Substance Use & Misuse最新文献

Background: Drug abuse has severe physical and psychological consequences, contributing to family and social instability. Given the challenges of substance use disorders, prevention is crucial. This study aimed to evaluate the effect of an educational intervention based on the Theory of Planned Behavior (TPB) on preventing drug relapse among those with substance use disorder in treatment centers in Shiraz.

Methods: This experimental study included 200 drug-dependent individuals undergoing methadone and buprenorphine treatment. Participants were selected through convenience sampling and randomly assigned to intervention and control groups. Data were collected using a validated researcher-made questionnaire based on TPB and the Billings & Moos Coping Strategies Questionnaire. The intervention consisted of 14 training sessions (50-55 min each), using lectures, discussions, visual aids, and videos.

Results: Before the intervention, the groups had no significant differences in knowledge, attitude, subjective norms, perceived behavioral control, or coping strategies. Six months after the intervention, the intervention group showed significant improvements in these areas compared to the control group. The relapse rate was significantly lower in the intervention group.

Conclusion: The TPB-based intervention effectively improved awareness, attitude, perceived behavioral control, and coping strategies, reducing relapse rates. Implementing such educational programs in treatment centers can enhance long-term recovery outcomes.

Objective: Alcohol use and anxiety both contribute significantly to the global burden of disease, and understanding their longitudinal relationships may clarify whether they exacerbate each another. However, previous research on the topic has yielded mixed results, potentially due to a lack of differentiation between alcohol use patterns. This study aimed to explore the bidirectional longitudinal correlations between alcohol use frequency and quantity, and anxiety.

Methods: A longitudinal random-intercept cross-lagged panel model was constructed using data from 18+ year-old individuals (N = 14,665), collected in the 2017 and 2019 waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) survey. Anxiety was measured with the Kessler Psychological Distress Scale anxiety subscale and participants' reported frequency and quantity of alcohol use.

Results: For individuals, anxiety was positively associated with subsequent alcohol use quantity, and alcohol use frequency and quantity were negatively and positively associated with subsequent anxiety, respectively. Cross-lagged effects were small in magnitude suggesting that alcohol use patterns and anxiety accounted for a small amount of change in each other.

Conclusion: Results strengthen support for a reciprocal relationship between heavier alcohol use and anxiety and provide novel insight into a relationship between frequent, low quantity alcohol use, and subsequent lower anxiety. These results underscore the importance of differentiating between alcohol use patterns when evaluating mental health outcomes and emphasize that heavier drinking patterns are particularly detrimental to psychological well-being.

Background: Whilst e-cigarettes are a less harmful means of consuming nicotine than combustible cigarettes, concerns have been expressed about their use by adults who have never smoked (ANS). It is important to quantify the prevalence of e-cigarette use and to understand patterns of use among ANS to effectively guide public health policy and regulatory decisions.

Methods: The prevalence and patterns of e-cigarette use among ANS were estimated drawing upon data from three national studies in the United States; Population Assessment of Tobacco and Health Study (n = 29,780); the Tobacco Product Prevalence Study (n = 6,428); and the National Health Interview Survey (n = 27,651).

Results: An estimated 5.0 million (5.5%) to 18.6 million (11.1%) ANS have tried e-cigarettes and most of this use is experimental. An estimated 1.5 million (1.6%) to 4.8 million (2.9%) ANS currently use e-cigarettes, and current use is primarily infrequent. However, an estimated 0.5 million (0.5%) to 2.2 million (1.3%) ANS use e-cigarettes frequently. Prevalence of e-cigarette use is highest among younger (18-24 years) ANS.

Conclusions: E-cigarettes are intended to be used by adults who are currently smoking combustible cigarettes as a means of quitting combustible cigarette use or substantially reducing the number of cigarettes smoked.Therefore ANS are an unintended user population. The public health impact associated with e-cigarette use by ANS depends on whether these adults are using e-cigarettes to displace combustible cigarette use (harm avoidance) or whether they would otherwise not have initiated nicotine use if e-cigarettes were not available (harm exposure).

Background: Medicinal cannabis has been legally available in Australia since 2016. The current study examined the motivations for seeking medicinal cannabis and the pathways through which Australians accessed it.

Methods: Brief semi-structured interviews were conducted with 15 adults who self-reported medicinal cannabis use within the past 12 months. Informants were recruited at two cannabis-related events in Queensland and New South Wales. Interviews explored motivations, pathways to access, and experiences with medicinal cannabis. Thematic analysis was conducted using Braun and Clarke's six-step framework which identified two key themes: "The Diverse Drivers of Medicinal Cannabis Use" and "Tales of Access: Journeys to Medicinal Cannabis."

Results: Informants reported varied motivations for medicinal cannabis use, including managing treatment-resistant medical conditions and avoiding the legal consequences of illicit cannabis use. Some described transitioning from recreational to medicinal use, with dual-use (i.e., both recreational and medicinal) motives described in the sample. Accessibility was reported as straightforward, through telehealth consultations and single-purpose dispensaries facilitating prescriptions. Informants reported financial barriers to accessing medicinal cannabis products and frustrations with initial prescriptions of cannabis oil rather than cannabis flower. Informants reported limited knowledge of product constituents and dosages.

Conclusions: The study highlights the nuanced motivations and pathways to medicinal cannabis in Australia, including legal and medical drivers. Accessibility was described as simple through telehealth, single-purpose dispensaries but cost remained a barrier. Dual usage raises concerns about the risks associated with medicinal cannabis use. More qualitative research is needed to better understand the behaviour and risks facing medicinal cannabis consumers.

Background: Xylazine, a veterinary tranquilizer, is increasingly found in the unregulated fentanyl supply. Researchers and public health officials have generally characterized this substance as an unwanted adulterant, associated with outcomes such as extreme sedation and necrotic wounds. However, some literature suggests a small percentage of people who use drugs (PWUD) may prefer using xylazine. Thus, in this exploratory study, we aimed to understand the intentional use of xylazine among PWUD. Methods: From August to November 2024, we conducted a mixed methods study in Connecticut, composed of surveys and in-depth interviews. We recruited n = 114, of which 56 had a lifetime exposure to xylazine. Interviews were conducted with n = 31, analysis was restricted to the n = 11 with intentional xylazine use. We utilized Fisher's exact and t-tests to explore differences between intentional and accidental xylazine use. Thematic analysis was employed to understand xylazine seeking and use motivations. Results: Among the 56 people reporting xylazine use, 23% used xylazine intentionally (n = 13). Intentional use was found at a higher proportion among females (46.1% vs. 25.6%), White individuals (69.2% vs. 55.8%), those with a fentanyl preference (61.5% vs. 42.95%), and those with daily xylazine use (61.5% vs. 34.9). Analysis of the qualitative data revealed numerous intentional use motivations, including enjoying xylazine's embodied effects and self-managing withdrawal. Conclusions: A notable portion of PWUD intentionally use xylazine, even while understanding potential risks. Healthcare and harm reduction services should not focus solely on xylazine avoidance strategies but must also address the needs of PWUD who seek out xylazine.

Background: While there are known high rates of tobacco and betel (areca) nut use in the U.S.-Affiliated Pacific Islands (USAPI), there have been limited efforts at preventing the initiation of tobacco and betel nut among those living in the region, particularly, adolescents. To meet this need, Fuetsan Manhoben (FM)-a culturally tailored, school-based tobacco and betel nut use prevention curriculum-was developed for adolescents in Guam, a USAPI in the Western Pacific. Method: A pilot randomized controlled trial was conducted to examine the efficacy of FM. Guam public middle school students were randomly assigned to either the FM intervention (n = 269) or a control (n = 269) condition. Data were collected at baseline, posttest (4 weeks after baseline), and 3-month follow-up. Results: At posttest, FM had a statistically significant positive direct effect on risk perceptions of both cigarettes and betel nut. Also, risk perceptions of both cigarettes and betel nut measured at posttest inversely predicted intent to use cigarettes and betel nut at follow-up. FM also had an indirect effect on reducing intent to use betel nut at follow-up through its immediate and prior effect on betel nut use risk perceptions at posttest. Conclusions: The results provide initial support for the efficacy and feasibility of FM.

Background: Bullying and the use of psychoactive substances are both prevalent among adolescents and appear to be interconnected. However, the literature has yet to reach a consensus regarding the association between being a victim of bullying and the use of psychoactive substances. In this cross-sectional study, the authors investigated the relationship between psychoactive substance use and involvement in bullying among Brazilian adolescents.

Methods: Data were analyzed from the 2019 National School Health Survey ("Pesquisa Nacional de Saúde do Escolar, PeNSE 2019"), which included responses from 123,261 students aged 13 to 17 years. The survey assessed experiences of bullying (both as victim and perpetrator), as well as lifetime and recent (past 30 days) use of various psychoactive substances. Multivariate logistic regression models were employed to examine associations, with odds ratios (ORs) calculated to estimate the likelihood of substance use across different bullying involvement profiles.

Results: Adolescents involved in bullying-whether as victims or perpetrators-had higher odds of using tobacco cigarettes, hookahs, e-cigarettes, clove cigarettes, straw cigarettes, alcohol, illicit drugs, marijuana, and crack. Those not involved in bullying had the lowest likelihood of substance use, followed by those who were only victims. The highest odds were observed among individuals who perpetrated bullying exclusively, followed by those involved as both perpetrators and victims.

Conclusions: In Brazil, being a victim of bullying is associated with increased use of various psychoactive substances. These findings align with studies conducted in other Latin American countries, yet diverge in part from patterns observed in high-income countries-highlighting the influence of geographic and sociocultural contexts on these risk associations.

Objective: Cannabis use is a globally prevalent, though potentially harmful, behavior whereby varying patterns of use manifest from a range of motivating factors. Individuals diagnosed with attention-deficit/hyperactivity disorder (ADHD) are often overrepresented in cannabis use statistics, with some users anecdotally reporting that cannabis improves ADHD symptoms. Current motive scales do not fully capture the breadth of cognitions, specifically perceived improvement in attention, necessary to capture the range of cannabis use motivations within this population. This study developed the Cannabis Attention and Affect Motives Scale (CAAMS) to assess cannabis use in response to various situations and affective states.

Method: Adult cannabis users (n = 417, 61.9% male, predominantly NZ/Other European) completed an online survey detailing their motives and expectancies of cannabis use as well as an ADHD risk screener.

Results: While the hypothesized 46-item, 3-factor model was not an appropriate fit, a split-half sample EFA and CFA yielded a refined, theoretically and psychometrically sound, 28-item, 5-factor model. Post-hoc between-groups comparisons on those having low, medium, or high risk of ADHD showed significant differences for CAAMS factors: Negative Affect Reduction, Attention Enhancement, Attention and Behavior Motivation, and Social Anxiety Reduction, but not for Recreation and Relaxation Enhancement.

Conclusions: The CAAMS is psychometrically valid, measuring five separate motives of cannabis use pertaining to cognitive enhancement. An initial analysis of these motives as a function of ADHD risk highlights the potential of this scale to understand the cognitive pathways leading to cannabis use in individuals with attentional difficulties.

Background: A strong association between alcohol use and adverse sexual experiences (e.g., sexual assault, risky sex, and regretted sexual experiences) exists on college campuses in the United States. The Sexual and Negative Dating Inventory (SANDI) is a recently developed measure of dating and sexual protective behavioral strategies (PBS).

Objectives: As part of the original development study, a subsample of participants (n = 15) was invited to participate in qualitative follow-up interviews examining contexts and environments in which they implement PBS. College students (93% female, M_age = 19.2, SD_age = 1.01, 66% heterosexual) all endorsed regular alcohol use and engagement in dating behaviors.

Results: Qualitative thematic analysis of double-coded transcripts was conducted with the overarching three aims in mind: 1) to identify barriers of using dating and sexual protective behaviors, 2) to identify facilitators of using dating and sexual protective behaviors, and 3) to identify contexts in which dating and sexual protective behaviors are utilized. The following themes were identified across the three questions: 1a) trusting the other person/location, 1b) awareness of and anticipation for high-risk situations, 2a) decreased reactivity and responsivity in high-risk situation, 2b) not knowing the other person/location well, 3a) being in public, 3b) being in private, and 3c) depending on safety/comfort.

Conclusions: Findings provide nuanced information on targeting problematic alcohol use and adverse sexual experiences among college students. Addressing barriers, facilitators, and contextual factors that influence PBS use is crucial for preventing and reducing adverse sexual experiences.

Introduction: This research aimed to understand the perspectives and experiences of pregnant individuals using cannabis as they navigate healthcare settings and their pregnancies. We applied the lens of the intersectional risk environment, a harm reduction framework which explores the ways that social locations and environmental factors combine to impact health and well-being.

Methods: Using qualitative, constructivist grounded theory methods, we conducted interviews with 19 participants between December 2022 and March 2023. Individuals self-identified as racially minoritized, were 21 years of age and older, spoke English/Spanish, resided in California, and had used cannabis during pregnancy in the last 0-2 years. We used constructivist grounded theory methods to analyze the socio-structural contexts and lived experiences surrounding cannabis use and disclosure to clinicians.

Results: Participants who used cannabis during pregnancy described: 1) how their race/ethnicity, gender, and socioeconomic status impacted their care experiences together with their cannabis use, 2) their experience of poor perinatal care due to their insurance coverage and location of care, 3) worsening of care after disclosing cannabis use (e.g., being judged, ignored), and 4) removal from perinatal care after disclosing cannabis use.

Discussion: Our study showed how patients' use of cannabis during pregnancy and their insurance status, gender, race/ethnicity, and socioeconomic level impacted the care they received across the perinatal period. Our findings emphasize the need for the multi-level import of an intersectional risk environment framework which addresses health inequities via a social justice-oriented lens. This can be operationalized via interventions that take place at the patient-clinician, institutional, and policy levels which acknowledge patients' overlapping identities to mitigate experiences of stigma and discrimination which are prevalent in perinatal care spaces today.