American Journal of Drug and Alcohol Abuse最新文献

Background: American Indian communities consistently identify adolescent substance use as a major concern. However, limited empirical work has examined how culturally specific protective factors - such as family disapproval and cultural affiliation - interact to influence substance use behavior. Given the importance of kinship networks and cultural continuity, understanding these dynamics is critical for informing culturally grounded prevention strategies.Objectives: This study examines the moderating role of cultural affiliation in the association between family disapproval of substance use and actual use among American Indian adolescents, a population often excluded from national health datasets.Methods: Secondary analysis was conducted using self-report data from the Our Youth, Our Future study, a nationally representative sample of American Indian adolescents attending schools on or near reservations (N = 8,950; 51% female; Mage = 14.64 years, SD = 1.77).Results: Multilevel analyses revealed that family disapproval was negatively associated with lifetime alcohol (b = -0.15, p < .001) and cannabis use (b = -0.34, p < .001), controlling for age. Among adolescents who endorsed use, cultural affiliation moderated the relationship between family disapproval and past-year alcohol and cannabis use. Specifically, family disapproval was significantly associated with lower alcohol use at high (b = -0.01, p = .002) but not low (b = -0.07, p = .48) levels of cultural affiliation. For cannabis use, the association was stronger at high (b = -0.51, p < .001) versus low (b = -0.32, p = .005) levels.Conclusions: Cultural affiliation strengthens the protective effects of family disapproval on substance use among American Indian youth. Findings support culturally responsive, family-based prevention efforts that promote cultural identity and intergenerational communication.

Background: Understanding which subgroups of vocational education students are more likely to use tobacco and/or alcohol is critical for designing interventions. Previous research has not explored important student subgroups.Objectives: This exploratory study examined tobacco use, risky alcohol consumption not meeting Australian guidelines, and concurrent use by type of vocational training and whether previously unexplored factors were associated with these health behaviors among vocational education students.Methods: A cross-sectional online survey was conducted among 1057 students (66% male) attending 14 Technical and Further Education campuses in New South Wales, Australia.Results: Type of vocational training was not associated with tobacco use, risky alcohol consumption, or concurrent use. Participants who were married/living with a partner (adjusted odds ratio (AOR): 0.69; 95% Confidence Interval (CI) 0.48, 0.99), or unemployed (AOR: 0.60; 95% CI 0.36, 0.99) had significantly lower odds of tobacco use. Indigenous students (AOR: 1.82; 95% CI 1.19, 2.80) or those who experienced symptoms of depression (AOR: 1.69; 95% CI 1.12, 2.55) had significantly higher odds of tobacco use. Participants aged ≥25 years (AOR: 0.59; 95% CI 0.40, 0.88), female (AOR: 0.42; 95% CI 0.29, 0.62), or unemployed (AOR: 0.57; 95% CI 0.37, 0.88) had significantly lower odds of risky alcohol consumption. Unemployed participants (AOR: 0.53; 95% CI 0.30, 0.95) had significantly lower odds of concurrent use. Those who experienced symptoms of anxiety (AOR: 1.55; 95% CI 1.02, 2.37) had significantly higher odds of concurrent use.Conclusion: Vocational education institutes could provide tailored and culturally appropriate interventions targeting students at increased risk of tobacco and/or alcohol use to prevent diseases.

Background: The Alcohol Use Disorders Identification Test (AUDIT) is a widely used screening tool for assessing problematic alcohol use. While strong cross-sectional psychometric support exists, little is known about its longitudinal performance, particularly within Australian populations and over extended intervals. Most prior studies have relied on short test - retest periods (2-6 weeks), simple correlations, and have not examined whether the AUDIT consistently measures the same constructs over time.Objectives: This study addresses these gaps by using longitudinal confirmatory factor analysis (CFA) to examine the AUDIT's factorial structure, test - retest reliability, and measurement invariance over a 12-month period.Method: A sample of 276 Australian adults (mean age = 31.86 years; SD = 9.94; 71% male), all current alcohol consumers, completed the AUDIT at two time points (2022 and 2023). Participants reported regular alcohol use, with an average AUDIT score of 7.14 at T1 and 7.78 at T2; 38.9% exceeded the threshold for hazardous drinking.Results: One-, two-, and three-factor models were compared, with the one-factor model showing the best fit (RMSEA = .078). The AUDIT demonstrated moderate test - retest reliability (r = .67) and partial longitudinal measurement invariance. Only a small number of factor loadings and intercepts were non-invariant. Full support was found for latent variance invariance, latent mean equivalence, and structural invariance.Conclusions: These findings offer novel longitudinal evidence for the psychometric stability of the AUDIT over 12 months in an Australian sample, supporting its value for monitoring alcohol use and evaluating treatment outcomes.

Background: Prescription opioid misuse (POM) remains a significant public health concern among college students, yet few studies have examined POM prevalence, misuse behaviors among those with prescriptions, and how students access opioids in college settings.Objectives: Assessing the prevalence of POM, patterns of opioid sourcing (i.e. prescribed vs. illicit), and the trends of misuse of one's own prescription (i.e. higher dosage and/or frequency) among college students.Methods: Data from the 2019-2022 American College Health Association-National College Health Assessment III survey, including responses from 331,156 students (64.4% cisgender female), were analyzed. Descriptive analyses assessed POM prevalence and misuse patterns, while multivariable logistic regression identified factors linked to illicit opioid sourcing and prescribed opioid misuse (higher dosage and/or increased frequency).Results: Lifetime POM was reported among 3.9% (n = 12,983) of students and past three-month POM was reported among 0.7% of all students (n = 2,327). Of participants with recent misuse, 55.5% used opioids that were not prescribed to them, and 44.5% used their own prescriptions. Among those with prescriptions, 26.0% exceeded the recommended dosage, and 22.7% shortened the dosing interval. Illicit sourcing was more common among gender-diverse students (aOR: 2.72, 95% CI: 1.62-4.71, p < .0001) and those with severe psychological distress (aOR: 1.42, 95% CI: 1.11-1.82, p = .0053). Misuse of higher dosages (aOR: 2.92, 95% CI: 2.07-4.32, p < .0001) and increased use frequency (aOR: 1.79, 95% CI: 1.23-2.63, p = .0026) was linked to suicidal risk.Conclusion: Prescription monitoring, substance use education, and harm reduction strategies to mitigate misuse risks are needed.

Background: Anxiety is a common reason for cannabis use, yet how symptoms evolve among medical cannabis patients over time remains underexplored. Characterizing anxiety trajectories in this population may inform clinical care and guide patient support.Objectives: To assess anxiety longitudinally among medical cannabis patients alongside concurrent changes in health and cannabis use.Methods: Between 2021-2023, 526 Pennsylvania-based medical cannabis patients (59% female) completed at least two quarterly GAD-7 anxiety assessments over 12 months. Latent class growth analysis identified longitudinal anxiety profiles and their predictors. Parallel changes in health and cannabis use were examined across profiles.Results: Three longitudinal anxiety profiles emerged: Minimal (43%), Moderate (36%), and Severe (21%), with minimal-decreasing, moderate-decreasing, and severe-stable GAD-7 scores, respectively. In Minimal and Moderate groups, anxiety declined but reductions were not clinically meaningful. Younger age and female sex predicted Moderate and Severe profiles, while lifetime PTSD and anxiety disorders as a primary qualifying condition predicted the Severe group only (p < .05). Depression, interference from anxiety and depression, and health-related quality of life aligned with anxiety profiles and significantly differed across them (p < .001). The Severe group had higher baseline levels of benzodiazepine prescriptions and cannabidiol use than the Minimal group (p < .05). Across profiles, prescription rates for anxiety medications remained stable, and cannabis use was near-daily.Conclusion: Anxiety trajectories varied, aligning with other mental health indicators. Only less severe profiles showed anxiety reductions, so patients with severe anxiety may require support. Potential co-use of cannabis and anxiety medications warrants clinical attention.

Background: Adverse childhood experiences (ACEs) are linked to negative health outcomes. Yet how ACEs patterns are associated with non-fatal overdose among people who use drugs (PWUD) is underexplored, despite disproportionate rates of ACEs among this population.Objectives: We examined latent classes of ACEs and their associations with non-fatal overdose in PWUD in New York City (NYC).Methods: We conducted a latent class analysis based on self-reported exposure to ACEs: emotional/physical neglect; emotional, physical, and sexual abuse; household mental illness; household substance use; domestic violence; parental separation/death; and household incarceration. Multivariable logistic regression assessed associations of ACEs classes with lifetime non-fatal overdose.Results: Of 247 PWUD, 74.9% were men and 43.3% reported a lifetime non-fatal overdose. Identified classes were: 1) no/low ACEs (26.3%), 2) household dysfunction (parental separation/death, household substance use) (25.1%), 3) household dysfunction + emotional, physical, and sexual abuse (19.4%), 4) emotional and physical abuse (16.2%), and 5) experienced all ACEs (13.0%). Compared to no/low ACEs, those in the experienced all ACEs class (aOR 4.92; 95%CI 1.71-14.9) and in the household dysfunction class (aOR 3.14; 95%CI 1.31-7.77) had higher odds of experiencing a non-fatal overdose. Other factors associated with non-fatal overdose included unstable housing (aOR 2.73; 95%CI 1.40-5.42), moderate/high cocaine use disorder (aOR 2.60; 95%CI 1.05-6.71), and moderate/high opioid use disorder (aOR 4.25; 95%CI 2.07-9.14).Conclusions: Findings suggest that those who experience a broad spectrum of ACEs may be at higher risk of non-fatal overdose. Addressing early-life adversity in harm reduction and treatment interventions may help mitigate overdose risk in this population.

Background: The use of legal sanctions is often framed as a way to deter driving under the influence (DUI). Yet little research has assessed frequent drinkers' knowledge of DUI penalties.Objectives: To assess the general public's knowledge of DUI penalties (an important element of deterrence) in their state and factors associated with more accurate knowledge.Methods: This US-based cross-sectional study used data from a Connect Platform survey of adult drinkers (n = 583, 58.0% male, 41.4% female) that asked their beliefs on the usual DUI fine and jail time penalty in their state, and how much they expected to be charged if imprisoned (jail fee). Responses were compared with data on minimum/maximum DUI penalties that appear in state statutes pertaining to DUI. For fines, responses were considered accurate if within $100 of the penalty on statute, and for jail time, if they matched the penalty on statute. Regression models were used to assess respondent characteristics associated with accurate penalty knowledge.Results: Among respondents, 83.7% and 67.2% underestimated the minimum DUI fine and jail time penalty in their state, respectively, and 8.7% and 19.7% overestimated. Although 75.4% of respondents lived in a state that charged jail fees, less than half were aware of this. No demographic or characteristic was consistently associated with accurate penalty knowledge across regression models (p > .05).Conclusions: The majority of respondents underestimated the DUI penalty in their state and suggest that large-scale campaigns to educate the public on the severity of DUI penalties are warranted.

Background: The immune system and inflammation have emerged as critical components in alcohol use disorder (AUD). The inflammatory molecule lipocalin-2 (LCN2) has been investigated in alcohol-associated liver disease, and assessment of LCN2 concentrations may aid in prevention and treatment of AUD. However, it is unknown how LCN2 concentrations fluctuate in response to acute and chronic alcohol exposure.Objectives: We examined plasma LCN2 concentrations in rats made alcohol-dependent via chronic, intermittent alcohol vapor exposure, and in people with AUD after acute alcohol administration. We hypothesized that chronic and/or acute alcohol exposure would alter LCN2 concentrations.Methods: Plasma LCN2 concentrations were measured in alcohol-dependent (n = 9) and nondependent (n = 8) male rats. LCN2 concentrations were also examined in two human laboratory studies with cue-reactivity and oral/intravenous alcohol administration in 15 (80% males) and 16 (68.8% males) participants with AUD, respectively.Results: A significant effect of Timepoint (morning versus afternoon; p = .001) but not of chronic alcohol exposure on LCN2 concentrations were found in rats. No significant effects were found after acute alcohol administration in humans.Conclusions: Chronic alcohol exposure in rats or acute alcohol administration in people with AUD had no impact on LCN2 concentrations. In rats, LCN2 concentrations were lower in the morning than in the afternoon, indicating time-related variations in LCN2 concentrations. Together, these findings suggest that LCN2 might play a role in the circadian rhythm, which is often disrupted in people with AUD. However, prospective studies are needed to further examine LCN2's potential clinical relevance in AUD.Clinical Trials Numbers: NCT01751386, NCT01779024.

Background: In animal models, third-trimester-equivalent acute alcohol exposure (TTAAE) leads to cell death in the subiculum, a hippocampal region critical for long-term memory. Proximal and distal regions of the dorsal subiculum have projections that contribute to different aspects of cognitive processing. GABAergic interneurons regulate excitatory pyramidal neurons in the subiculum, but the long-term effects of TTAAE on these interneurons remain unclear.Objective: To test the hypothesis that TTAAE triggers apoptotic pathways in dorsal subiculum interneurons, leading to a persistent reduction in their numbers and alterations in their functional properties during adolescence.Methods: Postnatal day (P) 7 vesicular GABA transporter (VGAT)-Venus mice were injected (2 × 2.5 mg/kg; subcutaneously, 2 hr apart). Cleaved caspase-3 expression was quantified 8 hr after the last injection. Adolescent neuronal and interneuronal densities were quantified using an anti-NeuN marker and Venus fluorescence. Whole-cell patch-clamp recordings were performed from interneurons and pyramidal neurons.Results: TTAAE activated apoptotic pathways in dorsal subicular interneurons in both regions (proximal, p = .005, g = -1.1; distal, p = .003, g = -1.1). Adolescent neuronal density was significantly decreased in exposed males' distal dorsal subiculum (p < .0001, g = -0.8). Ethanol exposure decreased instantaneous frequency evoked by 250-400 pA current injection in fast-spiking GABAergic interneurons only in female mice (250: p = .019, g = -1.08; 300-450: p = .038, g = -1.06 to- 1.18) but did not significantly affect spontaneous inhibitory postsynaptic currents (sIPSCs) evoked by interneuronal GABA release onto pyramidal neurons.Conclusion: TTAAE activates apoptotic pathways in subicular interneurons, leading to long-term, sex-specific changes, reducing male neuron density and altering female interneuron function. These effects may underlie memory deficits demonstrated in mice with TTAAE.

The minimum legal age (MLA) for non-medical cannabis use remains a contentious issue. While current regulations range from 18 to 21 years across jurisdictions, some advocates propose raising the threshold to 25, arguing that brain maturation continues until that age. They postulate that even individuals 22 through 25 exhibit increased neurodevelopmental vulnerability to cannabis. This Perspective examines this assertion, discussing the neuroscientific evidence on brain development and its implications for setting legal age limits for cannabis use. While most major macrostructural and microstructural brain development occurs early in life, processes such as synaptic pruning, gene expression, and prefrontal cortical changes persist through adolescence, with more subtle changes extending into the third decade. Nonetheless, there is no empirically defined neurodevelopmental endpoint at age 25. Brain maturation is a nonlinear process, region-specific, influenced by sex and specific physiological processes. Importantly, existing evidence does not demonstrate greater long-term cognitive or neurophysiological harm attributable to cannabis use in individuals aged 18-25 years compared to those older than 25. This Perspective concludes that an MLA between 18-21 years is a scientifically supportable and socially coherent threshold for non-medical cannabis use. Policy decisions should be informed not only by neurobiological evidence but also by legal, justice, sociocultural, psychological, and historical considerations.