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1.
MMWR Morb Mortal Wkly Rep ; 69(2): 30-34, 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31945030

RESUMO

Each year, excessive drinking accounts for one in 10 deaths among U.S. adults aged 20-64 years (1), and approximately 90% of adults who report excessive drinking* binge drink (i.e., consume five or more drinks for men or four or more drinks for women on a single occasion) (2). In 2015, 17.1% of U.S. adults aged ≥18 years reported binge drinking approximately once a week and consumed an average of seven drinks per binge drinking episode, resulting in 17.5 billion total binge drinks, or 467 total binge drinks per adult who reported binge drinking (3). CDC analyzed 2011-2017 Behavioral Risk Factor Surveillance System (BRFSS) data to assess trends in total annual binge drinks per adult who reported binge drinking in the United States overall and in the individual states. The age-adjusted† total annual number of binge drinks per adult who reported binge drinking increased significantly from 472 in 2011 to 529 in 2017. Total annual binge drinks per adult who reported binge drinking also increased significantly from 2011 to 2017 among those aged 35-44 years (26.7%, from 468 to 593) and 45-64 years (23.1%, from 428 to 527). The largest percentage increases in total binge drinks per adult who reported binge drinking during this period were observed among those without a high school diploma (45.8%) and those with household incomes <$25,000 (23.9%). Strategies recommended by the Community Preventive Services Task Force§ for reducing excessive drinking (e.g., regulating alcohol outlet density) might reduce binge drinking and related health risks.


Assuntos
Bebedeira/tendências , Adolescente , Adulto , Idoso , Sistema de Vigilância de Fator de Risco Comportamental , Bebedeira/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
2.
Alcohol Alcohol ; 54(4): 446-454, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31044220

RESUMO

AIMS: Alcohol consumption is a modifiable and plausible risk factor for age-related cognitive decline but more longitudinal studies investigating the association are needed. Our aims were to estimate associations of adult-life alcohol consumption and consumption patterns with age-related cognitive decline. METHODS: We investigated the associations of self-reported adult-life weekly alcohol consumption and weekly extreme binge drinking (≥10 units on the same occasion) with changes in test scores on an identical validated test of intelligence completed in early adulthood and late midlife in 2498 Danish men from the Lifestyle and Cognition Follow-up study 2015. Analyses were adjusted for year of birth, retest interval, baseline IQ, education and smoking. RESULTS: Men with adult-life alcohol consumption of more than 28 units/week had a larger decline in IQ scores from early adulthood to late midlife than men consuming 1-14 units/week (B29-35units/week = -3.6; P < 0.001). Likewise, a 1-year increase in weekly extreme binge drinking was associated with a 0.12-point decline in IQ scores (P < 0.001). Weekly extreme binge drinking explained more variance in IQ changes than average weekly consumption. In analyses including mutual adjustment of weekly extreme binge drinking and average weekly alcohol consumption, the estimated IQ decline associated with extreme binge drinking was largely unaffected, whereas the association with weekly alcohol consumption became non-significant. CONCLUSIONS: Adult-life heavy alcohol consumption and extreme binge drinking appear to be associated with larger cognitive decline in men. Moreover, extreme binge drinking may be more important than weekly alcohol consumption in relation to cognitive decline.


Assuntos
Envelhecimento/psicologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Bebedeira/psicologia , Bebedeira/tendências , Disfunção Cognitiva/psicologia , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Bebedeira/epidemiologia , Disfunção Cognitiva/epidemiologia , Dinamarca/epidemiologia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
3.
Alcohol Res ; 39(1): 23-30, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30557145

RESUMO

Rates of alcohol consumption continue to be a concern, particularly for individuals who are college age. Drinking patterns have changed over time, with the frequency of binge drinking (consuming four/five or more drinks for women/men) remaining high (30% to 40%). Young adults in the college age range are developmentally and socially at higher risk for drinking at binge levels. Changes in autonomy, parental control, norms, and attitudes affect binge drinking behaviors. This article reviews those changes, as well as the individual and environmental factors that increase or decrease the risk of participating in binge drinking behaviors. Risk factors include risky drinking events (e.g., 21st birthdays), other substance use, and drinking to cope, while protective factors include religious beliefs, low normative perceptions of drinking, and use of protective behavioral strategies. Additionally, this article discusses the physical, social, emotional, and cognitive consequences of consuming alcohol at binge levels. Alcohol policies and prevention and intervention techniques need to incorporate these factors to reduce experiences of alcohol-related problems. Targeting policy changes and prevention and intervention efforts toward young adults may increase effectiveness and prevent both short- and long-term consequences of binge drinking.


Assuntos
Consumo de Álcool na Faculdade , Bebedeira/epidemiologia , Bebedeira/tendências , Humanos , Estados Unidos/epidemiologia
4.
J Stud Alcohol Drugs ; 79(5): 790-798, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30422793

RESUMO

OBJECTIVE: Impulsigenic personality traits are among the many factors demonstrated to predict drinking behavior among late adolescents. The current study tested the opposite possibility, that during the emerging adulthood developmental period, problematic drinking behavior predicts increases in impulsigenic traits. This possibility is important because such traits increase risk for multiple forms of dysfunction. METHOD: Using a prospective design, we studied the personality traits and drinking behavior of 458 traditional college freshmen over one year. RESULTS: We found that drinking problems predicted increases in urgency (the tendency to act rashly when highly emotional), lack of planning (the tendency to act without forethought), and lack of perseverance (difficulty maintaining focus on a task). CONCLUSIONS: Maladaptive personality change may be one mechanism that increases risk transdiagnostically for some individuals who drink problematically during college. Increases in impulsigenic traits predictable from problem drinking put individuals at risk for not only more drinking, but a host of other negative outcomes.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/psicologia , Comportamento Impulsivo , Personalidade , Universidades , Adolescente , Adulto , Bebedeira/epidemiologia , Bebedeira/tendências , Estudos de Coortes , Feminino , Humanos , Comportamento Impulsivo/fisiologia , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Universidades/tendências , Adulto Jovem
5.
Alcohol Clin Exp Res ; 42(10): 1939-1950, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30080258

RESUMO

BACKGROUND: Recent trends in alcoholic liver disease, alcohol-related emergency room admissions, and alcohol use disorder prevalence as measured by general-population surveys have raised concerns about rising alcohol-related morbidity and mortality in the United States. In contrast, upward trends in per capita alcohol consumption have been comparatively modest. METHODS: To resolve these discordant observations, we sought to examine trends in the prevalence of alcohol use and binge drinking from 6 regularly or periodically administered national surveys using a meta-analytic approach. Annual or periodic prevalence estimates for past-12-month or past-30-day alcohol use and binge drinking were estimated for available time points between the years 2000 and 2016. Estimates were combined in a random-effects regression model in which prevalence was modeled as a log-linear function of time to obtain meta-analytic trend estimates for the full population and by sex, race, age, and educational attainment. RESULTS: Meta-analysis-derived estimates of average annual percentage increase in the prevalence of alcohol use and binge drinking were 0.30% per year (95% CI: 0.22%, 0.38%) and 0.72% per year (95% CI: 0.46%, 0.98%), respectively. There was substantial between-survey heterogeneity among trend estimates, although there was notable consistency in the degree to which trends have impacted various demographic groups. For example, most surveys found that the changes in prevalence for alcohol use and binge drinking were large and positive for ages 50 to 64 and 65 and up, and smaller, negative, or nonsignificant for ages 18 to 29. CONCLUSIONS: Significant increases in the prevalence of alcohol use and of binge drinking over the past 10 to 15 years were observed, but not for all demographic groups. However, the increase in binge drinking among middle-aged and older adults is substantial and may be driving increasing rates of alcohol-related morbidity and mortality.


Assuntos
Bebedeira/epidemiologia , Bebedeira/tendências , Inquéritos Epidemiológicos/tendências , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Bebedeira/diagnóstico , Feminino , Inquéritos Epidemiológicos/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
6.
Alcohol Clin Exp Res ; 42(9): 1815-1822, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29969149

RESUMO

BACKGROUND: Links between response inhibition and young adult problematic drinking (e.g., binge drinking) have been established, but only to an extent. Considering the presence of some inconsistent findings associated with these 2 variables, this study proposes the need to investigate the extent in which different inhibitory subcomponents are associated with binge drinking behaviors of the same sample. METHODS: Through the use of a 6-month longitudinal design, changes in Alcohol Use Questionnaire (AUQ) binge score of 163 college students (50.3% female) with a mean age of 21.06 years (SD = 1.83) were correlated with performance on 3 different inhibitory control tasks. Each task was selected to assess separate inhibitory subcomponents: Stop Signal Task (e.g., cancellation of a response), Go/No-Go Task (e.g., withholding of a response), and Simon Task (e.g., inhibiting response interference). Response inhibition was also compared between 2 groups, those who had a substantial increase in AUQ binge score during participation (inAUQ) and those who had a substantial decrease in AUQ binge score (deAUQ). RESULTS: A significant correlation was found with a change in AUQ binge score and stop signal reaction time among females only, where an increase in binge drinking score positively correlated with a reduced ability to cancel an already-initiated inhibitory response. Differences in inhibitory performance, where inAUQ performed worse than deAUQ, approached significance. CONCLUSIONS: The results suggest that the cancellation of a prepotent response, as opposed to the withholding of response or interference inhibition, is a more sensitive inhibitory measure associated with increases in binge drinking behavior among female young adult college students. Further exploration of inhibitory subcomponents relative to substance use is greatly needed (e.g., more extensive longitudinal designs and neuroimaging techniques).


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/psicologia , Bebedeira/tendências , Estudantes/psicologia , Adolescente , Adulto , Bebedeira/diagnóstico , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
7.
Alcohol Clin Exp Res ; 42(9): 1674-1683, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29894003

RESUMO

BACKGROUND: Daily drinking is an important public health concern and informative for evaluating diagnostic classification. In particular, daily binge drinkers might be considered as the prototype of some forms of alcoholism, as this drinking pattern may drive many alcohol use disorder (AUD) symptoms. However, daily drinking potentially captures a wide range of drinkers, including light-moderate daily drinkers who exhibit presumed control over their drinking behavior and might benefit from salutary effects on health. This study examined the heterogeneity of daily drinkers in detail. METHODS: Data from the 2 waves of the National Epidemiologic Survey on Alcohol and Related Conditions were used. Participants who reported drinking "every day" during the last 12 months were classified as daily drinkers. A series of regression and logistic regression analyses were conducted to investigate the association between daily drinking and various outcomes. RESULTS: Daily drinkers were found to vary considerably from each other with respect to diagnostic status, level of consumption, demographic composition, and a range of drinking and health correlates. Further, a substantial number of daily binge drinkers were not diagnosed with AUD under the DSM-IV or DSM-5, although in most groups, the DSM-5 criteria diagnosed a larger percentage of participants. CONCLUSIONS: Daily drinkers represent a highly heterogeneous group, and the correlates of daily drinking depend on the usual quantity of daily drinks and the frequency of alcohol-related problems in a given sample. Moreover, AUD, defined both according to DSM-IV and DSM-5, did not capture more than 68% of daily binge drinkers. Given that daily binge drinking is an extremely high threshold for use, this finding may present a challenge for our current classification system.


Assuntos
Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Bebedeira/diagnóstico , Bebedeira/epidemiologia , Autorrelato , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Bebedeira/tendências , Estudos Transversais/métodos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
8.
Alcohol Alcohol ; 53(5): 518-525, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-29889219

RESUMO

Aims: To determine if oral ethanol self-administration produces a conditioned place preference (CPP) and to determine if ethanol pre-exposure conditions during the juvenile/adolescent period alter the conditioned effects of ethanol and subsequent ethanol self-administration. Short summary: Modified conditioned place preference paradigm allowed rats to orally self-administer ethanol followed by short duration exposure to conditioning chambers. Ethanol produced a conditioned place aversion even though rats self-administered ethanol following the final conditioning test. Juvenile/adolescent pre-exposure to ethanol decreased the place aversion but did not produce place preference. Methods: Juvenile/adolescent rats consumed sweetened 5% ethanol in the home-cage either during continuous access or intermittent access with water restriction that promoted binge-like consumption. A control group had water access during the 4-week period. Adult rats were conditioned using a modified CPP paradigm wherein rats were water-restricted overnight before being placed in operant chambers to respond for 5% ethanol for 7 min. Following the operant session, rats were placed in the conditioning chamber for 8 min. After the conditioning post-test, rats self-administered ethanol during daily operant sessions. Results: Ethanol produced a conditioned place aversion in water access rats and the continuous access rats. Binge-like ethanol consumption induced by intermittent access with water restriction abolished the place aversion, but did not allow place preference to develop. After conditioning, continuous access rats self-administered ethanol above ~0.6 g/kg which was similar to rats with binge-like experience via intermittent access. Conclusions: Results suggest that oral ethanol self-administration elicits aversive properties in this model even though ethanol continues to maintain self-administration. Pre-exposure to ethanol during the juvenile/adolescent period may produce tolerance to ethanol's aversive properties only when consumed in a binge-like manner with water restriction. More exploration is needed to understand how behavioral history can influence sensitivity to ethanol's rewarding and aversive properties and subsequent ethanol consumption or self-administration.


Assuntos
Aprendizagem da Esquiva/efeitos dos fármacos , Bebedeira/psicologia , Etanol/administração & dosagem , Administração Oral , Fatores Etários , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Animais , Aprendizagem da Esquiva/fisiologia , Bebedeira/tendências , Masculino , Atividade Motora/efeitos dos fármacos , Atividade Motora/fisiologia , Ratos , Ratos Sprague-Dawley
9.
Alcohol Clin Exp Res ; 42(7): 1304-1314, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29757460

RESUMO

BACKGROUND: Heavy drinking among college students is a significant public health concern that can lead to profound social and health consequences, including alcohol use disorder. Behavioral economics posits that low future orientation and high valuation of alcohol (alcohol demand) combined with deficits in alternative reinforcement increase the likelihood of alcohol misuse. Despite this, no study has examined the incremental utility of all 3 variables simultaneously in a comprehensive model. METHODS: This study uses structural equation modeling to test the associations between behavioral economic variables-alcohol demand (latent), future orientation (measured with a delay discounting task and the Consideration of Future Consequences [CFC] scale), and proportionate substance-related reinforcement-and alcohol consumption and problems among 393 heavy drinking college students. Two models are tested as follows: (i) an iteration of the reinforcer pathology model that includes an interaction between future orientation and alcohol demand; and (ii) an alternative model evaluating the interconnectedness of behavioral economic variables in predicting problematic alcohol use. RESULTS: The interaction effects in Model 1 were nonsignificant. Model 2 suggests that greater alcohol demand and proportionate substance-related reinforcement are associated with greater alcohol consumption and problems. Furthermore, CFC was associated with alcohol-related problems and lower proportionate substance-related reinforcement but was not significantly associated with alcohol consumption or alcohol demand. Finally, greater proportionate substance-related reinforcement was associated with greater alcohol demand. CONCLUSIONS: Our results support the validity of the behavioral economic reinforcer pathology model as applied to young adult heavy drinking.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Bebedeira/psicologia , Bebedeira/tendências , Economia Comportamental/tendências , Modelos Psicológicos , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Universidades/tendências , Adulto Jovem
10.
Drug Alcohol Depend ; 188: 1-9, 2018 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-29709759

RESUMO

BACKGROUND: Neighborhood context plays a role in binge drinking, a behavior with major health and economic costs. Gentrification, the influx of capital and residents of higher socioeconomic status into historically-disinvested neighborhoods, is a growing trend with the potential to place urban communities under social and financial pressure. Hypothesizing that these pressures and other community changes resulting from gentrification could be tied to excessive alcohol consumption, we examined the relationship between gentrification and binge drinking in California neighborhoods. METHODS: California census tracts were categorized as non-gentrifiable, stable (gentrifiable), or gentrifying from 2006 to 2015. Outcomes and covariates were obtained from the California Health Interview Survey using combined 2013-2015 data (n = 60,196). Survey-weighted logistic regression tested for associations between gentrification and any binge drinking in the prior 12 months. Additional models tested interactions between gentrification and other variables of interest, including housing tenure, federal poverty level, race/ethnicity, sex, and duration of neighborhood residence. RESULTS: A third of respondents reported past-year binge drinking. Controlling for demographic covariates, gentrification was not associated with binge drinking in the population overall (AOR = 1.13, 95% CI = 0.95-1.34), but was associated with binge drinking among those living in the neighborhood <5 years (AOR = 1.49, 95% CI 1.15-1.93). No association was seen among those living in their neighborhood ≥5 years. CONCLUSIONS: For those newer to their neighborhood, gentrification is associated with binge drinking. Further understanding the relationship between gentrification and high-risk alcohol use is important for policy and public health interventions mitigating the impact of this process.


Assuntos
Bebedeira/epidemiologia , Bebedeira/tendências , Inquéritos Epidemiológicos/tendências , Características de Residência , Mudança Social , Adolescente , Adulto , Idoso , Bebedeira/economia , California/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Classe Social , Fatores de Tempo , Adulto Jovem
11.
Drug Alcohol Rev ; 37 Suppl 1: S76-S84, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29573000

RESUMO

INTRODUCTION AND AIMS: As alcohol use has decreased among Finnish adolescents, we aim to assess: (i) time trends in alcohol use, heavy episodic drinking (HED) and potential explanatory variables among adolescents; (ii) the relationship between trends of explanatory variables and trends in alcohol use and HED; and (iii) which of the explanatory variables can account for the temporal change in alcohol use and HED. DESIGN AND METHODS: The analyses are based on European School Survey Project on Alcohol and Other Drugs data collected from 15- to 16-year-old Finnish adolescents in 1999, 2003, 2007, 2011 and 2015. RESULTS: The decline in alcohol use and HED among underage youth in Finland is associated with at least three factors: (i) obtaining alcohol has become more difficult; (ii) parents know better than before where their children spend their Friday nights; and (iii) the risk attached to going out with friends on drinking has decreased. DISCUSSION AND CONCLUSIONS: Formal policy measures and adults' attitudes have probably affected the availability of alcohol for adolescents, and thus they partly explain the decline in youth drinking. This decline coincides with the introduction of new digital technologies, new forms of interaction within families and peer groups, and more conscientious teenagers. All these changes are not necessarily causes of the decline but are part of a similar broader change in adolescents' lives.


Assuntos
Comportamento do Adolescente/psicologia , Abstinência de Álcool/tendências , Bebedeira/tendências , Grupo Associado , Consumo de Álcool por Menores/tendências , Adolescente , Abstinência de Álcool/psicologia , Bebedeira/psicologia , Feminino , Finlândia , Amigos/psicologia , Inquéritos Epidemiológicos , Humanos , Masculino , Poder Familiar/psicologia , Instituições Acadêmicas , Consumo de Álcool por Menores/psicologia
12.
Addiction ; 113(7): 1317-1332, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29484751

RESUMO

AIMS: To estimate temporal trends in adolescents' current cigarette, alcohol and cannabis use in Europe by gender and region, test for regional differences and evaluate regional convergence. DESIGN AND SETTING: Five waves of the European School Survey Project on Alcohol and Other Drugs (ESPAD) from 28 countries between 1999 and 2015. Countries were grouped into five regions [northern (NE), southern (SE), western (WE), eastern Europe (EE) and the Balkans (BK)]. PARTICIPANTS: A total of 223 814 male and 211 712 female 15-16-year-old students. MEASUREMENTS: Daily cigarette use, weekly alcohol use, monthly heavy episodic drinking (HED) and monthly cannabis use. Linear and quadratic trends were tested using multi-level mixed-effects logistic regression; regional differences were tested using pairwise Wald tests; mean absolute differences (MD) of predicted prevalence were used for evaluating conversion. FINDINGS: Daily cigarette use among boys in EE showed a declining curvilinear trend, whereas in all other regions a declining linear trend was found. With the exception of BK, trends of weekly drinking decreased curvilinear in both genders in all regions. Among girls, trends in WE, EE and BK differed from trends in NE and SE. Monthly HED showed increasing curvilinear trends in all regions except in NE (both genders), WE and EE (boys each). In both genders, the trend in EE differed from the trend in SE. Trends of cannabis use increased in both genders in SE and BK; differences were found between the curvilinear trends in EE and BK. MD by substance and gender were generally somewhat stable over time. CONCLUSIONS: Despite regional differences in prevalence of substance use among European adolescents from 1999 to 2015, trends showed remarkable similarities, with strong decreasing trends in cigarette use and moderate decreasing trends in alcohol use. Trends of cannabis use only increased in southern Europe and the Balkans. Trends across all substance use indicators suggest no regional convergence.


Assuntos
Comportamento do Adolescente , Bebedeira/tendências , Fumar Cigarros/tendências , Uso da Maconha/tendências , Consumo de Álcool por Menores/tendências , Adolescente , Península Balcânica/epidemiologia , Bebedeira/epidemiologia , Fumar Cigarros/epidemiologia , Europa (Continente)/epidemiologia , Europa Oriental/epidemiologia , Feminino , Humanos , Masculino , Uso da Maconha/epidemiologia , Consumo de Álcool por Menores/estatística & dados numéricos
13.
Alcohol Clin Exp Res ; 42(1): 135-143, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29087584

RESUMO

BACKGROUND: There is evidence of racial/ethnic differences in the age at which young adults age out of heavy drinking. Some studies have found Black and Hispanic drinkers engage in more frequent heavy drinking than White people beyond adulthood. Yet, the alcohol-related disparities literature has produced contradictory findings on whether an age-crossover effect is evident among racial/ethnic groups; that is, whether racial/ethnic minorities' drinking levels or trajectories are lower than White people at young ages but later exceed (or crossover) those of White people. This study extends this scant literature by assessing whether racial/ethnic differences in heavy drinking have changed over time (possibly accounting for mixed findings from prior research); and tests for an age-crossover effect in heavy drinking using longitudinal data from 2 cohorts born 20 years apart. METHODS: Data are from the 1979 (n = 10,963) and 1997 (n = 8,852) cohorts of the National Longitudinal Survey of Youth (NLSY). Generalized estimating equations were used to model trajectories of heavy drinking frequency from ages 17 to 31. Racial/ethnic differences were determined using sex-stratified models and 3-way interactions of race/ethnicity with age, age-squared, and cohort. RESULTS: Racial/ethnic differences in heavy drinking trajectories have changed over time in men and women. In the older NLSY cohort, Hispanic men and Black women surpassed White men's and women's heavy drinking frequency by age 31. This crossover was absent in the younger cohort, where trajectories of all racial-sex groups converged by age 31. Normative trajectories have changed in Hispanics and White people of both sexes, with a delay in age of peak frequency, and greater levels of heavy drinking in the younger cohort of women. CONCLUSIONS: Changes in heavy drinking trajectories over time suggest the need for targeted interventions during young adulthood. While disparities in young adult heavy drinking were no longer apparent in the more recent birth cohort, continued monitoring is important.


Assuntos
Bebedeira/etnologia , Bebedeira/tendências , Grupos de Populações Continentais/etnologia , Grupos Étnicos , Disparidades nos Níveis de Saúde , Adolescente , Adulto , Bebedeira/psicologia , Estudos de Coortes , Grupos de Populações Continentais/psicologia , Grupos Étnicos/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
J Subst Abuse Treat ; 83: 15-26, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29129192

RESUMO

AIMS: Co-occurrence of drug and alcohol use among people living with HIV is linked to poor medication adherence and lack of viral suppression. HealthCall, a technological enhancement of brief Motivational Interviewing (MI), involves brief daily self-monitoring, positive reinforcement, and personalized feedback. This randomized pilot study among people living with HIV investigated the feasibility and efficacy of reducing non-injection drug and alcohol use with MI+HealthCall as adapted for smartphone technology. DESIGN: An urban, largely-minority community sample of adults living with HIV were screened for eligibility: last 30 day use of non-injection drugs (≥4days of crack/cocaine, methamphetamine, or heroin use) and binge drinking (≥1day of 4+ standard drinks). Those eligible were randomized to one of two groups: MI-only (n=21) and MI+HealthCall-S (n=21). Trained counselors delivered the brief MI at baseline. Drug and alcohol use assessments were completed at baseline, 30 and 60days (end of treatment). Primary outcomes derived from a Timeline Follow Back (TLFB) of the past 30 days included (1) total number of days used primary drug (NumDU) (2) total quantity of primary drug used (dollar amount spent per day; QuantU), (3) total number of drinking days (NumDD) and (4) mean number of drinks per day (QuantDD). Feasibility was determined by HealthCall use rates, patient satisfaction questionnaire (1-5 scale, 5 being best), and retention. FINDINGS: The median daily use rate for HealthCall was 95%, patient satisfaction was excellent (4.5) and retention was high (93%). Both treatment groups reduced drug and alcohol use by end of treatment, with MI+Healthcall-S showing significantly greater reductions than MI-only in QuantU (p=0.01) and NumDU (p=0.046). P-values for reductions in alcohol quantity and frequency in the MI+Healthcall group were 0.09-0.11. CONCLUSIONS: This proof-of-concept randomized trial indicates that HealthCall on the smartphone is a highly feasible intervention in urban, minority individuals with HIV, and suggests efficacy in reducing co-occurring drug and alcohol use. Results suggest opportunities for brief behavioral intervention that may be enhanced through interactive mobile technology to address complex alcohol and drug use patterns that interfere with HIV care, medication adherence and ultimately, viral suppression. A larger randomized trial is warranted to replicate and extend present results.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/terapia , Bebedeira/terapia , Transtornos Relacionados ao Uso de Cocaína/terapia , Infecções por HIV , Dependência de Heroína/terapia , Aplicativos Móveis , Entrevista Motivacional/métodos , Satisfação do Paciente , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Bebedeira/epidemiologia , Bebedeira/tendências , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Comorbidade , Feminino , Infecções por HIV/epidemiologia , Dependência de Heroína/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pobreza , Smartphone , População Urbana
15.
Alcohol Clin Exp Res ; 41(10): 1754-1759, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28800154

RESUMO

BACKGROUND: Heavy episodic drinking (HED) or consuming 4+/5+ drinks in 1 occasion for women/men is linked consistently with alcohol-related harms. Recent research suggests that many individuals drink at levels more than twice this cutoff (8+/10+ drinks), commonly referred to as "high-intensity drinking." Prevalence rates of high-intensity drinking and its dynamic association with alcohol use disorder (AUD) across all ages, however, remain unknown. The current study used data from a nationally representative sample to document age-varying prevalence rates of HED-only drinking and high-intensity drinking, prevalence rates of AUD for HED-only drinkers and high-intensity drinkers, and relative odds of experiencing an AUD for high-intensity drinkers as compared to HED-only drinkers. METHODS: Data were from the National Epidemiologic Survey on Alcohol and Related Conditions-III. The final analytic sample consisted of past-year drinkers aged 18 to 64 years (n = 22,776). RESULTS: Time-varying effect modeling revealed that high-intensity drinking and HED-only drinking were equally prevalent during young adulthood and prevalence rates of both types of drinking generally became less common with increasing age. At all ages, high-intensity drinkers were at 3 or more times greater odds of meeting criteria for an AUD than HED-only drinkers. The association between high-intensity relative to HED-only drinking was strongest earlier in adulthood with approximately 83% of 18-year-old high-intensity drinkers having AUD relative to 42% of HED-only drinkers. CONCLUSIONS: Future research aiming to identify drinkers most at risk of harms and in need of treatment may benefit from assessing the extent to which an individual exceeds the 8+/10+ threshold of drinking.


Assuntos
Intoxicação Alcoólica/diagnóstico , Intoxicação Alcoólica/epidemiologia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Bebedeira/diagnóstico , Bebedeira/epidemiologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/tendências , Bebedeira/tendências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
16.
Alcohol Clin Exp Res ; 41(7): 1319-1328, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28571107

RESUMO

BACKGROUND: This study examined changes during the past decade, from 2005 to 2015, in binge and high-intensity drinking in 7 separate age groups of U.S. 12th graders and young adults. METHODS: National longitudinal data (N = 6,711) from Monitoring the Future were used to examine trends in consuming 5+, 10+, and 15+ drinks on the same occasion in the past 2 weeks from ages 18 to 29/30 overall and by gender. Results were compared with trends in past 12-month and 30-day alcohol use for the same age groups. RESULTS: Between 2005 and 2015, binge (5+) and high-intensity drinking (10+, 15+) generally decreased for individuals in their early 20s, remained somewhat stable for individuals in their mid-20s, and increased for individuals at the end of young adulthood (age 29/30). The observed historical trends in binge and high-intensity drinking were similar to those for past 12-month and past 30-day alcohol use for those aged 18 to 20, but diverged for most other age groups in young adulthood. Trends were generally similar for men and women, except that the increase in prevalence began earlier in young adulthood for women than for men. CONCLUSIONS: Binge and high-intensity drinking among U.S. 12th graders and young adults are dynamic phenomena. Prevention and intervention efforts aimed at reducing the harms resulting from 5+, 10+, and 15+ drinking should acknowledge and focus on differences in trends in these behaviors by age and gender.


Assuntos
Bebedeira/tendências , Consumo de Álcool por Menores/tendências , Adolescente , Adulto , Fatores Etários , Bebedeira/epidemiologia , Feminino , Humanos , Masculino , Prevalência , Fatores Sexuais , Consumo de Álcool por Menores/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
17.
Alcohol Clin Exp Res ; 41(6): 1129-1136, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28423479

RESUMO

BACKGROUND: Among general population studies, lower rates of binge drinking tend to be found among African Americans and Hispanics compared to Whites. However, among older adult populations, minority groups have been shown to be at higher risk for binge drinking, suggesting the presence of a crossover effect from low to high risk as a function of age. To date, limited research has examined the crossover effect among African American and Hispanic populations compared to non-Hispanic Whites across large developmental time frames or explored variation in risk based on income or gender. This study aimed to fill these gaps in the literature. METHODS: Data were compiled from the 2010 to 2013 National Survey on Drug Use and Health surveys, which provide annual, nationally representative data on substance use behaviors among individuals aged 12 and older. Hispanic, non-Hispanic African American, and non-Hispanic White respondents were included (N = 205,198) in the analyses. RESULTS: A crossover effect was found for African American males and females among the lowest income level (i.e., incomes less than $20,000). Specifically, after controlling for education and marital status, compared to Whites, risk for binge drinking was lower for African American males at ages 18 to 24 and for females at ages 18 to 34, but higher for both African American males and females at ages 50 to 64. No crossover effect was found for Hispanic respondents. CONCLUSIONS: Although African Americans are generally at lower risk for binge drinking, risk appears to increase disproportionately with age among those who are impoverished. Explanatory factors, such as social determinants of health prevalent within low-income African American communities (e.g., lower education, violence exposure, housing insecurity) and potential areas for intervention programming are discussed.


Assuntos
Afro-Americanos/psicologia , Bebedeira/tendências , Inquéritos Epidemiológicos/tendências , Hispano-Americanos/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Bebedeira/economia , Bebedeira/epidemiologia , Estudos Cross-Over , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/economia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
18.
Alcohol Clin Exp Res ; 41(3): 541-550, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28195335

RESUMO

BACKGROUND: The still maturing adolescent brain may be particularly vulnerable to lasting consequences of ethanol (EtOH) exposure. Yet, human adolescents are the age group most likely to engage in binge drinking (a pattern of drinking leading to blood EtOH concentrations (BECs) of 80 mg/dl or greater). Most studies to date assessing the long-term effects of adolescent EtOH exposure in outbred rodent populations have either used experimenter-administered EtOH to produce BECs in the binge range or assessed voluntary intake of EtOH at well below binge levels. Beginning with a modified schedule-induced polydipsia (SIP) procedure, this study examined the suitability of several approaches to induce voluntary binge-like consumption during adolescence in an outbred rat strain. METHODS: Adolescent male and female Sprague Dawley rats were food deprived to 85% projected free-feeding weights beginning on postnatal day (P) 24 and were given 30 minutes of access to 10% EtOH in chocolate Boost® or Boost® alone daily from P28 to P41 (followed later by their daily allocation of food). Animals were tested within operant chambers (Exp. 1a, 1b and Exp. 2) or home and novel cages (Exp. 3). Animals received either scheduled delivery of banana pellets to examine SIP (Exp. 1a,b) or massed pellet presentation (Exp. 2 and Exp. 3). Blood samples were collected via the lateral tail vein on P33 and P41. RESULTS: Intakes produced BECs frequently in the binge range (>80 mg/dl) and modeled binge-like consumption patterns, with high consumption days typically followed by 1 to 2 days of lower consumption; this variability was less evident with Boost® alone. Consumption was not schedule induced and was generally high across all studies, although consumption in males appeared to be particularly pronounced when animals were tested in the presence of their cage mate. CONCLUSIONS: Binge-like patterns of EtOH consumption were produced using these procedures in adolescent Sprague Dawley rats of both sexes and may prove to be a useful model for work examining the short- and long-term consequences of high levels of voluntary EtOH intake in adolescence.


Assuntos
Bebedeira/sangue , Bebedeira/tendências , Chocolate , Etanol/administração & dosagem , Etanol/sangue , Edulcorantes/administração & dosagem , Fatores Etários , Consumo de Bebidas Alcoólicas/sangue , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/tendências , Animais , Bebedeira/psicologia , Feminino , Masculino , Ratos , Ratos Sprague-Dawley
19.
Alcohol Alcohol ; 52(3): 358-364, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28052857

RESUMO

Aims: Alcohol consumption among Swedish youth increased during the 1990s. In the following decade, levels declined coinciding with a reduction in the prevalence of self-reported alcohol-related harm. We examine how the trend in self-reported alcohol-related problems among young Swedish alcohol consumers has followed the trend in alcohol consumption during 1995-2012, and test whether the strength of the association between self-reported alcohol consumption and alcohol-related problems within individuals is inversely proportional to the overall level of consumption among youth. Methods: The study was based on a representative survey on alcohol and drug habits among ninth-year students, consisting of current alcohol consumers (n = 68 863), 1995-2012. Negative binominal regression models were used to estimate the relationship between three consumption variables (average volume of consumption, binge drinking and heavy drinking) and self-reported alcohol-related problems. Results: The prevalence of binge drinking showed a greater association with self-reported alcohol-related problems than did overall mean consumption. No noticeable variation in the strength of the individual-level alcohol and harm relationship was found over the study period. We found no significant interaction between the individual alcohol use measures and overall mean youth consumption. Conclusion: We found no signs of normalization; on the contrary, young alcohol consumers suffer about the same number of self-reported negative consequences from their drinking, regardless of the level of overall youth consumption. The study also suggests that binge drinking rather than overall consumption is the main factor that influences the development of self-reported problems experienced among young alcohol consumers. Short summary: Young alcohol consumers suffer about the same number of self-reported negative consequences from their drinking, regardless of the level of overall mean consumption in the youth population. Binge drinking consumption appears to be the main factor influencing the development of self-reported alcohol-related problems among young alcohol consumers.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Bebedeira/epidemiologia , Bebedeira/psicologia , Assunção de Riscos , Autorrelato , Adolescente , Consumo de Bebidas Alcoólicas/tendências , Bebedeira/tendências , Feminino , Humanos , Masculino , Inquéritos e Questionários , Suécia/epidemiologia
20.
Drug Alcohol Depend ; 171: 91-96, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-28038361

RESUMO

BACKGROUND: To examine whether a clinically meaningful alcohol consumption cutoff can be created for clinical samples, we used receiver operator characteristic (ROC) curves to derive gender-specific consumption cutoffs that maximized sensitivity and specificity in the prediction of a wide range of negative consequences from drinking. METHODS: We conducted secondary data analyses using data from two large clinical trials targeting alcohol use disorders: Project MATCH (n=1726) and COMBINE (n=1383). RESULTS: In both studies, we found that the ideal cutoff for men and women that maximized sensitivity/specificity varied substantially both across different alcohol consumption variables and alcohol consequence outcomes. Further, the levels of sensitivity/specificity were poor across all consequences. CONCLUSIONS: These results fail to provide support for a clinically meaningful alcohol consumption cutoff and suggest that binary classification of levels of alcohol consumption is a poor proxy for maximizing sensitivity/specificity in the prediction of negative consequences from drinking. Future research examining consumption-consequence associations should take advantage of continuous measures of alcohol consumption and alternative approaches for assessing the link between levels of consumption and consequences (e.g., ecological momentary assessment). Clinical researchers should consider focusing more directly on the consequences they aim to reduce instead of relying on consumption as a proxy for more clinically meaningful outcomes.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Bebedeira/classificação , Bebedeira/epidemiologia , Determinação de Ponto Final/classificação , Adulto , Consumo de Bebidas Alcoólicas/tendências , Transtornos Relacionados ao Uso de Álcool/classificação , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Bebedeira/tendências , Determinação de Ponto Final/métodos , Etanol , Feminino , Humanos , Masculino , Curva ROC
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