Bold Krysten W, Fucito Lisa M, Corbin William R, DeMartini Kelly S, Leeman Robert F, Kranzler Henry R, O'Malley Stephanie S
Department of Psychiatry.
Department of Psychology, Arizona State University.
Exp Clin Psychopharmacol. 2016 Oct;24(5):367-375. doi: 10.1037/pha0000090.
Heavy drinking among young adults is a serious public health problem. Naltrexone, an opioid antagonist, has been shown to reduce drinking in young adults compared to placebo and can be taken on a targeted (i.e., as needed) basis. Understanding risk factors for drinking and naltrexone effects within-person in young adults may help to optimize the use of targeted naltrexone. The current study was a secondary analysis of daily diary data from 127 (n = 40 female) young adults (age 18-25) enrolled in a double-blind clinical trial of daily (25 mg) plus targeted (25 mg) naltrexone versus placebo. Hierarchical linear models were used to examine the effects of daily affect, urge, and taking targeted medication on same-day risk of drinking to intoxication (defined as estimated blood-alcohol-concentration, BAC ≥ .08 g%). Results indicated urge significantly mediated within-person positive affect-drinking relations on a daily level. Specifically, positive affect was associated with greater urge to drink, which in turn was associated with greater odds of BAC ≥ .08 g%. Furthermore, days of greater positive affect and urge were associated with taking a targeted dose of medication, which reduced the likelihood of intoxication by nearly 23% in the naltrexone group compared to placebo. Gender and family history of alcohol dependence were examined as moderators of these daily level effects. These results provide further evidence of naltrexone's ability to reduce alcohol consumption in young adults and identify potential within-person risk processes related to heavy drinking that could inform alcohol-related interventions for this population. (PsycINFO Database Record
年轻人酗酒是一个严重的公共卫生问题。纳曲酮作为一种阿片类拮抗剂，与安慰剂相比，已被证明能减少年轻人的饮酒量，并且可以按需服用。了解年轻人饮酒的风险因素以及纳曲酮对个体的影响，可能有助于优化按需服用纳曲酮的使用。本研究是对127名（40名女性）年龄在18 - 25岁的年轻人的日常日记数据进行的二次分析，这些年轻人参与了一项每日（25毫克）加按需（25毫克）服用纳曲酮与安慰剂的双盲临床试验。采用分层线性模型来检验日常情绪、冲动以及服用按需药物对当日醉酒饮酒风险（定义为估计血液酒精浓度，BAC≥0.08 g%）的影响。结果表明，冲动在日常水平上显著介导了个体内部积极情绪与饮酒之间的关系。具体而言，积极情绪与更强的饮酒冲动相关，而更强的饮酒冲动又与BAC≥0.08 g%的更高几率相关。此外，积极情绪和冲动程度较高的日子与服用按需剂量的药物相关，与安慰剂相比，纳曲酮组服用按需剂量药物可使醉酒可能性降低近23%。研究还考察了性别和酒精依赖家族史作为这些日常水平效应的调节因素。这些结果进一步证明了纳曲酮减少年轻人酒精摄入量的能力，并确定了与酗酒相关的潜在个体内部风险过程，可为针对该人群的酒精相关干预措施提供参考。（PsycINFO数据库记录
