Drug and alcohol dependence最新文献_第5页

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 : 2026-02-01 Epub 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

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 : 2026-02-01 Epub 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

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 : 2026-02-01 Epub 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 : 2026-02-01 Epub 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

Gabapentin utilization and nontherapeutic use relative to select comparator drugs, United States 2013–2022 美国2013-2022年加巴喷丁的使用和非治疗性使用相对于选择比较药物

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2026-01-07 DOI: 10.1016/j.drugalcdep.2026.113026

Sara Karami , Jae Wook Yoo, Corinne Woods, Saranrat Wittayanukorn Conrad, Jana McAninch, Tamra Meyer, Celeste Mallama

Background

Gabapentin prescribing has increased over the past decade, including as part of efforts to reduce opioid analgesic use. Data on trends and scope of harms from gabapentin nontherapeutic use (NTU) are needed.

Methods

For gabapentin and selected contextual comparator drugs (pregabalin, diazepam, oxycodone), we describe utilization using a dispensed prescriptions all-payer claims database (2013–2023) and adverse events for NTU exposure cases using Poison Center data (2013–2022). We then calculated utilization-adjusted NTU exposure case rates, based on prescription units dispensed, for each drug.

Results

From 2013–2023, the number of units (e.g., tablets) dispensed increased for gabapentin (4.4–7.7 billion [B]) and pregabalin (0.68–1.0B) and decreased for diazepam (0.7–0.3B) and oxycodone (4.2–2.5B). From 2013–2022, gabapentin NTU exposure cases (N = 8729) exceeded pregabalin (N = 1257) and diazepam (N = 2452) but not oxycodone (N = 17,808) NTU exposure cases. Gabapentin NTU exposure cases and utilization-adjusted NTU exposure case rates increased from 2013-2017, then decreased through 2022; trends were similar for pregabalin, decreased throughout for diazepam, and fluctuated for oxycodone. From 2013–2022, gabapentin annual utilization-adjusted NTU exposure case rates most closely resembled those of pregabalin (range: 0.09–0.16 versus 0.08–0.22 exposure cases per million units dispensed), while diazepam and oxycodone exhibited higher rates (range: 0.33–0.55 and 0.39–0.85 exposure cases per million units dispensed, respectively). Most gabapentin (68 %) and comparator (55–80 %) NTU exposure cases involved multiple substances, particularly opioids, resulting in more severe clinical outcomes than single-substance exposures.

Conclusions

Our study highlights the harms from gabapentin NTU, particularly in combination with opioids.

背景加巴喷丁的处方在过去十年中有所增加，包括作为减少阿片类镇痛药使用的努力的一部分。需要关于加巴喷丁非治疗性使用（NTU）的趋势和危害范围的数据。方法对于加巴喷丁和选定的对照药物（普瑞巴林、地西泮、羟考酮），我们使用处方全付款人索赔数据库（2013-2023年）描述其使用情况，并使用毒物中心数据（2013-2022年）描述NTU暴露病例的不良事件。然后，我们根据分配的处方单位计算每种药物的利用率调整后的NTU暴露病例率。结果2013-2023年，加巴喷丁（44 - 77亿[B]）和普瑞巴林（0.68-1.0B）的用药单位（如片）增加，地西泮（0.7-0.3B）和羟考酮（4.2-2.5B）的用药单位（如片）减少。2013-2022年，加巴喷丁NTU暴露病例（N = 8729）超过普瑞巴林（N = 1257）和地西泮（N = 2452），但不超过羟考酮（N = 17808） NTU暴露病例。加巴喷丁NTU暴露病例和利用调整后的NTU暴露病例率从2013-2017年上升，然后到2022年下降；普瑞巴林的趋势相似，地西泮的趋势下降，羟考酮的趋势波动。2013-2022年，加巴喷丁年度利用调整后的NTU暴露病例率与普瑞巴林最接近（范围：0.09-0.16和0.08-0.22），而地西泮和羟考酮的暴露病例率更高（范围：0.33-0.55和0.39-0.85）。大多数加巴喷丁（68%）和比较剂（55 - 80%）NTU暴露病例涉及多种物质，特别是阿片类药物，导致比单一物质暴露更严重的临床结果。结论我们的研究强调了加巴喷丁NTU的危害，特别是与阿片类药物合用。

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引用次数: 0

Inequities in blunt use across multiple socio-demographic intersections among US adults 美国成年人在多个社会人口交叉点使用钝器的不平等

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-02-01 Epub Date: 2025-12-29 DOI: 10.1016/j.drugalcdep.2025.113019

Allison M. Glasser , Jessica K. Jensen , Kymberle L. Sterling , Andrea C. Villanti

Introduction

Blunts (cigars with tobacco replaced or mixed with cannabis) incur health risks from exposure to tobacco and cannabis and are disproportionately used by young adults, people identifying as Black/African American (B/AA), people with lower socioeconomic status (SES), and people with mental health issues. This study described patterns of blunt use among US adults with multiple identities or circumstances increasing risk for blunt use.

Methods

We used Wave 6 (2021) (US adults; N = 30,516) of the Population Assessment of Tobacco and Health Study to examine the association between current blunt use and race (B/AA vs. non-B/AA) + mental health (symptoms of internalizing/externalizing conditions) and socioeconomic status (SES; receipt of government assistance) using weighted multivariable logistic regression models, stratified by age (young adults [YAs] 18–34 vs. adults 35 + years).

Results

In 2021, 8.4 % of YAs and 1.4 % of adults 35 + currently used blunts. Compared to people with joint advantage (e.g., non-B/AA + high SES), those identifying as B/AA with low SES (aOR=5.10, 95 % CI=4.16–6.26), high internalizing (aOR=4.83, 95 % CI=3.70–6.32), or externalizing conditions (aOR=4.74, 95 % CI=3.47–6.48) had greater odds of using blunts. The magnitude of the association between identifying as B/AA and having low SES (alone and jointly) and blunt use was greater among adults 35 + years (vs. YAs).

Conclusions

Blunt use was most prevalent among B/AA adults with low SES or those who experienced mental health conditions. The magnitude of some inequities was greater among adults 35 + . Social and structural interventions to reduce blunt use among US adults could improve health equity.

blunts（用烟草代替或混合大麻的雪茄）会因接触烟草和大麻而造成健康风险，年轻人、黑人/非裔美国人（B/AA）、社会经济地位较低的人（SES）和有精神健康问题的人使用的比例过高。这项研究描述了美国成年人使用钝器的模式，他们有多种身份或情况增加了使用钝器的风险。方法：我们使用烟草与健康人口评估研究的第6期（2021年）（美国成年人，N = 30,516），使用加权多变量logistic回归模型，按年龄（18-34岁的年轻人与35岁以上的成年人）分层，检查当前钝性使用与种族（B/AA与非B/AA）、心理健康（内化/外化症状）和社会经济地位（SES；接受政府援助）之间的关系。结果2021年，8.4%的青少年和1.4%的35岁以上成年人使用钝器。与具有联合优势（例如，非B/AA +高SES）的人相比，低SES （aOR=5.10, 95% CI= 4.16-6.26）、高内化（aOR=4.83, 95% CI= 3.70-6.32）或外化条件（aOR=4.74, 95% CI= 3.47-6.48）的B/AA者使用钝器的几率更大。在35岁以上的成年人中，B/AA与低经济地位（单独或联合）和钝性使用之间的关联程度更大（与25岁相比）。结论在社会经济地位低或有心理健康问题的B/AA成人中，钝性用药最为普遍。一些不平等的程度在35岁以上的成年人中更为严重。减少美国成年人使用钝器的社会和结构干预措施可以改善健康公平。

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引用次数: 0

Driving after cannabis consumption among US adults ages 50 years and older: A short communication 美国50岁及以上成年人吸食大麻后驾车：简短交流。

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 Epub Date: 2025-11-25 DOI: 10.1016/j.drugalcdep.2025.112985

Erin E. Bonar , Lianlian Lei , Matthias Kirch , Kristen P. Hassett , Erica Solway , Dianne C. Singer , Sydney N. Strunk , J. Scott Roberts , Preeti N. Malani , Jeffrey T. Kullgren

Introduction

Adults’ cannabis consumption is increasing in the United States (US) and consumption can increase risks such as impaired driving. Understanding driving after cannabis use (DCU) can guide lifespan-tailored prevention efforts. We evaluated the prevalence and correlates of self-reported DCU among cannabis-using adults ages 50 + .

Methods

Data are from a nationally representative study of adults ages 50 + (N=3379); we included the sub-sample who self-reported past-year cannabis use (N = 729, 21.4 %). We measured socio-demographics, social functioning, caregiving, cannabis use, and motives for cannabis use and used unadjusted and adjusted logistic regression models to evaluate the associations of these factors with past-year DCU within 2 h of consumption (yes/no).

Results

Sample socio-demographics included: 64.8 % age 50–64, 35.2 % age 65 + ; 50.5 % female; 71.8 % White Non-Hispanic, 10.5 % Black Non-Hispanic, 11.3 % Hispanic and 6.5 % other Non-Hispanic. There were 20.2 % (n = 142) who reported DCU. In unadjusted analyses, more frequent cannabis use and cannabis use motives for mental health and sleep were significantly associated with DCU. In adjusted analyses, men (vs. women, OR = 1.72, 95 % CI = 1.03–3.01), daily cannabis use (vs. once/twice OR = 3.31, 95 % CI: 1.79–6.12] and mental health motives (OR = 1.93, 95 % CI: 1.13–3.30) were significant.

Conclusions

About 1 in 5 adults ages 50 + who use cannabis report DCU. Interventions to prevent cannabis-impaired driving should be targeted to these aging adults; clinicians may tailor intervention delivery based on relevant risk factors (e.g., mental health concerns, daily use).

在美国，成年人的大麻消费正在增加，消费会增加诸如驾驶障碍等风险。了解吸食大麻后驾驶（DCU）可以指导针对生命周期的预防工作。我们评估了50岁以上大麻使用者中自我报告的DCU的患病率及其相关因素。方法：数据来自一项具有全国代表性的50岁以上成年人研究（N=3379）；我们纳入了自我报告过去一年使用大麻的子样本（N = 729, 21.4%）。我们测量了社会人口统计学、社会功能、护理、大麻使用和大麻使用动机，并使用未调整和调整的逻辑回归模型来评估这些因素与消费后2小时内过去一年DCU的关系（是/否）。结果：样本社会人口统计包括：64.8%年龄在50-64岁，35.2%年龄在65岁以上；女性占50.5%；非西班牙裔白人占71.8%，非西班牙裔黑人占10.5%，西班牙裔占11.3%，其他非西班牙裔占6.5%。20.2% （n = 142）报告DCU。在未经调整的分析中，更频繁地使用大麻以及出于心理健康和睡眠目的使用大麻的动机与DCU显著相关。在调整分析中，男性（相对于女性，OR = 1.72, 95% CI = 1.03-3.01）、每日使用大麻（相对于一次/两次OR = 3.31, 95% CI: 1.79-6.12）和心理健康动机（OR = 1.93, 95% CI: 1.13-3.30）具有显著性。结论：大约五分之一的50岁以上成年人使用大麻报告DCU。预防大麻损害驾驶的干预措施应该针对这些老年人；临床医生可以根据相关风险因素（如心理健康问题、日常使用）量身定制干预措施。

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引用次数: 0

Comparison of remote to hybrid methods on recruitment and retention rates in a smoking cessation trial 远程方法与混合方法在戒烟试验中招募率和保留率的比较

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 Epub Date: 2025-11-27 DOI: 10.1016/j.drugalcdep.2025.112976

Elizabeth S. Hawes , Andrew P. Bontemps , William P. Wagner , Peter S. Hendricks , Adrienne C. Lahti , Andres Azuero , Karen L. Cropsey

Objectives

Due to the COVD-19 pandemic, many ongoing clinical trials had to rapidly shift to using remote trials, including our smoking cessation trial within a criminal legal population. The objective of this study was to compare recruitment rate, study adherence, retention, nicotine replacement therapy adherence, and quit attempts between participants who completed the study as planned (In-Person; N = 236), after implementation of a voucher system and additional check-in appointments (Incentivized; N = 126), and after the pandemic began (Hybrid; N = 153).

Methods

515 participants were recruited with criminal legal involvement from Birmingham, AL, and randomized to an In Vivo nicotine replacement therapy (NRT) sampling group or a standard smoking cessation counseling group, with both groups receiving 12 weeks of NRT.

Results

There were no significant differences in any of the study outcomes between the methodology groups, suggesting that hybrid methods of research do not result in a slower recruitment pace, less visits attended, or a higher likelihood of drop-out. Completing the study remotely did not appear to impact study outcomes such as likelihood of making a quit attempt or using NRT.

Conclusions

This study suggests that remote methods may be as effective as in-person methods in a clinical trial, although a randomized trial of these methods is needed.

由于covid -19大流行，许多正在进行的临床试验不得不迅速转向使用远程试验，包括我们在刑事合法人群中进行的戒烟试验。本研究的目的是比较按计划完成研究的参与者（面对面，N = 236）、实施代金券制度和额外登记预约后（N = 126）和大流行开始后（N = 153）的招募率、研究依从性、保留性、尼古丁替代疗法依从性和戒烟尝试。方法从美国伯明翰招募了515名涉及刑事法律的参与者，随机分为体内尼古丁替代疗法（NRT）采样组和标准戒烟咨询组，两组均接受12周的NRT治疗。结果两组研究结果均无显著差异，表明混合研究方法不会导致招募速度减慢、就诊人数减少或退出的可能性增加。远程完成研究似乎不会影响研究结果，如戒烟尝试或使用NRT的可能性。结论：本研究表明，在临床试验中，远程方法可能与现场方法一样有效，尽管需要对这些方法进行随机试验。

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引用次数: 0

Childhood trauma, family functioning, and the BDNF gene may affect the development of alcohol use disorder 童年创伤、家庭功能和BDNF基因可能影响酒精使用障碍的发展

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 Epub Date: 2025-11-26 DOI: 10.1016/j.drugalcdep.2025.112987

Yi-Wei Yeh , Catherine Shin Huey Chen , Shin-Chang Kuo , Chun-Yen Chen , Yu-Chieh Huang , Jyun-Teng Huang , You-Ping Yang , Jhih-Syuan Huang , Kuo-Hsing Ma , San-Yuan Huang

Background

Childhood trauma and family dysfunction substantially increase the risk of alcohol use disorder (AUD) among individuals with genetic susceptibility. Brain-Derived Neurotrophic Factor (BDNF) plays a crucial role in neuronal neuroplasticity.

Methods

The cross-sectional case-control study examines the associations between the BDNF gene, childhood trauma, and family functioning in relation to vulnerability to AUD. A total of 1085 participants were recruited from the Han Chinese population. The final analysis included data from 518 patients with AUD and 548 healthy controls, and 19 were excluded due to DNA issues. Three psychometric instruments—the childhood trauma questionnaire (CTQ), the adverse childhood experiences questionnaire (ACEs), and the family APGAR questionnaires were used to assess environmental risk factors contributing to AUD. An independent t-test was used to examine differences between controls, AUD, and its subgroups for each psychometric score. ANCOVA was performed to assess the effects of BDNF variants on CTQ, ACE, and APGAR scores in patients with AUD after adjusting for age and gender.

Results

The CTG haplotype in the rs6265-rs6484320-rs7934165 block of the BDNF gene was associated with the late-onset AUD (p = 9.9 ×10⁻⁵). Higher CTQ and ACEs scores were observed in AUD patients, particularly in those with early-onset AUD. Total CTQ score and ACEs score were negatively correlated with the onset age of AUD, although these scores were not influenced by BDNF genotype.

Conclusion

Childhood trauma and impaired family functioning may serve as predictive factors in the development of AUD. BDNF gene variants, childhood trauma, and family functioning appear to influence AUD risk.

背景：童年创伤和家庭功能障碍在遗传易感性个体中显著增加酒精使用障碍（AUD）的风险。脑源性神经营养因子（BDNF）在神经元可塑性中起着至关重要的作用。方法横断面病例对照研究探讨了BDNF基因、儿童创伤和家庭功能与AUD易感性之间的关系。总共从汉族人群中招募了1085名参与者。最终分析包括518名AUD患者和548名健康对照者的数据，其中19名因DNA问题而被排除在外。采用童年创伤问卷（CTQ）、童年不良经历问卷（ace）和家庭APGAR问卷三种心理测量工具评估环境风险因素对AUD的影响。使用独立t检验来检查每个心理测量分数在对照组、AUD及其亚组之间的差异。在调整年龄和性别后，采用ANCOVA评估BDNF变异对AUD患者CTQ、ACE和APGAR评分的影响。结果BDNF基因rs6265-rs6484320-rs7934165片段的CTG单倍型与晚发型AUD相关（p = 9.9 ×10−5）。在AUD患者中观察到较高的CTQ和ace评分，特别是在早发性AUD患者中。CTQ总分和ace评分与AUD发病年龄呈负相关，但不受BDNF基因型的影响。结论童年创伤和家庭功能障碍可能是AUD发生的预测因素。BDNF基因变异、童年创伤和家庭功能似乎影响AUD的风险。

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引用次数: 0

Impact of morphine dependence and withdrawal on economic demand for fentanyl, cocaine, and methamphetamine in rats 吗啡依赖和戒断对大鼠芬太尼、可卡因和甲基苯丙胺经济需求的影响

IF 3.6 2区医学 Q1 PSYCHIATRY

Drug and alcohol dependence

Pub Date : 2026-01-01 Epub Date: 2025-11-28 DOI: 10.1016/j.drugalcdep.2025.112992

Robert W. Seaman Jr. , Nima Shariatzadeh , Kelly A. Salinas , Christina M. George , Yong-Gong Shi , Gregory T. Collins

Background

Stimulant-opioid co-use has surged in the United States, with methamphetamine use among people who use opioids increasing 82.6 % from 2015 to 2017. This trend contributes to rising overdose deaths, marking a "fourth wave" of the opioid epidemic. This study examined how opioid dependence and withdrawal affect the reinforcing effects of opioids and stimulants.

Methods & results

Male Sprague-Dawley rats (8–12 per group) were trained to self-administer fentanyl (3.2 µg/kg/inf), cocaine (0.32 mg/kg/inf), or methamphetamine (0.1 mg/kg/inf) under fixed ratio (FR) schedules. Opioid dependence was established through escalating twice-daily morphine injections (10–40 mg/kg) over four days, then maintained with daily doses of 40 mg/kg morphine. Rats exhibited stable signs of withdrawal (somatic signs, weight loss, hyperalgesia) following 20 h but not 12 h of morphine deprivation. Demand curves were generated by progressively increasing work requirements (FR 3, 5, 10, 18, 32, 56, 100, etc.) across sessions conducted 12 (morphine dependent) or 20 (morphine withdrawn) hours after morphine or saline (non-dependent controls). Morphine withdrawal (20-hour deprived group) increased demand for fentanyl but decreased demand for cocaine and methamphetamine. Morphine dependence (12-hour deprived group) had minimal effects, but did reliably decrease demand for cocaine. Morphine dependence increased demand intensity (Q₀) only for the small dose of fentanyl; all other conditions were unaffected.

Conclusions

These results demonstrate that opioid withdrawal increases motivation for opioid use while reducing motivation for stimulants, particularly at higher costs. Understanding these dynamics is crucial for developing effective polysubstance treatments addressing both opioid dependence and stimulant co-use.

在美国，兴奋剂和阿片类药物的共同使用激增，从2015年到2017年，阿片类药物使用者中甲基苯丙胺的使用量增加了82.6%。这一趋势导致过量死亡人数上升，标志着阿片类药物流行的“第四波”。本研究探讨了阿片类药物依赖和戒断如何影响阿片类药物和兴奋剂的强化作用。方法和结果雄性Sprague-Dawley大鼠（每组8-12只）在固定比例（FR）计划下自我给药芬太尼（3.2µg/kg/inf）、可卡因（0.32 mg/kg/inf）或甲基苯丙胺（0.1 mg/kg/inf）。阿片类药物依赖是通过在4天内逐步增加每日两次吗啡注射（10-40 mg/kg），然后维持每日剂量40 mg/kg吗啡来建立的。大鼠在吗啡剥夺20小时后表现出稳定的戒断症状（躯体症状、体重减轻、痛觉过敏），而在12小时后则没有。需求曲线是通过在吗啡或生理盐水（非依赖对照）后12小时（吗啡依赖）或20小时（吗啡戒断）期间逐渐增加的工作需求（FR 3、5、10、18、32、56、100等）而产生的。吗啡戒断（剥夺20小时组）增加了对芬太尼的需求，但减少了对可卡因和甲基苯丙胺的需求。吗啡依赖（12小时剥夺组）影响最小，但确实减少了对可卡因的需求。吗啡依赖仅对小剂量芬太尼增加需求强度（Q0）；其他条件均未受影响。这些结果表明，阿片类药物戒断增加了阿片类药物使用的动机，同时减少了兴奋剂的动机，特别是在成本较高的情况下。了解这些动态对于开发有效的多物质治疗解决阿片类药物依赖和兴奋剂共同使用至关重要。

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引用次数: 0