Pub Date : 2025-11-27DOI: 10.1016/j.drugalcdep.2025.112990
Austen Markus , Margaret Shang , Olivia Studnicki , Ariana Freund , Jessica Merlin , Jane M. Liebschutz , Vikram K. Raghu , Raagini Jawa
Objectives
The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings.
Methods
Using a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability.
Results
Between February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively.
Conclusions
We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.
{"title":"Micro-costing analysis of harm reduction services in office-based addiction treatment","authors":"Austen Markus , Margaret Shang , Olivia Studnicki , Ariana Freund , Jessica Merlin , Jane M. Liebschutz , Vikram K. Raghu , Raagini Jawa","doi":"10.1016/j.drugalcdep.2025.112990","DOIUrl":"10.1016/j.drugalcdep.2025.112990","url":null,"abstract":"<div><h3>Objectives</h3><div>The U.S. opioid crisis, driven by rising polysubstance use and limited access to treatment, continues to strain healthcare systems with nearly 87 % of people with substance use disorders (SUD) lacking addiction treatment and SUD-related hospitalizations increasing. Integration of harm reduction services (HRS) into office-based addiction treatment (OBAT) can reduce high-risk drug use, overdose, infection, and healthcare utilization. However, stigma and reimbursement barriers have hindered adoption. To inform future implementation, we conducted a micro-costing analysis of HRS integration in OBAT settings.</div></div><div><h3>Methods</h3><div>Using a retrospective, ingredients-based, micro-costing approach from the health system perspective, we estimated the upfront and operational costs associated with distributing pre-packaged harm reduction kits in three OBAT clinics in Pittsburgh, PA, and assessed the absolute costs of the program to determine affordability.</div></div><div><h3>Results</h3><div>Between February 2024 and June 2024, a total of 784 kits were distributed, averaging 261 kits per site. The most popular kits distributed included fentanyl test strips (n = 155), wound care (n = 146), and xylazine test strips (n = 122). Total upfront costs were $1962.03, and 5-month operational costs were $5480.68 across all three sites. Thus, we estimated that HRS integration into OBAT settings would cost one site $654.01 upfront and $365.38 and $4384.54 to operate monthly and annually, respectively.</div></div><div><h3>Conclusions</h3><div>We found that the estimated costs of HRS integration into OBAT sites was affordable and on par with other medical supplies kept in clinic spaces. More research needs to be done to assess HRS cost-effectiveness in reducing healthcare utilization and patient morbidity.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112990"},"PeriodicalIF":3.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746354","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}
Pub Date : 2025-11-27DOI: 10.1016/j.drugalcdep.2025.112989
Luther Elliott , Adrian Harris , Dev Crasta , Melody S. Goodman , Yuyu Chen , Saba Rouhani , David Frank , Jemar R. Bather , Alex S. Bennett
Objective
To apply risk compensation theory to naloxone peer access and evaluate whether reported naloxone protection—having naloxone and someone to administer it present when using unprescribed opioids—correlated with greater opioid overdose risk behaviors.
Methods
Longitudinal cohort of 422 NYC residents using unprescribed opioids who completed at least three monthly surveys over 24 months. Mixed-effects models estimated unadjusted and adjusted associations between naloxone protection and both opioid risk and overdose events and were used to test whether race/ethnicity and gender modified the relationship between naloxone protection and risk behaviors.
Results
Being protected 75 % of the time or more was identified as a meaningful cutoff in the sample and was associated with fewer opioid risk behaviors and overdose events. Race/ethnicity, but not gender, was found to be a significant effect modifier of naloxone protection.
Conclusions
Findings indicate no support for the risk compensation-derived hypothesis that people who use opioids while protected by naloxone pursue more overdose-associated risk behaviors than those unprotected.
Policy implications
Concerns about how naloxone may disinhibit people who use opioids, leading to greater risk-taking, appear unfounded, reaffirming the importance of universal naloxone access.
{"title":"Higher levels of naloxone protection are associated with lower risk-taking: A longitudinal analysis of New York City residents using unprescribed opioids","authors":"Luther Elliott , Adrian Harris , Dev Crasta , Melody S. Goodman , Yuyu Chen , Saba Rouhani , David Frank , Jemar R. Bather , Alex S. Bennett","doi":"10.1016/j.drugalcdep.2025.112989","DOIUrl":"10.1016/j.drugalcdep.2025.112989","url":null,"abstract":"<div><h3>Objective</h3><div>To apply risk compensation theory to naloxone peer access and evaluate whether reported naloxone <em>protection</em>—having naloxone and someone to administer it present when using unprescribed opioids—correlated with greater opioid overdose risk behaviors.</div></div><div><h3>Methods</h3><div>Longitudinal cohort of 422 NYC residents using unprescribed opioids who completed at least three monthly surveys over 24 months. Mixed-effects models estimated unadjusted and adjusted associations between naloxone protection and both opioid risk and overdose events and were used to test whether race/ethnicity and gender modified the relationship between naloxone protection and risk behaviors.</div></div><div><h3>Results</h3><div>Being protected 75 % of the time or more was identified as a meaningful cutoff in the sample and was associated with fewer opioid risk behaviors and overdose events. Race/ethnicity, but not gender, was found to be a significant effect modifier of naloxone protection.</div></div><div><h3>Conclusions</h3><div>Findings indicate no support for the risk compensation-derived hypothesis that people who use opioids while protected by naloxone pursue more overdose-associated risk behaviors than those unprotected.</div></div><div><h3>Policy implications</h3><div>Concerns about how naloxone may disinhibit people who use opioids, leading to greater risk-taking, appear unfounded, reaffirming the importance of universal naloxone access.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112989"},"PeriodicalIF":3.6,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692346","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}
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.
{"title":"Childhood trauma, family functioning, and the BDNF gene may affect the development of alcohol use disorder","authors":"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","doi":"10.1016/j.drugalcdep.2025.112987","DOIUrl":"10.1016/j.drugalcdep.2025.112987","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>The cross-sectional case-control study examines the associations between the <em>BDNF</em> 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 <em>t</em>-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.</div></div><div><h3>Results</h3><div>The CTG haplotype in the <em>rs6265-rs6484320-rs7934165</em> block of the <em>BDNF</em> gene was associated with the late-onset AUD (<em>p</em> = 9.9 ×10<sup>−5</sup>). 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 <em>BDNF</em> genotype.</div></div><div><h3>Conclusion</h3><div>Childhood trauma and impaired family functioning may serve as predictive factors in the development of AUD. <em>BDNF</em> gene variants, childhood trauma, and family functioning appear to influence AUD risk.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112987"},"PeriodicalIF":3.6,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145692348","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}
Pub Date : 2025-11-25DOI: 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).
{"title":"Driving after cannabis consumption among US adults ages 50 years and older: A short communication","authors":"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","doi":"10.1016/j.drugalcdep.2025.112985","DOIUrl":"10.1016/j.drugalcdep.2025.112985","url":null,"abstract":"<div><h3>Introduction</h3><div>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 + .</div></div><div><h3>Methods</h3><div>Data are from a nationally representative study of adults ages 50 + (<em>N<strong>=</strong></em>3379); we included the sub-sample who self-reported past-year cannabis use (<em>N</em> = 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).</div></div><div><h3>Results</h3><div>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 % (<em>n</em> = 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.</div></div><div><h3>Conclusions</h3><div>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).</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112985"},"PeriodicalIF":3.6,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662929","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}
Pub Date : 2025-11-22DOI: 10.1016/j.drugalcdep.2025.112972
Leah A. Biessenberger , Adriana K. Cushnie , Bethany Stennett-Blackmon , Landrew S. Sevel , Michael E. Robinson , Sara Jo Nixon , Jeff Boissoneault
Alcohol intake disrupts cognitive and sensory processing. However, its effects on the role of individual structures within cortical networks, or on the larger network structure, remain unclear. This acute alcohol administration study addressed this gap using graph theory analysis. Healthy individuals (n = 107, 21–45 yrs, 61 women) consumed alcohol (0.08 g/dL target BrAC) or a placebo drink in 2 double-blinded sessions and self-reported their perceived intoxication using a visual analog scale. Resting state fMRI was acquired with a Siemens Prisma 3T scanner 30 min after consumption. The effect of alcohol on graph theory outcomes in a network of 106 cerebral ROIs was identified using the CONN toolbox. We also determined the association between graph theory metrics and subjective intoxication. Results revealed alcohol 1) significantly decreased global efficiency in several occipital nodes and increased global efficiency for nodes within the frontal and temporal cortex; 2) increased local efficiency at a network level as well as in specific nodes in the temporal and frontal cortices; 3) increased degree in frontal and temporal regions; 4) decreased closeness centrality and increased mean path length in parietal and occipital regions as well at the network level compared with placebo conditions. Additionally, decreases in global efficiency and increases in local efficiency and clustering coefficient in the alcohol vs. placebo condition significantly predicted subjective intoxication. Taken together, results provide new evidence that alcohol intake produces changes in the overall topography of the cerebral network that at least partially underlie individual differences in subjective alcohol response.
{"title":"Acute alcohol intake disrupts resting state network topology in healthy social drinkers","authors":"Leah A. Biessenberger , Adriana K. Cushnie , Bethany Stennett-Blackmon , Landrew S. Sevel , Michael E. Robinson , Sara Jo Nixon , Jeff Boissoneault","doi":"10.1016/j.drugalcdep.2025.112972","DOIUrl":"10.1016/j.drugalcdep.2025.112972","url":null,"abstract":"<div><div>Alcohol intake disrupts cognitive and sensory processing. However, its effects on the role of individual structures within cortical networks, or on the larger network structure, remain unclear. This acute alcohol administration study addressed this gap using graph theory analysis. Healthy individuals (n = 107, 21–45<!--> <!-->yrs, 61 women) consumed alcohol (0.08<!--> <!-->g/dL target BrAC) or a placebo drink in 2 double-blinded sessions and self-reported their perceived intoxication using a visual analog scale. Resting state fMRI was acquired with a Siemens Prisma 3T scanner 30<!--> <!-->min after consumption. The effect of alcohol on graph theory outcomes in a network of 106 cerebral ROIs was identified using the CONN toolbox. We also determined the association between graph theory metrics and subjective intoxication. Results revealed alcohol 1) significantly decreased global efficiency in several occipital nodes and increased global efficiency for nodes within the frontal and temporal cortex; 2) increased local efficiency at a network level as well as in specific nodes in the temporal and frontal cortices; 3) increased degree in frontal and temporal regions; 4) decreased closeness centrality and increased mean path length in parietal and occipital regions as well at the network level compared with placebo conditions. Additionally, decreases in global efficiency and increases in local efficiency and clustering coefficient in the alcohol vs. placebo condition significantly predicted subjective intoxication. Taken together, results provide new evidence that alcohol intake produces changes in the overall topography of the cerebral network that at least partially underlie individual differences in subjective alcohol response.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112972"},"PeriodicalIF":3.6,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622796","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}
Pub Date : 2025-11-21DOI: 10.1016/j.drugalcdep.2025.112974
Yongchao Ma , Brady T. West , Sean Esteban McCabe
Background
With the rising prevalence of daily cannabis use in the U.S., more individuals may seek treatment for adverse outcomes (e.g., cannabis use disorder) arising from frequent cannabis use. Adaptive interventions leverage self-reported motives for cannabis use to develop personalized support. Research has demonstrated that these motives can be collected on a yearly, monthly, or daily basis, and strongly predict both the frequency of cannabis use and associated adverse outcomes.
Methods
We employed a daily web survey over a 28-day period to assess daily motives and open-ended self-reported contexts of nonmedical cannabis use. Participants, aged 22–76 (n = 48, Mean = 48.8, SD = 17.1; 64 % female; 22 % African American), completed a baseline web survey on demographics and mental health and a follow-up web survey on mental health at present and cannabis use behaviors during the study. We applied latent transition analysis with random intercepts (RI-LTA) to analyze the data.
Results
In our descriptive analyses, we identified four types of transitions in weekly latent motive classes, particularly transitions toward motives dominated by sleep aid and cannabis availability. Participants experiencing these transitions reported higher subsequent cannabis use frequency. Open-ended contextual information revealed behaviors such as cannabis use related to managing sleep disturbances, anxiety triggered by daily stressors, and recovery from medical treatments (e.g., chemotherapy).
Conclusions
Our findings underscore the value of monitoring short-term transitions in cannabis use motives and contexts. This approach can inform the timing and content of adaptive interventions, proactively addressing the contexts and motives to prevent adverse cannabis use outcomes. Additional replications of this approach using larger samples are needed.
{"title":"Daily web survey data collection of time-varying cannabis use motives and contexts, with implications for adaptive interventions: A pilot study","authors":"Yongchao Ma , Brady T. West , Sean Esteban McCabe","doi":"10.1016/j.drugalcdep.2025.112974","DOIUrl":"10.1016/j.drugalcdep.2025.112974","url":null,"abstract":"<div><h3>Background</h3><div>With the rising prevalence of daily cannabis use in the U.S., more individuals may seek treatment for adverse outcomes (e.g., cannabis use disorder) arising from frequent cannabis use. Adaptive interventions leverage self-reported motives for cannabis use to develop personalized support. Research has demonstrated that these motives can be collected on a yearly, monthly, or daily basis, and strongly predict both the frequency of cannabis use and associated adverse outcomes.</div></div><div><h3>Methods</h3><div>We employed a daily web survey over a 28-day period to assess daily motives and open-ended self-reported contexts of nonmedical cannabis use. Participants, aged 22–76 (<em>n</em> = 48, Mean = 48.8, SD = 17.1; 64 % female; 22 % African American), completed a baseline web survey on demographics and mental health and a follow-up web survey on mental health at present and cannabis use behaviors during the study. We applied latent transition analysis with random intercepts (RI-LTA) to analyze the data.</div></div><div><h3>Results</h3><div>In our descriptive analyses, we identified four types of transitions in weekly latent motive classes, particularly transitions toward motives dominated by sleep aid and cannabis availability. Participants experiencing these transitions reported higher subsequent cannabis use frequency. Open-ended contextual information revealed behaviors such as cannabis use related to managing sleep disturbances, anxiety triggered by daily stressors, and recovery from medical treatments (e.g., chemotherapy).</div></div><div><h3>Conclusions</h3><div>Our findings underscore the value of monitoring short-term transitions in cannabis use motives and contexts. This approach can inform the timing and content of adaptive interventions, proactively addressing the contexts and motives to prevent adverse cannabis use outcomes. Additional replications of this approach using larger samples are needed.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112974"},"PeriodicalIF":3.6,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622797","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}
Pub Date : 2025-11-20DOI: 10.1016/j.drugalcdep.2025.112971
David J. Drobes , Steven K. Sutton , Melissa R. Conn , Thomas H. Brandon , Min-Jeong Yang , Leslie E. Sawyer , Dorothy K. Hatsukami , Eric C. Donny , Vani N. Simmons
Objective
We evaluated a behavioral intervention (facilitated extinction versus standard cessation counseling) and Very Low Nicotine Content (VLNC) reduction schedule (immediate versus gradual) for smoking cessation in a 2 × 2 design over 5 weeks prior to target quit date (TQD). The facilitated extinction strategies included maintaining the smoking rate across multiple smoking contexts to maximize extinction processes.
Method
Treatment-seeking individuals who smoke cigarettes were randomized to one of four conditions. The initial target sample size was 208 to detect differences in abstinence two months post-treatment. Due to the study pause with the onset of the COVID-19 pandemic, we achieved a sample size of 127 (58 % female). Primary outcomes were treatment feasibility and in-treatment measures, including weekly self-reports of cigarettes per day (CPD), reinforcing effects of smoking, and cravings to smoke study cigarettes. Treatment satisfaction was assessed at TQD.
Results
Treatment completion at 80 % supports feasibility, with a higher rate for gradual reduction groups (88 % versus 72 %, p = .026). High adherence to VLNC cigarettes across 5 weeks also supports feasibility. Mixed models found reduced craving to smoke study cigarettes (p < .001), reduced satisfaction with smoking (p < .001), and a decrease in study CPD (p < .001), with a greater decrease in CPD in immediate reduction groups (p = .006). Biochemically verified 7-day point prevalence abstinence two months post-treatment was 29 % and 31 % with missing data imputed as smoking, with no group differences. Overall high treatment satisfaction (M=3.8 out of 4) supports acceptability.
Conclusions
These findings suggest VLNC cigarettes may aid broadly in cessation efforts and demonstrate feasibility for larger trials
{"title":"Very low nicotine content cigarettes for smoking cessation: Examining a facilitated extinction approach and dosing schedule","authors":"David J. Drobes , Steven K. Sutton , Melissa R. Conn , Thomas H. Brandon , Min-Jeong Yang , Leslie E. Sawyer , Dorothy K. Hatsukami , Eric C. Donny , Vani N. Simmons","doi":"10.1016/j.drugalcdep.2025.112971","DOIUrl":"10.1016/j.drugalcdep.2025.112971","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluated a behavioral intervention (facilitated extinction versus standard cessation counseling) and Very Low Nicotine Content (VLNC) reduction schedule (immediate versus gradual) for smoking cessation in a 2 × 2 design over 5 weeks prior to target quit date (TQD). The facilitated extinction strategies included maintaining the smoking rate across multiple smoking contexts to maximize extinction processes.</div></div><div><h3>Method</h3><div>Treatment-seeking individuals who smoke cigarettes were randomized to one of four conditions. The initial target sample size was 208 to detect differences in abstinence two months post-treatment. Due to the study pause with the onset of the COVID-19 pandemic, we achieved a sample size of 127 (58 % female). Primary outcomes were treatment feasibility and in-treatment measures, including weekly self-reports of cigarettes per day (CPD), reinforcing effects of smoking, and cravings to smoke study cigarettes. Treatment satisfaction was assessed at TQD.</div></div><div><h3>Results</h3><div>Treatment completion at 80 % supports feasibility, with a higher rate for gradual reduction groups (88 % versus 72 %, <em>p</em> = .026). High adherence to VLNC cigarettes across 5 weeks also supports feasibility. Mixed models found reduced craving to smoke study cigarettes (<em>p</em> < .001), reduced satisfaction with smoking (<em>p</em> < .001), and a decrease in study CPD (<em>p</em> < .001), with a greater decrease in CPD in immediate reduction groups (<em>p</em> = .006). Biochemically verified 7-day point prevalence abstinence two months post-treatment was 29 % and 31 % with missing data imputed as smoking, with no group differences. Overall high treatment satisfaction (M=3.8 out of 4) supports acceptability.</div></div><div><h3>Conclusions</h3><div>These findings suggest VLNC cigarettes may aid broadly in cessation efforts and demonstrate feasibility for larger trials</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112971"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622795","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}
Pub Date : 2025-11-20DOI: 10.1016/j.drugalcdep.2025.112973
Andrea M. Hussong, Jennifer M. Traver
Background
Alcohol use surges in late adolescence, particularly among college students, and is associated with a wide variety of negative socio-emotional, academic, legal, and health consequences. Although most studies assess risk for these consequences through self-report of drinking quantity and frequency, ample evidence indicates that youth who drink alcohol can be inaccurate in reporting their drinking behavior and that estimates become increasingly biased as drinking increases. In the current study, we examined two approaches for optimizing self-reported alcohol consumption estimates to assess associations with drinking consequences.
Basic procedure
The primary sample included 572 college students (53.9 % female; 18–23 age; 61.4 % White, 20.5 % Black, and 18.1 % additional racial-ethnic groups) who completed surveys and a standard lab-based free-pour knowledge task. We tested associations between consumption and consequences (as moderated by body mass index) using both multiple regression with covariates and instrumental variable analyses.
Main findings
Indicators of inaccuracy in self-reported consumption met requirements for serving as instrumental variables. In all models, consumption and consequences were strongly associated, though predictive validity measures differed in which technique they favored. Consumption rates only predicted consequences when body mass index was less than ~34 (obesity class 1).
Conclusions
Our results demonstrate that including assessments of reporting inaccuracy, alcohol knowledge, and body mass index when studying alcohol consumption may be important for reducing bias due to measurement error and predicting consequences of alcohol use.
{"title":"Optimizing measures of drinking to predict alcohol-related consequences","authors":"Andrea M. Hussong, Jennifer M. Traver","doi":"10.1016/j.drugalcdep.2025.112973","DOIUrl":"10.1016/j.drugalcdep.2025.112973","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol use surges in late adolescence, particularly among college students, and is associated with a wide variety of negative socio-emotional, academic, legal, and health consequences. Although most studies assess risk for these consequences through self-report of drinking quantity and frequency, ample evidence indicates that youth who drink alcohol can be inaccurate in reporting their drinking behavior and that estimates become increasingly biased as drinking increases. In the current study, we examined two approaches for optimizing self-reported alcohol consumption estimates to assess associations with drinking consequences.</div></div><div><h3>Basic procedure</h3><div>The primary sample included 572 college students (53.9 % female; 18–23 age; 61.4 % White, 20.5 % Black, and 18.1 % additional racial-ethnic groups) who completed surveys and a standard lab-based free-pour knowledge task. We tested associations between consumption and consequences (as moderated by body mass index) using both multiple regression with covariates and instrumental variable analyses.</div></div><div><h3>Main findings</h3><div>Indicators of inaccuracy in self-reported consumption met requirements for serving as instrumental variables. In all models, consumption and consequences were strongly associated, though predictive validity measures differed in which technique they favored. Consumption rates only predicted consequences when body mass index was less than ~34 (obesity class 1).</div></div><div><h3>Conclusions</h3><div>Our results demonstrate that including assessments of reporting inaccuracy, alcohol knowledge, and body mass index when studying alcohol consumption may be important for reducing bias due to measurement error and predicting consequences of alcohol use.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"278 ","pages":"Article 112973"},"PeriodicalIF":3.6,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622794","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}
Pub Date : 2025-11-17DOI: 10.1016/j.drugalcdep.2025.112969
Nora Digranes , Emma Pettersson , Andreas Lervik , Inger Lise Bogen , Jannike Mørch Andersen , Janicke Nordgreen , Henning Andreas Haga
Background
Fentanyl can induce laryngospasm in humans and rats, a lethal effect if unresolved. The aim was to compare the effect of ketanserin, alone and combined with naloxone, to resolve fentanyl-induced laryngospasm in a rat model.
Material
Male Sprague-Dawley rats (n = 75) were instrumented with a venous catheter under isoflurane anesthesia before converting to IV α-chloralose (50–60 mg kg−1). Each rat was administered 25 µg kg−1 IV fentanyl or saline (Control) and further allocated to receive either 2 mg kg−1 ketanserin and 2 mg kg−1 naloxone (Fentanyl-Ketanserin-Naloxone), saline and 2 mg kg−1 naloxone (Fentanyl-Naloxone), 2 mg kg−1 ketanserin and saline (Fentanyl-Ketanserin), or two injections of saline (Fentanyl-Saline). Videos of the larynx were recorded by an endoscope positioned orally. The glottic diameter was measured retrospectively by a blinded observer. The effect of treatment on the change in glottic diameter from baseline after antagonist or saline injections was analyzed using a Wilcoxon Rank-Sum Test and a Bonferroni-corrected alpha of 0.01.
Results
Fentanyl reduced glottic opening to median −100 %. Median (IQR) changes in glottic opening were 51 % (10, 96), −13 % (-40, 10), −97 % (-100, −47) and −100 % (-100, −72) for Fentanyl-Ketanserin-Naloxone, Fentanyl-Naloxone, Fentanyl-Ketanserin and Fentanyl-Saline respectively. Fentanyl-Ketanserin-Naloxone was significantly different from Fentanyl-Naloxone, Fentanyl-Ketanserin and Fentanyl-Saline (p < 0.001). Fentanyl-Naloxone was significantly different from Fentanyl-Saline (p < 0.0001), no significant difference was found between Fentanyl-Ketanserin and Fentanyl-Saline.
Conclusion
Co-administration of ketanserin and naloxone resolved fentanyl-induced laryngospasm with an enhanced glottic opening compared to baseline. Findings suggest that both opioid and serotonergic mechanisms can be involved in fentanyl-induced laryngospasm.
芬太尼可以引起人类和大鼠的喉痉挛，如果不加以解决，这是一种致命的影响。目的是比较酮色林单独使用和纳洛酮联合使用对芬太尼引起的大鼠喉痉挛的缓解效果。材料雄性Sprague-Dawley大鼠（n = 75）在异氟醚麻醉下静脉置管，然后转入静脉注射α-氯氯糖（50-60 mg kg - 1）。每只大鼠静脉注射25µg kg - 1芬太尼或生理盐水（对照组），并进一步分配接受2mg kg - 1克坦色林和2mg kg - 1纳洛酮（芬太尼-酮色林-纳洛酮），生理盐水和2mg kg - 1纳洛酮（芬太尼-纳洛酮），2mg kg - 1克坦色林和生理盐水（芬太尼-酮色林），或两次注射生理盐水（芬太尼-生理盐水）。喉部的视频由口腔定位的内窥镜记录。由盲眼观察者回顾性测量声门直径。使用Wilcoxon秩和检验和bonferroni校正α值0.01分析治疗对注射拮抗剂或生理盐水后声门直径较基线变化的影响。结果芬太尼使声门开口降至中位- 100%。芬太尼-克坦瑟林-纳洛酮、芬太尼-纳洛酮、芬太尼-克坦瑟林和芬太尼-生理盐水的声门开口中位（IQR）变化分别为51%（10,96）、- 13%（- 40,10）、- 97%（-100,- 47）和- 100%（-100,- 72）。芬太尼-酮色林-纳洛酮与芬太尼-纳洛酮、芬太尼-酮色林和芬太尼-生理盐水差异有统计学意义（p < 0.001）。芬太尼-纳洛酮与芬太尼-生理盐水差异有统计学意义（p < 0.0001），芬太尼-酮色林与芬太尼-生理盐水差异无统计学意义。结论与基线相比，联合使用酮西林和纳洛酮可缓解芬太尼引起的喉痉挛，声门开口增强。研究结果表明阿片类药物和血清素能机制都可能参与芬太尼诱导的喉痉挛。
{"title":"Reversal of fentanyl-induced laryngospasm with ketanserin and naloxone: A prospective randomized blinded study in rats","authors":"Nora Digranes , Emma Pettersson , Andreas Lervik , Inger Lise Bogen , Jannike Mørch Andersen , Janicke Nordgreen , Henning Andreas Haga","doi":"10.1016/j.drugalcdep.2025.112969","DOIUrl":"10.1016/j.drugalcdep.2025.112969","url":null,"abstract":"<div><h3>Background</h3><div>Fentanyl can induce laryngospasm in humans and rats, a lethal effect if unresolved. The aim was to compare the effect of ketanserin, alone and combined with naloxone, to resolve fentanyl-induced laryngospasm in a rat model.</div></div><div><h3>Material</h3><div>Male Sprague-Dawley rats (n = 75) were instrumented with a venous catheter under isoflurane anesthesia before converting to IV α-chloralose (50–60<!--> <!-->mg<!--> <!-->kg<sup>−1</sup>). Each rat was administered 25<!--> <!-->µg<!--> <!-->kg<sup>−1</sup> IV fentanyl or saline (Control) and further allocated to receive either 2<!--> <!-->mg<!--> <!-->kg<sup>−1</sup> ketanserin and 2<!--> <!-->mg<!--> <!-->kg<sup>−1</sup> naloxone (Fentanyl-Ketanserin-Naloxone), saline and 2<!--> <!-->mg<!--> <!-->kg<sup>−1</sup> naloxone (Fentanyl-Naloxone), 2<!--> <!-->mg<!--> <!-->kg<sup>−1</sup> ketanserin and saline (Fentanyl-Ketanserin), or two injections of saline (Fentanyl-Saline). Videos of the larynx were recorded by an endoscope positioned orally. The glottic diameter was measured retrospectively by a blinded observer. The effect of treatment on the change in glottic diameter from baseline after antagonist or saline injections was analyzed using a Wilcoxon Rank-Sum Test and a Bonferroni-corrected alpha of 0.01.</div></div><div><h3>Results</h3><div>Fentanyl reduced glottic opening to median −100 %. Median (IQR) changes in glottic opening were 51 % (10, 96), −13 % (-40, 10), −97 % (-100, −47) and −100 % (-100, −72) for Fentanyl-Ketanserin-Naloxone, Fentanyl-Naloxone, Fentanyl-Ketanserin and Fentanyl-Saline respectively. Fentanyl-Ketanserin-Naloxone was significantly different from Fentanyl-Naloxone, Fentanyl-Ketanserin and Fentanyl-Saline (p < 0.001). Fentanyl-Naloxone was significantly different from Fentanyl-Saline (p < 0.0001), no significant difference was found between Fentanyl-Ketanserin and Fentanyl-Saline.</div></div><div><h3>Conclusion</h3><div>Co-administration of ketanserin and naloxone resolved fentanyl-induced laryngospasm with an enhanced glottic opening compared to baseline. Findings suggest that both opioid and serotonergic mechanisms can be involved in fentanyl-induced laryngospasm.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112969"},"PeriodicalIF":3.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576582","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}
Pub Date : 2025-11-17DOI: 10.1016/j.drugalcdep.2025.112960
Michael Deynu , Alexandrea Dunham , Jerry John Ouner , Glenn-Milo Santos
Background
Alcohol use is linked with HIV-associated sexual behaviors and new HIV infections, and individuals who drink alcohol may benefit from Pre-Exposure Prophylaxis (PrEP) to prevent HIV. We evaluated the prevalence and correlates of current PrEP use and missed PrEP doses due to alcohol.
Methods
We included 604 HIV-negative participants (i.e., those eligible for PrEP) in San Francisco. Primary outcomes were current PrEP use and missed PrEP doses due to alcohol use in the past 3 months. Modified Poisson regression models with robust standard errors were fitted separately for each exposure while controlling for age, gender, and race/ethnicity.
Results
We enrolled a diverse sample comprising 56 % cisgender male, 42 % cisgender female, and 2 % transgender participants, and 33 % who were sexual minority men (SMM). Mean age was 39.45 years (SD=12.50). Current PrEP use was 21 % and missed PrEP doses due to alcohol were reported by 51 % of the sample who used PrEP. Factors associated with greater odds of PrEP use overall include: having anal intercourse while under the influence of alcohol (14.57 [7.17,29.60], p < 0.001) and any STIs (1.94 [1.40,2.69], p < 0.001), all in the past 3 months. Each additional day of cocaine use was associated with lower odds of PrEP use (0.93 [0.89,0.98], p = 0.01). Condomless anal intercourse under the influence of alcohol were associated with greater odds of missing PrEP doses (17.47 [7.05–43.30], p < 0.001). Among SMM, cocaine use was associated with lower odds of PrEP use (0.91 [0.86–0.97], p = 0.03, while having condomless vaginal intercourse while under the influence of alcohol was associated with missing PrEP doses due to alcohol (2.07 [1.11,3.82], p = 0.02) in the last 3 months.
Conclusions
PrEP prevalence is low, with more than half the participants reporting missed PrEP doses due to alcohol use, which was associated with engaging in sexual activity while under the influence of alcohol. Furthermore, PrEP use is associated with increased alcohol use and recent STIs diagnoses. These findings can help optimize interventions to increase PrEP use and adherence among sexually active adults who drink alcohol, including SMM. Further, the findings also highlight the need for integrating alcohol use interventions into PrEP care.
{"title":"Prevalence and correlates of PrEP use and missed PrEP doses due to alcohol among sexually active adults and sexual minority men in San Francisco","authors":"Michael Deynu , Alexandrea Dunham , Jerry John Ouner , Glenn-Milo Santos","doi":"10.1016/j.drugalcdep.2025.112960","DOIUrl":"10.1016/j.drugalcdep.2025.112960","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol use is linked with HIV-associated sexual behaviors and new HIV infections, and individuals who drink alcohol may benefit from Pre-Exposure Prophylaxis (PrEP) to prevent HIV. We evaluated the prevalence and correlates of current PrEP use and missed PrEP doses due to alcohol.</div></div><div><h3>Methods</h3><div>We included 604 HIV-negative participants (i.e., those eligible for PrEP) in San Francisco. Primary outcomes were current PrEP use and missed PrEP doses due to alcohol use in the past 3 months. Modified Poisson regression models with robust standard errors were fitted separately for each exposure while controlling for age, gender, and race/ethnicity.</div></div><div><h3>Results</h3><div>We enrolled a diverse sample comprising 56 % cisgender male, 42 % cisgender female, and 2 % transgender participants, and 33 % who were sexual minority men (SMM). Mean age was 39.45 years (SD=12.50). Current PrEP use was 21 % and missed PrEP doses due to alcohol were reported by 51 % of the sample who used PrEP. Factors associated with greater odds of PrEP use overall include: having anal intercourse while under the influence of alcohol (14.57 [7.17,29.60], p < 0.001) and any STIs (1.94 [1.40,2.69], p < 0.001), all in the past 3 months. Each additional day of cocaine use was associated with lower odds of PrEP use (0.93 [0.89,0.98], p = 0.01). Condomless anal intercourse under the influence of alcohol were associated with greater odds of missing PrEP doses (17.47 [7.05–43.30], p < 0.001). Among SMM, cocaine use was associated with lower odds of PrEP use (0.91 [0.86–0.97], p = 0.03, while having condomless vaginal intercourse while under the influence of alcohol was associated with missing PrEP doses due to alcohol (2.07 [1.11,3.82], p = 0.02) in the last 3 months.</div></div><div><h3>Conclusions</h3><div>PrEP prevalence is low, with more than half the participants reporting missed PrEP doses due to alcohol use, which was associated with engaging in sexual activity while under the influence of alcohol. Furthermore, PrEP use is associated with increased alcohol use and recent STIs diagnoses. These findings can help optimize interventions to increase PrEP use and adherence among sexually active adults who drink alcohol, including SMM. Further, the findings also highlight the need for integrating alcohol use interventions into PrEP care.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"277 ","pages":"Article 112960"},"PeriodicalIF":3.6,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576644","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}
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