Brief group alcohol interventions with college students: examining motivational components.

Studies of the impairing effects of alcohol on behavior often show greater tolerance in heavy drinkers compared with light drinkers, suggesting a causal link between heavy consumption and tolerance. Tolerance also develops during the time course of a single drinking episode, and this "acute tolerance" might play an important role in the escalation to heavy drinking. The present study examined the development of acute tolerance to the impairing effects of alcohol on motor coordination and inhibitory control in a group of at-risk binge drinkers (n = 20) and a group of nonrisk moderate drinkers (n = 20). Participants performed the testing battery in response to placebo and a moderate dose of alcohol (0.65 g/kg) twice at comparable blood alcohol concentrations (BACs): once on the ascending limb and once on the descending limb of the blood alcohol curve. Results showed marked acute tolerance to the impairing effects of alcohol on motor coordination in the at-risk drinkers. By contrast, no recovery of motor skill was observed in the nonrisk drinkers. Regarding inhibitory control, both groups remained impaired on both the ascending and descending limbs, indicating no acute tolerance in either group. The findings suggest that at-risk binge drinkers display a faster recovery in their ability to execute versus inhibit action under alcohol. Such an "activational bias" of behavior could account for their continued alcohol consumption and impulsive behaviors while intoxicated, especially as BAC begins to decline.

The objective of this study was to use the EDAC score to detect heavy and at-risk drinking in young adults (mean age = 25 years) and compare the results to self-reports. The EDAC score is a linear discriminant function (LDF) derived from the analysis of a combination of up to 35 blood chemistry and hematology analytes ordered routinely in clinical settings. Subjects (N = 150) were recruited from medical care facilities at the University of Missouri, Columbia. Blood samples, obtained from males (N = 66) and females (N = 84), were sent to LabCorp (Burlington, NC) for analysis. The blood chemistry panels were evaluated using a Linear Discriminant Function method available through SPSS software to predict whether each individual was a Heavy Drinker or an At-Risk Drinker. Heavy Drinkers consumed on average > 4 drinks daily for males and > 3 drinks daily for females. At-Risk Drinkers consumed at least 14 drinks per week or drank more than 4 drinks on any occasion in the last 14 days if male and consumed at least 7 drinks per week or more than 3 drinks on any occasion if female. Not-Heavy Drinkers and Not-At-Risk Drinkers consumed less than the amounts above. The results showed 8/10 (80%) males and 2/2 women identified as Heavy Drinkers by both the EDAC score (priorprobability Not-Heavy vs. Heavy Drinker = 0.5:0.5) and self-report. Fifty of 56 (89%) males and 65/82 (79%) of females were identified as Not-Heavy Drinkers by both EDAC score and self-report. There were 6/54 (11%) males and 15/82 (18%) women with false positive results, of these, 14/21 (67%) met dependence criteria by DSM-IV. The EDAC test showed 30% sensitivity and 96% specificity when identifying At-Risk drinking males and 42% sensitivity and 90% specificity when identifying At-Risk drinking females. In females, the EDAC's sensitivity was higher than any single traditional or new laboratory marker previously reported for diagnosis of alcohol abuse such as GGT, MCV and CDT. As a complement or a substitute to an interview, in subjects who are less candid about their drinking, the EDAC is a useful tool to assess heavy and at-risk alcohol consumption in young adults.

The purpose of this study was to determine the relationship between alcohol use and health functioning in a sample of older adults screened in primary care settings. A cross-sectional study. Thirty-seven primary care clinics. Older adults (n = 8,578; aged 55-97) with regularly scheduled appointments in primary care clinics were screened. Participants were categorized based on alcohol consumption levels as abstainers, low-risk drinkers, and at-risk drinkers (women: 9 or more drinks/week; men: 12 or more drinks/week). Dependent variables were eight SF-36 health functioning scales. Sixty-one percent of participants were abstainers, 31% were low-risk drinkers, and 7% were at-risk drinkers. ANCOVAs found significant effects of drinking status on General Health, Physical Functioning, Physical Role Functioning, Bodily Pain, Vitality, Mental Health, Emotional Role, and Social Functioning, controlling for age and gender, with low-risk drinkers scoring significantly better than abstainers. At-risk drinkers had significantly poorer mental health functioning than low-risk drinkers. Few significant gender differences were found on SF-36 scales. Older adults who are at-risk drinkers may not present with poor physical health functioning. Future studies are needed to determine the relationship between drinking limits for older adults and other areas of physical and psychosocial health.

Unhealthy use of alcohol and acute kidney injury are major public health problems, but little is known about the impact of excessive alcohol consumption on kidney function in critically ill patients. We aimed to determine whether at-risk drinking is independently associated with acute kidney injury in the ICU and at ICU discharge. Prospective observational cohort study. A 21-bed polyvalent ICU in a university hospital. A total of 1,107 adult patients admitted over a 30-month period who had an ICU stay of greater than or equal to 3 days and in whom alcohol consumption could be assessed. None. We assessed Kidney Disease Improving Global Outcomes stages 2-3 acute kidney injury in 320 at-risk drinkers (29%) and 787 non-at-risk drinkers (71%) at admission to the ICU, within 4 days after admission and at ICU discharge. The proportion of patients with stages 2-3 acute kidney injury at admission to the ICU (42.5% vs 18%; p < 0.0001) was significantly higher in at-risk drinkers than in non-at-risk drinkers. Within 4 days and after adjustment on susceptible and predisposing factors for acute kidney injury was performed, at-risk drinking was significantly associated with acute kidney injury for the entire population (odds ratio, 2.15; 1.60-2.89; p < 0.0001) in the subgroup of 832 patients without stages 2-3 acute kidney injury at admission to the ICU (odds ratio, 1.44; 1.02-2.02; p = 0.04) and in the subgroup of 971 patients without known chronic kidney disease (odds ratio, 1.92; 1.41-2.61; p < 0.0001). Among survivors, 22% of at-risk drinkers and 9% of non-at-risk drinkers were discharged with stages 2-3 acute kidney injury (p < 0.001). Our results suggest that chronic and current alcohol misuse in critically ill patients is associated with kidney dysfunction. The systematic and accurate identification of patients with alcohol misuse may allow for the prevention of acute kidney injury.

Tobacco and alcohol use are among the leading preventable risk factors associated with premature mortality and a variety of diseases that have long-term effects. Although tobacco and alcohol use among adults is widespread in Germany, there is a trend towards lower levels of consumption. The foundations for health-related behaviour in adulthood are set at an early age: young people who use alcohol and tobacco also tend to do so regularly when they reach adulthood. With this in mind, health policies should focus on preventing young people from smoking, and encouraging them to adopt a responsible, low-risk approach to alcohol. This article analyses patterns of tobacco and alcohol use among children and adolescents (aged between 11 and 17 years). It describes the prevalences of tobacco and alcohol use, as well as trends and correlates. The data used in this article was sourced from the second follow-up to the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2). The survey’s results show that 7.2% of 11- to 17-year-old children and adolescents smoke at least occasionally, with 3.7% doing so daily. The survey also demonstrates that a good half (51.0%) of 11- to 17-year-olds have ever drunk alcohol; at-risk drinking was prevalent among 12.1%, and heavy episodic drinking among 7.0%. The consumption of tobacco and alcohol increases considerably with age. Patterns of at-risk drinking and heavy episodic drinking show gender-associated differences: While more girls than boys practice at-risk drinking, more boys than girls practice heavy episodic drinking. Nevertheless, the KiGGS survey waves demonstrate a highly significant trend towards a decline in tobacco use (KiGGS baseline study 21.4%, KiGGS Wave 1 12.4%). The proportion of 11- to 17-year-olds who have ever drunk alcohol is also declining (KiGGS baseline study 63.9%, KiGGS Wave 1 55.6%). The proportions of at-risk drinking (KiGGS Wave 1 16.5%) and heavy episodic drinking (KiGGS Wave 1 12.0%) decreased as well. The results presented here are in line with findings from other studies that have surveyed adolescent tobacco and alcohol use in Germany, and they underscore the success of preventive measures.

Dwi prevention: Profiles of drinkers who use designated drivers

BackgroundAlcohol misuse is a growing public health concern for older adults, particularly among primary care patients.ObjectivesTo determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients.DesignCross-sectional analysis of multisite screening data from 6 VA Medical Centers, 2 hospital-based health care networks, and 3 Community Health Centers.ParticipantsPatients, 43,606, aged 65 to 103 years, with scheduled primary care appointments were approached for screening; 27,714 (63.6%) consented to be screened. The final sample of persons with completed screens comprised 24,863 patients.MeasurementsQuantity and frequency of alcohol use, demographics, social support measures, and measures of depression/anxiety.ResultsOf the 24,863 older adults screened, 70.0% reported no consumption of alcohol in the past year, 21.5% were moderate drinkers (1–7 drinks/week), 4.1% were at-risk drinkers (8–14 drinks/week), and 4.5% were heavy (>14 drinks/week) or binge drinkers. Heavy drinking showed significant positive association with depressive/anxiety symptoms [Odds ratio (OR) (95% CI): 1.79 (1.30, 2.45)] and less social support [OR (95% CI): 2.01 (1.14, 2.56)]. Heavy drinking combined with binging was similarly positively associated with depressive/anxiety symptoms [OR (95%): 1.70 (1.33, 2.17)] and perceived poor health [OR (95% CI): 1.27 (1.03, 1.57)], while at-risk drinking was not associated with any of these variables.ConclusionsThe majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/anxiety symptoms and perceived poor health.

Smoking and drinking among patients with mental disorders: Evidence from a nationally representative Japanese survey

Inconsistent condom use among HIV-infected patients with alcohol problems

Brief alcohol intervention as pragmatic intervention: Who is voluntarily taking an offered intervention?

Behavioral economic theory suggests that a reduction in substance use is most likely when there is an increase in rewarding substance-free activities. The goal of this randomized controlled clinical trial was to evaluate the incremental efficacy of a novel behavioral economic supplement (Substance-Free Activity Session [SFAS]) to a standard alcohol brief motivational interviewing (BMI) session for heavy-drinking college students. Participants were 82 first-year college students (50% female; 81.7% White/European American; M age = 18.5 years, SD = 0.71) who reported 2 or more past-month heavy drinking episodes. After completing a baseline assessment and an individual alcohol-focused BMI, participants were randomized to either the SFAS or to a Relaxation Training (RT) control session. The SFAS was delivered in an MI style and attempted to increase the salience of delayed academic and career rewards and the patterns of behavior leading to those rewards. The combination of an alcohol BMI plus the SFAS was associated with significantly greater reductions in alcohol problems compared with an alcohol BMI plus RT at the 1-month and 6-month follow-up assessments (p = .015, ηp² = .07), an effect that was partially mediated by increases in protective behavioral strategies. BMI + SFAS was also associated with greater reductions in heavy drinking among participants who at baseline reported low levels of substance-free reinforcement or symptoms of depression. These results are consistent with behavioral economic theory and suggest that a single session focused on increasing engagement in alternatives to drinking can enhance the effects of brief alcohol interventions.

The impact of elevated posttraumatic stress on the efficacy of brief alcohol interventions for heavy drinking college students

Alcohol and tobacco use are interrelated. This study examined response to very low nicotine content (VLNC) and moderate nicotine content (MNC) cigarettes by problematic drinking. We utilized a double-blind, randomized, within-subjects crossover design of VLNC and MNC cigarettes in two groups of adult cigarette smokers: with at-risk drinking (ARD; n = 23) and without ARD (n = 24). Participants smoked only their assigned experimental cigarette in their home environment for 7 days, and completed laboratory visits, including ad libitum smoking of the assigned experimental cigarette, at the beginning and end of each experimental week. Participants smoked their usual cigarettes for 7 days between conditions. Participants provided daily reports of alcohol and cigarette consumption. Current Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) alcohol use disorder (AUD) was assessed at baseline and the end of each experimental week. Compliance with smoking of experimental cigarettes was good. Adjusting for baseline drinking, there was no significant effect of experimental cigarette or ARD group on drinks per day or alcohol urges. There was no effect of experimental cigarette or ARD group on cigarettes per day, or on any puff topography outcome or postsmoking exhaled carbon monoxide during laboratory smoking. No participant had a change in AUD status or AUD severity. After 7 days of exposure to VLNC cigarettes, adult cigarette smokers with ARD did not show compensatory drinking or compensatory smoking behavior. A future policy change in the United States to reduce nicotine content in cigarettes may not produce unintended compensatory drinking or smoking among this vulnerable and prevalent population of smokers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Implicit and explicit drinking identity predict latent classes that differ on the basis of college students’ drinking behaviors

We identified to what extent the Department of Defense postdeployment health surveillance program identifies at-risk drinking, alone or in conjunction with psychological comorbidities, and refers service members who screen positive for additional assessment or care. We completed a cross-sectional analysis of 333 803 US Army active duty members returning from Iraq or Afghanistan deployments in fiscal years 2008 to 2011 with a postdeployment health assessment. Alcohol measures included 2 based on self-report quantity-frequency items-at-risk drinking (positive Alcohol Use Disorders Identification Test alcohol consumption questions [AUDIT-C] screen) and severe alcohol problems (AUDIT-C score of 8 or higher)-and another based on the interviewing provider's assessment. Nearly 29% of US Army active duty members screened positive for at-risk drinking, and 5.6% had an AUDIT-C score of 8 or higher. Interviewing providers identified potential alcohol problems among only 61.8% of those screening positive for at-risk drinking and only 74.9% of those with AUDIT-C scores of 8 or higher. They referred for a follow-up visit to primary care or another setting only 29.2% of at-risk drinkers and only 35.9% of those with AUDIT-C scores of 8 or higher. This study identified missed opportunities for early intervention for at-risk drinking. Future research should evaluate the effect of early intervention on long-term outcomes.