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Drug and Alcohol Dependence Oct 2022There has been a lack of systematic exploration of remotely delivered intervention content and their effectiveness for behaviour change outcomes. This review provides a... (Review)
Review
BACKGROUND
There has been a lack of systematic exploration of remotely delivered intervention content and their effectiveness for behaviour change outcomes. This review provides a synthesis of the behaviour change techniques (BCT) contained in remotely delivered alcohol and/or substance misuse approaches and their association with intervention promise.
METHODS
Searches in MEDLINE, Scopus, PsycINFO (ProQuest), and the Cochrane Library, included studies reporting remote interventions focusing on alcohol and/or substance misuse among adults, with a primary behaviour change outcome (e.g., alcohol levels consumed). Assessment of risk of bias, study promise, and BCT coding was conducted. Synthesis focussed on the association of BCTs with intervention effectiveness using promise ratios.
RESULTS
Studies targeted alcohol misuse (52 studies) or substance misuse (10 studies), with predominantly randomised controlled trial designs and asynchronous digital approaches. For alcohol misuse studies, 16 were very promising, 17 were quite promising, and 13 were not promising. Of the 36 eligible BCTs, 28 showed potential promise, with seven of these only appearing in very or quite promising studies. Particularly promising BCTs were 'Avoidance/reducing exposure to cues for behaviour', 'Pros and cons' and 'Self-monitoring of behaviour'. For substance misuse studies, three were very promising and six were quite promising, with all 12 BCTs showing potential promise.
CONCLUSIONS
This review showed remotely delivered alcohol and substance misuse interventions can be effective and highlighted a range of BCTs that showed promise for improving services. However, concerns with risk of bias and the potential of promise ratios to inflate effectiveness warrant caution in interpreting the evidence.
Topics: Adult; Alcoholism; Behavior Therapy; Humans
PubMed: 35963209
DOI: 10.1016/j.drugalcdep.2022.109597 -
Addiction (Abingdon, England) Feb 2006To review studies of the prevalence of substance abuse and dependence in prisoners on reception into custody. (Review)
Review
AIMS
To review studies of the prevalence of substance abuse and dependence in prisoners on reception into custody.
DESIGN AND METHOD
A systematic review of studies measuring the prevalence of drug and alcohol abuse and dependence in male and female prisoners on reception into prison was conducted. Only studies using standardized diagnostic criteria were included. Relevant information, such as mean age, gender and type of prisoner, was recorded for eligible studies. The prevalence estimates were compared with those from large cross-sectional studies of prevalence in prison populations.
FINDINGS
Thirteen studies with a total of 7563 prisoners met the review criteria. There was substantial heterogeneity among the studies. The estimates of prevalence for alcohol abuse and dependence in male prisoners ranged from 18 to 30% and 10 to 24% in female prisoners. The prevalence estimates of drug abuse and dependence varied from 10 to 48% in male prisoners and 30 to 60% in female prisoners.
CONCLUSIONS
The prevalence of substance abuse and dependence, although highly variable, is typically many orders of magnitude higher in prisoners than the general population, particularly for women with drug problems. This highlights the need for screening for substance abuse and dependence at reception into prison, effective treatment while in custody, and follow-up on release. Specialist addiction services for prisoners have the potential to make a considerable impact.
Topics: Alcoholism; Cross-Sectional Studies; Female; Humans; Male; Prevalence; Prisoners; Substance-Related Disorders
PubMed: 16445547
DOI: 10.1111/j.1360-0443.2006.01316.x -
Alcoholism, Clinical and Experimental... Apr 2013Alcohol withdrawal syndrome (AWS) occurs in 16 to 31% of intensive care unit (ICU) patients after cessation of sedation. There exist many preventive and therapeutic... (Review)
Review
BACKGROUND
Alcohol withdrawal syndrome (AWS) occurs in 16 to 31% of intensive care unit (ICU) patients after cessation of sedation. There exist many preventive and therapeutic strategies, but no systematic review (SR) has been published on this topic so far. We aimed to perform a synopsis of all controlled trials of AWS prevention and therapy in ICU published between 1971 and 30 March 2011 following the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) statement.
METHODS
We performed a MEDLINE search with the terms "alcohol" AND "ICU" as well as "alcohol withdrawal" AND "intensive care." All publications that matched our eligibility criteria were analyzed according to our predefined criteria.
RESULTS
We identified 6 controlled trials about AWS prevention and 8 about AWS therapy in ICUs. For AWS prevention, benzodiazepines (BZO), ethanol (EtOH), and clonidine were evaluated as single agents, and BZO, clonidine, clomethiazol and haloperidol were studied in drug combinations. All evaluated single agents and combinations were found to be effective for AWS prevention. Clomethiazol was found to be associated with a higher tracheobronchitis rate and thus disadvised for critically ill patients. For AWS therapy, BZO, gamma-hydroxybutyric acid (GHB), and clomethiazol were evaluated in randomized controlled trials as single agents and phenobarbital, clonidine, and haloperidol as adjuncts. All evaluated regimens were found to be effective for AWS therapy. Overall, in the ICU, BZO were found to be superior to GHB and clomethiazol regarding safety and efficacy. Furthermore, 4 cohort trials with historical control groups evaluated the effect of the implementation of a standardized protocol of BZO therapy for AWS in ICUs. All of these 4 studies found better outcome for the intervention groups.
CONCLUSIONS
Based on the evidence of this SR, EtOH or BZO can be advised for AWS prevention on ICU patients with alcohol dependence, but EtOH is not allowed for therapy of AWS. AWS therapy should be standardized and based on symptom-triggered BZO administration. Alpha2-agonists and haloperidol should be added for autonomic and productive psychotic symptoms.
Topics: Alcoholism; Benzodiazepines; Controlled Clinical Trials as Topic; Humans; Intensive Care Units; Substance Withdrawal Syndrome
PubMed: 23550610
DOI: 10.1111/acer.12002 -
Substance Use & Misuse Aug 2018Latino men are disproportionately affected by the consequences of alcohol and substance abuse when compared to non-Latino white men. Latino men also face greater...
BACKGROUND
Latino men are disproportionately affected by the consequences of alcohol and substance abuse when compared to non-Latino white men. Latino men also face greater barriers to accessing, engaging, and completing alcohol and substance abuse treatment services. Culturally adapted interventions are promoted to overcome these barriers. However, the effectiveness of these efforts is unclear.
OBJECTIVES
The purpose of this review was to summarize the published evidence regarding gender-adapted and culturally adapted alcohol and substance abuse treatment that aims to improve physical, behavioral, and social outcomes in Latino men.
METHODS
A systematic literature search was conducted for articles reporting on culturally and/or gender-adapted alcohol and/or substance abuse interventions designed exclusively for Latino adults, including a Latino population sample of at least 10% and any proportion of Latino male participants. A thematic analysis based on predetermined themes was used to evaluate the nature of adaptations.
RESULTS
Searches yielded 2685 titles, resulting in 12 articles that fit review parameters. The most scientifically rigorous findings suggest culturally adapted interventions may outperform standard treatment. Nevertheless, a fraction of the interventions did not improve outcomes compared to standard treatment. Considering the scarce number of publications, it is difficult to discern if null findings reflect ineffective interventions or methodological limitations.
CONCLUSIONS
While studies are limited and findings are mixed, culturally tailored work shows promise. The growth rate of the Latino population and the current epidemic nature of substance abuse in the United States generate urgency to identify methods to diminish the disparate burden of alcohol and substance abuse in Latinos.
Topics: Adaptation, Psychological; Alcoholism; Anthropology, Cultural; Health Services Accessibility; Healthcare Disparities; Hispanic or Latino; Humans; Male; Men's Health; Randomized Controlled Trials as Topic; Substance Abuse Treatment Centers; Substance-Related Disorders; Treatment Outcome; United States; White People
PubMed: 29364763
DOI: 10.1080/10826084.2017.1417999 -
European Journal of Public Health Aug 2018There is growing awareness of the detrimental effects of alcohol industry commercial activities, and concern about possible adverse impacts of its corporate social...
BACKGROUND
There is growing awareness of the detrimental effects of alcohol industry commercial activities, and concern about possible adverse impacts of its corporate social responsibility (CSR) initiatives, on public health. The aims of this systematic review were to summarize and examine what is known about CSR initiatives undertaken by alcohol industry actors in respect of harmful drinking globally.
METHODS
We searched for peer-reviewed studies published since 1980 of alcohol industry CSR initiatives in seven electronic databases. The basic search strategy was organized around the three constructs of 'alcohol', 'industry' and 'corporate social responsibility'. We performed the searches on 21 July 2017. Data from included studies were analyzed inductively, according to the extent to which they addressed specified research objectives.
RESULTS
A total of 21 studies were included. We identified five types of CSR initiatives relevant to the reduction of harmful drinking: alcohol information and education provision; drink driving prevention; research involvement; policy involvement and the creation of social aspects organizations. Individual companies appear to undertake different CSR initiatives than do industry-funded social aspects organizations. There is no robust evidence that alcohol industry CSR initiatives reduce harmful drinking. There is good evidence, however, that CSR initiatives are used to influence the framing of the nature of alcohol-related issues in line with industry interests.
CONCLUSIONS
This research literature is at an early stage of development. Alcohol policy measures to reduce harmful drinking are needed, and the alcohol industry CSR initiatives studied so far do not contribute to the attainment of this goal.
Topics: Alcohol Drinking; Alcoholism; Food Industry; Health Promotion; Humans; Public Policy; Social Responsibility
PubMed: 29697783
DOI: 10.1093/eurpub/cky065 -
Drug and Alcohol Review Jul 2010Alcohol is an established risk factor for liver cirrhosis. It remains unclear, however, whether this relationship follows a continuous dose-response pattern or has a... (Comparative Study)
Comparative Study Review
INTRODUCTION AND AIMS
Alcohol is an established risk factor for liver cirrhosis. It remains unclear, however, whether this relationship follows a continuous dose-response pattern or has a threshold. Also, the influences of sex and end-point (i.e. mortality vs. morbidity) on the association are not known. To address these questions and to provide a quantitative assessment of the association between alcohol intake and risk of liver cirrhosis, we conducted a systematic review and meta-analysis of cohort and case-control studies.
DESIGN AND METHODS
Studies were identified by a literature search of Ovid MEDLINE, EMBASE, Web of Science, CINAHL, PsychINFO, ETOH and Google Scholar from January 1980 to January 2008 and by searching the references of retrieved articles. Studies were included if quantifiable information on risk and related confidence intervals with respect to at least three different levels of average alcohol intake were reported. Both categorical and continuous meta-analytic techniques were used to model the dose-response relationship.
RESULTS
Seventeen studies met the inclusion criteria. We found some indications for threshold effects. Alcohol consumption had a significantly larger impact on mortality of liver cirrhosis compared with morbidity. Also, the same amount of average consumption was related to a higher risk of liver cirrhosis in women than in men.
DISCUSSION AND CONCLUSIONS
Overall, end-point was an important source of heterogeneity among study results. This result has important implications not only for studies in which the burden of disease attributable to alcohol consumption is estimated, but also for prevention.
Topics: Alcohol Drinking; Alcoholism; Animals; Case-Control Studies; Cohort Studies; Endpoint Determination; Female; Humans; Liver Cirrhosis; Liver Cirrhosis, Alcoholic; Male; Risk Factors
PubMed: 20636661
DOI: 10.1111/j.1465-3362.2009.00153.x -
International Review of Psychiatry... 2023Alcohol consumption has a key role in more than 200 diseases and health injuries, being an important factor for social and public health costs. Studies with clinical... (Meta-Analysis)
Meta-Analysis
Alcohol consumption has a key role in more than 200 diseases and health injuries, being an important factor for social and public health costs. Studies with clinical populations show an association between alcohol use disorders (AUD) and bipolar disorder. In this meta-analysis we included studies, reports, or summaries identified in Google Scholar, Lilacs, Medline, and MedCaribe that reported original data published up to 31 January 2023. We included cross-sectional and longitudinal observational studies that investigated the prevalence of AUD in patients with bipolar disorder. We calculated the prevalence rates and conducted a meta-analysis using a random effects model. The meta-analysis included 20 unique studies conducted in 12 countries, with a total sample of 32,886 individuals with bipolar disorder, comprising 17,923 women and 13,963 men, all aged 18 years or older. The prevalence of AUD in individuals with bipolar disorder was found to be 29.12%, while the prevalence of Alcohol Dependence (AD) was 15.87% and the prevalence of Alcohol Abuse (AA) was 18.74%. The high prevalence of AUD individuals with bipolar disorder is important because it highlights the need for targeted interventions to prevent and address comorbid conditions, which may improve treatment outcomes, reduce harm, and promote public health.
Topics: Male; Humans; Female; Bipolar Disorder; Alcoholism; Cross-Sectional Studies; Comorbidity; Alcohol Drinking
PubMed: 38299650
DOI: 10.1080/09540261.2023.2249548 -
Progress in Neuro-psychopharmacology &... Jul 2020Alcohol dependence (AD) is characterized by a set of physical and behavioral symptoms, which may include withdrawal, tolerance and craving. Recently, noninvasive brain... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Alcohol dependence (AD) is characterized by a set of physical and behavioral symptoms, which may include withdrawal, tolerance and craving. Recently, noninvasive brain stimulation (NIBS) methods, namely transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), have been investigated as possible new therapeutic approaches for adjusting the pathological neuroplasticity involved in alcohol dependence. Therefore, we conducted a systematic review and meta-analysis on the therapeutic uses of tDCS and rTMS in AD patients.
METHODS
A systematic search was performed on Scopus, Web of Science, PubMed, Cochrane library and ProQuest. Search terms presented the diagnoses of interest (alcohol dependence, alcohol craving, alcohol use disorders and hazardous drinkers) and the intervention of interest (NIBS, TMS, rTMS, TBS, tDCS, tACS and transcranial). Original articles reporting the use of tDCS or rTMS to treat AD were screened and studied by two researchers independently based on PRISMA guidelines. Next, in the meta-analysis step, random-effects model was utilized to measure the pooled effect size.
RESULTS
We found 34 eligible studies including 11 tDCS trials and 23 rTMS trials. Three of these studies were case-reports, four were open label trials and the remaining 27 were controlled trials which assessed tDCS/rTMS effects on the three cognitive, behavioral and biological dimensions in AD. The pooled standardized mean differences for the effects of tDCS and rTMS on alcohol cravings were - 0.13 [-0.34, 0.08] and - 0.43 [-1.02, 0.17], respectively.
CONCLUSION
There is no evidence for a positive effect of tDCS/rTMS on various dimensions of AD. We need more randomized, double blind, sham controlled trials with enough follow-up periods to evaluate the efficacy of tDCS/rTMS for alcohol dependence treatment.
Topics: Alcoholism; Brain; Craving; Humans; Randomized Controlled Trials as Topic; Transcranial Direct Current Stimulation; Transcranial Magnetic Stimulation
PubMed: 32234509
DOI: 10.1016/j.pnpbp.2020.109938 -
Journal of Addiction MedicineManagement of alcohol use disorder (AUD) is rarely used in patients with liver disease. We performed a systematic review to examine the impact of AUD management among... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Management of alcohol use disorder (AUD) is rarely used in patients with liver disease. We performed a systematic review to examine the impact of AUD management among patients with liver disease.
METHODS
Twenty studies fulfilling the inclusion and exclusion criteria on 38,329 patients (7072 receiving AUD intervention) with liver disease (15 with liver disease and 6 liver transplant [LT] recipients) were analyzed. One study was common to both groups. Variable follow-up period across studies was weighted for sample size and converting to person-years. Primary outcome was alcohol use, and secondary outcomes were liver decompensation and patient mortality.
RESULTS
Abstinence and alcohol relapse rates/person-year with AUD intervention among liver disease patients were 0.41 (0.27-0.55) and 0.42 (0.30-0.755), similar for integrated (colocated liver and addiction clinics) versus concomitant (separate hepatology and addiction clinics) intervention. Compared with standard of care, odds for decompensation with AUD intervention (n = 1), 30-day readmission (n = 1), and patient mortality (n = 2) were lower by 44%, 59%, and 58% respectively. Similar figures were 1.24 (0.86-1.80) for abstinence and 0.52 (0.24-0.14) for relapse. Among LT recipients, odds for alcohol relapse and mortality with follow-up integrated with addiction team versus hepatology alone were 0.48 (0.25-0.72) and 0.29 (0.08-0.99), respectively.
CONCLUSIONS
Follow-up of LT recipients in an integrated clinic with addiction team is associated with improved outcomes. Simultaneous management of AUD in patients with liver disease improves liver-related outcomes. Large prospective studies are needed to examine benefits of AUD intervention in patients with liver disease.
Topics: Humans; Alcoholism; Treatment Outcome; Liver Transplantation; Liver Diseases; Chronic Disease; Recurrence
PubMed: 36259647
DOI: 10.1097/ADM.0000000000001084 -
Addictive Behaviors Feb 2023For decades, alcohol use disorder has been investigated in an attempt to understand its processes and implications. However, among all of the factors involved in alcohol... (Review)
Review
For decades, alcohol use disorder has been investigated in an attempt to understand its processes and implications. However, among all of the factors involved in alcohol use disorder, the role of guilt in alcohol use remains poorly explained, with many contradictory results. Therefore, the purpose of this review is to conduct a systematic analysis of the literature from 1990 to 2022 to review the studies investigating the link between guilt and alcohol consumption. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, 31 studies were included in this review. The results of this work enable to highlight the plurality of guilt that has been studied in the literature. Grouped in two categories: state guilt and trait guilt, they seem to have diverse implications towards alcohol use or misuse. Guilt proneness seems to act as a protective factor towards alcohol use, except for the few studies conducted on a clinical population. Numerous studies indicated that state guilt is deleterious toward alcohol use, even if some results are contradictory. Furthermore, this work allows us to shed light on the limits of the studies currently carried out, and thus to propose new directions for future studies.
Topics: Humans; Alcoholism; Guilt; Alcohol Drinking; Protective Factors
PubMed: 36332517
DOI: 10.1016/j.addbeh.2022.107531