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The manifestation of alcohol use disorder (AUD) and its social, health, and psychological implications depend in part on patient demographics. Yet researchers routinely exclude those demographics from analyses of non-medicinal AUD treatment trials, a review of studies has found. Consequently, little is known about how sex, gender, race, and ethnicity influence the effectiveness of those treatments, or which treatments are indicated — or not — for specific patients and communities. This is despite the National Institutes of Health Revitalization Act in 1993 requiring that NIH-funded studies include diversity of sex/gender and race/ethnicity in their participant samples and analysis. Problematic alcohol use, which has high prevalence and low treatment rates, is a leading contributor to preventable death and disease. Non-pharmacological treatments include cognitive behavioral therapy (CBT), motivational interviewing (MI), contingency management, twelve-step programs, and more. Inequalitie

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The COVID-19 pandemic has had a profound effect on many people’s lives. Emerging adults may have been particular impacted, given their transition from adolescence to adulthood during such a time of upheaval, with their educational and career aspirations thrown into disarray. A new study has found that the risk for depression tripled among young people – particularly younger women – during the pandemic, and that this risk persisted into 2021.

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During the COVID-19 pandemic, policy interventions designed to reduce the virus’ spread included shelter-in-place (SIP) orders and phased “reopenings” of public spaces. Knowing that adult alcohol and substance use generally rose during the pandemic due to factors such as stress, boredom, worsening mental health, and increased alcohol availability, a new study sought to understand the impact of SIPs and reopenings on adolescent alcohol use in California. Analysis shows SIP decreased frequency of alcohol use. Also, compliance with SIP orders was associated with decreased frequency and quantity of use.

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Older adults – those more than 50 years of age – who consume alcohol beyond healthy drinking guidelines are a growing public health concern. A new study has found that using text messaging can help reduce drinking among this population. These findings will be shared at the 45th annual scientific meeting of the Research Society on Alcoholism (RSA) in Orlando, Florida.

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Research shows that adolescents and young adults frequently overestimate the extent to which their peers drink alcohol, and that these overestimations increase risk for problem drinking behaviors, as well as dating violence. A recent study found that LGBTQIA2S+* teens likewise overestimate the frequency and quantity of alcohol use of other LGBTQIA2S+ teens, but also drink alcohol and experience dating violence at disproportionately higher rates than heterosexual, cisgender teens.

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During 2010-2019, roughly the same decade that more than 100,000 people in the U.S. died in alcohol-related crashes, ridehailing emerged as a technology that was often cheaper and/or easier to access than taxis and public transit.

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As of March 2022, 18 states and the District of Columbia allow recreational use of marijuana among adults 21 years and older, and recreational marijuana sales is legal in 14 of these states.

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Military sexual trauma (MST) can have a corrosive impact on trust within the U.S. military, as well as a number of negative effects on the individual. A recent study has examined the prevalence of MST history among U.S. Army Reserve/National Guard (USAR/NG) soldiers, the extent to which MST history predicts risk for alcohol misuse and problems, and potential sex differences in these experiences and outcomes. Findings indicate that MST is alarmingly prevalent for both female and male service members; in fact, the prevalence of MST appears to be much higher for male service members than is often reported.

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Prior research has demonstrated greater addiction vulnerability in women; for example, women advance from casual substance use to addiction at a faster rate, experience more severe withdrawal symptoms, exhibit higher rates of relapse, and have less treatment success than men. A new study shows that biobehavioral interactions in alcohol use disorders (AUDs) among women are cyclical in nature: women’s greater risk of personal histories of trauma coupled with a greater vulnerability to alcohol-related brain deficits can lead to more severe AUD effects.

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Scientists investigating substance use are making progress on eliminating stigmatizing language that can perpetuate negative biases and worsen outcomes, according to a new analysis of published research articles. Nevertheless, the field has further to go.

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New research has revealed a significant gap in prescribing of effective medications for alcohol use disorder (AUD). The study, reported in Alcoholism: Clinical and Experimental Research, showed that just one in twenty patients with an alcohol-related diagnosis were prescribed an approved AUD drug (naltrexone, disulfiram, or acamprosate). The findings reinforce and build on previous evidence of under-prescribing, despite these treatments being proven to reduce heavy drinking and relapse. In the inpatient acute care setting, provision of AUD medication has been shown to be both feasible and associated with a reduction in re-admissions and emergency department (ED) visits. However, few prior studies had reported on prescribing habits in this setting. The current study examined prescribing in the acute inpatient care setting compared to other care settings within the University of Colorado Healthcare System.

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Online resources for supporting recovery from Alcohol Use Disorder (AUD) are promising but underused, a new study suggests. The expansion of digital recovery supports, such as video meetings, discussion forums, and social networking sites, could potentially help address a substantial unmet need for services. In 2020, fewer than one in ten Americans with current or recent substance use disorder received any form of treatment. Women are less likely to access treatment than men, research shows. Online services may make recovery support more accessible, eliminating certain barriers associated with traditional treatment (e.g., transportation and cost) and reducing others (e.g., stigma). Research is sparse, however, and the factors influencing the use and effects of digital services are not well understood. For the study in Alcoholism: Clinical & Experimental Research, researchers explored how people in recovery from AUD use online supports and whether that use is linked to gender or outcome

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A five-year study has highlighted the importance of healthy sleep patterns in relation to future binge-drinking and cannabis use in adolescence and young adulthood, as reported in Alcoholism: Clinical and Experimental Research. The work builds on growing evidence that sleep characteristics are predictive of future substance use and related problems in young people, and could inform strategies for substance use prevention and intervention. Most previous studies assessed only a small range of sleep characteristics, and had limited follow-up. In the new analysis, researchers used six annual assessments from the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study to examine whether multiple sleep characteristics in any year predict alcohol and cannabis use the following year. Data from over eight hundred NCANDA study participants, aged 12 to 21 at baseline, were included.

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The language used in Facebook posts can identify people at risk of hazardous drinking and alcohol use disorders (AUDs), according to a new study. Social media platforms are a “low-cost treasure trove” of data, researchers claim, expanding the options for studying, screening, and helping people at risk. Social media content in recent years has been used to explore various public health phenomena. For example, language and “likes” have predicted depression, hospital visits, low birthweight, obesity, and life expectancy. Social media language has also been linked to patterns of alcohol consumption and related problems. For the study in Alcoholism: Clinical & Experimental Research, investigators explored how convincingly the language of Facebook could be used to identify risky drinking. They compared the accuracy of multiple predictive tools, including a new technique for processing language that has rarely been applied to health research.

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Pregnant women’s alcohol use is correlated with their partners’ drinking, according to a large European study — and partners are unlikely to meaningfully reduce or halt their alcohol consumption while expecting a baby. The findings may offer a new way of identifying women at risk of drinking in pregnancy and potentially intervening to prevent or reduce harm. Alcohol consumption during pregnancy can seriously impair fetal health and development, causing stillbirth and lifelong disabilities. These include fetal alcohol spectrum disorders (FASDs), the primary cause of non-genetic cognitive disability worldwide. Although the drinking patterns of women and their partners are known to be correlated, little attention has been given to partners’ alcohol use during pregnancy and how this may affect women’s drinking and pregnancy outcomes. For the study in Alcoholism: Clinical & Experimental Research, investigators searched for associations between pregnant women’s and their partners’ alcohol us

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A new generation of wearable alcohol sensor has potential for use as a self-management tool by social drinkers, as reported in Alcoholism: Clinical and Experimental Research.

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A study of adult drinking in the US over time has identified distinct demographic subpopulations with diverging drinking trajectories during the first ten months of the COVID-19 pandemic. Although population-wide average drinking increases in the pandemic were modest and time-limited, the aggregated data mask escalating drinking in certain subpopulations, raising public health concerns. The study, reported in Alcoholism: Clinical and Experimental Research, provides insights into the sociodemographic communities that might benefit from intervention to counteract drinking increases − or reinforce drinking reductions − that were acquired during the pandemic.

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Machine learning techniques can be used to predict treatment outcomes among people with alcohol use disorder (AUD), according to a study reported in Alcoholism: Clinical and Experimental Research. Patients often return to heavy drinking during and after their treatment for AUD, and may need multiple rounds of treatment before they can achieve long-term abstinence from heavy alcohol use. The predictive models identified in this study could be used to develop clinical systems that allow clinicians and patients to anticipate drinking relapses and adjust treatment before they occur, enhancing clinical care and outcomes. Patient characteristics associated with relapse have been identified previously using traditional statistical techniques, but methodological limitations have made it difficult to leverage these associations to create optimal predictive models. Machine learning – a branch of artificial intelligence involving the use of computer algorithms that can build and automatically imp

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A review of studies exploring changes in alcohol use during the COVID-19 pandemic has revealed an increase in problematic alcohol use in some countries. Overall, the pandemic’s impact on drinking was mixed, and likely dependent on multiple factors including the local social distancing and alcohol-specific policies in force. Although several countries, including the US, have previously reported higher alcohol sales during the pandemic, synthesized information on the impact on alcohol consumption was lacking. Factors potentially linked to greater pandemic drinking include social isolation, anxiety and depression, blurring of work and leisure hours, loss of employment, and the shift from in-premise to home-based drinking. However, for some people, the same factors may have prompted a reduction in drinking. Alcohol-related policies, as well as lockdown restrictions, varied around the world. In certain countries, such as South Africa, alcohol sales were temporarily banned, whereas in parts

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Adults who attended a four-day music festival subsequently exhibited diminished attentional performance that could have impaired their driving even after they were no longer intoxicated, an innovative study suggests. Alcohol is known to affect drivers’ attention and responses, both during acute intoxication and residually (while hungover). Little is known about which elements of cognition are affected by residual alcohol impairment, how vulnerable we might be to those effects, or how they interact with fatigue, another common source of driving impairment. This raises concerns about, for example, the ability of festival goers to drive home safely, even without traceable alcohol in their blood or breath. Assessing cognitive and driving performance in real-world circumstances calls for creative experimentation. For the study in Alcoholism: Clinical & Experimental Research, Australian investigators compared young adults’ performance on attention tasks in a controlled setting involving alco

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Many lesbian and bisexual women lack access to culturally sensitive and effective alcohol and mental health treatments, according to a new study. The findings suggest that sexual minority women (SMW), especially younger women, women of color, and those with low incomes, face multiple barriers to addressing problematic alcohol use. Previous research has shown that SMW experience higher rates of problem drinking and its negative consequences than heterosexual women. This partly reflects the impact of discrimination and its associated stress. Yet SMW appear relatively unlikely to seek help, and when they do, are less satisfied with it, for reasons including a lack of identity-affirming care and provider bias. Better understanding of SMW’s recognition of alcohol problems, motivation to reduce drinking, and treatment experiences — important influences on outcomes — as well as how their alcohol experiences vary by demographic characteristics can potentially help identify women at risk and in

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Approximately one-third of US adults experience recent unhealthy alcohol use, and of those, one in seven suffer from alcohol withdrawal syndrome (AWS), according to a new US population-based study with substantial clinical implications. Symptoms of alcohol withdrawal in heavy drinkers are linked to considerable distress and functional impairment, poorer long-term drinking and other health outcomes, greater likelihood of hospitalization, and higher healthcare costs and morbidity and mortality risk. The estimated prevalence of AWS varies widely. Little is known about its manifestations among people in the general population with unhealthy alcohol use, limiting clinicians’ ability to identify patients at risk of AWS. Better information on AWS could enhance its prevention and timely, targeted treatment efforts.

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Symptoms of alcohol use disorder (AUD) can be reliably assessed with an Alcohol Symptom Checklist during routine care among patients who screen positive for high-risk drinking, according to a study in Alcoholism: Clinical and Experimental Research. The checklist can be easily administered in primary care settings, and can help providers diagnose AUD, determine its severity, and monitor changes in symptoms over time. To date, a lack of practical tools to reliably assess AUD symptoms has contributed to the underdiagnosis and undertreatment of AUD, despite the availability of effective treatments. Brief screening questionnaires can identify people with high-risk drinking and are increasingly used, but these do not assess symptoms required for an AUD diagnosis or the number of AUD symptoms present (required for determining the severity of a diagnosis). Although well-validated interviews for diagnosing AUD are available for research use, these require considerable time and training to admin

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Scoring of common genetic variants can help identify people at high risk for alcohol use disorder (AUD), according to a study in Alcoholism: Clinical and Experimental Research. With prompt intervention, it may then be possible to prevent these individuals from developing AUD. For decades, a family history of AUD − which reflects both genetic and environmental risk − has been used to assess AUD liability. However, information on family history is not always available, and not all patients with AUD would be expected to have a positive family history. Therefore, relying on family history as the primary predictor of risk misses many high-risk individuals. For complex disorders like AUD, the common genetic variants that contribute to genetic risk each have a small effect on their own. However, when evaluated together, these variants can be used to calculate polygenic risk scores (PRS) – the weighted sum of multiple risk genes across the whole genome. PRS have shown promise in evaluating ris

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Worsening alcohol-related problems over the first nine months of the COVID-19 pandemic were associated with internal factors, such as loneliness and depression, more than household circumstances or income loss, a new study suggests. Studies of alcohol consumption during the pandemic have found varying impacts. The research has been limited, however, by its focus on alcohol consumption at certain points in time rather than variability in drinking and alcohol-related problems over the course of the pandemic. For the study in Alcoholism: Clinical & Experimental Research, Canadian investigators examined individuals’ drinking the first nine months of the pandemic to see if meaningful subgroups emerged. They also examined how shifting alcohol use related to depression, social disconnection, living alone, parenting a child, and income loss, among other potential influences.

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People with alcohol use disorder (AUD) have a distorted perception of the richness of imagined future scenarios, according to a study in Alcoholism: Clinical and Experimental Research. The findings could have important implications for AUD treatment and rehabilitation. The ability to imagine specific future events is a type of mental time travel known as episodic future thinking (EFT). EFT contributes to a range of skills needed to safely navigate daily life, including planning, goal-directed behavior, and emotional regulation. Previous research has indicated that people with short-sighted maladaptive behaviors, such as drug misuse and excessive gambling, tend to imagine future events that lack vividness and specificity. Impaired EFT was also suspected to be of clinical importance in AUD, but little was known about the mechanisms underlying the impairment.

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Emotionally detaching from a traumatic experience, a psychological defense known as dissociation, may play a key role in nudging some people with posttraumatic stress disorder (PTSD) toward alcohol-related problems, a new study suggests. A large minority of people with PTSD also have a substance use disorder (SUD), implying that using alcohol or drugs is a form of self-medication among traumatized people. Dissociation, a common symptom of PTSD, is a psychological escape from threatening situations that substitutes for physical escape; it can reflect particularly harmful early-life trauma and more severe PTSD. Previous research has linked dissociation with alcohol and substance use. Understanding the relevant pathway, or mechanism, could potentially inform and expand treatment options and effectiveness — a critical advance, since co-occurring PTSD and SUD come with a magnified risk of suicidality, functional impairment, and death. For the study in Alcoholism: Clinical & Experimental Res

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Exposure to alcohol in the womb exacerbates children’s vulnerability to social and environmental stressors and to mental health issues in adulthood, according to a new study. Prenatal alcohol exposure (PAE) is known to cause neurocognitive and physical conditions, including facial and growth abnormalities. Previous research has also linked PAE to long-term mental health effects, though these outcomes are not well understood. This is partly because the impact of alcohol exposure before birth is difficult to separate from the effects of other early social and environmental stressors, including adverse childhood experiences, that often accompany PAE. For the new study in Alcoholism: Clinical & Experimental Research, investigators compared mental health conditions among adults who’d been exposed to alcohol before birth with those who weren’t. They also explored the role of early childhood adversity and other social and environmental factors on mental health.

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A new study has reinforced the importance of implicit attitudes toward alcohol in escalating risk for heavy drinking as a young person transitions from adolescence to adulthood. Alcohol use peaks in emerging adulthood, with many associated health risks and negative consequences, so understanding risk and protective pathways to heavy drinking in this age group is a critical public health issue. In contrast to conscious information processing, implicit information processing occurs spontaneously, without deliberation or awareness. Although implicit alcohol attitudes are considered important in prompting alcohol use and maintaining heavy drinking, previous studies have provided mixed support for the association between positive (i.e. favorable) implicit alcohol attitudes and greater drinking. This may be partly attributable to difficulties in measuring implicit attitudes. A further complication is that associations between implicit alcohol attitudes and heavy drinking may be reciprocal: n

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A study in Alcoholism: Clinical and Experimental Research has underscored the importance of family in protecting against alcohol use among American Indian adolescents, especially those struggling with depression.

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A new study suggests that interventions modifying the time perspective of people with alcohol use disorder (AUD) may improve their recovery outcomes. Although more than 50 million adults in the US are in remission from AUD, our understanding of recovery is limited. The life-history theory emphasizes humans’ adaptation to environmental factors, predicting how we allocate energy and resources to different goals. Stable environments motivate longer-term goals and delayed investments. Such “slower” life-history strategies include education, self-care, and saving money, reflecting decision-making based on valuing future rewards. Unpredictable environments, in contrast, position us to favor short-term goals. “Faster” life-history strategies include brief relationships, early reproduction, reduced self-care, and substance use. In these scenarios, decision-making is influenced by the temporal window (i.e., how far in the future one can imagine and integrate into present decisions; as measured

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Sensors that measure alcohol concentration through the skin can provide valid measures of drinking intensity and predict alcohol consequences among young adult drinkers, according to a study in Alcoholism: Clinical and Experimental Research. Youth alcohol misuse is linked to many short- and long-term negative consequences, and finding ways to predict and prevent these consequences is an important goal for research and public health. In research studies, prediction of short-term consequences is typically based on the number of drinks that an individual reports consuming in a given drinking episode. Self-reports can be retrospective, in which the person reports on their consumption the previous day, or episodic, in which the individual provides real-time reports via smart devices. However, self-reported data have some limitations: number of drinks is an imperfect proxy for biologic alcohol concentrations (and therefore for alcohol-related risk), and self-report accuracy diminishes the mo

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People who need to drink relatively high amounts of alcohol before feeling its effects, a genetically influenced risk factor for future heavy drinking and alcohol problems, may have differences in brain connectivity that impair their ability to interpret facial expressions and recognize their own intoxication, a new study suggests. The paper, in Alcoholism: Clinical & Experimental Research, is believed to be the first to demonstrate differences in brain connectivity between people with low and high responses to alcohol. Varying levels of responses to alcohol — for example, how many drinks a person consumes before feeling intoxicated — are known to be related to neurobiological processing. Low responders, who drink more alcohol before feeling affected by it, are at greater risk of alcohol use disorder (AUD) than high responders, who feel the effects of fewer drinks. Scientists using functional magnetic resonance imaging (fMRI) are exploring the possibility that low responders are less a

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Drinking in the daytime, colloquially known as “day drinking”, is characterized by heavy alcohol consumption and is linked to other risky substance use behaviors in college students, according to a report in Alcoholism: Clinical and Experimental Research. Despite a lack of research on student day drinking, there is evidence that certain types of daytime drinking – such as social drinking before major sporting events, sometimes called tailgating – are characterized by particularly heavy alcohol use. However, it was unclear how prevalent and risky the broader behavior of day drinking is. The current study aimed to assess how many, and how often, students engaged in day drinking, and whether “day-drinking days” – defined as days when drinking started before 4pm - were linked to heavy drinking, negative alcohol consequences, and risky substance use behavior.

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Teens and young adults who use cannabis in the US are considerably more likely to drink alcohol compared to their peers who don’t use cannabis, a study has found.

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A new study has shown that alcohol-related diseases are driven by both environmental and genetic factors, a proportion of which are not shared with the underlying alcohol use disorder (AUD).

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Teens who experience social tensions related to their drinking, such as fighting with friends, may be at greater risk for hazardous alcohol use in early adulthood than those whose alcohol consequences are limited to hangovers and blackouts, a new study has found.

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A pilot study at the University of Washington in Seattle has shown that messaging on shifting “drinking norms” could help curb intentions to use alcohol among college students. Young people’s drinking is known to be influenced by their (often erroneous) perceptions of how their peers drink. To date, social norms interventions on campuses have focused on correcting students’ overestimates of how much alcohol their peers are consuming. Such interventions reflect the current state of normative behavior, known as static norms. In contrast, dynamic norms emphasize that a behavioral norm is shifting over time. These norms could be important in health behavior interventions, given emerging evidence that people align their behavior with social norms that they anticipate being prevalent in the future, even more so than the current norm. The new study, reported in Alcoholism: Clinical and Experimental Research, tested the concept of integrating dynamic norms messaging into alcohol interventions.

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Drinking alcohol may relieve boredom, enhance social enjoyment, cause a blackout or hangover, or impair performance, among other consequences. But whether these experiences are positive or negative is a matter of disagreement among college students, according to the literature and supported by findings from a new study. Moreover, how these drinkers subjectively rate their experiences may influence their future alcohol consumption and risk of problematic drinking. Heavy drinking is common among college students, despite its seemingly negative consequences. “Behavioral economic demand” refers to the value placed on a commodity, in this case alcohol. Alcohol demand may influence future behavior, including drinking. Greater reinforcement (alcohol demand) is a key risk factor for problematic drinking and alcohol use disorder. College students report more positive than negative alcohol consequences, and previous studies suggest that positive perceptions influence their drinking behavior more

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Availability of nonalcoholic beverages together with alcohol price increases could reduce alcohol consumption among college students at high risk for drinking-related harm, according to a study in Alcoholism: Clinical and Experimental Research.

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American Indians who believe a myth falsely implying that they are biogenetically predisposed to heavy drinking may experience more alcohol craving, more frequent drinking, and worse alcohol-related consequences than those who don’t believe that myth, according to a new study in Alcoholism: Clinical & Experimental Research.

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A study has revealed college students’ reasons for abstaining from alcohol or cannabis, including on days when they had initially planned to use one or both substances. The analysis, reported in Alcoholism: Clinical and Experimental Research, extends research into the so-called “intention-behavior gap” by being the first study to examine reasons for non-use following an intention to drink or to use cannabis. The findings could inform strategies for alcohol and substance use prevention and intervention on college campuses.

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Men, young adults, motorcyclists, and people in European and other reasonably well-developed countries are more likely to die in road crashes caused by drinking, according to a novel review of global data. Researchers found that the risk of dying in a road crash attributed to alcohol consumption varied markedly around the world and across population groups. The new review may be the first to provide detailed information on the rate of fatal injury in traffic crashes caused by alcohol use and its variation by location, the sex and age of victims, or transit circumstances. The World Health Organization estimates that in 2018, one in four road deaths worldwide were attributable to drinking. For the review in Alcoholism: Clinical & Experimental Research, investigators in Mexico explored how these fatalities are distributed, geographically and demographically. This more granular information can potentially help target prevention resources at locations and communities where they may most eff

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A study has revealed important gender and age differences in forecasted future levels of binge drinking, and highlighted key factors underlying these trends.

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Adults’ may report their symptoms of alcohol use disorders (AUDs) differently as they age, potentially impeding clinicians’ ability to recognize problematic drinking among older people, a new study suggests.

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College students’ beliefs around the likelihood and desirability of alcohol’s effects vary over time, and predict drinking level and consequences, according to a study in Alcoholism: Clinical and Experimental Research.

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During the early months of the COVID-19 pandemic, as false health information spread on social media, the number of children and teens poisoned with hand sanitizer or alcoholic beverages surged in Iran. These poisonings resulted in hundreds of hospitalizations and 22 deaths. Misinformation circulating on social media included the false suggestion that consuming alcohol (methanol) or hand sanitizer (ethanol or isopropyl alcohol) protected against COVID-19 infection (it does not). A major alcohol poisoning outbreak sickened nearly 6,000 Iranian adults, of whom 800 died. It was not known, however, to what extent children and adolescents were affected. For the study in Alcoholism: Clinical & Experimental Research, investigators compared pediatric hospitalizations for ethanol and methanol poisoning during the early COVID-19 pandemic in Iran with the same period the previous year. They also looked at types of exposure and how those were linked to the children’s ages and clinical outcomes.

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Researchers at the University at Buffalo, The State University of New York have explored the motivational impact of cigarette and alcohol “cues”, with important implications for understanding and treating addiction and relapse.