首页 > 最新文献

Substance Use & Misuse最新文献

英文 中文
Shifting Patterns of Injection Drug Use in San Francisco, United States: implications for Getting to Zero HIV Infections. 美国旧金山注射毒品使用模式的转变:对实现零艾滋病毒感染的启示。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-11 DOI: 10.1080/10826084.2026.2621979
Gabriel Tariq Xavier Salomão de Pina, Bow Suprasert, Rachel Brandão Raskin, Raul Ruiz, Moranda Tate, Joaquín Meza, Iris R O'Neal, José Francisco, Paavani Lella, Glenda Baguso, Erin C Wilson, Willi McFarland

Background: We analyzed trends in drugs most often injected and their associations with HIV risk among people who inject drugs (PWID) in San Francisco, United States from 2018 to 2024.

Methods: Data are from National HIV Behavioral Surveillance serial cross-sectional surveys in 2018, 2022, and 2024. Participants were recruited through respondent-driven sampling. Trends in drugs most often injected were assessed using multinomial logistic regression analysis, adjusting for demographic differences across survey samples. Secondary analyses examined trends by age and race/ethnicity, and associations between risk behaviors and drugs most often injected.

Results: A total of 1,500 PWID were surveyed. PWID who injected methamphetamine most often rose from 23.9% in 2018 to 55.7% in 2024, while those injecting heroin most often dropped from 52.5% to 15.8%, and those injecting fentanyl most often rose from 0.9% to 11.3%. These shifts occurred earlier among younger and Hispanic PWID, while later for Black/African American PWID. PWID who most often injected methamphetamine had the highest prevalence of HIV (12.7%), sexually transmitted infections (16.3%), male-male sex (28.2%), and multiple sexual partners (55.3%). PWID who injected fentanyl most often had the highest prevalence of condomless sex (64.4%) and sharing of injection equipment (54.0%). HIV pre-exposure prophylaxis use was low (1.5%-3.0%) regardless of the drug most often injected.

Conclusions: Methamphetamine supplanted heroin as the drug most often injected in San Francisco, with fentanyl increasing. These drugs' associations with HIV risk may increase transmission unless effective prevention methods such as PrEP can be rapidly scaled up.

背景:我们分析了2018年至2024年美国旧金山注射吸毒者(PWID)中最常注射的药物趋势及其与艾滋病毒风险的关系。方法:数据来自2018年、2022年和2024年全国艾滋病毒行为监测系列横断面调查。参与者是通过受访者驱动的抽样方式招募的。使用多项逻辑回归分析评估了最常注射的药物的趋势,调整了调查样本之间的人口统计学差异。二次分析考察了年龄和种族/民族的趋势,以及危险行为与最常注射的药物之间的关系。结果:共调查了1500名PWID患者。最常注射甲基苯丙胺的PWID从2018年的23.9%上升到2024年的55.7%,最常注射海洛因的从52.5%下降到15.8%,最常注射芬太尼的从0.9%上升到11.3%。这些变化在年轻人和西班牙裔PWID中发生得较早,而在黑人/非裔美国人PWID中发生得较晚。最常注射甲基苯丙胺的PWID的HIV患病率最高(12.7%),性传播感染(16.3%),男男性行为(28.2%)和多个性伴侣(55.3%)。最常注射芬太尼的PWID无安全套性行为发生率最高(64.4%),共用注射器具发生率最高(54.0%)。无论最常注射何种药物,HIV暴露前预防使用率都很低(1.5%-3.0%)。结论:甲基苯丙胺取代海洛因成为旧金山地区注射最多的毒品,芬太尼增加。这些药物与艾滋病毒风险的关联可能会增加传播,除非能够迅速扩大PrEP等有效预防方法。
{"title":"Shifting Patterns of Injection Drug Use in San Francisco, United States: implications for Getting to Zero HIV Infections.","authors":"Gabriel Tariq Xavier Salomão de Pina, Bow Suprasert, Rachel Brandão Raskin, Raul Ruiz, Moranda Tate, Joaquín Meza, Iris R O'Neal, José Francisco, Paavani Lella, Glenda Baguso, Erin C Wilson, Willi McFarland","doi":"10.1080/10826084.2026.2621979","DOIUrl":"https://doi.org/10.1080/10826084.2026.2621979","url":null,"abstract":"<p><strong>Background: </strong>We analyzed trends in drugs most often injected and their associations with HIV risk among people who inject drugs (PWID) in San Francisco, United States from 2018 to 2024.</p><p><strong>Methods: </strong>Data are from National HIV Behavioral Surveillance serial cross-sectional surveys in 2018, 2022, and 2024. Participants were recruited through respondent-driven sampling. Trends in drugs most often injected were assessed using multinomial logistic regression analysis, adjusting for demographic differences across survey samples. Secondary analyses examined trends by age and race/ethnicity, and associations between risk behaviors and drugs most often injected.</p><p><strong>Results: </strong>A total of 1,500 PWID were surveyed. PWID who injected methamphetamine most often rose from 23.9% in 2018 to 55.7% in 2024, while those injecting heroin most often dropped from 52.5% to 15.8%, and those injecting fentanyl most often rose from 0.9% to 11.3%. These shifts occurred earlier among younger and Hispanic PWID, while later for Black/African American PWID. PWID who most often injected methamphetamine had the highest prevalence of HIV (12.7%), sexually transmitted infections (16.3%), male-male sex (28.2%), and multiple sexual partners (55.3%). PWID who injected fentanyl most often had the highest prevalence of condomless sex (64.4%) and sharing of injection equipment (54.0%). HIV pre-exposure prophylaxis use was low (1.5%-3.0%) regardless of the drug most often injected.</p><p><strong>Conclusions: </strong>Methamphetamine supplanted heroin as the drug most often injected in San Francisco, with fentanyl increasing. These drugs' associations with HIV risk may increase transmission unless effective prevention methods such as PrEP can be rapidly scaled up.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacist-Led Fentanyl Test Strip Education and Distribution for Veterans in Substance Use Treatment: A Quality Improvement Project. 药剂师领导的芬太尼试纸教育和分发退伍军人药物使用治疗:质量改进项目。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-10 DOI: 10.1080/10826084.2026.2626837
Tessa Rife-Pennington, Michael P Douglas, David L Pennington

Background: Unregulated fentanyl use is driving overdose deaths, and fentanyl test strips (FTS) are a tool to support overdose risk reduction. This quality improvement project assessed a novel pharmacist-led model of FTS education and distribution Veterans Affairs (VA) substance use disorder (SUD) care and its association with fentanyl-related knowledge and overdose risk reduction behaviors (ORRBs).

Methods: This prospective single-arm cohort project was completed in outpatient SUD clinics at a VA Medical Center. A pharmacist delivered education (fentanyl, opioid overdose risk, FTS use) and offered Veterans FTS and intranasal naloxone. Veterans completed surveys pre-/post-education and at one-month. Pre-/post-changes in fentanyl knowledge, concerns, and planned ORRBs were analyzed using paired t-tests with Cohen's d for effect size.

Results: Fifty-seven Veterans (mean age 59.3 years, 100% male) participated (January-October 2020). Most (n = 56, 98.2%) accepted at least one FTS kit, and 25 (43.9%) accepted naloxone. Significant pre-post improvements were observed in knowledge of carfentanil potency (p < 0.001, d = 1.21), fentanyl potency (p < 0.001, d = 0.74), and concern about fentanyl contamination (p < 0.001, d = 0.59). Planned ORRBs improved: keeping naloxone nearby (p < 0.001, d = 0.67); testing non-prescribed opioids for fentanyl (p < 0.001, d = 0.61). Eleven (22.2%) reported using at least one FTS; most positive results were followed by ORRBs.

Conclusions: A brief, pharmacist-led FTS education and distribution model was feasible in outpatient VA SUD care and associated with improved knowledge and ORRBs among Veterans. This model may reach Veterans who do not access conventional community-based harm reduction services and supports broader integration of FTS education and distribution in Veteran-focused SUD care to reduce overdose risk.

背景:不受管制的芬太尼使用导致过量死亡,芬太尼试纸(FTS)是支持减少过量风险的工具。本质量改进项目评估了一种以药剂师为主导的FTS教育和分配新模式,退伍军人事务(VA)物质使用障碍(SUD)护理及其与芬太尼相关知识和过量风险降低行为(ORRBs)的关系。方法:该前瞻性单臂队列项目在VA医疗中心的门诊SUD诊所完成。一名药剂师提供教育(芬太尼、阿片类药物过量风险、FTS使用),并为退伍军人提供FTS和鼻内纳洛酮。退伍军人完成了教育前/教育后和一个月的调查。使用配对t检验分析芬太尼知识、关注点和计划ORRBs的前后变化,效应大小采用Cohen’s d。结果:2020年1 - 10月,57名退伍军人(平均年龄59.3岁,100%男性)参与研究。大多数(n = 56, 98.2%)接受至少一个FTS试剂盒,25(43.9%)接受纳洛酮。在卡芬太尼效价(p d = 1.21)、芬太尼效价(p d = 0.74)和对芬太尼污染的关注(p d = 0.59)方面,观察到前后显著的改善。计划ORRBs改善:纳洛酮保持在附近(p d = 0.67);非处方阿片类药物芬太尼检测(p d = 0.61)。11人(22.2%)报告至少使用过一次FTS;阳性结果最多的是阴性结果。结论:一个简短的、药剂师主导的FTS教育和分配模式在门诊VA SUD护理中是可行的,并与退伍军人的知识和orbs的提高有关。该模式可以覆盖那些无法获得传统社区减少伤害服务的退伍军人,并支持将FTS教育和分布更广泛地整合到以退伍军人为重点的SUD护理中,以降低过量用药风险。
{"title":"Pharmacist-Led Fentanyl Test Strip Education and Distribution for Veterans in Substance Use Treatment: A Quality Improvement Project.","authors":"Tessa Rife-Pennington, Michael P Douglas, David L Pennington","doi":"10.1080/10826084.2026.2626837","DOIUrl":"https://doi.org/10.1080/10826084.2026.2626837","url":null,"abstract":"<p><strong>Background: </strong>Unregulated fentanyl use is driving overdose deaths, and fentanyl test strips (FTS) are a tool to support overdose risk reduction. This quality improvement project assessed a novel pharmacist-led model of FTS education and distribution Veterans Affairs (VA) substance use disorder (SUD) care and its association with fentanyl-related knowledge and overdose risk reduction behaviors (ORRBs).</p><p><strong>Methods: </strong>This prospective single-arm cohort project was completed in outpatient SUD clinics at a VA Medical Center. A pharmacist delivered education (fentanyl, opioid overdose risk, FTS use) and offered Veterans FTS and intranasal naloxone. Veterans completed surveys pre-/post-education and at one-month. Pre-/post-changes in fentanyl knowledge, concerns, and planned ORRBs were analyzed using paired t-tests with Cohen's <i>d</i> for effect size.</p><p><strong>Results: </strong>Fifty-seven Veterans (mean age 59.3 years, 100% male) participated (January-October 2020). Most (<i>n</i> = 56, 98.2%) accepted at least one FTS kit, and 25 (43.9%) accepted naloxone. Significant pre-post improvements were observed in knowledge of carfentanil potency (<i>p</i> < 0.001, <i>d</i> = 1.21), fentanyl potency (<i>p</i> < 0.001, <i>d</i> = 0.74), and concern about fentanyl contamination (<i>p</i> < 0.001, <i>d</i> = 0.59). Planned ORRBs improved: keeping naloxone nearby (<i>p</i> < 0.001, <i>d</i> = 0.67); testing non-prescribed opioids for fentanyl (<i>p</i> < 0.001, <i>d</i> = 0.61). Eleven (22.2%) reported using at least one FTS; most positive results were followed by ORRBs.</p><p><strong>Conclusions: </strong>A brief, pharmacist-led FTS education and distribution model was feasible in outpatient VA SUD care and associated with improved knowledge and ORRBs among Veterans. This model may reach Veterans who do not access conventional community-based harm reduction services and supports broader integration of FTS education and distribution in Veteran-focused SUD care to reduce overdose risk.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep Duration and Adolescent Substance Use: Parallel Mediation by Depressive Symptoms and Self-Control. 睡眠时间与青少年物质使用:抑郁症状和自我控制的平行中介作用。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-08 DOI: 10.1080/10826084.2026.2621264
Chad N Loes

Background: Insufficient sleep is a known risk factor for various adolescent health issues, yet its pathways to substance use remain unclear. This study tested whether depressive symptoms and low self-control mediate the association between sleep duration and adolescent substance use.

Methods: Data were drawn from 47,572 Florida middle and high school students participating in the 2022 Florida Youth Substance Abuse Survey. Multilevel generalized structural equation modeling assessed direct and indirect associations between sleep duration, depressive symptoms, self-control, and substance use.

Results: Shorter sleep duration was significantly associated with greater depressive symptoms (b = -0.11), lower self-control (b = -0.06), and higher expected substance use. Each additional hour of sleep corresponded to a 3% decrease in past 30-day substance use (IRR = 0.97). Both depressive symptoms and self-control independently predicted substance use and significantly mediated the relationship between sleep and substance use.

Conclusions: Adequate sleep appears to protect against adolescent substance-use risk by reducing depressive symptoms and enhancing self-control. Findings support both general strain and self-control theories, which point to the critical role of sleep in youth prevention efforts.

背景:睡眠不足是各种青少年健康问题的已知风险因素,但其导致药物使用的途径尚不清楚。本研究测试了抑郁症状和低自我控制是否介导睡眠时间与青少年物质使用之间的关联。方法:数据来自参与2022年佛罗里达州青少年药物滥用调查的47,572名佛罗里达州中学生和高中生。多层广义结构方程模型评估了睡眠时间、抑郁症状、自我控制和物质使用之间的直接和间接关联。结果:较短的睡眠时间与较严重的抑郁症状(b = -0.11)、较低的自我控制(b = -0.06)和较高的预期物质使用显著相关。每增加一个小时的睡眠,过去30天内的物质使用就会减少3% (IRR = 0.97)。抑郁症状和自我控制均能独立预测物质使用,并显著调节睡眠与物质使用的关系。结论:充足的睡眠似乎通过减少抑郁症状和增强自我控制来防止青少年物质使用的风险。研究结果支持一般压力和自我控制理论,指出睡眠在青少年预防工作中的关键作用。
{"title":"Sleep Duration and Adolescent Substance Use: Parallel Mediation by Depressive Symptoms and Self-Control.","authors":"Chad N Loes","doi":"10.1080/10826084.2026.2621264","DOIUrl":"https://doi.org/10.1080/10826084.2026.2621264","url":null,"abstract":"<p><strong>Background: </strong>Insufficient sleep is a known risk factor for various adolescent health issues, yet its pathways to substance use remain unclear. This study tested whether depressive symptoms and low self-control mediate the association between sleep duration and adolescent substance use.</p><p><strong>Methods: </strong>Data were drawn from 47,572 Florida middle and high school students participating in the 2022 Florida Youth Substance Abuse Survey. Multilevel generalized structural equation modeling assessed direct and indirect associations between sleep duration, depressive symptoms, self-control, and substance use.</p><p><strong>Results: </strong>Shorter sleep duration was significantly associated with greater depressive symptoms (b = -0.11), lower self-control (b = -0.06), and higher expected substance use. Each additional hour of sleep corresponded to a 3% decrease in past 30-day substance use (IRR = 0.97). Both depressive symptoms and self-control independently predicted substance use and significantly mediated the relationship between sleep and substance use.</p><p><strong>Conclusions: </strong>Adequate sleep appears to protect against adolescent substance-use risk by reducing depressive symptoms and enhancing self-control. Findings support both general strain and self-control theories, which point to the critical role of sleep in youth prevention efforts.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship Between Electronic Cigarettes and Alcohol Use Behaviors: A Systematic Review and Meta-Analysis. 电子烟与酒精使用行为的关系:系统综述和meta分析。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-08 DOI: 10.1080/10826084.2026.2619020
Pandey Pratima, Anit Kumar Sinha, Pramil Tiwari

Background: Nicotine and alcohol are among the most commonly co-used substances. The rise in e-cigarette use, particularly among younger populations, has introduced new dynamics in substance use behaviors, potentially altering traditional consumption patterns and raising concerns about the relationship between e-cigarette use and alcohol consumption. This systematic review and meta-analysis aimed to synthesize existing data to elucidate the relationship between e-cigarette use and alcohol consumption behaviors.

Methods: A literature search was conducted across PubMed, Embase, and Web of Science up to July 15, 2024. Studies reporting measures of association between alcohol behaviors and e-cigarette use were included. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models, with heterogeneity assessed via the I2 statistic and prediction intervals. The Newcastle-Ottawa Scale was used for quality assessment. All statistical analyses were performed in R software version 4.4.

Results: Among the 4,771 records screened, 34 studies were included. The meta-analysis revealed a significant association between alcohol use and e-cigarette use (pooled OR = 1.796, 95% CI: 1.412 to 2.285). Additionally, binge drinking was strongly associated with e-cigarette use (pooled OR = 3.078, 95% CI: 2.364 to 4.007). E-cigarette users were also more likely to engage in alcohol consumption (pooled OR = 3.731, 95% CI: 2.137 to 6.514) and binge drinking (pooled OR = 4.071, 95% CI: 3.209 to 5.166).

Conclusion: The findings indicate a possible relationship between e-cigarette use and alcohol consumption and binge drinking. Integrated prevention strategies addressing the co-use of these substances, particularly among youth and young adults, are needed.

背景:尼古丁和酒精是最常同时使用的物质。电子烟使用的增加,特别是在年轻人群中,为物质使用行为带来了新的动态,可能改变传统的消费模式,并引发了对电子烟使用与酒精消费之间关系的担忧。本系统综述和荟萃分析旨在综合现有数据,阐明电子烟使用与酒精消费行为之间的关系。方法:检索截至2024年7月15日的PubMed、Embase和Web of Science的文献。研究报告了酒精行为和电子烟使用之间的关联。采用随机效应模型计算合并优势比(ORs)和95%置信区间(ci),并通过I2统计量和预测区间评估异质性。采用纽卡斯尔-渥太华量表进行质量评估。所有统计分析均在R软件4.4版中进行。结果:在筛选的4,771份记录中,包括34项研究。荟萃分析显示,酒精使用与电子烟使用之间存在显著关联(合并OR = 1.796, 95% CI: 1.412至2.285)。此外,酗酒与电子烟使用密切相关(合并OR = 3.078, 95% CI: 2.364至4.007)。电子烟使用者也更有可能饮酒(综合OR = 3.731, 95% CI: 2.137至6.514)和酗酒(综合OR = 4.071, 95% CI: 3.209至5.166)。结论:研究结果表明电子烟的使用与酒精消费和酗酒之间可能存在联系。需要制定综合预防战略,解决共同使用这些物质的问题,特别是在青年和青壮年中。
{"title":"Relationship Between Electronic Cigarettes and Alcohol Use Behaviors: A Systematic Review and Meta-Analysis.","authors":"Pandey Pratima, Anit Kumar Sinha, Pramil Tiwari","doi":"10.1080/10826084.2026.2619020","DOIUrl":"https://doi.org/10.1080/10826084.2026.2619020","url":null,"abstract":"<p><strong>Background: </strong>Nicotine and alcohol are among the most commonly co-used substances. The rise in e-cigarette use, particularly among younger populations, has introduced new dynamics in substance use behaviors, potentially altering traditional consumption patterns and raising concerns about the relationship between e-cigarette use and alcohol consumption. This systematic review and meta-analysis aimed to synthesize existing data to elucidate the relationship between e-cigarette use and alcohol consumption behaviors.</p><p><strong>Methods: </strong>A literature search was conducted across PubMed, Embase, and Web of Science up to July 15, 2024. Studies reporting measures of association between alcohol behaviors and e-cigarette use were included. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models, with heterogeneity assessed <i>via</i> the I<sup>2</sup> statistic and prediction intervals. The Newcastle-Ottawa Scale was used for quality assessment. All statistical analyses were performed in R software version 4.4.</p><p><strong>Results: </strong>Among the 4,771 records screened, 34 studies were included. The meta-analysis revealed a significant association between alcohol use and e-cigarette use (pooled OR = 1.796, 95% CI: 1.412 to 2.285). Additionally, binge drinking was strongly associated with e-cigarette use (pooled OR = 3.078, 95% CI: 2.364 to 4.007). E-cigarette users were also more likely to engage in alcohol consumption (pooled OR = 3.731, 95% CI: 2.137 to 6.514) and binge drinking (pooled OR = 4.071, 95% CI: 3.209 to 5.166).</p><p><strong>Conclusion: </strong>The findings indicate a possible relationship between e-cigarette use and alcohol consumption and binge drinking. Integrated prevention strategies addressing the co-use of these substances, particularly among youth and young adults, are needed.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2026-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond Overdose: How People Who Use Drugs Navigate Competing Risks in the Polydrug Era. 超越过量:使用药物的人如何在多种药物时代应对竞争风险。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-05 DOI: 10.1080/10826084.2026.2621981
Hillary L Mortensen, Adams L Sibley, David C Colston, Elizabeth Joniak-Grant, Monica E Swilley-Martinez, Brian W Pence, Shabbar I Ranapurwala

Background: With increasing polydrug overdose deaths, public health messaging has centered around overdose prevention. However, it is important to contextualize overdose risk through the lived experience of people who use drugs (PWUD) and challenge the assumption that overdose is their primary salient risk. PWUD navigate multiple competing risk priorities daily and will adjust their behaviors in response to risks they prioritize.

Objectives: Conduct in-depth interviews to explore the lived experience of PWUD in North Carolina, how they conceptualize the risks related to polydrug use, and what protective strategies they use to mitigate those risks.

Results: Four major themes emerged from the qualitative interviews. First, overdose is ubiquitous, but not salient. Participants did not express distress regarding overdose because they thought they were careful or because they were not afraid of dying. Second, participants' primary concern was avoiding withdrawal. The immediate suffering of withdrawal outweighed the probabilistic risk of overdose. Third, participants strategically engaged in polydrug use to mitigate risks they prioritized. Fourth, despite not being significantly concerned about overdose, participants were knowledgeable and open to harm reduction strategies. PWUD employed a range of risk reduction practices aligned with their risk hierarchies.

Conclusions: Implications for these findings include the need for harm reduction providers and other public health stakeholders to target education, treatment, and interventions to align with the risks and considerations most salient and potentially persuasive to PWUD.

背景:随着多种药物过量死亡人数的增加,公共卫生信息以过量预防为中心。然而,重要的是要通过使用药物的人(PWUD)的生活经验来了解过量风险的背景,并挑战过量是其主要突出风险的假设。PWUD每天在多个相互竞争的风险优先级中导航,并根据他们优先考虑的风险调整他们的行为。目的:进行深入访谈,探讨北卡罗来纳州PWUD患者的生活经历,他们如何认识与多种药物使用相关的风险,以及他们使用哪些保护策略来减轻这些风险。结果:定性访谈中出现了四个主要主题。首先,用药过量普遍存在,但并不突出。参与者没有对过量服用表示痛苦,因为他们认为自己很小心,或者因为他们不害怕死亡。其次,参与者最关心的是避免退出。停药带来的即时痛苦超过了服药过量的可能性风险。第三,参与者战略性地参与多种药物的使用,以减轻他们优先考虑的风险。第四,尽管参与者对药物过量没有太大的担忧,但他们对减少伤害的策略很了解并持开放态度。PWUD采用了一系列与他们的风险等级相一致的风险降低实践。结论:这些发现的含义包括减少伤害提供者和其他公共卫生利益相关者需要针对puwud最突出和最具说服力的风险和考虑因素,制定针对性的教育、治疗和干预措施。
{"title":"Beyond Overdose: How People Who Use Drugs Navigate Competing Risks in the Polydrug Era.","authors":"Hillary L Mortensen, Adams L Sibley, David C Colston, Elizabeth Joniak-Grant, Monica E Swilley-Martinez, Brian W Pence, Shabbar I Ranapurwala","doi":"10.1080/10826084.2026.2621981","DOIUrl":"https://doi.org/10.1080/10826084.2026.2621981","url":null,"abstract":"<p><strong>Background: </strong>With increasing polydrug overdose deaths, public health messaging has centered around overdose prevention. However, it is important to contextualize overdose risk through the lived experience of people who use drugs (PWUD) and challenge the assumption that overdose is their primary salient risk. PWUD navigate multiple competing risk priorities daily and will adjust their behaviors in response to risks they prioritize.</p><p><strong>Objectives: </strong>Conduct in-depth interviews to explore the lived experience of PWUD in North Carolina, how they conceptualize the risks related to polydrug use, and what protective strategies they use to mitigate those risks.</p><p><strong>Results: </strong>Four major themes emerged from the qualitative interviews. First, overdose is ubiquitous, but not salient. Participants did not express distress regarding overdose because they thought they were careful or because they were not afraid of dying. Second, participants' primary concern was avoiding withdrawal. The immediate suffering of withdrawal outweighed the probabilistic risk of overdose. Third, participants strategically engaged in polydrug use to mitigate risks they prioritized. Fourth, despite not being significantly concerned about overdose, participants were knowledgeable and open to harm reduction strategies. PWUD employed a range of risk reduction practices aligned with their risk hierarchies.</p><p><strong>Conclusions: </strong>Implications for these findings include the need for harm reduction providers and other public health stakeholders to target education, treatment, and interventions to align with the risks and considerations most salient and potentially persuasive to PWUD.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intersectional Oppression-Based Stress, School Safety, and Substance Use Among Sexual and Gender Minority Adolescents Who Are Black, Indigenous, and People of Color. 黑人、原住民和有色人种中性少数和性别少数青少年的交叉压迫压力、学校安全和物质使用。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-04 DOI: 10.1080/10826084.2026.2619021
Jessica R Abramson, Ashwathi Arumugam, Hannah G Vanlandingham, Ryan J Watson, Ethan H Mereish

Objective: This study investigated the association between intersectional oppression-based stressors and substance use among sexual and gender minority (SGM; queer and transgender [QT]) adolescents who are Black, Indigenous, and People of Color (QTBIPOC) and examined the potential moderating role of school safety.

Method: Data were a subset of QTBIPOC adolescents (N = 3,563) from a dataset of SGM adolescents in the United States ages 13-18 years old.

Results: Intersectional oppression-based stressors (OBS) were associated with greater likelihood of recent use of alcohol, cigarettes, cannabis, vaping, and other drugs; nonmedical use of prescription pain medicine; and heavy alcohol use. School safety was associated with lower likelihood of recent use of cigarettes, cannabis, vaping, and other drugs; nonmedical use of prescription pain medicine; and heavy alcohol use. School safety buffered the association between intersectional OBS and heavy alcohol use, but not other substances.

Conclusions: Intersectional OBS are prevalent in the lives of QTBIPOC adolescents and these experiences are associated with greater likelihood of recent substance use. Although higher levels of school safety were generally associated with lower likelihood of substance use, school safety does not appear to be a robust protective factor against substance use for QTBIPOC adolescents experiencing OBS. This study highlights the need for interventions reducing intersectional OBS and research identifying factors that protect against substance use in this population.

目的:本研究旨在调查黑人、原住民和有色人种(QTBIPOC)性少数群体(SGM; queer and transgender [QT])中基于交叉压迫的压力源与物质使用之间的关系,并探讨学校安全的潜在调节作用。方法:数据来自美国13-18岁SGM青少年数据集的QTBIPOC青少年(N = 3563)。结果:基于交叉压迫的压力源(OBS)与近期使用酒精、香烟、大麻、电子烟和其他药物的可能性较大相关;处方止痛药的非医疗使用;以及酗酒。学校安全与近期使用香烟、大麻、电子烟和其他药物的可能性较低有关;处方止痛药的非医疗使用;以及酗酒。学校安全缓冲了交叉OBS和大量饮酒之间的关联,而不是其他物质。结论:交叉OBS在QTBIPOC青少年的生活中很普遍,这些经历与近期药物使用的可能性较大有关。虽然较高的学校安全水平通常与较低的物质使用可能性相关,但对于经历OBS的QTBIPOC青少年来说,学校安全似乎并不是防止物质使用的有力保护因素。这项研究强调需要采取干预措施,减少交叉OBS,并研究确定这一人群中防止物质使用的因素。
{"title":"Intersectional Oppression-Based Stress, School Safety, and Substance Use Among Sexual and Gender Minority Adolescents Who Are Black, Indigenous, and People of Color.","authors":"Jessica R Abramson, Ashwathi Arumugam, Hannah G Vanlandingham, Ryan J Watson, Ethan H Mereish","doi":"10.1080/10826084.2026.2619021","DOIUrl":"https://doi.org/10.1080/10826084.2026.2619021","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the association between intersectional oppression-based stressors and substance use among sexual and gender minority (SGM; queer and transgender [QT]) adolescents who are Black, Indigenous, and People of Color (QTBIPOC) and examined the potential moderating role of school safety.</p><p><strong>Method: </strong>Data were a subset of QTBIPOC adolescents (<i>N</i> = 3,563) from a dataset of SGM adolescents in the United States ages 13-18 years old.</p><p><strong>Results: </strong>Intersectional oppression-based stressors (OBS) were associated with greater likelihood of recent use of alcohol, cigarettes, cannabis, vaping, and other drugs; nonmedical use of prescription pain medicine; and heavy alcohol use. School safety was associated with lower likelihood of recent use of cigarettes, cannabis, vaping, and other drugs; nonmedical use of prescription pain medicine; and heavy alcohol use. School safety buffered the association between intersectional OBS and heavy alcohol use, but not other substances.</p><p><strong>Conclusions: </strong>Intersectional OBS are prevalent in the lives of QTBIPOC adolescents and these experiences are associated with greater likelihood of recent substance use. Although higher levels of school safety were generally associated with lower likelihood of substance use, school safety does not appear to be a robust protective factor against substance use for QTBIPOC adolescents experiencing OBS. This study highlights the need for interventions reducing intersectional OBS and research identifying factors that protect against substance use in this population.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Illicit Substance Use Among Youth in Taiwanese Temple Parade Troupes: The Roles of Social Relationships and Substance Acquisition Settings. 台湾庙会青年非法物质使用:社会关系与物质获取环境的作用。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-04 DOI: 10.1080/10826084.2026.2621260
Ming-Wei Lin, Fang-Ying Li, Yin-Han Lin, Poyao Huang

Background: This study examined illicit substance use among youth in Taiwanese temple parade troupes, a culturally distinct but high-risk population.

Methods: In 2019, we surveyed 696 participants recruited on-site through convenience sampling across Taiwan using a structured questionnaire that assessed demographics, alcohol and tobacco use, substance-involved social ties, and acquisition settings. Three domains of substance-involved ties (family, peers, intimate partners; range 0-3) and three types of acquisition settings (private, social, public; range 0-3) were analyzed using descriptive statistics, one-way ANOVAs, and logistic regression models. The lifetime prevalence of illicit substance use was 9.8%. Because only three female participants reported illicit substance use, multivariable logistic regression analyses were restricted to male participants (n = 593) and adjusted for age and education.

Results: Odds of illicit substance use increased with the accumulation of substance-involved social relationships, with adjusted odds ratios (aORs, 95% CI) of 2.96 (1.48-5.91) for one type and 11.32 (3.72-34.44) for two types, compared with none; estimates for three types could not be obtained due to complete separation. In contrast, awareness of any acquisition setting was associated with markedly higher odds of illicit substance use (aORs, 95% CI: 1 = 22.48, 5.25-96.34; 2 = 59, 3.78-81.79; 3 = 37.27, 4.75-292.23).

Conclusions: Findings highlight that accumulated substance-involved relationships and access through any acquisition setting are key structural conditions shaping substance use in this cultural context. While limited by its cross-sectional design and convenience sampling, the study provides novel evidence on culture-embedded risk structures and underscores the need for longitudinal and context-sensitive prevention strategies.

背景:本研究调查台湾庙会团体中青少年的非法药物使用情况,这是一个文化独特但高风险的人群。方法:2019年,我们通过方便抽样的方式,对台湾各地现场招募的696名参与者进行了调查,使用了一份结构化问卷,评估了人口统计学、酒精和烟草使用、物质相关的社会关系和获取环境。使用描述性统计、单因素方差分析和逻辑回归模型分析了物质相关关系的三个领域(家庭、同伴、亲密伴侣;范围0-3)和三种类型的获取环境(私人、社会、公共;范围0-3)。非法药物使用的终生患病率为9.8%。由于只有三名女性参与者报告了非法药物使用,多变量logistic回归分析仅限于男性参与者(n = 593),并根据年龄和教育程度进行了调整。结果:非法药物使用的几率随着物质相关社会关系的积累而增加,一种类型的调整优势比(aORs, 95% CI)为2.96(1.48 ~ 5.91),两种类型的调整优势比(aORs, 95% CI)为11.32(3.72 ~ 34.44),而无;由于完全分离,无法获得三种类型的估计数。相比之下,任何获得环境的意识与非法药物使用的几率明显较高相关(aor, 95% CI: 1 = 22.48, 5.25-96.34; 2 = 59, 3.78-81.79; 3 = 37.27, 4.75-292.23)。结论:研究结果强调,在这种文化背景下,积累的物质相关关系和通过任何习得环境获得物质是形成物质使用的关键结构条件。虽然受限于其横断面设计和方便的抽样,该研究提供了关于文化嵌入风险结构的新证据,并强调了纵向和上下文敏感的预防策略的必要性。
{"title":"Illicit Substance Use Among Youth in Taiwanese Temple Parade Troupes: The Roles of Social Relationships and Substance Acquisition Settings.","authors":"Ming-Wei Lin, Fang-Ying Li, Yin-Han Lin, Poyao Huang","doi":"10.1080/10826084.2026.2621260","DOIUrl":"https://doi.org/10.1080/10826084.2026.2621260","url":null,"abstract":"<p><strong>Background: </strong>This study examined illicit substance use among youth in Taiwanese temple parade troupes, a culturally distinct but high-risk population.</p><p><strong>Methods: </strong>In 2019, we surveyed 696 participants recruited on-site through convenience sampling across Taiwan using a structured questionnaire that assessed demographics, alcohol and tobacco use, substance-involved social ties, and acquisition settings. Three domains of substance-involved ties (family, peers, intimate partners; range 0-3) and three types of acquisition settings (private, social, public; range 0-3) were analyzed using descriptive statistics, one-way ANOVAs, and logistic regression models. The lifetime prevalence of illicit substance use was 9.8%. Because only three female participants reported illicit substance use, multivariable logistic regression analyses were restricted to male participants (n = 593) and adjusted for age and education.</p><p><strong>Results: </strong>Odds of illicit substance use increased with the accumulation of substance-involved social relationships, with adjusted odds ratios (aORs, 95% CI) of 2.96 (1.48-5.91) for one type and 11.32 (3.72-34.44) for two types, compared with none; estimates for three types could not be obtained due to complete separation. In contrast, awareness of any acquisition setting was associated with markedly higher odds of illicit substance use (aORs, 95% CI: 1 = 22.48, 5.25-96.34; 2 = 59, 3.78-81.79; 3 = 37.27, 4.75-292.23).</p><p><strong>Conclusions: </strong>Findings highlight that accumulated substance-involved relationships and access through any acquisition setting are key structural conditions shaping substance use in this cultural context. While limited by its cross-sectional design and convenience sampling, the study provides novel evidence on culture-embedded risk structures and underscores the need for longitudinal and context-sensitive prevention strategies.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Examining How Academic Subscribers Implement Alcohol eCHECKUP to GO. 研究学术订阅者如何实施酒精检查。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-03 DOI: 10.1080/10826084.2026.2617971
Jennifer L Shipley, Megan Strowger, Jordan Ortman, Kate B Carey, Abby L Braitman

Background: Colleges and universities use various prevention and intervention programs to address high-risk drinking among their students. Alcohol eCHECKUP TO GO is one of the most popular programs to address this risk, with strong empirical support. However, it is unclear how the context of the efficacy studies aligns with the context of typical use.

Objectives: The current study examined how institutions are implementing Alcohol eCHECKUP TO GO on their campuses, including: who receives the program (e.g., first-year students), how it is disseminated (remotely versus in person), if the program is delivered on its own or with another program, and if administration systematically varies across institution characteristics (e.g., public or private school). An online survey was sent to all Alcohol eCHECKUP TO GO subscribers. The sample (83 institutions, 51.3% medium-sized schools, 20.5% minority serving) provided information about their implementation of Alcohol eCHECKUP TO GO and institution characteristics.

Results: Most institutions implemented Alcohol eCHECKUP TO GO remotely, to students who receive alcohol violations/sanctions and those who voluntarily seek out the program, and it is combined with another alcohol or health program for many student groups. These factors generally did not vary by institution characteristics; however, implementation to select student groups did vary by school size and if the institution was a minority serving institution.

Conclusions: Institutions implement Alcohol eCHECKUP TO GO with a variety of student groups and mostly remotely. This study provides intervention and prevention researchers interested in the effectiveness of the program with a better understanding of real-world conditions.

背景:高校采用各种预防和干预方案来解决学生中的高危饮酒问题。酒精检查是解决这一风险的最受欢迎的项目之一,得到了强有力的经验支持。然而,目前尚不清楚疗效研究的背景如何与典型使用的背景相一致。目的:目前的研究调查了各机构如何在其校园内实施酒精eCHECKUP TO GO,包括:谁接受该计划(例如,一年级学生),如何传播(远程还是亲自),该计划是单独实施还是与其他计划一起实施,以及管理是否因机构特征而系统地变化(例如,公立或私立学校)。一份在线调查被发送给了所有的Alcohol echecup to GO订阅者。样本(83所学校,51.3%中等学校,20.5%少数民族学校)提供了有关其实施酒精eCHECKUP TO GO和机构特征的信息。结果:大多数机构对受到酒精违规/处罚的学生和自愿寻求该计划的学生远程实施了酒精eCHECKUP TO GO,并且它与许多学生群体的另一个酒精或健康计划相结合。这些因素一般不会因机构特征而异;然而,选择学生群体的实施确实因学校规模和学校是否为少数民族服务而异。结论:各院校在各种学生群体中实施了酒精检查,而且大多是远程的。这项研究为干预和预防研究人员提供了对项目有效性感兴趣的更好的理解现实世界的条件。
{"title":"Examining How Academic Subscribers Implement Alcohol eCHECKUP to GO.","authors":"Jennifer L Shipley, Megan Strowger, Jordan Ortman, Kate B Carey, Abby L Braitman","doi":"10.1080/10826084.2026.2617971","DOIUrl":"https://doi.org/10.1080/10826084.2026.2617971","url":null,"abstract":"<p><strong>Background: </strong>Colleges and universities use various prevention and intervention programs to address high-risk drinking among their students. Alcohol eCHECKUP TO GO is one of the most popular programs to address this risk, with strong empirical support. However, it is unclear how the context of the efficacy studies aligns with the context of typical use.</p><p><strong>Objectives: </strong>The current study examined how institutions are implementing Alcohol eCHECKUP TO GO on their campuses, including: who receives the program (e.g., first-year students), how it is disseminated (remotely versus in person), if the program is delivered on its own or with another program, and if administration systematically varies across institution characteristics (e.g., public or private school). An online survey was sent to all Alcohol eCHECKUP TO GO subscribers. The sample (83 institutions, 51.3% medium-sized schools, 20.5% minority serving) provided information about their implementation of Alcohol eCHECKUP TO GO and institution characteristics.</p><p><strong>Results: </strong>Most institutions implemented Alcohol eCHECKUP TO GO remotely, to students who receive alcohol violations/sanctions and those who voluntarily seek out the program, and it is combined with another alcohol or health program for many student groups. These factors generally did not vary by institution characteristics; however, implementation to select student groups did vary by school size and if the institution was a minority serving institution.</p><p><strong>Conclusions: </strong>Institutions implement Alcohol eCHECKUP TO GO with a variety of student groups and mostly remotely. This study provides intervention and prevention researchers interested in the effectiveness of the program with a better understanding of real-world conditions.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Emerging Crisis in Non-Prescribed Ketamine Use: A Rapid Attenuation of Depression in Face of Abuse and "Chill-out" or Escapism Drug. 非处方氯胺酮使用的新危机:面对滥用和“冷静”或逃避药物的抑郁症的快速衰减。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-01 DOI: 10.1080/10826084.2025.2612330
Kai Uwe Lewandrowski, Kenneth Blum, Sergio Schmidt, Rossano Kepler Alvim Fiorelli, Mark S Gold, Kavya Mohankumar, Alireza Sharafshah, Debasis Bagchi, Albert Pinhasov, Morgan P Lorio, Edward J Modestino, Margaret A Madigan, David Baron, Alexander P L Lewandrowski, Catherine A Dennen, Panayotis K Thanos, Rajendra D Badgaiyan

Background: Since 2000, rates of suicide and opioid overdose have sharply increased. Approximately one-third of individuals with major depressive disorder (MDD) experience treatment-resistant depression (TRD), highlighting the urgent need for novel therapeutic approaches.

Objective: This review synthesizes pivotal preclinical and clinical findings on low-dose ketamine's rapid antidepressant effects and examines proposed mechanisms underlying its therapeutic action.

Methods: This is a narrative review of key contributions in the literature addressing ketamine's fast-acting antidepressant properties.

Results: Low-dose ketamine rapidly alleviates depressive symptoms, including in refractory depression. Despite multiple hypotheses supported by preliminary data, there is no consensus regarding its definitive mechanism of action. Proposed mechanisms include modulation of dopamine signaling via epigenetic neuroadaptation, interactions with D1/D2 receptor systems, optogenetic activation of D1 pathways, and alterations in D2/D3 receptor availability.

Conclusions: Elucidating ketamine's mechanism of action may inform the development of next-generation psychoplastogens that promote neural plasticity in TRD and unipolar MDD. However, ketamine's psychoactive properties and abuse potential, along with concerns regarding misuse and diversion, underscore the need for enhanced clinical oversight and regulatory frameworks.

背景:自2000年以来,自杀率和阿片类药物过量率急剧上升。大约三分之一的重度抑郁症(MDD)患者经历难治性抑郁症(TRD),这凸显了对新治疗方法的迫切需求。目的:本文综述了低剂量氯胺酮快速抗抑郁作用的关键临床前和临床研究结果,并探讨了其治疗作用的潜在机制。方法:这是一个叙述性的回顾,主要贡献的文献解决氯胺酮的速效抗抑郁药特性。结果:小剂量氯胺酮可迅速缓解抑郁症状,包括难治性抑郁症。尽管初步数据支持多种假设,但对其最终作用机制尚无共识。提出的机制包括通过表观遗传神经适应调节多巴胺信号,与D1/D2受体系统的相互作用,D1通路的光遗传激活以及D2/D3受体可用性的改变。结论:阐明氯胺酮的作用机制可能为开发下一代促进TRD和单极MDD神经可塑性的精神致畸剂提供信息。然而,氯胺酮的精神活性和滥用潜力,以及对滥用和转移的担忧,强调了加强临床监督和监管框架的必要性。
{"title":"The Emerging Crisis in Non-Prescribed Ketamine Use: A Rapid Attenuation of Depression in Face of Abuse and \"Chill-out\" or Escapism Drug.","authors":"Kai Uwe Lewandrowski, Kenneth Blum, Sergio Schmidt, Rossano Kepler Alvim Fiorelli, Mark S Gold, Kavya Mohankumar, Alireza Sharafshah, Debasis Bagchi, Albert Pinhasov, Morgan P Lorio, Edward J Modestino, Margaret A Madigan, David Baron, Alexander P L Lewandrowski, Catherine A Dennen, Panayotis K Thanos, Rajendra D Badgaiyan","doi":"10.1080/10826084.2025.2612330","DOIUrl":"https://doi.org/10.1080/10826084.2025.2612330","url":null,"abstract":"<p><strong>Background: </strong>Since 2000, rates of suicide and opioid overdose have sharply increased. Approximately one-third of individuals with major depressive disorder (MDD) experience treatment-resistant depression (TRD), highlighting the urgent need for novel therapeutic approaches.</p><p><strong>Objective: </strong>This review synthesizes pivotal preclinical and clinical findings on low-dose ketamine's rapid antidepressant effects and examines proposed mechanisms underlying its therapeutic action.</p><p><strong>Methods: </strong>This is a narrative review of key contributions in the literature addressing ketamine's fast-acting antidepressant properties.</p><p><strong>Results: </strong>Low-dose ketamine rapidly alleviates depressive symptoms, including in refractory depression. Despite multiple hypotheses supported by preliminary data, there is no consensus regarding its definitive mechanism of action. Proposed mechanisms include modulation of dopamine signaling via epigenetic neuroadaptation, interactions with D1/D2 receptor systems, optogenetic activation of D1 pathways, and alterations in D2/D3 receptor availability.</p><p><strong>Conclusions: </strong>Elucidating ketamine's mechanism of action may inform the development of next-generation psychoplastogens that promote neural plasticity in TRD and unipolar MDD. However, ketamine's psychoactive properties and abuse potential, along with concerns regarding misuse and diversion, underscore the need for enhanced clinical oversight and regulatory frameworks.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-18"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Public Support for Harm Reduction Strategies to Address the Opioid Pandemic in the United States: A Latent Class Analysis. 公众支持减少危害战略,以解决美国阿片类药物大流行:潜在类别分析。
IF 1.7 4区 医学 Q3 PSYCHIATRY Pub Date : 2026-02-01 DOI: 10.1080/10826084.2026.2620618
Weiwei Liu, Bruce Taylor, Harold A Pollack, John Schneider

Background and aims: Harm reduction represents an approach that aims to reduce risk, promote safety, and prevent disease or disability, and has proven to be effective in preventing overdose death. However, public perceptions are mixed. Past studies have not examined public perceptions across a range of different types of harm reduction strategies. We examine public support for five different types of common harm reduction strategies, including the legalization of safe consumption sites, FDA approval of over-the-counter/nonprescription naloxone, increased number of methadone clinic locations, decriminalizing Fentanyl testing strips, and implementation of syringe service programs, in a national representative sample.

Methods: Latent class analysis was applied to JCOIN Survey 10 data (N∼6500) to investigate whether there are distinct profiles of perceptions supporting these different types of harm reduction strategies. We also explore how demographics and past direct and indirect experiences with opioid use, overdose, and criminal legal involvement relate to these profiles.

Results: We found four distinct profiles: a group of 22.9% expressing strong support for harm reduction policies, a group with mixed support (35.4%), that is, they support some but not other harm reduction policies, a profile of individuals holding neutral opinions (22.4%), and a group holding strong opposition for harm reduction policies (19.3%). Demographics and past experiences with opioids and criminal legal involvement are differentially associated with these profiles.

Conclusions: Information and educational programs should be designed to target different groups of individuals to increase understanding and support for harm reduction policies and programs.

背景和目的:减少危害是一种旨在降低风险、促进安全和预防疾病或残疾的方法,已被证明在预防过量死亡方面是有效的。然而,公众的看法不一。过去的研究没有调查公众对一系列不同类型的减少危害战略的看法。我们调查了公众对五种不同类型的常见危害减少策略的支持,包括安全消费场所的合法化、FDA对非处方/非处方纳洛酮的批准、增加美沙酮诊所的数量、芬太尼试纸的合法化以及注射器服务项目的实施,这些都是在一个具有全国代表性的样本中进行的。方法:潜在类分析应用于JCOIN调查10数据(N ~ 6500),以调查是否存在支持这些不同类型的减少危害策略的不同感知概况。我们还探讨了人口统计数据和过去与阿片类药物使用、过量使用和刑事法律参与的直接和间接经历与这些概况的关系。结果:我们发现了四种不同的群体:22.9%的人表示强烈支持减少伤害政策,35.4%的人表示混合支持,即他们支持一些减少伤害政策,但不支持其他减少伤害政策,持中立意见的个人(22.4%)和强烈反对减少伤害政策的群体(19.3%)。人口统计数据和过去与阿片类药物和刑事法律相关的经验与这些概况有不同的关联。结论:应针对不同人群设计信息和教育方案,以增加对减少伤害政策和方案的理解和支持。
{"title":"Public Support for Harm Reduction Strategies to Address the Opioid Pandemic in the United States: A Latent Class Analysis.","authors":"Weiwei Liu, Bruce Taylor, Harold A Pollack, John Schneider","doi":"10.1080/10826084.2026.2620618","DOIUrl":"https://doi.org/10.1080/10826084.2026.2620618","url":null,"abstract":"<p><strong>Background and aims: </strong>Harm reduction represents an approach that aims to reduce risk, promote safety, and prevent disease or disability, and has proven to be effective in preventing overdose death. However, public perceptions are mixed. Past studies have not examined public perceptions across a range of different types of harm reduction strategies. We examine public support for five different types of common harm reduction strategies, including the legalization of safe consumption sites, FDA approval of over-the-counter/nonprescription naloxone, increased number of methadone clinic locations, decriminalizing Fentanyl testing strips, and implementation of syringe service programs, in a national representative sample.</p><p><strong>Methods: </strong>Latent class analysis was applied to JCOIN Survey 10 data (<i>N</i>∼6500) to investigate whether there are distinct profiles of perceptions supporting these different types of harm reduction strategies. We also explore how demographics and past direct and indirect experiences with opioid use, overdose, and criminal legal involvement relate to these profiles.</p><p><strong>Results: </strong>We found four distinct profiles: a group of 22.9% expressing strong support for harm reduction policies, a group with mixed support (35.4%), that is, they support some but not other harm reduction policies, a profile of individuals holding neutral opinions (22.4%), and a group holding strong opposition for harm reduction policies (19.3%). Demographics and past experiences with opioids and criminal legal involvement are differentially associated with these profiles.</p><p><strong>Conclusions: </strong>Information and educational programs should be designed to target different groups of individuals to increase understanding and support for harm reduction policies and programs.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Substance Use & Misuse
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1