Prediction of alcohol-related harm from controlled drinking strategies and alcohol consumption trajectories

Aims To establish predictors of age 21 alcohol-related harm from prior drinking patterns, current levels of alcohol consumption and use of controlled drinking strategies.

Participants One thousand, five hundred and ninety-six students recruited from an initial sample of 3300 during their final year of high school in 1993.

Design Longitudinal follow-up across five waves of data collection.

Setting Post high school in Victoria, Australia.

Measurements Self-administered surveys examining a range of health behaviours, including alcohol consumption patterns and related behaviour.

Findings Drinking behaviours at age 21 were found to be strongly predicted by drinking trajectories established through the transition from high school. Multivariate regression analysis revealed that alcohol-related harms at age 21 were reduced where current levels of alcohol use fell within limits recommended in Australian national guidelines. After controlling for this effect it was found that the range of strategies employed by participants to control alcohol use maintained a small protective influence. Post-high-school drinking trajectories continued to demonstrate a significant effect after controlling for current behaviours. Findings revealed that over one quarter of males and females drank alcohol, but on a less-than-weekly basis. This pattern of alcohol use demonstrated considerable stability through the post-school transition and was associated with a low level of subsequent harm at age 21.

Conclusions Future research should investigate whether encouraging more Australian adolescents to drink alcohol on a less-than-weekly basis may be a practical intervention target for reducing alcohol-related harms.

The relationship between social anxiety and alcohol use in remand prisoners

Community studies have found a consistently high co-occurrence, between alcohol use and anxiety disorders, such as social phobia. Despite high prevalence rates of alcohol use and anxiety disorders in remand prisoners, the extent to which they co-occur in this population and the use of alcohol as a strategy to reduce social anxiety, have not been examined. The aim of this study was to assess levels of social phobia and the use of alcohol to reduce anxiety associated with social and performance situations in a remanded prison population. One hundred and one male prisoners (age M = 34.88 years, SD = 11.70) participated in the study. They completed the Social Phobia Inventory (SoPhI) and a questionnaire designed to assess levels of drinking in social and performance situations to reduce anxiety. High levels of social anxiety were found, together with high levels of drinking to reduce anxiety associated with social or performance situations. Drinking was predictive of reduced levels of social anxiety but the effect of social anxiety on drinking was stronger. The implications for treatment and future research are discussed.

Family, school, peer and individual influences on early adolescent alcohol use: first-year impact of the Resilient Families programme

Introduction and Aims:  This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. Design and Methods:  Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n = 2128 for longitudinal analyses). A sub-set of parents (n = 1166) also returned baseline surveys. Results: The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). Discussion and Conclusions: The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school,   suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.

Estimated alcohol-caused deaths in Australia, 1990-97

The purpose of the study was to provide updated estimates of alcohol-caused mortality rates in Australia between 1990 and 1997, making adjustments for changes in the prevalence of high-risk alcohol use estimated on the basis of per capita alcohol consumption (PCAC). Deaths wholly and partially attributable to high-risk alcohol consumption were extracted from the Australian Bureau of Statistics Mortality Datafile (1990-1997) and multiplied by specific aetiologicalfractions, which in turn were adjusted by changes in the prevalence of high-risk alcohol use estimated on the basis of annual changes in PCAC. The yearly trends in age-standardized rates of estimated alcohol-caused deaths were compared with those using (i) aetiological fractions unadjusted for changes in PCAC, and (ii) wholly alcohol-caused conditions only (thus requiring no application of aetiological fractions). The age-standardized rates of all alcohol-caused deaths among males aged 15 + years declined from 1990 (4.01110000) to 1993 (3.19/10000) and decreased far more slowly up to 1997 (3.15/10000)-16% overall. For females, these rates declined steadily from 1990 (1.75/10000) to 1997 (1.33/10000)-19% overall. Similar patterns in time trends were noted for estimated alcohol-caused death rates calculated as in (i) and (ii). However, the proportional decreases in rates (21.6%for males; 24. O%for females) would have been underestimated by 16% (males) and 19% (females) if the alcohol aetiological fractions had not been adjusted to take account of the estimated annual changes in the prevalence of high-risk drinking. The declines in estimated alcohol-caused death rates were more pronounced than the 9% decline in PCAC, and were due mainly to decreasing death rates for stroke (men and women), alcoholic liver cirrhosis and road injuries (men only). When aetiological fractions are used to measure temporal trends in estimated alcohol-caused death rates from official mortality statistics, they should account for annual changes in the prevalence of high-risk drinking. Such changes in prevalence can be deduced from yearly fluctuations in PCAC.

"As long as it doesn't spill over into class": harms arising from students` alcohol use, and the role of policy in reducing them

While there is considerable evidence about the prevalence of student alcohol use, little empirical work has examined the range and level of exposure to alcohol-related risks facing student populations, and the views of key stakeholders about these. This study was conducted at a large multi-campus university in order to gauge the scale and severity of students’ alcohol-related problems, and ways in which these may be mitigated. Student perspectives on campus based policy making with respect to alcohol were also canvassed. This study utilised a range of evaluative instruments, including standardised questionnaire protocols, structured interviews and focus groups. Data gained from students showed a large level of exposure to alcohol-related harm, and staff informants reported student harms such as drink-driving, interpersonal aggression, social nuisance, inadequate security, sexually risky behaviour, and physical malaise. As a group, students seem receptive to campus-based policies that have a harm reduction focus, but are less supportive of institutionalised measures aimed at the student body. Given the divergence of views about the harms arising from student drinking, and a general repudiation of institutional policy measures which may lessen these, the development of harm-reducing policy on alcohol remains challenging.

The effects of the opioid pharmacotherapies methadone, LAAM and buprenorphine, alone and in combination with alcohol, on simulated driving

While methadone is currently the primary pharmacotherapy used in the treatment of heroin dependence in Australia, levo-alpha-acetyl-methodol (LAAM) and buprenorphine are new pharmacotherapies that are being examined as alternatives to methadone maintenance treatment. The aim of this research is to consider the effects of the methadone, buprenorphine and LAAM, as used in maintenance pharmacotherapy for heroin dependence, upon simulated driving. Clients stabilised in methadone, LAAM and buprenorphine treatment programs for 3 months, and a control group of non-drug-using participants, took part in this study which involved operating a driving simulator over a 75 min period.

Alcohol and drug use in Australian male sex workers: its relationship to the safety outcome of the sex encounter

This paper describes the self-reporting patterns of alcohol and drug consumption among male sex workers (MSWs) in three Australian cities during commercial sex encounters, and examines to what extent alcohol and drugs are used and whether this is related to the safe/unsafe outcome of the commercial sex encounter. One hundred and eighty-six MSWs from Brisbane, Sydney and Melbourne completed a diary following each commercial sex encounter over a two-week period. MSWs reported 2,087 commercial sex encounters during the study period. Alcohol or drug consumption was reported in 50.5% of the encounters.

The role of alcohol expectancy and drinking refusal self-efficacy beliefs in university student drinking

Aims: University student alcohol misuse is a considerable problem. Alcohol expectancy research has contributed significantly to our understanding of problem drinking in young adults. Most of this research has investigated positive expectancy alone. The current study utilized two measures of alcohol expectancy, the alcohol expectancy questionnaire (AEQ) and the drinking expectancy profile [consisting of the drinking expectancy questionnaire (DEQ) and the drinking refusal self-efficacy questionnaire] to predict severity of alcohol dependence, frequency of drinking, and the quantity of alcohol consumed per occasion. Methods: Measures of drinking behaviour and alcohol expectancy were completed by 174 undergraduate university students. Results: Positive alcohol expectancy factors accounted for significant variance in all three drinking indices, with the DEQ adding additional variance to AEQ scores on frequency and severity of alcohol dependence indices. Negative expectancy did not add incremental variance to the prediction of drinking behaviour in this sample. Drinking refusal self-efficacy and dependence beliefs added additional variance over positive and negative expectancies in the prediction of all three drinking parameters. Conclusions: Positive expectancy and drinking refusal self-efficacy were strongly related to university student drinking. The incorporation of expectancy as a means of informing prevention approaches in tertiary education shows promise.

Effects of Alcohol and Training on Exercise Performance and Muscle Recovery Biochemistry in the Brown Anole (Anolis sagrei)

Contrary to previous research, training may improve exercise performance in a lizard, the brown anole. A brief, two-week training period resulted in increased performance speed and distance before exhaustion in trained lizards. Trained lizards were also able to more effectively use leg glycogen stores, however each of these improvements were not found in lizards treated with alcohol. Liver glycogen concentrations were also lower in alcohol-treated lizards, and patterns of liver glycogen concentrations during recovery indicate some hepatic lactate gluconeogenesis.

University students' perceptions of the alcohol campaign : "Is Getting Pissed Getting Pathetic? (Just Ask Your Friends)"

The present study examined students' understanding and perceived effectiveness of a recent Australian alcohol campaign designed to increase students' awareness of excessive and harmful drinking. Six hundred and seventy one university students (51% females), who had seen the campaign posters, with the tagline "Is Getting Pissed Getting Pathetic? (Just Ask You Friends)", were asked to comment on the messages that the campaign was communicating and how informative, relevant, and effective they perceived the campaign. Many students were positive in their evaluations and described the messages as "truth and realistic", "clear and to the point", and that the campaign made them think about their own drinking. However, other views were more negative and indicative of psychological reactance. These included concerns that students "won't listen" or "don't care" about media campaigns, and that "they don't what to be told what to do". The findings highlight how media campaigns can help an audience contemplate behavioral change, however, they can also alienate students and promote counterproductive attitudes.