Abstract Aims To examine the effects of cannabidiol (CBD) on psychophysiological responding and risky decision-making in individuals with alcohol use disorder (AUD). Methods In a double-blind, placebo-controlled crossover trial, 18 participants with AUD completed the Columbia Card Task (CCT) following administration of CBD and placebo. Skin conductance responses (SCR) and high-frequency heart rate variability (HF-HRV) were assessed as indices of autonomic responding during task performance. Risk-taking was indexed by the number of cards selected on the CCT. Results CBD did not significantly affect SCR (P = .16, pBH = .326) or risky decision-making on the CCT (P > .63, pBH = 0.67). However, CBD significantly increased HF-HRV (β = 0.53, SE = 0.19, P = .005; pBH = 0.020). There was no evidence that the relationships between HF-HRV or SCR and risky decision-making differed between CBD and placebo conditions (drug × HF-HRV: P = .92; drug × SCR: P = .958; both pBH = .958). Discussion CBD increased HF-HRV but did not significantly alter SCR, risky decision-making, or the relationship between autonomic responses and risky decision-making. These findings suggest that CBD influences autonomic responding during task performance, although the functional significance of this effect remains uncertain. The modest sample size and relatively healthy, non-treatment-seeking sample may have limited the ability to detect broader physiological and behavioural effects.
Abstract Using National Violent Death Reporting System data (2022–2023), 14 909 suicide decedents (34%) tested positive for alcohol. The most common substances co-occurring with alcohol were marijuana, antidepressants, opioids, and benzodiazepines; polysubstance use was high, with 52% testing positive for alcohol and ≥1 other substance. Findings suggest an overall alcohol-involved suicide mortality rate of 24%, appearing higher than prior estimates.
Abstract This study aims to provide population-based descriptive information about the prevalence of fathers’ drinking in Australia and compare their drinking practices to non-fathers. Findings show that fatherhood is not protective when it comes to alcohol consumption, and fathers are more likely to drink at a level that places them at increased risk of short-term harm.
AIM:To examine the association between weekend discharge and post-transplant alcohol relapse, graft survival, and acute rejection in liver transplant recipients with alcohol-associated liver disease (ALD). METHODS:Single-center retrospective cohort study of 362 adult ALD liver transplant recipients (2016-2023). Weekend discharge was compared with weekday discharge. The primary outcome was alcohol relapse, analyzed using competing-risks methods with death as a competing event; secondary outcomes were graft survival and acute cellular rejection (ACR). RESULTS:Sixty one (16.9%) had weekend discharge. Weekend recipients were older (median 59 vs. 53 years; P = .01); other baseline characteristics were comparable. Three-year cumulative relapse incidence was 13.7% vs. 21.1% (P = .36). Weekend discharge was not independently associated with relapse (adjusted HR 0.89, 95% CI 0.46-1.71; P = .72); shorter pre-transplant abstinence was the only independent predictor (adjusted HR 0.99/month; P = .03). Although unadjusted 3-year graft survival was lower in the weekend group (76.6% vs. 89.6%; P = .03), this difference was not retained after adjustment (adjusted HR 1.50, 95% CI 0.80-2.83; P = .21). Unadjusted ACR incidence was comparable across all horizons (P ≥ .25). CONCLUSIONS:Among ALD liver transplant recipients managed with standardized discharge education and protocolized relapse surveillance, weekend discharge was not independently associated with alcohol relapse or graft survival after adjustment, and unadjusted ACR incidence did not differ between discharge groups. However, both adjusted estimates remain compatible with clinically meaningful benefit or harm, and these findings therefore represent a failure to detect an association rather than evidence of equivalence. Protocolized discharge care may mitigate the impact of reduced weekend staffing, although discharge timing itself may simply exert little influence on these outcomes. Multicenter studies are needed to assess generalizability.
BACKGROUND:Mutual help organizations (MHOs) for alcohol and substance use disorders are peer-based programs offering recovery-specific social support. A wide-ranging, diverse body of published MHO literature examines their clinical and public health utility. We conducted a meta-review ("overview of reviews") to synthesize this evidence and identify trends, limitations, and gaps across existing syntheses. METHODS:We searched five electronic databases (August 2023) using tailored search strings to identify reviews of MHOs. We coded review characteristics and quality ratings (A Measurement Tool to Assess Systematic Reviews 2) in duplicate and quantified overlap of primary studies [corrected covered area (CCA)]. RESULTS:Twenty-five reviews (one scoping, 15 systematic, and 9 meta-analyses) were included, encompassing 163 111 participants and 645 unique primary studies, with minimal overlap (CCA = 1.76%). Overall methodological quality was mixed. Most reviews focused on 12-step MHOs/12-step facilitation (20; 80%), particularly Alcoholics Anonymous (13; 52%). Few focused on adolescents (2), individuals with co-occurring disorders (3), or Indigenous populations (1). Over half (56%) did not report race/ethnicity; those that did reported ranges from 0% to 81% White (M = 58.4%). Sex/gender was reported in 48% (M = 71.5% male). All meta-analyses examined alcohol and/or other substance use outcomes; some also assessed related outcomes, e.g. social connection, physical/mental health, education/employment, criminal justice involvement, and cost-effectiveness/healthcare utilization. CONCLUSIONS:Despite numerous reviews, the synthesis literature is limited in methodological rigor, with a narrow focus on 12-step MHOs. Reporting of outcomes and demographic data is inconsistent, but improves over time. Given variation in individuals' recovery pathways, future syntheses should examine newer, non-12-step MHOs, distinct populations, and outcomes beyond alcohol/substance use behaviors.
