Drug and alcohol dependence最新文献_第3页

Impact of metabolic syndrome components on fibrosis severity and mortality in alcohol-related liver disease 代谢综合征成分对酒精相关性肝病纤维化严重程度和死亡率的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113027

Kodjo Kunale Abassa , Hongsheng Yu , Shuyan Tan , Mingkai Li , Zhenwei Zhong , Haoxiong Zhou , Yunwei Guo

Background/ Aim

The prognosis of concomitant chronic liver disease and metabolic syndrome (MetS) has been established. However, data on the impact of individual MetS components on mortality in patients with alcohol-related liver cirrhosis (ALC) remain scarce.

Methods

A cross-sectional cohort of 120 patients with alcohol-related liver disease (ArLD) and a longitudinal cohort of 789 patients with ALC were retrospectively enrolled. Patients were categorized into three groups based on the number of MetS components present: Group 1 included patients with no MetS components; Group 2 included those with 1 or 2 components; and Group 3 included patients with ≥ 3 components. Kaplan–Meier and regression analyses were performed to assess the severity of fibrosis in patients with ArLD and to compare mortality outcomes among those with ALC.

Results

Patients with ArLD in group 3 had the highest odds of significant fibrosis [adjusted OR = 2.80 (95 % CI: 1.01–7.76)] and advanced fibrosis [adjusted OR = 17.1 (95 % CI: 3.58–81.9)]. Elevated glucose levels were the only independent factor associated with both significant and advanced fibrosis. Furthermore, the presence of ≥ 3 MetS components predicted higher all-cause mortality (adjusted HR = 5.91, 95 % CI: 2.98–11.75) and liver-related mortality (adjusted HR = 4.73, 95 % CI: 2.05–10.94) in patients with ALC, with glucose and triglycerides levels emerging as the most significant independent risk factors. The presence of diabetes further exacerbated mortality risk in patients with ≥ 3 MetS components.

Conclusions

MetS, particularly abnormal fasting glucose, exacerbated liver fibrosis and significantly worsened mortality in patients with ArLD.

背景/目的慢性肝病合并代谢综合征（MetS）的预后已经确定。然而，关于个体MetS成分对酒精相关性肝硬化（ALC）患者死亡率影响的数据仍然很少。方法回顾性纳入120例酒精相关性肝病（ArLD）患者的横断面队列和789例ALC患者的纵向队列。根据存在的MetS成分的数量将患者分为三组：第一组包括没有MetS成分的患者；第2组为1组分或2组分；第3组包括≥3种成分的患者。Kaplan-Meier和回归分析评估了ArLD患者纤维化的严重程度，并比较了ALC患者的死亡率结果。结果第3组ArLD患者发生显著纤维化（调整OR = 2.80 (95% CI: 1.01-7.76)）和晚期纤维化（调整OR = 17.1 (95% CI: 3.58-81.9)）的几率最高。血糖水平升高是唯一与显著和晚期纤维化相关的独立因素。此外，≥3个MetS成分的存在预示着ALC患者更高的全因死亡率（校正HR = 5.91, 95% CI: 2.98-11.75）和肝脏相关死亡率（校正HR = 4.73, 95% CI: 2.05-10.94），其中葡萄糖和甘油三酯水平成为最重要的独立危险因素。糖尿病的存在进一步加剧了具有≥3个MetS成分的患者的死亡风险。结论smets，尤其是空腹血糖异常，加重了ArLD患者的肝纤维化，并显著加重了死亡率。

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引用次数: 0

Effects of acute adolescent stress on the acquisition and maintenance of intravenous oxycodone self-administration in male and female rats 青春期急性应激对雄性和雌性大鼠静脉注射羟考酮获得和维持的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113030

Corinne A. Gallagher , Daniel J. Chandler , Daniel F. Manvich

Background

The persistent threat of the opioid epidemic warrants investigation into risk factors that predispose individuals to opioid use disorder (OUD). Adolescent stress has been linked to enhanced risk for OUD in humans, however, attempts to model this preclinically have yielded mixed results. Additionally, few studies have explored whether adolescent stress modulates the reinforcing effects of prescription opioids. Here we investigate the impact of acute adolescent stress on oxycodone self-administration in male and female rats.

Methods

Adolescent male and female rats underwent acute restraint stress during concurrent exposure to predator odor, or control handling. Approximately one week later, subjects were allowed to acquire IV oxycodone self-administration (0.03 mg/kg/inf) over 10 sessions (2 h/day) under a fixed-ratio 1 (FR1) schedule of reinforcement. Following three additional FR1 sessions and seven sessions under FR3, rats underwent two progressive-ratio tests (0.03 mg/kg/inf and 0.06 mg/kg/inf, respectively). Separate groups of adolescent rats underwent similar experimental manipulations but were trained on sucrose reinforcement.

Results

Adolescent stress did not affect the rate of acquisition of IV oxycodone self-administration. However, oxycodone self-administration escalated during post-acquisition FR1 sessions and remained elevated during FR3 sessions in stressed rats as compared to unstressed controls. Adolescent stress exposure did not affect responding during progressive-ratio tests, nor did it affect any measure of sucrose pellet reinforcement.

Conclusions

The present results are the first to demonstrate adolescent stress-induced enhancement of oxycodone reinforcement in rats and provide a preclinical model for investigating the neurobiological mechanisms by which adolescent stress increases vulnerability for prescription opioid misuse.

背景：阿片类药物流行的持续威胁需要调查导致个体易患阿片类药物使用障碍（OUD）的危险因素。青少年压力与人类OUD风险增加有关，然而，在临床前建立这种模型的尝试产生了不同的结果。此外，很少有研究探讨青少年压力是否调节处方阿片类药物的强化作用。本文研究了急性青春期应激对雄性和雌性大鼠羟考酮自我给药的影响。方法雄性和雌性青春期大鼠在同时暴露于捕食者气味或对照处理时产生急性约束应激。大约一周后，受试者被允许在固定比率1 （FR1）强化计划下进行静脉注射羟考酮自我给药（0.03 mg/kg/inf），分10次（2小时/天）。在FR1下增加3次和FR3下增加7次后，大鼠进行了两次进行性比率测试（分别为0.03 mg/kg/inf和0.06 mg/kg/inf）。单独的青少年大鼠组进行了类似的实验操作，但接受了蔗糖强化训练。结果青少年应激不影响静脉注射羟考酮的获得率。然而，与非应激对照组相比，应激大鼠的羟考酮自我给药量在获得后FR1会话期间上升，在FR3会话期间保持升高。青少年压力暴露不影响在递进比率测试中的反应，也不影响任何蔗糖颗粒强化的测量。结论本研究首次证实了青春期应激诱导大鼠羟考酮强化增强，并为研究青春期应激增加处方阿片类药物滥用易感性的神经生物学机制提供了临床前模型。

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引用次数: 0

Test-retest reliability of mgTHC consumption in the self-administered Cannabis Exposure Index (CEI) 自用大麻暴露指数（CEI）中mgTHC消费的重测信度

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113028

Deborah S. Hasin , Jacob Borodovsky , Melanie Wall , Mohammad I. Habib , Eilis Murphy , Jun Liu , Malki Stohl , Cara A. Struble , Ofir Livne , Eliana Greenstein , Efrat Aharonovich , Caroline G. Wisell , Alan J. Budney

Introduction

Cannabis legalization and adult use are expanding across the U.S., requiring greater knowledge of cannabis risks and benefits. Cannabis use measures traditionally assessed frequency but omitted quantity, an essential element of consumption that is complicated by increasingly varied cannabis products and use patterns. To address this, we developed the self-administered CEI (Cannabis Exposure Inventory) to determine milligrams of THC used per using day (mgTHC/using day). In this study, we examined the test-retest reliability of the CEI mgTHC measure and key component items (i.e., products, routes of administration).

Methods

Participants were recruited through social media (Facebook and Instagram ads) and Qualtrics Research panels. Eligible participants (n = 511) completed initial and retest CEI surveys. Chance-corrected agreement between initial and retest surveys on mean mgTHC/using day was indicated with Intraclass Correlation Coefficients (ICCs); kappa (k) indicated reliability of key dichotomous component variables.

Results

Overall, ICC for mean mgTHC/using day= 0.77, indicating substantial reliability. In demographic subgroups, ICCs were 0.54 (‘other’ race/ethnicity) to 0.86 (Hispanic). ICCs for mean mgTHC/using day among those who used for medical-only, recreational-only and medical-plus-recreational reasons were 0.72, 0.69 and 0.77, respectively; ICCs for those in non-legalized, medical-only and medical-plus-recreational states were 0.70, 0.92 and 0.75, respectively. Binary measures generally exhibited substantial reliability (mean k, last 30 days=0.74; last 7 days=0.73).

Conclusion

Findings support the CEI mgTHC measure as a reliable instrument for quantifying cannabis use, addressing a critical gap in cannabis measurement. This measure offers a promising approach to provide urgently-needed information on potential harms and benefits of THC exposure.

大麻合法化和成人使用正在美国各地扩大，需要更多的大麻风险和好处的知识。大麻使用措施传统上评估频率，但忽略了数量，这是消费的一个基本要素，而大麻产品和使用模式的日益多样化使其复杂化。为了解决这个问题，我们开发了自我管理的CEI（大麻暴露清单）来确定每个使用日使用的四氢大麻酚毫克数（mgTHC/使用日）。在本研究中，我们检验了CEI mgTHC测量和关键成分项目（即产品，给药途径）的重测信度。方法通过社交媒体（Facebook和Instagram广告）和Qualtrics Research小组招募参与者。符合条件的参与者（n = 511）完成了初始和复测CEI调查。用类内相关系数（ICCs）表明，初次和复测调查中平均mgTHC/使用日的一致性经过机会校正；Kappa (k)表示关键二分类成分变量的信度。结果总体而言，平均mgTHC/使用日的ICC = 0.77，具有较高的可靠性。在人口统计学亚组中，icc为0.54（“其他”种族/民族）至0.86（西班牙裔）。仅用于医疗、仅用于娱乐和医疗加娱乐的患者的平均mgTHC/使用日icc分别为0.72、0.69和0.77；非合法化州、纯医疗州和医疗加娱乐州的ICCs分别为0.70、0.92和0.75。二元测量通常表现出相当高的信度（平均k，最近30天=0.74；最近7天=0.73）。结论研究结果支持CEI mgTHC测量作为量化大麻使用的可靠工具，解决了大麻测量的关键空白。这项措施提供了一种很有希望的方法，可以提供有关四氢大麻酚暴露的潜在危害和益处的迫切需要的信息。

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引用次数: 0

Leveraging a digital health intervention to improve recovery outcomes among people with substance misuse experiencing housing insecurity 利用数字健康干预措施，改善住房不安全的药物滥用者的康复结果

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113022

Vidya Eswaran , Fanghong Dong , Xiao Li , Hannah S. Szlyk , Nathaniel A. Dell , Erin Kasson , Jessica Williams , Patricia A. Cavazos-Rehg

Background

People with substance use disorders (PwSUD) who experience housing insecurity have disproportionate overdose deaths. Digital interventions may improve care among PwSUD, but evidence specifically for housing-insecure PwSUD, who face unique barriers, remains limited.

Methods

We examined the efficacy of a mHealth tool (uMAT-R) among people who have misused substances and reported current housing insecurity. Substance use, cravings, access to basic needs, social disconnection, and digital literacy were assessed at baseline and 1 month and compared by uMAT-R use. Generalized estimating equations were employed to assess the efficacy of the intervention.

Results

Participants who logged into uMAT-R were less likely to report other non-opioid illicit drug use (aOR (95 %CI): 0.49(0.29, 0.85)). Similarly, those who messaged the e-coach were less likely to report using opioids (aOR(95 %CI): 0.39(0.21, 0.73)) or other illicit drugs (aOR (95 % CI): 0.53(0.30, 0.92)) during past 30-days. Significant interaction effects were found in uMAT-R use by time in cravings (Coef (95 %CI): −2.11(-4.07, −0.17)) and perceived burdensomeness (Coef(95 %CI): −2.62 (-4.91, −0.36)). Messaging an e-coach by time was significantly associated with improved health literacy (Coef (95 %CI): 0.61(0.05, 1.18)) and decreased thwarted belongingness (Coef(95 %CI): −0.36 (-0.71, −0.02).

Conclusion

Our preliminary findings suggest that people who have misused substances and experience housing insecurity may benefit from uMAT-R, which was associated with improved recovery outcomes. Future research is needed to examine the unique barriers experienced by this population and how mHealth tools can be used to provide tailored, equitable access to supportive resources to reduce barriers and promote long-term recovery.

经历住房不安全的物质使用障碍（PwSUD）患者有不成比例的过量死亡。数字干预可能会改善残疾人的护理，但专门针对面临独特障碍的住房不安全的残疾人的证据仍然有限。方法我们检查了移动健康工具（uMAT-R）在滥用药物和报告当前住房不安全的人群中的功效。在基线和1个月时评估物质使用、渴望、基本需求获取、社会脱节和数字素养，并与uMAT-R使用情况进行比较。采用广义估计方程来评估干预的有效性。结果登录uMAT-R的参与者报告其他非阿片类非法药物使用的可能性较小(aOR （95% CI): 0.49(0.29, 0.85)）。同样，那些给电子教练发信息的人在过去30天内报告使用阿片类药物(aOR（95% CI): 0.39(0.21, 0.73)）或其他非法药物(aOR（95% CI): 0.53(0.30, 0.92)）的可能性较小。在渴望使用uMAT-R的时间(Coef（95% CI): - 2.11(-4.07, - 0.17)）和感知负担(Coef（95% CI): - 2.62(-4.91, - 0.36)）中发现了显著的交互效应。按时间向电子教练发送信息与提高健康素养(Coef（95% CI): 0.61(0.05, 1.18)）和减少受挫归属感(Coef(95% CI): - 0.36（-0.71, - 0.02）显著相关。结论我们的初步研究结果表明，滥用药物和经历住房不安全的人可能受益于uMAT-R，这与改善的康复结果有关。未来的研究需要检查这一人群所经历的独特障碍，以及如何使用移动健康工具来提供量身定制的、公平的支持性资源，以减少障碍并促进长期康复。

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引用次数: 0

Developmental windows of vulnerability: Substance-specific effects of prenatal exposure timing on child psychopathology 脆弱性的发育窗口：产前暴露时间对儿童精神病理的物质特异性影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-03 DOI: 10.1016/j.drugalcdep.2026.113029

Qiaojun Li , Zhen Pang , Yansong Lu , Lu Jiang , Mengyao Sun , Jiayuan Xu

Background

Prenatal alcohol, tobacco, and cannabis exposure are known risks for childhood psychopathology symptoms, but gaps persist in identifying substance-specific developmental vulnerability windows. Exposure timing relative to maternal pregnancy awareness may alter outcomes, yet this temporal specificity remains unclarified, limiting targeted risk assessment and prevention.

Methods

Data from 7777 children in the Adolescent Brain Cognitive Development Study (enrolled 2016–2018) were analyzed. Prenatal substance exposure timing was categorized as pre-awareness (exposure before maternal awareness of pregnancy) and post-awareness (exposure after maternal awareness of pregnancy). Six domains of childhood psychopathology symptoms were assessed via the Child Behavior Checklist (CBCL). Linear mixed-effects models were applied to investigate the timing effects of prenatal substance exposure on childhood psychopathology symptoms, adjusting for covariates.

Results

The analysis revealed distinct temporal patterns of risk for each substance. Childhood psychopathology symptoms were specifically linked to pre-awareness exposure for alcohol and post-awareness exposure for cannabis. In contrast, post-awareness alcohol use and pre-awareness cannabis use showed no significant associations. Prenatal tobacco exposure conferred modest risks across all timings without temporal divergence.

Conclusions

Prenatal substance exposure has substance-specific, timing-dependent effects on childhood psychopathology relative to maternal pregnancy awareness. Findings support distinct developmental vulnerability windows, highlighting the need to include substance type and timing in public health guidelines and clinical risk stratification.

背景产前酒精、烟草和大麻暴露是儿童精神病理症状的已知风险，但在确定特定物质的发育脆弱性窗口方面仍然存在差距。与孕妇妊娠意识相关的暴露时间可能会改变结果，但这种时间特异性仍不明确，限制了有针对性的风险评估和预防。方法对参与2016-2018年青少年大脑认知发展研究的7777名儿童的数据进行分析。产前物质暴露时间分为前意识（在母亲意识到怀孕之前暴露）和后意识（在母亲意识到怀孕之后暴露）。通过儿童行为检查表（CBCL）评估儿童精神病理症状的六个领域。采用线性混合效应模型，对协变量进行调整，研究产前物质暴露对儿童精神病理症状的时间效应。结果分析揭示了每种物质不同的风险时间模式。儿童精神病理症状与意识前接触酒精和意识后接触大麻特别相关。相比之下，意识觉醒后饮酒和意识觉醒前吸食大麻没有显著关联。产前烟草暴露在所有时间都具有适度的风险，没有时间差异。结论产前物质暴露对母亲妊娠意识相关的儿童精神病理具有物质特异性、时间依赖性的影响。研究结果支持不同的发育脆弱性窗口，强调需要在公共卫生指南和临床风险分层中包括物质类型和时间。

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引用次数: 0

Is cannabis legalization associated with treatment completion? A study of pregnant women admitted for cannabis use in substance use treatment facilities, 2020–2022 大麻合法化与治疗完成有关吗？对2020-2022年在药物使用治疗机构中使用大麻的孕妇的研究

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-02 DOI: 10.1016/j.drugalcdep.2026.113023

Rogie Royce Carandang , Taeho Greg Rhee , Toan Ha , Shayna D. Cunningham

Background

Cannabis is the most used illicit substance during pregnancy in the United States. While cannabis legislation is associated with prevalence and access to care, its relationship with treatment completion among pregnant women is unclear. This study examined the association between cannabis legalization and treatment completion among pregnant women admitted for cannabis use from 2020 to 2022.

Methods

This retrospective cross-sectional analysis used data from the Treatment Episode Data Set-Discharge (TEDS-D) to analyze treatment completion among pregnant women aged 12 or older who were admitted for cannabis use (n = 13,088) across states with fully legalized, partially legalized (medical use only), or illegal cannabis policies. Multivariable-adjusted logistic regression was used to assess the association between legalization status and treatment completion, with subgroup analyses by treatment setting and referral source.

Results

Among pregnant women admitted for cannabis use, 28.3 % completed treatment. Compared to states where cannabis remained illegal, those in states with fully legalized cannabis had significantly lower odds of treatment completion (adjusted odds ratio [AOR], 0.33 [95 % confidence interval, 0.27–0.41]), with a similar trend in states with partial legalization (AOR, 0.33 [0.28–0.40]). The negative association between cannabis legislation and treatment completion was more pronounced in outpatient settings than in residential programs, and stronger among court/other referrals than among voluntary referrals.

Conclusions

Cannabis legalization may be negatively associated with treatment completion among pregnant women admitted for cannabis use. Further research is needed to identify policy-related barriers and develop evidence-based interventions that improve treatment engagement and retention in this vulnerable population.

在美国，大麻是怀孕期间使用最多的非法药物。虽然大麻立法与流行率和获得保健有关，但其与孕妇完成治疗的关系尚不清楚。该研究调查了2020年至2022年大麻使用孕妇大麻合法化与治疗完成之间的关系。方法本回顾性横断面分析使用来自治疗事件数据集-出院（ted - d）的数据，分析在大麻完全合法化、部分合法化（仅用于医疗用途）或非法大麻政策的州，因大麻使用而入院的12岁及以上孕妇（n = 13088）的治疗完成情况。采用多变量调整逻辑回归评估合法化状态与治疗完成之间的关系，并根据治疗设置和转诊来源进行亚组分析。结果在因吸食大麻而入院的孕妇中，28.3%的人完成了治疗。与大麻仍然非法的州相比，大麻完全合法化州的治疗完成几率明显较低（调整优势比[AOR]， 0.33[95%置信区间，0.27-0.41]），部分合法化州的趋势相似（AOR, 0.33[0.28-0.40]）。大麻立法与治疗完成之间的负相关关系在门诊环境中比在住院项目中更为明显，在法院/其他转诊中比在自愿转诊中更强。结论大麻合法化可能与因大麻使用而入院的孕妇治疗完成度呈负相关。需要进一步的研究来确定与政策相关的障碍，并制定基于证据的干预措施，以提高这一弱势群体的治疗参与度和坚持度。

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引用次数: 0

Corrigendum to “Cross sectional multi-sample study of nonfatal overdose in adolescents and young adults in the fentanyl era” [Drug Alcohol Depend. 276 (2025) 112921] “芬太尼时代青少年和年轻人非致命性用药过量的横断面多样本研究”的勘误[药物酒精依赖，276(2025)112921]。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 DOI: 10.1016/j.drugalcdep.2025.112991

Amy M. Yule , Amy S.B. Bohnert , Ty A. Ridenour , Barrett Montgomery , Timothy E. Wilens , Maureen Walton , Erin E. Bonar , Lisa Saldana , Lynn E. Fiellin , Danica K. Knight , Yang Yang , Jason Williams , Sazid Khan , Liann Tucker , Feker Wondimagegnehu , Kym Ahrens

引用次数: 0

Prescribing of controlled substances to adolescents and young adults enrolled in Medicaid, 2001–2019 2001-2019年在医疗补助计划中登记的青少年和年轻人的受控物质处方。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 DOI: 10.1016/j.drugalcdep.2025.112975

Greta Bushnell , Mark Olfson , Kristen Lloyd , Stephanie Shiau , Tobias Gerhard , Katherine M Keyes , Deborah Hasin , Magdalena Cerdá , Hillary Samples

Objective

To examine nationwide trends in the prescribing of controlled medications to early adolescents, adolescents, and young adults enrolled in public insurance (Medicaid) from 2001 to 2019.

Methods

The study utilized US Medicaid data covering publicly insured enrollees from 43 states (2001–2019). Early adolescents (10–12 y), adolescents (13–17 y), and young adults (18–24 y, 25–29 y) with ≥ 10 months enrollment in each calendar year were included. Filled prescription for opioids, stimulants, benzodiazepines, Z-hypnotics, barbiturates, and gabapentin were identified. In each calendar year, annual proportions with 1 + controlled medication, 2 + classes of controlled medications, and each controlled medication were estimated.

Results

In 2019, the sample included 17.9 million enrollees (53 % female). The annual proportion prescribed any controlled medication peaked at 17.5 % in early adolescents (2003), 20.6 % in adolescents (2009), and 34.1 % (18–24 y) and 47.0 % (25–29 y) in young adults (2010). By 2019, the proportions declined to 11.7 % (early adolescents), 12.6 % (adolescents), 16.2 % (18–24 y), and 23.9 % (25–29 y). Trends varied by medication and age. The largest absolute decline was in the proportion with an opioid filled (2010 =29.8 %, 2019 =11.2 %, young adults 18–24 y; 2003 =14.3 %, 2019 =4.4 %, adolescents). In contrast, the proportion with a stimulant fill increased, with eight-fold increases in young adults 25–29 y (2001 =0.3 %, 2019 =2.6 %). Benzodiazepine and Z-hypnotic use peaked in 2010 and declined through 2019.

Conclusions

In the past two decades, there were increases in stimulant prescriptions among young Medicaid enrollees. The declines in opioid, benzodiazepines, barbiturate and Z-hypnotic prescribing are encouraging and may indicate more cautious prescribing related to greater awareness of harms such as misuse and overdose, along with policy initiatives.

目的：了解2001年至2019年全国范围内参加公共保险（医疗补助）的早期青少年、青少年和年轻人处方管制药物的趋势。方法：该研究利用了美国43个州（2001-2019年）的公共医疗补助数据。纳入每个日历年入组≥10个月的早期青少年（10-12岁）、青少年（13-17岁）和青壮年（18-24岁、25-29岁）。阿片类药物、兴奋剂、苯二氮卓类药物、z -催眠药、巴比妥类药物和加巴喷丁的处方被确定。在每个日历年，估计每年有1 +种控制药物、2 +种控制药物和每种控制药物的比例。结果：2019年，样本包括1790万参保者（53%为女性）。处方任何控制药物的年比例在青少年早期达到峰值17.5%（2003年），青少年20.6%（2009年），青壮年34.1%（18-24岁）和47.0%（25-29岁）（2010年）。到2019年，这一比例下降到11.7%（青少年早期）、12.6%（青少年）、16.2%（18-24岁）和23.9%（25-29岁）。趋势因药物和年龄而异。绝对降幅最大的是阿片类药物填充比例（2010年= 29.8%，2019年= 11.2%，18-24岁的年轻人；2003年= 14.3%，2019年= 4.4%，青少年）。相比之下，兴奋剂填充的比例增加了，25-29岁的年轻人增加了8倍（2001年= 0.3%，2019年= 2.6%）。苯二氮卓类药物和z -催眠药物的使用在2010年达到顶峰，到2019年一直在下降。结论：在过去的二十年中，年轻的医疗补助计划参保者中兴奋剂处方有所增加。阿片类药物、苯二氮卓类药物、巴比妥酸盐和z -催眠药物处方的减少令人鼓舞，这可能表明，随着对滥用和过量等危害的认识提高，处方更加谨慎，同时也采取了政策举措。

{"title":"Prescribing of controlled substances to adolescents and young adults enrolled in Medicaid, 2001–2019","authors":"Greta Bushnell , Mark Olfson , Kristen Lloyd , Stephanie Shiau , Tobias Gerhard , Katherine M Keyes , Deborah Hasin , Magdalena Cerdá , Hillary Samples","doi":"10.1016/j.drugalcdep.2025.112975","DOIUrl":"10.1016/j.drugalcdep.2025.112975","url":null,"abstract":"<div><h3>Objective</h3><div>To examine nationwide trends in the prescribing of controlled medications to early adolescents, adolescents, and young adults enrolled in public insurance (Medicaid) from 2001 to 2019.</div></div><div><h3>Methods</h3><div>The study utilized US Medicaid data covering publicly insured enrollees from 43 states (2001–2019). Early adolescents (10–12y), adolescents (13–17y), and young adults (18–24y, 25–29y) with ≥ 10 months enrollment in each calendar year were included. Filled prescription for opioids, stimulants, benzodiazepines, Z-hypnotics, barbiturates, and gabapentin were identified. In each calendar year, annual proportions with 1 + controlled medication, 2 + classes of controlled medications, and each controlled medication were estimated.</div></div><div><h3>Results</h3><div>In 2019, the sample included 17.9 million enrollees (53 % female). The annual proportion prescribed any controlled medication peaked at 17.5 % in early adolescents (2003), 20.6 % in adolescents (2009), and 34.1 % (18–24y) and 47.0 % (25–29y) in young adults (2010). By 2019, the proportions declined to 11.7 % (early adolescents), 12.6 % (adolescents), 16.2 % (18–24y), and 23.9 % (25–29y). Trends varied by medication and age. The largest absolute decline was in the proportion with an opioid filled (2010 =29.8 %, 2019 =11.2 %, young adults 18–24y; 2003 =14.3 %, 2019 =4.4 %, adolescents). In contrast, the proportion with a stimulant fill increased, with eight-fold increases in young adults 25–29y (2001 =0.3 %, 2019 =2.6 %). Benzodiazepine and Z-hypnotic use peaked in 2010 and declined through 2019.</div></div><div><h3>Conclusions</h3><div>In the past two decades, there were increases in stimulant prescriptions among young Medicaid enrollees. The declines in opioid, benzodiazepines, barbiturate and Z-hypnotic prescribing are encouraging and may indicate more cautious prescribing related to greater awareness of harms such as misuse and overdose, along with policy initiatives.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112975"},"PeriodicalIF":3.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770446","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

Reciprocal relationships among youth social media use, internalizing symptoms, and substance use 青少年社交媒体使用、内化症状和物质使用之间的相互关系

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 DOI: 10.1016/j.drugalcdep.2025.113018

Xia Zheng , Meng Yang , Ruobing Li , Wenbo Li , Nicole Lis , Hsien-Chang Lin

Objective

Mental health, substance use, and social media are three important, inter-related factors influencing youth development. This study examines the dynamic, reciprocal relationships among social media use, internalizing mental health symptoms, and substance use (e-cigarette, alcohol, cigarette, and marijuana) among U.S. adolescents.

Methods

Data were from restricted Population Assessment of Tobacco and Health (PATH) Study, Waves 4, 4.5, and 5 (2016–2019). The sample included 7759U.S. adolescents (weighted N = 15,032,305) who completed all three waves. Weighted generalized structural equation models with lagged dependent variables were performed to examine the reciprocal relationships between youth’s social media use frequency, internalizing symptoms, and use of substances. Each variable has a dual role as both a predictor and outcome across waves, with earlier waves predicting subsequent ones, to assess bidirectional influences over time.

Results

Higher social media use and internalizing symptoms were associated with higher odds of subsequent e-cigarette, alcohol, and marijuana use. Higher social media use predicted higher odds of e-cigarette use (AOR=1.33, p < 0.001) and alcohol use (AOR=1.19, p < 0.001). Internalizing symptoms predicted higher odds of cigarette use (AOR=1.71, 95 % CI=1.15–2.53). Social media use also predicted greater odds of experiencing internalizing symptoms (AORs=1.05, all ps < 0.01). We found both similarities and differences in the patterns of the reciprocal pathways overtime across the four substances.

Conclusions

Our study reveals a complex and dynamic relationship among social media use, mental health, and substance use among youth. The findings support the need for integrative interventions that simultaneously address mental health, social media behaviors, and substance use risk.

客观地说，心理健康、物质使用和社交媒体是影响青少年发展的三个重要的、相互关联的因素。本研究考察了美国青少年使用社交媒体、内化心理健康症状和物质使用（电子烟、酒精、香烟和大麻）之间的动态、互惠关系。方法数据来自烟草与健康限制性人群评估（PATH）研究，第4、4.5和5期（2016-2019）。样品中含有7759us。青少年（加权N = 15,032,305）完成了所有三个波。采用带有滞后因变量的加权广义结构方程模型来检验青少年社交媒体使用频率、内化症状和物质使用之间的相互关系。每个变量都有双重作用，既是预测者，也是波浪的结果，早期的波浪预测随后的波浪，以评估随着时间的推移的双向影响。结果较高的社交媒体使用和内化症状与随后使用电子烟、酒精和大麻的几率较高相关。使用越多的社交媒体，使用电子烟（AOR=1.33, p < 0.001）和饮酒（AOR=1.19, p < 0.001）的几率就越大。内化症状预示着较高的吸烟几率（AOR=1.71, 95% CI= 1.15-2.53）。使用社交媒体也预示着出现内化症状的可能性更大（aor =1.05，均p <； 0.01）。我们发现，随着时间的推移，这四种物质的相互路径模式既有相似之处，也有不同之处。结论我们的研究揭示了青少年社交媒体使用、心理健康和物质使用之间复杂而动态的关系。研究结果支持需要同时解决心理健康、社交媒体行为和物质使用风险的综合干预措施。

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引用次数: 0

Successful hepatitis C elimination through decentralized treatment in Dutch addiction care: A RE-AIM based evaluation 通过分散治疗在荷兰成瘾护理中成功消除丙型肝炎：基于RE-AIM的评估

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2025-12-30 DOI: 10.1016/j.drugalcdep.2025.113014

Daan W. Von den Hoff , Floor A.C. Berden , Annemarie Noordeloos , Thomas Knuijver , Arnt F.A. Schellekens , Joost P.H. Drenth

Background

People who use drugs (PWUD) are an important population of focus for hepatitis C virus (HCV) elimination. Case-finding and treatment of these patients in outpatient specialist care is a challenge due to population specific barriers. Screening and treatment integrated in addiction care might overcome these barriers. With this study we aim to evaluate the implementation of a decentralized PWUD-HCV care model.

Methods

We conducted a multicenter prospective observational study in Dutch addiction care centers to assess a decentralized HCV care pathway for PWUD. Implementation of HCV-care within addiction care was evaluated using the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework. Viral elimination, defined as the proportion of identified HCV-RNA positive PWUD achieving sustained virologic response (SVR), was the primary outcome.

Results

Reach: 870 anti-HCV tests were performed, 29 HCV-RNA positive PWUD were enrolled. Effectiveness: 23 patients initiated and completed on-site treatment, three patients were referred for treatment, two patients were lost to follow-up and one patient refused treatment. All patients tested for SVR achieved SVR, one patient was lost to follow-up before SVR test. The elimination rate was 86 % (25/29). Adoption: five out of eleven addiction care organizations (45 %) implemented decentralized HCV care within addiction care. Implementation fidelity was high.

Conclusion

This study demonstrates that successfully implemented decentralized HCV care within addiction services is feasible and highly effective, achieving an elimination rate of 86 %. However, adoption of decentralized HCV care was limited, underscoring the need for targeted strategies to enhance implementation. Our findings support expanding of decentralized HCV care models in addiction settings to meet HCV elimination targets.

药物使用者（PWUD）是消除丙型肝炎病毒（HCV）的重要人群。由于特定人群的障碍，在门诊专科护理中发现病例和治疗这些患者是一项挑战。将筛查和治疗整合到成瘾护理中可能会克服这些障碍。通过这项研究，我们旨在评估分散的PWUD-HCV护理模式的实施情况。方法：我们在荷兰成瘾护理中心进行了一项多中心前瞻性观察研究，以评估PWUD的分散HCV护理途径。使用可及性-有效性-采用-实施-维持（RE-AIM）框架评估成瘾治疗中hcv护理的实施情况。病毒消除，定义为鉴定的HCV-RNA阳性PWUD达到持续病毒学应答（SVR）的比例，是主要结局。结果：共进行抗hcv检测870例，纳入HCV-RNA阳性患者29例。效果：23例患者开始并完成现场治疗，3例患者转诊治疗，2例患者失访，1例患者拒绝治疗。所有SVR检测患者均达到SVR， 1例患者在SVR检测前失访。根除率为86%（25/29）。采用：11个成瘾治疗组织中有5个（45%）在成瘾治疗中实施了分散的丙型肝炎病毒治疗。实现保真度高。结论：本研究表明，在成瘾服务中成功实施分散的HCV护理是可行且高效的，可实现86%的消除率。然而，分散的丙型肝炎病毒治疗的采用是有限的，强调需要有针对性的战略来加强实施。我们的研究结果支持在成瘾环境中扩展分散的HCV护理模式，以满足HCV消除目标。

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引用次数: 0