Substance Use & Misuse最新文献

Introduction: Among US-adolescents, nicotine use, especially dual use of e-cigarettes and cigarettes is associated with poor mental health outcomes. This study examines associations between different nicotine use profiles and wellbeing and problem behaviors among German adolescents.

Methods: A school-based survey was conducted in secondary schools between November 2024 and February 2025 in 116 schools from 14 out of 16 federal German states. Symptoms of internalizing and externalizing behavioral problems were assessed using the Strengths and Difficulties Questionnaire. Wellbeing was assessed with the WHO-5 Well-Being Index. Nicotine use (past 30-day use) was categorized into four groups: monthly use of e-cigarettes only, monthly use of combustible cigarettes only, monthly dual use, and nonuse.

Results: A total of 25,128 adolescents with a mean age of 13 years with 52% being female participated. Compared with individuals who did not report e-cigarette and/or cigarette use, adolescents engaging in monthly dual use had the highest odds, with an adjusted OR of 2.11 (95% CI: 1.80-2.47) for reduced wellbeing and 3.65 (95% CI: 2.95-4.52) for externalizing behavioral problems. Regarding internalizing behavioral problems, individuals reporting cigarette use (OR = 2.23, 95% CI: 1.60-3.10) and dual use (OR = 1.90, 95% CI: 1.58-2.27) had the highest odds, with no significant difference between them.

Conclusions: German adolescents who use nicotine, especially dual use of e-cigarettes and cigarettes, are at an increased risk for internalizing and externalizing behavioral problems and have lower overall well-being. Due to design limitations, we are unable to draw causal conclusions.

Background: Substance use severity is shaped by a range of developmental and psychological factors, including the timing of stressor exposure across the lifespan. Previous research identified early-life stressor exposure as a factor in this progression, but emerging research has suggested the importance of considering the timing of stressor exposure across development. Objectives: Here, we tested whether distinct profiles of stressor exposure-in particular, consistent vs. mismatching patterns between early-life and recent stressor exposure-were associated with the severity of alcohol, cannabis, and nicotine use in a young adult sample of 249 college students. Results: A multivariate cluster analysis identified seven profiles of stressor exposure during development. Importantly, both high cumulative stressor exposure and mismatching patterns of early to recent life stressor exposure predicted greater substance use severity. Notably, follow-up ANOVA and regression analyses demonstrated the predictiveness of these stress profiles held even when including other strongly linked psychological predictors within the model. Conclusions: These findings suggest that both stressor patterning and individual attributes contribute to substance use severity, and advance personalized risk profiles of substance use.

Objective: Opioid misuse is a public health crisis in the United States, leading to high rates of addiction, overdose, disease, and death. There are strategies to reduce the harmful consequences associated with opioid use. Harm reduction strategies (HRS) are part of a broader, comprehensive approach to addressing the opioid crisis. By studying and implementing these strategies, communities can develop a more holistic approach to address the complexities of opioid addiction. How the public perceives HRS can influence their likelihood of being implemented across communities. This study examines how familiarity with substance use disorder (SUD) influences support for HRS.

Method: Data for this study were taken from a statewide survey of opioid use disorder stigma among adult Pennsylvanians. Participants were asked their level of support for the use of four HRS (i.e., needle exchange programs (NEP), naloxone distribution (ND), safe-injection sites, and fentanyl test strips [FTS]) and familiarity with people with SUD. A linear mixed effects model for repeated measures was used to examine support for HRS between two groups (familiar versus unfamiliar).

Results: In general, familiarity resulted in greater support for HRS. People who have a family member or close friend suffering from SUD were significantly more supportive of ND and NEP compared to those with no personal connection to SUD, but no differences were found for safe injection sites (SIS) or FTS.

Conclusions: The results underscore the importance of personalized experience in shaping public perception of HRS.

Introduction: Coping-oriented cannabis use is a robust predictor of hazardous cannabis use. Anxiety sensitivity (AS), the fear of anxiety-related sensations, may be a risk factor for coping-oriented cannabis use, however, findings are mixed in prior literature. The current study aimed to clarify inconsistent research by incorporating the role of positive cannabis expectancies, such as belief that cannabis use results in relaxation or positive social outcomes, in the association between AS, its subfactors, and coping-oriented cannabis use.

Materials and methods: Undergraduates (n = 232) reporting past-six-month cannabis use completed cross-sectional online self-report measures. Four moderation models were tested with PROCESS macro for SPSS.

Results: The interaction of AS and positive cannabis expectancies was significant, such that AS and coping-oriented cannabis use was stronger at high versus low levels of positive cannabis expectancies. Similar patterns emerged for AS cognitive and social, but not physical, concerns.

Discussion: Individuals with elevated AS, particularly cognitive and social concerns, may be at risk for increased coping-oriented cannabis use when they also have higher positive expectancies. Considering how other variables, including positive cannabis expectancies, affect associations between AS and coping motives may help to explain previous discrepant findings on associations between AS and cannabis use. Future work should replicate methods among other, diverse populations and consider alternative measures of cannabis expectancies. Pending future research, AS may be important to assess and target among individuals who use cannabis and endorse positive cannabis expectancies.

Introduction: Despite elevated need, young gay and bisexual men (YGBM) who use stimulants are underrepresented in research. Consent processes are essential for human subjects' protection, yet shortcomings in consent practices and their role in willingness to participate in research have been underexplored.

Methods: Between July 2024 and January 2025, we enrolled 115 YGBM who use stimulants and are at risk for HIV transmission/acquisition in an online survey assessing willingness to participate and competence to consent to participation in a hypothetical risk reduction trial. We used a mixed-methods approach to examine factors associated with willingness to participate in the hypothetical trial and consent competence and identify motivations to trial participations and shortcomings in competence to consent.

Results: Participants' mean age was 21.83 years and 53.1% identified as white. Most participants (76.8%) expressed willingness to participate in the hypothetical trial, driven by personal interest in research, altruism, and compensation. Barriers to participation included scheduling challenges and study risks, including confidentiality concerns. Willingness to participate was higher among younger individuals and those experiencing recent food insecurity (p < 0.05). Participants expressed inadequate comprehension of the experimental design of the trial and therapeutic misconception (i.e., the belief that the trial was primarily designed to benefit their health). Competence to consent was positively associated with health literacy and negatively associated with sensation seeking.

Discussion: When designing recruitment and retention strategies, researchers should help YGBM identify and navigate potential barriers to participation. Future studies should explore informed consent interventions that enhance participants' understanding of trial information.

Background: Heavy alcohol users with chronic Hepatitis C Virus (HCV) infection, particularly those co-infected with human immunodeficiency virus (HIV) infection, have not received adequate clinical attention. High levels of alcohol use can be very dangerous with chronic HCV and HIV/HCV co-infection, potentially leading to severe liver damage and death.

Objectives: This review aims to summarize the literature on alcohol interventions developed for (and tested in) chronic HCV and HIV/HCV populations, to expand on a prior review by Sims et al. (2016). A research team (consisting of a PhD-level investigator and a team of undergraduate students at Molloy University) identified studies evaluating drinking interventions among individuals with chronic HCV and HIV/HCV co-infection.

Results: Included studies consisted of four studies testing interventions to decrease alcohol use among individuals with chronic HCV, and three focused specifically on HIV/HCV co-infected individuals. Overall, participants demonstrated notable responses to interventions, specifically in terms of increased rates of abstinence, less alcohol consumed, fewer heavy alcohol drinking days, fewer alcoholic drinks per week, as well as increased engagement in alcohol treatment.

Conclusions: This review demonstrates the promise of psychosocial interventions to reduce drinking in populations with chronic HCV and HIV/HCV, a behavioral change that has important implications for their overall health.

Background: Exposure to e-cigarette marketing may influence youths' e-cigarette perceptions and behavior. However, less is known about the effect of specific advertisement (ad) features on youth who have never tried e-cigarettes.

Methods: We conducted an online 2x2x2 factorial experiment with a nationally-representative sample of e-cigarette-naïve youth (ages 13-17) (n = 516). Participants viewed two ads in one of eight randomized e-cigarette ad conditions that varied by three ad features: color (vibrant/muted), images of models (present/absent), and smoking-relevant language (present/absent). We assessed interest in trying e-cigarettes and perceptions. Analyses examined main effects of ad features and interactions with e-cigarette use susceptibility.

Results: Youth who saw vibrantly-colored ads (versus ads with muted colors) were more likely to perceive that fewer people their age vaped and peers disapproved of e-cigarette use. They were also more likely to rate the ads as appealing and targeting youth (with an interaction between color and e-cigarette susceptibility, such that susceptible youth were more likely to perceive brightly colored ads as targeting youth). Youth who saw ads with smoking-relevant language were less likely to rate them as appealing, compared to those who saw ads without such language. There was an interaction between presence of models and e-cigarette susceptibility on e-cigarette interest (less interest among susceptible youth) and the perception that ads were targeting youth (less likely among susceptible youth). None of the three ad features impacted noticeability of the nicotine warning.

Conclusions: Findings suggest that specific ad features may play a role in e-cigarette interest and perceptions among e-cigarette-naïve youth.

Background: Emerging adults aged 18 to 29 with opioid use disorder (OUD) have the lowest rates of treatment engagement and retention compared to other age groups. Understanding factors that influence retention and completion in this population is critical. Given the unique developmental stage of emerging adulthood, more research is needed on the role of medications for opioid use disorders (MOUD) in improving outcomes.

Methods: Using data from the 2022 Treatment Episode Data Set: Discharges (TEDS-D), this study examined factors associated with treatment retention and completion among emerging adults with OUD in outpatient settings (N = 4,126). We also explored how age and sex moderate the association between MOUD and treatment outcomes.

Results: Negative binomial regression showed that emerging adults of older age, female sex, White non-Hispanic race/ethnicity, higher educational attainment, and those who received the MOUD plan, without past month opioid use, and referred from institutional sources (compared to self-referral) showed longer treatment retention. Logistic regression indicated that emerging adults of male clients, individuals with higher education, those with no recent opioid use, and those referred from healthcare providers or institutional sources showed a greater likelihood of treatment completion. Moderation analyses revealed that age and sex influenced the relationship between MOUD and treatment completion: Younger emerging adults, compared to older emerging adults, and male emerging adults, compared to female emerging adults, had a lower likelihood of treatment completion when taking MOUD. In conjunction with their shorter treatment duration, this finding implies that younger emerging adults receiving MOUD may be more likely to encounter barriers to treatment completion than older adults.

Conclusion: These findings underscore the importance of considering within-group differences among emerging adults and highlight the complex role of MOUD in treatment outcomes. Treatment strategies should be tailored to the developmental stage and demographic characteristics to improve engagement and success in OUD treatment.

Background: Substance use disorders (SUDs) are a major global health burden, and third-wave therapies that target transdiagnostic processes such as psychological flexibility and mindfulness have emerged as promising options. This systematic review synthesized evidence on third-wave interventions for adults with diagnostic and statistical manual of mental disorder (DSM)-defined SUDs.

Methods: A comprehensive search of seven databases (2014-2025) identified randomized and non-randomized studies of acceptance and commitment therapy (ACT), related mindfulness-based programs, and dialectical behavioral therapy skills training. Two reviewers screened records, extracted data, assessed risk of bias with Risk of Bias 2 (RoB 2) and risk of bias in non-randomized studies of interventions (ROBINS-I), and synthesized findings using SWiM-consistent narrative methods. The review was prospectively registered in PROSPERO (CRD420251028610).

Results: Forty-seven studies (35 randomized, 12 non-randomized) met inclusion criteria. Across modalities, third-wave interventions yielded small-to-moderate benefits on abstinence, craving, and substance use outcomes compared with control conditions, with larger and more consistent gains in psychological flexibility, emotion regulation, and mindfulness. Effect sizes varied and most trials showed some concerns or serious risk of bias, resulting in generally low-to-moderate certainty of evidence.

Conclusions: Third-wave interventions may serve as adjunctive or alternative SUD treatments by engaging targeted mechanisms, enhancing psychological functioning, and producing modest but clinically relevant substance-use benefits. More rigorous, adequately powered mechanism-focused trials are needed to clarify comparative efficacy and guide process-based personalization and implementation in routine addiction services.

Background: Polysubstance use among adolescents is a growing public health concern related to serious health risks. While prior research has explored the impact of social media and cyberbullying on adolescent substance use, most studies focus on individual substances. This study examined the association between social media use frequency and adolescent polysubstance use, accounting for the role of cyberbullying.

Methods: This study utilized data from the 2023 Youth Risk Behavior Survey, a nationally representative sample of high school students (N = 18,149, 47.7% female). Descriptive analyses identified patterns of e-cigarette, alcohol, and marijuana use among adolescents. Multinomial logistic regression assessed the relationship between social media use and polysubstance use, with cyberbullying included as a covariate.

Results: Approximately 29.6% of participants (n = 5425) reported engaging in substance use behaviors. Among these adolescents, nearly one in four (24.8%) reported concurrent use of all three substances. The multinomial logistic regression revealed that adolescents using social media more than once per hour had nearly 10 times higher odds of using all three substances (OR = 9.79; 95% CI: 4.68-20.51) compared to nonsocial media users. Adolescents who experienced cyberbullying in the past year had four times higher odds (OR = 4.06; 95% CI: 3.01-5.49) of engaging in concurrent use of all three substances, compared with their peers.

Conclusions: Social media use frequency and cyberbullying are significantly associated with adolescents' polysubstance use behavior. To address this public health issue, intervention efforts may benefit from targeting high-frequency social media users and adolescents who have experienced cyberbullying.