Determinants of the risk and timing of alcohol and illicit drug use onset among natives and non‐natives: Similarities and differences in family attachment processes

Abstract

This study examines data from Native Ontario reserve residents (Embree, 1993) and a sample from the Ontario Health Survey Supplement (1990–91) in order to compare and contrast the importance of family attributes such as parent‐child attachment to Native and Non‐native patterns of drug and alcohol use onset. Proportional Hazards modeling (Cox, 1972) was employed to identify factors associated with the risk and timing of onset of alcohol and illicit drugs for both cultural groups. For both Natives and Non‐natives alike, and considering both drinking and drug use onset together, age cohort predominates as a risk factor, with youngest groups at greatest risk, and especially in the case of drug use other than alcohol. For the model of drug use timing, age of alcohol use onset is the second best predictor for Natives, although its effect is still apparent, albeit weaker, in the case of Non‐natives. As for family characteristics, a number of factors emerge as determinants of risk and depend, in part, on the cultural group and the substance under consideration. Consistent with attachment theory's prediction about the universal applicability of the need for close parent‐child relations (Bowlby, 1969), the findings for both Natives and Non‐natives alike point to the salience of psychosocial attachment and other indicators of family functioning in affecting early onset drinking and drug use, behaviors well‐recognized to lead to potentially adverse mental and physical health consequences as well as to negative social outcomes.     

Nostalgia and Degeneration: The Moral Economy of Drinking in Navajo Society

This article focuses on how some members of Navajo society use narratives regarding alcohol and drinking to comment on cultural degeneration and the decay of the traditional Navajo moral economy. These narratives drinking are seldom solely about alcohol but refer to a host of distinct yet interrelated concerns involving moral values, individual and collective identities, underdevelopment, imagined histories, psychic conflict, and social contention. This article sheds light on how evaluations of alcohol and drinking problems, as encapsulated in narratives of degeneration, fit into the overall context of contemporary Navajo society. Narratives of degeneration juxtapose a degenerate present to a nostalgic past and in the process direct moral censure toward two primary groups in Navajo society, namely, young people and others who drink to excess, [drinking, Native Americans, Navajo, narrative, alcohol]     

The Praxis of Indigenism and Alaska Native Timber Politics

This article addresses the most recent discourse on indigenism in Southeast Alaska that has emerged around the Alaska Native Claims Settlement Act of 1971 and its subsequent revisions. It argues that one must consider the "politics of recognition" in Southeast Alaska in terms of the larger political dynamics that shape state and industry access to resources, especially commercially valuable stands of timber. In Southeast Alaska, recognition of Native claims has allowed industrial timber and pulp producers to, in effect, circumvent environmental laws aimed at curbing production, thus allowing them to continue devastating the living conditions of many Natives. Among the local responses to the manipulation of Native claims and identity, the all–Native, radical Christian churches that have taken a strong stance against the recent, corporate–sponsored, cultural revitalization are unique in their resistance to indigenist politics. [Keywords: indigenism, Alaska Natives, development, Pentecostalism]     

Sociocultural stress and the american native in Alaska: An analysis of changing patterns of psychiatric illness and alcohol abuse among Alaska natives

This paper presents selected morbidity and mortality statistics to outline developing trends and the current status of psychiatric illness and alcohol abuse among the Aleut, Athabascan, Yupik, Inupiat, Tlingit, Haida and Tsimpshian people of Alaska. Analysis of the records of the Indian Health Service, the Community Mental Health Centers and the Alaska Psychiatric Institute, the providers of care for Alaska Natives, shows that the number of individuals treated as inpatients and outpatients for psychiatric illness and alcohol abuse has been rising steadily. Accidental injury and suicidal behavior are common. The treated prevalence rates for these diagnoses exceed recorded rates for other American Native and non-Native groups. For each category of violent death, suicide, homicide, accidents and alcohol, rates for Alaska Natives are higher than rates for Alaska non-Natives, American Indians and the U.S. (all races) and are rising. The data suggest a public health problem in which the primary elements are behavioral disturbance and violent death.     

Bridging the Divide: Drinking among Street Drug Users

In this research report, we present findings on drinking among drug users from a larger multimethod study of the public health consequences of emergent, changing, and understudied drug-related behavioral patterns among street drug users in Hartford, CT. Although drinking and illicit drug use traditionally have been studied in anthropology as separate cultural domains, this conceptual division has hindered examination of the significant level of drinking among street drug users, the motivations for heavy drinking in this population, and the public health consequences of mixing alcohol and other drugs, including drug relapse.     

Family background characteristics and relationship satisfaction in a native community in Canada

Abstract

Using data collected from a Native Canadian community by Embree (1993), we examine the influence of personal and family background characteristics on satisfaction with spousal relationships, both legal marriages and cohabitations. Of special interest are the quality of relationships with parents while growing up, alcohol abuse by the parent(s), and the experience of sexual abuse during childhood. Personal traits such as age, sex, and gender role attitudes and the respondent's own drinking behavior are also considered. Path analytic techniques model both the direct effects of independent variables on relationship satisfaction as well as the role of personal consumption of alcohol as an intervening variable in level of satisfaction with a relationship. The results of the analysis indicate that personal consumption of alcohol and the experience of sexual abuse during childhood are the best direct predictors of level of satisfaction with the current relationship, with higher alcohol consumption and experience of sexual abuse related to lower satisfaction. Age also has a significant direct, though smaller, positive influence on relationship satisfaction. Sexual abuse and the respondent's sex are also linked to level of satisfaction through personal alcohol consumption. With personal alcohol use, both the respondent's sex and the experience of sexual abuse during childhood have a significant effect, with males and those sexually abused as children reporting higher levels of alcohol consumption. The socialization explanation of the intergenerational consequences of parental behavior argues that parental role models are primary to the future family formation behavior of children. Consistent with this hypothesis, the findings concerning sexual abuse, in particular, as a predictor of both personal alcohol use and relationship satisfaction seem to underscore the importance of antecedent family characteristics in influencing later adjustment to adult roles and responsibilities.     

Genetic and environmental influences on alcohol use: DF analysis of NLSY kinship data

Research designs to study alcohol use and abuse have included twin, adoption and family history/high risk studies. Results have consistently implied a genetic factor in the aetiology of alcohol abuse. However, less research has been conducted in search of environmental factors. This study uses kinship structure in a large national dataset (the National Longitudinal Survey of Youth) to estimate (using DeFries-Fulker analysis) the extent of the shared genetic, non-shared genetic, shared environmental and non-shared environmental influences on alcohol use. The NLSY kinship sample contained 3890 pairs of cousins, half-siblings, full-siblings and twins between the ages of 14 and 21 in the initial year of the survey (1979). Estimates of heritability (h2) and shared environment (c2) were small to moderate for the entire dataset for both light drinking and heavy drinking behaviour, with h2 estimates slightly higher in each case. Non-shared genetic measures of self-esteem and locus of control accounted for a significant portion of the remaining variance in heavy drinking behaviour. Race and gender patterns showed c2 and h2 estimates that were also small to moderate for both light and heavy drinking behaviour. Significant non-shared effects were found for the White group for heavy drinking behaviour, and for male pairs for both heavy and light drinking behaviour. Additionally, implications and future directions are discussed.     

Alcohol abstinence and mortality in a general population sample of adults in Germany: A cohort study

BackgroundEvidence suggests that people who abstain from alcohol have a higher mortality rate than those who drink low to moderate amounts. However, little is known about factors that might be causal for this finding. The objective was to analyze former alcohol or drug use disorders, risky drinking, tobacco smoking, and fair to poor health among persons who reported abstinence from alcohol drinking in the last 12 months before baseline in relation to total, cardiovascular, and cancer mortality 20 years later.Methods and findingsA sample of residents aged 18 to 64 years had been drawn at random among the general population in northern Germany and a standardized interview conducted in the years 1996 to 1997. The baseline assessment included 4,093 persons (70.2% of those who had been eligible). Vital status and death certificate data were retrieved in the years 2017 and 2018.We found that among the alcohol-abstinent study participants at baseline (447), there were 405 (90.60%) former alcohol consumers. Of the abstainers, 322 (72.04%) had met one or more criteria for former alcohol or drug dependence or abuse, alcohol risky drinking, or had tried to cut down or to stop drinking, were daily smokers, or self-rated their health as fair to poor. Among the abstainers with one or more of these risk factors, 114 (35.40%) had an alcohol use disorder or risky alcohol consumption in their history. Another 161 (50.00%) did not have such an alcohol-related risk but were daily smokers. The 322 alcohol-abstinent study participants with one or more of the risk factors had a shorter time to death than those with low to moderate alcohol consumption. The Cox proportional hazard ratio (HR) was 2.44 (95% confidence interval (CI), 1.68 to 3.56) for persons who had one or more criteria for an alcohol or drug use disorder fulfilled in their history and after adjustment for age and sex. The 125 alcohol-abstinent persons without these risk factors (27.96% of the abstainers) did not show a statistically significant difference from low to moderate alcohol consumers in total, cardiovascular, and cancer mortality. Those who had stayed alcohol abstinent throughout their life before (42; 9.40% of the alcohol-abstinent study participants at baseline) had an HR 1.64 (CI 0.72 to 3.77) compared to low to moderate alcohol consumers after adjustment for age, sex, and tobacco smoking. Main limitations of this study include its reliance on self-reported data at baseline and the fact that only tobacco smoking was analyzed as a risky behavior alongside alcohol consumption.ConclusionsThe majority of the alcohol abstainers at baseline were former alcohol consumers and had risk factors that increased the likelihood of early death. Former alcohol use disorders, risky alcohol drinking, ever having smoked tobacco daily, and fair to poor health were associated with early death among alcohol abstainers. Those without an obvious history of these risk factors had a life expectancy similar to that of low to moderate alcohol consumers. The findings speak against recommendations to drink alcohol for health reasons.

In this cohort study conducted over 20 years, Ulrich John and colleagues examine the relationship between alcohol abstinence and mortality in a German adult population.     

Binge Drinking Associations with Patrons’ Risk Behaviors and Alcohol Effects after Leaving a Nightclub: Sex Differences in the "Balada com Ciência" Portal Survey Study in Brazil

The purpose of the present study was to investigate the potential associations of binge drinking detected at the exit of nightclubs and risk behaviors and alcohol effects just after leaving the venue in a representative sample of Brazilian nightclub patrons according to sex. For this purpose, a portal survey study called Balada com Ciência was conducted in 2013 in the megacity of São Paulo, Brazil, using a two-stage cluster sampling survey design. Individual-level data were collected in 2422 subjects at the entrance and 1822 subjects at the exit of 31 nightclubs, and breath alcohol concentration (BrAC) was measured using a breathalyzer. The following day, 1222 patrons answered an online follow-up survey that included questions about risk behaviors and alcohol effects practiced just after leaving the nightclub. Weighted logistic regressions were used to analyze binge drinking associated with risk behaviors by sex. For both sexes, the most prevalent risk behaviors practiced after leaving a nightclub were drinking and driving (men=27.9%; women=20.4%), the use of illicit drugs (men=15.8%; women=9.4%) and risky sexual behavior (men=11.4%; women=6.8%). The practice of binge drinking increased the behavior of illicit drug use after leaving the nightclub by 2.54 times [95% CI: 1.26-5.09] among men who drank and increased the risk of an episode of new alcohol use by 5.80 times [95% CI: 1.50-22.44] among women who drank. Alcoholic blackouts were more prevalent among men [OR=8.92; 95% CI: 3.83-20.80] and women [OR= 5.31; 95% CI: 1.68-16.84] whose BrAC was equivalent to binge drinking compared with patrons with a lower BrAC. Public policies aiming to reduce patrons’ BrAC at the exit of nightclubs, such as staff training in responsible beverage service and legislation to prevent alcohol sales to drunk individuals, would be useful to protect patrons from the risk behaviors associated with binge drinking in nightclubs.     

Whisky,women and song: men,alcohol and AIDS in northern Thailand

Biomedical analyses are primarily concerned with the disinhibiting effects of alcohol and the consequent increased likelihood of engaging in high-risk sexual behavior. However, such an approach ignores indigenous constructions of drinking behavior and sexuality. In northern Thailand, alcohol drinking and sex with prostitutes are closely linked and both are crucial to the construction of the male identity. Sexual encounters with a commercial sex worker generally follow a period of preparatory drinking. It is common practice for laborers to celebrate their monthly receipt of wages by going out in large groups to feast and visit brothels. Solitary drinking is highly unusual given the connection of alcohol use and the manipulation of social relations. The marital and extramarital spheres are conceptualized, within this culture, as distinct arenas of sexual experience. Drinking and drunkenness serve as framing devices for men to make the transition from the structured, non-eroticized domestic sphere to the transgressive world of commercial sex and the affirmation of stereotypical masculinity it confers. Because of the link between alcohol consumption and commercial sex, as well as the high likelihood that drinkers either will refuse to use condoms or will use them incorrectly, social drinking in the northern Thailand context must be considered as a major risk factor for acquired immunodeficiency syndrome.     

The role of early life experience and species differences in alcohol intake in microtine rodents

Social relationships have important effects on alcohol drinking. There are conflicting reports, however, about whether early-life family structure plays an important role in moderating alcohol use in humans. We have previously modeled social facilitation of alcohol drinking in peers in socially monogamous prairie voles. We have also modeled the effects of family structure on the development of adult social and emotional behaviors. Here we assessed whether alcohol intake would differ in prairie voles reared by both parents compared to those reared by a single mother. We also assessed whether meadow voles, a closely related species that do not form lasting reproductive partnerships, would differ in alcohol drinking or in the effect of social influence on drinking. Prairie voles were reared either bi-parentally (BP) or by a single mother (SM). BP- and SM-reared adult prairie voles and BP-reared adult meadow voles were given limited access to a choice between alcohol (10%) and water over four days and assessed for drinking behavior in social and non-social drinking environments. While alcohol preference was not different between species, meadow voles drank significantly lower doses than prairie voles. Meadow voles also had significantly higher blood ethanol concentrations than prairie voles after receiving the same dose, suggesting differences in ethanol metabolism. Both species, regardless of rearing condition, consumed more alcohol in the social drinking condition than the non-social condition. Early life family structure did not significantly affect any measure. Greater drinking in the social condition indicates that alcohol intake is influenced similarly in both species by the presence of a peer. While the ability of prairie voles to model humans may be limited, the lack of differences in alcohol drinking in BP- and SM-reared prairie voles lends biological support to human studies demonstrating no effect of single-parenting on alcohol abuse.     

Identifying Predictors and Prevalence of Alcohol Consumption among University Students: Nine Years of Follow-Up

AimTo evaluate the prevalence of alcohol consumption among university students during late adolescence and young adulthood and to identify the associated factors.ResultsThe rates of prevalence of RC were lower, but not statistically significant, in women. The age-related changes in these rates were similar in both genders, and the prevalence of RC peaked at 20 years. By contrast, the prevalence of HED was significantly lower in women and peaked at 18 years in women and at 22 years in men. Multivariate models showed that early age of onset of alcohol use (OR = 10.6 and OR = 6.9 for women; OR = 8.3 and OR = 8.2 for men) and positive expectations about alcohol (OR = 7.8 and OR = 4.5 for women; OR = 3.6 and OR = 3.3 for men) were the most important risk factors for RC and HED. Living away from the family home was also a risk factor for both consumption patterns among women (OR = 3.16 and OR = 2.34), while a high maternal education level was a risk factor for RC among both genders (OR = 1.62 for women; OR = 2.49 for men).ConclusionsAlcohol consumption decreases significantly at the end of youth, with higher rates of prevalence and a later peak among men. Prevention strategies should focus on beliefs and expectations about alcohol and on delaying the age of onset. Women are at particular risk for these consumption patterns if they live away from their parents. Belonging to a high-income family is a strong risk factor for RC.     

The Moderating Effects of Sex and Age on the Association between Traumatic Brain Injury and Harmful Psychological Correlates among Adolescents

Background

Although it is well established that sex is a risk factor in acquiring a traumatic brain injury (TBI) among adolescents, it has not been established whether it also moderates the influence of other TBI psychological health correlates.

Methods and Findings

Data were derived from a 2011 population-based cross-sectional school survey, which included 9,288 Ontario 7th–12th graders who completed anonymous self-administered questionnaires in classrooms. Response rate was 62%. Preliminary analyses found no evidence of nonresponse bias in the reporting of TBI. TBI was defined as a hit or blow to the head that resulted in a 5 minutes loss of consciousness or at least one overnight hospitalization due to symptoms associated with it. Reports of lifetime TBI were more common among males than females (23.1%, 95% CI: 20.5, 25.8 vs. 17.1%, 95% CI: 14.7, 19.8). Thirteen correlates were examined and included cigarette smoking, elevated psychological distress, suicide ideation, bully victimization (at school, as well as cyber bullying), bullying others, cannabis use, cannabis dependence and drug use problems, physical injuries, daily smoking, drinking alcohol, binge drinking, use of cannabis, and poor academic performance. Among the outcomes examined, sex moderated the relationship between lifetime TBI and cigarette smoking. In addition, sex and age jointly moderated the relationship between lifetime TBI and daily smoking, alcohol use and physical injuries. Late adolescent males who reported lifetime TBI, relative to females, displayed elevated daily smoking and injuries, whereas their females counterparts displayed elevated past year drinking. Possible bias related to self-report procedures and the preclusion of causal inferences due to the cross-sectional nature of the data are limitations of this study.

Conclusions

TBI differences in outcomes need to be assessed for potential moderating effects of sex and age. Results have important implications for more tailored injury prevention efforts.     

Nonmedical drug use among adolescent students: highlights from the 1999 Ontario Student Drug Use Survey

BACKGROUND: During the 1990s, rates of nonmedical drug use among adolescents escalated. We assessed data from 5 cycles of the Ontario Student Drug Use Survey for overall trends in the proportion of students reporting illegal drug use between 1991 and 1999. METHODS: The survey is a repeated, cross-sectional, 2-stage cluster-design survey of students enrolled in grades 7, 9, 11 and 13. Outcome measures were prevalence of use of 17 drugs, including alcohol and tobacco, over the 12 months preceding the survey. RESULTS: The rates of drug use increased between 1993 and 1999. The 95% confidence intervals (CIs) for the differences in proportions between 1997 and 1999 indicated significant increases in the overall use of 6 drugs: alcohol (95% CIdiff 6.1, 1.9-10.3), cannabis (95% CIdiff 46.3, 0.2-8.4), glue (95% CIdiff 2.3, 1.3-3.3), other solvents (95% CIdiff 5.0, 3.1-6.3), barbiturates (95% CIdiff 1.9, 0.4-3.4) and hallucinogens such as mescaline and psilocybin (95% CIdiff 3.5, 0.8-6.9). Fewer grade 7 students in 1999 than in earlier cohorts reported using alcohol or cigarettes by age 9. INTERPRETATION: The public health implications of the findings are mixed. On the positive side, there is no evidence of increases in early onset of drug use. On the negative side, the overall proportion of students reporting illegal drug use has continued to rise.     

Influence of circadian typology on drug consumption, hazardous alcohol use, and hangover symptoms

Few studies have focused on the influence of circadian typology on drug use, and none has considered the use of illegal drugs and hazardous alcohol consumption. This study analyzes the influence of circadian typology on several types of drug consumption (habitual or sporadic), hangover symptoms (past 12 mos), and, more specifically, hazardous alcohol consumption of young adults. Five hundred seventeen university students (173 males), between 17 and 30 yrs of age, answered the Composite Scale of Morningness (CSM), the Alcohol Use Disorders Identification Test (AUDIT), and a self-referred questionnaire on drug consumption during the previous month and on the prevalence of different hangover symptoms during the previous year. Our results confirm a higher prevalence of consumption of addictive substances, both legal (nicotine and cola drinks) and illegal (cannabis and ecstasy), in evening- compared to morning- and neither-type subjects (p?相似文献   

Heavy drinking relates to positive valence ratings of alcohol cues

A positive family history of alcohol use disorders (FH) is a robust predictor of personal alcohol abuse and dependence. Exposure to problem-drinking models is one mechanism through which family history influences alcohol-related cognitions and drinking patterns. Similarly, exposure to alcohol advertisements is associated with alcohol involvement and the relationship between affective response to alcohol cues and drinking behavior has not been well established. In addition, the collective contribution that FH, exposure to different types of problem-drinking models (e.g. parents, peers) and personal alcohol use have on appraisal of alcohol-related stimuli has not been evaluated with a large sample. We investigated the independent effects of FH, exposure to problem-drinking models and personal alcohol use on valence ratings of alcohol pictures in a college sample. College students (n = 227) completed measures of personal drinking and substance use, exposure to problem-drinking models, FH and ratings on affective valence of 60 alcohol pictures. Greater exposure to non-familial problem-drinkers predicted greater drinking among college students (beta = 0.17, P < 0.01). However, personal drinking was the only predictor of valence ratings of alcohol pictures (beta = -0.53, P < 0.001). Personal drinking level predicted valence ratings of alcohol cues over and above FH, exposure to problem-drinking models and demographic characteristics. This suggests that positive affective responses to alcohol pictures are more a function of personal experience (i.e. repeated heavy alcohol use) than vicarious learning.     

Rats bred for high alcohol drinking are more sensitive to delayed and probabilistic outcomes

Alcoholics and heavy drinkers score higher on measures of impulsivity than nonalcoholics and light drinkers. This may be because of factors that predate drug exposure (e.g. genetics). This study examined the role of genetics by comparing impulsivity measures in ethanol-naive rats selectively bred based on their high [high alcohol drinking (HAD)] or low [low alcohol drinking (LAD)] consumption of ethanol. Replicates 1 and 2 of the HAD and LAD rats, developed by the University of Indiana Alcohol Research Center, completed two different discounting tasks. Delay discounting examines sensitivity to rewards that are delayed in time and is commonly used to assess 'choice' impulsivity. Probability discounting examines sensitivity to the uncertain delivery of rewards and has been used to assess risk taking and risk assessment. High alcohol drinking rats discounted delayed and probabilistic rewards more steeply than LAD rats. Discount rates associated with probabilistic and delayed rewards were weakly correlated, while bias was strongly correlated with discount rate in both delay and probability discounting. The results suggest that selective breeding for high alcohol consumption selects for animals that are more sensitive to delayed and probabilistic outcomes. Sensitivity to delayed or probabilistic outcomes may be predictive of future drinking in genetically predisposed individuals.     

Is there a 24-hour rhythm in alcohol craving and does it vary by sleep/circadian timing?

ABSTRACT

Increasing evidence implicates sleep/circadian factors in alcohol use; however, the role of such factors in alcohol craving has received scant attention. Prior research suggests a 24-hour rhythm in related processes (e.g., reward motivation), but more research directly investigating a rhythm in craving is needed. Moreover, prior evidence is ambiguous whether such a rhythm in alcohol craving may vary by sleep/circadian timing. To examine these possibilities, 36 late adolescents (18–22 years of age; 61% female) with regular alcohol use but without a current alcohol use disorder were recruited to complete smartphone reports of alcohol craving intensity six times a day for two weeks. During these two weeks, participants wore wrist actigraphs and completed two in-lab assessments (on Thursday and Sunday) of dim light melatonin onset (DLMO). Average actigraphically derived midpoint of sleep on weekends and average DLMO were used as indicators of sleep and circadian timing, respectively. Multilevel cosinor analysis revealed a 24-hour rhythm in alcohol craving. Findings across the sleep and circadian timing variables converged to suggest that sleep/circadian timing moderated the 24-hour rhythm in alcohol craving. Specifically, people with later sleep/circadian timing had later timing of peak alcohol craving. These findings add to the growing evidence of potential circadian influences on reward-related phenomena and suggest that greater consideration of sleep and circadian influences on alcohol craving may be useful for understanding alcohol use patterns and advancing related interventions.     

ANTABUS IN THE TREATMENT OF ALCOHOLISM IN A PRIVATE GENERAL HOSPITAL

In 35 consecutive cases in which patients were admitted to a private hospital for alcoholism, antabus was contraindicated for eight patients and administered to 27. Sixteen patients, followed three to nine months, cooperated fully with treatment and did not return to use of alcohol. In four cases there was at least one episode of drinking, but the patients continued to cooperate with treatment and attained partial success. In seven cases, including three in which antabus was stopped because of organic disease, treatment was unsuccessful. Insufficient insight and lack of family cooperation accounted for four failures.The presence of cardiovascular or hepatic diseases contraindicates antabus. As the test of reaction to alcohol after antabus has been given is hazardous, continuous supervision by nurse and physician throughout the test reaction is mandatory.Sustained results depend upon psychotherapy, family cooperation, careful follow-up, and control of side-reactions to the drug.Antabus as an antagonist to alcohol is not safe enough to permit general use of the drug.