CCAPP: Number of deaths from untreated addiction may rival those from COVID‐19

In a far‐reaching clarion call for attention to addiction in the midst of the COVID‐19 pandemic, Pete Nielsen, CEO of the California Consortium of Addiction Professionals and Programs (CCAPP), urges policymakers to recognize that the isolation required in shelter‐in‐place will fuel even more deaths from alcohol, drugs and suicide. In The Disease of Addiction Thrives on Isolation, released this month, Nielsen warns that these deaths were already “on track to break records in the number of victims in our state this year,” and goes on to say that those “who survive this year will face a second wave of death due to tobacco related diseases and or relapse to drug of choice unless tobacco is routinely treated in substance use disorder.”     

The road to a world health organization global strategy for reducing the harmful use of alcohol

Harmful alcohol use and the related health effects are a global problem and therefore need to be addressed not only by individual nations but also on an international level. For example, the World Health Organization (WHO) noted that harmful alcohol use is the third leading risk factor for premature deaths and disabilities in the world, accounting for approximately 2.5 million deaths worldwide (corresponding to 3.8 percent of all deaths) in 2004 (WHO 2010). Moreover, harmful alcohol use was considered responsible for 4.5 percent of the global burden of disease as measured in disability-adjusted life-years lost in the same year. Given this scope of the impact, the WHO initiated a series of efforts that culminated in the development of a global strategy for reducing the harmful use of alcohol. This article reviews the alcohol-related activities of the WHO over the years and summarizes the central issues addressed by the global strategy.     

Gut bacteria can treat alcohol‐associated liver disease

Almost half of all liver disease deaths in the United States are related to alcohol use. With alcohol‐associated liver disease (AALD) now the leading cause of liver transplantation due to chronic liver disease, replacing hepatitis C, the National Institute on Alcohol Abuse and Alcoholism (NIAAA) is calling for effective interventions for AALD.     

Supplemental SOR grants released to states

Last month, the federal Department of Health and Human Services (HHS) released an additional $487 million to states and territories in its State Opioid Response (SOR) grant program, bringing the 2019 total to $1.4 billion, including the $933 million in second‐year, continuation SOR grants to be provided later this year. The SOR grants increase access to medication‐assisted treatment (MAT), reduce unmet treatment need and reduce opioid‐related overdose deaths.     

Infant Symbolic Play as an Early Indicator of Fetal Alcohol‐Related Deficit

Infant symbolic play was examined in relation to prenatal alcohol exposure and socioenvironmental background and to predict which infants met criteria for fetal alcohol syndrome (FAS) at 5 years. A total of 107 Cape‐Colored, South African infants born to heavy drinking mothers and abstainers/light drinkers were recruited prenatally. Complexity of play, sociodemographic and psychological correlates of maternal alcohol use, and quality of parenting were assessed at 13 months, and intelligence quotient and FAS diagnosis at 5 years. The effect of drinking on spontaneous play was not significant after control for social environment. In contrast, prenatal alcohol and quality of parenting related independently to elicited play. Elicited play predicted 5‐year Digit Span and was poorer in infants subsequently diagnosed with FAS/partial FAS and in nonsyndromal heavily exposed infants, compared with abstainers/light drinkers. Thus, symbolic play may provide an early indicator of risk for alcohol‐related deficits. The independent effects of prenatal alcohol and quality of parenting suggest that infants whose symbolic play is adversely affected by alcohol exposure may benefit from stimulation from a responsive caregiver.     

Secular Trends in Alcohol Drinking Among Danish 15‐Year‐Olds: Comparable Representative Samples From 1988 to 2010

This study describes the secular trends in weekly intake of beer, wine, liquor, and drunkenness among 15‐year‐olds 1988–2010 (total N = 8,701), a period with several policy initiatives regarding alcohol in Denmark. Data from seven comparative and representative school surveys conducted in 1988, 1991, 1994, 1998, 2002, 2006, and 2010 were used. The proportion of 15‐year‐olds in Denmark who drank alcohol and were drunk increased from 1988 to 2002, but decreased substantially to 2010; for example, the proportion of 15‐year‐old girls who drank beer at least weekly increased from 15% in 1988 to 31% in 2002 and decreased to 7% in 2010. We hypothesize that age limits for purchasing alcohol may have resulted in a decrease in young people's alcohol use.     

‘Violent’ deaths of children in England and Wales and the major developed countries 1974–2002: possible evidence of improving child protection?

Child protection services are criticised for failing to prevent abuse but demonstrating successful prevention is impossible as it is trying to prove a ‘negative’. The alternative is to examine ‘failures’, i.e. the ‘violent’ deaths of children (0–14 years) to indicate whether matters are improving or deteriorating. This paper uses the latest World Health Organisation data to compare children's ‘violent’ deaths in England and Wales with those in other major developed countries. To account for possible ‘hidden’ under‐reported abuse deaths, undetermined, i.e. ‘other external causes of death’ (OECD) and fatal accidents and adverse events (AAE), deaths are also analysed along with homicides, to compare all ‘violence‐related’ deaths between 1974–76 and 2000–02. England and Wales infant (<1 year) homicide rates were annually 57 per million but fell to 17 per million, a 74% fall. Infant AAE deaths fell in every country with England and Wales falling from 341 per million to 71 per million, a 76% reduction. Both these results were significantly better than those of eight other major developed countries, although England and Wales infant OECD at 26 per million, were high compared to the major developed countries. In the 1970s, combined ‘violent’ deaths of all children (0–14 years) (homicide, OECD and AAE) in England and Wales were 203 per million, they are now 61 per million, a 70% decline with only Italy having lower rates. The worst rates were in the USA which had the highest combined ‘violent’ death rate. These overall results in the major reductions of ‘violence‐related’ deaths in England and Wales can be a boost to the morale of front‐line staff and provide the public with an indication of the progress being made. Copyright © 2008 John Wiley & Sons, Ltd.     

SOCIAL WORK EDUCATION: THE AVAILABILITY OF ALCOHOL‐RELATED COURSE CURRICULUM AND SOCIAL WORKERS' ABILITY TO WORK WITH PROBLEM DRINKERS

An explanatory cross‐sectional investigation was employed to assess how well masters‐level social work (MSW) programs in the State of New York prepare students for practice with problem drinkers. The following areas were explored: (1) the incorporation of alcohol‐related coursework and field placement opportunities within MSW programs; (2) the relationship between students' completion of alcohol‐related courses and field placements and their subsequent ability to diagnose clients with alcohol problems, their willingness to work with problem drinkers, and their levels of alcohol‐related knowledge; and (3) subjects' levels of alcohol‐related knowledge in relation to their diagnostic ability and their willingness to work with problem drinkers. The sample consisted of 89 MSW‐level social work practitioners, who were active members of the New York State Chapter of the National Association of Social Workers (NASW) during the fall of 2005. Fewer than 3% of the sample reported the completion of an alcohol‐related course as a mandatory degree requirement and only 29.5% of the sample acknowledged the completion of an alcohol‐related field placement. These findings suggest that a possible gap exists in what social workers are being taught and what they need to know to successfully work with problem drinkers. The findings indicate that clients with alcohol problems are at risk of going untreated due to social workers' inability to correctly diagnose them as a result of insufficient training in the area of alcohol studies.     

Parent‐Child Communication About Adolescent Tobacco and Alcohol Use: What Do Parents Say and Does It Affect Youth Behavior?

Parent‐child communication about tobacco and alcohol use is assumed to be critical to child use of these substances, but it rarely has been systematically described and related to adolescent use. This study included a national sample of 537 adolescent‐parent pairs interviewed by telephone at baseline and again 1 year later. Factor analysis of parent reports of communication identified 3 domains: rules and discipline, consequences and circumstances, and media influences. Communication in these domains varied by family characteristics, including parents' substance use and mother's education level. Contrary to assumptions, parent‐child communication was not related to initiation of smoking or drinking. Additional analyses suggested, however, that parent‐child communication about rules and discipline predicted escalation of use.     

DO STATE EXCISE TAXES REDUCE ALCOHOL‐RELATED FATAL MOTOR VEHICLE CRASHES?

We study the effect of alcohol excise taxes on alcohol‐related fatal traffic crashes by examining two large increases in excise taxes in Illinois that occurred in 1999 and in 2009. Using the synthetic control method, we do not find evidence that the tax increases led to a long‐term reduction in fatal alcohol‐related motor vehicle crashes following either tax increase. These results are robust across several specifications and pass sensitivity tests. However, we find evidence that following the 2009 increase Illinois counties that do not share a border with another state experienced a temporary drop in alcohol‐related traffic fatalities. (JEL H71, H75, 118)     

‘You Just Get Blocked’. Teenage Drinkers: Reckless Rebellion or Responsible Reproduction?

The purpose of this study is to challenge the discourse that underage drinking is inevitably ‘deviant’. Rather than imposing an adultist lens, the article draws upon focus‐group interviews with 14–15 year olds. The meaningful role of drinking is explored, along with the capability of peer cultures to manage some alcohol‐related ‘risks’. The data suggest that the prioritisation of adultist constructs over teenage subject experiences appears somewhat misplaced since teenage norms are not complete subversions of the adult world. Apparent transgression is better understood as alternative socialisation, since teenage peer groups creatively reproduce the wider culture.     

Alcohol prevention strategies on college campuses and student alcohol abuse and related problems

This study examined the relationship between colleges' alcohol abuse prevention strategies and students' alcohol abuse and related problems. Alcohol prevention coordinators and first year students in 22 colleges reported whether their schools were implementing 48 strategies in six domains, and students (N = 2041) completed another survey concerning their use of alcohol and related consequences. Colleges were most likely to prevent alcohol use in public places on campus and the delivery and use of kegs. Four alcohol prevention domains were inversely associated with at least one of five outcomes related to student alcohol abuse or related consequences, and the alcohol policy and enforcement domain was inversely associated with all outcomes. Colleges should pay particular attention to strategies related to policy and enforcement.     

Religiosity and Effortful Control as Predictors of Indonesian Adolescents’ Tobacco and Alcohol Use: Moderation and Mediation

Moderation and mediation models of religiosity and effortful control as predictors of tobacco and alcohol use were tested in this 2‐year longitudinal study of 563 16‐year‐old Muslim Indonesian adolescents. Adolescents reported their effortful control, religiosity, and tobacco and alcohol use and peers provided reports of adolescents’ effortful control. Although both moderation and mediation effects emerged when predicting Year 2 substance use, predictions of change from Year 1 to Year 2 substance use yielded effects of moderation for peer‐ but not self‐reported effortful control for boys; no mediation effects emerged. These findings provide evidence of interconnections between effortful control and religiosity as predictors of substance use and suggest the need for further longitudinal studies that compare moderation and mediation models.     

Peer Group Patterns of Alcohol‐Using Behaviors Among Early Adolescents in Victoria,Australia, and Washington State,United States

The goal of this study was to examine and cross‐nationally compare the peer group patterns of alcohol‐drinking behaviors among cohorts of early adolescents (ages 11–14 years) in Victoria, Australia, and Washington State, United States. Latent transition analysis revealed that after 1 year, transitions congruent with peer influence (whereby non‐drinking adolescents initiated alcohol use in the presence of drinking peers) and reverse peer influence were observed in both states; however, transitions congruent with peer selection (whereby drinking adolescents self‐selected into drinking peer groups) were only observed among Victorian early adolescents. Findings were interpreted to suggest that Australian family and cultural norms that more commonly allow early adolescent alcohol use lead to a higher rate of peer selection.     

Losing Sleep Over It: Daily Variation in Sleep Quantity and Quality in Canadian Students' First Semester of University

Daily covariation of sleep quantity and quality with affective, stressful, academic, and social experiences were observed in a sample of Canadian 17–19‐year‐olds in their first year of university. Participants (N=191) completed web‐based checklists for 14 consecutive days during their first semester. Multilevel models predicting sleep quantity and quality from daily experiences indicated that more time on schoolwork, expecting a test, and alcohol use predicted less sleep whereas socializing predicted more sleep. More positive affect and no alcohol use predicted better sleep quality. Models predicting daily experiences from sleep the night before indicated that less sleep preceded increases in negative affect, decreases in schoolwork time, and a higher likelihood of socializing. Better sleep quality preceded increased positive affect, decreased negative affect and stress, and less time on schoolwork. These data are informative for understanding relations between sleep and daily experiences as they occur naturally in first‐year university students.     

Longitudinal Effects of Best‐Friend Communication Against Substance Use for Latino and Non‐Latino White Early Adolescents

Prior research examining peer influences on adolescent alcohol, cigarette, and marijuana use has primarily focused on the positive associations that peer substance use and offers have with adolescent use. Consequently, such research has often emphasized the negative influences of peers. This study, however, operationalizes peer influence through best‐friend communication against substance use and examines whether it indirectly protects against substance use by promoting anti–substance use norms. Structural equation modeling was utilized with longitudinal survey data from 277 Latino and 350 non‐Latino white 6th–8th‐grade‐students. For Latino and non‐Latino white students, best‐friend communication was indirectly related to alcohol and cigarette use through norms. Best‐friend communication also was indirectly related to marijuana use, but only for non‐Latino white students and for male students.     

Adolescent Girls' Alcohol Use as a Risk Factor for Relationship Violence

This research examined the relation between female adolescents' general alcohol use and their experience of relationship violence. This relation was examined both cross‐sectionally and longitudinally, controlling for the proximal (i.e., situational) effects of alcohol use. One hundred and six female high school students reported on their experiences of physical violence and sexual coercion by boyfriends, general patterns of alcohol use, victimization experiences while drinking, and hypothesized covariates including demographic and relationship variables and illicit drug use. Variables were assessed at 2 time points 4 months apart. Results indicated that general alcohol use was related to victimization both cross‐sectionally and longitudinally, but different findings emerged for different forms of victimization (physical‐only victimization vs. both physical and sexual victimization).     

Sources of Social Influence on Adolescents’ Alcohol Use

The present research examines social influences on self‐reported frequency of drunkenness in a longitudinal sample of 1,439 adolescents (46% female, 90% White, mean age = 14 at baseline) with social network measures from friends, romantic partners, and romantic partners’ friends. We build on past research by addressing multiple mechanisms of social influence—peers’ frequency of drunkenness, alcohol‐related attitudes, and unstructured socializing—across relationship types. Adolescents’ drunkenness frequency increased when their friends’ and partners’ friends’ drunkenness frequency increased and when their romantic partners’ positive alcohol‐related attitudes increased. Furthermore, the association between unstructured socializing and frequency of drunkenness was stronger for older than younger adolescents. Results advance understanding of the social transmission of alcohol use in adolescence and inform intervention efforts.     

The Moderating Effects of Pubertal Timing on the Longitudinal Associations Between Parent–Child Relationship Quality and Adolescent Substance Use

This prospective, longitudinal study investigated the moderating role of pubertal timing on reciprocal links between adolescent appraisals of parent–child relationship quality and girls' (N=1,335) and boys' (N=1,203) cigarette and alcohol use across a 12‐month period. Reciprocal effects were found between parent–child relations and on‐time maturing boys and girls' cigarette and alcohol use, after estimating stability in these constructs across time. Parent–child relationship quality was associated with increased alcohol use 12 months later for early maturing girls. Cigarette and alcohol use were associated with increased problems in the parent–child relationship for late maturing girls. No effects were observed for early and late maturing boys in the pathways between parent–child relationship quality and substance use. Pubertal timing moderated the pathway linking parent–child relationship quality with cigarette use 1 year later such that the association was stronger for late maturing girls compared with early and on‐time maturing girls. The findings indicate interplay between the psychosocial aspects of maturation, family relationships, and adolescent substance use and highlight possible gender‐specific influences.