Earlier sexual debut as a risk factor for substance use among men who have sex with men (MSM) in Kazakhstan.

Background: Limited research have examined predictors of illicit use of drugs and binge drinking among gay, bisexual, and other men who have sex with men (MSM) in Kazakhstan and Central Asia. This study examines earlier sexual debut as a risk factor for lifetime and recent substance use behaviors among MSM in Kazakhstan. Methods: We conducted a secondary analysis of self-reported data from a NIDA-funded HIV prevention trial including 902 adult cisgender MSM in Kazakhstan who completed structured screening interviews. Logistic regression models were used to estimate associations between earlier sexual debut (ages 16 and older as the reference group) and lifetime and recent substance use, with covariance adjustment for sociodemographic characteristics. Results: The majority of MSM in our sample reported lifetime binge drinking behavior (73%) and illicit use of drugs (65%). Participants with an earlier sexual debut before 13 years old had significantly higher odds of lifetime binge drinking and any illicit use of drugs (aOR= 2.3, 95%CI: 1.2-4.5; aOR=3.0, 95%CI: 1.6-5.8). MSM who reported an earlier sexual debut between 13-15 years old had significantly higher odds of lifetime binge drinking and illicit use of any drugs (aOR=1.6, 95%CI: 1.1-2.3; aOR=1.6, 95%CI: 1.1-2.3); as well as recent binge drinking behavior (aOR=1.6, 95%CI: 1.2-2.3). Conclusion: Future research should examine pathways between earlier sexual experiences and substance use behaviors among sexually diverse populations. Earlier sexual experiences during childhood and adolescence may be relevant contextual information for interventions aimed at substance use risk prevention, treatment, and recovery among MSM populations.

Affective dynamics surrounding craving, non-heavy alcohol use and binge drinking in female patients with alcohol use disorder and controls: An experience sampling method study.

BACKGROUND AND AIMS: Studies show that higher levels of positive affect (PA) and lower levels of negative affect (NA) are related to craving and alcohol consumption at a daily level in men, but little is known on these associations at a momentary level, and whether they are present in women. This study measured the dynamics of within-person NA and PA surrounding craving, non-heavy alcohol use and binge drinking in women with alcohol use disorder (AUD) and female controls without AUD. METHODS: 53 female patients with AUD and 75 female controls, all recruited in Belgium, were included in an experience sampling study where they reported on momentary NA, PA, craving and alcohol use in daily life over a period of 12 months. Assessments occurred eight times a day on Thursdays, Fridays and Saturdays in seven bursts of three weeks. RESULTS: Within-person NA at a previous assessment (t-1) predicted craving at the current assessment (t0) in patients with AUD in a positive linear [ß = 0.043; 95% confidence interval (CI) = 0.002, 0.057; P = 0.041] and quadratic fashion (ß = 0.034; CI = 0.011, 0.057; P = 0.004). Within-person PA at t-1 predicted craving at t0 in patients with AUD with a positive quadratic relation (ß = 0.042; CI = 0.08, 0.065; P < 0.001). Within-person NA at t-1 negatively predicted non-heavy alcohol use at t0 in a linear fashion in controls (ß = -0.495; CI = -0.677, -0.312; P < 0.001) and patients with AUD (ß = -0.276; CI = -0.421, -0.132; P < 0.001). Within-person PA at t-1 significantly predicted non-heavy alcohol use at t0 with a positive linear term (ß = 0.470; CI = 0.329, 0.610; P < 0.001) in controls, but with a positive linear term (ß = 0.399; CI = 0.260, 0.454; P < 0.001) and a positive quadratic term (ß = 0.203; CI = 0.060, 0.347; P = 0.003) in patients with AUD. Within-person NA at t-1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (ß = 0.236; CI = 0.060, 0.412; P = 0.008), but not for controls. Within-person PA at t-1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (ß = 0.378; CI = 0.215, 0.542; P < 0.001), and this was also the case for controls (ß = 0.487; CI = 0.158, 0.770; P < 0.001). Non-heavy alcohol use at t0 predicted lower levels of NA at t+1 in both patients with AUD (ß = -0.161; SE = 0.044; CI = -0.248, 0.074; P = 0.001) and controls (ß = -0.114; CI = -0.198, -0.029; P = 0.010). Non-heavy alcohol use at t0 also predicted higher levels of PA at t+1 in both patients with AUD (ß = 0.181; CI = 0.088, 0.274; P < 0.001) and controls (ß = 0.189; CI = 0.101, 0.278; P < 0.001). CONCLUSIONS: The momentary relation between affect and craving or alcohol use seems to be non-linear in female patients with alcohol use disorder, whereby a worse mood predicts subsequent alcohol use, though more for binge drinking than for non-heavy alcohol use.

Associative memory in alcohol-related contexts: An fMRI study with young binge drinkers.

BACKGROUND: Alcohol-related cues are known to influence craving levels, a hallmark of alcohol misuse. Binge drinking (BD), a pattern of heavy alcohol use, has been associated with cognitive and neurofunctional alterations, including alcohol attentional bias, memory impairments, as well as disrupted activity in prefrontal- and reward-related regions. However, literature is yet to explore how memories associated with alcohol-related cues are processed by BDs, and how the recall of this information may influence their reward processing. AIMS: The present functional magnetic resonance imaging (fMRI) study aimed to investigate the neurofunctional signatures of BD during an associative memory task. METHOD: In all, 36 university students, 20 BDs and 16 alcohol abstainers, were asked to memorize neutral objects paired with either alcohol or non-alcohol-related contexts. Subsequently, neutral stimuli were presented, and participants were asked to classify them as being previously paired with alcohol- or non-alcohol-related contexts. RESULTS: While behavioral performance was similar in both groups, during the recall of alcohol-related cues, BDs showed increased brain activation in two clusters including the thalamus, globus pallidus and dorsal striatum, and cerebellum and occipital fusiform gyrus, respectively. CONCLUSION: These findings suggest that BDs display augmented brain activity in areas responsible for mental imagery and reward processing when trying to recall alcohol-related cues, which might ultimately contribute to alcohol craving, even without being directly exposed to an alcohol-related context. These results highlight the importance of considering how alcohol-related contexts may influence alcohol-seeking behavior and, consequently, the maintenance or increase in alcohol use.

Age, period and cohort effects of heavy episodic drinking by sex/gender and socioeconomic position in Canada, 2000-2021.

BACKGROUND AND AIMS: Heavy episodic drinking (HED) trends have not been comprehensively examined in Canada. We measured age, period and birth cohort trends in HED in Canada by sex/gender and socioeconomic position. DESIGN AND SETTING: We analyzed repeat cross-sectional data from the 10 provinces in the Canadian Community Health Surveys from 2000 to 2021 using hierarchical cross-classified random effects logistic regression. PARTICIPANTS: 1 167 831 respondents aged 12+ . MEASUREMENTS: HED was defined as 4+ standard drinks for women or 5+ for men at least monthly in the past 12 months. Socioeconomic position was measured using household income and education. FINDINGS: We observed steeper HED decreases in young adult men (aged 18-29) than women (by 14.4% and 8.7%, respectively, from 2015 to 2021) and HED increases in middle adult women (ages 50-64) (by 8.0% from 2000 to 2014). Sex/gender-specific age-period-cohort models revealed strong age and birth cohort effects. In women and men, respectively, HED peaked in young adulthood (18.2% and 33.8%) and decreased with age, and HED was greatest in the 1980-1989 cohort (20.7% and 35.8%) and decreased in the most recent cohort born in 1990-2009 (15.6% and 19.8%), particularly in men. Higher household incomes had greater HED across age, periods and cohorts, while trends varied by education. Compared with lower education groups, people with a bachelor's degree or above had the lowest HED in middle adulthood. People with a bachelor's degree or above had low HED in earlier cohorts, which converged with other education groups in recent cohorts due to a pronounced HED increase, particularly in women. CONCLUSION: The sex/gender gap in heavy episodic drinking (HED) appears to be converging in Canada: current young adult men are reducing HED, while high-risk cohorts of women are aging into middle adulthood with greater HED. Recent birth cohorts with a bachelor's degree or above experienced pronounced HED increases, which among women suggests greater educational attainment contributes to the converging gender gap in HED.

Alcohol habits and alcohol-related health conditions of self-defined lifetime abstainers and never binge drinkers.

BACKGROUND: Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health-related consequences has several disadvantages. The aim of the present study was to examine the consistency of self-reported lifetime abstention and never-binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol-related morbidity among lifetime abstainers was examined by linking survey data to alcohol-related morbidity data in a national patient register. METHODS: Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow-up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid-August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow-up survey in 2020. Data in both waves were collected by self-administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol-related morbidity was obtained from the Danish National Patient Register. RESULTS: In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (n = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol-related health condition. CONCLUSION: The present research reaffirms previous studies which have found self-reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non-negligible proportion of lifetime abstainers had been diagnosed with an alcohol-related health condition.

Association of physical activity and sitting time with tobacco and alcohol use in 222,495 adolescents from 66 countries.

BACKGROUND: The prevalence of tobacco and alcohol use among adolescents is alarming, and these substances are among the leading risk factors for current and future health among adolescents. Physical activity has the potential to help prevent substance use among adolescents. The objective of this study was to evaluate the association between physical activity, modes of transportation to or from school, and sitting time with tobacco and alcohol use among 222,495 adolescents. METHODS: This cross-sectional study used data from national surveys conducted in 66 countries, obtained through the Global School-based Student Health Survey, and included adolescents aged 11 to 17 years. Information on physical activity, transportation to or from school, sitting time, and tobacco and alcohol use was collected through self-report questionnaires. Generalized linear models were employed to estimate the associations between these variables. RESULTS: The analysis, adjusted for sex, age, and region, revealed that being physically active was associated with lower odds of smoking (OR: 0.86, 95%CI: 0.83-0.89), alcohol use (OR: 0.74, 95%CI: 0.72-0.76), binge drinking (OR: 0.66, 95%CI: 0.62-0.69), and drunkenness (OR: 0.85, 95%CI: 0.83-0.88) compared to inactivity. Insufficiently active participants also had lower odds of tobacco use (OR: 0.83, 95%CI: 0.80-0.85), alcohol use (OR: 0.77, 95%CI: 0.75-0.79), binge drinking (OR: 0.91, 95%CI: 0.87-0.96), and drunkenness (OR: 0.88, 95%CI: 0.85-0.90) compared to inactive participants. Additionally, active transportation to or from school was associated with lower odds of tobacco use (OR: 0.97, 95%CI: 0.95-0.99), alcohol use (OR: 0.94, 95%CI: 0.92-0.96), and binge drinking (OR: 0.78, 95%CI: 0.75-0.81) compared to those using passive transportation. Participants with acceptable sitting time, however, were more likely to use tobacco (OR: 1.48, 95%CI: 1.45-1.52), use alcohol (OR: 1.68, 95%CI: 1.64-1.72), binge drink (OR: 1.68, 95%CI: 1.62-1.75), and experience drunkenness (OR: 1.66, 95%CI: 1.62-1.69) compared to those with excessive sitting time. CONCLUSION: Being physically active, even at insufficient levels, may have beneficial effects on tobacco and alcohol use in adolescents. Acceptable sedentary time, on the other hand, was positively associated with tobacco and alcohol use.

Sex differences in neural networks recruited by frontloaded binge alcohol drinking.

Frontloading is an alcohol drinking pattern where intake is skewed towards the onset of access. This study aimed to identify brain regions involved in frontloading. Whole brain imaging was performed in 63 C57Bl/6J (32 female, 31 male) mice that underwent 8 days of binge drinking using drinking-in-the-dark (DID). On Days 1-7 mice received 20% (v/v) alcohol or water for 2 h. Intake was measured in 1-min bins using volumetric sippers. On Day 8 mice were perfused 80 min into the DID session and brains were extracted. Brains were processed to stain for Fos protein using iDISCO+. Following light sheet imaging, ClearMap2.1 was used to register brains to the Allen Brain Atlas and detect Fos+ cells. For network analyses, Day 8 drinking patterns were used to characterize mice as frontloaders or non-frontloaders using a change-point analysis. Functional correlation matrices were calculated for each group from log10 Fos values. Euclidean distances were calculated from these R values and clustering was used to determine modules (highly connected groups of brain regions). In males, alcohol access decreased modularity (three modules in both frontloaders and non-frontloaders) as compared to water (seven modules). In females, an opposite effect was observed. Alcohol access (nine modules for frontloaders) increased modularity as compared to water (five modules). Further, different brain regions served as hubs in frontloaders as compared to control groups. In conclusion, alcohol consumption led to fewer, but more densely connected, groups of brain regions in males but not females and we identify several brain-wide signatures of frontloading.

Sex-dependent effects of acute stress and alcohol exposure during adolescence on mRNA expression of brain signaling systems involved in reward and stress responses in young adult rats.

BACKGROUND: Adolescent stress and alcohol exposure increase the risk of maladaptive behaviors and mental disorders in adulthood, with distinct sex-specific differences. Understanding the mechanisms underlying these early events is crucial for developing targeted prevention and treatment strategies. METHODS: Male and female Wistar rats were exposed to acute restraint stress and intermittent alcohol during adolescence. We assessed lasting effects on plasma corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels, and mRNA expression of genes related to corticotropin releasing hormone (CRH), neuropeptide Y (NPY), corticoid, opioid, and arginine vasopressin systems in the amygdala and hypothalamus. RESULTS: The main findings are as follows: (1) blood alcohol concentrations (BAC) increased after the final alcohol administration, but stressed males had lower BAC than non-stressed males; (2) Males gained significantly more weight than females; (3) Stressed females showed higher ACTH levels than non-stressed females, with no changes in males; (4) Stress increased CORT levels in males, while stressed, alcohol-treated females had lower CORT levels than non-stressed females; (5) CRH: Females had lower Crhr1 levels in the amygdala, while alcohol reduced Crhr2 levels in males but not females. Significant interactions among sex, stress, and alcohol were found in the hypothalamus, with distinct patterns between sexes; (6) NPY: In the amygdala, stress reduced Npy and Npy1r levels in males but increased them in females. Alcohol decreased Npy2r levels in males, with varied effects in females. Similar sex-specific patterns were observed in the hypothalamus; (7) Corticoid system: Stress and alcohol had complex, sex-dependent effects on Pomc, Nr3c1, and Nr3c2 in both brain regions; (8) Opioid receptors: Stress and alcohol blunted the elevated expression of Oprm1, Oprd1, and Oprk1 in the amygdala of males and the hypothalamus of females; (8) Vasopressin: Stress and alcohol interacted significantly to affect Avp and Avpr1a expression in the amygdala, with stronger effects in females. In the hypothalamus, alcohol increased Avp levels in females. CONCLUSIONS: This study demonstrates that adolescent acute stress and alcohol exposure induce lasting, sex-specific alterations in systems involved in reward and stress responses. These findings emphasize the importance of considering sex differences in the prevention and management of HPA dysfunction and psychiatric disorders.

Alcohol Consumption and Cardiovascular Disease: A Narrative Review of Evolving Perspectives and Long-Term Implications.

Cardiovascular illnesses remain the primary cause of death, accounting for at least 17.9 million fatalities per year and posing a significant public health problem because of its extensive predominance and effect on healthcare systems. The etiology of cardiovascular disease is complex and involves several environmental and lifestyle factors. Alcohol use is a highly important determinant because of its dual-edged effect on cardiovascular health. Multiple studies indicate that moderate alcohol consumption may have certain advantages, such as slight enhancements in lipid profiles. Conversely, excessive alcohol intake is associated with serious negative consequences, including cardiomyopathy, hypertension, arrhythmias, and even mortality. The aim of this study is to provide a comprehensive analysis of the several effects of alcohol on cardiovascular health and their understanding within the medical field over time. It uses an interpretative narrative review methodology and analyzes studies that focus on genetic risk factors, gender differences, and shifts in paradigms in recent years. This article highlights the need for obtaining a thorough understanding of the effects of alcohol on cardiovascular health to support public health guidelines and clinical practice, and it underscores the significance of including alcohol consumption into the broader context of cardiovascular risk management and identifies important subjects for further study.

Nonoperative Management of a Spontaneous Perforation of Neobladder Secondary to Blackout From Solitary Binge Drinking: A Case Report and Current Literature Review.

The orthotopic ileal neobladder is becoming a popular technique of urinary diversion after radical cystectomy (RC) for localized muscle-invasive bladder cancer (MIBC), allowing patient continence, with a more desirable body image and good quality of life. Minimally invasive robot-assisted RC and neobladder have the potential to minimize physical and psychological trauma and are increasingly being adopted for patients with MIBC worldwide. Spontaneous perforation of orthotopic neobladder is uncommon;however, it represents serious complications. Solitary binge drinking can be dangerous in a patient with a neobladder because of reduced level of consciousness and overdistension of the neobladder. We report a case of spontaneous ileal neobladder perforations one year post-robotic RC secondary to blackouts from binge drinking. We also describe nonoperative active management and review the literature. A 66-year-old gentleman was brought by ambulance to our emergency department with a reduced level of consciousness, vomiting, and abdominal pain in the early hours of the morning. Collateral history revealed that he had drunk alcohol alone the night before at his home where he lives alone. Initial examination revealed tachycardia and hypotension. Immediate resuscitation using the sepsis six protocol included intravenous normal saline, blood culture, broad-spectrum antibiotic, lactate measurement, and insertion of a urethral catheter to monitor urine output. Following contrast-enhanced computed tomography (CECT) of the abdomen and pelvis, the patient was referred to a urologist. A diagnosis of spontaneous perforation of the neobladder was made. A nonoperative or 'conservative' management approach was adopted with careful active monitoring at the intensive care unit (ICU) involving a multidisciplinary team. Follow-up CT was performed to assess radiological recovery. The patient recovered successfully and was discharged home five weeks post-admission with an indwelling urethral catheter. The catheter was removed 10 weeks post-admission following a cystogram confirming the integrity of the neobladder. The patient has preserved neobladder function and continence and is doing well until the last follow-up at six months post-discharge. Patients with neobladder should be rigorously counseled about the importance of timed voiding, intermittent self-catheter, serious consequences of solitary binge drinking, and urinary retention.

Psychometric properties and Longitudinal Measurement Invariance of the Spanish version of the Alcohol Expectancies Questionnaire Short Form among young adult binge drinkers.

Background: Longitudinal Measurement Invariance (LMI) is critically important to evaluate changes in alcohol expectancies over time. However, past research has not explored the longitudinal properties of the Spanish Expectancy Questionnaire Short Form (EQ-SF).Objectives: To examine the reliability, sources of validity (structural, invariance across sex, and concurrent validity), and LMI of the Spanish EQ-SF among young adults who engage in binge drinking.Methods: Participants (n = 279; 48.4% female) completed the EQ-SF and, two months later, completed it again along with measures of alcohol use, drinking motives, and protective behavioral strategies (PBS). We performed confirmatory factor analysis for structural validity and measurement invariance analysis for longitudinal and sex stability.Results: The eight-factor intercorrelated model (i.e. social facilitation, fun, sexual disinhibition, tension reduction, antisocial effects, negative emotional states, negative physical effects, and cognitive impairments) provided the best fit (χ2(df) = 497.29(224), CFI = .962, RMSEA = .064, SRMR = .049). This model was invariant across sex and time. Reliability coefficients (Ordinal alpha) for each dimension were consistently strong at both time points (from .72 to .93 at T1 and .73 to .91 at T2). Positive alcohol expectancies at baseline were positively related to alcohol use and drinking motives and negatively related to PBS at follow-up, demonstrating predictive validity.Conclusion: Our results support the temporal invariance of the EQ-SF scores among Spanish young adults who engage in binge drinking. The evidence supports the suitability of this measure for accurately assessing changes in alcohol expectancies over time in interventions aimed at preventing binge drinking in young adults.

Chronic binge drinking-induced susceptibility to colonic inflammation is microbiome-dependent.

Alterations in intestinal permeability and the gut microbiome caused by alcohol abuse are associated with alcoholic liver disease and with worsening of inflammatory bowel diseases (IBD) symptoms. To resolve the direct effects of chronic ethanol consumption on the colon and its microbiome in the absence of acute or chronic alcohol-induced liver disease, we developed a mouse model of chronic binge drinking that uncovers how alcohol may enhance susceptibility to colitis via the microbiota. Employing daily ethanol gavage, we recapitulate key features of binge ethanol consumption. We found that binge ethanol drinking worsens intestinal infection, colonic injury and inflammation, and this effect persists beyond the drinking period. Using gnotobiotics, we showed that alcohol-driven susceptibility to colitis is microbiota-dependent and transferable to ethanol-naïve mice by microbiome transplantation. Allobaculum spp. expanded in binge drinking mice, and administration of Allobaculum fili was sufficient to enhance colitis in non-drinking mice. Our study provides a model to study binge drinking-microbiota interactions and their effects on host disease and reinforces the pathogenic function of Allobaculum spp. as colitogenic bacteria. Our findings illustrate how chronic binge drinking-induced alterations of the microbiome may affect susceptibility to IBD onset or flares.

Binge drinking and progression of white matter hyperintensities of presumed vascular origin in older men.

BACKGROUND: Information on trajectories of diffuse subcortical brain damage of vascular origin associated with binge drinking in older adults is limited. We sought to evaluate the impact of this drinking pattern on the progression of white matter hyperintensities (WMH) of presumed vascular origin in individuals aged ≥60 years taken from the community. METHODS: Following a longitudinal prospective design, participants of the Atahualpa Project Cohort received interviews to assess patterns of alcohol intake as well as baseline and follow-up brain MRIs. Only men were included because alcohol consumption in women is negligible and tend not to engage in binge drinking in our studied population. Poisson regression models were fitted to assess the incidence rate ratio of WMH progression by patterns of alcohol use (binge drinking or not), after adjusting for demographics, level of education and cardiovascular risk factors. RESULTS: The study included 114 men aged ≥60 years (mean age: 65.1±5.4 years). Thirty-seven participants (32%) reported binge drinking for more than 30 years. Follow-up MRIs revealed WMH progression in 45 participants (39%) after a median of 7.2 years. In unadjusted analysis, the risk of WMH progression among individuals with binge drinking was 2.08 (95% C.I.: 1.16-3.73). After adjustment for age, education level and vascular risk factors, participants with this drinking pattern were 2.75 times (95% C.I.: 1.42-5.30) more likely to have WMH progression than those who did not. CONCLUSIONS: Study results show an independent association between binge drinking and WMH progression in community-dwelling older men.

Perceived Risk of Binge Drinking among Older Alcohol Users: Associations with Alcohol Use Frequency, Binge Drinking, Alcohol Use Disorder, and Alcohol Treatment Use.

Despite the high prevalence of alcohol use and binge drinking among older adults, little research has been conducted on the association between their alcohol risk perception and alcohol use patterns. Using data on past-year alcohol users aged 50 and older (N = 6693) in the 2022 National Survey on Drug Use and Health, we examined the (1) associations between risk perception of binge alcohol use 1-2 times a week and alcohol use frequency, binge use frequency, and alcohol use disorder (AUD), and (2) the association between alcohol treatment use and risk perception. About 40% of past-year alcohol users perceived great risk of binge alcohol use 1-2 times a week, and 27% of past-year users had binge drinking in the past month. Multivariable analyses showed the negative association between great risk perception and alcohol use frequency (IRR = 0.60, 95%CI = 0.48-0.74 for daily use) and past-month binge alcohol use (IRR = 0.33, 95%CI = 0.19-0.57 for 6-19 days of binge use). The odds of great risk perception were also lower among those with mild AUD. Risk perception was not significantly associated with alcohol treatment. The lower likelihood of risk perception among problematic alcohol users and low treatment use is concerning. Education and interventions to reduce harm from alcohol are needed.

Prevalence and Factors Associated With Alcohol-Related Road Traffic Injuries in Cameroon.

INTRODUCTION: While the negative effects of drunk driving, including road traffic injuries (RTIs) have been well documented in high-income countries, little has been reported in African countries like Cameroon. This study aimed to measure the prevalence of alcohol-related RTIs (ARRTIs), its associated factors, and its association with injury severity. METHODS: The Cameroon Trauma Registry prospectively collects trauma data from 10 hospitals in Cameroon. This study included patients enrolled between June 2022 and May 2023 for acute RTIs. We assessed the frequency of binge drinking episodes in the past year and self-reported alcohol consumption 6 h before RTI. Bivariate analysis using chi-squared or Fisher's exact test was used to test for associations between ARRTIs and independent variables. Multivariate logistic regression was performed with variables with a P value < 0.05. RESULTS: A total of 3761 RTI cases were recorded with 77.5% (n = 2909) males and a median age of 32 y (IQR = 20 y). Prevalence of ARRTI was 9.01% (n = 338). Any self-reported binge drinking episodes (less than monthly adjusted odds ratio [AOR] = 4.97, 95% confidence interval [CI] = 3.39-7.25; monthly AOR = 5.47, 95% CI = 3.66-8.11; weekly AOR = 6.55, 95% CI = 4.63-9.27; or daily AOR = 11.15, 95% CI = 7.52-16.52) was significantly associated with ARRTI compared to none reported. Male gender, higher educational status, tobacco use, depression, and means of transportation were other associated factors. CONCLUSIONS: Almost one in 10 patients had consumed alcohol 6 h prior to RTI with odds of ARRTI significantly increasing with increased frequency in binge drinking. There is a need for evidenced-based, integrated approaches targeting sociodemographic and behavioral factors toward prevention of ARRTIs in Cameroon.

Multi-dimensional predictors of first drinking initiation and regular drinking onset in adolescence: A prospective longitudinal study.

Early adolescent drinking onset is linked to myriad negative consequences. Using the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) baseline to year 8 data, this study (1) leveraged best subsets selection and Cox Proportional Hazards regressions to identify the most robust predictors of adolescent first and regular drinking onset, and (2) examined the clinical utility of drinking onset in forecasting later binge drinking and withdrawal effects. Baseline predictors included youth psychodevelopmental characteristics, cognition, brain structure, family, peer, and neighborhood domains. Participants (N=538) were alcohol-naïve at baseline. The strongest predictors of first and regular drinking onset were positive alcohol expectancies (Hazard Ratios [HRs]=1.67-1.87), easy home alcohol access (HRs=1.62-1.67), more parental solicitation (e.g., inquiring about activities; HRs=1.72-1.76), and less parental control and knowledge (HRs=.72-.73). Robust linear regressions showed earlier first and regular drinking onset predicted earlier transition into binge and regular binge drinking (ßs=0.57-0.95). Zero-inflated Poisson regressions revealed that delayed first and regular drinking increased the likelihood (Incidence Rate Ratios [IRR]=1.62 and IRR=1.29, respectively) of never experiencing withdrawal. Findings identified behavioral and environmental factors predicting temporal paths to youthful drinking, dissociated first from regular drinking initiation, and revealed adverse sequelae of younger drinking initiation, supporting efforts to delay drinking onset.

Binge Alcohol Consumption Elevates Sympathetic Transduction to Blood Pressure: A Randomized Controlled Trial.

BACKGROUND: Alcohol consumption is associated with cardiovascular disease, and the sympathetic nervous system is a suspected mediator. The present study investigated sympathetic transduction of muscle sympathetic nerve activity to blood pressure at rest and in response to cold pressor test following evening binge alcohol or fluid control, with the hypothesis that sympathetic transduction would be elevated the morning after binge alcohol consumption. METHODS: Using a randomized, fluid-controlled (FC) crossover design, 26 healthy adults (12 male, 14 female, 25±6 years, 27±4 kg/m2) received an evening binge alcohol dose and a FC. All participants underwent next-morning autonomic-cardiovascular testing consisting of muscle sympathetic nerve activity, beat-to-beat blood pressure, and heart rate during a 10-minute rest period and a 2-minute cold pressor test. Sympathetic transduction was assessed at rest and during the cold pressor test in both experimental conditions. RESULTS: Evening alcohol increased heart rate (FC: 60±9 versus alcohol: 64±9 bpm; P=0.010) but did not alter resting mean arterial pressure (FC: 80±6 versus alcohol: 80±7 mm Hg; P=0.857) or muscle sympathetic nerve activity (FC: 18±9 versus alcohol: 20±8 bursts/min; P=0.283). Sympathetic transduction to mean arterial pressure (time×condition; P=0.003), diastolic blood pressure (time×condition; P=0.010), and total vascular conductance (time×condition; P=0.004) was augmented after alcohol at rest. Sympathetic transduction during the cold pressor test was also elevated after evening binge alcohol consumption (P=0.002). CONCLUSIONS: These findings suggest that evening binge alcohol consumption leads to augmented morning-after sympathetic transduction of muscle sympathetic nerve activity to blood pressure, highlighting a new mechanism whereby chronic or excessive alcohol consumption contributes to cardiovascular disease progression via altered end-organ responsiveness to sympathetic neural outflow. REGISTRATION: URL: https://clinicaltrials.gov/study/NCT03567434; Unique identifier: NCT03567434.

Diagnostic Usefulness of Disialotransferrin as an Indicator of Binge Drinking in Children and Adolescents.

Background/Objective: The aim of the study was to evaluate the diagnostic usefulness of changes in transferrin isoforms, especially disialo-Tf, in identifying binge drinking children and adolescents admitted to hospital emergency. Methods: The study group consisted of 122 ambulatory children and adolescents below 18 years of age and 30 healthy subjects. From the group of drinkers, those with acute alcohol intoxication (AAI) were identified (ICD-11, code F10.0). The isoforms of transferrin were separated by capillary electrophoresis into five major fractions: asialo-Tf, disialo-Tf, trisialo-Tf, tetrasialo-Tf, and pentasialo-Tf. The differences between binge drinking youth and nondrinking subjects were evaluated by Mann-Whitney U-test. Results: In the total study group and in both genders, the concentration of disialo-Tf was significantly higher in the binge drinkers compared to the nondrinking youth (p = 0.006). With respect to the gender, the level of disialo-Tf was significantly higher in binge drinking than nondrinking girls (p = 0.028) and the value of trisialo-Tf was lower in binge drinking than nondrinking boys (p = 0.011). In the AAI subgroup, the concentrations of disialo-Tf and tetrasialo-Tf were significantly higher in comparison to nondrinking subjects (p = 0.002, p = 0.039, respectively). There were no significant correlations between the BAC and the transferrin isoforms in the total group and the AAI subgroup. The disialo-Tf reached the highest diagnostic power (AUC = 0.718) in identifying binge drinkers at diagnostic specificity and sensitivity of 86.7% and 51.6%, respectively (at cut-off 0.70), in the total group and it was growing up to AUC = 0.761 with the diagnostic sensitivity of 60% in the AAI subgroup. Conclusions: The disialo-Tf might be a useful biomarker to identify binge drinking children and adolescents.

The Relationship Between Men's Sociosexuality, Drinking Intake, and Blackouts.

Background: Sociosexuality-attitudes, behaviors, and desires related to casual sex-partly predicts drinking behavior in both men and women because drinking is thought to facilitate interactions that lead to casual sex. It follows that sociosexuality would predict drinking intake (e.g., quantity consumed)-but perhaps not drinking consequences (e.g., blacking out)-on the premise that drinking large quantities with high frequency (but not to such high degrees/levels of intoxication that negative consequences occur) would facilitate casual sex. Objectives: This set of studies evaluated whether baseline measures of sociosexuality predict drinking intake (i.e., frequency, quantity, and binge drinking) but not experiencing blacking out at follow-up in two samples (Study 1, N = 172; Study 2, N = 1,038) of college-aged men. Results: As predicted, men's sociosexuality prospectively predicted drinking frequency, quantity, and binge drinking. Contrary to our predictions, men's sociosexuality also predicted blacking out. Conclusions: College men's drinking interventions should be tailored to high-risk groups and consider individual differences like sociosexuality.