Change in binge drinking behavior after Hurricane Sandy among persons exposed to the 9/11 World Trade Center disaster

How does climate change impact people who use alcohol and other drugs? A scoping review of peer reviewed literature

BACKGROUND

The world has experienced devastating extreme weather events, alongside slow-onset processes including increasing temperature means, that scientists agree are manifestations of human-induced climate change. Even with radical action to reduce greenhouse gas emissions, effects of climate change will become increasingly severe.

OBJECTIVES

The aim of this review was to classify impacts of climate change for people who use alcohol and other drugs (AoD), as reflected in peer reviewed literature.

METHOD

A scoping review was conducted to achieve this. Included studies involved a human population, a climate change related exposure, and an AoD outcome. Studies were published in English between 1998 and November 2023. Exposure events of interest included extreme heat, fires, storms, floods, droughts, and longer-term environmental changes. 8,204 studies were screened, with 82 included for data extraction and narrative analysis.

RESULTS

Most papers describe increased AoD use, with smaller numbers showing decreased or unchanged substance use. Some studies identify unplanned withdrawal, changed drug markets, disrupted service access, specific physiological vulnerabilities of AoD users to extreme heat, and compounding effects on mental health. We note the relative absence of peer reviewed studies investigating impacts of climate change on AoD use in low-and middle-income countries. Further, few studies consider impacts that occur because of long-term or gradual climatic shifts such as environmental changes that are detrimental to livelihoods.

CONCLUSION

It is crucial to document effects of a changing climate on people who use AoD so that policy and services can meet future needs. We call for research to remedy gaps identified in this review.

Strategies to maintain recovery from alcohol problems during the COVID-19 pandemic: Insights from a mixed-methods national survey of adults in the United States

The COVID-19 pandemic has been associated with poorer mental health and, in some cases, increased alcohol consumption; however, little is known about the pandemic's effects on people in recovery from alcohol use disorder (AUD), especially how they have coped with novel stressors. Our mixed-methods study investigated strategies used to maintain recovery during the pandemic, with attention to variation by gender. We analyzed data obtained in fall 2020 from an online US national survey of adults with resolved AUD (n = 1,492) recruited from KnowledgePanel, a probability-based cohort of non-institutionalized adults maintained by Ipsos for internet-based research. Participants endorsed possible coping strategies on a 19-item choose-all-that-apply list, which were analyzed using chi-square tests. In addition, 1,008 participants provided text responses to an open-ended question about their strategies to maintain recovery during the pandemic, which were coded and analyzed using an inductive, thematic approach. The majority of our sample met criteria for severe lifetime AUD (72.9%), reported being in recovery more than five years (75.5%), and had never used specialty AUD services or mutual-help groups (59.7%). The ordering of the coping strategies was quite similar for women and men; however, the top strategy (talking with family and friends by phone, text, or video) was endorsed more frequently by women than men (49.7% vs. 36.1%; p < .001). Among qualitative themes, "staying connected" was the most common. It was dominated by statements about family, with women mentioning children more often than men. Among other themes, "cognitive strategies" mirrored established therapeutic modalities, and "active pursuits" aligned with many recent recommendations for service providers working with substance-using populations during the pandemic. A minority of participants invoked "willpower" for recovery or stated that pandemic restrictions helped by reducing exposure to relapse risks. These findings shed light on recovery mechanisms during the COVID-19 pandemic and suggest potential intervention targets to support recovery during other catastrophic events, such as natural disasters.

A Six-Year Prospective Study on Problem Drinking among Evacuees of the Great East Japan Earthquake: The Fukushima Health Management Survey

Evacuees of the Great East Japan Earthquake have experienced adverse, long-term physical and psychological effects, including problem drinking. This study examined the risk and recovery factors for problem drinking among evacuees between fiscal years (FY) 2012 and 2017 using data on residents in the evacuation area from the Mental Health and Lifestyle Survey. With the FY 2012 survey as a baseline, a survey comprising 15,976 men and women was conducted in the evacuation area from FY 2013 to FY 2017, examining the risk and protective factors for problem drinking. Particularly, the Cutting down, Annoyed by criticism, Guilty feeling, and Eye-opener (CAGE) questionnaire was used to evaluate problem drinking. Univariate and multivariate Cox proportional hazard models were constructed to identify the risk and recovery factors of problem drinking. The findings indicated that the male gender, insufficient sleep, job change, trauma symptoms, mental illness, family financial issues, and heavy drinking (≥4 drinks per day) were significant risk factors for the incidence of problem drinking among the evacuees. Furthermore, a high blood pressure diagnosis could exacerbate problem drinking among men, while younger age and a diabetes mellitus diagnosis could increase problem drinking among women. Trauma symptoms and heavy drinking inhibited recovery from problem drinking after the disaster. Understanding these factors can shape effective long-term intervention strategies to physically and psychologically support evacuees.

Long-Term Lower Respiratory Symptoms among World Trade Center Health Registry Enrollees Following Hurricane Sandy

Several studies showed an association between lower respiratory tract symptoms (LRS) and exposure to the 9/11 terrorist attack. However, few studies have examined the long-term impact of natural disasters on those with prior respiratory distress. The present study aims to assess the impact of Hurricane Sandy on persistent LRS among people exposed to the World Trade Center (WTC) terrorist attack. The analytic sample consisted of WTC Health Registry enrollees who completed survey waves 1, 3, and 4 and the Hurricane Sandy Survey and did not report LRS before the WTC terrorist attack. The log binomial was used to assess the association between the impact of Hurricane Sandy and persistent LRS. Of 3277 enrollees, 1111 (33.9%) reported persistent LRS post-Sandy. Participants of older age, males, lower household income, current smokers, and those with previous asthma were more likely to report persistent LRS. In separate adjusted models, multiple Sandy-related inhalation exposures (relative risk (RR): 1.2, 95% CI: 1.06-1.37), Sandy-related PTSD (RR: 1.27, 95% CI: 1.15-1.4), and Sandy LRS (RR: 1.64, 95% CI: 1.48-1.81) were associated with persistent LRS post-Sandy. Our findings suggest that respiratory protection is important for everyone performing reconstruction and clean-up work after a natural disaster, particularly among those with previous respiratory exposures.

Increases in Risky Drinking During the COVID-19 Pandemic Assessed via Longitudinal Cohort Design: Associations With Racial Tensions, Financial Distress, Psychological Distress and Virus-Related Fears

BACKGROUND

The COVID-19 pandemic has created disruptions to daily life resulting in wide-spread unemployment and psychological distress. Recent studies have reported high rates of alcohol use during this time; however, longitudinal data remain scarce and factors associated with increases in high-risk drinking observed over time are unknown.

AIMS

The current study examined changes in high-risk drinking patterns across four 7-day observation periods, prior to and following a university wide campus closure. Additionally, factors associated with changes in alcohol use patterns were examined including financial distress, psychological distress, impact of racial tensions and virus-related fears.

METHOD

Students (N = 1001) in the Midwestern USA completed repeated assessments between March and June 2020. Each survey included a timeline follow-back measure of alcohol use. Pandemic-related distress spanning several factors was assessed at the final follow-up.

RESULTS

Risky drinking patterns increased significantly over time. Overall, psychological distress and impact of racial tensions were associated with higher rates of risky drinking, whereas COVID-19-related fears were associated with lower rates. However, only financial-related distress was associated with an increase in risky drinking patterns over time.

CONCLUSIONS

Increased risky drinking patterns observed in the current study may signal problems that are likely to persist even after the direct impact of the COVID-19 pandemic on daily life ends. Individuals experiencing financial distress may represent a particularly high-risk group. Interventions targeting the cross-section of job loss, financial stress and problematic alcohol use will be important to identify.