Race/Ethnicity, Community of Residence, and DUI Arrest After Beginning Treatment for an Alcohol Use Disorder

A systematic meta-epidemiologic review on nonabstinence-inclusive interventions for substance use: inclusion of race/ethnicity and sex assigned at birth/gender

Background: Minoritized racial/ethnic and sex assigned at birth/gender groups experience disproportionate substance-related harm. Focusing on reducing substance-related harm without requiring abstinence is a promising approach.Objectives: The purpose of this meta-epidemiologic systematic review was to examine inclusion of racial/ethnic and sex assigned at birth/gender in published studies of nonabstinence-inclusive interventions for substance use.Methods: We systematically searched databases (PubMed and PsycINFO) on May 26, 2022 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Articles were eligible for inclusion if they: 1) reported in English language, 2) had a primary goal of investigating a nonabstinence-inclusive intervention to address substance use, 3) used human subjects, and 4) only included adults aged 18 or older. Two coders screened initial articles and assessed eligibility criteria of full text articles. A third consensus rater reviewed all coding discrepancies. For the remaining full-length articles, an independent rater extracted information relevant to study goalsResults: The search strategy yielded 5,759 records. 235 included articles remained. Only 73 articles (31.1%) fully reported on both racial/ethnic and sex assigned at birth/gender, and only seven articles (3.0%) reported subgroup analyses examining treatment efficacy across minoritized groups. Nine articles (3.8%) mentioned inclusion and diversity regarding both racial/ethnic and sex assigned at birth/gender in their discussion and four articles (1.7%) broadly mentioned a lack of diversity in their limitationsConclusion: Findings highlight that little is known about nonabstinence-inclusive interventions to address substance use for individuals from minoritized racial/ethnic and sex assigned at birth/gender groups.

A Review of Community Health Worker Interventions for Latinx/o/a Individuals With Unhealthy Alcohol Use

ABSTRACT

Unhealthy alcohol use (UAU) affects nearly 1 in 4 Latinx/o/a individuals in the United States (US). Compared with White individuals, Latinx/o/a individuals with UAU face increased morbidity, decreased access to addiction treatment, and higher rates of incarceration. Community health workers (CHWs), also known as promotores, provide culturally and linguistically informed services while augmenting social and health care interventions. Although there is extensive literature evaluating the role of CHW interventions for chronic conditions including hypertension and diabetes, less is known about CHW interventions for UAU in the US. To better understand how CHWs can address UAU in the Latinx/o/a community in the US, we performed a scoping review of the literature for CHW interventions for UAU in the Latinx/o/a population. We reviewed publications up to March 8, 2022, which described CHW interventions for UAU in Latinx/o/a individuals in the US and identified 6 publications that met inclusion criteria after full-text review. These publications included 3 randomized controlled trials, 2 follow-up feasibility and acceptability assessments within the randomized controlled trial intervention group, and a pre-post noncontrolled feasibility study. All interventions were brief, with low-intensity touchpoints between CHWs and patients. None included medications for alcohol use disorder. We found few publications related to CHW-delivered interventions for UAU within the Latinx/o/a population. Given the acceptance and success of CHW-delivered interventions other conditions, as well as the increasing use of CHWs in the US, we need to invest in research that examines the efficacy of the CHWs in UAU.

Prevalence and correlates of alcohol-induced blackout in a diverse sample of veterans

BACKGROUND

Alcohol-induced blackouts have been associated concurrently and prospectively with alcohol-related harm. Although rates of heavy drinking among military samples tend to be comparable or higher than rates among civilian samples, the prevalence and correlates of blackout in the military population are understudied.

METHODS

Veterans (N = 241, 29% female, 39% Black) reported on their alcohol consumption and mental health as part of a larger health-related study among veterans. In this secondary analysis, we tested theoretically and empirically informed predictors (gender, drinking quantity, and other drug use) and consequences [depression, posttraumatic stress disorder (PTSD)] of alcohol-induced blackout. Given the diversity of the sample, potential roles of racial/ethnic discrimination and drinking to cope in alcohol-induced blackout were also tested.

RESULTS

Past-year prevalence of alcohol-induced blackout was 53% among veterans who drank alcohol and 68% among those who screened positive for hazardous drinking. Everyday experience of racial discrimination was the strongest concurrent predictor of alcohol-induced blackout. Drinking quantity and use of other drugs were significant correlates only in bivariate models. Controlling for gender, race, drinking quantity, other drug use, and discrimination, blackout frequency was significantly associated with symptoms of depression, but not symptoms of PTSD. Both blackout and racial discrimination were associated with drinking to cope.

CONCLUSIONS

The prevalence and correlates of alcohol-induced blackout among veterans are largely consistent with those documented in civilian and young adult populations. Among racially diverse groups, racial discrimination may be more strongly associated with mental health symptoms than alcohol consumption or acute alcohol consequences such as blackout.

Gender, acculturation, and alcohol-related consequences among college students of color

OBJECTIVE

The present study examined if identification with mainstream American culture (acculturation) and heritage culture (enculturation) are differentially associated with blackouts and other drinking consequences among male and female college students of color.

PARTICIPANTS

Participants were college students (N = 150) who self-identified as a racial/ethnic minority and endorsed blackouts in the past year.

METHODS

Regression models were used to examine gender-by-acculturation/enculturation interaction effects on alcohol-induced blackout and other alcohol-related consequences.

RESULTS

While acculturation was not significantly associated with either drinking outcome, enculturation showed a significant relationship with blackout frequency. Gender moderated this relationship; greater enculturation was associated with increased blackout frequency among male but not female students.

CONCLUSIONS

The present findings suggest the importance of considering the interplay between enculturation and gender in understanding alcohol use among college students of color. Men who endorse high levels of enculturation may be at an increased risk of experiencing negative drinking-related consequences.