05 June 2020 In Drinking Patterns

PURPOSE: From 1991 to 2018, binge drinking among U.S. adolescents has precipitously declined; since 2012, depressive symptoms among U.S. adolescents have sharply increased. Binge drinking and depressive symptoms have historically been correlated, thus understanding whether there are dynamic changes in their association informs prevention and intervention.

METHODS: Data were drawn from the U.S. nationally representative cross-sectional Monitoring the Future surveys (1991-2018) among school-attending 12th-grade adolescents (N = 58,444). Binge drinking was measured as any occasion of more than five drinks/past 2 weeks; depressive symptoms were measured with four items (e.g., belief that life is meaningless or hopeless), dichotomized at 75th percentile. Time-varying effect modeling was conducted by sex, race/ethnicity, and parental education.

RESULTS: In 1991, adolescents with high depressive symptoms had 1.74 times the odds of binge drinking (95% confidence interval 1.54-1.97); by 2018, the strength of association between depressive symptoms and binge drinking among 12th(-)grade adolescents declined 24% among girls and 25% among boys. There has been no significant relation between depressive symptoms and binge drinking among boys since 2009; among girls, the relationship has been positive throughout most of the study period, with no significant relationship from 2016 to 2017.

CONCLUSIONS: Diverging trends between depressive symptoms and alcohol use among youth are coupled with declines in the strength of their comorbidity. This suggests that underlying drivers of recent diverging population trends are likely distinct and indicates that the nature of comorbidity between substance use and mental health may need to be reconceptualized for recent and future cohorts.

24 January 2020 In Drinking Patterns

BACKGROUND: Alcohol consumption, even at low-levels, can not be guaranteed as safe or risk free. Specifically, the 2009 Australian National Health and Medical Research Council drinking guidelines recommend that adults should not drink more than two standard drinks on any day on average, and no more than four drinks on a single occasion. Nearly 40% of Australians aged 12 years and older drink alcohol but don't exceed these recommended limits, yet adult low-risk drinkers have been largely overlooked in Australian alcohol survey research, where they are usually grouped with abstainers. This paper examines the socio-demographic profile of low-risk drinking adults (18+ years old), compared to those who abstain.

METHODS: Data from the 2013 National Drug Strategy Household Survey were used. In the past 12 months, 4796 Australians had not consumed alcohol and 8734 had consumed alcohol at low-risk levels, accounting for both average volume and episodic drinking (hereafter low-risk).

RESULTS: Multivariate logistic regression results indicated that low-risk drinkers were more likely to be older, married, Australian-born, and reside in a less disadvantaged neighbourhood compared with abstainers. There was no significant difference by sex between low-risk drinkers and abstainers.

CONCLUSIONS: The socio-demographic profile of low-risk drinkers differed from that of abstainers. Combining low-risk drinkers and abstainers into a single group, which is often the practice in survey research, may mask important differences. The study may support improved targeting of health promotion initiatives that encourage low-risk drinkers not to increase consumption or, in view of increasing evidence that low-risk drinking is not risk free, to move towards abstinence.

24 January 2020 In Drinking Patterns

The existence and potential level of cardioprotection from alcohol use is contested in alcohol studies. Assumptions regarding the risk relationship between alcohol use and ischaemic heart disease (IHD) are critical when providing advice for national drinking guidelines and for designing alcohol harm monitoring systems.

We use three meta-analyses regarding alcohol use and IHD risk to investigate how varying assumptions lead to differential estimates of alcohol-attributable (AA) deaths and weighted relative risk (RR) functions, in Australia and Canada. Alcohol exposure and mortality data were acquired from administrative sources and AA fractions were calculated using the International Model of Alcohol Harms and Policies.

We then customized a recent Global Burden of Disease (GBD) analysis to inform drinking guidelines internationally. Australians drink slightly more than Canadians, per person, but are also more likely to identify as lifetime abstainers.

Cardioprotective scenarios resulted in substantial differences in estimates of net AA deaths in Australia (between 2933 and 4570) and Canada (between 5179 and 8024), using GBD risk functions for all other alcohol-related conditions.

Country-specific weighted RR functions were analyzed to provide advice toward drinking guidelines: Minimum risk was achieved at or below alcohol use levels of 10 g/day ethanol, depending on scenario. Consumption levels resulting in 'no added' risk from drinking were found to be between 10 and 15 g/day, by country, gender, and scenario.

These recommendations are lower than current guidelines in Australia, Canada, and some other high-income countries: These guidelines may be in need of downward revision.

24 January 2020 In Drinking Patterns

This review provides the first systematic and quantitative synthesis of the literature examining the relationship between binge drinking, cognition, brain structure and function in youth aged 10 to 24 years. PubMed, EMBASE, Medline, PsychINFO and ProQuest were searched for neuroimaging, neurophysiological, and neuropsychological studies.

A total of 58 studies (21 neuroimaging, 16 neurophysiological, 21 neuropsychological) met the eligibility criteria and were included in the review. Overall, abnormal or delayed development of key frontal executive-control regions may predispose youth to binge drink.

These abnormalities appear to be further exacerbated by the uptake of binge drinking, in addition to alcohol-related neural aberrations in reward-seeking and incentive salience regions, indexed by cognitive deficits and maladaptive alcohol associations.

A meta-analysis of neuropsychological correlates identified that binge drinking in youth was associated with a small overall neurocognitive deficit (g = -0.26) and specific deficits in decision-making (g = -1.70), and inhibition (g = -0.39). Using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Evidence Profile, the certainty in outcomes ranged from very low to low.

Future prospective longitudinal studies should address concomitant factors, exposure thresholds, and age-related vulnerabilities of binge drinking, as well as the degree of recovery following discontinuation of use.

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