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The changing face of nicotine use in England: Age-specific annual trends, 2014 to 2024 英国尼古丁使用的变化面貌:2014年至2024年特定年龄的年度趋势。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-07 DOI: 10.1111/add.70243
Sarah E. Jackson, Lion Shahab, Vera Buss, Harry Tattan-Birch, Sharon Cox, Eve Taylor, Jamie Brown
<div> <section> <h3> Aims</h3> <p>To examine age-specific trends in patterns of nicotine use in England between 2014 and 2024, including types of products used, exclusive and dual use of smoking and vaping, smoking frequency and the smoking history of those who vape.</p> </section> <section> <h3> Design</h3> <p>Repeat monthly cross-sectional analysis of data from a nationally representative survey (the Smoking Toolkit Study).</p> </section> <section> <h3> Setting</h3> <p>England, 2014–2024.</p> </section> <section> <h3> Participants</h3> <p>217 433 adults (≥18y).</p> </section> <section> <h3> Measurements</h3> <p>Prevalence of (non-medicinal) nicotine use overall and by product type (combustible tobacco, e-cigarettes, heated tobacco products and nicotine pouches), exclusive and dual use of smoking and vaping, daily versus non-daily smoking and smoking history among those who vape. Estimates were stratified by age group (18–24, 25–34, 35–44, 45–54, 55–64, ≥65y) and year. Prevalence ratios (PR) with 95% confidence intervals (CI) were calculated to quantify relative changes in prevalence from 2014 to 2024.</p> </section> <section> <h3> Findings</h3> <p>Nicotine use patterns varied markedly by age. Among 18–24-year-olds, vaping prevalence increased fivefold, from 5.0% in 2014 to 25.0% in 2024 (PR = 5.00; 95% CI = 4.18–5.91), surpassing smoking by 2023. This contributed to an overall increase in nicotine use (26.1% to 36.5%; PR = 1.40; 95% CI = 1.29–1.53), despite declining smoking rates (25.3% to 19.9%; PR = 0.79; 95% CI = 0.71–0.88). In this age group, exclusive vaping became the most common mode of nicotine use, while nicotine pouch use also increased. Daily smoking declined substantially among 18–24-year-olds who smoked, with a shift toward non-daily smoking. Similar trends were observed among adults aged 25–44, though changes were smaller with increasing age. In older age groups (≥45), daily smoking declined modestly while vaping rose gradually, but there was little overall change in the prevalence of nicotine use. Most adults who vaped had a history of smoking, but the proportion who had never regularly smoked increased, particularly among 18–24-year-olds (4.3% to 34.3%; PR = 7.98; 95% CI = 4.56–26.2).</p> </section> <section> <h3> Conclusions</h3>
目的:研究2014年至2024年间英国尼古丁使用模式的年龄特定趋势,包括使用的产品类型、吸烟和电子烟的专用和双重用途、吸烟频率和电子烟使用者的吸烟史。设计:每月重复一次全国代表性调查(吸烟工具包研究)数据的横断面分析。背景:英国,2014-2024年。参与者:217433名成人(≥18岁)。测量方法:总体和按产品类型(可燃烟草、电子烟、加热烟草制品和尼古丁袋)的(非药用)尼古丁使用的流行程度,吸烟和电子烟的专用和双重用途,每日吸烟与非每日吸烟,以及电子烟使用者的吸烟史。评估结果按年龄组(18-24岁、25-34岁、35-44岁、45-54岁、55-64岁、≥65岁)和年龄分层。计算患病率比(PR)和95%置信区间(CI),以量化2014年至2024年患病率的相对变化。研究发现:尼古丁的使用模式因年龄的不同而有显著差异。在18-24岁的人群中,电子烟的流行率增加了五倍,从2014年的5.0%增加到2024年的25.0% (PR = 5.00; 95% CI = 4.18-5.91),到2023年将超过吸烟。尽管吸烟率下降(25.3%至19.9%;PR = 0.79; 95% CI = 0.71-0.88),但这导致了尼古丁使用的总体增加(26.1%至36.5%;PR = 1.40; 95% CI = 1.29-1.53)。在这一年龄组中,纯电子烟成为最常见的尼古丁使用方式,而尼古丁袋的使用量也有所增加。在18-24岁的吸烟者中,每日吸烟率大幅下降,并转向非每日吸烟。在25-44岁的成年人中也观察到类似的趋势,尽管随着年龄的增长变化较小。在年龄较大的年龄组(≥45岁)中,每日吸烟率略有下降,而电子烟的吸烟率逐渐上升,但尼古丁使用的总体变化不大。大多数吸电子烟的成年人都有吸烟史,但从未经常吸烟的比例有所增加,尤其是18-24岁的人群(4.3%至34.3%;PR = 7.98; 95% CI = 4.56-26.2)。结论:尼古丁使用的代际变化正在英国发生。在过去十年中,年轻人中尼古丁的使用量有所上升,但他们越来越多地从每天吸烟转向电子烟或非日常吸烟。虽然老年人也显示出远离日常吸烟的趋势,但传统的吸烟模式在这一群体中仍然更为普遍。这些趋势表明,电子烟可能会逐渐取代吸烟,成为尼古丁消费的主要形式。
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引用次数: 0
Cannabis consumption in Australia 2018-2025: Socio-economic and regional trends from wastewater and survey data. 2018-2025年澳大利亚大麻消费:废水和调查数据的社会经济和区域趋势。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-05 DOI: 10.1111/add.70277
Rory Verhagen, Cobus Gerber, Phong Thai, Richard Bade, Jake O'Brien, Emma L Keller, Bradley S Simpson, Wayne Hall, Janni Leung, Kevin V Thomas, Jochen F Mueller, Benjamin J Tscharke

Background and aims: This study examined whether socio-economic status (SES) and geographic remoteness are associated with cannabis consumption across Australia by comparing wastewater-based surveillance (WBS) data and self-reported cannabis use in national household surveys.

Methods: We compared cannabis consumption estimates from 6 years of wastewater data from the National Wastewater Drug Monitoring Program (NWDMP) with cannabis use data from the National Drug Strategy Household Survey (NDSHS). We categorised the Index of Relative Socio-economic Advantage and Disadvantage (IRSAD) into quartiles for each wastewater catchment area. Three remoteness categories (Major Cities, Inner Regional, Outer Regional/Remote) from the Australian Bureau of Statistics were used to categorise wastewater and survey data by degree of urbanisation. Trends were analysed using linear regression, analysis of variance and logistic regression.

Results: Wastewater: Estimated cannabis consumption in wastewater increased between 2018 and 2025 annually across SES quartiles from 2.9% [95% confidence interval (CI) = 2.0-3.9%] for the most disadvantaged to 5.2% (95% CI = 3.2-7.3%) for the second most disadvantaged quartile. The annual rates increased for all three categories of remoteness and ranged from 3.6% (95% CI = 2.2-5.2%) to 4.8% (95% CI = 4.2-5.5%) for Inner Regional and Major Cities, respectively. Consumption was statistically significantly higher in the most disadvantaged SES quartile (3000 mg/1000 people/day, 95% CI = 2900-3100) than in the least disadvantaged (1200 mg/1000 people/day, 95% CI = 1100-1200, P < 0.001). It was also highest in the most remote category (2400 mg/1000 people/day, 95% CI = 2300-2500), compared with the most urban category (980 mg/1000 people/day, 95% CI = 960-1000, P < 0.001).

Survey: In the NDSHS the prevalence of regular cannabis use was higher in the most disadvantaged SES quintile (6.1%, 95% CI = 5.2-7.3% in 2022/2023) than in the least disadvantaged (4.2%, 95% CI = 3.5-5.1% in 2022/2023). It was also higher in the most remote category (5.9%, 95% CI = 4.8-7.4%) than in the most urban category (4.3%, 95% CI = 3.9-4.8%), in all survey years (i.e. 2016 and 2019).

Conclusions: Wastewater-based surveillance and survey data describe similar trends in population cannabis use by socio-economic status and urban remoteness in Australia from 2018 to 2025.

背景和目的:本研究通过比较废水监测(WBS)数据和全国家庭调查中自我报告的大麻使用情况,研究了澳大利亚的社会经济地位(SES)和地理位置偏远是否与大麻消费有关。方法:我们比较了来自国家废水药物监测计划(NWDMP)的6年废水数据的大麻消费估计与来自国家药物战略家庭调查(NDSHS)的大麻使用数据。我们将每个污水集水区的相对社会经济优势和劣势指数(IRSAD)分为四分位数。来自澳大利亚统计局的三个偏远地区类别(主要城市、内陆地区、外围地区/偏远地区)被用于按城市化程度对废水和调查数据进行分类。趋势分析采用线性回归、方差分析和逻辑回归。结果:废水:2018年至2025年期间,SES四分位数中废水中的大麻消费量估计每年增加,从最弱势群体的2.9%[95%置信区间(CI) = 2.0-3.9%]增加到第二弱势群体的5.2% (95% CI = 3.2-7.3%)。所有三类偏远地区的年患病率均有所上升,内陆地区和主要城市的年患病率分别为3.6% (95% CI = 2.2-5.2%)至4.8% (95% CI = 4.2-5.5%)。最弱势的SES四分位数(3000 mg/1000人/天,95% CI = 2900-3100)的大麻消费量显著高于最弱势的SES四分位数(1200 mg/1000人/天,95% CI = 1100-1200, P调查:在NDSHS中,最弱势的SES五分位数(6.1%,95% CI = 5.2-7.3%, 2022/2023)的大麻使用率高于最弱势的SES五分位数(4.2%,95% CI = 3.5-5.1%, 2022/2023)。在所有调查年份(即2016年和2019年)中,最偏远的类别(5.9%,95% CI = 4.8-7.4%)也高于最城市的类别(4.3%,95% CI = 3.9-4.8%)。结论:基于废水的监测和调查数据描述了2018年至2025年澳大利亚社会经济地位和城市偏远地区人口大麻使用的类似趋势。
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引用次数: 0
HEALing communities study results, questions and implications 康复社区研究结果、问题和影响。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-04 DOI: 10.1111/add.70273
Jonathan P. Caulkins
<p>The $350 million HCS was the ‘largest implementation science study ever funded in addiction research’ [<span>1</span>]. The evaluation was rigorous, with 67 communities in four states randomly assigned to the Communities that HEAL (CTH) treatment or to the control group. The stated goal was ‘to reduce opioid overdose deaths by 40% in three years’ predicated on a belief that ‘opioid overdose deaths are largely preventable’ [<span>1</span>].</p><p>HCS embodied the field's best wisdom by including (1) community engagement; (2) communication campaigns to increase awareness and demand for evidence based practices (EBPs) and to reduce stigma against people with opioid use disorder (OUD) and against medications for treating opioid use disorder (MOUD); and (3) a requirement that communities implement EBP for (3a) overdose education and naloxone distribution (OEND), (3b) MOUD and (3c) safer prescribing of opioid analgesics that could ‘significantly reduce opioid overdose deaths in a relatively short period of time’ [<span>1</span>].</p><p>Regarding the central outcome, there was a statistically not-significant 8% reduction in the opioid overdose death rate (<i>P</i> = 0.30) [<span>2</span>] and the overall overdose death rate (<i>P</i> = 0.26) [<span>3</span>]. Secondary outcomes included a statistically significant 37% decline in deaths from opioids combined with a psychostimulant other than cocaine, and small and not statistically significant reductions in deaths from opioids plus cocaine (6%) and opioids with benzodiazepine (1%). Outcomes for additional aims (e.g. testing the study's conceptually driven framework) are less easily summarized.</p><p>Related studies found no statistically significant effect on (1) initiation, retention, and linkage to MOUD; (2) the rate of waivered practitioners or active prescribing of buprenorphine; or (3) the rate of individuals receiving behavioral health services reflected in Medicaid claims [<span>4-6</span>]. However, ‘the CTH intervention significantly changed stakeholders' perceived community stigma toward OUD and MOUD’ (<i>P</i> = 0.0007 and <i>P</i> = 0.0066, respectively) [<span>7</span>].</p><p>These results challenge confidence that CTH's recipe of community engagement; reducing stigma; and EBP for MOUD, OEND and safer prescribing necessarily produce major changes in death and other health outcomes. Researchers, policy makers and others who had that confidence need to adjust their beliefs or identify reasons why the trial failed. Three main conjectures have been offered for why CTH could have failed even if its approach remains sound.</p><p>First, the intervention began shortly before coronavirus disease (COVID), hampering deployment. However, 235 EBPs were implemented by the start of the evaluation's comparison year [<span>2</span>], which extended through 30 June 2022. Additionally, implementation proceeded enough to reduce stigma [<span>7</span>], although COVID could have interfered more with healthca
3.5亿美元的HCS是“有史以来在成瘾研究中资助的最大的实施科学研究”。评估是严格的,四个州的67个社区被随机分配到接受CTH治疗的社区或对照组。声明的目标是“在三年内将阿片类药物过量死亡人数减少40%”,基于“阿片类药物过量死亡在很大程度上是可以预防的”这一信念。HCS体现了该领域的最佳智慧,包括:(1)社区参与;(2)开展宣传活动,提高对循证实践(ebp)的认识和需求,减少对阿片类药物使用障碍(OUD)患者和治疗阿片类药物使用障碍(mod)的耻辱感;(3)要求社区实施EBP (3a)过量教育和纳洛酮分发(OEND), (3b) mod和(3c)更安全的阿片类镇痛药处方,可以“在相对较短的时间内显着减少阿片类药物过量死亡”[1]。关于中心结局,阿片类药物过量死亡率(P = 0.30)和总过量死亡率(P = 0.26)下降8%,统计学上不显著。次要结局包括阿片类药物与可卡因以外的精神兴奋剂联合使用导致的死亡率有统计学意义的37%下降,阿片类药物加可卡因(6%)和阿片类药物加苯二氮卓类药物(1%)导致的死亡率有统计学意义的小幅下降。其他目标(例如测试研究的概念驱动框架)的结果不太容易总结。相关研究未发现统计学上显著的影响(1)发病、保留和与mod的关联;(二)丁丙诺啡放弃执业或者主动开药的比例;或(3)在医疗补助申请中反映的个人接受行为健康服务的比率[4-6]。然而,“CTH干预显著改变了利益相关者对OUD和mod的社区耻辱感”(P = 0.0007和P = 0.0066)。这些结果挑战了CTH社区参与配方的信心;减少污名;以及治疗mod、OEND的EBP和更安全的处方必然会对死亡和其他健康结果产生重大变化。研究人员、政策制定者和其他有信心的人需要调整他们的信念,或者找出试验失败的原因。对于为什么CTH可能失败,尽管它的方法仍然是合理的,有三个主要的猜想。首先,干预措施在冠状病毒病(COVID)前不久开始,阻碍了部署。然而,截止到2022年6月30日的评估比较年[2]开始时,实施了235个ebp。此外,实施的进展足以减少耻辱感,尽管与减少耻辱感的努力相比,COVID对医疗服务的干扰可能更大。其次,“非法毒品市场的变化可能降低了干预的有效性,因为芬太尼成为了一种更普遍的阿片类药物……(而且)我们不知道随着时间的推移,芬太尼使用量的激增在各个社区是否相似”。图1绘制了包含对照社区的县、包含干预社区的县和干预州的其他县的非法阿片类药物芬太尼的比例(参见Caulkins和Giri获取更多数据)。芬太尼在这三个人中传播相似。如果有什么区别的话,对照县的基线和评估之间的差异更大,这可能增强而不是减弱CTH的明显有效性。因此,尽管芬太尼时代的CTH可能不如以前有效,但尚不清楚芬太尼传播的细节是否导致HCS对CTH的评估出现假阴性结果。第三,“选定ebp的HCS时间表和覆盖范围可能不够”;也就是说,ebp可能会产生变化——但不是很快——而且/或者剂量太小。Barocas等人对用于干预的资源的经济价值的bbbb10分析可能支持后一种观点。尽管HCS的研究预算接近3.5亿美元,但HCS用于实施CTH的支付总额仅为3750万美元。实物资源(例如社区成员的时间)和非hcs财政支持增加了2640万美元。因此,用于CTH的资源的总经济价值为6380万美元,即每个干预点仅为193万美元。此外,这些资源的一半用于社区参与,更多用于传播活动,只剩下三分之一(每个站点66.8万美元)用于实施EBP战略。从理论上讲,第四种可能性是,由于CTH授权每个社区从EBP列表中做出自己的选择,社区可能做出了不明智的选择。如果他们选择了证据清单中较弱的选项,那可能会稀释总体影响。 对于那些倾向于根据HCS结果调整对CTH的信念的人来说,有很多可能性。以下是我思考的四种可能性:(1)也许减少耻辱感努力的力量被夸大了,因为HCS减少了耻辱感,但没有产生其他结果。(注:评估耻辱感减少对远端结果(如死亡)影响的随机对照试验与mod的随机对照试验相比较少。)(2) CTH可能在小规模研究中具有较高的疗效,但在大规模研究中效果不佳。(3)也许EBP具有成本效益(每个站点在编程上的投资仅为66.8万美元,每个站点挽救一条生命的成本是合理的),但在人口水平上挽救的生命不足以明显扭转曲线。(4)也许EBP可以扭转这一趋势,但其投资规模要比设计高铁系统的规划者预计的要大得多。考虑到HCS的结果,我也想知道是什么让美国和加拿大在2023年中期到2025年中期之间的死亡率下降了8%以上。我不主张一种观点凌驾于另一种观点之上,也不希望读者一定同意我的观点。尽管如此,我还是建议我们共同应对这一挑战,并对思想上的一些变化持开放态度。如果我们不以某种方式改变我们的想法,当这笔钱可以在大约500个社区资助cth规模的EBP项目时,我们是否可以要求纳税人再提供3.5亿美元的研究?公共卫生界经常敦促人们在从疫苗到饮食建议再到缓解COVID等问题上听从科学证据。我们会注意到HCS的研究证据,从而在某种程度上改变我们的想法吗?乔纳森·p·考尔金斯:原稿(主笔);写作-审查和编辑(主导)。无。支持图1的数据由HIDTA PMP程序提供。它们不能由作者直接分享,但应从HIDTA PMP提供给任何希望复制该图的人。
{"title":"HEALing communities study results, questions and implications","authors":"Jonathan P. Caulkins","doi":"10.1111/add.70273","DOIUrl":"10.1111/add.70273","url":null,"abstract":"&lt;p&gt;The $350 million HCS was the ‘largest implementation science study ever funded in addiction research’ [&lt;span&gt;1&lt;/span&gt;]. The evaluation was rigorous, with 67 communities in four states randomly assigned to the Communities that HEAL (CTH) treatment or to the control group. The stated goal was ‘to reduce opioid overdose deaths by 40% in three years’ predicated on a belief that ‘opioid overdose deaths are largely preventable’ [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;HCS embodied the field's best wisdom by including (1) community engagement; (2) communication campaigns to increase awareness and demand for evidence based practices (EBPs) and to reduce stigma against people with opioid use disorder (OUD) and against medications for treating opioid use disorder (MOUD); and (3) a requirement that communities implement EBP for (3a) overdose education and naloxone distribution (OEND), (3b) MOUD and (3c) safer prescribing of opioid analgesics that could ‘significantly reduce opioid overdose deaths in a relatively short period of time’ [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Regarding the central outcome, there was a statistically not-significant 8% reduction in the opioid overdose death rate (&lt;i&gt;P&lt;/i&gt; = 0.30) [&lt;span&gt;2&lt;/span&gt;] and the overall overdose death rate (&lt;i&gt;P&lt;/i&gt; = 0.26) [&lt;span&gt;3&lt;/span&gt;]. Secondary outcomes included a statistically significant 37% decline in deaths from opioids combined with a psychostimulant other than cocaine, and small and not statistically significant reductions in deaths from opioids plus cocaine (6%) and opioids with benzodiazepine (1%). Outcomes for additional aims (e.g. testing the study's conceptually driven framework) are less easily summarized.&lt;/p&gt;&lt;p&gt;Related studies found no statistically significant effect on (1) initiation, retention, and linkage to MOUD; (2) the rate of waivered practitioners or active prescribing of buprenorphine; or (3) the rate of individuals receiving behavioral health services reflected in Medicaid claims [&lt;span&gt;4-6&lt;/span&gt;]. However, ‘the CTH intervention significantly changed stakeholders' perceived community stigma toward OUD and MOUD’ (&lt;i&gt;P&lt;/i&gt; = 0.0007 and &lt;i&gt;P&lt;/i&gt; = 0.0066, respectively) [&lt;span&gt;7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;These results challenge confidence that CTH's recipe of community engagement; reducing stigma; and EBP for MOUD, OEND and safer prescribing necessarily produce major changes in death and other health outcomes. Researchers, policy makers and others who had that confidence need to adjust their beliefs or identify reasons why the trial failed. Three main conjectures have been offered for why CTH could have failed even if its approach remains sound.&lt;/p&gt;&lt;p&gt;First, the intervention began shortly before coronavirus disease (COVID), hampering deployment. However, 235 EBPs were implemented by the start of the evaluation's comparison year [&lt;span&gt;2&lt;/span&gt;], which extended through 30 June 2022. Additionally, implementation proceeded enough to reduce stigma [&lt;span&gt;7&lt;/span&gt;], although COVID could have interfered more with healthca","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 2","pages":"222-224"},"PeriodicalIF":5.3,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145675976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Buprenorphine-based treatments outcomes in pregnant opioid-dependent women: A systematic review and meta-analysis. 基于丁丙诺啡的阿片类药物依赖孕妇治疗结果:系统回顾和荟萃分析。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-04 DOI: 10.1111/add.70265
Farzad Akbarzadeh, Alireza Ebrahimi

Background and aims: Opioid addiction poses a significant challenge to both the health of mothers and the outcomes for their newborns. Treatments based on buprenorphine offer a proven strategy for addressing opioid dependence among pregnant women. Various studies have examined the effectiveness of buprenorphine treatments versus methadone, revealing several potential advantages of buprenorphine for the outcomes of newborns. This systematic review sought to clarify the benefits and risks associated with buprenorphine therapy.

Methods: The PubMed, Web of Science and Scopus databases were searched with keywords for qualifying papers published before February 2025. Mean differences (MD) and 95% confidence intervals (CIs) were calculated for continuous data, while pooled proportions were estimated for categorical variables. Interstudy heterogeneity and publication bias were assessed using I2 and Egger's tests with Meta-Essential software analyses.

Results: The initial database search identified 2019 studies. Following a screening process based on inclusion criteria, 38 studies were selected for data extraction. The number of participants involved in all included studies was 5524. The results indicated that infants exposed to methadone had a higher incidence of neonatal abstinence syndrome (NAS) and required more pharmacologic treatment compared with those exposed to buprenorphine-naloxone (0.44, 95% CI = 0.25-0.75, P < 0.01). Additionally, infants exposed to buprenorphine had slightly higher birth weights than those exposed to methadone (0.17 kg, 95% CI = -0.14 to 1.49, P = 0.049), which might be linked to a greater need for NAS treatment.

Conclusion: Compared with methadone in treating opioid use disorder during pregnancy, buprenorphine-based therapies, buprenorphine-naloxone in particular, have demonstrated greater efficacy in enhancing neonatal outcomes.

背景和目的:阿片类药物成瘾对母亲的健康及其新生儿的结局构成了重大挑战。基于丁丙诺啡的治疗为解决孕妇阿片类药物依赖提供了一种行之有效的策略。各种研究已经检查了丁丙诺啡与美沙酮治疗的有效性,揭示了丁丙诺啡对新生儿结局的几个潜在优势。本系统综述旨在阐明丁丙诺啡治疗的益处和风险。方法:检索2025年2月前发表的符合条件的论文,检索PubMed、Web of Science和Scopus数据库。对连续数据计算平均差异(MD)和95%置信区间(ci),对分类变量估计合并比例。采用Meta-Essential软件分析的I2和Egger检验评估研究间异质性和发表偏倚。结果:最初的数据库搜索确定了2019项研究。在基于纳入标准的筛选过程中,选择38项研究进行数据提取。所有纳入研究的参与者人数为5524人。结果显示,与丁丙诺啡-纳洛酮组相比,美沙酮组新生儿戒断综合征(NAS)发生率更高,且需要更多的药物治疗(0.44,95% CI = 0.25-0.75, P)。结论:与美沙酮组相比,丁丙诺啡为主的治疗方法,尤其是丁丙诺啡-纳洛酮组在改善妊娠阿片类药物使用障碍方面效果更好。
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引用次数: 0
Associations between county-level e-cigarette-inclusive Tobacco 21 law population coverage and e-cigarette use behaviors among United States adolescents in Monitoring the Future. 在监测未来中,美国青少年电子烟使用行为与县级烟草21法律人口覆盖率之间的关系。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-04 DOI: 10.1111/add.70266
James H Buszkiewicz, Catherine A Vander Woude, Yanmei Xie, Steven Cook, Bukola Usidame Peters, Megan E Patrick, Michael R Elliott, James F Thrasher, Nancy L Fleischer
<p><strong>Background and aims: </strong>In the United States (US), Tobacco 21 (T21) laws set the minimum legal sale age for all tobacco products to 21 years. This study aimed to examine whether e-cigarette-inclusive T21 laws were associated with e-cigarette use behaviors and related disparities among US adolescents.</p><p><strong>Design: </strong>We used nationally representative, repeated cross-sectional Monitoring the Future data to compare self-reported current e-cigarette use (2014-2022) and first e-cigarette initiation (2015-2022) among adolescents in counties with 100% ('full') versus <100% ('partial or no') e-cigarette-inclusive T21 law population coverage using modified Poisson regression, examining differences by sex, race and ethnicity, parental educational attainment and college educational expectations through interactions.</p><p><strong>Setting: </strong>United States.</p><p><strong>Participants: </strong>8th, 10th and 12th graders.</p><p><strong>Measurements: </strong>County-level e-cigarette-inclusive T21 law population coverage was determined using Tobacco 21 Population Coverage Database and US Census Bureau population data. Current e-cigarette use was defined as any past 30-day use among the entire sample. First e-cigarette initiation was defined as first use in the current grade among adolescents who had not initiated use prior to the current grade.</p><p><strong>Findings: </strong>Compared with 8th, 10th and 12th graders in counties with partial or no e-cigarette-inclusive T21 law coverage, 8th [marginal effect (ME) = -1.8%, 95% confidence interval (CI) = -3.1% to -0.6%], 10th (ME = -2.6%, 95% CI = -4.6% to -0.6%) and 12th graders (ME = -2.7%, 95% CI = -5.2% to -0.1%) in counties with full coverage had a lower current e-cigarette use prevalence. For current e-cigarette use, we also observed statistically significant interactions by sociodemographic factors. Across all grades, full [8th: predicted prevalence (PP) = 5.9%, 95% CI = 4.7%-7.1%; 10th: PP = 11.8%, 95% CI = 10.2%-13.4%; 12th: 18.1%, 95% CI = 15.6%-20.6%] versus partial or no coverage (8th: PP = 7.5%, 95% CI = 6.2%-8.8%; 10th: PP = 16.3%, 95% CI = 15.0%-17.6%; 12th: 23.4%, 95% CI = 21.9%-24.8%) was associated with lower current e-cigarette use among males but not females. By race and ethnicity, associations were statistically significant across all grades, but the magnitude and direction of these associations varied by subgroup and grade. Among 12th graders, full (PP = 16.1%, 95% CI = 13.9%-18.3%) versus partial or no coverage (PP = 20.5%, 95% CI = 19.0%-22.1%) was associated with lower current e-cigarette use among those who said they 'probably will' graduate from a four-year college but not among those with other educational expectations. We did not find sufficient evidence to support an association between e-cigarette-inclusive T21 law coverage and first e-cigarette initiation overall or across sociodemographic subgroups.</p><p><strong>Conclusions: </strong>E-cigare
背景和目的:在美国,《21世纪烟草法》(T21)规定所有烟草制品的最低合法销售年龄为21岁。本研究旨在研究包括电子烟在内的T21法律是否与美国青少年的电子烟使用行为和相关差异有关。设计:我们使用具有全国代表性的重复横断面监测未来数据,比较100%(“完整”)县青少年自我报告的当前电子烟使用情况(2014-2022年)和首次电子烟使用情况(2015-2022年)与设定:美国。参与者:8年级,10年级和12年级。测量方法:使用烟草21人口覆盖数据库和美国人口普查局人口数据确定含电子烟的县级T21法律人口覆盖率。当前电子烟使用被定义为整个样本中任何超过30天的使用。首次使用电子烟被定义为在当前年级之前没有开始使用电子烟的青少年在当前年级的首次使用。研究结果:与部分或没有电子烟T21法律覆盖的县的8年级、10年级和12年级学生相比,完全覆盖县的8年级[边际效应(ME) = -1.8%, 95%置信区间(CI) = -3.1%至-0.6%]、10年级(ME = -2.6%, 95% CI = -4.6%至-0.6%)和12年级(ME = -2.7%, 95% CI = -5.2%至-0.1%)当前的电子烟使用率较低。对于目前的电子烟使用情况,我们还观察到社会人口因素与统计上显著的相互作用。在所有年级中,全[8]:预测患病率(PP) = 5.9%, 95% CI = 4.7%-7.1%;第10期:PP = 11.8%, 95% CI = 10.2%-13.4%;第12期:18.1%,95% CI = 15.6%-20.6%]与部分或无覆盖(第8期:PP = 7.5%, 95% CI = 6.2%-8.8%;第10期:PP = 16.3%, 95% CI = 15.0%-17.6%;第12期:23.4%,95% CI = 21.9%-24.8%)与男性当前较低的电子烟使用量相关,但与女性无关。在种族和民族方面,所有年级的相关性在统计上都是显著的,但这些相关性的大小和方向因亚组和年级而异。在12年级学生中,完全覆盖(PP = 16.1%, 95% CI = 13.9%-18.3%)与部分覆盖或没有覆盖(PP = 20.5%, 95% CI = 19.0%-22.1%)与那些说自己“可能”将从四年制大学毕业的学生(但没有其他教育期望的学生)当前较少使用电子烟有关。我们没有找到足够的证据来支持包括电子烟在内的T21法律覆盖范围与整体或跨社会人口亚群体的首次电子烟开始之间的关联。结论:包括电子烟在内的《21世纪烟草法》似乎与美国青少年当前较低的电子烟使用量有关。然而,我们缺乏足够的证据来支持与首次使用电子烟的关联。我们还观察到这些与当前电子烟使用相关的社会人口统计学差异。
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引用次数: 0
Substance Use and Sex Index version 2 (SUSI-2): Validation of a brief questionnaire for the measurement of behaviours associated with transmission of blood borne viruses and sexually transmitted infections 物质使用和性别指数第2版:验证用于测量与血源性病毒传播和性传播感染有关的行为的简短问卷。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-04 DOI: 10.1111/add.70253
Brendan Clifford, Raimondo Bruno, Liam Acheson, Michael E. Cecilio, Krista J. Siefried, Jack Freestone, Vincent J. Cornelisse, Brendan Crozier, Nicky Bath, Nadine Ezard
<div> <section> <h3> Aims</h3> <p>This study sought to validate a community-acceptable Substance Use & Sex Index (SUSI) for use in substance use intervention research. SUSI aims to measure behaviours associated with the transmission of blood-borne viruses (BBV) and sexually transmitted infections (STI) among people who use substances and incorporate contemporary sexual and drug practices.</p> </section> <section> <h3> Design</h3> <p>Validation of a self-administered online behavioural questionnaire.</p> </section> <section> <h3> Setting and Participants</h3> <p>An Australian anonymous online questionnaire advertised through health services and social media resulted in 289 respondents with a mean age 35 years (standard deviation [SD] 10.9 years).</p> </section> <section> <h3> Measurements</h3> <p>A 26-item scale assessing BBV- and STI-associated behaviours based on previous piloting and expert review was assessed for scale structure using exploratory and confirmatory factor analytic approaches. Item Response Theory (IRT) analyses were applied in decisions to retain and categorise items. Item weightings were defined following expert consensus informed by local BBV, STI and HIV epidemiological profiles. Test–retest reliability was examined on a subsample (n = 98) over three to five days. Criterion validity of the new SUSI-2 scale was examined in comparison to the HIV Risk-taking Behaviour subscale of the Opiate Treatment Index (OTI-HRBS).</p> </section> <section> <h3> Findings</h3> <p>Factor analysis identified a two-factor model (“sex”; “drugs with sex”), with moderate magnitude correlation (r = 0.38; 95% confidence interval [CI] 0.19–0.54) between factors and acceptable model fit (p = 0.061). IRT discrimination was statistically significant for all items (p < 0.05). Kappa values for test–retest reliability (n = 98 subsample) ranged from 0.66 to 1.00 with high agreement (all above 87%). Free text responses indicated the questionnaire items were acceptable to respondents, with minimal suggestion for improvements. There was a statistically significant positive correlation between the SUSI-2 and OTI-HRBS sex subscales (weighted r = 0.63, p < 0.001) and between the SUSI-2 sex with drugs and OTI-HRBS drug subscale (weighted r = 0.21, p < 0.01). Four additional items were retained to reflect local other BBV and STI transmission risk.</p> </section> <section> <h3> Conclusion
目的:本研究旨在验证社区可接受的物质使用和性别指数(SUSI)用于物质使用干预研究。SUSI的目的是衡量吸毒者中与血源性病毒(BBV)和性传播感染(STI)传播有关的行为,并纳入当代性行为和毒品行为。设计:验证自我管理的在线行为问卷。背景和参与者:一份澳大利亚匿名在线调查问卷通过卫生服务和社交媒体进行了广告宣传,结果有289名受访者,平均年龄35岁(标准偏差[SD] 10.9岁)。测量方法:使用探索性和验证性因素分析方法,评估了基于先前试点和专家评审的26项BBV和sti相关行为的量表结构。项目反应理论(IRT)分析应用于保留和分类项目的决策。项目权重是根据当地BBV、STI和HIV流行病学概况告知的专家共识来定义的。在三到五天内对子样本(n = 98)进行重测信度检验。与阿片类药物治疗指数(OTI-HRBS)的艾滋病毒冒险行为子量表比较,检验了新sus -2量表的标准效度。结果:因子分析确定了一个双因素模型(“性别”;“药物与性别”),各因素与可接受的模型拟合之间具有中等程度的相关性(r = 0.38; 95%可信区间[CI] 0.19-0.54) (p = 0.061)。结论:物质使用和性指数2 (usus -2)似乎是一种有效和可接受的双因素简短量表,用于测量与血源性病毒和性传播感染相关的行为,用于物质使用介入性研究。
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引用次数: 0
Commentary on Chang et al.: Drugs, disease and death 评Chang等人:药物、疾病和死亡。
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-03 DOI: 10.1111/add.70286
Shane Darke

The work by Chang and colleagues [1] is an important contribution to our understanding of drug-related death. Why does understanding death matter? The dead have much to teach the living. If we can understand why, and how, people die from various forms of drug toxicity, we will be better informed to prevent such deaths. In this work, the authors draw our attention to the important differences between opioid and psychostimulant toxicity deaths, and the role of cardiovascular and cerebrovascular disease in the latter. There are two important points here. First, that the mechanisms of opioid and psychostimulant ‘overdoses’ are distinct. Opioids lead to depressed respiration resulting from central nervous system (CNS) depression. Heart failure may occur secondary to respiratory failure, but it is respiration that is the primary mechanism. In contrast, psychostimulant toxicity relates primarily to the cardiovascular system, leading to psychostimulant-induced arrhythmia, coronary infarction and stroke. Indeed, the term overdose may not be appropriate for psychostimulant-related deaths.

The second important point raised in this article that distinguishes opioids from psychostimulants is the chronic effect of psychostimulants on the cardiovascular system. Chronic pathologies caused by psychostimulant use include cardiomegaly, ventricular hypertrophy, accelerated atherosclerotic coronary artery disease, ischaemic heart disease, hypertensive heart disease and cardiomyopathy. Indeed, it has been observed that we frequently see 70-year-old hearts in 30-year-old bodies. The use of a psychostimulant in the presence of such pathology increases the risk of acute cardiovascular effects, such as a fatal arrhythmia. In contrast, opioids have no such effects upon the cardiovascular system. Consistent with what we know about psychostimulants, Chang and colleagues found that psychostimulant-only deaths were significantly more likely than those involving opioids to have cardiovascular and cerebrovascular disease noted in the cause of death. These deaths were more likely to be a complex interaction of acute drug effects and chronic disease than an overdose per se.

A great deal of attention has been devoted over the years to psychiatric co-morbidity. The work of Chang and colleagues reminds us of the clinical importance of physical comorbidity. My colleagues and I recently drew attention to the underappreciated role of chronic obstructive pulmonary disease in heroin overdose deaths [2]. Chang and colleagues draw our attention to the importance of cardiovascular disease in psychostimulant deaths. The clinical monitoring and treatment of such comorbidities may not only improve the quality of life for people who use these drugs, but reduce their risk of death from drug toxicity.

Shane Darke: Conceptualization; writing—original draft.

None.

Chang及其同事的工作对我们理解药物相关死亡做出了重要贡献。为什么理解死亡很重要?死人有许多东西可以教给活着的人。如果我们能够理解人们为什么以及如何死于各种形式的药物毒性,我们就能更好地了解如何预防此类死亡。在这项工作中,作者提请我们注意阿片类药物和精神兴奋剂毒性死亡之间的重要差异,以及后者中心脑血管疾病的作用。这里有两点很重要。首先,阿片类药物和精神兴奋剂“过量使用”的机制是不同的。阿片类药物导致中枢神经系统(CNS)抑郁导致呼吸抑制。心力衰竭可能继发于呼吸衰竭,但呼吸是主要机制。相反,精神兴奋剂的毒性主要与心血管系统有关,导致精神兴奋剂引起的心律失常、冠状动脉梗死和中风。事实上,“过量”一词可能并不适用于与精神兴奋剂有关的死亡。本文提出的区分阿片类药物与精神兴奋剂的第二个重要观点是精神兴奋剂对心血管系统的慢性影响。使用精神兴奋剂引起的慢性病理包括心脏肥大、心室肥厚、加速动脉粥样硬化性冠状动脉疾病、缺血性心脏病、高血压心脏病和心肌病。事实上,据观察,我们经常在30岁的身体里看到70岁的心脏。在存在这种病理的情况下使用精神兴奋剂会增加急性心血管影响的风险,例如致命性心律失常。相比之下,阿片类药物对心血管系统没有这种影响。与我们对精神兴奋剂的了解一致,Chang和他的同事发现,只服用精神兴奋剂的死亡比服用阿片类药物的死亡更有可能死于心脑血管疾病。这些死亡更可能是急性药物作用和慢性疾病的复杂相互作用,而不是药物过量本身。多年来,人们对精神疾病的合并症给予了极大的关注。Chang及其同事的工作提醒我们身体合并症的临床重要性。我和我的同事最近引起了人们对慢性阻塞性肺病在海洛因过量死亡中未被充分认识的作用的关注。Chang及其同事提请我们注意心血管疾病在精神兴奋剂致死中的重要性。对这些合并症的临床监测和治疗不仅可以改善使用这些药物的人的生活质量,而且可以降低他们因药物毒性而死亡的风险。Shane Darke:概念化;原创作品draft.None。
{"title":"Commentary on Chang et al.: Drugs, disease and death","authors":"Shane Darke","doi":"10.1111/add.70286","DOIUrl":"10.1111/add.70286","url":null,"abstract":"<p>The work by Chang and colleagues [<span>1</span>] is an important contribution to our understanding of drug-related death. Why does understanding death matter? The dead have much to teach the living. If we can understand why, and how, people die from various forms of drug toxicity, we will be better informed to prevent such deaths. In this work, the authors draw our attention to the important differences between opioid and psychostimulant toxicity deaths, and the role of cardiovascular and cerebrovascular disease in the latter. There are two important points here. First, that the mechanisms of opioid and psychostimulant ‘overdoses’ are distinct. Opioids lead to depressed respiration resulting from central nervous system (CNS) depression. Heart failure may occur secondary to respiratory failure, but it is respiration that is the primary mechanism. In contrast, psychostimulant toxicity relates primarily to the cardiovascular system, leading to psychostimulant-induced arrhythmia, coronary infarction and stroke. Indeed, the term overdose may not be appropriate for psychostimulant-related deaths.</p><p>The second important point raised in this article that distinguishes opioids from psychostimulants is the chronic effect of psychostimulants on the cardiovascular system. Chronic pathologies caused by psychostimulant use include cardiomegaly, ventricular hypertrophy, accelerated atherosclerotic coronary artery disease, ischaemic heart disease, hypertensive heart disease and cardiomyopathy. Indeed, it has been observed that we frequently see 70-year-old hearts in 30-year-old bodies. The use of a psychostimulant in the presence of such pathology increases the risk of acute cardiovascular effects, such as a fatal arrhythmia. In contrast, opioids have no such effects upon the cardiovascular system. Consistent with what we know about psychostimulants, Chang and colleagues found that psychostimulant-only deaths were significantly more likely than those involving opioids to have cardiovascular and cerebrovascular disease noted in the cause of death. These deaths were more likely to be a complex interaction of acute drug effects and chronic disease than an overdose <i>per se</i>.</p><p>A great deal of attention has been devoted over the years to psychiatric co-morbidity. The work of Chang and colleagues reminds us of the clinical importance of <i>physical</i> comorbidity. My colleagues and I recently drew attention to the underappreciated role of chronic obstructive pulmonary disease in heroin overdose deaths [<span>2</span>]. Chang and colleagues draw our attention to the importance of cardiovascular disease in psychostimulant deaths. The clinical monitoring and treatment of such comorbidities may not only improve the quality of life for people who use these drugs, but reduce their risk of death from drug toxicity.</p><p><b>Shane Darke:</b> Conceptualization; writing—original draft.</p><p>None.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 2","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/add.70286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145666315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of opioid, cannabis and cocaine use disorder on the risk of diabetic retinopathy in patients with type 2 diabetes mellitus. 阿片类药物、大麻和可卡因使用障碍对2型糖尿病患者糖尿病视网膜病变风险的影响
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-02 DOI: 10.1111/add.70275
Ming-Pei Yueh, Yu-Ting Yu, Cyuan-Yi Yeh, Kai-Wen Cheng, Shih-Kai Kao

Background and aims: Opioid use disorder (OUD), cannabis use disorder (CUD) and cocaine use disorder have been associated with a range of adverse health outcomes, including certain ocular manifestations; however, their impact on diabetic retinopathy (DR) remains insufficiently explored. This study aimed to measure the association between OUD, CUD and cocaine use disorder and the risk of DR among patients with type 2 diabetes mellitus (T2DM).

Design: Propensity-score-matched retrospective cohort study.

Setting: This study used the TriNetX US Collaborative Network to access electronic health records (EHRs), including data on demographics, diagnoses, medication use and laboratory results.

Participants/cases: A total of 131 088 adult patients with T2DM and comorbid OUD, CUD or cocaine use disorder, and 131 088 adult patients with T2DM without these conditions, were identified following propensity score matching.

Measurements: The primary outcome was the risk of DR evaluated over a 5-year follow-up period. The risks of various DR subtypes and diabetic macular edema (DME) were also assessed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated.

Findings: Over a 5-year follow-up period, patients with T2DM comorbid with OUD, CUD or cocaine use disorder had a statistically significantly higher risk of developing DR [HR (95% CI) = 2.90 (2.55-3.30), P < 0.00] compared with those without any drug use disorder. Drug use disorders were also associated with elevated risks of vision-threatening diabetic retinopathy (VTDR) [HR (95% CI) = 2.78 (2.24-3.46), P < 0.00], non-proliferative diabetic retinopathy (NPDR) [HR (95% CI) = 3.10 (2.61-3.68), P < 0.00], proliferative diabetic retinopathy (PDR) [HR (95% CI) = 3.17 (2.26-4.45), P < 0.00] and DME [HR (95% CI) = 2.64 (2.04-3.42), P < 0.00] among patients with T2DM.

Conclusions: Opioid use disorder, cannabis use disorder and cocaine use disorder appear to be associated with an elevated risk of diabetic retinopathy among patients with type 2 diabetes mellitus.

背景和目的:阿片类药物使用障碍(OUD)、大麻使用障碍(CUD)和可卡因使用障碍与一系列不良健康结果相关,包括某些眼部表现;然而,它们对糖尿病视网膜病变(DR)的影响仍未得到充分探讨。本研究旨在测量2型糖尿病(T2DM)患者的OUD、CUD、可卡因使用障碍和DR风险之间的关系。设计:倾向-评分匹配的回顾性队列研究。设置:本研究使用TriNetX美国协作网络访问电子健康记录(EHRs),包括人口统计数据、诊断、药物使用和实验室结果。参与者/病例:通过倾向评分匹配,确定了131088例合并合并OUD、CUD或可卡因使用障碍的成年T2DM患者,以及131088例没有这些情况的成年T2DM患者。测量:主要结果是在5年随访期间评估DR的风险。同时评估了不同DR亚型和糖尿病性黄斑水肿(DME)的风险。计算风险比(hr)和95%置信区间(ci)。结果:在5年的随访期间,T2DM合并OUD、CUD或可卡因使用障碍的患者发生DR的风险有统计学意义上的增高[HR (95% CI) = 2.90 (2.55-3.30), P]。结论:阿片类药物使用障碍、大麻使用障碍和可卡因使用障碍似乎与2型糖尿病患者糖尿病视网膜病变的风险升高有关。
{"title":"The impact of opioid, cannabis and cocaine use disorder on the risk of diabetic retinopathy in patients with type 2 diabetes mellitus.","authors":"Ming-Pei Yueh, Yu-Ting Yu, Cyuan-Yi Yeh, Kai-Wen Cheng, Shih-Kai Kao","doi":"10.1111/add.70275","DOIUrl":"https://doi.org/10.1111/add.70275","url":null,"abstract":"<p><strong>Background and aims: </strong>Opioid use disorder (OUD), cannabis use disorder (CUD) and cocaine use disorder have been associated with a range of adverse health outcomes, including certain ocular manifestations; however, their impact on diabetic retinopathy (DR) remains insufficiently explored. This study aimed to measure the association between OUD, CUD and cocaine use disorder and the risk of DR among patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Design: </strong>Propensity-score-matched retrospective cohort study.</p><p><strong>Setting: </strong>This study used the TriNetX US Collaborative Network to access electronic health records (EHRs), including data on demographics, diagnoses, medication use and laboratory results.</p><p><strong>Participants/cases: </strong>A total of 131 088 adult patients with T2DM and comorbid OUD, CUD or cocaine use disorder, and 131 088 adult patients with T2DM without these conditions, were identified following propensity score matching.</p><p><strong>Measurements: </strong>The primary outcome was the risk of DR evaluated over a 5-year follow-up period. The risks of various DR subtypes and diabetic macular edema (DME) were also assessed. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated.</p><p><strong>Findings: </strong>Over a 5-year follow-up period, patients with T2DM comorbid with OUD, CUD or cocaine use disorder had a statistically significantly higher risk of developing DR [HR (95% CI) = 2.90 (2.55-3.30), P < 0.00] compared with those without any drug use disorder. Drug use disorders were also associated with elevated risks of vision-threatening diabetic retinopathy (VTDR) [HR (95% CI) = 2.78 (2.24-3.46), P < 0.00], non-proliferative diabetic retinopathy (NPDR) [HR (95% CI) = 3.10 (2.61-3.68), P < 0.00], proliferative diabetic retinopathy (PDR) [HR (95% CI) = 3.17 (2.26-4.45), P < 0.00] and DME [HR (95% CI) = 2.64 (2.04-3.42), P < 0.00] among patients with T2DM.</p><p><strong>Conclusions: </strong>Opioid use disorder, cannabis use disorder and cocaine use disorder appear to be associated with an elevated risk of diabetic retinopathy among patients with type 2 diabetes mellitus.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145659901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Estimating community-level prevalence of opioid use disorder: Extrapolating from Medicaid claims data and other publicly available data sources in Ohio, USA. 估计社区一级阿片类药物使用障碍的患病率:从美国俄亥俄州的医疗补助索赔数据和其他公开数据来源推断
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-02 DOI: 10.1111/add.70278
William N Dowd, Qiushi Chen, Carolina Barbosa, H Mert Sahinkoc, Joshua Barocas, Jagpreet Chhatwal, Arnie P Aldridge, Gary A Zarkin, Amy B Knudsen

Background and aims: Addressing the opioid crisis requires opioid use disorder (OUD) prevalence estimates at the community level for targeted interventions. This study presents a new method that utilizes Medicaid claims data and publicly available data to estimate OUD prevalence at the United States (US) county level and compares it with other existing estimates.

Design, setting and participants: This study utilized data on OUD diagnoses among Medicaid beneficiaries in combination with national survey data, Census data and published literature to estimate the prevalence of OUD (including undiagnosed OUD) in each of the US state of Ohio's 88 counties for the years 2019 to 2021 among the population aged 12 years and older. Prevalence estimates were adjusted for misclassification in claims data and for variation in healthcare utilization among individuals with OUD.

Measurements: Counts and proportions of the population aged 12 and older with OUD at the US state and county level.

Findings: OUD prevalence for Ohioans aged 12 years and older was relatively stable at 3.6% [95% uncertainty interval (UI) = 3.5%-3.8%] in 2019 and 3.7% (95% UI = 3.5%-3.9%) in 2021. County-level prevalence estimates ranged from 0.7% to 14.2% in 2021. Southern counties generally had higher OUD prevalence than northern counties. The prevalence estimates were strongly correlated (Pearson's r = 0.88) with prevalence estimates for 19 Ohio counties from a previous study. Compared with the previous estimates, estimates from the current study tended to be lower for most communities but remained within the 95% credible intervals of previous estimates.

Conclusions: This approach for estimating opioid use disorder prevalence within United States communities by using Medicaid claims data and publicly available data is a robust alternative to methods relying on individual-level data or multiple linked datasets.

背景和目的:解决阿片类药物危机需要在社区一级进行阿片类药物使用障碍(OUD)患病率估计,以进行有针对性的干预。本研究提出了一种新方法,该方法利用医疗补助索赔数据和公开数据来估计美国县一级的OUD患病率,并将其与其他现有估计进行比较。设计、环境和参与者:本研究利用医疗补助受益人的OUD诊断数据,结合全国调查数据、人口普查数据和已发表的文献,估计2019年至2021年美国俄亥俄州88个县12岁及以上人口中OUD(包括未诊断的OUD)的患病率。根据索赔数据中的错误分类和OUD患者医疗保健利用的差异,对患病率估计进行了调整。测量方法:美国州和县12岁及以上的OUD患者的数量和比例。研究结果:俄亥俄州12岁及以上人群的OUD患病率相对稳定,2019年为3.6%[95%不确定区间(UI) = 3.5%-3.8%], 2021年为3.7% (95% UI = 3.5%-3.9%)。2021年县级流行率估计数为0.7%至14.2%。南方县的患病率普遍高于北方县。患病率估计值与先前研究中俄亥俄州19个县的患病率估计值密切相关(Pearson’s r = 0.88)。与以前的估计相比,目前研究对大多数社区的估计往往较低,但仍在以前估计的95%可信区间内。结论:这种通过使用医疗补助索赔数据和公开数据来估计美国社区阿片类药物使用障碍患病率的方法是依赖于个人层面数据或多个关联数据集的方法的可靠替代方法。
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引用次数: 0
Young People, Alcohol, and Risk: A Culture of Caution. , Amy Pennay, Gabriel Caluzzi, Laura Fenton, John Holmes, Michael Livingston, Jonas Raninen, and Jukka Törrönen. Routledge, 2025, ISBN: 9781032542836 年轻人、酒精和风险:一种谨慎的文化。,艾米·彭尼,加布里埃尔·卡鲁齐,劳拉·芬顿,约翰·霍姆斯,迈克尔·利文斯顿,乔纳斯·拉尼宁和尤卡Törrönen。劳特利奇,2025,ISBN: 9781032542836
IF 5.3 1区 医学 Q1 PSYCHIATRY Pub Date : 2025-12-01 DOI: 10.1111/add.70271
Katherine East
{"title":"Young People, Alcohol, and Risk: A Culture of Caution. , Amy Pennay, Gabriel Caluzzi, Laura Fenton, John Holmes, Michael Livingston, Jonas Raninen, and Jukka Törrönen. Routledge, 2025, ISBN: 9781032542836","authors":"Katherine East","doi":"10.1111/add.70271","DOIUrl":"https://doi.org/10.1111/add.70271","url":null,"abstract":"","PeriodicalId":109,"journal":{"name":"Addiction","volume":"121 3","pages":"719-720"},"PeriodicalIF":5.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146154577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Addiction
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