Drug and alcohol dependence reports最新文献

Cannabidiol prescribing in the United States: An analysis of real-world data 美国的大麻二酚处方：真实世界数据分析

Drug and alcohol dependence reports

Pub Date : 2024-11-22 DOI: 10.1016/j.dadr.2024.100303

Binx Yezhe Lin , Chloe Lessard , Yifan Li , Lisa Gong , Ruth Ling , Pallawi Jyotsana , Jacob Steinle , Jacob T. Borodovsky , Fábio A. Nascimento , Kevin Y. Xu

Background

Off-label prescribing of Epidiolex® (pharmaceutical cannabidiol) comes with both potential benefits and risks for patients. The aims of this study were to: (1) identify the percentage of people prescribed Epidiolex® who do not have diagnostic indications for Epidiolex® (Lennox Gastaut Syndrome [LGS], Dravet Syndrome [DS], and Tuberous Sclerosis Complex [TSC]) and (2) examine potential co-prescribing of medications that may interact with Epidiolex®.

Method

Using TriNetX analytics, a web-based database of de-identified electronic health records spanning >110 million people in the United States, we analyzed 4214 people receiving Epidiolex® in 2022. We computed the number of people prescribed Epidiolex® who did not have diagnoses for LGS, DS, or TSC. We evaluated the prevalence of co-occurring prescriptions that are known to interact with cannabidiol following each individual’s first Epidiolex® prescription.

Results

Among individuals receiving Epidiolex®, 40 % did not have FDA-approved diagnostic indications (LGS/DS/TSC) in the medical record. In the overall sample, co-occurring psychotropic prescribing was prevalent, including medications with known interactions with cannabidiol (Clobazam=47.2 %; Diazepam=47.4 %; Clonazepam=40.7 %). Among individuals without LGS/DS/TSC who received Epidiolex®, the most common diagnoses received following the index prescription were unspecified epileptic syndromes (53.8 %), sleep disorders (25.7 %), anxiety disorders (25.9 %), mood disorders (18.6 %) and autism spectrum disorders (10.8 %).

Conclusion

Off-label prescribing and co-prescription of medications with known interactions with cannabidiol is prevalent. Further research is needed to elucidate longitudinal outcomes associated with off-label Epidiolex® prescribing.

背景Epidiolex®（药用大麻二酚）的标签外处方对患者既有潜在的益处，也有风险。本研究旨在(1) 确定开具 Epidiolex® 处方的患者中没有 Epidiolex® 诊断适应症（伦诺克斯-加斯托综合征 [LGS]、德拉沃综合征 [DS] 和结节性硬化症综合征 [TSC]）的患者所占的比例；(2) 检查可能与 Epidiolex® 发生相互作用的潜在联合处方药物。方法利用 TriNetX 分析（一个基于网络的去标识化电子健康记录数据库，涵盖美国 1.1 亿人），我们对 2022 年接受 Epidiolex® 治疗的 4214 人进行了分析。我们计算了未确诊为 LGS、DS 或 TSC 的 Epidiolex® 处方患者人数。结果在接受 Epidiolex® 治疗的患者中，40% 的人的病历中没有 FDA 批准的诊断适应症（LGS/DS/TSC）。在总体样本中，同时开具精神药物处方的情况很普遍，包括已知与大麻二酚有相互作用的药物（氯羟安定=47.2%；地西泮=47.4%；氯硝西泮=40.7%）。在没有接受 Epidiolex® 治疗的 LGS/DS/TSC 患者中，最常见的诊断是不明癫痫综合征（53.8%）、睡眠障碍（25.7%）、焦虑症（25.9%）、情绪障碍（18.6%）和自闭症谱系障碍（10.8%）。需要开展进一步研究，以阐明与标示外服用 Epidiolex® 相关的纵向结果。

{"title":"Cannabidiol prescribing in the United States: An analysis of real-world data","authors":"Binx Yezhe Lin , Chloe Lessard , Yifan Li , Lisa Gong , Ruth Ling , Pallawi Jyotsana , Jacob Steinle , Jacob T. Borodovsky , Fábio A. Nascimento , Kevin Y. Xu","doi":"10.1016/j.dadr.2024.100303","DOIUrl":"10.1016/j.dadr.2024.100303","url":null,"abstract":"<div><h3>Background</h3><div>Off-label prescribing of Epidiolex® (pharmaceutical cannabidiol) comes with both potential benefits and risks for patients. The aims of this study were to: (1) identify the percentage of people prescribed Epidiolex® who do not have diagnostic indications for Epidiolex® (Lennox Gastaut Syndrome [LGS], Dravet Syndrome [DS], and Tuberous Sclerosis Complex [TSC]) and (2) examine potential co-prescribing of medications that may interact with Epidiolex®.</div></div><div><h3>Method</h3><div>Using TriNetX analytics, a web-based database of de-identified electronic health records spanning >110 million people in the United States, we analyzed 4214 people receiving Epidiolex® in 2022. We computed the number of people prescribed Epidiolex® who did not have diagnoses for LGS, DS, or TSC. We evaluated the prevalence of co-occurring prescriptions that are known to interact with cannabidiol following each individual’s first Epidiolex® prescription.</div></div><div><h3>Results</h3><div>Among individuals receiving Epidiolex®, 40 % did not have FDA-approved diagnostic indications (LGS/DS/TSC) in the medical record. In the overall sample, co-occurring psychotropic prescribing was prevalent, including medications with known interactions with cannabidiol (Clobazam=47.2 %; Diazepam=47.4 %; Clonazepam=40.7 %). Among individuals without LGS/DS/TSC who received Epidiolex®, the most common diagnoses received following the index prescription were unspecified epileptic syndromes (53.8 %), sleep disorders (25.7 %), anxiety disorders (25.9 %), mood disorders (18.6 %) and autism spectrum disorders (10.8 %).</div></div><div><h3>Conclusion</h3><div>Off-label prescribing and co-prescription of medications with known interactions with cannabidiol is prevalent. Further research is needed to elucidate longitudinal outcomes associated with off-label Epidiolex® prescribing.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100303"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A systematic review of the reasons for quitting and/or reducing alcohol among those who have received alcohol use disorder treatment 对接受过酒精使用障碍治疗的人戒酒和/或减少饮酒的原因进行系统回顾

Drug and alcohol dependence reports

Pub Date : 2024-11-19 DOI: 10.1016/j.dadr.2024.100300

Christiana Prestigiacomo, Lindsey Fisher-Fox, Melissa A. Cyders

Research has primarily studied reasons for quitting and/or reducing alcohol use in non-treatment samples. This systematic review aimed to characterize the reasons for quitting and/or reducing alcohol use among those who have received treatment for AUD and examine how reasons endorsed differ across measurement methods used. Articles were identified through PsycINFO, Web of Science, PubMed, and CINAHL. Twenty-one articles met inclusion criteria. Thematic coding revealed 21 unique themes in reasons for quitting and/or reducing. Common reasons included physical health issues, misalignment with personal goals, family influence, and social factors—also noted in non-treatment populations. Unique themes like hitting rock bottom and avoiding disapproval were identified, potentially linked to treatment initiation or development. The measurement approach influenced the reasons reported, highlighting the need for standardized methods. Common reasons are fundamental and are not a result of treatment, while others are unique to individuals who have received AUD treatment, which may suggest that they are critical in leading one to seek treatment or may be developed during treatment. Assessing and tailoring treatment based on these reasons may enhance outcomes. Standardizing how we measure reasons for quitting or reducing alcohol is crucial for comparing studies and improving treatment. Future research should evaluate reasons over time, assess their importance at different treatment stages, and use varied assessment strategies for comprehensive insights.

研究主要研究了非治疗样本中戒酒和/或减少饮酒的原因。本系统综述旨在描述接受过 AUD 治疗的人群中戒酒和/或减少饮酒的原因，并研究不同测量方法所认可的原因有何不同。文章通过 PsycINFO、Web of Science、PubMed 和 CINAHL 进行了鉴定。21 篇文章符合纳入标准。主题编码揭示了戒烟和/或减量原因的 21 个独特主题。常见原因包括身体健康问题、与个人目标不符、家庭影响和社会因素--这在未接受治疗的人群中也同样存在。此外，还发现了一些独特的主题，如跌入谷底和避免不认可等，这可能与治疗的开始或发展有关。测量方法影响了所报告的原因，突出了对标准化方法的需求。常见的原因是根本性的，并不是治疗的结果，而其他原因则是接受过 AUD 治疗的人所特有的，这可能表明这些原因是导致一个人寻求治疗的关键，或者可能是在治疗过程中形成的。根据这些原因对治疗进行评估和调整可能会提高治疗效果。标准化衡量戒酒或减少饮酒原因的方法对于比较研究和改进治疗至关重要。未来的研究应评估不同时期的原因，评估其在不同治疗阶段的重要性，并采用不同的评估策略以获得全面的见解。

{"title":"A systematic review of the reasons for quitting and/or reducing alcohol among those who have received alcohol use disorder treatment","authors":"Christiana Prestigiacomo, Lindsey Fisher-Fox, Melissa A. Cyders","doi":"10.1016/j.dadr.2024.100300","DOIUrl":"10.1016/j.dadr.2024.100300","url":null,"abstract":"<div><div>Research has primarily studied reasons for quitting and/or reducing alcohol use in non-treatment samples. This systematic review aimed to characterize the reasons for quitting and/or reducing alcohol use among those who have received treatment for AUD and examine how reasons endorsed differ across measurement methods used. Articles were identified through PsycINFO, Web of Science, PubMed, and CINAHL. Twenty-one articles met inclusion criteria. Thematic coding revealed 21 unique themes in reasons for quitting and/or reducing. Common reasons included physical health issues, misalignment with personal goals, family influence, and social factors—also noted in non-treatment populations. Unique themes like hitting rock bottom and avoiding disapproval were identified, potentially linked to treatment initiation or development. The measurement approach influenced the reasons reported, highlighting the need for standardized methods. Common reasons are fundamental and are not a result of treatment, while others are unique to individuals who have received AUD treatment, which may suggest that they are critical in leading one to seek treatment or may be developed during treatment. Assessing and tailoring treatment based on these reasons may enhance outcomes. Standardizing how we measure reasons for quitting or reducing alcohol is crucial for comparing studies and improving treatment. Future research should evaluate reasons over time, assess their importance at different treatment stages, and use varied assessment strategies for comprehensive insights.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100300"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Discovering opioid slang on social media: A Word2Vec approach with reddit data 在社交媒体上发现阿片类药物俚语：利用 Reddit 数据的 Word2Vec 方法

Drug and alcohol dependence reports

Pub Date : 2024-11-19 DOI: 10.1016/j.dadr.2024.100302

E. Holbrook, B. Wiskur, Z. Nagykaldi

The CDC reported that the overdose of prescription or illicit opioids was responsible for the deaths of over 80,000 Americans in 2021. Social media is a valuable source of insight into problematic patterns of substance misuse. The way people converse with illicit drugs in online forums is highly variable, and slang terms are frequently used. Manually identifying names of specific drugs can be difficult in both time and labor.

Subjects and methods

The study utilized the Gensim Python library and its Word2Vec neural network model to develop an auto-encoding neural network, enabling the innovative analysis of drug-related discourse downloaded from the Reddit website. The slang terms were then used to qualitatively analyze the topics and categories of drugs discussed on the forum.

Results

The inclusion of slang terms facilitated the introduction of 200,000 specific mentions of opioid drugs and that stimulant drugs share a substantial semantic similarity with opioids, a 200 % increase in the number of drug-related terms as compared to using existing datasets.

Conclusions

This study advances the academic field with an extended collection of drug-related terms, offering a useful methodology and resource for tackling the opioid crisis with innovative, reduced-time detection and surveillance methods.

美国疾病预防控制中心报告称，2021 年，超过 80,000 名美国人死于处方或非法阿片类药物过量。社交媒体是了解药物滥用问题模式的宝贵来源。人们在网络论坛上谈论非法药物的方式千变万化，而且经常使用俚语。这项研究利用 Gensim Python 库及其 Word2Vec 神经网络模型开发了一个自动编码神经网络，从而能够对从 Reddit 网站下载的毒品相关言论进行创新分析。结果纳入俚语有助于引入 20 万个关于阿片类药物的具体提及，而且刺激类药物与阿片类药物在语义上有很大的相似性，与使用现有数据集相比，毒品相关术语的数量增加了 200%。

{"title":"Discovering opioid slang on social media: A Word2Vec approach with reddit data","authors":"E. Holbrook, B. Wiskur, Z. Nagykaldi","doi":"10.1016/j.dadr.2024.100302","DOIUrl":"10.1016/j.dadr.2024.100302","url":null,"abstract":"<div><div>The CDC reported that the overdose of prescription or illicit opioids was responsible for the deaths of over 80,000 Americans in 2021. Social media is a valuable source of insight into problematic patterns of substance misuse. The way people converse with illicit drugs in online forums is highly variable, and slang terms are frequently used. Manually identifying names of specific drugs can be difficult in both time and labor.</div></div><div><h3>Subjects and methods</h3><div>The study utilized the Gensim Python library and its Word2Vec neural network model to develop an auto-encoding neural network, enabling the innovative analysis of drug-related discourse downloaded from the Reddit website. The slang terms were then used to qualitatively analyze the topics and categories of drugs discussed on the forum.</div></div><div><h3>Results</h3><div>The inclusion of slang terms facilitated the introduction of 200,000 specific mentions of opioid drugs and that stimulant drugs share a substantial semantic similarity with opioids, a 200 % increase in the number of drug-related terms as compared to using existing datasets.</div></div><div><h3>Conclusions</h3><div>This study advances the academic field with an extended collection of drug-related terms, offering a useful methodology and resource for tackling the opioid crisis with innovative, reduced-time detection and surveillance methods.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100302"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington 华盛顿州金县引入芬太尼后注射器分发量大幅减少

Drug and alcohol dependence reports

Pub Date : 2024-11-19 DOI: 10.1016/j.dadr.2024.100301

Sara N. Glick , Joe Tinsley , Laura Pritchard Wirkman , Apoorva Mallya , Peter Cleary , Matthew R. Golden , Thomas Fitzpatrick

Background

Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization.

Material and Methods

We collected routine program data from three SSPs in King County, Washington. Trends in the annual number of syringes distributed and client encounters were assessed using joinpoint regression analysis to determine when statistically significant changes in trends in annual totals occurred and annual percent change (APC) during each period.

Results

The number of syringes distributed per year through King County SSPs reached a maximum of 8,733,413 in 2020 and then decreased sharply to 2,482,056 by 2023. Annual syringe distribution totals were stable or increasing during all periods from 1989 to 2020 (APC range: 2.0–35.3 %), and only developed a decreasing trend between 2020 and 2023 (APC=-32.8 %). Total number of SSP client encounters per year was stable between 2010 and 2023 (APC=0.7 %), but an increasing trend in encounters was identified starting in 2008 (APC=4.4 %) at a community-based SSP that distributed safer smoking supplies (pipes).

Discussion

A precipitous decline in syringe distribution through King County SSPs began in 2020 and continued through 2023, which coincided with increasing availability of fentanyl in the local drug market. Nevertheless, the trends in client encounters highlight that PWUD continued to seek harm reduction services, with preliminary evidence that distribution of safer smoking supplies may increase the number of client visits.

背景注射服务项目（SSP）是为吸毒者（PWUD）提供减低伤害服务的重要平台。毒品供应和毒品消费行为的变化，尤其是通过非注射方式使用芬太尼的情况日益增多，可能会影响 SSP 的利用率。我们使用连接点回归分析法评估了每年分发的注射器数量和客户接触次数的趋势，以确定每年总数的趋势何时发生统计学意义上的显著变化，以及每个时期的年百分比变化 (APC)。结果金县 SSP 每年分发的注射器数量在 2020 年达到最高值 8,733,413 支，随后急剧下降，到 2023 年降至 2,482,056 支。从 1989 年到 2020 年的所有时间段内，每年的注射器分发总量都保持稳定或增长（APC 范围：2.0-35.3%），仅在 2020 年到 2023 年期间出现下降趋势（APC=-32.8%）。在 2010 年至 2023 年期间，SSP 每年接待的客户总数保持稳定（APC=0.7 %），但从 2008 年开始（APC=4.4 %），在一个分发更安全的吸烟用品（烟斗）的社区 SSP 中，接待的客户数量呈上升趋势。讨论从 2020 年开始，金县 SSP 的注射器分发量急剧下降，一直持续到 2023 年，这与当地毒品市场中芬太尼供应量的增加不谋而合。尽管如此，客户访问量的趋势突出表明，PWUD 仍在继续寻求减低危害服务，初步证据表明，分发更安全的吸烟用品可能会增加客户访问量。

{"title":"Large decrease in syringe distribution following the introduction of fentanyl in King County, Washington","authors":"Sara N. Glick , Joe Tinsley , Laura Pritchard Wirkman , Apoorva Mallya , Peter Cleary , Matthew R. Golden , Thomas Fitzpatrick","doi":"10.1016/j.dadr.2024.100301","DOIUrl":"10.1016/j.dadr.2024.100301","url":null,"abstract":"<div><h3>Background</h3><div>Syringe services programs (SSPs) serve as key platforms to deliver harm reduction services to people who use drugs (PWUD). Changes in drug supply and drug consumption behaviors, particularly the increasing use of fentanyl through non-injection methods, may impact SSP utilization.</div></div><div><h3>Material and Methods</h3><div>We collected routine program data from three SSPs in King County, Washington. Trends in the annual number of syringes distributed and client encounters were assessed using joinpoint regression analysis to determine when statistically significant changes in trends in annual totals occurred and annual percent change (APC) during each period.</div></div><div><h3>Results</h3><div>The number of syringes distributed per year through King County SSPs reached a maximum of 8,733,413 in 2020 and then decreased sharply to 2,482,056 by 2023. Annual syringe distribution totals were stable or increasing during all periods from 1989 to 2020 (APC range: 2.0–35.3 %), and only developed a decreasing trend between 2020 and 2023 (APC=-32.8 %). Total number of SSP client encounters per year was stable between 2010 and 2023 (APC=0.7 %), but an increasing trend in encounters was identified starting in 2008 (APC=4.4 %) at a community-based SSP that distributed safer smoking supplies (pipes).</div></div><div><h3>Discussion</h3><div>A precipitous decline in syringe distribution through King County SSPs began in 2020 and continued through 2023, which coincided with increasing availability of fentanyl in the local drug market. Nevertheless, the trends in client encounters highlight that PWUD continued to seek harm reduction services, with preliminary evidence that distribution of safer smoking supplies may increase the number of client visits.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100301"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The power of lived experience in optimizing US policymakers’ engagement with substance use research: A series of rapid-cycle randomized controlled trials 生活经验在优化美国决策者参与药物使用研究方面的力量：一系列快速循环随机对照试验

Drug and alcohol dependence reports

Pub Date : 2024-11-15 DOI: 10.1016/j.dadr.2024.100299

Elizabeth C. Long , Riley Loria , Jessica Pugel , Patrick O’Neill , Camille C. Cioffi , Charleen Hsuan , Glenn Sterner , D. Max Crowley , J. Taylor Scott

Background

Research can inform policies on substance use/substance use disorders (SU/SUDs), yet there is limited experimental investigation into strategies for optimizing policymakers’ engagement with SU/SUD research. This study tested the use of narratives to boost policymakers’ research engagement.

Methods

In five rapid-cycle randomized controlled trials, SU/SUD research fact sheets were emailed to US legislative policymakers. We tested the use of narratives on the number of email opens, fact sheet clicks, and replies, relative to control emails without narratives. Narratives described lived experience with SU/SUD or motivations to study SU/SUD. The sender was a person with lived experience who authored the narrative or an author of the fact sheet.

Results

When the narrative was about the sender’s own lived experience (Trial 1), or when the narrative was about the sender's motivations to study SU/SUDs (Trial 2), the fact sheet was clicked more than the control (p=.049; p=.012; respectively). When the narrative was about someone else’s experience (Trials 3 and 4), the email was opened (p’s<.001) and replied to (p’s<.001) less, and the fact sheet was clicked (p’s<.001) less. Lastly, emails with lived experience narratives were replied to more than the control, regardless of sender (fact sheet author: p=.028; narrative author: p=.002; Trial 5), but were opened more if the sender authored the narrative (p<.001).

Conclusions

Policymakers’ engagement with SU/SUD research generally increased when the sender was telling their own story. This work highlights the power of people with lived experience and informs strategies for optimizing policymakers’ engagement with SU/SUD research.

背景研究可以为有关药物使用/药物使用失调（SU/SUDs）的政策提供信息，但有关优化政策制定者参与 SU/SUD 研究的策略的实验调查却很有限。本研究测试了如何使用叙述来提高政策制定者的研究参与度。方法在五项快速循环随机对照试验中，通过电子邮件将 SU/SUD 研究概况介绍发送给美国立法政策制定者。我们测试了相对于无叙述的对照邮件，使用叙述对邮件打开、概况介绍点击和回复数量的影响。叙述描述了 SU/SUD 的生活经历或研究 SU/SUD 的动机。结果当叙述的是发件人自己的亲身经历时（试验 1），或叙述的是发件人研究 SU/SUD 的动机时（试验 2），事实表的点击率高于对照组（p=.049；p=.012；分别为）。当叙述的是他人的经历时（试验 3 和试验 4），电子邮件的打开率（p's< .001）和回复率（p's< .001）都较低，情况说明的点击率（p's< .001）也较低。最后，无论发件人是谁，带有真实经历叙述的电子邮件都比对照组得到更多回复（概况介绍作者：p=.028；叙述作者：p=.002；试验 5），但如果发件人是叙述的作者，则被打开的次数更多（p< .001）。这项工作凸显了有亲身经历者的力量，并为优化决策者参与 SU/SUD 研究的策略提供了参考。

{"title":"The power of lived experience in optimizing US policymakers’ engagement with substance use research: A series of rapid-cycle randomized controlled trials","authors":"Elizabeth C. Long , Riley Loria , Jessica Pugel , Patrick O’Neill , Camille C. Cioffi , Charleen Hsuan , Glenn Sterner , D. Max Crowley , J. Taylor Scott","doi":"10.1016/j.dadr.2024.100299","DOIUrl":"10.1016/j.dadr.2024.100299","url":null,"abstract":"<div><h3>Background</h3><div>Research can inform policies on substance use/substance use disorders (SU/SUDs), yet there is limited experimental investigation into strategies for optimizing policymakers’ engagement with SU/SUD research. This study tested the use of narratives to boost policymakers’ research engagement.</div></div><div><h3>Methods</h3><div>In five rapid-cycle randomized controlled trials, SU/SUD research fact sheets were emailed to US legislative policymakers. We tested the use of narratives on the number of email opens, fact sheet clicks, and replies, relative to control emails without narratives. Narratives described lived experience with SU/SUD or motivations to study SU/SUD. The sender was a person with lived experience who authored the narrative or an author of the fact sheet.</div></div><div><h3>Results</h3><div>When the narrative was about the sender’s <em>own</em> lived experience (Trial 1), or when the narrative was about the sender's motivations to study SU/SUDs (Trial 2), the fact sheet was clicked more than the control (<em>p</em>=.049; <em>p</em>=.012; respectively). When the narrative was about someone <em>else’s</em> experience (Trials 3 and 4), the email was opened (<em>p’s</em><.001) and replied to (<em>p’s</em><.001) less, and the fact sheet was clicked (<em>p’s</em><.001) less. Lastly, emails with lived experience narratives were replied to more than the control, regardless of sender (fact sheet author: <em>p</em>=.028; narrative author: <em>p</em>=.002; Trial 5), but were opened more if the sender authored the narrative (<em>p</em><.001).</div></div><div><h3>Conclusions</h3><div>Policymakers’ engagement with SU/SUD research generally increased when the sender was telling their own story. This work highlights the power of people with lived experience and informs strategies for optimizing policymakers’ engagement with SU/SUD research.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100299"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations between social norms and at-risk status for e-cigarette use: A sex-stratified analysis of Texas sixth-grade students 社会规范与使用电子烟的风险状况之间的关联：对得克萨斯州六年级学生的性别分层分析

Drug and alcohol dependence reports

Pub Date : 2024-11-09 DOI: 10.1016/j.dadr.2024.100296

Sarina A. Attri , Andrew E. Springer , Baojiang Chen , Steven H. Kelder , Dale S. Mantey

Background

E-cigarette use remains high among adolescents, underscoring the need to identify targetable risk factors for intervention. This study examines associations between two social norms constructs (prevalence misperceptions and social acceptability) and at-risk status for e-cigarette use among Texas early adolescents.

Methods

We conducted a cross-sectional analysis of baseline data from the CATCH My Breath study, which included n=1032 Texas sixth graders. Students who had ever used or were susceptible to using e-cigarettes were categorized as at-risk for long-term use. Susceptibility was measured using a 3-item index assessing curiosity, intentions, and receptivity to using e-cigarettes. Multi-level logistic regressions assessed associations between social norm constructs and at-risk status for the full and sex-stratified samples. Covariates were race, ethnicity, academics, household/peer tobacco use.

Results

Overall, 36 % of 6th grade students were at-risk for e-cigarette use. Approximately 49 % of students overestimated peer e-cigarette use (“prevalence misperceptions”), and 43 % believed adolescent e-cigarette use is highly acceptable (“social acceptability”). Controlling for covariates, students with medium (aOR=1.89; 95 %CI=1.35–2.65) and high (aOR=1.98; 95 %CI=1.41–2.78) prevalence misperceptions had greater odds of being at-risk for e-cigarette use than those with low misperceptions. Students reporting medium (aOR=2.50; 95 %CI=1.66–3.76) and high (aOR=4.70; 95 %CI=3.21–6.90) social acceptability had greater odds of being at-risk for e-cigarette use than those reporting low acceptability. This association was stronger for females, relative to males.

Conclusions

Greater prevalence misperceptions and social acceptability were associated with being at-risk for e-cigarette use among this sample of Texas early adolescents. Interventions should consider incorporating these social norms into intervention content.

背景电子烟使用率在青少年中居高不下，这说明有必要确定可进行干预的目标风险因素。本研究探讨了两种社会规范结构（流行误解和社会可接受性）与德克萨斯州低年级青少年使用电子烟的风险状况之间的关联。方法我们对 CATCH My Breath 研究的基线数据进行了横断面分析，该研究包括 1032 名德克萨斯州六年级学生。曾经使用过或容易使用电子烟的学生被归类为有长期使用电子烟的风险。易感性采用 3 个项目的指数来衡量，分别评估使用电子烟的好奇心、意向和接受度。多级逻辑回归评估了全部样本和性别分层样本中社会规范构建与高危状态之间的关联。协变量包括种族、民族、学业、家庭/同伴烟草使用情况。约 49% 的学生高估了同伴使用电子烟的情况（"流行误解"），43% 的学生认为青少年使用电子烟是非常容易被接受的（"社会可接受性"）。在控制协变量的情况下，流行误解程度中等（aOR=1.89；95 %CI=1.35-2.65）和较高（aOR=1.98；95 %CI=1.41-2.78）的学生比误解程度低的学生有更大的使用电子烟的风险。与社会接受度低的学生相比，社会接受度中等（aOR=2.50；95 %CI=1.66-3.76）和高（aOR=4.70；95 %CI=3.21-6.90）的学生使用电子烟的风险几率更大。结论在德克萨斯州早期青少年样本中，较高的流行误解和社会接受度与使用电子烟的风险有关。干预措施应考虑将这些社会规范纳入干预内容。

{"title":"Associations between social norms and at-risk status for e-cigarette use: A sex-stratified analysis of Texas sixth-grade students","authors":"Sarina A. Attri , Andrew E. Springer , Baojiang Chen , Steven H. Kelder , Dale S. Mantey","doi":"10.1016/j.dadr.2024.100296","DOIUrl":"10.1016/j.dadr.2024.100296","url":null,"abstract":"<div><h3>Background</h3><div>E-cigarette use remains high among adolescents, underscoring the need to identify targetable risk factors for intervention. This study examines associations between two social norms constructs (prevalence misperceptions and social acceptability) and at-risk status for e-cigarette use among Texas early adolescents.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of baseline data from the CATCH My Breath study, which included n=1032 Texas sixth graders. Students who had ever used or were susceptible to using e-cigarettes were categorized as at-risk for long-term use. Susceptibility was measured using a 3-item index assessing curiosity, intentions, and receptivity to using e-cigarettes. Multi-level logistic regressions assessed associations between social norm constructs and at-risk status for the full and sex-stratified samples. Covariates were race, ethnicity, academics, household/peer tobacco use.</div></div><div><h3>Results</h3><div>Overall, 36 % of 6th grade students were at-risk for e-cigarette use. Approximately 49 % of students overestimated peer e-cigarette use (“prevalence misperceptions”), and 43 % believed adolescent e-cigarette use is highly acceptable (“social acceptability”). Controlling for covariates, students with medium (aOR=1.89; 95 %CI=1.35–2.65) and high (aOR=1.98; 95 %CI=1.41–2.78) prevalence misperceptions had greater odds of being at-risk for e-cigarette use than those with low misperceptions. Students reporting medium (aOR=2.50; 95 %CI=1.66–3.76) and high (aOR=4.70; 95 %CI=3.21–6.90) social acceptability had greater odds of being at-risk for e-cigarette use than those reporting low acceptability. This association was stronger for females, relative to males.</div></div><div><h3>Conclusions</h3><div>Greater prevalence misperceptions and social acceptability were associated with being at-risk for e-cigarette use among this sample of Texas early adolescents. Interventions should consider incorporating these social norms into intervention content.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence, patterns, and predictors of prescribing medications for opioid use disorder (MOUD) in the Inpatient setting 住院患者开具阿片类药物使用障碍（MOUD）处方的流行率、模式和预测因素

Drug and alcohol dependence reports

Pub Date : 2024-11-08 DOI: 10.1016/j.dadr.2024.100292

Ashley Burke , Nina Vadiei , Lea Mollon

Background

There are many barriers to prescribing medications for opioid use disorder (MOUD). This study evaluates the prevalence, patterns, and predictors of inpatient MOUD prescribing at discharge to patients with a diagnosis of opioid use/opioid use disorder (OUD) that developed opioid withdrawal during their hospital stay.

Methods

This multicenter, retrospective cross-sectional study occurred at three hospitals in Arizona. Patients who developed opioid withdrawal during their hospitalization and had a documented opioid-related disorder between January 1, 2021, and January 1, 2022, were included in the study. Patient-specific factors were evaluated as predictors of MOUD prescribing at hospital discharge using descriptive, multivariate regression.

Results

A total of 382 encounters were included; 249 had documented OUD (65.2 %), 75 of which were discharged with MOUD (75/249; 30.1 %). Patients with moderate/moderately severe opioid withdrawal had higher odds of being discharged with MOUD compared to those with mild opioid withdrawal (OR 2.87 [1.44–5.69], p=0.003). Patients admitted to the largest hospital in Phoenix had higher odds of being prescribed MOUD compared to the largest hospital in Tucson (OR 8.23 [3.02–22.49], p<0.001), as were patients who underwent a routine discharge compared to patient directed discharges (7.63 [2.35–24.71], p=0.001).

Conclusions

Less than one-third of patients with OUD that developed opioid withdrawal during their hospitalization were prescribed MOUD at discharge. Treatment facility, opioid withdrawal severity, and discharge disposition were predictors of MOUD prescribing. Inpatient health-systems and policymakers may consider these data when developing policies/procedures aimed at increasing MOUD prescribing rates.

背景开具阿片类药物使用障碍（MOUD）药物处方存在许多障碍。本研究评估了被诊断为阿片类药物使用/阿片类药物使用障碍（OUD）并在住院期间出现阿片类药物戒断的患者出院时开具 MOUD 处方的流行程度、模式和预测因素。研究纳入了在 2021 年 1 月 1 日至 2022 年 1 月 1 日期间住院期间出现阿片类药物戒断并有阿片类药物相关障碍记录的患者。研究使用描述性多变量回归法评估了患者的特异性因素，作为出院时开具 MOUD 的预测因素。结果共纳入了 382 例患者；249 例有记录的 OUD（65.2%），其中 75 例出院时开具了 MOUD（75/249；30.1%）。与轻度阿片类药物戒断患者相比，中度/中重度阿片类药物戒断患者带着MOUD出院的几率更高（OR 2.87 [1.44-5.69]，P=0.003）。与图森市最大的医院相比（OR 8.23 [3.02-22.49]，p<0.001），凤凰城最大的医院收治的患者获得 MOUD 处方的几率更高（7.63 [2.35-24.71]，p=0.001）。治疗机构、阿片类药物戒断严重程度和出院处置是开具 MOUD 处方的预测因素。住院医疗系统和决策者在制定旨在提高MOUD处方率的政策/程序时，可以考虑这些数据。

{"title":"Prevalence, patterns, and predictors of prescribing medications for opioid use disorder (MOUD) in the Inpatient setting","authors":"Ashley Burke , Nina Vadiei , Lea Mollon","doi":"10.1016/j.dadr.2024.100292","DOIUrl":"10.1016/j.dadr.2024.100292","url":null,"abstract":"<div><h3>Background</h3><div>There are many barriers to prescribing medications for opioid use disorder (MOUD). This study evaluates the prevalence, patterns, and predictors of inpatient MOUD prescribing at discharge to patients with a diagnosis of opioid use/opioid use disorder (OUD) that developed opioid withdrawal during their hospital stay.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective cross-sectional study occurred at three hospitals in Arizona. Patients who developed opioid withdrawal during their hospitalization and had a documented opioid-related disorder between January 1, 2021, and January 1, 2022, were included in the study. Patient-specific factors were evaluated as predictors of MOUD prescribing at hospital discharge using descriptive, multivariate regression.</div></div><div><h3>Results</h3><div>A total of 382 encounters were included; 249 had documented OUD (65.2 %), 75 of which were discharged with MOUD (75/249; 30.1 %). Patients with moderate/moderately severe opioid withdrawal had higher odds of being discharged with MOUD compared to those with mild opioid withdrawal (OR 2.87 [1.44–5.69], p=0.003). Patients admitted to the largest hospital in Phoenix had higher odds of being prescribed MOUD compared to the largest hospital in Tucson (OR 8.23 [3.02–22.49], p<0.001), as were patients who underwent a routine discharge compared to patient directed discharges (7.63 [2.35–24.71], p=0.001).</div></div><div><h3>Conclusions</h3><div>Less than one-third of patients with OUD that developed opioid withdrawal during their hospitalization were prescribed MOUD at discharge. Treatment facility, opioid withdrawal severity, and discharge disposition were predictors of MOUD prescribing. Inpatient health-systems and policymakers may consider these data when developing policies/procedures aimed at increasing MOUD prescribing rates.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100292"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

E-Cigarette switching and financial incentives to promote combustible cigarette cessation among adults accessing shelter services: A pilot study 通过电子烟转换和经济激励措施，促进接受庇护所服务的成年人戒除可燃卷烟：试点研究

Drug and alcohol dependence reports

Pub Date : 2024-11-06 DOI: 10.1016/j.dadr.2024.100295

Munjireen S. Sifat , Adam C. Alexander , Michael S. Businelle , Summer G. Frank-Pearce , Laili Kharazi Boozary , Theodore L. Wagener , Jasjit S. Ahluwalia , Darla E. Kendzor

Background

Smoking prevalence among U.S. adults experiencing homelessness is ≥70 %. Interventions are needed to address persisting tobacco disparities.

Methods

Adults who smoked combustible cigarettes (CC) daily (N=60) were recruited from an urban day shelter and randomly assigned to an e-cigarette switching intervention with or without financial incentives for carbon monoxide (CO)-verified CC abstinence (EC vs. EC+FI). All participants received an e-cigarette device and nicotine pods during the first 4 weeks post-switch; and those in the EC+FI group also received escalating weekly incentives for CC abstinence during the same period. Key follow-ups were conducted at 4- and 8-weeks post-switch.

Results

Participants were predominantly male (75 %), 50 % were racially/ethnically minoritized, with an average age of 48.8 years. Descriptive analyses indicated that CC smoking abstinence rates among EC and EC+FI were 3.3 % vs. 13.3 % at 4 weeks (8.3 % overall) and 10.0 % vs. 13.3 % at 8 weeks (11.7 % overall) in the intent-to-treat analyses (missing considered smoking). Among those who completed follow-ups (51.7 % and 45.0 % at 4- and 8-weeks), CC abstinence rates in EC and EC+FI were 6.3 % vs. 26.7 % at 4 weeks (16.1 % overall) and 21.4 % vs. 30.8 % at 8 weeks (25.9 % overall). EC+FI participants reported fewer days of smoking, more days of e-cigarette use, and greater reductions in CO at 4-week follow-up. Most participants reported a high likelihood of switching to e-cigarettes (67.7 %).

Conclusion

E-cigarette switching with financial incentives for CC cessation is a promising approach to tobacco harm reduction among adults accessing shelter services. Refinements are needed to improve engagement.

背景美国无家可归成年人的吸烟率≥70%。方法从一个城市的日间收容所招募每天吸可燃卷烟（CC）的成年人（60 人），并将他们随机分配到有或没有一氧化碳（CO）验证戒烟经济激励的电子烟转换干预中（EC vs. EC+FI）。所有参与者都在换烟后的前 4 周内收到了电子烟设备和尼古丁烟弹；在同一时期，EC+FI 组的参与者还收到了每周递增的一氧化碳戒断奖励。结果参与者主要为男性（75%），50%为少数种族/族裔，平均年龄为 48.8 岁。描述性分析表明，在意向治疗分析中，EC和EC+FI的CC戒烟率在4周时分别为3.3%和13.3%（总体为8.3%），在8周时分别为10.0%和13.3%（总体为11.7%）（缺失视为吸烟）。在完成随访的人群中（4周和8周分别为51.7%和45.0%），EC和EC+FI的CC戒断率分别为：4周为6.3%对26.7%（总体为16.1%），8周为21.4%对30.8%（总体为25.9%）。EC+FI参与者表示，在4周的随访中，吸烟天数减少，使用电子烟的天数增加，一氧化碳的减少幅度增大。大多数参与者表示很有可能改吸电子烟（67.7%）。需要改进以提高参与度。

{"title":"E-Cigarette switching and financial incentives to promote combustible cigarette cessation among adults accessing shelter services: A pilot study","authors":"Munjireen S. Sifat , Adam C. Alexander , Michael S. Businelle , Summer G. Frank-Pearce , Laili Kharazi Boozary , Theodore L. Wagener , Jasjit S. Ahluwalia , Darla E. Kendzor","doi":"10.1016/j.dadr.2024.100295","DOIUrl":"10.1016/j.dadr.2024.100295","url":null,"abstract":"<div><h3>Background</h3><div>Smoking prevalence among U.S. adults experiencing homelessness is ≥70 %. Interventions are needed to address persisting tobacco disparities.</div></div><div><h3>Methods</h3><div>Adults who smoked combustible cigarettes (CC) daily (<em>N</em>=60) were recruited from an urban day shelter and randomly assigned to an e-cigarette switching intervention with or without financial incentives for carbon monoxide (CO)-verified CC abstinence (EC vs. EC+FI). All participants received an e-cigarette device and nicotine pods during the first 4 weeks post-switch; and those in the EC+FI group also received escalating weekly incentives for CC abstinence during the same period. Key follow-ups were conducted at 4- and 8-weeks post-switch.</div></div><div><h3>Results</h3><div>Participants were predominantly male (75 %), 50 % were racially/ethnically minoritized, with an average age of 48.8 years. Descriptive analyses indicated that CC smoking abstinence rates among EC and EC+FI were 3.3 % vs. 13.3 % at 4 weeks (8.3 % overall) and 10.0 % vs. 13.3 % at 8 weeks (11.7 % overall) in the intent-to-treat analyses (missing considered smoking). Among those who completed follow-ups (51.7 % and 45.0 % at 4- and 8-weeks), CC abstinence rates in EC and EC+FI were 6.3 % vs. 26.7 % at 4 weeks (16.1 % overall) and 21.4 % vs. 30.8 % at 8 weeks (25.9 % overall). EC+FI participants reported fewer days of smoking, more days of e-cigarette use, and greater reductions in CO at 4-week follow-up. Most participants reported a high likelihood of switching to e-cigarettes (67.7 %).</div></div><div><h3>Conclusion</h3><div>E-cigarette switching with financial incentives for CC cessation is a promising approach to tobacco harm reduction among adults accessing shelter services. Refinements are needed to improve engagement.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142701722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Syndemic conditions associated with hazardous alcohol consumption among sexual minority men in San Francisco 旧金山性少数群体男性中与危险饮酒有关的综合症状

Drug and alcohol dependence reports

Pub Date : 2024-11-06 DOI: 10.1016/j.dadr.2024.100297

Thye Peng Ngo , Taylor Cuffaro , Glenn-Milo Santos

Background

Hazardous alcohol consumption (HAC) is prevalent among sexual minority men (SMM). Using syndemic theory, this study aimed to identify the number of syndemic conditions, including their combinations, and their association with HAC among SMM in San Francisco.

Method

We conducted a secondary analysis of cross-sectional data from 246 SMM who consume alcohol. Syndemic factors included multiple substance use, depressive symptoms, HIV/STI status, and houselessness. We conducted a multivariable logistic regression to estimate the odds of HAC associated with increasing syndemic conditions. We further examined which combinations of three syndemic factors were associated with the highest odds for HAC.

Results

The average age was 40.7; participants were predominantly White (33.3 %) and Black/African American (29.7 %) and graduated from high school (92.7 %). The prevalence of HAC increased with the number of syndemic conditions: 13.6 % with none, 30.9 % with one, 51.9 % with two, 65.1 % with three, and 69.2 % with four conditions. A significant log-linear trend was observed, with two syndemic conditions increasing the odds of HAC over fivefold (AOR=5.05, 95 % CI=1.68–15.15), and three and four syndemic conditions increasing the odds by more than eightfold (AOR=8.82, 95 % CI=2.74–28.39; AOR=8.55, 95 % CI=2.26–32.28). The combination of depressive symptoms, HIV/STI status, and houselessness tripled the odds for HAC (OR=3.07, 95 % CI=1.34–7.04).

Conclusion

HAC was associated with increasing syndemics, and specific conditions (depression, HIV/STI, and houselessness) had the greatest odds of HAC. These findings underscore the need for comprehensive screening and integrated interventions targeting these co-occurring conditions to reduce HAC in this population.

背景危险饮酒（HAC）在性少数群体男性（SMM）中十分普遍。本研究采用综合症理论，旨在确定综合症的数量，包括其组合，以及它们与旧金山性少数群体男性中 HAC 的关联。综合因素包括多种药物使用、抑郁症状、HIV/性传播感染状况和无家可归。我们进行了多变量逻辑回归，以估计与综合症增加相关的 HAC 发生几率。结果平均年龄为 40.7 岁；参与者主要为白人（33.3%）和黑人/非洲裔美国人（29.7%），高中毕业（92.7%）。HAC 患病率随综合症的数量而增加：13.6%的患者无任何并发症，30.9%的患者有一种并发症，51.9%的患者有两种并发症，65.1%的患者有三种并发症，69.2%的患者有四种并发症。观察到一个明显的对数线性趋势，两种综合症会使 HAC 的几率增加五倍以上（AOR=5.05，95 % CI=1.68-15.15），三种和四种综合症会使几率增加八倍以上（AOR=8.82，95 % CI=2.74-28.39；AOR=8.55，95 % CI=2.26-32.28）。抑郁症状、HIV/性传播感染和无家可归的组合使发生 HAC 的几率增加了三倍（OR=3.07，95 % CI=1.34-7.04）。结论 HAC 与综合症的增加有关，特定条件（抑郁症、HIV/性传播感染和无家可归）发生 HAC 的几率最大。这些发现强调了针对这些并发症进行全面筛查和综合干预的必要性，以减少这类人群的 HAC。

{"title":"Syndemic conditions associated with hazardous alcohol consumption among sexual minority men in San Francisco","authors":"Thye Peng Ngo , Taylor Cuffaro , Glenn-Milo Santos","doi":"10.1016/j.dadr.2024.100297","DOIUrl":"10.1016/j.dadr.2024.100297","url":null,"abstract":"<div><h3>Background</h3><div>Hazardous alcohol consumption (HAC) is prevalent among sexual minority men (SMM). Using syndemic theory, this study aimed to identify the number of syndemic conditions, including their combinations, and their association with HAC among SMM in San Francisco.</div></div><div><h3>Method</h3><div>We conducted a secondary analysis of cross-sectional data from 246 SMM who consume alcohol. Syndemic factors included multiple substance use, depressive symptoms, HIV/STI status, and houselessness. We conducted a multivariable logistic regression to estimate the odds of HAC associated with increasing syndemic conditions. We further examined which combinations of three syndemic factors were associated with the highest odds for HAC.</div></div><div><h3>Results</h3><div>The average age was 40.7; participants were predominantly White (33.3 %) and Black/African American (29.7 %) and graduated from high school (92.7 %). The prevalence of HAC increased with the number of syndemic conditions: 13.6 % with none, 30.9 % with one, 51.9 % with two, 65.1 % with three, and 69.2 % with four conditions. A significant log-linear trend was observed, with two syndemic conditions increasing the odds of HAC over fivefold (AOR=5.05, 95 % CI=1.68–15.15), and three and four syndemic conditions increasing the odds by more than eightfold (AOR=8.82, 95 % CI=2.74–28.39; AOR=8.55, 95 % CI=2.26–32.28). The combination of depressive symptoms, HIV/STI status, and houselessness tripled the odds for HAC (OR=3.07, 95 % CI=1.34–7.04).</div></div><div><h3>Conclusion</h3><div>HAC was associated with increasing syndemics, and specific conditions (depression, HIV/STI, and houselessness) had the greatest odds of HAC. These findings underscore the need for comprehensive screening and integrated interventions targeting these co-occurring conditions to reduce HAC in this population.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100297"},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rates of buprenorphine prescribing and racial disparities among patients with opioid overdose 阿片类药物过量患者的丁丙诺啡处方率和种族差异

Drug and alcohol dependence reports

Pub Date : 2024-11-04 DOI: 10.1016/j.dadr.2024.100298

Kimberly Y. Chieh , Lauren A. Walter , Karen L. Cropsey , Li Li

Background

Awareness of the relationship between real-world buprenorphine prescribing and overdose frequency is limited, especially in the Southeastern United States. We described buprenorphine prescribing rates for patients experiencing nonfatal opioid overdoses in the context of overdose frequency.

Methods

Electronic medical records review was conducted at an urban, academic hospital in Alabama from January 1 through December 31, 2021. Patients with opioid use disorder (OUD) and nonfatal opioid overdoses, dispositioned from either the emergency department (ED), inpatient, or outpatient affiliated clinics, were identified by International Classification of Diseases-10 codes.

Results

The study included 358 unique patients. Many patients were white (71.5 %), male (59.2 %), and uninsured (54.2 %), with a mean age of 42.0±12.8 years. The majority (85.5 %) experienced one to three overdoses, and 14.5 % of patients had more than three overdoses. The buprenorphine prescription rate increased to 55.8 % when patients had more than three overdoses, compared to one overdose (34.5 %) and two to three overdoses (37.4 %) (p=0.025). Compared to females, more males overdosed more than once (p=0.004). Black patients were less likely to receive buprenorphine prescriptions than white patients (27.3 % vs. 44.5 %, p=0.004). Compared to patients with multiple overdoses, more patients with one overdose had public insurance (p=0.028) and were less likely to present to the ED (p<0.001).

Conclusion

Under-prescribing of buprenorphine is high among patients with OUD and opioid overdoses, even in patients with multiple overdoses, and there appear to be racial disparities in prescribing. Our findings indicate clinical opportunities for improving buprenorphine prescribing and reducing the current disparities.

背景对现实世界中丁丙诺啡处方与用药过量频率之间关系的认识有限，尤其是在美国东南部。我们从用药过量频率的角度描述了非致命性阿片类药物过量患者的丁丙诺啡处方率。方法从 2021 年 1 月 1 日至 12 月 31 日，在阿拉巴马州的一家城市学术医院进行了电子病历审查。根据《国际疾病分类-10》代码确定了急诊科（ED）、住院部或附属门诊部的阿片类药物使用障碍（OUD）和非致命性阿片类药物过量患者。许多患者为白人（71.5%）、男性（59.2%）和无保险者（54.2%），平均年龄为（42.0±12.8）岁。大多数患者（85.5%）有一至三次过量服药经历，14.5%的患者有三次以上过量服药经历。与一次用药过量（34.5%）和两次至三次用药过量（37.4%）相比，当患者用药过量超过三次时，丁丙诺啡处方率上升至 55.8%（P=0.025）。与女性相比，更多男性吸毒过量超过一次（P=0.004）。黑人患者获得丁丙诺啡处方的可能性低于白人患者（27.3% 对 44.5%，p=0.004）。结论在 OUD 和阿片类药物过量患者中，丁丙诺啡处方不足的比例很高，即使在多次过量的患者中也是如此，而且在处方方面似乎存在种族差异。我们的研究结果表明，临床上有机会改进丁丙诺啡的处方并减少目前的差距。

{"title":"Rates of buprenorphine prescribing and racial disparities among patients with opioid overdose","authors":"Kimberly Y. Chieh , Lauren A. Walter , Karen L. Cropsey , Li Li","doi":"10.1016/j.dadr.2024.100298","DOIUrl":"10.1016/j.dadr.2024.100298","url":null,"abstract":"<div><h3>Background</h3><div>Awareness of the relationship between real-world buprenorphine prescribing and overdose frequency is limited, especially in the Southeastern United States. We described buprenorphine prescribing rates for patients experiencing nonfatal opioid overdoses in the context of overdose frequency.</div></div><div><h3>Methods</h3><div>Electronic medical records review was conducted at an urban, academic hospital in Alabama from January 1 through December 31, 2021. Patients with opioid use disorder (OUD) and nonfatal opioid overdoses, dispositioned from either the emergency department (ED), inpatient, or outpatient affiliated clinics, were identified by International Classification of Diseases-10 codes.</div></div><div><h3>Results</h3><div>The study included 358 unique patients. Many patients were white (71.5 %), male (59.2 %), and uninsured (54.2 %), with a mean age of 42.0±12.8 years. The majority (85.5 %) experienced one to three overdoses, and 14.5 % of patients had more than three overdoses. The buprenorphine prescription rate increased to 55.8 % when patients had more than three overdoses, compared to one overdose (34.5 %) and two to three overdoses (37.4 %) (<em>p</em>=0.025). Compared to females, more males overdosed more than once (<em>p</em>=0.004). Black patients were less likely to receive buprenorphine prescriptions than white patients (27.3 % vs. 44.5 %, <em>p</em>=0.004). Compared to patients with multiple overdoses, more patients with one overdose had public insurance (<em>p</em>=0.028) and were less likely to present to the ED (<em>p</em><0.001).</div></div><div><h3>Conclusion</h3><div>Under-prescribing of buprenorphine is high among patients with OUD and opioid overdoses, even in patients with multiple overdoses, and there appear to be racial disparities in prescribing. Our findings indicate clinical opportunities for improving buprenorphine prescribing and reducing the current disparities.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100298"},"PeriodicalIF":0.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0