OBJECTIVES: This study developed prevalence estimates of gambling-related disorders in the United States and Canada, identified differences in prevalence among population segments, and identified changes in prevalence over the past 20 years METHODS: A meta-analytic strategy was employed to synthesize estimates from 119 prevalence studies This method produced more reliable prevalence rates than were available from any single study RESULTS: Prevalence estimates among samples of adolescents were significantly higher than estimates among samples of adults for both clinical (level 3) and subclinical (level 2) measures of disordered gambling within both lifetime and past-year time frames (eg, 39% vs 16% for lifetime estimates of level 3 gambling) Among adults, prevalence estimates of disordered gambling have increased significantly during the past 20 years CONCLUSIONS: Membership in youth, treatment, or prison population segments is significantly associated with experiencing gambling-related disorders

/pdf/estimating-the-prevalence-of-disordered-gambling-behavior-in-homkgp1ft5.pdf

Estimating the prevalence of disordered gambling behavior in the United States and Canada: a research synthesis.

Aims As part of a larger study to estimate the global burden of disease attributable to alcohol:

• to quantify the relationships between average volume of alcohol consumption, patterns of drinking and disease and injury outcomes, and
• to combine exposure and risk estimates to determine regional and global alcohol-attributable fractions (AAFs) for major disease and injury categories.


Design, methods, setting  Systematic literature reviews were used to select diseases related to alcohol consumption. Meta-analyses of the relationship between alcohol consumption and disease and multi-level analyses of aggregate data to fill alcohol–disease relationships not currently covered by individual-level data were used to determine the risk relationships between alcohol and disease. AAFs were estimated as a function of prevalence of exposure and relative risk, or from combining the aggregate multi-level analyses with prevalence data.

Findings  Average volume of alcohol consumption was found to increase risk for the following major chronic diseases: mouth and oropharyngeal cancer; oesophageal cancer; liver cancer; breast cancer; unipolar major depression; epilepsy; alcohol use disorders; hypertensive disease; hemorrhagic stroke; and cirrhosis of the liver. Coronary heart disease (CHD), unintentional and intentional injuries were found to depend on patterns of drinking in addition to average volume of alcohol consumption. Most effects of alcohol on disease were detrimental, but for certain patterns of drinking, a beneficial influence on CHD, stroke and diabetes mellitus was observed.

Conclusions  Alcohol is related to many major disease outcomes, mainly in a detrimental fashion. While average volume of consumption was related to all disease and injury categories under consideration, pattern of drinking was found to be an additional influencing factor for CHD and injury. The influence of patterns of drinking may be underestimated because pattern measures have not been included in many epidemiologic studies. Generalizability of the results is limited by methodological problems of the underlying studies used in the present analyses. Future studies need to address these methodological issues in order to obtain more accurate risk estimates.

The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease: an overview.

Gender differences in risk factors and consequences for alcohol use and problems.

ion of relevant information from eligible articles and the creation of summary evidence tables presenting the key details and findings for the articles. The EPC paired trained abstractors with a senior reviewer, who used an analyticors with a senior reviewer, who used an analytic framework to guide development of abstraction tables. The EPC researchers used the same framework to rate the quality of both the primary research and primary community-based participation elements. They rated the quality of only those studies (often represented by a set of published articles) representative of a completed intervention study evaluation, or an observational study designed to permit extrapolation beyond the study population.

Community-based participatory research: assessing the evidence

A heavy load of symbolism surrounds psychoactive substance use, for reasons which are discussed. Psychoactive substances can be prestige commodities, but one or another aspect of their use seems to attract near--universal stigma and marginalization. Processes of stigmatization include intimate process of social control among family and friends; decisions by social and health agencies; and governmental policy decisions. What is negatively moralized commonly includes incurring health, casualty or social problems, derogated even by other heavy users; intoxication itself; addiction or dependence, and the loss of control such terms describe; and in some circumstances use per se. Two independent literatures on stigma operate on different premises: studies oriented to mental illness and disability consider the negative effects of stigma on the stigmatized, and how stigma may be neutralized, while studies of crime generally view stigma more benignly, as a form of social control. The alcohol and drug literature overlap both topical areas, and includes examples of both orientations. Whole poverty and heavy substance use are not necessary related, poverty often increases the harm for a given level of use. Marginalization and stigma commonly add to this effect. Those in treatment for alcohol or drug problems are frequently and disproportionately marginalized. Studies of social inequality and substance use problems need to pay attention also to processes of stigmatization and marginalization and their effect on adverse outcomes.

Stigma, social inequality and alcohol and drug use

In a national sample of 11 634 Canadians aged IS years and above, risk curves for harm to six life-areas from one's own drinking and for assault by another drinker rose steadily with the respondent's volume of alcohol consumption. While drinking five or more drinks on an occasion at least once a month substantially raised the risk at a given volume of drinking, the risk rose with volume even among those not regularly drinking Jive or more drinks. These relationships remained in logistic regressions which controlled for gender, age and educational level. Younger respondents, those without higher education and men reported more harm for a given level of their own drinking although differences by gender disappeared above one-third of one drink per day. Three sets of guidelines for low-risk drinking—two from Canada, and one generally used in Britain—were compared in terms of the proportions of respondents reporting harm from their own drinking among those who had kept within the guideline in the previous 7 days' drinking. More restrictiveness in the guidelines was associated with substantial reductions in reported drinking-related harm

The risk of harm to oneself from drinking, Canada 1989.

Objective:To demonstrate the link between gambling, alcohol and drug problems among Ontario adults and to present information on the relationship between expenditures on gambling and type of gambli...

Alcohol, drugs and gambling in the Ontario adult population, 1994

Entry to treatment is often precipitated by suggestions or pressure from relatives or friends, but we know little of the circumstances in which suggestions to cut down on drinking include advice to seek professional help. In 1993, 1034 Ontario adults were asked in a random digit dialling telephone survey if they had said something to a friend or relative about their drinking, or suggested they cut down. About 35% had said something within the last year, and 15% had taken the further step of suggesting they seek professional help or helping them get assistance. Respondents were asked a series of questions about the circumstances of the most recent time they had said something to the person. Whether respondents who said something recommended seeking professional help is related to these circumstances, and to the respondent's demographics and relationship to the drinker.

Determinants of suggestions for alcohol treatment.

Gambling in Ontario : a report from a general population survey on gambling-related problems and opinions

An overview of community-based action research projects is presented focusing on the community/research agenda interaction, the difficulties and rewards of this approach, and the unique opportunities of these projects. The potential for policy development as a result of these initiatives has not been fully explored, and some suggestions for the implementation of policies based on the results of action research projects are made. The policy implication of several specific interventions are discussed, along with the limitations and benefits of policy components within a project, rather than as spin-offs. The paper concludes with suggestions for planning community action projects to enhance the policy formulation aspect of these projects.

Jacqueline Ferris

Papers

The risk of harm to oneself from drinking, Canada 1989.

Alcohol, drugs and gambling in the Ontario adult population, 1994

Determinants of suggestions for alcohol treatment.

Gambling in Ontario : a report from a general population survey on gambling-related problems and opinions

Community-based research initiatives in prevention