Medicine › Epidemiology

Substance Abuse Treatment and Outcomes

Works Count: 73282

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Description

This cluster of papers focuses on the epidemiology, risk factors, comorbidities, and interventions related to substance use disorders, particularly alcohol dependence. It covers topics such as the global burden of disease, motivational interviewing, adolescent drug use, psychiatric disorders, impulsivity, college drinking, and behavioral interventions.

Keywords

Substance Use Disorders; Alcohol Dependence; Motivational Interviewing; Global Burden of Disease; Adolescent Drug Use; Psychiatric Disorders; Impulsivity; College Drinking; Behavioral Interventions; Prevention Efforts

Timeline Follow-Back

1992-01-01

Linda C. Sobell , Mark B. Sobell

Although the measurement of drinking is necessary for assessing and evaluating the treatment of alcohol problems, this key dependent variable has not always been reported in outcome studies.1–3 Today, the … Although the measurement of drinking is necessary for assessing and evaluating the treatment of alcohol problems, this key dependent variable has not always been reported in outcome studies.1–3 Today, the issue is not whether to measure drinking, but how to measure drinking. Concerns about how best to measure drinking patterns and problems date back to at least 1926, when Pearl stressed the importance of separating steady daily drinkers from occasional heavy drinkers.4

The Drugs/Violence Nexus: A Tripartite Conceptual Framework

1985-10-01

Paul J. Goldstein

Drug use and drug trafficking are examined as etiological factors in the creation of violence. A conceptual framework is presented for examining the drugs/violence nexus. Drugs and violence are seen … Drug use and drug trafficking are examined as etiological factors in the creation of violence. A conceptual framework is presented for examining the drugs/violence nexus. Drugs and violence are seen as being related in three possible ways: the psychopharmacological, the economically compulsive, and the systemic. Each of these models is examined in depth. The quality of data available in existing national crime data bases to explicate these relationships is assessed.

The CAGE Questionnaire: Validation of a New Alcoholism Screening Instrument

1974-10-01

Demmie G. Mayfield , Gail A McLeod , P. Bradley Hall

The CAGE questionnaire, a new brief alcoholism screening test, was administered to all patients (N = 366; 39 percent alcoholic) admitted to a psychiatric service over a one-year period. The … The CAGE questionnaire, a new brief alcoholism screening test, was administered to all patients (N = 366; 39 percent alcoholic) admitted to a psychiatric service over a one-year period. The authors indicate that the CAGE questionnaire is not a sensitive alcoholism detector if a four-item positive response is the criterion; however, if a two- or three-item criterion is used, it becomes a viable rapid alcoholism screening techniquefor large groups.

Epidemiology of<i>DSM-5</i>Alcohol Use Disorder

2015-06-03

Bridget F. Grant , Risë B. Goldstein , Tulshi D. Saha +7 more

National epidemiologic information from recently collected data on the new DSM-5 classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed.To present nationally representative … National epidemiologic information from recently collected data on the new DSM-5 classification of alcohol use disorder (AUD) using a reliable, valid, and uniform data source is needed.To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, associated disability, and treatment of DSM-5 AUD diagnoses overall and according to severity level (mild, moderate, or severe).We conducted face-to-face interviews with a representative US noninstitutionalized civilian adult (≥18 years) sample (N = 36 309) as the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions III (NESARC-III). Data were collected from April 2012 through June 2013 and analyzed in October 2014.Twelve-month and lifetime prevalences of AUD.Twelve-month and lifetime prevalences of AUD were 13.9% and 29.1%, respectively. Prevalence was generally highest for men (17.6% and 36.0%, respectively), white (14.0% and 32.6%, respectively) and Native American (19.2% and 43.4%, respectively), respondents, and younger (26.7% and 37.0%, respectively) and previously married (11.4% and 27.1%, respectively) or never married (25.0% and 35.5%, respectively) adults. Prevalence of 12-month and lifetime severe AUD was greatest among respondents with the lowest income level (1.8% and 1.5%, respectively). Significant disability was associated with 12-month and lifetime AUD and increased with the severity of AUD. Only 19.8% of respondents with lifetime AUD were ever treated. Significant associations were found between 12-month and lifetime AUD and other substance use disorders, major depressive and bipolar I disorders, and antisocial and borderline personality disorders across all levels of AUD severity, with odds ratios ranging from 1.2 (95% CI, 1.08-1.36) to 6.4 (95% CI, 5.76-7.22). Associations between AUD and panic disorder, specific phobia, and generalized anxiety disorder were modest (odds ratios ranged from 1.2 (95% CI, 1.01-1.43) to 1.4 (95% CI, 1.13-1.67) across most levels of AUD severity.Alcohol use disorder defined by DSM-5 criteria is a highly prevalent, highly comorbid, disabling disorder that often goes untreated in the United States. The NESARC-III data indicate an urgent need to educate the public and policy makers about AUD and its treatment alternatives, to destigmatize the disorder, and to encourage those who cannot reduce their alcohol consumption on their own, despite substantial harm to themselves and others, to seek treatment.

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Trends in College Binge Drinking During a Period of Increased Prevention Efforts: Findings from 4 Harvard School of Public Health College Alcohol Study Surveys: 1993–2001

2002-03-01

Henry Wechsler , Jae Eun Lee , Meichun Mohler‐Kuo +3 more

Abstract The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 … Abstract The 2001 Harvard School of Public Health College Alcohol Study surveyed students at 119 4-year colleges that participated in the 1993, 1997, and 1999 studies. Responses in the 4 survey years were compared to determine trends in heavy alcohol use, alcohol-related problems, and encounters with college and community prevention efforts. In 2001, approximately 2 in 5 (44.4%) college students reported binge drinking, a rate almost identical to rates in the previous 3 surveys. Very little change in overall binge drinking occurred at the individual college level. The percentages of abstainers and frequent binge drinkers increased, a polarization of drinking behavior first noted in 1997. A sharp rise in frequent binge drinking was noted among students attending all-women's colleges. Other significant changes included increases in immoderate drinking and harm among drinkers. More students lived in substance-free housing and encountered college educational efforts and sanctions resulting from their alcohol use. Key Words: alcoholalcohol-related problemsbinge drinkingcollege studentssecondhand effects of alcoholprevention Additional informationNotes on contributorsHang Lee All of the authors are with the Department of Health and Social Behavior at the Harvard School of Public Health in Boston. Hang Lee is also with the Massachusetts General Hospital in Boston.

The co-dependency concept: Does it offer a solution for the spouses of alcoholics?

1994-07-01

Kevin J. Miller

Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors

1986-05-01

Arnold M. Washton

"Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors" Journal of Studies on Alcohol, 47(3), pp. 260–261 "Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors" Journal of Studies on Alcohol, 47(3), pp. 260–261

The fifth edition of the addiction severity index

1992-06-01

A. Thomas McLellan , Harvey Kushner , David S. Metzger +5 more

Age at onset of alcohol use and its association with DSM-IV alcohol abuse and dependence: results from the national longitudinal alcohol epidemiologic survey

1997-01-01

Bridget F. Grant , Deborah A. Dawson

Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey.

1994-08-01

James C. Anthony , Lynn A. Warner , Ronald C. Kessler

Studying prevalence of Diagnostic and Statistical Manual (3rd ed., rev., American Psychiatric Association, 1987) drug dependence among Americans 15-54 years old, we found about 1 in 4 (24%) had a … Studying prevalence of Diagnostic and Statistical Manual (3rd ed., rev., American Psychiatric Association, 1987) drug dependence among Americans 15-54 years old, we found about 1 in 4 (24%) had a history of tobacco dependence; about 1 in 7 (14%) had a history of alcohol dependence; and about 1 in 13 (7.5%) had a history of dependence on an inhalant or controlled drug. About one third of tobacco smokers had developed tobacco dependence and about 15% of drinkers had become alcohol dependent. Among users of the other drugs, about 15% had become dependent. Many more Americans age 15-54 have been affected by dependence on psychoactive substances than by other psychiatric disturbances now accorded a higher priority in mental health service delivery systems, prevention, and sponsored research programs. The aim of this article is to report basic descriptive findings from new research on the epidemiology of drug dependence syndromes, conducted as part of the National Comorbidity Survey (NCS). In this study, our research team secured a nationally representative sample and applied standardized diagnostic assessments in a way that allows direct comparisons across prevalence estimates and cor

A self-administered Short Michigan Alcoholism Screening Test (SMAST).

1975-01-01

Melvin L. Selzer , Amiram D. Vinokur , L. Van Rooijen

The Michigan Alcoholism Screening Test and a shortened 13-item version can reliably be used as self-administered questionnaires. The Michigan Alcoholism Screening Test and a shortened 13-item version can reliably be used as self-administered questionnaires.

The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users

1995-05-01

Michael Gossop , Shane Darke , Paul Griffiths +4 more

Abstract The Severity of Dependence Scale (SDS) was devised to provide a short, easily administered scale which can be used to measure the degree of dependence experienced by users of … Abstract The Severity of Dependence Scale (SDS) was devised to provide a short, easily administered scale which can be used to measure the degree of dependence experienced by users of different types of drugs. The SDS contains five items, all of which are explicitly concerned with psychological components of dependence. These items are specifically concerned with impaired control over drug taking and with preoccupation and anxieties about drug use. The SDS was given to five samples of drug users in London and Sydney. The samples comprised users of heroin and users of cocaine in London, and users of amphetamines and methadone maintenance patients in Sydney. The SDS satisfies a number of criteria which indicate its suitability as a measure of dependence. All SDS items had significantly with a single factor, and the total SDS score was extremely highly correlated with the single factor score. The SDS score is related to behavioural patterns of drug taking that are, in themselves, indicators of dependence, such as dose, frequency of use, duration of use, daily use and degree of contact with other drug users; it also shows criterion validity in that drug users who have sought treatment at specialist and non‐specialist agencies for drug problems have higher SDS scores than non‐treatment samples. The psychometric properties of the scale were good in all five samples, despite being applied to primary users of different classes of drug, using different recruitment procedures in different cities in different countries.

DSM-5 Criteria for Substance Use Disorders: Recommendations and Rationale

2013-08-01

Deborah S. Hasin , Charles P. O’Brien , Marc Auriacombe +7 more

Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. … Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.

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An Improved Diagnostic Evaluation Instrument for Substance Abuse Patients

1980-01-01

A. Thomas McLellan , Lester Luborsky , George Woody +1 more

The Addiction Severity Index (ASI) is a structured clinical interview developed to fill the need for a reliable, valid, and standardized diagnostic and evaluative instrument in the field of alcohol … The Addiction Severity Index (ASI) is a structured clinical interview developed to fill the need for a reliable, valid, and standardized diagnostic and evaluative instrument in the field of alcohol and drug abuse. The ASI may be administered by a technician in 20 to 30 minutes producing 10-point problem severity ratings in each of six areas commonly affected by addiction. Analyses of these problem severity ratings on 524 male veteran alcoholics and drug addicts showed them to be highly reliable and valid. Correlational analyses using the severity ratings indicated considerable independence between the problem areas, suggesting that the treatment problems of patients are not necessarily related to the severity of their chemical abuse. Cluster analyses using these ratings revealed the presence of six subgroups having distinctly different patterns of treatment problems. The authors suggest the use of the ASI to match patients with treatments and to promote greater comparability of research findings.

Why do young people drink? A review of drinking motives

2005-08-11

Emmanuel Kuntsche , Ronald A. Knibbe , Gerhard Gmel +1 more

Towards the assessment of adolescent problem drinking.

1989-01-01

Helene R. White , Erich W. Labouvie

Longitudinal data were obtained from a nonclinical sample of 1,308 male and female adolescents covering the age range from 12 to 21. Factor analyses of 52 symptoms and/or consequences of … Longitudinal data were obtained from a nonclinical sample of 1,308 male and female adolescents covering the age range from 12 to 21. Factor analyses of 52 symptoms and/or consequences of alcohol use yielded three problem dimensions. In addition, a unidimensional, 23-item scale (the Rutgers Alcohol Problem Index, RAPI) was constructed with an internal consistency of .92. Correlations between RAPI and alcohol-use intensity were moderately strong for all age groups at each test occasion (ranging from .20 to .57), yet low enough to suggest that identification of problem drinkers requires both types of measures. The results suggest that the RAPI may be a useful tool for the standardized and efficient assessment of problem drinking during adolescence.

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Detecting alcoholism. The CAGE questionnaire

1984-10-12

J. A. Ewing

Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and … Four clinical interview questions, the CAGE questions, have proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The acronym "CAGE" helps the physician to recall the questions. How these questions were identified and their use in clinical and research studies are described.

A new, semi-structured psychiatric interview for use in genetic linkage studies: a report on the reliability of the SSAGA.

1994-03-01

Kathleen K. Bucholz , Remi J. Cadoret , C. Robert Cloninger +6 more

Within- and cross-center test-retest studies were conducted to study the reliability of a new, semistructured, comprehensive, polydiagnostic psychiatric interview being used in a multisite genetic linkage study of alcoholism. Findings … Within- and cross-center test-retest studies were conducted to study the reliability of a new, semistructured, comprehensive, polydiagnostic psychiatric interview being used in a multisite genetic linkage study of alcoholism. Findings from both studies indicated that reliability for the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) was high for DSM-III-R substance dependence disorders, but less so for substance abuse disorders. Reliability of depression was good in both studies, but mixed for antisocial personality disorder (ASP). Findings are presented in terms of specific substance dependence and abuse diagnoses, as well as for depression and ASP. Criterion-specific reliabilities are examined by type of substance used. Although SSAGA was designed to provide for broad phenotyping of alcoholism, review of its new features suggests its suitability for a variety of family studies, not just those focusing on substance abuse.

The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002

2004-06-01

Bridget F. Grant , Deborah A. Dawson , Frederick S. Stinson +3 more

The Alcohol Use Disorders Identification Test: An Update of Research Findings

2007-01-10

Duane F. Reinert , John P. Allen

The Alcohol Use Disorders Identification Test (AUDIT) has been extensively researched to determine its capability to accurately and practically screen for alcohol problems.During the 5 years since our previous review … The Alcohol Use Disorders Identification Test (AUDIT) has been extensively researched to determine its capability to accurately and practically screen for alcohol problems.During the 5 years since our previous review of the literature, a large number of additional studies have been published on the AUDIT, abbreviated versions of it, its psychometric properties, and the applicability of the AUDIT for a diverse array of populations. The current article summarizes new findings and integrates them with results of previous research. It also suggests some issues that we believe are particularly in need of further study.A growing body of research evidence supports the criterion validity of English version of the AUDIT as a screen for alcohol dependence as well as for less severe alcohol problems. Nevertheless, the cut-points for effective detection of hazardous drinking as well as identification of alcohol dependence or harmful use in women need to be lowered from the originally recommended value of 8 points. The AUDIT-C, the most popular short version of the AUDIT consisting solely of its 3 consumption items, is approximately equal in accuracy to the full AUDIT. Psychometric properties of the AUDIT, such as test-retest reliability and internal consistency, are quite favorable. Continued research is urged to establish the psychometric properties of non-English versions of the AUDIT, use of the AUDIT with adolescents and with older adults, and selective inclusion of alcohol biomarkers with the AUDIT in some instances.Research continues to support use of the AUDIT as a means of screening for the spectrum of alcohol use disorders in various settings and with diverse populations.

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Naltrexone and Coping Skills Therapy for Alcohol Dependence

1992-11-01

Stephanie S. O’Malley , Adam Jaffé , Grace Chang +3 more

• Ninety-seven alcohol-dependent patients were treated for 12 weeks in a double-blind, placebo-controlled study evaluating naltrexone and two manual guided psychotherapies in the treatment of alcohol dependence. Patients were randomized … • Ninety-seven alcohol-dependent patients were treated for 12 weeks in a double-blind, placebo-controlled study evaluating naltrexone and two manual guided psychotherapies in the treatment of alcohol dependence. Patients were randomized to receive either naltrexone or placebo and either coping skills/relapse prevention therapy or a supportive therapy designed to support the patient's own efforts at abstinence without teaching specific coping skills. Naltrexone proved superior to placebo in measures of drinking and alcohol-related problems, including abstention rates, number of drinking days, relapse, and severity of alcohol-related problems. Medication interacted with the type of psychotherapy received. The cumulative rate of abstinence was highest for patients treated with naltrexone and supportive therapy. For those patients who initiated drinking, however, patients who received naltrexone and coping skills therapy were the least likely to relapse.

AUDIT‐C as a Brief Screen for Alcohol Misuse in Primary Care

2007-04-19

Katharine A. Bradley , Anna F. DeBenedetti , Robert J. Volk +3 more

Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questions have been previously validated as a 3‐item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. … Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT‐C) questions have been previously validated as a 3‐item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT‐C's validity and optimal screening threshold(s) in other clinical populations are unknown. Methods: This cross‐sectional validation study compared screening questionnaires with standardized interviews in 392 male and 927 female adult outpatients at an academic family practice clinic from 1993 to 1994. The AUDIT‐C, full AUDIT, self‐reported risky drinking, AUDIT question #3, and an augmented CAGE questionnaire were compared with an interview primary reference standard of alcohol misuse, defined as a Diagnostic and Statistical Manual , 4th ed. alcohol use disorder and/or drinking above recommended limits in the past year. Results: Based on interviews with 92% of eligible patients, 128 (33%) men and 177 (19%) women met the criteria for alcohol misuse. Areas under the receiver operating characteristic curves (AUROCs) for the AUDIT‐C were 0.94 (0.91, 0.96) and 0.90 (0.87, 0.93) in men and women, respectively ( p =0.04). Based on AUROC curves, the AUDIT‐C performed as well as the full AUDIT and significantly better than self‐reported risky drinking, AUDIT question #3, or the augmented CAGE questionnaire ( p ‐values <0.001). The AUDIT‐C screening thresholds that simultaneously maximized sensitivity and specificity were ≥4 in men (sensitivity 0.86, specificity 0.89) and ≥3 in women (sensitivity 0.73, specificity 0.91). Conclusions: The AUDIT‐C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (≥4) and women (≥3) were the same as in previously published VA studies.

Brief interventions for alcohol problems: a review

1993-03-01

Thomas Bien , William R. Miller , J. Scott Tonigan

Abstract Relatively brief interventions have consistently been found to be effective in reducing alcohol consumption or achieving treatment referral of problem drinkers. To date, the literature includes at least a … Abstract Relatively brief interventions have consistently been found to be effective in reducing alcohol consumption or achieving treatment referral of problem drinkers. To date, the literature includes at least a dozen randomized trials of brief referral or retention procedures, and 32 controlled studies of brief interventions targeting drinking behavior, enrolling over 6000 problem drinkers in both health care and treatment settings across 14 nations. These studies indicate that brief interventions are more effective than no counseling, and often as effective as more extensive treatment. The outcome literature is reviewed, and common motivational elements of effective brief interventions are described. There is encouraging evidence that the course of harmful alcohol use can be effectively altered by well‐designed intervention strategies which are feasible within relatively brief‐contact contexts such as primary health care settings and employee assistance programs. Implications for future research and practice are considered.

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Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence

2006-05-02

Raymond F. Anton , Stephanie S. O’Malley , Domenic A. Ciraulo +7 more

Alcohol dependence treatment may include medications, behavioral therapies, or both. It is unknown how combining these treatments may impact their effectiveness, especially in the context of primary care and other … Alcohol dependence treatment may include medications, behavioral therapies, or both. It is unknown how combining these treatments may impact their effectiveness, especially in the context of primary care and other nonspecialty settings.To evaluate the efficacy of medication, behavioral therapies, and their combinations for treatment of alcohol dependence and to evaluate placebo effect on overall outcome.Randomized controlled trial conducted January 2001-January 2004 among 1383 recently alcohol-abstinent volunteers (median age, 44 years) from 11 US academic sites with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnoses of primary alcohol dependence.Eight groups of patients received medical management with 16 weeks of naltrexone (100 mg/d) or acamprosate (3 g/d), both, and/or both placebos, with or without a combined behavioral intervention (CBI). A ninth group received CBI only (no pills). Patients were also evaluated for up to 1 year after treatment.Percent days abstinent from alcohol and time to first heavy drinking day.All groups showed substantial reduction in drinking. During treatment, patients receiving naltrexone plus medical management (n = 302), CBI plus medical management and placebos (n = 305), or both naltrexone and CBI plus medical management (n = 309) had higher percent days abstinent (80.6, 79.2, and 77.1, respectively) than the 75.1 in those receiving placebos and medical management only (n = 305), a significant naltrexone x behavioral intervention interaction (P = .009). Naltrexone also reduced risk of a heavy drinking day (hazard ratio, 0.72; 97.5% CI, 0.53-0.98; P = .02) over time, most evident in those receiving medical management but not CBI. Acamprosate showed no significant effect on drinking vs placebo, either by itself or with any combination of naltrexone, CBI, or both. During treatment, those receiving CBI without pills or medical management (n = 157) had lower percent days abstinent (66.6) than those receiving placebo plus medical management alone (n = 153) or placebo plus medical management and CBI (n = 156) (73.8 and 79.8, respectively; P<.001). One year after treatment, these between-group effects were similar but no longer significant.Patients receiving medical management with naltrexone, CBI, or both fared better on drinking outcomes, whereas acamprosate showed no evidence of efficacy, with or without CBI. No combination produced better efficacy than naltrexone or CBI alone in the presence of medical management. Placebo pills and meeting with a health care professional had a positive effect above that of CBI during treatment. Naltrexone with medical management could be delivered in health care settings, thus serving alcohol-dependent patients who might otherwise not receive treatment.clinicaltrials.gov Identifier: NCT00006206.

The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings.

1995-07-01

Michael J. Bohn , Thomas F. Babor , Henry R. Kranzler

Objective: The concurrent, construct, and discriminant validity of the Alcohol Use Disorders Identification Test (AUDIT) were evaluated. AUDIT consists of a 10-item Core questionnaire and an 8-item Clinical procedure. AUDIT … Objective: The concurrent, construct, and discriminant validity of the Alcohol Use Disorders Identification Test (AUDIT) were evaluated. AUDIT consists of a 10-item Core questionnaire and an 8-item Clinical procedure. AUDIT was designed to identify hazardous drinkers (whose drinking increases their risk of alcohol-related problems, though alcohol-associated harm has not yet occurred); harmful drinkers (who have had recent physical or mental harm from their drinking, but who are not alcohol-dependent); and people with alcohol dependence. Method: Known alcoholics (n = 65) and general medical patients (n = 187) completed self-report questionnaires and underwent a diagnostic interview, physical examination and laboratory testing. Results: AUDIT scores correlated significantly with scores on the MAST and MacAndrew alcoholism screening tests, and with ALAT, ASAT, GGT and MCV levels, which reflect recent heavy drinking. AUDIT scores were correlated with measures of alcoholism vulnerability (e.g., familial alcoholism and sociopathy), and with somatic and affective consequences of drinking. Receiver operating characteristic and discriminant function analyses indicated that the AUDIT Core and Clinical Instruments were sensitive and specific in discriminating alcoholics from medical patients, most of whom were nonalcoholics. The AUDIT Core was superior to the MAST and the AUDIT Clinical in discriminating hazardous drinkers from nonhazardous drinkers. It was also superior to the AUDIT Clinical in discriminating harmful from nonharmful drinkers. Conclusions: The AUDIT Core Instrument is useful for early detection of hazardous or harmful drinking, while the AUDIT Clinical Instrument is better applied to identification and/or confirmation of cases of alcohol dependence.

The Michigan Alcoholism Screening Test: The Quest for a New Diagnostic Instrument

1971-06-01

Melvin L. Selzer

The Michigan Alcoholism Screening Test (MAST), devised to provide a consistent, quantifiable, structured interview instrument to detect alcoholism, consists of 25 questions that can be rapidly administered. Five groups were … The Michigan Alcoholism Screening Test (MAST), devised to provide a consistent, quantifiable, structured interview instrument to detect alcoholism, consists of 25 questions that can be rapidly administered. Five groups were given the MAST: hospitalized alcoholics, a control group, persons convicted of drunk driving, persons convicted of drunk and disorderly behavior, and drivers whose licenses were under review. The validity of the MAST was assessed by searching the records of legal, social, and medical agencies and reviewing the subjects' driving and criminal records. The MAST responses of 15 subjects who were found to be alcoholic in the record search were analyzed to determine where the screening failures had occurred. Recommendations are made for reducing the number of such "falsė negatives."

Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption‐II

1993-06-01

John B. Saunders , Olaf Gjerløw Aasland , Thomas F. Babor +2 more

Abstract The Alcohol Use Disorders Identification Test (A UDIT) has been developed from a six‐country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is … Abstract The Alcohol Use Disorders Identification Test (A UDIT) has been developed from a six‐country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10‐item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol‐related problems. Questions were selected from a 150‐item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non‐hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross‐national study.

A Meta-Analytic Review of Psychosocial Interventions for Substance Use Disorders

2008-01-16

Lissa Dutra , Georgia Stathopoulou , Shawnee L. Basden +3 more

Despite significant advances in psychosocial treatments for substance use disorders, the relative success of these approaches has not been well documented. In this meta-analysis, the authors provide effect sizes for … Despite significant advances in psychosocial treatments for substance use disorders, the relative success of these approaches has not been well documented. In this meta-analysis, the authors provide effect sizes for various types of psychosocial treatments, as well as abstinence and treatment-retention rates for cannabis, cocaine, opiate, and polysubstance abuse and dependence treatment trials.With a comprehensive series of literature searches, the authors identified a total of 34 well-controlled treatment conditions-five for cannabis, nine for cocaine, seven for opiate, and 13 for polysubstance users-representing the treatment of 2,340 patients. Psychosocial treatments evaluated included contingency management, relapse prevention, general cognitive behavior therapy, and treatments combining cognitive behavior therapy and contingency management.Overall, controlled trial data suggest that psychosocial treatments provide benefits reflecting a moderate effect size according to Cohen's standards. These interventions were most efficacious for cannabis use and least efficacious for polysubstance use. The strongest effect was found for contingency management interventions. Approximately one-third of participants across all psychosocial treatments dropped out before treatment completion compared to 44.6% for the control conditions.Effect sizes for psychosocial treatments for illicit drugs ranged from the low-moderate to high-moderate range, depending on the substance disorder and treatment under study. Given the long-term social, emotional, and cognitive impairments associated with substance use disorders, these effect sizes are noteworthy and comparable to those for other efficacious treatments in psychiatry.

Effectiveness of brief alcohol interventions in primary care populations

2018-02-24

Eileen Kaner , Fiona Beyer , C R Muirhead +6 more

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Peer influences on college drinking: A review of the research

2001-12-01

Brian Borsari , Kate B. Carey

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Alcohol and public health

2005-02-01

Robin Room , Thomas F. Babor , Jürgen Rehm

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The drug abuse screening test

1982-01-01

Harvey A. Skinner

Ten Things that Motivational Interviewing Is Not

2009-02-06

William R. Miller , Stephen Rollnick

In the 26 years since it was first introduced in this journal, motivational interviewing (MI) has become confused with various other ideas and approaches, owing in part to its rapid … In the 26 years since it was first introduced in this journal, motivational interviewing (MI) has become confused with various other ideas and approaches, owing in part to its rapid international diffusion.Based on confusions that have arisen in publications and presentations regarding MI, the authors compiled a list of 10 concepts and procedures with which MI should not be addled.This article discusses 10 things that MI is not: (1) the transtheoretical model of change; (2) a way of tricking people into doing what you want them to do; (3) a technique; (4) decisional balance; (5) assessment feedback; (6) cognitive-behavior therapy; (7) client-centered therapy; (8) easy to learn; (9) practice as usual; and (10) a panacea.Clarity about what does (and does not) constitute MI promotes quality assurance in scientific research, clinical practice, and training.

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New Data from the Addiction Severity Index Reliability and Validity in Three Centers

1985-07-01

A. Thomas McLellan , Lester Luborsky , John Cacciola +4 more

The Addiction Severity Index (ASI) is a clinical/research instrument which has been in wide use during the past 6 years to assess the treatment problems found in alcohol- and drug-abusing … The Addiction Severity Index (ASI) is a clinical/research instrument which has been in wide use during the past 6 years to assess the treatment problems found in alcohol- and drug-abusing patients. In a study of male veterans, a preliminary evaluation of the ASI has indicated reliability and validity. The present report presents an expanded examination of these issues; 181 subjects from three treatment centers were studied. Results of concurrent reliability studies indicate that trained technicians can estimate the severity of patients' treatment problems with an average concordance of .89. Test-retest studies show that the information obtained from the ASI is consistent over a 3-day interval, even with different interviewers. Comparisons of the ASI severity ratings and composite measures with a battery of previously validated tests indicate evidence of concurrent and discriminant validity. The reliability and validity results were consistent across subgroups of patients categorized by age, race, sex, primary drug problem, and treatment center. The authors discuss the strengths and limitations of the instrument based upon 5 years of use. The overall conclusion is that the ASI is a reliable and valid instrument that has a wide range of clinical and research applications, and that it may offer advantages in the examination of important issues such as the prediction of treatment outcome, the comparison of different forms of treatment, and the "matching" of patients to treatments.

Epidemiology of alcohol and other drug use among American college students.

2002-03-01

Patrick M. O’Malley , Lloyd D. Johnston

Objective: This article provides information on the extent of alcohol use and other drug use among American college students. Methods: Five different sources of data are examined for estimating recent … Objective: This article provides information on the extent of alcohol use and other drug use among American college students. Methods: Five different sources of data are examined for estimating recent levels of alcohol (and other drug) use among college students: Harvard School of Public Health College Alcohol Study (CAS), the Core Institute (CORE), Monitoring the Future (MTF), National College Health Risk Behavior Survey (NCHRBS) and National Household Survey on Drug Abuse (NHSDA). Results: Alcohol use rates are very high among college students. Approximately two of five American college students were heavy drinkers, defined as having had five or more drinks in a row in the past 2 weeks. Alcohol use is higher among male than female students. White students are highest in heavy drinking, black students are lowest and Hispanic students are intermediate. Use of alcohol--but not cigarettes, marijuana and cocaine--is higher among college students than among noncollege age-mates. Longitudinal data show that, while in high school, students who go on to attend college have lower rates of heavy drinking than do those who will not attend college. Both groups increase their heavy drinking after high school graduation, but the college students increase distinctly more and actually surpass their nonstudent age-mates. Trend data from 1980 to 1999 show some slight improvement in recent years. Conclusions: Despite improvements in the past 20 years, colleges need to do more to reduce heavy alcohol use among students.

Mental Health of College Students and Their Non–College-Attending Peers

2008-12-01

Carlos Blanco , Mayumi Okuda , Crystal Wright +4 more

Context: Although young adulthood is often characterized by rapid intellectual and social development, collegeaged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders.Objectives: To … Context: Although young adulthood is often characterized by rapid intellectual and social development, collegeaged individuals are also commonly exposed to circumstances that place them at risk for psychiatric disorders.Objectives: To assess the 12-month prevalence of psychiatric disorders, sociodemographic correlates, and rates of treatment among individuals attending college and their non-college-attending peers in the United States.Design, Setting, and Participants: Face-to-face interviews were conducted in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N=43 093).Analyses were done for the subsample of college-aged individuals, defined as those aged 19 to 25 years who were both attending (n = 2188) and not attending (n=2904) college in the previous year.Main Outcome Measures: Sociodemographic correlates and prevalence of 12-month DSM-IV psychiatric disorders, substance use, and treatment seeking among college-attending individuals and their non-collegeattending peers.Results: Almost half of college-aged individuals had a psychiatric disorder in the past year.The overall rate of psychiatric disorders was not different between college-attending individuals and their non-college-attending peers.The unadjusted risk of alcohol use disorders was significantly greater for college students than for their non-college-attending peers (odds ratio=1.25;95% confidence interval, 1.04-1.50),although not after adjusting for background sociodemographic characteristics (adjusted odds ratio=1.19;95% confidence interval, 0.98-1.44).College students were significantly less likely (unadjusted and adjusted) to have a diagnosis of drug use disorder or nicotine dependence or to have used tobacco than their non-college-attending peers.Bipolar disorder was less common in individuals attending college.College students were significantly less likely to receive past-year treatment for alcohol or drug use disorders than their non-college-attending peers.Conclusions: Psychiatric disorders, particularly alcohol use disorders, are common in the college-aged population.Although treatment rates varied across disorders, overall fewer than 25% of individuals with a mental disorder sought treatment in the year prior to the survey.These findings underscore the importance of treatment and prevention interventions among college-aged individuals.

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Stigma among health professionals towards patients with substance use disorders and its consequences for healthcare delivery: Systematic review

2013-03-13

Leonieke C. van Boekel , Evelien Brouwers , Jaap van Weeghel +1 more

Social determinants of alcohol consumption: The effects of social interaction and model status on the self-administration of alcohol.

1985-01-01

R. Lorraine Collins , George A. Parks , G. Alan Marlatt

R. Lorraine Collins State University of New York at Stony Brook George A. Parks and G. Alan Marlatt University of Washington Two studies were conducted to assess variables related to … R. Lorraine Collins State University of New York at Stony Brook George A. Parks and G. Alan Marlatt University of Washington Two studies were conducted to assess variables related to the social determinants of alcohol consumption. In Study 1, moderate- and heavy-drinking male under- graduates were paired with confederates who behaved in a sociable or unsociable manner while modeling either light or heavy consumption. Modeling occurred in the sociable conditions but not in the unsociable conditions, where subjects tended to drink heavily. In Study 2, a similar group of subjects was exposed to one of three social status conditions crossed with light versus heavy consumption. The results indicated a modeling effect in all social status conditions. These studies provide further support for the existence of a modeling effect that can be disrupted by a lack of rapport between drinking partners. This latter finding has implications for the etiology of problem drinking because it suggests that increased alcohol consumption may serve as a strategy for coping with aversive social interactions. Initial research on the effect of modeled consumption rates on social drinking (Caudill & Marlatt, 1975) suggested that heavy-drink- ing men tended to match the consumption of their drinking partner whether his con- sumption was heavy or light. Subsequent examinations of this phenomenon replicated these findings in laboratory analogue drinking tasks such as the taste-rating task (Cooper, Waterhouse, & Sobell, 1979; Hendricks, So- bell, & Cooper, 1978; Lied & Marlatt, 1979; Watson & Sobell, 1982), natural bar settings (Reid, 1978), and seminaturalistic bar settings (Caudill & Lipscomb, 1980). Much of the research concerning the mod- eling of alcohol consumption has focused on manipulating characteristics of the model, including the nature of the social interaction between the model and the subject. The effects of manipulating social interaction are unclear. In the Caudill and Marlatt study, model's drinking rate (light vs. heavy) and a

Prevalence and Co-occurrence of Substance Use Disorders and IndependentMood and Anxiety Disorders

2004-08-01

Bridget F. Grant , Frederick S. Stinson , Deborah A. Dawson +5 more

<h3>Background</h3> Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. <h3>Objective</h3> To present nationally representative data on the prevalence and comorbidity of<i>DSM-IV</i>alcohol … <h3>Background</h3> Uncertainties exist about the prevalence and comorbidity of substance use disorders and independent mood and anxiety disorders. <h3>Objective</h3> To present nationally representative data on the prevalence and comorbidity of<i>DSM-IV</i>alcohol and drug use disorders and independent mood and anxiety disorders (including only those that are not substance induced and that are not due to a general medical condition). <h3>Design</h3> Face-to-face survey. <h3>Setting</h3> The United States. <h3>Participants</h3> Household and group quarters' residents. <h3>Main Outcome Measures</h3> Prevalence and associations of substance use disorders and independent mood and anxiety disorders. <h3>Results</h3> The prevalences of 12-month<i>DSM-IV</i>independent mood and anxiety disorders in the US population were 9.21% (95% confidence interval [CI], 8.78%-9.64%) and 11.08% (95% CI, 10.43%-11.73%), respectively. The rate of substance use disorders was 9.35% (95% CI, 8.86%-9.84%). Only a few individuals with mood or anxiety disorders were classified as having only substance-induced disorders. Associations between most substance use disorders and independent mood and anxiety disorders were positive and significant (<i>P</i><.05). <h3>Conclusions</h3> Substance use disorders and mood and anxiety disorders that develop independently of intoxication and withdrawal are among the most prevalent psychiatric disorders in the United States. Associations between most substance use disorders and independent mood and anxiety disorders were overwhelmingly positive and significant, suggesting that treatment for a comorbid mood or anxiety disorder should not be withheld from individuals with substance use disorders.

Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders

2009-06-01

Jürgen Rehm , Colin Mathers , Svetlana Popova +3 more

Drug Dependence, a Chronic Medical Illness

2000-10-04

A. Thomas McLellan , D. C. Lewis , Charles P. O’Brien +1 more

The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical … The effects of drug dependence on social systems has helped shape the generally held view that drug dependence is primarily a social problem, not a health problem. In turn, medical approaches to prevention and treatment are lacking. We examined evidence that drug (including alcohol) dependence is a chronic medical illness. A literature review compared the diagnoses, heritability, etiology (genetic and environmental factors), pathophysiology, and response to treatments (adherence and relapse) of drug dependence vs type 2 diabetes mellitus, hypertension, and asthma. Genetic heritability, personal choice, and environmental factors are comparably involved in the etiology and course of all of these disorders. Drug dependence produces significant and lasting changes in brain chemistry and function. Effective medications are available for treating nicotine, alcohol, and opiate dependence but not stimulant or marijuana dependence. Medication adherence and relapse rates are similar across these illnesses. Drug dependence generally has been treated as if it were an acute illness. Review results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits. Drug dependence should be insured, treated, and evaluated like other chronic illnesses.

Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States

2007-07-01

Deborah S. Hasin , Frederick S. Stinson , Elizabeth L. Ogburn +1 more

Epidemiologic information is important to inform etiological research and service delivery planning. However, current information on the epidemiology of alcohol use disorders in the United States is lacking.To present nationally … Epidemiologic information is important to inform etiological research and service delivery planning. However, current information on the epidemiology of alcohol use disorders in the United States is lacking.To present nationally representative findings on the prevalence, correlates, psychiatric comorbidity, and treatment of DSM-IV alcohol abuse and dependence.Face-to-face interviews with a representative US adult sample (N = 43 093).Lifetime and 12-month DSM-IV alcohol abuse and dependence.Prevalence of lifetime and 12-month alcohol abuse was 17.8% and 4.7%; prevalence of lifetime and 12-month alcohol dependence was 12.5% and 3.8%. Alcohol dependence was significantly more prevalent among men, whites, Native Americans, younger and unmarried adults, and those with lower incomes. Current alcohol abuse was more prevalent among men, whites, and younger and unmarried individuals while lifetime rates were highest among middle-aged Americans. Significant disability was particularly associated with alcohol dependence. Only 24.1% of those with alcohol dependence were ever treated, slightly less than the treatment rate found 10 years earlier. Strong associations between other substance use disorders and alcohol use disorders (odds ratios, 2.0-18.7) were lower but remained strong and significant (odds ratios, 1.8-7.5) when controlling for other comorbidity. Significant associations between mood, anxiety, and personality disorders and alcohol dependence (odds ratios, 2.1-4.8) were reduced in number and magnitude (odds ratios, 1.5-2.0) when controlling for other comorbidity.Alcohol abuse and dependence remain highly prevalent and disabling. Comorbidity of alcohol dependence with other substance disorders appears due in part to unique factors underlying etiology for each pair of disorders studied while comorbidity of alcohol dependence with mood, anxiety, and personality disorders appears more attributable to factors shared among these other disorders. Persistent low treatment rates given the availability of effective treatments indicate the need for vigorous education efforts for the public and professionals.

The AUDIT Alcohol Consumption Questions (AUDIT-C)<subtitle>An Effective Brief Screening Test for Problem Drinking</subtitle>

1998-09-14

Kristen Bush

<h3>Objective</h3> To evaluate the 3 alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) as a brief screening test for heavy drinking and/or active alcohol abuse or dependence. … <h3>Objective</h3> To evaluate the 3 alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) as a brief screening test for heavy drinking and/or active alcohol abuse or dependence. <h3>Methods</h3> Patients from 3 Veterans Affairs general medical clinics were mailed questionnaires. A random, weighted sample of Health History Questionnaire respondents, who had 5 or more drinks over the past year, were eligible for telephone interviews (N=447). Heavy drinkers were oversampled 2:1. Patients were excluded if they could not be contacted by telephone, were too ill for interviews, or were female (n=54). Areas under receiver operating characteristic curves (AUROCs) were used to compare mailed alcohol screening questionnaires (AUDIT-C and full AUDIT) with 3 comparison standards based on telephone interviews: (1) past year heavy drinking (>14 drinks/week or ≥5 drinks/occasion); (2) active alcohol abuse or dependence according to the<i>Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition</i>, criteria; and (3) either. <h3>Results</h3> Of 393 eligible patients, 243 (62%) completed AUDIT-C and interviews. For detecting heavy drinking, AUDIT-C had a higher AUROC than the full AUDIT (0.891 vs 0.881;<i>P</i>=.03). Although the full AUDIT performed better than AUDIT-C for detecting active alcohol abuse or dependence (0.811 vs 0.786;<i>P</i><.001), the 2 questionnaires performed similarly for detecting heavy drinking and/or active abuse or dependence (0.880 vs 0.881). <h3>Conclusions</h3> Three questions about alcohol consumption (AUDIT-C) appear to be a practical, valid primary care screening test for heavy drinking and/or active alcohol abuse or dependence.

The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials.

2003-01-01

Brian L. Burke , Hal Arkowitz , Marisa Menchola

A meta-analysis was conducted on controlled clinical trials investigating adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors.AMIs were equivalent to other active treatments and yielded moderate … A meta-analysis was conducted on controlled clinical trials investigating adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors.AMIs were equivalent to other active treatments and yielded moderate effects (from .25 to .57)compared with no treatment and/or placebo for problems involving alcohol, drugs, and diet and exercise.Results did not support the efficacy of AMIs for smoking or HIV-risk behaviors.AMIs showed clinical impact, with 51% improvement rates, a 56% reduction in client drinking, and moderate effect sizes on social impact measures (d ϭ 0.47).Potential moderators (comparative dose, AMI format, and problem area) were identified using both homogeneity analyses and exploratory multiple regression.Results are compared with other review results and suggestions for future research are offered.

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The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility

2002-08-30

WHO ASSIST Working Group

ABSTRACT Aims The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect psychoactive … ABSTRACT Aims The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) was developed for the World Health Organization (WHO) by an international group of substance abuse researchers to detect psychoactive substance use and related problems in primary care patients. This report describes the new instrument as well as a study of its reliability and feasibility. Setting The study was conducted at participating sites in Australia, Brazil, Ireland, India, Israel, the Palestinian Territories, Puerto Rico, the United Kingdom and Zimbabwe. Sixty per cent of the sample was recruited from alcohol and drug abuse treatment facilities; the remainder was drawn from general medical settings and psychiatric facilities. Methods The study was concerned primarily with test item reliability, using a simple test–retest procedure to determine whether subjects would respond consistently to the same items when presented in an interview format on two different occasions. Qualitative and quantitative data were also collected to evaluate the feasibility of the screening items and rating format. Participants A total of 236 volunteer participants completed test and retest interviews at nine collaborating sites. Slightly over half of the sample (53.6%) was male. The mean age of the sample was 34 years and they had completed, on average, 10 years of education. Results The average test–retest reliability coefficients (kappas) ranged from a high of 0.90 (consistency of reporting ‘ever’ use of substance) to a low of 0.58 (regretted what was done under influence of substance). The average kappas for substance classes ranged from 0.61 for sedatives to 0.78 for opioids. In general, the reliabilities were in the range of good to excellent, with the following items demonstrating the highest kappas across all drug classes: use in the last 3 months, preoccupied with drug use, concern expressed by others, troubled by problems related to drug use, intravenous drug use. Qualitative data collected at the end of the retest interview suggested that the questions were not difficult to answer and were consistent with patients’ expectations for a health interview. The data were used to guide the selection of a smaller set of items that can serve as the basis for more extensive validation research. Conclusion The ASSIST items are reliable and feasible to use as part of an international screening test. Further evaluation of the screening test should be conducted.

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Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and <i>DSM-IV</i> Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013

2017-08-09

Bridget F. Grant , S. Patricia Chou , Tulshi D. Saha +7 more

Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap … Lack of current and comprehensive trend data derived from a uniform, reliable, and valid source on alcohol use, high-risk drinking, and DSM-IV alcohol use disorder (AUD) represents a major gap in public health information.To present nationally representative data on changes in the prevalences of 12-month alcohol use, 12-month high-risk drinking, 12-month DSM-IV AUD, 12-month DSM-IV AUD among 12-month alcohol users, and 12-month DSM-IV AUD among 12-month high-risk drinkers between 2001-2002 and 2012-2013.The study data were derived from face-to-face interviews conducted in 2 nationally representative surveys of US adults: the National Epidemiologic Survey on Alcohol and Related Conditions, with data collected from April 2001 to June 2002, and the National Epidemiologic Survey on Alcohol and Related Conditions III, with data collected from April 2012 to June 2013. Data were analyzed in November and December 2016.Twelve-month alcohol use, high-risk drinking, and DSM-IV AUD.The study sample included 43 093 participants in the National Epidemiologic Survey on Alcohol and Related Conditions and 36 309 participants in the National Epidemiologic Survey on Alcohol and Related Conditions III. Between 2001-2002 and 2012-2013, 12-month alcohol use, high-risk drinking, and DSM-IV AUD increased by 11.2%, 29.9%, and 49.4%, respectively, with alcohol use increasing from 65.4% (95% CI, 64.3%-66.6%) to 72.7% (95% CI, 71.4%-73.9%), high-risk drinking increasing from 9.7% (95% CI, 9.3%-10.2%) to 12.6% (95% CI, 12.0%-13.2%), and DSM-IV AUD increasing from 8.5% (95% CI, 8.0%-8.9%) to 12.7% (95% CI, 12.1%-13.3%). With few exceptions, increases in alcohol use, high-risk drinking, and DSM-IV AUD between 2001-2002 and 2012-2013 were also statistically significant across sociodemographic subgroups. Increases in all of these outcomes were greatest among women, older adults, racial/ethnic minorities, and individuals with lower educational level and family income. Increases were also seen for the total sample and most sociodemographic subgroups for the prevalences of 12-month DSM-IV AUD among 12-month alcohol users from 12.9% (95% CI, 12.3%-17.5%) to 17.5% (95% CI, 16.7%-18.3%) and 12-month DSM-IV AUD among 12-month high-risk drinkers from 46.5% (95% CI, 44.3%-48.7%) to 54.5% (95% CI, 52.7%-56.4%).Increases in alcohol use, high-risk drinking, and DSM-IV AUD in the US population and among subgroups, especially women, older adults, racial/ethnic minorities, and the socioeconomically disadvantaged, constitute a public health crisis. Taken together, these findings portend increases in many chronic comorbidities in which alcohol use has a substantial role.

Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses

1994-12-07

Henry Wechsler

<h3>Objective.</h3> —To examine the extent of binge drinking by college students and the ensuing health and behavioral problems that binge drinkers create for themselves and others on their campus. <h3>Design.</h3> … <h3>Objective.</h3> —To examine the extent of binge drinking by college students and the ensuing health and behavioral problems that binge drinkers create for themselves and others on their campus. <h3>Design.</h3> —Self-administered survey mailed to a national representative sample of US 4-year college students. <h3>Setting.</h3> —One hundred forty US 4-year colleges in 1993. <h3>Participants.</h3> —A total of 17592 college students. <h3>Main Outcome Measures.</h3> —Self-reports of drinking behavior, alcohol-related health problems, and other problems. <h3>Results.</h3> —Almost half (44%) of college students responding to the survey were binge drinkers, including almost one fifth (19%) of the students who were frequent binge drinkers. Frequent binge drinkers are more likely to experience serious health and other consequences of their drinking behavior than other students. Almost half (47%) of the frequent binge drinkers experienced five or more different drinking-related problems, including injuries and engaging in unplanned sex, since the beginning of the school year. Most binge drinkers do not consider themselves to be problem drinkers and have not sought treatment for an alcohol problem. Binge drinkers create problems for classmates who are not binge drinkers. Students who are not binge drinkers at schools with higher binge rates were more likely than students at schools with lower binge rates to experience problems such as being pushed, hit, or assaulted or experiencing an unwanted sexual advance. <h3>Conclusions.</h3> —Binge drinking is widespread on college campuses. Programs aimed at reducing this problem should focus on frequent binge drinkers, refer them to treatment or educational programs, and emphasize the harm they cause for students who are not binge drinkers. (<i>JAMA</i>. 1994;272:1672-1677)

Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH posttreatment drinking outcomes.

1997-01-01

Objective: To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of client attributes. Methods: Two parallel but independent randomized clinical trials … Objective: To assess the benefits of matching alcohol dependent clients to three different treatments with reference to a variety of client attributes. Methods: Two parallel but independent randomized clinical trials were conducted, one with alcohol dependent clients receiving outpatient therapy (N = 952; 72% male) and one with clients receiving aftercare therapy following inpatient or day hospital treatment (N = 774; 80% male). Clients were randomly assigned to one of three 12-week, manual-guided, individually delivered treatments: Cognitive Behavioral Coping Skills Therapy, Motivational Enhancement Therapy or Twelve-Step Facilitation Therapy. Clients were then monitored over a 1-year posttreatment period. Individual differences in response to treatment were modeled as a latent growth process and evaluated for 10 primary matching variables and 16 contrasts specified a priori. The primary outcome measures were percent days abstinent and drinks per drinking day during the 1-year posttreatment period. Results: Clients attended on average two-thirds of treatment sessions offered, indicating that substantial amounts of treatment were delivered, and research follow-up rates exceeded 90% of living subjects interviewed at the 1-year posttreatment assessment. Significant and sustained improvements in drinking outcomes were achieved from baseline to 1-year posttreatment by the clients assigned to each of these well-defined and individually delivered psychosocial treatments. There was little difference in outcomes by type of treatment. Only one attribute, psychiatric severity, demonstrated a significant attribute by treatment interaction: In the outpatient study, clients low in psychiatric severity had more abstinent days after 12-step facilitation treatment than after cognitive behavioral therapy. Neither treatment was clearly superior for clients with higher levels of psychiatric severity. Two other attributes showed time-dependent matching effects: motivation among outpatients and meaning-seeking among aftercare clients. Client attributes of motivational readiness, network support for drinking, alcohol involvement, gender, psychiatric severity and sociopathy were prognostic of drinking outcomes over time. Conclusions: The findings suggest that psychiatric severity should be considered when assigning clients to outpatient therapies. The lack of other robust matching effects suggests that, aside from psychiatric severity, providers need not take these client characteristics into account when triaging clients to one or the other of these three individually delivered treatment approaches, despite their different treatment philosophies.

The influence of past experiences, psychological dysfunction, and problematic mentalities: An investigation into the comprehensive nature of drink-driving deterrence

2025-06-25

Steven Love , Bevan Rowland , Grégoire S. Larue | Journal of Safety Research

Predicting individual treatment response in alcohol use disorders: a reverse translational proof-of-concept study

2025-06-24

Sara De Carlo , Hela Mrizak , Andrea Della Valle +7 more | Translational Psychiatry

The development of medications for alcohol use disorders (AUD) faces stagnation, as promising drugs failed to translate in clinic. Screening on homogeneous groups of animals drugs later tested on heterogeneous … The development of medications for alcohol use disorders (AUD) faces stagnation, as promising drugs failed to translate in clinic. Screening on homogeneous groups of animals drugs later tested on heterogeneous clinical cohorts may contribute to the translational gap. We hypothesized that a preclinical model of AUD accounting for inter-individual heterogeneity would predict the lack of efficacy of a drug that failed clinical trials (Memantine) and the efficacy of an approved AUD medication (Naltrexone). Baseline alcohol drinking, motivation, and cued reinstatement were screened in NIH genetically heterogeneous-stock rats before testing the effect of Memantine and Naltrexone on alcohol (ASA) and saccharin self-administration (SSA). Based on the individual effect of Memantine and Naltrexone on ASA, rats were allocated into independent clusters of responders and non-responders to each drug. The same doses of Memantine reduced both ASA and SSA in both clusters, while Naltrexone selectively reduced ASA in responder rats. Naltrexone responders were in majority males, while non-responders were mostly females. Naltrexone responders and non-responders showed similar alcohol drinking and motivation, but non-responders did not show cued reinstatement of alcohol seeking. In line with clinical observations, in a model accounting for individual heterogeneity Memantine failed to selectively reduce ASA, the population could be unbiasedly clustered in responders and non-responders, and cued reactivity associated with Naltrexone response in males. These results advocate the use of inter-individual heterogeneity for preclinical prediction of drug efficacy in AUD before clinical trials. In addition, we observed sex differences in response to Naltrexone that can be back-translated in clinic.

Keep on Keeping on? Patient Factors Predicting Discontinuation in Alcohol Use Disorder Treatment

2025-06-24

Kristoffer Høiland , Espen Kristian Ajo Arnevik , Lien My Diep +3 more | Substance Use & Misuse

A substantial portion of patients with alcohol use disorder (AUD) discontinue treatment. More knowledge of predictors of discontinuation is important for clinicians in preventing premature discontinuation and tailoring treatment to … A substantial portion of patients with alcohol use disorder (AUD) discontinue treatment. More knowledge of predictors of discontinuation is important for clinicians in preventing premature discontinuation and tailoring treatment to the patient. To investigate predictors of completion versus discontinuation in a sample from a multi-site study on outcome predictors of AUD treatment. The analyses included 136 patients from a multi-site study on treatment outcome predictors in group treatment of AUD. Patients were examined at baseline with measures of alcohol use, drug use, psychological symptoms, maladaptive personality functioning, and cognitive functioning. In addition, demographic factors were registered. First, we conducted univariate analyses to examine whether a measure was associated with completion or discontinuation. Second, we selected significant variables from the univariate analyses and conducted a binary logistic regression to assess predictive ability. In total, 23.5% of participants discontinued treatment. The completer and discontinuation groups did not differ on measures of sociodemographic factors, alcohol use, substance use, mental health, or personality functioning. Executive functioning (EF) predicted discontinuation from treatment in the direction that higher EF predicted a decreased risk of discontinuation. Clinicians should examine EF before treatment to inform treatment planning and improve retention by tailoring interventions to the patients. Clinical Trials.gov ID NCT04822987.

Within-day associations between affect and intentions to drink alcohol in adolescents and young adults: A registered report.

2025-06-23

Kevin M. King , Jonas Dora , Megan Elizabeth Schultz +7 more | Psychology of Addictive Behaviors

Motivational theories hypothesizing that people drink to relieve negative affect have not been supported using data from people's daily lives. People may experience negative affect when alcohol is unavailable or … Motivational theories hypothesizing that people drink to relieve negative affect have not been supported using data from people's daily lives. People may experience negative affect when alcohol is unavailable or when use would conflict with people's current goals, but people's thoughts about alcohol use, such as intentions to drink later in the day, are less contextually constrained. Alcohol intentions may serve as affect regulation and lead to decreases in negative or increases in positive affect prior to drinking itself. This registered report provides an initial test of this hypothesis across two large ecological momentary assessment samples of adolescents and young adults (total n = 1,511). We tested whether daily drinking intentions were associated with levels and within-day changes in negative and positive affect in two large samples of adolescents and young adults and whether drinking history and motives moderated these associations. We found evidence, replicated across studies, that positive affect was higher and increased more on days when people reported intending to drink more than usual, but negative affect was only very weakly associated with daily drinking intentions. We found no evidence of moderation that replicated across samples. Results suggest that prior research linking positive affect and alcohol use is at least in part capturing the anticipation of drinking rather than a causal association between affect and drinking behaviors among adolescents and young adults. Theories should consider how anticipation, as well as the contexts in which drinking occurs, shapes people's motives for drinking and their drinking behaviors themselves. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Letter to the Editor: Integrating Biochemical Parameters into the Psychological Assessment of Alcohol Dependence

2025-06-23

Gamze Demirel | Hitit Medical Journal

Letter to the Editor 'Integrating Biochemical Parameters into the Psychological Assessment of Alcohol Dependence ' Letter to the Editor 'Integrating Biochemical Parameters into the Psychological Assessment of Alcohol Dependence '

Supplemental Material for Testing Adaptations to Contingency Management for Alcohol Use Disorders: A Randomized Controlled Trial

2025-06-23

| Journal of Consulting and Clinical Psychology

Behavioral Variation in Individuals with a History of Alcohol Abuse

2025-06-23

Ana Terra Pires de Moraes , Josele Abreu‐Rodrigues | The Psychological Record

Referrals offered to affected family members: a cross-sectional analysis of a substance use program register

2025-06-23

J.R. Silva , Ronaldo Laranjeira , Martha Canfield +5 more | Journal of Addictive Diseases

Background: Demand is growing for support services for affected family members (AFM) of relatives with a substance use disorder or problematic substance use. This study examined referral patterns and factors … Background: Demand is growing for support services for affected family members (AFM) of relatives with a substance use disorder or problematic substance use. This study examined referral patterns and factors influencing referral types of AFM who sought support through the program 'Recomeço Família' in São Paulo, Brazil. Methods: A cross-sectional retrospective analysis of 5,192 records of family members registered in the program between 2014 and 2018. Referrals made by health professionals to external services were assessed and factors associated with referral types were assessed through univariate binary logistic regressions. Results: Most of the referrals were to individual therapies (counseling/psychotherapy)(64.30%), followed by family support groups (21.15%) and psychoeducational programs (14.55%). Referral destinations varied by AFM and their relative characteristics, including gender, age, kinship, levels of emotional distress, help-seeking history and substance type. Conclusion: The findings highlight factors that may influence referral decisions and underscore the need for further investigation into whether these referrals effectively address the specific needs of AFM.

Mutual‐Support Groups for Alcohol and Other Drug Use in East, South and Southeast Asia: A Scoping Review

2025-06-23

Wan Jie Tan , Briony Larance , Emma E. Walter +2 more | Drug and Alcohol Review

ABSTRACT Issues Given the growing need to understand mutual‐support groups for alcohol and other drug (AOD) recovery across diverse cultural contexts, it is essential to comprehensively examine these groups in … ABSTRACT Issues Given the growing need to understand mutual‐support groups for alcohol and other drug (AOD) recovery across diverse cultural contexts, it is essential to comprehensively examine these groups in East, South and Southeast Asia, including strategies to enhance their cultural appropriateness and their effectiveness. Approach Searches were conducted in Cinahl, EMBASE, MEDLINE, PsycINFO, PubMed, Scopus and Web of Science until November 2021. Original studies in peer‐reviewed journals of any language and design that examined mutual‐support groups for AOD use in these regions were included. Key Findings Forty‐six studies were identified from 1612 de‐duplicated records, predominantly from Japan (34.8%) and Iran (32.6%), with none from Southeast Asia. Most were cross‐sectional (47.8%) and examined 12‐step groups (76.1%). Culture‐oriented adaptation strategies (values, beliefs, traditions) were most reported, with religion/spirituality most employed and friends/family involvement often proposed as important. Across all employed strategies, the use of community spaces (e.g., community centres, places of worship) was most common. Preliminary evidence suggests that strategies, especially those addressing nuanced sociocultural factors, correlate with positive AOD recovery outcomes. Implications Findings reveal culture‐, language‐ and community‐oriented strategies that can be utilised to meet the cultural needs of target populations. Mutual‐support group membership is associated with positive outcomes. Conclusion Strategies to enhance cultural appropriateness of mutual‐support groups in East and South Asia were identified. Evidence on the effectiveness of mutual‐support groups, particularly in Southeast Asia, remains limited. Future investigation can elucidate potential differences in effectiveness between types and extents of strategies used to enhance cultural appropriateness of mutual‐support groups in these regions.

Depression and Alcohol Drinking Behavior: Association and Sex Differences Among Brazilian Adults

2025-06-22

Thaís Cristina Marquezine Caldeira , Luiza Eunice Sá da Silva , Paula Carvalho de Freitas +2 more | American Journal of Health Promotion

Purpose To evaluate the association of alcohol drinking behaviors with depression and sex differences among Brazilian adults. Design Cross-sectional study. Setting Brazilian National Health Survey of 2019. Subjects Population-based sample … Purpose To evaluate the association of alcohol drinking behaviors with depression and sex differences among Brazilian adults. Design Cross-sectional study. Setting Brazilian National Health Survey of 2019. Subjects Population-based sample of 88 531 Brazilian adults. Measures Alcohol drinking behaviors (heavy episodic drinking; alcohol-related impairment; alcohol-induced blackout), depression (Patient Health Questionnaire-9), and socioeconomic information (sex; age; education; income; geographic region; partner/spouse). Analysis Logistic regression models for the association between alcohol drinking behaviors and depression in the total population, stratified by sex and with interaction effect between depression and sex. Models were adjusted by socioeconomic variables. Results Heavy episodic drinking was reported by 40.5% and associated with depression in the total population ( Odds Ratio – OR1.31; 95%CI 1.14-1.51) and among women (OR1.30; 95%CI 1.10-1.54). Alcohol-related impairment was reported by 4.6% and associated with depression in the total population (OR2.47; 95%CI 1.88-3.23), among men (OR3.24; 95%CI 2.24-4.68) and women (OR1.85; 95%CI 1.27-2.70). Alcohol-induced blackout was reported by 9.7% and associated with depression in the total population (OR2.27; 95%CI 1.88-2.76), among men (OR2.39; 95%CI 1.82-3.12) and women (OR2.18; 95%CI 1.67-2.85). Men presented higher chance of alcohol-related impairment associated with depression than women (OR1.77; 95% CI 1.04-3.02). Conclusion Sex differences in alcohol drinking behaviors associated with depression were observed. These results emphasize the need for gender-specific approaches to tackle issues on mental health and alcohol consumption.

The Challenge of Alcohol Dependency among Uniformed Prison Officers in Kenya

2025-06-21

Jane W Kirii , Lawrence Ojwang | International Journal of Research and Innovation in Social Science

This paper examines the growing challenge of alcohol dependency among prison officers within the Kenya Prisons Service (KPS). Specifically, it focuses on evaluating success rates of alcoholic prison officers placed … This paper examines the growing challenge of alcohol dependency among prison officers within the Kenya Prisons Service (KPS). Specifically, it focuses on evaluating success rates of alcoholic prison officers placed in rehabilitation centers; assessing the effectiveness of the programs offered at the rehabilitation centers; examining the factors influencing relapse into alcohol dependency; and identifying consequences of alcohol dependency among prison officers. Alcohol dependency has emerged as a significant occupational health concern for correctional institutions globally, exacerbated by the inherently stressful, high-risk environment of prison work. Despite existing interventions by the KPS, such as medical insurance coverage, mental health facilities, and training programs, alcohol dependency continues to pose a threat to the staff productivity, service delivery and security of the prisons. The study employed both qualitative and quantitative methods, with data collected via a Google Forms questionnaire distributed to prison officers across Kenya. A total of 137 officers participated, representing diverse demographic characteristics, educational backgrounds, and ranks. Data analysis included descriptive statistics for quantitative responses and thematic analysis for qualitative data. Findings revealed that while 39% of respondents deemed rehabilitation efforts “somewhat successful,” only 5.1% considered them fully successful. Factors contributing to relapse include high occupational stress, trauma exposure, normalized drinking culture, peer pressure, lack of post-rehabilitation support, unresolved personal and mental health issues, financial stress, and stigmatization within the institution. Rehabilitation programs such as detoxification and life skills training received higher success ratings, while 12-step recovery programs and support groups showed moderate effectiveness. However, many participants identified the lack of aftercare, involuntary treatment participation, and failure to address root causes of addiction as major barriers to sustained recovery. Officers noted that some rehabilitation facilities were profit-driven and not tailored to the specific needs of prison staff. The impact of alcohol dependency is multifaceted. At the individual level, it leads to chronic health issues, mental health deterioration, and isolation. Professionally, it contributes to absenteeism, misconduct, impaired decision-making, and workplace accidents-factors that directly undermine prison security. Families of affected officers also experience emotional and financial stress, divorce and separation, while the institution suffers from reduced staff morale, increased disciplinary cases, and compromised rehabilitation efforts for inmates. Based on the findings, the paper makes key policy recommendations including: establishing structured aftercare programs; recognizing alcohol dependency as a medical condition; integrating technology into treatment; strengthening peer support networks; introducing mental health screenings; providing tailored treatment options; and promoting a non-stigmatizing workplace culture. It further calls for targeted supervisor training to detect early signs of addiction and the implementation of gradual reintegration strategies post-treatment.

Biomedical and behavioral research on alcohol and youth: Celebrating the alcohol research career achievements of Dr. Linda Patia Spear

2025-06-21

Marisa M. Silveri | Alcohol Clinical and Experimental Research

The Use of Psychoactive Substances in Al-Jouf Region: Prevention and Treatment

2025-06-20

Dhaifallah bin Muqhim Al-Otaibi , Hany Fouad Sayed Mohamed Suleiman | Journal of Posthumanism

The current study aimed to examine the abuse of psychoactive substances in the Al-Jouf region and to identify the psychological and social indicators of psychoactive substance abuse, along with prevention … The current study aimed to examine the abuse of psychoactive substances in the Al-Jouf region and to identify the psychological and social indicators of psychoactive substance abuse, along with prevention and treatment strategies. The objective is to develop practical preventive and therapeutic plans and programs to help reduce the spread of psychoactive substance abuse in the Al-Jouf region. The study employed the following material: a diagnostic interview (closed–open) for substance users in treatment (developed by the researchers), a diagnostic interview (closed–open) for therapists, and an addiction indicators scale (developed by the researchers). These study materials were applied to a sample of 78 substance users receiving treatment at Mental Health Hospital, and 57 therapists. The results indicated that the most important reasons for abusing psychoactive substances are: certain psychological variables such as impulsivity, psychological sensitivity, depression, anxiety, inability to communicate, and social isolation, psychological fatigue, bad peers at school, in the neighborhood, or at university, low self-confidence, attempts to feel self-worth and self-esteem, lack of hobbies or skills, leisure time and attempts to fill it, Improper reactionary behavior from the family of the abuser, family problems and feelings of fragmentation and domestic abuse, parental separation, lack of guidance, counseling and mentoring inside the family, presence of a substance abuser within the family, the wide spread of substance misuse in the user’s residential area, academic failure and lack of supervision at school or university, lastly, either the abundance of income (making it easier to access substances).

Participant experiences with Supporting Addiction Affected Families Effectively (SAFE): a qualitative study of the 5-Step method in Goa, India

2025-06-19

Emily Balcke , Urvita Bhatia , Richard Velleman +3 more | Drugs Education Prevention and Policy

Reasons and impacts of alcohol use disorder among ethnic minority young adults: a descriptive phenomenological study

2025-06-19

Getaneh Mulualem Belay , Mak Yim Wah , Katherine Ka Wai Lam +6 more | Frontiers in Public Health

Introduction Alcohol use disorder (AUD) is prevalent among ethnic minority young adults. However, there is limited evidence exploring its health impact and contributing factors in ethnically marginalized young adults. Therefore, … Introduction Alcohol use disorder (AUD) is prevalent among ethnic minority young adults. However, there is limited evidence exploring its health impact and contributing factors in ethnically marginalized young adults. Therefore, this study examined the reasons for developing AUD and its effect on the daily lives of ethnic minority young adults. Method A descriptive phenomenological study was conducted from March 1 to June 30, 2023. Participants were recruited through referral using the exponential snowball sampling technique. A total of 22 ethnic minority young adults were interviewed using a semi-structured interview guide. The sample size was determined based on data saturation. All interviews were audio-recorded and transcribed verbatim in English. Then, the data was analyzed using Colaizzi’s method. Results This study suggested that the reasons for developing AUD among ethnic minority young adults were (1) culture and family, (2) hedonistic motives, (3) curiosity, (4) low-risk perception, (5) coping motives, (6) social influences, and (7) subjective cravings. Moreover, this study indicated that ineffective daily performance, emotional turmoil, financial constraints, and social relationship issues were the impacts of AUD on this segment of the population. Conclusion The findings highlighted the multifaceted reasons contributing to AUD among ethnic minority young adults, including coping, low-risk perception, and influences from culture, family, and peers. The findings also showed how AUD severely affected their daily lives. Therefore, future interventional studies should consider cultural, family, social, and psychological aspects.

The Impact of Alcohol-Specific and Traditional Masculine Norms on Drinking Game Behaviors: A Multisite Study of Emerging Adult Men

2025-06-18

Byron L. Zamboanga , Amie R. Newins , Kathryne Van Hedger +6 more | Emerging Adulthood

Playing a drinking game (DG) can provide a context for men to behave in accordance with endorsed masculine norms. Using a multisite college sample of emerging adult men ( n … Playing a drinking game (DG) can provide a context for men to behave in accordance with endorsed masculine norms. Using a multisite college sample of emerging adult men ( n = 1142), we examined alcohol-specific masculine norms ( excess / control ) alongside traditional masculine norms and their relations to DG frequency and quantity, and the moderating effects of fraternity membership and hazardous drinking status on these associations. After adjusting for known demographic correlates of DG behaviors and non-DG-related alcohol use, we found that the masculine drinking norm of excess was positively associated with DG frequency, with the effect being primarily driven by this association among fraternity men. Excess was unrelated to DG quantity when accounting for covariates. Control was negatively associated with DG frequency but was unrelated to DG quantity; neither fraternity membership nor hazardous drinking status moderated these associations. Our findings further our theoretical understanding of how masculinity relates to DG behaviors among emerging adults.

Drogenbezogene Probleme im psychiatrischen Konsildienst

2025-06-18

Norbert Scherbaum , Udo Bonnet | Der Nervenarzt

Zusammenfassung Hintergrund Gesundheitliche Probleme beim Konsum psychoaktiver Substanzen sind ein häufiger Anlass für die Anforderung eines psychiatrischen Konsils. Ziel der Arbeit Darstellung somatischer und psychischer Komplikationen des akuten und chronischen … Zusammenfassung Hintergrund Gesundheitliche Probleme beim Konsum psychoaktiver Substanzen sind ein häufiger Anlass für die Anforderung eines psychiatrischen Konsils. Ziel der Arbeit Darstellung somatischer und psychischer Komplikationen des akuten und chronischen Konsums verschiedener Drogen (außer Alkohol und Benzodiazepinen) sowie des Vorgehens bei Konsilien. Material Narrative Literaturübersicht. Ergebnisse Schwerwiegende akute somatische wie auch psychische Komplikationen bei Drogenkonsum können auch bei sporadischem Konsum auftreten. Diagnostisch sind der sporadische Drogenkonsum, der schädliche Konsum und die Abhängigkeit abzugrenzen. Je nach Einzelfall sind Abstinenzempfehlung, Safer-use-Empfehlungen und motivierende Interventionen zur Aufnahme anschließender Hilfen vorzunehmen. Hierfür ist eine präzise Kenntnis der lokalen Hilfen für Drogenkonsumenten notwendig. Die medikamentöse Linderung von Entzugsbeschwerden erfolgt symptomatisch. Bei der Entzugsbehandlung sind potenzielle Komplikationen zu berücksichtigen, z. B. Entzugsdelir bei GABAergen Drogen. Bei Personen mit Opioidabhängigkeit ist eine bestehende Substitutionsbehandlung in aller Regel fortzusetzen bzw. eine solche Behandlung zu initiieren. Diskussion Aufgaben des Konsiliars sind die kollegiale Unterstützung bei erschwerter Diagnostik sowie die Hilfe bei der Erarbeitung einer differenzierten Behandlungsempfehlung. Das suchtpsychiatrische Konsil sollte dabei nicht nur beim Management akuter klinischer Probleme Hilfe bieten, sondern für Betroffene auch die Möglichkeiten weiterer Hilfen und Behandlungen aufzeigen.

Psychological Distress Trajectories in Residential Alcohol and Other Drug Treatment

2025-06-17

Emma L. Hatton , Peter J. Kelly , Laura Robinson +6 more | Drug and Alcohol Review

ABSTRACT Introduction Residential clients frequently report high psychological distress at intake, but little is known about changes in distress throughout treatment. This study aimed to identify in‐treatment trajectories for psychological … ABSTRACT Introduction Residential clients frequently report high psychological distress at intake, but little is known about changes in distress throughout treatment. This study aimed to identify in‐treatment trajectories for psychological distress and factors associated with trajectory classes. Methods A retrospective cohort of adults attending Australian non‐government residential substance use treatment between 2012 and 2023 was identified from routinely collected data, NADAbase. Participants ( N = 1492) completed ≥ 3 Kessler‐10 Psychological Distress Scale (K10) assessments within 90 days of intake. Latent growth curve analyses identified classes of K10 trajectories. Multinomial regression identified demographic and clinical correlates (Severity of Dependence Scale [SDS] and EUROHIS Quality of Life scale [EQoL‐8]) of class membership. Results A five‐class model describing K10 trajectories (1: moderate–low improved; 2: high–low improved; 3: very high–moderate improved; 4: very high–high improved; 5: very high unchanged) had the best model fit. Compared to high–low improved (34.5%; referent), moderate–low improved (45.4%) were less likely to identify as female, have higher SDS and lower EQoL‐8 scores, or use cannabis; very high–moderate improved (13.1%) were more likely to have lower SDS scores, be aged under 25 and use opioids; very high–high improved (5.6%) were less likely to identify as male, be aged over 25, have higher EQoL and SDS scores; and very high unchanged (1.3%) were more likely to have lower EQoL scores and have left without completing treatment. Discussion and Conclusions Four K10 trajectory classes showed improvement after 90 days. Around 7% reported sustained high to very high psychological distress. Routine monitoring of psychological distress provides opportunities to identify non‐improving clients and review treatment plans to improve outcomes.

“I Will Fight Tooth and Nail for My Recovery”: A Typology of Individuals in Long-Term Recovery From Addiction

2025-06-17

Ayala Elbaz , Keren Gueta , Natti Ronel | Journal of Drug Issues

Long-term recovery (LTR) refers to changes occurring over five years or more. This study aimed to establish a typology of individuals in LTR from the perspectives of various stakeholders. Using … Long-term recovery (LTR) refers to changes occurring over five years or more. This study aimed to establish a typology of individuals in LTR from the perspectives of various stakeholders. Using a qualitative phenomenological approach, semi-structured interviews were conducted with individuals in recovery from substance and behavioral addictions ( n = 30), family members ( n = 8), and professional therapists ( n = 9). The findings identified five distinct types of individuals in LTR: the Fighter, the Avoidant, the Wanderer, the Devout, and the Comrade. These types differ based on identity, recovery goals, and strategies. The study suggests recovery identity acts as a transitional stage, aiding individuals in stabilizing and resuming typical activities. This typology captures the multifaceted nature of addiction recovery, incorporating insights from prior research on identity and recovery strategies. It offers potential for tailoring therapeutic interventions to meet the diverse needs of individuals in recovery.

Access to substance use services on campus: What’s available in Ontario, Canada’s post-secondary institutions

2025-06-17

Chelsea Noël , Christopher Armiento , Deborah M. Scharf | Journal of American College Health

Objective: To examine substance use services available to post-secondary students in Ontario, Canada. Participants: All 23 universities and 24 public colleges in the province. Methods: Researchers coded substance use service … Objective: To examine substance use services available to post-secondary students in Ontario, Canada. Participants: All 23 universities and 24 public colleges in the province. Methods: Researchers coded substance use service information on institutional websites and social media. Mental health service information was also described in case substance use services were embedded in general mental healthcare. Chi-square tests evaluated relationships between institution size and substance use service availability. Results: Most institutions provided students with access to mental health services (counseling [96%], psychoeducational resources [83%], crisis services [91%]), either directly through institutions (62%) or through partnerships with external professionals (38%). Only 38% of any counseling service and 34% of psychoeducational resources specifically addressed substance use. Conclusions: Low rates of substance use-specific services at Ontario post-secondary institutions suggest that institutions are not meeting students' substance use needs. Integrated services and specialized training for mental health professionals are essential to address substance use among post-secondary students.

Enhancing support for student well-being: substance use resources and policy approaches in community colleges

2025-06-17

N. S. Mendoza , Michelle Santana , Winta Tekle +4 more | Journal of American College Health

Objective: Community colleges serve diverse students who often face substance use challenges. Policies may perpetuate stigma and deter help-seeking. This study examined the availability and comprehensiveness of substance use resources … Objective: Community colleges serve diverse students who often face substance use challenges. Policies may perpetuate stigma and deter help-seeking. This study examined the availability and comprehensiveness of substance use resources on community college websites in Health and Human Services Region IX and their association with punitive policy responses. Methods: A content analysis of 158 community college websites was conducted, followed by logistic regression to assess relationships between resource comprehensiveness, engagement opportunities, and punitive responses. Results: There was notable variability in resource availability. Overdose prevention and opioid-specific resources were limited. Comprehensive overdose prevention and treatment resources were associated with fewer punitive measures, as were engagement opportunities. Conclusion: Findings highlight the need to expand overdose prevention education, examine the punitive nature of policies, and assess the impact punitive policies have on student help-seeking behaviors. Results will inform the Region IX Pacific Southwest Addiction Technology Transfer Center's HOPES Project training and technical assistance.

Evolution of the Risk of Problematic Alcohol Use in University Students: A Longitudinal Study Based on the uniHcos Cohort Data

2025-06-17

Lorena Botella-Juan , Jorge Arias de la Torre , Carmen Amezcua‐Prieto +7 more | International Journal of Mental Health and Addiction

Demographic Correlates Associated with Blackout Rage Gallon (BORG) Drinking Knowledge and Participation Among College Students

2025-06-17

Timothy J. Grigsby , Kevin S. Montes , Jessica K. Perrotte | Substance Use & Misuse

An emergent and concerning alcohol use trend among college students is the consumption of a "blackout rage gallon" (BORG)-a gallon jug filled with a mixture of alcohol (often vodka), caffeinated … An emergent and concerning alcohol use trend among college students is the consumption of a "blackout rage gallon" (BORG)-a gallon jug filled with a mixture of alcohol (often vodka), caffeinated beverages, water, and flavor enhancers. The aim of this exploratory study was two-fold: (1) to describe U.S. college students' direct and indirect experience with BORG drinking and (2) to identify demographic factors that correlate with BORG consumption among college student drinkers. A cross-sectional study of college students (n = 581) was conducted using the Prolific platform in May 2024. Data were collected on drinking status, BORG knowledge and involvement, and demographic characteristics (age, sex, and ethnoracial group). Descriptive statistics across drinking status and bivariate tests of association were used to address study aims. The majority of nondrinkers (62%) had not heard of BORG while the majority of current drinkers knew someone who engaged in BORG (31.9%) or had tried BORG themselves (20%). Participants who had engaged in BORG drinking were significantly younger than those who had heard about BORG drinking (p = 0.001) and those who had never heard of BORG drinking (p < 0.001). There were no differences by sex or ethnoracial group. BORG drinking represents a novel and potentially widespread phenomena among college drinkers. Additional research is needed to understand the motivations for BORG drinking, and how BORG drinking fits into the landscape of college alcohol use behaviors. These data are essential for developing timely and appropriate interventions to reduce immediate and long-term harm from this hazardous drinking practice.

ALCOhol use, Norms, Identities and Motivations-based (ALCONIM) prevention program for binge drinking among college students: a study protocol for a parallel-group randomized controlled trial

2025-06-16

Thomas Lehoux , Nicolas Cabé , Margaret W. DuPont +7 more | Research Square (Research Square)

<title>Abstract</title> <bold>Background</bold> Binge drinking (BD) refers to repeated switches between intense and short intoxication as well as periods of abstinence. Subjective norms, drinking identity and social and enhancement motives are … <title>Abstract</title> <bold>Background</bold> Binge drinking (BD) refers to repeated switches between intense and short intoxication as well as periods of abstinence. Subjective norms, drinking identity and social and enhancement motives are found to be the most dominant determinants of BD in college students. Targeting these psychosocial factors could be of public health interest in this population, in which up to one out of five students would practice BD. The purpose of our study is to evaluate the efficacy of brief BD determinants-focused procedures, namely, hypocrisy induction (HI), social identity mapping (SIM) and motivational modeling (MM) as add-on interventions to motivational interviewing (MI), compared to MI alone, in preventing BD in college students. <bold>Methods</bold>: Two hundred and forty healthy college students (University of Caen Normandy, France) will be randomized in one of three one-meeting intervention experimental arms (<italic>i.e.</italic>, MI combined with HI, SIM or MM) or in one control arm (<italic>i.e.</italic>, MI alone). BD scores will be collected through ecological momentary assessment (EMA) and will be used to assess the primary outcome, <italic>i.e.</italic>, the decrease of self-reported BD intensity at one-month post-intervention. Secondary endpoints include self-reported alcohol drinking norms, identity, motives, frequency and craving, as well as readiness to change one’s alcohol-related behaviors. Assessments are scheduled at pre-intervention as well as at one and six-month follow-up. <bold>Discussion</bold>: The purpose of this study is to evaluate the complementary interest of HI, SIM or MM-based intervention combined with MI in an innovative prevention program aiming to target BD specific determinants and subsequently lower BD in college students. <bold>Trial registration</bold>: NCT06447350 [clinicaltrials.gov; URL: https://clinicaltrials.gov/study/NCT06447350]. Retrospectively registered on June 3rd, 2024.

Perspective Chapter: Motivation of Criminal Behavior in Secondary School Students in Chihuahua City, Northern Mexico

2025-06-16

Joel Monárrez‐Espino , Luisa Villareal-Varela , Estefanía Pinzón-Kranz +3 more | IntechOpen eBooks

Qualitative study with secondary school adolescents (~14–15 years) in the city of Chihuahua to identify motivators of criminal behavior. In-depth interviews were conducted using individual interview guides. Data were recorded, … Qualitative study with secondary school adolescents (~14–15 years) in the city of Chihuahua to identify motivators of criminal behavior. In-depth interviews were conducted using individual interview guides. Data were recorded, transcribed, and coded by thematic axes. The main reason for carrying weapons was for protection and safety when living in isolated dangerous areas. The motivation for physical aggression included self-defense or defense of family and friends, out of impulsiveness, as reaction to insults or mistreatment, to gain respect, and as an act of manliness. Using alcohol or drugs was relatively common among students from poor schools, especially men; curiosity or peer pressure was mentioned, as well as positive sensations that help combat stress, anxiety and depression, and family problems. Motivation for stealing included doing it as a prank and due to the influence or pressure from friends. Belonging to gangs had to do with the desire to be respected, to have prestige and protection, due to influence by friends or brothers, or to feel part of something. Crime behavior appears to be a problem among high-risk groups in poor and marginalized areas of the city; preventive efforts should be focused on vulnerable students.

Readdressing Addiction Stigma:

2025-06-15

Fay Dennis | Bristol University Press eBooks

Exploring the Relationship Between Opioid Use Disorder and Major Depressive Disorder: A Case Study from Kentucky of United States

2025-06-14

Md Rakibul Hasan | Journal of Current and Advance Medical Research

This case study explores the intricate and interconnected problems of drug usage and mental health in Kentucky, a state that has been greatly affected by the opioid epidemic and the … This case study explores the intricate and interconnected problems of drug usage and mental health in Kentucky, a state that has been greatly affected by the opioid epidemic and the high rate of mental illness. The study draws attention to the many difficulties that people with multiple diagnoses encounter, including as stigma, difficulty obtaining integrated treatment, and the need for extensive support networks. Through a thorough case study of a 35-year-old male patient from Louisville, Kentucky, who has been struggling with severe depressive disorder and opioid use disorder, the paper emphasizes how crucial integrated therapy methods are. By combining medication-assisted treatment (MAT), cognitive-behavioral therapy (CBT), and community support, the patient's journey from numerous unsuccessful rehabilitation endeavors to significant progress is meticulously documented. In treating drug use and mental health difficulties, the case study demonstrates the efficacy of creative alternatives including peer support groups, telemedicine services, and community-based therapies. In order to improve outcomes for people with dual diagnoses throughout the United States, the paper ends with suggestions for expanding integrated care models and a discussion of the wider implications for public health policy. Journal of Current and Advance Medical Research, January 2024;11(1):50-55

Cognitive-behavioral interventions for co-occurring substance use and mental health disorders

2025-06-14

Molly Magill , Emily C. Helminen , Blaine Lynch‐Gadaleta +3 more | Drug and Alcohol Dependence

Risky relationships: Secondhand harms and health indicators associated with college students' relationships with heavy drinkers

2025-06-13

Pamela J. Trangenstein , Erika Rosen , Christina Tam +3 more | Alcohol Clinical and Experimental Research

Abstract Background Heavy drinking is pervasive on college campuses, yet little is known about how heavy drinkers affect college students around them. People with versus without heavy drinkers in their … Abstract Background Heavy drinking is pervasive on college campuses, yet little is known about how heavy drinkers affect college students around them. People with versus without heavy drinkers in their lives often differ systematically, complicating such analyses. This study tested whether relationships with heavy drinkers were associated with alcohol‐related harms to others (AHTOs) and related health indicators among college students after using propensity score weighting to account for demographic and behavioral differences between those with and without heavy drinkers in their lives. Method Data were from a probability‐based survey of 1901 US college students, recruited in November–December 2021 (16% response rate), 271 of whom had a heavy drinker in their life. There were two sets of outcomes: (1) AHTOs (i.e., harassment, physical, sexual) and (2) health indicators (i.e., frequent mental distress and service use because of someone else's drinking). Secondary models were stratified by the heavy drinker's relationship to the participant (i.e., intimate peer, other peer, and family member). To correct for multiple testing, p ‐values < 0.002 were considered significant. Results In double‐robust propensity score‐weighted regressions, relationships with a heavy drinker (vs. not) were associated with harassment (aOR = 3.89 [2.05, 7.38]) and sexual AHTOs (aOR = 2.98 [1.29, 6.88]). Students with a heavy drinker in their life (vs. not) had greater odds of frequent mental distress (aOR = 2.05 [1.28, 3.29]) and service use because of someone else's drinking (aOR = 7.39 [3.32, 16.47]). All relationship types were associated with harassment and service use because of someone else's drinking. Relationships with heavy drinking other peers and family members were associated with frequent mental distress. Conclusions Relationships with a heavy drinker are associated with college AHTOs and health indicators.

Utilizing Decision Analysis to Assess the Safety of Providing Medication for Addiction Treatment to Professionals With Substance Use Disorder

2025-06-13

Matthew Robert Dernbach , Lisa J. Merlo , Robert L. DuPont +3 more | Journal of Addiction Medicine

Care models for professionals with substance use disorder (SUD), such as those for physicians, attorneys, military personnel and commercial pilots, currently do not have a standard method to determine whether … Care models for professionals with substance use disorder (SUD), such as those for physicians, attorneys, military personnel and commercial pilots, currently do not have a standard method to determine whether to allow medication for addiction treatment (MAT) in profession-specific treatment plans. The decision to endorse the use of MAT involves a tradeoff between maximizing SUD relapse prevention and minimizing MAT-related adverse effects that might impact safety. We propose a decision analysis process to facilitate an objective and evidence-based use of MAT in these circumstances. Already implemented in high-reliability sectors such as aviation, decision tree analysis of quantifiable hazards and mitigating variables can be used to calculate an evidence-based risk for the number of bad outcomes with one alternative versus another. Greater data transparency from and increased resource availability to professional care models are necessary to conduct and disseminate these analyses.

Comparing subjective effects and intoxication on simultaneous alcohol and cannabis use occasions relative to alcohol‐ or cannabis‐only occasions

2025-06-13

Ashley N. Linden‐Carmichael , Shou‐Chun Chiang , Walter G. Dyer +2 more | Alcohol Clinical and Experimental Research

Abstract Background Simultaneous use of alcohol and cannabis—or use of both substances so effects overlap—is common among college‐attending young adults and can heighten one's likelihood of experiencing substance‐related harms in … Abstract Background Simultaneous use of alcohol and cannabis—or use of both substances so effects overlap—is common among college‐attending young adults and can heighten one's likelihood of experiencing substance‐related harms in daily life. Limited ecological momentary assessment and daily diary work have examined the role of subjective intoxication and subjective effects when engaging in simultaneous relative to alcohol‐ or cannabis‐only use, and studies have yielded mixed results. As such, subjective experiences serve as important internal cues for decision making; this study aimed to examine the level of subjective intoxication and effects across simultaneous, alcohol‐only, and cannabis‐only occasions. Methods Participants were 119 college students aged 18–25 who reported weekly simultaneous use at baseline. Participants enrolled in a 4‐week ecological momentary assessment study with up to eight prompts per day collected on weekend days. Results Multilevel models revealed that relative to alcohol‐ and cannabis‐only days, simultaneous use days were not significantly associated with subjective alcohol or cannabis intoxication, respectively. Peak levels of subjective alcohol effects were, however, significantly stronger during simultaneous use occasions relative to alcohol‐only use occasions. Subjective cannabis effects were not significantly different between simultaneous and cannabis‐only use days. Conclusions Study findings suggest that “adding” cannabis to an alcohol use occasion may bolster subjective effects such as feeling clumsy, confused, and having difficulty concentrating. Findings also highlight that subjective effects, rather than degree of impairment/intoxication, more strongly differentiates alcohol and simultaneous use occasions, and may serve as a useful momentary intervention target in future work.

Provider Perspectives on Medication for AUD in Mental Health and Substance Use Disorder Clinics

2025-06-13

Corinne N. Kacmarek , Julie Kreyenbuhl , Hildi Hagedorn +6 more | Journal of Dual Diagnosis

Objectives: Alcohol Use Disorder (AUD) is comorbid with major mental illnesses, but prescribing rates for medications for AUD (mAUD) are low. Methods: We surveyed 71 mental health and 42 substance … Objectives: Alcohol Use Disorder (AUD) is comorbid with major mental illnesses, but prescribing rates for medications for AUD (mAUD) are low. Methods: We surveyed 71 mental health and 42 substance use disorder (SUD) treatment providers in an academic medical center about AUD treatment practices. Results: Fifty-three mental health and 14 SUD providers responded. Among the n = 22 mental health prescribers, a minority (29%) prescribed mAUD often. Sixty percent of mental health providers viewed mAUD as effective. Barriers to mAUD prescribing in mental health included believing SUD providers were better equipped to prescribe mAUD, whereas SUD providers assumed that patients were not interested in mAUD. All providers were willing to participate in mAUD education initiatives, but few were willing to engage in more time-intensive implementation activities. Conclusions: Improving knowledge and attitudes may improve mental health provider delivery of mAUD, but evidence-based strategies for improving prescribing may be less acceptable and feasible for providers.

Responding to the toxic drug crisis: Promising innovations, gaps, and calls to action

2025-06-13

Karen Urbanoski , David Moore , Cory Neudorf +2 more | Can J Public Health

Inhibitory control is affected by reward in patients with alcohol use disorder

2025-06-13

Y. Li , Cai Xu , Yinzhao Liu +2 more | Frontiers in Psychiatry

Introduction The present study aimed to investigate the effects of reward and punishment on inhibitory control in the alcohol use disorder (AUD) group and healthy control group. Methods Eighteen male … Introduction The present study aimed to investigate the effects of reward and punishment on inhibitory control in the alcohol use disorder (AUD) group and healthy control group. Methods Eighteen male patients with AUD and twenty-one age- and education-matched male healthy controls were recruited for the study. Participants engaged in the two-choice oddball paradigm, which included reward, punishment, and neutral conditions. Participants were asked to respond differently to standard and deviant stimuli as accurately and quickly as possible. Results For reaction time measures, deviant - standard difference of the healthy control group did not show any difference; however, deviant - standard difference of the AUD group was significantly larger in the reward condition than in the neutral condition. For accuracy measures, deviant - standard difference of the healthy control group did not show any difference; however, deviant - standard difference of the AUD group was significantly larger in the neutral condition than in the reward condition, indicating a greater decline in accuracy for deviant stimuli. Conclusion Our findings demonstrated that either reward nor punishment effectively enhanced inhibitory control in AUD patients. Notably, the reward condition was associated with a further decline in inhibitory control. It is advisable to avoid relying solely on reward- or punishment-based behavioral correction strategies, as they might heighten psychological stress and negative emotions, potentially worsening deficits in inhibitory control.

Collaboration Across Sectors: Bridging Gaps in Substance Use and Mental Health Treatment for Stronger Communities

2025-06-12

Anthony Coetzer-Liversage | Journal of Community Safety and Well-Being

Provincial and territorial results and recommendations from the Canadian Alcohol Policy Evaluation project: Room for improvement

2025-06-12

Isabella Priore , Nicole Vishnevsky , Elizabeth K. Farkouh +7 more | Can J Public Health

Is Naltrexone or acamprosate more effective in decreasing alcohol intake in patients with alcohol use disorder?

2025-06-11

Arfedele Del Re , Carl V. Tyler | Evidence-Based Practice