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Ross H, Kurbatfinski S, Szelest I. Investigating the unique service and treatment needs of women with alcohol use disorder: Literature review and key informant perspectives in British Columbia. Healthc Manage Forum 2024; 37:237-243. [PMID: 38330146 DOI: 10.1177/08404704241229973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Alcohol Use Disorder (AUD) is a medical condition uniquely affecting the female population, requiring widespread restructuring of current services to increase treatment utilization and efficacy. This review synthesizes the literature on the service and treatment needs of women with AUD. A literature search and review were conducted following PRISMA guidelines. Key informant information was collected during interviews with health leaders. Data from literature searches and interviews were analyzed to identify common themes. Results found women face more barriers when accessing and receiving AUD treatment. Major barriers include stigma, location, transportation, and childcare, which contribute to the AUD treatment gap among women. Recommendations to reduce barriers include (1) implementing universal screening, (2) improving care provider education and awareness, (3) providing childcare services, (4) establishing a strong client-clinician relationship, (5) building a community approach for Indigenous clients, (6) improving Managed Alcohol Programs, and (7) expanding virtual substance use prescribing practices.
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Affiliation(s)
- Hayley Ross
- The Canadian Alcohol Use Disorder Society, Penticton, British Columbia, Canada
| | - Stefan Kurbatfinski
- University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Izabela Szelest
- The Canadian Alcohol Use Disorder Society, Penticton, British Columbia, Canada
- Care.Transformed Consulting, Penticton, British Columbia, Canada
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2
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Owaki Y, Yoshimoto H, Saito G, Dobashi S, Kushio S, Nakamura A, Goto T, Togo Y, Mori K, Hokazono H. Effectiveness of genetic feedback on alcohol metabolism to reduce alcohol consumption in young adults: an open-label randomized controlled trial. BMC Med 2024; 22:205. [PMID: 38769537 PMCID: PMC11106878 DOI: 10.1186/s12916-024-03422-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/09/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND It is unclear whether brief interventions using the combined classification of alcohol-metabolizing enzymes aldehyde dehydrogenase 2 (ALDH2) and alcohol dehydrogenase 1B (ADH1B) together with behavioral changes in alcohol use can reduce excessive alcohol consumption. This study aimed to examine the effects of a brief intervention based on the screening of ALDH2 and ADH1B gene polymorphisms on alcohol consumption in Japanese young adults. METHODS In this open-label randomized controlled trial, we enrolled adults aged 20-30 years who had excessive drinking behavior (average amount of alcohol consumed: men, ≥ 4 drinks/per day and women, ≥ 2 drinks/per day; 1 drink = 10 g of pure alcohol equivalent). Participants were randomized into intervention or control group using a simple random number table. The intervention group underwent saliva-based genotyping of alcohol-metabolizing enzymes (ALDH2 and ADH1B), which were classified into five types. A 30-min in-person or online educational counseling was conducted approximately 1 month later based on genotyping test results and their own drinking records. The control group received traditional alcohol education. Average daily alcohol consumption was calculated based on the drinking diary, which was recorded at baseline and at 3 and 6 months of follow-up. The primary endpoint was average daily alcohol consumption, and the secondary endpoints were the alcohol-use disorder identification test for consumption (AUDIT-C) score and behavioral modification stages assessed using a transtheoretical model. RESULTS Participants were allocated to the intervention (n = 100) and control (n = 96) groups using simple randomization. Overall, 28 (29.2%) participants in the control group and 21 (21.0%) in the intervention group did not complete the follow-up. Average alcohol consumption decreased significantly from baseline to 3 and 6 months in the intervention group but not in the control group. The reduction from baseline alcohol consumption values and AUDIT-C score at 3 months were greater in the intervention group than in the control group (p < 0.001). In addition, the behavioral modification stages were significantly changed by the intervention (p < 0.001). CONCLUSIONS Genetic testing for alcohol-metabolizing enzymes and health guidance on type-specific excessive drinking may be useful for reducing sustained average alcohol consumption associated with behavioral modification. TRIAL REGISTRATION R000050379, UMIN000044148, Registered on June 1, 2021.
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Affiliation(s)
- Yukiko Owaki
- Department of Nursing, School of Nursing, Gunma Prefectural College of Health Sciences, Maebashi, Japan.
- Research and Development Center for Lifestyle Innovation, University of Tsukuba, Tsukuba, Japan.
| | - Hisashi Yoshimoto
- Research and Development Center for Lifestyle Innovation, University of Tsukuba, Tsukuba, Japan.
- Department of Family Medicine, General Practice and Community Health, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Go Saito
- Research and Development Center for Lifestyle Innovation, University of Tsukuba, Tsukuba, Japan
- Department of Primary Care and Medical Education, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Shohei Dobashi
- Research and Development Center for Lifestyle Innovation, University of Tsukuba, Tsukuba, Japan
| | | | | | | | - Yusuke Togo
- Sanwa Laboratory, Sanwa Shurui Company, Usa, Japan
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Ayaz L, Nazari F. Enhancing Relapse Prevention: Examining the Impact of Experiential Avoidance, Integrative Self-Knowledge, and Basic Psychological Needs in Substance Use Treatment. ADDICTION & HEALTH 2024; 16:69-75. [PMID: 39051040 PMCID: PMC11264483 DOI: 10.34172/ahj.2024.1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/15/2024] [Indexed: 07/27/2024]
Abstract
Background The harmful effects of drug relapse have always been one of the major challenges in addiction treatment. The present study aimed to predict drug relapse in addicted men under treatment based on experiential avoidance, integrative self-knowledge, and basic psychological needs. Methods The present study was a correlational one. The statistical population included all addicted men in Choubindar prison in Qazvin in 2021, among whom 200 individuals were selected randomly. Then, the participants filled out the Relapse Prediction Scale (RPS), Multidimensional Experiential Avoidance Questionnaire (MEAQ), Integrative Self-Knowledge Scale (ISK), and Basic Psychological Needs Scale (BPNS). Data were analyzed using stepwise regression via SPSS software (version 25). Findings The results of the study demonstrated that some of the components of experiential avoidance including distraction, distress endurance, behavioral avoidance, and distress aversion could account for 14.0% of the variance of the relapse in the addicts (P<0.05). Moreover, the obtained results considering the reflective self-knowledge component and the overall score of integrative self-knowledge could explain 15.0% of the variance in relapse in the addicts. Among the basic psychological needs, communication could predict 3.8% of the variance in relapse. Conclusion Based on the results of the present study, it is suggested that through addiction treatment and prevention of relapse programs, psychologists reduce drug relapse in addicts by decreasing distractions and behavioral avoidance, increasing distress endurance, enhancing self-knowledge, and improving efficient relationships.
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Affiliation(s)
- Leila Ayaz
- Faculty of Humanities and Arts, Islamic Azad University, Zanjan Branch, Zanjan, Iran
| | - Fatemeh Nazari
- Department of Psychology, Faculty of Humanities and Arts, Islamic Azad University, Zanjan Branch, Zanjan, Iran
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Águila-Morales N, Clua-García R. [Women drug-users in outpatient treatment: a qualitative study from a gender and community mental health perspective]. Salud Colect 2024; 20:e4648. [PMID: 38376859 DOI: 10.18294/sc.2024.4648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/05/2023] [Indexed: 02/21/2024] Open
Abstract
Women drug-users face significant challenges in accessing and adhering to outpatient treatment. However, this issue has been underexplored. The study aims to understand the experiences of a group of women undergoing drug use treatment. Between March and December 2021, a qualitative phenomenological interpretative study was carried out through semi-structured interviews with 16 women attending a drug-dependence care center in Catalonia, Spain. Data were processed through content analysis. The results indicate that, despite perceiving a positive impact of the treatment, women experience vulnerabilities related to stigmatization, lack of social support, and insufficient coverage of specific needs, impacting therapeutic follow-up. The findings emphasize the need to enhance resources for specialized care and promote a social support network where women drug-users actively participate.
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Affiliation(s)
- Noemí Águila-Morales
- Magíster en Salud Mental Comunitaria. Programa de Suport Individualitzat, Comunitat Terapèutica del Maresme, Malgrat de Mar, España
| | - Rafael Clua-García
- Doctor en Antropología Social y Cultural. Profesor asociado, Facultat de Ciències de la Salut de Manresa. Universitat de Vic - Universitat Central de Catalunya, Manresa, España
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van der Boor C, Andersen LS, Massazza A, Tol WA, Taban D, Roberts B, Ssebunnya J, Kinyanda E, May C, Nadkarni A, Fuhr D. Using theory of change to plan for the implementation of a psychological intervention addressing alcohol use disorder and psychological distress in Uganda. Glob Ment Health (Camb) 2024; 11:e6. [PMID: 38283880 PMCID: PMC10808976 DOI: 10.1017/gmh.2023.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings. Three half-day workshops in Uganda engaged 41 stakeholders to develop a ToC map. ToC is a participatory program theory approach aiming to create a visual representation of how and why an intervention leads to specific outcomes. Additionally, five semi-structured interviews were conducted to explore experiences of stakeholders that participated in the ToC workshops. Two necessary pathways influencing the implementation and maintenance of CHANGE were identified: policy impact, and mental health service delivery. Barriers identified included policy gaps, limited recognition of social determinants and the need for integrated follow-up care. Interviewed participants valued ToC's participatory approach and expressed concerns about its adaptability in continuously changing contexts (e.g., humanitarian settings). Our study underscores ToC's value in delineating context-specific outcomes and identifies areas requiring further attention. It emphasizes the importance of early planning and stakeholder engagement for sustainable implementation of psychological interventions in humanitarian settings.
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Affiliation(s)
- Catharina van der Boor
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Lena S. Andersen
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Wietse A. Tol
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Joshua Ssebunnya
- Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda
| | - Eugene Kinyanda
- Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda
| | - Carl May
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Abhijit Nadkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Addictions and Related Research Group, Sangath, Goa, India
| | - Daniela Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
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Ward S, Autaubo J, Waters P, Garrett E, Batioja K, Anderson R, Furr-Holden D, Vassar M. A scoping review of health inequities in alcohol use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:27-41. [PMID: 38295346 DOI: 10.1080/00952990.2023.2296860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 12/10/2023] [Indexed: 02/02/2024]
Abstract
Background: Alcohol Use Disorder (AUD) poses a significant health burden on individuals. The burden occurs more frequently in the medically underserved, as well as racial and sexual minority populations. Ameliorating health inequities is vital to improving patient-centered care.Objectives: The objective of this scoping review is to chart the existing evidence on health inequities related to AUD and identify existing knowledge gaps to guide future equity-centered research.Methods: We performed a literature search using the Ovid (Embase) and MEDLINE (PubMed) databases for articles on AUD that were published in the 5-year period spanning from 2017 to 2021 and written in English. The frequencies of each health inequity examined were analyzed, and findings from each included study were summarized.Results: Our sample consisted of 55 studies for analysis. The most common inequity examined was by race/ethnicity followed by sex or gender. The least reported inequities examined were rural under-resourced areas and occupational status. Our findings indicate that significant research gaps exist in education, rural under-resourced populations, and LGBTQ+ communities with AUD.Conclusions: This scoping review highlights the gaps in research on inequities in AUD. To bridge the current gaps, we recommend research on the following: 1) triage screening tools and the use of telemedicine for rural, under-resourced populations; 2) interventions to increase treatment engagement and retention for women; and 3) community-based participatory methodologies for the LGBTQ+ communities.
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Affiliation(s)
- Shaelyn Ward
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Josh Autaubo
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Philo Waters
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Elizabeth Garrett
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Kelsi Batioja
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Reece Anderson
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Debra Furr-Holden
- School of Global Public Health, New York University, New York, NY, USA
| | - Matt Vassar
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Watkins LE, Patton SC, Wilcox T, Drexler K, Rauch SAM, Rothbaum BO. Substance Use after Completion of an Intensive Treatment Program with Concurrent Treatment for Posttraumatic Stress Disorder and Substance Use among Veterans: Examining the Role of PTSD Symptoms. J Dual Diagn 2024; 20:16-28. [PMID: 38122816 DOI: 10.1080/15504263.2023.2290167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) are costly and highly co-occurring diagnoses, particularly among veterans, suggesting a need to understand this comorbidity and effectively treat both disorders among this population. METHODS The current study aimed to examine substance use outcomes among post-9/11 veterans and service members (N = 48) who completed a two-week intensive outpatient program with concurrent treatment for and PTSD using Prolonged Exposure and substance use. Substance use was assessed at two weeks and three months posttreatment. RESULTS The intensive program had high completion rates and demonstrated decreases in substance use at two weeks and three months posttreatment. Additionally, lower PTSD symptoms at treatment completion were related to less substance use posttreatment. CONCLUSIONS Concurrent intensive treatment of PTSD and SUDs can lead to symptom improvement in a short period of time. Findings support the self-medication model, such that PTSD symptoms at treatment completion were related to substance use at follow-up.
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Affiliation(s)
| | | | - Tiffany Wilcox
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Karen Drexler
- Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sheila A M Rauch
- Atlanta VA Medical Center, Emory University School of Medicine, Atlanta, Georgia, USA
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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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Hu D, Primc N. Should responsibility be used as a tiebreaker in allocation of deceased donor organs for patients suffering from alcohol-related end-stage liver disease? MEDICINE, HEALTH CARE, AND PHILOSOPHY 2023; 26:243-255. [PMID: 36780062 PMCID: PMC10175331 DOI: 10.1007/s11019-023-10141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 05/13/2023]
Abstract
There is a long-standing debate concerning the eligibility of patients suffering from alcohol-related end-stage liver disease (ARESLD) for deceased donor liver transplantation. The question of retrospective and/or prospective responsibility has been at the center of the ethical discussion. Several authors argue that these patients should at least be regarded as partly responsible for their ARESLD. At the same time, the arguments for retrospective and/or prospective responsibility have been strongly criticized, such that no consensus has been reached. A third option was proposed as a form of compromise, namely that responsibility should only be used as a tiebreaker in liver allocation. The present study provides an ethical investigation of this third option. First, we will provide an overview of the main arguments that have been offered for and against the use of responsibility as an allocation criterion. Second, we will explore the concept of responsibility as a tiebreaker in detail and discuss several types of situations, in which responsibility could be used as a tiebreaker, as well as the main ethical challenges associated with them. As we will show, an ethical justified use of responsibility as a tiebreaker is limited to a very restricted number of cases and is associated with a number of ethical concerns. For this reason, waiting time should be preferred as a tiebreaker in liver allocation, even though the criterion of waiting time, too, raises a number of equity-related concerns.
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Affiliation(s)
- Diehua Hu
- Department of Philosophy, Central South University, 410075, Changsha, China
| | - Nadia Primc
- Institute of History and Ethics of Medicine, Medical Department, Heidelberg University, Im Neuenheimer Feld 327, 69120, Heidelberg, Germany.
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Sedarous M, Flemming JA. Culture, stigma, and inequities creating barriers in alcohol use disorder management in alcohol-associated liver disease. Clin Liver Dis (Hoboken) 2023; 21:130-133. [PMID: 37274951 PMCID: PMC10238042 DOI: 10.1097/cld.0000000000000026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/21/2023] [Indexed: 06/07/2023] Open
Affiliation(s)
- Mary Sedarous
- Department of Medicine, Queen’s University, Kingston, Ontario, Canada
| | - Jennifer A. Flemming
- Department of Medicine, Queen’s University, Kingston, Ontario, Canada
- Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
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Malik NI, Saleem S, Ullah I, Rehan ST, De Berardis D, Atta M. Psychosocial Factors Affecting Drug Relapse among Youth in Punjab, Pakistan. J Clin Med 2023; 12:jcm12072686. [PMID: 37048769 PMCID: PMC10095218 DOI: 10.3390/jcm12072686] [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: 01/29/2023] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
The present study was intended to examine the effect of psychosocial factors on the stigma of mental illness among people addicted to drugs who have relapsed in Punjab, Pakistan. A sample composed of 116 people addicted to drugs and who have relapsed was collected through the purposive sampling technique. Certain self-report measures were used to assess the pertinent study variables. The results elucidated that self-efficacy, social support, and conscientiousness were found to be negative predictors and neuroticism a positive predictor of stigma. The results also confirmed social support as being a significant moderator in the relationship between self-efficacy and stigma, and self-efficacy as being a significant moderator in the relationship between social support and stigma. It was safe to conclude that psychosocial factors such as self-efficacy, social support, personality traits and stigma have a significant role in causing addiction relapse. The conclusions made have been discussed thoroughly.
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Affiliation(s)
- Najma Iqbal Malik
- Department of Psychology, University of Sargodha, Sargodha 40100, Pakistan
| | - Sidra Saleem
- Counseling Centre, University of Sargodha, Sargodha 40100, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar 25120, Pakistan
| | | | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, "G. Mazzini" Hospital, Piazza Italia 1, ASL 4, 64100 Teramo, Italy
| | - Mohsin Atta
- Department of Psychology, University of Sargodha, Sargodha 40100, Pakistan
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12
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Yamashita A, Yoshioka SI. Subjective recovery accounts of Japanese female patients suffering from alcohol use disorder. A phenomenological study. Perspect Psychiatr Care 2022; 58:2820-2827. [PMID: 35726722 DOI: 10.1111/ppc.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to examine the subjective recovery accounts of Japanese female patients with alcohol use disorder (AUD) and the factors that affect their recovery. DESIGN AND METHODS This qualitative study used a phenomenological design. A focus group with 10 Japanese participants was conducted. FINDINGS Five theme clusters emerged: drinking to forget unpleasant feelings, fighting compulsive cravings with craving, unhealed wounds from past traumatic experiences, encounters with role models in self-help groups, and changing one's mindset to a proactive pursuit of happiness. PRACTICE IMPLICATIONS To support the recovery of women with AUD, psychiatric nurses should help them improve their family relationships, find recovery models, and proactively provide them with trauma-informed care.
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Affiliation(s)
- Ayako Yamashita
- School of Health Sciences, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shin-Ichi Yoshioka
- School of Health Science, Faculty of Medicine, Tottori University, Yonago, Japan
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Oliverio R, Fitzgerald J, Velazquez-Cruz R, Whitehead B, Karelina K, Weil ZM. Ovarian Steroids Mediate Sex Differences in Alcohol Reward After Brain Injury in Mice. Front Behav Neurosci 2022; 16:907552. [PMID: 35801094 PMCID: PMC9253769 DOI: 10.3389/fnbeh.2022.907552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Intoxication is a leading risk factor for injury, and TBI increases the risk for later alcohol misuse, especially when the injury is sustained in childhood. Previously, we modeled this pattern in mice, wherein females injured at postnatal day 21 drank significantly more than uninjured females, while we did not see this effect in males. However, the biological underpinnings of this sex difference have remained elusive. In this study, we utilize this preclinical model and traditional endocrine manipulations to assess the effect of perinatal sex steroids on post-injury ethanol response. We found that perinatal androgen administration and adult ovariectomy prevented the development of conditioned place preference to ethanol in females, while there was not an effect of gonadectomy either developmental time point on the severity of axonal degeneration. Finally, although TBI increased the number of microglia in males, there was no corresponding effect of gonadectomy, which suggests that males exhibit prolonged neuroinflammation after brain injury irrespective of circulating sex steroids. Taken together, our results indicate a potential role for ovarian sex steroids in the development of greater alcohol preference after a juvenile TBI in female mice.
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Affiliation(s)
- Robin Oliverio
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
- *Correspondence: Robin Oliverio,
| | - Julie Fitzgerald
- Department of Neuroscience, Ohio State University, Columbus, OH, United States
| | - Ruth Velazquez-Cruz
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Bailey Whitehead
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Kate Karelina
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Zachary M. Weil
- Department of Neuroscience and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
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14
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Insights on rehabilitation programs, women, families, and COVID19. Transl Psychiatry 2022; 12:242. [PMID: 35680850 PMCID: PMC9184496 DOI: 10.1038/s41398-022-02008-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/11/2022] Open
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Alcohol Use Disorder: Neurobiology and Therapeutics. Biomedicines 2022; 10:biomedicines10051192. [PMID: 35625928 PMCID: PMC9139063 DOI: 10.3390/biomedicines10051192] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 02/04/2023] Open
Abstract
Alcohol use disorder (AUD) encompasses the dysregulation of multiple brain circuits involved in executive function leading to excessive consumption of alcohol, despite negative health and social consequences and feelings of withdrawal when access to alcohol is prevented. Ethanol exerts its toxicity through changes to multiple neurotransmitter systems, including serotonin, dopamine, gamma-aminobutyric acid, glutamate, acetylcholine, and opioid systems. These neurotransmitter imbalances result in dysregulation of brain circuits responsible for reward, motivation, decision making, affect, and the stress response. Despite serious health and psychosocial consequences, this disorder still remains one of the leading causes of death globally. Treatment options include both psychological and pharmacological interventions, which are aimed at reducing alcohol consumption and/or promoting abstinence while also addressing dysfunctional behaviours and impaired functioning. However, stigma and social barriers to accessing care continue to impact many individuals. AUD treatment should focus not only on restoring the physiological and neurological impairment directly caused by alcohol toxicity but also on addressing psychosocial factors associated with AUD that often prevent access to treatment. This review summarizes the impact of alcohol toxicity on brain neurocircuitry in the context of AUD and discusses pharmacological and non-pharmacological therapies currently available to treat this addiction disorder.
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16
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Scheer JR, Batchelder AW, Bochicchio LA, Kidd JD, Hughes TL. Alcohol use, behavioral and mental health help-seeking, and treatment satisfaction among sexual minority women. Alcohol Clin Exp Res 2022; 46:641-656. [PMID: 35318685 PMCID: PMC9018513 DOI: 10.1111/acer.14789] [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: 09/02/2021] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sexual minority women (SMW) report higher rates of heavy episodic drinking (HED) and adverse alcohol-related outcomes, including poor mental health, than heterosexual women. These disparities indicate a greater need for behavioral and mental health treatment for SMW. This study examined associations among alcohol outcomes, behavioral and mental health help-seeking, and treatment satisfaction among SMW by age, sexual identity, race/ethnicity, and income. METHODS Participants included a community sample of 695 SMW (Mage = 40.0, SD = 14.1; 74.1% lesbian, 25.9% bisexual; 37.6% White, 35.8% Black, 23.2% Latinx; 26.3% annual income $14,999 or less). We used bivariate analyses to characterize the sample's demographic characteristics and multivariable logistic regression analyses to examine associations among variables. RESULTS SMW subgroups based on age, race/ethnicity, and annual income differed in alcohol outcomes (i.e., HED, DSM-IV alcohol dependence, alcohol-related problem consequences, alcohol problem recognition, and motivation to reduce drinking); help-seeking; and treatment satisfaction. SMW who engaged in help-seeking for alcohol-related concerns were more likely than those who did not to meet criteria for DSM-IV alcohol dependence (adjusted odds ratio [aOR] = 7.13; 95% CI = 2.77; 18.36), endorse alcohol-related problem consequences (aOR = 11.44; 95% CI = 3.88; 33.71), recognize problematic drinking (aOR = 14.56; 95% CI = 3.37; 62.97), and report motivation to reduce drinking (aOR = 5.26; 95% CI = 1.74; 15.88). SMW's alcohol outcomes did not differ based on their satisfaction with treatment or with providers. CONCLUSIONS This study's findings confirm SMW's elevated risk for HED and other alcohol-related outcomes and underscore the importance of identity-affirmative and accessible behavioral and mental health treatment for young, Black, and low-income SMW. Clinicians and intervention scientists should develop or enhance existing brief behavioral and mental health treatments for SMW engaging in HED who may not recognize that their drinking is problematic or who are not motivated to reduce drinking.
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Affiliation(s)
| | - Abigail W. Batchelder
- Harvard Medical School, Harvard University, Boston, MA
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA
- The Fenway Institute, Fenway Health, Boston, MA
| | - Lauren A. Bochicchio
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
| | - Jeremy D. Kidd
- Columbia University Irving Medical Center, New York, NY
- New York State Psychiatric Institute, New York, NY
| | - Tonda L. Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY
- Columbia University Irving Medical Center, New York, NY
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17
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An Association Between Psychological Childbirth Trauma and Hazardous Alcohol Use. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Hazardous alcohol use is increasing amongst some groups of women, yet little is known about the underlying reasons or gender-specific influences. The purpose of this study was to explore the association between psychological childbirth trauma and women’s hazardous alcohol use. We aimed to identify predictors of hazardous alcohol use given childbirth-related trauma, other life trauma (combat, natural disasters, physical or sexual assault, experiences threatening loss of life or loss of loved ones) and coping motives for drinking, whilst controlling for age, socio-economic status, negative affect and other drinking motives (enhancement and social motives). Australian data from the Why Women Drink survey (N = 301) was analysed. Women who experienced childbirth as traumatic scored higher overall for hazardous drinking and endorsed coping reasons more strongly than those who did not. Analyses of individual differences affecting hazardous drinking revealed coping reasons, rather than trauma itself, as the strongest predictor in a regression model. Other significant predictors included socio-economic status, enhancement of positive emotions and, marginally, negative affect. Findings identified a link between traumatic childbirth and hazardous drinking as a coping strategy. Prospective research is required to characterise predisposing and perpetuating vulnerabilities determining maladaptive coping after traumatic childbirth, and to inform effective interventions.
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Changes in Serum N-Glycome for Risk Drinkers: A Comparison with Standard Markers for Alcohol Abuse in Men and Women. Biomolecules 2022; 12:biom12020241. [PMID: 35204742 PMCID: PMC8961540 DOI: 10.3390/biom12020241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 01/11/2023] Open
Abstract
Background and aim: Glycomic alterations serve as biomarker tools for different diseases. The present study aims to evaluate the diagnostic capability of serum N-glycosylation to identify alcohol risk drinking in comparison with standard markers. Methods: We included 1516 adult individuals (age range 18–91 years; 55.3% women), randomly selected from a general population. A total of 143 (21.0%) men and 50 (5.9%) women were classified as risk drinkers after quantification of daily alcohol consumption and the Alcohol Use Disorders Identification Test (AUDIT). Hydrophilic interaction ultra-performance liquid chromatography (HILIC-UPLC) was used for the quantification of 46 serum N-glycan peaks. Serum gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT), and red blood cell mean corpuscular volume (MCV) were measured by standard clinical laboratory methods. Results: Variations in serum N-glycome associated risk drinking were more prominent in men compared to women. A unique combination of N-glycan peaks selected by the selbal algorithm shows good discrimination between risk-drinkers and non-risk drinkers for men and women. Receiver operating characteristics (ROC) curves show accuracy for the diagnosis of risk drinking, which is comparable to that of the golden standards, GGT, MCV and CDT markers for men and women. Additionally, the inclusion of N-glycan peaks improves the diagnostic accuracy of the standard markers, although it remains relatively low, due to low sensitivity. For men, the area under the ROC curve using N-glycome data is 0.75, 0.76, and 0.77 when combined with GGT, MCV, and CDT, respectively. In women, the areas were 0.76, 0.73, and 0.73, respectively. Conclusion: Risk drinking is associated with significant variations in the serum N-glycome, which highlights its potential diagnostic utility.
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Qu X, Liu M, Ke C, Liang J, Du Y, Yao L, Li J, Mu G, Liu S, Wang C. Burden of alcohol use disorders in China and the regions with different income levels over the world. J Glob Health 2022; 11:08011. [PMID: 35003718 PMCID: PMC8710067 DOI: 10.7189/jogh.11.08011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Alcohol use disorders (AUD) has long been one of the most disability mental disorders and a major cause of health loss. Methods Based on open access data from the 2019 Global Burden of Disease (GBD 2019) study, we extracted data of years lived with disability (YLD), years of life lost (YLL) and disability-adjusted life years (DALY) to describe the changes of AUD burden over the period of 1990-2019 stratified by sex in globe, high-income countries (HICs), upper-middle income countries (UMCs), lower-middle income countries (LMCs), low-income countries (LICs) and China. We used Joinpoint regression model to fit the changing trend of years. And pairwise comparison was applied to test the coincidence parallelism and judge whether the difference of the trend among different regions is statistically significant. Results LMCs experienced the largest changes in the YLD rate of AUD from 1990 to 2019 (average annual percent change (AAPC) = -0.7, 95% confidence interval (CI) = -0.8, -0.7, P < 0.05), with China experienced a higher increase in 1990 to 1993 (annual percent change (APC) = 3.8, 95% CI = 3.2, 4.4, P < 0.05) than other regions, and the rate of decline in China from 1996 to 2002 (APC = -3.4, 95% CI = -3.6, -3.1, P < 0.05) was higher than that in other regions. UMCs experienced the largest changes in the YLL rate of AUD from 1990 to 2019 (AAPC = -1.1, 95% CI = -1.6, -0.6, P < 0.05), with a larger decline in 2004 to 2012 (APC = -6.2, 95% CI = -6.7, -5.7, P < 0.05) than other regions, and China experienced a larger increase in the rate of YLL from 1999 to 2004 (APC = 9.2, 95% CI = 8.5, 9.9, P < 0.05) than other regions. LMCs experienced the largest changes in the DALY rate of AUD from 1990 to 2019 (AAPC = -0.9, 95% CI = -1.0, -0.8, P < 0.05), with a larger decline in 2006 to 2010 (APC = -3.3, 95% CI = -3.6, -2.9, P < 0.05) than other regions, and UMCs showed a larger increase in the rate of DALY from 1990 to 1994 (APC = 4.5, 95% CI = 3.8, 5.1, P < 0.05) than other regions. Conclusions Given the large variations in AUD burden of disease by income level, future strategies to prevent and reduce the burden should be developed and implemented based on country-specific development status.
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Affiliation(s)
- Xiang Qu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Mi Liu
- Hospital infection management office, The Second People's Hospital of Lianyungang Lianyungang, China
| | - Changrong Ke
- School of Public Health, Weifang Medical University, Weifang, China
| | - Juanjuan Liang
- School of Public Health, Weifang Medical University, Weifang, China
| | - Yuanze Du
- School of Public Health, Weifang Medical University, Weifang, China
| | - Liqun Yao
- School of Public Health, Weifang Medical University, Weifang, China
| | - Juanjuan Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - Guixian Mu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Shiwei Liu
- Tobacco Control office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chunping Wang
- School of Public Health, Weifang Medical University, Weifang, China
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Kichloo A, El-Amir Z, Dahiya DS, Wani F, Singh J, Solanki D, Edigin E, Eseaton P, Mehboob A, Shaka H. Trends of alcoholic liver cirrhosis readmissions from 2010 to 2018: Rates and healthcare burden associated with readmissions. World J Hepatol 2021; 13:2128-2136. [PMID: 35070013 PMCID: PMC8727209 DOI: 10.4254/wjh.v13.i12.2128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/24/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Alcoholic liver cirrhosis (ALC) is a chronic liver disease with varying disease severity. Readmissions of ALC are associated with poor outcomes.
AIM To identify and assess trends of readmissions for ALC over an eight-year period.
METHODS This retrospective interrupted trend study analysed 30-d readmissions of ALC in the United States from 2010 to 2018 using the National Readmissions Database. Hospitalization for ALC was the reason for index admission obtained using the International Classification of Diseases codes (571.2 and K70.3X). Biodemographic characteristics and hospitalization trends were highlighted over time. A multivariate regression analysis model was used to calculate the trend for risk-adjusted odds of 30-d all-cause ALC readmissions, ALC specific readmission rate, ALC readmission proportion, inpatient mortality, mean length of stay (LOS) and mean total hospital cost (THC) following adjustments for age, gender, grouped Charlson Comorbidity Index, insurance, mean household income, and hospital characteristics.
RESULTS There was a trend towards increasing total 30-d readmissions of ALC from 7660 in 2010 to 15085 in 2018 (P < 0.001). Patients readmitted for ALC were noted to have an increasing comorbidity burden over time. We noted a rise in the risk-adjusted 30-d all-cause readmission of ALC from 24.9% in 2010 to 29.9% in 2018 (P < 0.001). ALC-specific readmission rate increased from 6.3% in 2010 to 8.4% in 2018 (P < 0.001) while ALC readmission proportion increased from 31.4% in 2010 to 36.3% in 2018 (P < 0.001). Inpatient mortality for 30-d readmissions of ALC declined from 10.5% in 2010 to 8.2% in 2018 (P = 0.0079). However, there was a trend towards increasing LOS from 5.6 d in 2010 to 6.3 d in 2018 (P < 0.001) and increasing THC from 13790 dollars in 2010 to 17150 dollars in 2018 (P < 0.001). The total days of hospital stay attributable to 30-d readmissions of ALC increased by 119.2% while the total attributable hospital costs increased by 149% by the end of 2018.
CONCLUSION There was an increase in the 30-d readmission rate and comorbidity burden for ALC; however, inpatient mortality declined. Additionally, there was a trend towards increasing LOS and THC for these readmissions.
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Affiliation(s)
- Asim Kichloo
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, United States
- Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
| | - Zain El-Amir
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, United States
| | - Dushyant Singh Dahiya
- Department of Internal Medicine, Central Michigan University College of Medicine, Saginaw, MI 48602, United States
| | - Farah Wani
- Department of Internal Medicine, Samaritan Medical Center, Watertown, NY 13601, United States
| | - Jagmeet Singh
- Department of Internal Medicine, Guthrie Robert Packer Hospital, Sayre, PA 18840, United States
| | - Dhanshree Solanki
- Department of Internal Medicine, Rutgers University, New Brunswick, NJ 07103, United States
| | - Ehizogie Edigin
- Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL 60612, United States
| | - Precious Eseaton
- Department of Internal Medicine, University of Benin School of Medicine, Edo 300213, Nigeria
| | - Asad Mehboob
- Division of Gastroenterology, Department of Internal Medicine, Covenant Healthcare, Saginaw, MI 48602, United States
| | - Hafeez Shaka
- Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL 60612, United States
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21
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Hadjistavropoulos HD, Chadwick C, Beck CD, Edmonds M, Sundström C, Edwards W, Ouellette D, Waldrop J, Adlam K, Bourgeault L, Nugent M. Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion. Internet Interv 2021; 26:100474. [PMID: 34722165 PMCID: PMC8536539 DOI: 10.1016/j.invent.2021.100474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/15/2022] Open
Abstract
Although Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse is efficacious in research trials, it is not routinely available in practice. Moreover, there is considerable variability in engagement and outcomes of ICBT for alcohol misuse across studies. The Alcohol Change Course (ACC) is an ICBT program that is offered free of charge by an online clinic in Saskatchewan, Canada, which seeks to fill this service gap, while also conducting research to direct future improvements of ICBT. As there is limited qualitative patient-oriented research designed to improve ICBT for alcohol misuse, in this study, we describe patient perceptions of the ACC post-treatment. Specifically, post-treatment feedback was obtained from 191 of 312 patients who enrolled in the ACC. Qualitative thematic analysis was used to examine post-treatment written comments related to what patients liked and disliked about the course, which skills were most helpful for them, and their suggestions for future patients. The majority of patients endorsed being very satisfied or satisfied with the course (n = 133, 69.6%) and 94.2% (n = 180) perceived the course as being worth their time. Worksheets (n = 61, 31.9%) and reflections of others (n = 40, 20.9%) received the most praise. Coping with cravings (n = 63, 33.0%), and identifying and managing risky situations (n = 46, 24.1%) were reported as the most helpful skills. Several suggestions for refining the course were provided with the most frequent recommendation being a desire for increased personal interaction (n = 24, 12.6%) followed by a desire for wanting more information (n = 22, 11.5%). Many patients offered advice for future ACC patients, including suggestions to make a commitment (n = 47, 24.6%), do all of the work (n = 29, 15.2%), and keep a consistent approach to the course (n = 24, 12.6%). The results provide valuable patient-oriented directions for improving ICBT for alcohol misuse.
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Affiliation(s)
| | - Carly Chadwick
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Cynthia D. Beck
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Michael Edmonds
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | | | - Wendy Edwards
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Dianne Ouellette
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Justin Waldrop
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Kelly Adlam
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Lee Bourgeault
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
| | - Marcie Nugent
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina S4S 0A2, SK, Canada
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22
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Miller SE, Apsley HB, Cross-Ramirez M. Correspondence: Potential Benefits of Online Recovery Services for Women During and After COVID-19. J Stud Alcohol Drugs 2021; 82:808-809. [PMID: 34762042 PMCID: PMC8819618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Affiliation(s)
- Sara E. Miller
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
| | - Hannah B. Apsley
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Marci Cross-Ramirez
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
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Miller SE, Apsley HB, Cross-Ramirez M. Correspondence: Potential Benefits of Online Recovery Services for Women During and After COVID-19. J Stud Alcohol Drugs 2021; 82:808-809. [PMID: 34762042 PMCID: PMC8819618 DOI: 10.15288/jsad.2021.82.808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024] Open
Affiliation(s)
- Sara E. Miller
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
- Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
| | - Hannah B. Apsley
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
| | - Marci Cross-Ramirez
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania
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24
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Gender Differences among Sardinians with Alcohol Use Disorder. J Clin Med 2021; 10:jcm10204688. [PMID: 34682808 PMCID: PMC8537954 DOI: 10.3390/jcm10204688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol use disorder (AUD). Knowledge of these characteristics in AUD patients is useful to improve access to treatments. This paper investigated the drinking characteristics of 66 female and 282 male outpatients with AUD, born from 1937 to 1991, living in Sardinia, and compared their characteristics with those of AUD patients living in other countries. Most Sardinian patients were men, approximately 3 years younger than women; women consumed lower amounts of alcohol than men but did not differ from men in the severity of AUD. Men were more often single than women, while a higher proportion of women reported that their mother or spouse was affected by AUD. Anxiety and depression were more prevalent among women while a higher proportion of men were affected by substance use disorders. Women were older than men at the age of first drink, regular drinking, and onset of AUD, and progressed faster than men from regular use to AUD onset. Women did not differ from men in age at first request for care, and in the lapse from AUD onset to first request for care. Women and men waited for more than 8 and 9 years, respectively, before receiving medical treatment. Gender differences progressively decreased among younger patients. Although the scarce number of women in some cohorts limits the strength of these findings, drinking characteristics of Sardinian patients did not vary significantly from those of AUD patients living in other countries. These results suggest that the number of Sardinian women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD.
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25
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Dulin P, Mertz R, Edwards A, King D. Contrasting a Mobile App with a Conversational Chatbot for Reducing Alcohol Consumption: A Pilot Trial (Preprint). JMIR Form Res 2021; 6:e33037. [PMID: 35576569 PMCID: PMC9152724 DOI: 10.2196/33037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/02/2021] [Accepted: 03/14/2022] [Indexed: 01/22/2023] Open
Abstract
Background Mobile apps have shown considerable promise for reducing alcohol consumption among problem drinkers, but like many mobile health apps, they frequently report low utilization, which is an important limitation, as research suggests that effectiveness is related to higher utilization. Interactive chatbots have the ability to provide a conversational interface with users and may be more engaging and result in higher utilization and effectiveness, but there is limited research into this possibility. Objective This study aimed to develop a chatbot alcohol intervention based on an empirically supported app (Step Away) for reducing drinking and to conduct a pilot trial of the 2 interventions. Included participants met the criteria for hazardous drinking and were interested in reducing alcohol consumption. The study assessed utilization patterns and alcohol outcomes across the 2 technology conditions, and a waitlist control group. Methods Participants were recruited using Facebook advertisements. Those who met the criteria for hazardous consumption and expressed an interest in changing their drinking habits were randomly assigned to three conditions: the Step Away app, Step Away chatbot, and waitlist control condition. Participants were assessed on the web using the Alcohol Use Disorders Identification Test, Adapted for Use in the United States, Readiness to Change Questionnaire, Short Inventory of Problems-Revised, and Timeline Followback at baseline and at 12 weeks follow-up. Results A total of 150 participants who completed the baseline and follow-up assessments were included in the final analysis. ANOVA results indicated that participants in the 3 conditions changed their drinking from baseline to follow-up, with large effect sizes noted (ie, η2=0.34 for change in drinks per day across conditions). However, the differences between groups were not significant across the alcohol outcome variables. The only significant difference between conditions was in the readiness to change variable, with the bot group showing the greatest improvement in readiness (F2,147=5.6; P=.004; η2=0.07). The results suggested that the app group used the app for a longer duration (mean 50.71, SD 49.02 days) than the bot group (mean 27.16, SD 30.54 days; P=.02). Use of the interventions was shown to predict reduced drinking in a multiple regression analysis (β=.25, 95% CI 0.00-0.01; P=.04). Conclusions Results indicated that all groups in this study reduced their drinking considerably from baseline to the 12-week follow-up, but no differences were found in the alcohol outcome variables between the groups, possibly because of a combination of small sample size and methodological issues. The app group reported greater use and slightly higher usability scores than the bot group, but the bot group demonstrated improved readiness to change scores over the app group. The strengths and limitations of the app and bot interventions as well as directions for future research are discussed. Trial Registration ClinicalTrials.gov NCT04447794; https://clinicaltrials.gov/ct2/show/NCT04447794
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Affiliation(s)
- Patrick Dulin
- Department of Psychology, University of Alaska Anchorage, Anchorage, AK, United States
| | - Robyn Mertz
- Department of Psychology, University of Alaska Anchorage, Anchorage, AK, United States
| | - Alexandra Edwards
- Center for Behavior Research and Services, University of Alaska Anchorage, Anchorage, AK, United States
| | - Diane King
- Center for Behavior Research and Services, University of Alaska Anchorage, Anchorage, AK, United States
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26
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Wechsberg WM, Browne FA, Bonner CP, Washio Y, Howard BN, van der Drift I. Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters. Curr HIV/AIDS Rep 2021; 18:351-364. [PMID: 34110591 PMCID: PMC8190977 DOI: 10.1007/s11904-021-00558-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Alcohol is the most misused substance in the world. For people living with HIV (PLWH), alcohol misuse may impact ART adherence and viral suppression. This review of the most recently published alcohol intervention studies with PLWH examines how these studies considered gender in the samples, design, and analyses. RECENT FINDINGS Three searches were conducted initially, and 13 intervention studies fit our criteria with alcohol outcomes. In general, most studies did not consider gender and had used small samples, and few demonstrated significant efficacy/effectiveness outcomes. Five studies considered gender in their samples or analyses and/or were woman-focused with larger samples and demonstrated significant outcomes. It is essential for women who misuse alcohol to not only be well represented in alcohol and HIV research but also for studies to consider the barriers to reaching them and their contextual demands and/or co-occurring issues that may affect participation and outcomes in intervention research.
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Affiliation(s)
- Wendee M Wechsberg
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA.
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Department of Psychology, North Carolina State University, Raleigh, NC, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Felicia A Browne
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Yukiko Washio
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Brittni N Howard
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Isa van der Drift
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
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27
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Bahorik A, Bobrow K, Hoang T, Yaffe K. Increased risk of dementia in older female US veterans with alcohol use disorder. Addiction 2021; 116:2049-2055. [PMID: 33449402 DOI: 10.1111/add.15416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/15/2020] [Accepted: 01/06/2021] [Indexed: 12/14/2022]
Abstract
AIM To determine whether alcohol use disorder (AUD) is associated with increased dementia risk among older women veterans. DESIGN Cohort study. SETTING United States. PARTICIPANTS Women veterans with AUD aged ≥ 55 years (n = 2207), receiving care from Veterans Health Administration medical centers from October 2004 to September 2015 with one or more follow-up visit and an age-matched sample of women veterans without AUD (n = 2207). Women at baseline with prevalent dementia or AUD in remission were excluded. MEASUREMENTS AUD, substance use disorder (SUD), smoking, psychiatric (depression, anxiety, post-traumatic stress disorder, anxiety) and medical comorbidities (diabetes, hypertension, stroke, chronic obstructive pulmonary disorder, traumatic brain disorder) and dementia determined by the International Classification of Diseases, 9th revision, Clinical Modification codes. Cox proportional hazards models were used to determine the association between AUD and dementia risk during follow-up. Sensitivity analyses were performed by excluding women (n = 349) with comorbid SUD and by excluding women (n = 1568) currently smoking. FINDINGS Veteran women had a mean [standard deviation (SD)] age of 65.0 (5.6) years at baseline. During follow-up (median 4 years, interquartile range: 2-6) 3.7% of women (n = 82) with AUD developed dementia compared with 1.1% (n = 24) without AUD (P < 0.001). After adjustment for demographics, medical and psychiatric conditions and accounting for different Veteran's Integrated Service Networks, the adjusted hazard ratio (aHR) for dementia was 3.12 (95% CI = 1.90-5.12) for women with AUD compared with women without AUD. After removing women with SUD (aHR = 3.53, 95% CI = 2.13-5.85) and women currently smoking (aHR = 3.80, 95% CI = 2.11-6.84), results were similar. CONCLUSIONS Alcohol use disorder among female US veterans aged more than 55 years appears to be associated with a more than threefold increase of dementia.
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Affiliation(s)
- Amber Bahorik
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Kirsten Bobrow
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Tina Hoang
- Northern California Institute for Research and Education, San Francisco, CA, USA.,San Francisco VA Medical Center, California, CA, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, CA, USA.,Northern California Institute for Research and Education, San Francisco, CA, USA.,San Francisco VA Medical Center, California, CA, USA.,Department of Neurology, University of California, San Francisco, CA, USA
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28
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Moskal D, Whitaker H, Bernstein J, Maisto SA, Connors GJ. Evaluation of a Web-based Psychosocial Education and Peer Support Program for Alcohol Use Concerns. ALCOHOLISM TREATMENT QUARTERLY 2021; 39:366-382. [PMID: 34326569 DOI: 10.1080/07347324.2020.1866473] [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: 10/22/2022]
Abstract
This outcomes assessment was implemented to evaluate a web-based alcohol use recovery program, Tempest Sobriety School (TSS), and to provide a model for outcome evaluation. Adults (N=541) enrolled in TSS were assessed at pre-program start and Month 2, 6, and 12. Participants reported decreased alcohol use, drug use, craving for alcohol, and alcohol use disorder symptoms over the course of the program; changes were maintained at Month 6 and 12. Participants reported sustained increases in overall physical and mental health and quality of life. Findings will inform TSS students and stakeholders and provide a model for others conducting similar evaluations.
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Affiliation(s)
| | | | | | | | - Gerard J Connors
- Clinical Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA
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29
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Hirchak KA, Tonigan JS, Hernandez-Vallant A, Herron J, Cloud V, Venner KL. The Validity of the Short Inventory of Problems and Drinking Intensity among Urban American Indian Adults. Subst Use Misuse 2021; 56:501-509. [PMID: 33605847 PMCID: PMC8095341 DOI: 10.1080/10826084.2021.1883656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND American Indian (AI) adults have both high prevalence rates of alcohol abstinence and alcohol use disorders compared to non-Hispanic White adults. We investigated the applicability and validity of the Short Inventory of Problems (SIP) among AI urban adults and the moderating effect of biological sex. METHODS AI adults from three Alcoholics Anonymous samples (n = 124) provided baseline, 3-, 6- and 9-month data. Measures included Form 90 and the SIP, which includes 5 domains of alcohol-related negative consequences including interpersonal, intrapersonal, physical, impulse control and social. Drinking frequency and intensity were assessed by percent days abstinent (PDA) and drinks per drinking day (DPDD). RESULTS Cronbach alphas of the SIP were similar between urban AI adults and the mainstream treatment-seeking population reported in the SIP manual. DPDD was a significant and positive predictor of all five SIP scales collected 9-months later. Higher PDA was significantly and negatively associated with later consequences, and all 5 SIP scales. Moderation tests indicated that the association between consequences and drinking intensity was stronger for AI females with fewer drinking days resulting in significantly fewer consequences for AI males relative to AI females. CONCLUSIONS Findings highlight the acceptability of SIP as a measure to assess drinking related consequences among AI urban adults, with clinical implications related to alcohol use and sex. Further research is warranted to examine differential drinking related outcomes among AI men and women in addition to adaptations of the SIP that more fully capture the range of negative drinking consequences.
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Affiliation(s)
- Katherine A Hirchak
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA.,Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA
| | - J Scott Tonigan
- Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | | | - Jalene Herron
- Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Violette Cloud
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kamilla L Venner
- Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
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30
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Abstract
The current article provides a brief summary of biopsychosocial gender differences in alcohol use disorder (AUD), then reviews existing literature on gender differences in treatment access, retention, outcomes, and longer-term recovery. Among psychotherapies for AUD, there is support for the efficacy of providing female-specific treatment, and for female-only treatment settings but only when female-specific treatment is included. However, despite mandates from the National Institutes of Health to do so, there is little work thus far that directly compares genders on outcomes of specific psychotherapies or pharmacotherapies for AUD. Although existing research has mixed findings on sex and gender differences in overall outcomes, there are more consistent findings suggesting different mechanisms of behavior change among men and women in AUD treatment and long-term recovery. Thus, more work is needed that attends to gender and sex differences, including planning studies that are structured to examine not only gender-differentiated outcomes in treatment response, but equally important, differences in treatment access and attendance as well as differences in mechanisms of change in drinking behavior.
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Affiliation(s)
- Cathryn Glanton Holzhauer
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts.,Division of Research and Education, VA Central Western Massachusetts, Leeds, Massachusetts
| | - Michael Cucciare
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas.,VA South Central Mental Illness Research, Education, and Clinical Center and Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas
| | - Elizabeth E Epstein
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts
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31
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McCaul ME, Grakalic I. From the Editors. Alcohol Res 2020; 40:14. [PMID: 33163317 PMCID: PMC7599072 DOI: 10.35946/arcr.v40.2.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Mary E McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ivana Grakalic
- Division of Neuroscience and Behavior, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland
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