Neighborhood socioeconomic characteristics,the retail environment,and alcohol consumption: A multilevel analysis

Background

The neighborhoods where people live can influence their drinking behavior. We hypothesized that living in a neighborhood with lower median income, higher alcohol outlet density, and only liquor stores and no grocery stores would be associated with higher alcohol consumption after adjusting for individual demographic and lifestyle factors.

Methods

We used two self-report measures to assess alcohol consumption in a sample of 9959 adults living in a large Midwestern county: volume of alcohol consumed (count) and binge drinking (5 or more drinks vs. < 5 drinks). We measured census tract median annual household income based on U.S. Census data. Alcohol outlet density was measured using the number of liquor stores divided by the census tract roadway miles. The mix of liquor and food stores in census tracts was assessed using a categorical variable based on the number of liquor and number of food stores using data from InfoUSA. Weighted hierarchical linear and Poisson regression were used to test our study hypothesis.

Results

Retail mix was associated with binge drinking. Individuals living in census tracts with only liquor stores had a 46% higher risk of binge drinking than individuals living in census tracts with food stores only after controlling for demographic and lifestyle factors.

Conclusion

Census tract characteristics such as retail mix may partly explain variability in drinking behavior. Future research should explore the mix of stores, not just the over-concentration of liquor stores in census tracts.     

Prevalence,patterns and predictors of substance use among Latino migrant men in a new receiving community

Background

The purpose of this study was to evaluate the prevalence, patterns and predictors (individual, social, cultural, and environmental) of illicit drug use and binge drinking in a cohort of Latino migrant men (LMM) in a new receiving community.

Methods

A cohort of LMM in New Orleans (n = 125) was assembled in 2007 using respondent driven sampling and interviewed quarterly for 18 months regarding past month substance use and other potential covariates. Baseline frequencies were weighted using RDSAT and longitudinal analyses included generalized estimating equations (GEE) and the Cochran–Armitage test for trends.

Results

At baseline, substance use behaviors were: drug use 15.0% (range 7.3–25.0%) and binge drinking 58.3% (range 43.6–74.6%). All three of these behaviors decreased over follow-up (P < 0.01). Baseline alcohol dependence and drug problem were 11.8% (range 5.6–24.3%) and 0.08% (range 0.00–2.7%) and both remained the same over time. Baseline rate of chlamydia was 9% (range 0.00–22.4%); all men tested negative for gonorrhea, HIV, and syphilis. For both binge drinking and drug use, having sex with a female sex worker was associated with increased risk, whereas belonging to a club or organization was associated with less risk. Additional factors associated with increased drug use were: having a friend in New Orleans upon arrival, symptoms of depression, and working in construction. An additional factor associated with less binge drinking was having family in New Orleans upon arrival.

Conclusion

Among LMM, substance use is influenced by social and environmental factors. Interventions increase community connectedness may help decrease usage.     

Inside the Physician's Black Bag: Critical Ingredients of Brief Alcohol Interventions

ABSTRACT

Brief primary care interventions structured around patient workbooks have been shown to be effective in modifying hazardous drinking behavior. However, the critical ingredients of such interventions are not well understood, possibly contributing to their underutilization. Seventeen campus-based clinicians trained in a brief, workbook-based alcohol intervention participated in a qualitative study to identify the most promising clinician-patient interaction components within this shared approach, utilizing a focus group with the clinicians and ranking of the 24 workbook ingredients. Based on the clinicians’ collective experience, consensus emerged around the perceived strength of 5 main components: (1 Harwood, H. Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data Report prepared by The Lewin Group for the National Institute on Alcohol Abuse and Alcoholism, 2000. Based on estimates, analyses, and data reported in Harwood, H.; Fountain, D.; and Livermore, G. The Economic Costs of Alcohol and Drug Abuse in the United States 1992. Report prepared for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services. Rockville, MD: National Institutes of Health; 1998. NIH publication no. 98-4327 [Google Scholar]) providing a summary of the patient's drinking level, (2 Grant, B F, Dawson, D A, Stinson, F S, Chou, S P, Dufour, M C and Pickering, R P. 2004. The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug Alcohol Depend., 74: 223–234. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) discussing drinking likes and dislikes, (3 Hingson, R, Heeren, T, Winter, M and Wechsler, H. 2005. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: changes from 1998 to 2001. Annu Rev Public Health., 26: 259–279. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) discussing life goals, (4 Hingson, R, Zha, W and Weitzman, E R. 2009. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. J Stud Alcohol Drugs., : 12–20. [Crossref], [Web of Science ®] , [Google Scholar]) encouraging a risk-reduction agreement, and (5 Wechsler, H, Lee, J E, Kuo, M, Seibring, M, Nelson, T F and Lee, H. 2002. Trends in college binge drinking during a period of increased prevention efforts: findings from 4 Harvard School of Public Health college alcohol study surveys: 1993–2001. J Am Coll Health., 50: 203–217. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) asking patients to track their drinking (on cards provided for this purpose). This is the first paper to examine primary care physician perspectives on potentially critical components of effective brief alcohol intervention.     

Intoxication and binge and high-intensity drinking among US young adults in their mid-20s

ABSTRACT

Background: Alcohol use is a key risk factor for young adult mortality and disease, but limited research has focused on high-risk alcohol use among individuals moving from early young adulthood into building and maintaining an initial structure of adult life. This study estimated the prevalence of a range of alcohol use behaviors among US young adults aged 25/26, examined evidence for historical change in prevalence rates, and estimated associations between alcohol use and key demographic, substance use, and adult social role characteristics. Methods: Data were obtained from 3542 individuals selected for follow-up from the nationally representative 12th-grade student Monitoring the Future study. Respondents self-reported alcohol use behaviors at age 25/26 during calendar years 2005–2014. Results: Two fifths (39.9%) of young adults aged 25/26 reported being intoxicated at least once in the past 30 days; 25.6% reported usually experiencing a sustained high of 3 or more hours when drinking alcohol. Past-2-week binge drinking (5+ drinks in a row) was reported by 36.3% of respondents. Past-2-week high-intensity drinking (10+ drinks in a row) was reported by 12.4%. These age 25/26 alcohol use prevalence rates remained stable over the 10 years of data examined, in contrast to significant declines over historical time in alcohol prevalence rates among these same individuals at age 18. High-risk drinking was particularly associated with being male, white, unmarried, employed, a nonparent, and an alcohol user before finishing high school. Conclusions: Among US young adults in their mid-20s, alcohol use was highly normative and frequently included participation in high-risk drinking behaviors. High-risk alcohol use prevention approaches developed specifically to reach young adults in their mid-20s are needed, as well as efforts to increase proactive clinician screening to identify young adults participating in high-risk alcohol use.     

Familial drinking in Italy: Harmful or protective factors?

Aims: This study examined relations between cultural norms and drinking practices in Italian young people using qualitative interviewing techniques. We collected self-report drinking history information from young people including whether or not they were allowed alcohol with meals in a family setting when growing up.

Methods: We conducted ethnographic interviews of 80 adolescent (ages 16–18) and 80 young adult (ages 25–30) regular and heavy drinkers in two regions (Abruzzo and Umbria). All 20 Italian regions produce wine. Abruzzo has a high ratio of heavy drinkers while Umbria has a high ratio of regular drinkers. We used the AUDIT to determine eligibility. We queried age at first drink, first 5+, first drunk, context of drinking, drinking with family during meals, availability of alcohol at home, parent's relationship to, attitudes about and discussion about alcohol.

Results: Half of regular and heavy drinkers were allowed alcohol in a family setting while growing up. Those allowed alcohol with meals when growing up consumed less on their first drink occasion and were more likely to never drink 5+ or get drunk than those not allowed. They also had reduced or delayed 5+ or drunk occasions.

Conclusions: In Italy the tradition of incorporating alcohol with meals in a family setting may protect against harmful drinking. Other qualitative research should explore family, other adult and peer relationships to clarify alcohol use and risk-related behaviors. Research in countries with similar and different early age introduction would increase knowledge about the protective aspect of drinking in a family setting.     

Evaluation of a new estradiol oral contraceptive: estradiol valerate and dienogest

Importance of the field: Since ethinyl estradiol is a potent activator of hepatic enzymes, the use of natural estradiol (E2) has been studied; but, until recently, bleeding control has hampered development of an E2 pill.

Areas covered in this review: A historical review of oral contraceptive development leading to the successful design of an estradiol pill. Pharmacology, mechanism of action and clinical trials of contraceptive efficacy and bleeding profile of the estradiol valerate/dienogest (E2V/DNG) pill are reviewed. Details of two placebo-controlled treatment trials of the E2V/DNG pill in women with heavy menstrual bleeding are discussed. All available literature was searched using pubMed and additional data were obtained from published abstracts.

What the reader will gain: Information on the novel features and indications for the E2V/DNG pill.

Take home message: The dynamic-dosing E2V/DNG oral contraceptive pill provides a highly effective contraceptive option with an adjusted Pearl Index (method failure) of 0.51 (upper limit of 95% CI 0.97) and unadjusted Pearl Index (user failure) of 1.01 (1.59) for women aged 18 – 35 years. In addition, two large randomized controlled trials have demonstrated that E2V/DNG provides effective treatment for women with heavy menstrual bleeding.     

The auditory event related potentials in episodic and chronic pain sufferers.

To examine the cognitive processing differences in chronic and episodic pain sufferers, auditory event-related potentials (P300 or P3) were recorded in two consecutive trials from 23 chronic lower back pain patients, 22 episodic tension-type headache sufferers, and from 23 age- and sex-matched healthy persons. P3 latency and amplitude showed no difference between groups at first trial. Considering P3 latency habituation, healthy controls and episodic tension-type headache sufferers showed a significant change of P3 latency whereas lower back pain sufferers failed. Comparing the amount of habituation lower back pain sufferers stood clearly apart from healthy controls. Although there was a remarkable increase of P3 latency in episodic tension-type headache sufferers, the amount of habituation was not statistically different than it was in lower back pain sufferers. Significant P3 amplitude habituation was observed only in healthy controls. Actually, episodic tension-type headache sufferers also showed some degree of habituation, which was not statistically remarkable. The amount of amplitude habituation was not different between groups. No correlation was observed between P3 habituation and age, disease duration and symptom severity. These results may point to a disturbed attentional processing in chronic pain sufferers. Our findings suggest that in spite of a similar cortical information processing, the neurocognitive networks related with decision making and memory processing seem to work differently in chronic pain sufferers from those in episodic pain sufferers in repeating tasks. Taking into consideration the reported P3 habituation abnormalities in chronic migraine patients we can say that not the location of pain but rather its temporal pattern may have a role in disturbed attentional processing.     

Binge Drinking,Marijuana Use,and Friendships: The Relationship Between Similar and Dissimilar Usage and Friendship Quality

Abstract

While it is commonly understood that the substance use of peers influences an individual's substance use, much less is understood about the interplay between substance use and friendship quality. Using a sample of 2,148 emerging adults nested within 1,074 dyadic friendships, this study separately investigates how concordance and discordance in binge drinking and marijuana use between friends is related to each friend's perceptions of friendship quality. Because “friendship quality” is a complex construct, we employ a measure containing five sub-elements – companionship, a lack of conflict, willingness to help a friend, relationship security, and closeness. Results for both binge drinking and marijuana use reveal that individuals in friendship pairs who are concordant in their substance use perceive significantly higher perceptions of friendship quality than individuals in dyads who are dissimilar in substance use. Specifically, concordant binge drinkers estimate significantly higher levels of companionship, relationship security, and willingness to help their friend than concordant non-users, discordant users, and discordant non-users. However, the highest amount of conflict in friendships is found when both friends engage in binge drinking and marijuana use. Several interpretations of these findings are discussed. Overall, concordance between friends’ binge drinking and marijuana use appears to help some elements of friendship quality and harm others.     

Heroin

Abstract

This study explored associations between adult Latina heavy drinking behaviors and potential psychosocial and demographic correlates. It used mother-daughter dyads and a cross-sectional design. Data were drawn from a community-based sample of 158 dyads of adult Latinas (n = 316), age 18 years or older, recruited between 2004 and 2006. Bivariate and multivariate statistical methods, including logistic regression and pathway models, were used to analyze data. The study found that protective factors for heavy drinking behaviors for the mother included daughter's social support and mother's age, while for the daughter, they were mother's attachment and daughter's country of birth. Risk factors for daughter's heavy drinking behaviors were mother's social support and daughter's education. For both mother and daughter, chronic stress and drinking behavior associations were mediated by attachment and social support. Preventive interventions should target increasing levels of mother-daughter attachment and daughter's social support while decreasing stress levels for mothers and daughters.