The Effects of State Alcohol and Pregnancy Policies on Women’s Health and Healthy Pregnancies

US states have enacted a wide range of laws to address health challenges associated with alcohol use during pregnancy. Some have taken punitive approaches that restrain women’s behavior, and some have taken supportive approaches aimed at improving women’s health and supporting healthy pregnancies. In this article we report on a study of implementation of supportive and punitive policies when both types of policies operate simultaneously in the same jurisdiction. Effects of mixed use laws on multiple stakeholder groups, especially pregnant and postpartum women, are studied. We conclude by identifying how our findings can be extended for future comparative state research.     

Urging College Alcohol and Drug Policies That Target Adverse Behavior,Not Use

Abstract

Although “zero tolerance” policies are being enacted on campuses nationwide, these policies may not be the most effective means of creating safer and healthier environments for students. Many historical precedents illustrate the value of moderation over prohibition College drug and alcohol policies should focus primarily on dysfunctional and disruptive student behaviors, not on student drug and alcohol use only.     

The Emerging Problems of Alcohol and Substance Abuse in Late Life

Treatment of substance abuse among older adults will become increasingly important as the number of aged Americans increases. The abuse of psychoactive substances is a major contributor to excess morbidity, mortality, and homelessness among persons of all ages and socioeconomic strata regardless of race or ethnicity. Alcohol and tobacco account for the majority of substance abuse-related death and disability in the United States; the former through cerebrovascular and hepatic disease, accidents and violence, the latter through chronic pulmonary disease and malignancy. Patterns of substance abuse in late life are substantially different from those observed among younger adults. However, treatment may be less challenging. Effective diagnosis and treatment requires a nonpunitive, supportive, but persistent approach. This means the capacity to collect a substance intake history and the ability to formulate a treatment plan or referral strategy to an addiction specialist or residential treatment setting. It is also important for the practitioner to manage negative feelings toward patients who decline treatment or who are chronic abusers.     

Going Green: Environmental Protest,Policy, and CO2 Emissions in U.S. States, 1990–2007

A major goal of the environmental movement is to conserve or improve the natural environment, but evidence showing that environmental mobilization produces positive environmental outcomes is mixed. This article addresses a fundamental question about the relative impact of pro‐environmental mobilization and the scope of an environmental policy regime on the natural environment. Using panel data at the state level from 1990 through 2007, we explore how environmental protest and environmental policies independently (or jointly) reduce CO₂ emissions in U.S. states. We find that the level of emissions in a state declines in states with increases in pro‐environmental protest, net of the effects of the range of environmental policies enacted, gasoline taxes, liberal attitudes, reliance on the fossil fuel industry, number of registered lobbyist organizations, gross state product, and population size.     

University Binge Drinking Patterns and Changes in Patterns of Alcohol Consumption Among Chinese Undergraduates in a Hong Kong University

Abstract

Objective: To examine patterns of binge drinking and changes in drinking patterns among Chinese university students. Participants and Methods: Responses to an anonymous questionnaire were compared between a random sample of 411 second year Chinese undergraduate students in 2006 and 2,630 first year students from the previous year. Students reporting any symptoms of alcohol abuse were classified as alcohol abusers whereas those reporting repeated inability to curtail use were categorized as alcohol dependent. Results: After 1 year of university, greatly increased rates of past-month drinking of different degrees were found in both genders. Binge drinking among second year undergraduates was significantly correlated with male gender, living in a student residence hall, smoking, drinking to relieve stress, and having friends who frequently drank. Conclusions: Alcohol misuse is a health hazard to Chinese students in a university environment. Proactive policies aimed at preventing harmful alcohol use should be considered by university authorities.     

Challenges and Recommendations to Enforcement of Alcohol Policies on College Campuses: An Administrator's Perspective

Abstract

Objective: The purpose of this study was to examine challenges and recommendations (identified by college administrators) to enforcing alcohol policies implemented at colleges in the southeastern United States. Methods: Telephone interviews were conducted with 71 individuals at 21 institutions. Results: Common challenges included inconsistent enforcement, mixed messages received by students, and students’ attitudes toward alcohol use. The most common recommendations were ensuring a comprehensive approach, collaboration with members of the community, and enhanced alcohol education.     

Alcohol Use in Students Seeking Primary Care Treatment at University Health Services

Abstract

Objective: Given the high rate of at-risk drinking in college students, the authors examined drinking behaviors and associated factors in students being seen in student health services for primary care visits from October 30, 2004, to February 15, 2007. Methods: Analyses were based on a Health Screening Survey completed by 10,234 college students seeking general medical treatment. Results: Alcohol use was similar to other studies with 57% (n = 5,840) meeting the National Institute on Alcohol Abuse and Alcoholism criteria for at-risk drinking. Twenty-six percent of the students reported smoking at least once in the last 3 months. Risk factors for at-risk drinking included young age, white males, drinking at a fraternity/sorority house, and use of tobacco. Conclusions: These findings support the widespread implementation of alcohol screening and intervention in university health services.     

Access Denied: The Relationship between Alcohol Prohibition and Driving under the Influence

Alcohol prohibition continues to be a policy pursued by more than 10 percent of the counties in the United States. However, many questions exist about the effectiveness of prohibition policies for controlling social maladies such as accidents and fatal injuries related to driving under the influence (DUI). In this research, a situational crime prevention framework is used to evaluate the hypothetical relationship between countywide alcohol prohibition and incidents of DUI. We focus specifically on county-level comparisons of DUI arrests in Arkansas where slightly more than half of the counties are "dry" (sale of alcohol to the general public is prohibited). Utilizing police reports of DUI arrests we examine whether the dry county distinction is indeed associated with fewer DUI arrests than found in wet counties. Findings indicate that the dry county distinction does not result in significantly lower rates of DUI arrest when law enforcement variables are considered. These findings are analyzed and implications for future research are discussed.     

Underage college students' drinking behavior, access to alcohol, and the influence of deterrence policies. Findings from the Harvard School of Public Health College Alcohol Study

Underage drinking is a major problem at American colleges, but little is known about the extent of alcohol use in different student groups, in different colleges, and in states with different control policies. We used data from the 2001 and 3 previous Harvard School of Public Health College Alcohol Studies that compared responses of underage students with those of their 21-23-year-old peers. Underage students drank alcohol less frequently but were more likely to drink to excess when they drank. College educational efforts and deterrent policies were limited in their outreach, and half of underage students obtained alcohol very easily. Underage students in states with extensive laws restricting underage and high-volume drinking were less likely to drink and to binge drink. A majority of underage students supported increasing efforts to control underage drinking. The results suggest that additional policy efforts to control underage drinking may be effective and feasible.     

Extreme Ritualistic Alcohol Consumption Among College Students on Game Day

Abstract

Alcohol use and the related consequences associated with college football games are a serious public health issue for university communities. Objective: Examining “Extreme Ritualistic Alcohol Consumption” (ERAC), defined as consuming 10 or more drinks on game day for a male, and 8 or more drinks for a female, is the focus of this study. Participants: In the fall of 2006, college students ages 18 to 24 were randomly selected to complete the Game Day Survey. Methods: Researchers utilized a cross sectional research design to collect data. Results: Sixteen percent of the respondents engaged in ERAC on game day, whereas 36% drank 5 or more drinks (4 or more for females). Male, Caucasian, Greek (members of a social fraternity or sorority), and students of legal drinking age consumed alcohol at disproportionately high rates. Conclusion: Alcohol use is common on game day, with a significant percentage of students placing themselves at risk by drinking large amounts of alcohol.     

What Is Valued in Gay and Lesbian Specific Alcohol and Other Drug Treatment?

Little is known about what gay and lesbian clients value about culturally specific alcohol and other drug treatment programs. This study involves a sample of clinical staff and former clients (N = 40) of four culturally specific alcohol and other drug treatment programs to clarify what is addressed and deemed valuable for the specific needs of gay and lesbian clients. Through the lens of the recovery capital conceptual framework, this qualitative research emphasizes resiliency and the supports necessary for long-term recovery. Results indicate three major themes that make this type of treatment valuable: (1) a separate treatment unit or facility, (2) a safe and supportive therapeutic milieu, and (3) specific tailored treatment approaches. Findings are discussed to include implications for ways to improve services for this all too often understudied population of potentially vulnerable individuals who can benefit from culturally sensitive care.     

Informed policy making for the prevention of unwanted pregnancy. Understanding low-income women's experiences with family planning

California health and welfare officials asked the authors to identify ways that their programs could encourage service use among low-income women. The project posed a challenge: The clients wanted to identify supply-side barriers amenable to intervention, but prior research suggested other factors might be more influential. The approach was to examine service-related issues, but in the broader context of women's experiences. The authors identify factors amenable to intervention, including inaccurate beliefs about methods. Other important influences--such as instability of relationships, skepticism about planning, or unsatisfactory method experiences--may be beyond the reach of specific policies, but are nevertheless critical to understanding program context. Findings suggest that punitive messages and policies based on a simplistic model of behavior may be unrealistic and ineffective.     

Mindfulness and Alcohol Problems in College Students: The Mediating Effects of Stress

Abstract

Objective: To examine the relationship between mindfulness and alcohol problems in college students, as well as the role of stress as a mediator in this relationship. Participants: Participants were 310 students from a small, private college in the Northeast. Methods: Students completed self-report measures, including the Perceived Stress Scale, the Five Facet Mindfulness Questionnaire, and the Rutgers Alcohol Problems Index. Results: Mindfulness was negatively correlated with alcohol problems and stress, whereas stress positively correlated with alcohol problems. Results implicated stress as fully mediating the relationship between mindfulness and alcohol problems. Alcohol problems were negatively correlated with the Acting With Awareness and Describing Experience facets of mindfulness. Conclusion: Mindfulness-based stress reduction or other mindfulness programs may be useful in decreasing alcohol problems on college campuses via the effects on stress.     

Changing the Culture of Alcohol Abuse on Campus: Lessons Learned From Secondhand Smoke

ABSTRACT

Alcohol abuse is the single greatest public health hazard on American college and university campuses, but the culture of abusive alcohol consumption continues to be highly resistant to change. The author argues that secondhand smoke campaigns can be used as models to change the culture of alcohol abuse on campus. He proposes the implementation of “secondhand alcohol” campaigns and describes their essential components and advantages.     

The Effect of Religiosity and Campus Alcohol Culture on Collegiate Alcohol Consumption

Abstract

Religiosity and campus culture were examined in relationship to alcohol consumption among college students using reference group theory. Participants and Methods: College students (N = 530) at a religious college and at a state university complete questionnaires on alcohol use and religiosity. Statistical tests and logistic regression were utilized to examine alcohol use, religiosity, and campus environment. Results: Alcohol consumption was significantly higher among students at the university (M = 26.9 drinks) versus students at the religious college (M = 11.9 drinks). University students also had lower religiosity scores (M = 23.8) than students at the religious college (M = 26.5). Students who attend a secular university are 4 times more likely to be moderate or heavy drinkers compared to students attending a religiously affiliated college. Students with the least religiosity were 27 times more likely to be a heavy alcohol user and 9 times more likely to be a moderate alcohol user compared to students with greater religiosity.     

“If Rainbows Were Everywhere”: Nonmetropolitan SGM Youth Identify Factors That Make Communities Supportive

ABSTRACT

Sexual and gender minority (SGM) youth in nonmetropolitan communities face marginalization due to their SGM identities. Community support may mitigate the negative outcomes associated with marginalization. Using the strengths perspective, this study investigated the factors SGM youth identify as making their communities supportive. Interviews were conducted with SGM youth to explore their perceptions of their community, community climate, and the factors that contribute to making communities supportive to SGM youth. Findings revealed four supportive community factors: supportive people, SGM visibility, SGM resources and education, and SGM-inclusive policies. Implications include creating SGM resources and providing professional training on SGM issues.     

Informal Caregiving and the Politics of Policy Drift in the United States

Informal caregivers play an increasingly important role in caring for aging Americans. Yet existing social policies that could support informal caregiving have experienced “policy drift,” a failure to adapt to social risks that develop after policies are initially enacted. This article examines policy makers’ success at updating seven major policies to address caregiver needs. It draws on an original data set of legislation in this area introduced between 1991 and 2006 (n = 96). Findings indicate that drift is more likely when policy updates are costly, lack support from members of majority parties in the House and Senate, and fail to generate bipartisan support.     

Beyond Public Opinion Polls: Punitive Public Sentiment & Criminal Justice Policy

The punitive turn in criminal justice policy, epitomized by policies like three-strikes, truth in sentencing, and mandatory minimums, is often attributed in part to demand for harsher criminal justice responses from an increasingly punitive public. It has been argued that public opinion, known to be both largely uninformed and often misunderstood, might both indirectly and directly affect policy. This survey article on punitiveness in public opinion opens with a discussion of competing depictions of the nature of the relationship between a punitive public and increasingly punitive criminal justice policies. The article then focuses on some of the most influential explanations for variations in punitiveness within individuals and across groups. A review of what we know about public attitudes toward punishment and a brief explanation of how we know what we know (e.g. the methodologies by which we gauge public opinion) follow. The article concludes with the observation that as methodologies continue to improve and the literature in this area continues to grow, so too does our understanding of punitive public opinion in all of its complexity.     

Building,Engaging, and Sustaining a Continuum of Care From Harm Reduction to Recovery Support: The Rutgers Alcohol and Other Drug Assistance Program

Since 1983, the focus of the Rutgers Alcohol and Other Drug Assistance Program (ADAP) has been developing policies, training staff to identify students at risk, developing and implementing evidence-based screening and brief interventions, providing short-term counseling by professionals trained in alcohol and other drug abuse to assist students beyond brief interventions, identifying effective treatment for college students, developing a campus recovery program, on-campus recovery housing, and other supports for students in recovery. This article presents a case study of the Rutgers ADAP program, of building and sustaining a program committed to engaging students in both evidence-based risk reduction interventions and an on-campus recovery community given their stage of change and motivation to make changes. Historical milestones are described as part of a creative model for intervention. We identify the challenges of integrating substance abuse recovery into campus mental health programs, and of integrating recovery into other university communities.     

Impact of Drugs and Alcohol on the Brain Through the Life Cycle

Abstract

This article discusses the impact of alcohol and other drugs on the brain during five stages of the life cycle: perinatal (pregnancy-2 years), childhood (2-12 years), adolescence (13-21), adulthood (22-50), and senior (50+). Alcohol and psychotropic drugs act through specific chemicals in the brain called neurotransmitters. Neurotransmitters have two main functions in the brain: mediate electrical transmission (synaptic activity) and promote growth (trophic activity). The trophic activity results in a neuron increasing its size and the complexity of its branches (dendrites). The ability of drugs and alcohol to influence neuronal growth (neuroplasticity) has unique consequences in children, adults, and seniors. Knowledge of such biological principles as developmental critical period, age-related cortical shrinkage and steroid-induced neuronal growth is presented in the context of alcohol and other drug abuse. A few suggestions are made for developing new treatment strategies based on the inherent dynamics of the brain during the life cycle.