COVID-19 and Stress-Related Disorders.

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(a) ObjectiveThis study aimed to identify trajectories of alcohol use (AU) and their associations with the development of alcohol use disorder (AUD) among young men with different weekly drinking patterns.(b) MethodA longitudinal latent class analysis integrating several aspects of AU, such as drinking quantity and frequency on weekends vs workweek days, involving 4719 young Swiss men at ages 20, 21, and 25, and collected by the Cohort Study on Substance Use Risk Factors, was used to identify different AU trajectories over time. The development of AUD scores in these trajectories was investigated using generalized linear mixed models.(c) ResultsSix AU trajectory classes, similar to those described in the literature, were identified: ‘abstainers–light drinkers’, ‘light workweek increasers’, ‘light decreasers’, ‘moderate weekend decreasers’, ‘moderate workweek increasers’, and ‘heavy drinkers’. Only 12% of participants were assigned to a trajectory class with decreasing AU associated with a decline in their AUD score. AUD scores increased in trajectory classes exhibiting increasing AU on workweek days, despite low and moderate general AU. Finally, more than 59% of participants were on an AU trajectory presenting no change in their mean AUD score over time.(d) ConclusionsMaturing out of problematic AU in emerging adulthood is not the norm in Switzerland, and the AUD score developed in late adolescence remains until at least emerging adulthood. AU on workweek days is a more practical marker of potentially problematic AU. This calls for timely interventions in adolescence and concerning regular drinking on workweek days in emerging adulthood.

Whereas striatal dopamine D2 receptor (D2R) availability has shown to be altered in individuals with alcohol use disorder (AUD) and in healthy individuals with a family history of AUD, the role of D2R in the development of AUD is unknown. In this positron emission tomography (PET) study, we measured whether D2R availability is associated with subsequent alcohol use and alcohol-related factors, at a follow-up 8 to 16 years post-PET scan, in social drinkers. Longitudinal study investigating the association between PET data and later self-report measures in healthy individuals. Academic research imaging centre in Stockholm, Sweden. There were 71 individuals (68 of whom had evaluable PET data, 5 females, 42.0 years mean age) from a series of previous PET studies. One PET examination with the D2R antagonist radioligand [11 C]raclopride at baseline and self-report measures assessing alcohol use, drug use, impulsivity, reward sensitivity and family history of alcohol or substance use disorder at follow-up. We found no evidence for an association between D2R availability and later alcohol use (B = -0.019, B 95% CI = -0.043 to -0.006, P = 0.147) nor for the majority of the alcohol-related factors (B 95% CI = -0.034 to 0.004, P = 0.273-0.288). A negative association with a small effect size was found between D2R availability and later impulsivity (B = -0.017, B 95% CI = -0.034 to -0.001, P = 0.046). Low striatal dopamine D2 receptor availability may not be a strong predictor in the development of alcohol use disorder.

Objective: To study the prevalence of alcohol and substance use among medical students.Material and Methods: A cross-sectional study surveyed Prince of Songkla University medical students in 2016. Questionnaires for demographic data, the Alcohol Use Disorder Identification Test (AUDIT), experience with alcohol and substance abuse, and the Patient Health Questionnaire-9 Thai version (PHQ-9) were used. We analyzed the data in order to describe the behavior of subjects by descriptive statistics. The factors associated with alcohol used were analyzed by chi-square test and logistic regression.Results: Seven hundred thirty-nine (70.1%) of medical students completed the questionnaires. Participants, 56.0% were female and 44.0% were male. Mean age was 21.2 years old; 53.3% have drunk alcohol; the gender proportion of drinkers was 60.0% of males and 48.1% of females. By AUDIT, 23.1% of medical students were high-risk drinkers. The most common reason for alcohol consumption was social engagement (91.9%) and the most common reason for not drinking was having knowledge about the harmful health effects of alcohol (51.2%). Of the medical students, 7.6% had experience with substance use. The drugs most commonly used were cigarettes (5.3%) and baraku (4.6%). According to the PHQ-9, 11.2% of all medical students, 12.6% in males and 10.1% in females had depression. However, these high levels of depression did not associate with a high-risk of alcohol consumption. The significant factors that associated with high-risk drinking were gender [odd ratio (OR)=1.9 (1.1-3.4)] and experience with substance use [OR=3.8 (2.0-7.3)].Conclusion: Half of medical students drank alcohol and approximate 1 in 10 had experience with substance use. Gender and experience with substance use were the significant factors that correlated with high-risk drinking.

The Evidence for SBIRT in Adolescents

Ventral striatal resting-state functional connectivity in adolescents is associated with earlier onset of binge drinking

Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic: a report of a joint workshop of the Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and American Society of Addiction Medicine

BackgroundMood disorders may affect lung cancer risk. We evaluated this hypothesis in two large studies.Methodology/Principal FindingsWe examined 1,939 lung cancer cases and 2,102 controls from the Environment And Genetics in Lung cancer Etiology (EAGLE) case-control study conducted in Italy (2002–2005), and 82,945 inpatients with a lung cancer diagnosis and 3,586,299 person-years without a lung cancer diagnosis in the U.S. Veterans Affairs Inpatient Cohort (VA study), composed of veterans with a VA hospital admission (1969–1996). In EAGLE, we calculated odds ratios (ORs) and 95% confidence intervals (CI), with extensive adjustment for tobacco smoking and multiple lifestyle factors. In the VA study, we estimated lung cancer relative risks (RRs) and 95% CIs with time-dependent Poisson regression, adjusting for attained age, calendar year, hospital visits, time within the study, and related previous medical diagnoses. In EAGLE, we found decreased lung cancer risk in subjects with a personal history of mood disorders (OR: 0.59, 95% CI: 0.44–0.79, based on 121 lung cancer incident cases and 192 controls) and family history of mood disorders (OR: 0.62, 95% CI: 0.50–0.77, based on 223 lung cancer cases and 345 controls). The VA study analyses yielded similar results (RR: 0.74, 95% CI: 0.71–0.77, based on 2,304 incident lung cancer cases and 177,267 non-cancer person-years) in men with discharge diagnoses for mood disorders. History of mood disorders was associated with nicotine dependence, alcohol and substance use and psychometric scales of depressive and anxiety symptoms in controls for these studies.Conclusions/SignificanceThe consistent finding of a relationship between mood disorders and lung cancer risk across two large studies calls for further research into the complex interplay of risk factors associated with these two widespread and debilitating diseases. Although we adjusted for smoking effects in EAGLE, residual confounding of the results by smoking cannot be ruled out.

The authors investigated the theoretical and clinical role of depression among cocaine abusers in treatment. Eighty-nine cocaine-abusing patients underwent 2 weeks of substance abuse treatment. Posttreatment major depressive disorder, depressive symptoms before and after substance abuse treatment, and alcohol diagnoses were assessed and their relation to pretreatment substance use, cravings in high-risk situations, and 3-month follow-up status was examined. High rates of major depressive disorder were found but were unrelated to pretreatment substance use. The decrease in depressive symptoms during treatment was independent of major depressive disorder or alcohol diagnoses and predicted treatment attrition. Higher levels of depressive symptoms during treatment were associated with greater urge to use cocaine, alcohol, and other drugs in high-risk situations. Concurrent major depressive disorder and depressive symptoms did not predict cocaine use at follow-up. However, patients who had an alcohol relapse episode experienced more depressive symptoms during treatment than did those who abstained. The results highlight the relationship of depression to alcohol use among cocaine abusers and suggest a need for further studies of the association between depression and substance use disorders.

Perceived Effectiveness of Medications Among Mental Health Service Users With and Without Alcohol Dependence

Studies of social drinkers indicate that subjective response (SR) to alcohol and impulsivity are risk factors for the development of alcohol use disorder which may be related. It is unclear, however, whether there are significant relationships between SR and impulsivity among individuals with alcohol dependence. Using data from an intravenous (IV) alcohol challenge study, the present study is the first to explore the relationship between impulsivity and SR during alcohol administration among alcohol-dependent individuals. Non-treatment-seeking, alcohol-dependent individuals (N = 42) completed the Delay Discounting Task to measure impulsivity and then completed two counterbalanced, placebo-controlled IV alcohol administration sessions, which included assessments of SR at breath alcohol concentration (BrAC) levels of 0.00, 0.02, 0.04 and 0.06 g/dl. Analyses revealed that more impulsive participants experienced higher subjective stimulation and positive mood in response to rising BrACs as compared to less impulsive individuals. More impulsive participants also experienced increased sedation over time regardless of condition (i.e. alcohol vs. saline). These findings suggest that among alcohol-dependent individuals, impulsivity is positively associated with the hedonic effects of alcohol as compared to placebo. High impulsivity may characterize a subset of alcohol-dependent individuals who drink to experience the rewarding effects of alcohol.

Some styles of alcohol consumption are riskier than others. How the level and rate of alcohol exposure contribute to the increased risk of alcohol use disorder is unclear, but likely depends on the alcohol concentration time course. We hypothesized that the brain is sensitive to the alcohol concentration rate of change and that people at greater risk would self‐administer faster. We developed a novel intravenous alcohol self‐administration paradigm to allow participants direct and reproducible control over how quickly their breath alcohol concentration changes. We used drinking intensity and the density of biological family history of alcohol dependence as proxies for risk. Thirty‐five alcohol drinking participants aged 21–28 years provided analytical data from a single, intravenous alcohol self‐administration session using our computer‐assisted alcohol infusion system rate control paradigm. A shorter time to reach 80 mg/dl was associated with increasing multiples of the binge drinking definition (p = 0.004), which was in turn related to higher density of family history of alcoholism (FHD, p = 0.04). Rate‐dependent changes in subjective response (intoxication and stimulation) were also associated with FHD (each p = 0.001). Subsequently, given the limited sample size and FHD range, associations between multiples of the binge drinking definition and FHD were replicated and extended in analyses of the Collaborative Study on the Genetics of Alcoholism database. The rate control paradigm models binge and high‐intensity drinking in the laboratory and provides a novel way to examine the relationship between the pharmacokinetics and pharmacodynamics of alcohol and potentially the risk for the development of alcohol use disorders.

Eating disorders (EDs) and substance use disorders are prevalent among college students in the United States, with underlying common mechanisms suggesting co-occurrence of these in the student population. As treatment prognosis of EDs improves when they are identified and treated with early intervention, it is essential to understand which substance use behaviors associate with EDs in students. Using a sample of 471 college students recruited for a study on high risk drinking (i.e., students needed to pregame regularly to be included), we explored the associations between ED symptomatology and two common substances used in this population: alcohol and cannabis. As most research on EDs focuses on female students only or does not separate out males and females, we examined whether sex assigned at birth moderated the association between ED symptomatology and substance use outcomes. About one-third (32.4%) of the sample screened positive for an ED, with females significantly more likely to screen positive. Males were significantly more likely to screen positive for an alcohol or cannabis use disorder. Screening positive for an ED associated with cannabis use frequency and cannabis use disorder symptoms, but not with alcohol outcomes. Sex moderated the association between ED and cannabis use disorder symptoms, with positive ED screen male students experiencing the highest cannabis use disorder symptoms. It is necessary to further assess how sex differences in substance use and ED symptomatology inform each other. Findings underscore the need to assess and screen for cannabis use disorder among students who screen positive for an ED, and, more specifically, with focused attention on male students with ED symptoms.

Comprised of three individual articles, this article-based dissertation investigates the relationship between bullying and substance use among high school students. Chapter One provides an overview of the dissertation’s purpose along with a discussion of the theoretical framework and development of the studies comprising the dissertation. Chapter Two examines the relationship between bullying victimization and substance use among high school students. Findings demonstrate that students who reported bullying victimization reported higher levels of alcohol and illicit drug use, but not marijuana use. Chapter Three is a mixed methods study assessing the appropriateness of an “aged-up” brief bullying bystander intervention (STAC) and exploring the lived experiences of high school students trained in the program. Quantitative results include an increase in knowledge and confidence to intervene in bullying situations, awareness of bullying, and use of the STAC strategies. Qualitative results support quantitative findings. These findings led to the final study, Chapter Four, which examines the efficacy of a brief, bystander bullying intervention (STAC) on reducing alcohol use among high school students. At 30-day follow-up, high-risk drinkers in the intervention group reported greater reductions in alcohol use compared to those in the control group.

Childhood trauma, PTSD, and problematic alcohol and substance use in low-income, African-American men and women