Trends in Alcohol Services Utilization from 1991–1992 to 2001–2002: Ethnic Group Differences in the U.S. Population

Background:  During the early 1990s in the United States, changes to the provision and financing of alcohol treatment services included reductions in inpatient treatment services and in private sector spending for treatment. We investigated trends in alcohol services utilization over the 10‐year period from 1991–1992 to 2001–2002 among U.S. whites, blacks, and Hispanics. Methods:  Data come from 2 household surveys of the U.S. adult population. The 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey and the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions conducted face‐to‐face interviews with a multistage cluster sample of individuals 18 years of age and older in the continental United States. Treatment utilization represented both total utilization and the use of alcohol services. Data analyses were prevalence rates and multivariate logistic regressions for lifetime utilization with drinkers and individuals with alcohol use disorders (AUDs). Results:  From 1991–1992 to 2001–2002, drinking‐related emergency room and human services use increased for drinkers, while total utilization and the use of private health professional services and mutual aid decreased for individuals with AUDs. In drinkers and individuals with AUDs, blacks and Hispanics were less likely than whites to use private health professional care. Hispanics with AUDs were less likely than whites with AUDs to use alcohol or drug programs. Ethnicity interacted with alcohol severity to predict alcohol services utilization. At higher levels of alcohol severity, blacks and Hispanics were less likely than whites to ever use treatment and to use alcohol services (i.e., human services for Hispanic drinkers, mental health services for blacks with AUDs, and mutual aid for Hispanics with AUDs). Conclusions:  Our findings showed increases from 1991–1992 to 2001–2002 in alcohol services utilization for drinkers, but reductions in utilization for individuals with AUDs. Blacks and Hispanics, particularly those at higher levels of alcohol severity, underutilized treatment services compared to whites. These utilization trends for blacks and Hispanics may reflect underlying disparities in healthcare access for minority groups, and language and logistical barriers to utilizing services

A 10-year Study of Factors Associated with Alcohol Treatment Use and Non-use in a U.S. Population Sample

Background This study seeks to identify changes in perceived barriers to alcohol treatment and predictors of treatment use between 1991–92 and 2001–02, to potentially help understand reported reductions in treatment use at this time. Social, economic, and health trends during these 10 years provide a context for the study. Methods Subjects were Whites, Blacks, and Hispanics. The data were from the National Longitudinal Alcohol Epidemiologic Survey (NLAES) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We conducted two analyses that compared the surveys on: 1) perceived treatment barriers for subjects who thought they should get help for their drinking, and 2) variables predicting past-year treatment use in an alcohol use disorder subsample using a multi-group multivariate regression model. Results In the first analysis, those barriers that reflected negative beliefs and fears about seeking treatment as well as perceptions about the lack of need for treatment were more prevalent in 2001–02. The second analysis showed that survey year moderated the relationship between public insurance coverage and treatment use. This relationship was not statistically significant in 1991–92 but was significant and positive in 2001–02, although the effect of this change on treatment use was small. Conclusions Use of alcohol treatment in the U.S. may be affected by a number of factors, such as trends in public knowledge about treatment, social pressures to reduce drinking, and changes in the public financing of treatment

Ray model and ray-wave correspondence in coupled optical microdisks

We introduce a ray model for coupled optical microdisks, in which we select coupling-efficient rays among the splitting rays. We investigate the resulting phase-space structure and report island structures arising from the ray-coupling between the two microdisks. We find the microdisks's refractive index to influence the phase-space structure and calculate the stability and decay rates of the islands. Turning to ray-wave correspondence, we find many resonances to be directly related to the presence of these islands. We study the relation between the (ray-picture originating) island structures and the (wave-picture originating) spectral properties of resonances, especially the leakiness of the resonances which is represented as the imaginary part of the complex wave vector.Comment: 9 pages, 8 figure

Intimate Partner Violence and Alcohol Problems in Interethnic and Intra-ethnic Couples

Despite the growing number of interethnic marriages in the U.S., few studies have examined intimate partner violence (IPV) in interethnic couples. This article examined past-year occurrences of IPV across interethnic and intra-ethnic couples and tested correlates of IPV specifically in interethnic couples. Data were from a national survey of couples 18 years of age and older from the 48 contiguous states. Interethnic couples (n = 116) included partners from different ethnic backgrounds, including black-white, Hispanic-white, and black-Hispanic couples. White (n = 555), black (n = 358), and Hispanic (n = 527) intra-ethnic couples included partners with the same ethnicity. Data analyses were prevalence rates and logistic regressions. The analyses showed that interethnic couples were comparatively younger and had shorter relationships than intra-ethnic white, black, and Hispanic couples. Male partners in interethnic couples had higher rates of binge drinking and alcohol problems compared to male partners in intra-ethnic couples. Past year prevalence rates for any occurrence of IPV and acts of severe IPV were higher for interethnic couples relative to intra-ethnic couples. Most occurrences of IPV for interethnic couples were mutual. Factors predicting IPV among interethnic couples included marital status, couples’ age, male alcohol problems, and female impulsivity. Mounting evidence points to interethnic couples as a high risk group for IPV. Interethnic couples may be at greater risk for IPV because of their younger age, binge drinking and alcohol problems. Future research could build on this study by examining cohort effects and regional differences in IPV for interethnic couples, and the risk for IPV across interethnic couples of different ethnic compositions

Ethnicity and Health Disparities in Alcohol Research

Recent advances in alcohol research continue to build our understanding of alcohol consumption and related consequences for U.S. ethnic minority groups. National surveys show variations across ethnicities in drinking, alcohol use disorders, alcohol problems, and treatment use. Higher rates of high-risk drinking among ethnic minorities are reported for Native Americans and Hispanics, although within-ethnic group differences (e.g., gender, age-group, and other subpopulations) also are evident for ethnicities. Whites and Native Americans have a greater risk for alcohol use disorders relative to other ethnic groups. However, once alcohol dependence occurs, Blacks and Hispanics experience higher rates than Whites of recurrent or persistent dependence. Furthermore, the consequences of drinking appear to be more profound for Native Americans, Hispanics, and Blacks. Disparities in alcohol treatment utilization are most apparent for Hispanics. Explanations for these differences are complex, likely affected by risky drinking behaviors, immigration experiences, racial/ethnic discrimination, economic and neighborhood disadvantage, and variations in alcohol-metabolizing genes. Research must maintain a systematic, strong, and growing focus on ethnic minorities. A more complete understanding of these effects for ethnic minority groups is needed to enable researchers to face the challenges of reducing and ultimately eliminating health disparities in the alcohol field

Introduction: Special issue on genetic research of alcohol use disorder in diverse racial/ethnic populations

This special issue of The American Journal on Addictions is an extension of a workshop held at the Research Society on Alcoholism (2015) highlighting several important issues related to studies of the genetic bases of alcohol use disorder among racially/ethnically diverse populations. While not exhaustive in their coverage, the papers in this special issue focus on three important topics: (1) the importance of considering the social and environmental context in genetic analyses; (2) social and cultural considerations for engaging diverse communities in genetic research; and (3) methodologies related to phenotype development for use with racially/ethnically diverse populations. A brief overview of each paper included in these three sections is presented. The issue concludes with additional considerations for genetic research with racially/ethnically diverse population groups along with a commentary. (Am J Addict 2017;26:422–423

Comorbidities and Race/Ethnicity Among Adults with Stimulant Use Disorders in Residential Treatment

Comorbid physical and mental health problems are associated with poorer substance abuse treatment outcomes; however, little is known about these conditions among stimulant abusers at treatment entry. This study compared racial and ethnic groups on baseline measures of drug use patterns, comorbid physical and mental health disorders, quality of life, and daily functioning among cocaine and stimulant abusing/dependent patients. Baseline data from a multi-site randomized clinical trial of vigorous exercise as a treatment strategy for a diverse population of stimulant abusers (N = 290) were analyzed. Significant differences between groups were found on drug use characteristics, stimulant use disorders, and comorbid mental and physical health conditions. Findings highlight the importance of integrating health and mental health services into substance abuse treatment and could help identify potential areas for intervention to improve treatment outcomes for racial and ethnic minority groups

Étude de l'enlèvement du Cd, Cu, Mn et Zn par solubilisation biologique dans les sédiments lacustres fortement contaminés

Des essais en erlenmeyers de 0,5 L ont été faits afin d'évaluer les possibilités d'application d'un procédé de solubilisation biologique aux sédiments. Ce procédé utilise la capacité des thiobacilles de lixivier les métaux en milieu acide. Au cours des essais, l'influence, sur la solubilisation des métaux, de la quantité de substrat (FeSO4 × 7H2O), du pourcentage d'inoculum et de la teneur en solides totaux a été suivie. La concentration de substrat n'a pas d'effet sur l'enlèvement du Cd, du Zn, du Mn et du Cu. Les taux d'enlèvement moyens pour le Cd, Zn et Mn, sont, après 46 heures, de 70 à 90 %, 90 à 100 % et 64 à 72 % pour des concentrations de substrat variant de 0 à 30 % FeSO4 × 7H2O (poids sec/poids sec). A 29 et 46 heures, des coefficients de détermination (r2) de 0,46 et 0,59 entre le pH et la concentration de FeSO4 × 7H2O, et de 0,92 et 0,55 entre le POR et la concentration de FeSO4 × 7H2O ont été trouvés. A plus forte teneur en FeSO4 × 7H2O, le POR est moins élevé, surtout au début des essais. La présence des ions ferreux en plus grande quantité expliquerait les plus faibles valeurs du potentiel-rédox. A 20 % d'inoculum, la solubilisation des métaux est optimale avec une solubili- sation de 86 % pour le Cd et 73 % pour le Cu et le Mn. La forte corrélation entre le POR, le pH et le pourcentage d'inoculum (r2 à 29, 46 et 70 heures de 0,94, 0,94 et 0,63 pour le POR et le pourcentage d'inoculum et de 0,80, 0,69 et 0,60 pour le pH et le pourcentage d'inoculum), a permis d'établir une corrélation entre le POR, le pH et la solubilisation du Cu. Les seuils trouvés permettant une solubilisation du Cu supérieure à 10 % sont un pH de 3,75 et un POR de 260 mV.L'augmentation des solides totaux (ST) semble limiter le développement des thiobacilles et diminue les rendements de solubilisation du Cd (à 21 heures) et du Zn (à 45 heures). Ainsi, pour le Cd, les pourcentages de solubilisation passent de 71 % à 24 % pour 3 et 15 % ST, alors que dans le cas du Zn, ils diminuent de 94 % à 81 % pour 3 et 15 % ST. La solubilisation du Mn serait, pour sa part, plutôt de type chimique.In the province of Québec, the St-Lawrence Seaway as well as the harbour areas undergo frequent dredging. Each year, more than 106 cubic metres of sediments must be dredged from the st-Lawrence river. The dredged sedirnents are generally dispersed in the water column. However, heavy metal contamination of these sediments may preclude open-water disposal and necessitate their confinement.The research work presented in this article applies to dredged sediments that are too contaminated for open-water disposal. In order to permit their safe disposal, it is necessary to have a method which effectively removes metals from these sediments. One of the effective methods of metal removal from contaminated sediments could be a microbial solubilization process, which was developed at INRS-Eau for sewage sludge decontamination and which has been tested on a pilot scale during the past year. In order to appty such a process to decontaminate sediments, it was necessary to study the influence of various factors affecting the microbial leaching process. This research verified the possibility of using a modified microbial leaching process to decontaminate sediments and also studied the influence of the enerry substrate, the microbial inoculum and the sediment total solids concentration on such a modified process.The experimental methodology consisted of mixing the contaminated sediment in a 500 ml Erlenmeyer flask for a period of 96 hours in the presence of thiobacillus inoculum and ferrous sulfate (FeSO4 • 7H2O) as the enerry substrate. Before each experiment sediments were adjusted to the desired total solids concentration with deionized water and were acidified with sulfuric acid to obtain the starting pH conditions.The solubilization of Cd, Cu, Zn and Mn was monitored at regular intervals in order to evaluate the influence of the various factors studied. Subsamples were removed, the sediments were digested and the metals were analyzed by inductively coupled plasma atomic emission spectrophotometry (ICP-AES). The elements analyzed were Al, Ca, Cd, Cr, Cu, Fe, Mg, Mn, Ni, Pb,Zn as well as S, P and C. All the digestions and analyses performed made according to the APHA guidelines. The total solids, both volatile and inert, were also determined according to APHA method no.209F (APHA, 1985).Regarding the influence of the ferrous sulfate concentration on the application of the microbial leaching process, the removal rates of Cd, Zn and Mn did not vary more than 12 %. For all experiments, the final pH value approached 2,5. The oxidation-reduction potential (ORP) varied for all experiments from 462 to 560 mV. An energy source could therefore be present in the sediments, which would support the growth of thiobacillus bacteria.During the experiments conducted to study the influence of inoculum concentration on the microbial leaching process, it was found that the pH decreased from 3.5 to 2.4 and the ORP increased from 284 to 593 mV when the inoculum addition increased from 0 to 30 % (v/v). This tendency was also observed during the removal of Cd and above all, Cu. Between 0 and 20 % (v/v) inoculum concentration, Cd removal increased from 64 to 86 % whereas Cu removal increased from 20 to73 %. However, these two metals did not show any appreciable increase in solubilization when the inoculum was increased from 20 to 30 % (v/v). In the case of Mn, it was not possible to determine the solubilization pattern since the inoculum concentration did not influence the solubilization of this element, Between 0 and 30 % inoculum, the Mn removal varied from 56 to 73 %. Hence the microbial influence on Mn solubilization may be negligible.The study on the influence of total solids content on the microbial leaching process showed that the total solids concentration had an influence on pH and ORP. The final pH increased from 2.43 to 3.32 and ORP decreasedfrom 492 to 321 mV when the total solids content was varied from 3 to 15 % . The percent solubilization of Cd after 21 h was 7l %, 69 %, 43 %, 44 % and, 24 % at 3, 5, 7, 10 and 15 % total solids respectively, On the other hand, Zn solubilization after 45 h was 94 %, 90 %, 84 %, 97 % and 8l % for the same concentrations of total solids. An increase in total solids content decreased the solubilization efficiency of Cd (at t=2l h) and, to a lesser extent, Zn (att=48h). However,in the case of Mn, the maximum solubilization was achieved right at the beginning and varied little with time. Its solubilization varied between 61 and 70 % for 3 % total solids, between 67 and, 79 % for 5 % total dolids, between 52 and,62 % for 7 % totaf solids, between 57 and, 75 % for l0 % total solids and tretween 40 and 63 % for 15 % total solids. In general, for the sediments studied here, total solids content has little influence on Mn solubilization.In conclusion, use of a microbial leaching process to remove metals from contaminated sediments seems to be less complex than for sewage sludges, since the maximum removal of metals is achieved in less than 48 h in a bench-scale experiment. The average metal solubilization was above 80 % for Cd, 73 % for Cu, 90 % for Zn and 65 % for Mn. The development of thiobacillus does not seem to be dependent upon the presence of an added energy substrate. Only a minimal quantity of substrate, say 5 % ferrous sulfate (dry wt./dry wt.), is required in order to assure optimal conditions for thiobacillus growth. It is probable that with time, without ferrous sulfate, the microbial conditions would deteriorate due to exhaustion ofthe enerry substrate. A 20 % microbial inoculum seems to be enough to assure an efficient metal solubilization process. Except for Mn, the increase in total solids concentration had a negative influence on the metal solubilization. It is hence preferable to work with a total solids concentration of less than 5 %. Nevertheless, it should be noted that this percentage is more than that used for sewage sludge decontaminaton (around 2 % total solids)

Explaining the Frequency of Alcohol Consumption in a Conflict Zone: Jews and Palestinians in Israel

Experiencing stress and exposure to terrorism may have an adverse effect on health risk behaviors. Few studies have examined alcohol use among adults living in Israel under chronic, stressful terrorism-related conditions. In this study, we examined the relationships of demographics, past stressful events, and terrorism exposure to the frequency of alcohol use and the mediating roles of depressive and post-traumatic stress disorder (PTSD) symptoms. We used three waves of data from a 2007–2008 nationally representative sample of Jewish and Palestinian adults in Israel. We assessed past stressful events, in addition to direct and indirect exposures to terrorism. Results indicated that past stressful events and exposure to terrorism were not directly associated with alcohol use, but were indirectly associated and mediated by depressive and PTSD symptomology. Mental health symptoms were differentially associated with alcohol use. More frequent drinking was mediated by higher levels of depression, including for women and Palestinians; however, PTSD symptom severity was related to less frequent drinking. Mental health may play a prominent role in the frequency of alcohol use among adults exposed to terrorism in Israel. Alcohol use, as a coping mechanism, may differ by demographic characteristics (gender and ethnicity) and psychological symptomology for adults living in a conflict zone in Israel

Hispanic Subgroups, Acculturation, and Substance Abuse Treatment Outcomes

This study explored Hispanic subgroup differences in substance use treatment outcomes, and the relationship of acculturation characteristics to these outcomes. Data were from a multisite randomized clinical trial of motivational enhancement therapy versus treatment as usual in a sample of Spanish-speaking substance abusers. Participants were Cuban American (n = 34), Mexican American (n = 209), Puerto Rican (n = 78), and other Hispanic American (n = 54). Results suggested that Cuban Americans and individuals with more connection to Hispanic culture had lower treatment retention. Hispanics born in the U.S and those who spoke English at home had a lower percentage of days abstinent during weeks 5–16, although Puerto Ricans born in the U.S. and Cuban Americans living more years in the U.S. had a higher percentage of days abstinent in weeks 1–4 and 5–16, respectively. Results may inform future hypothesis-driven studies in larger Hispanic treatment seeking samples of the relationship between acculturation and treatment outcome