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3 results

  • 9 - Alcohol

  • from Part IV - Use Disorders with Specific Drugs
  • Perry M. Duncan, Old Dominion University, Virginia
  • Book:
    Substance Use Disorders
    Published online:
    18 September 2020
    Print publication:
    17 September 2020, pp 305-338

  • Summary

    Alcohol can increase pleasurable feelings and facilitate social interactions. It may decrease anxiety, although unreliably. With alcohol-produced “myopia,” immediate events and surroundings become more salient than remote or distant concerns. Disinhibition of behavior is often part of the rewarding effect of low to moderate amounts of alcohol. However, larger amounts and greater degrees of disinhibition can lead to dangerous behavior, even in individuals who do not have a diagnosable alcohol use disorder. High levels of intoxication impair sound judgment, sometimes promoting risky sexual activity or sexual assault. Alcohol impairs coordination, concentration, and vigilance, causing many traffic accidents. Large doses of alcohol can suppress respiration and cause death. A life-threatening withdrawal syndrome can occur when prolonged heavy drinking stops. Alcohol can produce depressive states, and suicide risk increases, especially for individuals suffering from pre-existing clinical depression. Because about two-thirds of the adult population in the United States consume alcohol, the small percentage with an alcohol use disorder includes an estimated 14.5 million individuals.3

  • An integrated behavioural intervention combined with varenicline for heavy-drinking smokers: a randomized pilot study

  • Lisa M. Fucito, Ran Wu, Stephanie S. O'Malley, Tess H. Hanrahan, Jolomi T. Ikomi, Srinivas Muvvala, Kathleen M. Carroll, Ralitza Gueorguieva
  • Journal:
    Journal of Smoking Cessation / Volume 15 / Issue 3 / September 2020
    Published online by Cambridge University Press:
    18 March 2020, pp. 119-127
    Print publication:
    September 2020
  • Objectives

    Combined smoking and heavy drinking is a significant health burden. Varenicline, an efficacious tobacco pharmacotherapy that also shows promise for drinking, has yielded mixed results among heavy-drinking smokers. This pilot study investigated integrated tobacco and alcohol counselling plus varenicline for this vulnerable group.

    Design

    Twelve-week parallel, randomized controlled pilot trial of two behavioural interventions in combination with open-label varenicline. Participants were randomized using computer-generated tables, stratified by sex.

    Setting

    Outpatient academic medical centre research clinic.

    Participants

    Volunteers who reported smoking and heavy drinking and sought tobacco or alcohol treatment (N = 26).

    Intervention

    (1) Integrated tobacco + alcohol counselling (INT; n = 13) or (2) counselling focused on their presenting concern (i.e., tobacco or alcohol) (SINGLE; n = 13), plus varenicline (2 mg) for 12 weeks.

    Main outcomes

    Feasibility/acceptability, smoking quit rates and heavy drinking.

    Results

    INT feasibility/acceptability was high among men but not women. More participants quit smoking in INT than SINGLE. This outcome was only in men, not significant, but had a medium effect size. Both conditions yielded significant drinking reductions.

    Conclusion

    Integrated tobacco and alcohol behavioural counselling plus varenicline may be feasible and promote smoking cessation among men who smoke and drink heavily, but a larger sample is needed to replicate this finding.

  • Alcohol consumption as a risk factor for pneumonia: a systematic review and meta-analysis

  • A. V. SAMOKHVALOV, H. M. IRVING, J. REHM
  • Journal:
    Epidemiology & Infection / Volume 138 / Issue 12 / December 2010
    Published online by Cambridge University Press:
    12 April 2010, pp. 1789-1795
    • Article
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  • The aim of this study was to quantify the association between alcohol consumption and incidence of pneumonia and to examine possible pathways. This was done by a systematic review and meta-analyses on the dose–response relationship between alcohol consumption or alcohol-use disorders and the incidence of community-acquired pneumonia (CAP). The relative risk (RR) of CAP increased monotonically with increasing alcohol consumption. Individuals consuming 24, 60, and 120 g of pure alcohol daily demonstrated RRs for incident CAP of 1·12 (95% CI 1·02–1·23), 1·33 (95% CI 1·06–1·67) and 1·76 (95% CI 1·13–2·77), respectively, relative to non-drinkers. Clinically defined alcohol-use disorders were associated with an eightfold increased risk of CAP (RR 8·22, 95% CI 4·85–13·95). In conclusion, alcohol was found to be a risk factor for pneumonia with a clear statistical association, and a monotonic dose–response relationship.