Clinical and behavioral correlates in adult methamphetamine users with childhood exposure to household drug and alcohol use

Aims: To describe and compare methamphetamine (MA) users with and without a family history of alcohol or drug () use in the household. Design: A total of 1144 Thai-speaking MA users in Thailand were recruited for a cohort study. Cross-sectional baseline data were analyzed according to their exposure to FAOD use (FAOD+/FAOD-). The Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) was utilized to collect baseline socio-demographic information and variables known to be associated with the impact of FAOD use. Findings: FAOD+ participants had lower average years of education (p<0.01), fewer average months of employment in the past year (p<0.01) and reported higher rates of self-harm experience (p<0.001), gambling (p=0.018) and antisocial personality disorder (p=0.015). FAOD+ participants had more severe clinical, adverse consequences. FAOD+ significantly predicted episodes of lifetime MA use (R2 =0.004, p=0.032), the largest number of drinks ever had in a 24-hour period (R2 =0.01, p=0.001), paranoid experiences ([OR]=1.090, p=0.004), alcohol dependence ([OR]=1.112, p=0.001) and antisocial personality disorder ([OR]=1.139, p=0.015). FAOD+ participants who were exposed to alcohol only were more likely to report a significantly higher number of drinks ever had in a 24-hour periods (p<0.005). Similarly, FAOD+ participants who were exposed to MA use only were significantly more likely to report more frequent use of MA (p<0.005). Conclusions: FAOD+ participants were characterized by a generally more severe clinical presentation than FAOD- participants. Moreover, we show the specificity of drug type mattered, with family exposure of alcohol and MA associated with greater subsequent use of the respective drugs.

Socio-economic determinants of alcohol consumption for South Africa

Aims: To examine the socio-economic factors associated with alcohol consumption in South Africa. Design: Cross-sectional study exploring the various socio-economic factors associated with alcohol consumption in South Africa. Setting: South Africans older than 15 years across the country’s nine provinces. Participants: Adult respondents of the alcohol intensity and frequency questions in Wave 4 of the National Income Dynamics Study (NIDS) (n=28 401). Measures: Alcohol, demographic, emotional, health and neighbourhood variables. Findings: White and Mixed Heritage (referred to as ‘Coloured’ in South Africa) adults were more likely to consume alcohol, while Indian and White adults were less likely to binge drink relative to African adults. Males at greater risk of depression, and those who resided in neighbourhoods where frequent alcohol and drug abuse was common, were more likely to binge drink. Females who exercised more than three times a week were also more likely to drink and binge drink. Adults who smoked were more likely to drink and binge drink relative to non-smoking adults. Accounting for binge drinkers’ household size, average monthly household spending for binge drinkers was low, which suggests that binge drinkers under-reported household alcohol spending. There was evidence of drinking and binge drinking among pregnant women. Conclusions: Binge drinking trends related to race, gender, neighbourhood, pregnancy and household alcohol spending warrant further investigation and consideration for possible future alcohol interventions in South Africa.

Alcohol-related family violence in Australia: Secondary data analysis of the National Drug Strategy Household Survey

Aims: Alcohol is a risk factor for family violence that affects partners, parents, children and other relatives. This study aims to provide estimates of the prevalence of alcohol-related family violence reported in 2016 in Australia across numerous socio-demographic groups. Methods: This paper presents secondary data analysis of 23,749 respondents (10,840 men, 12,909 women) from the Australian Institute of Health and Welfare’s 2016 National Drug Strategy Household Survey (NDSHS). Alcohol-related family violence was measured by self-report as being physically or verbally abused or put in fear from a family member or partner deemed by the victim as under the influence of alcohol. Logistic regression was used to analyse which factors were associated with alcohol-related family violence. Findings: Analysis revealed that 5.9% of respondents (7.7% of women and 4.0% of men) reported alcohol-related family violence in the past year from either a partner or another family member. Respondents who were women (vs men), within less advantaged (vs more advantaged) socio-economic groups, risky drinkers (vs non-risky drinkers), residing in outer regional areas (vs major cities), holding a diploma (vs high school education) and single with dependents, reported higher overall rates of alcohol-related family violence. In contrast, respondents aged 55+ had significantly lower odds of experiencing alcohol-related family violence than all other age groups. Conclusions: Alcohol-related family violence was significantly more prevalent amongst respondents in a range of socio-demographic categories. Identification of these groups which are adversely affected by the drinking of family and partners can aid in informing current policy to protect those more vulnerable.

A cross-cultural comparison of factors associated with marijuana use among college students in the United States and Sweden

Aims: Marijuana is a popular drug among U.S. college students. In Sweden, the prevalence of marijuana use has been relatively low but is increasing. Brief, personalized interventions have been efficacious in reducing substance use, including marijuana, among college students in the U.S. However, prior to implementation of U.S. interventions in Sweden, it is important to compare factors associated with marijuana use among college students in the two countries. Design, Setting, and Participants: Data are from baseline assessments of two large college student intervention studies in the U.S. (N = 3,753, 39% male) and Sweden (N = 2,280, 35% male). Measures: Past 30-day prevalence and frequency of marijuana use was analyzed in regard to relevant demographic factors. The moderating role of nationality was also examined. Findings: Results support previous findings indicating marijuana use is more common in the U.S. than in Sweden. Most demographic factors were similar across the countries, except for relationship status and work status, in which associations with number of marijuana use days (but not odds of any marijuana use) were stronger for Swedish college students compared to U.S. college students. Conclusions: Based on overall similarities between the U.S. and Sweden, comparable interventions might be recommended in both countries.

Measuring alcohol’s cost, the Russian-language AUDIT, home-drinking, guilt, shame and forgiveness, and alcohol use among sexual minority women

Welcome to the first issue of Volume 9 of IJADR for 2021. This issue has papers that are likely to be of interest to a very broad audience. Again, we have a spread of international papers addressing issues related to (a) the measurement of cost of alcohol-attributable illness in studies across the globe (Carr et al., 2021); (b) drinking at home in Australia (Aplin et al., 2021); (c) the operationalisation of the Alcohol Use Disorders Identification Test (AUDIT) in the Russian Federation and other countries where Russian-language versions of the instrument have been used (Bunova et al., 2021); (d) alcohol consumption and problems among sexual minority women (SMW) in the United States of America (Hughes et al., 2021); and (e) emotions of shame and guilt feelings among people with alcohol use disorders (AUDs) in Turkey (Vatansever & Ozgur-Ilhan., 2021). There are many interesting, useful and important lessons about measuring alcohol consumption, alcohol-related problems and costs from this issue’s collection of papers.Cost of illness studies are relevant to policymakers because they summarize the societal burden from a given disease and enable comparison of costs for different health and social problems. Cost of illness studies have been broadened to include costs due to risk factors such as alcohol. The aim of the Carr, Rehm and Manthey (2021) paper was two-fold: to evaluate alcohol-attributable cost of illness metrics and improve guidelines for alcohol-specific and general cost of illness studies. Carr et al. (2021) undertook a systematic review firstly to identify guidelines for how cost of illness studies should be undertaken. They found 14 sets of guidelines and identified key criteria that cost of illness studies should meet. Secondly, they identified 18 alcohol-attributable cost of illness studies and reviewed whether these studies followed identified best practice guidelines. Disappointingly, Carr et al. found that adherence to guidelines in published alcohol-attributable (and general) cost of illness studies was low. Contrary to recommendations, many studies did not: define direct and indirect costs; compare the costs estimated to the national gross domestic figures; or estimate avoidable costs. Consequently, they concluded that the alcohol-related costs of illness estimated in many studies are deficient. Importantly Carr et al., (2021) set out common standards for cost of illness studies and suggest content-related and software-based solutions that should reduce heterogeneity and enhance comparability in future alcohol cost of illness studies.Aplin and colleagues’ (2021) paper describes a study in which the authors compared the role of habit and intention in drinking at home among a sample of adults (aged 35-60 years) in Australia. Although conducted pre-COVID, this study is particularly relevant to the COVID-19 times of increased home drinking due to the closure of on-premise outlets in many locations. A key finding of the study is that habit is more strongly associated with alcohol consumption than is drinking intention. In other words, drinking at home seems to involve more of an automatic than a conscious decision-making process. The study’s findings raise some important questions regarding drinking during the pandemic. With restrictions imposed on on-premise consumption in many countries, in one form or the other, home drinking is likely to have increased. What are the implications of these restrictions and new patterns or levels of “habitual drinking” for alcohol-related harms in the home? And will those habits be maintained once lockdown restrictions have been lifted?The AUDIT has been widely available since the 1980s, and validated and translated into several languages throughout the world. The paper by Anna Bunova and her colleagues (2021) describes a document analysis which was conducted to identify the different versions of the AUDIT as part of a larger validation project. Bunova et al. uncovered 61 unique versions of the AUDIT in Russian and identified a number of inconsistencies in the ways in which they had been operationalized and translated from English. For example, they found standard drinks were operationalised differently across different forms of the AUDIT, and speculated that this could be due to the absence of official definitions of a standard drink in Russia. It would be useful for these revelations to be disseminated widely to those interested in using the AUDIT in Russian. The shortcomings that have been highlighted are probably not unique to the Russian language AUDITs, and similar audits of the AUDIT are probably worth pursuing for other non-English language versions of the AUDIT. The Chicago Health and Life Experiences of Women (CHLEW) study is the longest-running and most comprehensive study of alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual) in the United States of America and globally. The first wave was undertaken in 2000 and the fifth wave is underway. The article by Hughes, Wilsnack, Martin, Matthews and Johnson (2021) describes CHLEW’s development and the challenges faced by the research team in developing and maintaining a longitudinal study. This paper celebrates the success of this study, including the 56 published manuscripts produced in the past 21 years, and describes the contribution the study has made to deepening understanding of SMW’s drinking and associated risks. Crucially, the paper also details how longitudinal designs can be used to understand how changes in social determinants impact alcohol use. This paper outlines the processes of this long-term study, its major findings, and the lessons learned, and acts as a model for future research that seeks to understanding and eliminate sexual orientation-related health disparities.In a study of treatment and non-treatment samples in Turkey, Vatansever and her colleagues (2021) sought to disentangle the relative importance of two similar, but unique concepts, among people with alcohol use disorders (AUDs) – guilt and shame. These constructs refer to a feeling and an emotion that are not uncommon among people with AUDs. They also assessed pride and forgiveness. A key finding was that individuals with substance use disorders had higher levels of guilt and shame, and lower levels of pride than a comparison group of people without an AUD. They also found that when both guilt and shame were entered into one model, only guilt was independently associated with having a substance use disorder. The findings have important implications for treatment of individuals with AUDs.

Forgiveness, guilt, and shame in alcohol dependence: A comparative study in a Turkish sample

Aims: The purpose of the present study was to compare individuals with and without alcohol dependence in terms of forgiveness, shame, and guilt. A further purpose was to investigate the association of shame and guilt with alcohol dependence. Methods: Fifty-five individuals with and 55 without alcohol dependence (based on ICD-10 criteria) were compared using the Heartland Forgiveness Scale (HFS), and Trait Shame and Guilt Scale (TSGS). Results: Individuals with alcohol dependence showed a significantly lower level of self-forgiveness, pride and a significantly higher level of both shame and guilt than the non-alcohol dependent group in the univariate analysis. However, only guilt was related to the presence of alcohol dependence in the multivariate analysis. Self-forgiveness was negatively correlated with both shame and guilt in the alcohol-dependent individuals, but not among individuals without alcohol use problems. Conclusions: The findings of this study support the importance of the self-conscious emotions of shame and guilt in alcohol dependence, together with self-forgiveness. These psychological states should be considered in the treatment of alcohol dependence.

The Russian translations of the Alcohol Use Disorders Identification Test (AUDIT): A document analysis and discussion of implementation challenges

Aims: To analyze existing Russian translations of the Alcohol Use Disorders Identification Test (AUDIT) and their applicability in Russian-language populations. Method: Document analysis of different Russian-language versions of the AUDIT and its shorter versions as identified in a systematic search. Findings: A total of 122 Russian translations of the AUDIT or its shorter versions from Russia and other countries were included in the document analysis, 61 of which were unique versions. Across the translations, a series of inconsistencies was identified, most of which related to the first three consumption items and the concept of a standard drink. The identified problems appeared to have been caused by difficulties in adapting the tool to local drinking patterns and local beverage volumes. None of the analyzed sources mentioned systematic translation procedures according to a predetermined protocol. Conclusions: Despite the fact that the AUDIT was developed as a standardized screening tool almost 30 years ago, there is still no official translation into the Russian language according to the commonly used procedures for the translation and adaptation of instruments. A systematic translation and validation appears to be urgently needed in order to have an internationally comparable AUDIT for research and clinical purposes in Russian-speaking populations.

Alcohol use among sexual minority women: Methods used and lessons learned in the 20-Year Chicago Health and Life Experiences of Women Study

Background: Two decades ago, there was almost no research on alcohol use among sexual minority women (SMW, e.g., lesbian, bisexual). Since then, a growing body of scientific literature documents substantial sexual orientation-related disparities in alcohol use and alcohol-related problems. Research has identified multiple risk factors associated with high-risk/hazardous drinking among SMW. However, this research has almost exclusively used cross-sectional designs, limiting the ability to draw conclusions about processes through which sexual minority status affects alcohol use. Longitudinal designs, although very rare in research on alcohol use among SMW, are important for testing mediational mechanisms and necessary to understanding how changes in social determinants impact alcohol use. Aim: To describe the processes and lessons learned in conducting a 20-year longitudinal study focused on alcohol use among SMW. Methods: The Chicago Health and Life Experiences of Women (CHLEW) study includes five waves of data collection (2000–present) with an age and racially/ethnically diverse sample of 815 SMW (ages 18–83) originally recruited in the Chicago Metropolitan Area in Illinois, a midwestern state in the United States (U.S.). Measures and focus have evolved over the course of the study. Results: The CHLEW study is the longest-running and most comprehensive study of SMW’s drinking in the U.S. or elsewhere. Findings reported in more than 50 published manuscripts have contributed to understanding variations in SMW’s risk for hazardous/harmful drinking based on sexual identity, age, race/ethnicity, sex/gender of partner, and many other factors. Conclusions: By describing the process used in conducting this long-term study, its major findings, and the lessons learned, we hope to encourage and support other researchers in conducting longitudinal research focused on SMW’s health. Such research is critically important in understanding and ultimately eliminating sexual orientation-related health disparities.

The Explanatory Roles of Habit and Intention on Alcohol Consumption by Adults at Home

Aims: The aim of this paper is to investigate the role of intention and habit in predicting adults’ drinking behaviour within the home setting. Measures: A convenience sample of 414 Australians aged between 35 and 60 were recruited through targeted Facebook advertising. Eligibility criteria for study participation included reporting consuming alcohol at least once a week at home. Participants completed self-report measures of alcohol consumption, habit strength regarding home drinking behaviour, and intentions to consume alcohol. Differences in home drinking controlling for age and gender, by level of habit, and intention were examined using ANCOVA. Results: Increases in intention were associated with an increase in home drinking. However, with habit and intention entered in the same model, only habit was a significant predictor of the amount of alcohol consumed in the home. For Australians, habit is a stronger predictor of alcohol consumption than intention. Conclusions: Given that a large proportion of people are doing the majority of their drinking when at home, home-based interventions which target the habitual nature of home consumption may help to reduce consumption and related harm.