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Tran A, Jiang H, Lange S, Rehm J. Trend of alcohol use disorder as a percentage of all-cause mortality in North America. BMC Res Notes 2024; 17:237. [PMID: 39210466 PMCID: PMC11360856 DOI: 10.1186/s13104-024-06882-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE To evaluate the trend of alcohol use disorder (AUD) mortality as a percentage of all-cause mortality in Canada and the United States (US) between 2000 and 2019, by age group. RESULTS Joinpoint regression showed that AUD mortality as a percentage of all-cause mortality significantly increased between 2000 and 2019 in both countries, and across all age groups (i.e., young adults (20-34 years), middle-aged adults (35-49 years), and older adults (50 + years)). The trend has been levelling off, and even reversing in some cases, in recent years. The average annual percentage change differed across countries and between age groups, with a greater increase among Canadian adults aged 35-49 years and among adults aged 50 + years in the US. Over the past two decades, AUD mortality as a percentage of all-cause mortality has been increasing among all adults in both Canada and the US.
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Affiliation(s)
- Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada.
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
- Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, ON, M5T 1R8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON, M5T 1R8, Canada
- Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, ON, M5S 1A8, Canada
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
- Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, 81-95 Roc Boronat St, Barcelona, 08005, Spain
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Aleer E, Alam K, Rashid A. A Systematic Literature Review of Substance-Use Prevention Programs Amongst Refugee Youth. Community Ment Health J 2024; 60:1151-1170. [PMID: 38592351 PMCID: PMC11199307 DOI: 10.1007/s10597-024-01267-6] [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: 09/18/2023] [Accepted: 03/09/2024] [Indexed: 04/10/2024]
Abstract
This paper aims at exploring existing literature on substance use prevention programs, focusing on refugee youth. A comprehensive search for relevant articles was conducted on Scopus, PubMed, and EBSCOhost Megafile databases including Academic Search Ultimate, APA PsycArticles, APA PsycInfo, CINAHL with Full Text, E-Journals, Humanities Source Ultimate, Psychology and Behavioural Sciences Collection, and Sociology Source Ultimate. Initially, a total of 485 studies were retrieved; nine papers were retained for quality assessment after removing duplicates. Of the nine studies that met the inclusion criteria, only three are found to partially addressed substance use prevention programs. The two substance use prevention programs that emerge from the study are Adelante Social and Marketing Campaign (ASMC), and Screening and Brief Intervention (SBI). Six others explored protective factors and strategies for preventing substance use. The study findings show that refugee youth held negative attitudes toward institutions that provide substance use prevention programs. This review concluded that refugee youth often experience persistent substance use as they are not aware of prevention programs that may reduce the prevalence and/or severity of such misuse.
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Affiliation(s)
- Elijah Aleer
- Faculty of Business, Education, Law and Arts, School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Khorshed Alam
- Faculty of Business, Education, Law and Arts, School of Business, Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, 4350, Australia
| | - Afzalur Rashid
- Faculty of Business, Education, Law and Arts, School of Business, University of Southern Queensland, Toowoomba, QLD, 4350, Australia.
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Kosonen J, Shorter GW, Kuusisto K. Navigating challenges and opportunities: perspectives on digital service development in substance use disorder treatment. Subst Abuse Treat Prev Policy 2024; 19:36. [PMID: 39090663 PMCID: PMC11293065 DOI: 10.1186/s13011-024-00618-6] [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: 01/12/2024] [Accepted: 07/06/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Some people with substance use disorders (SUD) can experience multiple co-occurring social problems. Digital solutions have been developed to support effective and cost-effective social welfare and healthcare in addictions treatment. Given the varying severity of problems from alcohol and other drug use, digital service tools can save money and provide tailored care. OBJECTIVE In this study we aimed to understand the perspectives of those who develop digital service tools on people with SUD and treatment encounters. As a case, we interviewed those who have been involved in the development of a digital client segmentation tool The Navigator. METHODS Ten (N = 10) semi-structured interviews were conducted with professionals involved in digital client segmentation tool development and were analysed with inductive content analysis. Participants were asked about the development of the Navigator from the perspectives of their own role as developers, the clients, the effectiveness of the services, and decision-making processes. FINDINGS Some people with SUD may face several obstacles when using digital services. Digital divide, feared or experienced stigma and biased attitudes, complex life situations, and difficulties in committing to treatment were identified as challenges. Nevertheless, digital solutions can offer the clients alternative ways of using the services that can better meet their individual needs. The anonymity and facelessness of digital solutions can reduce the fear of immediate judgement. Implementing digital solutions in substance use work poses challenges due to chronic staff shortages. Digitalisation often results in the creation of multiple simultaneously managed channels, potentially reducing time-consumption but increasing the perceived workload. There is a call for multi-professionalism, acknowledging inequalities between various disciplines within the field.
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Carr T, Kilian C, Llamosas-Falcón L, Zhu Y, Lasserre AM, Puka K, Probst C. The risk relationships between alcohol consumption, alcohol use disorder and alcohol use disorder mortality: A systematic review and meta-analysis. Addiction 2024; 119:1174-1187. [PMID: 38450868 PMCID: PMC11156554 DOI: 10.1111/add.16456] [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: 06/21/2023] [Accepted: 01/15/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND AND AIMS Increasing levels of alcohol use are associated with a risk of developing an alcohol use disorder (AUD), which, in turn, is associated with considerable burden. Our aim was to estimate the risk relationships between alcohol consumption and AUD incidence and mortality. METHOD A systematic literature search was conducted, using Medline, Embase, PsycINFO and Web of Science for case-control or cohort studies published between 1 January 2000 and 8 July 2022. These were required to report alcohol consumption, AUD incidence and/or AUD mortality (including 100% alcohol-attributable deaths). The protocol was registered with PROSPERO (CRD42022343201). Dose-response and random-effects meta-analyses were used to determine the risk relationships between alcohol consumption and AUD incidence and mortality and mortality rates in AUD patients, respectively. RESULTS Of the 5904 reports identified, seven and three studies from high-income countries and Brazil met the inclusion criteria for quantitative and qualitative syntheses, respectively. In addition, two primary US data sources were analyzed. Higher levels of alcohol consumption increased the risk of developing or dying from an AUD exponentially. At an average consumption of four standard drinks (assuming 10 g of pure alcohol/standard drink) per day, the risk of developing an AUD was increased sevenfold [relative risk (RR) = 7.14, 95% confidence interval (CI) = 5.13-9.93] and the risk of dying fourfold (RR = 3.94, 95% CI = 3.53-4.40) compared with current non-drinkers. The mortality rate in AUD patients was 3.13 (95% CI = 1.07-9.13) per 1000 person-years. CONCLUSIONS There are exponential positive risk relationships between alcohol use and both alcohol use disorder incidence and mortality. Even at an average consumption of 20 g/day (about one large beer), the risk of developing an alcohol use disorder (AUD) is nearly threefold that of current non-drinkers and the risk of dying from an AUD is approximately double that of current non-drinkers.
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Affiliation(s)
- Tessa Carr
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Carolin Kilian
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Laura Llamosas-Falcón
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
| | - Yachen Zhu
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Aurélie M Lasserre
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Klajdi Puka
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Charlotte Probst
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
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Schwarzinger M, Ferreira-Borges C, Neufeld M, Alla F, Rehm J. Alcohol rehabilitation and cancer risk: a nationwide hospital cohort study in France. Lancet Public Health 2024; 9:e461-e469. [PMID: 38942557 DOI: 10.1016/s2468-2667(24)00107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/09/2024] [Accepted: 05/15/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND Even though alcohol consumption is an established risk factor for cancer, evidence regarding the effect of a reduction or cessation of alcohol consumption on cancer incidence is scarce. Our main study aim was to assess the effect of alcohol rehabilitation and abstinence on cancer incidence in people with alcohol dependence. METHODS We conducted a nationwide hospital retrospective cohort study which included all adults residing in mainland France and discharged in 2018-21. Multivariable Cox proportional hazards models were used to estimate the effect of rehabilitation treatment at hospital or a history of abstinence versus alcohol dependence without rehabilitation or abstinence on the risk for incident alcohol-associated cancers by sex, controlled for potential confounding risk factors. FINDINGS 10 260 056 men and 13 739 369 women were discharged from French hospitals in 2018-21. Alcohol dependence was identified in 645 720 (6·3%) men and 219 323 (1·6%) women. Alcohol dependence was strongly related to alcohol-associated cancer sites in both sexes (hepatocellular carcinoma and oral, pharyngeal, laryngeal, oesophageal, and colorectal cancers), except for breast cancer. Rehabilitation treatment or abstinence was associated with significantly lower risks compared with alcohol dependence without rehabilitation or abstinence (adjusted hazard ratios: 0·58, 99·89% CI 0·56-0·60 in men and 0·62, 0·57-0·66 in women). Relative risk reductions were significant for each alcohol-associated cancer site in both sexes and supported by all subgroup and sensitivity analyses. INTERPRETATION Our study results support the clear benefits of alcohol rehabilitation and abstinence in reducing the risk for alcohol-associated cancers. As only two in five patients with alcohol dependence were recorded with a history of rehabilitation treatment or abstinence, a large untapped potential exists for reducing cancer incidence. FUNDING European Union's EU4Health programme.
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Affiliation(s)
- Michaël Schwarzinger
- Department of Prevention, Bordeaux University Hospital, Bordeaux, France; University of Bordeaux, INSERM, BPH, U1219, I-prev/PHARES, certified team under Ligue Contre le Cancer, CIC 1401, Bordeaux, France.
| | - Carina Ferreira-Borges
- Special Initiative on Noncommunicable Diseases and Innovation, WHO Regional Office for Europe, UN City, Copenhagen, Denmark
| | - Maria Neufeld
- Special Initiative on Noncommunicable Diseases and Innovation, WHO Regional Office for Europe, UN City, Copenhagen, Denmark
| | - François Alla
- Department of Prevention, Bordeaux University Hospital, Bordeaux, France; University of Bordeaux, INSERM, BPH, U1219, I-prev/PHARES, certified team under Ligue Contre le Cancer, CIC 1401, Bordeaux, France
| | - Jürgen Rehm
- Special Initiative on Noncommunicable Diseases and Innovation, WHO Regional Office for Europe, UN City, Copenhagen, Denmark; Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Institute of Medical Science (IMS), University of Toronto, Toronto, ON, Canada; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Program on Substance Abuse & WHO European Region Collaboration Centre, Public Health Agency of Catalonia, Barcelona, Catalonia, Spain
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Kräplin A, Joshanloo M, Wolff M, Fröhner JH, Baeuchl C, Krönke KM, Bühringer G, Smolka MN, Goschke T. No evidence for a reciprocal relationship between daily self-control failures and addictive behavior in a longitudinal study. Front Psychol 2024; 15:1382483. [PMID: 38751764 PMCID: PMC11095395 DOI: 10.3389/fpsyg.2024.1382483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/09/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction We all experience occasional self-control failures (SCFs) in our daily lives, where we enact behaviors that stand in conflict with our superordinate or long-term goals. Based on the assumption that SCFs share common underlying mechanisms with addictive disorders, we tested the hypothesis that a generally higher susceptibility to daily SCFs predicts more addictive behavior, or vice versa. Methods At baseline, 338 individuals (19-27 years, 59% female) from a community sample participated in multi-component assessments. These included among others (1) a clinical interview on addictive behaviors (quantity of use, frequency of use, DSM-5 criteria; n = 338) and (2) ecological momentary assessment of SCFs (n = 329, 97%). At the 3-year and 6 year follow-up, participation rates for both assessment parts were 71% (n = 240) and 50% (n = 170), respectively. Results Controlling for age, gender, IQ, and baseline addiction level, random-intercept cross-lagged panel models revealed that participants who reported more SCFs also showed pronounced addictive behavior at the between-person level, but we found no evidence of a predictive relationship at the within-person level over time. Discussion A higher rate of SCFs is associated with more addictive behavior, while there is no evidence of an intraindividual predictive relationship. Novel hypotheses suggested by additional exploratory results are that (1) only addiction-related SCFs in daily life are early markers of an escalation of use and thus for addictive disorders and that (2) an explicit monitoring of SCFs increases self-reflection and thereby promotes the mobilization of cognitive control in response to goal-desire conflicts.
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Affiliation(s)
- Anja Kräplin
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Mohsen Joshanloo
- Department of Psychology, Keimyung University, Daegu, Republic of Korea
| | - Max Wolff
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Mind Foundation, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Juliane Hilde Fröhner
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Christian Baeuchl
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | | | - Gerhard Bühringer
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
- Institut für Therapieforschung, Munich, Germany
| | - Michael N. Smolka
- Department of Psychiatry and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Thomas Goschke
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
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West R, Cox S, Notley CJ, Du Plessis G, Hastings J. Achieving consensus, coherence, clarity and consistency when talking about addiction. Addiction 2024; 119:796-798. [PMID: 37985001 DOI: 10.1111/add.16393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, London, UK
| | | | - Guy Du Plessis
- I-System Institute for Transdisciplinary Studies, Utah State University, Logan, Utah, USA
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Pasqualoni S, Bai Y, Curl A, Rettew J, Kimball L, Devadanam V, Yousef H, Hudziak J, Copeland WE. The substance use behaviors change of first-year college students before and during COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38227917 DOI: 10.1080/07448481.2023.2299419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 12/10/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE This article tests the substance use behaviors of college students before and during COVID-19 pandemic. METHODS In-depth assessment and nightly survey data was used from a longitudinal study (n = 675) which examined student substance use during the 2019-2020 academic year, both before and during the onset of the COVID-19 pandemic. Changes in beer/wine, tobacco, liquor, and marijuana use before versus during the pandemic, in addition to the interaction of COVID-19, were tested with gender and subjective social status. RESULTS Marijuana use significantly decreased from a weekly prevalence of 9.9% before COVID-19 to 6.4% during COVID-19 (p = 0.002). A similar decrease was seen in liquor use (10.6% before COVID to 6.4% during COVID, p = 0.01). There was no significant change observed for beer/wine use or for tobacco use. CONCLUSION In the wake of the COVID-19 pandemic, liquor, and marijuana use decreased for college students, while other substance use stayed the same.
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Affiliation(s)
| | - Yang Bai
- University of Utah, Salt Lake City, Utah, USA
| | - Azilee Curl
- University of Vermont, Burlington, Vermont, USA
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Donato S, Ray LA. Neurobiology and the Treatment of Alcohol Use Disorder: A Review of the Evidence Base. Subst Abuse Rehabil 2023; 14:157-166. [PMID: 38026786 PMCID: PMC10657770 DOI: 10.2147/sar.s409943] [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: 08/01/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Alcohol use disorder (AUD) is a significant public health concern, accounting for a majority of substance use disorder cases in the United States. Treatment for AUD is complex, with multiple intervention points that may be further complicated by genotype and phenotype, resulting in diverse outcomes. In order to better understand the current landscape of AUD treatment, the present review considers different etiological models of AUD and assesses the evidence base of current treatment options. The first section of this review summarizes various etiological models of AUD and presents different approaches to classifying the disorder. Various theories, including neurobiological models, are discussed. The second section presents a comprehensive analysis of available treatment options for AUD, encompassing behavioral and pharmacological interventions and their current evidence base. Finally, this review discusses the ongoing treatment gap and significant factors contributing to low treatment utilization. Together, this review provides an overview of different etiological processes and mechanisms of AUD, as well as summarizes the literature on key treatment approaches. By integrating historical, theoretical, and empirical data, this review aims to inform both researchers and providers with valuable insights to advance AUD treatment approaches and narrow the treatment gap.
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Affiliation(s)
- Suzanna Donato
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
- Brain Research Institute, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Van Dessel P, Cummins J, Wiers RW. ABC-training as a new intervention for hazardous alcohol drinking: Two proof-of-principle randomized pilot studies. Addiction 2023; 118:2141-2155. [PMID: 37349262 DOI: 10.1111/add.16271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 05/18/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND AND AIMS ABC-training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof-of-principle study was to test the effectiveness of web-based ABC-training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers. DESIGN One exploratory and one confirmatory experiment with two between-subject conditions (online ABC- and control-training) and assessments at baseline and 1 week later (after three sessions of training). SETTING Participants recruited on Prolific Academic completed the web-based study. PARTICIPANTS Adults with self-reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years). INTERVENTION AND COMPARATOR ABC-training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control-training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week. MEASUREMENTS Primary outcome was change in automatic and self-reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self-efficacy, craving and motivation (and approach-alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency. FINDINGS Findings of this study are as follows: stronger increase in negative outcome expectancies after ABC- than control-training (Experiment 1: self-report, 95% confidence interval of difference scores (CIdiff ) = [0.04, Inf]; automatic, CIdiff = [0.01, Inf]; Experiment 2: self-report, CIdiff = [0.16, Inf]; automatic, CIdiff = [0.002, Inf]). Stronger reduction in self-reported positive outcome expectancies after ABC- than control-training (Experiment 1: CIdiff = [-Inf, -0.01]; Experiment 2: CIdiff = [-Inf, -0.21]) but mixed findings on automatic positive outcome expectancies (Experiment 1: CIdiff = [-Inf, 0.02]; Experiment 2: CIdiff = [-Inf, -0.001]). CONCLUSIONS ABC-training may change outcome expectancies of alcohol consumption, but testing of clinically relevant effects in other samples is warranted.
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Affiliation(s)
- Pieter Van Dessel
- Learning and Implicit Processes (LIP) Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Jamie Cummins
- Learning and Implicit Processes (LIP) Lab, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT) Laboratory, Department of Psychology and Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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Sher KJ. The Heterogeneous Nature of Substance Use and Substance Use Disorders: Implications for Characterizing Substance-Related Stigma. Psychol Sci Public Interest 2023; 24:82-89. [PMID: 38095161 DOI: 10.1177/15291006231212385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Kenneth J Sher
- Department of Psychological Sciences, University of Missouri
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12
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Freichel R, Pfirrmann J, Cousjin J, de Jong P, Franken I, Banaschewski T, Bokde ALW, Desrivières S, Flor H, Grigis A, Garavan H, Heinz A, Martinot JL, Martinot MLP, Artiges E, Nees F, Orfanos DP, Poustka L, Hohmann S, Fröhner JH, Smolka MN, Vaidya N, Whelan R, Schumann G, Walter H, Veer IM, Wiers RW. Drinking motives, personality traits and life stressors-identifying pathways to harmful alcohol use in adolescence using a panel network approach. Addiction 2023; 118:1908-1919. [PMID: 37157052 DOI: 10.1111/add.16231] [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: 11/30/2022] [Accepted: 04/18/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND AND AIMS Models of alcohol use risk suggest that drinking motives represent the most proximal risk factors on which more distal factors converge. However, little is known about how distinct risk factors influence each other and alcohol use on different temporal scales (within a given moment versus over time). We aimed to estimate the dynamic associations of distal (personality and life stressors) and proximal (drinking motives) risk factors, and their relationship to alcohol use in adolescence and early adulthood using a novel graphical vector autoregressive (GVAR) panel network approach. DESIGN, SETTING AND CASES We estimated panel networks on data from the IMAGEN study, a longitudinal European cohort study following adolescents across three waves (aged 16, 19 and 22 years). Our sample consisted of 1829 adolescents (51% females) who reported alcohol use on at least one assessment wave. MEASUREMENTS Risk factors included personality traits (NEO-FFI: neuroticism, extraversion, openness, agreeableness and conscientiousness; SURPS: impulsivity and sensation-seeking), stressful life events (LEQ: sum scores of stressful life events), and drinking motives [drinking motives questionnaire (DMQ): social, enhancement, conformity, coping anxiety and coping depression]. We assessed alcohol use [alcohol use disorders identification test (AUDIT): quantity and frequency] and alcohol-related problems (AUDIT: related problems). FINDINGS Within a given moment, social [partial correlation (pcor) = 0.17] and enhancement motives (pcor = 0.15) co-occurred most strongly with drinking quantity and frequency, while coping depression motives (pcor = 0.13), openness (pcor = 0.05) and impulsivity (pcor = 0.09) were related to alcohol-related problems. The temporal network showed no predictive associations between distal risk factors and drinking motives. Social motives (beta = 0.21), previous alcohol use (beta = 0.11) and openness (beta = 0.10) predicted alcohol-related problems over time (all P < 0.01). CONCLUSIONS Heavy and frequent alcohol use, along with social drinking motives, appear to be key targets for preventing the development of alcohol-related problems throughout late adolescence. We found no evidence for personality traits and life stressors predisposing towards distinct drinking motives over time.
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Affiliation(s)
- René Freichel
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Janine Pfirrmann
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Janna Cousjin
- Center for Substance Use and Addiction Research. (CESAR), Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Peter de Jong
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Ingmar Franken
- Center for Substance Use and Addiction Research. (CESAR), Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arun L W Bokde
- Discipline of Psychiatry, School of Medicine and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Sylvane Desrivières
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, SGDP Centre, King's College London, UK
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Antoine Grigis
- NeuroSpin, CEA, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Hugh Garavan
- Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Jean-Luc Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 'Trajectoires développementales en psychiatrie', Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
| | - Marie-Laure Paillère Martinot
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 'Trajectoires développementales en psychiatrie', Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- AP-HP, Sorbonne Université, Department of Child and Adolescent Psychiatry, Pitié-Salpêtrière Hospital, Paris, France
| | - Eric Artiges
- Institut National de la Santé et de la Recherche Médicale, INSERM U A10 'Trajectoires développementales en psychiatrie', Université Paris-Saclay, Ecole Normale supérieure Paris-Saclay, CNRS, Centre Borelli, Gif-sur-Yvette, France
- Psychiatry Department, EPS Barthélémy Durand, Etampes, France
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, Kiel University, Kiel, Germany
| | | | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Juliane H Fröhner
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Michael N Smolka
- Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Nilakshi Vaidya
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
| | - Robert Whelan
- School of Psychology and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Department of Psychiatry and Neuroscience, Charité Universitätsmedizin Berlin, Germany
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute for Science and Technology of Brain-inspired Intelligence (ISTBI), Fudan University, Shanghai, China
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ilya M Veer
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Reinout W Wiers
- Addiction Development and Psychopathology (ADAPT)-lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Center for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
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13
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Vijayalakshmi J, Chaurasia RK, Srinivas KS, Vijayalakshmi K, Paul SF, Bhat N, Sapra B. Establishment of ex vivo calibration curve for X-ray induced "dicentric + ring" and micronuclei in human peripheral lymphocytes for biodosimetry during radiological emergencies, and validation with dose blinded samples. Heliyon 2023; 9:e17068. [PMID: 37484390 PMCID: PMC10361230 DOI: 10.1016/j.heliyon.2023.e17068] [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: 02/08/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
In the modern developing society, application of radiation has increased extensively. With significant improvement in the radiation protection practices, exposure to human could be minimized substantially, but cannot be avoided completely. Assessment of exposure is essential for regulatory decision and medical management as applicable. Until now, cytogenetic changes have served as surrogate marker of radiation exposure and have been extensively employed for biological dose estimation of various planned and unplanned exposures. Dicentric Chromosomal Aberration (DCA) is radiation specific and is considered as gold standard, micronucleus is not very specific to radiation and is considered as an alternative method for biodosimetry. In this study dose response curves were generated for X-ray induced "dicentric + ring" and micronuclei, in lymphocytes of three healthy volunteers [2 females (age 22, 23 years) and 1 male (24 year)]. The blood samples were irradiated with X-ray using LINAC (energy 6 MV, dose rate 6 Gy/min), in the dose range of 0-5Gy. Irradiated blood samples were cultured and processed to harvest metaphases, as per standard procedures recommended by International Atomic Energy Agency. Pooled data obtained from all the three volunteers, were in agreement with Poisson distribution for "dicentric + ring", however over dispersion was observed for micronuclei. Data ("dicentric + ring" and micronuclei) were fitted by linear quadratic model of the expression Y[bond, double bond]C + αD + βD2 using Dose Estimate software, version 5.2. The data fit has resulted in linear coefficient α = 0.0006 (±0.0068) "dicentric + ring" cell-1 Gy-1 and quadratic coefficient β = 0.0619 (±0.0043) "dicentric + ring" cell-1 Gy-2 for "dicentric + ring" and linear coefficient α = 0.0459 ± (0.0038) micronuclei cell-1 Gy-1 and quadratic coefficient β = 0.0185 ± (0.0010) micronuclei cell-1 Gy-2 for micronuclei, respectively. Background frequencies for "dicentric + ring" and micronuclei were 0.0006 ± 0.0004 and 0.0077 ± 0.0012 cell-1, respectively. Established curves were validated, by reconstructing the doses of 8 dose blinded samples (4 by DCA and 4 by CBMN) using coefficients generated here. Estimated doses were within the variation of 0.9-16% for "dicentric + ring" and 21.7-31.2% for micronuclei respectively. These established curves have potential to be employed for biodosimetry of occupational, clinical and accidental exposures, for initial triage and medical management.
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Affiliation(s)
- J. Vijayalakshmi
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
| | - Rajesh Kumar Chaurasia
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - K. Satish Srinivas
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
| | - K. Vijayalakshmi
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
| | - Solomon F.D. Paul
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (DU), Chennai, India
| | - N.N. Bhat
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - B.K. Sapra
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
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14
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Morris J, Boness CL, Witkiewitz K. Should we promote alcohol problems as a continuum? Implications for policy and practice. DRUGS (ABINGDON, ENGLAND) 2023; 31:271-281. [PMID: 38682086 PMCID: PMC11052541 DOI: 10.1080/09687637.2023.2187681] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/01/2023] [Indexed: 04/03/2023]
Abstract
The highly heterogeneous nature of alcohol use and problems has presented significant challenges to those attempting to understand, treat or prevent what is commonly termed alcohol use disorder (AUD). However, any attempts to capture this complex phenomenon, including the various current criterion of AUD, come with a number of limitations. One particular limitation has been how alcohol problems are represented or understood in ways which do not capture the broad spectrum of alcohol use and harms and the many potential routes to prevention, treatment, and recovery. One possible response to this has been proposed as more explicitly framing or conceptualizing a continuum model of alcohol use and harms. In this commentary, we attempt to identify the key implications of a continuum model for policy and practice, examining the historical and current context of alcohol problem classifications and models. We argue a continuum model of alcohol use and problems holds a number of advantages for advancing public health goals, but also some potential limitations, both of which require further examination.
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Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - C L Boness
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico
| | - K Witkiewitz
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, New Mexico
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15
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Rauschert C. In Reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:193-195. [PMID: 37222039 DOI: 10.3238/arztebl.m2022.0330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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16
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The Alcohol Use Disorders Identification Test and Mortality 20 Years later. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01008-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Abstract
The objective was to test whether Alcohol Use Disorders Identification Test (AUDIT) results may predict mortality after 20 years. An observational study was conducted. It included an interview of a general population sample aged 18 to 64 in northern Germany in the years 1996 − 1997 (baseline) and a mortality-follow-up in the years 2017 − 2018. Study participants were 3581 persons who had consumed alcohol during the last 12 months prior to the baseline assessment. It included the AUDIT which was filled in by study participants. At follow-up, death cases were ascertained including the date of death. Official records and death certificates from local health authorities were used. Cox proportional hazards regression revealed that the AUDIT predicted time to death. The hazard ratio was 1.70 (95% confidence interval: 1.43 − 2.02) with the lowest AUDIT zone of values as the reference group. Competing risks regression analysis for diagnosis-specific mortality data revealed that the AUDIT predicted cardiovascular mortality (subhazard ratio, 1.84; 95% confidence interval, 1.49 − 2.27). It is concluded that the alcohol screening predicted total and cardiovascular mortality in this adult general population sample.
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17
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Khalaf HKS, Martin AF, De Brito SA, Barker ED. The Underlying Mechanisms in the Association Between Traumatic Brain Injury in Childhood and Conduct Disorder Symptoms in Late Adolescence. Res Child Adolesc Psychopathol 2023; 51:709-725. [PMID: 36637701 PMCID: PMC10119055 DOI: 10.1007/s10802-022-01015-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/14/2023]
Abstract
The present study examined i) the direct association between traumatic brain injury (TBI) in childhood and conduct disorder symptoms in adolescence, ii) whether this effect is mediated by impulsivity and/or callous unemotional traits (CU traits), and iii) whether these indirect effects are moderated by childhood family adversity and adolescent substance use. Utilising data from the Avon Longitudinal Study of Parents and Children (ALSPAC), participants with head injury information up to 12 years (4.5 years, 5.4 years, 6.5 years, 8.6 years, 11.7 years) were identified and categorised into a TBI (n = 409), orthopaedic injury (n = 1469) or non-injury group (n = 5685). Psychosocial factors such as impulsivity at 13 years, CU traits at 13 years, childhood family adversity (between birth to 4 years) and substance use at 14 years were collated for moderated mediation analyses. Conduct disorder symptoms were assessed at 16 years of age. TBI and conduct disorder symptoms were positively associated, and this association was mediated by impulsivity but not CU traits. The indirect effects were higher in magnitude for individuals with higher levels of childhood family adversity. Adolescent substance use was not found to moderate the indirect effects between TBI and conduct disorder symptoms. These results were specific to TBI individuals, and not in participants with orthopaedic injury and no reported injuries. Targeting impulsivity and early family adversity may alleviate the risk of conduct disorder symptoms following TBI in childhood. These findings have important implications for informing neuro-rehabilitative and preventative measures in clinical and community settings.
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Affiliation(s)
- Hanan K S Khalaf
- Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Alex F Martin
- Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Edward D Barker
- Department of Psychology, Department of Psychology, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
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Tomczyk S, Schlick S, Gansler T, McLaren T, Muehlan H, Peter LJ, Schomerus G, Schmidt S. Continuum beliefs of mental illness: a systematic review of measures. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1-16. [PMID: 35927343 PMCID: PMC9845169 DOI: 10.1007/s00127-022-02345-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 07/19/2022] [Indexed: 01/21/2023]
Abstract
PURPOSE The continuum of mental health/illness has been subject to scientific debate for decades. While current research indicates that continuum belief interventions can reduce mental health stigma and improve treatment seeking in affected populations, no study has yet systematically examined measures of continuum beliefs. METHODS This preregistered systematic review summarizes measures of continuum beliefs. Following the PRISMA statement, three scientific databases (PubMed, PsycInfo and PsycArticles via EBSCOhost, Web of Science) are searched, instruments are described and discussed regarding their scope, and methodological quality. RESULTS Overall, 7351 records were identified, with 35 studies reporting relevant findings on 11 measures. Most studies examined general population samples and used vignette-based measures. Schizophrenia and depression were most commonly examined, few studies focused on dementia, ADHD, OCD, eating disorders, and problematic alcohol use, or compared continuum beliefs across disorders. Validity was very good for most measures, but reliability was rarely tested. Measures mostly assessed beliefs in the normality of mental health symptoms or the normality of persons with such symptoms but rarely nosological aspects (i.e., categorical v continuous conceptualization of mental disorders). CONCLUSIONS Current research provides psychometrically sound instruments to examine continuum beliefs for a variety of mental disorders. While studies suggest utility for general population samples and mental health professionals, more research is necessary to corroborate findings, for instance, regarding age (e.g., in adolescents), gender, or type of mental disorder. Future research should also compare self-report ratings, and vignette-based measures, include measures of nosological concepts to fully grasp the continuum concept of mental illness. PREREGISTRATION PROSPERO: CRD42019123606.
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Affiliation(s)
- S. Tomczyk
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - S. Schlick
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - T. Gansler
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - T. McLaren
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - H. Muehlan
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
| | - L.-J. Peter
- grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - G. Schomerus
- grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany ,grid.9647.c0000 0004 7669 9786Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - S. Schmidt
- grid.5603.0Department Health and Prevention, Institute of Psychology, University of Greifswald, Robert-Blum-Straße 13, 17489 Greifswald, Germany
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Brummer J, Bloomfield K, Karriker-Jaffe KJ, Pedersen MM, Hesse M. Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study. Addiction 2023; 118:86-94. [PMID: 35993432 PMCID: PMC10087303 DOI: 10.1111/add.16034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs). DESIGN We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first. SETTING Denmark. PARTICIPANTS Respondents (n = 4522) from a Danish national survey conducted in autumn 2011. MEASUREMENTS Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT-C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder. FINDINGS During the study period, 56 respondents had a first-time ARDD admission. Respondents who scored above the 8-point AUDIT cut-off and respondents who scored above the 5-point AUDIT-C cut-off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut-offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59-8.60; AUDIT-C: HR, 7.97; 95% CI, 3.66-17.31). CONCLUSIONS Scores above alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) cut-offs are associated with an increased risk of long-term alcohol-related hospital admissions. At widely used cut-offs, the AUDIT-C is a better predictor of alcohol-related hospitalizations among members of the general population than the full AUDIT.
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Affiliation(s)
- Julie Brummer
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark.,Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.,Institute of Biometry and Clinical Epidemiology, Charité- Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
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20
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Donato S, Nieto S, Ray LA. The Brief Alcohol Use Disorder Severity Scale: An Initial Validation Evaluation. Alcohol Alcohol 2022; 57:762-767. [PMID: 36063825 PMCID: PMC9651986 DOI: 10.1093/alcalc/agac039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/10/2022] [Accepted: 07/24/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS The goal of this study was to develop a standard measure of AUD severity that includes multiple dimensions and can be used in clinical settings to inform treatment selection. METHODS A large sample (n = 1939) of moderate to heavy drinkers was amassed from six psychopharmacology studies. The severity factor was comprised of four dimensions: withdrawal, craving, AUD symptoms and alcohol-related consequences. First, a confirmatory factor analysis (CFA) was conducted to examine model fit. Next, a comprehensive item list from the four measures (i.e. CIWA, DrinC, PACs and SCID-5 AUD criteria) was reduced through exploratory factor analysis (EFA). Once the final items were merged into a preliminary assessment, an EFA was run to observe the factor structure. Initial validation of the measure was obtained via associations with clinical endpoints. RESULTS The chi-square test statistic (${\chi}^2(2)=2.432\ P=0.297$) for a single-factor model of severity demonstrated good fit. Additional goodness-of-fit indices from the CFA revealed similar support for the single-factor model of severity (i.e. SRMSR = 0.011; RMSEA = 0.011; CFI = 0.999). Next, nine items from the individual EFAs were selected based on factor loading. The final EFA conducted on the 9-item scale demonstrated that a single factor model of severity best fit the data. Analysis of the psychometric properties revealed good internal consistency ($\alpha$= 0.79). CONCLUSIONS The current study extends upon the measurement of severity and supports a brief severity measure. This brief 9-item scale can be leveraged in future studies as a screening instrument and as a tool for personalized medicine.
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Affiliation(s)
- Suzanna Donato
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, USA
| | - Steven Nieto
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Lara A Ray
- Department of Psychology, University of California at Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, USA
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21
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The prevalence of alcohol use and risky driving practises among individuals who consume sedatives nonmedically: findings from the NESARC-III. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:745-754. [PMID: 35881870 DOI: 10.1080/00952990.2022.2089992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background: Worldwide, 1.3 million people die because of a road traffic collision each year, with over half (57.7%) of such deaths in the United States involving a psychoactive substance. The prevalence of drink-drivers is slowly declining; however, the number of drivers under the influence of other drugs, such as sedatives, continues to rise.Objectives: This study aimed to examine alcohol use and risky driving practices among individuals who consume sedatives nonmedically.Methods: A total of 36,309 US adults (48.1% male) who participated in wave 3 (2012) of the National Epidemiologic Survey on Alcohol and Related Conditions were included for analysis.Results: Overall, 827 respondents reported past-year nonmedical sedative use. Almost two-third (64.9%) of these individuals exceeded recommended drinking guidelines and 42.5% met the criteria for a past-year DSM-5 alcohol use disorder. When controlling for demographic, lifestyle, and health factors, they were 1.84 times as likely to drink-drive (95% confidence interval = 1.46-2.33, p < .001) compared to those not using sedatives or using them as prescribed. Among those who reported both drink-driving and driving under the influence of sedatives in the last 12 months, 68.1% met the criteria for a past-year DSM-5 sedative use disorder.Conclusion: Several driving outcomes relevant to road safety, such as driving under the influence of alcohol or sedatives, are impacted by sedative consumption. Given that individuals who consume sedatives nonmedically may be unaware or misperceive the impacts of substance use on safe driving, interventions to reduce such behavior should be targeted among this high-risk group.
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22
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Kräplin A, Joshanloo M, Wolff M, Krönke KM, Goschke T, Bühringer G, Smolka MN. The relationship between executive functioning and addictive behavior: new insights from a longitudinal community study. Psychopharmacology (Berl) 2022; 239:3507-3524. [PMID: 36190537 PMCID: PMC9584881 DOI: 10.1007/s00213-022-06224-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 08/24/2022] [Indexed: 11/09/2022]
Abstract
RATIONALE Although there is evidence that impaired executive functioning plays a role in addictive behavior, the longitudinal relationship between the two remains relatively unknown. OBJECTIVES In a prospective-longitudinal community study, we tested the hypothesis that lower executive functioning is associated with more addictive behavior at one point in time and over time. METHODS Three hundred and thirty-eight individuals (19-27 years, 59% female) from a random community sample were recruited into three groups: addictive disorders related to substances (n = 100) or to behaviors (n = 118), or healthy controls (n = 120). At baseline, participants completed nine executive function tasks from which a latent variable of general executive functioning (GEF) was derived. Addictive behavior (i.e., quantity and frequency of use, and number of DSM-5 criteria met) were assessed using standardized clinical interviews at baseline and three annual follow-ups. The trajectories of addictive behaviors were examined using latent growth curve modeling. RESULTS At baseline, we found weak to no evidence of an associations between GEF and addictive behavior. We found evidence for an association between a lower GEF at baseline and a higher increase in the quantity of use and a smaller decrease in frequency of use over time, but no evidence for an association with an increase in the number of DSM-5 criteria met. CONCLUSIONS Lower EFs appear to lead to a continuing loss of control over use, whereas addictive disorders may develop secondarily after a long period of risky use. Previous etiological models assuming lower EF as a direct vulnerability factor for addictive disorders need to be refined.
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Affiliation(s)
- Anja Kräplin
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany.
| | - Mohsen Joshanloo
- Department of Psychology, Keimyung University, Daegu, South Korea
| | - Max Wolff
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
- MIND Foundation, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | - Klaus-Martin Krönke
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
| | - Thomas Goschke
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
| | - Gerhard Bühringer
- Work Group Addictive Behaviors, Risk Analysis and Risk Management, Faculty of Psychology, Technische Universität Dresden, Chemnitzer Straße 46, D-01187, Dresden, Germany
- IFT Institut für Therapieforschung, Munich, Germany
- Department of Clinical Research, Faculty of Health, University of Southern Denmark, Odense, Denmark
| | - Michael N Smolka
- Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
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23
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Kräplin A, Kupka KF, Fröhner JH, Krönke KM, Wolff M, Smolka MN, Bühringer G, Goschke T. Personality Traits Predict Non-Substance Related and Substance Related Addictive Behaviours. SUCHT 2022. [DOI: 10.1024/0939-5911/a000780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract: Aims: To examine whether personality traits predict the course of addictive behaviours in general and whether predictive associations differ between non-substance related (NR) and substance related (SR) addictive behaviours. Methodology: We recruited 338 individuals (19–27 y, 59 % female) from a random community sample with NR, SR, or no DSM-5 addictive disorder. Predictors were the Big Five personality traits (NEO-FFI) and reward and punishment sensitivity (BIS/BAS questionnaire). Outcomes were the slopes of addictive behaviours (i. e., quantity, frequency, and number of DSM-5 criteria) over three years. Bayesian multiple regressions were used to analyse the probabilities for each hypothesis. Results: The evidence that higher neuroticism, lower conscientiousness, lower agreeableness, higher extraversion, lower openness, higher reward sensitivity, and lower punishment sensitivity predict increased addictive behaviours over time was, overall, moderate to high (69 % to 99 %) and varied by trait and outcome. Predictive associations were mostly higher for NR compared with SR addictive behaviours. Conclusions: Personality traits predict the course of addictive behaviours, but associations were only about half as large as expected. While some personality traits, such as lower conscientiousness, predict increases in both NR and SR addictive behaviours over time, others, such as lower punishment sensitivity, seem to specifically predict increases in NR addictive behaviours.
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Affiliation(s)
- Anja Kräplin
- Faculty of Psychology, Technische Universität Dresden, Germany
| | | | - Juliane H. Fröhner
- Faculty of Psychology, Technische Universität Dresden, Germany
- Department of Psychiatry, Technische Universität Dresden, Germany
| | | | - Max Wolff
- Faculty of Psychology, Technische Universität Dresden, Germany
- Department of Psychiatry, Technische Universität Dresden, Germany
- MIND Foundation, Berlin, Germany
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Berlin, Germany
| | | | - Gerhard Bühringer
- Faculty of Psychology, Technische Universität Dresden, Germany
- IFT Institut für Therapieforschung, Munich, Germany
| | - Thomas Goschke
- Faculty of Psychology, Technische Universität Dresden, Germany
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24
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Schomerus G, Leonhard A, Manthey J, Morris J, Neufeld M, Kilian C, Speerforck S, Winkler P, Corrigan PW. The stigma of alcohol-related liver disease and its impact on healthcare. J Hepatol 2022; 77:516-524. [PMID: 35526787 DOI: 10.1016/j.jhep.2022.04.026] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/19/2022] [Accepted: 04/21/2022] [Indexed: 02/08/2023]
Abstract
People with alcohol-related liver disease (ALD) experience stigma and discrimination. This review summarises the evidence on stigma in healthcare and its implications for people with ALD, drawing from the literature on the stigma associated with mental illness and, specifically, alcohol use disorder (AUD). Public stigma, self-stigma and structural stigma all contribute to failure to seek help or delays in seeking help, inferior healthcare, and negative health outcomes, which increase the overall burden of ALD. Stigma can be experienced, but also anticipated and avoided, with both scenarios negatively impacting on ALD healthcare. Blaming people with ALD for their condition is central to the stigma of ALD. Stigma affects ALD healthcare at all stages, from prevention, early detection and intervention, to allocation of scarce resources in liver transplantation. People with lived experience need to be empowered to lead action against the stigmatisation of patients with ALD. Promulgating a dynamic model of individual and social responsibility for AUD, a continuum model of harmful alcohol use, and establishing training on ALD-related stigma for healthcare professionals are strategies to address stigma. Integrating addiction and ALD services, providing stigma-free prevention, and overcoming the frequent separation of addiction services from general healthcare are necessary. Beyond healthcare, addressing social inequality, the social dimensions of ALD risk and outcomes, and ensuring equal access to services is necessary to improve outcomes for all people with ALD. More research is needed on the stigma of ALD in low- and middle-income countries and in countries with restrictive drinking norms. Interventions to reduce the stigma of ALD and facilitate early help-seeking need to be developed and evaluated.
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Affiliation(s)
- Georg Schomerus
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany.
| | - Anya Leonhard
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Jakob Manthey
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany; Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - James Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - Maria Neufeld
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sven Speerforck
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Petr Winkler
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czechia; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Patrick W Corrigan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
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25
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Epskamp S, van der Maas HLJ, Peterson RE, van Loo HM, Aggen SH, Kendler KS. Intermediate stable states in substance use. Addict Behav 2022; 129:107252. [PMID: 35182945 DOI: 10.1016/j.addbeh.2022.107252] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/15/2022]
Abstract
Many people across the world use potentially addictive legal and illegal substances, but evidence suggests that not all use leads to heavy use and dependence, as some substances are used moderately for long periods of time. Here, we empirically examine, the stability of and transitions between three substance use states: zero-use, moderate use, and heavy use. We investigate two large datasets from the US and the Netherlands on yearly usage and change of alcohol, nicotine, and cannabis. Results, which we make available through an extensive interactive tool, suggests that there are stable moderate use states, even after meeting criteria for a positive diagnosis of substance abuse or dependency, for both alcohol and cannabis use. Moderate use of tobacco, however, was rare. We discuss implications of recognizing three states rather than two states as a modeling target, in which the moderate use state can both act as an intervention target or as a gateway between zero use and heavy use.
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Affiliation(s)
- Sacha Epskamp
- University of Amsterdam, Department of Psychology, Psychological Methods Program Group, Amsterdam, The Netherlands; University of Amsterdam, Centre for Urban Mental Health, Amsterdam, The Netherlands.
| | - Han L J van der Maas
- University of Amsterdam, Department of Psychology, Psychological Methods Program Group, Amsterdam, The Netherlands
| | - Roseann E Peterson
- Virginia Commonwealth University, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Hanna M van Loo
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Steven H Aggen
- Virginia Commonwealth University, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - Kenneth S Kendler
- Virginia Commonwealth University, Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
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26
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Joseph J, Varghese A, Vijay VR, Grover S, Sharma S, Dhandapani M, Khakha DC, Arya S, Mahendia N, Varkey BP, Kishore K. The prevalence of alcohol use disorders using alcohol use disorders identification test (AUDIT) in the Indian setting: - a systematic review and meta-analysis. J Ethn Subst Abuse 2022; 23:2-20. [PMID: 35404781 DOI: 10.1080/15332640.2022.2056105] [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] [Indexed: 10/18/2022]
Abstract
There is a wide discrepancy in the epidemiology of alcohol use disorders (AUDs) due to diverse scales and survey approaches. We estimated the prevalence of AUDs by comparing the pooled prevalence based on the alcohol use disorders identification test (AUDIT) Vs. non-AUDIT (all scales other than AUDIT). This review searched the community-based prevalence of AUDs in PubMed, Web of Science, PsycINFO, Scopus, Ovid, and Google Scholar. Articles published during the years from 2000 to 2020 were included. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated, and the publication bias was evaluated. Twenty-one studies conducted in different states of India included 73997 community-based respondents, which estimated the overall prevalence of AUDs as 12.5% (95% CI: 9 to 17.3%). The pooled prevalence based on AUDIT was 12.4% (AUDIT ≥8; 95% CI: 8.8 to 17.1%) in which the magnitude of hazardous and harmful alcohol use (8.6%; 95% CI: 5.7 to 12.8%; AUDIT 8-19) was significantly higher than dependent alcohol use (2.3%; 95% CI: 1.1 to 4.8%; AUDIT ≥ 20). The pooled prevalence using the non-AUDIT tool was 14.2(95%; CI: 6-30%). Our findings further reveal that about one in twelve of the population of India have AUDs, and there is a gross variation in the patterns of alcohol use across the country. The high prevalence of AUDs suggests developing a national policy to benefit alcohol use, justifying regional variations.Supplemental data for this article is available online at https://doi.org/10.1080/15332640.2022.2056105 .
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Affiliation(s)
- Jaison Joseph
- Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Abin Varghese
- All India Institute of Medical Sciences, Nagpur, India
| | - V R Vijay
- AIl India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Sandeep Grover
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Suresh Sharma
- All India Institute of Medical Sciences (AIIMS), Jodhpur, India
| | - Manju Dhandapani
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Deepika C Khakha
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sidharth Arya
- Institute of Mental Health, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Neeraj Mahendia
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Biji P Varkey
- Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, India
| | - Kamal Kishore
- Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Lange S, Jiang H, Bagge C, Probst C, Tran A, Rehm J. Gender-specific risk relationship between heavy alcohol use/alcohol use disorders and suicidal thoughts and behavior among adults in the United States over time. Soc Psychiatry Psychiatr Epidemiol 2022; 57:721-726. [PMID: 35032174 PMCID: PMC8969096 DOI: 10.1007/s00127-022-02225-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 01/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Suicidal thoughts and behaviors have been on the rise in the recent years in the US. There is a well-known link between heavy alcohol use/alcohol use disorders (AUDs) and suicidal thoughts and behaviors. An increase in the respective risk relationships is one way in which heavy alcohol use/AUDs may be driving the increase in the rate of suicidal thoughts and behaviors. The objective of the current study was to investigate whether the gender-specific risk relationships between heavy alcohol use/AUDs and past-year (1) suicidal thoughts and (2) attempted suicide have increased over time. METHODS Individual-level annual data from the National Survey on Drug Use and Health for the past 12 years (2008-2019) were utilized. Year- and gender-specific multivariate binary logistic regression analyses were first conducted. Gender-stratified random-effects meta-regressions across study years were then conducted. RESULTS Heavy alcohol use/AUDs were associated with elevated odds of past-year suicidal thoughts and attempted suicide for both men and women; however, a linear increase in the risk relationships over time was not found. CONCLUSION Although a temporal increase in the risk relationships of interest was not found, until additional research in this area is conducted, heavy alcohol use/AUDs cannot be ruled out as being a driving force behind the increasing rate of suicidal thoughts and behaviors in the US.
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Affiliation(s)
- Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Courtney Bagge
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Veterans Affairs, Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Charlotte Probst
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Heidelberg Institute for Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin St., Room T521, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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28
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Dutey-Magni P, Brown J, Holmes J, Sinclair J. Concurrent validity of an estimator of weekly alcohol consumption (EWAC) based on the extended AUDIT. Addiction 2022; 117:580-589. [PMID: 34374144 DOI: 10.1111/add.15662] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 07/28/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS The three-question Alcohol Use Disorders Identification Test (AUDIT-C) is frequently used in healthcare for screening and brief advice about levels of alcohol consumption. AUDIT-C scores (0-12) provide feedback as categories of risk rather than estimates of actual alcohol intake, an important metric for behaviour change. The study aimed to (i) develop a continuous metric from the Extended AUDIT-C expressed in United Kingdom (UK) units (8 g pure ethanol), offering equivalent accuracy, and providing a direct estimator of weekly alcohol consumption (EWAC) and (ii) evaluate the EWAC's bias and error using the graduated-frequency (GF) questionnaire as a reference standard of alcohol consumption. DESIGN Cross-sectional diagnostic study based on a nationally-representative survey. SETTINGS Community dwelling households in England. PARTICIPANTS A total of 22 404 household residents aged ≥16 years reporting drinking alcohol at least occasionally. MEASUREMENTS Computer-assisted personal interviews consisting of (i) AUDIT questionnaire with extended response items (the 'Extended AUDIT') and (ii) GF. Primary outcomes were: mean deviation <1 UK unit (metric of bias); root-mean-square deviation <2 UK units (metric of total error) between EWAC and GF. The secondary outcome was the receiver operating characteristic area under the curve for predicting alcohol consumption in excess of 14 and 35 UK units. FINDINGS EWAC had a positive bias of 0.2 UK units (95% CI = 0.08, 0.4) compared with GF. Deviations were skewed: whereas the mean error was ±11 UK units/week [9.5, 11.9], in half of participants the deviation between EWAC and GF was between 0 and ±2.1 UK units/week. EWAC predicted consumption in excess of 14 UK units/week with a significantly greater area under the curve (0.918 [0.914, 0.923]) than AUDIT-C (0.870 [0.864, 0.876]) or the full AUDIT (0.854 [0.847, 0.860]). CONCLUSIONS A new estimator of weekly alcohol consumption, which uses answers to the Extended AUDIT-C, meets the targeted bias tolerance. It is superior in accuracy to AUDIT-C and the full 10-item AUDIT when predicting consumption thresholds, making it a reliable complement to the Extended AUDIT-C for health promotion interventions.
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Affiliation(s)
- Peter Dutey-Magni
- Institute of Health Informatics, University College London, London, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jamie Brown
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Julia Sinclair
- Faculty of Medicine, University of Southampton, Southampton, UK
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29
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Fomiatti R, Savic M, Fraser S, Edwards M, Farrugia A. Heavy drinking as phenomenon: gender and agency in accounts of men's heavy drinking. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:16-31. [PMID: 34018911 DOI: 10.1080/14461242.2020.1850317] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
Alcohol consumption is a significant public health concern in Australia, with men disproportionately represented in treatment for health issues related to heavy drinking. Despite this, little is known about the experiences of these men or the gender dynamics that may shape heavy drinking. Increasingly, the treatment of alcohol and other drug-related issues, including those related to heavy drinking, is based on a biopsychosocial approach. Within this framework, heavy drinking is understood as a symptom of individual pathology in the context of various social 'factors' that influence individual capacity to exercise agency. Following the work of Karen Barad, this article employs a feminist science studies account of agency to formulate heavy drinking as a gendered 'phenomenon': enacted and sustained through the 'intra-action' of other phenomena. Drawing on interviews with men who drink heavily, our analysis explores how the phenomenon of men's heavy drinking materialises through the intra-actions of gender, isolation and healthcare. We argue that heavy drinking is not a sign of failed individual agency but an expression of entangled agencies. In concluding, we suggest it is possible to enhance the well-being of men who drink heavily by addressing specific gendered intra-actions in the making of heavy drinking.
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Affiliation(s)
- Renae Fomiatti
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, Australia
| | - Michael Savic
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Clayton, Australia
- Eastern Health Turning Point, Box Hill, Australia
| | - Suzanne Fraser
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, Australia
- Centre for Social Research in Health, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, Australia
| | - Michael Edwards
- National Drug and Alcohol Research Centre, School of Medicine, University of New South Wales, Sydney, Australia
| | - Adrian Farrugia
- Australian Research Centre in Sex Health and Society, La Trobe University, Melbourne, Australia
- National Drug Research Institute, Curtin University, Perth, Australia
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30
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Helle AC, Boness CL, Sher KJ. College students' receptiveness to intervention approaches for alcohol and cannabis use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:157-176. [PMID: 33749290 PMCID: PMC8455707 DOI: 10.1037/adb0000699] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Addressing high-risk alcohol and cannabis use represent major challenges to institutions of higher education. A range of evidence-based treatment approaches are available, but little is known concerning students' receptiveness to such approaches. Prior work identified that students were most open to individual therapy and self-help options for reducing alcohol use, but less open to medication. The current study examines student receptiveness to intervention approaches across a wider range of intervention approaches (e.g., remote/telehealth), and extends to evaluate cannabis intervention receptiveness. METHOD Undergraduate students reported on alcohol and cannabis use, motives for and reasons against use, and openness to an array of interventions for reducing alcohol and cannabis use. RESULTS Informal options (self-help, talking with family/friends), individual therapy, and appointments with a primary care provider (PCP) were endorsed most frequently. Group therapy and medication were less commonly endorsed, though medication was endorsed at a higher prevalence than in prior studies. Women generally expressed higher receptiveness than men. Lower alcohol consumption was associated with increased receptiveness to some approaches. Students at high risk for alcohol and/or cannabis dependence were less receptive to many treatment options. CONCLUSIONS College students were open to a wide variety of approaches for reducing their alcohol and cannabis use. These results can inform selection, implementation, and availability of campus-wide services, especially as low-cost technological-based approaches are expanding. Further attention to existing services (e.g., PCP) for addressing alcohol and cannabis use may be considered, given students' receptiveness to such approaches. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Ashley C. Helle
- University of Missouri, Department of Psychological
Sciences, 200 South 7 Street, Columbia, MO 65211, United State
- Corresponding author:
| | - Cassandra L. Boness
- University of Missouri, Department of Psychological
Sciences, 200 South 7 Street, Columbia, MO 65211, United State
| | - Kenneth J. Sher
- University of Missouri, Department of Psychological
Sciences, 200 South 7 Street, Columbia, MO 65211, United State
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31
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, and Campbell Family Mental Health Research Institute, Toronto, ON M5S 2S1, Canada; Institute of Medical Science, Dalla Lana School of Public Health, and Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Robin Room
- Centre for Alcohol Policy Research, Turning Point, Fitzroy, VIC, Australia; School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia; Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
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32
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Wiese W, Friston KJ. AI ethics in computational psychiatry: From the neuroscience of consciousness to the ethics of consciousness. Behav Brain Res 2022; 420:113704. [PMID: 34871706 PMCID: PMC9125160 DOI: 10.1016/j.bbr.2021.113704] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022]
Abstract
Methods used in artificial intelligence (AI) overlap with methods used in computational psychiatry (CP). Hence, considerations from AI ethics are also relevant to ethical discussions of CP. Ethical issues include, among others, fairness and data ownership and protection. Apart from this, morally relevant issues also include potential transformative effects of applications of AI-for instance, with respect to how we conceive of autonomy and privacy. Similarly, successful applications of CP may have transformative effects on how we categorise and classify mental disorders and mental health. Since many mental disorders go along with disturbed conscious experiences, it is desirable that successful applications of CP improve our understanding of disorders involving disruptions in conscious experience. Here, we discuss prospects and pitfalls of transformative effects that CP may have on our understanding of mental disorders. In particular, we examine the concern that even successful applications of CP may fail to take all aspects of disordered conscious experiences into account.
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Affiliation(s)
- Wanja Wiese
- Institute of Philosophy II, Ruhr University Bochum, Universitätsstraße 150, 44780 Bochum, Germany.
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
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33
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Tran A, Jiang H, Kim KV, Room R, Štelemėkas M, Lange S, Rovira P, Rehm J. Predicting the Impact of Alcohol Taxation Increases on Mortality-A Comparison of Different Estimation Techniques. Alcohol Alcohol 2022; 57:500-507. [PMID: 35217852 PMCID: PMC9270989 DOI: 10.1093/alcalc/agac003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/22/2021] [Accepted: 01/17/2022] [Indexed: 11/12/2022] Open
Abstract
AIMS To examine how standard analytical approaches to model mortality outcomes of alcohol use compare to the true results using the impact of the March 2017 alcohol taxation increase in Lithuania on all-cause mortality as an example. METHODS Four methodologies were used: two direct methodologies: (a) interrupted time-series on mortality and (b) comparing predictions based on time-series modeling with the real number of deaths for the year following the implementation of the tax increase; and two indirect methodologies: (c) combining a regression-based estimate for the impact of taxation on alcohol consumption with attributable-fraction methodology and (d) using price elasticities from meta-analyses to estimate the impact on alcohol consumption before applying attributable-fraction methodology. RESULTS AND CONCLUSIONS While all methodologies estimated reductions in all-cause mortality, especially for men, there was substantial variability in the level of mortality reductions predicted. The indirect methodologies had lower predictions as the meta-analyses on elasticities and risk relations seem to underestimate the true values for Lithuania. Directly estimated effects of taxation based on the actual mortalities seem to best represent the true reductions in alcohol-attributable mortality. A significant increase in alcohol excise taxation had a marked impact on all-cause mortality in Lithuania.
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Affiliation(s)
- Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
| | - Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - Kawon Victoria Kim
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Bundoora, Victoria 3086, Australia
- Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Albanovägen 12, floor 5, Stockholm University, Stockholm 106 91, Sweden
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas 47181, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, Kaunas 47181, Lithuania
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Ursula Franklin Street 33, Toronto, OntarioM5S 3M1, Canada
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, 81-95 Roc Boronat St., Barcelona 08005, Spain
| | - Jürgen Rehm
- Corresponding author: Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Ursula Franklin Street 33, Toronto, Ontario M5S 3M1, Canada. Tel.: +1-416-535-8501 x 36173; E-mail:
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Rovira P, Belian G, Ferreira-Borges C, Kilian C, Neufeld M, Tran A, Štelemėkas M, Rehm J. Alcohol taxation, alcohol consumption and cancers in Lithuania: A case study. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:25-37. [PMID: 35308470 PMCID: PMC8899268 DOI: 10.1177/14550725211021318] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Aims The aim of this contribution was to estimate the impact of the last significant alcohol taxation increase in Lithuania in 2017 on alcohol consumption, incident cancer cases, and cancer mortality, as well as the number of cancer outcomes that could have potentially been averted in 2018 had larger increases in alcohol excise taxation been applied. Design Statistical modelling was used to estimate the change in alcohol per capita consumption following the tax increase, and alcohol-attributable fraction methodology was then used to estimate the associated cancer incidence and mortality. Potential increases of current excise duties were modelled in two steps. First, beverage-specific price elasticities of demand were used to predict the associated decreases in consumption and cancer outcomes, and second, the outcomes arising from the actual numbers and the modelled numbers were compared. Method Data were taken from the following sources: alcohol consumption data from Statistics Lithuania and the WHO, cancer data from the International Agency of Research on Cancer, and risk relations and elasticities of demand from published meta-analyses. Results A total of 15,857 new cancer cases (8,031 in women and 7,826 in men) and 8,534 cancer deaths (3,757 in women and 4,777 in men) were recorded in Lithuania in 2018. Using the attributable fraction methodology, we estimate that 4.8% of 761 of these new cancer cases were attributable to alcohol use (284 in women; 477 in men), as well as 5.5% or 466 cancer deaths (115 in women; 351 in men). With the taxation increase of 2017, 45 new cases and 24 deaths will be averted over the next 10 years. Further taxation increases of 100% could double the number of new cancer cases averted or saved. Conclusion In a high-consumption European country like Lithuania, alcohol use is an important and avoidable risk factor for cancer. Taxation is an important measure to reduce the alcohol-attributable cancer burden.
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Affiliation(s)
- Pol Rovira
- Public Health Agency of Catalonia, Barcelona, Spain
| | - Gražina Belian
- Tobacco and Alcohol Control Department, Vilnius, Lithuania
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Russian Federation
| | | | - Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Russian Federation Technische Universität Dresden, Germany; and Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | - Alexander Tran
- Centre for Addiction and Mental Health (CAMH), Toronto, Canada
| | | | - Jürgen Rehm
- Public Health Agency of Catalonia, Barcelona, Spain Drug, Tobacco and Alcohol Control Department, Vilnius, Lithuania Technische Universität Dresden, Dresden, Germany Centre for Addiction and Mental Health (CAMH), Toronto, Canada University of Toronto, Toronto, Canada I. M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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35
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Volpicelli JR, Menzies P. Rethinking Unhealthy Alcohol Use in the United States: A Structured Review. Subst Abuse 2022; 16:11782218221111832. [PMID: 35899221 PMCID: PMC9310219 DOI: 10.1177/11782218221111832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/06/2022] [Indexed: 11/21/2022]
Abstract
Greater than moderate alcohol use spans a continuum that includes high levels of
total alcohol consumed per period (heavy drinking) as well as episodes of
intense drinking (binges) and can give rise to alcohol use disorder (AUD) when
associated with an inability to control alcohol use despite negative
consequences. Although moderate drinking and AUD have standard, operable
definitions in the United States (US), a significant “gray area” remains in
which an individual may exceed recommended drinking guidelines but does not meet
the criteria for AUD (hereafter referred to as unhealthy alcohol use). To
address this need, we conducted a structured literature search to evaluate how
this gray area is defined and assess its burden within the US. For purposes of
this review, we will refer to this gray area as “unhealthy alcohol use.”
Although numerous terms are used to describe various unsafe drinking practices,
our review did not find any studies in which the specific prevalence and/or
burden of unhealthy alcohol use was evaluated. That is, we found no studies that
focus exclusively on individuals who exceed moderate drinking guidelines but do
not meet AUD criteria. Furthermore, we did not discover an established framework
for identifying individuals with unhealthy alcohol use. The lack of a consistent
framework for identifying unhealthy alcohol users has significant implications
for patient management and disease burden assessment. Therefore, we propose the
following framework in which unhealthy alcohol use comprises 2 distinct
subpopulations: those at risk of experiencing alcohol-related consequences and
those who have subthreshold problems associated with use. The former, termed
“risky drinkers,” are defined by exceeding recommended guidelines for moderate
drinking (⩽1 or 2 drinks per day for women and men, respectively). People with
subthreshold problems associated with use, defined as exhibiting exactly 1 AUD
symptom, would be classified as “problematic drinkers” within this proposed
framework. These definitions would help bring the core elements of unhealthy
alcohol use into focus, which in turn would help identify and provide management
strategies sooner to those affected and reduce the overall burden of unhealthy
alcohol use.
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Affiliation(s)
| | - Percy Menzies
- Assisted Recovery Centers of America, St Louis, MO, USA
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36
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Jakub G, Krzysztof O, Katarzyna D, Łukasz W. "It'll Never Be Safe, But You Can Limit the Harms". Exploring Adolescents' Strategies to Reduce Harms Associated with Psychoactive Substance Use. Subst Use Misuse 2022; 57:380-391. [PMID: 34895030 DOI: 10.1080/10826084.2021.2012694] [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] [Indexed: 10/19/2022]
Abstract
Introduction: Harm reduction strategies are behaviors that may be applied in order to reduce adverse consequences associated with psychoactive substance use. Adolescents who use substances make up a large population that may benefit from applying such strategies. However, previous research in this area has focused on adults. Therefore, the purpose of this qualitative study was to describe and examine harm reduction strategies among adolescents who use psychoactive substances. Methods: Semi-structured individual interviews were conducted with 72 adolescents of equal sex distribution (aged 17-18 years) who had used various substances at least three times in the past 12 months and had no history of substance use disorders (SUD) treatment. Data were transcribed and then analyzed thematically based on the Consensual Qualitative Research approach. Findings: Adolescents who use substances described the harm reduction strategies they use. According to the meaning youth attributed to these strategies, five themes were developed, that included approaches to risk, substance use safety conditions, preparation for use, manner of use, and controlled use. Most of the identified strategies correspond to those found in studies on adults. The main source of adolescents' knowledge about these strategies was the Internet. Peers appeared to play an important role in reducing substance-related risks. Conclusions: Despite risk-taking, adolescents in our study showed active engagement in reducing their substance-related risks and harms. Practical implications are provided, including supporting harm reduction strategies, enhancing the active role of peers and the Internet as communication channels in preventing SUDs as well as other substance-related problems among adolescents.
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Affiliation(s)
- Greń Jakub
- Department of Public Health, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Dąbrowska Katarzyna
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Wieczorek Łukasz
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
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37
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Hua JPY, de Lange SC, van den Heuvel MP, Boness CL, Trela CJ, McDowell YE, Merrill AM, Piasecki TM, Sher KJ, Kerns JG. Alcohol use in emerging adults associated with lower rich-club connectivity and greater connectome network disorganization. Drug Alcohol Depend 2022; 230:109198. [PMID: 34861495 PMCID: PMC8837437 DOI: 10.1016/j.drugalcdep.2021.109198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Emerging adulthood is a critical neurodevelopmental stage, with alcohol use during this period consistently associated with brain abnormalities and damage in anatomical structure and white matter integrity. However, it is less clear how alcohol use is associated with the brain's structural organization (i.e., white matter connections between anatomical regions). Recent connectome research has focused on rich-club regions, a collection of highly-interconnected hubs that are critical in brain communication and global network organization and disproportionately vulnerable to insults. METHODS For the first time, we examined alcohol use associations with structural rich-club and connectome organization in emerging adults (N = 66). RESULTS Greater lifetime drinks and current monthly drinks were significantly associated with lower rich-club organization (rs =-0.38, ps < 0.003) and lower rich-club connectivity (rs <-0.34, ps < 0.007). Additionally, rich-club connectivity was significantly more negatively correlated with alcohol use than connectivity among non-rich-club regions (ps < 0.035). Examining overall structural organization, greater lifetime drinks and current monthly drinks were significantly associated with lower network density (i.e., lower network resilience; rs <-0.36, ps = 0.004). Additionally, greater lifetime drinks and current monthly drinks were significantly associated with higher network segregation (i.e., network's tendency to divide into subnetworks; rs >0.33, ps<0.008). Alcohol use was not significantly associated with network integration (i.e., network's efficiency in combining information across the brain; ps > 0.064). CONCLUSIONS Results provide novel evidence that alcohol use is associated with decreased rich-club connectivity and structural network disorganization. Given that both are critical in global brain communication, these results highlight the importance of examining alcohol use and brain relationships in emerging adulthood.
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Affiliation(s)
- Jessica P Y Hua
- Sierra Pacific Mental Illness Research Education and Clinical Centers, San Francisco VA Medical Center and the University of California, San Francisco, CA, USA; Mental Health Service, San Francisco VA Medical Center, San Francisco, CA 94121, USA; Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA 94143, USA; Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA.
| | - Siemon C de Lange
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Martijn P van den Heuvel
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands; Department of Child Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Cassandra L Boness
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA; Center on Alcohol, Substance Use, and Addictions, University of New Mexico, Albuquerque, NM 87106, USA
| | - Constantine J Trela
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Yoanna E McDowell
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Anne M Merrill
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Thomas M Piasecki
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - Kenneth J Sher
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
| | - John G Kerns
- Department of Psychological Sciences, University of Missouri, Columbia, MO 65211, USA
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38
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Melia C, Kent A, Meredith J, Lamont A. Constructing and negotiating boundaries of morally acceptable alcohol use: A discursive psychology of justifying alcohol consumption. Addict Behav 2021; 123:107057. [PMID: 34385073 DOI: 10.1016/j.addbeh.2021.107057] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/01/2021] [Accepted: 07/12/2021] [Indexed: 12/22/2022]
Abstract
UK society has a complex relationship with alcohol; it is ever-present within social activities, yet alcohol problems are heavily stigmatised. As such, the nuance of acceptability is a key focus for understanding societal perceptions and understandings of alcohol. This research explored how the boundary between acceptable and problematic alcohol use was negotiated in justifying drinking behaviors. The paper draws upon data from two World Cafés and five focus groups conducted in the UK with 76 participants including 25 males and 51 females aged 18 to 82. Data was analysed using discursive psychology with a focus on how participants disclosed and accounted for alcohol consumption. The analysis highlighted two key discursive patterns: 1) Speakers created an interactionally-specific boundary of acceptable alcohol use. 2) Speakers built upon this boundary, justifying and portraying their own drinking as socially acceptable. The boundary of acceptable alcohol use was locally constructed and shifted between speakers and contexts. This locally occasioned boundary demonstrates the challenge of objective guidance - such as the UK Chief Medical Officer's unit guidelines - in relation to individualistic behaviors. Implications are discussed for how alcohol policy, health campaigns, and alcohol practitioners may consider this orientation to justifying drinking behaviors to make alcohol reduction efforts more effective.
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Johansson M, Berman AH, Sinadinovic K, Lindner P, Hermansson U, Andréasson S. Effects of Internet-Based Cognitive Behavioral Therapy for Harmful Alcohol Use and Alcohol Dependence as Self-help or With Therapist Guidance: Three-Armed Randomized Trial. J Med Internet Res 2021; 23:e29666. [PMID: 34821563 PMCID: PMC8663526 DOI: 10.2196/29666] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/23/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Alcohol use is a major contributor to health loss. Many persons with harmful use or alcohol dependence do not obtain treatment because of limited availability or stigma. They may use internet-based interventions as an alternative way of obtaining support. Internet-based interventions have previously been shown to be effective in reducing alcohol consumption in studies that included hazardous use; however, few studies have been conducted with a specific focus on harmful use or alcohol dependence. The importance of therapist guidance in internet-based cognitive behavioral therapy (ICBT) programs is still unclear. Objective This trial aims to investigate the effects of a web-based alcohol program with or without therapist guidance among anonymous adult help-seekers. Methods A three-armed randomized controlled trial was conducted to compare therapist-guided ICBT and self-help ICBT with an information-only control condition. Swedish-speaking adult internet users with alcohol dependence (3 or more International Classification of Diseases, Tenth Revision criteria) or harmful alcohol use (alcohol use disorder identification test>15) were included in the study. Participants in the therapist-guided ICBT and self-help ICBT groups had 12-week access to a program consisting of 5 main modules, as well as a drinking calendar with automatic feedback. Guidance was given by experienced therapists trained in motivational interviewing. The primary outcome measure was weekly alcohol consumption in standard drinks (12 g of ethanol). Secondary outcomes were alcohol-related problems measured using the total alcohol use disorder identification test-score, diagnostic criteria for alcohol dependence and alcohol use disorder, depression, anxiety, health, readiness to change, and access to other treatments or support. Follow-up was conducted 3 (posttreatment) and 6 months after recruitment. Results During the recruitment period, from March 2015 to March 2017, 1169 participants were included. Participants had a mean age of 45 (SD 13) years, and 56.72% (663/1169) were women. At the 3-month follow-up, the therapist-guided ICBT and control groups differed significantly in weekly alcohol consumption (−3.84, 95% Cl −6.53 to −1.16; t417=2.81; P=.005; Cohen d=0.27). No significant differences were found in weekly alcohol consumption between the self-help ICBT group and the therapist-guided ICBT at 3 months, between the self-help ICBT and the control group at 3 months, or between any of the groups at the 6-month follow-up. A limitation of the study was the large number of participants who were completely lost to follow-up (477/1169, 40.8%). Conclusions In this study, a therapist-guided ICBT program was not found to be more effective than the same program in a self-help ICBT version for reducing alcohol consumption or other alcohol-related outcomes. In the short run, therapist-guided ICBT was more effective than information. Only some internet help-seekers may need a multisession program and therapist guidance to change their drinking when they use internet-based interventions. Trial Registration ClinicalTrials.gov NCT02377726; https://clinicaltrials.gov/ct2/show/NCT02377726
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Affiliation(s)
- Magnus Johansson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Anne H Berman
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.,Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kristina Sinadinovic
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Philip Lindner
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Ulric Hermansson
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Sven Andréasson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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40
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Goldberg SB, Pace B, Griskaitis M, Willutzki R, Skoetz N, Thoenes S, Zgierska AE, Rösner S. Mindfulness-based interventions for substance use disorders. Cochrane Database Syst Rev 2021; 10:CD011723. [PMID: 34668188 PMCID: PMC8527365 DOI: 10.1002/14651858.cd011723.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Substance use disorders (SUDs) are highly prevalent and associated with a substantial public health burden. Although evidence-based interventions exist for treating SUDs, many individuals remain symptomatic despite treatment, and relapse is common.Mindfulness-based interventions (MBIs) have been examined for the treatment of SUDs, but available evidence is mixed. OBJECTIVES To determine the effects of MBIs for SUDs in terms of substance use outcomes, craving and adverse events compared to standard care, further psychotherapeutic, psychosocial or pharmacological interventions, or instructions, waiting list and no treatment. SEARCH METHODS We searched the following databases up to April 2021: Cochrane Drugs and Alcohol Specialised Register, CENTRAL, PubMed, Embase, Web of Science, CINAHL and PsycINFO. We searched two trial registries and checked the reference lists of included studies for relevant randomized controlled trials (RCTs). SELECTION CRITERIA RCTs testing a MBI versus no treatment or another treatment in individuals with SUDs. SUDs included alcohol and/or drug use disorders but excluded tobacco use disorders. MBIs were defined as interventions including training in mindfulness meditation with repeated meditation practice. Studies in which SUDs were formally diagnosed as well as those merely demonstrating elevated SUD risk were eligible. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS Forty RCTs met our inclusion criteria, with 35 RCTs involving 2825 participants eligible for meta-analysis. All studies were at high risk of performance bias and most were at high risk of detection bias. Mindfulness-based interventions (MBIs) versus no treatment Twenty-four RCTs included a comparison between MBI and no treatment. The evidence was uncertain about the effects of MBIs relative to no treatment on all primary outcomes: continuous abstinence rate (post: risk ratio (RR) = 0.96, 95% CI 0.44 to 2.14, 1 RCT, 112 participants; follow-up: RR = 1.04, 95% CI 0.54 to 2.01, 1 RCT, 112 participants); percentage of days with substance use (post-treatment: standardized mean difference (SMD) = 0.05, 95% CI -0.37 to 0.47, 4 RCTs, 248 participants; follow-up: SMD = 0.21, 95% CI -0.12 to 0.54, 3 RCTs, 167 participants); and consumed amount (post-treatment: SMD = 0.10, 95% CI -0.31 to 0.52, 3 RCTs, 221 participants; follow-up: SMD = 0.33, 95% CI 0.00 to 0.66, 2 RCTs, 142 participants). Evidence was uncertain for craving intensity and serious adverse events. Analysis of treatment acceptability indicated MBIs result in little to no increase in study attrition relative to no treatment (RR = 1.04, 95% CI 0.77 to 1.40, 21 RCTs, 1087 participants). Certainty of evidence for all other outcomes was very low due to imprecision, risk of bias, and/or inconsistency. Data were unavailable to evaluate adverse events. Mindfulness-based interventions (MBIs) versus other treatments (standard of care, cognitive behavioral therapy, psychoeducation, support group, physical exercise, medication) Nineteen RCTs included a comparison between MBI and another treatment. The evidence was very uncertain about the effects of MBIs relative to other treatments on continuous abstinence rate at post-treatment (RR = 0.80, 95% CI 0.45 to 1.44, 1 RCT, 286 participants) and follow-up (RR = 0.57, 95% CI 0.28 to 1.16, 1 RCT, 286 participants), and on consumed amount at post-treatment (SMD = -0.42, 95% CI -1.23 to 0.39, 1 RCT, 25 participants) due to imprecision and risk of bias. The evidence suggests that MBIs reduce percentage of days with substance use slightly relative to other treatments at post-treatment (SMD = -0.21, 95% CI -0.45 to 0.03, 5 RCTs, 523 participants) and follow-up (SMD = -0.39, 95% CI -0.96 to 0.17, 3 RCTs, 409 participants). The evidence was very uncertain about the effects of MBIs relative to other treatments on craving intensity due to imprecision and inconsistency. Analysis of treatment acceptability indicated MBIs result in little to no increase in attrition relative to other treatments (RR = 1.06, 95% CI 0.89 to 1.26, 14 RCTs, 1531 participants). Data were unavailable to evaluate adverse events. AUTHORS' CONCLUSIONS In comparison with no treatment, the evidence is uncertain regarding the impact of MBIs on SUD-related outcomes. MBIs result in little to no higher attrition than no treatment. In comparison with other treatments, MBIs may slightly reduce days with substance use at post-treatment and follow-up (4 to 10 months). The evidence is uncertain regarding the impact of MBIs relative to other treatments on abstinence, consumed substance amount, or craving. MBIs result in little to no higher attrition than other treatments. Few studies reported adverse events.
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Affiliation(s)
- Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin, Madison, WI, USA
| | | | - Matas Griskaitis
- Institute of Medical Biostatistics, Epidemiology, and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Reinhard Willutzki
- Private medical practice for Psychiatry and Psychotherapy, Zürich, Switzerland
| | - Nicole Skoetz
- Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Sven Thoenes
- Department of Psychology, Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - Aleksandra E Zgierska
- Departments of Family and Community Medicine, Pennsylvania State University College of Medicine, Hershey, PA, USA
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Rehm J, Neufeld M, Yurasova E, Bunova A, Gil A, Gornyi B, Breda J, Bryun E, Drapkina O, Fadeeva E, Kalinina A, Khaltourina D, Klimenko T, Kontsevaya A, Koshkina E, Martynova N, Nadezhdin A, Soshkina K, Tetenova E, Vujnovic M, Vyshinsky K, Ferreira-Borges C. Adaptation of and Protocol for the Validation of the Alcohol Use Disorders Identification Test (AUDIT) in the Russian Federation for Use in Primary Healthcare. Alcohol Alcohol 2021; 55:624-630. [PMID: 32728707 PMCID: PMC7576502 DOI: 10.1093/alcalc/agaa067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 01/10/2023] Open
Abstract
Aims To adapt and validate the Alcohol Use Disorders Identification Test (AUDIT) for use in the Russian Federation and countries with Russian-speaking populations by: Methods Systematic review of past use and validation of the Russian-language AUDIT. Interviews to be conducted with experts to identify problems encountered in the use of existing Russian-language AUDIT versions. A pilot study using a revised translation of the Russian-language AUDIT that incorporates country-specific drinking patterns in the Russian Federation. Results and Conclusions The systematic review identified over 60 different Russian-language AUDIT versions without systematic validation studies. The main difficulties encountered with the use of the AUDIT in the Russian Federation were related to the lack of: A revised version of the Russian-language AUDIT was created based on the pilot studies, and was validated in primary healthcare facilities in all regions in 2019/2020.
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Affiliation(s)
- Jürgen Rehm
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer St. 46, Dresden 01187, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.,Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario M5T 1R8, Canada.,Institute of Medical Science (IMS), University of Toronto, Medical Sciences Building, 1 King's College Circle, Room 2374, Toronto, Ontario M5S 1A8, Canada.,Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th Floor, Toronto, Ontario M5T 3M7, Canada.,Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya St., 8, b. 2, Moscow 119992, Russian Federation
| | - Maria Neufeld
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Chemnitzer St. 46, Dresden 01187, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.,WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, Moscow 125009, Russian Federation
| | - Elena Yurasova
- WHO Office in the Russian Federation, Leontyevsky Pereulok 9, Moscow 125009, Russian Federation
| | - Anna Bunova
- National Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, Moscow 101990, Russian Federation
| | - Artyom Gil
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya St., 8, b. 2, Moscow 119992, Russian Federation
| | - Boris Gornyi
- National Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, Moscow 101990, Russian Federation
| | - João Breda
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, Moscow 125009, Russian Federation
| | - Evgeniy Bryun
- National Research Centre on Addictions-branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Maly Mogiltsevskiy Pereulok 3, Moscow 119034, Russian Federation
| | - Oxana Drapkina
- National Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, Moscow 101990, Russian Federation
| | - Eugenia Fadeeva
- National Research Centre on Addictions-branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Maly Mogiltsevskiy Pereulok 3, Moscow 119034, Russian Federation
| | - Anna Kalinina
- National Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, Moscow 101990, Russian Federation
| | - Daria Khaltourina
- Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Dobrolyubov Street 11, Moscow 127254, Russian Federation
| | - Tatiana Klimenko
- National Research Centre on Addictions-branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Maly Mogiltsevskiy Pereulok 3, Moscow 119034, Russian Federation
| | - Anna Kontsevaya
- National Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation, Petroverigskiy Pereulok 10, Moscow 101990, Russian Federation
| | - Evgenia Koshkina
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Lublinskay Street 37/1, Moscow 109390, Russian Federation
| | - Natalya Martynova
- Department of Public Health and Communications, Ministry of Health of the Russian Federation, Rakhmanovsky Pereulok 3, Moscow 127051, Russian Federation
| | - Alexey Nadezhdin
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Lublinskay Street 37/1, Moscow 109390, Russian Federation
| | - Kristina Soshkina
- Department of Public Health and Communications, Ministry of Health of the Russian Federation, Rakhmanovsky Pereulok 3, Moscow 127051, Russian Federation
| | - Elena Tetenova
- Moscow Research and Practical Centre for Narcology of the Department of Public Health, Lublinskay Street 37/1, Moscow 109390, Russian Federation
| | - Melita Vujnovic
- WHO Office in the Russian Federation, Leontyevsky Pereulok 9, Moscow 125009, Russian Federation
| | - Konstantin Vyshinsky
- National Research Centre on Addictions-branch, V. Serbsky National Medical Research Centre for Psychiatry and Narcology of the Ministry of Health of the Russian Federation, Maly Mogiltsevskiy Pereulok 3, Moscow 119034, Russian Federation
| | - Carina Ferreira-Borges
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, Moscow 125009, Russian Federation
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Rehm J, Rovira P, Llamosas-Falcón L, Shield KD. Dose-Response Relationships between Levels of Alcohol Use and Risks of Mortality or Disease, for All People, by Age, Sex, and Specific Risk Factors. Nutrients 2021; 13:2652. [PMID: 34444809 PMCID: PMC8401096 DOI: 10.3390/nu13082652] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 11/17/2022] Open
Abstract
Alcohol use has been causally linked to more than 200 disease and injury conditions, as defined by three-digit ICD-10 codes. The understanding of how alcohol use is related to these conditions is essential to public health and policy research. Accordingly, this study presents a narrative review of different dose-response relationships for alcohol use. Relative-risk (RR) functions were obtained from various comparative risk assessments. Two main dimensions of alcohol consumption are used to assess disease and injury risk: (1) volume of consumption, and (2) patterns of drinking, operationalized via frequency of heavy drinking occasions. Lifetime abstention was used as the reference group. Most dose-response relationships between alcohol and outcomes are monotonic, but for diabetes type 2 and ischemic diseases, there are indications of a curvilinear relationship, where light to moderate drinking is associated with lower risk compared with not drinking (i.e., RR < 1). In general, women experience a greater increase in RR per gram of alcohol consumed than men. The RR per gram of alcohol consumed was lower for people of older ages. RRs indicated that alcohol use may interact synergistically with other risk factors, in particular with socioeconomic status and other behavioural risk factors, such as smoking, obesity, or physical inactivity. The literature on the impact of genetic constitution on dose-response curves is underdeveloped, but certain genetic variants are linked to an increased RR per gram of alcohol consumed for some diseases. When developing alcohol policy measures, including low-risk drinking guidelines, dose-response relationships must be taken into consideration.
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Affiliation(s)
- Jürgen Rehm
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (L.L.-F.); (K.D.S.)
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246 Hamburg, Germany
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Room 2374, Toronto, ON M5S 1A8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, ON M5T 1R8, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, b. 2, 119991 Moscow, Russia
- Program on Substance Abuse, Public Health Agency of Catalonia, 08005 Barcelona, Spain;
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, 08005 Barcelona, Spain;
| | - Laura Llamosas-Falcón
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (L.L.-F.); (K.D.S.)
- Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28041 Madrid, Spain
| | - Kevin D. Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada; (L.L.-F.); (K.D.S.)
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 1P8, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, 33 Ursula Franklin Street, Toronto, ON M5S 3M1, Canada
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Neufeld M, Rehm J, Bunova A, Gil A, Gornyi B, Rovira, P, Manthey J, Yurasova E, Dolgova S, Idrisov B, Moskvicheva M, Nabiullina G, Shegaym O, Zhidkova I, Ziganshina Z, Ferreira-Borges C. Validation of a screening test for alcohol use, the Russian Federation. Bull World Health Organ 2021; 99:496-505. [PMID: 34248222 PMCID: PMC8243036 DOI: 10.2471/blt.20.273227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). METHODS We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. FINDINGS Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's α : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non-specific thresholds resulted in few women being identified. CONCLUSION With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies.
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Affiliation(s)
- Maria Neufeld
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Anna Bunova
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Artyom Gil
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Boris Gornyi
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Pol Rovira,
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
| | - Elena Yurasova
- World Health Organization Office in the Russian Federation, Moscow, Russian Federation
| | | | - Bulat Idrisov
- Moscow Institute of Physics and Technology, Moscow, Russian Federation
| | - Marina Moskvicheva
- Department of Public Health and Healthcare, South Ural State Medical University, Chelyabinsk, Russian Federation
| | | | - Olga Shegaym
- Center for Medical Prevention, Tomsk, Russian Federation
| | - Irina Zhidkova
- Amur Regional Center for Preventive Medicine, Blagoveshchensk, Russian Federation
| | - Zukhra Ziganshina
- Institute of Management, Economics and Finance, Kazan Federal University, Kazan, Russian Federation
| | - Carina Ferreira-Borges
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - & the 2019/2020 RUS-AUDIT Collaborators & the RUS-AUDIT Project Advisory Board
- World Health Organization European Office for Prevention and Control of Noncommunicable Diseases, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
- Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
- Institute for Clinical Psychology and Psychotherapy, Technische Universität, Dresden, Germany
- World Health Organization Office in the Russian Federation, Moscow, Russian Federation
- Vologda City Policlinic, Vologda, Russian Federation
- Moscow Institute of Physics and Technology, Moscow, Russian Federation
- Department of Public Health and Healthcare, South Ural State Medical University, Chelyabinsk, Russian Federation
- Center for Medical Prevention, Astrakhan, Russian Federation
- Center for Medical Prevention, Tomsk, Russian Federation
- Amur Regional Center for Preventive Medicine, Blagoveshchensk, Russian Federation
- Institute of Management, Economics and Finance, Kazan Federal University, Kazan, Russian Federation
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McCambridge J. Reimagining brief interventions for alcohol: towards a paradigm fit for the twenty first century? : INEBRIA Nick Heather Lecture 2019: This lecture celebrates the work of Nick Heather in leading thinking in respect of both brief interventions and wider alcohol sciences. Addict Sci Clin Pract 2021; 16:41. [PMID: 34187582 PMCID: PMC8243462 DOI: 10.1186/s13722-021-00250-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/14/2021] [Indexed: 11/22/2022] Open
Abstract
Background There is no longer support for the idea that brief intervention programmes alone can contribute meaningfully to the improvement of population health relating to alcohol. As a result, calls for major innovations and paradigm shifts grow, notably among research leaders. This paper briefly examines the history of the development of the evidence-base from the landmark World Health Organisation projects on Screening and Brief Intervention (SBI) in the 1980s onwards. Particular attention is given to weaknesses in the theorisation of social influence and interventions design, and declining effect sizes over time. Although the old SBI paradigm may be exhausted where it has been applied, it has not been replaced by a new paradigm. Alcohol marketing encourages heavy drinking and today may have more powerful effects on thinking about alcohol, and about alcohol problems, than previously. The nature of the societal challenge being faced in an alcogenic environment in which alcohol is widely promoted and weakly regulated underpins consideration of the possibilities for contemporary evidence-informed public health responses. Evidence-informed perspectives in discourses on alcohol problems need to be strengthened in redeveloping rationales for brief interventions. This process needs to move away from sole reliance on a model based on a two-person discussion of alcohol, which is divorced from wider concerns the person may have. Reimagining the nature of brief interventions involves incorporating digital content, emphasising meso-level social processes based on material that people want to share, and seeking synergies with macro-level population and media issues, including alcohol policy measures. Conclusions Current versions of brief interventions may be simply too weak to contend with the pressures of an alcogenic environment. A new generation of brief interventions could have a key role to play in developing multi-level responses to the problems caused by alcohol.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.
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45
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López G, Orchowski LM, Reddy MK, Nargiso J, Johnson JE. A review of research-supported group treatments for drug use disorders. Subst Abuse Treat Prev Policy 2021; 16:51. [PMID: 34154619 PMCID: PMC8215831 DOI: 10.1186/s13011-021-00371-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2021] [Indexed: 11/10/2022] Open
Abstract
This paper reviews methodologically rigorous studies examining group treatments for interview-diagnosed drug use disorders. A total of 50 studies reporting on the efficacy of group drug use disorder treatments for adults met inclusion criteria. Studies examining group treatment for cocaine, methamphetamine, marijuana, opioid, mixed substance, and substance use disorder with co-occurring psychiatric conditions are discussed. The current review showed that cognitive behavioral therapy (CBT) group therapy and contingency management (CM) groups appear to be more effective at reducing cocaine use than treatment as usual (TAU) groups. CM also appeared to be effective at reducing methamphetamine use relative to standard group treatment. Relapse prevention support groups, motivational interviewing, and social support groups were all effective at reducing marijuana use relative to a delayed treatment control. Group therapy or group CBT plus pharmacotherapy are more effective at decreasing opioid use than pharmacotherapy alone. An HIV harm reduction program has also been shown to be effective for reducing illicit opioid use. Effective treatments for mixed substance use disorder include group CBT, CM, and women's recovery group. Behavioral skills group, group behavioral therapy plus CM, Seeking Safety, Dialectical behavior therapy groups, and CM were more effective at decreasing substance use and psychiatric symptoms relative to TAU, but group psychoeducation and group CBT were not. Given how often group formats are utilized to treat drug use disorders, the present review underscores the need to understand the extent to which evidence-based group therapies for drug use disorders are applied in treatment settings.
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Affiliation(s)
- Gabriela López
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, 02912, USA
| | - Lindsay M Orchowski
- Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, 02904, USA.
| | - Madhavi K Reddy
- Walter Reed Army Institute of Research, Silver Spring, MD, 20910, USA
| | - Jessica Nargiso
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Jennifer E Johnson
- Division of Public Health, Michigan State University, Flint, MI, 48502, USA
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46
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Jiang H, Lange S, Tran A, Imtiaz S, Rehm J. Determining the sex-specific distributions of average daily alcohol consumption using cluster analysis: is there a separate distribution for people with alcohol dependence? Popul Health Metr 2021; 19:28. [PMID: 34098997 PMCID: PMC8186209 DOI: 10.1186/s12963-021-00261-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND It remains unclear whether alcohol use disorders (AUDs) can be characterized by specific levels of average daily alcohol consumption. The aim of the current study was to model the distributions of average daily alcohol consumption among those who consume alcohol and those with alcohol dependence, the most severe AUD, using various clustering techniques. METHODS Data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were used in the current analyses. Clustering algorithms were applied in order to group a set of data points that represent the average daily amount of alcohol consumed. Gaussian Mixture Models (GMMs) were then used to estimate the likelihood of a data point belonging to one of the mixture distributions. Individuals were assigned to the clusters which had the highest posterior probabilities from the GMMs, and their treatment utilization rate was examined for each of the clusters. RESULTS Modeling alcohol consumption via clustering techniques was feasible. The clusters identified did not point to alcohol dependence as a separate cluster characterized by a higher level of alcohol consumption. Among both females and males with alcohol dependence, daily alcohol consumption was relatively low. CONCLUSIONS Overall, we found little evidence for clusters of people with the same drinking distribution, which could be characterized as clinically relevant for people with alcohol use disorders as currently defined.
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Affiliation(s)
- Huan Jiang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada.
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada.
| | - Shannon Lange
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Alexander Tran
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Sameer Imtiaz
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), 33 Ursula Franklin Street, Toronto, Ontario, M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 6th Floor, 155 College Street, Toronto, Ontario, M5T 3M7, Canada
- Institute of Clinical Psychology and Psychotherapy & Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Chemnitzer Str. 46, D-01187, Dresden, Germany
- Campbell Family Mental Health Research Institute, CAMH, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
- Department of Psychiatry, University of Toronto, 8th Floor, 250 College Street, Toronto, Ontario, M5T 1R8, Canada
- Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Trubetskaya str., 8, b. 2, Moscow, Russian Federation, 119992
- Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
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47
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Vergés A, Lee MR, Martin CS, Trull TJ, Martens MP, Wood PK, Sher KJ. Not all symptoms of alcohol dependence are developmentally equivalent: Implications for the false-positives problem. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:444-457. [PMID: 33956473 PMCID: PMC8184633 DOI: 10.1037/adb0000723] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Recent studies have examined the extent to which alcohol dependence (AD) criteria prospectively predict the course of AD. Critically, these studies have lacked a developmental perspective. However, the differential performance of criteria by age might indicate overendorsement in younger individuals. The current study examined AD criteria in terms of persistence and prediction of AD course and alcohol use by age in order to identify criteria that are likely to be overly endorsed by younger individuals. METHOD The current study used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions to depict age differences in rates of new onset, recurrence, and persistence for each AD criterion, thereby showing how these three factors contribute to the overall age-prevalence curve of each criterion. Additionally, we tested age moderation of the predictive association between each criterion at baseline and new onset, recurrence, and persistence of syndromal AD. RESULTS Some criteria (particularly, persistent desire or unsuccessful efforts to cut down or control drinking, and drinking despite physical/psychological problems) are both less persistent and less predictive of AD course among younger adults compared to older adults. CONCLUSIONS These findings raise the possibility of elevated rates of false-positive AD among younger adults and suggest ways to improve the assessment of AD criteria. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Manthey J, Hassan SA, Carr S, Kilian C, Kuitunen-Paul S, Rehm J. Estimating the economic consequences of substance use and substance use disorders. Expert Rev Pharmacoecon Outcomes Res 2021; 21:869-876. [PMID: 33899647 DOI: 10.1080/14737167.2021.1916470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This contribution gives an overview on estimating the economic impact of substance use (SU) and substance use disorders (SUDs) from a societal perspective. AREAS COVERED In this Expert Review, we first discuss the scope of the economic costs of SU to society and the methods used to estimate them. In general, cost studies should not be limited to SUDs, but should also include costs related to the consequences of any type of SU to achieve a comprehensive picture of the societal burden. Further, estimating potentially avoidable costs will increase the value of cost studies. Importantly, methodologically sound cost studies shed light on the magnitude of societal problems related to SU and can be used as a reference point to evaluate regulatory policies and other preventive measures. The area of estimating potential economic benefits of SU is understudied and lacks a theoretical and methodological framework. EXPERT OPINION Overall, economic studies on the impact of SU and SUDs can strongly contribute to better-informed decision-making in the creation of regulatory and control policies. The least developed area of research refers to a consensus methodology that could be used in studies which compare economic costs to potential economic benefits.
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Affiliation(s)
- Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Syed Ahmed Hassan
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, Toronto, Ontario, Canada
| | - Sinclair Carr
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Carolin Kilian
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Rehm
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.,WHO Collaborating Centre for Addiction and Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
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49
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Montes KS, Pearson MR. I am what I am: A meta-analysis of the association between substance user identities and substance use-related outcomes. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:231-246. [PMID: 33829814 DOI: 10.1037/adb0000721] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity-outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association. METHOD Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations. RESULTS Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (r w = .365, p < .001, rw² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity-outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity-outcome association was observed among younger individuals. CONCLUSIONS Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity-outcome association. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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50
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Rehm J, Patra J, Brennan A, Buckley C, Greenfield TK, Kerr WC, Manthey J, Purshouse RC, Rovira P, Shuper PA, Shield KD. The role of alcohol use in the aetiology and progression of liver disease: A narrative review and a quantification. Drug Alcohol Rev 2021; 40:1377-1386. [PMID: 33783063 PMCID: PMC9389623 DOI: 10.1111/dar.13286] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/16/2020] [Accepted: 03/10/2021] [Indexed: 12/16/2022]
Abstract
Issues. Alcohol use has been shown to impact on various forms of liver disease, not restricted to alcoholic liver disease. Approach. We developed a conceptual framework based on a narrative review of the literature to identify causal associations between alcohol use and various forms of liver disease including the complex interactions of alcohol with other major risk factors. Based on this framework, we estimate the identified relations for 2017 for the USA. Key Findings. The following pathways were identified and modelled for the USA for the year 2017. Alcohol use caused 35 200 (95% uncertainty interval 32 800–37 800) incident cases of alcoholic liver cirrhosis. There were 1700 (uncertainty interval 1100–2500) acute hepatitis B and C virus (HBV and HCV) infections attributable to heavy-drinking occasions, and 14 000 (uncertainty interval 5900–19 500) chronic HBV and 1700 (uncertainty interval 700–2400) chronic HCV infections due to heavy alcohol use interfering with spontaneous clearance. Alcohol use and its interactions with other risk factors (HBV, HCV, obesity) led to 54 500 (uncertainty interval 50 900–58 400) new cases of liver cirrhosis. In addition, alcohol use caused 6600 (uncertainty interval 4200–9300) liver cancer deaths and 40 700 (uncertainty interval 36 600–44 600) liver cirrhosis deaths. Implications. Alcohol use causes a substantial number of incident cases and deaths from chronic liver disease, often in interaction with other risk factors. Conclusion. This additional disease burden is not reflected in the current alcoholic liver disease categories. Clinical work and prevention policies need to take this into consideration.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jayadeep Patra
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Charlotte Buckley
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | | | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, USA
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Center of Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Robin C Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Paul A Shuper
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Kevin D Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
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