Age of onset or age at assessment-that is the question: Estimating newly incident alcohol drinking and rapid transition to heavy drinking in the United States, 2002-2014.
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ABSTRACT:
SUBMITTER: Cheng HG
PROVIDER: S-EPMC5834354 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background. State-level 'age 21' drinking laws conform generally with the United States National Minimum Drinking Age Act of 1984 (US), and are thought to protect young people from adverse drinking experiences such as heavy episodic drinking (HED, sometimes called 'binge drinking'). We shed light on this hypothesis while estimating the age-specific risk of transitioning from 1st full drink to 1st HED among 12-to-23-year-old newly incident drinkers, with challenge to a "gender gap" hypothesis and male excess described in HED prevalence reports. Methods. The study population consisted of non-institutionalized civilians in the United States, with nine independently drawn nationally representative samples of more than 40,000 12-to-23-year-olds (2006-2014). Standardized audio computer-assisted self-interviews identified 43,000 newly incident drinkers (all with 1st HED evaluated within 12 months of drinking onset). Estimated age-specific HED risk soon after first full drink is evaluated for males and females. Results. Among 12-to-23-year-old newly incident drinkers, an estimated 20-30% of females and 35-45% of males experienced their 1st HED within 12 months after drinking onset. Before mid-adolescence, there is no male excess in such HED risk. Those who postponed drinking to age 21 are not spared (27% for 'postponer' females; 95% CI [24-30]; 42% for 'postponer' males; 95% CI [38-45]). An estimated 10-18% females and 10-28% males experienced their 1st HED in the same month of their 1st drink; peak HED risk estimates are 18% for 'postponer' females (95% CI [15-21]) and 28% for 'postponer' males (95% CI [24-31]). Conclusions. In the US, one in three young new drinkers transition into HED within 12 months after first drink. Those who postpone the 1st full drink until age 21 are not protected. Furthermore, 'postponers' have substantial risk for very rapid transition to HED. A male excess in this transition to HED is not observed until after age 14.
| S-EPMC4924122 | biostudies-literature
Project description:BACKGROUND:To study male-female and age differences in estimates of rapid transition from first full drink to alcohol dependence among youthful newly incident drinkers in the United States (US). METHOD:The study population included 12-to-25-year-old non-institutionalized US civilian residents, sampled for US National Surveys on Drug Use and Health 2002-2013, with assessments via confidential computer assisted self-interviews. Newly incident drinkers are those who had their first full drink soon before the assessment (n=32,562 12-to-25-year- olds). Alcohol dependence (AD) criteria are from DSM-IV. RESULTS:For 12-to-25-year-old females, the peak risk for making a rapid transition from first full drink to alcohol dependence is seen during adolescence, followed by declining estimates (meta-analysis summary=3% at 12-17 years of age, 95% CI=2%, 3%). Among males, corresponding estimates fluctuate around 2%, with no appreciable differences across age strata. Among 12-to-17-year-old newly incident drinkers, there is a female excess in the rapid transition to alcohol dependence; a male excess is observed among young adult newly incident drinkers. Evaluated cohort-wise, using an epidemiological mutoscope view, individual cohorts show a congruent pattern, with age at first drink held constant. CONCLUSIONS:Studying multiple replication samples of young newly incident drinkers, we discovered a clear female excess in the risk of a rapid transition from first full drink to alcohol dependence among adolescents, with age patterns differing across males and females.
| S-EPMC5086294 | biostudies-literature
Project description:ObjectiveIn this study of newly incident drinkers (NIDs), we (a) investigate and calibrate measurement equivalence of 7 clinical features of an alcohol dependence syndrome (ADS) across sex and age-of-onset subgroups and (b) estimate female-male differences in ADS levels soon after taking the first full drink, with focus on those with first full drink before the 24th birthday.MethodsThe study population is 12- to 23-year-old NIDs living in the United States (n = 33,561). Calibrated for measurement equivalence, male-female differences in levels of newly incident ADS are estimated for 6 age-of-onset subgroups.ResultsMeasurement equivalence is achieved by dropping the "difficulty cutting down" item. Then, among early-adolescent-onset NID, females have higher ADS levels (for 12- to 13-year-old NID: β = .25; 95% CI [0.05, 0.45]). In contrast, when drinking onset is delayed to adulthood, males have higher ADS levels (e.g., for 18- to 19-year-old NID: β = -.27; 95% CI [-0.52, -0.02]; for 20- to 21-year-old NID: β = -.38; 95% CI [-0.65, -0.12]).ConclusionsIn the United States, there is female excess in ADS levels measured soon after drinking onset in early adolescence. The traditional male excess is seen when drinking onset occurs after mid-adolescence. Evidence from other countries will be useful.
| S-EPMC6744833 | biostudies-literature
Project description:BACKGROUND:A comprehensive epidemiology of dependence on prescription opioid pain relievers requires evidence about age-specific female-male differences, possibly manifest during adolescent and early adult years. In this study, we identified newly incident extra-medical users of prescription pain relievers (EMPPR), all observed with onsets before the 22nd birthday. We then quantified female-male differences in clinical features or manifestations of opioid dependence (OD), devised a measurement-equivalent OD dimension, and estimated age-specific female-male differences in OD levels. METHOD:The population under study included 12-to-21-year-old non-institutionalized civilian community residents of United States sampled for recent nation-scale surveys. Confidential computer-assisted self-interviews identified newly incident EMPPR users (n?=?10,188). Analysis-weighted estimation procedures yielded cumulative incidence proportions for each OD feature, evaluated measurement non-equivalence across subgroups, and estimated female-male differences age-by-age. RESULTS:(1) Tolerance and salience ('spending a lot of time') are most common OD features. (2) Measurement non-equivalence (bias) was found across sex- and onset-age groups. (3) With biasing features removed, we can see elevated OD levels for female new initiates, age-by-age. Subsidiary analyses suggested possibly accelerated progression toward higher OD levels when extra-medical PPR use starts before age 18. CONCLUSIONS:Dimensional approaches to OD and other drug use disorders have gained popularity but can be fragile when differential measurement biases are left uncontrolled. This study's bias-corrected dimensional view of female-male differences shows elevated OD levels among newly incident female EMPPR users relative to new male initiates. Future studies can check for accelerated progression to higher OD levels when EM use starts before age 18?years.
| S-EPMC6878123 | biostudies-literature
Project description:Liberalized state-level recreational cannabis policies in the United States (US) fostered important policy evaluations with a focus on epidemiological parameters such as proportions [e.g., active cannabis use prevalence; cannabis use disorder (CUD) prevalence]. This cannabis policy evaluation project adds novel evidence on a neglected parameter-namely, estimated occurrence of newly incident cannabis use for underage (<21 years) versus older adults. The project's study populations were specified to yield nationally representative estimates for all 51 major US jurisdictions, with probability sample totals of 819,543 non-institutionalized US civilian residents between 2008 and 2019. Standardized items to measure cannabis onsets are from audio computer-assisted self-interviews. Policy effect estimates are from event study difference-in-difference (DiD) models that allow for causal inference when policy implementation is staggered. The evidence indicates no policy-associated changes in the occurrence of newly incident cannabis onsets for underage persons, but an increased occurrence of newly onset cannabis use among older adults (i.e., >21 years). We offer a tentative conclusion of public health importance: Legalized cannabis retail sales might be followed by the increased occurrence of cannabis onsets for older adults, but not for underage persons who cannot buy cannabis products in a retail outlet. Cannabis policy research does not yet qualify as a mature science. We argue that modeling newly incident cannabis use might be more informative than the modeling of prevalences when evaluating policy effects and provide evidence of the advantages of the event study model over regression methods that seek to adjust for confounding factors.
| S-EPMC9302774 | biostudies-literature
Project description:BackgroundCannabis use and cannabis regulatory policies recently re-surfaced as noteworthy global research and social media topics, including claims that Mexicans have been sending cannabis and other drug supplies through a porous border into the United States. These circumstances prompted us to conduct an epidemiological test of whether the states bordering Mexico had exceptionally large cannabis incidence rates for 2002-2011. The resulting range of cannabis incidence rates disclosed here can serve as 2002-2011 benchmark values against which estimates from later years can be compared.MethodsThe population under study is 12-to-24-year-old non-institutionalized civilian community residents of the US, sampled and assessed with confidential audio computer-assisted self-interviews (ACASI) during National Surveys on Drug Use and Health, 2002-2011 (aggregate n ∼ 420,000) for which public use datasets were available. We estimated state-specific cannabis incidence rates based on independent replication sample surveys across these years, and derived meta-analysis estimates for 10 pre-specified regions, including the Mexico border region.ResultsFrom meta-analysis, the estimated annual incidence rate for cannabis use in the Mexico Border Region is 5% (95% CI [4%-7%]), which is not an exceptional value relative to the overall US estimate of 6% (95% CI [5%-6%]). Geographically quite distant from Mexico and from states of the western US with liberalized cannabis policies, the North Atlantic Region population has the numerically largest incidence estimate at 7% (95% CI [6%-8%]), while the Gulf of Mexico Border Region population has the lowest incidence rate at 5% (95% CI [4%-6%]). Within the set of state-specific estimates, Vermont's and Utah's populations have the largest and smallest incidence rates, respectively (VT: 9%; 95% CI [8%-10%]; UT: 3%; 95% CI [3%-4%]).DiscussionBased on this study's estimates, among 12-to-24-year-old US community residents, an estimated 6% start to use cannabis each year (roughly one in 16). Relatively minor variation in region-wise and state-level estimates is seen, although Vermont and Utah might be exceptional. As of 2011, proximity to Mexico, to Canada, and to the western states with liberalized policies apparently has induced little variation in cannabis incidence rates. Our primary intent was to create a set of benchmark estimates for state-specific and region-specific population incidence rates for cannabis use, using meta-analysis based on independent US survey replications. Public health officials and policy analysts now can use these benchmark estimates from 2002-2011 for planning, and in comparisons with newer estimates.
| S-EPMC5530998 | biostudies-literature
Project description:While there has been considerable research on the analysis of extreme values and outliers by using heavy-tailed distributions, little is known about the semi-heavy-tailed behaviors of data when there are a few suspicious outliers. To address the situation where data are skewed possessing semi-heavy tails, we introduce two new skewed distribution families of the hyperbolic secant with exciting properties. We extend the semi-heavy-tailedness property of data to a linear regression model. In particular, we investigate the asymptotic properties of the ML estimators of the regression parameters when the error term has a semi-heavy-tailed distribution. We conduct simulation studies comparing the ML estimators of the regression parameters under various assumptions for the distribution of the error term. We also provide three real examples to show the priority of the semi-heavy-tailedness of the error term comparing to heavy-tailedness. Online supplementary materials for this article are available. All the new proposed models in this work are implemented by the shs R package, which can be found on the GitHub webpage.
| S-EPMC9041666 | biostudies-literature
Project description:Heavy episodic drinking (HED) is highly prevalent in college students. In Argentina, there is a notable lack of longitudinal studies examining drinking trajectories. The present study identified HED trajectories in Argentinean college students during the first 3 years of college (seven waves) and examined the association between risk factors for alcohol use and HED trajectories. The sample was composed of 1,240 college students [63.1% women, aged 18-25 years (M = 19.1 ± 1.7)] who completed at least three waves (the first data collection and ?2 follow-ups). For 3 years, participants completed seven surveys that measured HED frequency, age of drinking onset, drunkenness occurrence, trait impulsivity, family history of alcohol abuse, stressful life events, and perceived peer's drinking. Latent Class Growth Analysis (LCGA) and Multinomial Logistic Regression (MLR) were used to identify the pattern and number of HED trajectories and to explore which risk factors better distinguished between the trajectories, respectively. Six HED trajectories were identified: Heavy Stable Frequency, Moderate Stable Frequency, Moderate Decreasing Frequency, Stable Infrequent, Decreasing Infrequent, and No-HED. Younger age of drinking onset, alcohol intoxication, greater perception of peer drinking frequency and higher levels of impulsivity (i.e., sensation seeking, lack of premeditation, and positive urgency) increased the probability of belonging to the trajectories with more frequent HED. These trajectories partially coincide with those identified in studies from other cultures. Unlike previous studies, we did not find a trajectory with increasing/ascending HED frequency. This may be related to contextual/cultural variables unique to Argentina, like differences in the age when the peak in alcohol consumption is reached or the legal minimum age to buy alcoholic beverages in this country, and the idiosyncratic elements that characterize college life in Argentina. This work represents a step forward in the identification of risk factors differentiating between different HED trajectories, and help understand changes in alcohol use during college, in an understudied population.
| S-EPMC7311794 | biostudies-literature
Project description:Alcohol-related harm decreases as socioeconomic position increases, although sometimes the opposite happens with alcohol intake. The objective was to know the educational gradient in monthly measures of drinking amount and heavy episodic drinking (HED) among people aged 25-64 years in Spain from 1997-2017. Such gradient was characterized with the relative percent change (PC) in drinking measures per year of education from generalized linear regression models after adjusting for age, year, region, marital status and immigration status. Among men, the PCs were significantly positive (p < 0.05) for prevalence of <21 g alcohol/day (2.9%) and 1-3 HED days (1.4%), and they were negative for prevalences of 21-40 g/day (-1.1%), >40 g/day (-6.0%) and ≥4 HED days (-3.2%), while among women they ranged from 3.6% to 5.7%. The gradient in prevalences of >40 g/day (men) and >20 g/day (women) was greatly attenuated after additionally adjusting for HED, while that of ≥4 HED days was only slightly attenuated after additionally adjusting for drinking amount. Among women, the gradients, especially in HED measures, seem steeper in 2009-2017 than in 1997-2007. Educational inequality remained after additional adjustment for income and occupation, although it decreased among women. These results can guide preventive interventions and help explain socioeconomic inequalities in alcohol-related harm.
| S-EPMC8998990 | biostudies-literature
Project description:BACKGROUND:Low socioeconomic status (SES) has been associated with lower alcohol consumption, but also with heavier drinking. To explain this contradictory relationship, we examined SES differences in drinking patterns from an age-period-cohort (APC) perspective. METHODS:Data are from seven waves of the U.S. National Alcohol Surveys from 1979 to 2010. As a proxy for SES, educational attainment was used. Past-year alcohol volume was calculated from frequency (never-to-every day) and usual quantity (1-2, 3-4, or 5-6 drinks). Past-year frequency of heavy episodic drinking was labelled as total days of 5+ drinks. Gender-stratified APC fixed-effects models were conducted controlling for demographics and adjusting for survey design and weights. RESULTS:Significant APC effects by education were found, but the direction varied by alcohol measure. Education and total volume were positively associated across APC. Cross-over effects for age occurred with a positive education-heavy drinking relationship in young adulthood and negative relationship in mid-adulthood. Cohort-by-education effects showed greater heavy drinking among less educated women in 1956-60 cohort and more educated men and women in younger cohorts (post-1976). CONCLUSIONS:Higher SES is consistently associated with total volume across age, period, and cohort, but less consistently with heavy drinking. While there are currently significant intervention efforts to reduce heavy drinking in young adulthood, our study suggests the need for age-specific strategies targeting lower-SES groups in mid-adulthood and cohort-specific strategies for lower-SES women in the baby boomer cohort and higher-SES men and women in younger birth cohorts.
| S-EPMC6003414 | biostudies-literature