Substance Use & Misuse最新文献

Introduction: Waterpipe tobacco (WT) is unique compared to other tobacco products. Retailers and manufacturers may promote WT products using different marketing appeals and sales propositions on popular digital marketing media. This study examined WT digital marketing content in the United States (U.S.).

Methods: In 2020, a census of WT manufacturers that sold WT products in the U.S. was created and 33 WT manufacturers and 30 WT retailers across the U.S. were identified. Business websites and the 20 most recent Facebook and Instagram posts from identified manufacturers and retailers were recorded. Marketing appeals were coded for themes including sexuality and romance, U.S. patriotism, Middle Eastern culture, WT smoking cues, health or safety, and enjoyable experiences. Sale proposition content was also coded and included price promotions, scarcity, and free products.

Results: Digital marketing content posts (n = 1,520) were recorded, including 70 webpages (primary and secondary pages), 770 Instagram posts, and 680 Facebook posts. Most content (91.0%) included at least one examined marketing appeal, including smoking cues (54.3% of all marketing content), Middle Eastern culture (29.1%), enjoyable experiences (22.4%), and sexuality and romance (19.7%). At least one sales proposition was used in 28.6% of all marketing content. The most commonly used sales proposition was a financial incentive, which was included in 11.8% marketing content.

Conclusions: Manufacturers and retailers in the U.S. use a variety of digital marketing strategies to promote WT products. Research is needed examine the impact of WT digital marketing on consumer perceptions, particularly among youth and young adults who are at greatest risk for WT smoking.

Background: Extended-release naltrexone (XR-NTX, Vivitrol^®) is an effective, but underutilized, evidence-based treatment for people with opioid use disorder (POUD) who are incarcerated. Networks of family, friends, and clinicians serve as social influencers of health behaviors, including XR-NTX initiation, and are especially salient in Appalachia.

Objectives: Using a triangulation of perspectives, this study examined concordance between the social network themes that emerged from qualitative interviews with clinicians and POUD social network findings.

Methods: Audio-recorded qualitative interviews were conducted with all clinicians (n = 15) providing assessments and community-based treatment linkages to justice-involved POUDs in Kentucky's Appalachian counties. Two independent coders coded the transcribed interviews. Social network data were collected from POUDs who completed prison-based treatment programs and were recently released from prison (n = 52).

Results: Three themes related to POUDs' social network barriers of XR-NTX emerged from the clinician interviews: (1) networks with limited knowledge of XR-NTX, (2) homophily in networks, and (3) limited support networks. From the perspective of the POUD, knowledge of XR-NTX was nonexistent within their networks, aligning with the clinician theme. Homophily was prevalent in some attributes (e.g., employment), but only 31.8% of POUD networks had used drugs, providing mixed support for this theme. In concordance with clinicians, POUDs received high levels of emotional support, but lacked instrumental, financial, and treatment support from networks.

Conclusions: The network characteristics of Appalachian POUDs recently released from prison create challenges associated with recovery, which may be addressed through network and educational interventions.

Syringe services programs (SSPs) provide critical evidence-based public health services that decrease harms from drug use for people who use drugs (PWUD). Many SSPs have experienced significant and evolving COVID-19-related disruptions. We aimed to characterize the impacts of COVID-19 on SSP operations in the United States approximately two years into the pandemic.

Participating sites, selected from a national sample of SSPs, completed a semi-structured interview via teleconference and brief electronic survey evaluating the impacts of COVID-19 on program operations. Data collection explored program financing, service delivery approaches, and perspectives on staff morale two years into the pandemic. Interview data were analyzed qualitatively using Rapid Assessment Process. Survey data were analyzed using descriptive statistics and triangulated with qualitative findings.

Twenty-five SSPs completed the interview and survey between April - June 2022. Triangulation of qualitative and quantitative data characterized the dynamic ways that demand for SSP services has evolved throughout the pandemic, and how approaches to care delivery have increased in flexibility and participant-centeredness. However, SSPs expressed worry about longer-term barriers to program participant and staff engagement, and a mismatch between available programmatic resources and the "new normal" of service delivery needs.

The COVID-19 pandemic has had lasting impacts on multiple facets of syringe service delivery. While SSPs consistently meet barriers with ingenuity, greater programmatic and staff support is needed to ensure SSPs can continue to meet the changing public health needs for PWUD.

Background: Multiracial American adults have the highest rates of binge drinking and illicit drug use of all racial groups, yet little is known about the risk and promotive factors that contribute to their substance use.

Objectives: This study examines how individual factors (i.e., shifting racial expressions, perceived racial ambiguity, creating third space, self-esteem, depression) and family cohesion relate to substance use among 574 Multiracial young adults in the United States (M_age = 19.87).

Results: Findings suggested that Multiracial young adults who reported higher scores on perceived racial ambiguity, self-esteem, and depression had a higher likelihood of drinking to feel drunk and binge drinking, while more family cohesion with their first primary caregiver was associated with a lower likelihood of drinking to feel drunk. Perceived racial ambiguity was also associated with a higher likelihood of illicit drug use, while family cohesion with their second primary caregiver was associated with a lower likelihood of illicit drug use. Multiracial young adults with White ancestry were more likely to drink to feel drunk than Multiple Minority Multiracials, but there were no differences between groups in binge drinking or illicit drug use.

Conclusions: In sum, the unique racialized experiences, mental health, and family relationships of Multiracial Americans may play a role in substance use.

Background: Persons with posttraumatic stress disorder (PTSD) compared to those without evince high rates of hazardous drinking, or patterns of alcohol consumption that increase the risk for harmful consequences. One potential marker of vulnerability for PTSD-hazardous drinking comorbidity may be smoking behavior. Individuals with PTSD have a higher prevalence of smoking and smoke at higher rates. Smokers, compared to nonsmokers, are more apt to engage in hazardous alcohol use. Notably, there is a need to expand research on smoking in the context of PTSD and hazardous drinking to inform treatment of these morbidities. Objective: The present cross-sectional investigation sought to examine smoking status as a marker of risk among persons with probable PTSD who engage in hazardous drinking (N = 647; M_age = 38.90 years, SD = 10.71; 51.2% female). Results: Results indicated that trauma-exposed smokers, compared to non-smokers, evinced greater severity of PTSD symptoms, depression, emotion regulation difficulties, hazardous drinking, and substance use problems, with small effect sizes. No statistically significant group differences were found for anxiety symptom severity. Secondary analyses among only smokers supported an interrelation between cigarette dependence and each of the criterion variables that demonstrated statistically significant group differences. Specifically, cigarette dependence was statistically significantly and incrementally related to PTSD symptom severity, depression, emotion regulation difficulties, more severe hazardous drinking, and a greater degree of substance use problems. Conclusions: Overall, the current investigation found that smoking status among persons with probable PTSD who engaged in hazardous drinking was associated with numerous indicators of mental health and substance use vulnerability.

Background: Electronic cigarettes (e-cigs) contain fewer hazardous ingredients than traditional cigarettes, yet they still pose health hazards. This study evaluates experienced e-cig users' quitting interest and Quitline utilization.

Methods: In a 2012 (Wave 1) baseline survey, 1875 (28.9%) provided consent consented to future study contact. This study focused on a follow-up survey sent in 2022 (4). The main indicators assessed were participants' were participants awareness, willingness, and motivations to utilize Quitlines to quit e-cigs. The Penn State Electronic Cigarette Nicotine Dependence Index (PSECDI) was used to assess the level of dependence on e-cigs. Descriptive statistics were used to examine the outcomes of interest. Additionally, a thematic analysis was performed to evaluate qualitative data.

Results: Participants (n = 195) had a mean age of 52.4 (SD = 12.1) years, 64.6% (n = 126) were male, and the majority were Caucasian/White (88.2%, n = 172). About 42% (n = 82/195) of respondents had previously tried to quit e-cig use. Of these, more than half (63.4%, n = 52/82); had heard of Quitline; however, very few (9.8%, n = 8/82) were interested in utilizing Quitline services for assistance with quitting e-cigs. The themes that emerged included the impersonal nature of telephone counseling, lack of trust in external assistance, belief in participants' ability to quit without help, and skepticism about the effectiveness of Quitline interventions.

Conclusion: There was widespread reluctance to utilize Quitline cessation services among experienced e-cig users. To enhance engagement in cessation programs, such as Quitline, it may be helpful to consider specialized counseling and support tailored to the unique challenges among e-cig users.

Background: Polysubstance use is common among people who use methamphetamine. This prospective study examined the three-month polysubstance use profiles among people enrolled in outpatient treatment for methamphetamine use and associated substance use, mental health, and treatment correlates.

Method: The present study used routinely collected client-reported outcome measures data from N = 1,507 clients enrolled in outpatient treatment who reported methamphetamine as their primary drug of concern (Mean age = 34.48; SD = 8.68; 56% male). Past-month substance use was assessed at baseline, one-, and three-months.

Findings: Repeated measures latent class analyses revealed four classes: (1) high and decreasing methamphetamine + stable moderate alcohol + stable high cannabis and daily tobacco (n = 474, 31.45%); (2) stable high methamphetamine + stable high alcohol and daily tobacco (n = 346, 22.96%); (3) low and decreasing methamphetamine + stable moderate daily tobacco (n = 322, 21.37%); (4) stable high methamphetamine + stable moderate daily tobacco (n = 365, 24.22%). Probability of using substances other than methamphetamine remained relatively stable for each class across time. Classes 1 and 4 had greatest severity of methamphetamine involvement at baseline and three-months. Class 1 had greater odds of experiencing moderate-to-severe depression and anxiety, and PTSD and psychosis, compared to class 3.

Conclusion: Individuals enrolled in outpatient treatment who report methamphetamine as their primary drug of concern report distinct substance use patterns, although daily tobacco use was mostly ubiquitous. Polysubstance use was widespread, with 79% of participants having moderate-to-high probability of polysubstance use at all timepoints. Clients with the most severe polysubstance use had the highest rates of co-occurring psychopathology.

Background: Prior research suggests that individuals reporting autistic traits are at heightened risk for alcohol dependence once they begin drinking; thus, examining factors that may lead to problematic drinking in this population is imperative. Neurotypical college students higher in autistic traits tend to have more social anxiety, more challenges with social skills and communication, and weaker social adjustment than those lower in autistic traits, which are risk factors for problematic alcohol use.

Objectives: The present study sought to assess whether university students with more autistic traits would report greater alcohol-related negative consequences, and whether this association would be indirectly influenced by social anxiety, emotion regulation, and drinking to cope. Students (n=3,756; 71.4% female) from 12 universities spanning seven countries completed questionnaires assessing autistic traits, social anxiety, emotion regulation, drinking to cope, and negative alcohol-related consequences.

Results: Results from our comprehensive path model indicated that exhibiting more autistic traits was associated with higher social anxiety and distinct emotion regulation strategies (i.e., higher endorsement of expressive suppression and lower endorsement of cognitive reappraisal), which in turn were associated with more drinking to cope motives, which in turn was associated with more alcohol-related problems. These findings were consistent across gender and country groupings (i.e., test of model invariance).

Conclusions: These results inform our understanding of how university students with higher autistic traits may develop problems with alcohol and our results may inform interventions or preventative efforts. Future research should examine longitudinal designs to further refine this model and establish temporal evidence of its trajectory.

Recognizing the severe consequences of alcohol consumption during pregnancy, such as fetal alcohol spectrum disorders (FASDs), the present study explored the role of drinking attitudes, trait impulsivity, and decision-making toward instant gratification in alcohol craving and consumption during pregnancy among mothers of reproductive age.

Utilizing participants from Amazon Mechanical Turk (N = 141), we first categorized mothers into three groups: those who neither craved nor consumed alcohol during their last pregnancy, those who craved but did not consume, and those who craved and consumed alcohol. Using binomial logistic regression, we then examined what factors, if any, could differentiate between (a) mothers who craved alcohol during pregnancy and those who did not and (b) mothers who resisted alcohol cravings and those who yielded to them.

The findings indicated that drinking attitudes significantly predicted alcohol craving during pregnancy. However, trait impulsivity emerged as a significant predictor of alcohol consumption among those who experienced cravings.

The present study contributes to a better understanding of psychological mechanisms underlying alcohol craving and consumption during pregnancy, which in turn may contribute to the development of targeted interventions for this problem.

ABSTRACT Background: Drinker identity research has proliferated over the last decade, resulting in 10 self-report questionnaire measures of this construct. However, it is unknown to what extent these measures accurately reflect the theorized multi-dimensional conceptualization of drinker identity.

Objectives: The current study set out to investigate and compare these different measures using content, correlational, and factor analyses. A content analysis is conducted to investigate dimensions captured within the 10 measures of drinker identity. Correlational and exploratory factor analyses on the items is conducted within a young adult sample (n = 1006). Descriptions of the measures, items, and factors within the measures are discussed.

Results: Across the 10 measures, seven distinct factors were identified by the content analysis, and multi-dimensionality was confirmed by both the correlational and factor analyses. Factor analysis on all items yielded four interpretable factors representing generalized identity, relative identity importance, identity value/affect, and social identification.

Conclusions: The results are discussed in terms of the multi-dimensional nature of drinker identity, the psychometric equivalence of the included measures, and further issues in defining and measuring drinker identity.