value of treatments centered around nutritional supplementation or environmental enrichment, aimed at mitigating oxidative stress and inflammation, implying shared mechanisms in FASD pathogenesis. Moreover, the review spotlights emerging evidence pertaining to the involvement of novel molecular components with potential pharmacological targets (such as NOX2, MCP1/CCR2, PPARJ, and PDE1).Conclusions: Preclinical studies have identified oxidative imbalance and neuroinflammation as relevant pathological mechanisms induced by prenatal ethanol exposure. The relevance of these mechanisms, which exhibit positive feedback loop mechanisms, appear to peak during early development and decreases in adulthood. These findings provide a framework for the future development of therapeutic avenues in the development of specific clinical treatments for FASD.

Background: Cortical differences in thickness, folding, and complexity may reflect synaptic pruning and myelination alterations. Individuals with opioid use disorder (OUD) may demonstrate differences in these cortical metrics due to neurodevelopmental aberrations or early opioid exposure.Objectives: We compared the cortical metrics between individuals with OUD and controls. The influence of age and duration of opioid exposure were considered indirect evidence for preexisting or opioid-exposure-based structural aberrations.Methods: Sixty-nine treatment-naïve men with OUD (52 heroin, 17 non-heroin) and 25 age and education-matched non-drug-using male controls were recruited from a treatment center and community, respectively. 3-Tesla Siemens Magnetom Verio scanner and Computational Anatomy Toolbox 12 were used for image acquisition and processing. Cortical parcellation was performed using Destrieux atlas. Surface-based morphometry (SBM) metrics were cortical thickness, sulcal depth, fractal dimension, and gyrification index.Results: Only two cortical areas survived corrections for multiple comparisons: persons with OUD had greater sulcal depth in the right lateral orbital sulcus (p = .0003, Glass's delta = 0.98) and lower gyrification index in the left frontal middle gyrus (p = .0005, Glass's delta = 0.67) than controls. The group-by-age interaction effect on the cortical thickness was non-significant. Lower age of initiation of opioid use was associated with larger cortical thickness in the inferior frontal (r = -0.36, p = .002) and anterior cingulate (r = -0.35, p = .003) regions. Duration of OUD negatively correlated with cortical thickness in frontal and occipital areas (r > -.30, p = .004-.007).Conclusion: Cortical abnormalities may stem from altered synaptic pruning and myelination, possibly due to neurodevelopmental aberrations or early opioid exposure.

Background: Prior meta-analyses have evaluated digital interventions for alcohol exclusively and alcohol/tobacco combined. These meta-analyses showed positive outcomes pertaining to alcohol and alcohol/tobacco combined. Yet questions remain pertaining to the effect of digital cognitive-behavioral therapy (CBT) on reducing alcohol and drug use.Objectives: The purpose of the meta-analysis was to determine the mean effect size, relative to control groups, of digital CBT, for posttest reductions in drug and/or alcohol use.Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria was used to guide this review and meta-analysis. Electronic databases (APA PsycArticles, Academic Search Complete, APA PsycInfo, CINAHL Complete, ERIC, MEDLINE, Psychology and Behavioral Sciences Collection, Social Sciences Full Text, Social Work Abstracts, SocINDEX), clinicaltrials.gov, reference lists were searched. The protocol was registered in PROSPERO (ID#: CRD42023471492). The CBT interventions included cognitive restructuring.Results: All but one of the effect sizes favored digital CBT (from -0.02 to -1.45). After the removal an outlier, a small, significant, random effects model Hedges' g summary effect of -0.23 (95% confidence interval: -0.32, -0.14, p < .0001) showed a reduction in substance use at the posttest, favoring digital CBT relative to the control group. A variety of control conditions were used; however, the effects sizes had minimal heterogeneity (k = 17, I² = 5.34, Q = 16.9, p = .39). The funnel plot and Egger regression test intercept (0.01, p = .99) lacked publication bias.Conclusion: The meta-analytic findings suggest digital CBT is an efficacious treatment for reducing alcohol and drug use overall.