Alcohol and alcoholism最新文献

Aims: This study evaluated the accuracy of phosphatidylethanol (PEth), a direct biomarker of alcohol consumption, in distinguishing individuals with and without heavy drinking days, and sought to establish an optimal cutoff using data from a recent clinical trial in alcohol use disorder (AUD).

Methods: Data from a 26-week randomized, double-blind, placebo-controlled clinical trial of 127 individuals with AUD were analyzed. A total of 447 blood PEth samples were compared with self-reported heavy drinking days (≥60 grams of alcohol/day for men and ≥48 g/day for women) via Timeline Follow back method and weekly alcohol logs. Spearman correlations between PEth and self-reports were calculated for the past 7, 14, 21, and 28 days at each study visit. Periods with the strongest correlations (past 14-21 days at the Week 4 follow-up) were used for receiver operating characteristic (ROC) analyses.

Results: Among 127 participants, 63 completed the 26-week follow-up. Moderate-to-strong correlations were observed, strongest at Week 4 (Rho = 0.65, 95% CI, 0.52-0.75, P < .001). ROC analysis at Week 4 showed high discrimination between participants with ≥1 heavy drinking days versus no heavy drinking days (AUC = 0.90, 95% CI, 0.86-0.92), with a PEth cutoff of 0.145 μmol/L (101.9 ng/ml), yielding 95% sensitivity (95% CI, 86-98) and 80% specificity (95% CI, 61-92).

Conclusions: Our findings support the use of PEth as an objective measure of heavy drinking days in a clinical setting. Further research is needed to validate these findings in larger cohorts.

Research aims: To describe alcohol consumption and preferences among both drinkers, and high-risk drinkers; to compare consumption before and after the onset of the COVID-19 pandemic across eight European countries.

Method: Secondary analysis of a dataset from 24 946 respondents 18-90 years old from eight European countries who reported having drunk any alcoholic beverages during the week prior to the online interview (October-November 2022).

Results: Weekly alcohol consumption across countries was between 123.6 and 197.2 grams of pure alcohol per person, with a male/female ratio between 1.1:1 and 1.5:1. Traditional wine-drinking pattern was confirmed for France, Italy, and Greece, as well as for Great Britain. Prevalence of high-risk drinkers (daily consumption >30 grams for females, >40 grams for males) was highest in Great Britain; M/F ratio was between 1.1:1 and 1.3:1, except in Belgium, Great Britain, and Greece, where females outnumbered males. Those older than 65 years and those who resided in the countryside were less likely to be high-risk drinkers. Most respondents reported drinking the same amount of wine and beer in 2022 as before the COVID-19 outbreak, with high-risk drinkers increasing their drinking frequency of all types of alcoholic beverages.

Conclusions: Our results confirm a downward trend in alcohol consumption in most European countries. The gender gap between male and female high-risk drinkers is narrowing or, in some cases, reversing. In 2022, compared with before the COVID-19 outbreak, the majority of respondents reported drinking the same amount of alcoholic beverages, whereas high-risk drinkers increased the frequency of their drinking.

Background and aims: Early alcohol onset and its association with current use of illicit substances remains understudied in France, and specific information by gender is lacking. To address this question, this study examined the effects of age of alcohol onset and gender on past month use of illicit substances among patients treated for alcohol use disorder (AUD) in France.

Method: The data come from the RECAP study, a national database containing detailed information on patients seeking treatment for substance use disorders collected between 2012 and 2022. The sample comprised 643 942 patients with AUD (21% females). We conducted multivariable modified Poisson regressions to identify factors associated with current use of cannabis, opioids and stimulants. Current use of illicit substances was expressed as incidence rate ratios (IRR).

Results: There has been a decreasing trend of age of alcohol onset over time among patients, particularly notable among women. Women in treatment for AUD were less likely to engage in illicit substance use relative to men. However, an interaction revealed a complementary mechanism: the earlier the age of alcohol onset, the more women with AUD used current opioids or stimulants relative to men.

Conclusion: Early age of onset remains a key feature in the development of polysubstance use among patients treated for AUD, especially among women. Age of onset should be routinely incorporated into assessment protocols as it may help identify patients with high risks of polysubstance use, which is likely to disrupt their recovery process.

Aims: The direction and temporality of the association between alcohol use and pain remain understudied among non-manual workers. This study investigated bidirectional associations between alcohol consumption and pain among current and retired non-manual workers, with exploratory subgroup analyses by retirement transition status, retirement age, and socioeconomic position (SEP).

Methods: Survey data from Phases 7, 9, and 12 (2002-15) of the Whitehall II cohort study were analyzed (n = 5928, baseline mean age 60.7 years, 71% men). Alcohol consumption was assessed through self-reported intake converted to pure alcohol units. Pain severity was derived from musculoskeletal pain-site number and RAND-36 bodily pain measures, categorized as none, mild, or moderate/severe. Random-intercept cross-lagged panel models without equality constraints estimated within-person associations, with subgroup analyses by retirement transition and SEP.

Results: At baseline, 23.1% reported above-moderate pain severity and 30.0% exceeded recommended limits (>14 units/week). During 14-year follow-up, 47.3% remained retired, 10.1% were employed, and 40.1% transitioned from employment to retirement. Elevated alcohol consumption was associated with increased pain severity among all participants (βP7 → P9 = 0.07, 95% confidence interval [CI]: 0.02-0.12; βP9 → P12 = 0.04, 95% CI: 0.00-0.08), with stronger effect among midlife retirees (βP9→P12 = 0.15, 95% CI: 0.04-0.25) and low-SEP participants (βP9→P12 = 0.22, 95% CI: 0.04-0.51). Pain was associated with alcohol consumption at earlier intervals, but associations attenuated subsequently.

Conclusions: Elevated alcohol consumption might be associated with increased pain severity among non-manual workers, particularly midlife retirees and low-SEP individuals. Pain-to-alcohol associations were observed but were inconsistent across intervals.

Aims: Traditional longitudinal models of adolescent alcohol use often assume that within-person variability-the extent to which an individual's alcohol use fluctuates over time-is the same for everyone. However, in the real world, some adolescents show relatively stable patterns of use, while others fluctuate substantially across different measurement waves. To capture these individual differences, the present study applies a Bayesian hierarchical linear modeling approach that allows between-person differences in within-person variability.

Methods: This study compared 16 model variants that crossed the following features: within-person error variance (fixed or random), lag effect (present or absent), linear and quadratic effects (random linear and quadratic terms included or excluded), and transformation (probit-transformed or untransformed).

Results: The best-fitting model (DIC = -2,615; Deviance = -4,362) included a lag parameter, varying error terms, and random linear and quadratic effects for probit-transformed data. Notably, the average of the within-person standard deviation (${mu}_{sigma_j}$ = 0.231) was almost twice that of the varying intercept (${sigma}_{beta_{0j}}$ = 0.124), indicating substantial within-person variability in adolescent alcohol use across time.

Conclusions: Accounting for heterogeneous within-person variability and modeling alcohol use with a non-normal distribution significantly improved model-data fit and yielded extra insights into adolescents' alcohol use research. This approach allows researchers and practitioners to more accurately identify individuals with irregular or unstable drinking patterns, enhancing early detection and targeted intervention strategies.

Background: Alcohol use disorder (AUD) is common worldwide, but the proportion of patients receiving pharmacotherapy remains low. In Japan, patterns of pharmacotherapy initiation for AUD have not been fully characterized. Here, we quantified the cumulative incidence of pharmacotherapy initiation among patients newly diagnosed with AUD in Japan.

Methods: We conducted a descriptive study using a Japanese insurance claims database. We created annual cohorts of adults aged 20-64 years who were newly diagnosed with AUD during fiscal years (FYs) 2012-21. Cumulative incidence for pharmacotherapy initiation was estimated, with death treated as a competing risk.

Results: The study included 13 936 patients. Across FY 2012-21 cohorts, mean age was 43.3-44.8 years and men accounted for 72.6%-79.3% of each cohort. At cohort entry (Day 0), the cumulative incidence of pharmacotherapy initiation rose from 18.0% in FY 2012 to 35.2% in FY 2021. The 1-year corresponding cumulative incidences were 28.1% and 44.9%, respectively. Market approval of acamprosate (FY 2013) and nalmefene (FY 2018) and the publication of Japan's AUD treatment guideline (FY 2018) were each followed by marked year-on-year increases in pharmacotherapy initiation.

Conclusions: Although the observed incidence may have been inflated by Japan's reimbursement policy, which requires an AUD diagnosis before medication can be prescribed, pharmacotherapy initiation exceeded that reported in other countries and has increased steadily since FY 2012. Introduction of new drugs and guideline dissemination appear to have accelerated treatment initiation and substantially altered treatment practice. These findings can help clinicians and policy-makers close the persistent treatment gap.

Background: Early onset alcohol use, mental health problems, familial alcohol use, and adverse childhood experiences (ACEs) increase the likelihood of persistent alcohol-use disorders later in life. This study aimed to determine the relative influence of such risk factors when predicting adolescent alcohol treatment outcomes, an area overlooked in prior research.

Methods: Retrospective cross-sectional analysis using the National Drug Treatment Monitoring System, incorporating data from all publicly funded community alcohol services in England. The study included adolescents (aged 11-17) whose alcohol treatment took place between 1 April 2018 and 31 March 2023 (n = 2621). Logistic regression models tested for associations between predictors and key outcomes, including treatment non-completion and being non-abstinent at treatment completion. Predictors included demographics, treatment information, alcohol use, ACEs, care status, psychological, and socioeconomic factors.

Results: Significant predictors of not completing treatment: increased age; increased monthly drinking days; year of exit 2020-2021; Not in Education, Employment or Training (NEET) status and being placed on a child protection plan. NEET adolescents had double the incomplete treatment rate compared to the general cohort. Significant predictors of non-abstinent completion: increased age, monthly drinking days, units per drinking day, mental health treatment need, early onset use, affected by others' substance use, and illicit substance use.

Conclusions: Adolescents with higher alcohol or illicit substance use at treatment start, NEET status and/or child protection plan (care status indicating prior ACE exposure) have worse alcohol treatment outcomes. These groups are highlighted for tailored interventions which consider psychological and environmental challenges adolescents may be experiencing.

Introduction: Policies mandating posting of signs warning of the risks of alcohol consumption during pregnancy (MWS-alcohol-pregnancy) are common in the United States Previous research suggests these policies are ineffective and relate to increased adverse infant and maternal outcomes. Research about MWS-alcohol-pregnancy using quasi-experiments is needed.

Materials and methods: This study uses Vital Statistics birth certificate data and commercial insurance claims data from Merative MarketScan® and policy data from NIAAA's Alcohol Policy Information System. We systematically selected a treatment (Texas) and comparison (Florida) state for a quasi-experimental examination of effects of an MWS-alcohol-pregnancy policy going into effect in 2007. Difference-in-difference models compared changes in birthweight, low-birthweight, and infant injuries consistent with maltreatment from pre- to post-policy change between the treatment and comparison state.

Results: Mean birthweight decreased 4.06 g more from pre- to post-periods in the treatment as compared to the comparison (average treatment effect on the treated [ATET] -4.06, 95% CI -7.02, -1.09) state. The difference in the pre- to post-policy change in low-birthweight in the treatment relative to the comparison state was not statistically significant (ATET .0 pp, 95% CI -.0, .0). The pre- to post-policy change in infant maltreatment was .5 percentage points greater in the treatment relative to the comparison state (ATET .5 pp, 95% CI .2, .8).

Conclusions: The MWS-alcohol-pregnancy policy was associated with lower birthweight and more infant maltreatment. This study provides further evidence that MWS-alcohol-pregnancy policies are mostly ineffective and possibly harmful.

Observational data on glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a reduction in alcohol use. In this review of three randomized controlled trials (RCTs) (n = 48-151), semaglutide reduced alcohol use, dulaglutide lowered alcohol intake in current drinkers, while exenatide had no significant effect on heavy drinking days. Large RCTs are needed to substantiate the role of GLP-1 RAs in treating alcohol use disorder.

Background: Exposure to alcohol advertisements and imagery is associated with alcohol initiation and use by adolescents and adults. The current study provides an update on the previously published article 'A content analysis of alcohol imagery in season 2 of The Kardashians' by exploring content in season 4 and estimating population exposure to this content.

Methods: A content analysis of alcohol content in all 10 episodes of season 4 of The Kardashians was undertaken, and alcohol content was measured using 1-min interval coding. The presence of alcohol in the following four categories was noted: (i) actual use, (ii) implied use, (iii) other alcohol reference, and (iv) brand appearances, with particular attention paid to appearances of the Kardashian-owned brand of tequila, 818. Population exposure to content in season 2 and season 4 was estimated using population estimates and viewing figures.

Results: Alcohol content and branding continue to be shown in season 4, with a significant increase in any alcohol content, other alcohol content, alcohol branding, and 818 branding in season 4 compared to season 2. The two series resulted in a combined 347 million 818 tequila-branded gross impressions to the UK population.

Conclusions: This content is not recognized by the UK regulator Ofcom as product placement, as there is no product placement deal in place. The current study posits that, despite this, 818 tequila is receiving widespread exposure through inclusion in the programme, suggesting that regulation on other forms of brand inclusion should exist.