Pub Date : 2025-08-19DOI: 10.1016/j.dadr.2025.100371
Rebecca K. Denson , Mayra Guerrero , William Bond , Anna Patterson , Gina May , Tamar Polatsek , Robin J. Mermelstein
Background
Cannabis use in pregnancy is increasing, despite evidence linking perinatal cannabis use (PCU) to maternal and infant health risks. To investigate factors contributing to increasing PCU, this study used qualitative interviews to examine beliefs and perceptions of PCU.
Methods
Semi-structured qualitative interviews with pre- and post-pregnancy women examined beliefs and perceived benefits and harms of PCU. Interviews were transcribed and coded using a combined inductive/deductive approach. Thematic analysis identified themes related to beliefs, benefits, and harms associated with PCU.
Results
Twenty participants (50 % Black/African-American, 50 % White, 10 % Hispanic/Latina, mean age = 29.8 years) completed the study. Participants held contradictory beliefs about the safety of PCU, expressing ideas about both safety and potential harms. Perceived harms included themes of harm to infant/fetus, harm to pregnant women, and route of administration. Although most (75 %) participants had heard of potential PCU-related harms, participants were unsure about the accuracy of this information. Only one participant experienced PCU-related harm during pregnancy. Almost all (90 %) participants perceived benefits of PCU; these centered on coping with mental health symptoms, alleviation of pregnancy-related symptoms, and improved parenting experiences. Participants felt cannabis was effective in relieving perinatal symptoms of anxiety, depression, nausea, and vomiting.
Conclusions
Perceived benefits and perceptions that PCU is safe may underlie increasing prevalence. However, these beliefs and perceptions are nuanced, and may be influenced more by personal experience than information received about PCU risks. Education addressing pregnant women’s desire for credible, evidence-based information on PCU is crucial to inform decision-making and mitigate potential risks.
{"title":"Beliefs and perceived benefits and harms of perinatal cannabis use among pre- and post-pregnancy women","authors":"Rebecca K. Denson , Mayra Guerrero , William Bond , Anna Patterson , Gina May , Tamar Polatsek , Robin J. Mermelstein","doi":"10.1016/j.dadr.2025.100371","DOIUrl":"10.1016/j.dadr.2025.100371","url":null,"abstract":"<div><h3>Background</h3><div>Cannabis use in pregnancy is increasing, despite evidence linking perinatal cannabis use (PCU) to maternal and infant health risks. To investigate factors contributing to increasing PCU, this study used qualitative interviews to examine beliefs and perceptions of PCU.</div></div><div><h3>Methods</h3><div>Semi-structured qualitative interviews with pre- and post-pregnancy women examined beliefs and perceived benefits and harms of PCU. Interviews were transcribed and coded using a combined inductive/deductive approach. Thematic analysis identified themes related to beliefs, benefits, and harms associated with PCU.</div></div><div><h3>Results</h3><div>Twenty participants (50 % Black/African-American, 50 % White, 10 % Hispanic/Latina, mean age = 29.8 years) completed the study. Participants held contradictory beliefs about the safety of PCU, expressing ideas about both safety and potential harms. Perceived harms included themes of harm to infant/fetus, harm to pregnant women, and route of administration. Although most (75 %) participants had heard of potential PCU-related harms, participants were unsure about the accuracy of this information. Only one participant experienced PCU-related harm during pregnancy. Almost all (90 %) participants perceived benefits of PCU; these centered on coping with mental health symptoms, alleviation of pregnancy-related symptoms, and improved parenting experiences. Participants felt cannabis was effective in relieving perinatal symptoms of anxiety, depression, nausea, and vomiting.</div></div><div><h3>Conclusions</h3><div>Perceived benefits and perceptions that PCU is safe may underlie increasing prevalence. However, these beliefs and perceptions are nuanced, and may be influenced more by personal experience than information received about PCU risks. Education addressing pregnant women’s desire for credible, evidence-based information on PCU is crucial to inform decision-making and mitigate potential risks.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100371"},"PeriodicalIF":2.9,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144913239","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}
Pub Date : 2025-08-18DOI: 10.1016/j.dadr.2025.100373
Christine M. Kaiver , Erin L. Thompson , Samuel W. Hawes , Sarah M. Lehman , Ashley R. Adams , David Wing , Angela R. Laird , Raul Gonzalez
Physical Activity (PA) is important for mental, physical, and brain health. Adolescence is marked by increased engagement in risky substance use (SU) behaviors, which can negatively affect brain development. This study aims to determine if PA influences SU experimentation and initiation among adolescents. We predicted higher levels of PA would be associated with less SU, with a larger effect in more vigorous compared to light PA. A sample of 2541 participants from the Adolescent Brain Cognitive Development (ABCD) Study provided three weeks of Fitbit-measured PA data at the 2-year follow-up, and SU outcomes at the 3- and 4-year follow-up. SU outcomes of experimentation (i.e., sip/puff/try of alcohol, nicotine, or cannabis) and initiation (i.e., full drink of alcohol, more than a puff/try of nicotine or cannabis, or anything else) were examined dichotomously (i.e., yes/no). Logistic regression analyses were conducted, controlling for demographics, externalizing, and depressive symptoms endorsed on Child Behavior Checklist (CBCL). Total PA was associated with 24 % decreased odds in SU initiation (OR 0.82, 95 % CI 0.69–0.99, p < .05). After examining PA intensities more closely, light PA predicted 26 % decreased odds of SU initiation (OR 0.73, 95 % CI 0.61–0.88, p = .001). No significant associations emerged between PA and experimentation, or moderate and vigorous PA and initiation. More engagement in total and light PA reduced the odds of SU initiation, suggesting that low-intensity activity, not moderate or vigorous PA, may provide protection against adolescent SU. Future research should examine underlying mechanisms and contextual factors that account for these results.
体育活动(PA)对精神、身体和大脑健康都很重要。青春期的特点是更多地参与危险物质使用(SU)行为,这可能对大脑发育产生负面影响。本研究旨在确定PA是否影响青少年的SU实验和开始。我们预测,较高水平的PA与较低的SU相关,与轻度PA相比,更强烈的PA影响更大。来自青少年大脑认知发展(ABCD)研究的2541名参与者在2年随访期间提供了三周fitbit测量的PA数据,以及3年和4年随访时的SU结果。实验结果(即,小口/吸一口/尝试酒精、尼古丁或大麻)和开始(即,完全喝下酒精,多吸一口/尝试尼古丁或大麻,或其他任何东西)的两种方法(即,是/否)进行了检验。进行Logistic回归分析,控制人口统计学、外化和儿童行为检查表(CBCL)上的抑郁症状。总PA与发生SU的几率降低24%相关(OR 0.82, 95% CI 0.69-0.99, p < 0.05)。在更仔细地检查PA强度后,轻度PA预测SU发生的几率降低26% (OR 0.73, 95% CI 0.61-0.88, p = .001)。在PA和实验之间,或适度和剧烈的PA和入会之间没有显著的关联。更多的全强度和轻度PA的参与降低了SU发生的几率,这表明低强度的活动,而不是中度或剧烈的PA,可能对青少年SU提供保护。未来的研究应该检查解释这些结果的潜在机制和背景因素。
{"title":"The impact of physical activity on substance use experimentation and initiation among adolescents: Results from the ABCD Study® cohort","authors":"Christine M. Kaiver , Erin L. Thompson , Samuel W. Hawes , Sarah M. Lehman , Ashley R. Adams , David Wing , Angela R. Laird , Raul Gonzalez","doi":"10.1016/j.dadr.2025.100373","DOIUrl":"10.1016/j.dadr.2025.100373","url":null,"abstract":"<div><div>Physical Activity (PA) is important for mental, physical, and brain health. Adolescence is marked by increased engagement in risky substance use (SU) behaviors, which can negatively affect brain development. This study aims to determine if PA influences SU experimentation and initiation among adolescents. We predicted higher levels of PA would be associated with less SU, with a larger effect in more vigorous compared to light PA. A sample of 2541 participants from the Adolescent Brain Cognitive Development (ABCD) Study provided three weeks of Fitbit-measured PA data at the 2-year follow-up, and SU outcomes at the 3- and 4-year follow-up. SU outcomes of experimentation (i.e., sip/puff/try of alcohol, nicotine, or cannabis) and initiation (i.e., full drink of alcohol, more than a puff/try of nicotine or cannabis, or anything else) were examined dichotomously (i.e., yes/no). Logistic regression analyses were conducted, controlling for demographics, externalizing, and depressive symptoms endorsed on Child Behavior Checklist (CBCL). Total PA was associated with 24 % decreased odds in SU initiation (OR 0.82, 95 % CI 0.69–0.99, <em>p</em> < .05). After examining PA intensities more closely, light PA predicted 26 % decreased odds of SU initiation (OR 0.73, 95 % CI 0.61–0.88, p = .001). No significant associations emerged between PA and experimentation, or moderate and vigorous PA and initiation. More engagement in total and light PA reduced the odds of SU initiation, suggesting that low-intensity activity, not moderate or vigorous PA, may provide protection against adolescent SU. Future research should examine underlying mechanisms and contextual factors that account for these results.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100373"},"PeriodicalIF":2.9,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144904136","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}
Pub Date : 2025-08-10DOI: 10.1016/j.dadr.2025.100367
Rost Elin , Westergren Victor , Luksha Yauheni , Anna Mia Ekström , Lindberg Daniel
Background
Chemsex, typically defined as the use of specific psychoactive substances to enhance sexual experiences, has been linked to increased sexual health risks among men who have sex with men (MSM). This study examines frequency of chemsex use and associations between chemsex, risk-taking, and sexual practices among MSM on pre-exposure prophylaxis against HIV (PrEP) attending Sweden’s largest sexual health clinic.
Methods
A survey among MSM on PrEP (n = 290) mapped demographics, sexualized drug use, sexual practices, and alcohol use at Venhälsan, (South General Hospital), Stockholm, Sweden.
Results
18 % engaged in chemsex at least once in the past year and 49 % of respondents using chemsex reported high-risk alcohol use or alcohol dependence and 13 % classified as dependent. Most individuals on PrEP practiced unprotected sex, 42 % used condoms as passive/bottom, only 31 % as active/top. Chemsex tripled the odds of not using a condom at least 50 % of the time: adjusted for age, education, AUDIT, and being born in Sweden. Participants using chemsex were 3 times more likely, to have more than 14 temporary partners (past year) and were twice as likely to engage in group sex (82 %) compared to those not using chemsex (40 %).
Conclusions
Chemsex was associated with a threefold increased risk of condomless sex and showed a significant link to alcohol dependency. While PrEP offers effective protection against HIV infection, it does not prevent sexually transmitted infections. Health professionals and social workers should identify MSM who engage in chemsex and tailor interventions to address their specific needs.
{"title":"Chemsex and sexual risk behavior among MSM on PrEP in Stockholm, Sweden","authors":"Rost Elin , Westergren Victor , Luksha Yauheni , Anna Mia Ekström , Lindberg Daniel","doi":"10.1016/j.dadr.2025.100367","DOIUrl":"10.1016/j.dadr.2025.100367","url":null,"abstract":"<div><h3>Background</h3><div>Chemsex, typically defined as the use of specific psychoactive substances to enhance sexual experiences, has been linked to increased sexual health risks among men who have sex with men (MSM). This study examines frequency of chemsex use and associations between chemsex, risk-taking, and sexual practices among MSM on pre-exposure prophylaxis against HIV (PrEP) attending Sweden’s largest sexual health clinic.</div></div><div><h3>Methods</h3><div>A survey among MSM on PrEP (n = 290) mapped demographics, sexualized drug use, sexual practices, and alcohol use at Venhälsan, (South General Hospital), Stockholm, Sweden.</div></div><div><h3>Results</h3><div>18 % engaged in chemsex at least once in the past year and 49 % of respondents using chemsex reported high-risk alcohol use or alcohol dependence and 13 % classified as dependent. Most individuals on PrEP practiced unprotected sex, 42 % used condoms as passive/bottom, only 31 % as active/top. Chemsex tripled the odds of not using a condom at least 50 % of the time: adjusted for age, education, AUDIT, and being born in Sweden. Participants using chemsex were 3 times more likely, to have more than 14 temporary partners (past year) and were twice as likely to engage in group sex (82 %) compared to those not using chemsex (40 %).</div></div><div><h3>Conclusions</h3><div>Chemsex was associated with a threefold increased risk of condomless sex and showed a significant link to alcohol dependency. While PrEP offers effective protection against HIV infection, it does not prevent sexually transmitted infections. Health professionals and social workers should identify MSM who engage in chemsex and tailor interventions to address their specific needs.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100367"},"PeriodicalIF":2.9,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852735","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}
Pub Date : 2025-08-06eCollection Date: 2025-09-01DOI: 10.1016/j.dadr.2025.100370
Juhan Lee, Frank Merenda, Andrea H Weinberger
Background: The rising use of nicotine pouches has emerged as a public health concern. Increasing use might be driven by exposure to marketing (e.g., discounts, coupons) but little is known about marketing and nicotine pouch use. This study is the first to use United States (US) nationally representative data to examine the relationship between exposure to discounts and coupons for nicotine pouches and nicotine pouch use among US adults.
Methods: Using respondents from the Population Assessment of Tobacco and Health (PATH) Study Wave 7 (2022-2023) dataset (N = 27,712), we examined the association between past 12-month exposure to nicotine pouch discounts/coupons and past-30-day nicotine pouch use, adjusting for sociodemographic, psychological, and behavioral covariates.
Results: Among respondents, 0.3 % (weighted) reported past-12-month receipt of discounts or coupons for nicotine pouches, and 0.8 % reported past-30-day use of nicotine pouches, with a significant bivariate association (p < 0.001). After controlling for covariates, individuals exposed to discounts or coupons for nicotine pouches during the past 12 months were more likely to report past-30-day use of nicotine pouches (adjusted odds ratio=33.85, 95 % confidence interval=19.13, 59.92).
Conclusions: Exposure to discounts/coupons for nicotine pouches was associated with an increased risk of product use in the past 30 days among US adults. Continual surveillance of tobacco marketing strategies and sustained research efforts are necessary to inform tobacco control efforts and cessation strategies related to nicotine pouches.
{"title":"Receiving coupons and discounts for nicotine pouches is associated with current use of nicotine pouches among United States adults: Results from the population assessment of tobacco and health (PATH) study wave 7 (2022-2023).","authors":"Juhan Lee, Frank Merenda, Andrea H Weinberger","doi":"10.1016/j.dadr.2025.100370","DOIUrl":"10.1016/j.dadr.2025.100370","url":null,"abstract":"<p><strong>Background: </strong>The rising use of nicotine pouches has emerged as a public health concern. Increasing use might be driven by exposure to marketing (e.g., discounts, coupons) but little is known about marketing and nicotine pouch use. This study is the first to use United States (US) nationally representative data to examine the relationship between exposure to discounts and coupons for nicotine pouches and nicotine pouch use among US adults.</p><p><strong>Methods: </strong>Using respondents from the Population Assessment of Tobacco and Health (PATH) Study Wave 7 (2022-2023) dataset (N = 27,712), we examined the association between past 12-month exposure to nicotine pouch discounts/coupons and past-30-day nicotine pouch use, adjusting for sociodemographic, psychological, and behavioral covariates.</p><p><strong>Results: </strong>Among respondents, 0.3 % (weighted) reported past-12-month receipt of discounts or coupons for nicotine pouches, and 0.8 % reported past-30-day use of nicotine pouches, with a significant bivariate association (p < 0.001). After controlling for covariates, individuals exposed to discounts or coupons for nicotine pouches during the past 12 months were more likely to report past-30-day use of nicotine pouches (adjusted odds ratio=33.85, 95 % confidence interval=19.13, 59.92).</p><p><strong>Conclusions: </strong>Exposure to discounts/coupons for nicotine pouches was associated with an increased risk of product use in the past 30 days among US adults. Continual surveillance of tobacco marketing strategies and sustained research efforts are necessary to inform tobacco control efforts and cessation strategies related to nicotine pouches.</p>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"100370"},"PeriodicalIF":2.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877093","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 : 2025-07-30DOI: 10.1016/j.dadr.2025.100369
Rachel A. Rabin , Joseph Farrugia , Ranjini Garani , Romina Mizrahi , Pablo Rusjan
Tobacco is commonly co-used with cannabis. This is unfortunate because tobacco co-use exacerbates select clinical consequences associated with cannabis use. Evidence demonstrates that low levels of anandamide, a prominent endocannabinoid, correlate with worse clinical outcomes. Fatty acid amide hydrolase (FAAH) degrades anandamide, and greater FAAH levels may underlie poorer clinical outcomes in people who co-use relative to those who use only cannabis. Therefore, we tested whether tobacco co-use increases FAAH levels beyond those associated with cannabis use alone. Cannabis-using participants (N = 13) were parsed into individuals with daily tobacco use (CT, n = 5) and no current tobacco use (CAN, n = 8). We evaluated group differences in FAAH, quantified using positron emission tomography and [11C]CURB, while controlling for sex and FAAH genotype in the prefrontal cortex, hippocampus, thalamus, sensorimotor striatum, substantia nigra, and cerebellum. A significant group x ROI interaction for [11C]CURB λk3 [F(5, 45)= 3.15, p = 0.016] emerged. Bonferroni-corrected post-hoc tests indicated greater FAAH levels in CT compared to CAN in the substantia nigra (p = 0.023, d=1.54) and cerebellum (p = 0.003, d=1.76), while a trend emerged in the sensorimotor striatum (p = 0.054, d=1.33). Preliminary findings suggest that tobacco co-use is associated with elevated FAAH activity relative to cannabis-only use, which may underlie poorer clinical outcomes associated with co-use.
烟草通常与大麻一起使用。这是不幸的,因为烟草的共同使用加剧了与大麻使用相关的某些临床后果。有证据表明,低水平的anandamide(一种重要的内源性大麻素)与较差的临床结果相关。脂肪酸酰胺水解酶(FAAH)可降解大麻酰胺,与仅使用大麻的人相比,共同使用大麻的人的FAAH水平较高,可能导致临床结果较差。因此,我们测试了共同使用烟草是否比单独使用大麻增加了FAAH水平。使用大麻的参与者(N = 13)被分为每天吸烟的个体(CT, N = 5)和目前不吸烟的个体(CAN, N = 8)。我们评估各组FAAH的差异,使用正电子发射断层扫描和[11C]CURB进行量化,同时控制前额皮质、海马、丘脑、感觉运动纹状体、黑质和小脑中FAAH的性别和基因型。[11C]CURB λk3 [F(5,45)= 3.15, p = 0.016]出现了显著的组x ROI交互作用。bonferroni校正后的事后测试显示,CT显示FAAH水平高于CAN在黑质(p = 0.023, d=1.54)和小脑(p = 0.003, d=1.76),而在感觉运动纹状体(p = 0.054, d=1.33)中也出现了这种趋势。初步研究结果表明,与仅使用大麻相比,烟草共使用与FAAH活性升高有关,这可能是与共使用相关的较差临床结果的基础。
{"title":"A preliminary investigation of tobacco co-use on endocannabinoid activity in people with cannabis use","authors":"Rachel A. Rabin , Joseph Farrugia , Ranjini Garani , Romina Mizrahi , Pablo Rusjan","doi":"10.1016/j.dadr.2025.100369","DOIUrl":"10.1016/j.dadr.2025.100369","url":null,"abstract":"<div><div>Tobacco is commonly co-used with cannabis. This is unfortunate because tobacco co-use exacerbates select clinical consequences associated with cannabis use. Evidence demonstrates that low levels of anandamide, a prominent endocannabinoid, correlate with worse clinical outcomes. Fatty acid amide hydrolase (FAAH) degrades anandamide, and greater FAAH levels may underlie poorer clinical outcomes in people who co-use relative to those who use only cannabis. Therefore, we tested whether tobacco co-use increases FAAH levels beyond those associated with cannabis use alone. Cannabis-using participants (N = 13) were parsed into individuals with daily tobacco use (CT, n = 5) and no current tobacco use (CAN, n = 8). We evaluated group differences in FAAH, quantified using positron emission tomography and [<sup>11</sup>C]CURB, while controlling for sex and FAAH genotype in the prefrontal cortex, hippocampus, thalamus, sensorimotor striatum, substantia nigra, and cerebellum. A significant group x ROI interaction for [<sup>11</sup>C]CURB λk<sub>3</sub> [F(5, 45)= 3.15, p = 0.016] emerged. Bonferroni-corrected post-hoc tests indicated greater FAAH levels in CT compared to CAN in the substantia nigra (p = 0.023, d=1.54) and cerebellum (p = 0.003, d=1.76), while a trend emerged in the sensorimotor striatum (p = 0.054, d=1.33). Preliminary findings suggest that tobacco co-use is associated with elevated FAAH activity relative to cannabis-only use, which may underlie poorer clinical outcomes associated with co-use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100369"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756840","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}
Pub Date : 2025-07-29DOI: 10.1016/j.dadr.2025.100368
Paige Guyatt , Glenda Babe , Anastasia Gayowsky , Tea Rosic , Myanca Rodrigues , Paxton Bach , Richard Perez , Claire de Oliveira , Jeffrey H. Samet , Geneviève Kerkerian , Jessica Hann , Joanna C. Dionne , Aijaz Ahmed , Donghee Kim , Seonaid Nolan , Lehana Thabane , Zainab Samaan , Brittany B. Dennis
Objectives
Varied substance use outcomes have been reported among individuals with a hepatitis C viral (HCV) infection on opioid agonist treatment (OAT) for opioid use disorder. Accordingly, the current study sought to evaluate the association between HCV serostatus, among other factors, and opioid-related acute health service utilization (e.g., emergency department [ED] visits and hospitalizations) among individuals prescribed OAT.
Methods
Multi-site prospective cohort study data were used to characterize demographic characteristics, substance use patterns, and physical health amongst individuals prescribed OAT. Logistic regression models were built to estimate the association between HCV-seropositivity and opioid-related ED visits and hospitalizations over a three-year follow up period.
Results
Among 3430 participants, 10.6 % (n = 365) were HCV-seropositive. In the follow-up period, 21.3 % (n = 730) attended the ED and 8.7 % (n = 298) were hospitalized for opioid related-harms. HCV-seropositivity was associated with an increased incidence of ED visits for opioid poisoning (9.0 % vs 4.9 % for participants who were HCV-seronegative, p < 0.01) and other opioid-related harms (22.5 % vs. 20.8 % for seronegative participants, p = 0.03). However, multiple logistical regression models showed no association between HCV serostatus and opioid-related health service utilization; rather, injection drug use was a significant predictor of opioid-related ED visits (OR 3.39, p < 0.01) and hospitalizations (OR 1.21, p = 0.01).
Conclusion
Among individuals prescribed OAT, those with seropositive HCV have increased incidence of ED visits and hospitalizations for opioid-related harms, an association which may be driven by injection use practices. These findings highlight the importance of screening for injection use practices and health symptoms, as well as the potential role for targeting resources (e.g., harm reduction supplies, education regarding transmission) within this vulnerable subgroup.
{"title":"Impact of hepatitis C serostatus on health service utilization for opioid-related harms among individuals prescribed opioid agonist therapy: A longitudinal prospective cohort study","authors":"Paige Guyatt , Glenda Babe , Anastasia Gayowsky , Tea Rosic , Myanca Rodrigues , Paxton Bach , Richard Perez , Claire de Oliveira , Jeffrey H. Samet , Geneviève Kerkerian , Jessica Hann , Joanna C. Dionne , Aijaz Ahmed , Donghee Kim , Seonaid Nolan , Lehana Thabane , Zainab Samaan , Brittany B. Dennis","doi":"10.1016/j.dadr.2025.100368","DOIUrl":"10.1016/j.dadr.2025.100368","url":null,"abstract":"<div><h3>Objectives</h3><div>Varied substance use outcomes have been reported among individuals with a hepatitis C viral (HCV) infection on opioid agonist treatment (OAT) for opioid use disorder. Accordingly, the current study sought to evaluate the association between HCV serostatus, among other factors, and opioid-related acute health service utilization (e.g., emergency department [ED] visits and hospitalizations) among individuals prescribed OAT.</div></div><div><h3>Methods</h3><div>Multi-site prospective cohort study data were used to characterize demographic characteristics, substance use patterns, and physical health amongst individuals prescribed OAT. Logistic regression models were built to estimate the association between HCV-seropositivity and opioid-related ED visits and hospitalizations over a three-year follow up period.</div></div><div><h3>Results</h3><div>Among 3430 participants, 10.6 % (<em>n</em> = 365) were HCV-seropositive. In the follow-up period, 21.3 % (<em>n</em> = 730) attended the ED and 8.7 % (<em>n</em> = 298) were hospitalized for opioid related-harms. HCV-seropositivity was associated with an increased incidence of ED visits for opioid poisoning (9.0 % vs 4.9 % for participants who were HCV-seronegative, p < 0.01) and other opioid-related harms (22.5 % vs. 20.8 % for seronegative participants, p = 0.03). However, multiple logistical regression models showed no association between HCV serostatus and opioid-related health service utilization; rather, injection drug use was a significant predictor of opioid-related ED visits (OR 3.39, p < 0.01) and hospitalizations (OR 1.21, p = 0.01).</div></div><div><h3>Conclusion</h3><div>Among individuals prescribed OAT, those with seropositive HCV have increased incidence of ED visits and hospitalizations for opioid-related harms, an association which may be driven by injection use practices. These findings highlight the importance of screening for injection use practices and health symptoms, as well as the potential role for targeting resources (e.g., harm reduction supplies, education regarding transmission) within this vulnerable subgroup.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100368"},"PeriodicalIF":2.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826992","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}
Pub Date : 2025-07-26DOI: 10.1016/j.dadr.2025.100366
Andrea RAYNAK , Michel Bédard , Brianne Wood , Christopher Mushquash
Background
The Alcohol and Alcohol Problems Perception Questionnaire and the Drug and Drug Problems Perception Questionnaires were developed decades ago to assess health care providers’ attitudes toward patients who use substances. Although reliable, the language in these tools no longer aligns with contemporary societal and academic discourse on person-centred language. Therefore, this study aimed to evaluate whether modifying the language in the Alcohol and Alcohol Problems Perception Questionnaire and Drug and Drug Problems Perception Questionnaire to create the person-centered Alcohol and Alcohol Problems Perception Questionnaire and person-centered Drug and Drug Problems Perception Questionnaire would affect their reliability, internal consistency, and factor structures when used with registered nurses and registered practical nurses.
Methods
In fall 2024, an electronic survey was distributed to 1400 RNs and RPNs at an acute care hospital in northwestern Ontario, with 412 responding (29.4 % response rate). Participants were randomly assigned to complete either the original Alcohol and Alcohol Problems Perception Questionnaire and Drug and Drug Problems Perception Questionnaire or the revised person-centred versions. Confirmatory factor analysis and exploratory factor analysis were conducted to assess the factor structures of both versions.
Results
Confirmatory factor analysis revealed suboptimal model fits for both the Alcohol and Alcohol Problems Perception Questionnaire and the person-centred Alcohol and Alcohol Problems Perception Questionnaire. The best-fitting Alcohol and Alcohol Problems Perception Questionnaire was a seven-factor, 30-item model, and the person-centred Alcohol and Alcohol Problems Perception Questionnaire was a revised four-factor, 22-item model after exploratory factor analysis. Confirmatory factor analysis for the Drug and Drug Problems Perception Questionnaire indicated support for the original five-factor structure, but a four-factor, 16-item model emerged after exploratory factor analysis for the person-centred version.
Conclusions
Although limited by a small sample size and data from a single setting, the findings of this study provide preliminary support that slightly modified versions of the PC- AAPPQ and PC-DDPPQ may hold promise for use with practising clinical nurses in similar contexts.
{"title":"Adapting the alcohol and alcohol problems perception questionnaire and the drug and drug problems perception questionnaire: A psychometric analysis of a person-centred approach","authors":"Andrea RAYNAK , Michel Bédard , Brianne Wood , Christopher Mushquash","doi":"10.1016/j.dadr.2025.100366","DOIUrl":"10.1016/j.dadr.2025.100366","url":null,"abstract":"<div><h3>Background</h3><div>The Alcohol and Alcohol Problems Perception Questionnaire and the Drug and Drug Problems Perception Questionnaires were developed decades ago to assess health care providers’ attitudes toward patients who use substances. Although reliable, the language in these tools no longer aligns with contemporary societal and academic discourse on person-centred language. Therefore, this study aimed to evaluate whether modifying the language in the Alcohol and Alcohol Problems Perception Questionnaire and Drug and Drug Problems Perception Questionnaire to create the person-centered Alcohol and Alcohol Problems Perception Questionnaire and person-centered Drug and Drug Problems Perception Questionnaire would affect their reliability, internal consistency, and factor structures when used with registered nurses and registered practical nurses.</div></div><div><h3>Methods</h3><div>In fall 2024, an electronic survey was distributed to 1400 RNs and RPNs at an acute care hospital in northwestern Ontario, with 412 responding (29.4 % response rate). Participants were randomly assigned to complete either the original Alcohol and Alcohol Problems Perception Questionnaire and Drug and Drug Problems Perception Questionnaire or the revised person-centred versions. Confirmatory factor analysis and exploratory factor analysis were conducted to assess the factor structures of both versions.</div></div><div><h3>Results</h3><div>Confirmatory factor analysis revealed suboptimal model fits for both the Alcohol and Alcohol Problems Perception Questionnaire and the person-centred Alcohol and Alcohol Problems Perception Questionnaire. The best-fitting Alcohol and Alcohol Problems Perception Questionnaire was a seven-factor, 30-item model, and the person-centred Alcohol and Alcohol Problems Perception Questionnaire was a revised four-factor, 22-item model after exploratory factor analysis. Confirmatory factor analysis for the Drug and Drug Problems Perception Questionnaire indicated support for the original five-factor structure, but a four-factor, 16-item model emerged after exploratory factor analysis for the person-centred version.</div></div><div><h3>Conclusions</h3><div>Although limited by a small sample size and data from a single setting, the findings of this study provide preliminary support that slightly modified versions of the PC- AAPPQ and PC-DDPPQ may hold promise for use with practising clinical nurses in similar contexts.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100366"},"PeriodicalIF":2.9,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756841","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}
Pub Date : 2025-07-22DOI: 10.1016/j.dadr.2025.100363
Mark Hawes , Jessica Alway , Deepalika Chakravarty , Margot Kushel , Wendy Max , Fan Xia , Narges Neyazi , Maya Vijayaraghavan
Introduction
Globally, tobacco use causes 8.7 million deaths annually. Approximately 50 % of formerly homeless adults in permanent supportive housing (PSH) in the United States smoke cigarettes. Secondhand smoke exposure is high in the absence of smoke-free policies. There is a need to understand attitudes toward smoke-free policies and factors associated with smoke-free home adoption attempts among PSH residents.
Methods
Between 2022 and 2024, we recruited 400 PSH residents who smoked into a smoke-free home intervention trial in 40 multi-unit PSH sites. Using baseline data, we applied generalized linear mixed models to examine factors associated with past 3-month smoke-free home adoption attempts, adjusting for age, gender, and race-ethnicity.
Results
Median age was 56 years (IQR 46, 62), and 41.8 % were Black/African American. Of the sample, 34.8 % previously attempted to adopt a smoke-free home, daily cigarette consumption averaged 11.1 (SD 7.5), and 19.3 % used e-cigarettes in the past 30 days. E-cigarette use (AOR 2.92, 95 % CI 1.48, 5.77) and positive attitudes toward smoke-free policies (AOR 2.13, 95 % CI 1.43, 3.18) were associated with increased odds of smoke-free home adoption attempts. Longer tenure at current residence (AOR 0.94, 95 % CI 0.89, 0.99), smoking within 5 min of waking (AOR 0.55, 95 % CI 0.31, 0.97), and having a serious mental illness (AOR 0.51, 95 % CI 0.30, 0.88) were associated with lower odds.
Conclusions
Support for smoke-free policies among PSH residents can be strengthened by promoting access to tobacco treatment, addressing the role of e-cigarette use, and providing tailored support for residents with serious mental illness.
在全球范围内,烟草使用每年造成870万人死亡。在美国,住在永久性支持性住房(PSH)的前无家可归的成年人中约有50%吸烟。在没有无烟政策的情况下,二手烟暴露率很高。有必要了解PSH居民对无烟政策的态度以及与无烟家庭收养尝试相关的因素。方法在2022年至2024年间,我们在40个多单元PSH站点招募了400名吸烟的PSH居民参加无烟家庭干预试验。使用基线数据,我们应用广义线性混合模型来检查与过去3个月无烟家庭收养尝试相关的因素,调整年龄、性别和种族。结果中位年龄为56岁(IQR 46,62), 41.8%为黑人/非裔美国人。在样本中,34.8%的人曾经尝试过无烟家庭,每天平均吸烟11.1支(SD 7.5), 19.3%的人在过去30天内使用过电子烟。使用电子烟(AOR 2.92, 95% CI 1.48, 5.77)和对无烟政策的积极态度(AOR 2.13, 95% CI 1.43, 3.18)与尝试在家中采用无烟的几率增加有关。较长的居住时间(AOR 0.94, 95% CI 0.89, 0.99)、清醒后5分钟内吸烟(AOR 0.55, 95% CI 0.31, 0.97)以及患有严重精神疾病(AOR 0.51, 95% CI 0.30, 0.88)与较低的风险相关。结论可通过促进烟草治疗的可及性,解决电子烟使用的作用,并为患有严重精神疾病的居民提供有针对性的支持,加强对PSH居民无烟政策的支持。
{"title":"Cigarette smoke-free home adoption attempts among formerly homeless adults living in permanent supportive housing","authors":"Mark Hawes , Jessica Alway , Deepalika Chakravarty , Margot Kushel , Wendy Max , Fan Xia , Narges Neyazi , Maya Vijayaraghavan","doi":"10.1016/j.dadr.2025.100363","DOIUrl":"10.1016/j.dadr.2025.100363","url":null,"abstract":"<div><h3>Introduction</h3><div>Globally, tobacco use causes 8.7 million deaths annually. Approximately 50 % of formerly homeless adults in permanent supportive housing (PSH) in the United States smoke cigarettes. Secondhand smoke exposure is high in the absence of smoke-free policies. There is a need to understand attitudes toward smoke-free policies and factors associated with smoke-free home adoption attempts among PSH residents.</div></div><div><h3>Methods</h3><div>Between 2022 and 2024, we recruited 400 PSH residents who smoked into a smoke-free home intervention trial in 40 multi-unit PSH sites. Using baseline data, we applied generalized linear mixed models to examine factors associated with past 3-month smoke-free home adoption attempts, adjusting for age, gender, and race-ethnicity.</div></div><div><h3>Results</h3><div>Median age was 56 years (IQR 46, 62), and 41.8 % were Black/African American. Of the sample, 34.8 % previously attempted to adopt a smoke-free home, daily cigarette consumption averaged 11.1 (SD 7.5), and 19.3 % used e-cigarettes in the past 30 days. E-cigarette use (AOR 2.92, 95 % CI 1.48, 5.77) and positive attitudes toward smoke-free policies (AOR 2.13, 95 % CI 1.43, 3.18) were associated with increased odds of smoke-free home adoption attempts. Longer tenure at current residence (AOR 0.94, 95 % CI 0.89, 0.99), smoking within 5<!--> <!-->min of waking (AOR 0.55, 95 % CI 0.31, 0.97), and having a serious mental illness (AOR 0.51, 95 % CI 0.30, 0.88) were associated with lower odds.</div></div><div><h3>Conclusions</h3><div>Support for smoke-free policies among PSH residents can be strengthened by promoting access to tobacco treatment, addressing the role of e-cigarette use, and providing tailored support for residents with serious mental illness.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100363"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714281","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}
Pub Date : 2025-07-22DOI: 10.1016/j.dadr.2025.100365
Lindsey K. Galbo-Thomma , Carly Baehr , Elaine A. Gay , Scott Runyon , Marco Pravetoni , Charles P. France
Approximately 70 % of fatal drug overdoses in the United States are attributed to fentanyl and fentanyl analogs. Current medications for reversing overdose and treating opioid use disorder might not be as effective against fentanyl and fentanyl analogs compared with other opioids, possibly due to their lipophilicity and high potency at the mu-opioid receptor (MOR). Hence, fentanyl and fentanyl analog-targeting monoclonal antibodies (mAb) could be an alternative treatment. The humanized (h) mAb hHY6-F9 has high relative affinity for fentanyl and decreases intravenous (i.v.) fentanyl self-administration in monkeys. hHY6-F9 has lower affinity for fentanyl analogs, including carfentanil; however, the effects of hHY6-F9 on fentanyl analogs in vivo have not been characterized. This study examined the effects of hHY6-F9 on i.v. carfentanil self-administration. hHY6-F9 was administered to two male rhesus monkeys self-administering carfentanil, heroin, cocaine, or fentanyl during twice daily sessions. Based on prior in vitro and in vivo findings, hHY6-F9 was hypothesized to attenuate fentanyl but not carfentanil, heroin, or cocaine self-administration. However, hHY6-F9 significantly decreased carfentanil self-administration for up to 5 weeks while having little or no effect on heroin, cocaine, or fentanyl self-administration. A cell-based pharmacological assay of carfentanil-induced MOR activation supported the carfentanil self-administration findings, showing that murine HY6-F9 reduced the effects of carfentanil. The ability of hHY6-F9 to attenuate the effects of an ultra-potent fentanyl analog could be advantageous for treating opioid use disorder or overdose given the unpredictability of the unregulated opioid supply.
{"title":"A humanized monoclonal antibody attenuates carfentanil self-administration in nonhuman primates","authors":"Lindsey K. Galbo-Thomma , Carly Baehr , Elaine A. Gay , Scott Runyon , Marco Pravetoni , Charles P. France","doi":"10.1016/j.dadr.2025.100365","DOIUrl":"10.1016/j.dadr.2025.100365","url":null,"abstract":"<div><div>Approximately 70 % of fatal drug overdoses in the United States are attributed to fentanyl and fentanyl analogs. Current medications for reversing overdose and treating opioid use disorder might not be as effective against fentanyl and fentanyl analogs compared with other opioids, possibly due to their lipophilicity and high potency at the <em>mu</em>-opioid receptor (MOR). Hence, fentanyl and fentanyl analog-targeting monoclonal antibodies (mAb) could be an alternative treatment. The humanized (h) mAb hHY6-F9 has high relative affinity for fentanyl and decreases intravenous (i.v.) fentanyl self-administration in monkeys. hHY6-F9 has lower affinity for fentanyl analogs, including carfentanil; however, the effects of hHY6-F9 on fentanyl analogs <em>in vivo</em> have not been characterized. This study examined the effects of hHY6-F9 on i.v. carfentanil self-administration. hHY6-F9 was administered to two male rhesus monkeys self-administering carfentanil, heroin, cocaine, or fentanyl during twice daily sessions. Based on prior <em>in vitro</em> and <em>in vivo</em> findings, hHY6-F9 was hypothesized to attenuate fentanyl but not carfentanil, heroin, or cocaine self-administration. However, hHY6-F9 significantly decreased carfentanil self-administration for up to 5 weeks while having little or no effect on heroin, cocaine, or fentanyl self-administration. A cell-based pharmacological assay of carfentanil-induced MOR activation supported the carfentanil self-administration findings, showing that murine HY6-F9 reduced the effects of carfentanil. The ability of hHY6-F9 to attenuate the effects of an ultra-potent fentanyl analog could be advantageous for treating opioid use disorder or overdose given the unpredictability of the unregulated opioid supply.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100365"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724436","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}
Pub Date : 2025-07-22DOI: 10.1016/j.dadr.2025.100364
Joseph Friedman , Caitlin A. Molina , Adam J. Koncsol , Ruby Romero , Morgan E. Godvin , Elham Jalayer , Spider Davila , Oscar Arellano , Amanda Cowan , Brian Hurley , Chelsea L. Shover
Background
The veterinary sedative xylazine has been mostly described on the East Coast—yet early reports indicate that it is now arriving to West Coast fentanyl markets. Emerging drug checking approaches can provide information about the concentration and prevalence of xylazine in illicit fentanyl.
Methods
Fentanyl samples from a community-based drug checking program in Los Angeles, California were assessed using direct analysis in real time mass spectrometry (DART-MS). A subset was analyzed with liquid chromatography-mass spectrometry (LC-MS) to quantify the concentration of xylazine, fentanyl, and other compounds.
Results
Among n = 536 fentanyl-positive samples, n = 103 were xylazine-positive, and n = 78 had quantitative results available. Xylazine positivity rose from 0 % in 2023 quarter 1 to a peak of 29.5 % in 2025 quarter 1. A significant time trend was observed (OR per quarter year= 1.35 [95 %CI: 1.19–1.52]). Xylazine concentration in fentanyl samples was generally low, with a highly skewed distribution (mean=2.42 %, sd=7.80 %). 76.9 % of xylazine-positive samples had <1.0 % xylazine concentration. Compared to xylazine-negative samples, xylazine-positive samples were more likely to contain bis(2,2,6,6-tetramethyl-4-piperidyl) sebacate (BTMPS) [46.60 % vs 17.30 %], and lidocaine (65.0 % vs 29.6 %), and had lower average fentanyl concentration (6.12 % vs 10.7 %).
Conclusions
We note increasing xylazine positivity among samples of illicit fentanyl in Los Angeles, California. The distribution of xylazine concentration is highly skewed, with a small number of very high concentration samples, and majority with <1 %. Nevertheless, more research is needed to study the health impacts of even the low concentration xylazine that is most predominant here; the average participant may still be exposed to a physiologically significant dose of xylazine.
{"title":"Xylazine prevalence and concentration in the Los Angeles fentanyl market, 2023–2025","authors":"Joseph Friedman , Caitlin A. Molina , Adam J. Koncsol , Ruby Romero , Morgan E. Godvin , Elham Jalayer , Spider Davila , Oscar Arellano , Amanda Cowan , Brian Hurley , Chelsea L. Shover","doi":"10.1016/j.dadr.2025.100364","DOIUrl":"10.1016/j.dadr.2025.100364","url":null,"abstract":"<div><h3>Background</h3><div>The veterinary sedative xylazine has been mostly described on the East Coast—yet early reports indicate that it is now arriving to West Coast fentanyl markets. Emerging drug checking approaches can provide information about the concentration and prevalence of xylazine in illicit fentanyl.</div></div><div><h3>Methods</h3><div>Fentanyl samples from a community-based drug checking program in Los Angeles, California were assessed using direct analysis in real time mass spectrometry (DART-MS). A subset was analyzed with liquid chromatography-mass spectrometry (LC-MS) to quantify the concentration of xylazine, fentanyl, and other compounds.</div></div><div><h3>Results</h3><div>Among n = 536 fentanyl-positive samples, n = 103 were xylazine-positive, and n = 78 had quantitative results available. Xylazine positivity rose from 0 % in 2023 quarter 1 to a peak of 29.5 % in 2025 quarter 1. A significant time trend was observed (OR per quarter year= 1.35 [95 %CI: 1.19–1.52]). Xylazine concentration in fentanyl samples was generally low, with a highly skewed distribution (mean=2.42 %, sd=7.80 %). 76.9 % of xylazine-positive samples had <1.0 % xylazine concentration. Compared to xylazine-negative samples, xylazine-positive samples were more likely to contain bis(2,2,6,6-tetramethyl-4-piperidyl) sebacate (BTMPS) [46.60 % vs 17.30 %], and lidocaine (65.0 % vs 29.6 %), and had lower average fentanyl concentration (6.12 % vs 10.7 %).</div></div><div><h3>Conclusions</h3><div>We note increasing xylazine positivity among samples of illicit fentanyl in Los Angeles, California. The distribution of xylazine concentration is highly skewed, with a small number of very high concentration samples, and majority with <1 %. Nevertheless, more research is needed to study the health impacts of even the low concentration xylazine that is most predominant here; the average participant may still be exposed to a physiologically significant dose of xylazine.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100364"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714282","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}