Pub Date : 2025-11-13DOI: 10.1016/j.drugalcdep.2025.112965
Mia I. Rough, Emory A. Lewis, Cameron F. Rough, Michael A. Nader
In the clinical population, cocaine is frequently used sequentially or simultaneously with alcohol, and this pattern is linked to poorer treatment outcomes for cocaine use disorder (CUD). Yet, the impact of ethanol on cocaine reinforcement when non-drug alternatives are available remains unclear. In this study, we examined the effects of ethanol self-administration (1.5 g/kg, one hour prior) on cocaine reinforcement under a concurrent cocaine vs. food choice (0.001–0.1 mg/kg/injection) procedure in eight socially housed male and female cynomolgus monkeys. Daily sessions consisted of an initial 1 hr access to either 1.5 g/kg of a sweetened ethanol solution or a sweetened vehicle solution of corresponding volume. These solutions were available in the operant chamber. After the 1-hr fluid access, food (1.0-g food pellet) was available as an alternative to cocaine; only one cocaine dose was available per session. Cocaine choice increased in a dose-dependent manner and ethanol self-administration did not alter the potency of cocaine. To determine whether the reinforcing strength of cocaine was altered by co-use of ethanol, delays were added to the lowest preferred dose of cocaine. When monkeys were exposed to ethanol self-administration, they required longer delays to decrease cocaine choice, suggesting that ethanol increased the reinforcing strength of cocaine. These effects were consistent across sex and social rank. Together, these findings suggest that ethanol may diminish the effectiveness of interventions designed to shift behavior away from cocaine and towards non-drug alternatives. Modeling polysubstance use in preclinical studies will likely improve the likelihood that candidate treatments for CUD will translate successfully to the clinic.
{"title":"Ethanol self-administration reduced the efficacy of a behavioral intervention to decrease cocaine choice in socially housed male and female monkeys","authors":"Mia I. Rough, Emory A. Lewis, Cameron F. Rough, Michael A. Nader","doi":"10.1016/j.drugalcdep.2025.112965","DOIUrl":"10.1016/j.drugalcdep.2025.112965","url":null,"abstract":"<div><div>In the clinical population, cocaine is frequently used sequentially or simultaneously with alcohol, and this pattern is linked to poorer treatment outcomes for cocaine use disorder (CUD). Yet, the impact of ethanol on cocaine reinforcement when non-drug alternatives are available remains unclear. In this study, we examined the effects of ethanol self-administration (1.5<!--> <!-->g/kg, one hour prior) on cocaine reinforcement under a concurrent cocaine vs. food choice (0.001–0.1<!--> <!-->mg/kg/injection) procedure in eight socially housed male and female cynomolgus monkeys. Daily sessions consisted of an initial 1<!--> <!-->hr access to either 1.5<!--> <!-->g/kg of a sweetened ethanol solution or a sweetened vehicle solution of corresponding volume. These solutions were available in the operant chamber. After the 1-hr fluid access, food (1.0-g food pellet) was available as an alternative to cocaine; only one cocaine dose was available per session. Cocaine choice increased in a dose-dependent manner and ethanol self-administration did not alter the potency of cocaine. To determine whether the reinforcing strength of cocaine was altered by co-use of ethanol, delays were added to the lowest preferred dose of cocaine. When monkeys were exposed to ethanol self-administration, they required longer delays to decrease cocaine choice, suggesting that ethanol increased the reinforcing strength of cocaine. These effects were consistent across sex and social rank. Together, these findings suggest that ethanol may diminish the effectiveness of interventions designed to shift behavior away from cocaine and towards non-drug alternatives. Modeling polysubstance use in preclinical studies will likely improve the likelihood that candidate treatments for CUD will translate successfully to the clinic.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112965"},"PeriodicalIF":3.6,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-13DOI: 10.1016/j.drugalcdep.2025.112968
Meghan E. Morean, Rachel R. Ouellette, Wei Li, Akshika Sharma
Introduction
Nicotine withdrawal promotes continued use and deters cessation efforts, making it an important target for research and intervention efforts. However, validated measures of e-cigarette withdrawal were absent until the recent addition of the retrospective Nicotine E-cigarette Withdrawal Scale (NEWS), which was developed and validated for adolescents. Here, we evaluated its psychometric properties for use with adults.
Methods
In Fall 2024, 458 adults ages ≥ 21 (mean = 29.29, standard deviation = 7.98) who resided in the United States and reported using e-cigarettes ≥ 20 days in the past month completed a 15-minute, anonymous, online survey. Analyses included conducting exploratory and confirmatory factor analyses to determine the optimal latent structure of the NEWS, examining internal reliability, testing measurement invariance (e.g., daily versus non-daily e-cigarette use), evaluating between-groups differences, and examining test-criterion relationships with constructs including e-cigarette dependence and previous e-cigarette cessation attempts.
Results
The 25-item, 4-factor solution previously validated for youth was confirmed for adults. The NEWS can be scored to reflect Overall Withdrawal and by its subscales: Negative Affect, Negative Physical Symptoms, Craving, and Appetite/Food. Internal reliability was excellent (mean α = 0.91). Scalar measurement invariance was met for all groups tested (e.g., sex, exclusive e-cigarette use versus dual-use), and between-group differences were detected. Evidence for concurrent validity included, but was not limited to, observed relationships between greater e-cigarette dependence and all NEWS scores.
Conclusions
The NEWS evidenced good psychometric properties for use with adults. Additional research should establish the utility of the NEWS for assessing acute nicotine e-cigarette withdrawal in adults.
{"title":"Psychometric properties of the Nicotine E-cigarette Withdrawal Scale for use with adults","authors":"Meghan E. Morean, Rachel R. Ouellette, Wei Li, Akshika Sharma","doi":"10.1016/j.drugalcdep.2025.112968","DOIUrl":"10.1016/j.drugalcdep.2025.112968","url":null,"abstract":"<div><h3>Introduction</h3><div>Nicotine withdrawal promotes continued use and deters cessation efforts, making it an important target for research and intervention efforts. However, validated measures of e-cigarette withdrawal were absent until the recent addition of the retrospective Nicotine E-cigarette Withdrawal Scale (NEWS), which was developed and validated for adolescents. Here, we evaluated its psychometric properties for use with adults.</div></div><div><h3>Methods</h3><div>In Fall 2024, 458 adults ages ≥ 21 (mean = 29.29, standard deviation = 7.98) who resided in the United States and reported using e-cigarettes ≥ 20 days in the past month completed a 15-minute, anonymous, online survey. Analyses included conducting exploratory and confirmatory factor analyses to determine the optimal latent structure of the NEWS, examining internal reliability, testing measurement invariance (e.g., daily versus non-daily e-cigarette use), evaluating between-groups differences, and examining test-criterion relationships with constructs including e-cigarette dependence and previous e-cigarette cessation attempts.</div></div><div><h3>Results</h3><div>The 25-item, 4-factor solution previously validated for youth was confirmed for adults. The NEWS can be scored to reflect Overall Withdrawal and by its subscales: Negative Affect, Negative Physical Symptoms, Craving, and Appetite/Food. Internal reliability was excellent (mean <em>α</em> = 0.91). Scalar measurement invariance was met for all groups tested (e.g., sex, exclusive e-cigarette use versus dual-use), and between-group differences were detected. Evidence for concurrent validity included, but was not limited to, observed relationships between greater e-cigarette dependence and all NEWS scores.</div></div><div><h3>Conclusions</h3><div>The NEWS evidenced good psychometric properties for use with adults. Additional research should establish the utility of the NEWS for assessing acute nicotine e-cigarette withdrawal in adults.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112968"},"PeriodicalIF":3.6,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Women with substance use disorders often experience stigma from others, including healthcare workers (HCW), in part due to gendered expectations about substance use. Thus, there is likely a positive association between health service utilization and perceptions of stigma, but this has been understudied. This project explores the relationship between healthcare utilization and substance use-related stigma from HCW among incarcerated women with opioid use disorder (OUD).
Methods
Women from nine Kentucky jails were randomly selected, screened for OUD, and interviewed while incarcerated (N = 900). Measures included two subscales from the Substance Use Stigma Mechanisms Scale examining enacted and anticipated substance use-related stigma from HCW and self-reported health service utilization 90 days prior to incarceration (PTI). T-tests and linear regression were used to analyze this relationship.
Results
Independent samples T-tests revealed that participants who reported hospital utilization within 90 days PTI (including emergency visits) reported significantly more enacted (t[897]= -3.349, p < 0.001) and anticipated stigma (t[897]= -3.055, p = 0.002) from HCW than participants who did not. Linear regression confirmed these relationships remained significant after controlling for demographic covariates. No significant difference in enacted or anticipated stigma from HCW was observed between 90-day PTI substance use treatment, outpatient, or residential healthcare.
Conclusion
Hospital utilization, but not other healthcare utilization (e.g. substance use treatment), was significantly associated with stigma from HCW among incarcerated women with OUD. Receiving healthcare at hospitals may be a particularly stigmatizing experience for women with OUD. Women’s future healthcare-seeking behavior may be negatively impacted by prior enacted stigma experiences and anticipated stigma from HCW.
{"title":"Healthcare utilization and perceived substance use-related stigma from healthcare workers among incarcerated women with opioid use disorder","authors":"Marguerite Webster , Martha Tillson , Jaxin Annett , Doug Terrill , Michele Staton","doi":"10.1016/j.drugalcdep.2025.112961","DOIUrl":"10.1016/j.drugalcdep.2025.112961","url":null,"abstract":"<div><h3>Purpose</h3><div>Women with substance use disorders often experience stigma from others, including healthcare workers (HCW), in part due to gendered expectations about substance use. Thus, there is likely a positive association between health service utilization and perceptions of stigma, but this has been understudied. This project explores the relationship between healthcare utilization and substance use-related stigma from HCW among incarcerated women with opioid use disorder (OUD).</div></div><div><h3>Methods</h3><div>Women from nine Kentucky jails were randomly selected, screened for OUD, and interviewed while incarcerated (N = 900). Measures included two subscales from the Substance Use Stigma Mechanisms Scale examining enacted and anticipated substance use-related stigma from HCW and self-reported health service utilization 90 days prior to incarceration (PTI). T-tests and linear regression were used to analyze this relationship.</div></div><div><h3>Results</h3><div>Independent samples T-tests revealed that participants who reported hospital utilization within 90 days PTI (including emergency visits) reported significantly more enacted (t[897]= -3.349, <em>p</em> < 0.001) and anticipated stigma (t[897]= -3.055, <em>p</em> = 0.002) from HCW than participants who did not. Linear regression confirmed these relationships remained significant after controlling for demographic covariates. No significant difference in enacted or anticipated stigma from HCW was observed between 90-day PTI substance use treatment, outpatient, or residential healthcare.</div></div><div><h3>Conclusion</h3><div>Hospital utilization, but not other healthcare utilization (e.g. substance use treatment), was significantly associated with stigma from HCW among incarcerated women with OUD. Receiving healthcare at hospitals may be a particularly stigmatizing experience for women with OUD. Women’s future healthcare-seeking behavior may be negatively impacted by prior enacted stigma experiences and anticipated stigma from HCW.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112961"},"PeriodicalIF":3.6,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1016/j.drugalcdep.2025.112957
Mohammad Darharaj , Mohsen Roshanpajouh , Mahdi Amini , Lydia A. Shrier , Iman Hamraz , Mojtaba Habibi Asgarabad
Aim
The objective of this study was to examine the effect of Ecological Momentary Motivational Enhancement Therapy (EM-MET) on cannabis use temptation and dependence severity among young adults with Cannabis Use Disorder (CUD).
Design
Multicenter single-blinded randomized controlled trial (RCT) with two equal-sized parallel groups, in which only the data analyst was blinded (see Fig. 1).
Setting
Participants were recruited from three substance use treatment centers in Tehran, Iran, between February 25, 2023, and October 31, 2023.
Participants
Participants with CUD randomly assigned to either the EM-MET (n = 35) or MET group (n = 35).
Interventions
In EM-MET, four individual sessions of face-to-face MET (twice a week) were followed by two weeks of Ecological Momentary Assessment (EMA) of cannabis use and its triggers. When a cannabis use trigger was reported, a therapist delivered EM-MET by telephone call through an emergency helpline. Patients in the MET group received the four MET sessions only.
Measurements
Primary outcomes were self-reported temptation on the Self-efficacy and Temptation Scale and dependence severity on the Leeds Dependence Questionnaire.
Findings
Compared to MET alone, EM-MET was associated with greater reductions in cannabis use temptation (F = 37.09, Partial η2 =.35, p < .001) and dependence severity (F = 19.66, Partial η2 =.24, p < .001).
Conclusions
EM-MET appears to be a feasible and promising intervention for reducing cannabis use temptation and dependence severity among young adults with CUD.
Trial registration
This trial was registered in the Iranian Registry of Clinical Trials on 21 February 2023. Registry No. IRCT20221224056908N1
{"title":"Effect of mobile-based ecological momentary motivational enhancement therapy on cannabis use temptation and dependence severity among Iranian young adults with cannabis use disorder: A randomized clinical trial","authors":"Mohammad Darharaj , Mohsen Roshanpajouh , Mahdi Amini , Lydia A. Shrier , Iman Hamraz , Mojtaba Habibi Asgarabad","doi":"10.1016/j.drugalcdep.2025.112957","DOIUrl":"10.1016/j.drugalcdep.2025.112957","url":null,"abstract":"<div><h3>Aim</h3><div>The objective of this study was to examine the effect of Ecological Momentary Motivational Enhancement Therapy (EM-MET) on cannabis use temptation and dependence severity among young adults with Cannabis Use Disorder (CUD).</div></div><div><h3>Design</h3><div>Multicenter single-blinded randomized controlled trial (RCT) with two equal-sized parallel groups, in which only the data analyst was blinded (see Fig. 1).</div></div><div><h3>Setting</h3><div>Participants were recruited from three substance use treatment centers in Tehran, Iran, between February 25, 2023, and October 31, 2023.</div></div><div><h3>Participants</h3><div>Participants with CUD randomly assigned to either the EM-MET (<em>n</em> = 35) or MET group (<em>n</em> = 35).</div></div><div><h3>Interventions</h3><div>In EM-MET, four individual sessions of face-to-face MET (twice a week) were followed by two weeks of Ecological Momentary Assessment (EMA) of cannabis use and its triggers. When a cannabis use trigger was reported, a therapist delivered EM-MET by telephone call through an emergency helpline. Patients in the MET group received the four MET sessions only.</div></div><div><h3>Measurements</h3><div>Primary outcomes were self-reported temptation on the Self-efficacy and Temptation Scale and dependence severity on the Leeds Dependence Questionnaire.</div></div><div><h3>Findings</h3><div>Compared to MET alone, EM-MET was associated with greater reductions in cannabis use temptation (<em>F</em> = 37.09, <em>Partial η</em><sup><em>2</em></sup> =.35, <em>p</em> < .001) and dependence severity (<em>F</em> = 19.66, <em>Partial η</em><sup><em>2</em></sup> =.24, <em>p</em> < .001).</div></div><div><h3>Conclusions</h3><div>EM-MET appears to be a feasible and promising intervention for reducing cannabis use temptation and dependence severity among young adults with CUD.</div></div><div><h3>Trial registration</h3><div>This trial was registered in the Iranian Registry of Clinical Trials on 21 February 2023. Registry No. IRCT20221224056908N1</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112957"},"PeriodicalIF":3.6,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The effect of cannabis use on romantic relationship satisfaction remains unclear, partly due to methodological shortcomings in earlier studies, such as the reliance on a single index of cannabis exposure.
Methods
In this study, we explored the association between an integrated frequency-by-quantity measure of cannabis use exposure and quality of romantic relationships, while addressing possible sex differences. 110 couples completed validated questionnaires assessing cannabis use patterns, general satisfaction with relationship quality, satisfaction with the quality of sex, and perceived partner responsiveness. The effects of between-partner concordance in cannabis use intensity on relationship quality were tested using multilevel linear regression analyses. Within-partner and between-partner effects of cannabis use intensity on relationship quality, as well as possible sex differences, were tested using the Actor-Partner Interdependence Model.
Results
Regression analyses indicated that a discrepancy in cannabis use intensity was negatively associated with general relationship satisfaction (β = −.19, p = .008) and with the quality of sex (β = −.16, p = .02). Dyadic analyses revealed significant Actor and Partner intensity × sex interactions related to the quality of romantic relationship. These interactions indicated that women who used cannabis at high intensity reported greater relationship satisfaction and perceived both their own and their partner's responsiveness as higher, whereas men reported the opposite.
Conclusions
Cannabis use intensity may have different effects on romantic relationship satisfaction for men and women. Further research is needed to uncover the nature of these differences.
大麻使用对恋爱关系满意度的影响尚不清楚，部分原因是早期研究方法上的缺陷，例如依赖于大麻暴露的单一指数。在这项研究中，我们探讨了大麻使用暴露的综合频率与浪漫关系质量之间的关系，同时解决了可能的性别差异。110对夫妇完成了有效的问卷调查，评估大麻使用模式、对关系质量的总体满意度、对性质量的满意度以及对伴侣反应的感知。采用多水平线性回归分析检验大麻使用强度的伴侣间一致性对关系质量的影响。使用行为者-伴侣相互依赖模型测试了大麻使用强度对伴侣内部和伴侣之间关系质量的影响，以及可能的性别差异。结果回归分析表明，大麻使用强度的差异与一般关系满意度呈负相关（β =−）。19、p =。008)，与性的质量(β = -。16, p = .02)。二元分析显示，行为者和伴侣强度×性互动与恋爱关系质量相关。这些相互作用表明，高强度使用大麻的女性报告了更高的关系满意度，并认为自己和伴侣的反应性都更高，而男性报告的情况恰恰相反。结论大麻使用强度对男女恋爱关系满意度有不同的影响。需要进一步的研究来揭示这些差异的本质。
{"title":"The association between cannabis use and romantic relationship satisfaction: The role of intensity, concordance, and sex differences","authors":"Aviya Ashwal-Malka , Yoram Braw , Hadar Nataf , Daniel Feingold","doi":"10.1016/j.drugalcdep.2025.112956","DOIUrl":"10.1016/j.drugalcdep.2025.112956","url":null,"abstract":"<div><h3>Introduction</h3><div>The effect of cannabis use on romantic relationship satisfaction remains unclear, partly due to methodological shortcomings in earlier studies, such as the reliance on a single index of cannabis exposure.</div></div><div><h3>Methods</h3><div>In this study, we explored the association between an integrated frequency-by-quantity measure of cannabis use exposure and quality of romantic relationships, while addressing possible sex differences. 110 couples completed validated questionnaires assessing cannabis use patterns, general satisfaction with relationship quality, satisfaction with the quality of sex, and perceived partner responsiveness. The effects of between-partner concordance in cannabis use intensity on relationship quality were tested using multilevel linear regression analyses. Within-partner and between-partner effects of cannabis use intensity on relationship quality, as well as possible sex differences, were tested using the Actor-Partner Interdependence Model.</div></div><div><h3>Results</h3><div>Regression analyses indicated that a discrepancy in cannabis use intensity was negatively associated with general relationship satisfaction (β = −.19, <em>p</em> = .008) and with the quality of sex (β = −.16, <em>p</em> = .02). Dyadic analyses revealed significant Actor and Partner intensity × sex interactions related to the quality of romantic relationship. These interactions indicated that women who used cannabis at high intensity reported greater relationship satisfaction and perceived both their own and their partner's responsiveness as higher, whereas men reported the opposite.</div></div><div><h3>Conclusions</h3><div>Cannabis use intensity may have different effects on romantic relationship satisfaction for men and women. Further research is needed to uncover the nature of these differences.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112956"},"PeriodicalIF":3.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.drugalcdep.2025.112954
Ryan M. Sullivan , Alexander L. Wallace , April C. May , Joshua K. Lyman , Krista M. Lisdahl , Natasha E. Wade , Kelly E. Courtney , Neal Doran , Joanna Jacobus
Nicotine use is increasing in prevalence among adolescents and emerging adults in the United States. While young adulthood nicotine use has been linked to alterations in white matter tissue brain structure, little is known about late childhood nicotine initiation and its associations with white matter microstructural development. In this study, nicotine initiators (ages 9–16, n = 556) were compared on white matter regions-of-interest (ROIs) to sociodemographically matched peers (n = 556) using a subsample of the Adolescent Brain Cognitive Development (ABCD) Study (baseline to year-4 follow-up). Fractional anisotropy and mean diffusivity metrics were examined across 11 diffusion tensor imaging ROIs. Linear mixed-effects models examined nicotine initiation while controlling for prenatal nicotine exposure, parental history of problematic alcohol/drug use, and other substance use initiation. Findings indicated nicotine initiation-by-age effects for widespread cortical and subcortical fractional anisotropy ROIs, which maintained significance after multiple comparison correction and conducting sensitivity analyses covarying for pubertal staging. These ROIs did not correlate with any dose-dependent (e.g., lifetime use days) measurements among the nicotine initiators. Additionally, no significant findings were observed for mean diffusivity, or exploratory interactions with sex. Overall, neurodevelopmental effects of nicotine use on white matter integrity may appear early and are associated with trajectories of white matter development, yet continued investigations of nicotine initiation and escalation across the lifespan and its relationships with structural neuroimaging outcomes are needed.
{"title":"Early nicotine initiation and white matter integrity: Associations from late childhood to mid-adolescence","authors":"Ryan M. Sullivan , Alexander L. Wallace , April C. May , Joshua K. Lyman , Krista M. Lisdahl , Natasha E. Wade , Kelly E. Courtney , Neal Doran , Joanna Jacobus","doi":"10.1016/j.drugalcdep.2025.112954","DOIUrl":"10.1016/j.drugalcdep.2025.112954","url":null,"abstract":"<div><div>Nicotine use is increasing in prevalence among adolescents and emerging adults in the United States. While young adulthood nicotine use has been linked to alterations in white matter tissue brain structure, little is known about late childhood nicotine initiation and its associations with white matter microstructural development. In this study, nicotine initiators (ages 9–16, n = 556) were compared on white matter regions-of-interest (ROIs) to sociodemographically matched peers (n = 556) using a subsample of the Adolescent Brain Cognitive Development (ABCD) Study (baseline to year-4 follow-up). Fractional anisotropy and mean diffusivity metrics were examined across 11 diffusion tensor imaging ROIs. Linear mixed-effects models examined nicotine initiation while controlling for prenatal nicotine exposure, parental history of problematic alcohol/drug use, and other substance use initiation. Findings indicated nicotine initiation-by-age effects for widespread cortical and subcortical fractional anisotropy ROIs, which maintained significance after multiple comparison correction and conducting sensitivity analyses covarying for pubertal staging. These ROIs did not correlate with any dose-dependent (e.g., lifetime use days) measurements among the nicotine initiators. Additionally, no significant findings were observed for mean diffusivity, or exploratory interactions with sex. Overall, neurodevelopmental effects of nicotine use on white matter integrity may appear early and are associated with trajectories of white matter development, yet continued investigations of nicotine initiation and escalation across the lifespan and its relationships with structural neuroimaging outcomes are needed.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112954"},"PeriodicalIF":3.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.drugalcdep.2025.112955
Gezelle Dali , Antoinette Poulton , Tobias Banaschewski , Arun L.W. Bokde , Sylvane Desrivières , Herta Flor , Hugh Garavan , Antoine Grigis , Andreas Heinz , Jean-Luc Martinot , Frauke Nees , Dimitri Papadopoulos Orfanos , Luise Poustka , Michael N. Smolka , Sarah Hohmann , Nilakshi Vaidya , Henrik Walter , Robert Whelan , Gunter Schumann , Robert Hester
Background
Delay discounting is consistently implicated in nicotine use, with individuals dependent on smoking exhibiting greater discounting rates than those who do not smoke. The temporal relationship of delay discounting and smoking, however, has been relatively understudied as much of the existing literature has used cross-sectional designs. This study examined whether delay discounting is predictive of both the initiation of occasional smoking and the transition from occasional to daily use and whether escalating smoking behaviour predicts increased delay discounting.
Methods
Participants were drawn from the IMAGEN sample – a large, longitudinal, multicentre study. Data were collected at ages 14, 16, 18 and 22 years. Our sample consisted of 1668 participants (52 % female) who had completed at least two waves of data collection. Delay discounting was measured using the 27-item Monetary Choice Questionnaire. The European School Survey Project on Alcohol and Drugs (ESPAD) and the Timeline Follow-back were used to assess smoking behaviours.
Results
Higher delay discounting predicted a greater likelihood of initiation of occasional use but not the transition to daily smoking. The trajectory of smoking frequency was predicted by both baseline levels of delay discounting and the trend of delay discounting over time. Smoking, however, was not found to predict changes in delay discounting.
Conclusions
High delay discounting appears to precede the initiation of smoking and is predictive of the trajectory of smoking but may not distinguish between discrete states of smoking. Identifying heightened delay discounting in young people may offer the opportunity to prevent excessive smoking trajectories before they are initiated.
{"title":"Trajectories of delay discounting and smoking from adolescence to young adulthood","authors":"Gezelle Dali , Antoinette Poulton , Tobias Banaschewski , Arun L.W. Bokde , Sylvane Desrivières , Herta Flor , Hugh Garavan , Antoine Grigis , Andreas Heinz , Jean-Luc Martinot , Frauke Nees , Dimitri Papadopoulos Orfanos , Luise Poustka , Michael N. Smolka , Sarah Hohmann , Nilakshi Vaidya , Henrik Walter , Robert Whelan , Gunter Schumann , Robert Hester","doi":"10.1016/j.drugalcdep.2025.112955","DOIUrl":"10.1016/j.drugalcdep.2025.112955","url":null,"abstract":"<div><h3>Background</h3><div>Delay discounting is consistently implicated in nicotine use, with individuals dependent on smoking exhibiting greater discounting rates than those who do not smoke. The temporal relationship of delay discounting and smoking, however, has been relatively understudied as much of the existing literature has used cross-sectional designs. This study examined whether delay discounting is predictive of both the initiation of occasional smoking and the transition from occasional to daily use and whether escalating smoking behaviour predicts increased delay discounting.</div></div><div><h3>Methods</h3><div>Participants were drawn from the IMAGEN sample – a large, longitudinal, multicentre study. Data were collected at ages 14, 16, 18 and 22 years. Our sample consisted of 1668 participants (52 % female) who had completed at least two waves of data collection. Delay discounting was measured using the 27-item Monetary Choice Questionnaire. The European School Survey Project on Alcohol and Drugs (ESPAD) and the Timeline Follow-back were used to assess smoking behaviours.</div></div><div><h3>Results</h3><div>Higher delay discounting predicted a greater likelihood of initiation of occasional use but not the transition to daily smoking. The trajectory of smoking frequency was predicted by both baseline levels of delay discounting and the trend of delay discounting over time. Smoking, however, was not found to predict changes in delay discounting.</div></div><div><h3>Conclusions</h3><div>High delay discounting appears to precede the initiation of smoking and is predictive of the trajectory of smoking but may not distinguish between discrete states of smoking. Identifying heightened delay discounting in young people may offer the opportunity to prevent excessive smoking trajectories before they are initiated.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112955"},"PeriodicalIF":3.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145526318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.drugalcdep.2025.112959
Jennifer Cornacchione Ross , Rachel L. Denlinger-Apte , Mariel S. Bello , Jennifer W. Tidey , Suzanne M. Colby , Rachel N. Cassidy
Introduction
Rates of cannabis and tobacco co-use continue to increase among adolescents, but the behavioral mechanisms underlying co-use patterns are not well understood. The study goal was to assess the reinforcing effects (rewards) of cigarettes (behavioral economic demand) and sensitivity to immediate rewards (delay discounting) by cannabis use status.
Method
Participants (N = 70, ages 17–19 and reported smoking at least 1 cigarette per day for the past 6 months) completed a timeline follow-back interview assessing past 30-day cannabis use; a Cigarette Purchase Task (how many cigarettes would purchase in a 24-hour period across range of prices per cigarette) assessing five cigarette demand indices; and a Delay Discounting Task assessing the tendency to choose smaller, sooner rewards over larger, later rewards. Participants were categorized into three cannabis use groups (daily, non-daily, non-use). We compared the three cannabis use group curves across the two parameters of the exponentiated demand equation, and delay discounting was analyzed using area under the curve.
Results
Cigarette demand intensity was significantly higher among those who reported daily cannabis use than those who do not use. Additionally, those who used cannabis daily were more sensitive to changes in cigarette price (alpha) than those who used non-daily and did not use cannabis. We found no differences in delay discounting by cannabis use status.
Conclusion
Among adolescents who smoke cigarettes daily, those who also use cannabis daily reported greater cigarette demand than those who do not use cannabis. However, adolescents who smoke cannabis daily were more sensitive to price, suggesting less persistence of purchasing in the face of higher prices.
{"title":"The Relationship between Cannabis Use and Demand for Cigarettes in Adolescents who Smoke Cigarettes","authors":"Jennifer Cornacchione Ross , Rachel L. Denlinger-Apte , Mariel S. Bello , Jennifer W. Tidey , Suzanne M. Colby , Rachel N. Cassidy","doi":"10.1016/j.drugalcdep.2025.112959","DOIUrl":"10.1016/j.drugalcdep.2025.112959","url":null,"abstract":"<div><h3>Introduction</h3><div>Rates of cannabis and tobacco co-use continue to increase among adolescents, but the behavioral mechanisms underlying co-use patterns are not well understood. The study goal was to assess the reinforcing effects (rewards) of cigarettes (behavioral economic demand) and sensitivity to immediate rewards (delay discounting) by cannabis use status.</div></div><div><h3>Method</h3><div>Participants (N = 70, ages 17–19 and reported smoking at least 1 cigarette per day for the past 6 months) completed a timeline follow-back interview assessing past 30-day cannabis use; a Cigarette Purchase Task (how many cigarettes would purchase in a 24-hour period across range of prices per cigarette) assessing five cigarette demand indices; and a Delay Discounting Task assessing the tendency to choose smaller, sooner rewards over larger, later rewards. Participants were categorized into three cannabis use groups (daily, non-daily, non-use). We compared the three cannabis use group curves across the two parameters of the exponentiated demand equation, and delay discounting was analyzed using area under the curve.</div></div><div><h3>Results</h3><div>Cigarette demand intensity was significantly higher among those who reported daily cannabis use than those who do not use. Additionally, those who used cannabis daily were more sensitive to changes in cigarette price (alpha) than those who used non-daily and did not use cannabis. We found no differences in delay discounting by cannabis use status.</div></div><div><h3>Conclusion</h3><div>Among adolescents who smoke cigarettes daily, those who also use cannabis daily reported greater cigarette demand than those who do not use cannabis. However, adolescents who smoke cannabis daily were more sensitive to price, suggesting less persistence of purchasing in the face of higher prices.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112959"},"PeriodicalIF":3.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.drugalcdep.2025.112958
Bridget M. Whitney , Joseph A.C. Delaney , Lydia N. Drumright , Robin M. Nance , Rob J. Fredericksen , Geetanjali Chander , Edward R. Cachay , Nathaniel T. Fox , Katerina A. Christopoulos , Karen L. Cropsey , Michael A. Owens , Greer A. Burkholder , Kenneth H. Mayer , Mary E. McCaul , Sonia Napravnik , Conall O’Cleirigh , Allison R. Webel , George A. Yendewa , Michael S. Saag , Mari M. Kitahata , Andrew W. Hahn
Background
We evaluated the harm reduction-based cannabis substitution hypothesis, that increased cannabis use may lead to decreased harmful alcohol or tobacco use, among people with HIV (PWH).
Setting/methods
Data are from the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort between 2009 and 2023. PWH completed longitudinal assessments of cannabis, alcohol, and tobacco use. Two trajectories of change in cannabis use were evaluated: increasing use (initiation and increased use frequency vs. non-increasing use) and decreasing use (abstinence and reduced use frequency vs. non-decreasing use). Associations between changes in frequency of cannabis use and subsequent frequency of alcohol and tobacco use were estimated using time-updated, multivariable linear mixed models. Joint longitudinal and survival models were used to examine associations with hazardous alcohol use.
Results
Among 12,143 PWH, 31.9 % reported cannabis use, 17.5 % hazardous alcohol use, and 35.6 % cigarette use at baseline. Compared to those who did not increase use, increasing cannabis use was associated with 0.67 additional drinking days/month (95 %CI:0.42–0.92), 0.25 additional heavy episodic drinking days/month (95 %CI:0.04–0.46), and a 2.2 times higher odds of hazardous alcohol consumption (95 %CI:1.67–2.44). Increasing cannabis use was also associated with 0.60 additional cigarettes/day (95 %CI:0.27–0.93). Initiation of cannabis resulted in similar estimates. Conversely, decreasing cannabis use, with and without abstinence, was associated with less alcohol and cigarette consumption.
Conclusions
Increasing cannabis use was associated with more drinking, more hazardous drinking, and higher cigarette intake. Contrary to the cannabis substitution hypothesis, increased cannabis use did not result in a reduction of alcohol or tobacco use among PWH.
{"title":"Brief report: Are changes in cannabis use frequency associated with changes in alcohol use and smoking among people with HIV (PWH) – A substitution question","authors":"Bridget M. Whitney , Joseph A.C. Delaney , Lydia N. Drumright , Robin M. Nance , Rob J. Fredericksen , Geetanjali Chander , Edward R. Cachay , Nathaniel T. Fox , Katerina A. Christopoulos , Karen L. Cropsey , Michael A. Owens , Greer A. Burkholder , Kenneth H. Mayer , Mary E. McCaul , Sonia Napravnik , Conall O’Cleirigh , Allison R. Webel , George A. Yendewa , Michael S. Saag , Mari M. Kitahata , Andrew W. Hahn","doi":"10.1016/j.drugalcdep.2025.112958","DOIUrl":"10.1016/j.drugalcdep.2025.112958","url":null,"abstract":"<div><h3>Background</h3><div>We evaluated the harm reduction-based cannabis substitution hypothesis, that increased cannabis use may lead to decreased harmful alcohol or tobacco use, among people with HIV (PWH).</div></div><div><h3>Setting/methods</h3><div>Data are from the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort between 2009 and 2023. PWH completed longitudinal assessments of cannabis, alcohol, and tobacco use. Two trajectories of change in cannabis use were evaluated: increasing use (initiation and increased use frequency vs. non-increasing use) and decreasing use (abstinence and reduced use frequency vs. non-decreasing use). Associations between changes in frequency of cannabis use and subsequent frequency of alcohol and tobacco use were estimated using time-updated, multivariable linear mixed models. Joint longitudinal and survival models were used to examine associations with hazardous alcohol use.</div></div><div><h3>Results</h3><div>Among 12,143 PWH, 31.9 % reported cannabis use, 17.5 % hazardous alcohol use, and 35.6 % cigarette use at baseline. Compared to those who did not increase use, increasing cannabis use was associated with 0.67 additional drinking days/month (95 %CI:0.42–0.92), 0.25 additional heavy episodic drinking days/month (95 %CI:0.04–0.46), and a 2.2 times higher odds of hazardous alcohol consumption (95 %CI:1.67–2.44). Increasing cannabis use was also associated with 0.60 additional cigarettes/day (95 %CI:0.27–0.93). Initiation of cannabis resulted in similar estimates. Conversely, decreasing cannabis use, with and without abstinence, was associated with less alcohol and cigarette consumption.</div></div><div><h3>Conclusions</h3><div>Increasing cannabis use was associated with more drinking, more hazardous drinking, and higher cigarette intake. Contrary to the cannabis substitution hypothesis, increased cannabis use did not result in a reduction of alcohol or tobacco use among PWH.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112958"},"PeriodicalIF":3.6,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1016/j.drugalcdep.2025.112953
Zeynep Hasgul , Erin Stringfellow , Mohammad S. Jalali , Huiru Dong
Background
Fentanyl has become the dominant opioid in the illicit market in the U.S.; however, trends and variety of substances co-presented in samples involving fentanyl and fentanyl-related substances remain largely unexplored, limiting state public health responses. This paper aims to analyze temporal and geographical trends in substances co-reported with fentanyl in illicit drug supply across the U.S. from 2013 to 2023 to inform overdose prevention strategies.
Methods
We conducted a serial cross-sectional analysis using data from the National Forensic Laboratory Information System. At national and state levels, we examined trends in co-reported substance categories: heroin, cocaine, psychostimulants, natural and synthetic cannabinoids, hallucinogens/dissociatives, club drugs, other illicit opioids, prescription opioids, illicit benzodiazepines, prescription benzodiazepines, and xylazine.
Results
Among 1,011,034 samples involving fentanyl and fentanyl-related substances, 25.8 % contained at least one additional substance category. Xylazine co-reporting increased significantly from 0.4 % in 2018 to 8.1 % in 2023, becoming the most frequently reported that year, overtaking heroin, which had been the most frequently co-reported substance overall. Geographically, fentanyl co-reporting with xylazine and cocaine was more prevalent on the East Coast, while psychostimulant co-reporting was more common on the West Coast.
Conclusions
The rising prevalence of co-reporting xylazine and large geographic variations in co-reported substances highlight the shifts in the illicit drug supply. These findings emphasize the need for enhanced drug supply monitoring and region-specific overdose prevention strategies.
{"title":"Substances in fentanyl samples in the U.S. illicit drug supply: A decade of trends and regional variations using serial cross-sectional analysis","authors":"Zeynep Hasgul , Erin Stringfellow , Mohammad S. Jalali , Huiru Dong","doi":"10.1016/j.drugalcdep.2025.112953","DOIUrl":"10.1016/j.drugalcdep.2025.112953","url":null,"abstract":"<div><h3>Background</h3><div>Fentanyl has become the dominant opioid in the illicit market in the U.S.; however, trends and variety of substances co-presented in samples involving fentanyl and fentanyl-related substances remain largely unexplored, limiting state public health responses. This paper aims to analyze temporal and geographical trends in substances co-reported with fentanyl in illicit drug supply across the U.S. from 2013 to 2023 to inform overdose prevention strategies.</div></div><div><h3>Methods</h3><div>We conducted a serial cross-sectional analysis using data from the National Forensic Laboratory Information System. At national and state levels, we examined trends in co-reported substance categories: heroin, cocaine, psychostimulants, natural and synthetic cannabinoids, hallucinogens/dissociatives, club drugs, other illicit opioids, prescription opioids, illicit benzodiazepines, prescription benzodiazepines, and xylazine.</div></div><div><h3>Results</h3><div>Among 1,011,034 samples involving fentanyl and fentanyl-related substances, 25.8 % contained at least one additional substance category. Xylazine co-reporting increased significantly from 0.4 % in 2018 to 8.1 % in 2023, becoming the most frequently reported that year, overtaking heroin, which had been the most frequently co-reported substance overall. Geographically, fentanyl co-reporting with xylazine and cocaine was more prevalent on the East Coast, while psychostimulant co-reporting was more common on the West Coast.</div></div><div><h3>Conclusions</h3><div>The rising prevalence of co-reporting xylazine and large geographic variations in co-reported substances highlight the shifts in the illicit drug supply. These findings emphasize the need for enhanced drug supply monitoring and region-specific overdose prevention strategies.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112953"},"PeriodicalIF":3.6,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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