Estimating need for alcohol treatment in Ireland using national treatment surveillance data

Background International evidence indicates that about 10% of people with alcohol dependence will seek and commence treatment each year. Based upon Irish estimates of prevalence of dependence, a target of 690.0 treated cases per 100,000 population per annum is expected. Aims This study analyses routine national surveillance data on alcohol treatment to measure how treatment need is being met. Methods National treatment surveillance data on problem alcohol use collected by the National Drug Treatment Reporting System (NDTRS) were analysed. The study included cases resident in Ireland, aged 18–64 years entering treatment for alcohol use disorder (AUD) between 2015 and 2019 (n = 44,079). Treatment rates were calculated per 100,000 of the population. Descriptive and exploratory statistics were used to describe characteristics of cases treated. Results National rate of treated AUD was 270 cases per 100,000 annually, with a rate of treated alcohol dependence of 165/100,000. There was a fivefold difference between the lowest and highest rates (119 cases per 100,000 in Meath versus 633 in Waterford). Drinking patterns indicate high levels of alcohol consumption and prolonged use prior to treatment. The use of other drugs alongside alcohol was common. Conclusions Despite high rates of alcohol consumption and dependence, the rate of treatment entry nationally is sub-optimal, although there are wide geographic variations. There is a need to better understand the reasons for low treatment entry rates in Ireland for people with alcohol dependence. Monitoring and surveillance play a key role in measuring the successful efforts to reduce the harm of alcohol.

The Mental Health of U.S. Parents During the COVID-19 Pandemic

Evidence suggests parents experience unique pandemic-related stressors related to isolation, food insecurity, school closures, and unemployment. This study examined 1,048 U.S. parents’ depression, anxiety, stress, and alcohol and substance use behaviors during March and April 2020 to better understand the impact of pandemic-related conditions on parents’ mental health. Mean scores indicated severe levels of depression and stress and extremely severe anxiety. Nearly two thirds (74.7%) indicated alcohol use in the past month, with 26.5% scoring in the range for problem alcohol use. Almost half of the sample reported using at least one substance in the previous 2 weeks. Men had significantly higher alcohol consumption and substance use than women. Depression, anxiety, and stress were higher for parents who consumed alcohol or substances and had a history of depression or anxiety. The long-term impact of COVID-19 is unknown, and mental health care is likely to be in high demand moving forward.

A trait-like propensity to experience internalizing symptoms is associated with problem alcohol involvement across adulthood, but not adolescence

There are stable between-person differences in an internalizing “trait,” or the propensity to experience symptoms of internalizing disorders, such as social anxiety, generalized anxiety disorder, and depression. Trait internalizing may serve as a marker of heightened risk for problem alcohol outcomes (such as heavier drinking, binge drinking or alcohol dependence). However, prior research on the association between internalizing symptoms and alcohol outcomes has been largely mixed in adolescence, with more consistent support for an association during adulthood. It may be that trait internalizing is only associated with problem alcohol outcomes in adulthood, after individuals have gained experience with alcohol. Some evidence suggested that these effects may be stronger for females than males. We used data from a community sample (n = 790) interviewed during adolescence (ages 14 – 16) and again at ages 21, 24, 27, 30, 33, and 39. Using generalized estimating equations, we tested the association between trait internalizing and alcohol outcomes during both adolescence and adulthood, and tested whether adult trait internalizing mediated the association between adolescent trait internalizing and adult alcohol outcomes. Trait internalizing in adulthood (but not adolescence) was associated with more frequent alcohol use, binge drinking and symptoms of alcohol use disorders, and mediated the effects of adolescent trait internalizing on alcohol outcomes. We observed no moderation by gender or change in these associations over time. Understanding the developmental pathways of trait internalizing may provide further insights into preventing the emergence of problem alcohol use behavior during adulthood.

Problem Electronic Device Use in a Representative Sample of Adults in Ontario

There is growing evidence of correlations between the amount of time spent using electronic devices in leisure and negative health outcomes. However, studies often lack indicators of problematic technology use, rarely investigate relationships between such problem use patterns and indicators of poor mental health, and use samples that are unrepresentative of the adult population. Using a representative telephone survey of adults, we applied the Problem Electronic Device Use (PEDU) scale to estimate the level of PEDU in Ontario, Canada, and the associations between PEDU scores and a wide range of outcomes with a series of multivariate logistic regressions. We found an average weekly electronic device use of 15.57 hr, excluding work or school, and moderate to severe problem technology use among 7.9% of the adult population. Moderate to severe PEDU was significantly associated with suicidal ideation, serious psychological distress, problem alcohol use, and treatment for anxiety. Implications for the findings are discussed.RésuméIl existe des preuves croissantes de corrélations entre la durée d’utilisation d’un appareil électronique à des fins de divertissement et les conséquences négatives sur la santé. On note souvent l’absence d’indicateurs de l’usage problématique des technologies dans les études qui examinent les corrélations entre cet usage et les indicateurs de troubles de santé mentale ou qui utilisent des échantillons représentatifs de la population adulte. À partir des résultats d’un sondage téléphonique représentatif mené auprès d’adultes, la présente étude a eu recours à l’échelle d’évaluation de l’usage problématique des appareils électroniques (Problem Electronic Device Use ou PEDU) pour estimer l’ampleur de ce phénomène dans la province (Ontario) et a appliqué une série de régressions logistiques multivariées pour établir des liens entre les résultats PEDU et un large éventail de conséquences sur la santé mentale. L’étude a révélé que l’usage hebdomadaire moyen des appareils électroniques chez les adultes sondés était de 15,57 heures et que 7,9 % d’entre eux rapportaient un niveau modéré à sévère d’usage problématique de la technologie. Des liens significatifs ont été établis entre l’usage problématique des appareils électroniques et plusieurs indicateurs de troubles de santé mentale et de consommation de substances psychoactives. Les implications de ces constats sont discutées ici.

Predicting Different Types of Intimate Partner Aggression Perpetration: The Roles of Problem Alcohol Use and Distress Tolerance

Intimate partner aggression (IPA) victimization and substance use have been well established as risk factors for IPA perpetration ( Leonard, 2005 ; Sprunger et al., 2015 ). Recent research has identified a negative association between distress tolerance and physical and psychological IPA perpetration, specifically in males in substance use treatment ( Shorey et al., 2017 ). Research examining the interplay of problem substance use, distress tolerance, and other forms of IPA (i.e., sexual coercion, controlling behaviors) in non-clinical samples is limited. The present analysis aimed to examine the potential moderating effect of distress tolerance on problem alcohol use and four types of IPA perpetration (physical assault, psychological aggression, sexual coercion, and controlling behaviors) in a diverse, national sample ( N = 323; 44.3% female; 52.9% sexual minority; age M = 33.61 years, SD = 8.71). Results showed that alcohol use and distress tolerance had differing influences on each IPA perpetration type. In line with hypotheses, distress tolerance significantly moderated the relationship between problem alcohol use and two forms of IPA (physical assault and controlling behaviors); this relationship was stronger for individuals with low levels of distress tolerance. Significant interaction effects did not emerge for psychological aggression or sexual coercion. Findings suggest that treatment strategies that focus specifically on increasing distress tolerance may be effective in reducing alcohol-facilitated IPA perpetration involving physical assault and controlling behaviors.

Factors associated with syphilis seroprevalence in women with and at-risk for HIV infection in the Women’s Interagency HIV Study (1994–2015)

ObjectiveSyphilis rates among women in the USA more than doubled between 2014 and 2018. We sought to identify correlates of syphilis among women enrolled in the Women’s Interagency HIV Study (WIHS) to inform targeted interventions.MethodsThe retrospective cross-sectional analysis of secondary data included women with HIV or at-risk of HIV who enrolled in the multisite US WIHS cohort between 1994 and 2015. Syphilis screening was performed at baseline. Infection was defined serologically by a positive rapid plasma reagin test with confirmatory treponemal antibodies. Sociodemographic and behavioural characteristics stratified by baseline syphilis status were compared for women enrolled during early (1994–2002) and recent (2011–2015) years. Multivariable binomial modelling with backward selection (p>0.2 for removal) was used to model correlates of syphilis.ResultsThe study included 3692 women in the early cohort and 1182 women in the recent cohort. Syphilis prevalence at enrolment was 7.5% and 3.7% in each cohort, respectively (p<0.01). In adjusted models for the early cohort, factors associated with syphilis included age, black race, low income, hepatitis C seropositivity, drug use, HIV infection and >100 lifetime sex partners (all p<0.05). In the recent cohort, age (adjusted prevalence OR (aPOR) 0.2, 95% CI 0.1 to 0.6 for 30–39 years; aPOR 0.5, 95% CI 0.2 to 1.0 for 40–49 years vs ≥50 years), hepatitis C seropositivity (aPOR 2.1, 95% CI 1.0 to 4.1) and problem alcohol use (aPOR 2.2, 95% CI 1.1 to 4.4) were associated with infection.ConclusionsSyphilis screening is critical for women with HIV and at-risk of HIV. Targeted prevention efforts should focus on women with hepatitis C and problem alcohol use.

Motives for Alcohol and Marijuana Use as Predictors of Use and Problem Use Among Young Adult College Students

This study examined (a) differences between alcohol-only users and alcohol–marijuana co-users and (b) motives for use in relation to alcohol and marijuana use and problem use. Spring 2016 data among 1,870 past 4-month alcohol users (63.6% female, 69.1% White) from seven Georgia colleges/universities were analyzed cross-sectionally and with regard to problem use measured 4 months later. Correlates of co-use ( n = 345; vs. alcohol-only use, n = 1,525) included greater alcohol and marijuana use frequency, problem drinking and marijuana use, and alcohol use motives ( p’s < .05). Controlling for covariates, alcohol use frequency correlated with greater marijuana use frequency and Coping and Self-enhancement alcohol use motives, but lower Conformity alcohol use motives ( p’s < .001); greater Coping and Self-enhancement alcohol use motives ( p’s < .01) predicted problem alcohol use. Marijuana use frequency correlated with greater Coping and Expansion marijuana use motives ( p’s < .05); greater Expansion marijuana use motives ( p = .005) predicted problem marijuana use. College-based substance use interventions should target Coping and Self-enhancement alcohol use motives and Expansion marijuana use motives.