Binge Drinking Associations with Patrons’ Risk Behaviors and Alcohol Effects after Leaving a Nightclub: Sex Differences in the "Balada com Ciência" Portal Survey Study in Brazil

The purpose of the present study was to investigate the potential associations of binge drinking detected at the exit of nightclubs and risk behaviors and alcohol effects just after leaving the venue in a representative sample of Brazilian nightclub patrons according to sex. 

For this purpose, a portal survey study called Balada com Ciência was conducted in 2013 in the megacity of São Paulo, Brazil, using a two-stage cluster sampling survey design. Individual-level data were collected in 2422 subjects at the entrance and 1822 subjects at the exit of 31 nightclubs, and breath alcohol concentration (BrAC) was measured using a breathalyzer. The following day, 1222 patrons answered an online follow-up survey that included questions about risk behaviors and alcohol effects practiced just after leaving the nightclub. Weighted logistic regressions were used to analyze binge drinking associated with risk behaviors by sex. 

For both sexes, the most prevalent risk behaviors practiced after leaving a nightclub were drinking and driving (men=27.9%; women=20.4%), the use of illicit drugs (men=15.8%; women=9.4%) and risky sexual behavior (men=11.4%; women=6.8%). The practice of binge drinking increased the behavior of illicit drug use after leaving the nightclub by 2.54 times among men who drank and increased the risk of an episode of new alcohol use by 5.80 times among women who drank. Alcoholic blackouts were more prevalent among men and women whose BrAC was equivalent to binge drinking compared with patrons with a lower BrAC. 

Public policies aiming to reduce patrons’ BrAC at the exit of nightclubs, such as staff training in responsible beverage service and legislation to prevent alcohol sales to drunk individuals, would be useful to protect patrons from the risk behaviors associated with binge drinking in nightclubs.

Via:  http://ht.ly/RUn8I

By: Zila M. Sanchez,* Karen J. Ribeiro, and Gabriela A. Wagner

Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

A Forensic-Psychiatric Study of Sexual Offenders in Rio de Janeiro, Brazil

Sexual violence is defined as any sexual act forced upon a person who did not give his or her consent. Our objective is to investigate the socio-demographic features, clinical correlates, criminal behaviour characteristics, and the level of penal responsibility of sexual offenders who were referred to forensic psychiatric assessment in the city of Rio de Janeiro, Brazil. This is a cross-sectional descriptive study. All written reports made in the year of 2008 by court-appointed psychiatric experts on individuals charged with having committed sexual crimes and referred to the main forensic hospital in the State of Rio de Janeiro, Brazil, for assessment were reviewed. 

Forty-four expert reports were identified. All alleged offenders were male. Nineteen (43.2%) offenders did not receive any psychiatric diagnostic. Nine offenders (20.4%) were diagnosed with mental retardation. In 16 cases (36.4%), some form of mental or neurological disorder was diagnosed. Thirty-one (70.4%) offenders were considered fully responsible, eight (18.2%) partially responsible, and five (11.4%) not responsible by reason of insanity. The sexual crimes allegedly perpetrated by the offenders were rape (n=14, 32%), attempted rape (n=4, 9%), indecent assault (n=26, 59%), and indecent exposure (n=5, 11.4%). In 10 cases (22.7%), the offender was under alcohol influence at the moment of the crime. 

The profile of Brazilian sex offenders subject to forensic psychiatric assessment were male, caucasian, single, working part time, with no mental disorder, who perpetrated indecent assault.

Via: http://ht.ly/Rg6lc HT https://twitter.com/portalufrj

The Interplay Between Drug-Use Behaviors, Settings & Access to Care: Exploring Attitudes & Experiences of Crack Cocaine Users in Rio De Janeiro & São Paulo, Brazil

Despite the growing attention surrounding crack cocaine use in Brazil, little is understood about crack users’ histories, use patterns and the interplay of drug-use behaviors, settings, and access/barriers to care. Qualitative studies seldom cross-compare findings regarding people who use crack from different settings. This study aims to explore the insights of regular crack users in two major Brazilian cities and to examine how social and contextual factors, including stigma and marginalization, influence initial use and a range of health and social issues.

For study participants from both cities, frequent crack cocaine use plays a central role in daily life and leads to a range of physical, psychological, and social consequences. Common concerns among users include excessive crack use, engagement in risky habits, infrequent health service utilization, marginalization, and difficulty reducing use.

Disadvantaged conditions in which many crack cocaine users grow up and live may perpetuate risk behaviors and stigma may further marginalize users from necessary health and recovery services. Reducing stigma and moralizing discourse related to drug use, especially among health professionals and law enforcement personnel, may help encourage users to seek necessary care. New harm-reduction-based care and treatment alternatives for marginalized drug users are being developed in parts of Brazil and elsewhere and should be adapted and expanded for other populations in need.

Read at:   http://ht.ly/QzkAM HT @reitoriaUFRJ

Patterns of Alcohol Consumption and Related Behaviors in Brazil: Evidence from the 2013 National Health Survey (PNS 2013)

Below:  State-level prevalence rates of selected drinking behaviors among adults aged 18 and above, Brazil 2013.

Data source: PNS 2013, public use Arc-GIS shape files; authors’ calculations. Results include sample weights and control for survey design. Current drinkers defined as reporting having at least 1 drink in the past 30 days. Rates for drinking and driving are among current drinkers who also drive a car or motorcycle. Binge drinking defined as at least 5 (for men) or 4 (for women) drinks in one occasion among current drinkers. Frequent binge drinking defined as 4 or more episodes in the past 30 days, among binge drinkers.

Below:  Probability of drinking and driving by report of binge drinking, sex, and age.

Data source: PNS 2013, authors’ calculations. Results are predicted probabilities of self-reported drinking and driving, controlling for age, sex, educational attainment, rural and capital city residence, skin color, martial status, drinking before age 18, binge drinking, and interactions between age, sex, and binge drinking.

This study uses data from a nationally representative household survey (the 2013 National Health Survey, n = 62,986) to describe patterns of alcohol consumption and related behaviors among Brazilian adults. Analyses include descriptive and multivariable Poisson regression for self-reports in the past 30 days of: drinking any alcohol, binge drinking, binge drinking 4 or more times, and driving after drinking (DD); as well as age of alcohol consumption initiation. Results show that current drinking prevalence was 26%, with an average age of initiation of 18.7 years. Binge drinking was reported by 51% of drinkers, 43% of whom reported binge drinking 4 or more times. Drinking and driving was reported by nearly one quarter of those who drive a car/motorcycle. Current drinking was more likely among males, ages 25–34, single, urban, and those with more education. Binge drinking was more likely among males, older age groups, and people who started drinking before 18. Drinking and driving was higher among males, those with more education, and rural residents. Those who binge-drink were nearly 70% more likely to report DD. All behaviors varied significantly among Brazilian states. Given their potential health consequences, the levels of injurious alcohol behaviors observed here warrant increased attention from Brazilian policymakers and civil society.

Via:  http://goo.gl/z3hH0Y HT @UCLAFSPH