Clinician contributions to central nervous system-active polypharmacy among older adults with dementia in the United States.

Background: Exposure to central nervous system (CNS)-active polypharmacy-overlapping exposure to three or more CNS-active medications-is potentially harmful yet common among persons living with dementia (PLWD). The extent to which these medications are prescribed to community-dwelling PLWD by individual clinicians versus distributed across multiple prescribers is unclear.

Methods: We identified community-dwelling Medicare beneficiaries with a dementia diagnosis and Medicare Parts A, B, and D coverage for at least one month in 2019.

Study protocol for a sequential multiple assignment randomized trial to decrease alcohol use before and after surgery.

Background: High-risk alcohol consumption in the weeks before and after surgery poses significant risks for postoperative recovery. Despite this, elective surgical patients are rarely offered alcohol-focused education, interventions, or treatment. This paper describes the protocol of a research study designed to evaluate the effectiveness of brief, non-pharmacological, therapeutic approaches to reduce alcohol use before and after surgery.

Interpersonal discrimination and depressive symptoms among older Black and African American adults.

To examine the association between recent experiences of discrimination and depressive symptom presentation and severity among a U.S. sample of older Black and African American adults.

Acceptability and feasibility of a mobile behavioral economic health intervention to reduce alcohol use in adults in rural areas.

Background: At-risk alcohol use is associated with increased adverse health consequences, yet is undertreated in healthcare settings. People residing in rural areas need improved access to services; however, few interventions are designed to meet the needs of rural populations. Mobile interventions can provide feasible, low-cost, and scalable means for reaching this population and improving health, and behavioral economic approaches are promising.

Alcohol Use and Mortality Among Older Couples in the United States: Evidence of Individual and Partner Effects.

Background And Objectives: Spouses with concordant (i.e., similar) drinking behaviors often report better quality marriages and are married longer compared with those who report discordant drinking behaviors.

Adaptive interventions for alcohol misuse and violent behaviors among adolescents and emerging adults in the emergency department: A sequential multiple assignment randomized controlled trial protocol.

Alcohol use and violent behaviors among youth are associated with morbidity and mortality. An emergency department (ED) visit provides an opportunity to initiate prevention efforts. Despite promising findings from our single session SafERteens brief intervention (BI), impact is limited by modest effect sizes, with data lacking on optimal boosters to enhance effects.

Peer- and web-based interventions for risky drinking among US National Guard members: Mission Strong randomized controlled trial.

Aims: To test separatel the efficacy of a web-based and a peer-based brief intervention (BI), compared with an expanded usual care control (EUC) group, among military reserve component members using alcohoI in a hazardous and harmful manner.

Design: In the randomized controlled trial, participants were assigned to: [1] web-based BI with web-based boosters (BI + web), [2] web-based BI with peer-based boosters (BI + peer) or [3] enhanced usual care (EUC).

Setting: Michigan, USA.

Patterns of same-day alcohol and cannabis use in adolescents and young adults with risky alcohol use.

Same-day alcohol and cannabis use is relatively common in adolescents and young adults, constituting a higher-risk behavior relative to single-substance use. However, the association between quantity of alcohol and cannabis use on co-use days is understudied. We examined the association between the quantity of alcohol and same-day cannabis use with a multilevel regression analysis in a sample of youth (16-24 years old) with risky alcohol use.

Strategies Associated With Reducing Benzodiazepine Prescribing to Older Adults: A Mixed Methods Study.

Purpose: Unlike in many community-based settings, benzodiazepine (BZD) prescribing to older veterans has decreased. We sought to identify health care system strategies associated with greater facility-level reductions in BZD prescribing to older adults.

Methods: We completed an explanatory sequential mixed methods study of health care facilities in the Veterans Health Administration (N = 140).

A randomized controlled trial of social media interventions for risky drinking among adolescents and emerging adults.

Purpose: Alcohol use among adolescents and emerging adults is an important public health issue requiring prevention approaches. Herein, we describe outcomes from a randomized controlled trial testing the efficacy of group-based social media interventions targeting risky drinking among youth.

Procedures: Using social media advertisements to screen potential participants, we recruited 955 youth (ages 16-24) reporting recent risky drinking.

Alcohol Use and Blood Pressure Among Older Couples: The Moderating Role of Negative Marital Quality.

Objectives: Spouses often have concordant drinking behaviors and important influences on one another's cardiovascular health. However, little is known about the implications of dyadic drinking patterns for blood pressure, and the marital factors that confer risk or resilience. This article examined links between alcohol use and blood pressure within individuals and opposite-sex couples over time, and whether those links vary by negative marital quality among older adults.

High-intensity drinking among adolescent and emerging adult risky drinkers.

High-intensity drinking (HID; 8+ U.S. standard drinks for women, 10+ men) is initiated during adolescence/emerging adulthood, increasing risk for negative outcomes, including blackouts.

Predictors of Booster Engagement Following a Web-Based Brief Intervention for Alcohol Misuse Among National Guard Members: Secondary Analysis of a Randomized Controlled Trial.

Background: Alcohol misuse is a major health concern among military members. Reserve component members face unique barriers as they live off base with limited access to behavioral health services. Web and app-based brief interventions are a promising means to improve access to treatment for those who misuse alcohol, with the use of booster sessions to enhance effectiveness, solidify gains, and reinforce changes.

Alcohol and cannabis motives: Differences in daily motive endorsement on alcohol, cannabis, and alcohol/cannabis co-use days in a cannabis-using sample.

Objective: Same day use of alcohol and cannabis is prevalent among emerging/young adults and increases the risk for negative consequences. Although motives for alcohol and cannabis use are well-documented, specific motives on co-use days are under-investigated. We examined differences in motives on single substance use (i.

Benzodiazepine Prescribing from VA and Medicare to Dually Enrolled Older Veterans: A Retrospective Cohort Study.

Background: There has been a reduction in BZD prescribing in the Veterans Affairs (VA) health care system since 2013. It is unknown whether the decline in VA-dispensed BZDs has been offset by Medicare Part D prescriptions.

Objectives: To examine (1) whether, accounting for Part D, declines in BZD prescribing to older Veterans remain; (2) patient characteristics associated with obtaining BZDs outside VA and facility variation in BZD source (VA only, VA and Part D, Part D only).

Piloting a brief intervention plus mobile boosters for drug use among emerging adults receiving emergency department care.

Purpose: There are few efficacious prevention interventions for emerging adults (ages 18-25) drug use and concomitant risks (e.g., sexual risk behaviors).

Bariatric surgery and the risk of alcohol-related cirrhosis and alcohol misuse.

Background & Aims: Bariatric surgery is common, but alcohol misuse has been reported following these procedures. We aimed to determine if bariatric surgery is associated with increased risk of alcohol-related cirrhosis (AC) and alcohol misuse.

Methods: Retrospective observational analysis of obese adults with employer-sponsored insurance administrative claims from 2008 to 2016.

Benzodiazepine Use among Medicare, Commercially Insured, and Veteran Older Adults, 2013-2017.

Background/objectives: Benzodiazepines (BZDs) are widely prescribed to older adults. Although prescribing has declined in the U.S.

Gaps in Alcohol Screening and Intervention Practices in Surgical Healthcare: A Qualitative Study.

Objectives: Risky alcohol use before surgery is associated with an increased risk of postoperative complications and longer hospital stays. Preoperative alcohol interventions can improve surgical outcomes but are not commonly integrated into routine care. This study sought to better understand patient's and provider's perceptions of alcohol-related surgical health and healthcare practices and illuminate gaps in care and how they could be improved.

Efficacy of a Psychosocial Pain Management Intervention for Men and Women With Substance Use Disorders and Chronic Pain: A Randomized Clinical Trial.

Importance: Chronic pain is common in those with substance use disorders (SUDs) and predicts poorer addiction treatment outcomes. A critical challenge for addiction treatment is to develop effective methods to improve pain-related and substance use-related outcomes for those in treatment for SUDs.

Objective: To examine the efficacy of an integrated behavioral pain management intervention (Improving Pain During Addiction Treatment [ImPAT]) for men and women with SUDs to treat pain, functioning, and substance use.

Polysubstance use and association with opioid use disorder treatment in the US Veterans Health Administration.

Aims: To understand the role of comorbid substance use disorders (SUDs), or polysubstance use, in the treatment of opioid use disorder (OUD), this study compared patients with OUD only to those with additional SUDs and examined association with OUD treatment receipt.

Design, Setting And Participants: Retrospective national cohort study of Veterans diagnosed with OUD (n = 65 741) receiving care from the US Veterans Health Administration (VHA) in fiscal year (FY) 2017.

Measurements: Patient characteristics were compared among those diagnosed with OUD only versus those with one other SUD (OUD + 1 SUD) and with multiple SUDs (OUD + ≥ 2 SUDs).

Social Media Interventions for Risky Drinking Among Adolescents and Emerging Adults: Protocol for a Randomized Controlled Trial.

Background: Despite intervention efforts to date, the prevalence of risky drinking among adolescents and emerging adults remains high, increasing the risk for health consequences and the development of alcohol use disorders. Peer influences are particularly salient among this age group, including via social media. Thus, the development of efficacious early interventions for youth, delivered with a broad reach via trained peers on social media, could have an important role in addressing risky drinking and concomitant drug use.

Association between relationship quality and concurrent alcohol use and sedative-tranquilizer misuse in middle and later life.

Objectives: Mid-life adults have notably higher rates of alcohol and other substance misuse than older adults and maintain higher levels of use over time. Social isolation has been linked to higher risk use with increasing age. The purpose of this study is to examine the associations between social relationships, drinking, and misuse of sedative-tranquilizers.