Drug and alcohol dependence reports最新文献

Hallucinogen use in the United States, 2021–2023: Diverging trends and subgroup patterns 致幻剂在美国的使用，2021-2023：不同的趋势和亚组模式

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-01-19 DOI: 10.1016/j.dadr.2026.100410

Jing-Jer Chen , Carla J. Berg , Y. Tony Yang

Background

While interest in the therapeutic and recreational use of hallucinogens has increased, national surveillance often reports use in aggregate, potentially masking shifting trends among pharmacologically distinct substances. This study assessed trends in specific hallucinogens from 2021 to 2023 and identified correlates of use, with particular attention to subgroup patterns in populations commonly prioritized for prevention and access-focused interventions.

Methods

Using nationally representative NSDUH data (2021–2023; ages ≥12), we estimated annual past-year prevalence of LSD, PCP, ecstasy (MDMA), ketamine, Salvia divinorum, and tryptamines (including DMT). We fit survey-weighted logistic regression models with year (continuous) to assess trends and pooled multivariable models to examine demographic correlates.

Results

Although overall past-year hallucinogen use was stable (2.83 % [95 % CI: 2.52–3.14] in 2021; 2.82 % [2.52–3.12] in 2023), substance-specific trends diverged. LSD declined (aOR per year=0.83, 95 % CI: 0.75–0.93), from 0.88 % (0.72–1.04) in 2021–0.58 % (0.47–0.68) in 2023. Ketamine increased (aOR=1.11, 95 % CI: 1.02–1.21), from 1.61 % (1.42–1.80) to 1.91 % (1.67–2.16). Ecstasy/MDMA and tryptamines were stable, and PCP and Salvia remained rare. Use concentrated among young adults and males; adjusted models indicated higher odds among uninsured respondents and those below the federal poverty level.

Conclusions

Despite stable overall hallucinogen prevalence, significant increases were observed for ketamine alongside declines for LSD, suggesting a shifting landscape of hallucinogen use. Substance-specific monitoring may better inform screening, prevention, and harm-reduction efforts than aggregate hallucinogen indicators, especially as ketamine’s medical availability expands and disparities in access to mental health treatment persist.

虽然对致幻剂治疗和娱乐用途的兴趣有所增加，但国家监测经常报告总体使用情况，可能掩盖了药理学上不同物质之间的变化趋势。本研究评估了2021年至2023年特定致幻剂的趋势，并确定了使用的相关性，特别关注通常优先考虑预防和以获取为重点的干预措施的人群中的亚组模式。方法使用具有全国代表性的NSDUH数据（2021-2023年，年龄≥12岁），我们估计了过去一年LSD、PCP、摇头丸（MDMA）、氯胺酮、鼠尾草和色胺（包括DMT）的年度患病率。我们拟合调查加权逻辑回归模型与年份（连续）来评估趋势，并合并多变量模型来检查人口统计学相关性。结果尽管过去一年致幻剂的总体使用情况稳定（2021年为2.83% [95% CI: 2.52-3.14]； 2023年为2.82%[2.52-3.12]），但具体药物的使用趋势存在差异。LSD下降（aOR每年=0.83,95% CI: 0.75-0.93），从2021年的0.88%（0.72-1.04）下降到2023年的0.58%（0.47-0.68）。氯胺酮增加（aOR=1.11, 95% CI: 1.02 ~ 1.21），从1.61%（1.42 ~ 1.80）增加到1.91%（1.67 ~ 2.16）。摇头丸/MDMA和色胺稳定，PCP和鼠尾草仍然罕见。使用集中在年轻人和男性中；调整后的模型显示，未投保的受访者和低于联邦贫困线的受访者的患病几率更高。结论：尽管致幻剂的总体使用率稳定，但氯胺酮的使用率显著上升，LSD的使用率下降，这表明致幻剂的使用正在发生变化。与综合致幻剂指标相比，特定物质的监测可能更好地为筛查、预防和减少危害的努力提供信息，特别是在氯胺酮的医疗可用性扩大和精神健康治疗方面的差距持续存在的情况下。

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引用次数: 0

Rurality weakens the positive association between the COVID-19 pandemic and substance use treatment involving medications for opioid use disorder 乡村性削弱了COVID-19大流行与涉及阿片类药物使用障碍药物的药物使用治疗之间的正相关关系

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2026-01-05 DOI: 10.1016/j.dadr.2026.100408

Ryan J. Lofaro , Leanne M. Confer , Robert M. Bohler , Jessica S. Schwind

Introduction

During the COVID-19 pandemic, policies and practices were adopted to increase access to medications for opioid use disorder (MOUD), an evidence-based treatment that has lower utilization rates in rural areas compared to urban regions. However, limited attention has been given to rural-urban differences in MOUD use associated with pandemic policy and practice changes. We examine associations between the pandemic, rurality, and MOUD use in residential and outpatient treatment programs in the United States.

Methods

Using 2018–2022 Treatment Episode Data Set Admissions (TEDS-A) data from residential short-term (RST), residential long-term (RLT), and outpatient treatment centers, we explored bivariate associations between MOUD as part of a treatment plan as the outcome variable and rurality and the pandemic as key independent variables. We then employed logistic regression, adjusting for multiple factors to analyze base and moderation models.

Results

Findings indicated MOUD use increased across all treatment modalities in the post-COVID period with the strongest association in RLT treatment (OR = 2.298). In all treatment modalities, rurality reduced the strength of the positive relationship between the pandemic and MOUD use (interaction term ORs ranged from .441 to .91). Rural areas experienced a sharp drop in MOUD use from 2021 to 2022 in RLT and outpatient treatment.

Conclusions

Gains in the use of MOUD post-pandemic appeared short-lived in rural areas, ultimately widening urban-rural disparities. Providers, policymakers, and other stakeholders should work together to sustain policies and practices that promote MOUD, particularly in rural areas.

在2019冠状病毒病大流行期间，采取了政策和做法，以增加阿片类药物使用障碍药物的可及性，这是一种基于证据的治疗方法，与城市地区相比，农村地区的使用率较低。然而，对与大流行病政策和做法变化有关的城乡间使用mod的差异关注有限。我们研究了美国住院和门诊治疗项目中流感大流行、乡村性和mod使用之间的关系。方法使用2018-2022年住院短期（RST）、长期住院（RLT）和门诊治疗中心的治疗事件数据集入院（TEDS-A）数据，我们探讨了作为治疗计划一部分的mod作为结果变量与农村性和大流行作为关键自变量之间的双变量关联。然后，我们采用逻辑回归，调整多因素来分析基础和调节模型。结果发现，在新冠肺炎后的所有治疗方式中，mod的使用都有所增加，与RLT治疗的相关性最强（OR = 2.298）。在所有治疗方式中，乡村性降低了大流行与使用mod之间正相关关系的强度(相互作用术语or范围从。441 - 0.91)。从2021年到2022年，农村地区在RLT和门诊治疗中的mod使用量急剧下降。结论大流行后在农村地区使用mod的效果是短暂的，最终扩大了城乡差距。提供者、政策制定者和其他利益攸关方应共同努力，维持促进mod的政策和做法，特别是在农村地区。

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引用次数: 0

Exploring gender differences in tobacco cue-induced craving and heart rate variability in individuals with a tobacco use disorder 探讨烟草使用障碍个体中烟草线索诱导的渴望和心率变异性的性别差异

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-29 DOI: 10.1016/j.dadr.2025.100407

Lucia Hoffmann , Annel, P. Koomen , Taco J. De Vries , Anne Marije Kaag

Introduction

Women face greater challenges quitting smoking and higher health risks than men, yet gender remains understudied in tobacco use disorder (TUD). This study investigates gender differences in subjective craving and heart rate variability (HRV) following tobacco cue exposure in abstinent individuals with a tobacco use disorder. Unlike heart rate, HRV reflects parasympathetic modulation, critical for understanding risk and resilience in addiction, but has rarely been studied as a cue-reactivity biomarker.

Methods

Data from 41 men and 40 women who smoked cigarettes for more than 10 years were analyzed. Participants underwent a cue-exposure paradigm consisting of a relaxation phase (75 s), exposure to smoking videos (150 s) and pictures (150 s), and handling tobacco paraphernalia (120 s). Relief craving (the urge to use nicotine to alleviate negative emotions) and reward craving (the urge to use nicotine for its pleasurable effects) were measured pre/post cue exposure via the brief Questionnaire on Smoking Urges. HRV was continuously measured as root mean square of successive differences (RMSSD).

Results

Cue exposure increased relief and reward craving and reduced HRV across participants (p < .001) without gender differences. Significant craving-HRV associations emerged only in women: those with higher exposure-induced reward craving showed the largest HRV reductions and recovery during paraphernalia handling (p < 0.01), whereas those with higher exposure-induced relief craving had smaller HRV declines and weaker recovery (p < 0.01).

Conclusion

These findings reinforce HRV as a clinically relevant biomarker for tobacco cue reactivity and highlight gender differences in the autonomic nervous system’s role in craving among individuals with TUD, suggesting stronger involvement in women.

与男性相比，女性面临更大的戒烟挑战和更高的健康风险，但性别在烟草使用障碍（TUD）中的研究仍然不足。本研究探讨了烟草使用障碍的戒烟个体在烟草线索暴露后主观渴望和心率变异性（HRV）的性别差异。与心率不同，HRV反映副交感神经调节，对理解成瘾风险和恢复力至关重要，但很少作为线索反应性生物标志物进行研究。方法对吸烟10年以上的41名男性和40名女性的数据进行分析。参与者经历了一个线索暴露范式，包括放松阶段（75秒），吸烟视频（150秒）和图片（150秒），以及处理烟草用具（120秒）。缓解渴望（使用尼古丁来缓解负面情绪的冲动）和奖励渴望（使用尼古丁来获得愉悦效果的冲动）通过简短的吸烟欲望问卷来测量提示暴露前后的情况。HRV连续测量为连续差的均方根（RMSSD）。结果提示暴露增加了参与者的缓解和奖励渴望，降低了HRV (p < .001)，没有性别差异。明显的渴望-HRV关系只出现在女性身上：在处理随身物品时，那些高暴露诱导的奖励渴望表现出最大的HRV下降和恢复（p < 0.01），而那些高暴露诱导的缓解渴望表现出较小的HRV下降和较弱的恢复（p < 0.01）。结论：这些发现强化了HRV作为烟草线索反应性的临床相关生物标志物的作用，并强调了自主神经系统在TUD个体中对渴望的作用的性别差异，表明女性的作用更大。

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引用次数: 0

Characteristics and comorbidities of patients on opioid agonist therapy in Switzerland: A descriptive analysis of the nationwide SAMMSU cohort 瑞士阿片类激动剂治疗患者的特征和合并症：对全国SAMMSU队列的描述性分析

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-16 DOI: 10.1016/j.dadr.2025.100404

Michael Lütolf , Andrea Bregenzer , Philip Bruggmann , Alberto Moriggia , Claude Scheidegger , Katharina Hensel-Koch , Erika Castro Batänjer , Maria Christine Thurnheer , Pascale Della Santa , Oliver Senn , Thomas Grischott

Background

Opioid agonist therapy (OAT) is the gold standard of treatment for opioid dependence and a cornerstone of Swiss drug policy. The Swiss Association for the Medical Management in Substance Users (SAMMSU) cohort was established to monitor health trends and improve care for OAT patients across Switzerland.

Methods

Baseline and follow-up data collected from eight centres between 2014 and 2024 were analysed descriptively, including demographic and psychosocial characteristics, substance use history, prescribed OAT, co-medications, and somatic and psychiatric comorbidities.

Results

During the study, the SAMMSU cohort included 1 502 participants. Median individual age at registration was 44.3 years, rising to a cohort median of 50.9 years by the end of 2024; 75.7 % of participants were male. Lifetime heroin use was reported by 97.2 %, with 73.2 % having a history of intravenous drug use. Ongoing illicit and intravenous drug use declined over time, while prescribed OAT shifted from methadone to long-acting morphine and diacetylmorphine. The most prevalent lifetime somatic comorbidities were hepatitis C (56.5 %), (pre)hypertension (18.6 %), musculoskeletal disorders (13.8 %), and needle abscesses (13.7 %). Psychiatric disorders – primarily affective (34.8 %), personality (23.2 %), and anxiety disorders (18.0 %) – contributed to multimorbidity and a high prevalence of polypharmacy (49.2 %). There were 120 deaths, mainly from malignancy, overdose, and liver failure, with a median age at death of 51.6 years.

Conclusion

SAMMSU cohort trends corroborate the effectiveness of OAT in reducing illicit drug use and underscore the need for OAT services to evolve from an addiction-focused model to comprehensive chronic care for an ageing and highly vulnerable population.

阿片类药物激动剂治疗（OAT）是治疗阿片类药物依赖的黄金标准，也是瑞士药物政策的基石。瑞士药物使用者医疗管理协会（SAMMSU）队列的建立是为了监测瑞士各地OAT患者的健康趋势和改善护理。方法对2014年至2024年8个中心收集的基线和随访数据进行描述性分析，包括人口统计学和社会心理特征、药物使用史、处方OAT、联合用药以及躯体和精神合并症。结果在研究期间，SAMMSU队列包括1 502名参与者。个人登记年龄中位数为44.3岁，到2024年底将上升到50.9岁；75.7%的参与者为男性。97.2%的人终生使用海洛因，其中73.2%的人有静脉吸毒史。持续的非法和静脉注射药物的使用随着时间的推移而下降，而处方OAT从美沙酮转向长效吗啡和二乙酰吗啡。最常见的终生躯体合并症是丙型肝炎（56.5%）、高血压（18.6%）、肌肉骨骼疾病（13.8%）和针脓肿（13.7%）。精神障碍——主要是情感性障碍（34.8%）、人格障碍（23.2%）和焦虑症（18.0%）——导致多重发病和多重用药的高患病率（49.2%）。有120例死亡，主要死于恶性肿瘤、用药过量和肝功能衰竭，死亡时的中位年龄为51.6岁。结论：sammsu队列趋势证实了OAT在减少非法药物使用方面的有效性，并强调了OAT服务需要从以成瘾为重点的模式发展为针对老龄化和高度脆弱人群的综合慢性护理。

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引用次数: 0

High-volume buprenorphine prescribers: Examining state policy contexts 大容量丁丙诺啡处方：检查国家政策背景

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-16 DOI: 10.1016/j.dadr.2025.100406

Megan S. Schuler , Flora Sheng , Brendan Saloner , Adam J. Gordon , Bradley D. Stein

Background

Most patients prescribed buprenorphine depend on a small number of high-volume prescribers. However, little is known about how state policies may affect high-volume prescribing.

Methods

We used 2009–2018 IQVIA Real World Data – Longitudinal Prescriptions (a national dataset capturing approximately 90 % of U.S. retail pharmacy transactions) to examine associations between four state policies and high-volume buprenorphine prescribing (i.e., clinicians averaging ≥30 active buprenorphine patients/month). Using multivariable event-time linear probability models, we estimated the percentage-point changes in the share of prescribers qualifying as high-volume in the three years following the implementation of: (1) mandatory behavioral health counseling when prescribing buprenorphine, (2) mandatory substance use disorder-related continuing medical education (CME) for licensure, (3) Affordable Care Act (ACA) Medicaid expansion, and (4) mandatory prescription drug monitoring program (PDMP) laws.

Results

Of 109,218 clinicians who prescribed buprenorphine, 8.8 % were classified as high-volume prescribers for at least one year. Both high- and low-volume prescribers increased substantially over the study period, with total prescribers rising nearly 70 %. Policies mandating behavioral health counseling were consistently significantly associated with an increase in the share of high-volume prescribers post-implementation (Y1: +3.4 %age points; Y2: +5.1 %age points; Y3: +3.2 %age points). Conversely, mandatory PDMP laws were correlated with a decreased share of high-volume prescribers (Y1: −1.6 %age points; Y2: −3.2 %age points; Y3: −4.1 %age points). No significant associations were found for mandatory CME or ACA Medicaid expansion.

Conclusions

The proportion of buprenorphine prescribers who are high-volume increased during 2009–2018, reflecting faster growth among high-volume prescribers. Our findings indicate that state policies coincided with differential patterns of growth.

背景：大多数服用丁丙诺啡的患者依赖于少量大剂量处方者。然而，人们对国家政策如何影响大批量处方知之甚少。方法：我们使用2009-2018年IQVIA真实世界数据-纵向处方（一个国家数据集，捕获了约90%的美国零售药房交易）来检查四种州政策与大量丁丙诺啡处方（即临床医生平均每月服用丁丙诺啡的患者≥30例）之间的关系。使用多变量事件时间线性概率模型，我们估计了在实施以下措施后的三年内，合格的高剂量处方者所占比例的百分比变化：(1)在开丁丙诺啡处方时强制行为健康咨询，(2)强制物质使用障碍相关继续医学教育（CME）许可，(3)平价医疗法案（ACA）医疗补助扩张，以及(4)强制性处方药监测计划（PDMP）法律。结果109,218名开具丁丙诺啡的临床医生中，8.8%的人被归类为至少一年的大剂量处方者。在研究期间，大剂量和小剂量处方者都大幅增加，总处方者增加了近70%。强制性行为健康咨询政策与实施后大量处方者比例的增加一致显著相关（Y1: + 3.4%年龄点；Y2: + 5.1%年龄点；Y3: + 3.2%年龄点）。相反，强制性PDMP法律与大批量处方者的比例下降相关（Y1: - 1.6%年龄点；Y2: - 3.2%年龄点；Y3: - 4.1%年龄点）。没有发现强制性CME或ACA医疗补助扩张的显著关联。结论2009-2018年丁丙诺啡大剂量处方者比例增加，反映出大剂量处方者增长较快。我们的研究结果表明，国家政策与不同的增长模式相吻合。

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引用次数: 0

Morbidity, mortality, and health outcomes following emergency department visits for fentanyl-related overdoses: A retrospective cohort study 芬太尼相关用药过量急诊就诊后的发病率、死亡率和健康结果：一项回顾性队列研究

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-15 DOI: 10.1016/j.dadr.2025.100405

Lyn Yuen Choo , Samantha Nash , Baylee Farmer , Zebulun Mallow , Liv E. Miller , E. Ashley Six-Workman , James J. Mahoney III , Erin L. Winstanley

Background

Overdose (OD)-related mortality has been extensively studied; however, less is known about OD-related morbidity beyond neurocognitive impairments (NCI). The purpose of this study is to systematically describe morbidity, mortality, and health outcomes following a fentanyl-related OD treated in the emergency department (ED).

Methods

A retrospective cohort study (n = 205) was conducted using electronic medical record (EMR) data of patients who presented to an ED for a suspected or confirmed fentanyl-related OD within a rural health system that includes 25 hospitals across 4 states. Eligible events occurred between November 1, 2021 and October 31, 2022.

Results

A third (32 %) of patients were discharged the same day, 6 % were hospitalized for 10 + days, 34 % were transferred to the intensive care unit (ICU) and 8 % died during their hospitalization. Twenty-three patients had ongoing health conditions that necessitated transfer to another inpatient hospital or a skilled nursing facility. Among the 633 diagnoses recorded, the majority (64 %) were categorized as related to the OD and specifically 20 % of patients had amnesia or memory loss. Diagnoses were also categorized as mental health (17 %) and medical conditions (11 %). A third of patients were administered naloxone in the hospital and other medication administered included gastrointestinal agents, central nervous system agents and analgesics.

Conclusion

Patients treated in the ED for a non-fatal OD had significant hospital service utilization and had complex morbidity suggesting the need for coordinated aftercare, as well as screening for NCI.

过量（OD）相关的死亡率已被广泛研究；然而，除了神经认知障碍（NCI）外，对od相关的发病率知之甚少。本研究的目的是系统地描述在急诊科（ED）治疗芬太尼相关的过量用药后的发病率、死亡率和健康结果。方法回顾性队列研究（n = 205）使用电子医疗记录（EMR）数据进行，这些患者在4个州的25家农村卫生系统中因疑似或确诊芬太尼相关的过量用药而到急诊科就诊。符合条件的事件发生在2021年11月1日至2022年10月31日之间。结果1 / 3（32%）的患者当天出院，6%的患者住院10天以上，34%的患者转重症监护病房（ICU）， 8%的患者在住院期间死亡。23名患者有持续的健康问题，需要转到另一家住院医院或专业护理机构。在记录的633例诊断中，大多数（64%）被归类为与吸毒过量有关，特别是20%的患者患有健忘症或记忆丧失。诊断还分为精神健康（17%）和医疗状况（11%）。三分之一的患者在医院服用纳洛酮，其他药物包括胃肠道药物、中枢神经系统药物和止痛药。结论非致死性用药过量在急诊科就诊的患者有显著的医院服务利用率，且发病率复杂，提示需要协调的术后护理和NCI筛查。

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引用次数: 0

Characterizing patterns of opioid and stimulant use by route and associations with non-fatal overdose and xylazine use in people who have injected drugs from Baltimore, MD, 2023–2024 2023-2024年马里兰州巴尔的摩市注射毒品人群中阿片类药物和兴奋剂使用途径的特征及其与非致命性过量和噻嗪使用的关系

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-06 DOI: 10.1016/j.dadr.2025.100403

Jacqueline E. Rudolph , Liz M. Martinez-Ocasio , Kenneth A. Feder , Catherine Tomko , Javier A. Cepeda , Gregory D. Kirk , Shruti H. Mehta , Danielle German , Becky L. Genberg

Background

The fourth wave of the overdose epidemic in the United States (US) is characterized by deaths involving fentanyl with stimulants. Understanding patterns of substance use as novel drugs continue to emerge is critical to inform overdose prevention. Among people with a history of injection drug use in Baltimore, MD, we examined opioid-stimulant use by route and the association of injection with non-fatal overdose and xylazine use.

Methods

We included 1132 participants in the AIDS Linked to the IntraVenous Experience cohort with a study visit in 2023–2024. We characterized participants by self-reported past-six-month use of any opioid and any stimulant by route using descriptive statistics. Adjusted associations were estimated using targeted minimum loss-based estimation.

Results

Most participants were Black (68 %), male (67 %), and older (median: 56 years). 53 % reported using both opioids and stimulants; these participants were more likely to report using other substances, non-fatal overdose, depressive symptoms, and homelessness. Among participants using both, those injecting both were more likely to report non-fatal overdose and xylazine use than those using by non-injection (overdose: PD = 22.3 %, 95 % CI= 17.2 %-27.5 %; xylazine: PD = 13.3 %, 95 % CI = 4.7 %-21.9 %).

Conclusions

We provide one of the most comprehensive summaries of substance use during the fourth wave in Baltimore, a city with the highest rate of fatal overdose in the US during the study period. Use of multiple substances was common, and many participants reported injection. Overdose prevention should be targeted to those injecting both drugs as this pattern had heightened overdose risk.

背景：在美国，芬太尼与兴奋剂有关的死亡是过量流行的第四波浪潮。随着新型药物的不断出现，了解药物使用模式对于告知过量预防至关重要。在马里兰州巴尔的摩市有注射用药史的人群中，我们检查了阿片类兴奋剂的使用途径以及注射与非致死性过量和噻嗪使用的关系。方法：我们纳入了1132名与静脉注射相关的艾滋病患者，并于2023-2024年进行了研究访问。我们通过使用描述性统计方法，通过自我报告过去六个月使用任何阿片类药物和任何兴奋剂来描述参与者的特征。调整后的关联使用目标最小损失为基础的估计估计。结果大多数参与者为黑人（68%）、男性（67%）和老年人（中位数：56岁）。53%报告同时使用阿片类药物和兴奋剂；这些参与者更有可能报告使用其他物质，非致命性过量，抑郁症状和无家可归。在使用这两种药物的参与者中，注射这两种药物的参与者比不注射的参与者更有可能报告非致命性过量和木嗪的使用（过量：PD = 22.3%, 95% CI= 17.2% - 27.5%；木嗪：PD = 13.3%, 95% CI= 4.7% - 21.9%）。结论：我们提供了巴尔的摩第四波药物使用最全面的总结之一，巴尔的摩是研究期间美国致命药物过量率最高的城市。使用多种物质是常见的，许多参与者报告注射。过量预防应针对注射这两种药物的人，因为这种模式增加了过量的风险。

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引用次数: 0

Sexualized alcohol and drug use among men who have sex with men and the PrEP retention in Thailand 泰国男男性行为者酒精和药物的性化使用和预防措施的保留

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-05 DOI: 10.1016/j.dadr.2025.100402

Awirut Oon-arom , David J. Grelotti , Kriengkrai Srithanaviboonchai , Chaisiri Angurawaranon , Sherry Larkins , Sung-Jae Lee , Wichuda Jiraporncharoen

Introduction

Sexualized alcohol use (SAU) and sexualized drug use (SDU) involve the use of alcohol and/or drugs in sexual contexts, which may impact the HIV pre-exposure prophylaxis (PrEP) continuum of care. This study examines associations between SAU, SDU, and PrEP retention among Thai men who have sex with men (MSM), and explores the acceptability of mobile health interventions.

Methods

A quantitative study with embedded qualitative data was employed, with one hundred MSM recruited from a community clinic to complete a survey assessing SAU, SDU, and other health risks. The psychosocial syndemic count was calculated based on symptoms of alcohol and drug use, depression, anxiety, and experiences of physical or sexual trauma. Factors associated with PrEP retention were analyzed using multivariable logistic regression. Additionally, thirty participants who reported SAU and SDU participated in semi-structured qualitative interviews. Rapid thematic analysis was performed to assess the acceptability of mobile health interventions aimed at improving the PrEP continuum.

Results

In the sample, 27 % reported SAU only, 12 % SDU only, and 23 % combining SAU and SDU. SDU included alkyl nitrite (51.6 %), Cannabis (14.5 %), and stimulants (9.7 %). PrEP retention was not associated with syndemic count or SDU, but was associated with SAU and experiences of sexual violence. Qualitative interviews indicated enthusiasm for mobile health interventions, particularly those offering PrEP reminders, incentives for healthy behaviors, and improved PrEP access.

Conclusion

SAU and sexual violence were identified as barriers to PrEP retention among MSM in Thailand, while SDU was not. Mobile health interventions emphasizing pro-health incentives and harm reduction may enhance PrEP adherence in this population.

性酒精使用（SAU）和性药物使用（SDU）涉及在性环境中使用酒精和/或药物，这可能影响艾滋病毒暴露前预防（PrEP）的连续护理。本研究探讨了泰国男男性行为者（MSM）中SAU、SDU和PrEP保留之间的关系，并探讨了移动卫生干预措施的可接受性。方法采用嵌入定性数据的定量研究方法，从某社区诊所招募100名男男性行为者，对其进行SAU、SDU及其他健康风险评估。心理社会综合征计数是根据酒精和药物使用、抑郁、焦虑以及身体或性创伤经历的症状计算的。采用多变量logistic回归分析与PrEP保留相关的因素。此外，30名报告SAU和SDU的参与者参加了半结构化的定性访谈。进行了快速专题分析，以评估旨在改善预防PrEP连续性的流动卫生干预措施的可接受性。结果单纯SAU占27%，单纯SDU占12%，合并SAU和SDU占23%。SDU包括亚硝酸盐烷基酯（51.6%）、大麻（14.5%）和兴奋剂（9.7%）。PrEP保留与综合征计数或SDU无关，但与SAU和性暴力经历有关。定性访谈表明，人们对移动卫生干预措施很有热情，特别是那些提供预防措施提醒、鼓励健康行为和改善预防措施获取的措施。结论性暴力和性暴力是泰国男男性接触者保留PrEP的障碍，而性暴力则不是。强调有利于健康的激励措施和减少危害的流动卫生干预措施可能会提高这一人群的PrEP依从性。

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引用次数: 0

Corrigendum to “Relationship between Medicaid coverage design and receipt of medication for alcohol use disorder (MAUD): Probability of receipt increases based on comprehensiveness of plan” [Drug Alcohol Depend. Rep. 16 (2025) 100374] “医疗补助覆盖设计与接受酒精使用障碍（MAUD）药物治疗之间的关系：基于计划的全面性，接受药物治疗的可能性增加”[药物酒精依赖]的更正。众议员16 (2025)100374]

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-01 DOI: 10.1016/j.dadr.2025.100382

Miguel Antonio Garcia Estrada , Shelby R. Steuart , Christina M. Andrews , Colleen M. Grogan , Olivia M. Hinds , Emily C. Lawler , Felipe Lozano-Rojas , Melissa A. Westlake , Lauren Peterson , Coady Wing , Amanda J. Abraham

引用次数: 0

Syringe service program leader and participant perspectives on reasons for opioid-stimulant co-use in the United States 注射器服务项目负责人和参与者对美国阿片类兴奋剂共同使用原因的看法

IF 2.9

Drug and alcohol dependence reports

Pub Date : 2025-12-01 DOI: 10.1016/j.dadr.2025.100396

Barbara Andraka-Christou , Shana Harris , Whitney D. Margaritis , M.H. Clark , Fatema Z. Ahmed , Suhas Shewale

Background

Opioids and stimulants are increasingly used together in North America. Using syringe service program (SSP) leaders’ and participants’ perspectives, we sought to identify reasons for intentional and unintentional co-use.

Methods

We used a sequential exploratory mixed method design with interviews and a questionnaire of SSP leaders and participants in the U.S. between 2022 and 2024. We recruited a national sample of SSP leaders for telephone/virtual interviews, stratifying for counties with higher overdose rates, higher percentages of non-white residents, and geographic variation. We asked SSP leaders to share flyers with their SSP’s participants. We analyzed qualitative data using iterative categorization and developed an online quantitative questionnaire based on qualitative findings. We disseminated the questionnaire to all SSP program leaders listed on a public website of SSPs in the U.S. and asked them to share it with their SSPs’ participants. We analyzed quantitative data using descriptive statistics and chi-square tests.

Results

Individuals (n = 30) from 13 U.S. states completed interviews, indicating the following reasons for co-use: seeking enhanced euphoria, unintentional co-use due to adulteration, staying awake part of the day and sleeping during the other part, using any drug available, perceived health benefits, and balancing effects for a comfortable experience. Individuals (n = 171) from 45 states and Washington, D.C. completed the quantitative questionnaire. Enhanced euphoria was the most frequently perceived reason for co-use (indicated by 67 % of respondents), with no significant differences in reasons for use by region.

Discussion

Co-use is often intentional. SSPs should address risks through education.

在北美，类兴奋剂和兴奋剂越来越多地一起使用。利用注射器服务计划（SSP）领导者和参与者的观点，我们试图找出有意和无意共同使用的原因。方法采用顺序探索性混合方法设计，对2022年至2024年美国SSP领导人和参与者进行访谈和问卷调查。我们在全国范围内招募了SSP领导人进行电话/虚拟访谈，对用药过量率较高、非白人居民比例较高和地理差异较大的县进行分层。我们要求SSP领导人与他们的SSP参与者分享传单。我们使用迭代分类法分析定性数据，并根据定性结果开发了在线定量问卷。我们将问卷分发给美国SSP公共网站上列出的所有SSP项目负责人，并要求他们与SSP的参与者分享。我们使用描述性统计和卡方检验分析定量数据。结果来自美国13个国家的30名患者各国完成了访谈，说明了共同使用的以下原因：寻求增强欣愉感、因掺假而无意中共同使用、在一天中部分时间保持清醒而在另一部分时间睡觉、使用任何可用的药物、感知到的健康益处、以及平衡效果以获得舒适体验。来自45个州和华盛顿特区的个人（n = 171）完成了定量问卷。增强欣快感是共同使用的最常见原因（67%的受访者表示），不同地区的使用原因没有显著差异。共同使用通常是有意的。ssp应通过教育解决风险。

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