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Aims: Our study aimed to a) describe the distribution of hospital discharges with primary and secondary alcohol‐specific diagnoses by sex and age group, and b) describe how the number of hospital discharges with primary and secondary alcohol‐specific diagnoses have changed across different diagnostic groups (categorized by primary International Classification of Diseases, 10th Revision [ICD‐10] diagnosis) over time. Design: Retrospective cross‐sectional analysis. Setting: German hospital settings between 2012 and 2021. Participants: All persons aged 15–69 admitted to hospitals as registered in a nationwide data set. Measurements We counted a) the number of all hospital discharges and b) the number of hospital discharges with at least one alcohol‐specific secondary diagnosis (secondary alcohol‐specific diagnosis) by year, sex, age group, and diagnostic group. One diagnostic group included all primary alcohol‐specific diagnoses, while 13 additional groups aligned with ICD‐10 chapters (e.g., neoplasms). Alcohol‐involvement was defined as either a primary or secondary alcohol‐specific diagnosis. Findings Of 95 417 204 recorded hospital discharges between 2012 and 2021, 3 828 917 discharges (4.0%; 2 913 903 men (6.4%); 915 014 women (1.8%)) involved either a primary or at least one secondary diagnosis related to alcohol. Of all alcohol‐involved hospital discharges, 56.8% (1 654 736 discharges) had no primary but only a secondary alcohol‐specific diagnosis. Secondary alcohol‐specific diagnoses were particularly prevalent in hospital discharges due to injuries. With rising age, alcohol‐involvement in hospital discharges due to digestive or cardiovascular diseases increased. Between 2012 and 2021, the rate of alcohol‐involved hospital discharges has decreased more in younger as compared with older adults (average change between 2012 and 2021: 15–24: −55%; 25–34: −41%; 35–44: −23%; 45–54: −31%; 55–64: −21%; 65–69: −8%). Conclusions: The number of alcohol‐involved hospital discharges in Germany from 2012 to 2021 more than doubles (from 1 654 736 to 3 828 917) when including secondary alcohol‐specific diagnoses. More pronounced declines among younger adults may be attributed to unequal changes in alcohol consumption patterns across the population and to the hazardous effects of long‐term alcohol use. [ABSTRACT FROM AUTHOR]

Aims: Voluntary self-exclusion (VSE) programmes are intended to minimise gambling-related harm. They are considered effective for the individual but several weaknesses have been reported that deter individuals from enrolment. The present paper summarises opinions about and experiences with VSE strategies and assesses gaps and needs with regard to the current self-exclusion regulations and programmes in seven jurisdictions. Methods: A total of 102 representatives from various sectors (research community; addiction help and care services; prevention; regulatory bodies; gambling providers) in Finland, Germany, Italy, Massachusetts (USA), Norway, Sweden, and Victoria (Australia) were surveyed about their experiences with and opinions about VSE strategies, as well as gaps and needs of the current VSE regulations in their jurisdiction. Results: The respondents agreed on the need for and importance of VSE programmes. However, in all participating jurisdictions, VSE regulations at the time of the survey were considered insufficient, and the respondents suggested potential improvements to facilitate the exclusion process, increase utilisation and reduce gamblers' breaching VSE. Representatives of the gambling industry also emphasised the individual's responsibility. Conclusions: Individuals with gambling disorder require effective VSE programmes to cope with their addictive behaviour. To effectively reduce breaches, technical and legal solutions are necessary. This includes access controls based on complete nationwide registries, strict enforcement and preventing excluded gamblers from accessing unlicensed online operators. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion We aimed to assess: (i) trends in alcohol‐specific — that is, fully attributable — morbidity and mortality in the German adult population aged 15–69 between 2000 and 2021; and (ii) changes in alcohol‐attributable disease burden — that is, fully and partially alcohol‐attributable categories — for 2006, 2012, 2018 and 2021.Morbidity data was pulled from hospitalisation and rehabilitation statistics and mortality data was pulled from the causes of death registry. Alcohol use, adjusted for unrecorded consumption, was estimated using the Epidemiological Survey of Substance Abuse and triangulated with per capita consumption from annual sales data. For major disease categories, alcohol‐attributable fractions were estimated for males and females by age groups (15–29, 30–49, 50–69 years) using the comparative risk assessment methodology.For males and females, the age‐standardised rate of alcohol‐specific morbidity peaked in 2012 and decreased thereafter showing a steep decline from 2019 to 2021. The rates of alcohol‐specific mortality decreased constantly from 2000 to 2019 but increased from 2019 to 2021. Compared to 2006 the age‐standardised alcohol‐attributable morbidity and mortality rates in males and females were lower in 2021. For both sexes, the age‐standardised alcohol‐attributable morbidity and mortality rates and the proportions of morbidity/mortality rates relative to all‐cause morbidity/mortality decreased between 2006 and 2021.The declines in alcohol‐attributable morbidity and mortality are in line with decreases in consumption and signal that the importance of alcohol in health service utilisation and mortality has weakened. Sex ratios in morbidity and mortality do not indicate a strong converging trend. [ABSTRACT FROM AUTHOR]

Background: In Germany, most individuals with alcohol dependence are recognized by the health care system and about 16% per year receive addiction-specific care. This paper aimed to analyze the prevalence and treatment utilization rate of people with alcohol dependence by type of addiction-specific care in the federal state of Bremen using routine and survey data. Methods: The number of individuals with alcohol dependence was estimated using data from the 2018 Epidemiological Survey of Substance Abuse (ESA). Furthermore, linked routine data of two statutory health insurances (SHIs), the German pension insurance (GPI), and the communal hospital group Gesundheit Nord - Bremen Hospital Group (GeNo), from 2016/2017, were analyzed. Based on SHI data, the administrative prevalence of various alcohol-related diagnoses according to the International Classification of Diseases (ICD-10), in various treatment settings, was extrapolated to the total population of Bremen. Based on all routine data sources, treatment and care services for individuals with alcohol dependence were also extrapolated to Bremen's total population. Care services included outpatient addiction care visits and addiction-specific treatments, [i.e., qualified withdrawal treatment (QWT), outpatient pharmacotherapy as relapse prevention, and rehabilitation treatment]. Results: Of the survey-estimated 15,792 individuals with alcohol dependence in Bremen, 72.6% (n = 11,467) had a diagnosis documented with an ICD-10 code for alcohol dependence (F10.2) or withdrawal symptoms (F10.3-F10.4). One in ten individuals with alcohol dependence (n = 1,689) used one or more addiction-specific care services during the observation period. Specifically, 4.3% (n = 675) received outpatient addiction care, 4.7% (n = 736) initiated QWT, 0.8% (n = 133) received pharmacotherapy, and 3.9% (n = 614) underwent rehabilitation treatment. The share of seeking addiction-specific treatment after diagnosis was highest among younger and male patients. Conclusion: Although more than half of the individuals with alcohol dependence are documented in the health system, utilization rates of addiction-specific treatments are low. These low utilization rates suggest that there are existing barriers to transferring patients with alcohol dependence into addiction-specific care. Strengthening primary medical care provision in dealing with alcohol-related disorders and improving networking within the addiction support system appear to be particularly appropriate. [ABSTRACT FROM AUTHOR]

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Background and aims: Sweden has experienced a substantial decrease in adolescent drinking over the past decades. Whether the reduction persists into early adulthood remains unclear. Using survey data, the present study aimed to determine whether reductions in indicators of alcohol use observed among adolescents remain in early adulthood and whether changes in alcohol intake are consistent among light/moderate and heavy drinkers. Design: Data from the Swedish monthly Alcohol Monitoring Survey (2001–20) were used to construct five 5‐year birth cohorts (1978–82, 1983–87, 1988–92, 1993–97 and 1998–2002). Setting: Sweden. Participants: A total of n = 52 847 respondents (48% females) aged 16 and 30 years were included in this study. Measurements For both males and females, temporal changes in the prevalence of any drinking, the prevalence of heavy episodic drinking (HED) and total alcohol intake in the past 30 days in centilitres were analysed. Findings The prevalence of any drinking in more recent cohorts remained low until young people came into their early (females) and mid‐ (males) 20s. Male cohorts differed in the prevalence of HED across age, with the later cohorts showing lower odds than earlier cohorts (odds ratios between 0.54 and 0.66). Among females, no systematic differences between cohorts across age could be observed. Later male birth cohorts in light/moderate drinkers had lower alcohol intake than earlier cohorts (correlation coefficients between −0.09 and −0.54). No statistically significant cohort effects were found for male heavy drinkers. Although differences in alcohol intake among females diminished as age increased, the cohorts did not differ systematically in their level of alcohol intake. Conclusions: In Sweden, the reduced uptake of drinking in adolescents appears to fade as people move into adulthood. Observed reductions in alcohol intake among light and moderate drinkers appear to persist into adulthood. More recent male cohorts show a lower prevalence rate of heavy episodic drinking. [ABSTRACT FROM AUTHOR]

Aims: To measure the current trends of cannabis use in Germany, measure trends in the proportion of heavy cannabis users and estimate future cannabis use rates. Design: Repeated waves of the Epidemiological Survey on Substance Abuse, a cross‐sectional survey conducted between 1995 and 2021 with a two‐stage participant selection strategy where respondents completed a survey on substance use delivered through the post, over the telephone or on‐line. Setting: Germany. Participants/cases: German‐speaking participants aged between 18 and 59 years living in Germany who self‐reported on their cannabis use in the past 12 months (n = 78 678). With the application of a weighting scheme, the data are nationally representative. Measurements Questions on the frequency of cannabis use in the past 12 months and self‐reported changes in frequency of use due to the COVID‐19 pandemic. Findings The prevalence of past 12‐month cannabis users increased from 4.4% [95% confidence interval (CI) = 3.7, 5.1] in 1995 to 10.0% (95% CI = 8.9, 11.3) in 2021. Modeling these trends revealed a significant increase that accelerated over the past decade. The proportion of heavy cannabis users [cannabis use (almost) daily or at least 200 times per year] among past‐year users has remained steady from 1995 (11.4%, 95% CI = 7.7, 16.5) to 2018 (9.5%, 95% CI = 7.6, 11.9), but significantly increased to 15.7% (95% CI = 13.1, 18.8) in 2021 during the COVID‐19 pandemic. Extrapolating from these models, the prevalence of 12‐month cannabis users in 2024 is expected to range between 10.4 and 15.0%, while the proportion of heavy cannabis users is unclear. Conclusions: Trends from 1995 to 2021 suggest that the prevalence of past 12‐month cannabis users in Germany will continue to increase, with expected rates between 10.4 and 15.0% for the German‐speaking adult population, and that at least one in 10 cannabis users will continue to use cannabis heavily (almost daily or 200 + times in the past year). [ABSTRACT FROM AUTHOR]