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ObjectiveWe examined whether race/ethnicity was related to exposure to acute economic losses in the 2008-2009 recession, even accounting for individual-level and geographic variables, and whether it influenced associations between economic losses and drinking patterns and problems.MethodData were from the 2010 National Alcohol Survey (N = 5,382). Surveys assessed both severe losses (i.e., job and housing loss) and moderate losses (i.e., reduced hours/pay and trouble paying the rent/mortgage) attributed to the 2008-2009 recession. Alcohol outcomes included total annual volume, monthly drunkenness, drinking consequences, and alcohol dependence (based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).ResultsCompared with Whites, Blacks reported significantly greater exposure to job loss and trouble paying the rent/mortgage, and Latinos reported greater exposure to all economic losses. However, only Black-White differences were robust in multivariate analyses. Interaction tests suggested that associations between exposure to economic loss and alcohol problems were stronger among Blacks than Whites. Given severe (vs. no) loss, Blacks had about 13 times the odds of both two or more drinking consequences and alcohol dependence, whereas the corresponding odds ratios for Whites were less than 3. Conversely, associations between economic loss and alcohol outcomes were weak and ambiguous among Latinos.ConclusionsResults suggest greater exposure to economic loss for both Blacks and Latinos (vs. Whites) and that the Black population may be particularly vulnerable to the negative effects of economic hardship on the development and/or maintenance of alcohol problems. Findings extend the economic literature and signal policy makers and service providers that Blacks and Latinos may be at special risk during economic downturns.

Sexual and gender minority individuals (e.g., gay, bisexual, non-binary, transgender; SGMI) are 2-6 times as likely as cisgender heterosexual individuals to experience alcohol or other substance use disorders. SGMI participate in 12-Step groups, such as Alcoholics Anonymous (AA), at high rates. Though social support is an established mechanism through which 12-Step programs support reductions in substance use, little is known about SGMI's experiences of the social support in 12-Step programs. This qualitative study aims to understand the experiences of social and community support among SGMI involved in 12-Step programs. This study employed thematic analysis to interpret open-ended responses from 302 SGMI who had participated in 12-Step programs. Data was from The PRIDE Study, a large, national, online, longitudinal, cohort study of SGMI. Two themes emerged about how SGMI experienced social and community support in 12-Step programs: beneficial connections and harmful environments. Beneficial connections included a sense of community, shared experiences, and skills provision. Harmful environments included marginalization, oppression, violence, and bullying. This study highlights the variability of experiences of SGMI participating in 12-Step programs. These findings suggest that many SGMI may benefit from 12-Step programs but may need support in coping with potential harms that can emerge through participation. [ABSTRACT FROM AUTHOR]

Objective: Although racial and ethnic minorities are often disadvantaged in multiple ways, little research has examined the interactive effects of multiple forms of disadvantage in these populations. The current study describes the independent and interactive effects of perceived prejudice, perceived unfair treatment, poverty, and foreign nativity on problem drinking outcomes among Black and Latino adults. Method: The data source was Black (n 504) and Latino (n - 766) drinkers from the nationally representative, weighted 2005 National Alcohol Survey. Perceived prejudice was assessed using a composite measure of racial stigma consciousness; perceived unfair treatment was assessed using a single item. Respondents whose per capita household income was below the 2004 poverty guidelines were coded as 'poor'; nativity status was assessed among Latinos. Outcomes included past-year drinking to drunkenness, any drinking-related consequences, and two or more dependence symptoms. Results: In bivariate tests, higher levels of unfair treatment were significantly associated with all three outcomes among Blacks (marginally so for drunkenness) and dependence symptoms among Latinos. Further, higher racial stigma was significantly associated with higher rates of any drinking consequences among Latinos. In multivariate logistic regressions, six significant or marginally significant interactions emerged. For each, the pattern of results suggested stronger associations between perceived prejudice/unfair treatment and problem drinking given either poverty or foreign nativity. Conclusions: Although findings were somewhat mixed, the pattern of results tentatively supports the hypothesis that associations between problem drinking and both prejudice and unfair treatment can be exacerbated given the presence of other stressors, particularly among Latinos. Results extend the literature on the health consequences of prejudice and discrimination, highlighting important effects of cumulative adversity and suggesting a need to focus particularly on drinkers exposed to the combined effects of multiple stressors in prevention and treatment efforts. (J Stud. Alcohol Drugs. 72, 361-370, 2011), ALTHOUGH OVERT EXPRESSIONS of racial prejudice have declined significantly since the 1950s (Firebaugh and Davis, 1988; Schuman et al., 1997; Smith, 1990; Smith and Dempsey, 1983), prejudice and discrimination are [...]

Objective: The purpose of this article is to identify the factors that predict initial Alcoholics Anonymous (AA)-related helping following treatment admission. Method: Data were derived from Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), a longitudinal investigation of the efficacy of three behavioral treatments for alcohol abuse and dependence. Cox proportional hazard regressions were performed to determine the extent to which demographic, clinical, belief, and AA factors predicted initial AA-related helping. Results: Demographic characteristics, drinking severity, antisocial personality, and purpose in life were not associated with initial AA-related helping. Increased sell-efficacy, faith-based practices, meeting attendance, number of steps worked, having a sponsor, and length of sobriety predicted initial AA-related helping. Alcoholics reported elevated depressive symptoms before initial AA-related helping, lowered depressive symptoms at the start of AA-related helping, and similarly lowered depressive symptoms in the interval following initial AA-related helping. Conclusions: The profile of prospective helpers in AA is not limited to alcoholics from certain backgrounds or higher functioning in terms of drinking or clinical severity. To increase participation in AA-related helping, and hence outcomes, results suggest strengthening sell-efficacy and progress in other AA programmatic components., THE SYMBOL FOR ALCOHOLICS ANONYMOUS (AA), emblazed on celebratory coins members receive for accumulating periods of sobriety, is a triangle representing AA's three core dimensions. One side of the triangle [...]

Objective: This study examined the relationship between acculturation and six distinct drinking outcomes. We expected high levels of acculturation to be associated with higher odds of being a drinker and, among drinkers, with lower frequency of drinking, less alcohol consumption per year, less heavy drinking, fewer episodes of drunkenness, and fewer dependence symptoms. Method: The data consisted of a nationally representative sample of Latino men ages 18 and older (N = 784) from the 2005 National Alcohol Survey. The men were predominantly Mexican and Mexican American (64%), and most were born outside the United States (68%). Analyses included both bivariate and multivariate regression models using weights to adjust for sampling and nonresponse. Results: The hypotheses were partially supported. Men at high levels of acculturation were more likely than their peers at low levels of acculturation to be drinkers but only if they had above-average incomes. Counter to expectations, among drinkers there was a protective effect of medium, rather than high, levels of acculturation on frequency of drinking, volume of alcohol consumed, drinking to drunkenness, and dependence symptoms, with a protective effect approaching significance for heavy drinking. Conclusions: The findings have implications for future research and public health programs designed to reach Latino men in the United States., THROUGH THE ACCULTURATION PROCESS, immigrants exposed to new values and opportunities begin to adopt the traditions and practices of the dominant culture in the host country. Such changes may involve [...]

Objective: Despite growing evidence of the adverse health effects of social disadvantage on minority populations, few studies have investigated whether such effects extend to alcohol problems. This study examines social disadvantage as a source of stress and analyzes its association with alcohol use and problems in the three largest racial/ethnic groups in the United States. Method: Data on white, black, and Hispanic Americans (n = 6,631) were obtained from the 2005 U.S. National Alcohol Survey, a nationally representative telephone-based survey of adults ages 18 and older. Social disadvantage was measured by poverty level, frequency of unfair treatment, racial/ethnic stigma consciousness, and cumulative disadvantage. Outcomes included drinking status, at-risk drinking, and problem drinking. Results: Blacks and Hispanics reported greater exposure to social disadvantage than whites, including greater poverty, unfair treatment, racial/ethnic stigma, and cumulative disadvantage. In all three racial/ethnic groups, exposure to disadvantage was associated with problem drinking. Frequent unfair treatment, high racial stigma (among minorities), and multiple sources of extreme disadvantage corresponded to a twofold to sixfold greater risk of alcohol problems, partially explained by psychological distress. Conclusions: These results are consistent with other studies of stress and adverse health consequences associated with social disadvantage. Although there is a clear disparity in exposure to such hardship, experiences of disadvantage appear to have similar effects on problem drinking among both racial/ethnic minorities and whites. Future research should attempt to assess causal directions in the relationships among social and economic hardship, stress, and alcohol problems., ALTHOUGH ADVERSE HEALTH EFFECTS of poverty have long been recognized (Adler et al., 1994; Lynch and Kaplan, 2000), it is only in recent years that racial discrimination has been identified [...]

Objective: The purpose of this study is to examine how helping activities and spirituality--perhaps key influences on sobriety-change over recovery. The study also explores interrelations among Alcoholics Anonymous (AA), helping and spirituality. Method: Questionnaires were administered to recovering alcoholics (118 men, 80 women) recruited at AA and Women for Sobriety meetings, treatment programs and through personal connections. A helping scale measured Recovery Helping (8-item α = 0.78), Life Helping (12-item α = 0.62), and Community Helping (6-item α = 0.60). The Daily Spiritual Experiences scale assessed two components of spirituality identified by factor analysis: Theism and Self-Transcendence. Two components of an AA scale, Involvement and Achievement, were also treated separately on the basis of factor analysis. Results: Structural equation modeling revealed that longer sobriety predicted significantly more time spent on Community Helping, less time spent on Recovery Helping and higher levels of Theism, Self-Transcendence and AA Achievement. Model covariances revealed that both AA components were related to more Recovery Helping and higher Theism. Both spirituality components related to all forms of helping, with one exception. Conclusions: The findings highlight important changes in helping with length of sobriety. As their sobriety accumulates, recovering alcoholics seem to devote less time to informal helping and more time to organized community projects--perhaps indicating evolving needs and abilities. The results also suggest roles for AA and spirituality in encouraging helping, and they indicate that some forms of spirituality relate to AA affiliation. Future work might establish whether and when helping in different domains contributes to the maintenance of abstinence and to other drinking-related outcomes., AS PEOPLE RECOVER from alcoholism, they can experience dramatic changes in how they think about themselves, others and the world in general. In fact, common wisdom in Alcoholics Anonymous (AA) [...]

Objectives: The misuse of prescription drugs in the U.S. is an alarming public health crisis. Prior research at the U.S.-Mexico border has found high rates of prescription drug misuse, but with rates varying significantly across border communities. We aimed to examine a model of permissive climate measures and stress exposures as potential mediators of community differences in prescription drug misuse at the U.S.-Mexico border. Design: We analyzed data from the U.S.-Mexico Study of Alcohol and Related Conditions (UMSARC). Household, in-person interviews were conducted with Mexican-origin residents of the Texas border cities Laredo (n = 751) and Brownsville/McAllen (n = 814). Interviews assessed past-year misuse of any and pain-reliever prescription drugs. Drug availability, neighborhood safety, exposure to violence/crime, and social support were examined as potential mediators. Analyses were stratified by gender and employed regressions and mediation analysis with Mplus. Results: The past-year prevalence of any prescription drug misuse in Laredo was 26.3% among women and 24.4% among men, and in Brownsville/McAllen was 12.4% among men, and 6.7% among women. Mediation analysis revealed site effects via some of the hypothesized risk factors for men, but not for women. Specifically, for men, site effects on any and pain reliever prescription drug misuse were partially mediated via high drug availability and low family support. Conclusions: Past-year prescription drug misuse was over 3 times the 2015 national prevalence among both men and women in Laredo and calls for immediate attention. Findings regarding the model suggest drug availability and social support may be relevant to understanding community differences in prescription drug misuse among men living at the border, and that additional factors should be investigated to understand misuse among women living at the border. [ABSTRACT FROM AUTHOR]