Alcohol

Issues Available Online

MANN, R.E., SMART, R.G., STODUTO, G., ADLAF, E.M. AND IALOMITEANU, A. Alcohol Consumption and Problems among Road Rage Victims and Perpetrators

Objective: Road rage has generated public concern; however, data on the causes of this behavior have not been available. We examine the alcohol consumption correlates of road rage victimization and perpetration based on a population survey of adults. Method: Data are based on the 2001-2002 Centre for Addiction and Mental Health Monitor, a repeated cross-sectional telephone survey of Ontario adults aged 18 and older (N = 2,610). Logistic regression analyses were performed with drinking measures (Alcohol Use Disorders Identification Test [AUDIT] consumption, dependence and problems) and demographic factors as independent variables. Results: In the past year, 44.4% of respondents reported that someone shouted, cursed or made rude gestures at them, 6.0% were threatened with damage to their vehicle or personal injury, and 5.2% had someone attempt to or actually damage their vehicle or hurt them. Over the same period, 32% admitted shouting, etc., at someone, 1.7% threatened someone, and 1.0% attempted to or actually did damage someone’s vehicle or hurt someone. Univariate analyses revealed several significant relationships between road rage and alcohol measures. Multivariate analyses revealed that the AUDIT alcohol problems measure was most consistently associated with measures of road rage victimization and perpetration, including reporting attempting or actually hurting someone or attempting or actually damaging his or her vehicle. Conclusions: These data indicate there is a significant relationship between alcohol problems, as measured by the AUDIT, and road victimization and perpetration. Further work must be undertaken to identify the mechanisms involved. (J. Stud. Alcohol 65: 161-168, 2004)

REPETTO, P.B., ZIMMERMAN, M.A. AND CALDWELL, C.H. A Longitudinal Study of the Relationship between Depressive Symptoms and Alcohol Use in a Sample of Inner-City Black Youth

Objective: The purpose of this study was to examine longitudinally the relationship between depressive symptoms and alcohol use in a sample of black youth. Method: Participants were 458 black males and females interviewed annually during the high school years and then for 3 years during the transition to adulthood. The relationship was examined using growth curves with Hierarchical Linear Modeling. Results: The results suggest that depressive symptoms decrease over time, whereas the use of alcohol increases. The findings also suggest that youths use alcohol as a way to cope with depressive symptoms and that males are more likely to use alcohol as self-medication. The results also indicate that changes in alcohol use do not predict depressive symptoms, but that life changes associated with the transition to adulthood, such as attending college, predict changes in depressive symptoms and alcohol use. Conclusions: Findings highlight the role of depressive symptoms for predicting alcohol use among black youth and the role of significant life transitions in altering the pattern of alcohol use presented previously by these youths. (J. Stud. Alcohol 65: 169-178, 2004)

TURNER, J.C. AND SHU, J. Serious Health Consequences Associated with Alcohol Use among College Students: Demographic and Clinical Characteristics of Patients Seen in an Emergency Department

Objective: Heavy episodic alcohol use has been associated with numerous consequences among college students. However, neither the incidence nor the demographic and clinical characteristics of serious health consequences have been clearly defined in this population. This study is conducted to better understand clinical outcomes associated with alcohol use in college students. Method: In a prospective observational study, medical records of students presenting to a large university medical center emergency department were examined. Demographic and clinical features of alcohol-related visits were gathered on patients who were enrolled as undergraduates at a 4-year public institution during 2 academic years from July 2000 through June 2002. Enrollment was ~12,500 undergraduates per year. Results: Of all emergency visits, 13% were alcohol related; and of all undergraduate students, 0.7% presented with alcohol-related medical conditions each year. Injuries accounted for 53% of all visits, and acute intoxication accounted for 34%. Nine of 185 patients were hospitalized. Men aged 21 years and older had the highest odds of visiting the emergency department. Trauma occurred more frequently among men, students >18 years of age and white students. Accidents (84%) and fights (16%) were the sources of injuries. Acute intoxication occurred more frequently among women, students ≤18 years of age and nonwhite students. Conclusions: Alcohol use contributes to a small yet significant proportion of emergency room visits for college students. Distinctive subgroups of college students, including legal-age drinkers, experience patterns of serious health consequences as a result of problem use of alcohol. (J. Stud. Alcohol 65: 179-183, 2004)

SAREMI, A., HANSON, R.L., TULLOCH-REID, M., WILLIAMS, D.E. AND KNOWLER, W.C. Alcohol Consumption Predicts Hypertension but Not Diabetes

Objective: This study examines the associations between alcohol consumption, Type 2 diabetes and hypertension in a native American population. Method: Data were collected in a population-based cross-sectional and prospective study conducted on 3,789 individuals aged ≥20 years. Reported alcohol consumption was classified as never, occasional or <1 a day, 1-2 drinks a day, ≥3 drinks a day, and occasional heavy drinking. The prevalence and incidence of diabetes and hypertension by categories of alcohol intake were determined. Results: About 68% of men and 39% of women reported some degree of alcohol consumption. There was no association between alcohol consumption and prevalence or incidence of diabetes, but a positive, statistically significant association between blood pressure and alcohol consumption was found in both genders. After adjustment for age, body mass index (BMI) and diabetes in a proportional hazards model in men, moderate drinkers (occasional or <1 drink a day and 1-2 drinks a day combined) had 1.24 (95% confidence interval: 0.98-1.57) and occasional heavy drinkers had 1.49 (1.02-2.17) times the incidence of hypertension as nondrinkers. The corresponding estimates of hypertension incidence for women were 1.53 (1.29-1.83) for moderate drinking and 1.38 (0.81-2.36) for occasional heavy drinking. As only 1% of participants reported ≥3 drinks a day, this group was excluded from these analyses. Conclusions: Alcohol consumption did not affect the development of Type 2 diabetes, but it was associated with increased risk of hypertension, and this effect was independent of diabetes or BMI in both genders. (J. Stud. Alcohol 65: 184-190, 2004)

ANDERSON, P., LAURANT, M., KANER, E., WENSING, M. AND GROL, R. Engaging General Practitioners in the Management of Hazardous and Harmful Alcohol Consumption: Results of a Meta-Analysis

Objective: A systematic review was undertaken of studies that test the effectiveness of different strategies used to increase general practitioners’ rates of screening for and giving advice about hazardous and harmful alcohol consumption. Method: Resources were MEDLINE, EMBASE, Cinahl and the Cochrane Library (1966-2001). Inclusion criteria were those of the Effective Practice and Organisation of Care Group of the Cochrane Collaboration. A meta-analysis was undertaken, using a random effects model, of 15 programs identified in 12 trials. Effect sizes, calculated using the logged odds ratio, were adjusted by inverse variance weights to control for the sample sizes of the studies. Results: Analysis of the intervention groups resulted in screening and advice-giving rates of 45% (95% CI: 33%-56%) and analysis of the comparison groups resulted in rates of 32% (95% CI: 20%-43%). The weighted mean effect size (logged odds ratio = 0.73; 95% CI: 0.56-0.90) was heterogeneous. Regression analysis to explain the heterogeneity found a significant effect for alcohol-specific programs compared with general prevention programs in which alcohol was included, and for multicomponent programs compared with single component programs. No significant differences were found between educational-based or office-based interventions. Conclusions: Although the small numbers of programs studied suggest caution be used in interpreting the results, it seems it is possible to increase the engagement of general practitioners in screening and giving advice for hazardous and harmful alcohol consumption. Although considerably more research of high quality is needed, promising programs are those that have a specific focus on alcohol and those that are multicomponent. (J. Stud. Alcohol 65: 191-199, 2004)