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Halcomb ME, Dzemidzic M, Avena-Koenigsberger A, Hile KL, Durazzo TC, Yoder KK. Greater ventral striatal functional connectivity in cigarette smokers relative to non-smokers across a spectrum of alcohol consumption. Brain Imaging Behav 2024:10.1007/s11682-024-00903-9. [PMID: 39106000 DOI: 10.1007/s11682-024-00903-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2024] [Indexed: 08/07/2024]
Abstract
Cigarette smoking is associated with elevated risk of disease and mortality and contributes to heavy healthcare-related economic burdens. The nucleus accumbens is implicated in numerous reward-related behaviors, including reinforcement learning and incentive salience. The established functional connectivity of the accumbens includes regions associated with motivation, valuation, and affective processing. Although the high comorbidity of cigarette smoking with drinking behaviors may collectively affect brain activity, there could be independent effects of smoking in alcohol use disorder that impact brain function and behavior. We hypothesized that smoking status, independent of alcohol use, would be associated with aberrations of nucleus accumbens functional connectivity to brain regions that facilitate reward processing, salience attribution, and inhibitory control. Resting state functional magnetic resonance imaging data from thirty-one nonsmokers and nineteen smoking individuals were analyzed using seed-based correlations of the bilateral accumbens with all other brain voxels. Statistical models accounted for drinks consumed per week. The smoking group demonstrated significantly higher functional connectivity between the left accumbens and the bilateral insula and anterior cingulate cortex, as well as hyperconnectivity between the right accumbens and the insula. Confirmatory analyses using the insula and cingulate clusters generated from the original analysis as seed regions reproduced the hyperconnectivity in smokers between the bilateral insular regions and the accumbens. In conclusion, smoking status had distinct effects on neural activity; hyperconnectivity between the accumbens and insula in smokers may reflect enhanced encoding of the reinforcing effects of smoking and greater orientation toward smoking-associated stimuli.
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Affiliation(s)
- Meredith E Halcomb
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
| | - Mario Dzemidzic
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
- Department of Neurology, Indiana University School of Medicine, 355 W. 16th St., GH 4700, Indianapolis, IN, 46202, USA
| | - Andrea Avena-Koenigsberger
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
| | - Karen L Hile
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA
| | - Timothy C Durazzo
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA
| | - Karmen K Yoder
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA.
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 355 W. 16th St., GH 4100, Indianapolis, IN, 46202, USA.
- Department of Psychology, Indiana University Purdue University Indianapolis, 402 N. Blackford St, Indianapolis, IN, 46202, USA.
- Stark Neurosciences Research Institute, 320 W. 15th St., NB 414, Indianapolis, IN, 46202, USA.
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Wong BKC, Veldhuizen S, Minian N, Zawertailo L, Selby P. The effects of alcohol use on smoking cessation treatment with nicotine replacement therapy: An observational study. Addict Behav 2024; 155:108045. [PMID: 38692071 DOI: 10.1016/j.addbeh.2024.108045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/10/2024] [Accepted: 04/26/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Concurrent users of tobacco and alcohol are at greater risk of harm than use of either substance alone. It remains unclear how concurrent tobacco and alcohol use affects smoking cessation across levels of alcohol use and related problems. This study assessed the relationship between smoking cessation and levels of alcohol use problems. METHODS 59,018 participants received nicotine replacement therapy through a smoking cessation program. Alcohol use and related symptoms were assessed using the Alcohol Use Disorders Identification Test (AUDIT-10) and the AUDIT-Concise (AUDIT-C). The primary outcome was 7-day point prevalence cigarette abstinence (PPA) at 6-month follow-up. We evaluated the association between alcohol use (and related problems) and smoking cessation using descriptive methods and mixed-effects logistic regression. RESULTS 7-day PPA at 6-months was lower in groups meeting hazardous alcohol consumption criteria, with the lowest probability of smoking abstinence observed in the highest risk group. The probability of successful tobacco cessation fell with increasing levels of alcohol use and related problems. Adjusted predicted probabilities were 30.3 (95 % CI = 29.4, 31.1) for non-users, 30.2 (95 % CI = 29.4, 31.0) for low-risk users, 29.0 (95 % CI = 28.1, 29.9) for those scoring below 8 on the AUDIT-10, 27.3 (95 % CI = 26.0, 28.6) for those scoring 8-14, and 24.4 (95 % CI = 22.3, 26.5) for those scoring 15 or higher. CONCLUSION Heavy, hazardous alcohol use is associated with lower odds of successfully quitting smoking compared to low or non-use of alcohol. Targeting alcohol treatment to this group may improve tobacco cessation outcomes.
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Affiliation(s)
- Benjamin K C Wong
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Scott Veldhuizen
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Nadia Minian
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Canada
| | - Laurie Zawertailo
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Peter Selby
- INTREPID Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Campbell Family Mental Health Research Institute, IMHPR, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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Robinson LE, Didier N, Thomas R, Vena A, King A. Combination Treatment With Varenicline and Nicotine Patch on Smoking Cessation Outcomes in Heavy Drinkers at 26-Week Follow-up. J Clin Psychopharmacol 2024; 44:362-368. [PMID: 38752924 PMCID: PMC11211054 DOI: 10.1097/jcp.0000000000001864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
PURPOSE/BACKGROUND People who smoke cigarettes and drink alcohol heavily are less likely to quit smoking compared with those who do not drink heavily. The current study examined the effects of a 12-week treatment phase of combination varenicline and nicotine patch compared with placebo and nicotine patch on smoking cessation (primary outcome) and alcohol consumption (secondary outcome) in heavy drinking smokers at 26-week follow-up. METHODS/PROCEDURES Participants were daily smokers who met heavy drinking criteria. They were randomly assigned to receive either varenicline and nicotine patch (n = 61) or placebo and nicotine patch (n = 61) for 12 weeks. At week 26, self-reports of point prevalence cigarette abstinence were biochemically confirmed, and past-month alcohol drinking days and heavy drinking days were assessed. FINDINGS/RESULTS At week 26, smoking quit rates did not differ by treatment group (25% varenicline and 26% placebo). Relative to week 12 outcomes, week 26 quit rates significantly dropped off in the varenicline group but not in the placebo group. Alcohol drinking reductions for the whole sample that were previously observed from baseline to week 12 were sustained at week 26, although they did not differ between treatment groups. IMPLICATIONS/CONCLUSIONS In heavy drinking smokers, smoking cessation success was evident in a quarter of the total sample at 3 months postmedication discontinuation. At this time, quit rates were the same between those who received varenicline and nicotine patch and those who received nicotine patch alone. Future research is warranted to examine what may aid in longer-term smoking quit rates in heavy drinking smokers.
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Affiliation(s)
- Layne E Robinson
- From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
| | - Nathan Didier
- From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
| | - Riya Thomas
- From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
| | | | - Andrea King
- From the Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago IL
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Blaes SL, Lewis B, Teitelbaum S, Reisfield G, Boissoneault J. Associations between smoking and pain in early recovery in residential substance use treatment-seekers. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209311. [PMID: 38336263 DOI: 10.1016/j.josat.2024.209311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/03/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION A growing literature indicates bidirectional associations between pain and tobacco use. Cigarette smokers are at increased risk for chronic pain, and observational and experimental studies indicate that pain increases motivation to smoke. Tobacco use disorder frequently co-occurs with other substance use disorders, which are also associated with chronic pain vulnerability. Despite evidence that pain significantly predicts smoking and relapse, associations between smoking history/trajectory and changes in pain over the course of treatment have not been characterized. The objective of the study was to determine the association between in-treatment smoking trajectory, pack-years (i.e., number of cigarette packs smoked per day multiplied by smoking duration), pain-related interference in daily activities, and pain intensity over the course of residential treatment. METHODS In this study, 280 adult smokers in a residential SUD treatment center in North Central Florida completed questionnaires assessing cigarette use, pain intensity, and pain interference at treatment entry and discharge (Mean = 80.3 days, SD = 25.6). Most participants were diagnosed with alcohol use disorder (66.1 %). Opioid (27.9 %) and cannabis use disorders (29.6 %) were also common. Participants were grouped by whether their smoking increased (n = 36), decreased (n = 46), or stayed the same (n = 133) from entry to discharge. RESULTS Analyses indicated a positive association between pack-years and pain intensity at both baseline (r = 0.185, p = 0.018) and discharge (r = 0.184, p = 0.019). Smoking trajectory was associated with pack-years, with those decreasing smoking having greater pack-years than those sustaining or increasing use [F(2,136) = 8.62, p < 0.01, η2p = 0.114]. Mixed general linear models indicated pain intensity [F(1,274) = 44.15, p < 0.0001, η2p = 0.138] and interference in day-to-day activities [F(1,276) = 31.79, p < 0.0001, η2p = 0.103] decreased significantly over time. However, there was no main effect of smoking trajectory on pain intensity [F(2,212) = 2.051, p = 0.131, η2p = 0.019] or of smoking trajectory by time interaction [F(2, 212) = 1.228, p = 0.295, η2p = 0.011]. CONCLUSIONS Overall, findings provide evidence that smoking behavior influences pain within the context of residential substance use treatment. Given that pain is associated with urge to use substances and risk of return to use, more consistent and rigorous assessment of pain and proactive pain management is likely to enhance substance use treatment outcomes among people who smoke.
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Affiliation(s)
- Shelby L Blaes
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA
| | - Ben Lewis
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Scott Teitelbaum
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Gary Reisfield
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, USA; Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA.
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Kose J, Duquenne P, Hercberg S, Galan P, Touvier M, Fezeu LK, Andreeva VA. Co-occurrence of habit-forming risk behaviors and their socio-demographic, health status and lifestyle determinants: a population-based cross-sectional study. Arch Public Health 2024; 82:26. [PMID: 38419088 PMCID: PMC10900606 DOI: 10.1186/s13690-024-01251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Although habit-forming risk behaviors frequently co-occur, determinants of concurrent risk behaviors have rarely been investigated. The aim of the present study was to investigate socio-demographic, health status, and lifestyle determinants of single versus concurrent risk behaviors in general-population adults. METHODS We analyzed data from 32,622 participants (74.5% female; mean age = 57.9 ± 14.2 years) of the NutriNet-Santé cohort who completed the Alcohol Use Disorders Identification Test, the 12-item Cigarette Dependence Scale, the modified Yale Food Addiction Scale 2.0, and the Internet Addiction Test in 2021-2022. Using established cutoffs, participants were first split into 2 groups (presence versus absence) for each risk variable (alcohol use disorders, nicotine dependence, food addiction, Internet addiction) and were then divided into 3 groups (no risk behavior, 1 risk behavior (reference), and ≥ 2 risk behaviors). The association between socio-demographic, health status, and lifestyle exposures and individual/concurrent risk behaviors were investigated with polytomous logistic regression. RESULTS Younger age (Odds Ratio (OR) = 2.04; 95% Confidence Interval (CI: 1.62-2.56), current financial difficulties (OR = 1.29; CI: 1.08-1.54), self-perceived poor health (OR = 1.70; CI: 1.32-2.20), overall poor dietary quality (OR = 2.88; CI: 2.06-4.02), being underweight (OR = 1.46; CI: 1.05-2.04), having obesity (OR = 1.62; CI: 1.31-1.99), lack of affection during childhood (OR = 1.41; CI: 1.18-1.69), and a lifetime prevalence or medication use for a mental disorder (OR = 1.46; CI: 1.24-1.73) were positively associated with having ≥ 2 versus 1 risk behavior (all p < 0.05). The comparison of none versus 1 risk behavior revealed the same determinants in addition to having a higher education, being physically active at work, and being overweight. CONCLUSIONS We investigated determinants of concurrent habit-forming risk behaviors among adults in a large, population-based study. The findings could serve as impetus for future research in this domain and ultimately help guide addiction prevention efforts.
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Affiliation(s)
- Junko Kose
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Pauline Duquenne
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Serge Hercberg
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
- Department of Public Health, AP-HP Paris Seine-Saint-Denis Hospital System, Bobigny, France
| | - Pilar Galan
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Léopold K Fezeu
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France
| | - Valentina A Andreeva
- Nutritional Epidemiology Research Group (EREN), Epidemiology and Statistics Research Center, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, University of Paris (CRESS), Bobigny, France.
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Alpers SE, Druckrey-Fiskaaen KT, Madebo T, Vold JH, Pallesen S, Skogen JC, Lunde LH, Mæland S, Fadnes LT. The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study. BMC Public Health 2024; 24:375. [PMID: 38317145 PMCID: PMC10840189 DOI: 10.1186/s12889-024-17943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/01/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries. METHODS Data were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption. RESULTS A total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50-59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%). CONCLUSIONS Smoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | - Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tesfaye Madebo
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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McDaniel JT, Redner R, Jayawardene W, Haun J, Clapp J, Che D, Renzaglia K, Abou-Jabal D. Moral Injury is a Risk Factor for Substance Use and Suicidality Among US Military Veterans with and without Traumatic Brain Injury. JOURNAL OF RELIGION AND HEALTH 2023; 62:3926-3941. [PMID: 37679519 DOI: 10.1007/s10943-023-01905-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
A national survey of United States veterans was conducted, yielding 252 veterans with Traumatic Brain Injury (TBI) and 1235 veterans without TBI. Participants were asked questions about moral injury, suicidality, substance use, and other sociodemographic variables. Multivariable linear regression analysis was used to examine the previously described relationships. Increasing severity of moral injury was associated with higher scores on the substance use tool (b = 0.02, p = 0.04), although the magnitude of effect was not different from those without TBI (Z = - 0.57, p = 0.72). Increasing severity of moral injury was positively associated with suicidal behavior scores (b = 0.10, p < 0.01). The strength of this relationship was stronger in veterans with TBI than those without TBI (Z = 1.78, p = 0.04). Rehabilitation programs that treat veterans for TBI may need to consider the evaluation of moral injury given its association with adverse events in this population.
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Affiliation(s)
- Justin T McDaniel
- School of Human Sciences, Southern Illinois University, 475 Clocktower Drive, Carbondale, IL, 62901, USA.
| | - Ryan Redner
- School of Psychological and Behavioral Sciences, Southern Illinois University, Carbondale, IL, USA
| | | | - Jolie Haun
- James A. Haley Veterans' Hospital, US Veterans Health Administration, Tampa, FL, USA
| | - John Clapp
- School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Dunren Che
- School of Computing, Southern Illinois University, Carbondale, IL, USA
| | - Karen Renzaglia
- Department of Plant Biology, Southern Illinois University, Carbondale, IL, USA
| | - Dania Abou-Jabal
- School of Human Sciences, Southern Illinois University, Carbondale, IL, USA
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Lau G, Gabbe B, Mitra B, Dietze P, Reeder S, Cameron P, Read DJ, Symons E, Beck B. Biases in the collection of blood alcohol data for adult major trauma patients in Victoria, Australia. Emerg Med J 2023; 40:744-753. [PMID: 37562944 DOI: 10.1136/emermed-2023-213186] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/09/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND In-hospital alcohol testing provides an opportunity to implement prevention strategies for patients with high risk of experiencing repeated alcohol-related injuries. However, barriers to alcohol testing in emergency settings can prevent patients from being tested. In this study, we aimed to understand potential biases in current data on the completion of blood alcohol tests for major trauma patients at hospitals in Victoria, Australia. METHODS Victorian State Trauma Registry data on all adult major trauma patients from 1 January 2018 to 31 December 2021 were used. Characteristics associated with having a blood alcohol test recorded in the registry were assessed using logistic regression models. RESULTS This study included 14 221 major trauma patients, of which 4563 (32.1%) had a blood alcohol test recorded. Having a blood alcohol test completed was significantly associated with age, socioeconomic disadvantage level, preferred language, having pre-existing mental health or substance use conditions, smoking status, presenting during times associated with heavy community alcohol consumption, injury cause and intent, and Glasgow Coma Scale scores (p<0.05). Restricting analyses to patients from a trauma centre where blood alcohol testing was part of routine clinical care mitigated most biases. However, relative to patients injured while driving a motor vehicle/motorcycle, lower odds of testing were still observed for patients with injuries from flames/scalds/contact burns (adjusted OR (aOR)=0.33, 95% CI 0.18 to 0.61) and low falls (aOR=0.17, 95% CI 0.12 to 0.25). Higher odds of testing were associated with pre-existing mental health (aOR=1.39, 95% CI 1.02 to 1.89) or substance use conditions (aOR=2.33, 95% CI to 1.47-3.70), and living in a more disadvantaged area (most disadvantaged quintile relative to least disadvantaged quintile: aOR=2.30, 95% CI 1.52 to 3.48). CONCLUSION Biases in the collection of blood alcohol data likely impact the surveillance of alcohol-related injuries. Routine alcohol testing after major trauma is needed to accurately inform epidemiology and the subsequent implementation of strategies for reducing alcohol-related injuries.
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Affiliation(s)
- Georgina Lau
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University, Swansea, UK
| | - Biswadev Mitra
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Paul Dietze
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
- National Drug Research Institute, Curtin University, Melbourne, Victoria, Australia
| | - Sandra Reeder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter Cameron
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia
| | - David J Read
- Trauma Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
- Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Evan Symons
- Alfred Mental and Addiction Health, Alfred Health, Melbourne, Victoria, Australia
| | - Ben Beck
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Vrettou M, Thalhammer SB, Svensson AL, Dumas S, Nilsson KW, Wallén-Mackenzie Å, Fredriksson R, Nylander I, Comasco E. Vesicular glutamate transporter 2 expression in the ventral tegmental area of outbred male rats following exposure to nicotine and alcohol. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 8:100180. [PMID: 37533815 PMCID: PMC10391930 DOI: 10.1016/j.dadr.2023.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 07/11/2023] [Indexed: 08/04/2023]
Abstract
Background Initiation of use/co-use of nicotine and alcohol, commonly occurring in an episodic manner during adolescence, can imprint vulnerability to the developing brain and lead to addiction. The ventral tegmental area (VTA) is a key heterogeneous region of the mesocorticolimbic circuit involved in the binge-drinking and intoxication step of the addiction circuit. Higher human post-mortem VTA expression of vesicular glutamate transporter 2 (VGLUT2), a marker of the glutamatergic phenotype also expressed in dopaminergic [Tyrosine Hydroxylase (Th)-positive] neurons, has been associated with chronic nicotine use and co-use with alcohol. Methods The present study aimed to map and characterize the Vglut2- and Th-expressing neurons in the VTA of adolescent male rats exposed or not to prolonged (six-weeks) episodic (three consecutive days/week) nicotine and/or alcohol administration. Nicotine (0.35 mg/kg free base) was injected subcutaneously, whereas alcohol (2 g/kg 20%) was administrated via gavage. Vglut2 and Th mRNA was assessed in the anterior and posterior VTA by use of in situ hybridization. Results The profile of neurons varied with substance-exposure among VTA subregions. Th-only expressing neurons were more abundant in the posterior VTA of the group exposed to nicotine-only, compared to controls. The same neurons were, on the contrary, less present in the anterior VTA of animals exposed to alcohol-only, who also displayed a higher number of Vglut2-expressing neurons in the lateral anterior VTA. Conclusions VTA Vglut2- and Th-only neurons seem differentially involved in the effects of adolescent episodic nicotine and alcohol exposure in the anterior and posterior VTA.
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Affiliation(s)
- Maria Vrettou
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Stefan Bernhard Thalhammer
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Anne-Lie Svensson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | | | - Kent W Nilsson
- Centre for Clinical Research Västerås, Uppsala University, Västmanland County Hospital Västerås, Sweden
| | | | - Robert Fredriksson
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Ingrid Nylander
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Erika Comasco
- Department of Women's and Children's Health, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Akahilem KE, Omole OB. Conjoint tobacco and alcohol use and depression among HIV-positive patients in Sedibeng, South Africa. S Afr Fam Pract (2004) 2023; 65:e1-e7. [PMID: 37265138 DOI: 10.4102/safp.v65i1.5687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/24/2023] [Accepted: 03/24/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND Psychosocial challenges among human immunodeficiency virus (HIV)-positive patients may promote substance use disorders. This study explored the relationship between conjoint tobacco and alcohol use and depression symptoms among HIV positive patients in Sedibeng District, South Africa. METHODS In a cross-sectional study of 404 participants, a questionnaire collected information on sociodemography, tobacco and alcohol use and depression symptoms. Outcome measures included the prevalence of conjoint tobacco and alcohol use and its association with positive screen for depression. RESULTS The mean participant age was 43.2 years. Most completed secondary school (62.9%), were black (99.0%), female (65.8%), unemployed (53.6%) and on antiretroviral therapy (ART) for 1 year (97.8%). Current tobacco use was reported by 23.3% (n = 94) participants with most smoking cigarette (73.7%) and having low nicotine dependence (75.5%). Current alcohol use was reported by 43.6% (n = 176) participants, and 36.9% were categorised as harmful users. Only 7.7% (n = 31) participants screened positive for depression; the prevalence of conjoint tobacco and alcohol use was 19.6% (n = 79) and this was not associated with depression (p = 0.438). Harmful alcohol users were more than five times likely to report conjoint tobacco and alcohol use (p = 0.000), but women were less likely to report it (p = 0.000). CONCLUSION Conjoint tobacco and alcohol use is common among patients with HIV infection. Although not associated with positive screen for depression, its relationship with harmful alcohol use reiterates the need for an integrated tobacco and alcohol use screening and treatment strategy in the HIV treatment programme in primary care.Contribution: To the authors best knowledge, this study is the first published study that explored the relationship between conjoint tobacco and alcohol use, and depression among HIV-positive patients in the South African primary care settings.
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Affiliation(s)
- Kenneth E Akahilem
- Department of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
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11
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Cheng Y, Dao C, Zhou H, Li B, Kember RL, Toikumo S, Zhao H, Gelernter J, Kranzler HR, Justice AC, Xu K. Multi-trait genome-wide association analyses leveraging alcohol use disorder findings identify novel loci for smoking behaviors in the Million Veteran Program. Transl Psychiatry 2023; 13:148. [PMID: 37147289 PMCID: PMC10162964 DOI: 10.1038/s41398-023-02409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 05/07/2023] Open
Abstract
Smoking behaviors and alcohol use disorder (AUD), both moderately heritable traits, commonly co-occur in the general population. Single-trait genome-wide association studies (GWAS) have identified multiple loci for smoking and AUD. However, GWASs that have aimed to identify loci contributing to co-occurring smoking and AUD have used small samples and thus have not been highly informative. Applying multi-trait analysis of GWASs (MTAG), we conducted a joint GWAS of smoking and AUD with data from the Million Veteran Program (N = 318,694). By leveraging GWAS summary statistics for AUD, MTAG identified 21 genome-wide significant (GWS) loci associated with smoking initiation and 17 loci associated with smoking cessation compared to 16 and 8 loci, respectively, identified by single-trait GWAS. The novel loci for smoking behaviors identified by MTAG included those previously associated with psychiatric or substance use traits. Colocalization analysis identified 10 loci shared by AUD and smoking status traits, all of which achieved GWS in MTAG, including variants on SIX3, NCAM1, and near DRD2. Functional annotation of the MTAG variants highlighted biologically important regions on ZBTB20, DRD2, PPP6C, and GCKR that contribute to smoking behaviors. In contrast, MTAG of smoking behaviors and alcohol consumption (AC) did not enhance discovery compared with single-trait GWAS for smoking behaviors. We conclude that using MTAG to augment the power of GWAS enables the identification of novel genetic variants for commonly co-occuring phenotypes, providing new insights into their pleiotropic effects on smoking behavior and AUD.
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Affiliation(s)
- Youshu Cheng
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Cecilia Dao
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Hang Zhou
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Boyang Li
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Rachel L Kember
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Sylvanus Toikumo
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Hongyu Zhao
- Yale School of Public Health, New Haven, CT, 06511, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Joel Gelernter
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Henry R Kranzler
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, 19104, USA
- Crescenz Veterans Affairs Medical Center, Philadelphia, PA, 19104, USA
| | - Amy C Justice
- Yale School of Public Health, New Haven, CT, 06511, USA
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Yale School of Medicine, New Haven, CT, 06511, USA
| | - Ke Xu
- VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
- Yale School of Medicine, New Haven, CT, 06511, USA.
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Cruz B, Castañeda K, Aranda M, Hinojosa CA, Castro-Gutierrez R, Flores RJ, Spencer CT, Vozella V, Roberto M, Gadad BS, Roychowdhury S, O’Dell LE. Alcohol self-administration and nicotine withdrawal alter biomarkers of stress and inflammation and prefrontal cortex changes in Gβ subunits. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:321-332. [PMID: 36206520 PMCID: PMC10348398 DOI: 10.1080/00952990.2022.2121656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/28/2022] [Accepted: 09/02/2022] [Indexed: 11/07/2022]
Abstract
Background: Although alcohol and nicotine are often used together, the biological consequences of these substances are not well understood. Identifying shared targets will inform cessation pharmacotherapies and provide a deeper understanding of how co-use of alcohol and nicotine impacts health, including biomarkers of stress and inflammation.Objective: We examined the effects of nicotine exposure and withdrawal on alcohol self-administration (SA), stress and inflammatory biomarkers, and a G-protein coupled receptor subunit (Gβ) in brain areas associated with drug use.Methods: Male rats were trained to SA alcohol and then received a nicotine pump (n = 7-8 per group). We assessed alcohol intake for 12 days during nicotine exposure and then following pump removal to elicit withdrawal. After the behavioral studies, we assessed plasma leptin, corticosterone, and interleukin-1β (IL-1β), and Gβ protein expression in the amygdala, nucleus accumbens (NAc), and prefrontal cortex (PFC).Results: Nicotine exposure or withdrawal did not alter alcohol intake (p > .05). Alcohol and nicotine withdrawal elevated corticosterone levels (p = .015) and decreased Gβ levels in the PFC (p = .004). In the absence of nicotine, alcohol SA suppressed IL-1β levels (p = .039). Chronic exposure to nicotine or withdrawal during alcohol SA did not alter leptin levels or Gβ expression in the amygdala or NAc (p's > .05).Conclusions: The combination of alcohol SA and nicotine withdrawal produced a persistent increase in stress biomarkers and a suppression in Gβ expression in the PFC, providing an important first step toward understanding the common biological mechanisms of alcohol/nicotine misuse.
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Affiliation(s)
- Bryan Cruz
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Karen Castañeda
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Michelle Aranda
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Cecilia A. Hinojosa
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | | | - Rodolfo J. Flores
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
| | - Charles T. Spencer
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Valentina Vozella
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Marisa Roberto
- Department of Molecular Medicine, The Scripps Research Institute, La Jolla, CA, USA
| | - Bharathi S. Gadad
- Department of Psychiatry, Paul L Foster School of Medicine, Texas Tech University Health Science Center, El Paso, TX, USA
- Southwest Brain Bank, Texas Tech University Health Science Center, El Paso, TX, USA
| | - Sukla Roychowdhury
- Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Laura E. O’Dell
- Department of Psychology, The University of Texas at El Paso, El Paso, TX, USA
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Sadath A, Kabir Z, K M J, G R, Uthaman SP. Smoking, betel quid chewing, and alcohol use among an indigenous primitive Tribal group in the Kerala State of India: Secondary analysis of a Tribal household survey. J Ethn Subst Abuse 2023:1-16. [PMID: 36946893 DOI: 10.1080/15332640.2023.2185721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background: In India, indigenous populations, known as Tribes, are among the poorest and most marginalized groups. We estimated the prevalence of smoking, alcohol use, and betel quid chewing and examined the association between gender and smoking, alcohol use, and betel quid chewing among Kattunayakan primitive Tribes who are categorized as a Particularly Vulnerable Tribal Group (PVTG) in the Kerala State of India.Methods: A secondary analysis of a sample of the Wayanad District Tribal Household survey comprising 388 Kattunayakan PVTG households selected through multistage cluster random sampling was undertaken. Binary logistic regression models were used to estimate an association between gender and smoking, alcohol use, and betel quid chewing in these Tribal households.Results: Mean age was 39.2 years (±15.1), more than three-fourths of the respondents were female (75.3%), and approximately 24% of the respondents reported smoking tobacco in past 12 months. A fivefold increased odds of smoking among males compared to smoking among females was observed (OR = 4.92; p < .01). More than 64% reported betel quid chewing. Prevalence of alcohol use was 16%, which significantly varied between males (49%) and females (5.1%; OR = 17.71; p < .01). Among tobacco smokers, 64.1% were involved in betel quid use. Among alcohol users, 62.9% were involved in betel quid use and more than 58% were smoking tobacco. Betel quid chewing was the most prevalent substance use.Conclusion: Single and dual substance use of the three commonest types were disproportionately high among this hard-to-reach Tribal population in the southern state of India, with some gender variations. Alcohol consumption was relatively low. However, the complex nature of substance use, compounded by inaccessible health services, poses a significant challenge to rethink and to reimagine innovative methods of providing mental health care services, for instance, mobile health clinics.
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Affiliation(s)
- Anvar Sadath
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Zubair Kabir
- School of Public Health, University College Cork, Cork, Ireland
| | - Jiji K M
- Department of Psychiatric Social Work, Institute of Mental Health and Neurosciences, Kozhikode, Kerala, India
| | - Ragesh G
- Department of Psychiatric Social Work, Institute of Mental Health and Neurosciences, Kozhikode, Kerala, India
| | - Seema P Uthaman
- Department of Psychiatric Social Work, Institute of Mental Health and Neurosciences, Kozhikode, Kerala, India
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Caira-Chuquineyra B, Fernandez-Guzman D, Quispe-Vicuña C, Gutierrez-Rodriguez R, Valencia PD. Factors associated with alcohol abuse in the Peruvian population: analysis of a national health survey 2019. J Public Health (Oxf) 2022:6782834. [DOI: 10.1093/pubmed/fdac116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 06/21/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract
Aim
To evaluate the factors associated with alcohol abuse in the Peruvian population.
Methods
A secondary analysis was performed using data from the Demographic and Family Health Survey of Peru, 2019. We included 24 264 Peruvians between 18 and 59 years. For the analysis of association, the Poisson regression model with robust standard errors was used. Adjusted Prevalence Ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated.
Results
The prevalence of alcohol abuse was 5.2%. Having higher education (aPR:1.61; 95%CI:1.04–2.48), being widowed, separated or divorced (aPR:1.73; 95%CI:1.18–2.54), belonging to the third (aPR:1.70; 95%CI:1.12–2.60), fourth (aPR:2.08; 95%CI:1.33–3.23) or fifth socioeconomic quintile (aPR:2.16; 95%CI:1.33–3.50), being from the Sierra (aPR:1.45; 95%CI:1.12–1.87) or Selva (aPR:1.48; 95%CI:1.13–1.94), not having health insurance (aPR:1.25; 95%CI:1.04–1.50), being a current smoker (aPR:2.43; 95%CI:2.02–2.93) and having major depression (aPR:1.77; 95%CI:1.32–2.36) were associated with a higher prevalence of alcohol abuse. On the other hand being a middle-aged adult (aPR:0.73; 95%CI:0.60–0.88), female (aPR:0.16; 95%CI:0.12–0.22) and having started drinking alcohol after the age of 18 years (aPR:0.57; 95%CI:0.47–0.69) were associated with a lower prevalence.
Conclusions
One in 20 Peruvians between 18 and 59 years had alcohol abuse. Age, gender, education level, marital status, socioeconomic level, region, age of first drink, smoking and depression were associated with alcohol abuse.
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Affiliation(s)
- Brenda Caira-Chuquineyra
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola , 15074 Lima , Peru
- Facultad de Medicina, Universidad Nacional de San Agustín de Arequipa , 04000 Arequipa , Peru
| | - Daniel Fernandez-Guzman
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola , 15074 Lima , Peru
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco , 08000 Cusco , Peru
| | - Carlos Quispe-Vicuña
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola , 15074 Lima , Peru
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos , 15081 Lima , Peru
| | - Raysa Gutierrez-Rodriguez
- Escuela Profesional de Medicina Humana, Universidad Nacional de San Antonio Abad del Cusco , 08000 Cusco , Peru
| | - Pablo D Valencia
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México , 04510 Mexico , Mexico
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Powell A, Sumnall H, Smith J, Kuiper R, Montgomery C. Recovery of neuropsychological function following abstinence from alcohol in adults diagnosed with an alcohol use disorder: Protocol for a systematic review of longitudinal studies. PLoS One 2022; 17:e0274752. [PMID: 36173976 PMCID: PMC9521940 DOI: 10.1371/journal.pone.0274752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Alcohol use disorders (AUD) associate with structural and functional brain differences, including impairments in neuropsychological functions; however, review level research (largely cross-sectional) is inconsistent with regards to recovery of such functions following abstinence. Such recovery is important, as these impairments associate with treatment outcomes and quality of life. OBJECTIVE(S) To assess neuropsychological function recovery following abstinence in individuals with a clinical AUD diagnosis. The secondary objective is to assess predictors of neuropsychological recovery in AUD. METHODS Four electronic databases (APA PsycInfo, EBSCO MEDLINE, CINAHL, Web of Science Core Collection) will be searched between 1999-2022, with search strategies adapted for each source. Study reporting will follow the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, study quality will be assessed using the JBI Checklist for Cohort Studies. Eligible studies are those with a longitudinal design that assessed neuropsychological recovery following abstinence from alcohol in adults with a clinical diagnosis of AUD. Studies will be excluded if participant group is defined by another or co-morbid condition/injury, or by relapse. RESULTS This is an ongoing review. As of July 2022, the review protocol is registered on PROSPERO (CRD42022308686), searches have been conducted, and screening is in progress. Results are predicted to be complete by October 2022. CONCLUSIONS Comparing data on neuropsychological recovery from AUD will improve understanding of the impact of alcohol on the brain, and the relationship between AUD recovery and quality of life/treatment outcomes. It may provide information that could one day inform aspects of treatment and aftercare (e.g., options for cognitive training of functions that do not improve on their own).
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Affiliation(s)
- Anna Powell
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Harry Sumnall
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jessica Smith
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
- Faculty of Health, Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Rebecca Kuiper
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
| | - Catharine Montgomery
- Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
- Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, United Kingdom
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Lal A, Mohebi M, White SL, Scollo M, McCaffrey N. Household expenditure of smokers and ex-smokers across socioeconomic groups: results from a large nationwide Australian longitudinal survey. BMC Public Health 2022; 22:1706. [PMID: 36076210 PMCID: PMC9461138 DOI: 10.1186/s12889-022-14083-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Countries with best practice tobacco control measures have experienced significant reductions in smoking prevalence, but socioeconomic inequalities remain. Spending on tobacco products, particularly by low-income groups can negatively affect expenditure on other goods and services. This study aims to compare the household expenditure of adults who smoke tobacco products and those who formerly smoked across socioeconomic groups. METHODS Daily smokers and ex-smokers were compared using the Household, Income and Labour Dynamics in Australia Survey, over 7 waves. Adults who never smoked were not included. Participants were continuing sample members across waves. Mean number of participants per wave was 2505, 25% were smokers and 75% ex-smokers. The expenditure variables investigated included tobacco products, alcohol, motor vehicle fuel, health practitioners, insurance, education, and meals eaten out. Regression models using the generalized estimating equation technique were employed to compare expenditure data aggregated across the waves by Socioeconomic Index for Areas (SEIFA) quintiles of relative socio-economic advantage/disadvantage while accounting for within-participant autocorrelation. Quintiles are ranked by information such as the income, occupation and access to material and social resources of the residents. RESULTS Smokers from all quintiles spent significantly less per year on meals out, education and insurance than ex-smokers (p < 0.001). Smokers from quintiles 2-5 spent less on groceries, medicines, and health practitioners (p < 0.01). Smokers from quintiles 1 and 2 (most disadvantaged), spent less on motor vehicle fuel than ex-smokers ($280;95%CI: $126-$434), ($213;95%CI: $82-$344). Smokers from quintiles 2 and 3 spent more on alcohol ($212;95%CI: $86-$339), ($231.8;95%CI: $94-$370) than ex-smokers. Smokers from the least disadvantaged groups spent less on clothing than ex-smokers ($348;95%CI: $476-$221), ($501; 95%CI: $743-$258). Across the whole sample, smokers spent more than ex-smokers on alcohol ($230;95%CI:$95-$365) and less on meals out ($361;95%CI:$216-$379), groceries ($529;95%CI:$277-$781), education ($456;95%CI:$288-$624), medicine ($71;95%CI:$38-$104), health practitioners ($345;95%CI:$245-$444) and insurance ($318;95%CI:$229-$407). CONCLUSIONS Smoking cessation leads to reallocation of spending across all socioeconomic groups, which could have positive impacts on households and their local communities. Less spending on alcohol by ex-smokers across the whole sample could indicate a joint health improvement associated with smoking cessation.
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Affiliation(s)
- Anita Lal
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia.
| | - Mohammadreza Mohebi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Australia
| | | | - Michelle Scollo
- Quit, Cancer Council Victoria, Melbourne, Australia
- Cancer Council Victoria, Melbourne, Australia
| | - Nikki McCaffrey
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Australia
- Cancer Council Victoria, Melbourne, Australia
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Nicotine alleviates alcohol-induced memory and long-term potentiation impairment. Neurosci Lett 2022; 786:136813. [PMID: 35878655 DOI: 10.1016/j.neulet.2022.136813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Alcohol and nicotine are routinely abused together. There is one plausible explanation that comorbidity can alleviate alcohol-induced cognitive impairment. However, the mechanism involved is not known. The aim of this report was to evaluate the interactive effects of alcohol coadministration with nicotine on hippocampal memory and long-term potentiation (LTP). C57BL/6 mice were distributed into 4 treatment groups: control, alcohol, nicotine, and alcohol plus nicotine. All mice received tap water or alcohol solution and saline or nicotine. In water maze test, the alcohol group showed significant decreases in hippocampus function and acquisition training than control, nicotine, and combined treatment groups. The alcohol group also showed a significantly shorter latency in entering the foot-shock compartment than control, nicotine, and combined treatment groups in a passive avoidance test. Theta burst stimulation was adopted to induce concrete LTP in CA1 field recording using hippocampal slice. Alcohol alone administration failed to maintain LTP. Nicotine alone administration did not alter hippocampal LTP. There were no negative effects of alcohol on hippocampal LTP in mice administrated with nicotine. The current study successfully demonstrated beneficial effects of nicotine on alcohol induced memory impairment accompanied by hippocampal LTP impairment after one week of co-administration and one-day withdrawal.
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18
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AshaRani PV, Sin KY, Abdin E, Vaingankar JA, Shafie S, Shahwan S, Chang S, Sambasivam R, Subramaniam M. The Relationship of Socioeconomic Status to Alcohol, Smoking, and Health: a Population-Level Study of the Multiethnic Population in Singapore. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00882-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Frie JA, Nolan CJ, Murray JE, Khokhar JY. Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping. Nicotine Tob Res 2022; 24:1141-1149. [PMID: 34758090 PMCID: PMC9278825 DOI: 10.1093/ntr/ntab231] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/03/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022]
Abstract
PURPOSE Nicotine and alcohol-containing products are some of the most commonly used substances of abuse and are both leading causes of preventable death. These substances also have significant interactions that have additive and, in some cases, multiplicative effects on the health consequences of their use. Thus, to reduce these negative consequences, it is important to understand the abuse liability of nicotine and alcohol in combination, especially in the most relevant use cases among those who are most vulnerable. Specifically, as tobacco cigarette use is continually decreasing, vaping is quickly replacing cigarettes as the primary mode of nicotine use. This pattern is especially true in adolescent populations in which vaping has grown considerably. Particularly concerning is that adolescents are more vulnerable than adults to the negative consequences of substance use. It is therefore imperative to revisit the literature as it relates to the rising state of co-use of vaping products with alcohol. Here, we review the clinical outcomes of nicotine and alcohol co-use as they relate to the abuse liability of each individually. Special attention is paid to adolescent findings, where available, as well as investigations that use nontobacco nicotine products as these may more accurately reflect the more recent trends of co-use. IMPLICATIONS Though nicotine alone has previously been considered a proxy for tobacco and tobacco cigarette use, combustible routes of administration have been decreasing. They are, instead, being replaced by e-cigarettes that do not involve other tobacco constituents and contain additional nonnicotine constituents of their own. Unfortunately, the literature remains limited with regard to e-cigarettes and their interactions with other substances, especially their prevalent co-use with alcohol. This review attempts to discuss the current literature on nicotine and alcohol co-use in the context of the vaping epidemic, predominantly focusing on addiction-related outcomes and why e-cigarette use may be unique.
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Affiliation(s)
- Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
| | - Caitlin J Nolan
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Jennifer E Murray
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
- Collaborative Neurosciences Graduate Program, University of Guelph, Guelph, ON, Canada
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Seemiller LR, Logue SF, Gould TJ. Inbred mouse strain differences in alcohol and nicotine addiction-related phenotypes from adolescence to adulthood. Pharmacol Biochem Behav 2022; 218:173429. [PMID: 35820468 DOI: 10.1016/j.pbb.2022.173429] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/18/2022] [Accepted: 07/06/2022] [Indexed: 11/20/2022]
Abstract
Understanding the genetic basis of a predisposition for nicotine and alcohol use across the lifespan is important for public health efforts because genetic contributions may change with age. However, parsing apart subtle genetic contributions to complex human behaviors is a challenge. Animal models provide the opportunity to study the effects of genetic background and age on drug-related phenotypes, while controlling important experimental variables such as amount and timing of drug exposure. Addiction research in inbred, or isogenic, mouse lines has demonstrated genetic contributions to nicotine and alcohol abuse- and addiction-related behaviors. This review summarizes inbred mouse strain differences in alcohol and nicotine addiction-related phenotypes including voluntary consumption/self-administration, initial sensitivity to the drug as measured by sedative, hypothermic, and ataxic effects, locomotor effects, conditioned place preference or place aversion, drug metabolism, and severity of withdrawal symptoms. This review also discusses how these alcohol and nicotine addiction-related phenotypes change from adolescence to adulthood.
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Affiliation(s)
- Laurel R Seemiller
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA
| | - Sheree F Logue
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA
| | - Thomas J Gould
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA.
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21
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Endashaw Hareru H, Kaso AW, Debela BG, Abebe L, Sisay W/Tsadik D, Kassa Abebe R, Kassaw C. Alcohol use disorder and its associated factors among residents in Southern Ethiopia during the era of COVID-19. SAGE Open Med 2022; 10:20503121221105031. [PMID: 35756350 PMCID: PMC9218489 DOI: 10.1177/20503121221105031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/14/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives: To determine the prevalence of alcohol use disorder and associated factors among residents of Dilla town, Gedeo zone, Southern Ethiopia, 2021. Methods: A community-based cross-sectional study was conducted among 666 randomly selected participants. Interview-assisted structured questionnaire was used to collect data, and alcohol use disorder identification test was employed to measure alcohol use disorder. The data were entered in to Epi info version 7 and exported in to SPSS version 25 for analysis. Both bivariate and multivariate binary logistic regression analysis were used to identify significant factors related with alcohol use disorder. In the multivariate model, variables with p value < 0.05 were considered as a statistical significant factor for the outcome variable. Finally, adjusted odds ratio with 95% confidence interval was computed to assess the strength of association. Results: The magnitude of alcohol used disorder during the past year was 30.6% (95% confidence interval: 25.5%–35.7%). Being male (adjusted odds ratio = 8.33, 95% confidence interval: (4.34, 15.98)), age of less than 33 years old (adjusted odds ratio = 1.78, 95% confidence interval: (1.06, 3.00)), current cigarette smoking (adjusted odds ratio = 2.49, 95% confidence interval: (1.42, 4.37)), current khat chewing (adjusted odds ratio = 6.23, 95% confidence interval: (3.8, 9.92)), high level of psychological distress (adjusted odds ratio = 7.69, 95% confidence interval: (4.16, 14.28)) and poor social support (adjusted odds ratio = 2.30, 95% confidence interval: (1.27, 4.18)) were significantly associated with alcohol use disorder. Conclusion: A large percentage of respondents in our sample had an alcohol use disorder. Alcohol use problems were linked to being men, under the age of 33 years old, current khat chewing, current cigarette smoking, a high level of psychological distress, and poor of social support. As a result, early screening, public health intervention programs and establishing appropriate referral linkages with mental health facilities are recommended.
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Affiliation(s)
- Habtamu Endashaw Hareru
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Abdene Weya Kaso
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Berhanu Gidisa Debela
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Lulu Abebe
- Department of Psychiatry, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Daniel Sisay W/Tsadik
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Reta Kassa Abebe
- School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Chalachew Kassaw
- Department of Psychiatry, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
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22
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Moore JR, Castro Y, Cubbin C, von Sternberg K. Associations of At-Risk Drinking, Current Smoking, and Their Co-Occurrence With Primary Care Service Utilization. Am J Health Promot 2022; 36:429-439. [PMID: 34865517 PMCID: PMC10409595 DOI: 10.1177/08901171211056130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Smoking and at-risk drinking are each associated with lower primary care utilization, but the influence of their co-occurrence is not known. The current study compared associations of endorsement of one behavior vs endorsement of both with primary care utilization. DESIGN Cross-sectional telephone survey. SETTING All United States and Territories. SUBJECTS 246 801 adults aged 18-64. MEASURES The outcome was endorsement of attending a past-year primary care visit. Predictor variables included drinking and smoking status examined individually and combined. ANALYSIS Multivariable logistic regressions, adjusted for socio-demographics and number of chronic health conditions. RESULTS The odds of attending a past-year primary care visit were 24% lower for persons who drank at risk levels compared to the odds of persons who did not drink and 36% lower for persons who smoked vs those who did not smoke. Among persons who endorsed at least one risk behavior, the odds of attending a past-year primary care visit were 25-35% lower for those who engaged in multiple behaviors compared to the odds of persons who engaged in one behavior. CONCLUSION Substance use screening and intervention services in primary care may not be reaching individuals with the greatest need for services. Proactive outreach and identification of primary care utilization barriers are needed, with special consideration of those with co-occurring substance use.
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Affiliation(s)
- John R. Moore
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Catherine Cubbin
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Kirk von Sternberg
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
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Walsh BE, Williams CM, Zale EL. Expectancies for and Pleasure from Simultaneous Alcohol and E-Cigarette Use among Young Adults. Subst Use Misuse 2022; 57:2101-2109. [PMID: 36331140 DOI: 10.1080/10826084.2022.2136495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: Young adults' use of alcohol and e-cigarettes are of public health concern, as they report among the highest prevalence for use of both substances. Many young adults use alcohol and e-cigarettes simultaneously (i.e., at the same time with overlapping effects) despite heightened risk for adverse effects. Objectives: This study assessed simultaneous use expectancies and changes in pleasure from e-cigarettes as a function of alcohol consumption and simultaneous use frequency. Participants (N = 408; Mage = 23.64 years; 52.7% female) recruited through Amazon MTurk completed measures of alcohol and e-cigarette use, and expectancies, pleasure and frequency of simultaneous use. Results: Separate linear regression models revealed that alcohol consumption was positively associated with expectancies for simultaneous use of e-cigarettes/alcohol and pleasure from simultaneous use (ps ≤ .015). As individuals engaged in simultaneous use more frequently, they also reported greater expectancies for, and increased pleasure from, simultaneous use (ps < .001). Conclusions/Importance: Expectancies for simultaneous use may be greatest among young adults who consume more alcohol and engage in simultaneous use more frequently. Increased pleasure from e-cigarettes while drinking suggests that positive reinforcement may be implicated in simultaneous use patterns. Future research should examine the role of pleasure in simultaneous use trajectories.
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Affiliation(s)
- Brendan E Walsh
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Callon M Williams
- Department of Psychology, Harpur College of Arts & Sciences, Binghamton University, Binghamton, New York, USA
| | - Emily L Zale
- Department of Psychology, Harpur College of Arts & Sciences, Binghamton University, Binghamton, New York, USA
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Martinez MC, Latorre MDRDDO, Fischer FM. Factors associated with alcohol abuse in nursing professionals in São Paulo State, Brazil. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2022. [DOI: 10.1590/2317-6369/01322en2022v47edepi1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract Objective: to identify factors associated with alcohol abuse in nursing professionals in São Paulo State. Methods: this is a case-control nested in a cross-sectional study. We collected data on demographic characteristics, lifestyle, work ability, occupational features, physical and psychosocial work environment, and alcohol abuse (CAGE Questionnaire). Multiple logistic regression analyses were performed. Results: the study involved 119 participants in the case group and 356 in the control group. After age adjustment, alcohol abuse was associated with male sex (OR: 3.39; 95%CI: 1.96;5.85), current or former smoking (OR: 2.11; 95%CI: 1.32;3.38), and poor sleep quality (OR: 1.91; 95%CI: 1.12;3.25); and negatively associated with ≥50 weekly working hours (OR: 0.54;95%CI: 0.32;0.92) and a monthly family income ≥6.1 minimum wages(OR: 0.37; 95%CI: 0.20;0.67). Conclusions: working hours and individual characteristics were associated with alcohol abuse. Workplaces should implement programs to prevent and treat alcohol abuse in nursing professionals to reduce workers’ and patients’ alcohol-related harms.
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Martinez MC, Latorre MDRDDO, Fischer FM. Fatores associados ao consumo abusivo de álcool em profissionais de enfermagem no estado de São Paulo, Brasil. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2022. [DOI: 10.1590/2317-6369/01322pt2022v47edepi1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Resumo Objetivo: identificar fatores associados ao consumo abusivo de álcool entre profissionais de Enfermagem no estado de São Paulo. Métodos: trata-se de um estudo caso-controle aninhado a um transversal. Foram coletados dados sobre características demográficas, do estilo de vida, capacidade para o trabalho, aspectos ocupacionais, do ambiente de trabalho físico e psicossocial e de consumo abusivo de álcool (questionário CAGE). Foi realizada análise de regressão logística múltipla. Resultados: o estudo envolveu 119 casos e 356 controles. Após ajuste por idade, o consumo abusivo de álcool foi associado ao sexo masculino (OR: 3,39; IC95%:1,96;5,85), tabagismo atual ou pregresso (OR: 2,11; IC95%: 1,32;3,38) e à qualidade do sono ruim (OR: 1,91; IC95%:1,12;3,25); e negativamente associado a carga horária de trabalho semanal ≥50 horas (OR: 0,54; IC95%:0,32;0,92) e renda familiar mensal de ≥6,1 salários-mínimos (OR: 0,37; IC95%: 0,20;0,67). Conclusões: jornada de trabalho e características individuais estiveram associadas ao consumo abusivo de álcool. Programas de prevenção e tratamento do consumo abusivo de álcool em profissionais da Enfermagem deveriam ser implementados nos locais de trabalho, visando reduzir os danos causados pelo álcool para trabalhadores e pacientes.
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Kechter A, Cho J, Miech RA, Barrington-Trimis JL, Leventhal AM. Nicotine dependence symptoms in U.S. youth who use JUUL E-cigarettes. Drug Alcohol Depend 2021; 227:108941. [PMID: 34416679 PMCID: PMC8464491 DOI: 10.1016/j.drugalcdep.2021.108941] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 06/24/2021] [Accepted: 07/03/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To estimate the prevalence, patterns, and correlates of self-reported nicotine dependence symptoms among U.S. youth who use JUUL - a widely-sold e-cigarette brand - in 2019 and compare findings to nicotine dependence symptoms in youth who smoke cigarettes. METHODS Data were from a nationally-representative subsample of 8th, 10th, and 12th grade students in the Monitoring the Future Study who had used JUUL or cigarettes in the past 30 days. Participants self-reported presence/absence of 9 different nicotine dependence symptoms for JUUL or cigarettes. Weighted percentages for JUUL or cigarette nicotine dependence symptom status (≥1 vs. 0 symptoms) and severity (count, range: 0-9) were calculated. Among JUUL users, we estimated associations of sociodemographic characteristics and other substance use with nicotine dependence and severity. RESULTS Among 1,748 past 30-day JUUL users, 41.3 % screened positive for ≥1 nicotine dependence symptoms; the mean symptom count was 1.6 (SD = 2.6). Non-nicotine substance use and more frequent JUUL use was associated with significantly greater odds of dependence and more severe dependence symptoms in multivariable models. The severity distribution of most (craving) and least (inability to quit) dependence symptom types observed in JUUL dependence paralleled those observed in analysis of combustible cigarette dependence symptoms in past 30-day smokers. CONCLUSION A substantial proportion of U.S. adolescent JUUL users reported symptoms of nicotine dependence, which is greater for those who vape more frequently and use other substances. Nicotine dependence screening, prevention, and regulatory policies addressing use of JUUL or similar e-cigarette products should be considered to protect U.S. youth.
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Affiliation(s)
- Afton Kechter
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States.
| | - Junhan Cho
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA
| | - Richard A. Miech
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | | | - Adam M. Leventhal
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA,Institute for Addiction Science, University of Southern California, Los Angeles, CA
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27
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Legas G, Asnakew S, Belete A, Beyene GM, Wubet GM, Bayih WA, Chanie ES, Tigabu A, Dessie T. Magnitude and correlates of alcohol use disorder in south Gondar zone, northwest Ethiopia: A community based cross-sectional study. PLoS One 2021; 16:e0257804. [PMID: 34591890 PMCID: PMC8483395 DOI: 10.1371/journal.pone.0257804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Alcohol use disorder is the major public health problem in low- and middle-income countries that account for up to 70% of alcohol related premature mortality in the region. Therefore, the aim of this study was to assess the magnitude of alcohol use disorder and its associated factors among adult residents in south Gondar zone, Northwest Ethiopia. METHODS A community-based cross-sectional study was conducted among 848 adult residents of the south Gondar zone from January 13 to February 13, 2020. A multistage sampling technique was used to recruit study participants. We assessed alcohol use disorder (AUD) using the alcohol use disorder identification test (AUDIT). A binary logistic regression model was employed to identify factors associated with AUD. RESULTS The prevalence of alcohol use disorder over the last 12-months was found to be 23.7% (95% CI: 20.9, 26.7). Being male (AOR = 4.34, 95 CI; 2.800, 6.743), poor social support (AOR = 1.95, 95 CI: 1.098, 3.495), social phobia (AOR = 1.69, 95 CI; 1.117, 2.582), perceived high level of stress (AOR = 2.85, 95 CI; 1.829, 34.469), current cigarette smoking (AOR = 3.06, 95 CI; 1.764, 5.307) and comorbid depression (AOR = 1.81, 95 CI; 1.184, 2.778) were significantly associated with alcohol use disorder. CONCLUSION The prevalence of alcohol use disorder is high among adult residents of the south Gondar zone and associated with many factors. So, it needs public health attention to decrease the magnitude of alcohol use disorder in Ethiopia.
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Affiliation(s)
- Getasew Legas
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Mihretie Beyene
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Mehiret Wubet
- Department of Medicine, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Agimasie Tigabu
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Dessie
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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28
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Motschman CA, Tiffany ST. Combined smoking and alcohol cues: Effects on craving, drug-seeking, and consumption. Alcohol Clin Exp Res 2021; 45:1864-1876. [PMID: 34469584 DOI: 10.1111/acer.14662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol and cigarettes are commonly used together, but little is known about their joint motivational impact. Cue reactivity studies have customarily examined alcohol and smoking cues in isolation, despite the potential for cues to elicit stronger motivational responses when combined. This study used a validated cue reactivity procedure (Choice Behavior Under Cued Conditions) systematically to disentangle the separate and joint effects of alcohol and cigarette cues on substance use motivation. METHODS Participants were 110 adults (Mage = 34.0, SD = 10.8) who consumed both cigarettes and alcohol. Participants completed 40 cue reactivity trials with four in vivo cue types: water, alcohol, cigarette, and combined cigarette and alcohol. Participants rated their craving prior to receiving opportunities to spend real money to gain access to the cues. Spending larger amounts of money increased the probability that the substance(s) would be available for consumption. When granted access, participants took one cigarette puff and/or sip of the beverage. A multimethod approach assessed three key motivational indices: craving, drug-seeking (spending, latency to access the cue), and consumption (puff duration, alcohol consumed). Effects of cue type and rates of substance use (cigarettes per day, drinks per day, relative frequency of co-use) were assessed using hierarchical linear models. RESULTS Both alcohol and smoking cues enhanced cue-specific craving but not craving for the alternative substance. In a novel finding, combined cues elicited higher craving and greater spending than single-drug cues. All drug cues elicited greater spending than water cues, and spending was moderated by the relative frequency of co-use. CONCLUSIONS We found that combined alcohol and cigarette cues provoke more powerful craving and drug-seeking responses and, therefore, may be more motivationally potent among individuals who use multiple substances.
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Affiliation(s)
- Courtney A Motschman
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA.,Department of Psychological Sciences, University of Missouri, Columbia, Columbia, Missouri, USA
| | - Stephen T Tiffany
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York, USA
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29
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Blondino CT, Clifford JS, Lu J, Prom-Wormley EC. The association between internalizing and externalizing severity with current use of cigarettes, e-cigarettes, and alcohol in adults: Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. Addict Behav 2021; 119:106890. [PMID: 33901812 PMCID: PMC9294613 DOI: 10.1016/j.addbeh.2021.106890] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/26/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Concurrent tobacco/alcohol use is common in adults, and associated with the severity of symptoms experienced by those with mental health disorders. However, few studies have explored this relationship across different combinations of tobacco products [i.e., conventional cigarette (CC) and electronic cigarette (EC)] and alcohol. METHODS Data from the Wave 1 (2013-2014) Population Assessment of Tobacco and Health study were used. A total of 15,947 adults aged 18 years or older with complete study information were included. Multinomial logistic regression analyses were performed to determine the relationship between lifetime internalizing/externalizing severity and past 30-day use of tobacco and alcohol, adjusting for nicotine dependence (ND), sex, age, race, education, and income. RESULTS Internalizing severity was more strongly associated with CC and alcohol use (moderate AOR = 1.47, 95% CI = 1.22-1.77; high AOR = 1.29, 95% CI = 1.03-1.61) as well as alcohol-exclusive use (moderate AOR = 1.58, 95% CI = 1.27-1.96; high AOR = 1.31, 95% CI = 1.05-1.64) while externalizing severity was more strongly associated with EC and alcohol use (high AOR = 2.97, 95% CI = 1.84-4.81, moderate AOR = 2.29, 95% CI = 1.53-3.43) when accounting for ND compared to none. The relationship between externalizing severity with EC use was dependent on alcohol being used with EC. CONCLUSIONS The associations between psychopathology (internalizing vs. externalizing severity) varies by different combinations of alcohol, CC, and EC. Further, these relationships may be mediated through ND. Future investigations into the comorbidity between mental disorder symptoms with tobacco and alcohol use should consider use of specific substances as well as their combination.
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Affiliation(s)
- Courtney T Blondino
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA.
| | - James S Clifford
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA
| | - Elizabeth C Prom-Wormley
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, 830 East Main Street, PO Box 980212, Richmond, VA 23298-0212, USA
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30
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Watten RG, Watten VP. Snus and Alcohol: Mutually Rewarding Effects in the Brain? A Matched Controlled Population Study. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 15:11782218211027124. [PMID: 34366668 PMCID: PMC8317241 DOI: 10.1177/11782218211027124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/28/2021] [Indexed: 12/02/2022]
Abstract
Background: The use of moist smokeless tobacco (snus) is increasing in the U.S. and other Western countries, and especially among young people. Snus is associated with several health problems, but the relationship between use of snus and alcohol is scarcely explored. Neuro-cognitive and psychological research suggest an association due to possible mutually rewarding effects in the limbic brain. We investigated this issue in a matched controlled population study. Methods: Matched control group design where drinking habits and alcohol consumption in a group of users of snus (n = 1043, mean age = 35.20; n men = 749, n women = 294) were compared to a control group of non-users matched on age and gender (n = 1043, mean age = 35.65; n men = 749, n women = 294). In addition, we registered background variables such as level of education, income, self-perceived general, dental health, mental health, current depressive symptoms, and BMI. In estimation of alcohol consumption, the background variables were used as covariates in factorial analyses of variance (ANCOVA). Results: Users of snus had lower level of education, lower income, poorer general, dental, and mental health status than non-users, but there were no differences in BMI. Differences in mental health status were related to drinking habits. Users of snus had a higher frequency of drinking, higher frequency of intoxication, and showed more excess drinking. Controlled for background variables users of snus had a 25.2% higher estimated yearly consumption of alcohol in terms of standard units of alcohol on the weekdays, 26.4% higher on weekends and a 60.2% higher yearly excess consumption. Conclusion: Users of snus had an elevated alcohol consumption and another drinking style than non-users. The findings are discussed according to neuro-cognitive and psychopharmacological mechanisms, reward learning and conditioning. The results have implications for prevention, treatment and rehabilitation of alcohol and nicotine dependence.
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Affiliation(s)
- Reidulf G Watten
- Department of Psychology, Inland Norway University of Applied Sciences, INN University, Norway
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de Veld L, Wolberink IM, van Hoof JJ, van der Lely N. The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication. BMC Pediatr 2021; 21:233. [PMID: 34001049 PMCID: PMC8127301 DOI: 10.1186/s12887-021-02710-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/05/2021] [Indexed: 11/28/2022] Open
Abstract
Background This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated. Methods The national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information. Results During the period 2007–2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0–23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9–12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission. Conclusions Assessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians’ attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents’ alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.
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Affiliation(s)
- Loes de Veld
- Erasmus University, European School of Health Policy and Management, Burg. Oudlaan 50, 3062, Rotterdam, PA, The Netherlands. .,Department of Paediatrics, Reinier de Graaf Gasthuis, Reinier de Graafweg 5, 2635, Delft, AD, The Netherlands.
| | - Inge M Wolberink
- Department of Paediatrics, Reinier de Graaf Gasthuis, Reinier de Graafweg 5, 2635, Delft, AD, The Netherlands
| | - Joris J van Hoof
- Faculty of Behavioural, Management and Social Sciences, University of Twente, PO Box 217, 7500, Enschede, AE, The Netherlands
| | - Nico van der Lely
- Department of Paediatrics, Reinier de Graaf Gasthuis, Reinier de Graafweg 5, 2635, Delft, AD, The Netherlands.,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, WILRIJK, 2610, Antwerpen, Belgium
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Suarez JA, Solano JL, Barrios KP, Ortega LA. Nicotine increases behavioral variability on radial arm maze extinction. A preliminary study. LEARNING AND MOTIVATION 2021. [DOI: 10.1016/j.lmot.2021.101721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Quraishi R, Sharma J, Jain R, Ambekar A. Influence of catechol-O-methyltransferase enzyme gene polymorphism on alcohol and tobacco consumption in North Indian treatment seeking population. Indian J Psychiatry 2021; 63:240-244. [PMID: 34211216 PMCID: PMC8221225 DOI: 10.4103/psychiatry.indianjpsychiatry_465_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/17/2020] [Accepted: 05/30/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The co-occurrence of alcohol and tobacco dependence is frequently witnessed in treatment settings. It is a challenge for clinicians to treat such patients due to their powerful biological association. AIM The study is aimed to assess the relationship of Catechol-O-methyltransferase (COMT) Val158Met polymorphism with substance intake among individuals who are dependent on both alcohol and tobacco. MATERIALS AND METHODS A cross-sectional study involving patients coming to the outpatient department was planned. Brief information on their sociodemographic and substance use profile was recorded. Genotyping of COMT Val158Met was carried out using established polymerase chain reaction-restriction fragment length polymorphism method. The COMT genotyping was classified based on the presence or absence of Met allele using the dominant model. Descriptive statistics, Chi-square test, Mann-Whitney test, and Binary logistic regression analysis were performed to analyze the data. RESULTS The study included 104 alcohol and nicotine co-dependent subjects. More than eighty percent of the participants were educated above secondary level, married, and employed. The allele frequencies of met and Val were found to be 0.23 and 0.77, respectively. Forty percent of the participants reported tobacco-related health problems. The odds of consuming alcohol and nicotine were four times high among Met allele carriers. While the Fagerström test for nicotine dependence and heaviness of smoking index scores were up to four and eight times higher among met allele (odds ratio 4.3 and 8.9, respectively). CONCLUSION Patients carrying Met allele are reported to consume higher amounts of alcohol and tobacco and were likely to score high among measures of nicotine dependence. Thus met allele carriers needs additional attention for a successful treatment outcome.
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Affiliation(s)
- Rizwana Quraishi
- Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences, Delhi, India
| | - Jaydeep Sharma
- Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences, Delhi, India
| | - Raka Jain
- Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences, Delhi, India
| | - Atul Ambekar
- Department of Psychiatry, National Drug Dependence Treatment Center, All India Institute of Medical Sciences, Delhi, India
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Saxton J, Rodda SN, Booth N, Merkouris SS, Dowling NA. The efficacy of Personalized Normative Feedback interventions across addictions: A systematic review and meta-analysis. PLoS One 2021; 16:e0248262. [PMID: 33793583 PMCID: PMC8016245 DOI: 10.1371/journal.pone.0248262] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 02/23/2021] [Indexed: 12/11/2022] Open
Abstract
Personalized Normative Feedback (PNF) may help address addictive disorders. PNF highlights discrepancies between perceived and actual peer norms, juxtaposed against self-reported behavior. PNF can be self-directed and cost-efficient. Our study estimates the efficacy of PNF alone, and in combination with other self-directed interventions, to address frequency and symptom severity of hazardous alcohol use, problem gambling, illicit drug and tobacco use. We searched electronic databases, grey literature, and reference lists of included articles, for randomized controlled trials published in English (January 2000-August 2019). We assessed study quality using the Cochrane Risk of Bias tool. Thirty-four studies met inclusion criteria (k = 28 alcohol, k = 3 gambling, k = 3 cannabis, k = 0 tobacco). Thirty studies provided suitable data for meta-analyses. PNF alone, and with additional interventions, reduced short-term alcohol frequency and symptom severity. PNF with additional interventions reduced short-term gambling symptom severity. Effect sizes were small. PNF did not alter illicit drug use. Findings highlight the efficacy of PNF to address alcohol frequency and symptom severity. The limited number of studies suggest further research is needed to ascertain the efficacy of PNF for gambling and illicit drug use. Cost-effectiveness analyses are required to determine the scale of PNF needed to justify its use in various settings.
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Affiliation(s)
- Jenny Saxton
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Simone N. Rodda
- School of Population Health, University of Auckland, Auckland, New Zealand
- School of Psychology, Deakin University, Geelong, Australia
- * E-mail:
| | - Natalia Booth
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Nicki A. Dowling
- School of Psychology, Deakin University, Geelong, Australia
- Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
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Drug addiction co-morbidity with alcohol: Neurobiological insights. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 157:409-472. [PMID: 33648675 DOI: 10.1016/bs.irn.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Addiction is a chronic disorder that consists of a three-stage cycle of binge/intoxication, withdrawal/negative affect, and preoccupation/anticipation. These stages involve, respectively, neuroadaptations in brain circuits involved in incentive salience and habit formation, stress surfeit and reward deficit, and executive function. Much research on addiction focuses on the neurobiology underlying single drug use. However, alcohol use disorder (AUD) can be co-morbid with substance use disorder (SUD), called dual dependence. The limited epidemiological data on dual dependence indicates that there is a large population of individuals suffering from addiction who are dependent on more than one drug and/or alcohol, yet dual dependence remains understudied in addiction research. Here, we review neurobiological data on neurotransmitter and neuropeptide systems that are known to contribute to addiction pathology and how the involvement of these systems is consistent or divergent across drug classes. In particular, we highlight the dopamine, opioid, corticotropin-releasing factor, norepinephrine, hypocretin/orexin, glucocorticoid, neuroimmune signaling, endocannabinoid, glutamate, and GABA systems. We also discuss the limited research on these systems in dual dependence. Collectively, these studies demonstrate that the use of multiple drugs can produce neuroadaptations that are distinct from single drug use. Further investigation into the neurobiology of dual dependence is necessary to develop effective treatments for addiction to multiple drugs.
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Domi A, Barbier E, Adermark L, Domi E. Targeting the Opioid Receptors: A Promising Therapeutic Avenue for Treatment in “Heavy Drinking Smokers”. Alcohol Alcohol 2021; 56:127-138. [DOI: 10.1093/alcalc/agaa139] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/12/2023] Open
Abstract
Abstract
Aims
Despite a general decline in tobacco use in the last decades, the prevalence of tobacco smoking in individuals with alcohol use disorder (AUD) remains substantial (45–50%). Importantly, the co-use of both substances potentiates the adverse effects, making it a significant public health problem. Substantial evidence suggests that AUD and Tobacco use disorder (TUD) may share common mechanisms. Targeting these mechanisms may therefore provide more effective therapy. Numerous studies describe a potential role of the endogenous opioid system in both AUD and TUD. Reviewing this literature, we aim to evaluate the efficacy of molecules that target the opioid system as promising therapeutic interventions for treating alcohol and tobacco co-use disorders.
Methods
We provide a synthesis of the current epidemiological knowledge of alcohol and tobacco co-use disorders. We evaluate clinical and preclinical research that focuses on the regulation of the endogenous opioid system in alcohol, nicotine, and their interactions.
Results
The epidemiological data confirm that smoking stimulates heavy drinking and facilitates alcohol craving. Pharmacological findings suggest that treatments that are efficacious in the dual addiction provide a beneficial treatment outcome in comorbid AUD and TUD. In this regard, MOP, DOP and NOP-receptor antagonists show promising results, while the findings prompt caution when considering KOP-receptor antagonists as a treatment option in alcohol and tobacco co-use disorders.
Conclusions
Existing literature suggests a role of the opioid system in sustaining the high comorbidity rates of AUD and TUD. Molecules targeting opioid receptors may therefore represent promising therapeutic interventions in ‘heavy drinking smokers.’
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Affiliation(s)
- Ana Domi
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Box 410, Gothenburg 405 30, Sweden
| | - Estelle Barbier
- Center for Social and Affective Neuroscience, Linköping University, Campus US, Entrance 65, Linköping 581 85, Sweden
| | - Louise Adermark
- Addiction Biology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy University of Gothenburg, Box 410, Gothenburg 405 30, Sweden
| | - Esi Domi
- Center for Social and Affective Neuroscience, Linköping University, Campus US, Entrance 65, Linköping 581 85, Sweden
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Amato MS, El-Toukhy S, Abroms LC, Goodfellow H, Ramsey AT, Brown T, Jopling H, Khadjesari Z. Mining Electronic Health Records to Promote the Reach of Digital Interventions for Cancer Prevention Through Proactive Electronic Outreach: Protocol for the Mixed Methods OptiMine Study. JMIR Res Protoc 2020; 9:e23669. [PMID: 33382041 PMCID: PMC7808893 DOI: 10.2196/23669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/12/2020] [Accepted: 11/24/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Digital behavior change interventions have demonstrated effectiveness for smoking cessation and reducing alcohol intake, which ultimately reduce cancer risk. Leveraging electronic health records (EHR) to identify at-risk patients and increasing the reach of digital interventions through proactive electronic outreach provide a novel approach that may increase the number of individuals who engage with evidence-based treatment. OBJECTIVE This study aims to increase the reach of digital behavior change interventions by implementing a proactive electronic message system for smoking cessation and alcohol reduction among a large, at-risk population identified through an acute hospital EHR. METHODS This protocol describes a 3-phase, mixed-methods implementation study to assess the acceptability, feasibility, and reach of a proactive electronic message system to digital interventions using a hospital's EHR system to identify eligible patients. In Phase 1, we will conduct focus group discussions with patients and hospital staff to assess the overall acceptability of the electronic message system. In Phase 2, we will conduct a descriptive analysis of the patient population in the hospital EHR regarding target risk behaviors and other person-level characteristics to determine the project's feasibility and potential reach. In Phase 3, we will send proactive messages to patients identified as smokers or risky drinkers. Messages will encourage and provide access to behavior change mobile apps via an embedded link; the primary outcome will be the proportion of participants who click on the link to access information about the apps. RESULTS At the time of initial protocol submission, data collection was complete, but analysis had not begun. This study was funded by Cancer Research UK from April 2019 to March 2020. Health Research Authority approval was granted in June 2019. CONCLUSIONS Increasing the reach of digital behavior change interventions can improve population health by reducing the burden of preventable death and disease. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/23669.
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Affiliation(s)
- Michael S Amato
- Truth Initiative, Washington DC, DC, United States
- College of Medicine and Science, Mayo Clinic, Rochester, MN, United States
| | - Sherine El-Toukhy
- Division of Intramural Research, The National Institute on Minority Health and Health Disparities, The National Institutes of Health, Bethesda, MD, United States
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, Washington DC, DC, United States
| | - Henry Goodfellow
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Alex T Ramsey
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
| | - Tracey Brown
- Behavioural and Implementation Science research group, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Helena Jopling
- West Suffolk NHS Foundation Trust, Bury St Edmunds, United Kingdom
| | - Zarnie Khadjesari
- Behavioural and Implementation Science research group, School of Health Sciences, University of East Anglia, Norwich, United Kingdom
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Determining nicotine-related behavior changes in juvenile female rats through long-term maternal nicotine exposure. Behav Pharmacol 2020; 31:34-44. [PMID: 31625971 DOI: 10.1097/fbp.0000000000000504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nicotine replacement therapy (NRT) has been developed as a drug therapy for smoking cessation and has been considered a safe alternative to smoking during pregnancy. However, the effects of long-term nicotine exposure via NRT on the fetus are still being debated. Here, we determined the effects of long-term maternal nicotine exposure in gestation and lactation on nicotine-related behavior and drug vulnerability in dams and offspring rats. To expose long-term nicotine, on gestation day 14, pregnant rats were implanted with osmotic minipumps releasing nicotine tartrate (6 mg/kg/day, subcutaneously, equivalent to 2 mg nicotine-freebase) for 28 days. The concentration of cotinine in blood was 373.0 ± 109.0 ng/ml in dams and 12.50 ± 1.19 ng/ml in offspring rats. In dams, we found no significant differences in anxiety-like behaviors and various maternal behaviors such as touching, sniffing, pup licking, laying on pups, and retrieval between saline- and nicotine-exposed groups. Adolescent offspring female rats showed no significant differences in anxiety-like behavior and forced alcohol consumption between saline- and nicotine-exposed groups. Nicotine-exposed offspring rats showed more increased nicotine aversion than saline-exposed groups, but the effect was disturbed in the forced alcohol consumption condition on the first day of the nicotine consumption test. Taken together, these results suggest that, in the last gestation and lactation period corresponding to the second and third trimester of human pregnancy, long-term maternal nicotine exposure has a minor effect on dam and female offspring health and does not involve serious pathological changes in rat offspring, despite the presence of nicotine in their blood.
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Necho M, Belete A, Getachew Y. The prevalence and factors associated with alcohol use disorder among people living with HIV/AIDS in Africa: a systematic review and meta-analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2020; 15:63. [PMID: 32831129 PMCID: PMC7444054 DOI: 10.1186/s13011-020-00301-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/12/2020] [Indexed: 01/11/2023]
Abstract
Background Alcohol use disorder (AUD) in HIV/AIDS patient’s decreases adherence and effectiveness of medications and help-seeking to HIV/AIDS care and treatment. This study, therefore, assessed the average 1 year prevalence and associated factors of alcohol use disorder in HIV/AIDS patients. Methods We did an electronic data search on PubMed, Scopus, EMBASE, Psych-INFO libraries, African index Medicus and African Journals Online (AJOL). Google scholar was also investigated for non-published articles. The reference lists of published articles were also reviewed. The stata-11meta-prop package was employed. Subgroup and sensitivity analyses were done. Cochran’s Q-statistics and the Higgs I2 test were used to check heterogeneity. Publication bias was evaluated with Egger’s test and funnel plots. Results Of 1362 articles identified using the search strategies; only 22 studies were included in the final analysis. The average 1 year prevalence of AUD was 22.03% (95% CI: 17.18, 28.67). The average prevalence of AUD in South Africa (28.77%) was higher than in Uganda (16.61%) and Nigeria (22.8%). The prevalence of AUD in studies published before 2011, 2011–2015, and after 2015 was found to be 13.47, 24.93, and 22.88% respectively. The average prevalence of AUD among studies with a sample size > 450 was 16.71% whereas it was 26.46% among studies with a sample size < 450. Furthermore, the average prevalence of hazardous, harmful, and dependent drinking was 10.87, 8.1, and 3.12% respectively. Our narrative analysis showed that male sex, cigarette smoking, family history of alcohol use, missing ART medication, mental distress, khat chewing, low CD4 count, and low income were among the associated factors for AUD in people with HIV AIDS. On quantitative meta-analysis for associated factors of AUD, the AOR of being male, Cigarette smoking and khat chewing were 5.5, 3.95, and 3.34 respectively. Conclusion The average 1 year prevalence of AUD in HIV/AIDs patients was high and qualitatively factors such as being Male, cigarette smoking, and khat chewing were associated with it. Therefore, clinical services for people living with HIV/AIDS should integrate this public health problem. Policymakers should also develop guidelines and implementation strategies for addressing this problem.
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Affiliation(s)
- Mogesie Necho
- Wollo University, College of Medicine and Health Sciences, Department of Psychiatry, Dessie, Ethiopia.
| | - Asmare Belete
- Wollo University, College of Medicine and Health Sciences, Department of Psychiatry, Dessie, Ethiopia
| | - Yibeltal Getachew
- College of Medicine and Health Sciences, Department of Psychiatry, Diredawa University, Diredawa, Ethiopia
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Bailey KL, Smith H, Mathai SK, Huber J, Yacoub M, Yang IV, Wyatt TA, Kechris K, Burnham EL. Alcohol Use Disorders Are Associated With a Unique Impact on Airway Epithelial Cell Gene Expression. Alcohol Clin Exp Res 2020; 44:1571-1584. [PMID: 32524622 PMCID: PMC7484391 DOI: 10.1111/acer.14395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 05/28/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Alcohol use disorders (AUDs) and cigarette smoking both increase risk for the development of community-acquired pneumonia (CAP), likely through adverse effects on proximal airway mucociliary clearance and pathogen recognition. Smoking-related alterations on airway gene expression are well described, but little is known about the impact of AUDs. We measured gene expression in human airway epithelial cells (AECs), hypothesizing that AUDs would be associated with novel differences in gene expression that could alter risk for CAP. METHODS Bronchoscopy with airway brushings was performed in participants with AUDs and controls to obtain AECs. An AUD Identification Test was used to define AUD. RNA was extracted from AECs, and mRNA expression data were collected on an Agilent micro-array. Differential expression analyses were performed on the filtered and normalized data with correction for multiple testing. Enrichment analyses were performed using clusterProfiler. RESULTS Expression data from 19 control and 18 AUD participants were evaluated. After adjustment for smoking, AUDs were associated with significant differential expression of 520 AEC genes, including genes for ribosomal proteins and genes involved in protein folding. Enrichment analyses indicated significant differential expression of 24 pathways in AUDs, including those implicated in protein targeting to membrane and viral gene expression. Smoking-associated AEC gene expression differences mirrored previous reports, but differed from those associated with AUDs. CONCLUSIONS AUDs have a distinct impact on AEC gene expression that may influence proximal airway function independent of smoking. Alcohol-associated alterations may influence risk for CAP through modifying key mechanisms important in protecting proximal airway integrity.
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Affiliation(s)
- Kristina L. Bailey
- University of Nebraska Medical Center, Department of Internal Medicine. Division of Pulmonary, Critical Care, Sleep and Allergy
- VA Nebraska-Western Iowa Health Care System
| | - Harry Smith
- University of Colorado Anschutz Medical Campus, Department of Biostatistics and Informatics, Colorado School of Public Health
| | - Susan K. Mathai
- Baylor University Medical Center, Center for Advanced Heart & Lung Disease
| | - Jonathan Huber
- University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Allergy & Clinical Immunology
| | - Mark Yacoub
- University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine
| | - Ivana V. Yang
- University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine
- University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Biomedical Informatics and Personalized Medicine
| | - Todd A. Wyatt
- VA Nebraska-Western Iowa Health Care System
- University of Nebraska Medical Center, Department of Environmental, Agricultural, & Occupational Health
| | - Katerina Kechris
- University of Colorado Anschutz Medical Campus, Department of Biostatistics and Informatics, Colorado School of Public Health
- University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Biomedical Informatics and Personalized Medicine
| | - Ellen L. Burnham
- University of Colorado Anschutz Medical Campus, Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine
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Srivastav A, Davis RE, Strompolis M, Crouch E, Thrasher JF, Spencer M. Responding to Adverse Childhood Experiences: Understanding the Role of Safe, Stable, and Nurturing Relationships in Reducing Alcohol and Tobacco Related Risk Behaviors. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020. [DOI: 10.1080/1067828x.2020.1774027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Aditi Srivastav
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Children’s Trust of South Carolina, Columbia, SC, USA
| | - Rachel E. Davis
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | | | - Elizabeth Crouch
- Department of Health Services, Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Mindi Spencer
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Khaliq K, Ajibawo T, Bhandari R, Patel RS. Problematic Alcohol Use and Mortality Risk in Arrhythmia: Nationwide Study of 114,958 Hospitalizations. Cureus 2020; 12:e8194. [PMID: 32572353 PMCID: PMC7302717 DOI: 10.7759/cureus.8194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives To assess the risk of in-hospital mortality due to alcohol use disorder (AUD) and other cardiovascular risk factors in arrhythmia inpatients. Methods We included 114,958 patients (age, 15-54 years) by conducting a cross-sectional cohort study using the Nationwide Inpatient Sample (NIS, 2010-2014). These patients were primarily managed for arrhythmia and further grouped by comorbid AUD. A logistic regression model was used to measure the odds ratio (OR) of association of AUD and in-hospital mortality after adjusting for demographic confounders and cardiovascular risk factors. Results Mortality risk statistically increases with age as elders (45-54 years) had two times higher risk (95% confidence interval [CI] 1.49-3.09), whereas men had a lower risk (OR 0.8, 95% CI 0.74-0.96) of inpatient death. Comorbid atherosclerosis (OR 4.5, 95% CI 3.38-5.92) and diabetes (OR 1.4, 95% CI 1.18-1.67) increased mortality risk in arrhythmia inpatients. AUD significantly increased the risk of mortality in arrhythmia inpatients (OR 1.7, 95% CI 1.43-2.07). Conclusions AUD is an independent risk factor for mortality in arrhythmia inpatients, and it is elevated by 72% in such patients. Strategies to reduce alcohol consumption and abstinence should be focused to improve the health-related quality of life of at-risk patients.
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Affiliation(s)
- Khalida Khaliq
- Psychiatry/Medicine, North Tampa Behavioral Health, Tampa, USA
| | - Temitope Ajibawo
- Internal Medicine, Brookdale University Hospital Medical Center, New York City, USA
| | - Renu Bhandari
- Medicine, Manipal College of Medical Sciences, Kaski, NPL
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Waeiss RA, Knight CP, Engleman EA, Hauser SR, Rodd ZA. Co-administration of ethanol and nicotine heightens sensitivity to ethanol reward within the nucleus accumbens (NAc) shell and increasing NAc shell BDNF is sufficient to enhance ethanol reward in naïve Wistar rats. J Neurochem 2020; 152:556-569. [PMID: 31721205 PMCID: PMC10826843 DOI: 10.1111/jnc.14914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 12/26/2022]
Abstract
Alcohol use disorder most commonly presents as a polydrug disorder where greater than 85% are estimated to smoke. EtOH and nicotine (NIC) co-abuse or exposure results in unique neuroadaptations that are linked to behaviors that promote drug use. The current experiments aimed to identify neuroadaptations within the mesolimbic pathway produced by concurrent EtOH and NIC exposure. The experiments used four overall groups of male Wistar rats consisting of vehicle, EtOH or NIC alone, and EtOH+NIC. Drug exposure through direct infusion into the posterior ventral tegmental area (pVTA) stimulated release of glutamate and dopamine in the nucleus accumbens (NAc) shell, which was quantified through high-performance liquid chromatography. Additionally, brain-derived neurotrophic factor (BDNF) protein levels were measured via enzyme-linked immunosorbent assay (ELISA). A second experiment investigated the effects of drug pretreatment within the pVTA on the reinforcing properties of EtOH within the NAc shell through intracranial self-administration (ICSA). The concluding experiment evaluated the effect of NAc shell pretreatment with BDNF on EtOH reward utilizing ICSA within that region. The data indicated that only EtOH+NIC administration into the pVTA simultaneously increased glutamate, dopamine, and BDNF in the NAc shell. Moreover, only pVTA pretreatment with EtOH+NIC enhanced the reinforcing properties of EtOH in the NAc shell. BDNF pretreatment in the NAc shell was also sufficient to enhance the reinforcing properties of EtOH in the NAc shell. The collected data suggest that concurrent EtOH+NIC exposure results in a distinct neurochemical response and neuroadaptations within the mesolimbic pathway that alter EtOH reward.
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Affiliation(s)
- Robert A Waeiss
- Program in Medical Neuroscience, Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Christopher P Knight
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Eric A Engleman
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Sheketha R Hauser
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zachary A Rodd
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Barrett ST, Thompson BM, Emory JR, Larsen CE, Pittenger ST, Harris EN, Bevins RA. Sex Differences in the Reward-Enhancing Effects of Nicotine on Ethanol Reinforcement: A Reinforcer Demand Analysis. Nicotine Tob Res 2020; 22:238-247. [PMID: 30982885 PMCID: PMC7297098 DOI: 10.1093/ntr/ntz056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 04/10/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND Alcohol is often consumed with tobacco, and dependence to alcohol and tobacco are highly comorbid. In addition, there are differences in the prevalence of nicotine- and alcohol-abuse between the sexes. Nicotine produces enhancing effects on the value of other reinforcers, which may extend to alcohol. METHODS Male and female Wistar rats were trained to self-administer 15% ethanol solution in 30-minute sessions. Once ethanol self-administration was established, demand for ethanol was evaluated using an exponential reinforcer demand method, in which the response cost per reinforcer delivery was systematically increased over blocks of several sessions. Within each cost condition, rats were preinjected with nicotine (0.05, 0.1, 0.2, or 0.4 mg/kg base, SC) or saline 5 minutes before self-administration sessions. The effects of nicotine dose and biological sex were evaluated using the estimates generated by the reinforcer demand model. RESULTS Under saline conditions, males showed greater sensitivity to ethanol reinforcement than females. Nicotine enhanced the reinforcement value of alcohol and this varied with sex. In both sexes, 0.4 mg/kg nicotine decreased intensity of ethanol demand. However, 0.05, 0.1, and 0.2 mg/kg nicotine decreased elasticity of ethanol demand in females, but not in males. CONCLUSIONS Nicotine enhances ethanol reinforcement, which may partially drive comorbidity between nicotine-abuse and alcohol-abuse. Males showed signs of greater ethanol reinforcement value than females under saline conditions, and nicotine attenuated this effect by increasing ethanol reinforcement value in the females. These findings highlight that a complete understanding of alcohol-abuse must include a thorough study of alcohol use in the context of other drug use, including nicotine. IMPLICATIONS Nicotine dose dependently enhances the alcohol reinforcement value in a manner that is clearly influenced by biological sex. Under saline baseline conditions, males show lower elasticity of demand for alcohol reinforcement than females, indicative of greater reinforcement value. However, nicotine attenuated this difference by enhancing alcohol reward in the females. Specifically, low-to-moderate doses (0.05-0.2 mg/kg) of nicotine decreased elasticity of alcohol demand in female rats, increasing the perseverance of their alcohol taking behavior. These data indicate that the well-documented reward-enhancing effects of nicotine on sensory reinforcement extend to alcohol reinforcement and that these vary with biological sex.
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Affiliation(s)
- Scott T Barrett
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, NE
| | - Brady M Thompson
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, NE
| | - Jessica R Emory
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, NE
| | - Chris E Larsen
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, NE
| | | | - Edward N Harris
- Department of Biochemistry, University of Nebraska–Lincoln, Lincoln, NE
| | - Rick A Bevins
- Department of Psychology, University of Nebraska–Lincoln, Lincoln, NE
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Marmet S, Studer J, Wicki M, Bertholet N, Khazaal Y, Gmel G. Unique versus shared associations between self-reported behavioral addictions and substance use disorders and mental health problems: A commonality analysis in a large sample of young Swiss men. J Behav Addict 2019; 8:664-677. [PMID: 31891314 PMCID: PMC7044575 DOI: 10.1556/2006.8.2019.70] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND AIMS Behavioral addictions (BAs) and substance use disorders (SUDs) tend to co-occur; both are associated with mental health problems (MHPs). This study aimed to estimate the proportion of variance in the severity of MHPs explained by BAs and SUDs, individually and shared between addictions. METHODS A sample of 5,516 young Swiss men (mean = 25.47 years old; SD = 1.26) completed a self-reporting questionnaire assessing alcohol, cannabis, and tobacco use disorders, illicit drug use other than cannabis, six BAs (Internet, gaming, smartphone, Internet sex, gambling, and work) and four MHPs (major depression, attention-deficit hyperactivity disorder, social anxiety disorder, and borderline personality disorder). Commonality analysis was used to decompose the variance in the severity of MHPs explained (R2) by BAs and SUDs into independent commonality coefficients. These were calculated for unique BA and SUD contributions and for all types of shared contributions. RESULTS BAs and SUDs explained between a fifth and a quarter of the variance in severity of MHPs, but individual addictions explained only about half of this explained variance uniquely; the other half was shared between addictions. A greater proportion of variance was explained uniquely or shared within BAs compared to SUDs, especially for social anxiety disorder. CONCLUSIONS The interactions of a broad range of addictions should be considered when investigating their associations with MHPs. BAs explain a larger part of the variance in MHPs than do SUDs and therefore play an important role in their interaction with MHPs.
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Affiliation(s)
- Simon Marmet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Corresponding author: Simon Marmet; Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 23, CH-1011 Lausanne, Switzerland; Phone: +41 21 314 18 97; Fax: +41 21 314 05 62; E-mail:
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Matthias Wicki
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Research Centre, University Institute of Mental Health at Montréal, Québec, Canada
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland,Research Department, Addiction Switzerland, Lausanne, Switzerland,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada,Department of Health and Social Sciences, University of the West of England, Bristol, UK
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46
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Castillo-Carniglia A, Keyes KM, Hasin DS, Cerdá M. Psychiatric comorbidities in alcohol use disorder. Lancet Psychiatry 2019; 6:1068-1080. [PMID: 31630984 PMCID: PMC7006178 DOI: 10.1016/s2215-0366(19)30222-6] [Citation(s) in RCA: 167] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/13/2019] [Accepted: 05/30/2019] [Indexed: 01/10/2023]
Abstract
Alcohol use disorder is a major contributor to the morbidity and mortality burden worldwide. It often coexists with other psychiatric disorders; however, the nature of this comorbidity is still a matter of debate. In this Series paper, we examine the main psychiatric disorders associated with alcohol use disorder, including the prevalence of co-occurring disorders, the temporal nature of the relationship, and mechanisms that might explain comorbidity across the lifespan. Overall, this disorder co-occurs with a wide range of other psychiatric disorders, especially those disorders involving substance use and violent or aggressive behaviour. The causal pathways between alcohol use disorder and other psychiatric disorders are heterogeneous. Hypotheses explaining these relationships include reciprocal direct causal associations, shared genetic and environmental causes, and shared psychopathological characteristics of broader diagnostic entities (eg, externalising disorders). Efforts to untangle the associations between alcohol use disorder and other disorders across the lifespan remain a crucial avenue of research.
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Affiliation(s)
- Alvaro Castillo-Carniglia
- Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile; Department of Population Health, New York University School of Medicine, New York, NY, USA.
| | - Katherine M Keyes
- Department of Epidemiology, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, Mailman School of Public Health, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University School of Medicine, New York, NY, USA
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Morley KC, Lagopoulos J, Logge W, Chitty K, Moustafa AA, Haber PS. Brain N-Acetyl Aspartate and associations with cognitive impairment in alcohol dependent patients. J Clin Exp Neuropsychol 2019; 42:111-117. [DOI: 10.1080/13803395.2019.1685078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kirsten C. Morley
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Jim Lagopoulos
- Sunshine Coast Mind and Neuroscience – Thompson Institute, University of Sunshine Coast, Maroochydore, Australia
| | - Warren Logge
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Kate Chitty
- School of Pharmacology, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Ahmed A. Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | - Paul S. Haber
- NHMRC Centre of Research Excellence in Mental Health and Substance Use, Central Clinical School, Sydney Medical School, University of Sydney, Sydney, Australia
- Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia
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Quraishi R, Varshney M, Singh A, Singh D, Kumar M, Rao R, Jain R, Ambekar A. Use of Filter Paper to Measure Alcohol Biomarkers among Opioid-Dependent Patients on Agonist Maintenance Treatment: A Community-Based Study. Indian J Psychol Med 2019; 41:529-534. [PMID: 31772439 PMCID: PMC6875832 DOI: 10.4103/ijpsym.ijpsym_304_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/28/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Harmful Alcohol use is frequent among opioid dependents patients undergoing agonist maintenance treatment. The objective assessment of harmful alcohol use can be done using laboratory measures of serum biomarkers. For community-based patients, there is often a requirement of an alternative method due to lack of onsite laboratory services. The aim of the study was to examine filter paper as a matrix to measure serum biomarkers of harmful alcohol use. METHODS The initial phase involved standardization of the filter-paper-based assay. Conditions were optimised for extraction and estimation of alcohol biomarkers (Aspartate Aminotransferase; AST, Alanine Aminotransferase; ALT, Gamma Glutamyl transferase; GGT and Carbohydrate Deficient Transferrin; CDT) from the filter paper. For clinical validation, serum samples were collected from community clinics. Biomarker levels obtained from both the methods were correlated using linear regression analysis. Limits of agreement between the two methods was estimated using the Intraclass Correlation Coefficient (ICC). RESULTS The extraction of enzymes (AST, ALT and GGT) from filter paper was carried out using the substrate buffer available with the reagent kit (Randox, UK). CDT was readily extracted from filter paper using deionised water. Serum biomarker levels measured from samples collected from community clinics correlated well with filter paper extracted levels (ICC 0.97-0.99). More than 90% of alcohol biomarker levels were recovered from the filter paper matrix using this method. CONCLUSION Filter paper has the potential to be used as a matrix to objectively measure alcohol biomarkers among opioid-dependent patients from community settings lacking onsite laboratory facilities.
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Affiliation(s)
- Rizwana Quraishi
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mohit Varshney
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Singh
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Dharamveer Singh
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mukesh Kumar
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Rao
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Raka Jain
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Ambekar
- National Drug-Dependence Treatment Centre and Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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49
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Impact of Taxation Policy on Household Spirit Consumption and Public-Finance Sustainability. SUSTAINABILITY 2019. [DOI: 10.3390/su11205858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The objective of this study was to estimate the sensitivity of spirit quantity demanded for price and income changes in Montenegro and to show the effectiveness of taxation-policy changes in the reduction of spirit consumption. It is the first study on this topic in Montenegro, where adverse effects of alcohol are recognized as an important obstacle in achieving Sustainable Development Goals (SDGs). The price elasticity of spirits was estimated using Deaton’s methodology on the Household Budget Survey (HBS) data in the period of 2006–2017. Cigarettes were included as a control variable as, along with spirits, they are one of the most harmful substances used in Montenegro. Using these results, we simulated the effects of spirit use on public revenue. The results show that the spirits’ own price elasticity equaled −0.45, while the cross-price elasticity equaled −0.17, showing that spirits and cigarettes are complementary goods. These results, along with elasticities calculated by sex (male, −0.55; female, −0.5), income groups (low income, −1.16; middle-income, −0.46; high-income, −0.26), and for the working-age group (−0.74), demonstrate that an increase in excise taxes could be a very efficient tool in decreasing the adverse effect of spirits and cigarettes on household member’s productivity, health, and budget, which is in line with SDGs. An efficient road map for sustainable development for Montenegro must include the reduction of health-harmful substance use through excise tax increase.
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50
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Besson M, Forget B, Correia C, Blanco R, Maskos U. Profound alteration in reward processing due to a human polymorphism in CHRNA5: a role in alcohol dependence and feeding behavior. Neuropsychopharmacology 2019; 44:1906-1916. [PMID: 31288250 PMCID: PMC6785024 DOI: 10.1038/s41386-019-0462-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/12/2019] [Accepted: 07/01/2019] [Indexed: 01/08/2023]
Abstract
Human genetic variation in the nicotinic receptor gene cluster CHRNA5/A3/B4, in particular the non-synonymous and frequent CHRNA5 variant rs16969968 (α5SNP), has an important consequence on smoking behavior in humans. A number of genetic association studies have additionally implicated the CHRNA5 gene in addictions to other drugs, and also body mass index (BMI). Here, we model the α5SNP, in a transgenic rat line, and establish its role in alcohol dependence, and feeding behavior. Rats expressing the α5SNP consume more alcohol, and exhibit increased relapse to alcohol seeking after abstinence. This high-relapsing phenotype is reflected in altered activity in the insula, linked to interoception, as established using c-Fos immunostaining. Similarly, relapse to food seeking is increased in the transgenic group, while a nicotine treatment reduces relapse in both transgenic and control rats. These findings point to a general role of this human polymorphism in reward processing, and multiple addictions other than smoking. This could pave the way for the use of medication targeting the nicotinic receptor in the treatment of alcohol use and eating disorders, and comorbid conditions in smokers.
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Affiliation(s)
- Morgane Besson
- Department of Neuroscience, Unité de Neurobiologie Intégrative des Systèmes Cholinergiques, CNRS UMR 3571, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France.
| | - Benoît Forget
- Department of Neuroscience, Unité de Neurobiologie Intégrative des Systèmes Cholinergiques, CNRS UMR 3571, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, INSERM, CNRS, Neuroscience Paris Seine - Institut de Biologie Paris Seine (NPS - IBPS), 75005, Paris, France
| | - Caroline Correia
- Department of Neuroscience, Unité de Neurobiologie Intégrative des Systèmes Cholinergiques, CNRS UMR 3571, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
- Laboratoire de Neurosciences Cognitives et Adaptatives, CNRS UMR 7364, Université de Strasbourg, 67000, Strasbourg, France
| | - Rodolphe Blanco
- Department of Neuroscience, Unité de Neurobiologie Intégrative des Systèmes Cholinergiques, CNRS UMR 3571, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France
| | - Uwe Maskos
- Department of Neuroscience, Unité de Neurobiologie Intégrative des Systèmes Cholinergiques, CNRS UMR 3571, Institut Pasteur, 25 rue du Dr Roux, 75015, Paris, France.
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