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1.
BMC Psychiatry ; 21(1): 427, 2021 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465307

RESUMO

BACKGROUND: This study aimed to describe the prevalence and lifetime criteria profiles of DSM-5 alcohol use disorder (AUD) and the transitions from alcohol use to disorder in Chifeng, China. METHODS: Face-to-face interviews were conducted using Composite International Diagnostic Interview-3.0 (CIDI-3.0) among 4528 respondents in Chifeng. RESULTS: The weighted lifetime and 12-month prevalence of DSM-5 AUD were 3.03 and 1.05%, respectively. Mild lifetime AUD was the most prevalent severity level (69.53%). The two most common criteria were "failure to quit/cutdown" and "drinking more or for longer than intended." Lifetime prevalence was 65.59% for alcohol use, and 22.97% for regular drinking. Male and domestic violence were risk factors for the transition from alcohol use to regular drinking or AUD and from regular drinking to AUD. Younger age was risk factor for the transition to AUD from alcohol use or regular drinking. Poverty (OR = 2.49) was risk factor for the transition from alcohol use to regular drinking. The earlier drinkers were more likely to develop to regular drinking (OR = 2.11). CONCLUSION: AUD prevalence in Chifeng was not as high as that in Western countries. The study revealed that multiple risk factors might contribute to the transition across different stages of alcohol use. Further research should explore the underlying mechanisms.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Alcoolismo , Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , China/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Masculino , Prevalência , Fatores de Risco
2.
JNMA J Nepal Med Assoc ; 59(240): 787-790, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34508468

RESUMO

INTRODUCTION: Alcohol dependence syndrome is an important and major public health issue seen in our community and health center. It is mostly associated with different mental health problems and psychiatric co-morbidities. This study aims to find out the prevalence of depression among alcohol dependence syndrome in a tertiary care hospital. METHODS: A descriptive cross-sectional study was conducted over one year from April 15, 2020, to February 15, 2021 at a tertiary care hospital. The ethical approval was obtained from the Institutional Review Committee of Nobel Medical College (reference number: 409/2020). Convenience sampling method was used. The patients admitted for alcohol use and related problems in the Psychiatry Department, Nobel Medical College Teaching Hospital, Biratnagar were included. Data entry was done using Microsoft Excel and statistical analysis was done by using Statistical Packages of Social Sciences Version 16.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage. RESULTS: The prevalence of depression in patients with Alcohol Dependence Syndrome was 17 (16.3%) (95% Confidence Interval= 9.20-23.39) . The patients suffering from depressive disorder male and female were 16 (94.1%) and 1 (5.8%) respectively. The participants with Alcohol Dependence Syndrome with no other comorbid psychiatric disorders were found to be 60 (57.7%). CONCLUSIONS: Psychiatric comorbidity was found to be common in alcohol dependent people among which depression was found to be most common.


Assuntos
Alcoolismo , Alcoolismo/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Centros de Atenção Terciária
3.
Pediatr Clin North Am ; 68(5): 977-990, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34538307

RESUMO

Studies have yielded mixed findings regarding changes in adolescent substance use during the COVID-19 pandemic; some report increased alcohol and cannabis use, others show less binge drinking and vaping behaviors, and others no change. In 2019, only 8.3% of the 1.1 million adolescents with a substance use disorder received specialized treatment. Treatment rates for 2020 have not yet been published. Stay-at-home orders and social distancing guidelines put into place in March 2020 caused the partial closure of many outpatient substance use clinics. The implications of this treatment suspension and special considerations for working with adolescents during stay-at-home orders are discussed.


Assuntos
Comportamento do Adolescente/psicologia , COVID-19/psicologia , Isolamento Social/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Alcoolismo/epidemiologia , COVID-19/epidemiologia , Comportamentos Relacionados com a Saúde , Humanos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Vaping/epidemiologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-34444639

RESUMO

BACKGROUND: Naltrexone, a medication for addiction treatment (MAT), is an FDA-approved medication recommended for the treatment of alcohol use disorder (AUD). Despite the high prevalence of AUD and efficacy of naltrexone, only a small percentage of individuals with AUD receive treatment. OBJECTIVES: To identify trends for the prescription of naltrexone in AUD admissions in substance use treatment centers across the U.S. METHODS: Data from the 2000-2018 U.S. Treatment Episode Data Set: Admissions (TEDS-A) were used in temporal trend analysis of naltrexone prescription in admissions that only used alcohol. Data from the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) were also used to characterize medication use among AUD clients across different treatment service settings. RESULTS: Treatment of AUD with naltrexone was 0.49% in 2000 and tripled from 0.53% in 2015 to 1.64% in 2018 in AUD admissions (p < 0.0001 for the Cochran-Armitage trend test). Women, middle-aged adults, and admissions for clients living in the Northeast U.S. were more likely to be prescribed naltrexone than their respective counterparts, as were admissions with prior treatment episodes and referrals through alcohol/drug use care providers, who paid for treatment primarily through private insurance, used alcohol daily in the month prior to admission, and waited 1-7 days to enter treatment. Naltrexone was more commonly prescribed by AUD admissions compared to acamprosate and disulfiram and was more frequently prescribed in residential and outpatient services as opposed to hospital inpatient services. CONCLUSIONS: Naltrexone remains underutilized for AUD, and factors that influence prescription of medication are multifaceted. This study may contribute to the creation of effective interventions aimed at reducing naltrexone disparities for AUD.


Assuntos
Dissuasores de Álcool , Alcoolismo , Transtornos Relacionados ao Uso de Substâncias , Acamprosato/uso terapêutico , Adulto , Dissuasores de Álcool/uso terapêutico , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Naltrexona/uso terapêutico , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
6.
Artigo em Russo | MEDLINE | ID: mdl-34460170

RESUMO

A combination of depression and alcohol use disorder (AUD) is a typical and most common example of a dual diagnosis at the intersection of general psychiatry and addiction psychiatry. A comorbidity of depression and AUD is more common than it can be brought about by mere coincidence, which might be explained to some extent by the synergetic effect of both diseases, with each of them complicating the course and worsening the prognosis of the other. Treatment protocols for patients with depression and comorbid AUD include antidepressants, specific medications for alcohol dependence, and psychotherapy. The first-line antidepressants in the treatment of patients with a comorbid combination of depression and alcohol use disorder, as in other clinical situations implying use of antidepressants, are selective serotonin reuptake inhibitors (SSRIs). Fluvoxamine has certain advantages over the other SSRIs in the treatment of patients with a depression and comorbid AUD.


Assuntos
Alcoolismo , Alcoolismo/complicações , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Antidepressivos/uso terapêutico , Depressão/diagnóstico , Depressão/tratamento farmacológico , Depressão/epidemiologia , Fluvoxamina , Humanos , Inibidores de Captação de Serotonina/uso terapêutico
7.
Am J Public Health ; 111(9): 1610-1619, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34410817

RESUMO

Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were "more than usual" during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts.


Assuntos
COVID-19/epidemiologia , Saúde Mental/estatística & dados numéricos , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Adolescente , Adulto , Idoso , Alcoolismo/epidemiologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos , População Urbana/estatística & dados numéricos , Adulto Jovem
9.
J Affect Disord ; 293: 329-337, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34229286

RESUMO

OBJECTIVE: Depressive disorders are common among adults with alcohol use disorder and with suicidality; however, demographic differences in comorbid alcohol use disorder, binge drinking, and suicidality are understudied. The objective of this study was to determine the extent to which comorbid suicidality and alcohol use disorders and comorbid suicidality and binge drinking differ by age and gender among adults with depressive symptoms. METHOD: The sample included adults (unweighted N=29,460) in the United States who completed the 2015-2018 National Survey of Drug Use and Heath and screened positively for depression. Gender and age groups odds of alcohol use disorder only, suicidality only, and alcohol use disorder+suicidality were compared to neither problem. Similar analyses were conducted for binge drinking. RESULTS: Men showed disproportional odds of alcohol use disorder only, all suicidality and alcohol use disorder comorbidities, and binge drinking+active suicidal ideation than women. Emerging adults showed higher odds of: passive and active suicidal ideation only and suicidality+alcohol use disorder than adults 35 and older; binge drinking only, binge drinking+passive suicidal ideation, and binge drinking+active suicidal ideation than all older adults; binge drinking+suicide planning and binge drinking+attempts than adults 50 and older. LIMITATIONS: Because participants all reported depression symptoms either at the subclinical or clinical level, demographic differences in suicidality, alcohol use disorder, and binge drinking found in this study cannot be generalized to non-depressed samples. CONCLUSIONS: Treatment providers should be aware of disproportionately higher odds of comorbid suicidality and alcohol use disorder, and suicidality and binge drinking among men and emerging adults.


Assuntos
Alcoolismo , Suicídio , Idoso , Alcoolismo/epidemiologia , Comorbidade , Depressão/epidemiologia , Feminino , Humanos , Masculino , Ideação Suicida , Estados Unidos/epidemiologia
10.
J Affect Disord ; 293: 314-319, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34229284

RESUMO

BACKGROUND: Alcohol use disorder (AUD) is highly comorbid with depression and posttraumatic stress disorder (PTSD) and can complicate their treatment. Transcranial magnetic stimulation is a promising treatment for these disorders, yet prior research often excluded AUD patients out of concern for safety or poorer outcomes. To this end, we revisited a prior study of intermittent theta burst stimulation (iTBS) for PTSD, to evaluate whether mild AUD impacted safety and clinical outcomes. METHODS: Fifty veterans with PTSD (n=17, with comorbid AUD) received 10 days of sham-controlled iTBS, followed by 10 unblinded sessions. Stimulation was delivered at 80% of the motor threshold for 1800 pulses to the right dorsolateral prefrontal cortex. Safety, PTSD and depressive outcomes were evaluated with repeated measures analysis of variance, to examine the effects of time, treatment group and comorbid AUD. RESULTS: iTBS was safe, although AUD patients reported more adverse events, regardless of whether they received active or sham stimulation. Regarding clinical outcomes, patients with AUD who received active stimulation demonstrated a greater rate of improvement in depression symptoms than those without comorbid AUD. The presence of AUD did not impact PTSD symptom change. LIMITATIONS: Limitations include a modest sample size and use of a categorical, rather than continuous, index of AUD diagnosis. CONCLUSION: While these results require replication, they indicate that iTBS is likely safe in patients with mild comorbid AUD. We propose that comorbid AUD should not preclude clinical use of iTBS, and that iTBS should be further investigated as a novel treatment option for AUD.


Assuntos
Alcoolismo , Transtornos de Estresse Pós-Traumáticos , Estimulação Magnética Transcraniana , Veteranos , Alcoolismo/epidemiologia , Alcoolismo/terapia , Humanos , Córtex Pré-Frontal , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Ritmo Teta
11.
Addict Behav ; 122: 107035, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34246987

RESUMO

BACKGROUND: Substance use is a strong risk factor for suicidal behavior. To date, however, no known study has evaluated optimal cut-off scores on substance use severity measures to identify individuals who may be at elevated risk for suicide. METHODS: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4069 U.S. veterans. Receiver operating characteristic curve analyses were conducted to identify cut-off scores on the Alcohol Use Disorders Identification Test (AUDIT) and Screen of Drug Use (SDU) that optimally differentiated veterans with and without past-year suicidal ideation (SI) in the full sample, as well a high-risk subsample with histories of major depressive disorder (MDD) and/or posttraumatic stress disorder (PTSD). RESULTS: The prevalence of past-year SI was 11.7% (n = 387); A total of 10.5% (n = 360) of the sample screened positive for past-year alcohol use disorder, 9.1% (n = 314) for past-year drug use disorder, and 22.4% (n = 833) for lifetime MDD/PTSD. The optimal AUDIT cut-off score that differentiated suicide ideators and non-ideators was ≥14 in the full sample, and ≥18 in the high-risk subsample; these scores are indicative of moderate-to-severe alcohol use disorder. The optimal SDU cut-off score was ≥1 for both the full sample and high-risk subsample, which is lower than the recommend cut-off score for probable drug use disorder (≥7). CONCLUSIONS: Results identify high-specificity thresholds on the AUDIT and SDU that may have clinical utility in suicide risk assessment in veterans. Veterans with moderate-to-severe alcohol use disorder or who use non-prescription drugs may warrant further suicide risk assessment.


Assuntos
Alcoolismo , Transtorno Depressivo Maior , Transtornos de Estresse Pós-Traumáticos , Suicídio , Veteranos , Alcoolismo/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Humanos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ideação Suicida
12.
Bull World Health Organ ; 99(7): 496-505, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34248222

RESUMO

Objective: To validate a Russian-language version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT). Methods: We invited 2173 patients from 21 rural and urban primary health-care centres in nine Russian regions to participate in the study (143 declined and eight were excluded). In a standardized interview, patients who had consumed alcohol in the past 12 months provided information on their sociodemographic characteristics and completed the Russian AUDIT, the Kessler Psychological Distress Scale and the Composite International Diagnostic Interview to identify problem drinking and alcohol use disorders. We assessed the feasibility of administering the test, its internal consistency and its ability to predict hazardous drinking and alcohol use disorders in primary health care in the Russian Federation. Findings: Of the 2022 patients included in the study, 1497 were current drinkers with Russian AUDIT scores. The test was internally consistent with good psychometric properties (Cronbach's α : 0.842) and accurately predicted alcohol use disorders and other outcomes (area under the curve > 75%). A three-item short form of the test correlated well with the full instrument and had similar predictive power (area under the curve > 80%). We determined sex-specific thresholds for all outcomes, as non-specific thresholds resulted in few women being identified. Conclusion: With the validated Russian AUDIT, there is no longer a barrier to introducing screening and brief interventions into primary health care in the Russian Federation to supplement successful alcohol control policies.


Assuntos
Alcoolismo/diagnóstico , Programas de Rastreamento/métodos , Inquéritos e Questionários/normas , Consumo de Bebidas Alcoólicas/efeitos adversos , Alcoolismo/epidemiologia , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Psicometria , Reprodutibilidade dos Testes , População Rural , Federação Russa/epidemiologia , População Urbana
13.
Front Public Health ; 9: 645376, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34268284

RESUMO

Introduction: Before the pandemic, mid-life women in Australia were among the "heaviest" female alcohol consumers, giving rise to myriad preventable health risks. This paper uses an innovative model of social class within a sample of Australian women to describe changes in affective states and alcohol consumption patterns across two time points during COVID-19. Methods: Survey data were collected from Australian mid-life women (45-64 years) at two time points during COVID-19-May 2020 (N = 1,218) and July 2020 (N = 799). We used a multi-dimensional model for measuring social class across three domains-economic capital (income, property and assets), social capital (social contacts and occupational prestige of those known socially), and cultural capital (level of participation in various cultural activities). Latent class analysis allowed comparisons across social classes to changes in affective states and alcohol consumption patterns reported at the two time points using alcohol consumption patterns as measured by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and its component items. Results: Seven social classes were constructed, characterized by variations in access to capital. Affective states during COVID-19 differed according to social class. Comparing between the survey time points, feeling fearful/anxious was higher in those with high economic and cultural capital and moderate social capital ("emerging affluent"). Increased depression was most prominent in the class characterized by the highest volumes of all forms of capital ("established affluent"). The social class characterized by the least capital ("working class") reported increased prevalence of uncertainty, but less so for feeling fearful or anxious, or depressed. Women's alcohol consumption patterns changed across time during the pandemic. The "new middle" class-a group characterized by high social capital (but contacts with low prestige) and minimal economic capital-had increased AUDIT-C scores. Conclusion: Our data shows the pandemic impacted women's negative affective states, but not in uniform ways according to class. It may explain increases in alcohol consumption among women in the emerging affluent group who experienced increased feelings or fear and anxiety during the pandemic. This nuanced understanding of the vulnerabilities of sub-groups of women, in respect to negative affect and alcohol consumption can inform future pandemic policy responses designed to improve mental health and reduce the problematic use of alcohol. Designing pandemic responses segmented for specific audiences is also aided by our multi-dimensional analysis of social class, which uncovers intricate differences in affective states amongst sub-groups of mid-life women.


Assuntos
Alcoolismo , COVID-19 , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Austrália/epidemiologia , Feminino , Humanos , SARS-CoV-2 , Classe Social
14.
Artigo em Inglês | MEDLINE | ID: mdl-34206276

RESUMO

Gambling has significant costs to the community, with a health burden similar in scale to major depression. To reduce its impact, it is necessary to understand factors that may exacerbate harm from gambling. The gambling environment of late-night licensed venues and 24/7 online gambling has the potential to negatively impact sleep and increase alcohol consumption. This study explored gambling, alcohol, and sleep problems to understand whether there is a relationship between these three factors. Telephone interviews were conducted with a representative sample of Australian adults (n = 3760) combined across three waves of the National Social Survey. Participants completed screening measures for at-risk gambling, at-risk alcohol consumption, insomnia (2015 wave only), and sleep quality. There were small but significant positive correlations between problem gambling and alcohol misuse, problem gambling and insomnia, and problem gambling and poor sleep quality. A regression model showed that gambling problems and alcohol misuse were significant independent predictors of insomnia. A separate regression showed gambling problems (and not alcohol misuse) were a significant predictor of poor sleep quality, but only in one survey wave. Findings suggest that gambling, alcohol, and sleep problems are related within persons. Further research should examine the mechanisms through which this relationship exists.


Assuntos
Alcoolismo , Jogo de Azar , Distúrbios do Início e da Manutenção do Sono , Adulto , Consumo de Bebidas Alcoólicas , Alcoolismo/epidemiologia , Austrália/epidemiologia , Jogo de Azar/epidemiologia , Humanos , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Telefone
15.
Am J Cardiol ; 153: 119-124, 2021 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-34210505

RESUMO

Excessive alcohol use is a risk factor for most cardiac diseases. The prevalence of unhealthy alcohol use among hospitalized cardiac patients is uncertain as is the frequency with which it is addressed. We performed a single center, patient-level anonymous survey among hospitalized cardiac patients eligible for cardiac rehabilitation. Hazardous drinking was defined as an Alcohol Use Disorders Identification Test (AUDIT) score of 8 or greater. Binge drinking was defined as 5+ drinks for men or 4+ for women on ≥1 occasion within the past 30 days. Unhealthy drinking was defined as either hazardous or binge drinking. Of 300 patients approached, 290 (96.7%) completed the survey. Mean ( ± SD) age was 69 ± 11 years; 70% were male and 31% were cardiac surgical patients. The proportion (95% CI) of hazardous, binge, and unhealthy drinking was 12% (9 to 16), 16% (12 to 20), and 18% (14-23), respectively. Overall, 58% of subjects reported being screened for alcohol use, mostly by nurses (56%). Those with unhealthy drinking reported being counseled more frequently about their alcohol use compared to non-unhealthy drinkers (11% versus 3%, p = 0.03), but the large majority (89%) of unhealthy drinkers reported receiving no advice about their alcohol use while admitted. In conclusion, almost one-fifth of hospitalized cardiac patients reported unhealthy drinking, these patients were only screened about half of the time, and were rarely counseled about their alcohol use.


Assuntos
Alcoolismo/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Procedimentos Cirúrgicos Cardíacos , Doenças Cardiovasculares , Hospitalização , Idoso , Idoso de 80 Anos ou mais , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Reabilitação Cardíaca , Aconselhamento , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Médicos , Inquéritos e Questionários
16.
Drug Alcohol Depend ; 226: 108834, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34216857

RESUMO

BACKGROUND: Persons with severe opioid or cocaine use disorders are particularly vulnerable to morbidity and mortality. Heaviest use of mu-opioid receptor agonists and cocaine typically commences in early adulthood and is preceded by substantial adolescent exposure to cannabis and/or alcohol. Little information exists on the age trajectories of exposure to cannabis or alcohol in persons diagnosed with severe opioid or cocaine use disorders, compared to persons diagnosed with other substance use disorders (unrelated to opioids or cocaine). METHOD: This observational study had n = 854 volunteers (male = 581, female = 273; ≥18 years of age at the time of interview) and examined the ages of onset of heaviest use of cannabis and alcohol in persons diagnosed by DSM-IV criteria with opioid dependence (OD), both opioid and cocaine dependence (OD + CD) and cocaine dependence (CD). These age trajectory measures were compared to persons with other substance use disorders (primarily cannabis and alcohol use disorders, termed "Any Other Diagnoses"). RESULTS: Unadjusted survival analyses showed persons diagnosed with either OD + CD or CD had earlier onset of heaviest use of cannabis (mean ages of 16.2 and 17.8, respectively) compared to the "Any Other Diagnoses" reference group (mean age = 19.5). A multivariate logistic regression showed that later onset of heaviest use of cannabis was associated with lower odds of being in the OD + CD or CD groups, when compared to the reference group. CONCLUSIONS: Persons diagnosed with severe cocaine use disorders or dual opioid and cocaine use disorders exhibit a pattern of heavy and especially early adolescent exposure to cannabis, compared to persons with other substance use disorders.


Assuntos
Alcoolismo , Cannabis , Cocaína , Abuso de Maconha , Transtornos Relacionados ao Uso de Opioides , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Idade de Início , Alcoolismo/epidemiologia , Analgésicos Opioides , Cannabis/efeitos adversos , Humanos , Abuso de Maconha/epidemiologia , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Adulto Jovem
17.
Drug Alcohol Depend ; 226: 108876, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34225226

RESUMO

BACKGROUND: While the dual system model has been found to have utility for predicting drug use, examinations have yet to extend to the clinically relevant issue of drug/alcohol dependence. This study sought to provide better understanding of how the dual systems model constructs (impulse control and sensation-seeking) predicted risk for drug/alcohol dependence in early adulthood among a sample of young adults who were adjudicated for a serious offense as minors. METHODS: Data from several waves of the Pathways to Desistance data were used in analyses. Logistic regression was used to model covariate effects on drug/alcohol dependence risk. RESULTS: Findings indicated that lower impulse control predicted increased odds of meeting criteria for drug/alcohol dependence in early adulthood. Sensation-seeking was not a significant predictor of drug/alcohol dependence risk at follow-up. CONCLUSIONS: Lower impulse control was predictive of drug/alcohol dependence risk. Prevention programming should seek to boost impulse control during adolescence to mitigate this risk and treatment programming should focus on impulse control training in order to treat drug/alcohol dependence in inpatient and outpatient contexts.


Assuntos
Alcoolismo , Preparações Farmacêuticas , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Adulto , Alcoolismo/epidemiologia , Humanos , Sensação , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
18.
Drug Alcohol Depend ; 226: 108886, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34245997

RESUMO

BACKGROUND AND AIMS: Persons with opioid use disorder (OUD) and co-occurring alcohol use disorder (AUD) are understudied. We identified whether co-occurring AUD was associated with OUD treatment type, compared associations between treatment type and six-month treatment retention and determined whether co-occurring AUD moderated these relationships. METHODS: We used an observational cohort study design to analyze insurance claims data from 2011 to 2016 from persons aged 12-64 with an opioid abuse or opioid dependence diagnosis and OUD treatment claim. Our unit of analysis was the treatment episode; we used logistic regression for analyses. RESULTS: Of 211,047 treatment episodes analyzed, 14 % had co-occurring alcohol abuse or dependence diagnoses. Among persons with opioid dependence, persons with co-occurring alcohol dependence were 25 % less likely to receive medication treatment relative to those without AUD. Further, alcohol dependence was associated with decreased likelihood of treatment with buprenorphine (AOR 0.47, 95 % CI 0.44-0.49) or methadone (AOR 0.31, 95 % CI 0.28-0.35) and increased likelihood of treatment with extended-release (AOR 1.36, 95 % CI 1.21-1.54) or oral (AOR 1.73, 95 % CI 1.57-1.90) naltrexone relative to psychosocial treatment. Buprenorphine and methadone were associated with highest retention prevalence regardless of OUD or AUD severity. Co-occurring alcohol abuse or dependence did not meaningfully change retention prevalence associated with buprenorphine or methadone. Co-occurring AUD was not associated with improved retention among persons receiving either formulation of naltrexone. CONCLUSIONS: Buprenorphine and methadone are associated with relatively high likelihood of treatment retention among persons opioid and alcohol dependence, but are disproportionately under-prescribed.


Assuntos
Alcoolismo , Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Alcoolismo/tratamento farmacológico , Alcoolismo/epidemiologia , Analgésicos Opioides/uso terapêutico , Buprenorfina/uso terapêutico , Humanos , Metadona/uso terapêutico , Naltrexona/uso terapêutico , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia
19.
Drug Alcohol Depend ; 226: 108872, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34246918

RESUMO

BACKGROUND: Knowledge is lacking on distinct health-related risk profiles among the substantial group of middle-aged and older adults with risky alcohol use (AU). Such profiles could inform the planning of interventions and prevention. AIMS: To 1) identify distinct health-related profiles based on different types of health-related functioning limitations and distress and 2) assess associations between these profiles and age, sex, and health-relevant behaviors (e.g., smoking). METHODS: Cross-sectional nation-wide Danish health survey with n = 6630 adults aged 55-64 and n = 7605 aged 65-74 with at least risky AU (>84 g ethanol/week in women, >168 in men). Health-related risk profiles were identified with Latent Class Analysis (LCA). Multinomial regression was applied for the association between risk profiles and auxiliary variables. RESULTS: A six-class LCA solution was found among 55-64 year-olds (classes: 'Normative' [61%], 'Distress' [6%], 'Mental health limitations [5%]', 'Pain-related distress [10%]', 'Broad limitations and pain distress [7%]', 'High overall burden' [11%]) and a five-class solution among 65-74 year-olds. Most classes were comparable across age groups. The 'Distress'-class characterized by pain-distress, tiredness-distress, and sleep-related distress (6%) only showed in the younger group. In both age groups, auxiliary covariates (high-risk AU, possible alcohol use disorder, weekly smoking) were positively associated with problematic profile membership (vs. normative class membership). CONCLUSION: Middle-aged and older adults with risky AU have distinct health-related profiles relevant for the form and content of prevention and interventions. Despite their distinct features, almost all problematic health profiles warrant careful attention regarding high-risk AU and probable alcohol use disorder.


Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Estudos Transversais , Dinamarca/epidemiologia , Feminino , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade
20.
Addict Behav ; 122: 107031, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34237611

RESUMO

BACKGROUND: Alcohol use disorder (AUD) is prevalent among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veterans. Pain and posttraumatic stress disorder (PTSD) are highly comorbid and increase risk of AUD. Prior studies linking pain or PTSD to AUD have not explored interactions between pain and PTSD symptoms. METHODS: OEF/OIF/OND veterans (N = 1230) were recruited from social media websites for a cross-sectional study of health behavior. Pain was assessed using the Pain Outcomes Questionnaire. PTSD symptoms and PTSD symptom clusters were assessed using the Posttraumatic Stress Disorder Checklist for DSM-5. AUD symptoms were assessed with the AUD Identification Test. Linear regression models were used to test for main and interaction effects in the full sample and separately by sex. RESULTS: Both pain and PTSD symptoms were associated with increased AUD symptomology, though the relationship between pain and AUD was heighted at relatively low PTSD symptoms. With respect to PTSD symptom clusters, re-experiencing and negative cognitions and mood were associated with increased AUD symptomology. Interactions between pain and re-experiencing as well as pain and avoidance were revealed. Results for men mirrored the full sample, while an interaction between pain and negative cognitions and mood was associated with AUD in women. CONCLUSIONS: Results highlight associations between AUD, PTSD symptoms, and pain among veterans. While the relationship between pain and AUD appeared stronger in the context of low PTSD symptoms, both pain and PTSD symptoms were associated with increased AUD. Clinicians treating veterans with AUD should address the range of potential comorbidities.


Assuntos
Alcoolismo , Transtornos de Estresse Pós-Traumáticos , Veteranos , Campanha Afegã de 2001- , Alcoolismo/epidemiologia , Estudos Transversais , Feminino , Humanos , Guerra do Iraque 2003-2011 , Masculino , Dor , Transtornos de Estresse Pós-Traumáticos/epidemiologia
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