A comparison of problems-of-life for blacks and whites entering substance abuse treatment programs.

Blacks in the general population experience alcohol-related health problems to a greater extent than Whites, even though surveys of drinking behavior find that Blacks generally drink no more than Whites and, in fact, at younger ages Blacks actually drink less than Whites. In this study, Blacks and Whites entering randomly selected state-supported substance abuse treatment programs within a given period of time were interviewed and administered a battery of assessment instruments; results are derived from the Addiction Severity Index. A major research question was whether the higher rates of alcohol-related problems for Blacks in the general population were matched by greater severity of life-problems for Blacks in a clinical treatment population. Blacks had more severe problems than Whites in two problem areas: employment support and other drug use. Results point to socioeconomic factors as well as combined alcohol and other drug use as potential contributors to the greater alcohol-related health problems for Blacks in the general population. Comprehensive study of alcohol and other drug use norms and customs within the Black community is recommended to aid in the development of prevention and treatment strategies for alcohol-related problems among Blacks.     

Exploring patterns of alcohol misuse in treatment-seeking UK veterans: A cross-sectional study

AimsTo explore patterns of alcohol misuse in a sample of treatment-seeking veterans compared to the UK Armed Forces personnel population and the general public. Furthermore, the present study investigated which variables were associated with alcohol misuse in this sample, and in particular what factors were associated with increased or decreased severity of alcohol misuse.MethodThe present study investigated alcohol misuse in treatment-seeking veterans and compared it with the UK Armed Forces and the general public. In addition, it explored associations between sociodemographic, physical health and mental health variables and alcohol misuse.ResultsResults suggested that treatment-seeking veterans report different patterns of alcohol misuse compared to the UK Armed Forces and the general public. This group was more likely to report alcohol dependence and alcohol-related harm. They also reported higher levels of overall alcohol misuse than the general public. Mental health problems including PTSD, anxiety and depression, as well as anger, functional impairment and being single were all related to greater alcohol misuse. Being older and not in work were related to reduced alcohol misuse.ConclusionsThese findings add further weight to the importance of ensuring appropriate support is provided to personnel leaving the Armed Forces. Treatment-seeking veterans have specific patterns of alcohol-related needs that should be addressed. Knowing more about the common alcohol-related problems in this group can help inform and improve mental health interventions. Findings on related variables will help in identifying those individuals who may be at most risk of alcohol-related problems.     

Ethnic Differences in the Salience of Risk and Protective Factors for Alcohol and Marijuana

ABSTRACT

The purpose of the study was to distinguish risk and protective factors that predict adolescent alcohol and marijuana use across all ethnic backgrounds from those that predict use for particular ethnic groups. Analysis of data from the 2000 Florida Youth Substance Abuse Survey was conducted separately for the three major ethnic groups- Whites, Blacks, and Hispanics. The outcome measures were 30-day use of alcohol and marijuana and twenty-eight risk and protective factors were considered for inclusion into two logistic regression models as independent variables. Six variables were associated with all three ethnic groups' alcohol use, two with Whites and Blacks, one with Whites and Hispanics, four with Whites only, and one with Hispanics' use only. For marijuana, five variables were significant for all three ethnic groups, one for Whites and Blacks, one for Whites and Hispanics, and three for Whites only. These findings can be used to tailor adolescent drug preventive programs to specific groups, which should increase their impact.     

Predictors of alcohol-related outcomes in college athletes: the roles of trait urgency and drinking motives

Research has shown that college students participating in athletics drink more than other students, yet relatively few studies have examined variables that are associated with alcohol-related outcomes among this population. The purpose of this study was to examine the relationships among trait urgency, general drinking motives and sport-related drinking motives, and both alcohol use and alcohol-related problems. Data were collected from 198 college students participating in either intercollegiate or recreational athletics at three U.S. universities. Structural equation modeling was used to examine a series of theoretically derived explanatory models. All variables included in the model were directly associated with alcohol use and/or alcohol-related problems. The specific patterns of relationships differed across the motives and trait urgency variables. Sport-related coping motives, sport-related positive reinforcement motives, and general enhancement motives had direct relationships with alcohol use, while trait urgency, general coping motives, and sport-related positive reinforcement motives had direct relationships with alcohol-related problems. Several indirect effects on alcohol use and alcohol-related problems were also found. This study suggests that general drinking motives, sport-related drinking motives, and trait urgency all serve as important predictors of alcohol-related outcomes in college athletes.     

Relationship between General and Sport-Related Drinking Motives and Athlete Alcohol Use and Problems

Objective: Alcohol use (and adverse consequences due to alcohol use) among college student-athletes is a common occurrence and consequently garners attention as a health concern within athletic departments and the NCAA. One of the strongest predictors of alcohol use in athletes is motivation to drink. However, not much is known about the influence of alcohol use motivations on drinking in collegiate athletes. Therefore, this study examined the influence of sport-related and general drinking motives on alcohol use and alcohol-related problems. Method: Participants were female collegiate softball players (N?=?721) from 62 NCAA teams. Athletes completed the Athlete Drinking Scale (Martens et al., 2005), the Drinking Motives Questionnaire, revised (Cooper, 1994; Cooper et al., 1992), alcohol consumption measures, and the Rutgers Alcohol Problems Index (White & Labouvie, 1989). Multilevel modeling was used to analyze the data. Results: Higher scores on Positive Reinforcement motives were associated with greater alcohol consumption, heavy episodic drinking, and alcohol-related problems. Enhancement motives were positively associated with heavy episodic drinking and alcohol-related problems, while Coping motives were positively associated with alcohol-related problems. Lower scores on Conformity motives were related to higher alcohol consumption, whereas higher scores were related to more alcohol-related problems. Conclusions: These results assist in understanding salient drinking motives among athletes while accounting for nesting effects of athletes within teams. Results demonstrate alcohol use as a perceived means of reward for hard work or good athletic performance, thus attempts to control alcohol use in college athletics should emphasize alternative methods to positively reinforce efforts or celebrate victories.     

Mental Health Service Utilization and Drinking Outcomes in a National Population Sample: Are There Racial/Ethnic Differences?

ABSTRACT

Racial and ethnic disparities in alcohol use and alcohol-related problems have been well-documented. Less information is available about possible disparities in outcomes related to mental health services utilization. The differential effect of mental health services use by race on drinking outcomes was examined. Wave 2 of a national population sample of employed adults who reported having at least one alcoholic drink in the past year (N = 1,058) encompassed measures of the prevalence of mental health services use in response to stress, and alcohol-related outcomes. Non-white participants who reported using any mental health services, four or more mental health visits in the past year, and eight or more mental health visits in the past year reported lower rates of problematic drinking behaviors, including frequency of drinking to intoxication, heavy episodic drinking, and modified Brief MAST scores, than whites who reported similar use of mental health services.     

An examination of alcohol risk profiles and co-occurring mental health symptoms among OEF/OIF veterans

IntroductionCompared to the general population, veterans of the wars in Afghanistan and Iraq (OEF/OIF) are more likely to engage in hazardous alcohol use and meet criteria for mental health disorders including Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder. Less is known how distinct profiles of alcohol use behavior relate to mental health symptoms.MethodThe current study examined the extent that indicators of alcohol use (i.e., drinks per week, peak blood alcohol concentration, and alcohol-related problems) are categorized into different alcohol risk profiles utilizing a person-centered approach. We also examined how mental health symptoms (i.e., PTSD, depression, and anxiety-related symptoms) were associated with the alcohol risk profiles. Participants were 252 Veterans who reported consuming alcohol within the past month.ResultsLatent profile analysis indicated a four-class solution yielded the best-fitting model, and profiles were named based on their respective levels and patterns of alcohol use. Mental health symptoms were significantly different among the four profiles. Profiles of veterans who endorsed more alcohol-related problems (i.e., the “Severe alcohol behavior” and “Steady drinkers with functional impairment”) also reported comorbid clinical symptoms of PTSD, depression, and anxiety. The “Binge drinkers with no functional impairment” and “Mild alcohol behavior” profiles reported the lowest levels of mental health symptoms.DiscussionFindings highlight the unique relationship between distinct alcohol risk profiles and mental health outcomes. Targeted interventions and treatment options based on unique alcohol risk profiles may be helpful in tailoring prevention and intervention efforts in detecting co-occurring mental health symptoms among OEF/OIF veterans.     

Age at drinking onset,age at first intoxication,and delay to first intoxication: Assessing the concurrent validity of measures of drinking initiation with alcohol use and related problems

IntroductionDrinking at an early age (AO) and quickly progressing to drinking to intoxication (Delay = Age of Intoxication[AI]-AO) confer risk for alcohol use and alcohol-related problems. However, inconsistencies exist in the literature, which may reflect the use of different definitions of AO and AI. We evaluated whether 1) defining AO as age at first sip of alcohol (AO sip) versus age at which at least one standard drink was consumed (AO drink); and 2) defining AI as age at first “drunk” (AI drunk) versus age at first binge episode (≥ 5 standard drinks consumed; AI binge) resulted in different self-reported ages or differentially predicted drinking outcomes.Methods248 high school students (53.6% male; 16.50[1.19] years; 71.4% White) completed anonymous surveys assessing alcohol use.ResultsParticipants reported a younger AO (sip) than AO (drink) and a younger AI (drunk) than AI (binge), resulting in significantly different Delay values for the four AO-AI pairings. Univariate general linear models indicated that AO-Delay pairings accounted for more variance in maximum drinks and alcohol-related problems than did the individual AO and AI variables. Pairings comprising AO (drink) and Delay (drink-binge) and AO (sip) and Delay (sip-binge), respectively, uniquely accounted for variance in both maximum drinks and problems.ConclusionsClearly defining AO and AI using objective definitions that reflect specific amounts of alcohol (e.g., first sip; first standard drink; first binge) appears to outperform subjective definitions of alcohol use (e.g., first drunk).     

Co-occurrence of alcohol and cigarette use among adolescents

Concurrent use of alcohol and cigarettes among adolescents is a serious public health issue. Trends in concurrent use of alcohol and cigarettes were determined using data from three comparable large statewide samples of 7-12th-grade students in New York State, from surveys conducted in 1983, 1990, and 1994. The prevalence of use of alcohol and cigarettes decreased from 1983 (23%) to 1990 (19%), and increased by 1994 (22%). Logistic regression analysis showed that these trends are highly significant, and that the probability of use of alcohol and cigarettes is higher for females than males, increases with age, and is lower for most ethnic minorities than for Whites. In the 1990s, Blacks, Hispanics, and Asians increased in their probability of concurrent use more than did Whites. Users of both alcohol and cigarettes are at increased risk of personal and social problems, as well as increased risk of delinquency. Drinking and smoking show synergistic effects on illicit drug use and drug problems.     

Alcohol-related effects of POST-9/11 discrimination in the context of the great recession: Race/ethnic variation

ObjectivesThis study examined whether race/ethnic variation in discrimination is differentially associated with economic adversity during the period of the Great Recession for Blacks and Latinos compared to non-Hispanic Whites, thereby contributing to higher rates of alcohol use and problematic drinking among these groups.MethodsStructural equation modeling was used to analyze data from a national mail survey.ResultsThe association of 9/11-related discrimination with problem-related drinking substantially derives from the association between 9/11-related discrimination and recession-era economic adversity. The association between 9/11-related discrimination and economic adversity is also significantly greater for Blacks and Latinos compared to non-Hispanic Whites, and is more strongly linked with problem-related drinking for both groups in contrast to non-Hispanic Whites.ConclusionsOverall, the results demonstrate the sustained association of 9/11-related discrimination with alcohol use for Blacks and Latinos compared to non-Hispanic Whites, as well as the differential impact of the Great Recession for these race/ethnic groups. The findings highlight the need to acknowledge macro-level stressors that disproportionately affect disadvantaged groups, such as those occasioned by discriminatory legislation and social policies.     

Alcohol-related problem behaviors among Latin American immigrants in the US

BackgroundPrior research indicates that Latino immigrants are less likely than US-born individuals to use alcohol and meet criteria for an alcohol use disorder. However, our understanding of alcohol-related problem behaviors among Latino immigrants remains limited. We report the prevalence of alcohol-related problem behaviors among Latino immigrants vis-à-vis the US-born and examine the relationship between alcohol-related problem behavior and key migration-related factors and injury/receipt of emergency medical care.MethodsThe data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012–2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and key outcomes.ResultsForeign-born Latinos were less likely to report one or more alcohol-related problems compared to US-born Latinos (AOR = 0.41, 95% CI = 0.33–0.50) and the US-born general population (AOR = 0.38, 95% CI = 0.32–0.46). Latino immigrants arriving as children were, compared to those arriving later in life, significantly more likely to report alcohol-related problem behaviors, and experiences of discrimination were linked with greater risk of alcohol-related problem behavior as well. Latino immigrants reporting recurrent injury/emergency medical care utilization were more likely to report alcohol-related problem behavior.ConclusionsLatino immigrants are significantly less likely than US-born Latinos and the US-born general population to operate a vehicle under the influence of alcohol, take part in risky behaviors or fight while drinking, or to be arrested due to alcohol consumption.     

Personality and motivational correlates of alcohol consumption and alcohol-related problems among excessive drinking university students

ObjectivesThe study had three objectives: (1) to assess relationships between personality characteristics and alcohol consumption and alcohol-related problems among university students who drink alcohol excessively; (2) to assess relationships between motivational structure and alcohol consumption and problems among students who consume excessive amounts of alcohol; and (3) to assess how personality characteristics and motivational structure are related to each other and how the two are jointly related to alcohol consumption and problems.DesignPersonality, motivational structure, alcohol use, and alcohol-related problems were assessed among 111 undergraduate students.FindingsMediation analyses showed that both maladaptive motivational structure and novelty seeking predicted participants' alcohol-related problems beyond that predicted by alcohol consumption.ConclusionFuture research should aim to reduce alcohol-related negative consequences by targeting students with a maladaptive motivational structure, while taking into account the role of personality characteristics. Screening and intervention programmes would benefit from addressing novelty seeking and maladaptive motivation.     

Alcohol use and related harm among older adolescents treated in an emergency department: the importance of alcohol status and college status

OBJECTIVE: Patients treated in an urban emergency department were studied to determine if college status, gender and having alcohol as a reason for medical treatment were related to alcohol use and related problem behaviors. METHOD: Patients ages 18-19 years (N = 250; 55% men) who had or had not been drinking alcohol prior to the event that precipitated their medical treatment were assessed on their alcohol use, alcohol-related problems and drug use. RESULTS: There were high levels of alcohol use, tobacco use and other drug use in the sample, regardless of the reason for medical treatment. Analyses consistently showed that patients treated for alcohol-related reasons had more severe drinking patterns and problems than patients who were alcohol negative. Patients not enrolled in college showed similar patterns of alcohol consumption as their college-attending peers, but bad more severe alcohol-related behaviors and problems. Few gender differences were found and no interactions were found between gender, alcohol status and college status. CONCLUSIONS: Findings indicate that older adolescents who receive medical treatment for alcohol use are not inexperienced drinkers. Furthermore, in this convenience sample, college students did not appear to be at greater risk for substance use or problems. Findings underscore the potential usefulness of alcohol intervention programs for alcohol-involved medical patients, and the need to attend to the alcohol and drug use of nonstudent populations.     

Patterns of Alcohol Abuse Among Black and White Alcoholics

The drinking practices of a matched sample of 78 Black and 78 White, male, hospitalized alcoholics were compared. The groups were matched on age and educational level; and they were equivalent in terms of marital and employment status, number of times hospitalized for treatment of alcoholism and other neuropsychiatric disorders, and number of arrests. The Alcohol Use Inventory was used to assess drinking practices. Significant multivariate and univariate analysis of variance indicated that (a) Whites reported greater daily consumption of alcohol, a tendency to perceive alcohol as a means of relieving psychological distress, and a greater level of psychological distress as a consequence of alcohol abuse than Blacks; and (b) Blacks reported a tendency to perceive alcohol as a means to improve mental functioning and to experience more serious psychoperceptual withdrawal symptoms than Whites.     

General practitioners' diagnostic skills and referral practices in managing patients with drug and alcohol-related health problems: implications for medical training and education programmes

The aim of this study was to determine the current practices of established general practitioners in managing patients with drug and alcohol-related problems and identify gaps in training. A random sample of general practitioners completed a survey assessing diagnostic skills and referral practices concerning alcohol and illicit drug use in general practices in February 1999, comprising 110 general practitioners registered with the Central Sydney Division of General Practice. The main outcome measures were competent skills and knowledge, willingness to treat. The majority (96%) of GPs provided clinically appropriate responses for at least one drug category, although none received this rating for all six. Most general practitioners reported that they were unwilling to treat heroin and cocaine problems themselves but expressed willingness to refer patients appropriately. More than a quarter of general practitioners were unaware of the safe drinking levels for men and women or the appropriate treatment for patients consuming above such levels. Age, years in practice, type of practice, willingness to obtain drug use histories and post-graduate training were all significantly associated with general practitioners' willingness to treat and competence in managing drug and alcohol-related problems. In this study, general practioners reported low levels of skills and referrals for treatment of illicit drug use and suboptimal skills in the management of alcohol problems. The results suggest that a more comprehensive approach to education and training is required to bring about a change in practice behaviour. [Fucito LM, Gomes BS, Murnion B, Haber PS. General practitioners' diagnostic skills and referral practices in managing patients with drug and alcohol-related health problems: implications for medical training and education programmes. Drug Alcohol Rev 2003;22:417 - 424]     

Substance use trajectories of black and white young men from adolescence to emerging adulthood: a two-part growth curve analysis

This study examined trajectories of substance use among Black and White young men (N?=?983) from adolescence to emerging adulthood using two-part growth curve analysis. Controlling for parental socioeconomic status, Blacks were significantly less likely to use alcohol and hard drugs than Whites at age 17 and drank significantly fewer drinks. The alcohol prevalence gap between Blacks and Whites further increased over time. Blacks in the older cohort had higher growth in the frequency of alcohol use than Whites. Blacks and Whites did not differ in prevalence of marijuana use, although Blacks in the younger cohort reported higher growth in prevalence and higher frequency at age 17. Different prevention approaches may be needed to reduce substance use among Blacks and Whites.     

Identifying high-risk pregnant drinkers: biological and behavioral correlates of continuous heavy drinking during pregnancy

To determine whether women who continued to drink during pregnancy could be differentiated from women who discontinued alcohol use during their second trimester of pregnancy based on biological, social and behavioral data collected during a prenatal interview, 267 women receiving prenatal care at Grady Memorial Hospital, a large metropolitan hospital in Atlanta, were interviewed antepartum, assessing current drug and alcohol use as well as other demographic information. Postpartum interviews were conducted during the first 3 days following delivery to determine any changes in drug use or alcohol consumption that occurred after the first interview. Women who continued to drink throughout pregnancy and women who stopped drinking were similar on most demographic variables examined, including age, marital status, ethnic group, income, obstetrical complications risk score, amount of alcohol consumed per week and use of other drugs. Discriminant analysis was used to determine whether drinking-group membership could be predicted from self-reported drinking behaviors or biological and other demographic variables. The best predictors of drinking throughout pregnancy were the length of drinking history, reported tolerance to alcohol, a history of alcohol-related illness and drinking by siblings. In addition, women who continued to drink throughout pregnancy were more likely to report that they drank most often with other family members. Of the subjects who continued to drink, 81% were correctly classified based on this discriminant function. These findings suggest that women who continue to drink during pregnancy may be experiencing more chronic and severe alcohol-related problems than women who discontinue alcohol use and may thus be identified and targeted for intensive prevention effects.     

Alcohol use by healthcare professionals

BACKGROUND: This study investigated alcohol use, misuse and abuse in a sample of dentists, nurses, pharmacists and physicians. Previous studies have lacked cross healthcare group comparisons and have rarely included dentists. METHODS: As part of a larger mail survey, 479 healthcare professionals (68.7% response) completed self-report items on patterns of alcohol use, monthly drinking, heavy episodic drinking, alcohol-related dysfunction and social or professional influences. RESULTS: Dentists consumed more alcohol than other groups of healthcare professionals; however, use of alcohol by nurses may have a wider impact. The data also suggest alcohol use by healthcare professionals may be related to age, but not gender or income. Physicians received significantly more offers to drink alcohol from pharmaceutical companies and dentists received significantly more offers to drink alcohol in social situations than other healthcare professionals. CONCLUSIONS: When compared to the general population, healthcare professionals appear to drink less, however, these findings also suggest that dentists use significantly more alcohol than most other groups of healthcare professionals. Together these findings address significant knowledge gaps that exist surrounding the prevalence of and pathways promoting alcohol use and misuse by healthcare professionals.