Family Structure in Association with Alcohol Use Among Adolescents: A Systematic Review and Meta-analysis

Context: It is proposed that family structure influences adolescent alcohol use; however, the findings are mixed, and no systematic review has been conducted to summarize the evidence. Objectives: We aimed to identify the association between family structures and adolescent alcohol consumption through a systematic review and meta-analysis of observational studies. Evidence Acquisition: PubMed, Scopus, and Google Scholar were searched until June 2017 for observational studies, which examined the relationship between family structure and adolescent alcohol use. A random-effects model was used to derive the overall odds ratio (OR) for the likelihood of alcohol use in different non-intact families compared with intact families (adolescents growing up with both biological parents). Results: Fifty-seven articles met the eligibility criteria for the systematic review, and 29 were included in the meta-analysis. The meta-analysis revealed a significant increase in alcohol use among adolescents with non-intact families (OR = 1.27, 95% confidence interval: 1.19, 1.36) compared with adolescents with intact families in which both biological parents were present. Living with one biological parent, living in a divorced family, loss of parents, and other types of the non-intact family also significantly increased the odds of alcohol use in adolescents (P < 0.05). Conclusions: All types of the non-intact family were linked to adolescents' alcohol use. The family structure could have an essential role in reducing high-risk behaviors, including alcohol use and its consequences in adolescents.

Adolescent ethanol drinking promotes hyperalgesia, neuroinflammation and serotonergic deficits in mice that persist into adulthood

Adolescent alcohol use can permanently alter brain function and lead to poor health outcomes in adulthood. Emerging evidence suggests that alcohol use predispose to pain disorders or exacerbate existing pain conditions, but the neural mechanisms are currently unknown. Here we report that mice exposed to adolescent intermittent access to ethanol (AIE) exhibit increased pain sensitivity and depressive-like behaviors that persist after alcohol cessation and are accompanied by elevated CD68 expression in microglia and reduced numbers of serotonin (5-HT)-expressing neurons in the dorsal raphe nucleus (DRN). 5-HT expression was also reduced in the thalamus, anterior cingulate cortex (ACC) and amygdala as well as the lumbar dorsal horn of the spinal cord. We then found that chronic minocycline administration after AIE alleviated hyperalgesia and social deficits, while chemogenetic activation of microglia in the DRN of Cx3cr1-cre-GFP mice reproduced the effects of AIE on pain and social interaction. Taken together, these results indicate that microglial activation in the DRN may be a primary driver of pain and negative affect after AIE.

Insights Into Adolescents' Substance Use in a Low–Middle-Income Country During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic and its lockdown have been a significant life event for many individuals, particularly adolescents. The immense psychological pressure could drive risky behavior, e.g., substance use, while lockdown might lead to decreased use. This study aimed to observe the change in substance use among adolescents in Indonesia and the moderating variables to consumption during the COVID-19 lockdown period.Methods: This study utilized an online survey from April 28, 2020 to June 30, 2020. The hyperlink was disseminated to school administrators and parenting groups through social media and direct messages. A total of 2,932 adolescents (17.4 ± 2.24 and 78.7% females) submitted valid responses. The survey was comprised of a sociodemographic section, substance use details, and psychometric sections, including the Alcohol Use Disorders Identification Test (AUDIT), Cigarette Dependence Scale 12 (CDS-12), Pittsburgh Sleep Quality Index (PSQI), and Strength and Difficulties Questionnaire (SDQ).Results: Overall, adolescent alcohol use during the pandemic was 5.1%, cigarette smoking was 3.1%, and drug consumption was 0.4%. Over half (53.4%) of alcohol drinkers reported increased drinking, and 33.1% had harmful or dependence-like drinking behavior; in contrast, 44.4% of adolescent smokers disclosed reduced cigarette consumption. Around 37.8% of the drug users indicated increased use. During the pandemic, adolescent alcohol use was associated with higher education [adjusted odds ratio (AOR) = 2.67, 95% confidence interval (CI) 1.02–4.86, p = 0.04], higher AUDIT scores (AOR = 1.33, 95% CI 1.25–1.42, p &lt; 0.001), and very low prosocial behavior (AOR = 2.46, 95% CI 1.52–3.88, p &lt; 0.001). Cigarette smoking was correlated with male sex (AOR = 9.56, 95% CI 5.64–16.62, p &lt; 0.001), age (AOR = 1.40, 95% CI 1.14–1.75, p &lt; 0.001), and higher CDS score (AOR = 1.17, 95% CI 1.13–1.20, p &lt; 0.001).Conclusions: Rates of adolescent substance use were significant, with sizeable proportions reporting higher usage. This appeared to occur predominantly in specific demographics and those with a lower protective psychosocial attribute, i.e., prosocial behavior, during the lockdown. These findings should urge the strengthening of adolescent addiction care during and after the pandemic.

Adolescent alcohol use in Estonia compared with Latvia, Lithuania, Finland and Sweden: results from cross-sectional surveys, 2003–2015

ObjectivesThe aims of the study were (1) to describe trends in the prevalence of monthly alcohol use from 2003 to 2015 and (2) to analyse the associations between alcohol use and family-related and school-related factors, risk behaviours and perceived alcohol availability in Estonia compared with Latvia, Lithuania, Finland and Sweden.MethodsThe study used nationally representative data of 15–16-year-old adolescents from the European School Survey Project on Alcohol and Other Drugs. Data from Estonia, Latvia, Lithuania, Finland and Sweden collected in 2003, 2007, 2011 and 2015 were utilised (n=57 779). The prevalence of monthly alcohol use including light and strong alcohol use was calculated for each study year. A χ2 test for trend was used to evaluate statistically significant changes in alcohol use over the study period. A multilevel logistic regression analysis was used for assessing the association between alcohol use and explanatory factors. Marginal ORs with 95% CIs for each country were calculated.ResultsMonthly alcohol use decreased significantly among boys and girls in all countries from 2003 to 2015. In 2015, the prevalence of monthly alcohol use among boys was 36.1% in Estonia, 44.3% in Latvia, 32.4% in Lithuania, 32.3% in Finland and 22.4% in Sweden. Among girls, it was 39.1%, 45.9%, 35.6%, 31.8% and 29.1%, respectively. In all countries, higher odds of monthly alcohol use were observed among adolescents who skipped school, smoked cigarettes, used cannabis, perceived alcohol to be easy to access and had parents who did not know always/often about their child’s whereabouts on Saturday nights. Compared with Estonia, associations between alcohol use and explanatory factors were similar in Latvia and Lithuania but different in Finland and Sweden.ConclusionResults of cross-national comparison of alcohol use and explanatory factors could be effectively used to further decrease alcohol use among adolescents.

Adolescent Substance Use

BACKGROUND Adolescent substance use has long been a global public health issue. In this study, we explored developmental contexts that correspond with protective and risk factors associated with adolescent substance use. The developmental contexts of interest are the family domain, the school domain, the peer domain, and the structured and unstructured leisure domains. The leisure domain is of particular interest as it often corresponds with protective and risk factors different from those associated with the other domains. The purpose of this study was to assess whether the identified domains are associated with adolescent alcohol use and cannabis use. METHODS This study used previously collected adolescent health and behavior surveillance data from (N = ~ 3,500) 7th-12th graders in a Northeastern state in the fall of 2019. The data was used to assess whether the identified domains are associated with adolescent alcohol use and cannabis use. We analyzed each outcome variable using separate hierarchical multiple regression models. RESULTS Each of the selected variables in our analysis: family, school, peer, structured and unstructured leisure domains were significantly associated with one or both of the dependent variables (alcohol or cannabis use). In our model, the peer domain was the strongest risk factor for adolescent substance use in our study, followed by the unstructured leisure domain. Family, structured leisure, and school offered similar levels of protection against substance use in per unit change. CONCLUSIONS Implications for utilizing the peer and leisure developmental contexts to prevent adolescent substance use and recommendations for further research and investment are discussed.