Drug and alcohol dependence最新文献_第3页

Sustained effects of reduced nicotine cigarettes and co-use of non-combusted alternative nicotine delivery systems: A one-month follow-up to a randomized clinical trial 减少尼古丁香烟和共同使用非燃烧替代尼古丁输送系统的持续影响：一个月的随机临床试验随访。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-16 DOI: 10.1016/j.drugalcdep.2026.113051

Elias M. Klemperer , Xianghua Luo , Qing Cao , Dana M. Carroll , F. Joseph McClernon , Neal L. Benowitz , Andrew A. Strasser , Jennifer W. Tidey , Eric C. Donny , Dorothy K. Hatsukami

Introduction

The US FDA has proposed a nicotine-reducing standard for cigarettes. A recent trial found that, with access to alternative nicotine delivery systems (ANDS; i.e., e-cigarettes, nicotine medicines), participants randomized to very low nicotine content (VLNC) vs normal nicotine content (NNC) cigarettes achieved greater smoking reduction. This secondary analysis compared effects of the VLNC+ANDS-access versus NNC+ANDS-access conditions on post-intervention cigarette smoking.

Methodology

Adults who smoke were randomized to 12 weeks of an experimental marketplace with VLNC (0.4 mg nicotine/gram tobacco) vs NNC (15.8 mg/g) cigarettes. All participants had access to non-combusted ANDS. Multivariable regressions were used to examine effects of VLNC vs NNC condition and co-use of ANDS with cigarettes on smoking and cessation-related outcomes during follow-up, when no study products were provided (weeks 12–16).

Results

Among those who completed follow-up (n = 336), VLNC vs NNC participants achieved more 7-day point-prevalence smoking abstinence (VLNC=19.6 % vs NNC=11.0 %; p = 0.031), had more smokefree days (VLNC mean=9.7 vs NNC mean=4.9; p = 0.043), and smoked fewer cigarettes/day (VLNC mean=7.3 vs NNC mean=10.7; p < 0.001). Among participants smoking at week-12 (n = 281), co-use of ANDS vs exclusive smoking was associated with more quit attempts (25.5 % vs 13.0 %; p = 0.005) and fewer cigarette/day (mean=9.3 vs mean=12.4; p < 0.001) during follow-up.

Conclusions

Switching to VLNC cigarettes with access to non-combusted ANDS produced sustained effects on smoking abstinence. Among those who continued smoking, co-use of ANDS was associated with fewer cigarettes/day and more attempts to quit. Findings provide further support for a nicotine-reducing standard for cigarettes in the context of a marketplace which includes ANDS.

导语：美国食品和药物管理局提出了一项减少香烟尼古丁的标准。最近的一项试验发现，通过使用替代尼古丁传递系统（即电子烟、尼古丁药物），参与者被随机分配到尼古丁含量极低（VLNC）和尼古丁含量正常（NNC）的香烟中，吸烟量减少得更多。这一次要分析比较了VLNC+ and - and -access条件与NNC+ and -access条件对干预后吸烟的影响。方法：吸烟的成年人被随机分为VLNC （0.4mg尼古丁/克烟草）和NNC （15.8mg/克烟草）香烟的实验市场，为期12周。所有参与者都能接触到未燃烧的手。在随访期间（第12-16周），当没有提供研究产品时，采用多变量回归来检查VLNC与NNC状况以及ANDS与香烟共同使用对吸烟和戒烟相关结果的影响。结果：在完成随访的参与者中（n = 336）， VLNC与NNC参与者实现了更多的7天点流行戒烟（VLNC= 19.6% vs NNC= 11.0%; p = 0.031），有更多的无烟天数（VLNC平均=9.7 vs NNC平均=4.9;p = 0.043），每天吸烟更少(VLNC平均=7.3 vs NNC平均=10.7；p结论：切换到可获得非燃烧源的VLNC香烟对戒烟产生了持续的影响。在那些继续吸烟的人中，共同使用ANDS与每天吸烟的减少和更多的戒烟尝试有关。研究结果进一步支持在包括ANDS在内的市场背景下制定减少香烟尼古丁的标准。

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引用次数: 0

A pilot trial of using ecological momentary intervention to deliver tetris for alcohol craving among women 一项使用生态瞬时干预的试点试验，为女性的酒精渴望提供俄罗斯方块

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-16 DOI: 10.1016/j.drugalcdep.2026.113052

Christine K. Hahn , Alexandra N. Brockdorf , Jeffrey M. Pavlacic , Christopher L. Metts , Kathleen T. Brady , Michaela Hoffman , Constance Guille , Michael E. Saladin , Sudie E. Back

Innovative and accessible interventions are critical to address rising rates of alcohol misuse and low rates of alcohol treatment engagement among women. Ecological momentary interventions (EMI) that use technology to deliver interventions in real-time may be a promising avenue to reduce barriers to alcohol interventions for women and ensure they receive intervention when they need it most. Craving is a key proximal predictor of alcohol use that may be beneficial to target using EMI. Tetris is a visuospatial task that may disrupt craving by placing competing demands on visual working memory. This study tested a Tetris EMI for craving and alcohol use among women who reported alcohol misuse. Forty women completed a two-week experimental EMA protocol involving a daily interval-contingent survey assessing past-day alcohol craving and consumption, as well as four daily signal-contingent surveys assessing momentary craving. Participants assigned to the intervention condition (n = 20) were prompted to complete Tetris for four minutes in response to momentary craving and those assigned to the control condition (n = 20) were prompted to wait four minutes before re-rating craving. Participants also completed baseline and post-experimental questionnaires. Results indicated that the Tetris EMI was highly acceptable and generally feasible. The EMI predicted average decreases in momentary craving for those who reported high levels of recognition of possible harms related to their drinking and readiness to change. However, the EMI did not lead to decreases in average daily craving or drinking. Findings suggest craving is a modifiable target for EMIs among women who are more ready for treatment.

创新和可获得的干预措施对于解决妇女酒精滥用率上升和酒精治疗参与率低的问题至关重要。利用技术实时提供干预措施的生态瞬时干预（EMI）可能是一种很有希望的途径，可以减少对妇女进行酒精干预的障碍，并确保她们在最需要的时候得到干预。渴望是酒精使用的一个关键的近端预测因子，可能对使用EMI的目标有益。俄罗斯方块是一项视觉空间任务，它可能通过对视觉工作记忆施加竞争性要求来破坏渴望。这项研究在报告酒精滥用的女性中测试了俄罗斯方块EMI对渴望和酒精使用的影响。40名女性完成了为期两周的实验EMA方案，包括每日间隔随机调查评估过去一天的酒精渴望和消费，以及每日四次信号随机调查评估瞬间渴望。被分配到干预组的参与者（n = 20）被要求完成4分钟的俄罗斯方块来回应短暂的渴望，而被分配到控制组的参与者（n = 20）被要求在重新评估渴望之前等待4分钟。参与者还完成了基线和实验后问卷调查。结果表明，俄罗斯方块电磁干扰是高度可接受和普遍可行的。EMI预测，对于那些高度认识到饮酒可能带来的危害并准备改变的人来说，他们的瞬时渴望平均会减少。然而，EMI并没有导致平均每日渴望或饮酒的减少。研究结果表明，对于那些更愿意接受治疗的女性来说，渴望是一个可以改变的目标。

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引用次数: 0

Dyadic association between support persons’ attitudes towards medication for opioid use disorder and patients’ mental health outcomes 支持人员对阿片类药物使用障碍用药态度与患者心理健康结果的二元关联

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-16 DOI: 10.1016/j.drugalcdep.2026.113053

Kyle J. Moon , Lane F. Burgette , Jasmin Choi , Katherine Nameth , Kevan Shah , Katherine E. Watkins , Karen Chan Osilla

Introduction

Nearly one in three adults with opioid use disorder (OUD) has co-occurring depression or anxiety. Pervasive stigma towards medication for OUD has been identified as a barrier to OUD treatment initiation and retention, but whether stigma also complicates patient mental health outcomes remains unclear.

Methods

We analyzed longitudinal, dyadic data (n = 356 dyads) from a cohort of patients receiving buprenorphine from community health centers in California, who were accompanied by support persons (e.g., partner, family member, friend). We assessed how changes in support persons’ stigmatizing attitudes towards buprenorphine were associated with patients’ depressive and anxiety symptoms at 3-month follow-up using ordinary least squares regression models. To aid in clinical interpretability, we used logistic regression models to estimate the probability of clinically significant depressive and anxiety symptoms at 3-month follow-up.

Results

Support persons’ changes in stigmatizing attitudes towards buprenorphine were significantly associated with patients’ depressive (χ²= 10.95, P = 0.012) and anxiety (χ² = 14.40, P = 0.002) symptoms at follow-up, adjusted for patients’ sociodemographic characteristics and baseline symptoms. Patients whose support person reported increased stigma towards buprenorphine had the highest estimated probability of clinically significant depressive (36.7 % [95 % CI: 21.2, 52.1]) and anxiety symptoms (33.3 % [95 % CI: 18.7, 47.9]).

Conclusions

Stigmatizing attitudes towards buprenorphine held by patients’ loved ones were associated with worse depression and anxiety outcomes. Interventions are needed to address the stigma towards MOUD among support persons; these interventions may also improve the mental health and wellbeing of patients with OUD.

近三分之一的阿片类药物使用障碍（OUD）成年人同时伴有抑郁或焦虑。对OUD药物治疗普遍存在的耻辱感已被确定为OUD治疗开始和保持的障碍，但耻辱感是否也使患者的心理健康结果复杂化仍不清楚。方法我们分析了来自加利福尼亚州社区卫生中心接受丁丙诺啡治疗的患者的纵向、双元数据（n = 356对），这些患者有支持人员（如伴侣、家庭成员、朋友）陪同。在3个月的随访中，我们使用普通最小二乘回归模型评估了支持人员对丁丙诺啡的污名化态度的变化与患者抑郁和焦虑症状的关系。为了帮助临床可解释性，我们使用逻辑回归模型来估计3个月随访时临床显著抑郁和焦虑症状的概率。结果支持人员对丁丙诺啡污名化态度的改变与患者随访时的抑郁（χ2= 10.95, P = 0.012）和焦虑（χ2= 14.40, P = 0.002）症状相关，并根据患者的社会人口学特征和基线症状进行调整。支持人报告对丁丙诺啡的耻耻感增加的患者出现临床显著抑郁（36.7% [95% CI: 21.2, 52.1]）和焦虑症状（33.3% [95% CI: 18.7, 47.9]）的估计概率最高。结论患者家属对丁丙诺啡的污名化态度与患者抑郁、焦虑状况恶化有关。需要采取干预措施，解决支助人员对mod的耻辱感；这些干预措施也可能改善OUD患者的心理健康和福祉。

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引用次数: 0

Alcohol consumption in the Western Province of Sri Lanka: Prevalence, patterns, and health implications 斯里兰卡西部省的酒精消费：流行、模式和健康影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-15 DOI: 10.1016/j.drugalcdep.2026.113049

Prasad Katulanda , Sanduni Gamage , Tharindu Bandara , Akhila Imantha Nilaweera , Desha Rajni Fernando , Gaya Wijeweera Katulanda , Vithanage Pujitha Wickramasinghe , Eranga Wijewickrama

Introduction

Alcohol contributes to global morbidity and mortality. This study aimed to describe the prevalence and patterns of alcohol use, its correlates with health related quality of life (HRQoL) and chronic medical conditions in the Western Province of Sri Lanka.

Methods

A cross-sectional study (2018–2020) was conducted in Western Province recruited 1800 adults (>20 years) via multi-stage stratified cluster sampling. Data collection included interviewer-administered questionnaires, physiological, anthropometric, and biochemical measurements. Alcohol consumption patterns were assessed with Alcohol Use Disorders Identification Test and CAGE tools, and HRQoL with RAND-36.

Results

A total of 1333 adults participated. Alcohol consumption at any point in their life was reported by 25.5 % of participants (95 %CI:18.9–32.1), and 21.3 % (95 %CI:16.8–25.7) had consumed alcohol in the past year. The prevalence was highest among males (56.8 %;95 %CI:46.2–67.4), those aged 40–49 (27.9 %;95 %CI:20.9–34.6), residents of Gampaha district (33.2 %;95 %CI:21.4–44.9), rural dwellers (27.9 %;95 %CI:18.3–37.6), and those earning $300–400 monthly (46.5 %;95 %CI:28.4–64.6). Daily consumption was 5.2 % (95 %CI:1.9–8.3), harmful alcohol use was 28.1 % (95 %CI:19.5–36.7), and clinical alcoholism was 26.6 % (95 %CI:19.5–33.8) among alcohol consumers. Those without clinical alcoholism had higher quality of life than those with the condition. Comorbidities among consumers included dyslipidemia (81.3 %, undiagnosed:58.5 %), hypertension (61.6 %, undiagnosed:33.9 %), diabetes (41.4 %, undiagnosed:11.3 %), and prediabetes (33.8 %).

Conclusions

One-fourth of Western Province adults reported alcohol consumption, highest among middle-aged, middle-income, and residents in Gampaha district. Cardio-metabolic diseases were high among individuals who consume alcohol, many remaining undiagnosed. Non-communicable diseases programs should focus high-risk screening, alcohol control, and preventive community initiatives.

酒精导致全球发病率和死亡率。本研究旨在描述斯里兰卡西部省酒精使用的流行程度和模式，及其与健康相关生活质量（HRQoL）和慢性医疗状况的相关性。方法：采用多阶段分层整群抽样的方法，在西部省开展横断面研究（2018-2020年）。数据收集包括访谈者填写的问卷、生理、人体测量和生化测量。使用酒精使用障碍识别测试和CAGE工具评估酒精消费模式，使用RAND-36评估HRQoL。结果：共有1333名成年人参与。25.5%的参与者（95% CI:18.9-32.1）报告在他们生命中的任何时候饮酒，21.3% （95% CI:16.8-25.7）在过去一年中饮酒。患病率最高的人群为男性（56.8%,95% CI:46.2-67.4）、40-49岁人群（27.9%,95% CI:20.9-34.6）、甘帕哈区居民（33.2%,95% CI:21.4-44.9）、农村居民（27.9%,95% CI:18.3-37.6）和月收入300-400美元的人群（46.5%,95% CI:28.4-64.6）。在饮酒者中，每日饮酒量为5.2% (95% CI:1.9-8.3)，有害饮酒为28.1% (95% CI:19.5-36.7)，临床酒精中毒为26.6% （95% CI:19.5-33.8）。那些没有临床酒精中毒的人比那些有这种情况的人生活质量更高。消费者的合并症包括血脂异常（81.3%，未确诊：58.5%）、高血压（61.6%，未确诊：33.9%）、糖尿病（41.4%，未确诊：11.3%）和前驱糖尿病（33.8%）。结论：西部省份四分之一的成年人报告饮酒，在Gampaha区的中年、中等收入和居民中最高。在饮酒者中，心脏代谢疾病的发病率很高，其中许多尚未被诊断出来。非传染性疾病项目应注重高风险筛查、酒精控制和预防性社区倡议。

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引用次数: 0

“Not in my backyard”: The impact of recovery residences on property values “不在我家后院”：恢复性住宅对房地产价值的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-14 DOI: 10.1016/j.drugalcdep.2026.113044

Ryan Ramphul , Sheryl A. McCurdy , Jooyeon Lee , Yanchen Liu , Yixiao Chen , Serena A. Rodriguez , Kathryn R. Gallardo , Sreelatha Akkala , Hadiza Theyra-Enias , J. Michael Wilkerson

Background

In 2023, an estimated 39.6 million adults aged ≥ 18 years had a substance use disorder (SUD) and 94.7 % did not seek treatment. Recovery residences provide essential support for individuals recovering from SUD, yet their presence in residential neighborhoods often raises concerns on potential decline in property values. Our study examines the relationship between presence of recovery residences and median home values at the census tract level in Texas.

Methods

We used publicly available tract-level data on area, total population, housing units, CDC/ATSDR Social Vulnerability Index (SVI), and median home values. Data on the recovery residences were obtained from a cross-sectional statewide survey of substance use service providers. Census tracts with and without recovery residences were matched using a k-nearest neighbors (KNN) algorithm. Logistic regression and permutation tests were used to assess differences in median home values between matched tracts.

Results

Results from comparison of 329 census tracts with recovery residences and 1161 matched controls showed no significant association between presence of recovery house and property values, after adjusting for population and the covariates that are used for KNN matching. Sensitivity analysis showed no significant association between median home value and the presence of recovery housing.

Conclusions

Our findings suggest no significant association between the likelihood of a tract having recovery residence and home values. Policymakers should consider these findings when addressing zoning restrictions and community opposition to recovery housing.

2023年，估计有3960万≥18岁的成年人患有物质使用障碍（SUD）， 94.7%的人没有寻求治疗。康复住宅为从SUD中康复的个人提供必要的支持，但它们在居民区的存在经常引起人们对房地产价值潜在下降的担忧。我们的研究考察了在德克萨斯州人口普查区水平的恢复住宅和房屋价值中位数之间的关系。方法采用可公开获得的区域数据，包括面积、总人口、住房单位、CDC/ATSDR社会脆弱性指数（SVI）和房屋价值中位数。康复住宅的数据是从全州范围内对物质使用服务提供者的横断面调查中获得的。使用k近邻（KNN）算法对有和没有恢复住宅的人口普查区进行匹配。使用逻辑回归和排列检验来评估匹配区域间房屋中位数价值的差异。结果对329个人口普查区的恢复住宅和1161个匹配对照的比较结果显示，在调整人口和用于KNN匹配的协变量后，恢复住宅的存在与财产价值之间没有显着关联。敏感性分析显示，房屋价值中位数与恢复住房的存在之间没有显着关联。结论：我们的研究结果表明，康复住宅的可能性与房屋价值之间没有显著的关联。政策制定者在解决分区限制和社区对恢复住房的反对时，应该考虑这些发现。

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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 : 2026-01-13 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。

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引用次数: 0

Impact of a brief fentanyl educational intervention on demand for cocaine mixed with fentanyl 短暂芬太尼教育干预对混合芬太尼可卡因需求的影响。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-13 DOI: 10.1016/j.drugalcdep.2026.113042

Cecilia Nunez , Benedicta Anighoro , Jin H. Yoon , Margaret C. Wardle

Background

People who use cocaine are at increased risk of overdose related to fentanyl in the cocaine supply, yet few interventions address fentanyl risks among this population. Demand tasks use hypothetical decisions about drug purchases to quantify likely real-world behavior. Our cocaine demand task, the Adulterated Cocaine Purchasing Task, contrasts planned purchases of cocaine when there is 0 % probability (no chance) the cocaine is mixed with fentanyl vs. 10 % probability (in 10 chance) the cocaine is mixed with fentanyl.

Methods

Using a between-subjects design, participants who reported purchasing cocaine in the past year (N = 58) were randomly assigned to complete test measures either following (intervention group; n = 30) or before receiving (control group; n = 28) fentanyl education. Test measures consisted of the Adulterated Cocaine Purchasing Task, self-reported fentanyl knowledge, and harm reduction strategies. Demographics and substance use history were also assessed.

Results

Findings suggested providing brief fentanyl education significantly increased fentanyl knowledge. Results also indicated higher probability (1 in 10 chance) of fentanyl admixture was consistently related to decreased cocaine demand across multiple demand indices (e.g., reducing their consumption when cocaine is free). However, providing brief education did not lead to reduced demand for cocaine mixed with fentanyl relative to those in the control group. Results also showed fentanyl education did not affect endorsement of harm reduction behaviors.

Conclusion

Our findings further suggest the urgent need to prioritize strategies aside from education to address overdose risk among people who use cocaine.

背景：使用可卡因的人在可卡因供应中与芬太尼相关的过量风险增加，但很少有干预措施解决芬太尼在这一人群中的风险。需求任务使用关于药品购买的假设决策来量化可能的现实行为。我们的可卡因需求任务，掺假可卡因购买任务，将可卡因与芬太尼混合的概率为0%（没有机会）与可卡因与芬太尼混合的概率为10%（有10个机会）的可卡因计划购买进行对比。方法：采用受试者间设计，在过去一年中报告购买可卡因的参与者（N = 58）被随机分配在芬太尼教育之后（干预组，N = 30）或接受芬太尼教育之前（对照组，N = 28）完成测试措施。测试措施包括掺假可卡因购买任务、自我报告的芬太尼知识和减少危害策略。人口统计和药物使用史也进行了评估。结果：研究结果表明，提供简短的芬太尼教育可显著提高芬太尼知识。结果还表明，在多个需求指数中，芬太尼混合物的较高概率（十分之一的机会）与可卡因需求的减少一致相关（例如，当可卡因免费时，减少其消费量）。然而，与对照组相比，提供简短的教育并没有导致可卡因与芬太尼混合的需求减少。结果还显示芬太尼教育并不影响对减少危害行为的认可。结论：我们的研究结果进一步表明，除了教育之外，迫切需要优先考虑策略来解决可卡因使用者的过量风险。

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引用次数: 0

Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California 社会人口、行为和地理空间因素与注射器服务计划在旧金山，加利福尼亚的使用。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-13 DOI: 10.1016/j.drugalcdep.2026.113046

Esther O. Chung , Bradley Ray , Jamie L. Humphrey , Megan Lindstrom , Cariné E. Megerian , Barrot H. Lambdin , Alex H. Kral

Background

Syringe services programs (SSPs) are a cornerstone of preventing infectious disease and overdose for people who use drugs. Given efforts to achieve universal access, we examined factors associated with SSP use, including proximity.

Methods

We used cross-sectional data from 713 people who use drugs across San Francisco, California (September 2023-September 2024). We assessed proximity to an SSP by calculating the walking time between where participants slept the night before and nearest SSP location. We conducted multivariable negative binomial models to explore factors associated with SSP use and assess whether the association between proximity and SSP use was modified by race-ethnicity.

Results

Almost 80 % of participants used an SSP at least once in the past 3 months. Age, race-ethnicity, mode of use, and proximity to SSP were negatively associated with SSP use. Participants who only smoked used SSPs less often than those who used in other ways (adjusted rate ratio [aRR]=0.77, 95 % CI: 0.61–0.97), as well as those more than a 20-minute walk to an SSP (aRR=0.54, 95 % CI: 0.36–0.83). The effect size between walking time to SSP and SSP use was substantially larger for Black participants than non-Black (Black: aRR=0.38, 95 % CI: 0.15–0.60 vs. non-Black: aRR=0.72, 95 % CI: 0.40–1.31).

Conclusions

Geographic distance was a barrier to SSP use, especially for Black participants. SSPs may not reach people who only smoke drugs. SSPs should be added to areas with limited geographic access and include safer smoking supply distribution.

背景：注射器服务计划（ssp）是预防传染病和吸毒过量的人的基石。鉴于实现普遍可及的努力，我们研究了与SSP使用相关的因素，包括邻近性。方法：我们使用了2023年9月至2024年9月在加利福尼亚州旧金山使用药物的713人的横断面数据。我们通过计算参与者前一天晚上睡觉的地方和最近的SSP地点之间的步行时间来评估与SSP的接近程度。我们使用多变量负二项模型来探索与SSP使用相关的因素，并评估邻近性与SSP使用之间的关系是否受到种族的影响。结果：近80%的参与者在过去3个月内至少使用过一次SSP。年龄、种族、使用方式和接近SSP与SSP使用呈负相关。仅吸烟的参与者使用SSP的频率低于以其他方式吸烟的参与者（调整率比[aRR]=0.77, 95% CI: 0.61-0.97），以及步行超过20分钟到SSP的参与者（aRR=0.54, 95% CI: 0.36-0.83）。黑人受试者到SSP的步行时间和使用SSP之间的效应量明显大于非黑人受试者（黑人：aRR=0.38, 95% CI: 0.15-0.60 vs.非黑人：aRR=0.72, 95% CI: 0.40-1.31）。结论：地理距离是使用SSP的障碍，尤其是对黑人参与者。ssp可能无法触及只吸食毒品的人。ssp应增加到地理通道有限的地区，并包括更安全的吸烟供应分配。

{"title":"Sociodemographic, behavioral, and geospatial factors associated with syringe services program use in San Francisco, California","authors":"Esther O. Chung , Bradley Ray , Jamie L. Humphrey , Megan Lindstrom , Cariné E. Megerian , Barrot H. Lambdin , Alex H. Kral","doi":"10.1016/j.drugalcdep.2026.113046","DOIUrl":"10.1016/j.drugalcdep.2026.113046","url":null,"abstract":"<div><h3>Background</h3><div>Syringe services programs (SSPs) are a cornerstone of preventing infectious disease and overdose for people who use drugs. Given efforts to achieve universal access, we examined factors associated with SSP use, including proximity.</div></div><div><h3>Methods</h3><div>We used cross-sectional data from 713 people who use drugs across San Francisco, California (September 2023-September 2024). We assessed proximity to an SSP by calculating the walking time between where participants slept the night before and nearest SSP location. We conducted multivariable negative binomial models to explore factors associated with SSP use and assess whether the association between proximity and SSP use was modified by race-ethnicity.</div></div><div><h3>Results</h3><div>Almost 80 % of participants used an SSP at least once in the past 3 months. Age, race-ethnicity, mode of use, and proximity to SSP were negatively associated with SSP use. Participants who only smoked used SSPs less often than those who used in other ways (adjusted rate ratio [aRR]=0.77, 95 % CI: 0.61–0.97), as well as those more than a 20-minute walk to an SSP (aRR=0.54, 95 % CI: 0.36–0.83). The effect size between walking time to SSP and SSP use was substantially larger for Black participants than non-Black (Black: aRR=0.38, 95 % CI: 0.15–0.60 vs. non-Black: aRR=0.72, 95 % CI: 0.40–1.31).</div></div><div><h3>Conclusions</h3><div>Geographic distance was a barrier to SSP use, especially for Black participants. SSPs may not reach people who only smoke drugs. SSPs should be added to areas with limited geographic access and include safer smoking supply distribution.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"279 ","pages":"Article 113046"},"PeriodicalIF":3.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021044","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

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 : 2026-01-12 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

Identification of hazardous alcohol use in outpatient psychiatric care: A comparison of biomarker phosphatidylethanol (PEth) and self-report 鉴定精神科门诊危险酒精使用：生物标志物磷脂酰乙醇（PEth）和自我报告的比较

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-12 DOI: 10.1016/j.drugalcdep.2026.113047

Lena Lundholm , Johan Skånberg , Sara Wallhed-Finn , Fabian Lenhard

Background

Phosphatidylethanol (PEth) is a reliable biomarker of recent hazardous alcohol use but is resource-intensive and not always feasible in routine mental health care. The Alcohol Use Disorders Identification Test (AUDIT-10) and its short form, AUDIT-C, are widely used self-report tools that may offer practical alternatives. This study examined whether AUDIT scores can serve as proxies for PEth and whether machine learning models enhance prediction.

Methods

Data were collected from 4063 psychiatric outpatients who completed both PEth testing and AUDIT assessments. Regression models evaluated associations between AUDIT scores and PEth concentrations. Receiver Operating Characteristic (ROC) analyses determined cut-offs for hazardous alcohol use (PEth ≥ 0.3 µmol/L). Logistic regression, random forest, and XGBoost models were trained using AUDIT-10/AUDIT-C scores, age, and gender.

Results

AUDIT-10 and AUDIT-C correlated strongly with PEth (pseudo-R² = 30–47 %). ROC analyses showed good discrimination for hazardous use: AUDIT-10 AUC = 0.80 (optimal cut-off ≥5) and AUDIT-C AUC = 0.83 (optimal cut-off ≥4). XGBoost models improved classification modestly, yielding AUCs of 0.90 (AUDIT-10) and 0.88 (AUDIT-C), with balanced accuracies of 79–83 %, outperforming logistic regression and random forest.

Conclusions

AUDIT-10 and AUDIT-C are effective, accessible tools for identifying hazardous alcohol use in psychiatric populations, supporting their role as practical alternatives when PEth testing is unavailable. Machine learning methods offer incremental gains, but simple cut-off scores remain clinically useful. Findings highlight the value of integrating brief alcohol screening into psychiatric care to guide timely interventions, while considering PEth’s biological variability.

磷脂酰乙醇（PEth）是近期危险酒精使用的可靠生物标志物，但它是资源密集型的，在常规精神卫生保健中并不总是可行的。酒精使用障碍鉴定测试（AUDIT-10）及其简短形式AUDIT-C是广泛使用的自我报告工具，可能提供实际的替代方案。本研究考察了审计分数是否可以作为PEth的代理，以及机器学习模型是否可以增强预测。方法收集4063例完成PEth检测和AUDIT评估的精神科门诊患者的数据。回归模型评估了审计分数和PEth浓度之间的关系。受试者工作特征（ROC）分析确定了有害酒精使用的截止值（PEth≥0.3µmol/L）。使用AUDIT-10/AUDIT-C分数、年龄和性别训练逻辑回归、随机森林和XGBoost模型。结果audit -10和AUDIT-C与PEth相关性较强（拟r²= 30 ~ 47%）。ROC分析显示对危险用途有很好的辨别能力：AUDIT-10 AUC = 0.80（最佳临界值≥5），AUDIT-C AUC = 0.83（最佳临界值≥4）。XGBoost模型适度改善了分类，产生的auc为0.90 （AUDIT-10）和0.88 (AUDIT-C)，平衡精度为79 - 83%，优于逻辑回归和随机森林。结论：audit -10和AUDIT-C是识别精神科人群有害酒精使用的有效、可获得的工具，在无法进行PEth检测时支持它们作为实际替代方案的作用。机器学习方法提供增量收益，但简单的截止分数在临床上仍然有用。研究结果强调了将简短的酒精筛查纳入精神科护理以指导及时干预的价值，同时考虑到PEth的生物学变异性。

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引用次数: 0