Journal of studies on alcohol and drugs最新文献

Objective: The opioid overdose crisis continues within the United States, and the role of prescribed opioids and prescribing patterns in overdose deaths remains an important area of research. This study investigated patterns of prescription opioids dispensed in the 12 months before opioid-detected overdose death in Connecticut between May 8, 2016, and January 2, 2018, considering differences by demographic characteristics.

Method: The sample included decedents who had an opioid dispensed within 30 days preceding death. Using multilevel modeling, we estimated the slope of change in mean morphine equivalent (MME) daily dose over 12 months before death, considering linear and quadratic effects of time. We also estimated the main effects of age, sex, race, and ethnicity and their interactions with time on MME. A sensitivity analysis examined how excluding decedents who did not receive long-term (≥90 days) opioid therapy affected mean MME slopes. The secondary analysis explored differences according to toxicology results.

Results: Among 1,580 opioid-detected deaths, 179 decedents had prescribed opioids dispensed within 30 days preceding death. Decedents' mean age was 47.3 years (SD = 11.5), 65.5% were male, 81% were White non-Hispanic, 9.5% were Black non-Hispanic, and 9.5% were Hispanic. In the time-only model, linear (beta = 6.25, p < .01) and quadratic (beta = 0.49, p = .02) effects of time were positive, indicating exponentially increasing dose before death. Linear change in MME was significantly attenuated in men compared with women (beta = -4.87, p = .03); however, men were more likely to have nonprescription opioids in their toxicology results (p = .02). Sensitivity analysis results supported the primary findings.

Conclusions: Rapid dose increases in dispensed opioids may be associated with opioid-detected overdose deaths, especially among women.

Background: The COVID-19 pandemic had dramatic adverse impacts on people with opioid use disorder (OUD), as evidenced by significant disruptions to care and unprecedented increases in drug overdoses. In this study, we evaluated the impacts of COVID-19 on utilization of emergency and inpatient care, and fatal and non-fatal overdoses among veterans with OUD.

Methods: We used Veterans Health Administration (VHA) electronic medical record and mortality data to compare emergency department (ED) visits, inpatient hospitalizations, and fatal and non-fatal overdoses between a pandemic-exposed cohort of veterans with OUD observed both pre- and post-pandemic onset (n = 53,803; observed January 2019-March 2021) to a matched pre-pandemic control group (n = 53,803; observed October 2017-December 2019).

Results: Compared to pre-pandemic trends, there were significant decreases in the odds of ED and inpatient admissions and total number of ED and inpatient admissions during COVID-19. There was a significant decrease in the odds of having a recorded non-fatal overdose. The odds of overdose death increased during the pandemic compared to pre-pandemic trends.

Conclusion: We observed significant decreases in the utilization of ED and inpatient care services, and fewer non-fatal overdoses, post-pandemic onset. Healthcare disruptions limiting access to emergency and inpatient care could account for the lower number of recorded non-fatal overdoses, potentially reflecting an underestimate of risk. In contrast, fatal overdoses increased during the pandemic compared to pre-pandemic trends. Lower utilization of emergency and inpatient care, and higher rates of fatal overdoses during the pandemic, suggest an exacerbation of unmet treatment need post-pandemic onset.

Background: The United States has seen a rapid increase in the use of Δ-8-tetrahydrocannabinol (Δ⁸-THC), a psychoactive compound similar to Δ-9-tetrahydrocannabinol (Δ⁹-THC). This study aimed to explore themes in Δ⁸-THC related tweets from U.S. jurisdictions with varying cannabis regulations from 2020 to 2022.

Methods: Tweets mentioning Δ⁸-THC were collected using search terms: D8, Delta-8, and Delta8 THC. The tweets were date-restricted from January 21, 2020, to May 31, 2022, resulting in 139,843 tweets. The final dataset included 61,800 U.S. tweets with complete location data. A subset of 1,000 tweets (n = 250 for each legal jurisdiction) was selected for content analysis.

Results: Three main themes related to Δ⁸-THC emerged across all jurisdictions: 'Sales and Advertising', 'Policy', and 'Personal Use'. In states where cannabis was legal for adult use, sales-themed tweets were most prevalent, promoting product sales and discounts. 'Policy' tweets were more common in medical CBD-only (34.5%) and fully illegal (24.8%) jurisdictions than in those with legalized medical (20.4%) and adult use (20.2%). Tweets about personal use appeared at similar rates in fully illegal (27.7%), medical (25.0%), medical CBD-only (24.5%), and fully legal jurisdictions (22.8%). Reports of adverse effects were frequent in tweets from fully illegal (28.9%), fully legal (27.7%), and medical (27.7%) jurisdictions, with the lowest frequency in medicinal CBD-only (15.6%) jurisdictions.

Conclusion: The current study on the public discourse on Twitter indicates that discussions about the use and marketing of Δ⁸-THC are present in all U.S. jurisdictions, not just those without legal recreational cannabis markets.

Objective: Sexual minority (SM) college students have higher alcohol use and alcohol-related consequences than heterosexual students. Peers are salient determinants of young adult drinking, and examining social network characteristics is useful for understanding peer influence. This study used social network methods to understand network characteristics, alcohol use (i.e., max drinks), and alcohol consequences of SM and heterosexual college students.

Method: Sexual minority and heterosexual junior-year college students (N = 1,150) were compared on (1) social network features (eigenvector centrality, indegree, outdegree, mutuality, closeness), and (2) alcohol use and consequences. We also determined (3) whether social network characteristics were associated with alcohol use and consequences, and (4) whether these associations differed based on sexual identity or attraction.

Results: Students reporting a bisexual identity or same-gender attraction had greater eigenvector centrality (global popularity or prestige) than heterosexual or students reporting exclusively other-gender attraction, respectively. Students reporting same-gender attraction had higher outdegree (expansiveness) and more reciprocated ties (mutuality) than individuals reporting exclusively other-gender attraction, but heterosexual students and students with other-gender attraction reported higher relationship closeness; they also reported a higher number of drinks than bisexual students and students with same-gender attraction. One significant interaction showed that outdegree (expansiveness) was associated with alcohol consequences for students who reported any same-gender attraction, but not for students who reported exclusively opposite-gender attraction.

Conclusions: SM college students' greater network prominence differs from research with adolescents and might reflect students' efforts to establish more affirming social connections in a college environment.

Objective: Driving under the influence (DUI) of substances is the first cause of death among young populations. Unfortunately, there is a paucity of research looking at DUI risk factors in adolescents. This study aimed to estimate the past-year prevalence and correlates of DUI of alcohol (DUI-A), cannabis (DUI-C), and both (DUI-A+C) in adolescents who reported past-year alcohol and cannabis use.

Method: The study sample comprised 3,175 [(47.9 % females; M_age (SD) = 16.76 (.70)] Spanish adolescents from a national representative survey (ESTUDES) conducted by the Spanish Ministry of Health. Hierarchical regression models were conducted to identify correlates of DUI-A only, DUI-C only, and both behaviors, including sociodemographic, substance use and parental control variables.

Results: Past-year prevalence of DUI was 9.9 % among past-year alcohol and cannabis users. Past-year DUI of substances was more likely among males (15.4 %) relative to females (6 %) [χ² = 73.39, p = <.001, Φ = .152]. Being male, reporting higher past-month days of cannabis use and cannabis-related problems were common risk factors for DUI-C and DUI-A+C. Risk factors of DUI-A were greater money availability for going out, higher past-month frequency of heavy drinking episodes and lower past-month cannabis use days. Specific correlates of DUI-A+C were being 18, past-year simultaneous alcohol and cannabis use, and earlier age of alcohol use initiation.

Conclusions: There is a need to address DUI in substance use prevention in school settings. Screening should be particularly focused on adolescent substance users, while interventions should target attitudes and risk of substance use and driving.

Objective: Alcohol expectancy theory proposes that beliefs about drinking motivate or deter drinking. Although expectancies influence drinking, less is known about how the consequences of drinking influence expectancies. We modeled a feedback conceptualization of how the experience of specific consequences influenced people's beliefs about how likely a consequence will occur (i.e., likelihoods) and how positive the consequence will be (i.e., valences).

Method: We re-analyzed cross-sectional data from college drinkers (n = 504), using Bayesian cross-classified multilevel ordinal regressions to estimate associations between consequences, likelihoods, and valences. We performed a preregistered replication in new data (n = 362).

Results: Participants had higher likelihoods (95% CI_{Study 1} = [2.06, 2.43], 95% CI_{Study 2} = [1.75, 2.12]) and valences (95% CI_{Study 1} = [0.28, 0.52], 95% CI_{Study 2} = [0.33, 0.60]) when they had experienced consequences more often, but these associations leveled off at higher consequence frequencies. Participants also believed consequences to be more likely when they viewed them as more positive, and vice versa, and again, these associations leveled off at higher levels of the predictor. Critically, the strength of these associations varied across both people and consequences.

Conclusions: Experiencing specific consequences more often was related to people judging them to be more likely and more positive in the future, aligning with alcohol expectancy theory. This may lead to experiencing negative consequences repeatedly because people are not being demotivated from drinking in the same fashion. Given the person and consequence level variability, clinicians should consider an individualized approach when targeting drinking consequences.

Introduction: This paper considers how harm from others' drinking is distributed across several economic and environmental factors.

Method: Economic, environmental, demographic and drinking measures include: household income, financial disadvantage indicators, home spaciousness; neighbourhood socioeconomic status (SES), connections and safety; and respondent's gender, age group and risky drinking status. The paper explores interactions of these factors with harms from the drinking of others in a 2021 survey of 2574 Australian adults.

Results: The home's degree of crowding (persons per bedroom) is related to harms from others in the household, while financial disadvantage is related to harm from drinkers outside the household, whether known or strangers. Perceived neighbourhood safety and knowing neighbours are negatively related to harms from the drinking of others outside the household. In multivariate analyses for harms from household members and from strangers, these findings are little affected by three individual factors related to harms from others' drinking: the respondent's gender, age group and risky drinking status.

Discussion: Some economic and ecological factors play an important role in the occurrence of harms from others' drinking, but the relationship varies both between factors and by the category of other person involved.

Objective: As more states legalize cannabis in the US, marketing from the cannabis industry and news coverage of cannabis have increased. Sources of information on cannabis can influence beliefs about risks and benefits. Yet, little is known about how the use and influence of specific sources of information have changed over time.

Method: We conducted a longitudinal study of 5053 US adults between 2017 and 2021. Participants were asked about sources of information on cannabis risks and benefits and which sources were most influential using a web-based survey at three different time points (2017, 2020, 2021). We evaluated changes in the use/influence of multiple sources of information from 2017 to 2021 and examined interactions with age, cannabis use and state cannabis legal status.

Results: The largest increases in sources of information on cannabis benefits and risks were in use of health professionals (+5.5% for benefits and +17.4% for risks). The largest declines were in use of traditional media (TV, radio, newspapers) (-12.3% and -11.4%). Use of cannabis advertisements and dispensaries/other industry sources also significantly increased. Health professionals were the most influential source of information in all three waves regardless of age, cannabis use or state legal status.

Conclusions: Participants sought information from different sources, and increasingly relied on health professionals as a primary source, highlighting the need to train healthcare providers about cannabis risks and benefits. While fewer people used traditional media, use of industry sources increased, underscoring the need for accurate cannabis information sources.

Background: Collegiate Recovery Programs (CRPs) play a vital and expanding role in supporting students in recovery from substance use disorders and behavioral addictions at higher education institutions. Despite their importance, there is a lack of comprehensive research characterizing CRPs, including their program directors and the nature and influence of their funding streams.

Methods: A survey was administered to 70 CRP directors across the US and Canada. Directors reported on their CRPs across a variety of site physical features, policy and program offerings, and funding sources, with "sustainable" funding defined as two or more sources.

Results: CRP directors were predominantly non-Hispanic, White, and female, with representation from gender and sexual minorities. The highest concentration of directors responding were in the US states of North Carolina, California, and Texas. CRPs with more than one funding source served twice as many students and had significantly more space, drop-in facilities, and relapse management policies. CRP directors had positive perceptions of harm reduction principles. Additionally, results highlighted the robust availability of All Recovery meetings and the wide diversity of mutual-help group meetings offered within CRPs and directors' positive perceptions of these meetings.

Conclusion: This research lays a foundation for enhancing CRPs within higher education settings, emphasizing the significance of sustained funding and an inclusive support framework for the program directors that run CRPs. Future studies should further explore the effectiveness of CRPs and their impacts on the schools and students they serve.