Women's use of alcohol: Neurobiobehavioral concomitants and consequences.

In this narrative review, we draw from historical and contemporary literature to explore the impact of alcohol consumption on brain and behavior among women. We examine three domains: 1) the impact of alcohol use disorder (AUD) on neurobiobehavioral outcomes, 2) its impact on social cognition/emotion processing, and 3) alcohol's acute effects in older women. There is compelling evidence of alcohol-related compromise in neuropsychological function, neural activation, and brain structure. Investigations of social cognition and alcohol effects in older women represent emerging areas of study. Initial analyses suggest that women with AUD show significant deficits in emotion processing, a finding also observed in older women who have consumed a moderate dose of alcohol. Critically, despite the long-recognized need for programmatic interrogation of alcohol's effect in women, studies with sufficient numbers of women for meaningful analysis represent a small proportion of the literature, constraining interpretation and generalization.

Barriers to fire spread in northern Australian tropical savannas, deriving fire edge metrics from long term high-frequency fire histories.

The savannas of northern Australia are amongst the most fire-prone landscapes in the world. However, over the last fifteen years, increasing effort has been put into reducing fire extent and severity using prescribed burning strategies early in the dry season. This study seeks to improve the application of strategic fire management by providing a more detailed understanding of the landscape features that impede fire spread in Australia's tropical savannas using long-term satellite-derived fire histories. Spatial analysis of fire edges in Kakadu National Park based on fine-scale (30 m) Landsat imagery found that most fires stopped along linear edges, which were primarily associated with known features (roads, rivers and cliffs). Further analysis found linear features with the highest stopping ability covered only 13% of the park but divided the whole park into smaller containment regions. The stopping power of each feature type was found to vary according to their width and to change during the fire season, results that could help plan strategic fuel reduction burns. Similar results were seen with the lower-resolution continental-scale MODIS satellite-derived edge data. The MODIS dataset provided a means for applying fire edge analysis to support planning in areas of northern Australia that lack fine scale fire history mapping.

Transforming fire management in northern Australia through successful implementation of savanna burning emissions reductions projects.

Savannas are the most fire-prone of Earth's biomes and currently account for most global burned area and associated carbon emissions. In Australia, over recent decades substantial development of savanna burning emissions accounting methods has been undertaken to incentivise more conservative savanna fire management and reduce the extent and severity of late dry season wildfires. Since inception of Australia's formal regulated savanna burning market in 2012, today 25% of the 1.2M km2 fire-prone northern savanna region is managed under such arrangements. Although savanna burning projects generate significant emissions reductions and associated financial benefits especially for Indigenous landowners, various biodiversity conservation considerations, including fine-scale management requirements for conservation of fire-vulnerable taxa, remain contentious. For the entire savanna burning region, here we compare outcomes achieved at 'with-project' vs 'non-project' sites over the period 2000-19, with respect to explicit ecologically defined fire regime metrics, and assembled fire history and spatial mapping coverages. We find that there has been little significant fire regime change at non-project sites, whereas, at with-project sites under all land uses, from 2013 there has been significant reduction in late season wildfire, increase in prescribed early season mitigation burning and patchiness metrics, and seasonally variable changes in extent of unburnt (>2, >5 years) habitat. Despite these achievements, it is acknowledged that savanna burning projects do not provide a fire management panacea for a variety of key regional conservation, production, and cultural management issues. Rather, savanna burning projects can provide an effective operational funded framework to assist with delivering various landscape-scale management objectives. With these caveats in mind, significant potential exists for implementing incentivised fire management approaches in other fire-prone international savanna settings.

Neurophysiological and Interpersonal Correlates of Emotional Face Processing in Alcohol Use Disorder.

BACKGROUND: A growing literature suggests deficient emotional facial expression (EFE) processing among recently abstinent individuals with alcohol use disorders (AUDs). Further investigation is needed to clarify valence-related discrepancies and elucidate neural and psychosocial correlates. We examined neurobehavioral indices of EFE processing and interpersonal problems in treatment seekers with AUDs and healthy community controls (CCs). METHODS: Thirty-four individuals with AUDs and 39 CCs completed an emotion judgment task (EJT), requiring discrimination between happy, angry, and sad EFEs. A second task requiring discrimination of male and female faces with neutral expressions served as the control task (i.e., sex judgment task, SJT). Neurophysiological (i.e., N170 and P3) and behavioral measures were analyzed using generalized linear mixed models (GLMM). Interpersonal problems were assessed with the Inventory of Interpersonal Problems-64 (IIP-64). The relationship of IIP-64 and EJT performance was investigated via within-group correlations. RESULTS: Analysis of the SJT revealed no group differences in behavioral measures, N170 amplitude, or P3 latency. P3 amplitudes, however, were significantly lower in the AUD group. For the EJT, initial observations of group differences in P3 amplitude were accounted for by differences in the control task. Behavioral analyses indicated that the AUD group was significantly less accurate than the CC group. Hypothesis-driven analyses using GLMM-estimated group differences indicated that anger processing was affected to a greater degree than were other emotions. Significant EJT/IIP-64 correlations were observed for anger processing within the AUD group and were confined to IIP-64 subscales with relatively high ratings on the affiliation dimension. CONCLUSIONS: Findings provide partial support for an emotion-specific processing deficit in persons with AUDs. Anger processing was more robustly affected than other emotions and was associated with interpersonal problems characterized by being overly needy, nonassertive, and overly accommodating. Results extend prior reports and reinforce the need for comprehensive study of emotion processing and its real-world implications.

Emotional Face Processing among Treatment-Seeking Individuals with Alcohol Use Disorders: Investigating Sex Differences and Relationships with Interpersonal Functioning.

BACKGROUND: Individuals in treatment for alcohol use disorder (AUD) display deficits across a broad range of cognitive processes. Disruptions in affective processing are understudied, but may be particularly important for interpersonal functioning and post-treatment adaptation. In particular, the role of sex in AUD-associated emotion processing deficits remains largely unaddressed and was a focus of the current investigation. METHODS: Fifty-six treatment seekers with AUD and 54 healthy community controls (N = 110) were administered an emotional face discrimination task. Non-affective tasks included a sex-discrimination task and two brief measures of executive functioning. Two measures of interpersonal function were included. RESULTS: Emotion processing deficits were evident among women with AUD relative to other groups. This sex-contingent relationship was not observed in measures of executive function, sex-discrimination or interpersonal problems, although individuals with AUD performed more poorly on these measures. CONCLUSIONS: Results were consistent with extant literatures examining cognitive, affective and interpersonal functioning among individuals with AUD, and provided novel evidence of vulnerability to alcohol-associated deficits in emotion processing among women. While similar sex-contingent effects were not apparent among other measures, results support modest interrelationships, specifically including the import of emotion processing to interpersonal functioning in AUD. These data offer guidance for further systematic investigation and highlight important considerations for future relapse-prevention and recovery-facilitation efforts.

Race and socioeconomic status in substance use progression and treatment entry.

This study examined trajectories of progression from early substance use to treatment entry as a function of race, among inpatient treatment seekers (N = 945). Following primary race-contingent analyses of use progression, secondary analyses were conducted to investigate the effects of socioeconomic status (SES) on the observed differences. African Americans reported significant delays in treatment entry relative to Caucasians. Racial differences in alcohol, marijuana, and cocaine use trajectories were observed. Accounting for SES rendered observations of accelerated use among African Americans nonsignificant. However, inclusion of SES failed to mitigate the marked racial disparity in treatment entry.

Characterizing Anxiety Among Individuals Receiving Treatment for Alcohol and Substance Use Disorders.

BACKGROUND: Despite high prevalence of generalized anxiety disorder (GAD) substance use disorder (SUD) comorbidity, little is known regarding demographic characteristics associated with GAD in SUD treatment seekers. OBJECTIVE: To characterize demographic differences between inpatient SUD treatment seekers reporting varying levels of GAD symptomatology. DESIGN: General linear models, chi-square test, t test, and correlational analyses were utilized to assess group differences. Groups included those with no history of significant anxiety (No GAD; n = 256), subclinical anxiety (Subclinical; n = 85), and those meeting GAD diagnostic criteria (GAD; n = 61). RESULTS: The No GAD group differed substantially from Subclinical and GAD individuals. With the exception of polysubstance use, no differences were found regarding Subclinical and GAD groups. CONCLUSION: Individuals with subclinical GAD symptoms and those meeting diagnostic criteria were nearly identical regarding precursors to problematic substance use, severity of use, and key mental health indicators. Findings suggest subclinical levels of GAD should not be overlooked when assessing and treating SUDs.

Opioid Misuse Trends in Treatment Seeking Populations: Revised Prescription Opioid Policy and Temporally Corresponding Changes.

BACKGROUND: Over the last two decades, U.S. rates of prescription opioid (PO) misuse have risen drastically. In response, federal and state governments have begun to implement new PO policies. Recent legislative changes warrant up-to-date assessments of today's misuse rates. OBJECTIVE: To explore potential changes in opioid misuse trends among substance-using treatment seekers, in temporal relation to legislative response. METHODS: Substance-use data were collected from two cross-sectional Florida-based inpatient cohorts during periods preceding (pre-policy; n = 647) and following (post-policy; n = 396) statewide PO policy initiatives. Participants provided information concerning their most frequently used drugs before treatment. PO and illicit opioid (IO) use prevalence, frequency and route of administration were examined for pre-policy vs. post-policy cohort differences. RESULTS: Relative to the pre-policy cohort, a greater percentage of the post-policy cohort reported recent misuse, daily use, and intravenous administration of POs. IO use was also more frequently reported post-policy. Non-opioid drug use prevalence did not significantly differ between cohorts. Among the opioid-using subsample, equivalent percentages of the pre- and post-policy cohorts reported the use of POs without IOs, IOs without POs, and POs/IOs concurrently. Conclusions/Importance: Florida's PO policy amendments were temporally accompanied by a higher prevalence of PO misuse and IO use among treatment-seekers assessed in this study. Whether our data reflect increased awareness of and treatment seeking for opioid use disorders or insufficient efficacy of new policies to reduce opioid misuse remains in question. Regardless, findings suggest the need for enhanced emphasis on mitigating hazardous PO-use behaviors (e.g., IV use).

Effects of Age and Acute Moderate Alcohol Administration on Electrophysiological Correlates of Working Memory Maintenance.

BACKGROUND: Previous studies suggest older adults may be differentially susceptible to the acute neurobehavioral effects of moderate alcohol intake. To our knowledge, no studies have addressed acute moderate alcohol effects on the electrophysiological correlates of working memory in younger and older social drinkers. This study characterized alcohol-related effects on frontal theta (FTP) and posterior alpha power (PAP) associated with maintenance of visual information during a working memory task. METHODS: Older (55 to 70 years of age; n = 51, 29 women) and younger (25 to 35 years of age; n = 70, 39 women) community-dwelling moderate drinkers were recruited for this study. Participants were given either placebo or an active dose targeting breath alcohol concentrations (BrACs) of 0.04 or 0.065 g/dl. Following absorption, participants completed a visual working memory task assessing cue recognition following a 9-s delay. FTP and PAP were determined via Fourier transformation and subjected to 2 (age group) × 3 (dose) × 2 (repeated: working memory task condition) mixed models analysis. RESULTS: In addition to expected age-related reductions in PAP, a significant age group × dose interaction was detected for PAP such that 0.04 g/dl dose level was associated with greater PAP in younger adults but lower PAP in their older counterparts. PAP was lower in older versus younger adults at both active doses. Further mixed models revealed a significant negative association between PAP and working memory efficiency for older adults. No effects of age, dose, or their interaction were noted for FTP. CONCLUSIONS: Results bolster the small but growing body of evidence that older adults exhibit differential sensitivity to the neurobehavioral effects of moderate alcohol use. Given the theoretical role of PAP in attentional and working memory function, these findings shed light on the attentional mechanisms underlying effects of acute moderate alcohol on working memory efficiency in older adults.

Effects of Age and Acute Moderate Alcohol Administration on Neurophysiology During Simulated Driving.

BACKGROUND: Driver age and blood alcohol concentration are both important factors in predicting driving risk; however, little is known regarding the joint import of these factors on neural activity following socially relevant alcohol doses. We examined age and alcohol effects on brain oscillations during simulated driving, focusing on 2 region-specific frequency bands implicated in task performance and attention: parietal alpha power (PAP; 8 to 12 Hz) and frontal theta power (FTP; 4 to 7 Hz). METHODS: Participants included 80 younger (aged 25 to 35 years) and 40 older (aged 55 to 70 years) community-dwelling, moderate drinkers. Participants consumed placebo, low, or moderate doses of alcohol designed to achieve target peak breath alcohol concentrations of 0, 0.04, or 0.065 g/dl, respectively. Electrophysiological measures were recorded during engagement in a simulated driving task involving 4 scenarios of varied environmental complexity. RESULTS: A main effect of age was detected in FTP, but neither an alcohol effect nor interactions were observed. For PAP, an age-by-alcohol interaction was detected. Relative to placebo controls, older and younger participants receiving low-dose (0.04 g/dl) alcohol evinced divergent PAP alterations, with a pattern of higher power among older participants and lower power among younger participants. This interaction was noted across the varied environmental contexts. CONCLUSIONS: These findings are consistent with the hypothesis that compared with younger individuals, older drivers may be differentially susceptible to alcohol effects. While these age-by-alcohol interactions in neural activity are provocative, further investigation exploring the mechanisms and behavioral correlates of these effects will be crucial in determining their behavioral impact.

Characterizing gender differences in treatment seekers.

BACKGROUND: Available evidence suggests women may be more vulnerable to the effects of chronic alcohol consumption than men. The few investigations of gender differences in treatment-seeking populations have often involved study samples restricted by selection criteria (e.g., age, education). The current study examined gender differences in a heterogeneous sample of individuals seeking treatment for a substance use disorder. We examined alcohol drinking levels, age at drinking milestones (e.g., first drink, first intoxication), and progression from milestones to alcohol problems or treatment. Additionally, family history, spousal alcoholism, and nicotine use were analyzed. METHODS: Participants included men (n = 274) and women (n = 257) in substance abuse treatment facilities. Participants completed inventories quantifying affect, intellectual ability, and drinking consequences. A family tree for substance use and personal histories for alcohol and nicotine use, including chronicity, frequency, and regularity, were collected. RESULTS: Telescoping was not observed when progression from drinking milestones to alcoholism or alcohol problems was compared between men and women. In contrast, when considered as progression to treatment, marked telescoping effects were detected, with women entering treatment more rapidly by approximately 4 years. Familial differences included a greater proportion of women reporting alcoholic parents (73% women; 61% men) and alcoholic spouses (58% women; 38% men). Smoking behaviors were similar between genders; however, men reporting higher levels of alcohol consumption reported greater intensity of chronic smoking. Smoking and drinking behaviors were correlated among men, but not women. Rates of pretreatment drug problems were equivalent between genders. CONCLUSIONS: When contrasted with the available literature, our data were only partially supportive of gender-contingent telescoping. While women did not experience alcohol problems or alcoholism earlier than men, they progressed to treatment more quickly. These results highlight the importance of carefully considering the sample and specific outcome variables when interpreting gender differences.

Associations between smoking and pain in early recovery in residential substance use treatment-seekers.

INTRODUCTION: A growing literature indicates bidirectional associations between pain and tobacco use. Cigarette smokers are at increased risk for chronic pain, and observational and experimental studies indicate that pain increases motivation to smoke. Tobacco use disorder frequently co-occurs with other substance use disorders, which are also associated with chronic pain vulnerability. Despite evidence that pain significantly predicts smoking and relapse, associations between smoking history/trajectory and changes in pain over the course of treatment have not been characterized. The objective of the study was to determine the association between in-treatment smoking trajectory, pack-years (i.e., number of cigarette packs smoked per day multiplied by smoking duration), pain-related interference in daily activities, and pain intensity over the course of residential treatment. METHODS: In this study, 280 adult smokers in a residential SUD treatment center in North Central Florida completed questionnaires assessing cigarette use, pain intensity, and pain interference at treatment entry and discharge (Mean = 80.3 days, SD = 25.6). Most participants were diagnosed with alcohol use disorder (66.1 %). Opioid (27.9 %) and cannabis use disorders (29.6 %) were also common. Participants were grouped by whether their smoking increased (n = 36), decreased (n = 46), or stayed the same (n = 133) from entry to discharge. RESULTS: Analyses indicated a positive association between pack-years and pain intensity at both baseline (r = 0.185, p = 0.018) and discharge (r = 0.184, p = 0.019). Smoking trajectory was associated with pack-years, with those decreasing smoking having greater pack-years than those sustaining or increasing use [F(2,136) = 8.62, p < 0.01, η2p = 0.114]. Mixed general linear models indicated pain intensity [F(1,274) = 44.15, p < 0.0001, η2p = 0.138] and interference in day-to-day activities [F(1,276) = 31.79, p < 0.0001, η2p = 0.103] decreased significantly over time. However, there was no main effect of smoking trajectory on pain intensity [F(2,212) = 2.051, p = 0.131, η2p = 0.019] or of smoking trajectory by time interaction [F(2, 212) = 1.228, p = 0.295, η2p = 0.011]. CONCLUSIONS: Overall, findings provide evidence that smoking behavior influences pain within the context of residential substance use treatment. Given that pain is associated with urge to use substances and risk of return to use, more consistent and rigorous assessment of pain and proactive pain management is likely to enhance substance use treatment outcomes among people who smoke.

The effect of incidental ethanol exposures on the formation of blood phosphatidylethanol.

Blood phosphatidylethanol (PEth), a metabolite of ethanol, is emerging as a direct biomarker of choice for characterizing ethanol consumption in clinical, research, and forensic contexts. An accumulating body of evidence, and a recent international consensus conference, supports a cutoff of 20 µg/L of PEth (16:0/18:1) to distinguish abstinence from beverage ethanol consumption. There is a dearth of research, however, on whether exposures to nonbeverage ethanol sources are sufficient to produce PEth concentrations that exceed this cutoff. To explore this possibility, we recruited 30 participants, who indicated past-90-day abstinence from beverage alcohol, to characterize their past-30-day nonbeverage ethanol exposures (including source, frequency, and intensity of exposures) and to undergo PEth testing. Two of the 30 participants (6.7%) produced PEth concentrations ≥20 µg/L. One of these participants (PEth = 26 µg/L) reported multiple ethanol exposure sources, including near-daily intensive exposures to ethanol vapor. The other participant (PEth = 49 µg/L) reported only once-daily use of an ethanol-containing mouthwash; the veracity of his abstinence claim is refuted. The results of this study support a rebuttable presumption that PEth ≥20 µg/L is indicative of beverage ethanol consumption. They suggest, however, that intensive, incidental alcohol exposures have the potential, under unusual circumstances, to result in PEth concentrations that modestly exceed this threshold.

Urine and hair drug test results associated with daily consumption of codeine-predominant poppy seed food products.

This study examined the urine and hair opiate profiles associated with the daily consumption of presumptive codeine-predominant poppy seed food products. Ten participants consumed one of five food products at breakfast for 10 consecutive days. Baseline urine and hair samples were collected on Day 1. The urine samples were collected 4, 8 and 12 h following poppy seed consumption on Days 1 and 10, and the first morning void urine samples were collected on Days 2-10. A second hair specimen was collected on Day 20 ± 2. Urine drug test results: Three of the food products were associated with opiate-negative urine drug test results at all time points at a 300 ng/mL cut-off. Two of the food products were associated with opiate-positive drug test results at all non-baseline time points at a 300 ng/mL cut-off. Of these, all samples (n = 60) were codeine-positive, and 27 (45%) were morphine-positive. Codeine concentrations exceeded morphine concentrations in every sample and always by multiples. Thirty-nine of the 60 samples (65%) were codeine-positive at a 2,000 ng/mL cut-off, while none of these samples were morphine-positive at this cut-off. None of the 60 samples reached an opiate threshold of 15,000 ng/mL, although one participant produced a maximum codeine concentration of 13,161 ng/mL (13,854 ng/mg creatinine). There was no clear trend toward increasing urinary opiate concentrations over the course of the study. Hair drug test results: The hair samples of two participants produced quantifiable codeine (41 pg/mg and 51 pg/mg), but no sample reached a common reporting threshold of 200 pg/mg for codeine or morphine.

Pain Predicts Dropout From Substance Use Treatment.

OBJECTIVE: This project aimed to characterize the relationship between physical pain experienced at time of entry to residential treatment for substance use disorders (SUDs) and the frequency of treatment dropout. We hypothesized that both endorsement of recent pain and higher magnitude of endorsed pain intensity would be associated with higher dropout rates. We further hypothesized that these effects would be exacerbated among patients with opioid use disorder (OUD). METHOD: Participants included 1,095 individuals in residential treatment for SUD. Data were collected within 24 hours of treatment entry. Analyses were conducted using logistic regression with dropout as the dependent variable. Dropout was operationally defined as leaving treatment against medical advice or being discharged from treatment because of use of substances. Pain (including endorsement and intensity) was the primary independent variable in all analyses. Analyses included demographic and affective covariates and included both main effects of OUD and interaction terms between OUD and pain. RESULTS: Pain endorsement was associated with greater frequency of dropout (odds ratio [OR] = 1.49, p = .04). Higher levels of pain intensity predicted increased rates of dropout (OR = 1.13, p < .01). In contrast with our hypothesis, no interactions between OUD and pain were observed. CONCLUSIONS: These results underscore the import of integrating pain monitoring and pain interventions as core components of treatment for SUD. Our findings are highly consistent with a growing literature recognizing the impact of pain across a constellation of important treatment outcomes and provide novel data strongly suggesting that pain predicts early cessation of treatment.

Neurophysiological correlates of moderate alcohol consumption in older and younger social drinkers.

BACKGROUND: Nearly 40% of adults aged 65 and older in the United States consume alcohol. Research in older adults has largely examined potential health effects of a moderate drinking lifestyle. Examination of acute effects in this population is generally lacking. To investigate alcohol-induced alteration of electrophysiological correlates of attention in this population, we employed a covert attentional task. We hypothesized that moderate alcohol administration as well as older age would reduce P3 amplitude and increase latency. We anticipated an interaction such that, relative to their age-matched controls, older adults receiving alcohol would be more affected than their younger counterparts. METHODS: Participants included healthy older (aged 50 to 67; n = 20; 9 men) and younger (aged 25 to 35; n = 12; 5 men) moderate drinkers. Participants received either a moderate dose of alcohol (breath alcohol concentration ~50 mg/dl) or a placebo beverage. Following absorption, the task was administered and neurophysiological measures were obtained. P3 amplitude and latency were separately subjected to ANOVA across cue conditions using age and dose as independent variables. RESULTS: As predicted, P3 amplitude in older adults was significantly lower than in younger adults across cue conditions. An age by alcohol interaction was detected, revealing that older adults receiving alcohol showed lower P3 amplitudes than any other group. An age effect for P3 latency was found, with older adults having longer latencies than their younger counterparts. A significant age by alcohol interaction for P3 latency was detected, revealing that older adults receiving alcohol displayed delayed P3 latencies relative to older adults receiving placebo. In contrast, younger adults receiving alcohol had reduced latency compared to those receiving placebo, although this effect did not reach significance. CONCLUSIONS: Results suggest that older adults demonstrated alcohol-related shifts in P3 characteristics during an intentional attention task, whereas younger adults failed to demonstrate this pattern.

Age as a potential modulator of alcohol-related deficits.

Although their individual significance is well-documented, the interaction effects of age, sex, and alcohol use disorder (AUD) have undergone little systematic investigation. Here, we extend prior work interrogating sex and group (AUD vs. community comparison [CC]) by probing the main and interaction effects of age on emotion processes as well as two conventional neuropsychological tests. Main effects for age and group were anticipated; however, interaction effects comprise our primary focus. While sex differences in AUD prevalence are commonly reported, sex differences within AUD samples are inconsistently found. Therefore, we pose our inquiry regarding sex as exploratory. In this study, 54 CC (n = 30 women) and 55 AUD (n = 14 women) subjects completed a battery that included an emotional face discrimination task, the Trail-Making Test-B (TMT-B), and the Digit Symbol Substitution Test (DSST). The initial/full models included the main and interaction effects of age (as a continuous variable; 25-59 years of age), sex, and group (AUD, CC). In analysis of the emotional face discrimination task, performance on a non-affective face discrimination task was entered as a covariate. Analysis of emotion identification revealed group and age main (p = .02; d = .53 & .003; d = .50, respectively) and interaction effects (p = .05; d = .41). The latter suggested that age and emotion processing performance were positively correlated in the AUD group, but unrelated in the CC group. Notably, neither sex, main, nor interaction effects achieved significance. Using the full model, analysis of the TMT-B and DSST failed to show sex effects or reveal expected performance decrement in the AUD group. To clarify the latter, simple models including only group as well as correlations between age and performance by group for each task were conducted. These analyses demonstrated the expected AUD-related deficits and suggested differential relationships between age and neurocognitive performance as a function of both group and task. Outcomes across tasks emphasize the need to reframe aging effects, particularly in the context of AUD.

Substance familiarity in middle childhood and adolescent substance use.

BACKGROUND: Childhood familiarity with (knowledge of) substances is a potentially important, currently understudied adolescent substance use risk factor. We aimed to describe changes in childhood familiarity with substances and to test whether baseline familiarity predicts early adolescent substance use. METHODS: Utilizing the Substance Use Module of the longitudinal cohort study, Adolescent Brain Cognitive Development (ABCD; US youth aged 9-10 years followed for 10 years) through Data Release 4 (n=7896; individuals who completed all six assessments in the first three years), we conducted longitudinal mixed models and survival analyses to describe changes in familiarity and to determine the adjusted odds of substance use by age 13 based on number of familiar substances at baseline. RESULTS: The sample consisted of 3754 females and 4142 males, aged 9-10 at baseline, with majority White individuals (68.9%). Unconditional time models indicated age significantly predicted familiarity (B=0.08, p<0.001; R2=0.288) with ~3.59 familiar substances at 9 years increasing to ~7.43 substances at 13 years. Family history, home use, peer use, and neighborhood availability predicted familiarity, accounting for 1% of additional variance (R2=0.299; ∆R2=0.011). For each additional familiar substance at baseline, adjusted odds of future use increased 1.28 times (95% CI 1.22, 1.34). CONCLUSIONS: This is the first study to characterize substance familiarity in this age range as a predictor of future substance use. Familiarity increases with age (age being the most predictive indicator). Familiarity at age 9-10 predicts early adolescent substance use. As such, childhood familiarity may represent an easily implemented screening tool for at-risk youth.

Blood Phosphatidylethanol (PEth) Concentrations following Intensive Use of an Alcohol-based Hand Sanitizer.

Alcohol use disorders are prevalent in the USA and throughout the world. Monitoring for alcohol abstinence is useful in several clinical and forensic contexts. The direct alcohol biomarkers have the requisite sensitivity and specificity for abstinence monitoring. The relatively new direct biomarker phosphatidylethanol (PEth), measured in blood, is gaining increasing acceptance in monitoring abstinence from beverage alcohol consumption, but there remains little research addressing the potential for PEth formation consequent to incidental alcohol exposures. In the midst of the coronavirus disease 2019 pandemic, high-alcohol content hand sanitizer is a particularly important source of nonbeverage alcohol exposure. To assess the extent of alcohol absorption and subsequent formation of blood PEth related to intensive use of high alcohol content hand sanitizer, we recruited 15 participants to use a 70% ethyl alcohol-based hand sanitizer 24-100 times daily, for 12-13 consecutive days. Blood was analyzed for PEth 16:0/18:1 by liquid chromatography--tandem mass spectrometry. Our hypothesis that blood PEth concentrations would fail to reach a 20 ng/mL threshold was confirmed. This work adds to the nascent literature on the effects of incidental alcohol exposures on blood PEth formation.

Co-occurring pain and addiction: prognostic implications for healthcare professionals in residential treatment for substance use disorder.

Objectives: Chronic pain is both an important antecedent and consequence of substance use. Although evidence suggests healthcare professionals may be uniquely vulnerable to chronic pain, this vulnerability remains largely unexamined in the context of recovery from substance use disorders (SUDs). We characterized pain in a sample of treatment-seeking individuals, examined potential differences in pain trajectories between healthcare professionals and non-healthcare patients, and interrogated potential pain-related vulnerabilities in treatment outcomes between these groups. Methods: Patients with SUDs (n = 663; 251 women) completed questionnaires indexing pain intensity, craving, and abstinence self-efficacy (including self-efficacy in pain-related contexts). Assessments were conducted at treatment entry, 30 days, and discharge. Analyses included chi-square and longitudinal mixed models. Results: The proportion of healthcare and non-healthcare patients endorsing recent pain was equivalent (χ2=1.78, p=.18). Healthcare professionals reported lower pain intensity (p = 0.02) and higher abstinence self-efficacy (p < 0.001). Profession by pain interactions (ps <.040) revealed that among medical professionals, associations between pain and all three treatment outcomes of interest were more robust relative to the non-healthcare group. Conclusions: Results suggest that although healthcare professionals endorse similar rates of pain and lower average pain intensity, they may be uniquely vulnerable to pain-related disruptions in craving and abstinence self-efficacy.