Drug and alcohol dependence最新文献_第2页

Illicit cannabis use among workers in Australia: A nationally representative cross-sectional analysis of prevalence, determinants, and associated absenteeism 非法大麻在澳大利亚工人中的使用：流行，决定因素和相关旷工的全国代表性横断面分析。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.drugalcdep.2026.113057

Gianluca Di Censo , Kirrilly Thompson , Jacqueline Bowden

Introduction

Cannabis is the most used illicit substance among workers in Australia, yet the epidemiology of frequent use and risk of harm remains underexplored. This study investigated the prevalence and determinants of, as well as absenteeism associated with, weekly illicit cannabis use and risk of cannabis-related harm among Australian workers.

Method

The study used data from the 2019 and 2022–23 National Drug Strategy Household Surveys (N = 24,954).

Results

Weekly cannabis use was reported by 5.0 % (SE = 0.2) of respondents, while 2.2 % (SE = 0.1) were classified as at risk of harm. Workers in construction and hospitality, as well as labourers and tradesmen, exhibited elevated rates of use and harm. Significant determinants of weekly illicit cannabis use identified in multivariate regression models include being male, younger (14–39 years), never married, born in Australia, smoking (current or former), and heavy episodic drinking (HED). Determinants of being at risk of harm were being male, never married, born in Australia, residing in a major city, experiencing psychological distress, smoking (current or former), and HED. Current smoking showed the strongest associations with both outcome measures. Weekly illicit cannabis use and being at risk of harm were associated with 2.8 and 6.9 additional days absent from work due to illness or injury, respectively.

Conclusions

By identifying the determinants and consequences of frequent illicit cannabis use and being at risk of harm among employed individuals, these findings provide key insights necessary to develop targeted behavioural change and workplace substance use interventions.

导言：大麻是澳大利亚工人中使用最多的非法物质，但频繁使用的流行病学和危害风险仍未得到充分探讨。本研究调查了澳大利亚工人每周非法使用大麻的流行程度和决定因素，以及与之相关的缺勤情况，以及大麻相关危害的风险。方法：研究使用2019年和2022-23年国家毒品战略住户调查的数据（N = 24954）。结果：5.0% （SE = 0.2）的受访者报告每周使用大麻，而2.2% （SE = 0.1）被归类为有危害风险。建筑业和酒店业的工人，以及劳工和商人，使用和伤害的比例都有所上升。在多变量回归模型中确定的每周非法大麻使用的重要决定因素包括男性、年轻（14-39岁）、未婚、在澳大利亚出生、吸烟（目前或以前）和严重的间歇性饮酒（HED）。有伤害风险的决定因素是男性、未婚、出生在澳大利亚、居住在主要城市、经历心理困扰、吸烟（现在或以前）和HED。当前吸烟与这两项结果指标的相关性最强。每周使用非法大麻和面临伤害风险分别与因病或受伤而缺勤的天数增加2.8天和6.9天有关。结论：通过确定就业人员频繁使用非法大麻的决定因素和后果以及受到伤害的风险，这些发现为制定有针对性的行为改变和工作场所药物使用干预措施提供了必要的关键见解。

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引用次数: 0

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 : 2026-03-01 Epub 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

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 : 2026-03-01 Epub 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。

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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 : 2026-03-01 Epub 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

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 : 2026-03-01 Epub 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

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 : 2026-03-01 Epub 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

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 : 2026-03-01 Epub 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

Alcohol quantity mediates the association between daily alcohol and cannabis co-use and alcohol consequences 酒精量介导每日酒精和大麻共同使用与酒精后果之间的关联

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-12 DOI: 10.1016/j.drugalcdep.2026.113043

Rachel L. Gunn , Alexander W. Sokolovsky , Lindy K. Howe , Nancy P. Barnett , Kristina M. Jackson , Sharon Lipperman-Kreda , Robert Miranda Jr. , Timothy Trull , Jane Metrik

Background

Alcohol and cannabis are commonly used substances for young adults, and person-level co-use (i.e., concurrent or simultaneous use of both) is associated with increased likelihood of experiencing positive and negative alcohol-related consequences. However, findings regarding within-person effects (i.e.,day-level) co-use on consequences are mixed, possibly due to inconsistency in including alcohol quantity (i.e., total number of standard drinks consumed) when examining the association between co-use and consequences. In the present study, we examined whether the number of drinks mediates the association between co-use and positive or negative alcohol consequences at the day level.

Methods

Data from morning reports in a 28-day field-based study of young adults reporting frequent past 60-day alcohol and cannabis use (N = 115) were used to test multilevel mediation models.

Results

We found significant mediation for both positive and negative alcohol consequences; consuming more alcoholic drinks on co-use days, relative to alcohol-only days, was associated with a higher likelihood of experiencing negative consequences and a lower likelihood of positive consequences. These results suggest that daily number of drinks is a significant driver of the relationship between co-use and alcohol-related consequences at the day-level.

Conclusions

In the context of increased cannabis use among young adults, this finding provides critical information for prevention and intervention efforts aimed at reducing the alcohol-related consequences associated with co-use days. Overall, reducing total alcohol consumption remains a prominent harm-reduction strategy among this population.

酒精和大麻是年轻人常用的物质，个人层面的共同使用（即同时或同时使用两者）与经历与酒精有关的积极和消极后果的可能性增加有关。然而，关于共同使用对后果的个人影响（即日水平）的发现是混合的，可能是由于在检查共同使用与后果之间的关系时，包括酒精量（即消耗的标准饮料总数）不一致。在目前的研究中，我们研究了饮酒的数量是否介导了共同使用和积极或消极酒精后果之间的联系。方法对过去60天频繁使用酒精和大麻的年轻人（N = 115）进行了一项为期28天的实地研究，研究数据来自晨间报告，用于检验多层次中介模型。结果我们发现酒精对积极和消极后果都有显著的中介作用；与只喝酒的日子相比，在一起喝酒的日子里喝更多的酒，经历负面后果的可能性更高，而产生积极后果的可能性更低。这些结果表明，每天的饮酒量是共同使用和酒精相关后果之间关系的重要驱动因素。结论：在年轻人大麻使用增加的背景下，这一发现为预防和干预工作提供了重要信息，旨在减少与共同使用天数相关的酒精相关后果。总的来说，减少酒精消费总量仍然是这一人群减少危害的主要策略。

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引用次数: 0

Rising and disparate trends in the private/for-profit acquisition of nonprofit substance use treatment facilities, US, 2019–2024 私人/营利性收购非营利性物质使用治疗设施的上升和不同趋势，美国，2019-2024

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-13 DOI: 10.1016/j.drugalcdep.2026.113045

George Pro , Jonathan Cantor , Mofan Gu , Kari Weber , Brooke Montgomery

Background

Private acquisition of public and nonprofit healthcare facilities is increasing throughout the United States (US). While privatization can be beneficial, growing evidence has demonstrated higher costs, larger patient volumes, and worsening outcomes. These trends are also apparent in substance use disorder (SUD) treatment facilities at a time when overdose and treatment demand are at an all time high. This study was designed to measure whether increases in private acquisitions of nonprofit substance use treatment facilities are happening faster in underrepresented and underresourced communities.

Methods

We used the Mental health and Addiction Treatment Tracking Repository (MATTR) to identify SUD treatment facilities that were nonprofit/public owned in 2019 (N = 2826 facilities). Our outcome was whether a facility became privatized and owned by a for-profit company by 2024. We linked MATTR to demographic census data and modeled privatization using a generalized estimating equation with a modified Poisson distribution, log link function, and robust standard errors.

Results

Twenty percent (n = 572) of public/nonprofit SUD treatment facilities were privatized between 2019 and 2024. Privatization of nonprofit/public facilities was more common in communities with lower household incomes (p < 0.01).

Conclusion

Private acquisition of nonprofit/public SUD treatment facilities increased between 2019 and 2024. Acquisitions were disproportionately located in communities with higher rates of low-income households. Private acquisition can be beneficial for some facilities, but a growing evidence base is demonstrating how privatization is generally followed by worsening health outcomes in the process of restructuring and reselling at a profit. Treatment systems must not be extractive. Oversight and community involvement may help ensure mutual beneficence.

背景：在美国，私人收购公共和非营利医疗机构的情况正在增加。虽然私有化可能是有益的，但越来越多的证据表明，成本更高，患者人数更多，结果更差。这些趋势在药物使用障碍（SUD）治疗设施中也很明显，因为过量和治疗需求处于历史高位。本研究旨在衡量在代表性不足和资源不足的社区，私人收购非营利性药物使用治疗设施的增长是否更快。方法使用心理健康和成瘾治疗跟踪库（matr）识别2019年非营利性/公营的SUD治疗机构（N = 2826家机构）。我们的结果是，到2024年，一个设施是否会私有化，并由一家营利性公司拥有。我们将matr与人口普查数据联系起来，并使用带有修正泊松分布、日志链接函数和鲁棒标准误差的广义估计方程来建模私有化。结果2019 - 2024年，20% （n = 572）的公立/非营利SUD治疗机构实现了私有化。非营利性/公共设施私有化在家庭收入较低的社区更为常见（p < 0.01）。结论2019 - 2024年间，非营利性/公立SUD治疗设施的私人收购有所增加。收购不成比例地位于低收入家庭比例较高的社区。私人收购对某些设施可能是有益的，但越来越多的证据表明，私有化之后，在重组和转售过程中，健康结果通常会恶化。处理系统不能是萃取性的。监督和社区参与可能有助于确保互惠互利。

{"title":"Rising and disparate trends in the private/for-profit acquisition of nonprofit substance use treatment facilities, US, 2019–2024","authors":"George Pro , Jonathan Cantor , Mofan Gu , Kari Weber , Brooke Montgomery","doi":"10.1016/j.drugalcdep.2026.113045","DOIUrl":"10.1016/j.drugalcdep.2026.113045","url":null,"abstract":"<div><h3>Background</h3><div>Private acquisition of public and nonprofit healthcare facilities is increasing throughout the United States (US). While privatization can be beneficial, growing evidence has demonstrated higher costs, larger patient volumes, and worsening outcomes. These trends are also apparent in substance use disorder (SUD) treatment facilities at a time when overdose and treatment demand are at an all time high. This study was designed to measure whether increases in private acquisitions of nonprofit substance use treatment facilities are happening faster in underrepresented and underresourced communities.</div></div><div><h3>Methods</h3><div>We used the Mental health and Addiction Treatment Tracking Repository (MATTR) to identify SUD treatment facilities that were nonprofit/public owned in 2019 (N = 2826 facilities). Our outcome was whether a facility became privatized and owned by a for-profit company by 2024. We linked MATTR to demographic census data and modeled privatization using a generalized estimating equation with a modified Poisson distribution, log link function, and robust standard errors.</div></div><div><h3>Results</h3><div>Twenty percent (n = 572) of public/nonprofit SUD treatment facilities were privatized between 2019 and 2024. Privatization of nonprofit/public facilities was more common in communities with lower household incomes (p < 0.01).</div></div><div><h3>Conclusion</h3><div>Private acquisition of nonprofit/public SUD treatment facilities increased between 2019 and 2024. Acquisitions were disproportionately located in communities with higher rates of low-income households. Private acquisition can be beneficial for some facilities, but a growing evidence base is demonstrating how privatization is generally followed by worsening health outcomes in the process of restructuring and reselling at a profit. Treatment systems must not be extractive. Oversight and community involvement may help ensure mutual beneficence.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"279 ","pages":"Article 113045"},"PeriodicalIF":3.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973939","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

Are there differences in gradual versus abrupt smoking cessation quit attempts and success by social grade? A population study in England 渐进式戒烟和突然戒烟的尝试和成功是否因社会等级而有差异？英国的一项人口研究。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2025-12-24 DOI: 10.1016/j.drugalcdep.2025.113017

Sharon Cox , Lion Shahab , Claire Garnett , Nicola Lindson , Sarah Jackson

Background and aims

Smoking rates remain higher among individuals from less advantaged social grades, who tend to be less successful when they try to quit. Abrupt quitting may be more successful than cutting down first, though evidence is mixed. It is not clear whether the quit methods chosen, and their effects, differ by social grade. This study aimed to: (1) compare the prevalence of gradual versus abrupt quit attempts across social grades; (2) examine the association between quit method and quit success; and (3) assess whether social grade moderates this association.

Methods

We used data from 27,390 adults in England who reported a past-year quit attempt in the Smoking Toolkit Study (2006–2025). Quit method used (gradual vs. abrupt) and quitting success were self-reported. Logistic regression analyses examined the two-way interaction between quit method and social grade (ABC1 =more advantaged vs. C2DE=less advantaged) and success, adjusting for sociodemographic and smoking-related covariates.

Results

People from less advantaged social grades were less likely to attempt to quit abruptly (53.2 % [95 % CI: 52.3–54.0 %] vs. 57.4 % [56.4–58.4 %]). Abrupt quitting was associated with higher odds of success compared with gradual quitting (OR = 1.70; 95 % CI: 1.58–1.84) providing no clear evidence this was moderated by social grade (interaction OR = 1.13; 95 % CI: 0.97–1.33, p = 0.14).

Conclusion

People who choose to quit abruptly are more likely to quit successfully than people who choose to quit gradually, irrespective of their social grade. However, people from less advantaged social grades are less likely to choose to quit abruptly.

背景和目的：社会地位较低的人的吸烟率仍然较高，他们在试图戒烟时往往不太成功。尽管证据不一，但突然戒烟可能比先戒烟更成功。目前尚不清楚所选择的戒烟方法及其效果是否因社会等级而异。本研究的目的是：(1)比较不同社会阶层中逐渐戒烟和突然戒烟的流行程度；(2)研究戒烟方法与戒烟成功的关系；(3)评估社会等级是否调节了这种关联。方法：我们使用了英国27,390名成年人的数据，这些成年人在吸烟工具包研究（2006-2025）中报告了过去一年的戒烟尝试。采用的戒烟方法（渐进式与突然式）和戒烟成功均为自我报告。逻辑回归分析检验了戒烟方法与社会等级（ABC1 =优势vs. C2DE=劣势）和成功之间的双向相互作用，调整了社会人口统计学和吸烟相关协变量。结果：社会地位较低的人不太可能试图突然戒烟（53.2% [95% CI: 52.3- 54.0%]对57.4%[56.4- 58.4%]）。与逐渐戒烟相比，突然戒烟的成功几率更高（OR = 1.70; 95% CI: 1.58-1.84），没有明确的证据表明这与社会等级有关（相互作用OR = 1.13; 95% CI: 0.97-1.33, p = 0.14）。结论：选择突然戒烟的人比选择逐渐戒烟的人更有可能成功戒烟，无论他们的社会地位如何。然而，社会地位较低的人不太可能选择突然戒烟。

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引用次数: 0