Contribution of time of drinking onset and family history of alcohol problems in alcohol and drug use behaviors in Argentinean college students

Age at onset of alcohol consumption and its association with alcohol misuse in adulthood

OBJECTIVE

This study aimed to explore the association between early age onset of alcohol consumption and alcohol misuse in adulthood.

METHODS

The study sample consisted of 16 829 individuals' (8349 males, 8435 females) survey responses obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 through 2019. Alcohol dependence was measured using the AUDIT-C (Alcohol Use Disorder Identification Test-Consumption), and the ages at which alcohol consumption began were grouped into four categories: under 16, 16 to 18, 19 to 23, and over 24. Multiple logistic regression was used to examine the association between current alcohol misuse and age at onset of alcohol consumption.

RESULTS

Compared to individuals who started drinking alcohol after the age of 24, those who began drinking alcohol before the age of 16 were more likely to score 8 or more on AUDIT-C questions (under 16: males, odds ratio [OR] 2.50, confidence interval [CI] 1.97-3.17; females, OR: 1.66, CI: 1.18-2.33). Similar to the main analysis, the earlier the onset of alcohol assumption starts, the more likely one is to develop alcohol misuse in adulthood according to subgroup analysis stratified by independent variables in both gender.

CONCLUSION

The lower the age at the onset of alcohol consumption, the higher the likelihood of alcohol misuse in adulthood. While both males and females showed the same trend in response to the AUDIT-C questions, males tended to have a stronger association between early onset alcohol consumption and alcohol misuse.

Initiation of and Escalation to High-Intensity Drinking in Young Adults

Importance

High-intensity drinking (HID) (≥10 drinks in a row) is associated with acute negative outcomes. Identifying factors associated with HID initiation in adolescence and how it is associated with young adulthood outcomes can inform screening and prevention.

Objective

To identify when individuals initiate HID and speed of escalation from first drink and first binge to first HID; characteristics associated with initiation and escalation; and whether these characteristics are associated with weekly alcohol consumption, HID frequency, and symptoms of alcohol use disorder at age 20 years.

Design, Setting, and Participants

This cohort study analyzed web-based survey data from respondents in the US who reported alcohol use in the past 30 days recruited from the 2018 12th grade Monitoring the Future study and surveyed again from February 14 through April 17, 2020, at modal age 20 years in the Young Adult Daily Life Study. Only respondents who reported HID by modal age 20 years were included in the analyses.

Exposures

Retrospective alcohol use initiation and self-reported alcohol use measures.

Main Outcomes and Measures

Key retrospective measures included year of initiation for alcohol, first binge (≥5 drinks), and HID (≥10 drinks). Measures at age 20 years included weekly alcohol consumption, HID frequency, and Alcohol Use Disorders Identification Test (AUDIT) scores. Covariates included biologic sex, race and ethnicity, parental college education, family history of alcohol problems, and college status. Descriptive statistics and multivariable regression models were used, and all analyses were weighted.

Results

Of the 451 participants with data eligible for analysis, 62.0% were male (38.0% female). On average, alcohol, binge, and HID were initiated during high school. Mean time of escalation from first drink to first HID was 1.9 (95% CI, 1.8-2.1) years and between first binge and first HID, 0.7 (95% CI, 0.6-0.8) years. Initiating HID by grade 11 (vs later) was associated with higher average weekly alcohol consumption (adjusted incidence rate ratio [aIRR], 1.40; 95% CI, 1.10-1.79]), HID frequency (aIRR, 2.01; 95% CI, 1.25-3.22]), and AUDIT score (adjusted odds ratio, 1.17; 95% CI, 1.02-1.34]) at age 20 years. Escalation from first binge to first HID in the same year (vs ≥1 year) was associated with higher HID frequency at age 20 years (aIRR, 1.66; 95% CI, 1.06-2.61).

Conclusions and Relevance

These findings suggest that understanding ages and patterns of HID initiation and escalation associated with particular risk may facilitate screening for adolescents and young adults.

Disentangling the physical, social, and situational contexts of young adolescents' initiation to alcohol use and intoxication: A mixed methods study

BACKGROUND

The onset of alcohol use during adolescence is associated with concurrent and subsequent related problems. Research on drinking contexts that underly these key first-time experiences and how they differ by initiation type is needed. The current study examined the physical, social, and situational characteristics of three types of initiation: first drink, first heavy episodic drinking (HED), and first intoxication and considered variations between early and later initiating adolescents.

METHODS

A mixed-methods approach was used to survey and interview adolescents who reported lifetime drinking. Survey responses from 471 participants were analyzed using multilevel multinomial and logistic regressions accounting for nesting of drinking events (i.e., type of initiation) within respondents. A subsample of 50 participants recruited at baseline took part in-depth interviews that were thematically coded.

RESULTS

After controlling for demographics, initiation of HED and intoxication, compared to initiation of a whole drink, were more likely to occur when more close friends are present and when those close friends are also drinking. The likelihood of early initiation of a whole drink and intoxication was also positively associated with being in an outdoor setting. Narratives identified distinct and shared patterns of context characteristics across the types of alcohol initiation.

CONCLUSION

The quantitative and qualitative findings revealed several parallels as well as aspects that differ, enriching our understanding of early drinking contexts. Results highlight the importance of considering contextual characteristics by initiation type for prevention efforts.

Magnitude of Substance Use and Its Associated Factors Among the Medical Students in India and Implications for Medical Education: A Narrative Review

BACKGROUND

Medical students are at an increased risk of developing substance use and related problems (SURP) because of the inherent stress associated with the professional medical course apart from the developmental risk factors. However, this is under-researched. Moreover, a comprehensive review on the prevalence of SURP among the medical undergraduates (UGs) and associated factors is lacking from India. To fill this gap, the current research work is aimed to review the existing literature on the magnitude of the SURP among UGs of India and its determinants.

METHODS

PubMed, Medline, and Google Scholar databases were searched for the original articles studying the prevalence of SURP among medical UGs of India, published from inception till date. Non-original articles, studies on behavioral addictions, and those not directly assessing the prevalence of SURP among the medical UGs were excluded.

RESULTS

A total of 39 studies were found eligible for the review. Alcohol (current use: 3.2%-43.8%), followed by tobacco (3.7%-28.8%) and cannabis (1.6%-15%), were the common substances used by the medical students. Among the females, an increasing trend of substance use, particularly of nonprescription sedatives (even higher than males), alcohol, and smoking, was seen. Family history, peer pressure, transition from school to college life, and progression in the medical course were important associated factors.

CONCLUSION

Sensitizing medical students and college authorities, increasing the duration of training on SURP in medical curricula, and providing psychological support for the students with SURP could address this issue.

"I feel good when I drink"-detecting childhood-onset alcohol abuse and dependence in a Ugandan community trial cohort

BACKGROUND

Alcohol, substance use, and mental health disorders constitute major public health issues worldwide, including in low income and lower middle-income countries, and early initiation of use is an important predictor for developing substance use disorders in later life. This study reports on the existence of childhood alcohol abuse and dependence in a sub-study of a trial cohort in Eastern Uganda.

METHODS

The project SeeTheChild-Mental Child Health in Uganda (STC) included a sub-study of the Ugandan site of the study PROMISE SB: Saving Brains in Uganda and Burkina Faso. PROMISE SB was a follow-up study of a trial birth cohort (PROMISE EBF) that estimated the effect that peer counselling for exclusive breast-feeding had on the children's cognitive functioning and mental health once they reached 5-8 years of age. The STC sub-study (N = 148) used the diagnostic tool MINI-KID to assess mental health conditions in children who scored medium and high (≥ 14) on the Strengths and Difficulties Questionnaire (SDQ) in the PROMISE SB cohort N = (119/148; 80.4%). Another 29/148 (19.6%) were recruited from the PROMISE SB cohort as a comparator with low SDQ scores (< 14). Additionally, the open-ended questions in the diagnostic history were analysed. The MINI-KID comprised diagnostic questions on alcohol abuse and dependence, and descriptive data from the sub-study are presented in this paper.

RESULTS

A total of 11/148 (7.4%) children scored positive for alcohol abuse and dependence in this study, 10 of whom had high SDQ scores (≥ 14). The 10 children with SDQ-scores ≥ 14 had a variety of mental health comorbidities of which suicidality 3/10 (30.0%) and separation anxiety disorder 5/10 (50.0%) were the most common. The one child with an SDQ score below 14 did not have any comorbidities. Access to homemade brew, carer's knowledge of the drinking, and difficult household circumstances were issues expressed in the children's diagnostic histories.

CONCLUSIONS

The discovery of alcohol abuse and dependence among 5-8 year olds in clinical interviews from a community based trial cohort was unexpected, and we recommend continued research and increased awareness of these conditions in this age group.Trial registration Trial registration for PROMISE SB: Saving Brains in Uganda and Burkina Faso: Clinicaltrials.gov (NCT01882335), 20 June 2013. Regrettably, there was a 1 month delay in the registration compared to the commenced re-inclusion in the follow-up study: https://clinicaltrials.gov/ct2/show/NCT01882335?term=saving+brains&draw=2&rank=1.

Does Drinking Initiation of Young Thai Drinkers Vary Over Time and Generation? Results of the National Surveys on Tobacco and Alcohol Consumption of the Thai Populations 2007 to 2017

BACKGROUND

Early age at drinking initiation may be one factor responsible for underage drinking in Thailand and this may be affected by cultural and generational changes over certain periods of time. This study aimed to explore the effects of time period and generation on drinking onset of young Thai drinkers in the past decade.

METHODS

We analyzed data from a total of 60,018 Thais aged 15 to 24 years from 4 national surveys conducted in 2007, 2011, 2014, and 2017. We used multilevel and event history analysis to examine the effects of period (survey year) and cohort (birth year of participants), adjusted for sex, age, area of residence, and region on drinking onset.

RESULTS

The overall prevalence of past-year drinking was 23.6 % (95% confidence interval [CI]: 23.2, 23.9) among participants of all surveys. Cox proportional hazards model revealed significantly different probabilities to have initiated drinking between participants of different surveys and birth years, indicating significant period and cohort effects. After adjusting for sex, age, cohort, living region, and area of residence, participants in the 2014 survey had the highest likelihood to have started drinking (hazard ratio [HR]: 1.25 CI: 1.15 to 1.36), compared to the participants of the same age in the 2007 survey while those in the 2011 (HR: 0.89, CI: 0.85, 0.93) and 2017 (HR: 0.63, CI: 0.58, 0.68) surveys had less likelihood. Participants born in 1993 to 2002 (later cohort) had higher probability to have started drinking than those born in 1983 to 1992 (HR: 1.80, CI: 1.69, 1.92).

CONCLUSION

Thai youths of the recent generations living in recent years tend to have a higher probability of initiating drinking than those in the past. Interventions to prevent underage drinking should begin earlier for the young generation.

Selective alterations in endogenous opioid system genes expression in rats selected for high ethanol intake during adolescence

Historically, the roots of alcoholism have been linked to either environment or heredity. However, the interaction between these factors is still largely unexplored. The evidence supports a link between alcohol consumption and the endogenous opioid system. We here studied the opioid genes expression in male and female Wistar rats derived from a short-term breeding program which selected -- at adolescence -- for high (ADHI line) or low (ADLO line) ethanol drinking. Specifically, in this work we analyzed central opioid gene expression in the rats of the second filial generation (S₂-ADLO and S₂-ADHI). Selective downregulation of pronociceptin (Pnoc) and its receptor (Oprl1) mRNA levels were observed in the prefrontal cortex of male S₂-ADHI rats when compared to S₂-ADLO, and for Oprl1 also in the nucleus accumbens. An increase in gene expression was instead observed for pro-opiomelanocortin (Pomc) in the nucleus accumbens of S₂-ADHI males when compared to S₂-ADLO, as well as for mu opioid receptor (Oprm1) but in females. The differences in mRNA levels may be due to the different alcohol consumption between the two groups of rats or may represent pre-existing differences between them. Moreover, we show a sex-specific modulation of the expression of these genes, thus pointing out the importance of sex on ethanol responses. The results might lead to more specific and effective pharmacological treatments for alcoholism.

ELSA 2014 Cohort: Risk Factors Associated With Heavy Episodic Drinking Trajectories in Argentinean College Students

Heavy episodic drinking (HED) is highly prevalent in college students. In Argentina, there is a notable lack of longitudinal studies examining drinking trajectories. The present study identified HED trajectories in Argentinean college students during the first 3 years of college (seven waves) and examined the association between risk factors for alcohol use and HED trajectories. The sample was composed of 1,240 college students [63.1% women, aged 18–25 years (M = 19.1 ± 1.7)] who completed at least three waves (the first data collection and ≥2 follow-ups). For 3 years, participants completed seven surveys that measured HED frequency, age of drinking onset, drunkenness occurrence, trait impulsivity, family history of alcohol abuse, stressful life events, and perceived peer’s drinking. Latent Class Growth Analysis (LCGA) and Multinomial Logistic Regression (MLR) were used to identify the pattern and number of HED trajectories and to explore which risk factors better distinguished between the trajectories, respectively. Six HED trajectories were identified: Heavy Stable Frequency, Moderate Stable Frequency, Moderate Decreasing Frequency, Stable Infrequent, Decreasing Infrequent, and No-HED. Younger age of drinking onset, alcohol intoxication, greater perception of peer drinking frequency and higher levels of impulsivity (i.e., sensation seeking, lack of premeditation, and positive urgency) increased the probability of belonging to the trajectories with more frequent HED. These trajectories partially coincide with those identified in studies from other cultures. Unlike previous studies, we did not find a trajectory with increasing/ascending HED frequency. This may be related to contextual/cultural variables unique to Argentina, like differences in the age when the peak in alcohol consumption is reached or the legal minimum age to buy alcoholic beverages in this country, and the idiosyncratic elements that characterize college life in Argentina. This work represents a step forward in the identification of risk factors differentiating between different HED trajectories, and help understand changes in alcohol use during college, in an understudied population.

Illicit drug use among students of a university in Southern Brazil

OBJECTIVE

To describe drug consumption and the co-occurrence use of more than one illegal drug as well as associated factors in freshmen at a public university in Southern Brazil.

METHODS

Cross-sectional study with census of students entering undergraduate courses in 2017. A total of 1,788 university students answered questions about illicit drug use. For analysis, ordinal logistic regression was used.

RESULTS

Marijuana was the most consumed drug (lifetime: 42.1%; 30-day use: 22.7%), followed by hallucinogens (lifetime: 13.1%, 30-day use: 2.8%). Rates for lifetime use of 0, 1 and 2 or more drugs were 56.2%, 23.3% and 20.4%, respectively, and were associated with men (OR = 2.2; 95%CI:1.4–3.5), being at least 23 years old (OR = 2.7; 95%CI: 1.4–5.1), under 18 years old first experimentation with drugs (OR = 2.3; 95%CI: 1.3–3.9) and living with friends (OR = 2.0; 95%CI: 1.2–3.4). Rates for 30-day use of 0, 1 and 2 or more drugs were 76.8%; 18.1% and 5.1%, respectively, and were associated with being single, separated or widowed (OR = 3.2; 95%CI: 1.4–7.0), lower socioeconomic classes (OR = 0.3; 95%CI: 0.1–1.1; p = 0.001), under 18 years old first experimentation with drugs (OR = 1.8; 95%CI: 1.1–2.9) and living with friends (OR = 1.8 95%CI: 1.2–2.8).

CONCLUSION

Results indicate that students are at greater risk of illicit drug-related health problems. Thus, a better understanding of this consumption should be pursued, as well as the development of a prevention plan.

Individual and Environmental Factors Associated with Tobacco Smoking, Alcohol Abuse and Illegal Drug Consumption in University Students: A Mediating Analysis

Substance abuse is a major and prevalent public health concern among university students. Tobacco smoking, risky alcohol behavior, and illegal drug consumption may lead to health problems and behavioral and academic issues. Several individual and environmental factors associate with substance abuse in this population, and the mediating effect of alcohol abuse in the relationship between tobacco smoking and drug consumption is yet to be explored. The purposes of this study were to evaluate the association of individual and environmental factors and substance use, and to analyze the relationship between tobacco smoking, alcohol abuse, and drug consumption, considering alcohol abuse as a possible mediator. A total of 550 Spanish undergraduate and postgraduate students completed several questionnaires regarding their smoking status, alcohol use, and drug consumption during the last six months. Bivariate and multivariate analyses were conducted to explore associations between factors. Direct, indirect and mediating effects were tested using a partial least squares approach (PLS-SEM). The results indicated that substance abuse is associated with being male, living with other students, and combined substance consumption. PLS-SEM showed a significant effect of tobacco smoking and alcohol abuse on drug consumption. Alcohol abuse plays a mediating role in the relationship between tobacco smoking and drug use.

Consequences of alcohol use, and its association with psychological distress, sensitivity to emotional contagion and age of onset of alcohol use, in Uruguayan youth with or without college degree

Psychological distress can promote alcohol consumption during emerging adulthood. Still unknown is, however, how predisposition to emotional contagion alters psychological distress, and how these phenomena are affected by level of education. The present study analyzed the effect of psychological distress, age of first contact with alcohol (early, late), and predisposition to emotional contagion on alcohol-induced negative consequences and on the volume of alcohol consumed during the last year. We also described alcohol-use behaviors as a function of sex, maximum level of education and age of first contact with alcohol, in 1505 youth from Uruguay (18-30 years). A survey measured alcohol use (Alcohol Use Disorders Identification Test and ad-hoc questionnaire), negative consequences of alcohol use [young adult alcohol consequences questionnaire (YAACQ)], psychological distress (Kessler scale) and proclivity to emotional contagion (Doherty Emotional contagion scale). The patterns of alcohol use were greater in men vs. women and in those featuring an early age of first alcohol use, yet similar in college and non-college graduates. Early drinkers had greater levels of psychological distress than late-onset drinkers. There was a significant bivariate and multiple correlation between psychological distress and the number of negative consequences of alcohol experienced during the last year, which remained significant even after controlling for total volume of alcohol consumed. Significant associations emerged between YAACQ scores and frequency of heavy episodic or binge drinking, and between psychological distress and emotional contagion, but not between emotional contagion and any of the remaining variables. Psychological distress was not significantly correlated with heavy episodic or binge drinking. The study indicates that, during adolescence and youth, psychological distress is associated with experiencing negative consequences of alcohol consumption. The study also suggested that greater levels of psychological distress may underlie the facilitating effect of an early age of drinking onset upon alcohol drinking patterns.

Binge Drinking, Cannabis Co-Consumption and Academic Achievement in First Year University Students in Spain: Academic Adjustment as a Mediator

Little is known about how binge drinking or the combination of binge drinking and cannabis consumption affect academic achievement in students during the transition to university, or about the mechanisms that mediate this relationship. The purpose of this study was to evaluate the association between this pattern of alcohol/cannabis consumption and academic achievement, considering academic adjustment as a possible mediator. A total of 258 Spanish, first-year university students (145 females and 113 males), enrolled in undergraduate degree courses, were categorized into three groups on the basis of their patterns of alcohol/cannabis consumption: control, binge drinkers and co-consumers. The findings showed a significant effect of the combined binge drinking/cannabis consumption, but not of binge drinking alone, upon academic achievement and academic adjustment. Grade point average (GPA) and academic adjustment were lower in the co-consumers than in the other groups. Regarding the mediation effect, 34.33% of the impact of combined alcohol/cannabis use on GPA was mediated by academic adjustment. The combined consumption of alcohol and cannabis led to difficulties in adaptation to academic life, which in turn contributed to poorer performance at university. The implications of the findings are discussed.

An examination of the association between early initiation of substance use and interrelated multilevel risk and protective factors among adolescents

One of the major goals of drug use prevention programs is to delay the age of onset of substance use. What is called early initiation, usually occurring in adolescents under the age of 15, is a salient predictor of Substance Use Disorders later in adulthood. The causes of early initiation are complex and multifaceted and this has led to the identification of a rich set of risk and protective factors that influence age of onset. Nonetheless, there is little knowledge about the interdependence of these factors in their impact on early initiation. This paper addresses this question by applying Multiple Correspondence Analysis to data on family, community and social risk and protective factors from over 1200 adolescents. We find that community and to a lesser extent social factors are the most clearly associated to early initiation and we compare our results to those obtained from linear regression analyses of the same data that do not incorporate interdependence and find opposite results. We discuss the differences between linear regressions and MCA to evaluate the interplay of risk and protective factors and the implications of our findings for health policy and the design of prevention interventions aimed at delaying age of onset.

ELSA cohort 2014: association of age of first drink and progression from first drink to drunkenness on alcohol outcomes in Argentinean college freshmen

Background: College freshman are at-risk for hazardous alcohol drinking and for experiencing alcohol-related negative consequences. This is exacerbated in those featuring an early age of first alcohol use or of first drunkenness. It remains unclear which of these milestones is more strongly associated with alcohol outcomes. Objective: We examined, in Argentinean college drinkers (n = 4088; 43% men; racially and ethnically homogeneous), the association of age at drinking onset and progression to drunkenness (drunkenness naïve [Drunk-Naïve]; No-Delay [same age of first alcohol use and first alcohol intoxication]; one year of delay between age of first alcohol use and first alcohol intoxication; ≥2years of delay) on several alcohol outcomes. Methods: A survey measured substance use, age at drinking and drunkenness onset and alcohol-related consequences. Results: Alcohol consumption per drinking occasion was significantly greater in men than in women. An early drinking onset (alcohol use before age 13) and lifetime drunkenness independently exacerbated alcohol consumption per drinking occasion and during the last year. In men, Early-Onset was associated with a greater number of alcohol-related consequences when the delay between Early-Onset and the first drunkenness episode was 1 or ≥2 years yet did not significantly alter the number of negative consequences in Drunk-naïve or No-delay drinkers. In women, Early-Onset significantly enhanced the number of negative consequences when the delay was two years, but not when the delay was one-year or in Drunk-naïve or No-delay drinkers. Conclusions: The window between the first contact with alcohol and the first episode of drunkenness is a critical period to reduce alcohol-related problems.

Restraint stress exacerbates cell degeneration induced by acute binge ethanol in the adolescent, but not in the adult or middle-aged, brain

Restraint stress (RS) induces neurotoxicity in the hippocampus, yet most of the studies have employed protracted RS (i.e., ≈ 21 days). Binge ethanol can induce brain toxicity, an effect affected by age. It could be postulated that RS may facilitate ethanol-induced neurotoxicity, perhaps to a greater extent in adolescent vs. older subjects. We analyzed whether adolescent, adult or middle-aged male rats exposed to five episodes of RS followed, 72h later, by binge ethanol (i.e., two administrations of 2.5 g/kg ethanol) exhibited hippocampal neurotoxicity. Adolescents, but not adult or middle-aged rats, exhibited sensitivity to the neurotoxic effects of ethanol at dorsal CA2, ventral CA3 and ventral DG, and a neurotoxic effect of stress at dorsal CA1. Moreover, the combination of ethanol and stress exerted a synergistic effect upon cell degeneration at ventral CA1 and CA2, which was restricted to adolescents. Ethanol also increased cell degeneration, irrespective of age or stress, in dorsal CA3 and in dorsal DG; and ethanol and stress had, across all ages, a synergistic effect upon cell degeneration at the dorsal CA1. The greater neurotoxic response of adolescents to ethanol, stress, or ethanol+stress can put them at risk for the development of alcohol problems.

Development and psychometric evaluation of a new measure to assess pregaming motives in Spanish-speaking young adults

AIMS

The present study was divided into two different stages that sought to develop (Stage 1) and validate (Stage 2) the Argentinean-version of the Pregaming Motives Questionnaire (PMQ-Arg), a new, ecologically valid measure to assess pregaming (i.e., the consumption of alcohol prior to attending a social/sporting event where alcohol may or may not be available) motives among Spanish-speaking youth.

METHOD

Two separate samples of Argentinian young adults (all last-year pregamers) were recruited by disseminating an invitation through online social networks and e-mail listings.

RESULTS

In Stage 1, a total of 635 participants answered an open-ended question about their reasons for pregaming. In Stage 2 (n=361), exploratory factor analysis was conducted with the preliminary set of high-quality, high-frequency pregaming motives that were obtained in Stage 1, yielding a final 23-item measure that was grouped in four factors: (i) Intoxication and Fun, (ii) Gathering and Social Enhancement, (iii) Going with the Flow, and (iv) Beverage Preference. Despite some broad similarities with measures that were developed with U.S. young adults, the present results indicated that the narrow content of some items of the PMQ-Arg were somewhat unique, possibly reflecting cultural differences between the United States and Argentina. The findings supported the adequate reliability, discriminant validity, convergent validity, and criterion-related validity of PMQ-Arg scores.

CONCLUSIONS

The findings suggest that the PMQ-Arg meets the psychometric requirements of validity and reliability for its use to assess reasons for pregaming among Spanish-speaking youth.

Amphetamine, but not methylphenidate, increases ethanol intake in adolescent male, but not in female, rats

INTRODUCTION

There has been an increasing interest in analyzing the interactions between stimulants and ethanol during childhood and adolescence. Stimulants are used to treat attention-deficit hyperactivity disorder (ADHD) in these developmental stages, during which ethanol initiation and escalation often occur.

METHODS

This study assessed the effects of repeated d-amphetamine (AMPH) or methylphenidate (MPH) treatment during adolescence [male and female Wistar rats, between postnatal day (PD) 28 to PD34, approximately] on the initiation of ethanol intake during a later section of adolescence (PD35 to PD40).

RESULTS

Amphetamine and MPH exerted reliable acute motor stimulant effects, but there was no indication of sensitized motor or anxiety responses. MPH did not affect dopamine (DA) levels, whereas AMPH significantly reduced insular levels of DA in both sexes and norepinephrine levels in females only. Repeated treatment with AMPH, but not with MPH, enhanced ethanol intake during late adolescence in male, but not in female, rats.

CONCLUSION

A short treatment with AMPH during adolescence significantly altered DA levels in the insula, both in male and females, and significantly enhanced ethanol intake in males. The present results suggest that, in adolescent males, a very brief history of AMPH exposure can facilitate the initiation of ethanol intake.

Age at drinking onset, age at first intoxication, and delay to first intoxication: Assessing the concurrent validity of measures of drinking initiation with alcohol use and related problems

INTRODUCTION

Drinking at an early age (AO) and quickly progressing to drinking to intoxication (Delay=Age of Intoxication[AI]-AO) confer risk for alcohol use and alcohol-related problems. However, inconsistencies exist in the literature, which may reflect the use of different definitions of AO and AI. We evaluated whether 1) defining AO as age at first sip of alcohol (AO sip) versus age at which at least one standard drink was consumed (AO drink); and 2) defining AI as age at first "drunk" (AI drunk) versus age at first binge episode (≥5 standard drinks consumed; AI binge) resulted in different self-reported ages or differentially predicted drinking outcomes.

METHODS

248 high school students (53.6% male; 16.50[1.19] years; 71.4% White) completed anonymous surveys assessing alcohol use.

RESULTS

Participants reported a younger AO (sip) than AO (drink) and a younger AI (drunk) than AI (binge), resulting in significantly different Delay values for the four AO-AI pairings. Univariate general linear models indicated that AO-Delay pairings accounted for more variance in maximum drinks and alcohol-related problems than did the individual AO and AI variables. Pairings comprising AO (drink) and Delay (drink-binge) and AO (sip) and Delay (sip-binge), respectively, uniquely accounted for variance in both maximum drinks and problems.

CONCLUSIONS

Clearly defining AO and AI using objective definitions that reflect specific amounts of alcohol (e.g., first sip; first standard drink; first binge) appears to outperform subjective definitions of alcohol use (e.g., first drunk).

Ethanol-induced autonomic responses and risk taking increase in young adults with a positive family history of alcohol problems

The mechanisms that underlie the greater prevalence of alcohol use disorders in individuals with a positive family history (FH+) of alcohol abuse are still under investigation. These subjects may exhibit differential sensitivity to alcohol's effects on psychomotor stimulation and impulsivity. Alcohol-induced psychomotor stimulation, measured as the heart rate (HR) response, is a proxy for the positive rewarding effects of the drug. We analyzed alcohol-induced effects on time perception (Time Production Task), risk taking (Balloon Analogue Risk Task [BART]), and HR in FH+ and FH- participants. In the FH+ and FH- groups, women and men received 0.6 and 0.7g/kg alcohol, respectively. The alcohol dose yielded a breath alcohol concentration of 0.08% throughout the experiment. The control groups received placebo, and the subjective perception of alcohol intoxication was assessed. Alcohol intoxication significantly increased HR and the adjusted average number of pumps on the BART (a measure of risk taking) in FH+ men and women but not in FH- participants. Behavioral impulsivity was unaffected by alcohol or a FH of alcohol abuse. FH- but not FH+ participants who received alcohol reported significantly greater subjective perception of alcohol's effects than their placebo counterparts. These results indicate that FH+ individuals presented heightened sensitivity to alcohol-induced HR stimulation and alcohol-induced risk taking compared with their FH- counterparts. FH+ subjects, however, were insensitive to the subjective effects of alcohol. This idiosyncratic response pattern may be a likely pathway by which a FH of alcohol problems promotes alcohol drinking.

Short-term selection for high and low ethanol intake yields differential sensitivity to ethanol's motivational effects and anxiety-like responses in adolescent Wistar rats

Alcohol use disorders are modulated by genetic factors, but the identification of specific genes and their concomitant biological changes that are associated with a higher risk for these disorders has proven difficult. Alterations in the sensitivity to the motivational effects of ethanol may be one way by which genes modulate the initiation and escalation of ethanol intake. Rats and mice have been selectively bred for high and low ethanol consumption during adulthood. However, selective breeding programs for ethanol intake have not focused on adolescence. This phase of development is associated with the initiation and escalation of ethanol intake and characterized by an increase in the sensitivity to ethanol's appetitive effects and a decrease in the sensitivity to ethanol's aversive effects compared with adulthood. The present study performed short-term behavioral selection to select rat lines that diverge in the expression of ethanol drinking during adolescence. A progenitor nucleus of Wistar rats (F₀) and filial generation 1 (F₁), F₂, and F₃ adolescent rats were derived from parents that were selected for high (STDRHI) and low (STDRLO) ethanol consumption during adolescence and were tested for ethanol intake and responsivity to ethanol's motivational effects. STDRHI rats exhibited significantly greater ethanol intake and preference than STDRLO rats. Compared with STDRLO rats, STDRHI F₂ and F₃ rats exhibited a blunted response to ethanol in the conditioned taste aversion test. F₂ and F₃ STDRHI rats but not STDRLO rats exhibited ethanol-induced motor stimulation. STDRHI rats exhibited avoidance of the white compartment of the light-dark box, a reduction of locomotion, and a reduction of saccharin consumption, suggesting an anxiety-prone phenotype. The results suggest that the genetic risk for enhanced ethanol intake during adolescence is associated with lower sensitivity to the aversive effects of ethanol, heightened reactivity to ethanol's stimulating effects, and enhanced innate anxiety.

ELSA 2016 Cohort: Alcohol, Tobacco, and Marijuana Use and Their Association with Age of Drug Use Onset, Risk Perception, and Social Norms in Argentinean College Freshmen

The transition from high school to college is a high-risk stage for the initiation and escalation of substance use. Substance use and its associated risk factors have been thoroughly described in developed countries, such as the United States, but largely neglected in Argentina, a South American country with patterns of a collectivist culture. The present cross-sectional study describes the occurrence of alcohol, tobacco, and marijuana use and the association between these behaviors and the age of onset of substance use and cognitive (i.e., risk perception) and social (i.e., prescriptive) variables in a large sample of Argentinean college freshmen (n = 4083, 40.1% men; mean age = 19.39 ± 2.18 years). The response rate across courses was ≥90% and was similarly distributed across sex. Participants completed a survey that measured substance use (alcohol [with a focus on heavy drinking and binge drinking behaviors], tobacco, and marijuana), age of onset of the use of each substance, perceived risk associated with various substance use behaviors, prescriptive norms associated with substance use, and descriptive norms for alcohol use (AU). The results indicated that AU is nearly normative (90.4 and 80.3% with last year and last month use, respectively) in this population, and heavy drinking is highly prevalent (68.6 and 54.9% with heavy episodic and binge drinking, respectively), especially among those with an early drinking onset (97.8 and 93.6% with last year and last month use and 87.8 and 76.3% with heavy episodic and binge drinking, respectively). The last-year occurrence of tobacco and marijuana use was 36 and 28%, respectively. Early substance use was associated with the greater use of that specific substance. The students overestimated their same-sex friend's AU, and women overestimated the level of AU of their best male friend. At the multivariate level, all of the predictors, with the exception of the parents' prescriptive norms, significantly explained the frequency of marijuana and tobacco use and frequency of hazardous drinking. Overall, despite important cultural and contextual differences between Argentina and the United States, our findings suggest that certain vulnerability factors have a similar influence across these cultural contexts.

Effects of environmental enrichment upon ethanol-induced conditioned place preference and pre-frontal BDNF levels in adolescent and adult mice

Environmental enrichment (EE) provides a non-pharmacological tool to alter drug-induced reward, yet its effects on ethanol-induced reward remain controversial. We analyzed adolescent vs. adult (mice) differences in the influence of EE on ethanol-induced conditioned place preference (CPP). The effects of these treatments on brain-derived neurotrophic factor (BDNF) levels in the prefrontal cortex were examined in a separate group of animals. Ethanol-induced CPP was found in adults, and it was similar in EE and in animals reared under standard housing conditions (SC). Adolescents kept under EE, but not those in SC, exhibited CPP. Among SC, but not among EE, adolescents, BDNF levels were significantly lower in those treated with ethanol than in those given vehicle. These results indicate that, compared to adults, adolescent exhibited reduced sensitivity to ethanol’s rewarding effects, yet the youth but not the adults exhibited sensitivity to the promoting effect of EE upon CPP by ethanol. Ethanol significantly reduced BDNF levels in adolescents reared under standard housing conditions, but not in adult mice nor in adolescents given EE housing conditions. The present results add to the plethora of adolescent-specific responses to ethanol or to environmental stimuli that may put the youth at risk for escalation of ethanol intake.

Revision of AUDIT Consumption Items to Improve the Screening of Youth Binge Drinking

This study analyzes the appropriateness of an improved version of one of the most frequently used instruments for the screening of high-risk alcohol consumption. This adaptation was created in accordance with certain limitations recognized by other researchers and in an attempt to adjust the content and scales of some items to a more consensual definition of binge drinking. After revising items 2 and 3, the areas under the ROC curves of the AUDIT and of different abbreviated versions were calculated. A total of 906 minors (468 females) between the ages of 15 and 17 were evaluated. Stratified sampling was conducted on a population of high school students in the city of Valencia (Spain). One school was randomly chosen from each of the city’s 16 school districts. Information was collected on sociodemographic aspects, consumption patterns and the AUDIT containing the improved items. The percentage of underage BD reached 36%, regardless of gender or age. BD groups have been differentiated by different intensity levels, both in males and females. Upon comparing the effectiveness of the distinct versions of the AUDIT, it is recommended that researchers and clinics use the combination of the revised items 2 and 3 to ensure a more precise identification of underage BD. A cut-off point of 5 for this test would permit identification of 94% of the underage BD and would notably reduce false positives.

Edad de inicio en el consumo, motivos y cantidad de alcohol en la determinación de consecuencias en consumidores intensivos universitarios

Las implicaciones clínicas y sociales derivadas del consumo intensivo de alcohol (CIA) en universitarios motivan la necesidad de analizar los factores que favorecen su aparición. Este estudio evalúa cómo influye la cantidad de alcohol ingerido, la edad de inicio en el consumo de esta sustancia y los motivos asociados a esta conducta en la presencia de un mayor o menor número de consecuencias psicosociales. 312 estudiantes de primero de la Universidad de Valencia que realizan CIA cumplimentaron el instrumento IECI (Cortés et al., 2012): autoregistro de consumo, motivos asociados a esta ingesta y consecuencias psicosociales derivadas. Se confirman resultados de investigaciones precedentes. Ambos sexos duplican los gramos de alcohol que definen un CIA. Aparecen diferencias en los efectos esperados en función del sexo, así como en la edad de inicio en el consumo y en el número de consecuencias experimentadas. Los análisis de regresión de orden jerárquico muestran la importancia de la edad de inicio y los motivos, por encima de los gramos consumidos, para dar cuenta del deterioro psicosocial generado por la ingesta. Esto apoya la necesidad de atender a la combinación de variables en la explicación y posterior intervención para paliar las consecuencias derivadas del CIA.

Is 'age at first drink' a useful concept in alcohol research and prevention? We doubt that

AIM

To address and discuss the weaknesses of age at first drink (AFD) as a concept in alcohol research and prevention.

METHODS

Narrative literature review.

RESULTS

Varying from one sip to the consumption of several full drinks, and sometimes including the specification of particular conditions (e.g. without parental consent), no exact definition and operationalization of AFD was found. Evidence reveals poor test-retest reliability when the same individuals report their AFD two or more times. Theoretical arguments and empirical evidence fail to explain why having one sip or one drink earlier than peers should cause heavier drinking and related problems later in life. Alternative explanations such as self-selection, third variable effects and systematic report bias are not considered in most studies. These shortcomings also make AFD unsuitable as an indicator or marker of underlying problems such as conduct problems and academic failure. Together with unjustified causal inferences, this has led to an over-emphasis on the relevance of postponing AFD as a way to prevent problems later in life.

CONCLUSION

We argue in favour of shifting the focus of alcohol research and prevention away from AFD towards a better understanding of the progression from infrequent, low-quantity drinking to more detrimental drinking patterns and the prevention of associated acute and short-term harm.

Adolescent rats are resistant to the development of ethanol-induced chronic tolerance and ethanol-induced conditioned aversion

The analysis of chronic tolerance to ethanol in adult and adolescent rats has yielded mixed results. Tolerance to some effects of ethanol has been reported in adolescents, yet other studies found adults to exhibit greater tolerance than adolescents or comparable expression of the phenomena at both ages. Another unanswered question is how chronic ethanol exposure affects subsequent ethanol-mediated motivational learning at these ages. The present study examined the development of chronic tolerance to ethanol's hypothermic and motor stimulating effects, and subsequent acquisition of ethanol-mediated odor conditioning, in adolescent and adult male Wistar rats given every-other-day intragastric administrations of ethanol. Adolescent and adult rats exhibited lack of tolerance to the hypothermic effects of ethanol during an induction phase; whereas adults, but not adolescents, exhibited a trend towards a reduction in hypothermia at a challenge phase (Experiment 1). Adolescents, unlike adults, exhibited ethanol-induced motor activation after the first ethanol administration. Adults, but not adolescents, exhibited conditioned odor aversion by ethanol. Subsequent experiments conducted only in adolescents (Experiment 2, Experiment 3 and Experiment 4) manipulated the context, length and predictability of ethanol administration. These manipulations did not promote the expression of ethanol-induced tolerance. This study indicated that, when moderate ethanol doses are given every-other day for a relatively short period, adolescents are less likely than adults to develop chronic tolerance to ethanol-induced hypothermia. This resistance to tolerance development could limit long-term maintenance of ethanol intake. Adolescents, however, exhibited greater sensitivity than adults to the acute motor stimulating effects of ethanol and a blunted response to the aversive effects of ethanol. This pattern of response may put adolescents at risk for early initiation of ethanol intake.

La historia familiar y la conducta de consumo de alcohol como factor sociocultural en el adolescente. Perspectiva de enfermería

Los adolescentes con mayor probabilidad de presentar la conducta de consumo de alcohol son los que están sometidos a diferentes factores de riesgo, los cuales pueden ser personales; dentro de estos factores se encuentra la historia familiar de consumo de alcohol (HFCA). Objetivo: establecer las diferencias y la relación entre el factor personal sociocultural a través de la HFCA y la conducta no saludable de consumo de alcohol en adolescentes de preparatoria del Estado de Nuevo León. Materiales y métodos: estudio descriptivo correlacional, la población estuvo conformada por 743 adolescentes de preparatoria, la muestra fue de 240, con un poder del 90 %. Muestreo aleatorio estratificado con asignación proporcional al tamaño del estrato. Dentro de cada estrato se empleó muestreo aleatorio por conglomerados unietápicos. Los instrumentos empleados fueron el Inventario de HFCA y el Cuestionario de Identificación de los Trastornos debidos al Consumo de Alcohol. Resultados: los adolescentes con HFCA positiva fueron quienes presentaron mayores prevalencias de conducta no saludable (consumo de alcohol); asimismo, el tipo de consumo de alcohol dependiente y dañino presentó esta misma tendencia observándose diferencias estadísticamente significativas (p < 0,05). Cuando se analiza la conducta de consumo de alcohol en los adolescentes se identificó una relación positiva y significativa (rs = 0,196, p < 0,01), lo que indica que a mayor consumo de alcohol por parte de los padres, se presenta un mayor consumo por parte del hijo adolescente.

Personality and Alcohol Expectancies Discriminate Alcohol Consumption Patterns in Female College Students

AIMS

To characterize patterns of alcohol use in a sample of Argentinean female college students according to personality traits and alcohol expectancies.

METHODS

Data from 298 female college students (M age = 18.27 years; SD = 1.37 years) from the city of Cordoba, Argentina were analysed using multinomial regression.

RESULTS

Three drinking categories were identified, abstainers, moderate drinkers and regular drinkers with heavy episodic drinking, and these were differentiated by three personality traits [extraversion, disinhibition (DIS) and experience seeking (ES)] and three alcohol expectancies dimensions (sociability, risk/aggression and negative mood). Regular drinkers with heavy episodic drinking and moderate drinkers had, compared to abstainers, higher scores in extroversion and alcohol expectancies for social facilitation, and lower scores in alcohol expectancies for risk and aggression. Regular drinkers with heavy episodic drinking exhibited, compared to moderate drinkers, higher scores in ES, DIS, extroversion, alcohol expectancies for social facilitation and negative mood alcohol expectancies; as well as lower scores in risk and aggression alcohol expectancies.

CONCLUSION

College women in Argentina with problematic alcohol drinking can be distinguished from those drinking moderately.

Relationship between ethanol-induced activity and anxiolysis in the open field, elevated plus maze, light-dark box, and ethanol intake in adolescent rats

It is yet unclear if ethanol-induced motor stimulation in the open field (OF) merely reflects psychomotor stimulating effects of the drug or if this stimulation is driven or modulated by ethanol's antianxiety properties. In the present study, adolescent rats were administered with different ethanol doses or remained untreated. They were sequentially assessed in the OF, elevated plus maze (EPM), and light-dark box (LDB) and then assessed for ethanol intake. The aims were to assess the relationship between measures of ethanol-induced activity and anxiolysis, analyze ethanol intake as a function of prior ethanol exposure, and associate behavioral responsiveness in these apparatus with ethanol intake during adolescence. The results suggested that the enhanced exploration of the OF observed after 2.5 and 3.25 g/kg ethanol reflected a motor-stimulating effect that appeared to be relatively independent of anxiolysis. The 1.25 g/kg dose induced motor stimulation in the OF and anti-anxiety effects in the EPM, but these effects were relatively independent. The 0.5 g/kg ethanol dose exerted significant anxiolytic effects in the EPM in the absence of stimulating effects in the OF. A multivariate regression analysis indicated that adolescents with a higher frequency of rearing behavior in the OF, higher percentage of open arm entries in the EPM, and lower propensity to enter the central area of the OF exhibited greater ethanol intake. These results indicate that the OF is a valid procedure for the measurement of ethanol-induced stimulation, and provide information toward characterizing subpopulations of adolescents at risk for initiating alcohol drinking.