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Addressing the limited access to treatments for alcohol dependence, we developed ALM-002, a therapeutic application to be "prescribed" for non-abstinence-oriented treatment in internal medicine settings. Our objective was to preliminarily assess the efficacy and safety of ALM-002. In a multicenter, open-label randomized controlled trial, participants aged ≥20 with alcohol dependence and daily alcohol consumption exceeding 60 g for men and 40 g for women, without severe complications, were randomly assigned to either the intervention group using ALM-002 or the treatment-as-usual control group. Participant in both groups received individual face-to-face sessions by physicians at weeks 0, 4, 8, and 12. The primary endpoint was the change in heavy drinking days (HDDs) from week 0 to week 12. A mixed model for repeated measures was employed. We enrolled 43 participants: 22 in the intervention group and 21 in the control group. A significant reduction in HDDs every 4 weeks from week 0 to week 12 was observed, with a between-group difference of −6.99 days (95% CI: −12.4 to −1.6 days, standardized mean difference: −0.80). These results indicate the potential of ALM-002 as a viable treatment for alcohol dependence. Further studies are needed to evaluate the clinical potential of ALM-002. [ABSTRACT FROM AUTHOR]

Background: Rates of alcohol and/or substance use (ASU) among residents of predominantly Black and marginalized communities are similar to ASU rates in White communities. Yet ASU has worse consequences in predominantly Black and marginalized communities (e.g., higher incarceration). Objective: We randomized participants to one of 16 intervention conditions using a 24 full factorial design to optimize a multilevel intervention reducing ASU among 602 formerly incarcerated men with substance-use-disorders (SUD). Candidate intervention components included (1) critical dialogue (CD; six weekly 2-hour-long group sessions vs. no CD sessions), (2) Quality of Life Wheel (QLW; six weekly 1-hour-long group sessions vs. no QLW sessions), (3) capacity building projects (CBP; six weekly 1-hour-long group sessions vs. no CBP sessions), and (4) delivery by a trained peer versus licensed facilitators. Outcome was percentage of days in which participants used alcohol, cocaine, opioid, and/or cannabis in previous 30 days. Results: Intent-to-treat analysis did not meet a priori component selection criteria due to low intervention attendance. After controlling for intervention group attendance (percentage of sessions attended), peer-delivered CD and CBP produced statistically and clinically significant main and interaction effects in ASU over 5 months. Per the multiphase optimization strategy framework, we selected peer-delivered CD and CBP for inclusion as the optimized version of the intervention with a cost of US$1,380 per 10 individuals. No adverse intervention effects occurred. Conclusion: CD and CBP were identified as the only potentially effective intervention components. Future research will examine strategies to improve attendance and test the optimized intervention against standard of care in a randomized-controlled-trial. [ABSTRACT FROM AUTHOR]

Objective: Research shows that personal relevance may affect the impact of alcohol-related health information. This study explored alcohol consumption during the UK Covid-19 lockdown, and whether a message emphasising the effect of alcohol on the immune system was more effective in altering intentions to follow low-risk drinking guidelines than other messages about the effects of alcohol on health. Methods & Measures: From April to June 2020, 953 drinkers completed an online questionnaire, and were randomly allocated to exposure to a control condition or one of three messages emphasising the impact of alcohol on: the immune system; mental health; or physical health. Outcome variables were: concern about alcohol intake, and intention to adhere to low-risk drinking guidelines. Results: Pre-post ANCOVAs revealed that participants in the immunity message group had significantly stronger intention to adhere to low-risk guidelines than the control group (after controlling for initial intention). Concern for the effect of alcohol on health was not significantly affected. Conclusion: During Covid-19 lockdown, a message emphasising the impact of alcohol on the immune-system had a greater effect on intention to observe low-risk drinking guidelines than other messages. Contextually relevant messages could be used for alcohol health campaigns and for improving alcohol labelling. [ABSTRACT FROM AUTHOR]

The present study examined young adults' completion of the Web-based intervention content in a randomized trial that tested two Personalized Feedback Interventions (PFIs) for alcohol use and risky sex behavior (RSB). Data are from a study that evaluated efficacy of two Web-delivered PFIs (combined PFI and integrated PFI) among 269 sexually active young adults between the ages of 18 and 25. We described the view patterns of the Web-based intervention and examined if baseline sociodemographic and alcohol- and sex-related behavioral factors were associated with the completion of PFI. Many participants viewed the intervention more than one time, and the majority finished all intervention pages in at least one session. Older participants and participants who drink more frequently prior to or during sex were more likely to complete. Most participants, especially the young adults who were at higher risk, utilized the intervention contents as intended. [ABSTRACT FROM AUTHOR]

This study experimentally investigated the effect of dogmatic and suggestive language in Christian-sourced excessive alcohol consumption messages among college-aged participants who identify as Christians or non-Christians, as well as the role of perceived similarity with the message source, on their self-reported freedom-threat, psychological reactance, and behavioral intentions to consume alcohol. The results from this study support psychological reactance theory and demonstrate the various message strategies to effectively communicate the negative health effects of excessive alcohol consumption to individuals who identify either as Christians or non-Christians. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the drinking patterns of older adults and what influences them • To gauge how to approach the subject of alcohol misuse with older adults in your care • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Older adulthood is a unique time of transition often referred to as the ‘golden years’. It is characterised by positive life experiences such as retirement but also by a loss of routine, identity and meaning. The literature identifies alcohol misuse as a growing issue in this population. However, the stigma, perceptions and patterns of drinking associated with alcohol misuse among older people can be a barrier to individuals seeking health advice. This article identifies that older adulthood is a period when nurses can offer health education and support using their unique relationships with patients to encourage healthy drinking behaviours. [ABSTRACT FROM AUTHOR]

Background: South Africa has the highest rate of fetal alcohol spectrum disorders (FASD) globally. As with alcohol use during pregnancy, alcohol consumption while breastfeeding adversely impacts infant development. We pilot tested an incentive‐based text‐messaging intervention to reduce alcohol use during pregnancy and lactation in South Africa. Methods: A single‐arm pilot trial was conducted over 3 months in healthcare facilities in Cape Town, South Africa. Pregnant and breastfeeding participants tested positive for recent alcohol use by urinalysis. The three‐month intervention had two components, contingency management of alcohol abstinence confirmed by urinalysis twice weekly and weekly health‐related text messaging from an evidence‐based brief intervention. We collected twice weekly urine samples for measurement of ethyl glucuronide (EtG), an alcohol biomarker, and measures of self‐reported alcohol and drug use, violence exposure, and mental health at six weeks and three months post‐enrollment. Results: Sixty participants were enrolled, of whom 31 were pregnant and 29 lactating. The number of days with four or more drinks in the past month decreased from 9 days at baseline, on average, to 1–3 days (p‐value range: 0.144–0.010) at follow‐up timepoints. There were statistically significant increases in the proportions of participants with alcohol‐negative urine tests (p < 0.001). The percentages of participants breastfeeding while using alcohol decreased from baseline to the end of 3 months in the overall sample and among those enrolled postpartum, though these were not significant (p‐value range: 0.255–0.147). Maternal depression scores also decreased among participants enrolled postpartum (p = 0.054). Emotional abuse by the main partner, but neither physical nor sexual abuse, significantly decreased at both follow‐ups in the overall sample (p = 0.032) and among participants enrolled while pregnant (p = 0.015). Conclusions: This study is among the first to pilot test an incentive‐based text‐messaging intervention for maternal alcohol use and other outcomes such as depression and violence exposure. Further testing is warranted in a well‐powered, randomized controlled trial. [ABSTRACT FROM AUTHOR]

Rural Appalachian adolescents are disproportionately affected by alcohol misuse, depression, and mortality rates. Disparities in Appalachia influence national health indicators and the social determinants of health, which may lead to marginalization and vulnerability to poorer health outcomes. Geographic and social isolation often results in missed opportunities for preventative and mental health care. There are an estimated 35% fewer mental health providers in rural areas to deal with these issues. This article examines the influence of marginalization on rural Appalachian adolescents. A case example was used to describe rural Appalachian adolescent alcohol misuse within the context of the Triple Threat for Marginalization, utilizing conversation within a natural setting. Marginalization contributes to alcohol misuse and adverse health outcomes. Nurses must advocate for marginalized rural adolescent patients to decrease alcohol misuse, depression, and mortality rates in this vulnerable population. [ABSTRACT FROM AUTHOR]

Aims: From 1 January 2018, the number of retail hours for the sale of alcohol was reduced from 14 to 5 hours on Sundays and from 14 to 10 hours on the other days of the week in Lithuania. The significant reduction of hours for the sale of alcohol on Sundays may have affected the distribution of alcohol-attributable deaths during the week. This study aimed to examine the change in the weekly pattern of alcohol-attributable male mortality before and after imposing limits on the hours when alcohol can be sold. Methods: Age-standardised male death rates by days of the week were calculated for four groups according to cause of death: alcohol poisoning (X45), all external causes of death (V01–Y98), diseases of the circulatory system (I00–I99) and all other causes of death. We compared age-standardised death rates for two periods: before (2015–2017) and after (2018–2019) the intervention. Mortality and population data were obtained from the Lithuanian Institute of Hygiene and Human Mortality Database. Results: We found that during 2018–2019, earlier observed peak in age-standardised death rates for external causes of death on Sunday diminished, and this day no longer differed from the weekly average. The same tendency was also observed for the Monday excess mortality due to circulatory diseases. Conclusions: The reduction of the hours when alcohol can be sold from the beginning of 2018 was associated with a change in a weekly pattern of alcohol-attributable male mortality. However, more studies are needed to examine the causes of the change in mortality pattern. [ABSTRACT FROM AUTHOR]

In Sub-Saharan Africa, efficacy trials of brief interventions to reduce unhealthy drinking among persons living with HIV (PLWH) have yielded mixed results. A better understanding of the perceptions of drinking, especially by PLWH, and how drinking is talked about at HIV treatment clinics in this setting, may guide more optimal designs for future trials. We conducted a qualitative study at an HIV treatment clinic in South Western Uganda to better understand perceptions of drinking, how drinking is talked about, and perceptions of interventions, especially a protocolled screening and brief intervention (SBI) for unhealthy drinking among PLWH. We conducted in-depth interviews with 17 PLWH who engaged in unhealthy drinking and 6 health workers, and one focus group discussion with 3 community advisory-board members. We performed manual preliminary data analysis and computer-assisted detailed thematic analysis to identify emergent themes. Four themes emerged: perceptions of alcohol use in the general population; perceptions of alcohol use in PLWH; interaction between PLWH and health workers about alcohol use; perceptions of interventions for unhealthy drinking including SBI. Unhealthy drinking was seen as a problem in the general population and among those with HIV, where it was negatively perceived. Communication about drinking was done by counselors, but doctors participated in screening for unhealthy alcohol use. Messages about drinking covered reduction and abstinence. Participants expressed positive attitudes towards SBI and preference for person-delivered SBI over technological alternatives. A protocolled SBI for unhealthy alcohol use among PLWH would be well-received but successful implementation may depend on mode of delivery. [ABSTRACT FROM AUTHOR]

Background and aims: Pre‐clinical studies suggest that the simultaneous blockade of the α1b and 5HT2A receptors may be effective in reducing alcohol consumption. This study aimed to assess the efficacy and safety of prazosin (α1b blocker) and cyproheptadine (5HT2A blocker) combination in decreasing total alcohol consumption (TAC) in alcohol use disorder (AUD). Design, setting and participants: This was a double‐blind, parallel group, placebo‐controlled, Phase 2, randomized clinical trial conducted in 32 addiction treatment centres in France. A total of 108 men and 46 women with severe AUD took part. Intervention: Participants were randomly assigned to one of the following 3‐month treatments: (1) low‐dose group (LDG) receiving 8 mg cyproheptadine and 5 mg prazosin extended‐release (ER) formulation daily; (2) high‐dose group (HDG) receiving 12 mg cyproheptadine and 10 mg prazosin ER daily; and (3) placebo group (PG) receiving placebo of cyproheptadine and prazosin ER. A total of 154 patients were randomized: 54 in the PG, 54 in the LDG and 46 in the HDG. Measurements The primary outcome was TAC change from baseline to month 3. Findings: A significant main treatment effect in the change in TAC was found in the intent‐to‐treat population (P = 0.039). The HDG and LDG showed a benefit in the change in TAC from baseline to month 3 compared with PG: −23.6 g/day, P = 0.016, Cohen's d = −0.44; −18.4 g/day, P = 0.048 (Bonferroni correction P < 0.025), Cohen's d = −0.36. In a subgroup of very high‐risk drinking‐level participants (> 100 g/day of pure alcohol for men and > 60 g/day for women), the difference between the HDG and the PG in the primary outcome was −29.8 g/day (P = 0.031, Cohen's d = −0.51). The high and low doses were well‐tolerated with a similar safety profile. Conclusions: A randomized controlled trial of treatment of severe alcohol use disorder with a cyproheptadine−prazosin combination for 3 months reduced drinking by more than 23 g per day compared with placebo. A higher dose combination was associated with a larger magnitude of drinking reduction than a lower dose combination while showing similar safety profile. [ABSTRACT FROM AUTHOR]

The purpose of this randomized controlled trial (Trial registration ID: redacted) was to examine the feasibility, acceptability, and efficacy of the Step One program, an SMS-based alcohol intervention for same-sex attracted women (SSAW). Ninety-seven SSAW who scored ≥8 on the Alcohol Use Disorders Identification Test (AUDIT) were randomly allocated to receive the Step One program (n = 47; mean age = 36.79) or a weekly message containing a link to a website with health information and support services for LGBT individuals (n = 50; mean age = 34.08). Participants completed questionnaires on alcohol use, wellbeing, and help-seeking at baseline (T1), intervention completion (T2; 4 wk after baseline) and 12 wk post-intervention (T3). In addition, participants in the intervention condition completed feasibility and accessibility measures at T2, and a subsample (n = 10) was interviewed about acceptability at T3. Across conditions, participants significantly reduced their alcohol intake and improved their wellbeing and help-seeking over time. However, there were no significant differences between the intervention and control condition. Furthermore, frequency of help-seeking was low; only four intervention group participants and three control group participants began accessing support between T1 and T3. Overall, our findings indicate the intervention would benefit from revision prior to implementation. Our approach was consistent with best practice in the development of an ecologically valid intervention; however, this intervention, in its current form, lacks the complexity desired by its users to optimally facilitate alcohol reduction among SSAW. Keywords: Alcohol intervention; Intervention mapping framework; Randomized controlled trial (RCT); Same-sex attracted women; Short-message service (SMS). [ABSTRACT FROM AUTHOR]

We evaluated the feasibility, acceptability, and preliminary efficacy of an economic and relationship-strengthening intervention to reduce heavy alcohol use among couples living with HIV in Malawi (Mlambe). Mlambe consisted of training on financial literacy and relationship skills, combined with 1:1 matched savings accounts to invest in an income-generating activity. In a randomized controlled trial, we compared Mlambe to enhanced usual care (EUC). We enrolled 78 married couples having a partner on antiretroviral therapy (ART) who reported heavy alcohol use based on the AUDIT-C. Using targets of 75%, primary outcomes included retention rates at 10 and 15-months, session attendance rates, and satisfaction with Mlambe. Exploratory outcomes were heavy alcohol use (AUDIT-C and/or PEth positive), number of drinking days in the past month, AUDIT-C score, optimal adherence to ART (95% or higher), and viral suppression. We exceeded our targets for feasibility and acceptability metrics. Retention rates were 96% at 15-months. Session attendance and satisfaction levels were both 100%. From baseline to 15-months, Mlambe participants reported decreases in mean number of drinking days (from 6.8 to 2.1) and AUDIT-C scores (from 7.5 to 3.1); while ART adherence rates improved across the same period (from 63.2 to 73.9%). Participants in Mlambe, as compared to those in EUC, had lower rates of heavy alcohol use (89.5% vs. 97.2%) and higher rates of viral suppression (100% vs. 91.9%) at 10-months. Differences between arms were not statistically significant in this small pilot study. Mlambe was highly feasible and acceptable, and shows promise for reducing heavy alcohol use and viral non-suppression among couples with HIV in a larger efficacy study. [ABSTRACT FROM AUTHOR]

The recent Federal Trade Commission (FTC) and Department of Justice (DOJ) action against Monument Inc. for selling patient data, is just the tip of the iceberg. Monument Inc. positions itself as a treatment provider (the website home page says it provides "therapy" for alcoholism) but in its extensive terms of use, it says it is not a treatment provider. And in fact, since the FTC/DOJ action this spring, Monument radically changed its website, removing the offending promise of "confidentiality" which it breached, but still selling services (lowest price $15/month). [ABSTRACT FROM AUTHOR]

Background: Enhanced liver fibrosis (ELF) score is an accurate, noninvasive test for assessing the severity of liver fibrosis in chronic liver disease, including alcohol‐related liver disease. However, whether the ELF score changes during alcohol withdrawal is unknown. This pilot study assessed changes in the ELF score during withdrawal in patients with a history of excessive alcohol intake. Methods: In this prospective study, ELF was performed on day 0 (D0, at the beginning of hospitalization), at day 7 (D7, on discharge from hospital), and at follow‐up visits on days 30 (D30) and 90 (D90). Transient elastography (TE) was also assessed on days 4 (D4) and D30. Results: The study included 35 patients (71% male) with a mean alcohol intake of 139 g/day. On D30 and D90, 8 and 13 patients had resumed alcohol consumption (mean intake of 90 and 80 g/day, respectively). In patients who remained abstinent, the mean ELF score was 8.93 on D0, 9.14 on D30 (p = 0.32), and 9.27 on D90 (p = 0.14). In patients who resumed alcohol, mean ELF score was 9.7 on D0, 10.05 on D30 (p = 0.09), and 9.71 on D90 (p = 0.12). ELF score was comparable over the first months after withdrawal, although there was a slight increase in the first week (mean ELF score increased from 9.24 on D0 to 9.74 on D7, p < 0.001). Mean TE value was 7.9 kPa on D4 and 8.1 kPa on D30 (p = 0.84) in patients who resumed alcohol consumption, and 8.3 and 7.5 kPa (p = 0.03) on D4 and D30, respectively, in abstinent patients. Conclusion: The ELF score is stable during the first months after withdrawal and thus appears to be a useful tool to assess liver fibrosis or cirrhosis in this setting. Nevertheless, because in the first week there is a transient increase in ELF score, caution in interpretation is warranted. [ABSTRACT FROM AUTHOR]

Background: Among youth, symptoms of depression, anxiety, and alcohol use are associated with considerable illness and disability. Youth face many personal and health system barriers in accessing mental health care. Mobile applications (apps) offer youth potentially accessible, scalable, and anonymous therapy and other support. Recent systematic reviews on apps to reduce mental health symptoms among youth have reported uncertain effectiveness, but analyses based on the type of app‐delivered therapy are limited. Objectives: We conducted this systematic review with youth co‐researchers to ensure that this review addressed the questions that were most important to them. The objective of this review is to synthesize the best available evidence on the effectiveness of mobile apps for the reduction of depressive symptoms (depression, generalized anxiety, psychological distress) and alcohol use among youth. Search Methods: We conducted electronic searches of the following bibliographic databases for studies published between January 1, 2008, and July 1, 2022: MEDLINE (via Ovid), Embase (via Ovid), PsycINFO (via Ovid), CINAHL (via EBSCOHost), and CENTRAL (via the Cochrane Library). The search used a combination of indexed terms, free text words, and MeSH headings. We manually screened the references of relevant systematic reviews and included randomized controlled trials (RCTs) for additional eligible studies, and contacted authors for full reports of identified trial registries or protocols. Selection Criteria: We included RCTs conducted among youth aged 15–24 years from any setting. We did not exclude populations on the basis of gender, socioeconomic status, geographic location or other personal characteristics. We included studies which assessed the effectiveness of app‐delivered mental health support or therapy interventions that targeted the management of depressive disorders and/or alcohol use disorders. We excluded apps that targeted general wellness, apps which focused on prevention of psychological disorders and apps that targeted bipolar disorder, psychosis, post‐traumatic stress disorder, attention‐deficit hyperactivity disorder, substance use disorders (aside from alcohol), and sleep disorders. Eligible comparisons included usual care, no intervention, wait‐list control, alternative or controlled mobile applications. We included studies which reported outcomes on depressive symptoms, anxiety symptoms, alcohol use and psychological distress over any follow‐up period. Data Collection and Analysis: We standardized the PICO definitions (population, intervention, comparison, and outcome) of each included study and grouped studies by the type of therapy or support offered by the app. Whenever app design and clinical homogeneity allowed, we meta‐analyzed outcomes using a random‐effects model. Outcome data measured using categorical scales were synthesized using odds ratios. Outcome data measured using continuous scales were synthesized as the standardized mean difference. We assessed the methodological quality of each included study using the Cochrane Risk of Bias 2.0 tool and we assessed certainty of the evidence using the GRADE approach. Main Results: From 5280 unique citations, we included 36 RCTs published in 37 reports and conducted in 15 different countries (7984 participants). Among the 36 included trials, we assessed two with an overall low risk of bias, 8 trials with some concern regarding risk of bias, and 26 trials with a high risk of bias. Interventions varied in the type of therapy or supports offered. The most common intervention designs employed mindfulness training, cognitive behavioral therapy (CBT), or a combination of the two (mindfulness + CBT). However, other interventions also included self‐monitoring, medication reminders, cognitive bias modification or positive stimulation, dialectical behavioral therapy, gamified health promotion, or social skill building. Mindfulness apps led to short term improvements in depressive symptoms when compared to a withheld control (SMD = −0.36; 95% CI [−0.63, −0.10]; p = 0.007, n = 3 RCTs, GRADE: very low certainty) and when compared to an active control (SMD = −0.27; 95% CI [−0.53, −0.01]; p = 0.04, n = 2 RCTs, GRADE: very low). Apps delivering this type of support also significantly improved symptoms of anxiety when compared to a withheld control (SMD = −0.35; 95% CI [−0.60, −0.09]; p = 0.008, n = 3 RCTs, GRADE: very low) but not when compared to an active control (SMD = −0.24; 95% CI [−0.50, 0.02]; p = 0.07, n = 2 RCTs, GRADE: very low). Mindfulness apps showed improvements in psychological stress that approached statistical significance among participants receiving the mindfulness mobile apps compared to those in the withheld control (SMD = −0.27; 95% CI [−0.56, 0.03]; p =.07, n = 4 RCTs, GRADE: very low). CBT apps also led to short‐term improvements in depressive symptoms when compared to a withheld control (SMD = −0.40; 95% CI [−0.80, 0.01]; p = 0.05, n = 2 RCTs, GRADE: very low) and when compared to an active control (SMD = −0.59; 95% CI [−0.98, −0.19]; p = 0.003, n = 2 RCTs, GRADE: very low). CBT‐based apps also improved symptoms of anxiety compared to a withheld control (SMD = −0.51; 95% CI [−0.94, −0.09]; p = 0.02, n = 3 RCTs, GRADE: very low) but not when compared to an active control (SMD = −0.26; 95% CI [−1.11, 0.59]; p = 0.55, n = 3 RCTs, GRADE: very low). Apps which combined mindfulness and CBT did not significantly improve symptoms of depression (SMD = −0.20; 95% CI [−0.42, 0.02]; p = 0.07, n = 2 RCTs, GRADE: very low) or anxiety (SMD = −0.21; 95% CI [−0.49, 0.07]; p = 0.14, n = 2 RCTs, GRADE: very low). However, these apps did improve psychological distress (SMD = −0.43; 95% CI [−0.74, −0.12]; p = 0.006, n = 2 RCTs, GRADE: very low). The results of trials on apps to reduce alcohol use were inconsistent. We did not identify any harms associated with the use of apps to manage mental health concerns. All effectiveness results had a very low certainty of evidence rating using the GRADE approach, meaning that apps which deliver therapy or other mental health support may reduce symptoms of depression, anxiety and psychological distress but the evidence is very uncertain. Authors' Conclusions: We reviewed evidence from 36 trials conducted among youth. According to our meta‐analyses, the evidence is very uncertain about the effect of apps on depression, anxiety, psychological distress, and alcohol use. Very few effects were interpreted to be of clinical importance. Most of the RCTs were small studies focusing on efficacy for youth at risk for depressive symptoms. Larger trials are needed to evaluate effectiveness and allow for further analysis of subgroup differences. Longer trials are also needed to better estimate the clinical importance of these apps over the long term. [ABSTRACT FROM AUTHOR]

Existing measures of reasons for limiting alcohol use are over 30 years old or don't distinguish between limiting drinking/abstinence and limiting heavy drinking. The present study describes the development and evaluation of the Reasons for Limiting Heavy Drinking (RFLHD), a 15-item measure assessing reasons to limit heavy drinking. Participants were 591 college students from two southern universities identifying primarily as White (68%) and female (82.3%) who completed the RFLHD, Protective Behavioral Strategies Survey-20, US-Alcohol Use Disorder Identification Test Consumption scale, and the Brief Young Adult Alcohol Consequences Questionnaire. Exploratory factor analyses supported a two-factor solution – Avoiding Consequences (i.e., limiting use to reduce alcohol related negative consequences) and – Personal and Other's Values (i.e., limiting use in accordance with personal, or other people's values, regarding alcohol consumption). Generally, the RFLHD was negatively correlated with measures of alcohol use measures and positively correlated with measures of alcohol harm reduction. The RFLHD displayed promising preliminary psychometric properties in this study. Harm reduction interventions aimed at the behavioral component of alcohol use may benefit from using the RFLHD to examine cognitive motivations for limiting heavy drinking. Further investigation of the RFLHD is needed to advance the measure. [ABSTRACT FROM AUTHOR]

Heavy drinking among people living with HIV (PLWH) reduces ART adherence and worsens health outcomes. Lengthy interventions are not feasible in most HIV care settings, and patients infrequently follow referrals to outside treatment. Utilizing visual and video features of smartphone technology, we developed HealthCall as an electronic means of increasing patient involvement in a brief intervention to reduce drinking and improve ART adherence. The objective of the current study is to evaluate the efficacy of HealthCall to improve ART adherence among PLWH who drink heavily when paired with two brief interventions: the National Institute on Alcoholism and Alcohol Abuse (NIAAA) Clinician's Guide (CG) or Motivational Interviewing (MI). Therefore, we conducted a 1:1:1 randomized trial among 114 participants with alcohol dependence at a large urban HIV clinic. Participants were randomized to one of three groups: (1) CG only (n = 37), (2) CG and HealthCall (n = 38), or (3) MI and HealthCall (n = 39). Baseline interventions targeting drinking reduction and ART adherence were ~ 25 min, with brief (10–15 min) booster sessions at 30 and 60 days. The outcome was ART adherence assessed using unannounced phone pill-count method (possible adherence scores: 0–100%) at 30-day, 60-day, 3, 6, and 12 months. Analyses were conducted using generalized linear mixed models with pre-planned contrasts. Of the 114 enrolled patients, 58% were male, 75% identified as Black/African American, 28% were Hispanic, and 62% had less than a high school education. The mean age was 47.5 years (standard deviation [SD] 10 years) and the mean number of years since they were diagnosed with HIV was 18.6 (SD 7.6). Participants assigned to HealthCall to extend the CG had increased levels of ART adherence at 60-day and 6-month follow-up (compared to CG only), although there was no statistically significant difference by 12-month follow-up. Participants who were assigned to HealthCall to extend the MI never had statistically significant higher levels of ART adherence. These results suggest that the use of a smartphone app can be used to initially extend the reach of a brief drinking intervention to improve ART adherence over a short period of time; however, sustained long-term improvements in ART adherence after intervention activity ends remains a challenge. [ABSTRACT FROM AUTHOR]

Aim: Alcohol-related illnesses represent a major burden and challenge to families and pose health risks for all involved. Therefore, health promotion attempts need to focus on these vulnerable families and identify effective interventions. A systematic review was conducted of approaches to health promotion and prevention and their effectiveness for families with addiction concerns. The review focused on parental alcohol dependency. Subject and methods: A systematic search of relevant databases was conducted, followed by a multistep screening process and a narrative synthesis of results. Results: A total of 20 studies were included that evaluated 14 intervention programmes. The main target group was children with any form of fetal alcohol spectrum disorders and their caregivers. The study sample was dominated by behavioural approaches. The evidence base was heterogeneous. There was limited evidence of the effectiveness of combined counselling and coaching interventions that aimed to strengthen psychosocial resources. Conclusion: The robustness of the results is limited by the moderate methodological quality of the studies. Because of the search strategy, which focused on studies with outcomes for parents with alcohol dependence, and the systematic review methodology, almost all studies reviewed featured behavioural prevention interventions. Very few studies provided specific information on the effectiveness of interventions for alcohol-dependent parents with a focus on environmental changes. The selected approach provided a limited mapping of the field of interest. However, these review findings provide the foundation for an evidence-based approach to health promotion for families with parental alcohol dependence. [ABSTRACT FROM AUTHOR]

Aims Among individuals with alcohol use disorder (AUD), sleep disturbances are pervasive and contribute to the etiology and maintenance of AUD. However, despite increased attention toward the relationship between alcohol use and sleep, limited empirical research has systematically examined whether reductions in drinking during treatment for AUD are associated with improvements in sleep problems. Methods We used data from a multisite, randomized, controlled trial that compared 6 months of treatment with gabapentin enacarbil extended-release with placebo for adults with moderate-to-severe AUD (N  = 346). The Timeline Follow-back was used to assess WHO risk drinking level reductions and the Pittsburgh Sleep Quality Index was used to assess sleep quality over the prior month at baseline and the end of treatment. Results Sleep problem scores in the active medication and placebo groups improved equally. Fewer sleep problems were noted among individuals who achieved at least a 1-level reduction (B  = −0.99, 95% confidence interval (CI) [−1.77, −0.20], P  = .014) or at least a 2-level reduction (B  = −0.80, 95% CI [−1.47, −0.14], P  = .018) in WHO risk drinking levels at the end of treatment. Reductions in drinking, with abstainers excluded from the analysis, also predicted fewer sleep problems at the end of treatment (1-level: B  = −1.01, 95% CI [−1.83, −0.20], P  = .015; 2-level: B  = −0.90, 95% CI [−1.59, −0.22], P  = .010). Conclusions Drinking reductions, including those short of abstinence, are associated with improvements in sleep problems during treatment for AUD. Additional assessment of the causal relationships between harm-reduction approaches to AUD and improvements in sleep is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Intimate partner cyber abuse (IPCA) is a prevalent form of intimate partner violence (IPV) that has detrimental effects on victims' well-being. Although research has documented associations with other forms of IPV perpetration, additional research is needed to identify IPCA perpetration risk factors. One of the most common risk factors for offline IPV is perpetrators' alcohol use; however, less is known about how this translates to online contexts. There is also a need to identify protective factors that mitigate the effects of alcohol. Methods: This study evaluated associations between drinking, relationship satisfaction, and IPCA perpetration via self-report questionnaires within a longitudinal framework. Participants included 544 adults in an intimate relationship (n = 296 at T2). Results: Results indicated that relationship satisfaction buffered the effects of problem drinking on IPCA perpetration at T1, but not at T2. Further, 20.2% of individuals who perpetrated IPCA at T1 drank alcohol during at least one incident, and these individuals reported more problem drinking and more frequent IPCA perpetration compared to those who reported IPCA without alcohol. Conclusion: Results from this study provide insight into both risk and protective factors for IPCA perpetration among adults and have the potential to guide concurrent prevention strategies that target intersections between problem drinking, IPCA, and offline IPV, and promote healthy and satisfying intimate relationships. [ABSTRACT FROM AUTHOR]

Objective: Research shows that alcohol use is linked to suicidal ideation (SI), while depression is strongly associated with SI. Protective behavioral strategies (PBS) are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers (n = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Methods: Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Results: Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. Conclusions: PBS may be protective for heavier drinkers who are at heightened risk for SI. [ABSTRACT FROM AUTHOR]

Objective: College students report high rates of alcohol use and negative alcohol-related consequences (ARC). Many studies document that protective behavioral strategy (PBS) use is negatively associated with ARC. Few studies examine consequence severity and PBS helpfulness, both of which may provide nuance to this relationship. Participants and method: The current study used latent profile analysis to examine variability in PBS use, PBS helpfulness, ARC count, and ARC severity patterns among college students (n = 1156). We identified latent profiles and differences in alcohol use and drinking motives across profiles. Results: Three profiles best represented the data: (1) high PBS/low consequences, (2) moderate PBS/moderate consequences, (3) low PBS/high consequences. Conclusions: College students endorsing stronger drinking motives might be less likely to use and select helpful PBS and might experience more severe ARC. Results suggest that simple modifications to common measures can add depth of understanding and nuance to the examination of alcohol-related behaviors. [ABSTRACT FROM AUTHOR]

The highly heterogeneous nature of alcohol use and problems has presented significant challenges to those attempting to understand, treat or prevent what is commonly termed alcohol use disorder (AUD). However, any attempts to capture this complex phenomenon, including the various current criteria of AUD, come with a number of limitations. One particular limitation has been how alcohol problems are represented or understood in ways which do not capture the broad spectrum of alcohol use and harms and the many potential routes to prevention, treatment, and recovery. One possible response to this has been proposed as more explicitly framing or conceptualizing a continuum model of alcohol use and harms. In this commentary, we attempt to identify the key implications of a continuum model for policy and practice, examining the historical and current context of alcohol problem classifications and models. We argue a continuum model of alcohol use and problems holds a number of advantages for advancing public health goals, but also some potential limitations, both of which require further examination. [ABSTRACT FROM AUTHOR]

Although empirical work focused on smoking-drinking comorbidity among Latinx persons is growing, no work has explored the relation between alcohol use severity in terms of co-occurring smoking processes and mental health. Therefore, the present investigation aimed to explore the prevalence and role of alcohol use severity in relation to clinically significant tobacco and mental health problems among English-speaking Latinx adults who smoke cigarettes. Participants included 338 English-speaking Latinx adults who smoked cigarettes daily (Mage = 35.5 years; SD = 8.65; age range 18–61; 37.3% female). Results indicated that approximately 68% of male and 61% of female smokers scored above established clinical cutoffs for hazardous and harmful alcohol use and possible alcohol dependence. Moreover, alcohol use severity was associated with increased risk for cigarette dependence, perceived barriers for quitting, and more problematic symptoms when trying to quit. Alcohol use severity was also related to more severe anxiety and depressive symptoms. Overall, the current findings suggest that intervening to reduce alcohol use severity may be important to improving smoking cessation and mental health among Latinx persons who smoke. [ABSTRACT FROM AUTHOR]

Youth alcohol use (AU) is a major global health problem. Tomando Buenas Decisiones (TBD), an adapted family-based prevention program based on the existing Guiding Good Choices program, was piloted and tested in Zacatecas, Mexico. We examined the effects of the TBD program on reducing family risk for youth AU. We used a quasi-experimental design comprising a sample of 268 parents with children 8 to 16 years. All participants were working actively in one of five Zacatecan private companies. Inverse probability weighting based on intervention status, along with censoring propensity scores, was used to estimate the difference in risk levels between intervention participants and wait-listed controls. Latent growth curve modeling was used to analyze the intervention impact on three first-order risk factors (i.e., positive attitudes for drug use, family conflict, poor family management) and a combined measure of general family risk (i.e., a second-order factor using the three first-order risk factors) at baseline, post-intervention, and 3-month follow-up. Relative to wait-listed controls, the TBD program was efficacious in reducing positive attitudes for drug use, family conflict, poor family management, and general family risk levels. However, at the 3-month follow-up, effects on positive attitudes toward drug use were no longer significant. Findings from this study address a gap in establishing efficacious preventive interventions for youth AU in Latin America. We anticipate that our study's findings could help inform prevention efforts to reduce leading youth alcohol-related harms such as drunk driving, and domestic violence among Mexican adolescents and their families. Highlights: Tomando Buenas Decisiones has the potential to reduce family risks associated with alcohol use among Mexican youth. Inverse probability weighting improves the effect-estimation of preventive interventions in non-experimental conditions. Testing the proximal effects of preventive programs is an appropriate strategy to validate its adaptability in other contexts. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the impact of a culturally based intervention, the Intertribal Talking Circle program, compared to a standard alcohol and drug abuse education, the Be A Winner program. Community‐based participatory research was used to implement a two‐condition, quasi‐experimental study. The sample included 540 Native American youth ages 10−12 years old from three tribal areas in the United States. Data were collected at baseline, 6 and 12‐months post‐intervention for both the intervention and control groups using demographic, cultural identity, alcohol use, and drug use questionnaires. Regression models evaluated participants' improvement in decreasing alcohol and drug use and increasing cultural identity. Findings revealed that alcohol and drug use decreased more significantly among youth who participated in the Intertribal Talking Circle (ITC) intervention program than youth who participated in a standard alcohol and drug abuse education Be A Winner (BAW) program. Cultural identity also increased more significantly among participants who completed the Talking Circle intervention program. Native American youth ages 10−12 years old respond positively to a culturally based intervention for the reduction of alcohol and drug use. The findings highlight the importance of cultural values and identity and their significance in preventing and reducing alcohol and drug use among Native American youth. [ABSTRACT FROM AUTHOR]

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Suboptimal adherence to oral PrEP medications, particularly among younger sexual minority men (SMM), continues to be a key barrier to achieving more substantial declines in new HIV infections. Although variety of interventions, including web and text-message-based applications, have successfully addressed PrEP adherence, very few have addressed the potential influence of alcohol. This pilot study explored whether the Game Plan for PrEP, a brief, web-based and text messaging intervention, helped promote PrEP persistence and adherence and reduced condomless sex and alcohol use. Seventy-three heavy-drinking SMM on PrEP were recruited online from states with Ending the HIV Epidemic jurisdictions and randomly assigned 1:1 to receive either the Game Plan for PrEP intervention or an attention-matched control. We collected online surveys assessing primary outcomes at one, three, and six months post-enrollment. As secondary outcomes, we also collected dried blood spot samples at baseline, three, and six months to analyze for biomarkers of PrEP and alcohol use. Our results showed that the odds of stopping PrEP or experiencing a clinically meaningful lapse in PrEP adherence (≥ 4 consecutive missed doses) were not different across the two conditions. We also did not find evidence of any differences in condomless sex or drinking outcomes across conditions, although participants in both conditions reported drinking less often over time. These findings were consistent across both self-reported outcomes and biomarkers. Overall, we did not find evidence that our brief, web and text messaging intervention encouraged more optimal PrEP coverage or moderate their alcohol use. [ABSTRACT FROM AUTHOR]

There is research using craving reduction as a measure of recovery from drug addiction, as recently reported at the College on Problems of Drug Dependence (CPDD) from National Institute on Drug Abuse (NIDA) researchers. We wanted to find out whether craving reduction can also be used as a measure of recovery from alcohol use disorder (AUD). So, we asked George F. Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), who, with Laura E. Kwako, Ph.D., chief of NIAAA's treatment, health services, and recovery branch, responded to our questions. [ABSTRACT FROM AUTHOR]

Semaglutide (Ozempic, Wegovy), a medication for type 2 diabetes that has also been popular with people trying to lose weight because it decreases appetite, has been shown to reduce the desire to drink, which has raised interest in the use of the drug to treat alcohol use disorder (AUD). A recent study, "Associations of semaglutide with incidence and recurrence of alcohol use disorder in real‐world population," based on 83,825 patients with obesity, has found that these patients reduced their risk of AUD incidence or recurrence by 50%–56%. The study, published in the May issue of Nature Communications, found that consistent reductions were seen for a 12‐month period. The findings provide evidence of the potential benefit of these drugs, now commonly called weight‐loss drugs, to treat AUD, and the researchers (lead author William Wang, second author Nora D. Volkow, M.D., director of the National Institute on Drug Abuse) have called for clinical trials. [ABSTRACT FROM AUTHOR]

Objective: College students engage in high rates of risky substance use. Standard college prevention strategies focus on providing feedback about current substance use behaviors and harm reduction strategies but do not address the underlying genetically-influenced risk factors impacting these behaviors. We created an online Personalized Feedback Program (PFP) for college students that targets genetically-influenced externalizing and internalizing risk pathways and provides personalized recommendations and campus resources. College students received personalized feedback on four risk domains (Sensation Seeking, Impulsivity, Extraversion, and Neuroticism). Methods: An open trial (n = 300) was conducted at a large public university in spring of 2021 to assess initial responses to the PFP and evaluate intentions related to future substance use and campus resource use. Results: 81% of students in the open trial reported they enjoyed the Personalized Feedback Program. Participants reported intending to use significantly more campus resources after completing the PFP. Among participants that drank, 39% reported they intended to decrease their alcohol consumption and 41% reported they intended to decrease the number of times they get drunk after completing the PFP; these intentions to reduce use after completing the PFP are higher than rates found in previous studies. Conclusion: Preliminary data indicate that the Personalized Feedback Program may be a complementary method to enhance current college substance use prevention programs. [ABSTRACT FROM AUTHOR]

College students consume more alcohol and engage in binge drinking more frequently than their non-college attending peers, and prevalence of alcohol-related consequences (e.g., drinking and driving; taking avoidable risks) has not decreased proportionally with decreases in consumption. Social anxiety and alcohol expectancies, or beliefs about the effects of alcohol, have been found to be significantly related to alcohol use and account for significant variance in alcohol use and related consequences. Few studies, however, have examined how other social variables such as need to belong and social connectedness may fit into existing models of increased and risky alcohol use. Methods: Students at a large state university (n = 1,278) completed an online survey measuring alcohol expectancies, need to belong, social anxiety, and social connectedness. Mean age of participants was 19.65 years, and 59.5% self-identified as female, 39.8% male, and 0.7% identified as transgender. Structural equation modeling supported hypothesized relationships between need to belong, social anxiety, social connectedness, alcohol expectancies, and alcohol use, a mean centered variable that included binge drinking, drinking frequency, and amount of consumption. Results: Positive alcohol expectancies related to tension reduction, sociability, and sexuality, were positively related to drinking, such that increased alcohol expectancies were associated with increased drinking. Alcohol expectancies mediated the relationship between need to belong and increased alcohol use, as well as social connectedness and increased alcohol use. Similarly, social anxiety also mediated these relationships. No direct relationships were found between need to belong or social connectedness and alcohol use, suggesting previous research exploring these relationships may have excluded control variables (e.g., biological sex, race/ethnicity) that better explain the impact of need to belong and social connectedness on alcohol use. Conclusion: Prevention and intervention efforts might be more effective in reducing alcohol use if social factors are more broadly targeted. [ABSTRACT FROM AUTHOR]

The article discusses the significance of understanding reward and relief drinking profiles in individuals with alcohol use disorder (AUD) and heavy drinkers, exploring their implications for treatment and intervention strategies. It highlights a study that examines binge-drinking college students and identified three drinking profiles, emphasizing the importance of including social reward motives in the reward profile for better model fit.

Topiramate (TPM), a GABA/glutamate modulator, has shown positive results for treating alcohol use disorder (AUD), but causes significant cognitive adverse effects. TPM causes cognitive side effects by reducing glutathione levels in the frontal lobe. N-acetyl cysteine (NAC) increases level of intracellular glutathione. We hypothesized that combining NAC with TPM may mitigate the possible cognitive side effects of TPM, as well as working synergistically in reducing alcohol consumption more efficaciously than using TPM alone. A 12-week, double-blind randomized trial assessing the effects of combining NAC (1200 mg/day) with TPM (200 mg/day) vs TPM alone (i) cognitive side effects caused by TPM, (ii) percentage of heavy drinking days (PHDD) and percentage of days abstinent (PDA) using weekly calendar, and (iii) craving outcomes using the obsessive–compulsive drinking scale. Seventeen participants were randomized into the study (nine received TPM + NAC and eight matching TPM + Placebo). Cognitive adverse events were not significantly different between the treatment arms (P  = 0.581). There was no difference in PHDD (P  = 0.536) and in PDA over the entire study period (P  = 0.892). However, both treatment groups at study end, compared with the baseline, significantly reduced their PHDD and increased their PDA. As for cravings: TPM + NAC group has shown higher level in automaticity of drinking (P  = 0.029) and interference due to drinking (P  = 0.014) subscales compared with the TPM + Placebo group. No difference was observed between groups in terms of Drinking Obsessions and Alcohol Consumption subscales. This pilot study indicates that combining NAC with TPM is overall safe, but the addition of NAC has no significant benefit over placebo in the incidence of TPM-related cognitive impairment, and alcohol drinking. Furthermore, craving outcomes may become worse with the addition of NAC. [ABSTRACT FROM AUTHOR]

Introduction: This study utilizes a machine learning model to predict unhealthy alcohol use treatment levels among women of childbearing age. Methods: In this cross-sectional study, women of childbearing age (n = 2397) were screened for alcohol use over a 2-year period as part of the AL-SBIRT (screening, brief intervention, and referral to treatment in Alabama) program in three healthcare settings across Alabama for unhealthy alcohol use severity and depression. A support vector machine learning model was estimated to predict unhealthy alcohol use scores based on depression score and age. Results: The machine learning model was effective in predicting no intervention among patients with lower Patient Health Questionnaire (PHQ)-2 scores of any age, but a brief intervention among younger patients (aged 18–27 years) with PHQ-2 scores >3 and a referral to treatment for unhealthy alcohol use among older patients (between the ages of 25 and 50) with PHQ-2 scores >4. Conclusions: The machine learning model can be an effective tool in predicting unhealthy alcohol use treatment levels and approaches. [ABSTRACT FROM AUTHOR]

ObjectiveWhile college can be a period of exploration, it is also marked by risky alcohol use. Brief alcohol screening and intervention for college students (BASICS) has yet to be used in the telehealth platform among minority students. This study assesses the short-term outcomes of a pilot telehealth brief alcohol abuse intervention for students attending a Hispanic Serving Institution (HSI). Participants: One hundred and fifty-two students attending a large public university participated. MethodsStudents participated in a BASICS-adapted telehealth brief intervention with a certified alcohol counselor. Baseline and 30-day follow-up surveys were completed electronically. ResultsThere were significant changes in drinking behaviors at 30-day follow-up after participating in the telehealth pilot among high-risk drinkers. ConclusionTelehealth interventions are accessible and convenient for students at a HSI, and brief alcohol interventions adapted from BASICS utilizing telehealth can significantly impact alcohol use behaviors. [ABSTRACT FROM AUTHOR]

Alcohol dependence is common, yet highly undertreated. Smartphone applications (apps) have potential to enhance treatment accessibility and effectiveness, however evidence is limited, especially studies focussing on user experiences. The aim was to describe patient perceptions on the usability and acceptability of self-monitoring apps provided as treatment complement for alcohol dependence. Individual semi-structured interviews were conducted through video or phone calls with 21 participants, recruited from a randomized controlled trial at a dependency clinic in Stockholm. The participants had used two specific apps for self-monitoring consumption ("Glasklart" and "iBAC") during 12 wk prior to the interviews. Data was analyzed using Qualitative Content Analysis. Two domains were identified: 1) Smartphone applications as facilitators to treatment, and 2) Barriers to smartphone application use. Using apps within the treatment context was believed to increase the accuracy of the reported consumption. Participants became more aware of their alcohol problem and described the apps as reinforcers that could increase both the motivation to change and the focus on the problem and commitment to treatment. The apps were further described as helpful to control alcohol consumption. However, app usage was constrained by technical problems, unfit app-specific features and procedures, and alcohol-related shame and stigma. Self-monitoring alcohol apps have several beneficial features that can help assess, track, and control alcohol consumption, and improve communication with clinicians. The results indicate they can be useful complements to treatment for patients with alcohol dependence, but their use can be limited by different, foremost technical, issues. Smartphone applications for self-monitoring of alcohol consumption may help provide accurate data, increase consumption awareness, focus, motivation, and perceived control; Smartphone applications for self-monitoring of alcohol consumption are considered helpful complements to alcohol treatment; The use of smartphone applications for self-monitoring of alcohol consumption can be constrained by technical problems, and unfit app-specific features and procedures. [ABSTRACT FROM AUTHOR]

Background: Low‐Risk Alcohol Drinking Guidelines (LRDGs) aim to reduce the harms caused by alcohol. However, considerable discrepancies exist in the 'low‐risk' thresholds employed by different countries. Argument/analysis: Drawing upon Canada's LRDGs update process, the current paper offers the following propositions for debate regarding the establishment of 'low‐risk' thresholds in national guidelines: (1) as an indicator of health loss, years of life lost (YLL) has several advantages that could make it more suitable for setting guidelines than deaths, premature deaths or disability adjusted years of life (DALYs) lost. (2) Presenting age‐specific guidelines may not be the most appropriate way of providing LRDGs. (3) Given past overemphasis on the so‐called protective effects of alcohol on health, presenting cause‐specific guidelines may not be appropriate compared with a 'whole health' effect derived from a weighted composite risk function comprising conditions that are causally related to alcohol consumption. (4) To help people reduce their alcohol use, presenting different risk zones associated with alcohol consumption instead of a single low risk threshold may be advantageous. Conclusions: National LRDGs should be based on years of life lost and should be neither age‐specific nor cause‐specific. We recommend using risk zones rather than a single drinking threshold to help people assess their own risk and encourage the adoption of behaviours with positive health impacts across the alcohol use spectrum. [ABSTRACT FROM AUTHOR]

Objective: One strategy to address the health issues among college students is through bystander intervention. However, much is still unknown about bystander behavior. The purpose of the current study was to assess the feasibility of daily diary methodology as applied to bystander opportunity. Method: Using a convenience sample, we examined (1) the frequency at which students encounter alcohol use risk and SDV risk bystander opportunities, and (2) the association between participants' daily alcohol use and daily bystander opportunity. Participants were a small group of 32 college students (75% women; 100% heterosexual; 93.7% White; 6.3% multiracial; 3.1% Hispanic) who took up to nine daily diary surveys for a total of 207 days. Results: Over 80% of participants completed the required days. Participants experienced at least one bystander opportunity on 24% of days. Participants were significantly more likely to report an alcohol risk bystander opportunity on days when they drank alcohol, compared to non-drinking days. [ABSTRACT FROM AUTHOR]

This study used secondary data from a randomized controlled trial of a Brief Motivational Intervention (BMI) to examine whether Non-White participants had different treatment results compared to White participants. The outcome variables of this study were divided into primary outcomes (heavy drinking and consequences associated with alcohol use) and secondary outcomes (cognitive variables such as motivation to change alcohol use, and behavioral variables, including protective behavioral strategies). Linear regression analyses were conducted with the PROCESS macro for SPSS, to test if race or ethnicity moderated the relationship between BMI and each treatment outcome. Data was collected at two time points, six weeks and three months after treatment. This study showed that race or ethnicity did not moderate treatment results for the four outcome variables. Additional within-group effect sizes were calculated for all racial and ethnic categories, showing that Hispanic/Latine and Black participants had larger effect sizes in all the outcome variables. The discussion examines the potential strength of Motivational Interviewing due to its client-centered spirit, which naturally allows for incorporating values and identity-based factors, such as culture, into the session. The results suggest similar BMI outcomes among White and Non-White emerging adults who engage in heavy drinking, potentially due to its client-centered approach. This is a preliminary study, and the results are therefore tentative. [ABSTRACT FROM AUTHOR]

Aim Intervention design may be improved through evaluating the feedback from those who have been exposed to such interventions. As such, here the perspectives of the intervention group from a recent randomized control trial investigating the effectiveness of a digital alcohol intervention, in terms of perceived suitability and usefulness of the support tool they engaged with, were investigated. Methods Respondents (N=475; 45% of the intervention group) answered five quantitative questions addressing user experience, completed the 10-item System Useability Scale, and were offered the opportunity to write free-text feedback. Quantitative measures were analysed using ordinal and linear regression with baseline characteristics as predictors, and free-text responses were evaluated using content analysis. Results Overall, respondents were positive towards the intervention in terms of it fitting their needs, the usefulness of the tools included, and the usefulness of text message content. The intervention was perceived as more helpful by respondents with lower total weekly alcohol consumption, higher self-reported confidence in their ability to reduce their drinking, and the perceived importance there of, at baseline. The free-text comments revealed the value of reminders as prompts to reflect on one's own drinking behaviour. Nonetheless, criticisms of the intervention were voiced, primarily highlighting the repetitive nature of the reminders and the lack of individuation in advice. Some also feltlike the intervention was impersonal and targeted only a specific drinking pattern. Conclusions Experiences of the intervention group in this trial were generally positive, though there may be demand for more individualised, targeted intervention design. [ABSTRACT FROM AUTHOR]

Coparenting partners experience feelings of shame and anger and have higher risks of alcohol and drug use. Mothers experience unique challenges that exacerbate their vulnerability to substance use. Using data from the multisite family study on incarceration, parenting, and partnering was used to examine the association between social support and hazardous alcohol use among mothers with incarcerated partners. A hierarchical binary regression indicated several support factors that were shown to be connected to precarious alcohol use. Results showed that multiple forms of support are potentially helpful in mitigating hazardous alcohol use. Findings highlight the importance of considering the proverbial village. [ABSTRACT FROM AUTHOR]

BACKGROUND: A trauma registry review of our trauma center's alcohol misuse screening compliance noted inconsistent screening and data collection methods, putting our American College of Surgeons trauma center reverification at risk for a deficiency. OBJECTIVE: The objective of this study was to evaluate an alcohol misuse screening improvement initiative on screening compliance in trauma patients. METHODS: This before and after analysis of a quality improvement initiative to improve alcohol misuse screening was conducted from 2019 to 2021 at a Southwestern U.S. Level II trauma center on admitted trauma patients aged 13 years and older. The multicomponent initiative included a change in the screening instrument and timing of application, implementing electronic medical record documentation screens, and educating staff. The primary outcome measure was screening adherence. RESULTS: A total of n = 4,734 patients were included in the study period. Alcohol misuse screening improved from 2.9% to 87.4% and remained sustained for over a year after the initiative's implementation. CONCLUSION: The performance improvement initiative improved the alcohol misuse screening process, resulting in consistent screenings exceeding the American College of Surgeons standards of 80% for verified trauma centers. [ABSTRACT FROM AUTHOR]

The authors comment on a study by J. Manthey and colleagues about the absence of robust evidence for or against statutory restrictions on alcohol advertising. Topics include the need to accompany marketing restrictions by comprehensive evaluation programmes, principal issue about the overall evidence base, and suggestion on jurisdictions planning statutory restrictions.