The Patterns of Drug and Alcohol Use and Associated Problems Over 30 Years in 397 Men

Alcoholism: Clinical and Experimental Research

1. Marc A. Schuckit, 
2. Tom L. Smith, 
3. Jelger A. Kalmijn

Article first published online: 29 JUL 2013

Background

Alcohol and drug use disorders (AUDs and SUDs) and their combination are relatively common and often occur together. However, the relationships of potential early life correlates of alcohol and drug disorders to the combined diagnoses have rarely been evaluated in long-term prospective studies or in populations at high risk of one of these diagnoses but not the other.

Methods

Data were analyzed from 397 males (half with an alcohol-dependent father) who had no AUDs or SUDs at age 20 and who were followed approximately every 5 years for 3 decades. Early life correlates and the course of AUDs, SUDs, and combined disorders were evaluated for 4 groups of subjects based on subsequent alcohol and/or drug diagnoses.

Results

While the overall rates of the development of AUDs and SUDs were 41 and 21%, respectively, the rates of the second substance-related diagnosis were almost 2-fold higher for individuals who had the first condition. Among potential risk factors, scores for externalizing traits were elevated for men with AUDs, SUDs, and their combination, but a low level of response (low LR) to alcohol was associated only with the risk of AUDs, even when observed in the context of SUDs. The same earlier life characteristics that related to AUDs and to SUDs also related to the combination of these diagnoses in the same person. Finally, in this prospective study, subjects with both AUDs and SUDs had a more severe course than subjects with either condition alone.

Conclusions

This prospective evaluation of a group at high risk of AUDs confirmed the selective impact of the low LR on the risk of AUDs, the relationship of externalizing characteristics to both AUDs and SUDs and confirmed the more severe clinical course for both conditions when seen together

Keywords:

• Alcoholism;
• Drug Dependence;
• Comorbidity;
• Level of Response to Alcohol;
• Externalizing Clinical Course

Alcohol consumption in late adolescence and early adulthood – where is the problem?

Published 25 July 2013, doi:10.4414/smw.2013.13826

Emmanuel Kuntsche, Gerhard Gmel

Risky single-occasion drinking (RSOD) is more common in late adolescence and early adulthood (approximately between the ages of 16 and 30) than in any other period in life. This is also the age when young people in Switzerland and many other European countries are legally allowed to buy and drink alcohol, but they usually do not yet have adult responsibilities. This paper reviews evidence from the international literature and provides examples of studies conducted in Switzerland demonstrating that (a) RSOD is by far most prevalent on Saturday evenings followed by Friday evenings, usually because young people go out and do not have any work or study responsibilities the next day; (b) RSOD results from drinking in private before going out (“predrinking”) and accelerating the pace of drinking (i.e. increasing the number of drinks consumed per hour); (c) RSOD is often not accidental but purposeful,. to seek excitement, to have fun and to feel the effects of alcohol; (d) RSOD occurs predominantly outside the home, mostly in bars, pubs, discos or at special events and festivals; (e) RSOD often results in intended and unintended injuries and other acute consequences, which are leading risk factors for mortality and morbidity in this age group. Effective prevention strategies should include attempts to reduce opportunities to engage in heavy drinking as well as strategies to reduce its harmful consequences.

Keywords: Risky drinking; predrinking; injuries; adolescence; young adults; harm reduction

Full article

"La Justicia Terapéutica. Una Alternativa en Desarrollo" Seminario por CONADIC/SALUD - IIJ/UNAM

Más información aquí

Use of evidence to influence alcohol policy: Case studies, the Alcohol Industry...

Jim McCambridge on 'Use of evidence to influence alcohol policy': 

Case studies, the Alcohol Industry and Minimum Unit Pricing

Watch video

Jim McCambridge leads two presenatations. In the first one he discusses a paper, which was published in 2013: 'Industry use of evidence to influence alcohol policy: A case study of submissions to the 2008 Scottish Government Consultation'. Jim examines how research evidence is used in alcohol industry submissions made to a Scottish Government consultation in 2008 to advocate policies in line with their commercial interests. Moreover, he argues that industry actors consistently oppose the approaches found in research to be most likely to be effective at a population level without actually engaging with the research literature in any depth.

In the second talk he discusses another paper 'Alcohol Industry influence on Public Policy: A case study of minimum pricing', where he focuses on corporate political activity. Whilst much of the literature on alcohol policy exhibits a clear assumption that industry actors are extremely powerful, there is relatively little about the processes through which alcohol policy is made and the specific role played by industry actors in these processes. This project aimed to fill this gap by examining the debates around pricing and promotions policy in England and Scotland. 

Estados con Altas Tasas de Incidencias por Intoxicación Aguda (2005 - 2012)

Las 5 Entidades Federativas con mayor promedio anual en Tasa de Incidencia de Intoxicación Aguda por Alcohol (F10.0) entre 2005 y 2012 son:

1. Yucatán: 583.4

2. Zacatecas: 90.8

3. Aguascalientes: 70.4

4. Quintana Roo: 65.2

5. Campeche: 63.7

Mapa 1.  Estados con altas Tasas de Incidencia de F10.0 y sus promedios regionales en 2012.

Gráficas.  Distribución de Tasas de Incidencia: 2005 - 2012.

Tabla 1.  Tasas de Incidencia de F10.0 por entidad. 2005 - 2012.

Información proveniente de los Anuarios de Morbilidad (2005-2011) y del Reporte Mensual de la Notificación Semanal (2012) de la Dirección General de Epidemiología de la Secretaría de Salud, México.

¿En qué estados de México se intoxican más con alcohol?

Con base en los Anuarios de Morbilidad (2005-2011) y al Reporte Mensual de la Notificación Semanal (2012) de la Dirección General de Epidemiología de la Secretaría de Salud, las 5 Entidades Federativas con mayor promedio anual de nuevos casos de Intoxicación Aguda por Alcohol (F10.0) reportados al sistema de salud  entre 2005 y 2012 son:

1. Yucatán: 10,950

2. Jalisco: 4,160

3. Guanajuato: 2,635

4. Nuevo León: 2,665

5. Distrito Federal: 2,302

Tabla 1.  Número de casos de F10.0 por entidad. 2005 - 2012.

Embriaguez - Imágenes sobre Alcohol

Images from the History of Medicine: http://www.nlm.nih.gov/hmd/ihm/

Alcoholismo por Gustave Philippon

Paris, France : Fils d'Émile Deyrolle, [191-?]

Alcohol: Políticas públicas. Curso en línea de la OPS

Curso virtual sobre políticas de salud pública

en materia de consumo de alcohol.

Más información aquí

Overcoming Addictions, a Web-Based Application...

Overcoming Addictions, a Web-Based Application, and SMART Recovery, an Online and In-Person Mutual Help Group for Problem Drinkers, Part 1: Three-Month Outcomes of a Randomized Controlled Trial

Reid K Hester, Kathryn L Lenberg; William Campbell; Harold D Delaney

http://www.jmir.org/2013/7/e134/

Background: Overcoming Addictions (OA) is an abstinence-oriented, cognitive behavioral, Web application based on the program of SMART Recovery. SMART Recovery is an organization that has adapted empirically supported treatment strategies for use in a mutual help framework with in-person meetings, online meetings, a forum, and other resources.

Objective: To evaluate the effectiveness of OA and SMART Recovery (SR) with problem drinkers who were new to SMART Recovery. Our experimental hypotheses were: (1) all groups will reduce their drinking and alcohol/drug-related consequences at follow-up compared to their baseline levels, (2) the OA condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR), and (3) the OA+SR condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR only).

Methods: We recruited 189 heavy problem drinkers primarily through SMART Recovery’s website and in-person meetings throughout the United States. We randomly assigned participants to (1) OA alone, (2) OA+attend SMART Recovery (SR) meetings (OA+SR), or (3) attend SR only. Baseline and follow-ups were conducted via GoToMeeting sessions with a Research Assistant (RA) and the study participant. We interviewed significant others to corroborate the participant’s self-report. Primary outcome measures included percent days abstinent (PDA), mean drinks per drinking day (DDD), and alcohol/drug-related consequences.

Results: The intent-to-treat analysis of the 3-month outcomes supported the first hypothesis but not the others. Participants in all groups significantly increased their percent days abstinent from 44% to 72% (P<.001), decreased their mean drinks per drinking day from 8.0 to 4.6 (P<.001), and decreased their alcohol/drug-related problems (P<.001). Actual use relationships were found for the OA groups, between SR online meetings and improvement in PDA (r=.261, P=.033). In addition in the OA groups, the number of total sessions of support (including SR & other meetings, counselor visits) was significantly related to PDA (r=.306, P=012) and amount of improvement in alcohol-related problems (r=.305, P=.012). In the SR only group, the number of face-to-face meetings was significantly related to all three dependent variables, and predicted increased PDA (r=.358, P=.003), fewer mean DDD (r=-.250, P=.039), and fewer alcohol-related problems (r=-.244, P=.045), as well as to the amount of improvement in all three of these variables. Six-month follow-ups have been completed, and the results are currently being analyzed.

Conclusions: These results support our first experimental hypothesis but not the second or third. All groups significantly increased their PDA and decreased both their mean DDD and their alcohol-related problems, which indicates that both interventions being investigated were equally effective in helping people recover from their problem drinking.

Preferences Regarding Treatment for Alcohol Problems

Sven Andréasson, Anna-Karin Danielsson and Sara Wallhed-Finn




Alcohol and Alcoholism (2013). 
First published online: July 10, 2013








http://alcalc.oxfordjournals.org/content/early/2013/07/09/alcalc.agt067.abstract

1. Aims: The aim of the study was to investigate preferences in the general population regarding type of treatment for alcohol problems and the preferred setting for delivery of treatment and reasons for not seeking treatment for alcohol problems. 

   
   

   Method: Data were from a random, cross-sectional, interview survey of 9005 of the Swedish general population. Proportions of respondents preferring a certain treatment and source of treatment, and reasons suggested for why people do not seek treatment, were analysed in relation to number of standard drinks, employment status, education and income. 

   
   

   Results: Most frequently endorsed forms of treatment were alcoholics anonymous or similar support groups and psychotherapy. More than 50% preferred psychiatric or addiction specialist treatment. Around 10% preferred primary health care and around 20% the occupational health services. About 5% preferred the social services. Respondents rated ‘feeling ashamed’ as the most important reason why people would not seek help for alcohol problems.

   
   

   Conclusion: Large majorities of the respondents preferred treatment in the health care services and few in the social services. Internet-based treatment and pharmacological treatment attracted few respondents, the majority preferring more traditional forms of treatment. Alcohol treatment remains a stigmatized field, evidenced by shame being the most commonly reported reason for not seeking treatment.

The MATRICES explained.

The MATRICES explained

Last month we told you about the treatment evidence matrices you can find for alcohol and drugs respectively at:

Alcohol matrix for alcohol brief interventions and treatment
Drug matrix for harm reduction and treatment in relation to illegal drugs

Now thanks to Lifeline's FEAD web site we can go a step further with a video of the matrices' developer Mike Ashton explaining their genesis and construction. The presentation also drills down to one of the studies in one of the 25 cells of the alcohol matrix. This sample study from the 1950s illustrates the riches to be found in the matrices and the contemporary relevance of their seminal studies. Also available is an updated version of the presentation's slides.

Each cell of the matrices also cites contemporary research landmarks, reviews and expert guidance, and provides a one-click option to yourself explore beyond these dozen or so selected documents.

To view the video click the button below.VIEW VIDEO

Stigma among health professionals towards patients with substance use disorders... Systematic review

• Leonieke C. van Boeke
, 
• Evelien P.M. Brouwers
, 
• Jaap van Weeghel
, 
• Henk F.L. Garretsen

• Drug and Alcohol Dependence
    Volume 131, Issue 1 , Pages 23-35, 1 July 2013

• http://www.drugandalcoholdependence.com/article/S0376-8716(13)00067-7/abstract

Background

Healthcare professionals are crucial in the identification and accessibility to treatment for people with substance use disorders. Our objective was to assess health professionals’ attitudes towards patients with substance use disorders and examine the consequences of these attitudes on healthcare delivery for these patients in Western countries.

Methods

Pubmed, PsycINFO and Embase were systematically searched for articles published between 2000 and 2011. Studies evaluating health professionals’ attitudes towards patients with substance use disorders and consequences of negative attitudes were included. An inclusion criterion was that studies addressed alcohol or illicit drug abuse. Reviews, commentaries and letters were excluded, as were studies originating from non-Western countries.

Results

The search process yielded 1562 citations. After selection and quality assessment, 28 studies were included. Health professionals generally had a negative attitude towards patients with substance use disorders. They perceived violence, manipulation, and poor motivation as impeding factors in the healthcare delivery for these patients. Health professionals also lacked adequate education, training and support structures in working with this patient group. Negative attitudes of health professionals diminished patients’ feelings of empowerment and subsequent treatment outcomes. Health professionals are less involved and have a more task-oriented approach in the delivery of healthcare, resulting in less personal engagement and diminished empathy.

Conclusions

This review indicates that negative attitudes of health professionals towards patients with substance use disorders are common and contribute to suboptimal health care for these patients. However, few studies have evaluated the consequences of health professionals’ negative attitudes towards patients with substance use disorders.

Divorce in Russia: The Role of Individual/Couple Drinking

Longitudinal Prediction of Divorce in Russia: 

the Role of Individual and Couple Driking Pattterns

Katherine Keenan, 

Michael G. Kenward, 

Emily Grundy and 

David A. Leon

1. 
   

   
   Alcohol and Alcoholism (2013) First published online: July 12, 2013

http://alcalc.oxfordjournals.org/content/early/2013/07/11/alcalc.agt068.short?rss=1

Aims: The aim of the study was to explore associations between dimensions of alcohol use in married couples and subsequent divorce in Russia using longitudinal data. 

Methods: Follow-up data on 7157 married couples were extracted from 14 consecutive annual rounds (1994–2010) of the Russian Longitudinal Monitoring Survey, a national population-based panel study. Discrete-time hazard models were fitted to estimate the probability of divorce among married couples by drinking patterns reported in the previous survey wave. 

Results: In adjusted models, increased odds of divorce were associated with greater frequency of husband and wife drinking (test for trend P = 0.005, and P = 0.05, respectively), wife's binge drinking (P = 0.05) and husband's heavy vodka drinking (P = 0.005). Couples in whom the wife drank more frequently than the husband were more likely to divorce (OR 2.86, 95% CI 1.52–5.36), compared with other combinations of drinking. The association between drinking and divorce was stronger in regions outside Moscow or St. Petersburg. 

Conclusion: This study adds to the sparse literature on the topic and suggests that in Russia heavy and frequent drinking of both husbands and wives put couples at greater risk of future divorce, with some variation by region and aspect of alcohol use.

SAMHSA seeks public comment on Federal Guidelines for Opioid Treatment

SAMHSA Bulletin
Date: 6/27/2013 10:40 AM 



The Substance Abuse and Mental Health Services Administration (SAMHSA), is seeking public comments on the Federal Guidelines for Opioid Treatment. (...) 

As part of its effort to finalize the guidelines, SAMHSA is asking representatives from OTPs, accreditation organizations, patients groups, the medical community and other interested members of the public to review and comment on these preliminary guidelines. 

The guidelines are available at: 

 http://www.dpt.samhsa.gov/pdf/FederalGuidelinesforOpioidTreatment5-6-2013revisiondraft_508.pdf. 

More

Imágenes sobre Alcohol. "Your baby begins depending on you long before he's born"

Images from the History of Medicine: http://www.nlm.nih.gov/hmd/ihm/

Your baby begins depending on you long before he's born 

Greater Indianapolis Council on Alcoholism, U.S.

Prenatal Alcohol Exposure and Educational Achievement in Children Aged 8–9 Years

Colleen M. O’Leary, 

Cate Taylor, 

Stephen R. Zubrick, 

Jennifer J. Kurinczuk, nd 

Carol Bower

.

Published online July 8, 2013

http://pediatrics.aappublications.org/content/early/2013/07/02/peds.2012-3002

OBJECTIVE: This study examines the relationships between the dose, pattern, and timing of prenatal alcohol exposure and achievement in reading, writing, spelling, and numeracy in children aged 8 to 9 years.

METHODS: Data from a randomly selected, population-based birth cohort of infants born to non-Indigenous women in Western Australia between 1995 and 1997 (n = 4714) (Randomly Ascertained Sample of Children born in Australia’s Largest State Study cohort) were linked to the Western Australian Midwives’ Notification System and the Western Australian Literacy and Numeracy Assessment statewide education testing program. The records for 86% (n = 4056) of the cohort were successfully linked with education records when the children were aged 8 to 9 years. The associations between prenatal alcohol exposure and achievement of national benchmarks in school numeracy, reading, spelling, and writing tests and nonattendance for the tests was examined. Logistic regression was used to generate adjusted odds ratios (aOR) and 95% confidence intervals (CI), adjusting for potential confounding factors. The referent group included children of mothers who previously drank alcohol but who abstained during pregnancy.

RESULTS: Children were twice as likely not to achieve the benchmark for reading after heavy prenatal alcohol exposure during the first trimester (aOR 2.26; 95% CI 1.10–4.65) and for writing when exposed to occasional binge drinking in late pregnancy (aOR 2.35; 95% CI 1.04–5.43). Low-moderate prenatal alcohol exposure was not associated with academic underachievement.

CONCLUSIONS: The type of learning problems expressed depends on the dose, pattern, and timing of prenatal alcohol exposure.

Alcohol intake in lactating women assisted in a University Hospital.

 
 vol.31, n.2, pp. 198-204

Nascimento, Ana Luisa V.; Souza, Amanda Fernandes O. de; Amorim, Ana Carolina R. de; Leitão, Mayara Brasil de S.; Maio, Regiane; Burgos, Maria Goretti P. A.

http://www.scielo.br/scielo.php?script=sci_abstract&pid=S0103-05822013000200010&lng=en&nrm=iso&tlng=en

OBJECTIVE: To determine the prevalence of alcohol intake and the degree of alcohol-related risk among nursing mothers attended at the Child Care Service of Hospital das Clínicas of Universidade Federal de Pernambuco, Brazil. 

METHODS: A cross-sectional study was carried out with 157 nursing mothers enrolled in the Child Care Program of the university hospital. A questionnaire was administered addressing demographic and socioeconomic variables, type and duration of breastfeeding, smoking habits and consumption of foods considered as appetizers. The Alcohol Use Disorders Identification Test (AUDIT C) was applied for assessing alcohol consumption in the previous 12 months. Pearson's chi-square test and Fisher's exact test were used for statistical analysis. 

RESULTS: Twelve percent of the nursing mothers reported consuming alcoholic beverages, 100% of whom were classified as being at low risk for alcohol use disorders. The frequency of nursing mothers who consumed appetizers during alcohol consumption was 100%, the most common of which was cheese - 18 (95%). 

CONCLUSIONS: The prevalence of alcohol intake was low in the nursing mothers analyzed. The users exhibited a low risk for alcohol disorders and a high frequency of the consumption of appetizers during alcohol consumption.

Keywords : alcoholic beverages; breast feeding; maternal nutrition; infant nutrition.