Substance Use & Misuse最新文献

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.

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.

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.

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.

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.

Introduction: TikTok promotes methods that circumvent commerce laws and advances disinformation about tobacco policies. Currently, flavor-related policies are contentious tobacco control issues. This paper examines flavor bans content on TikTok.

Methods: TikTok videos (n = 1,139) and metadata posted between September 2018 and September 2023 were scraped using a TikTok application programming interface (API) and popular hashtags related to flavor ban content (i.e., #menthol [135.3 million]), #mentholban [11.7 million], #nonmenthol [25K]), #flavorban [3.9 million]. Data were classified for relevance to menthol bans and emergent codes by two trained coders.

Results: Flavor-ban-related videos (n = 609) displayed cigarettes (51.6%), e-cigarettes (23.9%), and nicotine pouches (2.0%). Overall, 9.5% of the videos were filmed in retail settings such as vape shops (6.4%) and gas stations (2.6%). Policy circumvention methods appeared in videos promoting flavor capsule injectors (13.3%), discussing non-menthol cigarettes (4.1%), and displaying other circumvention methods (e.g., flavor cards; 12.6%). Videos that depicted methods of circumventing tobacco control policies received 66.6% of all views and 31.4% of all likes. Influencers discussed menthol bans in 226 (37%) videos; 58.4% were against the ban, 9.3% in support, and 32.3% were neutral. Among influencer videos, 17.7% focused on racial implications, with 55% opposing the ban and 32.5% supported it. These discussions received 11.2% of all views and 25.3% of all likes.

Conclusions: Although videos aimed at policy discussions and political mobilization are noteworthy, those promoting circumvention strategies were viewed more often. TikTok's role for underregulated marketing and sales of tobacco products and accessories is a pressing tobacco regulatory issue.

Background: The rise of electronic cigarettes (e-cigarettes) has attracted both former smokers and teenagers looking for an alternative nicotine source. This study aimed to assess the prevalence of e-cigarette use, the determinants associated with its use, dependence, and the impact of e-cigarette use on physical activity and mental health among the Saudi population.

Methods: A cross-sectional study was conducted from September 27, 2024, to October 21, 2024. We used Penn State Nicotine Dependence Index, the Kessler Psychological Distress Scale, and the Global Physical Activity Questionnaire. Convenience and snowball sampling methods were used to recruit participants using an electronic survey questionnaire and face-to-face interviews.

Results: Among 3092 participants, the prevalence of e-cigarette use was 9.8%.Nicotine dependence was notable among users, with 41.7% exhibiting medium dependence and 22.2% reporting high dependence. Physical activity levels varied: 22.3% engaged in high activity, 34.1% in moderate, and 24.3% in low activity. Regarding mental health, 42.2% experienced high psychological distress. Participants with high physical activity had significantly higher odds of e-cigarette use [crude odds ratio (cOR) = 1.79, 95% confidence interval (CI): 1.29-2.49], while those with high distress had lower odds [cOR = 0.27, 95% CI: 0.19-0.39]. Path analysis revealed that mental distress positively predicted e-cigarette dependence ($\beta =0.118$), whereas physical activity showed a small positive association with dependence ($\beta =0.209$).

Conclusions: E-cigarette use in this population is significantly influenced by socio-demographic factors, physical activity levels, and mental health status. The complex relationship observed, where high physical activity is associated with use and mental distress is protective against initiation but predictive of dependence, highlights the need for integrated public health strategies. Interventions should focus on high-risk groups and address the dual role of lifestyle and psychological factors in both prevention and dependence management.

Background: Pictorial warnings are superior to text-only warnings for cigarettes. However, little research has examined the impact of cigar warnings among youth, including image characteristics that may increase their effectiveness.

Methods: We conducted an online within-subjects experiment September-October 2022 among N = 680 youth ages 15-20 who reported little filtered cigar or cigarillo (LCC) use or susceptibility to LCCs. Participants evaluated six FDA-proposed warning statements with one of six randomly assigned images selected from an earlier study phase. We double-coded warning images based on presence/absence of image features, including wound depiction; internal organ depiction; smoking cues; and symbolic/metaphoric representations; and assessed level of graphicness. Outcomes were perceived message effectiveness (PME), negative affect, and believability for each warning. We used linear mixed models to assess associations between image characteristics and outcomes, controlling for participant characteristics and warning statements.

Results: About half of the sample identified as a woman/girl (56.2%) and White (56.3%). Warning images with a wound or an internal organ (vs. not) resulted in higher PME, negative affect, and believability (ps < 0.05). Warning images that were "very" or "moderately" graphic versus "not" graphic elicited higher negative affect ratings but lower believability ratings (ps < 0.05); with no significant difference for PME. Symbolic representations (vs. not) and smoking cues (vs. not) resulted in lower PME and negative affect (ps < 0.05).

Conclusions: LCC warnings with images depicting internal organs or wounds of the health effects may enhance the effectiveness of warnings, which could hold promise for deterring LCC use among youth.

Background: Non-cigarette tobacco product use behavior among foreign-born Koreans in the U.S. remains understudied and is poorly captured in most national surveys.

Objectives: This study explored the non-cigarette tobacco product use patterns, acculturation influences, and associated factors among foreign-born Korean young adults (aged 18-39 years) in the District of Columbia, Maryland, and Virginia.

Methods: Twenty-one participants (aged 18-39 years) in the District of Columbia, Maryland, and Virginia who currently or formerly used any non-cigarette tobacco products completed a 60-minute semi-structured in-depth interview. Individual interviews were transcribed verbatim, coded, and analyzed thematically.

Results: Electronic nicotine delivery system (ENDS), hookah, and IQOS were the most commonly used non-cigarette tobacco products. Participants demonstrated ambivalence toward ENDS and hookah, frequently perceiving these as less harmful than traditional cigarettes. Peer influence served as the primary driver of smoking initiation. Participants' behaviors reflected influences from both Korean and American smoking cultures, with varying impacts based on acculturation levels. Price significantly influenced purchasing decisions, with increased consumption during sales promotions and coupons availability.

Conclusion: These findings provide meaningful insights into non-cigarette tobacco use patterns and influencing factors among foreign-born Koreans in the United States. As multiple cultural, social, and economic factors shape tobacco use in this population, culturally-tailored research and prevention interventions are needed to address established and emerging risks associated with non-cigarette tobacco products.

Background: People who inject drugs (PWID) have high risk for overdose, but there are no current estimates of overdose rates in this population. We aimed to estimate rates of non-fatal and fatal overdose among PWID living in the United States (US) and comparator countries (Canada, Mexico, United Kingdom, Australia), and ratios of non-fatal to fatal overdose rates, using literature published 01/01/2010 - 09/29/2023.

Methods: PubMed, PsycINFO, Embase, and ProQuest databases were systematically searched to identify publications reporting prevalence or rates of recent non-fatal and fatal overdose among PWID. Non-fatal and fatal overdose rates were meta-analyzed using random effects models. Risk of bias was assessed using a quality assessment tool, and heterogeneity was explored using sensitivity analyses.

Results: Our review included 143 studies, with 58 contributing unique data to the meta-analysis. Non-fatal and fatal overdose rates among PWID in the US were 32.9 per 100 person-years (PY) (95% CI: 26.4-40.9) and 1.7 per 100 PY (95% CI: 0.9-3.2), respectively. Post-2016 data yielded a non-fatal overdose rate of 41.0 per 100 PY (95% CI: 32.1-52.5) and a fatal overdose rate of 2.5 per 100 PY (95% CI: 1.4-4.3) in the US. An estimated 5% of overdoses among PWID in the US and Canada resulted in death during 2010-2023, compared to 6% in the UK and 2% in Australia.

Conclusion: Findings demonstrate substantial burden of non-fatal and fatal overdose among PWID in the US and some comparator countries. Scale-up of interventions to prevent overdose mortality are urgently needed.