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Trangenstein PJ, Tiongson PJ, Lu Y, Lipson SK, Xuan Z, Naimi TS, Jernigan DH. Gender and sexual identity and harms from others' drinking among U.S. college students: Results from a multi-campus survey. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1978-1982. [PMID: 36036804 PMCID: PMC9971347 DOI: 10.1080/07448481.2022.2112045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 05/16/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND College is a critical life stage for alcohol-related harms to others (AHTOs), gender, and sexual identity. We tested associations between inclusively-defined gender and sexual identities (separately) and AHTOs among college students. METHODS The Healthy Minds Study (n = 8,308) provided data about three AHTOs: (1) babysitting a drunk student, (2) alcohol-related unwanted sexual advance, and (3) alcohol-related sexual assault. Independent variables included gender and sexual identity. RESULTS One in four students (25.5%) reported babysitting, 6.2% reported unwanted advances, and 1.2% reported sexual assaults. Compared to cisgender males, cisgender females had higher odds of reporting babysitting (aOR = 1.36, p < 0.001) and unwanted advances (aOR = 2.59, p < 0.001); trans masculine students had higher odds of reporting sexual assaults (aOR = 4.49, p = 0.04). CONCLUSIONS AHTOs are prevalent on college campuses, and cisgender female and trans masculine students have higher odds of experiencing them. Alcohol interventions may protect cisgender female and gender minority students from the drinkers around them.
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Affiliation(s)
| | - Patrick J.D. Tiongson
- Boston University School of Public Health, Department of Health Law, Policy & Management, Boston, MA, USA
| | - Yi Lu
- Health Effects Institute, Boston, MA, USA
| | - Sarah K. Lipson
- Boston University School of Public Health, Department of Health Law, Policy & Management, Boston, MA, USA
| | - Ziming Xuan
- Boston University School of Public Health, Department of Community Health Sciences, Boston, MA, USA
| | - Timothy S. Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - David H. Jernigan
- Boston University School of Public Health, Department of Health Law, Policy & Management, Boston, MA, USA
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2
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Cucciare MA, Han X, Yousef S, Timko C. Predictors of concerned others' mental health and quality of life over 12 months following adults' entry into treatment for an alcohol use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 164:209434. [PMID: 38866140 PMCID: PMC11322894 DOI: 10.1016/j.josat.2024.209434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 05/10/2024] [Accepted: 06/04/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION People in treatment for alcohol use disorders (AUDs) can negatively impact their Concerned Others (COs). This longitudinal study examined patient and CO characteristics associated with CO outcomes. METHOD Participants were 279 dyads of patients entering residential treatment and their CO. Outcomes were COs' mental health and quality of life. The study collected patient and CO predictors and CO outcomes at baseline and 3-, 6-, and 12-month follow-ups as part of a randomized controlled trial. In the first set of models, the analytic approach identified baseline patient predictors associated with COs' outcomes measured at baseline and follow-ups. In the second set of models, we examined whether those effects remained after adding baseline CO characteristics. RESULTS In the first set of models, COs of older age and whose patient reported less CO-patient relationship stress had better mental health. Also, married COs and those with higher income and whose patient reported no violence in the CO-patient relationship had better quality of life. In the second set of models, COs whose patient entered treatment due to criminal justice involvement, with more social support, less reported stigma, and less use of avoidance coping had better mental health. Also, married COs, those with higher income, and less reported discrimination stigma had better quality of life. CONCLUSIONS Understanding patient and CO characteristics that are associated with COs' outcomes may inform AUD treatment programs' efforts to help COs. Identifying modifiable determinants of CO outcomes is important to clinical practice regardless of whether the patient chooses to obtain treatment.
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Affiliation(s)
- Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA; Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72205, USA.
| | - Xiaotong Han
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA; Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72205, USA.
| | - Sara Yousef
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA 94304, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
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3
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Lai D, Kuo SIC, Wetherill L, Aliev F, Zhang M, Abreu M, Schwantes-An TH, Dick D, Francis MW, Johnson EC, Kamarajan C, Kinreich S, Kuperman S, Meyers J, Nurnberger JI, Liu Y, Edenberg HJ, Porjesz B, Agrawal A, Foroud T, Schuckit M, Plawecki MH, Bucholz KK, McCutcheon VV. Associations between alcohol use disorder polygenic score and remission in participants from high-risk families and the Indiana Biobank. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:283-294. [PMID: 38054532 PMCID: PMC10922306 DOI: 10.1111/acer.15239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND In the United States, ~50% of individuals who meet criteria for alcohol use disorder (AUD) during their lifetimes do not remit. We previously reported that a polygenic score for AUD (PGSAUD ) was positively associated with AUD severity as measured by DSM-5 lifetime criterion count, and AUD severity was negatively associated with remission. Thus, we hypothesized that PGSAUD would be negatively associated with remission. METHODS Individuals of European (EA) and African ancestry (AA) from the Collaborative Study on the Genetics of Alcoholism (COGA) who met lifetime criteria for AUD, and two EA cohorts ascertained for studies of liver diseases and substance use disorders from the Indiana Biobank were included. In COGA, 12-month remission was defined as any period of ≥12 consecutive months without meeting AUD criteria except craving and was further categorized as abstinent and non-abstinent. In the Indiana Biobank, remission was defined based on ICD codes and could not be further distinguished as abstinent or non-abstinent. Sex and age were included as covariates. COGA analyses included additional adjustment for AUD severity, family history of remission, and AUD treatment history. RESULTS In COGA EA, PGSAUD was negatively associated with 12-month and non-abstinent remission (p ≤ 0.013, βs between -0.15 and -0.10) after adjusting for all covariates. In contrast to the COGA findings, PGSAUD was positively associated with remission (p = 0.004, β = 0.28) in the Indiana Biobank liver diseases cohort but not in the Indiana Biobank substance use disorder cohort (p = 0.17, β = 0.15). CONCLUSIONS PGSAUD was negatively associated with 12-month and non-abstinent remission in COGA EA, independent of behavioral measures of AUD severity and family history of remission. The discrepant results in COGA and the Indiana Biobank could reflect different ascertainment strategies: the Indiana Biobank participants were older and had higher rates of liver disease, suggesting that these individuals remitted due to alcohol-related health conditions that manifested in later life.
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Affiliation(s)
- Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Sally I-Chun Kuo
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Fazil Aliev
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ
| | - Michael Zhang
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Marco Abreu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Tae-Hwi Schwantes-An
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Danielle Dick
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ
| | | | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Jacquelyn Meyers
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - John I Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, SUNY Downstate Health Science University, NY
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Marc Schuckit
- Department of Psychiatry, University of California, San Diego Medical School, San Diego, CA
| | - Martin H. Plawecki
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Kathleen K. Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Vivia V. McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
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Lushin V, Rivera R, Chandler M, Rees J, Rzewinski J. Emotional Distress in a Marginalized Population as a Function of Household-Level Social Determinants of Health. SOCIAL WORK 2023; 68:287-297. [PMID: 37421650 DOI: 10.1093/sw/swad024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/16/2023] [Accepted: 06/06/2023] [Indexed: 07/10/2023]
Abstract
Low-income, underrepresented communities of color are disproportionally affected by emotional distress. Little is known about malleable, household-level determinants of emotional distress, addressable by feasible, stigma-neutral interventions. The present study addressed this knowledge gap by analyzing secondary data from a cross-sectional community needs assessment survey in a marginalized urban community (N = 677). Relying on dominance analyses, authors found that, on average, the largest household-level contributions to respondents' emotional distress included exposures to fellow household members' alcohol use and anger-driven behaviors. Both determinants are arguably feasible to address via household-level interventions and community-level preventive efforts. Household members' physical and serious mental illness and drug use were moderately associated with respondents' emotional distress; household cohesion and communications, residential overcrowding, and child behavior played a minimal role. Article concludes with a discussion of public health implications of the results.
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Affiliation(s)
- Victor Lushin
- MD, are assistant professors, Department of Social Work, Long Island University Brooklyn, Brooklyn, NY, USA
| | - Rebecca Rivera
- PhD, LCSW, are assistant professors, Department of Social Work, Long Island University Brooklyn, Brooklyn, NY, USA
| | - Marquis Chandler
- PhD, LSW, are assistant professors, Department of Social Work, Long Island University Brooklyn, Brooklyn, NY, USA
| | - Jo Rees
- PhD, is associate dean, School of Health Professions, Long Island University Brooklyn, Brooklyn, NY, USA
| | - Justyna Rzewinski
- LCSW, is clinical director, Revcore Recovery Center of Manhattan, New York, NY, USA
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Karriker-Jaffe KJ, Blackburn N, Graham K, Walker MJ, Room R, Wilson IM, Waleewong O, Gilchrist G, Ramsoomar L, Laslett AM. Can alcohol policy prevent harms to women and children from men's alcohol consumption? An overview of existing literature and suggested ways forward. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104148. [PMID: 37540918 PMCID: PMC10734562 DOI: 10.1016/j.drugpo.2023.104148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/06/2023]
Abstract
The World Health Organization's list of cost-effective alcohol control policies is a widely-used resource that highlights strategies to address alcohol-related harms. However, there is more evidence on how recommended policies impact harms to people who drink alcohol-such as physical health problems caused by heavy alcohol use-than on secondhand harms inflicted on someone other than the person drinking alcohol, i.e., alcohol's harms to others. In this essay, we describe evidence of impacts of alcohol policy on harms to women and children resulting from men's alcohol consumption, as well as options for making policies more relevant for reducing intimate partner violence and child abuse. We begin with an overview of harms to women and children resulting from men's alcohol consumption and review cost-effective alcohol policies with potential to reduce these harms based on likely mechanisms of action. Next, we present a rapid review of reviews to describe existing evidence of impacts of these policies on the outcomes of physical violence, sexual violence, and child abuse and neglect. We found little evidence of systematic evaluation of impacts of these important alcohol policies on harms to women and children. Thus, we advocate for increased attention in evaluation research to the impacts of alcohol policies on harms experienced by women and children who are exposed to men who drink alcohol. We also argue for more consideration of a broader range of policies and interventions to reduce these specific types of harm. Finally, we present a conceptual model illustrating how alcohol policies may be supplemented with other interventions specifically tailored to reduce alcohol-related harms commonly experienced by women and children as a result of men's alcohol use.
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Affiliation(s)
| | - Natalie Blackburn
- Center for Health Behavior & Implementation Science, RTI International, Berkeley, CA, USA
| | - Kathryn Graham
- Institute for Mental Health Policy Research, Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, London/Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Mary Jean Walker
- Department of Politics, Media, & Philosophy, La Trobe University, Melbourne, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Centre for Social Research on Alcohol & Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
| | - Ingrid M Wilson
- Health & Social Sciences, Singapore Institute of Technology, Singapore; Judith Lumley Centre, La Trobe University, Australia
| | - Orratai Waleewong
- International Health Policy Program, Ministry of Public Health, Thailand
| | - Gail Gilchrist
- National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Leane Ramsoomar
- Gender & Health Research Unit, South African Medical Research Council, Pretoria, South Africa; School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; School of Public Health & Health Systems, University of the Pretoria, Gauteng, South Africa
| | - Anne-Marie Laslett
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia; Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia
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Kinjo A, Kuwabara Y, Fujii M, Okada T, Shimogawa K, Minobe R, Maesato H, Higuchi S, Osaki Y. Alcohol's harm to others in Japan: Different rates for different relationships to the drinker in a 2018 national survey. Drug Alcohol Rev 2023; 42:456-466. [PMID: 36471634 DOI: 10.1111/dar.13589] [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: 03/31/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION No study in Japan has investigated alcohol's harm to others (AHTO). Therefore, this study aimed to reveal the situation of AHTO in Japan and examine the factors associated with it based on the relationship with the drinker. METHODS A cross-sectional population-based survey was performed in 2018 with 2121 men and 2507 women. Respondents were asked questions about factors such as verbal or physical aggression, being forced to drink alcohol, sexual harassment and their relationship with the drinker. Binomial logistic regression was performed to quantify the associations of AHTO with participants' socio-demographic status and drinking patterns. RESULTS The lifetime experience of AHTO was 24.7% for men and 19.3% for women. AHTO from the father and co-workers were the most common in and outside the home, respectively. The frequency of AHTO from the spouse or co-workers showed no significant difference for abstainers and drinkers. However, AHTO from the father was more commonly reported among drinkers and those with Alcohol Use Disorders Identification Test scores ≥8 points than abstainers. Of those who experienced AHTO, 24.5% of men and 27.6% of women, and 6.1% of men and 12.9% of women were profoundly affected by it in and outside the home, respectively. DISCUSSION AND CONCLUSIONS One in five Japanese residents experienced AHTO in their life, and the characteristics associated with AHTO differed according to the affected individual's relationship with the drinker. Continued monitoring of AHTO and measures aimed at reducing alcohol-related harm that include AHTO should be promoted.
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Affiliation(s)
- Aya Kinjo
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Yuki Kuwabara
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Maya Fujii
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Tomomi Okada
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Ko Shimogawa
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Ruriko Minobe
- National Hospital Organization Kurihama Medical and Addiction Centre, Kanagawa, Japan
| | - Hitoshi Maesato
- National Hospital Organization Kurihama Medical and Addiction Centre, Kanagawa, Japan
| | - Susumu Higuchi
- National Hospital Organization Kurihama Medical and Addiction Centre, Kanagawa, Japan
| | - Yoneatsu Osaki
- Division of Environmental and Preventive Medicine, Department of Social Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
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Gomez R, Brown T, Tullett-Prado D, Stavropoulos V. Co-occurrence of Common Biological and Behavioral Addictions: Using Network Analysis to Identify Central Addictions and Their Associations with Each Other. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-022-00995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
AbstractThe present study used network analysis to examine the network properties (network graph, centrality, and edge weights) comprising ten different types of common addictions (alcohol, cigarette smoking, drug, sex, social media, shopping, exercise, gambling, internet gaming, and internet use) controlling for age and gender effects. Participants (N = 968; males = 64.3%) were adults from the general community, with ages ranging from 18 to 64 years (mean = 29.54 years; SD = 9.36 years). All the participants completed well-standardized questionnaires that together covered the ten addictions. The network findings showed different clusters for substance use and behavioral addictions and exercise. In relation to centrality, the highest value was for internet usage, followed by gaming and then gambling addiction. Concerning edge weights, there was a large effect size association between internet gaming and internet usage; a medium effect size association between internet usage and social media and alcohol and drugs; and several small and negligible effect size associations. Also, only 48.88% of potential edges or associations between addictions were significant. Taken together, these findings must be prioritized in theoretical models of addictions and when planning treatment of co-occurring addictions. Relatedly, as this study is the first to use network analysis to explore the properties of co-occurring addictions, the findings can be considered as providing new contributions to our understanding of the co-occurrence of common addictions.
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Bischof G, Bischof A, Velleman R, Orford J, Kuhnert R, Allen J, Borgward S, Rumpf HJ. Prevalence and self-rated health and depression of family members affected by addictive disorders: results of a nation-wide cross-sectional study. Addiction 2022; 117:3140-3147. [PMID: 35638375 DOI: 10.1111/add.15960] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 05/08/2022] [Indexed: 12/14/2022]
Abstract
AIMS To estimate the prevalence of family members affected by addictive disorders (FMA) with regard to various types of addictive disorders, and self-rated health and depression in the general population. DESIGN Cross-sectional general population survey. SETTING The German Health Update study (GEDA) 2014/2015, a nationally representative panel of German residents aged 15 years or older. PARTICIPANTS A total of 24 824 residents aged 15 years or older. MEASUREMENTS Participants were asked if they had a family member with current or past addictive disorder, the type of addiction and the relationship status. In addition, self-rated health and depression were assessed using standardized questionnaires. FINDINGS Of the respondents, 9.5% [95% confidence interval (CI) = 9.0-10.0] reported being affected by a current addictive disorder of a relative (cFMA), with a further 4.5% (95% CI = 4.2-4.9) reported having been affected by the addictive disorders of a relative in the past but not within the last 12 months (pFMA). Most FMAs reported having been affected by disorders due to alcohol, followed by cannabis and other drugs. Compared with life-time non-FMAs, FMAs reported significantly (P < 0.001) higher odds ratios for depression (cFM = 2.437; 95% CI = 2.082-2.853; pFMA = 1.850; 95% CI = 1.519-2.253) and ill-health (cFMA = 1.574; 95% CI = 1.374-1.805; pFMA = 1.297; 95% CI = 1.082-1.555). CONCLUSIONS In Germany, family members affected by addictive disorder are a substantial group within the general population. This group is characterized by ill-health and has not yet been adequately addressed by the addiction treatment system.
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Affiliation(s)
- Gallus Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Anja Bischof
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Richard Velleman
- Department of Psychology, University of Bath, Bath, UK.,Sangath Community Health, Goa, India
| | - Jim Orford
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Ronny Kuhnert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jennifer Allen
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Stefan Borgward
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Hans-Jürgen Rumpf
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
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9
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Thornburg B, Bray JW, Wittenberg E. Health Utility of Drinkers' Family Members: A Secondary Analysis of a US Population Data Set. MDM Policy Pract 2022; 7:23814683221128507. [PMID: 36187422 PMCID: PMC9520150 DOI: 10.1177/23814683221128507] [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: 12/29/2021] [Accepted: 08/16/2021] [Indexed: 12/03/2022] Open
Abstract
Background. Problematic alcohol use is known to harm individuals surrounding the drinker. This study described the health utility of people who reported having a family member(s) whom they perceived as a "problem drinker."Methods. We conducted a secondary analysis of the US National Epidemiologic Survey of Alcohol and Related Conditions Wave 3 (NESARC-III, 2012-13) data to estimate the independent associations of a family member's problem drinking on the respondent's health utility, also known as health-related quality of life, assessed via the SF-6D. Participants included 29,159 noninstitutionalized adults, of whom 21,808 reported perceiving a family member or members as having a drinking problem at any point in that person's life. Respondent drinking was assessed via self-report and diagnostic interview. We used population-weighted multivariate regression to estimate disutility. Results. After adjusting for the respondent's own alcohol consumption, alcohol use disorder (AUD), family structure, and sociodemographic characteristics, the mean decrement in SF-6D score associated with perceiving a family member as a problem drinker ranged from 0.033 (P < 0.001) for a spouse/partner to 0.023 (P < 0.001) for a grandparent, sibling, aunt, or uncle. The mean decrement in SF-6D score from having AUD oneself was 0.039 (P < 0.001). Conclusions. Perceived problem drinking within one's family is associated with statistically significant losses in health utility, the magnitude of which is dependent on relationship type. The adverse consequences associated with problem drinking in the family may rival having AUD oneself. Implications. Family-oriented approaches to AUD interventions may confer outsize benefits, especially if focused on the spouse or partner. Economic evaluation of alcohol misuse could be made more accurate through the inclusion of family spillover effects. Highlights Spillover effects from problem drinking in the family vary by relationship type.One's perception of their spouse or child as having a drinking problem is associated with a utility decrement of equal magnitude to having alcohol use disorder oneself.Medical decision makers should consider the outsize effects of family spillovers in treatment decisions in the context of alcohol consumption, particularly among spouses and children of problem drinkers.Economic evaluation should consider how to incorporate family spillover effects from problem drinking in alcohol-related models.
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Affiliation(s)
- Benjamin Thornburg
- Benjamin Thornburg, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205-2103, USA; ()
| | - Jeremy W. Bray
- Bryan School of Business and Economics, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Eve Wittenberg
- Harvard TH Chan School of Public Health, Boston, MA, USA
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10
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Stephenson ME, Lönn SL, Salvatore JE, Sundquist J, Kendler KS, Sundquist K, Edwards AC. Sibling alcohol use disorder is associated with increased risk for suicide attempt. Clin Psychol Sci 2022; 10:374-382. [PMID: 35599838 PMCID: PMC9119630 DOI: 10.1177/21677026211025041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The association between having a sibling diagnosed with alcohol use disorder (AUD) and risk for suicide attempt may be attributable to shared genetic liability between AUD and suicidal behavior, effects of environmental exposure to a sibling's AUD, or both. To distinguish between these alternatives, we conducted a series of Cox regression models using data derived from Swedish population-based registers with national coverage. Among full sibling pairs (656,807 males and 607,096 females), we found that proband risk for suicide attempt was significantly elevated when their sibling was affected by AUD, even after accounting for the proband's AUD status. Further, risk for proband suicide attempt was consistently higher when the sibling's AUD registration had occurred more recently. Our findings provide evidence for exposure to sibling AUD as an environmental risk factor for suicide attempt and suggest that clinical outreach may be warranted following a sibling's diagnosis with AUD.
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Affiliation(s)
- Mallory E. Stephenson
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Sara Larsson Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jessica E. Salvatore
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychiatry and School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | | | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychiatry and School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
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Timko C, Grant KM, Han X, Young LB, Cucciare MA. Al-Anon Intensive Referral to facilitate concerned others' participation in Al-Anon Family Groups: a randomized controlled trial. Addiction 2022; 117:590-599. [PMID: 34427006 PMCID: PMC8844037 DOI: 10.1111/add.15670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
Abstract
AIMS To test the effectiveness of an intervention, Al-Anon Intensive Referral (AIR), to facilitate participation in Al-Anon Family Groups (Al-Anon). DESIGN, SETTING AND PARTICIPANTS Multi-site, randomized controlled trial of AIR versus usual care (UC), with follow-up assessments at 3, 6 and 12 months. The 12-month follow-up rate was 74%. Residential alcohol use disorder (AUD) treatment programs in three US locations. Concerned others (COs) of patients in treatment for AUD. COs were mainly women (77%) who were patients' spouses (33%) or parents (25%). INTERVENTION AND COMPARATOR AIR (n = 128) consisted of four sessions over 3 months with an Al-Anon coach. UC (n = 151) was the treatment program's offer of educational sessions for COs. MEASUREMENTS Primary outcome: COs' self-reports of any Al-Anon attendance (yes or no) at 3 months. SECONDARY OUTCOMES number of Al-Anon meetings and the CO-patient relationship (stressors, resources). Potential predictors of outcomes examined in generalized linear mixed models were their baseline value, time, CO-patient relationship type (marital or non-marital), treatment program and condition. FINDINGS There was no effect of condition for the primary outcome (28% in AIR, 21% in UC; Bayes factor = 1.86). Relationship stressors at follow-ups were more severe for COs in a marital relationship with the patient than for COs in a non-marital relationship [β = 2.19, 95% confidence interval (CI) = 1.07, 3.32]. For CO-patient relationship resources at follow-ups, the main effect for condition was significant (β = 1.33, 95% CI = 0.04, 2.61). COs assigned to the AIR condition had more resources than COs who were in the UC condition. CONCLUSIONS Relative to usual care, Al-Anon Intensive Referral was not associated with increases in participation of concerned others in Al-Anon, but was associated with more resources in the concerned other-patient relationship.
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Affiliation(s)
- Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, CA, 94304, USA,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Kathleen M Grant
- Mental Health and Behavioral Science Department, VA Nebraska-Western Iowa Health Care System, Omaha, NE, 68105, USA,Pulmonary Section, Department of Internal Medicine, University of Nebraska Medical Center, 42 and Emile Streets, Omaha, NE, 68198, USA
| | - Xiaotong Han
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA,Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA
| | - Lance Brendan Young
- Department of Communication, Western Illinois University-Quad Cities, 3300 River Drive, Moline, IL, 61265, USA
| | - Michael A Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA,Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, AR 72205, USA,Veterans Affairs South Central Mental Illness Research, Education and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, AR 72205, USA
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Baloh J, Curran GM, Timko C, Grant KM, Cucciare MA. Al-Anon Intensive Referral (AIR): A qualitative formative evaluation for implementation. J Subst Abuse Treat 2022; 132:108520. [PMID: 34111772 PMCID: PMC8636615 DOI: 10.1016/j.jsat.2021.108520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The Al-Anon mutual-help program helps concerned others (COs; e.g., families, friends) of persons with excessive alcohol use. Despite widespread availability of Al-Anon meetings, participation is limited and little is known about how to best facilitate engagement. Al-Anon Intensive Referral (AIR) was developed to facilitate COs' engagement in Al-Anon and is being tested in a randomized controlled trial (RCT). Toward the end of the recruitment for the RCT, a qualitative formative evaluation was conducted to learn about facilitators, barriers, and recommendations for AIR implementation in substance use disorder (SUD) treatment clinics. METHODS Thirty-one directors and staff at ten VA and community SUD clinics were interviewed. Semi-structured interviews were based on the Consolidated Framework for Implementation Research and were thematically analyzed to identify facilitators, barriers, and recommendations for AIR implementation. RESULTS Perceived facilitators of AIR implementation included AIR's face validity, adaptability, and alignment with staff values and skills, requiring only minimal training. Several interviewees in community settings thought AIR would fit with their current practices (e.g., family groups), and some clinics reported having sufficient staff available for delivering AIR. Perceived barriers included limited staff time, and VA clinics having limited resources for providing services to COs. Furthermore, many clients have no COs, or COs who are unwilling or unable to engage with them. Recommendations included fitting AIR within existing workflows and focusing on COs with highest readiness to receive support. Interviewees also thought AIR could be adapted to a website format or smartphone app, which may expand its reach while decreasing staff burden and cost; however, it may not be as effective and appealing to some demographic groups (e.g., older COs). CONCLUSIONS AIR has strong potential for implementation in SUD treatment settings, but clinics vary on implementation capacity. Most clinics could implement AIR partially (e.g., case-by-case basis) while clinics with sufficient capacity (e.g., staff time) could implement it more fully. These findings can also inform implementation of other interventions for concerned others.
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Affiliation(s)
- Jure Baloh
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Corresponding author: Department of Health Policy and Management, College of Public Health, 4301 W. Markham St., Mail slot 820, Little Rock, AR 72205,
| | - Geoffrey M. Curran
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
| | - Christine Timko
- VA Palo Alto Health Care System, Palo Alto, CA, USA,Stanford University School of Medicine, Palo Alto, CA, USA
| | - Kathleen M. Grant
- VA Nebraska-Western Iowa Healthcare System (Omaha), Omaha, NE, USA,University of Nebraska Medical Center, Omaha, NE, USA
| | - Michael A. Cucciare
- University of Arkansas for Medical Sciences, Little Rock, AR, USA,Central Arkansas Veterans Healthcare System, North Little Rock, AR, USA
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Association between Exposure to Alcohol's Harm to Others and Health-Related Quality of Life in Korean Adults: A Nationwide Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052714. [PMID: 33800243 PMCID: PMC7967438 DOI: 10.3390/ijerph18052714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the association between exposure to alcohol's harm to others (AHTO) and health-related quality of life HRQoL using a nationally representative sample. Data from 2016-2018 of 17,346 South Korean individuals aged ≥19 years were obtained from the Korea National Health and Nutrition Examination Survey. HRQoL was evaluated using the European Quality of Life-5 Dimensions (EQ-5D) index. A significant positive association was found between exposure to AHTO and lower EQ-5D scores (p = 0.022). In the final model of multiple regression analysis, participants' HRQoL decreased by 0.932 points when exposed to AHTO (R2 = 36.5%, p < 0.001). In addition, the exposure to AHTO group had significantly higher odds ratios (OR) for pain/discomfort (OR: 1.42, 95% CI: 1.15-1.75) and anxiety/depression (OR: 1.55, 95% CI: 1.68-2.80) compared to the non-AHTO group. Further studies are required for intervention when exposed to reduce the pain/discomfort and anxiety/depression in AHTO victims as well as to reduce the incidence of AHTO.
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Di Sarno M, De Candia V, Rancati F, Madeddu F, Calati R, Di Pierro R. Mental and physical health in family members of substance users: A scoping review. Drug Alcohol Depend 2021; 219:108439. [PMID: 33333362 DOI: 10.1016/j.drugalcdep.2020.108439] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/02/2020] [Accepted: 11/17/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Due to the high pressure they sustain, family members of substance users are thought to experience negative consequences in mental and physical health. This scoping review provided a comprehensive overview on the mental and physical health of adult Affected Family Members (AFMs). METHOD We searched in-journal English articles in PubMed, with no date limit, guided by the concepts of stress, strain, and burden, and including several terms related to substance use. Eligibility criteria included focus on adult AFMs, mental and physical health, and clinical forms of substance use. RESULTS PubMed search identified 3549 articles, with 46 additional papers from other sources. Fifty-six articles were included, quantitative (N = 39), qualitative (N = 15) and both (N = 2). Quantitative findings show that AFMs are subject to increased stress and burden, and impaired mental health. Variable rates of physical problems emerge, with some medical conditions being more common among AFMs of substance users versus controls. Finally, evidence shows increased risk for aggression and reduced quality of life and social adjustment. AFMs report higher stress and strain if they are women, in low socio-economic families, and co-habiting with more severe substance users. Qualitative studies additionally suggest that stigma, self-blame, and social isolation are common. CONCLUSIONS AFMs of substance users represent a population at higher risk for negative health-related outcomes and should be systematically regarded as targets for treatment.
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Affiliation(s)
- Marco Di Sarno
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy.
| | | | - Fabio Rancati
- Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy
| | - Fabio Madeddu
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy; Personality Disorders Lab (PDlab), Parma - Milan, Italy
| | - Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
| | - Rossella Di Pierro
- Department of Psychology, University of Milan-Bicocca, Milan, Italy; Centro per lo studio e la terapia dei disturbi della personalità (C.R.E.S.T), Milan, Italy; Personality Disorders Lab (PDlab), Parma - Milan, Italy
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15
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Karriker-Jaffe KJ, Drabble L, Trocki KF, Hughes TL, Greenfield TK. Harm from Others' Drinking Among Sexual Minority Adults in the United States. LGBT Health 2020; 8:50-59. [PMID: 33337273 DOI: 10.1089/lgbt.2020.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Due to discrimination and stigma, sexual minority adults may be more likely than their heterosexual counterparts to experience harms from other people's drinking. We compared prevalence of second-hand alcohol harms for sexual minority and heterosexual adults in the United States. Methods: Data from the 2014-15 U.S. National Alcohol Survey (n = 5516; 10.2% sexual minority adults) were analyzed using logistic regression with survey weights to account for sampling and nonresponse. Multivariable models included simple main effects of sexual identity on the past-year harm outcomes, as well as interactions of drinker status with sexual identity. Results: In bivariate results stratified by sex, bisexual women were significantly more likely than heterosexual women to report all five types of harms. Lesbian respondents had greater odds relative to heterosexual women of reporting harm by a friend/coworker and assault or physical harm by a drinker. Bisexual identity among men was associated with greater odds of reporting assault/physical harm relative to heterosexual men in bivariate models. In adjusted models, differences by sexual identity were substantially reduced, with significance remaining only for friend/coworker-perpetrated harms and assault/physical harm among lesbian respondents compared with heterosexual women. For assault/physical harm, an interaction of sexual identity with the respondent's own drinking showed that the increased odds of harm associated with heavy drinking was even greater among sexual minority respondents (both bisexual and lesbian/gay respondents) than among heterosexual respondents. Conclusion: These findings underscore the importance of preventive interventions that consider disparities in risk for alcohol-related harms, particularly interpersonal violence, among sexual minority adults in the United States.
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Affiliation(s)
| | - Laurie Drabble
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA.,College of Health and Human Sciences, San Jose State University, San Jose, California, USA
| | - Karen F Trocki
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, New York, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
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16
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Kerr WC, Williams E, Patterson D, Karriker-Jaffe KJ, Greenfield TK. Extending the Harm to Others Paradigm: Comparing Marijuana- and Alcohol-Attributed Harms in Washington State. J Psychoactive Drugs 2020; 53:149-157. [PMID: 33269983 DOI: 10.1080/02791072.2020.1847364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Harms attributed to others' alcohol use have been extensively studied in the US and internationally, but no studies have measured harms from others' marijuana use. We utilize data from five cross-sectional waves of a survey series with representative samples of Washington state residents conducted every 6 months from 2014 to 2016, after the legalization of adult use marijuana. Harms attributed to others' drinking and to others' marijuana use included family and financial problems, assault, harassment, and vandalism experiences, and accidents due to impaired drivers. Past year harms attributed to others' marijuana use were reported by 8.4% of the sample, while 21.3% reported alcohol-attributed harms and 4.3% experienced both. Women were more likely to experience harms from either substance. While heavy drinkers were most likely to experience alcohol harms from others' use, frequent marijuana users reported the least harms from others. About three times as many individuals reported harassment, vandalism, or family problems attributed to someone's alcohol use compared to those harms attributed to someone's marijuana use, with a smaller ratio seen for financial trouble and a wider ratio for physical harm. Harms attributed to other's marijuana use in Washington were found to be substantial, but lower than harms from others' drinking.
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Affiliation(s)
- William C Kerr
- Public Health Institute, Alcohol Research Group, Emeryville, CA, USA
| | - Edwina Williams
- Public Health Institute, Alcohol Research Group, Emeryville, CA, USA
| | - Deidre Patterson
- Public Health Institute, Alcohol Research Group, Emeryville, CA, USA
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de Oliveira JB, Kerr-Corrêa F, Lopes ÍC, Vitti W, Nunes HRDC, Lima MCP. Alcohol use and risk of vehicle accidents: cross-sectional study in the city of São Paulo, Brazil. SAO PAULO MED J 2020; 138:208-215. [PMID: 32491088 PMCID: PMC9671233 DOI: 10.1590/1516-3180.2019.0470.r1.27012020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 01/27/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Harm to other people caused by an individual under the influence of alcohol (UIA) can occur in a variety of relationship situations between the drinker and these other people. OBJECTIVES To estimate the prevalence of the risk of vehicle accidents (RVA) involving people who are UIA, according to sociodemographic variables, respondent alcohol use and gender. DESIGN AND SETTING Cross-sectional study, in which a household survey was carried out on a cluster-stratified representative sample of urban residents in the city of São Paulo. METHODS The final sample was composed of 1,155 subjects aged 18-59 years, who were interviewed using the GENACIS Harm-to-Others questionnaire. Individuals were defined as having been harmed if an affirmative response was given to at least one of the questions that refers to RVA involving people who had been UIA in the last twelve months. Post-stratification weights were calculated to adjust for the study design and for no response. Since the outcome was binary, logistic regression was used in multivariable analysis. RESULTS The final response rate was 58.6%. The overall prevalence of RVA was 13.6% (95% confidence interval, CI 11.0-16.7): 16.6% among men and 10.8% among women. After the logistic regression, age remained as a protective factor (odds ratio, OR 0.95) and binge drinking as a risk factor (OR 2.03). CONCLUSION This study showed that binge drinking was associated with RVA.
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Affiliation(s)
- Janaina Barbosa de Oliveira
- PhD. Psychologist, Centro de Estudos da Educação e da Saúde/Centro Especializado em Reabilitação (CEES/CER II), Universidade Estadual Paulista (UNESP), Marília (SP), Brazil.
| | - Florence Kerr-Corrêa
- PhD. Psychiatrist and Full Professor, Department of Neurology, Psychology and Psychiatry, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu (SP), Brazil.
| | - Ícaro Caresia Lopes
- MSc. Psychologist, Department of Public Health, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu (SP), Brazil.
| | - Walter Vitti
- PhD. Physician and Professor, Department of Public Health, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu (SP), Brazil.
| | - Hélio Rubens de Carvalho Nunes
- PhD. Statistician and Methods and Statistics Consultant, Department of Public Health, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu (SP), Brazil.
| | - Maria Cristina Pereira Lima
- PhD. Psychiatrist and Associate Professor, Department of Neurology, Psychology and Psychiatry, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual Paulista (UNESP), Botucatu (SP), Brazil.
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Nayak MB, Patterson D, Wilsnack SC, Karriker-Jaffe KJ, Greenfield TK. Alcohol's Secondhand Harms in the United States: New Data on Prevalence and Risk Factors. J Stud Alcohol Drugs 2020. [PMID: 31250790 DOI: 10.15288/jsad.2019.80.273] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined a range of indicators of alcohol's harm to others (AHTO) among U.S. adults and assessed sociodemographic and alcohol-related risk factors for AHTO. METHOD The data came from 8,750 adult men and women in two parallel 2015 U.S. national surveys conducted in English and Spanish. Both surveys used computer-assisted telephone interviews and two-stage, stratified, list-assisted, random samples of adults ages 18 and older. RESULTS One in five adults experienced at least one of ten 12-month harms because of someone else's drinking. The prevalence of specific harm types and characteristics differed by gender. Women were more likely to report harm due to drinking by a spouse/partner or family member, whereas men were more likely to report harm due to a stranger's drinking. Being female also predicted family/financial harms. Younger age increased risk for all AHTO types, except physical aggression. Being of Black/other ethnicity, being separated/widowed/divorced, and having a college education without a degree each predicted physical aggression harm. The harmed individual's own heavy drinking and having a heavy drinker in the household increased risk for all AHTO types. The risk for physical aggression due to someone else's drinking was particularly elevated for heavy drinking women. CONCLUSIONS Secondhand effects of alcohol in the United States are substantial and affected by sociodemographics, the harmed individual's own drinking, and the presence of a heavy drinker in the household. Broad-based and targeted public health measures that consider AHTO risk factors are needed to reduce alcohol's secondhand harms.
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Affiliation(s)
- Madhabika B Nayak
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Deidre Patterson
- Alcohol Research Group, Public Health Institute, Emeryville, California
| | - Sharon C Wilsnack
- Department of Psychiatry and Behavioral Science, University of North Dakota, School of Medicine & Health Sciences, Grand Forks, North Dakota
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Trangenstein PJ, Subbaraman MS, Greenfield TK, Mulia N, Kerr WC, Karriker-Jaffe KJ. Association between state-level alcohol availability and taxation policies on the prevalence of alcohol-related harms to persons other than the drinker in the USA, 2000-2015. Drug Alcohol Rev 2020; 39:255-266. [PMID: 32202007 DOI: 10.1111/dar.13041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 01/31/2020] [Accepted: 02/02/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Alcohol-related harms to others (AHTO) are consequences of alcohol use borne by persons other than the drinker. This study assessed whether the odds of experiencing AHTO are associated with alcohol availability and taxation policies. DESIGN AND METHODS This study pooled data from four waves of the National Alcohol Survey (n = 20656 adults). We measured past-year AHTO exposure using three binary variables: physical (pushed/hit/assaulted or property damage by someone who had been drinking), family or financial (family/marital problems or financial harms by someone who had been drinking) and driving AHTO (riding in a vehicle with a drink-driver or being in a drink-driving crash). Policies included bar and off-premise alcohol outlet density (separately), alcohol retail hours, beer and spirits taxes (separately) and monopoly on retail/wholesale alcohol purchases. RESULTS Monopolies were associated with 41.2% lower odds of physical harms [adjusted odds ratio (aOR) = 0.59, 95% confidence interval (CI) 0.45, 0.77, q < 0.001 correcting for multiple analyses], and a 10% increase in bar density was associated with a 1.2% increase in odds of driving-related harms ( e ln(1.1) * β =1.01, 95% CI 1.00, 1.02, q = 0.03). Among men, beer taxes were associated with lower odds of physical harms ( eln(1.1) * β =0.93, 95% CI 0.88, 0.98 q = 0.03) and monopolies were associated with lower odds of physical (aOR = 0.45, 95% CI 0.35, 0.59, q < 0.001) and driving harms (aOR = 0.66, 95% CI 1.00, 1.02, q = 0.03). DISCUSSION AND CONCLUSIONS Monopolies, taxes and outlet density are associated with odds of some AHTO. Future longitudinal research should test whether physical availability and taxation policies may be protective for bystanders as well as drinkers.
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Affiliation(s)
| | | | | | - Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, USA
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Karriker-Jaffe KJ, Tam CC, Cook WK, Greenfield TK, Roberts SC. Gender Equality, Drinking Cultures and Second-Hand Harms from Alcohol in the 50 US States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4619. [PMID: 31766337 PMCID: PMC6926546 DOI: 10.3390/ijerph16234619] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gender inequality and cultures of binge drinking may increase the risk of second-hand harms from alcohol. METHODS Using the 2014-2015 National Alcohol Survey and 2015 National Alcohol's Harm to Others Survey (N = 7792), we examine associations of state-level gender equality measures (contraceptive access, abortion rights, women's economic equality) and binge drinking cultures (rates of men's and women's binge drinking) with individual-level indicators of second-hand harms by drinking strangers and partners/spouses. RESULTS In main effects models, only male binge drinking was associated with greater odds of harms from drinking strangers. There were significant interactions of gender equality with male binge drinking: High male binge drinking rates were more strongly associated with stranger-perpetrated harms in states low on contraceptive access or abortion rights compared to states high on these measures. Conversely, male binge drinking was more strongly associated with spouse/partner-perpetrated second-hand harms in states with more economic equality, compared to states lower on this measure. CONCLUSIONS Detrimental effects of high male binge drinking rates may be modified by gender equality. Targeted interventions may reduce alcohol-related harms experienced by women in states with high rates of male binge drinking. Restrictions in access to contraception and abortion may exacerbate harms due to men's drinking.
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Affiliation(s)
| | - Christina C. Tam
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA; (C.C.T.); (W.K.C.); (T.K.G.)
| | - Won Kim Cook
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA; (C.C.T.); (W.K.C.); (T.K.G.)
| | - Thomas K. Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608, USA; (C.C.T.); (W.K.C.); (T.K.G.)
| | - Sarah C.M. Roberts
- Advancing New Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, Oakland, CA 94612, USA;
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Moan IS, Bye EK, Storvoll EE, Lund IO. Self-reported harm from others' alcohol, cigarette and illegal drug use in Norway. NORDIC STUDIES ON ALCOHOL AND DRUGS 2019; 36:413-429. [PMID: 32934576 PMCID: PMC7434141 DOI: 10.1177/1455072519836372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 02/14/2019] [Indexed: 11/25/2022] Open
Abstract
AIMS While it is documented that substance use harms others than the user, less is known about which substances people experience most harm from, and who the victims and perpetrators are. The aims were: (i) to estimate the prevalence of and overlap in self-reported harm from others' alcohol, cigarette, and illegal drug use; (ii) to examine potential differences in the prevalence of harm from close relations' and strangers' use; and (iii) to examine how the prevalence of harm varies according to demographics and the respondents' substance use. METHODS Population surveys conducted among 16-64-year-old Norwegians in 2012 and 2016 (N = 3407) assessed self-reported harm from others' alcohol, cigarette and illegal drug use with identical measures, demographic variables and the respondents' substance use. RESULTS Experience of harm from others' alcohol use was most common, followed by others' smoking. For all three substances, a higher proportion experienced harm from close relations' use. Nearly half had experienced harm from others' use of at least one substance. Women and younger participants were more likely to report harm from others' alcohol and cigarette use. While alcohol and illegal drug users were more often harmed by others' use of these substances, smokers reported being less often harmed by others' smoking. CONCLUSIONS Self-reported harm from others' alcohol, cigarette and illegal drug use corresponds with the prevalence of use of these substances in Norway. For all three substances, close relations' use accounted for more harm than strangers' use. Own substance use was an important correlate of experienced harm.
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Affiliation(s)
- Inger Synnøve Moan
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Norway
| | - Elin K Bye
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Norway
| | - Elisabet E Storvoll
- Norwegian Institute of Public Health, Division of Mental and Physical Health, Norway
| | - Ingunn Olea Lund
- Norwegian Institute of Public Health, Department of Mental Disorders, Norway
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Timko C, Grant KM, Cucciare MA. Functioning of Concerned Others When Adults Enter Treatment for an Alcohol Use Disorder. Alcohol Clin Exp Res 2019; 43:1986-1993. [PMID: 31335974 DOI: 10.1111/acer.14153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Poor functioning among Concerned Others (COs; family and friends of an individual with an alcohol or other substance use disorder) is a significant public health problem. The purpose of this study was to inform interventions for COs by examining potential correlates of 3 aspects of functioning: quality of life, mental health, and knowledge of how to handle problems related to their drinker. METHODS This study collected data from 277 COs when their friend or family member (their "drinker") was entering treatment for an alcohol use disorder. Potential correlates were the drinker's substance use severity, the CO-drinker relationship and communication, and COs' coping and perceived stigma related to involvement with their drinker. RESULTS In a summary analysis, only stressors in the CO-drinker relationship (the drinker's criticism, disagreement, anger, and demands) were consistently associated with poorer functioning as indicated by COs' poorer quality of life and mental health. In contrast, only COs' use of approach coping was associated with COs' knowing how to handle problems related to the drinker. CONCLUSIONS Because reducing both relationship stressors and the link between stressors and poor functioning can be achieved through CO and drinker education and intervention, these findings inform how to effectively support COs' goals for better functioning.
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Affiliation(s)
- Christine Timko
- Center for Innovation to Implementation, Department of Veterans Affairs Health Care System, Palo Alto, California.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California
| | - Kathleen M Grant
- Mental Health and Behavioral Science Department, VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska.,Pulmonary Section, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska
| | - Michael A Cucciare
- Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Affairs Healthcare System, North Little Rock, Arkansas.,Veterans Affairs South Central Mental Illness Research, Education, and Clinical Center, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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23
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Greenfield TK, Cook WK, Karriker-Jaffe KJ, Patterson D, Kerr WC, Xuan Z, Naimi TS. The Relationship Between the U.S. State Alcohol Policy Environment and Individuals' Experience of Secondhand Effects: Alcohol Harms Due to Others' Drinking. Alcohol Clin Exp Res 2019; 43:1234-1243. [PMID: 31166048 PMCID: PMC6553486 DOI: 10.1111/acer.14054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 04/05/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although restrictive state alcohol policy environments are protective for individuals' binge drinking, research is sparse on the effect of alcohol policies on alcohol's harms to others (AHTO). We examined the lagged associations between efficacy of U.S. state alcohol policies and number of harms from others' drinking 1 year later. METHODS Individuals with AHTO data in a nationally representative sample of U.S. adults (analytic sample n = 26,744) that pooled the 2000, 2005, 2010, and 2015 National Alcohol Surveys and a 2015 National Alcohol's Harm to Others Survey were linked with prior-year state policy measures. We used 2 measures from the Alcohol Policy Scale (APS)-effectiveness in reducing (i) binge drinking and (ii) impaired driving, based on experts' efficacy judgments regarding 29 state alcohol policies. Three 12-month AHTO measures (due to another drinker) were experiencing: (i) either family/marriage difficulties or financial troubles; (ii) being assaulted or vandalized; and (iii) passenger with drunk driver or traffic accident. Multilevel models accounting for clustering within states and stratified by age-groups (<40 vs. ≥40) examined associations between the APS and AHTO measures, controlling for individual covariates (gender, race, education, employment and marital status, family problem-drinking history) of the victim. RESULTS Only for those aged <40, the lagged APS-Binge drinking and APS-Impaired driving scores were each inversely associated with aggression-related harms and, separately, with drunk driving-related harm from someone else's drinking (ps < 0.05 to < 0.01). Family/financial harms were not associated with APS scores for either age-group. Composite AHTO measures (any of 3 harm-types) also were inversely associated with stronger state alcohol policy environments (ps < 0.05 to <0.01). CONCLUSIONS State alcohol policies may be effective in reducing, to a meaningful degree, aggression-related harms and vehicular hazards due to other drinkers, but mainly in those under 40.
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Affiliation(s)
| | - Won K. Cook
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | | | - Deidre Patterson
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | - William C. Kerr
- Public Health Institute, Alcohol Research Group, Emeryville California USA
| | - Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Timothy S. Naimi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, USA
- Clinical Addiction Research & Education Unit, Section of General Internal Medicine, Boston Medical Center, Boston, Massachusetts, USA
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24
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Wilsnack SC, Greenfield TK, Bloomfield K. The GENAHTO Project (Gender and Alcohol's Harm to Others): Design and methods for a multinational study of alcohol's harm to persons other than the drinker. INTERNATIONAL JOURNAL OF ALCOHOL AND DRUG RESEARCH 2018; 7:37-47. [PMID: 30740190 PMCID: PMC6366670 DOI: 10.7895/ijadr.253] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIMS Most alcohol research has focused on how drinking harms the drinker. Research on alcohol's harms to others (AHTO) has studied primarily single or small groups of countries. This article describes the methodology of a new multinational study - GENAHTO - of how social and cultural contexts are related to AHTO, from the perspectives of both perpetrators and victims. DESIGN The GENAHTO Project uses surveys in 21 countries that provide data from drinkers who report causing harms to others, and surveys in 16 countries that provide data from victims of AHTO. The countries surveyed vary widely in alcohol policies, drinking cultures, gender-role definitions, and socioeconomic conditions. PARTICIPANTS More than 140,000 men and women, aged 15-84, participated in the surveys. MEASURES Individual-level measures include demographics, alcohol use patterns, and alcohol-related harms. Regional- and societal-level measures include socioeconomic conditions, drinking patterns, alcohol policies, gender inequality, and income inequality. FINDINGS The project seeks to identify characteristics of AHTO victims and perpetrators; within-country regional differences in AHTO; and associations between national alcohol polices and individual and regional levels of AHTO. CONCLUSIONS GENAHTO is the first project to assess AHTO in diverse societies. Its findings can inform policies to abate AHTO in varying cultural contexts.
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Affiliation(s)
- Sharon C Wilsnack
- University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
| | | | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
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