Substance Use & Misuse最新文献

Background: Following the United States (U.S.) Federal Agriculture Improvement Act of 2018, many retailers began selling intoxicating cannabis products, including Delta-8 tetrahydrocannabinol (THC) as "hemp," claiming that it provided a legal loophole to do so. This qualitative study assessed Delta-8 THC messaging on YouTube, the world's second-most visited website.

Methods: In 2022, two researchers searched the terms "Delta 8" and "Delta-8" on YouTube; 47 unique videos were identified. A combination of inductive and deductive coding was used. The larger team discussed the coding after every ten videos and reached a consensus.

Results: Four overarching themes were identified related to Delta-8 THC: reasons to use, how to use, effects of using, and safety/harm reduction. Content creators used Delta-8 THC for its alleged federal legality, easy accessibility, and the psychoactive effects which they described as a more mild, euphoric high than 'traditional' cannabis. Some mentioned that the quality of the Delta-8 THC products may vary based on the purchase location, with online typically being favored over gas stations. Few videos were age-restricted.

Conclusions: This study provides an overview of public attitudes and beliefs regarding Delta-8 THC, as discussed on YouTube. Findings suggest media campaigns to correct misinformation and other prevention efforts are important.

Background: Research suggests that individuals who experience four or more adverse childhood experiences (ACEs) have increased rates of cannabis use. However, most prior research does not separate recreational and medical usage. Medical cannabis is used legally in many states to treat a variety of health conditions, many of which are also associated with ACEs. Objectives: Therefore, we explore the extent to which medical cannabis users differ from recreational cannabis users and whether medical use is associated with ACEs, poor health, or disability. Accordingly, we ask the following questions: Are ACEs associated with any cannabis use when controlling for measures of poor health and disability? Are ACEs associated with medical cannabis use? Are associations between ACEs and medical cannabis use explained by poor health and/or disability? Results: Using 2019 BRFSS data, we find that ACEs are significantly associated with cannabis use, but that disability and poor health fully account for the effect of ACEs on medical cannabis use. Conclusions: We conclude that practitioners screen for ACEs and disability status when prescribing medical cannabis.

Background: Alcohol-impaired driving is a costly public health problem with a high rate of recidivism.

Objectives: This investigation aimed to examine the associations among negative alcohol expectancies (NAE), locus of control (LoC), and motivation to reduce alcohol use among repeat alcohol-impaired drivers.

Methods: Fifty-nine participants with ≥ 2 previous driving under the influence (DUI) arrests were recruited from a correctional treatment facility or the community. Participants completed NAE, LoC, Motivation to Change alcohol use, and psychiatric disorders (e.g., alcohol and/or substance use disorder) assessments.

Results: Both proximal (β = -0.37, p = 0.022) and distal (β = -0.40, p = 0.011) NAE were negatively associated with Motivation to Change. External LoC was associated with lower Motivation to Change among repeat alcohol-impaired drivers (β = -0.42, p = 0.006). The association of distal NAE with Motivation to Change was moderated by LoC (β = -0.48, p < 0.002): those with greater internal LoC had greater Motivation to Change when they focused more on distal NAE, whereas those with greater external LoC exhibited weaker Motivation to Change as they perceived more distal NAE.

Conclusion: The relationship between NAE and motivation to change among repeat alcohol-impaired drivers can be better explained by considering their association with LoC. Distal NAE can help repeat alcohol-impaired drivers have stronger motivation to change especially when they have greater internal LoC. Treatment programs for repeat alcohol-impaired drivers can be improved when they focus on the enhancement of both internal LoC and the awareness of long-term negative outcomes of alcohol use.

Background: Pain is a highly common and costly health problem that is strongly linked to cigarette smoking. Pain interference, the degree to which pain impedes physical, occupational, recreational, and social functioning, may have an important role in terms of smoking cessation. However, no study has examined the role of pain interference as a predictor of relapse following a quit attempt in a smoking cessation trial. Objectives: The current study examined the role of pain interference, above the effects of pain intensity, on relapse following a quit attempt. Participants were 121 treatment-seeking adult cigarette smokers (29% female; Mage = 29.32, SD = 7.52) who attended a randomized-controlled trial (RCT) testing the effect of a digital single-session personalized feedback intervention (PFI) for distress tolerance and cigarette smoking behavior. Multiple logistic regressions were conducted to examine pain intensity and pain interference scores as predictors of 7-day point prevalence abstinence (PPA) at 2 weeks and 4 weeks following the 1-session intervention. Models controlled for sex, baseline cigarette dependence, treatment condition, and baseline distress tolerance. Results: Pain interference was associated with higher odds of reporting relapse at 4-week post intervention (OR: 1.54, 95% CI [1.06, 2.25]).), while pain intensity only showed a non-significant association with higher odds of reporting relapse at 2-week (OR: 1.40, 95% CI [0.67, 2.94]). Conclusions: This prospective study highlights the effect of pain interference on later-stage relapse outcomes following participation in a cigarette smoking cessation program.

Background: While illicit substances are commonly involved in the overdose crisis, prescription substances still play a role. Oftentimes, decedents do not have prescriptions for these substances at the time of death. As such, we sought to examine the prevalence of nonmedical drug use in Tennessee through linkage of fatal drug overdose and prescription data.

Methods: We used State Unintentional Drug Overdose Reporting System (SUDORS) data to identify fatal drug overdoses in Tennessee from 2019 to 2022. Deaths were linked to Controlled Substances Monitoring Program data deterministically using name and date of birth. Nonmedical use was defined as a decedent having a prescription substance on toxicology but not having an active prescription for that substance at the time of death. Descriptive statistics were performed to assess prevalence overall and examine differences between drug classes.

Results: We identified 7,281 SUDORS deaths from January 2019-2022 with complete toxicology that were able to be linked to prescription data. The median age of decedents was 40 years with 34.2% female and 65.8% males. Prevalence of nonmedical use differed for each category, 1,263(17.3%) for nonmedical opioid use, 1,216(16.7%) for nonmedical benzodiazepine use, 436 (6.0%) for nonmedical gabapentin use, and 152 (2.1%) for nonmedical stimulant use. Overtime, nonmedical use of opioids, benzodiazepines, and stimulants has decreased.

Conclusion: Through linkage of fatal overdose and prescription data, we found the prevalence of nonmedical use to be 33% in Tennessee. Increasing education on the dangers of nonmedical use, the importance of safe drug disposal, storage, and only using medications as prescribed is encouraged to reduce improper use as the drug landscape continues to shift.

Background: Alcohol use among emerging adults is a public health concern, as it has been associated with numerous negative consequences. Poor sleep has repeatedly been associated with alcohol-related consequences in this age group, yet factors impacting this relationship and potential moderators remain largely unexplored.

Objectives: The primary objective of this study was to examine the indirect effect of poor sleep quality on alcohol-related consequences through alcohol craving and to determine whether depression moderates this association.

Methods: Emerging adults (N = 371, 56.9% White; 53.9% Male) were recruited through Prolific Academic. Participants answered questions related to alcohol use, alcohol-related consequences, alcohol craving, depression symptoms, and sleep habits.

Results: Bivariate correlations indicated there were significant positive associations between sleep quality, depression symptoms, alcohol craving, and alcohol-related consequences. There was an indirect effect of poor sleep quality on alcohol-related consequences through alcohol craving. Depression symptoms did not moderate this indirect effect.

Conclusion: These findings indicate that alcohol craving may be important to consider when investigating the relationship between poor sleep quality and alcohol-related consequences in emerging adult populations.

Background: This study investigated relationships between low-income adolescent drinkers' frequent alcohol use and five factors: social disorganization, social structural, social integration, mental health, and access to healthcare.

Objective: A sample of 1,256 low-income adolescent drinkers and caregivers were extracted from the Future of Families and Child Wellbeing Study.

Results: Logistic regression yielded results showing adolescent drinkers' weekly drinking to be associated positively with Hispanic adolescents, drinking peers, adolescents' depression/anxiety, and caregiver's daily drinking. Adolescent drinkers' weekly drinking was associated negatively with caregiver's age, family income below 100% of federal poverty level, caregiver supervision, and having usual place for health care.

Conclusions/importance: Implications included support of adolescents' selection of desirable peers, promotion of caregiver supervision (especially among Hispanic adolescents), provision of assistance to families in poverty, provision of substance use treatment for caregivers and adolescents, and provision of mental health services to adolescents with depression or anxiety.

Objective: To explore recently/currently pregnant people's experiences and views about cannabis use during pregnancy and their associated support for policies that punish pregnant people who use cannabis.

Methods: A market research firm administered a survey (May-June 2022) to pregnant and recently pregnant people ages 18-49 regarding their attitudes about cannabis use policies and practices. We used multivariable regression to assess whether cannabis use and beliefs are associated with support for punishing people who use cannabis.

Results: 3,571 people initiated the survey, 3,569 completed support for punishment items. More participants (32%) agreed that cannabis use should be illegal for pregnant people than for everyone (17%); 30% agreed that using cannabis during pregnancy is child abuse; most agreed that pregnant people should be able to talk with their doctor about cannabis use without worrying about getting in trouble (72%) and that doctors and nurses should get consent from the pregnant person before testing their urine for cannabis (52%), although uncertainty was high (22%-39%) across items. Cannabis use pre-pregnancy (-0.39, 95% CI, -0.46, -0.32) and during pregnancy (-0.42, 95% CI, -0.49, -0.35) was associated with less support for punishment. Agreeing that use during pregnancy is safe for the baby (-0.47, 95% CI, -0.58, -0.36) and that people who use cannabis during pregnancy can be great parents (-0.55, 95% CI -0.63, -0.46) were associated with less support for punishment.

Conclusions: While recently/currently pregnant people's perspectives about cannabis use during pregnancy were complex and varied by policy, most supported policies and practices that protect the patient-provider relationship.

Objectives: To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years.

Data and methods: The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate.

Results: While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%; p < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively).

Conclusion: In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.

Background: Despite limited scientific evidence, public perceptions of cannabis as health enhancing are significant. As food products, cannabis edibles (edibles), may also leverage food-related associations that convey health. Social media is a prominent and influential source of largely unregulated cannabis information and a potential place to correct misinformation. Given its potential to shape product appeal and perceptions of health benefits and risks, understanding the social media landscape around edibles and health is a priority.

Methods: We conducted a quantitative content analysis of a random sample of #edibles Instagram posts (N = 702) published in January 2020. A structured coding instrument analyzed posts for: (1) non-food related health, medicine, and wellness content (2) food-related characteristics/associations suggesting edibles are healthy foods or appropriate for particular diets.

Results: The majority of posts (61%) featured non-food related health, medicine, or wellness content. 35% of posts noted a general health or wellness issue or benefit, while 9% highlighted a medical condition, clinical diagnosis or attendant benefit; a wide range of wellness, health, and clinical issues were cited. Nearly half of all posts (45%) alluded to medicine or being medicated, while 22% referenced medical marijuana specifically. Connections to health were also made through food-related associations, with 13% of posts citing a dietary need or nutrient claim and 10% highlighting food-related characteristics that imply product healthfulness.

Conclusions: Health-related content is widespread among #edibles Instagram posts. Communication approaches to counter unsubstantiated health claims and regulatory strategies limiting commercial promotion should be considered. Explicit connections between edibles and health and more implicit associations via hashtags and images warrant particular attention.