The Kettil Bruun Society for Social and Epidemiological
Research on Alcohol is an international organization of scientists
engaged in research on the social aspects of alcohol use and alcohol
problems.
KBS 31st
Annual Symposium
Alcohol,
Drugs, and Violence:
Youth Risk Taking, Behaviors and Prevention
Scientific
meeting, Monday, 30 May - Friday, 3 June 2005
Professionals track, Monday, 30 May - Wednesday, 1 June 2005
Pre-Symposium meetings, Friday, 27 May - Sunday, 29 May 2005
Riverside , California,
USA
ACCEPTED ABSTRACTS
Maria Abrahamson
Centre for Social Research on Alcohol and Drugs (SoRAD)
Stockholm University
Sweden
Young women’s and men’s different worlds of alcohol, fear and violence in focus group discussions with 18 year olds in Stockholm
The purpose of the paper is to investigate how young women and men in focus group discussions reason about alcohol, street violence and fear of assault by a stranger and to compare the different kinds of threats that young women and men present of what might happen when they are out at night and on their way home. The interviews are analysed from the point of view of the accounts the young people give for their feelings and behaviours. The young women’s accounts are dominated by their answers to an implicit question of blame for how they ensure their security and which measures they have taken. What the young women are afraid of is rarely formulated explicitly. It goes without saying. For the young women alcohol and intoxication have no excuse value in this context. On the other hand the accounts the young men are giving for their actions consist of answers to the implicit question of blame for violence they have been involved in and also of blame for fear of violence. The young men’s picture of threat is concrete and consists of other young men of the same age. By their accounts they show that, fear of violence is something that has to be given an explanation. The young men use intoxication both as an excuse for the violence they are using and as an explanation to why violence occurs.
Marianne
Aeberhard
University of Applied Sciences Bern
School of Social Work (HSA)
Institute for Social Planning and Social Management (ISS)
Bern, Switzerland
Natural recovery from a survey perspective epidemiology of recovery without professional treatment from addiction of alcohol, legal and illegal drugs, tobacco and pathological gambling in Switzerland relation between general and addiction-specific attitudes and natural recovery
Numerous surveys and reviews show that natural recovery is the most important pathway to change in a wide range of addiction problems. Additional information about self-change is provided from community research and studies with special samples focusing on factors contributing or impeding natural recovery. Extracted factors vary study by study but many support the importance of cognitive decision making. The study is the first survey in Switzerland conducted to assess self-change rates from different addictions and to find out about cognitive factors other than cost and benefit considerations influencing natural recovery. In a representative telephone survey (N=707) life time prevalence rates of addiction problems with alcohol, hard drugs, cannabis, prescription drugs and gambling and the respective solutions to the addiction problems are assessed. Respondents who did not seek any professional help (including self-help groups) are defined as natural remitters. This group is compared with professionally treated persons with resolved addiction problems, with currently addicted respondents both treated and non-treated and with a control group (no addiction problems). Dimensions of comparison are besides socio-demographic characteristics general attitudes such as locus of control, socio-political preferences and general trust in professional and political authorities. They are used as predictors for group classification. The study allows for an international comparison with other surveys on natural remission as the normal way to quit addictive behaviour. Characteristics which discriminate between the group of natural remitters from the other groups are outlined, using general attitudes as discriminative factors.
Allaman Allamani,
Vittorio Boscherini, Ilaria Basetti Sani, Gabriele Bardazzi, Manuele Falcone,
Ivana Pili, and Fabio Voller
Italy
The Florence 1 early identification and brief intervention project
Notwithstanding the dramatic decrease in the amount of wine consumption since 1970s and of the new drinking patterns that begin to be popular among youngsters, the Italian drinking pattern still sticks to tradition, i.e. daily drinking of wine (or beer) during the mean meal. However, since 1990s, increasing attention has grown among the general population and the health professionals related to the potential physical and behavioural harm that alcohol may produce. Is of interest to note how one of the first Italian known community alcohol prevention experiences, implemented within the neighbourhood of Rifredi in Florence (1992-1998), contributed to the planning of the Italian Early Identification and Brief Intervention (EIBI) Project.
The Florence 1 EIBI project is one of the 4 official projects in the WHO Europe “Phase IV” EIBI study that were eventually funded in 2004 by the Italian Ministry of Health. The project' aim is that general practitioners and primary health Care professionals identify risky drinkers and alcohol-related problems among their clients and use communication skills to educate patients at risk to reduce drinking alcohol beverages or stop drinking if necessary. In the planning process, emphasis has been given both to the customisation of the international protocol and to the alliance with general practitioners, in order that they at least partly own the project.
As a consequence, a co-operative of Florence GPs and the Florence Health Agency have formally agreed that: (a) all the approximately 50 GPs involved in the EIBI project receive an Alcohol Training (b) a random sample of 10,000 clients (18-75 years) at GPs’ offices in two different set of communities in the province of Florence will be enrolled in the study; the two communities being Scandicci and North Chianti (c) those clients who turn out to be risky drinkers enter a 12-month brief intervention program with follow up at three months as an average (d) the interaction between physicians and their patients is randomly evaluated by means of both a self-report questionnaire and a videotape study focusing on doctor-client communication (e) the quantitative evaluation relies on the changes in both intervention rates in the doctors office and in community diagnoses of alcohol-related disease, while the qualitative evaluation relies on baseline and final interviews with key people in each of the two communities.
The project is intended to end in 2006. So far, building institutional alliances, implementing alcohol training for GPs and planning the baseline qualitative evaluation were accomplished.
Airi-Alina
Allaste
PhD student
Estonia
Risk behaviour and drug use in connection with social environment and cultural representations
Abstract: Illicit drug use is a rather new phenomenon in Estonia as compared to Western countries. Rapid growth of illicit drug use started in the 1990s, alongside with significant social change in the society in general and the value orientations of youth in particular.
Association with different users is largely affected by social background and cultural conditions. Today it is possible to separate the recreational scene influenced by international club-culture and the marginal scene which is largely connected with criminal activities.
The empirical part of the paper is based on in-depth interviews with drug users. I have investigated different type of drug users, whose initiation into the drug scene took place according to the youth culture and the marginalisation models. Health sense and risk behaviour are mostly influenced by the drug user group, its position in society and self-perception
Moderate recreational users with high sub-cultural capital have relatively good positions in the society. According to the Levi-Strauss triangle, they perceive themselves as representing the culture, and "others" are either raw (young clubbers who exaggerate with drugs) or rotten (marginalised heroin users). This distinction stresses responsible and health-sensitive behaviour and avoids the transition to problem use. Heroin users from marginalized communities lack the capacity to make choices from the health perspective. Culturally, they have partly negative, "rotten" images of themselves – they perceive addiction as stronger than their will and are of opinion that opiates rule their lives. Having low position in society and positioning themselves "under the master of heroin" makes it hard to quit or control their drug use. Drug user groups are rather distinctive and standing apart. Social background of drug users and social and cultural reasons for drug use largely influence the future of drug experimenters and the health risks they take.
Ellen J.
Amundsen1 and Brit Oppedal2
1
Norwegian Institute for Alcohol and Drug Research
2 Norwegian Institute of Public Health
Associations between intoxication and exposure to violence in the youth population of the multicultural city of Oslo
Background: The association between intoxication and exposure to violence is well documented. It is not well documented whether such associations are the same for different ethnic groups in a multicultural society. Groups with Muslim background report a much lower level of drinking than the host population. Non-western/non-Muslim youth report a level in between those in the host population and those with Muslim background. Is the association influenced by aspects of development in a multi-cultural context for youth with immigrant background?
Methods: Data from the youth part of the Oslo Health Study conducted during 2000-2001 among 15-16 year olds were used; a total of 8,361 students in 10th grade with response rate 88.3percent.
Results: (preliminary) Intoxication was highly associated with exposure to violence. Among never drinkers 17.2 percent (CI 14.6- 19.9) of the boys and 9.0 percent (CI 7.1- 11.0) of the girls had been exposed to violence. Among those who had been intoxicated twice or more 40.9 percent (CI 38.4- 43.4) of the boys and 21.7 percent (CI 19.7- 23.7) of the girls had been exposed to violence. For boys none of the associations were significantly different between those with Norwegian background, Muslim background and Non-Western/Non Muslim background. For girls there were significant differences between those with two Norwegian parents and those with Muslim background. The girls with Muslim background report a higher level of exposure to violence than the girls with two Norwegian born parents, especially by grownups.
Conclusion: Further work will be presented.
Key words: alcohol, youth, intoxication, violence exposure, immigrants, epidemiology
Barbro
Andersson and Björn Hibell
The Swedish Council for Information on Alcohol and Other Drugs, CAN
The ESPAD drunkenness scale
Abstract: In the 1999 and 2003 the European School Survey Project on Alcohol and Other Drugs (ESPAD), an analogue scale, marked from 1 (somewhat merry only) to 10 (heavily intoxicated to the point of being unable to stand on my feet), was included in the questionnaire to indicate the intoxication level on the last drunkenness occasion. In addition, the scale was included, from 1999 on, in the questionnaire of the Swedish annual surveys among students aged 15-16. This paper reports primarily the findings from the six Swedish surveys. Students indicating different levels of intoxication are almost normally distributed over the scale in all of the surveys, with a slight skewedness to the right. However, when controlling for annual average alcohol consumption it is obvious that the distribution changes. Among students with the smallest alcohol consumption the distribution of the drunkenness scale is sloped from the left to the right, among students with a medium high consumption the distribution is about normal and within the group with the highest consumption it is skewed to the right. The scale is significantly correlated with the average annual alcohol intake among the students (2004: Pearson .99), the higher value on the intoxication scale the higher the annual alcohol intake. Although the subjective feeling of being drunk is very much dependent on a person’s weight and length, experience of alcohol consumption and physical condition at the time of consumption, the scale seems to measure quite well the different levels of alcohol intoxication. The paper also discusses the usefulness of the scale in other ESPAD countries with different consumption pattern and different alcohol cultures.
Key words: ESPAD drunkenness scale, students, annual alcohol consumption, alcohol culture
Christina
Andersson, Lena Spak, and Fredrik Spak
Department of Social Medicine
The Sahlgrenska Academy at Göteborg University
Sweden
Prevalence of drug use in three cohorts of young Swedish women
Abstract: The study presents prevalence of drug use among 1123 women aged 20 and 25 years in Göteborg, Sweden. The aim of the study was to measure prevalence of illegal and legal drug use in three cross-sectional cohorts interviewed in 1990, 1995 and 2000 as well as to describe the development of drug use within the same period. Prevalence was calculated for illicit and licit drug use in total and for three different patterns of drug use; narcotics only, medications only or a combination of the use of these substances. Also presented is the frequency of drug use. Further were analysed trends in changes of the use of nine specified drugs. Results: Both life-time and 12-months use of illicit drugs was significantly higher for 20-year-old women in 2000 (from 20.2percent to 33.4percent and from 9.5percent to 22.3percent respectively). The use of licit drugs was highest (but not significant) among 25-year-old women in 1990. Cannabis was the most prevalent drug used with a significant increase in life-time use for 20-year-old women from 17,4percent to 28,8percent. Both age-groups reported significant increases in the use of heroin, 25-year-old women in use of psychedelica and 20-year-old women in use of other drugs. Conclusions: The prevalence rates found were higher than compared to contemporary studies in Sweden. Further was found a significant trend for using both illegal and legal drugs among the youngest cohort, and a tendency for more regular use of drugs in both age-groups in 2000.
Key words: Prevalence, illegal drug use, legal drug use, young women
Franca Beccaria, Franco Prina, Daniele Scarscelli, and Odillo Vidoni
Alcohol Research Group
Department of Social Science
University of Torino, Italy
The Mediterranean alcohol project: changes in the consumption of alcoholic beverages in Italy: An explorative study into the causes of the decrease in consumption between 1970 - 2000
Italy is a “wet country” traditionally characterized by high alcohol consumption, although consumption has been decreasing constantly for the last thirty years. Between 1970 and 2000 pure alcohol consumption has passed from more than 13 litres to 7,5 pro capite, with a decreasing trend without interruption. In a period of a intense European discussion about the opportunity of having more homogeneous alcohol policies among member states, the Italian case is becoming more and more interesting for his specificity: in fact, this reduction occurs in a context without any specific alcohol policy.
The aim of this study is to explore some factors that may have produced this relevant alcohol consumption reduction (in particular in wine and spirits). The data we present are the results from a qualitative field study carried out in 4 Italian regions in 2004. 117 males (40-45 years old and 65-70 years old) who had reduced their alcohol consumption were interviewed. Furthermore, some individual interviews with experts were carried out as well as two focus groups. In reconstructing the drinking careers of the people interviewed we have focused our attention on the qualitative aspects of the transitions that take place during life and on different subjects’ capacity to cope.
The complex theme of the study of drinking careers has been approached using a guideline interview which combines completely standardised survey techniques (a questionnaire with multiple-choice questions) with partially standardized ones (a semi-structured interview).
Key words: alcohol consumption, reduction, alcohol culture, wet drinking culture, alcohol policy.
Agnieszka Bielinska-Kwapisz and Douglas J. Young
Department of Agricultural Economics and Economics
Montana State University
USA
Alcohol prices, consumption, and traffic fatalities
JEL Classifications: Il (Health), H2 (Taxation), and C3 (Econometrics)
We examine the relationships among alcohol prices, alcohol consumption and youth traffic fatalities using data across U.S. states from 1982-2000. Some previous studies have found large, negative associations between alcohol taxes and fatalities. However, commonly-used price data suggest little or no connection between alcohol prices and fatalities. These apparently conflicting findings may result from measurement error and/or endogeneity in the price data, which biases ordinary least squares estimators toward a finding of no price effects.
Using alcohol taxes as instrumental variables, we find youth fatalities to be negatively related to prices: A ten percent increase in alcohol prices is predicted to reduce youth fatalities by 9 percent. In addition, alcohol consumption is positively related to fatalities: A 10 percent increase in per capita consumption is associated with a 12.9 percent increase in fatalities.
Increasing the drinking age by one year is estimated to reduce teen fatalities by one to three percent, with the largest estimated impact on weekend night fatalities. There is some evidence that keg registration is associated with lower teen fatalities, but not on weekend nights. A youth BAC law is not significantly related to fatalities.
All of these results rely on the assumption that alcohol taxes and other measured policies are appropriately "exogenous," i.e. that these policies affect consumption and drunk driving, but are unrelated to unmeasured attitudes that affect both consumption and policy. Further research on the determinants of policy will help to assess the validity of this assumption.
Anders Bergmark
and Lars Oscarsson
Sweden
The concept of treatment for substance abuse: Context, modality and choice
The definition of basic concepts is often a source of substantial problems in most areas of science, this holds to be true also in the field of substance abuse research. In the following we intend to discuss some conceptual and practical problems that can be identified in connection with the concept of treatment. The paper sets out to discuss both the content and boundaries of the concept of treatment within the field of substance abuse. It entails a critical discussion of some existing definitions of treatment and puts forward a tentative and flexible definition that takes its point of departure in the context and the intention behind activities or interventions that are described as treatment. The paper also deals with by what means it is possible to make meaningful distinctions between different modalities of treatment and the difficulties to establish an evidence-base for best practices. Finally we try to discuss the relation between some basic theoretical mechanisms behind a number of popular treatment modalities and the relative importance of the individual’s choice of entering treatment.
Sharon Bernards1,
Kathryn Graham2, Samantha Wells1, and Andrée Demers3
1 Centre for Addiction and Mental Health, Canada
2 Centre for Addiction and Mental Health and Department of
Psychology, University of Western Ontario, Canada
3 Université de Montréal, Canada
Adapting the audit for use in a non-clinical telephone survey: Results from the GENACIS Canada survey
This paper addresses various methodological issues related to the use of the AUDIT in a non-clinical Canadian population sample including adapting the questions for drink size and pattern, and for use in a lengthy telephone interview, as well as respondent and item missingness. In addition, we compare the psychometric properties of the AUDIT and AUDIT-C. Factor analysis and scale reliability analysis are also used to examine the contribution made by the first question (drinking frequency) alone and the first three questions (frequency, quantity and frequency of binge drinking) towards total AUDIT scores. Prevalence rates and correlates of alcohol problems as measured by the AUDIT in this sample of Canadians are also presented. The analysis indicates a significant difference between gender, age, partner status and education in prevalence rates of alcohol-related problems using the AUDIT with a cut-off score of 8.
Key words: AUDIT, AUDIT-C, methodology, psychometric, telephone survey, prevalence
Kim Bloomfield1, 2,
Ulrike Grittner2, Hanna Barbara Rasmussen3
1
Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark
2 Institute for Medical Statistics, Biometry and Epidemiology, Free
University Berlin, Berlin, Germany
3 Copenhagen University, Copenhagen, Denmark
Socio-demographic determinants of alcohol consumption in the Danish general population
Danes have been characterized as in a “league of their own” when comparing their drinking style to their Nordic counterparts. Denmark can also be found among the top ten highest alcohol consuming countries in Europe, and in recent international youth studies, Danish teens have ranked near the top with regard to frequency of binge drinking.
Although such facts are known about Danish drinking, little research has examined actual drinking patterns and determinants of drinking outcomes in the general population. The proposed paper intends to fill in the “landscape” of Danish drinking patterns and explores how various socio-demographic factors are related to specific drinking patterns.
The data come from a national telephone survey of the Danish general population conducted August and September 2003. The response rate for the survey was 49,6 percent with a final sample size of 2030 cases. The age of respondents ranged from 15 to 99 years with 56 percent women and 44 percent men.
Preliminary analyses indicate that 5.6 percent of the population is abstainers. About 17 percent of men and 7 percent of women are daily drinkers and 15 percent of men and 10 percent of women can be categorized as heavy drinkers. Almost 40 percent of men and 20 percent of women are heavy episodic drinkers. Among drinkers, men’s mean alcohol consumption is 19 grams per ethanol per day and women’s is 8 grams. Among both genders age is negatively correlated with heavy drinking and heavy episodic drinking, but positively correlated with daily drinking. Results from multivariate analyses as well as conclusions will be presented.
Key words: drinking patterns, Denmark, general population
Alexandra
Bogren
PhD student
Department of Sociology
Stockholm University
Sweden
‘Out-of-the-ordinary’ an exploration of the concepts of intoxication and sexuality
The purpose of this study is a sociological exploration of the concepts intoxication and sexuality and the links between these. As the cultural conceptions linking alcohol consumption, intoxication, and sexuality typically are gender based, the study will focus on the role of conceptions of gender in this equation.
Weber ([1920] 1996), in his writings about the world religions, talks about the orgy and its links to sexual practice and in line of association he also talks about intoxication or sobriety. Maffesoli (1993) uses the metaphor of the orgy to describe contemporary group attachments, and the orgy in its original form of religious ritual practice is linked both to intoxication and sexual practices. Hence, both Weber and Maffesoli discuss the orgy and its religious roots, and they both discuss intoxication and/or sobriety, in Weber’s case metaphorically.
The first step of the exploration of the concepts is to find out what these two sociological perspectives can tell us about the points of contact between intoxication and sexuality. I discuss what can be seen as common in intoxication and certain sexual experiences and how these ways of seeing sexuality and intoxication might help us understand what these mean to people today. The second step is a discussion of what role gender plays in the relationship between intoxication and sexuality. Can these concepts of intoxication and sexuality combined with cultural conceptions of gender help us understand why women’s and men’s intoxication is viewed (and evaluated) differently?
Key words: intoxication, sexuality, Max Weber, gender
Ulrika Boman
Centre for Social Research on Alcohol and Drugs (SoRAD)
Stockholm University
Sweden
Do changes in availability of alcohol affect the levels and patterns of drinking?
During recent years, two major changes have taken place that have affected availability of alcohol in the south of Sweden. The first change came about in October 2003 when Denmark lowered their taxes on spirits by 45 percent which corresponds to a reduction of the price of cheaper brands by about one fourth. The second change occurred in January 1st 2004, when travellers’ allowances were increased substantially. The implication of these two policy changes is a price reduction on alcoholic beverages for people living in the south of Sweden.
The aim of the study is to investigate weather these policy changes have had an effect on the consumption of alcohol in the south of Sweden, using northern Sweden as a control site. The study uses representative samples of the adult population from the south and the north of Sweden. Telephone interviews have been conducted both prior to and after these policy changes. In both parts of Sweden 1500 respondents were interviewed in each of the 3rd and 4th quarter in 2003 and about 70 percent of these were reinterviewed in the same period in 2004. Data has also been collected from new samples in 2004. The study will estimate the combined as well as the independent effects of the two policy changes on the level of consumption, both in terms of total consumption and beverage-specific consumption. For this purpose, a Q-F-measure of the last 30 days will be used. The study might also analyse changes in drinking patterns, e.g. binge drinking.
Key words: Alcohol consumption, taxation, price changes, longitudinal study
Jason C. Bond,
Thomas K. Greenfield, Nina Mulia, and William C. Kerr
Alcohol Research Group
Public Health Institute
Berkeley, California
USA
Explaining ethnic differences in risk of alcohol-related problems and
dependence symptoms among US drinkers
Background: Rates of social consequences and dependence symptoms associated with alcohol use have been found to be elevated among certain at-risk segments of the US population including youth, ethnic minorities, and the poor. In associating alcohol consumption and related adverse effects among ethnic subgroups, studies have traditionally assumed that risk rises proportionally with consumption which, in general, may not be the case.
Method: Using the combined 1995, 2000 US National Alcohol Surveys, yearly volume of consumption and frequency of consuming five or more drinks/day were used to predict alcohol-related problems and dependence symptoms among men and women for blacks, whites, and Hispanics separately, using Generalized Additive Modeling methods.
Results: For men, the relationship between volume and both alcohol-related problems and dependence were lowest among whites and appeared nearly linear across the range of volume. For black and Hispanic men, the relationship also appeared linear and elevated above that of whites. Similar results were found using freq 5+ drinks/day for men. Risk appeared linear for white and Hispanic women for predicting consequences from volume, but increased sharply for black women drinking above an average of two drinks/day. This sharp increase was also found for both black and Hispanic women when predicting dependence. Fewer differences were seen among female ethnic groups when using frequency of 5+ for prediction. Other variables, such as the income, age, or education level of drinkers can be incorporated in these models and may disproportionately put some groups at higher risk for adverse effects of alcohol.
Sander Bot¹,
Rutger Engels¹, Ronald Knibbe², and Wim Meeus3
¹ Radboud University Nijmegen, the Netherlands
² Maastricht University, the Netherlands
3 Utrecht University, the Netherlands
Pastime in a pub: Observations of young adults’ activities and alcohol consumption
A limited number of studies have focussed on situational characteristics that may predict alcohol consumption. These studies have shown that factors like location, day of the week, group size and gender distribution are related to differences in drinking, and might explain as much variance in alcohol consumption as individual characteristics. But when young people share the same situational characteristics, it does not necessarily imply that this will lead to identical drinking behaviour. Alcohol consumption typically takes place in a time-out situation, and a time-out can be spent by engaging in several leisure time activities. In a bar, palaver is the dominant pastime, but this may take place during other activities, like watching TV or playing games. These activities might inhibit drinking because of the physical difficulties of combining drinking with other activities. Findings of an observational study on drinking in young adults in a bar lab (N = 238) will be discussed. In this study, we followed the ad-lib drinking of peer groups (7 - 9 persons) during a 1h period. The main aims were to assess 1) to what extent involvement in certain activities is related to drinking pace during that activity; 2) to what extent the differences in drinking pace between activities are related to alcohol consumption over activities, and 3) whether initial drinking level (measured by questionnaires before the pastime) predicts selection of specific activities.
Key words: Alcohol, Young Adults, Activities, Observations
Didra BrownTaylor
Integrated Substance Abuse Programs
University of California, Los Angeles
The development of international PSAs and break-through messaging about under-aged drinking: An innovative partnership between academia, a college of design and a global health organization
Global public health problems associated with alcohol consumption have reached alarming proportions, and alcohol has become one of the most important risks to the global health of young people. Few prevention efforts have successfully focused on reducing the consumption and negative consequences related to under-aged drinking throughout the Americas. Typical collaborative efforts have included research teams primarily composed of multi-disciplined academicians but few approaches--if any--have combined the expertise of a college of design, a global health promotion organization and academia. In an effort to counter alcohol advertisements that appeal to under-aged drinkers throughout the Americas, the Pan American Health Organization commissioned Art Center College of Design in Pasadena, California to design and develop anti-drinking Public Service Announcements (PSAs) for international distribution. This paper addresses the research methodology, creative process, and integrated educational approach behind this innovative partnership, led by designmatters @ Art Center College of Design, a college-wide initiative dedicated to broaden the humanitarian impact designers exert on issues of societal consequence. This is an exemplary project that demonstrates how the interplay of academic research (in this case, an alcohol expert that educated students in the film and advertising disciplines about the complex scope of the problem) with multi-disciplinary design expertise at the service of a global health organization can result in a bold awareness campaign that provides a new paradigm for break-through messaging about alcohol consumption among youth.
Key words: PSAs, alcohol, under-aged drinking
Sandra L.
Bullock
Department of Health Studies and Gerontology
University of Waterloo, Canada
The relationship between alcohol use related-related harms and drug use and harm among a Swedish university sample
Objective: This paper examines the relationship between alcohol and drug use, including frequency of use, heavy use and experiences of alcohol and drug-related harm, within a Swedish University sample.
Method: A quantitative, postal survey collected data on sociodemographic characteristics, lifestyle, school-related variables, alcohol/drug use and related attitudes. Participants were randomly selected from all students registered in levels A to D (years 1-4) in four participating universities. Students participated anonymously. A response rate of 70.0 percent resulted in 4,575 completed surveys. Analysis is largely descriptive.
Results: 96 percent of students consumed alcohol within the last year, 45 percent reported drinking 5+ drinks/occasion at least monthly. Alcohol-related harm was reported by 42.7 percent of current drinkers. Cannabis was used by 25.4 percent of respondents (lifetime), 8.9 percent reported use in the last year. Only 9.9 percent (lifetime) and 2.8 percent (last year) reported using other drugs. Drug-related harm was reported by 16.5 percent of current drug-users.
Binge drinkers, individuals scoring 8+ on the audit, daily smokers, and those experiencing alcohol harms in the last year were more likely to have used drugs, lifetime and past year (p<=0.0001). However for current drug users, the only alcohol-related variables that predicted drug-related harms were the age at which the student first experienced drunkenness and their frequency of drinking (p<0.0001).
Discussion: While heavy drinking was related to the use of illicit drugs, neither it nor the experience of alcohol-related harms was predictive of drug-related harms. In Sweden, students who experience alcohol-related harm appear to represent a different group than those experiencing drug-related harm.
Key words: drug use, alcohol, binge drinking, harm, cross-sectional postal survey
Elin K. Bye
Norwegian Institute for Alcohol and Drug Research
Oslo, Norway
Assaults and homicide rates in Norway 1880 - 2003: Alcohol, economy and the role of social integration
Several studies have explored the relationship between alcohol consumption and different measurements of violence such as assaults and homicide on the aggregate level. However, the majority of these studies deals with bivariate relationships, e.g. one outcome is regressed onto per capita consumption (or beverage-specific consumption). A number of studies have linked aspects of social integration to suicidal behaviour, following the Durkheimian tradition, and the question is whether this may be a suitable approach for assaults and homicides as well.
The aim of this study is to make a contribution to the sparse literature regarding other factors that may explain the changes in violence rates. The main question will be to test the relationship between alcohol consumption and violence rates, and to investigate to what extent changes in variables related to economic circumstances and social integration might contribute to the explaining of the changes in violence rates. In Norway, both violence rates and alcohol consumption have increased the past 30 - 40 years. Additionally, the study will explore whether effects of some variables have changed over time. The data comprise aggregate time series for Norway during the period 1880-2003, and the data will be analysed utilizing the Box–Jenkins technique for time series analysis.
Key words: assaults, homicide, alcohol, social integration, time series.
Cheryl J. Cherpitel1,
Yu Ye1, Jacek Moskalewicz2, and Grazyna Swiatkiewicz2
1 Public Health Institute, Alcohol Research Group, Berkeley,
California, USA;
2 Institute of Psychiatry and Neurology, Warsaw, Poland
Risk of injury: A case-crossover analysis of emergency service patients in Poland
Rates of heavy, problem drinking and alcohol dependence are thought to be high in Central and Eastern European countries, including Poland, where large changes in alcohol consumption and the health care system have occurred over the last 15 years, but data on risk of injury from alcohol consumption are relatively non-existent. Estimates for risk of injury from drinking within six hours prior to the event are reported in samples of emergency services patients from Warsaw (n=508) and Sosnowiec (n=432), using case-crossover analysis based on usual frequency of drinking. A four-fold risk of injury was found, and was significantly greater for those positive for alcohol use disorders compared to those negative. A 17-fold increase in risk for violence-related injury was found, and was significantly greater for males than females. Injury risk related to drinking was expected to be significantly greater in Sosnowiec, due to more traditional drinking styles of infrequent intake of large quantities of spirits, than in Warsaw, but this was only partially borne out by these data. Risk estimates for all injuries were similar to those found in other case-crossover studies in emergency departments. Given the high relative risk estimates for injury related to drinking prior to the event, especially for violence-related injury, even when chronic drinking patterns are controlled, hospital-based emergency services in Poland may be an important site for identification of those who could benefit from a brief intervention or referral for a reduction in alcohol-related injuries.
Key words: Emergency services, case-crossover, Poland, injury risk, violence
D.Mohan1,
A.Chopra1, H.Sethi1, A. Dhawan1, and P
Lal2
1 National Drug Dependence Treatment Centre, All India Institute of
Medical Sciences, Ansari Nagar, New Delhi, India
2 Thrissur Medical College, Kerala
(presenting author)
Drinking practices in Thrissur District, South India
Alcohol abuse and dependence are an increasing problem in India as also in South East Asia. Little is known about the alcohol drinking patterns such as hazardous or harmful use and dependence in the country. As part of a larger study to estimate prevalence of tobacco, alcohol and illicit drugs in Thrissur district (Kerala, South India) the current communication examines and identifies drinking practices in Thrissur District (Kerala, India).
Data were re-analysed from the 2002 rapid assessment survey conducted in the district collected by a stratified random sampling method (n = 12,731). Among 4,371 males, self-report of alcohol consumption (n=917) were categorized into infrequent, harmful, dependent and heavy users.
Drinkers reported consuming only beer (locally prepared brew called toddy, (16.0 percent), spirits (74.0 percent) and both (10.1 percent). Based on QF measures, 40.3 percent were infrequent, 43.9 percent hazardous 11.3 percent dependent and 4.1 percent heavy episodic (5+ more drinks) drinkers. Concomitant tobacco use was reported by 71.2 percent users. Infrequent users were in younger age group while heavy episodic were in higher age group though the associations were not significant. Alcohol dependence and heavy episodic use was characterized by weekly/ daily use whereas Infrequent and hazardous use was associated with intermittent use. Logistic regression analysis showed variables education, employment status, living in rural areas, type of alcohol (beer or spirits) and tobacco use to be associated with drinking.
Interpretations and Conclusions: A clearer understanding of these factors would be of immense benefit in planning intervention programmes for alcohol consumers in the district.
Key words : Rapid assessment , alcohol, hazardous drinking
Aleksandra G.
Davidaviciene
Education Development Centre
Lithuania
The use of alcohol and other drugs amongst students in different regional areas in Lithuania
Objective: This paper examines the use of alcohol and other drugs amongst students in Lithuania and its different regional areas and compares the Lithuanian data with data of neighbouring countries (the other Baltic countries and Poland).
Methods: The study was conducted as school survey in 2003 (ESPAD 03). The stratified random sampling model was used. Response rates of 87,6 percent resulted in 5036 completed surveys. This paper presents the analysis of data in the capital, four other largest cities, largest towns, and centres of districts and rural areas.
Result: The study provided us with data about substance use in different areas of Lithuania: data of lifetime or daily use of cigarettes, use of alcohol (include 40 and more times) during lifetime or last year and during last 30 days, prevalence of drunkenness during lifetime or last year and during last 30 days, lifetime use of tranquillisers or sedatives without a doctor’s prescription, lifetime use of inhalants varied in different areas and had peculiar structure and gender differences. Particularly striking difference was found in prevalence of drug use in various areas of country. The highest prevalence was in Harbour City (more than twice higher compared with the country data average). The proportion of students who use drugs was lower in Capital City than in the harbour one. The lowest prevalence of drug use was in rural areas. These findings require special attention to the risky behaviour of youth. The paper also presents the comparison of Lithuanian data with data of the neighbouring counties.
Conclusion: Results of this study let us assess the trends of prevalence of substance use in the country. High level of drug use in some regional areas can grow hotbed of epidemic and provoke an increase of prevalence.
Key words: comparison, regional differences, hotbed of epidemic.
Deborah A. Dawson, Bridget F. Grant, and W. June Ruan
Laboratory of Epidemiology and Biometry
Division of Intramural Clinical and Biological Research
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
Bethesda, Maryland, USA
The association between stress and drinking: Modifying effects of gender and vulnerability
Aims: To assess the relationship between number and type of past-year stressful experiences and alcohol consumption, with a focus on how gender, poverty and psychological vulnerability moderated this association.
Methods: Data from 26,946 U.S. past-year drinkers 18 years of age and over, interviewed in the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), were used to construct multivariate linear regression models predicting six measures of drinking pattern and volume.
Results: There was a consistent positive relationship between number of past-year stressors experienced and all measures of heavy drinking. Frequency of binge drinking increased by 24 percent with each additional stressor reported by men and by 13 percent with each additional stressor reported by women. In contrast, the frequency of non-binge drinking decreased as stress levels increased. Job-related and legal sources of stress were more strongly associated with alcohol consumption than were social and health-related stress. Men showed a stronger association than women between number of stressors and most consumption measures; they also responded more strongly to the presence of any legal and job-related stress. Having an income below the poverty level intensified the effects of job-related stress, but having a mood or anxiety disorder did not affect any of the associations between stress and consumption.
Conclusions: Stress does not so much lead individuals to drink more often as to substitute larger quantities of alcohol on the days when they do drink. Treatment and brief interventions aimed at problem drinkers should address the issue of tension alleviation and the development of alternative coping mechanisms.
Key words: stress, consumption, binge drinking, gender
Andrée Demers1,
Sylvia Kairouz2,
Edward Adlaf3,
and Louis Gliksman3
1 Université de Montréal, Canada
2 Institut national de santé publique
du Québec, Sainte-Foy, Canada
3Centre
for Addiction and Mental Health, Centre for Addiction and Mental Health,
Toronto, Canada
When the forest hides the trees: A setting typology of drinking contexts among Canadian undergraduates
Undergraduates’ drinking is contingent upon drinking context. However, contexts are multifaceted and it is through the combination of the various features of the drinking setting that the drinking context takes its symbolic meaning and provides a normative frame of reference for drinking. The aim of this paper is to develop a holistic typology of drinking contexts. The data are derived from the Canadian Campus Survey conducted in 1998 with a random sample of 8,864 students in 18 universities. For each student, up to five drinking occasions were investigated, resulting in 26,348 drinking occasions among 6,850 drinkers. The drinking occasions included information on alcohol intake and about why, when, where and with whom drinking occurred. Decision tree analysis was used to develop a typology of lighter to heavier drinking contexts, reflecting the complex interplay between places, relationships, time and other circumstances on alcohol intake. Such information may be useful to orient socio-environmental interventions among undergraduates.
Jakob Demant and Margaretha Järvinen
Department of Sociology
Project Youth and Alcohol (PUNA)
Copenhagen,
Denmark
The construction of high personal social status through risk-taking alcohol behaviour
In this paper we will present results from a focus group study conducted among 14 - 16 years olds between March 2004 and March 2005. This qualitative study is part of a large research project on Youth and Alcohol supervised by Professor Peter Gundelach and Professor Margaretha Järvinen that also includes an extensive quantitative study. The overall motivation of this research project is to contribute to an understanding of the alcohol culture among Danish youth, taking on a distinct sociological approach. The focus group study aims to explain how alcohol is used as a naturalized and normal part of hedonistic youth culture, and how the adolescents use alcohol in their construction of social identity. The participants in the focus group interviews are sampled from what we consider the most important networks for the adolescents, primarily their school classes and secondly their friendship networks outside the school. A total of 25 focus group interviews have been conducted.
This paper will focus on one case in which two girls successfully use alcohol to position themselves as highly popular and mature among the classmates. This can be interpreted from the way the girls in the interviews construct a dominant position by presenting their experiences with parties and drinking alcohol as an attractive and mature lifestyle. We anticipate that the girls are constructing maturity (social age) by using alcohol to perform a culturally recognizable identity in their social networks. Alcohol consumption thus seems to be one way to perform a mature, feminine identity that makes the girls stand out from the less self confident classmates who lack the same natural, adult way of drinking.
Key words: Drinking practice, adolescents, social constructivism, culture, social age, focus group interviews
Maria Dinis1, Lee
Kaskutas2, and Lyndsay Ammon2
1 California State University, Sacramento, California, USA
2 Alcohol Research Group, Berkeley, Berkeley, California, USA
Provider service profile: Choices for treatment of alcohol/cocaine-using clients
Objective: This study describes providers’ treatment recommendations for pregnant and non-pregnant women and men using alcohol and/or cocaine.
Method: In this study, a probability sample of 457 service providers (73 percent response rate) was drawn from alcohol/drug treatment, criminal justice, mental health, hospitals/medical services, and social welfare settings. Providers were interviewed about their service recommendations. Logistic regression was used to examine the predictors of treatment choices, focusing on provider work setting and demographics.
Results: Four dominant services emerged: hospital-based; AA; therapy; and halfway houses. Combinations of these services were usually recommended, although some providers (especially those not in the treatment field) chose just a single type of treatment (47 percent for pregnant, 36 percent for non-pregnant women and men). Providers primarily recommended hospital-based treatment for pregnant women, while AA dominated for other clients. Providers in criminal justice and mental health settings were more likely than those working in alcohol/drug treatment programs to recommend only the hospital-based service for pregnant women and less likely to adopt AA services. Male providers were less likely to recommend only the hospital-based service for pregnant women. Providers with postgraduate degrees were twice as likely as those without a college education to recommend therapy for all clients.
Conclusions: The majority of providers recommended treatment services within the four major profiles. For some providers selecting only one service, training in multi-service selection may broaden the range of treatment alternatives recommended to clients. Some work settings and demographics were predictors of providers’ treatment choices.
Key words: Service Profiles; Providers; Alcohol/Drug (cocaine-using); Pregnant Women; Survey Methods
Karen Elmeland, and Lau Laursen Storgaard
Centre
for Alcohol and Drug Research,
University of Aarhus, Denmark
“Meet your new family:” Danish discotheques and their methods of recruitment
This paper presents and discusses results from a subproject of the Danish contribution to a common Nordic project on restaurants.
The number of on-premise alcohol sale outlets has increased steadily for the last decades in Denmark, and especially types of restaurants, whose target groups are the very young customers. This manifests itself in the growing number of discotheques in all parts of Denmark. Danish youth has a high-level consumption of alcohol, and research indicates that a large part of their alcohol consumption occurs in public houses with licence to sell alcohol.
Well-developed internet-sites are among the methods that discotheques use to advertise and also recruit their customers. The results from a qualitative analysis of about 50 web-sites will be presented. The aim is to discuss the found values of appeal, which move in a field of tension between on the one hand emphasis on elements that create identity and confidence/safety and promises of transcendental experiences on the other.
Key words: Discotheques, methods of recruitment, web-sites, qualitative analysis, identity.
Rutger C. M. E. Engels¹, Haske van der Vorst¹, and Wim Meeus² and Maja
Deković²
¹ Radboud University Nijmegen, the Netherlands
² Utrecht University, the Netherlands
Reciprocal influences on alcohol consumption of siblings
Ample studies have established that parents as well as peers function as role models in the development of adolescents’ alcohol use. The relative importance of siblings, however, has been largely neglected. This seems remarkable because of the long-term nature of a sibling relationship. Still, the few studies that indeed concentrated on siblings and alcohol use have been primarily using twin samples or perception data of adolescents on drinking of their siblings.
The present study examined the impact of siblings on drinking behavior of adolescents using longitudinal data from 416 sibling dyads (sib 1; mean age 13.3, sib 2; mean age 15.2). Moreover, we explored which factors (gender constellation of the sibling dyad, quality of the sibling relationship, and similarity in norms about alcohol) affect reciprocal influences in alcohol use of siblings.
Descriptive analyses showed that although older siblings drink more frequently and intensively than the younger siblings, moderate associations were found between frequency and intensity of drinking in siblings. These similarities are hardly affected by age-differences. Findings of structural equation modeling showed that alcohol use of the older sibling affected drinking of the younger sibling one year later. In accordance with our expectations, older siblings do not model the drinking of their younger brother or sister. Further, the moderating role of (a) having the same or opposite gender as a sibling, (b) a low or high quality relationship, and (c) the same or different norms about alcohol, on the association between siblings’ alcohol use and adolescents’ drinking over time will be discussed.
Key words: adolescents, alcohol, siblings, longitudinal, survey
Antonina
Eriksson
Centre for Social Research on Alcohol and Drugs
Stockholm University, Sweden
How daily newspapers portray alcohol policy measures regarding restaurants: A historical perspective
This paper is focused on how daily newspapers portray alcohol policy measures regarding restaurants in Stockholm and the county of Södermanland, in a historical perspective. It is a small part of a larger project on restaurants and alcohol, and is conducted at SoRAD, Stockholm University. The paper examines a 25-year time period, which particular emphasis upon the years 1977, 1990 and 2002. Since 1977 the number of licensed on-premise alcohol establishments has increased 284 percent (from 2,523 in 1977 to 9,690 in 2002).
Data for the project have been obtained from mostly newspaper archives and partly from official documents of local inspectors. While the archives at the Central Association on Alcohol and Drug Information in Stockholm provides rather full coverage of the press, it has been somewhat harder to assemble complete data coverage from the official authorities.
Discussion will focus on the portrayal of alcohol policy measures regarding restaurants in the newspapers and how this has changed over time. Who are the actors and what areas and problems appears in the press.
Key words: newspapers, restaurants, alcohol policy measures.
Kaye Middleton Fillmore1, William C. Kerr1, 2, Tim
Stockwell3, Tanya Chikritzhs4,
and Alan Bostrom1
1 University of California, San Francisco, USA
2 Alcohol Research Group, Berkeley, California, USA
3 Centre for Addictions Research of British Columbia, University of
Victoria, Canada
4 National Drug Research Institute, Curtin University,
Australia
Alcohol and mortality risk: Systematic error in prospective studies
The majority of prospective studies on alcohol use and mortality risk indicate that abstainers are at increased risk of coronary heart disease. A meta-analysis tested whether they contained a systematic error by including as ‘abstainers’ many people who had reduced or stopped drinking, a phenomenon associated with ageing and ill health. Most published studies were found to suffer from this error. The few error-free studies found no significant cardiac protection. Estimates of cardiac mortality from heavier drinking may also be higher than previously estimated. The conclusion that regular moderate drinking improves coronary health may be premature.
Ana Maria Garcia Flores
Natera Guillermina
Juárez Francisco
Instituto Nacional de Psiquiatría Ramón de la Fuente, México
Domestic Violence Related To Alcohol Consumption Among The Population Seeking Assistance From State Prosecutor’s Offices And Among The General Population (Ages 18 To 29)
The main purpose of this paper is to study associated factors, such as habitual alcohol consumption, consumption on the day of the event, abuse and dependence, drug consumption and type of family violence by comparing two populations, one interviewed in a household survey, the other comprising those that sought assistance from State Prosecutors’ Offices (SPO), either because they were detained or because they filed a complaint, in Pachuca, Hidalgo, a modern city lying 100 km outside the capital of México with approximately one million inhabitants.
The samples were obtained during the same period in the second half of 1996. The household survey (Medina Mora, ME.) (n=980) was obtained through a stratified sample of the population ages 18 to 65, through face-to-face interviews. The interviews in the State Prosecutors’ Offices were conducted at the only two offices in this city. Data was obtained every 24 hours for a period of 45 days (N=471). Both surveys included similar questions and were undertaken face to face by trained professionals using standardized questionnaires. Univariate and multivariate analyses were carried out through logistical regression to determine associated characteristics to population that commits crimes or files complaints in comparison with the general population. Emphasis will be placed on the population ages 18 to 29, which was the population most at risk of ending up at a SPO (OR 2.7) compared with other ages. The type of crime involved and links with domestic violence were also compared.
Key words: Domestic violence, crime, denunciations, alcohol consumption, household survey, México
Bridget Freisthler1,
Paul J. Gruenewald2, Lillian G. Remer2, Bridgette Lery3,
Barbara Needell3
1UCLA Department of Social Welfare
2Prevention Research Center, Berkeley, CA
3Center for Social Services Research, University of California, Berkeley
Examining child abuse and neglect over time and space
Using social disorganization and routine activities theories, recent studies have examined the cross-sectional relationship of alcohol outlets and neighborhood rates of child maltreatment. The current study examines how changes in alcohol outlet densities over six years affect rates of Child Protective Services referrals, substantiations, and foster care entries due to child maltreatment while controlling for demographic characteristics of the neighborhood in 579 stable zip codes in California. As such, this study begins disentangling complicated associations found in neighborhood environments that may place children at greater or lesser risk for abuse. Using random effects panel models we find that zip codes with higher concentrations of off-premise alcohol outlets, bars, and higher percentage of Black residents had higher rates of maltreatment, while greater average household size and median household income had lower child maltreatment rates. Characteristics of adjacent zip codes were also related to maltreatment rates in local neighborhoods, indicating a spatial dynamic to this relationship. The results suggest that environmental strategies to limit alcohol access through zoning and planning laws may effectively reduce child maltreatment. Relying on social disorganization theory, an intervention that increases social contacts between neighbors in high alcohol outlet density areas may facilitate and strengthen social ties and networks, thus reducing maltreatment rates. Efforts to prevent and reduce maltreatment suggested by routine activities theory include addressing behaviors related to parental monitoring and supervision as well as policies and procedures that reduce the number of alcohol outlets in neighborhood areas where large numbers of children live.
Key words: Child abuse and neglect, alcohol outlet densities, panel study, social disorganization theory, routine activities theory
Bridget Freisthler
Department of Social Welfare
University of California, Los Angeles
USA
Alcohol outlet density, parental monitoring, and adolescent deviance: A multilevel analysis
Lower levels of parental monitoring are associated with youth problem behaviors, including substance use and delinquency. Recently studies employing routine activities theory have hypothesized that greater densities of alcohol outlets, particularly bars, may provide parents more opportunities to social outside the home. This, in turn, may decrease a parent’s ability to effectively monitor the activities of his or her child, resulting in more deviant behaviors by the adolescent. Using hierarchical linear modeling (HLM) the current study assesses whether or not greater densities of alcohol outlets in zip code areas (n = 50) interact with levels of parental monitoring to affect levels of deviance among adolescents aged 14 to 16 (n = 1,541). The study finds that older adolescents who have higher grade point averages, and are not current drinkers report the lowest levels of deviant behaviors. Furthermore, the density of bars interacts with reports of parental monitoring such that adolescents in areas with more bars per roadway mile report lower levels of parental monitoring behaviors, which is associated with higher levels of deviance. Based on these findings, it may be that in those areas with greater densities of bars parents may be spending more time away from home, making monitoring of their adolescents more difficult or parents may be drinking more frequently, thus impairing their ability to adequately monitor their children. Regardless, policies and practices that limit the number of bars in neighborhood areas with large populations of adolescents may reduce deviant behaviors.
Key words: alcohol outlet density, parental monitoring, deviance, adolescents
A.
Garduño-Lobo
Nesis Consulting Group
Sinaloa, México
Integral Prevention: A Holistic Approach In Developing Prevention Programs
Nesis Consulting Group develops a State Prevention Program “INTEGRA-T” in Sinaloa, México with the support of the government and the sponsoring of social associations.
Sinaloa is well known for agriculture development; nevertheless it has an enormous problem in production and drug traffic.
The
context:
Very violent atmosphere (gangs fighting for local costumers)
A complex immigrations issues
Poor farmers hired to seed drugs
Connections with Colombian cartels
Hot weather (first beer dinking in México)
In México prevention policies and practices are inefficient or don’t exist. During 2004, we started up INTEGRA-T developing new strategies to prevent use-abuse of drugs and addictive behaviors.
INTEGRA-T
is a comprehensive approach:
Including strategies taking current actions address to the cause instead to the
consequences
Putting emphasis in the self development
Teaching people and organizations to identify their particular needs and satisfy
them by themselves.
Promoting law enforcement
Making alliances with media and local coalitions
Presenting a co-responsible action plan in a network structure.
Some
specific points to share:
Dynamics in families and educational processes in Sinaloa´s youth.
Protective factors in healthy persons
Resiliency builders and resiliency factor in a natural way
Experience of working with farmers, politicians, entrepreneurs, and local
leaders.
Development of 60 workshops and 100 conferences
Design of a media campaign
Creation of alliances with locals
We work face to face with more of 1500 persons that embrace de Integral Prevention Approach.
Key words: Prevention, resiliency, programs, México, social response, integral prevention.
Henk F.L. Garretsen1, 2, Inge Bongers1,
2, and Ien van de Goor1, 2
1
Tilburg University, Tranzo Department, the Netherlands
2
Addiction Research Institute, Universities of Rotterdam, Maastricht, Tilburg and
Nijmegen, the Netherlands
Academic centres: A solution to the gap between science and practice?
Many parts of the addiction care sector do not work evidence-based. The same is true for policy and prevention. It is desirable to bridge the gap between science and practice. In the presentation the use of academic centres (like academic hospitals but smaller) to bridge this gap is described. Main components of an academic centre are a long-term research program and a knowledge-exchange infrastructure. So-called science practitioners play an important role.
In the southern part of the Netherlands several academic centres have been developed successfully, among others centres in the field of addiction and mental health care (with an emphasis on youth and forensic care), public health and chronic care. The centres differ in important characteristics. Points of departure, conditions and experiences are described.
Key words: Evidence-based care, addiction care, addiction policy, addiction prevention, mental health care
Anne George, Bob Armstrong, and Michael Papsdorf
Faculty of Medicine, University of British Columbia
Prenatal alcohol exposure and health care costs
Prenatal alcohol exposure can result in serious, costly consequences – for individuals, families, communities and societies. Our purpose is to examine the relationship between health care utilization and risk of alcohol exposure during pregnancy.
We used the T-ACE screening tool in a population based study in a large geographical region in British Columbia, Canada. The T-ACE (Sokol et al, 1989) was adapted from the CAGE specifically for use with pregnant women as a screening tool to determine risk. Originally, our purpose was to determine the feasibility and utility of the screening tool on a population basis. Data were collected on at-risk alcohol use and other variables for 3,659 pregnant women for a one-year period, 1990-1991.
Health service utilization was examined in the offspring of this cohort through data held by the British Columbia Health Linked Database (BCHLD). The BCHLD provides longitudinal person-specific health utilization information within a single publicly funded health care system, and its data is accessible for research purposes. We examined hospitalization rates to 12 years of age in relation to maternal prenatal T-ACE risk scores.
Children whose mothers were in the high risk category for alcohol use during pregnancy had a significantly higher number of hospital visits than children whose mothers were found to be in the low or medium risk category (F=5.76, p=.003). The results should assist with better understanding the health care implications associated with maternal risk of excess alcohol consumption during pregnancy.
Keywords: prenatal alcohol exposure; health care utililization
Norman Giesbrecht,
Lise Anglin, and Anca
Ialomiteanu
Centre for Addiction and Mental Health, Toronto, Canada
Alcohol policy effectiveness and public opinion: Is there support for effective policies in Ontario?
In recent years, the term “evidence-based” has often been used to describe alcohol-related programs and interventions. However, the reach of the term exceeds its grasp in that there is sometimes little evidence of a reduction in consumption and drinking-related harm resulting from the most popular interventions. This paper compares the conclusions from a WHO-sponsored project examining which alcohol policies have, to date, been shown to be effective with the public opinion of Ontarians drawn from cross-sectional surveys. The telephone surveys were conducted with representative samples of adults, aged 18+, between 1993-2003, with Ns ranging from 667 to 1,742. Not all alcohol policy items considered here were asked each year.
In Alcohol: No Ordinary Commodity, Babor et al. (2003) rate 31 alcohol policies. We examine eight of them for which Ontario survey data were available: advertising ban, a monopoly retailing system, raising the minimum legal drinking age, restricted hours/days of sale, restricted outlet density, raising taxes on alcohol, stopping service to intoxicated patrons, and warning labels on alcoholic beverage containers. Based on Babor et al., these eight policy measures were organized into high to low effectiveness. The results of twelve public opinion items were scored according to degree of public support or opposition to an alcohol policy, and then compared to the evidence-based policies. There is public support for a range of policies, including effective and less effective ones. In some cases, support for effective policies (e.g. raising taxes) is modest. The implications for research and policy are discussed.
Gerhard Gmel1,2, Alvine Bissery1, Roland Gammeter1, Jean-Claude Givel3, Jean-Marie Calmes3, Bertrand Yersin4, and Jean-Bernard Daeppen1
1
Alcohol Treatment
Center, Lausanne University Hospital, Switzerland
2 Swiss Institute for the Prevention of Alcohol and Drug Problems,
Lausanne, Switzerland
3 General Surgery Department, Lausanne University Hospital, Switzerland
4 Emergency Department, Lausanne University Hospital, Switzerland
Alcohol attributable risks of injury in a Swiss emergency room: The link between volume of drinking, drinking patterns and drinking in the event
Background: The association between alcohol consumption and injuries is clearly established for volume of drinking, heavy episodic drinking (HED) and consumption prior to injury. Little is known about how these three dimensions interact as regards the risk for injury, and which combination of risk factors exposes individuals at highest risk. This study explores the combination of risk factors for injury related to alcohol consumption. It expands on current literature by estimating which group of alcohol consumers contributes the most in absolute numbers to alcohol-attributable injuries.
Methods: In total, 8,736 patients of who 5,077 were injured (cases) and 3,659 non-injured (quasi-controls) enrolling in the surgical ward of the ER department of the Lausanne University Hospital, Lausanne, Switzerland between January 1, 2003 and June 30, 2004 were screened for alcohol use and provided sufficient data on all relevant questions. Eleven mutually exclusive consumer groups were constructed based on usual volume of drinking (abstinence, 7 (women)/14 (men) drinks a week), HED in the past month (never, at least once 4+ (women) /