alcohol consumption

Background While the COVID-19 pandemic caused major disruptions to social connections and lifestyles, many countries continued the sale of alcohol as an essential commodity. Evidence on change in alcohol use, and its association with mental health and wellbeing during the pandemic is, however, mixed and limited to initial periods of the pandemic. This study aimed to address these research gaps. Methods Data were drawn from the COVID-19 Risks Across the Lifespan (CORAL) Study, a three-wave longitudinal study conducted between May 2020 and April 2021. The present sample included 2,369 participants (age M = 38.81 ± 16.94 years, range = 11–100; 90% females) from the United Kingdom, United States, and Australia. Measures included pre-pandemic alcohol use and changes in consumption frequency, quantity, drinking behaviours (e.g., drinking earlier in the day), and motivations (e.g., drinking for enjoyment) during the pandemic. General perceived stress, COVID-19-related stress, loneliness, and symptoms of depression and anxiety were also assessed. Findings Drinking frequency and quantity remained stable across the first year of the pandemic; however, non-linear age associations were found. Young individuals aged between 11 to 20 years, and mid-aged individuals aged between 50 to 70 years, had the highest probability of increased alcohol use frequency and quantity. Drinking behaviours and motivations also remained largely stable, although age- and country-specific differences emerged, potentially reflecting policy differences such as alcohol access restrictions and lockdown measures. Finally, loneliness unidirectionally predicted subsequent alcohol use quantity. Conclusions These findings highlight the heterogeneous alcohol use patterns across age groups and countries during the pandemic, and underscore loneliness as an important public health issue with implications for alcohol misuse.

Health shocks—such as new diagnoses of chronic disease—can disrupt daily life and create potential “teachable moments” for behavioral improvement. Yet, existing evidence on post-diagnosis behavior change remains mixed and largely limited to high-income countries. This study addresses a major empirical gap by examining whether chronic disease diagnoses are associated with measurable within-person changes in health behaviors among middle-aged and older adults in Thailand, a rapidly aging middle-income society. We analyzed four waves (2015–2022) of the Health, Aging, and Retirement in Thailand (HART) survey. The analytic sample comprised adults aged ≥45 years with no baseline diagnosis of cancer, diabetes, or cardiovascular disease (N = 2,891; 9,577 person-wave observations). Self-reported physician-diagnosed conditions were used to construct disease-status indicators. Behavioral outcomes included smoking, current alcohol use, sufficient physical activity (≥150 minutes/week), normal body mass index (BMI) (18.5–23), and waist obesity (sex-specific cutoffs). Individual fixed-effects linear probability models with survey-wave fixed effects and adjustment for time-varying covariates (log income, activities of daily living [ADL] score, and marital status) estimated within-person associations, with standard errors clustered at the individual level. Disease-specific models and models including interactions with sex assessed heterogeneity. In pooled analyses, the disease-status indicator was not significantly associated with smoking, alcohol use, physical activity, BMI, or waist obesity. In contrast, a diabetes diagnosis was associated with a reduction of 3.6 percentage-point in current alcohol use, and both diabetes and cancer diagnoses were associated with reductions in frequent drinking. Models including interactions with sex suggested larger diagnosis-associated reductions in selected alcohol-use outcomes among men, although statistical evidence varied by outcome and disease type. Among middle-aged and older Thai adults, chronic disease diagnoses were associated with selective, rather than comprehensive, changes in health behaviors. Diagnosis alone is insufficient to support changes across multiple health behaviors, underscoring the need for structured post-diagnosis counselling, follow-up, and gender-sensitive secondary prevention in aging middle-income populations.

LGBTQ+ adolescents face more substance use risk than straight peers; however, within-group differences remain understudied. This study analyzed 2023 Youth Risk Behavior Survey data to compare alcohol and cannabis use between bisexual adolescents and their peers. Bisexual adolescents were 1.31x as likely to use alcohol as peers identifying “some other way” (95% CI [1.01, 1.52]). Cannabis use was 1.57x as likely among bisexual adolescents as straight adolescents (95% CI [1.48, 1.64]), 1.30x as likely as lesbian/gay adolescents (95% CI [1.02, 1.50]), and 1.64x as likely as peers unsure of their sexual identity (95% CI [1.46, 1.76]). Use of both substances was 1.54x as likely among bisexual adolescents as straight peers (95% CI [1.47, 1.61]) and 1.28x as likely as peers unsure of their sexual identity (95% CI [1.04, 1.45]). Findings support elevated cannabis use risk among bisexual adolescents. Bisexual-specific stressor awareness may enhance adolescent cannabis use prevention and reduction efforts.

نوجوانان LGBTQ+ با خطر بیشتری برای مصرف مواد نسبت به همسالان دگرجنس‌گرا مواجه هستند؛ با این حال، تفاوت‌های درون‌گروهی کمتر مورد مطالعه قرار گرفته‌اند. این پژوهش داده‌های پیمایش رفتارهای پرخطر نوجوانان سال ۲۰۲۳ را برای مقایسه مصرف الکل و کانابیس بین نوجوانان دوجنس‌گرا و همسالان آن‌ها تحلیل کرد. احتمال مصرف الکل در نوجوانان دوجنس‌گرا ۱٫۳۱ برابر بیشتر از همسالانی بود که هویت جنسی خود را «به گونه‌ای دیگر» اعلام کرده بودند (۹۵٪ CI [1.01, 1.52]). احتمال مصرف کانابیس در نوجوانان دوجنس‌گرا ۱٫۵۷ برابر بیشتر از نوجوانان دگرجنس‌گرا (۹۵٪ CI [1.48, 1.64])، ۱٫۳۰ برابر بیشتر از نوجوانان همجنس‌گرا/لزبین (۹۵٪ CI [1.02, 1.50]) و ۱٫۶۴ برابر بیشتر از همسالانی بود که نسبت به هویت جنسی خود مطمئن نبودند (۹۵٪ CI [1.46, 1.76]). احتمال مصرف هر دو ماده در نوجوانان دوجنس‌گرا ۱٫۵۴ برابر بیشتر از همسالان دگرجنس‌گرا (۹۵٪ CI [1.47, 1.61]) و ۱٫۲۸ برابر بیشتر از همسالانی بود که نسبت به هویت جنسی خود مطمئن نبودند (۹۵٪ CI [1.04, 1.45]). یافته‌ها نشان‌دهنده افزایش خطر مصرف کانابیس در میان نوجوانان دوجنس‌گرا است. آگاهی از عوامل استرس‌زای خاص دوجنس‌گرایان می‌تواند تلاش‌ها برای پیشگیری و کاهش مصرف کانابیس در نوجوانان را بهبود بخشد.

While psychedelic experiences are often reported as positive, adverse psychological reactions can occur. We present the case of a 19-year-old Caucasian male who presented to the ER with suicidal thoughts after taking lysergic acid diethylamide (LSD) alone. He was diagnosed with anxious state associated with panic attacks, and suicidal thoughts without ideation or behaviors. He was admitted to the psychiatric ward and treated with trazodone, a serotonin antagonist and reuptake inhibitor antidepressant, and brexpiprazole, an atypical antipsychotic. He responded well and was discharged after 12 days with recommendations to continue therapy with brexpiprazole and attend follow-up at the territorial mental health services. Five days later, he engaged in alcohol consumption with a roommate met during the psychiatric admission, and suicidal thoughts re-emerged. He presented again to the ER but was not admitted to the inpatient unit, since he improved with supportive conversation and medication. One month later, he returned to the ER a third time due to pervasive doubt and confusion that distressed him to the point of triggering unstructured suicidal thoughts. After one week of hospitalization, he was discharged and citalopram (a selective serotonin reuptake inhibitor [SSRI]) was added to the therapy. Following the third admission, the clinical suspicion strengthened that he may have an underlying obsessive functioning pattern that became clinically apparent following LSD use, although the contribution of other vulnerability factors could not be excluded. This case highlights the importance of set and setting, underscores the relevance of harm reduction strategies for both recreational and clinical users, and highlights a potentially negative interaction between serotonergic psychedelics and alcohol.

اگرچه تجربه‌های روان‌گردان اغلب به‌عنوان تجربه‌هایی مثبت گزارش می‌شوند، واکنش‌های روان‌شناختی نامطلوب نیز می‌توانند رخ دهند. در این مقاله، مورد یک مرد قفقازی ۱۹ ساله ارائه می‌شود که پس از مصرف لیسرجیک اسید دی‌اتیل‌آمید (LSD) به‌تنهایی، با افکار خودکشی به بخش اورژانس مراجعه کرد. او با وضعیت اضطرابی همراه با حملات پانیک و افکار خودکشی بدون تمایل یا رفتار تشخیصی شد. وی در بخش روان‌پزشکی بستری و با ترازودون، یک داروی ضدافسردگی آنتاگونیست سروتونین و مهارکننده بازجذب، و برکسپیپرازول، یک داروی ضدروان‌پریشی غیرمعمول، درمان شد. او به درمان پاسخ مناسبی داد و پس از ۱۲ روز با توصیه ادامه درمان با برکسپیپرازول و پیگیری در خدمات سلامت روان منطقه‌ای ترخیص شد. پنج روز بعد، او با هم‌اتاقی‌ای که در مدت بستری با او آشنا شده بود، الکل مصرف کرد و افکار خودکشی مجدداً ظاهر شد. او بار دیگر به اورژانس مراجعه کرد اما به دلیل بهبود با گفت‌وگوی حمایتی و دارو بستری نشد. یک ماه بعد، برای بار سوم به دلیل شک و تردید فراگیر و سردرگمی که او را تا حد بروز افکار خودکشی بدون ساختار آزار می‌داد، به اورژانس مراجعه کرد. پس از یک هفته بستری، ترخیص شد و سیتالوپرام (یک مهارکننده انتخابی بازجذب سروتونین [SSRI]) به درمان او افزوده شد. پس از سومین بستری، ظن بالینی تقویت شد که ممکن است او الگوی عملکرد وسواسی زمینه‌ای داشته باشد که پس از مصرف LSD به‌صورت بالینی آشکار شده است، اگرچه نقش سایر عوامل آسیب‌پذیری نیز قابل رد نیست. این مورد اهمیت شرایط ذهنی و محیطی، لزوم راهبردهای کاهش آسیب برای مصرف‌کنندگان تفریحی و بالینی، و همچنین احتمال تعامل منفی بین روان‌گردان‌های سروتونرژیک و الکل را برجسته می‌کند.