Findings

Impaired

Kevin Lewis

September 17, 2015

Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality: A Study Among 1,215 Healthy Young Men

Tina Djernis Gundersen et al.
American Journal of Epidemiology, 15 September 2015, Pages 473-481

Abstract:
A total of 1,215 young Danish men aged 18–28 years were recruited between 2008 and 2012 when they attended a compulsory medical examination to determine their fitness for military service. The participants delivered a semen sample, had a blood sample drawn, and underwent a physical examination. They responded to questionnaires including information on marijuana and recreational drug use during the past 3 months (no use, use once per week or less, or use more than once per week). A total of 45% had smoked marijuana within the last 3 months. Regular marijuana smoking more than once per week was associated with a 28% (95% confidence interval (CI): −48, −1) lower sperm concentration and a 29% (95% CI: −46, −1) lower total sperm count after adjustment for confounders. The combined use of marijuana more than once per week and other recreational drugs reduced the sperm concentration by 52% (95% CI: −68, −27) and total sperm count by 55% (95% CI: −71, −31). Marijuana smokers had higher levels of testosterone within the same range as cigarette smokers. Our findings are of public interest as marijuana use is common and may be contributing to recent reports of poor semen quality.

---------------------

The Prospective Association Between Sipping Alcohol by the Sixth Grade and Later Substance Use

Kristina Jackson et al.
Journal of Studies on Alcohol and Drugs, March 2015, Pages 212–221

Objective: Although there is a clear association between early use of alcohol and short- and long-term adverse outcomes, it is unclear whether consumption of minor amounts of alcohol (less than a full drink) at a young age is prognostic of risk behaviors in later adolescence.

Method: Data were taken from 561 students enrolled in an ongoing prospective web-based study on alcohol initiation and progression (55% female; 25% White non-Hispanic). Based on a combination of monthly and semiannual surveys, we coded whether participants sipped alcohol before sixth grade and examined associations between early sipping and alcohol consumption by fall of ninth grade, as well as other indices of problem behavior. Participants also reported on the context of the first sipping event.

Results: The prevalence of sipping alcohol by fall of sixth grade was 29.5%. Most participants indicated that their first sip took place at their own home, and the primary source of alcohol was an adult, usually a parent. Youth who sipped alcohol by sixth grade had significantly greater odds of consuming a full drink, getting drunk, and drinking heavily by ninth grade than nonsippers. These associations held even when we controlled for temperamental, behavioral, and environmental factors that contribute to proneness for problem behavior, which suggests that sipping is not simply a marker of underlying risk.

Conclusions: Our findings that early sipping is associated with elevated odds of risky behaviors at high school entry dispute the idea of sipping as a protective factor. Offering even just a sip of alcohol may undermine messages about the unacceptability of alcohol consumption for youth.

---------------------

Breaking Bad: Are Meth Labs Justified in Dry Counties?

Jose Fernandez, Stephan Gohmann & Joshua Pinkston
University of Louisville Working Paper, August 2015

Abstract:
This paper examines the influence of local alcohol prohibition on the prevalence of methamphetamine labs. Using multiple sources of data for counties in Kentucky, we compare various measures of meth manufacturing in wet, moist, and dry counties. Our preferred estimates address the endogeneity of local alcohol policies by using as instrumental variables data on religious affiliations in the 1930s, when most local-option votes took place. Alcohol prohibition status is influenced by the percentage of the population that is Baptist, consistent with the “bootleggers and Baptists” model. Our results suggest that the number of meth lab seizures in Kentucky would decrease by 24.4 percent if all counties became wet.

---------------------

Poor Body Image and Alcohol Use in Women

Cathryn Glanton Holzhauer, Ashley Zenner & Edelgard Wulfert
Psychology of Addictive Behaviors, forthcoming

Abstract:
Two studies were conducted to examine the association between body image and alcohol use. Of interest was the extent to which alcohol outcome expectancies act as a moderator in this relationship, particularly in women. In Study 1, 421 college students (175 men, 246 women) provided self-report data on body image, social expressiveness expectancies, and average weekly alcohol use; the data were examined using a moderation model. Results showed that women with poor body image and high social expressiveness expectancies reported a significantly greater amount of average weekly alcohol consumption, whereas no such interaction was observed for men. Study 2 tested the same moderation model with 67 female participants; however, this second study utilized an in-lab behavioral measure of alcohol consumption as the outcome variable. The second study replicated results from Study 1, showing that women with overweight body image and alcohol-related high social expressiveness expectancies consumed significantly more beer during a taste rating task than women with other combinations of these variables. Taken together, the results of Studies 1 and 2 indicate that, specifically for women, an overweight body image and positive expectancies about the social, confidence-enhancing benefits of alcohol act as risk factors for excessive drinking.

---------------------

Initiation of Alcohol, Marijuana, and Inhalant Use by American-Indian and White Youth Living On or Near Reservations

Linda Stanley & Randall Swaim
Drug and Alcohol Dependence, forthcoming

Background: Early initiation of drinking, intoxication, marijuana, and inhalant use is associated with negative outcomes and substance use trajectories. Using national datasets, American Indian (AI) youth have been found to initiate substance use earlier than other youth. This study uses a population-based sample of youth living on or near reservations to compare substance use onset for AI and white youth where socioeconomic conditions may be similar for these youth.

Methods: Student survey data were gathered from 32 schools in 3 regions from 2009-2012. A retrospective person-period data set was constructed using reported age of initiation of intoxication and marijuana and inhalant use. Multi-level modeling and event history analysis were used to estimate initiation as a function of age, gender, ethnicity, and region.

Results: The results provide further evidence that AI youth living on or near reservations initiate substance use significantly earlier than white youth who attend the same schools and live in the same communities. Differences between the two cultural groups were most evident for marijuana initiation where the odds of initiating marijuana use ranged from seven to 10 times greater for nine vs. eight-year-old AI compared to white youth.

Conclusions: Prevention efforts targeted to AI youth must begin earlier than for non-AI youth in order to delay or prevent initiation. In addition, better understanding about the differences in the psychosocial environments of AI and white youth living in these communities is of paramount importance in designing prevention efforts.

---------------------

Life Events, Genetic Susceptibility, and Smoking among Adolescents

Fred Pampel et al.
Social Science Research, November 2015, Pages 221–232

Abstract:
Although stressful life events during adolescence are associated with the adoption of unhealthy behaviors such as smoking, both social circumstances and physical traits can moderate the relationship. This study builds on the stress paradigm and gene-environment approach to social behavior by examining how a polymorphism in the serotonin transporter gene 5-HTTLPR moderates the effect of life events on adolescent smoking. Tests of interaction hypotheses use data from the Family Transitions Project, a longitudinal study of 7th graders followed for 5 years. A sibling-pair design with separate models for the gender composition of pairs (brothers, sisters, or brother/sister) controls for unmeasured family background. The results show that negative life events are significantly and positively associated with smoking. Among brother pairs but not other pairs, the results provide evidence of gene-environment interaction by showing that life events more strongly influence smoking behavior for those with more copies of the 5-HTTLPR S allele.

---------------------

Differential Susceptibility: The Genetic Moderation of Peer Pressure on Alcohol Use

Amanda Griffin et al.
Journal of Youth and Adolescence, October 2015, Pages 1841-1853

Abstract:
Although peer pressure can influence adolescents’ alcohol use, individual susceptibility to these pressures varies across individuals. The dopamine receptor D4 gene (DRD4) is a potential candidate gene that may influence adolescents’ susceptibility to their peer environment due to the role dopamine plays in reward sensation during social interaction. We hypothesized that DRD4 genotype status would moderate the impact of 7th-grade antisocial peer pressure on 12th-grade lifetime alcohol use (n = 414; 58.7 % female; 92.8 % White). The results revealed significant main effects for antisocial peer pressure, but no main effects for DRD4 genotype on lifetime alcohol use. Adolescent DRD4 genotype moderated the association between peer pressure and lifetime alcohol use. For individuals who carried at least one copy of the DRD4 7-repeat allele (7+), antisocial peer pressure was associated with increased lifetime alcohol use. These findings indicate that genetic sensitivity to peer pressure confers increased alcohol use in late adolescence.

---------------------

Humanizing Machines: Anthropomorphization of Slot Machines Increases Gambling

Paolo Riva, Simona Sacchi & Marco Brambilla
Journal of Experimental Psychology: Applied, forthcoming

Abstract:
Do people gamble more on slot machines if they think that they are playing against humanlike minds rather than mathematical algorithms? Research has shown that people have a strong cognitive tendency to imbue humanlike mental states to nonhuman entities (i.e., anthropomorphism). The present research tested whether anthropomorphizing slot machines would increase gambling. Four studies manipulated slot machine anthropomorphization and found that exposing people to an anthropomorphized description of a slot machine increased gambling behavior and reduced gambling outcomes. Such findings emerged using tasks that focused on gambling behavior (Studies 1 to 3) as well as in experimental paradigms that included gambling outcomes (Studies 2 to 4). We found that gambling outcomes decrease because participants primed with the anthropomorphic slot machine gambled more (Study 4). Furthermore, we found that high-arousal positive emotions (e.g., feeling excited) played a role in the effect of anthropomorphism on gambling behavior (Studies 3 and 4). Our research indicates that the psychological process of gambling-machine anthropomorphism can be advantageous for the gaming industry; however, this may come at great expense for gamblers’ (and their families’) economic resources and psychological well-being.

---------------------

Single-session interventions for problem gambling may be as effective as longer treatments: Results of a randomized control trial

Tony Toneatto
Addictive Behaviors, January 2016, Pages 58–65

Abstract:
Empirically supported treatments for problem gambling tend to be multimodal combining cognitive, behavior and motivational interventions. Since problem gamblers often prefer briefer treatments it is important that interventions adopt strategies that are optimally effective. In this study, 99 community-recruited problem gamblers (74% male, mean age: 47.5 years) were randomized to one of four treatments: six sessions of cognitive therapy, behavior therapy, and motivational therapy or a single-session intervention. The sample was followed up for 12 months post-treatment. In both the Intent-to-Treat and Completer statistical analyses, no significant group differences on key gambling variables (i.e., frequency, expenditures, severity) were found. All four treatments showed significant improvement as a result of treatment that endured throughout the follow-up period. These results, although preliminary, suggest that very brief, single-session interventions may be as effective as longer treatments.

---------------------

Alcohol Use and Caloric Intake From Alcohol in a National Cohort of U.S. Career Firefighters

Christopher Keith Haddock et al.
Journal of Studies on Alcohol and Drugs, May 2015, Pages 360–366

Objective: Both media reports and preliminary research suggest that problem drinking is a concern in the U.S. fire service. However, no national epidemiological research has been conducted. This study presents the first national data on alcohol consumption patterns among firefighters.

Method: Data are from 954 male firefighters at 20 career fire departments. The departments covered 14 U.S. states, commonwealths, and/or territories and each of the four major U.S. Census Bureau Regions. Alcohol use was assessed through both surveys and, in a subsample, 24-hour dietary recall interviews from an off-duty day.

Results: More than 85% of participants consumed alcohol, nearly half reported excessive drinking, and approximately one third reported episodic heavy use when off duty. Firefighters (in comparison with officers or chiefs) and those with fewer years of service had particularly high levels of alcohol intake. Among firefighters who drank, the energy derived from alcohol averaged 539 kcals, or nearly 18% of total energy. Twenty five percent of firefighters consumed more than 770 kcals from alcohol in a single day.

Conclusions: Given the high prevalence of excessive and episodic heavy drinking and the impact of alcohol on energy intake in this population, national surveillance programs and targeted prevention interventions for problem drinking in the U.S. fire service are critically needed.

---------------------

Divergent marijuana trajectories among men: Socioeconomic, relationship, and life satisfaction outcomes in the mid-30s

Helene White et al.
Drug and Alcohol Dependence, forthcoming

Background: Given recent changes in marijuana policy in the United States, it is important to understand the long-term effects of marijuana use on adult functioning. We examined whether men who displayed different trajectories of marijuana use from adolescence through emerging adulthood (age ∼15–26) differed in terms of socioeconomic, social, and life satisfaction outcomes in their mid-30s.

Methods: Data came from a longitudinal sample of men who were recruited in early adolescence (N = 506) and followed into adulthood. Four trajectory groups based on patterns of marijuana use from adolescence into emerging adulthood were compared on adult outcomes (age ∼36) before and after controlling for co-occurring use of other substances and several pre-existing confounding factors in early adolescence. The potential moderating effect of race was also examined.

Results: Although there were initially group differences across all domains, once pre-existing confounds and co-occurring other substance use were included in the model, groups only differed in terms of partner and friend marijuana use. Chronic marijuana users reported the highest proportions of both. Frequent and persistent marijuana use was associated with lower socioeconomic status (SES) for Black men only.

Conclusions: After statistically accounting for confounding variables, chronic marijuana users were not at a heightened risk for maladjustment in adulthood except for lower SES among Black men. Chronic users were more likely to have friends and partners who also used marijuana. Future studies should take into account pre-existing differences when examining outcomes of marijuana use.

---------------------

A comprehensive examination of U.S. laws enacted to reduce alcohol-related crashes among underage drivers

Eduardo Romano et al.
Journal of Safety Research, forthcoming

Introduction: To effectively address concerns associated with alcohol-related traffic laws, communities must apply comprehensive and well-coordinated interventions that account for as many factors as possible. The goal of the current research article is to examine and evaluate the simultaneous contribution of 20 underage drinking laws and 3 general driving safety laws, while accounting for demographic, economic, and environmental variables.

Methods: Annual fatal crash data (1982 to 2010), policies, and demographic, economic, and environmental information were collected and applied to each of the 51 jurisdictions (50 states and the District of Columbia). A structural equation model was fit to estimate the relative contribution of the variables of interest to alcohol-related crashes.

Results: As expected, economic factors (e.g., unemployment rate, cost of alcohol) and alcohol outlet density were found highly relevant to the amount of alcohol teens consume and therefore to teens' impaired driving. Policies such as those regulating the age of bartenders, sellers, or servers; social host civil liability laws; dram shop laws; internal possession of alcohol laws; and fake identification laws do not appear to have the same impact on teens' alcohol-related crash ratios as other types of policies such as those regulating alcohol consumption or alcohol outlet density.

Conclusions: This effort illustrates the need for comprehensive models of teens' impaired driving. After simultaneously accounting for as many factors as possible, we found that in general (for most communities) further reductions in alcohol-related crashes among teens might be more rapidly achieved from efforts focused on reducing teens' drinking rather than on reducing teens' driving. Future efforts should be made to develop models that represent specific communities. Practical applications: Based on this and community-specific models, simulation programs can be developed to help communities understand and visualize the impact of various policy alternatives.

---------------------

Gambling and Problem Gambling in the United States: Changes Between 1999 and 2013

John Welte et al.
Journal of Gambling Studies, September 2015, Pages 695-715

Abstract:
Telephone surveys of US adults were conducted in 1999–2000 and again in 2011–2013. The same questions and methods were used so as to make the surveys comparable. There was a reduction in percentage of past-year gambling and in frequency of gambling. Rates of problem gambling remained stable. Lottery was included among the specific types of gambling for which past year participation and frequency of play declined. Internet gambling was the only form of gambling for which the past-year participation rate increased. The average win/loss increased for several forms of gambling, providing a modest indication that gamblers were betting more, albeit less frequently. Between the two surveys, the rates of past-year participation in gambling declined markedly for young adults. In both surveys, rates of problem gambling were higher for males than females, and this difference increased markedly between surveys as problem gambling rates increased for males and decreased for females. For the combined surveys, rates of problem gambling were highest for blacks and Hispanics and lowest for whites and Asians. In both surveys, the rates of problem gambling declined as socio-economic status became higher. Possible explanations for these trends are discussed.

---------------------

Effect of Florida’s Prescription Drug Monitoring Program and Pill Mill Laws on Opioid Prescribing and Use

Lainie Rutkow et al.
JAMA Internal Medicine, forthcoming

Objective: To quantify the effect of Florida’s PDMP and pill mill laws on overall and high-risk opioid prescribing and use.

Design, Setting, and Participants: We applied comparative interrupted time-series analyses to IMS Health LifeLink LRx data to characterize the effect of PDMP and pill mill law implementation on a closed cohort of prescribers, retail pharmacies, and patients from July 2010 through September 2012 in Florida (intervention state) compared with Georgia (control state). We conducted sensitivity analyses, including varying length of observation and modifying requirements for continuous observation of individuals throughout the study period.

Results: From July 2010 through September 2012, a cohort of 2.6 million patients, 431 890 prescribers, and 2829 pharmacies was associated with approximately 480 million prescriptions in Florida and Georgia, 7.7% of which were for opioids. Total monthly opioid volume, MME per transaction, days’ supply, and prescriptions dispensed were higher in Florida than Georgia before implementation. Florida’s laws were associated with statistically significant declines in opioid volume (2.5 kg/mo, P < .05; equivalent to approximately 500 000 5-mg tablets of hydrocodone bitartrate per month) and MME per transaction (0.45 mg/mo, P < .05), without any change in days’ supply. Twelve months after implementation, the policies were associated with approximately a 1.4% decrease in opioid prescriptions, 2.5% decrease in opioid volume, and 5.6% decrease in MME per transaction. Reductions were limited to prescribers and patients with the highest baseline opioid prescribing and use. Sensitivity analyses, varying time windows, and enrollment criteria supported the main results.

Conclusions and Relevance: Florida’s PDMP and pill mill laws were associated with modest decreases in opioid prescribing and use. Decreases were greatest among prescribers and patients with the highest baseline opioid prescribing and use.


Insight

from the

Archives

A weekly newsletter with free essays from past issues of National Affairs and The Public Interest that shed light on the week's pressing issues.

advertisement

Sign-in to your National Affairs subscriber account.


Already a subscriber? Activate your account.


subscribe

Unlimited access to intelligent essays on the nation’s affairs.

SUBSCRIBE
Subscribe to National Affairs.