1
|
Giustino A, Natola A, Savoia G, De Salvia MA, Finelli C. Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in A Large District of Southern Italy. J Clin Med 2024; 13:3057. [PMID: 38892768 PMCID: PMC11172439 DOI: 10.3390/jcm13113057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Background Stress during a pandemic increases the risk of alcohol consumption, which may require pharmacological management. Methods An observational single-center retrospective study was conducted from 1 January 2018 to 31 December 2021, and divided into 2-year periods (2018-2019 and 2020-2021). This study focused on calls to one of the emergency departments (EDs) of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ESs) who were either admitted or not admitted, due to their refusal. Results A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, an inverse association was found between pharmacological treatment and number of calls coded green (non-critical) and yellow (fairly critical) in patients admitted to EDs. An inverse association was also found for calls coded green in patients not admitted to EDs and pharmacological treatment. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. Conclusions ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.
Collapse
Affiliation(s)
- Arcangela Giustino
- Department of Precision and Regenerative Medicine and Ionian Area, Medical School, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (A.G.); (M.A.D.S.)
| | - Annamaria Natola
- Operations Centre of Emergency Services (118)—Policlinico Hospital, Piazza Giulio Cesare, 11, 70124 Bari, Italy (G.S.)
| | - Giovanni Savoia
- Operations Centre of Emergency Services (118)—Policlinico Hospital, Piazza Giulio Cesare, 11, 70124 Bari, Italy (G.S.)
| | - Maria Antonietta De Salvia
- Department of Precision and Regenerative Medicine and Ionian Area, Medical School, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (A.G.); (M.A.D.S.)
| | - Carmine Finelli
- Department of Internal Medicine, Hospital “A. Maresca”–ASL Naples 3 Sud, Via Montedoro, 1, 80059 Torre del Greco (Naples), Italy
| |
Collapse
|
2
|
Castelli V, Plescia F, Maniaci G, Lavanco G, Pizzolanti G, Brancato A, Cannizzaro C. Alcohol binge drinking in adolescence and psychological profile: Can the preclinical model crack the chicken-or-egg question? Front Psychiatry 2022; 13:996965. [PMID: 36159952 PMCID: PMC9500321 DOI: 10.3389/fpsyt.2022.996965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022] Open
Abstract
During adolescence, internal and external factors contribute to engaging with alcohol binge drinking (ABD), putting at risk the neurodevelopment of brain regions crucial for emotional control and stress coping. This research assessed the prevalence of ABD in late adolescent students of Southern Italy and characterized their psychological profile and drinking motives. Translational effects of alcohol binge drinking in the animal model were also studied. Seven hundred and fifty-nine high school students of both sexes (aged 18-20) were recruited. Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), Drinking Motives Questionnaire-Revised Short Form, Millon Clinical Multiaxial Inventory-Third Ed., State-Trait Anxiety Inventory, Connor-Davidson Resilience Scale, and Basic Self-Esteem Scale identified alcohol habits, drinking motives, and psychopathological profile. Eighty-five percentage of the students drank alcohol and 28% of them engaged in ABD; AUDIT-C correlated with enhancement, coping, and conformity motives. ABD was related to a greater likelihood of presenting clinical syndromes and personality disorders, as well as low resilience and self-esteem. Thereafter, in the pre-clinical model, adolescent male rats were exposed to alcohol (3.5 g/kg) in an intermittent binge-like paradigm and tested during prolonged abstinence. Rats were evaluated for anxiety-like behavior, motivated behaviors, resilience, and stress response following a psychosocial challenge. Binge-like alcohol-exposed adolescent rats displayed high integrated z-score for social- and novelty-induced anxiety, altered motivation-driven output, decreased resilience, and a blunted HPA axis response to psychosocial stress, with respect to respective controls. Our data confirm that ABD is the chosen pattern of drinking in a significant percentage of high school students in Southern Italy, and highlights AUDIT-C score as a relevant parameter able to predict the occurrence of affective disturbances. The evidence from the preclinical model shows that ABD produces detrimental consequences in the adolescent rat brain, resulting in negative affect, emotional dysregulation, and aberrant stress response, pointing to decreasing excessive alcohol drinking as a primary goal for the global act for brain health.
Collapse
Affiliation(s)
- Valentina Castelli
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Fulvio Plescia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuseppe Maniaci
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Gianluca Lavanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Giuseppe Pizzolanti
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Anna Brancato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Carla Cannizzaro
- Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| |
Collapse
|
3
|
Ballestar-Tarín ML, Ibáñez-del-Valle V, Cauli O, Navarro-Martínez R. Personal and Social Consequences of Psychotropic Substance Use: A Population-Based Internet Survey. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:65. [PMID: 35056373 PMCID: PMC8777796 DOI: 10.3390/medicina58010065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 11/17/2022]
Abstract
Background and objectives: Drug abuse has become a major worldwide health concern among all age groups. The present study analyses substance misuse and its social and personal consequences using a population-based internet survey in Spain. Materials and Methods: Screening for drug abuse (of alcohol, marijuana/hashish and psychostimulants) and its related risks and problems was performed using the Car, Relax, Alone, Forget, Friends, Trouble (CRAFFT) score. Socio-demographic factors, depressive, anxiety and stress symptoms as well as health habits were also evaluated. We used Linear regression methods to compare each variable's individual contribution so as to determine which one best explains the results. Results: In this population-based study, 1224 people completed and returned the online survey. Of all participants, 57% reported consuming at least one substance based on the CRAFFT scale. While increasing age reduces the probability of personal and social consequences of consumption, people who smoke receive up to three times more (OR = 3.370) recommendations from family and friends to reduce their consumption. As for the type of substance, the consumption of marijuana increases the risk of forgetting (OR = 2.33) and the consumption of other psychostimulant substances almost triples the risk of consuming alone (OR = 2.965). Combining substances can increase the rate of driving a vehicle after consumption by 3.4 times. Conclusions: Although age, smoking and the type of substances used increase the risk of suffering from social and personal consequences of the use or abuse of substances, future studies are needed to determine the influence of new variables as a potential tool for treating and minimizing the adverse consequences of drug abuse.
Collapse
Affiliation(s)
- María Luisa Ballestar-Tarín
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
| | - Vanessa Ibáñez-del-Valle
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
- Frailty and Cognitive Impairment Organized Group (FROG), Department of Nursing, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
- Frailty and Cognitive Impairment Organized Group (FROG), Department of Nursing, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
| | - Rut Navarro-Martínez
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain; (M.L.B.-T.); (V.I.-d.-V.); (R.N.-M.)
- Frailty and Cognitive Impairment Organized Group (FROG), Department of Nursing, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
| |
Collapse
|
4
|
Di Serio F, Giustino A, Calamita C, Savoia G, Lovero R, Mascolo E, Buttiglione M, Finelli C, Zambetta G, De Salvia MA. Acute alcohol intoxication across different age groups in 2014-2018: Prehospital care and biochemical correlates at a large University Hospital in southern Italy. Int Emerg Nurs 2022; 60:101113. [PMID: 34942538 DOI: 10.1016/j.ienj.2021.101113] [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] [Received: 12/21/2020] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Risky alcohol consumption can occur from a young age and affects people of all age groups, sometimes requiring the intervention of the emergency medical services. OBJECTIVES Determining the timing and characteristics of emergency calls (to the "118" emergency number) relating to subjects in all age groups, in which alcohol was a contributing factor, along with the biochemical correlates, in a great metropolitan area. On the basis of these, future interventions would target specific training for nurses and paramedics working in emergency medical services. METHOD An observational single-centre retrospective study carried out from 1 January 2014 to 31 December 2018 involving patients requiring emergency care and attending the Emergency Department of an University Hospital. RESULTS Out of a total of 47,252 emergency calls, 2.22% were for alcohol-related conditions and mainly involved male patients (78.4%). A high incidence of alcoholic coma was found in patients aged 11 to 17 years. Emergency medical assistance was required mainly at night on weekdays by patients aged 11-17, 25-44 years and during the weekend and on weekdays by patients aged 18-24 years. A blood alcohol concentration higher than 50 mg/dL was found in more than 67% of patients aged 11-17 and 18-24 years at weekends. CONCLUSIONS The most alarming finding from our data is that, despite prevention policies, young people requiring emergency medical assistance showed similar alcohol levels as adults and a high incidence of alcoholic coma.
Collapse
Affiliation(s)
- Francesca Di Serio
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Arcangela Giustino
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Cesare Calamita
- Operations Centre of Emergency Services (118) - Policlinico Hospital, Bari, Italy
| | - Giovanni Savoia
- Operations Centre of Emergency Services (118) - Policlinico Hospital, Bari, Italy
| | - Roberto Lovero
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Elisa Mascolo
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Maura Buttiglione
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Carmine Finelli
- Department of Internal Medicine, Hospital "Cavalier Raffaele Apicella"-ASL Naples 3 Sud, Pollena (Napoli), Italy
| | - Giovanni Zambetta
- Forensic Medicine, Hospital "Miulli", Acquaviva delle Fonti (Bari), Italy
| | - Maria A De Salvia
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
| |
Collapse
|
5
|
Delgado-Lobete L, Montes-Montes R, Vila-Paz A, Cruz-Valiño JM, Gándara-Gafo B, Talavera-Valverde MÁ, Santos-del-Riego S. Individual and Environmental Factors Associated with Tobacco Smoking, Alcohol Abuse and Illegal Drug Consumption in University Students: A Mediating Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3019. [PMID: 32349213 PMCID: PMC7246518 DOI: 10.3390/ijerph17093019] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 12/13/2022]
Abstract
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.
Collapse
Affiliation(s)
- Laura Delgado-Lobete
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
| | - Rebeca Montes-Montes
- TALIONIS Research Group, Faculty of Health Sciences, University of A Coruña, 15008 A Coruña, Spain
| | - Alba Vila-Paz
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
| | - José-Manuel Cruz-Valiño
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
- Institute for Oral Implantology and Rehabilitation of A Coruña (Instituto Coruñés de Implantología y Rehabilitación Oral-ICIRO), 15007 A Coruña, Spain
| | - Berta Gándara-Gafo
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
| | - Miguel-Ángel Talavera-Valverde
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
| | - Sergio Santos-del-Riego
- Health Integration and Promotion Research Unit (INTEGRA SAÚDE), Faculty of Health Sciences, University of A Coruña, 15006 A Coruña, Spain
- UDC Saudable, Health Promotion Department of University of A Coruña, 15011 A Coruña, Spain
| |
Collapse
|