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How does binge drinking affect risky behaviors on the road?
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Abstracts / Drug and Alcohol Dependence 146 (2015) e34–e117
How does binge drinking affect risky behaviors on the road? Graciela Pasa 1 , Tanara R. Sousa 1 , Jeffrey Lunnen 2 , Flavio P. Pechansky 1 1 Center for Drug and Alcohol Research – CPAD, Federal University of Rio Grande do Sul – UFRGS, Porto Alegre, Brazil 2 Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
Aims: Alcohol abuse can lead to engaging in risky behaviors. In the context of road safety, evidence points to an association between binge drinking and crashes as well as injury severity. The aim of this study is to compare the differences between three groups of drivers: (a) binge drank in the last year, (b) who drank but did not binge in the last year and (c) drivers who did not drink in the last year – in relation to socio-demographic characteristics and risky behaviors. Methods: A knowledge, attitude and perception (KAP) survey was conducted among drivers from two capital cities (Palmas and Teresina), representing the North and Northeast regions of Brazil. In October and November 2013, 1556 face to face interviews were conducted (30.3% binge-drinking [BD], 26% no binge-drinking [NBD] and 43.7% no drinking [ND]); sampling was done by quotas, according to driver’s sex and age. The variables were analyzed through chi-square test. Results: Drivers who reported binge drinking are younger (BD: 34.6 ± 10.5 years; NBD: 38.2 ± 12.2 years; ND: 40.5 ± 13.8 years, p < 0.001) and mostly males (BD: 81.6%; NBD: 74.5%; ND: 61.3, p < 0.001). In relation to risky behaviors, 41% of those who binge drink used a cell phone while driving compared to 34.2% NBD and 25.6% ND (p < 0.001); 60% of binge drinkers reported being passengers to drivers who had been drinking as compared to 46.5% NBD and 30.4% ND (p < 0.001). Also binge drinkers comprised a greater proportion of drivers who were involved in a road traffic crash after drinking in the last year (BD: 15.9%; NBD: 6.2% and 5.1%, p < 0.001). Conclusions: Our findings suggest that binge drinkers are more prone to other risky behaviors, which could translate to greater vulnerability to road traffic injury. This information may be of use to authorities in Palmas and Teresina. We suggest additional research be done to understand motives behind drinking and driving behaviors, particularly among binge drinkers. Financial support: This study is supported by Bloomberg Philanthropies. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.542 A quality improvement innovation to establish a PCMH tailored to homeless veterans who utilize the ED Beena Patel 1 , Rishi Manchanda 1 , Ronald Andersen 1,2 , Lisa Altman 1,2 , Lillian Gelberg 1,2 1 Department of Veterans Affairs, Los Angeles, CA, United States 2 University of California Los Angeles, Los Angeles, CA, United States
Aims: Homeless veterans have high rates of medical, mental health, and substance use co-morbidities, and emergency department (ED) and inpatient service utilization. In 2013, VA established a homeless-oriented patient centered medical home national demonstration program, referred to as the Homeless Patient Aligned Care Team (HPACT). Unlike traditional PCMH
models, the West Los Angeles VA Medical Center (WLA) HPACT employed a series of complex primary care management interventions tailored to homeless Veterans seeking care in the ED for low-acuity problems. Methods: Development of the WLA HPACT was carried out in three phases – literature review, diagnosis, and implementation. In phase 1, we conducted a literature review of the factors contributing to homeless Veteran ED utilization patterns. In the diagnosis phase, we undertook a local needs assessment (conducted by informal stakeholder focus groups) to determine the organizational context for the WLA HPACT program and how to best evaluate HPACT’s objective to reduce ED utilization rates for HPACT patients. The implementation phase employed a mixed-method progressfocused formative evaluation to examine patient characteristics, intervention processes, ED utilization patterns, staff perceptions and interventions to decrease ED visits. Results: Findings suggest high prevalence of patients with substance abuse needs (73%), increased engagement in substance abuse treatment programs after being enrolled in the HPACT program for 6 months (26%), and reduction in ED visits at 6 months (mean reduction 3.2 visits). Conclusions: The findings of this QI effort inform clinical and organization processes for the WLA HPACT that should be considered for on-going implementation. Recommendations for future implementation include complex care management interventions for patients with pain needs, substance abuse conditions, as well as modifications to organizational features of the program such as hours of operations, and substance use/mental health team composition. Financial support: Financial support was provided by VA. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.543 Influence of sensation seeking on d-amphetamine reinforcement Mollie E. Patrick 1 , Andrew C. Meyer 2 , Stephen T. Higgins 1,2 , Stacey C. Sigmon 1,2 1 Psychology, University of Vermont, Burlington, VT, United States 2 Psychiatry, University of Vermont, Burlington, VT, United States
Aims: Abuse of psychomotor stimulants is a significant public health problem. While many individuals experiment with stimulants, there is marked variability in the subjective and behavioral response to these drugs, which may influence susceptibility to abuse. One characteristic associated with drug use is sensation seeking (SS). While studies have suggested an association between SS and vulnerability for stimulant abuse, the precise relationship between these variables remains unknown. Methods: We conducted a NIDA-funded laboratory study in which 37 healthy adults received repeated opportunities to sample and choose between d-amphetamine (d-AMPH; 5, 10, 20 mg/70 kg) or placebo. The Zuckerman Sensation Seeking Scale V was administered at intake, providing an opportunity to investigate the influence of Total SS, as well as each of the four subscales, on sensitivity to d-AMPH reinforcement. Logistic regression based on GEE models was used to investigate the association between SS and d-AMPH choice. We hypothesized that elevated SS would predict subsequent increased d-AMPH choice. Results: Participants were 22.9 + 2.9 yrs old, 57% female and had 15.1 + 1.3 yrs of education. Among males, SS was a significant predictor of d-AMPH choice, with each one standard deviation increase in Thrill and Adventure Seeking, Experience Seeking, Disinhibition,
Abstracts / Drug and Alcohol Dependence 146 (2015) e34–e117
How does binge drinking affect risky behaviors on the road? Graciela Pasa 1 , Tanara R. Sousa 1 , Jeffrey Lunnen 2 , Flavio P. Pechansky 1 1 Center for Drug and Alcohol Research – CPAD, Federal University of Rio Grande do Sul – UFRGS, Porto Alegre, Brazil 2 Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
Aims: Alcohol abuse can lead to engaging in risky behaviors. In the context of road safety, evidence points to an association between binge drinking and crashes as well as injury severity. The aim of this study is to compare the differences between three groups of drivers: (a) binge drank in the last year, (b) who drank but did not binge in the last year and (c) drivers who did not drink in the last year – in relation to socio-demographic characteristics and risky behaviors. Methods: A knowledge, attitude and perception (KAP) survey was conducted among drivers from two capital cities (Palmas and Teresina), representing the North and Northeast regions of Brazil. In October and November 2013, 1556 face to face interviews were conducted (30.3% binge-drinking [BD], 26% no binge-drinking [NBD] and 43.7% no drinking [ND]); sampling was done by quotas, according to driver’s sex and age. The variables were analyzed through chi-square test. Results: Drivers who reported binge drinking are younger (BD: 34.6 ± 10.5 years; NBD: 38.2 ± 12.2 years; ND: 40.5 ± 13.8 years, p < 0.001) and mostly males (BD: 81.6%; NBD: 74.5%; ND: 61.3, p < 0.001). In relation to risky behaviors, 41% of those who binge drink used a cell phone while driving compared to 34.2% NBD and 25.6% ND (p < 0.001); 60% of binge drinkers reported being passengers to drivers who had been drinking as compared to 46.5% NBD and 30.4% ND (p < 0.001). Also binge drinkers comprised a greater proportion of drivers who were involved in a road traffic crash after drinking in the last year (BD: 15.9%; NBD: 6.2% and 5.1%, p < 0.001). Conclusions: Our findings suggest that binge drinkers are more prone to other risky behaviors, which could translate to greater vulnerability to road traffic injury. This information may be of use to authorities in Palmas and Teresina. We suggest additional research be done to understand motives behind drinking and driving behaviors, particularly among binge drinkers. Financial support: This study is supported by Bloomberg Philanthropies. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.542 A quality improvement innovation to establish a PCMH tailored to homeless veterans who utilize the ED Beena Patel 1 , Rishi Manchanda 1 , Ronald Andersen 1,2 , Lisa Altman 1,2 , Lillian Gelberg 1,2 1 Department of Veterans Affairs, Los Angeles, CA, United States 2 University of California Los Angeles, Los Angeles, CA, United States
Aims: Homeless veterans have high rates of medical, mental health, and substance use co-morbidities, and emergency department (ED) and inpatient service utilization. In 2013, VA established a homeless-oriented patient centered medical home national demonstration program, referred to as the Homeless Patient Aligned Care Team (HPACT). Unlike traditional PCMH
models, the West Los Angeles VA Medical Center (WLA) HPACT employed a series of complex primary care management interventions tailored to homeless Veterans seeking care in the ED for low-acuity problems. Methods: Development of the WLA HPACT was carried out in three phases – literature review, diagnosis, and implementation. In phase 1, we conducted a literature review of the factors contributing to homeless Veteran ED utilization patterns. In the diagnosis phase, we undertook a local needs assessment (conducted by informal stakeholder focus groups) to determine the organizational context for the WLA HPACT program and how to best evaluate HPACT’s objective to reduce ED utilization rates for HPACT patients. The implementation phase employed a mixed-method progressfocused formative evaluation to examine patient characteristics, intervention processes, ED utilization patterns, staff perceptions and interventions to decrease ED visits. Results: Findings suggest high prevalence of patients with substance abuse needs (73%), increased engagement in substance abuse treatment programs after being enrolled in the HPACT program for 6 months (26%), and reduction in ED visits at 6 months (mean reduction 3.2 visits). Conclusions: The findings of this QI effort inform clinical and organization processes for the WLA HPACT that should be considered for on-going implementation. Recommendations for future implementation include complex care management interventions for patients with pain needs, substance abuse conditions, as well as modifications to organizational features of the program such as hours of operations, and substance use/mental health team composition. Financial support: Financial support was provided by VA. http://dx.doi.org/10.1016/j.drugalcdep.2014.09.543 Influence of sensation seeking on d-amphetamine reinforcement Mollie E. Patrick 1 , Andrew C. Meyer 2 , Stephen T. Higgins 1,2 , Stacey C. Sigmon 1,2 1 Psychology, University of Vermont, Burlington, VT, United States 2 Psychiatry, University of Vermont, Burlington, VT, United States
Aims: Abuse of psychomotor stimulants is a significant public health problem. While many individuals experiment with stimulants, there is marked variability in the subjective and behavioral response to these drugs, which may influence susceptibility to abuse. One characteristic associated with drug use is sensation seeking (SS). While studies have suggested an association between SS and vulnerability for stimulant abuse, the precise relationship between these variables remains unknown. Methods: We conducted a NIDA-funded laboratory study in which 37 healthy adults received repeated opportunities to sample and choose between d-amphetamine (d-AMPH; 5, 10, 20 mg/70 kg) or placebo. The Zuckerman Sensation Seeking Scale V was administered at intake, providing an opportunity to investigate the influence of Total SS, as well as each of the four subscales, on sensitivity to d-AMPH reinforcement. Logistic regression based on GEE models was used to investigate the association between SS and d-AMPH choice. We hypothesized that elevated SS would predict subsequent increased d-AMPH choice. Results: Participants were 22.9 + 2.9 yrs old, 57% female and had 15.1 + 1.3 yrs of education. Among males, SS was a significant predictor of d-AMPH choice, with each one standard deviation increase in Thrill and Adventure Seeking, Experience Seeking, Disinhibition,