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Stumbrys D, Štelemėkas M, Jasilionis D, Rehm J. Weekly pattern of alcohol-attributable male mortality before and after imposing limits on hours of alcohol sale in Lithuania in 2018. Scand J Public Health 2024; 52:698-703. [PMID: 37401472 PMCID: PMC10877377 DOI: 10.1177/14034948231184288] [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: 10/13/2022] [Revised: 06/01/2023] [Accepted: 06/08/2023] [Indexed: 07/05/2023]
Abstract
AIMS From 1 January 2018, the number of retail hours for the sale of alcohol was reduced from 14 to 5 hours on Sundays and from 14 to 10 hours on the other days of the week in Lithuania. The significant reduction of hours for the sale of alcohol on Sundays may have affected the distribution of alcohol-attributable deaths during the week. This study aimed to examine the change in the weekly pattern of alcohol-attributable male mortality before and after imposing limits on the hours when alcohol can be sold. METHODS Age-standardised male death rates by days of the week were calculated for four groups according to cause of death: alcohol poisoning (X45), all external causes of death (V01-Y98), diseases of the circulatory system (I00-I99) and all other causes of death. We compared age-standardised death rates for two periods: before (2015-2017) and after (2018-2019) the intervention. Mortality and population data were obtained from the Lithuanian Institute of Hygiene and Human Mortality Database. RESULTS We found that during 2018-2019, earlier observed peak in age-standardised death rates for external causes of death on Sunday diminished, and this day no longer differed from the weekly average. The same tendency was also observed for the Monday excess mortality due to circulatory diseases. CONCLUSIONS The reduction of the hours when alcohol can be sold from the beginning of 2018 was associated with a change in a weekly pattern of alcohol-attributable male mortality. However, more studies are needed to examine the causes of the change in mortality pattern.
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Affiliation(s)
- Daumantas Stumbrys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Lithuania
- Institute of Sociology, Lithuanian Centre for Social Sciences, Lithuania
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Lithuania
| | - Domantas Jasilionis
- Demographic Research Centre, Vytautas Magnus University, Lithuania
- Demographic Data Laboratory, Max Planck Institute for Demographic Research, Germany
| | - Jürgen Rehm
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Canada
- Zentrum für Interdisziplinäre Suchtforschung der Universität Hamburg (ZIS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Abbas D, Ciricillo JA, Elom HA, Moon AM. Extrahepatic Health Effects of Alcohol Use and Alcohol-associated Liver Disease. Clin Ther 2023; 45:1201-1211. [PMID: 37806811 DOI: 10.1016/j.clinthera.2023.08.018] [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: 05/16/2023] [Revised: 08/08/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Alcohol use disorder (AUD) is a growing public health concern and an important contributor to global morbidity and mortality. While the hepatotoxic effects of alcohol are well known, the adverse effects of alcohol are manifested in almost every organ system. With the growing public health impact of AUD, the aim of this narrative review is to highlight the epidemiology and burden of AUD and its association with extrahepatic diseases including malignancy and disorders of the gastrointestinal (GI), cardiovascular, immunologic, neurologic, endocrine, and hematologic systems. METHODS A narrative review of the literature was performed to identify studies addressing the epidemiology, pathophysiology, clinical manifestations, and therapy of extrahepatic health manifestations of alcohol use. FINDINGS In the United States, an estimated 14.5 million people have AUD and approximately 88,000 adults die yearly due to alcohol-related causes. The consumption of alcohol and AUD is associated with injuries, violence, cancers, nonmalignant conditions of the GI system, infections, effects on the cardiovascular system, and neurodegenerative diseases. These conditions contribute to the increased mortality associated with AUD and are burdensome to patients and caregivers. IMPLICATIONS Increased awareness of the extrahepatic manifestations of AUD, screening for AUD using validated screening tools, such as the Alcohol Use Disorders Identification Test-Concise (AUDIT-C) score, and offering evidence-based interventions to patients with AUD is imperative to reduce the public health burden of AUD. Although historically controversial, recent evidence suggests that any level of alcohol consumption can have negative health consequences. Further research is warranted to determine if any amount of alcohol is safe for consumption. Public health efforts are warranted to help curtail the growing burden of AUD.
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Affiliation(s)
- Daniyal Abbas
- Department of Internal Medicine, East Carolina University, Greenville, North Carolina
| | - Jacob A Ciricillo
- Department of Internal Medicine, University of Cincinnati Medicine Center, Cincinnati, Ohio
| | - Hilary A Elom
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi
| | - Andrew M Moon
- Department of Gastroenterology and Hepatology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
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Sullivan EV, Pfefferbaum A. Alcohol use disorder: Neuroimaging evidence for accelerated aging of brain morphology and hypothesized contribution to age-related dementia. Alcohol 2023; 107:44-55. [PMID: 35781021 DOI: 10.1016/j.alcohol.2022.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 12/22/2022]
Abstract
Excessive alcohol use curtails longevity by rendering intoxicated individuals vulnerable to heightened risk from accidents, violence, and alcohol poisoning, and makes chronically heavy drinkers vulnerable to acceleration of age-related medical and psychiatric conditions that can be life threatening (Yoon, Chen, Slater, Jung, & White, 2020). Thus, studies of factors influencing age-alcohol interactions must consider the potential that the alcohol use disorder (AUD) population may not represent the oldest ages of the unaffected population and may well have accrued comorbidities associated with both AUD and aging itself. Herein, we focus on the aging of the brains of men and women with AUD, keeping AUD contextual factors in mind. Knowledge of the potential influence of the AUD-associated co-factors on the condition of brain structure may lead to identifying modifiable risk factors to avert physical declines and may reverse or arrest further AUD-related degradation of the brain. In this narrative review, we 1) describe quantitative, controlled studies of brain macrostructure and microstructure of adults with AUD, 2) consider the possibility of recovery of brain integrity through harm reduction with sustained abstinence or reduced drinking, and 3) speculate on the ramifications of accelerated aging in AUD as contributing to age-related dementia.
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Affiliation(s)
- Edith V Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States.
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States; Center for Health Sciences, SRI International, Menlo Park, CA, United States
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Mair C, Sumetsky N, Dougherty M, Thakar M. Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence? CURR EPIDEMIOL REP 2022; 9:282-289. [PMCID: PMC9672597 DOI: 10.1007/s40471-022-00315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Michelle Dougherty
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Maya Thakar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
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Conde K, Peltzer RI, Gimenez PV, Salomón T, Suarez G, Monteiro M, Cherpitel CJ, Cremonte M. Road traffic injury risk from alcohol and cannabis use among emergency department patients in Argentina. Rev Panam Salud Publica 2022; 46:e116. [PMID: 36060199 PMCID: PMC9426949 DOI: 10.26633/rpsp.2022.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objective To report the risk from alcohol, cannabis, and their combined use for non-fatal road traffic injuries for drivers, passengers, and pedestrians. Methods Risk was estimated using the case-crossover method. Participants (N= 306) were injured patients from an emergency department in Mar del Plata, Argentina. Results Alcohol use (OR= 6.78, CI 95% 3.75-12.25) as well as combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.73) significantly increased the risk of a road traffic injuries. Alcohol use increased the risk in both, women (OR= 8.87, CI 95% 2.69-29.21) and men (OR= 6.16, CI 95% 3.10-12.23); in those >30 years old (OR= 6.01, CI 95% 2.09-17.24) and those <30 years old (OR= 7.15, CI 95% 3.49-14.65). This last group also had an increased risk after combined alcohol and cannabis use (OR= 7.05, CI 95% 1.16-42.75). Both drivers (OR= 6.40, CI 95% 3.23-12.69) and passengers (OR= 13.83, CI 95% 2.87-66.42) had an increased risk after alcohol consumption. Conclusions To our knowledge, these are the first estimates of the risk of having a road traffic injury after alcohol and cannabis consumption in one of the countries of the Southern Cone (Argentina, Chile, and Uruguay). These results highlight the urgent need to implement and enforce comprehensive alcohol control measures. Furthermore, given the global trend towards legalizing cannabis for recreational use, our results could also inform policymakers to enact or amend impaired driving laws.
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Affiliation(s)
- Karina Conde
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Raquel Inés Peltzer
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Paula Victoria Gimenez
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Tomás Salomón
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
| | - Gabriel Suarez
- Hospital Interzonal General de Agudos “Dr. Oscar Alende”Mar del PlataArgentinaHospital Interzonal General de Agudos “Dr. Oscar Alende”, Mar del Plata, Argentina
| | - Maristela Monteiro
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Cheryl J Cherpitel
- Public Health InstituteEmeryvilleUnited States of AmericaPublic Health Institute, Emeryville, United States of America
| | - Mariana Cremonte
- Universidad Nacional de Mar del PlataMar del PlataArgentinaUniversidad Nacional de Mar del Plata, Mar del Plata, Argentina.
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7
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Schölin L, Weerasinghe M, Agampodi S, Chathurange U, Rajapaksha S, Holloway A, Norrie J, Mohamed F, Eddleston M, Pearson M. Involvement of alcohol in injury cases in rural Sri Lanka: prevalence and associated factors among in-patients in three primary care hospitals. BMC Public Health 2022; 22:514. [PMID: 35296275 PMCID: PMC8928674 DOI: 10.1186/s12889-022-12958-8] [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: 05/16/2021] [Accepted: 03/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background Injuries account for a major proportion of global morbidity and mortality related to alcohol use. Information on the prevalence of alcohol-related injury in rural Sri Lanka is limited. The aims of this study were to determine the burden of alcohol-related injury in a hospital-based sample in rural Sri Lanka and explore factors associated with an increased risk of alcohol-related injury. Methods Involvement of alcohol in injury amongst in-patients was assessed in three hospitals in the North Central Province of Sri Lanka over 6 months. Adult (≥ 18 years) patients were eligible. Patients were assessed for: injury characteristics, current alcohol use (in the past year) using the Alcohol Use Disorder Identification Test (AUDIT), and acute intoxication. Patients with a blood alcohol concentration (BAC) reading equivalent of 10 mg/dL (2.17 mmol/L) were considered as having an alcohol-related injury. Binary logistic regression was used to explore association between alcohol-related injury and demographic and injury characteristics. Results A total of 883 injured patients were eligible and consented to the study. No alcohol use was reported by 487 (55.2%) of patients (35.6% of men, 95.2% of women). Prevalence of alcohol-related injuries was 14.8% overall and 32.8% among current alcohol users. Almost all patients with an alcohol-related injury were male (122/123; 99.2%); 24 (18.8%) of these patients scored positive for possible alcohol dependence. Patients with an alcohol-related injury had significantly higher AUDIT scores (median = 15 vs 6, p < 0.001), were significantly more likely to be aged 26–40 (OR 2.29, 95% CI:1.11, 4.72) or 41–55 years (OR 2.76, 95% CI: 1.29, 5.90) (compared to 18–25 years), to have a transport-related injury (OR 5.14, 95% CI: 2.30, 11.49) (compared to animal/plant sting/bite), and have intentional injuries (OR 3.47, 95% CI: 1.01, 11.87). Conclusions One in three injuries among people who drank alcohol in this sample were alcohol-related. In addition, problematic alcohol use was higher among those with alcohol-related injury. Further work is needed to explore whether this prevalence of alcohol-related injury is reflected in other rural settings in Sri Lanka. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12958-8.
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Affiliation(s)
- L Schölin
- Centre for Pesticide Suicide Prevention & Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
| | - M Weerasinghe
- Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - S Agampodi
- Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - U Chathurange
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - S Rajapaksha
- Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| | - A Holloway
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - J Norrie
- Usher Institute, Edinburgh Clinical Trials Unit, University of Edinburgh, Edinburgh, UK
| | - F Mohamed
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - M Eddleston
- Centre for Pesticide Suicide Prevention & Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - M Pearson
- Centre for Pesticide Suicide Prevention & Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Development of mental health first aid guidelines for problem drinking: a Delphi expert consensus study in Argentina and Chile. BMC Psychiatry 2022; 22:113. [PMID: 35151295 PMCID: PMC8841054 DOI: 10.1186/s12888-022-03749-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/28/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Among all psychoactive substances, alcohol consumption presents the most significant public health problem and is a leading risk factor for overall disease burden in Latin America. However, most people who meet criteria for a substance use disorder do not receive treatment in primary or secondary care sources. Community members can play a role in helping people to seek help as they are likely to encounter people experiencing problem drinking and recognize the signs. However, many do not have adequate mental health first aid knowledge or skills to provide help. We aimed to culturally adapt the existing English-language mental health first aid guidelines for helping someone with problem drinking for Argentina and Chile. METHODS The Delphi consensus method was used to determine the importance of helping actions translated from the English-language guidelines and to add new actions suggested by expert panellists. The importance of each statement was rated by two expert panels. Panel one included people with lived experience (either their own or as a support person, n = 23) recruited in Argentina and panel two included health professionals (n = 31) recruited in Argentina and Chile. RESULTS Overall, 165 helping actions were endorsed by panellists across two consecutive survey rounds. Endorsed items included 132 of the 182 items translated into Spanish from the English-language guidelines and 33 of the 61 new items generated from panellists' comments in the first survey round. CONCLUSIONS While there were some similarities in recommended helping actions between English-speaking countries, and Argentina and Chile, key differences were seen in attitudes to low-risk drinking. While there was a relatively high level of agreement between health professionals and people with lived experience, some divergence of opinion was seen, particularly in the area of commitment to recovery as a condition for help. Future research should explore the implementation of the guidelines.
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Choo EK, Nishijima D, Trent S, Eichelberger A, Ye Y, Audett A, Brasel K, Kazmierczak S, Cherpitel CJ. Cannabis presentations to the emergency department after MVC in the era of legalization for recreational use. JOURNAL OF SAFETY RESEARCH 2022; 80:341-348. [PMID: 35249614 DOI: 10.1016/j.jsr.2021.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/22/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The objectives of this study were to examine cannabis and alcohol use among injured patients presenting to emergency departments (ED) in cannabis-legal states to capture an expanded profile of cannabis use and evaluate differences in motor-vehicle collision (MVC) characteristics among those using cannabis alone and in combination with alcohol. METHODS This was a cross-sectional study of ED visits by drivers in MVC who presented to one of three study sites. Event-related and usual drug and alcohol use information were obtained using a detailed interviewer-administered computerized questionnaire. We also obtained data from blood and breathalyzer tests and the electronic medical record. We examined frequency and types of acute and past-year cannabis and alcohol use and crash mechanisms and characteristics. Our primary method of determining substance use was self-report; we used biosamples secondarily. RESULTS Eight percent of drivers reported cannabis use in the 8 h prior to MVC, alone or in combination with alcohol; however, a higher proportion (18%) were positive by biosample. High-risk crash features were common in MVCs associated with cannabis, as they were for alcohol use and co-use of cannabis and alcohol; however, patients injured seriously enough to require admission were less likely to report cannabis use (7% vs. 9%) and more likely to report alcohol use (16% vs. 10%). CONCLUSIONS Cannabis use was common among patients presenting after MVC in this sample of cannabis-legal states. Practical Applications: Differences between self-report and biosample data for cannabis and alcohol use were significant and supports the need to use both means of assessing acute use.
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Affiliation(s)
- Esther K Choo
- Oregon Health & Science University, Portland, OR, United States.
| | | | - Stacy Trent
- Denver Health Medical Center, Department of Emergency Medicine, Denver, CO, United States
| | | | - Yu Ye
- Alcohol Research Group, Emeryville, CA, United States
| | - Ariane Audett
- Oregon Health & Science University, Portland, OR, United States
| | - Karen Brasel
- Oregon Health & Science University, Portland, OR, United States
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10
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Tran A, Jiang H, Lange S, Livingston M, Manthey J, Neufeld M, Room R, Štelemėkas M, Telksnys T, Petkevičienė J, Radišauskas R, Rehm J. The Impact of Increasing the Minimum Legal Drinking Age from 18 to 20 Years in Lithuania on All-Cause Mortality in Young Adults-An Interrupted Time-Series Analysis. Alcohol Alcohol 2021; 57:513-519. [PMID: 34864838 DOI: 10.1093/alcalc/agab076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/22/2021] [Accepted: 10/30/2021] [Indexed: 11/14/2022] Open
Abstract
AIMS To determine the effect of an alcohol policy change, which increased the minimum legal drinking age (MLDA) from 18 years of age to 20 years of age on all-cause mortality rates in young adults (18-19 years old) in Lithuania. METHODS An interrupted time series analysis was conducted on a dataset from 2001 to 2019 (n = 228 months). The model tested the effects of the MLDA on all-cause mortality rates (deaths per 100,000 individuals) in three age categories (15-17 years old, 18-19 years old, 20-22 years old) in order to control for general mortality trends in young adults, and to isolate the effects of the MLDA from other alcohol control policies. Additional models that included GDP as a covariate and a taxation policy were tested as well. RESULTS There was a significant effect of the MLDA on all-cause mortality rates in those 18-19 years old, when modelled alone. Additional analyses controlling for the mortality rate of other age groups showed similar findings. Inclusion of confounding factors (policies on alcohol taxation, GDP) eliminated the effects of MLDA. CONCLUSIONS Although there was a notable decline in all-cause mortality rates among young adults in Lithuania, a direct causal impact of MLDA on all-cause mortality rates in young adults was not definitively found.
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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.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada
| | - 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, 250 College St, Toronto, Ontario M5T 1R8, Canada
| | - Michael Livingston
- Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Plenty Rd. x Kingsbury Rd., Bundoora, Victoria 3086, Australia.,National Drug Research Institute, Health Sciences, Curtin University, Perth, 6102, Australia.,Department of Clinical Neuroscience, Karolinska Institutet, Solnavägen 1, 171 77 Solna, Sweden
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat 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.,Department of Psychiatry, Medical Faculty, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Maria Neufeld
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.,Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat Dresden, Chemnitzer Str. 46, 01187 Dresden, Germany.,WHO Regional Office for Europe, Office for Prevention and Control of Noncommunicable Diseases, Moscow, Leontyevsky Pereulok 9, 125009 Moscow, Russian Federation
| | - Robin Room
- Centre for Alcohol Policy Research, Building NR-1, La Trobe University, Plenty Rd. x Kingsbury Rd., Bundoora, Victoria 3086, Australia.,Centre for Social Research on Alcohol and Drugs, Department of Public Health Sciences, Stockholm University, 3rd floor, Sveavägen 160, 113 46 Stockholm, Sweden
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Tadas Telksnys
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Janina Petkevičienė
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Tilžės str. 18, 47181 Kaunas, Lithuania.,Institute of Cardiology, Lithuanian University of Health Sciences, Sukilėlių str. 17, 50162 Kaunas, Lithuania
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 1P8, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College St, Toronto, Ontario M5T 1R8, Canada.,Institute of Clinical Psychology and Psychotherapy, Faculty of Psychologie, Technische Universitat 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.,World Health Organization/ Pan American Health Organization Collaborating Centre, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, Ontario M5S 2S1, Canada.,Faculty of Medicine, Institute of Medical Science, 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.,Department of International Health Projects, Institute for Leadership and Health Management, .M. Sechenov First Moscow State Medical University, ITrubetskaya str., 8, b. 2, 119992, Moscow, Russian Federation
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11
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Nunes HRDC, Murta-Nascimento C, Lima MCP. Impact of the Dry Law on road traffic mortality in Brazilian states: an interrupted time series analysis. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210045. [PMID: 34406207 DOI: 10.1590/1980-549720210045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/04/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the impact of 2008 Public Law number 11,705, also known as Dry Law (DL-08), on mortality from road traffic accidents (RTA), in each of the 27 Brazilian Federative Units (BFUs). METHODS Ecological study of interrupted time series with RTA data from 2002 to 2015, totalizing 168 months. Data were obtained from the Mortality Information System, the Brazilian Institute of Geography and Statistics, and from the National Traffic Department. Autoregressive integrated moving average (ARIMA) models were adjusted to assess the impact of DL-08 in each BFUs. RESULTS After the implementation of the DL-08, there was a significant decrease in mortality from RTA in the state of Santa Catarina (pre DL-08 = 2.60 ± 0.30 and post DL-08 = 2.32 ± 0.35; p < 0.001) and in the Federal District (pre DL-08 = 2.22 ± 0.40 and post DL-08 = 1.76 ± 0.35; p = 0.002), a significant increase in mortality in the states of Acre, Amazonas, Rondônia, Maranhão, Piauí, Ceará, Rio Grande do Norte, Paraíba, Pernambuco, Alagoas, Sergipe and Mato Grosso, and a stability in the other states. The sensitivity analysis conducted over a shorter time series with 24 months showed results similar to those obtained with the 168-month series for most of the 27 BFUs. CONCLUSION The DL-08 had a heterogeneous impact on mortality from traffic accidents on BFUs.
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Affiliation(s)
- Hélio Rubens de Carvalho Nunes
- Departamento de Saúde Pública, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
| | - Cristiane Murta-Nascimento
- Departamento de Saúde Pública, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
| | - Maria Cristina Pereira Lima
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - Botucatu (SP), Brasil
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12
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Chikritzhs T, Livingston M. Alcohol and the Risk of Injury. Nutrients 2021; 13:2777. [PMID: 34444939 PMCID: PMC8401155 DOI: 10.3390/nu13082777] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/14/2022] Open
Abstract
Globally, almost four and a half million people died from injury in 2019. Alcohol's contribution to injury-related premature loss of life, disability and ill-health is pervasive, touching individuals, families and societies throughout the world. We conducted a review of research evidence for alcohol's causal role in injury by focusing on previously published systematic reviews, meta-analyses and where indicated, key studies. The review summarises evidence for pharmacological and physiological effects that support postulated causal pathways, highlights findings and knowledge gaps relevant to specific forms of injury (i.e., violence, suicide and self-harm, road injury, falls, burns, workplace injuries) and lays out options for evidence-based prevention.
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Affiliation(s)
- Tanya Chikritzhs
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia;
| | - Michael Livingston
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA 6008, Australia;
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Melbourne, VIC 3086, Australia
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13
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Hamilton I. Role of non-specialist nurses in supporting people who misuse drugs. Nurs Stand 2020; 35:61-66. [PMID: 32323931 DOI: 10.7748/ns.2020.e11522] [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] [Accepted: 01/28/2020] [Indexed: 06/11/2023]
Abstract
In their practice, nurses are likely to encounter people who misuse drugs, but they may find it daunting to support these patients. While specialist drug treatment services have an important role in providing substitution treatment and talking therapies, referral is not always appropriate for some patients. Non-specialist nurses are well placed to use techniques such as brief interventions and motivational interviewing to engage patients in discussions about their drug misuse and prompt them to consider how they could reduce it. This article defines drug misuse, describes the contributing factors that can lead to it and its associated health issues. It also discusses how non-specialist nurses can manage and provide optimal support for patients who misuse drugs.
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14
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López-Pelayo H, Zuluaga P, Caballeria E, Van den Brink W, Mann K, Gual A. Safety of nalmefene for the treatment of alcohol use disorder: an update. Expert Opin Drug Saf 2019; 19:9-17. [PMID: 31868031 DOI: 10.1080/14740338.2020.1707802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: Reduced drinking has been debated as a treatment goal for heavy drinking alcohol-dependent patients, in whom treatment based on abstinence is not always an option. Nalmefene was the first drug approved by the European Medicines Agency (2013) with the indication of reduced drinking in high drinking risk level alcohol-dependent patients. Six years after its introduction in Europe, data from clinical experience can be compared with those from preclinical studies and pivotal registration studies to evaluate what nalmefene has added to the treatment of AUD.Areas covered: Systematic review of efficacy and safety data of nalmefene use in humans from preclinical, phase III and phase IV studies, including systematic reviews, meta-analyses, cost-effectiveness analyses, and other secondary analyses.Expert opinion: Nalmefene introduces a paradigm change in the treatment of AUD that makes it appealing to patients that are reluctant to embrace abstinence, and facilitate patient-centered care in heavy users. However, information regarding safety data in special populations (e.g., patients with alcohol-related diseases, pregnancy, psychiatric disease), and direct comparisons with other potential drugs for alcohol reduction are further needed. Despite the promising role of nalmefene, there are still some factors that limit its wide prescription further than in specialized settings.
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Affiliation(s)
- Hugo López-Pelayo
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Paola Zuluaga
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Elsa Caballeria
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
| | - Wim Van den Brink
- Department of Psychiatry, Amsterdam University Medical Centres, Location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Karl Mann
- Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Antoni Gual
- Grup Recerca Addiccions Clínic (GRAC-GRE), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic Barcelona, Barcelona, Spain
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15
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Snoswell CL, Puljević C, Ferris J. A Commentary on the Dose-Response Relationship of Alcohol and Injury: Effects of Country-Level Drinking Patterns and Alcohol Policies. Alcohol Clin Exp Res 2019; 43:1373-1375. [PMID: 31081925 DOI: 10.1111/acer.14109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Centaine L Snoswell
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Cheneal Puljević
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
| | - Jason Ferris
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia
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16
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Kaplan MS, McFarland BH, Huguet N, Valenstein M. Suicide risk and precipitating circumstances among young, middle-aged, and older male veterans. Am J Public Health 2012; 102 Suppl 1:S131-7. [PMID: 22390587 PMCID: PMC3496453 DOI: 10.2105/ajph.2011.300445] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2011] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the risk of suicide among veteran men relative to nonveteran men by age and to examine the prevalence of suicide circumstances among male veterans in different age groups (18-34, 35-44, 45-64, and ≥ 65 years). METHODS Data from the National Violent Death Reporting System (2003-2008) were used to calculate age-specific suicide rates for veterans (n = 8440) and nonveterans (n = 21,668) and to calculate the age-stratified mortality ratio for veterans. Multiple logistic regression was used to compare health status, stressful life events preceding suicide, and means of death among young, middle-aged, and older veterans. RESULTS Veterans were at higher risk for suicide compared with nonveterans in all age groups except the oldest. Mental health, substance abuse, and financial and relationship problems were more common in younger than in older veteran suicide decedents, whereas health problems were more prevalent in the older veterans. Most male veterans used firearms for suicide, and nearly all elderly veterans did so. CONCLUSIONS Our study highlighted heightened risk of suicide in male veterans compared with nonveterans. Within the veteran population, suicide might be influenced by different precipitating factors at various stages of life.
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