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Treatment options for alcohol use disorders (AUDs) have minimally advanced since 2004, while the annual deaths and economic toll have increased alarmingly. Phosphodiesterase type 4 (PDE4) is associated with alcohol and nicotine dependence. PDE4 inhibitors were identified as a potential AUD treatment using a bioinformatics approach. We prioritized a newer PDE4 inhibitor, apremilast, as ideal for repurposing (i.e., FDA approved for psoriasis, low incidence of adverse events, excellent safety profile) and tested it using multiple animal strains and models, as well as in a human phase IIa study. We found that apremilast reduced binge-like alcohol intake and behavioral measures of alcohol motivation in mouse models of genetic risk for drinking to intoxication. Apremilast also reduced excessive alcohol drinking in models of stress- facilitated drinking and alcohol dependence. Using site-directed drug infusions and electrophysiology, we uncovered that apremilast may act to lessen drinking in mice by increasing neural activity in the nucleus accumbens, a key brain region in the regulation of alcohol intake. Importantly, apremilast (90 mg/d) reduced excessive drinking in non-treatment-seeking individuals with AUD in a double-blind, placebo-controlled study. These results demonstrate that apremilast suppresses excessive alcohol drinking across the spectrum of AUD severity., Introduction Alcohol use disorder (AUD) is a complex psychiatric disease with far reaching impacts on society, including more than 95,000 associated deaths annually in the United States and a net [...]

Evidence supports the hypothesis that adolescent peer groups play a significant role in the genesis of youth antisocial behavior. A longstanding interest in research focused on individual differences in teen exposure to deviant peer groups is the notion that high-risk youth aggregate because of their common rejection within social contexts, such as the school environment. Snijders and colleagues developed a statistical modeling methodology, SIENA, for retaining advantages of network methodology while addressing these challenges. In this article, the authors present an empirical exploration of peer network mechanisms that encourage antisocial behavior in early adolescents. The authors apply SIENA to test a set of specific hypotheses derived from the social learning-based account of antisocial deviant peer processes. These deviant peer processes include: (1) Youth at risk for antisocial behavior tend to affiliate differentially with each other (selection); and (2) These affiliations then increase the risk for higher frequency and severity of such behavior (influence). (Contains 2 tables.)

An important step in reducing health disparities among racial and ethnic minorities with substance use disorders involves identifying interventions that lead to successful recovery outcomes for this population. The current study evaluated outcomes of a community-based recovery support program for those with substance use disorders. Participants included 632 residents of recovery homes in three states in the US. A multi-item recovery factor was found to increase over time for these residents. However, rates of improvement among Black individuals were higher than for other racial/ethnic groups. Black Americans perhaps place a higher value on communal relationships relative to all other racial/ethnic groups, and by adopting such a communitarian perspective, they might be even more receptive to living in a house that values participation and involvement. The implications of these findings for health disparities research are discussed. [ABSTRACT FROM AUTHOR]

Recovery homes may facilitate individuals with substance use disorders re-integration back into community settings by providing friendship, resources, and advice. Participants of the current study were over 600 residents of 42 Oxford House recovery homes. Findings indicated that willingness to share resources in the form of loans was associated with higher levels of house involvement in recovery home chapters. Active involvement in house and community affairs may influence more recovery within homes or may be an indicator of houses with residents with more capacities and skills for positive long-term health outcomes. Such findings suggest that recovery is a dynamic process with multiple ecological layers embedding individuals, their immediate social networks, and the wider community. [ABSTRACT FROM AUTHOR]

Recovery homes in the US provide stable housing for over 250,000 individuals with past histories of homelessness, psychiatric comorbidity and criminal justice involvement. We need to know more about how these settings help those who remain in recovery. Our study measured advice seeking and willingness-to-loan relationships, and operationalized them as a dynamic multiplex social network—multiple, simultaneous interdependent relationships—that exist within 42 Oxford House recovery homes over time. By pooling relationship dynamics across recovery houses, a Stochastic Actor-Oriented Modeling (SAOM) framework was used to estimate a set of parameters governing the evolution of the network and the recovery attributes of the nodes simultaneously. Findings indicated that advice and loan relationships and recovery-related attitudes were endogenously interdependent, and these results were affected exogenously by gender, ethnicity, and reason for leaving the recovery houses. Prior findings had indicated that higher advice seeking in recovery houses was related to higher levels of stress with more negative outcomes. However, the current study found that recovery is enhanced over time if advice was sought from residents with higher recovery scores. Our study shows that social embedding, i.e., one's position in relationship networks affects recovery prospects. More specifically, the formation of ties with relatively more recovered residents is an important predictor of better outcomes. [ABSTRACT FROM AUTHOR]

Objective: Heavy drinking among college students continues to be a substantial problem on campuses across the United States. Attempts to predict these drinking events have been restricted to assessments of the correlates of heavy drinking (measured at 4 or 5 drinks) and have not examined the peak drinking levels that can be fatal to students. This article presents a theoretical analysis of college drinking patterns that provides a basis for estimating peak drinking levels and predicts future risks related to peak drinking events. Method: Survey data were collected on sociodemographics and drinking patterns of 2,102 college students from two college campuses in California. A mathematical model of drinking patterns was used to characterize the stochastic distribution of drinking events among 1,273 students who drank five or more times and consumed more than one drink on some occasion since the beginning of the school year. An application of extreme value theory enabled the estimation of peak drinking levels for every college drinker. These estimates were related to self-reported maximum drinking levels and sociodemographic characteristics of respondents. Results: Among these drinkers, the distribution of self-reported maximum drinking levels ranged from 2 to 43 drinks per occasion. Estimated peak drinking levels ranged from 3 to 49. Maximum drinking levels were well characterized by peak drinking estimates ([R.sup.2] = 0.503). Variations in peak drinking levels were large and specifically related to particular sociodemographic groups (i.e., white male freshmen). Conclusions: The theoretical model of peak drinking events effectively characterizes maximum drinking levels among college students. High levels of peak drinking are to be expected among specific sociodemographic subgroups. These risks can be assessed on an individual basis. At the population level, risks for harm related to peak drinking events are predictable., HEAVY DRINKING among college students places them at greater risks for a variety of problem outcomes. At the highest drinking levels, these risks include alcohol overdoses and physical harm related [...]

Objective: One of the most difficult challenges confronting alcohol researchers is the assessment of specific risks associated with specific drinking levels (one, two or three or more drinks). In this article, a model-based method is presented that provides specific measures of dose, exposures and risks related to drinking and enables adequate assessment of dose-response relationships using survey data. Method: Survey data collected from 2,102 college students on drinking patterns and related problems were analyzed using a mathematical model that extracts separable measures of dose (number of drinks consumed per occasion) and exposures (numbers of occasions) for every respondent. A constrained class of quadratic risk models was estimated that relates units of exposure at each dose (e.g., number of occasions drinking five drinks) to problem outcomes (e.g., number of hangovers). The resulting dose-response functions provided an estimate of the rate of problems produced on each occasion of drinking at a given drinking level. Population risks were estimated by reintegrating dose response with the population distribution of drinking exposures. Results: The distribution of drinking exposures among college drinkers was markedly peaked at a modal dose of two drinks, with variations in light and heavy drinking between demographic groups. Multivariate analyses showed that relative rates of heavier drinking were greatest among white male freshmen and unrelated to residential settings. Most drinking problems showed a marked dose-response relationship to drinking levels. Population risks, however, were typically unimodal, with many problems reported at moderate drinking levels (two or three drinks). Conclusions: Distributed across a large number of drinkers and drinking occasions, problems reported by students occurred most often at moderate drinking levels (two to three drinks). Nevertheless, heavier drinking remained substantively related to many drinking problems. These observations encourage a view of college drinking that supports interventions related to both moderate and heavy drinking., THOSE NEW TO ALCOHOL RESEARCH are often surprised, if not shocked, to learn that there are a number of competing measures of alcohol consumption available, and that opinions differ over [...]

Some recovery homes have facilitating relationships and organizational characteristics, and there are also social capital differences among residents of these recovery homes. It is important to better understand the impact of protective and risk individual and house factors on recovery issues among residents of these community-based settings. Individuals from 42 recovery homes were followed for up to six data collection periods over two years. House level latent class analyses tapped relationship and organizational domains and individual level latent class analyses were from derived from elements of recovery capital. Houses that manifested protective factors provided most residents positive outcomes, except those with elevated self-esteem. Houses that were less facilitating had more negative exits, except for those residents who were the highest functioning. Both individual and house characteristics are of importance in helping to understand risk factors associated with eviction outcomes for residents in recovery homes. [ABSTRACT FROM AUTHOR]

Oxford Houses (OHs) are a large network of self‐run community‐based settings for individuals with substance use disorders. This present study explored a model based on conceptualizing recovery home social systems as dynamic multirelational (multiplex) social networks. The model is developed from data obtained from 42 OH recovery homes in three parts of the US, addressing whole networks of friendship, close friendship, and willingness to loan money. Findings indicated that close friend and loan relationships mutually reinforced each other over time as they coevolved. These types of insights can help community psychologists to better understand complex network dynamics in community‐based settings. [ABSTRACT FROM AUTHOR]

Genetic and environmental factors affect alcohol use and dependence, with the impact of genetic risk factors being greater for men than for women. Environmental exposure to alcoholism during childhood and a family history of alcoholism are associated with a higher risk of alcohol dependence for both current and former drinkers. There is an absence of interaction between genetic and environmental factors for both sexes.

The purpose of this study is to contribute to the literature on the prediction of substance use relapse, using sophisticated systems' approaches to individuals and their contexts. In the current study of 42 recovery homes, we investigated the construct of social capital from the perspective of both recovery home residents and the house level. A confirmatory factor analysis found a latent recovery factor (including elements of recovery capital, comprising resources such as wages, self‐efficacy, stress, self‐esteem, quality of life, hope, sense of community, and social support) at both the individual and the recovery house level. Next, using longitudinal data from homes, an individual's probability of relapse was found to be related to house rather than individual‐level latent recovery scores. In other words, an individual's probability of relapse was primarily related to the average of the "recoveries" of his or her recovery home peers, and not of his or her own personal "recovery" status. The finding that resident relapse is based primarily upon the total recovery capital available in the homes highlights the importance of the social environment for recovery. Highlights: House level factors predicted relapse. Individual level factors did not predict relapse.Residents status in recovery homes is based upon the total recovery capital available in homes.Recovery is strongly influenced by others with whom the recovering person has regular social contact.Individual's probability of relapse was primarily related to the "recoveries" of home peers.Recovery capital available in homes highlights the importance of the social environment for recovery. [ABSTRACT FROM AUTHOR]