Drug and alcohol dependence reports最新文献

{"title":"Changes in patterns of use and perceptions of cannabis among students in Canada: A decade of data from the Canadian Student Alcohol and Drugs Survey","authors":"Samantha Goodman ,&nbsp;Sebastian A. Srugo ,&nbsp;Emilia Krzeminska ,&nbsp;Hanan Abramovici","doi":"10.1016/j.dadr.2025.100399","DOIUrl":"10.1016/j.dadr.2025.100399","url":null,"abstract":"<div><h3>Introduction</h3><div>The Canadian Student Alcohol and Drugs Survey is a biennial, repeat cross-sectional survey of grade 7–12 students in the Canadian provinces. This study examined cannabis-related behaviours at five timepoints before and after legalization of cannabis for non-medical purposes.</div></div><div><h3>Methods</h3><div>Trends over time were examined using data from 2014–15 to 2023–24 (n = 264,558). Binary logistic regression examined changes in cannabis use and related behaviours, including frequency; usual method of use; perceived risk and access; usual source; and motor vehicle behaviours. Data were stratified by sex and grade group (grade 7–9 vs. 10–12).</div></div><div><h3>Results</h3><div>Overall, there was no change in prevalence of past 12-month, past 30-day, or frequent cannabis use (p &gt; 0.05 for all); however, modest increases were observed among females and grade 7–9 students (p &lt; 0.05 for both). Vaping surpassed smoking as the most common method of consumption in 2023–24. Smoking and dabbing cannabis decreased over time, whereas vaping and eating cannabis increased (p &lt; 0.001 for all). Perceived risk of regularly smoking cannabis decreased (p &lt; 0.001), and perceived ease of cannabis access increased (p &lt; 0.001). The most common cannabis sources were social sources. There was no change in driving after using cannabis (p &gt; 0.05), whereas there was a recent increase in riding with a driver who had used cannabis (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>While legalization and regulation of cannabis for non-medical purposes was not associated with increases in overall cannabis use among students in Canada, increasing rates of use in females and younger students, and changes in perceptions of risk and accessibility require continued monitoring.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100399"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic differences in buprenorphine and methadone prescribing for surgical patients with opioid use disorder","authors":"Caitlin P. Coates ,&nbsp;Margaret McGlothlin Carroll ,&nbsp;Janelle M. Richard ,&nbsp;Wendy Y. Craig ,&nbsp;Aurora N. Quaye","doi":"10.1016/j.dadr.2025.100397","DOIUrl":"10.1016/j.dadr.2025.100397","url":null,"abstract":"<div><h3>Background</h3><div>Patients with opioid use disorder (OUD) frequently present for surgery while receiving medications for OUD (MOUD), typically buprenorphine or methadone. This study evaluated MOUD use among surgical patients with OUD in a health-system spanning both urban and rural areas in Maine; a predominantly rural state with a significant opioid crisis.</div></div><div><h3>Methods</h3><div>We retrospectively identified adult surgical patients with OUD admitted to MaineHealth hospitals from 2014 to 2023 who were receiving MOUD prior to the day of surgery. Demographics and clinical characteristics were collected; rural designation was determined using Rural-Urban Commuting Area codes. The primary outcome was the temporal trend in proportion of surgical patients with OUD receiving methadone versus buprenorphine prior to admission. Temporal trends and geographic differences were compared using chi-square tests (p &lt; 0.05).</div></div><div><h3>Results</h3><div>Of 2099 surgical patients on MOUD, 71.4 % received buprenorphine and 28.6 % methadone. Overall, rural patients were more likely to receive buprenorphine than urban patients (75.1 % vs. 68.5 %) (p &lt; 0.001). Buprenorphine prescribing increased from 52.0 % to 84.2 % in rural areas and from 59.3 % to 72.9 % in urban areas, with corresponding declines in methadone use (both p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Temporal trends showed a significant shift in MOUD prescribing over the study period, with buprenorphine use increasing and methadone use declining in rural and urban populations. Although both medications are considered safe in hospitalized and surgical patients, perioperative management remains inconsistent. Further work is needed to evaluate how these prescribing trends influence clinical outcomes and ensure perioperative protocols support continuity of care for patients with OUD.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100397"},"PeriodicalIF":2.9,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between injection status, cocaine use, overdose, and drug-related behaviors among people who use opioids","authors":"Carl A. Latkin ,&nbsp;Lauren Dayton ,&nbsp;Haley Bonneau ,&nbsp;Melissa A. Davey-Rothwell ,&nbsp;Grace Tian Yi ,&nbsp;Kaori Suga ,&nbsp;Oluwaseun Falade-Nwulia","doi":"10.1016/j.dadr.2025.100398","DOIUrl":"10.1016/j.dadr.2025.100398","url":null,"abstract":"<div><h3>Background</h3><div>The co-use of opioids and stimulants is associated with elevated health risks. This study examined patterns of injection drug use and cocaine use frequency among people who use opioids.</div></div><div><h3>Methods</h3><div>Cross-sectional data were collected from community-recruited adults who use opioids in Baltimore, Maryland, between December 7, 2022 and January 26, 2025. Participants were categorized into four groups based on injection status and cocaine use frequency. Multinomial logistic regression examined factors associated with group membership, calculating relative risk ratios (RRR) and adjusted relative risk ratios (aRRR) with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>Of 777 participants (60.7 % male, 71.6 % Black, median age 52), 29.2 % reported past-month injection drug use. Daily/almost daily use was reported for heroin/fentanyl (79.5 %), crack cocaine (43.2 %), and powder cocaine (9.3 %). Four distinct drug use patterns emerged: not inject/lower frequency cocaine use (42.0 %), inject/lower frequency cocaine use (9.3 %), not inject/higher frequency cocaine use (28.8 %), and inject/higher frequency cocaine use (19.9 %). Factors significantly associated with injecting and higher frequency cocaine use group membership included: overdose history (aRRR=2.58, 95 % CI=1.52–4.38), withdrawal behavior with high overdose risk (aRRR=1.29, 95 % CI=1.14–1.46), and using in multiple locations (aRRR=1.09, 95 % CI=1.02–1.18).</div></div><div><h3>Conclusions</h3><div>Nearly one-fifth of people who use opioids reported both injection drug use and high-frequency cocaine use, and greater frequency of cocaine use was associated with higher overdose risk. Targeted interventions addressing polysubstance use patterns, social networks, and environmental factors are urgently needed to reduce harm among this high-risk population.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100398"},"PeriodicalIF":2.9,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel determinants of medication preferences for opioid use disorder among criminal-legal-involved populations: Insights from a scoping review","authors":"Amelia Bailey ,&nbsp;Jaclyn M.W. Hughto ,&nbsp;Claudia Stagoff-Belfort ,&nbsp;Shira I. Dunsiger ,&nbsp;Rosemarie A. Martin","doi":"10.1016/j.dadr.2025.100395","DOIUrl":"10.1016/j.dadr.2025.100395","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with opioid use disorder (OUD) hold varying perceptions of the three medications to treat OUD (MOUD). Data on these perceptions among those with criminal-legal involvement is limited. To optimize MOUD service delivery, especially in criminal-legal settings, it is essential to explore the preferences and attitudes of those with legal involvement.</div></div><div><h3>Methods</h3><div>We conducted a scoping review of literature published via PubMed, Embase, Web of Science, Scopus, PsycInfo, and SocINDEX (January 1, 2014-September 17, 2024). Three-stage screening process was employed by two reviewers: title/abstract (n = 2085 articles), full-text (n = 88), and data extraction of 44 articles included in the final sample. Content analysis was used to understand preferences/attitudes toward MOUD and related influential factors.</div></div><div><h3>Results</h3><div>Factors that influenced MOUD preferences/attitudes were clustered in positive (n = 39 articles; i.e., like), negative (n = 38; i.e., dislike), or mixed (n = 20; both positive and negative) valences. Methadone was the most referenced (n = 30), with more articles noting negative attitudes than positive. Fewer studies focused on oral buprenorphine (n = 18), with balanced positive and negative views. Seven articles on injectable MOUD highlighted mostly positive attitudes. Factors shaping preferences/attitudes spanned from individual to structural levels. Common factors associated with negative preferences included MOUD program rules, side or adverse effects, and drug-free ideology. Positive preferences were often engendered by flexible MOUD delivery and beliefs about MOUD. Influential factors differed by MOUD type.</div></div><div><h3>Conclusions</h3><div>Preferences/attitudes toward MOUD among criminal-legal-involved populations are shaped by intersecting multilevel determinants and differ by MOUD type. Identified factors might serve as intervention targets to better meet individuals’ needs.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100395"},"PeriodicalIF":2.9,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically characterizing adults who use kava or kratom: Substance use disorder assessment challenges for increasingly popular botanical products","authors":"Katherine Hill ,&nbsp;Edward W. Boyer ,&nbsp;Kirsten E. Smith","doi":"10.1016/j.dadr.2025.100394","DOIUrl":"10.1016/j.dadr.2025.100394","url":null,"abstract":"<div><h3>Background</h3><div>Kratom (<em>Mitragyna speciosa</em>) and kava (<em>Piper methysticum</em>) are psychoactive botanicals with growing popularity We aimed to characterize the clinical characteristics of people who have consumed these products.</div></div><div><h3>Methods</h3><div>We conducted an online survey of US adults who have used kava or kratom. Diagnostic and Statistical Manual-5 (DSM-5) substance use disorder (SUD) criteria were used to assess symptoms related to past-year kratom and/or kava use. Respondents were also asked to report on the compatibility of kava and kratom effects with daily living.</div></div><div><h3>Results</h3><div>Of the 367 participants, 91.3 % reported lifetime kratom use and 49.0 % reported lifetime kava use. There was substantial overlap of lifetime use of both substances (40.3 %). Past-year SUD diagnostic criteria for kratom were met by 38.1 % of participants; when this group was dichotomized by past-year kava use, those who also co-used kava had higher proportions of endorsing symptoms of “using more kratom than intended” and “needing to use larger amounts to feel the same effect” than those who used kratom without kava (p = 0.032 and p = 0.011, respectively). Meeting SUD criteria for kava was uncommon among those reporting past-year use (7.5 %), regardless of past-year kratom use. Kratom effects were perceived as helpful and compatible with daily living, though fewer reported this for kava effects.</div></div><div><h3>Conclusions</h3><div>Assessment of patients using kratom or kava may become challenging due to co-use. The relative rewarding and reinforcing effects of these botanicals alone or combined requires systematic study. SUD for either is possible but should be contextualized by patient-level factors including other substance use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100394"},"PeriodicalIF":2.9,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of substance-free alternatives in treating and preventing harmful substance use: A narrative review of the translational research spectrum","authors":"Justin T. Van Heukelom,&nbsp;Lesleigh A. Stinson,&nbsp;Jalie A. Tucker","doi":"10.1016/j.dadr.2025.100393","DOIUrl":"10.1016/j.dadr.2025.100393","url":null,"abstract":"<div><div>Interventions primarily focused on constraining access to substances have largely failed to reduce substance use and associated harms. Alternative approaches informed by behavioral theories of choice focus on reducing harmful substance use by increasing access to and engagement in substance-free rewards that can compete with substance use. This narrative review of the translational research spectrum, organized by research phases in the Food and Drug Administration’s Drug Approval Process, summarizes wide-ranging research on associations between substance-free alternatives (palatable stimuli, money, social interaction, physical activity) and substance use and related harms. Studies reviewed span laboratory experiments with nonhuman animals to human experiments and treatment and prevention research. With limited exceptions, research across the translational spectrum supported the role of substance-free alternative rewards in reducing harmful substance use. Effective substitutes for substance use under specific conditions included palatable stimuli in animal studies and monetary incentives and social interaction opportunities with non-substance using peers in human studies. Evidence for physical activity was mixed, with stronger support found in animal than human research. Emerging research further suggests that increasing access to substance-free activities in broader socioecological contexts surrounding harmful use (e.g., communities, drug-related policy) also are needed. Increasing access to substance-free rewards through individual- and community-level interventions is a promising alternative to conventional approaches that primarily focus on reducing substance use and related negative consequences by constraining access to substances. Community-level and public health policy efforts guided by behavioral theories of choice merit further development and evaluation.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100393"},"PeriodicalIF":2.9,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New methodology to improve tracking of Veteran overdose deaths and characterization of a population of Veteran overdose decedents in San Diego County","authors":"Benjamin I. Felleman ,&nbsp;Neal M. Doran ,&nbsp;Octaviana Hemmy Asamsama ,&nbsp;Elizabeth M. Oliva ,&nbsp;Benjamin H. Han","doi":"10.1016/j.dadr.2025.100392","DOIUrl":"10.1016/j.dadr.2025.100392","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;National trends indicate that drug-related deaths among Veterans have been increasing from 2010 to 2019. The present study involves a recent analysis of drug mortality data for a single large Veterans Affairs (VA) Healthcare System. The aims of the study included (1) the identification of VA patients with drug-related deaths, (2) patient characteristics and service utilization patterns of VA patients with drug-related deaths, and (3) the evaluation of existing internal tracking systems for monitoring drug-related deaths.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This retrospective study matched VA enrollment records to San Diego County Medical Examiner (ME) data from January 2019 to June 2023. The records of individuals who died of a drug-related overdose in San Diego County were matched to VA medical records. Chart reviews were conducted to evaluate the extent to which intentional and accidental overdose events were documented in electronic medical records, and to examine demographic and clinical characteristics and healthcare utilization in Veterans who died by overdose.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From January 2019 to June 2023 there were a total of 140 drug overdose deaths, 91.4 % were accidental (&lt;em&gt;n&lt;/em&gt; = 128) and 8.6 % were intentional (n = 12). Prior to ME data matching, VA records captured 9.6 % of accidental drug overdoses (n = 15) and 100 % of intentional drug overdoses (n = 12). Fentanyl or fentanyl analogs were involved in 37.1 % (n = 52) of intentional and unintentional drug overdose deaths with the combination of fentanyl and methamphetamine being the next most specific common cause of death (n = 30; 21.4 %). In terms of VA healthcare utilization, in the year prior to their death, 63.6 % of Veterans accessed care. Among those 89&lt;!--&gt; &lt;!--&gt;VA patients, they most commonly utilized the emergency department (75 %) and primary care (56.2 %). Among the 20 % of Veterans with opioid use disorder (OUD), in the year prior to their death, 39.3 % were dispensed a prescription for naloxone and 35.7 % were dispensed a medication for OUD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Comparing VA records to county ME records revealed that VA records missed over 80 % of drug-related overdose deaths—4 out of every 5 deaths. While accurate for intentional overdoses, accidental overdoses—which comprise the vast majority of drug overdose deaths—were missing over 90 % of the time. Given that drug toxicology results were consistent with county trends, this suggests that VA records severely underestimate drug overdose deaths. Approximately two-thirds of VA patients who died of drug overdose access VA and most were seen in the emergency department and over half in primary care—identifying these as important intervention targets for overdose prevention. Given the gaps in capturing drug overdose deaths, other healthcare systems looking to prevent overdose deaths, and especially other VA systems, may want to consider adopting si","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100392"},"PeriodicalIF":2.9,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for harm reduction vending machine design among rural people who use drugs","authors":"April M. Young ,&nbsp;Tasfia Jahangir ,&nbsp;Susan Westneat ,&nbsp;Chelsi Cheatom ,&nbsp;Amanda Fallin-Bennett ,&nbsp;Laura C. Fanucchi ,&nbsp;Patricia R. Freeman ,&nbsp;Jennifer R. Havens ,&nbsp;Hannah K. Knudsen ,&nbsp;Kathryn E. McCollister ,&nbsp;Susannah Stitzer ,&nbsp;Jack Stone ,&nbsp;Peter Vickerman ,&nbsp;Melvin D. Livingston","doi":"10.1016/j.dadr.2025.100391","DOIUrl":"10.1016/j.dadr.2025.100391","url":null,"abstract":"<div><div>Globally, harm reduction vending machines (HRVMs) have been used for decades to dispense safe injection equipment and other supplies to people who use drugs (PWUD). However, HRVMs have only recently scaled up in the U.S. and few operate in rural settings. This study describes preferences for HRVM design among rural PWUD in two Appalachian Kentucky communities. Peer-referral and outreach were used to recruit participants (n = 731). Eligibility criteria were ≥ 18 years, residing in the target counties, and having used any drug (excluding alcohol, cannabis, and tobacco) to get high within 6 months. Interviewer-administered questionnaires elicited data on behavioral/demographic characteristics and HRVM design preferences. Sample characteristics and site-level differences were estimated accounting for peer-referral chain clustering. Naloxone was the most desired supply (95.6 %), followed by syringes (94.5 %) and fentanyl test strips (83.7 %). Supplies for basic needs were popular, including water (82.6 %), food (72.8 %), and personal care kits (71.3 %). The most endorsed location was the health department (71.1 %). More than twice the number of participants wanted HRVMs installed outdoors (52.3 %) rather than indoors (19.6 %), but for 25.4 %, indoor/outdoor installation preference varies depending on the venue. While over three-quarters reported that a surveillance camera would not affect their HRVM use, a substantial minority indicated it would be a deterrent, highlighting a key consideration for implementation. There were significant differences in supply and location preferences across the two communities. HRVMs may expand harm reduction service access in rural settings, but PWUD input is needed to ensure that their design responds to community needs.</div><div>Clinical Trials Registration</div><div>NCT05657106</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100391"},"PeriodicalIF":2.9,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145571738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mothers and fathers who use medical cannabis: A comparison of sociodemographic characteristics, cannabis use, and health","authors":"Janna Ataiants,&nbsp;Ekaterina V. Fedorova,&nbsp;Ojaswini D. Parab,&nbsp;Maddy Finkelstein,&nbsp;Elizabeth S. Valdez,&nbsp;Olivia Cordingley,&nbsp;Stephen E. Lankenau","doi":"10.1016/j.dadr.2025.100390","DOIUrl":"10.1016/j.dadr.2025.100390","url":null,"abstract":"<div><h3>Background</h3><div>While increasing numbers of parents use medical cannabis, little is known about their cannabis use or health, despite potential implications for child well-being. Recognizing that parenting is shaped by gendered roles and norms, this study compared mothers and fathers who use cannabis as medical cannabis patients.</div></div><div><h3>Methods</h3><div>Parents living with children (N = 372; 62.9 % mothers, 37.1 % fathers) were identified from an ongoing study of Pennsylvania-based medical cannabis patients. Bivariate and multivariable analyses assessed sociodemographic, cannabis use, and health characteristics by parent’s sex.</div></div><div><h3>Results</h3><div>Compared to fathers, mothers were less likely to be married, have a higher income, report arrest history, veteran status, and lifetime opioid misuse, and more likely to report PTSD (all <em>p</em> &lt; 0.05). Problematic cannabis use did not significantly differ by parent’s sex (mothers: 15.0 %; fathers: 20.3 %). However, mothers had lower odds of using concentrates (AOR: 0.56, 95 % CI: 0.33–0.96) and higher odds of using capsules (AOR: 1.87, 95 % CI: 1.09–3.19), tinctures (AOR: 1.71, 95 % CI: 1.01–2.87), using at specific times (AOR: 1.85, 95 % CI: 1.08–3.16), and using alone (AOR: 1.79, 95 % CI: 1.02–3.14). Mothers also had higher odds of frequent sleep problems (AOR: 1.96, 95 % CI: 1.18–3.25) and moderate-to-severe anxiety (AOR: 1.91, 95 % CI: 1.14–3.20).</div></div><div><h3>Discussion</h3><div>Mothers showed greater socioeconomic vulnerability, elevated anxiety and sleep disturbances, and more discreet cannabis use, while fathers had more flexible use patterns and fewer anxiety symptoms, despite greater lifetime adversity. These differences highlight the need for gender-responsive programs to support parents who use medical cannabis.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100390"},"PeriodicalIF":2.9,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nicotine pouch pharmacokinetics compared to smoked tobacco: A systematic review and meta-analysis","authors":"Javad Heshmati ,&nbsp;Emma Lynn Bates ,&nbsp;Spencer Shahen ,&nbsp;Sarah Visintini ,&nbsp;Evyanne Quirouette ,&nbsp;Kerri-Anne Mullen ,&nbsp;Hassan Mir","doi":"10.1016/j.dadr.2025.100389","DOIUrl":"10.1016/j.dadr.2025.100389","url":null,"abstract":"<div><div>Nicotine pouches (NP) are novel agents that deliver nicotine through buccal absorption as opposed to combustion. They are proposed as a harm reduction tool compared to smoking tobacco. However, there is limited evidence on their efficacy and safety. This review article summarizes the current evidence regarding NP pharmacokinetics compared to conventional tobacco products. We searched Medline, Embase, CENTRAL and Scopus for studies that assessed pharmacokinetic parameters of nicotine pouches. We identified studies involving tobacco-dependent adults and examined pharmacokinetic parameters such as total exposure, peak concentration, and time to peak. A meta-analysis was conducted using random-effects models to calculate pooled effect sizes. The Cochrane ROB 2.0 tool was used to evaluate the risk of bias in the included studies. A total of seven RCTs and crossover trials were included. Five compared NP pharmacokinetics with smoked tobacco, while two used moist snuff as comparators. Total nicotine exposure was significantly lower with 1.5<!--> <!-->mg and 2<!--> <!-->mg pouches, similar with 3.5<!--> <!-->mg and 4<!--> <!-->mg pouches, and significantly higher with pouches containing 8<!--> <!-->mg or more when compared to cigarettes. A meta-analysis of three trials showed that 4<!--> <!-->mg pouches delivered 91.73 % (95 % CI 85.03 %–98.42 %) of cigarette total nicotine exposure. Peak concentration was significantly lower with 1.5<!--> <!-->mg, 2<!--> <!-->mg, and 3.5<!--> <!-->mg pouches while higher concentration pouches had greater peak when compared to cigarettes. A meta-analysis of three trials showed that 4<!--> <!-->mg pouches showed a peak nicotine concentration of 69.15 % (95 % CI 58.55 %–79.76 %) compared with cigarettes. Peak nicotine concentration was consistently achieved earlier with cigarettes (5–8<!--> <!-->min) than with pouches (20–65<!--> <!-->min). Despite their buccal absorption, 4<!--> <!-->mg pouches (most commonly used), deliver similar total nicotine exposure to cigarettes, though with lower peak concentrations and slower absorption. When combined with their flavours and aggressive marketing to youth, this raises concerns about the potential of nicotine pouches to cause nicotine dependence, especially among those using the product recreationally.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100389"},"PeriodicalIF":2.9,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}