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BACKGROUND: The overall prevalence of United States young adult alcohol use has decreased, but less 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 is to examine historical change in SAM use prevalence among U.S. young adult alcohol users from 1977–2016, 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 six modal ages (19/20, 21/22, 23/24, 25/26, 27/28, 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 one of four 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.

Purpose This pilot study examined a telemedicine-based intervention using motivational enhancement therapy (METelemedicine) to reduce alcohol use among a sample of at-risk, rural alcohol users. Methods A total of 127 rural alcohol users were recruited from community supervision offices and engaged in brief intervention sessions using telemedicine. Analysis examined alcohol outcomes at 3 months postbaseline. Findings Findings indicated that although there were no overall differences between comparison groups on alcohol outcomes, 3+ sessions of METelemedicine significantly reduced the likelihood of any alcohol use by 72% (P < .05). In addition, 3+ sessions of the intervention predicted fewer days of drinking in the follow-up period, fewer drinks per week, and fewer days experiencing alcohol problems. Conclusions Findings demonstrate that telemedicine may be a promising approach to deliver interventions with alcohol users who may not utilize formal treatment services. This method has potential to decrease some of the barriers to access and use of evidence-based treatment for populations in need of services.

Background Recent research suggests low-demand housing (ie, not contingent upon abstinence) is effective in helping people exit homelessness, even among recent active substance users. Whether active users of illicit drugs and stimulants have worse housing outcomes than primary alcohol users, however, is unknown. Methods A total of 149 participants in a multisite supportive housing program who reported high levels of active substance use at program entry were classified as either (1) predominantly “Alcohol Use” (>10 of 30 days alcohol, but not >10 days of drug use) or (2) “Illicit Drug Use” (>10 of 30 days any single illicit drug use with or without alcohol use). Sub-analysis of the “Illicit Drug Use” group compared participants reporting high levels of “Stimulant Use” (>10 days cocaine, crack, or methamphetamine use) to those with high levels of “Non-stimulant Use” (>10 days marijuana or other non-stimulant drug use). Group differences in housing outcomes were examined with mixed model multivariate regression. Results During 24-month follow-up, days housed increased dramatically for both the “Alcohol Use” and the “Illicit Drug Use” groups without significant differences. Sub-analysis of illicit drug users showed stimulant use was associated with fewer days housed (p = .01) and more days homeless (p = .02) over time. Conclusions Among illicit drug users, stimulant users have somewhat less successful housing outcomes than other active drug and alcohol users, though both groups maintained substantial housing improvements in low-demand housing. (Am J Addict 2014;23:243–248)1

Background Hepatic enzyme cytochrome P450 2B6 (CYP2B6) plays a role in the metabolism of efavirenz drugs. CYP2B6 516G>T variation showed an implication for HIV treatment. Methods CYP2B6 516G>T polymorphism was genotyped in a total 165 HIV patients that include 34 with and 131 without hepatotoxicity and 155 healthy individuals by the PCR‐RFLP. Results In patients with hepatotoxicity, the prevalence of CYP2B6 516TT genotype was higher as compared to healthy individuals (35.3% vs. 30.5%, OR = 1.74). Patients with hepatotoxicity using tobacco had a higher prevalence of genotypes CYP2B6 516GT, 516TT, 516GT+TT as compared to healthy individuals (28.57% vs. 25.93%; 57.14% vs. 29.63%; 85.71% vs. 55.56%). Likewise, hepatotoxicity in patients consuming alcohol showed higher distributions of CYP2B6 516GT, 516TT, 516GT+TT genotypes (57% vs. 25.93%; 42.86% vs. 33.33%; 71.43% vs. 59.26%). Nevirapine users with hepatotoxicity overrepresented genotypes CYP2B6 TT and 516GT+TT as compared to efavirenz users (47.83% vs. 45.45%, OR = 6.88, 65.22% vs. 54.55%, OR = 1.56). Similarly, in nevirapine +alcohol users with hepatotoxicity, the frequency of CYP2B6 516GT, 516GT+TT genotypes was higher than with nevirapine +alcohol nonusers (40.0% vs. 11.11%, OR = 8.00, 80.0% vs. 27.78%, OR = 4.00). In HIV patients, nevirapine users had higher frequency of CYP2B6 516GT, 516GT+TT genotypes as compared to efavirenz users (42.02% vs. 25.00%, OR = 2.53; 72.27% vs. 58.33%, OR = 1.86). Likewise, in HIV patients, genotypes CYP2B6 516GT, 516GT+TT were predominant with nevirapine +alcohol users as compared to nevirapine +alcohol nonusers (57.89% vs. 34.57%, OR = 2.46; 78.95% vs. 69.14%, OR = 1.67). In multivariate logistic regression, taking nevirapine had a protection for severity of ARV‐associated hepatotoxicity (OR = 0.23, p = 0.005). Conclusions No significant association was detected between CYP2B6 516G>T polymorphism and susceptibility to ARV‐associated hepatotoxicity.

Issues. The aim of this study is to compare studies by their setting in order to identify design differences between studies on brief interventions (BI) for heavy alcohol use conducted in primary care and those in hospital settings. Approach. Potential studies were extracted from 16 reviews and from systematically searching literature up to October 2011. We assessed whether the following factors were statistically significant predictors of study setting: exclusion of very heavy/dependent drinkers; mean age of study sample; gender composition of study samples; sample size; total intervention delivery time; number of sessions; interventionist (physician vs. non-physician); various study design and intervention fidelity aspects; accounting for screening/assessment reactivity; and control condition utilised. Key Findings. Seventy-six studies (30 in primary care and 46 in hospital settings) met the inclusion criteria. The following factors were statistically significant predictors of study setting: number of sessions {odds ratio [OR] = 0.281 [95% confidence interval (CI) 0.081, 0.979; P = 0.046]}, exclusion of very heavy/dependent drinkers [OR = 0.052 (95% CI 0.004, 0.716, P = 0.027)] and gender composition of study samples [OR = 1.063 (95% CI 1.005, 1.125; P = 0.033)]. Implications. Researchers developing hospital setting BIs for excessive alcohol consumption should take into account methodological issues that could explain differences in the consistency of findings between hospital setting studies and primary care setting studies where BIs have been more consistently found effective in reducing alcohol use. Conclusion. The observed study design differences between hospital and primary care settings might partly explain the disparity in the consistency of findings on effectiveness of BIs between these settings.[Mdege ND, Watson J. Predictors of study setting (primary care vs. hospital setting) among studies of the effectiveness of brief interventions among heavy alcohol users: A systematic review.Drug Alcohol Rev 2013;32:368–380]

Background Smoking and alcohol use impair post-operative outcomes. However, no studies include fast-track surgery, which is a multimodal-enhanced recovery programme demonstrated to improve outcome. We hypothesised that outcome is similar in smokers and alcohol users as in non-users after fast-track hip and knee arthroplasty. Methods Prospective questionnaires on co-morbidity and smoking/alcohol use were cross-referenced with the Danish National Health Registry to investigate relationship between smoking/alcohol use and length of stay of > 4 days and readmissions ≤ 90 days after fast-track hip and knee arthroplasty. Results In 3041 consecutive patients, 458 reported smoking and 216 drinking > 2 drinks a day, of which 66 did both. Smokers/alcohol users were younger than non-users (mean age: 64.3 vs. 68.0 years, P 4 days and smoking (odds ratio [95% confidence interval], P) (1.34 [0.92–1.95], 0.127) or alcohol use (0.59 [0.30–1.16], 0.127). Thirty- and ninety-day readmission rate was 6.6% (n = 201) and 9.4% (n = 285). Multiple logistic regression analysis showed an increased risk of readmissions in smokers at 30 (1.60 [1.05–2.44], 0.028) but not 90-day follow-up (1.17 [0.80–1.73], 0.419). No increased risk of readmissions was found in alcohol users at 30 (0.94 [0.50–1.76], 0.838) or 90-day follow-up (0.83 [0.47–1.49], 0.532). No increased risk of specific readmissions (i.e. wound infections or pneumonia) typically related to smoking/alcohol use was found in smokers (1.56 [0.93–2.62], 0.091) or alcohol users (1.00 [0.47–2.15], 0.999) at 90-day follow-up. Conclusion Influence of smoking or alcohol use may be less pronounced in fast-track hip and knee arthroplasty compared with data with conventional care programmes.

The aim of the study was to explore problem drug and alcohol users' perceptions of family members' coping in a cross-sectional interview study of problem drug and alcohol users, using a long semistructured interview. Participants comprised nine problem drinkers, five problem drug users and one problem drug and alcohol user (two-thirds male). Detailed qualitative analysis of interview reports suggested that drug and alcohol users have clear ideas regarding family members' coping. Coping strategies which encompass clear elements of concern for them appear to be well-received, in particular supportive coping and, in some cases, assertive coping. Controlling coping may be viewed positively by drug and alcohol users provided it is used in conjunction with supportive coping, thereby indicating concern. Furthermore, results suggested that users found all other forms of coping such as emotional, tolerant, inactive and avoidance to be unsupportive, the only exception being tolerant coping, which was found to be su...

This article presents findings from a survey of programmes available for tobacco and alcohol users working in 455 of Australia's top 600 companies. Companies were twice as likely to have programmes for smokers (43%) as for problem drinkers (24%) and these programmes were more apparent in large companies. The majority of programmes for smoking were delivered within a health promotion context which included other life-style issues, such as nutrition, exercise, weight management and stress management. Although Employee Assistance Programs (EAPs) were the most commonly available type of work-place programme for excessive drinkers and other drug users, followed by Alcoholics Anonymous and local hospital clinics, only 6% had an EAP for alcohol. Only 21% of programmes for smokers and 12% for excessive alcohol users were evaluated. Around one-quarter of companies knew the costs of smoking programmes, and 9% reported costs of conducting programmes for excessive alcohol consumers.

Purpose Each textbook on ophthalmology in the 19th and the 20th centuries included a description of “tobacco-alcohol amblyopia”. In the last 200 years several thousand cases of “tobacco-alcohol amblyopia” were described, but the occurrence of the disorder has considerably decreased in modern times. Methods Review of the literature and described cases of the entity. Results By the end of the 20th century, a paradox had become apparent: the population of tobacco and alcohol users in some areas of the world continued to be very high, but there was a marked decrease in the incidence of the disease. Some believe that the disease never existed, some argue that it was a mismatch – or / and overdiagnosed. Conclusion The presentation is going to cover the present status of knowledge about “tobacco-alcohol amblyopia” and to finally give the answer whether such entity exists.

Summary Two recent studies estimating the economic cost of alcohol-related health care in New Zealand are critically assessed. It is suggested that some estimates are based on unscientific methods, and that estimated costs substantially over-emphasize the net impact of alcohol abuse on properly-defined net expenditures of the health system. To the extent that they are comprehensive, even the overstated estimated health costs appear to fall far short of indirect tax revenue extracted from alcohol users, including non-abusers.

Accepting that opioid use and crime are associated and develop together, amongst opioid-using criminals the need for opioids may cause crime on a day-to-day basis or both may tend to be determined by some other set of factors. Previous studies have either failed to allow for such other factors, or have failed to compare opioid users to adequate control groups. From interviews with 151 Scottish prisoners and non-prisoners, divided into five drug-using groups: (1) alcohol only; (2) cannabis and alcohol; (3) other drugs but not opioids; (4) moderate opioids; (5) heavy opioids, data were obtained on drug use frequency, crime frequency and a variety of other variables. It was found that: (1) there were no differences between incarcerated and non-incarcerated opioid users, in fact incarceration had no substantial effects on other variables; (2) heavy opioid users committed crimes significantly more frequently than did moderate opioid users, non-opioid polydrug users, cannabis users or alcohol users. But, moderate opioid users did not commit crimes significantly more frequently than did the other groups; (3) other drugs were related to crime. Polydrug use (including cannabis use) was more related to theft and delinquency than was opioid use. Alcohol use was related to fraud; (4) there were larger explanations of crime than opioid use--criminal experience and polydrug use--and crime was a better explanation of opioid use variance than opioid use was of crime. It is concluded that need for opioids did not simply cause crime. Rather, crime and opioid use tended to influence each other. However, this relationship was not special to opioids but, depending on historical circumstances, could--and to some extent does--apply to any drug. In consequence, society's treatment of drug-using criminals needs to deal with drug use and crime together.

In a house-to-house survey in Ernakulam district, Kerala State, 10914 individuals were interviewed for their tobacco and alcohol habits and examined for the presence of oral leukoplakia. Very few females (1.6%) were found to be alcohol users and they were excluded from further analysis. Among 7604 males, 30.4% used alcohol regularly, 25.4% occasionally and 44.2% were non-users. The prevalence of leukoplakia was significantly higher among regular (5.7%) and occasional (3.9%) users than among non-users (2.9%) of alcohol. Alcohol usage was found to be related to age as well as tobacco habits. The prevalence of leukoplakia was higher among alcohol users in each age-group as well as in each tobacco habit category. After age-adjustment the difference between alcohol users and non-users, although reduced, remained significant. For most tobacco habit categories the trend remained similar after age-adjustment except for the mixed habits group, for which there was a reversal of the trend. The alcohol habit may, perhaps, produce discernible effects only in association with other 'weak' etiological risk factors, such as a single tobacco habit of smoking or chewing rather than a 'strong' etiologic factor such as the mixed habits of chewing and smoking.

One method of coping with perceived stress is the use of oral behaviors (e.g., eating, drinking, smoking). This study addressed the influence of perceived daily stress level (day rated as pleasant, neutral, or unpleasant) on oral behaviors in three groups of women, aged 25 to 45. Subjects included 37 female normal alcohol users of normal weight, 23 recovering alcoholics of normal weight, and 37 normal alcohol users who were 25% to 100% overweight. The normals responded to daily stress levels by changing their oral behaviors in predictable and consistent ways. On unpleasant days, the normals and the recovering alcoholic women ate more sweet, starchy, and salty/spicy foods. The overweight women ate more food, especially salty/spicy and sweet foods regardless of the type of day. The alcoholic women desired alcohol and smoked more than the other two groups all the time. Hence, the alcoholics and overweight women desired to or engaged in their habituated oral behaviors regardless of fluctuating daily stress levels.

Basic sociocultural changes are often reflected in changing drinking patterns. Data from rural Uganda suggests that with increasing acculturation, there is a trend toward informal drinking behavior, a preference for modern beverages, and the elaboration of drinking settings. Modern settings appear to provide important opportunities for access to the national culture. Results indicate that the marginal population, not the least or most acculturated, are the heaviest alcohol users. An application of item-analysis to acculturation scale construction and suggestions for further research are also presented.

A Western Australian metropolitan sample of alcohol users stratified by age and socioeconomic status was asked to predict the effect increased opening hours of premises selling alcoholic beverages would have on their drinking behaviour. All groups believed that they would increase their drinking behaviour: young drinkers and male drinkers indicated that they would do so significantly more than others.