49 CFR 199.229 - Reporting of alcohol testing results.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Reporting of alcohol testing results. 199.229... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.229 Reporting of alcohol testing results. (a) Each... alcohol testing results using the Management Information System (MIS) form and instructions as required by...

49 CFR 199.229 - Reporting of alcohol testing results.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Reporting of alcohol testing results. 199.229... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.229 Reporting of alcohol testing results. (a) Each... alcohol testing results using the Management Information System (MIS) form and instructions as required by...

49 CFR 655.31 - Alcohol testing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Alcohol testing. 655.31 Section 655.31..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Prohibited Alcohol Use § 655.31 Alcohol testing. (a) An employer shall establish a program that provides for...

49 CFR 655.31 - Alcohol testing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Alcohol testing. 655.31 Section 655.31..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Prohibited Alcohol Use § 655.31 Alcohol testing. (a) An employer shall establish a program that provides for...

Education, income and alcohol misuse: a stress process model.

PubMed

Elliott, Marta; Lowman, Jennifer

2015-01-01

This study applies stress process theory to study and explain the negative association between socioeconomic status (SES) and alcohol misuse. SES is theorized to reduce alcohol misuse by reducing exposure to stressors and increasing access to resources. The National Co-Morbidity panel sample (N = 4,979) interviewed in 1990-1992 and 2000-2002 are analyzed to estimate direct and indirect pathways between SES and alcohol misuse over time via stressors and resources. Higher education and income predict decreased alcohol misuse via internal and external locus of control. External locus of control is associated with increased alcohol intake over time, whereas internal locus of control is associated with a lower likelihood of developing future alcohol-related disorders. Income is also associated with increased alcohol misuse via religiosity, which is more common among people of low income, and protects against alcohol misuse. SES is negatively associated with alcohol misuse because low SES increases people's perceptions that their lives are determined by luck, and reduces their sense of personal control. However, low income has a countervailing negative influence on alcohol misuse via its association with religiosity.

A multi‐faceted intervention to reduce alcohol misuse and harm amongst sports people in Ireland: A controlled trial

PubMed Central

O'Farrell, Anne; Kenny, Susan; Eldin, Nazih; Wiggers, John; Wolfenden, Luke; Allwright, Shane

2017-01-01

Abstract Introduction and Aims Alcohol misuse and harm are more prevalent amongst sports people than non‐sports people. Few studies have trialled interventions to address alcohol misuse for this group. The study aimed to test the effectiveness of an intervention to reduce alcohol misuse and related harms amongst amateur sports people in Ireland. Design and Methods A controlled trial was conducted in two counties in Ireland. A random selection of sports clubs in one county received a 4 month multi‐faceted intervention. All sports clubs in a non‐adjacent county acted as control sites. Consumption of more than 21 units of alcohol per week and six or more standard drinks on a single occasion at least once per week was the primary study outcome. Alcohol Use Disorders Identification Test scores and number of alcohol‐related harms were also reported. Outcomes were assessed for cross‐sectional samples of players at pre‐intervention and post‐intervention and paired samples of players who completed surveys at both times. Generalised linear mixed model analysis was used. Results There was no evidence of effect for the primary outcomes or Alcohol Use Disorders Identification Test scores. There was a statistically significant difference in the median number of alcohol‐related harms reported by intervention group players compared with control group players at post‐intervention for the paired samples [intervention: 0; control: 3; incident rate ratio 0.56 (0.37, 0.84); P = 0.005]. Discussion and Conclusions Intervention in community sports clubs may be effective in reducing the number of alcohol‐related harms. Low levels of intervention participation and inadequate intervention dose are possible reasons for lack of a broader intervention effect. [O'Farrell A, Kingsland M, Kenny S, Eldin N, Wiggers J, Wolfenden L, Allwright S. A multi‐faceted intervention to reduce alcohol misuse and harm amongst sports people in Ireland: A controlled trial. Drug Alcohol Rev 2018;37:14–22] PMID:28782136

Predicting Alcohol Misuse Among College Students in the US and South Korea.

PubMed

Kim, Sang-Yeon; Ahn, Seokhoon; Lim, Tae-Seop

2015-01-01

This study examines contributing factors of alcohol misuse among college students in South Korea and the U.S. Exploratory factor analyses (EFA) on measurements of alcohol expectancy, alcohol efficacy, and accommodation resulted in social and personal causes for alcohol misuse. Social causes alone predicted alcohol misuse for both countries. Social factors constituted a much stronger predictor of alcohol misuse among South Korean students than among American students. Practical implications for effective deterrence of student binge drinking are discussed.

The role of community nursing in providing integrated care for older people with alcohol misuse.

PubMed

Rao, Tony

2014-02-01

Alcohol misuse in older people is a growing problem for health and social care providers, but remains largely hidden from public view and therefore largely overlooked by commissioners. Many older people with alcohol misuse have a 'dual diagnosis' (alcohol misuse accompanying other mental disorders) rather than alcohol misuse alone, which requires specialist nursing expertise. Over the past 10 years, assessment of and interventions for the detection of alcohol misuse in older people have been developed within one London borough. This article details the background, strategy and outcomes of this service, which provides integrated care in a multi-disciplinary community mental health team covering an inner-city area with a high prevalence of alcohol misuse and dual diagnosis in older people.

Pre-deployment Alcohol Misuse Among Shipboard Active-Duty U.S. Military Personnel.

PubMed

Harbertson, Judith; Hale, Braden R; Watkins, Eren Y; Michael, Nelson L; Scott, Paul T

2016-08-01

The burden of alcohol misuse is unknown among shipboard U.S. Navy and Marine Corps military personnel immediately prior to deployment and may be elevated. Anonymous survey data on hazardous, dependent, and binge alcohol misuse and involuntary drug consumption were collected during 2012-2014 among shipboard personnel within approximately 2 weeks of deployment. Using the Alcohol Use Disorders Identification Test Consumption (AUDIT-C), hazardous alcohol misuse was defined using two cut-point scoring criteria: (1) ≥3 for women and ≥4 for men; and (2) ≥4 for women and ≥5 for men; binge drinking as ≥4 drinks for women and ≥5 drinks for men on a typical day in past 30 days; and dependent alcohol misuse as an AUDIT-C score of ≥8. Demographic- and sex-stratified self-reported alcohol misuse prevalence was reported for analysis conducted during 2014-2015. Among 2,351 male and female shipboard personnel, 39%-54% screened positive for hazardous, 27% for binge, and 15% for dependent alcohol use. Seven percent reported involuntary drug consumption history. A larger proportion of those aged 17-20 years screened positive for dependent alcohol use compared with the overall study population prevalence. A large proportion of shipboard personnel screened positive for hazardous and dependent alcohol use (18% among those aged <21 years) at deployment onset. These data can inform interventions targeting shipboard personnel engaging in hazardous use before progression to dependent use and enable early identification and care for dependent users. Future studies should include more comprehensive assessment of factors associated with involuntary drug consumption. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

49 CFR 219.901 - Retention of alcohol testing records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... test results; and (2) A copy of the annual report summarizing the results of its alcohol misuse... connection with decisions to administer reasonable suspicion alcohol tests. (iv) Documents generated in connection with decisions on post-accident testing. (v) Documents verifying the existence of a medical...

Religious moral beliefs as mental health protective factor of war veterans suffering from PTSD, depressiveness, anxiety, tobacco and alcohol abuse in comorbidity.

PubMed

Hasanović, Mevludin; Pajević, Izet

2010-06-01

Our aim was to investigate is there association between level of religious moral beliefs and severity of PTSD symptoms, depressiion symptoms, anxiety and severity of alcohol abuse we tested 152 war veterans on presence of PTSD, depression symptoms, anxiety, alcohol misuse and level of religious moral beliefs. We used Harvard trauma questionnaire (HTQ), Hopkins Check Scale SBCL 25, check list for alcohol misuse MAST. Subjects were assessed with regard to the level of belief in some basic ethical principles that arise from religious moral values. The score of religious moral belief index was used to correlate with severity of PTSD symptoms, depression symptoms, anxiety and severity of alcohol misuse. Mean age of tested subjects was 40.8 (SD=6.6) years. The score of the moral belief index was negatively correlated to PTSD symptom severity and depressiveness (Pearson's r=-0.325, p<0.001; r=-0.247, p=0.005, respectively). Besides that the score of moral belief index negatively correlated with presented anxiety (Pearson's r=-0.199,p=0.026). Related to severity of tobacco and alcohol misuse we found negative association of these with the moral belief index (Pearson's r=-0.227, p=0.011; r=-0.371, p<0.001, respectively). A higher index of religious moral beliefs in war veterans enables better control distress, providing better mental health stability. It enables post traumatic conflicts typical for combatants' survivors to be more easily overcome. It also causes healthier reactions to external stimuli. A higher index of religious moral beliefs of war veterans provides a healthier and more efficient mechanism of tobacco and alcohol misuse control. In this way, it helps overcoming postwar psychosocial problems and socialization of the personality, leading to the improvement in mental health.

Study design to develop and pilot-test a web intervention for partners of military service members with alcohol misuse.

PubMed

Osilla, Karen Chan; Pedersen, Eric R; Gore, Kristie; Trail, Thomas; Howard, Stefanie Stern

2014-09-02

Alcohol misuse among military service members from the recent conflicts in Iraq and Afghanistan is over two times higher compared to misuse in the civilian population. Unfortunately, in addition to experiencing personal consequences from alcohol misuse, partners and family members of alcohol-misusing service members also suffer in negative ways from their loved one's drinking. These family members represent important catalysts for helping their loved ones identify problem drinking and overcoming the barriers to seeking care. This paper describes the protocol to a pilot study evaluating a 4-session, web-based intervention (WBI) for concerned partners (CPs) of service members with alcohol misuse. The WBI will be adapted from the Community Reinforcement and Family Training (CRAFT) intervention. In the first phase, we will develop and beta-test the WBI with 15-20 CPs. In the second phase, we will randomize CPs to WBI (n = 50) or to delayed-WBI (n = 50) and evaluate the impact of the WBI on CPs' perceptions of service member help-seeking and drinking, as well as the CP's well-being and relationship satisfaction 3 months after the intervention. In the third phase, we will recruit 15-20 service members whose partners have completed the study. We will interview the service members to learn how the CP-focused WBI affected them and to assess whether they would be receptive to a follow-on WBI module to help them. This project has the potential to benefit a large population of military service members who may be disproportionately affected by recent conflicts and whose drinking misuse would otherwise go undetected and untreated. It also develops a new prevention model that does not rely on service members or partners attending a hospital or clinical facility to access care. NCT02073825.

49 CFR 219.23 - Railroad policies.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., addresses, and telephone numbers of substance abuse professionals and counseling and treatment programs. (f... start of alcohol testing under the railroad's alcohol misuse prevention program and to each person...) The procedures that will be used to test for the presence of alcohol and controlled substances...

49 CFR 219.23 - Railroad policies.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., addresses, and telephone numbers of substance abuse professionals and counseling and treatment programs. (f... start of alcohol testing under the railroad's alcohol misuse prevention program and to each person...) The procedures that will be used to test for the presence of alcohol and controlled substances...

49 CFR 219.23 - Railroad policies.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., addresses, and telephone numbers of substance abuse professionals and counseling and treatment programs. (f... start of alcohol testing under the railroad's alcohol misuse prevention program and to each person...) The procedures that will be used to test for the presence of alcohol and controlled substances...

49 CFR 219.23 - Railroad policies.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., addresses, and telephone numbers of substance abuse professionals and counseling and treatment programs. (f... start of alcohol testing under the railroad's alcohol misuse prevention program and to each person...) The procedures that will be used to test for the presence of alcohol and controlled substances...

49 CFR 219.23 - Railroad policies.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., addresses, and telephone numbers of substance abuse professionals and counseling and treatment programs. (f... start of alcohol testing under the railroad's alcohol misuse prevention program and to each person...) The procedures that will be used to test for the presence of alcohol and controlled substances...

Identifying depression severity risk factors in persons with traumatic spinal cord injury.

PubMed

Williams, Ryan T; Wilson, Catherine S; Heinemann, Allen W; Lazowski, Linda E; Fann, Jesse R; Bombardier, Charles H

2014-02-01

Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics. PsycINFO Database Record (c) 2014 APA, all rights reserved.

49 CFR 199.215 - Alcohol concentration.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Alcohol concentration. 199.215 Section 199.215... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.215 Alcohol concentration. Each operator shall prohibit a covered employee from...

49 CFR 199.215 - Alcohol concentration.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Alcohol concentration. 199.215 Section 199.215... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.215 Alcohol concentration. Each operator shall prohibit a covered employee from...

Prospective risk factors for alcohol misuse in late adolescence.

PubMed

Ellickson, S L; Tucker, J S; Klein, D J; McGuigan, K A

2001-11-01

This longitudinal study investigated Grade-7 and Grade-10 risk factors for alcohol misuse at Grade 12. Alcohol misuse was conceptualized as problem-related drinking (e.g., missing school), high-risk drinking (e.g., drunk driving) and high consumption. Prospective analyses using two-part models predicted any alcohol misuse and the amount of misuse (given that some has occurred) for over 4,200 (52% male) participants in the RAND Adolescent Panel Study. Predictor variables were demographics, substance use and exposure, prodrug attitudes, rebelliousness and deviant behavior, self-esteem, family structure and relations, and grades. Grade-7 predictors of alcohol misuse 5 years later included early drinking onset, parental drinking, future intentions to drink, cigarette offers, difficulty resisting pressures to smoke, being white, being male, having an older sibling, deviant behavior and poor grades. By Grade 10, predictors of alcohol misuse 2 years later included drinking and marijuana use by self and peers, future intentions to drink, difficulty resisting pressures to drink and use marijuana, being male, coming from a disrupted family and deviant behavior. Somewhat different predictors were identified for problem-related, high-risk and high consumption drinking, emphasizing the importance of investigating multiple dimensions of misuse. The high social acceptability of alcohol use makes prevention difficult. Curbing alcohol misuse may be a more attainable goal than preventing any use. These results indicate that predictors of misuse in late adolescence can be identified by Grade 7 and are generally visible and modifiable. Prevention efforts should begin by early adolescence, address both familial and peer influences to drink and use other substances, and take into account problems that predict alcohol misuse (e.g., poor academic performance and early deviant behavior).

14 CFR 120.37 - Misuse of alcohol.

Code of Federal Regulations, 2010 CFR

2010-01-01

... he or she has been given a post-accident test under subpart F of this part, or the employer has... functions shall permit the employee to perform or continue to perform safety-sensitive functions. (d) Pre... to a required alcohol test. A covered employee must not refuse to submit to any alcohol test required...

14 CFR 120.37 - Misuse of alcohol.

Code of Federal Regulations, 2012 CFR

2012-01-01

... he or she has been given a post-accident test under subpart F of this part, or the employer has... functions shall permit the employee to perform or continue to perform safety-sensitive functions. (d) Pre... to a required alcohol test. A covered employee must not refuse to submit to any alcohol test required...

14 CFR 120.37 - Misuse of alcohol.

Code of Federal Regulations, 2013 CFR

2013-01-01

... he or she has been given a post-accident test under subpart F of this part, or the employer has... functions shall permit the employee to perform or continue to perform safety-sensitive functions. (d) Pre... to a required alcohol test. A covered employee must not refuse to submit to any alcohol test required...

14 CFR 120.37 - Misuse of alcohol.

Code of Federal Regulations, 2014 CFR

2014-01-01

... he or she has been given a post-accident test under subpart F of this part, or the employer has... functions shall permit the employee to perform or continue to perform safety-sensitive functions. (d) Pre... to a required alcohol test. A covered employee must not refuse to submit to any alcohol test required...

14 CFR 120.37 - Misuse of alcohol.

Code of Federal Regulations, 2011 CFR

2011-01-01

... he or she has been given a post-accident test under subpart F of this part, or the employer has... functions shall permit the employee to perform or continue to perform safety-sensitive functions. (d) Pre... to a required alcohol test. A covered employee must not refuse to submit to any alcohol test required...

Personality disorder traits, family environment, and alcohol misuse: a multivariate behavioural genetic analysis.

PubMed

Jang, K L; Vernon, P A; Livesley, W J

2000-06-01

This study seeks to estimate the extent to which a common genetic and environmental basis is shared between (i) traits delineating specific aspects of antisocial personality and alcohol misuse, and (ii) childhood family environments, traits delineating broad domains of personality pathology and alcohol misuse. Postal survey data were collected from monozygotic and dizygotic twin pairs. Twin pairs were recruited from Vancouver, British Columbia and London, Ontario, Canada using newspaper advertisements, media stories and twin clubs. Data obtained from 324 monozygotic and 335 dizygotic twin pairs were used to estimate the extent to which traits delineating specific antisocial personality traits and alcohol misuse shared a common genetic and environmental aetiology. Data from 81 monozygotic and 74 dizygotic twin pairs were used to estimate the degree to which traits delineating personality pathology, childhood family environment and alcohol misuse shared a common aetiology. Current alcohol misuse and personality pathology were measured using scales contained in the self-report Dimensional Assessment of Personality Pathology. Perceptions of childhood family environment were measured using the self-report Family Environment Scale. Multivariate genetic analyses showed that a subset of traits delineating components of antisocial personality (i.e. grandiosity, attention-seeking, failure to adopt social norms, interpersonal violence and juvenile antisocial behaviours) are influenced by genetic factors in common to alcohol misuse. Genetically based perceptions of childhood family environment had little relationship with alcohol misuse. Heritable personality factors that influence the perception of childhood family environment play only a small role in the liability to alcohol misuse. Instead, liability to alcohol misuse is related to genetic factors common a specific subset of antisocial personality traits describing conduct problems, narcissistic and stimulus-seeking behaviour.

49 CFR 199.237 - Other alcohol-related conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Other alcohol-related conduct. 199.237 Section 199... MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.237 Other alcohol-related conduct. (a) No operator shall...

49 CFR 199.237 - Other alcohol-related conduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Other alcohol-related conduct. 199.237 Section 199... MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY DRUG AND ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.237 Other alcohol-related conduct. (a) No operator shall...

Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. preventive services task force recommendation statement.

PubMed

Moyer, Virginia A

2013-08-06

Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening and behavioral counseling interventions in primary care to reduce alcohol misuse. The USPSTF reviewed new evidence on the effectiveness of screening for alcohol misuse for improving health outcomes, the accuracy of various screening approaches, the effectiveness of various behavioral counseling interventions for improving intermediate or long-term health outcomes, the harms of screening and behavioral counseling interventions, and influences from the health care system that promote or detract from effective screening and counseling interventions for alcohol misuse. These recommendations apply to adolescents aged 12 to 17 years and adults aged 18 years or older. These recommendations do not apply to persons who are actively seeking evaluation or treatment of alcohol misuse. The USPSTF recommends that clinicians screen adults aged 18 years or older for alcohol misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse. (Grade B recommendation)The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening and behavioral counseling interventions in primary care settings to reduce alcohol misuse in adolescents. (I statement)

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 3 2011-01-01 2011-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... 145 certificate holder who has your own drug testing program Obtain an Antidrug and Alcohol Misuse...

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 3 2012-01-01 2012-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... 145 certificate holder who has your own drug testing program Obtain an Antidrug and Alcohol Misuse...

14 CFR 120.117 - Implementing a drug testing program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Implementing a drug testing program. 120... AND ALCOHOL TESTING PROGRAM Drug Testing Program Requirements § 120.117 Implementing a drug testing... 145 certificate holder who has your own drug testing program Obtain an Antidrug and Alcohol Misuse...

Comparison of Student Self-Reported and Administrative Data Regarding Intercession into Alcohol Misuse among College Freshmen Dormitory Residents.

PubMed

Novik, Melinda Griffin; Boekeloo, Bradley O

2013-03-01

Intercession into collegiate alcohol misuse by the Department of Resident Live (DRL) in freshmen dormitories at one large, Mid-Atlantic, diverse, public university was examined. Freshmen dormitory resident drinkers (n=357), 71% of whom reported alcohol misuse, were surveyed. Student self-report and DRL documentation, respectively, revealed that 6.4% and 7.8% (Kappa=.77) of drinkers were documented with an alcohol violation, 4.2% and 3.4% (Kappa=.81) lost housing priority points, 1.4% and .6% (Kappa=.28) were referred for alcohol counseling, and 1.4% and .3% (Kappa = .33) were taken to the emergency room. DRL infrequently interceded into alcohol misuse, perhaps because most misuse occurred off-campus.

Comparison of Student Self-Reported and Administrative Data Regarding Intercession into Alcohol Misuse among College Freshmen Dormitory Residents

PubMed Central

Novik, Melinda Griffin; Boekeloo, Bradley O.

2012-01-01

Intercession into collegiate alcohol misuse by the Department of Resident Live (DRL) in freshmen dormitories at one large, Mid-Atlantic, diverse, public university was examined. Freshmen dormitory resident drinkers (n=357), 71% of whom reported alcohol misuse, were surveyed. Student self-report and DRL documentation, respectively, revealed that 6.4% and 7.8% (Kappa=.77) of drinkers were documented with an alcohol violation, 4.2% and 3.4% (Kappa=.81) lost housing priority points, 1.4% and .6% (Kappa=.28) were referred for alcohol counseling, and 1.4% and .3% (Kappa = .33) were taken to the emergency room. DRL infrequently interceded into alcohol misuse, perhaps because most misuse occurred off-campus. PMID:24659855

Alcohol Misuse and Psychological Resilience among U.S. Iraq and Afghanistan Era Veteran Military Personnel

PubMed Central

Green, Kimberly T.; Beckham, Jean C.; Youssef, Nagy; Elbogen, Eric B.

2013-01-01

Objective The present study sought to investigate the longitudinal effects of psychological resilience against alcohol misuse adjusting for socio-demographic factors, trauma-related variables, and self-reported history of alcohol abuse. Methodology Data were from National Post-Deployment Adjustment Study (NPDAS) participants who completed both a baseline and one-year follow-up survey (N=1090). Survey questionnaires measured combat exposure, probable posttraumatic stress disorder (PTSD), psychological resilience, and alcohol misuse, all of which were measured at two discrete time periods (baseline and one-year follow-up). Baseline resilience and change in resilience (increased or decreased) were utilized as independent variables in separate models evaluating alcohol misuse at the one-year follow-up. Results Multiple linear regression analyses controlled for age, gender, level of educational attainment, combat exposure, PTSD symptom severity, and self-reported alcohol abuse. Accounting for these covariates, findings revealed that lower baseline resilience, younger age, male gender, and self-reported alcohol abuse were related to alcohol misuse at the one-year follow-up. A separate regression analysis, adjusting for the same covariates, revealed a relationship between change in resilience (from baseline to the one-year follow-up) and alcohol misuse at the one-year follow-up. The regression model evaluating these variables in a subset of the sample in which all the participants had been deployed to Iraq and/or Afghanistan was consistent with findings involving the overall era sample. Finally, logistic regression analyses of the one-year follow-up data yielded similar results to the baseline and resilience change models. Conclusions These findings suggest that increased psychological resilience is inversely related to alcohol misuse and is protective against alcohol misuse over time. Additionally, it supports the conceptualization of resilience as a process which evolves over time. Moreover, our results underscore the importance of assessing resilience as part of alcohol use screening for preventing alcohol misuse in Iraq and Afghanistan era military veterans. PMID:24090625

Distress tolerance and physiological reactivity to stress predict women's problematic alcohol use.

PubMed

Holzhauer, Cathryn Glanton; Wemm, Stephanie; Wulfert, Edelgard

2017-06-01

Research has shown that measures of reactivity to distress-including distress tolerance and physiological reactivity to stress-are dysregulated in women who misuse alcohol. These variables may interact and create a risk profile for young adult women, reflecting patterns of stress reactivity that confer a risk for alcohol misuse. The current study tested this hypothesis by examining the independent and interactive associations of subjective distress tolerance, behavioral distress tolerance, and physiological stress reactivity with women's alcohol misuse. The study was conducted with a sample of 91 college women recruited on a large northeastern university campus. Results showed that subjective levels of distress tolerance and physiological reactivity to stress (skin conductance reactivity, SCR), but not behavioral distress tolerance, were independently associated with alcohol misuse. In addition, subjective distress tolerance moderated the relationship between SCR and negative alcohol-related consequences. Specifically, women with low physiological reactivity (SCR) to a stressful task and greater urge to quickly rid themselves of distress (low subjective distress tolerance) endorsed a significantly greater number of adverse consequences from their alcohol use. These results extend prior findings by showing that, even among a nonclinical sample of women, lower stress reactivity in combination with low subjective distress tolerance is associated with increased risk for various drinking-related negative consequences. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Management of alcohol misuse in patients with liver diseases

PubMed Central

Peng, Jennifer L; Patel, Milan Prakash; McGee, Breann; Liang, Tiebing; Chandler, Kristina; Tayarachakul, Sucharat; O’Connor, Sean; Liangpunsakul, Suthat

2017-01-01

Excessive alcohol use not only causes alcoholic liver disease (ALD) but also increases the risk of liver-related mortality in patients who already have other chronic liver diseases. Screening for alcohol misuse or alcohol use disorder (AUD) among patients with underlying liver disease is essential. This clinical review covers what is known about ALD, the impact of alcohol in patients with underlying liver diseases, current management of alcohol misuse and AUD, and the management of alcohol misuse and AUD specifically in patients with liver diseases. Several treatment options for alcohol misuse and AUD exist such as psychosocial intervention and behavioral and pharmacological therapies. The strategies used in the treatment of alcohol misuse and AUD are still applicable in those who consume alcohol and have underlying liver disease. However, certain medications still need to be carefully used due to potentially worsening already compromised liver function. Screening of ongoing alcohol use in subjects with liver disease is important, and prompt intervention is needed to prevent the associated morbidity and mortality from the detrimental effects of continued alcohol use on underlying liver disease. Considering alcoholism is a complex disease, probably a multidisciplinary approach combining psychotherapy and comprehensive medical care will be the most effective. Future research could focus on identifying additional treatment options for addressing the psychotherapy component since the self-determination and will to quit drinking alcohol can play such a crucial role in promoting abstinence. PMID:27940551

Violent behaviour and post-traumatic stress disorder in US Iraq and Afghanistan veterans

PubMed Central

Elbogen, Eric B.; Johnson, Sally C.; Wagner, H. Ryan; Sullivan, Connor; Taft, Casey T.; Beckham, Jean C.

2014-01-01

Background Violence towards others in the community has been identified as a significant problem for a subset of Iraq and Afghanistan veterans. Aims To investigate the extent to which post-traumatic stress disorder (PTSD) and other risk factors predict future violent behaviour in military veterans. Method A national, multiwave survey enrolling a random sample of all US veterans who served in the military after 11 September 2001 was conducted. A total of 1090 veterans from 50 US states and all military branches completed two survey waves mailed 1 year apart (retention rate = 79%). Results Overall, 9% endorsed engaging in severe violence and 26% in other physical aggression in the previous year, as measured at Wave 2. Younger age, financial instability, history of violence before military service, higher combat exposure, PTSD, and alcohol misuse at Wave 1 were significantly associated with higher severe violence and other physical aggression in the past year at Wave 2. When combinations of these risk factors were present, predicted probability of violence in veterans rose sharply. Veterans with both PTSD and alcohol misuse had a substantially higher rate of subsequent severe violence (35.9%) compared with veterans with alcohol misuse without PTSD (10.6%), PTSD without alcohol misuse (10.0%) or neither PTSD nor alcohol misuse (5.3%). Using multiple regression, we found that veterans with PTSD and without alcohol misuse were not at significantly higher risk of severe violence than veterans with neither PTSD nor alcohol misuse. There was a trend for other physical aggression to be higher in veterans with PTSD without alcohol misuse. Conclusions Co-occurring PTSD and alcohol misuse was associated with a marked increase in violence and aggression in veterans. Compared with veterans with neither PTSD nor alcohol misuse, veterans with PTSD and no alcohol misuse were not significantly more likely to be severely violent and were only marginally more likely to engage in other physical aggression. Attention to cumulative effects of multiple risk factors beyond diagnosis - including demographics, violence history, combat exposure, and veterans’ having money to cover basic needs like food, shelter, transportation, and medical care - is crucial for optimising violence risk management. PMID:24578444

Risk Factors for Intimate Partner Violence During Pregnancy and Postpartum

PubMed Central

Hellmuth, Julianne C.; Gordon, Kristina Coop; Stuart, Gregory L.; Moore, Todd M.

2012-01-01

Purpose This longitudinal investigation examined potential risk factors for intimate partner violence (IPV) among women during pregnancy and 6 weeks postpartum. Methods A sample of 180 pregnant women was collected in order to investigate 1) whether associations between partner alcohol misuse, partner jealousy, partner suspicion of infidelity, and stress were associated with IPV victimization, 2) the indirect effects of alcohol misuse on these relationships, and 3) factors related to changes in IPV victimization over time. Results At baseline, partner alcohol misuse was associated with each type of IPV victimization and the combination of partner alcohol misuse, partner jealousy, and partner suspicion of infidelity was most strongly associated with severe physical victimization. Partner alcohol misuse mediated the relationship between partner jealousy and psychological and severe physical victimization. At follow-up, partner jealousy and stress were related to women’s psychological victimization and partner alcohol misuse was related to women’s severe physical victimization. Conclusions Findings suggest that partner alcohol misuse is a risk factor for women’s IPV victimization during pregnancy and jealousy and stress may increase risk for some types of IPV. Findings also suggest that intervention should target parents early in pregnancy in order to reduce the risk for future IPV. PMID:23053216

Alcohol misuse, firearm violence perpetration, and public policy in the United States.

PubMed

Wintemute, Garen J

2015-10-01

Firearm violence is a significant public health problem in the United States, and alcohol is frequently involved. This article reviews existing research on the relationships between alcohol misuse; ownership, access to, and use of firearms; and the commission of firearm violence, and discusses the policy implications of these findings. Narrative review augmented by new tabulations of publicly-available data. Acute and chronic alcohol misuse is positively associated with firearm ownership, risk behaviors involving firearms, and risk for perpetrating both interpersonal and self-directed firearm violence. In an average month, an estimated 8.9 to 11.7 million firearm owners binge drink. For men, deaths from alcohol-related firearm violence equal those from alcohol-related motor vehicle crashes. Enforceable policies restricting access to firearms for persons who misuse alcohol are uncommon. Policies that restrict access on the basis of other risk factors have been shown to reduce risk for subsequent violence. The evidence suggests that restricting access to firearms for persons with a documented history of alcohol misuse would be an effective violence prevention measure. Restrictions should rely on unambiguous definitions of alcohol misuse to facilitate enforcement and should be rigorously evaluated. Copyright © 2015 Elsevier Inc. All rights reserved.

Examination of the dynamic interplay between posttraumatic stress symptoms and alcohol misuse among combat-exposed Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans.

PubMed

Langdon, Kirsten J; Fox, Annie B; King, Lynda A; King, Daniel W; Eisen, Susan; Vogt, Dawne

2016-05-15

Although alcohol misuse co-occurs with PTSD symptoms at a strikingly high rate (i.e., nearly 52% of men and 28% of women with PTSD also meet diagnostic criteria for an Alcohol Use Disorder), the functional associations between these symptom types remain unclear. The current study sought to clarify the nature of posttraumatic stress-alcohol misuse relations by employing a prospective longitudinal methodology-the latent difference score approach-to examine dynamic change in posttraumatic stress symptoms and alcohol misuse among 478 combat-exposed Veterans completing a longitudinal survey of post-deployment mental and physical health. This study builds on the existing literature, as most prior research has been limited to cross-sectional studies and has not explored prospective relations between specific PTSD symptom clusters and alcohol misuse. Consistent with the self-medication model, results indicated that PTSD symptoms demonstrate a prospective and proximal association with alcohol misuse during the assessment period; however, alcohol misuse did not appear to be a unique contributor to overall PTSD symptom exacerbation over time. Examination of individual PTSD symptom clusters revealed that more severe symptoms of intrusion and numbing, but not avoidance and hyperarousal, predicted greater alcohol misuse at subsequent time intervals. The constructs examined within this investigation relied on self-report data; diagnostic criteria for PTSD and/or Alcohol Use Disorders were not assessed. Future work may benefit from replicating these findings in clinical populations formally diagnosed with PTSD via clinician-administered structured interviews. Findings underscore the importance of addressing PTSD symptoms in the context of alcohol treatment to facilitate improved drinking outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

Examination of the Dynamic Interplay between Posttraumatic Stress Symptoms and Alcohol Misuse among Combat-Exposed Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans

PubMed Central

Langdon, Kirsten J.; Fox, Annie B.; King, Lynda A.; King, Daniel W.; Eisen, Susan; Vogt, Dawne

2016-01-01

Background Although alcohol misuse co-occurs with PTSD symptoms at a strikingly high rate (i.e., nearly 52% of men and 28% of women with PTSD also meet diagnostic criteria for an Alcohol Use Disorder; Kessler et al., 1995), the functional associations between these symptom types remain unclear. Methods The current study sought to clarify the nature of posttraumatic stress-alcohol misuse relations by employing a prospective longitudinal methodology - the latent difference score approach - to examine dynamic change in posttraumatic stress symptoms and alcohol misuse among 478 combat-exposed Veterans completing a longitudinal survey of post-deployment mental and physical health. This study builds on the existing literature, as most prior research has been limited to cross-sectional studies and has not explored prospective relations between specific PTSD symptom clusters and alcohol misuse. Results Consistent with the self-medication model, results indicated that PTSD symptoms demonstrate a prospective and proximal association with alcohol misuse during the assessment period; however, alcohol misuse did not appear to be a unique contributor to overall PTSD symptom exacerbation over time. Examination of individual PTSD symptom clusters revealed that more severe symptoms of intrusion and numbing, but not avoidance and hyperarousal, predicted greater alcohol misuse at subsequent time intervals. Limitations The constructs examined within this investigation relied on self-report data; diagnostic criteria for PTSD and/or Alcohol Use Disorders were not assessed. Future work may benefit from replicating these findings in clinical populations formally diagnosed with PTSD via clinician-administered structured interviews. Conclusions Findings underscore the importance of addressing PTSD symptoms in the context of alcohol treatment to facilitate improved drinking outcomes. PMID:26938966

Are veterans different? Understanding veterans' help-seeking behaviour for alcohol problems.

PubMed

Kiernan, Matthew D; Osbourne, Alison; McGill, Gill; Jane Greaves, Peta; Wilson, Gemma; Hill, Mick

2018-05-31

Alcohol misuse in the United Kingdom's veteran community is not an isolated phenomenon. Internationally, alcohol and wider substance misuse would appear to be an historic and current global issue within veteran communities. Although research has been undertaken both in the United Kingdom and the United States into why veterans are reluctant to seek help for mental health problems, little is understood as to why veterans encounter difficulties in engaging with treatment for alcohol misuse. The aim of this study was to understand why veterans in the United Kingdom are either reluctant or have difficulty in accessing help for alcohol problems. An applied social policy research methodology was used, employing in-depth semi-structured interviews with 19 UK veterans in the North East of England, who had a history of alcohol misuse. The findings showed that participants appeared to excuse or normalise their excessive alcohol consumption, which led to a delay in meaningful engagement in substance misuse services, resulting in complex and complicated presentations to health and social care services. The findings of this study clearly suggest that veterans who misuse alcohol have a range of distinctive and unique difficulties that subtly differentiate them from the wider civilian substance misuse population, and that the use of peer-support models would appear to mitigate against them disengaging from alcohol treatment services. © 2018 John Wiley & Sons Ltd.

Prevalence and Socio-Demographic Determinants of Tobacco, Alcohol, Substance Use and Drug Misuse in General Population in Turkey

PubMed Central

İLHAN, Mustafa Necmi; ARIKAN, Zehra; KOTAN, Zeynep; TUNÇOĞLU, Tolga; PINARCI, Mustafa; TAŞDEMİR, Ahmet; AY, Bülent; KOÇAK, Nadir

2016-01-01

Introduction The aim of the current study is to determine prevalence ratios of tobacco, alcohol, substance use and drug misuse in a large scale sample of general population and recognize related socio-demographic factors. Methods The study was based on a cross-sectional survey conducted with a nationally representative sample of 8045 individuals with face-to-face, in-house interviews implemented by a trained team of interviewers. Results Life-time prevalences of tobacco, alcohol, substance use and drug misuse are 51.8%, 28.3%, 2.8% and 10.5% respectively. Age, gender, education level and marital status are important socio-demographic determinants for tobacco, alcohol use and drug misuse. Income level is an important determinant for alcohol and substance use. Conclusion Tobacco, alcohol, substance use and drug misuse are significant health concerns in Turkey. Socio-demographic status is an important determinant of several aspects of tobacco, alcohol, substance use and drug misuse and should therefore be evaluated carefully to develop effective protective and preventive strategies. PMID:28373796

Genes involved in stress response and alcohol use among high-risk African American youth.

PubMed

Goyal, Neeru; Aliev, Fazil; Latendresse, Shawn J; Kertes, Darlene A; Bolland, John M; Byck, Gayle R; Mustanski, Brian; Salvatore, Jessica E; Dick, Danielle M

2016-01-01

Genetic and environmental factors influence substance use behaviors in youth. One of the known environmental risk factors is exposure to life stressors. The aim of this project is to study the interaction between NR3C1 and CRHBP, genes thought to be involved in stress pathways, exposure to stressful life events, and adolescent alcohol use/misuse. The sample included 541 African American individuals (ages 13-18) from the Genes, Environment, and Neighborhood Initiative, a subset of the Mobile Youth Survey sample from whom DNA and more extensive phenotypic data were collected. Participants were selected from high-poverty neighborhoods in Mobile, Alabama, with potential exposure to a variety of extreme life stressors. A measure of stressful life events was significantly predictive of alcohol use/misuse. In addition, this association was significantly dependent upon the number of putative risk variants at rs1715749, a single-nucleotide polymorphism (SNP) in CRHBP (P ≤ .006). There was no significant interaction between NR3C1 and stressful life events with respect to alcohol use/misuse, after taking into account multiple testing. These findings suggest that CRHBP variants are potentially relevant for adolescent alcohol use/misuse among African American youth populations being reared within the context of stressful life events and warrant replication.

49 CFR 219.104 - Responsive action.

Code of Federal Regulations, 2013 CFR

2013-10-01

... information requirements listed in § 219.23 do not apply to applicants who refuse to submit to a pre-employment test or who have a pre-employment test with a result indicating the misuse of alcohol or... fluid tests for alcohol or drugs that are conducted exclusively under authority other than that provided...

49 CFR 219.104 - Responsive action.

Code of Federal Regulations, 2011 CFR

2011-10-01

... information requirements listed in § 219.23 do not apply to applicants who refuse to submit to a pre-employment test or who have a pre-employment test with a result indicating the misuse of alcohol or... fluid tests for alcohol or drugs that are conducted exclusively under authority other than that provided...

49 CFR 219.104 - Responsive action.

Code of Federal Regulations, 2012 CFR

2012-10-01

... information requirements listed in § 219.23 do not apply to applicants who refuse to submit to a pre-employment test or who have a pre-employment test with a result indicating the misuse of alcohol or... fluid tests for alcohol or drugs that are conducted exclusively under authority other than that provided...

49 CFR 219.104 - Responsive action.

Code of Federal Regulations, 2014 CFR

2014-10-01

... information requirements listed in § 219.23 do not apply to applicants who refuse to submit to a pre-employment test or who have a pre-employment test with a result indicating the misuse of alcohol or... fluid tests for alcohol or drugs that are conducted exclusively under authority other than that provided...

49 CFR 219.104 - Responsive action.

Code of Federal Regulations, 2010 CFR

2010-10-01

... information requirements listed in § 219.23 do not apply to applicants who refuse to submit to a pre-employment test or who have a pre-employment test with a result indicating the misuse of alcohol or... fluid tests for alcohol or drugs that are conducted exclusively under authority other than that provided...

A Randomized Controlled Trial of a Telephone Intervention for Alcohol Misuse with Injured Emergency Department Patients

PubMed Central

Mello, Michael J.; Baird, Janette; Lee, Christina; Strezsak, Valerie; French, Michael T.; Longabaugh, Richard

2015-01-01

Objective This was a randomized controlled trial to test efficacy of a telephone intervention (TBMI) for injured ED patients with alcohol misuse to decrease alcohol use, impaired driving, alcohol-related injuries and alcohol-related negative consequences. Methods ED patients screening positive for alcohol misuse were randomized to a three-session telephone brief motivational intervention on alcohol (TBMI) delivered by a counselor trained in motivational interviewing over 6 weeks or a control intervention of a scripted home fire and burn safety education delivered in three calls. Patients were followed for 12 months and assessed for changes in alcohol use, impaired driving, alcohol-related injuries and alcohol-related negative consequences. Results 730 ED patients were randomized; 78% received their assigned intervention by telephone and of those, 72% completed 12 months assessments. There were no differential benefits of TBMI intervention versus assessment and a control intervention in all three variables of alcohol use (frequency of binge alcohol use over the prior 30 days, maximum number of drinks at one time in past 30 days, typical alcohol use in past 30 days), alcohol impaired driving, alcohol related injuries and alcohol-related negative consequences. Conclusions Despite the potential advantage of delivering a TBMI in not disrupting ED clinical care, our study found no efficacy for it over an assessment and control intervention. Potential etiologies for our finding include that injury itself or alcohol assessments, or the control intervention had active ingredients for alcohol change. PMID:26585044

Brief report: The Brief Alcohol Social Density Assessment (BASDA): convergent, criterion-related, and incremental validity.

PubMed

MacKillop, James; Acker, John D; Bollinger, Jared; Clifton, Allan; Miller, Joshua D; Campbell, W Keith; Goodie, Adam S

2013-09-01

Alcohol misuse is substantially influenced by social factors, but systematic assessments of social network drinking are typically lengthy. The goal of the present study was to provide further validation of a brief measure of social network alcohol use, the Brief Alcohol Social Density Assessment (BASDA), in a sample of emerging adults. Specifically, the study sought to examine the BASDA's convergent, criterion, and incremental validity in relation to well-established measures of drinking motives and problematic drinking. Participants were 354 undergraduates who were assessed using the BASDA, the Alcohol Use Disorders Identification Test (AUDIT), and the Drinking Motives Questionnaire. Significant associations were observed between the BASDA index of alcohol-related social density and alcohol misuse, social motives, and conformity motives, supporting convergent validity. Criterion-related validity was supported by evidence that significantly greater alcohol involvement was present in the social networks of individuals scoring at or above an AUDIT score of 8, a validated criterion for hazardous drinking. Finally, the BASDA index was significantly associated with alcohol misuse above and beyond drinking motives in relation to AUDIT scores, supporting incremental validity. Taken together, these findings provide further support for the BASDA as an efficient measure of drinking in an individual's social network. Methodological considerations as well as recommendations for future investigations in this area are discussed.

Examining the Changing Influence of Predictors on Adolescent Alcohol Misuse

ERIC Educational Resources Information Center

Tyler, Kim A.; Stone, Rosalie Torres; Bersani, Bianca

2007-01-01

The purpose of this study was to examine whether the influence of key characteristics on adolescent alcohol misuse (i.e., maternal binge drinking, parenting, peers, school characteristics, and the adolescent's own behavior) change over time and whether predictors of adolescent alcohol misuse vary by gender and race/ethnicity. Using prospective,…

76 FR 12559 - Antidrug and Alcohol Misuse Prevention Programs for Personnel Engaged in Specified Aviation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... Machining and N welding of ground support parts for planes. Manufacturing & N precision grinding and testing... governing drug and alcohol testing to clarify that each person who performs a safety-sensitive function for a regulated employer by contract, including bysubcontract at any tier, is subject to testing. DATES...

14 CFR 91.1047 - Drug and alcohol misuse education program.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) Information on the substances that they test for, for example, alcohol and a list of the drugs; (2) The categories of employees tested, the types of tests, for example, pre-employment, random, reasonable cause/suspicion, post accident, return to duty and follow-up; and (3) The degree to which the program manager's...

14 CFR 91.1047 - Drug and alcohol misuse education program.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Information on the substances that they test for, for example, alcohol and a list of the drugs; (2) The categories of employees tested, the types of tests, for example, pre-employment, random, reasonable cause/suspicion, post accident, return to duty and follow-up; and (3) The degree to which the program manager's...

14 CFR 91.1047 - Drug and alcohol misuse education program.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Information on the substances that they test for, for example, alcohol and a list of the drugs; (2) The categories of employees tested, the types of tests, for example, pre-employment, random, reasonable cause/suspicion, post accident, return to duty and follow-up; and (3) The degree to which the program manager's...

14 CFR 91.1047 - Drug and alcohol misuse education program.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) Information on the substances that they test for, for example, alcohol and a list of the drugs; (2) The categories of employees tested, the types of tests, for example, pre-employment, random, reasonable cause/suspicion, post accident, return to duty and follow-up; and (3) The degree to which the program manager's...

14 CFR 91.1047 - Drug and alcohol misuse education program.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) Information on the substances that they test for, for example, alcohol and a list of the drugs; (2) The categories of employees tested, the types of tests, for example, pre-employment, random, reasonable cause/suspicion, post accident, return to duty and follow-up; and (3) The degree to which the program manager's...

Training and experience of nurses in responding to alcohol misuse in rural communities.

PubMed

Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine

2013-07-01

Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.

Adult attention deficit hyperactivity disorder symptom profiles and concurrent problems with alcohol and cannabis: sex differences in a representative, population survey.

PubMed

Kolla, Nathan J; van der Maas, Mark; Toplak, Maggie E; Erickson, Patricia G; Mann, Robert E; Seeley, Jane; Vingilis, Evelyn

2016-02-27

Adult attention deficit hyperactivity disorder (ADHD) shows a robust association with alcohol and cannabis misuse, and these relationships are expressed differently in males and females. Manifestation of specific ADHD symptom profiles, even in the absence of the full disorder, may also be related to problems with alcohol and cannabis, although these relationships have not been investigated in epidemiological studies. To address this question, we studied the sex-specific associations of ADHD symptomatology with problematic alcohol and cannabis use in a representative sample of adults aged 18 years and older residing in Ontario, Canada. Data were obtained from the Centre for Addiction and Mental Health Monitor, an ongoing cross-sectional telephone survey, between January 2011 and December 2013. Respondents (n =  5080) reported on current ADHD symptomatology, measured using the Adult ADHD Self-Report Version 1.1 Screener (ASRS-V1.1) and four additional items, and alcohol and cannabis use, which were measured using the Alcohol Use Disorders Identification Test (AUDIT) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), respectively. Logistic regression analyses were conducted in men and women to test the association of each ADHD symptom cluster (hyperactivity, inattentiveness, impulsivity) with problematic alcohol and cannabis use. After controlling for age, education, and comorbid internalizing and externalizing psychopathology, hyperactive symptoms were associated with problematic alcohol use in both men and women and with problematic cannabis use in men. Impulsive symptoms were independently associated with problematic cannabis use in men. By contrast, inattentive symptomatology predicted problems with alcohol and cannabis only in women. In all models, age was negatively associated with substance misuse and externalizing behavior was positively correlated and the strongest predictor of hazardous alcohol and cannabis use. ADHD symptom expression in adulthood is related to concurrent hazardous use of alcohol and cannabis. Distinctive ADHD symptom profiles may confer increased risk for substance misuse in a sex-specific manner.

49 CFR 655.43 - Reasonable suspicion testing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the appearance, behavior, speech, or body odors of the covered employee. A supervisor(s), or other company official(s) who is trained in detecting the signs and symptoms of drug use and alcohol misuse must.../or alcohol test when the employer has reasonable suspicion to believe that the covered employee has...

An Economic Perspective on Personality Traits and Alcohol Misuse: Evidence from the Health and Retirement Study.

PubMed

Kessler, Asia Sikora; Maclean, Johanna Catherine

2015-06-01

Recent economic work suggests a role for personality traits in determining socioeconomic outcomes. Much of this work has considered labor market outcomes, human capital accumulation, and, to some extent, health outcomes. No economic studies have explored the role of the Big Five taxonomy in alcohol use and misuse. Given defining characteristics of the Big Five, they are plausibly linked with these outcomes. Alcohol misuse is associated with large social costs through healthcare costs, traffic fatalities, violence, and reduced labor market productivity. Thus, understanding risk factors for such use is warranted. To investigate the associations between the Big Five, and measures of alcohol use and alcohol misuse. We obtain data on older adults 50 years and older from the Health and Retirement Study (HRS). Our outcomes include one measure of use (any use) and two measures of misuse (heavy drinking and binge drinking). Comparing across different measures of alcohol consumption can shed light on whether the Big Five are related to moderate alcohol use that need not impose social costs or alcohol misuse that may indeed impose such costs. A randomly selected sub-set of respondents completed a self-administered questionnaire developed for the Midlife Development Inventory in either the 2006 or 2008 round of the HRS. We use information collected in this instrument to generate our independent variables of primary interest: agreeableness, openness, extraversion, neuroticism, and conscientiousness traits. We find that the Big Five personality traits are linked with measures of both alcohol use and alcohol misuse. We observe substantial heterogeneity in the associations by personality traits. Specifically, agreeableness is associated with increased risk for alcohol use/misuse while extraversion and openness are negatively associated with risk for these patterns of alcohol consumption. We find no evidence that neuroticism or contentiousness predict alcohol use and misuse. We identify heterogeneity in the associations across demographic characteristics. We find associations between the Big Five and our measures of alcohol use and alcohol misuse. Our findings are subject to several data limitations, however. Although the Big Five personality taxonomy is well utilized, it has known limitations. Even in a survey as rich as the HRS, it is likely that we are unable to control for all important variables leading to omitted variable bias. Because we focus on a sample of older adults, the generalizability of our findings to other demographic groups is not clear. Agreeableness is significantly associated with alcohol use and misuse, which could lead to greater utilization of healthcare services and thus increased costs to the healthcare system. Healthcare providers should consider aspects of personality when developing and communicating treatment options. Moreover, psychology and economic work documents that interventions can alter aspects of personality even among older adults. Further research on and implementation of effective interventions may be warranted. Future studies should examine the implications of personality for a broader range of outcomes. Survey administrators could consider including validated measures of personality in surveys to facilitate such research.

Comparison of Student Self-Reported and Administrative Data regarding Intercession into Alcohol Misuse among College Freshmen Dormitory Residents

ERIC Educational Resources Information Center

Novik, Melinda G.; Boekeloo, Bradley O.

2013-01-01

Intercession into collegiate alcohol misuse by the Department of Resident Life (DRL) in freshmen dormitories at one large Mid-Atlantic, diverse, public university was examined. Freshmen dormitory resident drinkers (n = 357), 71% of whom reported alcohol misuse, were surveyed. Student self-report and DRL documentation, respectively, revealed that…

Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions.

PubMed

Chavez, Laura J; Williams, Emily C; Lapham, Gwen T; Rubinsky, Anna D; Kivlahan, Daniel R; Bradley, Katharine A

2016-05-01

Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP; 2007-2011) who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C ≥ 5) was estimated for each year. Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation.

Alcohol-Related Problems among Younger Drinkers Who Misuse Prescription Drugs: Results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC)

ERIC Educational Resources Information Center

Hermos, J.; Winter, M.; Heeren, T.; Hingson, R.

2009-01-01

The authors determined whether lifetime prescription drug misuse (PDM) associated with increased risks for alcohol-related problems among 18- to 34-year-old, NESARC respondents. Among 8222 "ever-drinkers," 15.4% reported ever "misusing sedatives, tranquilizers, painkillers or stimulants ... as prescriptions or from indirect sources." Outcomes were…

The role of alcohol and drugs in homicides in England and Wales.

PubMed

Shaw, Jenny; Hunt, Isabelle M; Flynn, Sandra; Amos, Tim; Meehan, Janet; Robinson, Jo; Bickley, Harriet; Parsons, Rebecca; McCann, Kerry; Burns, James; Kapur, Nav; Appleby, Louis

2006-08-01

The annual number of homicide convictions in England and Wales is increasing. Previous studies have highlighted the aetiological role of alcohol and drugs in homicide. To examine rates of alcohol and drug misuse and dependence in people convicted of homicide; the role of alcohol and drugs in the offence; the social and clinical characteristics of alcohol- and drug-related homicides; and the social and clinical characteristics of patients with dual diagnosis who commit homicide. A national clinical survey based on a 3-year (1996-9) consecutive sample of people convicted of homicide in England and Wales. Information on rates of alcohol and drug misuse/dependence, the role of alcohol and drugs in the offence and social and clinical characteristics of perpetrators were collected from psychiatric reports prepared for the court in homicide convictions. Detailed clinical information was gathered from questionnaires completed by mental health teams for those in contact with mental health services. Of the 1594 homicide perpetrators, more than one-third (42%) occurred in people with a history of alcohol misuse or dependence and 40% in people with a history of drug misuse or dependence. Alcohol or drug misuse played a contributory role in two-fifths of homicides. Alcohol played a major role in 52 (6%) and a minor role in 364 (39%) homicides. Drugs played a major role in six (1%) and a minor role in 138 (14%) homicides. Forty-two homicides (17%) were committed by patients with severe mental illness and substance misuse. Alcohol- and drug-related homicides were generally associated with male perpetrators who had a history of violence, personality disorders, mental health service contact and with stranger victims. Substance misuse contributes to the majority of homicides in England and Wales. A public health approach to homicide would highlight alcohol and drugs before severe mental illness.

Alcohol and drug misuse, abuse, and dependence in women veterans.

PubMed

Hoggatt, Katherine J; Jamison, Andrea L; Lehavot, Keren; Cucciare, Michael A; Timko, Christine; Simpson, Tracy L

2015-01-01

We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Alcohol misuse in Greece: a 15-year experience from a specialized outpatient service.

PubMed

Pomini, V; Mellos, L; Paparrigopoulos, T; Liappas, J

2014-01-01

Alcohol use in Greece is traditionally diffused among its population. According to general population surveys, three out of four Greeks aged 12-64 referred to alcohol consumption during the last year and 10% reported at least one episode of alcohol abuse during the last month. Furthermore, the large majority of young people aged 13-18 reported lifetime use of alcohol and 14.8% of them reported more than three episodes of alcohol abuse during the last month. Apparently, cultural factors have influenced the pattern of alcohol consumption and the ensuing alcohol-related problems during the last two decades. The "Athena" Service is an outpatient therapeutic unit for the management of substance misusers and their families. It is a specialized abstinence-oriented service that does not administer substance substitutes; mental health professionals of the service work as a multidisciplinary team. Motivational approaches, individual cognitive-behavioural psychotherapy and family interventions of a systemic orientation are the principal therapeutic techniques applied. Adjunctive medication is prescribed whenever mild to moderate concomitant psychopathology is detected. Support measures such as provisional use of medication, use of antagonistic agents or brief hospitalization can be provided if deemed necessary. No strict time limits are applied regarding treatment duration and discharge from the program. During the period 1998-2013, a total of 1511 individuals with alcohol-related problems addressed the service. The changing pattern of substance misuse over the last fifteen years can be summarized as follows: (a) there is a gradually increasing number of women misusing substances; (b) there is an increasing proportion of young adults reporting multi-substance use with concurrent psychiatric disorders; (c) there is an increasing proportion of young adults regularly using/misusing substances; (d) there is a decreasing proportion of middle-aged individuals presenting with chronic alcohol misuse and dependence, with a long-ago onset and slow development of alcohol-related problems; and (e) the proportion of older age individuals presenting chronic alcohol misuse and dependence with concurrent severe neurological impairments is increasing. Also, detailed information on a sample of 133 individuals who addressed the service for alcohol-related problems during 2012 is given and further discussed. Finally, the need for close monitoring of dangerous alcohol consumption and changing patterns of misuse in times of socio-economic crisis, alongside with an increasing need to provide treatment, is highlighted.

Screening for alcohol use disorders and at-risk drinking in the general population: psychometric performance of three questionnaires.

PubMed

Rumpf, Hans-Jürgen; Hapke, Ulfert; Meyer, Christian; John, Ulrich

2002-01-01

Most screening questionnaires are developed in clinical settings and there are few data on their performance in the general population. This study provides data on the area under the receiver-operating characteristic (ROC) curve, sensitivity, specificity, and internal consistency of the Alcohol Use Disorders Identification Test (AUDIT), the consumption questions of the AUDIT (AUDIT-C) and the Lübeck Alcohol Dependence and Abuse Screening Test (LAST) among current drinkers (n = 3551) of a general population sample in northern Germany. Alcohol dependence and misuse according to DSM-IV and at-risk drinking served as gold standards to assess sensitivity and specificity and were assessed with the Munich-Composite Diagnostic Interview (M-CIDI). AUDIT and LAST showed insufficient sensitivity for at-risk drinking and alcohol misuse using standard cut-off scores, but satisfactory detection rates for alcohol dependence. The AUDIT-C showed low specificity in all criterion groups with standard cut-off. Adjusted cut-points are recommended. Among a subsample of individuals with previous general hospital admission in the last year, all questionnaires showed higher internal consistency suggesting lower reliability in non-clinical samples. In logistic regression analyses, having had a hospital admission increased the sensitivity in detecting any criterion group of the LAST, and the number of recent general practice visits increased the sensitivity of the AUDIT in detecting alcohol misuse. Women showed lower scores and larger areas under the ROC curves. It is concluded that setting specific instruments (e.g. primary care or general population) or adjusted cut-offs should be used.

Genetic and Psychosocial Predictors of Alcohol Use Trajectories Among Disaster-Exposed Adolescents

PubMed Central

Bountress, Kaitlin; Danielson, Carla Kmett; Williamson, Vernell; Vladmirov, Vladimir; Gelernter, Joel; Ruggiero, Kenneth; Amstadter, Ananda

2017-01-01

Background and Objectives Adolescent alcohol misuse is associated with numerous long-term adverse outcomes, so we examined predictors of alcohol use among disaster-exposed adolescents, a group at-risk for alcohol misuse. Methods The current study (n =332) examined severity of tornado-related exposure, posttraumatic stress disorder (PTSD) symptoms, emotional support, and a genetic risk sum score (GRSS) as predictors of alcohol use trajectories. Results Severity of exposure interacted with the GRSS to predict both intercept (12-month follow up quantity of alcohol use) and growth rate. Emotional support also interacted with adolescent PTSD symptoms to predict intercept and growth rate. Discussion and Conclusions Adolescents with greater severity of disaster exposure and high genetic risk comprise a high risk group, on which efforts to prevent alcohol use should be focused. Additionally, emotional support is essential in buffering the effects of PTSD symptoms on alcohol use outcomes among adolescents. Scientific Significance Toward the aim of reducing adolescent alcohol misuse following disaster exposure, there is utility in inserting immediate supports (e.g., basic resources) into communities/families that have experienced significant disaster-related severity, particularly among adolescents at high levels of genetic risk for alcohol use/misuse. Additionally, prevention efforts aimed at improving emotional supports for adolescents with more PTSD symptoms may reduce propensity for alcohol misuse following disaster. This information can be easily incorporated into existing web-based interventions. PMID:28594439

Genetic and psychosocial predictors of alcohol use trajectories among disaster-exposed adolescents.

PubMed

Bountress, Kaitlin; Danielson, Carla Kmett; Williamson, Vernell; Vladmirov, Vladimir; Gelernter, Joel; Ruggiero, Kenneth; Amstadter, Ananda

2017-09-01

Adolescent alcohol misuse is associated with numerous long-term adverse outcomes, so we examined predictors of alcohol use among disaster-exposed adolescents, a group at-risk for alcohol misuse. The current study (n = 332) examined severity of tornado-related exposure, posttraumatic stress disorder (PTSD) symptoms, emotional support, and a genetic risk sum score (GRSS) as predictors of alcohol use trajectories. Severity of exposure interacted with the GRSS to predict both intercept (12-month follow up quantity of alcohol use) and growth rate. Emotional support also interacted with adolescent PTSD symptoms to predict intercept and growth rate. Adolescents with greater severity of disaster exposure and high genetic risk comprise a high risk group, on which efforts to prevent alcohol use should be focused. Additionally, emotional support is essential in buffering the effects of PTSD symptoms on alcohol use outcomes among adolescents. Toward the aim of reducing adolescent alcohol misuse following disaster exposure, there is utility in inserting immediate supports (e.g., basic resources) into communities/families that have experienced significant disaster-related severity, particularly among adolescents at high levels of genetic risk for alcohol use/misuse. Additionally, prevention efforts aimed at improving emotional supports for adolescents with more PTSD symptoms may reduce propensity for alcohol misuse following disaster. This information can be easily incorporated into existing web-based interventions. (Am J Addict 2017;26:623-631). © 2017 American Academy of Addiction Psychiatry.

Moving alcohol prevention research forward-Part II: new directions grounded in community-based system dynamics modeling.

PubMed

Apostolopoulos, Yorghos; Lemke, Michael K; Barry, Adam E; Lich, Kristen Hassmiller

2018-02-01

Given the complexity of factors contributing to alcohol misuse, appropriate epistemologies and methodologies are needed to understand and intervene meaningfully. We aimed to (1) provide an overview of computational modeling methodologies, with an emphasis on system dynamics modeling; (2) explain how community-based system dynamics modeling can forge new directions in alcohol prevention research; and (3) present a primer on how to build alcohol misuse simulation models using system dynamics modeling, with an emphasis on stakeholder involvement, data sources and model validation. Throughout, we use alcohol misuse among college students in the United States as a heuristic example for demonstrating these methodologies. System dynamics modeling employs a top-down aggregate approach to understanding dynamically complex problems. Its three foundational properties-stocks, flows and feedbacks-capture non-linearity, time-delayed effects and other system characteristics. As a methodological choice, system dynamics modeling is amenable to participatory approaches; in particular, community-based system dynamics modeling has been used to build impactful models for addressing dynamically complex problems. The process of community-based system dynamics modeling consists of numerous stages: (1) creating model boundary charts, behavior-over-time-graphs and preliminary system dynamics models using group model-building techniques; (2) model formulation; (3) model calibration; (4) model testing and validation; and (5) model simulation using learning-laboratory techniques. Community-based system dynamics modeling can provide powerful tools for policy and intervention decisions that can result ultimately in sustainable changes in research and action in alcohol misuse prevention. © 2017 Society for the Study of Addiction.

Tackling drug and alcohol misuse in Brazil: priorities and challenges for nurses.

PubMed

Rassool, G H; Villar-Luis, M

2004-12-01

To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.

Living in the Here and Now: Interrelationships between Impulsivity, Mindfulness, and Alcohol Misuse

PubMed Central

Murphy, Cara; MacKillop, James

2013-01-01

Rationale Impulsivity and mindfulness both emphasize orientation to the present, and both have been linked to alcohol misuse, but the relationship between the two is not clearly understood. Objectives To examine the relationships between elements of impulsivity and mindfulness, and to examine both variables in relation to alcohol misuse. Method Young adults (N = 116) were assessed for alcohol use, mindfulness, and impulsivity using psychometrically validated measures. Results Numerous significant associations were present among the facets of impulsivity and mindfulness. The variable most substantially associated with alcohol misuse was Negative Urgency (NU; i.e., proneness to act out under conditions of negative affect). After controlling for other variables, Negative Urgency (NU), Positive Urgency (PU), and delay discounting (DD) were significantly related to alcohol consumption. When examining drinking related consequences, only Lack of Premeditation (LoP) and Negative Urgency (NU) were significant associated. Conclusions There was considerable overlap between some elements of impulsivity and mindfulness while the overlap was negligible for other facets. The associations between mindfulness and alcohol misuse were entirely a function of impulsivity. In particular, acting on impulses while experiencing negative affect was significantly associated with level of alcohol consumption and level of alcohol-related risk. Steep discounting of future rewards was associated with alcohol consumption while poor premeditation was associated with adverse drinking consequences. These findings illustrate the importance of jointly studying impulsivity when examining purported effects of mindfulness traits. PMID:22169883

Social and Cultural Contexts of Alcohol Use

PubMed Central

Sudhinaraset, May; Wigglesworth, Christina; Takeuchi, David T.

2016-01-01

Alcohol use and misuse account for 3.3 million deaths every year, or 6 percent of all deaths worldwide. The harmful effects of alcohol misuse are far reaching and range from individual health risks, morbidity, and mortality to consequences for family, friends, and the larger society. This article reviews a few of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact. It includes a discussion of macrolevel factors, such as advertising and marketing, immigration and discrimination factors, and how neighborhoods, families, and peers influence alcohol use. Specifically, the article describes how social and cultural contexts influence alcohol use/misuse and then explores future directions for alcohol research. PMID:27159810

Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework.

PubMed

Sudhinaraset, May; Wigglesworth, Christina; Takeuchi, David T

2016-01-01

Alcohol use and misuse account for 3.3 million deaths every year, or 6 percent of all deaths worldwide. The harmful effects of alcohol misuse are far reaching and range from individual health risks, morbidity, and mortality to consequences for family, friends, and the larger society. This article reviews a few of the cultural and social influences on alcohol use and places individual alcohol use within the contexts and environments where people live and interact. It includes a discussion of macrolevel factors, such as advertising and marketing, immigration and discrimination factors, and how neighborhoods, families, and peers influence alcohol use. Specifically, the article describes how social and cultural contexts influence alcohol use/misuse and then explores future directions for alcohol research.

Problem gambling symptomatology and alcohol misuse among adolescents: A parallel-process latent growth curve model.

PubMed

Mutti-Packer, Seema; Hodgins, David C; El-Guebaly, Nady; Casey, David M; Currie, Shawn R; Williams, Robert J; Smith, Garry J; Schopflocher, Don P

2017-06-01

The objective of the current study was to examine the possible temporal associations between alcohol misuse and problem gambling symptomatology from adolescence through to young adulthood. Parallel-process latent growth curve modeling was used to examine the trajectories of alcohol misuse and symptoms of problem gambling over time. Data were from a sample of adolescents recruited for the Leisure, Lifestyle, and Lifecycle Project in Alberta, Canada (n = 436), which included 4 assessments over 5 years. There was an average decline in problem gambling symptoms followed by an accelerating upward trend as the sample reached the legal age to gamble. There was significant variation in the rate of change in problem gambling symptoms over time; not all respondents followed the same trajectory. There was an average increase in alcohol misuse over time, with significant variability in baseline levels of use and the rate of change over time. The unconditional parallel process model indicated that higher baseline levels of alcohol misuse were associated with higher baseline levels of problem gambling symptoms. In addition, higher baseline levels of alcohol misuse were associated with steeper declines in problem gambling symptoms over time. However, these between-process correlations did not retain significance when covariates were added to the model, indicating that one behavior was not a risk factor for the other. The lack of mutual influence in the problem gambling symptomatology and alcohol misuse processes suggest that there are common risk factors underlying these two behaviors, supporting the notion of a syndrome model of addiction. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Personality disorders, alcohol use, and alcohol misuse.

PubMed

Maclean, Johanna Catherine; French, Michael T

2014-11-01

Personality disorders (PDs) are psychiatric conditions that manifest early in life from a mixture of genetics and environment, are highly persistent, and lead to substantial dysfunction for the affected individual and those with whom s/he interacts. In this study we offer new information on the associations between PDs and alcohol use/misuse. Specifically, we consider all 10 PDs recognized by the American Psychiatric Association; carefully address important sources of bias in our regression models; and study heterogeneity across PDs, drinking pattern, and gender. To investigate the relationships between PDs and alcohol consumption we analyze data from the 2004/2005 National Epidemiological Survey of Alcohol and Related Conditions (N=34,653). We construct measures of any drinking, drinking quantity, and patterns of misuse that could lead to significant social costs including drinking to intoxication, driving after drinking, drinking during the day, and alcohol abuse/dependence. Results show that persons with PDs are significantly more likely to use and misuse alcohol, although associations vary across gender. Moreover, antisocial, borderline, histrionic, and narcissistic PDs display the strongest links with alcohol use and misuse, and the relationships are strongest among the heaviest drinkers. These findings have important public health implications and underscore the potential social costs associated with mental health conditions. Copyright © 2014 Elsevier Ltd. All rights reserved.

49 CFR 199.239 - Operator obligation to promulgate a policy on the misuse of alcohol.

Code of Federal Regulations, 2010 CFR

2010-10-01

... health, work, and personal life; signs and symptoms of an alcohol problem (the employee's or a coworker's); and including intervening evaluating and resolving problems associated with the misuse of alcohol including intervening when an alcohol problem is suspected, confrontation, referral to any available EAP...

49 CFR 199.239 - Operator obligation to promulgate a policy on the misuse of alcohol.

Code of Federal Regulations, 2011 CFR

2011-10-01

... health, work, and personal life; signs and symptoms of an alcohol problem (the employee's or a coworker's); and including intervening evaluating and resolving problems associated with the misuse of alcohol including intervening when an alcohol problem is suspected, confrontation, referral to any available EAP...

Tobacco and hazardous or harmful alcohol use in Thailand: joint prevalence and associations with socioeconomic factors.

PubMed

Aekplakorn, Wichai; Hogan, Margaret C; Tiptaradol, Siriwat; Wibulpolprasert, Suwit; Punyaratabandhu, Porapan; Lim, Stephen S

2008-04-01

This study estimates the individual and joint prevalence of cigarette smoking and alcohol misuse, and examines the association between these risks and socioeconomic factors in Thailand. The self-reported data on cigarette and alcohol use are from a 2004 nationally representative cross-sectional survey of 39290 individuals aged 15 and over. Substantially more men than women were current smokers (45.8% vs. 2.3%; p<0.001) as well as harmful (5.4% vs. 0.9%, p<0.0001) and hazardous alcohol users (11.2% vs. 1.2%, p<0.001). The strongest predictor of alcohol misuse was smoking, and the strongest predictor of smoking was alcohol misuse in both sexes. There was an inverse relationship between education and family income with the odds of current smoking, whereas average levels of family income (not low or high) were associated with higher odds of harmful or hazardous alcohol use. Tobacco and alcohol misuse could be more effectively addressed by targeting and tailoring programs towards those who are most at risk - joint tobacco and harmful or hazardous alcohol users, and those of lower socioeconomic status.

Vital Signs Screening for Alcohol Misuse in a Rural Primary Care Clinic: A Feasibility Study

ERIC Educational Resources Information Center

Seale, J. Paul; Guyinn, Monique R.; Matthews, Michael; Okosun, Ike; Dent, M. Marie

2008-01-01

Context: Alcohol misuse is more common in rural areas, and rural problem drinkers are less likely to seek alcohol treatment services. Rural clinics face unique challenges to implementing routine alcohol screening and intervention. Purpose: To assess the feasibility of using the single alcohol screening question (SASQ) during routine nursing vital…

[Screening for alcohol use by pregnant women of public health care in Rio de Janeiro, Brazil].

PubMed

Moraes, Claudia Leite; Reichenheim, Michael Eduardo

2007-10-01

To assess the prevalence of suspected cases of alcohol use during pregnancy in women seeking care in public health services. Cross-sectional study comprising 537 women randomly selected in public maternity hospitals in Rio de Janeiro, Southeastern Brazil, from March to October 2000. A well-trained team of female interviewers used the instruments Cut-down, Annoyed, Guilty, Eye-opener (CAGE), Tolerance Cut-down, Annoyed, Eye-opener (T-ACE) and Tolerance Worry Eye-opener Annoyed Cut-down (TWEAK) to assess suspect cases of alcohol misuse. The Chi-square test was used in the analysis according to socioeconomic and demographic variables. About 40% of women informed having used any type of alcoholic beverage during pregnancy. Beer was the most frequently used drink (83.9%). Depending on the measurement instrument used, estimates of alcohol misuse varied from 7.3% to 26.1%. Suspected cases of alcohol abuse were more common among non-white, older and less educated women; those not living with a partner; those reporting use of tobacco and illicit drugs either by one or both partners in a couple; and those with little social support. High prevalence of suspected alcohol misuse and its overlapping with several risk factors for adverse pregnancy outcomes indicate this is an important issue of public health concern requiring continuous screening during prenatal care.

Childhood socioeconomic status and longitudinal patterns of alcohol problems: Variation across etiological pathways in genetic risk.

PubMed

Barr, Peter B; Silberg, Judy; Dick, Danielle M; Maes, Hermine H

2018-05-14

Childhood socioeconomic status (SES) is an important aspect of early life environment associated with later life health/health behaviors, including alcohol misuse. However, alcohol misuse is modestly heritable and involves differing etiological pathways. Externalizing disorders show significant genetic overlap with substance use, suggesting an impulsivity pathway to alcohol misuse. Alcohol misuse also overlaps with internalizing disorders, suggesting alcohol is used to cope. These differing pathways could lead to different patterns over time and/or differential susceptibility to environmental conditions, such as childhood SES. We examine whether: 1) genetic risk for externalizing and internalizing disorders influence trajectories of alcohol problems across adolescence to adulthood, 2) childhood SES alters genetic risk these disorders on trajectories of alcohol problems, and 3) these patterns are consistent across sex. We find modest evidence of gene-environment interaction. Higher childhood SES increases the risk of alcohol problems in late adolescence/early adulthood, while lower childhood SES increases the risk of alcohol problems in later adulthood, but only among males at greater genetic risk of externalizing disorders. Females from lower SES families with higher genetic risk of internalizing or externalizing disorders have greater risk of developing alcohol problems. Copyright © 2018 Elsevier Ltd. All rights reserved.

Culture and alcohol use: historical and sociocultural themes from 75 years of alcohol research.

PubMed

Castro, Felipe Gonzalez; Barrera, Manuel; Mena, Laura A; Aguirre, Katherine M

2014-01-01

For the period of almost 75 years, we examined the literature for studies regarding the influences of culture on alcohol use and misuse. This review is a chronology of research articles published from 1940 to 2013. From a structured literature search with select criteria, 38 articles were identified and 34 reviewed. This analysis revealed a progression across this period of research from studies that began as descriptive ethnographic evaluations of one or more indigenous societies or cultural groups, evolving to studies using complex multivariate models to test cross-cultural effects in two or more cultural groups. Major findings across this period include the assertions that (a) a function of alcohol use may be to reduce anxiety, (b) certain cultural groups possess features of alcohol use that are not associated with negative consequences, (c) the disruptive effects of acculturative change and the stressors of new demands are associated with an increase in alcohol consumption, (d) cultural groups shape expectations about the effects of alcohol use and their definition of drunkenness, and (e) the hypothesized relationships of culture with alcohol use and misuse have been demonstrated in multivariate model analyses. Across this 75-year period, the early proposition that culture is an important and prominent correlate of alcohol use and misuse has persisted. Within the current era of alcohol studies, this proposition has been supported by multivariate model analyses. Thus, the proposition that culture might affect alcohol use remains prominent and is as relevant today as it was when it was first proposed nearly 75 years ago.

Alcohol misuse, risky sexual behaviors, and HIV or syphilis infections among Chinese men who have sex with men

PubMed Central

Liu, Yu; Ruan, Yuhua; Strauss, Shiela M.; Yin, Lu; Liu, Hongjie; Amico, K. Rivet; Zhang, Chen; Shao, Yiming; Qian, Han-Zhu; Vermund, Sten H.

2017-01-01

Background Few studies have employed standardized alcohol misuse measures to assess relationships with sexual risk and HIV/syphilis infections among Chinese men who have sex with men (MSM). Methods We conducted a cross-sectional study among MSM in Beijing during 2013–2014. An interviewer-administered survey was conducted to collect data on sociodemographics, high-risk behaviors, and alcohol use/misuse patterns (hazardous/binge drinking and risk of alcohol dependence) in the past 3 months using Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). We defined AUDIT-C score ≥4 as recent hazardous drinkers, and drinking ≥6 standard drinks on one occasion as recent binge drinkers. Results Of 3,588 participants, 14.4% reported hazardous drinking, 16.8% reported binge drinking. Hazardous and binge drinking are both associated with these factors (p<0.05): older age, being migrants, living longer in Beijing, township/village origin, being employed, higher income, self-perceived low/no HIV risk, and sex-finding via non-Internet venues. Hazardous (vs non-hazardous) or binge (vs. non-binge) drinkers were more likely to use illicit drugs, use alcohol before sex, have multiple partnerships, pay for sex, and have condomless insertive anal intercourse. MSM who reported binge (AOR, 1.34, 95% CI, 1.02–1.77) or hazardous (AOR, 1.36, 95% CI, 1.02–1.82) drinking were more likely to be HIV-infected. MSM at high risk of current alcohol dependence (AUDIT-C ≥8) were more likely to be HIV- (AOR, 2.37, 95% CI, 1.39–4.04) or syphilis-infected (AOR, 1.96, 95% CI, 1.01–3.86). Conclusions Recent alcohol misuse was associated with increased sexual and HIV/syphilis risks among Chinese MSM, emphasizing the needs of implementing alcohol risk reduction programs in this population. PMID:27723554

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

49 CFR 199.243 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ALCOHOL TESTING Alcohol Misuse Prevention Program § 199.243 Referral, evaluation, and treatment. (a) Each... abuse professionals and counseling and treatment programs. (b) Each covered employee who engages in conduct prohibited under §§ 199.215 through 199.223 shall be evaluated by a substance abuse professional...

Correlates of lifetime alcohol misuse among older community residents in Brazil

PubMed Central

Blay, Sergio Luis; Fillenbaum, Gerda G.; Andreoli, Sergio Baxter; Gastal, Fabio Leite

2009-01-01

Background Little is known about the sociodemographic correlates and health effects associated with lifetime alcohol misuse in community resident elderly in Brazil. Method Data came from a representative sample of 6961 residents aged 60+ in the State of Rio Grande do Sul, Brazil. The structured interview included a five-item lifetime alcohol use questionnaire addressing abuse and dependence, and enquiry regarding sociodemographic characteristics, lifestyle and social support, and health conditions. Results Of the sample, 10.6% (25.3% men, 2.9% women) endorsed at least one lifetime alcohol misuse question. Controlled analyses comparing a gradient of alcohol misuse (none, one, more than one item endorsed), found that men, people age 60–69 (compared to older persons), and tobacco users were more likely to endorse alcohol misuse items. Persons reporting lower income, and of nonWhite race/ethnicity did not differ from their comparison groups with respect to endorsing one item, but they were more likely to endorse two or more items. Endorsing more than one item was associated with impaired activities of daily living, the presence of respiratory problems and psychiatric disorder, but was protective against vascular conditions. Conclusions Major lifetime alcohol misuse (defined as endorsing more than one of five items reflecting alcohol abuse or dependence) is more common in certain sociodemographic groups (men, younger elderly, lower income, nonWhites). With the exception of vascular conditions, it is associated with smoking, poorer functional status, respiratory problems, and psychiatric disorder. Endorsing only one item has a reduced association, significant only for male gender, smoking, and psychiatric disorder. PMID:19141169

A Multidimensional Model of Mothers’ Perceptions of Parent Alcohol Socialization and Adolescent Alcohol Misuse

PubMed Central

Ennett, Susan T.; Jackson, Christine; Cole, Veronica T.; Haws, Susan; Foshee, Vangie A.; Reyes, Heathe Luz McNaughton; Burns, Alison Reimuller; Cox, Melissa J.; Cai, Li

2015-01-01

We assessed a multidimensional model of parent alcohol socialization in which key socialization factors were considered simultaneously to identify combinations of factors that increase or decrease risk for development of adolescent alcohol misuse. Of interest was the interplay between putative risk and protective factors, such as whether the typically detrimental effects on youth drinking of parenting practices tolerant of some adolescent alcohol use are mitigated by an effective overall approach to parenting and parental modeling of modest alcohol use. The sample included 1,530 adolescents and their mothers; adolescents’ mean age was 13.0 (SD = .99) at the initial assessment. Latent profile analysis was conducted of mothers’ reports of their attitude toward teen drinking, alcohol-specific parenting practices, parental alcohol use and problem use, and overall approach to parenting. The profiles were used to predict trajectories of adolescent alcohol misuse from early to middle adolescence. Four profiles were identified: two profiles reflected conservative alcohol-specific parenting practices and two reflected alcohol-tolerant practices, all in the context of other attributes. Alcohol misuse accelerated more rapidly from grade 6 through 10 in the two alcohol-tolerant compared with conservative profiles. Results suggest that maternal tolerance of some youth alcohol use, even in the presence of dimensions of an effective parenting style and low parental alcohol use and problem use, is not an effective strategy for reducing risky adolescent alcohol use. PMID:26415053

Alcohol Misuse Among Recent Latino Immigrants: The Protective Role of Preimmigration Familismo

PubMed Central

Dillon, Frank R.; De La Rosa, Mario; Sastre, Francisco; Ibañez, Gladys

2013-01-01

Familismo in the Latino culture is a value hallmarked by close relations with nuclear and extended family members throughout the life span, with pronounced levels of loyalty, reciprocity, and solidarity. Familismo is posited as health protective against alcohol misuse among Latinos in the United States. This study examines the relative influence of pre- and postimmigration familismo on alcohol use behaviors among recent Latino immigrants while accounting for myriad sociocultural factors (gender, age, documentation status, education, income, marital status, presence of family members in the United States, primary language used in the community, English language proficiency, and time in the United States). Participants included 405 young adults, aged 18 to 34 years, who were primarily of Cuban (50%), Columbian (19%), and Central American (15%) descent. Retrospective assessment of preimmigration familismo occurred during participants’ first 12 months in the United States. Follow-up assessment of alcohol use behaviors occurred during participants’ second year in the United States. Multiple Indicators Multiple Causes (MIMIC) path modeling was used to test study hypotheses. Inverse associations were determined between preimmigration familismo and alcohol use quantity and harmful/hazardous alcohol use. Men and participants who reported more proficiency in English, and those living in neighborhoods where English is predominantly spoken, indicated more alcohol use quantity and harmful/hazardous alcohol use. By considering both pre- and postimmigration determinants of alcohol use, findings offer a fuller contextual understanding of the lives of Latino young adult immigrants. Results support the importance of lifelong familismo as a buffer against alcohol misuse in young adulthood. PMID:23276317

Alcohol and labor supply: the case of Iceland.

PubMed

Asgeirsdottir, Tinna Laufey; McGeary, Kerry Anne

2009-10-01

At a time when the government of Iceland is considering privatization of alcohol sales and a reduction of its governmental fees, it is timely to estimate the potential effects of this policy change. Given that the privatization of sales coupled with a tax reduction should lead to a decrease in the unit price of alcohol, one would expect the quantity consumed to increase. While it is of interest to project the impact of the proposed bill on the market for alcohol, another important consideration is the impact that increased alcohol consumption and, more specifically, probable alcohol misuse would have on other markets in Iceland. The only available study on this subject using Icelandic data yields surprising results. Tómasson et al. (Scand J Public Health 32:47-52, 2004) unexpectedly found no effect of probable alcohol abuse on sick leave. A logical next step would be to examine the effect of probable alcohol abuse on other important labor-market outcomes. Nationally representative survey data from 2002 allow for an analysis of probable misuse of alcohol and labor-supply choices. Labor-supply choices are considered with reference to possible effects of policies already in force, as well as proposed changes to current policies. Contrary to intuition, but in agreement with the previously mentioned Icelandic study, the adverse effects of probable misuse of alcohol on employment status or hours worked are not confirmed within this sample. The reasons for the results are unclear, although some suggestions are hypothesized. Currently, data to test those theories convincingly are not available.

Associations of Drug Use, Violence, and Depressive Symptoms with Sexual Risk Behaviors Among Women with Alcohol Misuse.

PubMed

Lee, Kristen; Hutton, Heidi E; Lesko, Catherine R; Monroe, Anne K; Alvanzo, Anika; McCaul, Mary E; Chander, Geetanjali

2018-05-18

Alcohol misuse is associated with increased human immunodeficiency virus sexual risk behaviors by women. Drug use, intimate partner violence (IPV), and depressive symptoms frequently co-occur, are well-recognized alcohol misuse comorbidities, and may interact to increase risk behaviors. Using a syndemic framework we examined associations between drug use, IPV, and depressive symptoms and sexual risk behaviors by 400 women with alcohol misuse attending an urban sexually transmitted infections clinic. Participants completed computer-assisted interviews querying drug use, IPV, and depressive symptoms and sexual risk behavior outcomes-unprotected sex under the influence of alcohol, sex for drugs/money, and number of lifetime sexual partners. We used multivariable analysis to estimate prevalence ratios (PR) for independent and joint associations between drug use, IPV, and depressive symptoms and our outcomes. To investigate synergy between risk factors we calculated the relative excess prevalence owing to interaction for all variable combinations. In multivariable analysis, drug use, IPV, and depressive symptoms alone and in combination were associated with higher prevalence/count of risk behaviors compared with women with alcohol misuse alone. The greatest prevalence/count occurred when all three were present (unprotected sex under the influence of alcohol [PR, 2.6; 95% confidence interval, 1.3-4.9]), sex for money or drugs [PR, 2.6; 95% confidence interval, 1.7-4.2], and number of lifetime partners [PR, 3.2; 95% confidence interval, 1.9-5.2]). Drug use, IPV, and depressive symptoms did not interact synergistically to increase sexual risk behavior prevalence. A higher prevalence of sexual risk behaviors by women with alcohol misuse combined with drug use, IPV, and depressive symptoms supports the need for alcohol interventions addressing these additional comorbidities. Copyright © 2018 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Psychological interventions for the treatment of depression, anxiety, alcohol misuse or anger in armed forces veterans and their families: systematic review and meta-analysis protocol.

PubMed

O'Shea, Luke; Watkins, Ed; Farrand, Paul

2017-06-15

Evidence highlights a high prevalence of common mental health disorders in armed forces veterans and their families, with depression, anxiety, alcohol misuse and anger being more common than PTSD. This paper presents a protocol for a systematic review and meta-analysis to identify existing randomised controlled trial (RCT) research testing the effectiveness of psychological interventions for these difficulties in armed forces veterans and their family members. Electronic databases (CENTRAL, PsycInfo, MEDLINE, CINAHL, The Cochrane Register of Clinical Trials, EMBASE and ASSIA) will be searched to identify suitable studies for inclusion in the review supplemented by forward and backward reference checking, grey literature searches and contact with subject authors. Research including armed forces veterans and their family members will be included in the review with research including serving personnel or individuals under the age of 18 being excluded. Few RCTs examining the treatment of depression, anxiety, alcohol misuse or anger exist in armed forces veterans to date. The primary outcome will be symptomatic change following intervention for these difficulties. The secondary outcomes will include methodological aspects of interest such as discharge type and recruitment setting if data permits. In the event that the number of studies identified is too low to undertake a meta-analysis, a narrative review will be conducted. Quality assessment will be undertaken using the Cochrane Collaboration Tool and Cochran's Q statistic calculated to test for heterogeneity as suggested by the Cochrane handbook. The review will examine the findings of existing intervention research for depression, anxiety, alcohol misuse or anger in armed forces veterans and their families, along with any effect sizes that may exist. PROSPERO CRD42016036676.

Applications of virtual reality in individuals with alcohol misuse: A systematic review.

PubMed

Ghiţă, Alexandra; Gutiérrez-Maldonado, José

2018-06-01

Alcohol use and misuse have been intensively studied, due to their negative consequences in the general population. Evidence-based literature emphasizes that alcohol craving plays a crucial role in the development and maintenance of alcohol-drinking patterns. Many individuals develop Alcohol Use Disorders (AUD); significantly, after treatment many also experience relapses, in which alcohol craving has been repeatedly implicated. Cue-exposure therapy (CET) has been widely used in the treatment of alcohol misuse, but the results are inconsistent. Virtual reality (VR) can add effectiveness to cue-exposure techniques by providing multiple variables and inputs that enable personalized alcohol use assessment and treatment. The aim of this review was to examine the applications of virtual reality in individuals who misuse alcohol. We conducted an exhaustive literature search of the Web of Science, Scopus, Embase, Google Scholar, and PsycInfo databases, using as search items terms such as "alcohol" and its derivates, and virtual reality. We identified 13 studies on alcohol craving that implemented virtual reality as an assessment or treatment tool. The studies that incorporate VR present clear limitations. First, no clinical trials were conducted to explore the efficacy of the VR as a treatment tool; nor were there any studies of the generalization of craving responses in the real world, or of the long-term effects of VR treatment. Despite these limitations, the studies included showed consistent results as regards eliciting and reducing alcohol craving. We suggest that VR shows promise as a tool for the assessment and treatment of craving among individuals with alcohol misuse. Further studies implementing VR in the field of alcohol consumption are now required. Copyright © 2018 Elsevier Ltd. All rights reserved.

Comparison of Alcohol Use Disorder Screens During College Athlete Pre-Participation Evaluations.

PubMed

Majka, Erek; Graves, Travis; Diaz, Vanessa A; Player, Marty S; Dickerson, Lori M; Gavin, Jennifer K; Wessell, Andrea

2016-05-01

The US Preventive Services Task Force (USPSTF) recommends screening adults for alcohol misuse, a challenge among young adults who may not have regular primary care. The pre-participation evaluation (PPE) provides an opportunity for screening, but traditional screening tools require extra time in an already busy visit. The objective of this study was to compare the 10-item Alcohol Use Disorders Identification Test (AUDIT) with a single-question alcohol misuse screen in a population of college-aged athletes. This cross-sectional study was performed during an athletic PPE clinic at a college in the Southeastern United States among athletes ages 18 years and older. Written AUDIT and single-question screen "How many times in the past year have you had X or more drinks in a day?" (five for men, four for women) asked orally were administered to each participant. Sensitivity, specificity, and positive and negative predictive values for the single-question screen were compared to AUDIT. A total of 225 athletes were screened; 60% were female; 29% screened positive by AUDIT; 59% positive by single-question instrument. Males were more likely to screen positive by both methods. Compared to the AUDIT, the brief single-question screen had 92% sensitivity for alcohol misuse and 55% specificity. The negative predictive value of the single-question screen was 95% compared to AUDIT. A single-question screen for alcohol misuse in college-aged athletes had a high sensitivity and negative predictive value compared to the more extensive AUDIT screen. Ease of administration of this screening tool is ideal for use within the pre-participation physical among college-aged athletes who may not seek regular medical care.

Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings.

PubMed

Marotta, Phillip L

2017-05-12

Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

The social costs of alcohol misuse in Estonia.

PubMed

Saar, Indrek

2009-01-01

The aim of this study was to estimate the social costs of alcohol misuse in Estonia in 2006. Using a prevalence-based cost-of-illness approach, both direct and indirect costs were considered, including tangible costs associated with health care, criminal justice, rescue services, damage to property, premature mortality, incarceration, incapability of working due to illnesses, and lower labor productivity. The results show that alcohol misuse cost Estonia more than EUR 200 million in 2006. The costs involved are estimated to represent 1.6% of the gross domestic product (GDP), which is relatively high in comparison with many other countries. In addition, the state receives less receipts from the alcohol excise tax than the costs that it incurs as a consequence of alcohol misuse, which points to the existence of economic inefficiency with respect to the alcohol market. The results of this study suggest that there is definitely a need for further cost-benefit analysis to reach a conclusion regarding the possible utility of government intervention. Copyright 2008 S. Karger AG, Basel.

14 CFR 120.19 - Misuse of alcohol.

Code of Federal Regulations, 2014 CFR

2014-01-01

... safety-sensitive functions. (d) Pre-duty use. No covered employee shall perform air traffic control... accident shall use alcohol for 8 hours following the accident, unless he or she has been given a post-accident test under subpart F of this part or the employer has determined that the employee's performance...

14 CFR 120.19 - Misuse of alcohol.

Code of Federal Regulations, 2010 CFR

2010-01-01

... safety-sensitive functions. (d) Pre-duty use. No covered employee shall perform air traffic control... accident shall use alcohol for 8 hours following the accident, unless he or she has been given a post-accident test under subpart F of this part or the employer has determined that the employee's performance...

14 CFR 120.19 - Misuse of alcohol.

Code of Federal Regulations, 2013 CFR

2013-01-01

... safety-sensitive functions. (d) Pre-duty use. No covered employee shall perform air traffic control... accident shall use alcohol for 8 hours following the accident, unless he or she has been given a post-accident test under subpart F of this part or the employer has determined that the employee's performance...

14 CFR 120.19 - Misuse of alcohol.

Code of Federal Regulations, 2011 CFR

2011-01-01

... safety-sensitive functions. (d) Pre-duty use. No covered employee shall perform air traffic control... accident shall use alcohol for 8 hours following the accident, unless he or she has been given a post-accident test under subpart F of this part or the employer has determined that the employee's performance...

14 CFR 120.19 - Misuse of alcohol.

Code of Federal Regulations, 2012 CFR

2012-01-01

... safety-sensitive functions. (d) Pre-duty use. No covered employee shall perform air traffic control... accident shall use alcohol for 8 hours following the accident, unless he or she has been given a post-accident test under subpart F of this part or the employer has determined that the employee's performance...

Alcohol, Tobacco, and Other Drug Misuse Prevention and Cessation Programming for Alternative High School Youth: A Review

ERIC Educational Resources Information Center

Sussman, Steve; Arriaza, Bridget; Grigsby, Timothy J.

2014-01-01

Background: Relative to youth in regular high schools, alternative high school (AHS) youth are at high risk for alcohol, tobacco, and other drug (ATOD) misuse. Prevention and cessation efforts are needed for this population. Methods: A systematic, exhaustive literature search was completed to identify ATOD misuse prevention and cessation research…

The Influence of Parental Emotional Neglect on Assault Victims Seeking Treatment for Depressed Mood and Alcohol Misuse: A Pilot Study.

PubMed

Bailey, Kylie A; Baker, Amanda L; McElduff, Patrick; Kavanagh, David J

2016-10-09

This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS), depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants ( n = 220) with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions) project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation) identified the two assault factors of sexual assault ( SA ) and physical assault ( PA ). A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.

AUDIT-C scores as a scaled marker of mean daily drinking, alcohol use disorder severity, and probability of alcohol dependence in a U.S. general population sample of drinkers.

PubMed

Rubinsky, Anna D; Dawson, Deborah A; Williams, Emily C; Kivlahan, Daniel R; Bradley, Katharine A

2013-08-01

Brief alcohol screening questionnaires are increasingly used to identify alcohol misuse in routine care, but clinicians also need to assess the level of consumption and the severity of misuse so that appropriate intervention can be offered. Information provided by a patient's alcohol screening score might provide a practical tool for assessing the level of consumption and severity of misuse. This post hoc analysis of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) included 26,546 U.S. adults who reported drinking in the past year and answered additional questions about their consumption, including Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C) alcohol screening. Linear or logistic regression models and postestimation methods were used to estimate mean daily drinking, the number of endorsed alcohol use disorder (AUD) criteria ("AUD severity"), and the probability of alcohol dependence associated with each individual AUDIT-C score (1 to 12), after testing for effect modification by gender and age. Among eligible past-year drinkers, mean daily drinking, AUD severity, and the probability of alcohol dependence increased exponentially across increasing AUDIT-C scores. Mean daily drinking ranged from < 0.1 to 18.0 drinks/d, AUD severity ranged from < 0.1 to 5.1 endorsed AUD criteria, and probability of alcohol dependence ranged from < 1 to 65% across scores 1 to 12. AUD severity increased more steeply across AUDIT-C scores among women than men. Both AUD severity and mean daily drinking increased more steeply across AUDIT-C scores among younger versus older age groups. Results of this study could be used to estimate patient-specific consumption and severity based on age, gender, and alcohol screening score. This information could be integrated into electronic decision support systems to help providers estimate and provide feedback about patient-specific risks and identify those patients most likely to benefit from further diagnostic assessment. Copyright © 2013 by the Research Society on Alcoholism.

"You can never work with addictions in isolation": Addressing intimate partner violence perpetration by men in substance misuse treatment.

PubMed

Radcliffe, Polly; Gilchrist, Gail

2016-10-01

Studies have shown rates of IPV-perpetration among men in substance misuse treatment at rates far higher than the general population. There is poor evidence for the effectiveness of IPV perpetrator programmes. An analysis of drugs and alcohol policy documents 1998-2015 was conducted using discourse analysis to examine how English drug and alcohol policy has addressed IPV among substance misusers. Transcripts of interviews with 20 stake holders were analysed thematically. How policy 'frames' IPV-perpetration among drug and alcohol misusers has implications for service provision. IPV has increasingly been framed in terms of its implications for child safeguarding, and has been 'folded in' to policies targeting Troubled Families. With increasing 'localism' in English drug and alcohol policy there has been little specification of services for substance misusing IPV-perpetrators. Policy and literature produced by IPV perpetrator and victim organisations has framed IPV-perpetration as an individual choice with intoxication as a post hoc excuse for violence with limited implications for effective service development. Interviews with stake holders indicate a range of understandings/explanations for IPV among substance misusing men. Stake holders suggest that not all staff have the confidence or skills to ask men about their relationships and that there are few referral routes for substance misusing men who seek help for their IPV perpetration. There are gaps and contradictions in the extent to which English drug and alcohol policy has sought to address IPV-perpetration among substance misusers. Recent National Institute for Health and Care Excellence guidance provide an opportunity to include domestic abuse training for all front line social care staff including in the substance misuse sector. There is a need for further research into effective services for substance misusing perpetrators and the development of training for front-line staff. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Determinants of Problem Drinking and Depression among Latino Day Laborers

PubMed Central

Bacio, Guadalupe A.; Moore, Alison A.; Karno, Mitchell P.; Ray, Lara

2014-01-01

Little is known about alcohol misuse and depression among Latino day laborers despite the fact that they encounter multiple stressors (e.g. job instability, unsafe work environments). A structural equation model tested the relationships among laborer stress, social support, health status, current alcohol misuse, and depression. A sample of 89 male, urban Latino day laborers completed measures assessing these constructs in 2011. Stress was negatively related to physical health status, which was associated with depression. Findings suggest that stressors specific to being a day laborer resulting from their work and living conditions generate and maintain health disparities in this vulnerable population. PMID:24779503

Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study.

PubMed

McPherson, Tracy L; Goplerud, Eric; Derr, Dennis; Mickenberg, Judy; Courtemanche, Sherry

2010-11-01

Substantial empirical support exists for alcohol screening, brief intervention, and referral to treatment (SBIRT) in medical, but not non-medical settings such as the workplace. Workplace settings remain underutilised for delivering evidenced-based health services. This research aims to translate medical research into behavioural health-care practice in a telephonic call centre acting as a point of entry into an Employee Assistance Program (EAP). The goal of the study is to examine the feasibility of implementing routine telephonic alcohol SBIRT in an EAP call centre and assess whether routine SBIRT results in increased identification of workers who misuse alcohol. The design was pretest-posttest, one-group, pre-experimental. An alcohol SBIRT program developed based on World Health Organization recommendations was implemented in one EAP call centre serving one large employer. Workers were offered screening using the Alcohol Use Disorder Identification Test (AUDIT) during intake, brief counselling using motivational interviewing, referral to counselling, and follow-up. At 5 months, 93% of workers contacting the EAP completed the AUDIT-C: 40% prescreened positive and 52% went on to screen at moderate or high risk for an alcohol problem. Overall identification rate (18%) approached general US population estimates. Most agreed to follow-up and three-quarters set an appointment for face-to-face counselling. Integration of routine alcohol SBIRT into EAP practice is feasible in telephonic delivery systems and increases identification and opportunity for brief motivational counselling. When SBIRT is seamlessly integrated workers are willing to answer questions about alcohol and participate in follow-up.[McPherson TL, Goplerud E, Derr D, Mickenberg J, Courtemanche S. Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study. © 2010 Australasian Professional Society on Alcohol and other Drugs.

14 CFR 91.1051 - Pilot safety background check.

Code of Federal Regulations, 2014 CFR

2014-01-01

... previous employers must include, as applicable— (1) Crew member records. (2) Drug testing—collection, testing, and rehabilitation records pertaining to the individual. (3) Alcohol misuse prevention program...

14 CFR 91.1051 - Pilot safety background check.

Code of Federal Regulations, 2010 CFR

2010-01-01

... previous employers must include, as applicable— (1) Crew member records. (2) Drug testing—collection, testing, and rehabilitation records pertaining to the individual. (3) Alcohol misuse prevention program...

Prescription Stimulant Misuse, Alcohol Abuse, and Disordered Eating among College Students

ERIC Educational Resources Information Center

Ward, Rose Marie; Oswald, Barbara B.; Galante, Marina

2016-01-01

The misuse of prescription stimulants (MPS), risky drinking, and drunkorexia are current public health concerns. The present study assessed the prevalence of MPS and drunkorexia using an online survey. Specifically, we examined alcohol consumption, the Rutgers Alcohol Problem Index, Compensatory Eating and Behaviors in Response to Alcohol…

Alcohol Misuse in Reserve Soldiers and their Partners: Cross-Spouse Effects of Deployment and Combat Exposure.

PubMed

Vest, Bonnie M; Heavey, Sarah Cercone; Homish, D Lynn; Homish, Gregory G

2018-04-16

Military deployment and combat are associated with worse outcomes, including alcohol misuse. Less is known about how these experiences affect soldiers' spouses. The study objective was to explore relationships between deployment, combat exposure, and alcohol misuse; especially cross-spouse effects (effect of one partner's experiences/behavior on the other partner), which has been under-examined in military samples. U.S. Army Reserve/National Guard soldiers and their partners completed a questionnaire covering physical and mental health, military service and substance use. Negative binomial regression models examined number of deployments and combat exposure individually for alcohol misuse and frequent heavy drinking (FHD). In additional models, we examined combat exposure's role on alcohol outcomes, controlling for the soldiers' number of deployments, PTSD symptoms, age, and in cross-spouse models, alcohol use and FHD. We considered individuals' deployment experiences related to their alcohol outcomes and to their spouses' alcohol outcomes. The study sample included male soldiers with current/lifetime military service (n = 248) and their female partners. Combat exposure was related to FHD (RR: 1.01, p < .05, 95% CI: 1.01, 1.01) among male soldiers while controlling for PTSD symptoms, number of deployments, and age. Female partners of male soldiers were more likely to engage in FHD (RR: 1.01, p < .05, 95% CI: 1.01, 1.01) if their spouse experienced combat. Our results demonstrate that male soldiers and their spouses are at increased risk of FHD if the soldier experienced combat. This points to the need for better screening, particularly of spouses of soldiers, whose alcohol misuse may be overlooked.

Assessing the feasibility of screening and providing brief advice for alcohol misuse in general dental practice: a clustered randomised control trial protocol for the DART study

PubMed Central

Ntouva, Antiopi; Porter, Jessie; Crawford, Mike J; Britton, Annie; Gratus, Christine; Newton, Tim; Tsakos, Georgios; Heilmann, Anja; Pikhart, Hynek; Watt, Richard G

2015-01-01

Introduction Alcohol misuse is a significant public health problem with major health, social and economic consequences. Systematic reviews have reported that brief advice interventions delivered in various health service settings can reduce harmful drinking. Although the links between alcohol and oral health are well established and dentists come into contact with large numbers of otherwise healthy patients regularly, no studies have been conducted in the UK to test the feasibility of delivering brief advice about alcohol in general dental settings. Methods and analysis The Dental Alcohol Reduction Trial (DART) aims to assess the feasibility and acceptability of screening for alcohol misuse and delivering brief advice in patients attending National Health Service (NHS) general dental practices in North London. DART is a cluster randomised control feasibility trial and uses a mixed methods approach throughout the development, design, delivery and evaluation of the intervention. It will be conducted in 12 NHS general dental practices across North London and will include dental patients who drink above the recommended guidance, as measured by the Alcohol Use Disorders Identification Test (AUDIT-C) screening tool. The intervention involves 5 min of tailored brief advice delivered by dental practitioners during the patient's appointment. Feasibility and acceptability measures as well as suitability of proposed primary outcomes of alcohol consumption will be assessed. Initial economic evaluation will be undertaken. Recruitment and retention rates as well as acceptability of the study procedures from screening to follow-up will be measured. Ethics and dissemination Ethical approval was obtained from the Camden and Islington Research Ethics Committee. Study outputs will be disseminated via scientific publications, newsletters, reports and conference presentations to a range of professional and patient groups and stakeholders. Based on the results of the trial, recommendations will be made on the conduct of a definitive randomised controlled trial. Trial registration number ISRCTN81193263. PMID:26443659

The costs of alcohol, illegal drugs, and tobacco in Canada, 2002.

PubMed

Rehm, Jürgen; Gnam, William; Popova, Svetlana; Baliunas, Dolly; Brochu, Serge; Fischer, Benedikt; Patra, Jayadeep; Sarnocinska-Hart, Anna; Taylor, Benjamin

2007-11-01

The aim of this study was to estimate costs attributable to substance use and misuse in Canada in 2002. Based on information about prevalence of exposure and risk relations for more than 80 disease categories, deaths, years of life lost, and hospitalizations attributable to substance use and misuse were estimated. In addition, substance-attributable fractions for criminal justice expenditures were derived. Indirect costs were estimated using a modified human capital approach. Costs of substance use and misuse totaled almost Can. $40 billion in 2002. The total cost per capita for substance use and misuse was about Can. $1,267: Can. $463 for alcohol, Can. $262 for illegal drugs, and Can. $541 for tobacco. Legal substances accounted for the vast majority of these costs (tobacco: almost 43% of total costs; alcohol: 37%). Indirect costs or productivity losses were the largest cost category (61%), followed by health care (22%) and law enforcement costs (14%). More than 40,000 people died in Canada in 2002 because of substance use and misuse: 37,209 deaths were attributable to tobacco, 4,258 were attributable to alcohol, and 1,695 were attributable to illegal drugs. A total of about 3.8 million hospital days were attributable to substance use and misuse, again mainly to tobacco. Substance use and misuse imposes a considerable economic toll on Canadian society and requires more preventive efforts.

Interaction effects between the 5-hydroxy tryptamine transporter-linked polymorphic region (5-HTTLPR) genotype and family conflict on adolescent alcohol use and misuse.

PubMed

Kim, Jueun; Park, Aesoon; Glatt, Stephen J; Eckert, Tanya L; Vanable, Peter A; Scott-Sheldon, Lori A J; Carey, Kate B; Ewart, Craig K; Carey, Michael P

2015-02-01

To investigate whether the effects of family conflict on adolescent drinking differed as a function of 5-hydroxy tryptamine transporter-linked polymorphic region (5-HTTLPR) genotype cross-sectionally and prospectively in two independent samples of adolescents. Path analysis and multi-group analysis of two prospective datasets were conducted. United States and United Kingdom. Sample 1 was 175 adolescents in the United States (mean age = 15 at times 1 and 2 with a 6-month interval); Sample 2 was 4916 adolescents in the United Kingdon (mean age = 12 at time 1 and 15 at time 2). In both samples, demographics, tri-allelic 5-HTTLPR genotype and perceived family conflict were assessed at time 1. Alcohol use (frequency of drinking) and alcohol misuse (frequency of intoxication, frequency of drinking three or more drinks, maximum number of drinks) were assessed at times 1 and 2. A significant gene-environment interaction on alcohol misuse at time 1 was found in both sample 1 (β = 0.57, P = 0.001) and sample 2 (β = 0.19, P = 0.01), indicating that the 5-HTTLPR low-activity allele carriers exposed to higher levels of family conflict were more likely to engage in alcohol misuse than non-carriers. A significant gene-environment interaction effect on change in alcohol misuse over time was found only in sample 1 (β = 0.48, P = 0.04) but not in sample 2. Compared with non-carriers, adolescents carrying the 5-HTTLPR low-activity allele are more susceptible to the effects of family conflict on alcohol misuse. © 2014 Society for the Study of Addiction.

Universal alcohol misuse prevention programmes for children and adolescents: Cochrane systematic reviews.

PubMed

Foxcroft, David R; Tsertsvadze, Alexander

2012-05-01

Alcohol misuse by young people causes significant health and social harm, including death and disability. Therefore, prevention of youth alcohol misuse is a policy aim in many countries. Our aim was to examine the effectiveness of (1) school-based, (2) family-based and (3) multi-component universal alcohol misuse prevention programmes in children and adolescents. Three Cochrane systematic reviews were performed: searches in MEDLINE, EMBASE, PsycINFO, Project CORK and the Cochrane Register of Controlled Trials up to July 2010, including randomised trials evaluating universal alcohol misuse prevention programmes in school, family or multiple settings in youths aged 18 years or younger. Two independent reviewers identified eligible studies and any discrepancies were resolved via discussion. A total of 85 trials were included in the reviews of school (n = 53), family (n = 12) and multi-component (n = 20) programmes. Meta-analysis was not performed due to study heterogeneity. Most studies were conducted in North America. Risk of bias assessment revealed problems related to inappropriate unit of analysis, moderate to high attrition, selective outcome reporting and potential confounding. Certain generic psychosocial and life skills school-based programmes were effective in reducing alcohol use in youth. Most family-based programmes were effective. There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions. In these Cochrane reviews, some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies identified in these reviews and pay particular attention to content and context factors through rigorous evaluation.

Alcohol-related driving in China: Countermeasure implications of research conducted in two cities.

PubMed

Jia, Keqin; Fleiter, Judy; King, Mark; Sheehan, Mary; Ma, Wenjun; Lei, Jing; Zhang, Jianzhen

2016-10-01

Drunk driving (blood alcohol concentration (BAC) 80mg/100ml) was upgraded to become a criminal offence under China's Criminal Law in May 2011. While this had a major road safety benefit, there was still a high level of alcohol related crashes and fatalities. This paper develops recommendations based on a programme of research undertaken in 2012 that examined the perceptions of general motor vehicle drivers, convicted drunk driving offenders and traffic police about drinking and driving and law enforcement in the cities of Guangzhou and Yinchuan. Alcohol misuse problems were also explored using the Alcohol Use Disorders Identification Test (AUDIT). This paper integrates the findings to examine existing problems in alcohol management, law enforcement, education and rehabilitation and provides recommendations for addressing alcohol-related driving in China. A multi-study cross-sectional research programme was conducted in two Chinese cities involving general drivers, drunk driving offenders and traffic police. In total, 16 traffic police officers were interviewed and 105 traffic police officers were surveyed. In addition, 207 drunk driving offenders in detention facilities and 802 general motor vehicle drivers were surveyed. Traffic police resources including human resources and facilities such as breathalysers were reported as insufficient in both cities. There were problems reported in the process of law enforcement, and shortcomings in police knowledge of factors involved in drink/drunk driving and in the practice of conducting breath alcohol testing (BAT). Knowledge about legal BAC levels and how to keep under the legal limit was very low among general motor vehicle drivers and drunk driving offenders. Proportions with alcohol misuse problems in the two driver groups were high, especially among offenders. Recommendations to manage alcohol-related driving are proposed for the three groups of traffic police, general motor vehicle drivers and drunk driving offenders. In particular, traffic police resources need to be improved and further education provided to police on the general deterrence potential of BAT. There should be enhanced community education and publicity to improve knowledge of drink driving regulations and how to avoid breaking the law. Alcohol misuse problems should be addressed, particularly for drunk driving offenders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Alcohol and Cigarette Use and Misuse among Hurricane Katrina Survivors: Psychosocial Risk and Protective Factors

PubMed Central

Flory, Kate; Hankin, Benjamin L.; Kloos, Bret; Cheely, Catherine; Turecki, Gustavo

2008-01-01

The present study examined survivors’ use and misuse of cigarettes and alcohol following Hurricane Katrina. We also examined several psychosocial factors that we expected would be associated with higher or lower rates of substance use following the Hurricane. Participants were 209 adult survivors of Hurricane Katrina interviewed in Columbia, SC or New Orleans, LA between October 31, 2005 and May 13, 2006. Results revealed that survivors were smoking cigarettes, consuming alcohol, and experiencing alcohol-related problems at a substantially higher rate than expected based on pre-Hurricane prevalence data. Results also suggested that certain psychosocial factors were associated with participants’ substance use and misuse following the Hurricane. PMID:19895302

The latent structure of alcohol misuse in young adults: Do taxometric results differ as a function of prior criminal history?

PubMed

Walters, Glenn D

2015-12-01

The purpose of this study was to determine whether the latent structure of alcohol misuse is categorical or continuous in male and female adults with and without a history of prior criminal offending. Data from 3452 (1530 male, 1922 female) 27-to-32 year old members of the National Longitudinal Study of Adolescent to Adult Health (Add Health) were subjected to taxometric analysis using three nonredundant taxometric procedures--mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent mode factor analysis (L-Mode). Analyses produced results consistent with categorical latent structure in males with a previous history of criminal offending but not in males without a previous history of criminal offending or females with or without a history of criminal offending. The findings from the other groups were indeterminate for the most part (i.e., neither categorical nor continuous). The presumptive taxon was validated by testing differences in age of onset and frequency of criminal arrest and drunkenness between the putative taxon and the upper portion of the complement. As predicted, all four validation outcomes were significantly worse in the taxon group. On the basis of these results it is concluded that alcohol misuse in young adults may have features of both categorical and continuous latent structure and that the categorical aspects are more prominent in males with a history of offending behavior. Additional research is required to determine which aspects and features of alcohol misuse are categorical and which aspects and features are continuous. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Targeting Alcohol Misuse: A Promising Strategy for Reducing Military Sexual Assaults?

DTIC Science & Technology

2014-01-01

unit” (Barlas et al., 2013). In addition, alcoholic beverages are available at military installations at reduced prices (DoDI 1330.09), which is worth...Vol. 39, No. 1994, pp. 99–112. Wagenaar, Alexander C., Matthew J. Salois, and Kelli A. Komro, “Effects of Beverage Alcohol Price and Tax Levels on...consideration of policies to reduce alcohol misuse as a part of a strategy to prevent sexual assaults as well as a broader strategy to address alcohol use

The Effect of Neighborhood Context on the Relationship Between Substance Misuse and Weapons Aggression in Urban Adolescents Seeking ED Care

PubMed Central

Goldstick, Jason Elliott; Lipton, Robert I.; Carter, Patrick; Stoddard, Sarah A.; Newton, Manya F.; Reischl, Thomas; Walton, Maureen; Zimmerman, Marc A.; Cunningham, Rebecca M.

2015-01-01

Background Frameworks for studying the ecology of human behavior suggest that multiple levels of the environment influence behavior and that these levels interact. Applied to studies of weapons aggression, this suggests proximal risk factor (e.g., substance use) effects may differ across neighborhoods. Objectives To estimate how the association between weapons aggression and substance use varies as a function of several community-level variables. Methods Individual-level measures (demographics, behavioral measures) were obtained from a survey of youth aged 14–24 years old seeking care at a Level-1 ED in Flint, Michigan. Community-level variables were obtained from public sources. Logistic generalized additive models were used to test whether community-level variables (crime rates, alcohol outlets, demographics) modify the link between individual-level substance use variables and the primary outcome measure: self-reported past 6-month weapon (firearm/knife) related aggression. Results The effect of marijuana misuse on weapons aggression varied significantly as a function of five community-level variables: racial composition, vacant housing rates, female headed household rates, density of package alcohol outlets, and nearby drug crime rates. The effect of high-risk alcohol use did not depend on any of the eight community variables tested. Conclusions The relationship between marijuana misuse and weapons aggression differed across neighborhoods with generally less association in more disadvantaged neighborhoods, while high-risk alcohol use showed a consistently high association with weapons aggression that did not vary across neighborhoods. The results aid in understanding the contributions of alcohol and marijuana use to the etiology of weapon-related aggression among urban youth, but further study in the general population is required. PMID:25607807

The Effect of Neighborhood Context on the Relationship Between Substance Misuse and Weapons Aggression in Urban Adolescents Seeking ED Care.

PubMed

Goldstick, Jason Elliott; Lipton, Robert I; Carter, Patrick; Stoddard, Sarah A; Newton, Manya F; Reischl, Thomas; Walton, Maureen; Zimmerman, Marc A; Cunningham, Rebecca M

2015-04-01

Frameworks for studying the ecology of human behavior suggest that multiple levels of the environment influence behavior and that these levels interact. Applied to studies of weapons aggression, this suggests proximal risk factor (e.g., substance use) effects may differ across neighborhoods. To estimate how the association between weapons aggression and substance use varies as a function of several community-level variables. Individual-level measures (demographics, behavioral measures) were obtained from a survey of youth aged 14-24 years old seeking care at a Level-1 ED in Flint, Michigan. Community-level variables were obtained from public sources. Logistic generalized additive models were used to test whether community-level variables (crime rates, alcohol outlets, demographics) modify the link between individual-level substance use variables and the primary outcome measure: self-reported past 6-month weapon (firearm/knife) related aggression. The effect of marijuana misuse on weapons aggression varied significantly as a function of five community-level variables: racial composition, vacant housing rates, female headed household rates, density of package alcohol outlets, and nearby drug crime rates. The effect of high-risk alcohol use did not depend on any of the eight community variables tested. The relationship between marijuana misuse and weapons aggression differed across neighborhoods with generally less association in more disadvantaged neighborhoods, while high-risk alcohol use showed a consistently high association with weapons aggression that did not vary across neighborhoods. The results aid in understanding the contributions of alcohol and marijuana use to the etiology of weapon-related aggression among urban youth, but further study in the general population is required.

An exploratory study of the relationship between parental attitudes and behaviour and young people's consumption of alcohol.

PubMed

Moore, Graham F; Rothwell, Heather; Segrott, Jeremy

2010-04-22

Concern is growing regarding frequent and excessive misuse of alcohol by young people. The average age at which young people in Europe start to drink is twelve and a half, and during the last decade, the quantity of alcohol consumed by younger adolescents in the UK has increased. Families are known to play an important role in shaping young people's alcohol misuse, although family risk and protective factors associated with misuse in a UK context are in need of further investigation. The study used a cross-sectional design, involving secondary analyses of self-completion questionnaire responses from 6,628 secondary school children (i.e. aged 11-16 years), from 12 schools within an urban location in Wales. Items relating to family functioning and perceived parental attitudes were first subjected to factor analysis. Associations of family closeness and conflict, parental monitoring and attitudes and family history of substance misuse with children's self reported alcohol consumption were examined using logistic regression analyses. Approximately three quarters of respondents reported having tried alcohol, most of whom had first tried alcohol aged 12 or under. Parental monitoring and family closeness were positively correlated with one another and were both associated with significantly lower levels of drinking behaviours. Family violence and conflict, more liberal parental attitudes towards substance use and towards alcohol and petty crime, and family history of substance misuse were positively correlated with one another and with higher levels of drinking behaviours. Parental monitoring was identified as the family functioning factor most consistently associated with drinking behaviour in multivariate analyses. Significant relationships were found between young people's drinking behaviours and perceptions of risk and protective factors in the family environment. Parental monitoring was strongly associated with family closeness and appeared to form one part of a parenting style of more general communication and regulation of children's behaviour. Findings support the need for alcohol misuse prevention interventions which address risk and protective factors within the family setting. Timing of such prevention work should be related both to the development of family relationships and the age at which young people begin drinking alcohol.

Decreased risk of alcohol dependence and/or misuse in women with high self-assertiveness and leadership abilities.

PubMed

Hensing, G; Spak, F; Thundal, K L; Ostlund, A

2003-01-01

To analyse dimensions of gender identity and its association to psychiatric disorders and alcohol consumption. The study was performed in two stages: an initial screening (n = 8335) for alcohol consumption, followed by a structured psychiatric interview (n = 1054). The Masculinity/Femininity-Questionnaire was used as an indicator of gender identity. The final study group included 836 women. Leadership, caring, self-assertiveness and emotionality were dimensions of gender identity found in a factor analysis. Low self-assertiveness, high emotionality and to some extent low leadership were associated with increased odds for having bipolar disorders, severe anxiety disorders and alcohol dependence and misuse. Low self-assertiveness and high emotionality were not only associated with alcohol dependence and misuse, but also with high episodic drinking. There was an association between some of the dimensions of gender identity and psychiatric disorders and alcohol consumption. Further attention is needed in both clinical work and research.

Protocol for a cluster-randomised controlled trial evaluating the impact of a preschool-based capacity building intervention on intimate partner violence and substance misuse in Sri Lanka.

PubMed

Lokuge, Kamalini; Wallace, Polly; Subasinghe, Kalini; Thurber, Katherine; De Silva, Tissa; Clarke, Naomi; Waas, Dulshika; Liyanage, Nisansala; Attygalle, Udena; Carron-Arthur, Bradley; Rodrigo, Kalyana; Banks, Emily; D'Este, Cate; Rajapakse, Thilini

2018-05-02

Past research has identified links between intimate partner violence (IPV) and alcohol misuse and poverty in Sri Lanka. Services that address substance misuse are amongst the few interventions shown to reduce IPV in settings similar to Sri Lanka. This paper describes the protocol for a study examining the impact of a preschool-based capacity building intervention on the prevalence of IPV and substance misuse in parents with children attending preschools, including uptake of available government services. The study is a cluster randomised controlled trial. Government-managed preschools (n = 34) in Galle and Colombo municipalities  will be randomly assigned to an intervention (n = 17) or control group (n = 17). Parents with children attending these preschools will be recruited to participate. The study intervention will build the capacity of selected community volunteers (parents) and preschool teachers in the provision of information and support to families affected by IPV and substance misuse. This intervention is directed at improving uptake, access and coordination of existing services. Data will be collected from all parents, and teachers in the intervention group, pre-intervention and 10 months post-intervention. The primary outcome for this study is experience of IPV amongst mothers of preschool-attending children. Secondary outcomes are substance misuse amongst fathers, measured via the locally adapted Alcohol Use Disorders Identification Test and Drug Abuse Screening Test; and awareness and uptake of services for these issues measured through locally-relevant tools. Demographic information and satisfaction with the intervention will also be assessed. By intervening through preschools we aim to support high-risk families early enough to arrest the cycle of violence that results in children themselves becoming victims and perpetrators of such violence. The innovative project design will reach the most vulnerable sections of the community and will provide a sustainable and feasible strategy for scale-up of the intervention. This study is registered with the Sri Lankan Clinical Trials Registry (2017/038) and has been submitted to ClinicalTrials.gov (U.S National Institutes of Health) under the title "Randomized control trial: preschool-based training and support programs to reduce intimate partner violence (IPV) by addressing alcohol and drug misuse in young families in Sri Lanka"; Registration number: NCT03341455 ; Registration date: 14 November 2017.

Treatment of substance misuse in older women: using a brief intervention model.

PubMed

Finfgeld-Connett, Deborah L

2004-08-01

Alcohol and benzodiazepine misuse is a significant problem in older women for a number of reasons such as physiological changes, outdated prescribing practices, and failure to identify hazardous use. In addition, treatment barriers involving the health-care system, conflicting information, and ageism also exist. Substance misuse among older women is predicted to become a bigger problem as the baby boom generation ages. Brief interventions that consist of assessment, feedback, responsibility, advice, menu, empathy, and self-efficacy, or A-FRAMES, have the potential to reduce alcohol and benzodiazepine misuse among older women in a cost-effective manner.

Readability of Self-Report Alcohol Misuse Measures

PubMed Central

McHugh, R Kathryn; Sugarman, Dawn E; Kaufman, Julia S; Park, Sara; Weiss, Roger D; Greenfield, Shelly F

2014-01-01

Objective: Self-report measures of alcohol misuse and alcohol use disorders are valuable assessment tools for both research and clinical practice settings. However, readability is often overlooked when establishing the validity of these measures, which may result in measures written at a reading-grade level that is higher than the ability level of many potential respondents. The aim of the current study was to estimate the reading-grade level of validated measures of alcohol misuse and associated problems. Method: A total of 45 measures were identified, and reading-grade level was calculated using three validated readability formulas. Results: The majority of measures were written above the recommended reading-grade level for patient materials (5th–6th grade), with particularly poor readability for measure instructions. Conclusions: Given that many self-report alcohol misuse measures are written at a high reading-grade level, the consideration of readability is important when selecting measures for use in research and practice settings. Moreover, the development or modification of measures to target low-literacy populations may facilitate the broader applicability of these instruments. PMID:24650827

Bicultural stress, identity formation, and alcohol expectancies and misuse in Hispanic adolescents: a developmental approach.

PubMed

Oshri, Assaf; Schwartz, Seth J; Unger, Jennifer B; Kwon, Josephine A; Des Rosiers, Sabrina E; Baezconde-Garbanati, Lourdes; Lorenzo-Blanco, Elma I; Córdova, David; Soto, Daniel W; Lizzi, Karina M; Villamar, Juan A; Szapocznik, José

2014-12-01

Hispanic immigrant youth engage in increased health risk behaviors, such as alcohol misuse, due in part to being confronted with acculturative stress in addition to facing major normative developmental challenges, such as identity consolidation (Berry et al. in Appl Psychol 55:303-332, 2006). Using a developmental psychopathology framework, in the present study we examined the effect of bicultural stress on alcohol misuse among immigrated Hispanic adolescents, indirectly through trajectories of identity formation and alcohol expectancies. Our sample consisted of 302 recently immigrated Hispanic adolescents (53 % male; Mage = 14.5 at baseline) who were interviewed every 6 months for 3 years. Bivariate growth curve modeling was used to examine the influence of initial early bicultural stress on later alcohol misuse via change in identity development (i.e., coherence and confusion) and subsequent growth in cognitive alcohol expectancies. Findings revealed that initial levels and growth of identity coherence were not significantly associated with either bicultural stress or tension reduction (TR) alcohol expectancies. Multiple mediation analyses indicated that the effect of bicultural stress at time 1 on the frequency of being drunk at time 6 was mediated via high initial levels of identity confusion, followed by growth in risky TR expectancies (T4-T6). A developmental approach to the genesis of alcohol use problems in immigrant youth is discussed.

Pilot study of traumatic brain injury and alcohol misuse among service members.

PubMed

Bogner, Jennifer; French, Louis M; Lange, Rael T; Corrigan, John D

2015-01-01

Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Service members (n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention.

49 CFR 655.5 - Stand-down waivers for drug testing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Stand-down waivers for drug testing. 655.5 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS General § 655.5 Stand-down waivers for drug testing. (a) An employer subject to this part may...

49 CFR 655.5 - Stand-down waivers for drug testing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Stand-down waivers for drug testing. 655.5 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS General § 655.5 Stand-down waivers for drug testing. (a) An employer subject to this part may...

49 CFR 655.5 - Stand-down waivers for drug testing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Stand-down waivers for drug testing. 655.5 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS General § 655.5 Stand-down waivers for drug testing. (a) An employer subject to this part may...

49 CFR 655.5 - Stand-down waivers for drug testing.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Stand-down waivers for drug testing. 655.5 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS General § 655.5 Stand-down waivers for drug testing. (a) An employer subject to this part may...

49 CFR 655.5 - Stand-down waivers for drug testing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Stand-down waivers for drug testing. 655.5 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS General § 655.5 Stand-down waivers for drug testing. (a) An employer subject to this part may...

Representations of Codeine Misuse on Instagram: Content Analysis

PubMed Central

Cherian, Roy; Westbrook, Marisa; Ramo, Danielle

2018-01-01

Background Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). Objective The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. Methods We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. Results A majority of images (50/100; 50.0%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. Conclusions The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. PMID:29559422

Family violence, employment status, welfare benefits, and alcohol drinking in the United States: what is the relation?

PubMed Central

Rodriguez, E; Lasch, K; Chandra, P; Lee, J

2001-01-01

OBJECTIVES—This study examined the contribution of employment status, welfare benefits, alcohol use, and other individual, and contextual factors to physical aggression during marital conflict.
METHODS—Logistic regression models were used to analyse panel data collected in the National Survey of Families and Households in 1987 and 1992. A total of 4780 married or cohabiting persons re-interviewed in 1992 were included in the analysis. Domestic violence was defined as reporting that both partners were physically violent during arguments.
RESULTS—It was found that non-employed respondents are not at greater risk of family violence in comparison with employed respondents, after controlling for alcohol misuse, income, education, age, and other factors; however, employed persons receiving welfare benefits are at significantly higher risk. Alcohol misuse, which remains a predictor of violence even after controlling for other factors, increases the risk of family violence while satisfaction with social support from family and friends decreases it.
CONCLUSION—These results underscore the important effect of alcohol misuse on domestic violence, and the need to monitor the potential impact of welfare reform on domestic violence.


Keywords: family violence; alcohol misuse; employment status; welfare benefits PMID:11160171

From Pubs to Scrubs: Alcohol Misuse and Health Care Use

PubMed Central

Balsa, Ana I; French, Michael T; Maclean, Johanna Catherine; Norton, Edward C

2009-01-01

Objective To analyze the relationships between alcohol misuse and two types of acute health care use—hospital admissions and emergency room (ER) episodes. Data Sources/Study Setting The first (2001/2002) and second (2004/2005) waves of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). Study Design Longitudinal study using a group of adults (18–60 years in Wave 1, N=23,079). Gender-stratified regression analysis adjusted for a range of covariates associated with health care use. First-difference methods corrected for potential omitted variable bias. Data Collection The target population of the NESARC was the civilian noninstitutionalized population aged 18 and older residing in the United States and the District of Columbia. The survey response rate was 81 percent in Wave 1 (N=43,093) and 65 percent in Wave 2 (N=34,653). Principal Findings Frequent drinking to intoxication was positively associated with hospital admissions for both men and women and increased the likelihood of using ER services for women. Alcohol dependence and/or abuse was related to higher use of ER services for both genders and increased hospitalizations for men. Conclusions These findings provide updated and nationally representative estimates of the relationships between alcohol misuse and health care use, and they underscore the potential implications of alcohol misuse on health care expenditures. PMID:19500163

Moving alcohol prevention research forward-Part I: introducing a complex systems paradigm.

PubMed

Apostolopoulos, Yorghos; Lemke, Michael K; Barry, Adam E; Lich, Kristen Hassmiller

2018-02-01

The drinking environment is a complex system consisting of a number of heterogeneous, evolving and interacting components, which exhibit circular causality and emergent properties. These characteristics reduce the efficacy of commonly used research approaches, which typically do not account for the underlying dynamic complexity of alcohol consumption and the interdependent nature of diverse factors influencing misuse over time. We use alcohol misuse among college students in the United States as an example for framing our argument for a complex systems paradigm. A complex systems paradigm, grounded in socio-ecological and complex systems theories and computational modeling and simulation, is introduced. Theoretical, conceptual, methodological and analytical underpinnings of this paradigm are described in the context of college drinking prevention research. The proposed complex systems paradigm can transcend limitations of traditional approaches, thereby fostering new directions in alcohol prevention research. By conceptualizing student alcohol misuse as a complex adaptive system, computational modeling and simulation methodologies and analytical techniques can be used. Moreover, use of participatory model-building approaches to generate simulation models can further increase stakeholder buy-in, understanding and policymaking. A complex systems paradigm for research into alcohol misuse can provide a holistic understanding of the underlying drinking environment and its long-term trajectory, which can elucidate high-leverage preventive interventions. © 2017 Society for the Study of Addiction.

Physical dating violence among adolescents and young adults with alcohol misuse.

PubMed

Singh, Vijay; Epstein-Ngo, Quyen; Cunningham, Rebecca M; Stoddard, Sarah A; Chermack, Stephen T; Walton, Maureen A

2015-08-01

This study determined prevalence and correlates of physical dating violence (victimization or aggression) among male and female youth with alcohol misuse and seeking emergency department (ED) care. Patients age 14-20 seeking care at a single large university-based ED completed a computerized, self-administered, cross-sectional survey. Measures included demographics, alcohol and substance use, mental health problems, health service use, peer influences, parent support, and community involvement. Bivariate and multivariate regression assessed physical dating violence correlates. Among 842 male and female youth seeking ED care who screened positive for alcohol misuse, 22.3% (n=188) reported dating violence in the past year. Multivariate analyses showed variables associated with dating violence were female gender (AOR 2.17, CI 1.46-3.22), Caucasian race (AOR 0.59, CI 0.37-0.93), receipt of public assistance (AOR 1.82, CI 1.16-2.87), AUDIT Score (AOR 1.06, CI 1.02-1.10), older age of drinking onset (AOR 0.86, CI 0.77-0.96), suicidal ideation or attempt (AOR 1.95, CI 1.13-3.37), frequency of ED visits (AOR 1.22, CI 1.05-1.46), negative peer influences (AOR 1.05, CI 1.01-1.10), and positive peer influences (AOR 0.86, CI 0.80-0.93). Nearly 1 in 4 youth with alcohol misuse seeking ED care report dating violence. Key correlates of dating violence included alcohol use severity, suicidal ideation, ED services, and peer influences. Evidence-based dating violence interventions addressing these correlates are needed for youth with alcohol misuse seeking ED care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The impact of substance use on brain structure in people at high risk of developing schizophrenia.

PubMed

Welch, Killian A; McIntosh, Andrew M; Job, Dominic E; Whalley, Heather C; Moorhead, Thomas W; Hall, Jeremy; Owens, David G C; Lawrie, Stephen M; Johnstone, Eve C

2011-09-01

Ventricular enlargement and reduced prefrontal volume are consistent findings in schizophrenia. Both are present in first episode subjects and may be detectable before the onset of clinical disorder. Substance misuse is more common in people with schizophrenia and is associated with similar brain abnormalities. We employ a prospective cohort study with nested case control comparison design to investigate the association between substance misuse, brain abnormality, and subsequent schizophrenia. Substance misuse history, imaging data, and clinical information were collected on 147 subjects at high risk of schizophrenia and 36 controls. Regions exhibiting a significant relationship between level of use of alcohol, cannabis or tobacco, and structure volume were identified. Multivariate regression then elucidated the relationship between level of substance use and structure volumes while accounting for correlations between these variables and correcting for potential confounders. Finally, we established whether substance misuse was associated with later risk of schizophrenia. Increased ventricular volume was associated with alcohol and cannabis use in a dose-dependent manner. Alcohol consumption was associated with reduced frontal lobe volume. Multiple regression analyses found both alcohol and cannabis were significant predictors of these abnormalities when simultaneously entered into the statistical model. Alcohol and cannabis misuse were associated with an increased subsequent risk of schizophrenia. We provide prospective evidence that use of cannabis or alcohol by people at high genetic risk of schizophrenia is associated with brain abnormalities and later risk of psychosis. A family history of schizophrenia may render the brain particularly sensitive to the risk-modifying effects of these substances.

Family history of problem drinking is associated with less sensitivity of alcohol demand to a next-day responsibility.

PubMed

Murphy, James G; Yurasek, Ali M; Meshesha, Lidia Z; Dennhardt, Ashley A; MacKillop, James; Skidmore, Jessica R; Martens, Matthew P

2014-07-01

Behavioral economic demand curves measure alcohol consumption as a function of price and may capture clinically relevant individual differences in alcohol-reinforcing efficacy. This study used a novel, behavioral-economic, hypothetical demand-curve paradigm to examine the association between family history of alcohol misuse and individual differences in both alcohol demand and the relative sensitivity of alcohol demand to next-day responsibilities. Participants were 207 college students (47% male, 68.5% White, 27.4% African American, Mage = 19.5 years) who reported at least one heavy drinking episode (5/4 or more drinks on one occasion for a man/woman) in the past month and completed two versions of an alcohol purchase task (APT) that assessed hypothetical alcohol consumption across 17 drink prices. In one APT (standard), students imagined they had no next-day responsibilities, and in the other, they imagined having a 10:00 a.m. test the next day. A series of analyses of covariance indicated that participants with at least one biological parent or grandparent who had misused alcohol reported similar levels of alcohol demand on the standard APT but significantly less sensitivity to the next-day academic responsibility as measured by the percentage of reduction in demand intensity and breakpoint across the no-responsibility and next-day-test conditions. These findings provide initial evidence that APTs might clarify one potential mechanism of risk conferred by family history. Young adult heavy drinkers with a family history of problematic drinking may be less sensitive to next-day responsibilities that might modulate drinking in drinkers without a family history of alcohol problems.

Representations of Codeine Misuse on Instagram: Content Analysis.

PubMed

Cherian, Roy; Westbrook, Marisa; Ramo, Danielle; Sarkar, Urmimala

2018-03-20

Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. A majority of images (50/100; 50.0%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. ©Roy Cherian, Marisa Westbrook, Danielle Ramo, Urmimala Sarkar. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.03.2018.

14 CFR 91.1051 - Pilot safety background check.

Code of Federal Regulations, 2013 CFR

2013-01-01

... (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional Ownership... previous employers must include, as applicable— (1) Crew member records. (2) Drug testing—collection, testing, and rehabilitation records pertaining to the individual. (3) Alcohol misuse prevention program...

14 CFR 91.1051 - Pilot safety background check.

Code of Federal Regulations, 2012 CFR

2012-01-01

... (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES GENERAL OPERATING AND FLIGHT RULES Fractional Ownership... previous employers must include, as applicable— (1) Crew member records. (2) Drug testing—collection, testing, and rehabilitation records pertaining to the individual. (3) Alcohol misuse prevention program...

Information standards for recording alcohol use in electronic health records: findings from a national consultation.

PubMed

Haroon, Shamil; Wooldridge, Darren; Hoogewerf, Jan; Nirantharakumar, Krishnarajah; Williams, John; Martino, Lina; Bhala, Neeraj

2018-06-07

Alcohol misuse is an important cause of premature disability and death. While clinicians are recommended to ask patients about alcohol use and provide brief interventions and specialist referral, this is poorly implemented in routine practice. We undertook a national consultation to ascertain the appropriateness of proposed standards for recording information about alcohol use in electronic health records (EHRs) in the UK and to identify potential barriers and facilitators to their implementation in practice. A wide range of stakeholders in the UK were consulted about the appropriateness of proposed information standards for recording alcohol use in EHRs via a multi-disciplinary stakeholder workshop and online survey. Responses to the survey were thematically analysed using the Consolidated Framework for Implementation Research. Thirty-one stakeholders participated in the workshop and 100 in the online survey. This included patients and carers, healthcare professionals, researchers, public health specialists, informaticians, and clinical information system suppliers. There was broad consensus that the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) questionnaires were appropriate standards for recording alcohol use in EHRs but that the standards should also address interventions for alcohol misuse. Stakeholders reported a number of factors that might influence implementation of the standards, including having clear care pathways and an implementation guide, sharing information about alcohol use between health service providers, adequately resourcing the implementation process, integrating alcohol screening with existing clinical pathways, having good clinical information systems and IT infrastructure, providing financial incentives, having sufficient training for healthcare workers, and clinical leadership and engagement. Implementation of the standards would need to ensure patients are not stigmatised and that patient confidentiality is robustly maintained. A wide range of stakeholders agreed that use of AUDIT-C and AUDIT are appropriate standards for recording alcohol use in EHRs in addition to recording interventions for alcohol misuse. The findings of this consultation will be used to develop an appropriate information model and implementation guide. Further research is needed to pilot the standards in primary and secondary care.

Substance use in remand prisoners: a consecutive case study.

PubMed Central

Mason, D.; Birmingham, L.; Grubin, D.

1997-01-01

OBJECTIVES: To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN: A consecutive case study of remand prisoners screened at reception for substance misuse and treatment needs and comparison of findings with those of prison reception screening and treatment provision. SETTING: A large adult male remand prison (Durham). SUBJECTS: 548 men aged 21 and over awaiting trial. MAIN OUTCOME MEASURES: Prevalence of substance misuse; treatment needs of substance misusers; effectiveness of prison reception screening for substance misuse; provision of detoxification programmes. RESULTS: Before remand 312 (57%) men were using illicit drugs and 181 (33%) met DSM-IV drug misuse or dependence criteria; 177 (32%) men met misuse or dependence criteria for alcohol. 391 (71%) men were judged to require help directed at their drug or alcohol use and 197 (36%) were judged to require a detoxification programme. The prison reception screen identified recent illicit drug use in 131 (24%) of 536 men and problem drinking in 103 (19%). Drug use was more likely to be identified by prison screening if an inmate was using multiple substances, using opiates, or had a diagnosis of abuse or dependence. 47 (9%) of 536 inmates were prescribed treatment to ease the symptoms of substance withdrawal. CONCLUSIONS: The prevalence of substance misuse in newly remanded prisoners is high. Prison reception health screening consistently underestimated drug and alcohol use. In many cases in which substance use is identified the quantities and numbers of different substances being used are underestimated. Initial management of inmates identified by prison screening as having problems with dependence producing substances is poor. Few receive a detoxification programme, so that many are left with the option of continuing to use drugs in prison or facing untreated withdrawal. PMID:9233320

Universal screening for alcohol misuse in acute medical admissions is feasible and identifies patients at high risk of liver disease.

PubMed

Westwood, Greta; Meredith, Paul; Atkins, Susan; Greengross, Peter; Schmidt, Paul E; Aspinall, Richard J

2017-09-01

Many people who die from alcohol related liver disease (ARLD) have a history of recurrent admissions to hospital, representing potential missed opportunities for intervention. Universal screening for alcohol misuse has been advocated but it is not known if this is achievable or effective at detecting individuals at high risk of ARLD. We systematically screened all admissions to the Acute Medical Unit (AMU) of a large acute hospital using an electronic data capture system in real time. Patients at an increasing risk of alcohol harm were referred for either brief intervention (BI) or further assessment by an Alcohol Specialist Nursing Service (ASNS). Additional data were recorded on admission diagnoses, alcohol unit consumption, previous attendances, previous admissions, length of stay and mortality. Between July 2011 and March 2014, there were 53,165 admissions and 48,211 (90.68%) completed screening. Of these, 1,122 (2.3%) were classified as "increasing", and 1,921 (4.0%) as "high" risk of alcohol harm. High risk patients had more hospital admissions in the three previous years (average 4.74) than the low (3.00) and increasing (2.92) risk groups (p<0.001). The high risk patients also had more frequent emergency department (ED) attendances (7.68) than the lower (2.64) and increasing (3.81) groups (p<0.001 for both). A total of 1,396 (72.6%) of the high risk group were seen by the ASNS and 1,135 (81.2%) had an Alcohol Use Disorders Identification Test (AUDIT) score over 20 with 527 (37.8%) recording the maximum value of 40. Compared to the other groups, high risk patients had a distinct profile of admissions with the most common diagnoses being mental health disorders, gastro-intestinal bleeding, poisoning and liver disease. Universal screening of admissions for alcohol misuse is feasible and identifies a cohort with frequent ED attendances, recurrent admissions and an elevated risk of ARLD. An additional group of patients at an increasing risk of alcohol harm can be identified in a range of common presentations. These patients can be targeted with interventions to reduce the burden of alcohol related harm. Lay summary: Many people who die from alcohol related liver disease (ARLD) have a recent history of recurrent admissions to hospital. These admissions may represent missed opportunities to intervene earlier and offer effective therapies for alcohol misuse. Unfortunately, we know that patients are often missed because medical staff may not routinely ask about alcohol consumption. In our study of over 50,000 admissions, we have demonstrated the feasibility of offering screening for alcohol misuse to all medical admissions to hospital and delivered this 24hours a day, 7days a week, with automatic referral to treatment services. We have shown that it is possible to identify those people who are at the highest risk of dependency, those who have attended the emergency department the most and those who are at an increased risk of ARLD. We hope this study will lead to improved detection and management of alcohol problems in acute hospitals. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

HOW CAN WE USE OUR KNOWLEDGE OF ALCOHOL-TOBACCO INTERACTIONS TO REDUCE ALCOHOL USE?

PubMed Central

McKee, Sherry A.; Weinberger, Andrea H.

2013-01-01

Currently, 8.5% of the US population meets criteria for alcohol use disorders, with a total cost to the US economy estimated at $234 billion per year. Alcohol and tobacco use share a high degree of co-morbidity and interact across many levels of analysis. This review begins by highlighting alcohol and tobacco co-morbidity and presenting evidence that tobacco increases the risk for alcohol misuse and likely has a causal role in this relationship. We then discuss how knowledge of alcohol and tobacco interactions can be used to reduce alcohol use focusing on whether; 1) smoking status can be used as a clinical indicator for alcohol misuse; 2) tobacco policies reduce alcohol use; and 3) nAChR medications can be used to treat alcohol use disorders. PMID:23157448

Alcohol use and misuse: What are the contributions of occupation and work organization conditions?

PubMed Central

Marchand, Alain

2008-01-01

Background This research examines the specific contribution of occupation and work organization conditions to alcohol use and misuse. It is based on a social-action model that takes into account agent personality, structures of daily life, and macro social structures. Methods Data come from a representative sample of 10,155 workers in Quebec, Canada. Multinomial regression models corrected for sample design effect have been used to predict low-risk and high-risk drinking compared to non-drinkers. The contribution of occupation and work organization conditions (skill used, decision authority, physical and psychological demands, hours worked, irregular work schedule, harassment, unionization, job insecurity, performance pay, prestige) have been adjusted for family situation, social network outside the workplace, and individual characteristics. Results Compared to non-qualified blue-collars, both low-risk and high-risk drinking are associated with qualified blue-collars, semi-qualified white-collars, and middle managers; high-risk drinking is associated with upper managers. For constraints-resources related to work organization conditions, only workplace harassment is an important determinant of both low-risk and high-risk drinking, but it is modestly moderated by occupation. Family situation, social support outside work, and personal characteristics of individuals are also associated with alcohol use and misuse. Non-work factors mediated/suppressed the role of occupation and work organization conditions. Conclusion Occupation and workplace harassment are important factors associated with alcohol use and misuse. The results support the theoretical model conceptualizing alcohol use and misuse as being the product of stress caused by constraints and resources brought to bear simultaneously by agent personality, structures of daily life, and macro social structures. Occupational alcohol researchers must expand their theoretical perspectives to avoid erroneous conclusions about the specific role of the workplace. PMID:18816388

Alcohol use and misuse: what are the contributions of occupation and work organization conditions?

PubMed

Marchand, Alain

2008-09-24

This research examines the specific contribution of occupation and work organization conditions to alcohol use and misuse. It is based on a social-action model that takes into account agent personality, structures of daily life, and macro social structures. Data come from a representative sample of 10,155 workers in Quebec, Canada. Multinomial regression models corrected for sample design effect have been used to predict low-risk and high-risk drinking compared to non-drinkers. The contribution of occupation and work organization conditions (skill used, decision authority, physical and psychological demands, hours worked, irregular work schedule, harassment, unionization, job insecurity, performance pay, prestige) have been adjusted for family situation, social network outside the workplace, and individual characteristics. Compared to non-qualified blue-collars, both low-risk and high-risk drinking are associated with qualified blue-collars, semi-qualified white-collars, and middle managers; high-risk drinking is associated with upper managers. For constraints-resources related to work organization conditions, only workplace harassment is an important determinant of both low-risk and high-risk drinking, but it is modestly moderated by occupation. Family situation, social support outside work, and personal characteristics of individuals are also associated with alcohol use and misuse. Non-work factors mediated/suppressed the role of occupation and work organization conditions. Occupation and workplace harassment are important factors associated with alcohol use and misuse. The results support the theoretical model conceptualizing alcohol use and misuse as being the product of stress caused by constraints and resources brought to bear simultaneously by agent personality, structures of daily life, and macro social structures. Occupational alcohol researchers must expand their theoretical perspectives to avoid erroneous conclusions about the specific role of the workplace.

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: a decision-making approach.

PubMed

Barrett, Barbara; Byford, Sarah; Crawford, Mike J; Patton, Robert; Drummond, Colin; Henry, John A; Touquet, Robin

2006-01-04

We present the cost and cost-effectiveness of referral to an alcohol health worker (AHW) and information only control in alcohol misusing patients. The study was a pragmatic randomised controlled trial conducted from April 2001 to March 2003 in an accident and emergency department (AED) in a general hospital in London, England. A total of 599 adults identified as drinking hazardously according to the Paddington Alcohol Test were randomised to referral to an alcohol health worker who delivered a brief intervention (n = 287) or to an information only control (n = 312). Total societal costs, including health and social services costs, criminal justice costs and productivity losses, and clinical measures of alcohol consumption were measured. Levels of drinking were observably lower in those referred to an AHW at 12 months follow-up and statistically significantly lower at 6 months follow-up. Total costs were not significantly different at either follow-up. Referral to AHWs in an AED produces favourable clinical outcomes and does not generate a significant increase in cost. A decision-making approach revealed that there is at least a 65% probability that referral to an AHW is more cost-effective than the information only control in reducing alcohol consumption among AED attendees with a hazardous level of drinking.

[Alcohol and drug misuse of the elderly in health care facilities].

PubMed

Kuhn, S; Haasen, C

2012-05-01

A nationwide representative survey was conducted in residential care facilities and facilities offering care for the elderly in their homes (home care facilities) with the aim to estimate the rate of alcohol and drug misuse among this population and to evaluate the way in which nursing staff deal with the problem. A total of 5000 randomly selected facilities were contacted with a 2-page questionnaire. Reliable data were obtained from 550 residential care facilities and from 436 home care facilities. According to the investigated facilities, the mean rate of misuse among the elderly was 14%. Nearly all facilities acknowledge the necessity to react to these facts, but only a quarter of them considered their staff to be sufficiently trained. 38.4% of the residential care facilities and 26.9% of the home care facilities have a concept on how to react to misuse problems. Addiction services are rarely contacted. The prevalence of alcohol and drug misuse among the elderly in health care facilities is high compared to the same age cohort of the total population. The lack of networking between facilities for the elderly and addiction services is remarkable. © Georg Thieme Verlag KG Stuttgart · New York.

Development of an Adolescent Alcohol Misuse Intervention Based on the Prototype Willingness Model: A Delphi Study

ERIC Educational Resources Information Center

Davies, Emma; Martin, Jilly; Foxcroft, David

2016-01-01

Purpose: The purpose of this paper is to report on the use of the Delphi method to gain expert feedback on the identification of behaviour change techniques (BCTs) and development of a novel intervention to reduce adolescent alcohol misuse, based on the Prototype Willingness Model (PWM) of health risk behaviour. Design/methodology/approach: Four…

14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

Code of Federal Regulations, 2010 CFR

2010-01-01

... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

Code of Federal Regulations, 2014 CFR

2014-01-01

... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

Code of Federal Regulations, 2012 CFR

2012-01-01

... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

Code of Federal Regulations, 2013 CFR

2013-01-01

... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

14 CFR 120.223 - Alcohol misuse information, training, and substance abuse professionals.

Code of Federal Regulations, 2011 CFR

2011-01-01

... substance abuse professionals. 120.223 Section 120.223 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... misuse information, training, and substance abuse professionals. (a) Employer obligation to promulgate a... misuse. (c) Substance abuse professional (SAP) duties. The SAP must perform the functions set forth in 49...

Substance misuse prevention as corporate social responsibility.

PubMed

Radacsi, Gergely; Hardi, Peter

2014-03-01

All sectors of society should be involved in reducing substance misuse, including businesses. However, the business sector is typically involved only to the extent that their products compel them to be (e.g., alcohol producers promoting responsible alcohol consumption). This article examines why business participation has been limited and how embedding prevention within a framework of health promotion could increase participation. It reviews both Hungarian and international cases, concluding that although corporate social responsibility (CSR) offers a framework to approach substance misuse reduction, a different perception of the role of the business sector is necessary to make it viable.

Effect of Middle School Interventions on Alcohol Misuse and Abuse in Mexican American High School Adolescents: Five-Year Follow-up of a Randomized Clinical Trial.

PubMed

Gonzales, Nancy A; Jensen, Michaeline; Tein, Jenn Yun; Wong, Jessie J; Dumka, Larry E; Mauricio, Anne Marie

2018-05-01

Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking, particularly for US Latino populations. To test whether a universal middle school prevention program can reduce the frequency of alcohol misuse and rates of alcohol use disorder 5 years after implementation with a Mexican American sample. A previous randomized clinical trial was conducted with 516 Mexican American 7th graders and at least 1 parent who identified as having Mexican origin. Three annual cohorts of families were recruited from rosters of 4 middle schools and randomized to the 9-session Bridges/Puentes family-focused group intervention or a workshop control condition. Recruitment, screening, pretest, and randomization occurred in the same academic year for each cohort: 2003-2004, 2004-2005, and 2005-2006. Data acquisition for the follow-up assessments of late-adolescent alcohol misuse and abuse, which were not included in the initial randomized clinical trial, was conducted from September 2009 to September 2014; analysis was conducted between August 2016 and July 2017. In this assessment, 420 children (81.4%) of the sample were included, when the majority were in their final year of high school. The 9-session Bridges/Puentes intervention integrated youth, parent, and family intervention sessions that were delivered in the spring semester at each school, with separate groups for English-dominant vs Spanish-dominant families. The control workshop was offered during the same semester at each school, also in English and Spanish. Primary outcomes were diagnostic assessment of lifetime alcohol use disorder in the 12th grade, 5 years after the intervention, based on the Diagnostic Interview Schedule for Children and past-year frequency of alcohol use, binge drinking, and drunkenness based on the 2001 Youth Risk Behavior Survey. Of the 420 participants, 215 (51.2%) were girls (mean [SD] age, 17.9 [0.62] years). The intervention reduced the likelihood of having an alcohol use disorder (β = -.93; SE, 0.47; P = .047; odds ratio, 0.39). Intervention associations with past-year alcohol use frequency, binge drinking, and drunkenness were moderated by baseline substance use. The intervention reduced the frequency of alcohol use (β = -.51; SE, 0.24; P = .04; Cohen d = 0.43) and drunkenness (β = -.51; SE, 0.26; P = .049; Cohen d = 0.41) among youth who reported any previous substance use at baseline (T1 initiators) but not among those who had not initiated any substance use (T1 abstainers) at baseline. For past-year binge drinking, the intervention finding did not reach statistical significance among T1 initiators (β = -.40; SE, 0.23; P = .09) or T1 abstainers (β = .23; SE, 0.14; P = .11). Study results support an association between a universal middle school intervention and alcohol misuse and alcohol use disorders among Mexican American high school students and implementation of universal middle school interventions to reach Latino communities.

Impulsivity and Alcohol Demand in relation to Combined Alcohol and Caffeine Use

PubMed Central

Amlung, Michael; Few, Lauren R.; Howland, Jonathan; Rohsenow, Damaris J.; Metrik, Jane; MacKillop, James

2014-01-01

Problematic alcohol use among college students continues to be a prominent concern in the United States, including the growing trend of consuming caffeine with alcoholic beverages (CABs). Epidemiologically, CAB use is associated with incremental risks from drinking, although these relationships could be due to common predisposing factors rather than specifically due to CABs. This study investigated the relationship between CAB use, alcohol misuse, and person-level characteristics including impulsive personality traits, delayed reward discounting, and behavioral economic demand for alcohol use. Participants were 273 regularly drinking undergraduate students. Frequency of CAB use was assessed over the past month. A multidimensional assessment of impulsivity included the UPPS-P questionnaire and a validated, questionnaire-based measure of delayed reward discounting. Demand was assessed via a hypothetical alcohol purchase task. Frequency of CAB consumption was significantly higher in males compared to females and was also associated with higher impulsivity on the majority of the UPPS-P subscales, steeper delayed reward discounting, and greater demand for alcohol. Significant correlations between CAB use and both alcohol demand and lack of premeditation remained present after including level of alcohol misuse in partial correlations. In a hierarchical linear regression incorporating demographic, demand, and impulsivity variables, CAB frequency continued to be a significant predictor of hazardous alcohol use. These results suggest that although there are significant associations between CAB consumption and gender, impulsivity, and alcohol demand, CAB use continues to be associated with alcohol misuse after controlling for these variables. PMID:24364537

Personalised Normative Feedback for Preventing Alcohol Misuse in University Students: Solomon Three-Group Randomised Controlled Trial

PubMed Central

Moreira, Maria T.; Oskrochi, Reza; Foxcroft, David R.

2012-01-01

Background Young people tend to over-estimate peer group drinking levels. Personalised normative feedback (PNF) aims to correct this misperception by providing information about personal drinking levels and patterns compared with norms in similar aged peer groups. PNF is intended to raise motivation for behaviour change and has been highlighted for alcohol misuse prevention by the British Government Behavioural Insight Team. The objective of the trial was to assess the effectiveness of PNF with college students for the prevention of alcohol misuse. Methodology Solomon three-group randomised controlled trial. 1751 students, from 22 British Universities, allocated to a PNF group, a normal control group, or a delayed measurement control group to allow assessment of any measurement effects. PNF was provided by email. Participants completed online questionnaires at baseline, 6- and 12-months (only 12-months for the delayed measurement controls). Drinking behaviour measures were (i) alcohol disorders; (ii) frequency; (iii) typical quantity, (iv) weekly consumption; (v) alcohol-related problems; (vi) perceived drinking norms; and (vii) positive alcohol expectancies. Analyses focused on high-risk drinkers, as well as all students, because of research evidence for the prevention paradox in student drinkers. Principal Findings Follow-up rates were low, with only 50% and 40% responding at 6- and 12-months, respectively, though comparable to similar European studies. We found no evidence for any systematic attrition bias. Overall, statistical analyses with the high risk sub-sample, and for all students, showed no significant effects of the intervention, at either time-point, in a completed case analysis and a multiple imputation analysis. Conclusions We found no evidence for the effectiveness of PNF for the prevention of alcohol misuse and alcohol-related problems in a UK student population. Registration Controlled-Trials.com ISRCTN30784467 PMID:22984466

Misuse of Prescribed Stimulant Medication for ADHD and Associated Patterns of Substance Use: Preliminary Analysis Among College Students

PubMed Central

Sepúlveda, Dalissa R.; Thomas, Lisl M.; McCabe, Sean Esteban; Cranford, James A.; Boyd, Carol J.; Teter, Christian J.

2012-01-01

Objectives To explore the prevalence and characteristics associated with college students who misuse their prescribed stimulants for attention-deficit hyperactivity disorder (ADHD) and examine diversion and substance use behaviors as a function of misuse. Methods Cohort of 55 past-year prescribed stimulant users was identified from a random sample (n = 1738) at a large Midwestern research university following the self-administration of a web-based survey. An index was created to assess misuse of prescribed stimulants (i.e., Misuse Index). Results Of 55 college students who reported past-year use of prescribed stimulants for ADHD, 22 (40%) endorsed at least one item on the misuse index. The most frequently endorsed misuse items were used too much (36%), self-reported misuse (19%), and intentionally used with alcohol or other drugs (19%). Misusers of prescribed stimulant medication were more likely to report cigarette smoking (p = 0.022), binge drinking (p = 0.022), illicit use of cocaine (p = 0.032), and screen positive on the Drug Abuse Screening test (DAST-10) criteria (p = 0.002). The bivariate odds ratio for the DAST-10 findings was 8.4 (95% CI: 2.0–34.6). Diversion of prescribed stimulants was common (36%) and occurred more frequently among stimulant misusers (57%; p = 0.008). Conclusion There is a strong relationship between misuse of prescribed stimulants for ADHD and substance use behaviors, as well as other deleterious behaviors such as diversion. These findings suggest the need for close screening, assessment, and therapeutic monitoring of medication use in the college population. PMID:22095577

Alcohol education revisited: exploring how much time we devote to alcohol education in the nursing curriculum.

PubMed

Cund, Audrey

2013-01-01

This study examines student nurses knowledge, attitudes and educational preparation to work with patients who misuse alcohol. The study begins to quantify how much time is devoted to alcohol education at one Scottish University. The study modified the Short Alcohol Attitudes Problem Perception Questionnaire (SAAPPQ) and incorporated three case vignettes to examine the student nurses knowledge, attitudes and experience of working with patients who have an alcohol problem. The questionnaire was hand delivered to a convenience sample of third year nursing students. The results show that the student nurses exhibit positive attitudes and beliefs about working with patients who have an alcohol misuse problem. A series of significant associations was found between the adult nursing cohort and their ability to include a comprehensive alcohol history in their nursing assessments (χ(2) = 19.82, df = 4, p < 0.0005); recognise signs of acute alcohol withdrawal (χ(2) = 52.26, df = 16, p < 0.000); and the psychological signs associated with alcohol misuse (χ(2) = 41.81, df = 16, p < 0.000). A baseline figure of 2.5 h of alcohol education is noted at this university. Alcohol education strongly features in three out of the five nursing programmes surveyed. Nurse education needs to focus on strategies that extend to teaching nurses how to respond, provide brief interventions and identify when to refer the patient for specialist intervention. These approaches should be universal to all areas of nursing practice. Copyright © 2012 Elsevier Ltd. All rights reserved.

The relation of family violence, employment status, welfare benefits, and alcohol drinking in the United States

PubMed Central

Rodriguez, Eunice; Lasch, Kathryn E; Chandra, Pinky; Lee, Jennifer

2001-01-01

Objective To examine the contribution of employment status, welfare benefits, alcohol use, and other individual and contextual factors to physical aggression during marital conflict. Methods Logistic regression models were used to analyze panel data collected in the National Survey of Families and Households in 1987 and 1992. A total of 4,780 married or cohabiting persons reinterviewed in 1992 were included in the analysis. Domestic violence was defined as reporting that both partners were physically violent during arguments. Results Unemployed respondents are not at greater risk of family violence than employed respondents, after alcohol misuse, income, education, age, and other factors are controlled for; however, employed persons receiving welfare benefits are at significantly higher risk. Alcohol misuse, which remains a predictor of violence even after other factors are controlled for, increases the risk of family violence, and satisfaction with social support from family and friends is associated with its decrease. Conclusions Alcohol misuse has an important effect on domestic violence, and the potential impact of welfare reform on domestic violence needs to be monitored. PMID:11342506

Impact of a Brief Training on Medical Resident Screening for Alcohol Misuse and Illicit Drug Use

PubMed Central

Gunderson, Erik W.; Levin, Frances R.; Owen, Patricia

2011-01-01

Educational initiatives are needed to improve primary care substance use screening. This study assesses the impact on 24 medical residents of a 2.5-day curriculum combining experiential and manual-based training on screening for alcohol misuse and illicit drug use. A retrospective chart review of new primary care outpatients demonstrated that nearly all were asked about current alcohol use before and after curriculum participation. Adherence to national screening guidelines on quantification of alcohol consumption modestly improved (p < .05), as did inquiry about current illicit drug use (p < .05). Continued efforts are needed to enhance educational initiatives for primary care physicians. PMID:18393059

Impact of a brief training on medical resident screening for alcohol misuse and illicit drug use.

PubMed

Gunderson, Erik W; Levin, Frances R; Owen, Patricia

2008-01-01

Educational initiatives are needed to improve primary care substance use screening. This study assesses the impact on 24 medical residents of a 2.5-day curriculum combining experiential and manual-based training on screening for alcohol misuse and illicit drug use. A retrospective chart review of new primary care outpatients demonstrated that nearly all were asked about current alcohol use before and after curriculum participation. Adherence to national screening guidelines on quantification of alcohol consumption modestly improved (p < .05), as did inquiry about current illicit drug use (p < .05). Continued efforts are needed to enhance educational initiatives for primary care physicians.

Women and Men Admitted for Alcohol Intoxication at an Emergency Department: Alcohol Use Disorders, Substance Use and Health and Social Status 7 Years Later.

PubMed

Adam, Angéline; Faouzi, Mohamed; Yersin, Bertrand; Bodenmann, Patrick; Daeppen, Jean-Bernard; Bertholet, Nicolas

2016-09-01

To assess the prevalence of alcohol use disorder (AUD), substance use, mental health and social status 7 years following an Emergency Department (ED) admission for alcohol intoxication. To assess gender differences in these prevalences. Cohort of 631 patients aged 18-30 years admitted for alcohol intoxication in 2006-2007 at a tertiary referral hospital in Switzerland, contacted for an interview in 2014. Assessment consisted of demography, Alcohol Use Disorders Identification Test-Consumption, Mini International Neuropsychiatric Interview for AUD, Patient Health Questionnaire (depression, anxiety) and lifetime/past year use of tobacco/illegal drugs. Gender differences were assessed with Chi-square tests, t-tests and Wilcoxon tests. In 2014, 318/631 (50.4%) completed the interview. Study completers were not different from non-completers on baseline characteristics (all P > 0.2). Of study completers, 36.8% were unemployed, 56.9% reported hazardous alcohol use, 15.1% alcohol dependence, 13.2% harmful use, 18.6% depression, 15.4% anxiety disorder. Prevalence of any use (lifetime/past year) was 93.4%/80.2% for tobacco, 86.6%/53.1% for cannabis, 54.7%/22.6% for cocaine, 25.6%/13.5% for sedatives, 40.9%/11.0% for stimulants, 21.7%/7.2% for opioids. Men reported significantly more binge drinking, AUD, cannabis use (past year) and more lifetime cannabis, cocaine and stimulants use (all P < 0.05). There was no gender difference in the prevalence of hazardous alcohol use and tobacco use. The prevalence of psychiatric disorders was significantly higher in women (P < 0.05). Seven years after being admitted for alcohol intoxication, young patients are likely to present substance misuse, mental health disorders and social problems, suggesting  that they should be offered secondary prevention measures while in the ED. We studied a cohort of patients aged 18-30 and admitted for alcohol intoxication in 2006-2007 at a tertiary hospital. Participants were interviewed in 2014. Seven years after an admission for alcohol intoxication, patients are likely to present AUDs, substance misuse, mental health disorders and social problems. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The alcohol use disorders identification test (AUDIT): validation of a Nepali version for the detection of alcohol use disorders and hazardous drinking in medical settings

PubMed Central

2012-01-01

Background Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse. Methods This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females. Results A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females. Conclusion The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal. PMID:23039711

The alcohol use disorders identification test (AUDIT): validation of a Nepali version for the detection of alcohol use disorders and hazardous drinking in medical settings.

PubMed

Pradhan, Bickram; Chappuis, François; Baral, Dharanidhar; Karki, Prahlad; Rijal, Suman; Hadengue, Antoine; Gache, Pascal

2012-10-05

Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse. This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females. A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females. The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal.

The mental health and substance misuse needs of male ex-armed forces personnel in prison

PubMed Central

Wainwright, Verity; Lennox, Charlotte; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

2018-01-01

Abstract Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision. PMID:29238268

The mental health and substance misuse needs of male ex-armed forces personnel in prison.

PubMed

Wainwright, Verity; Lennox, Charlotte; McDonnell, Sharon; Shaw, Jenny; Senior, Jane

2018-01-01

Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision.

Interactive Effects of the BIS and the BAS on Trajectories of Alcohol Misuse after University Graduation.

PubMed

Keough, Matthew T; O'Connor, Roisin M

2015-01-01

Reinforcement Sensitivity Theory predicts that those with a strong behavioral inhibition system (BIS) likely experience considerable anxiety and uncertainty during the transition out of university. Accordingly, they may continue to drink heavily to cope during this time (a period associated with normative reductions in heavy drinking), but only if they also have a strong behavioral approach system (BAS) to enhance the anxiolytic effects of drinking. The purpose of this study was to test this hypothesis. Participants completed online measures prior to and at 3-month intervals over the course of the year following graduation. As hypothesized, results showed that an elevated BIS predicted impeded maturing out, but only when the impulsivity facet of BAS was also elevated. In contrast, a strong BIS predicted rapid maturing out if BAS impulsivity was weak. Study findings advance our understanding of BIS-related alcohol misuse trajectories in young adulthood and provide direction for clinical interventions.

Impulsivity and alcohol demand in relation to combined alcohol and caffeine use.

PubMed

Amlung, Michael; Few, Lauren R; Howland, Jonathan; Rohsenow, Damaris J; Metrik, Jane; MacKillop, James

2013-12-01

Problematic alcohol use among college students continues to be a prominent concern in the United States, including the growing trend of consuming caffeinated alcoholic beverages (CABs). Epidemiologically, CAB use is associated with incremental risks from drinking, although these relationships could be due to common predisposing factors rather than specifically due to CABs. This study investigated the relationship between CAB use, alcohol misuse, and person-level characteristics, including impulsive personality traits, delayed reward discounting, and behavioral economic demand for alcohol use. Participants were 273 regularly drinking undergraduate students. Frequency of CAB use was assessed over the past month. A multidimensional assessment of impulsivity included the UPPS-P questionnaire, which measures positive and negative urgency, premeditation (lack thereof), perseverance (lack thereof), and sensation seeking (Lynam, Smith, Whiteside, & Cyders, 2007), and a validated questionnaire-based measure of delayed reward discounting. Demand was assessed via a hypothetical alcohol purchase task. Frequency of CAB consumption was significantly higher in men than in women and was also associated with higher impulsivity on the majority of the UPPS-P subscales, steeper delayed reward discounting, and greater demand for alcohol. Significant correlations between CAB use and both alcohol demand and lack of premeditation remained present after including level of alcohol misuse in partial correlations. In a hierarchical linear regression incorporating demographic, demand, and impulsivity variables, CAB frequency continued to be a significant predictor of hazardous alcohol use. These results suggest that although there are significant associations between CAB consumption and gender, impulsivity, and alcohol demand, CAB use continues to be associated with alcohol misuse after controlling for these variables.

Symptom endorsement in men versus women with a diagnosis of depression: A differential item functioning approach.

PubMed

Cavanagh, Anna; Wilson, Coralie J; Caputi, Peter; Kavanagh, David J

2016-09-01

There is some evidence that, in contrast to depressed women, depressed men tend to report alternative symptoms that are not listed as standard diagnostic criteria. This may possibly lead to an under- or misdiagnosis of depression in men. This study aims to clarify whether depressed men and women report different symptoms. This study used data from the 2007 Australian National Survey of Mental Health and Wellbeing that was collected using the World Health Organization's Composite International Diagnostic Interview. Participants with a diagnosis of a depressive disorder with 12-month symptoms (n = 663) were identified and included in this study. Differential item functioning (DIF) was used to test whether depressed men and women endorse different features associated with their condition. Gender-related DIF was present for three symptoms associated with depression. Depressed women were more likely to report 'appetite/weight disturbance', whereas depressed men were more likely to report 'alcohol misuse' and 'substance misuse'. While the results may reflect a greater risk of co-occurring alcohol and substance misuse in men, inclusion of these features in assessments may improve the detection of depression in men, especially if standard depressive symptoms are under-reported. © The Author(s) 2016.

Context effects and false memory for alcohol words in adolescents.

PubMed

Zack, Martin; Sharpley, Justin; Dent, Clyde W; Stacy, Alan W

2009-03-01

This study assessed incidental recognition of Alcohol and Neutral words in adolescents who encoded the words under distraction. Participants were 171 (87 male) 10th grade students, ages 14-16 (M=15.1) years. Testing was conducted by telephone: Participants listened to a list containing Alcohol and Neutral (Experimental--Group E, n=92) or only Neutral (Control--Group C, n=79) words, while counting backwards from 200 by two's. Recognition was tested immediately thereafter. Group C exhibited higher false recognition of Neutral than Alcohol items, whereas Group E displayed equivalent false rates for both word types. The reported number of alcohol TV ads seen in the past week predicted higher false recognition of Neutral words in Group C and of Alcohol words in Group E. False memory for Alcohol words in Group E was greater in males and high anxiety sensitive participants. These context-dependent biases may contribute to exaggerations in perceived drinking norms previously found to predict alcohol misuse in young drinkers.

Brief Motivational Interviewing Intervention for Peer Violence and Alcohol Use in Teens: One-Year Follow-up

PubMed Central

Chermack, Stephen T.; Zimmerman, Marc A.; Shope, Jean T.; Bingham, C. Raymond; Blow, Frederic C.; Walton, Maureen A.

2012-01-01

BACKGROUND AND OBJECTIVES: Emergency department (ED) visits present an opportunity to deliver brief interventions (BIs) to reduce violence and alcohol misuse among urban adolescents at risk for future injury. Previous analyses demonstrated that a BI resulted in reductions in violence and alcohol consequences up to 6 months. This article describes findings examining the efficacy of BIs on peer violence and alcohol misuse at 12 months. METHODS: Patients (14–18 years of age) at an ED reporting past year alcohol use and aggression were enrolled in the randomized control trial, which included computerized assessment, random assignment to control group or BI delivered by a computer or therapist assisted by a computer. The main outcome measures (at baseline and 12 months) included violence (peer aggression, peer victimization, violence-related consequences) and alcohol (alcohol misuse, binge drinking, alcohol-related consequences). RESULTS: A total of 3338 adolescents were screened (88% participation). Of those, 726 screened positive for violence and alcohol use and were randomly selected; 84% completed 12-month follow-up. In comparison with the control group, the therapist assisted by a computer group showed significant reductions in peer aggression (P < .01) and peer victimization (P < .05) at 12 months. BI and control groups did not differ on alcohol-related variables at 12 months. CONCLUSIONS: Evaluation of the SafERteens intervention 1 year after an ED visit provides support for the efficacy of computer-assisted therapist brief intervention for reducing peer violence. PMID:22614776

Prescription Opioid Initiation, Correlates, and Consequences Among a Sample of OEF/OIF Military Personnel

PubMed Central

Golub, Andrew; Bennett, Alex S.

2013-01-01

Prescription opioid (PO) misuse represents a major health risk for many service members and veterans. This paper examines the pathways to misuse among a sample of US veterans who recently returned from Iraq and Afghanistan to low-income, predominately minority sections of New York City. Recreational PO misuse was not common on deployment. Most PO misusers initiated use subsequent to PO use for pain management, an iatrogenic pathway. However, most PO users did not misuse them. Veterans that misused POs were more likely to have other reintegration problems including drug and alcohol use disorders, traumatic brain injury (TBI), unemployment, and homelessness. PMID:23869455

Prescription opioid initiation, correlates, and consequences among a sample of OEF/OIF military personnel.

PubMed

Golub, Andrew; Bennett, Alex S

2013-07-01

Prescription opioid (PO) misuse represents a major health risk for many service members and veterans. This paper examines the pathways to misuse among a sample of U.S. veterans who recently returned from Iraq and Afghanistan to low-income, predominately minority sections of New York City. Recreational PO misuse was not common on deployment. Most PO misusers initiated use subsequent to PO use for pain management, an iatrogenic pathway. However, most PO users did not misuse them. Veterans that misused POs were more likely to have other reintegration problems including drug and alcohol use disorders, traumatic brain injury (TBI), unemployment, and homelessness.

Development and Evaluation of a Manual for Extended Brief Intervention for Alcohol Misuse for Adults with Mild to Moderate Intellectual Disabilities Living in the Community: The EBI-LD Study Manual

ERIC Educational Resources Information Center

Kouimtsidis, Christos; Scior, Katrina; Baio, Gianluca; Hunter, Rachael; Pezzoni, Vittoria; Hassiotis, Angela

2017-01-01

Background: Extended brief interventions for alcohol misuse are effective in the general population. The process of manualising the first ever such intervention for people with mild to moderate intellectual disabilities in the UK is the focus of this study. Methods: The manual was an adaptation of existing manuals based on Motivational Enhancement…

Alcohol and other drug use in older adults: results from a community needs assessment.

PubMed

Loscalzo, Emily; Sterling, Robert C; Weinstein, Stephen P; Salzman, Brooke

2017-12-01

With the "Baby Boomer" generation reaching older adulthood, substance abuse treatment providers find themselves needing to address the unique needs of this population. Heavy drinking in adults ages 65 and over is strongly correlated with depression, anxiety, decreased social support, and poor health. However, while alcohol misuse has been shown to be predictive of a lower quality of life in older adults, the generalizability of these findings to urban dwelling, lower socioeconomic status individuals remains unclear. To identify potential treatment needs of this population, a city-funded needs assessment was conducted. Subjects were 249 individuals (44% male) who voluntarily completed measures of quality of life (QOL), depression, and substance abuse. Measures used included the Psychological General Well-Being Schedule, the Geriatric Depression Scale-15, and the Alcohol Use Disorders Identification Test (AUDIT). Alcohol or substance abuse was reported by over 20% of respondents, with 3.4% of respondents engaged in maladaptive alcohol use. Scores on the AUDIT were predictive of increased depression (r = - .209, p = .01), anxiety (r = - .201, p = .002), lower general well-being (r = - .154, p = .019), and decreased self-control (r = - .157, p = .017). A substantial percentage of the sample reported alcohol and substance misuse. Alcohol use was predictive of depression, global psychological distress, and decreased quality of life. This needs assessment reinforces findings from previous studies and addresses the added dimension of examining this in an urban, lower socioeconomic population.

Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials.

PubMed

Krebs, Teri S; Johansen, Pål-Ørjan

2012-07-01

Assessments of lysergic acid diethylamide (LSD) in the treatment of alcoholism have not been based on quantitative meta-analysis. Hence, we performed a meta-analysis of randomized controlled trials in order to evaluate the clinical efficacy of LSD in the treatment of alcoholism. Two reviewers independently extracted the data, pooling the effects using odds ratios (ORs) by a generic inverse variance, random effects model. We identified six eligible trials, including 536 participants. There was evidence for a beneficial effect of LSD on alcohol misuse (OR, 1.96; 95% CI, 1.36-2.84; p = 0.0003). Between-trial heterogeneity for the treatment effects was negligible (I² = 0%). Secondary outcomes, risk of bias and limitations are discussed. A single dose of LSD, in the context of various alcoholism treatment programs, is associated with a decrease in alcohol misuse.

Understanding and shifting drug-related decisions: Contributions of automatic decision-making processes

PubMed Central

Carpenter, Kenneth M.; Bedi, Gillinder; Vadhan, Nehal P.

2015-01-01

While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse, and may offer important avenues for developing novel intervention strategies. PMID:26084667

Understanding and shifting drug-related decisions: contributions of automatic decision-making processes.

PubMed

Carpenter, Kenneth M; Bedi, Gillinder; Vadhan, Nehal P

2015-08-01

While substance use is common, only a minority of individuals who use drugs or alcohol develop problematic use. An understanding of the factors underlying the transition from substance use to misuse may improve prevention and intervention efforts. A key feature of substance misuse is ongoing decisions to use drugs or alcohol despite escalating negative consequences. Research findings highlight the importance of both relatively automatic, associative cognitive processes and relatively controlled, deliberative, and rational-analytic cognitive processes, for understanding situational decisions to use drugs. In this review, we discuss several cognitive component processes that may contribute to decision-making that promotes substance use and misuse, with a focus on more automatic processes. A growing body of evidence indicates that relative differences in the strength of these component processes can account for individual differences in the transition from substance use to misuse and may offer important avenues for developing novel intervention strategies.

Attitudes of college students toward mental illness stigma and the misuse of psychiatric medications.

PubMed

Stone, Amanda M; Merlo, Lisa J

2011-02-01

Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P < .001). Psychiatric medication misusers reported less stigmatized beliefs toward mental illness, including lower anxiety around the mentally ill (t = 3.26, P < .001) as well as more favorable attitudes toward psychiatric medications (t = 2.78, P < .01) and stronger beliefs in the potential for recovery from mental illness (t = -2.11, P < .05). Students with more stigmatized beliefs had greater concerns about psychiatric medications and less favorable beliefs regarding their effectiveness. Reasons for misuse varied by medication class, with 57.1% of stimulant misusers noting help with studying as their primary reason for use and 33.3% of benzodiazepine misusers noting attempts to get high or "party" as their primary reason for misuse. Results suggest the need for improved education regarding the nature of mental illness, the appropriate use of psychiatric medications, and the potential consequences associated with abuse of these potent drugs. © Copyright 2011 Physicians Postgraduate Press, Inc.

49 CFR 199.231 - Access to facilities and records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Access to facilities and records. 199.231 Section... TESTING Alcohol Misuse Prevention Program § 199.231 Access to facilities and records. (a) Except as... access to all facilities utilized in complying with the requirements of this subpart to the Secretary of...

Developing Curriculum for Education of Youth in Meeting Modern Problems.

ERIC Educational Resources Information Center

Dayton Public Schools, OH.

The objectives of this program are to develop, field test, and evaluate a K-12 curriculum containing learner objectives of the following types: (1) increased student knowledge of probable effects resulting from the use, misuse, and abuse of drug substances including alcohol and nicotine; (2) increased student understanding of human behavior; and…

U.S. Marines' Perceptions of Environmental Factors Associated With Alcohol Binge Drinking.

PubMed

Woodruff, Susan I; Hurtado, Suzanne L; Simon-Arndt, Cynthia M

2018-02-07

Alcohol misuse, in particular binge drinking, is a serious concern among military personnel because it is strongly associated with adverse consequences and has a deleterious effect on readiness. Although most alcohol misuse studies have focused on individual risk factors, studies are increasingly examining environmental influences and strategies for reducing alcohol risks. The purpose of this study is to address gaps in what is known about how service members' perceptions of environmental factors are related to binge drinking in the U.S. Marine Corps. The relationship between Marines' self-reports of environmental factors and alcohol binge drinking was assessed in this correlational study using data from three large Marine Corps installations drawn from the Department of Defense 2011 Health Related Behaviors Survey of Active Duty Military Personnel (N = 2,933). We proposed several directional hypotheses based on existing civilian and military studies of alcohol use and misuse, as well as health behavior theory. Agreement with the statements that alcoholic beverages cost too much, that drinking might negatively affect one's military career, and that one's immediate supervisor and installation discourage alcohol use were independently associated with decreased odds of binge drinking (i.e., protective factors). Perceptions that alcoholic beverages are difficult to get was particularly protective; the odds of having binged were lower for participants who endorsed this belief than for those who did not. Perceptions that drinking is part of being in one's unit was a risk factor for binge drinking (odds ratio = 1.29). Even after accounting for strong sociodemographic correlates, binge drinking was independently associated with a number of environmentally oriented perceptions. Beliefs that alcohol is affordable and easy to access were the strongest environmental correlates of increased risk of binge drinking. Addressing the threat alcohol misuse poses to both Marines and mission readiness will likely require multiple strategies, including both policy and environmental changes. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Adolescent Substance Misusers with and without Delinquency: Death, Mental and Physical Disorders, and Criminal Convictions from Age 21 to 45.

PubMed

Larm, Peter; Silva, Teresa C; Hodgins, Sheilagh

2015-12-01

Little is known about adult outcomes of males who as adolescents sought treatment for alcohol misuse or drug use, and who additionally were engaging or not engaging in other forms of delinquency. Since the rates of negative outcomes vary in the general population, the study determined whether the sub-groups of clinic attendees fared differently as compared to males of the same age who had not sought treatment for substance misuse from age 21 to 45. Adolescent males who consulted the only substance misuse clinic in a Swedish city between 1968 and 1971 were divided into four groups: ALCOHOL no drug use, no criminal offending (n=52); ALCOHOL+D no drug use, plus criminal offending (n=105); DRUG use, no criminal offending (n=92); and DRUG+D plus criminal offending (n=474). These four groups were compared to a general population sample (GP) of males matched on age and birthplace, who did not seek treatment for SM in adolescence. National Swedish registers provided data on death, hospitalizations for substance misuse (SM), mental and physical disorders, and criminal convictions. Compared to the GP, and after controlling for co-occurring adult outcomes, ALCOHOL showed elevated risks for SM hospitalization and convictions for violent crimes, and DRUG showed elevated risks for SM hospitalization, convictions for non-violent crimes, and hospitalization for psychosis. ALCOHOL+D and DRUG+D showed increased risk for SM hospitalization, violent and non-violent convictions, and DRUG+D additionally, for death, and hospitalizations for psychosis and physical illness. Misuse of alcohol without drug use or other delinquency in adolescence was associated with increased risk for convictions for violent crimes during the subsequent 25 years, in addition to SM, while adolescent drug use without other forms of delinquency was associated with increased risks for convictions for non-violent crimes, hospitalizations for SM, and non-affective psychosis. Cannabis use, with and without delinquency, was associated with subsequent hospitalization for non-affective psychosis. Consistent with contemporary studies, most adolescents treated for SM from 1968-1971 presented delinquency that was associated with an increase in risk of all adverse outcomes to age 45. Copyright © 2015 Elsevier Inc. All rights reserved.

Identification of chemicals, possibly originating from misuse of refillable PET bottles, responsible for consumer complaints about off-odours in water and soft drinks.

PubMed

Widén, H; Leufvén, A; Nielsen, T

2005-07-01

Mineral water and soft drinks with a perceptible off-odour were analysed to identify contaminants originating from previous misuse of the refillable polyethylene terephthalate (PET) bottle. Consumers detected the off-odour after opening the bottle and duly returned it with the remaining content to the producers. The contaminants in question had thus been undetected by the in-line detection devices (so-called 'sniffers') that are supposed to reject misused bottles. GC-MS analysis was carried out on the headspace of 31 returned products and their corresponding reference products, and chromatograms were compared to find the possible off-odour compounds. Substances believed to be responsible for the organoleptic change were 2-methoxynaphthalene (10 bottles), dimethyl disulfide (4), anethole (3), petroleum products (4), ethanol with isoamyl alcohol (1) and a series of ethers (1). The mouldy/musty odour (5 bottles) was caused by trichloroanisole in one instance. In some cases, the origins of the off-odours are believed to be previous consumer misuse of food products (liquorice-flavoured alcohol, home-made alcohol containing fusel oil) or non-food products (cleaning products, petroleum products, oral moist snuff and others). The results also apply to 1.5-litre recyclable PET bottles, since the nature and extent of consumer misuse can be expected to be similar for the two bottle types.

Adaptation to the Spanish population of the Substance Use Risk Profile Scale (SURPS) and psychometric properties.

PubMed

Fernández-Calderón, Fermín; Díaz-Batanero, Carmen; Rojas-Tejada, Antonio J; Castellanos-Ryan, Natalie; Lozano-Rojas, Óscar M

2017-07-14

The identification of different personality risk profiles for substance misuse is useful in preventing substance-related problems. This study aims to test the psychometric properties of a new version of the Substance Use Risk Profile Scale (SURPS) for Spanish college students. Cross-sectional study with 455 undergraduate students from four Spanish universities. A new version of the SURPS, adapted to the Spanish population, was administered with the Beck Hopelessness Scale, the UPPS-P Impulsive Behavior Scale, the State-Trait Anxiety Inventory (STAI) and the Alcohol Use Disorders Identification Test (AUDIT). Internal consistency reliability ranged between 0.652 and 0.806 for the four SURPS subscales, while reliability estimated by split-half coefficients varied from 0.686 to 0.829. The estimated test-retest reliability ranged between 0.733 and 0.868. The expected four-factor structure of the original scale was replicated. As evidence of convergent validity, we found that the SURPS subscales were significantly associated with other conceptually-relevant personality scales and significantly associated with alcohol use measures in theoretically-expected ways. This SURPS version may be a useful instrument for measuring personality traits related to vulnerability to substance use and misuse when targeting personality with preventive interventions.

Cognitive Enhancement Therapy in Substance Misusing Schizophrenia: Results of an 18-Month Feasibility Trial

PubMed Central

Eack, Shaun M.; Hogarty, Susan S.; Greenwald, Deborah P.; Litschge, Maralee Y.; McKnight, Summer A. F.; Bangalore, Srihari S.; Pogue-Geile, Michael F.; Keshavan, Matcheri S.; Cornelius, Jack R.

2014-01-01

Substance use is a frequent problem in schizophrenia, and although many substance misusing patients with the disorder also experience considerable cognitive impairments, such individuals have been routinely excluded from clinical trials of cognitive remediation that could support their functional and addiction recovery. This study conducted a small-scale feasibility trial of Cognitive Enhancement Therapy (CET) in substance misusing schizophrenia patients to assess the feasibility and efficacy of implementing comprehensive neurocognitive and social-cognitive remediation in this population. A total of 31 schizophrenia outpatients meeting addiction severity criteria for alcohol and/or cannabis use were randomized to 18 months of CET or usual care. Feasibility findings indicated high degrees of satisfaction with CET, but also presented significant challenges in the recruitment and retention of substance misusing patients, with high levels of attrition (50%) over the study period, primarily due to positive symptom exacerbation. Intent-to-treat efficacy analyses showed large and significant improvements in neurocognition (d = .86), social cognition (d = 1.13), and social adjustment (d = .92) favoring CET. Further, individuals treated with CET were more likely to reduce alcohol use (67% vs. 25%) during treatment (p = .021). These results suggest that once engaged and stabilized, CET is a feasible and potentially effective treatment for cognitive impairments in patients with schizophrenia who misuse alcohol and/or cannabis. Substance misusing patients who are able to engage in treatment may be able to benefit from cognitive remediation, and the treatment of cognitive impairments may help improve substance use outcomes among this underserved population. PMID:25510926

Modelling possible causality in the associations between unemployment, cannabis use, and alcohol misuse.

PubMed

Boden, Joseph M; Lee, Jungeun Olivia; Horwood, L John; Grest, Carolina Villamil; McLeod, Geraldine F H

2017-02-01

There has been considerable interest in the extent to which substance use and unemployment may be related, particularly the causal pathways that may be involved in these associations. It has been argued that these associations may reflect social causation, in which unemployment influences substance use, or that they may reflect social selection, in which substance use increases the risk of becoming and remaining unemployed. The present study sought to test these competing explanations. Data from the Christchurch Health and Development Study, featuring a longitudinal birth cohort, were used to model the associations between unemployment and both cannabis and alcohol. Data on patterns of unemployment, involvement with cannabis, and symptoms of alcohol use disorder were examined from ages 18-35 years. The associations between unemployment and both cannabis dependence and alcohol use disorder (AUD) were modelled using conditional fixed-effects regression models, augmented by time-dynamic covariate factors. The analyses showed evidence of possible reciprocal causal processes in the association between unemployment and cannabis dependence, in which unemployment of at least three months' duration significantly (p < 0.0001) increased the risk of cannabis dependence, and cannabis dependence significantly (p < 0.0001) increased the risk of being unemployed. Similar evidence was found for the associations between unemployment and AUD, although these associations were smaller in magnitude. The present findings support both social causation and social selection arguments, by indicating that unemployment plays a causal role in substance misuse, and that it is also likely that a reverse causal process whereby substance misuse increases the risk of unemployment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Psychosocial impact of visual impairment and coping strategies in female ex-Service personnel.

PubMed

Stevelink, Sharon A M; Fear, N T

2016-04-01

To examine how vision loss affects the psychosocial well-being of female ex-Service personnel and how they cope with their visual impairment. A cross-sectional study was conducted consisting of two study phases. During phase 1, a questionnaire was undertaken via the telephone with nine female ex-Service personnel (all under 55 years of age) using clinical screening measures to identify the probable presence of the following mental health disorders: depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder Assessment), post-traumatic stress disorder (PTSD, PTSD Checklist-Civilian) and alcohol misuse (Alcohol Use Disorders Identification Test). In phase 2, eight of the participants were interviewed face to face regarding the impact being visually impaired had had on their daily lives. Approximately 1 in 10 women screened positive for probable depression, probable PTSD or alcohol misuse; 1 in 5 fulfilled the criteria for probable anxiety disorder. Participants struggled to adjust to the loss of vision and its impact on their lives. They reported low self-esteem, feeling down and social withdrawal. As time went by, the women were able to apply various coping strategies such as having a positive attitude, relearning skills and integrating low vision aids in their daily routine. However, some coping strategies, such as alcohol misuse and lack of help-seeking when needed, hindered participants' success in adjusting to their visual impairment. Sustaining a visual impairment negatively affects psychosocial well-being in female ex-Service personnel. Over time, participants learnt to cope with the challenges and limitations associated with being visually impaired. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Alcohol and other substance use among medical and law students at a UK university: a cross-sectional questionnaire survey.

PubMed

Bogowicz, Paul; Ferguson, Jennifer; Gilvarry, Eilish; Kamali, Farhad; Kaner, Eileen; Newbury-Birch, Dorothy

2018-03-01

To examine the use of alcohol and other substances among medical and law students at a UK university. Anonymous cross-sectional questionnaire survey of first, second and final year medical and law students at a single UK university. 1242 of 1577 (78.8%) eligible students completed the questionnaire. Over half of first and second year medical students (first year 53.1%, second year 59.7%, final year 35.9%) had an Alcohol Use Disorders Identification Test (AUDIT) score suggestive of an alcohol use disorder (AUDIT≥8), compared with over two-thirds of first and second year law students (first year 67.2%, second year 69.5%, final year 47.3%). Approximately one-quarter of medical students (first year 26.4%, second year 28.4%, final year 23.7%) and over one-third of first and second year law students (first year 39.1%, second year 42.4%, final year 18.9%) reported other substance use within the past year. Over one-third of medical students (first year 34.4%, second year 35.6%, final year 46.3%) and approximately half or more of law students (first year 47.2%, second year 52.7%, final year 59.5%) had a Hospital Anxiety and Depression Scale anxiety score suggestive of a possible anxiety disorder. Study participants had high levels of substance misuse and anxiety. Some students' fitness to practice may be impaired as a result of their substance misuse or symptoms of psychological distress. Further efforts are needed to reduce substance misuse and to improve the mental well-being of students. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Social Support, Religious Involvement and Alcohol Use among Students at a Conservative Religious University

PubMed Central

Thompson, Wendy E.

2017-01-01

The misuse of alcohol among college students remains a significant public health concern in the United States. Excessive drinking among college students has been linked to numerous negative consequences, including rape, impaired academic performance, absenteeism from work and school and damaged social relations. This study examined whether religious involvement and social support played a role in reducing the frequency of alcohol use. A non-random convenience sample of 364 students from a larger study of 760 college students—18 years old and older—were recruited over a 2 month period. The survey used in this study consisted of 124 items and collected information on areas such as substance misuse, sexual activity, use of pornography, relationships, personal religious practices, and social support. A descriptive analysis and chi-square were performed to determine if there was a relationship between frequency of alcohol use and gender, marital status, student class, GPA, religion, ethnicity and age. Linear regression was conducted to determine if social support and religious involvement were predictors of frequency of alcohol misuse. Multivariate regression analysis was used for predicting religious involvement when including social support while controlling for gender, age, ethnicity and grade. The present study revealed that religious involvement was a predictor for reduced frequency of alcohol use, while social support was not a predictor of lower frequency of alcohol use. PMID:28538657

49 CFR 655.35 - Other alcohol-related conduct.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Other alcohol-related conduct. 655.35 Section 655... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Prohibited Alcohol Use § 655.35 Other alcohol-related conduct. (a) No employer shall permit a...

49 CFR 655.35 - Other alcohol-related conduct.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Other alcohol-related conduct. 655.35 Section 655... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Prohibited Alcohol Use § 655.35 Other alcohol-related conduct. (a) No employer shall permit a...

Overlooked and underestimated? Problematic alcohol use in clients recovering from drug dependence.

PubMed

Staiger, Petra K; Richardson, Ben; Long, Caroline M; Carr, Victoria; Marlatt, G Alan

2013-07-01

Despite recognition of the harms related to alcohol misuse and its potential to interfere substantially with sustained recovery from drug dependency, research evaluating drug treatment outcomes has not addressed the issue comprehensively. It has been overlooked possibly because treatment research has been framed according to the primary drug of choice, rather than investigating the interactions between different combinations of drugs and/or alcohol use. This paper reports on a systematic review investigating whether concurrent alcohol use could impede recovery from illicit drug use in two potential ways: first, alcohol could become a substitute addiction and/or secondly, alcohol misuse post-treatment may place an individual at risk for relapse to their primary drug problem. A systematic search of four relevant databases was undertaken to identify peer-reviewed, quantitative drug treatment outcome studies that reported alcohol use pre-, post-treatment and follow-up. The search revealed 567 papers, of which 13 were assessed as fulfilling the key inclusion criteria.The review indicated inconsistent and therefore inconclusive support for the substitution hypothesis. However, the data revealed consistent support for the hypothesis that alcohol use increases relapse to drug use. (i) The potential negative impact of alcohol misuse on drug treatment outcomes remains under-researched and overlooked; (ii) alcohol consumption post-drug treatment may increase the likelihood that an individual will relapse to their primary drug; (ii) existing evidence regarding the substitution hypothesis is inconclusive, although there was an indication that a subgroup of participants will be vulnerable to alcohol becoming the primary addiction instead of drugs. We argue that future drug treatment outcome studies need to include detailed analysis of the influence of alcohol use pre- and post-drug treatment. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

General Motor Vehicle Drivers' Knowledge and Practices Regarding Drink Driving in Yinchuan and Guangzhou, China.

PubMed

Jia, Keqin; King, Mark; Fleiter, Judy; Sheehan, Mary; Ma, Wenjun; Lei, Jing; Zhang, Jianzhen

2015-01-01

Drink driving contributes to significant levels of injury and economic loss in China but is not well researched. This study examined knowledge, drink-driving practices, and alcohol misuse problems among general drivers in Yinchuan. The objectives were to gain a better understanding of drink driving in Yinchuan, identify areas that need to be addressed, and compare the results with a similar study in Guangzhou. This was a cross-sectional study with a survey designed to collect information on participants' demographic characteristics and their knowledge and practices in relation to drinking and driving. The survey was composed of questions on knowledge and practices in relation to drink driving and was administered to a convenience sample of 406 drivers. Alcohol misuse problems were assessed by using the Alcohol Use Disorders Identification Test (AUDIT). Males accounted for the main proportion of drivers sampled from the general population ("general drivers"). A majority of general drivers in both cities knew that drunk driving had become a criminal offense in 2011; however, knowledge of 2 legal blood alcohol concentration (BAC) limits was quite low. Fewer drivers in Yinchuan (22.6%) than in Guangzhou (27.9) reported having been stopped by police conducting breath alcohol testing at least once in the last 12 months. The mean AUDIT score in Yinchuan (M = 8.2) was higher than that in Guangzhou (M = 7.4), and the proportion of Yinchuan drivers with medium or higher alcohol misuse problems (31.2%) was correspondingly higher than in Guangzhou (23.1%). In Yinchuan, males had a significantly higher AUDIT score than females (t = 3.454, P <.001), similar to Guangzhou. Multiple regression analyses were conducted on potential predictors of the AUDIT score (age, gender, monthly income, education level, years licensed, and age started drinking). There were significant individual contributions of gender (beta = 0.173, P =.09) and age at which drinking started (beta = 0.141, P =.033), but the overall model for Yinchuan was not significant, unlike Guangzhou. The results show that there are shortfalls in knowledge of the legislation and how to comply with it and deficiencies in police enforcement. In addition, there was evidence of drink driving and drink riding at high levels in both cities. Recommendations are made to address these issues.

Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq.

PubMed

Thomas, Jeffrey L; Wilk, Joshua E; Riviere, Lyndon A; McGurk, Dennis; Castro, Carl A; Hoge, Charles W

2010-06-01

A growing body of literature has demonstrated the association of combat in Iraq and Afghanistan with postdeployment mental health problems, particularly posttraumatic stress disorder (PTSD) and depression. However, studies have shown varying prevalence rates of these disorders based on different case definitions and have not assessed functional impairment, alcohol misuse, or aggressive behavior as comorbid factors occurring with PTSD and depression. To (1) examine the prevalence rates of depression and PTSD using several case definitions including functional impairment, (2) determine the comorbidity of alcohol misuse or aggressive behaviors with depression or PTSD, and (3) compare rates between Active Component and National Guard soldiers at the 3- and 12-month time points following their deployment to Iraq. Population-based, cross-sectional study. United States Army posts and National Guard armories. A total of 18 305 US Army soldiers from 4 Active Component and 2 National Guard infantry brigade combat teams. Between 2004 and 2007, anonymous mental health surveys were collected at 3 and 12 months following deployment. Current PTSD, depression, functional impairment, alcohol misuse, and aggressive behavior. Prevalence rates for PTSD or depression with serious functional impairment ranged between 8.5% and 14.0%, with some impairment between 23.2% and 31.1%. Alcohol misuse or aggressive behavior comorbidity was present in approximately half of the cases. Rates remained stable for the Active Component soldiers but increased across all case definitions from the 3- to 12-month time point for National Guard soldiers. The prevalence rates of PTSD and depression after returning from combat ranged from 9% to 31% depending on the level of functional impairment reported. The high comorbidity with alcohol misuse and aggression highlights the need for comprehensive postdeployment screening. Persistent or increased prevalence rates at 12 months compared with 3 months postdeployment illustrate the persistent effects of war zone service and provide important data to guide postdeployment care.

Social Networks and Sexual Orientation Disparities in Tobacco and Alcohol Use

PubMed Central

Hatzenbuehler, Mark L; McLaughlin, Katie A; Xuan, Ziming

2015-01-01

Objective: The purpose of this study was to examine whether the composition of social networks contributes to sexual orientation disparities in substance use and misuse. Method: Data were obtained from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative cohort study of adolescents (N = 20,745). Wave 1 collected extensive information about the social networks of participants through peer nomination inventories. Results: Same- and both-sex–attracted youths had higher frequency/quantity of tobacco use in their peer networks than did opposite-sex–attracted youths, and both-sex–attracted youths had higher frequency/quantity of alcohol use and misuse in their peer networks than opposite-sex–attracted youths. Among same- and both-sex–attracted youths, greater frequency/quantity of tobacco use in one’s social network predicted greater use of cigarettes. In addition, greater frequency/quantity of peers’ drinking and drinking to intoxication predicted more alcohol use and alcohol misuse in the both-sex–attracted group. These social network factors mediated sexual orientation–related disparities in tobacco use for both- and same-sex–attracted youths. Moreover, sexual orientation disparities in alcohol misuse were mediated by social network characteristics for the same-sex and both-sex–attracted youths. Importantly, sexual minority adolescents were no more likely to have other sexual minorities in their social networks than were sexual majority youths, ruling out an alternative explanation for our results. Conclusions: These findings highlight the importance of social networks as correlates of substance use behaviors among sexual minority youths and as potential pathways explaining sexual orientation disparities in substance use outcomes. PMID:25486400

Extended brief intervention to address alcohol misuse in people with mild to moderate intellectual disabilities living in the community (EBI-ID): study protocol for a randomised controlled trial.

PubMed

Kouimtsidis, Christos; Fodor-Wynne, Lucy; Scior, Katrina; Hunter, Rachael; Baio, Gianluca; Pezzoni, Vittoria; Hassiotis, Angela

2015-03-25

There is some evidence that people with intellectual disabilities who live in the community are exposed to the same risks of alcohol use as the rest of the population. Various interventions have been evaluated in the general population to tackle hazardous or harmful drinking and alcohol dependence, but the literature evaluating interventions is very limited regarding intellectual disabilities. The National Institute for Health and Clinical Excellence recommends that brief and extended brief interventions be used to help young persons and adults who have screened as positive for hazardous and harmful drinking. The objective of this trial is to investigate the feasibility of adapting and delivering an extended brief intervention (EBI) to persons with mild/moderate intellectual disability who live in the community and whose level of drinking is harmful or hazardous. The study has three stages, which include the adaptation of the Extended Brief Intervention (EBI) for people with intellectual disability, a single blind, randomised controlled trial of an individual Extended Brief Intervention to test the feasibility of the intervention, and a qualitative study that will assess the perceived acceptability and usefulness of the intervention. Fifty participants in total will be recruited from community intellectual disability services and social care or third sector organisations. The main outcome is a reduction in alcohol consumption measured by the Alcohol Use Disorders Identification Test. Alcohol misuse is a relatively under-researched mental health problem in people with intellectual disabilities. Therefore, the study addresses both diagnostic issues and the delivery of a simple first stage intervention, which is available to the population of average intelligence and young persons in particular. The findings from the study will guide the preparation of a large-scale study to test whether this treatment is clinically and cost-effective in this population. ISRCTN58783633 (19 December 2013).

Predictive validity of clinical AUDIT-C alcohol screening scores and changes in scores for three objective alcohol-related outcomes in a Veterans Affairs population.

PubMed

Bradley, Katharine A; Rubinsky, Anna D; Lapham, Gwen T; Berger, Douglas; Bryson, Christopher; Achtmeyer, Carol; Hawkins, Eric J; Chavez, Laura J; Williams, Emily C; Kivlahan, Daniel R

2016-11-01

To evaluate the association between Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) alcohol screening scores, collected as part of routine clinical care, and three outcomes in the following year (Aim 1), and the association between changes in AUDIT-C risk group at 1-year follow-up and the same outcomes in the subsequent year (Aim 2). Cohort study. Twenty-four US Veterans Affairs (VA) healthcare systems (2004-07), before systematic implementation of brief intervention. A total of 486 115 out-patients with AUDIT-Cs documented in their electronic health records (EHRs) on two occasions ≥ 12 months apart ('baseline' and 'follow-up'). Independent measures were baseline AUDIT-C scores and change in standard AUDIT-C risk groups (no use, low-risk use and mild, moderate, severe misuse) from baseline to follow-up. Outcome measures were (1) high-density lipoprotein cholesterol (HDL), (2) alcohol-related gastrointestinal hospitalizations ('GI hospitalizations') and (3) physical trauma, each in the years after baseline and follow-up. Baseline AUDIT-C scores had a positive association with outcomes in the following year. Across AUDIT-C scores 0-12, mean HDL ranged from 41.4 [95% confidence interval (CI) = 41.3-41.5] to 53.5 (95% CI = 51.4-55.6) mg/l, and probabilities of GI hospitalizations from 0.49% (95% CI = 0.48-0.51%) to 1.8% (95% CI = 1.3-2.3%) and trauma from 3.0% (95% CI = 2.95-3.06%) to 6.0% (95% CI = 5.2-6.8%). At follow-up, patients who increased to moderate or severe alcohol misuse had consistently higher mean HDL and probabilities of subsequent GI hospitalizations or trauma compared with those who did not (P-values all < 0.05). For example, among those with baseline low-risk use, in those with persistent low-risk use versus severe misuse at follow-up, the probabilities of subsequent trauma were 2.65% (95% CI = 2.54-2.75%) versus 5.15% (95% CI = 3.86-6.45%), respectively. However, for patients who decreased to lower AUDIT-C risk groups at follow-up, findings were inconsistent across outcomes, with only mean HDL decreasing in most groups that decreased use (P-values all < 0.05). When AUDIT-C screening is conducted in clinical settings, baseline AUDIT-C scores and score increases to moderate-severe alcohol misuse at follow-up screening appear to have predictive validity for HDL cholesterol, alcohol-related gastrointestinal hospitalizations and physical trauma. Decreasing AUDIT-C scores collected in clinical settings appear to have predictive validity for only HDL. © 2016 Society for the Study of Addiction.

Alcohol Expectancies Mediate and Moderate the Associations between Big Five Personality Traits and Adolescent Alcohol Consumption and Alcohol-Related Problems.

PubMed

Ibáñez, Manuel I; Camacho, Laura; Mezquita, Laura; Villa, Helena; Moya-Higueras, Jorge; Ortet, Generós

2015-01-01

Personality and expectancies are relevant psychological factors for the development of adolescent alcohol use and misuse. The present study examined their direct, mediated and moderated effects on different drinking behaviors in adolescence. Personality domains of the five-factor model, positive and negative alcohol expectancies (AEs), alcohol use during the week and the weekend, and alcohol-related problems were assessed in a sample of 361 adolescents. Different personality dimensions were directly associated with specific alcohol outcomes: Extraversion, low Conscientiousness and low Openness were associated with weekend alcohol use; low Agreeableness was related to weekday use; whereas low Agreeableness, low Conscientiousness and Extraversion were associated with alcohol-related problems. In addition, positive AEs mediated the relationship between Extraversion and alcohol use, whereas both positive and negative expectancies mediated the association between Neuroticism and alcohol consumption and alcohol-related problems. Finally, both types of expectancies interacted with Extraversion to predict alcohol problems. Our results highlight the importance of examining the complex interplay of comprehensive personality models and AEs to gain a better understanding of the development of different alcohol use and misuse patterns in adolescence.

Co-occurring Mental Health and Alcohol Misuse Symptoms: Dual Disorder Symptoms in Combat Injured Veterans

DTIC Science & Technology

2014-03-03

required from Department of Veterans Af fairs hospitals. The rate of alcohol misuse among veterans screening for PTSD or de pression in the present...facilities only (casualties treated at forward deployed Army facilities, and those transported directly to Combat Support Hospitals from the point of injury...Psychiatry, 163, 1777–1783. Hien, D. A., Jiang, H., Campbell, A. N. C., Hu, M. C., Miele , G. M., Cohen, L. R., et al. (2010). Do treatment improvements

76 FR 40798 - Antidrug and Alcohol Misuse Prevention Programs for Personnel Engaged in Specified Aviation...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-12

... includes contractors and subcontractors. Contracting companies have two testing options: Option one is for... case today and as such, there are no alternatives to the final rule that could have been considered and... stations would be classified as small business under NAICS 488180, the FAA reviewed a recent study...

Alcohol-Related Problems in High-Risk Groups. EURO Reports and Studies 109. Report on a WHO Study.

ERIC Educational Resources Information Center

Plant, Martin, Ed.

Alcohol consumption has risen dramatically in many countries since the Second World War. Accompanying this rise has been a rise in alcohol-related problems, including liver cirrhosis mortality, alcohol dependence, and alcohol-related crimes and accidents. Alcohol misuse presents huge health, social, and legal problems throughout most of Europe and…

Prescription opioid use: Patient characteristics and misuse in community pharmacy.

PubMed

Cochran, Gerald; Bacci, Jennifer L; Ylioja, Thomas; Hruschak, Valerie; Miller, Sharon; Seybert, Amy L; Tarter, Ralph

2016-01-01

Opioid pain medication misuse is a major concern for US public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings; and 2) describe the extent of opioid medication misuse behaviors among these patients. We recruited and screened a convenience sample of patients with the use of a tablet computer-based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics. Patients were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Survey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis. None. Validated screening measures included the Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test C, Short Form 12, Drug Abuse Screening Test 10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire 2. A total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse-with hydrocodone having more than 4 times higher odds of misuse compared with other medications (adjusted odds ratio [AOR] 4.48, 95% confidence interval [CI] 1.1-17.4). Patients with positive screens for illicit drug use (AOR 8.07, 95% CI 2.7-24.0), PTSD (AOR 5.88, 95% CI 2.3-14.7), and depression (AOR 2.44, 95% CI 1.0-5.9) also had significantly higher odds for misuse compared with those with negative screening results. These findings provide important foundational data that suggest implementation of regular opioid misuse screening protocols within community pharmacies. Such screening activities could foster a culture of prevention and overall reduction for misuse among patients filling opioid medications in community pharmacies. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Preliminary research informing policy on remote alcohol monitoring in criminal justice: the Scottish experience.

PubMed

Goodall, Christine A; Neville, Fergus G; Williams, Damien J; Donnelly, Peter D

2016-11-01

To explore the views of Scottish offenders on the impact of alcohol on their experience of offending and their lives in general. Furthermore, to explore their views on the concept of remote alcohol monitoring (RAM) as a way to address alcohol misuse upon liberation from prison. A convenience sample of 12 serving offenders participated in one of three focus groups. Data were analysed using the principles of thematic analysis. Analysis of the data revealed the significant impact of alcohol on the lives of the participants. Key themes included the amount and frequency of alcohol consumption; the association of alcohol with harm; the association of alcohol with offending; the previous attempts to reduce alcohol consumption and possible reasons for failure; and the views of participants on the utility of RAM in relation to crime prevention. Participants had significant issues with alcohol misuse prior to incarceration that had impacted on their offending and resulted in both health and social harms. Participants were generally positive but pragmatic about RAM, recognising that technology alone may not be enough to change deeply ingrained and addictive behaviours.

Geriatric Alcoholism and Drug Abuse

ERIC Educational Resources Information Center

Schuckit, Marc A.

1977-01-01

This paper reviews the literature and presents new data on alcohol and drug problems in older individuals. Drug abusers include users of opiates, inadvertent misusers, and deliberate abusers of nonopiates. Two to 10 percent of the elderly are alcoholic, and these are usually individuals beginning alcohol abuse after age 40. (Author)

Workplace harassment/abuse and alcohol-related outcomes: the mediating role of psychological distress.

PubMed

Richman, Judith A; Shinsako, Stephanie A; Rospenda, Kathleen M; Flaherty, Joseph A; Freels, Sally

2002-07-01

This article embraces a tension-reduction or self-medication perspective on alcohol use and misuse. It empirically addresses the role that psychological distress plays in mediating the relationships between harassing and abusive interpersonal experiences in the workplace and altered alcohol use and misuse. A mail survey was completed by 2,038 university employees (1,098 women and 940 men) at two points in time. Specific hypotheses were tested involving (1) the extent to which the onset and chronicity of harassment and abuse predicted varied Wave-2 drinking outcomes, (2) the extent to which the onset and chronicity of harassment and abuse predicted three forms of Wave-2 psychological distress, (3) the associations between Wave-2 psychological distress and drinking outcomes and (4) the extent to which the associations between harassment/abuse and drinking outcomes disappeared when the salient forms of symptomatic distress functioned as control variables. The data showed that harassment and abuse predicted drinking outcomes and psychological distress, and that the associations between harassment/abuse and drinking outcomes were partially mediated by distress. The findings lend support to the tension-reduction perspective and have important implications for intervention and prevention involving workplace harassment and abuse.

Substance Use in Undergraduate Students With Histories of Attention-Deficit/Hyperactivity Disorder (ADHD): The Role of Impulsivity.

PubMed

Egan, Theresa E; Dawson, Anne E; Wymbs, Brian T

2017-08-24

Emerging adulthood (18-25 years old) is regarded as a time of identity exploration that includes a peak in risky behaviors, such as substance use and misuse. Attention-deficit/hyperactivity disorder (ADHD) is also associated with greater levels of risky behaviors, including substance use and misuse; however, there is a lack of research on substance use by emerging adults with ADHD, in particular the potential mechanisms that may facilitate this risk. The present study builds on the existing research regarding the association between ADHD and substance use by examining roles of multiple facets of impulsivity in facilitating this association during emerging adulthood. In a sample of 197 undergraduate students (24 students with an ADHD diagnostic history), we assessed for components of impulsivity (e.g., urgency, sensation-seeking) and rates of alcohol abuse, tobacco use, cannabis use, illicit drug use, and stimulant medication misuse within the past year. Findings indicate that facets of impulsivity, as a whole, explained the association between an ADHD diagnostic history and both illicit drug use and alcohol abuse such that students with ADHD histories tended to report higher levels of impulsivity, which increased risk of alcohol abuse and illicit drug use. Higher levels of specific facets of impulsivity, particularly negative urgency, also facilitated associations between having ADHD and engaging in most forms of substance use tested herein. Conclusions/Importance: Specific facets of impulsivity appear to be important mediators of the association between ADHD and substance use, and should be considered as potential targets of substance use interventions for this population.

Primary care validation of a single screening question for drinkers.

PubMed

Seale, J Paul; Boltri, John M; Shellenberger, Sylvia; Velasquez, Mary M; Cornelius, Monica; Guyinn, Monique; Okosun, Ike; Sumner, Heather

2006-09-01

The aim of this study was to conduct a primary care validation study of a single screening question for alcohol misuse ("When was the last time you had more than X drinks in 1 day?," where X was four for women and X was five for men), which was previously validated in a study conducted in emergency departments. This cross-sectional study was accomplished by interviewing 625 male and female adult drinkers who presented to five southeastern primary care practices. Patients answered the single question (coded as within 3 months, within 12 months, ever, or never), Alcohol Use Disorders Identification Test (AUDIT), and AUDIT consumption questions (AUDIT-C). Alcohol misuse was defined as either at-risk drinking, identified by a 29-day Timeline Followback interview or a current (past-year) alcohol-use disorder by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, or both. Among 625 drinkers interviewed, 25.6% were at-risk drinkers, 21.7% had a current alcohol- use disorder, and 35.2% had either or both conditions. Considering "within the last 3 months" as positive, the sensitivity of the single question was 80% and the specificity was 74%. Chi-square analyses revealed similar sensitivity across ethnic and gender groups; however, specificity was higher in women and whites (p = .0187 and .0421, respectively). Considering "within the last 12 months" as positive increased the question's sensitivity, especially for those with alcohol-use disorders. The area under the receiver operating characteristic curve of the single alcohol screening question (0.79) was slightly lower than for the AUDIT and AUDIT-C, but sensitivity and specificity were similar. A single question about the last episode of heavy drinking is a sensitive, time-efficient screening instrument that shows promise for increasing alcohol screening in primary care practices.

There has been little progress in implementing comprehensive alcohol control strategies in Africa.

PubMed

Peer, Nasheeta

2017-11-01

Alcohol is the most common substance of addiction and a threat not only to health but also to sustainable human development. Consequently, at least a 10% relative reduction in the harmful use of alcohol has been advocated by the World Health Organization (WHO). This perspective describes alcohol use in Africa, strategies to reduce harmful alcohol use, and the ability of African countries to meet this target. Although alcohol consumption in Africa was intermediate compared to other world regions, the total alcohol per capita among alcohol consumers was the second highest (19.5 liters); 19% of Sub-Saharan African men could be classified as binge drinkers. The alcohol industry is the key driver behind the uptake of alcohol use and misuse. The most cost-effective ways to reduce alcohol-related harm is to make alcohol less available and more expensive and to prohibit alcohol advertising. Most African countries have alcohol excise taxes, but these are not adjusted for inflation, meaning that the effectiveness of these taxes will likely decrease with time, leading to greater affordability. The majority of African countries do not have legally binding regulations for alcohol marketing. Alcohol misuse in Africa is not being addressed at a time when available strategies can efficiently and cost-effectively control alcohol-related harm.

Screening for current opioid misuse and associated risk factors among patients with chronic nonalcoholic pancreatitis pain.

PubMed

Barth, Kelly S; Balliet, Wendy; Pelic, Christine M; Madan, Alok; Malcolm, Robert; Adams, David; Morgan, Katherine; Owczarski, Stefanie; Borckardt, Jeffrey J

2014-08-01

The objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis. This study utilized a descriptive, quasi-experimental, cross sectional design. Three hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center. Participants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures. Mean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P < 0.0001), increased pain rating at the time of the office visit (β = 0.16, P = 0.03), impairment of psychological quality of life (β = -0.27, P = 0.001) and endorsement of alcohol use (β = 0.16, P = 0.03). These factors accounted for 37% of the variance in current opioid misuse scores. Depression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis. Wiley Periodicals, Inc.

Parental Perspectives on Alcohol Use among School-Aged Children in Ghana

ERIC Educational Resources Information Center

Obeng, Cecilia

2011-01-01

Research on alcohol misuse and abuse indicates that it can cause many personal health and family problems. This study investigated whether Ghanaian parents would reward their children with alcohol if they sent the children to buy alcoholic drinks and whether they would favor legislation banning children from using alcohol. Also addressed in this…

Substance misuse and sexual function in adolescents with chronic diseases.

PubMed

Araújo, Priscila; Carvalho, Márcio Guilherme Nunes; van Weelden, Marlon; Lourenço, Benito; Queiroz, Lígia Bruni; Silva, Clovis Artur

2016-09-01

To evaluate alcohol/tobacco and/or illicit drug misuse in Chronic Diseases (CDs). A cross-sectional study with 220 CDs adolescents and 110 healthy controls including: demographic/anthropometric data; puberty markers; modified questionnaire evaluating sexual function, alcohol/smoking/illicit drug misuse and bullying; and the physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk. The frequencies of alcohol/tobacco and/or illicit drug use were similar in both groups (30% vs. 34%, p=0.529), likewise the frequencies of bullying (42% vs. 41%, p=0.905). Further analysis solely in CDs patients that used alcohol/tobacco/illicit drug versus those that did not use showed that the median current age [15 (11-18) vs. 14 (10-18) years, p<0.0001] and education years [9 (5-14) vs. 8 (3-12) years, p<0.0001] were significant higher in substance use group. The frequencies of Tanner 5 (p<0.0001), menarche (p<0.0001) and spermarche (p=0.001) were also significantly higher in patients with CDs that used alcohol/tobacco/illicit, likewise sexual activity (23% vs. 3%, p<0.0001). A trend of a low frequency of drug therapy was observed in patients that used substances (70% vs. 82%, p=0.051). A positive correlation was observed between CRAFFT score and current age in CD patients (p=0.005, r=+0.189) and controls (p=0.018, r=+0.226). A later age was evidenced in CDs patients that reported licit/ilicit drug misuse. In CDs adolescent, substance use was more likely to have sexual intercourse. Our study reinforces that these patients should be systematically screened by pediatricians for drug related health behavioral patterns. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

[Pilot study on the prevalence of dual pathology in community mental health and substance misuse services in Madrid].

PubMed

Szerman Bolotner, Néstor; Arias Horcajadas, Francisco; Vega Astudillo, Pablo; Babín Vich, Francisco; Mesías Perez, Beatriz; Basurte Villamor, Ignacio; Morant, Consuelo; Ochoa Mangado, Enriqueta; Poyo Calvo, Félix

2011-01-01

To evaluate retrospectively the comorbidity of mental and addictive disorders in community mental health and substance misuse services in Madrid. The medical records of 400 patients from mental health and substance misuse services in Madrid were evaluated. Records were examined for the last 20 patients from each service unit. Dual pathology was constituted when a current diagnosis of mental and addictive disorders, excluding nicotine addiction, appeared on the patient's records. Prevalence of dual pathology was 34%. There were differences in the prevalence figures for the two kinds of service: 36.78% in substance misuse services, and 28.78% in mental health services. There was an association of dual diagnosis with alcohol or cocaine dependence, but not with opioid dependence. The mental disorders more prevalent in dually diagnosed than in non-dually diagnosed patients were mood disorders, personality disorders, and schizophrenia. There is a high prevalence of dual pathology in those seeking treatment, being higher in substance misuse services than in mental health services, and higher in patients with alcohol or cocaine dependence. These findings could be of help in the planning of care resource policies for these patients.

Taxing junk food: applying the logic of the Henry tax review to food.

PubMed

Bond, Molly E; Williams, Michael J; Crammond, Brad; Loff, Bebe

2010-10-18

The recent review of taxation in Australia - the Henry tax review - has recommended that the federal government increase the taxes already levied on tobacco and alcohol. Tobacco and alcohol taxes are put forward as the best way of reducing the social harms caused by the use and misuse of these substances. Junk foods have the same pattern of misuse and the same social costs as tobacco and alcohol. The Henry tax review rejects the idea of taxing fatty foods, and to date the government has not implemented a tax on junk food. We propose that a tax on junk food be implemented as a tool to reduce consumption and address the obesity epidemic.

Nurses' attitudes toward substance misusers. III. Emergency room nurses' attitudes, nurses' attitudes toward impaired nurses, and studies of attitudinal change.

PubMed

Howard, M O; Chung, S S

2000-08-01

Emergency room nurses generally regard alcohol and drug misusers as troublesome patients and dislike caring for them. Surveys of nurses' and nurse managers' attitudes toward impaired nurses, all published in recent years, suggest that they are generally supportive of impaired nurses and sanguine about their prospects for recovery; nonetheless, a substantial minority oppose the return to work of a formerly substance-misusing nurse colleague. Programs designed to change nurses' attitudes toward substance misusers are generally ineffective, although significant gains in substance-related knowledge are commonly reported.

PRESCRIPTION OPIOID USE: PATIENT CHARACTERISTICS AND MISUSE IN COMMUNITY PHARMACY

PubMed Central

Cochran, Gerald; Bacci, Jennifer L.; Ylioja, Thomas; Hruschak, Valerie; Miller, Sharon; Seybert, Amy L.; Tarter, Ralph

2016-01-01

Objective Opioid pain medication misuse is a major concern for U.S. public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings and 2) describe the extent of opioid medication misuse behaviors among these patients. Design We recruited and screened a convenience sample of patients using a tablet computer-based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics. Setting Patients were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Participants Survey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis. Main Outcome Measures Validated screening measures included the: Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test-C, Short-Form-12, Drug Abuse Screening Test-10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire-2. Results A total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse—with hydrocodone having higher odds for misuse by more than four times compared to other medications (AOR=4.48; 95% CI=1.1–17.4). Patients with positive screens for illicit drug use (AOR=8.07; 95% CI=2.7–24.0), PTSD (AOR=5.88; 95% CI=2.3–14.7), and depression (AOR=2.44; 95% CI=1.0–5.9) also had significantly higher odds for misuse compared to those with negative screening results. Conclusion These findings provide important foundational data that suggest implementation of regular opioid misuse screening protocols within community pharmacies. Such screening activities could foster a culture of prevention and overall reduction for misuse among patients filling opioid medications in community pharmacies. PMID:27053277

Communication and Supervision of Alcohol in the Family: Parental Perspectives

ERIC Educational Resources Information Center

Sherriff, Nigel; Cox, Louise; Coleman, Lester; Roker, Debi

2008-01-01

It is now well acknowledged that parents can have a central role in supporting sensible alcohol use and reducing alcohol misuse amongst young people. However, little research has considered how communication and supervision in relation to alcohol actually takes place within the family. Drawing upon interviews with the parents of young people aged…

Understanding and Confronting Alcohol-Induced Risky Behavior among College Students

ERIC Educational Resources Information Center

Dornier, Lucien J.; Fauquier, Katharine J.; Field, April R.; Budden, Michael C.

2010-01-01

Confronting alcohol abuse is a challenge for most higher education institutions. Each year, students are admitted to hospitals for issues arising from the misuse of alcohol. The deaths of some engaged in alcohol related activities is especially worrisome. Factors such as age and financial standing could impact the likelihood of abuse. So-called…

Drinking Level Versus Drinking Pattern and Cigarette Smoking Among Older Adults.

PubMed

Holahan, Charles J; Brennan, Penny L; Schutte, Kathleen K; Holahan, Carole K; Hixon, J Gregory; Moos, Rudolf H

2018-04-01

There is a lack of research on the role of alcohol consumption in cigarette smoking among older adults, and the few studies on alcohol use and smoking with older adults have failed to distinguish between average level and pattern of drinking as predictors of smoking. The main purpose of this study was to examine the independent contributions of average level versus pattern of drinking as predictors of cigarette smoking among older adults. A subsidiary purpose was to examine the link between continued smoking and mortality among older smokers. We investigated average level and pattern of drinking as predictors of current smoking among 1,151 older adults at baseline and of continued smoking and mortality among the subset of 276 baseline smokers tracked across 20 years. We used multiple linear and logistic regression analyses and, to test mediation, bias-corrected bootstrap confidence intervals. A high level of average drinking and a pattern of episodic heavy drinking were concurrently associated with smoking at baseline. However, only episodic heavy drinking was prospectively linked to continued smoking among baseline smokers. Continued smoking among baseline smokers increased the odds of 20-year mortality and provided an indirect pathway through which heavy episodic drinking related to mortality. Smokers who misuse alcohol are a challenging population for smoking cessation efforts. Older adults who concurrently misuse alcohol and smoke cigarettes provide a unique target for public health interventions. Copyright © 2018 by the Research Society on Alcoholism.

Pills, Thrills and Bellyaches: Case Studies of Prescription Pill Use and Misuse among Marijuana/Blunt Smoking Middle Class Young Women.

PubMed

Bardhi, Flutura; Sifaneck, Stephen J; Johnson, Bruce D; Dunlap, Eloise

2007-01-01

Recent survey research has documented important increases during the 2000s in the misuse and abuse of several prescription drugs (Vicodin, Percocet, Codeine, Dilaudid, Xanax, Klonopin, Valium, Ativan, Adderall, Ritalin, among others). This article focuses upon the patterns of pill use and misuse among young women who are middle-class white and college-educated, and they are also experienced marijuana users who report recreational consumption of other illegal drugs. The ethnographic data provides insights about various ways and reasons that such prescription pill misuse occurs among 12 college-educated, (upper) middle-class, white/Asian women in their 20s who were involved in a major ethnographic study of marijuana and blunts. Three patterns of pill use were observed: recreational; quasi-medical; and legal medical; shifts among these patterns of pill use was common. Few reported that their pill use interfered with their conventional jobs and lifestyles; they concealed such use from their employers and coworkers, and from non-using friends and family members. None reported contacts with police nor seeking treatment specifically for their pill misuse. Many reported misusing prescription pills in conjunction with illegal drugs (marijuana, cocaine, ecstasy) and alcohol. Pills were used as a way to enhance the euphoric effects of other drugs, as well as a way to avoid the negative side effects of illegal drugs. Some reported pill use as a means for reducing expenditures (and use of) alcohol and cocaine. The implications suggest a hidden subpopulation of prescription pill misusers among regular users of marijuana and other illegal drugs. Future research should include users and misusers of various pills to better understand how prescriptions pills interact with illegal drug use patterns.

Pills, Thrills and Bellyaches: Case Studies of Prescription Pill Use and Misuse among Marijuana/Blunt Smoking Middle Class Young Women

PubMed Central

Bardhi, Flutura; Sifaneck, Stephen J.; Johnson, Bruce D.; Dunlap, Eloise

2008-01-01

Recent survey research has documented important increases during the 2000s in the misuse and abuse of several prescription drugs (Vicodin, Percocet, Codeine, Dilaudid, Xanax, Klonopin, Valium, Ativan, Adderall, Ritalin, among others). This article focuses upon the patterns of pill use and misuse among young women who are middle-class white and college-educated, and they are also experienced marijuana users who report recreational consumption of other illegal drugs. The ethnographic data provides insights about various ways and reasons that such prescription pill misuse occurs among 12 college-educated, (upper) middle-class, white/Asian women in their 20s who were involved in a major ethnographic study of marijuana and blunts. Three patterns of pill use were observed: recreational; quasi-medical; and legal medical; shifts among these patterns of pill use was common. Few reported that their pill use interfered with their conventional jobs and lifestyles; they concealed such use from their employers and coworkers, and from non-using friends and family members. None reported contacts with police nor seeking treatment specifically for their pill misuse. Many reported misusing prescription pills in conjunction with illegal drugs (marijuana, cocaine, ecstasy) and alcohol. Pills were used as a way to enhance the euphoric effects of other drugs, as well as a way to avoid the negative side effects of illegal drugs. Some reported pill use as a means for reducing expenditures (and use of) alcohol and cocaine. The implications suggest a hidden subpopulation of prescription pill misusers among regular users of marijuana and other illegal drugs. Future research should include users and misusers of various pills to better understand how prescriptions pills interact with illegal drug use patterns. PMID:19081798

Alcohol dehydrogenase ADH2-1 and ADH2-2 allelic isoforms in the Russian population correlate with type of alcoholic disease.

PubMed

Ogurtsov, Pavel P.; Garmash, Irina V.; Miandina, Galina I.; Guschin, Alexander E.; Itkes, Alexander V.; Moiseev, Valentin S.

2001-09-01

The frequency ADH2-2 allele in the Moscow urban population and a correlation between the ADH2-2 allele, alcoholic dependence without cirrhosis, symptomatic alcoholic cirrhosis and status on hepatitis B and C infection have been studied. One hundred and twenty-three inhabitants of Moscow (50 healthy donors, 36 patients with alcoholic cirrhosis (subdivided into infected and uninfected by HBV and/or HCV) and 37 patients with alcoholic dependence) of a similar age/sex and drinking pattern have been analysed. The frequency of 41% for ADH2-2 allele is characteristic for an urban Moscow population. This value is intermediate between that found for Asian peoples and for Central and Western Europe. There is a negative correlation between the ADH2-2 allele and alcohol misuse (both alcoholic dependence and alcoholic cirrhosis). This correlation is expressed more in alcoholic dependence. In spite of the possession of the ADH2-2 allele (or genotype ADH2-1/2), alcohol misuse increases the risk of cirrhosis. At the same time, positive status for active hepatitis B, C or combined infection B + C (replication markers HBV-DNA or HCV-RNA) increases the risk for symptomatic alcoholic cirrhosis in alcohol abusing patients, independently of ADH2 genotype.

Partnership Working in Community Alcohol Prevention Programmes

ERIC Educational Resources Information Center

Mastache, Claudia; Mistral, Willm; Velleman, Richard; Templeton, Lorna

2008-01-01

The National Alcohol Harm Reduction Strategy for England places much emphasis on creating partnerships at both national and local levels between government, the drinks industry, health services, police, individuals and communities to tackle alcohol misuse and associated harm and disorder. This article describes the characteristic structures and…

Healthcare and medical graduates of 2009: their reactions to four key proposals in the Scottish Government's strategy for tackling alcohol misuse.

PubMed

Gill, Jan S; Gibson, Caroline; Nicol, Maggie

2010-01-01

This study compares the views of final year medical, and nursing and allied health professional (NAHP) students in relation to four governmental proposals impacting on the sale and purchase of alcohol. Against a background of political will to address alcohol abuse in Scotland and moves within the National Health Service promoting a shifting of professional roles, self-completed questionnaires were administered in spring 2009 through course websites and lectures to final year medical and NAHP students. Questionnaires were returned by 406 NAHPs and 121 medical students. Over three quarters of all students agreed with the proposed change to reduce the drink driving limit to 50 mg/100 ml blood. Less support was evident for the raising of the minimum legal purchase age for off-sales (37%), the banning of below cost price promotions of alcohol (47%) and minimum retail pricing (37%). However, there were differences between the NAHP and medical students in the case of the final two proposals; over 60% of the medical students agreed they would have a positive impact. For NAHPs, figures were 41% and 31%, respectively. Support for four key proposals outlined by the Scottish Government to address alcohol misuse varied. Only the suggestion to lower the drink driving limit received backing overall and within students in these professions. Effectiveness of proposed restrictions on the price of alcohol was less well regarded except by medical students. Evident gaps in knowledge around health guidelines, and the finding that almost half of NAHPs disagreed that they had the appropriate knowledge to advise patients about responsible drinking advice and alcohol misuse problems, suggest a need for improved undergraduate education and continued professional development with respect to public health aspects of alcohol use.

The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans.

PubMed

Hassija, Christina M; Jakupcak, Matthew; Maguen, Shira; Shipherd, Jillian C

2012-04-01

The present study evaluated the impact of combat and interpersonal trauma exposure in a sample of 115 U.S. women veterans from Gulf War I and the Iraq and Afghanistan wars on 3 postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Patients presenting for healthcare services at a Veterans Affairs postdeployment health specialty clinic completed screening questionnaires that assessed combat exposure, lifetime interpersonal trauma history of childhood neglect, physical, or sexual abuse, and adult sexual and physical assault. In a regression model, combat exposure was the only significant independent variable associated with PSS, DSS, and alcohol misuse (β = .42, .27 and B = 1.58, respectively) even after adding lifetime interpersonal assault exposure to the model. Results highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Incorporating combat exposure into routine screening procedures for Gulf War and Iraq and Afghanistan war women veterans can aid in mental health treatment planning. Copyright © 2012 International Society for Traumatic Stress Studies.

[Detection of zopiclone in many drivers--a sign of misuse or abuse].

PubMed

Bramness, J G; Skurtveit, S; Mørland, J

1999-08-20

In 1998 zopiclone had a 42% share of the prescribed hypnotic drug market in Norway. The National Institute of Forensic Toxicology analyses all blood samples from suspected drugged drivers. The rise in zopiclone prescription was partly reflected in an increase in the number of drivers with zopiclone detected in the blood. We looked closer at the test results from 101 drivers with zopiclone detected in their blood in the January 1994 to April 1999 period. 60% had blood concentrations of zopiclone above the concentration observed after intake of therapeutic doses; 80% had higher blood concentrations than those expected 8 hours after intake of therapeutic doses. The majority of the drivers also tested positive for illegal drugs, prescription drugs with abuse potential, or alcohol. This indicates that zopiclone is misused or abused. Therefore the same caution should be applied when prescribing zopiclone as is applied when prescribing e.g. benzodiazepines.

Alcohol use in the military: associations with health and wellbeing.

PubMed

Waller, Michael; McGuire, Annabel C L; Dobson, Annette J

2015-07-28

This study assessed the extent to which alcohol consumption in a military group differed from the general population, and how alcohol affected the military group's health and social functioning. A cross sectional survey of military personnel (n = 5311) collected self-reported data on alcohol use (AUDIT scale) and general health, role limitations because of physical health problems (role physical), and social functioning scores (SF36 subscales). Logistic regression was used to compare drinking behaviours between the military sample and a general population sample, using the categories risky drinkers (>2 units per day), low risk drinkers (≤2 standard drinks per day) and abstainers. Groups in the military sample with the highest levels of alcohol misuse (harmful drinking AUDIT ≥ 16, alcohol dependence AUDIT ≥ 20, and binge drinking) were also identified. Linear regression models were then used to assess the association between alcohol misuse and SF36 scores. There were fewer risky drinkers in the military sample than in the general population sample. There were also fewer abstainers, but more people who drank at a lower risk level (≤2 standard drinks per day), than in a sample of the general population. Harmful drinking and alcohol dependence were most commonly observed in men, younger age groups, non-commissioned officers and lower ranks as well as reserve and ex-serving groups. Alcohol misuse was clearly associated with poorer general health scores, more role limitations because of physical health problems, and lower social functioning. Although risky drinking was lower in the military group than in the general population, drinking was associated with poorer health, more limitations because of physical health problems, and poorer social functioning in Defence members. These results highlight the potential benefits for Defence forces in reducing alcohol use among members, in both those groups identified at highest risk, and across the military workforce as a whole.

YouthAccess to Alcohol: early findings from a community action project to reduce the supply of alcohol to teens.

PubMed

Clark, Sam

2007-01-01

The Youth Access to Alcohol (YATA) project was implemented in 2002 by the Alcohol Advisory Council of New Zealand (ALAC) in thirty communities in New Zealand, with the aim of reducing the harm experienced by young people as a result of alcohol misuse in New Zealand through reducing the supply of alcohol by adults to young people. The communities include a mix of rural and urban from both Islands in New Zealand. The project uses a community action approach, which has included setting up collaborative partnerships of key agencies, the delivery of key strategies, and multimedia awareness raising campaigns. The communities are encouraged to identify unique issues in their community regarding alcohol abuse and young people and to develop action plans incorporating a range of strategies that include tested strategies as well as innovative ideas. Communities are trained to implement several tools to monitor changes in their community over time. The study's limitations are noted and future needed research is suggested.

Deficits in Emotion-Regulation Skills Predict Alcohol Use during and after Cognitive-Behavioral Therapy for Alcohol Dependence

ERIC Educational Resources Information Center

Berking, Matthias; Margraf, Matthias; Ebert, David; Wupperman, Peggilee; Hofmann, Stefan G.; Junghanns, Klaus

2011-01-01

Objective: As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, our aim in the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD). Method: A prospective study investigated whether emotion-regulation skills were associated with AD and whether these…

The Feasibility of a Web-Intervention for Military and Veteran Spouses Concerned about their Partner’s Alcohol Misuse

PubMed Central

Osilla, Karen Chan; Pedersen, Eric R.; Tolpadi, Anagha; Howard, Stefanie Stern; Phillips, Jessica L.; Gore, Kristie L.

2017-01-01

Concerned partners (CPs) of military service members and veterans with alcohol misuse can be an important catalyst for change. We adapted the Community Reinforcement and Family Training (CRAFT) intervention into a 4-session web-based intervention (WBI) called Partners Connect. The program aims to help the CP increase their own well-being, teach the CP how to manage his/her behavior (e.g., communication) toward their partner, and identify ways the CP can help their partner reduce drinking and seek treatment. We recruited CPs through social media, and then tested the feasibility and acceptance of the WBI by conducting qualitative interviews and post-WBI session surveys after their WBI sessions. CPs (n=12) spontaneously reported improvements in communication and more effective management of their partner’s drinking due to skills learned. They discussed how the online approach can help overcome barriers to seeking in-person help. This WBI fills an important gap in clinical services for military and veteran CPs and CPs in the general population who may not otherwise seek in-person counseling. PMID:28039559

Postdeployment Behavioral Health Screens and Linkage to the Veterans Health Administration for Army Reserve Component Members.

PubMed

Vanneman, Megan E; Harris, Alex H S; Chen, Cheng; Adams, Rachel Sayko; Williams, Thomas V; Larson, Mary Jo

2017-08-01

Approximately three to six months after returning from deployment, military service members complete the Post-Deployment Health Reassessment (PDHRA), which includes screens for alcohol misuse, depression, and posttraumatic stress disorder (PTSD). To determine whether Army Reserve Component (RC) members (Army National Guard and Army Reserve) with positive screening scores on the PDHRA receive needed care, the investigators examined the association between positive scores and enrollment and utilization of care ("linkage") in the Veterans Health Administration (VHA), as well as rescreening scores, diagnosis, and behavioral treatment in VHA. Mixed-effects regression models were used to predict linkage to VHA within six months after RC members (N=73,164) completed the PDHRA, with alcohol misuse, depression, and PTSD screen scores as key independent variables. Regression models were stratified by gender and National Guard versus Reserve status. Among those who linked to VHA (N=25,168), screening scores and subsequent diagnosis and treatment in VHA were also examined. Army RC members with positive PTSD and depression screening scores were more likely than those with negative screens to link to VHA, and most (54%-84%) received VHA treatment once diagnosed. Positive screens for alcohol misuse were associated with linkage to VHA for men but not for women, and treatment rates for alcohol use disorders were relatively low (0%-25%) for both men and women diagnosed as having an alcohol use disorder. The finding that Army RC members with greater indications of behavioral health problems linked to VHA is encouraging. However, more outreach and treatment engagement strategies could be directed to those with alcohol use disorder, particularly women.

Depression, Anxiety, and Alcohol Use in Elite Rugby League Players Over a Competitive Season.

PubMed

Du Preez, Etienne J; Graham, Kenneth S; Gan, Thomas Y; Moses, Bassam; Ball, Chris; Kuah, Donald E

2017-11-01

To assess the prevalence of symptoms of depression, anxiety, and rates of alcohol misuse in elite rugby league players in Australasia. A cross-sectional, epidemiological study with repeated measures. Surveys were conducted during the 2015 preseason and in-season. Four hundred four elite rugby league players participated preseason and 278 players in-season. Symptoms of depression were measured using the Patient Health Questionnaire-9 scale, symptoms of generalized anxiety disorder (GAD) with the GAD-7 scale, and the Alcohol Use Disorders Identification Test Consumption scale was used to assess hazardous alcohol use. The overall prevalence of depression was 12.6% preseason and 10.1% in-season. Generalized anxiety disorder had a prevalence of 14.6% and 10.1% for these 2 periods. Overall, 68.6% of players had hazardous levels of alcohol use preseason, and 62.8% in-season. There was no significant difference for any of the main outcomes between the periods. Players with a history of mental illnesses had 5.62 greater odds (95% confidence interval [CI], 2.62-12.04) of depression than those without during preseason, and 22.08 greater odds (95% CI, 7.77-62.71) in-season. Players reporting ≥3 previous concussions had 2.02 greater odds (95% CI, 1.07-3.82) of depression than those reporting ≤2 in the preseason sample. Rugby league players have a lower prevalence of depression compared with studies of the general population and other athletes, but a higher prevalence of GAD, and high rates of alcohol misuse. Clubs may consider implementing regular screening for these conditions. Further prospective research to determine causality of independent factors is required.

Development of an Instrument to Assess Parent-College Child Communication Regarding Alcohol Use Behaviors

ERIC Educational Resources Information Center

Chaney, Beth H.; Cremeens, Jennifer

2013-01-01

Background: Past research suggests that parent-child communication can serve as protective factors to reduce alcohol misuse among college-aged children. Purpose: This article presents the methodology used and preliminary findings for developing and validating an instrument to assess parent-college student communication regarding alcohol use.…

Alcohol Drinking Onset: A Reliability Study

ERIC Educational Resources Information Center

Prause, JoAnn; Dooley, David; Ham-Rowbottom, Kathleen A.; Emptage, Nicholas

2007-01-01

Early alcohol drinking onset (ADO) is associated with adult alcohol misuse, but the accuracy of ADO is unclear. Reliability of self-reported ADO was studied in two panels of the National Longitudinal Survey of Youth. For the Adult sample (n = 6,215), the intraclass correlation coefficient (ICC) was 0.36. Older respondents had higher reliabilities…

An Examination of Alcohol Expectations and Social Desirability in Fraternity Members on American College Campuses

ERIC Educational Resources Information Center

Sasso, Pietro A.

2012-01-01

Males who are members of American college fraternal organizations remain one of the heaviest drinking populations among college students (Wall, 2006). Within fraternities, alcohol use is ceded to social status (Larimer et al., 1997). This culturally ingrained alcohol misuse has confounded interventions and programming to address this phenomenon…

An Exploration of Substance Misuse in People with Intellectual Disabilities

ERIC Educational Resources Information Center

Taggart, L.; McLaughlin, D.; Quinn, B.; Milligan, V.

2006-01-01

Background: Little is known about the characteristics of people with intellectual disabilities (IDs) who misuse substances and how such problems impinge upon their well-being. The aim of this paper is to describe how alcohol and drugs affect the health of people with IDs. Methods: A questionnaire was forwarded to all the community ID teams and…

Testing the Social Interaction Learning Model's Applicability to Adolescent Substance Misuse in an Australian Context.

PubMed

Mehus, Christopher J; Doty, Jennifer; Chan, Gary; Kelly, Adrian B; Hemphill, Sheryl; Toumbourou, John; McMorris, Barbara J

2018-03-06

Parents and peers both influence the development of adolescent substance misuse, and the Social Interaction Learning (SIL) model provides a theoretical explanation of the paths through which this occurs. The SIL model has primarily been tested with conduct outcomes and in US samples. This study adds to the literature by testing the SIL model with four substance use outcomes in a sample of Australian youth. We used structural equation modeling to test the fit of the SIL model to a longitudinal sample (n = 907) of students recruited in grade 5 in Victoria, Australia participating in the International Youth Development Study, who were resurveyed in grades 6 and 10. The model fit was good (χ2(95) = 248.52, p < .001; RMSEA = .04 [90% CI: .036 - .049]; CFI = .94; SRMR = .04). Path estimates from parenting to antisocial behavior and from antisocial behavior to antisocial peers were significant. In turn, having antisocial peers was significantly related to alcohol use, binge drinking, tobacco use, and marijuana use. From parenting, only the direct path to marijuana use was significant, but indirect effects were significant. The SIL model illustrates that parenting plays an early role in the formation of adolescent peer relations that influence substance misuse and identifies etiological pathways that can guide the targets of prevention. The SIL pathways appear robust to the Australian social and policy context.

The Role of Violent Thinking in Violent Behavior: It's More About Thinking Than Drinking.

PubMed

Bowes, Nicola; Walker, Julian; Hughes, Elise; Lewis, Rhiannon; Hyde, Gemma

2017-08-01

This article aims to explore and report on violent thinking and alcohol misuse; how these factors may predict self-reported violence. The role of violent thinking in violent behavior is both well established in theoretical models, yet there are few measures that explain this role. One measure that has been identified is the Maudsley Violence Questionnaire (MVQ). This is the first study to explore the use of the MVQ with a general (nonoffender) adult sample, having already been shown to be valid with young people (under 18 years old), adult male offenders, and mentally disordered offenders. This study involved 808 adult participants-569 female and 239 male participants. As figures demonstrate that around half of all violent crime in the United Kingdom is alcohol related, we also explored the role of alcohol misuse. Regression was used to explore how these factors predicted violence. The results demonstrate the important role of violent thinking in violent behavior. The MVQ factor of "Machismo" was the primary factor in regression models for both male and female self-reported violence. The role of alcohol in the regression models differed slightly between the male and female participants, with alcohol misuse involved in male violence. The study supports theoretical models including the role of violent thinking and encourages those hoping to address violence, to consider "Machismo" as a treatment target. The study also provides further validation of the MVQ as a helpful tool for clinicians or researchers who may be interested in "measuring" violent thinking.

Development and validation of the alcohol Expectancy Questionnaire Short Form (EQ-SF).

PubMed

Mezquita, Laura; Camacho, Laura; Suso-Ribera, Carlos; Ortet, Generós; Ibáñez, Manuel I

2018-01-15

Alcohol expectancies are proximal variables to alcohol use and misuse. In recent decades, different measures have been developed to assess this construct. One of the most frequently used and recommended instruments is the Expectancy Questionnaire (EQ; Leigh y Stacy, 1993). Our aim is to develop a short version of the EQ (EQ-SF) for suitable use in time-limited administrations. Two samples, adolescents (N = 514, 57.20% females) and adults (N = 548, 61.50% females), completed the EQ together with alcohol-use measures. Different item selection strategies were applied to select the 24 items. The EQ-SF structure was explored using confirmatory factor analysis, and measurement invariance was tested running a multi-group analysis comparing groups by sex and age. Reliability was tested using Cronbach's alpha and omega coefficients. Concurrent validity was investigated with regression analyses. The EQ-SF showed acceptable between-groups measurement invariance. Alphas and omegas ranged from .77 to .93. Positive expectancies predicted both alcohol use and alcohol-related problems. Negative expectancies predicted alcohol-related problems. Sex and age moderated these associations. Males with high positive alcohol expectancies showed higher alcohol consumption than females, while adults with high negative alcohol expectancies showed greater alcohol-related problems than adolescents. Different evidence on the validity and reliability of the EQ-SF suggest that it is a suitable instrument to assess alcohol expectancies in the Spanish population.

49 CFR 382.601 - Employer obligation to promulgate a policy on the misuse of alcohol and use of controlled...

Code of Federal Regulations, 2010 CFR

2010-10-01

... controlled substances use on an individual's health, work, and personal life; signs and symptoms of an alcohol or a controlled substances problem (the driver's or a co-worker's); and available methods of intervening when an alcohol or a controlled substances problem is suspected, including confrontation, referral...

49 CFR 382.601 - Employer obligation to promulgate a policy on the misuse of alcohol and use of controlled...

Code of Federal Regulations, 2011 CFR

2011-10-01

... controlled substances use on an individual's health, work, and personal life; signs and symptoms of an alcohol or a controlled substances problem (the driver's or a co-worker's); and available methods of intervening when an alcohol or a controlled substances problem is suspected, including confrontation, referral...

Sleep Quality and Alcohol Risk in College Students: Examining the Moderating Effects of Drinking Motives

ERIC Educational Resources Information Center

Kenney, Shannon R.; Paves, Andrew P.; Grimaldi, Elizabeth M.; LaBrie, Joseph W.

2014-01-01

Objective: Sleep problems and alcohol misuse are common issues experienced by college students that can have detrimental effects on overall health. Previous work indicates a strong relationship between poor sleep quality and alcohol risk in this population. This study explored the moderating effect of drinking motives in the relationship between…

Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

PubMed

Akram, Yasmin; Copello, Alex; Moore, David

2014-08-15

Worldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. Extensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded. The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted. This systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of family-based interventions for substance misuse. It will evaluate all the available systematic-review-level literature to report on the effectiveness of family-based psychological interventions in improving substance-related outcomes and improving health and wellbeing of substance misusers and/or their families. This will inform future treatment policies and commissioning decisions.In addition, it will identify areas of poor quality, inconsistency and gaps in the evidence base for family-based psychological interventions in substance misuse with respect to secondary evidence in order to inform future research. PROSPERO CRD42014006834.

The Quik Fix study: a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care.

PubMed

Hides, Leanne; Kavanagh, David J; Daglish, Mark; Cotton, Susan; Connor, Jason P; Barendregt, Jan J; Young, Ross McD; Sanders, Davina; White, Angela; Mergard, Lance

2014-08-08

Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people. This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718.

ADHD Symptoms, Autistic Traits, and Substance Use and Misuse in Adult Australian Twins

PubMed Central

De Alwis, Duneesha; Agrawal, Arpana; Reiersen, Angela M; Constantino, John N; Henders, Anjali; Martin, Nicholas G; Lynskey, Michael T

2014-01-01

Objective: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder frequently co-occur. Several studies show increased risk of substance use disorders in ADHD, yet there is limited information related to how ADHD symptoms, autistic traits, and their combined effects are associated with nicotine, alcohol, and cannabis use and use disorders in the general population. Method: Cross-sectional interview and self-report questionnaire data from 3,080 young adult Australian twins (mean age 31.9 years) were used to assess ADHD symptoms, autistic traits, substance use, and substance use disorders. Substance use disorders—based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria—were assessed in the full sample as well as in those who reported substance use. Logistic regression analyses were used for comparing the associations between ADHD symptoms, autistic traits, substance use, and substance misuse after conduct disorder, sex, age, and zygosity were controlled for. Results: Greater ADHD symptoms and autistic traits scores were associated with elevated levels of regular smoking; cannabis use; and nicotine, alcohol, and cannabis use disorders, even after conduct disorder was adjusted for. In contrast, for alcohol use, those with high autistic traits scores were less likely to report drinking to intoxication. However, upon initiation, and similar to the findings for nicotine and cannabis, they were at elevated risk for developing alcohol dependence. Conclusions: Increased liability to ADHD and elevated autistic traits scores were associated with substance use and misuse, with the exception of alcohol use. Given the social underpinnings of drinking, persons with autistic traits may be less likely to engage in it; however, upon engagement in drinking, their vulnerability to alcohol dependence is elevated. PMID:24650814

ADHD symptoms, autistic traits, and substance use and misuse in adult Australian twins.

PubMed

De Alwis, Duneesha; Agrawal, Arpana; Reiersen, Angela M; Constantino, John N; Henders, Anjali; Martin, Nicholas G; Lynskey, Michael T

2014-03-01

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder frequently co-occur. Several studies show increased risk of substance use disorders in ADHD, yet there is limited information related to how ADHD symptoms, autistic traits, and their combined effects are associated with nicotine, alcohol, and cannabis use and use disorders in the general population. Cross-sectional interview and self-report questionnaire data from 3,080 young adult Australian twins (mean age 31.9 years) were used to assess ADHD symptoms, autistic traits, substance use, and substance use disorders. Substance use disorders-based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria-were assessed in the full sample as well as in those who reported substance use. Logistic regression analyses were used for comparing the associations between ADHD symptoms, autistic traits, substance use, and substance misuse after conduct disorder, sex, age, and zygosity were controlled for. Greater ADHD symptoms and autistic traits scores were associated with elevated levels of regular smoking; cannabis use; and nicotine, alcohol, and cannabis use disorders, even after conduct disorder was adjusted for. In contrast, for alcohol use, those with high autistic traits scores were less likely to report drinking to intoxication. However, upon initiation, and similar to the findings for nicotine and cannabis, they were at elevated risk for developing alcohol dependence. Increased liability to ADHD and elevated autistic traits scores were associated with substance use and misuse, with the exception of alcohol use. Given the social underpinnings of drinking, persons with autistic traits may be less likely to engage in it; however, upon engagement in drinking, their vulnerability to alcohol dependence is elevated.

Postdeployment Behavioral Health Screens and Linkage to the Veterans Health Administration for Army Reserve Component Members

PubMed Central

Vanneman, Megan E.; Harris, Alex H. S.; Chen, Cheng; Adams, Rachel Sayko; Williams, Thomas V.; Larson, Mary Jo

2017-01-01

Objective Approximately three to six months after returning from deployment, military service members complete the Post-Deployment Health Reassessment (PDHRA), which includes screens for alcohol misuse, depression, and post-traumatic stress disorder (PTSD). To determine whether Army Reserve Component (RC) members (Army National Guard and Army Reserve) with positive screening scores on the PDHRA receive needed care, the investigators examined the association between positive scores and enrollment and utilization of care (“linkage”) in the Veterans Health Administration (VHA), as well as rescreening scores, diagnosis, and behavioral treatment in VHA. Methods Mixed-effects regression models were used to predict linkage to VHA within six months after RC members (N=73,164) completed the PDHRA, with alcohol misuse, depression, and PTSD screen scores as key independent variables. Regression models were stratified by gender and National Guard versus Reserve status. Among those who linked to VHA (N=25,168), screening scores and subsequent diagnosis and treatment in VHA were also examined. Results Army RC members with positive PTSD and depression screening scores were more likely than those with negative screens to link to VHA, and most (54%–84%) received VHA treatment once diagnosed. Positive screens for alcohol misuse were associated with linkage to VHA for men but not for women, and treatment rates for alcohol use disorders were relatively low (0%–25%) for both men and women diagnosed as having an alcohol use disorder. Conclusions The finding that Army RC members with greater indications of behavioral health problems linked to VHA is encouraging. However, more outreach and treatment engagement strategies could be directed to those with alcohol use disorder, particularly women. PMID:28412888

Characterizing spouse/partner depression and alcohol problems over the course of military deployment.

PubMed

Erbes, Christopher R; Kramer, Mark; Arbisi, Paul A; DeGarmo, David; Polusny, Melissa A

2017-04-01

Spouse/partners of military personnel demonstrate elevated levels of distress during military deployments, yet there is insufficient information about courses of adjustment over time. The current study identified trajectories of depression and alcohol use problems and predictors of those trajectories across the deployment cycle. National Guard soldiers (N = 1973) and spouses/intimate partners (N = 1020) completed assessments of risk/protective factors and baseline measures of mental health functioning 2 to 5 months prior to soldiers' 1-year deployments (Time 1) to Kuwait/Iraq in support of Operation New Dawn or Afghanistan in support of Operation Enduring Freedom. Partners' mental health was reassessed at 4 months (Time 2) and 8 months (Time 3) after soldiers deployed, and both spouses/partners and soldiers were reassessed 2-3 months postdeployment (Time 4). Latent class growth modeling of partner depression symptoms over time revealed 4 groups: Resilience (79.9%), Deployment Distress (8.9%), Anticipatory Distress (8.4%), and Post-Deployment Distress (2.7%). Three alcohol misuse trajectories were identified: Resilience (91.3%), Deployment Onset (5.4%), and Deployment Desistance (3.3%). Predeployment predictors of partners' depression symptom trajectories varied by group and included soldier reports of stressors and social support and partner levels of neuroticism, introversion, disconstraint, and reported stressors. Predeployment predictors of alcohol misuse trajectories varied by group, and included soldier levels of alcohol misuse as well as partner neuroticism, disconstraint, and family readiness. Delineating and predicting trajectories of partner adjustment can allow for better targeted interventions toward those most at risk for heightened distress or alcohol problems over the deployment cycle. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Reliability of a questionnaire on substance use among adolescent students, Brazil.

PubMed

Machado Neto, Adelmo de Souza; Andrade, Tarcisio Matos; Fernandes, Gilênio Borges; Zacharias, Helder Paulo; Carvalho, Fernando Martins; Machado, Ana Paula Souza; Dias, Ana Carmen Costa; Garcia, Ana Carolina Rocha; Santana, Lauro Reis; Rolin, Carlos Eduardo; Sampaio, Cyntia; Ghiraldi, Gisele; Bastos, Francisco Inácio

2010-10-01

To analyze reliability of a self-applied questionnaire on substance use and misuse among adolescent students. Two cross-sectional studies were carried out for the instrument test-retest. The sample comprised male and female students aged 1119 years from public and private schools (elementary, middle, and high school students) in the city of Salvador, Northeastern Brazil, in 2006. A total of 591 questionnaires were applied in the test and 467 in the retest. Descriptive statistics, the Kappa index, Cronbach's alpha and intraclass correlation were estimated. The prevalence of substance use/misuse was similar in both test and retest. Sociodemographic variables showed a "moderate" to "almost perfect" agreement for the Kappa index, and a "satisfactory" (>0.75) consistency for Cronbach's alpha and intraclass correlation. The age which psychoactive substances (tobacco, alcohol, and cannabis) were first used and chronological age were similar in both studies. Test-retest reliability was found to be a good indicator of students' age of initiation and their patterns of substance use. The questionnaire reliability was found to be satisfactory in the population studied.

Alcohol Screening and Brief Intervention: A Potential Role in Cancer Prevention for Young Adults

PubMed Central

McKnight-Eily, Lela R.; Henley, S. Jane; Green, Patricia P.; Odom, Erika C.; Hungerford, Daniel W.

2017-01-01

Excessive or risky alcohol use is a preventable cause of significant morbidity and mortality in the U.S. and worldwide. Alcohol use is a common preventable cancer risk factor among young adults; it is associated with increased risk of developing at least six types of cancer. Alcohol consumed during early adulthood may pose a higher risk of female breast cancer than alcohol consumed later in life. Reducing alcohol use may help prevent cancer. Alcohol misuse screening and brief counseling or intervention (also called alcohol screening and brief intervention among other designations) is known to reduce excessive alcohol use, and the U.S. Preventive Services Task Force recommends that it be implemented for all adults aged ≥ 18 years in primary healthcare settings. Because the prevalence of excessive alcohol use, particularly binge drinking, peaks among young adults, this time of life may present a unique window of opportunity to talk about the cancer risk associated with alcohol use and how to reduce that risk by reducing excessive drinking or misuse. This article briefly describes alcohol screening and brief intervention, including the Centers for Disease Control and Prevention’s recommended approach, and suggests a role for it in the context of cancer prevention. The article also briefly discusses how the Centers for Disease Control and Prevention is working to make alcohol screening and brief intervention a routine element of health care in all primary care settings to identify and help young adults who drink too much. PMID:28818247

Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare?

PubMed Central

MCLELLAN, A. THOMAS

2017-01-01

This paper first introduces important conceptual and practical distinctions among three key terms: substance “use,” “misuse,” and “disorders” (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States. With this as background, the paper then describes historical views, perspectives, and efforts to deal with substance misuse problems in the United States and discusses how basic, clinical, and health service research, combined with recent changes in healthcare legislation and financing, have set the stage for a more effective, comprehensive public health approach. PMID:28790493

Substance Misuse and Substance use Disorders: Why do they Matter in Healthcare?

PubMed

McLellan, A Thomas

2017-01-01

This paper first introduces important conceptual and practical distinctions among three key terms: substance "use," "misuse," and "disorders" (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States. With this as background, the paper then describes historical views, perspectives, and efforts to deal with substance misuse problems in the United States and discusses how basic, clinical, and health service research, combined with recent changes in healthcare legislation and financing, have set the stage for a more effective, comprehensive public health approach.

Prescription Stimulant Misuse in a Military Population

DTIC Science & Technology

2015-03-01

physical injuries. INTRODUCTION Attention - deficit and hyperactivity disorder (ADHD) is reported to affect between 8% and 12% of children and 4% of...admitted with unintentional poisonings of attention - deficit / hyperactivity disorder drugs in the United States. Clin Toxicol 2013; 51: 147–50. 8. Bray...postdeployment post-traumatic stress disorder (PTSD), depres- sion, and alcohol misuse in Operation Enduring Freedom/ Operation Iraqi Freedom veterans showed

Diverting the Pathway to Substance Misuse by Improving Sleep

DTIC Science & Technology

2015-05-01

Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT The recent Institute of Medicine report underscores an alarming increase in ...common among Warfighters with recent deployments and are associated with mental health problems and alcohol and other substance misuse. Insomnia is...for this proposal is that targeting sleep disturbance in post-deployed Veterans in a manner that addresses factors that are specific to military

Examining a Brief Suicide Screening Tool in Older Adults Engaging in Risky Alcohol Use

ERIC Educational Resources Information Center

Ribeiro, Jessica D.; Braithwaite, Scott R.; Pfaff, Jon J.; Joiner, Thomas E.

2012-01-01

Alcohol misuse increases risk of suicidal behavior in older adults. The Depressive Symptom Inventory-Suicidality Subscale (DSI-SS; Metalsky & Joiner, 1997) and its relation to suicide attempt history was examined to see if it differed for older adults as a function of their alcohol use. Structural equation modeling was used in a sample (N = 1,061)…

Parenting Programmes for Preventing Tobacco, Alcohol or Drugs Misuse in Children Less than 18: A Systematic Review

ERIC Educational Resources Information Center

Petrie, Jane; Bunn, Frances; Byrne, Geraldine

2007-01-01

We conducted a systematic review of controlled studies of parenting programmes to prevent tobacco, alcohol or drug abuse in children less than 18. We searched Cochrane Central Register of Controlled Trials, specialized Register of Cochrane Drugs and Alcohol Group, Pub Med, psych INFO, CINALH and SIGLE. Two reviewers independently screened studies,…

Influence of Sports' Programs and Club Activities on Alcohol Use Intentions and Behaviors among Adolescent Males

ERIC Educational Resources Information Center

Leaver-Dunn, Deidre; Turner, Lori; Newman, Brian M.

2007-01-01

In the United States, more than 70 percent of all deaths among youth and young adults each year are related to four causes: motor vehicle crashes, other unintentional injuries, homicide, and suicide. Alcohol misuse and abuse contribute to each of these behaviors. Alcohol is the most frequently consumed mind-altering substance among…

Remaining Off Alcohol and Drugs: A Self-Management Skills Program for Abstinence.

ERIC Educational Resources Information Center

Dunphy, Peter Hughes

The Remaining Off Alcohol and Drugs Program (ROAD) was developed to teach newly abstinent chemical misusing clients how to remain alcohol and drug free. It provides its participants with a repertoire of knowledge, skills and behaviors that they can use in dealing with the most common problems caused by discontinuing chemical use and which can be…

Adolescents' Reported Reasons for Alcohol and Marijuana Use as Predictors of Substance Use and Problems in Adulthood*

PubMed Central

Patrick, Megan E.; Schulenberg, John E.; O'malley, Patrick M.; Johnston, Lloyd D.; Bachman, Jerald G.

2011-01-01

Objective: The aim of this study was to examine how reasons for substance use at age 18 relate to alcohol and marijuana use at ages 18 and 35 and to symptoms of alcohol use disorder and marijuana use disorder at age 35. Method: Bivariate correlation and multivariate regression analyses were conducted to examine the prediction of substance use and misuse by social/recreational, coping with negative affect, compulsive, and drug effect reasons for alcohol and marijuana use. Control variables included gender, race/ethnicity, parent education, and previous substance use (for age 35 outcomes). Results: Social/recreational, coping, and drug effect reasons for drinking predicted symptoms of alcohol use disorder 17 years later. Reasons for marijuana use were generally associated only with concurrent marijuana use; an exception was that drug effect reasons predicted marijuana use disorder at age 35. Conclusions: The long-term longitudinal predictive power of reasons for alcohol use (and, to a lesser extent, for marijuana use) suggests that adolescents' self-reported reasons, in particular those involving regulating emotions and experiences, may be early risk factors for continued use and misuse of substances into adulthood. PMID:21138717

Sport-related achievement motivation and alcohol outcomes: an athlete-specific risk factor among intercollegiate athletes.

PubMed

Weaver, Cameron C; Martens, Matthew P; Cadigan, Jennifer M; Takamatsu, Stephanie K; Treloar, Hayley R; Pedersen, Eric R

2013-12-01

Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed. © 2013.

Alcohol and Alzheimer's Disease-Does Alcohol Dependence Contribute to Beta-Amyloid Deposition, Neuroinflammation and Neurodegeneration in Alzheimer's Disease?

PubMed

Venkataraman, Ashwin; Kalk, Nicola; Sewell, Gavin; Ritchie, Craig W; Lingford-Hughes, Anne

2017-03-09

To investigate the underlying neurobiology between alcohol use, misuse and dependence and cognitive impairment, particularly Alzheimer's disease (AD). Review of the literature using searches of Medline, Pubmed, EMBASE, PsycInfo, and meeting abstracts and presentations. The role of alcohol as a risk factor and contributor for cognitive decline associated with AD has received little attention. This is despite the high prevalence of alcohol use, the potential reversibility of a degree of cognitive impairment and the global burden of AD. Until now the focus has largely been on the toxic effects of alcohol, neuronal loss and the role of thiamine. We propose alcohol adds to the cognitive burden seen in dementia through additional mechanisms to neurodegenerative processes or may contribute at various mechanistic points in the genesis and sustenance of AD pathology via neuroinflammation. We describe the common underlying neurobiology in alcohol and AD, and examine ways alcohol likely contributes to neuroinflammation directly via stimulation of Toll-like receptors and indirectly from small bowel changes, hepatic changes, withdrawal and traumatic brain injury to the pathogenesis of AD. Alcohol use, misuse and dependence cause cognitive impairment. We propose alcohol adds to the cognitive burden seen in dementia through additional mechanisms to neurodegenerative processes or may contribute at various mechanistic points in the genesis and sustenance of AD pathology via neuroinflammation. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Sport-Related Achievement Motivation and Alcohol Outcomes: An Athlete-Specific Risk Factor among Intercollegiate Athletes

PubMed Central

Weaver, Cameron C.; Martens, Matthew P.; Cadigan, Jennifer M.; Takamatsu, Stephanie K.; Treloar, Hayley R.; Pedersen, Eric R.

2014-01-01

Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n = 263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed. PMID:24064192

Parental alcohol dependence and the transmission of adolescent behavioral disinhibition: a study of adoptive and non-adoptive families.

PubMed

King, Serena M; Keyes, Margaret; Malone, Stephen M; Elkins, Irene; Legrand, Lisa N; Iacono, William G; McGue, Matt

2009-04-01

To examine the genetic and environmental influences of parental alcoholism on offspring disinhibited behavior. We compared the effect of parental alcoholism history on offspring in adoptive and non-adoptive families. In families with a history of parental alcohol dependence, we examined the effect of exposure to parental alcoholism symptoms during the life-time of the adolescent. Setting Assessments occurred at the University of Minnesota from 1998 to 2004. Adolescents adopted in infancy were ascertained systematically from records of three private Minnesota adoption agencies; non-adopted adolescents were ascertained from Minnesota birth records. Adolescents and their rearing parents participated in in-person assessments. For adolescents, measures included self- reports of delinquency, deviant peers, substance use, antisocial attitudes and personality. For parents, we conducted DSM-IV clinical assessments of alcohol abuse and dependence. A history of parental alcohol dependence was associated with higher levels of disinhibition only when adolescents were related biologically to their rearing parents. Within families with a history of parental alcoholism, exposure to parental alcohol misuse during the life-time of the adolescent was associated with increased odds of using alcohol in adopted adolescents only. These findings suggest that the association between a history of parental alcohol dependence and adolescent offspring behavioral disinhibition is attributable largely to genetic rather than environmental transmission. We also obtained some evidence for parental alcohol misuse as a shared environmental risk factor in adoptive families.

Misuse of Psychologically Active Substances of Convicts being in Prisons and their Treatment

PubMed Central

Plojovic, Safuadan; Dimitrijevic, Slavica; Maksimovic, Andrijana; Zejnelagic, Sabina; Hurem, Adem; Muraspahic, Muamer

2016-01-01

Due to the data of the Ministry of Justice of the Republic of Serbia, over 70% of persons being in prisons and serving their sentences are drug addicts, and 50% of them are drug users. In the European prisons, the percentage of persons using drugs in the entire prison population is 20-70%, and in the USA 70-80%, in the Australian prisons between 50 and 80% of the convicts in prisons are addicts of psychologically active substances. The results of our survey are pursuant to official statistics data for Serbia, the European countries, USA and Australia, since 80% of our convicts in prisons have misused psychologically active substances during the period of 30 days, the previous period before coming to these institutions. More than a half of our examinees (60%), misuses narcotics and alcohol occasionally or permanently, the alcohol users only 12.7%, and only narcotics 7.3% of the ones, meaning that a treatment of addiction disease should have a significant role in prevention of recidivism. PMID:27275354

Biomolecules and Biomarkers Used in Diagnosis of Alcohol Drinking and in Monitoring Therapeutic Interventions.

PubMed

Nanau, Radu M; Neuman, Manuela G

2015-06-29

The quantitative, measurable detection of drinking is important for the successful treatment of alcohol misuse in transplantation of patients with alcohol disorders, people living with human immunodeficiency virus that need to adhere to medication, and special occupational hazard offenders, many of whom continually deny drinking. Their initial misconduct usually leads to medical problems associated with drinking, impulsive social behavior, and drunk driving. The accurate identification of alcohol consumption via biochemical tests contributes significantly to the monitoring of drinking behavior. A systematic review of the current methods used to measure biomarkers of alcohol consumption was conducted using PubMed and Google Scholar databases (2010-2015). The names of the tests have been identified. The methods and publications that correlate between the social instruments and the biochemical tests were further investigated. There is a clear need for assays standardization to ensure the use of these biochemical tests as routine biomarkers. Alcohol ingestion can be measured using a breath test. Because alcohol is rapidly eliminated from the circulation, the time for detection by this analysis is in the range of hours. Alcohol consumption can alternatively be detected by direct measurement of ethanol concentration in blood or urine. Several markers have been proposed to extend the interval and sensitivities of detection, including ethyl glucuronide and ethyl sulfate in urine, phosphatidylethanol in blood, and ethyl glucuronide and fatty acid ethyl esters in hair, among others. Moreover, there is a need to correlate the indirect biomarker carbohydrate deficient transferrin, which reflects longer lasting consumption of higher amounts of alcohol, with serum γ-glutamyl transpeptidase, another long term indirect biomarker that is routinely used and standardized in laboratory medicine.

Biomolecules and Biomarkers Used in Diagnosis of Alcohol Drinking and in Monitoring Therapeutic Interventions

PubMed Central

Nanau, Radu M.; Neuman, Manuela G.

2015-01-01

Background: The quantitative, measurable detection of drinking is important for the successful treatment of alcohol misuse in transplantation of patients with alcohol disorders, people living with human immunodeficiency virus that need to adhere to medication, and special occupational hazard offenders, many of whom continually deny drinking. Their initial misconduct usually leads to medical problems associated with drinking, impulsive social behavior, and drunk driving. The accurate identification of alcohol consumption via biochemical tests contributes significantly to the monitoring of drinking behavior. Methods: A systematic review of the current methods used to measure biomarkers of alcohol consumption was conducted using PubMed and Google Scholar databases (2010–2015). The names of the tests have been identified. The methods and publications that correlate between the social instruments and the biochemical tests were further investigated. There is a clear need for assays standardization to ensure the use of these biochemical tests as routine biomarkers. Findings: Alcohol ingestion can be measured using a breath test. Because alcohol is rapidly eliminated from the circulation, the time for detection by this analysis is in the range of hours. Alcohol consumption can alternatively be detected by direct measurement of ethanol concentration in blood or urine. Several markers have been proposed to extend the interval and sensitivities of detection, including ethyl glucuronide and ethyl sulfate in urine, phosphatidylethanol in blood, and ethyl glucuronide and fatty acid ethyl esters in hair, among others. Moreover, there is a need to correlate the indirect biomarker carbohydrate deficient transferrin, which reflects longer lasting consumption of higher amounts of alcohol, with serum γ-glutamyl transpeptidase, another long term indirect biomarker that is routinely used and standardized in laboratory medicine. PMID:26131978

Are baby boomer women unique? The moderating effect of birth cohort on age in substance use patterns during midlife.

PubMed

Sarabia, Stephanie Elias; Martin, James I

2016-01-01

This study examined the relationships of age to use of alcohol, marijuana, and illicit drugs, and misuse of prescription drugs, among midlife women and whether these relationships are modified by birth cohort. Structural Equation Modeling was used to analyze National Survey on Drug Use and Health data, which included 2,035 baby boomer and silent generation cohort women, ages 30 to 55. Midlife women across cohorts reduced alcohol and marijuana use, but not illicit and prescription drug misuse, as they aged. A modifying effect of birth cohort was not supported, but findings did support differential aging effects across substances. Implications are discussed.

Assessment of an alternative postdeployment reintegration strategy with soldiers returning from Iraq.

PubMed

Sipos, Maurice L; Foran, Heather M; Wood, Michael D; Wright, Kathleen M; Barnhart, Vincent J; Riviere, Lyndon A; Adler, Amy B

2014-05-01

The present study examined behavioral health outcomes, risk behaviors, aggression, alcohol misuse, marital satisfaction, and attitudes toward reintegration associated with an alternative, front-loaded reintegration strategy compared with a more standardized reintegration process in soldiers returning from combat deployments. The type of reintegration strategy used did not predict differences in posttraumatic stress disorder (PTSD) symptoms, alcohol misuse, aggression, and marital satisfaction, although slightly higher reports of risk behaviors were found in the unit using the standard reintegration approach even after controlling for demographic covariates and combat exposure. These findings may help guide leadership when making decisions regarding reintegration approaches in the future. PsycINFO Database Record (c) 2014 APA, all rights reserved.

An alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting (ADAPTA): study protocol for a randomized, controlled pilot trial.

PubMed

Watson, Judith; Tober, Gillian; Raistrick, Duncan; Mdege, Noreen; Dale, Veronica; Crosby, Helen; Godfrey, Christine; Lloyd, Charlie; Toner, Paul; Parrott, Steve

2013-04-30

Alcohol misuse is a major cause of premature mortality and ill health. Although there is a high prevalence of alcohol problems among patients presenting to general hospital, many of these people are not help seekers and do not engage in specialist treatment. Hospital admission is an opportunity to steer people towards specialist treatment, which can reduce health-care utilization and costs to the public sector and produce substantial individual health and social benefits. Alcohol misuse is associated with other lifestyle problems, which are amenable to intervention. It has been suggested that the development of a healthy or balanced lifestyle is potentially beneficial for reducing or abstaining from alcohol use, and relapse prevention. The aim of the study is to test whether or not the offer of a choice of health-related lifestyle interventions is more acceptable, and therefore able to engage more problem drinkers in treatment, than an alcohol-focused intervention. This is a pragmatic, randomized, controlled, open pilot study in a UK general hospital setting with concurrent economic evaluation and a qualitative component. Potential participants are those admitted to hospital with a diagnosis likely to be responsive to addiction interventions who score equal to or more than 16 on the Alcohol Use Disorders Identification Test (AUDIT). The main purpose of this pilot study is to evaluate the acceptability of two sorts of interventions (healthy living related versus alcohol focused) to the participants and to assess the components and processes of the design. Qualitative research will be undertaken to explore acceptability and the impact of the approach, assessment, recruitment and intervention on trial participants and non-participants. The effectiveness of the two treatments will be compared at 6 months using AUDIT scores as the primary outcome measure. There will be additional economic, qualitative and secondary outcome measurements. Development of the study was a collaboration between academics, commissioners and clinicians in general hospital and addiction services, made possible by the Collaboration in Leadership in Applied Health Research and Care (CLAHRC) program of research. CLAHRC was a necessary vehicle for overcoming the barriers to answering an important NHS question--how better to engage problem drinkers in a hospital setting. ISRCTN47728072.

Self-Reported Alcohol and Drug Problems Among Internal Medicine Outpatients: Relationships With Criminal Behavior

PubMed Central

Lam, Charlene; Wiederman, Michael W.

2011-01-01

Objective: Previous research indicates relationships between alcohol/substance misuse and criminal behavior, but past studies have restricted investigations to atypical samples and/or utilized limited assessments of illegal behavior. In the present study, we explored relationships between alcohol/drug problems and charges for 27 criminal behaviors in a primary care sample. Method: Participants were a cross-sectional sample of 376 consecutive men and women, aged 18 years or older, being seen for nonemergent medical care at an outpatient internal medicine clinic staffed predominantly by residents and located in a midsized, midwestern city in October 2010. Using a self-report survey methodology, we examined relationships between alcohol and drug problems (“Have you ever had a problem with alcohol?” and “Have you ever had a problem with drugs?”) and 27 illegal behaviors as delineated by the categories used by the US Federal Bureau of Investigation. Results: Men with alcohol or drug problems statistically exhibited the greatest number of charges for different forms of illegal behavior (P < .001). These charges were directly related to alcohol/drug misuse (eg, driving under the influence of alcohol or drugs) and otherwise (eg, aggravated assault, simple assault, gambling, larceny-theft). Conclusions: In primary care settings, men with alcohol/drug problems may also have a history of illegal behaviors—a finding that is relevant in terms of social and legal implications. PMID:22454803

Referral to treatment for hospitalized medical patients with an alcohol use disorder: A proof-of-concept brief intervention study.

PubMed

Berger, Lisa; Hernandez-Meier, Jennifer; Hyatt, John; Brondino, Michael

2017-01-01

Substance misuse intervention in healthcare settings is becoming a US national priority, especially in the dissemination and implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT). Yet, the referral to treatment component of SBIRT is understudied. This proof-of-concept investigation tested an enhanced coordinated hospital-community two session brief intervention designed to facilitate the referral to treatment of hospitalized medical patients with an alcohol use disorder. Participants (N = 9) attended the second session of the brief intervention held in the community in most cases (56%), while one out of three (33%) received some level of post-brief intervention alcohol and/or other drug treatment. Alcohol use and alcohol-related problems also statistically improved. Based, in part, on the results plus the widespread dissemination of SBIRT, next step investigations of brief interventions to help bridge hospitalized medical patients in need to community substance abuse treatment are warranted.

Specific impact of stimulant, alcohol and cannabis use disorders on first-episode psychosis: 2-year functional and symptomatic outcomes.

PubMed

Ouellet-Plamondon, C; Abdel-Baki, A; Salvat, É; Potvin, S

2017-10-01

Many studies have concluded that cannabis use disorder (CUD) negatively influences outcomes in first-episode psychosis (FEP). However, few have taken into account the impact of concurrent misuse of other substances. This 2-year, prospective, longitudinal study of FEP patients, aged between 18 and 30 years, admitted to early intervention programs in Montreal, Quebec, Canada, examined the specific influence of different substance use disorders (SUD) (alcohol, cannabis, cocaine, amphetamines) on service utilization, symptomatic and functional outcomes in FEP. Drugs and alcohol were associated with lower functioning, but drugs had a greater negative impact on most measures at 2-year follow-up. Half of CUD patients and more than 65% of cocaine or amphetamine abusers presented polysubstance use disorder (poly-SUD). The only group that deteriorated from years 1 to 2 (symptoms and functioning) were patients with persistent CUD alone. Outcome was worse in CUD than in the no-SUD group at 2 years. Cocaine, amphetamines and poly-SUD were associated with worse symptomatic and functional outcomes from the 1st year of treatment, persisting over time with higher service utilization (hospitalization). The negative impact attributed to CUD in previous studies could be partly attributed to methodological flaws, like including polysubstance abusers among cannabis misusers. However, our investigation confirmed the negative effect of CUD on outcome. Attention should be paid to persistent cannabis misusers, since their condition seems to worsen over time, and to cocaine and amphetamine misusers, in view of their poorer outcome early during follow-up and high service utilization.

A case-comparison study of executive functions in alcohol-dependent adults with maternal history of alcoholism.

PubMed

Cottencin, Olivier; Nandrino, Jean-Louis; Karila, Laurent; Mezerette, Caroline; Danel, Thierry

2009-04-01

As executive dysfunctions frequently accompany alcohol dependence, we suggest that reports of executive dysfunction in alcoholics are actually due, in some case to a maternal history of alcohol misuse (MHA+). A history of maternal alcohol dependence increases the risk for prenatal alcohol exposure to unborn children. These exposures likely contribute to executive dysfunction in adult alcoholics. To assess this problem, we propose a case-comparison study of alcohol-dependent subjects with and without a MHA. Ten alcohol-dependent subjects, with a maternal history of alcoholism (MHA) and paternal history of alcoholism (PHA), were matched with 10 alcohol-dependent people with only a paternal history of alcoholism (PHA). Executive functions (cancellation, Stroop, and trail-making A and B tests) and the presence of a history of three mental disorders (attention deficit hyperactivity disorder, violent behavior while intoxicated, and suicidal behavior) were evaluated in both populations. Alcohol-dependent subjects with MHA showed a significant alteration in executive functions and significantly more disorders related to these functions than PHA subjects. The major measures of executive functioning deficit are duration on task accomplishment in all tests. Rates of ADHD and suicidality were found to be higher in MHA patients compared to the controls. A history of MHA, because of the high risk of PAE (in spite of the potential confounding factors such as environment) must be scrupulously documented when evaluating mental and cognitive disorders in a general population of alcoholics to ensure a better identification of these disorders. It would be helpful to replicate the study with more subjects.

Screening for Addictive Disorders Within a Workers’ Compensation Clinic: An Exploratory Study

PubMed Central

Parhami, Iman; Hyman, Mark; Siani, Aaron; Lin, Stephanie; Collard, Michael; Garcia, Johnny; Casaus, Laurie; Tsuang, John; Fong, Timothy W.

2012-01-01

We conducted a cross-sectional study investigating the extent of addictive disorders within a workers’ compensation (WC) clinic. We also examined the feasibility of substance abuse screening within the same clinic. In 2009, 100 patients were asked to complete the World Health Organization’s Alcohol, Smoking, Substance Involvement Screening Test (WHO-ASSIST) and the Current Opioid Misuse Measure (COMM). According to the WHO-ASSIST, we found that 46% of WC patients required intervention for at least one substance-related disorder (25% tobacco, 23% sedatives, 8% opioids), and according to the COMM, 46% screened positive for prescription opioid misuse. Importantly, the addition of this screening was brief, economical, and well accepted by patients. Further research should analyze the costs and benefits of detection and intervention of substance-related disorders in this setting. PMID:22066751

Alcohol Misuse and Associations with Childhood Maltreatment and Out-of-Home Placement among Urban Two-Spirit American Indian and Alaska Native People

PubMed Central

Yuan, Nicole P.; Duran, Bonnie M.; Walters, Karina L.; Pearson, Cynthia R.; Evans-Campbell, Tessa A.

2014-01-01

This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals. PMID:25317980

Management of alcohol misuse in Scotland: the role of A&E nurses.

PubMed

Anderson, S; Eadie, D R; MacKintosh, A M; Haw, S

2001-04-01

Despite national targets to reduce excessive drinking in Scotland, rates have increased dramatically since the mid-eighties. The role of Accident and Emergency (A&E) departments in the management of alcohol misuse is much debated. This postal survey was conducted with senior medical and nursing staff in A&E departments and minor injury units throughout Scotland to examine the prevalence of alcohol-related attendances and staff's attitudes towards identifying and responding to alcohol-related attendances. A 57% response rate was achieved, representing 87% of all A&E institutions in Scotland (n = 84). The results reveal an estimated 1 in 7 attendances in A&E in Scotland are alcohol-related, and 1 in 5 of these result in admission. However, over two-fifths of departments do not routinely screen for, or keep records of, patients who attend with alcohol problems. Intervention is normally limited to a brief dialogue and referral to the patient's GP. Despite considerable barriers, A&E nursing staff express a willingness to assume a preventive role, but acknowledge lack of appropriate training and sources of support. It is concluded that there is scope for developing identification and brief intervention services within A&E. However, such developments are dependent upon alcohol issues assuming a higher priority among senior A&E staff.

Economic consequences of legal and illegal drugs: The case of social costs in Belgium.

PubMed

Lievens, Delfine; Vander Laenen, Freya; Verhaeghe, Nick; Putman, Koen; Pauwels, Lieven; Hardyns, Wim; Annemans, Lieven

2017-06-01

Legal and illegal drugs impose a considerable burden to the individual and to society. The misuse of addictive substances results in healthcare and law enforcement costs, loss of productivity and reduced quality of life. A social cost study was conducted to estimate the substance-attributable costs of alcohol, tobacco, illegal drugs and psychoactive medication to Belgian society in 2012. The cost-of-illness framework with prevalence-based and human capital approach was applied. Three cost components were considered: direct, indirect and intangible costs related to substance misuse. The direct and indirect cost of addictive substances was estimated at 4.6 billion euros in Belgium (419 euros per capita or 1.19% of the GDP) and more than 515,000 healthy years are lost due to substance misuse. The Belgian social cost study reaffirms that alcohol and tobacco impose the highest cost to society compared to illegal drugs. Health problems are the main driver of the social cost of legal drugs. Law enforcement expenditure exceed the healthcare costs but only in the case of illegal drugs. Estimating social costs of addictive substances is complex because it is difficult to determine to what extent the societal harm is caused by substances. It can be argued that social cost studies take only a 'snapshot' of the monetary consequences of substance misuse. Nevertheless, the current study offers the most comprehensive analysis thus far of the social costs of substance misuse in Belgium. Copyright © 2017 Elsevier B.V. All rights reserved.

Faculty buy-in to teach alcohol and drug use screening.

PubMed

Puskar, Kathy; Mitchell, Ann M; Kane, Irene; Hagle, Holly; Talcott, Kimberly S

2014-09-01

Educating nursing faculty about the use of an evidence-based practice to screen and intervene earlier along the continuum of alcohol and other drug use, misuse, and dependence is essential in today's health care arena. Misuse of alcohol and other drugs is a significant problem for both individual health and societal economic welfare. The purpose of this article is to describe nursing faculty buy-in for the implementation of an evidence-based addiction training program at a university-based school of nursing. Derived from an academic-community partnership, the training program results suggest implications for continuing education and curriculum innovation in schools of nursing and clinical practice. The training content presented can be used in continuing education for nursing faculty across all types of nursing school programs and professional nursing staff employed in multiple settings. The training program was funded by the Health Resources and Services Administration.

Preventing alcohol misuse in young people aged 9-11 years through promoting family communication: an exploratory evaluation of the Kids, Adults Together (KAT) Programme

PubMed Central

2011-01-01

Background Alcohol misuse by young people is an important public health issue, and has led to the development of a range of prevention interventions. Evidence concerning the most effective approaches to intervention design and implementation is limited. Parental involvement in school-based interventions is important, but many programmes fail to recruit large numbers of parents. This paper reports findings from an exploratory evaluation of a new alcohol misuse prevention programme - Kids, Adults Together (KAT), which comprised a classroom component, engagement with parents through a fun evening for families with children aged 9-11 years, and a DVD. The evaluation aimed to establish the programme's theoretical basis, explore implementation processes and acceptability, and identify plausible precursors of the intended long-term outcomes. Methods Documentary analysis and interviews with key personnel examined the programme's development. Classroom preparation and KAT family events in two schools were observed. Focus groups with children, and interviews with parents who attended KAT family events were held immediately after programme delivery, and again after three months. Interviews with head teachers and with teachers who delivered the classroom preparation were conducted. Follow-up interviews with programme personnel were undertaken. Questionnaires were sent to parents of all children involved in classroom preparation. Results KAT achieved high levels of acceptability and involvement among both children and parents. Main perceived impacts of the programme were increased pro-social communication within families (including discussions about harmful parental alcohol consumption), heightened knowledge and awareness of the effects of alcohol consumption and key legal and health issues, and changes in parental drinking behaviours. Conclusions KAT demonstrated promise as a prevention intervention, primarily through its impact on knowledge and communication processes within families, and its ability to engage with large numbers of parents. A key programme mechanism was the classroom preparation's facilitation of parental involvement in the family fun evening. The programme also incorporated features identified in the literature as likely to increase effectiveness, including a focus on harm reduction, interactive delivery, and targeting primary-school-age children. Further research is needed to test and develop programme theory through implementation in different school contexts, and to examine potential longer-term impacts, and the feasibility of large scale delivery. PMID:22004185

Suicidal ideation in Veterans misusing alcohol: Relationships with insomnia symptoms and sleep duration

PubMed Central

Chakravorty, Subhajit; Grandner, Michael A.; Mavandadi, Shahrzad; Perlis, Michael L.; Sturgis, Elliott B.; Oslin, David W.

2015-01-01

Objective The aim of this investigation was to assess the relationships between suicidal ideation and insomnia symptoms in Veterans misusing alcohol. Method Data were extracted in this retrospective chart review of Veterans referred from primary care for a behavioral health evaluation (N = 161) based on evidence of heavy drinking, drug use or another behavioral problem. Suicidal ideation (SI) was assessed using the Paykel questionnaire. Insomnia symptoms were assessed with standard diary questions in an interview format and pertained to sleep latency (SL), wake after sleep onset time (WASO), sleep quality (SQ), and habitual sleep duration (HSD). The relations between suicidal ideation and insomnia symptoms were assessed using ordinal regression analyses adjusted for socio-demographic, psychiatric and addiction-related variables. Results Suicidal ideation was reported in 62 (39%) of the Veterans interviewed. In a multivariable model, only inadequate SQ was associated with suicidal ideation. Short sleepers were more likely to endorse suicidal ideation and have attempted suicide in the past year. In addition, older age, inadequate financial status, and the presence of a psychiatric disorder were also significantly associated with suicidal ideation in most of the adjusted models. Conclusion Given their association with suicidal ideation, insomnia symptoms in Veterans misusing alcohol should prompt an assessment of underlying psychiatric and social factors. PMID:24169371

An exploration of research into substance misuse and psychiatric disorder in the UK: what can we learn from history?

PubMed

Crome, Ilana B

2007-01-01

This review explores UK-based research developments in substance misuse and mental illness over the last 25 years. The main body of work comprises policy-orientated projects funded by the Department of Health from the late 1990s. Early research tended to focus on alcohol, especially alcoholic hallucinosis: the relationship of the latter with schizophrenia-like illness was examined, with the finding that very few cases did develop into schizophrenia. Parallels are drawn with the current debate around the link between cannabis and psychosis, urging caution in too rapid an assertion that cannabis is necessarily 'causal'. The clinical and policy implications of the misinterpretation of evidence are discussed. A proposal is put forward that the genesis of psychotic illness in alcohol misuse be revisited using more sophisticated research methodologies. Given the changing landscape of substance use in the UK, particularly the fashion of polysubstance use and the recognition that this is associated with psychotic illness, other drugs that are associated with psychotic illness should be similarly investigated to determine whether there is a common mechanism that might throw light on understanding the relationship between substance use and psychotic illness or schizophrenia. Copyright (c) 2007 John Wiley & Sons, Ltd.

Exploratory Trial of a School-Based Alcohol Prevention Intervention with a Family Component

ERIC Educational Resources Information Center

Segrott, Jeremy; Rothwell, Heather; Pignatelli, Ilaria; Playle, Rebecca; Hewitt, Gillian; Huang, Chao; Murphy, Simon; Hickman, Matthew; Reed, Hayley; Moore, Laurence

2016-01-01

Purpose: Involvement of parents/carers may increase effectiveness of primary school-based alcohol-misuse prevention projects through strengthening family-based protective factors, but rates of parental engagement are typically low. This paper reports findings from an exploratory trial of a school-based prevention intervention--Kids, Adults…

Jocks, Gender, Race, and Adolescent Problem Drinking

ERIC Educational Resources Information Center

Miller, Kathleen E.; Hoffman, Joseph H.; Barnes, Grace M.; Farrell, Michael P.; Sabo, Don; Melnick, Merrill J.

2003-01-01

Alcohol remains the drug of choice for many adolescents; however, the nature of the relationship between athletic involvement and alcohol misuse remains ambiguous. In this article, we used a longitudinal sample of over 600 Western New York adolescents and their families to explore the gender-specific and race-specific relationships between…

Developing substance misuse services in United Arab Emirates: the National Rehabilitation Centre experience

PubMed Central

Al Ghaferi, Hamad A.; Ali, Ahmed Y.; Gawad, Tarek A.

2017-01-01

In 2001 a directive was issued to establish the National Rehabilitation Centre (NRC) to deal with the growing problem of substance misuse in the United Arab Emirates. The NRC has achieved many goals as a treatment and rehabilitation facility as well as a drug and alcohol demand reduction response centre. It is now working towards being an international centre of excellence. PMID:29093960

Tobacco and Alcohol Use in People with Mild/Moderate Intellectual Disabilities: Giving Voice to Their Health Promotion Needs

ERIC Educational Resources Information Center

Kerr, Susan; Lawrence, Maggie; Middleton, Alan R.; Fitzsimmons, Lorna; Darbyshire, Christopher

2017-01-01

Background: Concerns have been raised about the use/misuse of tobacco and alcohol by people with mild/moderate intellectual disabilities. Aiming to address an identified gap in the current evidence base, this study sought to gain an understanding of the tobacco- and alcohol-related health promotion needs of this client group. Methods: Informed by…

Co-occurring aggression and suicide attempt among veterans entering residential treatment for PTSD: The role of PTSD symptom clusters and alcohol misuse.

PubMed

Watkins, Laura E; Sippel, Lauren M; Pietrzak, Robert H; Hoff, Rani; Harpaz-Rotem, Ilan

2017-04-01

Aggression and suicidality are two serious public health concerns among U.S. veterans that can co-occur and share many overlapping risk factors. The current study aims to elucidate the contribution of posttraumatic stress disorder (PTSD) symptom clusters defined by a five-factor model and alcohol misuse in predicting aggression and suicide attempts among veterans entering residential treatment for PTSD. Participants were 2570 U.S. veterans across 35 Veterans Health Administration sites. Multinomial logistic regression models were used to identify correlates of aggression only (n = 1471; 57.2%), suicide attempts only (n = 41; 1.6%), co-occurring aggression and suicide attempts (n = 202; 7.9%), and neither behavior (n = 856; 33.3%) over the past four months. When compared to veterans endorsing neither behavior, greater PTSD re-experiencing symptoms were related to suicide attempts (odds ratio [OR] = 1.58, 95% confidence interval [CI] = 1.09-2.30), aggression (OR = 1.13, 95% CI = 1.02-1.26), and co-occurring aggression and suicide (OR = 1.38, 95% CI = 1.13-1.68), and higher PTSD dysphoric arousal symptoms and alcohol misuse symptoms were related to aggression (OR = 1.54, 95% CI = 1.38-1.71; OR = 1.30, 95% CI = 1.18-1.44, respectively) and co-occurring aggression and suicide (OR = 1.66, 95% CI = 1.35-2.04; OR = 1.50, 95% CI = 1.28-1.75, respectively). Our findings suggest that assessment of PTSD symptom clusters and alcohol misuse can potentially help to identify veterans who endorse suicide attempts, aggression, or both concurrently. These results have important implications for risk assessment and treatment planning with U.S. veterans seeking care for PTSD. Published by Elsevier Ltd.

Evaluating Behavioral Economic Models of Heavy Drinking Among College Students.

PubMed

Acuff, Samuel F; Soltis, Kathryn E; Dennhardt, Ashley A; Berlin, Kristoffer S; Murphy, James G

2018-05-14

Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse (Bickel et al., 2011). Despite this, no study has examined the incremental utility of all three variables simultaneously in a comprehensive model METHOD: The current study uses structural equation modeling to test the associations between behavioral economic variables - alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences (CFC) scale), and proportionate substance-related reinforcement - and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested: 1) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and 2) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use RESULTS: The interaction effects in model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance-related reinforcement is associated with greater alcohol consumption and problems. Further, CFC was associated with alcohol-related problems and lower proportionate substance-related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance-related reinforcement was associated with greater alcohol demand CONCLUSIONS: Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The Quik Fix study: a randomised controlled trial of brief interventions for young people with alcohol-related injuries and illnesses accessing emergency department and crisis support care

PubMed Central

2014-01-01

Background Alcohol is a major preventable cause of injury, disability and death in young people. Large numbers of young people with alcohol-related injuries and medical conditions present to hospital emergency departments (EDs). Access to brief, efficacious, accessible and cost effective treatment is an international health priority within this age group. While there is growing evidence for the efficacy of brief motivational interviewing (MI) for reducing alcohol use in young people, there is significant scope to increase its impact, and determine if it is the most efficacious and cost effective type of brief intervention available. The efficacy of personality-targeted interventions (PIs) for alcohol misuse delivered individually to young people is yet to be determined or compared to MI, despite growing evidence for school-based PIs. This study protocol describes a randomized controlled trial comparing the efficacy and cost-effectiveness of telephone-delivered MI, PI and an Assessment Feedback/Information (AF/I) only control for reducing alcohol use and related harm in young people. Methods/design Participants will be 390 young people aged 16 to 25 years presenting to a crisis support service or ED with alcohol-related injuries and illnesses (including severe alcohol intoxication). This single blinded superiority trial randomized young people to (i) 2 sessions of MI; (ii) 2 sessions of a new PI or (iii) a 1 session AF/I only control. Participants are reassessed at 1, 3, 6 and 12 months on the primary outcomes of alcohol use and related problems and secondary outcomes of mental health symptoms, functioning, severity of problematic alcohol use, alcohol injuries, alcohol-related knowledge, coping self-efficacy to resist using alcohol, and cost effectiveness. Discussion This study will identify the most efficacious and cost-effective telephone-delivered brief intervention for reducing alcohol misuse and related problems in young people presenting to crisis support services or EDs. We expect efficacy will be greatest for PI, followed by MI, and then AF/I at 1, 3, 6 and 12 months on the primary and secondary outcome variables. Telephone-delivered brief interventions could provide a youth-friendly, accessible, efficacious, cost-effective and easily disseminated treatment for addressing the significant public health issue of alcohol misuse and related harm in young people. Trial registration This trial is registered with the Australian and New Zealand Clinical Trials Registry ACTRN12613000108718. PMID:25103779

Chapter 3. A multidimensional model for narrative analysis of substance use-related dependency.

PubMed

Larsson, Sam; von Braun, Therese; Lilja, John

2013-11-01

This chapter examines the possibilities and limitations of using a narrative method as a framework within a multidimensional model for exploring and analyzing the use and misuse of alcohol and drugs. It is posited that a multidimensional model, based on narrative reasoning, can give a more detailed and specific understanding of substance users, who represent a heterogeneous population of people, and of substance use-related dependency problems. Such a model describes and analyses the drug-use related problems in a manner that provides holistic and important information and knowledge about the person by contextual and situation interaction processes which are involved in the use/misuse of alcohol and drugs. Tentative conclusions and unresolved critical issues are considered.

Risk of future trauma based on alcohol screening scores: A two-year prospective cohort study among US veterans

PubMed Central

2012-01-01

Background Severe alcohol misuse as measured by the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) is associated with increased risk of future fractures and trauma-related hospitalizations. This study examined the association between AUDIT-C scores and two-year risk of any type of trauma among US Veterans Health Administration (VHA) patients and assessed whether risk varied by age or gender. Methods Outpatients (215, 924 male and 9168 female) who returned mailed AUDIT-C questionnaires were followed for 24 months in the medical record for any International Statistical Classification of Diseases and Related Health Problems (ICD-9) code related to trauma. The two-year prevalence of trauma was examined as a function of AUDIT-C scores, with low-level drinking (AUDIT-C 1–4) as the reference group. Men and women were examined separately, and age-stratified analyses were performed. Results Having an AUDIT-C score of 9–12 (indicating severe alcohol misuse) was associated with increased risk for trauma. Mean (SD) ages for men and women were 68.2 (11.5) and 57.2 (15.8), respectively. Age-stratified analyses showed that, for men ≤50 years, those with AUDIT-C scores ≥9 had an increased risk for trauma compared with those with AUDIT-C scores in the 1–4 range (adjusted prevalence, 25.7% versus 20.8%, respectively; OR = 1.24; 95% confidence interval [CI], 1.03–1.50). For men ≥65 years with average comorbidity and education, those with AUDIT-C scores of 5–8 (adjusted prevalence, 7.9% versus 7.4%; OR = 1.16; 95% CI, 1.02–1.31) and 9–12 (adjusted prevalence 11.1% versus 7.4%; OR = 1.68; 95% CI, 1.30–2.17) were at significantly increased risk for trauma compared with men ≥65 years in the reference group. Higher AUDIT-C scores were not associated with increased risk of trauma among women. Conclusions Men with severe alcohol misuse (AUDIT-C 9–12) demonstrate an increased risk of trauma. Men ≥65 showed an increased risk for trauma at all levels of alcohol misuse (AUDIT-C 5–8 and 9–12). These findings may be used as part of an evidence-based brief intervention for alcohol use disorders. More research is needed to understand the relationship between AUDIT-C scores and risk of trauma in women. PMID:22966411

Improving Alcohol Screening for College Students: Screening for Alcohol Misuse amongst College Students with a Simple Modification to the CAGE Questionnaire

ERIC Educational Resources Information Center

Taylor, Purcell; El-Sabawi, Taleed; Cangin, Causenge

2016-01-01

Objective: To improve the CAGE (Cut down, Annoyed, Guilty, Eye opener) questionnaire's predictive accuracy in screening college students. Participants: The sample consisted of 219 midwestern university students who self-administered a confidential survey. Methods: Exploratory factor analysis, confirmatory factor analysis, receiver operating…

Examining the Differential Effectiveness of a Life Skills Program (IPSY) on Alcohol Use Trajectories in Early Adolescence

ERIC Educational Resources Information Center

Spaeth, Michael; Weichold, Karina; Silbereisen, Rainer K.; Wiesner, Margit

2010-01-01

Objective: This study investigated whether a universal school-based life skills program--IPSY (Information + Psychosocial Competence = Protection)--against substance misuse exerted the same effectiveness for young adolescents (10.5-13 years) from distinct alcohol use trajectories characterized by late childhood risk factors (temperament,…

Efficacy of Cognitive-Behavioral Interventions Targeting Personality Risk Factors for Youth Alcohol Misuse

ERIC Educational Resources Information Center

Conrod, Patricia J.; Stewart, Sherry H.; Comeau, Nancy; Maclean, A. Michael

2006-01-01

Sensation seeking, anxiety sensitivity, and hopelessness are personality risk factors for alcohol use disorders, each associated with specific risky drinking motives in adolescents. We developed a set of interventions and manuals that were designed to intervene at the level of personality risk and associated maladaptive coping strategies,…

Use (and Misuse) of the Responsible Drinking Message in Public Health and Alcohol Advertising: A Review

ERIC Educational Resources Information Center

Barry, Adam E.; Goodson, Patricia

2010-01-01

The objective is to present a comparative analysis examining the alcohol industry's and scholarly researchers' use of the concept "responsible drinking." Electronic databases associated with health, education, sociology, psychology, and medicine were the date sources. Results were limited to English, peer-reviewed articles and commentaries…

Conceptual and Clinical Issues in the Treatment of Adolescent Alcohol and Substance Misusers.

ERIC Educational Resources Information Center

Filstead, William J.; Anderson, Carl L.

1983-01-01

Describes a system of care and clinical issues central to service delivery to adolescents with alcohol/drug problems. Recognizes the importance of adolescence as a developmental period and its implications for treatment. Develops criteria to distinguish the most appropriate level of care for the adolescent's presenting clinical condition. (CMG)

Preventing substance misuse: study protocol for a randomised controlled trial of the Strengthening Families Programme 10–14 UK (SFP 10–14 UK)

PubMed Central

2014-01-01

Background Prevention of alcohol, drug and tobacco misuse by young people is a key public health priority. There is a need to develop the evidence base through rigorous evaluations of innovative approaches to substance misuse prevention. The Strengthening Families Programme 10–14 is a universal family-based alcohol, drugs and tobacco prevention programme, which has achieved promising results in US trials, and which now requires cross-cultural assessment. This paper therefore describes the protocol for a randomised controlled trial of the UK version of the Strengthening Families Programme 10–14 (SFP 10–14 UK). Methods/Design The trial comprises a pragmatic cluster randomised controlled effectiveness trial with families as the unit of randomisation, with embedded process and economic evaluations. Participating families will be randomised to one of two treatment groups - usual care with full access to existing services (control group), or usual care plus SFP 10–14 UK (intervention group). The trial has two primary outcomes - the number of occasions that young people report having drunk alcohol in the last 30 days, and drunkenness during the last 30 days, both dichotomised as ‘never’ and ‘1-2 times or more’. The main follow-up is at 2 years past baseline, and short-term and intermediate outcomes are also measured at 9 and 15 months. Discussion The results from this trial will provide evidence on the effectiveness and cost-effectiveness of an innovative universal family-based substance misuse prevention programme in a UK context. Trial registration Current Controlled Trials ISRCTN63550893. PMID:24438460

The impact of training and delivering alcohol brief intervention on the knowledge and attitudes of community pharmacists: a before and after study.

PubMed

Dhital, Ranjita; Whittlesea, Cate M; Milligan, Peter; Khan, Natasha S; Norman, Ian J

2013-03-01

Alcohol misuse is the third leading cause of ill health in the UK. Alcohol brief intervention can identify risky drinkers and motivate individuals to take action. Community pharmacists have been identified as having a role in providing brief interventions. This study aimed to evaluate: pharmacists' attitudes towards hazardous/harmful drinkers and knowledge before training and after delivering brief intervention; and their experience of training. Pharmacists' attitudes to alcohol problems were assessed using Short Alcohol and Alcohol Problems Perception Questions before training and after brief intervention delivery. Alcohol misuse knowledge was assessed by questionnaire prior to and immediately after training, and after the delivery period. Following brief intervention delivery, pharmacists' experience of training was obtained using a questionnaire and focus groups. Qualitative thematic analysis identified experiences of brief intervention training. Quantitative data were analysed using spss. One hundred and thirty-nine alcohol interventions were delivered by 19 pharmacists over five months (recruiters). Ten pharmacists completed no interventions (non-recruiters). Both groups improved their alcohol knowledge between baseline and immediately following training; and their knowledge decreased between the end of training and following service delivery. Pharmacists who were initially more motivated recruited more participants and increased their work satisfaction. This confirmed findings of previous studies that pharmacists unfamiliar with brief intervention could be trained to deliver this service. Pharmacists with positive attitude towards drinkers delivered a greater number of alcohol interventions and experienced increased work satisfaction than those pharmacists with less positive attitudes. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Prevalence of alcohol-impaired driving and riding in northern Ghana.

PubMed

Damsere-Derry, James; Palk, Gavan; King, Mark

2016-01-01

The objective of this study was to determine the roadside prevalence of alcohol-impaired driving among drivers and riders in northern Ghana. The study also verifies motorists' perceptions of their own alcohol use and knowledge of the legal blood alcohol concentration (BAC) limit in Ghana. With the assistance of police, systematic random sampling was used to collect data at roadblocks using a cross-sectional study design. Breathalyzers were used to screen whether motorists had detectable alcohol in their breath and follow-up breath tests were conducted to measure the actual breath alcohol levels among positive participants. In all, 9.7% of the 789 participants had detectable alcohol, among whom 6% exceeded the legal BAC limit of 0.08%. The prevalence of alcohol-impaired driving/riding was highest among cyclists (10% of all cyclists breath-tested) followed by truck drivers (9%) and motorcyclists (7% of all motorcyclists breath-tested). The occurrence of a positive BAC among cyclists was about 8 times higher (odds ratio [OR] = 7.73; P < .001) and it was 2 times higher among motorcyclists (OR = 2.30; P = .039) compared to private car drivers. The likelihood for detecting a positive BAC among male motorists/riders was higher than that among females (OR = 1.67; P = .354). The odds for detecting a positive BAC among weekend motorists/riders was significantly higher than on weekdays (OR = 2.62; P = .001). Alcohol-impaired driving/riding in Ghana is high by international standards. In order to attenuate the harmful effects of alcohol misuse such as alcohol-impaired driving/riding, there is the need to educate road users about how much alcohol they can consume and stay below the legal limit. The police should also initiate random breath testing to instill the deterrence of detection, certainty of apprehension and punishment, and severity and celerity of punishment among drink-driving motorists and riders.

Pathways to prevention: protocol for the CAP (Climate and Preventure) study to evaluate the long-term effectiveness of school-based universal, selective and combined alcohol misuse prevention into early adulthood.

PubMed

Newton, Nicola C; Stapinski, Lexine; Slade, Tim; Champion, Katrina E; Barrett, Emma L; Chapman, Catherine; Smout, Anna; Lawler, Siobhan; Mather, Marius; Castellanos-Ryan, Natalie; Conrod, Patricia J; Teesson, Maree

2018-05-21

Alcohol use and associated harms are among the leading causes of burden of disease among young people, highlighting the need for effective prevention. The Climate and Preventure (CAP) study was the first trial of a combined universal and selective school-based approach to preventing alcohol misuse among adolescents. Initial results indicate that universal, selective and combined prevention were all effective in delaying the uptake of alcohol use and binge drinking for up to 3 years following the interventions. However, little is known about the sustainability of prevention effects across the transition to early adulthood, a period of increased exposure to alcohol and other drug use. This paper describes the protocol for the CAP long-term follow-up study which will determine the effectiveness of universal, selective and combined alcohol misuse prevention up to 7 years post intervention, and across the transition from adolescence into early adulthood. A cluster randomized controlled trial was conducted between 2012 and 2015 with 2190 students (mean age: 13.3 yrs) from 26 Australian high schools. Participants were randomized to receive one of four conditions; universal prevention for all students (Climate); selective prevention for high-risk students (Preventure); combined universal and selective prevention (Climate and Preventure; CAP); or health education as usual (Control). The positive effect of the interventions on alcohol use at 12-, 24- and 36-month post baseline have previously been reported. This study will follow up the CAP study cohort approximately 5- and 7-years post baseline. The primary outcome will be alcohol use and related harms. Secondary outcomes will be cannabis use, alcohol and other drug harms including violent behavior, and mental health symptomatology. Analyses will be conducted using multi-level, mixed effects models within an intention-to-treat framework. This study will provide the first ever evaluation of the long-term effectiveness of combining universal and selective approaches to alcohol prevention and will examine the durability of intervention effects into the longer-term, over a 7-year period from adolescence to early adulthood. This trial was registered in the Australian New Zealand Clinical Trials Registry ( ACTRN12612000026820 ) on January 6th 2012.

Acute and chronic alcohol use correlated with methods of suicide in a Swiss national sample.

PubMed

Pfeifer, P; Bartsch, C; Hemmer, A; Reisch, T

2017-09-01

Chronic and acute alcohol use are highly associated risk factors for suicides worldwide. Therefore, we examined suicide cases with and without alcohol use disorder (AUD) using data from the SNSF project "Suicide in Switzerland: A detailed national survey". Our investigations focus on correlations between acute and chronic alcohol use with reference to suicide and potential interactions with the methods of suicide. We used data from the SNSF project in which all cases of registered completed suicide in Switzerland reported to any of the seven Swiss institutes of legal and forensic medicine between 2000 and 2010 were collected. We extracted cases that were tested for blood alcohol to use in our analysis. We compared clinical characteristics, blood alcohol concentrations, and methods of suicide in cases with and without AUD. Out of 6497 cases, 2946 subjects were tested for acute alcohol use and included in our analysis. Of the latter, 366 (12.4%) persons had a medical history of AUD. Subjects with AUD significantly had higher blood alcohol concentrations and were more often in medical treatment before suicide. Drug intoxication as method of suicide was more frequent in cases with AUD compared to NAUD. Overall, we found a high incidence of acute alcohol use at the time of death in chronic alcohol misusers (AUD). The five methods of suicide most commonly used in Switzerland differed considerably between individuals with and without AUD. Blood alcohol concentrations varied across different methods of suicide independently from the medical history in both groups. Copyright © 2017 Elsevier B.V. All rights reserved.

Early Initiation of Substance Use as an Indicator of Problematic Substance Use Among Young Men Who Have Sex with Men (YMSM).

PubMed

Kecojevic, Aleksandar; Basch, Corey H; Lankenau, Stephen E

2018-01-02

Much research has documented that young men who have sex with men (YMSM) are at higher risk for substance use-related problems. This study examined the age of substance use initiation and it's relationship to current substance use-related problems among substance-using YMSM. A cross-sectional survey of 191 YMSM (aged 18 to 29) with recent histories of prescription drug misuse was conducted in Philadelphia in 2012-13. Participants were surveyed about age of initiation of cigarette smoking, alcohol use to the point of intoxication, marijuana, prescription, and illicit drugs, and about alternate modes of prescription drug administration. The severity of participants' current substance use related problems was measured using the Drug Abuse Screening Test (DAST-10). Mean age of initiation was 14.6 years for cigarette smoking, 15.3 years for alcohol use to the point of intoxication, 15.2 years for marijuana, 16.8 years for prescription drugs, and 17.9 years for illicit drugs. Use of 2 or more substances by the age of 15 was reported by 56% of the participants. Odds of substance-related problems were significantly greater among those who reported earlier initiation of alcohol, prescription drugs, or polysubstance use. Odds of prescription drug misuse via altered routes of administration were significantly greater among participants with earlier onset of alcohol, marijuana, prescription, illicit drugs, or polysubstance use. This study demonstrates that earlier initiation of substance use is associated with higher risk of substance-related problems among substance-using YMSM. Early interventions addressing substance use initiation could benefit this population.

Job Strain, Depressive Symptoms, and Drinking Behavior Among Older Adults: Results From the Health and Retirement Study

PubMed Central

Bohnert, Amy S. B.; Ratliff, Scott; Zivin, Kara

2011-01-01

Objective. To examine the relationship between job strain and two indicators of mental health, depression and alcohol misuse, among currently employed older adults. Method. Data come from the 2004 and 2006 waves of the Health and Retirement Study (N = 2,902). Multivariable logistic regression modeling was used to determine the association between job strain, indicated by the imbalance of job stress and job satisfaction, with depression and alcohol misuse. Results. High job strain (indicated by high job stress combined with low job satisfaction) was associated with elevated depressive symptoms (odds ratio [OR] = 2.98, 95% confidence interval [CI]: 1.99–4.45) relative to low job strain after adjusting for sociodemographic characteristics, labor force status, and occupation. High job stress combined with high job satisfaction (OR = 1.93) and low job stress combined with low job satisfaction (OR = 1.94) were also associated with depressive symptoms to a lesser degree. Job strain was unrelated to either moderate or heavy drinking. These associations did not vary by gender or age. Discussion. Job strain is associated with elevated depressive symptoms among older workers. In contrast to results from investigations of younger workers, job strain was unrelated to alcohol misuse. These findings can inform the development and implementation of workplace health promotion programs that reflect the mental health needs of the aging workforce. PMID:21427175

Modeling PTSD Symptom Clusters, Alcohol Misuse, Anger, and Depression as They Relate to Aggression and Suicidality in Returning Veterans

PubMed Central

Hellmuth, Julianne C.; Stappenbeck, Cynthia A.; Hoerster, Katherine D.; Jakupcak, Matthew

2014-01-01

Suicidal ideation (SI) and aggression are common correlates of Posttraumatic Stress Disorder (PTSD) among Iraq and Afghanistan War veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and SI and general aggression (without a specified target) via depression, alcohol misuse, and trait anger. Participants were 359 (92% male) Iraq/Afghanistan War veterans. Path analysis results suggest that the PTSD numbing cluster was directly (β=.28, p<.01.) and indirectly (β=.17, p=.001) related to SI through depression and the PTSD hyperarousal cluster was indirectly related to SI through depression (β=.13, p<.001). The PTSD re-experiencing cluster was directly related to aggression (β=.17, p<.05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (β=.05, p<.05; β=.20, p<.001). These findings suggest that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in returning Veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at-risk veterans and facilitate preventative interventions. PMID:23073972

Assessment of generalizability, applicability and predictability (GAP) for evaluating external validity in studies of universal family-based prevention of alcohol misuse in young people: systematic methodological review of randomized controlled trials.

PubMed

Fernandez-Hermida, Jose Ramon; Calafat, Amador; Becoña, Elisardo; Tsertsvadze, Alexander; Foxcroft, David R

2012-09-01

To assess external validity characteristics of studies from two Cochrane Systematic Reviews of the effectiveness of universal family-based prevention of alcohol misuse in young people. Two reviewers used an a priori developed external validity rating form and independently assessed three external validity dimensions of generalizability, applicability and predictability (GAP) in randomized controlled trials. The majority (69%) of the included 29 studies were rated 'unclear' on the reporting of sufficient information for judging generalizability from sample to study population. Ten studies (35%) were rated 'unclear' on the reporting of sufficient information for judging applicability to other populations and settings. No study provided an assessment of the validity of the trial end-point measures for subsequent mortality, morbidity, quality of life or other economic or social outcomes. Similarly, no study reported on the validity of surrogate measures using established criteria for assessing surrogate end-points. Studies evaluating the benefits of family-based prevention of alcohol misuse in young people are generally inadequate at reporting information relevant to generalizability of the findings or implications for health or social outcomes. Researchers, study authors, peer reviewers, journal editors and scientific societies should take steps to improve the reporting of information relevant to external validity in prevention trials. © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

Coming home: A prospective study of family reintegration following deployment to a war zone.

PubMed

Balderrama-Durbin, Christina; Cigrang, Jeffrey A; Osborne, Laura J; Snyder, Douglas K; Talcott, G Wayne; Slep, Amy M Smith; Heyman, Richard E; Tatum, JoLyn; Baker, Monty; Cassidy, Daniel; Sonnek, Scott

2015-08-01

The consequences of deployment extend beyond the service member to impact the entire family. The current investigation evaluated the unique challenges of family reintegration for partnered service members using a prospective design. In total, 76 partnered service members who deployed on a year-long, high-risk mission to Iraq were assessed across the entirety of the deployment cycle, i.e., pre-, during, and postdeployment. At follow-up, nearly 1 in 5 partnered service members reported moderate to severe difficulties in multiple aspects of family reintegration. Prospective interpersonal indicators such as preparations for deployment as a couple, shared commitment to the military, and predeployment relationship distress predicted postdeployment family reintegration difficulties. Significant interpersonal risk factors were medium to large in their effect sizes. Airmen's willingness to disclose deployment- and combat-related experiences, and postdeployment relationship distress served as concurrent interpersonal correlates of difficulties with family reintegration. Intrapersonal factors, including posttraumatic stress symptoms and alcohol misuse were concurrently related to challenges with family reintegration; predeployment alcohol misuse also predicted subsequent family reintegration difficulties. Additional analyses indicated that pre- and postdeployment relationship distress, combat disclosure, and postdeployment alcohol misuse each contributed to family reintegration when controlling for other intra- and interpersonal risk factors. Implications for prevention and early intervention strategies as well as future research are discussed. (c) 2015 APA, all rights reserved).

A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions.

PubMed

Higgins-Biddle, John C; Babor, Thomas F

2018-05-03

The US Preventive Services Task Force recommends that clinicians screen all adults for alcohol misuse and provide brief counseling to those engaged in risky or hazardous drinking. The World Health Organization's (WHO's) Alcohol Use Disorders Identification Test (AUDIT) is the most widely tested instrument for screening in primary health care. This paper describes the structural and functional features of the AUDIT and methodological problems with the validation of the alcohol consumption questions (AUDIT-C). The content, scoring, and rationale for a new version of the AUDIT (called the USAUDIT), adapted to US standard drink size and hazardous drinking guidelines, is presented. Narrative review focusing on the consumption elements of the AUDIT. Four studies of the AUDIT-C are reviewed and evaluated. The AUDIT has been used extensively in many countries without making the changes in the first three consumption questions recommended in the AUDIT User's Manual. As a consequence, the original WHO version is not compatible with US guidelines and AUDIT scores are not comparable with those obtained in countries that have different drink sizes, consumption units, and safe drinking limits. Clinical and Scientific Significance. The USAUDIT has adapted the WHO AUDIT to a 14 g standard drink, and US low-risk drinking guidelines. These changes provide greater accuracy in measuring alcohol consumption than the AUDIT-C.

Men's and women's pathways to adulthood and associated substance misuse.

PubMed

Oesterle, Sabrina; Hawkins, J David; Hill, Karl G

2011-09-01

Social role transitions have been linked to changes in substance use and misuse during young adulthood. This study examined how commonly observed pathways to adulthood, defined by education, employment, marriage, and parenthood, were associated with alcohol, tobacco, and marijuana misuse from ages 18 to 33. Data came from a longitudinal panel of 412 men and 396 women recruited when they were in fifth grade in Seattle public schools in 1985. Participants were followed through age 33 in 2008, with 92% retention. Young adults who had little postsecondary education and remained unmarried through age 30 generally had the highest rates of substance misuse. Those who were involved in postsecondary education and postponed family formation had the lowest rates, particularly with respect to daily smoking and nicotine dependence. Parenting during the young adult years was associated with lower rates of substance misuse for both men and women. However, taking on parenting responsibilities early, during the late teen years and early 20s (observed mostly for women), was associated with higher rates of tobacco misuse. Differences in substance misuse by pathways to adulthood were fairly constant across the young adulthood years and were already observed at age 18, suggesting that substance misuse patterns are established early. Young adults may change their substance use only partially in response to new freedoms and responsibilities in young adulthood. Preventive efforts should include a focus on early initiation of substance use and educational experiences that move people into life trajectories and associated substance misuse patterns.

[Drug using risks screening in primary care patients using the ASSIST test: Cross sectional study].

PubMed

López-Rodríguez, Juan A; Rigabert, Alina; Gómez Llano, M Nieves; Rubio, Gabriel

2018-03-15

The aim of this study is to estimate risky-drug use patterns of consumption of primary care patients. Multicentric descriptive cross-sectional study. five primary health care centers of the South of Madrid. all patients between 16-100 year-old consulting with their family physician. Spanish-validated World Health Organization ASSIST test was use to screen risky drug use in primary care. Total points scored at the test were obtained. A sum of 441 screening test were collected. Mean age was 51,3 years and 51.6% of patients presented a moderate-severe risky drug use out of the nine drugs tested. The more frequent drug use screened were tobacco (41.7%) followed by alcohol (15.4%), hypnotics (13.7%) and cannabis (5.7%). Differences were found between genders in the patterns: men had higher risky drug uses compared to women regarding alcohol and cannabis. Women had higher sedatives/hypnotics consumption prevalence. A 16% of patients presented with polyconsumption drug use patterns. There is risk derived from drug misuse in primary care for tobacco, alcohol, hypnotics and cannabis as detected by the ASSIST test. There is a higher rate of hypnotics than expected. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

Brief Intervention for Truant Youth Sexual Risk Behavior and Alcohol Use: A Parallel Process Growth Model Analysis

ERIC Educational Resources Information Center

Dembo, Richard; Briones-Robinson, Rhissa; Ungaro, Rocio; Barrett, Kimberly; Gulledge, Laura; Winters, Ken C.; Belenko, Steven; Karas, Lora M.; Wareham, Jennifer

2014-01-01

Truant youths frequently experience family problems, emotional/psychological issues, substance misuse, and delinquency. They are likely engaging in alcohol use and sexual risk behavior at a higher rate than the general youth population. Early intervention services would benefit them, their families, and society. We present interim findings from an…

Friendship Context Matters: Examining the Domain Specificity of Alcohol and Depression Socialization among Adolescents

ERIC Educational Resources Information Center

Giletta, Matteo; Scholte, Ron H. J.; Prinstein, Mitchell J.; Engels, Rutger C. M. E.; Rabaglietti, Emanuela; Burk, William J.

2012-01-01

Driven by existing socialization theories, this study describes specific friendship contexts in which peer influence of alcohol misuse and depressive symptoms occurs. In the fall and spring of the school year, surveys were administered to 704 Italian adolescents (53% male, M[subscript age] = 15.53) enrolled in Grades 9, 10 and 11. Different…

Class start times, sleep, and academic performance in college: a path analysis.

PubMed

Onyper, Serge V; Thacher, Pamela V; Gilbert, Jack W; Gradess, Samuel G

2012-04-01

Path analysis was used to examine the relationship between class start times, sleep, circadian preference, and academic performance in college-aged adults. Consistent with observations in middle and high school students, college students with later class start times slept longer, experienced less daytime sleepiness, and were less likely to miss class. Chronotype was an important moderator of sleep schedules and daytime functioning; those with morning preference went to bed and woke up earlier and functioned better throughout the day. The benefits of taking later classes did not extend to academic performance, however; grades were somewhat lower in students with predominantly late class schedules. Furthermore, students taking later classes were at greater risk for increased alcohol consumption, and among all the factors affecting academic performance, alcohol misuse exerted the strongest effect. Thus, these results indicate that later class start times in college, while allowing for more sleep, also increase the likelihood of alcohol misuse, ultimately impeding academic success.

NIDA Notes

MedlinePlus

... Alcohol Club Drugs Cocaine Fentanyl Hallucinogens Inhalants Heroin Marijuana MDMA (Ecstasy/Molly) Methamphetamine Opioids Over-the-Counter ... were more likely to misuse opioid analgesics. Why Marijuana Displeases Basic Science , Published March 2018 This study ...

Prevalence of HIV/AIDS and psychiatric disorders and their related risk factors among adults in Epworth, Zimbabwe.

PubMed

Sebit, M B; Tombe, M; Siziya, S; Balus, S; Nkomo, S D A; Maramba, P

2003-10-01

To examine the prevalence of HIV infection, neuropsychiatric disorders, psychiatric symptoms/signs, alcohol use/misuse, CD4 cell counts and risk factors in adult patients. Cross-sectional study. Epworth, which is about 15 km on the southeastern part of Harare, Zimbabwe. Two hundred subjects were included in the study out of which six were excluded beacause of HIV-1 indeterminate results. A convenience sample of 200 subjects recruited in a cross-sectional study in Epworth, Zimbabwe. Six subjects had indeterminate HIV-1 antibody results and were excluded from the study. The remaining 194 subjects of whom 101 (52.1%) knew about their sero-status and were consecutively recruited, whereas, 93 (47.9%) did not know about their sero-status and were recruited by a systematic random sampling method (1-in-3). They were then interviewed about neuropsychiatric disorders using BPRS, MADRS, AUDIT and MINI Mental State Test, including the risk factors related to HIV infection. After ELISA tests' results, the two groups were combined and then categorised into HIV positive (n=115) and HIV negative (n=79) subjects. Prevalence, neuropsychiatric disorders, increased CD4 cell counts and risk factors associated with HIV infection. The findings were that the overall point prevalence of the HIV infection was 59.3% (115/194). Comparative analyses between seropositive and seronegative HIV/AIDS subjects showed: over two thirds (71.3%) of the HIV positive subjects suffered from psychiatric disorders, more than those with HIV negative 44.3% (OR=3.12, 95% CI=1.64-5.95, P=0.0002), and subjects aged 35 years and less were mostly HIV seronegatives (n=77.2%, OR=2.34, 95% CI=1.18-4.75, P=0.014). The overall prevalence of alcohol use/misuse was 41 (21.1%), with higher prevalence rate among HIV positive subjects, 28 (24.3%) than those who were HIV negative, 13 (16.5%). The commonest psychiatric symptoms/signs (P<0.05) were emotional withdrawal, depressed mood, suspiciousness, apparent sadness, reduced sleep and suicidal thoughts (especially among women). There is very high point prevalence of HIV/AIDS and psychiatric disorders, including a moderate prevalence rate of alcohol use/misuse in this less affluent community that warranted intervention.

Prospective risk factors for post-deployment heavy drinking and alcohol or substance use disorder among US Army soldiers.

PubMed

Campbell-Sills, Laura; Ursano, Robert J; Kessler, Ronald C; Sun, Xiaoying; Heeringa, Steven G; Nock, Matthew K; Sampson, Nancy A; Jain, Sonia; Stein, Murray B

2017-10-17

Investigations of drinking behavior across military deployment cycles are scarce, and few prospective studies have examined risk factors for post-deployment alcohol misuse. Prevalence of alcohol misuse was estimated among 4645 US Army soldiers who participated in a longitudinal survey. Assessment occurred 1-2 months before soldiers deployed to Afghanistan in 2012 (T0), upon their return to the USA (T1), 3 months later (T2), and 9 months later (T3). Weights-adjusted logistic regression was used to evaluate associations of hypothesized risk factors with post-deployment incidence and persistence of heavy drinking (HD) (consuming 5 + alcoholic drinks at least 1-2×/week) and alcohol or substance use disorder (AUD/SUD). Prevalence of past-month HD at T0, T2, and T3 was 23.3% (s.e. = 0.7%), 26.1% (s.e. = 0.8%), and 22.3% (s.e. = 0.7%); corresponding estimates for any binge drinking (BD) were 52.5% (s.e. = 1.0%), 52.5% (s.e. = 1.0%), and 41.3% (s.e. = 0.9%). Greater personal life stress during deployment (e.g., relationship, family, or financial problems) - but not combat stress - was associated with new onset of HD at T2 [per standard score increase: adjusted odds ratio (AOR) = 1.20, 95% CI 1.06-1.35, p = 0.003]; incidence of AUD/SUD at T2 (AOR = 1.54, 95% CI 1.25-1.89, p < 0.0005); and persistence of AUD/SUD at T2 and T3 (AOR = 1.30, 95% CI 1.08-1.56, p = 0.005). Any BD pre-deployment was associated with post-deployment onset of HD (AOR = 3.21, 95% CI 2.57-4.02, p < 0.0005) and AUD/SUD (AOR = 1.85, 95% CI 1.27-2.70, p = 0.001). Alcohol misuse is common during the months preceding and following deployment. Timely intervention aimed at alleviating/managing personal stressors or curbing risky drinking might reduce risk of alcohol-related problems post-deployment.

Enhancing the efficacy of computerized feedback interventions for college alcohol misuse: An exploratory randomized trial.

PubMed

Miller, Mary Beth; Leavens, Eleanor L; Meier, Ellen; Lombardi, Nathaniel; Leffingwell, Thad R

2016-02-01

Personalized feedback interventions (PFIs) have been associated with decreased alcohol consumption and related problems among college students; however, the necessary and sufficient components responsible for efficacy remain unclear. The present study investigated the relative efficacy of 3 computerized PFIs with differing content, the content-specific mechanisms of change within PFIs, and the moderating roles of comparison orientation and baseline risk in intervention outcomes. College students (N = 212) reporting alcohol use in a typical week completed an assessment prior to randomization (norms PFI, enhanced PFI, choice PFI, assessment only) and 1 month postintervention. Participants who received a PFI reported greater decreases in alcohol use, peak blood alcohol concentration (BAC), related problems, and perceptions of typical students' drinking than those in the control group. Neither tendency to compare oneself with others nor baseline risk moderated outcomes. PFIs influenced weekly alcohol use indirectly through changes in descriptive normative perceptions and alcohol-related consequences indirectly through changes in peak BAC. Computerized PFIs are more effective than assessment alone in decreasing alcohol use and related problems among college students. Normative comparisons may be sufficient to elicit behavior change, and inclusion of select additional components may not yield significant improvements in outcomes. However, the consistent benefit of including feedback on physical and monetary costs of drinking and moderation strategies, although nonsignificant, may warrant the negligible increase in time and money required to provide such information electronically. Computerized PFIs seem to be an ideal first step to the prevention and treatment of college alcohol misuse. (c) 2016 APA, all rights reserved).

Working Memory and Decision-Making Biases in Young Adults With a Family History of Alcoholism: Studies from the Oklahoma Family Health Patterns Project

PubMed Central

Lovallo, William R.; Yechiam, Eldad; Sorocco, Kristen H.; Vincent, Andrea S.; Collins, Frank L.

2008-01-01

Background Alcohol misuse is more common in persons with a family history of alcoholism (FH+) than in those with no such history (FH−). Among FH+, behavioral disinhibition and male sex seem to signal the presence of an increased risk. Methods This study examined cognitive and behavioral characteristics of 175 nonabusing 18- to 30-year-olds, 87 FH+ and 88 FH−, who were further characterized by their degree of behavioral disinhibition using the Sociability scale of the California Personality Inventory. Working memory and decision making were tested using the Stroop Color-Word Test and the Iowa Gambling Task, a simulated card game. Results Persons with a family history of alcoholism who were behaviorally disinhibited displayed significantly greater interference on the Stroop task than the other subgroups. On the Iowa Gambling Task, FH+ males, but not the females, were significantly more attentive to financial gains than other subgroups, and they had greater consistency in their choice behaviors. Conclusions Persons with a family history of alcoholism, in combination with behavioral disinhibition, appears to signal working memory deficits and in combination with male sex indicates an attraction to the rewarding aspects of a risk-taking challenge. These findings are not secondary to heavy exposure to alcohol or other drugs, but instead reflect intrinsic risk-related familial and personal characteristics of the subjects. PMID:16634844

Depressive Symptoms Anticipate Changes in the Frequency of Alcohol Intoxication Among Low-Accepted Adolescents

PubMed Central

Richmond, Ashley D.; Laursen, Brett; Kerr, Margaret; Stattin, Håkan

2015-01-01

Objective: There is strong evidence that depression anticipates later drinking problems among adults. These associations have not been consistently documented during adolescence, perhaps because little attention has been given to individual differences in peer relationships, which are the primary setting for adolescent alcohol consumption. This study investigated associations between depressive affect and alcohol misuse as moderated by peer group acceptance. Method: A community sample of 1,048 Swedish youth provided self-reports of depressive symptoms and intoxication frequency at annual intervals across the middle school years (seventh grade: M = 13.21 years old; eighth grade: M = 14.27 years old; ninth grade: M = 15.26 years old). Peer nominations provided a measure of individual acceptance. Results: Growth curve analyses revealed differences in the extent to which initial levels of depressive symptoms predicted the slope of increase in intoxication frequency. Higher levels of depressive symptoms at the outset anticipated sharp increases in intoxication frequency from seventh to ninth grades for low-accepted youth but not for average- or high-accepted youth. Conclusions: poor peer relations and depressive affect are vulnerabilities that set the stage for escalating adolescent alcohol misuse. Across the middle school years, when most youth have their first experiences with alcohol, peer difficulties exacerbated the tendency of depressed youth to drink to excess. PMID:26098034

Summary of the 2016 Alcohol and Immunology Research Interest Group (AIRIG) meeting.

PubMed

Boule, Lisbeth A; Ju, Cynthia; Agudelo, Marisela; Parira, Tiyash; Cannon, Abigail; Davis, Booker; Eby, Jonathan; Cresci, Gail; Samuelson, Derrick R; Shukla, Pradeep; Alrefai, Waddah A; Sureshchandra, Suhas; Pandey, Subhash C; Schnabl, Bernd; Curtis, Brenda J; Wyatt, Todd A; Choudhry, Mashkoor A; Kovacs, Elizabeth J

2018-02-01

On November 18, 2016 the 21st annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at the Center for Translational Research and Education at Loyola University Chicago's Health Sciences Campus in Maywood, IL. The 2016 meeting focused broadly on alcohol and inflammation, epigenetics, and the microbiome. The four plenary sessions of the meeting were Alcohol, Inflammation, and Immunity; Alcohol and Epigenetics; Alcohol, Transcriptional Regulation, and Epigenetics; and Alcohol, Intestinal Mucosa, and the Gut Microbiome. Presentations in all sessions of the meeting explored putative underlying causes for chronic diseases and mortality associated with alcohol consumption, shedding light on future work and potential therapeutic targets to alleviate the negative effects of alcohol misuse. Copyright © 2017 Elsevier Inc. All rights reserved.

Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study.

PubMed

Johnston, Marjorie C; Ludbrook, Anne; Jaffray, Mariesha A

2012-01-01

To examine the distribution of the costs of alcohol misuse across Scotland in 2009/2010, in relation to deprivation. A cost of illness approach was used. Alcohol-related harmful effects were assessed for inclusion using a literature review. This was based upon the following categories: direct healthcare costs, intangible health costs, social care costs, crime costs and labour and productivity costs. An analysis of secondary data supplemented by a literature review was carried out to quantify each harmful effect, determine its value and provide an estimate of the distribution by deprivation. The deprivation distributions used were area measures (primarily the Scottish Index of Multiple Deprivation). The overall cost was £7457 million. Two alcohol harmful effects were not included in the overall cost by deprivation due to a lack of data. These were 'children's social work and hearing system' and the criminal justice system costs from 'alcohol-specific offences'. The included alcohol harmful effects demonstrated that 40.41% of the total cost arose from the 20% most deprived areas. The intangible cost category was the largest category (78.65%). The study found that the burden of alcohol harmful effects is greater in deprived groups and these burdens do not simply arise from deprived groups but are also experienced more by these groups. The study was limited by a lack of data availability in certain areas, leading to less-precise cost estimates.

Inbound College Students Drink Heavily during the Summer before Their Freshman Year: Implications for Education and Prevention Efforts

ERIC Educational Resources Information Center

White, Aaron; Swartzwelder, H. Scott

2009-01-01

Background: Alcohol misuse among college students remains a pervasive problem. Relatively little is known about alcohol consumption by incoming students during the summer between high school graduation and the start of the freshman year. It is possible that many students bring unhealthy drinking habits with them to college. Purpose: The present…

Responding to Family Problems, Alcohol and Substance Misuse. A Survey of Service Provision in the Glasgow Area.

ERIC Educational Resources Information Center

McKellar, Susan; Coggans, Niall

1997-01-01

Surveyed social agencies' awareness of possible developmental problems of alcohol and substance abusers' children, extent to which agency felt it could deal with the problem involving the family, and development of services for children of substance abusers. Found that many agency workers considered involvement in family problems to be part of…

Motivational Interventions to Reduce Alcohol Use in a Military Population

DTIC Science & Technology

2010-01-01

toward preventing the misuse of alcohol, providing counseling or rehabilitation services to abusers, and providing education to various target audiences...d10107p.txt). Washington, DC: Department of Defense. Department of Defense. (1985, March 13). Instruction No. 1010.6: Rehabilitation and referral...change • Additional reasons… 16 REFLECTIONS 17 Exercise : Reflective Listening 1 BEFORE STARTING TO SHAPE REFLECTIVE

Moving beyond Alcohol: A Review of Other Issues Associated with Fraternity Membership with Implications for Practice and Research

ERIC Educational Resources Information Center

Biddix, J. Patrick

2016-01-01

This review of research synthesizes more than a decade of published studies on problems associated with fraternity membership beyond alcohol misuse. Topics include sex-related issues, drug use, hazing, and other issues such as gambling, academic dishonesty, campus civility, and fake identification use. Recommendations suggest the need for a role…

Personality-Targeted Interventions Delay Uptake of Drinking and Decrease Risk of Alcohol-Related Problems when Delivered by Teachers

ERIC Educational Resources Information Center

O'Leary-Barrett, Maeve; Mackie, Clare J.; Castellanos-Ryan, Natalie; Al-Khudhairy, Nadia; Conrod, Patricia J.

2010-01-01

Objective: This trial examined the efficacy of teacher-delivered personality-targeted interventions for alcohol-misuse over a 6-month period. Method: This randomized controlled trial randomly allocated participating schools to intervention (n = 11) or control (n = 7) conditions. A total of 2,506 (mean age, 13.7 years) were assessed for elevated…

49 CFR 655.62 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., including the names, addresses, and telephone numbers of substance abuse professionals (SAPs) and counseling and treatment programs. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT...

49 CFR 655.62 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., including the names, addresses, and telephone numbers of substance abuse professionals (SAPs) and counseling and treatment programs. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT...

49 CFR 655.62 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., including the names, addresses, and telephone numbers of substance abuse professionals (SAPs) and counseling and treatment programs. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT...

49 CFR 655.62 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., including the names, addresses, and telephone numbers of substance abuse professionals (SAPs) and counseling and treatment programs. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT...

49 CFR 655.62 - Referral, evaluation, and treatment.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., including the names, addresses, and telephone numbers of substance abuse professionals (SAPs) and counseling and treatment programs. ... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT...

Men's and Women's Pathways to Adulthood and Associated Substance Misuse*

PubMed Central

Oesterle, Sabrina; Hawkins, J. David; Karl G. Hill

2011-01-01

Objective: Social role transitions have been linked to changes in substance use and misuse during young adulthood. This study examined how commonly observed pathways to adulthood, defined by education, employment, marriage, and parenthood, were associated with alcohol, tobacco, and marijuana misuse from ages 18 to 33. Method: Data came from a longitudinal panel of 412 men and 396 women recruited when they were in fifth grade in Seattle public schools in 1985. Participants were followed through age 33 in 2008, with 92% retention. Results: Young adults who had little postsecondary education and remained unmarried through age 30 generally had the highest rates of substance misuse. Those who were involved in postsecondary education and postponed family formation had the lowest rates, particularly with respect to daily smoking and nicotine dependence. Parenting during the young adult years was associated with lower rates of substance misuse for both men and women. However, taking on parenting responsibilities early, during the late teen years and early 20s (observed mostly for women), was associated with higher rates of tobacco misuse. Differences in substance misuse by pathways to adulthood were fairly constant across the young adulthood years and were already observed at age 18, suggesting that substance misuse patterns are established early. Conclusions: Young adults may change their substance use only partially in response to new freedoms and responsibilities in young adulthood. Preventive efforts should include a focus on early initiation of substance use and educational experiences that move people into life trajectories and associated substance misuse patterns. PMID:21906504

Risk correlates for physical-mental multimorbidities in South Africa: a cross-sectional study.

PubMed

Petersen, I; Rathod, S; Kathree, T; Selohilwe, O; Bhana, A

2017-12-04

The aim of this study was to identify the risk correlates for coexisting common mental disorders (CMDs) in the chronic care population in South Africa, with the view to identifying particularly vulnerable patient populations. The sample comprised 2549 chronic care patients enrolled in the baseline and endline rounds of a facility detection survey conducted by the Programme for Improving Mental Health Care in three large facilities in the Dr Kenneth Kaunda district in the North West province of South Africa. Participants were screened for depression using the Patient Health Questionnaire (PHQ9) and for alcohol misuse using the Alcohol Use Disorders Identification Test (AUDIT). Data were analysed according to the number of morbidities, disorder type (physical or mental) and demographic variables. Multimorbidity was defined as the presence of two or more disorders (physical and/or mental). Just over one-third of the sample reported two or more physical conditions. Women were more at risk of being depressed than were men, with men more at risk of alcohol misuse. Those who were employed were at lower risk of having coexisting CMDs, while being younger, HIV positive, and food deprived were all found to be associated with higher risk for having coexisting CMDs. In the face of the large treatment gap for CMDs in South Africa, and the role that coexisting CMDs can play in exacerbating the burden of chronic physical diseases, mental health screening and treatment interventions should target HIV-positive, younger patients living in circumstances where there is household food insecurity.

14 CFR 91.147 - Passenger carrying flights for compensation or hire.

Code of Federal Regulations, 2011 CFR

2011-01-01

... business; (5) Name of person responsible for aircraft maintenance; (6) Type of aircraft, registration number(s), and make/model/series; and (7) An Antidrug and Alcohol Misuse Prevention Program registration...

14 CFR 91.147 - Passenger carrying flights for compensation or hire.

Code of Federal Regulations, 2014 CFR

2014-01-01

... person responsible for aircraft maintenance; (6) Type of aircraft, registration number(s), and make/model/series; and (7) An Antidrug and Alcohol Misuse Prevention Program registration. (d) The Operator must...

14 CFR 91.147 - Passenger carrying flights for compensation or hire.

Code of Federal Regulations, 2013 CFR

2013-01-01

... person responsible for aircraft maintenance; (6) Type of aircraft, registration number(s), and make/model/series; and (7) An Antidrug and Alcohol Misuse Prevention Program registration. (d) The Operator must...

14 CFR 91.147 - Passenger carrying flights for compensation or hire.

Code of Federal Regulations, 2012 CFR

2012-01-01

... person responsible for aircraft maintenance; (6) Type of aircraft, registration number(s), and make/model/series; and (7) An Antidrug and Alcohol Misuse Prevention Program registration. (d) The Operator must...

Modeling PTSD symptom clusters, alcohol misuse, anger, and depression as they relate to aggression and suicidality in returning U.S. veterans.

PubMed

Hellmuth, Julianne C; Stappenbeck, Cynthia A; Hoerster, Katherine D; Jakupcak, Matthew

2012-10-01

Suicidal ideation and aggression are common correlates of posttraumatic stress disorder (PTSD) among U.S. Iraq and Afghanistan war veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and suicidal ideation in general aggression (without a specified target) regarding depression, alcohol misuse, and trait anger. Participants were 359 (92% male) U.S. Iraq/Afghanistan war veterans. Path analysis results suggested that the PTSD numbing cluster was directly (β = .28, p < .01) and indirectly (β = .17, p = .001) related through depression. The PTSD hyperarousal cluster was indirectly related to suicidal ideation through depression (β = .13, p < .001). The PTSD reexperiencing cluster was directly related to aggression (β = .17, p < .05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (β = .05, p < .05; β = .20, p < .001). These findings indicate that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at risk veterans and facilitate preventative interventions. Published 2012. This article is a US Government work and is in the public domain in the USA.

The effects of price and perceived quality on the behavioural economics of alcohol, amphetamine, cannabis, cocaine, and ecstasy purchases.

PubMed

Goudie, Andrew J; Sumnall, Harry R; Field, Matt; Clayton, Hannah; Cole, Jon C

2007-07-10

Behavioural economic models of substance use describe the relationship between changes in unit price and consumption. However, these models rarely take account of the perceived quality (i.e. potency) of controlled drugs. Therefore we investigated the effects of both price and quality on the decision to purchase controlled drugs by polysubstance misusers. Forty current polysubstance misusers (29 males, 11 females; mean age 23.8) were recruited into the study. Participants were asked to hypothetically purchase drugs from a price list of alcohol, amphetamine, cannabis, cocaine and ecstasy at different levels of quality and price (i.e. better quality drugs cost more money). The disposable income available for those purchases was systematically varied in order to determine the impact of income on the decision to purchase drugs. Demand for both normal and strong alcohol was income inelastic. Demand for both poor and average quality cannabis and ecstasy was income inelastic, but demand for good quality cannabis and ecstasy was income elastic. The demand for poor quality cocaine was income inelastic, with the demand for both average and good quality cocaine being income elastic. Participants reported too few purchases of amphetamine, which precluded behavioural economic analysis. These results suggest that, like other goods, controlled drugs are purchased based upon the consumer's interpretations of their relative value. Therefore, it is probable that the purchase and subsequent use of controlled drugs by polysubstance misusers will be heavily influenced by the economic environment.

Alcohol Consumption Reduction Among a Web-Based Supportive Community Using the Hello Sunday Morning Blog Platform: Observational Study

PubMed Central

Leo, Briony; Moore, Jamie Christopher

2018-01-01

Background Alcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol misuse are not receiving treatment. Objective This study aimed to assess whether alcohol consumption changes are associated with participation in Hello Sunday Morning’s blog platform, an online forum discussing experiences in abstaining from alcohol. Methods The study reports on Hello Sunday Morning participants who signed up for a 3-month period of abstinence from November 2009 to November 2016. The sample comprised 1917 participants (female: 1227/1917, 64.01%; male: 690/1917, 35.99%). Main outcome measures were Alcohol Use Disorders Identification Test (AUDIT) scores, mood, program engagement metrics, and slip-ups. Results Individuals who reported hazardous (preprogram AUDIT mean 11.92, SD 2.25) and harmful consumption levels (preprogram AUDIT mean 17.52, SD 1.08) and who engaged in the Hello Sunday Morning program reported a significant decrease in alcohol consumption, moving to lower risk consumption levels (hazardous, mean 7.59, SD 5.70 and harmful, mean 10.38, SD 7.43), 4 months following program commencement (P<.001). Those who reported high-risk or dependent consumption levels experienced the biggest reduction (preprogram mean 25.38, SD 4.20), moving to risky consumption (mean 15.83, SD 11.11), 4 months following program commencement (P<.001). These reductions in risk were maintained by participants in each group, 7 months following program commencement. Furthermore, those who engaged in the program more (as defined by more sign-ins, blogs posted, check-ins completed, and engagement with the community through likes and following) had lower alcohol consumption. Finally, those who experienced more slip-ups had lower alcohol consumption. Conclusions Participation in an online forum can support long-term behavior change in individuals wishing to change their drinking behavior. Importantly, reductions in AUDIT scores appeared larger for those drinking at high-risk and hazardous levels before program commencement. This has promising implications for future models of alcohol reduction treatment, as online forums are an anonymous, accessible, and cost-effective alternative or adjunct to treatment-as-usual. Further research is needed into the specific mechanisms of change within a Web-based supportive community, as well as the role of specific mood states in predicting risky drinking behavior. PMID:29773530

Addiction, stigma and movies.

PubMed

Cape, G S

2003-03-01

To identify common character stereotypes of alcohol and other drug users as portrayed in motion pictures. A selective review of a number of movies prominently portraying alcohol and other drug use and misuse. The great majority of popular films portray alcohol and drug use whether as a routinized background, routinized foreground or exceptional foreground. Four main stereotypes of alcohol and other drug users appear to be prevalent - the tragic hero, the demonized user, the rebellious free spirit and the comedic user. A number of movies are selected which portray alcohol and other drug use as a prominent theme. Movies, as a medium for mass communication, have a powerful influence on the public and perpetuate popular mythologies regarding alcohol and other drug use.

Health-related quality of life among heavy-drinking college students.

PubMed

Monahan, Christopher J; Bracken-Minor, Katherine L; McCausland, Claudia M; McDevitt-Murphy, Meghan E; Murphy, James G

2012-03-01

To examine unique contributions of depression, alcohol consumption, and alcohol-related consequences on functional health outcomes in college students. Participants were heavy-drinking undergraduate students (N = 207) who completed self-report questionnaires. For men and women, depression predicted overall general health and mental health ratings. For women, depression predicted number of days of role limitations due to poor physical or mental health and number of days of not getting enough sleep or rest. Findings suggest that depression may have a more pervasive association with HRQOL than alcohol misuse or alcohol-related consequences in college students.

Preventing impaired driving using alcohol policy.

PubMed

Grube, Joel W; Stewart, Kathryn

2004-09-01

Considerable progress has been made in the reduction of impaired driving crashes during the last two decades. Much of this progress is attributable to strengthening laws against impaired driving along with vigorous enforcement efforts aimed at deterring impaired driving. In addition, many useful strategies can also be applied that focus on the control of alcohol availability, use, and promotion. Alcohol policies include controls on the price of alcohol, the location, density, and opening hours of sales outlets, controls on the social availability of alcohol, and on the promotion and advertising of alcohol. Enforcement of these policies is an important aspect of their effectiveness. These strategies have been shown to be effective or promising in reducing impaired driving as well as other consequences related to alcohol use and misuse.

Short-term recovery from alcohol abuse or dependence: any evidence of a relationship with treatment use in a general population sample?

PubMed

Cunningham, John A

2005-01-01

To test whether survey respondents who report alcohol misuse in the past year are more likely to be abstinent or binge-free in the past 30 days if they have used treatment, than if they have not. Analysis of data from the 2002 US National Survey on Drug Use and Health was obtained. A total of 5730 respondents scored positive for alcohol abuse or dependence in the preceding year. Fewer than 10% had used any treatment for alcohol or drugs in this period, but this was associated with a 10% increase in the past-month abstinence and past-month binge-free drinking compared with respondents who did not access treatment. Such an apparent short-term recovery appeared greater in those whose treatment had been received in a formal treatment setting, a doctor's office, or in self-help groups than in the emergency room or in prison. Even if part of the association between treatment and recent abstinence and non-binge drinking was causal, indicating that treatment has some impact, it is a pathway chosen only by the minority.

Emotion-related regulatory difficulties contribute to negative psychological outcomes in active-duty Iraq war soldiers with and without posttraumatic stress disorder.

PubMed

Klemanski, David H; Mennin, Douglas S; Borelli, Jessica L; Morrissey, Paul M; Aikins, Deane E

2012-07-01

Data suggest military personnel involved in U.S. military initiatives in Iraq and Afghanistan are returning from deployment with elevated rates of mental health diagnoses, including posttraumatic stress disorder (PTSD). The aim of this study was to examine difficulties with emotion regulation as a potential contributory mechanism by which soldiers have poorer psychological outcomes, such as depression, dissociation, alcohol abuse, and interpersonal difficulties. Participants were 44 active-duty male service members who comprised three groups, including those deployed with and without diagnosed PTSD and those prior to deployment. Participants in the PTSD group scored significantly higher on measures of self-reported depression, trauma-related dissociation, alcohol misuse, and social adjustment difficulties than did comparison groups. Importantly, difficulties with emotion regulation were found to partially mediate the relationship between PTSD and depression, poor social adjustment, and trauma-related depersonalization but not alcohol misuse. Emotion-regulation difficulties are important to consider in the relationship between PTSD and additional psychological outcomes in recently deployed personnel. Implications for treatment are briefly discussed. © 2012 Wiley Periodicals, Inc.

The mediation role of licit drugs in the influence of socializing on cannabis use among adolescents: A quantitative approach.

PubMed

Mayet, Aurélie; Legleye, Stéphane; Chau, Nearkasen; Falissard, Bruno

2010-10-01

Licit substance use could be an early stage leading on to cannabis use. The aim of the study was to test a hypothetical sequential process leading from socializing to cannabis use so as to evaluate the mediator role of tobacco and alcohol. Data was derived from a French nationwide survey carried out in 2005 involving 29,393 teenagers aged 17. The analysis used structural equation modelling. The sequence tested was: socializing with friends-tobacco/alcohol use-cannabis use-cannabis use disorders (CUD). Tobacco and alcohol consumptions appeared to be similarly influenced by the time spent with friends. However, tobacco mediation explained 57% of the sequence leading to cannabis use and 61% of the sequence leading to CUD, while the role of alcohol was weaker, at around 13%. Our results underline the effect of peer influence, in the course of night-out socializing, on substance use among adolescents, and the importance of tobacco mediation in the process leading to cannabis use and misuse. This suggests that prevention in places frequented by adolescents should primarily target tobacco consumption, which explains the largest part of cannabis use variance. However, processes linking substance uses seem to be more complex, with the existence of reverse pathways from cannabis to licit drugs. Thus, the gateway effects of tobacco and alcohol require further exploration in relation to simultaneous polysubstance use. 2010. Published by Elsevier Ltd.

School and work status, drug-free workplace protections, and prescription drug misuse among Americans ages 15-25.

PubMed

Miller, Ted; Novak, Scott P; Galvin, Deborah M; Spicer, Rebecca S; Cluff, Laurie; Kasat, Sandeep

2015-03-01

We assessed the prevalence and characteristics of prescription drug misuse among youth ages 15-25 to examine differences by student and employment status, and associations with workplace antidrug policies and programs. Multivariate logistic regressions analyzed associations in weighted data on the 20,457 young adults in the combined 2004-2008 National Surveys on Drug Use and Health. Demographic controls included sex, race, community size, and age group. After we accounted for demographic controls, at ages 15-25, students were less likely than nonstudents to misuse prescription drugs. Segmenting student from nonstudent groups, working consistently was associated with a further reduction in misuse for those ages 18-25. When we controlled for demographics and substance use history, both Employee Assistance Program (EAP) services and awareness that one's employer had a drug-free workplace policy were associated with significantly lower misuse of prescription drugs (OR = 0.85 for each program, 95% CI [0.73, 1.00] and [0.72, 1.00]). Associations of workplace antidrug policies and programs with marijuana use and with Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for alcohol abuse and dependence contrasted sharply with these patterns. All four aspects were significantly associated with lower marijuana use. None was associated with problem drinking. Protective effects of drug-free workplace policy and EAPs persist after other substance use was controlled for. Comparing the effects of workplace programs on illicit drug use and problem drinking versus prescription misuse suggests that those protective associations do not result from selection bias. Thus, drug-free workplace policies and EAPs appear to help protect younger workers against prescription misuse. If workplace substance use disorder programs focused prevention messages and interventions on prescription drug misuse, their impact on misuse might increase.

Gambling, Alcohol, and Other Substance Use Among Youth in the United States*

PubMed Central

Barnes, Grace M.; Welte, John W.; Hoffman, Joseph H.; Tidwell, Marie-Cecile O.

2009-01-01

Objective: Problem gambling has been linked with substance misuse among youth in a number of regional studies, yet there have been no large representative U.S. surveys of gambling behaviors and substance use among youth. The present study is designed to compare the patterns and co-occurrence of gambling and alcohol and other substance use among youth in the United States. Method: A random telephone survey was conducted with 2,274 youth ages 14-21 years old living in households in every area of the United States. Results: Problem gambling and substance misuse are prevalent among young people. For instance, 17% of youth reported gambling 52 or more times in the past year, and the same percentage of youth drank five or more drinks on 12 or more days in the past year. Ten percent of youth reported having three or more gambling problems in the past year, and 15% of young people reported having three or more alcohol problems. Controlling for gender, age, and socioeconomic status, black youth have a significantly increased probability of frequent gambling compared with other racial/ethnic groups, yet they have a significantly decreased probability of heavy drinking. Alcohol problems and gambling problems show high co-occurrence, especially for male youth and black youth. Conclusions: Population subgroups with a high co-occurrence of alcohol and gambling problems are important for targeted prevention and intervention strategies. PMID:19118402

The Association Between Adverse Child Health, Psychological, Educational and Social Outcomes, and Nondependent Parental Substance: A Rapid Evidence Assessment.

PubMed

McGovern, Ruth; Gilvarry, Eilish; Addison, Michelle; Alderson, Hayley; Geijer-Simpson, Emma; Lingam, Raghu; Smart, Debbie; Kaner, Eileen

2018-01-01

Between 5% and 30% of children in high-income countries live with a substance misusing parent, the majority of which is below dependent levels. However, little is understood about the impact of nondependent parental substance misuse upon children. We searched the international literature using rigorous systematic methods to identify studies examining parental substance misuse and adverse outcomes in children. The inclusion criteria were cross-sectional, longitudinal, case-control, and cohort studies; of children aged 0-18 years whose parents are high-risk substance misusers; reporting on their health, psychological, substance use, educational, and social outcomes. We identified 36 papers (from 33 unique studies), most of which were assessed as being of medium to high methodological quality ( N= 28). Parental nondependent substance misuse was found to be associated with adversity in children, with strong evidence of an association with externalizing difficulties ( N = 7 papers, all finding an association) and substance use ( N = 23 papers, all finding an association) in adolescents and some evidence of adverse health outcomes in early childhood ( N = 6/8 papers finding an association). There is less evidence of an association between parental substance misuse and adverse educational and social outcomes. The body of evidence was largest for parental alcohol misuse, with research examining the impact of parental illicit drug use being limited. Methodological limitations restrict our ability to make causal inference. Nonetheless, the prevalence of adverse outcomes in children whose parents are nondependent substance misusers highlights the need for practitioners to intervene with this population before a parent has developed substance dependency.

The psychometric properties of a shortened Dutch version of the consequences scale used in the Core Alcohol and Drug Survey.

PubMed

De Bruyn, Sara; Wouters, Edwin; Ponnet, Koen; Van Damme, Joris; Van Hal, Guido

2017-01-01

Alcohol and drug misuse among college students has been studied extensively and has been clearly identified as a public health problem. Within more general populations alcohol misuse remains one of the leading causes of disease, disability and death worldwide. Conducting research on alcohol misuse requires valid and reliable instruments to measure its consequences. One scale that is often used is the consequences scale in the Core Alcohol and Drug Survey (CADS). However, psychometric studies on the CADS are rare and the ones that do exist report varying results. This article aims to address this imbalance by examining the psychometric properties of a Dutch version of the CADS in a large sample of Flemish university and college students. The analyses are based on data collected by the inter-university project 'Head in the clouds', measuring alcohol use among students. In total, 19,253 students participated (22.1% response rate). The CADS scale was measured using 19 consequences, and participants were asked how often they had experienced these on a 6-point scale. Firstly, the factor structure of the CADS was examined. Two models from literature were compared by performing confirmatory factor analyses (CFA) and were adapted if necessary. Secondly, we assessed the composite reliability as well as the convergent, discriminant and concurrent validity. The two-factor model, identifying personal consequences (had a hangover; got nauseated or vomited; missed a class) and social consequences (got into an argument or fight; been criticized by someone I know; done something I later regretted; been hurt or injured) was indicated to be the best model, having both a good model fit and an acceptable composite reliability. In addition, construct validity was evaluated to be acceptable, with good discriminant validity, although the convergent validity of the factor measuring 'social consequences' could be improved. Concurrent validity was evaluated as good. In deciding which model best represents the data, it is crucial that not only the model fit is evaluated, but the importance of factor reliability and validity issues is also taken into account. The two-factor model, identifying personal consequences and social consequences, was concluded to be the best model. This shortened Dutch version of the CADS (CADS_D) is a useful tool to screen alcohol-related consequences among college students.

Dating Violence among Male and Female Youth seeking Emergency Department Care

PubMed Central

Singh, Vijay; Walton, Maureen A; Whiteside, Lauren K; Stoddard, Sarah; Epstein-Ngo, Quyen; Chermack, Stephen T; Cunningham, Rebecca M

2014-01-01

Objective To determine prevalence and correlates of dating violence, dating victimization, and dating aggression among males and females age 14–20 seeking emergency department (ED) care. Methods Systematic sampling of subjects age 14–20 seeking care at a single large academic ED between 9/2010- 3/2013. Participants completed a computerized, self-administered, cross-sectional survey of demographics, dating violence from physical abuse measures of the Conflict in Adolescent Dating Relationships Inventory, associated behaviors, and ED health service use. Separate analyses were conducted for males and females. Results 4389 youth (86.1% participation rate) were screened, and 4089 (mean age 17.5 years, 58% female) were eligible for analysis. Almost 1 in 5 females (n= 215, 18.4%) and 1 in 8 males (n= 212, 12.5%) reported past year dating violence. Of females, 10.6% reported dating victimization, and 14.6% dating aggression, while of males, 11.7% reported dating victimization, and 4.9% reported dating aggression. Multivariate analyses showed variables associated with any male dating violence were African American race (AOR 2.26, CI 1.54–3.32), alcohol misuse (AOR 1.03, CI 1.00–1.06), illicit drug misuse (AOR 2.38, CI 1.68–3.38), and depression (AOR 2.13, CI 1.46–3.10); any female dating violence was associated with African-American race (AOR 1.68, CI 1.25–2.25), public assistance (AOR 1.64, CI 1.28–2.09), grades D and below (AOR 1.62, CI 1.07–2.43), alcohol misuse (AOR 1.04, CI 1.02–1.07), illicit drug misuse (AOR 2.85, CI 2.22–3.66), depression (AOR 1.86, CI 1.42–2.44), and any past year ED visit for intentional injury (AOR 2.64, CI 1.30–5.40). Conclusions Nearly 1 of 6 male and female adolescents seeking ED care report recent dating violence, and health disparities remain among this population. Dating violence was strongly associated with alcohol, illicit drug misuse, and depression, and correlated with prior ED service utilization among female youth. ED interventions should consider addressing these associated health conditions as well as improving screening protocols to address dating violence among male and female youth. PMID:24993689

Report on psychoactive drug use among adolescents using ayahuasca within a religious context.

PubMed

Doering-Silveira, Evelyn; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Da Silveira, Dartiu Xavier

2005-06-01

Ritual use of ayahuasca within the context of the Brazilian ayahuasca churches often starts during late childhood or early adolescence. Premature access to psychoactive drugs may represent a risk factor for drug misuse. Conversely, religious affiliation seems to play a protective role in terms of substance abuse. The objective of this study was to describe patterns of drug use in a sample of adolescents using ayahuasca within a religious setting. Forty-one adolescents from a Brazilian ayahuasca sect were compared with 43 adolescents who never drank ayahuasca. No significant differences were identified in terms of lifetime substance consumption. Throughout the previous year period, ayahuasca adolescents used less alcohol (46.31%) than the comparison group (74.4%). Recent use of alcohol was also more frequent among the latter group (65.1%) than among ayahuasca drinkers (32.5%). Although not statistically significant, slight differences in terms of patterns of drug use were definitely observed among groups. Despite their early exposure to a hallucinogenic substance, adolescents using ayahuasca in a controlled setting were mostly comparable to controls except for a considerably smaller proportion of alcohol users. Religious affiliation may have played a central role as a possible protective factor for alcohol use. Thus, ayahuasca seems to be a relatively safe substance as far as drug misuse is concerned.

Investigating the interlinkages of alcohol use and misuse, spirituality and culture - Insights from a systematic review.

PubMed

Castaldelli-Maia, João Mauricio; Bhugra, Dinesh

2014-06-01

Religious values are part of cultures, but spirituality is an internal dimension which may be present in varying degrees across all nations. As both cultural and spiritual factors are important in determining the pattern of alcohol consumption by individuals, it is important to study the relationships between them. The present systematic review aims to summarize the knowledge on the relationship between alcohol use and misuse, religiousness/spirituality and culture drawn from medical studies. Data from the medical literature to date indicate that for some racial and ethnic minorities a return to the traditional culture linked with concepts of spiritual or religious factors can produce a major degree of support for people trying to maintain abstinence from alcohol. This can be seen even in the worst environments. On the other hand, among the general population, religion and/or spirituality can play a positive role in the maintenance of abstinence, but a local heavy drinking culture is a strong risk factor for relapse. These factors are important and can be used for interventions and prevention strategies. However, possible mediating effects need to be explored further. It is likely that both types of intervention (classical medical treatment plus spiritual-based treatment) may work in individuals.

PTSD as a mediator between lifetime sexual abuse and substance use among jail diversion participants.

PubMed

Cusack, Karen J; Herring, Amy H; Steadman, Henry J

2013-08-01

Many of the individuals with serious mental illness involved in the criminal justice system have experienced interpersonal victimization, such as sexual abuse, and have high rates of alcohol and drug use disorders. Little attention has been paid to the prevalence of posttraumatic stress disorder (PTSD) and its potential role in the substance misuse of offenders with mental illness. The study used a path analytic framework to test the hypothesis that PTSD mediates the relationship between sexual abuse and level of alcohol and drug use among individuals (N=386) with mental illness enrolled in a multisite (N=7) jail diversion project. Sexual abuse was strongly associated with PTSD, which was in turn associated with both heavy drug use and heavy drinking. These findings suggest that PTSD may be an important target for jail diversion programs.

Prevention and early intervention to improve mental health in higher education students: a review.

PubMed

Reavley, Nicola; Jorm, Anthony F

2010-05-01

The age at which most young people are in higher education is also the age of peak onset for mental and substance use disorders, with these having their first onset before age 24 in 75% of cases. In most developed countries, over 50% of young people are in higher education. To review the evidence for prevention and early intervention in mental health problems in higher education students. The review was limited to interventions targeted to anxiety, depression and alcohol misuse. Interventions to review were identified by searching PubMed, PsycINFO and the Cochrane Database of Systematic Reviews. Interventions were included if they were designed to specifically prevent or intervene early in the general (non-health professional) higher education student population, in one or more of the following areas: anxiety, depression or alcohol misuse symptoms, mental health literacy, stigma and one or more behavioural outcomes. For interventions to prevent or intervene early for alcohol misuse, evidence of effectiveness is strongest for brief motivational interventions and for personalized normative interventions delivered using computers or in individual face-to-face sessions. Few interventions to prevent or intervene early with depression or anxiety were identified. These were mostly face-to-face, cognitive-behavioural/skill-based interventions. One social marketing intervention to raise awareness of depression and treatments showed some evidence of effectiveness. There is very limited evidence that interventions are effective in preventing or intervening early with depression and anxiety disorders in higher education students. Further studies, possibly involving interventions that have shown promise in other populations, are needed.

History of childhood abuse, sensation seeking, and intimate partner violence under/not under the influence of a substance: a cross-sectional study in Russia.

PubMed

Zhan, Weihai; Shaboltas, Alla V; Skochilov, Roman V; Krasnoselskikh, Tatiana V; Abdala, Nadia

2013-01-01

To examine correlates of perpetration and victimization of intimate partner violence (IPV) under and not under the influence of a substance, we conducted a study among women in Russia. In 2011, a cross-sectional survey was conducted among patients receiving services at a clinic for sexually transmitted infections in St. Petersburg, Russia. Multinomial logistic regression was used for analysis. Of 299 women, 104 (34.8%) and 113 (37.8%) reported a history of IPV perpetration and victimization, respectively. Nearly half (47.1%) of perpetrators and 61.1% of victims reported that the latest IPV event (perpetration and victimization, respectively) was experienced under the influence of a substance. Factors independently associated with IPV victimization under the influence of a substance were alcohol misuse and a higher number of lifetime sex partners, whereas only experience of childhood abuse (emotional and physical abuse) was independently associated with IPV victimization that did not occur under the influence of a substance. Childhood physical abuse, lower age of first sex, sensation seeking, and alcohol misuse were independently associated with IPV perpetration under the influence of a substance, while only childhood abuse (emotional and physical abuse) was independently associated with IPV perpetration that did not occur under the influence of a substance. IPV under and not under the influence of a substance had different correlates (e.g., alcohol misuse and sensation seeking). Despite the strong association between substance use and IPV, experience of childhood abuse is an important predictor of IPV perpetration and victimization in Russia, above and beyond substance use.

Does abortion reduce the mental health risks of unwanted or unintended pregnancy? A re-appraisal of the evidence.

PubMed

Fergusson, David M; Horwood, L John; Boden, Joseph M

2013-09-01

There have been debates about the linkages between abortion and mental health. Few reviews have considered the extent to which abortion has therapeutic benefits that mitigate the mental health risks of abortion. The aim of this review was to conduct a re-appraisal of the evidence to examine the research hypothesis that abortion reduces rates of mental health problems in women having unwanted or unintended pregnancy. Analysis of recent reviews (Coleman, 2011; National Collaborating Centre for Mental Health, 2011) identified eight publications reporting 14 adjusted odds ratios (AORs) spanning five outcome domains: anxiety; depression; alcohol misuse; illicit drug use/misuse; and suicidal behaviour. For each outcome, pooled AORs were estimated using a random-effects model. There was consistent evidence to show that abortion was not associated with a reduction in rates of mental health problems (p>0.75). Abortion was associated with small to moderate increases in risks of anxiety (AOR 1.28, 95% CI 0.97-1.70; p<0.08), alcohol misuse (AOR 2.34, 95% CI 1.05-5.21; p<0.05), illicit drug use/misuse (AOR 3.91, 95% CI 1.13-13.55; p<0.05), and suicidal behaviour (AOR 1.69, 95% CI 1.12-2.54; p<0.01). There is no available evidence to suggest that abortion has therapeutic effects in reducing the mental health risks of unwanted or unintended pregnancy. There is suggestive evidence that abortion may be associated with small to moderate increases in risks of some mental health problems.

THE RELATIONSHIP BETWEEN MEASURES OF IMPULSIVITY AND ALCOHOL MISUSE: AN INTEGRATIVE STRUCTURAL EQUATION MODELING APPROACH

PubMed Central

Courtney, Kelly E.; Arellano, Ryan; Barkley-Levenson, Emily; Gálvan, Adriana; Poldrack, Russell A.; MacKillop, James; Jentsch, J. David; Ray, Lara A.

2011-01-01

Background Higher levels of impulsivity have been implicated in the development of alcohol use disorders. Recent findings suggest that impulsivity is not a unitary construct, highlighted by the diverse ways in which the various measures of impulsivity relate to alcohol use outcomes. This study simultaneously tested the following dimensions of impulsivity as determinants of alcohol use and alcohol problems: risky decision-making, self-reported risk attitudes, response inhibition, and impulsive decision-making. Method Participants were a community sample of non-treatment seeking problem drinkers (N = 158). Structural Equation Modeling (SEM) analyses employed behavioral measures of impulsive decision-making (Delay Discounting Task, DDT), response inhibition (Stop Signal Task, SST), and risky decision-making (Balloon Analogue Risk Task, BART), and a self-report measure of risk attitudes (Domain-specific Risk-attitude Scale, DOSPERT), as predictors of alcohol use and of alcohol-related problems in this sample. Results The model fit well, accounting for 38% of the variance in alcohol problems, and identified two impulsivity dimensions that significantly loaded onto alcohol outcomes: (1) impulsive decision-making, indexed by the DDT; and (2) risky decision-making, measured by the BART. Conclusions The impulsive decision-making dimension of impulsivity, indexed by the DDT, was the strongest predictor of alcohol use and alcohol pathology in this sample of problem drinkers. Unexpectedly, a negative relationship was found between risky decision-making and alcohol problems. The results highlight the importance of considering the distinct facets of impulsivity in order to elucidate their individual and combined effects on alcohol use initiation, escalation, and dependence. PMID:22091877

Alcohol consumption, hazardous drinking, and alcohol dependency among the population of Andaman and Nicobar Islands, India.

PubMed

Manimunda, Sathya Prakash; Sugunan, Attayuru Purushottaman; Thennarasu, Kandavelu; Pandian, Dhanasekara; Pesala, Kasturi S; Benegal, Vivek

2017-01-01

Harmful use of alcohol is one of the globally recognized causes of health hazards. There are no data on alcohol consumption from Andaman and Nicobar Islands. The objective of the study was to assess the prevalence and pattern of alcohol use among the population of Andaman and Nicobar Islands, India. A representative sample of 18,018 individuals aged ≥14 years were chosen by multistage random sampling and administered a structured instrument, a modified version of the Gender, Alcohol, and Culture: An International Study (GENACIS) which included sociodemographic details and Alcohol Use Disorders Identification Test (AUDIT). The overall prevalence of alcohol consumption was 35% among males and over 6.0% in females, aged 14 and above. Two out of every five alcohol users fit into a category of hazardous drinkers. One-fourth of the total users (23%) are alcohol dependents. Both the hazardous drinking and dependent use are high among males compared to females. Almost 18.0% of male drinkers and 12.0% of female drinkers reported heavy drinking on typical drinking occasions. The predominant beverages consumed were in the category of homebrews such as toddy and handia. The present study highlights the magnitude of hazardous drinking and alcohol dependence in Andaman and Nicobar Islands, India and the complex sociocultural differences in the pattern of alcohol use. Based on the AUDIT data, among the population of Andaman and Nicobar Islands (aged 14 and above), one out of ten requires active interventions to manage the harmful impact of alcohol misuse.

A Ten-year Assessment of Anabolic Steroid Misuse among Competitive Athletes in Puerto Rico

PubMed Central

Acevedo, P; Jorge, JC; Cruz-Sánchez, A; Amy, E; Barreto-Estrada, JL

2012-01-01

Objective Little is known about anabolic androgenic steroids (AAS) misuse in the Caribbean region in spite of increased popularity among athletes and adolescents. The present study examines the usage of AAS among competitive athletes in Puerto Rico. Methods Doping test results of competitive athletes obtained by random sampling out of competition during the 2000–2009 period were analysed. Doping tests were executed by the Centre for Sports, Health and Exercise Sciences (Albergue Olímpico, Salinas, Puerto Rico). A total of 550 athletes were monitored during 2000–2009. Information was collected with regard to competitive sport, gender and AAS compounds whenever a positive test result was encountered. Results From the total sample of monitored cases during the past decade, 5.4% showed adverse analytical findings. Anabolic androgenic steroids misuse was detected among male (62%) and female (38%) athletes. Weightlifting showed the greatest percentage of positive AAS doping test results (70% of total cases) and stanozolol was the most commonly misused exogenous androgen (60% of abused AAS whether alone or as part of a cocktail). Testosterone was the most common endogenous misused steroid (10% of misused compounds). Conclusion In Puerto Rico, AAS misuse was detected across competitive sports for both genders. Although AAS misuse among Puerto Rican athletes shares some features that are consistent with the international sports community, it is imperative to address AAS misuse in the Caribbean region. PMID:22519228

Associations of Poor Housing with Mental Health Among North Carolina Latino Migrant Farmworkers.

PubMed

Mora, Dana C; Quandt, Sara A; Chen, Haiying; Arcury, Thomas A

2016-01-01

This analysis examines the associations of housing conditions with mental health among migrant farmworkers. Data are from a 2010 cross-sectional study conducted in 16 North Carolina counties. Interviews and housing inspections were completed with 371 farmworkers in 186 camps. Mental health measures included depression (Center for Epidemiologic Studies Depression Scale, CES-D), anxiety (Personality Assessment Inventory, PAI), and alcohol misuse (Alcohol Use Disorders Identification Test, AUDIT-C). Housing measures were number of people per sleeping room, perceived security of self and belongings, having a key to dwelling's door, having bedroom storage, toilet privacy issues, and number of housing regulation violations. Sixty (16.7%) participants had substantial depressive symptoms (CES-D ≥10), 31 (8.8%) had substantial anxiety (PAI ≥27), and 185 (50.1%) had the potential for alcohol misuse (AUDIT-C ≥4). Those with 5+ persons sleeping per room were more likely to have a depression score ≥10 (31.5% vs. 13-14%, P = .01) and an anxiety scores ≥27 (19.6% vs. 5-9%, P = .02). Those who did not feel they or their belongings were secure were more likely to have a depression score ≥10 (19.4% vs. 9.1%, P = .01). Those without a key were more likely to have an anxiety score ≥27 (11.5% vs. 5.1%, P = .04). Those with no bedroom storage were more likely to have a depression score ≥10 (28.9% vs. 14.9%, P = .03). This article suggests links between poor housing and farmworkers' mental health. These results inform regulations surrounding farmworker housing and inform health care providers on how to prevent and treat poor mental health among migrant farmworkers.

The Associations of Financial Stress and Parenting Support Factors with Alcohol Behaviors During Young Adulthood

PubMed Central

Lawry, Charles; Li, Gu; Conger, Katherine J.; Russell, Stephen T.

2014-01-01

This study examined concurrent and prospective associations of financial stress (financial strain, lack of financial access, public assistance) and parenting support factors (relationship quality, living at home, financial support) with young adults’ alcohol behaviors (alcohol use, heavy drinking, and problematic drinking) over a 5-year period. Analyses of National Longitudinal Study of Adolescent Health (Add Health) data (N = 7,159) showed that, over the study period, alcohol use and heavy drinking declined while problematic drinking increased. In addition, living at home and parental relationship quality were associated with fewer concurrent and prospective alcohol behaviors whereas financial strain and parents’ financial support were associated with more alcohol behaviors. The implications for minimizing alcohol misuse in young adults amid uncertain economic conditions are discussed. PMID:26388681

Alcohol studies and science: trapped in the velvet cage of medical research? An editorial.

PubMed

Roman, Paul M

2014-01-01

This article offers the author's assessment of the progress in research on alcohol related to alcohol misuse and alcohol use disorders. The historical background of alcohol-problem research is reviewed in the context of defining problems for study and the pattern by which research is funded. Progress in terms of cumulative research has been affected by the lack of central authority and the National Institutes of Health structure within which almost all funding for alcohol research in the United States has occurred. Problems are traced to the particular history and nature of alcohol-problem research, the continuing prominence of moral elements, and particular features of the treatment of alcohol use disorders. Although the scope of activity and production of publications in alcohol research has expanded greatly during the past 75 years, there is a potential shortfall in the cumulative research that has led to solutions to major problems associated with alcohol.

Acceptability of screening for early detection of liver disease in hazardous/harmful drinkers in primary care.

PubMed

Eyles, Caroline; Moore, Michael; Sheron, Nicholas; Roderick, Paul; O'Brien, Wendy; Leydon, Geraldine M

2013-08-01

It is estimated that one-quarter of adults in the UK drink at harmful/hazardous levels leading to increased mortality and alcohol liver disease (ALD). The Alcohol Liver Disease Detection Study (ALDDeS) aimed to test out in primary care the feasibility of alcohol misuse screening in adults, using the AUDIT questionnaire, and to assess screening harmful/hazardous alcohol users for ALD using newer non-invasive serum markers of fibrosis. To explore patients' experiences of taking part in ALDDeS and understanding of the delivery and process of screening for ALD using self-report questionnaires and feedback of liver fibrosis risk using levels of non-invasive serum markers. A nested qualitative study based in five primary care practices in the UK. From a sample of patients who were identified as drinking at harmful/hazardous levels, 30 participants were identified by maximum variation sampling for qualitative in-depth interviews. Using the principles of constant comparison the transcribed interviews were thematically analysed. Receiving a postal AUDIT questionnaire was viewed as acceptable by participants. For some completing the AUDIT increased awareness of their hazardous alcohol use and a positive blood test indicating liver fibrosis was a catalyst for behaviour change. For others, a negative blood test result provided a licence to continue drinking at hazardous levels. A limited understanding of safe drinking and of ALD was common. Educational and training needs of primary care professionals must be taken into account, so that patients with marker levels indicating low risk of fibrosis are correctly informed about the likely risks of continuing to drink at the same levels.

Hazardous alcohol consumption in non-aboriginal male inmates in New South Wales.

PubMed

Field, Courtney

2018-03-12

Purpose The purpose of this paper is to examine correlates and predictors of hazardous drinking behaviour, that may be considered evidence of generalised strain, in a sample of incarcerated non-Aboriginal males in New South Wales, Australia. Design/methodology/approach Data were collected from 283 non-Aboriginal male inmates as part of a larger epidemiological survey of inmates in NSW undertaken in 2015 by the Justice Health and Forensic Mental Health Network. Data relating to a range of social factors were selected with reference to relevant literature and assessed with regards their predictive value for scores from the Alcohol Use Disorders Identification Test (AUDIT). To facilitate regression analysis, variables were logically organised into historical factors or adult factors. Findings Almost all participants reported some history of alcohol consumption. Hazardous drinking was common among participants. While parental alcohol problems and adult drug use were the only correlates of AUDIT scores, parental misuse of alcohol was shown to be an important predictor of AUDIT scores in regression analysis. The role of parent gender was inconclusive. Previous incarceration as an adult, employment status, and drug use as an adult also predicted AUDIT scores. Originality/value Alcohol abuse is common among inmates and the use of alcohol is implicated in the commission of many offences. A better understanding of its genesis may inspire novel approaches to treatment, leading to improved health outcomes for inmates.

Innovative Surveillance and Risk Reduction Systems for Family Maltreatment, Suicidality, and Substance Problems in USAF

DTIC Science & Technology

2005-03-01

prevention, spouse 13 abuse, child abuse , suicide, alcohol, drug abuse 16. PRICE CODE 17. SECURITY CLASSIFICA TION 18. SECURITY CLASSIFICA TION 19...cohesion 9 Triple P Command) • Spouse emotional 0 Depressive 9 Common Sense Parenting abuse symptomatology * Child abuse & neglect e Relationship...and secretive problems Partner Physical Prescr. Illicit Child Abuse Abuse Partner Emo. Abuse Alcohol Drug Drug Suicid- c3-to- Problems Misuse Use ality

Impulsivity, Impulsive and Reflective Processes and the Development of Alcohol Use and Misuse in Adolescents and Young Adults

PubMed Central

Wiers, Reinout W.; Ames, Susan L.; Hofmann, Wilhelm; Krank, Marvin; Stacy, Alan W.

2010-01-01

This paper contrasts dual-process and personality approaches in the prediction of addictive behaviors and related risk behaviors. In dual-process models, behavior is described as the joint outcome of qualitatively different “impulsive” (or associative) and “reflective” processes. There are important individual differences regarding both types of processes, and the relative strength of both in a specific situation is influenced by prior behavior and state variables (e.g., fatigue, alcohol use). From this perspective, a specific behavior (e.g., alcohol misuse) can be predicted by the combined indices of the behavior-related impulsive processes (e.g., associations with alcohol), and reflective processes, including the ability to refrain from a motivationally salient action. Personality approaches have reported that general traits such as impulsivity predict addictive behaviors. Here we contrast these two approaches, with supplementary analyses on four datasets. We hypothesized that trait impulsivity can predict specific risky behaviors, but that its predictive power disappears once specific behavior-related associations, indicators of executive functioning, and their interaction are entered into the equation. In all four studies the observed interaction between specific associations and executive control (EC) was robust: trait impulsivity did not diminish the prediction of alcohol use by the interaction. Trait impulsivity was not always related to alcohol use, and when it was, the predictive power disappeared after entering the interaction between behavior-specific associations and EC in one study, but not in the other. These findings are interpreted in relation to the validity of the measurements used, which leads to a more refined hypothesis. PMID:21833213

Effects of delaying binge drinking on adolescent brain development: a longitudinal neuroimaging study.

PubMed

Bourque, Josiane; Baker, Travis E; Dagher, Alain; Evans, Alan C; Garavan, Hugh; Leyton, Marco; Séguin, Jean R; Pihl, Robert; Conrod, Patricia J

2016-12-13

Onset of alcohol use by 14 relative to 21 years of age strongly predicts elevated risk for severe alcohol use problems, with 27% versus 4% of individuals exhibiting alcohol dependence within 10 years of onset. What remains unclear is whether this early alcohol use (i) is a marker for later problems, reflected as a pre-existing developmental predisposition, (ii) causes global neural atrophy or (iii) specifically disturbs neuro-maturational processes implicated in addiction, such as executive functions or reward processing. Since our group has demonstrated that a novel intervention program targeting personality traits associated with adolescent alcohol use can prevent the uptake of drinking and binge drinking by 40 to 60%, a crucial question is whether prevention of early onset alcohol misuse will protect adolescent neurodevelopment and which domains of neurodevelopment can be protected. A subsample of 120 youth at high risk for substance misuse and 30 low-risk youth will be recruited from the Co-Venture trial (Montreal, Canada) to take part in this 5-year follow-up neuroimaging study. The Co-Venture trial is a community-based cluster-randomised trial evaluating the effectiveness of school-based personality-targeted interventions on substance use and cognitive outcomes involving approximately 3800 Grade 7 youths. Half of the 120 high-risk participants will have received the preventative intervention program. Cognitive tasks and structural and functional neuroimaging scans will be conducted at baseline, and at 24- and 48-month follow-up. Two functional paradigms will be used: the Stop-Signal Task to measure motor inhibitory control and a modified version of the Monetary Incentive Delay Task to evaluate reward processing. The expected results should help identify biological vulnerability factors, and quantify the consequences of early alcohol abuse as well as the benefits of early intervention using brain metrics.

Incidental treatment effects of CBT on suicidal ideation and hopelessness.

PubMed

Handley, Tonelle E; Kay-Lambkin, Frances J; Baker, Amanda L; Lewin, Terry J; Kelly, Brian J; Inder, Kerry J; Attia, John R; Kavanagh, David J

2013-10-01

Depression and alcohol misuse are among the most prevalent diagnoses in suicide fatalities. The risk posed by these disorders is exacerbated when they co-occur. Limited research has evaluated the effectiveness of common depression and alcohol treatments for the reduction of suicide vulnerability in individuals experiencing comorbidity. Participants with depressive symptoms and hazardous alcohol use were selected from two randomised controlled trials. They had received either a brief (1 session) intervention, or depression-focused cognitive behaviour therapy (CBT), alcohol-focused CBT, therapist-delivered integrated CBT, computer-delivered integrated CBT or person-centred therapy (PCT) over a 10-week period. Suicidal ideation, hopelessness, depression severity and alcohol consumption were assessed at baseline and 12-month follow-up. Three hundred three participants were assessed at baseline and 12 months. Both suicidal ideation and hopelessness were associated with higher severity of depressive symptoms, but not with alcohol consumption. Suicidal ideation did not improve significantly at follow-up, with no differences between treatment conditions. Improvements in hopelessness differed between treatment conditions; hopelessness improved more in the CBT conditions compared to PCT and in single-focused CBT compared to integrated CBT. Low retention rates may have impacted on the reliability of our findings. Combining data from two studies may have resulted in heterogeneity of samples between conditions. CBT appears to be associated with reductions in hopelessness in people with co-occurring depression and alcohol misuse, even when it is not the focus of treatment. Less consistent results were observed for suicidal ideation. Establishing specific procedures or therapeutic content for clinicians to monitor these outcomes may result in better management of individuals with higher vulnerability for suicide. © 2013 Elsevier B.V. All rights reserved.

Adverse Childhood Experiences (ACEs) and Alcohol Abuse among South Carolina Adults.

PubMed

Crouch, Elizabeth; Radcliff, Elizabeth; Strompolis, Melissa; Wilson, Abygail

2018-06-07

Adverse childhood experiences (ACEs) have been associated with negative adult health outcomes, including alcohol misuse. The impact of ACEs on alcohol use may vary by gender, with ACEs impacting women more than men in coping with adulthood stressors. The objective of this study is to examine the gender-specific relationships between ACEs and self-reported binge drinking and heavy drinking in adulthood among South Carolina residents. This study analyzed a sample of 8492 respondents who completed the 2014 or 2015 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) survey. Logistic regression was used to examine the impact of types and the number of ACEs on binge drinking and heaving drinking in adulthood. Thirty-seven percent of men and 22.8% of women survey respondents reported binge drinking and 12.2% of men and 4.1% of women reported heavy drinking. Almost all categories of ACE were associated with increased odds of reporting binge and heavy drinking; household mental illness had the greatest odds for men (aOR 1.31, 95% CI 1.30-1.33) and emotional abuse had the greatest odds for women (aOR 1.42, 95% CI 1.40-1.43). Men and women with four or more ACEs had greater odds of reporting binge and heavy drinking compared to their counterparts. Conclusions/Importance: Given the potential for negative outcomes associated with alcohol misuse and transmission of risky alcohol-related behaviors from parent to child, strategies that utilize a multigenerational approach could have a large impact on population health.

[Alcoholic ketoacidosis and reversible neurological complications due to hypophosphataemia].

PubMed

Fernández López, Ma T; García Bargo, Ma D; Rivero Luis, Ma T; Álvarez Vázquez, P; Saenz Fernández, C A; Mato Mato, J A

2012-01-01

A 57-year-old man with chronic alcoholism was admitted to our hospital due to disturbance of consciousness and polyradiculitis. Laboratory examination revealed metabolic acidosis, hypokalemia and hypophosphataemia. Alcoholic ketoacidosis is a common disorder in alcoholic patients. All patients present with a history of heavy alcohol misuse, preceding a bout of particularly excesive intake, which had been terminated by nausea, vomiting and abdominal pain. The most important laboratory results are: normal or low glucose level, metabolic acidosis with a raised anion GAP, low or absent blood alcohol level and urinary ketones. The greatest threats to patients are: hypovolemia, hypokaliemia, hypoglucemia and acidosis. Alcohol abuse may result in a wide range of electrolyte and acid-base disorders including hypophosphataemia, hypomagnesemia, hypocalcemia, hypokalemia, metabolic acidosis and respiratory alkalosis. Disturbance of consciousness in alcoholic patients is observed in several disorders, such drunkenness, Wernicke encephalopathy, alcohol withdrawal syndrome, central pontine myelinolysis, hepatic encephalopathy, hypoglucemia and electrolyte disorders.

Peer, social media, and alcohol marketing influences on college student drinking.

PubMed

Roberson, Angela A; McKinney, Cliff; Walker, Courtney; Coleman, Ashley

2018-07-01

To investigate how alcohol marketing and peers may promote college students' alcohol use through social media. College students (N = 682) aged 18 to 22 years from a large Southern university completed paper surveys in April 2014. Structural equation modeling was used to investigate relationships among variables as well as moderation by gender and race. Drinking behavior was directly related to perceived norms and attitudes toward alcohol that develop, in part, from direct and indirect interactions with their online and offline peers, as well as engagement with alcohol-related content on social media. Gender and ethnicity moderated some effects. College student drinking is influenced by friends' alcohol-related content posted on social networking sites and by greater engagement with traditional and online alcohol marketing. College campus alcohol misuse interventions should include components to counter peer influences and alcohol marketing on social media.

Alcohol Consumption Reduction Among a Web-Based Supportive Community Using the Hello Sunday Morning Blog Platform: Observational Study.

PubMed

Kirkman, Jessica Jane Louise; Leo, Briony; Moore, Jamie Christopher

2018-05-17

Alcohol misuse is a major social and public health issue in Australia, with an estimated cost to the community of Aus $30 billion per annum. Until recently, a major barrier in addressing this significant public health issue is the fact that the majority of individuals with alcohol use disorders and alcohol misuse are not receiving treatment. This study aimed to assess whether alcohol consumption changes are associated with participation in Hello Sunday Morning's blog platform, an online forum discussing experiences in abstaining from alcohol. The study reports on Hello Sunday Morning participants who signed up for a 3-month period of abstinence from November 2009 to November 2016. The sample comprised 1917 participants (female: 1227/1917, 64.01%; male: 690/1917, 35.99%). Main outcome measures were Alcohol Use Disorders Identification Test (AUDIT) scores, mood, program engagement metrics, and slip-ups. Individuals who reported hazardous (preprogram AUDIT mean 11.92, SD 2.25) and harmful consumption levels (preprogram AUDIT mean 17.52, SD 1.08) and who engaged in the Hello Sunday Morning program reported a significant decrease in alcohol consumption, moving to lower risk consumption levels (hazardous, mean 7.59, SD 5.70 and harmful, mean 10.38, SD 7.43), 4 months following program commencement (P<.001). Those who reported high-risk or dependent consumption levels experienced the biggest reduction (preprogram mean 25.38, SD 4.20), moving to risky consumption (mean 15.83, SD 11.11), 4 months following program commencement (P<.001). These reductions in risk were maintained by participants in each group, 7 months following program commencement. Furthermore, those who engaged in the program more (as defined by more sign-ins, blogs posted, check-ins completed, and engagement with the community through likes and following) had lower alcohol consumption. Finally, those who experienced more slip-ups had lower alcohol consumption. Participation in an online forum can support long-term behavior change in individuals wishing to change their drinking behavior. Importantly, reductions in AUDIT scores appeared larger for those drinking at high-risk and hazardous levels before program commencement. This has promising implications for future models of alcohol reduction treatment, as online forums are an anonymous, accessible, and cost-effective alternative or adjunct to treatment-as-usual. Further research is needed into the specific mechanisms of change within a Web-based supportive community, as well as the role of specific mood states in predicting risky drinking behavior. ©Jessica Jane Louise Kirkman, Briony Leo, Jamie Christopher Moore. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.05.2018.

Impulsivity in bipolar disorders in a Tunisian sample.

PubMed

Feki, Ines; Moalla, Mariem; Baati, Imen; Trigui, Dorsaf; Sellami, Rim; Masmoudi, Jaweher

2016-08-01

Impulsivity as a trait characteristic is increased in bipolar disorder and may be a core factor of the illness. The objectives of our work are to evaluate the level of impulsivity among patients with bipolar disorder and to study its relation with mood state, alcohol misuse, suicide attempts and other socio-demographic and clinical factors. We measured impulsivity in 60 subjects with bipolar disorder in relationship to socio-demographic and clinical variables. The subjects completed Data included socio-demographic details and clinical variables, the Barratt Impulsiveness Scale (BIS-11) in an Arabic version to assess impulsivity, The Mini International Neuropsychiatric Interview "MINI" version 05 to screen for alcohol abuse or dependence and mood graphic rate scale (MGRS) to evaluate mood state. Our results show that the mean score of BIS-11 was 71.5. Fifty-five per cent of the patients had a high level of impulsiveness. No differences were found relating to mood state. Impulsivity was related to Male gender, lower educational level, early age of onset, smoking, alcohol and drug misuse and prior suicide attempts. The treatment of patients with BD should consider to reduce impulsivity to improve morbidity. Copyright © 2016 Elsevier B.V. All rights reserved.

Social norms information for alcohol misuse in university and college students.

PubMed

Foxcroft, David R; Moreira, Maria Teresa; Almeida Santimano, Nerissa M L; Smith, Lesley A

2015-01-26

Drinking is influenced by youth (mis)perceptions of how their peers drink. If misperceptions can be corrected, young people may drink less. To determine whether social norms interventions reduce alcohol-related negative consequences, alcohol misuse or alcohol consumption when compared with a control (ranging from assessment only/no intervention to other educational or psychosocial interventions) among university and college students. The following electronic databases were searched up to May 2014: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (only to March 2008). Reference lists of included studies and review articles were manually searched. Randomised controlled trials or cluster-randomised controlled trials that compared a social normative intervention versus no intervention, alcohol education leaflet or other 'non-normative feedback' alcohol intervention and reported on alcohol consumption or alcohol-related problems in university or college students. We used standard methodological procedures as expected by The Cochrane Collaboration. Each outcome was analysed by mode of delivery: mailed normative feedback (MF); Web/computer normative feedback (WF); individual face-to-face normative feedback (IFF); group face-to-face normative feedback (GFF); and normative marketing campaign (MC). A total of 66 studies (43,125 participants) were included in the review, and 59 studies (40,951 participants) in the meta-analyses. Outcomes at 4+ months post intervention were of particular interest to assess when effects were sustained beyond the immediate short term. We have reported pooled effects across delivery modes only for those analyses for which heterogeneity across delivery modes is not substantial (I(2) < 50%). Alcohol-related problems at 4+ months: IFF standardised mean difference (SMD) -0.16, 95% confidence interval (CI) -0.31 to -0.01 (participants = 1065; studies = 7; moderate quality of evidence), equivalent to a decrease of 1.5 points in the 69-point alcohol problems scale score. No effects were found for WF or MF. Binge drinking at 4+ months: results pooled across delivery modes: SMD -0.06, 95% CI -0.11 to -0.02 (participants = 11,292; studies = 16; moderate quality of evidence), equivalent to 2.7% fewer binge drinkers if 30-day prevalence is 43.9%. Drinking quantity at 4+ months: results pooled across delivery modes: SMD -0.08, 95% CI -0.12 to -0.05 (participants = 20,696; studies = 33; moderate quality of evidence), equivalent to a reduction of 0.9 drinks consumed each week, from a baseline of 13.7 drinks per week. Drinking frequency at 4+ months: WF SMD -0.12, 95% CI -0.18 to -0.05 (participants = 9456; studies = 9; moderate quality of evidence), equivalent to a decrease of 0.19 drinking days/wk, from a baseline of 2.74 days/wk; IFF SMD -0.21, 95% CI -0.31 to -0.10 (participants = 1464; studies = 8; moderate quality of evidence), equivalent to a decrease of 0.32 drinking days/wk, from a baseline of 2.74 days/wk. No effects were found for GFF or MC. Estimated blood alcohol concentration (BAC) at 4+ months: peak BAC results pooled across delivery modes: SMD -0.08, 95% CI -0.17 to 0.00 (participants = 7198; studies = 13; low quality of evidence), equivalent to a reduction in peak PAC from an average of 0.144% to 0.135%. No effects were found for typical BAC with IFF. The results of this review indicate that no substantive meaningful benefits are associated with social norms interventions for prevention of alcohol misuse among college/university students. Although some significant effects were found, we interpret the effect sizes as too small, given the measurement scales used in the studies included in this review, to be of relevance for policy or practice. Moreover, the statistically significant effects are not consistent for all misuse measures, heterogeneity was a problem in some analyses and bias cannot be discounted as a potential cause of these findings.

Primary Care Providers’ Experiences with Urine Toxicology Tests to Manage Prescription Opioid Misuse and Substance Use Among Chronic Non-Cancer Pain Patients in Safety Net Healthcare Settings

PubMed Central

Ceasar, Rachel; Chang, Jamie; Zamora, Kara; Hurstak, Emily; Kushel, Margot; Miaskowski, Christine; Knight, Kelly

2016-01-01

Background Guideline recommendations to reduce prescription opioid misuse among patients with chronic non-cancer pain include the routine use of urine toxicology tests for high-risk patients. Yet little is known about how the implementation of urine toxicology tests among patients with co-occurring chronic non-cancer pain and substance use impacts primary care providers’ management of misuse. In this paper, we present clinicians’ perspectives on the benefits and challenges of implementing urine toxicology tests in the monitoring of opioid misuse and substance use in safety net healthcare settings. Methods We interviewed 23 primary care providers from six safety net healthcare settings whose patients had a diagnosis of co-occurring chronic non-cancer pain and substance use. We transcribed, coded, and analyzed interviews using grounded theory methodology. Results The benefits of implementing urine toxicology tests for primary care providers included less reliance on intuition to assess for misuse and the ability to identify unknown opioid misuse and/or substance use. The challenges of implementing urine toxicology tests included insufficient education and training about how to interpret and implement tests, and a lack of clarity on how and when to act on tests that indicated misuse and/or substance use. Conclusions These data suggest that primary care clinicians’ lack of education and training to interpret and implement urine toxicology tests may impact their management of patient opioid misuse and/or substance use. Clinicians may benefit from additional education and training about the clinical implementation and use of urine toxicology tests. Additional research is needed on how primary care providers implementation and use of urine toxicology tests impacts chronic non-cancer pain management in primary care and safety net healthcare settings among patients with co-occurring chronic non-cancer pain and substance use. PMID:26682471

Factors Associated with Alcohol Use Before or During Sex Among Men Who Have Sex with Men in a Large Internet Sample from Asia.

PubMed

Yang, Cui; Guadamuz, Thomas E; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2016-04-01

We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions.

Advisory Board on Alcoholism and Drug Abuse

Science.gov Websites

Agencies Alaska Pioneer Homes Behavioral Health Office of Children's Services Office of the Commissioner Office of Substance Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice Public Assistance Public Health Seniors & Disabilities Services Boards

49 CFR 655.71 - Retention of records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... employee's entry into and completion of the treatment program recommended by the substance abuse..., and covered employee referrals to the substance abuse professional, and copies of annual MIS reports..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS...

49 CFR 655.71 - Retention of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... employee's entry into and completion of the treatment program recommended by the substance abuse..., and covered employee referrals to the substance abuse professional, and copies of annual MIS reports..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS...

49 CFR 655.71 - Retention of records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... employee's entry into and completion of the treatment program recommended by the substance abuse..., and covered employee referrals to the substance abuse professional, and copies of annual MIS reports..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS...

49 CFR 655.71 - Retention of records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... employee's entry into and completion of the treatment program recommended by the substance abuse..., and covered employee referrals to the substance abuse professional, and copies of annual MIS reports..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS...

49 CFR 655.71 - Retention of records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... employee's entry into and completion of the treatment program recommended by the substance abuse..., and covered employee referrals to the substance abuse professional, and copies of annual MIS reports..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS...

Preference conditioning in healthy individuals: correlates with hazardous drinking.

PubMed

Balodis, Iris M; Lockwood, Kathleen P; Magrys, Sylvia A; Olmstead, Mary C

2010-06-01

Conditioned reward is a classic measure of drug-induced brain changes in animal models of addiction. The process can be examined in humans using the Conditioned Pattern Preference (CPP) task, in which participants associate nonverbal cues with reward but demonstrate low awareness of this conditioning. Previously, we reported that alcohol intoxication does not affect CPP acquisition in humans, but our data indicated that prior drug use may impact conditioning scores. To test this possibility, the current study examined the relationship between self-reported alcohol use and preference conditioning in the CPP task. Working memory was assessed during conditioning by asking participants to count the cues that appeared at each location on a computer screen. Participants (69 female and 23 male undergraduate students) completed the Alcohol Use Disorders Identification Test (AUDIT) and the Rutgers Alcohol Problem Index (RAPI) as measures of hazardous drinking. Self-reported hazardous drinking was significantly correlated with preference conditioning in that individuals who scored higher on these scales exhibited an increased preference for the reward-paired cues. In contrast, hazardous drinking did not affect working memory errors on the CPP task. These findings support evidence that repeated drug use sensitizes neural pathways mediating conditioned reward and point to a neurocognitive disposition linking substance misuse and responses to reward-paired stimuli. The relationship between hazardous drinking and conditioned reward is independent of changes in cognitive function, such as working memory.

Dimensions of Problem Drinking among Young Adult Restaurant Workers

PubMed Central

Moore, Roland S.; Cunradi, Carol B.; Duke, Michael R.; Ames, Genevieve M.

2009-01-01

Background Nationwide surveys identify food service workers as heavy alcohol users. Objectives This article analyzes dimensions and correlates of problem drinking among young adult food service workers. Methods A telephone survey of national restaurant chain employees yielded 1294 completed surveys. Results Hazardous alcohol consumption patterns were seen in 80% of men and 64% of women. Multivariate analysis showed that different dimensions of problem drinking measured by the AUDIT were associated with workers' demographic characteristics, smoking behavior and job category. Conclusions & Scientific Significance These findings offer evidence of extremely high rates of alcohol misuse among young adult restaurant workers. PMID:20180660

Prevalence of psychiatric morbidity in United States military spouses: The Millennium Cohort Family Study.

PubMed

Steenkamp, Maria M; Corry, Nida H; Qian, Meng; Li, Meng; McMaster, Hope Seib; Fairbank, John A; Stander, Valerie A; Hollahan, Laura; Marmar, Charles R

2018-05-10

Approximately half of US service members are married, equating to 1.1 million military spouses, yet the prevalence of psychiatric morbidity among military spouses remains understudied. We assessed the prevalence and correlates of eight mental health conditions in spouses of service members with 2-5 years of service. We employed baseline data from the Millennium Cohort Family Study, a 21-year longitudinal survey following 9,872 military-affiliated married couples representing all US service branches and active duty, Reserve, and National Guard components. Couples were surveyed between 2011 and 2013, a period of high military operational activity associated with Operation Iraqi Freedom and Operation Enduring Freedom. Primary outcomes included depression, anxiety, posttraumatic stress disorder (PTSD), panic, alcohol misuse, insomnia, somatization, and binge eating, all assessed with validated self-report questionnaires. A total of 35.90% of military spouses met criteria for at least one psychiatric condition. The most commonly endorsed conditions were moderate-to-severe somatization symptoms (17.63%) and moderate-to-severe insomnia (15.65%). PTSD, anxiety, depression, panic, alcohol misuse, and binge eating were endorsed by 9.20%, 6.65%, 6.05%, 7.07%, 8.16%, and 5.23% of spouses, respectively. Having a partner who deployed with combat resulted in higher prevalence of anxiety, insomnia, and somatization. Spouses had lower prevalence of PTSD, alcohol misuse, and insomnia but higher rates of panic and binge eating than service members. Both members of a couple rarely endorsed having the same psychiatric problem. One third of junior military spouses screened positive for one or more psychiatric conditions, underscoring the need for high-quality prevention and treatment services. © 2018 Wiley Periodicals, Inc.

History of Childhood Abuse, Sensation Seeking, and Intimate Partner Violence under/Not under the Influence of a Substance: A Cross-Sectional Study in Russia

PubMed Central

Zhan, Weihai; Shaboltas, Alla V.; Skochilov, Roman V.; Krasnoselskikh, Tatiana V.; Abdala, Nadia

2013-01-01

Objectives To examine correlates of perpetration and victimization of intimate partner violence (IPV) under and not under the influence of a substance, we conducted a study among women in Russia. Methods In 2011, a cross-sectional survey was conducted among patients receiving services at a clinic for sexually transmitted infections in St. Petersburg, Russia. Multinomial logistic regression was used for analysis. Results Of 299 women, 104 (34.8%) and 113 (37.8%) reported a history of IPV perpetration and victimization, respectively. Nearly half (47.1%) of perpetrators and 61.1% of victims reported that the latest IPV event (perpetration and victimization, respectively) was experienced under the influence of a substance. Factors independently associated with IPV victimization under the influence of a substance were alcohol misuse and a higher number of lifetime sex partners, whereas only experience of childhood abuse (emotional and physical abuse) was independently associated with IPV victimization that did not occur under the influence of a substance. Childhood physical abuse, lower age of first sex, sensation seeking, and alcohol misuse were independently associated with IPV perpetration under the influence of a substance, while only childhood abuse (emotional and physical abuse) was independently associated with IPV perpetration that did not occur under the influence of a substance. Conclusions IPV under and not under the influence of a substance had different correlates (e.g., alcohol misuse and sensation seeking). Despite the strong association between substance use and IPV, experience of childhood abuse is an important predictor of IPV perpetration and victimization in Russia, above and beyond substance use. PMID:23844148

Reasons to use e-cigarettes and associations with other substances among adolescents in Switzerland.

PubMed

Surís, Joan-Carles; Berchtold, André; Akre, Christina

2015-08-01

The objectives of this research were to describe the main reason(s) why adolescents use electronic cigarettes, to assess how e-cigarette experimenters and users differ based on personal characteristics, and to determine whether its use is associated with the use of other substances among a representative sample of youths in Switzerland. A representative sample of 621 youths (308 females) was divided into never users (n=353), experimenters (Only once, n=120) and users (Several times, n=148) of e-cigarettes. Groups were compared on socio-demographic data and current smoking, alcohol misuse and cannabis use. Reasons for e-cigarette use were compared between experimenters and users. A multinomial regression was performed using never users as the reference category. Forty-three percent had ever tried e-cigarettes, and the main reason was curiosity. Compared to never users, experimenters were more likely to be out of school (Relative Risk Ratio [RRR]: 2.68) and to misuse alcohol (RRR: 2.08), while users were more likely to be male (RRR: 2.75), to be vocational students (RRR: 2.30) or out of school (RRR: 3.48) and to use any of the studied substances (tobacco, RRR: 5.26; alcohol misuse, RRR: 2.71; cannabis use, RRR: 30.2). Although often still part of adolescent experimentation, e-cigarettes are becoming increasingly popular among adolescents and they should become part of health providers' standard substance use screening. As health providers (and especially paediatricians) do not seem to have high levels of knowledge and, consequently, little comfort in discussing e-cigarettes, training in this domain should be available to them. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Traditional Chinese medicine for treatment of alcoholism: from ancient to modern.

PubMed

Liu, Qing; Lawrence, Andrew J; Liang, Jian-Hui

2011-01-01

Alcohol has long been used as a daily beverage in China and around the world. It is a medicinal substance with various biological activities. In fact, alcohol has played an important role in the development of traditional Chinese medicine (TCM), within which it is considered as the earliest exhilarant and anaesthetic. Yet, as a substance with great potency of misuse and addiction, the consumption of alcohol can lead to serious damage to individual health and the society. Over the past 20 years, alcohol abuse or alcoholism has become an increasing social problem in China along with the rapid economic development. China, the country of origin for TCM, has accumulated abundant clinical experience in the treatment of alcoholism with its ancient medicine. In the present research, we have summarized clinical and primary studies concerning various remedies of TCM for alcohol abuse, including herbal components (such as Kudzu/Pueraria Lobata, Pediculus melo, Hypericumpperforatum L.), decoctions and acupuncture.

Alcohol use and cultural change in an indigenous population: a case study from Venezuela.

PubMed

Seale, J Paul; Shellenberger, Sylvia; Rodriguez, Carlos; Seale, Josiah D; Alvarado, Manuel

2002-01-01

To explore the historical and cultural context of problem drinking in a Latin American indigenous population and identify possible areas for intervention. Focus group discussions. Participants reported that prior to 1945, binge drinking and fighting were part of cultural festivals held several times each year. Alcohol was brewed in limited quantities by specially qualified individuals. Limited family violence and injuries resulted. Increasing contact with Western civilization resulted in year-round access to large supplies of commercial alcohol and exposure to alcohol-misusing role models. Increased heavy drinking and decreases in subsistence farming resulted in escalation of problems, including hunger, serious injury, family violence, divorce and legal problems. Communities are beginning to regain control by prohibiting sale of alcohol in villages, sponsoring alcohol-free celebrations, and increasing involvement in religious activities. Though alcohol may cause devastating consequences in cultures in transition, studies of community responses may identify useful strategies for reducing alcohol-related harm.

Treating substance abuse and mental health issues as 'mutually-exclusive' entities: Best practice or an outmoded approach to intervention?

PubMed

Webber, Adrian; Clark, Jane; Kelly, David

2016-02-01

Addressing the psychological distress of individuals experiencing substance use disorders has too often been relegated to the 'too hard basket', leaving those affected with little choice but to receive treatments aimed solely at addressing their drug and alcohol issues. Conversely, individuals receiving support for psychological issues are often underdiagnosed with regards to any comorbid substance misuse problems. In fact, to date, no definitive treatment model exists that gives equal focus to the treatment of both psychological well-being and substance-related addictions. This is not to suggest, however, that existing treatment programmes for substance misuse are not impacting positively on clients' mental health, rather that further research is needed in order to determine what it is that is supporting such improvements. The aim of this study, therefore, was to address this imbalance by examining the correlation between substance dependence and psychological well-being. Using a descriptive correlation design, the Severity of Dependence and Kessler 10 scales were administered to 37 inpatient and outpatient clients at a rural drug and alcohol rehabilitation service, at intake and 2 months into treatment. Data were analysed using descriptive statistics and paired-samples t-tests. Positive correlative factors of improvement between substance dependence and psychological well-being were found for both groups. In light of these findings, the authors recommend that future research be undertaken to investigate the causal factors for this correlation. © 2016 Australian College of Mental Health Nurses Inc.

The Behavioral Economics of Young Adult Substance Abuse

PubMed Central

Murphy, James G.; Dennhardt, Ashley A.

2016-01-01

Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes. PMID:27151545

Nigerian medical students' opinions about individuals who use and abuse psychoactive substances.

PubMed

James, Bawo O; Omoaregba, Joyce O

2013-01-01

Substance use disorders are prevalent in Nigeria. The number of available specialist health providers is inadequate to fill the treatment gap. Interventions can be provided by nonspecialist health providers and have been found to be beneficial. However, attitudes toward substance misuse and misusers can impede the provision of this service. We aimed to determine attitudes of medical trainees toward substance use by utilizing a modified form of the Substance Abuse Attitude Scale (SAAS). Medical students (n = 200) had positive attitudes toward individuals who misuse psychoactive substances. The medial students, however, preferred treatment to be offered by trained specialists and held restrictive views regarding cannabis and alcohol use. More positive attitudes were expressed by participants who were male or had a lifetime history of psychoactive substance use. The role of personal and family-related psychoactive substance use factors are probably associated with attitudinal responses and would require further exploration.

Alcohol's acute effect on food intake is mediated by inhibitory control impairments.

PubMed

Christiansen, Paul; Rose, Abigail; Randall-Smith, Laura; Hardman, Charlotte A

2016-05-01

There is a strong association between alcohol misuse and excess weight. Although alcohol is highly calorific and may directly contribute to weight gain, it is also likely to have indirect effects on weight. Indeed, alcohol primes have been found to stimulate appetite and increase energy intake in experimental taste tests. The current study investigated whether the effects of alcohol on energy intake are the result of inhibitory control impairments and whether this effect is moderated by individual differences in dietary restraint. Sixty undergraduate females completed measures of dietary restraint and the Food Craving Questionnaire-State (FCQS). Following this, they were given an alcohol prime (0.6 g of alcohol per kg of body weight) or a placebo drink manipulated to smell and taste alcoholic. Participants then completed another FCQS and a color conflict Stroop to measure inhibitory control. Finally, participants were asked to taste cookies for 15 minutes. Participants in the alcohol condition performed worse on the Stroop (d = .61) and consumed more cookie calories (d = .61) than participants in the placebo condition. Notably, the effect of the experimental condition on the amount of cookies consumed was mediated by Stroop performance (Κ2 = .08), although this effect was not evident under high levels of restraint. There was no effect of experimental condition on any subscale of craving. The current study suggests that increased energy intake after alcohol administration may be the product of inhibitory control impairments. However, the most restrained eaters are able to maintain control over their eating behavior. (c) 2016 APA, all rights reserved).

Substance use and misuse in burn patients: Testing the classical hypotheses of the interaction between post-traumatic symptomatology and substance use.

PubMed

Eiroa-Orosa, Francisco Jose; Giannoni-Pastor, Anna; Fidel-Kinori, Sara Guila; Argüello, José María

2016-01-01

The authors aimed to test whether the three classical hypotheses of the interaction between post-traumatic symptomatology and substance use (high risk of trauma exposure, susceptibility for post-traumatic symptomatology, and self-medication of symptoms), may be useful in the understanding of substance use among burn patients. Substance use data (nicotine, alcohol, cannabis, amphetamines, cocaine, opiates, and tranquilizers) and psychopathology measures among burn patients admitted to a burn unit and enrolled in a longitudinal observational study were analyzed. Lifetime substance use information (n = 246) was incorporated to analyses aiming to test the high risk hypothesis. Only patients assessed for psychopathology in a 6-month follow-up (n = 183) were included in prospective analyses testing the susceptibility and self-medication hypotheses. Regarding the high risk hypothesis, results show a higher proportion of heroin and tranquilizer users compared to the general population. Furthermore, in line with the susceptibility hypothesis, higher levels of symptomatology were found in lifetime alcohol, tobacco, and drug users during recovery. The self-medication hypothesis could be tested partially due to the hospital stay "cleaning" effect, but severity of symptoms was linked to the amount of caffeine, nicotine, alcohol, and cannabis use after discharge. It was found that the 3 classical hypotheses could be used to understand the link between traumatic experiences and substance use explaining different patterns of burn patient's risk for trauma exposure and emergence of symptomatology.

49 CFR 199.227 - Retention of records.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Prevention Program § 199.227 Retention of records. (a) General requirement. Each operator shall maintain records of its alcohol misuse prevention program as provided in this section. The records shall be... pertaining to a determination by a substance abuse professional concerning a covered employee's need for...

49 CFR 199.227 - Retention of records.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Prevention Program § 199.227 Retention of records. (a) General requirement. Each operator shall maintain records of its alcohol misuse prevention program as provided in this section. The records shall be... pertaining to a determination by a substance abuse professional concerning a covered employee's need for...

49 CFR 199.227 - Retention of records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Prevention Program § 199.227 Retention of records. (a) General requirement. Each operator shall maintain records of its alcohol misuse prevention program as provided in this section. The records shall be... pertaining to a determination by a substance abuse professional concerning a covered employee's need for...

49 CFR 199.227 - Retention of records.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Prevention Program § 199.227 Retention of records. (a) General requirement. Each operator shall maintain records of its alcohol misuse prevention program as provided in this section. The records shall be... pertaining to a determination by a substance abuse professional concerning a covered employee's need for...

49 CFR 199.227 - Retention of records.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Prevention Program § 199.227 Retention of records. (a) General requirement. Each operator shall maintain records of its alcohol misuse prevention program as provided in this section. The records shall be... pertaining to a determination by a substance abuse professional concerning a covered employee's need for...

Self-guided Change: The most common form of long-term, maintained health behavior change

PubMed Central

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review—similar in nature to a scoping review—was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80–90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated. PMID:29375888

Self-guided Change: The most common form of long-term, maintained health behavior change.

PubMed

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review-similar in nature to a scoping review-was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80-90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated.

Patterns of Harmful Alcohol Consumption among Truck Drivers: Implications for Occupational Health and Work Safety from a Systematic Review and Meta-Analysis.

PubMed

Bragazzi, Nicola Luigi; Dini, Guglielmo; Toletone, Alessandra; Rahmani, Alborz; Montecucco, Alfredo; Massa, Emanuela; Manca, Alessia; Guglielmi, Ottavia; Garbarino, Sergio; Debarbieri, Nicoletta; Durando, Paolo

2018-05-30

Alcohol consumption is one of the main causes of productivity losses arising from absenteeism, presenteeism, and workplace injuries. Among occupational categories most affected by the use of this substance, truck drivers are subject to risk factors and risky behaviors that can have a serious impact on their health, their work, and the general road safety. The use of alcohol during truck-driving activities is, indeed, an important risk factor for traffic accidents. The present systematic review and meta-analysis aims at synthesizing the literature regarding harmful alcohol consumption patterns among truck drivers in a rigorous way. A 'binge drinking' prevalence of 19.0%, 95% confidence interval or CI (13.1, 26.9) was present. An 'everyday drinking' pattern rate of 9.4%, 95% CI (7.0, 12.4) was found, while the rate of alcohol misuse according to the "Alcohol Use Disorders Identification Test" (AUDIT)-"Cut down-Annoyed-Guilty-Eye opener questionnaire" (CAGE) instruments was computed to be of 22.7%, 95% CI (14.8, 33.0). No evidence of publication bias could be found. However, there is the need to improve the quality of published research, utilizing standardized reliable instruments. The knowledge of these epidemiological data can be useful for decision makers in order to develop, design, and implement ad hoc adequate policies.

Parents' level of support for adults' purchase and consumption of alcohol at primary school events when children are present.

PubMed

Ward, Bernadette; Kippen, Rebecca; Buykx, Penny; Gilligan, Conor; Chapman, Kathy

2015-03-01

Environmental and societal factors are significant determinants of children's initiation to and use of alcohol. Schools are important settings for promoting well-being and substantial resources have been devoted to curriculum-based alcohol programs, but the effects of these in reducing the misuse of alcohol have been modest. Adults can and do consume alcohol at school events when students are present, but there is a dearth of evidence about parents' level of support for the practice. The aim of this study was to examine parents' level of support for the purchase and consumption of alcohol at primary school fundraising events when children are present. Four hundred seventy-nine Australian parents of children aged 0-12 years participated in an online survey. Logistic regression was used to assess the impact of parent characteristics on the level of agreement with parental purchase and consumption of alcohol at school fundraising events when children are present. The majority of parents (60%) disagreed/strongly disagreed with the practice of adults being able to purchase and consume alcohol at school fundraising events when children were present. The 21% of parents who supported the practice were more likely to be daily smokers and/or have higher (>6) Alcohol Use Disorders Identification Test-alcohol consumption scores. Despite the fact that the majority of parents disagree with this practice, published reports suggest that adults' use of alcohol at primary school events is an emerging issue. It is important that school decision-makers are mindful of the financial and educational value of fundraising activities. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Volatile Substance Misuse Among High School Students in South America

PubMed Central

Hynes-Dowell, Marya; Mateu-Gelabert, Pedro; Barros, Helena Maria Taunhauser; Delva, Jorge

2012-01-01

This article summarizes data from a 2004 study of over 300,000 high school students (aged 13–18 years) in nine South American countries. A probabilistic sample targeted urban secondary schools, utilizing a self-administered questionnaire on prevalence and frequency of substance use. Multivariate analysis showed that volatile substances were the first or second most commonly reported substances used after alcohol and cigarettes in all countries (lifetime prevalence range: 2.67% [Paraguay] to 16.55% [Brazil]). Previous studies have highlighted volatile substance misuse among street children, whereas this study demonstrates that it is common among South American high school students. PMID:21609142

Neuropsychological Functioning in College Students Who Misuse Prescription Stimulants

PubMed Central

Wilens, Timothy; Carrellas, Nicholas W.; Martelon, MaryKate; Yule, Amy M.; Fried, Ronna; Anselmo, Rayce; McCabe, Sean E.

2017-01-01

Background and Objectives Relatively little is known about the neuropsychological profiles of college students who misuse prescription stimulant medications. Methods Data presented are from college students aged 18 to 28 years who misused prescription stimulants prescribed for attention-deficit/hyperactivity disorder and controls (no prescription stimulant misuse). Students were assessed neuropsychologically using the self-report Behavioral Rating Inventory of Executive Functioning (BRIEF-A), the Cambridge Automated Neuropsychological Test and Battery (CANTAB), and other tests of cognitive functioning. The analyses included 198 controls (age 20.7 ± 2.6 years) and 100 prescription stimulant misusers (age 20.7 ± 1.7 years). Results On the BRIEF-A, misusers were more likely than controls to endorse greater dysfunction on 8 of 12 measures including Inhibition, Self Monitor, Initiation, Working Memory, and Plan/Organize, when adjusting for race and sex (all p’s <0.05). Similarly, when dichotomizing the BRIEF-A as abnormal (T score ≥ 65), misusers had more abnormalities on 5 of 9 subscales, as well as all major indices (p’s<0.05). Misusers also performed worse on several subtests of the CANTAB and standardized cognitive battery (p’s <0.05). A proxy of prescription stimulant misuse frequency was positively correlated with greater executive dysfunction on the BRIEF-A. Discussion and Conclusions These data demonstrate elevated risk for neuropsychological dysfunction among students who misuse prescription stimulants compared to non-misusing peers. The presence of ADHD contributed significantly to these cognitive findings. Students who misuse prescription stimulants should be screened for neuropsychological dysfunction. Scientific Significance These data may better elucidate the neuropsychological profile of college-aged prescription stimulant misusers. PMID:28494131

Using Behavior Economics to Understand Alcohol Use Disorders: A Concise Review and Identification of Research Priorities

PubMed Central

Gray, Joshua C.; MacKillop, James

2016-01-01

We review recent advances in the application of behavioral economics to alcohol use disorders (AUDs). Specifically, we review individual differences in alcohol demand (i.e., the relative reinforcing value of alcohol) and delayed reward discounting (i.e., impulsive decision making) in relation to AUDs. Additionally, we review the efficacy of reinforcement-based clinical applications. What emerges from the literature is an extensive body of cross-sectional research implicating alcohol demand and delayed reward discounting with alcohol misuse. However, more research is needed to examine these domains across the lifespan in order to understand their longitudinal trajectories. Similarly, clinical research is consistently supportive of reinforcement-based clinical interventions, but the number of randomized controlled trials to date is relatively small and there has been limited examination of the putative mechanisms of behavior change. PMID:27795939

Alcohol Use and Alcohol-Related Problems Before and After Military Combat Deployment

PubMed Central

Jacobson, Isabel G.; Ryan, Margaret A. K.; Hooper, Tomoko I.; Smith, Tyler C.; Amoroso, Paul J.; Boyko, Edward J.; Gackstetter, Gary D.; Wells, Timothy S.; Bell, Nicole S.

2009-01-01

Context High rates of alcohol misuse after deployment have been reported among personnel returning from past conflicts, yet investigations of alcohol misuse after return from the current wars in Iraq and Afghanistan are lacking. Objectives To determine whether deployment with combat exposures was associated with new-onset or continued alcohol consumption, binge drinking, and alcohol-related problems. Design, Setting, and Participants Data were from Millennium Cohort Study participants who completed both a baseline (July 2001 to June 2003; n=77 047) and follow-up (June 2004 to February 2006; n=55 021) questionnaire (follow-up response rate=71.4%). After we applied exclusion criteria, our analyses included 48 481 participants (active duty, n=26 613; Reserve or National Guard, n=21 868). Of these, 5510 deployed with combat exposures, 5661 deployed without combat exposures, and 37 310 did not deploy. Main Outcome Measures New-onset and continued heavy weekly drinking, binge drinking, and alcohol-related problems at follow-up. Results Baseline prevalence of heavy weekly drinking, binge drinking, and alcohol-related problems among Reserve or National Guard personnel who deployed with combat exposures was 9.0%, 53.6%, and 15.2%, respectively; follow-up prevalence was 12.5%, 53.0%, and 11.9%, respectively; and new-onset rates were 8.8%, 25.6%, and 7.1%, respectively. Among active-duty personnel, new-onset rates were 6.0%, 26.6%, and 4.8%, respectively. Reserve and National Guard personnel who deployed and reported combat exposures were significantly more likely to experience new-onset heavy weekly drinking (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.36–1.96), binge drinking (OR, 1.46; 95% CI, 1.24–1.71), and alcohol-related problems (OR, 1.63; 95% CI, 1.33–2.01) compared with nondeployed personnel. The youngest members of the cohort were at highest risk for all alcohol-related outcomes. Conclusion Reserve and National Guard personnel and younger service members who deploy with reported combat exposures are at increased risk of new-onset heavy weekly drinking, binge drinking, and alcohol-related problems. PMID:18698065

49 CFR 655.15 - Policy statement contents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false Policy statement contents. 655.15 Section 655.15 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Program Requirements § 655.15 Policy...

49 CFR 655.15 - Policy statement contents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... immediately from his or her safety-sensitive function and be evaluated by a substance abuse professional, as..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Program Requirements § 655.15 Policy statement contents. The local governing board of the employer or...

49 CFR 655.15 - Policy statement contents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... immediately from his or her safety-sensitive function and be evaluated by a substance abuse professional, as..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Program Requirements § 655.15 Policy statement contents. The local governing board of the employer or...

49 CFR 655.15 - Policy statement contents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... immediately from his or her safety-sensitive function and be evaluated by a substance abuse professional, as..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Program Requirements § 655.15 Policy statement contents. The local governing board of the employer or...

49 CFR 655.15 - Policy statement contents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... immediately from his or her safety-sensitive function and be evaluated by a substance abuse professional, as..., DEPARTMENT OF TRANSPORTATION PREVENTION OF ALCOHOL MISUSE AND PROHIBITED DRUG USE IN TRANSIT OPERATIONS Program Requirements § 655.15 Policy statement contents. The local governing board of the employer or...

Factors Associated with Alcohol Use Before or During Sex Among Men Who Have Sex with Men in a Large Internet Sample from Asia

PubMed Central

Guadamuz, Thomas E.; Lim, Sin How; Koe, Stuart; Wei, Chongyi

2016-01-01

Abstract We explored factors associated with alcohol use before or during sex among a sample of 10,861 men who have sex with men (MSM) in Asia who were recruited online for the study. Multinomial logistic regression analysis indicated that having sex under the influence of alcohol was associated with having multiple male partners, seeking partners primarily through gay bar/gym/dance party/friends, selling sex and using multiple drugs during the past 6 months, and unprotected anal sex. More efforts are needed to better assess alcohol use and misuse among MSM in Asia and understand contextual influences on alcohol use and HIV-related behaviors in order to implement culturally-specific interventions. PMID:26789393

Misuse study of latch attachment: a series of frontal sled tests.

PubMed

Menon, Rajiv; Ghati, Yoganand

2007-01-01

This study was initiated to quantify the effects of the misuse in LATCH lower webbing. In the short period since the implementation of the LATCH system several cases of potential misuses have been reported. A series of sled tests in frontal impact mode were conducted with various misuse conditions (loose attachment of LATCH lower webbing, misrouting of LATCH lower webbing and child seat back inclination) for both forward and rearward facing child safety seats (FFCSS and RFCSS). Results from these tests are compared and discussed with that of the standard test with no misuse and showed that as the slack in the lower LATCH webbing increased, ATD injury measures exceeded the limits. The FFCSS tests in the reclined condition yielded lower injury values for all except the chest G's when compared to the standard upright test. In the misrouting tests the ATD kinematics depended on the routing pivot point, the lower the pivot point the better the ATD kinematics. Similar findings were also observed in the RFCSS tests. The use of top tether with the FFCSS substantially improved the performance of the Hybrid III 3 year old ATD in spite of misuse conditions and the injury values were lower than the corresponding tests with no top tether. The effective reduction was 37% in the HIC values, 6% in the chest G's, 30% in the head excursion, 22 % in the knee excursion and finally 37 % reduction in the Nij values.

Sex differences in the interacting roles of impulsivity and positive alcohol expectancy in problem drinking: A structural brain imaging study.

PubMed

Ide, Jaime S; Zhornitsky, Simon; Hu, Sien; Zhang, Sheng; Krystal, John H; Li, Chiang-Shan R

2017-01-01

Alcohol expectancy and impulsivity are implicated in alcohol misuse. However, how these two risk factors interact to determine problem drinking and whether men and women differ in these risk processes remain unclear. In 158 social drinkers (86 women) assessed for Alcohol Use Disorder Identification Test (AUDIT), positive alcohol expectancy, and Barratt impulsivity, we examined sex differences in these risk processes. Further, with structural brain imaging, we examined the neural bases underlying the relationship between these risk factors and problem drinking. The results of general linear modeling showed that alcohol expectancy best predicted problem drinking in women, whereas in men as well as in the combined group alcohol expectancy and impulsivity interacted to best predict problem drinking. Alcohol expectancy was associated with decreased gray matter volume (GMV) of the right posterior insula in women and the interaction of alcohol expectancy and impulsivity was associated with decreased GMV of the left thalamus in women and men combined and in men alone, albeit less significantly. These risk factors mediated the correlation between GMV and problem drinking. Conversely, models where GMV resulted from problem drinking were not supported. These new findings reveal distinct psychological factors that dispose men and women to problem drinking. Although mediation analyses did not determine a causal link, GMV reduction in the insula and thalamus may represent neural phenotype of these risk processes rather than the consequence of alcohol consumption in non-dependent social drinkers. The results add to the alcohol imaging literature which has largely focused on dependent individuals and help elucidate alterations in brain structures that may contribute to the transition from social to habitual drinking.

Attention deficit hyperactivity disorder and arrest history: Differential association of clinical characteristics by sex.

PubMed

Kolla, Nathan J; van der Maas, Mark; Erickson, Patricia G; Mann, Robert E; Seeley, Jane; Vingilis, Evelyn

Attention deficit hyperactivity disorder (ADHD) is often cited as a risk factor for criminality. However, many studies do not take other criminogenic variables into account when reporting on this relationship. It is even less clear whether models that include ADHD as a potential risk factor for criminality consider the importance of sex differences. To answer this question, we collected data from a telephone population survey sampling adults over the age of 18 years in the province of Ontario, Canada (final sample size = 5196). Respondents were screened for ADHD using the Adult ADHD Self-Report Version 1.1 Screener (ASRS-V1.1) and four extra items. Problematic drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT), while cannabis misuse was evaluated using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The Antisocial Personality Disorder Scale from the Mini-International Neuropsychiatric Interview provided a measure of previous conduct disorder symptoms and the 12-item General Health Questionnaire screening procedure was used to gauge general distress. History of arrest was self-reported. Three separate logistic regression analyses (entire sample, male only, and female only) were applied to estimate the association of the foregoing variables with arrest history. In the combined sample, conduct disorder symptoms, problem alcohol use, and problem cannabis use all predicted history of arrest. With regard to the male sample, conduct disorder symptoms, elevated AUDIT and ASSIST scores, and general distress were associated with an arrest history. For the female subsample, only conduct disorder symptoms and problematic cannabis use showed a relationship with criminality. To summarize, ADHD did not predict history of arrest for either subsample or the combined sample. When comparing males and females, conduct disorder symptoms and cannabis misuse exerted stronger effects on history of arrest for females than males. These results suggest that the relative importance and type of clinical risk factors for arrest may differ according to sex. Such information could be useful for crime prevention policies and correctional programs that take into account differences in experience by sex. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effects of televised alcohol messages on teenage drinking patterns.

PubMed

Atkin, C K

1990-01-01

This paper presents an overview of theoretical perspectives applicable to the effects of television drinking portrayals on adolescent audiences, focusing on the influence of beer and wine advertising and entertainment depictions of drinking behavior. A critical review of survey research evidence indicates that alcohol commercials contribute to a modest increase in overall consumption by teenagers and may have a slight impact on alcohol misuse and drunk driving. There are no studies measuring the effects of entertainment programming on adolescents, but content analyses suggest the potential for increased prodrinking attitudes and behaviors. Policy implications for addressing the deleterious effects of televised drinking are discussed, and priorities for future research are identified.

Protective Predictors of Alcohol Use Trajectories among Canadian Aboriginal Youth

ERIC Educational Resources Information Center

Rawana, Jennine S.; Ames, Megan E.

2012-01-01

Some Aboriginal youth are at disproportionate risk of using substances and developing abuse and dependence disorders. However, not all Aboriginal youth misuse substances and limited research has examined the protective factors conferring against substance use among these youth. The present study aimed to identify protective factors related to the…

Content Assessment of Selected College Health Textbooks.

ERIC Educational Resources Information Center

Huetteman, Julie Doidge

Six college health textbooks published between 1980 and 1987 were analyzed to determine the extent of coverage of 10 selected content areas from "Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention." Content areas assessed included: motor vehicle accidents, alcohol and drug misuse, teenage pregnancy,…

Risks, Management, and Monitoring of Combination Opioid, Benzodiazepines, and/or Alcohol Use

PubMed Central

Gudin, Jeffrey A.; Mogali, Shanthi; Jones, Jermaine D.; Comer, Sandra D.

2014-01-01

The concurrent use of opioids, benzodiazepines (BZDs), and/or alcohol poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs and/or alcohol are at higher risk for fatal/nonfatal overdose and have more aberrant behaviors. Few practice guidelines for BZD treatment are readily available, especially when they are combined clinically with opioid analgesics and other central nervous system–depressant agents. However, coadministration of these agents produces a defined increase in rates of adverse events, overdose, and death, warranting close monitoring and consideration when treating patients with pain. To improve patient outcomes, ongoing screening for aberrant behavior, monitoring of treatment compliance, documentation of medical necessity, and the adjustment of treatment to clinical changes are essential. In this article, we review the prevalence and pharmacologic consequences of BZDs and/or alcohol use among patients with pain on chronic opioid therapy, as well as the importance of urine drug testing, an indispensable tool for therapeutic drug monitoring, which helps to ensure the continued safety of patients. Regardless of risk or known aberrant drug-related behaviors, patients on chronic opioid therapy should periodically undergo urine drug testing to confirm adherence to the treatment plan. PMID:23933900

Comparing counselling models for the hazardous use of alcohol at the Swedish National Alcohol Helpline: study protocol for a randomised controlled trial.

PubMed

Säfsten, Eleonor; Forsell, Yvonne; Ramstedt, Mats; Galanti, Maria Rosaria

2017-06-06

Hazardous and harmful consumption of alcohol is a leading cause of preventable disease and premature deaths. Modifying the amount and pattern of risky alcohol consumption conveys substantial benefits to individuals and to society at large. Telephone helplines provide a feasible alternative to face-to-face counselling in order to increase the reach of brief interventions aiming at modifying the hazardous and harmful use of alcohol. However, there is a lack of studies on the implementation and evaluation of population-based telephone services for the prevention and treatment of alcohol misuse. A randomised controlled trial was designed to compare a brief, structured intervention to usual care within the Swedish National Alcohol Helpline (SAH), concerning their effectiveness on decreasing the hazardous use of alcohol. Between May 2015 and December 2017, about 300 callers are to be individually randomised with a 1:1 ratio to a brief, structured intervention (n = 150) or to usual care (n = 150). The brief, structured intervention consists of the delivery of a self-help booklet followed by one proactive call from SAH counsellors to monitor and give feedback about the client's progression. Callers assigned to usual care receive telephone counselling according to existing practice, i.e., motivational interviewing in a tailored and client-driven combination of proactive and reactive calls. The primary outcome is defined as a change from a higher to a lower AUDIT risk-level category between baseline and follow-up. General linear modeling will be used to calculate risk ratios of the outcome events. The primary analysis will follow an intention-to-treat (ITT) approach. The trial is designed to evaluate the effectiveness in decreasing the hazardous and harmful consumption of alcohol of a brief, structured intervention compared to usual care when delivered at the SAH. The results of the study will be used locally to improve the effectiveness of the service provided at the SAH. Additionally, they will expand the evidence base about optimal counselling models in population-based telephone services for alcohol misuse prevention and treatment. ISRCNT.com, ID: ISRCTN13160878 . Retrospectively registered on 18 January 2016.

Alcohol policy and taxation in South Africa: an examination of the economic burden of alcohol tax.

PubMed

Ataguba, John Ele-Ojo

2012-01-01

Alcohol consumption accounts for over 4% of the global burden of disease and an even higher figure in developing countries. Several policies have been proposed to curb the negative impact of alcohol misuse. Apart from South Africa, which has witnessed a rapid development in alcohol policy, such policies are poorly developed in most African countries. South Africa uses taxation as a policy lever, in line with international evidence, to reduce alcohol consumption. However, the problem of alcohol abuse still exists. The objective of this article is to present an analysis of alcohol tax incidence for the first time in South Africa. This was done for each category of alcohol tax (wines, spirits, beer and traditional brew [sorghum beer]) and for alcohol tax as a whole. The paper also uses the results to point to the areas where a greater understanding of the issues surrounding alcohol abuse needs to be developed. Data were drawn from the 2005/06 South African Income and Expenditure Survey. Reported expenditures on alcohol beverages were used to obtain the tax component paid by households. This was done under certain assumptions relating to alcohol content and the price per litre of alcohol. Per adult equivalent consumption expenditure was used as the measure of relative living standards and concentration curves and Kakwani indices to assess relative progressivity of alcohol taxes. Statistical dominance tests were also performed. Most sorghum beer and malt beer drinkers were in the poorer quintiles. The reverse was the case for wines and spirits. Overall, alcohol tax in South Africa was regressive (Kakwani index -0.353). The individual categories were found to be regressive. The most regressive tax was that on sorghum beer (Kakwani index -1.01); the least regressive was that on spirits (Kakwani index -0.09), although this was not statistically significant at conventional levels. These results were confirmed by the test of dominance. In South Africa, there has been a renewed interest in addressing the problem of rising alcohol abuse, but the extent to which this will translate into meaningful policies is unclear. The use of an excise tax is increasingly being recognized by economists as a way to get around some of the negative effects of abusive alcohol consumption. However, this study indicates that alcohol taxes are regressive in South Africa.

Tackling risky alcohol consumption in sport: a cluster randomised controlled trial of an alcohol management intervention with community football clubs

PubMed Central

Kingsland, Melanie; Wolfenden, Luke; Tindall, Jennifer; Rowland, Bosco C; Lecathelinais, Christophe; Gillham, Karen E; Dodds, Pennie; Sidey, Maree N; Rogerson, John C; McElduff, Patrick; Crundall, Ian; Wiggers, John H

2015-01-01

Background An increased prevalence of risky alcohol consumption and alcohol-related harm has been reported for members of sporting groups and at sporting venues compared with non-sporting populations. While sports clubs and venues represent opportune settings to implement strategies to reduce such risks, no controlled trials have been reported. The purpose of the study was to examine the effectiveness of an alcohol management intervention in reducing risky alcohol consumption and the risk of alcohol-related harm among community football club members. Method A cluster randomised controlled trial of an alcohol management intervention was undertaken with non-elite, community football clubs and their members in New South Wales, Australia. Risky alcohol consumption (5+ drinks) at the club and risk of alcohol-related harm using the Alcohol Use Disorders Identification Test (AUDIT) were measured at baseline and postintervention. Results Eighty-eight clubs participated in the trial (n=43, Intervention; n=45, Control) and separate cross-sectional samples of club members completed the baseline (N=1411) and postintervention (N=1143) surveys. Postintervention, a significantly lower proportion of intervention club members reported: risky alcohol consumption at the club (Intervention: 19%; Control: 24%; OR: 0.63 (95% CI 0.40 to 1.00); p=0.05); risk of alcohol-related harm (Intervention: 38%; Control: 45%; OR: 0.58 (95% CI 0.38 to 0.87); p<0.01); alcohol consumption risk (Intervention: 47%; Control: 55%; OR: 0.60 (95% CI 0.41 to 0.87); p<0.01) and possible alcohol dependence (Intervention: 1%; Control: 4%; OR: 0.20 (95% CI 0.06 to 0.65); p<0.01). Conclusions With large numbers of people worldwide playing, watching and sports officiating, enhancing club-based alcohol management interventions could make a substantial contribution to reducing the burden of alcohol misuse in communities. Trial registration number ACTRN12609000224224. PMID:26038252

The behavioral economics of young adult substance abuse.

PubMed

Murphy, James G; Dennhardt, Ashley A

2016-11-01

Alcohol and drug use peaks during young adulthood and can interfere with critical developmental tasks and set the stage for chronic substance misuse and associated social, educational, and health-related outcomes. There is a need for novel, theory-based approaches to guide substance abuse prevention efforts during this critical developmental period. This paper discusses the particular relevance of behavioral economic theory to young adult alcohol and drug misuse, and reviews of available literature on prevention and intervention strategies that are consistent with behavioral economic theory. Behavioral economic theory predicts that decisions to use drugs and alcohol are related to the relative availability and price of both alcohol and substance-free alternative activities, and the extent to which reinforcement from delayed substance-free outcomes is devalued relative to the immediate reinforcement associated with drugs. Behavioral economic measures of motivation for substance use are based on relative levels of behavioral and economic resource allocation towards drug versus alternatives, and have been shown to predict change in substance use over time. Policy and individual level prevention approaches that are consistent with behavioral economic theory are discussed, including brief interventions that increase future orientation and engagement in rewarding alternatives to substance use. Prevention approaches that increase engagement in constructive future-oriented activities among young adults (e.g., educational/vocational success) have the potential to reduce future health disparities associated with both substance abuse and poor educational/vocational outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Targeting Cognitive-Affective Risk Mechanisms in Stress-Precipitated Alcohol Dependence: An Integrated, Biopsychosocial Model of Automaticity, Allostasis, and Addiction

PubMed Central

Garland, Eric L.; Boettiger, Charlotte A.; Howard, Matthew O.

2011-01-01

This paper proposes a novel hypothetical model integrating formerly discrete theories of stress appraisal, neurobiological allostasis, automatic cognitive processing, and addictive behavior to elucidate how alcohol misuse and dependence are maintained and re-activated by stress. We outline a risk chain in which psychosocial stress initiates physiological arousal, perseverative cognition, and negative affect that, in turn, triggers automatized schema to compel alcohol consumption. This implicit cognitive process then leads to attentional biases toward alcohol, subjective experiences of craving, paradoxical increases in arousal and alcohol-related cognitions due to urge suppression, and palliative coping through drinking. When palliative coping relieves distress, it results in negative reinforcement conditioning that perpetuates the cycle by further sensitizing the system to future stressful encounters. This model has implications for development and implementation of innovative behavioral interventions (such as mindfulness training) that disrupt cognitive-affective mechanisms underpinning stress-precipitated dependence on alcohol. PMID:21354711

Meat Consumption During Pregnancy and Substance Misuse Among Adolescent Offspring: Stratification of TCN2 Genetic Variants.

PubMed

Hibbeln, Joseph R; SanGiovanni, John Paul; Golding, Jean; Emmett, Pauline M; Northstone, Kate; Davis, John M; Schuckit, Marc; Heron, Jon

2017-11-01

Reducing meat consumption is often advised; however, inadvertent nutritional deficiencies during pregnancy may result in residual neurodevelopmental harms to offspring. This study assessed possible effects of maternal diets in pregnancy on adverse substance use among adolescent offspring. Pregnant women and their 13-year-old offspring taking part in a prospective birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), provided Food Frequency Questionnaire data from which dietary patterns were derived using principal components analysis. Multivariable logistic regression models including potential confounders evaluated adverse alcohol, cannabis, and tobacco use of the children at 15 years of age. Lower maternal meat consumption was associated with greater problematic substance use among 15-year-old offspring in dose-response patterns. Comparing never to daily meat consumption after adjustment, risks were greater for all categories of problem substance use: alcohol, odds ratio OR = 1.75, 95% CI = (1.23, 2.56), p < 0.001; tobacco use OR = 1.85, 95% CI = (1.28, 2.63), p < 0.001; and cannabis OR = 2.70, 95% CI = (1.89, 4.00), p < 0.001. Given the likelihood of residual confounding, potential causality was evaluated using stratification for maternal allelic variants that impact biological activity of cobalamin (vitamin B12) and iron. Lower meat consumption disproportionally increased the risks of offspring substance misuse among mothers with optimally functional (homozygous) variants (rs1801198) of the gene transcobalamin 2 gene (TCN2) which encodes the vitamin B12 transport protein transcobalamin 2 implicating a causal role for cobalamin deficits. Functional maternal variants in iron metabolism were unrelated to the adverse substance use. Risks potentially attributable to cobalamin deficits during pregnancy include adverse adolescent alcohol, cannabis, and tobacco use (14, 37, and 23, respectively). Lower prenatal meat consumption was associated with increased risks of adolescent substance misuse. Interactions between TCN2 variant status and meat intake implicate cobalamin deficiencies. Copyright © 2017 by the Research Society on Alcoholism.

Alcohol dependence as a chronic pain disorder

PubMed Central

Egli, Mark; Koob, George F.; Edwards, Scott

2013-01-01

Dysregulation of pain neurocircuitry and neurochemistry has been increasingly recognized as playing a critical role in a diverse spectrum of diseases including migraine, fibromyalgia, depression, and PTSD. Evidence presented here supports the hypothesis that alcohol dependence is among the pathologies arising from aberrant neurobiological substrates of pain. In this review, we explore the possible influence of alcohol analgesia and hyperalgesia in promoting alcohol misuse and dependence. We examine evidence that neuroanatomical sites involved in the negative emotional states of alcohol dependence also play an important role in pain transmission and may be functionally altered under chronic pain conditions. We also consider possible genetic links between pain transmission and alcohol dependence. We propose an allostatic load model in which episodes of alcohol intoxication and withdrawal, traumatic stressors, and injury are each capable of dysregulating an overlapping set of neural substrates to engender sensory and affective pain states that are integral to alcohol dependence and comorbid conditions such as anxiety, depression, and chronic pain. PMID:22975446

Relationship between body mass index, alcohol use, and alcohol misuse in a young adult female twin sample.

PubMed

Duncan, Alexis E; Grant, Julia D; Bucholz, Kathleen Keenan; Madden, Pamela A F; Heath, Andrew C

2009-05-01

The aim of this study was to examine the relationships between body mass index (BMI) and alcohol use and misuse in young adulthood in a sample of black and white female twins. Cox proportional hazards and logistic regression models were used to examine the relationships between BMI category and first alcohol use, current weekly alcohol use, and current weekly heavy episodic drinking in 3,514 (14.06% black) young adult female twins. Analyses were conducted separately in black and white women. After adjusting for relevant covariates, in white women obesity was protective against alcohol use (hazard ratio = 0.83; 95% confidence interval [CI]: 0.73-0.93) and against weekly drinking (odds ratio [OR] = 0.36; 95% CI: 0.24-0.53) and weekly heavy episodic drinking (OR = 0.51; 95% CI: 0.31-0.82) among ever drinkers compared with women of ideal weight. Overweight women living with their parents were less likely to be weekly drinkers (OR = 0.31; 95% CI: 0.16-0.61), whereas overweight women who were not living with their parents were less likely to be weekly heavy episodic drinkers (OR = 0.51; 95% CI: 0.31-0.82). Among black women, obesity was not associated with any of the drinking outcomes; however, black women who were overweight and who reported that the majority of their friends were not weekly drinkers had greater odds of reporting weekly drinking than those of ideal weight (OR = 2.91; 95% CI: 1.33-6.39). Obese white women were less likely to ever use alcohol, be weekly drinkers, or be weekly heavy episodic drinkers than their ideal-weight peers. Body weight may affect drinking behavior in young women, and this effect may differ by race. Future research is needed to identify mediators and moderators of this relationship as well as to explore racial differences in the effect of body weight on drinking behavior.

Evaluation of direct and indirect ethanol biomarkers using a likelihood ratio approach to identify chronic alcohol abusers for forensic purposes.

PubMed

Alladio, Eugenio; Martyna, Agnieszka; Salomone, Alberto; Pirro, Valentina; Vincenti, Marco; Zadora, Grzegorz

2017-02-01

The detection of direct ethanol metabolites, such as ethyl glucuronide (EtG) and fatty acid ethyl esters (FAEEs), in scalp hair is considered the optimal strategy to effectively recognize chronic alcohol misuses by means of specific cut-offs suggested by the Society of Hair Testing. However, several factors (e.g. hair treatments) may alter the correlation between alcohol intake and biomarkers concentrations, possibly introducing bias in the interpretative process and conclusions. 125 subjects with various drinking habits were subjected to blood and hair sampling to determine indirect (e.g. CDT) and direct alcohol biomarkers. The overall data were investigated using several multivariate statistical methods. A likelihood ratio (LR) approach was used for the first time to provide predictive models for the diagnosis of alcohol abuse, based on different combinations of direct and indirect alcohol biomarkers. LR strategies provide a more robust outcome than the plain comparison with cut-off values, where tiny changes in the analytical results can lead to dramatic divergence in the way they are interpreted. An LR model combining EtG and FAEEs hair concentrations proved to discriminate non-chronic from chronic consumers with ideal correct classification rates, whereas the contribution of indirect biomarkers proved to be negligible. Optimal results were observed using a novel approach that associates LR methods with multivariate statistics. In particular, the combination of LR approach with either Principal Component Analysis (PCA) or Linear Discriminant Analysis (LDA) proved successful in discriminating chronic from non-chronic alcohol drinkers. These LR models were subsequently tested on an independent dataset of 43 individuals, which confirmed their high efficiency. These models proved to be less prone to bias than EtG and FAEEs independently considered. In conclusion, LR models may represent an efficient strategy to sustain the diagnosis of chronic alcohol consumption and provide a suitable gradation to support the judgment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Drinking Over the Lifespan: Focus on Early Adolescents and Youth.

PubMed

Windle, Michael

2016-01-01

Historical trends in alcohol use among U.S. adolescents, as well as data regarding alcohol-related traffic fatalities among youth, indicate decreases in alcohol use. Nevertheless, alcohol use patterns still indicate high rates of binge drinking and drunkenness and the co-occurrence of alcohol use among youth with risky sexual activity, illicit substance use, and poor school performance. This article discusses unique elements of alcohol use among adolescents relative to adults that pose risks for alcohol misuse and alcohol-related problems. These differences range from patterns of drinking to differential sensitivity to alcohol. Developmental differences between adolescents and adults also are discussed with regard to age-normative developmental tasks and distinctions in brain development that may affect differences in drinking patterns. Epidemiologic findings on sexual-minority youth are provided, as are global trends in alcohol use among early adolescents and youth. It is proposed that using information about differences between youth and adults will be helpful in directing future etiologic and intervention research by capitalizing on unique biological, psychological, and social factors that may affect the success of efforts to reduce alcohol use among early adolescents and youth.

Heavy drinking, impulsivity and attentional narrowing following alcohol cue exposure.

PubMed

Hicks, Joshua A; Fields, Sherecce; Davis, William E; Gable, Philip A

2015-08-01

Research shows that alcohol-related stimuli have the propensity to capture attention among individuals motivated to consume alcohol. Research has further demonstrated that impulsive individuals are especially prone to this type of attentional bias. Recently, it is suggested that alcohol cue exposure can also produce a general narrowing of attention consistent with the activation of approach motivational states. Based on previous models of addiction and recent research on the activation of approach motivational states, we predicted that impulsive individuals would demonstrate a constriction of attentional focus in response to alcohol cue exposure. Participants (n = 392) completed a task assessing attentional breadth in response to alcohol and non-alcohol cues, followed by measures of alcohol use and impulsivity. The findings revealed that impulsivity scores predicted narrowing of attentional scope following the presentation of alcohol cues for heavier drinkers but not for light drinkers. These results suggest that impulsive individuals who drink more heavily demonstrate a narrowing of attention in the presence of alcohol-related incentive cues. Implications for how these findings might account for the link between impulsivity and alcohol use and misuse are discussed.

Multiple and substitute addictions involving prescription drugs misuse among 12th graders: gateway theory revisited with Market Basket Analysis.

PubMed

Jayawardene, Wasantha Parakrama; YoussefAgha, Ahmed Hassan

2014-01-01

This study aimed to identify the sequential patterns of drug use initiation, which included prescription drugs misuse (PDM), among 12th-grade students in Indiana. The study also tested the suitability of the data mining method Market Basket Analysis (MBA) to detect common drug use initiation sequences in large-scale surveys. Data from 2007 to 2009 Annual Surveys of Alcohol, Tobacco, and Other Drug Use by Indiana Children and Adolescents were used for this study. A close-ended, self-administered questionnaire was used to ask adolescents about the use of 21 substance categories and the age of first use. "Support%" and "confidence%" statistics of Market Basket Analysis detected multiple and substitute addictions, respectively. The lifetime prevalence of using any addictive substance was 73.3%, and it has been decreasing during past few years. Although the lifetime prevalence of PDM was 19.2%, it has been increasing. Males and whites were more likely to use drugs and engage in multiple addictions. Market Basket Analysis identified common drug use initiation sequences that involved 11 drugs. High levels of support existed for associations among alcohol, cigarettes, and marijuana, whereas associations that included prescription drugs had medium levels of support. Market Basket Analysis is useful for the detection of common substance use initiation sequences in large-scale surveys. Before initiation of prescription drugs, physicians should consider the adolescents' risk of addiction. Prevention programs should address multiple addictions, substitute addictions, common sequences in drug use initiation, sex and racial differences in PDM, and normative beliefs of parents and adolescents in relation to PDM.

The obsessive compulsive drinking scale is a valid measure of alcohol craving in young adults.

PubMed

Connor, Jason P; Feeney, Gerald F X; Jack, Alyssa; Young, Ross McD

2010-12-01

Alcohol craving is associated with greater alcohol-related problems and less favorable treatment prognosis. The Obsessive Compulsive Drinking Scale (OCDS) is the most widely used alcohol craving instrument. The OCDS has been validated in adults with alcohol use disorders (AUDs), which typically emerge in early adulthood. This study examines the validity of the OCDS in a nonclinical sample of young adults. Three hundred and nine college students (mean age of 21.8 years, SD = 4.6 years) completed the OCDS, Alcohol Use Disorders Identification Test (AUDIT), and measures of alcohol consumption. Subjects were randomly allocated to 2 samples. Construct validity was examined via exploratory factor analysis (n = 155) and confirmatory factor analysis (n = 154). Concurrent validity was assessed using the AUDIT and measures of alcohol consumption. A second, alcohol-dependent sample (mean age 42 years, SD 12 years) from a previously published study (n = 370) was used to assess discriminant validity. A unique young adult OCDS factor structure was validated, consisting of Interference/Control, Frequency of Obsessions, Alcohol Consumption and Resisting Obsessions/Compulsions. The young adult 4-factor structure was significantly associated with the AUDIT and alcohol consumption. The 4 factor OCDS successfully classified nonclinical subjects in 96.9% of cases and the older alcohol-dependent patients in 83.7% of cases. Although the OCDS was able to classify college nonproblem drinkers (AUDIT <13, n = 224) with 83.2% accuracy, it was no better than chance (49.4%) in classifying potential college problem drinkers (AUDIT score ≥13, n = 85). Using the 4-factor structure, the OCDS is a valid measure of alcohol craving in young adult populations. In this nonclinical set of students, the OCDS classified nonproblem drinkers well but not problem drinkers. Studies need to further examine the utility of the OCDS in young people with alcohol misuse. Copyright © 2010 by the Research Society on Alcoholism.

Child and Adolescent Suicide Attempts, Suicidal Behavior, and Adverse Childhood Experiences in South Africa: A Prospective Study.

PubMed

Cluver, Lucie; Orkin, Mark; Boyes, Mark E; Sherr, Lorraine

2015-07-01

This is the first known prospective study of child suicidal behavior in sub-Saharan Africa. Aims were to determine whether (1) cumulative exposure to adverse childhood experiences (ACEs) predicts later suicidality and (2) heightened risks are mediated by mental health disorder and drug/alcohol misuse. Longitudinal repeated interviews were conducted 1 year apart (97% retention) with 3,515 adolescents aged 10-18 years in South Africa (56% female; <2.5% refusal). Random selection of census enumeration areas from urban/rural sites within two provinces and door-to-door sampling included all homes with a resident adolescent. Measures included past-month suicide attempts, planning, and ideation, mental health disorders, drug/alcohol use, and ACE, for example, parental death by AIDS or homicide, abuse, and exposure to community violence. Analyses included multivariate logistic regression and multiple mediation tests. Past-month suicidality rates were 3.2% of adolescents attempting, 5.8% planning, and 7.2% reporting ideation. After controlling for baseline suicidality and sociodemographics, a strong, graded relationship was shown between cumulative ACE and all suicide behaviors 1 year later. Baseline mental health, but not drug/alcohol misuse, mediated relationships between ACE and subsequent suicidality. Suicide attempts rose from 1.9% among adolescents with no ACE to 6.3% among adolescents with >5 ACEs (cumulative odds ratio [OR], 2.46; confidence interval [CI], 1.00-6.05); for suicide planning, from 2.4% to 12.5% (cumulative OR, 4.40; CI, 2.08-9.29); and for suicide ideation, from 4.2% to 15.6% (cumulative OR, 2.99; CI, 1.68-5.53). Preventing and mitigating childhood adversities have the potential to reduce suicidality. Among adolescents already exposed to adversities, effective mental health services may buffer against future suicidality. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Anorexia nervosa and Wernicke-Korsakoff syndrome: a case report

PubMed Central

2010-01-01

Introduction Wernicke's encephalopathy is an acute, potentially fatal, neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is still greatly under-diagnosed, and failure to promptly identify and adequately treat the condition can lead to death or to the chronic form of the encephalopathy - Korsakoff's syndrome. Wernicke's encephalopathy has traditionally been associated with alcoholism but, in recent years, there has been an increase in the number of clinical settings in which the disorder is observed. Case presentation We report the case of a 45-year-old Caucasian woman who arrived at the emergency room presenting signs of marked malnutrition and mental confusion, ataxic gait and ophthalmoplegia. Main laboratory test findings included low serum magnesium and megaloblastic anemia. Brain magnetic resonance imaging revealed increased T2 signal in the supratentorial paraventricular region, the medial regions of the thalamus and the central and periaqueductal midbrain. The diagnosis of Wernicke's encephalopathy was made at once and immediate reposition of thiamine and magnesium was started. The patient had a long history of recurrent thoughts of being overweight, severe self-imposed diet restrictions and self-induced vomiting. She had also been drinking gin on a daily basis for the last eight years. One day after admittance the acute global confusional state resolved, but she presented severe memory deficits and confabulation. After six months of outpatient follow-up, memory deficits remained unaltered. Conclusion In this case, self-imposed long-lasting nutritional deprivation is thought to be the main cause of thiamine deficiency and subsequent encephalopathy, but adjunct factors, such as magnesium depletion and chronic alcohol misuse, might have played an important role, especially in the development of Korsakoff's syndrome. The co-morbidity between eating disorders and substance abuse disorders has emerged as a significant health issue for women, and the subgroup of patients with anorexia nervosa who also misuse alcohol is probably at a particular risk of developing Wernicke-Korsakoff syndrome. The present case report highlights this relevant issue. PMID:20646296

Anorexia nervosa and Wernicke-Korsakoff syndrome: a case report.

PubMed

Saad, Laura; Silva, Luiz Fal; Banzato, Claudio Em; Dantas, Clarissa R; Garcia, Celso

2010-07-20

Wernicke's encephalopathy is an acute, potentially fatal, neuropsychiatric syndrome resulting from thiamine deficiency. The disorder is still greatly under-diagnosed, and failure to promptly identify and adequately treat the condition can lead to death or to the chronic form of the encephalopathy - Korsakoff's syndrome. Wernicke's encephalopathy has traditionally been associated with alcoholism but, in recent years, there has been an increase in the number of clinical settings in which the disorder is observed. We report the case of a 45-year-old Caucasian woman who arrived at the emergency room presenting signs of marked malnutrition and mental confusion, ataxic gait and ophthalmoplegia. Main laboratory test findings included low serum magnesium and megaloblastic anemia. Brain magnetic resonance imaging revealed increased T2 signal in the supratentorial paraventricular region, the medial regions of the thalamus and the central and periaqueductal midbrain. The diagnosis of Wernicke's encephalopathy was made at once and immediate reposition of thiamine and magnesium was started. The patient had a long history of recurrent thoughts of being overweight, severe self-imposed diet restrictions and self-induced vomiting. She had also been drinking gin on a daily basis for the last eight years. One day after admittance the acute global confusional state resolved, but she presented severe memory deficits and confabulation. After six months of outpatient follow-up, memory deficits remained unaltered. In this case, self-imposed long-lasting nutritional deprivation is thought to be the main cause of thiamine deficiency and subsequent encephalopathy, but adjunct factors, such as magnesium depletion and chronic alcohol misuse, might have played an important role, especially in the development of Korsakoff's syndrome. The co-morbidity between eating disorders and substance abuse disorders has emerged as a significant health issue for women, and the subgroup of patients with anorexia nervosa who also misuse alcohol is probably at a particular risk of developing Wernicke-Korsakoff syndrome. The present case report highlights this relevant issue.

Undifferentiated Gender Role Orientation, Drinking Motives, and Increased Alcohol Use in Men and Women.

PubMed

Fugitt, Jessica L; Ham, Lindsay S; Bridges, Ana J

2017-05-12

Alcohol misuse has historically affected men more than women. However, the differences in drinking behaviors across sex have steadily decreased over time and accumulating research suggests that gender role orientation, or culturally scripted gender-specific characteristics, and negative reinforcement drinking motives may better explain risk for alcohol use and related problems than sex. The current study tested a mediational model of the undifferentiated orientation (low masculinity and low femininity), an oft neglected orientation despite evidence that it could carry much weight in drinking behaviors, versus the other three gender role orientations, coping and conformity drinking motives, and hazardous alcohol use. Participants were 426 current drinkers over age 21 (41% men; 77.8% Caucasian; M age = 34.5, range = 21-73) residing across the United States who completed an online survey. Structural equation modeling analyses suggested that individuals with an undifferentiated orientation (n = 99), compared to masculine (high masculinity, low femininity; n = 102), feminine (high femininity, low masculinity; n = 113), or androgynous (high masculinity, high femininity; n = 112) orientations, reported higher coping drinking motives, which were positively associated with levels of hazardous alcohol use. Although analyses suggested that undifferentiated individuals reported drinking for conformity motives more often than masculine and androgynous individuals, conformity motives were not associated with increased use. Conclusions/Importance: An undifferentiated gender role orientation may contribute a unique risk for alcohol use and related problems by increasing frequency of drinking to cope, a motive specifically associated with hazardous use trajectories.

Health on the Web: Randomised Controlled Trial of Online Screening and Brief Alcohol Intervention Delivered in a Workplace Setting

PubMed Central

Khadjesari, Zarnie; Freemantle, Nick; Linke, Stuart; Hunter, Rachael; Murray, Elizabeth

2014-01-01

Background Alcohol misuse in England costs around £7.3 billion (US$12.2 billion) annually from lost productivity and absenteeism. Delivering brief alcohol interventions to employees as part of a health check may be acceptable, particularly with online delivery which can provide privacy for this stigmatised behaviour. Research to support this approach is limited and methodologically weak. The aim was to determine the effectiveness of online screening and personalised feedback on alcohol consumption, delivered in a workplace as part of a health check. Methods and Findings This two-group online individually randomised controlled trial recruited employees from a UK-based private sector organisation (approx. 100,000 employees). 3,375 employees completed the online health check in the three week recruitment period. Of these, 1,330 (39%) scored five or more on the AUDIT-C (indicating alcohol misuse) and were randomised to receive personalised feedback on their alcohol intake, alongside feedback on other health behaviours (n = 659), or to receive feedback on all health behaviours except alcohol intake (n = 671). Participants were mostly male (75%), with a median age of 48 years and half were in managerial positions (55%). Median Body Mass Index was 26, 12% were smokers, median time undertaking moderate/vigorous physical activity a week was 173 minutes and median fruit and vegetable consumption was three portions a day. Eighty percent (n = 1,066) of participants completed follow-up questionnaires at three months. An intention to treat analysis found no difference between experimental groups for past week drinking (primary outcome) (5.6% increase associated with the intervention (95% CI −4.7% to 16.9%; p = .30)), AUDIT (measure of alcohol-related harm) and health utility (EQ-5D). Conclusions There was no evidence to support the use of personalised feedback within an online health check for reducing alcohol consumption among employees in this organisation. Further research is needed on how to engage a larger proportion of employees in screening. Trial Registration International Standard Randomised Controlled Trial Number Register ISRCTN50658915 PMID:25409454

Violent offending by UK military personnel deployed to Iraq and Afghanistan: a data linkage cohort study.

PubMed

Macmanus, Deirdre; Dean, Kimberlie; Jones, Margaret; Rona, Roberto J; Greenberg, Neil; Hull, Lisa; Fahy, Tom; Wessely, Simon; Fear, Nicola T

2013-03-16

Violent offending by veterans of the Iraq and Afghanistan conflicts is a cause for concern and there is much public debate about the proportion of ex-military personnel in the criminal justice system for violent offences. Although the psychological effects of conflict are well documented, the potential legacy of violent offending has yet to be ascertained. We describe our use of criminal records to investigate the effect of deployment, combat, and post-deployment mental health problems on violent offending among military personnel relative to pre-existing risk factors. In this cohort study, we linked data from 13,856 randomly selected, serving and ex-serving UK military personnel with national criminal records stored on the Ministry of Justice Police National Computer database. We describe offending during the lifetime of the participants and assess the risk factors for violent offending. 2,139 (weighted 17.0%) of 12,359 male UK military personnel had a criminal record for any offence during their lifetime. Violent offenders (1,369 [11.0%]) were the most prevalent offender types; prevalence was highest in men aged 30 years or younger (521 [20.6%] of 2,728) and fell with age (164 [4.7%] of 3027 at age >45 years). Deployment was not independently associated with increased risk of violent offending, but serving in a combat role conferred an additional risk, even after adjustment for confounders (violent offending in 137 [6.3%] of 2178 men deployed in a combat role vs 140 (2.4%) of 5,797 deployed in a non-combat role; adjusted hazard ratio 1.53, 95% CI 1.15-2.03; p=0.003). Increased exposure to traumatic events during deployment also increased risk of violent offending (violent offending in 104 [4.1%] of 2753 men with exposure to two to four traumatic events vs 56 [1.6%] of 2944 with zero to one traumatic event, 1.77, 1.21-2.58, p=0.003; and violent offending in 122 [5.1%] of 2582 men with exposure to five to 16 traumatic events, 1.65, 1.12-2.40, p=0.01; test for trend, p=0.032). Violent offending was strongly associated with post-deployment alcohol misuse (violent offending in 120 [9.0%] of 1363 men with alcohol misuse vs 155 [2.3%] of 6768 with no alcohol misuse; 2.16, 1.62-2.90; p<0.0001), post-traumatic stress disorder (violent offending in 25 [8.6%] of 344 men with post-traumatic stress disorder vs 221 [3.0%] of 7256 with no symptoms of post-traumatic stress disorder; 2.20, 1.36-3.55; p=0.001), and high levels of self-reported aggressive behaviour (violent offending in 56 [6.7%] of 856 men with an aggression score of six to 16 vs 22 [1.2%] of 1685 with an aggression score of zero; 2.47, 1.37-4.46; p=0.003). Of the post-traumatic stress disorder symptoms, the hyperarousal cluster was most strongly associated with violent offending (2.01, 1.50-2.70; p<0.0001). Alcohol misuse and aggressive behaviour might be appropriate targets for interventions, but any action must be evidence based. Post-traumatic stress disorder, though less prevalent, is also a risk factor for violence, especially hyperarousal symptoms, so if diagnosed it should be appropriately treated and associated risk monitored. Medical Research Council and the UK Ministry of Defence. Copyright © 2013 Elsevier Ltd. All rights reserved.

Are elite cricketers more prone to suicide? A psychological autopsy study of Test cricketer suicides.

PubMed

Shah, Ajit; Sava-Shah, Shrenik; Wijeratne, Chanaka; Draper, Brian

2016-06-01

It has been hypothesised that the very nature of the game predisposes elite cricketers to higher rates of suicide. We aim to estimate the suicide rate of male Test cricketers and to determine the reasons for suicide. The suicide rate in male Test cricketers was determined. A psychological autopsy was conducted using published biographical data. Twenty suicides amongst 2794 male Test cricketers from 1877 to 2014 yielded a suicide rate of 715.4 per 100,000 for that period. Health, financial and relationship issues were prominent; depression and alcohol misuse were common. Most suicides in Test cricketers occurred post-retirement in mid to late life with similar correlates to those found in the general male population. The idiosyncrasies of cricket are unlikely to contribute to suicide; however, the post-retirement welfare of Test cricketers should remain a focus of concern and the greater supports available to contemporary Test cricketers needs to extend beyond retirement. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Social norms information for alcohol misuse in university and college students.

PubMed

Foxcroft, David R; Moreira, Maria Teresa; Almeida Santimano, Nerissa M L; Smith, Lesley A

2015-12-29

Drinking is influenced by youth perceptions of how their peers drink. These perceptions are often incorrect, overestimating peer drinking norms. If inaccurate perceptions can be corrected, young people may drink less. To determine whether social norms interventions reduce alcohol-related negative consequences, alcohol misuse or alcohol consumption when compared with a control (ranging from assessment only/no intervention to other educational or psychosocial interventions) among university and college students. The following electronic databases were searched up to July 2015: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, PsycINFO. The Cumulative Index to Nursing and Allied Health Literature (CINAHL) only to March 2008. Reference lists of included studies and review articles were manually searched. No restriction based on language or date was applied. Randomised controlled trials or cluster-randomised controlled trials that compared a social normative intervention versus no intervention, alcohol education leaflet or other 'non-normative feedback' alcohol intervention and reported on alcohol consumption or alcohol-related problems in university or college students. We used standard methodological procedures as expected by Cochrane. Each outcome was analysed by mode of delivery: mailed normative feedback (MF); web/computer normative feedback (WF); individual face-to-face normative feedback (IFF); group face-to-face normative feedback (GFF); and normative marketing campaign (MC). A total of 70 studies (44,958 participants) were included in the review, and 63 studies (42,784 participants) in the meta-analyses. Overall, the risk of bias assessment showed that these studies provided moderate or low quality evidence.Outcomes at four or more months post-intervention were of particular interest to assess when effects were sustained beyond the immediate short term. We have reported pooled effects across delivery modes only for those analyses for which heterogeneity across delivery modes is not substantial (I(2) < 50%).Alcohol-related problems at four or more months: IFF standardised mean difference (SMD) -0.14, 95% confidence interval (CI) -0.24 to -0.04 (participants = 2327; studies = 11; moderate quality evidence), equivalent to a decrease of 1.28 points in the 69-point alcohol problems scale score. No effects were found for WF or MF.Binge drinking at four or more months: results pooled across delivery modes: SMD -0.06, 95% CI -0.11 to -0.02 (participants = 11,292; studies = 16; moderate quality evidence), equivalent to 2.7% fewer binge drinkers if 30-day prevalence is 43.9%.Drinking quantity at four or more months: results pooled across delivery modes: SMD -0.08, 95% CI -0.12 to -0.04 (participants = 21,169; studies = 32; moderate quality evidence), equivalent to a reduction of 0.9 drinks consumed each week, from a baseline of 13.7 drinks per week.Drinking frequency at four or more months: WF SMD -0.11, 95% CI -0.17 to -0.04 (participants = 9929; studies = 10; moderate quality evidence), equivalent to a decrease of 0.17 drinking days/wk, from a baseline of 2.74 days/wk; IFF SMD -0.21, 95% CI -0.31 to -0.10 (participants = 1464; studies = 8; moderate quality evidence), equivalent to a decrease of 0.32 drinking days/wk, from a baseline of 2.74 days/wk. No effects were found for GFF or MC.Estimated blood alcohol concentration (BAC) at four or more months: peak BAC results pooled across delivery modes: SMD -0.08, 95% CI -0.17 to 0.00 (participants = 7198; studies = 11; low quality evidence), equivalent to a reduction in peak BAC from an average of 0.144% to 0.135%. No effects were found for typical BAC with IFF. The results of this review indicate that no substantive meaningful benefits are associated with social norms interventions for prevention of alcohol misuse among college/university students. Although some significant effects were found, we interpret the effect sizes as too small, given the measurement scales used in the studies included in this review, to be of relevance for policy or practice. Moreover, the significant effects are not consistent for all misuse measures, heterogeneity was a problem in some analyses and bias cannot be discounted as a potential cause of these findings.

32 CFR 901.4 - Basic eligibility requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... eliminated by official action. (5) Habitual alcohol misuse or drug abuse which exceeds the standards of AFR.... Applicant must not have a legal obligation to support a child, children, or any other person. Note: For the purpose of this regulation, children are defined as the natural children of a parent and adopted children...

32 CFR 901.4 - Basic eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... eliminated by official action. (5) Habitual alcohol misuse or drug abuse which exceeds the standards of AFR.... Applicant must not have a legal obligation to support a child, children, or any other person. Note: For the purpose of this regulation, children are defined as the natural children of a parent and adopted children...

Personality-Targeted Interventions Delay the Growth of Adolescent Drinking and Binge Drinking

ERIC Educational Resources Information Center

Conrod, Patricia J.; Castellanos, Natalie; Mackie, Clare

2008-01-01

Background: Personality factors are implicated in the vulnerability to adolescent alcohol misuse. This study examined whether providing personality-targeted interventions in early adolescence can delay drinking and binge drinking in high-risk youth. Methods: A randomised control trial was carried out with 368 adolescents recruited from years 9 and…

Steps Toward Healthy Growth. Health Education Curriculum Guide; Grades 7-9.

ERIC Educational Resources Information Center

Dippo, Jeanette, Ed.

Grades or Ages: Grades 7-9. Subject Matter: Health Education (includes chapters covering the following: (a) nutrition, (b) sensory perception, (c) dental health, (d) disease prevention and control, (e) smoking and health, (f) alcohol education, (g) use and misuse of chemical substances, (h) identity and human sexuality, (i) environmental health,…

Endangered Children and the Misuse of Intoxication by Controlling Adults.

ERIC Educational Resources Information Center

Walonick, David

A review of the academic literature regarding the existence or lack of relationship between chemically dependent adults and neglected or abused children supports the conclusion that alcohol and other drugs are a significant factor in most behavioral patterns associated with endangering children. The author identifies five modes of parent-child…

Effects of Parental Monitoring and Peer Deviance on Substance Use and Delinquency

ERIC Educational Resources Information Center

Barnes, Grace M.; Hoffman, Joseph H.; Welte, John W.; Farrell, Michael P.; Dintcheff, Barbara A.

2006-01-01

From socialization theory, it was hypothesized that parental support and monitoring as well as peer deviance would influence individual trajectories of alcohol misuse, other substance use, and delinquency. Six waves of data were analyzed using interviews with 506 adolescents in a general population sample. Results from multilevel modeling showed…

Substance Use over the Military-Veteran Life Course: An Analysis of a Sample of OEF/OIF Veterans Returning to Low-Income Predominately Minority Communities

PubMed Central

Golub, Andrew; Bennett, Alex S.

2013-01-01

This paper presents an overview of substance use patterns of recent veterans returning to low-income predominately minority communities over four periods of the military-veteran career. Respondent driven sampling (RDS) was used so that unbiased estimates could be obtained for the characteristics of the target population. The majority of participants had used marijuana but no other illegal drugs. In the military, marijuana use was substantially lower and alcohol was the drug of choice; the majority were binge drinkers and nearly half were heavy drinkers. While deployed, alcohol and marijuana use were both lower, though some participants (6%) initiated the misuse of prescription painkillers. After separating from the military and returning to civilian life, heavy drinking was much lower, marijuana use increased, and some veterans misused prescription painkillers (7%). Further research based on these data will examine these distinct periods of substance use, contexts of use, related substance and mental health problems, treatment use and avoidance, and civilian reintegration. PMID:23932708

Prevalence of delayed-onset posttraumatic stress disorder in military personnel: is there evidence for this disorder?: Results of a prospective UK cohort study.

PubMed

Goodwin, Laura; Jones, Margaret; Rona, Roberto J; Sundin, Josefin; Wessely, Simon; Fear, Nicola T

2012-05-01

Delayed-onset posttraumatic stress disorder (PTSD) is defined as onset at least 6 months after a traumatic event. This study investigates the prevalence of delayed-onset PTSD in 1397 participants from a two-phase prospective cohort study of UK military personnel. Delayed-onset PTSD was categorized as participants who did not meet the criteria for probable PTSD (assessed using the PTSD Checklist Civilian version) at phase 1 but met the criteria by phase 2. Of the participants, 3.5% met the criteria for delayed-onset PTSD. Subthreshold PTSD, common mental disorder (CMD), poor/fair self-reported health, and multiple physical symptoms at phase 1 and the onset of alcohol misuse or CMD between phases 1 and 2 were associated with delayed-onset PTSD. Delayed-onset PTSD exists in this UK military sample. Military personnel who developed delayed-onset PTSD were more likely to have psychological ill-health at an earlier assessment, and clinicians should be aware of the potential comorbidity in these individuals, including alcohol misuse. Leaving the military or experiencing relationship breakdown was not associated.

The relationship between substance use and exit security on psychiatric wards.

PubMed

Simpson, Alan; Bowers, Len; Haglund, Kristina; Muir-Cochrane, Eimear; Nijman, Henk; Van der Merwe, Marie

2011-03-01

In this paper we report on the rates of drug/alcohol use on acute psychiatric wards in relation to levels and intensity of exit security measures. Many inpatient wards have become permanently locked, with staff concerned about the risk of patients leaving the ward and harming themselves or others, and of people bringing illicit substances into the therapeutic environment. In 2004/2005, a cross sectional survey on 136 acute psychiatric wards across three areas of England was undertaken. A comprehensive range of data including door locking and drug/alcohol use were collected over 6 months on each ward. In 2006, supplementary data on door locking and exit security were collected. Door locking, additional exit security measures and substance misuse rates of the 136 wards were analysed and the associations between these were investigated. No consistent relationships were found with exit security features, intensity of drug/alcohol monitoring procedures, or the locking of the ward door. There were indications that use of breath testing for alcohol might reduce usage and that the use of 'sniffer' dogs was associated with greater alcohol use. Greater exit security or locking of the ward door had no influence on rates of use of alcohol or illicit drugs by inpatients and thus cannot form part of any strategy to control substance use by inpatients. There are some grounds to believe that a greater use of screening might help reduce the frequency of alcohol/substance use on wards and may lead to a reduction in verbal abuse. © 2010 The Authors. Journal of Advanced Nursing © 2010 Blackwell Publishing Ltd.

French validation of the compulsive internet use scale (CIUS).

PubMed

Khazaal, Yasser; Chatton, Anne; Horn, Alessandra; Achab, Sophia; Thorens, Gabriel; Zullino, Daniele; Billieux, Joël

2012-12-01

The popularity of using the Internet and related applications has grown in European countries in the last two decades. Despite numerous advantages in terms of optimizing communications among individuals and social systems, the use of the Internet may be associated with excessive use and possible Internet addiction. The goals of the current study were to validate a French version of the compulsive Internet use scale (CIUS) and to assess its links with common psychiatric symptoms such as depression (assessed with the Beck depression inventory: BDI), anxiety (assessed with the trait anxiety inventory: STAI) and alcohol misuse (assessed with the alcohol use disorder identification test: AUDIT). The French versions of the CIUS, BDI, STAI and AUDIT were administered to a sample of Internet users. Exploratory and confirmatory analyses, correlation analysis and logistic regression were performed. As previously found with the original version, a one-factor model of the CIUS had good psychometric properties and fit the data well. Excessive use of the Internet was associated with depressive symptoms.

Cost-effectiveness of motivational intervention with significant others for patients with alcohol misuse.

PubMed

Shepard, Donald S; Lwin, Aung K; Barnett, Nancy P; Mastroleo, Nadine; Colby, Suzanne M; Gwaltney, Chad; Monti, Peter M

2016-05-01

To estimate the incremental cost, cost-effectiveness and benefit-cost ratio of incorporating a significant other (SO) into motivational intervention for alcohol misuse. We obtained economic data from the one year with the intervention in full operation for patients in a recent randomized trial. The underlying trial took place at a major urban hospital in the United States. The trial randomized 406 (68.7% male) eligible hazardous drinkers (196 during the economic study) admitted to the emergency department or trauma unit. The motivational interview condition consisted of one in-person session featuring personalized normative feedback. The significant other motivational interview condition comprised one joint session with the participant and SO in which the SO's perspective and support were elicited. We ascertained activities across 445 representative time segments through work sampling (including staff idle time), calculated the incremental cost in per patient of incorporating an SO, expressed the results in 2014 US$, incorporated quality and mortality effects from a closely related trial and derived the cost per quality-adjusted life-year (QALY) gained. From a health system perspective, the incremental cost per patient of adding an SO was $341.09 [95% confidence interval (CI) = $244.44-437.74]. The incremental cost per year per hazardous drinker averted was $3623 (CI = $1777-22,709), the cost per QALY gained $32,200 (CI = $15,800-201,700), and the benefit-cost ratio was 4.73 (95% CI = 0.7-9.66). If adding an SO into the intervention strategy were concentrated during the hours with highest risk or in a trauma unit, it would become even more cost-beneficial. Using criteria established by the World Health Organization (cost-effectiveness below the country's gross domestic product per capita), incorporating a significant other into a patient's motivational intervention for alcohol misuse is highly cost-effective. © 2015 Society for the Study of Addiction.

Maternal welfare, morbidity and mortality 6-15 years after a pregnancy complicated by alcohol and substance abuse: a register-based case-control follow-up study of 524 women.

PubMed

Kahila, Hanna; Gissler, Mika; Sarkola, Taisto; Autti-Rämö, Ilona; Halmesmäki, Erja

2010-10-01

A register-based retrospective case-control study to investigate the long-term morbidity, mortality, and welfare among women with alcohol and/or substance misuse identified during pregnancy. Cohort of 524 women followed-up ante- and perinatally 1992-2001 at special out-patient clinics of maternity hospitals in the capital area of Finland. The control group of 1792 women with no evidence of alcohol or substance misuse was matched for maternal age, parity, date of birth and hospital of index delivery. Both groups were followed-up until end of 2007. 7.9% (42/524) of the cases and 0.2% (4/1792) of the controls had died by the end of the median follow-up of 9 years (OR 38, 95% CI 14-108). The cases displayed significant morbidity requiring in-patient care in the areas of mental disorders (AOR 8.8, 95% CI 6.5-11.9), viral (AOR 23.5, 95% CI 8.8-62.7) and bacterial (AOR 6.1, 95% CI 3.5-10.4) infections, skin diseases (AOR 3.9, 95% CI 2.0-7.8) and injury and poisoning (AOR 4.2, 95% CI 3.1-5.6). The cases displayed more out-patient visits (OR 2.7, 95% CI 2.7-2.8). Their mean length of hospital stay was longer compared to controls (10.3 vs. 4.4 days, p<0.001). The risk of pension granted due to a disorder, disease or disability (OR 8.8, 95% CI 6.0-13.0) and the risk for minimum unemployment benefit were higher compared to controls (OR 2.1, 95% CI 1.8-2.5). These women display significant long-term morbidity, mortality and loss of productivity after delivery. The results emphasize the importance of adequate postnatal follow-up and treatment for misuse. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Patients with multiple sclerosis do not necessarily consume more alcohol or tobacco than the general population.

PubMed

Fragoso, Yara Dadalti; Gomes, Sidney; Goncalves, Marcus Vinicius M; Machado, Suzana C Nunes; Morales, Rogerio de Rizo; Oliveira, Francisco Tomas M de; Oliveira, João Filipe de; Olmo, Neide R Simoes; Parolin, Monica K Fiuza; Siquineli, Fabio; Stoney, Patrick N

2015-10-01

Purpose Recent papers suggest that patients with multiple sclerosis (MS) are prone to alcohol misuse. This may be due to the combination of a lifelong and disabling disease with a psychiatric profile typical of MS. The objective of the present study was to assess these findings in a culturally different population of patients with MS.Method The present case-control transversal study assessed 168 patients with MS and 168 control subjects from Brazil.Results There were no evidence that patients with MS drank more alcohol or, smoked more than did controls. In fact, control subjects had a significantly higher alcohol consumption. The only trait associated to higher alcohol consumption was anxiety, both for patients and controls.Conclusion Unlike previous reports in the literature, patients with MS in our study did not drink or smoked more than a control population.

Welfare, temperance and compulsory commitment to care for persons with substance misuse problems: a comparative study of 38 European countries.

PubMed

Israelsson, Magnus

2011-01-01

The study explores the existence and types of law on compulsory commitment to care (CCC) of adult substance misusers in Europe and how such laws are related to variations in demographics, alcohol consumption and epidemiology in misuse of opiates, cocaine, amphetamines, temperance culture heritage, health and welfare expenditure, and involvement and role of the state in welfare distribution. Legal information on laws on CCC of misusers was obtained primarily through a survey of 38 European countries. Predictors of laws on CCC, and types of such, were analyzed from country descriptors in multivariate models. A majority (74%) of the explored countries have a law concerning CCC. The most common type of CCC law is within criminal justice legislation (45%), but civil CCC is almost as frequent (37%). These two models of CCC legislation are related to differences in cultural heritage and welfare distribution models. Temperance cultures, i.e. countries with a history of a strong temperance movement, and countries with a Beveridgean distribution of welfare, i.e. through the state, tend to favor civil CCC, while countries with a Bismarckian distribution of welfare, i.e. through insurance with less state interference, tend to favor CCC within criminal justice legislation. Copyright © 2011 S. Karger AG, Basel.

Measuring the impact of alcohol-related disorders on quality of life through general population preferences.

PubMed

Rodríguez-Míguez, Eva; Mosquera Nogueira, Jacinto

To estimate the intangible effects of alcohol misuse on the drinker's quality of life, based on general population preferences METHODS: The most important effects (dimensions) were identified by means of two focus groups conducted with patients and specialists. The levels of these dimensions were combined to yield different scenarios. A sample of 300 people taken from the general Spanish population evaluated a subset of these scenarios, selected by using a fractional factorial design. We used the probability lottery equivalent method to derive the utility score for the evaluated scenarios, and the random-effects regression model to estimate the relative importance of each dimension and to derive the utility score for the rest of scenarios not directly evaluated. Four main dimensions were identified (family, physical health, psychological health and social) and divided into three levels of intensity. We found a wide variation in the utilities associated with the scenarios directly evaluated (ranging from 0.09 to 0.78). The dimensions with the greatest relative importance were physical health (36.4%) and family consequences (31.3%), followed by psychological (20.5%) and social consequences (11.8%). Our findings confirm the benefits of adopting a heterogeneous approach to measure the effects of alcohol misuse. The estimated utilities could have both clinical and economic applications. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Wernicke-Korsakoff syndrome in patients with cancer: a systematic review.

PubMed

Isenberg-Grzeda, Elie; Rahane, Sudhanshu; DeRosa, Antonio P; Ellis, Janet; Nicolson, Stephen E

2016-04-01

Wernicke-Korsakoff syndrome in patients with cancer is understudied. Much of what is known-that significant under-recognition and delays in treatment exist-comes from studies of alcohol misuse disorders or non-alcohol-related Wernicke-Korsakoff syndrome in patients. We investigated the frequency and associated features of cancer-related Wernicke-Korsakoff syndrome in the published literature. We included 90 articles reporting on 129 patients. Only 38 (30%) of 128 patients with data available exhibited the entire triad of classic features of Wernicke-Korsakoff syndrome: confusion, ataxia, and ophthalmoplegia or nystagmus. Diagnosis during life was missed altogether in 22 (17%) of 128 patients. The operational diagnostic criteria (at least two of the following: nutritional deficiency, ocular signs, cerebellar signs, and either altered mental status or mild memory impairment), which are considered more reliable than the classical triad, were used in only nine (7%) cases, yet 120 (94%) met the operational criteria for diagnosis at the time of presentation when applied retroactively. Complete recovery was reported in only 47 (36%) cases. Given that oncologists or haematologists accounted for only 17 (19%) first authors among the articles included, it is important that oncologists are aware of the risk factors for cancer-related Wernicke-Korsakoff syndrome, and that they are vigilant about diagnosing and treating the disease especially in the absence of alcohol misuse disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Steps Towards Alcohol Misuse Prevention Programme (STAMPP): a school-based and community-based cluster randomised controlled trial

PubMed Central

McKay, Michael; Agus, Ashley; Cole, Jonathan; Doherty, Paul; Foxcroft, David; Harvey, Séamus; Murphy, Lynn; Percy, Andrew; Sumnall, Harry

2018-01-01

Objectives To assess the effectiveness of a combined classroom curriculum and parental intervention (the Steps Towards Alcohol Misuse Prevention Programme (STAMPP)), compared with alcohol education as normal (EAN), in reducing self-reported heavy episodic drinking (HED) and alcohol-related harms (ARHs) in adolescents. Setting 105 high schools in Northern Ireland (NI) and in Scotland. Participants Schools were stratified by free school meal provision. Schools in NI were also stratified by school type (male/female/coeducational). Eligible students were in school year 8/S1 (aged 11–12 years) at baseline (June 2012). Intervention A classroom-based alcohol education intervention, coupled with a brief alcohol intervention for parents/carers. Primary outcomes (1) The prevalence of self-reported HED in the previous 30 days and (2) the number of self-reported ARHs in the previous 6 months. Outcomes were assessed using two-level random intercepts models (logistic regression for HED and negative binomial for number of ARHs). Results At 33 months, data were available for 5160 intervention and 5073 control students (HED outcome), and 5234 and 5146 students (ARH outcome), respectively. Of those who completed a questionnaire at either baseline or 12 months (n=12 738), 10 405 also completed the questionnaire at 33 months (81.7%). Fewer students in the intervention group reported HED compared with EAN (17%vs26%; OR=0.60, 95% CI 0.49 to 0.73), with no significant difference in the number of self-reported ARHs (incident rate ratio=0.92, 95% CI 0.78 to 1.05). Although the classroom component was largely delivered as intended, there was low uptake of the parental component. There were no reported adverse effects. Conclusions Results suggest that STAMPP could be an effective programme to reduce HED prevalence. While there was no significant reduction in ARH, it is plausible that effects on harms would manifest later. Trial registration number ISRCTN47028486; Post-results. PMID:29525770

How well do the DSM-5 alcohol use disorder designations map to the ICD-10 disorders?

PubMed

Hoffmann, Norman G; Kopak, Albert M

2015-04-01

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), and the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10), both establish diagnostic criteria for alcohol use disorders. The dimensional severity perspective provided by the DSM-5 may overlap in important ways but also may diverge from the categorical harmful use versus dependence designations presented by the ICD-10. It is especially important to consider the convergence of these 2 diagnostic approaches as the DSM is widely used by clinicians, but the U.S. Centers for Medicare and Medicaid Services has recently required that providers bill for services using the ICD-10 designations. Data from 6,871 male and 801 female admissions to a state prison system were used to compare the DSM-5 severity index for alcohol use disorder to the ICD-10 clinical and research formulations for harmful use and dependence. The DSM-5 and the ICD-10 were highly convergent for the most severe alcohol use disorders and also for those who did not receive a diagnosis. Most DSM-5 moderate alcohol use disorder cases were classified as dependence cases under both the clinical and research ICD criteria. In contrast, there was much more variation in the DSM mild cases. These were divided into categories of harmful use or misuse, depending on whether the clinical or research ICD criteria were applied. Results were similar among male and female inmates. The DSM-5 and ICD-10 exhibit a high level of agreement for cases that would not receive a diagnosis as well as the most severe cases. However, there are important distinctions to be made between the 2 approaches for mild and moderate DSM disorders in addition to harmful use/misuse cases in the ICD. The cases influenced by these discrepancies are most likely to be affected by recently implemented service provider billing practices. Copyright © 2015 by the Research Society on Alcoholism.

Computer-based psychological treatment for comorbid depression and problematic alcohol and/or cannabis use: a randomized controlled trial of clinical efficacy.

PubMed

Kay-Lambkin, Frances J; Baker, Amanda L; Lewin, Terry J; Carr, Vaughan J

2009-03-01

To evaluate computer- versus therapist-delivered psychological treatment for people with comorbid depression and alcohol/cannabis use problems. Randomized controlled trial. Community-based participants in the Hunter Region of New South Wales, Australia. Ninety-seven people with comorbid major depression and alcohol/cannabis misuse. All participants received a brief intervention (BI) for depressive symptoms and substance misuse, followed by random assignment to: no further treatment (BI alone); or nine sessions of motivational interviewing and cognitive behaviour therapy (intensive MI/CBT). Participants allocated to the intensive MI/CBT condition were selected at random to receive their treatment 'live' (i.e. delivered by a psychologist) or via a computer-based program (with brief weekly input from a psychologist). Depression, alcohol/cannabis use and hazardous substance use index scores measured at baseline, and 3, 6 and 12 months post-baseline assessment. (i) Depression responded better to intensive MI/CBT compared to BI alone, with 'live' treatment demonstrating a strong short-term beneficial effect which was matched by computer-based treatment at 12-month follow-up; (ii) problematic alcohol use responded well to BI alone and even better to the intensive MI/CBT intervention; (iii) intensive MI/CBT was significantly better than BI alone in reducing cannabis use and hazardous substance use, with computer-based therapy showing the largest treatment effect. Computer-based treatment, targeting both depression and substance use simultaneously, results in at least equivalent 12-month outcomes relative to a 'live' intervention. For clinicians treating people with comorbid depression and alcohol problems, BIs addressing both issues appear to be an appropriate and efficacious treatment option. Primary care of those with comorbid depression and cannabis use problems could involve computer-based integrated interventions for depression and cannabis use, with brief regular contact with the clinician to check on progress.

The Effects of Perceived Racial/Ethnic Discrimination on Substance Use Among Youths Living in the Cherokee Nation

PubMed Central

Garrett, Brady A.; Livingston, Bethany J.; Livingston, Melvin D.; Komro, Kelli A.

2017-01-01

We examined frequency and intensity of racial/ethnic discrimination and the longitudinal relationship to substance use. The sample included (N = 1,421) American Indian, American Indian and White, and White adolescents. A high frequency of perceived racial discrimination was associated with an increased risk for heavy alcohol use, prescription drug misuse, and other illicit drug use. Experiences of perceived racial discrimination high in intensity were associated with further increased risk of prescription drug misuse and other illicit drug use. Race/ethnicity did not moderate the relationship between perceived racial discrimination and substance use. Interventions targeting the deleterious effects of racial discrimination may need to be designed to account for both the environment and the individual. PMID:29225452

A New Prescription for Fighting Drug Abuse

ERIC Educational Resources Information Center

Schachter, Ron

2012-01-01

It's a drug prevention conversation--and program--that was largely missing as recently as a decade ago in most middle and high schools. In those days, the principal concern of health educators and disciplinarians alike was to keep students from misusing alcohol and illegal street drugs such as ecstasy, cocaine and even heroine. But driven by the…

Lagos "Area Boys", Substance Usage and Potential Risk Factors

ERIC Educational Resources Information Center

Salaam, Abeeb Olufemi; Brown, Jennifer

2012-01-01

The current study explores the rate at which members of Lagos' "area boys" engage in drug and alcohol use, and determines the predictive roles of parental and neighbourhood characteristics in the gang patterns of psychoactive substance misuse behaviour. The study approached gang members (N = 129) aged from 18 to 38 years (M = 25.83, SD = 4.82)…

School-Based Drug Prevention among At-Risk Adolescents: Effects of ALERT Plus

ERIC Educational Resources Information Center

Longshore, Douglas; Ellickson, Phyllis L.; McCaffrey, Daniel F.; St. Clair, Patricia A.

2007-01-01

In a recent randomized field trial, Ellickson et al. found the Project ALERT drug prevention curriculum curbed alcohol misuse and tobacco and marijuana use among eighth-grade adolescents. This article reports effects among ninth-grade at-risk adolescents. Comparisons between at-risk girls in ALERT Plus schools (basic curriculum extended to ninth…

Taking on Substance Abuse in the Emergency Room: One Hospital's SBIRT Story

ERIC Educational Resources Information Center

Parker, Gary; Libart, Dane; Fanning, Linda; Higgs, Tracy; Dirickson, Cathy

2012-01-01

Screening for alcohol and drugs seems to be gaining traction and is becoming more commonplace in the healthcare setting. With emergency departments often being a point of contact for many individuals needing healthcare services, it makes sense to provide screening for substance misuse within this setting. The purpose of this paper is to share how…

Binge Drinking during the First Semester of College: Continuation and Desistance from High School Patterns

ERIC Educational Resources Information Center

Reifman, Alan; Watson, Wendy K.

2003-01-01

Students' first semester on campus may set the stage for their alcohol use/misuse throughout college. The authors surveyed 274 randomly sampled first-semester freshmen at a large southwestern university on their past 2 weeks' binge drinking, their high school binge drinking, and psychosocial factors possibly associated with drinking. They…

A Closer Look at Party Hosting Behaviors within Off-Campus College Settings

ERIC Educational Resources Information Center

Jakeman, Rick C.; McClure, Tracae M.; Silver, Blake R.

2015-01-01

Colleges and universities have taken a variety of approaches to combat alcohol and other drug misuse among students. This descriptive quantitative study aims to investigate the behaviors of students who host off-campus parties and how these behaviors shape party environments. Undergraduate students (N = 2,146) completed an online survey to capture…

The Impact of Recent Stressful Experiences on HIV-Risk Related Behaviors

ERIC Educational Resources Information Center

Wong, Carolyn F.; Kipke, Michele D.; Weiss, George; McDavitt, Bryce

2010-01-01

Limited research has captured the wide varieties of distinct, but interrelated, life stressors that young men who have sex with men (YMSM) experience as emerging adults. We examined the way recent experiences of a diverse set of stressors predict illicit drug use, alcohol misuse, and inconsistent condom use (i.e., unprotected anal intercourse)…

The International Development of the "Social Norms" Approach to Drug Education and Prevention

ERIC Educational Resources Information Center

McAlaney, John; Bewick, Bridgette; Hughes, Clarissa

2011-01-01

The social norms approach to health promotion has become remarkably popular in the last 20 years, particularly in the American college system. It is an alternative to traditional fear-based approaches of health education, which a growing body of research demonstrates is often ineffective in reducing alcohol and drug misuse. The social norms…