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Background: The use of pejorative or stigmatizing language to describe individuals with alcohol and drug use disorders adversely affects treatment seeking, quality of care, and treatment outcomes. In 2015, the International Society of Addiction Journal Editors released terminology guidelines that recommended against the use of words that contribute to stigma against individuals with an addictive disorder. This study examined the use of stigmatizing language in National Institutes of Health (NIH)‐funded research and reviews published by the journal, Alcoholism: Clinical and Experimental Research (ACER) from 2010 to 2020, with the goal of sharing the results with the alcohol research community to enhance awareness. Methods: The search for stigmatizing language in ACER was limited to NIH‐funded articles made publicly available on PubMed Central (PMC). Though ACER is not an open‐access journal, original research and reviews directly funded by NIH are published to PMC for open access to the public as required by the conditions of NIH funding. ACER articles published on PMC were searched from 2010 to 2020 with specific queries for individual terms of interest including those considered pejorative ("alcoholic," "addict," and "abuser") and outdated ("alcohol dependent," "alcohol abuse," and "alcoholism"). The number of articles containing a term of interest for a given year was divided by the total number of articles published in that year to determine the percent use of each term per year. Results: Our search of research and reviews (n = 1903) published in ACER on PMC determined that although the use of pejorative and outdated terminology has decreased over time, there is continued use of the term "alcoholic" over the last decade. Specifically, in 2020, over 40% of articles searched for in PMC still included "alcoholic." The results of a separate manual search (n = 110) on the Wiley Online Database showed that approximately 30% of articles used the term "alcoholic" in a stigmatizing manner. Conclusions: Stigmatizing language can perpetuate negative biases against people with alcohol use disorder. We encourage researchers to shift away from language that maintains discriminatory conceptions of alcohol use disorder. Reducing stigma has the potential to increase rates of treatment seeking and improve treatment outcomes for individuals with alcohol use disorder. [ABSTRACT FROM AUTHOR]

Aims: This paper examines trends and correlates of alcohol‐involved motor vehicle crashes (AMVCs) in California between 2005 and 2016 among Hispanic and non‐Hispanic Whites (Whites hereafter). Together these two groups comprise 76% of the state population. The paper also examines whether alcohol outlet density, percentage of Hispanics in census tract populations, and distance to the U.S./Mexico border are related to greater risks for AMVCs. The border is of interest given the greater availability of alcohol in the area. Methods: Crash data come from Statewide Integrated Traffic Records System maintained by the California Highway Patrol. Sociodemographic and community characteristics data from the U.S. Census and alcohol outlet density were aggregated to census tracts. Total motor vehicle crashes and AMVCs were related to these characteristics using hierarchical Bayesian Poisson space–time models. Results: There were over two million injury and fatality crashes during the period of analysis, of which 11% were AMVCs. About 1.7% of these crashes had fatalities. The rate of AMVCs increased among both Whites and Hispanics until 2008. After 2008, the rate among Whites declined through 2016 while the rate among Hispanics declined for 2 years (2009 and 2010) and increased thereafter. Crash distance from the border (RR = 1.016, 95% CI = 1.010 to 1.022) and percent Hispanic population (RR = 1.006; 95% CI = 1.003 to 1.009) were well‐supported results with 95% credible intervals that did not include 1. The percentages of the following: bars/pubs, males, individuals aged 18 to 29 and 40 to 49 years, U.S. born population, individuals below the 150% poverty level, unemployed, housing vacant, and housing owner‐occupied were all positively associated with AMVCs and well supported. Conclusions: Between 2005 and 2016 the rate of AMVCs in California declined among Whites but not among Hispanics. Population‐level indicators of percent Hispanic population, distance to the U.S. Mexico border, gender, age distribution, and socioeconomic stability were positively associated with crash rates, indicating that important contextual characteristics help determine the level of AMVC rates in communities. [ABSTRACT FROM AUTHOR]

Background: We recently showed that alcohol and cannabis can interact prenatally, and in a recent review paper, we identified parvalbumin‐positive (PV) interneurons in the hippocampus as a potential point of convergence for these teratogens. Methods: A 2 (Ethanol [EtOH], Air) × 2 (tetrahydrocannabinol [THC], Vehicle) design was used to expose pregnant Sprague‐Dawley rats to either EtOH or air, in addition to either THC or the inhalant vehicle solution, during gestational days 5–20. Immunohistochemistry was performed to detect PV interneurons in 1 male and 1 female pup from each litter at postnatal day 70. Results: Significant between‐group and subregion‐specific effects were found in the dorsal cornu ammonis 1 (CA1) subfield and the ventral dentate gyrus (DG). In the dorsal CA1 subfield, there was an increase in the number of PV interneurons in both the EtOH and EtOH +THC groups, but a decrease with THC alone. There were fewer changes in interneuron numbers overall in the DG, though there was a sex difference, with a decrease in the number of PV interneurons in the THC‐exposed group in males. There was also a greater cell layer volume in the DG in the EtOH +THC group than the control group, and in the CA1 region in the EtOH group compared to the control and THC groups. Conclusions: Prenatal exposure to alcohol and THC differentially affects parvalbumin‐positive interneuron numbers in the hippocampus, indicating that both individual and combined exposure can impact the balance of excitation and inhibition in a structure critically involved in learning and memory processes. [ABSTRACT FROM AUTHOR]

Background: Despite high levels of prenatal alcohol exposure in the UK, evidence on the prevalence of fetal alcohol spectrum disorders (FASD) is lacking. This paper reports on FASD prevalence in a small sample of children in primary school. Methods: A 2‐phase active case ascertainment study was conducted in 3 mainstream primary schools in Greater Manchester, UK. Schools were located in areas that ranged from relatively deprived to relatively affluent. Initial screening of children aged 8–9 years used prespecified criteria for elevated FASD risk (small for age; special educational needs; currently/previously in care; significant social/emotional/mental health symptoms). Screen‐positive children were invited for detailed ascertainment of FASD using gold standard measures that included medical history, facial dysmorphology, neurological impairment, executive function, and behavioral difficulties. Results: Of 220 eligible children, 50 (23%) screened positive and 12% (26/220) proceeded to Phase 2 assessment. Twenty had a developmental disorder, of whom 4 had FASD and 4 were assessed as possible FASD. The crude prevalence rate of FASD in these schools was 1.8% (95% CI: 1.0%, 3.4%) and when including possible cases was 3.6% (2.1%, 6.3%). None of these children had previously been identified with a developmental diagnosis. Conclusions: FASD was found to be common in these schools and most of these children's needs had not previously been identified. A larger, more definitive study that uses a random sampling technique stratified by deprivation level to select schools is needed to make inferences regarding the population prevalence of FASD. [ABSTRACT FROM AUTHOR]

In the article, the authors discuss how prenatal ethanol alcohol (EtOH) exposure (PEE) can be used as a sign of EtOH involvement among adolescent people. Also cited are the association of PEE with various neuropsychological deficits and mental disorders like fetal alcohol spectrum disorders (FASD), mental retardation, and autism spectrum disorder, the generator of alcoholism hypothesis, and the double hit exposure protocols.

Background: High alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts of alcohol. Methods: We obtained information from the UK Biobank on approximately 500,000 participants aged 40–70 years at baseline assessment in 2006–2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported consuming ≥80 or ≥50 g/day, respectively, were used in survival analysis. Results: Mortality hazard ratios for these excessive drinkers, compared to all other participants, were 2.02 (95% CI 1.89–2.17) for all causes, 1.89 (1.69–2.12) for any cancer, 1.87 (1.61–2.17) for any circulatory disease, and 9.40 (7.00–12.64) for any liver disease. Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake; diagnosed alcohol dependence, harmful use, or withdrawal syndrome; and current smoking at assessment. Conclusions: People with chronic excessive alcohol intake experience decreased average survival, but there is substantial variation in their mortality, with liver abnormality and alcohol dependence or other alcohol use disorders associated with a worse prognosis. Clinically, patients with these risk factors and high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality. [ABSTRACT FROM AUTHOR]

Background: This study aims to increase understanding of the relationship between heavy episodic drinking (HED) and fathers' involvement in parenting in five countries. The potential moderating effect of fathers' experiences of childhood trauma is also studied, controlling for the possible confounding of the effect of HED by father's attitudes toward gender equality, father's age and father's education. Method: United Nations Multi‐Country Study on Men and Violence (UNMCS) survey data from 4562 fathers aged 18–49 years from Cambodia, China, Indonesia and Papua New Guinea (PNG) and Sri Lanka were used to assess the relationship between fathering involvement (e.g., helping children with their homework) and self‐reported HED of 6+ drinks in one occasion vs. non‐HED and abstaining. Moderating effects of a 13‐item fathers' childhood trauma (FCT) scale were tested and analyses were adjusted for gender‐inequitable attitudes using the Gender‐Equitable Men scale score. Bivariate and adjusted individual participant meta‐analyses were used to determine effect estimates for each site and across all sites. Results: Fathers' HED was associated with less positive parental involvement after adjusting for gender‐equitable attitudes, FCT, age and education. No overall interaction between HED and FCT was identified. Gender equitable attitudes were associated with fathering involvement in some countries but not overall (p = 0.07). Conclusions: Heavy episodic drinking was associated with reduced positive fathering involvement. These findings suggest that interventions to increase fathers' involvement in parenting should include targeting reductions in fathers' HED. Structural barriers to fathers' involvement should be considered alongside HED in future studies of fathers' engagement with their children. [ABSTRACT FROM AUTHOR]

Background: The chronic‐plus‐binge model of ethanol consumption, where chronically (8‐week) ethanol‐fed mice are gavaged a single dose of ethanol (E8G1), is known to induce steatohepatitis in mice. However, how chronically ethanol‐fed mice respond to multiple binges of ethanol remains unknown. Methods: We extended the E8G1 model to three gavages of ethanol (E8G3) spaced 24 h apart, sacrificed each group 9 h after the final gavage, analyzed liver injury, and examined gene expression changes using microarray analyses in each group to identify mechanisms contributing to liver responses to binge ethanol. Results: Surprisingly, E8G3 treatment induced lower levels of liver injury, steatosis, inflammation, and fibrosis as compared to mice after E8G1 treatment. Microarray analyses identified several pathways that may contribute to the reduced liver injury after E8G3 treatment compared to E8G1 treatment. The gene encoding cytochrome P450 2B10 (Cyp2b10) was one of the top upregulated genes in the E8G1 group and was further upregulated in the E8G3 group, but only moderately induced after chronic ethanol consumption, as confirmed by RT‐qPCR and western blot analyses. Genetic disruption of Cyp2b10 worsened liver injury in E8G1 and E8G3 mice with higher blood ethanol levels compared to wild‐type control mice, while in vitro experiments revealed that CYP2b10 did not directly promote ethanol metabolism. Metabolomic analyses revealed significant differences in hepatic metabolites from E8G1‐treated Cyp2b10 knockout and WT mice, and these metabolic alterations may contribute to the reduced liver injury in Cyp2b10 knockout mice. Conclusion: Hepatic Cyp2b10 expression is highly induced after ethanol binge, and such upregulation reduces acute‐on‐chronic ethanol‐induced liver injury via the indirect modification of ethanol metabolism. [ABSTRACT FROM AUTHOR]

Background and aims: For most treatment‐seeking patients with severe Alcohol Use Disorder (AUD), abstinence is the clinically indicated goal. Existing AUD motivation scales are non‐specific about treatment consumption goals, which limit their effectiveness. Desires and mental imagery are relevant in the motivation for AUD treatment engagement. The Motivational Thought Frequency Scale for an abstinence goal (MTF‐A) was adapted from the MTF for controlled drinking (MTF‐CD). This study psychometrically evaluated the MTF‐A in an alcohol‐dependent sample engaged in treatment with a goal of abstinence. To enhance the clinical utility of the scale, a secondary aim was to evaluate a psychometrically equivalent short version of the MTF‐A. Method: A sample N of 329 treatment‐seeking patients with AUD (mean age of 44.44 years, SD = 11.89 years, 72% male) who were undertaking a cognitive behavioral treatment (CBT) program for abstinence completed the Motivational Thought Frequency Scale for Abstinence (MTF‐A) and the Severity of Alcohol Dependence Questionnaire (SADQ). The MTF‐A measured motivation for abstinence through four factors: intensity, self‐efficacy imagery, incentives imagery, and availability. Confirmatory factor analyses (CFAs) were conducted to examine factor structure and model fit. Cronbach's alpha assessed internal consistency. Predictive validity was determined by logistic regression predicting first‐session treatment non‐attendance and alcohol consumption between baseline assessment and commencement of treatment, controlling for potential confounds. Results: A four‐factor structure provided the best fit for the MTF‐A, compared with one‐ and three‐factor models. A shortened 9‐item MTF‐A scale (S‐MTF‐A) provided better fit than the 13‐item MTF‐A scale. Both MTF‐A and S‐MTF‐A displayed good internal consistency. Although both MTF‐A and S‐MTF‐A successfully predicted first‐session treatment non‐attendance, neither predicted alcohol consumption between the baseline assessment and commencement of treatment. Conclusions: The model fit of the four‐factor, 9‐item S‐MTF‐A was superior to the original 13‐item MTF‐A. Both scales were predictive of participation of AUD treatment. Desires and mental imagery play an important role in AUD treatment motivation. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) commonly occurs in patients with chronic pain, and a major barrier to achieving abstinence and preventing relapse is the emergence of hyperalgesia during alcohol withdrawal. Elucidating novel therapeutic approaches to target hyperalgesia associated with alcohol withdrawal could have important implications for treating AUD. Here, we examined the role of 2‐arachidonoylglycerol (2‐AG)‐mediated endocannabinoid (eCB) signaling in the regulation of hyperalgesia associated with alcohol withdrawal in mice. We tested the hypothesis that pharmacological augmentation of 2‐AG signaling could reduce hyperalgesia during withdrawal. Methods: Male and female C57BL/6J mice were tested during withdrawal from a continuous access two‐bottle choice (2BC) paradigm to investigate how eCB signaling modulates mechanical and thermal sensitivity during withdrawal. Mice were pretreated with the monoacylglycerol lipase (MAGL) inhibitor JZL184 to elevate levels of 2‐AG. Rimonabant or AM630 were given to block CB1 and CB2 receptor activity, respectively. DO34 was given to reduce 2‐AG by inhibiting the 2‐AG synthetic enzyme diacylglycerol lipase (DAGL). Results: After 72 h of withdrawal, male and female mice exhibited increased mechanical, but not thermal, hypersensitivity, which normalized by 7 days. This effect was reversed by pretreatment with JZL184. The effects of JZL184 were prevented by coadministration of either the CB1 or the CB2 antagonist. DO34, Rimonabant, and AM630 exacerbated mechanical hypersensitivity during alcohol withdrawal, causing an earlier onset and persistent hypersensitivity even 1 week into withdrawal. Conclusions: Our findings demonstrate the critical role of 2‐AG signaling in the bidirectional regulation of mechanical sensitivity during alcohol withdrawal, with enhancement of 2‐AG levels reducing sensitivity, and inhibition of 2‐AG signaling exacerbating sensitivity. These data suggest that 2‐AG augmentation represents a novel approach to the treatment of alcohol withdrawal‐associated hyperalgesia and AUD in patients with comorbid pain disorders. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic has resulted in pronounced changes for college students, including shifts in living situations and engagement in virtual environments. Although college drinking decreased at the onset of the pandemic, a nuanced understanding of pandemic‐related changes in drinking contexts and the risks conferred by each context on alcohol use and related consequences have yet to be assessed. Methods: Secondary data analyses were conducted on screening data from a large parent clinical trial assessing a college student drinking intervention (N = 1669). Participants across six cohorts (from Spring 2020 to Summer 2021) reported on the frequency of drinking in each context (i.e., outside the home, home alone, home with others in‐person, and home with others virtually), typical amount of drinking, and seven alcohol‐related consequence subscales. Results: Descriptive statistics and negative binomial regressions indicated that the proportion and frequency of drinking at home virtually with others decreased, while drinking outside the home increased from Spring 2020 to Summer 2021. Limited differences were observed in the proportion or frequency of individuals drinking at home alone or at home with others in‐person. Negative binomial and logistic regressions indicated that the frequency of drinking outside the home was most consistently associated with more alcohol‐related consequences (i.e., six of the seven subscales). However, drinking at home was not without risks; drinking home alone was associated with abuse/dependence, personal, social, hangover, and social media consequences; drinking home with others virtually was associated with abuse/dependence and social consequences; drinking home with others in‐person was associated with drunk texting/dialing. Conclusion: The proportion and frequency of drinking in certain contexts changed during the COVID‐19 pandemic, although drinking outside the home represented the highest risk drinking context across the pandemic. Future prevention and intervention efforts may benefit from considering approaches specific to different drinking contexts. [ABSTRACT FROM AUTHOR]

Background: Deficits in theory of mind (ToM) found in individuals with alcohol use disorder (AUD) are often thought to result from prolonged heavy alcohol use. However, links between deficits in ToM and greater alcohol problems are often also present in non‐clinical samples (e.g., adolescents and young adults) who may not have a similar long‐lasting history of alcohol consumption as individuals with AUD. The current study is the first to systematically review and meta‐analyze results from studies examining associations between lower ToM and greater alcohol problems in non‐clinical samples. Evidence of reliable associations in these non‐clinical samples would support the idea that deficits in ToM might also precede the emergence of AUD. Methods: PsycINFO, PubMed, and Google Scholar were searched according to our preregistered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) methodology. We systematically reviewed sample characteristics and ToM measures in identified articles. We then meta‐analyzed the findings of association between ToM and alcohol problems in non‐clinical samples using random effects models. Results: Nearly all studies used a measure of ToM that assessed the ability to infer the mental states of others based on eye region cues. Meta‐analytic results demonstrated that lower ToM was associated with more alcohol problems (r = −0.16, k = 6, CI = [−0.26, −0.04], p < 0.01, Q = 15.55, I2 = 67.85), and there was significant heterogeneity across studies. Gender (ß = 0.0003, CI = [−0.006, 0.007], z = 0.09, p = 0.93), age (ß = −0.008, CI = [−0.03, 0.01], z = −0.82, p = 0.42), and study quality (ß = −0.10, CI = [−0.35, 0.15], z = −0.82, p = 0.41) did not explain the heterogeneity. Conclusion: In non‐clinical samples, lower ToM is associated with more alcohol problems, indicative of a small effect size. Future longitudinal studies are needed to explore whether socio‐cognitive deficits may also serve as a risk factor for alcohol misuse. [ABSTRACT FROM AUTHOR]

In Dec. 2019‐January 2020, a pneumonia illness originating in Wuhan, China, designated as coronavirus disease 2019 (COVID‐19) was shown to be caused by a novel RNA coronavirus designated as severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). People with advanced age, male sex, and/or underlying health conditions (obesity, type 2 diabetes, cardiovascular disease, hypertension, chronic kidney disease, and chronic lung disease) are especially vulnerable to severe COVID‐19 symptoms and death. These risk factors impact the immune system and are also associated with poor health, chronic illness, and shortened longevity. However, a large percent of patients without these known risk factors also develops severe COVID‐19 disease that can result in death. Thus, there must exist risk factors that promote exaggerated inflammatory and immune response to the SARS‐CoV‐2 virus leading to death. One such risk factor may be alcohol misuse and alcohol use disorder because these can exacerbate viral lung infections like SARS, influenza, and pneumonia. Thus, it is highly plausible that alcohol misuse is a risk factor for either increased infection rate when individuals are exposed to SARS‐CoV‐2 virus and/or more severe COVID‐19 in infected patients. Alcohol use is a well‐known risk factor for lung diseases and ARDS in SARS patients. We propose that alcohol has three key pathogenic elements in common with other COVID‐19 severity risk factors: namely, inflammatory microbiota dysbiosis, leaky gut, and systemic activation of the NLRP3 inflammasome. We also propose that these three elements represent targets for therapy for severe COVID‐19. [ABSTRACT FROM AUTHOR]

Background: Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood‐to‐alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods and drinking across individuals. Method: We used two EMA samples: 96 heavy drinking college students (sample 1) and 19 young adults completing an ecological momentary intervention (EMI) for drinking to cope (sample 2). Mood and alcohol use were measured multiple times per day for 4–6 weeks. Mood–alcohol relationships were examined using three different analytic approaches: standard multilevel modeling, group causal modeling, and idiographic causal modeling. Results: Both multilevel modeling and group causal modeling showed that participants in both samples drank in response to positive moods only. However, idiographic causal analyses revealed that only 63% and 21% of subjects (in samples 1 and 2, respectively) drank following any positive mood. Many subjects (24% and 58%) did not drink in response to either positive or negative mood in their daily lives, and very few (5% and 16%) drank in response to negative moods throughout the EMA protocol, despite sample 2 being selected specifically because they endorse drinking to cope with negative mood. Conclusion: Traditional group‐level analyses and corresponding population‐wide theories assume relative homogeneity within populations in mood–alcohol relationships, but this nomothetic approach failed to characterize accurately the relationship between mood and alcohol use in approximately half of the subjects in two samples that were demographically and clinically homogeneous. Given inconsistent findings in the mood–alcohol relationships to date, we conclude that idiographic causal analyses can provide a foundation for more accurate theories of mood and alcohol use. In addition, idiographic causal models may also help improve psychosocial treatments through direct use in clinical settings. [ABSTRACT FROM AUTHOR]

Background: In a previous study, ondansetron, a serotonin 5‐HT3 receptor antagonist, reduced drinking intensity (drinks/drinking day [DPDD]) among European‐ancestry (EA) participants with moderate‐to‐severe alcohol use disorder (AUD) and variants in genes encoding the serotonin transporter (SLC6A4) and 5‐HT3A (HTR3A), and 5‐HT3B (HTR3B) receptors. We tested whether (1) ondansetron reduces DPDD among individuals of either European or African ancestry (AA), and (2) that reductions in DPDD are greatest among ondansetron‐treated individuals with population‐specific combinations of genotypes at SLC6A4, HTR3A, and HTR3B. Methods: In this 16‐week, double‐blind, placebo‐controlled, parallel‐group clinical trial, adults with AUD were randomized to receive low‐dose oral ondansetron (0.33 mg twice daily) or placebo stratified by "responsive" versus "nonresponsive" genotype defined using population‐specific genotypes at the three genetic loci. Generalized estimating equation regression models and a modified intent‐to‐treat analysis were used to compare the treatment groups on the primary outcome—DPDD—and two secondary outcomes—heavy drinking days per week [HDD] and drinks per day [DPD] across the 16 weeks of treatment. Results: Of 296 prospective participants screened, 95 (58 EA and 37 AA) were randomized and received at least one dose of study medication. In the modified intent‐to‐treat analysis, the ondansetron group averaged 0.40 more DPDD (p = 0.51), 1.35 times as many HDD (p = 0.16), and 1.06 times as many DPD (p = 0.59) as the placebo group. There were no significant interactions with genotype. There were no study‐related serious adverse events (AEs) and similar proportions of participants in the two treatment groups experienced AEs across organ systems. Conclusions: We found no evidence that low‐dose oral ondansetron is beneficial in the treatment of AUD, irrespective of genotype, thus failing to confirm prior study findings. However, the study was underpowered to identify medication by genotype interactions. [ABSTRACT FROM AUTHOR]

Background: The serotonin transporter (SERT) mRNA was previously reported to be a quantitative and pathophysiology‐based biomarker of heavy drinking in 5HTTLPR:LL genotype‐carriers treated with ondansetron. Here, we validated the potential use of SERT mRNA for quantitative prediction of recent alcohol consumption (in the absence of treatment) and compared it with the known biomarkers ethyl glucuronide (EtG) and ethyl sulfate (EtS). Methods: Binge drinking men and women of European ancestry aged 21 to 65 years were enrolled in a 12‐day, in‐patient, randomized, double‐blind, crossover study, where they were administered three beverage doses (placebo, 0.5 g/kg [0.4 g/kg] ethanol, and 1 g/kg [0.9 g/kg] ethanol for men [women]) individually in three 4‐day periods (experiments), separated by minimum 7‐day washout period. Diet, sleep, and physical activity were controlled throughout the inpatient experiments. Twenty‐nine participants were randomized to receive beverage doses counterbalancing the sequence of treatment and gender within subgroups stratified by SERT genotypes 5HTTLPR:LL+rs25531:AA (LALA) versus 5HTTLPR:LS/SS. Peripheral venous blood was collected daily for (1) quantification of SERT mRNA (the primary outcome measure) using qRT‐PCR and (2) plasma EtG and EtS levels using tandem mass‐spectrometry. Results: The association between administered beverage dose and SERT mRNA from completers of at least one 4‐day experiment (N = 18) assessed by a linear mixed model was not statistically significant. Significant positive associations were found with beverage dose and plasma EtG, EtS and EtG/EtS ratio (β = 5.8, SE = 1.2, p < 0.0001; β = 1.3, SE = 0.6, p = 0.023; and β = 3.0, SE = 0.7, p < 0.0001, respectively; the C‐statistics for discriminating outcomes were 0.97, 0.8, and 0.92, respectively). Additionally, we observed a sequence effect with a greater placebo effect on SERT mRNA when it was administered during the first experiment (p = 0.0009), but not on EtG/EtS measures. Conclusion: The findings do not validate the use of SERT as a biomarker of heavy drinking. Larger and more innovative studies addressing the effects of placebo, race, gender, and response to treatment with serotonergic agents are needed to fully assess the utility of SERT as a biomarker of heavy and binge drinking. [ABSTRACT FROM AUTHOR]

Background: Adolescent alcohol use is a significant public health concern and rates of alcohol use are higher among American Indian (AI) adolescents than national samples of non‐AI youth. A potential factor in understanding AI alcohol use is cultural identity, which can vary widely based on experiences of historical trauma. We used latent class analysis to examine cultural identity in AI and White adolescents and their alcohol use outcomes in relation to the latent class solutions. Methods: The samples included 3189 AI adolescents (Mage = 14.76, 48.9% female) and 1579 White adolescents (Mage = 15.56, 48.7% female) living on or near a reservation. Participants completed self‐report measures of AI and White cultural identity affiliation, alcohol use, and alcohol‐related problems. We examined (1) the best‐fitting latent class solution with respect to American Indian (AI) and White cultural identity; (2) equivalence of the latent class solution; and (3) alcohol use outcomes across the optimal latent class solution. Results: Latent profile analyses indicated an optimal 3‐class solution in both the AI and White samples, which differed by level of affiliation with AI and White cultural identity. While the optimal number of classes were similar across racial groups (configural profile similarity), the nature of the classes differed (structural profile dissimilarity). The three classes represented low overall scores on AI and White cultural identity (Marginalized), a mixture of high and low scores on AI and White cultural identity (Third Culture), and overall high scores on AI and White cultural identity (Bicultural). Alcohol‐related problems predicted membership in the Third Culture class compared with the Marginalized class and the Bicultural class. Specifically, youth in the Third Culture class reported significantly fewer alcohol‐related problems than youth in the Marginalized and Bicultural classes. Alcohol use did not predict latent class membership. Conclusions: The future‐oriented nature of the Third Culture class may provide protection against adverse alcohol‐related outcomes. Research is needed to test interventions that target greater future orientation and future plans to integrate culture into adolescents' lives. [ABSTRACT FROM AUTHOR]

Background: This study is the ninth cross‐sectional community study of fetal alcohol spectrum disorders (FASD) conducted by the multidisciplinary Fetal Alcohol Syndrome Epidemiology Research team in the Western Cape Province of South Africa. It is the third comprehensive study of FASD in a rural, agricultural region of South Africa. Methods: Population‐based, active case ascertainment methods were employed among a school‐based cohort to assess child physical and neurobehavioral traits, and maternal risk factor interviews were conducted to identify all children with FASD to determine its prevalence. Results: Consent was obtained for 76.7% of 1158 children attending first grade in the region's public schools. Case–control results are presented for 95 with fetal alcohol syndrome (FAS), 64 with partial fetal alcohol syndrome (PFAS), 77 with alcohol‐related neurodevelopmental disorder (ARND), 2 with alcohol‐related birth defects (ARBD), and 213 randomly‐selected controls. Four techniques estimating FASD prevalence from in‐person examinations and testing yielded a range of total FASD prevalence of 206–366 per 1000. The final weighted, estimated prevalence of FAS was 104.5 per 1000, PFAS was 77.7 per 1000, ARND was 125.2 per 1000, and total FASD prevalence was 310 per 1000 (95% CI = 283.4–336.7). Expressed as a percentage, 31% had FASD. Although the rate of total FASD remained steady over 9 years, the proportion of children within the FASD group has changed significantly: FAS trended down and ARND trended up. A detailed evaluation is presented of the specific child physical and neurobehavioral traits integral to assessing the full continuum of FASD. The diagnosis of a child with FASD was significantly associated with maternal proximal risk factors such as: co‐morbid prenatal use of alcohol and tobacco (OR = 19.1); maternal drinking of two (OR = 5.9), three (OR = 5.9), four (OR = 38.3), or more alcoholic drinks per drinking day; and drinking in the first trimester (OR = 8.4), first and second trimesters (OR = 17.7), or throughout pregnancy (OR = 18.6). Distal maternal risk factors included the following: slight or small physical status (height, weight, and head circumference), lower BMI, less formal education, late recognition of pregnancy, and higher gravidity, parity, and older age during the index pregnancy. Conclusion: The prevalence of FASD remained a significant problem in this region, but the severity of physical traits and anomalies within the continuum of FASD is trending downwards. [ABSTRACT FROM AUTHOR]

Background: Excessive alcohol use is a leading cause of global morbidity and premature mortality. This study evaluated the effectiveness of two types of nurse‐delivered interventions to reduce excessive alcohol consumption among screened participants using the alcohol use disorders identification test (AUDIT) in the workplace. Methods: A randomized controlled trial involving AUDIT‐positive employees of five Japan‐based companies was conducted. A total of 351 participants were randomized into groups that received a patient information leaflet (PIL), 5 min of brief advice, or 15 min of brief advice and counseling. Outcomes (weekly alcohol consumption and drinking and binge drinking frequency in the previous 30 days) were evaluated at 6 and 12‐month follow‐up. Results: The follow‐up rates were 96.3% (n = 338) and 94.9% (n = 333) at 6 and 12 months, respectively. At 6 months, the mean change in weekly alcohol consumption was −38.1 g (−1.64 US fluid oz/week) in the 15‐min brief advice and counseling group, which differed significantly from the PIL group. The reduction in the advice and counseling group persisted at 12‐month follow‐up but was no longer significantly different from the PIL group. There was no significant change in alcohol consumption observed in the 5‐min brief advice group. Improvement in drinking and binge drinking frequency was observed in all three groups. Conclusions: Nurse‐delivered 15‐min brief advice and counseling was effective over a 6‐month period in reducing alcohol consumption in a workplace setting. This finding suggests that the implementation of workplace screening and brief intervention could play a useful role in preventing the burden of harmful alcohol use. [ABSTRACT FROM AUTHOR]

Background: Simultaneous use of alcohol and cannabis to enhance each other's effect can cause potential harm. Time trends are diverging in adolescent use of alcohol, which is declining, and cannabis, which is increasing among certain subgroups. However, little is known about trends in their simultaneous and non‐simultaneous use. Racial and socioeconomic disparities are emerging in cannabis use, which may portend consequences to public health. Methods: The 2000 to 2020 Monitoring the Future surveys included approximately 38,000 U.S. 12th‐grade students with information on simultaneous use and pertinent demographic factors. A 5‐level alcohol/cannabis measure included past‐year simultaneous use (i.e., alcohol and cannabis use at the same time), non‐simultaneous alcohol and cannabis use, alcohol‐use‐only, cannabis‐use‐only, and no use. Multinomial logistic regressions estimated associations (adjusted relative risk ratios; aRRR) with time period (2000 to 2004, 2005 to 2009, 2010 to 2014, 2015 to 2020). Models were adjusted and included interactions with sex, race/ethnicity, and parental education. Results: Between 2000 and 2020, simultaneous alcohol/cannabis use among 12th graders decreased from 24.4% to 18.7%. From 2015 to 2020 compared to 2000 to 2004, the odds of simultaneous use (adjusted relative risk ratio (aRRR) vs. no use = 0.57, 95% CI [0.50, 0.66]) and alcohol‐use‐only (aRRR = 0.55, 95% CI [0.49, 0.61]) decreased, while cannabis‐use‐only odds increased (aRRR = 2.59, 95% CI [1.87, 3.59]). Notably, the prevalence of cannabis‐use‐only more than doubled from 2011 to 2019. The odds of simultaneous use, alcohol‐use‐only, and non‐simultaneous use of alcohol and cannabis declined more rapidly among males than females, whereas the odds for cannabis‐use‐only increased faster for females than males. Increases in cannabis‐use‐only were faster for non‐white adolescents. Conclusion: Simultaneous use of alcohol and cannabis is declining among U.S. adolescents, but the decline is slower among females than males. Declines in simultaneous use are largely concomitant with historical declines in alcohol use, indicating that a continued focus on reducing alcohol use among adolescents and young adults has extended benefits to other adolescent substance use. However, cannabis use without any reported past‐year alcohol use more than doubled in the last decade, a concerning trend. [ABSTRACT FROM AUTHOR]

Purpose: Neighborhood context may influence alcohol use, but effects may be heterogeneous, and prior evidence is threatened by confounding. We leveraged a housing voucher experiment to test whether housing vouchers' effects on alcohol use differed for families of children with and without socioemotional health or socioeconomic vulnerabilities. Trial design In the Moving to Opportunity (MTO) study, low‐income families in public housing in five US cities were randomized in 1994 to 1998 to receive one of three treatments: (1) a housing voucher redeemable in a low‐poverty neighborhood plus housing counseling, (2) a housing voucher without locational restriction, or (3) no voucher (control). Alcohol use was assessed 10 to 15 years later (2008 to 2010) in youth ages 13 to 20, N = 4600, and their mothers, N = 3200. Methods: Using intention‐to‐treat covariate‐adjusted regression models, we interacted MTO treatment with baseline socioemotional health vulnerabilities, testing modifiers of treatment on alcohol use. Results: We found treatment effect modification by socioemotional factors. For youth, MTO voucher treatment, compared with controls, reduced the odds of ever drinking alcohol if youth had behavior problems (OR = 0.26, 95% CI [0.09, 0.72]) or problems at school (OR = 0.46, [0.26, 0.82]). MTO low‐poverty treatment (vs. controls) also reduced the number of drinks if their health required special medicine/equipment (OR = 0.50 [0.32, 0.80]). Yet treatment effects were nonsignificant among youth without socioemotional vulnerabilities. Among mothers of children with learning problems, MTO voucher treatment (vs. controls) reduced past‐month drinking (OR = 0.69 [0.47, 0.99]), but was harmful otherwise (OR = 1.22 [0.99, 1.45]). Conclusions: For low‐income adolescents with special needs/socioemotional problems, housing vouchers protect against alcohol use. In the 1990's the Moving to Opportunity study randomized low‐income families to receive housing vouchers vs staying in public housing. For low‐income adolescents with special needs/socioemotional problems at baseline, housing vouchers protected against alcohol use 10‐15 years later. [ABSTRACT FROM AUTHOR]

Background: Adults experiencing homelessness have much higher rates of alcohol misuse than housed individuals. This study describes the development and preliminary effectiveness of a smartphone‐based, just‐in‐time adaptive intervention (JITAI) to reduce alcohol use among adults experiencing homelessness. Methods: We conducted a pilot trial (N = 41; mean age [SD] = 45.2 [11.5]; 19.5% women) of the Smart‐T Alcohol JITAI where participants completed brief ecological momentary assessments (EMAs) each day, received personalized treatment messages following each EMA, and accessed on‐demand intervention content for 4 weeks. The prediction algorithm and treatment messages were developed based on an independent but similar sample as part of the trial. We examined three drinking outcomes: daily drinking (yes/no), drinks per day, and heavy episodic drinking, controlling for scores on the Alcohol Use Disorders Identification Test (AUDIT) at baseline, age, and sex using quadratic growth curve models. Results: Over the 4‐week period, participants showed a decline in all alcohol use outcomes. Participants also reported high levels of satisfaction with the JITAI. Conclusions: Use of the Smart‐T Alcohol JITAI was well received and provided encouraging evidence that it may reduce any drinking, drinks per day, and heavy episodic drinking among adults experiencing homelessness. [ABSTRACT FROM AUTHOR]

Background: While consumption of alcohol does not often begin until early adolescence, young children are highly capable of internalizing normative information through observational learning. We used a longitudinal multiple‐informant family study to examine the impact of exposure to mothers' and fathers' drinking on young children's normative perceptions of who drinks alcohol. Methods: Three hundred twenty‐nine children (4 to 6 years old at baseline [Mage 4.78 (SD = 0.725)], 51% girls) completed the Dutch electronic appropriate beverage task [eABT] where they attributed alcoholic beverages to a variety of persons depicted in an illustrated scenario. Their parents completed an online survey that included information on alcohol use and exposure. Results: Children more frequently exposed to their mothers' drinking provided females shown in the eABT illustrations with alcohol significantly more often than children less frequently exposed to mothers' drinking. There was no effect of mother's exposure on providing males in the eABT with alcoholic beverages. Similarly, children more frequently exposed to their fathers' drinking provided fathers with alcoholic beverages significantly more often than children less frequently exposed to their fathers' drinking. There was no effect of father's exposure on providing the females with alcoholic beverages, nor was there an effect of father's exposure on providing "other males" with alcohol. These patterns held after adjusting for age and sex. Conclusions: This study demonstrates that there are gender‐specific effects of exposure to parents' (particularly mothers') drinking on young children's perceptions of person‐specific drinking norms. The findings provide unique evidence in a young population group of effects on an understudied dimension of alcohol‐related perceptions with implications for future drinking behavior. [ABSTRACT FROM AUTHOR]

Background: Alcohol withdrawal is a key component of severe alcohol use disorder. Animal models of alcohol withdrawal tend to focus on traditional anxiety/stress tests. While these have been essential to advancing our understanding of the biology of alcohol withdrawal, abrupt cessation of drinking following heavy alcohol consumption can also trigger withdrawal‐related affective states that impact responses to a variety of life events and stressors. To this end, we show that behaviors in a variety of tasks that differ in task demand and intensity are altered during withdrawal in male and female mice after voluntary alcohol access. Methods: Male and female miceunderwent six weeks of intermittent two‐bottle choice alcohol exposure followed by behavioral tests. The tests included—Home cage: low‐stress baseline environment to measure spontaneous natural behaviors; Open field: anxiety‐inducing bright novel environment; Looming disc: arena with a protective hut where mice are exposed to a series of discs that mimic an overhead advancing predator, and Robogator‐simulated predator task: forced foraging behavioral choice in the presence of an advancing robot predator that "attacks" when mice are near a food pellet in a large open arena. Results: A history of alcohol exposure impacted behaviors in these tasks in a sex‐dependent manner. In the home cage, alcohol induced reductions in digging and heightened stress coping through an increase in grooming time. In males, increased rearing yielded greater vigilance/exploration in a familiar environment. The open‐field test revealed an anxiety phenotype in both male and female mice exposed to alcohol. Male mice showed no behavioral alterations to the looming disc task, while females exposed to alcohol showed greater escape responses than water controls, indicative of active stress‐response behaviors. In males, the Robogator task revealed a hesitant/avoidant phenotype in alcohol‐exposed mice under greater task demands. Conclusions: Few drugs show robust evidence of efficacy in clinical trials for alcohol withdrawal. Understanding how withdrawal alters a variety of behaviors in both males and females that are linked to stress coping can increase our understanding of alcohol misuse and aid in developing better medications for treating individuals with AUD. [ABSTRACT FROM AUTHOR]

Background: Ongoing alcohol use is strongly associated with progressive liver damage and higher mortality in patients with alcohol‐related liver disease (ArLD). Reduction in alcohol use is therefore the cornerstone of treatment to improve the long‐term outcome of these patients. However, a large proportion of patients continue to use alcohol and do not access or engage with alcohol treatment services after a diagnosis of ArLD. We reviewed the literature on factors associated with ongoing alcohol consumption among patients with ArLD to identify barriers or facilitators to their accessing alcohol treatment. Methods: A search of MEDLINE and EMBASE was conducted using search strategies relating to ArLD and the psychosocial factors hypothesized to influence alcohol reduction and/or abstinence. Results: There were few relevant studies pertinent to this population group. Several studies reported a high prevalence of mental health diagnoses associated with the severity of alcohol dependence. Social and environmental factors were shown to be important determinants of alcohol use. Common themes perceived as barriers to treatment from qualitative interviews with ArLD patients across studies included poor communication between the clinical team and patient, lack of symptoms recognized by patients themselves, and perceived loss of control over their condition. Conclusions: We recommend that future clinical studies of patient cohorts with ArLD include detailed psychosocial assessments to capture information on mental health and social factors. Qualitative studies are required to explore the patient journey pre and post hospital admission, which should focus on identifying facilitators and barriers to accessing treatment. Well‐designed, controlled studies are needed to identify patient, social, and environmental factors associated with relapse to alcohol use after a diagnosis of ArLD. These data will enable us to adapt our support for patients to enhance engagement with services and improve long‐term outcomes. [ABSTRACT FROM AUTHOR]

Background: Heavy alcohol use, including binge drinking, is associated with high morbidity and mortality among men who have sex with men (MSM). Self‐reported alcohol measures may lead to inaccurate estimates due to recall and social desirability biases. Objective alcohol biomarkers like phosphatidylethanol (PEth) can be used to corroborate self‐report and could help to inform treatment approaches and research strategies for alcohol using MSM. Methods: From 2015 to 2020, alcohol using MSM ≥18 years were enrolled in a randomized controlled trial evaluating the efficacy of naltrexone in reducing binge drinking. Using this trial's baseline data, we applied multivariable logistic regression to identify the correlates of high PEth levels (i.e., ≥87 ng/ml) and concordance between PEth levels and self‐reported heavy drinking. Results: Of 118 MSM, 64% had PEth levels ≥87 ng/ml and 72% had PEth levels that were concordant with self‐reported heavy alcohol use. Factors significantly associated in separate models with elevated PEth levels were income ≥$60,000 (adjusted odds ratio [aOR] = 4.09; 95% CI = 1.13 to 14.82), being employed (aOR = 4.04; 95% CI = 1.45 to 11.32), episodic cannabis use (aOR = 4.63; 95% CI = 1.27 to 16.92), and any alcohol/substance use prior to or during anal intercourse (aOR = 2.52; 95% CI = 1.08 to 5.90). Living with HIV was associated with significantly lower odds of elevated PEth levels (aOR = 0.23; 95% CI = 0.09 to 0.61). Factors associated with significantly higher concordance between PEth levels and self‐reported heavy alcohol use included at least weekly use of poppers (aOR = 6.41; 95% CI = 1.27 to 32.28) and polysubstance use (aOR = 2.53; 95% CI = 1.02 to 6.27). Living with HIV was associated with lower odds of concordance (aOR = 0.36; 95% CI = 0.14 to 0.97). Conclusions: PEth may enhance the detection of heavy drinking among MSM, including the identification of subpopulations that may benefit from targeted alcohol reduction interventions. However, PEth values for MSM living with HIV showed modest concordance with self‐reported alcohol use and may need to be supplemented with additional biomarkers or evaluated against a different cutoff. [ABSTRACT FROM AUTHOR]

Background: Research conducted during the COVID‐19 Pandemic has identified two co‐occurring public health concerns: loneliness and substance use. Findings from research conducted prior to the pandemic are inconclusive as to the links between loneliness and substance use. This study aimed to measure associations of loneliness with three different types of substance use during COVID‐19: daily number of alcoholic drinks, cannabis use, and non‐cannabis drug use. Method: Data were obtained between October 2020 and May 2021 from 2,648 US adults (Mage = 38.76, 65.4% women) diverse with respect to race and ethnicity using online recruitment. Participants completed baseline surveys and daily assessments for 30 days. A daily loneliness measure was recoded into separate within‐ and between‐person predictor variables. Daily outcome measures included the number of alcoholic drinks consumed and dichotomous cannabis and non‐cannabis drug use variables. Generalized linear multilevel models (GLMLM) were used to examine within‐ and between‐person associations between loneliness and substance use. Results: The unconditional means model indicated that 59.0% of the variance in the daily number of alcoholic drinks was due to within‐person variability. GLMLM analyses revealed that, overall, people drank more on days when they felt a particularly high or particularly low degree of loneliness (positive quadratic effect). There was a negative and significant within‐person association between daily loneliness and the likelihood of cannabis use. There was also a positive and significant within‐person association between daily loneliness and the likelihood of non‐cannabis drug use. Conclusions: Associations between loneliness and substance use vary with substance type and whether within‐ or between‐person differences are assessed. These findings are relevant to the persistence of substance use disorders and thus of potential clinical importance. Individuals who do not experience severe loneliness at intake but who show daily increases in loneliness above baseline levels are at heightened risk of alcohol and non‐cannabis drug use. Future research could profitably examine just‐in‐time adaptive interventions that assess fluctuations in loneliness to prevent the development or exacerbation of substance use disorders. [ABSTRACT FROM AUTHOR]

Background: Excessive alcohol consumption during pregnancy is associated with high risk of congenital heart defects, but it is unclear how alcohol specifically affects heart development during the acute aftermath of a maternal binge drinking episode. We hypothesize that administration of a single maternal binge dose of alcohol to pregnant mice at embryonic day 9.5 (E9.5) causes perturbations in the expression patterns of specific genes in the developing heart in the acute period (1–3 days) following the binge episode. To test this hypothesis and identify strong candidate ethanol‐sensitive target genes of interest, we adapted a mouse binge alcohol model that is associated with a high incidence of congenital heart defects as described below. Methods/Results: Pregnant mice were administered a single dose of alcohol (2.5 g/kg in saline) or control (saline alone) via oral gavage. To evaluate the impact of maternal binge alcohol on cardiac gene expression profiles, we isolated embryonic hearts from both groups (n = 5/group) at 24, 48, and 72 h post‐gavage for transcriptomic analyses. RNA was extracted and evaluated using quantitative RNA‐sequencing (RNA‐Seq) methods. To identify a cohort of binge‐altered cardiac genes, we set the threshold for change at >2.0‐fold difference with adjusted p < 0.05 versus control. RNA‐Seq analysis of cardiac gene expression revealed that of the 17 genes that were altered within the first 48 h post‐binge, with the largest category consisting of transcription factors (Alx1, Alx4, HoxB7, HoxD8, and Runx2), followed by signaling molecules (Adamts18, Dkk2, Rtl1, and Wnt7a). Furthermore, multiple comparative and pathway analyses suggested that several of the candidate genes identified through differential RNA‐Seq analysis may interact through certain common pathways. To investigate this further, we performed gene‐specific qPCR analyses for three representative candidate targets: Runx2, Wnt7a, and Mlxipl. Notably, only Wnt7a showed significantly (p < 0.05) decreased expression in response to maternal binge alcohol in the qPCR assays. Conclusions: These findings identify Wnt7a and a short list of potential other candidate genes and pathways for further study, which could provide mechanistic insights into how maternal binge alcohol consumption produces congenital cardiac malformations. [ABSTRACT FROM AUTHOR]

Background: Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross‐sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state‐of‐the‐art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level. Methods: Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone‐based interactive voice recording. Results: Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co‐occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross‐lagged effects. Conclusions: Findings showed that negative and positive emotion dysregulation co‐occurred with alcohol use and that there was significant interindividual variability in the cross‐lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation. [ABSTRACT FROM AUTHOR]

Background: The relationship between alcohol and pain is complex. Associations between pain and alcohol use disorder (AUD) vary by race, but the underlying biological basis is not understood. We examined the association of the kappa opioid receptor (KOR) with responses to the cold‐pressor test (CPT), before and after treatment with the opioid antagonist naltrexone, among individuals with AUD who self‐identified as Black or White. Methods: Thirty‐seven individuals (12 Black, 24 White, and 1 Multiracial) with AUD participated in two CPTs, separated by 1 week during which they received naltrexone 100 mg daily. During each CPT, pain reporting threshold (PRT), average pain increase rate (APIR), relative pain recovery (RPR), and alcohol craving were recorded. KOR availability was measured using [11C]‐LY2795050 positron emission tomography (PET) prior to treatment with naltrexone. Results: Black participants reported higher PRT and APIR than White participants during the CPT before, but not after, naltrexone treatment. Among Black participants, KOR availability was positively associated with PRT and APIR before, but not after naltrexone. Greater KOR availability was associated with faster RPR for White, but not Black, participants. The CPT induced more alcohol craving in Black than White participants, particularly in individuals with low KOR availability, an effect that was not attenuated by naltrexone. Conclusions: KOR involvement and naltrexone effects on responses to the CPT were different between Black and White participants. These preliminary findings suggest that further exploration of the differences in the opioid system and pain among Black and White individuals with AUD and their relationship with naltrexone's effects is warranted. [ABSTRACT FROM AUTHOR]

Facial imaging tools have rapidly advanced in recent years and show potential for use in fetal alcohol spectrum disorder (FASD) screening and diagnosis. This scoping review describes the current state of evidence regarding the use of facial imaging being as a screening tool for FASD at a community level. This review follows the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) extension for scoping reviews and is registered with the Open Science Framework (osf.io/e4xw6). An electronic search of five databases was conducted. The time frame was limited to the period 2006 to 2022. The search included any form of imaging of the head, neck, oral cavity, and dentition. Animal and antenatal studies were excluded, as were those using only brain imaging. The search retrieved 730 unique titles. After title, abstract, and full‐text screening, 28 primary studies were included in this review. Most studies were conducted with South African participants. Imaging included 2D photographs, 3D stereophotogrammetry, 3D laser scanning, and radiographs. Various measurements and landmarks were used to discriminate FASD from non‐FASD participants, which included anthropometry, face shape analysis, and facial curvatures. Methods of data processing, analysis, and modeling ranged from manual methods to fully automated systems utilizing artificial intelligence. The use of facial imaging to screen for and diagnose patients with FASD is a rapidly advancing field. Most studies in the field remain exploratory, attempting to find accurate, reliable, and consistent landmarks and measures across different populations. For community screening, none of the tools in this review in their current form completely fulfill all the identified properties of an ideal screening tool. More research and development are needed prior to advocating for the use of any tool listed and the ethical implications are yet to be fully explored. [ABSTRACT FROM AUTHOR]

Background: Alcohol intoxication impairs inhibitory control, resulting in disinhibited, impulsive behavior. The anterior cingulate cortex (ACC) plays an essential role in a range of executive functions and is sensitive to the effects of alcohol, which contributes to the top‐down cognitive dysregulation. This study used a multimodal approach to examine the acute effects of alcohol on the neural underpinnings of inhibitory control, inhibition failures, and neurobehavioral optimization as reflected in trial‐to‐trial dynamics of post‐error adjustments. Methods: Adult social drinkers served as their own controls by participating in the Go/NoGo task during acute alcohol and placebo conditions in a multi‐session, counterbalanced design. Distributed source modeling of the magnetoencephalographic signal was combined with structural magnetic resonance imaging to characterize the spatio‐temporal dynamics of inhibitory control in the time‐frequency domain. Results: Successful response inhibition (NoGo) elicited right‐lateralized event‐related theta power (4 to 7 Hz). Errors elicited a short‐latency increase in theta power in the dorsal (dACC), followed by activity in the rostral (rACC), which may underlie an affective "oh, no!" orienting response to errors. Error‐related theta in the dACC was associated with subsequent activity of the motor areas on the first post‐error trial, suggesting the occurrence of post‐error output adjustments. Importantly, a gradual increase of the dACC theta across post‐error trials closely tracked improvements in accuracy under placebo, which may reflect cognitive control engagement to optimize response accuracy. In contrast, alcohol increased NoGo commission errors, dysregulated theta during correct NoGo withholding, and abolished the post‐error theta enhancement of cognitive control. Conclusions: Confirming the sensitivity of frontal theta to inhibitory control and error monitoring, the results support functional and temporal dissociation along the dorso‐rostral axis of the ACC and the deleterious effects of alcohol on the frontal circuitry subserving top‐down regulation. Over time, alcohol‐induced disinhibition may give rise to compulsive drinking and contribute to alcohol misuse. [ABSTRACT FROM AUTHOR]

Background: Early recovery from alcohol use disorder (AUD) is commonly associated with high levels of negative affect, stress, and emotional vulnerability, which confer significant relapse risk. Emotion differentiation—the ability to distinguish between discrete emotions—has been shown to predict relapse after treatment for a drug use disorder, but this relationship has not been explored in individuals recovering from AUD. Methods: The current study used thrice daily random and up to thrice daily self‐initiated ecological momentary assessment surveys (N = 42, observations = 915) to examine whether 1) moments of high affective arousal are characterized by momentary differences in emotion differentiation among individuals in the first year of a current AUD recovery attempt, and 2) individuals' average emotion differentiation would predict subsequent alcohol use measured by the timeline follow‐back over a 3‐month follow‐up period. Results: Multilevel models showed that moments (Level 1) of higher‐than‐average negative affect (p < 0.001) and/or stress (p = 0.033) were characterized by less negative emotion differentiation, while moments of higher‐than‐average positive affect were characterized by greater positive emotion differentiation (p < 0.001). At the between‐person level (Level 2), participants with higher stress overall had lower negative emotion differentiation (p = 0.009). Linear regression showed that average negative, but not positive, emotion differentiation was inversely associated with percent drinking days over the subsequent 3‐month follow‐up period (p = 0.042). Neither form of average emotion differentiation was associated with drinking quantity. Conclusions: We found that for individuals in early AUD recovery, affective states are associated with acute shifts in the capacity for emotion differentiation. Further, we found that average negative emotion differentiation prospectively predicts subsequent alcohol use. [ABSTRACT FROM AUTHOR]

Alcohol use disorders (AUDs) are among the most prevalent behavioral and mental health diagnoses. Individuals with an AUD are at increased risk for numerous consequences across their social, health, and psychological functioning. Research suggests that differences may exist in the prevalence and consequences of AUD and in the efficacy of AUD treatment across demographic characteristics (i.e., sex/gender and race/ethnicity). This meta‐epidemiologic review examined the inclusion of diverse groups (sex/gender and race/ethnicity) in published randomized controlled trials of nonpharmacological treatments for AUD since 1994, following passage of the National Institutes of Health Revitalization Act of 1993. We systematically searched databases following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement criteria. The initial search strategy yielded 7931 articles. After excluding ineligible articles, 155 were included in the present review for synthesis. Of the articles included in this review, only 57 (36.8%) fully reported on both their sample's sex/gender and racial/ethnic breakdown. Of the total sample, seven articles specifically examined one racial/ethnic group and 32 specifically examined one sex/gender group. Six articles (3.9%) reported no information regarding the racial/ethnic breakdown of their sample and five articles (3.2%) reported no information regarding the sex/gender breakdown of their participants. Only two articles (1.3%) reported on subgroup analyses that examined differences in treatment outcomes by both sex/gender and race/ethnicity, despite guidelines set forth by NIH. Only 46 articles (29.7%) described the failure to include diverse sex/gender or racial/ethnic groups or concerns about the generalizability of study findings given their sample's sex/gender or racial/ethnic composition as methodological limitations. These results indicate that substantial efforts must be put forth by the scientific community to ensure the inclusion, analysis, and reporting of data focused on women/females and members of minoritized racial/ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Progression through the stages of change is a proposed mechanism underlying the effects of treatment for alcohol use disorder (AUD). However, examining stages of change as a mechanism of treatment effects requires that the measure be invariant across patient subgroups, treatment conditions, and time. In this study, we examined measurement invariance of the University of Rhode Island Change Assessment Scale (URICA) in Project MATCH using an exploratory structural equation modeling (ESEM) approach. Methods: We conducted a secondary analysis of data from Project MATCH (N = 1726; Mage = 40.2, SD = 10.9; 75.7% male; 80% non‐Hispanic white), a multisite randomized clinical trial that tested three AUD treatments: Motivational Enhancement Therapy, Cognitive‐Behavioral Therapy, or Twelve‐Step Facilitation. Participants completed the 24‐item URICA for assessing the stages of change in relation to drinking at baseline and post‐treatment (3 months after baseline). Results: A 4‐factor ESEM provided a good fit to the data and a better fit to the data than a conventional 4‐factor confirmatory factor analysis model. Further, the URICA demonstrated scalar invariance across each patient subgroup at baseline (sex, ethnicity, marital status, education, and parental history of AUD) and treatment condition at follow‐up. However, the URICA was not longitudinally invariant as the metric model resulted in a significant decrement in model fit. Conclusions: Measurement invariance of the URICA over time was not supported. Longitudinally invariant measures of the stages of change are needed to test the proposal that progression through the stages explains treatment effects. [ABSTRACT FROM AUTHOR]

The article offers information on the 45th Research Society on Alcoholism (RSA) annual scientific meeting to be held in Orlando, Florida on June 25-29, 2022.

Background: Previous research indicates college students report heavier drinking on certain events (e.g., 21st birthday). While past research has identified heavier drinking events, students' own reports of which events are associated with elevated drinking remains understudied. The current study utilized mixed methods to explore potential high‐risk drinking events (HRDE) for college student drinkers and how these events differed from typical drinking and each other. Methods: College student drinkers (N = 204) reported the number of drinks they consume on nine predetermined events (e.g., Halloween). Students also responded to open‐ended questions listing five events during which they had elevated drinking and indicating the amount consumed on each event. Open‐ended responses were coded into similar event categories. Descriptive statistics for drinks consumed were calculated for predetermined and coded open‐ended events. Chi‐square analyses assessed differences in endorsement of open‐ended events by birth sex, age group, and Greek membership. Two multilevel count regressions assessed within‐person differences in number of drinks consumed between participants' typical drinking occasions and (1) highly endorsed open‐ended events and (2) predetermined events. Results: For all open‐ended event categories, average number of drinks consumed exceeded heavy episodic drinking thresholds; however, there was substantial variability. Comparing predetermined events to participants' typical drinking indicated elevated drinking on participants' birthdays, New Year's Eve, Halloween, Finals, and Spring Break; significant differences between events also emerged. Comparison of open‐ended categories to participants' typical drinking indicated elevated drinking on birthdays, celebrations, parties, and holidays; however, there were no significant differences between open‐ended events. Conclusions: Students who drink alcohol report heavier drinking on specific calendar‐based events (e.g., Spring Break). However, students also report non‐calendar‐related events (e.g., non‐specific parties) as some of their highest drinking events. More research is needed to understand how intervention and prevention programs can be adapted to target both known calendar‐based HRDE, and unknown, idiosyncratic HRDE. [ABSTRACT FROM AUTHOR]

Background: Surveys of changes in drinking during the COVID‐19 pandemic have primarily relied on retrospective self‐report. Further, most such surveys have not included detailed measures of alcohol use patterns, such as beverage‐specific consumption, nor measures of alcohol use disorder (AUD) symptoms that would allow a comprehensive understanding of changes in alcohol use. Methods: Data from 1819 completed interviews from the N14C follow‐up survey to the 2019 to 2020 National Alcohol Survey (N14) were conducted between January 30 and March 28, 2021. Questions on alcohol use from the Graduated Frequency series, beverage‐specific quantity and frequency, and DSM‐5 AUD items were asked in both surveys and used to estimate changes from pre‐pandemic drinking to drinking during the pandemic. Analyses focus on changes in these measures over time and comparisons between key subgroups defined by gender, race/ethnicity, and age. Results: Key findings include particularly large increases in drinking and AUD for African Americans and women, reduced drinking and heavy drinking prevalence among men and White respondents, and a concentration of increased drinking and AUD among respondents aged 35 to 49. Increases in alcohol use were found to be driven particularly by increases in drinking frequency and the consumption of spirits. Conclusions: Results confirm prior findings of overall increases and subgroup‐specific changes, and importantly, provide detailed information on the patterns of change across major socio‐demographic subgroups. Substantial increases in the prevalence of DSM‐5 moderate to severe AUDs are a novel finding that is of particular concern. [ABSTRACT FROM AUTHOR]

Background: Evidence implicates sleep/circadian factors in alcohol use, suggesting the existence of a 24‐h rhythm in alcohol craving, which may vary by individual differences in sleep factors and alcohol use frequency. This study sought to (1) replicate prior findings of a 24‐h rhythm in alcohol craving, and (2) examine whether individual differences in sleep timing, sleep duration, or alcohol use frequency are related to differences in the timing of the peak of the craving rhythm (i.e., the acrophase) or magnitude of fluctuation of the rhythm (i.e., amplitude). Finally, whether such associations varied by sex or racial identity was explored. Methods: Two‐hundred fifteen adult drinkers (21 to 35 years of age, 72% male, 66% self‐identified as White) completed a baseline assessment of alcohol use frequency and then smartphone reports of alcohol craving intensity six times a day across 10 days. Sleep timing was also recorded each morning of the 10‐day period. Multilevel cosinor analysis was used to test the presence of a 24‐h rhythm and to estimate acrophase and amplitude. Results: Multilevel cosinor analysis revealed a 24‐h rhythm in alcohol craving. Individual differences in sleep timing or sleep duration did not predict rhythm acrophase or amplitude. However, alcohol use frequency moderated this rhythm wherein individuals who used alcohol more frequently in the 30 days prior to beginning the study had higher mean levels of craving and greater rhythm amplitudes (i.e., greater rhythmic fluctuations). Associations did not vary by sex or racial identity. Conclusions: Results show that alcohol craving exhibits a systematic rhythm over the course of the 24 h and that the frequency of alcohol use may be relevant to the shape of this rhythm. Consideration of daily rhythms in alcohol craving may further our understanding of the mechanisms that drive alcohol use. [ABSTRACT FROM AUTHOR]

Background: A strong predictor for the development of alcohol use disorder (AUD) is altered sensitivity to the intoxicating effects of alcohol. Individual differences in the initial sensitivity to alcohol are controlled in part by genetic factors. Mice offer a powerful tool to elucidate the genetic basis of behavioral and physiological traits relevant to AUD, but conventional experimental crosses have only been able to identify large chromosomal regions rather than specific genes. Genetically diverse, highly recombinant mouse populations make it possible to observe a wider range of phenotypic variation, offer greater mapping precision, and thus increase the potential for efficient gene identification. Methods: We have taken advantage of the Diversity Outbred (DO) mouse population to identify and precisely map quantitative trait loci (QTL) associated with ethanol sensitivity. We phenotyped 798 male J:DO mice for three measures of ethanol sensitivity: ataxia, hypothermia, and loss of the righting response. We used high‐density MegaMUGA and GigaMUGA to obtain genotypes ranging from 77,808 to 143,259 SNPs. We also performed RNA sequencing in striatum to map expression QTLs and identify gene expression–trait correlations. We then applied a systems genetic strategy to identify narrow QTLs and construct the network of correlations that exists between DNA sequence, gene expression values, and ethanol‐related phenotypes to prioritize our list of positional candidate genes. Results: We observed large amounts of phenotypic variation with the DO population and identified suggestive and significant QTLs associated with ethanol sensitivity on chromosomes 1, 2, and 16. The implicated regions were narrow (4.5–6.9 Mb in size) and each QTL explained ~4–5% of the variance. Conclusions: Our results can be used to identify alleles that contribute to AUD in humans, elucidate causative biological mechanisms, or assist in the development of novel therapeutic interventions. [ABSTRACT FROM AUTHOR]

Background: American Indian (AI) adolescents report disproportionate higher rates of alcohol use and alcohol‐related consequences than adolescents from other racial/ethnic groups. Trauma exposure is also reported at high rates among AI individuals and likely confers risk for alcohol use. The purpose of the present study was to examine the effects of assaultive trauma experiences (e.g., physical assault, sexual assault) on alcohol use and alcohol‐related consequences in AI adolescents. Methods: We conducted a secondary analysis of self‐reported data on trauma exposure, alcohol consumption, and lifetime alcohol‐related consequences provided by AI 7th to 12th graders residing on or near a reservation (n = 3498, Mage = 14.8; 49.5% female). Institutional Review Boards, tribal authorities, and school boards approved the study protocols prior to beginning data collection. Results: Nearly half (49.3%, n = 1498) of AI adolescents reported having experienced at least one assaultive trauma in their lifetime. Those who had experienced assaultive trauma were more likely to report lifetime alcohol use (χ2 = 111.84, p < 0.001) and experienced greater alcohol‐related consequences (t(1746) = 12.21, p < 0.001) than those with no assaultive trauma exposure. Multilevel regression analyses indicated that a greater number of assaultive traumatic events was significantly associated with greater odds of lifetime alcohol use (p < 0.001, OR = 1.81, 95% CI [1.65, 2.00]) and having experienced a greater number of alcohol‐related consequences (b = 0.36, SE = 0.04, t = 16.95, p < 0.001, 95% CI [0.31, 0.46]). Conclusions: Findings of the present study highlight the relevance of exposure to assaultive trauma to AI adolescents' use of alcohol and experiences of alcohol‐related consequences. These findings support the need for trauma‐informed interventions in addressing alcohol use among AI adolescents. [ABSTRACT FROM AUTHOR]

Background: Binge alcohol exposure during adolescence results in long‐lasting alterations in the brain and behavior. For example, adolescent intermittent ethanol (AIE) exposure in rodents results in long‐term loss of functional connectivity among prefrontal cortex (PFC) and striatal regions as well as a variety of neurochemical, molecular, and epigenetic alterations. Interneurons in the PFC and striatum play critical roles in behavioral flexibility and functional connectivity. For example, parvalbumin (PV) interneurons are known to contribute to neural synchrony and cholinergic interneurons contribute to strategy selection. Furthermore, extracellular perineuronal nets (PNNs) that surround some interneurons, particularly PV+ interneurons, further regulate cellular plasticity. The effect of AIE exposure on the expression of these markers within the PFC is not well understood. Methods: The present study tested the hypothesis that AIE exposure reduces the expression of PV+ and choline acetyltransferase (ChAT)+ interneurons in the adult PFC and striatum and increases the related expression of PNNs (marked by binding of Wisteria floribunda agglutinin lectin) in adulthood. Male rats were exposed to AIE (5 g/kg/day, 2‐days‐on/2‐days‐off, i.e., P25 to P54) or water (CON), and brain tissue was harvested in adulthood (>P80). Immunohistochemistry and co‐immunofluorescence were used to assess the expression of ChAT, PV, and PNNs within the adult PFC and striatum following AIE exposure. Results: ChAT and PV interneuron densities in the striatum and PFC were unchanged after AIE exposure. However, PNN density in the PFC of AIE‐exposed rats was greater than in CON rats. Moreover, significantly more PV neurons were surrounded by PNNs in AIE‐exposed subjects than controls in both PFC subregions assessed: orbitofrontal cortex (CON = 34%; AIE = 40%) and medial PFC (CON = 10%; AIE = 14%). Conclusions: These findings indicate that, following AIE exposure, PV interneuron expression in the adult PFC and striatum is unaltered, while PNNs surrounding these neurons are increased. This increase in PNNs may restrict the plasticity of the ensheathed neurons, thereby contributing to impaired microcircuitry in frontostriatal connectivity and related behavioral impairments. [ABSTRACT FROM AUTHOR]

Background: Growing evidence indicates that sleep characteristics predict future substance use and related problems. However, most prior studies assessed a limited range of sleep characteristics, studied a narrow age span, and included few follow‐up assessments. Here, we used six annual assessments from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study, which spans adolescence and young adulthood with an accelerated longitudinal design, to examine whether multiple sleep characteristics in any year predict alcohol and cannabis use the following year. Methods: The sample included 831 NCANDA participants (423 females; baseline age 12–21 years). Sleep variables included circadian preference, sleep quality, daytime sleepiness, the timing of midsleep (weekday/weekend), and sleep duration (weekday/weekend). Using generalized linear mixed models (logistic for cannabis; ordinal for binge severity), we tested whether each repeatedly measured sleep characteristic (years 0–4) predicted substance use (alcohol binge severity or cannabis use) the following year (years 1–5), covarying for age, sex, race, visit, parental education, and previous year's substance use. Results: Greater eveningness, more daytime sleepiness, later weekend sleep timing, and shorter sleep duration (weekday/weekend) all predicted more severe alcohol binge drinking the following year. Only greater eveningness predicted a greater likelihood of any cannabis use the following year. Post‐hoc stratified exploratory analyses indicated that some associations (e.g., greater eveningness and shorter weekend sleep duration) predicted binge severity only in female participants, and that middle/high school versus post‐high school adolescents were more vulnerable to sleep‐related risk for cannabis use. Conclusions: Our findings support the relevance of multiple sleep/circadian characteristics in the risk for future alcohol binge severity and cannabis use. Preliminary findings suggest that these risk factors vary based on developmental stage and sex. Results underscore a need for greater attention to sleep/circadian characteristics as potential risk factors for substance use in youth and may inform new avenues to prevention and intervention. [ABSTRACT FROM AUTHOR]

Background: Assessing risk for excessive alcohol use is important for applications ranging from recruitment into research studies to targeted public health messaging. Social media language provides an ecologically embedded source of information for assessing individuals who may be at risk for harmful drinking. Methods: Using data collected on 3664 respondents from the general population, we examine how accurately language used on social media classifies individuals as at‐risk for alcohol problems based on Alcohol Use Disorder Identification Test‐Consumption score benchmarks. Results: We find that social media language is moderately accurate (area under the curve = 0.75) at identifying individuals at risk for alcohol problems (i.e., hazardous drinking/alcohol use disorders) when used with models based on contextual word embeddings. High‐risk alcohol use was predicted by individuals' usage of words related to alcohol, partying, informal expressions, swearing, and anger. Low‐risk alcohol use was predicted by individuals' usage of social, affiliative, and faith‐based words. Conclusions: The use of social media data to study drinking behavior in the general public is promising and could eventually support primary and secondary prevention efforts among Americans whose at‐risk drinking may have otherwise gone "under the radar." [ABSTRACT FROM AUTHOR]

Background: Although pregnant women in Russia are thought to have a high level of alcohol consumption, nationwide data have not been available. We compared changes in consumption among pregnant and nonpregnant women of childbearing age from 1994 to 2018 and examined predictors of consumption among the pregnant women. Methods: Data were obtained from the annual, nationally representative Russian Longitudinal Monitoring Survey (RLMS‐HSE), comprising 1,943 pregnant and 80,237 nonpregnant women of childbearing age. Past 30‐day alcohol prevalence and current pregnancy status were self‐reported. Logistic regressions using generalized linear mixed models examined two dependent variables: (1) current drinkers (any alcohol in the past 30 days) versus nondrinkers and (2) current drinkers and occasional drinkers (ever drinkers at any level) versus nondrinkers. Analyses included a series of predictors and control variables. Results: Between 1994 and 2018, a decrease in the 30‐day prevalence of alcohol consumption was observed in both pregnant (from 25.6 (95% CI ± 3.3) to 9.4% (95% CI ± 2.2)) and nonpregnant (from 57.3 (95% CI ± 0.7) to 39.0% (95% CI ± 0.6)) women. Between 2006 and 2018, the percentage of pregnant abstainers increased from 46.8% (95% CI ± 4.2) to 54.6% (95% CI ± 3.6) while occasional drinking among pregnant women remained at 35% (95% CI ± 4.0). Time period, preventative check‐ups, hospitalization, and frequent doctor's visits were significant predictors of the decrease in the 30‐day prevalence of alcohol intake in pregnant women, but these did not predict the prevalence of occasional drinking. Conclusion: Despite significant reductions in consumption among pregnant women in Russia, a substantial proportion reported occasional drinking. Conflicting information on how low alcohol intake affects health risks limited efforts to promote abstinence. Occasional drinking reflects a self‐control domain for women that, depending on perceptions of a healthy pregnancy, is framed by social institutions and the environment. [ABSTRACT FROM AUTHOR]

Background: There is a need for novel alcohol biosensors that are accurate, able to detect alcohol concentration close in time to consumption, and feasible and acceptable for many clinical and research applications. We evaluated the field accuracy and tolerability of novel (BACTrack Skyn) and established (Alcohol Monitoring Systems SCRAM CAM) alcohol biosensors. Methods: The sensor and diary data were collected in a larger study of a biofeedback intervention and compared observationally in the present sub‐study. Participants (high‐risk drinkers, 40% female; median age 21) wore both Skyn and SCRAM CAM sensors for 1–6 days and were instructed to drink as usual. Data from the first cohort of participants (N = 27; 101 person‐days) were used to find threshold values of transdermal alcohol that classified each day as meeting or not meeting defined levels of drinking (heavy, above‐moderate, any). These values were used to develop scoring metrics that were subsequently tested using the second cohort (N = 20; 57 person‐days). Data from both biosensors were compared to mobile diary self‐report to evaluate sensitivity and specificity in relation to a priori standards established in the literature. Results: Skyn classification rules for Cohort #1 within 3 months of device shipment showed excellent sensitivity for heavy drinking (94%) and exceeded expectations for above‐moderate and any drinking (78% and 69%, respectively), while specificity met expectations (91%). However, classification worsened when Cohort #1 devices ≥3 months from shipment were tested (area under curve for receiver operator characteristic 0.87 vs. 0.79) and the derived classification threshold when applied to Cohort #2 was inadequately specific (70%). Skyn tolerability metrics were excellent and exceeded the SCRAM CAM (p ≤ 0.001). Conclusions: Skyn tolerability was favorable and accuracy rules were internally derivable but did not yield useful scoring metrics going forward across device lots and months of usage. [ABSTRACT FROM AUTHOR]