Substance Use & Misuse最新文献

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.

Background: People experiencing homelessness are disproportionately affected by opioid use disorder (OUD), yet treatment engagement remains low. Understanding opioid-related health beliefs in this population may inform more tailored interventions.

Objective: To characterize opioid-related health beliefs among homeless-experienced individuals with OUD and examine their alignment with opioid use severity.

Methods: We conducted a cross-sectional survey of individuals initiating opioid treatment at a homeless healthcare program in Boston, Massachusetts. The survey assessed key Health Belief Model domains related to opioid use and incorporated the World Health Organization's Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) to quantify opioid use severity. We used nonparametric trend tests to examine associations between ASSIST quartiles (Q1 ≤ 23.5, Q2 23.6-33.0, Q3 33.1-38.0, and Q4 > 38.0) and belief domains.

Results: Among 148 participants, the mean age was 41.7 years; 51.4% identified as White, 16.2% as Black, and 38.5% as Hispanic. Higher ASSIST quartiles, indicating higher opioid use severity, were significantly associated with greater perceived threat, including being very worried about opioid use (25% in Q1 vs. 72.7% in Q4; p = 0.001), perceiving very high overdose risk (4.2% vs. 40.9%; p = 0.006), and viewing overdose as very dangerous (87.5% vs. 100%; p = 0.036). Higher ASSIST quartiles were also significantly associated with greater perceived benefits, including that abstaining from opioids (78.3% vs. 100%; p = 0.004) and taking MOUD (69.6% vs. 95.2%; p = 0.016) would improve quality of life.

Conclusions: Individuals with greater opioid use severity endorsed higher perceived opioid-related threats and treatment-related benefits. Interventions that highlight these beliefs may help enhance treatment engagement in this high-risk population.

Objective: Research indicates that heavy alcohol use is increasingly prevalent among college young adult women and is associated with a range of negative health outcomes. To expand upon prior quantitative research examining the influence of distinct feminine norms and cultural factors on college women's alcohol consumption, the present study seeks to develop a comprehensive, in-depth understanding of these factors through a qualitative approach, providing deeper insight into the cultural, gender-relevant and normative influences shaping college women's heavy drinking behaviors.

Method: Thirteen White and twelve Asian American college women were randomly selected from two latent drinking classes based on latent class analyses in previous research: college women who engage in heavy drinking (n = 10) and college women who engage in low/no drinking (n = 15). Participants then participated in an in-depth semistructured interview, which were coded and analyzed using thematic analysis.

Results: Our main findings demonstrate that while endorsing the sexual fidelity feminine norms discourages heavy alcohol use, conforming to the appearance investment norm and resisting submissive norms motivate participants' alcohol use. We also found that toward women who drink, Asian women's attitudes tended to be more critical, while White women were more lenient. Furthermore, we identified various interpersonal influences on participants' alcohol use, such as drinking for social acceptance and distinct drinking patterns when drinking with men compared to drinking with women.

Conclusions: Our findings emphasize the significance for clinicians to be conscious about the impact of conformity to certain feminine norms and cultural influences when providing interventions toward college women's alcohol use.

Background: Nearly one million young adults experienced sports injuries in 2023, with almost half of collegiate athletes unable to play for one or more days due to sports injuries each year.

Results: Sports injuries result in a trauma to the body often from a force of impact, including musculoskeletal injuries and traumatic brain injuries. Sports injuries, including those among youth, may also constitute emotional trauma that in turn increases the risk of mental health conditions. Likewise, if individuals are exposed to prescribed opioids to alleviate injury-related pain, this may also increase their risk of opioid misuse and opioid use disorder. To understand the enduring effects of sports injuries, this article applies a framework combining concepts from social cognitive theory and the developmental psychopathology model.

Conclusion: Ultimately, we call for action: assessing trauma symptoms during the physical assessment and recovery phases to identify and address trauma and prevent or mitigate the development of mental health and/or substance use disorders, as well as reducing the stigma surrounding disclosure of mental health or substance use issues when they arise and advocating for policies that support athletes' mental health.

Introduction: The depiction of substance use in popular music videos is a potential risk factor for consumption among children and adolescents. This study tested whether German and US hip-hop/rap videos differ in nicotine and cannabis content.

Methods: The sample included all German- and English-language videos from the 2024 YouTube Top 100 charts (n = 1,160). Videos were categorized by genre (hip-hop/rap vs. other) and by substance content (nicotine, cannabis, both, none). For videos containing nicotine or cannabis, occurrences were counted. Exposure was approximated by multiplying the number of occurrences by the number of views for each video (March 2025 view counts).

Results: Overall, 41% of videos (n = 479) contained at least one depiction of nicotine or cannabis. This was more common in hip-hop/rap (59.5%) than in other genres (10.1%; OR = 13.11; 95% CI 9.26-18.57; p < 0.001). German hip-hop/rap videos depicted nicotine more often (38.0%) than US hip-hop/rap videos (8.8%; OR = 0.16; 95% CI 0.10-0.24; p < 0.001). Cannabis occurred more often in US hip-hop/rap (37.2%) than in German hip-hop/rap (9.4%; OR = 5.73; 95% CI 3.84-8.56; p < 0.001). In total, 4,478 occurrences of nicotine or cannabis were recorded, resulting in an estimated 57 billion nicotine and 49 billion cannabis impressions.

Conclusions: Music video audiences are widely exposed to substance depictions, particularly in hip-hop/rap. In the USA, cannabis is particularly prevalent, while in Germany nicotine dominates. Preventive measures to reduce young people's exposure include age restrictions and warning messages.

Introduction: "Work therapy" is not an evidence-based treatment for substance use disorders. Nevertheless, many substance use service providers impose labor obligations. The purpose of this study was to describe the prevalence and correlates of obligatory labor at providers of residential substance use services in North Carolina.

Methods: This audit study surveyed residential substance use service providers in North Carolina, systematically collecting program characteristics including obligatory labor. We used Fisher's exact tests to assess associations between program characteristics and two conditions of interest: obligatory labor and obligatory labor in agency-owned and -operated commercial enterprises. We qualitatively described the nature of labor mandates as summarized by program staff.

Results: Of 66 providers surveyed, 28 (42.4%) mandated labor, and 20 (30.3%) mandated labor in an agency-owned or -operated commercial enterprises. Providers who imposed either of these mandates were more likely to be faith-based and operating without a state license for adult substance use services. Providers imposing labor requirements were more likely to offer residential services at low or no cost. Providers mandating labor in agency-owned and -operated commercial enterprises were more likely to restrict eligibility to persons meeting health and "able-bodiedness" requirements. Many providers described these labor obligations as therapeutic and mandatory.

Conclusions: More providers require residents to work in an agency-owned and operated commercial enterprise than allow access to opioid agonist treatment, the gold standard treatment for opioid use disorder. Adjustments to state regulations may help improve the availability of evidence-based services and increase regulatory supervision of these service providers.

Background: This study investigates the clinical evolution of Belgian individuals following an inpatient treatment for substance use disorder (SUD), based on the presence or absence of alexithymia, as defined by difficulties in emotional identification and expression.

Objectives: The objective of this study was to examine differences in clinical evolution during inpatient SUD treatment between individuals with high versus low levels of alexithymia. Among 119 inpatients, 92 were classified into two groups based on TAS-20 scores: a high-alexithymia group (n₁ = 51, 42.86%, TAS-20 > 60) and a low-alexithymia group (n₂ = 41, 34.45%, TAS-20 < 52). Clinical assessments were conducted at baseline, during the first week of hospitalization, and then at 2 weeks (n₁ = 35, n₂ = 29), and after 4 weeks of treatment (n₁ = 24, n₂ = 14).

Results: At baseline, high alexithymia scores were associated with higher anxiety, emotional reactivity, and depressive symptoms. However, differences in addiction-related indicators, such as craving and self-efficacy, were less pronounced. All patients showed improvements in clinical symptoms during treatment, particularly in perceived stress and ruminations, but those with high alexithymia retained higher symptom severity. While both groups reported similar levels of craving, patients with alexithymia appeared to struggle more with emotional regulation.

Conclusions: These findings suggest that alexithymia may negatively impact emotional regulation during SUD treatment and potentially affect long-term recovery. The results highlight the need for increased interventions that enhance emotional processing in individuals with alexithymia. Limitations include the small sample size and reliance on self-report measures, which may affect generalizability. Overall, this research enhances understanding of alexithymia's contribution to SUD treatment and supports the necessity for tailored therapeutic approaches, warranting further investigation into long-term effects and specific interventions for alexithymic traits.

Background: While moral injury is associated with adverse health behaviors among veterans, no studies have examined the association between e-cigarette consumption among women veterans and moral injury.

Methods: Using a nicotine continuum of harm perspective, we recruited women veterans who used e-cigarettes or e-cigarettes + combustible cigarettes (n = 55) via Amazon MTurk and Reddit from June 2023 to September 2024. Women veterans completed the e-cigarette purchase task (e-CPT) assessing the relative reinforcing value (RRV) of e-cigarettes, the e-cigarette Fagerstrom Test for Cigarette Dependence (e-FTCD), and the Moral Injury Symptom Scale (MISS-M-SF). We estimated five e-CPT demand indices and calculated an exponential demand model stratified by moral injury status (i.e., probable vs. unlikely). Comparisons were adjusted for dual user status, length of service, and e-FTCD scores.

Results: Those with probable moral injury were more likely than unlikely morally injured veterans to be dual users (p = 0.02). Probable morally injured veterans exhibited significantly higher demand for e-cigarettes than unlikely morally injured veterans (p = 0.01). Average e-cigarette consumption at $0 was significantly higher (M = 118.6 vs. M = 29.9) in probable versus unlikely morally injured veterans (p = 0.03).

Conclusions: This study offers preliminary evidence of the RRV of using e-cigarettes in morally injured women veterans.