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Addressing the limited access to treatments for alcohol dependence, we developed ALM-002, a therapeutic application to be "prescribed" for non-abstinence-oriented treatment in internal medicine settings. Our objective was to preliminarily assess the efficacy and safety of ALM-002. In a multicenter, open-label randomized controlled trial, participants aged ≥20 with alcohol dependence and daily alcohol consumption exceeding 60 g for men and 40 g for women, without severe complications, were randomly assigned to either the intervention group using ALM-002 or the treatment-as-usual control group. Participant in both groups received individual face-to-face sessions by physicians at weeks 0, 4, 8, and 12. The primary endpoint was the change in heavy drinking days (HDDs) from week 0 to week 12. A mixed model for repeated measures was employed. We enrolled 43 participants: 22 in the intervention group and 21 in the control group. A significant reduction in HDDs every 4 weeks from week 0 to week 12 was observed, with a between-group difference of −6.99 days (95% CI: −12.4 to −1.6 days, standardized mean difference: −0.80). These results indicate the potential of ALM-002 as a viable treatment for alcohol dependence. Further studies are needed to evaluate the clinical potential of ALM-002. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is associated with significant psychological and economic burdens, as well as physical comorbidities that can lead to death. Previous research has found that probiotics may reduce inflammatory biomarkers in persons with AUD and comorbid conditions such as cirrhosis of the liver. This relationship has not been explored in heavy drinkers without comorbid conditions. In a proof-of-concept study, individuals who were heavy drinkers without known comorbidities received a 30-day course of a daily probiotic supplement in an open-label pilot trial. Eligible participants (N = 16) met NIAAA guidelines for heavy alcohol use and did not report any preexisting medical problems. Blood samples were taken at four timepoints: prior to the probiotic course, at the midpoint, at the end, and after a washout period of at least one month. Immunoassays were conducted on plasma samples to quantify the following inflammatory biomarkers: IL-6, IL-8, IL-10, LBP, MCP-1, sCD14, sCD163, and TNF-α. Linear mixed models were used to test within-subjects changes in biomarker concentrations over the study period, with alcohol use included as a time-varying covariate. Biomarker concentrations did not change significantly. A higher number of heavy drinking days was statistically associated with higher concentrations of IL-6 (F (1,8) = 6.66, p = 0.0326) and IL-8 (F (1,17) = 6.38, p = 0.0218). Greater days since last drink was associated with a lower concentration of MCP-1 (F (1,17) = 5.77, p = 0.028). In summary, biomarker trajectories were associated with alcohol consumption variables, but not probiotic use, in this open-label pilot study. Randomized controlled trials are needed to evaluate fully the potential benefits of probiotics in heavy drinkers without known comorbidities and under conditions of non-abstinence. • Greater heavy drinking days was associated with higher levels of cytokines IL-6 and IL-8. • Greater number of days since last drink was associated with lower levels of chemokine MCP-1. • Probiotic use was not associated with changes in inflammatory biomarkers. [ABSTRACT FROM AUTHOR]

This study assessed the association between alcohol use patterns and the prevalence of hypertension. Data on alcohol use patterns and hypertension among 5918 adults from the 2015–2016 National Health and Nutrition Examination Survey was used for this study. The association of alcohol use patterns; "ever-used alcohol", "binge drinking", "heavy drinking", and "everyday alcohol use" with hypertension were assessed using multivariable-adjusted logistic regression to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) at a two-sided P < 0.05. Overall, the mean age of respondents was 48.3 ± 18.5 years, 50.9% (n = 3034) were women, and 44.6% (n = 2132) were hypertensive. Also, 85.9% (n = 4177) had used alcohol in their lifetime, 51.9% (n = 1764) were heavy drinkers, 25.1% (n = 370) engaged in binge drinking, and 17.7% (n = 721) reported everyday alcohol use. Compared to those that have never used alcohol, the aOR (95%CI) of stage II hypertension was 1.570 (1.565, 1.575) for overall alcohol use, 1.370 (1.367, 1.373) for everyday alcohol use, 1.127 (1.125, 1.129) for heavy drinking, and 1.092 (1.087, 1.098) for binge drinking. Among current active smokers, the aOR (95%CI) of stage II hypertension was aggravated for everyday alcohol use; 2.583 (2.576, 2.590). Alcohol use patterns were associated with a higher prevalence of hypertension, particularly among smokers. A population-based longitudinal study should clarify whether these alcohol use phenotypes are predictive of hypertension at the population level in the United States. [ABSTRACT FROM AUTHOR]

Nociceptin, which binds to the nociceptin opioid peptide receptor (NOP), regulates stress and reward in addiction. In a previous [11C]NOP-1A positron emission tomography (PET) study, we found no differences in NOP in non–treatment-seeking individuals with alcohol use disorder (AUD) relative to healthy control subjects Here, we evaluated NOP in treatment-seeking individuals with AUD to document its relationship with relapse to alcohol. [11C]NOP-1A distribution volume (V T) was measured in recently abstinent individuals with AUD and healthy control subjects (n = 27/group) using an arterial input function–based kinetic analysis in brain regions that regulate reward and stress behaviors. Recent heavy drinking before PET was quantified using hair ethyl glucuronide (≥30 pg/mg was defined as heavy drinking). To document relapse, 22 subjects with AUD were followed with urine ethyl glucoronide tests (3/week) for 12 weeks after PET, where they were incentivized with money to abstain. There were no differences in [11C]NOP-1A V T between individuals with AUD and healthy control subjects. Individuals with AUD who drank heavily before the study had significantly lower V T than those with no recent heavy drinking history. Significant negative correlations between V T and the number of drinking days and the number of drinks consumed per drinking day in the 30 days before enrollment were also present. Individuals with AUD who relapsed (and dropped out) had significantly lower V T than those who abstained for 12 weeks. Lower NOP V T in heavy drinking AUD predicted relapse to alcohol during a 12-week follow-up period. The results of this PET study support the need to investigate medications that act at NOP to prevent relapse in individuals with AUD. [ABSTRACT FROM AUTHOR]

To determine whether peer drunkenness, parental knowledge about their adolescent's whereabouts and behaviors, and depressive symptoms contribute to sexual orientation disparities in high-risk drinking behaviors; if they do, they would be potential intervention targets. Longitudinal survey data from 2,051 adolescents who participated in the NEXT Generation Health Study were analyzed. Latent growth curve and longitudinal path analyses were used to test for indirect effects linking sexual orientation in 11th grade (3.4% males and 8.4% females were sexual minorities) to past 30-day heavy episodic drinking (HED) over 6 years and past year high-intensity binge drinking at 4 years after high school. Sexual minority males were not more likely to engage in high-risk drinking than heterosexual males. In contrast, sexual minority females were more likely than heterosexual females to engage in HED when they were in 11th grade (Odds Ratio = 2.83, 95% confidence interval = 1.43, 5.61), in part because of lower parental knowledge. Sexual minority females also had higher depressive symptoms during the transition from adolescence to young adulthood, which in turn was associated with greater risk of high-intensity binge drinking in young adulthood. Peer drunkenness was a strong risk factor for HED and high-intensity binge drinking among both males and females. Sexual minority females reported lower levels of parental knowledge during adolescence and higher levels of depressive symptoms during the transition to young adulthood than heterosexual females. Both factors were associated with high-risk drinking behavior, suggesting developmentally sensitive opportunities to mitigate sexual orientation disparities in high-risk drinking. [ABSTRACT FROM AUTHOR]

Background: Acute use of alcohol is a proximal risk factor for suicidal behavior and suicide attempts. Previous studies have established that alcohol consumption prior to suicide increases the risk of suicide completion. Thus, the current study aims to explore the association between alcohol use and suicide mortality in Kazakhstan. This is the first study to address this association in Kazakhstan.Methods: The main outcome measure was the presence of alcohol in blood of suicide decedents. Logistic regression models were used to test unadjusted and adjusted odds ratios of the risk of suicide involving acute use of alcohol. Regression modeling was used to identify significant predictors of alcohol use among suicide decedents.Results: Males (22.5 %) used alcohol more commonly before conducting suicide than females (13.4 %). The odds of alcohol involvement was 2.73 times higher for males compared to females after controlling for age and other covariates. Being a male younger than 45 years old and using suicide methods such as poisoning, immolation, and drowning increased the odds of acute use of alcohol among suicide decedents.Limitations: Data on alcohol use included information only on individuals with a positive alcohol test, and it is unknown how many suicide decedents were not tested for alcohol.Conclusions: Alcohol use is common factor contributing to suicide, particularly among young and middle-aged male adults. Alcohol use is also associated more strongly with certain methods of suicide. Further studies and more detailed data exploring alcohol consumption and suicide risks are needed in countries such as Kazakhstan. [ABSTRACT FROM AUTHOR]

• Cognitive control and attentional control share similar goal-driven attributes. • Heavy drinkers and controls performed similarly on go/no-go and Stroop tasks. • Suppression of high-frequency distractors was blunted in heavy drinkers. • Drinkers had difficulty leveraging statistical regularities to facilitate ignoring. • Distractor suppression is distinct from the suppression of prepotent responses. Impaired cognitive control has been linked to weakened self-regulatory processes underlying compulsive substance intake. Previous research has provided evidence for impaired task performance in substance-abusing groups during Stroop and Go/No-Go tasks. Mechanisms of distractor suppression in visual search might also involve overlapping regulatory components that support goal-directed behavior by resolving the attentional competition between distractors and the target of search. However, the efficiency of learning-dependent distractor suppression has not been examined in the context of drug abuse and a direct comparison between cognitive control and distractor suppression is lacking. A total of 84 participants were assigned either to the heavy drinking group (ALC, n = 42) or the control group (CTL, n = 42) based on self-reported substance use. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and Barratt Impulsiveness Scale (BIS). After that, participants completed a computerized version of the Stroop task, Go/No-go task, and a visual search task measuring learning-dependent distractor suppression. The Stroop effect and the frequency of no-go errors did not differ between groups. However, learned distractor suppression was significantly blunted in the ALC group compared to the control group. Across participants, performance on the Stroop and Go/No-go task were correlated, while the magnitude of distractor suppression was related to neither. Our findings support a divergence of mechanistic processes underlying cognitive control and attentional control, and demonstrate impaired learning-dependent distractor suppression in heavy drinkers relative to a control group. Impaired distractor suppression offers new insight into why drug cues can be difficult to ignore. [ABSTRACT FROM AUTHOR]

Integrating across motivational models suggests that different self-damaging behaviors (SDBs) are enacted for similar reasons. However, it remains unclear whether some motives are more relevant to certain SDBs than others. To answer this question, the present study compared the salience of 8 potentially shared motives across 3 exemplar SDBs, selected to represent different points along the internalizing and externalizing spectra: binge drinking, disordered eating (binge eating, purging, fasting), and nonsuicidal self-injury (NSSI). Seven hundred and four first-year university students (73% female, Mage = 17.97) completed monthly surveys assessing their engagement in and motives for SDBs. Motives were conceptualized as either interpersonal (bonding with others, conforming with others, communicating strength, communicating distress, reducing demands) or intrapersonal (reducing negative emotions, enhancing positive emotions, punishing oneself). Multilevel models compared endorsement of each motive across SDBs. Results revealed that SDBs were motivated by similar goals, albeit to different degrees. Although some exceptions emerged, interpersonal motives were most salient to binge drinking, followed by disordered eating, and then NSSI. In contrast, intrapersonal motives were most salient to NSSI, followed by disordered eating, and then binge drinking. Motivational differences were also found within disordered eating. For example, punishing oneself was more relevant to purging and fasting than binge eating, whereas relieving negative emotions was more relevant to binge eating and purging than fasting. Similar to dimensional models that position SDBs on internalizing or externalizing spectra, the salience of motives for binge drinking and NSSI may fall on distinct spectra (i.e., interpersonal and intrapersonal, respectively), with motives for disordered eating exhibiting elements consistent with both spectra. This study supports a common motivational framework for investigating and potentially treating a variety of topographically distinct SDBs. [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) young adults are disproportionately impacted by homelessness and heavy drinking (i.e., having five or more drinks of alcohol in a row within a couple of hours). Social support, in general, is protective in reducing individuals' risk of heavy drinking. However, whether and how support from different sources may have different implications on heavy drinking among SGM young adults experiencing homelessness (SGM-YAEH) remains unclear. Informed by the risk amplification and abatement model (RAAM), this study examined the associations between support sources and heavy drinking among SGM-YAEH. A purposive sample of SGM-YAEH (N=425) recruited in homeless service agencies from seven major cities in the U.S. completed a self-administered computer-assisted anonymous survey. This survey covered heavy drinking behaviors and social network properties. Logistic regression models were conducted to identify social support sources associated with SGM-YAEH's heavy drinking. Over 40 % of SGM-YAEH were involved in heavy drinking in the past 30 days. Receiving support from street-based peers (OR=1.9; 95 % CI=1.1, 3.2) and home-based peers (OR=1.7; 95 % CI=1.0, 2.8) were each positively associated with SGMYAEH heavy drinking risks. This study was not able to identify the protective role social supports may play in reducing SGM-YAEH's heavy drinking. Furthermore, receiving support from network members was correlated with elevated heavy drinking risks among this population. As heavy drinking prevention programs develop interventions: they should use affirming and trauma approaches to promote protective social ties, as research points to its association in reducing alcohol use disparities among SGM-YAEH. • For SGM-YAEH, receiving social support from street and home-based peers is significantly associated with heavy drinking. • Over 40 % of SGM-YAEH had drank heavily in the past 30 days. • Further research is needed to explore which supportive ties are protective of SGM-YAEH's heavy drinking. • Heavy drinking reduction programs should be tailored to SGM-YAEH distinctive needs, including affirmative and trauma informed approaches. [ABSTRACT FROM AUTHOR]

Introduction: Heavy drinking and depression frequently co-occur and make a substantial contribution to the global non-communicable disease burden. Positive evidence exists for the use of digital interventions with these conditions alone, but there has been limited assessment of combined approaches.Objective: A systematic review of the effectiveness of combined digital interventions for comorbid heavy drinking and major depression in community-dwelling populations.Methods and Analysis: Electronic databases were searched to October 2021 for randomised controlled trials that evaluated any personalised digital intervention for comorbid heavy drinking and depression. Primary outcomes were changes in quantity of alcohol consumed and depressive symptoms. Two reviewers independently assessed study eligibility, extracted data, and undertook risk of bias assessment. Due to the limited number and heterogeneity of studies identified, meta-analysis was not possible, therefore data were synthesised narratively.Results: Of 898 articles identified, 24 papers were reviewed in full, five of which met the inclusion criteria (N = 1503 participants). Three utilised web-based intervention delivery; two computer programmes delivered in a clinic setting. All involved multi-component interventions; treatment length varied from one to ten sessions. Four studies found no evidence for the superiority of combined digital interventions for comorbid heavy drinking and depression over therapist-delivered approaches, single condition interventions (including online), or assessment-only controls. Positive impacts of integrated online therapy compared to generalist online health advice were reported in a fifth study, but not maintained beyond the 1-month follow-up.Limitations: Few eligible, heterogeneous studies prevented meta-analysis.Conclusion: Limited evidence exists of the effectiveness of combined digital interventions for comorbid heavy drinking and depression in community dwelling populations. [ABSTRACT FROM AUTHOR]

Several studies have objectively quantified drinking through the use of Alcohol Monitoring System's (AMS) transdermal alcohol concentration (TAC) device known as SCRAM CAM. Criteria that AMS uses to detect drinking are known to be conservative and only reliably detect heavy drinking equivalent to 5 or more standard drinks. Our group has developed Research Rules used to process TAC data in a manner that will detect low-level and moderate drinking even though it is below the AMS criteria for detection. Sixteen male and 14 female paid research volunteers wore TAC monitors for 28 days in their natural environments and responded daily to text message prompts to self-report the previous day's drinking. Current analyses describe the Research Rules that we developed and how use of those rules impacts the detection of self-reported drinking treated as the standard in sensitivity/specificity analysis. We observed 606 occurrences of positive TAC events over a total of 867 days and processed the TAC data to retain 345 as possible drinking events, even though AMS criteria confirmed drinking for only 163 of these events. The kinds of TAC events removed or retained by our rules are illustrated as cases of low and moderate drinking days that were detected by our rules but not by the conservative AMS criteria. AMS-confirmed TAC events have a high specificity (99.8%) to detect primarily heavy drinking, but have a poor sensitivity to detect lower-level drinking and a poor specificity as an indicator of alcohol abstinence. In contrast, our Research Rules detected 100% of TAC events detected by AMS but also detected 31% of the lower-level drinking events not detected by AMS, with 91% specificity. Reliance upon the AMS criteria for alcohol detection affords a high specificity for detection of heavy drinking but is a poor indicator of abstinence rates. In contrast, use of our Research Rules provides more sensitive means to quantify either any drinking or low–moderate levels of drinking while still maintaining good specificity. • Transdermal alcohol concentration (TAC) data can be used to objectively detect low–moderate levels of drinking. • SCRAM (Alcohol Monitoring Systems, AMS) detects only "heavy" drinking and lacks sensitivity to detect lower drinking levels. • 9 Research Rules are described to detect drinking that is not detected by AMS SCRAM CAM. • Our rules remove false-positive TAC readings and achieve 90% specificity and 69% sensitivity for detection of "any" drinking. [ABSTRACT FROM AUTHOR]

Wearable alcohol biosensors have emerged as a valuable tool for noninvasive, objective, and continuous monitoring of alcohol consumption. However, to date their research and clinical applications have been limited by several factors including large size, high cost, and social stigma. In contrast, recently developed wrist-worn alcohol biosensors are smaller, less expensive, and may be more acceptable for daily use. However, these devices are at the prototype phase and have just begun to be tested for research applications. In this paper, we describe our experiences with two prototypes of these new wrist-worn alcohol biosensors (i.e., Quantac Tally and BACtrack Skyn) and their associated smartphone applications in both a controlled laboratory setting and the real-world environment. Our preliminary experiences with these devices highlight their advantages including comfort, high participant acceptability, and good compliance. However, there are various limitations that should be addressed prior to future research applications of these biosensors, including large interpersonal variations in transdermal alcohol readings, lack of immediately applicable data analysis/interpretation software, and poor battery life after a few months. More research is also needed to further validate the new biosensors, and investigate individual (e.g., skin thickness, gender differences) and environmental factors (e.g., humidity, temperature) contributing to the variations in transdermal alcohol readings measured by wrist-worn alcohol biosensors. • Wrist-worn alcohol biosensors may be a powerful tool for real-life alcohol monitoring. • Advantages include small size, low cost, power efficiency, and high acceptability. • Limitations include variable data quality due to personal and environmental factors. • Future directions include validation research and development of analysis software. [ABSTRACT FROM AUTHOR]

Background: Research suggests that sexual minority adults face disparate risks for poor health outcomes. However, prior research on transgender populations has been limited by small and nonprobability samples and has potentially masked important differences between transgender subgroups. We examined disparities in cigarette, smokeless tobacco, and alcohol consumption by transgender and cisgender adults.Methods: 2014-2017 Behavioral Risk Factor Surveillance System data were used. Multivariable logistic regressions examined differences in cigarette, smokeless tobacco, and alcohol use between cisgender adults and transgender sub-identities: male to female (MTF), female to male (FTM), and gender nonconforming.Results: Cigarette and smokeless tobacco use were higher among transgender adults. The gender nonconforming subgroup reported more binge and heavy drinking. In a multivariable logistic analysis, higher odds of smokeless tobacco use were found for all transgender sub-identities compared to cisgender females. The gender nonconforming group had higher odds of heavy drinking (AOR = 2.09, 95% CI 1.14-3.82) and binge drinking (AOR = 1.94, 95% CI 1.25-3.02) compared to cisgender females. The MTF subcategory was more likely to binge drink (AOR = 1.88, 95% CI 1.44-2.46) compared to cisgender females. The FTM subcategory had lower odds of binge drinking (AOR = 0.49, 95% CI 0.33-0.73) compared to cisgender males.Conclusions: Significant heterogeneity in smokeless tobacco and alcohol use were found among transgender subgroups, particularly when compared to cisgender females. Our findings demonstrate that it is important to consider sub-identities in both the transgender population and in the reference cisgender population. [ABSTRACT FROM AUTHOR]

• Glutamate and glycine disturbances have been reported in alcohol use disorder. • In vivo MRS research has focused exclusively on glutamate disturbances in people. • Glutamate and glycine levels were each associated with recent heavy drinking. • Lower metabolite concentrations correlated with relatively more heavy drinkin. • Only associations involving glycine were significant controlling for glutamate levels. Although the neurotransmitters/modulators glutamate and, more recently, glycine have been implicated in the development and maintenance of Alcohol Use Disorder (AUD) in preclinical research, human proton magnetic resonance spectroscopy (1H-MRS) studies have focused solely on the measurement of glutamate. The purpose of the present analysis was to examine the relative associations of brain glutamate and glycine levels with recent heavy drinking in 41 treatment naïve individuals with AUD using 1H-MRS. The present study is the first that we are aware of to report in vivo brain glycine levels from an investigation of addiction. Dorsal Anterior Cingulate Cortex (dACC) glutamate and glycine concentration estimates were obtained using Two-Dimensional J-Resolved Point Resolved Spectroscopy at 3 Tesla, and past 2-week summary estimates of alcohol consumption were assessed via the Timeline Followback method. Glutamate (β = −0.44, t = −3.09, p = 0.004) and glycine (β = −0.68, t = −5.72, p < 0.001) were each significantly, inversely associated with number of heavy drinking days when considered alone. However, when both variables were simultaneously entered into a single regression model, the effect of glutamate was no longer significant (β = −0.11, t = −0.81, p = 0.42) whereas the effect of glycine remained significant (β = −0.62, t = −4.38, p < 0.001). The present study extends the literature by demonstrating a unique, inverse association of brain glycine levels with recent heavy drinking in treatment naïve individuals with AUD. If replicated and extended, these data could lead to enhanced knowledge of how glycinergic systems change with alcohol consumption and AUD progression leading to pharmacological interventional/preventative strategies that modulate brain glycine levels. [ABSTRACT FROM AUTHOR]

Background: In the United States (U.S.), higher levels of acculturation have been associated with higher rates of heavy alcohol use more consistently among Latino women than among Latino men. This paper explores mechanisms underlying the link between acculturation and alcohol use among Latino/as in the U.S. We examine alcohol use expectancies and motives from the perspectives of the social cognitive theory of gender development.Methods: Qualitative narratives data from six focus groups of individuals (total n = 37), who met criteria for heavy drinking (4/5 drinks/occasion for females/males), were examined separately by gender (18 females; 19 males). Coded narratives data were analyzed using a framework that compared lives in Latin America and in the U.S. Emergent themes were analyzed for their consistency across genders. Gender-specific themes were identified.Results: Changes in family structure and the loss of social networks prompted divergent patterns of drinking among men and women, such that relative to patterns in their countries of origin, drinking among Latino women increased while it decreased among Latino men. Men and women reported drinking to replace missing social bonds, a motive not frequently reported in the literature on drinking motives. Women who engaged in heavy-drinking nonetheless described traditional gender role expectations after U.S. arrival. Only men endorsed positive alcohol expectancies in Latin America. Women reported drinking to alleviate psychological distress in the U.S.Conclusions: Pre and post-immigration comparisons revealed different drinking trajectories among men and women after immigration to the U.S. These patterns appeared to be influenced by new social contexts and changes in familial expectations regarding women's roles. Future inquiry that examines gender-specific themes in alcohol expectancies and motives unique to the experience of immigration, is warranted. [ABSTRACT FROM AUTHOR]

• Enhancement motives and fitting in interacted to predict prospective consumption. • The effect of enhancement motives depended on the level of fitting in. • Social motives did not interact with fitting in. • Students with low perceptions of fitting in may benefit from an alcohol intervention. The first year of college is often marked by increased levels of alcohol consumption; first-year students also vary in their sense of fitting in on campus. Research has amply documented the links between social and enhancement drinking motives with various alcohol outcomes among college students. However, it is unclear how perceived levels of fitting in on campus potentially buffers or amplifies the relationship between drinking motives and drinking behavior. We explored whether perceptions of fitting in on campus moderated effects of social and/or enhancement drinking motives on drinks per week. A sample of 121 heavy drinking first year college students (50 % female, 58 % non-Latinx White, M = 18 years of age) were assessed twice in their first semester (baseline, 3 months) in the context of an alcohol-specific intervention. Hierarchical linear regressions were conducted to test whether drinking motives (social and enhancement) at baseline prospectively predicted drinks per week at 3 months. We hypothesized a positive association between both drinking motives and drinks per week; whether fitting in moderates these relationships was exploratory. Regression analyses yielded non-significant main effects of social motives, enhancement motives, and feelings of fitting in on drinks per week. There was no significant interaction for social motives, but the interaction between enhancement motives and fitting in was significant. Participants with a low sense of fitting in had a strong positive relationship between enhancement motives and drinks per week. Improving perceptions of fitting in for first-year college students may potentially reduce the association between enhancement drinking motives and drinks per week. [ABSTRACT FROM AUTHOR]

Highlights • Pharmacological treatments for alcohol use disorder show a modest effect, and they are unavailable in certain countries. • Effects of gabapentin on alcohol drinking in a Thai alcohol-dependent population were explored. • Individuals in the gabapentin group showed a lower frequency of drinking and heavy-drinking days per week than those in the placebo group. Abstract Pharmacological treatments for alcohol use disorder show a modest effect, and they are unavailable in certain countries. The study's aim is to investigate the effects of gabapentin on alcohol drinking. One hundred twelve Thai individuals with alcohol dependence and very high alcohol consumption were randomly assigned to either of two groups: gabapentin treatment or placebo. Oral treatment with at least 300 mg of gabapentin per day or placebo was administered once a day for twelve weeks. The alcohol drinking pattern was assessed by means of the timeline followback method. The drinking behaviours of the two groups were compared by means of the Poisson repeated measures model and Generalized Estimating Equations (GEE) analysis. Twenty subjects (35.7%) from the gabapentin group and 14 subjects (25.0%) from the placebo group completed the study protocol. The participants in the gabapentin group did not differ from those in the placebo group with respect to demographics or baseline alcohol drinking behaviour. After follow-up, the gabapentin group showed a lower percentage of heavy drinking days per week than the placebo group (p < 0.005). GEE analysis showed treatment by time interaction on lowering drinking days within a week (p < 0.05). In conclusion, gabapentin may be used to reduce alcohol-drinking behaviours. [ABSTRACT FROM AUTHOR]

Introduction: Poly-tobacco use is common among youth and young adults. This study examined sociodemographic, tobacco-related, and substance use characteristics of poly-tobacco use compared to mono-tobacco use among youth and young adults (12-34 years) in the United States.Methods: We conducted a descriptive analysis by age-group of 12898 youth (12-17 years), 8843 younger young adults (18-24 years), and 6081 older young adults (24-34 years) from the 2013-2014 Population Assessment of Tobacco and Health study. Multiple logistic regression modeling was conducted to assess the sociodemographic, tobacco-related, and substance use associations with current (past 30 days) tobacco use on a binary scale (poly- versus mono-tobacco use) among tobacco users.Results: Between 2013 and 2014, 3.6% of youth, 21.7% of younger young adults, and 15.8% of older young adults were current poly-tobacco users in the general population. In the regression analyses, among youth tobacco users, heavy drinking was the only factor associated with higher odds of poly-tobacco use. Factors associated with higher odds of poly-tobacco use among younger young adults included being male, having less than high school diploma or GED, residing in the South, having 2 and ≥3 quit attempts, heavy drinking, and marijuana use. Residing in the South, older ages of exposure to tobacco use, and marijuana use were associated with higher odds of poly-tobacco use among older young adults.Conclusions: Regardless of tobacco product type, poly-tobacco use was common among youth and young adults. Interventions designed to address factors associated with poly-tobacco use among youth and young adults are warranted. [ABSTRACT FROM AUTHOR]

Background: Heavy drinkers are at high risk for suicide attempt and suicide. Multiple factors, when examined in isolation, have been implicated in the risk of suicide attempt in this population. In this report, we present a comprehensive model of the 3-year risk of suicide attempt in heavy drinkers using a longitudinal nationally representative study, the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; wave 1, 2001-2002; wave 2, 2004-2005).Methods: We used structural equation modeling to simultaneously examine effects of four broad groups of clinical factors previously identified as potential predictors of attempted suicides: 1) alcohol use disorder severity, 2) severity of comorbidity, 3) sociodemographic characteristics and 4) help-seeking for alcohol problems. Heavy drinking was defined as drinking 5 or more drinks in a day more than once a week in the month prior to Wave 1.Results: About 1.5% of the 1573 heavy drinker participants (i.e., 5.1% of the NESARC sample) attempted suicide during the 3-year follow-up period. After adjusting for all other factors, several factors independently predicted attempted suicides: the alcohol use disorder liability factor measured by DSM-IV-TR criteria for alcohol abuse and dependence and two dimensions of psychopathology, the general psychopathology factor accounting for the shared effects of all comorbid psychiatric disorders and the externalizing dimension accounting for the shared effects of comorbid substance use disorders. No other factor predicted this risk in addition.Conclusion: This model may help identify individuals with heavy drinking at high risk of suicide and develop more effective suicide prevention strategies. [ABSTRACT FROM AUTHOR]

Trauma exposure is linked to heavy drinking and drug use among college students. Extant research reveals positive associations between negative affect lability and both trauma exposure and alcohol use. This study aimed to extend past research by using daily diary methods to test whether (a) individuals with (versus without) trauma exposure experience greater negative and positive affect lability, (b) negative and positive affect lability are associated with heavy drinking and drug use, and (c) negative and positive affect lability mediate the relations between trauma exposure and heavy drinking and drug use. Participants were 1640 college students (M age=19.2, 54% female, 80% European American) who provided daily diary data for 30days via online surveys. Daily diaries assessed negative and positive affect and substance use (i.e., percent days of heavy drinking, percent days of drug use, total number of drugs used). Individuals with (versus without) a history of trauma exposure demonstrated higher levels of negative and positive affect lability. Negative, but not positive, affect lability was associated with percent days of heavy drinking, percent days of drug use, and total number of drugs used, and mediated the associations between trauma exposure and heavy drinking and drug use outcomes. Findings provide support for the underlying role of negative affect lability in the relations between trauma exposure and heavy drinking and drug use among college students, suggesting that treatments targeting negative affect lability may potentially serve to reduce heavy drinking and drug use among trauma-exposed college students. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption is pivotal for the subsequent development of alcohol use disorders (AUD). The Alcohol Use Disorders Identification Test (AUDIT) is a recommended AUD screening tool for prevention and primary care settings. The objectives of this study were to test how many participants with heavy drinking are unidentified by the AUDIT, if proportions of unidentified participants vary over time, and whether this unidentified risk group (URG) was clinically relevant in terms of drinking behavior reports and AUD risk factors, as well as future adverse outcomes, such as craving, dependence symptoms, or depression.Methods: Our prospective cohort study followed 164 German males aged 18-19years without an alcohol dependence diagnosis over 24months. Only men were included due to higher AUD prevalence and gender-specific differences in metabolism, drinking patterns, and progression to AUD. All participants were screened via telephone interview and answered questionnaires both in person and via internet. Heavy drinking was classified using the AUDIT consumption score (AUDIT-C≥4.50). Standardized AUD diagnoses and symptoms, as well as alcohol use-related outcome criteria were assessed via standardized Composite International Diagnostic Interview (CIDI), and self-report questionnaires.Results: One in four participants (22-28% across all four follow-ups) reported heavy drinking but was unidentified by AUDIT total score (i.e. score<8), thus qualifying for URG status. The URG status did not fluctuate considerably across follow-ups (repeated-measures ANOVA, p=0.293). URG participants identified at the six-month follow-up did not generally differ from participants without URG status in terms of AUD family history or temperament (multivariate ANOVA, p=0.114), except for anxiety sensitivity (pBonferroni<0.001). After two years, URG participants reported a similar level of adverse outcomes compared to low-risk participants (multivariate ANOVA, p=0.438), but less alcohol-related problems and less loss of control due to craving compared to high-risk participants (pBonferroni≤0.007).Conclusions: Despite the considerable number of heavy-drinking individuals unidentified by AUDIT total scores, an additional classification according to AUDIT-C values did not prove useful. Combining AUDIT and AUDIT-C scores might not be sufficient for identifying AUD risk groups among young adult German males. There is an urgent need for a replication of our findings among female participants. [ABSTRACT FROM AUTHOR]

Background: The relationship between driver blood alcohol concentration (BAC) and crash involvement is well understood. However, the role of alcohol use disorders (AUDs) (i.e., dependence or abuse) in crash occurrence, as distinguished from non-clinical heavy alcohol consumption, has not been adequately explored.Methods: Data from the 2010-2011 Crash Risk Study conducted in Virginia Beach, VA, were used in this study. Drivers involved in crashes were compared with control drivers, and four drinker groups were examined: alcohol dependent, alcohol abusers, heavy drinkers, and all other current (i.e., normative) drinkers. Logistic regression analyses were conducted on two outcomes: having a moderate BAC (≥0.05 g/dl), and crash involvement.Results: Overall, 2411 crash-involved and 5514 control drivers provided useable data, 52.4% of which were men and 70.8% Whites. The prevalence of drivers with AUDs was lower for the crash-involved drivers (8.7%) than for the control drivers (12.7%). Only heavy drinkers, but not abusive or dependent drinkers, were over four times more likely to drive with moderate BACs at nighttime. More important, at nighttime, the odds of crash involvement for dependent drinkers were only one third of those for normative drinkers. Daytime crashes, however, were more likely to involve normative drinkers than any of the other three drinker types.Conclusions: Drivers with AUDs are not more likely than normative drinkers to drive with moderate BACs at night. After accounting for the influence of BAC, dependent drinkers have a lower risk of being involved in a crash, at any time of the day. [ABSTRACT FROM AUTHOR]

• We studied the association between long work hours and risky alcohol use and how cumulative exposure to long work hours intensifies the effect. • Alcohol Use Disorders Identification Test was used to assess risky alcohol use. • Working ≥55 h/week was positively related to the onset of risky alcohol use. • Cumulative long work hours increased the likelihood of risky alcohol use in a dose-dependent manner. • Association between long work hours and risky alcohol use was observed in both male and female workers. We aimed to investigate the association between long working hours and onset of risky alcohol use. We included a nationally representative sample comprising 11,226 workers in South Korea (57,887 observations). The Alcohol Use Disorders Identification Test was used to assess risky alcohol use. Fixed effect regressions were employed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Adjusted ORs (95% CIs) of risky alcohol use were 1.08 (0.95–1.22) for 41–48 h/week, 1.12 (0.96–1.31) for 49–54 h/week, and 1.40 (1.21–1.63) for ≥55 h/week, compared with standard working hours (35–40 h/week). ORs (95% CIs) of the association between working ≥55 h/week and risky alcohol use was 1.39 (1.17–1.65) for men and 1.34 (0.98–1.82) for women. Yearly cumulative exposure to long working hours (>40 h/week) is positively associated with risky alcohol use in a dose-dependent manner. For instance, exposure to long working hours for ≥3 years was associated with an increased likelihood of risky alcohol use (OR [95% CI]: 2.20 [1.78–2.72]). Sex-stratified analyses showed that long work hours are associated with risky alcohol use in both male and female workers. Appropriate work-hour policy is needed to prevent workers from risky alcohol use. [ABSTRACT FROM AUTHOR]

Culturally adapted motivational interviewing (CAMI) is a form of motivational interviewing that was adapted to address immigration- and acculturation-related stressors among Latinx adults who met criteria for hazardous drinking. This study hypothesized that (1) receiving CAMI was associated with reduced immigration/acculturation stress and related drinking and that (2) these associations differed by participants' acculturation and perceived discrimination levels. This study employed a single group pre-post study design using data from a randomized controlled trial. Participants were Latinx adults who received CAMI (N = 149). The study assessed immigration/acculturation stress with the Measure of Immigration and Acculturation Stressors (MIAS) and measured related drinking with the Measure of Drinking Related to Immigration and Acculturation Stressors (MDRIAS). The study team conducted linear mixed modeling for repeated measures to examine outcome changes between the baseline and the 6-month and 12-month follow-ups and moderation effects. Compared to baseline, the study found significant decreases in the total MIAS and MDRIAS scores and subscale scores at 6- and 12-month follow-ups. Moderation analysis results showed that lower acculturation levels and higher levels of perceived discrimination were significantly associated with larger decreases at follow-up in total MIAS and MDRIAS scores and several subscale scores. Findings provide preliminary support for CAMI's efficacy in reducing immigration and acculturation stress and related drinking among Latinx adults with heavy drinking problems. The study observed more improvements among the less acculturated and more discriminated participants. Larger studies with more rigorous designs are needed. • Culturally Adapted Motivational Interviewing (CAMI) targets Latinx heavy drinkers. • CAMI is linked to reduced immigration/acculturation stress. • CAMI is linked to reduced immigration/acculturation stress related drinking. [ABSTRACT FROM AUTHOR]

Objective Performance monitoring, which allows efficient behavioral regulation using either internal (error processing) or external (feedback processing) cues, has not yet been explored in binge drinking despite its adaptive importance in everyday life, particularly in the regulation of alcohol consumption. Capitalizing on a theoretical model of risky behaviors, the present study aimed at determining the behavioral and electrophysiological correlates of the cognitive (inhibition) and motivational (reward sensitivity) systems during performance monitoring. Methods Event-related potentials were recorded from 20 binge drinkers and 20 non-binge drinkers during two experimental tasks, a speeded Go/No-Go Task [investigating internal error processing by Error-Related Negativity (ERN) and error positivity (Pe)] and a Balloon Analogue Risk Task [investigating external feedback processing by Feedback-Related Negativity (FRN) and P3]. Results While no group differences were observed at the behavioral level, electrophysiological results showed that binge drinkers, despite having intact feedback-related components, presented modified error-monitoring components (i.e. larger ERN amplitude, delayed Pe latency). Conclusions Internal performance monitoring is impaired in binge drinkers, showing an abnormal automatic processing of response errors (ERN) and a decreased processing of their motivational significance (Pe). Significance These results suggest that the electrophysiological correlates of inhibitory control allow identifying the specific binge drinking consumption pattern. [ABSTRACT FROM AUTHOR]

Background: Despite over 35 years of study, the relationship between life events (LEs) and alcohol use disorder (AUD) treatment outcome lacks consistent empirical support, which may be due to a lack of theoretically driven designs and corresponding statistical analyses. The purpose of this study was to elucidate the LEs-AUD treatment outcome relationship by statistically modeling the dynamic relationship between negative LEs and alcohol use post-treatment, as it is conceptualized within the dynamic model of relapse.Methods: Existing longitudinal data from 417 AUD treatment-seeking adults were randomly assigned to two demographically comparable samples. One sample (N=208) was used to estimate a series of dynamic bivariate latent change score models that differentially relate latent indicators of distal and proximal negative LEs (i.e., events subjectively rated as negative) and percent heavy drinking days across 12 months. Cross-validation was conducted on the second sample (N=209).Results: Findings indicated that distal negative LEs were positively associated with a greater increase in negative LEs, but not heavy drinking, over the subsequent 12 months. Proximal negative LEs were significantly associated with subsequent increases in heavy drinking, though heavy drinking was not a determinant of change in negative LEs. These findings were cross-validated with the second sample.Conclusions: This study provides initial justification for the further study of the LEs-alcohol use relationship as it is described in the dynamic model of relapse. [ABSTRACT FROM AUTHOR]

Objectives The study investigated the relationships between adverse childhood experiences (ACEs) and heavy and binge drinking, stratified by gender. Study design Population-based cross-sectional study. Methods Data were retrieved from 2012 Behavioral Risk Factor Surveillance System. Over 39,000 individuals from five states were included in the study. Multiple logistic regression models were used to analyze the weighted data to determine factors associated with heavy and binge drinking for men and women. Each model included ACEs and controlled for sociodemographic variables, depression and smoking status. Bonferroni method was used to correct multiple comparisons. Results Only a few relationships between ACEs and problem drinking were observed. Among men, living with a drug abuser as a child was significantly associated with both heavy and binge drinking compared to men who did not reside with a drug abuser as a child. Childhood verbal abuse was linked with men's binge drinking compared to men who were not verbally abused as children. Among women, none of the nine ACEs examined in the study were associated with their heavy drinking. Only one ACE, verbal abuse, was found to be correlated with binge drinking, compared to women who did not experience childhood verbal abuse. In addition, we did not find the hypothesized, step-wise, graded relationship between the number of ACEs and heavy and binge drinking. However, the risk of heavy drinking was greater if the individual was exposed to four or more childhood adversities among both men and women. Conclusion Study hypotheses were only partially supported. Future studies should unpack the interplay among gender, socio-economic status, ACEs, and problem alcohol consumption. [ABSTRACT FROM AUTHOR]

Background: Excessive alcohol use among the homeless may contribute to their high rates of emergency department use. Survey-based studies have provided some information on the relation between alcohol and emergency department use among the homeless.Methods: This study used an intensive schedule of random breath collections and self-report assessments to examine the relation between emergency department utilization and alcohol use in homeless alcohol-dependent adults. Data were from homeless alcohol-dependent adults (N=116) who were participating in a therapeutic workplace that provided job-skills training every weekday for 26 weeks. Breath-sample collections and assessments of self-reported alcohol use were scheduled each week, an average of twice per week per participant, at random times between 9:00 A.M. and 5:00 P.M. Participants received $35 for each breath sample collected. Self-reports of emergency department use were assessed throughout the study.Results: Thirty-four percent of participants reported attending an emergency department and reported an average of 2.2 emergency department visits (range 1-10 visits). Alcohol intoxication was the most common reason for emergency department use. Participants who used the emergency department had significantly more alcohol-positive breath samples and more self-reported heavy alcohol use than participants who did not use the emergency department.Conclusions: This study provided a rare intensive assessment of alcohol and emergency department use in homeless alcohol-dependent adults over an extended period. Emergency department use was high and was significantly related to indices of alcohol use. [ABSTRACT FROM AUTHOR]

Background: Nearly 10% of U.S. 12th graders report high-intensity drinking (10+ or 15+ drinks in a row), but the extent to which these drinkers also engage in nonmedical use of prescription drugs (NMUPD) is largely unknown. This study examined the associations between different thresholds of past two-week high-intensity drinking and past-month NMUPD among U.S. 12th graders.Methods: The sample consisted of eleven nationally representative cross-sections of 12th graders in the Monitoring the Future study (2005-2015) who answered questions on past two-week drinking behaviors and past-month nonmedical use of prescription opioids, sedative, stimulants, and tranquilizers (N=26,502 respondents).Results: High-intensity drinking during the past two-weeks was associated with an increased risk of past-month NMUPD. The odds of NMUPD were four times larger among 12th graders who indicated drinking 15 or more drinks on at least one occasion (AOR=4.43, 95% CI=3.18, 5.01) relative to those who had 0-4 drinks during the past two-weeks, after adjusting for relevant covariates. These associations were similar across different classes of prescription drugs and tended to be stronger among non-white respondents. A sub-analysis revealed simultaneous co-ingestion of alcohol and NMUPD was more prevalent among high-intensity drinkers.Conclusions: More than 1 in every 4 U.S 12th graders who engage in high-intensity drinking (15+ drinks in a row) also report NMUPD. Given the greater likelihood of simultaneous co-ingestion of alcohol and prescription drugs among high-intensity drinkers, adolescent substance use interventions need to address the risks associated with mixing alcohol and prescription drugs. [ABSTRACT FROM AUTHOR]

Purpose: A family history of alcoholism has been found associated with problematic alcohol use among college students, but less research has examined the effects of family history density of substance use problems in this population. This study examined the prevalence of family history density of substance use problems and its associations with heavy alcohol use, negative alcohol consequences, and alcohol use disorder in a college sample.Methods: Based on a secondary analysis of a probability sample, data were analyzed from 606 undergraduate students. Family history density of substance use problems included both first and second degree biological relatives. Heavy alcohol use was the total number of days in which participants drank five/four or more drinks for men/women, negative alcohol consequences were derived from items commonly asked in college student surveys, and an alcohol use disorder was defined as meeting diagnostic criteria for alcohol abuse or dependence. Point prevalence estimated rates of family history density of substance use problems, and negative binomial, ANCOVA, and logistic regression models examined associations between family history density and the alcohol variables while adjusting for sociodemographic variables.Results: Family history density of substance use problems was not significantly associated with total days of heavy alcohol use. Having a second degree, a first degree, or both a first and second degree relative(s) with a substance use problem, however, was significantly associated with experiencing negative alcohol consequences. In addition, having both a first and second degree relative(s) with a substance use problem significantly increased the odds of having an alcohol use disorder.Conclusions: Family history density of substance use problems may play a role in experiencing negative alcohol consequences and in having an alcohol use disorder among undergraduate college students and may be an important risk factor to assess by college health professionals. [ABSTRACT FROM AUTHOR]

Responses from N = 60,598 interviews from the 2010 Behavioral Risk Factor Surveillance System (the 10 states and the District of Columbia that included the optional Adverse Childhood Experience (ACE) module) were used to test whether associations between childhood adversity and adult mental health and alcohol behaviors vary by race/ethnicity and sex. ACE items were categorized into two types – household challenges and child abuse. Outcomes were current depression, diagnosed depression, heavy drinking and binge drinking. Logistic regression models found ACEs significantly associated with depression and excessive alcohol use, but sex did not moderate any relationships. Race/ethnicity moderated the relationship between ACEs and heavy drinking. In stratified analyses, compared to those not exposed to ACEs, non-Hispanic blacks who experienced either type of ACE were about 3 times as likely to drink heavily; Non-Hispanic whites who experienced child abuse or both ACE types were 1.5–2 times as likely to drink heavily; and Hispanics who experienced household challenges or both ACE types were 1.2 and 11 times as likely to report heavy drinking. ACEs impact depression and excessive alcohol use similarly across men and women. With the exception of heavy drinking, ACEs appear to have the same association with excessive alcohol use across race/ethnicity. It may be prudent to further investigate why the relationship between ACEs and heavy drinking may differ by race/ethnicity such that prevention strategies can be developed or refined to effectively address the needs of all sub-groups. [ABSTRACT FROM AUTHOR]

Distress tolerance (DT) has been considered an important contributor to manifestation, maintenance, and relapse of alcohol use problems. However, factors that could influence DT among heavy drinkers are unclear. The current study examined the role of affects linked to avoidance/withstanding behavioral options in deciding whether to withstand distressful experiences with a sample of heavy drinkers. To this end, the author administered a well-validated instrument to assess implicit affective associations of avoidance/withstanding options to 36 heavy drinkers and conducted ecological momentary assessment to measure DT of the participants for one week. Multilevel model analyses revealed that affects linked to avoidance/withstanding options were closely related to DT. Affects linked to avoidance/withstanding options could influence DT in heavy drinkers and warrant further exploration. [ABSTRACT FROM AUTHOR]

Adolescence and early adulthood are periods of particular vulnerability to the neurotoxic effects of alcohol. Young people with alcohol-use disorders display deficits in working memory (WM). This function is supported by the prefrontal cortex, a late-maturing brain region. However, little is known about the progression of cognitive dysfunctions associated with a binge-drinking (BD) pattern of alcohol consumption among non-clinical adolescents. The objective of this study was to analyze the relationship between BD trajectory and WM in university students. An initial sample of 155 male and female first-year university students was followed prospectively over 6 years. The participants were classified as stable non-BDs, stable BDs, and ex-BDs, according to the third item of the Alcohol Use Disorders Identification Test (AUDIT). WM was assessed using the Self-Ordered Pointing Task. Generalized linear mixed models were applied. The results showed that stable BDs committed more total perseverative errors and showed a lower WM span in the difficult blocks than stable non-BDs. Difficulties in WM span showed some improvement, whereas perseveration errors remained constant throughout the follow-ups in the stable BDs. There were no significant differences between ex-BDs and non-BDs. In conclusion, stable BD is associated with WM deficits, particularly perseverations and low WM span in demanding trials, when compensatory mechanisms may no longer be successful. The partial improvement in WM span may support the notion of a neuromaturational delay, whereas the temporal stability of perseveration deficits may reflect either neurotoxic effects of alcohol or premorbid characteristics. Abandoning the BD pattern of alcohol consumption may lead to partial recovery. [ABSTRACT FROM AUTHOR]

Alcohol and smoking frequently co-occur and alcohol is a primary trigger for smoking behavior and relapse back to smoking. This study examined whether several indices of alcohol use behavior and consequences of use would be associated with changes in implicit alcohol-approach versus implicit cigarette-approach cognitions under cigarette deprived and non-deprived cognitions in 109 smokers who drank at risky or non-risky levels. An Implicit Association Task (IAT) measured how quickly respondents paired alcohol and cigarette pictures with approach and avoid words. Regression analyses examined the associations of quantity/frequency, proportion heavy drinking days, number of DSM-IV alcohol use disorder (AUD) symptoms, and risky drinking status to IAT scores under deprived conditions, controlling for IAT order effects, non-deprived IAT score, and deprived cigarette craving and withdrawal. Interactions with craving and withdrawal intensity were also examined. Results showed a significant positive association between proportion of heavy drinking days and stronger alcohol-approach than cigarette-approach motivations when deprived. There was also a conditional association of AUD symptoms to alcohol-approach motivations among respondents reporting more intense withdrawal when deprived. Alcohol quantity and frequency, as well as risky drinking status were unrelated to change in IAT scores. Findings suggest that cigarette deprivation may magnify motivation to drink, rather than smoke, among smokers who engage in more frequent bouts of heavy drinking and who report more alcohol-related problems. Results also show relative momentary and unconscious "preference" or choice for alcohol over cigarettes in some high-risk smokers, when cigarette craving and withdrawal are high. [ABSTRACT FROM AUTHOR]

Background: To examine whether a clinically meaningful alcohol consumption cutoff can be created for clinical samples, we used receiver operator characteristic (ROC) curves to derive gender-specific consumption cutoffs that maximized sensitivity and specificity in the prediction of a wide range of negative consequences from drinking.Methods: We conducted secondary data analyses using data from two large clinical trials targeting alcohol use disorders: Project MATCH (n=1726) and COMBINE (n=1383).Results: In both studies, we found that the ideal cutoff for men and women that maximized sensitivity/specificity varied substantially both across different alcohol consumption variables and alcohol consequence outcomes. Further, the levels of sensitivity/specificity were poor across all consequences.Conclusions: These results fail to provide support for a clinically meaningful alcohol consumption cutoff and suggest that binary classification of levels of alcohol consumption is a poor proxy for maximizing sensitivity/specificity in the prediction of negative consequences from drinking. Future research examining consumption-consequence associations should take advantage of continuous measures of alcohol consumption and alternative approaches for assessing the link between levels of consumption and consequences (e.g., ecological momentary assessment). Clinical researchers should consider focusing more directly on the consequences they aim to reduce instead of relying on consumption as a proxy for more clinically meaningful outcomes. [ABSTRACT FROM AUTHOR]

Background: Racial/ethnic minorities bear a disproportionate burden of alcohol-related problems in the U.S. It is unknown whether this reflects harmful patterns of lifecourse heavy drinking. Prior research shows little support for the latter but has been limited to young samples. We examine racial/ethnic differences in heavy drinking trajectories from ages 21 to 51.Methods: Data on heavy drinking (6+ drinks/occasion) are from the 1979 National Longitudinal Survey of Youth (N=9468), collected between 1982 and 2012. Sex-stratified, generalized estimating equations (GEE) were used to model heavy drinking frequency trajectories as a function of age with a cubic curve, and interactions of race with age terms were tested to assess racial/ethnic differences. Models adjusted for time-varying socioeconomic status and marital and parenting status; predictors of trajectories were examined in race- and sex-specific models.Results: White men and women had similarly steep declines in heavy drinking frequency throughout the 20s, contrasting with slower declines (and lower peaks) in Black and Hispanic men and women. During the 30s there was a Hispanic-White crossover in men's heavy drinking curves, and a Black-White female crossover among lifetime heavy drinkers; by age 51, racial/ethnic group trajectories converged in both sexes. Greater education was protective for all groups.Conclusion: Observed racial/ethnic crossovers in heavy drinking frequency following young adulthood might contribute to disparities in alcohol-related problems in middle adulthood, and suggest a need for targeted interventions during this period. Additionally, interventions that increase educational attainment may constitute an important strategy for reducing heavy drinking in all groups. [ABSTRACT FROM AUTHOR]

Theory of mind (ToM) – the ability to understand others' beliefs, mental states, and knowledge – is an important part of successful social interaction. There is a growing (albeit mixed) evidence base suggesting that individuals with substance use disorder or who are intoxicated (relative to sober controls) perform worse on a number of ToM tasks. The aim of this study was to explore the hitherto little explored notion that ToM-related capabilities such as the ability to see the world from another person's perspective (termed Visual Perspective Taking; VPT), may be impacted by alcohol-related stimuli. In this pre-registered study, 108 participants (M age = 25.75, SD age = 5.67) completed a revised version of the director task where they followed the instructions of an avatar to move both alcohol beverages and soft drinks that were mutually visible (target objects) while avoiding those only visible to the participant (distractor items). Contrary to predictions, accuracy was lower when the target drink was alcohol and the distractor was a soft drink, although higher AUDIT scores were associated with significantly lower accuracy when alcohol drinks were the distractor items. There may be some contexts when being able to see alcohol beverages makes it harder to take another person's perspective. It also appears that poorer VPT and perhaps ToM capacity may be evident in individuals who consume more alcohol. Future research is warranted to examine how alcohol beverages, alcohol consumption behaviours, and intoxication interact to impact VPT capacity. • The ability to understand others' perspectives is important for social interactions. • Seeing alcohol beverages may make it harder to take another's perspective. • Heavier consumption may be associated with poorer Visual Perspective Taking capacity. [ABSTRACT FROM AUTHOR]

Background: A clinical trial demonstrated that a therapeutic workplace could promote alcohol abstinence in homeless, alcohol-dependent adults. This secondary-data analysis examined rates of homelessness and their relation to the therapeutic workplace intervention and alcohol use during the trial.Methods: In the trial, homeless, alcohol-dependent adults could work in a therapeutic workplace for 6 months and were randomly assigned to Unpaid Training, Paid Training, or Contingent Paid Training groups. Unpaid Training participants were not paid for working. Paid Training participants were paid for working. Contingent Paid Training participants were paid for working if they provided alcohol-negative breath samples. Rates of homelessness during the study were calculated for each participant and the three groups were compared. Mixed-effects regression models were conducted to examine the relation between alcohol use (i.e., heavy drinking, drinks per drinking day, and days of alcohol abstinence) and homelessness.Results: Unpaid Training, Paid Training, and Contingent Paid Training participants did not differ in the percentage of study days spent homeless (31%, 28%, 17%; respectively; F(2,94)=1.732, p=0.183). However, participants with more heavy drinking days (b=0.350, p<0.001), more drinks per drinking day (b=0.267, p<0.001), and fewer days of alcohol abstinence (b=-0.285, p<0.001) spent more time homeless.Conclusions: Reducing heavy drinking and alcohol use may help homeless, alcohol-dependent adults transition out of homelessness. [ABSTRACT FROM AUTHOR]

Background: Drawing on a survey of transgender people in Canada's most populous province, we estimate the frequency of heavy episodic drinking (HED), compare HED prevalence to the age-standardized background population, and examine associations with socio-demographics, gender transition, and social exclusion.Methods: 433 transgender persons aged 16+ completed a respondent-driven sampling survey in 2009-2010. Analyses were weighted using RDS II methods, including frequencies and prevalence ratios. Overall and sex-specific estimates of HED among Ontario residents in the 2009-2010 Canadian Community Health Survey (n=39,980) were standardized to the overall and gender-specific transgender age distributions.Results: Estimated prevalence of HED at least monthly among transgender Ontarians was 33.2% (95% CI: 26.3, 40.1), 1.5 times greater than expected based on the age-standardized Ontario population. Transmasculine (female-to-male spectrum) persons were more likely than transfeminine persons to report HED (42.2% versus 22.7%), an effect robust to covariate adjustment. Current sex work was associated with greater HED, but gender transition and social exclusion factors were not.Conclusion: Gendered pathways to alcohol misuse, particularly among transmasculine persons, warrant further research and intervention development. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this study was to examine the relation between affects linked to avoidance/withstanding options and distress tolerance in heavy drinkers. It has been suggested that the expected rewards of taking withstanding options and the expected punishments of taking avoidance options could have an influence on judgment regarding withstanding ongoing distress. However, there are no studies that have tested this hypothesis. Thus, we measured the affects linked to each option and examined their relations with distress tolerance based on the theoretical/empirical evidence that proves that affects reflect the expected rewards and punishments of certain options. We hypothesized that affects linked to avoidance/withstanding options are closely related to distress tolerance in heavy drinkers.Methods: Forty heavy drinkers completed a self-report measure that assessed the affective associations of options and took a behavioral task indexing distress tolerance.Results: Hierarchical regression analyses revealed that affects linked to avoidance/withstanding options are closely associated with distress tolerance, even after controlling for negative emotional experiences and alcohol use problems.Conclusions: Our findings indicate that affects linked to avoidance/withstanding options may have an important influence on distress tolerance and therefore deserve further explorations. [ABSTRACT FROM AUTHOR]

Predrinking (or pregaming) is common among undergraduates and has been linked with problem alcohol use. While many students predrink to save money, evidence suggests that some students predrink to cope with social anxiety (SA). Tension reduction and cognitive theories predict that those high in SA may predrink to reduce anticipatory anxiety before attending social events and their predrinking may be done alone rather than in normative social contexts. Available data suggest that, relative to social drinking, solitary drinking elevates risk for alcohol use and related problems. Informed by this evidence, we speculated that context for predrinking may be an important mechanism by which SA-risk for alcohol use unfolds. Specifically, we offered the novel hypothesis that those high in SA would engage frequently in solitary predrinking and this in turn would be associated with elevated alcohol use and related problems. Undergraduate drinkers (N=293; 70% women) completed self-reports of social anxiety, predrinking context (social, solitary), alcohol use, and alcohol-related problems. In partial support of our hypotheses, SA was a positive predictor of solitary predrinking, which in turn predicted elevated alcohol-related problems, but not alcohol use. While not hypothesized, we also found that SA was a negative predictor of social predrinking, which in turn reduced risk for alcohol use and related problems. Our study is the first in the literature to show that solitary predrinking helps explain the well-documented association between SA and alcohol-related problems. These findings may inform etiological models and clinical interventions, suggesting that SA-risk for problem drinking begins even before the party starts. [ABSTRACT FROM AUTHOR]

Background: This study uses national survey data to examine the veracity of the longstanding belief that, compared to whites, Native Americans (NA) have elevated alcohol consumption.Methods: The primary data source was the National Survey on Drug Use and Health (NSDUH) from 2009 to 2013: whites (n=171,858) and NA (n=4,201). Analyses using logistic regression with demographic covariate adjustment were conducted to assess differences in the odds of NA and whites being alcohol abstinent, light/moderate drinkers (no binge/heavy consumption), binge drinkers (5+ drinks on an occasion 1-4 days), or heavy drinkers (5+ drinks on an occasion 5+ days) in the past month. Complementary alcohol abstinence, light/moderate drinking and excessive drinking analyses were conducted using Behavioral Risk Factor Surveillance System (BRFSS) data from 2011 to 2013: whites (n=1,130,658) and NA (n=21,589).Results: In the NSDUH analyses, the majority of NA, 59.9% (95% CI: 56.7-63.1), abstained, whereas a minority of whites, 43.1% (CI: 42.6-43.6), abstained-adjusted odds ratio (AOR): 0.64 (CI: 0.56-0.73). Approximately 14.5% (CI: 12.0-17.4) of NA were light/moderate-only drinkers, versus 32.7% (CI: 32.2-33.2) of whites (AOR: 1.90; CI: 1.51-2.39). NA and white binge drinking estimates were similar-17.3% (CI: 15.0-19.8) and 16.7% (CI: 16.4-17.0), respectively (AOR: 1.00; CI: 0.83-1.20). The two populations' heavy drinking estimates were also similar-8.3% (CI: 6.7-10.2) and 7.5% (CI: 7.3-7.7), respectively (AOR: 1.06; CI: 0.85-1.32). Results from the BRFSS analyses generally corroborated those from NSDUH.Conclusions: In contrast to the 'Native American elevated alcohol consumption' belief, Native Americans compared to whites had lower or comparable rates across the range of alcohol measures examined. [ABSTRACT FROM AUTHOR]

Background: Public policies are a powerful tool to change behaviors that may harm population health, but little is known about how state alcohol policies affect different population groups. This study assesses the effects of a comprehensive measure of the state alcohol regulatory environment (the State Alcohol Policy Score or SAPS) on heavy drinking-a risk factor for premature death-on different population groups, defined by levels of educational attainment, then by race/ethnicity, and sex.Methods: We pool each state's Behavioral Risk Factor Surveillance Survey (BRFSS) 2011-2019 and use robust Poisson regression analyses that control for individual-level factors, state-level factors (1 year lagged SAPS score for each state, state fixed effects), and year fixed effects to assess the relationship between SAPS and heavy drinking behaviors by education group. Interaction terms test whether education moderates the relationship by race/ethnicity and gender.Results: SAPS scores increased 2010-2018, but substantial gaps persist between states. A 10 % increase in a state's alcohol policy score is associated with a 2 % lower prevalence in current drinking (APR=0.97, 95 % CI=0.97-0.97, p < 0.0011) although not for those with a high school education or less. A 10 % increase in the SAPS was associated with a 3 % lower prevalence of heavy drinking; interaction terms in models reveal that a 10 % increase in the SAPS was associated with a lower prevalence of heavy drinking among those with less than a college education.Conclusion: Narrowing gaps in alcohol policies between states may reduce heavy drinking among those with lower educational attainment. [ABSTRACT FROM AUTHOR]

The purpose of this mixed methods study was to describe the smoking and psychological characteristics of heavy-drinking smokers, their perceptions of smoking and drinking, and their smoking and alcohol treatment preferences to inform an integrated smoking and alcohol intervention. Heavy-drinking smokers (N=26) completed standardized surveys and participated in semi-structured focus group interviews. Participants reported a strong association between their smoking and drinking. Participants were more motivated to quit smoking than to reduce their drinking but perceived greater barriers to smoking cessation. Stress/negative affect was closely linked with both behaviors. They expressed overall enthusiasm for a smoking and alcohol intervention but had specific format and content preferences. Half preferred an integrated treatment format whereas others preferred a sequential treatment model. The most preferred content included personalized health feedback and a way to monitor health gains after behavior changes. [ABSTRACT FROM AUTHOR]

Objective The literature indicates that protective behavioral strategies (PBS) have been effective in addressing problem drinking among college students. However, the effects of PBS on problem drinking have not been thoroughly investigated among Korean college students. Thus, the two study aims were to (a) examine drinking behavior among Korean college students and (b) investigate the effects of PBS on problem drinking. Methods A pilot study was first conducted to obtain information needed to determine a sample size and to examine the understandability and reliability of seven instruments. The instruments were then used to collect data from full-time college students ( N = 479). The data were analyzed using (a) descriptive statistics such as frequencies and means for the first aim and (b) multivariate logistic regression for the second aim. Results Approximately 93% of the respondents had drunk alcohol during the month before the survey, and 72.7% were problem drinkers. The use of PBS significantly decreased the odds of problem drinking (odds ratio [OR] = 0.90 [95% CI, 0.87–0.93]). In addition, male gender and positive alcohol expectancy were associated with increased odds of problem drinking (ORs = 3.32 [95% CI, 1.59–6.94] and 1.04 [95% CI, 1.01–1.08]), whereas greater age of drinking onset was associated with decreased odds of problem drinking (OR = 0.81 [95% CI, 0.70–0.94]). Conclusions Given the prevalence of the drinking problem among Korean college students, it is important to develop and implement interventions that will encourage students to use PBS in order to avoid problem drinking and its negative consequences. [ABSTRACT FROM AUTHOR]

Aims: This study investigated which ethyl glucuronide immunoassay (EtG-I) cutoff best detects heavy versus light drinking over five days in alcohol dependent outpatients.Methods: A total of 121 adults with alcohol use disorders and co-occurring psychiatric disorders took part in an alcohol treatment study. Participants provided self-reported drinking data and urine samples three times per week for 16-weeks (total samples=2761). Agreement between low (100 ng/mL, 200 ng/mL), and moderate (500 ng/mL) EtG-I cutoffs and light (women ≤3 standard drinks, men ≤4 standard drinks) and heavy drinking (women >3, men >4 standard drinks) were calculated over one to five days.Results: The 100 ng/mL cutoff detected >76% of light drinking for two days, and 66% at five days. The 100 ng/mL cutoff detected 84% (1 day) to 79% (5 days) of heavy drinking. The 200 ng/mL cutoff detected >55% of light drinking across five days and >66% of heavy drinking across five days. A 500 ng/mL cutoff identified 68% of light drinking and 78% of heavy drinking for one day, with detection of light (2-5 days <58%) and heavy drinking (2-5 days <71%) decreasing thereafter. Relative to 100 ng/mL, the 200 ng/mL and 500 ng/mL cutoffs were less likely to result in false positives.Conclusions: An EtG-I cutoff of 100 ng/mL is most likely to detect heavy drinking for up to five days and any drinking during the previous two days. Cutoffs of ≥500 ng/mL are likely to only detect heavy drinking during the previous day. [ABSTRACT FROM AUTHOR]

Background Heavy drinking is highly comorbid with nicotine and marijuana use among young adults. Yet, our knowledge about the longitudinal effects of nicotine and marijuana use (including onset timing and quantity/frequency) on heavy drinking and whether the effects vary by gender is very limited. This study aims to characterize gender-specific developmental trajectories of multiple substance use and to examine gender differences in the effects of nicotine and marijuana use on heavy drinking. Methods We conducted secondary analysis on 8 waves of data from 850 high-risk youth who were recruited as ninth graders with low GPA in an economically disadvantaged school district in the Midwest and were followed up annually to young adulthood. Onset ages and quantity/frequency of multiple substance use were assessed by a self-report questionnaire at each wave. The time-varying effect model and linear mixed model were adopted for statistical analysis. Results Males' levels of heavy drinking, nicotine use, and marijuana use tended to grow persistently from adolescence to emerging adulthood. Females, on the other hand, only gradually increased their nicotine use across time while maintaining low levels of heavy drinking and marijuana use. Controlling for the early onset status of alcohol use, early onset statuses of nicotine use and marijuana use both added additional risk for heavy drinking; late onset marijuana users were also at higher risk for heavy drinking than nonusers of marijuana. Controlling for substance use onset statuses, higher quantity/frequency of nicotine and marijuana use both contributed to more involvement in heavy drinking. We also found that the effect of nicotine use quantity on heavy drinking was greater among males. Conclusions Our study demonstrates the longitudinal effects of onset timing and quantity/frequency of nicotine and marijuana use on heavy drinking. Our analysis of gender differences also identifies female youth's nicotine use and male youth's co-use of nicotine and alcohol as two important areas for future prevention and intervention work. [ABSTRACT FROM AUTHOR]

Introduction Little epidemiological evidence exists on alcohol or other substance use and related problems along the U.S.–Mexico border, although the border has been the focus of recent media attention related to the escalating drug/violence “epidemic”. The purpose of this study was to analyze the association of variables related to crossing the border (cross-border mobility) with three substance use outcomes reported for the last year: 1) heavy drinking (5 + drinks per day for men or 4 + for women), 2) alcohol use disorder (AUD), and 3) co-occurring heavy drinking and drug use (any use of illicit and/or non-medically prescribed drugs). Methods Household surveys were conducted, using area probability sampling of 1565 Mexican-American residents, aged 18–65, living at the Texas–Mexico border in the metropolitan areas of Laredo and McAllen/Brownsville. Results Among those 18–29, more frequent crossing of the border was significantly predictive of AUD (OR = 1.61, p < 0.01) and co-occurring heavy drinking and drug use (OR = 1.70, p < 0.01). Staying more than one full day was predictive of AUD (OR = 3.07, p < 0.001) and crossing to obtain over-the-counter or prescription drugs (“drug tourism”) or for nightlife/drinking were predictive of heavy drinking (ORs = 4.14, p < 0.001; 3.92, p < 0.01, respectively), AUD (ORs = 7.56, p < 0.001; 7.68, p < 0.01, respectively) and co-occurring heavy drinking and drug use (ORs = 8.53, p < 0.01; 4.96, p < 0.01, respectively). Among those 30–65, staying more than a full day and crossing for pharmaceutical reasons were predictive of heavy drinking (OR = 2.54, p < 0.001; 2.61, p < 0.05, respectively) and co-occurring heavy drinking and drug use (OR = 3.31, p < 0.001; 4.86, p < 0.01, respectively), while none of the mobility variables were predictive of AUD in this age group. Conclusions Cross-border mobility may play an important role in substance use and problems, especially among those 18–29. Findings also highlight the importance of “drug tourism” in substance use across the age spectrum. [ABSTRACT FROM AUTHOR]

Heavy drinkers in Scotland may consume 1600 g ethanol per week. Due to its low price, cider may be preferred over other beverages. Anecdotal evidence has linked cider to specific health hazards beyond other alcoholic beverages. To examine this hypothesis, nine apple and pear cider samples were chemically analysed for constituents and contaminants. None of the products exceeded regulatory or toxicological thresholds, but the regular occurrence of acetaldehyde in cider was detected. To provide a quantitative risk assessment, two collectives of exclusive drinkers of cider and vodka were compared and the intake of acetaldehyde was estimated using probabilistic Monte–Carlo type analysis. The cider consumers were found to ingest more than 200-times the amount of acetaldehyde consumed by vodka consumers. The margins of exposure (MOE) of acetaldehyde were 224 for the cider and over 220,000 for vodka consumers. However, if the effects of ethanol were considered in a cumulative assessment of the combined MOE, the effect of acetaldehyde was minor and the combined MOE for both groups was 0.3. We suggest that alcohol policy priority should be given on reducing ethanol intake by measures such as minimum pricing, rather than to focus on acetaldehyde. [ABSTRACT FROM AUTHOR]

Background To examine the relationship of alcohol consumption, alcohol use disorder and mortality. Method A cohort of 4316 male former Vietnam-era US army personnel participating in telephone survey and medical examination in middle age (mean age 38.3 years) in 1985–1986 was used. Alcohol consumption was reported in face-to-face interview on medical history and information on DSM-III alcohol use disorder was obtained from structured psychiatric interview (using the Diagnostic Interview Schedule). Mortality hazard during 15 years of follow-up was assessed with Cox proportional hazard regression modeling. Result A total of 4251 individuals participated in the psychiatric interview and the medical history interview. Of these 998 were abstainers, and for the remaining 3253 we calculated weekly average consumption and monthly frequency of binge drinking. A total of 1988 had alcohol dependence, abuse or both. There were 237 deaths during follow up. A J-shaped association was found for both consumption and binging. In multivariable analysis jointly modeling average consumption and disorder, and binging and disorder, increased mortality remained significant for both very high consumption (Hazard Ratio (HR) 1.62, 95% Confidence Intervals [1.02–2.57]) for drinking 29 or more drinks per week, and frequent bingeing HR 1.81 [1.03–3.18] for bingeing 16 or more times per month). Conclusion This study showed that alcohol consumption measures were associated with mortality, partly independent from the potential confounding effect of alcohol use disorder, which is an established risk factor for mortality. This further highlights the importance of alcohol consumption measures in public health. [ABSTRACT FROM AUTHOR]