Alcohol consumption and lifestyle in medical students

[Temperament and alcoholic behavior in medical students]

BACKGROUND AND AIMS

The Tunisian medical student population is very heterogeneous. This heterogeneity is based among other things on temperamental differences between different students and their behavior and strategies to cope with the requirements and constraints of medical studies. We conducted this study aiming: to determine the prevalence of alcohol use in a student population at Sfax Medical School and to evaluate the factors associated with this use; to study the relationship between affective temperament and alcohol consumption among medical students.

METHODS

We conducted a descriptive and analytical cross-sectional study in the form of a survey between July 2018 and January 2019 among students (aged between 19 and 30) recruited from the University of Medicine of Sfax during their internship in the psychiatric department "A" at CHU HédiChaker of Sfax. We used a pre-established survey sheet based on data from the substance use and affective temperament literature in medical students that was completed by the participants after obtaining their consent and having explained the anonymity and confidentiality of the questionnaire. This sheet included a section on student sociodemographic characteristics, a second part describing the history and characteristics of alcohol consumption and the evaluation of alcohol consumption through the Alcohol Use Disorders Identification Test (AUDIT), and a third part for temperament evaluation by TIME-A, and Temperament Evaluation of Memphis Pisa Paris and San Diego Auto-questionnaire.

RESULTS

We recruited 136 students with an average age of 21.63 years (SD 2 years) and a sex ratio (H/F) of 0.66. Alcohol consumption was observed among 19.8 % of students surveyed, 19.1 % of whom were occasional consumers. The mean age of onset of alcohol consumption was 18.48 years (SD 1.76 years). All consumer students had started using alcohol with their friends. The desired effect was euphoric in 74 % of cases, sleeping for 14.8 % of them. Among consumers, the average score at AUDIT was 6.44 (SD 5.3). Among them 70.4 % had a risk-free consumption (score of 8 or less); 14.8% were at risk (score 9-12) and 11.1 % were likely alcohol dependent (score>12). The evaluation of affective temperament according to TIME-A showed that the cyclothymic and hyperthymic temperament scores were the highest among the students (respectively 5.5 and 4). The analytical study showed that alcohol dependence was significantly more common among male students (p=0.048). Alcohol use was significantly more common among students who smoke (p<0.001) and those who consume cannabis (p<0.001). The bivariate correlation showed that more students had a high score of depressive temperaments (r=0.18, p=0.032), irritable (r=0.2, P=0.018) and hyperthymic (r=0.27, p=0.001). The higher their scores on the AUDIT scale, the more alcohol-dependent they were.

CONCLUSION

The implementation of preventive measures is an obvious emergency. In the same way, taking into account the difference in affective temperaments in this very particular population could have a grandiose importance and an interesting impact both in the screening and in the care of these students.

The legal and moral perceptions of clinical and non-clinical undergraduates regarding substance use: a pilot project

Introduction Heavy alcohol and illicit drug use has been documented amongst medical and dental professionals and educational programs have been developed to attempt to reduce such behaviour in clinical undergraduates. This pilot study aims to investigate the legal and moral perceptions of substance use in clinical and non-clinical undergraduates.Method A cross-sectional self-report questionnaire was administered to 107 clinical and non-clinical undergraduates to investigate their moral and legal perceptions of alcohol and illicit substance use.Results More clinical (72.5%) than non-clinical students (66%) drink alcohol regularly. Both groups perceive ecstasy, cocaine and ketamine as 'high risk' drugs. A third of both clinical (34%) and non-clinical (36%) students support the legalisation of illicit drugs. Forty-seven percent of non-clinical students would consider changing their behaviour if illicit substances were legalised compared to 32% of clinical students. Clinical students believe the legal punishment for Class A drugs is appropriate, but disagree with that for Class C drug use. Personal values of clinical students differ regarding some immoral activities. Social perceptions of illicit substance users are similar for both clinical and non-clinical students with those who use heroin perceived most negatively by 86.5% of all undergraduates.Conclusion Individual substance use behaviours may be influenced by legal perceptions of illicit substance use. Personal values and social norms are also likely to be important. Further research is required to investigate how these perceptions affect a clinical student's decision to participate in excessive alcohol and illicit substance use behaviours.

Tobacco, Alcohol and Drug Use among Dental Undergraduates at One UK University in 2015

The aim of this study was determine the prevalence of tobacco, alcohol and illicit substance use among dental undergraduates at one UK university in 2015. A cross-sectional survey of all 344 dental undergraduates using an anonymous self-report questionnaire was carried out. The response rate was 77%, of which 29% were male and 71% female. Tobacco smoking was reported by 23.6% of males and 12.2% of females, with only 1.6% of females reporting to smoke ≥10 cigarettes per day. Alcohol consumption was reported by 85.5% of males and 84% of females, and reported levels of alcohol consumption increased since becoming undergraduates. Binge drinking was reported by 35.3% of males and 41% of female students. Only 2.6% of males and 0.5% of females reported to be current regular users of cannabis. The vast majority of respondents claimed to have never used any illicit substance. The only other reported regularly used substances by males was Ecstasy (1.3%) and by females were LSD (0.5%), Ecstasy (1.5%), Cocaine (0.5%), Inhalants (0.5%) and Ketamine (0.5%). These results are encouraging. Fewer students reported smoking than in the general population, levels of binge drinking were considerably lower than previously reported figures, as were the numbers of regular users of cannabis and other illicit substances.

'Being sick a lot, often on each other': students' alcohol-related provocation

CONTEXT

Many medical students consume alcohol in excess, which can compromise their professionalism and increase their risk of future alcohol dependency. Just one study in Japan has examined the social influences of alcohol consumption among medical students. Eighty-six per cent (n = 821) of their respondents reported experiencing some form of alcohol-related harassment since the beginning of medical school. No similar research has been conducted in the UK.

METHODS

A cross-sectional online questionnaire of medical students at three British medical schools. In total, 216 students answered questions regarding their experiences of alcohol-related provocation (as targets and instigators), the rate of occurrence of events and their distress following acts of provocation. An open-ended question enabled respondents to report personal experiences of alcohol-related provocation.

RESULTS

Seventy-five per cent (n = 162) of respondents reported experiencing alcohol-related provocation during the past year, with 49.1% (n = 106) reporting instigating acts of provocation. The most prevalent experience (both for targets and instigators) was coercion to drink an entire alcoholic beverage at once as part of a game. Most acts of alcohol-related provocation generated little or no distress. Males were significantly more likely to experience some events than females. Thirty-two personal narratives of alcohol-related provocation were reported (only three reported resisting provocation). Thematic analysis identified three themes with differing power relations: ongoing 'peer-peer provocation' as a commonplace social activity, hierarchical 'peer provocation' at initiation ceremonies and 'team-mate provocation' at sports socials as bonding exercises. The tone of the narratives depended on the context in which the events described occurred.

CONCLUSIONS

Alcohol-related provocation occurs among some UK medical students and may present professionalism issues to medical students. Medical schools may wish to integrate more teaching regarding behaviour around alcohol into their curricula by addressing students' explicit and implicit attitudes towards alcohol consumption.

Drinking at European universities? A review of students' alcohol use

BACKGROUND

High volumes of alcohol consumption and risky single occasion drinking (RSOD) among university students have been shown to be associated with considerable harm to both those who consume alcohol and their fellow students. The vast majority of these studies are based on US and Canadian samples.

AIM

The present article provides an overview of the characteristics of alcohol-consuming university students in Europe.

METHOD

65 relevant articles published within the last 20years using European student populations could be identified.

RESULTS

Sociodemographic, individual, social, and university-related characteristics associated with alcohol consumption patterns could be identified. Male students, in particular, tended to consume alcohol more often and in higher quantities, including RSOD. Students consumed alcohol chiefly during social gatherings and for social and enhancement motives. Those without family obligations and those living alone, with roommates or in areas with a high density of students were more likely to consume alcohol in higher quantities, and to engage in RSOD. Students tend to overestimate the extent of their fellow students' alcohol consumption.

CONCLUSIONS

Health promotion and prevention efforts which focus on these characteristics (i.e., gender, drinking motives, living conditions and social norms), and which have been successful and evaluated among university students in the US and Canada, may also be very promising for their European counterparts.

Tobacco, alcohol and drug use among dental undergraduates at one English university in 1998 and 2008

OBJECTIVE

To estimate the prevalence of tobacco, alcohol and drug use among dental undergraduates at one English university in 2008, and compare these with prevalence in 1998.

DESIGN

Cross-sectional survey using an anonymous self-report questionnaire.

SUBJECTS AND METHODS

In 2008 all 384 dental undergraduates at one English university were sent a questionnaire in order to obtain data on the frequency and amount of tobacco, alcohol, cannabis and other illicit drugs used before and during their time as a dental undergraduate. The same survey had been conducted on dental undergraduates at the university 10 years earlier.

RESULTS

Tobacco smoking was reported by 27% of males and 13.5% of females, a reduction from 1998 (42% of males and 32% of females) being significant among females. 63% of males and 69.5% of females reported drinking alcohol: significantly fewer than in 1998 (82% males and 90% females). Binge drinking was reported by 69.5% of males compared to 56% in 1998. In females 66% binged compared to 58.5% in 1998. The increase in males was significant. 62% of males and 68% of females had never used cannabis compared to 38% in males and 50.5% of females in 1998, a significant reduction. A significant reduction in amphetamine use was reported among both male and female undergraduates in 2008 compared to 1998 and a significant increase in amyl nitrate use was reported by females. Reported illicit drug use was associated with alcohol drinking, and particularly with tobacco use.

CONCLUSION

Dental undergraduates at one English university in 2008 when compared to those in 1998 are reported to be significantly less likely to drink alcohol, use cannabis and amphetamines. If female, they are significantly less likely to smoke tobacco and overestimate the number of units of alcohol they can safely consume in a week, but more likely to use amyl nitrate. If male, those who drink alcohol are significantly less likely to drink at a level of increased risk, but more likely to binge drink.

Changes in undergraduate student alcohol consumption as they progress through university

Background

Unhealthy alcohol use amongst university students is a major public health concern. Although previous studies suggest a raised level of consumption amongst the UK student population there is little consistent information available about the pattern of alcohol consumption as they progress through university. The aim of the current research was to describe drinking patterns of UK full-time undergraduate students as they progress through their degree course.

Method

Data were collected over three years from 5895 undergraduate students who began their studies in either 2000 or 2001. Longitudinal data (i.e. Years 1–3) were available from 225 students. The remaining 5670 students all responded to at least one of the three surveys (Year 1 n = 2843; Year 2 n = 2219; Year 3 n = 1805).

Results

Students reported consuming significantly more units of alcohol per week at Year 1 than at Years 2 or 3 of their degree. Male students reported a higher consumption of units of alcohol than their female peers. When alcohol intake was classified using the Royal College of Physicians guidelines [1] there was no difference between male and females students in terms of the percentage exceeding recommended limits. Compared to those who were low level consumers students who reported drinking above low levels at Year 1 had at least 10 times the odds of continuing to consume above low levels at year 3. Students who reported higher levels of drinking were more likely to report that alcohol had a negative impact on their studies, finances and physical health. Consistent with the reduction in units over time students reported lower levels of negative impact during Year 3 when compared to Year 1.

Conclusion

The current findings suggest that student alcohol consumption declines over their undergraduate studies; however weekly levels of consumption at Year 3 remain high for a substantial number of students. The persistence of high levels of consumption in a large population of students suggests the need for effective preventative and treatment interventions for all year groups.

Adult outcomes of binge drinking in adolescence: findings from a UK national birth cohort

AIMS

The aim of the study was to determine outcomes in adult life of binge drinking in adolescence in a national birth cohort.

DESIGN AND SETTING

Longitudinal birth cohort: 1970 British Birth Cohort Study surveys at 16 years (1986) and 30 years (2000).

PARTICIPANTS

A total of 11 622 subjects participated at age 16 years and 11 261 subjects participated at age 30 years.

MEASUREMENTS

At the age of 16 years, data on binge drinking (defined as two or more episodes of drinking four or more drinks in a row in the previous 2 weeks) and frequency of habitual drinking in the previous year were collected. Thirty-year outcomes recorded were alcohol dependence/abuse (CAGE questionnaire), regular weekly alcohol consumption (number of units), illicit drug use, psychological morbidity (Malaise Inventory) and educational, vocational and social history.

FINDINGS

17.7% of participants reported binge drinking in the previous 2 weeks at the age of 16 years. Adolescent binge drinking predicted an increased risk of adult alcohol dependence (OR 1.6, 95% CI 1.3 to 2.0), excessive regular consumption (OR 1.7, 95% CI 1.4 to 2.1), illicit drug use (OR 1.4, 95% CI 1.1 to 1.8), psychiatric morbidity (OR 1.4, 95% CI 1.1 to 1.9), homelessness (OR 1.6, 95% CI 1.1 to 2.4), convictions (1.9, 95% CI 1.4 to 2.5), school exclusion (OR 3.9, 95% CI 1.9 to 8.2), lack of qualifications (OR 1.3, 95% CI 1.1 to 1.6), accidents (OR 1.4, 95% CI 1.1 to 1.6) and lower adult social class, after adjustment for adolescent socioeconomic status and adolescent baseline status of the outcome under study. These findings were largely unchanged in models including both adolescent binge drinking and habitual frequent drinking as main effects.

CONCLUSIONS

Adolescent binge drinking is a risk behaviour associated with significant later adversity and social exclusion. These associations appear to be distinct from those associated with habitual frequent alcohol use. Binge drinking may contribute to the development of health and social inequalities during the transition from adolescence to adulthood.

Effect of Brief Behavioral Intervention Program in Managing Stress in Medical Students from Two Southern California Universities

The study aims to assess 1) the prevalence of stress among a group of third and fourth year medical students (MS) from two Southern California universities and 2) the effect of a brief behavioral intervention program (BBIP) on stress management among the students instructed on stress intervention techniques. The stress level was determined by using the General Well Being Scale (GWBS), a self-report questionnaire designed by the National Center for Health Statistics.1 The stress testing was done prior to the psycho-educational lecture on stress. The prevalence of stress and the variation of stress based on gender, academic year (third vs. fourth year) and time of testing (beginning vs. end of rotation) was measured in 104 medical students. To assess the effect of the psycho-educational lectures on stress, the last 32 students who rotated in our service had the pre-test and the lecture at the beginning of the rotation and the post-test at the end of the rotation. Among the medical students studied, 53/104 (51%) reported stress; among this group, 20/53 (37.7%) reported severe stress or distress. The prevalence of stress in this group of students was not significantly different if the stress level was measured at the beginning (46.9%) vs. the end of the rotation (52.8%, p = 0.57). The total stress score was lower (suggesting higher stress) in the fourth vs. third year MS (69.7+/-16.3 vs. 73.2+/-12.7, p=0.2), and in female students vs. male students (69.9+/-14.5 vs. 73.7+/-13.8, p=0.17). Female students, when compared to their male counterparts, had a lower anxiety score (12.2+/-4.4 vs. 15.4+/-4.3, p p0.005), consistent with higher anxiety level, since the polarity for the anxiety questions is reversed. Among the students who had both a pre and post-test (N=32) after the BBIP (deep diaphragmatic breathing, self-control relaxation, walking meditation), the reported stress decreased from 46.9 % (15/32) to 21.9% (7/25) (p 0.05). In addition, scores indicated that the brief behavioral intervention program significantly decreased the anxiety level and improved the positive well-being. Our study showed that stress is very prevalent among the medical students tested, affecting 51% of the students. Among those who reported stress, 37.7% reported distress. Female students reported a higher level of anxiety compared to their male colleagues. Following the implementation of a brief behavioral program, the prevalence of stress in this group of students decreased by 46.7 %. This was associated with a decrease in the reported anxiety and an increase in the positive well-being. Since stress is very prevalent among medical students, increased awareness of stress and early intervention may prevent burnout, improve job satisfaction and ultimately improve health care delivery.

A comparison of alcohol and drug use among dental undergraduates and a group of non-medical, professional undergraduates

OBJECTIVE

To compare the alcohol and drug use of dental and law undergraduates.

DESIGN

Anonymous self-report questionnaire.

SUBJECTS AND METHODS

All dental undergraduates (n = 263) and a randomly selected group of law undergraduates (n = 180) from the same university were questioned on their use of alcohol, tobacco and illicit drugs.

RESULTS

Current tobacco use was reported by 7% of dental students and 19% of law students. Alcohol use was reported by 86% of dental students and 88% of law students, with 44% of dental students and 52% of law students estimating they drank above recommended safe limits (14 units for females, 21 units for men). Binge drinking was reported by 71% of dental students and 75% of law students, with weekly binge drinking reported by 27% and 34% of dental and law students respectively. Cannabis experience was reported by 44% of dental students and 52% of law students, with current use reported by 12% and 25% of dental and law students respectively. A small proportion of dental and law students reported using other class A and B drugs including ecstasy, amphetamines and cocaine.

CONCLUSIONS

Dental students appear to be indulging in similar levels of alcohol and illicit drug use when compared to students of a different, non-medical faculty. Binge drinking may be more prevalent than previously thought, with potential risks to health, patient safety and professional status.

Binge drinking and sex: effects on mood and cognitive function in healthy young volunteers

This study compared the mood and cognitive performance of male and female teetotal and binge drinking students. The binge drinkers had significantly lower self-ratings of trait anxiety and depression and of state alertness at the time of testing than did the teetotallers. The females had significantly higher ratings of trait and state anxiety, but there were no Sex x Bingeing interactions on mood. The binge drinkers made significantly fewer correct responses in a test of sustained attention and recalled fewer line drawings. There was a significant Sex x Binge interaction in a spatial recognition task because the male, but not the female, binge drinkers were slower to make correct responses. Males performed better than females in both the spatial and pattern recognition memory tasks. There were three tests of executive function. In a spatial working memory task, males performed better than females, but there were no effects of binge drinking. There were no effects in a test of mental flexibility. However, in a test of planning, the binge drinkers were significantly slower than the teetotallers were. Thus, compared with a group of teetotallers, the binge drinkers had lower trait anxiety and depression and poorer performance in tests of sustained attention, episodic memory and planning ability.

Demonstration of the efficacy and safety of a novel substance P (NK1) receptor antagonist in major depression

The efficacy and safety of a selective NK(1) antagonist, L-759274, was investigated in outpatients with diagnosis of major depressive disorder with melancholic features, following evidence obtained with the novel compound aprepitant that Substance P (NK(1)) antagonists may provide a unique mechanism of antidepressant activity. A randomized, double-blind placebo-controlled study was carried out. Patients, male or female, aged 18-60, scoring >/=25 points on total of first 17 items of 21-item Hamilton Depression Scale (HAMD), and scoring >/=4 (moderately ill) on Clinical Global Impressions-Severity Scale were randomized to oral L-759274 40 mg daily (n=66) or placebo (n=62) for 6 weeks. For patients receiving L-759274, improvement (mean decrease from baseline) in HAMD-17 total score was 10.7 points, compared with a mean 7.8 point improvement in patients receiving placebo (p<0.009). Mean scores for item 1 of HAMD-17 (depressed mood) also improved to a greater extent in the active group compared with the placebo group (0.3 points, p<0.058). Compared with placebo, mean scores on Clinical Global Impressions-Improvement Scale improved significantly by the end of the trial (p=0.009). L-759274 was generally safe and well-tolerated. The incidence of sexual side effects was on par with that observed in patients receiving placebo, and the incidences of gastrointestinal effects were low. Antidepressant actions have now been observed with two different highly selective NK(1) antagonists (aprepitant and L-759274). NK(1) antagonism is a replicated and generally well-tolerated antidepressant mechanism.

Generalised anxiety disorder: treatment options

In recent years generalised anxiety disorder (GAD) has become a much better defined disorder, with specific criteria distinguishing it from the other anxiety disorders; however, it still lacks the same public and scientific interests as some of the other anxiety disorders such as panic and social phobia. Nevertheless, refinement in the treatment of GAD is becoming more evident through the conduct of clinical trials. Up until the mid-1980's, treatment consisted primarily of benzodiazepines. However, as a result of growing characterisation of their abuse potential, other therapeutic options were explored. Benzodiazepines became seen as an effective short-term therapy, and buspirone and some of the newer antidepressants have become the treatment of choice for patients with GAD requiring long-term treatment. Buspirone was the first available alternative to the benzodiazepines in the US; however, the initial excitement over this agent was somewhat dampened because of its mild efficacy combined with a slow onset of action. The antidepressants were seen as beneficial for the treatment of GAD because of the high comorbidity with depression, thus allowing a better outcome for these patients. The antidepressants that offer both a good adverse effect profile and efficacy are the selective serotonin reuptake inhibitors including paroxetine, and the serotonin-norepinephrine reuptake inhibitors such as venlafaxine. Clinicians should also consider the potential benefits of psychotherapy as an adjunct to medication. There are a number of potentially new pharmacotherapies being investigated, including newer serotonin 5-HT1A receptor agonists, cholecystokinin receptor antagonists, neurokinin receptor antagonists, gabapentin and its analogues, and gamma-aminobutyric acid (GABA)A receptor modulators. However, these compounds are all in the early stages of investigation, and there are no new therapies expected to be released in the near future. Nonetheless, in the search for the ideal anxiolytic, a more positive outlook is allowed by imminent future research for new treatment options in patients with GAD.

The changing patterns of drinking, illicit drug use, stress, anxiety and depression in dental students in a UK dental school: a longitudinal study

OBJECTIVE

To investigate alcohol and illicit drug use in a cohort of dental undergraduates through to VT year.

SETTING

A UK dental school (with a medical school comparison group).

SUBJECTS AND METHODS

A cohort of dental students anonymously completed a lifestyle questionnaire about drinking and smoking, illicit drug use, stress, anxiety and depression in the spring of 1995 and 1998 as second and final year undergraduate students respectively, and in the summer of 1999 after one year working as qualified dentists. A parallel cohort of medical students also anonymously completed the questionnaire at the same time points in their undergraduate course as for the dental students, and at the end of a year working as Pre-Registration House Officers (PRHOs).

RESULTS

The proportion of dental students in Newcastle drinking above the recommended low risk limits of alcohol declined from 47% as second year students to 25% as final year students and then it increased to 41% as qualified dentists, whilst in medical students it steadily increased over the three time points of the survey (33% to 43% to 54%). A greater proportion of dental students were drinking at hazardous levels at all three time-points, compared with medical students. Experimentation with illicit drugs ranged from 47% as second year students to 54% as final year students and to 51% as dentists. The prevalence of illicit drug use in medical students was similar to that in dental students. Forty seven per cent of the dental student cohort as second year students, 67% as final year students and 16% as dentists suffered from possible pathological anxiety, compared with 47%, 26% and 30% in the medical student cohort. The proportion of dentists suffering from stress decreased from 72% as final year students to 19% as dentists. In the medical student group, the proportion increased from 32% as final year students to 39% as PRHOs.

CONCLUSION

This longitudinal study revealed that a high proportion of dental students from Newcastle continue to drink excessively and experiment with illicit drugs both as undergraduates and as practising dentists. A significant proportion also suffer from anxiety and stress. Further measures are needed in order to reduce alcohol and substance misuse and stress and anxiety among dental students and dentists.

Drink and drugs: from medical students to doctors

Drinking and illicit drug use were assessed longitudinally in a cohort of medical students who were surveyed in the second and fifth year of their undergraduate studies and after 1 year as PRHOs. Mean alcohol consumption had increased significantly (P<0.015) over the three time points; 15.2-16.0-18.8 units/week. Experimentation with illicit drugs had increased from 50 to 63 to 65%. Although education on alcohol and illicit drugs should be part of core curriculum in medical schools, support and intervention in the workplace is also needed for individuals with alcohol and/or drug problems.

A survey of alcohol and drug use among UK based dental undergraduates

OBJECTIVE

This study was designed to investigate the prevalence of alcohol and drug use.

DESIGN

Anonymous self-report questionnaire.

SETTING

A UK dental school in May 1998.

SUBJECTS AND METHODS

1st-5th year dental undergraduates (n = 264) were questioned on their use of alcohol and tobacco, cannabis and other illicit drugs whilst at dental school, and before entry.

RESULTS

Eighty two per cent of male and 90% of female undergraduates reported drinking alcohol. Of those drinking, 63% of males and 42% of females drank in excess of sensible weekly limits (14 units for females, 21 units for males), with 56% of males and 58.5% of females 'binge drinking'. Regular tobacco smoking (10 or more cigarettes a day) was found to have a statistically significant association with year of study, 4th-5th year undergraduates being eight times more likely to regularly smoke than their junior colleagues. Fifty five per cent of undergraduates reported cannabis use at least once or twice since starting dental school, with 8% of males and 6% of females reporting current regular use at least once a week.

CONCLUSION

Dental undergraduates are drinking above sensible weekly limits of alcohol, binge drinking and indulging in illicit drug use. Dental Schools should designate a teacher responsible for education of undergraduates regarding alcohol and substance abuse.

Factors influencing alcohol and illicit drug use amongst medical students

Alcohol, illicit drug use, and other lifestyle variables, as well as stress, anxiety and personality were evaluated in 194 first year medical students. 45% of the students reported drinking above the recommended UK limits for alcohol consumption. The age at which the first full drink of alcohol was taken was predictive of the current level of alcohol use. Cannabis was the most frequently used illicit drug (45%). There were significant positive associations between alcohol consumption and experiences such as missing study, becoming more sexually involved and getting into a physical fight or argument. There were also significant positive associations between the personality characteristic of psychoticism and alcohol and illicit drug consumption. The effectiveness of current health education on alcohol and illicit drugs is questioned.

Social influences as explanations for substance use differences among Asian-American and European-American adolescents

The present study examines the social influences in the Asian-American and European-American adolescent environment to provide a greater understanding of effect of ethnic differences on the prevalence of substance abuse. Participants were 957 Asian-American and 3705 European-American seventh grade adolescents. It was found that Asian-American students were less likely to use alcohol and cigarettes, and had a more abstinence-promoting environment than European-American adolescents. This difference in Asian-American adolescents appeared to be the result of less adult and peer influence to use alcohol or cigarettes, less offers of alcohol, and an increased likelihood of having an intact family when compared to European-American adolescents. Additionally, Asian-American adolescents reported having fewer friends and spending less time with their friends than European-American adolescents. It was concluded that social influences play an important role in explaining why Asian-American adolescents have lower rates of substance use.

An update on British medical students' lifestyles

Information about medical students' lifestyles was obtained from 785 second-year students from seven medical schools in Great Britain by a personally administered questionnaire. Fifteen per cent of the students were non-drinkers. Among those who drank, 48% of the men and 38% of the women exceeded sensible weekly limits of alcohol consumption, and high-risk levels of consumption were reported by 12% of men and 7% of women. Cannabis had been used at least once or twice by more than half the men and 40% of the women, and 10% reported regular use (weekly or more often). Experience with other illicit drugs was also reported: amphetamines (8% of students), LSD (7%), ecstasy (4%), amyl/butyl nitrate (10%) and magic mushrooms (7%). Nineteen per cent of the students had used two or more different drugs. Experience with illicit drugs started before entering university in more than a third of those who used them. Comparison of the results with other student surveys suggests that the lifestyles of medical students differ little from those of other student groups, but that alcohol and illicit drug consumption is increasing in university students generally. Prospective studies are under way to establish whether medical students change their lifestyles at later stages of their course and after qualification.

The effect of lorazepam on long-term verbal recall in heavy and light social drinkers

Two experiments investigated long-term verbal memory performance in groups of 20-year-old heavy (HSDs) and light social drinkers (LSDs), in the presence and absence of a pharmacological challenge (lorazepam 2 mg). In Experiment 1 (n = 13), a verbal learning task was presented visually and it was found that lorazepam significantly impaired delayed verbal recall performance in both groups. Experiment 2 (n = 14) assessed the effect of presenting the verbal learning task in the auditory compared to the visual modality. Both groups' performance on the delayed trials of the visually presented task was reduced in the lorazepam treatment. However, in the auditory presented task, lorazepam reduced 30-min delayed recall performance in the HSDs but not in the LSDs. The differential effect of lorazepam on HSDs compared to LSDs on delayed recall performance when material is presented in the auditory modality may suggest that frequent heavy social drinking results in changes in CNS functioning.

Patterns of alcohol consumption, smoking and illicit drug use in British university students: interfaculty comparisons

The use of tobacco, alcohol and illicit drugs was investigated by questionnaire in 3699 second year students in ten UK universities. Patterns of use varied considerably between different faculty groups. Tobacco use was most prevalent in arts, social science and biological science students, among whom 36-39% of men and nearly one third of women were regular smokers, and least in female veterinary students (5%). Alcohol consumption was greatest in biological science students: 23% of those who drank exceeded 'hazardous' levels compared with 10-16% in all other faculties. Prevalence of cannabis use was highest in arts and social science students of whom 27% reported regular weekly use compared with 9-22% in other faculties. Experience with other illicit drugs was greatest among arts, social science and physical science students, of whom 64-71% reported experience at least once or twice, and least among veterinary students (42%). Identification of different lifestyles may help to direct appropriate health information to particular student groups.

Alcohol and drug use in UK university students

BACKGROUND

Alcohol and illicit drug use are increasing among school children and young adults in the UK. Such increases have also been noted among university students and there is a need for a large survey across different universities and faculties. We report such a survey.

METHODS

Information about drinking, use of cannabis and other illicit drugs, other lifestyle variables, and subjective ratings of anxiety and depression was obtained by questionnaire in a cross-faculty sample of 3075 second-year university students (1610 men, 1447 women, 18 sex not stated) from ten UK universities. The questionnaire was personally administered during scheduled lecture hours and almost all the students participated. The sample reflected the interfaculty and sex distribution and the proportion of non-white students at UK universities.

FINDINGS

11% of the students were non-drinkers. Among drinkers, 61% of the men and 48% of the women exceeded "sensible" limits of 14 units per week for women and 21 for men. Hazardous drinking (> or = 36 units per week for women, > or = 51 for men) was reported by 15% of the drinkers. Binge drinking was declared by 28% of drinkers. 60% of the men and 55% of the women reported having used cannabis once or twice and 20% of the sample reported regular cannabis use (weekly or more often). Experience with other illicit drugs was reported by 33% of the sample, most commonly LSD (lysergic acid diethylamide), amphetamines, Ecstasy (methylenedioxymethamphetamine), and amyl/butyl nitrate which had each been used by 13-18% of students. 34% of these had used several drugs. Drug use had started at school in 46% of the sample; 13% began after entering university. The overwhelming reason given for taking alcohol or drugs was pleasure. Subjective ratings of anxiety on the hospital anxiety depression scale were high, and sleep difficulties were common, but neither related to alcohol or drug use.

INTERPRETATION

There is a need for better education about alcohol, drugs, and general health in universities. Such education should include all faculties. It remains unclear whether university students' lifestyles are carried over into later life.

Personality, lifestyles, alcohol and drug consumption in a sample of British medical students

Personality characteristics and lifestyle variables were assessed in two cohorts of second-year medical students at the University of Newcastle upon Tyne, UK as part of a psychopharmacology 'teach-in' in 1993 and 1994. The pooled sample included 186 students: 77 men, 109 women, mean age 20.4 +/- 1.8 years. Measures included the Eysenck Personality Questionnaire, the Hospital Anxiety Depression Scale, and a questionnaire concerning consumption of alcohol, tobacco, cannabis and other illicit drugs, and physical exercise. The results were compared, where possible, with a similar survey in Newcastle upon Tyne medical students in 1983 and 1984. Personality variables, prevalence of cigarette smoking, levels of caffeine consumption and participation in sports had not changed significantly over the decade. There appeared to be a modest overall increase in alcohol consumption and in the 1993 and 1994 cohorts of students, 25.5% of those who drank alcohol exceeded recommended low risk levels (comparable data not available for 1983 and 1984). Reported use of cannabis and other illicit drugs had more than doubled, and in the present survey 49.2% of students recorded using cannabis and 22% had tried other illicit drugs. Corresponding figures for 1983 and 1984 were 20.9% for cannabis and 3.3% for other illicit drugs. Anxiety levels were not measured in 1983 and 1984 but in the present survey 39.3% of the students had anxiety ratings within the clinically significant range. The high levels of alcohol consumption and illicit drug use, and the high anxiety ratings, in this sample of medical students are a cause for concern.(ABSTRACT TRUNCATED AT 250 WORDS)