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Problem drinking is a perennial concern in the US fire service. A large literature has documented the importance of addressing alcohol norms in intervention research. The purpose of this study was to explore alcohol norms in a national cohort of firefighters (FFs) to inform intervention development in this occupational group.Data were from a national online survey of career and volunteer FFs (N = 674). Participants were recruited through national fire service listservs and a database of FFs who had agreed to be contacted for research.When asked about "acceptable" levels of alcohol consumption, FFs on average suggested levels which exceeded public health guidelines. Further, approximately half of career and volunteer FFs believed that, at least under some circumstances, drinking until intoxicated was normative. When asked how long should elapse between a FFs last drink and reporting for duty, the average suggested lag was 11.2 hours (sd = 4.6). However, among male volunteer FFs who reported heavy drinking, the average was 6.68 hours (sd = 4.77).Given the high prevalence of heavy and binge drinking in the fire service, it is not surprising that the alcohol norms found in this study were consistent with a culture of drinking. Participants' reports of alcohol use among their peers were consistent with the actual prevalence of problem drinking. Thus, education and prevention efforts in this occupation should focus on changing norms about alcohol use, including linking heavy drinking to other health and safety issues they face.

Urban ED patients have elevated rates of substance use and intimate partner violence. The purpose of this study is to describe the risk profiles for intimate partner violence among urban ED patients who report at-risk alcohol use only, cannabis use only, or both types of substance use.Cross-sectional survey data were collected from study participants (N = 1037; 53% female; ages 18-50) following informed consent. We measured participants' past-year at-risk drinking (women/men who had 4+/5+ drinks in a day), cannabis use, psychosocial and demographic characteristics, and past-year physical intimate partner violence (assessed with the Revised Conflict Tactics Scale). We used bivariate analysis to assess whether rates of intimate partner violence perpetration and victimization differed by type of substance use behavior. Multivariate logistic regression models were estimated for each intimate partner violence outcome. All analyses were stratified by gender.Rates of intimate partner violence differed significantly by type of substance use behavior and were highest among those who reported both at-risk drinking and cannabis use. Multivariate analysis showed that women who reported at-risk drinking only, cannabis use only, or both types of substance use had increased odds for intimate partner violence perpetration and victimization compared with women who reported neither type of substance use. Men's at-risk drinking and cannabis use were not associated with elevated odds of intimate partner violence perpetration or victimization.Brief screening of patients' at-risk drinking and cannabis use behaviors may help identify those at greater risk for intimate partner violence and those in need of referral to treatment.

This paper examines trends and population-level correlates of violent crime rates from 2005 to 2017 in California, including proximity to the U.S./Mexico border and alcohol outlet density. Crime data come from the Crimes and Clearances report compiled by the California Department of Justice. These and U.S. Census data were aggregated at the level of 499 Law Enforcement Reporting Areas (LERA) that contributed to the report. Reported crime rates were related to area characteristics using hierarchical Bayesian Poisson space-time models. Violent crime rates declined 16% from 2005 to 2017. Crime rates were positively related to distance to the border, total alcohol outlet density, percent outlets that are bars and pubs, percent population Black, percent population Hispanic, percent population 30–49 years of age, percent population U.S. born, percent 150% below federal poverty level, percent high school graduate, and percent houses vacant. Violent crimes were negatively related to percent total outlets that are off-premise, percent population male, percent with higher than 2017 adjusted median income, percent owner occupied houses, and lower population density. In conclusion, several population level characteristics including ethnic composition, community socioeconomic stability, and alcohol availability are associated with violent crime rates. Contrary to public perceptions, violent crime rates increase as distance to the Mexico border increases.

Objective To describe the prevalence of substance use and the associations between adverse early life experiences, sexual behaviour and violence in sexual minority (SM) individuals. Methods The Brazilian National Alcohol and Drugs Survey is a probabilistic household survey performed in 2012, collecting data from 4067 Brazilians aged 14 years and older. Results 3.4% of the sample declared themselves as sexual minorities, 53.8% female, 66.5% single, mean age of 29.5 years (standard deviation 16.0 years). A high prevalence of alcohol dependence (15.2%) and binge drinking (22.2%) was identified in the SM group. Respondents were more likely to use crack cocaine and hallucinogens, to have been involved in child prostitution, child sexual abuse and to report suicidal ideation in the previous year. Respondents were also more likely to engage in unprotected sex compared to non-sexual minorities. Nearly one-third referred to having suffered homophobic discrimination in their lives. Respondents also reported higher rates of domestic violence (18.9%) and urban violence (18%) among the SM. Conclusion The findings reinforce that violence directed at individuals in the Brazilian SM community begins early in life and persists into adulthood when compared to non-sexual minorities. This population is also more exposed to substance use disorders.

Background Border Mexican Americans (MA) are exposed to poverty and under-education, all of which are predictors of cigarette smoking. Methods This study analyzed two epidemiologic surveys among border and non-border MA. In the border sample, interviews were conducted in urban areas of U.S.-Mexico border counties of California, Arizona, New Mexico, and Texas. The non-border sample consisted of respondents interviewed in Los Angeles, Houston, New York, Philadelphia, and Miami. Analyses were stratified by gender, adjusted for age and education, and modeled the effects of acculturation and binge drinking on cigarette smoking behavior. Results There were 2595 respondents, 1307 residing in border counties and 1288 from 5 other cities. There was no difference in cigarette smoking in the past 12 months between border and non-border MA among men (25.8% vs. 29.4%) or women (9.4% vs. 9.9%), respectively. Acculturation was not significantly related with cigarette smoking among men; however, women with high acculturation levels were more marginally likely to be past year smokers than those with low acculturation (RRR = 2.06, 95% CI 0.97–4.78). Binge drinking was associated with being past year smoker in both men (RRR = 3.54, 95% CI = 2.31–5.42) and women (RRR = 2.23, 95% CI 1.17–4.27), but not with being a former smoker. Conclusions Border residence did not influence cigarette smoking behavior among Mexican Americans and both groups had significant associations between smoking and binge drinking.

Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18-30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure.Copyright © 2016. Published by Elsevier Ltd. Language: en

Research has shown differences in alcohol use and problems across race/ethnicity. This study examines whether there are differential effects of alcohol use disorder (AUD) symptoms on drinking outcomes across race/ethnicity. Data from 1483 patients admitted to a hospital for treatment of an injury were utilized (19% Black, 45% non-Latino White, and 36% Latino). AUD symptoms and race/ethnicity reported at baseline and their interaction were the predictor variables. Drinking patterns and associated problems measured at the 6- and 12-month follow-up were the outcome variables of interest. Linear regression was the analytic method employed. Endorsement of "spending a great deal of time to obtain, use, or recover from effects of drinking," "craving," "failure to fulfill major role obligations," and "alcohol use in physically hazardous situations" at baseline was associated with greater levels of subsequent alcohol use and alcohol-related problems at both 6- and 12-month follow-ups, regardless of race/ethnicity. Endorsement of "important social, occupational, or recreational activities given up because of drinking" was differentially associated with greater alcohol-related problems at both 6- and 12-month follow-ups dependent on race/ethnicity. Follow-up analyses indicated that this symptom was a significant predictor of alcohol problems among Latino and Black participants, but not non-Latino White participants. Brief interventions targeting these AUD symptoms could increase the effectiveness of brief motivational interventions among different racial/ethnic groups.

Purpose The drinking practices of a nationally representative sample of white, black, Mexican American, and other Hispanic adult diabetics are described and compared. Methods Combined years (2005/2006–2011/2012) of the National Health and Nutrition Examination Survey provided home interview data from 2220 adults with self-reported diabetes of white ( n = 875), black ( n = 720), Mexican American ( n = 402), and other Hispanic ( n = 223) ethnicity. Current drinking status, the number of drinks consumed per week, and binge drinking were compared across ethnicity. Results The multivariate findings for both diabetic men and women showed no statistically significant ethnic differences in current drinking status, and among women, there were no statistically significant ethnic differences in binge drinking. Among male diabetics, Mexican Americans consumed more drinks per week than whites ( b = 0.35; 95% confidence interval, 0.13–0.58; P = .002) and were at increased risk for binge drinking (odds ratio, 2.04; 95% confidence interval, 1.30–3.21; P = .002). Conclusions Binge drinking is prevalent among Mexican American male diabetics. This pattern of drinking may put them at risk for poor diabetes management and control. It is important that health care providers routinely assess their patients' drinking practices and address the health risks associated with alcohol consumption.

The goal of this study was to investigate gambling-related behavior, onset and progression in a sample of at-risk gamblers from the community. A national household survey was conducted in Brazil, covering individuals 14 years old or older. Subjects were screened for at-risk gambling, those testing positive answered a questionnaire about gambling progression, preferred games and DSM-IV pathological gambling criteria. Out of 3007 respondents, 118 were considered at-risk gamblers according to the Lie/Bet Questionnaire. According to the DSM-IV, 32.7% and 24.9% of those were considered problem and pathological gamblers, respectively. Early at-risk gamblers (onset prior to 20 years of age), were more likely to be male, to prefer non-commercially structured games, and to chase losses while gambling. Young pathological gamblers (under 35 years of age) progressed faster from regular to problem gambling (roughly 2 years) than mature pathological gamblers (12 years). Such findings had not been described before because previous reports focused mostly on clinical samples that lack young, male, early-onset gamblers. Gambling programs have not satisfactorily covered this segment of gamblers. Outreach strategies and early interventions should be provided to prevent these individuals from rapidly evolving into pathological gambling.

Studies have shown that moderate alcohol use confers protection against some of the dominant predictors of long-term care placement, including diminished cognitive functioning, physical disability, and injury. But little is known about the association between alcohol use and the likelihood of placement in long-term care facilities. A nationally representative sample of 5,404 community-dwelling Canadians ages 50 years and older at baseline (1994/95) was obtained from the longitudinal National Population Health Survey. Alcohol use categories were developed based on the quantity and frequency of use in the 12 months before the interview. Cox proportional hazards models were used to estimate the association between alcohol use at baseline and subsequent placement in long-term care facilities after adjusting for covariates measured at baseline. During the 14-year follow-up period, 14% of lifetime abstainers, 10% of former drinkers, 7% of infrequent drinkers, 4% of moderate drinkers, and 3% of heavy drinkers were placed in long-term care facilities. Furthermore, the multivariate analysis revealed that abstainers, former drinkers, and infrequent drinkers were more than twice as likely to be placed in long-term care as moderate drinkers. Moderate drinking was protective against placement in long-term care facilities even after adjusting for an array of well-known confounders. The strong protective effect of moderate alcohol use on long-term care entry is likely due to a complex mix of physical, cognitive and psychosocial health factors.

Research on ethnic health disparities requires the use of psychometrically sound instruments that are appropriate when applied to ethnically diverse populations. The Short Inventory of Problems (SIP) assesses alcohol-related consequences and is often used as a measure to evaluate intervention effectiveness in alcohol research; however, whether the psychometric properties of this instrument are comparable across language and ethnicity remains unclear.Multi-group confirmatory factor analysis (MGCFA) was used to test for the invariance of the measurement structure of the SIP across White Non-Hispanic English speaking (N=642), Hispanic English speaking (N=275), and Hispanic Spanish speaking (N=220) groups.The MGCFA model in which factor loadings, measurement intercepts, and item residuals were constrained to be equal between English speakers and Spanish speakers exhibited a reasonable fit to the data, χ(2)(221)=1089.612 p.001, TLI=.926; CFI=.922, RMSEA=.059 (90% CI=.055-.062). The ΔCFI supported strict factorial invariance, ΔCFI=.01, across groups; no significant group differences were found between factor loadings, measurement intercepts, or item residuals between English speakers and Spanish speakers.This study extends the existing confirmatory factor analysis results of the SIP by providing additional data to inform the utility of the SIP among Hispanics. Strict factorial invariance between Spanish and English speakers is necessary to: conclude that the underlying constructs have the same meaning across groups; test for group differences in the latent variables across groups; and presume that group differences are attributable only to true differences between groups. Thus, the SIP is strongly supported for evaluating the effectiveness of alcohol treatment among Hispanics.

Objective To determine the current prevalence rates of cocaine use and dependence in a representative sample of the Brazilian population, and to investigate possible associations with sociodemographic factors. Method The Second Brazilian Alcohol and Drugs Survey (II BNADS) interviewed 4607 individuals aged 14 years and older from the Brazilian household population including an oversample of 1157 adolescents (14 to 18 years old). The survey gathered information on alcohol, tobacco and illegal substances use as well as on risk factors for abuse and dependence. The Severity of Dependence Scale was used to evaluate cocaine dependence rates among users. Results Last year consumption of crack-cocaine was 2.2% in the overall population excluding the elderly group. Lifetime and last year prevalence rate of snorted cocaine was 3.9% and 1.7%, respectively. Smoked cocaine use in Brazil was estimated in 1.5% for lifetime and 0.8% for last year use. Cocaine addiction was identified in 41.4% between users in the prior year. Conclusions The prevalence rates of snorted and smoked cocaine in Brazil suggests that the country is amongst the nations with greatest annual consumption rates becoming one of the biggest consumer markets of cocaine worldwide. Prevention and treatment policies should take this into consideration and strengthen the focus on cocaine use in the country.

Background Binge drinking (BD) is a harmful pattern of alcohol use. This study describes this pattern of drinking and the sociodemographic variables associated with it in a representative sample of Brazilians. Methods A cross-sectional survey of 3007 individuals using a multistage probabilistic sample was conducted in 143 Brazilian municipalities. The frequency of BD in the year preceding the study was assessed. BD was defined as the consumption of four drinks of alcohol within a two-hour period for women and five drinks in two hours for men. Weighted-ordered logit regression was used to assess the relationship between sociodemographic factors and BD. Results Most respondents had not engaged in binge drinking (69.7%; 95% confidence interval (CI) 67.0–72.2%). Binge drinking was more common among participants who were male (odds ratio (OR) 2.9; 95% CI 2.3–3.6) or single (OR 1.5; 95% CI 1.1–2.1) or had higher family income (OR 2.3; 95% CI 1.3–3.8). Individuals between 18 and 44 years of age were four times more likely to engage in binge drinking than adolescents (OR 4.7; 95% CI 3.3–6.8). Evangelicals/Protestants were less likely to engage in binge drinking (OR 0.7; 95% CI 0.2–0.5). Conclusions Our study, which is the first representative survey of BD in Brazil, showed that the age range of adults who engaged in BD is wider than the age range observed in other countries. These individuals are at increased risk for the adverse consequences of binge drinking, including addiction, car accidents, involvement in crime, absenteeism, and family violence.

Acculturation to U.S. society has been associated with an increase in drinking and binge drinking among Hispanics. This paper examines the association between acculturation and three drinking-related outcomes: average number of drinks consumed, binge drinking, and drinking 12 drinks or more in a single day in four major Hispanic national groups. The 2006 Hispanic Americans Baseline Alcohol Survey used a multistage cluster sample design to interview 5224 adult Hispanics (18+ years) in five selected U.S. metropolitan areas: Miami, New York, Philadelphia, Houston, and Los Angeles. The four national groups interviewed were: Puerto Ricans, Cuban Americans, Mexican Americans, and South/Central Americans. The survey response rate was 76%. Data on drinking behavior were collected and the analyses include bivariate and multivariate regression techniques. Multivariate analysis did not show an association between acculturation and volume of drinking, binge drinking, or drinking 12 or more drinks in a single day among men. Acculturation stress, however, was associated with drinking 12 or more in a day among men. Among women, high acculturation was associated with a higher volume of drinking, and it also interacted with national group to increase the likelihood of binge drinking. Acculturation does not have a homogeneous effect on drinking across gender and Hispanic national groups. The results confirm that acculturation has a more consistent association with increased drinking and binge drinking among women than among men. The effect of acculturation is therefore gender-specific. This heterogeneity across Hispanic national groups must be considered in future research, treatment, and prevention efforts.

This paper examines alcohol-related social problems among Mexican Americans living along the U.S.–Mexico border and in non-border areas. Interviews were conducted among Mexican Americans in the border regions of California, Arizona, New Mexico, and Texas (N = 1307). Non-border respondents were interviewed primarily in Houston and Los Angeles (N = 1288) as part of the Hispanic Americans Baseline Alcohol Survey (HABLAS). Both the border and HABLAS surveys employed multistage cluster sample designs (response rates were 67% and 76%, respectively). In the bivariate analysis, there were no significant differences between border and non-border areas in the proportion of those with one or more social problem. In non-border areas, the prevalence of alcohol problems did not differ significantly by age. However, along the border the prevalence of alcohol problems was significantly different across age groups, with 18 to 29 year old men and women having the highest prevalence. The final models showed no residence effect on problem likelihood. Drinking was strongly associated with problems. Although young border residents had higher problem prevalence rates than older residents, the logistic regression models showed no effect of border residence on the likelihood of problems, indicating that problems are due to alcohol consumption, not the border environment. The border, however, did appear to influence more drinking among young people. Regardless of residence, alcohol treatment and preventive interventions tailored to Mexican Americans are essential and special attention should be focused on younger individuals near the border.

This study examines the psychometric properties of alcohol expectancies among Hispanic subgroups. Face-to-face interviews were conducted as part of the 2006 Hispanic Americans Baseline Alcohol Survey (HABLAS), which employed a multistage cluster sample design. A total of 5,224 individuals (18+ years of age) representing four Hispanic national groups (Puerto Ricans, Cuban Americans, Mexican Americans, and South/Central Americans) were selected at random from the household population in five metropolitan areas (Miami, New York, Philadelphia, Houston, and Los Angeles). Alcohol expectancies included 18 items covering positive (e.g., laugh more, become more talkative) and negative dimensions (e.g., become aggressive, lose control) when alcohol is consumed. Confirmatory factor models replicated a previously proposed three-factor dimensional structure with a substantial majority of items exhibiting measurement invariance across Hispanic national group and gender. Items covering social extroversion were an exception, showing a lack of invariance for female Cuban and South/Central Americans. Latent mean differences across groups were detected for expectancies concerning emotional fluidity, and the pattern of differences largely mirrored known differences in alcohol consumption patterns. Results suggest that caution should be exercised in interpreting differences in expectancies concerning social extroversion across Hispanic groups, and additional work is needed to identify indices of this construct with invariant measurement properties. However, measures of emotional/behavioral impairment and emotional fluidity expectancies can be validly compared across gender and Hispanic national groups.

Background Research investigating the differential effectiveness of Brief Motivational Interventions (BMIs) among alcohol-dependent and non-dependent patients in the medical setting is limited. Clinical guidelines suggest that BMI is most appropriate for patients with less severe alcohol problems. As a result, most studies evaluating the effectiveness of BMI have excluded patients with an indication of alcohol dependence. Methods A randomized controlled trial of brief intervention in the trauma care setting comparing BMI to treatment as usual plus assessment (TAU+) was conducted. Alcohol dependence status was determined for 1336 patients using DSM-IV diagnostic criteria. The differential effectiveness of BMI among alcohol-dependent and non-dependent patients was determined with regard to volume per week, maximum amount consumed, percent days abstinent, alcohol problems at 6 and 12 months follow-up. In addition, the effect of BMI on dependence status at 6 and 12 months was determined. Results There was a consistent interaction between BMI and alcohol dependence status, which indicated significantly higher reductions in volume per week at 6 and 12 months follow-up (β = −.56, p = .03, β = −.63, p = .02, respectively), maximum amount at 6 months (β = −.31, p = .04), and significant decreases in percent days abstinent at 12 months (β = .11, p = .007) and alcohol problems at 12 months (β = −2.7, p12 = .04) among patients with alcohol dependence receiving BMI. In addition, patients with alcohol dependence at baseline that received BMI were .59 (95% CI = .39–.91) times less likely to meet criteria for alcohol dependence at six months. Conclusions These findings suggest that BMI is more beneficial among patients with alcohol dependence who screen positive for an alcohol-related injury.

Aims To estimate the prevalence of cannabis use in the last 12 months in the Brazilian population and to examine its association with individual and geographic characteristics. Design Cross-sectional survey with a national probabilistic sample. Participants 3006 individuals aged 14 to 65 years. Measurements Questionnaire based on well established instruments, adapted to the Brazilian population. Findings The 12-month prevalence of cannabis use was 2.1% (95%CI 1.3–2.9). Male gender, better educational level, unemployment and living in the regions South and Southeast were independently associated with higher 12-month prevalence of cannabis use. Conclusion While the prevalence of cannabis use in Brazil is lower than in many countries, the profile of those who are more likely to have used it is similar. Educational and prevention policies should be focused on specific population groups.

Study objective The current study evaluates whether the effectiveness of brief alcohol intervention in reducing 6- and 12-month risk of injuries in a large Level I urban trauma center varies according to trauma patients' ethnicity. Methods Eligible white, Hispanic, and black trauma patients aged 18 years or older were randomized to brief alcohol intervention or treatment as usual. The intervention was a "non-confrontational, patient-centered conversation" focused on patients' drinking pattern, with the purpose of encouraging them to change risky drinking. Study outcomes were patient-reported 6- and 12-month incidence of all-type injuries, alcohol-related injuries, and serious injuries (ie, injuries requiring emergency department visit or hospital admission). Results A total of 1,493 trauma patients (668 whites, 537 Hispanics, 288 blacks) participated in this study. After 1 year of follow-up, we were not able to detect any important association between brief intervention and the risk of all-type injuries, alcohol-related injuries, or serious injuries among study participants. In addition, the association between brief intervention and the outcomes of interest was not modified by patients' ethnicity. Conclusion Our study, congruent with some recent publications, implies that there are some patient- and provider-related impediments that could restrict the effectiveness of brief intervention programs in trauma centers, regardless of patient ethnicity. Unless those impediments are identified and eliminated, assuming that brief intervention will be an effective strategy for controlling future alcohol-related injuries among trauma patients and should be provided under any circumstances might not be reasonable.

OBJECTIVES: We sought to examine racial and ethnic disparities in police-reported intimate partner violence (IPV) and hospitalization rates and rate ratios among women with police-reported IPV relative to those without such reports. METHODS: This retrospective cohort study linked adult male-to-female IPV police records of non-Hispanic Black, Hispanic, and non-Hispanic White women residing in a south central US city with regional hospital discharge data. Rates and incidence rate ratios (IRR) were calculated and age-adjusted where the data allowed. RESULTS: Police-reported IPV rates were 2-3 times higher among Black and Hispanic women compared with White women. Overall, hospitalization rates were higher among Black and White victims and lower among Hispanic victims than their counterparts in the comparison group (age-adjusted IRR [aIRR], 1.23; 95% confidence interval [CI], 1.08-1.41; aIRR, 1.46; 95% CI, 1.19-1.79; and aIRR, 0.68; 95% CI, 0.54-0.86, respectively). Rate ratios were significant for victims among 1) White women for any mental disorder (aIRR, 2.02; 95% CI, 1.30-3.13) and for episodic mood/depressive disorders in particular (aIRR, 2.18; 95% CI, 1.33-3.59); 2) Black and White women for any injury-related diagnosis (aIRR, 2.46; 95% CI, 1.48-4.10 and aIRR, 3.20; 95% CI, 1.65-6.19, respectively); and 3) all women for intentional injury (IRR, 10.45; 95% CI, 3.56-30.69) and self-inflicted injury (IRR, 4.91; 95% CI, 2.12-11.37). CONCLUSIONS: Exposure to IPV as reported to police increases the rate of hospital utilization among Black and White women, but lowers the rate for Hispanic women. Screening for IPV in hospitals may identify a substantial number of IPV-exposed women. Primary and secondary prevention efforts related to IPV should be culturally informed and specific. Language: en

This paper examines rates of self-reported driving under the influence (DUI) of alcohol and 12 month and lifetime DUI arrest rates among Mexican Americans, Puerto Ricans, Cuban Americans and South/Central Americans in the U.S. population. Using a multistage cluster sample design, a total of 5,224 individuals 18 years of age and older were selected from the household population in five metropolitan areas of the U.S.: Miami, New York, Philadelphia, Houston and Los Angeles. The survey weighted response rate was 76%. Among men, 21% of Mexican Americans, 19.9% of South/Central Americans, 11.6% of Puerto Ricans and 6.9% of Cuban Americans reported DUI. Rates were lower among women, ranging from 9.7% for Mexican Americans to 1.3% for Cuban Americans. Mexican American men had the highest 12-month arrest rate (1.6%) and the highest lifetime arrest rate (11.2%). Drinkers who reported DUI were heavier drinkers than those not reporting DUI according to a variety of indicators. However, most DUI incidents involved non-alcohol dependent drivers. Mexican Americans and South Central/Americans, men, younger drivers, those with less than high school education, those with higher income and higher alcohol consumption were more likely to report DUI and DUI arrests. These findings show that Hispanic national groups in the U.S. are diverse regarding drinking and DUI-related experiences.

Objective: Few emergency department (ED) studies have described the relationship between family violence and subsequent intimate partner violence (IPV) or accounted for partner alcohol use in IPV victimization. This study sought to identify family history and substance-use factors associated with IPV among women presenting to an urban emergency department. Methods: Case–control study in which cases (women identified as having IPV concerns and an IPV history) and controls (women without IPV) were frequency-matched by age group and race/ethnicity. Logistic regression was performed to calculate adjusted odds ratios (AOR) for any IPV, physical IPV, and sexual IPV. Results: The sample included 182 cases and 147 controls. Living with a partner (not married) and witnessing parental violence were independent risk factors for any IPV (AOR 2.55 and AOR 2.21, respectively). Partner’s alcohol use (AOR 1.22 for every five drinks consumed per week) and heavier drinking (AOR 5.07) were also significant risk factors, but not subject’s substance-use. The pattern of risk factors varied only slightly for physical IPV and sexual IPV. Conclusion: This study suggests a substantial relationship between partner alcohol use and IPV among women beyond the woman’s substanceuse and confirms previous reports regarding the cycle of violence in women’s lives. © 2004 Elsevier Ireland Ltd. All rights reserved.

Objective: To report nationwide survey data on driving under the influence of alcohol and drugs (DUI) among U.S. ethnic groups. Methods: Data come from a probability sample of 39,250 adults 18 years of age and older interviewed by the U.S. National Household Survey on Drug Abuse in 2000. Interviews averaging 1 h in length were conducted in respondents’ homes by trained interviewers. The survey response rate was 74%. Results: Self-reported rates of DUI were highest among White men (22%), Native American/Native Alaskan men (20.8%) and men of Mixed race (22.5%). Twelve-month arrest rates for DUI were highest among men of Mixed race (5%) and Native American/Native Alaskan men (3.2%). Drinkers who DUI are more likely to be men (regardless of ethnicity), not married, consume more alcohol, and be alcohol dependent than drinkers who do not engage in alcohol-impaired driving. However, important ethnic specific predictors are also identified across the different ethnic groups.

Purpose: Using reports from both partners, this study estimated prevalence rates of intimate partner violence (IPV) among white, black, and Hispanic couples in the U.S., and assessed the contribution of drinking patterns, psychosocial, and other sociodemographic factors to the risk of partner violence. Methods: A multistage area probability sample consisting of 555 white, 358 black, and 527 Hispanic couples in the U.S. household population was interviewed in 1995. Logistic regression analyses revealed that predictors of IPV vary by ethnicity. Results: Rates of male-to-female (MFPV) and female-to-male partner violence (FMPV) were highest among black couples (23% and 30%), followed by Hispanic (17% and 21%), and white couples (12% and 16%). Between 27 percent and 41 percent of the men, and 4 percent and 24 percent of the women were drinking at the time of the violent incident. Implications: Black and Hispanic couples are at higher risk for IPV than white couples and should be targeted for prevention intervention. The interrelationships among IPV, alcohol consumption, and ethnicity are complex. These findings suggest that future attempts at modeling IPV should be ethnically sensitive and, ideally, include separate analyses of each ethnic group.

Purpose: Past research has revealed a strong correspondence between alcohol use and family dysfunction (e.g., Straus and Gelles in 1986 and 1990). Unfortunately, much of this research has relied on reports from only one family member. Methods: Here, we present the results from a recent, nationwide study of alcohol-consumption patterns, alcohol-related partnership problems, and intimate partner violence (IPV) based on reports from both romantic partners of 1,615 married and cohabiting couples. Results: Using the “drinking partnerships” construct developed by Roberts and Leonard in 1997, we found that despite considerable concordance between couple members' drinking behaviors, discrepant drinking patterns were strongly predictive of relational distress and the incidence of physical violence. Implications: These findings suggest that the interaction between couple members' alcohol-related behaviors has crucial implication for the health and well-being of the entire family.

Objective: To report nationwide survey data on patterns of driving under the influence of alcohol among Whites, Blacks and Hispanics. Method: Data were obtained from a probability sample consisting of 1582 Blacks, 1585 Hispanics and 1636 Whites in the US household population. Interviews averaging 1 h in length were conducted in respondents’ homes by trained interviewers. Results: Self-reported rates of driving a car after having drunk enough ‘to be in trouble if stopped by the police’ were highest among White and Hispanic men (22 and 21%, respectively), as were lifetime arrest rates for driving under the influence of alcohol (13% for White men, 19% for Hispanic men). Additionally, our analyses suggest that drinkers who drive under the influence of alcohol are more likely to be men (regardless of ethnicity), consume more alcohol, and be alcohol dependent than drinkers who do not engage in alcohol-impaired driving.

This paper examines the association between DSM-IV alcohol dependence, drug use and DSM-IV drug abuse/dependence in a sample of White (n = 256), Black (n = 263) and Mexican American (n = 212) men consecutively admitted to five alcohol treatment programs in a Northern California county. Results show that drug use is higher among Blacks and Mexican Americans than among Whites. About 35% of the Whites, 43% of the Blacks and 35% of the Mexican Americans are both alcohol and drug dependent. Among alcohol dependent individuals, about 44% of the Whites, 72% of the Blacks and 52% of the Mexican Americans report using at least one drug other than alcohol once a week or more in the 12 months previous to the interview. The drug most frequently used by Whites is marijuana, followed by cocaine and amphetamines. The drug most frequently used by Blacks and Mexican Americans is cocaine, followed by marijuana. Severity of drug dependence is inversely related to severity of alcohol dependence among Whites. Alcohol treatment programs for Whites, Blacks and Mexican Americans must offer assessment, treatment matching and relapse prevention that takes into consideration this high prevalence of drug use and dependence.

This paper reports a risk function analysis of average daily volume of alcohol consumed and the frequency of consuming 5 or more drinks during a single day with reporting an injury in a probability sample of the U.S. adult household population living in the 48 contiguous states. The data are from the 1990 National Alcohol Survey on a weighted sample of 1150 respondents, 748 of whom were current drinkers. Risk of injury was found to increase with an average daily volume of 1 drink for both males and females and for those 30 and younger and those over 30, and to increase with a frequency of consuming 5 or more drinks on one day more often than twice a year. These data suggest that risk for injury may be increased at relatively low levels of consumption and, if so, that preventive efforts aimed at more moderate drinkers may have a greater impact on the reduction of alcohol-related accidents than efforts focused on heavier drinkers who are fewer in number.

One of the main difficulties hampering research with the concept of the alcohol dependence syndrome is the lack of a set of agreed-upon operational definitions of each element composing the syndrome. To illustrate the possible impact of these different operationalizations of alcohol dependence on research results, this article shows the correlation between two different sets of items used to operationalize DSM-III-R alcohol dependence in a clinical sample. Results show that the correlations between the various sets of items are low. About 60% of the correlations are in between .21 and .40. These results suggest that different operationalizations of dependence may not be measuring the same phenomena, and should not be seen as interchangeable.

This paper describes the correlates of DSM-III-R alcohol dependence in a general population and in a treatment sample. The frequency of drinking 5 or more drinks per occasion is the only significant predictor of alcohol dependence in the general population. This indicator of drinking plus being unemployed are the predictors of alcohol dependence in the treatment sample. Severity of dependence (as assessed by the number of dependence indicators reported) in the general population sample is positively associated with the frequency of drinking 5 or more drinks, with being younger, being unmarried and being a male. In the treatment sample the correlates are the frequency of drinking 5 or more drinks, being unemployed and being older. These results suggest that alcohol dependent individuals in the treatment sample are more severely dependent and more socially marginal than their counterparts in the general population.

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This paper reviews the concepts of dependence on alcohol as embodied by the Alcohol Dependence Syndrome and as proposed in the Diagnostic and Statistical Manual of the American Psychiatric Association (D.S.M.-III). Evidence in support of the unidimensionality of this concept is still controversial, and the elements necessary to diagnose dependence under each of these two proposals are different. Alcohol Dependence in the D.S.M.-III has indicators of social and occupational impairment which are not part of the Alcohol Dependence Syndrome. Knowledge on the concept of dependence will advance more rapidly if researchers begin to develop comparative studies of these two models. Future work should also include studies in the general population, with women, ethnic minorities and cross-cultural research. Longitudinal research to establish the evolution of dependence both in clinical and general populations should also be developed.

This paper reports survey data on drinking in different social settings and the acculturation of Hispanics to U.S. society. Respondents comprise a household probability sample of U.S. Hispanics. The acculturation scale resulted from the factor analysis of respondents' answer to questions on daily use and ability to speak, read and write English and Spanish; preference for media (books, radio TV, music) in English or in Spanish; ethnicity of people they interact with in their church, parties and neighborhood now and when growing up, as well as questions about values thought to be characteristic of the Hispanic way of life. Seven different social settings are considered: when having an evening meal at a restaurant; when having lunch at a restaurant; when attending clubs or organizational meetings; in bars, taverns or cocktail lounges; at parties; during evenings at home; and when friends are visiting. Analysis of these data confirm the hypothesis that Hispanics who are more acculturated go more frequently and drink more frequently than less acculturated Hispanics in a number of social settings. The effect of acculturation is independent of income and work status.