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Drug poisoning is the leading method of suicide-related deaths among females and third among males in the United States. Alcohol can increase the severity of drug poisonings, yet the prevalence of alcohol overdoses in suicide-related drug poisonings (SRDP) remains unclear. Data from the Nationwide Inpatient Sample was examined to determine rates of inpatient hospital stays for SRDP and co-occurring alcohol overdoses in adolescents (ages 12-17) and young adults (ages 18-24) between 1999 and 2008. Among adolescents, there were 14,615 hospitalizations for drug poisonings in 2008, of which 72% (10,462) were suicide-related at a cost of $43 million. Rates of SRDP in this age group decreased between 1999 and 2008. The prevalence of co-occurring alcohol overdoses increased from 5% in 1999 to 7% in 2008. Among young adults, there were 32,471 hospitalizations for drug poisonings in 2008, of which 64% (20,746) were suicide-related at a cost of $110 million. Rates of SRDP did not change significantly between 1999 and 2008. The prevalence of co-occurring alcohol overdoses increased from 14% in 1999 to 20% in 2008. Thus, while rates of SRDP decreased for adolescents and remained unchanged for young adults, the prevalence of co-occurring alcohol overdoses increased for both age groups. Such hospitalizations provide important opportunities to employ intervention techniques to prevent further suicide attempts. (Contains 2 tables and 2 figures.)

Compares the level of knowledge about human immunodeficiency virus (HIV) transmission and risk behavior of 1,057 foreign-born and 1,963 U.S.-born high school and middle school students in Boston (Massachusetts). Results suggest that Acquired Immunodeficiency Syndrome education should be taught to immigrant students in their native languages. (SLD)

Surveyed 1,773 Massachusetts adolescents to explore relationships among the following topics: (1) alcohol and drug use; (2) perceived susceptibility to human immunodeficiency virus (HIV); (3) use of condoms; (4) effectiveness of condoms in preventing infection; (5) barriers to condom use; and (6) behavioral cues about AIDS related to condom use. (JS)

Magnitude and Prevention of College Drinking and Related Problems NIAAA published a landmark report on college drinking in 2002, with a follow-up report in 2007 (NIAAA, Task Force of the [...]

Objective: The aim of this study was to estimate, among college students ages 18-24, the numbers of alcohol-related unintentional injury deaths and other problems over the period from 1998 through 2005. Method: The analysis integrated data on 18- to 24-year-olds and college students from each of the following data sources: the National Highway Traffic Safety Administration Fatality Analysis Reporting System, Centers for Disease Control and Prevention Injury Mortality Data, National Coroner Studies, census and college enrollment data, the National Household Survey on Drug Use and Health, and the College Alcohol Study. Results: Among college students ages 18-24, alcohol-related unintentional injury deaths increased 3% per 100,000 from 1,440 in 1998 to 1,825 in 2005. From 1999 to 2005, the proportions of college students ages 18-24 who reported consuming five or more drinks on at least one occasion in the past month increased from 41.7% to 44.7%, and the proportions who drove under the influence of alcohol in the past year increased from 26.5% to 28.9%-7% and 9% proportional increases, respectively. The increases occurred among college students ages 21-24, not 18-20. In 2001, 599,000 (10.5%) full-time 4-year college students were injured because of drinking, 696,000 (12%) were hit or assaulted by another drinking college student, and 97,000 (2%) were victims of alcohol-related sexual assault or date rape. A 2005 follow-up of students in schools with the highest proportions of heavy drinkers found no significant changes in the proportions experiencing these events. Conclusions: The persistence of college drinking problems underscores an urgent need to implement prevention and counseling approaches identified through research to reduce alcohol-related harms among college students and other young adults., IN 1998, THE NATIONAL ADVISORY COUNCIL of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) created a task force to review the research on college drinking to advise administrators [...]

Objective: We explored among people who ever consumed alcohol whether early age at drinking onset and alcohol dependence predicted drug use and dependence. We also examined among drinkers who have used drugs whether they also predict driving under the influence of drugs and motor-vehicle crash involvement because of drugs. Method: A U.S. national sample of 42,867 persons age 18 and older was surveyed in 1991-1992 (response rate = 90%). Logistic regression examined these potential associations among 27,616 respondents who ever drank alcohol, controlling for numerous demographic and personal characteristics. Results: Among 'ever' drinkers, 22% used drugs, 10% had driven under the influence of drugs, and nearly 1% was in a motor-vehicle crash because of drug use, the equivalent of 1 rail lion people. The younger the age of respondents when they first began drinking and whether they ever experienced alcohol dependence were independently associated with greater odds of ever using drugs and experiencing drug dependence. Among persons who consumed alcohol and drugs, having ever experienced drug dependence was the strongest predictor of driving under the influence of drugs and motor-vehicle crash involvement because of drug use. After controlling for drug dependence and age at first drug use, having experienced alcohol dependence was also independently associated with both outcomes. Conclusions: Efforts to prevent drug-related crashes should include drug use prevention and treatment, as well as prevention of early alcohol use and treatment of alcohol dependence., BOTH DRIVING AFTER DRINKING AND DRUG USE are common behaviors. According to the 2006 National Household Survey on Drug Use and Health of more than 67,500 persons age 12 and [...]

Objective: This article reviews comprehensive community interventions that sought to reduce (1) cardiovascular disease risks; (2) smoking; (3) alcohol use disorders, alcohol-related injury and illicit drug use; or (4) sexual risk taking that could lead to HIV infection, sexually transmitted disease and pregnancy. Method: Comprehensive community programs typically involve multiple city government agencies as well as private citizens and organizations and use multiple intervention strategies such as school-based and public education programs, media advocacy, community organizing, environmental policy changes and heightened enforcement of existing policies. This review focused on English-language papers published over the past several decades. Results: Some programs in each of the four problem areas achieved their behavioral and health goals. The most consistent benefits were found in programs targeting behaviors with immediate health consequences such as alcohol misuse or sexual risk taking. Results were less consistent when consequences of targeted behaviors were more distant in time such as cardiovascular risks and smoking. Also, programs that targeted youth to prevent them from starting new health-compromising behaviors tended to be more successful than programs aimed at modifying preexisting habits among adults. Programs that combined environmental and institutional policy change with theory-based education programs were the most likely to be successful. Finally, programs tailored to local conditions by the communities themselves tended to achieve more behavior change than programs imported from the outside. Conclusions: Comprehensive community intervention approaches may have considerable potential to reduce college-age drinking problems, especially given the success of these programs in reducing alcohol-related problems and in preventing health-compromising behaviors among youth. (J. Stud. Alcohol, Supplement No. 14: 226-240, 2002), CITING THE SUCCESS of comprehensive multifactorial community interventions with other public health problems, the National Academy of Sciences has recommended this approach for reducing alcohol-related health problems (Institute of Medicine, [...]

Objective: This report estimates the numbers of 18-24 year old United States college students who annually experience alcohol-related deaths, injuries and other health problems. Method: We examined traffic and unintentional injury deaths in 1998 reported by the National Highway Traffic Safety Administration and the Centers for Disease Control (CDC). We also examined results of national coroner studies, Department of Education college enrollment data, the National Household Survey on Drug Abuse (NHSDA), the CDC National College Health Risk Behavior Survey and the Harvard School of Public Health College Alcohol Survey (CAS). All survey participants were ages 18-24: 6,930 college and 12,394 noncollege respondents in the NHSDA survey; 3,077 college students in the CDC survey; and 12,217 full-time 4year college students in the CAS. Based on the number and proportion of 18-24 year olds enrolled in college, data on alcohol involvement in injury deaths among 18-24 year olds and survey responses, we calculated the numbers of 18-24 year old alcohol-related injury deaths and other health problems. Results: We estimate that over 1,400 students aged 18-24 and enrolled in 2- and 4-year colleges died in 1998 from alcohol-related unintentional injuries, including motor vehicle crashes. According to surveys conducted in 1999, in the preceding year, over 2 million of the 8 million college students in the United States drove under the influence of alcohol and over 3 million rode with a drinking driver. Over 500,000 full-time 4-year college students were unintentionally injured under the influence of alcohol and over 600,000 were hit or assaulted by another student who had been drinking. Conclusions: There is an urgent need for expanding prevention and treatment programs, to reduce alcohol-related harm among U.S. college students and other young adults. (J Stud. Alcohol 63: 136-144, 2002), NATIONAL SURVEYS of college-student drinking practices have focused attention on the heavy drinking patterns of many college students. In 1993, 1997 and 1999, the Harvard School of Public Health College [...]

Objectives. This study assessed current levels of sunbathing and sunscreen use in the United States. Methods. From a general-population telephone survey of aquatic activities among adults in 3042 US households, we examined responses by the 2459 Whites. Results. Most adults (59%) reported sunbathing during the past year, and 25% reported frequent sunbathing. Of the subsample who reported sunbathing during the month before the interview, 47% routinely used sunscreen. Of these individuals, almost half did not use sunscreens with a solar protection factor of 15 or higher. Conclusions. About a quarter of US White adults report frequent sunbathing, and only about a quarter of sunbathers use sunscreens at recommended levels. These results should help focus future sun protection educational efforts. (Am J Public Health. 1997;87:1214-1217)

Which Interventions Work? Where to refer alcohol abusers for treatment has been under debate for years. In an attempt to address this debate, a recent study compared referral to 'intensive' [...]

Many physicians may be missing the signs of alcohol abuse in their patients, but those who do not may find that a warning about the consequences of alcohol abuse may encourage their patients to quit. Seventy-four percent of the employees entering an employee assistance program (EAP) because of drinking problems said they had seen a doctor within the past year. However, only 22% recalled a warning from the doctor about the consequences of their drinking habits. Older individuals, those with a history of liver disease and those who continued drinking despite a serious illness were more likely to be warned about the consequences of alcohol abuse by their physician. Two years after entry into the EAP, 63.6% of the employees who had been warned had stopped drinking, compared to 32.2% of those who had not been warned., Objective.- To study whether alcoholic workers had seen physicians during the year they were identified by their company, whether they recalled physicians' warnings about drinking, and whether such warnings affected outcomes 2 years later. Design.-workers were interviewed at intake and 2 years later: subgroups who did and did not see physicians and who did and did not recall warnings were compared. Setting.-A company-union employee assistance program. Participants.-Two hundred problem drinkers, newly identified on the job, predominantly male, blue-collar workers. Outcomes.-Drinking, drunkenness, average daily alcohol consumption, and impairment score. Results.-Among the 200 participants, 74% saw physicians in the index year; only 22% recalled warnings. Recall of a warning was associated with liver disease, continued drinking while ill, supervisors'job warnings, older age, and marijuana use. Two years later, those warned were more likely to be abstaining, and sober, and were less impaired. Conclusions. - Recalling a physician's warning at intake into alcoholism treatment was associated with better prognosis 2 years later. However, among this group of employees whose drinking was serious enough to be identified on the job, fewer than a quarter recalled physicians'warnings, even though more than three quarters had seen physicians in the year preceding intake. (JAMA. 1992;267:663-667)

Many US residents who live in urban areas that are particularly plagued by AIDS and HIV infection were not born in this country. Little is known about the sexual behaviors and drug use of foreign-born residents or about their knowledge of HIV. To gain insight into this, 3,049 foreign-born Boston public school students were surveyed in their native language. Only 35 percent of the immigrants surveyed knew how HIV could be transmitted. This was a significantly lower percentage compared with nonimmigrants. Only 38 percent of immigrants reported that they always used condoms. Four percent reported having sex with intravenous drug users (compared with 1 percent of nonimmigrants), and 31 percent of immigrants reported being sexually active compared with 53 percent of nonimmigrants. AIDS education is needed by immigrant students and should be available in their native languages. (Consumer Summary produced by Reliance Medical Information, Inc.)

Alcoholism and other forms of substance abuse constitute a significant health, social and economic problem. Employers and labor unions routinely refer workers with alcohol problems for treatment, yet little is known about how effective various treatments actually are. A large industrial plant with 10,000 workers provided an opportunity to compare the effectiveness of various treatment options. The plant maintained an employee-assistance program which helped workers who were found to have alcohol problems. For the purposes of this study, workers with newly discovered alcohol problems were randomly assigned into one of three experimental groups. One group was assigned to an inpatient program for alcohol abuse; another group began mandatory attendance at Alcoholics Anonymous (AA) meetings; the third group was permitted a choice of options - the assistance program provided information about options but did not provide advice on the choice. A total of 227 workers were assigned in this manner and followed-up over a two-year period. Data were collected on work performance and also on direct measures of drinking and drug abuse. These data indicated that there were improvements in all three groups. The three groups were comparable in job performance. However, some indicators of drinking and drug abuse revealed differences among the three treatment groups. Sixty-three percent of the workers enrolled in the AA program required additional inpatient treatment at some point, in contrast with only 38 percent of the workers enrolled in the inpatient program. The workers who chose a program had outcomes which were between these two extremes. The differences between the AA program and the inpatient program were even more striking among the workers who had abused cocaine in addition to alcohol. It should be pointed out that although the AA program was significantly cheaper than the inpatient program, the overall costs were not much different. The increased requirement for further treatment among the AA group resulted in a cost of AA treatment which was only about 10 percent less than the inpatient program. The results indicate that treatment in AA programs is riskier than inpatient programs and that workers treated in such programs should be watched closely for signs of relapse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Twenty percent of the cases of AIDS (acquired immunodeficiency syndrome) reported in the United States have been diagnosed in people aged 20 to 29. Because of the relatively long incubation period of HIV (human immunodeficiency virus, which causes AIDS), it is likely that many of these people were infected during or soon after the high school years. Most teenagers have been informed about ways to prevent HIV transmission, but since two-thirds always or sometimes engage in sexual intercourse without using condoms, it is necessary to determine how their behavior can be influenced. Certain health beliefs have been found to predict health behaviors. A telephone survey was conducted to assess the AIDS-related health beliefs and behaviors of 16- to 19-year-old youths; the study was carried out in Massachusetts in August 1988. Sixty-one percent of the respondents reported that they were sexually active; in this group of 1,050 subjects, factors related to condom use were assessed. Those teenagers who believed condoms are effective in preventing HIV transmission and were worried about getting AIDS were 3.1 and 1.8 times, respectively, more likely to use condoms all the time. Individuals who carried condoms were 2.7 times more likely to use them, and those who had talked to a physician about AIDS were 1.7 times more likely to use condoms. Respondents who stated that condoms do not reduce sexual pleasure and that they would not feel embarrassed if a partner suggested using them were 3.1 and 2.4 times, respectively, more likely to use them. Teenagers who were heavy drinkers or used marijuana were two to three times less likely to use condoms, and some reported using them less often after drinking or using drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)

THE RECENT DEATHS of students at Louisiana State University and Massachusetts Institute of Technology of acute alcohol overdose remind us that despite progress to reduce underage drinking in the United […]

Background: Underage binge drinking is a serious health concern that is likely influenced by the neighbourhood environment. However, longitudinal evidence has been limited and few studies have examined time-varying neighbourhood factors and demographic subgroup variation.Methods: We investigated neighbourhood influences and binge drinking in a national cohort of US 10th grade students at four times (2010-2014; n = 2745). We estimated odds ratios (OR) for past 30-day binge drinking associated with neighbourhood disadvantage, personal and property crime (quartiles), and number of liquor, beer and wine stores within 5 km, and then evaluated whether neighbourhood associations differ by age, sex and race/ethnicity.Results: Neighbourhood disadvantage was associated with binge drinking before 18 [OR = 1.54; 95% confidence interval (1.14, 2.08)], but not after 18 years of age. Property crime in neighbourhoods was associated with a higher odds of binge drinking [OR = 1.54 (0.96, 2.45)], an association that was stronger in early adulthood [4th vs 1st quartile: OR = 1.77 (1.04, 3.03)] and among Whites [4th vs 1st quartile: OR = 2.46 (1.03, 5.90)]. Higher density of liquor stores predicted binge drinking among Blacks [1-10 stores vs none: OR = 4.31 (1.50, 12.36)] whereas higher density of beer/wine stores predicted binge drinking among Whites [one vs none for beer: OR = 2.21 (1.06, 4.60); for wine: OR = 2.04 (1.04, 4.03)].Conclusions: Neighbourhood conditions, particularly those related to economic circumstances, crime and alcohol outlet density, were related to binge drinking among young adults, but associations varied across age and individual characteristics. [ABSTRACT FROM AUTHOR]

Compares interview and fatal crash data from Massachusetts after the legal drinking age was raised, with data from New York, where drinking is legal from age 18. Suggests that without intensive, coordinated enforcement efforts, raising the legal drinking age does not reduce fatalities significantly. (GC)

A driver does not necessarily have to be intoxicated to be impaired by alcohol. Even moderate drinking, defined as drinking no more than two drinks per day for men and [...]