Alcohol and alcoholism最新文献

Aims: Alcohol consumption is associated with socioeconomic disadvantage, but causality is unclear. We used Mendelian randomisation (MR) to estimate the effect of alcohol consumption on socioeconomic and employment-related outcomes.

Methods: We conducted observational analyses and two-sample MR analyses using 230 775 working-age participants (aged 40+) of White British ethnicity/ancestry (54.5% male) from the UK Biobank.

Outcomes: employment status (employed vs not; employed vs sickness/disability, unemployment, retirement or caring for home/family); weekly hours worked (among employed); deprivation (Townsend Deprivation Index); highest educational attainment; and household income.

Exposures: alcohol consumption (units per week), hazardous alcohol consumption assessed by Alcohol Use Disorder Identification Test-C score and Alcohol use disorder (AUD).

Results: MR analyses suggested that alcohol exposure increased the risk of living in a more deprived area. A unit per week increase in alcohol consumption increased deprivation by 0.31 deciles (95% CI: 0.10, 0.52). A unit increase in liability for AUD increased deprivation by 0.09 deciles (95% CI: 0.02, 0.16). Findings, and often effect directions, differed by sex. In men, increased alcohol consumption decreased household income and increased the risk of not being in paid employment and unemployment. In women, increased alcohol consumption decreased the risk of not being in paid employment, retirement, and caring for home/family. Effects were generally more detrimental for men than women. This is especially evident for not being in paid employment, household income, and deprivation.

Conclusions: Alcohol consumption may increase the risk of living in deprived neighbourhoods. It may have deleterious effects on employment (including unemployment) and income, but these differ strongly by sex, largely affecting men.

Aims: Safety and tolerability data from the first open-label feasibility study of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for alcohol use disorder was recently published. This paper presents a Bayesian analysis of the impact of MDMA-assisted psychotherapy on treatment success, defined as 2-level reduction in the World Health Organization (WHO) drinking risk at the 3 months follow-up. We also examined the impact on drinking behavior and psychosocial measures at 3 months compared to baseline.

Methods: Fourteen participants with a diagnosis of alcohol use disorder who had recently undergone detoxification completed an eight-week course of ten psychotherapy sessions, including two sessions with MDMA. Measures assessing drinking behavior, quality of life, sleep, self-compassion, and empathy were collected. Bayesian analysis using flat and skeptical priors was performed to determine treatment success defined as a 2-level reduction in WHO drinking risk.

Results: Bayesian analysis suggested that the probability of a 2-level reduction in WHO drinking risk from baseline to 3 months post-treatment is 55%-63%, based upon either a flat or skeptical prior respectively. We present preliminary findings suggesting reductions in alcohol craving (measured by the Penn Alcohol Craving Scale and Obsessive Compulsive Drinking Scale) and improvements in sleep and aspects of psychosocial functioning at 3 months follow-up compared to baseline.

Conclusions: The Bayesian analysis provides a useful harm reduction endpoint interpretation of drinking in terms of a 2-level reduction in WHO drinking risk. Further findings provide preliminary insights into the potential impact of MDMA-assisted psychotherapy on quality of life and well-being in addition to reductions in drinking. ClinicalTrials.gov ID: NCT04158778.

Background: As a serious public health problem, alcoholic cardiomyopathy (ACM) has caused a heavy burden of disease.

Methods: To summarize and deeply analyze the development trend of ACM at the global, regional, and national levels in the past 30 years, this study used the age-period-cohort model to analyze the age, period, and cohort effects of the prevalence, deaths, and disability-adjusted life years (DALYs) of ACM.

Results: The results found that the overall time trend of ACM prevalence, deaths, and DALYs had been decreasing worldwide, but the opposite trend was observed in some countries and regions. The disease burden of male ACM patients was significantly higher than that of female patients. Moreover, the ASRs of prevalence, deaths, and DALYs for ACM were positively correlated with sociodemographic index levels. Finally, this study predicted that ACM prevalence will continue to decline over the next 10 years, while death rates and DALYs are expected to increase.

Conclusions: Overall, the results of this study provided an insightful, up-to-date global perspective on time trends in ACM-related disease burden, shedding light on the inadequacy of ACM prevention, control, and intervention programs at multiple levels.

Background: Developed over nine decades ago, the 12 Steps were intended to provide structured and clear guidelines to promote recovery from alcohol use. The steps are designed to help individuals find a sense of purpose, meaning, and hope. The 12 Steps are meant to be guides for an ongoing process or spiritual progress. A more concrete way of understanding the steps relative to spiritual principles may be instructive for those working the steps and seeking a fulfilling meaning and purpose for their lives.

Purpose: This paper provides a framework for understanding the 12 Steps in accord with four principles of spirituality: awareness, acceptance, interdependence, and self-transcendence.

Methodology: A matrix was developed using each of the four principles of spiritualty. Each word or phrase from each of the 12 Steps was assigned to one principle. Examples for key words or phrases were provided.

Results: Each of the 12 Steps are mapped to the four principles of spirituality, with annotations.

Conclusions: The resulting guide serves as a concrete and instructive guide to understanding the spiritual nature of the 12 Steps.

Introduction: Patients with alcohol use disorders have a high hospital re-admission rate, adding to the strain on the healthcare system. To address this issue, this study aimed to predict 28-day unplanned hospital re-admission for these patients.

Methods: From linked de-identified datasets, patients with alcohol use disorders who had hospital re-admissions between 2015 and 2018 were identified. Univariate and multiple logistic regression were conducted to select variables for inclusion in five machine learning models-logistic regression (baseline), random forest, support vector machine, long-short term memory and clinical bio bidirectional encoder representation of transformers (Clinical Bio-BERT)-to predict the 28-day re-admission.

Results: Eight hundred and sixty-nine patients with alcohol use disorders incurred 2254 hospital admissions. Patients aged 45-49 or 70-74 or 75-79 were 4-5 times more likely to be re-admitted than those in other age groups; males were 36% more likely than females; patients who use polysubstance were 3.3 times more likely than otherwise. Patients with "respiratory system disorders" or "hepatobiliary system and pancreas disorders" had 60% higher risk than otherwise. Interaction with emergency department or drug and alcohol service after discharge reduced the risk by 71% and 79%, respectively. The 10-variable Clinical Bio-BERT demonstrated the highest sensitivity (.724).

Discussion and conclusions: Patients with alcohol use disorders with the following characteristics were more likely to have unplanned re-admissions within 28 days: male, aged 45-49 or 70-74 or 75-79, with "respiratory system disorders" or "hepatobiliary system and pancreas disorders", or patients who use polysubstance. Interactions with emergency department or drug and alcohol service after discharge had reduced risk of hospital re-admission.

Aims: The current study aimed to identify possible measurement non-equivalence (i.e., bias) with respect to sex (proxy for gender), race/ethnicity, and intersectional identity (sex by race/ethnicity) and generate adjusted scores for the Alcohol Expectancy Questionnaire-Adolescent, Brief (AEQ-AB) in a sample of middle-school-aged Black, Latinx, and White youth.

Methods: Data were drawn from Follow-up 3 of the Adolescent Brain Cognitive Development Study, conducted from 2020-2022 (n = 8981; mean age = 12.91, SD = .65; 47.29% female; 15.02% Black, 22.95% Latinx, and 62.03% White). Moderated nonlinear factor analysis was applied to the 4-item Positive Expectancies and 3-item Negative Expectancies subscales.

Results: Analyses revealed non-equivalence with respect to both sex and race/ethnicity on the Positive Expectancies subscale and race/ethnicity on the Negative Expectancies subscale. AEQ-AB mean subscale scores were compared across groups pre- and post-adjustment for measurement non-equivalence. Adjusted scores revealed previously undetected higher positive expectancies in girls versus boys, a lower magnitude of differences in positive expectancies between racial/ethnic groups, previously observed higher negative expectancies among girls versus boys as non-significant, and even higher relative negative expectancies for Black and Latinx than White youth.

Conclusions: Collectively, our findings highlight the importance of establishing measurement equivalence broadly, and specifically for the AEQ-AB, and demonstrate the potential for measurement bias to underestimate or even mask the relative risk in girls and youth of color, which can impact assumptions about and attention to these marginalized groups.

Background and aims: Studies on the commercial determinants of health (CDoH) are rapidly growing in Western countries. Nevertheless, despite the ubiquity of transnational alcohol corporations (TNACs)-a leading harmful commodity industry-in Nigeria and across Africa, few studies have focused specifically on alcohol marketing as a CDoH. TNACs in Nigeria and other low-resource settings deploy diverse and aggressive marketing strategies to mitigate the decline in youth drinking in many Western countries. Yet, no study to date has contextualised alcohol marketing as a CDoH and its impact on young people's drinking. This study explores the awareness and impact of alcohol advertising and promotion on young people's drinking behaviours in Benin, Nigeria.

Methods: We collected data through three focus group discussions (n = 26) and 53 semi-structured interviews with 18-24-year-old adolescents and young adults. Data were analysed thematically.

Results: The findings show that participants were exposed to alcohol marketing on TV, radio, and social media and demonstrated a high awareness of various other alcohol promotional strategies. Participants acknowledged the persuasive influence of alcohol marketing in trying new products and changing brands temporarily and permanently. Celebrity advertising and endorsement through sports were also recounted as an impactful alcohol marketing strategy. Furthermore, quantity deals, discount sales, and other promotional strategies, facilitated impulse buying and heavy drinking.

Conclusions: The findings demonstrate how alcohol marketing in Nigeria is a major pervasive and harmful CDoH. Policymakers are encouraged to implement policies to mitigate the impact of alcohol marketing through prevention and intervention strategies, including marketing regulation and enforcement.

Background: Alcohol consumption among women of reproductive age is a growing concern in India, with significant implications for reproductive health. Despite evidence linking alcohol use to suboptimal contraceptive behaviors, research on the patterns and determinants of contraceptive use remains limited.

Methods: Data from 6626 married women aged 15-49 years who reported alcohol consumption and 468 142 who did not were drawn from the National Family Health Survey-5 (2019-2021). Contraceptive use was classified by the World Health Organization's effectiveness levels. Alcohol consumption was examined by type (homemade, country liquor, Indian Made Foreign Liquor), frequency (daily, weekly, less than weekly), and duration. Covariates included age, education, wealth, residence, parity, and tribal status. Ordinal logistic regression was used to identify predictors of contraceptive use.

Results: Alcohol use was associated with lower odds of effective contraceptive use (aOR = .86, 95% CI: .82-0.90)-31.18% reported no contraceptive use, while 75.09% used very effective or effective methods, primarily female sterilization (45.44%) and oral contraceptives (19.32%). Homemade alcohol users showed the highest prevalence of effective methods (82.76%), while IMFL consumers reported higher non-use (33.44%). Those who drink daily relied more on effective methods compared to less frequent drinkers. Education and wealth were significant predictors among all women but not in those who drink alcohol. State-wise variations were notable, with low rates of contraceptive use in Meghalaya (18.52%) and high rates in Sikkim (81.72%).

Conclusion: Integrated family planning and alcohol screening and brief intervention services are needed, especially in underserved regions.

In this retrospective study of 251 300 patient encounters at Veterans Administration Emergency Departments associated with alcohol intoxication per blood testing or ICD 9/10 coding, we found that 79% of these patients had positive Alcohol Use Disorders Identification Test-Consumption screens within 6 months of their visit. Therefore, we propose that presentation to an emergency department with any detectable ethanol concentration should prompt intervention accordingly.

Aims: This integrative review aims to synthesize and update the current literature on mHealth applications and devices, such as smartphones, wearables, and breathalyzers, in alcohol use disorder (AUD) monitoring. It discusses the evolution of these tools, the current level of evidence, and facilitators and barriers to their implementation in research and interventions. The future potential for personalized interventions is also explored.

Methods: Integrative review. Three databases-PubMed, Web of Science, and PsycINFO-were used to identify quantitative and qualitative English written publications between 2014 and 2024, using terms related to mHealth, remote monitoring, and AUD. Results were extracted and comprehensively presented by topic.

Results: Fifty-eight studies were included in the synthesis. Smartphones, mobile phones, breathalyzers, and wearables with transdermal sensors are the most frequently used devices for remote monitoring. The included studies demonstrated varying levels of development and evidence across devices. Ecological Momentary Assessment via smartphones was the most frequently used and, along with breathalyzers, was successfully applied in clinical trials involving interventions. Wearables were scarcely tested in interventions. Challenges related to adherence and psychological factors remain in a longer period of monitoring. Incipient use of predictive models integrating ongoing data shows promise in informing care providers and optimizing intervention delivery.

Conclusions: Evidence supporting mHealth tools for AUD remains uneven across device types. While smartphones and breathalyzers show greater clinical applicability, wearables and passive sensing remain exploratory. Robust, comparative research is needed to guide effective selection and integration into care.