Journal of studies on alcohol and drugs最新文献

Objective: Developing a better mechanistic and multilevel understanding of sexual violence on college campuses can help us evaluate and implement existing interventions, as well as develop new ones. We brought together scientists, practitioners, and college students to collaboratively characterize the systems surrounding alcohol-involved sexual violence on college campuses. Using collaborative model-building, they created models that highlight interconnected and multilevel influences and consequences of sexual violence.

Method: Collaborative model-building activities involved two collaborator groups (twelve students and eight practitioners) and a core modeling team (seven scientists). Each collaborator group met for four two-hour sessions to develop systems models of alcohol use and sexual violence on college campuses. The core modeling team facilitated each session and worked between sessions to ensure the successful development of the model. Specific activities included identifying and prioritizing the causes and consequences of alcohol-involved sexual violence, characterizing the causal relationships between these factors, and developing and modifying causal loop diagrams to illustrate these relationships.

Results: Both students and practitioners identified key causes and consequences, including both individual-level (e.g., drinking to intoxication) and campus-level (e.g., institutional support for survivors) constructs. Both groups identified the causal relationships between these variables and identified salient, modifiable mechanisms for reducing alcohol-involved sexual violence.

Conclusions: The collaborative model-building process successfully included diverse collaborator voices, integrating influential factors across multiple social-ecological levels. This iterative and capability-building approach can bridge intensive modeling efforts with the implementation and development of more effective sexual violence interventions.

Objective: This paper explores the challenges, opportunities, and successes encountered in implementing Safer Bars, a bystander intervention training program to prevent sexual aggression in bars. The study aims to assess the feasibility of program implementation and its acceptability among bar staff and bar owners/managers.

Methods: Utilizing a mixed-methods approach, the study assessed the feasibility of Safer Bars by documenting bar participation, reasons for declination, and the time elapsed during recruitment, offering insights into experienced challenges and successes. Acceptability was gauged through post-training surveys for bar staff (N = 220) and owners/managers (N = 22), including Likert-scale questions on various aspects of the program and open-ended inquiries about the training's best aspects and potential improvements.

Results: Despite challenges in bar enrollment due to time constraints and financial considerations, the program demonstrated high acceptability among participating bars. Bar staff expressed confidence in applying acquired bystander skills, emphasizing the importance of skilled and knowledgeable trainers. The qualitative analysis of participant feedback revealed valuable insights into the practicality and reception of the intervention.

Conclusion: The study provides data from implementation to guide upscaling Safer Bars. Despite feasibility challenges amidst the COVID-19 pandemic, the program showed high acceptability among bar staff and owners/managers, indicating its potential impact on addressing sexual aggression in nightlife settings. Future efforts must consider the reality of the alcohol-serving industry and focus on innovative strategies to overcome additional industry-specific barriers to enhance program feasibility.

Introduction: Chronic use of nicotine and tobacco products (NTP) continues to be a leading cause of morbidity and mortality. Uptake is most common among youth and young adults but knowledge about effective prevention and intervention approaches is insufficient. The goal of the present study was to examine the impact of social cognitive factors on NTP risk over time among youth in the national ABCD cohort.

Methods: Participants (n=11,880, 47.8% female) were 9-10 years old at baseline, and completed multiple assessments of NTP use and related cognitions over two years. Structural equation modeling was used to estimate concurrent and prospective associations between social cognitive factors (peer and parent NTP use and perceptions of peer approval and harms from e-cigarette use) and risk for NTP use.

Results: Participant NTP use was primarily of e-cigarettes. Higher levels of parental and especially peer NTP use were significant prospective predictors of greater risk of NTP use. Lower perceived harm from and higher peer approval of e-cigarette use were significant predictors of heightened current but not future NTP risk.

Conclusion: Findings suggest that youth perceptions of peer NTP use is a key predictor of the likelihood of use and a potential target for interventions designed to prevent or reduce e-cigarette and other NTP use in youth.

Implications: findings indicate that perceived peer use is a more powerful predictor of nicotine and tobacco product (NTP) use than cognitive factors or parental use, even at early ages when youth NTP use is uncommon. This suggests a need for additional early intervention targeting perceptions of and responding to peer NTP use.

Background: Given that individuals with substance use disorders (SUDs) have a variety of needs beyond substance use, it is critical to examine the comprehensiveness of services offered within outpatient SUD treatment facilities, where many individuals with SUDs receive care. This study's objective is to develop clusters of services offered, and assess organizational, policy, and environmental characteristics associated with having a more comprehensive treatment model.

Methods: We conducted a principal component analysis (PCA) using data on SUD treatment facilities (n=8, 197) from the 2022 Mental Health and Addiction Treatment Tracking Repository, a national database of SUD treatment facilities. We applied a K-means cluster analysis on the generated components to cluster facilities by service offerings, and calculated the mean for different organizational, policy and environmental characteristics for each cluster.

Results: We retained five components from the PCA which represented the availability of different services (Pharmacotherapies, Infectious Disease and Harm Reduction, Supportive and Social Determinant of Health (SDOH) Services, Psychosocial Services, and General Healthcare.) The cluster analysis resulted in five SUD service models, with the most comprehensive having the highest percentage of accredited and Medicaid-accepting facilities, and facilities that were government-operated and located in a Medicaid expansion state, and the least comprehensive having lowest percentage of accredited, licensed and Medicaid-accepting facilities, and the highest percentage of private for-profit facilities.

Conclusions: Our study found that SUD treatment facilities varied in the availability of five treatment components, but more comprehensive service models had a higher percentage of facilities that were licensed, accredited, and accepting Medicaid.

The rescheduling of cannabis, from the US Drug Enforcement Administration (DEA), current most restrictive (Schedule 1) designation, would be an important step for cannabis research and researchers. We are researchers who have experience with cannabis research in pre-clinical, clinical, and policy domains, who represent a range of social science disciplines (e.g., Psychology, History). In this commentary, we share our perspectives on the history, policies, challenges and benefits of moving cannabis from the current Schedule 1 designation (similar to heroin) to the less restrictive Schedule III (similar to ketamine). The rescheduling has the potential to contribute in multiple ways to research on cannabis' effects on the brain and behavior, policies for regulating medicinal and recreational use, and the use of cannabis to treat health conditions such as chronic pain. While there is scientific evidence to support this rescheduling, there also are challenges and pushback for keeping the regulations as they currently exist. Although "the devil is in the details," we present our reasons to advocate for improving access to cannabis for research.

Objective: To examine trends in cannabis-related hospital visits in Arizona from 2016-2021 and associations with hospital visits for a mental health condition.

Methods: Data were emergency department and inpatient hospital discharge records from all Arizona licensed hospitals from 2016-2021. Records comprised 18,758,614 hospital visits. Cannabis-related visits were defined by International Classification of Diseases (ICD) diagnostic code for cannabis use (unspecified use, abuse, dependence) or poisoning. Mental health visits were defined by ICD diagnostic codes for mental health conditions.

Results: The rate of cannabis-related hospital visits increased from 1,301.50 per 100k visits in 2016 to 1,565.54 per 100k visits in 2021 - a 20% increase. The increase was larger for visits by adolescents and older adults ages 65+ -- 63.94% and 84.45%, respectively. Cannabis-related visits were 7.75 (95% CI: 7.69, 7.81) times as likely as visits unrelated to cannabis to have a mental health condition as the primary diagnosis from 2016-2021, and were 2.32 (95% CI: 2.30, 2.34) times as likely after adjustment for covariates, including alcohol and other substance-related diagnoses. The association between cannabis-related visits and mental health-related visits increased each year, particularly for older adults ages 65+.

Conclusions: The rate of cannabis-related hospital visits is increasing, as is the cannabis-related risk of a hospital visit for a mental health condition. The increases are especially pronounced among hospital visits by older adults (ages 65+), highlighting the need for prevention and intervention in this under-recognized at-risk group.

Objective: Sexual aggression and heavy drinking are interrelated concerns among college men. As a result, integrated prevention interventions now exist to address co-occurring risk for sexual aggression and heavy drinking. The Sexual Assault and Alcohol Feedback and Education (SAFE) program is a multi-session integrated alcohol and sexual assault prevention program for college men that addresses alcohol use, sexual activity, social norms, alcohol-related sexual consequences, understanding of consent, and engagement in bystander intervention. Given that prior sexual aggression is a risk factor for subsequent perpetration of sexual aggression, the present study examined whether the effect of SAFE on a range of outcomes (rape myth acceptance, hypergender ideology, labeling of consent, and bystander intervention intentions) depended on men's baseline history of perpetration.

Method: Participants in the study were heavy drinking college men (N = 115) randomly assigned to SAFE or a mindfulness-based control condition, and who completed follow-ups at two and six months. Data were analyzed using multilevel modeling.

Results: Degree of prior sexual aggression significantly moderated effects of SAFE on change in intentions to intervene, as well as rape myth acceptance, between baseline and six months. As baseline perpetration decreased, those receiving SAFE significantly increased bystander intervention intentions more so than the control group. As baseline perpetration increased, those receiving SAFE significantly increased rape myth acceptance more so than the control group.

Conclusion: Findings emphasize the importance of continued examination of who benefits from integrated alcohol and sexual assault prevention programs.

Objective: Buprenorphine is the standard of care for treatment of opioid withdrawal. However, when sublingual (SL) administration is not appropriate or practical, parenteral administration by the intravenous (IV) or intramuscular (IM) route may be a reasonable substitute. Although previously used intravenously for the treatment of pain, current practitioners have limited experience with parenteral use of buprenorphine.

Methods: This is a case series using retrospective chart review of patients at an urban public hospital who received IV or IM buprenorphine for treatment of opioid withdrawal. A query of the electronic health record (EHR) was performed to identify patients who had received IV or IM buprenorphine from January 2020 to December 2021. Charts were reviewed for patient demographics, medical history, substance use history, urine drug screens, clinical scenario, indication for parenteral buprenorphine, dose of buprenorphine, vital sign trends, and any measure of change in withdrawal.

Results: Eight patients were identified. The most frequent initial dose of parenteral buprenorphine was 0.3 mg, and if buprenorphine needed to be re-dosed it was most commonly administered every six hours. The most common indications for use were delirium or intractable nausea and vomiting related to opioid withdrawal. Withdrawal improved in 6 of the 8 cases, and often allowed for subsequent use of SL buprenorphine. There were no adverse effects identified.

Conclusion: Parenteral buprenorphine was successfully used to treat opioid withdrawal in a select group of patients. Further studies are needed to identify the optimal use parameters of parenteral buprenorphine.

Individuals access and perceive information about cannabis differently according to age groups. This study compared differences in beliefs and knowledge regarding cannabis, and exposure to information, advertisement, and prevention messages among emerging (18-24 years old), prime-age (25-44), middle-age (45-64), and old-age adults (65 and over). Participants (n=2,001) completed online questionnaires regarding their sociodemographic characteristics, mental health perception, cannabis use, sources of cannabis information, and exposure to advertisement and prevention messages. Bivariate analyses allowed the detection of differences among the age groups. Emerging adults exhibited more positive attitudes regarding cannabis and were more knowledgeable regarding cannabis facts than their older counterparts. Online media constituted the principal source of information for the overall sample. Health resources were the most trusted information source for all age groups, but only one-fifth of the sample consulted them. A higher proportion of emerging adults were exposed to cannabis advertisements and prevention messages. Old-age adults were more likely to be reached through traditional media. As perceptions and beliefs about cannabis, information access, and exposure to advertisement or prevention messages vary across age groups, effective prevention and education should be tailored accordingly. Health resources and scientific literature about cannabis should become more accessible and understandable to the general population.

Objective: Sexual victimization (SV) is common among men who have sex with men (MSM) as is dating and sexual networking (DSN) app use. We developed a novel laboratory paradigm ("G-Date") of sexual violence risk perception in DSN app environments and explored its validity and the role of substance misuse and SV history on sexual violence risk perception.

Method: Using convenience sampling, we recruited 145 MSM to use G-Date to interact with two bogus speed dates whose responses were scripted to be risky or non-risky. Risky dates displayed several cues indicating risk for sexual violence perpetration. Dependent variables included pre/post changes in ratings of their dating partner's appeal; ratings of the presence of each of the embedded risk cues; and the duration of the speed dates.

Results: Compared to non-risky dates, participants terminated risky dates significantly sooner, rated them higher in each of the risk cues, and their pre- to post-date ratings of partner appeal declined significantly more. Participants' drug misuse was associated with reduced interest in the non-risky date, but not the risky date and predicted shorter speed date length and lower partner appeal ratings across date type. Substance-facilitated SV history interacted with alcohol misuse and date type to predict sexual violence risk perception.

Conclusions: Results provide evidence for the paradigm's validity and suggest that drug misuse and substance-facilitated SV history shape MSM's risk perception in DSN apps. Efforts to prevent SV among MSM should consider individual characteristics, including substance misuse, in risk perception.