Intention to reduce drinking alcohol and preferred sources of support: An international cross-sectional study

Introduction. Drinking alcohol is legal in most countries of the world. Given the social acceptance of this behavior despite potential negative impact on health, help-seeking behavior could differ when compared to other drugs. This paper aimed to assess intentions to reduce drinking and the preferred sources of support among a large international sample of people who drink alcohol. Materials and methods. The Global Drug Survey (GDS) is the world’s largest annual survey of drug use. This paper included data from 82,190 respondents from 12 countries on four continents who reported the use of alcohol in the last 12 months, collected during November 2016 - January 2017 (GDS2017). Results. Overall, 34.8% said they would like to drink less in the following 12 months and 7.6% said they would like help to drink less. Online tools were the preferred source of support to reduce drinking by respondents from Australia, New Zealand, and the UK, those with low AUDIT scores and without a mental health condition. Specialist counselling was most preferred by those from Germany, Switzerland, and Denmark and those with high AUDIT scores, not educated to degree level and with a mental health condition. Conclusion. Interest in online interventions for harmful drinking is significant and highest among people who drink at low risk. Online tools should offer brief screening and feedback, ensuring that people with high risk drinking patterns are referred to more specialist services

Where and what you drink is linked to how much you drink: A survey of alcohol use in 17 countries

Background:  This paper aimed to explore the differences in subjective experiences of intoxication depending on drinking location and drink type. Methods: Data came from 32,194 respondents to The Global Drug Survey (GDS) 2015, an annual, cross-sectional, online survey. Respondents selected their usual drinking location (home alone: home with partner/family: house parties: pubs/bars or clubs) and usual drink (wine; beer/cider/lager; spirits or alcopops/coolers). They indicated how many drinks they required to reach three stages of intoxication (feeling the effects; an ideal stage of intoxication; and the tipping point) and how frequently they reached each stage. Results: Drink type affected grams of alcohol reported to reach the tipping point: 109gm wine, 127gm alcopops, 133gm of beer, and 134gm of spirts. Respondents who drank at home alone, or in clubs reached their tipping point more frequently compared to other locations. Conclusions: Where people drink, and the type of alcohol they drink, affected the amount of alcohol reported to reach different stages of intoxication. Understanding why different drinking locations, and drink types lead to a need for greater consumption to reach an ideal state of drunkenness, such as social cues from other people who drink, may enable people to reduce their drinking

Drinking to excess and the tipping point: An international study of alcohol intoxication in 61,000 people

Background: People who drink alcohol often seek to manage their intake in order to maximise the pleasurable effects, such as feelings of sociability and relaxation, without reaching their ‘tipping point’, where they feel out of control, or unwell. This paper aimed to explore three stages of intoxication; feeling the effects; being as drunk as you would like to be; and reaching the tipping point (feeling more drunk than you want to be) in a large international sample. Methods: The Global Drug Survey (GDS) is an annual, cross-sectional, online survey of drug use. This paper draws on data from 61,043 respondents (63.7% male) from 21 countries who took part in GDS2015 collected in November 2014 to January 2015. Respondents reported their usual type of drink; how many drinks they would require to reach each stage of intoxication and how frequently they reached each stage. Alongside socio-demographic measures, they also completed the Alcohol Use Disorders Identification Test (AUDIT). Results: Male respondents reported consuming 87.55gm to be as drunk as they want to be and female respondents reported 70.16gm, on average. The tipping point was reached at 138.65gm for male respondents and 106.54 gm for female respondents. Overall 20.3% reported reaching their tipping point at least once a month. Being male, aged under 25 and at higher risk for alcohol use disorder was associated with reporting reaching the tipping point more frequently. Conclusions: The amount of alcohol being consumed to reach a desired point of intoxication is much higher than the maximum daily, and sometimes weekly, amount recommended by country guidelines. Encouraging people to avoid reaching their tipping point may be a useful intervention point alongside better communication of low risk drinking guidelines

Comparing transgender and cisgender experiences of being taken advantage of sexually while under the influence of alcohol and/or other drugs

A small body of literature suggests that transgender people are more frequently exposed to sexual violence while they are under the influence of alcohol than cisgender counterparts. The goal of this study was to report any differences between transgender (n=1,136) and cisgender (n=74,277) respondents to the Global Drug Survey on their experiences of being taken advantage of sexually while under the influence of alcohol and/or other drugs. We found that transgender people were more likely than cisgender people to have experienced being taken advantage of in the last year (9.3% vs 4.2%) and more than 12 months preceding the survey (24.9% vs 14.3%). Non-binary participants were more likely than binary transgender participants (27.7% vs 17.8%) to report being taken advantage of sexually more than a year preceding the survey. Similarly, trans respondents assigned female at birth were more likely than trans respondents assigned male at birth to report this (30.0% vs 19.7%). Non-specialist services for survivors of sexual violence should be adequately prepared for and accommodating towards transgender clients. Future research should explore their unique needs. Moreover, clinicians who assess transgender people should remain mindful of their increased likelihood of being taken advantage of sexually while under the influence of alcohol and other drugs and consider trauma-informed interventions

Pandemic-related changes in alcohol use among LGB+ people with and without mental health and neurodevelopmental conditions: a multinational cross-sectional study

Purpose: Using data from 36,981 respondents to the Global Drug Survey (GDS) COVID-19 Special Edition, this study aims to compare changes, following the first “lockdown,” in alcohol consumption between lesbian, gay, bisexual and other sexual minority (LGB+) and heterosexual respondents with and without lifetime mental health and neurodevelopmental (MHND) conditions. Design/methodology/approach: Characteristics and drinking behavior of respondents to GDS who disclosed their sexual orientation and past 30-day alcohol use were described and compared. LGB+ participants with and without MHND conditions were compared, and logistic regression models identified correlates of increased drinking among LGB+ people. The impact of changed drinking on the lives of LGB+ participants with and without MHND conditions was assessed. Findings: LGB+ participants who reported that they were “not coping well at all” with the pandemic had twofold greater odds of reporting increased binge drinking. LGB+ participants with MHND conditions were significantly more likely than those without to report increased drinking frequency (18.7% vs 12.4%), quantity (13.8% vs 8.8%) and that changed drinking had impacted their lives. Originality/value: This study, which has a uniquely large and international sample, explores aspects of alcohol use not considered in other COVID-19 alcohol use research with LGB+ people; and to the best of the authors’ knowledge, this is the first study to explore alcohol use among LGB+ people with MHND conditions

Efficacy of an internet-based self-help intervention to reduce co-occurring alcohol misuse and depression symptoms in adults: study protocol of a three-arm randomised controlled trial

Introduction: In the general population, alcohol use disorder and depression more often occur together than any other combination of a mental illness with a substance use disorder. It is important to have a cost-effective intervention that is able to reach at-risk individuals in the early stages of developing alcohol use disorders and depression disorders. Methods and analysis: This paper presents the protocol for a 3-arm multicentre randomised controlled trial (RCT) to test the efficacy and cost-effectiveness of the combined internet-based self-help intervention Take Care of You (TCOY) to reduce alcohol misuse and depression symptoms in comparison with a waiting list control group and a comparable intervention focusing on problematic alcohol use only. The active interventions consist of modules designed to reduce alcohol use, based on the principles of motivational interviewing and methods of cognitive behavioural therapy, together with additional modules in the combined study arm to reduce symptoms of depression. Data will be collected at baseline, as well as at 3 and 6 months postrandomisation. The primary outcome is the quantity of alcohol used in the past 7 days. A number of secondary outcome measures will be studied. These include the Centre of Epidemiologic Studies of Depression Scale (CES-D) and a combined measure with the criteria of values below the cut-off for severe alcohol use disorder and for CES-D. Data analysis will follow the intention-to-treat principle using (generalised) linear mixed models. In order to investigate the interventions’ cost-utility and cost-effectiveness, a full economic evaluation will be performed. Ethics and dissemination: This RCT will be executed in compliance with the Helsinki Declaration and has been approved by 2 local Ethics Committees. Results will be reported at conferences and in peer-reviewed publications. Participant-friendly summaries of trial findings will be published on the TCOY websites. Trial registration number: ISRCTN10323951

Mindfulness-Based Childbirth and Parenting Education: Promoting Family Mindfulness During the Perinatal Period

We present the conceptual and empirical foundation and curriculum content of the Mindfulness-Based Childbirth and Parenting (MBCP) program and the results of a pilot study of n = 27 pregnant women participating in MBCP during their third trimester of pregnancy. MBCP is a formal adaptation of the Mindfulness-Based Stress Reduction program and was developed and refined over the course of 11 years of clinical practice with 59 groups of expectant couples. MBCP is designed to promote family health and well-being through the practice of mindfulness during pregnancy, childbirth, and early parenting. Quantitative results from the current study include statistically significant increases in mindfulness and positive affect, and decreases in pregnancy anxiety, depression, and negative affect from pre- to post-test (p < .05). Effect sizes for changes in key hypothesized intervention mediators were large (d > .70), suggesting that MBCP is achieving its intended effects on maternal well-being during pregnancy. Qualitative reports from participants expand upon the quantitative findings, with the majority of participants reporting perceived benefits of using mindfulness practices during the perinatal period and early parenting. Our future research will involve conducting a randomized controlled trial of MBCP to test effects on psychophysiological stress mechanisms and to examine effects on birth outcomes, family relationship quality, and child development outcomes