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Lam J, Garcia J. Daily activities of older adults before and during the COVID pandemic. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae076. [PMID: 39041598 PMCID: PMC11264048 DOI: 10.1093/geronb/gbae076] [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: 02/13/2023] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES This study examines how older adults' (65 years old plus) daily activities shifted in the years around the coronavirus disease (COVID) pandemic. METHODS Using data from American Time Use Survey, this study compares activities across the pre-pandemic (2019 to March 2020), early-pandemic (May to December 2020), and pandemic-normal (2021) periods. RESULTS In the first year of the pandemic, there was less time spent on average on leisure outside the home, traveling, and with nonhousehold members, and more time alone and at home, compared with before the pandemic. Moving beyond averages, sequence and cluster analyses find 5 similar typologies of days across the three periods, characterized by days predominated by (a) housework, (b) leisure at home, (c) TV, (d) a combination of leisure at home and outside with TV, and (e) paid work. Duration of time across various daily activities differed, however, even for the same clusters. For example, in days predominated by indoor leisure, adults spent 405 min in this activity before the pandemic, 432 min during the early-pandemic period, and 549 min during the pandemic-normal period. We also observed changes in the proportion of older adults in each cluster. Across the pre-pandemic and early-pandemic periods, the proportion of days predominated by leisure at home increased (9.9%-17.9%) whereas the proportion belonging to days predominated by housework decreased (45.7%-17.6%). DISCUSSION COVID-19 shifted the daily life of older adults, and our findings are consistent with selection, optimization, and compensation theory, documenting that older adult adapted across the first 2 years of the pandemic.
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Affiliation(s)
- Jack Lam
- Discipline of Sociology, School of Social and Political Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia
| | - Joan Garcia
- Centre d’Estudis Demogràfics, Bellaterra, Catalonia, Spain
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2
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Mellinger JL, Winder GS, Fernandez AC, Asefah H, Zikmund-Fisher BJ. Critical misconceptions and knowledge gaps regarding alcohol cessation and risk of relapse in alcohol-related liver disease patients: A qualitative mental models study. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209292. [PMID: 38364995 DOI: 10.1016/j.josat.2024.209292] [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: 05/05/2023] [Revised: 09/27/2023] [Accepted: 01/11/2024] [Indexed: 02/18/2024]
Abstract
INTRODUCTION Despite the mortality benefits of alcohol cessation and alcohol treatment, few patients with alcohol-related liver disease (ALD) get such treatment. To understand reasons for low treatment rates, we performed a qualitative mental models study to explore how ALD patients understand factors influencing alcohol cessation, relapse and their liver health. METHODS Using a mental models framework, we interviewed experts in alcohol use disorder (AUD) and ALD to determine factors influencing alcohol cessation, risk of relapse and liver health. An expert influence diagram was constructed and used to develop a patient interview guide. We recruited participants with ALD enrolled in hepatology or transplant clinics at a single tertiary-care center. We conducted interviews either face-to-face or by phone, per participant preference. We transcribed all interviews verbatim and analyzed them using combined deductive coding schema based on both the interview guide and emergent coding. RESULTS 25 (10 women, 15 men) participants with a mean age of 57 years completed interviews. 68 % had decompensated cirrhosis. Major omissions included gender (as a factor in alcohol use or liver disease) and the influence of benzodiazepines/opioids on relapse. Misconceptions were common, in particular the idea that the absence of urges to drink meant participants were safe from relapse. Conceptual differences from the expert model emerged as well. Participants tended to view the self as primary and the only thing that could influence relapse in many cases, resulting in a linear mental model with few nodes influencing alcohol cessation. Participants' risky drinking signals (i.e., elevated liver enzymes) differed from known definitions of hazardous or high-risk drinking, which largely emphasize dose of alcohol consumed irrespective of consequences. Finally, participants sometimes viewed stopping on one's own as the primary means of stopping alcohol use, not recognizing the many other nodes in the influence diagram impacting ability to stop alcohol. CONCLUSION Patients with ALD had critical misconceptions, omissions, and conceptual reorganizations in their mental models of the ability to stop alcohol use. Attention to these differences may allow clinicians and researchers to craft more impactful interventions to improve rates of alcohol abstinence and AUD treatment engagement.
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Affiliation(s)
- Jessica L Mellinger
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States of America; Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, United States of America.
| | - Gerald Scott Winder
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, United States of America; University of Michigan Department of Surgery, Michigan Medicine, Ann Arbor, MI, United States of America; University of Michigan Department of Neurology, Michigan Medicine, Ann Arbor, MI, United States of America
| | - Anne C Fernandez
- Department of Psychiatry, Michigan Medicine, Ann Arbor, MI, United States of America; University of Michigan Addiction Treatment Service, Michigan Medicine, Ann Arbor, MI, United States of America
| | - Haila Asefah
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States of America
| | - Brian J Zikmund-Fisher
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, United States of America; Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
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Tang Y, Kirk B, Olanrewaju F, Abildso CG, Winstanley EL, Lilly CL, Rudisill TM. Cannabis use among adolescents and young adults during the COVID-19 pandemic: A systematic review. DRUG AND ALCOHOL DEPENDENCE REPORTS 2024; 11:100232. [PMID: 38682152 PMCID: PMC11053264 DOI: 10.1016/j.dadr.2024.100232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 05/01/2024]
Abstract
Background A systematic review of the literature was performed to summarize cannabis use among adolescents and young adults during the COVID-19 pandemic. Special focus was given to the prevalence of cannabis use during COVID-19, as well as factors that may explain changes in cannabis consumption patterns. Methods The protocol of this systematic review was registered. Articles from seven publication databases were searched in January 2022. The inclusion criteria for studies were as follows: 1) published in English; 2) study instruments needed to include items on COVID-19; 3) conducted after January 1st, 2020; 4) published in a peer-reviewed journal, dissertation, or thesis; 5) study population ≤25 years of age; 6) study designs were limited to observational analytical studies; 7) measured cannabis use. This review excluded other reviews, editorials, and conference abstracts that were not available as full text manuscripts. Independent review, risk of bias assessment, and data abstraction were performed by two authors. Results Fifteen articles from the United States (n=11) and Canada (n=4) were included in this review. The findings of this review showed that the prevalence of cannabis use during the pandemic among adolescents and young adults were mixed. Some mental health symptoms, including depression and anxiety, were identified as the most commonly reported reasons for increased cannabis use during the pandemic. Conclusions This review highlights the inconsistencies in the prevalence of cannabis use among adolescents and young adults during the pandemic. Therapeutic interventions for mental health and continued public health surveillance should be conducted to understand the long-term effects of cannabis use among adolescents and young adults.
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Affiliation(s)
- Yuni Tang
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Brenna Kirk
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Folawiyo Olanrewaju
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Christiaan G. Abildso
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Erin L. Winstanley
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Christa L. Lilly
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States
| | - Toni M. Rudisill
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, United States
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Minami M, Miyauchi M, Eitoku M, Morizane A, Kawauchi A, Kidokoro K, Suganuma N, Nishiyama K. Comparison of emergency transport for acute alcohol intoxication before and after the coronavirus disease 2019 pandemic: A retrospective observational study. Alcohol 2024; 116:21-27. [PMID: 37739324 DOI: 10.1016/j.alcohol.2023.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 09/24/2023]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic has had a broad effect on social, economic, educational, and political systems. We investigated the effect of COVID-19 on emergency transportation due to acute alcohol intoxication in the Kochi Prefecture in Japan, a region with high alcohol consumption. This retrospective observational study was conducted using the data of 62,138 patients from the Kochi-Iryo-Net database, Kochi Prefecture's emergency medical and wide-area disaster information system. Chi-square tests and multiple logistic regression analyses were performed to examine the association between emergency transportation and alcohol intoxication. This analysis compared the monthly number of transportations during 2019 (as reference) with that throughout 2020 and 2021. Approximately 1.5 % of all emergency transportation cases were related to acute alcohol intoxication. The number of emergency transportation cases due to acute alcohol intoxication declined by 0.5 % in 2020 and 0.7 % in 2021 compared with that in 2019. Moreover, compared with that in 2019, the number of cases of emergency transportation due to acute alcohol intoxication significantly decreased in 2020 (incidence rate ratio: 0.78; 95 % confidence interval: 0.67-0.91) and 2021 (incidence rate ratio: 0.73; 95 % confidence interval: 0.63-0.86). Lifestyle changes due to the COVID-19 pandemic affected the number of emergency transports due to acute alcohol intoxication in 2020 and 2021 (during the COVID-19 pandemic) compared to that in 2019 (before the pandemic).
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Affiliation(s)
- Marina Minami
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan; Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
| | - Masato Miyauchi
- Department of Disaster and Emergency Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan.
| | - Masamitsu Eitoku
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan.
| | - Atsushi Morizane
- Emergency and Critical Care Center, Kochi Health Sciences Center, Kochi City, Kochi 781-8555, Japan.
| | - Atsufumi Kawauchi
- Department of Health Policy, Kochi Prefectural Government, Kochi City, Kochi 780-8570, Japan.
| | - Kazumoto Kidokoro
- Department of Disaster and Emergency Medicine, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
| | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan.
| | - Kingo Nishiyama
- Department of Disaster and Emergency Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan.
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Quanbeck A, Chih MY, Park L, Li X, Xie Q, Pulvermacher A, Voelker S, Lundwall R, Eby K, Barrett B, Brown R. Testing support models for implementing an evidence-based digital intervention for alcohol use disorder: results of a pragmatic hybrid implementation-effectiveness trial. RESEARCH SQUARE 2024:rs.3.rs-4004555. [PMID: 38585768 PMCID: PMC10996781 DOI: 10.21203/rs.3.rs-4004555/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
This paper reports results of a hybrid effectiveness-implementation randomized trial that systematically varied levels of human oversight required to support implementation of a digital medicine intervention for persons with mild to moderate alcohol use disorder (AUD). Participants were randomly assigned to three groups representing possible digital health support models within a health system: self-monitored use (n = 185), peer-supported use (n = 186), or a clinically integrated model (n = 187). Across all three groups, percentage of risky drinking days dropped from 38.4% at baseline (95%CI [35.8%, 41%]) to 22.5% (19.5%, 25.5%) at 12 months. The clinically integrated group showed significant improvements in mental health quality of life compared to the self-monitoring group (p = 0.011). However, higher rates of attrition in the clinically integrated group warrants consideration in interpreting this result. Results suggest that making a self-guided digital intervention available to patients may be a viable option for health systems looking to promote alcohol risk reduction.
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Ghai MB, Rangan P, Alkhouri N, Mellinger J, Wijarnpreecha K. THE TRENDS AND INCIDENCE OF ALCOHOL-ASSOCIATED HEPATITIS HOSPITALIZATIONS FROM 2016-2020 AND THE IMPACT OF THE COVID-19 PANDEMIC. Alcohol 2024:S0741-8329(24)00039-9. [PMID: 38460710 DOI: 10.1016/j.alcohol.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION The impact of the COVID-19 pandemic on hospitalizations for alcohol-associated hepatitis (AH) is poorly understood. Here we explore AH trends from 2016-2020 and evaluate demographic disparities including sex and race. METHODS A retrospective analysis of the 2016-2020 Healthcare Cost and Utilization Project National Inpatient Sample was performed to assess temporal trends in hospitalizations for AH. The 2020 dataset was evaluated to compare AH hospitalizations between those with and without an additional diagnosis of COVID-19. RESULTS Included were 607,140 weighted inpatient AH discharges per 145,055,152 all-cause discharges from 2016-2020. AH hospitalizations increased at a rate of 23.4 hospitalizations per 100,000 all-cause discharges per year between 2016-2019 and increased to 113 hospitalizations per 100,000 all-cause discharges in 2020. Mortality was higher in females despite lower rates of hospitalization than males. The adjusted odds of hospitalization for AH in 2020 were higher than in 2016-2019 (aOR= 1.28, p < 0.001). The Hispanic population had greater odds of hospitalization with AH and COVID-19 compared to other races (aOR= 2.71, p <0.001). DISCUSSION Increased efforts toward primary prevention of excessive alcohol use and greater social support for those with alcohol used disorder are needed. More research is required to elucidate the racial disparities among the Hispanic population with AH and COVID-19.
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Affiliation(s)
- Megan B Ghai
- University of Arizona College of Medicine- Phoenix, Department of Internal Medicine.
| | - Pooja Rangan
- University of Arizona College of Medicine- Phoenix, Department of Internal Medicine
| | | | - Jessica Mellinger
- University of Michigan Medical School, Department of Internal Medicine, Division of Gastroenterology & Hepatology
| | - Karn Wijarnpreecha
- University of Arizona College of Medicine- Phoenix, Department of Internal Medicine, Division of Gastroenterology & Hepatology
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Lin TW, Richman JA, Johnson TP, Rospenda KM. Lingering Effects of COVID-19 Stressors on Mental Health and Alcohol Use in Middle Aged to Older Adults. AGING AND HEALTH RESEARCH 2024; 4:100178. [PMID: 38469172 PMCID: PMC10927003 DOI: 10.1016/j.ahr.2023.100178] [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] [Indexed: 03/13/2024] Open
Abstract
Background Older adults have faced not only health threats but grave mental health challenges since the emergence of the Coronavirus disease 2019 (COVID-19) pandemic. Using factor analysis, this study is the first to identify the underlying dimensions of COVID-19-related stressors, then examine the relationship between these factors and mental health and alcohol use/misuse longitudinally in a middle aged to older adult sample in the United States. Methods As part of a long-term follow-up study, 921 survey participants completed measures of COVID-related stressors, psychological distress, and alcohol use/misuse in a 2020 survey. An exploratory factor analysis was conducted to examine the dimensionality of COVID-related stress. Regression models were utilized to examine relationships between the extracted factors and depression, anxiety, and alcohol-related outcomes measured approximately one year later, in 2021. Results Four dimensions of COVID-19 stressors were extracted, including 1) jobs, finances and loss of routine; 2) practical difficulties; 3) social worries and challenges; and 4) supply shortages. Practical difficulties were associated with higher depression at follow-up, while jobs, finances and loss of routine were associated with past 12 month frequency of intoxication at follow-up. Conclusions Challenges from the pandemic may have longer-term implications for mental health in older adults past the acute phase of the pandemic. It is important to allocate sufficient attention and resources to the prevention of late life depression and mental health as policymakers and health professionals continue to deal with the pandemic and future variants of the virus.
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Affiliation(s)
- Tracy W. Lin
- Department of Psychiatry (MC 912), 1601 W. Taylor St., 5th Floor, University of Illinois at Chicago, Chicago, Illinois
| | - Judith A. Richman
- Department of Psychiatry (MC 912), 1601 W. Taylor St., 4th Floor, University of Illinois at Chicago, Chicago, Illinois
| | - Timothy P. Johnson
- Department of Psychiatry (MC 912), 1601 W. Taylor St., 4th Floor, University of Illinois at Chicago, Chicago, Illinois
| | - Kathleen M. Rospenda
- Department of Psychiatry (MC 912), 1601 W. Taylor St., 4th Floor, University of Illinois at Chicago, Chicago, Illinois
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Waddell JT, King SE, Okey SA, Corbin WR. Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:8-18. [PMID: 35834201 PMCID: PMC9839898 DOI: 10.1037/adb0000866] [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] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Decades of research has found support for the motivational model of alcohol use, such that positive/negative affect are indirectly associated with drinking behavior through drinking motives. However, research on event-level drinking motives is in its nascent stage, and studies have yet to consider how drinking context plays a role in the motivational pathway to both event- and person-level drinking behavior. Therefore, the present study seeks to test whether drinking context mediates the effect of affect and motivation on drinking outcomes at both the event- and person-level. METHOD Data for this Stage 1 Registered Report will come from a recently completed ecological momentary assessment (EMA) study in emerging adults. The study collected data on 131 emerging adults, of whom 107 reported event-level social and solitary drinking during the EMA period. Multilevel structural equation modeling will be used to test whether predrinking affect is associated with predrinking motives, and whether drinking context (social vs. solitary drinking) mediates the effect of drinking motives on drinking outcomes. Models will parse within-/between-person variance, allowing the present study to test whether drinking context serves as a mechanism of risk in the motivational model at the event-level, or solely at the between-person level. Findings will inform personalized interventions and motivational models of drinking behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Russell JA. Innocent bystanders: effects of the COVID-19 pandemic on non-COVID-19 critical illness outcomes. Thorax 2024; 79:101-103. [PMID: 38050148 DOI: 10.1136/thorax-2023-220431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 12/06/2023]
Affiliation(s)
- James A Russell
- Division of Critical Care Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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Haucke M, Heinzel S, Liu S. Involuntary social isolation and alcohol consumption: an ecological momentary assessment in Germany amid the COVID-19 pandemic. Alcohol Alcohol 2024; 59:agad069. [PMID: 37934974 DOI: 10.1093/alcalc/agad069] [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: 05/05/2023] [Revised: 09/05/2023] [Accepted: 09/28/2023] [Indexed: 11/09/2023] Open
Abstract
AIMS Alcohol consumption often occurs in a social setting, which was affected by social distancing measures amid the coronavirus disease-2019 (COVID-19) pandemic. In this study, we examine how involuntary social isolation (i.e. comparing a no-lockdown stage with a lockdown stage) affects the association between loneliness, social activities, and drinking behavior. METHOD We performed an ecological momentary assessment eight times per day for 7 days amid the COVID-19 pandemic in Germany. We recruited 280 participants and assessed their trait loneliness, daily state loneliness, social activities, and drinking behaviors. RESULTS We found that a lockdown condition moderates the association between trait and daily state loneliness and alcohol consumption. During a lockdown stage, trait loneliness was positively associated, whereas state loneliness was negatively associated with alcohol consumption. During a no-lockdown stage, trait and state loneliness were both negatively associated with alcohol consumption. For both no-lockdown and lockdown stages, duration of social interaction, male gender, and weekends was positively associated with alcohol consumption. CONCLUSION Our study suggests that an involuntary social isolation condition (i.e. a lockdown stage) changes how trait loneliness is associated with alcohol consumption.
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Affiliation(s)
- Matthias Haucke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin (Campus Charité Mitte), Berlin 10117, Germany
| | - Stephan Heinzel
- Institute of Psychology, Department of Educational Sciences and Psychology, TU Dortmund University, Dortmund 44227, Germany
| | - Shuyan Liu
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin (Campus Charité Mitte), Berlin 10117, Germany
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Veldhuis CB, Kreski NT, Usseglio J, Keyes KM. Are Cisgender Women and Transgender and Nonbinary People Drinking More During the COVID-19 Pandemic? It Depends. Alcohol Res 2023; 43:05. [PMID: 38170029 PMCID: PMC10760999 DOI: 10.35946/arcr.v43.1.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
PURPOSE This narrative review of research conducted during the first 2 years of the COVID-19 pandemic examines whether alcohol use among cisgender women and transgender and nonbinary people increased during the pandemic. The overarching goal of the review is to inform intervention and prevention efforts to halt the narrowing of gender-related differences in alcohol use. SEARCH METHODS Eight databases (PubMed, APA PsycInfo, CINAHL, Embase, Scopus, Gender Studies Database, GenderWatch, and Web of Science) were searched for peer-reviewed literature, published between March 2020 and July 2022, that reported gender differences or findings specific to women, transgender or nonbinary people, and alcohol use during the pandemic. The search focused on studies conducted in the United States and excluded qualitative research. SEARCH RESULTS A total 4,132 records were identified, including 400 duplicates. Of the remaining 3,732 unique records for consideration in the review, 51 were ultimately included. Overall, most studies found increases in alcohol use as well as gender differences in alcohol use, with cisgender women experiencing the most serious consequences. The findings for transgender and nonbinary people were equivocal due to the dearth of research and because many studies aggregated across gender. DISCUSSION AND CONCLUSIONS Alcohol use by cisgender women seems to have increased during the pandemic; however, sizable limitations need to be considered, particularly the low number of studies on alcohol use during the pandemic that analyzed gender differences. This is of concern as gender differences in alcohol use had been narrowing before the pandemic; and this review suggests the gap has narrowed even further. Cisgender women and transgender and nonbinary people have experienced sizable stressors during the pandemic; thus, understanding the health and health behavior impacts of these stressors is critical to preventing the worsening of problematic alcohol use.
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Affiliation(s)
- Cindy B Veldhuis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois
| | - Noah T Kreski
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Usseglio
- Augustus C. Long Health Sciences Library, Columbia Irving Medical Center, Columbia University, New York, New York
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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Park LS, Kornfield R, Yezihalem M, Quanbeck A, Mellinger J, German M. Testing a Digital Health App for Patients With Alcohol-Associated Liver Disease: Mixed Methods Usability Study. JMIR Form Res 2023; 7:e47404. [PMID: 37966869 PMCID: PMC10687677 DOI: 10.2196/47404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 09/25/2023] [Accepted: 09/27/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Alcohol-associated liver disease (ALD) is increasingly common and associated with serious and costly health consequences. Cessation of drinking can improve ALD morbidity and mortality; however, support for cessation is not routinely offered to those diagnosed with ALD, and continued drinking or resumption of drinking after diagnosis is common. Mobile health (mHealth) has the potential to offer convenient and scalable support for alcohol cessation to those diagnosed with ALD, but mHealth interventions for alcohol cessation have not been designed for or evaluated in a population with ALD. OBJECTIVE This study aims to understand how individuals with ALD would perceive and use an mHealth tool for alcohol cessation and to gather their perspectives on potential refinements to the tool that would allow it to better meet their needs. METHODS We interviewed 11 individuals who attended clinic visits related to their ALD to elicit their needs related to support for alcohol cessation and views on how mHealth could be applied. After completing initial interviews (pre), participants were provided with access to an mHealth app designed for alcohol cessation, which they used for 1 month. Afterward, they were interviewed again (post) to give feedback on their experiences, including aspects of the app that met their needs and potential refinements. We applied a mixed methods approach, including a qualitative analysis to identify major themes from the interview transcripts and descriptive analyses of use of the app over 1 month. RESULTS First, we found that a diagnosis of ALD is perceived as a motivator to quit drinking but that patients had difficulty processing the overwhelming amount of information about ALD they received and finding resources for cessation of alcohol use. Second, we found that the app was perceived as usable and useful for supporting drinking recovery, with patients responding favorably to the self-tracking and motivational components of the app. Finally, patients identified areas in which the app could be adapted to meet the needs of patients with ALD, such as providing information on the medical implications of an ALD diagnosis and how to care for their liver as well as connecting individuals with ALD to one another via a peer-to-peer support forum. Rates of app use were high and sustained across the entire study, with participants using the app a little more than half the days during the study on average and with 100% (11/11) of participants logging in each week. CONCLUSIONS Our results highlight the need for convenient access to resources for alcohol cessation after ALD diagnosis and support the potential of an mHealth approach to integrate recovery support into care for ALD. Our findings also highlight the ways the alcohol cessation app should be modified to address ALD-specific concerns.
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Affiliation(s)
- Linda S Park
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rachel Kornfield
- Preventive Medicine (Behavioral Medicine), Feinberg School of Medicine, Northwestern University, Evanston, IL, United States
| | | | - Andrew Quanbeck
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Jessica Mellinger
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
| | - Margarita German
- Department of Medicine, Division of Gastroenterology and Hepatology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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Choi KW, Waite LJ, Finch LE, Kotwal AA. Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic. J Gerontol B Psychol Sci Soc Sci 2023; 78:1903-1916. [PMID: 37591797 PMCID: PMC10645306 DOI: 10.1093/geronb/gbad122] [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: 09/15/2022] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVES We examine the relationship between social isolation, poor health behaviors, and the perceived worsening of older adults' health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors. METHODS Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its coronavirus immune disease 2019 (COVID-19) substudy (2020; N = 2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic-infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started-are associated with (1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and (2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started. RESULTS Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and a decrease in in-person contact with friends, and to a lesser extent, with family. DISCUSSION Our study suggests that in-person contact may play a distinct role in shaping older adults' well-being during the pandemic.
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Affiliation(s)
- Kyung Won Choi
- Department of Sociology, University of Chicago, Chicago, Illinois, USA
| | - Linda J Waite
- Department of Sociology, University of Chicago, Chicago, Illinois, USA
- Academic Research Centers, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Laura E Finch
- Academic Research Centers, NORC at the University of Chicago, Chicago, Illinois, USA
| | - Ashwin A Kotwal
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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Phillips AZ, Carnethon MR, Bonham M, Lovett RM, Wolf MS. Hazardous drinking by older adults with chronic conditions during the COVID-19 pandemic: Evidence from a Chicago-based cohort. J Am Geriatr Soc 2023; 71:3508-3519. [PMID: 37403969 PMCID: PMC10766865 DOI: 10.1111/jgs.18497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND It is unclear how older adults with chronic conditions, who have greater risk of alcohol-related adverse outcomes, used alcohol throughout the COVID-19 pandemic. We assess changes in hazardous drinking prevalence May 2020-December 2021 and factors associated with hazardous drinking. METHODS Data are from structured phone interviews of older adults (age 60+) with chronic conditions (e.g., hypertension, diabetes, pulmonary disease, heart disease) in a Chicago-based longitudinal cohort (Chicago COVID-19 Comorbidities survey, Waves 3-7, n = 247). We tested differences in the prevalence of hazardous drinking (defined as AUDIT-C score of 3+ for women and 4+ for men) across waves for the full sample, by demographic group (sex, race, and ethnicity), and by chronic condition burden (<3 conditions, 3+ conditions). Generalized estimating equations investigated associations of hazardous drinking with sociodemographic and pandemic coping-related factors (stress, loneliness, outside contacts, depression, anxiety). RESULTS Participants were 66.8% female; 27.9% non-Hispanic Black, 14.2% Hispanic, 4.9% other race. Hazardous drinking was reported by 44.9% of participants in May 2020, but declined to 23.1% by July-August 2020 and continued to slowly decline to 19.4% by September-December 2021. Differences from May 2020 were significant at the 0.05 level. Subgroups followed similar trajectories. Hazardous drinking prevalence was initially higher but declined more among men than women, consistently higher among non-Hispanic White respondents than among Hispanic and non-Hispanic Black respondents, and declined more rapidly among adults with 3+ chronic conditions. In adjusted models, race and ethnicity were associated with lower prevalence of hazardous drinking (non-Hispanic Black: adjusted prevalence ratio [aPR] = 0.50, 95% confidence interval [CI] = 0.33, 0.74; other race: aPR = 0.26, 95% CI = 0.09, 0.81, compared with non-Hispanic White). No coping-related factors were significantly associated with hazardous drinking. CONCLUSION Among a cohort of older adults with chronic conditions, almost half engaged in hazardous drinking in early summer of the COVID-19 pandemic. While prevalence fell, these rates reinforce the need for alcohol screening and intervention in clinical settings among this population.
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Affiliation(s)
- Aryn Z. Phillips
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD
| | - Mercedes R. Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Morgan Bonham
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Rebecca M. Lovett
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Michael S. Wolf
- Center for Applied Health Research on Aging, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
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15
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Lee T, Walley KR, Boyd JH, Cawcutt KA, Kalil A, Russell JA. Impact of the COVID-19 pandemic on non-COVID-19 community-acquired pneumonia: a retrospective cohort study. BMJ Open Respir Res 2023; 10:e001810. [PMID: 37865420 PMCID: PMC10603472 DOI: 10.1136/bmjresp-2023-001810] [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: 05/06/2023] [Accepted: 09/22/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic could impact frequency and mortality of non-COVID-19 community-acquired pneumonia (CAP). Changes in frequency, patient mix, treatment and organ dysfunction could cascade together to increase mortality of CAP during compared with pre-COVID-19. METHODS Hospitalised CAP patients at St. Paul's Hospital, Vancouver, Canada pre-COVID-19 (fiscal years 2018/2019 and 2019/2020) and during COVID-19 pandemic (2020/2021 and 2021/2022) were evaluated. RESULTS In 5219 CAP patients, there was no significant difference prepandemic versus during pandemic in mean age, gender and Charlson Comorbidity Score. However, hospital mortality increased significantly from pre-COVID-19 versus during COVID-19 (7.5% vs 12.1% respectively, (95% CI for difference: 3.0% to 6.3%), p<0.001), a 61% relative increase, coincident with increases in ICU admission (18.3% vs 25.5%, respectively, (95% CI for difference: 5.0% to 9.5%) p<0.001, 39% relative increase) and ventilation (12.7% vs 17.5%, respectively, (95% CI for difference: 2.8% to 6.7%) p<0.001, 38% relative increase). Results remained the same after regression adjustment for age, sex and Charlson score. CAP hospital admissions decreased 27% from pre-COVID-19 (n=1349 and 1433, 2018/2019 and 2019/2020, respectively) versus the first COVID-19 pandemic year (n=1047 in 2020/2021) then rose to prepandemic number (n=1390 in 2021/2022). During prepandemic years, CAP admissions peaked in winter; during COVID-19, the CAP admissions peaked every 6 months. CONCLUSIONS AND RELEVANCE This is the first study to show that the COVID-19 pandemic was associated with increases in hospital mortality, ICU admission and invasive mechanical ventilation rates of non-COVID-19 CAP and a transient, 1-year frequency decrease. There was no winter seasonality of CAP during the COVID-19 pandemic era. These novel findings could be used to guide future pandemic planning for CAP hospital care.
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Affiliation(s)
- Terry Lee
- Centre for Health Evaluation and Outcome Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Keith R Walley
- Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John H Boyd
- Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kelly A Cawcutt
- Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Andre Kalil
- Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - James A Russell
- Division of Critical Care Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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16
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Titus-Lay E, Nehira J, Courtney J, Jee J, Kumar M, Tiet J, Le V, Durbin-Johnson B, Chen MS, Vinall R. A pharmacist-led community-based survey study: Determining the impact of the Covid-19 pandemic on actionable factors associated with worse cancer outcomes and cancer health disparities. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 11:100311. [PMID: 37533758 PMCID: PMC10392607 DOI: 10.1016/j.rcsop.2023.100311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
Purpose The goals of this cross-sectional community-based survey study were to assess the impact of the Covid-19 pandemic on actionable factors which are known to contribute to worse cancer outcomes, and to determine whether race and ethnicity-based differences exist. Methods A survey study which captured demographic information and changes in cancer outcomes-related factors since the start of the Covid-19 pandemic, was conducted at a public Covid-19 vaccination clinic over a period of 10 days during March 2021. Surveys were administered in multiple languages. Chi-square tests and ANOVA followed by post-hoc Dunnett testing assessed for race and ethnicity-based differences. Results A total of 949 people participated (61.6% participation rate). Ninety-three surveys were removed based on inclusion criteria giving a final participant number of 856. Many participants reported postponing cancer screenings (17.8%) and cancellation of medical appointments (22.8% and 25.8% reported cancelled appointments by providers or themselves, respectively) due to the pandemic. Participants also reported decreased physical activity (44.7%) and increased tobacco and/or marijuana usage (7.0%). Conversely, participants reported consuming more fruits and vegetables (21.4%) and decreasing alcohol consumption (21.4%). Several race-related differences but no ethnicity-related differences were observed. Conclusion Our data can be used to help guide pharmacist-led targeted outreach in our community which will help mitigate Covid-19 pandemic-driven changes in behaviors associated with worse cancer outcomes and exacerbation of cancer health disparities. To our knowledge, this is the first cancer outcomes-related study to be conducted at a public Covid-19 vaccination site and is the first pharmacist-led study in this area.
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Affiliation(s)
- Erika Titus-Lay
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jeffrey Nehira
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jennifer Courtney
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jacquelyn Jee
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Marissa Kumar
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Jenny Tiet
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Vivi Le
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
| | - Blythe Durbin-Johnson
- Department of Public Health Sciences, School of Medicine, University of California Davis, One Shields Avenue, Davis, CA 95616, USA
| | - Moon S. Chen
- Division of Hematology and Oncology, UC Davis School of Medicine, Sacramento, CA 95817, USA
| | - Ruth Vinall
- California Northstate University College of Pharmacy (CNUCOP), Elk Grove, CA 95757, USA
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17
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Findling JW, Raff H. Recognition of Nonneoplastic Hypercortisolism in the Evaluation of Patients With Cushing Syndrome. J Endocr Soc 2023; 7:bvad087. [PMID: 37440963 PMCID: PMC10334485 DOI: 10.1210/jendso/bvad087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Indexed: 07/15/2023] Open
Abstract
The evaluation of suspected hypercortisolism is one of the most challenging problems in medicine. The signs and symptoms described by Dr Harvey Cushing are common and often create diagnostic confusion to even experienced endocrinologists. Cushing syndrome is classically defined as neoplastic hypercortisolism resulting from an ACTH-secreting tumor or from autonomous secretion of excess cortisol associated with benign or malignant adrenal neoplasia. The increasing recognition of the negative cardiometabolic effects of mild cortisol excess without overt physical signs of Cushing syndrome has led to more screening for endogenous hypercortisolism in patients with adrenal nodular disease, osteoporosis, and the metabolic syndrome. However, sustained or intermittent activation of the dynamic hypothalamic-pituitary-adrenal axis caused by chemical (alcohol), inflammatory (chronic kidney disease), psychologic (major depression), and physical (starvation/chronic intense exercise) stimuli can result in clinical and/or biochemical features indistinguishable from neoplastic hypercortisolism. Nonneoplastic hypercortisolism (formerly known as pseudo-Cushing syndrome) has been recognized for more than 50 years and often causes diagnostic uncertainty. This expert consultation describes two patients with features of Cushing syndrome who were referred for inferior petrosal sinus sampling for the differential diagnosis of ACTH-dependent hypercortisolism. Both patients were discovered to have nonneoplastic hypercortisolism: one from a covert alcohol use disorder and the other to chronic kidney disease. This consultation emphasizes the value of a good history and physical examination, appropriate laboratory testing, and the desmopressin acetate stimulation test to aid in distinguishing neoplastic from nonneoplastic hypercortisolism.
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Affiliation(s)
- James W Findling
- Department of Medicine (Endocrinology and Molecular Medicine), Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Department of Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Hershel Raff
- Correspondence: Hershel Raff, PhD, Endocrinology Research HRC4150, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226, USA.
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18
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Surani A, Carroll TB, Javorsky BR, Raff H, Findling JW. Alcohol-induced Cushing syndrome: report of eight cases and review of the literature. Front Endocrinol (Lausanne) 2023; 14:1199091. [PMID: 37409223 PMCID: PMC10319132 DOI: 10.3389/fendo.2023.1199091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Alcohol-induced hypercortisolism (AIH) is underrecognized and may masquerade as neoplastic hypercortisolism [Cushing syndrome (CS)] obscuring its diagnosis. Objective and methods In order to characterize AIH, we performed a chart review of eight patients (4 males and 4 females; 2014-2022) referred for evaluation and treatment of neoplastic hypercortisolism - six for inferior petrosal sinus sampling, one due to persistent CS after unilateral adrenalectomy, and one for pituitary surgery for Cushing disease (CD). Five underwent dDAVP stimulation testing. Results All eight patients had clinical features of hypercortisolism and plasma ACTH levels within or above the reference interval confirming hypothalamic-pituitary mediation. All had abnormal low-dose dexamethasone suppression test and increased late-night salivary cortisol. Only one had increased urine cortisol excretion. In contrast to CD, the 5 patients tested had blunted or absent ACTH and cortisol responses to desmopressin. Two had adrenal nodules and one had abnormal pituitary imaging. Most patients underreported their alcohol consumption and one denied alcohol use. Elevated blood phosphatidyl ethanol (PEth) was required in one patient to confirm excessive alcohol use. All patients had elevations of liver function tests (LFTs) with AST>ALT. Conclusion AIH is an under-appreciated, reversible cause of non-neoplastic hypercortisolism that is indistinguishable from neoplastic CS. Incidental pituitary and adrenal imaging abnormalities as well as under-reporting of alcohol consumption further confound the diagnosis. Measurement of PEth helps to confirm an alcohol use disorder. Elevations of LFTs (AST>ALT) and subnormal ACTH and cortisol responses to dDAVP help to distinguish AIH from neoplastic hypercortisolism.
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Affiliation(s)
- Asif Surani
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ty B. Carroll
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Bradley R. Javorsky
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Medicine. Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee, WI, United States
| | - Hershel Raff
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - James W. Findling
- Departments of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
- Departments of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
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19
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Myran D, Friesen EL, Pugliese M, Milani C, Kurdyak P, Saraswat M, Tanuseputro P. Changes in health service use due to alcohol during the COVID-19 pandemic among individuals with and individuals without pre-existing alcohol-related medical diagnoses. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:185-194. [PMID: 36719599 PMCID: PMC9888341 DOI: 10.17269/s41997-023-00739-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To compare changes in outpatient and acute care visits due to alcohol during the COVID-19 pandemic between individuals with and those without a history of alcohol-related health service use (AHSU). METHODS We conducted a cross-sectional analysis of health administrative data in Ontario, Canada. The Ontario population was stratified into those with and those without 1+ health service encounter(s) due to alcohol in the past 2 years. We compared age- and sex-standardized rates of alcohol-related outpatient visits, emergency department (ED) visits, and hospitalizations during the first 15 months of the pandemic (March 2020-May 2021) to those during the same 15-month period prior to the pandemic (March 2018-May 2019). RESULTS Of 13,450,750 eligible Ontarians on March 11, 2022, 129,434 (1.0%) had AHSU in the previous 2 years. Overall, rates of alcohol-related outpatient visits and hospitalizations increased, while rates of alcohol-related ED visits decreased during the pandemic. There was a similar relative increase in rates of alcohol-related outpatient visits and hospitalizations between those with and those without prior AHSU. However, the absolute increase in rates of alcohol-related outpatient visits and hospitalizations was higher among those with prior AHSU (outpatient rate difference (RD) per 10,000 population: 852.3, 95% confidence interval (CI): 792.7, 911.9; inpatient RD: 26.0, 95% CI: -2.3, 54.2) than among those without (outpatient RD: 6.5, 95% CI: 6.0, 6.9; inpatient RD: 0.4, 95% CI: 0.2, 0.7). CONCLUSION Rates of alcohol-related outpatient and inpatient care increased during the COVID-19 pandemic, and high rate of recurrent harm among individuals with pre-pandemic AHSU was an important contributor to this trend.
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Affiliation(s)
- Daniel Myran
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Erik Loewen Friesen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Pugliese
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christina Milani
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Paul Kurdyak
- ICES Mental Health & Addictions Research Program, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Manu Saraswat
- Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
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20
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West RW, Davari SB, Hammoud NM, Ismail MH. AuTomaTed Alcohol Misuse INterventions in a Bariatric Surgery Population: The ATTAIN Bariatric Pilot. Perm J 2023; 27:36-44. [PMID: 36866440 PMCID: PMC10015607 DOI: 10.7812/tpp/22.145] [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: 03/04/2023]
Abstract
Introduction Alcohol screening and brief intervention has been shown to reduce unhealthy alcohol use, although widespread adoption into primary care practice has been slow. Patients undergoing bariatric surgery are at an increased risk of unhealthy alcohol use. The authors compared a novel, web-based screening tool called ATTAIN to usual care for real-world effectiveness and accuracy among bariatric surgery registry patients. Methods The authors analyzed the results of a quality improvement project that tested ATTAIN among bariatric surgery registry patients. Participants were stratified into 3 groups by surgery status (preoperative vs postoperative) and prior screening for unhealthy alcohol use (screened vs not screened in the past year). Participants in these 3 groups were divided into intervention plus usual care (n = 2249) and control (n = 2130) groups, with intervention being an email to complete ATTAIN, and control being usual care (eg, office-based screening). Primary outcomes included screening and positivity rates for unhealthy drinking behavior between groups. Secondary outcomes included positivity rates via ATTAIN vs usual care for individuals who were screened by both modalities. Chi-square test was used for statistical analysis. Results The overall screening rates were 67.4% (intervention arm) and 38.6% (control). The ATTAIN response rate was 47% of those invited. The overall positive screen rate was 7.7% (intervention) and 2.6% (control); p < .001 for both. For dual screened intervention participants, the positive screen rate was 10% (ATTAIN) vs 2% (usual care) with p < .001. Conclusion ATTAIN is a promising method of increasing screening and detection rates for unhealthy drinking behavior.
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Affiliation(s)
| | | | - Nadine M Hammoud
- Kaiser Permanente Orange County Family Medicine, Santa Ana, CA, USA
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21
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Leggio L, Mellinger JL. Alcohol use disorder in community management of chronic liver diseases. Hepatology 2023; 77:1006-1021. [PMID: 35434815 DOI: 10.1002/hep.32531] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 02/06/2023]
Abstract
Rising rates of alcohol use disorder (AUD) combined with increases in alcohol-related liver disease (ALD) and other liver disease have resulted in the need to develop alcohol management strategies at all levels of patient care. For those with pre-existing liver disease, whether ALD or others, attention to alcohol use treatment and abstinence becomes critical to avoiding worsening liver-related consequences. Modalities to help patients reduce or stop alcohol include screening/brief intervention/referral to treatment, various therapeutic modalities including cognitive behavioral therapy, motivational enhancement therapy and 12-step facilitation, and alcohol relapse prevention medications. Harm reduction approaches versus total abstinence may be considered, but for those with existing ALD, particularly advanced ALD (cirrhosis or acute alcoholic hepatitis), total abstinence from alcohol is the recommendation, given clear data that ongoing alcohol use worsens mortality and liver-related morbidity. For certain populations, alcohol cessation is even more critically important. For those with hepatitis C or NAFLD, alcohol use accelerates negative liver-related outcomes. In women, alcohol use accelerates liver damage and results in worsened liver-related mortality. Efforts to integrate AUD and liver disease care are urgently needed and can occur at several levels, with establishment of multidisciplinary ALD clinics for fully integrated co-management as an important goal.
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Affiliation(s)
- Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section , Translational Addiction Medicine Branch , National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism , National Institutes of Health , Baltimore and Bethesda , Maryland , USA
- Medication Development Program , National Institute on Drug Abuse Intramural Research Program , National Institutes of Health , Baltimore , Maryland , USA
- Center for Alcohol and Addiction Studies , Department of Behavioral and Social Sciences , School of Public Health , Brown University , Providence , Rhode Island , USA
- Division of Addiction Medicine , Department of Medicine , School of Medicine , Johns Hopkins University , Baltimore , Maryland , USA
- Department of Neuroscience , Georgetown University Medical Center , Washington , DC , USA
| | - Jessica L Mellinger
- Department of Internal Medicine , Michigan Medicine , Ann Arbor , Michigan , USA
- Department of Psychiatry , Michigan Medicine , Ann Arbor , Michigan , USA
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22
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Anouti A, Mellinger JL. The Changing Epidemiology of Alcohol-Associated Liver Disease: Gender, Race, and Risk Factors. Semin Liver Dis 2023; 43:50-59. [PMID: 36529138 DOI: 10.1055/a-2000-6680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Cases of alcohol-associated liver disease (ALD) are increasing at a steady rate in the United States with more patients presenting with alcohol-associated hepatitis and alcohol-associated cirrhosis. While alcohol use has increased across many demographic groups, women are suffering from a greater increase in alcohol use disorder (AUD), and are at a greater risk of ALD due to pathophysiological differences which include absorption of alcohol, first pass metabolism, and hormonal differences. Differences across race have also been found with Native Americans and Hispanics suffering from some of the largest increases in ALD rates. Younger adults are heavily impacted by rising rates of both AUD and ALD. Comorbidities such as obesity and NASH have been shown to augment the deleterious effects of AUD and ALD, resulting in more advanced liver disease. Finally, COVID-19 and policies related to the pandemic have resulted in increased AUD across many cohorts, which have resulted in marked increases in ALD. In conclusion, ALD rates are rising, with young people and women particularly impacted.
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Affiliation(s)
- Ahmad Anouti
- Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jessica L Mellinger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, Michigan
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23
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Prevalence of Poor Mental Health Days and Adverse Childhood Experience Reporting in U.S. Adults Before and After COVID-19. Community Ment Health J 2023; 59:233-242. [PMID: 35829803 PMCID: PMC9859877 DOI: 10.1007/s10597-022-01001-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/09/2022] [Indexed: 01/25/2023]
Abstract
This is the first study of US adults to examine change in the prevalence of psychological burden (i.e., self-reported poor mental health days in the past 30 days, and ACEs recollections) before compared to after COVID-19 started. We analyzed the prevalence of self-reported poor mental health days, and ACEs recollections from 17 states using the Behavioral Risk Factor Surveillance System. Adjusted models identified an increase in prevalence from before compared to after COVID-19 onset in those married or partnered reporting 48% more poor mental health days in the past 30 days; persons of color reporting living with anyone with mental illness during childhood by 73% and reporting more ACEs by 35%; those employed or self-employed reporting childhood sexual abuse by 45%. This ecological-level analysis revealed population-level changes in psychological well-being reporting of U.S. adults from before compared to after the pandemic onset.
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Goodyear K, Moyo P, Avila JC, Ahluwalia JS, Monnig MA. Associations between alcohol and cannabis use before and during the COVID-19 pandemic: Results of a community survey. Addict Behav Rep 2022; 16:100455. [PMID: 36101549 PMCID: PMC9458547 DOI: 10.1016/j.abrep.2022.100455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
The COVID-19 pandemic has impacted individuals around the world, creating unprecedented challenges. Due to lockdowns and social distancing measures, many people have turned to contactless modes of obtaining alcohol and other substances (e.g., home delivery). This study investigated associations between alcohol and cannabis use before and during the initial months of the COVID-19 pandemic and factors associated with use. An online, cross-sectional survey with a non-probability sample (N = 1126) was conducted in Northeast states during June-July 2020. Outcomes examined prevalence of alcohol and cannabis use for the overall sample and predictors of use in individuals who used substances. In the overall sample, we found that alcohol and cannabis use decreased from before to during the pandemic. For individuals who drank alcohol, higher pre-pandemic drinking, mid-range household income, and obtaining alcohol through home delivery were associated with higher alcohol drinking during the pandemic. For individuals who used cannabis, higher pre-pandemic cannabis use and obtaining cannabis through home delivery were associated with higher cannabis use during the pandemic. Overall, from before to during the pandemic, we found a decrease in the proportion of individuals who used substances and no changes in quantity for individuals who continued to use substances. Home delivery was associated with greater use of alcohol and marijuana, supporting a need for further research on risk factors for heavier substance use.
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Affiliation(s)
- Kimberly Goodyear
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Patience Moyo
- Center for Gerontology and Healthcare Research, Department of Health Services, Policy and Practice, Brown University, Providence, RI, USA
| | - Jaqueline C. Avila
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Jasjit S. Ahluwalia
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Mollie A. Monnig
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
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Russell AM, Valdez D, Chiang SC, Montemayor BN, Barry AE, Lin HC, Massey PM. Using Natural Language Processing to Explore "Dry January" Posts on Twitter: Longitudinal Infodemiology Study. J Med Internet Res 2022; 24:e40160. [PMID: 36343184 PMCID: PMC9719059 DOI: 10.2196/40160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 10/13/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Dry January, a temporary alcohol abstinence campaign, encourages individuals to reflect on their relationship with alcohol by temporarily abstaining from consumption during the month of January. Though Dry January has become a global phenomenon, there has been limited investigation into Dry January participants' experiences. One means through which to gain insights into individuals' Dry January-related experiences is by leveraging large-scale social media data (eg, Twitter chatter) to explore and characterize public discourse concerning Dry January. OBJECTIVE We sought to answer the following questions: (1) What themes are present within a corpus of tweets about Dry January, and is there consistency in the language used to discuss Dry January across multiple years of tweets (2020-2022)? (2) Do unique themes or patterns emerge in Dry January 2021 tweets after the onset of the COVID-19 pandemic? and (3) What is the association with tweet composition (ie, sentiment and human-authored vs bot-authored) and engagement with Dry January tweets? METHODS We applied natural language processing techniques to a large sample of tweets (n=222,917) containing the term "dry january" or "dryjanuary" posted from December 15 to February 15 across three separate years of participation (2020-2022). Term frequency inverse document frequency, k-means clustering, and principal component analysis were used for data visualization to identify the optimal number of clusters per year. Once data were visualized, we ran interpretation models to afford within-year (or within-cluster) comparisons. Latent Dirichlet allocation topic modeling was used to examine content within each cluster per given year. Valence Aware Dictionary and Sentiment Reasoner sentiment analysis was used to examine affect per cluster per year. The Botometer automated account check was used to determine average bot score per cluster per year. Last, to assess user engagement with Dry January content, we took the average number of likes and retweets per cluster and ran correlations with other outcome variables of interest. RESULTS We observed several similar topics per year (eg, Dry January resources, Dry January health benefits, updates related to Dry January progress), suggesting relative consistency in Dry January content over time. Although there was overlap in themes across multiple years of tweets, unique themes related to individuals' experiences with alcohol during the midst of the COVID-19 global pandemic were detected in the corpus of tweets from 2021. Also, tweet composition was associated with engagement, including number of likes, retweets, and quote-tweets per post. Bot-dominant clusters had fewer likes, retweets, or quote tweets compared with human-authored clusters. CONCLUSIONS The findings underscore the utility for using large-scale social media, such as discussions on Twitter, to study drinking reduction attempts and to monitor the ongoing dynamic needs of persons contemplating, preparing for, or actively pursuing attempts to quit or cut down on their drinking.
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Affiliation(s)
- Alex M Russell
- Center for Public Health and Technology, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Danny Valdez
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Shawn C Chiang
- Center for Public Health and Technology, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Ben N Montemayor
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
| | - Adam E Barry
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Philip M Massey
- Center for Public Health and Technology, Department of Health, Human Performance, and Recreation, University of Arkansas, Fayetteville, AR, United States
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Pytell JD, Thakrar AP, Chander G, Colantuoni E. Changes in Alcohol Consumption by Beverage Type Attributable to the COVID-19 Pandemic for 10 States, March 2020 to November 2020: An Ecological Simulation-based Analysis. J Addict Med 2022; 16:e412-e416. [PMID: 35749776 PMCID: PMC9653060 DOI: 10.1097/adm.0000000000000999] [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: 08/09/2021] [Accepted: 03/06/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Consumption of high potency alcohol is associated with greater healthcare burden, yet little attention has been placed on the change in types of alcohol consumed during the COVID-19 pandemic. We estimate the change in alcohol consumption by beverage type attributable to the COVID-19 pandemic. METHODS The National Institute on Alcohol Abuse and Alcoholism provided apparent alcohol consumption ("consumption") by beverage type for 10 states for January 2017 through November 2020 based on sales and tax data. The 38-month period to February 2020 was used to train quasi-Poisson regression models. The models then predicted the monthly consumption based on the historical trends in the absence of the COVID-19 pandemic from March through November 2020. The difference between the observed and predicted is the change in consumption attributable to the COVID-19 pandemic. RESULTS Beyond what was expected based on historical trends, spirits consumption increased significantly for 6 states (Colorado, Massachusetts, Missouri, North Dakota, Minnesota, and Tennessee) ranging from 4% (95% confidence interval [CI] 1%-6%) to 17% (95% CI 6%-28%) which is equivalent to 7 (95% CI 2-18) to 32 95% CI 12-48) excess standard spirits drinks per-capita; Alaska, Florida, Illinois, and Kentucky had no significant change. Wine consumption increased 10% (95% CI 3%-18%) in Colorado and 8% (95% CI 3%-12%) in Tennessee. Wine consumption in Alaska decreased 6% (95% CI, 3%-10%) and beer consumption decreased 8% (95% CI 4%-11%). CONCLUSIONS During the COVID-19 pandemic, spirits consumption increased relative to wine and beer. Increased consumption of higher potency alcohol beverages could lead to higher alcohol-related healthcare and societal burden.
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Drug use trajectories among U.S. adults during the first year of the COVID-19 pandemic. J Psychiatr Res 2022; 154:145-150. [PMID: 35939999 PMCID: PMC9339074 DOI: 10.1016/j.jpsychires.2022.07.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 12/29/2022]
Abstract
This study characterized the prevalence, sociodemographic characteristics, and behavioral health of U.S. adult subpopulations with distinct drug use trajectories during the first year of the COVID-19 pandemic. Adult respondents (n = 8306) in a nationally-representative longitudinal study completed 13 monthly web surveys (March 2020-March 2021). Frequency of past-week drug use, cannabis use, and alcohol use (range:0-7), as well as anxiety and depressive symptoms, were assessed at each survey. Growth mixture models were used to parse out distinct subpopulations with homogenous drug use trajectories based on mean drug use days over time. Four drug use trajectories were identified: Stable Abstinence (85.7% [95%CI = 85.0-86.5] of the sample) with <1 mean past-week drug use days; Escalating Infrequent Use (7.1% [95%CI = 6.6-7.7]) with 0.2 March mean past-week drug use days and increases from April to October; Use Cessation (4.3% [95%CI = 3.8-4.7]) with 1.1 March mean past-week drug use days that initially increased, then sharply decreased to near zero; and Stable Frequent Use (2.9% [95%CI = 2.5-3.3]) with between 2.4 and 3.5 past-week drug use days across the study period. Compared to the stable abstinence group, the other subgroups were more likely to be Hispanic or Black, younger in age, unemployed, below the federal poverty line, and less likely to have a college degree or be married. They also reported higher levels of alcohol and cannabis use, as well as higher anxiety and depressive symptoms. These results provide opportunities to optimize the targeted delivery of preventive interventions for substance use during the COVID-19 pandemic and future public health emergencies.
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Chong WWY, Acar ZI, West ML, Wong F. A Scoping Review on the Medical and Recreational Use of Cannabis During the COVID-19 Pandemic. Cannabis Cannabinoid Res 2022; 7:591-602. [PMID: 34981958 PMCID: PMC9587770 DOI: 10.1089/can.2021.0054] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background/Introduction: The shelter-in-place orders and social distancing regulations on account of the COVID-19 pandemic have impacted lifestyles, including the use of cannabis. The purpose of this scoping review is to summarize both the gray and academic literature on the use of cannabis during the pandemic. Materials and Methods: A total of 11 databases, including 2 medical databases, 7 social science databases, and 2 gray literature databases were searched resulting in 316 titles and abstracts of which 76 met inclusion criteria. Results: Nine themes emerged: (a) prevalence and trends of cannabis use during COVID[1]19; (b) demographics; (c) profile of mode of consumption; (d) context of using cannabis (i.e., solitary use vs. in groups); (e) factors contributing to use; (f) factors inhibiting use; (g) adverse clinical and psychiatric outcomes of cannabis use during the pandemic; (h) similarities between EVALI (E-Cigarette or Vaping Product Use-Associated Lung Injury) and COVID-19 symptoms; (i) implications for policy and practice. Studies published until February 2, 2021 were included in this review. Discussion: Findings have highlighted that feelings of boredom, depression, and anxiety during the pandemic have contributed to an increase in the use of cannabis. Furthermore, accessibility to cannabis was noted to affect use during the pandemic. Adverse psychiatric and clinical outcomes were associated with the increased use of cannabis. Conclusion: Practitioners and policymakers are called to employ harm reduction strategies to respond to increasing cannabis use. There is a need for population-based studies and further examination of factors contributing to the increased use of cannabis during the pandemic and associated negative consequences.
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Affiliation(s)
- Wendy Wing-Yee Chong
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Zeynep Ilgaz Acar
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Meghan Lee West
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Francis Wong
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Briggs M, Peacock A. Screening Older Adults for Alcohol Use. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Barbosa C, Dowd WN, Neuwahl SJ, Rehm J, Imtiaz S, Zarkin GA. Modeling the impact of COVID-19 pandemic-driven increases in alcohol consumption on health outcomes and hospitalization costs in the United States. Addiction 2022; 118:48-60. [PMID: 35915549 PMCID: PMC9539393 DOI: 10.1111/add.16018] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Alcohol consumption increased in the early phases of the COVID-19 pandemic in the United States. Alcohol use disorder (AUD) and risky drinking are linked to harmful health effects. This paper aimed to project future health and cost impacts of shifts in alcohol consumption during the COVID-19 pandemic. DESIGN An individual-level simulation model of the long-term drinking patterns for people with life-time AUD was used to simulate 10 000 individuals and project model outcomes to the estimated 25.9 million current drinkers with life-time AUD in the United States. The model considered three scenarios: (1) no change (counterfactual for comparison); (2) increased drinking levels persist for 1 year ('increase-1') and (3) increased drinking levels persist for 5 years ('increase-5'). SETTING United States. PARTICIPANTS Current drinkers with life-time AUD. MEASUREMENTS Life expectancy [life-years (LYs)], quality-adjusted life-years (QALYs), alcohol-related hospitalizations and associated hospitalization costs and alcohol-related deaths, during a 5-year period. FINDINGS Short-term increases in alcohol consumption (increase-1 scenario) resulted in a loss of 79 000 [95% uncertainty interval (UI]) 26 000-201 000] LYs, a loss of 332 000 (104 000-604 000) QALYs and 295 000 (82 000-501 000) more alcohol-related hospitalizations, costing an additional $5.4 billion ($1.5-9.3 billion) over 5 years. Hospitalizations for cirrhosis of the liver accounted for approximately $3.0 billion ($0.9-4.8 billion) in hospitalization costs, more than half the increase across all alcohol-related conditions. Health and cost impacts were more pronounced for older age groups (51+), women and non-Hispanic black individuals. Increasing the duration of pandemic-driven increases in alcohol consumption in the increase-5 scenario resulted in larger impacts. CONCLUSIONS Simulations show that if the increase in alcohol consumption observed in the United States in the first year of the pandemic continues, alcohol-related mortality, morbidity and associated costs will increase substantially over the next 5 years.
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Affiliation(s)
| | - William N. Dowd
- Community Health Research DivisionRTI International, Research Triangle ParkNCUSA
| | | | - Jürgen Rehm
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research InstituteCentre for Addiction and Mental Health (CAMH)TorontoONCanada,Dalla Lana School of Public HealthTorontoONCanada,Institute of Health Policy, Management and Evaluation and Department of PsychiatryUniversity of Toronto (UofT)TorontoONCanada,PAHO/WHO Collaborating Centre for Addiction and Mental HealthTechnische Universität Dresden, Klinische Psychologie and PsychotherapieDresdenGermany
| | - Sameer Imtiaz
- PAHO/WHO Collaborating Centre for Addiction and Mental HealthTechnische Universität Dresden, Klinische Psychologie and PsychotherapieDresdenGermany
| | - Gary A. Zarkin
- Community Health Research DivisionRTI International, Research Triangle ParkNCUSA
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Acharya B, Dhakal C. Risky health behaviors during the COVID-19 pandemic: Evidence from the expenditures on alcohol, non-alcoholic beverages, and tobacco products. PLoS One 2022; 17:e0268068. [PMID: 35587483 PMCID: PMC9119561 DOI: 10.1371/journal.pone.0268068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/22/2022] [Indexed: 12/12/2022] Open
Abstract
Background The COVID-19 pandemic has increased mental stress among the population and, at the same time, has lowered consumer income. Alcohol, non-alcoholic beverages, and tobacco consumption are associated with multiple health conditions but the information on how the consumption pattern of these goods shifted during the pandemic remains limited. Objective To examine the consumer spending on alcohol, non-alcoholic beverages, and tobacco products during the COVID-19 pandemic compared to the pre-pandemic period. Design An observational study utilizing the expenditures data on alcohol, non-alcoholic beverages, and tobacco between 2017 and 2020 obtained from the US Consumer Expenditure Diary Survey. Participants 18,808 respondents aged ≥ 21 years who answered the Consumer Expenditure Diary Survey. Main Outcome Measure(s): Bi-weekly expenditure on alcohol, non-alcoholic beverages, and tobacco products. Analysis Multivariable linear regression models. Results A total of 18,808 respondents (mean [SD] age = 52.5[16.9] years; 53.8% females) were included. Compared to the pre-pandemic levels, household expenditures on alcohol, non-alcoholic beverages, and tobacco products significantly decreased during the pandemic period by 28.6%, 7.9%, and 15.5%, respectively, after controlling for the state-, individual-, and household-level characteristics. Individual age, race/ethnicity, income, and education were significant predictors of spending. Heterogeneities in expenditures were evident across subgroups, with less educated and low-income households cutting their alcohol expenses while the wealthy and more educated consumers spent more during the pandemic. Conclusions and implications Household expenditures on alcohol, non-alcoholic beverages, and tobacco products significantly decreased. The results might be beneficial in understanding consumer spending habits concerning risky health behaviors during the period of economic disruption.
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Affiliation(s)
- Binod Acharya
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, United States of America
- * E-mail:
| | - Chandra Dhakal
- Department of Agricultural and Applied Economics, University of Georgia, Athens, Georgia, United States of America
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Batterham PJ, Shou Y, Farrer LM, Murray K, Morse AR, Gulliver A, Slade T, Newton NC, Calear AL. Patterns and predictors of alcohol use during the early stages of the COVID-19 pandemic in Australia: Longitudinal cohort study. Alcohol Clin Exp Res 2022; 46:1248-1257. [PMID: 35567305 PMCID: PMC9348344 DOI: 10.1111/acer.14858] [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] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/21/2022] [Accepted: 04/29/2022] [Indexed: 11/26/2022]
Abstract
Background The COVID‐19 pandemic has resulted in disruptions across many life domains. The distress associated with the pandemic itself, and with public health efforts to manage the outbreak, could result in increased alcohol use. This study aimed to quantify changes in alcohol use during the early stages of the pandemic and factors associated with different patterns of use. Methods Data were obtained from a longitudinal survey of a representative Australian adult sample (N = 1296, 50% female, Mage = 46.0) conducted from March to June 2020, during the first wave of the COVID‐19 outbreak in Australia. Change in alcohol consumption was examined using Alcohol Use Disorders Identification Test‐Consumption (AUDIT‐C) scores from waves one, three, five, and seven of the study, each 4 weeks apart. Factors associated with alcohol consumption were examined, including depression (PHQ‐9) and anxiety (GAD‐7) symptoms, health risk tolerance, stress and coping, work and social impairment (WSAS), COVID impacts, and sociodemographic variables. We tested changes in alcohol use across the full sample using a mixed effects repeated measure ANOVA model and a multinomial logistic regression to identify factors assessed at wave 1 that were independently associated with alcohol use. Results There was no significant change in AUDIT‐C scores across the study. For most participants, alcohol use did not increase during the early phase of the COVID‐19 pandemic in Australia. COVID‐19 exposure, higher perceived coping, depression symptoms, and male gender were associated with greater odds of increasing or elevated levels of alcohol use. Social changes, which included working from home, had mixed effects on alcohol consumption. Conclusions Although no evidence was found for increased alcohol use overall during the early months of the pandemic, several factors were associated with alcohol consumption at risky levels. Greater understanding of motivations for drinking across public and private contexts, along with targeted support for high‐risk groups, could assist in reducing harm associated with alcohol consumption.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Yiyun Shou
- Research School of Psychology, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Louise M Farrer
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Kristen Murray
- Research School of Psychology, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Alyssa R Morse
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Amelia Gulliver
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Tim Slade
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, NSW, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
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Stickley A, Shirama A, Inagawa T, Sumiyoshi T. Binge drinking in Japan during the COVID-19 pandemic: Prevalence, correlates and association with preventive behaviors. Drug Alcohol Depend 2022; 234:109415. [PMID: 35381568 PMCID: PMC8934738 DOI: 10.1016/j.drugalcdep.2022.109415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/08/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is some evidence that alcohol use may have changed during the coronavirus pandemic. However, as yet, there has been comparatively little focus on heavy/excessive drinking. This study examined binge drinking (BD) in Japan during the coronavirus pandemic and its association with COVID-19 preventive behaviors. METHOD Data were analyzed from an online sample of 1452 individuals aged 18 and above that were collected one year after the beginning of the pandemic. Self-reported information was obtained on current and pre-pandemic BD and a range of sociodemographic and health-related variables. Logistic regression analysis was used to examine associations. RESULTS Just under one-third of the sample (29.3%) reported past-month BD. More individuals reduced rather than increased BD during the pandemic (11.5% > 6.5%). Worsening household finances and depressive symptoms were associated with both current and increased BD, while young age (18-29) was linked to both increased and decreased BD. Individuals who binged had significantly lower odds for engaging in several COVID-19 preventive behaviors including wearing a mask (odds ratio [OR]: 0.47, 95% confidence interval [CI]: 0.30-0.76), hand washing (OR: 0.58, 95%CI: 0.44-0.76) and avoiding crowds/staying at home (OR: 0.72, 95%CI: 0.55-0.93). CONCLUSION BD is prevalent in Japan during the coronavirus pandemic and associated with poorer adherence to COVID-19 preventive behaviors. Increasing public awareness of the potentially detrimental effects of heavy alcohol use during the ongoing pandemic is now a public health priority.
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Affiliation(s)
- Andrew Stickley
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan.
| | - Aya Shirama
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
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Brenneke SG, Nordeck CD, Riehm KE, Schmid I, Tormohlen KN, Smail EJ, Johnson RM, Kalb LG, Stuart EA, Thrul J. Trends in cannabis use among U.S. adults amid the COVID-19 pandemic. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 100:103517. [PMID: 34894469 PMCID: PMC8653409 DOI: 10.1016/j.drugpo.2021.103517] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/18/2021] [Accepted: 10/20/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The COVID-19 pandemic has had an impact on mental health and alcohol use in the US, however there is little research on its impacts on cannabis use. Considering the role of cannabis as a coping strategy or self-medicating behavior, there is a need to understand how individuals who use cannabis have adapted their use amid the pandemic. Therefore, this study examined changes in self-reported cannabis use among US adults in the context of COVID-19 pandemic by (1) describing trends of use during the first 8 months of the pandemic among adults who used cannabis in this period; and (2) characterizing trends of use within sociodemographic subgroups and by state cannabis policy status. METHODS The sample consisted of 1,761 US adults who used cannabis at least once during the 8-month study period from the nationally representative Understanding America Study. Linear mixed-effect models were used to model changes in the number of days of past-week cannabis use across 16 waves from March 10, 2020, to November 11, 2020. RESULTS Compared to early March, the number of days cannabis was used per week was significantly higher at the start of April (β=0.11, 95% CI=0.03, 0.18) and May (β=0.21,95% CI=0.05, 0.36). In subsequent months (June - November), the number of days of cannabis use attenuated to levels comparable to March. Trends of cannabis use across the study period generally did not differ across sociodemographic characteristics and state cannabis policy status. CONCLUSION Though increases in use were marginal among many groups, the evolving pandemic and the growing concern for the mental health of segments of the U.S. population warrant close monitoring of coping behaviors, including substance use.
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Affiliation(s)
- Savannah G Brenneke
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA.
| | - Courtney D Nordeck
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Kira E Riehm
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Ian Schmid
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Kayla N Tormohlen
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Emily J Smail
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Renee M Johnson
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Luther G Kalb
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA; Department of Neuropsychology, Kennedy Krieger Institute, Johns Hopkins University, 1750 E Fairmount Ave, Baltimore, MD 21231, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA
| | - Johannes Thrul
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624N Broadway, Baltimore, MD 21205, USA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
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Chartier KG, Karriker‐Jaffe KJ. Commentary on Nordeck et al.: Disruption of social roles and daily routines in the initial phase of the COVID-19 pandemic may explain changes in alcohol use frequency. Addiction 2022; 117:341-342. [PMID: 34676603 PMCID: PMC8652924 DOI: 10.1111/add.15707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/21/2021] [Indexed: 01/13/2023]
Affiliation(s)
- Karen G. Chartier
- School of Social Work and Department of PsychiatryVirginia Commonwealth UniversityRichmondVAUSA
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Hwang CL, Phillips SA, Tu MH, Piano MR. Time to Promote the Awareness of Unhealthy Alcohol Use Among Women. J Womens Health (Larchmt) 2022; 31:1-3. [PMID: 34935470 PMCID: PMC8785765 DOI: 10.1089/jwh.2021.0546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
- Chueh-Lung Hwang
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Shane A. Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Min-Hsuan Tu
- Department of Organization and Human Resources, School of Management, State University of New York—University at Buffalo, Buffalo, New York, USA
| | - Mariann R. Piano
- Center for Research Development and Scholarship, Vanderbilt University School of Nursing, Nashville, Tennessee, USA.,Address correspondence to: Mariann R. Piano, PhD, Center for Research Development and Scholarship, Vanderbilt University School of Nursing, 415 Godchaux Hall 461 21st Avenue South, Nashville, TN 37240-1119, USA
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Bascuñan-Wiley N, DeSoucey M, Fine GA. Convivial Quarantines: Cultivating Co-presence at a Distance. QUALITATIVE SOCIOLOGY 2022; 45:371-392. [PMID: 35915819 PMCID: PMC9330930 DOI: 10.1007/s11133-022-09512-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 05/16/2023]
Abstract
Sociology's focus on sociality and co-presence has long oriented studies of commensality-the social dimension of eating together. This literature commonly prioritizes face-to-face interactions and takes physical proximity for granted. The onset of the COVID-19 pandemic in March 2020 largely halted in-person gatherings and altered everyday foodways. Consequently, many people turned to digital commensality, cooking and eating together through video-call technology such as Zoom and FaceTime. We explore the implications of these new foodways and ask: has digital commensality helped cultivate co-presence amidst pandemic-induced physical separation? If so, how? To address these questions, we analyze two forms of qualitative data collected by the first author: interviews with individuals who cooked and ate together at a distance since March 2020 and digital ethnography during different groups' online food events (e.g., happy hours, dinners, holiday gatherings, and birthday celebrations). Digital commensality helps foster a sense of co-presence and social connectedness at a distance. Specifically, participants use three temporally oriented strategies to create or maintain co-presence: they draw on pre-pandemic pasts and reinvent culinary traditions to meet new circumstances; they creatively adapt novel digital foodways through online dining; and they actively imagine post-pandemic futures where physically proximate commensality is again possible.
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Affiliation(s)
- Nicholas Bascuñan-Wiley
- Department of Sociology, Northwestern University, 1810 Chicago Avenue, IL 60208 Evanston, USA
| | - Michaela DeSoucey
- Department of Sociology & Anthropology, North Carolina State University, Campus Box 8107, 1911 Building, NC 27695 Raleigh, USA
| | - Gary Alan Fine
- Department of Sociology, Northwestern University, 1810 Chicago Avenue, IL 60208 Evanston, USA
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Oksanen A, Oksa R, Savela N, Celuch M, Savolainen I. Drinking and Social Media Use Among Workers During COVID-19 Pandemic Restrictions: Five-Wave Longitudinal Study. J Med Internet Res 2021; 23:e33125. [PMID: 34662290 PMCID: PMC8641700 DOI: 10.2196/33125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/07/2023] Open
Abstract
Background The COVID-19 pandemic restricted everyday life during 2020-2021 for many people worldwide. It also affected alcohol consumption patterns and leisure activities, including the use of social media. Objective The aim of this study was to analyze whether social media use predicts increased risky drinking over time and during the COVID-19 pandemic restrictions in particular. Methods This 5-wave longitudinal survey study, based on a nationwide sample of workers, was conducted in Finland in 2019-2021. A total of 840 respondents (male: 473/840, 56.31%; age range 18-64 years; mean age 43.90, SD 11.14 years) participated in all 5 waves of the study. The outcome variable was risky drinking, measured using the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). Multilevel linear hybrid modeling enabled the investigation of both within-person and between-person effects. Predictors included social media use and communication, involvement in social media identity bubbles, psychological distress, and remote working. Controls included sociodemographic factors and the Big Five personality traits. Results Increased involvement in social media identity bubbles was associated with an increase in risky drinking behavior. Of all social media platforms examined, online dating app use was associated with riskier use of alcohol over time during the COVID-19 crisis. Daily social media communication with colleagues about nonwork topics was associated with risky drinking. Female gender, younger age, university education, nonindustrial occupational field, conscientiousness, agreeableness, and neuroticism were associated with lower levels of risky drinking. Conclusions Social media use during a pandemic carries some risks for alcohol consumption. Involvement in social media identity bubbles and online dating are risk factors for excessive drinking during the COVID-19 pandemic.
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Affiliation(s)
- Atte Oksanen
- Tampere University, Faculty of Social Sciences, Tampere, Finland
| | - Reetta Oksa
- Tampere University, Faculty of Social Sciences, Tampere, Finland
| | - Nina Savela
- Tampere University, Faculty of Social Sciences, Tampere, Finland
| | - Magdalena Celuch
- Tampere University, Faculty of Social Sciences, Tampere, Finland
| | - Iina Savolainen
- Tampere University, Faculty of Social Sciences, Tampere, Finland
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Nesoff ED, Gutkind S, Sirota S, McKowen AL, Veldhuis CB. Mental health and economic stressors associated with high-risk drinking and increased alcohol consumption early in the COVID-19 pandemic in the United States. Prev Med 2021; 153:106854. [PMID: 34695505 PMCID: PMC8548050 DOI: 10.1016/j.ypmed.2021.106854] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023]
Abstract
Physical distancing measures to curb COVID-19 transmission introduced mental health and economic stressors, possibly impacting problematic drinking. This cross-sectional study examines mental health and economic stressors early in the COVID-19 pandemic which may be associated with heavy alcohol use and increased alcohol use. We administered an online survey of U.S. adults via social media April 5 to May 5, 2020. High-risk drinking was defined by WHO risk drinking levels, a daily average of ≥4 drinks for men and ≥3 drinks for women. Participants reported retrospective assessments of increased alcohol use if their past-week alcohol consumption exceeded their past-year average weekly alcohol consumption. We used logistic regression to assess possible covariates of high-risk drinking and increased alcohol use. Among 2175 participants, 10% (n = 222) reported high-risk drinking, and 36% (n = 775) reported increased alcohol consumption. In multivariable analysis, high-risk drinking was significantly associated with household job loss (OR = 1.41, 95%CI = (1.06, 1.88)) and depressive symptoms (OR = 1.05, 95% CI = (1.02, 1.07)), and women had higher odds of high-risk drinking than men (OR = 2.37, 95% CI = (1.32, 4.69)). Previous mental health diagnosis was not significantly associated with high-risk drinking during the pandemic (OR = 1.31, 95% CI = (0.98, 1.76)) in univariable analysis. High-risk drinkers were almost six times as likely to report retrospective assessments of increased alcohol consumption, controlling for mental health and economic stressors (OR = 5.97, 95% CI = (4.35, 8.32)). Findings suggest a need for targeted interventions to address the complex mental health and economic stressors that may increase alcohol consumption and high-risk drinking during and after the pandemic.
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Affiliation(s)
- Elizabeth D Nesoff
- University of Pennsylvania Perelman School of Medicine, Department of Biostatistics, Epidemiology, and Informatics, 423 Guardian Dr, Philadelphia, PA 19104, USA.
| | - Sarah Gutkind
- Columbia University Mailman School of Public Health, Department of Epidemiology, 722 W168th St, New York, NY 10032, USA
| | - Safiya Sirota
- Columbia University Mailman School of Public Health, Department of Biostatistics, 722 W168th St, New York, NY 10032, USA
| | - Anna Laura McKowen
- Teachers College, Columbia University, 525 W120th St, New York, NY 10027, USA
| | - Cindy B Veldhuis
- Columbia University School of Nursing, 560 W168th St, New York, NY 10032, USA
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Santos-Molina L, Herrerias A, Zawatsky CN, Gunduz-Cinar O, Cinar R, Iyer MR, Wood CM, Lin Y, Gao B, Kunos G, Godlewski G. Effects of a Peripherally Restricted Hybrid Inhibitor of CB1 Receptors and iNOS on Alcohol Drinking Behavior and Alcohol-Induced Endotoxemia. Molecules 2021; 26:5089. [PMID: 34443679 PMCID: PMC8399901 DOI: 10.3390/molecules26165089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/26/2022] Open
Abstract
Alcohol consumption is associated with gut dysbiosis, increased intestinal permeability, endotoxemia, and a cascade that leads to persistent systemic inflammation, alcoholic liver disease, and other ailments. Craving for alcohol and its consequences depends, among other things, on the endocannabinoid system. We have analyzed the relative role of central vs. peripheral cannabinoid CB1 receptors (CB1R) using a "two-bottle" as well as a "drinking in the dark" paradigm in mice. The globally acting CB1R antagonist rimonabant and the non-brain penetrant CB1R antagonist JD5037 inhibited voluntary alcohol intake upon systemic but not upon intracerebroventricular administration in doses that elicited anxiogenic-like behavior and blocked CB1R-induced hypothermia and catalepsy. The peripherally restricted hybrid CB1R antagonist/iNOS inhibitor S-MRI-1867 was also effective in reducing alcohol consumption after oral gavage, while its R enantiomer (CB1R inactive/iNOS inhibitor) was not. The two MRI-1867 enantiomers were equally effective in inhibiting an alcohol-induced increase in portal blood endotoxin concentration that was caused by increased gut permeability. We conclude that (i) activation of peripheral CB1R plays a dominant role in promoting alcohol intake and (ii) the iNOS inhibitory function of MRI-1867 helps in mitigating the alcohol-induced increase in endotoxemia.
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Affiliation(s)
- Luis Santos-Molina
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.S.-M.); (A.H.); (G.K.)
| | - Alexa Herrerias
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.S.-M.); (A.H.); (G.K.)
| | - Charles N. Zawatsky
- Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (C.N.Z.); (R.C.)
| | - Ozge Gunduz-Cinar
- Laboratory of Behavioral and Genomic Neuroscience, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Resat Cinar
- Section on Fibrotic Disorders, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (C.N.Z.); (R.C.)
| | - Malliga R. Iyer
- Section on Medicinal Chemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (M.R.I.); (C.M.W.)
| | - Casey M. Wood
- Section on Medicinal Chemistry, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (M.R.I.); (C.M.W.)
| | - Yuhong Lin
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (Y.L.); (B.G.)
| | - Bin Gao
- Laboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (Y.L.); (B.G.)
| | - George Kunos
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.S.-M.); (A.H.); (G.K.)
| | - Grzegorz Godlewski
- Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA; (L.S.-M.); (A.H.); (G.K.)
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Kyaw Hla Z, Ramalho R, Teunissen L, Cuykx I, Decorte P, Pabian S, Van Royen K, De Backer C, Gerritsen S. Socioeconomic and Environmental Factors Associated With Increased Alcohol Purchase and Consumption in 38 Countries During the Covid-19 Pandemic. Front Psychiatry 2021; 12:802037. [PMID: 35095616 PMCID: PMC8795628 DOI: 10.3389/fpsyt.2021.802037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/09/2021] [Indexed: 12/24/2022] Open
Abstract
AIMS To explore changes in alcohol purchase and consumption during the first few months of the Covid-19 pandemic, and assess associations between increased alcohol purchase/use and socioeconomic and environmental factors. DESIGN Secondary data from a cross-sectional online survey conducted from 17 April to 25 June 2020. SETTING Thirty-eight countries from all continents of the world. PARTICIPANTS A total of 37,206 adults (mean age:36.7, SD:14.8, 77% female) reporting alcohol purchasing and drinking habit before and during the pandemic. MEASUREMENTS Changes in alcohol stock-up and frequency of alcohol use during the pandemic and increased alcohol stock-up and use were stratified by gender, age, education, household structure, working status, income loss, psychological distress, and country based on alcohol consumption per capita. The associations between increased alcohol stock-up/use and living with children, working from home, income loss and distress were examined using multivariate logistic regression, controlling for demographic factors. FINDINGS The majority of respondents reported no change in their alcohol purchasing and drinking habits during the early pandemic period. Increased drinking was reported by 20.2% of respondents, while 17.6% reported decreased alcohol use. More than half (53.3%) of respondents experienced psychological distress, with one in five (20.7%) having severe distress. Female gender, being aged under 50, higher educational attainment, living with children, working from home, and psychological distress were all independently associated with increased alcohol drinking during lockdown. Limitations of the study were the non-representative sample, the data collection early in the pandemic, and the non-standard measurement of alcohol consumption. CONCLUSION Increased psychological distress among people during the early pandemic period, resulted in increased alcohol consumption, especially among women with children working from home during lockdown.
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Affiliation(s)
- Zaheer Kyaw Hla
- Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Rodrigo Ramalho
- Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Lauranna Teunissen
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Isabelle Cuykx
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Paulien Decorte
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Sara Pabian
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium.,Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Kathleen Van Royen
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium.,Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium
| | - Charlotte De Backer
- Department of Communication Sciences, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Sarah Gerritsen
- Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
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