Drinking Motives Moderate the Impact of Predrinking on Heavy Drinking on a Given Evening and Related Adverse Consequences – an Event-Level Study.

Drinking motives moderate the impact of predrinking on heavy drinking on a given evening and related adverse consequences – An event-level study.

Addiction. 2013 May 21;
Kuntsche E, Labhart F

AIMS: To test whether (a) drinking motives predict the frequency of predrinking (i.e. alcohol consumption before going out); (b) drinking motives predict HDGE (heavy drinking on a given evening: 4+ for women, 5+ for men) and related adverse consequences (hangover, injuries, blackouts etc.) even when predrinking is accounted for, and (c) drinking motives moderate the impact of predrinking on HDGE and consequences. DESIGN: Using the Internet-based cell phone-optimised assessment technique (ICAT), participants completed a series of cell phone questionnaires every Thursday, Friday and Saturday evening over five weeks. SETTING: French-speaking Switzerland. PARTICIPANTS: 183 young adults (53.0% female, mean age [SD] = 23.1 [3.1]) who completed 7,828 questionnaires on 1,441 evenings. MEASUREMENTS: Drinking motives assessed at baseline, alcohol consumption assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m. and midnight and consequences assessed at 11 a.m. the next day. FINDINGS: Gender-separate multilevel models revealed that predrinking predicted HDGE (men: B = 2.17, p < .001; women: B = 2.12, p < .001) and alcohol-related consequences (men: B = 0.24, p < .01; women: B = 0.29, p < .001). Enhancement motives were found to predict HDGE (B = 0.48, p < .05) and related consequences (B = 0.09, p < .05) among men, while among women coping motives had the same effect (HDGE: B = 0.73, p < .001; consequences: B = 0.13, p < .01). With the exception of conformity motives among women (B = 0.54, p < .05), however, no drinking motive dimension predicted the frequency of predrinking, while coping and conformity motives moderated the impact of predrinking on HDGE (Men, conformity: B = -1.57, p < .05) and its consequences (Men, coping: B = -0.46, p < .01; women, coping: B = 0.76, p < .05). CONCLUSIONS: Among young adults in Switzerland, heavy weekend drinking and the related consequences seem to result from the combination of predrinking, level of negative reinforcement drinking for women and positive reinforcement drinking for men. HubMed – addiction


Comparative performance of biomarkers of alcohol consumption in a population sample of working-aged men in Russia: the Izhevsk Family Study.

Addiction. 2013 May 21;
McDonald H, Borinskya S, Kiryanov N, Gil A, Helander A, Leon DA

AIMS: To assess the performance of a range of biomarkers of alcohol consumption in a heavy-drinking population of working-aged Russian men. DESIGN: Cross-sectional study of men originally sampled at random from a population register. SETTING: Izhevsk, a Russian city with a population of 650,000 people PARTICIPANTS: 1,023 men aged 27-59 years living in Izhevsk who took part in a health check examination in 2008-2009. MEASUREMENTS: Self-reported alcohol consumption, hazardous drinking behaviours, socio-economic position, anthropometric measurements plus blood levels of alcohol biomarkers (CDT, GGT, ALT, AST and MCV) and hepatitis B and C status. FINDINGS: In the year before interview there was a high prevalence of high-risk alcohol consumption indicated by consumption of non-beverage alcohols (5.0%), problem drinking behaviours (4.4%), and alcohol consumption exceeding an average 40 g per day (12.6%). All biomarkers were strongly associated with total beverage alcohol consumption even after adjustment for confounders. CDT performed best as an alcohol biomarker, with a sensitivity of 67% and specificity of 71% for detecting an average consumption of over 40 g per day vs. less. For all biomarkers sensitivity was considerably lower than specificity. Hazardous drinking patterns per se were not well detected by any of the biomarkers, all with sensitivity below 60%. CONCLUSIONS: In a Russian population with high levels of alcohol consumption, carbohydrate deficient transferrin (CDT) may be the most sensitive and specific biomarker for detecting ethanol consumption above 40g/day. A biomarker reflecting hazardous drinking patterns has yet to be established. HubMed – addiction


CHRNA5-A3-B4 genetic variants alter nicotine intake and interact with tobacco use to influence body weight in Alaska-Native tobacco users.

Addiction. 2013 May 21;
Zhu AZ, Renner CC, Hatsukami DK, Benowitz NL, Tyndale RF

BACKGROUND AND AIMS: Gene variants in CHRNA5-A3-B4, which encode for the ?5, ?3 and ?4 nicotinic receptor subunits, are associated with altered smoking behaviors in European-Americans. Little is known about CHRNA5-A3-B4 and its association with smoking behaviors and weight in Alaska-Native people, which is a population with high prevalence but low levels of tobacco consumption, extensive smokeless tobacco use, and high rates of obesity. We investigated CHRNA5-A3-B4 haplotype structure and its association with nicotine intake and obesity in Alaska-Native people. DESIGN, SETTING, PARTICIPANTS: A cross sectional study of 400 Alaska-Native individuals including 290 tobacco users. MEASUREMENTS: CHRNA5-A3-B4 genotype, body weight, and tobacco consumption biomarkers such as plasma cotinine and urinary total nicotine equivalents (TNE). FINDINGS: Alaska-Native people have a distinct CHRNA5-A3-B4 haplotype structure compared with European/African-Americans. In 290 Alaska-Native tobacco users, the ‘G’ allele of rs578776, which tagged a 30kb haplotype in CHRNA5-A3-B4, was prevalent (16%) and significantly associated with nicotine intake (20% higher plasma cotinine, P<0.001, 16% higher TNE, P=0.076), while rs16969968 was not associated with nicotine intake. Rs578776 acted in combination with CYP2A6, the main nicotine-metabolizing enzyme, to increase nicotine intake by 1.8 fold compared with the low risk group (P<0.001). Furthermore rs2869950, a single nucleotide polymorphism 5' to CHRNB4, was significantly associated with increased body mass index (P<0.01) in the tobacco users even after controlling for differences in nicotine intake (P<0.01). CONCLUSIONS: Genetic variants in CHRNA5-A3-B4 alter nicotine intake and body mass index in a population of Alaska-Native people, who have a distinct haplotype structure, smoking behaviors and prevalence of obesity. HubMed – addiction


Non-medical use of prescription opioids and prescription opioid-related harms: why so markedly higher in North America compared to the rest of the world?

Addiction. 2013 May 20;
Fischer B, Keates A, Bühringer G, Reimer J, Rehm J

AIMS: This paper aims to identify possible system-level factors contributing to the marked differences in the levels of non-medical prescription opioid use (NMPOU) and prescription opioid (PO)-related harms in North America (i.e. the United States and Canada) compared to other global regions. METHODS: Scientific literature and information related to relevant areas of health systems, policy and practice were reviewed and integrated. RESULTS: We identified several but different factors contributing to the observed differences. First, North American health-care systems consume substantially more Pos-even when compared to other high-income countries-than any other global region, with dispensing levels associated strongly with levels of NMPOU and PO-related harms. Secondly, North American health-care systems, compared to other systems, appear to have lesser regulatory access restrictions for, and rely more upon, community-based dispensing mechanisms of POs, facilitating higher dissemination level and availability (e.g. through diversion) of POs implicated in NMPOU and harms. Thirdly, we note that the generally high levels of psychotrophic drug use, dynamics of medical-professional culture (including patient expectations for ‘effective treatment’), as well as the more pronounced ‘for-profit’ orientation of key elements of health care (including pharmaceutical advertising), may have boosted the PO-related problems observed in North America. CONCLUSIONS: Differences in the organization of health systems, prescription practices, dispensing and medical cultures and patient expectations appear to contribute to the observed inter-regional differences in non-medical prescription opioid use and prescription opioid-related harms, although consistent evidence and causal analyses are limited. Further comparative examination of these and other potential drivers is needed, and also for evidence-based intervention and policy development. HubMed – addiction