Substance use disorder and alcohol consumption patterns among Dutch physicians: a nationwide register-based study

PURPOSE

Problematic substance use and Substance Use Disorders (SUD) are common in all layers of the population. Several studies suggest higher prevalence rates of problematic substance use among physicians compared to the general population, which is harmful for themselves and potentially impairs quality of care. However, nationwide comparison with a highly educated reference group is lacking. Using nationwide register data, this study compared the prevalence of clinical SUD diagnoses and alcohol consumption patterns between physicians and a highly educated reference population.

METHODS

A retrospective study was performed using registry data from 2011 up to and including 2019, provided by Statistics Netherlands. From the data, a highly educated reference group was selected and those with an active medical doctor registration were identified as "physicians". Clinical SUD diagnoses were identified by DSM-IV codes in mental healthcare registries. Benchmark analyses were performed, without statistical testing, to compare the prevalence of SUD diagnoses and alcohol consumption patterns between physicians and the reference population.

RESULTS

Clinical SUD diagnoses were found among 0.3% of the physicians and 0.5% of the reference population, with higher proportions of sedative use disorder among physician patients. Among drinkers, the prevalence rates of heavy and excessive drinking were respectively 4.0% and 4.3% for physicians and 7.7% and 6.4% for the reference population.

CONCLUSION

Prevalence rates of SUD diagnoses were fairly comparable between physicians and the highly educated reference population, but physicians displayed more favorable alcohol consumption patterns. The use of sedatives by physicians might deserve attention, given the relatively higher prevalence of sedative use disorder among physicians. Overall, we observed relatively low prevalence rates of SUD diagnoses and problematic alcohol use, which may reflect a treatment gap and social desirable answers.

Alcohol consumption patterns and the risk of sarcopenia: a population-based cross-sectional study among chinese women and men from Henan province

Objectives

Sarcopenia is a clinically relevant syndrome with health, social, and economic implications. Alcohol consumption is one of the risk factors for sarcopenia, but it has not been fully investigated in Chinese populations. The purpose of the present study was to assess the relationship between alcohol consumption patterns (including the volume and frequency of alcohol consumption) and sarcopenia or its elements among Chinese women and men from Henan Province.

Method

A cross-sectional study was designed to collect information about nutrition and health in Henan Province, China, and a total of 680 individuals were studied. Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria updated in 2019. Alcohol consumption was calculated in grams per day and divided into three groups. Drinking frequency was divided into four groups. We assessed the likelihood that sarcopenia was associated with drinking patterns using multiple logistic regression analysis by odds ratios (ORs) with 95% confidence interval (CIs) after multiple adjustments.

Results

We found that men who consumed > 25 g of ethanol per day were approximately three times more likely to have low muscle mass (OR, 3.99; 95% CI, 1.10–17.05) or low grip strength (OR, 3.39; 95% CI, 1.33–9.92) than nondrinkers after multiple adjustments. In addition, males who consumed alcohol more than 4 times per week were approximately threefold to fivefold more likely to have low muscle mass (OR, 4.99; 95% CI, 1.24–25.55) or low grip strength (OR, 3.37; 95% CI, 1.40–8.74) than nondrinkers. Unfortunately, we did not find a relationship between alcohol consumption patterns and sarcopenia or gait speed among males, and there was no association between alcohol consumption patterns and sarcopenia or any elements.

Conclusion

Heavy alcohol consumption and frequent drinking are important risk factors for low muscle mass and muscle strength in Chinese men from Henan province.

Alcohol consumption patterns and attitudes toward drink-drive behaviours and road safety enforcement strategies

BACKGROUND

Alcohol contributes to approximately 30% of all serious crashes. While the majority of drivers acknowledge the risks associated with drink-driving, a significant proportion of the population continue to engage in this behaviour. Attitudes towards drink-driving as well as personal alcohol consumption patterns are likely to underpin a driver's decision to drink-drive. These associations were explored in the current study.

METHODS

A large (N=2994) cross-sectional online survey of a representative sample of drivers in Australia was conducted. Participants provided information about their own alcohol consumption patterns, drink-driving behaviour as well as attitudes towards drink-driving (own and others) and enforcement strategies.

RESULTS

Alcohol consumption patterns differed according to age, gender and work status. Drivers who reported drink-driving behaviour and had high risk alcohol consumption patterns were less likely to agree that drink-driving leads to increased crash risk and more likely to agree they drink and drive when they believed they could get away with it. In contrast, drivers who did not report drink-driving and had low risk consumption patterns were more likely to report that the enforcement strategies are too lenient. Binary logistic regression showed that high risk alcohol consumption patterns and agreement from drivers that they drink and drive when they believe they can get away with it had the strongest associations with drink-driving. These findings highlight the relationships between one's drinking patterns, drink-drive behaviour and attitudes towards drink-driving and drink-driving enforcement CONCLUSIONS AND IMPLICATIONS: The patterns of associations that emerged suggest that drink-driving is the expression of a broader health issue for the most "at-risk" cohort of drinkers. The decision to drink and drive may result from a need borne from an alcohol dependent lifestyle exacerbated by a social acceptability of the behaviour and positive attitudes towards one's ability to drink-drive with few adverse consequences. Therefore, the broader alcohol consumption patterns of drink-drivers needs to be considered when targeting drink-drive reductions.

Are nondrinkers missing from the picture?

WHO statistics indicate that half the world's population does not drink alcohol. With a Western outlook this fact is often overlooked.

FINDINGS

The article explores the global drinking patterns focusing on non-drinking and the global forces that contribute towards change. The large segment of non-drinking population is beneficial for public health but it is also seen as a great potential for the international alcoholic beverage industry.

CONCLUSION

The forces of globalization towards conformity and a global mono-culture deprived of cultural diversity also affects non-drinking populations, to the detriment of public health.

An empirical study of alcohol consumption by patients considering HCV treatment

BACKGROUND

Alcohol accelerates the course of hepatitis C (HCV) infection and liver damage. Little is known about recency of alcohol use among patients with HCV.

OBJECTIVES

Alcohol consumption recency was compared among HCV patients with and without alcohol use disorders and current and lifetime alcohol use histories.

METHODS

Patients considering antiviral treatment for HCV (n = 309) recruited from university-affiliated and VA liver and infectious disease clinics were assessed for lifetime and current-year psychiatric disorders and alcohol-use patterns. Full diagnostic interviews, self-report surveys, medical record review, and urine screening for recent alcohol and drug use were conducted.

RESULTS

60% used alcohol in the last year. Besides alcohol history, those who stopped using alcohol in the past year differed from those with no lifetime use only in gender (60% vs. 22%); however, patients no longer using alcohol in the last year were less likely than those still using to have a current drug use disorder (16% vs. 3%) or last-month drug use (52% vs. 30%), and had fewer current risky behaviors (1.3 vs. 0.6). Among patients with last-year alcohol use, those with past alcohol use disorders differed from those without only by higher prevalence of drug use disorder (84% vs. 47%) and drug use after HCV diagnosis (67% vs. 43%).

CONCLUSIONS

Patients who had stopped using alcohol for at least a year were much like those who never used alcohol in regard to other drug use, psychiatric history, smoking, and risky behaviors. These findings indicate that HCV patients with at least a year of abstinence from alcohol, including those with a history of alcohol use disorder, should be considered HCV treatment candidates.