Impaired Control (Both Attempts to Control Drinking and Failed Control) as Prospective Predictors of Negative Outcomes among Young Adults who Drink Heavily.

BACKGROUND AND AIM: Impaired control over alcohol is a hallmark of addiction relevant to young adults but additional prospective findings are needed, particularly in samples reporting heavy drinking. Further, we lack understanding of how attempts and failed efforts to control drinking relate to each other in predicting outcomes. We hypothesized attempted and failed control would prospectively predict outcomes, with endorsement of both being especially problematic. METHODS: We used data from young adults reporting heavy drinking who enrolled in laboratory alcohol self-administration studies (N=109). Mixed effects models were used to predict drinks per drinking day, heavy drinking, and negative consequences across baseline, 6- and 12-month follow-up. Interactions by time and between attempted and failed control were tested. RESULTS: Higher failed control was associated with steeper declines in consequences and heavy drinking over time compared to lower failed control. However, higher attempted or failed control was still associated with more consequences and alcohol use than lower impaired control at multiple timepoints. A significant interaction indicated that the combination of higher attempted and failed control was associated with the most drinks per drinking day. There was also a significant attempted-by-failed control interaction for heavy drinking. CONCLUSIONS: These findings provide further evidence supporting impaired control over alcohol use as a risk factor among young adults. Those reporting both higher attempted and failed control drank the most per day. Either attempted or failed control was associated with negative consequences. Those reporting both higher attempted and failed control may be in greatest need of intensive intervention.

Using Crowdsourcing for Alcohol and Nicotine Use Research: Prevalence, Data Quality, and Attrition on Amazon Mechanical Turk.

BackgroundGauging the feasibility of using Amazon Mechanical Turk ® (MTurk) for various types of substance use research is precluded by a lack of information pertaining to the recruitment process in published studies utilizing it and concurrent information on data quality. ObjectiveThe present report addressed this gap by documenting the prevalence of alcohol and nicotine use, self-reported major health conditions, and information on data quality and retention on MTurk. Individuals 21 to 90 years old (N = 1101, Mdn age = 30) with United States-based MTurk accounts completed a stand-alone screening survey. The screening consisted of basic demographic, substance use, and physical/mental health questions, as well as items to gauge language proficiency/attention (i.e., data quality). ResultsPoor quality data was infrequent (6.5% of participants) and associated with self-reported non-United States residence, affirmative responding (e.g., currently pregnant, using both alcohol and nicotine), and other response characteristics (e.g., not disclosing health conditions). Among those passing quality checks, alcohol and nicotine use were relatively common (71.5% and 24.8%). Major physical (6.3%) and mental health conditions (14.8%) were less common. Despite not sending direct invitations, most eligible participants returned to and completed the main study (81.7%). Conclusions/Importance: Alcohol and nicotine use were relatively common among MTurk workers and retention rates were high. Together with the low prevalence of poor quality data, MTurk appears to remain a fruitful platform for substance use research; although researchers must be diligent in using appropriate screening tools, as substance use was sometimes associated with poor data quality and MTurk account information may not be reliable.

Using greenspace and nature exposure as an adjunctive treatment for opioid and substance use disorders: Preliminary evidence and potential mechanisms.

The demand for opioid medication to effectively treat pain has contributed to the surging opioid crisis, which is a major source of morbidity and mortality in the U.S. More than 100,000 people begin opioid maintenance treatment (OMT) annually, the standard pharmacotherapy for opioid use disorder (OUD). Although OMT is the standard care for OUD, patients often experience or develop a heightened sensitivity to pain (hyperalgesia) as a result of the opioid medication, and also have high rates of stress, affective, and anxiety-related conditions. These conditions are interactive with other behavioral and environmental correlates of opioid and other substance use disorders including impulsive decision-making (e.g., harmful opioid use associated with increased delay discounting), and a lack of alternative (i.e., substance-free) and social reinforcement. Collectively these complex and multifaceted factors constitute significant predictors of lack of adherence to OMT (and other pharmacotherapies) and relapse. There is an urgent need, therefore, to develop novel adjunctive treatments that preserve the benefits of OMT and various pharmacotherapies, and simultaneously diminish continued pain and hyperalgesia, reduce stress and anxiety-related conditions, target relevant behavioral mechanism such as impulsive choice, and also serve to enhance the value of alternative and substance free activities. Here, we discuss evidence that an environmental manipulation - access to greenspace and nature - could serve as a potential adjunctive treatment to standard pharmacotherapies by targeting multiple biological and behavioral mechanisms that standard pharmacotherapies do not address.