Pub Date : 2024-12-15DOI: 10.1016/j.dadr.2024.100313
Belina Rodrigues , Nicolas Bertholet , Jean-Bernard Daeppen , Jacques Gaume
Introduction
The influence of age on brief motivational interventions (BMI) effects remains unknown. In the present study, we explored whether change in alcohol consumption after BMI differs across age groups and whether these differences are reflected in motivational interviewing (MI) counsellor skills.
Method
Secondary analysis of a randomized controlled trial among emergency room (ER) patients screened for unhealthy alcohol consumption. Participants (N = 97, 80 % men, 18–21 y: 19.6 %, 22–29 y: 22.7 %, 30–49 y: 34.0 % and ≥50 y: 23.7 %) received a single BMI in the ER, which was coded using the MI Skills Code 2.0. Alcohol outcomes were measured at 12-month. First, we tested whether BMI effect varied by age group using negative binomial regression for weekly drinking consumption, and logistic regression for change to low-risk drinking. Second, MI counsellor skills (global ratings of empathy, MI spirit and acceptance, and percentages of open questions, complex reflections (CR) and MI-consistent behaviors) were examined through one-way ANOVA or Welch test.
Results
The 22–29 y group i) reported lower consumption at follow-up compared to the 30–49 y group (IRR=1.60, p = .04) and the ≥ 50 y group (IRR=1.67, p = .03), and ii) was more likely to change to low-risk drinking than the 18–21 y group (OR=11.25, p = .04). When comparing MI counsellor skills across age groups, higher empathy ratings (F(3,93)= 2.70, p = .05) and a higher percentage of CR (F(3,93)= 4.10, p = .009) were recorded for the 22–29 y group.
Conclusion
This exploratory study shows that BMI was associated with significantly better 12-month alcohol outcomes among patients aged 22–29 years, which corresponded with higher counsellor empathy ratings and percentage of CR.
年龄对短暂动机干预（BMI）效应的影响尚不清楚。在本研究中，我们探讨了不同年龄组BMI后饮酒的变化是否不同，以及这些差异是否反映在动机访谈（MI）咨询师技能中。方法：对筛查出不健康饮酒的急诊室（ER）患者的随机对照试验进行二次分析。参与者（N = 97, 80%男性，18-21岁：19.6%，22-29岁：22.7%，30-49岁：34.0%和≥50岁：23.7%）在急诊室接受单一BMI，使用MI技能编码2.0进行编码。在12个月时测量酒精的结果。首先，我们通过对每周饮酒量的负二项回归和对低风险饮酒变化的逻辑回归，检验了BMI效应是否因年龄组而异。其次，通过单因素方差分析或韦尔奇检验，检验心理咨询师的技能（共情、心理咨询精神和接受度的总体评分，以及开放性问题、复杂反思（CR）和心理咨询一致行为的百分比）。结果：与30-49岁组（IRR=1.60, p = 0.04）和≥50岁组（IRR=1.67, p = 0.03）相比，22-29岁组（i)在随访时报告的饮酒量较低（IRR=1.60, p = 0.04）， ii）比18-21岁组更容易转变为低风险饮酒（OR=11.25, p = 0.04）。当比较不同年龄组的心理咨询师技能时，22-29岁年龄组的共情评分较高（F(3,93)= 2.70, p = 0.05）， CR百分比较高（F(3,93)= 4.10, p = 0.009）。结论：本探索性研究表明，在22-29岁的患者中，BMI与12个月的酒精预后显著相关，这与更高的咨询师共情评分和CR百分比相对应。
{"title":"The influence of age on brief motivational intervention for unhealthy alcohol use","authors":"Belina Rodrigues , Nicolas Bertholet , Jean-Bernard Daeppen , Jacques Gaume","doi":"10.1016/j.dadr.2024.100313","DOIUrl":"10.1016/j.dadr.2024.100313","url":null,"abstract":"<div><h3>Introduction</h3><div>The influence of age on brief motivational interventions (BMI) effects remains unknown. In the present study, we explored whether change in alcohol consumption after BMI differs across age groups and whether these differences are reflected in motivational interviewing (MI) counsellor skills.</div></div><div><h3>Method</h3><div>Secondary analysis of a randomized controlled trial among emergency room (ER) patients screened for unhealthy alcohol consumption. Participants (N = 97, 80 % men, 18–21<!--> <!-->y: 19.6 %, 22–29<!--> <!-->y: 22.7 %, 30–49<!--> <!-->y: 34.0 % and ≥50<!--> <!-->y: 23.7 %) received a single BMI in the ER, which was coded using the MI Skills Code 2.0. Alcohol outcomes were measured at 12-month. First, we tested whether BMI effect varied by age group using negative binomial regression for weekly drinking consumption, and logistic regression for change to low-risk drinking. Second, MI counsellor skills (global ratings of empathy, MI spirit and acceptance, and percentages of open questions, complex reflections (CR) and MI-consistent behaviors) were examined through one-way ANOVA or Welch test.</div></div><div><h3>Results</h3><div>The 22–29<!--> <!-->y group i) reported lower consumption at follow-up compared to the 30–49<!--> <!-->y group (IRR=1.60, <em>p</em> = .04) and the ≥ 50<!--> <!-->y group (IRR=1.67, <em>p</em> = .03), and ii) was more likely to change to low-risk drinking than the 18–21<!--> <!-->y group (OR=11.25, <em>p</em> = .04). When comparing MI counsellor skills across age groups, higher empathy ratings (F(3,93)= 2.70, <em>p</em> = .05) and a higher percentage of CR (F(3,93)= 4.10, <em>p</em> = .009) were recorded for the 22–29<!--> <!-->y group.</div></div><div><h3>Conclusion</h3><div>This exploratory study shows that BMI was associated with significantly better 12-month alcohol outcomes among patients aged 22–29 years, which corresponded with higher counsellor empathy ratings and percentage of CR.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985484","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}
Pub Date : 2024-12-14DOI: 10.1016/j.dadr.2024.100311
Olivia C. Reynolds , Kathleen F. Carlson , Adam J. Gordon , Robert L. Handley , Benjamin J. Morasco , Todd P. Korthuis , Travis I. Lovejoy , Jessica J. Wyse
Aim
We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.
Methods
Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018–9/30/20. Rurality was identified by the Rural Urban Commuting Area (RUCA) code of patients’ home address. Associations between rurality and MOUD receipt, as well as type of MOUD received, were examined using logistic regression.
Results
Among 66,842 patients with OUD, 27.4 % were rural residents. Compared to urban patients, rural patients were slightly younger (50.1 vs. 52.5 years), more often white (87.7 % vs. 70.3 %) and less often received MOUD (42.6 % vs 45.5 %). Multivariable models confirmed that rural patients had a lower likelihood of accessing any form of MOUD (aOR= 0.84, 95 % CI: 0.81–0.87) relative to urban VA patients. Medication-specific analyses identified a lower likelihood of receiving methadone (aOR= 0.36, 95 % CI: 0.33–0.39) and naltrexone (aOR= 0.89, 95 % CI: 0.80–0.99) among rural patients, but higher likelihood of receiving buprenorphine (aOR= 1.05, 95 % CI: 1.01–1.09).
Conclusion
Rural VA patients have a lower likelihood of receiving methadone and naltrexone for OUD treatment relative to urban patients, but greater likelihood of receiving buprenorphine. Continued work is needed to ensure that rural Veterans have equitable access to the most appropriate medication for their health care needs.
{"title":"Receipt of medications for opioid use disorder among rural and urban veterans health administration patients","authors":"Olivia C. Reynolds , Kathleen F. Carlson , Adam J. Gordon , Robert L. Handley , Benjamin J. Morasco , Todd P. Korthuis , Travis I. Lovejoy , Jessica J. Wyse","doi":"10.1016/j.dadr.2024.100311","DOIUrl":"10.1016/j.dadr.2024.100311","url":null,"abstract":"<div><h3>Aim</h3><div>We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.</div></div><div><h3>Methods</h3><div>Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018–9/30/20. Rurality was identified by the Rural Urban Commuting Area (RUCA) code of patients’ home address. Associations between rurality and MOUD receipt, as well as type of MOUD received, were examined using logistic regression.</div></div><div><h3>Results</h3><div>Among 66,842 patients with OUD, 27.4 % were rural residents. Compared to urban patients, rural patients were slightly younger (50.1 vs. 52.5 years), more often white (87.7 % vs. 70.3 %) and less often received MOUD (42.6 % vs 45.5 %). Multivariable models confirmed that rural patients had a lower likelihood of accessing any form of MOUD (aOR= 0.84, 95 % CI: 0.81–0.87) relative to urban VA patients. Medication-specific analyses identified a lower likelihood of receiving methadone (aOR= 0.36, 95 % CI: 0.33–0.39) and naltrexone (aOR= 0.89, 95 % CI: 0.80–0.99) among rural patients, but higher likelihood of receiving buprenorphine (aOR= 1.05, 95 % CI: 1.01–1.09).</div></div><div><h3>Conclusion</h3><div>Rural VA patients have a lower likelihood of receiving methadone and naltrexone for OUD treatment relative to urban patients, but greater likelihood of receiving buprenorphine. Continued work is needed to ensure that rural Veterans have equitable access to the most appropriate medication for their health care needs.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100311"},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025539","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}
Pub Date : 2024-12-13DOI: 10.1016/j.dadr.2024.100310
Alison Athey , Jaimie Shaff , Geoffrey Kahn , Kathryn Brodie , Taylor C. Ryan , Holly Sawyer , Aubrey DeVinney , Paul S. Nestadt , Holly C. Wilcox
Background
Rates of suicide mortality and substance use have increased globally. We updated and extended existing systematic reviews of the association between substance use and suicide.
Methods
This systematic review and meta-analysis explored the association between substance use and suicide mortality in peer reviewed, longitudinal cohort studies published from 2003 through 2024. Risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled data were analyzed using a quality effects model. Meta-regression was used to assess the effect of moderation by study quality. Asymmetry in funnel plots and Doi plots were used to detect reporting bias.
Findings
The analysis involved 47 studies from 12 countries. Substance misuse (SMR: 5.58, 95 % CI: 3.63–8.57, I2: 99 %) was significantly associated with risk for suicide. Alcohol (SMR: 65.39, 95 % CI: 3.02–19.62, I2: 99 %), tobacco (SMR: 1.83, 95 % CI: 1.20–2.79, I2: 83 %), opioid (SMR: 5.46, 95 % CI: 3.66–8.15, I2: 96 %), cannabis (SMR 3.31, 95 % CI: 1.42–7.70, I2: 95 %), and amphetamine (SMR 11.97, 95 % CI: 3.13–45.74, I2: 99 %) misuse were each linked to higher rates of suicide mortality. The association between substance misuse and suicide was stronger for females (SMR: 12.37, 95 % CI: 7.07–21.63, I2: 98 %) than males (SMR: 5.21, 95 % CI: 3.09–8.78, I2: 99 %) overall and in analyses of specific substances. Further disaggregated data were not available to sufficiently explore for potential health inequities across social factors.
Conclusions
This meta-analysis highlights that substance misuse remains a significant suicide risk factor. It underscores the need for universal and targeted prevention and equitable access to effective interventions.
{"title":"Association of substance use with suicide mortality: An updated systematic review and meta-analysis","authors":"Alison Athey , Jaimie Shaff , Geoffrey Kahn , Kathryn Brodie , Taylor C. Ryan , Holly Sawyer , Aubrey DeVinney , Paul S. Nestadt , Holly C. Wilcox","doi":"10.1016/j.dadr.2024.100310","DOIUrl":"10.1016/j.dadr.2024.100310","url":null,"abstract":"<div><h3>Background</h3><div>Rates of suicide mortality and substance use have increased globally. We updated and extended existing systematic reviews of the association between substance use and suicide.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis explored the association between substance use and suicide mortality in peer reviewed, longitudinal cohort studies published from 2003 through 2024. Risk of bias was assessed using the Newcastle-Ottawa Scale. Pooled data were analyzed using a quality effects model. Meta-regression was used to assess the effect of moderation by study quality. Asymmetry in funnel plots and Doi plots were used to detect reporting bias.</div></div><div><h3>Findings</h3><div>The analysis involved 47 studies from 12 countries. Substance misuse (SMR: 5.58, 95 % CI: 3.63–8.57, I<sup>2</sup>: 99 %) was significantly associated with risk for suicide. Alcohol (SMR: 65.39, 95 % CI: 3.02–19.62, I<sup>2</sup>: 99 %), tobacco (SMR: 1.83, 95 % CI: 1.20–2.79, I<sup>2</sup>: 83 %), opioid (SMR: 5.46, 95 % CI: 3.66–8.15, I<sup>2</sup>: 96 %), cannabis (SMR 3.31, 95 % CI: 1.42–7.70, I<sup>2</sup>: 95 %), and amphetamine (SMR 11.97, 95 % CI: 3.13–45.74, I<sup>2</sup>: 99 %) misuse were each linked to higher rates of suicide mortality. The association between substance misuse and suicide was stronger for females (SMR: 12.37, 95 % CI: 7.07–21.63, I<sup>2</sup>: 98 %) than males (SMR: 5.21, 95 % CI: 3.09–8.78, I<sup>2</sup>: 99 %) overall and in analyses of specific substances. Further disaggregated data were not available to sufficiently explore for potential health inequities across social factors.</div></div><div><h3>Conclusions</h3><div>This meta-analysis highlights that substance misuse remains a significant suicide risk factor. It underscores the need for universal and targeted prevention and equitable access to effective interventions.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017440","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}
Pub Date : 2024-12-12DOI: 10.1016/j.dadr.2024.100312
Meenakshi S. Subbaraman , Elizabeth Mahoney , Amy Mericle , Douglas Polcin
Background
Evidence supporting cannabis substitution along with liberalized cannabis laws have left recovery homes such as sober living houses (SLHs) in a difficult position regarding policies relating to cannabis use among SLH residents. Moreover, there are few studies of cannabis use among SLH residents that can be used to inform cannabis use policies. Here we assess whether cannabis is related to alcohol use among SLH residents.
Methods
Data came from N = 205 SLH residents entering 28 SLHs in Los Angeles from 2021 to 2023. Interviews were at baseline and one-, two-, three-, and six-month follow-ups. All participants reported lifetime alcohol use disorder (AUD). The primary predictor was any past 30-day cannabis use. Past 30-day outcomes were any drinking, number of drinking days, and any alcohol problems. Longitudinal generalized estimating equation models tested associations between any past-30-day cannabis use and outcomes, adjusting for demographics, treatment, 12-step attendance, social network use, baseline drug use, and AUD severity.
Results
After adjustment for demographics and covariates, any past-30-day cannabis use was related to 7.02 times higher odds of any past 30-day drinking (OR=7.02, 95 % CI: 3.06, 16.12), 2.03 times more drinking days (IRR=2.03, 95 % CI: 1.01, 4.08), and 3.21 times higher odds of any past-30-day alcohol problems (OR=3.21, 95 % CI: 1.68, 6.14) vs. no past-30-day cannabis use.
Conclusions
Cannabis use is positively correlated with alcohol use and related problems in a sample of sober living house residents in Los Angeles.
{"title":"Cannabis use and alcohol-related outcomes among sober living house residents with alcohol use disorders","authors":"Meenakshi S. Subbaraman , Elizabeth Mahoney , Amy Mericle , Douglas Polcin","doi":"10.1016/j.dadr.2024.100312","DOIUrl":"10.1016/j.dadr.2024.100312","url":null,"abstract":"<div><h3>Background</h3><div>Evidence supporting cannabis substitution along with liberalized cannabis laws have left recovery homes such as sober living houses (SLHs) in a difficult position regarding policies relating to cannabis use among SLH residents. Moreover, there are few studies of cannabis use among SLH residents that can be used to inform cannabis use policies. Here we assess whether cannabis is related to alcohol use among SLH residents.</div></div><div><h3>Methods</h3><div>Data came from N = 205 SLH residents entering 28 SLHs in Los Angeles from 2021 to 2023. Interviews were at baseline and one-, two-, three-, and six-month follow-ups. All participants reported lifetime alcohol use disorder (AUD). The primary predictor was any past 30-day cannabis use. Past 30-day outcomes were any drinking, number of drinking days, and any alcohol problems. Longitudinal generalized estimating equation models tested associations between any past-30-day cannabis use and outcomes, adjusting for demographics, treatment, 12-step attendance, social network use, baseline drug use, and AUD severity.</div></div><div><h3>Results</h3><div>After adjustment for demographics and covariates, any past-30-day cannabis use was related to 7.02 times higher odds of any past 30-day drinking (OR=7.02, 95 % CI: 3.06, 16.12), 2.03 times more drinking days (IRR=2.03, 95 % CI: 1.01, 4.08), and 3.21 times higher odds of any past-30-day alcohol problems (OR=3.21, 95 % CI: 1.68, 6.14) vs. no past-30-day cannabis use.</div></div><div><h3>Conclusions</h3><div>Cannabis use is positively correlated with alcohol use and related problems in a sample of sober living house residents in Los Angeles.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100312"},"PeriodicalIF":0.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985439","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}
Pub Date : 2024-12-11DOI: 10.1016/j.dadr.2024.100306
Samantha M. Rundle, David Hammond
Background
Little literature exists on what sources of help individuals utilize for cannabis-related problems. The current study examined the percentage of consumers who sought help to manage cannabis-related problems, such as perceived cannabis use disorder, the most common sources of help sought, and factors associated with help-seeking.
Methods
Past 12-month cannabis consumers (N = 13,209) completed an online survey from the International Cannabis Policy Study. Past 3-month help-seeking behaviours, respondent’s perceived addiction to cannabis, legal status of cannabis in their jurisdiction, and risky behaviours associated with cannabis use was assessed.
Results
A minority sought help from any source (9.2 %) with the most likely being a doctor/physician (44.9 %). Help-seekers were most likely to be younger, mixed race (p = .011), more educated, financially stable, male, and higher perceived addiction to cannabis (all contrasts p < .001). In comparison to consumers in Canada and ‘legal’ US states, respondents in ‘illegal’ US states were more likely to seek help from family and friends (Canada: AOR = 5.73, 2.21–14.91; US: AOR = 4.76, 2.00–11.11) and less likely to seek help from a doctor/physician (Canada: AOR = 0.46, 0.24–0.90; US: AOR = 0.51, 0.27–0.99).
Conclusion
Roughly 1 in 10 cannabis consumers sought help from a range of sources, including a third who are at high risk of problematic use. More informal sources of help, such as seeking help from online sources are frequently used. Future research should examine these frontline sources of help for cannabis consumers.
{"title":"Help-seeking behaviours among cannabis consumers in Canada and the United States: Findings from the international cannabis policy study","authors":"Samantha M. Rundle, David Hammond","doi":"10.1016/j.dadr.2024.100306","DOIUrl":"10.1016/j.dadr.2024.100306","url":null,"abstract":"<div><h3>Background</h3><div>Little literature exists on what sources of help individuals utilize for cannabis-related problems. The current study examined the percentage of consumers who sought help to manage cannabis-related problems, such as perceived cannabis use disorder, the most common sources of help sought, and factors associated with help-seeking.</div></div><div><h3>Methods</h3><div>Past 12-month cannabis consumers (<em>N</em> = 13,209) completed an online survey from the International Cannabis Policy Study. Past 3-month help-seeking behaviours, respondent’s perceived addiction to cannabis, legal status of cannabis in their jurisdiction, and risky behaviours associated with cannabis use was assessed.</div></div><div><h3>Results</h3><div>A minority sought help from any source (9.2 %) with the most likely being a doctor/physician (44.9 %). Help-seekers were most likely to be younger, mixed race (<em>p</em> = .011), more educated, financially stable, male, and higher perceived addiction to cannabis (all contrasts <em>p</em> < .001). In comparison to consumers in Canada and ‘legal’ US states, respondents in ‘illegal’ US states were more likely to seek help from family and friends (Canada: AOR = 5.73, 2.21–14.91; US: AOR = 4.76, 2.00–11.11) and less likely to seek help from a doctor/physician (Canada: AOR = 0.46, 0.24–0.90; US: AOR = 0.51, 0.27–0.99).</div></div><div><h3>Conclusion</h3><div>Roughly 1 in 10 cannabis consumers sought help from a range of sources, including a third who are at high risk of problematic use. More informal sources of help, such as seeking help from online sources are frequently used. Future research should examine these frontline sources of help for cannabis consumers.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100306"},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985467","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}
Pub Date : 2024-12-10DOI: 10.1016/j.dadr.2024.100309
Mohammad Rifat Haider , Samantha Clinton , Monique J. Brown , Nathan B. Hansen
Background
Syringe services programs (SSP) are evidence-based venues offering harm reduction services to persons who inject drugs (PWID), such as sterile syringes, STI/HIV testing, and linkage to care to decrease drug use-related morbidities and mortalities. Adverse childhood experiences (ACEs) have been linked with reduced resilience, while increased resilience can help PWID attend SSPs. This study examined the potential mediating role of resilience between ACEs and SSP attendance among PWID.
Methods
Data were collected from adult HIV-negative PWID in northeast Georgia, between February-December 2023 (N = 173). Data were collected on SSP attendance (Yes vs. No), resilience, and ACEs. Covariates included age, gender, sexual orientation, race/ethnicity, education, homelessness, HIV risk behavior, syringe sharing, syringe use frequency, and primary drug. Path analysis was performed using Stata 18.0.
Results
The majority of PWID were cisgender men (68.8 %), heterosexual (92.5 %), homeless (93.6 %), had HIV risk behavior (65.9 %), had high resilience (54.3 %), and had never attended SSP (64.2 %). The mean number of ACEs was 4.1 (SD=3.2). After adjusting for covariates, high resilience was positively associated with SSP attendance (β= 0.204; p = 0.005). ACEs were negatively associated with high resilience (β= −0.035 p = 0.005) and SSP attendance (β= −0.026; p = 0.034). ACEs had a significant indirect effect on SSP attendance through high resilience (β= −0.007; p = 0.044).
Conclusions
Results indicate that resilience may mediate the relationship between ACEs and SSP attendance among PWID. It is important to develop and implement trauma-informed and resilience-based interventions to address the mental and sexual health challenges of PWID with a history of ACEs.
{"title":"Adverse childhood experiences, resilience, and syringe services program attendance among persons who inject drugs in Northeast Georgia, USA: A mediation analysis","authors":"Mohammad Rifat Haider , Samantha Clinton , Monique J. Brown , Nathan B. Hansen","doi":"10.1016/j.dadr.2024.100309","DOIUrl":"10.1016/j.dadr.2024.100309","url":null,"abstract":"<div><h3>Background</h3><div>Syringe services programs (SSP) are evidence-based venues offering harm reduction services to persons who inject drugs (PWID), such as sterile syringes, STI/HIV testing, and linkage to care to decrease drug use-related morbidities and mortalities. Adverse childhood experiences (ACEs) have been linked with reduced resilience, while increased resilience can help PWID attend SSPs. This study examined the potential mediating role of resilience between ACEs and SSP attendance among PWID.</div></div><div><h3>Methods</h3><div>Data were collected from adult HIV-negative PWID in northeast Georgia, between February-December 2023 (N = 173). Data were collected on SSP attendance (Yes vs. No), resilience, and ACEs. Covariates included age, gender, sexual orientation, race/ethnicity, education, homelessness, HIV risk behavior, syringe sharing, syringe use frequency, and primary drug. Path analysis was performed using Stata 18.0.</div></div><div><h3>Results</h3><div>The majority of PWID were cisgender men (68.8 %), heterosexual (92.5 %), homeless (93.6 %), had HIV risk behavior (65.9 %), had high resilience (54.3 %), and had never attended SSP (64.2 %). The mean number of ACEs was 4.1 (SD=3.2). After adjusting for covariates, high resilience was positively associated with SSP attendance (β= 0.204; p = 0.005). ACEs were negatively associated with high resilience (β= −0.035 p = 0.005) and SSP attendance (β= −0.026; p = 0.034). ACEs had a significant indirect effect on SSP attendance through high resilience (β= −0.007; p = 0.044).</div></div><div><h3>Conclusions</h3><div>Results indicate that resilience may mediate the relationship between ACEs and SSP attendance among PWID. It is important to develop and implement trauma-informed and resilience-based interventions to address the mental and sexual health challenges of PWID with a history of ACEs.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985419","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}
Pub Date : 2024-12-04DOI: 10.1016/j.dadr.2024.100305
Dennis E. McChargue , Bilal Khan , Jessica Phelps , Patrick Duryea , Kimberly A. Tyler , Arthur Andrews , Ellie Reznicek , Lucy Napper , Mohamed Saad , Hsuan-Wei Lee
Preliminary data from a prospective micro-longitudinal study (30 days) that examined the co-evolution of return to use risk among people diagnosed with an alcohol use disorder (AUD) in residential substance treatment is presented. Data assessed the feasibility of using the open dynamic interaction network (ODIN) responsive ecological momentary assessment (rEMA). rEMA collected daily estimates on affect, urges, sober-support engagement, and use. The ODIN app administered twelve daily questions at established EMA times. GPS-identified sober support engagement and alcohol access exposure prompted additional questions. Of the eight hundred questions, most people answered 500 questions. Five-day estimates showed that 80 % of the participants answered between 80 and 100 questions (10–30 questions/day). The ODIN app acquired 95 % of GPS readings across 30 days (~288 GPS readings/day). Most were satisfied with the stability (84 %), look/feel (82 %), and ease of use (92 %) of the ODIN app. Participants also reported interest in longer assessments that prompted them to call a sponsor (85 %) or to use prevention skills (72 %). Preliminary findings show that the ODIN platform accurately and efficiently collects data amongst this population.
{"title":"The feasibility of utilizing the open dynamic interaction network (ODIN) app to assess rEMA data across 30 days among those recovering from alcohol use disorders","authors":"Dennis E. McChargue , Bilal Khan , Jessica Phelps , Patrick Duryea , Kimberly A. Tyler , Arthur Andrews , Ellie Reznicek , Lucy Napper , Mohamed Saad , Hsuan-Wei Lee","doi":"10.1016/j.dadr.2024.100305","DOIUrl":"10.1016/j.dadr.2024.100305","url":null,"abstract":"<div><div>Preliminary data from a prospective micro-longitudinal study (30 days) that examined the co-evolution of return to use risk among people diagnosed with an alcohol use disorder (AUD) in residential substance treatment is presented. Data assessed the feasibility of using the open dynamic interaction network (ODIN) responsive ecological momentary assessment (rEMA). rEMA collected daily estimates on affect, urges, sober-support engagement, and use. The ODIN app administered twelve daily questions at established EMA times. GPS-identified sober support engagement and alcohol access exposure prompted additional questions. Of the eight hundred questions, most people answered 500 questions. Five-day estimates showed that 80 % of the participants answered between 80 and 100 questions (10–30 questions/day). The ODIN app acquired 95 % of GPS readings across 30 days (~288 GPS readings/day). Most were satisfied with the stability (84 %), look/feel (82 %), and ease of use (92 %) of the ODIN app. Participants also reported interest in longer assessments that prompted them to call a sponsor (85 %) or to use prevention skills (72 %). Preliminary findings show that the ODIN platform accurately and efficiently collects data amongst this population.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100305"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886463","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}
Pub Date : 2024-11-22DOI: 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.
{"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}
Pub Date : 2024-11-22DOI: 10.1016/j.dadr.2024.100304
Caitlin E. Martin , James M. Bjork , Lori Keyser-Marcus , Roy T. Sabo , Tiffany Pignatello , Kameron Simmons , Christina La Rosa , Albert J. Arias , Tatiana Ramey , F. Gerard Moeller
Background
Evidence supports the common incidence of sleep disturbance in opioid use disorder (OUD) as a potential marker of disrupted orexin system functioning. This study evaluated the initial safety and tolerability of a challenge dose of lemborexant, a dual orexin antagonist, as an adjunct to buprenorphine/naloxone.
Methods
Patients (18–65 years old) with OUD receiving sublingual buprenorphine/naloxone, with a Pittsburgh Sleep Quality Index total score of 6 or higher, were recruited from outpatient clinics. After randomization, while being monitored on an inpatient research unit over two 10-hour daytime periods, participants received a placebo or lemborexant (5 mg on day one and 10 mg on day two) along with buprenorphine/naloxone. Primary outcomes included safety and tolerability: adverse events, physiologic measures, sedation level assessments. Generalized linear mixed model analysis assessed the effect of study drug and time on outcomes.
Results
N=18 (14=male, 4=female) were randomized to lemborexant (n=12) or placebo (n=6). No unanticipated problems occurred; five adverse events occurred in the lemborexant group and two in the placebo group with no serious adverse events. None of the physiologic measures showed a significant interaction of time and placebo vs. lemborexant (5 or 10 mg): Pulse oximetry (F=0.6; p=0.84), End-tidal CO2 (F=0.5; p=0.91), Heart rate (F=0.6; p=0.82), Systolic blood pressure (F=0.7; p=0.73), Diastolic blood pressure (F=2.0; p=0.06). At 9 hours after study drug administration, all participants returned to baseline sedation levels and were discharged.
Conclusions
Findings support the initial safety and tolerability of lemborexant as an adjunctive treatment for insomnia in humans receiving buprenorphine for OUD. Future longitudinal work is warranted with larger samples.
{"title":"Phase 1b/2a safety study of lemborexant as an adjunctive treatment for insomnia to buprenorphine-naloxone for opioid use disorder: A randomized controlled trial","authors":"Caitlin E. Martin , James M. Bjork , Lori Keyser-Marcus , Roy T. Sabo , Tiffany Pignatello , Kameron Simmons , Christina La Rosa , Albert J. Arias , Tatiana Ramey , F. Gerard Moeller","doi":"10.1016/j.dadr.2024.100304","DOIUrl":"10.1016/j.dadr.2024.100304","url":null,"abstract":"<div><h3>Background</h3><div>Evidence supports the common incidence of sleep disturbance in opioid use disorder (OUD) as a potential marker of disrupted orexin system functioning. This study evaluated the initial safety and tolerability of a challenge dose of lemborexant, a dual orexin antagonist, as an adjunct to buprenorphine/naloxone.</div></div><div><h3>Methods</h3><div>Patients (18–65 years old) with OUD receiving sublingual buprenorphine/naloxone, with a Pittsburgh Sleep Quality Index total score of 6 or higher, were recruited from outpatient clinics. After randomization, while being monitored on an inpatient research unit over two 10-hour daytime periods, participants received a placebo or lemborexant (5<!--> <!-->mg on day one and 10<!--> <!-->mg on day two) along with buprenorphine/naloxone. Primary outcomes included safety and tolerability: adverse events, physiologic measures, sedation level assessments. Generalized linear mixed model analysis assessed the effect of study drug and time on outcomes.</div></div><div><h3>Results</h3><div>N=18 (14=male, 4=female) were randomized to lemborexant (n=12) or placebo (n=6). No unanticipated problems occurred; five adverse events occurred in the lemborexant group and two in the placebo group with no serious adverse events. None of the physiologic measures showed a significant interaction of time and placebo vs. lemborexant (5 or 10<!--> <!-->mg): Pulse oximetry (F=0.6; p=0.84), End-tidal CO2 (F=0.5; p=0.91), Heart rate (F=0.6; p=0.82), Systolic blood pressure (F=0.7; p=0.73), Diastolic blood pressure (F=2.0; p=0.06). At 9<!--> <!-->hours after study drug administration, all participants returned to baseline sedation levels and were discharged.</div></div><div><h3>Conclusions</h3><div>Findings support the initial safety and tolerability of lemborexant as an adjunctive treatment for insomnia in humans receiving buprenorphine for OUD. Future longitudinal work is warranted with larger samples.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"14 ","pages":"Article 100304"},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980858","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}
Pub Date : 2024-11-19DOI: 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.
{"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}
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