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Background and aimsMost studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries.Design, setting and participantsCross-sectional study based on a probability sample of fatally injured adult victims (n = 365) autopsied in São Paulo, Brazil. Victims were sampled within systematically selected 8-hour sampling blocks, generating a representative sample of fatal injuries occurring during all hours of the day for each day of the week between June 2014 and December 2015.MeasurementsThe presence of alcohol and blood alcohol concentration (BAC) were the primary outcomes evaluated according to victims' socio-demographic, injury context data (type, day, time and injury place) and criminal history characteristics.FindingsAlcohol was detected in 30.1% [95% confidence interval (CI) = 25.6-35.1)] of the victims, with a mean blood alcohol level (BAC) level of 0.11% w/v (95% CI = 0.09-0.13) among alcohol-positive cases. Black and mixed race victims presented a higher mean BAC than white victims (P = 0.03). Fewer than one in every six suicides tested positive for alcohol, while almost half of traffic-related casualties were alcohol-positive. Having suffered traffic-related injuries, particularly those involving vehicle crashes, and injuries occurring during weekends and at night were associated significantly with alcohol use before injury (P

[phrase omitted] Introduction Alcohol use is among the top 10 risk factors for ill health globally and is one of the five leading risk factors among men, such use accounts [...], Objective To examine the empirical basis for including the diagnostic category of "a single episode of harmful substance use" in the 11th revision of the International statistical classification of diseases and related health problems (ICD-11). Methods We used data on patients admitted to emergency departments in 21 countries with alcohol-related injuries (i.e. with drinking within the preceding six hours) who had no sign of alcohol intoxication or withdrawal, no alcohol in blood and no sign of alcohol dependence or harmful drinking as described in the ICD-10. We obtained data on alcohol-related injuries, the patient&apos;s causal attribution of injury to drinking, the alcohol amount consumed, blood alcohol concentration and usual drinking pattern. Patients with and without alcohol dependence or harmful drinking were compared. Findings We included a representative sample of 18 369 patients. After adjustment for unequal sampling, 18.8% reported drinking in the six hours before injury and 47.1 % of these attributed their injury to drinking; 16.3% of those reporting drinking and 10.3% of those attributing their injury to drinking were not alcohol dependent or harmful drinkers. The majority of these last two groups reported never having had five or more drinks on one occasion during the last year and had a blood alcohol concentration less than 0.05%. Conclusion Some individuals attending emergency departments had alcohol-attributable injuries due to a single episode of drinking but had no history of harmful use or dependence. These findings highlight the public health relevance of including the new diagnostic category in the ICD-11. Objectif Examiner les conditions empiriques de l&apos;inclusion de la categorie de diagnostic <> dans la 11e revision de la Classification internationale des maladies et des problemes de sante connexes (CIM-11). Methodes Nous avons utilise des donnees relatives a des patients admis dans des services d&apos;urgence dans 21 pays pour des traumatismes lies a l&apos;alcool (consommation au cours des six dernleres heures) qui ne presentaient aucun signe d&apos;intoxication a l&apos;alcool ou de sevrage alcoolique, aucune trace d&apos;alcool dans le sang et aucun signe de dependance a l&apos;alcool ou de consommation nocive, comme decrit dans la CIM-10. Nous avons recueilli des donnees sur les traumatismes lies a l&apos;alcool, i&apos;attribution causale du traumatisme a la consommation d&apos;alcool par le patient, la quantite d&apos;alcool consommee, la concentration d&apos;alcool dans le sang et les habitudes de consommation. Nous avons compare des patients qui presentaient une dependance a l&apos;alcool ou une consommation nocive a d&apos;autres pour qui ce n&apos;etait pas le cas. Resultats Nous avons inclus un echantillon representatif de 18 369 patients. Apres ajustement pour echantillonnage inegal, 18,8% des patients ont indique avoir consomme de l&apos;alcool au cours des six heures ayant precede le traumatisme, 47,1 % d&apos;entre eux attribuant leur traumatisme a la consommation d&apos;alcool; 16,3% des patients ayant indique avoir consomme de l&apos;alcool et &apos;10,3% de ceux attribuant leur traumatisme a la consommation d&apos;alcool n&apos;etaient ni dependants a l&apos;alcool, ni des consommateurs excessifs. La majorite des membres de ces deux derniers groupes ont signale n&apos;avoir jamais consomme cinq verres ou plus lors d&apos;une meme occasion au cours de l&apos;annee ecoulee et presentalent une concentration d&apos;alcool dans le sang inferieure a 0,05%. Conclusion Certains patients pris en charge par des services d&apos;urgence avaient des traumatismes attribuables a l&apos;alcool en raison d&apos;un episode isole de consommation, mais ne presentaient pas d&apos;antecedents de consommation nocive ou de dependance. Ces conclusions soulignent l&apos;interet pour la sante publique d&apos;inclure une nouvelle categorie de diagnostic danslaCIM-11. Objetivo Examinar las bases empiricas para incluir la categoria diagnostica de "episodio unico de consumo de sustancia nociva" en la undecima revision de la Clasificacion internacional de enfermedades y problemas relacionados con la salud (CIE-11). Metodos Utilizamos datos de pacientes admitidos en salas de emergencia en 21 paises con danos asociados al alcohol (es decir, consumo de alcohol en las seis horas previas) que no presentaron signos de intoxicacion por alcohol o abstinencia, sin rastros de alcohol en sangre y sin signos de dependencia del alcohol o consumo nocivo segun se describe en la CIE-10. Obtuvimos datos sobre danos relacionados con el alcohol, la atribucion causal del dano a la bebida realizada por el paciente, la cantidad de alcohol consumido, la concentracion de alcohol en sangre y el patron habitual de consumo. Se compararon pacientes con dependencia al alcohol y sin dependencia o consumo nocivo. Resultados Incluimos una muestra representativa de 18369 pacientes. Despues del ajuste por muestreo desigual, el 18,8% informaron haber bebido en las seis horas previas al dano y el 47,1 % atribuyo el dano a la bebida; el 16,3% de los que Indicaron haber bebido y el 10,3% de los que atribuyeron el dano a la bebida no eran dependientes al alcohol o consumidores nocivos. La mayoria en estos ultimos dos grupos dijo&apos;no haber bebido cinco o mas tragos en una ocasion durante el ultimo ano y su concentracion de alcohol en sangre fue inferior al 0,05%. Conclusion Algunos individuos recibidos en salas de emergencia presentaron danos atribuibles al alcohol debido aun unico episodio de consumo de alcohol, pero no tenian antecedentes de consumo nocivo o dependencia. Estos resultados destacan la Importancia para la salud publica de la Inclusion de la nueva categoria diagnostica en la CIE-11.

Background: Many patients admitted to general emergency departments (EDs) have a pattern of drinking that could lead to future alcohol-related complications. However, it is often difficult to screen these patients in the context of emergency. The aim of this study is to analyze whether reasons for admission could help to screen patients who have an unhealthy alcohol use. Method: Patients were recruited among six public hospital ED in France, between 2012 and 2014. During a one-month period in each hospital, anonymous questionnaires including sociodemographic questions, AUDIT-C and RAPS4-QF were administered to each patients visiting the ED. The reason for admission of each patient was noted at the end of their questionnaire by the ED practitioner. Results: Ten thousand Four hundred twenty-one patients were included in the analysis. Patients who came to the ED for injuries and mental disorders were more likely to report unhealthy alcohol use than non-harmful use or no use. Among male patients under 65  years old admitted to the ED for a mental disorder, 24.2% drank more than four drinks (40  g ethanol) in typical day at least four time a week in the last 12  months. Among these patients, 79.7% reported daily or almost daily heavy episodic drinking (HED, 60  g ethanol), and all were positive on the RAPS4-QF. Conclusion: This study highlights that unhealthy alcohol use is frequent among ED patients and particularly among those who come for injuries or mental disorders. Men under 65  years old with a mental disorder require special attention because of their increased prevalence of daily or almost daily HED. [ABSTRACT FROM AUTHOR]

The authors show associations between immigration and alcohol disorders using data from the 1995 and 2000 U.S. National Alcohol Surveys and the 1998 Mexico National Household Survey on Addictions. The prevalence of alcohol dependence was 4.8% for the Mexicans, 4.2% for the Mexico-born immigrants, and 6.6% for the U.S.-born Mexican Americans. They found a general lack of significance for the immigration variables with few consistent dose-response findings for alcohol use disorders. High acculturation was associated with higher risks for women; however, unexpectedly, high acculturation was associated with lower risks for males. Among Mexican Americans, the impact of immigration to the United States on the prevalence of alcohol use disorders differs by gender. Male and female differences and possible sources of immigrant selection are important issues for future research. (Contains 4 tables.)

It is reasonable to believe that the alcohol policy environment can impact the suicide mortality rates in a given country, considering the well-known link between alcohol use and death by suicide. The current literature, albeit limited, suggests that an increase in alcohol taxation may result in a decrease in deaths by suicide and that the effect is sex-specific. Therefore, the objective of the current study was to test the impact of three alcohol control policy enactments (in 2008, 2017 and 2018) on suicide mortality among adults 25–74 years of age in Lithuania, by sex. To estimate the unique impact of three alcohol control policies, we conducted interrupted time-series analyses by employing a generalized additive mixed model on monthly sex-specific age-standardized suicide mortality rates from January 2001 to December 2018. Analyses showed a significant impact of the 2017 (p = 0.016) alcohol control policy on suicide mortality for men only. Specifically, we estimated that in the year following the 2017 policy enactment, approximately 57 (95% CI: 9–107) deaths by suicide were prevented among men, 25–74 years of age. The three policy enactments tested were not found to significantly impact the suicide mortality rate among women. Alcohol control policies involving pricing, which result in a notable decrease in alcohol affordability, could be a cost-effective indirect suicide prevention mechanism in not only countries of the former Soviet Union, but in other high-income countries with a comparable health care system to that in Lithuania. Increasing excise tax on alcohol was found to have a sex-specific impact on suicide mortality The 2017 alcohol policy prevented 57 deaths by suicide among men, 25–74 years of age, in the following year Alcohol pricing policies may be a cost-effective indirect suicide prevention mechanism [ABSTRACT FROM AUTHOR]

Objective. This article describes the demographic characteristics and psychological differences in a sample of female heavy and non-heavy drinkers who attended three emergency services of the Mexican city of Pachuca, Hidalgo. Material and Methods. A sample of patients seen at emergency services (ES) patients over the age of 18 was selected using ES admission forms. Twenty-five-minute, face-to-face interviews were conducted by a group of trained interviewers. Patients answered various questionnaires and scales to measure alcohol consumption and to provide information on variables that have proved to be related to female drinking. Results. Thirty-six women (5.2%) out of 717 of the total number of women were found to be heavy drinkers according to the TWEAK scale. This group of women had 2.3 times the risk of becoming depressed, 2.87 times the risk of taking other drugs, 1.95 times the likelihood of having been sexually abused and 1.57 times the risk of displaying suicidal ideation. Conclusions. Data from this small analysis confirm international findings that problem drinking among females throughout the life cycle is linked to depression. As regards the screening instruments employed, it is necessary to conduct more in-depth research to enrich their contents and increase their reliability and validity when used among female populations. In this study, the TWEAK proved to be extremely useful for studies in emergency services. The English version of this paper is available too at: http://www.insp.mx/salud/index.html

Alcohol consumption is a leading risk factor for morbidity and mortality related to both intentional (i.e., violence-related) and unintentional injury. In 2000, 16.2 percent of deaths and 13.2 percent of [...]