Harmful drinking and alcohol dependence

Alcohol is one of the most popular psychoactive substances in the world, and drinking it is considered a social norm in the UK. The pandemic has increased the potential for hazardous drinking, as well as the risk of relapse from abstinence in those with dependence. This article will discuss the risks associated with drinking alcohol, how to assess alcohol consumption and what interventions can be provided for motivated patients who want to cut their alcohol intake.

The Juramento: Secondary and Tertiary Preventive Benefits of a Religious-Based Brief Alcohol Intervention in the Mexican Immigrant Community

Our chapter addresses the prevention benefits of the juramento, a grassroots religious-based brief intervention for harmful drinking practiced in Mexico and the Mexican immigrant community in the United States. With origins in Mexican folk Catholicism, it is a sacred pledge made to Our Lady of Guadalupe to abstain from alcohol for a specific time period; in most cases, at least six months. We draw on our data from a subsample of 15 Mexican workers who made juramentos and two priests who administered the juramento to the workers. The sample is from a larger qualitative study on the use of the juramento among Mexican immigrant and migrant workers in southeastern Pennsylvania. Our findings reveal that, in addition to serving as an intervention, the juramento results in secondary prevention—by identifying a harmful drinking before the onset of heavy drinking—and tertiary prevention—by slowing or abating the progression of heavy drinking.

An Assessment of the Psychosocial Evaluation for Early Liver Transplantation in Patients with Acute Alcoholic Hepatitis in the context of Alcohol Use Disorder, A Case Control Study

Background Severe acute alcoholic hepatitis (AAH) has an excessive mortality rate. As a result, many centers, including our own, have allowed transplant listing patients for transplantation prior to achievement of 6-months sobriety. Concurrently, scoring systems have been proposed to identify patients with alcohol use disorder (AUD) predisposed to relapse after liver transplantation. These scoring systems target patients with a minimal period of sobriety. Methods We conducted a retrospective case control study of 11 patients who underwent early liver transplantation for AAH matched with 11 controls who were declined secondary to low insight into AUD. Blinded raters confirmed the severity of the DSM-5 diagnosis and scored the patients on a variety of structured psychometric scales used to predict alcohol relapse. These included the High Risk for Alcohol Relapse scale (HRAR), Stanford Integrated Psychosocial Assessment Tool (SIPAT), Alcohol Relapse Risk Assessment (ARRA), Hopkins Psychosocial Scale (HPSS), Michigan Alcoholism Prognosis Score (MAPS), Alcohol Use Disorders Identification Test -Consumption (AUDIT-C) and Sustained Alcohol Use Post-Liver Transplant (SALT) scales. All patients who underwent transplantation were followed for harmful and non-harmful drinking until the end of the study period. Results Mean psychometric scores of the transplanted cases were significantly different than the controls. Cases chosen for transplant had significantly favorable MAPS, HRAR, SIPAT, ARRA, and HPSS scores with cut-offs matching their prior research. The SALT and AUDIT-C scores were not predictive of our selection of patients for transplant. Despite expedited assessment and no significant period of sobriety, our case cohort had a 30% relapse to harmful drinking after an average of 6.6 years (5 to 8.5 years) of follow-up. Discussion Despite the expedited assessment and short to no period of sobriety, the patient cohort demonstrated a 30% relapse to harmful drinking, consistent with the reported 20-30% after liver transplantation for all forms of alcoholic liver disease. The average MAPS, HRAR, SIPAT, ARRA, and HPSS scores all corroborated our current stratification procedures, with lower risk mean scores found in the transplanted group. Conclusion The traditional psychosocial selection criteria for patients with alcoholic hepatitis at our institution is consistent with four of the five investigated scoring systems.

Alcohol Consumption in the Australian Mining Industry: The Role of Workplace, Social, and Individual Factors

Background: Coal miners have been reported to have higher rates of risky/harmful alcohol misuse; however, it is not known if metalliferous mining employees whose working conditions differ in workplace practices, also have increased rates of risky/harmful alcohol misuse. This study aimed to examine alcohol consumption in a sample of Australian metalliferous mining workers and to examine the demographic and workplace factors associated with risky/harmful alcohol use. Methods: All employees from a convenience sample of four Australian mine sites were invited to complete a paper-based cross-sectional survey between June 2015 and May 2017. The survey contained questions relating to social networks, health behaviors, psychological distress, demographic characteristics, and risky/harmful drinking. Current alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated measure of risky and/or harmful drinking. Factors associated with risky/harmful drinking were investigated using univariate and multivariable logistic regression. Findings: A total of 1,799 participants completed the survey (average site response rate 95%). Overall, 94.8% of males and 92.1% of females reported using alcohol in the preceding 12 months. The odds of risky/harmful alcohol use were significantly higher in those who were male, younger, and reported higher psychological distress. Conclusions/Application to Practice: This study identified that metalliferous mining employees engage in at-risk levels of alcohol consumption significantly higher than the national average despite workplace policies and practices that restrict alcohol use. Personal and workplace risk factors that may help target specific employee groups and inform the development of tailored, integrated multicomponent intervention strategies for the industry were identified.

Young adult cancer risk behaviours originate in adolescence: a longitudinal analysis using ALSPAC, a UK birth cohort study

Background An estimated 40% of cancer cases in the UK in 2015 were attributable to cancer risk behaviours. Tobacco smoking, alcohol consumption, obesity, and unprotected sexual intercourse are known causes of cancer and there is strong evidence that physical inactivity is associated with cancer. These cancer risk behaviours co-occur however little is known about how they pattern longitudinally across adolescence and early adulthood. Using data from ALSPAC, a prospective population-based UK birth cohort study, we explored patterns of adolescent cancer risk behaviours and their associations with cancer risk behaviours in early adulthood. Methods Six thousand three hundred fifty-one people (46.0% of ALSPAC participants) provided data on all cancer risk behaviours at one time during adolescence, 1951 provided data on all cancer risk behaviours at all time points. Our exposure measure was quartiles of a continuous score summarising cumulative exposure to cancer risk behaviours and longitudinal latent classes summarising distinct categories of adolescents exhibiting similar patterns of behaviours, between age 11 and 18 years. Using both exposure measures, odds of harmful drinking (Alcohol Use Disorders Identification Test-C ≥ 8),daily tobacco smoking, nicotine dependence (Fagerström test ≥4), obesity (BMI ≥30), high waist circumference (females: ≥80 cm and males: ≥94 cm, and high waist-hip ratio (females: ≥0.85 and males: ≥1.00) at age 24 were estimated using logistic regression analysis. Results We found distinct groups of adolescents characterised by consistently high and consistently low engagement in cancer risk behaviours. After adjustment, adolescents in the top quartile had greater odds of all outcomes in early adulthood: nicotine dependency (odds ratio, OR = 5.37, 95% confidence interval, CI = 3.64–7.93); daily smoking (OR = 5.10, 95% CI =3.19–8.17); obesity (OR = 4.84, 95% CI = 3.33–7.03); high waist circumference (OR = 2.48, 95% CI = 1.94–3.16); harmful drinking (OR = 2.04, 95% CI = 1.57–2.65); and high waist-hip ratio (OR = 1.88, 95% CI = 1.30–2.71), compared to the bottom quartile. In latent class analysis, adolescents characterised by consistently high-risk behaviours throughout adolescence were at higher risk of all cancer risk behaviours at age 24, except harmful drinking. Conclusions Exposure to adolescent cancer risk behaviours greatly increased the odds of cancer risk behaviours in early adulthood. Interventions to reduce these behaviours should target multiple rather than single risk behaviours and should focus on adolescence.

Influence of alcohol drinking forms on development of depression, anxiety and somatic disorder in the area of Krupa na Uni

Introduction: Alcohol consumption can lead to different psychiatric pathologies, both during maintenance of the addictive cycle and after abstinence is established. Objective: The study aimed to examine the existence of a statistically significant association of drinking patterns alcohol with the intensity of anxiety, depression and somatic disorders in alcohol users. Methods: The study was performed as a cross-sectional study at the Health Center Krupa na Uni in the period from 01.10.2018. to 01.06.2019. The sample consisted of 110 randomly selected patients consuming alcohol, 35 (31.8%) women and 75 (68.2%) men, with an average age of 51 ± 1.9 years. The survey used the following questionnaires: Alcohol Use Disorders Identification Test, Generalized Anxiety Disorder, Patient Health Questionnaire, Beck's Depression Inventory. The chi-square test was used in the data analysis. Results: Low-risk drinking was verified in 36 (32.7%) of respondents, high-risk drinking in 50 (45.5%) of them. Harmful drinking was found in 20 (18.2%) of respondents, alcohol abuse in 4 (3.6%) of them. Symptoms of anxiety were 85 (77. 3%) of respondents. The same number of subjects had somatic problems. 66 (60.0%) of the study participants were depressed. There was a statistically significant association of drinking patterns with the intensity of anxiety and depression (p <0.05). In the case of somatic disorders, the same was not verified (p> 0.05) Conclusion: The pattern of drinking alcohol is consistent with the intensity of anxiety disorders. Harmful drinking alcohol results in intense somatic distress, while alcohol abuse is not statistically significantly associated with the same. The intensity of depression is correlated with the pattern of drinking alcohol. The obtained results are in accordance with researchers from other countries.

Assessment of risky drinking, harmful drinking and alcohol addiction among lawyers

Background: Not much is known about alcohol dependence, risky or harmful drinking among Polish lawyers. Studies conducted around the world have so far shown that this professional group is at a greater risk of alcohol addiction than the total population or other professional groups. Aim: The aim of this study was to determine the model of alcohol consumption among lawyers, as well as the factors influencing this phenomenon. Materials and methods: The study was conducted among 206 lawyers, including 102 women and 104 men, aged between 29 and 84 years. The AUDIT test, developed by World Health Organization, was used. Results: In the study group of lawyers, 22.33% drink in a risky and harmful manner, including nearly 3% whose score suggests alcohol addiction. It was shown that the sex criterion differentiated the alcohol consumption model among lawyers, with statistically significant higher average values obtained for men (p = 0.002). The study showed that the drinking model is influenced both by the marital status of respondents and whether they have children or not (p = 0.000033). There was no influence of weekly working hours on the alcohol use pattern (p = 0.169, r = 0.10). An analysis using the Pearson’s r correlation coefficient showed a statistically significant relationship (p = 0.021) between age and AUDIT score. This was a low-strength negative correlation (r = −0.16), i.e. AUDIT scores decreased with the age of respondents. Conclusions: This study is the first medical assessment of the prevalence of alcohol use among Polish lawyers. Lawyers are a professional group reluctant to undergo evaluation, who are at a high risk of problematic alcohol use. The study shows that there is a need for in-depth diagnosis of alcohol addiction and development of educational, preventive and therapeutic programs that take into account the specificity of the work of lawyers.

Young Adult Cancer Risk Behaviours Originate in Adolescence: A Longitudinal Analysis using ALSPAC, a UK birth Cohort Study

Background: An estimated 40% of cancer cases in the UK in 2015 were attributable to cancer risk behaviours. Tobacco smoking, alcohol consumption, obesity, and unprotected sexual intercourse are known causes of cancer and there is strong evidence that physical inactivity is associated with cancer. These cancer risk behaviours co-occur however little is known about how they pattern longitudinally across adolescence and early adulthood. Using data from ALSPAC, a prospective population-based UK birth cohort study, we explored patterns of adolescent cancer risk behaviours and their associations with cancer risk behaviours in early adulthood. Methods: 6,351 people (46.0% of ALSPAC participants) provided data on all cancer risk behaviours at one time during adolescence, 1,951 provided data on all cancer risk behaviours at all time points. Our exposure measure was a continuous score summarising cumulative exposure to cancer risk behaviours and longitudinal latent classes summarising distinct categories of adolescents exhibiting similar patterns of behaviours, between age 11 and 18 years. Using both exposure measures, odds of harmful drinking (Alcohol Use Disorders Identification Test-C ≥8),daily tobacco smoking, nicotine dependence (Fagerström test ≥4), obesity (BMI ≥30), high waist circumference (females: ≥80cm and males: ≥94cm, and high waist-hip ratio (females: ≥0.85 and males: ≥1.00) at age 24 were estimated using logistic regression analysis. Results: We found distinct groups of adolescents characterised by consistently high and consistently low engagement in cancer risk behaviours. After adjustment, adolescents in the top quartile had greater odds of all outcomes in early adulthood: nicotine dependency (odds ratio, OR=5.37, 95% confidence interval, CI=3.64-7.93); daily smoking (OR=5.10, 95% CI =3.19-8.17); obesity (OR=4.84, 95% CI=3.33-7.03); high waist circumference (OR=2.48, 95% CI=1.94-3.16); harmful drinking (OR=2.04, 95% CI=1.57-2.65); and high waist-hip ratio (OR=1.88, 95% CI=1.30-2.71), compared to the bottom quartile. In latent class analysis, adolescents characterised by consistently high-risk behaviours throughout adolescence were at higher risk of all cancer risk behaviours at age 24, except harmful drinking.Conclusions: Exposure to adolescent cancer risk behaviours greatly increased the odds of cancer risk behaviours in early adulthood. Interventions to reduce these behaviours should target multiple rather than single risk behaviours and should focus on adolescence.

Engagement With a Web-Based Intervention to Reduce Harmful Drinking: Secondary Analysis of a Randomized Controlled Trial

Background Engagement with digital behavior change interventions (DBCIs) is considered a prerequisite for intervention efficacy. However, in many trials on DBCIs, participants use the intervention either only little or not at all. Objective To analyze engagement with a web-based intervention to reduce harmful drinking, we explored (1) whether engagement with a web-based alcohol intervention is related to drinking outcomes, (2) which user characteristics are associated with measures of engagement, and (3) whether reported outcomes are associated with data captured by voluntary intervention questionnaires. Methods We analyzed data of the intervention arm of a randomized controlled trial on a DBCI to reduce risky alcohol consumption. Data were collected at baseline (T0), after 90 days (T1), and at the end of the 180-day usage period (T2). Engagement with the intervention was measured via system usage data as well as self-reported usage. Drinking behavior was measured as average daily alcohol consumption as well as the number of binge drinking days. User characteristics included demographics, baseline drinking behavior, readiness to change, alcohol-related outcome expectancies, and alcohol abstinence self-efficacy. Following a bivariate approach, we performed two-tailed Welch’s t tests and Wilcoxon signed rank/Mann-Whitney U tests or calculated correlation coefficients. Results The data of 306 users were analyzed. Time spent engaging with the intervention as measured by system usage did not match self-reported usage. Higher self-reported usage was associated with higher reductions in average daily alcohol consumption (T1: ρ=0.39, P<.001; T2: ρ=0.29, P=.015) and in binge drinking days (T1: ρ=0.62, P<.001; T2: ρ=0.3, P=.006). Higher usage was reported from users who were single (T1: P<.001; T2: P<.001), users without children (T1: P<.001; T2: P<.001), users who did not start or finish secondary education (T1: P<.001; T2: P<.001), users without academic education (T1: P<.001; T2: P<.001), and those who worked (T1: P=.001; T2: P=.004). Relationships between self-reported usage and clinical or psychological baseline characteristics were complex. For system usage, the findings were mixed. Reductions in drinking captured by intervention questionnaires were associated with reported outcomes. Conclusions Though self-reported usage could be consistently linked to better outcomes and multiple user characteristics, our findings add to the overall inconclusive evidence that can be found throughout the literature. Our findings indicate potential benefits of self-reports as measures of engagement and intervention questionnaires as a basis for tailoring of intervention content. Future studies should adopt a theory-driven approach to engagement research utilizing psychometrically sound self-report questionnaires and include short ecological momentary assessments within the DBCIs. Trial Registration German Clinical Trials Register DRKS00006104; https://tinyurl.com/y22oc5jo