Harm from others' drinking among young adults in Taiwan: Predictors and deteriorating quality of life

INTRODUCTION

This study aimed to investigate the prevalence of different forms of harm from others' drinking (HFOD), predictors and the relationship with multi-dimensional quality of life among young adults in an emerging alcohol market in Asia-Taiwan.

METHODS

Data were extracted from a 2018 household survey with national representativeness on substance use experiences. The analytic sample comprised 4901 participants aged 18-34. Eight items were used to measure HFOD experiences. Five-dimensional quality of life was assessed by the EQ-5D-5L. Multivariable regressions with complex survey analyses were performed to estimate the prevalence and risk association.

RESULTS

Almost 4.2% of young adults experienced any form of HFOD; psychological harm occurred more prevalently than physical harm (3.7% and 1.5%, respectively). Those aged 25-29 and 30-34 had a two- to three-fold risk of HFOD compared with those aged 18-24. Both non-drunk drinking and drunk drinking were associated with an increased risk of psychological HFOD (adjusted odds ratio 2.36 and 5.89, respectively), whereas the risk of physical HFOD was related only to drunk drinking (adjusted odds ratio 7.8). Psychological HFOD victimisation emerged as the strongest predictor for deteriorated quality of life (adjusted b -0.14; 95% confidence interval -0.24, -0.04), especially in the dimensions of pain/discomfort and anxiety/depression. Among HFOD victims, only 33% sought help.

DISCUSSION AND CONCLUSIONS

The HFOD among young adults, commonly exhibited in psychological form, was linked with deteriorated quality of life; nonetheless, young HFOD victims are under-recognised. When devising interventions for alcohol harm, developmental perspectives should be integrated into policies implemented in healthcare and community settings.

Applying a 'harm to others' research framework to illicit drugs: political discourses and ambiguous policy implications

During the past decade, 'alcohol's harm to others' (AHTO) has emerged as an international approach to studying alcohol problems and informing policy. The AHTO approach seeks to increase political will for alcohol policy by mapping, measuring and often costing harms beyond the person who drinks (e.g. family members, co-workers). In this paper we consider the implications of a 'harm to others' approach for illicit drugs. We ask whether it could and should be used as a policy tool, given the high risks of further stigmatizing people who use drugs. We consider the ways in which the concept and measurement of 'harm to others' may be either productive or potentially harmful, depending on the extent to which the AHTO is replicated for illicit drugs. Shifting the language may assist: the term 'harm from others' appears to carry less risk of stigma. In addition, all harms inclusive of drug supply and drug consumption need to be included if a full picture of harms that accrue to other people from illicit drugs is to be achieved.

Associations between parental alcohol problems in childhood and adversities during childhood and later adulthood: a cross-sectional study of 28047 adults from the general population

Background

Adverse childhood experiences (ACE) are related to adverse physical and mental health outcomes. However, few larger studies based on a general population sample with age groups ranging from young adults to elderly have investigated whether parental alcohol problems increase the risk of offspring subjective reports of ACE both during childhood and current adult adversities. The purpose of this study was to examine the associations between parental alcohol problems and adversities during childhood and later in adulthood.

Methods

The 28,047 respondents were adults (> 18 years old) from the general population who participated in the Norwegian Counties Public Health Survey. The study had a cross-sectional design and included respondents’ evaluations of childhood experiences and current adult adversities. The short version of the Children of Alcoholics Screening Test (CAST-6, cut-off ≥3) measured parental alcohol problems. Multivariable logistic regression was adjusted for gender, age, and education.

Results

Growing up with parental alcohol problems strongly increased the risk of experiencing a dysfunctional family environment during childhood (odds ratio [OR] 6.84; 95% confidence interval [CI] 6.36–7.36), perceiving childhood as difficult (OR 5.01; 95% CI 4.58–5.49), and reporting a lack of support from a trusted adult (OR 3.07; 95% CI 2.86–3.29). Parental alcohol problems were associated with a modestly increased risk of harmful alcohol use (OR 1.38; 95% CI 1.29–1.48), but the association with struggling with bad memories was strong (OR 4.56; 95% CI 4.17–4.98).

Conclusions

Parental alcohol problems increased the risk of offspring experiencing adversities during both childhood and adulthood. Providing supportive services to these children and their families and addressing this issue as part of treatment is important to prevent alcohol related harm.

Extending the Harm to Others Paradigm: Comparing Marijuana- and Alcohol-Attributed Harms in Washington State

Harms attributed to others' alcohol use have been extensively studied in the US and internationally, but no studies have measured harms from others' marijuana use. We utilize data from five cross-sectional waves of a survey series with representative samples of Washington state residents conducted every 6 months from 2014 to 2016, after the legalization of adult use marijuana. Harms attributed to others' drinking and to others' marijuana use included family and financial problems, assault, harassment, and vandalism experiences, and accidents due to impaired drivers. Past year harms attributed to others' marijuana use were reported by 8.4% of the sample, while 21.3% reported alcohol-attributed harms and 4.3% experienced both. Women were more likely to experience harms from either substance. While heavy drinkers were most likely to experience alcohol harms from others' use, frequent marijuana users reported the least harms from others. About three times as many individuals reported harassment, vandalism, or family problems attributed to someone's alcohol use compared to those harms attributed to someone's marijuana use, with a smaller ratio seen for financial trouble and a wider ratio for physical harm. Harms attributed to other's marijuana use in Washington were found to be substantial, but lower than harms from others' drinking.

Parental alcohol intoxication and adverse health outcomes among offspring. A 4-year follow up HUNT study among 2399 Norwegian adolescents

This study aimed to investigate whether experience of parental alcohol intoxication was associated with adverse health outcomes among adolescents four years later. A population-based Norwegian cohort study of 2399 adolescents who participated in the Young-HUNT1 Survey 1995-97 (T1, 13-15 years old) was followed up four years later (T2) in 2000 (Young-HUNT2, 17-19 years old). Measures were based on adolescent self-report of exposure to parental alcohol intoxication, self-rated general health, mental distress (SCL-5) and lifetime hospital admission. Multivariable logistic regression analyses, adjusted for gender, age and parental education were applied. Results show that half of the adolescents (51%) had seen parents intoxicated at age 13-15 years. Four years later, those who had reported parental alcohol intoxication at T1 had increased odds of admission to hospital with odds ratios ranging from OR1.3; CI 1.0-1.7 to OR 2.2; CI 1.3-3.9, poorer self-rated health (odds ratio ranging from 1.8;1.2-2.6 to 2.0;1.1-3.7) and more mental distress (odds ratio ranging from 1.7;1.1-2.5 to 1.9;1.0-3.6). Furthermore, the increased frequency of experience of parental alcohol intoxication are associated with higher prevalence of admission to hospital and mental distress and lower levels of self-rated health. Findings from this large, representative population of Norwegian adolescents indicate that adverse health outcomes among adolescents in a general population are related to relatively common heavy drinking behaviours among parents.

Alcohol’s harms to others: the self-rated health of those with a heavy drinker in their lives

Background

Studies have examined the self-rated health (SRH) of the drinker, but only few have examined the health of those affected by a heavy drinker. This Nordic study aimed to examine the association between exposure to heavy drinkers and SRH.

Methods

Data come from surveys from the five Nordic countries that participated in the Reducing Alcohol-Related Harm Standardized European Survey in 2015 (n = 7065 aged 18–64 years). Variables included a five-point Likert-scale question on one’s SRH, a question on whether the respondent knew a heavy drinker in the last 12 months, and covariates. The ‘fair’, ‘poor’ and ‘very poor’ response categories were combined and are referred to as poor SRH. Multiple logistic regression models were used to examine the relationship between knowing a heavy drinker and one’s SRH.

Results

Country-pooled adjusted analyses showed a significant relationship between knowing (and being negatively affected by) a heavy drinker and poor SRH [odds ratios (OR) = 1.39, 95% confidence intervals (CI): 1.02–1.89 for heavy drinker in household; OR = 1.23, 95% CI: 1.07–1.42 for other known heavy drinker, compared to not knowing a heavy drinker or knowing a heavy drinker, but not being negatively affected]. A graded relationship appeared such that increasing proximity of the known heavy drinker increased likelihood to report poor SRH.

Conclusion

Knowing and being negatively affected by someone close who drinks heavily increases the likelihood of reporting poor SRH. These results have implications for public health messaging regarding the well-being of relatives of heavy drinkers.

Alcohol-related child maltreatment: Reports to the Child Rights Protection Service in Kaunas municipality

Aim

To increase understanding of alcohol-related child maltreatment on the basis of child protection cases in Lithuania. The study is based on a document content analysis of 203 case records of families at social risk. It identifies the prevalence of alcohol-related harm by analysing associations between types of drinkers and child maltreatment. It also maps the distribution of people who typically report this maltreatment. Both qualitative and quantitative analytical approaches are employed.

Results

Child neglect was the most prevalent type of child maltreatment and was usually reported together with other types of child maltreatment. Child maltreatment was typically mentioned in the context of a caregiver's heavy drinking. In 85.7% (174) of the cases, the family had at least one problem drinker. More than one problem drinker was detected in as many as a third of all cases. At least one form of child maltreatment was detected in families with a drinking mother in 60% of the cases (χ² = 4.825, p < 0.05), with a drinking father in 36% of the cases (p > 0.05), and in 15% of the cases (p > 0.05) when there was a drinking partner in the family. The most common source of reporting by the authorities was the police (26.6%), and the most typical non-official source was the child's relatives (16.3%).

Conclusions

Alcohol-related child maltreatment needs special attention if issues of child safety in Lithuania are to be disclosed, evaluated, and responded to. Further research on this topic is needed.