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Aim: We introduce a new remote real-time breathalyzer-based method for monitoring and early identification of lapse/relapse patterns for alcohol use disorder (AUD) patients using a composite measure of sobriety, the Addiction Monitoring Index (AMI). Methods: We constructed AMI from (a) obtained test results and (b) the pattern of ignored tests using data from the first 30 patients starting in the treatment arms of two on-going clinical trials. The patients performed 2-4 scheduled breath alcohol content (BrAC)-tests per day presented as blood alcohol content (BAC) data. In total, 10,973 tests were scheduled, 7743 were performed and 3230 were ignored during 3982 patient days. Results: AMI-time profiles could be used to monitor the daily trends of alcohol consumption and detect early signs of lapse and relapses. The pattern of ignored tests correlates with the onset of drinking. AMI correlated with phosphatidyl ethanol (n = 61, F-ratio = 34.6, P < 0.0001, R = -0.61). The recognition of secret drinking could further be improved using a low alcohol detection threshold (BrAC = 0.025 mg/l, BACSwe = 0.05‰ or US = 0.0053 g/dl), in addition to the legal Swedish traffic limit (BrAC = 0.1 mg/l, BACSwe = 0.2‰ or US = 0.021 g/dl). Nine out of 10 patients who dropped out from the study showed early risk signs as reflected in the level and pattern in AMI before the actual dropout. Conclusions: AMI-time profiles from an eHealth system are useful for monitoring the recovery process and for early identification of lapse/relapse patterns. High-resolution monitoring of sobriety enables new measurement-based treatment methods for proactive personalized long-term relapse prevention and treatment of AUD patients. Clinical Trial Registration: The data used for construction of AMI was from two clinical trials approved by the Regional Ethics Committee of Uppsala, Sweden and performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participating subjects. The study was registered at ClinicalTrials.gov (NCT03195894). [ABSTRACT FROM AUTHOR]

Background: Alcohol intoxication and overserving of alcohol at sporting events are of great concern, given the relationships between alcohol consumption, public disturbances, and violence. During recent years this matter has been on the agenda for Swedish policymakers, authorities and key stakeholders, with demands that actions be taken. There is promising potential for utilizing an environmental approach to alcohol prevention as a strategy to reduce the level of alcohol intoxication among spectators at sporting events. Examples of prevention strategies may be community mobilization, Responsible Beverage Service training, policy work, and improved controls and sanctions. This paper describes the design of a quasi-experimental control group study to examine the effects of a multi-component community-based alcohol intervention at matches in the Swedish Premier Football League.Methods: A baseline assessment was conducted during 2015 and at least two follow-up assessments will be conducted in 2016 and 2017. The two largest cities in Sweden are included in the study, with Stockholm as the intervention area and Gothenburg as the control area. The setting is Licensed Premises (LP) inside and outside Swedish football arenas, in addition to arena entrances. Spectators are randomly selected and invited to participate in the study by providing a breath alcohol sample as a proxy for Blood Alcohol Concentration (BAC). Actors are hired and trained by an expert panel to act out a standardized scene of severe pseudo-intoxication. Four types of cross-sectional data are generated: (i) BAC levels among ≥ 4 200 spectators, frequency of alcohol service to pseudo-intoxicated patrons attempting to purchase alcohol at LP (ii) outside the arenas (≥200 attempts) and (iii) inside the arenas (≥ 200 attempts), and (iv) frequency of security staff interventions towards pseudo-intoxicated patrons attempting to enter the arenas (≥ 200 attempts).Discussion: There is an urgent need nationally and internationally to reduce alcohol-related problems at sporting events, and it is essential to test prevention strategies to reduce intoxication levels among spectators. This project makes an important contribution not only to the research community, but also to enabling public health officials, decision-makers, authorities, the general public, and the sports community, to implement appropriate evidence-based strategies. [ABSTRACT FROM AUTHOR]

The present study was intended to investigate personality characteristics and mental health of severe driving under influence (DUI) offenders in a Swedish cohort. More specifically the aim was to investigate the personality traits as assessed by The NEO personality inventory (NEO-PI-R) and aspects of mental health as assessed by the symptom checklist (SCL-90) as compared to the general population. The subjects were 162 severe DUI offenders (with the BAC >0.099%) with an age range of 18–88 years, 143 males and 19 females. It was found that the openness to experience and conscientiousness scales of NEO-PI-R differentiated Swedish DUI offenders from Swedish norm population. The differences between the DUI group and the general population on the on SCL-90 scales were all significant except on the Hostility scale. Two main subtypes of DUI offenders identified were roughly comparable to types I and II alcoholics, as in Cloninger’s typology. Among all the scales used (personality traits, psychiatric comorbidity and alcohol use), the only factor that was predictive for future relapses to drunk driving was the factor of depression. [ABSTRACT FROM AUTHOR]

Objective. To investigate the prevalence of alcohol problems in a representative sample of Swedish drivers suspected of drunk driving in comparison with control drivers and the general Swedish population in relation to mode and time of detection. Is the time of day or night or the detection mode important for the prevalence of alcohol problems and which are the best predictors for identifying alcohol problems among DUI offenders? Methods. Two thousand and one hundred drivers (169 females) suspected of DUI offence during 1997-2001 who agreed to respond to the AUDIT questionnaire (Alcohol Use Disorders Identification Test) and 785 control drivers (266 females) not suspected of DUI recruited at general traffic controls were investigated. Results. Both mode and time of detection were found to be important. The greatest impact on the prevalence of alcohol problems emanated from the predictors in the following order: high BAC; unlicensed driving; detection hours between 12.00 and 18.00, and age under 26 years. Age over 55 years and detection in general traffic controls were the two strongest factors negatively correlated to alcohol problems prevalence. The differences between regions with regard to alcohol problems incidence could only partly be explained by police routines and resources. Conclusions. Mode and time of detection affect the prevalence of DUI offenders with alcohol problems, and to a lesser degree also BAC level. Both the detection mode and the time of detection are significant for the proportion of identified DUIs with alcohol problems. Because the majority of committed DUI offenses are never identified, it is important to optimize the detection strategies of the police with the purpose of minimizing public damage and expenses. [ABSTRACT FROM AUTHOR]