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Helaakoski V, Zellers S, Hublin C, Ollila HM, Latvala A. Associations between sleep medication use and alcohol consumption over 36 years in Finnish twins. Alcohol 2023:S0741-8329(23)00344-0. [PMID: 38101525 DOI: 10.1016/j.alcohol.2023.12.004] [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: 08/16/2023] [Revised: 11/23/2023] [Accepted: 12/12/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Sleep medication use is an indicator of underlying sleep problems that might be induced by various factors such as alcohol use. However, the longitudinal relationship between drinking and sleep problems remains poorly understood. We investigated associations between sleep medication and alcohol use throughout adulthood, and examined the role of familial and potential confounding factors contributing to these associations. METHODS We used information of zygosity and self-report questionnaire data over a follow-up period of 36 years from the Older Finnish Twin Cohort (N=13,851). RESULTS Logistic regression analyses suggested consistent associations between sleep medication use and heavy/binge drinking at all four time points (OR range =1.36-3.18, P <0.05), implying that increased drinking is associated with increased sleep medication use over time. Cross-lagged path analyses suggested that moderate/heavy and binge drinking predict sleep medication use at most time points (OR range = 1.15-1.94, P <0.05), whilst sleep medication use predicts subsequent abstaining from alcohol (OR range =2.26-2.47, P <0.05). Within-pair analyses implied that familial factors play a role, and quantitative genetic modelling estimated genetic factors to explain approximately 80% of the lifetime association of sleep medication use with moderate/heavy and binge drinking. CONCLUSIONS Drinking is associated with sleep medication use throughout adulthood. Further, our results suggest that drinking is likely to predict sleep medication use, thereby potentially constituting a risk factor for sleep problems, and that genetic factors contribute to the association. These findings are important in terms of better understanding the development of sleep and alcohol use disorders.
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Affiliation(s)
- Viola Helaakoski
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland.
| | - Stephanie Zellers
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland
| | - Christer Hublin
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hanna M Ollila
- Institute for Molecular Medicine Finland, HiLIFE, University of Helsinki, Helsinki, Finland; Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, USA; Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Antti Latvala
- Institute of Criminology and Legal Policy, University of Helsinki, Helsinki, Finland
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Tseng YJ, Lai CY, Wang YC, Chen WK, Kao CH, Chen CH. Possible increased risk of colonic diverticular disease from alcohol intoxication or abuse. Medicine (Baltimore) 2020; 99:e18840. [PMID: 32011498 PMCID: PMC7220395 DOI: 10.1097/md.0000000000018840] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Alcohol consumption has been suggested as a potential risk factor for diverticular diseases. This study investigated the association between alcohol intoxication or abuse and colonic diverticular disease (CDD).Using the National Health Insurance Research Database of Taiwan from January 1, 2000, to December 31, 2008, 51, 866 subjects newly diagnosed with alcohol intoxication were enrolled in this study as the alcohol intoxication cohort. The control (nonalcohol intoxication) cohort was frequency-matched 1:4 by age, sex and index year. Data were analyzed using a Cox proportional hazards model.The overall incidence of CDD (per 10,000 person-years) for the alcohol intoxication and control cohorts was 16.4 and 3.46, respectively. Compared with patients in the control cohort (95% confidence interval [CI] = 2.76-3.74), those with alcohol intoxication exhibited a 3.21-fold risk of CDD; the risk was particularly higher in male patients (adjusted hazard ratio [aHR] = 3.19, 95% CI = 2.72-3.74) and in those aged <45 years (aHR = 4.95, 95% CI = 3.91-6.27). The alcohol intoxication still had higher risk of CDD than nonalcohol intoxication, regardless of subjects without comorbidity (aHR = 3.38, 95% CI = 2.77-4.11) or with (aHR = 2.85, 95% CI = 2.25-3.61).There was a significant relationship between alcohol intoxication or abuse and CDD.
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Affiliation(s)
| | - Ching-Yuan Lai
- Department of Emergency Medicine
- School of Medicine, College of Medicine
| | - Yu-Chiao Wang
- School of Medicine, College of Medicine
- Management Office for Health Data
| | | | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hung Chen
- Department of Emergency Medicine
- School of Medicine, College of Medicine
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Haighton C, Kidd J, O’Donnell A, Wilson G, McCabe K, Ling J. 'I take my tablets with the whiskey': A qualitative study of alcohol and medication use in mid to later life. PLoS One 2018; 13:e0205956. [PMID: 30335835 PMCID: PMC6193697 DOI: 10.1371/journal.pone.0205956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 10/04/2018] [Indexed: 01/11/2023] Open
Abstract
Background Concurrent alcohol and medication use can result in significant problems especially in mid to later life. Alcohol is often used instead of medication for a number of health-related conditions. This novel qualitative study explored concurrent alcohol and medication use, as well as the use of alcohol for medicinal purposes, in a sample of individuals in mid to later life. Methods Twenty-four interviews (12 men/12 women, ages 51–90 years) and three focus groups (n = 27, 6 men/21 women, ages 50–95 years) from three branches of Age UK and two services for alcohol problems in North East England. Results Older people in this study often combined alcohol and medication, frequently without discussing this with their family doctor. However, being prescribed medication could act as a motivating factor to stop or reduce alcohol consumption. Participants also used alcohol to self-medicate, to numb pain, aid sleep or cope with stress and anxiety. Some participants used alcohol to deal with depression although alcohol was also reported as a cause of depression. Women in this study reported using alcohol to cope with mental health problems while men were more likely to describe reducing their alcohol consumption as a consequence of being prescribed medication. Conclusions As older people often combine alcohol and medication, health professionals such as family doctors, community nurses, and pharmacists should consider older patients’ alcohol consumption prior to prescribing or dispensing medication and should monitor subsequent drinking. In particular, older people should be informed of the dangers of concurrent alcohol and medication use.
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Affiliation(s)
- Catherine Haighton
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, United Kingdom
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Jess Kidd
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Amy O’Donnell
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Graeme Wilson
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
- Reid School of Music, University of Edinburgh, Edinburgh, United Kingdom
| | - Karen McCabe
- School of Nursing and Health Sciences, University of Sunderland, Sunderland, United Kingdom
| | - Jonathan Ling
- School of Nursing and Health Sciences, University of Sunderland, Sunderland, United Kingdom
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Karjalainen K, Haukka J, Lintonen T, Joukamaa M, Lillsunde P. The use of psychoactive prescription drugs among DUI suspects. Drug Alcohol Depend 2015; 155:215-21. [PMID: 26282109 DOI: 10.1016/j.drugalcdep.2015.07.1195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 07/06/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The study seeks to increase understanding of the use of psychoactive prescription drugs among persons suspected of driving under the influence (DUI). We studied whether the use of prescribed psychoactive medication was associated with DUI, and examined the difference in the use of prescription drugs between DUI recidivists and those arrested only once. METHODS In this register-based study, persons suspected of DUI (n=29470) were drawn from the Register of DUI suspects, and an age- and gender-matched reference population (n=30043) was drawn from the Finnish general population. Data on prescription drug use was obtained by linkage to the National Prescription Register. The associations of DUI arrest and use of psychoactive prescription drugs in different DUI groups (findings for alcohol only, prescription drugs, prescription drugs and alcohol, illicit drugs) were estimated by using mixed-effect logistic regression. RESULTS The use of psychoactive prescription drugs and DUI appeared to be strongly associated, with DUI suspects significantly more likely to use psychoactive prescription drugs compared to the reference population. Gender differences existed, with the use of benzodiazepines being more common among female DUI suspects. Moreover, DUI recidivists were more likely to use psychoactive prescription drugs compared to those arrested only once. CONCLUSIONS In addition to alcohol and/or illicit drug use, a significant proportion of DUI suspects were using psychoactive prescription drugs. When prescribing psychoactive medication, especially benzodiazepines, physicians are challenged to screen for possible substance use problems and also to monitor for patients' alcohol or illicit drug use while being medicated.
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Affiliation(s)
| | - Jari Haukka
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland; Hjelt-Institute, Department of Public Health, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland
| | - Tomi Lintonen
- The Finnish Foundation for Alcohol Studies, P.O. Box 30, FI-00271 Helsinki, Finland; School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
| | - Matti Joukamaa
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
| | - Pirjo Lillsunde
- National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
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Ivanets NN, Kinkulkina MA, Avdeeva TI, Tikhonova YG. Remote consequences of the long-term uncontrollable consumption of anxiolytics and hypnotics in elderly: a problem of drug dependence. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:47-59. [DOI: 10.17116/jnevro20151157147-59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Haaramo P, Lallukka T, Lahelma E, Hublin C, Rahkonen O. Insomnia symptoms and subsequent psychotropic medication: a register-linked study with 5-year follow-up. Soc Psychiatry Psychiatr Epidemiol 2014; 49:1993-2002. [PMID: 24643300 DOI: 10.1007/s00127-014-0862-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 02/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study examined the associations of insomnia symptoms with subsequent psychotropic medication, reflecting mental health. METHODS Postal baseline surveys among 40- to 60-year-old employees of the city of Helsinki, Finland, were collected in 2000-2002 (N = 6,227, response rate 67%, 78% women) and longitudinally linked with national register data on prescribed reimbursed medication. Insomnia symptoms at baseline comprised difficulties in initiating and maintaining sleep, and non-restorative sleep. All purchased psychotropic medication 5-7 years prior to and 5 years after baseline was included. Outcomes were any psychotropic medication; antidepressants; and anxiolytics, hypnotics, and sedatives. Covariates included socio-demographic and work-related factors, health behaviors, lifetime mental disorders, and prior psychotropic medication. Logistic regression analysis was used to calculate odds ratios (OR) and their 95% confidence intervals (CI). RESULTS Insomnia symptoms were associated with higher frequency of subsequent psychotropic medication prescriptions. The associations were strongest for frequent insomnia symptoms (women OR 3.55, 95% CI 2.64-4.77; men OR 4.64, 95% CI 2.49-8.66, adjusted for age and prior medication), but also rare and occasional symptoms were associated with psychotropic medication. Further adjustments had negligible effects. CONCLUSIONS Insomnia symptoms were associated with prescribed psychotropic medication during follow-up in a dose-response manner. Attention should be given to the prevention of insomnia symptoms to curb subsequent mental problems.
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Affiliation(s)
- Peija Haaramo
- Department of Public Health, Hjelt Institute, University of Helsinki, Mannerheimintie 172, PO Box 41, 00014, Helsinki, Finland,
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Billioti de Gage S, Moride Y, Ducruet T, Kurth T, Verdoux H, Tournier M, Pariente A, Bégaud B. Benzodiazepine use and risk of Alzheimer's disease: case-control study. BMJ 2014; 349:g5205. [PMID: 25208536 PMCID: PMC4159609 DOI: 10.1136/bmj.g5205] [Citation(s) in RCA: 329] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the relation between the risk of Alzheimer's disease and exposure to benzodiazepines started at least five years before, considering both the dose-response relation and prodromes (anxiety, depression, insomnia) possibly linked with treatment. DESIGN Case-control study. SETTING The Quebec health insurance program database (RAMQ). PARTICIPANTS 1796 people with a first diagnosis of Alzheimer's disease and followed up for at least six years before were matched with 7184 controls on sex, age group, and duration of follow-up. Both groups were randomly sampled from older people (age >66) living in the community in 2000-09. MAIN OUTCOME MEASURE The association between Alzheimer's disease and benzodiazepine use started at least five years before diagnosis was assessed by using multivariable conditional logistic regression. Ever exposure to benzodiazepines was first considered and then categorised according to the cumulative dose expressed as prescribed daily doses (1-90, 91-180, >180) and the drug elimination half life. RESULTS Benzodiazepine ever use was associated with an increased risk of Alzheimer's disease (adjusted odds ratio 1.51, 95% confidence interval 1.36 to 1.69; further adjustment on anxiety, depression, and insomnia did not markedly alter this result: 1.43, 1.28 to 1.60). No association was found for a cumulative dose <91 prescribed daily doses. The strength of association increased with exposure density (1.32 (1.01 to 1.74) for 91-180 prescribed daily doses and 1.84 (1.62 to 2.08) for >180 prescribed daily doses) and with the drug half life (1.43 (1.27 to 1.61) for short acting drugs and 1.70 (1.46 to 1.98) for long acting ones). CONCLUSION Benzodiazepine use is associated with an increased risk of Alzheimer's disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.
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Affiliation(s)
| | - Yola Moride
- Research Center, University of Montreal Hospital Center, Montreal, Canada Faculty of Pharmacy, University of Montreal, Montreal, Canada
| | - Thierry Ducruet
- Research Center, University of Montreal Hospital Center, Montreal, Canada
| | - Tobias Kurth
- Inserm Research Center for Epidemiology and Biostatistics, U897-Team Neuroepidemiology, F-33000 Bordeaux, France University of Bordeaux, College of Health Sciences, F-33000 Bordeaux, France
| | - Hélène Verdoux
- INSERM, U657-Pharmacoepidemiology, Université de Bordeaux, F-33000 Bordeaux, France Centre Hospitalier Charles Perrens, F-33000 Bordeaux, France
| | - Marie Tournier
- INSERM, U657-Pharmacoepidemiology, Université de Bordeaux, F-33000 Bordeaux, France Centre Hospitalier Charles Perrens, F-33000 Bordeaux, France
| | - Antoine Pariente
- INSERM, U657-Pharmacoepidemiology, Université de Bordeaux, F-33000 Bordeaux, France
| | - Bernard Bégaud
- INSERM, U657-Pharmacoepidemiology, Université de Bordeaux, F-33000 Bordeaux, France
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Ilomäki J, Paljärvi T, Korhonen MJ, Enlund H, Alderman CP, Kauhanen J, Bell JS. Prevalence of concomitant use of alcohol and sedative-hypnotic drugs in middle and older aged persons: a systematic review. Ann Pharmacother 2013; 47:257-68. [PMID: 23362039 DOI: 10.1345/aph.1r449] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To systematically review the prevalence of concomitant alcohol and sedative-hypnotic use among middle-aged and older persons. DATA SOURCES A bibliographic search of English-language literature was performed using MEDLINE, EMBASE, and PsycINFO (January 1990-August 2012). The reference lists of all included articles were screened for additional relevant articles not identified by any of the bibliographic searches. STUDY SELECTION AND DATA EXTRACTION Population-based studies in which the mean age of participants was 40 years or older were included. For a study to be included in the review, alcohol use had to be reported in terms of the quantity or frequency consumed. Data from included articles were extracted using a standardized data extraction tool. DATA SYNTHESIS Five population-based studies conducted in North America, 10 in Europe, and 1 in Australia were included in the review. Up to 88% of men and 79% of women who used sedative-hypnotics also consumed alcohol. Up to 28% of those who consumed alcohol were concomitant users of sedative-hypnotics. Alcohol was consumed at higher levels among middle-aged than older persons. Risky drinking (eg, binge drinking, heavy drinking) was more prevalent among middle-aged than older persons. In contrast, sedative-hypnotic use was more prevalent among older persons. CONCLUSIONS Our review identified a higher prevalence of alcohol consumption among middle-aged than older persons. However, middle-aged persons may experience harm from alcohol/sedative-hypnotic drug interactions due to risky drinking behavior. Despite lower levels of alcohol consumption, older persons may be more susceptible to addictive central nervous system effects than younger persons because of physiologic changes in psychotropic drug and alcohol metabolism. Clinicians should consider patients' alcohol consumption patterns before prescribing sedative-hypnotic drugs.
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Affiliation(s)
- Jenni Ilomäki
- Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia.
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Ilomäki J, Gnjidic D, Hilmer SN, Le Couteur DG, Naganathan V, Cumming RG, Waite LM, Seibel MJ, Blyth FM, Handelsman DJ, Bell JS. Psychotropic drug use and alcohol drinking in community-dwelling older Australian men: the CHAMP study. Drug Alcohol Rev 2012; 32:218-22. [DOI: 10.1111/j.1465-3362.2012.00496.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 07/11/2012] [Indexed: 12/15/2022]
Affiliation(s)
- Jenni Ilomäki
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide; Australia
| | | | | | | | - Vasi Naganathan
- Centre for Education and Research on Ageing (CERA); Concord Hospital; Sydney; Australia
| | - Robert G. Cumming
- School of Public Health; The University of Sydney; Sydney; Australia
| | | | | | | | | | - J. Simon Bell
- Quality Use of Medicines and Pharmacy Research Centre; Sansom Institute; School of Pharmacy and Medical Sciences; University of South Australia; Adelaide; Australia
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