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NESARC Wave 2 demographic characteristics among past-year alcohol-dependent individuals in Wave 1 (N = 1,172)
Source publication
Background:
We have previously reported on an empirical classification of Alcohol Dependence (AD) individuals into subtypes using nationally representative general population data from the 2001 to 2002 Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and latent class analysis. Our results suggested a typology...
Context in source publication
Context 1
... were 312 AD subjects lost to attrition from Wave 1 to Wave 2. We conducted an attrition analysis and found that no specific AD subtype was overrepresented in the loss of subjects to follow-up (Pearson Chi-sq [df = 4] = 4.3; p = 0.37). Table 2 displays the demographic characteristics of these AD individuals subtyped at Wave 1 and carried forward to Wave 2 of the NESARC. ...Similar publications
Intimate partner violence (IPV) is a major public health issue, yet little is known about the association between IPV victimization and problem drinking among women. Study objectives were to (a) identify subtypes of problem drinking among women according to abuse and dependence criteria from the Diagnostic and Statistical Manual of Mental Disorders...
Two nationally representative epidemiological samples (the National Longitudinal Alcohol Epidemiological Survey and the National Epidemiological Survey of Alcohol and Related Conditions) have been used to track changes in the prevalence of alcohol use disorders (AUDs) between 1992 and 2002 in the United States. Strikingly, estimates from these two...
Citations
... Individuals who have experienced substance use disorders without yet seeking (or recently seeking) professional services are a hard-to-reach population and critical target for future research. This is because (a) most individuals experiencing substance use disorders resolve their problems without ever receiving specialty treatment (Dawson et al., 2005;Moss et al., 2010), (b) substance use disorder resolution typically spans years, with important changes occurring before and after specialty treatment receipt (Dennis et al., 2007;Kelly et al., 2018Kelly et al., , 2019, and (c) relatively few studies to data have examined the course of substance use disorder resolution outside of and long after specialty treatment (Eddie et al., 2021;Kelly et al., 2017;Rubio et al., 2023). ...
Background
Although studies are increasingly adopting online protocols, few such studies in the addiction field have comprehensively described their data review procedures and successes in detecting low‐quality/fraudulent data. The current study describes data collection protocols and outcomes of a large, longitudinal study (the PAL Study 2021) that implemented online design elements to study individuals seeking peer support for an alcohol use disorder.
Methods
In 2021, the PAL Study collaborated with mutual‐help group (MHG) partners and recovery‐related organizations to recruit individuals attending a 12‐step group, Women for Sobriety (WFS), LifeRing Secular Recovery, and/or SMART Recovery for an alcohol problem in‐person and/or online in the prior 30 days. Participation was solicited both online and in‐person. Individuals accessed baseline surveys via an open web link; follow‐ups occurred at 6 and 12 months. Analyses included calculating the proportion of surveys eliminated in data quality review; comparing MHG subsamples to internal survey (benchmark) data for Alcoholics Anonymous (AA), WFS, LifeRing, and SMART; and examining response rates and attrition.
Results
Although 93% of respondents who opened the baseline survey completed it, 87% of baseline surveys were eliminated in data quality review (final N = 531). Nonetheless, cleaned MHG subsamples were generally similar to benchmark samples on gender, age, race/ethnicity, and education. Follow‐up rates for the cleaned sample were 88% (6 months) and 85% (12 months). Analyses revealed some differences in attrition by gender, primary MHG, and lifetime drug problems, but there was no evidence of greater attrition among those in earlier/less stable recovery.
Conclusions
Study methods appear to have produced a valid, largely representative sample of the hard‐to‐reach target population that was successfully followed across 12 months. However, given the high survey elimination rate and need for extensive data review, we recommend that researchers avoid open‐link designs and include comprehensive data review when incorporating online design elements.
... Results of analyses of treatment effects on alcohol problems in NESARC have been mixed. For example, one analysis found that treatment seeking is associated with more severe presentations of alcohol use at baseline [27], while others indicated that treatment is associated with abstinence (no alcohol use or symptoms) at follow-up [17,18]. ...
... Our cross-sectional analyses found that using SU and/or MH services in the past year was associated with being in a more severe alcohol use class at wave 1. This suggests that women with more alcohol use problems are most likely to receive substance use and/or mental health services, which is consistent with prior research [27]. A third explanation may have to do with treatment effectiveness. ...
Background
Alcohol use has profound public health impact on women; however, modifiable factors that may influence alcohol use progression/recovery, including health service utilization, are understudied in women.
Objective
To investigate the association between mental health (MH) and substance use (SU) treatment with alcohol use progression and recovery among women who currently use alcohol or have in the past.
Methods
This study is a secondary data analysis of prospective data from waves 1 (2001–2002) and 2 (2004–2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; a US-nationally representative sample of adults). The analytic sample was limited to women who reported past or current alcohol use at wave 1 (N = 15,515). Latent transition analysis (LTA) examined whether receiving SU/MH treatment in the year prior to wave 1 was associated with transitioning between three empirically-derived stages of alcohol involvement (no, moderate, and severe problems classes), between Waves 1 and 2 adjusting for possible confounders using propensity score weight.
Results
Compared to White female drinkers, female drinkers who were from Black, Hispanic, or other races were less likely to receive SU/MH treatment (p-values ≤. 001). SU/MH treatment in the year prior to wave 1 was associated with transitioning from the moderate problems class to the no problems class between Waves 1 and 2 (p-value = .04).
Conclusion
Receipt of SU or MH treatment among women, was associated with a higher likelihood of remission from moderate alcohol use problems to no problems over time. Future research, including investigation into treatment characteristics (e.g., frequency, duration, type) should further explore why women initially experiencing severe alcohol use problems did not experience similar remission.
... Substances relatively commonly consumed in the general population within one year indicated a prevalence of 11% and ever use in life was a prevalence of 16.6% [16]. The prevalence of anxiety disorders ranges from 15% to 26% among substance users [11,17]. Many studies showed a high rate of anxiety disorders in the consumption of substances especially the use of alcohol and cigarette substances [11,18,19]. ...
Introduction
Anxiety disorder is an unpleasant emotional feeling with symptoms related to psychological and autonomic symptoms such as headache, perspiration, palpitations, dizziness, and stomach discomfort. The use of substances become a worldwide problem among youth which brings situation that leads to serious social and health-related problems. Anxiety disorders with substance use have a huge impact on their high prevalence, therapeutic issues, and poor prognosis on clinical effects. Although the prevalence of anxiety disorders is significant among young people who use substances, limited studies were conducted. Therefore, this study revealed the burden of anxiety disorders among youth with substance use and associated factors in Ethiopia.
Method
A community-based multi-stage with a simple random sampling technique was conducted. A total of 372 substance users study participants were recruited for this study. Alcohol, Smoking, and Substance Involvement Screening Tests, Depression Anxiety Stress Scales, and other tools were used to assess anxiety disorders with substance use and associated factors. Data were entered into Epi-data version 4.6, and exported to SPSS version 20 for further analysis. Bi-variables logistic regression analysis was employed to identify variables with a p-value of < 0.2 and associated factors were determined in multi-variables logistic regression analysis with a p-value < 0.05 with AOR and CI.
Results
From a total of 372 respondents the overall prevalence of anxiety disorders with substance use was 48.1%. Male sex [AOR = 1.99; 95% CI: (1.01–3.93)], low educational status of the father [AOR = 6.38 95%CI: (1.50–7.08)], and the presence of stress [AOR = 2.48; 95% CI: 2.48(2.43–4.40)] were significantly associated factors with anxiety disorders with substances use.
Conclusions and recommendations
The prevalence of anxiety disorders with substance use was 48.1% therefore; it is recommended that the zonal administration give collaborative work with the health bureau and facilitate awareness creation about the impact of substance abuse. Clinicians are recommended to mitigate anxiety disorders with substance use to get a good prognosis for clients with controlling their stress.
... As alcohol and different drug classes (e.g., opiates, amphetamines, barbiturates) exhibit different patterns of cognitive impairment (Bruijnen et al., 2019), the impairments we observed may not be strictly attributable to alcohol use alone. However, comorbid substance use disorder is common in those with alcohol use related problems (Moss et al., 2010), and therefore the deficits we observe may be of relevance to people seeking help for polysubstance use, although with alcohol use as a primary concern. ...
Background:: Cognitive disinhibition underpins alcohol and drug use problems. Although higher-risk substance use is consistently associated with poorer disinhibition, current findings may be limited by narrow recruitment methods, which over-represent individuals engaged in traditional treatment services with more severe presentations. We embedded a novel gamified disinhibition task (the Cognitive Impulsivity Suite; CIS) in a national online addiction support service (). Method:: Participants aged 18 to 64 ( = 137; 109 women) completed the Alcohol-Use Disorders Identification Test (AUDIT) and Drug Use Disorders Identification Test (DUDIT) along with the CIS, which measures three aspects of disinhibition (Attentional Control, Information-Sampling, and Feedback Monitoring/Shifting). The majority of the sample comprised people with alcohol use, and AUDIT scores were differentiated into ‘higher-risk’ or ‘lower-risk’ groups using latent-class analysis. These classes were then regressed against CIS performance measures. Results:: Compared to lower-risk, higher-risk alcohol use was associated with poorer attentional control and feedback monitoring/shifting. While higher-risk alcohol use was associated with slower information accumulation, this was only observed for older adults, who appeared to compensate with a more conservative response criterion. Conclusions:: Our results reveal novel relationships between higher-risk alcohol use and specific aspects of disinhibition in participants who sought online addiction help services.
... Additionally, it has been suggested that some microstructural deficits may reflect a pre-existing vulnerability to development of AD. 20,21 Studies seeking to distinguish subtypes of AD have tended to include a group characterised by a high occurrence of other forms of substance abuse and dependence. [22][23][24] Polydrug use by clients within treatment services has been long been recognised as a treatment issue, though this remains understudied, with inpatient prevalence rates of alcohol-polydrug dependence ranging from 47% to 64%. [25][26][27] Furthermore, emerging evidence has highlighted worse treatment outcomes-greater risk of relapse, lower treatment retention rates, higher mortality rates and a greater prevalence of psychiatric comorbidity. ...
Evidence suggests that alcohol dependence (AD) is associated with microstructural deficits in white matter, but the relationship with lifetime alcohol exposure and the impact of polydrug dependence is not well understood. Using diffusion tensor magnetic resonance (MR) imaging, we examined white matter microstructure in relation to alcohol and polydrug dependence using data from the Imperial College Cambridge Manchester (ICCAM) platform study. Tract‐based spatial statistics were used to examine fractional anisotropy (FA) in a cohort of abstinent AD participants, most of whom had a lifetime history of dependence to nicotine. A further subgroup also had a lifetime history of dependence to cocaine and/or opiates. Individuals with AD had lower FA throughout the corpus callosum, and negative associations with alcohol and nicotine exposure were found. A group‐by‐age interaction effect was found showing greater reductions with age in the alcohol‐dependent group within corpus callosum, overlapping with the group difference. We found no evidence of recovery with abstinence. A comparison of alcohol‐only‐ and alcohol‐polydrug‐dependent groups found no differences in FA. Overall, our findings show that AD is associated with lower FA and suggest that these alterations are primarily driven by lifetime alcohol consumption and cigarette smoking, showing no relationship with exposure to other substances such as cocaine, opiates or cannabis. Reductions in FA across the adult lifespan are more pronounced in AD and offer further support for the notion of accelerated ageing in relation to alcohol dependence. These findings highlight there may be lasting structural differences in white matter in alcohol dependence, despite continued abstinence.
... Previous studies on alcohol use disorder have examined if different subgroups of patients have varying disease prognosis and treatment outcomes in clinical and general population settings; however, these studies were based on a younger population and had not investigated the differential risk of alcohol-, polydrug-and psychiatricrelated hospitalizations [59][60][61]. We demonstrated the possibility of using social service and longitudinal health-care data to follow the health outcome of older addiction service users in a context where the addiction care and treatment system is publicly funded and uncoordinated across municipal and regional systems. ...
Background and Aims
Older persons with problematic alcohol use vary in psychosocial functioning, age of onset for problem drinking and use of other drugs. The study measured the differential risks of all-cause, alcohol, polydrug and psychiatric-related repeated hospitalizations among older persons with problematic alcohol use.
Design
A linked register-based cohort study with discontinuous multiple-failure (time-to-repeated-event) data. Hospitalization and mortality were considered as failure.
Setting
Sweden, March 2003-November 2017, using data from the Addiction Severity Index (ASI) register linked to National Inpatient Register and the Swedish Cause of Death Register.
Participants
50 years and older (n= 1741; 28% women), with one or more alcohol problem days in the 30 days before an ASI assessment.
Measurements
Five mutually exclusive latent classes of problematic alcohol use, identified with eleven ASI items, were the independent variables: “Late Onset with Fewer Consequence (LO:FC; reference group)”; “Early Onset/Prevalent Multi-Dimensional problems (EO:MD)”; “Late Onset with co-occurring Anxiety and Depression (LO:AD)”; “Early Onset with co-occurring Psychiatric Problems (EO:PP)”; and “Early Onset with major Alcohol Problem (EO:AP)”. Covariates included sociodemographic characteristics, previous hospitalization and Elixhauser comorbidity index. Outcome measurements included recurrent hospitalization, and/or mortality due to: (a) all-cause, (b) alcohol-related disorders and diseases (c) polydrug use (d) other psychiatric disorders.
Findings
During the study period, 73.2% were hospitalized at least once, 57.3% were alcohol-related, 8.5% polydrug use and 18.5% psychiatric-related diagnoses.
Compared with LO:FC, EO:PP had higher risk for all-cause (adjusted hazard ratio [aHR]= 1.27, 95% confidence interval [CI]= 1.02—1.59) and alcohol-related (aHR= 1.34, 95% CI= 1.02—1.75) hospitalizations. Adjusted risks for polydrug-related hospitalization were 2.55, 95%CI= 1.04—6.27 for EO:MD and 2.62, 95%CI= 1.07—6.40 for EO:PP. Adjusted risk for psychiatric-related hospitalization was higher for LO:AD (aHR= 1.78, 95%CI= 1.16—2.73 and EO:PP (aHR= 2.03, 95%CI= 1.22—3.38).
Conclusions
Older addiction service users in Sweden have varying risks of hospitalization due to alcohol use, polydrug use and psychiatric disorders. Older persons with problematic alcohol use who have multiple needs and are assessed in social services may benefit from earlier interventions with an integrated focus on substance use and mental health.
... One study speculates that the high rate of illicit drug use among those with ADHD may be explained by the accelerated gateway hypothesis, which proposes that the earlier onset of substance use among adolescents with ADHD leads to higher rates of cocaine and heroin abuse later in life (Dunne et al., 2015). However, it is also important to consider that the lower likelihood of alcohol use disorders in comparison to drug use disorders (excluding cannabis) in the current study may be influenced by the fact that many people do not develop alcohol use disorders until middle age (Moss et al., 2010) and thus may not have been reflected in our analysis. Lastly, we were able to control for a larger range of variables than past research, specifically, smoking, mental health, socioeconomic status and ACEs. ...
Aim
(a) To document the prevalence and odds of (i) alcohol use disorders, (ii) cannabis use disorders, (iii) other drug use disorders and (iv) any substance use disorder (SUD), among young adults with and without ADHD, and (b) to investigate the degree to which the association between ADHD and SUDs is attenuated by socio-demographics, early adversities and mental health.
Method
Secondary analysis of the nationally representative Canadian Community Health Survey-Mental Health (CCHS-MH). The sample included 6872 respondents aged 20–39, of whom 270 had ADHD. The survey response rate was 68.9%.
Measurements
Substance Use Disorder: World Health Organization’s Composite International Diagnostic Interview criteria, SUDs, were derived from lifetime algorithms for alcohol, cannabis and other substance abuse or dependence. ADHD was based on self-report of a health professional’s diagnosis.
Findings
One in three young adults with ADHD had a lifetime alcohol use disorder (36%) compared to 19% of those without ADHD (P < 0.001). After adjusting for all control variables, those with ADHD had higher odds of developing alcohol use disorders (OR = 1.38, 95% CI: 1.05, 1.81), cannabis use disorders (OR = 1.46, 95% CI: 1.06, 2.00), other drug use disorders (OR = 2.07, 95% CI: 1.46, 2.95) and any SUD (OR = 1.69, 95% CI: 1.28, 2.23). History of depression and anxiety led to the largest attenuation of the ADHD-SUD relationship, followed by childhood adversities and socioeconomic status.
Conclusions
Young adults with ADHD have a high prevalence of alcohol and other SUDs. Targeted outreach and interventions for this extremely vulnerable population are warranted.
... Disorder severity is one of the most robust factors associated with seeking treatment for AUD (17,30,51,52,55,59,70,78,79). Early research on this topic suggests that one's perceived severity of their drinking problem plays a key role in treatment entry and is associated with greater depressive levels, alcohol dependence symptoms, and negative life events (80). ...
... Results suggest a lag of approximately 10 years between the first onset of AUD and the decision to seek formal treatment (12). Regarding "who" is most likely to seek treatment, the literature suggests that men are more likely to seek treatment than women (49,54,(58)(59)(60)(61)(62), along with individuals with more severe AUD presentations (17,30,51,52,55,59,70,78,79). Some health disparities are noted in regard to "who" seeks treatment, with minority groups facing delays to treatment and receiving lower quality care. ...
Despite a well-documented global burden of disease attributable to alcohol use disorder (AUD), treatment seeking rates remain low. In this qualitative literature review, we address treatment seeking for AUD from a host of perspectives and summarize the literature on key factors. First, we summarize the rates of alcohol treatment seeking across various epidemiological surveys, spanning decades. Second, we discuss the definition of treatment seeking and ‘what’ is typically considered formal treatment. Third, we consider timing and discuss ‘when’ individuals are most likely to seek treatment. Fourth, we review the literature on ‘who’ is most likely to seek treatment, including demographic and clinical correlates. Fifth, we address the critical question of ‘why’ so few people receive clinical services for AUD, relative to the number of individuals affected by the disorder, and review barriers to treatment seeking at the treatment- and person-levels of analysis. Finally, we identify opportunities to improve treatment seeking rates by focusing on tangible points of intervention. Specifically, we recommend a host of adaptations to models of care including efforts to make treatment more appealing across stages of AUD severity, accept a range of health-enhancing drinking goals as opposed to an abstinence-only model, educate providers and consumers about evidence-based behavioral and pharmacological treatments, and incentivize the delivery of evidence-based services.
... Such differences may have prognostic significance, as for instance patients whose lives function better have a later onset of AUD, and patients who have less family history of alcohol problems, are more likely to recover (e.g. Moss et al. 2010). However, other patient-specific differences may be as important as their characteristics. ...
Introduction: Premature drop-out and lack of success from alcohol treatment is common. Within recent years, Shared Decision Making (SDM) has gained increased attention in treatment planning in health care. Results from research in SDM in addiction treatment points in different directions, hence this review focuses on alcohol addiction only. Furthermore, studies on Informed Choice is included in this review. The objective is to measure outcome results on the following four measures: (1) drinking outcome, (2) quality of life, (3) enrollment, and (4) adherence.
Method: MEDLINE, PubMed and PsychInfo databases were searched. Studies included were RCT or Quasi-RCT measuring SDM or informed choice in treatment planning in alcohol addiction. The PRISMA guidelines was followed. Two researchers measured the quality of the studies. If disagreement could not be resolved by discussion, a third researcher was consulted.
Results: 1203 studies were identified. Thirteen met the inclusion criteria, of which 7 were excluded. The remaining 6 studies were too heterogeneous to perform a meta-analysis, resulting in a narrative discussion of results.
Discussion: The inadequate evidence limits the conclusions on our four objectives. (1) Drinking outcome, it seems that patient involvement in treatment planning does not have an effect. (2) Quality of life might be improved. (3) Enrollment might be increased. (4) Adherence was improved.
Conclusion: Very few studies have been performed in this field; hence, no clear recommendation can be given to clinical practice at this point.
PROSPERO Registration code: CRD42019124794
... [2] Alcohol can be a significant contributing factor to many medical conditions. [3] The medical consequences of drinking alcohol may manifest in any organ system of the body. [4] An estimated 4% to 40% of medical and surgical patients experience problems related to alcohol intoxication or abuse. ...
Alcohol consumption has been suggested as a potential risk factor for diverticular diseases. This study investigated the association between alcohol intoxication or abuse and colonic diverticular disease (CDD).
Using the National Health Insurance Research Database of Taiwan from January 1, 2000, to December 31, 2008, 51, 866 subjects newly diagnosed with alcohol intoxication were enrolled in this study as the alcohol intoxication cohort. The control (nonalcohol intoxication) cohort was frequency-matched 1:4 by age, sex and index year. Data were analyzed using a Cox proportional hazards model.
The overall incidence of CDD (per 10,000 person-years) for the alcohol intoxication and control cohorts was 16.4 and 3.46, respectively. Compared with patients in the control cohort (95% confidence interval [CI] = 2.76–3.74), those with alcohol intoxication exhibited a 3.21-fold risk of CDD; the risk was particularly higher in male patients (adjusted hazard ratio [aHR] = 3.19, 95% CI = 2.72–3.74) and in those aged <45 years (aHR = 4.95, 95% CI = 3.91–6.27). The alcohol intoxication still had higher risk of CDD than nonalcohol intoxication, regardless of subjects without comorbidity (aHR = 3.38, 95% CI = 2.77–4.11) or with (aHR = 2.85, 95% CI = 2.25–3.61).
There was a significant relationship between alcohol intoxication or abuse and CDD.
