Drug and alcohol dependence最新文献_第2页

Descriptive content analysis assessment of ChatGPT responses to substance use disorder treatment questions compared to National health guidelines 与国家健康指南相比，ChatGPT对物质使用障碍治疗问题的回答的描述性内容分析评估。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-30 DOI: 10.1016/j.drugalcdep.2026.113074

Morgan Decker , Christine Kamm , Sara Burgoa , Meera Rao , Maria Mejia , Christine Ramdin , Adrienne Dean , Melodie Nasr , Lewis S. Nelson , Lea Sacca

Background

Artificial intelligence (AI)–powered large language models like ChatGPT are increasingly used by the public to access health information. These platforms may be particularly appealing for high-risk conditions such as substance use disorder (SUD), where anonymity and nonjudgmental responses are valued. Despite growing interest in AI-assisted health education, limited research has assessed the quality of ChatGPT’s content when it comes to accuracy and completeness on complex behavioral health topics. This study evaluated the accuracy and clinical consistency of ChatGPT’s responses to SUD-related questions compared to national health guidelines.

Methods

This descriptive study, using a content analysis approach, analyzed ChatGPT 3.5’s and 5’s responses to 14 clinically relevant SUD-related questions, drawn from over 200 FAQs sourced from six leading U.S. health organizations in comparison to the top SUD questions asked by US adults using ChatGPT. Each response was independently assessed by a multidisciplinary team for accuracy, clarity, and appropriateness using an evidence-informed rating system. Responses were categorized as excellent, satisfactory requiring minimal clarification, satisfactory requiring moderate clarification, or unsatisfactory. Discrepancies were resolved through consensus.

Results

Among the 14 responses, 3 were rated excellent, 9 were satisfactory requiring minimal clarification, and 2 were satisfactory requiring moderate clarification. None were rated unsatisfactory. ChatGPT responses were generally accurate for straightforward questions but lacked clinical nuance and specificity in more complex scenarios, particularly regarding individualized care recommendations, withdrawal management, and treatment planning.

Conclusion

As AI becomes more integrated into health information-seeking behaviors, continued evaluation of its role and potential impact in addiction medicine is essential.

背景：公众越来越多地使用ChatGPT等人工智能（AI）驱动的大型语言模型来获取健康信息。这些平台可能特别吸引高风险的情况，如物质使用障碍（SUD），在这些情况下，匿名和非判断性的反应是有价值的。尽管人们对人工智能辅助健康教育的兴趣越来越大，但有限的研究评估了ChatGPT内容在复杂行为健康主题方面的准确性和完整性。与国家健康指南相比，本研究评估了ChatGPT对sud相关问题的回答的准确性和临床一致性。方法：本描述性研究采用内容分析方法，分析了ChatGPT 3.5和5对14个临床相关的SUD相关问题的回答，这些问题来自美国六家领先的卫生组织的200多个常见问题，并与使用ChatGPT的美国成年人提出的顶级SUD问题进行了比较。每个回答都由一个多学科小组独立评估，使用循证评分系统评估其准确性、清晰度和适当性。回答被分类为优秀，满意需要最少的澄清，满意需要适度的澄清，或不满意。分歧通过协商一致解决。结果：在14个回答中，3个被评为优秀，9个被评为满意，需要最少的解释，2个被评为满意，需要中度的解释。没有人被评为不满意。ChatGPT的回答对于简单的问题通常是准确的，但在更复杂的情况下缺乏临床细微差别和特异性，特别是在个性化护理建议、戒断管理和治疗计划方面。结论：随着人工智能越来越多地融入健康信息寻求行为，持续评估其在成瘾医学中的作用和潜在影响至关重要。

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引用次数: 0

Could the telescoping effect and comorbidity with substance use disorders account for sex differences in the processes and therapeutic outcomes? A latent-class moderation analysis 可伸缩效应和物质使用障碍的共病能解释过程和治疗结果的性别差异吗？一个潜在类的适度分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-30 DOI: 10.1016/j.drugalcdep.2026.113062

Daniel Dacosta-Sánchez , Cinta Mancheño-Velasco , Marta Narváez-Camargo , Óscar M. Lozano

Background

Sex differences in substance use disorder (SUD) treatment outcomes remain unclear; protocols focused on male prevalence may overlook female-specific needs. This study tested interactions among sex, the telescoping effect, and comorbid profiles in outcomes.

Methods

Retrospective multisite electronic health record study (N = 4818) of patients with co-occurring disorders. Interaction regressions and latent class analysis tested sex moderation of links between years of substance use (telescoping) and outcomes within SUD and co-occurring diagnostic groups.

Results

Slower progression from substance use onset to diagnosis was associated with lower readmission likelihood at 3 years in males than females; similar patterns appeared at 18 and 24 months for alcohol dependence and at 18 months for co-occurring mood disorders. Six comorbid classes were identified (feature-based labels): behavioral dysregulation (Class 1), anxious distress (Class 2), adolescence–cannabis (Class 3), emotional–interpersonal dysregulation (Class 4), affective–alcohol (Class 5), and reality distortion (Class 6). Only Classes 2 and 4 showed the telescoping effect. Latent-class moderation revealed males in Classes 1 and 3 had higher readmission over 3 years, whereas females in Class 4 had lower adherence to scheduled appointments and higher predicted readmissions across all follow-ups. Females in Class 6 showed better appointment adherence than males.

Conclusions

Telescoping and sex differences may contribute to higher readmission in females, particularly with alcohol dependence and mood or personality disorders. Males with impulse-control or childhood disorders may require more post-treatment care. Sex-specific interventions and moderation/latent class approaches may improve targeting.

背景：物质使用障碍（SUD）治疗结果的性别差异尚不清楚；侧重于男性患病率的方案可能忽略了女性的特定需求。这项研究测试了性别之间的相互作用、伸缩效应和合并症的结果。方法：回顾性多站点电子健康记录研究（N = 4818）共患疾病患者。相互作用回归和潜在类别分析测试了在SUD和共同发生的诊断组中，物质使用年数（伸缩）和结果之间的联系的性别调节。结果：从物质使用开始到诊断进展较慢，男性3年再入院的可能性低于女性；类似的模式出现在18个月和24个月的酒精依赖和18个月的同时发生的情绪障碍。确定了六种共病类别（基于特征的标签）：行为失调（1类），焦虑困扰（2类），青春期大麻（3类），情绪-人际失调（4类），情感酒精（5类）和现实扭曲（6类）。只有2级和4级表现出伸缩效应。潜在等级调节显示，在所有随访中，1级和3级的男性在3年内的再入院率较高，而4级的女性对预定预约的依从性较低，预测再入院率较高。6班女生的预约依从性高于男生。结论：伸缩和性别差异可能导致女性再入院率更高，特别是酒精依赖和情绪或人格障碍。患有冲动控制或童年障碍的男性可能需要更多的治疗后护理。性别特异性干预和适度/潜在类别方法可能改善靶向性。

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引用次数: 0

Perspectives on collaboration between drug courts and MOUD providers: Impact of interagency implementation strategies 药物法庭和mod提供者之间合作的观点：机构间执行战略的影响。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-29 DOI: 10.1016/j.drugalcdep.2026.113065

Ekaterina Pivovarova , Faye S. Taxman , Barbara Andraka-Christou , Alexandra Boland , Dara Drawbridge , David Smelson , Stephenie C. Lemon , Peter D. Friedmann

Background

Effective working relationships between drug courts and community providers are critical to improving access to medications for opioid use disorder (MOUD), but collaboration is often inadequate. We adapted and piloted a package of implementation strategies (Clinical Organizations and Legal Agency Alliance Building; COLAAB) designed to enhance collaboration between recovery courts and MOUD agencies. COLAAB activities included structured interagency meetings, agency tours, academic liaison, and development of local resource guides.

Methods

After the implementation of COLAAB in three courts, we conducted semi-structured interviews (n = 24) with drug court and MOUD staff to assess the impact of COLAAB on collaboration, communication, and referrals. Data were analyzed using a modified iterative categorization approach.

Results

Drug court and MOUD agency staff perceived COLAAB as facilitating interagency relationships and referrals to MOUD, increasing MOUD agencies’ understanding of drug courts, improving communication quality, strengthening understanding and trust in MOUD providers and drug courts, and reducing time to referrals to MOUD. COLAAB also increased the MOUD agency staff’s awareness of other community providers and helped build their potential referral networks. COLAAB may have also enhanced drug court staff’s willingness to speak with clients about MOUD and MOUD provider staff’s willingness to discuss clients’ criminal legal involvement.

Discussion

Our pilot study provides preliminary evidence that court-MOUD agency collaborations can be enhanced through active learning about one another’s practices and services, participation in regularly scheduled meetings or activities, and the identification and use of resources that support efficient interagency referral processes.

背景：药物法院和社区提供者之间的有效工作关系对于改善阿片类药物使用障碍（mod）药物的可及性至关重要，但合作往往不足。我们调整并试行了一套执行战略（临床组织和法律机构联盟建设；COLAAB），旨在加强康复法院和国防部机构之间的合作。COLAAB的活动包括有组织的机构间会议、机构参观、学术联络和开发当地资源指南。方法：在三个法院实施COLAAB后，我们对毒品法院和国防部的工作人员进行了半结构化访谈（n = 24），以评估COLAAB对合作、沟通和转诊的影响。使用改进的迭代分类方法对数据进行分析。结果：药品法院和药品法院机构工作人员认为COLAAB促进了机构间关系和转介到药品法院，增加了药品法院机构对药品法院的了解，提高了沟通质量，加强了对药品法院和药品法院的理解和信任，减少了转介到药品法院的时间。COLAAB还提高了国防部工作人员对其他社区提供者的认识，并帮助他们建立潜在的转诊网络。COLAAB可能还增强了毒品法庭工作人员与客户谈论毒品成瘾问题的意愿，以及毒品成瘾提供者工作人员讨论客户刑事法律参与的意愿。讨论：我们的试点研究提供了初步证据，表明可以通过积极了解彼此的实践和服务、参与定期安排的会议或活动，以及识别和使用支持有效的机构间转诊流程的资源，来加强法院与机构间的合作。

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引用次数: 0

Daily patterns of substance use among young adults who vape nicotine and cannabis: Latent class analysis of smartphone-based daily diary data 吸食尼古丁和大麻的年轻人的日常物质使用模式：基于智能手机的日常日记数据的潜在类分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-29 DOI: 10.1016/j.drugalcdep.2026.113060

Deanna M. Halliday , Lisbeth Lund , Pamela M. Ling , Nhung Nguyen

Introduction

Using multiple tobacco and cannabis products is common among young adults and raises concerns about addiction and health risks. Few studies address daily use patterns of multiple products on the same day. We used daily diaries to identify patterns of substance use and associated factors among young adults who reported vaping nicotine and cannabis.

Methods

We collected smartphone-based daily diaries from 113 California young adults (mean age=23.8) who vaped nicotine or cannabis for 20 + days in the past month. For 30 consecutive days, participants reported their daily use of nicotine/tobacco, cannabis, alcohol, craving for nicotine and cannabis vaping, and mood. We used multilevel latent class analysis to identify daily substance use patterns and mixed-effects logistic regression to identify factors associated with these patterns, controlling for baseline covariates (e.g., demographics, nicotine/cannabis dependence).

Results

Three latent classes emerged: Class 1 – “Nicotine vaping days” (52.7 % of the assessments), Class 2 – “Nicotine and cannabis co-vaping days” (39.9 %), and Class 3 -“Combustible tobacco and cannabis use days” (7.4 %). Higher levels of feeling sad on a given day were associated with increased likelihood of that day belonging to Class 1 (adjusted OR = 1.11, 95%CI95 %CI = 1.01 – 1.23). Higher cravings for cannabis vaping on a given day were associated with increased likelihood of that day belonging to Class 2 (adjusted OR = 1.81, 95 % CI = 1.63 – 2.01).

Conclusion

Interventions should be tailored to varying daily substance use patterns among young adults who vape. Efforts targeting vaping cessation may also address combustible product use.

导言：使用多种烟草和大麻产品在年轻人中很常见，这引起了对成瘾和健康风险的关注。很少有研究涉及在同一天使用多种产品的日常使用模式。我们使用每日日记来确定报告吸食尼古丁和大麻的年轻人的物质使用模式和相关因素。方法：我们收集了113名加利福尼亚年轻人（平均年龄为23.8岁）在过去一个月里吸食尼古丁或大麻20多天的智能手机日记。在连续30天的时间里，参与者报告了他们每天使用尼古丁/烟草、大麻、酒精、对尼古丁和大麻电子烟的渴望以及情绪。我们使用多水平潜类分析来确定日常物质使用模式，并使用混合效应逻辑回归来确定与这些模式相关的因素，控制基线共变量（例如，人口统计学，尼古丁/大麻依赖）。结果：出现了三个潜在类别：第1类-“尼古丁雾化日”（占评估的52.7%），第2类-“尼古丁和大麻共同雾化日”（39.9%），第3类-“可燃烟草和大麻使用日”（7.4%）。在某一天感到悲伤的程度越高，这一天属于第一类的可能性就越大（调整后OR = 1.11, 95%CI = 1.01 - 1.23）。在某一天吸食大麻的欲望越高，当天属于第2类的可能性就越大（调整后OR = 1.81, 95% CI = 1.63 - 2.01）。结论：干预措施应针对吸电子烟的年轻人不同的日常物质使用模式。针对戒烟的努力也可能涉及可燃产品的使用。

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引用次数: 0

The evolving burden of drug use disorders in Mexico: Secondary data analysis from the global burden of disease study 2021 墨西哥药物使用障碍负担的演变：来自2021年全球疾病负担研究的二级数据分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-29 DOI: 10.1016/j.drugalcdep.2026.113061

Claudio A. Dávila-Cervantes

Objective

To analyze the burden of disease from drug use disorders (DUD) in Mexico by state from 1990 to 2021 and to assess the association of this burden of disease with the Healthcare Access and Quality Index (HAQI).

Methods

Secondary data analysis from the GBD-2021 study. The paper analyzes mortality, premature mortality, disability and disability-adjusted life years (DALYs). A log-linear segmented regression model to analyze trends in DUD DALYs over time was used. The information was disaggregated by age-groups and sub-causes, at the national and state levels.

Results

DUD mortality increased by 27.9 % over the last three decades. The DUD burden of disease remained stable with DALY rates of 85.8 per 100000 in 1990 and 86.9 in 2021. Males showed mortality rates over four times higher than females. In 2021, DUD premature mortality was higher for males (35.6 vs. 8.2 per 100000 among females), while disability rates were higher for females (70.7 vs. 59.7 among males). The highest DUD DALYs occurred among individuals aged 20–29, with cocaine and opioid use disorders as the leading contributors to the DUD DALYs, with notable differences between males and females. Regionally, the northern states, especially Baja California and Chihuahua, exhibited the highest DUD DALYs, whereas central states like Tlaxcala and the State of Mexico had the lowest. A complex relationship between DUD DALYs and the HAQI was observed.

Conclusions

There is also an urgent need for age- and gender-responsive public health strategies, evidence-based harm reduction programs, and comprehensive policy interventions to lessen the impact of DUD in Mexico.

目的：分析1990 - 2021年墨西哥各州药物使用障碍（DUD）的疾病负担，并评估该疾病负担与卫生保健可及性和质量指数（HAQI）的关系。方法：对GBD-2021研究的二手数据进行分析。本文分析了死亡率、过早死亡率、残疾和残疾调整生命年（DALYs）。使用对数线性分段回归模型分析DUD DALYs随时间的变化趋势。这些信息在国家和州两级按年龄组和子原因分类。结果：DUD死亡率在过去三十年中增加了27.9%。DUD疾病负担保持稳定，1990年的DALY比率为85.8 / 10万，2021年为86.9 / 10万。男性的死亡率是女性的四倍多。2021年，男性DUD过早死亡率更高（女性为35.6比8.2 / 100000），而女性的致残率更高（70.7比59.7 / 100000）。DUD DALYs最高发生在20-29岁的人群中，可卡因和阿片类药物使用障碍是DUD DALYs的主要原因，男性和女性之间存在显著差异。从区域上看，北部各州，尤其是下加利福尼亚州和奇瓦瓦州，显示出最高的DUD DALYs，而中部各州，如特拉斯卡拉州和墨西哥州，则最低。DUD DALYs与HAQI之间存在复杂的关系。结论：墨西哥还迫切需要针对年龄和性别的公共卫生战略、基于证据的减少伤害计划和综合政策干预，以减轻DUD的影响。

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引用次数: 0

Emotional arousal of graphic cigarette warning labels loses its beneficial effects on craving reduction after repeated exposure – A longitudinal neuroimaging study 一项纵向神经影像学研究表明，香烟警告标签的情绪唤醒在反复接触后失去了对减少渴望的有益作用。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-29 DOI: 10.1016/j.drugalcdep.2026.113066

Astrid P. Ramos-Rolón, Daniel D. Langleben, Kevin G. Lynch, Corinde E. Wiers, Zhenhao Shi

Background

Graphic warning labels (GWLs) on cigarette packaging have been implemented in many countries. In the U.S., however, GWLs have faced legal challenges based on concerns that their aversive imagery elicits excessive emotional arousal without sufficient data to support its beneficial impact. This longitudinal study examined how GWLs’ level of arousal affects cigarette craving and neural responses related to emotional processing.

Methods

A total of 158 adults who smoked cigarettes were exposed to either high-arousal (n = 79) or low-arousal (n = 79) GWLs attached to their cigarette packs for 4 weeks. Cigarette craving and brain responses to GWLs were measured using functional magnetic resonance imaging before and after the exposure period. The amygdala, a key region involved in emotional processing, was the brain region of interest.

Results

At baseline, high-arousal GWLs elicited a greater reduction in craving and stronger amygdala activation than low-arousal GWLs. However, by week 4, the differences in craving reduction and amygdala response between groups were no longer significant. Amygdala activity mediated the effect of GWLs on craving reduction, with the mediation effect being more pronounced in the high-arousal group than the low-arousal group at baseline but not at week 4.

Conclusions

The impact of GWL-induced arousal on cigarette craving appears to diminish over time, likely due to habituation in amygdala reactivity. High-arousal GWLs do not provide sustained advantages over low-arousal ones. Low-arousal GWLs may represent a more practical and legally defensible approach to tobacco control in the U.S.

背景：许多国家已经在卷烟包装上实施了图形警告标签。然而，在美国，基于对其令人反感的图像在没有足够数据支持其有益影响的情况下引发过度情绪唤起的担忧，gwl面临着法律挑战。这项纵向研究考察了gwl的觉醒水平如何影响香烟渴望和与情绪处理相关的神经反应。方法：共有158名吸烟的成年人在4周内暴露于烟盒上附着的高唤醒性（n = 79）或低唤醒性（n = 79） gwl。在接触前后，使用功能磁共振成像测量香烟渴望和大脑对gwl的反应。杏仁核是参与情绪处理的关键区域，也是我们感兴趣的大脑区域。结果：在基线水平上，高唤醒的gwl比低唤醒的gwl引起更大的渴望减少和更强的杏仁核激活。然而，到了第4周，两组之间的渴望减少和杏仁核反应的差异不再显著。杏仁核活动介导了高唤醒组对渴望减少的影响，在基线时高唤醒组的中介作用比低唤醒组更明显，但在第4周时没有。结论：gwl诱导的觉醒对香烟渴望的影响似乎随着时间的推移而减弱，可能是由于杏仁核反应的习惯化。高唤醒的gwl并不比低唤醒的gwl提供持续的优势。在美国，低唤醒的gwl可能代表了一种更实际、更合法的烟草控制方法

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引用次数: 0

Impulsivity as a dynamic mechanism linking young adult sleep and drinking behavior during naturally occurring drinking episodes 冲动作为一种动态机制，在自然发生的饮酒事件中连接年轻人的睡眠和饮酒行为

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-23 DOI: 10.1016/j.drugalcdep.2026.113054

Jack T. Waddell , Andrea M. Wycoff , Mary Beth Miller

Background

Impulsivity is implicated in theories linking sleep and drinking behavior. While well-studied across individuals, research regarding sleep, impulsivity, and drinking in real-world contexts is lacking. This study tested a theoretical pathway wherein better-than-average sleep predicts decreased impulsivity while drinking, which then predicts lesser drinking and negative alcohol consequences experienced during drinking episodes.

Method

Young adults (N = 131) completed 21 days of ecological momentary assessment, including morning reports, self-initiated drink reports after first drink, and follow-up drinking reports 60/120 min later. Past-day drinking quantity, negative alcohol consequences, and sleep (duration, nighttime awakenings, and morning readiness to start day) were measured each morning. Impulsivity (urgency, lack of premeditation, lack of perseverance, and sensation seeking) was measured during drink initiation/follow-up reports.

Results

In two of the four multilevel mediation models (one for each facet of impulsivity), better sleep (higher morning readiness and longer sleep duration) predicted decreased state impulsivity (lack of premeditation and sensation seeking) while drinking, which indirectly predicted fewer negative consequences via lighter drinking quantity. Above and beyond state impulsivity while drinking, higher morning readiness indirectly predicted fewer negative consequences via lighter drinking quantity. Increased urgency also indirectly predicted negative consequences via heavier drinking quantity but was unrelated to sleep. Findings were unchanged when accounting for cumulative sleep debt, except relations between morning readiness and sensation seeking while drinking.

Conclusions

Dampened state impulsivity while drinking may explain protective associations between good sleep health and less risky drinking. Sleep interventions may be effective at reducing impulsivity while drinking and alcohol-related harms.

冲动性与睡眠和饮酒行为有关。虽然对个体的研究很充分，但在现实环境中关于睡眠、冲动和饮酒的研究还很缺乏。这项研究测试了一个理论途径，其中比平均水平更好的睡眠预示着饮酒时冲动的减少，这预示着饮酒期间饮酒和负面酒精后果的减少。方法年轻成人（N = 131）完成21天的生态瞬间评估，包括晨间报告、首次饮酒后的主动饮酒报告和60/120分钟后的随访饮酒报告。每天早上测量过去一天的饮酒量、负面酒精后果和睡眠（持续时间、夜间醒来和早晨开始一天的准备情况）。冲动性（紧迫感、缺乏预谋、缺乏毅力和寻求感觉）在饮酒开始/后续报告中被测量。结果在四个多层次中介模型中的两个模型（冲动性各一个）中，较好的睡眠（较高的早晨准备和较长的睡眠时间）预测饮酒时状态冲动性（缺乏预谋和感觉寻求）的降低，通过较轻的饮酒量间接预测较少的负面后果。除了饮酒时的状态冲动之外，早晨准备程度越高间接预示着饮酒量越少的负面后果越少。紧迫感的增加也间接预示着大量饮酒带来的负面影响，但与睡眠无关。当考虑到累积的睡眠债务时，研究结果没有变化，除了早晨准备和喝酒时寻求感觉之间的关系。结论：饮酒时的抑制状态冲动可能解释了良好睡眠健康和低风险饮酒之间的保护性联系。睡眠干预可能对减少饮酒时的冲动和酒精相关危害有效。

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引用次数: 0

Cannabis legalization and cannabis and opioid use in a large, multistate sample of people who inject drugs: A staggered adoption difference-in-differences analysis 大麻合法化、大麻和阿片类药物在大量多州注射吸毒者中的使用：一项交错采用的差异分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-23 DOI: 10.1016/j.drugalcdep.2026.113040

Danielle F. Haley , Stephanie Beane , Leo Beletsky , Courtney R. Yarbrough , Sabriya Linton , Umedjon Ibragimov , Hannah LF Cooper

Background

The role of cannabis reform in shaping North America’s overdose and addiction crisis remains hotly contested. People who inject drugs (PWID) sometimes substitute cannabis for opioids. Yet, no research has examined the effects of cannabis legalization on opioid use among PWID-- despite major potential for PWID to benefit from policy interventions reducing opioid-related harms. We examined whether legalizing cannabis for medical use (MCL) vs. both MCL and adult/recreational use (MCL+RCL) was associated with changes in substance use among PWID, overall and by sex and race/ethnicity.

Methods

This serial cross-sectional observational study used staggered adoption difference-in-differences models to analyze data (2012, 2015, 2018, 2022) from 28,069 PWID from 13 states. We examined associations between time-varying implementation of MCLs and MCL+RCLs and self-reported past 12-month daily use of cannabis and non-medical opioid use.

Results

Compared to MCL, MCL+RCL was associated with a 9–11 % decrease in the probability of daily opioid misuse (95 % CIs: [any opioids: −14.0, −4.0]; [injected opioids, −19.0, −2.0]). The probability of daily cannabis use increased from 15 % to 20 % for non-Latinx White PWID in states transitioning from no legalization to MCL (95 % CIs: 14.0, 17.0; 17.0, 23.0).

Conclusions

Cannabis legalization may shape daily opioid consumption among PWID, potentially reducing drug-related harms. Differences in cannabis use following legalization may reflect disparate impact by race, due to structural racism or other factors. Future research examining whether policy attributable changes in substance use manifest health benefits among PWID is critical to developing evidence- based cannabis reform.

背景：大麻改革在形成北美过量和成瘾危机中的作用仍然存在激烈争议。注射毒品（PWID）的人有时会用大麻代替阿片类药物。然而，没有研究调查大麻合法化对PWID中阿片类药物使用的影响——尽管PWID有很大的潜力从减少阿片类药物相关危害的政策干预中受益。我们研究了医用大麻合法化（MCL）与MCL和成人/娱乐大麻合法化（MCL+RCL）是否与PWID中药物使用的变化有关，总体而言，按性别和种族/民族划分。方法：本系列横断面观察研究采用交错采用差异中差异模型分析来自13个州28,069名PWID的数据（2012年，2015年，2018年，2022年）。我们研究了MCL和MCL+ rcl的时变实施与自我报告的过去12个月每日大麻使用和非医用阿片类药物使用之间的关系。结果：与MCL相比，MCL+RCL与每日阿片类药物滥用概率降低9- 11%相关（95% ci:[任何阿片类药物：-14.0,-4.0]；[注射阿片类药物，-19.0,-2.0]）。在从不合法化过渡到MCL的州，非拉丁裔白人PWID的每日大麻使用概率从15%增加到20% （95% ci: 14.0, 17.0; 17.0, 23.0）。结论：大麻合法化可能会影响PWID的日常阿片类药物消费，潜在地减少与毒品相关的危害。大麻合法化后大麻使用的差异可能反映了由于结构性种族主义或其他因素造成的种族差异影响。未来研究是否政策可归因于物质使用的变化在PWID中表现出健康益处对于发展基于证据的大麻改革至关重要。

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引用次数: 0

Caregiver-reported evaluation for and diagnosis of fetal alcohol spectrum disorders in the United States 在美国，照顾者报告胎儿酒精谱系障碍的评估和诊断

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-21 DOI: 10.1016/j.drugalcdep.2026.113055

Nicholas P. Deputy , Ashleigh M. Kellerman , Amanda N. Dorsey , Clark H. Denny , Mary Kate Weber , Shawn A. Thomas , Jessica Jones , Shin Y. Kim , Jacquelyn Bertrand

Background

In-person, active case ascertainment studies suggest the prevalence of children with fetal alcohol spectrum disorders (FASDs), lifelong disorders caused by prenatal alcohol exposure, in selected communities ranges from 11.3 to 71.4 per 1000 (including diagnosed and undiagnosed FASDs). National, population-based estimates of children with an FASD diagnosis and who are at different stages of a prototypical diagnostic process are limited.

Methods

Data are from the 2022–2024 National Survey of Children’s Health (n = 160,640). We estimated the caregiver-reported prevalence of children who had ever been recommended for an FASD evaluation, received an FASD evaluation, and received an FASD diagnosis, overall and by demographic subgroups; Chi-square tests assessed differences by subgroup.

Results

Based on caregiver report, 2.4 per 1000 children were recommended for an FASD evaluation, 3.1 per 1000 received an evaluation, and 2.0 per 1000 received an FASD diagnosis. Prevalence varied by several characteristics; for example, the prevalence of children with an FASD diagnosis was higher among those cared for by grandparents or other relations (10.8 per 1000, 95 % confidence interval [CI]: 7.2–16.0) than those cared for by two parents (1.2 per 1000, 95 % CI: 0.9–1.6). Of the 4.6 per 1000 children either recommended for an FASD evaluation, received an evaluation, or diagnosed with an FASD, 20.0 % had all three experiences.

Conclusions

These nationally representative, caregiver-reported estimates for children with an FASD diagnosis are lower than those from active case ascertainment studies, suggesting efforts are needed to improve the screening, evaluation, and diagnosis process for children suspected of an FASD.

背景：积极的病例确定研究表明，在选定社区，胎儿酒精谱系障碍（由产前酒精暴露引起的终身障碍）儿童的患病率为每1000人中11.3至71.4人（包括确诊和未确诊的fasd）。在全国范围内，基于人群的FASD诊断儿童和处于典型诊断过程不同阶段的儿童的估计是有限的。方法数据来自2022-2024年全国儿童健康调查（n = 160640）。我们估计了照顾者报告的曾被推荐进行FASD评估、接受FASD评估和接受FASD诊断的儿童的总体和人口亚组患病率；卡方检验按亚组评估差异。结果根据护理人员报告，每1000名儿童中有2.4名被推荐进行FASD评估，每1000名儿童中有3.1名接受评估，每1000名儿童中有2.0名接受FASD诊断。流行程度因几个特征而异；例如，由祖父母或其他亲属照顾的儿童患FASD的比例（10.8 / 1000,95%可信区间[CI]: 7.2-16.0）高于由双亲照顾的儿童（1.2 / 1000,95%可信区间：0.9-1.6）。每1000名儿童中有4.6名被推荐进行FASD评估，接受评估或被诊断为FASD，其中20.0%的儿童同时经历了这三种经历。结论：这些具有全国代表性的护理人员报告的FASD诊断儿童的估计低于积极的病例确定研究，这表明需要努力改进FASD疑似儿童的筛查、评估和诊断过程。

{"title":"Caregiver-reported evaluation for and diagnosis of fetal alcohol spectrum disorders in the United States","authors":"Nicholas P. Deputy , Ashleigh M. Kellerman , Amanda N. Dorsey , Clark H. Denny , Mary Kate Weber , Shawn A. Thomas , Jessica Jones , Shin Y. Kim , Jacquelyn Bertrand","doi":"10.1016/j.drugalcdep.2026.113055","DOIUrl":"10.1016/j.drugalcdep.2026.113055","url":null,"abstract":"<div><h3>Background</h3><div>In-person, active case ascertainment studies suggest the prevalence of children with fetal alcohol spectrum disorders (FASDs), lifelong disorders caused by prenatal alcohol exposure, in selected communities ranges from 11.3 to 71.4 per 1000 (including diagnosed and undiagnosed FASDs). National, population-based estimates of children with an FASD diagnosis and who are at different stages of a prototypical diagnostic process are limited.</div></div><div><h3>Methods</h3><div>Data are from the 2022–2024 National Survey of Children’s Health (n = 160,640). We estimated the caregiver-reported prevalence of children who had ever been recommended for an FASD evaluation, received an FASD evaluation, and received an FASD diagnosis, overall and by demographic subgroups; Chi-square tests assessed differences by subgroup.</div></div><div><h3>Results</h3><div>Based on caregiver report, 2.4 per 1000 children were recommended for an FASD evaluation, 3.1 per 1000 received an evaluation, and 2.0 per 1000 received an FASD diagnosis. Prevalence varied by several characteristics; for example, the prevalence of children with an FASD diagnosis was higher among those cared for by grandparents or other relations (10.8 per 1000, 95 % confidence interval [CI]: 7.2–16.0) than those cared for by two parents (1.2 per 1000, 95 % CI: 0.9–1.6). Of the 4.6 per 1000 children either recommended for an FASD evaluation, received an evaluation, or diagnosed with an FASD, 20.0 % had all three experiences.</div></div><div><h3>Conclusions</h3><div>These nationally representative, caregiver-reported estimates for children with an FASD diagnosis are lower than those from active case ascertainment studies, suggesting efforts are needed to improve the screening, evaluation, and diagnosis process for children suspected of an FASD.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"280 ","pages":"Article 113055"},"PeriodicalIF":3.6,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146057311","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}

引用次数: 0

Randomized studies assessing the effect of flavor on pharmacokinetic and subjective parameters for dry and moist nicotine pouches 评估风味对干湿尼古丁袋的药代动力学和主观参数影响的随机研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-20 DOI: 10.1016/j.drugalcdep.2026.113050

Mikael Staaf, Anna E. Masser , Camilla Pramfalk , Robert Pendrill, Sara Moses, Johan Lindholm, Tryggve Ljung

Background

Nicotine pouches (NPs) have different formulations (e.g., dry or moist), and the vast majority are flavored. However, it is unclear if flavors exert any effect on nicotine pharmacology and subjective parameters.

Methods

Data from two, open-label, randomized, nine-way cross-over, single-dose administration, pharmacokinetic and subjective effects studies were analyzed, evaluating dry 6-mg and moist 9-mg NPs, respectively. The studies included unflavored and flavored varieties (flavor characteristics: traditional [tobacco], cooling, minty, fruit, beverage). All participants were adults who currently used snus and/or NPs daily (n = 38 for moist, n = 39 for dry).

Results

Maximum plasma concentrations (C_max) of nicotine were observed at NP removal at ~60 min (T_max), with overlapping geometric least squares mean (GLSM) values for the dry and moist products (12.08–15.07 ng/mL). The total nicotine exposure (calculated as area under the curve from time point 0 to infinity, AUC_inf) was 40.84–50.86 h⁎ng/mL, with overlapping GLSM values for dry and moist varieties. Equivalence testing for AUC_inf and C_max between unflavored and flavored varieties showed equivalence for all varieties except two of the moist minty NPs. For subjective parameters, the effect of flavor was more pronounced for moist NPs, with participants rating the flavored varieties higher for satisfaction, product liking, and intent to use again.

Conclusions

For dry varieties, flavor had no effect on C_max and AUC_inf, but two moist varieties were different from moist unflavored. Flavor did not affect T_max for dry or moist NPs. Considerable variation in participant preferences suggest a need for diverse varieties and product types.

尼古丁袋（NPs）有不同的配方（例如，干的或湿的），绝大多数是调味的。然而，尚不清楚香料是否对尼古丁的药理学和主观参数有任何影响。方法分析两项开放标签、随机、九向交叉、单剂量给药、药代动力学和主观效应研究的数据，分别评价干燥型6 mg和湿润型9 mg NPs。研究包括无风味和有风味的品种（风味特征：传统[烟草]，冷却，薄荷，水果，饮料）。所有参与者都是目前每天使用鼻烟和/或NPs的成年人（n = 38为潮湿，n = 39为干燥）。结果在NP去除~60 min （Tmax）时，烟碱的最大血浆浓度（Cmax）出现重叠，干湿产品的几何最小二乘平均值（GLSM）为12.08 ~ 15.07 ng/mL。总尼古丁暴露量（以从时间点0到无限长的曲线下面积计算，AUCinf）为40.84 ~ 50.86 h·ng/mL，干湿品种的GLSM值重叠。无味和有味品种间的AUCinf和Cmax等效性试验表明，除两种湿薄荷NPs外，其他品种均相等。在主观参数方面，风味的影响对潮湿的NPs更为明显，参与者在满意度、产品喜好和再次使用的意图方面对风味品种的评价更高。结论对于干型品种，风味对Cmax和aucf没有影响，但两种湿型品种与湿型无风味品种不同。风味对干性和湿性NPs的Tmax没有影响。参与者偏好的巨大差异表明需要多样化的品种和产品类型。

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引用次数: 0