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Background: The overall prevalence of U.S. young adult alcohol use has decreased, but little is known about historical change in related behaviors such as simultaneous alcohol and marijuana (SAM) use that may increase alcohol‐related risks and societal costs. The purpose of this paper was to examine historical change in SAM use prevalence among U.S. young adult alcohol users from 1977 to 2016, and consider the extent to which observed historical change in SAM use among alcohol users reflects co‐occurring change in marijuana use during these years. Methods: Data on past 12‐month alcohol, marijuana, and SAM use at up to 6 modal ages (19/20, 21/22, 23/24, 25/26, 27/28, and 29/30) were collected from 11,789 individuals (45.0% men) participating in the Monitoring the Future panel study. Annual prevalence estimates within modal age group were obtained; historical SAM use trends among alcohol and marijuana users were estimated. Results: From 2014 to 2016, SAM use was reported by approximately 30% of alcohol users aged 19/20 and 21/22, and 20 to 25% of alcohol users aged 23/24 through 29/30. Since the mid‐1990s, age‐specific historical trends in SAM use prevalence among alcohol users followed 1 of 4 patterns: significant increase followed by oscillating increases/decreases (at modal age 19/20), consistent and significant increases (at modal ages 21/22, 23/24, and 25/26), stability followed by increase (at modal ages 27/28), or stability (at modal ages 29/30). In contrast, SAM use trends among marijuana users primarily reflected stability, with some evidence of a decrease across time at modal ages 19/20 and 23/24. Historical change in SAM prevalence among alcohol users was strongly and positively correlated with changes in overall marijuana use prevalence. Conclusions: A growing proportion of early and mid‐young adult alcohol users reported SAM use, with the highest risk among those in the early years of young adulthood. Young adult SAM use may continue to increase in proportion to the degree that young adult marijuana use continues to increase. This paper examined historical change in simultaneous alcohol and marijuana (SAM) use prevalence among U.S. young adult alcohol users from 1977‐2016. While the overall prevalence of U.S. young adult alcohol use has decreased, a growing proportion of early and mid‐young adult alcohol users reported SAM use, with the highest risk among those in the early years of young adulthood. Young adult SAM use may continue to increase in proportion to the degree that young adult marijuana use continues to increase. [ABSTRACT FROM AUTHOR]

Background: This paper reports findings from the first longitudinal study on the evolution of the physical phenotypes of fetal alcohol syndrome (FAS) and partial FAS (PFAS) from early childhood through adolescence. Methods: The sample consisted of 155 children (78 males and 77 females) born to women recruited at an antenatal clinic serving a Cape Coloured (mixed ancestry) population in Cape Town, South Africa. Two expert FASD dysmorphologists, blind regarding prenatal alcohol exposure, independently evaluated each child's growth and dysmorphology at 4 clinics conducted over an 11‐year period. Case conferences were held to reach consensus regarding which children had FAS or PFAS growth and physical features using the Revised Institute of Medicine (2005) guidelines. Results: The prevalence of the physical phenotype was stable across the 4 ages for about half of the children with FAS and about one‐third of those with PFAS but more variable for the others. Test–retest reliability was substantial for the FAS phenotype, but poorer for PFAS. Two distinct patterns were seen: a "strong phenotype" that was consistently identified and a less consistent one in which dysmorphic features and/or anthropometric deficits fluctuated or diminished with age. The physical phenotype was most apparent during early childhood and least apparent during puberty, due to differences in timing of the growth spurt and the evolving adult face. Short palpebral features and small head circumference diminished with age, flat philtrum fluctuated, while thin vermilion and weight and height restriction were stable. Conclusions: Key facial features that characterize FASD in early childhood diminish or evolve in some individuals, making diagnostic examinations that rely on these characteristics most sensitive during early childhood and school age. Moreover, puberty poses classification problems due to variability in timing of the growth spurt. Given that several features and small head circumference diminished with age, many individuals would be misdiagnosed if only examined at a later age. [ABSTRACT FROM AUTHOR]

Background: The objective of this paper is to examine 10-year trends (1992 to 2002) in the number and type of indicators of DSM-IV abuse and dependence among whites, blacks, and Hispanics in the United States. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Increases in the prevalence of alcohol abuse between 1992 and 2002 seem associated with a rise in the prevalence of the indicator for 'hazardous use.' which usually means reports of driving after drinking. The decrease in dependence was not associated with changes in a particular indicator. In addition, both in 1992 and 2002, 12.3 to 15.4% of the men and 5.2 to 7.9% of the women were diagnostic 'orphans.' These respondents reported 1 or 2 indicators of alcohol dependence as present. Conclusions: The observed trends in number and types of indicators of DSM-IV alcohol abuse and dependence were probably triggered by a complex interplay between individuals' volume and pattern of drinking and reactions from the drinkers' social environment. The close association between hazardous use of alcohol and the prevalence of abuse deserves further discussion. A medical diagnostic category should not be so dependent on a criterion that may be influenced by social situations. It is necessary to understand more about diagnostic 'orphans' to better design interventions to address their problems. [ABSTRACT FROM AUTHOR]

Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR = 3.5; 95% CI 2.6 to 4.8) and dependence (OR = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in adult women, even when controlling for parental alcohol problems. The study results point to the need to screen for and treat underlying issues related to child abuse, particularly in an alcohol treatment setting. [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: 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: Despite its potential to produce serious adverse outcomes, DSM‐5 alcohol withdrawal syndrome (AWS) has not been widely studied in the general population. Methods: We used cross‐sectional data from 36,309 U.S. adults from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions‐III to examine the past‐year prevalence of AWS and its correlates. We focused on an important clinical population–past‐year drinkers with unhealthy alcohol use–i.e., those with a positive score on the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C) questionnaire. We also examined the association of AWS with sociodemographic measures, psychiatric disorders, alcohol‐related measures, and healthcare utilization. Results: Approximately one‐third (n = 12,634) of respondents reported unhealthy alcohol use (AUDIT‐C+). Of these, 14.3% met criteria for a DSM‐5 AWS diagnosis. The mean (SE) number of withdrawal symptoms among individuals with AWS was 2.83 (1.88), with the most common being nausea/vomiting and insomnia (19.8% and 11.6%, respectively). Among AUDIT‐C+ respondents, the odds of AWS were significantly higher among males (adjusted odds ratio [aOR] = 1.17 [95% CI, 1.02–1.33]), unmarried participants (aOR = 1.55 [95% CI, 1.25–1.92]), and those at the lowest (vs. highest) income levels (aOR = 1.62 [95% CI, 1.37–1.92]). Among AUDIT‐C+ respondents, AWS was also associated with psychiatric disorders (with aORs that ranged from 2.08 [95% CI, 1.79–2.41]) for major depressive disorder to 3.14 (95% CI, 1.79–2.41) for borderline personality disorder. AUDIT‐C+ respondents with AWS also had higher odds of past‐year alcohol use disorder (aOR = 11.2 [95% CI, 9.66–13.07]), other alcohol‐related features (e.g., binge drinking), and healthcare utilization. Conclusions: Among individuals with unhealthy alcohol use, AWS is prevalent, highly comorbid, and disabling. Given the risk of AWS among unhealthy drinkers, a comparatively large segment of the general population, clinicians should seek to identify individuals with AWS and intervene with them to prevent serious adverse outcomes. [ABSTRACT FROM AUTHOR]

Background: Although the effects of prenatal alcohol exposure (PAE) have been studied extensively, there is relatively little information available on adult mental health functioning among exposed individuals. The current study compares the self‐reported midlife mental health status of individuals who were prenatally exposed to alcohol and diagnosed in childhood with the effects of this exposure with that of unexposed individuals. Methods: Participants (N = 292) were recruited from two longitudinal cohorts in Atlanta and Seattle and asked to complete an Adult Health Questionnaire that surveyed their current health and mental health status. The questionnaire was completed either in‐person or remotely and included questions about current symptoms of depression and anxiety and mental health disorder diagnoses. The analysis compared a Nonexposed Contrast group to those in two exposure groups: (1) Alcohol Exposed with Fetal Alcohol Effect but not meeting criteria for Fetal Alcohol Syndrome (FAS) and (2) Alcohol Affected and meeting criteria for FAS. Results: Both alcohol‐exposed groups reported higher levels of current depressive symptoms and a higher prevalence of diagnoses of depression, anxiety, bipolar disorder, and/or attention deficit/hyperactivity disorder. No differences were noted for psychotic disorders. PAE was also associated with greater environmental stressors, including higher levels of adverse childhood events and lower current socioeconomic status. Path analyses suggested that PAE was indirectly related to mood disorders with its effects being mediated by other environmental factors. Conclusions: PAE is associated with greater rates of mental health disorders in middle adulthood. These outcomes appear to result from multiple stressors that affect individuals made vulnerable by their early alcohol exposure. Clinical outcomes could be improved by prevention efforts directed at preventing prenatal alcohol use and reducing environmental stressors later in life, and by the early identification of PAE and its effects. [ABSTRACT FROM AUTHOR]

Background: Binge drinking among adolescents and young adults has changed over time, but patterns differ by age and gender. Identifying high‐risk groups to target future efforts at reducing drinking in this population remains a public health priority. Forecasting methods can provide a better understanding of variation and determinants of future binge drinking prevalence. Methods: We implemented regression‐based forecasting models to estimate the prevalence and gender differences in binge drinking among cohort groups of U.S. young adults, ages 18, 23–24, and 29–30 through 2040. Forecasting models were adjusted for covariates accounting for changes in demographic, Big‐5 social roles (e.g., residential independence), and drinking norms and related substance use, to understand the drivers of forecasted binge drinking estimates. Results: From the last observed cohort group (years varied by age) through 2040, unadjusted binge drinking prevalence was forecasted to decrease from 26% (95% CI: 20, 33%) (2011–15) to 11% (95% CI: 4, 27%) at age 18, decrease from 38% (95% CI: 30, 45%) (2006–2010) to 34% (95% CI: 18, 55%) at ages 23/24, and increase from 32% (95% CI: 25, 40%) (2001–2005) to 35% (95% CI: 16, 59%) at ages 29/30. Gender‐stratified forecasts show a continuation in the narrowing of binge drinking prevalence between young men and women, though the magnitude of narrowing differs by age. Estimated trends were partially explained by changing norms regarding drinking and other substance use, though these indirect effects explained less of the total trend as age increased. Conclusions: Understanding how covariates influence binge drinking trends can guide public health policies to leverage the most important determinants of future binge drinking to reduce the harm caused by binge drinking from adolescence to adulthood. [ABSTRACT FROM AUTHOR]

Background: The degree to which binge and high‐intensity drinking prevalence estimates vary from fixed threshold frequency and continuous maximum drinks measures is unknown. The current study compared prevalence estimates for adolescent binge and high‐intensity drinking (5+ drinks, 10+ drinks, respectively) and sex‐specific thresholds using fixed threshold frequency and continuous maximum drinks measures. Methods: Data were obtained from 7911 respondents participating in the 2018 and 2019 nationally representative Monitoring the Future 12th‐grade surveys. Comparisons of frequency prevalence (e.g., any occasions of 5+ drinking using the frequency measure) versus maximum drinks prevalence (e.g., reporting 5 or more drinks using the maximum number of drinks measure) were made using all respondents and then separately within males and females. Results: Among the sample overall and within sex, binge drinking estimates from the 5+ frequency prevalence and 5+ maximum drinks prevalence measures evidenced overlapping confidence intervals (estimates were slightly higher for frequency prevalence); similar results were observed for high‐intensity drinking 10+ frequency prevalence and 10+ maximum drinks prevalence. For example, among the sample overall, 5+ frequency prevalence was 11.4% [95% CI 10.3, 12.6]; 5+ maximum drinks prevalence was 10.7% [9.6, 11.8]; 10+ frequency prevalence was 5.1% [4.4, 5.8]; and 10+ maximum drinks prevalence was 4.1% [3.5, 4.7]. Using sex‐specific thresholds (i.e., 4+ drinks for females and 5+ drinks for males), binge frequency and maximum drinks levels also had overlapping confidence intervals. Binge drinking prevalence estimates for females were approximately 1.5 times higher using sex‐specific (4+) versus universal (5+) thresholds. Conclusions: In this nationally representative sample of 12th‐grade students, prevalence levels for 5+ and 10+ drinking did not differ significantly when using frequency versus maximum drinks measures. Among females, binge drinking prevalence was higher using sex‐specific versus universal thresholds. Both the frequency and maximum drinks measures provided comparable estimates of binge and high‐intensity drinking prevalence among older adolescents. [ABSTRACT FROM AUTHOR]

Background: The prevalence of alcohol misuse among older adults has grown dramatically in the past decade, yet little is known about the association of alcohol misuse with hospitalization and death in this patient population. Methods: We examined the association between alcohol use (measured by a screening instrument in primary care) and rates of all‐cause and cardiovascular disease (CVD)‐related 6‐month hospitalization or death via electronic health records (EHRs) in a nationally representative sample of older, high‐risk Veterans. Models were adjusted for sociodemographic and clinical characteristics, including frailty and comorbid conditions. Results: The all‐cause hospitalization or death rate at 6 months was 14.9%, and the CVD‐related hospitalization or death rate was 1.8%. In adjusted analyses, all‐cause hospitalization or death was higher in older Veterans who were nondrinkers or harmful use drinkers compared to moderate use drinkers, but CVD‐related hospitalization or death was similar in all categories of drinking. Conclusions: These findings suggest that the complex association between alcohol and all‐cause acute healthcare utilization found in the broader population is similar in older, high‐risk Veteran patients. These findings do not support an association between alcohol consumption and CVD‐specific hospitalizations. [ABSTRACT FROM AUTHOR]

Background: Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care for persons with AUD. Methods: Using 2015–2019 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: (1) adult prevalence of AUD; (2) proportion of adults with AUD who utilized health care in the past 12 months; (3) proportion with AUD screened about their alcohol use; (4) proportion with AUD who received a brief intervention about their alcohol misuse; (5) proportion with AUD who received information about treatment for alcohol misuse; and (6) proportion with AUD who received treatment. Analyses were stratified by AUD severity. Results: Of the 214,505 persons included in the sample, the weighted prevalence of AUD was 7.8% (95% CI 7.6–8.0%). Cascades of care showed the majority of individuals with AUD utilized health care in the past 12 months [81.4% (95% CI 80.7–82.1%)] and were screened about alcohol use [69.9% (95% CI 68.9–70.8%)]. However, only a minority of individuals received subsequent steps of care, including 11.6% (95% CI 11.0–12.2%) who reported receiving a brief intervention, 5.1% (95% CI 4.6–5.6%) who were referred to treatment, and 5.8% (95% CI 5.4–6.3%) who received treatment. Similar patterns were observed when cascades of care were stratified by AUD severity. Conclusions: Persons with AUD commonly utilize health care and are often screened about alcohol use, but few receive treatment. Healthcare settings—particularly primary care settings—represent a prime opportunity to implement AUD treatment to improve outcomes in this high‐risk population. [ABSTRACT FROM AUTHOR]

Alcohol use disorder (AUD) is 1 of the most prevalent of all substance use disorders and contributes significantly to global disease burden. Despite its prevalence, <10% of individuals with AUD receive treatment. A significant barrier to receiving treatment is a lack of effective pharmacotherapies. While 3 medications have been approved by the FDA for AUD (disulfiram, acamprosate, naltrexone), their efficacy remains low. Furthermore, a number of undesirable side effects associated with these drugs further reduce patient compliance. Thus, research into new effective pharmacotherapies for AUD is warranted. Due to their involvement in regulating synaptic neurotransmitter levels, solute carrier (SLC) transporters could be targeted for developing effective treatment strategies for AUD. Indeed, a number of studies have shown beneficial reductions in alcohol consumption through the use of drugs that target transporters of dopamine, serotonin, glutamate, glycine, and GABA. The purpose of this narrative review is to summarize preclinical and clinical studies from the last 2 decades targeting SLC neurotransmitter transporters for the treatment of AUD. Limitations, as well as future directions for expanding this field, are also discussed. [ABSTRACT FROM AUTHOR]

Objective: To determine the characteristics of children with fetal alcohol spectrum disorders (FASD) and their mothers in a Midwestern city. Methods: Case–control samples were drawn from 2 separate first‐grade cohorts (combined N = 4,047) in every city school using different methods. In Cohort Sample 1, all consented small children (≤25th centile on height, weight, and/or head circumference) entered the study along with a random sample from all enrolled students. Cohort Sample 2 was drawn totally at random. Child growth, dysmorphology, and neurobehavior were assessed using the Collaboration on FASD Prevalence (CoFASP) criteria, and mothers were interviewed. Results: For the samples combined, 891 children received dysmorphology examinations, and 692 were case‐conferenced for final diagnosis. Forty‐four children met criteria for FASD. Total dysmorphology scores differentiated diagnostic groups: fetal alcohol syndrome (FAS), 16.7; partial FAS, 11.8; alcohol‐related neurodevelopmental disorder (ARND), 6.1; and typically developing controls, 4.2. Neurobehavioral tests distinguished children with FASD from controls, more for behavioral problems than cognitive delay. Children with ARND demonstrated the poorest neurobehavioral indicators. An adjusted regression model of usual prepregnancy drinking indicated that maternal reports of 3 drinks per drinking day (DDD) were significantly associated with a FASD diagnosis (p = 0.020, OR = 10.1, 95% CI = 1.44 to 70.54), as were 5 or more DDD (p < 0.001, OR = 26.47, 95% CI = 4.65 to 150.62). Other significant maternal risk factors included the following: self‐reported drinking in any trimester; smoking and cocaine use during pregnancy; later pregnancy recognition and later and less prenatal care; lower maternal weight, body mass index (BMI), and head circumference; and unmarried status. There was no significant difference in FASD prevalence by race, Hispanic ethnicity, or socioeconomic status at this site, where the prevalence of FASD was 14.4 to 41.2 per 1,000 (1.4 to 4.1%). Conclusion: This city displayed the lowest prevalence of FASD of the 4 CoFASP sites. Nevertheless, FASD were common, and affected children demonstrated a common, recognizable, and measurable array of traits. [ABSTRACT FROM AUTHOR]

Objective: To document prevalence and traits of children with fetal alcohol spectrum disorders (FASD) and maternal risk factors in a Rocky Mountain city. Methods: Variations on active case ascertainment methods were used in 2 first‐grade cohorts in all city schools. The consent rate was 59.2%. Children were assessed for physical growth, dysmorphology, and neurobehavior and their mothers interviewed. Results: Thirty‐eight children were diagnosed with FASD and compared with 278 typically developing controls. Total dysmorphology scores summarized well the key physical indicators of FASD and defined specific diagnostic groups. On average, children with FASD performed significantly poorer than controls on intellectual, adaptive, learning, attention, and behavioral tasks. More mothers of children with FASD reported drinking prior to pregnancy and in the first and second trimesters, and had partners with drinking problems than mothers of controls; however, reports of comorbid alcohol use and 6 other drugs were similar for mothers of children with FASD and mothers of controls. Mothers of children with FASD were significantly younger at pregnancy, had lower average weight before pregnancy and less education, initiated prenatal clinic visits later, and reported more health problems (e.g., stomach ulcers and accidents). Children with FASD had significantly lower birth weight and more problems at birth, and were less likely to be living with biological mother and father. Controlling for other drug and tobacco use, a FASD diagnosis is 6.7 times (OR = 6.720, 95% CI = 1.6 to 28.0) more likely among children of women reporting prepregnancy drinking of 3 drinks per drinking day (DDD) and 7.6 times (OR = 7.590, 95% CI = 2.0 to 31.5) more likely at 5 DDD. Prevalence of FAS was 2.9–5.8 per 1,000 children, and total FASD was 34.9 to 82.5 per 1,000 children or 3.5 to 8.3% at this site. Conclusion: This site had the second highest prevalence of FASD of the 4 Collaboration on FASD Prevalence sites and clearly identifiable child and maternal risk traits. [ABSTRACT FROM AUTHOR]

Background: Little is known about remission, recovery, and other outcomes of alcohol use disorder (AUD) as defined by the DSM‐5. Methods: Data from a large representative sample of the United States was used to examine correlates of past‐year AUD status among individuals with prior‐to‐past‐year AUD: persistent AUD, symptomatic high‐risk drinking, asymptomatic high‐risk drinking, symptomatic low‐risk drinking, asymptomatic low‐risk drinking (nonabstinent recovery, NAR), and abstainer (abstinent recovery, AR). Multiple logistic regression analyses were conducted to compare: (i) AR and NAR with persistent AUD, (ii) AR with NAR, and (iii) asymptomatic and symptomatic high‐risk drinking with AR and NAR. Results: Among individuals with AUD prior to past year (n = 7,785), 34.2% were classified with persistent AUD, 8.8 and 1.6% were symptomatic high‐risk and symptomatic low‐risk drinkers, respectively, 21.5% were asymptomatic high‐risk drinkers, 17.9% were asymptomatic low‐risk drinkers, and 16.0% were abstainers. One‐quarter of individuals with AUD prior to past year achieved AR or NAR without the benefit of treatment, while a much greater percentage of individuals achieving AR (43.2%) reported receiving treatment relative to those with NAR (12.3%). The number of lifetime AUD symptoms was greater among those achieving AR (among the treated) and lower among those achieving NAR relative to persistent AUD. The number of AUD symptoms was also greater among those achieving AR than NAR and lower among asymptomatic and symptomatic risk drinkers relative to those achieving AR and NAR. Consumption was greater among those achieving AR relative to those achieving NAR and greater among asymptomatic and symptomatic risk drinkers relative to AR and NAR. Odds of achieving AR or NAR relative to persistent AUD were generally lower among non‐Hispanic Blacks and those with higher education, greater among women and married individuals, and lower among illicit drug users and individuals with histories of a personality disorder or mood/anxiety disorder. Conclusions: There appears to be a substantial level of recovery from AUD. Information on specific factors associated with AUD outcomes can be useful in targeting appropriate treatment efforts. [ABSTRACT FROM AUTHOR]

Background: This study examined the extent to which the developmental pattern of prevalence of binge drinking in the past 2 weeks from ages 18 through 30 has changed across 29 cohorts of U.S. young adults, and whether the changes differed by gender. Methods: Analyses used national longitudinal data from 58,019 12th‐grade students (from graduating high school classes 1976 to 2004) participating in the Monitoring the Future study followed through modal age 30 (with age 29/30 data collected from 1987 to 2016). Weighted time‐varying effect modeling was used to model cohort group differences in age‐related patterns of binge drinking. Results: The age of peak binge drinking prevalence increased across cohorts (from age 20 in 1976 to 1985 to 22 in 1996 to 2004 for women, and from 21 in 1976 to 1985 to 23 in 1996 to 2004 for men). Historical change in the developmental pattern of binge drinking across all ages of young adulthood differed for men and women. Even after controlling for key covariates, women in the more recent cohort group reported significantly higher binge drinking prevalence than women in earlier cohorts from ages 21 through 30. Men in the more recent cohort group reported higher binge drinking prevalence at ages 25 to 26, but prevalence levels then converged to those seen in earlier cohort groups by age 30. Conclusions: An older age of peak binge drinking and a decreased rate of decline in the prevalence of binge drinking in later young adulthood among more recent cohorts have resulted in an extension of individual and societal risks associated with binge drinking, particularly for women, across young adulthood. High‐risk alcohol use prevention efforts are needed throughout at least the third decade of life. Age of peak binge drinking (5+ drinks per occasion) prevalence has increased from 20 to 22 for women and 21 to 23 for men among high school graduating classes from 1976 to 2004. Women from more recent cohorts reported significantly higher binge drinking prevalence from ages 21 to 30 than women in earlier cohorts. Increased age of peak binge drinking and a longer time period during which young adults are engaging in binge drinking likely confer greater risks. [ABSTRACT FROM AUTHOR]

Background: To describe sociodemographic and selected psychiatric disorder patterns and estimate correlates of seeking alcohol treatment among American Indians and Alaska Natives (AIAN) and non‐Hispanic Whites (NHW) with lifetime alcohol use disorder (AUD). Methods: Data come from the 2012 to 2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions‐III. We retrospectively identified participants who completed information on lifetime AUD, race/ethnicity, and seeking alcohol treatment or help for AUD. We used a generalized linear model with a log link and Poisson distribution to estimate prevalence ratios (PRs) among adults with DSM‐5 lifetime AUD. We included the following correlates: race/ethnicity, sex, age, personal annual income, marital status, education, urban/rural status, U.S. region, any illegal drug use disorder, nicotine use disorder, and select mood‐, anxiety‐, personality‐, and trauma‐related disorders. Results: Among AIAN, the prevalence of lifetime AUD was 46.6%. Among AIAN with lifetime AUD, 33.8% sought alcohol‐related treatment. Among individuals with lifetime AUD, AIAN were associated with greater alcohol‐related treatment‐seeking compared to NHW (adjusted PR = 1.41 [95% CI 1.26 to 1.58]). Among AIAN with AUD, being male and age 35 to 64 were statistically significant correlates of seeking treatment or help for AUD. Conclusions: A relatively higher proportion of AIAN than NHW with AUDs sought alcohol treatment. Among individuals with lifetime AUD, significant demographic and psychiatric disorder correlates of treatment are present, showing that certain groups are less likely to seek treatment or help for alcohol‐related issues. Among AIAN with AUD, these correlates may reflect distinct patterns of seeking alcohol‐related treatment, which can inform more effective treatment promotion efforts with this population. Alcohol treatment seeking by American Indians/Alaska Natives (AIAN) has been understudied when compared to other U.S. racial/ethnic minorities. Our analysis suggests that among individuals ever diagnosed with an alcohol use disorder (AUD), AIAN were 41% more likely to seek alcohol‐related treatment or help for AUD compared to Non‐ Hispanic Whites (NHW). Among AIAN, being male and 35 to 64 years old were statistically significant correlates of alcohol‐related treatment and help‐seeking. These analyses show differences in AUD help or treatment‐seeking among AIAN. [ABSTRACT FROM AUTHOR]

Background: Few Internet smoking cessation programs specifically address the impact of alcohol use during a quit attempt, despite its common role in relapse. This study used topic modeling to describe the most prevalent topics about alcohol in an online smoking cessation community, the prevalence of negative sentiment expressed about alcohol use in the context of a quit attempt (i.e., alcohol should be limited or avoided during a quit attempt) within topics, and the degree to which topics differed by user social connectivity within the network. Methods: Data were analyzed from posts from the online community of a larger Internet cessation program, spanning January 1, 2012 to May 31, 2015 and included records of 814,258 online posts. Posts containing alcohol‐related content (n = 7,199) were coded via supervised machine learning text classification to determine whether the post expressed negative sentiment about drinking in the context of a quit attempt. Correlated topic modeling (CTM) was used to identify a set of 10 topics of at least 1% prevalence based on the frequency of word occurrences among alcohol‐related posts; the distribution of negative sentiment and user social network connectivity was examined across the most salient topics. Results: Three salient topics (with prevalence ≥10%) emerged from the CTM, with distinct themes of (i) cravings and temptations; (ii) parallel between nicotine addiction and alcoholism; and (iii) celebratory discussions of quit milestones including "virtual" alcohol use and toasts. Most topics skewed toward nonnegative sentiment about alcohol. The prevalence of each topic differed by users' social connectivity in the network. Conclusions: Future work should examine whether outcomes in Internet interventions are improved by tailoring social network content to match user characteristics, topics, and network behavior. Correlated Topic Modeling revealed three salient topics about alcohol use within the online community of a digital smoking cessation program. Topic prevalence differed by users' social connectivity in the community (in‐degree). Posts about alcohol craving and temptations were common among less socially connected users, while posts involving alcohol for celebrations were more common among more socially connected users, who have likely been abstinent for years. Posts about the similarities of nicotine addiction and alcoholism did not vary across centrality groups. [ABSTRACT FROM AUTHOR]

Background: Blackouts—or memory loss for all or part of a drinking event—are reliable predictors of alcohol‐related consequences. Studies suggest a distinction between en bloc (complete memory loss) and fragmentary (off‐and‐on memory loss) blackouts; however, research has not consistently differentiated between these 2 forms of blackout. This study aimed to validate the distinction between en bloc and fragmentary blackouts among young adults. Methods: Data were collected using qualitative (Study 1) and quantitative (Study 2) research methods. Participants in both studies were college students with a history of alcohol‐induced memory impairment. They were recruited using community advertisement (Study 1, N = 50, 56% female) and Qualtrics survey panels (Study 2, N = 350, 56% female). Study 1 participants engaged in 8 focus groups. Discussions were audio‐recorded, transcribed verbatim, and coded using applied thematic analysis. Findings guided assessment of en bloc and fragmentary blackout in Study 2. In Study 2, a separate sample of participants completed an online survey assessing drinking behavior, alcohol‐induced memory impairment, and theoretical correlates of en bloc and fragmentary blackouts. Results: Study 1 participants differentiated between en bloc and fragmentary blackouts (which they referred to as “blackouts” and “brownouts,” respectively) based on duration and extent of memory loss. They indicated that blackouts occur along a continuum, with en bloc “blackouts” at the extreme. They also stated that the term “blackout drinking” does not always imply memory loss. Study 2 participants reported higher rates of “brownouts” (81%) than “blackouts” (54%). They reported less negative outcome expectancies and attitudes, greater personal approval, higher prevalence estimates, lower self‐efficacy, and stronger intentions for “brownouts” than “blackouts” (p < 0.001). Women perceived “blackouts/brownouts” as more prevalent than men and reported lower intentions to experience “blackouts” (p < 0.005). Conclusions: Young adults are more permissive of fragmentary than en bloc blackout. En bloc blackouts may be a target for future interventions. [ABSTRACT FROM AUTHOR]

Background: Our aim was to examine lifetime criteria profiles and correlates of severity (mild, moderate, severe) of DSM‐5 alcohol use disorders (AUD) in Puerto Rico. Methods: Data are from a household random sample of individuals 18 to 64 years of age in San Juan, Puerto Rico. The survey response rate was 83%. DSM‐5 AUD was identified with the Spanish version of the World Health Organization's Composite International Diagnostic Interview. The analyses also identify correlates of each severity level using an ordered logistic regression model. Results: The prevalence of lifetime DSM‐5 AUD among men and women was 38 and 16%, respectively. Mild lifetime DSM‐5 AUD was the most prevalent severity level among both men (18%) and women (9%). The most common criteria, independent of gender and severity level, were drinking larger quantities and for longer than planned (men range: 80 to 97%; women range: 78 to 91%) and hazardous use (men range: 56 to 91%; women range: 42 to 74%). Results from ordered logistic regression showed that the adjusted odds ratio for weekly drinking frequency, greater volume of alcohol consumed per drinking occasion, positive attitudes about drinking, drinking norms, and male gender invariantly increased risks across all DSM‐5 AUD severity levels (mild, moderate, severe). Greater negative attitudes about drinking, low family cohesion, and Protestant religion were related to greater risks at higher AUD severity levels. Conclusions: AUD prevalence is high in San Juan, Puerto Rico. Prevalence rates for some criteria are equally high across severity levels and poorly differentiate between mild, moderate, or severe DSM‐5 AUD. The sociodemographic and alcohol‐related risks vary across DSM‐5 severity levels. [ABSTRACT FROM AUTHOR]

Background Heavy episodic drinking ( HED) or consuming 4+/5+ drinks in 1 occasion for women/men is linked consistently with alcohol-related harms. Recent research suggests that many individuals drink at levels more than twice this cutoff (8+/10+ drinks), commonly referred to as 'high-intensity drinking.' Prevalence rates of high-intensity drinking and its dynamic association with alcohol use disorder (AUD) across all ages, however, remain unknown. The current study used data from a nationally representative sample to document age-varying prevalence rates of HED-only drinking and high-intensity drinking, prevalence rates of AUD for HED-only drinkers and high-intensity drinkers, and relative odds of experiencing an AUD for high-intensity drinkers as compared to HED-only drinkers. Methods Data were from the National Epidemiologic Survey on Alcohol and Related Conditions- III. The final analytic sample consisted of past-year drinkers aged 18 to 64 years ( n = 22,776). Results Time-varying effect modeling revealed that high-intensity drinking and HED-only drinking were equally prevalent during young adulthood and prevalence rates of both types of drinking generally became less common with increasing age. At all ages, high-intensity drinkers were at 3 or more times greater odds of meeting criteria for an AUD than HED-only drinkers. The association between high-intensity relative to HED-only drinking was strongest earlier in adulthood with approximately 83% of 18-year-old high-intensity drinkers having AUD relative to 42% of HED-only drinkers. Conclusions Future research aiming to identify drinkers most at risk of harms and in need of treatment may benefit from assessing the extent to which an individual exceeds the 8+/10+ threshold of drinking. [ABSTRACT FROM AUTHOR]

Background This study examined changes during the past decade, from 2005 to 2015, in binge and high-intensity drinking in 7 separate age groups of U.S. 12th graders and young adults. Methods National longitudinal data ( N = 6,711) from Monitoring the Future were used to examine trends in consuming 5+, 10+, and 15+ drinks on the same occasion in the past 2 weeks from ages 18 to 29/30 overall and by gender. Results were compared with trends in past 12-month and 30-day alcohol use for the same age groups. Results Between 2005 and 2015, binge (5+) and high-intensity drinking (10+, 15+) generally decreased for individuals in their early 20s, remained somewhat stable for individuals in their mid-20s, and increased for individuals at the end of young adulthood (age 29/30). The observed historical trends in binge and high-intensity drinking were similar to those for past 12-month and past 30-day alcohol use for those aged 18 to 20, but diverged for most other age groups in young adulthood. Trends were generally similar for men and women, except that the increase in prevalence began earlier in young adulthood for women than for men. Conclusions Binge and high-intensity drinking among U.S. 12th graders and young adults are dynamic phenomena. Prevention and intervention efforts aimed at reducing the harms resulting from 5+, 10+, and 15+ drinking should acknowledge and focus on differences in trends in these behaviors by age and gender. [ABSTRACT FROM AUTHOR]

Background Posttraumatic stress disorder ( PTSD) and alcohol use disorder disproportionately impact certain populations including American Indians/Alaska Natives ( AIAN). While PTSD and alcohol use disorder have been studied both separately and in tandem, less is known about the association in AIAN. The objective was to examine the association between lifetime PTSD and past year alcohol use disorder among AIAN and non-Hispanic Whites ( NHW). Methods Data come from the 2012 to 2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions- III. We used logistic regression to estimate odds of AUD among adults with and without PTSD by race. Results A total of 19,705 participants, of whom 511 were AIAN and 19,194 were NHW, were included in this study. The percentage of PTSD among AIAN was 22.9% ( n = 117) compared to 11.7% ( n = 2,251) in NHW ( p-value <0.0001). The percentage of past year alcohol use disorder among AIAN was 20.2% ( n = 103) compared to 14.2% ( n = 2,725) in NHW ( p-value <0.0001). The percentage of comorbid past year alcohol use disorder with lifetime PTSD among AIAN was 6.5% ( n = 33) compared to 2.4% ( n = 457) in NHW ( p-value <0.0001). Regarding the joint distribution of PTSD and AUD, AIAN men have greater than 3 times the percentage compared to NHW men (9.5% vs. 3.1%). When stratifying by race (after adjusting for age, sex, depression, and education), among AIAN, the odds of past year alcohol use disorder with (vs. without) lifetime PTSD were 1.76 (95% CI 1.07, 2.90) and among NHW, the odds were 1.59 (95% CI 1.41, 1.80). Conclusions PTSD is significantly associated with alcohol use disorder in the study populations. Despite a lack of pre- PTSD measures of alcohol use disorder, these findings show a trend indicating that AIAN exposed to PTSD are more burdened with alcohol use disorder compared to NHW in the general U.S. population. [ABSTRACT FROM AUTHOR]

Background A limited number of measures exist to assess alcohol problems during adolescence. Item response theory modeling was used to scale a measure of adolescent alcohol problems, including drinking and driving, and then related to alcohol and other psychiatric disorders that occurred over a 15-year period. Methods High school students ( N = 832) completed the 13-item Alcohol Problems Index ( API) at age 18 years as part of a long-term longitudinal study of predictors of alcohol use and alcohol disorders. Frequency of drinking and driving was also measured during adolescence. Lifetime psychiatric disorders, including alcohol disorders, were measured during young adulthood. Rasch modeling was used to scale the severity of alcohol problems, and the scaled total score was used to prospectively predict alcohol disorders. The area under the receiver operating characteristic ( ROC) curve was also computed between the adolescent alcohol problems and alcohol and other psychiatric disorders across a 15-year period. Results The prevalence of alcohol disorders was 38.7% (for alcohol dependence, it was 27.7%). Rasch modeling indicated that the API assessed a range of severity of alcohol problems and that drinking and driving were among the less severe indicators. Age 18 API scores significantly correlated with an alcohol diagnosis (0.34), and ROC curve analysis indicated that for adolescent alcohol problem scores, the diagnostic accuracy (or area under the curve) for an alcohol diagnosis by age 33 was 0.70. Conclusions Our findings supported the unidimensionality and reliability of the API, and statistically significant prospective prediction of young adult alcohol disorders. The measurement of alcohol problems during adolescence, in addition to drinking and driving, may be beneficial in understanding adverse consequences of drinking during adolescence as well as transitions in alcohol use and alcohol disorders across the lifespan. [ABSTRACT FROM AUTHOR]

Background Highly caffeinated 'energy drinks' ( ED) are commonly consumed and sometimes mixed with alcohol. Associations between ED consumption, risk-taking, and alcohol-related problems have been observed. This study examines the relationship between ED consumption-both with and without alcohol-and drunk driving. Methods Data were derived from a longitudinal study of college students assessed annually via personal interviews. In Year 6 (modal age 23; n = 1,000), participants self-reported their past-year frequency of drunk driving, ED consumption patterns (frequency of drinking alcohol mixed with energy drinks [AmED] and drinking energy drinks without alcohol [ED]), alcohol use (frequency, quantity), and other caffeine consumption. Earlier assessments captured suspected risk factors for drunk driving. Structural equation modeling was used to develop an explanatory model for the association between ED consumption patterns and drunk driving frequency while accounting for other suspected risk factors. Results More than half (57%) consumed ED at least once during the past year. Among ED consumers, 71% drank Am ED and 85% drank ED alone; many (56%) engaged in both styles of ED consumption while others specialized in one or the other (29% drank ED alone exclusively, while, 15% drank Am ED exclusively). After accounting for other risk factors, ED consumption was associated with drunk driving frequency in 2 ways. First, a direct path existed from ED frequency (without alcohol) to drunk driving frequency. Second, an indirect path existed from Am ED frequency through alcohol quantity to drunk driving frequency. Conclusions Among this sample, ED consumption with and without alcohol was common, and both styles of ED consumption contributed independently to drunk driving frequency. Results call for increased attention to the impact of different patterns of ED consumption on alcohol-related consequences, such as drunk driving. [ABSTRACT FROM AUTHOR]

Background This study is the first to examine the developmental course of high-intensity drinking (i.e., consuming 10+ drinks in a row) across late adolescence and the transition to adulthood. Methods National longitudinal data ( N = 3,718) from Monitoring the Future were used to examine trajectories of 10+ high-intensity drinking from age 18 through 25/26 overall and across sociodemographic subgroups; results were compared with similar analysis of 5+ binge drinking trajectories. Results Results document that 10+ drinkers consume not just a greater quantity of alcohol on a given drinking occasion, but also engage in 5+ drinking more frequently than drinkers who do not report having 10 or more drinks. Developmental patterns for 10+ and 5+ drinking were similar, with peak frequencies reported at age 21/22. Greater peaks in both 10+ and 5+ drinking were documented among men and among college attenders, compared with women and nonattenders, respectively. However, there was a steeper decline in 10+ drinking after age 21/22, indicating that risk for consumption of 10 or more drinks in a row is more clearly focused on the early 20s. Patterns of developmental change in both behaviors were driven largely by college students: No significant age-related change in 10+ drinking was observed among men and women who did not go to college, and no significant age-related change in 5+ drinking was observed among female nonattenders. Conclusions Findings underscore the importance of recognizing high-intensity drinkers as a unique high-risk group, and that college attendance is associated with particularly strong peaks in the developmental course of high-intensity drinking. [ABSTRACT FROM AUTHOR]

Background The current study sought to examine the diagnostic overlap in DSM- IV and DSM-5 alcohol use disorder ( AUD) and determine the clinical correlates of changing diagnostic status across the 2 classification systems. Methods DSM- IV and DSM-5 definitions of AUD were compared using cross-national community survey data in 9 low-, middle-, and high-income countries. Participants were 31,367 respondents to surveys in the World Health Organization's World Mental Health Survey Initiative. The Composite International Diagnostic Interview, version 3.0, was used to derive DSM- IV and DSM-5 lifetime diagnoses of AUD. Clinical characteristics, also assessed in the surveys, included lifetime DSM- IV anxiety; mood and drug use disorders; lifetime suicidal ideation, plan, and attempt; general functional impairment; and psychological distress. Results Compared with DSM- IV AUD (12.3%, SE = 0.3%), the DSM-5 definition yielded slightly lower prevalence estimates (10.8%, SE = 0.2%). Almost one-third ( n = 802) of all DSM- IV abuse cases switched to subthreshold according to DSM-5 and one-quarter ( n = 467) of all DSM- IV diagnostic orphans switched to mild AUD according to DSM-5. New cases of DSM-5 AUD were largely similar to those who maintained their AUD across both classifications. Similarly, new DSM-5 noncases were similar to those who were subthreshold across both classifications. The exception to this was with regard to the prevalence of any lifetime drug use disorder. Conclusions In this large cross-national community sample, the prevalence of DSM-5 lifetime AUD was only slightly lower than the prevalence of DSM- IV lifetime AUD. Nonetheless, there was considerable diagnostic switching, with a large number of people inconsistently identified across the 2 DSM classifications. [ABSTRACT FROM AUTHOR]

Background U.S. border populations have been found to be at high risk for alcohol problems. However, results from the U.S.-Mexico Study on Alcohol and Related Conditions ( UMSARC) revealed surprisingly large variation in alcohol outcomes even among Texas border sites, with alcohol use disorder ( AUD) prevalence ~1.5 to 1.6 times greater in the border city of Laredo compared to both San Antonio and the border site of McAllen/Brownsville. Because a better understanding of this variation is important to identifying environmental influences on AUD, we developed and tested a conceptual model addressing variation in AUD prevalence across Texas UMSARC sites. Methods Surveys involved in-person, household interviews with Mexican-origin residents of the Texas border cities Laredo ( n = 751) and McAllen/Brownsville ( n = 814), with San Antonio as an off-border comparison ( n = 771). Interviews assessed past-year DSM-5 AUD; past-year heavy drinking; coping and enhancement motives; and 7 indicators of substance use climate and stress exposure hypothesized to mediate site effects. Analyses, conducted separately by gender, included regressions and structural equation modeling with Mplus. Results Preliminary analyses revealed that site effects on AUD prevalence were, unexpectedly, exclusive to men, and that Laredan men were similar to McAllen/Brownsville men on demographics, acculturation, and cross-border mobility. However, sites differed dramatically on most of the hypothesized risk factors. Structural equation models confirmed that site effects on AUD were partially mediated via effects of site on indicators of a permissive climate (i.e., permissive drinking norms, high drug availability) and stress exposures (i.e., high exposure to violence/crime, low family support), and via downstream effects on drinking motives and heavy drinking. Conclusions Findings of very high rates of past-12-month AUD among Laredan men (35%) suggest the possibility of significant heterogeneity even within demographically similar border areas and underline the need for additional study of the border region. Findings regarding our conceptual model suggest that this model may constitute a useful initial framework for future research on alcohol problems at the border. However, additional research using representative samples is needed to confirm and expand this model to comprehensively address relevant individual and community factors. [ABSTRACT FROM AUTHOR]

Background Alcohol-induced blackouts, or memory loss for all or portions of events that occurred during a drinking episode, are reported by approximately 50% of drinkers and are associated with a wide range of negative consequences, including injury and death. As such, identifying the factors that contribute to and result from alcohol-induced blackouts is critical in developing effective prevention programs. Here, we provide an updated review (2010 to 2015) of clinical research focused on alcohol-induced blackouts, outline practical and clinical implications, and provide recommendations for future research. Methods A comprehensive, systematic literature review was conducted to examine all articles published between January 2010 through August 2015 that focused on vulnerabilities, consequences, and possible mechanisms for alcohol-induced blackouts. Results Twenty-six studies reported on alcohol-induced blackouts. Fifteen studies examined prevalence and/or predictors of alcohol-induced blackouts. Six publications described the consequences of alcohol-induced blackouts, and 5 studies explored potential cognitive and neurobiological mechanisms underlying alcohol-induced blackouts. Conclusions Recent research on alcohol-induced blackouts suggests that individual differences, not just alcohol consumption, increase the likelihood of experiencing an alcohol-induced blackout, and the consequences of alcohol-induced blackouts extend beyond the consequences related to the drinking episode to include psychiatric symptoms and neurobiological abnormalities. Prospective studies and a standardized assessment of alcohol-induced blackouts are needed to fully characterize factors associated with alcohol-induced blackouts and to improve prevention strategies. [ABSTRACT FROM AUTHOR]

Background This research extends prior epidemiological estimates for the United States and re-examines a previously described male excess in alcohol drinking. Its aim was to estimate fine-grained age-specific incidence of becoming a drinker among 12- to 24-year-old U.S. males and females, and to compare incidence estimates with prevalence proportions. Methods The study population is 12- to 24-year-old noninstitutionalized U.S. civilian residents. Estimates are from 12 successive U.S. National Surveys on Drug Use and Health ( NSDUH), with nationally representative samples drawn each year from 2002 to 2013 and assessed via computer-assisted self-interviews ( n ~ 390,000). Analysis-weighted incidence and prevalence estimates are generated using the NSDUH Restricted Data Analysis System for 6 year-pairs. Meta-analysis-derived summary estimates are provided, treating each year-pair as a replication. Results In this 21st century evidence, there no longer is male excess of incidence with respect to underage drinking. Indeed, in mid-adolescence, there is a clear female excess for the risk of becoming an underage drinker. Meta-analytic summaries disclosed no other male-female differences in incidence. Nevertheless, a male excess in the prevalence of recently active drinking can be seen after the age of 19 years. Conclusions This new evidence from the United States shows that the so-called 'gender gap' in risk of becoming a drinker has narrowed to the point of there being no gap at all. Indeed, in mid-adolescence, risk of starting to drink is greater for females than for males. [ABSTRACT FROM AUTHOR]

Background There has been a significant growth in the energy drink ( ED) market in Australia and around the world; however, most research investigating the popularity of ED and alcohol and energy drink ( AED) use has focused on specific subpopulations such as university students. The aim of this study was to estimate the prevalence, consumption patterns, and sociodemographic correlates of ED and combined AED use among a representative Australian population sample. Methods A computer-assisted telephone interview survey ( n = 2,000) was undertaken in March-April 2013 of persons aged 18 years and over. Half of the interviews were obtained through randomly generated landline telephone numbers and half through mobile phones. Approximately half of the sample was female (55.5%; n = 1,110) and the mean age of participants was 45.9 (range 18 to 95, SD 20.0). Results Less than 1 in 6 Australians reported ED use (13.4%, n = 268) and 4.6% ( n = 91) reported AED use in the past 3 months. Majority of ED and AED users consumed these beverages monthly or less. ED and AED users are more likely to be aged 18 to 24 years, live in a metropolitan area, and be moderate risk or problem gamblers. AED consumers are more likely to report moderate levels of psychological distress. Conclusions Our findings in relation to problem gambling and psychological distress are novel and require further targeted investigation. Health promotion strategies directed toward reducing ED and AED use should focus on young people living in metropolitan areas and potentially be disseminated through locations where gambling takes place. [ABSTRACT FROM AUTHOR]

Background Fetal alcohol spectrum disorders are thought to be a leading cause of developmental disabilities worldwide. However, data are lacking on alcohol use among pregnant women in many countries. The purpose of this study was to evaluate the prevalence and predictors of alcohol consumption by pregnant women in Ukraine. Methods Cross-sectional screening of pregnant women was conducted in 2 regions of Ukraine during the recruitment phase of an ongoing clinical study that is part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders. Women attending a routine prenatal visit at 1 of 2 participating regional centers were asked about alcohol consumption. Quantity and frequency of alcoholic beverages consumed in the month around conception and in the most recent month of pregnancy were measured using a standard interview instrument. Results Between 2007 and 2012, 11,909 pregnant women were screened on average in the second trimester of pregnancy. Of these, 92.7% reported being ever-drinkers. Among ever-drinkers, 54.8% reported drinking alcohol in the month around conception and 12.9% consumed at least 3 drinks on at least 1 day in that time period. In the most recent month of pregnancy, 46.3% continued to report alcohol use and 9.2% consumed at least 3 drinks per day. Significant predictors of average number of drinks or heavier drinking per day in either time period in pregnancy included lower gravidity, being single, unmarried/living with a partner, or separated, lower maternal education, smoking, younger age at initiation of drinking, and higher score on the TWEAK screening test for harmful drinking. Conclusions These findings support the need for education/intervention in women of childbearing age in Ukraine and can help inform targeted interventions for women at risk of an alcohol-exposed pregnancy. The initiation of a standard screening protocol in pregnancy is a step in the right direction. [ABSTRACT FROM AUTHOR]

Background: Alcohol consumption has demonstrated substantial temporal trends, with some evidence suggesting strong birth cohort effects. The identification of at-risk birth cohorts can inform the interpretation of alcohol trends across age, time, and demographic characteristics such as gender. The present literature review has 2 objectives. First, we conduct a cross-national review of the literature on birth cohort differences in alcohol consumption, disorder, and mortality. Second, we determine the consistency of evidence for birth cohort effects on gender differences. Methods: A search was conducted and key data on population characteristics, presence and direction of cohort effects, and interactions with gender compiled. Thirty-one articles were included. Results: Evidence suggests that younger birth cohorts in North America, especially those born after World War II, are more likely than older cohorts to engage in heavy episodic drinking and develop alcohol disorders, but this cohort effect is not found in Australia and western Europe. Cross-nationally, substantial evidence indicates that women in younger cohorts are at especially high risk for heavy episodic drinking and alcohol disorders. Discussion: Younger birth cohorts in North America and Europe are engaging in more episodic and problem drinking. The gender gap in alcohol problems is narrowing in many countries, suggesting shifting social norms surrounding gender and alcohol consumption. These trends suggest that public health efforts to specifically target heavy drinking in women are necessary. [ABSTRACT FROM AUTHOR]

This study examined alcohol use patterns among men and women with depression seeking outpatient psychiatric treatment, including factors associated with recent heavy episodic drinking and motivation to reduce alcohol consumption. The sample consisted of 1,183 patients aged 18 and over who completed a self-administered, computerized intake questionnaire and who scored ≥10 on the Beck Depression Inventory-II (BDI-II). Additional measures included current and past alcohol questions based on the Addiction Severity Index, heavy episodic drinking (≥5 drinks on 1 or more occasions in the past year), alcohol-related problems on the Short Michigan Alcoholism Screening Test (SMAST), and motivation to reduce drinking using the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Among those who consumed any alcohol in the past year (73.9% of the sample), heavy episodic drinking in the past year was reported by 47.5% of men and 32.5% of women. In logistic regression, prior-year heavy episodic drinking was associated with younger age ( p = 0.011), male gender ( p = 0.001), and cigarette smoking ( p = 0.002). Among patients reporting heavy episodic drinking, motivation to reduce alcohol consumption was associated with older age ( p = 0.008), greater usual quantity of alcohol consumed ( p < 0.001), and higher SMAST score ( p < 0.001). In contrast to prior clinical studies, we examined subdiagnostic alcohol use and related problems among psychiatric outpatients with depression. Patients reporting greater drinking quantities and alcohol-related problems also express more motivation to reduce drinking, providing intervention opportunities for mental health providers that should not be overlooked. [ABSTRACT FROM AUTHOR]

Background: Previous research has suggested a positive risk-relationship between volume of consumption and adverse behavioral and social consequences of drinking. However, because the risk-relationship may be modified by factors such as pattern of drinking, attributes of social drinking contexts, and drunken comportment, the shape of the risk-function appear to be contingent upon the larger cultural context of drinking. Methods: In this article, I use graphical risk-curve analyses and model estimations to assess how the risk of experiencing alcohol-related problems is associated with self-reported volume of alcohol consumption in the 3 Baltic countries (Estonia, Latvia, and Lithuania) as well as Sweden and Italy. The analysis utilized data from 2 general population surveys (including Sweden plus Italy and the Baltic countries, respectively) with approximately 1,000 respondents from each country. Results: The risk-curves for the 3 Baltic countries and Sweden were fairly parallel and clearly steeper than that for Italy. In the logistic regression models, the country-specific Baltic estimates were not entirely homogenous; for Estonia and Latvia, the estimates were similar to that for Sweden and significantly larger than that for Italy, whereas the estimate for Lithuania did not differ significantly from that for Italy. However, the negative binominal regression models suggested that increasing volume of consumption is associated with the risk of experiencing a larger number of different problems in all 3 Baltic countries and Sweden than in Italy. Overall, the result thus suggests that there is a significant relationship between volume of consumption and risk of experiencing alcohol-related problems in all countries but that the relationship generally is stronger in the Baltic countries and Sweden than in Italy. Conclusions: The results were largely in line with the hypothesis of a European north to south gradient in the strength of the risk-relationship, but also add that most Baltic countries may be placed alongside the Nordic countries in this context. Because only volume of consumption is considered, the results cannot be used to specify which factors and mechanisms that actually modify the shape of the risk-function in each culture. [ABSTRACT FROM AUTHOR]