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European Addiction Research
Journal Prestige (SJR): 1.425

Citation Impact (citeScore): 3
Number of Followers: 19

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ISSN (Print) 1022-6877 - ISSN (Online) 1421-9891
Published by Karger

[120 journals]

The Effects of COVID-19 Pandemic Lockdowns on Alcohol Consumption and
Tobacco Smoking Behaviour in South Africa: A National Survey
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  Abstract: Introduction: During the first phase of the coronavirus (COVID-19) pandemic lockdowns in South Africa (SA), both alcohol and tobacco were considered non-essential goods and their sales were initially prohibited and further restricted to certain days and timeframes. This study investigates self-reported changes in alcohol consumption and tobacco smoking behaviour in the general population during the COVID-19 pandemic lockdowns in SA. Methods: A cross-sectional national survey was conducted in October 2021 (before the Omicron wave 4 and while SA was in low-level lockdown) among 3,402 nationally representative respondents (weighted to 39,640,674) aged 18 years and older. Alcohol consumption and tobacco use were assessed from the beginning of the lockdown towards the end of March 2020 until October 2021 using the WHO-AUDIT and the US Centre for Disease Control (CDC) Global Adult Tobacco Survey questionnaires, respectively. Results: Among those that drank alcohol (33.2%), 31.4% were classified as having a drinking problem that could be hazardous or harmful and 18.9% had severe alcohol use disorder during the COVID-19 lockdowns. Twenty-two per cent (22.0%) of those that reported alcohol consumption reported that the COVID-19 pandemic lockdowns changed their alcohol consumption habits, with 38.1% reporting a decreased intake or quitting altogether. Among the one in five respondents (19.2%) who had ever smoked, most reported smoking at the time of the survey (82.6%) with many classified as light smokers (87.8%; ≤10 cigarettes/day). Almost a third (27.2%) of those smoking reported that the COVID-19 pandemic lockdowns had changed their use of tobacco products or vaping, with 60.0% reporting a reduction/quitting tobacco use. Given that sales were restricted this indicates that people could still get hold of tobacco products. Heavy smoking was associated with older age (p = 0.02), those classified as wealthy (p lt; 0.001), those who started or increased tobacco smoking during the pandemic lockdowns (p = 0.01) and residential provinces (p = 0.04). Conclusion: Given restrictions on the sale of alcohol and tobacco in SA between 27 March and August 17, 2020, during the pandemic, respondents reported an overall decline in alcohol consumption and tobacco use which might suggest that the regulatory restrictive strategies on sales had some effect but may be inadequate, especially during times where individuals are likely to experience high-stress levels. These changes in alcohol consumption and tobacco use were different from what was reported in several European countries, possibly due to differences in the restrictions imposed in SA when compared to these European countries.
  Eur Addict Res
  PubDate: Fri, 17 Mar 2023 15:34:40 +010
Erratum
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  Abstract:
  Eur Addict Res
  PubDate: Wed, 22 Feb 2023 16:13:12 +010
Using Direct and Indirect Estimates for Alcohol-Attributable Mortality: A
Modelling Study Using the Example of Lithuania
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  Abstract: Introduction: Comparative risk assessments (CRAs) for alcohol use are based on indirect estimates of attributable harm, and usually combine country-specific exposure estimates and global risk relations derived from meta-analyses. CRAs for Eastern European countries, such as Lithuania, base their risk relations not on global risk relations, but on a large Russian cohort study. The availability of a direct estimate of alcohol-attributable mortality following the 2017 implementation of a large increase in alcohol excise taxes in Lithuania has allowed a comparison of these indirect estimates with a country-specific gold standard. Methods: A statistical modelling study compared direct (predictions based on a time-series methodology) and indirect (predictions based on an attributable-fraction methodology) estimates of alcohol-attributable mortality before and after a large increase in alcohol excise taxes in Lithuania. Specifically, Russia-specific versus global relative risks were compared against the gold standard of time-series based predictions. Results: Compared to direct estimates, indirect estimates markedly underestimated the reduction of alcohol-attributable mortality 12 months post intervention by at least 63%. While both of the indirect estimates differed markedly from the direct estimates, the Russia-specific estimates were closer to the direct estimates, primarily due to higher estimates for alcohol-attributable cardiovascular mortality. Discussion: As all indirect estimates were markedly lower than direct estimates, current overall relative risks and price elasticities should be re-evaluated. In particular, global estimates should be replaced by new regional estimates based on cohort studies.
  Eur Addict Res
  PubDate: Tue, 07 Feb 2023 12:59:24 +010
An Eye Tracking Investigation of Young People’s Gaze Behaviour to
Gambling and Non-Gambling Moving Adverts
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  Abstract: Introduction: Data from several areas of public health (e.g., harmful alcohol and tobacco) are consistent with the assertion that children’s exposure to advertising strategies increases intention to consume such products. Most studies have measured self-rated impact of gambling advertising using questionnaires. Given that gambling advertisements come in different forms such as print media/television advertising and contain variable content, it is difficult to understand using subjective measures which aspects of the gambling advertisements increase craving and desire to trigger a gambling session. In the present study, we applied a novel data-driven methodology that directly tracks eye movements to reveal attentional biases towards gambling adverts and promotions by examining differences in young people’s eye gaze behaviour when watching gambling and non-gambling (control) moving adverts. Method: A total of 98 (16–18 years old) children who self-identify as having a low or high craving to gambling watched gambling and non-gambling (control) television adverts, while their eye movements were recorded. Results: The results show that the data-driven method can isolate video clips that best distinguish people on the low-high craving spectrum, reveal the type of each video clip with the largest group differences, and accurately predict young people’s gambling craving on the basis of eye movement patterns. Conclusion: Our findings demonstrate that young people’s craving for gambling can be predicted based on their eye movements to video clips of gambling advertisements and that certain features of gambling advertisements may be more appealing to some group of viewers, particularly those with high craving for gambling.
  Eur Addict Res
  PubDate: Tue, 07 Feb 2023 12:52:05 +010
Anabolic Androgenic Steroid Use Patterns and Steroid Use Disorders in a
Sample of Male Gym Visitors
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  Abstract: Introduction: The use of anabolic androgenic steroids (AAS) and other image- and performance-enhancing drugs is a growing public health concern. AAS use is associated with various physical and mental harms, including cardiovascular risks, cognitive deficiencies, and dependence. The aim of this study was to determine whether patterns of AAS use and other variables are associated with the presence of an AAS use disorder (AASUD). Methods: An online survey was completed by 103 male AAS consumers visiting gyms. The association of different patterns of AAS consumption (cycling vs. continuous forms of AAS use), psychoactive substance use, mental health disorders, and sociodemographic variables with moderate-severe AASUD (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ≥4 criteria) was investigated. The associations between duration of AAS use and the AAS dose with moderate-severe AASUD were investigated using logistic regression analysis with moderate-severe AASUD as the dependent variable. Results: Moderate-severe AASUD was present in 25 (24.3%) of the participants. AAS consumers meeting criteria for moderate-severe AASUD, compared to those that did not, in the last 12 months reported a longer duration of AAS use (in weeks), a higher average AAS dose (mg/week), and a greater number of AAS side effects. Duration of AAS use and the AAS dose were the only independent predictors, with an increase of 3.4% in the probability of moderate-severe AASUD with every week increase of the duration of AAS use in the last year (p #x3c; 0.05) and an increase in moderate-severe AASUD of 0.1% with every 10 mg increase in the average AAS dose per week (p #x3c; 0.05), respectively. Conclusion: Our findings show that moderate-severe AASUD is relatively frequent among male AAS consumers and is positively associated with the duration and average dose of AAS use in the last 12 months.
  Eur Addict Res
  PubDate: Thu, 02 Feb 2023 11:55:42 +010
Assessing the Effect of an Inpatient Smoking Cessation Brief Intervention
Tool on Long-Term Smoking Cessation Rates and Patient Interest for
Nicotine Replacement Therapy: A Retrospective Analysis
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  Abstract: Introduction: Smoking cessation among hospital inpatients is essential to reduce risk of surgical complications and all-cause mortality. In the Australian state of Queensland, the Smoking Cessation Clinical Pathway (SCCP), a brief intervention tool, has been used by clinical staff in public hospitals to uniformly support patients to quit smoking since 2015. This study aims to assess the effect of the SCCP on long-term smoking cessation rates recorded in subsequent readmissions, and whether the SCCP as an intervention affects inpatients’ interest in nicotine replacement therapy (NRT) during admission and after discharge. Methods: We retrospectively analysed data provided by the Princess Alexandra Hospital (PAH) on patients who self-identified as a current smoker on admission to any ward and were admitted to the PAH between 1st January 2018 and 31st December 2019. Smoking cessation rates and patient interest in NRT by SCCP completion were analysed using χ2 tests and a multinomial logistic regression. Results: Of 1,902 included patients, NRT was offered to 1,397 patients (73.4%) and accepted by 332 patients (17.5%). Patients who had completed a SCCP were more likely to be offered NRT than those who had not (p #x3c; 0.0001). Of the 452 patients with multiple readmissions, 100 (22%) ceased smoking at any point in the 2-year study period. At the end of the 2-year study period, 75 (75%) patients remained abstinent and only 25 (25%) relapsed to smoking as per their final smoking status at the end of the 2-year study period. Patients with a completed SCCP were 1.8 times (RRR: 1.825, p = 0.030) more likely to quit smoking at any point in the 2-year study period, and twice as likely to have quit at the end of the 2-year study period (RRR: 2.064, p = 0.044). Discussion: The SCCP may be effective at increasing smoking cessation rates among hospital inpatients. Future policies promoting long-term smoking cessation should consider implementation of post-discharge follow-up appointments.
  Eur Addict Res
  PubDate: Mon, 30 Jan 2023 13:25:33 +010
Seasonality and Delirium Tremens in Hospitalized Patients with Alcohol
Dependence Syndrome
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  Abstract: Introduction: Due to the high rate of mortality, recognizing the contributing factors of alcohol-related delirium tremens (DT), which is the most severe form of alcohol withdrawal state (AWS) is pivotal in clinical settings. Previous studies suggested relationship between seasonality and other types of delirium; however, to our knowledge, this is the first empirical study which examined the role of seasonality in DT in alcohol dependence syndrome (ADS). Methods: A retrospective study was undertaken between 2008 and 2015; medical records of 1,591 patients were included, which yielded 2,900 hospital appearances. Three groups were formed based on the ICD-10 diagnoses: ADS, AWS, and DT. The characteristics of the groups were analysed with one-way ANOVA and χ2 tests. Multinomial logistic regression was used to explore the potential predictors of DT, including seasonality. Results: The highest incidence of DT was in spring (36.8%; χ2 (3) = 27.666; p #x3c; 0.001), especially in March (13.9%; χ2 (11) = 33.168; p #x3c; 0.001). Spring, higher mean age, higher presence of comorbid somatic disorders, and lower occurrence of comorbid psychiatric disorders were significant predictive variables for DT with the control of socio-demographic and clinical variables. Conclusions: The present study revealed that spring, especially March is a critical period in temperate climate zone regarding DT. This can be interpreted as a late winter effect since the temperature is lower in this month compared to other spring months. Furthermore, higher age and the occurrence of comorbid somatic disorders can be considered as risk factors in case of DT. These results support the need of further clinical studies to better understand the impact of seasonality on DT.
  Eur Addict Res
  PubDate: Mon, 23 Jan 2023 13:15:38 +010
Self-Assessment of Addiction Medicine Core Competencies in Four Year
Groups of Psychiatrists in Training: Efficacy of the Addiction Medicine
Training Needs Assessment Scale in a Local Training Context
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  Abstract: Background: In addiction medicine training, self-assessment is increasingly used to support self-regulation learning by identifying standards of excellence, competence gaps, and training needs. To ensure psychiatrists in Lithuania also develop specific addiction competencies, the Lithuanian Health Sciences University faculty in Kaunas developed an addiction psychiatry curriculum. Objectives: The aim of this research is to explore the efficacy of the AM-TNA scale to measure individual and group differences in proficiency in the core competencies of addiction medicine. A cross-sectional study and a convenience sample were used. Method: We studied the differences in performance in addiction medicine competencies between 4 successive year groups and analysed the variance to determine the statistical differences between the means of 4 year groups with biases, resulting from repeated measurement statistically corrected-for. Results: Of the psychiatrists in training, 41% or 59% completed the scale. The assessment of competencies suggested that all but 2 competencies differ significantly (p #x3c; 0.05) between the 4 groups. The post hoc analyses indicated that mean scores for 24 of the 30 core competencies differed significantly between the year groups (p #x3c; 0.05) and showed a gradual increase in scores of self-assessed competencies over the 4 year groups. We found adequate scale variance and a gradual increase in self-assessed competencies between the 4 year groups, suggesting a positive association between the results of incremental professional training and improved self-assessed substance use disorders (SUD) competency scores. Conclusions: This study illustrates the efficacy of the AM-TNA scale as an assessment instrument in a local training context. Future research should aim to have larger sample sizes, be longitudinal in design, assess individual progress, and focus on comparing and combining self-reported competencies with validated objective external assessment and feedback.
  Eur Addict Res 2023;29:76–81
  PubDate: Tue, 17 Jan 2023 09:21:13 +010
Systematic Client Feedback in Youth Mental Health and Addiction Care: A
Controlled Study Comparing Two Treatment Cohorts
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  Abstract: Introduction: We investigated the value of systematic client feedback in youth mental health and addiction care. In the present study, we examined whether a client feedback intervention would result in improved therapeutic alliance and treatment outcomes. Methods: Two hundred and four adolescents participated in the study using a – non-randomized – between-group A/B design. In the first study group, 127 patients were offered 4 months of treatment as usual (TAU), and in the second study group, 77 patients received the client feedback intervention as an add-on to TAU during 4 months. Results: Youths who received systematic client feedback in addition to TAU did not show better treatment outcomes or better alliance ratings after 4 months than youths receiving TAU only. Sensitivity analyses, in which we compared the more adherent patients of the second study group with patients receiving TAU, did not show significant beneficial effects of client feedback either. Also, the client feedback intervention did not result in lower rates of early treatment drop-out. Discussion/Conclusion: Our results cautiously suggest that client feedback does not have incremental effects on alliance and the treatment outcome for youth in mental health and addiction treatment. Moreover, our study highlights the challenges of implementing client feedback in clinical practice and the need for additional research addressing these challenges.
  Eur Addict Res 2023;29:52–62
  PubDate: Tue, 17 Jan 2023 08:00:21 +010
Feasibility and Short-Term Effects of Low-Threshold Opioid Substitution
Treatment during the COVID-19 Pandemic in Hamburg, Germany
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  Abstract: Introduction: After rapidly opening up a low-threshold clinic to support heavily opioid-dependent persons at the beginning of the COVID-19 pandemic in April 2020 in Hamburg (Germany), this non-interventional study evaluated the feasibility and short-term effects of opioid substitution treatment (OST). The low-threshold concept was customized for the pandemic situation and is the first of its kind in Germany. Methods: Patients who had already begun treatment were questioned in two assessments, at T1 shortly after beginning treatment and at T2 6 months later. The primary outcome criterion was their quality of life using the OSTQOL. Secondary criteria included retention rate, their mental and physical health (measured by the BSI-18 and the OTI Health Scale), social situation, drug use, COVID-19 status, and satisfaction with treatment. Results: Out of 84 patients included in the study, 51 participated in both assessments, resulting in a 6-month retention rate of 60.7%. 27.5% were females, and 72.5% were males. The feasibility question of the low-threshold OST clinic can clearly be answered positively. During the course of the study over 6 months, the situation mainly remained stable regarding quality of life, physical and mental health, and days of drug consumption. Patients significantly reduced the time they spent on the drug scene from 8.5 (SD = 7.56) to 6.1 (SD = 6.71) hours a day between the beginning of OST and T2 (p = 0.020). While 56.9% answered to be homeless at the beginning of OST, only 33.3% answered not to have found an accommodation by T2 (p = 0.012). The number of patients having contact to social workers increased from 51.0% to 74.5% (p = 0.004). Almost 2 fifths of the patients took part in PCR testing for COVID-19 (that only being done if they had symptoms), and none of the tests were positive. Discussion/Conclusions: Overall, the low-threshold OST clinic has been successfully implemented in order to help a vulnerable group of people navigate through a global pandemic and support the public health sector. Further conclusions on effects are limited by the short study period and the small number of patients, which calls for further research studies in a larger setting.
  Eur Addict Res 2023;29:44–51
  PubDate: Mon, 19 Dec 2022 12:35:40 +010