Journal of Substance Use最新文献

Objective: Individuals who are in recovery from opioid use disorder experience enacted stigma, which can undermine treatment retention and recovery. Stronger understanding of who is at risk of experiencing enacted stigma can inform intervention efforts to reduce experiences of enacted stigma, enhance wellbeing, and promote treatment outcomes among people in recovery from OUD. The current study applies a machine learning framework to examine predictors of enacted stigma among people in recovery from OUD.

Methods: This study employed a longitudinal approach, with n=112 participants responding to surveys before a possible disclosure and again after three months. We tested three different machine learning models and used a variety of performance metrics to evaluate model performance.

Results: The random forest model performed the best with an R-squared of 0.85, indicating that our predictors explained 85% of the variance in enacted stigma. Important predictors of enacted stigma were recovery duration, age, disclosure, current issues with drugs, and sobriety commitment.

Conclusions: Individuals who are in recovery for a shorter time, did not disclose, have greater issues with drugs, and are younger were at higher risk of experiencing enacted stigma. Interventions may be needed to address stigma among people with these characteristics in treatment for OUD.

Background and objectives: Alcohol continues to be one of the most consumed substances worldwide, with unhealthy use on the rise. This study investigates the transition from the first full drink to the onset of alcohol dependence within 12 months among individuals with newly incident alcohol use in the United States.

Methods: Data come from the US National Surveys on Drug Use and Health (2002-2019), encompassing 67,135 participants, with assessments via confidential computer-assisted self-interviews. Newly incident drinkers had their first full drink no more than 12 months before evaluation. Alcohol dependence (AD) was based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).

Results: We found that an estimated 1.7% of individuals transition into alcohol dependence within the first year of alcohol use (95% CI = 1.5-1.9). The study includes a diverse age group and emphasizes a shorter transition time between initiation and dependence compared to previous studies.

Scientific significance: Results reflect the possibility of a rapid transition to dependence within the first year of alcohol use and help identify a high-risk group that could benefit from more specialized public health prevention and intervention strategies.

The use of Delta-8 THC, a naturally occurring isomer of Delta-9 THC, has increased in the United States following the 2018 Farm Bill. However, data on the prevalence of its use and associated health conditions remain limited. This study aims to assess the association between chronic health conditions and Delta-8 THC use among U.S. adults. A cross-sectional internet-based survey collected self-reported Delta-8 THC use and chronic medical conditions from 1,080 adults aged 18-59 through the Qualtrics^® research panel. Logistic regression was used to examine the relationship between sociodemographic and clinical correlations of Delta-8 THC use. Results showed that participants reporting any chronic medical conditions had higher odds of reporting Delta-8 THC use in the past 12 months [(aOR)=1.87, 95% (CI): 1.04, 3.28; p<0.05)]. More specifically, participants reporting a history of diabetes [(aOR)=1.95, 95% CI: 1.09, 3.48; p<0.05)], heart disease [(aOR)=3.74, 95% CI: 1.81, 7.72; p<0.01)], and cancer [(aOR)=3.51, 95% CI: 1.75, 7.04; p>0.01)] had higher odds of using Delta-8 THC. Comprehensive research using larger, nationally representative samples and longitudinal assessments is essential to understand the health implications of Delta-8 THC use and inform public health policy.

Background: The e-cigarette industry has targeted low- and middle-income countries and young adults, suggesting the particular susceptibility of populations at the intersection. This study assessed e-cigarette perceptions, use, and use intention among college students in Georgia, an LMIC with high smoking rates.

Methods: We analyzed 2023 cross-sectional survey data among 225 students (M_age=21.68, SD=3.43; 56.4% female) at a large medical university in Tbilisi, Georgia. Multivariable regression analyses assessed sociodemographics, tobacco use, and e-cigarette perceptions in relation to past-month e-cigarette use and next-year use intentions.

Results: Past-month use of cigarettes and e-cigarettes was 44.9% and 23.3%, respectively. The most common sources of initial exposure were friends/family (72.2%), followed by media (25.6%). The most common reasons for initiation were curiosity (49.6%), friends' use (28.5%), cigarette cessation (15.5%), and lower perceived risk versus cigarettes (2.4%). Past-month e-cigarette use was associated with past-month cigarette use (p<.001), being more informed about e-cigarettes (p=.001), and more favorable e-cigarette perceptions (p=.009). Greater next-year e-cigarette use intent was associated with past-month e-cigarette use and perceiving e-cigarettes as less of a public health problem (p=.029).

Discussion: Enhanced regulatory and educational efforts must address e-cigarette use and related factors among young adults in Georgia and countries with similar contexts.

Introduction: The opioid overdose crisis continues to worsen in suburban and rural regions. Expanding harm reduction approaches in primary care offers a patient-centered approach to reduce opioid overdoses.

Methods: We conducted a semi-structured survey among 26 buprenorphine prescribers to assess acceptability of office-based harm reduction strategies for people who use opioids (PWUOs) and expanding partnerships with community stakeholders to ensure low-threshold access to buprenorphine.

Results: Respondents were mostly very or somewhat supportive of providing HIV testing (96.2%), information on opioid overdose prevention (100%), safe syringe disposal (100%) and use (100%), and referrals to free HIV testing (100%), social services (100%), naloxone sales in community pharmacies (96.2%) and partnering with pharmacists to facilitate referrals for patients requesting buprenorphine treatment (84.6%). Suggested strategies for enhancing care for PWUOs included addressing insurance-related barriers (e.g., prior authorization requirements, insufficient reimbursements), lifting of limits on patients prescribed buprenorphine, allowing for safe-injection sites, lifting urine drug testing requirements, integrating social services and mental health providers within primary care, and expanding the use of telebuprenorphine services.

Conclusion: Findings from this study suggest strong buprenorphine provider support for adopting harm reduction strategies in primary care and collaborating with community pharmacists to facilitate referrals for PWUOs.

Background: The opioid epidemic is a significant public health concern, particularly among adults with chronic pain. Although sex differences in opioid-related behaviors have been observed, little work has examined the role of negative affect and related variables in greater opioid misuse severity risk among men.

Methods: We tested whether, among 206 (72.3% female) adults (aged 18-64, M = 45.5) with chronic lower back pain (CLBP), the relation of sex with opioid misuse severity would be moderated by a range of negative affect-related variables (anxiety, depression, pain anxiety, pain catastrophizing, difficulty with emotion regulation, anxiety sensitivity, and distress intolerance).

Results: Although these negative affect-related variables were related to more severe opioid misuse for both men and women, the relation of sex to misuse varied as a function of the following variables: anxiety, pain anxiety, pain catastrophizing, and difficulty with emotion regulation, such that at higher levels of these variables, men reported more severe opioid misuse than women. This same pattern was not evident for depression, anxiety sensitivity, or distress intolerance.

Conclusions: Results highlight the important roles specific types of negative affect-related variables may play in observed sex differences in opioid misuse severity among individuals with CLBP.

Background: To investigate the differences in alcohol use among Black adults by sex across U.S. states the Behavioral Risk Factor Surveillance System.

Methods: Measured any alcohol use, heavy drinking (8+/15+ for women/men in a 7-day period), and binge drinking (4+/5+ in one session). Weighted prevalence estimates were age-standardized to the 2000 US population.

Results: Binge drinking among Black men in the Midwest was highest ranging from 40% in Minnesota to 45.8% in Iowa. Black women in southern states had 6-10 percentage point higher prevalence of heavy drinking than Black men.

Conclusions: Prevalence in Southern states was higher than expected, especially among Black women.