The arousal effect of An-Gong-Niu-Huang-Wan on alcoholic-induced coma rats: A research based on EEG

ETHNOPHARMACOLOGICAL RELEVANCE

Acute alcohol intoxication is one of the leading causes of coma. A well-regarded Chinese herbal formula, known as An-Gong-Niu-Huang-Wan (AGNHW), has garnered recognition for its efficacy in treating various brain disorders associated with impaired consciousness, including acute alcohol-induced coma. Despite its clinical effectiveness, the scientific community lacks comprehensive research on the mechanistic aspects of AGNHW's impact on the electroencephalogram (EEG) patterns observed during alcohol-induced coma. Gaining a deeper understanding of AGNHW's mechanism of action in relation to EEG characteristics would hold immense importance, serving as a solid foundation for further advancing its clinical therapeutic application.

AIM OF THE STUDY

The study sought to investigate the impact of AGNHW on EEG activity and sleep EEG patterns in rats with alcoholic-induced coma.

MATERIALS AND METHODS

A rat model of alcohol-induced coma was used to examine the effects of AGNHW on EEG patterns. Male Sprague-Dawley rats were intraperitoneally injected with 32% ethanol to induce a coma, followed by treatment with AGNHW. Wireless electrodes were implanted in the cortex of the rats to obtain EEG signals. Our analysis focused on evaluating alterations in the Rat Coma Scale (RCS), as well as assessing changes in the frequency and distribution of EEG patterns, sleep rhythms, and body temperature subsequent to AGNHW treatment.

RESULTS

The study found a significant increase in the δ-band power ratio, as well as a decrease in RCS scores and β-band power ratio after modeling. AGNHW treatment significantly reduced the δ-band power ratio and increased the β-band power ratio compared to naloxone, suggesting its superior arousal effects. The results also revealed a decrease in the time proportion of WAKE and REM EEG patterns after modeling, accompanied by a significant increase in the time proportion of NREM EEG patterns. Both naloxone and AGNHW effectively counteracted the disordered sleep EEG patterns. Additionally, AGNHW was more effective than naloxone in improving hypothermia caused by acute alcohol poisoning in rats.

CONCLUSION

Our study provides evidence for the arousal effects of AGNHW in alcohol-induced coma rats. It also suggests a potential role for AGNHW in regulating post-comatose sleep rhythm disorders.

Young adults' change talk within brief motivational intervention in the emergency department and booster sessions is associated with a decrease in heavy drinking over 1 year

OBJECTIVE

Investigate the effect of change talk (CT) within successive brief motivational interventions (BMIs) as a mechanism of change for alcohol use.

METHOD

We conducted a secondary analysis of data from a randomized controlled trial in which 344 young adults (18-35 years old) admitted to a Swiss emergency department with alcohol intoxication received either BMI (N = 171) or brief advice (N = 173). Participants with a baseline audio-recorded BMI were included (N = 140; median age 23 [Q1-Q3: 20-27], 72.9% men). Up to three booster sessions by phone were offered at 1 week, 1 month, and 3 months. Percent CT and CT Average Strength were used as predictor variables. The outcome was the number of heavy drinking days (HDD) over the 30 days prior to research assessments at 1-, 3-, 6-, and 12-month follow-up. A latent growth curve modeling framework was first used to estimate predictor and outcome variable growth parameters (i.e., intercept and slope) over time, and then to regress HDD growth parameters on CT growth parameters.

RESULTS

CT increased specifically from baseline to the 1-week booster session and thereafter remained stable. Higher baseline CT was associated with lower HDD at 1 month (Percent CT: b = -0.04, 95% confidence interval [-0.06, -0.01]; Average Strength: b = -0.99 [-1.67, -0.31]). An increase in CT from baseline to the 1-week booster session was related to a decrease in HDD from 1 month to 12 months (Percent CT: b = -0.08 [-0.14, -0.03]; Average Strength: b = -2.29 [-3.52, -1.07]).

CONCLUSIONS

Both baseline CT and CT trajectory over the first week are meaningful predictors of HDD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between discrimination, alcohol use severity, and PTSD symptoms among Latinx heavy drinkers

INTRODUCTION

Discrimination is linked to alcohol use severity among Latinx adults, who also show high prevalence rates of PTSD compared to non-Latinx adults. We know little about whether PTSD symptoms affects the relationship between discrimination and alcohol use severity. We hypothesized that the association between discrimination and alcohol use severity might differ by level of PTSD symptom severity.

METHODS

This is a secondary cross-sectional analysis of data collected at baseline from a completed randomized clinical trial testing the relative efficacy of a culturally adapted motivational interview designed to address discrimination and drinking behavior against an unadapted motivational interview for Latinx adults. Eligible participants screened positive for the NIAAA Single Alcohol Screening Question for heavy drinking days, identified as Latinx, and were 18-65 years old. We assessed the Everyday Discrimination Scale, Primary Care PC-PTSD screener, Alcohol Use Disorder Identification Test, and the Short Acculturation Scale for Hispanics. The study analyzed the main and interactive effects of discrimination and PTSD symptoms on alcohol use severity, while controlling for age, sex, household income, and acculturation.

RESULTS

After controlling for covariates in model 2, the interaction of discrimination and PTSD symptoms was significantly related to alcohol use severity. Simple slopes analysis indicated that discrimination was positively related to alcohol use severity among those with high (1 SD above the mean) but not low (1 SD below the mean) levels of PTSD symptoms.

CONCLUSIONS

Evidence suggests that the experiences of discrimination were associated with alcohol use severity among those who reported more PTSD symptoms. Specifically, discrimination may have a stronger effect on alcohol use severity among Latinx adults who report more PTSD symptoms. Screening Latinx adults for heavy drinking days, discrimination, and PTSD symptoms is clinically important. Culturally adapted alcohol interventions that target discrimination may be particularly effective for Latinx individuals with more PTSD symptoms.

Development and internal validation of a multivariable model for the prediction of the probability of 1-year readmission to the emergency department for acute alcohol intoxication

To develop and internally validate a multivariable logistic regression model (LRM) for the prediction of the probability of 1-year readmission to the emergency department (ED) in patients with acute alcohol intoxication (AAI). We developed and internally validated the LRM on a previously analyzed retrospective cohort of 3304 patients with AAI admitted to the ED of the Sant'Orsola-Malpighi Hospital (Bologna, Italy). The benchmark LRM employed readmission to the same ED for AAI within 1 year as the binary outcome, age as a continuous predictor, and sex, alcohol use disorder, substance use disorder, at least one previous admission for trauma, mental or behavioral disease, and homelessness as the binary predictors. Optimism correction was performed using the bootstrap on 1000 samples without replacement. The benchmark LRM was gradually simplified to get the most parsimonious LRM with similar optimism-corrected overall fit, discrimination and calibration. The 1-year readmission rate was 15.7% (95% CI 14.4-16.9%). A reduced LRM based on sex, age, at least one previous admission for trauma, mental or behavioral disease, and homelessness, performed nearly as well as the benchmark LRM. The reduced LRM had the following optimism-corrected metrics: scaled Brier score 17.0%, C-statistic 0.799 (95% CI 0.778 to 0.821), calibration in the large 0.000 (95% CI - 0.099 to 0.099), calibration slope 0.985 (95% CI 0.893 to 1.088), and an acceptably accurate calibration plot. An LRM based on sex, age, at least one previous admission for trauma, mental or behavioral disease, and homelessness can be used to estimate the probability of 1-year readmission to ED for AAI. To begin proving its clinical utility, this LRM should be validated in external cohorts.

Trends in psychosomatic symptoms among adolescents and the role of lifestyle factors

BACKGROUND

Adolescent mental health problems are on the rise globally, including in Sweden. One indicator of this trend is increased psychosomatic symptoms (PSS) over time. Lifestyle factors such as physical activity (PA), diet, smoking, and alcohol consumption may influence the time trends in PSS; however, the evidence base is scarce. The aim of this study was to investigate associations between time trends in PSS and lifestyle factors.

METHODS

The study was based on data collected from a nationally representative sample of 9,196 fifteen-year-old boys and girls in Sweden using the Health Behavior in School-aged Children (HBSC) symptom checklist. The sample comprised nearly equal proportions of girls (50.5%) and boys. The lifestyle factors examined in this study included PA, regular breakfast intake, consumption of fruits, vegetables, sweets, or soft drinks, smoking, and alcohol drunkenness. We used data from 2002 to 2018 and stratified by family affluence scale (FAS) to demonstrate how the associations varied among the FAS groups. We fitted separate regression models for the high- and low-FAS groups, where interaction terms between the year of survey and each lifestyle factor were used to estimate the level and direction of associations between the factors and trends in PSS.

RESULTS

There was a generally increasing trend in PSS mean scores from 2.26 in 2002 to 2.49 in 2018 (p <.001). The changes in each survey year compared to the average mean scores during the preceding years were significant in all years except 2010. Regular breakfast intake, daily fruit and vegetable consumption, and higher PA were associated with lower PSS mean scores, while smoking and drunkenness had opposite associations with PSS. The only significant interaction between survey year and the lifestyle factors was observed regarding drunkenness in the high FAS group, suggesting that the association between trends in PSS and the experience of getting drunk at least twice got stronger over time (B = 0.057; CI:0.016, 0.097; p <.01).

CONCLUSIONS

The results indicate increasing trends in PSS among young people in Sweden from 2002 to 2018, with a significant increase observed among adolescents in the high FAS group who reported getting drunk on at least two occasions.

The Association of Acute Intoxication and Threats to Masculinity on Laboratory-Based Sexual Aggression

OBJECTIVE

Men's alcohol intoxication and perceptions of their masculinity as precarious (i.e., viewing masculinity as easily threatened) are independently related to men's perpetration of sexual aggression. Yet, the interactive effects of these constructs on sexual aggression are unclear. The goal of this study was to assess if precarious masculinity-measured as a static trait-and acute alcohol intoxication-measured in a laboratory setting-were positively associated with men's perpetration of laboratory-based sexual aggression after their masculinity is threatened.

METHOD

Cisgender heterosexual men (n = 120, ages 21-30 years) completed a self-report measure of precarious masculinity, were randomly assigned to consume an alcoholic or nonalcoholic beverage, and engaged in the Sexual Imposition Paradigm, which assessed laboratory-based sexual aggression perpetration toward a female confederate. Immediately before the Sexual Imposition Paradigm, all participants' masculinity was threatened via feedback from an ostensible personality test that indicated they are less masculine than other men.

RESULTS

Self-reported precarious masculinity and the Precarious Masculinity × Beverage Condition interaction were not associated with laboratory-based sexual aggression. However, intoxicated men showed higher levels of laboratory-based sexual aggression than sober men.

CONCLUSIONS

Acute alcohol intoxication facilitated men's sexually aggressive responding toward women when their masculinity was threatened. Consistent with pertinent theory and research, this effect suggests that acute intoxication facilitates men's focus on salient cues (i.e., threatened masculinity), which then may proximally motivate sexual aggression. Sexual aggression prevention programs should continue to address alcohol in their programming.

Effects of Hovenia dulcis fruit and peduncle extract on alcohol metabolism

ETHNOPHARMACOLOGICAL RELEVANCE

The dried fruit and peduncle of Hovenia dulcis Thunberg (Rhamnaceae) (HD) has been used as a folk medicine to treat liver disease, detoxify alcoholism, and prevent and cure hangovers.

AIM OF THE STUDY

We investigated the pharmacology of HD on the kinetics of EtOH and on the enzymes related to alcohol metabolism to seek the scientific evidence of HD to prevent hangover, the effectiveness as a folk medicine.

MATERIALS AND METHODS

EtOH was orally administered 30 min after oral administration of HD boiling water extract in rats. Then, the profiles of blood EtOH concentrations were measured. Mice were reared with food containing powdered HD for 7 days, and the activities of alcohol dehydrogenase (ADH) and acetaldehyde dehydrogenase (ALDH) in liver were measured. Hepa1c1c7 cells were cultured with the medium containing HD extract, and the activities of ADH and ALDH were measured.

RESULTS

HD extract reduced the blood EtOH concentrations in rats and induced the activities of ADH and ALDH and mRNA and protein expressions of ADH1B, ALDH1A1, and ALDH2 in the liver of mice and Hepa1c1c7 cells. Dihydromyricetin, one of the ingredients of HD, significantly induced the activities of ADH and ALDH in Hepa1c1c7 cells, however, the fractions containing hydrophilic organic compounds with small molecular weight contributed the most of the activities of HD extract.

CONCLUSIONS

We clarified the experimental pharmacological evidences of HD as a folk medicine to detoxify alcoholism and prevent hangovers.

The Effects of Alcohol Intoxication on Perceptions of Consent and Refusal Indicators in a Fictional Alcohol-Involved Sexual Encounter

Alcohol intoxication may influence how bystanders interpret other people's consent and refusal cues. We examined the effects of alcohol intoxication on participants' perceptions of characters' consent and refusal indicators in a fictional vignette depicting an alcohol-involved sexual encounter. Young adults (n = 119, 52% women) participated in an alcohol administration experiment examining the influence of acute intoxication on bystander perceptions during a vignette depicting a character who is intoxicated and declines a sexual advance from another character, who ignores her refusal and continues to pursue sexual activity. Participants were randomly assigned to an alcohol or non-alcohol condition and then guided through a semi-structured interview in which we asked about the characters' consent and refusal cues. Interviews were analyzed using both inductive and deductive coding. Most participants eventually indicated the encounter was nonconsensual, but approximately 9% of participants described the encounter as entirely consensual and another 42% of participants described the interaction as initially consensual and then nonconsensual. Participants discussed nuanced accounts of consent and refusal cues, including indicators related to alcohol consumption. Disregarding intoxication and gender, participants eventually recognized the situation as nonconsensual and thus potentially risky. However, some participants recognized this risk earlier in the encounter than others. Consequently, bystanders who recognize risk later in a situation may have fewer opportunities to intervene before a situation escalates. We recommend sexual assault prevention educators take a more nuanced approach when discussing consent and refusal indicators, emphasizing contextual factors that may indicate risk.

Alcohol-involved rape: Limitations of the "rape exception" for abortion access

OBJECTIVE

In June 2022, the U.S. Supreme Court removed federal abortion protections, giving individual states the authority to enact abortion regulations. Since that ruling, many states have enacted abortion bans; however, several of these states allow "rape exceptions," theoretically providing rape victims who become pregnant access to abortion services. Notably, alcohol use by the rape victim and perpetrator is common. In this brief report, we describe findings from research on alcohol-involved rape that have the potential to impact the utility of rape exceptions.

METHOD

In this synthesis of the research literature pertaining to alcohol-involved rape victimization and perpetration, we focus on key concepts detailed in extant research likely relevant to accessing abortion services through rape exceptions.

RESULTS

Victim alcohol intoxication may limit the use of rape exceptions to abortion bans by delaying rape acknowledgment, increasing victim blame, undermining victim credibility, and deterring rape reporting. Commensurately, perpetrator alcohol intoxication may increase the need for victims to access abortion services by reducing perpetrator condom use during rape and increasing other sexually aggressive acts such as nonconsensual condom removal.

CONCLUSIONS

Research evidence suggests that alcohol-involved rape incidents present critical obstacles to utilizing statutory rape exceptions to banned abortion services beyond challenges that non-alcohol-involved rape survivors are also likely to experience. Rape survivors from oppressed communities (e.g., people of color, gender minorities, and/or sexual minorities) may be disproportionately impacted. Empirical investigations specifically examining how substance use during rape impacts reproductive health care accessibility are paramount for informing health care providers, law enforcement, legal practitioners, and policymakers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Alcohol consumption as a socially contagious phenomenon in the Framingham Heart Study social network

We use longitudinal social network data from the Framingham Heart Study to examine the extent to which alcohol consumption is influenced by the network structure. We assess the spread of alcohol use in a three-state SIS-type model, classifying individuals as abstainers, moderate drinkers, and heavy drinkers. We find that the use of three-states improves on the more canonical two-state classification, as the data show that all three states are highly stable and have different social dynamics. We show that when modelling the spread of alcohol use, it is important to model the topology of social interactions by incorporating the network structure. The population is not homogeneously mixed, and clustering is high with abstainers and heavy drinkers. We find that both abstainers and heavy drinkers have a strong influence on their social environment; for every heavy drinker and abstainer connection, the probability of a moderate drinker adopting their drinking behaviour increases by [Formula: see text] and [Formula: see text], respectively. We also find that abstinent connections have a significant positive effect on heavy drinkers quitting drinking. Using simulations, we find that while both are effective, increasing the influence of abstainers appears to be the more effective intervention compared to reducing the influence of heavy drinkers.

Does a Place of Last Drink (POLD) Initiative Affect Alcohol Serving Staff Attitudes and Perceptions Related to Overservice of Alcohol?

Background: One enforcement strategy used to address illegal sales of alcohol to intoxicated patrons (i.e., overservice) is Place of Last Drink (POLD). When law enforcement responds to an alcohol-related incident, they ask persons involved in the incident where they had their last drink; POLD data can then be used to track patterns of overservice.Methods: We evaluated potential effects of a POLD initiative in one state (USA) on the attitudes and perceptions of serving staff (i.e., bartenders and servers) about their experiences in refusing sales to intoxicated customers. We conducted interviews with 44 serving staff across 24 communities (14 communities that participated in the POLD initiative and 10 comparison communities). We analyzed the interview transcripts using a qualitative matrix to identify major themes.Results: We found few differences across the two study conditions, with interview participants having no apparent awareness of POLD and many stating that overservice occurs frequently without law enforcement getting involved. One difference we identified was serving staff from communities in the POLD initiative reporting generally positive experiences with their managers when refusing sales to intoxicated patrons, whereas serving staff in comparison communities more commonly saying they were overruled by their managers. It is possible that these differences are the result of the POLD initiative; however, more research is needed.Conclusions: In general, serving staff across communities share many similar perceptions and attitudes around overservice. These findings can inform future implementation of POLD and other strategies to reduce overservice of alcohol.

Early closing of hotels: Impacts on alcohol consumption, drunkenness, liver disease and injury mortality

INTRODUCTION

Early (six o'clock) closing of hotels was introduced in 1916 in Australia to curb heavy drinking. It lasted between 21 and 51 years in four Australian states. The aim of this study is to assess the impact of early closing on alcohol consumption, liver disease mortality rates, drunkenness and various forms of injury.

METHODS

Time series analysis was undertaken using an Autoregressive Integrated Moving Averages modelling technique. Relevant data were derived from annual publications of the Australian Bureau of Statistics and its predecessor organisations.

RESULTS

Early closing had a substantial downward effect on alcohol consumption across 1901-2006. It had a substantial and beneficial effect on liver disease mortality. Drunkenness rates declined pre-World War II (WWII), though they increased post-WWII. Rates for homicide decreased substantially, and close to substantially for suicide and female homicide. Early closing impacts were more beneficial pre-WWII than post-WWII.

DISCUSSION AND CONCLUSIONS

Early closing has not been favourably remembered in Australia in recent years. However, all pre-WWII impacts of early closing were beneficial including public drunkenness rates. Post-WWII, beneficial effects were less clear-cut and drunkenness increased. Resistance to early closing may also have arisen in the 1950s as families had more disposable income and ability to consume alcohol. While universal six o'clock closing is no longer feasible or desirable, opening hours and days for hotels are still part of the policy discussion in Australia. The experience of early closing pre-WWII gives confidence that the impacts of these can be beneficial.

Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers

BACKGROUND

Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship.

METHODS

A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology.

RESULTS

Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes.

DISCUSSION

Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups.

Drinking alcohol appears to have no impact on self-perceptions of morality, aggressiveness, or intelligence

People generally perceive themselves as moral but does this tendency change after alcohol consumption? In the current research, we tested whether alcoholic intoxication affects self-assessments of morality (i.e., the self-importance of moral identity and the moral self-concept), and we also tested self-assessment of aggressiveness and intelligence. We conducted a preregistered laboratory experiment with participants divided into three groups: alcohol intoxication (n = 106), placebo (n = 114), and control condition (n = 109). We did not detect statistically significant differences in self-assessments across conditions. These data are consistent with the conclusion that self-assessments of morality, aggressiveness, and intelligence may be too stable to be affected by the momentary changes in self-perception caused by alcoholic intoxication. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Longitudinal clustering of health behaviours and their association with multimorbidity in older adults in England: A latent class analysis

BACKGROUND

Health-risk behaviours such as smoking, unhealthy nutrition, alcohol consumption, and physical inactivity (termed SNAP behaviours) are leading risk factors for multimorbidity and tend to cluster (i.e. occur in specific combinations within distinct subpopulations). However, little is known about how these clusters change with age in older adults, and whether and how cluster membership is associated with multimorbidity.

METHODS

Repeated measures latent class analysis using data from Waves 4-8 of the English Longitudinal Study of Ageing (ELSA; n = 4759) identified clusters of respondents with common patterns of SNAP behaviours over time. Disease status (from Wave 9) was used to assess disorders of eight body systems, multimorbidity, and complex multimorbidity. Multinomial and binomial logistic regressions were used to examine how clusters were associated with socio-demographic characteristics and disease status.

FINDINGS

Seven clusters were identified: Low-risk (13.4%), Low-risk yet inactive (16.8%), Low-risk yet heavy drinkers (11.4%), Abstainer yet inactive (20.0%), Poor diet and inactive (12.9%), Inactive, heavy drinkers (14.5%), and High-risk smokers (10.9%). There was little evidence that these clusters changed with age. People in the clusters characterised by physical inactivity (in combination with other risky behaviours) had lower levels of education and wealth. People in the heavy drinking clusters were predominantly male. Compared to other clusters, people in the Low-risk and Low-risk yet heavy drinkers had a lower prevalence of all health conditions studied. In contrast, the Abstainer but inactive cluster comprised mostly women and had the highest prevalence of multimorbidity, complex multimorbidity, and endocrine disorders. High-risk smokers were most likely to have respiratory disorders.

CONCLUSIONS

Health-risk behaviours tend to be stable as people age and so ought to be addressed early. We identified seven clusters of older adults with distinct patterns of behaviour, socio-demographic characteristics and multimorbidity prevalence. Intervention developers could use this information to identify high-risk subpopulations and tailor interventions to their behaviour patterns and socio-demographic profiles.

Initial Results from a New College Substance Use Prevention Program Targeting Externalizing and Internalizing Traits

Objective: College students engage in high rates of risky substance use. Standard college prevention strategies focus on providing feedback about current substance use behaviors and harm reduction strategies but do not address the underlying genetically-influenced risk factors impacting these behaviors. We created an online Personalized Feedback Program (PFP) for college students that targets genetically-influenced externalizing and internalizing risk pathways and provides personalized recommendations and campus resources. College students received personalized feedback on four risk domains (Sensation Seeking, Impulsivity, Extraversion, and Neuroticism). Methods: An open trial (n = 300) was conducted at a large public university in spring of 2021 to assess initial responses to the PFP and evaluate intentions related to future substance use and campus resource use. Results: 81% of students in the open trial reported they enjoyed the Personalized Feedback Program. Participants reported intending to use significantly more campus resources after completing the PFP. Among participants that drank, 39% reported they intended to decrease their alcohol consumption and 41% reported they intended to decrease the number of times they get drunk after completing the PFP; these intentions to reduce use after completing the PFP are higher than rates found in previous studies. Conclusion: Preliminary data indicate that the Personalized Feedback Program may be a complementary method to enhance current college substance use prevention programs.

Adolescent alcohol and cannabis use and early adulthood educational attainment in the 1986 Northern Finland birth cohort study

BACKGROUND

Heavy alcohol and cannabis use during adolescence have been previously described as risk factors not only for morbidity in adulthood, but also social problems including adversities in educational attainment. Attempts to consider overlapping risk factors and confounders for these associations are needed.

METHODS

Using weighted multivariable models, we examined prospective associations between age at first drink (AFD), age at first intoxication (AFI), frequency of alcohol intoxication, as well as self-reported alcohol tolerance (i.e., number of drinks needed for the subjective experience of intoxication), and lifetime cannabis use at age 15/16 years with subsequent educational attainment obtained from comprehensive registers until age 33 in the Northern Finland Birth Cohort 1986 (6,564 individuals, 49.1% male). Confounding variables including sex, family structure (intact vs. non-intact), maternal and paternal education level, behavioural/emotional problems in school at age 7/8 years, having a history of illicit substance use in adolescence, having any psychiatric diagnosis before age 16, and parental psychiatric diagnoses, were adjusted for.

RESULTS

In this large birth cohort study with a 17-year follow-up, younger age at first intoxication, higher frequency of alcohol intoxication, and high self-reported alcohol tolerance at age 15/16 years were associated with poorer educational outcomes by the age of 33 years. These associations were evident regardless of potential confounders, including parental education and childhood behavioural/emotional problems. The association between adolescent cannabis use and educational attainment in adulthood was no longer statistically significant after adjusting for confounders including frequency of alcohol intoxication at age 15/16.

CONCLUSIONS

Assessments of age of first alcohol intoxication, high self-reported alcohol tolerance and frequency of intoxication during adolescence should be included when implementing screening strategies aimed at identifying adolescents at risk for subsequent social problems.

Association of over the counter "hangover remedy" use with alcohol use problems and consumption patterns among young adults

This cross-sectional study of young adults examined associations of hangover remedy use with alcohol use problems. Results suggest that ever-use of hangover remedy products was positively associated with alcohol use problem score, drinks per typical drinking day, and alcohol use disorder symptom count. Use of hangover remedies among young adults merits further scientific and regulatory attention.

Sexual violence in nightlife and positive bystander intervention in an English city

BACKGROUND

Nightlife environments are high risk settings for sexual violence and bystander intervention programmes are being developed in response. However, more research is needed to understand nightlife-related sexual violence, and factors that influence bystander interventions. This study examined nightlife patron's experiences of sexual violence and associated factors; and relationships between attitudes towards, awareness and experience of sexual violence, and confidence to intervene.

METHODS

Cross-sectional on-street survey of nightlife patrons (N = 307, aged 18+) on a night out in an English city. Surveys (7.30pm-1.30am; Wednesday-Saturday) established sexual violence awareness, myth acceptance, and experience, and confidence to intervene. Participant's socio-demographics, nightlife alcohol consumption, and frequency of nightlife usage were collected.

RESULTS

58.0% had ever experienced sexual violence whilst on a night out. In adjusted analyses, sexual violence was higher amongst females (adjusted odds ratio [AOR] 4.0; p < 0.001), and regular nightlife patrons (AOR 2.1; p < 0.05). The majority agreed that they would feel confident asking someone who has experienced sexual violence if they are okay/would like support (92.2%). In adjusted analyses, confidence to intervene was higher amongst those who agreed that sexual violence was an issue in nightlife (AOR 3.6; p < 0.05), however it reduced as sexual violence myth acceptance increased (AOR 0.5; p < 0.05).

CONCLUSION

Sexual violence is a pertinent issue in nightlife. Programmes aiming to address nightlife-related sexual violence must address the wider social norms that promote sexual violence, and ensure patrons understand the extent and significance of the issue, to increase confidence to positively intervene.

Alcohol use patterns and hypertension among adults in the United States: findings from the 2015-2016 NHANES data

OBJECTIVES

This study assessed the association between alcohol use patterns and the prevalence of hypertension.

STUDY DESIGN

Data on alcohol use patterns and hypertension among 5918 adults from the 2015-2016 National Health and Nutrition Examination Survey was used for this study.

METHODS

The association of alcohol use patterns; "ever-used alcohol", "binge drinking", "heavy drinking", and "everyday alcohol use" with hypertension were assessed using multivariable-adjusted logistic regression to estimate the adjusted odds ratio (aOR) and 95% confidence interval (CI) at a two-sided P < 0.05.

RESULTS

Overall, the mean age of respondents was 48.3 ± 18.5 years, 50.9% (n = 3034) were women, and 44.6% (n = 2132) were hypertensive. Also, 85.9% (n = 4177) had used alcohol in their lifetime, 51.9% (n = 1764) were heavy drinkers, 25.1% (n = 370) engaged in binge drinking, and 17.7% (n = 721) reported everyday alcohol use. Compared to those that have never used alcohol, the aOR (95%CI) of stage II hypertension was 1.570 (1.565, 1.575) for overall alcohol use, 1.370 (1.367, 1.373) for everyday alcohol use, 1.127 (1.125, 1.129) for heavy drinking, and 1.092 (1.087, 1.098) for binge drinking. Among current active smokers, the aOR (95%CI) of stage II hypertension was aggravated for everyday alcohol use; 2.583 (2.576, 2.590).

CONCLUSION

Alcohol use patterns were associated with a higher prevalence of hypertension, particularly among smokers. A population-based longitudinal study should clarify whether these alcohol use phenotypes are predictive of hypertension at the population level in the United States.

Virtual reality efficiency as exposure therapy for alcohol use: A systematic literature review

Virtual reality is an immersive technology that can be used as a tool in the treatment of disorders linked to substance use disorders, such as alcohol use disorder. This systematic review of the literature examines the effectiveness of virtual reality as exposure therapy for heavy social drinkers, defined as people who regularly consume alcohol in a variety of social contexts, with or without a diagnosis of alcohol use disorder. The current review includes ten studies with a total of 377 participants. Most participants were adult men (61.03%), with an age average of 44.1 years [± 7.42] and alcohol use ranging from light to heavy. Although studies show heterogeneous results, the use of virtual reality cue exposure therapies has shown greater improvement in terms of craving reduction for patients suffering from alcohol use disorder. Studies have also shown that the realism of the virtual environment can influence levels of craving and anxiety, both in heavy social drinkers. In addition, the use of virtual reality has proven to increase feeling of self-efficacy and decrease the tendency to engage in automatic drinking behaviors. However, the review also mentions the necessity of larger research to determine the efficiency of virtual reality as a therapeutic treatment for alcohol use disorder, whilst considering comorbidities and treatment background, especially for resistant patients.

Review of patterns in homicides by sharp force: one institution's experience

This paper presents a retrospective review of patterns found in cases of homicides by sharp force over a 13-year period at the Department of Forensic Pathology of the Ostrava University Hospital, Czech Republic. The review summarizes all frequently discussed aspects of such cases including the number and localization of injuries, the presence of defensive wounds, the type of the offending weapon, the cause of death, the place of death, victims' and perpetrators' profiles, their relationship, or toxicological findings. Furthermore, special attention was paid to the evaluation of any accompanying blunt force trauma that may be indicative of an escalation of the assault. The set of data was statistically analyzed. Even though most of the results of this review are consistent with available published studies, noteworthy differences have emerged in some aspects such as the sex and age of the victims, the relationship between the number of injuries suffered and the victims' sex, or the severity of alcohol intoxication in victims.

Centre of pressure changes during stance but not during gait in young women after alcohol intoxication

Background

Women are underrepresented in research focused on alcohol (e.g., Brighton, Moxham & Traynor, 2016; DOI 10.1097/JAN.0000000000000136) despite the changing patterns of alcohol consumption, which has been increasing in women in recent decades. The purpose of this study was to analyse the relationship between habitual alcohol consumption and centre of pressure (CoP) parameters during stance and gait while intoxicated by alcohol.

Methods

Thirty women (24.39 ± 2.93 years) participated in this study. All participants were asked to answer the AUDIT questionnaire. Stance and gait analysis were repeated under two conditions on a Zebris platform (FDM GmbH; Munich, Germany): when the participants were sober (0.00% breath alcohol concentration, BrAC) and when they were in an intoxicated state (0.11% BrAC). Participants were divided by their AUDIT score into a low-risk alcohol consumption group (n = 15; AUDIT score: 3 to 6) and a hazardous alcohol consumption group (n = 15; AUDIT score: 7 to 13).

Results

No statistical difference was observed in stance and gait parameters when comparing the low-risk and hazardous groups under 0.00% BrAC and 0.11% BrAC conditions. A statistically significant difference was observed when comparing 0.00% BrAC and 0.11% BrAC conditions within each group. This significant difference was found in CoP path length and CoP average velocity during quiet stance. However, no statistically significant differences were observed in CoP parameters during gait. An alcohol intoxication of 0.11% BrAC was not sufficient to cause statistically significant impairments in butterfly parameters of gait.

Alcohol protective behavioral strategies for young adults: a content analysis across drinking contexts and gender

Background: Protective behavioral strategies (PBS) are specific harm reduction behaviors which mitigate alcohol-related consequences among young adults. Prior work indicates PBS utilization varies according to drinking context and gender, suggesting a need for further research assessing whether young adults employ unidentified PBS according to such factors.Objectives: This study examined alcohol PBS young adults suggest using across drinking contexts and gender to inform alcohol-related harm reduction interventions.Methods: An online survey with 514 young adult heavy drinkers (n = 269 female, Mage = 22.36 years) assessed PBS use generally, and across 12 physical and social contexts. We utilized qualitative content analysis methods to code and derive themes from open-ended responses from a prompt asking participants to state additional PBS used per context. The frequency of each theme's appearance was calculated across the overall sample, by gender, and within each context.Results: PBS endorsement varied across context and gender within each theme. Young adults who reported PBS use most frequently endorsed utilizing strategies related to drink content (18.30%), social support (12.36%), and engaging in other activities (10.34%). Participants infrequently endorsed strategies related to awareness of time (0.23%), standards of behavior (0.78%) and avoiding environments (0.87%).Conclusions: Young adults endorse utilizing additional PBS in varying frequency according to drinking context and gender. Given PBS are often a key component of alcohol harm reduction interventions, monitoring trends in young adult PBS use is crucial to ensure continued relevance and efficacy of such interventions to minimize harms associated with young adult heavy alcohol use.

Just One Shot? The Contextual Effects of Matched and Unmatched Intoxication on Perceptions of Consent in Ambiguous Alcohol-fueled Sexual Encounters

The current research examined how contextual factors-the quantity of alcohol consumed by each partner, and whether this quantity matched-influenced how alcohol-fueled sexual encounters were perceived with regard to consent, coercion, sexual assault, and perceived responsibility of the focal partner for the outcome of the encounter. Across four studies (Ntotal = 535), participants read vignettes in which one person described a sexual encounter they had following a night out drinking. These scenarios differed within studies as a function of quantified alcohol consumed (1 shot; 15 shots) and whether both people in the vignettes consumed the same amount of alcohol (matched; unmatched). They also differed between studies as a function of whether the couples described were mixed gender or same gender. Across all four studies, scenarios in which both people in the scenario consumed different quantities of alcohol (i.e., 15 vs. 1 shot) were seen as less consensual, more coercive, and more likely to be an assault compared to scenarios where consumption was matched, especially at lower levels of intoxication (i.e., 1 shot each vs. 15 shots each). However, focal partners were also seen as less responsible for the outcome of the interaction when levels of intoxication were unmatched compared to matched. This pattern replicated across scenarios depicting same-gender and mixed-gender couples. These findings suggest that people prioritize information regarding whether sexual partners are "matched" or "unmatched" in terms of their intoxication when evaluating whether ambiguous sexual encounters are consensual and perceived individual responsibility.

Risky Sexual Behaviour and Sexual Victimization among Young People with Risky Substance Use in Europe-Perspectives from Belgium, Sweden, the Czech Republic, and Germany

BACKGROUND

Research indicates that among the risks associated with young people's alcohol and illicit drug use are sexual risks. However, insights into co-occurrence of substance use and sexual risks in adolescent samples and possible differences across countries are limited.

METHODS

A sample of 1449 adolescents from Belgium, Sweden, the Czech Republic, and Germany screened positive for risky alcohol/illicit drug use in a web-based intervention against alcohol and illicit drug use. They also reported incidents of sex while being drunk and/or high on drugs, condomless sex on these occasions, and sexualized touching and sexual victimization while being drunk or high on drugs.

RESULTS

In the sample, 21.5% of the participants reported sexualized touching, 9.9% being victim to sexual assault, and 49.8% having had sex while being drunk and/or high on drugs; of the latter, 48.3% had condomless sex. Reports on having had sex while being drunk and/or high on drugs were associated with higher levels of past 30-day binge drinking. Being a victim of sexual assault was associated with past 30-day binge drinking only in young men.

CONCLUSION

When devising preventive interventions against risky substance use in adolescents, an additional focus should be set on integrating steps against sexual risks.

Alcohol and morality: one alcoholic drink is enough to make people declare to harm others and behave impurely

We aimed to understand if alcohol intoxication affects the willingness to violate moral foundations (care, fairness, authority, loyalty, and purity). We conducted a laboratory study (N = 387) with three randomized groups: alcohol intoxication, placebo, and control, measuring the sacralization of moral foundations via the Moral Foundations Sacredness Scale. The study showed intoxicated participants sacralized moral foundations of care and purity more often than participants from control and placebo groups. It means participants declared more willing to physically harm other people and animals and behave impurely, e.g., doing deviant sexual behaviors or selling their souls. No differences related to fairness, authority, and loyalty were found. Our study helps to understand the decision processes underlying immoral behaviors, including crimes. We showed that even one drink makes people change their judgments about what is right and wrong (in the cases of harmful and impure behaviors), and because this kind of judgment precedes immoral behaviors, our results may help explain why some people under the influence of alcohol break the rules by doing things which they would never do when sober.

Modeling the value-based decision to consume alcohol in response to emotional experiences

Evidence for negative reinforcement of alcohol use is mixed; one possible explanation for this is that people make value-based decisions whether to regulate their emotions via alcohol or an alternative, and only drink-to-cope when alcohol's reinforcing value is larger than that of available alternatives. If this is the case, immediately following a negative emotional event, the value for alcohol should increase primarily in heavy drinkers, whereas in light drinkers, alternative ways of coping should be valued. We conducted a preregistered online experiment (N = 200) with a mixed design (between: heavy vs. light drinker; within: negative/neutral/positive mood induction). In each of three experimental sessions, participants first provided value ratings for a set of alcohol and food stimuli. Second, they were subjected to a mood induction. Third, they made forced choices between either two alcohol or food stimuli. We then applied a drift-diffusion model to these data and tested whether alcohol- and food-related decision-making parameters are differentially affected following the mood inductions in heavy and light drinkers. In preregistered analyses, we found that heavy drinkers did not value alcohol more but valued food less after the negative mood induction. Exploratory analyses uncovered that both heavy- and light-drinking participants valued alcohol more following the negative mood induction if they reported high alcohol craving at the start of the session. Collectively, these results provide some evidence for the idea that drinking-to-cope might be a value-based decision-making process. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Fluid intake at work in foresters working in different thermal conditions

The primary aim of this study was to assess the impact of fluid intake on hydration status indices in men at work. The secondary aim was to determine the type of fluids drunk at work in different thermal conditions. Fifty-nine male foresters were examined before and after one working day during summer, autumn, and winter. Before and after work, urine and blood samples were obtained from foresters. Immediately after a shift, participants completed a questionnaire regarding fluid intake during one working day. The amount of fluid consumed affects the hydration urine indices. Urine specific gravity and urine osmolality significantly decreased with increasing fluid intake (r = - 0.385 and r = - 0.405, respectively). Moreover, an impact of season on the type of fluids consumed by workers was observed. Tea was significantly more often chosen by workers to drink in winter (68%) than in summer (32%) (p = 0.026). The consumption of any non-alcoholic fluids contributes to the daily total water intake, but it is necessary to create individualized fluid replacement plans. Workers should know how much and what types of drinks to consume at work.

Meta-analysis of acute alcohol effects on response inhibition

Alcohol intoxication impairs response inhibition; however, discrepant findings have been reported regarding the magnitude and moderators of this effect. This meta-analysis of human laboratory studies aimed to quantify acute effects of alcohol on response inhibition and evaluate moderators of this effect. Eligible studies examined alcohol's effects on response inhibition with the Go/No-Go (GNG) task (n = 1616 participants) or Stop Signal Task (SST) (n = 1310 participants). Results revealed a detrimental effect of acute alcohol on response inhibition overall (g = 0.411, 95 % CI [0.350, 0.471]), with similar effects in studies using GNG (g = 0.431, SE = 0.031) and SST (g = 0.366, SE = 0.063). Effect sizes were larger in studies involving higher breath alcohol concentration levels and under GNG conditions that established a prepotent response set. These findings establish the magnitude, precision, and potential moderators of alcohol's effects on inhibitory control, furthering understanding of a key neurobehavioral mechanism proposed to underlie alcohol-related impulsivity and impaired control over consumption.

Alcohol's harm to others in 2021: Who bears the burden?

BACKGROUND AND AIMS

Alcohol's harm to others (AHTO) has become a key driver of national and international alcohol policy. This study aimed to produce a contemporary, comprehensive estimate of the correlates and harms from others' drinking in 2021 in Australia.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS

Across Australia, 2574 adults (1380 women; 1172 men) were sampled via two cross-sectional survey modes: a random-digit dial mobile phone sample of 1000 people and 1574 people from the Life in Australia™ panel survey. In 2021 participants were asked about harms they had experienced from the drinking of family, friends, co-workers and the public in the past year. Applying combined sample weights from each mode, bivariable and adjusted multivariable logistic regressions were used to analyse differences in rates of AHTO by participant gender, age, residence in rural or metropolitan regions, country of birth, education and employment.

FINDINGS

In 2021, 23.6% reported being negatively affected by strangers' drinking and 21.3% by the drinking of someone they knew, with 34.3% reporting being negatively affected a lot or a little by either; 42.4% of respondents reported specific harms from strangers' drinking. Thus, 48.1% of respondents reported any harm (negative effects or specific harms) from others' drinking. Women, younger people, Australian-born and heavier episodic drinkers reported significantly higher rates of AHTO compared with other respondents. Smaller percentages (7.5%) of participants reported being harmed substantially by others' drinking, including by people they knew (5.8%) or strangers (2.3%). Stratified analyses showed that heavier drinking, furloughed, younger men who were born overseas in English-speaking countries were affected by others' drinking, whereas women were affected regardless of these factors (apart from age).

CONCLUSIONS

More than one-third of Australian adults appear to have been negatively affected by others' drinking in 2021, with women, younger people and heavier drinkers at greater risk. Substantial harm appears to be more likely to arise from the drinking of people Australians know than from strangers' drinking.

Helping a friend: The impact of victim alcohol intoxication and perpetrator social status on bystander behaviors and responses to assault disclosure

OBJECTIVE

Although data evaluating bystander interventions are promising (e.g., Banyard et al., 2007), little is known about factors that may interfere with friends taking action to prevent assault or to support victims upon assault disclosure. The present study examines the effects of victim alcohol intoxication and perpetrator social status (represented as a collegiate athlete) as potential barriers to effective bystander intervention and supportive responses to disclosure.

METHOD

Using an experimental vignette design, participant responses were assessed in response to a situation involving imminent sexual risk to a friend (T1) and in response to the friend's disclosure of sexual assault (T2). Victim alcohol intoxication and perpetrator status were hypothesized to relate to bystander responses during the sexual risk scenario, which in turn were predicted to impact disclosure responses after the victim's assault.

RESULTS

Victim intoxication-though not perpetrator status-predicted friends' likelihood to intervene at T1 such that those in the high intoxication condition were more likely to intervene than were those in the low and no intoxication conditions. Further, friends' likelihood to intervene in the moment at T1 predicted a number of responses to the victim's disclosure at T2. Those who were more likely to intervene in the moment responded to the victim's disclosure with more supportive responses and less blameful responses.

IMPLICATIONS

Bystander programs should teach friends to intervene in risk situations regardless of victim alcohol use and should highlight the importance of responding supportively to assault disclosure, regardless of initial intervention behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association of serum uric acid with risk of stroke in US adults: A cross-sectional study from NHANES 1999-2020

BACKGROUND AND AIMS

The validity of high uric acid levels as an independent cause of stroke remains controversial, and the association between its low concentration and stroke is unclear. This study determines how different serum uric acid (SUA) levels are associated with stroke risk.

METHODS

This cross-sectional study used continuous National Health and Nutrition Examination Survey data in the United States during 1999-2020. The SUA levels of 6.0, 6.8, and 9.0 mg/dL were all considered as cut-off points. Restricted cubic spline interpolation and logistic regression models were used to evaluate the different associations. Subgroup analyses and sensitivity analyses were conducted to evaluate the influence of multiple factors on the outcomes.

RESULTS

The study included 23,413 participants aged ≥ 20 years. A J-shaped curve existed between SUA and stroke risk, and the risk of stroke was positively correlated with SUA levels in the overall population. Subgroup analysis of all adults in the SUA 6.8-9.0 mg/dL group showed that stroke risk for non-Hispanic white, obese, ex-smoker, and heavy drinking groups was increased, but for the other Hispanic group was reduced. In the SUA < 6.0 mg/dL group, stroke risk for ex-smoker, heavy drinkers, and no chronic kidney disease groups was increased.

CONCLUSION

Our findings indicate a J-shaped relationship between SUA levels and stroke risk. Low and high SUA levels increased stroke risk for different populations, except in the other Hispanic population. Early SUA management is highly significant for stroke prevention in high-risk populations.

Quantitative Simulation of Enzymatic Breakdown of Alcohol in Human Metabolism

The breakdown of ethanol, the active chemical in alcohol, is tightly regulated by the body, yet alcohol intoxication occurs in thousands of Americans annually. Many factors contribute to the concentration of ethanol in the bloodstream and the tolerance an individual has, including body size, previous drinking experience, and liver functionality. We propose a model that estimates both the blood alcohol concentration and the concentration of acetaldehyde (the toxic intermediate during catabolism) in the liver over time to quantify organ damage for an average person. From the current literature, we derived ordinary differential equations that govern the absorption of ethanol in the body and extended it with the metabolic enzyme mechanisms. We also altered the parameters of our system in order to show the effects of Asian flush, which impairs the body's processing of acetaldehyde. We demonstrated the accumulation of acetaldehyde in Asian flush patients was about 660 times higher compared to those without the disease.Clinical relevance-With further improvements and personalization, our model would be able to quantitatively describe the effects of alcohol consumption without having volunteers go through repetitive trials with extensive exposure to alcohol. Liver damage can also be estimated with the acetaldehyde buildup predicted by the model.

Change in brain asymmetry reflects level of acute alcohol intoxication and impacts on inhibitory control

Alcohol is one of the most commonly used substances and frequently abused, yet little is known about the neural underpinnings driving variability in inhibitory control performance after ingesting alcohol. This study was a single-blind, placebo-controlled, randomized design with participants (N = 48 healthy, social drinkers) completing three study visits. At each visit participants received one of three alcohol doses; namely, a placebo dose [equivalent Blood Alcohol Concentration (BAC) = 0.00%], a low dose of alcohol (target BAC = 0.04%), or a moderate dose of alcohol (target BAC = 0.08%). To measure inhibitory control, participants completed a Go/No-go task paradigm twice during each study visit, once immediately before dosing and once after, while their brain activity was measured with time-domain functional near-infrared spectroscopy (TD-fNIRS). BAC and subjective effects of alcohol were also assessed. We report decreased behavioral performance for the moderate dose of alcohol, but not the low or placebo doses. We observed right lateralized inhibitory prefrontal activity during go-no-go blocks, consistent with prior literature. Using standard and novel metrics of lateralization, we were able to significantly differentiate between all doses. Lastly, we demonstrate that these metrics are not only related to behavioral performance during inhibitory control, but also provide complementary information to the legal gold standard of intoxication (i.e. BAC).

How Does Being under the Influence Affect Willingness to Experience Overlapping Effects of Alcohol and Marijuana?

OBJECTIVE

This study tested how individuals anticipate they will respond to opportunities to engage in simultaneous alcohol and marijuana (SAM) use.

METHODS

Two studies utilizing a within-subjects design were conducted. Study 1 was conducted in Spring 2021 and a replication (Study 2) was conducted in Fall 2021. Participants were presented with pairs of scenarios. One scenario pair compared how willing participants expected to be to get drunk if they were sober vs. high. Another pair compared how willing participants would be to take a hit of marijuana if they were sober vs. drunk. College attending young adults (Study 1: N = 173; female = 81%; Study 2: N = 212; female = 49.1%) with varying degrees of substance use experience were recruited.

RESULTS

In Study 1 participants reported greater willingness to get drunk when sober than when high. This was qualified by a statistically significant interaction whereby differences were greater among those who had more experience with past 30-day heavy drinking. Similar findings emerged for willingness to use marijuana. Participants anticipated greater willingness to use marijuana when sober than when drunk. This was also qualified by a statistically significant interaction whereby differences were greater among experimental or established users of marijuana than among abstainers. Study 2 findings replicated those from Study 1.

CONCLUSIONS

College attending young adults state greater willingness to remain under the influence of one substance than to engage in SAM use when opportunities arise. Simultaneous use of alcohol and marijuana among college students is likely an exception, not the rule. Implications for prevention are discussed.

A 20-Year Review of Recumbent Pedestrian Fatalities (2001-2020)

ABSTRACT

A retrospective study was performed in the Northern Territory of Australia of all cases of pedestrian fatalities where the decedents had been sitting, crouching, sleeping, or lying on or next to a road, over a 20-year period (January 1, 2001 to December 31, 2020). Of the 865 road traffic fatalities, 161 (19%) were pedestrians, and 42 of these were recumbent at the time of the incident (26% of all pedestrians). The most common age range was 30 to 39 years with a male to female ratio of 25:17. No individuals younger than 15 years were involved. Acute alcohol intoxication played a role in death in all of the cases with medium to high range blood alcohol concentrations. In addition, cannabis or its metabolites were detected in 6 cases, and methylamphetamine in 1 case. A history of chronic alcohol use or dependence was known in 6 (14%) of cases. In no case was an underlying medical condition contributory to death. The majority of incidents occurred at night. This study has shown a very high incidence of recumbent pedestrian deaths in an Australian subpopulation related to acute alcohol intoxication, decreased visibility, and vulnerability because of their position on or proximate to a road.

A Laboratory Test of Alcohol-Related Intimate Partner Aggression: Expectancies Are Not to Blame

Background: The role of alcohol expectancies and evaluations (i.e., perceived outcomes of drinking and whether these outcomes are desirable) in alcohol-related intimate partner aggression (IPA) has been debated, with some researchers arguing that expectancies fully account for the alcohol-IPA relationship and others suggesting they play a minimal if any role in alcohol-related IPA. In the current study, we examine the impact of expectancies and evaluations on alcohol-related IPA observed in the lab, in order to clarify what impact, if any, alcohol expectancies have on alcohol-related IPA. Consistent with findings from laboratory studies examining general aggression, we expected that individuals who were intoxicated would display greater IPA than individuals who were sober, but that alcohol expectancies and evaluations would be unrelated to in vivo IPA. Method: Participants were 69 dating couples (total N = 138), randomly assigned to consume either an alcohol or placebo beverage. IPA was measured with an in vivo aggression task based on the Taylor Aggression Paradigm. Results: As expected, alcohol intoxication predicted in vivo IPA following provocation (p < .03), whereas alcohol expectancies and evaluations were not related to IPA. Conclusions: These findings provide further support that alcohol expectancies and evaluations play little if any role in alcohol-related IPA. Rather, intoxication likely increases risk for IPA through its physiological effects on perception and thought. Further, treatments targeting alcohol use, rather than beliefs about outcomes of drinking, may have a greater impact on alcohol-related IPA.

Negative but Not Positive Alcohol-Related Consequences Tend to Occur Above the Heavy Episodic Drinking Threshold: A Daily Study of Young Adult Heavy Drinkers

AIMS

This study used event-level data to identify the threshold (i.e. number of standard alcoholic drinks) at which specific negative and positive alcohol-related consequences are likely to occur.

METHODS

Ninety-six college students aged 18-20 reporting weekly heavy episodic drinking (HED) or at least one negative alcohol-related consequence in the past 2 weeks completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and negative (e.g. nausea) and positive (e.g. new friend) alcohol-related consequences on 492 drinking nights. The area under the receiver operating characteristic (AUROC) curve measured the ability of an increasing number of drinks consumed to discriminate between nights with versus without a given consequence. The Youden Index method was used to identify the optimal threshold of drinks for each consequence. Thresholds were examined for each consequence by participants' biological sex and heavy drinking status.

RESULTS

Across subgroups, most consequences occurred on nights where participants reported higher consumption levels relative to nights where consequences did not occur. Thresholds for negative consequences ranged between four and nine drinks and thresholds for positive consequences were between three and six drinks.

CONCLUSIONS

Many negative consequences are likely to occur following the traditional HED threshold of 4+/5+ drinks (females/males), with more severe consequences occurring at slightly higher thresholds. Positive consequences are likely to occur at lower thresholds. There may be an optimal number of drinks that maximize positive while minimizing negative consequences for heavy drinking college students.

Effect of the COVID-19 pandemic on adolescent mental health and substance use up to March, 2022, in Iceland: a repeated, cross-sectional, population-based study

BACKGROUND

Poor mental health in the first year of the COVID-19 pandemic has been well documented in adolescents; however, less is known about the longer-term effect of the pandemic. We aimed to examine adolescent mental health and substance use as well as covariates associated with these outcomes 1 year or more into the pandemic.

METHODS

A nationwide sample of adolescents aged 13-18 years enrolled in school in Iceland were invited to complete surveys administered during October-November or February-March, 2018, October-November, 2020, February-March or October-November, 2021, and February-March 2022. The survey was in Icelandic for all administrations and offered to adolescents aged 13-15 years in English in 2020 and 2022 and in Polish in 2022. Surveys assessed depressive symptoms (Symptom Checklist-90); mental wellbeing (Short Warwick Edinburgh Mental Wellbeing Scale); and the frequency of cigarette smoking, e-cigarette use, and alcohol intoxication. Covariates comprised age, gender, and migration status as determined by language spoken at home, level of social restrictions based on residency, parental social support, and sleep duration (≥8 h nightly). Weighted mixed-effect models were used to determine the effect of time and the covariates on mental health and substance use. The main outcomes were assessed in all participants with more than 80% of the necessary data, and multiple imputation was used to handle missing data. Bonferroni corrections were used to adjust for multiple testing and analyses were considered significant at a p value of <0·0017.

FINDINGS

64 071 responses were submitted and analysed between 2018 and 2022. Elevated depressive symptoms and worsened mental wellbeing across girls and boys aged 13-18 years were observed to have been maintained up to 2 years into the pandemic (p>0·0017). Alcohol intoxication initially decreased during the pandemic but increased again as social restrictions eased (p<0·0001). No changes were observed in cigarette smoking and e-cigarette use during the COVID-19 pandemic. Higher levels of parental social support and an average sleep duration of 8 h or more per night were associated with mental health better outcomes and less substance use (p<0·0001). Social restrictions and migration background were inconsistently associated with the outcomes.

INTERPRETATION

Population-level prevention targeting adolescent depressive symptoms should be prioritised in health policy in the wake of COVID-19.

FUNDING

Icelandic Research Fund.

Protection from alcohol intoxication: Must be FGF21 to enter

Fibroblast growth factor 21 (FGF21) is generally known as a stress-induced metabolic regulator with enormous therapeutic potential to treat metabolic diseases, but a more specific role of FGF21 concerns physiological handling of alcohol in mammals. In this issue of Cell Metabolism, Choi et al. demonstrate that FGF21 mediates the recovery from alcohol intoxication by directly activating noradrenergic neurons in mice, thus advancing our knowledge on FGF21 biology and further diversifying its therapeutic potential.

FGF21 counteracts alcohol intoxication by activating the noradrenergic nervous system

Animals that consume fermenting fruit and nectar are at risk of exposure to ethanol and the detrimental effects of inebriation. In this report, we show that the hormone FGF21, which is strongly induced by ethanol in murine and human liver, stimulates arousal from intoxication without changing ethanol catabolism. Mice lacking FGF21 take longer than wild-type littermates to recover their righting reflex and balance following ethanol exposure. Conversely, pharmacologic FGF21 administration reduces the time needed for mice to recover from ethanol-induced unconsciousness and ataxia. FGF21 did not counteract sedation caused by ketamine, diazepam, or pentobarbital, indicating specificity for ethanol. FGF21 mediates its anti-intoxicant effects by directly activating noradrenergic neurons in the locus coeruleus region, which regulates arousal and alertness. These results suggest that this FGF21 liver-brain pathway evolved to protect against ethanol-induced intoxication and that it might be targeted pharmaceutically for treating acute alcohol poisoning.

The role of effortful control in mitigating negative consequences associated with emerging adult drinking

BACKGROUND

Identifying factors that protect against alcohol-related negative consequences associated with emerging adult drinking is a critical public health issue. It has been proposed that high levels of self-regulation moderate risks associated with drinking, decreasing alcohol-related negative consequences. Past research testing this possibility is limited by a lack of advanced methodology for testing moderation and failure to consider facets of self-regulation. This study addressed these limitations.

METHODS

Three hundred fifty-four community emerging adults (56% female; predominantly non-Hispanic Caucasian (83%) or African American (9%)) were assessed annually for 3 years. Moderational hypotheses were tested using multilevel models and the Johnson-Neyman technique was used to examine simple slopes. Data were organized such that repeated measures (level 1) were nested within participants (level 2) to test cross-sectional associations. Self-regulation was operationalized as effortful control and its facets (attentional, inhibitory, and activation control).

RESULTS

We found evidence of moderation. The association between alcohol use during a heavy drinking week and consequences weakened as effortful control increased. This pattern was supported for two facets (attentional and activation control), but not for inhibitory control. Regions of significance results revealed that this protective effect was only evident at very high levels of self-regulation.

CONCLUSIONS

The results provide some evidence that very high levels of attentional and activation control protect against alcohol-related negative consequences associated with drinking. Emerging adults who are very high in attentional and activation control are likely better able to control their attention and engage in goal-directed behavior, like leaving a party at a reasonable hour, or attending school and/or work when experiencing the punishing effects of a hangover. Results emphasize the importance of distinguishing facets of self-regulation when testing self-regulation models.

Acute Consequences Associated With Co-use of Alcohol and Cannabis: A Daily Survey Analysis

OBJECTIVE

Co-use of alcohol and cannabis has been associated with more total negative consequences than single-substance use, but results have been mixed depending on whether the single substance was alcohol or cannabis. The present study used within-person analyses to examine whether co-use increased the risk for experiencing specific acute negative consequences.

METHOD

College students who were co-users of alcohol and cannabis (N = 341; M age = 19.8 years; 51.3% female; 74.8% White) completed 56 days of five daily surveys across two bursts. We used generalized linear mixed effects models to examine the effects of type of substance use day on specific negative consequences, controlling for consumption and covariates.

RESULTS

Relative to both alcohol-only and co-use days, cannabis-only days were associated with decreased likelihood of experiencing hangover, blackout, nausea/vomiting, injury, rude/aggressive behavior, and unwanted sex. Relative to alcohol-only days, cannabis-only and co-use days were associated with an increased likelihood of driving high/drunk. Finally, there was an increased likelihood of hangovers on alcohol-only days compared with co-use days.

CONCLUSIONS

Days with different types of substance use differed in specific consequences. Most of the negative co-use consequences investigated here appear to be driven by alcohol consumption rather than cannabis use. The results also indicated that these young adults were more likely to endorse driving under the influence of cannabis than alcohol. Interventions for co-use should target alcohol consumption to reduce negative consequences such as blackout, injury, rude/aggressive behavior, and unwanted sex and highlight the dangers of driving under the influence of cannabis.

Efficacy of Varenicline in the Treatment of Alcohol Dependence: An Updated Meta-Analysis and Meta-Regression

BACKGROUND

Although varenicline has been used for alcohol dependence (AD) treatment, its efficacy for this condition remains controversial.

AIMS

This systematic review and meta-analysis of randomized controlled trials (RCTs) assesses the efficacy and safety of varenicline in patients with AD.

METHODS

PubMed, Cochrane Library, ScienceDirect, Web of Science, and ThaiLis were systematically searched. RCTs investigating the efficacy and safety of varenicline in patients with AD were included. Study selection, data extraction, and quality assessment were independently performed by two authors. The Jadad score and Cochrane risk of bias were used to assess the quality of the included studies. Heterogeneity was assessed using I² and chi-squared tests.

RESULTS

Twenty-two high-quality RCTs on 1421 participants were included. Varenicline significantly reduced alcohol-related outcomes compared with placebo based on percentage of abstinent days (standardized mean difference [SMD] 4.20 days; 95% confidence interval [CI]: 0.21, 8.19; p = 0.04), drinks per day (SMD -0.23 drinks; 95% CI: -0.43, -0.04; p = 0.02), drinks per drinking day (SMD -0.24 drinks; 95% CI: -0.44, -0.05; p = 0.01), craving assessed using the Penn alcohol craving scale (SMD -0.35; 95% CI: -0.59, -0.12; p = 0.003), and craving assessed using the alcohol urge questionnaire (SMD -1.41; 95% CI: -2.12, -0.71; p < 0.0001). However, there were no significant effects on abstinence rate, percentage of drinking days, percentage of heavy drinking days, alcohol intoxication, or drug compliance. Serious side effects were not observed in the varenicline or placebo groups.

CONCLUSION

Our results indicated that AD patients treated with varenicline showed improvement in percentage of very heavy drinking days, percentage of abstinent days, drinks per day, drinks per drinking day, and craving. However, well-designed RCTs with a large sample size and long duration on varenicline treatment in AD remain warranted to confirm our findings.

Genetic nurture effects for alcohol use disorder

We tested whether aspects of the childhood/adolescent home environment mediate genetic risk for alcohol problems within families across generations. Parental relationship discord and parental divorce were the focal environments examined. The sample included participants of European ancestry (N = 4806, 51% female) and African ancestry (N = 1960, 52% female) from the high-risk Collaborative Study on the Genetics of Alcoholism. Alcohol outcomes in the child generation included lifetime criterion counts for DSM-5 Alcohol Use Disorder (AUD), lifetime maximum drinks in 24 h, age at initiation of regular drinking, and age at first alcohol intoxication. Predictors in the parent generation included relationship discord, divorce, alcohol measures parallel to those in the child generation, and polygenic scores for alcohol problems. Parental polygenic scores were partitioned into alleles that were transmitted and non-transmitted to the child. The results from structural equation models were consistent with genetic nurture effects in European ancestry families. Exposure to parental relationship discord and parental divorce mediated, in part, the transmission of genetic risk for alcohol problems from parents to children to predict earlier ages regular drinking (βindirect = -0.018 [-0.026, -0.011]) and intoxication (βindirect = -0.015 [-0.023, -0.008]), greater lifetime maximum drinks (βindirect = 0.006 [0.002, 0.01]) and more lifetime AUD criteria (βindirect = 0.011 [0.006, 0.016]). In contrast, there was no evidence that parental alleles had indirect effects on offspring alcohol outcomes via parental relationship discord or divorce in the smaller number of families of African ancestry. In conclusion, parents transmit genetic risk for alcohol problems to their children not only directly, but also indirectly via genetically influenced aspects of the home environment. Further investigation of genetic nurture in non-European samples is needed.

Heightened motor impairment as a protective factor against heavy drinking in individuals with high alcohol-induced disinhibition

BACKGROUND

Behavioral disinhibition and motor impairment are both acutely elevated following alcohol consumption, and individual differences in sensitivity to alcohol-induced increases in these effects are associated with drinking habits. Specifically, high alcohol-induced disinhibition and low motor impairment have been identified as separate markers for alcohol-related problems. This study tested the degree to which alcohol-induced disinhibition and motor impairment jointly predict heavy drinking. We hypothesized that heavier drinkers would exhibit a combination of high sensitivity to alcohol-induced disinhibition and low sensitivity to its motor impairing effect.

METHODS

Data from three studies were aggregated to comprise a sample of 96 young adults. Participants' motor coordination (grooved pegboard) and behavioral disinhibition (cued go/no-go) were assessed following consumption of 0.65 g/kg alcohol and a placebo during separate sessions.

RESULTS

As BAC was ascending, alcohol increased motor impairment and disinhibition compared to placebo. Combined effects at this time of alcohol on motor impairment and disinhibition predicted typical drinking habits. Specifically, a combination of high sensitivity to alcohol's disinhibiting effect and low sensitivity to its motor impairing effect was associated with heavy drinking. As BAC was descending, only reduced sensitivity to motor impairment remained as a predictor of heavy drinking.

CONCLUSIONS

The findings suggest that although motor impairment following alcohol consumption is associated with certain negative outcomes (e.g., increased risk for physical injury and motor vehicle accidents), such heightened motor impairment from alcohol may actually serve as a protective factor against the excessive drinking that can accompany the disinhibiting effect of alcohol.

"Keeping your composure": A digital ethnography of gendered alcohol norms on Instagram

BACKGROUND

The increase in alcohol consumption among young women has been the most striking change in drinking culture in Spain in recent years. This study sets out to examine how images and stories about alcohol consumption are presented on Instagram, the strategies for constructing them, and the impact of social norms, including gender norms, on the strategies of making alcohol consumption visible.

METHODS

We have carried out a digital ethnography study in which different research techniques have been applied. We held 13 discussion groups, conducted a three-month period of observation on Instagram, and 38 in-depth interviews of young Spanish men and women between the ages of 15 and 24 (N = 118).

RESULTS

The representation of alcohol consumption on Instagram by young people shows fashionable party spaces for shared disinhibition, fun and youth gatherings. This social network permits different types of alcohol advertising and promotion of the image associated with its consumption, and is thus a space that brands and influencers exploit. Young people avoid the diffusion on Instagram of images related to their heavy use of alcohol through particular strategies. They untag, delete or avoid using their smartphone; and they choose the audience to whom images are directed, and the areas of publication. The desire to be posting and exhibiting constantly converges with embarrassment and precaution with (un)known audiences. Gender is a key element for understanding the differences in the way in which posts on Instagram related to drinking and drunkenness affect young people.

CONCLUSIONS

Our data show that Instagram fosters the spreading of an ideal model of "alcohol consumption" online that tends to conceal the adverse effects of the substance, and that the online diffusion of behaviour concerning drinking is not gender-neutral.