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ICCPUD News

The connection between alcohol use, PTSD symptoms, risk taking, and impulsivity

There is a link between post-traumatic stress disorder (PTSD) and alcohol use in veterans who experienced combat. Researchers found that both more risk taking and impulsivity were associated with increased alcohol use, number of drinks, and days of binge drinking in the past month. However, they found that neither impulsivity nor risk taking moderated the positive relationship between PTSD symptoms and alcohol use.

The paper, “Examination of the effects of impulsivity and risk-taking propensity on alcohol use in OEF/OIF/OND Veterans” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the Journal of Military, Veteran and Family Health.

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Different factors affect differential risks of alcohol use disorder

People have different levels of risks for alcohol use disorder, even unrelated to the amount of alcohol they drink. In this paper, this is referred to as “addiction resistance.” Researchers sought to improve understanding of addiction resistance and what factors contribute to it. They studied a sample of healthy young adults to compare their levels of alcohol use and alcohol use disorder symptoms to look for moderating factors. Their results showed that greater emotional stability, norm adherence, and risky behavior avoidance, along with fewer family members with substance use disorders, enhanced addiction resistance.

The article, “Addiction resistance to alcohol: What about heavy drinkers who avoid alcohol problems?” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal Drug and Alcohol Dependence.

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The connection between alcohol use, PTSD symptoms, and sleep disturbance

A factor that may influence both post-traumatic stress disorder (PTSD) symptoms and alcohol-related problems is sleep disturbance. This study sought to answer whether sleep disorders affected the relationship between PTSD symptoms and alcohol use, and whether PTSD symptoms influenced the association between sleep and alcohol problems. Researchers followed a group of veterans for a year and found that PTSD symptoms at baseline influenced the severity of alcohol problems 12 months later, but sleep disturbance did not mediate the relationship between PTSD symptoms and severity of alcohol problems. They also found that sleep disturbance at the beginning of the study was associated with alcohol problems, and PTSD symptoms somewhat mediated the association between sleep disturbance and alcohol problems.

The paper, “Longitudinal associations between sleep, intrusive thoughts, and alcohol problems among veterans” was funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal Alcoholism: Clinical and Experimental Research.

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Polysubstance use of opioids, stimulants, and alcohol in college

Researchers examined the relationship between use of opioids, stimulants, and alcohol in combination by college students and how they predicted consequences of alcohol use. The researchers used data from nearly 500,000 AlcoholEDU for College™ users. Opioid and/or stimulant misuse was positively associated with alcohol use, as well as consequences from that alcohol misuse. They also found that using both opioids and stimulants was not associated with an increased risk of alcohol use over using just one.

The paper, “Alcohol use and consequences in matriculating US college students by prescription stimulant/opioid nonmedical misuse status” was funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal Addictive Behaviors.

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Differences in alcohol misuse prevention policies between urban and nonurban communities

Alcohol misuse prevention policies may differ by the number and types of enforcement activities across different environments. Researchers wanted to see if officials in rural, suburban, or urban communities approached alcohol policy enforcement differently. They analyzed data from a national survey of law enforcement agencies and found that those in urban areas conducted more enforcement activities than agencies in rural or suburban areas. They were also more likely to use different types of enforcement activities such as underage sales compliance checks, patrols, and sobriety checkpoints.

The article, “Variation in alcohol policy enforcement across urban and nonurban communities” was funded by the National Institute on
Alcohol Abuse and Alcoholism. It was published in the Journal of Rural Health.

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CONNECT: a school-based intervention for diverse communities

Researchers developed and tested a multi-year school-based intervention called CONNECT among white and American Indian students in a Cherokee Nation high school. While other research papers focused on the program outcomes, this research paper focused on the program design and implementation. CONNECT contains two prevention strategies: screening and brief intervention using motivational interviewing administered by a trained coach; and, a media campaign consisting of posters and postcards for students and parents. This paper reveals that throughout the CONNECT intervention, at least 73% of eligible students met with a coach each semester. Additionally, the CONNECT communities did embrace the marketing campaign and poster/postcards could be found throughout the communities.

The paper, “CONNECT: Implementation of a School-Based Alcohol Screening and Brief Intervention for Youth in the Cherokee Nation,” was funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. It was published in the Journal of School Health.

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The connection between alcohol use disorder and chronic pain

To understand common neuroanatomical factors in individuals with alcohol use disorder (AUD) and those with chronic pain, researchers reviewed the literature on both topics and how AUD can affect pain. They learned that reward and oversight circuits, as well as other neural substrates, are dysfunctional in individuals with either AUD or chronic pain. They also showed how AUD can contribute to chronic pain and discussed how clinicians can respond to either or both in light of the connection.

The paper, “At the intersection of alcohol use disorder and chronic pain,” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal Neuropsychology.

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Evaluating the U.S. MHPAEA’s effect on alcohol treatment admissions

The U.S. Mental Health Parity and Addiction Equity Act (MHPAEA) is an important federal policy designed to enhance insurance coverage of and thus increase access to substance use treatment. Researchers used the National Institute on Alcohol Abuse and Alcoholism’s Alcohol Policy Information System to rate the strength of states’ laws that were in place before the start of MHPAEA and, similar to MHPAEA, designed to enhance parity of insurance coverage for treatment. They used SAMHSA’S Treatment Episode Data Set (TEDS) to examine treatment rates over time. They found that regardless of whether MHPAEA had taken effect, states with stronger pre-existing parity laws had higher treatment rates than states with weaker laws. For the most part, MHPAEA implementation did not appear to affect alcohol treatment rates. As the exception, in states that mandated insurance coverage and partial parity before the start of MHPAEA, alcohol treatment rates increased after the start of MHPAEA implementation.

The paper, “U.S. alcohol treatment admissions after the Mental Health Parity and Addiction Equity Act: Do state parity laws and race/ethnicity make a difference?,” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the Journal of Substance Abuse Treatment.

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Exploring how social networks affect alcohol use in adults

Social network characteristics may shed light on risk and protective factors for alcohol use in adults. Researchers conducted a systematic review, examining relevant pieces of scientific literature to see if there were overarching patterns in determining what the field still needs to learn. They found that most studies were conducted with young adults in college settings or were longitudinal studies, following adolescents into adulthood. Although the different studies used a variety of methods, all found statistically significant results between social network-related factors and alcohol consumption in young adulthood. Researchers still know very little about the relationship between social networks and drinking in older age groups.

The paper, “Using social network analysis to examine alcohol use among adults: A systematic review,” was funded by the National Institute on Drug Abuse. It was published in the journal PLOS ONE.

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The relationship between genetics and neighborhoods on risky behavior

Researchers examined the connection between (a) the physical and social dynamics of a neighborhood and genetic risk factors and (b) markers of alcohol use disorder (e.g., drinking without parental approval) in African American adolescents. They measured how people’s reactions to social stress can relate to the development of alcohol-related problems. Overall, family stress, experiences of discrimination, and genetics, rather than factors related to the physical neighborhood, were associated with the markers of alcohol use disorder. However, researchers also found significant interactions between family stress and neighborhood factors (such as violence) in the transition to problematic alcohol use. Their findings underscore the recommendation for holistic prevention programs for adolescents who live in economically disadvantaged areas.

The paper, “Evaluating Neighborhood, Social, and Genetic Influences on Precursors of Alcohol Use Risk Behavior in African American Adolescents,” was funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. It was published in the International Journal of Environmental Research and Public Health.

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Many people who misuse prescription opioids also binge drink

Researchers at the Centers for Disease Control and Prevention (CDC) sought to understand the relationship between binge drinking and prescription opioid misuse. They used the National Survey on Drug Use and Health and found that 3.5 percent of binge drinkers misused opioids, compared to 1.6 percent of all people ages 12 and older. This finding means more than half of everyone who misused prescription opioids from 2012 to 2014 also binge drank. 

The article, “Binge Drinking and Prescription Opioid Misuse in the U.S., 2012-2014,” was funded by CDC. It was published in the American Journal of Preventative Medicine.

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Alcohol and marijuana use predicted sexual intercourse in truant adolescents

Researchers studied data from a group of at-risk, truant adolescents to understand the influence of alcohol and marijuana use on the odds of engaging in sexual intercourse on a given day. They collected information on the daily behavior of this group and found that both alcohol and marijuana use significantly increased the odds of engaging in sexual intercourse on the same day as the substance use. Their results show a connection between these separate risk behaviors.

The article, “Marijuana use, alcohol use, and sexual intercourse among truant adolescents,” was funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal, Substance Abuse.

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Prenatal alcohol exposure increases the risk of miscarriage

Researchers sought to understand the scientific consensus on alcohol exposure during pregnancy and miscarriage. They collected, evaluated, and analyzed research papers related to prenatal alcohol exposure and its negative outcomes. They found combined scientific evidence that shows that pregnant women who drank alcohol had a higher chance of miscarriage, and that having more drinks per week increased a woman’s chance of having a miscarriage.

The paper, “Alcohol Use in Pregnancy and Miscarriage: A Systematic Review and Meta-Analysis,” was funded by the National Institutes of Health’s National Center for Advancing Translational Sciences and the National Institute of General Medical Sciences. It was published in the journal, Alcoholism: Clinical and Experimental Research.

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Tobacco and nicotine use are linked to changes in drinking behavior

Researchers wanted to understand how likely a person is to increase or decrease their alcohol use and whether tobacco or nicotine impacts alcohol use over time. They used two different years of the National Epidemiologic Survey on Alcohol and Related Conditions to see how people changed and whether nicotine was related to the change. They found that people who used tobacco but did not have alcohol use problems were more likely to increase their drinking than non-tobacco users. They also found women with both tobacco and alcohol use problems were more likely to decrease their drinking than women not using tobacco.

The article, “Current tobacco use, nicotine dependence, and transitions across stages of alcohol involvement: A latent transition analysis approach,” was funded by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. It was published in the International Journal of Methods in Psychiatric Research.

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Naltrexone affects how people respond to alcohol

Naltrexone is a medication that can effectively treat alcohol use disorders. In this paper, researchers studied both the mechanism that Naltrexone uses and how people taking the drug experience alcohol. They collected, reviewed, and analyzed the body of scientific literature on the drug and its effects. They found evidence that Naltrexone did reduce alcohol cravings and stimulation but increased sedation and negative moods. The effects varied based on amount of alcohol use, although effects were found in both heavy-drinking individuals and those with alcohol use disorder. These results suggest that Naltrexone changes how much neurological activation people experience when exposed to alcohol and how pleasant they perceive it is.

The article, “Naltrexone effects on subjective responses to alcohol in the human laboratory: A systematic review and meta-analysis,” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal, Addiction Biology.

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Climate affects levels of alcohol use and alcoholic cirrhosis

Researchers sought to determine if climate could affect drinking behavior. They used epidemiological data from all 50 states and 192 other countries to examine the relationship between climate, alcohol use, and cirrhosis. Their data show that people who live in colder climates with fewer hours of sunshine have higher levels of alcohol consumption as well as binge and heavy drinking. This increased drinking leads to more consequences, such as higher levels of alcoholic cirrhosis. These results show a global pattern and were true within the United States and all countries they measured.

The study, “Colder weather and fewer sunlight hours increase alcohol consumption and alcoholic cirrhosis worldwide,” was funded by the National Institute on Alcohol Abuse and Alcoholism and published in the journal Hepatology.

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Psychoactive experiences can help reduce alcohol use

This study looks at the effect of using psychoactive substances for treatment of substance use and mental health disorders in non-clinical settings. Researchers surveyed people with alcohol use problems who also took psychedelics about their experiences and drinking behaviors before and after. They found that most reduced their drinking after the experience and many no longer qualified for alcohol use disorder. Higher psychoactive doses and personally meaningful or mystical experiences were associated with greater reduction in alcohol use.

The Study, “Cessation and reduction in alcohol consumption and misuse after psychedelic use,” was funded by the National Institute on Drug Abuse and published in the Journal of Psychopharmacology.

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Sexual minority youth and substance use

Sexual minority youth are at increased risk for substance use disorders; however, little is known about differences within that group. Researchers used large national datasets to stratify participants into subgroups and compare their substance use behavior. They found that within this group, lesbians and bisexual youth were more likely to use tobacco and marijuana earlier and for a longer time compared to female heterosexual youth. Male bisexual youth were at the greatest risk for using marijuana, alcohol, and tobacco. The paper also contains intervention and prevention programming for this population.

The paper, “Sexual minority youth at risk of early and persistent alcohol, tobacco, and marijuana use,” was funded by the National Institute on Alcohol Abuse and Alcoholism and published in Archives of Sexual Behavior.

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Party music is associated with riskier drinking decisions

In this study, researchers tested different types of music on hypothetical drinking decisions in a sample of women with different levels of alcohol use. They found that listening to “party music” increased the likelihood of making risky drinking decisions compared to “home music.” This was true for all types of alcohol use, although heavy users made more risky drinking decisions overall. As an experimental control, they compared drinking decisions to eating and found that eating was less affected by music.

The study, “Risky drinking decisions: The influence of party music and alcohol abuse in young adult women,” was funded by the National Institute on Alcohol Abuse and Alcoholism and published in the journal Alcohol.

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An overview of alcohol use among women

This paper provides an overview of the ways that women use alcohol, including the epidemiology of alcohol use among women, their health and behavioral consequences, prenatal use, programs and interventions that can be used with women, and future directions for research and public health programs targeting women.

The paper, “Alcohol and women: A brief overview,” was supported by the National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism. It was published in the journal Alcoholism: Clinical and Experimental Research.

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Understanding the relationship between alcohol and sleep

The role that alcohol can play in sleep is often misunderstood, and some people report using alcohol to help them sleep. A new paper looks to summarize information about the connection between alcohol and sleep. Researchers found a relationship with alcohol and sleep disorders and several sleep mechanisms that alcohol disrupts. Alcohol use can impair electrophysiologic sleep architecture, circadian rhythms, sleep duration, and breathing and is affiliated with insomnia, snoring, and insufficient sleep. Researchers call for additional research to help further understand how alcohol contributes to sleep disorders.

The article, “Alcohol and sleep-related problems,” was funded by a collaborative grant from the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse. It was published in the journal, Current Opinion in Psychology.

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Genetic associations for alcohol consumption and potential use disorders

Research has shown the development of alcohol use and other substance use disorders has a genetic component. A new paper sheds light on this process and identifies specific genes that likely contribute to both alcohol consumption and use disorder. Scientists conducted a genome-wide association study to search for specific genes that are statistically associated with different types of drinking behavior. Researchers found that propensity for consumption was associated with actual alcohol use and other drinking outcomes. They recommended future research to look at how multiple genes contribute to these complex behaviors.

This paper, “The genetic relationship between alcohol consumption and aspects of problem drinking in an ascertained sample,” was funded by a collaborative grant from the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse. It was published in the journal, Alcoholism: Clinical and Experimental Research.

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Identifying risk and protective factors to prevent alcohol use during tailgating

Tailgating before college football games can be a common site of alcohol use. Understanding what contributes to alcohol use at these events may highlight opportunities for prevention. The context and individual alcohol-related expectations may encourage risky behaviors and discourage students from using strategies to limit consumption or reduce harms. In this study, researchers surveyed students before and after tailgating. They found that positive expectations around alcohol use were associated with the use of harm-reduction strategies, such as using designated drivers. Conversely, students with positive expectations around alcohol use were also associated with more drinking.

This study, “Tailgating protective behavioral strategies mediate the effects of positive alcohol outcome expectancies on game day drinking,” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the Journal of Primary Prevention.

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Examining motivations in college students for alcohol and marijuana use

College students with social anxiety symptoms are more likely to partake in problematic alcohol and marijuana use. Researchers studied motivations for engaging in the use of alcohol and marijuana in a sample of college students from across the United States who recently used both substances. They found similar reasons for using both substances to enhance situations or cope with general anxiety. The exception was participants who used substances to combat their social anxiety by trying to fit in; that group used alcohol more to help with their social anxiety.

The article, “The relationship between social anxiety and alcohol and marijuana use outcomes among concurrent users: A motivational model of substance use,” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal, Alcoholism: Clinical and Experimental Research.

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Drinking and driving among U.S. adults

Despite the seriousness of alcohol-impaired driving, very little data are collected on how frequently people drive after drinking as a means toward gauging its prevalence. This study uses the National Institute on Alcohol Abuse and Alcoholism’s National Epidemiologic Survey on Alcohol and Related Conditions to examine how frequently U.S. adults drive after drinking. They found that 5.7 percent of people self-reported driving after drinking more than once, 3.9 percent self-reported driving after drinking too much, 0.61 percent self-reported accidents while intoxicated, and 0.23 percent reported accidents with injuries. Men and peoples ages 18–29 were the most likely to self-report their own alcohol-impaired driving and its consequences.

The article, “Drinking and driving among adults in the United States: Results from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions-III,” was funded by the National Institute on Alcohol Abuse and Alcoholism. It was published in the journal, Accident Analysis & Prevention.

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Do colleges adopt effective alcohol use prevention policies?

Alcohol use on college campuses continues to be a significant public health problem, exposing many students to a high risk of injury or even death. This paper is a useful resource for college administrators working to address alcohol use on campus and in the surrounding community by looking at campus alcohol policies from 15 colleges in Maryland. The paper assesses the colleges’ policies for accessibility, clarity, and effectiveness, and finds that schools do well communicating the policies they have, but few have adopted the most effective policies. Many have ineffective sanctions.

The paper, “Assessing campus alcohol policies: Measuring accessibility, clarity, and effectiveness,” was funded by the National Institute on Drug Abuse and appeared in the March 2019 issue of Alcoholism: Clinical and Experimental Research.

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Do state policies to prevent alcohol use during pregnancy work?

Alcohol use during pregnancy can cause harm to the developing fetus. As many states have policies designed to prevent this behavior, researchers compared the drinking behavior of pregnant women by state and calculated the association with each type of policy. They found that having both punitive and supportive policies were associated with more drinking, but not binge or heavy drinking, than having no policies. Individually targeted policies had mixed effects, and combinations of policies were not associated with any outcome. This counterintuitive finding could mean that states with more alcohol use adopt more policies or that the policies they do have could be ineffective.

The paper, "State policies targeting alcohol use during pregnancy and alcohol use among pregnant women 1985–2016: Evidence from the Behavioral Risk Factor Surveillance System," was funded by the National Institute on Alcohol Abuse and Alcoholism and was published online in Women’s Health Issues.

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Social stress and alcohol initiation in adolescent girls

Social stress may be an important factor that influences adolescent alcohol use; however, most studies looking at social stress and alcohol have been limited by reliance on self-report. This current study used a controlled research environment and time series analysis rather than self-reporting to examine the relationship between social stress and alcohol use in a group of female adolescents. Researchers gave participants an anxiety-inducing task, measured stress levels, and then tracked their alcohol use over time. They found that the girls who were more anxious before the task began started drinking younger than those who were calmer, providing strong evidence for the relationship.

The paper, “Real-time social stress response and subsequent alcohol use initiation among female adolescents,” was funded by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse and appeared in the journal, Psychology of Addictive Behaviors.

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How do perceptions of close peers’ drinking behavior affect college students?

Young adults often can overestimate their peers’ level of drinking, leading to drinking more themselves. This study looked at both important peers and general peers in a college sample to see if social importance or closeness of peers affected this dynamic. Researchers asked students in a social network to track their drinking behaviors and estimate the drinking behavior of others. They found that students were more accurate when predicting the drinking behaviors of their close peers, but that overestimating peer behavior was still associated with heavier drinking.

The paper, “Do misperceptions of peer drinking influence personal drinking behavior? Results from a complete social network of first-year college students,” was funded by the National Institute on Alcohol Abuse and Alcoholism and appeared in the journal, Psychology of Addictive Behaviors.

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Study finds molecular link between adolescent alcohol use and adult anxiety

Early alcohol use is strongly linked to anxiety issues and new research in rats may show how those connections are formed in the brain. Scientists studied the epigenetics that affect an important protein in the amygdala, part of the brain linked to anxiety and alcohol misuse. They exposed rats to early alcohol and found that rats had more anxiety and different epigenome expression than non-exposed rats. Both the anxiety and gene expression were lessened by giving the rat alcohol, providing further evidence for the relationship. This research provides more understanding of the molecular process that leads to both anxiety and alcohol use and provides targets for future research in animal models.

The study, “Adolescent alcohol exposure epigenetically suppresses amygdala Arc enhancer RNA expression to confer adult anxiety susceptibility,” was funded by the National Institute on Alcohol Abuse and Alcoholism and was published in the journal, Biological Psychiatry.

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Does parental influence decrease as their children progress through college?

Alcohol use prevention research has shown that parents are very influential on their children’s drinking behavior, even after they leave to go to college. However, less is known about how that influence changes as children progress through their college years. Researchers studied samples at several public universities to examine the relationship between parental permissiveness and drinking and how they changed over time. They found that the more permissive the parents were, the more likely the students were to drink in college and that those students experienced more consequences.

The article, "An examination of parental permissiveness of alcohol use and monitoring, and their association with emerging adult drinking outcomes across college" was supported by the National Institute on Alcohol Abuse and Alcoholism and published in February in Alcoholism: Clinical and Experimental Research.

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Does substance use affect students’ chances of attending graduate school?

Research has shown that alcohol and other substance use can cause a variety of consequences, but consequences are weighed differently by each individual. This study followed almost 1,000 students over time to see how their drug use, including alcohol, affected their chances of getting into and attending graduate school. Researchers found that participants who misused alcohol had a lower likelihood of getting into graduate school.

The study, "Excessive drinking and drug use during college: Prospective associations with graduate school plans and attendance" was supported by the National Institute on Drug Abuse and published in the Journal of American College Health.

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Alcohol screening and other drug use in pediatric emergency departments.

Effective and efficient screening tools are important for effective diagnosis and response to alcohol use, especially in settings like an emergency department where providers don’t have much time to diagnose and treat patients. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed a two-question screening guide that seeks to monitor alcohol use; however, it’s not known how this screening tool relates to cigarette and other drug misuse. Researchers used the questionnaire and other screening tools in 16 pediatric emergency departments to explore their relationship to other substances. They found that lifetime tobacco and drug use was predicted by past-year alcohol use detected when using the NIAAA screener.

The article, "Screening for adolescent alcohol use in the emergency department: What does it tell us about cannabis, tobacco, and other drug use?" was supported by the National Institute on Drug Abuse and the Health Resources and Services Administration, along with several other operating divisions. It was published in Substance Use & Misuse.

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More positive expectations about drug use predicts earlier initiation.

While substance use throughout the lifespan is bad, substance use initiation in earlier adolescent years is particularly associated with negative consequences. Research has shown that perceptions and perceived expectations of adolescents affects their substance use. This study attempts to further general understanding by looking at the relationship between perceived expectations and early use onset. Researchers followed high schoolers from 9th through 12th grade and surveyed them about beliefs and behaviors with drugs. They found a correlation between perceived positive effects of alcohol, tobacco, and marijuana and earlier use by adolescents. Researchers also found that perceived negative outcomes delayed the onset of marijuana use, but not alcohol or tobacco use.

The study, "Alcohol, tobacco, and marijuana expectancies as predictors of substance use initiation in adolescence: A longitudinal examination" was funded by the National Institute on Alcohol Abuse and Alcoholism, the National Cancer Institute, and the National Institute on Drug Abuse and was published in the February issue of Psychology of Addictive Behaviors.

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Drinking beyond the heavy episodic drinking threshold increases risk for alcohol use disorder.

The threshold of binge drinking is 4 drinks for women and 5 drinks for men within the time span of about 2 hours and is generally well known in the alcohol research and prevention communities. However, the implications associated with that definition may not capture the elevated risk that occurs with even higher levels of drinking. In this study, researchers used advanced techniques and a large national dataset of drinking behavior to show that the more someone drinks per episode, the higher their risk of developing an alcohol use disorder. In young adult drinkers, that risk continues to increase as people drink up to 10 drinks for women and 11 drinks for men per episode, after which it flattens out. For older adults, the risk increases as people drink up to 14 drinks per episode.

The article, "Flexibly modeling alcohol use disorder risk: How many drinks should we count?" was funded by the National Institute on Drug Abuse and was published in the February issue of Psychology of Addictive Behaviors.

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NASEM develops report on eliminating alcohol-impaired driving fatalities

A new report from the National Academies of Sciences, Engineering, and Medicine (NASEM) discusses the elimination of alcohol-related traffic fatalities over the next 30 to 40 years. The report explores the perspective that every fatality is a failure of a system with many interrelated parts. Each system component has weaknesses that can be addressed through the adoption of the promising interventions pulled from the scientific literature and summarized in the report. Prevention professionals and public officials who wish to solve such traffic problems should read and consider recommendations made in this latest NASEM report.

“Getting to Zero Alcohol-Impaired Driving Fatalities: A Comprehensive Approach to a Persistent Problem” is available for download online.

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An empirical look at diagnostic criteria for alcohol use disorders

Alcohol use disorders (AUD) are primarily understood in psychiatric terms, which can have a big impact on how the concept is used and by whom. However, research using the latest empirical methods is needed to understand the relationship between the individual and combined criteria for AUD and their ability to predict functional impairment. Researchers used the National Survey on Drug Use and Health, along with advanced statistical techniques, to understand and optimize the relationship between the criteria, alcohol consumption, and impairment. They found that either three of nine criteria would be needed for a diagnosis, or—second-best solution—two of five. Efficiency should be balanced with predictive power when designing any screening or diagnostic tools.

The article, “Deriving alternative criteria sets for alcohol use disorders using statistical optimization: Results from the National Survey on Drug Use and Health” was published in the Journal of Experimental and Clinical Psychopharmacology and funded by the National Institute on Alcohol Abuse and Alcoholism.

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Looking at the relationship between alcohol and suicide

Alcohol has long been known to be associated with suicide; however, this relationship is not fully understood. In this study, researchers identified three possible factors in both—problem-solving skills, avoidant coping, and negative urgency—which had been thought to be part of the association. They then tested their models with data using a sample of college-age drinkers with a history of suicidal ideation. Their results show that all three factors were either directly or indirectly related to the level of suicidal ideation, as well as their alcohol-related indicators such as frequency of binge drinking. These findings provide targets for prevention professionals working with this population to impact multiple public health problems.

The article, “Factors linking suicidal ideation with drinking to cope and alcohol problems in emerging adult college drinkers,” was published in the Journal of Experimental and Clinical Psychopharmacology and funded by the National Institute on Alcohol Abuse and Alcoholism.

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Relationship between underage drinking and prescription pain pill use examined

Substance use is often co-occurring—use of one substance related to use of another. In this study, researchers used advanced statistical techniques and a large U.S. epidemiological dataset to examine the role that underage drinking and alcohol dependence plays in the development and trajectory of prescription pain reliever use. They found that alcohol use disorder associated with prescription pain reliever use was either especially persistent, or resistant to treatment. This study offers a lesson for both prevention and medical professionals: consider the interaction between substances used by patients.

The article, “Underage drinking, alcohol dependence, and young people starting to use prescription pain relievers extra-medically: A zero-inflated Poisson regression model,” was published in the Journal of Experimental and Clinical Psychopharmacology and funded by the National Institute on Drug Abuse.

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Free NIAAA Research Journal Issue on Binge Drinking

The National Institute on Alcohol Abuse and Alcoholism edits and produces a biannual journal called Alcohol Research: Current Reviews that publishes scientific reviews on a single topic related to alcohol. It is a free resource that highlights quality research and provides illuminating information for all fields studying alcohol and alcohol use. The most recent issue on Binge Drinking highlights this especially risky and unfortunately common drinking pattern. The issue contains important articles that are particularly relevant to work in the prevention and public health fields. Some example articles are "Adolescent Binge Drinking: Developmental Context and Opportunities for Prevention," "Effects of Binge Drinking on the Developing Brain—Studies in Humans," and others.

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Combined community- and individual-level interventions show reductions in alcohol use among American Indian/Alaska Native youths

American Indian/Alaska Native (AI/AN) youths at high risk for alcohol use benefit greatly from a multilevel response. In this study, researchers combined individual-level interventions such as motivational interviewing with community-level initiatives such as community mobilization and restrictions on alcohol sales to minors. They implemented the program on a rural California reservation and found significant reductions in drinking when compared with the comparison group. This is a great example for prevention professionals to follow when designing multilevel programs.

The study, “Prevention of Underage Drinking on California Indian Reservations Using Individual- and Community-Level Approaches,” was funded by the National Institute on Alcohol Abuse and Alcoholism and published in the American Journal of Public Health.

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Examining resources to prevent underage drinking from a social ecological perspective

Adolescent and college underage drinking are significant public health problems both on their own and together. It is important for prevention professionals to understand and help prevent the development of alcohol misuse, both on different ecological levels and over time. Health education researchers at Texas A&M promoted a socio-ecological mindset in this review article. They discuss this framework using two free, publicly available prevention resources—the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) CollegeAIM and the Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Talk. They Hear You.” campaigns, showing how these resources cover the risk-development period from adolescence to college. Readers interested in the perspectives behind these resources NIAAA and SAMHSA produce should read the article linked below and view the online resources.

The article, “Resources to Reduce Underage Drinking Risks and Associated Harms: Social Ecological Perspectives,” was published recently in the Journal of Health Promotion Practice and cites both NIAAA and SAMHSA resources.

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The U.S. Preventive Services Task Force recommends screening and intervention for unhealthy alcohol use

Researchers from the U.S. Preventive Services Task Force (USPSTF) conducted a systematic review examining 113 studies on screening and intervening in unhealthy alcohol use in primary care or similar healthcare settings. They found that screening was effective in detecting unhealthy alcohol use and counseling interventions were effective in reducing unhealthy drinking behavior. Based on those benefits and the small to nonexistent potential for harm, the USPSTF recommends that organizations provide screening and intervention services.

The report has several components that are linked to from the Final Summary page, including the Recommendation Statement and Evidence Report and Systematic Review, both of which were published in the Journal of the American Medical Association. The review was funded by the Agency for Healthcare Research and Quality.

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College students can learn to protect themselves from harm during high-intensity drinking days

While working to limit unhealthy drinking behavior among college students, it’s important not to ignore harm-reduction approaches. Researchers at Penn State taught college students behavioral strategies they could use to limit how much they drank and to avoid exposure to the consequences of high-intensity drinking. They found that using the strategies made certain consequences such as passing out while drinking, driving drunk, or regretting sexual behaviors less likely. Those conducting prevention efforts in working with college students should use these strategies to limit the harms that students face.

The article, “Are protective behavioral strategies associated with fewer negative consequences on high-intensity drinking days? Results from a measurement-burst design,” was published in Psychology of Addictive Behaviors. It was funded by the National Institute on Alcohol Abuse and Alcoholism.

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How do youth with bad peer experiences start using alcohol?

Understanding how adolescents begin to use alcohol and what factors influence that process is key to preventing it and its associated harms. Researchers at the University of Buffalo studied peer influences on this developmental pathway in a new paper. They followed a sample of adolescents over time, tracking their peer relationships and alcohol use, either through internalizing mechanisms like coping or externalizing mechanisms like changing social groups. They found that both peer victimization and exclusion were related to alcohol use through internalized pathways, although some models only supported that pathway for excluded youth. Their findings suggest that more attention should be paid to adolescents who are excluded by their peers.

The full report, “A longitudinal examination of mediational pathways linking chronic victimization and exclusion to adolescent alcohol use,” was published in Developmental Psychology. The study was funded by the National Institute on Drug Abuse.

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Reducing World Health Organization (WHO) drinking levels helps those with alcohol use disorder.

While abstinence and reductions in the riskiest types of alcohol use are important goals, there are benefits to all reductions in alcohol use. Researchers at the University of New Mexico and the National Institute on Alcohol Abuse and Alcoholism conducted a secondary data analysis of individuals in a randomized placebo-controlled clinical trial using WHO drinking risk levels to capture reduced drinking and associated consequences. They found improvements in physical health indicators and self-reported quality of life even on one or two levels of reduction. Their findings have implications for clinicians and prevention specialists helping people with unhealthy alcohol use.

Their paper, “Drinking Risk Level Reductions Associated with Improvements in Physical Health and Quality of Life Among Individuals with Alcohol Use Disorder,” was published in Alcoholism: Clinical and Experimental Research. The analysis was funded by the National Institute on Alcohol Abuse and Alcoholism.

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More information on the connection between prenatal alcohol exposure and adult alcohol use problems.

Developmental pathways, especially prenatal ones, are key for determining whether someone will have problems with alcohol use later in their life. Prenatal exposure is linked to drinking problems in adulthood, but this paper provides even more information about this connection by finding that the amount of prenatal alcohol exposure was associated with the frequency of alcohol use and related consequences by the study’s participants. Researchers found that “as little as one drink per day during gestation are at risk of higher levels of drinking and more problems with alcohol by age 22.” Clinicians and prevention specialists should communicate the risks to pregnant women they encounter and help avoid this unnecessary risk factor.

The study, “Prenatal alcohol exposure and offspring alcohol use and misuse at 22? years of age: A prospective longitudinal study,” was published in Neurotoxicology and Teratology. The National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism supported this work.

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Getting less sleep means more risky behavior, including alcohol use.

This paper provides further evidence on the importance of sleep for a number of health and behavior indicators. Researchers compared U.S. high school students who slept 8 hours a night with students who slept 6 hours a night. They found that sleeping less was associated with a variety of risky behaviors, from drinking alcohol to getting in a fight or attempting suicide. They also found that 70 percent of their sample got less than the recommended 8 hours of sleep on school nights.

This study, “Dose-Dependent Associations Between Sleep Duration and Unsafe Behaviors Among US High School Students,” was published in JAMA Pediatrics. The National Heart, Lung, and Blood Institute supported this research effort.

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Researchers shed light on Alcopops, both in the United States and internationally.

Researchers in India sought to understand “Alcopops,” a term used to describe different types of flavored alcoholic beverages. Since their introduction in the 1990s, Alcopops have been a problem for the underage drinking prevention community. Their sweet taste, appealing colors, and youth-aimed marketing makes them attractive for those beginning to drink, especially for teenage girls. In this paper, researchers summarize available information about Alcopops, including evidence and regulations from the European Union and Australia.

This study, “Alcopops: a global perspective on the new category of alcoholic beverage,” was published in Drugs and Alcohol Today.

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Young adults in rural areas and drinking and driving.

Drinking and driving is a significant problem in rural areas, such as Montana, but there is little empirical research about why young adults engage in such risky behavior. Researchers examined possible reasons through a theoretical framework and by conducting focus groups with young adults in rural Montana. They found several upstream social and cultural factors that can help us understand the problem and guide future research and prevention efforts.

This study, “Context and culture: Reasons young adults drink and drive in rural America,” was published in Accident Analysis & Prevention. The National Institute of General Medical Sciences at the National Institutes of Health supported this work.

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Studies examining alcohol use in group settings can use placebo beverages.

Researchers examined the effects of placebo beverages in group settings for possible disruptive effects caused by other participants. They found that participants in group settings reported consuming an alcoholic beverage and feeling intoxicated, just like when consuming a placebo beverage alone. Their result adds to the methodological toolkit for researchers when isolating the effects of alcohol in social contexts.

This study, “Using Placebo Beverages in Group Alcohol Studies,” was published in Alcoholism: Clinical and Experimental Research. It was supported by the National Institute on Alcohol Abuse and Alcoholism.

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Adolescents’ experiences with alcohol use and expectations about peer use affect drinking onset.

Initiation of alcohol use among adolescents has many potential factors. Researchers analyzed data from a longitudinal survey of adolescent substance use and health behaviors. They found interacting effects, within individuals, of early initiation, alcohol outcome experiences, and perceived social norms. More positive experiences and the norms of close friends predicted early initiation in a survival analysis. Their results have implications for alcohol screening and prevention initiatives.

This study, “Developmental relations between alcohol expectancies and social norms in predicting alcohol onset,” was published in Developmental Psychology. The full paper is under embargo and will be available in early 2019.

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Value of even brief substance abuse interviews highlighted.

Researchers conducted a randomized, controlled trial to determine the benefits of a 15-minute motivational interviewing session on risk factors for alcohol and marijuana use in a primary care setting for at-risk adolescents (ages 12–18). They found significant effects on several risk factors or consequences of use, including less perceived peer use of alcohol and marijuana and negative alcohol consequences experienced compared to participants who underwent the usual care. This study highlights the value of even a brief intervention in primary care settings on substance use among adolescents. 


This study, “Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care,” was published recently in the Journal of Consulting and Clinical Psychology, and was supported by the National Institute on Alcohol Abuse and Alcoholism and utilized its screening tools. 

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Most effective community-based interventions reviewed.

Included as a chapter in the Adolescent Substance Abuse issue of the book series, Issues in Children’s and Families’ Lives, researchers conducted a literature review on effective and evidence-based prevention initiatives aimed at adolescent substance use. They drew from two sources, the National Institute on Alcohol Abuse and Alcoholism’s CollegeAIM Alcohol Interventions Matrix and Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, which combine to give a comprehensive view on prevention initiatives and environmental strategies that have positive results. 


The chapter, “Evidence-based practices: Community-based interventions to reduce alcohol use and misuse,” draws heavily from ICCPUD sources and is relevant for the prevention community. 

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Strong links found between family history and alcohol problems.

Researchers examined potential factors affecting the relationship between how much a person enjoys non-substance rewards and their increased risk for substance misuse. They compared how a sample of college students responded to rewards and how they drank based on their family history of drinking behavior. They found strong links between family history and alcohol problems but not drinking behavior, and that women’s, but not men’s, drinking behavior was affected by how they responded to non-substance rewards. They also found that a negative family history with alcohol risk combined with less enjoyment of substance-free rewards, together created greater alcohol problems. 


The study, “Alcohol family history moderates the association between evening substance-free reinforcement and alcohol problems,” is published in Experimental and Clinical Psychopharmacology and was supported by the National Institute on Alcohol Abuse and Alcoholism.

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Giving a brief intervention in English versus Spanish.

In this study, researchers tried to determine whether the language in which a brief intervention is delivered affects drinking behavior among Mexican-origin young adults. They used data from an emergency department to show that while the interventions were effective, there were no significant differences in drinking outcomes regarding whether it was given in English or Spanish. This paper shows that language may not be a crucial factor for achieving cultural congruence and should not be a barrier for anyone providing these services. 

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Clinical trial shows promising results for alcohol use disorder with mixed results for smoking.

Researchers used data from a recent clinical trial of the nicotinic antagonist mecamylamine, used to treat alcohol use disorder, to examine its effects on smoking and the association between reductions in alcohol use and smoking. They found that participants smoked less over the trial but that there were no significant differences when compared to the control group. They also found that those who reduced their smoking more, also reduced their drinking more.

This paper, “Tobacco use during a clinical trial of mecamylamine for alcohol dependence: Medication effects on smoking and associations with reductions in drinking,” appeared in the Journal of Substance Abuse Treatment. It was supported by the National Institute on Alcohol Abuse and Alcoholism.

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Laboratory and life experience with wearable alcohol biosensors.

Wearable alcohol biosensors are a developing, important technology in the alcohol treatment field. A team of researchers from Yale examined two newer devices in the field and the laboratory. They found them to be comfortable and acceptable, and with potential. They also highlighted limitations such as high variance in readings, lack of real-time data and recommendations, and poor battery life. Researchers also lay out key questions that will need to be resolved as the technology progresses.

To learn more, read “Wrist-worn alcohol biosensors: Strengths, limitations, and future directions” in the Journal of Substance Abuse Treatment. This study was funded, in part, by grants from the National Institute on Alcohol Abuse and Alcoholism.

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Influence of Paternal Alcohol Use on Adolescent Educational Attainment

Researchers examined the role paternal alcohol problems and separation, and early alcohol, tobacco, and marijuana use play in offspring educational attainment among European American and African American families. The study screened families with children ages 13-19 years to determine high-risk or low-risk status for paternal heavy drinking and analyzed data from 340 African American and 288 European American offspring who were not enrolled in school. In European Americans, neither paternal drinking status nor offspring substance use was associated with educational outcomes. However, paternal separation elevated the likelihood of not completing high school. For African Americans, paternal separation did not significantly reduce the likelihood for high school completion, but early marijuana use and higher levels of paternal alcohol problems did.

The study “The Influence of Paternal Separation, Paternal History of Alcohol Use Disorder Risk, and Early Substance Use on Offspring Educational Attainment by Young Adulthood,” is published in the Journal of Studies on Alcohol and Drugs. The National Institute on Alcohol Abuse and Alcoholism supported this research effort.

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Substance Use and Childhood Adversity Among Young Black Men

Scientists investigated the effects of alcohol and marijuana use and the exposure to adverse childhood experiences on depressive symptoms among young Black men. Data from 505 rural Black men age 19-22 showed that substance use significantly predicted an increase in depressive symptoms only among participants who were exposed to adverse childhood experiences.

The study “The influence of substance use on depressive symptoms among young adult black men: The sensitizing effect of early adversity” is published in The American Journal on Addictions. The National Institute on Drug Abuse supported this research effort.

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Web-based Alcohol Intervention to Reduce Sexual Risk in College Women

Researchers examined the effect of a brief, web-based alcohol intervention on reducing alcohol use and sexual risk behaviors in college women. Data from 160 participants revealed that the alcohol intervention was associated with higher levels of condom use assertiveness at a three-month follow-up. More alcohol use was associated with less condom use assertiveness for those with more significant sexual assault histories.

The study “Reducing sexual risk behaviors: secondary analyses from a randomized controlled trial of a brief web-based alcohol intervention for underage, heavy episodic drinking college women,” is published in Addiction Research and Theory. The National Institute on Alcohol Abuse and Alcoholism and the National Institute of Mental Health supported this research effort.

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Roles of Drinking Level and Pattern on Late-Life Drinking Problems

A longitudinal study examined the individual contributions of an episodic heavy drinking pattern versus a high average level of drinking as predictors of drinking problems. Researchers assessed alcohol consumption and indexed drinking problems of 1,107 adults aged 55-65 across 20 years. Findings showed that a high average level of drinking and an episodic heavy pattern of drinking each independently increased the number of drinking problems by more than 50%.

The study “Late-Life Drinking Problems: The Predictive Roles of Drinking Level vs. Drinking Pattern,” is published in the Journal of Studies on Alcohol and Drugs. The National Institute on Alcohol Abuse and Alcoholism supported this research effort.

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Stress Effects on Alcohol-Motivated Behaviors

The current study examined the effects of psychosocial stress on alcohol cravings and alcohol-motivated behaviors in people with alcohol use disorder. 30 heavy, non-treatment-seeking drinkers completed a comprehensive assessment of recent drinking, mood and health followed by a stress test and a procedure in which subjects worked for money or alcohol. Findings showed that the stress test increased alcohol cravings and rate of response time. Alcohol cravings were associated with a higher amount of drinks earned during the stress session. 

The study “A paradigm for examining stress effects on alcohol-motivated behaviors in participants with alcohol use disorder,” is published in Addiction Biology. The National Institute on Alcohol Abuse and Alcoholism and the National Center for Advancing Translational Sciences supported this research effort.

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