Alcohol and cocaine interactions and aggressive behaviors

Dental injuries in Swiss soccer supporters: A comparative study of regular fans, ultras, and hooligans for public health strategies

OBJECTIVES

Violence among soccer supporters continues to pose a significant public health concern in many parts of the world. In Switzerland, hooliganism is largely uninvestigated. This study aimed to examine incidents of violence and associated dental injuries among different groups of soccer supporters, as well as assess the impact of intoxicants on their behavior, using survey data from regular fans, ultras, and hooligans in the Swiss Football League.

MATERIAL AND METHODS

A cross-sectional survey using a standardized questionnaire was conducted among distinct factions of soccer supporters in the Swiss Football League in 2022. A total of 165 participants self-identified as belonging to one of three subgroups: "regular fan," "ultra," or "hooligan." Data were gathered on physical altercations, dental injuries, possession of mouthguards, intoxicant use, and medical assistance. Descriptive statistics, logistic regression models, and significance tests were used for data analysis (α = .05).

RESULTS

Hooligans had a higher frequency of dental injuries resulting from fights than ultras and regular fans. Hooligans with 11-20 fights per soccer season had a 9.6 times higher probability of dental trauma than those with 0-5 fights (p = .048). Possession of a mouthguard was associated with a lower risk of dental injuries for hooligans but an increased risk for ultras. Additionally, hooligans were found to differ significantly from other groups in their consumption of amphetamines and cocaine (p < .001).

CONCLUSIONS

The study found a strong link between physical altercations and dental injuries among soccer supporters. To promote better prevention, there is a necessity for enhanced educational initiatives facilitated by dentists to amplify the dissemination of mouthguards. Furthermore, it is crucial to raise awareness regarding their proper fitting to minimize the occurrence of combat-related dental injuries. Health authorities and other stakeholders should take a comprehensive approach to addressing some of the root causes of violent behavior, which include alcohol abuse and illicit substance consumption.

Peripubertal stress-induced behavioral changes are associated with altered expression of genes involved in excitation and inhibition in the amygdala

Early-life stress is a critical risk factor for developing psychopathological alterations later in life. This early adverse environment has been modeled in rats by exposure to stress during the peripubertal period-that is, corresponding to childhood and puberty-and has been shown to lead to increased emotionality, decreased sociability and pathological aggression. The amygdala, particularly its central nucleus (CeA), is hyperactivated in this model, consistent with evidence implicating this nucleus in the regulation of social and aggressive behaviors. Here, we investigated potential changes in the gene expression of molecular markers of excitatory and inhibitory neurotransmission in the CeA. We found that peripubertal stress led to an increase in the expression of mRNA encoding NR1 (the obligatory subunit of the N-methyl D-aspartate (NMDA) receptor) but to a reduction in the level of mRNA encoding glutamic acid decarboxylase 67 (GAD67), an enzyme that is critically involved in the activity-dependent synthesis of GABA, and to an increase in the vesicular glutamate transporter 1 (VGLUT1)/vesicular GABA transporter (VGAT) ratio in the CeA. These molecular alterations were present in addition to increased novelty reactivity, sociability deficits and increased aggression. Our results also showed that the full extent of the peripubertal protocol was required for the observed behavioral and neurobiological effects because exposure during only the childhood/prepubertal period (Juvenile Stress) or the male pubertal period (Puberty Stress) was insufficient to elicit the same effects. These findings highlight peripuberty as a period in which stress can lead to long-term programming of the genes involved in excitatory and inhibitory neurotransmission in the CeA.

Neuropsychiatry of aggression

Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or psychiatric disorders. A comprehensive patient evaluation is needed. Treatment options include pharmacotherapy as well as nonpharmacologic interventions, both of which need to be individualized to the patient.

Stimulant use by young adult African Americans in a rural community: a pipeline to prison?

The association between stimulant use and legal outcomes was examined in rural adults aged 18-21 years (n = 98) in the Mississippi River Delta of Arkansas from 2003 through 2008. Participants were interviewed at baseline and every 6 months for 2 years, using the Substance Abuse Outcomes Module, Addiction Severity Index, Short-Form 8 Health Survey, Brief Symptom Inventory, Patient Health Questionnaire depression screen, and an abbreviated antisocial personality disorder measure. More than three quarters were arrested before baseline; 47 were arrested over the next 2 years. Early arrest but not substance use was related to subsequent arrest. Limitations and implications for interventions are discussed.

Role of dopamine and glutamate receptors in cocaine-induced social effects in isolated and grouped male OF1 mice

Cocaine administration in paired male mice decreases social contacts as well as increases avoidance and flee elements. As dopamine (DA) and glutamate seem to be involved in some of cocaine's effects, an attempt was made to assess whether a range of associated receptors influenced the social impacts of this drug of abuse. The NMDA antagonist memantine (10 and 40 mg/kg); the AMPA antagonist CNQX (1 and 20 mg/kg); the DA release inhibitor CGS 10746b (2 and 8 mg/kg): the DA D1 antagonist SCH 23390 (0.05 and 0.5 mg/kg); and the DA D2/D3 antagonist raclopride (0.03 and 0.3 mg/kg) were administered prior to 25 mg/kg of cocaine and behaviour was evaluated during an encounter between an experimental and a standard opponent in a neutral cage for 10 min. Memantine reverts cocaine-induced social withdrawal and the increase in avoidance and flee, CNQX being effective only in these latter actions. On the other hand, SCH 23390 counteracts the social as well as the defensive action of cocaine, raclopride being effective only in blocking the cocaine-induced increase in avoidance and flee behaviours. In conclusion, although both neurotransmitter systems are involved in the effects of cocaine on social behaviour, NMDA and D1DA receptors seem to have an important role.

Social behavioural profile of cocaine in isolated and grouped male mice

Studies concerning the relationship between cocaine and aggression in humans as well as in animals have discrepant outcomes. Increases, decreases, or no changes, have been reported after single or chronic cocaine administration in animal models. To clarify, at least in part, the complex behavioural actions of cocaine, the present study evaluated cocaine effects on social behaviours of mice exposed to different situations (isolated or group housed) using confrontations between two male mice in a neutral area. Different doses of cocaine (6, 25 and 50 mg/kg) were administered in a single or binge pattern (three doses in 24 h) and the behavioural test was performed 20 min after the last injection. No increases in aggression were observed in any situation tested. Instead, cocaine at the two higher doses employed (either in single or binge administration), decreased aggressive behaviours in isolated mice, with no changes being observed in grouped animals. In both types of animals, cocaine increased defensive elements (avoidance/flee) and abolishes social contacts. In conclusion, cocaine presents an anti-aggressive action and may be interpreted as having an anxiogenic-like effect.

Collisions and traffic violations of alcohol, cannabis and cocaine abuse clients before and after treatment

Prior research has shown that those with alcohol problems have significantly elevated rates of traffic events (i.e. traffic violations and collisions) than licensed drivers from the general population and that treatment is associated with reductions in alcohol-related collisions. However, very little research exists on traffic events and the impact of treatment for cannabis or cocaine clients. The objectives of this research are: (1) to determine whether clients in treatment for a primary problem of alcohol, cannabis or cocaine have significantly elevated rates of traffic events than a matched control group of licensed drivers; and (2) to assess whether a significant reduction in traffic events occurs after treatment for each client group compared to a control group. Driver records of patients admitted to substance abuse treatment in 1994 for a primary problem of alcohol (n = 117), cannabis (n = 80) or cocaine (n = 169) were accessed from the Ministry of Transportation for Ontario, Canada. A comparison group of 504 licensed drivers frequency matched by age, sex and place of residence, was also randomly selected. Data was collapsed into two 6-year time periods: 1988-1993 (i.e. before treatment) and 1995-2000 (i.e. after treatment). Six repeated measures analysis of variance tests were conducted where traffic violations and collisions of three treatment groups (i.e. alcohol, cannabis or cocaine) and a control group were compared before and after treatment. All three treatment groups had significantly more traffic violations than the control group and no significant interactions between time period and group membership were found. For collisions, there was a significant interaction between the alcohol and control groups and between the cocaine and control groups. The average number of collisions for the alcohol and cocaine groups decreased after completing treatment, whereas the number for the control group was stable over the same time periods. Neither the interaction term nor the between group effect was significant in the comparison of the cannabis and control groups. When rates of collisions were calculated based on the period that each driver had a valid license, the interaction term was still significant for the comparison of the alcohol and control groups but not for the cocaine and control groups. The results contribute to existing literature by demonstrating that cocaine and cannabis clients have a higher risk of traffic violations than matched controls and that reductions in collision risk was found after treatment for the alcohol and cocaine groups. More research is needed to better understand the reasons for the higher risk of traffic events and to determine reasons for declines.

The role of the physician in addiction prevention and treatment

With increasing pressure on general physicians by managed care organizations and the public to treat and advocate for drug and alcohol addicted patients, it is more necessary than ever that physicians have the knowledge and skills to appropriately address this segment of the population. Specifically, physicians need a better understanding of the prevalence of alcohol and drug dependence in a variety of populations, along with increased awareness of the economic impact of addictive illnesses on our society. Routine screening questions should be incorporated into patient encounters, and physicians should be able to identify environments that may pose a risk for the development of addiction. Physicians need training and practice in referring patients to treatment teams, monitoring patients in recovery, and providing interventions that will eliminate or reduce substance abuse before it becomes addiction. The treatment outcomes in abstinence-based programs, particularly those combined with referral to AA, have been encouraging, demonstrating that addiction is a treatable illness and not a character defect. In addition, several studies provide evidence that addiction treatment is cost-beneficial, resulting in reduced medical costs, lowered absenteeism, and increased productivity. Despite these encouraging results, there is still room for improvement. Treatment is not always effective, and it is not sufficiently available to everyone who needs it. Addicted individuals are both stigmatized and marginalized, and many are too ill to advocate for themselves. Widespread recognition in the medical community of addiction as a treatable illness will contribute to a greater understanding of addictive disorders and reduce the stigma attached to the diagnosis and treatment of addiction. For this to occur, better training for physicians in the recognition and management of addictive disorders, starting at the medical school level, is necessary. The approval of addiction medicine as a clinical specialty by the American Medical Association also has helped to advance the legitimacy of addiction as a treatable illness, and provides a focal point for the synthesis and integration of clinical, teaching, and research activities central to addiction medicine. The combination of knowledge, skills, and attitudes outlined in the article will go a long way toward increasing physicians' abilities to assist their patients with recovery from addiction.