Exploring Binge Drinking and Drug Use among American Indians: Data from Adolescent Focus Groups

Risk factors for binge substance use and non-suicidal self-injury (NSSI) are similar, suggesting the importance of exploring how binge substance use and self-injury interrelate.

To gain insight from a sample of American Indian (AI) adolescents regarding how binge drinking and drug use function in their lives, including as overlapping forms of self-injury, and to identify community-based ideas for dual prevention strategies.

A total of N = 58 White Mountain Apache (Apache) adolescents participated in ten mixed gender (n = 33 males, 55.9%) focus group discussions. Results were interpreted and categorized by Apache researchers and compared to Nock’s behavioral model of NSSI.

Participants reported substance use most commonly with “family” and “friends,” “at a house,” or “around the community.” Substance use was not confined to a particular time of day, and often occurred “at school.” Commonly endorsed reasons fell into two main categories: “to avoid problems” or “to reduce negative feelings,” versus “to be cool” or “to feel part of a group.” All adolescents but one thought that some youths use substances excessively as a way to harm/injure themselves (n = 25 responses). Prevention approaches included encouraging healthy relationships, teaching about consequences of use, providing alternative recreation, and changing/enforcing laws on the reservation.

Tribal-specific data support the idea that binge substance use sometimes functions as a form of self-injury. Home/school environments are critical prevention settings, in addition to improved law enforcement and increased recreation.

Understanding possible shared root causes and functions of binge substance use and self-injury may advance integrated prevention approaches.


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Request Reprint E-Mail: ltingey@jhsph.edu

Understanding the Relationship between Substance Use and Self-Injury in American Indian Youth

American Indian communities compared to other US populations are challenged by the largest health disparities in substance abuse and suicidal behavior among youth ages 15–24.

This article examines the co-occurrence of substance use and self-injury among reservation-based youth in the US.

White Mountain Apache tribal leaders and Johns Hopkins University formed a partnership to address self-injury and substance abuse among Apache youth. Data on suicide (deaths, attempts, ideation), non-suicidal self-injury, and substance use were analyzed from the White Mountain Apache tribally mandated self-injury surveillance registry from 2007 to 2010, including 567 validated incidents from 352 individuals aged 15–24 years. Findings regarding characteristics of co-occurrence – including differences in the type of self-harm behavior, gender, and reported reasons for the act – were interpreted through a community-based participatory research process.

From 2007 to 2010, 64% (n = 7/11) of Apache youth ages 15–24 were “drunk or high” at the time of suicide death with data missing for 2/11 deaths; 75.7% (n = 118/156) were “drunk or high” during suicide attempt; 49.4% (n = 83/168) during suicidal ideation; and 49.4% (81/166) during non-suicidal self-injury. Co-occurrence of substance use was higher for more lethal acts and among males.

High rates of co-occurring self-injury and substance use within this population highlight the importance of research to understand relationships between these behaviors to design preemptive and integrated interventions.

Tribal-specific and culturally informed data on the co-occurrence of self-injury and substance use hold promise for reducing the combined toll of years of productive life lost among American Indian youth.

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Request Reprint E-Mail: abarlow@jhsph.edu

Review of Substance Use Disorder Treatment Research in Indian Country: Future Directions to Strive toward Health Equity

American Indians and Alaska Natives (AI/ANs) have disproportionately high rates of substance use disorders (SUDs). Effective treatment can help to reduce these disparities.

To review and summarize the AI/AN SUD treatment research literature.

The literature between 1965 and 2011 was reviewed to identify AI/AN SUD treatment articles.

Twenty-four unique studies were identified. Earlier treatment research focused on clinical ratings of improvement; later studies employed formal assessment measures. Poor outcomes were attributed to psychosocial factors. Where treatment outcomes appeared to be similar to comparison samples, interpretation was hampered by methodological concerns.

The research has improved across the decades, as has the inclusion of cultural adaptations. Future research should examine factors that influence treatment effectiveness and improve retention to bolster confidence in findings.

AI/ANs experience SUD-related health disparities. Understanding what factors contribute to positive treatment outcomes can help to address these disparities.


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Patterns of Protective Factors in an Intervention for the Prevention of Suicide and Alcohol Abuse with Yup’ik Alaska Native Youth

Community-based participatory research (CBPR) with American Indian and Alaska Native communities creates distinct interventions, complicating cross-setting comparisons.

The objective of this study is to develop a method for quantifying intervention exposure in CBPR interventions that differ in their forms across communities, permitting multi-site evaluation.

Attendance data from 195 youth from three Yup’ik communities were coded for the specific protective factor exposure of each youth, based on information from the intervention manual. The coded attendance data were then submitted to latent class analysis to obtain participation patterns.

Five patterns of exposure to protective factors were obtained: Internal, External, Limits, Community/family, and Low Protection. Patterns differed significantly by community and youth age.

Standardizing interventions by the functions an intervention serves (protective factors promoted) instead of their forms or components (specific activities) can assist in refining CBPR interventions and evaluating effects in culturally distinct settings.

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A Review of Evidence-Based Approaches for Reduction of Alcohol Consumption in Native Women Who Are Pregnant or of Reproductive Age

Fetal alcohol spectrum disorders (FASDs) are the leading preventable cause of developmental disabilities in the United States and likely throughout the world. FASDs can be prevented by avoiding alcohol use during pregnancy; however, efforts to prevent risky alcohol consumption in women of childbearing potential have not been universally successful. Objectives: Data suggest that successful interventions may require tailoring methods to meet the needs of specific populations and cultures. Key findings of interventions previously tested among American Indian and Alaskan Native (AI/AN) women who are or may become pregnant, data gaps, and promising ongoing interventions are reviewed.

A systematic review of the current literature on empirically based interventions among AI/AN women was conducted. Selected alternative approaches currently being tested in AI/AN settings are also described.

Similar to findings among other populations of women in the United States, a number of interventions have been implemented; however, only a small number have measured results. Approaches have included standard interventions involving hospitalization, inpatient, or outpatient care; wellness education; traditional approaches; and case management for high-risk women. An ongoing Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol comparing the effectiveness of a web-based culturally adapted tool, or a peer health educator model to standard clinical practice is described.

Translation of successful interventions from other settings to AI/AN populations holds promise.

FASDs represent a significant health issue with high personal and societal costs. Improvement of interventions to prevent prenatal alcohol consumption in specific populations, including AI/AN women, is a critical public health need.

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Epidemiology and Etiology of Substance Use among American Indians and Alaska Natives: Risk, Protection, and Implications for Prevention

The epidemiology and etiology of substance use and disorder in American Indian and Alaska Native (AI/AN) communities have received increasing attention over the past 25 years and accumulating evidence provides important insights into substance use patterns in these populations.

We provide a descriptive sketch of the AI/AN population in the United States today, present a brief review of the literature on the epidemiology and etiology of substance use within these populations, and discuss key implications of this literature for prevention efforts.

Patterns of alcohol use and abuse in AI/AN populations are complex and vary across cultural groups, but alcohol clearly impacts both physical health and mental health within these communities. Tobacco use – and associated health consequences – is typically higher in these populations than among other US groups, although significant variation across Native communities is apparent here as with alcohol. Evidence regarding drug use and disorder is less extensive and thus less conclusive, but evidence demonstrates higher rates of use as well. Etiological explanations for substance use and disorder cut across individual characteristics (e.g., genetics) or experiences (e.g., exposure to trauma), to social contexts (e.g., family disruption), and to cultural factors (e.g., historical trauma). Protective factors likely cut across these multiple levels as well and deserve more focused attention for informing prevention efforts. The development of effective prevention strategies, built through collaboration between researchers and Native communities, drawing from the wisdom of both, is a high priority.

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ADH and ALDH Polymorphisms and Alcohol Dependence in Mexican and Native Americans

Ethanol is primarily metabolized in the liver by two rate-limiting reactions: conversion of ethanol to acetaldehyde by alcohol dehydrogenase (ADH) and subsequent conversion of acetaldehyde to acetate by aldehyde dehydrogenase (ALDH). ADH and ALDH exist in multiple isozymes that differ in their kinetic properties. Notably, polymorphisms within the genes that encode for these isozymes vary in their allele frequencies between ethnic groups, and thus, they have been considered as candidate genes that may differentially influence risk for the development of alcohol dependence across ethnic groups.

Associations between alcohol dependence and polymorphisms in ADH1B, ADH1C, and ALDH2 were compared in a community sample of Native Americans (n 791) living on reservations and Mexican Americans (n 391) living within the same county.


Two Mexican Americans and no Native Americans possessed one ALDH2*2 allele. Presence of at least one ADH1B*2 allele was found in 7% of the Native Americans and 13% of the Mexican Americans, but was only associated with protection against alcohol dependence in the Mexican Americans. Presence of at least one ADH1B*3 allele was found in 4% of the Native Americans and 2% of the Mexican Americans, but was associated with protection against alcohol dependence only in the Native Americans. No associations between alcohol dependence and polymorphisms in ADH1C were found.

Polymorphisms in ADH1B are protective against alcoholism in these two populations; however, these findings do not explain the high prevalence of alcoholism in these populations.

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Request Reprint E-Mail: cindye@scripps.edu

Advancing American Indian and Alaska Native Substance Abuse Research: Current Science and Future Directions

American Indians and Alaska Natives (AI/AN) have disproportionately high rates of substance abuse yet there is little empirical research addressing this significant public health problem.

This paper is an introduction to a special issue that includes cutting edge science in this research area. We identify several areas that require consideration in this field and indicate how the papers in the special issue address these gaps. These overarching areas of need, which should be considered in any substantive research, include attention to heterogeneity within the population, research that has tangible health benefits, continued work on research methods and strategies, increased focus on strength based and community oriented approaches, and the need for strong research partnerships.

The special issue marks a major step forward for AI/AN substance abuse research. However, articles also highlight where more work is need to improve public health in AI/AN communities by addressing identified gap areas.

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Request Reprint E-Mail: ketz@nida.nih.gov

Global Actions August 30, 2012

Key Recent Milestones:

· Nigeria: The second phase of the drink driving health education intervention for the Lagos-Apapa route is underway with Global Actions partner Save and Strap Initiative.


Global Actions in Focus: Conference Speakers Announced

Keynote speakers have been announced for the international conference Global Actions: Initiative to Reduce Harmful Drinking to be held in Washington, D.C. on October 8 and 9, 2012. The conference will feature informative discussions on industry members’ current and future contributions to reducing harmful drinking.

Brown-Forman Corporation Chief Executive Paul Varga will speak on the WHO Global Alcohol Strategy: Making a Difference. The conference is bringing together representatives from industry and public health to share their perspectives on the WHO Global Strategy to Reduce the Harmful Use of Alcohol. As CEO of Brown-Forman since 2005, Mr. Varga has led the company’s long-term growth strategy, resulting in the fast-paced international expansion of the business and the transformation of its portfolio of consumer brands.

Carlos Brito was appointed Chief Executive Officer of Anheuser-Busch InBev in 2005. “For the past 30 years at Anheuser-Busch InBev, we have invested and created partnerships to help prevent the harmful use of alcohol. We’re proud to support the Global Actions projects and look forward to helping highlight their successes at the conference,” said Brito.

On day-two of the conference, Pernod Ricard Chief Executive Pierre Pringuet will speak on “Engaging for the Future,” including a discussion on industry members’ current and future contributions to reducing harmful drinking.

The international conference has currently registered attendees from 43 different countries representing a broad range of government, industry, and health organizations. Visit http://event.global-actions.org/Speakers.aspx for the full list of speakers and event details.

What’s Happening Next:

· Nigeria: ICAP has partnered with the Beer Sector Group (BSG) of the Manufacturers Association of Nigeria and the Advertising Practitioners Council of Nigeria (APCON) to organize a beverage alcohol summit in Lagos on September 18, 2012. The summit will be the first of its kind in Nigeria, part of efforts to strengthen the self-regulatory environment among beverage alcohol manufacturing sector.

Web-based alcohol intervention for Māori university students: double-blind, multi-site randomised controlled trial

Like many indigenous peoples, New Zealand Māori bear a heavy burden of alcohol-related harm relative to their non-indigenous compatriots, and disparaties are greatest among young adults. We tested the effectiveness of web-based alcohol screening and brief intervention (e-SBI) for reducing hazardous drinking among Māori university students.

Parallel, double-blind, multi-site, randomised controlled trial.

Seven of New Zealand's eight universities.

In April 2010, we sent e-mail invitations to all 6,697 17-24 year-old Māori students to complete a brief web questionnaire including the AUDIT-C, a screening tool for hazardous and harmful drinking.

Those screening positive were computer randomised to: <10 minutes of web-based alcohol assessment and personalized feedback (intervention) or screening alone (control).

We conducted a fully automated five month follow-up assessment with observers and participants blinded to study hypotheses, design, and intervention delivery. Predetermined primary outcomes were: (1) frequency of drinking (2) amount consumed per typical drinking occasion, (3) overall volume of alcohol consumed, and (4) academic problems.

1,789 participants were hazardous or harmful drinkers (AUDIT-C ≥ 4) and were randomized: 850 to control, 939 to intervention. Follow-up assessments were completed by 682 controls (80%) and 733 intervention group members (78%). Relative to controls, participants receiving intervention drank less often (RR=0.89; 95% confidence interval: 0.82 to 0.97), less per drinking occasion (RR=0.92; 0.84 to 1.00), less overall (RR=0.78; 0.69 to 0.89), and had fewer academic problems (RR=0.81; 0.69 to 0.95).

Web-based screening and brief intervention reduced hazardous and harmful drinking among non-help-seeking Māori students in a large scale pragmatic trial. The study has wider implications for behavioural intervention in the important but neglected area of indigenous health.

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Request Reprint E-Mail: kypros.kypri@newcastle.edu.au

2nd HEC Paris Workshop on Regulation

Alberto Alemanno (HEC Paris) and Amandine Garde (Durham University)
are pleased to welcome you to the 2nd HEC Paris Workshop on Regulation:
Regulating Lifestyle Risks in Europe - The Case of Alcohol,
Tobacco, Unhealthy Diets & Gambling
September, 20-21 2012

Conference Home Page

The association between low alcohol use and traffic risk behaviors among Brazilian college students

Although there are a large number of studies focused on binge drinking and traffic risk behaviors (TRB), little is known regarding low levels of alcohol consumption and its association to TRB. The aim of this cross-sectional study is to examine the association of low to moderate alcohol intake pattern and TRB in college students in Brazil.

7037 students from a National epresentative sample were selected under rigorous inclusion criteria. All study participants voluntarily fulfilled a structured, anonymous, and self-questionnaire regarding alcohol and drug use, social-demographic data, and TRB. Alcohol was assessed according to the average number of alcoholic units consumed on standard occasions over the past 12 months. The associations between alcohol intake and TRB were summarized with odds ratio and their confidence interval obtained from logistic regression.

Compared with abstainers students who consumed only one alcohol unit had the risk of being a passenger in a car driven by a drunk driver increased by almost four times, students who reported using five or more units were increased by almost five times the risk of being involved in a car crash. Compared with students who consumed one alcohol unit, the risk of driving under the influence of
alcohol increased four times in students using three alcohol units. Age group, use of illicit drugs, employment status, gender, and marital status significantly influenced occurrence of TRB among college students.

Our study highlights the potential detrimental effects of low and moderate pattern of alcohol consumption and its relation to riding with an intoxicated driver and other TRB. These data suggest that targeted interventions should be implemented in order to prevent negative consequences due to alcohol use in this population.

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Request Reprint E-Mail: pri_dib@yahoo.com.br

Alcohol News - 35/2012

15min.lt (Lithuania) - Lobbying in Lithuania - conservative MP suspected of taking bribe for revoking alcohol ad ban

55 thousand litas (16 thousand euros) in exchange for three bills. Such a deal was allegedly struck by conservative MP Vitas Matuzas. If suspicions are proven correct, it will be a major embarrassment not only for the Conservative Party, but for the entire Parliament that passed the bought bills.

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riga.com (Latvia) - Illegal alcohol market proportion in Latvia is nearly 40%

During the first half-year of 2012, excise tax on alcoholic beverage (except beer) was collected in the amount of 39.55 million LVL, which is 2.16 million LVL or 6% more than was collected in the same period of 2011.

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Econpapers (Sweden/Finland) - Cross-Border Health and Productivity Effects of Alcohol Policies

This paper studies the cross-border health and productivity effects of alcohol taxes. We estimate the effect of a large cut in the Finnish alcohol tax on mortality, alcohol related illnesses and work absenteeism in Sweden.

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Grapevine.is (Iceland) - Alcohol Permitted In Nursing Homes

City council has just passed a measure that would allow the sale of beer and wine in nursing homes.

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CBS News (USA) - Survey: "Digital peer pressure" fueling drug, alcohol use in high school students

Back-to-school season is just around the corner, and researchers at Columbia University are warning that teens could face added drug and alcohol risks once classes start up.

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World Socialist Web Site (South Africa) - Rising incidence of Fetal Alcohol Syndrome in South Africa

Fetal Alcohol Spectrum Disorder (FASD) describes a range of permanent birth defects caused by the maternal intake of alcohol. The term Fetal Alcohol Syndrome (FAS) is applied to children at the severe end of the spectrum. South Africa’s Western Cape and Northern Cape Provinces have the highest FAS prevalence in the world.

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Stuff.co.nz (New Zealand) - 6% alcohol limit for RTDs dumped

The liquor industry has scored a win over the planned regulation of RTDs in the Government's alcohol reform package.

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The Australian (Australia) - Alcohol use putting workers at safety risk

Many Australian construction workers are putting their safety at risk by drinking heavily and using drugs, a national survey shows.

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Laboratory Equipment - Research Explains How Alcohol is a Carcinogenic

Almost 30 years after discovery of a link between alcohol consumption and certain forms of cancer, scientists are reporting the first evidence from research on people explaining how the popular beverage may be carcinogenic. The results, which have special implications for hundreds of millions of people of Asian descent, were reported at the 244th National Meeting & Exposition of the American Chemical Society.

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Firstpost - Just one alcoholic drink a day may up risk of cancer: Study

Binge drinkers are not the only ones who need to worry about the health implications of alcohol, even light drinking increases the cancer risk significantly, a new study has claimed.

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Counsel & Heal - Imaging Study Sheds New Light on Alcohol-related Birth Defects

Researchers said maternal alcohol use is the leading known and preventable cause of birth defects and mental disability in the United States and alcohol's effects can cause a range of cognitive, developmental and behavioral problems that typically become evident during childhood, and last a lifetime.

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Bangkok Post (Thailand) - Alcohol, tobacco taxes up

The cabinet on Tuesday approved the Finance Ministry's proposal to raise the excise tax on liquor and tobacco, meaning an immediate increase in the retail price of liquor and cigarettes, but not beer or wine.

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Daily Mail (UK) - Parents who buy alcohol are 'creating underage drinking problems' for teenage girls

Parents are contributing to teenagers' drinking problems by buying them bottles of cheap booze, a probation watchdog has warned. Liz Calderbank, HM Chief Inspector of Probation, says parents underestimate the risks of buying 'boxes of lager' for their teenage children.

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Wall Street Journal (USA) - Liquor Ads Win Airtime

The broadcasters are easing decades-old voluntary bans that limited their national alcohol advertising to beer and wine, which have less alcohol by volume than spirits.

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New Zealand Doctor Online (New Zealand) - Regulate alcohol first, then ciggies: experts

Alcohol regulation should have preceded tobacco regulation because the direct harm to others from overuse of alcohol is the greater, addiction specialist Doug Sellman argues.

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New Zealand Herald (New Zealand) - New research shows alcohol causes most harm to innocent victims

Stark new research has laid bare alcohol's toll on innocent victims, with liquor playing a major part in large numbers of murders, fires, car crashes, random assaults and violence in the home.

Read more

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Quantitative trait loci for response to ethanol in an intercontinental set of recombinant inbred lines of Drosophila melanogaster

Alcohol, a drug widely abused, impacts the central nervous system functioning of diverse organisms. The behavioral responses to acute alcohol exposure are remarkably similar among humans and fruit flies. In its natural environment, rich in fermentation products, the fruit fly Drosophila melanogaster encounters relatively high levels of ethanol. The effects of ethanol and its metabolites on Drosophila have been studied for decades, as a model for adaptive evolution. Although extensive work has been done for elucidating patterns of genetic variation, substantially less is known about the genomic regions or genes that underlie the genetic variation of this important trait.

To identify regions containing genes involved in the responses to ethanol, we used a mapping population of recombinant inbred (RIL) lines to map quantitative trait loci (QTL) that affect variation in resistance and recovery from ethanol sedation in adults and ethanol resistance in larvae. We mapped fourteen QTL affecting the response to ethanol on the three chromosomes. Seven of the QTL influence the resistance to ethanol in adults, two QTL are related to ethanol-coma recovery in adults and five affect the survival to ethanol in larvae.

Most of the QTL were trait specific, suggesting that overlapping but generally unique genetic architectures underlie each trait. Each QTL explained up to 16.8% of the genetic variance among lines. Potential candidate loci contained within our QTL regions were identified and analyzed.



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Request Reprint E-Mail: raqueldefays@hotmail.com

Alcohol Justice Blasts California Legislature for Buckling to Big Alcohol’s Demand for Booze Sweepstakes and Contests

In stunning denial of the public health and safety threats of encouraging more alcohol consumption, the California State Legislature has passed a bill to allow the use of sweepstakes and contests to promote alcohol sales in the state.

”We are deeply disturbed by this election year gift to Big Alcohol,” stated Alcohol Justice Public Affairs Director Michael Scippa. “We are calling upon Governor Brown to veto this irresponsible measure because overturning the state’s existing ban on alcohol-related contests will lead to increased over-consumption and increased public health and safety costs.”

Proponents of SB 778, led by Wine Institute, the bill’s sponsor, and Senator Alex Padilla (D-San Fernando Valley), the bill’s author, pleaded that California was at a competitive disadvantage by being one of the only states in the country that did not allow alcohol sweepstakes and contests. This hollow argument ignores the facts that California not only leads the country in alcohol sales at nearly $22 billion a year, but also leads the country in alcohol-related harm, which was estimated in 2008 to be more than $38 billion a year. > > > > Read More

Unmet need for treatment for substance use disorders across race and ethnicity

The objective was to analyze disparities in unmet need for substance use treatment and to observe variation across different definitions of need for treatment.

Data were analyzed from the 2002 to 2005 National Survey of Drug Use and Health and the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regressions estimated the likelihood of specialty substance use treatment across the two data sets. Parallel variables for specialty, informal and any substance abuse treatment were created. Perceived need and normative need for substance use treatment were defined, with normative need stratified across lifetime disorder, past twelve month disorder, and heavy alcohol/any illicit drug use. Treatment rates were analyzed, comparing Blacks, Asians and Latinos to non-Latino whites across need definitions, and adjusting for age, sex, household income, marital status, education and insurance.

Asians with past year substance use disorder had a higher likelihood of unmet need for specialty treatment than whites. Blacks with past year disorder and with heavy drinking/illicit drug use had significantly lower likelihood of unmet need. Latinos with past year disorder had a higher likelihood of unmet need for specialty substance abuse treatment. Asians with heavy drinking/illicit drug use had lower likelihood of unmet need.

The findings suggest that pathways to substance abuse treatment differ across groups. Given high rates of unmet need, a broad approach to defining need for treatment is warranted. Future research to disentangle social and systemic factors from factors based on diagnostic criteria is necessary in the identification of need for treatment.

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Request Reprint E-Mail: Norah_MulvaneyDay@abtassoc.com

Neighborhood context and substance use disorders: A comparative analysis of racial and ethnic groups in the United States

There is evidence that ethnic/racial minorities are conferred differential risk for substance use problems based on where they live. Despite a burgeoning of research focusing on the role of neighborhood characteristics on health, limited findings are available on substance use. Our study uses nationally representative data (N = 13,837) to examine: (1) what neighborhood characteristics are associated with risk of substance use disorders?; (2) do the associations between neighborhood characteristics and substance use disorders remain after adjusting for individual-level factors?; and (3) do neighborhood characteristics associated with substance use disorders differ by race/ethnicity after adjusting for individual-level factors?

Data were drawn from the Collaborative Psychiatric Epidemiology Studies (CPES-Geocode file) with 836 census tracts. Analyses included African Americans, Asians, Caribbean Blacks, Latinos, and non-Latino whites. Separate logistic regression models were fitted for any past-year substance use disorder, alcohol use disorder, and drug use disorder.

Living in more affluent and residentially unstable census tracts was associated with decreased risk of past-year substance use disorder, even after adjusting for individual-level factors. However, when we investigated the interaction of race/ethnicity and census latent factors with past-year substance use disorders, we found different associations for the different racial/ethnic groups. We also found different associations between neighborhood affluence, residential instability and any past-year substance use and alcohol disorders by nativity.

Characteristics of the environment might represent differential risk for substance disorders depending on a person's ethnicity/race and nativity status.

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Request Reprint E-Mail: kmolina@psy.miami.edu

Substance use and sexual behavior among recent Hispanic immigrant adolescents: Effects of parent–adolescent differential acculturation and communicati

To ascertain the effects of parent–adolescent acculturation gaps, perceived discrimination, and perceived negative context of reception on adolescent cigarette smoking, alcohol use, sexual activity, and sexual risk taking. We used an expanded, multidimensional model of acculturation.

A sample of 302 recently immigrated parent–adolescent dyads (152 from Miami and 150 from Los Angeles) completed measures of acculturation (Hispanic and American practices and identifications, and individualist and collectivist values) and parent–adolescent communication. Adolescents completed measures of recent cigarette smoking, alcohol use, sexual behavior, and sexual risk taking.

Parent–adolescent gaps in American practices and ethnic identity, and perceptions of a negative context of reception, predicted compromised parent–adolescent communication. In Miami only, adolescent-reported communication negatively predicted odds of cigarette smoking, occasions of drunkenness, and number of sexual partners. Also in Miami only, parent-reported communication positively predicted these outcomes, as well as occasions of adolescent binge drinking, drunkenness, number of sexual partners, and odds of unprotected sex. The only significant findings in Los Angeles were protective effects of parent-reported communication on frequency of alcohol use and of binge drinking. Mediational effects emerged only in the Miami sample.

Efects of parent–adolescent acculturation gaps vary across Hispanic groups and receiving contexts. The especially strong parental control in many Mexican families may account for these differences. However, other important differences between Hispanic subgroups and communities of reception could also account for these differences. Prevention efforts might encourage Hispanic youth both to retain their culture of origin and to acquire American culture.

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Request Reprint E-Mail: SSchwartz@med.miami.edu

The efficacy of Familias Unidas on drug and alcohol outcomes for Hispanic delinquent youth: Main effects and interaction effects by parental stress an

Drug and alcohol use disproportionately affect Hispanic youth. Despite these disparities, few empirically supported preventive interventions are available to ameliorate this public health concern among Hispanic youth. This study examined the effects of Familias Unidas, relative to Community Practice, in reducing past 90-day substance use, alcohol and marijuana dependence, and having sex while under the influence of alcohol or drugs. Additionally, this study explored whether Familias Unidas’ effects varied by environmental context, namely parental stress and social support for parents.

A total of 242 delinquent Hispanic youth aged 12–17 years and their primary caregivers were randomized to either Familias Unidas or Community Practice and assessed at three time points.

Familias Unidas was efficacious in reducing past 90-day substance use, illicit drug use, and in reducing the proportion of youth with an alcohol dependence diagnosis, relative to Community Practice. Results also showed a reduction in the proportion of youth who reported having sex while under the influence of alcohol or drugs. No differences between conditions were observed in past 90-day alcohol use or marijuana dependence. Intervention effects on illicit drug use and alcohol dependence varied by environmental context. For example, Familias Unidas was most efficacious for adolescents with parents exhibiting high stress and lower levels of social support.

Familias Unidas was efficacious in reducing some drug and alcohol related outcomes. The findings also support the concept of targeting family-based interventions, such as Familias Unidas, for adolescents with parents exhibiting high stress and low levels of social support.

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Request Reprint E-Mail: gprado@med.miami.edu

Mexican immigration to the US and alcohol and drug use opportunities: Does it make a difference in alcohol and/or drug use?

Mexican immigrants in the US do not have increased risk for alcohol use or alcohol use disorders when compared to Mexicans living in Mexico, but they are at higher risk for drug use and drug use disorders. It has been suggested that both availability and social norms are associated with these findings. We aimed to study whether the opportunity for alcohol and drug use, an indirect measure of substance availability, determines differences in first substance use among people of Mexican origin in both the US and Mexico, accounting for gender and age of immigration.

Data come from nationally representative surveys in the United States (2001–2003) and Mexico (2001–2002) (combined n = 3432). We used discrete time proportional hazards event history models to account for time-varying and time-invariant characteristics. The reference group was Mexicans living in Mexico without migration experience.

Female immigrants were at lower risk of having opportunities to use alcohol if they immigrated after the age of 13, but at higher risk if they immigrated prior to this age. Male immigrants showed no differences in opportunity to use alcohol or alcohol use after having the opportunity. Immigration was associated with having drugs opportunities for both sexes, with larger risk among females. Migration was also associated with greater risk of using drugs after having the opportunity, but only significantly for males.

The impacts of immigration on substance use opportunities are more important for drugs than alcohol. Public health messages and educational efforts should heed this distinction.

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Request Reprint E-Mail: guibor@imp.edu.mx

Current Issue: July–August 2012

Interventions and Assessments

• Prevalence of Alcohol Use Disorder Symptoms Increased after Bariatric Surgery
• Interim Methadone with Limited Counseling for 4 Months Yields Similar 12-Month Outcomes as Methadone with Standard Counseling
• A Retrospective Study of High-Dose Baclofen for High-Risk Drinking Supports the Need for a Randomized Controlled Trial
• Does Alcohol Screening, Brief Intervention, and Referral to Treatment Work for Adolescents Presenting to Emergency Departments?

Health Outcomes

• Do Patients with Alcoholic Cirrhosis Require Surveillance for Hepatocellular Carcinoma?
• Even Occasional Cocaine, Opioid, or Amphetamine Use Persisting into Middle Age Increases Mortality
• Higher Quality of Life Seen among Regular Moderate Drinkers than among Abstainers in Canada

HIV and HCV

• Association between HIV Treatment Status and Alcohol Metabolism
• Injection-Drug and Heavy Alcohol Use Did Not Affect Hepatitis-C Treatment Outcomes in an Australian Study
• Providing Rapid HIV Testing in Drug Treatment Centers Increased Testing Rates, but Adding Counseling Did Not Reduce Sex-Risk Behaviors
• Entering Methadone Maintenance Treatment Has Little Impact on HIV Sex-Risk Behaviors in Heroin-Addicted Adults
• Screening Tool to Identify Candidates for Pre-exposure HIV Prophylaxis in Men Who Have Sex with Men Includes Amphetamine and Alkyl Nitrite Use

Slide Presentations

• Update on Alcohol, Other Drugs, and Health
• Journal Club

Read Full Issue (PDF)