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1.
BMJ Open ; 12(5): e060498, 2022 05 18.
Article in English | MEDLINE | ID: covidwho-1854359

ABSTRACT

INTRODUCTION: In the UK, alcohol use is the main driver of chronic liver disease and each year results in over 1 million unplanned hospital admissions and over 25 000 deaths from alcohol-related liver disease (ArLD). The only effective treatment to prevent progression of liver damage is reducing or ceasing alcohol consumption. Psychological and pharmacological therapies for alcohol misuse are ineffective in patients with ArLD. Functional imagery training (FIT) is a novel psychological therapy that builds on motivational interviewing techniques with multisensory imagery. This pilot trial aims to test the feasibility of training alcohol liaison nurses to deliver FIT therapy and of recruiting and retaining patients with ArLD and alcohol dependence to a randomised trial of FIT and treatment as usual (TAU) versus TAU alone. METHODS AND ANALYSIS: This is a randomised pilot trial of FIT and TAU versus TAU alone in 90 patients with ArLD and alcohol dependence admitted to one of four UK centres. The primary objectives are to estimate rates of screening, recruitment, randomisation, retention, adherence to FIT/TAU and a preliminary assessment of the FIT intervention in the ArLD population. Data from the pilot study will be used to finalise the design of a definitive randomised controlled trial to assess the effectiveness and cost-effectiveness of FIT. The proposed primary outcome measure for the definitive trial is self-reported alcohol use assessed using timeline follow-back. ETHICS AND DISSEMINATION: Research ethics approval was given by the Yorkshire and Humber-Bradford Leeds Research Ethics Committee (reference: 21/YH/0044). Eligible patients will be approached and written informed consent obtained prior to participation. Results will be disseminated through peer-reviewed open access journals, international conferences and a lay summary published on the Trials Unit website and made available to patient groups. TRIAL REGISTRATION NUMBER: ISRCTN41353774.


Subject(s)
Alcoholism , Liver Diseases, Alcoholic , Alcoholism/complications , Alcoholism/therapy , Cost-Benefit Analysis , Humans , Pilot Projects , Randomized Controlled Trials as Topic , Syndrome
3.
J Glob Health ; 12: 05002, 2022.
Article in English | MEDLINE | ID: covidwho-1771700

ABSTRACT

Background: During the COVID-19 pandemic, an increase of heavy alcohol use has been reported in several high-income countries. We examined changes in alcohol use during the pandemic among primary health care (PHC) patients in two middle income countries, Colombia and Mexico. Methods: Data were collected during routine consultations in 34 PHC centres as part of a large-scale implementation study. Providers measured patients' alcohol consumption with the three item 'Alcohol Use Disorders Identification Test' (AUDIT-C). Generalized linear mixed models were performed to examine changes in two dependent variables over time (pre-pandemic and during pandemic): 1) the AUDIT-C score and 2) the proportion of heavy drinking patients (8+ on AUDIT-C). Results: Over a period of more than 600 days, data from N = 17 273 patients were collected. During the pandemic, the number of patients with their alcohol consumption measured decreased in Colombia and Mexico. Each month into the pandemic was associated with a 1.5% and 1.9% reduction in the mean AUDIT-C score in Colombia and Mexico, respectively. The proportion of heavy drinking patients declined during the pandemic in Colombia (pre-pandemic: 5.4%, 95% confidence interval (CI) = 4.8% to 6.0%; during the pandemic: 0.8%, 95% CI = 0.6% to 1.1%) but did not change in Mexico. Conclusions: Average consumption levels declined and the prevalence of heavy drinking patterns did not increase. In addition to reduced opportunities for social drinking during the pandemic, changes in the population seeking PHC and restrictions in alcohol availability and affordability are likely drivers for lower levels of alcohol use by patients in this study.


Subject(s)
Alcoholism , COVID-19 , Alcohol Drinking/epidemiology , Alcoholism/epidemiology , COVID-19/epidemiology , Colombia/epidemiology , Humans , Mexico/epidemiology , Pandemics , Primary Health Care
4.
BMC Psychiatry ; 22(1): 228, 2022 03 31.
Article in English | MEDLINE | ID: covidwho-1770512

ABSTRACT

BACKGROUND: People with substance use disorders may be at a greater risk of contracting COVID-19 infection and developing medical complications. Several institutional and governmental health agencies across the world developed ad hoc guidance for substance use disorder services and care of individuals misusing substances. We aimed to synthesise the best available recommendations on management and care of people with or at risk of substance use disorders during the COVID-19 pandemic from existing guidelines published in UK, USA, Australia, Canada, New Zealand, and Singapore. METHODS: We systematically searched existing guidelines and websites from 28 international institutions and governmental bodies in the context of the COVID-19 pandemic (May 4th 2021). We summarized the extracted data as answers to specific clinical questions. RESULTS: We organised the available recommendations from 19 sources in three sections. First, we focused on general advice and recommendations for people who misuse alcohol or drugs during the COVID-19 pandemic, the design of contingency plans, safeguarding issues for children and families of service users and advice to the public, patients, and carers. Then, we summarised specific guidelines for people who use illicit drugs and related services, such as opioid substitution treatment and needle and syringe programmes. Finally, we provided a synthesis on specific recommendations for services supporting people who misuse alcohol and key topics in the field, such as management of alcohol detoxification and safe transition between supervised and unsupervised consumption. CONCLUSIONS: Available guidance reflected different approaches, ranging from being extremely cautious in providing recommendations other than generic statements to proposing adaptation of previously available guidelines to confront the challenges of the COVID-19 pandemic. After the early phase, guidance focused on reduction of infection transmission and service delivery. Guidance did not provide advice on infection prevention via vaccination programmes and service access strategies tailored to individuals with substance use disorders.


Subject(s)
Alcoholism , COVID-19 , Substance-Related Disorders , Alcoholism/psychology , Alcoholism/therapy , Child , Guidelines as Topic , Health Personnel , Humans , Pandemics , Substance-Related Disorders/psychology
5.
Sci Rep ; 12(1): 4963, 2022 03 23.
Article in English | MEDLINE | ID: covidwho-1758374

ABSTRACT

Problematic alcohol use is a major contributor to the global burden of death and disabilities, and it represents a public health concern that has grown substantially following the COVID-19 pandemic. The available treatment options remain limited and to develop better pharmacotherapies for alcohol misuse we need to identify suitable biological targets. Previous research has implicated the brain's endocannabinoid system (ECS) in psychiatric and stress-related outcomes, including substance use and habituation to repeated stress. Moreover, genetic variants in the cannabinoid-1 receptor gene (CNR1; CB1R) have been associated with personality traits, which are in turn predictors of substance use disorders. To date, however, no human genome-wide association study has provided evidence for an involvement of the ECS in substance use outcomes. One reason for this ECS-related "missing heritability" may be unexamined gene-environment interactions. To explore this possibility, we conducted cross-sectional analyses using DNA samples and stress-exposure data from a longitudinal Swedish population-based study (N = 2,915). Specifically, we genotyped rs2023239, a functional C/T single nucleotide polymorphism in CNR1, previously reported to be associated with CNR1 binding in the brain, subjective reward following alcohol intake, and alcohol cue-elicited brain activation. Our two outcomes of interest were (i) problematic alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT), and (ii) personality trait scores based on the Five Factor Model. We found no baseline association between rs2023239 and problematic alcohol use or personality traits. However, there was a clear trend for interaction between rs2023239's risk allele (C) and stressful life events (SLEs) in both childhood and adulthood, which predicted problematic alcohol use. Although not significant, there was also some indication that the risk allele interacted with child SLEs to increase scores on neuroticism. Our study supports the notion that the ECS can affect alcohol intake behaviors by interacting with life adversities and is-to the best of our knowledge-the first to focus on the interaction between CNR1 and stressors in both childhood and adulthood in humans. Further studies are warranted to confirm these findings.


Subject(s)
Alcoholism , COVID-19 , Adult , Alcohol Drinking/genetics , Alcohol Drinking/psychology , Alcoholism/genetics , Alcoholism/psychology , Child , Cross-Sectional Studies , Genome-Wide Association Study , Humans , Pandemics , Receptors, Cannabinoid
6.
Acta Biomed ; 93(1): e2022081, 2022 03 14.
Article in English | MEDLINE | ID: covidwho-1754155

ABSTRACT

BACKGROUND AND AIM: The destructive impact of the still ongoing COVID-19 pandemic on those struggling with substance use disorders (SUD) stems from the daunting challenges which SUD patients experience in terms of coping with their condition and receiving care in a timely fashion. METHODS: Patients struggling with addiction are at particularly high risk, due to the underlying vulnerabilities in their conditions and the stigmatization they often suffer. New Psychoactive Substances stand out as a critical area of concern. The authors have conducted a broad-ranging search to assess the impact of SUDs, along with their related mental, physical, and behavioral symptoms, against the backdrop of the COVID-19, taking into account how drug trafficking and consumption trends have evolved as the emergency draws out, and the cyberspace comes to play an ever-bigger role. RESULTS: Given that roughly 1.5%-5% of the global burden of disease can be ascribed to alcohol abuse and substance addiction, the role of pandemic-related potential contributing factors in the exacerbation and relapse of SUDs and behavioral addiction cannot be discounted and needs targeted measures tailored to the special needs of SUD patients. Escalating environmental stressors stemming from abnormal circumstances can undermine recovery efforts and threaten the very survival of countless SUD patients, increasing the likelihood of relapsing for those in recovery. CONCLUSIONS: Policymakers and legislators have not yet put in place targeted measures and adjustments in the health care delivery mechanisms in order to countervail the pandemic impact on SUD sufferers, and the ever-evolving patterns of use and trafficking.


Subject(s)
Alcoholism , COVID-19 , Substance-Related Disorders , Alcoholism/complications , Alcoholism/epidemiology , Humans , Pandemics , Recurrence , Substance-Related Disorders/complications , Substance-Related Disorders/epidemiology
7.
Psychiatry Res ; 311: 114521, 2022 05.
Article in English | MEDLINE | ID: covidwho-1747629

ABSTRACT

People with Substance or Alcohol Use Disorders (SUDs/AUDs) are likely to be more vulnerable to COVID-19 infection than the general population. We performed a cross-sectional study to compare the hospitalization rate (CHR) for COVID-19 in 2020 in patients diagnosed with SUDs or AUDs in the previous 10 years vs the population without these disorders (NAS). We included individuals who were resident in the Metropolitan Area of Bologna (Northern Italy). People with SUDs or AUDs have a greater probability of being hospitalized for COVID-19 infection compared to the general population NAS, suggesting that they suffer from worse physical symptoms/conditions than the general population. Furthermore, we found higher mortality rates during hospitalization for COVID-19 in patients with AUDs or SUDs than the general population NAS. These findings highlight the importance of a careful monitoring and early intervention measures in these patients.


Subject(s)
Alcoholism , COVID-19 , Substance-Related Disorders , Alcoholism/epidemiology , Cross-Sectional Studies , Hospitalization , Humans , Substance-Related Disorders/diagnosis , Substance-Related Disorders/epidemiology
8.
BMJ Open ; 12(3): e055699, 2022 03 04.
Article in English | MEDLINE | ID: covidwho-1731276

ABSTRACT

OBJECTIVES: This study aimed to estimate the prevalence of psychoactive substance (PAS) use in night-shift healthcare workers (NSHW) during France's first COVID-19 wave (March-May 2020). DESIGN: Observational cross-sectional online survey. SETTING: 39 public hospitals in the Assitance Publique des Hôpitaux de Paris (AP-HP) network in the Parisian area. PARTICIPANTS: A total of 1238 nurses, assistant nurses, X-ray technicians, managers, lab technicians, midwives and childcare assistants working at night or alternating between days and nights answered the questionnaire. INTERVENTION: Online survey. OUTCOME MEASURES: PAS use prevalence after weighting data for sex, age and profession using calibration on margins, in order to be representative of all AP-HP NSHW. We used the Fagerström scale and the Alcohol Use Disorders Identification Test Concise to assess PAS use. RESULTS: The weighted estimated prevalences of daily smoking, alcohol drinking and tranquilliser use in participating NSHW were 21.4, 1.3 and 2.4%, respectively. Twelve per cent (11.7%) of our study sample used opioids. During the first COVID-19 wave, PAS use remained stable except for tobacco use, with 8.6% of participants reporting an increase. Previous 3-month prevalences of tranquilliser and opioid use were significantly higher than in the general population. CONCLUSION: Daily smoking (especially in younger men) and tranquilliser and opioid use were highly prevalent in NSHW in the AP-HP network during France's first COVID-19 wave. Specific interventions for quitting smoking and addressing determinants of tranquilliser and opioid use in NSHW need to be developed and evaluated to improve quality of life in these essential, underdiagnosed and undertreated health personnel.


Subject(s)
Alcoholism , COVID-19 , COVID-19/epidemiology , Cross-Sectional Studies , Health Personnel , Hospitals, Public , Humans , Male , Pandemics , Quality of Life , SARS-CoV-2
9.
Public Health ; 205: 72-78, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1712937

ABSTRACT

OBJECTIVES: Online platforms enable real-time trading activities that are similar to those of gambling. This study aimed to investigate the associations of traditional investing, real-time stock trading, and cryptocurrency trading with excessive behavior and mental health problems. STUDY DESIGN: This was a cross-sectional population-based survey. METHODS: The participants were Finnish people aged 18-75 years (N = 1530, 50.33% male). Survey asked about monthly regular investing, real-time stock-trading platform use, and cryptocurrency trading. The study had measures for excessive behavior: gambling (Problem Gambling Severity Index), gaming (Internet Gaming Disorder Test), internet use (Compulsive Internet Use Scale), and alcohol use (Alcohol Use Disorders Identification Test). Psychological distress (Mental Health Inventory), perceived stress (Perceived Stress Scale), COVID-19 anxiety, and perceived loneliness were also measured. Background factors included sociodemographic variables, instant loan taking, and involvement in social media identity bubbles (Identity Bubble Reinforcement Scale). Multivariate analyses were conducted with regression analysis. RESULTS: Within the sample, 22.29% were categorized into monthly regular investors only, 3.01% were investors using real-time stock-trading platforms, and 3.59% were cryptomarket traders. Real-time stock-trading platform use and cryptocurrency trading were associated with younger age and male gender. Cryptomarket traders were more likely to have an immigrant background and have taken instant loans. Both real-time stock-trading platform use and cryptomarket trading were associated with higher excessive behavior. Cryptomarket traders especially reported higher excessive gambling, gaming, and internet use than others. Cryptomarket traders reported also higher psychological distress, perceived stress, and loneliness. CONCLUSIONS: Regular investing is not a risk factor for excessive behavior. However, rapid online trading platforms and applications were significantly more commonly used by participants reporting excessive behavior and mental health problems. The strong association between cryptomarket trading and excessive behavior in particular underlines the need to acknowledge the potential risks related to real-time trading platforms.


Subject(s)
Alcoholism , Behavior, Addictive , COVID-19 , Gambling , Anxiety Disorders , Behavior, Addictive/epidemiology , Behavior, Addictive/psychology , Cross-Sectional Studies , Female , Gambling/epidemiology , Gambling/psychology , Humans , Internet , Male
10.
Addiction ; 117(7): 1908-1919, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1704933

ABSTRACT

AIMS: To estimate the associations between high-risk alcohol consumption and (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroconversion, (2) self-reported new SARS-CoV-2 infection and (3) symptomatic COVID-19. DESIGN: Prospective cohort study. SETTING: Indiana University Bloomington (IUB), IN, USA. PARTICIPANTS: A total of 1027 IUB undergraduate students (64% female), aged 18 years or older, residing in Monroe County, Indiana, seronegative for SARS-CoV-2 at study baseline. MEASUREMENTS: Primary exposure was high-risk alcohol consumption measured with an Alcohol Use Disorders Identification Test (AUDIT) questionnaire score of 8 or more. Primary outcome was SARS-CoV-2 seroconversion since baseline, assessed with two SARS-CoV-2 antibody tests, at baseline (September 2020) and end-line (November 2020). Secondary outcomes were (a) self-reported new SARS-CoV-2 infection at the study end-line and (b) self-reported symptomatic COVID-19 at baseline. FINDINGS: Prevalence of high-risk alcohol consumption was 32 %. In models adjusted for demographics, students with high-risk alcohol consumption status had 2.44 [95% confidence interval (CI) = 1.35, 4.25] times the risk of SARS-CoV-2 seroconversion and 1.84 (95% CI = 1.04, 3.28) times the risk of self-reporting a positive SARS-CoV-2 infection, compared with students with no such risk. We did not identify any association between high-risk alcohol consumption and symptomatic COVID-19 (prevalence ratio = 1.17, 95% CI = 0.93, 1.47). Findings from sensitivity analyses corroborated these results and suggested potential for a dose-response relationship. CONCLUSIONS: Among American college students, high-risk alcohol consumption appears to be associated with higher risk for severe acute respiratory syndrome coronavirus 2 seroconversion/infection.


Subject(s)
Alcoholism , COVID-19 , Alcohol Drinking/epidemiology , COVID-19/epidemiology , Cohort Studies , Female , Humans , Male , Prospective Studies , SARS-CoV-2 , Seroconversion , Students , United States/epidemiology
11.
J Prev Med Hyg ; 62(4): E859-E863, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1701533

ABSTRACT

SUD is a widespread non-communicable disease (NCD) with biological, social, or psychological foundations which policymakers have given less attention during the COVID-19 pandemic. People with alcohol dependence went into withdrawal as a result of the lockdown and acute lack of alcohol availability, which led to black marketing and, in extreme cases, suicide. On the other hand, De-addiction services in India were not adequately equipped for the SUD pandemic, and as a result, most services could not cope with lockdown problems. To generate revenue and to get out of this Catch-22 situation, the Government opened liquor shops and sold alcohol while people purchased it as usual because of excess stress, lack of social contact, loneliness and boredom. We recommend that during COVID-19 pandemic, national, state, and local governments, as along with organisations such as Alcoholics Anonymous, develop and support networks to address the needs of patients with SUD.


Subject(s)
Alcoholism , COVID-19 , Substance-Related Disorders , Alcoholism/epidemiology , COVID-19/epidemiology , Communicable Disease Control , Humans , Pandemics , Substance-Related Disorders/epidemiology
12.
Int J Environ Res Public Health ; 19(4)2022 02 10.
Article in English | MEDLINE | ID: covidwho-1690262

ABSTRACT

The present study investigates the extent to which the COVID-19 crisis disturbed different life domains of patients with alcohol use disorder (AUD) and assessed the associations between these disturbances and the risk of short-term alcohol drinking. All patients aged >18 years receiving outpatient care at three addiction treatment facilities from 15 April to 30 May 2021 were eligible for inclusion in the study. A trained resident assessed the extent to which the COVID-19 crisis affected their professional activity, social life, access to healthcare, and drinking problems, together with craving, drinking behavior, psychological distress, physical/mental health, and sociodemographic and clinical data. The same investigator assessed alcohol drinking 1 month after their visit. Nearly half of the patients felt that the COVID-19 crisis had a serious impact on their drinking problems, despite minor disruptions in access to healthcare. These disturbances significantly influenced short-term alcohol drinking in univariate analysis, together with psychological distress, craving, and drinking problems. Only craving predicted alcohol drinking in multivariate analyses, suggesting that psychological and drinking problems, as well as COVID-19 disturbances, increased the risk of alcohol drinking by increasing craving. Craving should be systematically investigated in patients with AUD to establish adapted social support systems during pandemics.


Subject(s)
Alcoholism , COVID-19 , Adolescent , Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , Alcoholism/epidemiology , Alcoholism/psychology , COVID-19/epidemiology , Craving , Humans , Outpatients , Pandemics , Prospective Studies , SARS-CoV-2
13.
J Subst Abuse Treat ; 138: 108732, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1670818

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, online video platforms became the primary mode of accessing substance use-focused mutual-help group meetings, which may persist after in-person meetings are available again. This study examined the characteristics (demographic, substance use and recovery, and mutual-help group use) of attendees of online recovery support meetings, and associations of online meeting attendance with substance use outcomes, using national data (without ensured representativeness) collected before the pandemic. METHODS: Data were from the Peer Alternatives in Addiction (PAL) Study of attendees of 12-step groups (e.g., Alcoholics Anonymous), Women for Sobriety (WFS), LifeRing Secular Recovery (LifeRing), and SMART Recovery (SMART). The baseline sample, collected in 2015 (pre-pandemic), was 647 adults with lifetime alcohol use disorder who were surveyed online at baseline and 6-month (81%) and 12-month follow-up (83%). RESULTS: At baseline, 62% (n = 402) had attended an online mutual-help group meeting in their lifetime, and 36% (n = 236) had done so in the past 30 days. Bivariate analyses found that online meeting attendance was more likely among women than men, younger than older participants, and participants with more recent alcohol and drug use, and less abstinence self-efficacy. In addition, online meeting attendance was more likely among respondents who attended two or more different types of mutual-help groups (rather than just one type), and whose primary group was 12-step or WFS rather than LifeRing or SMART. Longitudinal analyses found an interaction between online meeting attendance (yes or no) and time on the outcomes of alcohol and total abstinence such that, compared to those who did not attend online meetings, online meeting attendees were less likely to be abstinent at baseline but were about the same on abstinence at 12 months. However, the interaction effect was attenuated when the model adjusted for mutual-help use characteristics. CONCLUSIONS: The findings inform mutual-help groups, providers, and researchers' efforts to sustain and expand this resource by suggesting that online meeting attendance may have appeal and be helpful to mutual-help group members who are earlier in their recovery.


Subject(s)
Alcoholism , COVID-19 , Substance-Related Disorders , Adult , Alcoholics Anonymous , Alcoholism/therapy , Female , Humans , Male , Pandemics , Self-Help Groups
14.
Am J Public Health ; 111(9): 1610-1619, 2021 09.
Article in English | MEDLINE | ID: covidwho-1666846

ABSTRACT

Objectives. To describe disparities in depression, anxiety, and problem drinking by sexual orientation, sexual behavior, and gender identity during the COVID-19 pandemic. Methods. Data were collected May 21 to July 15, 2020, from 3245 adults living in 5 major US metropolitan areas (Atlanta, Georgia; Chicago, Illinois; New Orleans, Louisiana; New York, New York; and Los Angeles, California). Participants were characterized as cisgender straight or LGBTQ+ (i.e., lesbian, gay, bisexual, and transgender people, and men who have sex with men, and women who have sex with women not identifying as lesbian, gay, bisexual, or transgender). Results. Cisgender straight participants had the lowest levels of depression, anxiety, and problem drinking compared with all other sexual orientation, sexual behavior, and gender identity groups, and, in general, LGBTQ+ participants were more likely to report that these health problems were "more than usual" during the COVID-19 pandemic. Conclusions. LGBTQ+ communities experienced worse mental health and problem drinking than their cisgender straight counterparts during the COVID-19 pandemic. Future research should assess the impact of the pandemic on health inequities. Policymakers should consider resources to support LGBTQ+ mental health and substance use prevention in COVID-19 recovery efforts.


Subject(s)
COVID-19/epidemiology , Mental Health/statistics & numerical data , Sexual Behavior/statistics & numerical data , Sexual and Gender Minorities/psychology , Adolescent , Adult , Aged , Alcoholism/epidemiology , Anxiety/epidemiology , Depression/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Socioeconomic Factors , United States , Urban Population/statistics & numerical data , Young Adult
16.
Int J Environ Res Public Health ; 19(3)2022 Jan 26.
Article in English | MEDLINE | ID: covidwho-1648281

ABSTRACT

The disruption in healthcare attention to people with alcohol dependence, along with psychological decompensation as a consequence of lockdown derived from the COVID-19 pandemic could have a negative impact on people who suffer from alcohol abuse disorder. Observational real world data pre-post study included 9966 men aged >16 years registered as having the diagnosis of alcohol abuse disorder in the electronic medical records (EMR) of the Aragon Regional Health Service (Spain). Clinical (Glutamate-oxaloacetate -GOT-, Glutamate pyruvate -GPT-, creatinine, glomerular filtration, systolic blood pressure -SBP-, diastolic blood pressure -DBP-, total cholesterol, LDL, HDL, triglycerides, and body mass index -BMI-), pharmacological (dose per inhabitant per day, DHD, of drugs used in addictive disorders, benzodiazepines and antidepressants) and health resource use variables (primary and specialized care) were considered. A Student's t-test for matched samples was performed to analyze the changes in clinical variables between alcohol abuse disorder patients with and without COVID-19. Only creatinine and LDL showed a significant but clinically irrelevant change six months after the end of the strict lockdown. The total number of DHDs for all drugs included in the study (except for benzodiazepines), decreased. In the same way, the use of health services by these patients also decreased. The impact of COVID-19 among this group of patients has been moderate. The reorganization of health and social services after the declaration of the state of alarm in our country made possible the maintenance of care for this vulnerable population.


Subject(s)
Alcoholism , COVID-19 , Pharmaceutical Preparations , Adolescent , Alcoholism/epidemiology , Communicable Disease Control , Health Resources , Humans , Male , Pandemics , SARS-CoV-2
18.
Alcohol Clin Exp Res ; 45(12): 2560-2568, 2021 12.
Article in English | MEDLINE | ID: covidwho-1596023

ABSTRACT

BACKGROUND: There are concerns that the coronavirus disease 2019 (COVID-19) pandemic may increase drinking, but most accounts to date are cross-sectional studies of self-attributions about alcohol-related impacts and the accuracy of those perceptions has not been investigated. The current study examined the correspondence between self-attributions of pandemic-related changes in drinking and longitudinally-measured changes in drinking and alcohol-related consequences in a sample of emerging adults. METHODS: In an existing ongoing longitudinal study on alcohol misuse (≥1 heavy episodic drinking day/month) in emerging adults, 473 individuals (Mage  = 23.8; 41.7% male) received a supplemental assessment from June 17th to July 1st, 2020, during public health restrictions in Ontario, Canada. These intrapandemic data were matched to the most recent assessment prior to the pandemic (~8 months earlier). Self-attributions about changes in drinking were assessed globally (i.e., increases/decreases/no change) and with higher resolution questions clarifying the magnitude of changes. RESULTS: Global self-attributions about changes in drinking substantively paralleled longitudinal changes in weekly drinking days (DD). In the longitudinal data, individuals' who self-reported increases in drinking exhibited significant increases; individuals' who self-reported decreases exhibited significant decreases; and individuals who self-reported no change exhibited nonsignificant changes. Higher resolution items likewise revealed longitudinal patterns of weekly drinking that were substantively consistent with self-attributions. Heavy DD and alcohol-related consequences exhibited similar patterns, but only individuals who self-reported large increases in drinking exhibited increases on these outcomes. Individuals who reported large increases in drinking also exhibited significant increases in depression and posttraumatic stress disorder symptoms. CONCLUSIONS: Self-attributions about drinking closely corresponded to longitudinal changes in drinking, supporting the validity of self-attributions in population-level surveys, particularly in young adults. Notably, a subgroup was identified that exhibited pronounced increases for all alcohol-related outcomes and concurrent increases in internalizing psychopathology.


Subject(s)
Alcohol Drinking/epidemiology , COVID-19/epidemiology , SARS-CoV-2 , Adult , Alcohol Drinking/psychology , Alcoholism/epidemiology , Alcoholism/psychology , Anxiety/epidemiology , COVID-19/psychology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Longitudinal Studies , Male , Ontario/epidemiology , Psychopathology , Self Report , Stress Disorders, Post-Traumatic/epidemiology , Surveys and Questionnaires , Young Adult
19.
Int J Environ Res Public Health ; 18(24)2021 12 14.
Article in English | MEDLINE | ID: covidwho-1597023

ABSTRACT

The sleep-wake cycle plays a fundamental role in maintaining the physiological balance of our body. Its alteration favours the genesis of several organic alterations and diseases including sleep disorders and the consumption of several substances of abuse. It has been reported that the work activity, especially that carried out during the night, is able to influence the sleep-wake cycle, promoting the development of insomnia, which, in turn, would subject the worker to a stressful condition such as to encourage adverse behaviour such as the use/abuse of psychotropic substances. Based on the above premises, the aim of our research was to evaluate, in night workers: (i) the pattern of consumption of alcoholic beverages; (ii) the presence of insomnia; and (iii) the possible correlation between alcohol consumption and insomnia disorder. We used the AUDIT-C test (the abbreviated version of the Alcohol Use Disorders Identification Test) and the Insomnia Severity Index to assess alcohol consumption and insomnia disorder, respectively. All questionnaires were completed by workers of both sexes belonging to different types of work activities, exclusively day or night. The results of our research show a higher propensity of night workers to consume alcoholic beverages than those who work during daytime hours, often in binge-drinking mode. In addition, an increase in the amount of alcohol consumed was found to be related to insomnia disorder, especially in night workers. This study provides further awareness of the importance of the negative impact of alcohol consumption on sleep quality in night workers.


Subject(s)
Alcoholism , Sleep Initiation and Maintenance Disorders , Alcohol Drinking/epidemiology , Alcoholism/epidemiology , Female , Humans , Male , Sleep , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/etiology , Surveys and Questionnaires
20.
Ann Diagn Pathol ; 57: 151881, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1588329

ABSTRACT

Hepatic disease is common in severe COVID-19. This study compared the histologic/molecular findings in the liver in fatal COVID-19 (n = 9) and age-matched normal controls (n = 9); three of the fatal COVID-19 livers had pre-existing alcohol use disorder (AUD). Controls showed a high resident population of sinusoidal macrophages that had variable ACE2 expression. Histologic findings in the cases included periportal/lobular inflammation. SARS-CoV2 RNA and nucleocapsid protein were detected in situ in 2/9 COVID-19 livers in low amounts. In 9/9 cases, there was ample in situ SARS-CoV-2 spike protein that co-localized with viral matrix and envelope proteins. The number of cells positive for spike/100× field was significantly greater in the AUD/COVID-19 cases (mean 5.9) versus the non-AUD/COVID-19 cases (mean 0.4, p < 0.001) which was corroborated by Western blots. ACE2+ cells were 10× greater in AUD/COVID-19 livers versus the other COVID-19/control liver samples (p < 0.001). Co-expression experiments showed that the spike protein localized to the ACE2 positive macrophages and, in the AUD cases, hepatic stellate cells that were activated as evidenced by IL6 and TNFα expression. Injection of the S1, but not S2, subunit of spike in mice induced hepatic lobular inflammation in activated macrophages. It is concluded that endocytosed viral spike protein can induce hepatitis in fatal COVID-19. This spike induced hepatitis is more robust in the livers with pre-existing AUD which may relate to why patients with alcohol abuse are at higher risk of severe liver disease with SARS-CoV2 infection.


Subject(s)
Alcoholism/pathology , COVID-19/pathology , Liver Diseases/pathology , Aged , Alcoholism/complications , Animals , COVID-19/complications , Female , Humans , Liver Diseases/complications , Male , Mice , Middle Aged
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