Pub Date : 2025-06-13DOI: 10.1016/j.dadr.2025.100350
Chrystal Vergara-Lopez , George D. Papandonatos , Margaret H. Bublitz , Alicia M. Allen , Laura R. Stroud
Introduction
Exogenous and endogenous ovarian hormones (e.g., estradiol, progesterone) may influence nicotine use. Prior research has focused on combustible cigarettes and yielded mixed results, which may be due to a lack of granular assessment of nicotine use across the menstrual cycle or oral contraceptive (OC) regimen. We conducted a small proof-of-concept study on Electronic Nicotine Delivery Systems (ENDS). Our goals were to examine the utility of intensive longitudinal methods to assess ENDS use in a ~month long protocol, and explore ENDS use levels and variability among naturally cycling (NC) individuals and those using OCs.
Methods
There were 12 NC participants (Mage=22) and 7 participants using OCs (Mage=21). ENDS occasions were assessed 4 times a day across the protocol.
Results
On average, the NC group completed 77 % and the OC group completed 86 % of ENDS assessments. The average number of missing data was 2.2 days (SD=2.9). Time-Varying Effect Modeling (TVEM) examine changes in links between variables over time. TVEM revealed increases in ENDS use coinciding with rises in estradiol across the menstrual cycle. In contrast, ENDS use was consistent in the OC group.
Conclusions
Preliminary evidence indicates that ENDS use among NC individuals varies as a function of natural fluctuations in ovarian hormones while OCs appear to lower and stabilize ENDS use. Despite the small sample, this study suggests that intensive longitudinal methods are useful for examining links between the menstrual cycle, OCs, and ENDS use. This proof-of-concept research may galvanize mechanistic and intervention research on ovarian hormones and ENDS use.
{"title":"Electronic nicotine delivery systems (ENDS) use across the menstrual cycle and oral contraceptive regimen: A proof-of-concept intensive longitudinal study","authors":"Chrystal Vergara-Lopez , George D. Papandonatos , Margaret H. Bublitz , Alicia M. Allen , Laura R. Stroud","doi":"10.1016/j.dadr.2025.100350","DOIUrl":"10.1016/j.dadr.2025.100350","url":null,"abstract":"<div><h3>Introduction</h3><div>Exogenous and endogenous ovarian hormones (e.g., estradiol, progesterone) may influence nicotine use. Prior research has focused on combustible cigarettes and yielded mixed results, which may be due to a lack of granular assessment of nicotine use across the menstrual cycle or oral contraceptive (OC) regimen. We conducted a small proof-of-concept study on Electronic Nicotine Delivery Systems (ENDS). Our goals were to examine the utility of intensive longitudinal methods to assess ENDS use in a ~month long protocol, and explore ENDS use levels and variability among naturally cycling (NC) individuals and those using OCs.</div></div><div><h3>Methods</h3><div>There were 12 NC participants (<em>M</em><sub><em>age</em></sub>=22) and 7 participants using OCs (M<sub>age</sub>=21). ENDS occasions were assessed 4 times a day across the protocol.</div></div><div><h3>Results</h3><div>On average, the NC group completed 77 % and the OC group completed 86 % of ENDS assessments. The average number of missing data was 2.2 days (<em>SD</em>=2.9). Time-Varying Effect Modeling (TVEM) examine changes in links between variables over time. TVEM revealed increases in ENDS use coinciding with rises in estradiol across the menstrual cycle. In contrast, ENDS use was consistent in the OC group.</div></div><div><h3>Conclusions</h3><div>Preliminary evidence indicates that ENDS use among NC individuals varies as a function of natural fluctuations in ovarian hormones while OCs appear to lower and stabilize ENDS use. Despite the small sample, this study suggests that intensive longitudinal methods are useful for examining links between the menstrual cycle, OCs, and ENDS use. This proof-of-concept research may galvanize mechanistic and intervention research on ovarian hormones and ENDS use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330166","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 : 2025-06-10DOI: 10.1016/j.dadr.2025.100351
Rachel J. Smith , Vanessa M. McMahan , Nicole C. McCann , Sarah Kosakowski , Sarah Brennan , Xochitl Luna Marti , Alexander Y. Walley , Phillip O. Coffin
Background
Non-fatal opioid overdoses that do not result in an emergency medical system (EMS), emergency department or hospital encounter are not tracked. We aimed to understand the proportion of non-fatal overdoses with and without a healthcare encounter.
Methods
We used data from the REpeated-dose Behavioral intervention to reduce Opioid Overdose inTervention (REBOOT) trial among opioid overdose survivors in San Francisco and Boston. Participants reported the number of non-fatal overdoses over the prior 4-months at baseline and follow-up visits over 16 months. We asked details about the three most recent overdoses, including naloxone administration, EMS attendance, transport to an emergency department, or hospitalization.
Results
A total of 268 individuals completed 1163 assessments. Across the assessments, 150 participants reported a total of 504 overdoses. Complete details were collected for 384 of the overdose events. Naloxone was administered at 306 out of 384 (80 %) overdose events. EMS attended the scene in 177 out of 384 (46 %) of events, with naloxone administration occurring in 159 of these events (90 %); 130 of the 384 (34 %) events resulted in transportation to the emergency department, and only 18 (5 %) led to hospital admission.
Conclusions
Among opioid overdose survivors in urban settings, EMS were present at less than half of self-reported overdoses, emergency department visits occurred in about one third, and admission to the hospital occurred in one of twenty overdoses. Most overdoses involved naloxone administration, frequently by lay responders. Estimating non-fatal overdose prevalence should not rely solely on measures of EMS attendance, emergency department or hospital admissions.
{"title":"Emergency medical system response, emergency department visits, and hospital admissions in response to non-fatal opioid overdoses reported by a cohort of overdose survivors in San Francisco and Boston, 2019 – 2022","authors":"Rachel J. Smith , Vanessa M. McMahan , Nicole C. McCann , Sarah Kosakowski , Sarah Brennan , Xochitl Luna Marti , Alexander Y. Walley , Phillip O. Coffin","doi":"10.1016/j.dadr.2025.100351","DOIUrl":"10.1016/j.dadr.2025.100351","url":null,"abstract":"<div><h3>Background</h3><div>Non-fatal opioid overdoses that do not result in an emergency medical system (EMS), emergency department or hospital encounter are not tracked. We aimed to understand the proportion of non-fatal overdoses with and without a healthcare encounter.</div></div><div><h3>Methods</h3><div>We used data from the REpeated-dose Behavioral intervention to reduce Opioid Overdose inTervention (REBOOT) trial among opioid overdose survivors in San Francisco and Boston. Participants reported the number of non-fatal overdoses over the prior 4-months at baseline and follow-up visits over 16 months. We asked details about the three most recent overdoses, including naloxone administration, EMS attendance, transport to an emergency department, or hospitalization.</div></div><div><h3>Results</h3><div>A total of 268 individuals completed 1163 assessments. Across the assessments, 150 participants reported a total of 504 overdoses. Complete details were collected for 384 of the overdose events. Naloxone was administered at 306 out of 384 (80 %) overdose events. EMS attended the scene in 177 out of 384 (46 %) of events, with naloxone administration occurring in 159 of these events (90 %); 130 of the 384 (34 %) events resulted in transportation to the emergency department, and only 18 (5 %) led to hospital admission.</div></div><div><h3>Conclusions</h3><div>Among opioid overdose survivors in urban settings, EMS were present at less than half of self-reported overdoses, emergency department visits occurred in about one third, and admission to the hospital occurred in one of twenty overdoses. Most overdoses involved naloxone administration, frequently by lay responders. Estimating non-fatal overdose prevalence should not rely solely on measures of EMS attendance, emergency department or hospital admissions.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100351"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306209","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 : 2025-06-06DOI: 10.1016/j.dadr.2025.100349
Sabrina Gaiazov , William Mullen , Ann Wheeler , Swapna Munnangi , Yifan Gu , Mitch DeKoven , Robert Dunne
Objective
Identify factors associated with 6-month emergency room (ER) outcomes in patients with opioid use disorder (OUD) and/or treated with buprenorphine (extended-release [BUP-XR] or transmucosal [BUP-TM]). Compare baseline characteristics and 6-month ER visits and healthcare resource utilization (HCRU) across treatment groups.
Methods
Patient claims data from September 2017– March 2022 were analyzed for patients diagnosed with OUD and/or treated with buprenorphine. Adjusted logistic regression models were used to identify factors associated with ER visits 6-months post-index.
Results
543 patients initiating BUP-XR, 52,569 BUP-TM and 57,125 patients with OUD diagnosis but no-medications for opioid use disorder (MOUD) were identified.
Patients who received BUP-XR (OR: 0.43, 95 % CI: 0.36–0.53) or BUP-TM (OR: 0.78; CI: 0.76–0.81) had lower odds for an all-cause post-index ER visit compared to those with no MOUD treatment.
Patients with later index years or those who had an opioid overdose ER visit in the baseline period had higher odds of post-index all-cause and opioid overdose ER visits.
1.2 % in BUP-TM cohort and 1 % in the no MOUD cohort had an opioid overdose ER visit, compared to 0 % in the BUP-XR cohort. The BUP-XR cohort had lower rates of inpatient stays, ER visits, and outpatient physician office visits compared to the BUP-TM and no MOUD cohorts but incurred higher pharmacy costs.
Conclusions
This study found that any buprenorphine treatment, particularly BUP-XR, was associated with lower odds of all-cause ER visits compared to patients with no MOUD, and highlighted potential risk factors that could help reduce the demand on ER services.
{"title":"Factors associated with emergency room visits among patients with opioid use disorder: A study of buprenorphine-treated and untreated patients","authors":"Sabrina Gaiazov , William Mullen , Ann Wheeler , Swapna Munnangi , Yifan Gu , Mitch DeKoven , Robert Dunne","doi":"10.1016/j.dadr.2025.100349","DOIUrl":"10.1016/j.dadr.2025.100349","url":null,"abstract":"<div><h3>Objective</h3><div>Identify factors associated with 6-month emergency room (ER) outcomes in patients with opioid use disorder (OUD) and/or treated with buprenorphine (extended-release [BUP-XR] or transmucosal [BUP-TM]). Compare baseline characteristics and 6-month ER visits and healthcare resource utilization (HCRU) across treatment groups.</div></div><div><h3>Methods</h3><div>Patient claims data from September 2017– March 2022 were analyzed for patients diagnosed with OUD and/or treated with buprenorphine. Adjusted logistic regression models were used to identify factors associated with ER visits 6-months post-index.</div></div><div><h3>Results</h3><div>543 patients initiating BUP-XR, 52,569 BUP-TM and 57,125 patients with OUD diagnosis but no-medications for opioid use disorder (MOUD) were identified.</div><div>Patients who received BUP-XR (OR: 0.43, 95 % CI: 0.36–0.53) or BUP-TM (OR: 0.78; CI: 0.76–0.81) had lower odds for an all-cause post-index ER visit compared to those with no MOUD treatment.</div><div>Patients with later index years or those who had an opioid overdose ER visit in the baseline period had higher odds of post-index all-cause and opioid overdose ER visits.</div><div>1.2 % in BUP-TM cohort and 1 % in the no MOUD cohort had an opioid overdose ER visit, compared to 0 % in the BUP-XR cohort. The BUP-XR cohort had lower rates of inpatient stays, ER visits, and outpatient physician office visits compared to the BUP-TM and no MOUD cohorts but incurred higher pharmacy costs.</div></div><div><h3>Conclusions</h3><div>This study found that any buprenorphine treatment, particularly BUP-XR, was associated with lower odds of all-cause ER visits compared to patients with no MOUD, and highlighted potential risk factors that could help reduce the demand on ER services.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291117","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 : 2025-05-23DOI: 10.1016/j.dadr.2025.100348
Natasha A. Sokol , Eva Sharma , Janet O. Joseph , Janet A.J. Johnson , Laura R. Stroud
Purpose
To understand the observed increase in prenatal cannabis use during the COVID-19 pandemic, this study compared differences in prenatal cannabis perceptions among pregnant people who used cannabis before versus during the pandemic.
Method
From 2018–2022, participants who ever used cannabis during pregnancy (N = 136, Mage = 27.0 years, 29.9 % white) were recruited in their first trimester and surveyed during their first and second trimesters. Participants responded to the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory, Reasons for Using Marijuana measure, and Marijuana Perceptions Questionnaire.
Results
Compared to those responding before the pandemic, those responding during the pandemic were more likely to use cannabis to manage physical and psychological symptoms, including vomiting, depressed mood, chronic illness, pain, sleep, and appetite (RR’s > 2.0, p’s ≤ 0.020). Among those who reported medical use, participants responding during the pandemic were more likely to report physician-recommended use (RR=2.2, p = 0.075). Participants responding during the pandemic were more likely to use edibles (RR=1.72, p = 0.023), and less likely to smoke cannabis mixed with tobacco (RR=0.69, p = 0.009), and they were more likely to have attempted to quit or reduce use (RR=1.14, p = 0.047).
Conclusions
The shift in cannabis use to treat pregnancy and pandemic-related symptoms during the pandemic underscores the necessity of enhancing prenatal support systems for managing physical and mental health symptoms in times of significant disruption to routine prenatal care and daily life. This may be particularly important given projected increases in the frequency of epidemics and pandemics.
为了了解在COVID-19大流行期间观察到的产前大麻使用的增加，本研究比较了在大流行之前和期间使用大麻的孕妇对产前大麻的看法的差异。方法从2018年至2022年，在怀孕前三个月招募曾在怀孕期间使用大麻的参与者（N = 136，年龄= 27.0,29.9%为白人），并在妊娠前三个月和妊娠中期进行调查。参与者回答了每日会话，频率，发病年龄，大麻使用清单的数量，使用大麻的原因测量和大麻感知问卷。结果与大流行前有反应的人相比，大流行期间有反应的人更有可能使用大麻来控制身体和心理症状，包括呕吐、情绪抑郁、慢性疾病、疼痛、睡眠和食欲（RR 's > 2.0, p 's≤0.020）。在报告医疗使用的参与者中，在大流行期间作出反应的参与者更有可能报告医生建议的使用（RR=2.2, p = 0.075）。在大流行期间做出反应的参与者更有可能使用可食用的食物（RR=1.72, p = 0.023），更不可能吸食大麻和烟草混合（RR=0.69, p = 0.009），他们更有可能试图戒烟或减少使用（RR=1.14, p = 0.047）。结论：大流行期间大麻用于治疗妊娠和大流行相关症状的转变，突显出在常规产前护理和日常生活受到严重干扰时，有必要加强产前支持系统，以管理身心健康症状。鉴于预计流行病和大流行病的发生频率会增加，这一点可能特别重要。
{"title":"Changes in prenatal cannabis use and perceptions during the COVID-19 pandemic","authors":"Natasha A. Sokol , Eva Sharma , Janet O. Joseph , Janet A.J. Johnson , Laura R. Stroud","doi":"10.1016/j.dadr.2025.100348","DOIUrl":"10.1016/j.dadr.2025.100348","url":null,"abstract":"<div><h3>Purpose</h3><div>To understand the observed increase in prenatal cannabis use during the COVID-19 pandemic, this study compared differences in prenatal cannabis perceptions among pregnant people who used cannabis before versus during the pandemic.</div></div><div><h3>Method</h3><div>From 2018–2022, participants who ever used cannabis during pregnancy (N = 136, M<sub>age</sub> = 27.0 years, 29.9 % white) were recruited in their first trimester and surveyed during their first and second trimesters. Participants responded to the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory, Reasons for Using Marijuana measure, and Marijuana Perceptions Questionnaire.</div></div><div><h3>Results</h3><div>Compared to those responding before the pandemic, those responding during the pandemic were more likely to use cannabis to manage physical and psychological symptoms, including vomiting, depressed mood, chronic illness, pain, sleep, and appetite (RR’s > 2.0, p’s ≤ 0.020). Among those who reported medical use, participants responding during the pandemic were more likely to report physician-recommended use (RR=2.2, p = 0.075). Participants responding during the pandemic were more likely to use edibles (RR=1.72, p = 0.023), and less likely to smoke cannabis mixed with tobacco (RR=0.69, p = 0.009), and they were more likely to have attempted to quit or reduce use (RR=1.14, p = 0.047).</div></div><div><h3>Conclusions</h3><div>The shift in cannabis use to treat pregnancy and pandemic-related symptoms during the pandemic underscores the necessity of enhancing prenatal support systems for managing physical and mental health symptoms in times of significant disruption to routine prenatal care and daily life. This may be particularly important given projected increases in the frequency of epidemics and pandemics.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242733","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 : 2025-05-19DOI: 10.1016/j.dadr.2025.100347
Thye Peng Ngo , Salomeh Keyhani , Samuel Leonard , Katherine J. Hoggatt
Background
Few studies have reported on the prevalence and health risks associated with substance use and substance use disorder (SU/SUD) in Veterans who use long-term opioid therapy (LTOT). We leveraged health record data to estimate SU/SUD prevalence and its association with mortality among Veterans on LTOT.
Methods
We conducted a secondary analysis of cohort data for Veterans on LTOT within Veterans Health Administration outpatient settings (2014–2019). SU/SUD was defined as a positive screen for risky alcohol use; a positive urine drug screen for cannabis, benzodiazepines, or stimulants; or a documented SUD diagnosis. We fit Cox models for all-cause mortality, fatal overdose, and traumatic deaths, comparing Veterans on LTOT with SU/SUD vs. LTOT-only.
Results
One in four (25.0 %) Veterans on LTOT have risky alcohol use, tested positive for other substances, or had a diagnosed SUD. Alcohol was the most common SU/SUD (9.8 %), followed by sedative (8.1 %), cannabis (6.6 %), and stimulant (0.6 %). Relative to Veterans on LTOT only, mortality rates were higher for Veterans on LTOT with cannabis (HR=1.16, 95 % CI=1.03, 1.30), sedative (HR=1.29, 95 % CI=1.10, 1.52), or stimulant SU/SUD (HR=1.54, 95 % CI=1.17, 2.02). Fatal overdose rates were higher for LTOT with alcohol (HR=1.43, 95 % CI=1.10, 1.86), sedatives (HR=1.40, 95 % CI=1.04, 1.91), or stimulant SU/SUD (HR=3.29, 95 % CI=1.60, 6.77). LTOT with sedative SU/SUD was associated with traumatic death rates (HR=1.30, 95 % CI=1.05, 1.61).
Conclusion
Substance co-use is common among Veterans on LTOT and is associated with elevated mortality and overdose risks. Comprehensive screening and targeted interventions may be needed.
{"title":"Substance use and use disorders among Veterans on long-term opioid therapy","authors":"Thye Peng Ngo , Salomeh Keyhani , Samuel Leonard , Katherine J. Hoggatt","doi":"10.1016/j.dadr.2025.100347","DOIUrl":"10.1016/j.dadr.2025.100347","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have reported on the prevalence and health risks associated with substance use and substance use disorder (SU/SUD) in Veterans who use long-term opioid therapy (LTOT). We leveraged health record data to estimate SU/SUD prevalence and its association with mortality among Veterans on LTOT.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of cohort data for Veterans on LTOT within Veterans Health Administration outpatient settings (2014–2019). SU/SUD was defined as a positive screen for risky alcohol use; a positive urine drug screen for cannabis, benzodiazepines, or stimulants; or a documented SUD diagnosis. We fit Cox models for all-cause mortality, fatal overdose, and traumatic deaths, comparing Veterans on LTOT with SU/SUD vs. LTOT-only.</div></div><div><h3>Results</h3><div>One in four (25.0 %) Veterans on LTOT have risky alcohol use, tested positive for other substances, or had a diagnosed SUD. Alcohol was the most common SU/SUD (9.8 %), followed by sedative (8.1 %), cannabis (6.6 %), and stimulant (0.6 %). Relative to Veterans on LTOT only, mortality rates were higher for Veterans on LTOT with cannabis (HR=1.16, 95 % CI=1.03, 1.30), sedative (HR=1.29, 95 % CI=1.10, 1.52), or stimulant SU/SUD (HR=1.54, 95 % CI=1.17, 2.02). Fatal overdose rates were higher for LTOT with alcohol (HR=1.43, 95 % CI=1.10, 1.86), sedatives (HR=1.40, 95 % CI=1.04, 1.91), or stimulant SU/SUD (HR=3.29, 95 % CI=1.60, 6.77). LTOT with sedative SU/SUD was associated with traumatic death rates (HR=1.30, 95 % CI=1.05, 1.61).</div></div><div><h3>Conclusion</h3><div>Substance co-use is common among Veterans on LTOT and is associated with elevated mortality and overdose risks. Comprehensive screening and targeted interventions may be needed.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178318","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 : 2025-05-16DOI: 10.1016/j.dadr.2025.100345
Ayesha C. Sujan , Natalie E. Slama , Brian T. Bateman , Deborah Ansley , Carley Castellanos , Kelly C. Young-Wolff
Background
Research to date evaluating the safety of benzodizapine use during pregnancy has shown mixed results and has relied on self-report or filled prescription data, which are unlikely to capture non-medical use and, consequently, could bias results. Therefore, research on non-medical benzodiazepine use during pregnancy is needed.
Methods
The present study used data from a large, healthcare system with universal screening for prenatal substance use via urine toxicology tests and information on filled prescriptions. We first evaluated the prevalence of pregnancies with non-medical benzodiazepine use (positive urine toxicology test and no filled prescriptions in the past year) and medical benzodiazepine use (positive urine toxicology test and >1 filled prescription in the past year). We also evaluated the presence of co-occurrence of substance use and mental health conditions among these pregnancies.
Results
Our results showed that benzodiazepine use during early pregnancy was rare (<1 % had a positive toxicology test). However, more than one-third of those with a positive toxicology test did not have a filled prescription (i.e., had non-medical use) We also found similar rates of substance use and mental health conditions among pregnancies with medical and non-medical benzodiazepine use.
Conclusion
Our results suggest that research relying on prescription data alone and the medical system may be missing pregnant individuals using benzodiazepines. This points to a need for additional measures and screenings (e.g., urine toxicology tests) in both research and clinical settings. Our findings also underscore a need for additional services for pregnant individuals with both medical and non-medical benzodiazepine use.
{"title":"Substance use and mental health characteristics among pregnant individuals with medical and non-medical benzodiazepine use early in pregnancy","authors":"Ayesha C. Sujan , Natalie E. Slama , Brian T. Bateman , Deborah Ansley , Carley Castellanos , Kelly C. Young-Wolff","doi":"10.1016/j.dadr.2025.100345","DOIUrl":"10.1016/j.dadr.2025.100345","url":null,"abstract":"<div><h3>Background</h3><div>Research to date evaluating the safety of benzodizapine use during pregnancy has shown mixed results and has relied on self-report or filled prescription data, which are unlikely to capture non-medical use and, consequently, could bias results. Therefore, research on non-medical benzodiazepine use during pregnancy is needed.</div></div><div><h3>Methods</h3><div>The present study used data from a large, healthcare system with universal screening for prenatal substance use via urine toxicology tests and information on filled prescriptions. We first evaluated the prevalence of pregnancies with non-medical benzodiazepine use (positive urine toxicology test and no filled prescriptions in the past year) and medical benzodiazepine use (positive urine toxicology test and <u>></u>1 filled prescription in the past year). We also evaluated the presence of co-occurrence of substance use and mental health conditions among these pregnancies.</div></div><div><h3>Results</h3><div>Our results showed that benzodiazepine use during early pregnancy was rare (<1 % had a positive toxicology test). However, more than one-third of those with a positive toxicology test did not have a filled prescription (i.e., had non-medical use) We also found similar rates of substance use and mental health conditions among pregnancies with medical and non-medical benzodiazepine use.</div></div><div><h3>Conclusion</h3><div>Our results suggest that research relying on prescription data alone and the medical system may be missing pregnant individuals using benzodiazepines. This points to a need for additional measures and screenings (e.g., urine toxicology tests) in both research and clinical settings. Our findings also underscore a need for additional services for pregnant individuals with both medical and non-medical benzodiazepine use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100345"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124189","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 : 2025-05-16DOI: 10.1016/j.dadr.2025.100346
Kevin Wenzel , Julia Thomas , Jennifer Carrano , Jennifer Stidham , Marc Fishman
Background
Substance use disorders (SUDs) including opioid use disorder (OUD) and alcohol use disorder (AUD) contribute to significant morbidity and mortality in the United States. Pharmacotherapy treatment, including extended-release naltrexone (XR-NTX), is underutilized in large part due to poor treatment retention. The MAT-PLUS (Medication Adherence Therapy: Psychosocial Leverage Using a Significant other) intervention combines assertive outreach, significant other involvement, and low-barrier access to medicine to improve retention on XR-NTX, and has shown promising results in a pilot RCT. Methods: This report explored secondary outcomes from the MAT-PLUS pilot RCT (NCT03567356) to determine the impact of the intervention on recovery experience as measured by the Recovery Assessment Scale (RAS) and mental health indicators as measured by the patient health questionnaire- somatic, anxiety, depression scale (PHQ-SADS) on N = 41 participants. Results: A series of repeated measures mixed ANOVAs did not find evidence of an effect of the MAT-PLUS intervention on these outcomes. Although total RAS scores did not improve over time in either condition, an independent samples t-test at the post-intervention follow up suggested some evidence of a possible treatment effect on two subscales of the RAS: 1) Not being dominated by symptoms and 2) Goal and success orientation. Discussion: The results of this study suggest that mental health symptoms are attenuated during treatment, whether usual care or the MAT-PLUS intervention, but that recovery indicators did not improve with treatment. Approaches to SUD care, including the MAT-PLUS intervention, should be refined to target improvements in recovery capital in addition to focusing on symptom reduction.
{"title":"Exploring the impact of a medication adherence intervention on recovery and mental health outcomes: A secondary analysis of the MAT-PLUS pilot RCT","authors":"Kevin Wenzel , Julia Thomas , Jennifer Carrano , Jennifer Stidham , Marc Fishman","doi":"10.1016/j.dadr.2025.100346","DOIUrl":"10.1016/j.dadr.2025.100346","url":null,"abstract":"<div><h3>Background</h3><div>Substance use disorders (SUDs) including opioid use disorder (OUD) and alcohol use disorder (AUD) contribute to significant morbidity and mortality in the United States. Pharmacotherapy treatment, including extended-release naltrexone (XR-NTX), is underutilized in large part due to poor treatment retention. The MAT-PLUS (Medication Adherence Therapy: Psychosocial Leverage Using a Significant other) intervention combines assertive outreach, significant other involvement, and low-barrier access to medicine to improve retention on XR-NTX, and has shown promising results in a pilot RCT. <em>Methods:</em> This report explored secondary outcomes from the MAT-PLUS pilot RCT (NCT03567356) to determine the impact of the intervention on recovery experience as measured by the Recovery Assessment Scale (RAS) and mental health indicators as measured by the patient health questionnaire- somatic, anxiety, depression scale (PHQ-SADS) on <em>N</em> = 41 participants. <em>Results:</em> A series of repeated measures mixed ANOVAs did not find evidence of an effect of the MAT-PLUS intervention on these outcomes. Although total RAS scores did not improve over time in either condition, an independent samples t-test at the post-intervention follow up suggested some evidence of a possible treatment effect on two subscales of the RAS: 1) Not being dominated by symptoms and 2) Goal and success orientation. <em>Discussion:</em> The results of this study suggest that mental health symptoms are attenuated during treatment, whether usual care or the MAT-PLUS intervention, but that recovery indicators did not improve with treatment. Approaches to SUD care, including the MAT-PLUS intervention, should be refined to target improvements in recovery capital in addition to focusing on symptom reduction.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100346"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124190","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 : 2025-05-10DOI: 10.1016/j.dadr.2025.100342
Christina S. Lee , Erika G. Cordova-Ramos , Damaris J. Rohsenow , Kim T. Mueser , Christine A. Pace , Rosemarie Martin , Suzanne M. Colby , Victoria Lopez , Melanie Morris , Jake R. Morgan , Ari Kriegsman , Mari-Lynn Drainoni
Background
Stigma related to substance use or addiction contributes to health care inequality. Structural stigma - embedded in societal conditions, policies, practices, and cultural norms - has been less studied than interpersonal (e.g., provider bias) and individual level stigma processes. The perspectives of staff working with patients who navigate health care systems can help to identify substance use stigma at the structural and interpersonal levels. The study aimed to examine staff perceptions of structural and interpersonal stigma processes, their association with barriers to substance use disorder (SUD) care, the interplay between different levels of stigma, and their impacts at the individual level.
Methods
Care management staff (n = 20, 75 % community health workers, CHWs) from a complex care management program were interviewed about the challenges Latine compared to non-Latine patients faced in accessing care for substance use treatment. Thematic analysis was used to analyze interview transcripts. The Structural Stigma framework was used to guide analysis.
Results
Structural and interpersonal stigma processes as well as intersectional stigma were associated with barriers to SUD care. Latine patients were reported as being frequently affected by intersecting systems of oppression due to multiple stigmatized identities (e.g., persons with substance use and as immigrants) than non-Latine patients. Structural and interpersonal stigma processes were associated with self-stigma and hindered help-seeking behaviors.
Conclusion
Care management staff offer unique perspectives into how stigma at multiple levels is experienced by patients and perpetuated. Stigma processes may discourage the initiation of needed substance use care among Latine persons experiencing oppression.
{"title":"Care management staff perspectives on stigma and barriers to substance use treatment experienced by latine adults who use substances","authors":"Christina S. Lee , Erika G. Cordova-Ramos , Damaris J. Rohsenow , Kim T. Mueser , Christine A. Pace , Rosemarie Martin , Suzanne M. Colby , Victoria Lopez , Melanie Morris , Jake R. Morgan , Ari Kriegsman , Mari-Lynn Drainoni","doi":"10.1016/j.dadr.2025.100342","DOIUrl":"10.1016/j.dadr.2025.100342","url":null,"abstract":"<div><h3>Background</h3><div>Stigma related to substance use or addiction contributes to health care inequality. Structural stigma - embedded in societal conditions, policies, practices, and cultural norms - has been less studied than interpersonal (e.g., provider bias) and individual level stigma processes. The perspectives of staff working with patients who navigate health care systems can help to identify substance use stigma at the structural and interpersonal levels. The study aimed to examine staff perceptions of structural and interpersonal stigma processes, their association with barriers to substance use disorder (SUD) care, the interplay between different levels of stigma, and their impacts at the individual level.</div></div><div><h3>Methods</h3><div>Care management staff (n = 20, 75 % community health workers, CHWs) from a complex care management program were interviewed about the challenges Latine compared to non-Latine patients faced in accessing care for substance use treatment. Thematic analysis was used to analyze interview transcripts. The Structural Stigma framework was used to guide analysis.</div></div><div><h3>Results</h3><div>Structural and interpersonal stigma processes as well as intersectional stigma were associated with barriers to SUD care. Latine patients were reported as being frequently affected by intersecting systems of oppression due to multiple stigmatized identities (e.g., persons with substance use and as immigrants) than non-Latine patients. Structural and interpersonal stigma processes were associated with self-stigma and hindered help-seeking behaviors.</div></div><div><h3>Conclusion</h3><div>Care management staff offer unique perspectives into how stigma at multiple levels is experienced by patients and perpetuated. Stigma processes may discourage the initiation of needed substance use care among Latine persons experiencing oppression.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100342"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115368","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 : 2025-05-08DOI: 10.1016/j.dadr.2025.100343
Samuel J. Chen , Harold A. Pollack , Elizabeth M. Salisbury-Afshar , Mai T. Pho
Substance use-related overdose continues to be one of the leading causes of preventable death in the U.S. People returning from prisons and jails are at heightened risk. Certain substance use treatment methods in carceral facilities – especially medication for opioid use disorder (MOUD) – have shown promise in reducing overdose rates. Treatment availability has been under-studied, with past research often measuring whether facilities offer treatment, but not whether individuals actually receive it. This study used individual-level data to characterize who qualifies for prison-based treatment, who receives it, and what factors affect one’s likelihood of being treated, drawing from the most recent nationally-representative U.S. Survey of Prison Inmates. Descriptive statistics indicate that people with substance use disorder (SUD) who entered American prisons from 2014 to 2016 had lower levels of educational attainment, employment and housing, and higher levels of physical and mental illness. Just 13 % of individuals with SUD received any form of substance use treatment in prison; pharmacotherapies like methadone were almost nonexistent (<1 %). In controlled analysis, individuals who self-identified as Non-Hispanic Black or Hispanic had lower odds of receiving any treatment or support compared to Non-Hispanic White individuals. People convicted of a violent offense had lower odds of treatment than those convicted of other classes of crimes. These novel findings indicate that, in 2016, America’s prison-based substance use treatment had both poor accessibility and inequitable distribution. This raises concerns that, even as facility-level availability of modalities like MOUD continues to expand, certain groups may be left out without attention to individual-level availability.
{"title":"Access to and predictors of substance use treatment and support among people experiencing incarceration in the United States: Analysis of a national cross-sectional study","authors":"Samuel J. Chen , Harold A. Pollack , Elizabeth M. Salisbury-Afshar , Mai T. Pho","doi":"10.1016/j.dadr.2025.100343","DOIUrl":"10.1016/j.dadr.2025.100343","url":null,"abstract":"<div><div>Substance use-related overdose continues to be one of the leading causes of preventable death in the U.S. People returning from prisons and jails are at heightened risk. Certain substance use treatment methods in carceral facilities – especially medication for opioid use disorder (MOUD) – have shown promise in reducing overdose rates. Treatment availability has been under-studied, with past research often measuring whether facilities offer treatment, but not whether individuals actually receive it. This study used individual-level data to characterize who qualifies for prison-based treatment, who receives it, and what factors affect one’s likelihood of being treated, drawing from the most recent nationally-representative U.S. Survey of Prison Inmates. Descriptive statistics indicate that people with substance use disorder (SUD) who entered American prisons from 2014 to 2016 had lower levels of educational attainment, employment and housing, and higher levels of physical and mental illness. Just 13 % of individuals with SUD received any form of substance use treatment in prison; pharmacotherapies like methadone were almost nonexistent (<1 %). In controlled analysis, individuals who self-identified as Non-Hispanic Black or Hispanic had lower odds of receiving any treatment or support compared to Non-Hispanic White individuals. People convicted of a violent offense had lower odds of treatment than those convicted of other classes of crimes. These novel findings indicate that, in 2016, America’s prison-based substance use treatment had both poor accessibility and inequitable distribution. This raises concerns that, even as facility-level availability of modalities like MOUD continues to expand, certain groups may be left out without attention to individual-level availability.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068551","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 : 2025-05-07DOI: 10.1016/j.dadr.2025.100344
Felipe I. Varas , Gonzalo Miguez , Vanetza E. Quezada-Scholz , Esperanza Ibáñez-Jiménez , Camila Aguilar , Simón Ramírez , Jonathan Badilla , Felipe Alfaro , Francisca Bertin , Javier Bustamante , Rocío Angulo , José A. Fuentealba , Alvaro Vergés , Mario A. Laborda
Experimental evaluation of cannabis tolerance has lacked an associative learning approach, focusing primarily on physiological variables. The present study assessed acute effects, chronic tolerance, and contextual specificity, exploring a potential associative component underlying cannabis tolerance. Sixteen adult Sprague-Dawley rats of both sexes were assigned to two groups, one receiving vaporized administrations of cannabis and the other receiving the vehicle substance, in two different counterbalanced contexts. An initial measurement was performed to assess acute effects, followed by four measurements to evaluate the development of chronic tolerance, and a final measurement to test the context specificity of tolerance, comparing the responses to the usual administration context and a novel context. Ten behaviors were analyzed in an open field. Acute effects were observed in seven indicators, corresponding to greater exploration activity in the group that received the drug compared to the control group. In five of these, the data also showed the development of chronic tolerance to the effects of cannabis on exploration, which was indicated by a progressive decrease in exploratory activity in the drug group. However, no evidence of context specificity was found in any variables in which chronic tolerance was observed. We discuss factors that may be related to the lack of contextual specificity of cannabis tolerance. Together, our findings show that a single administration of cannabis induces acute effects, and repeated exposure leads to chronic tolerance, ultimately reducing exploratory behavior.
{"title":"Assessment of the associative determinants of tolerance to the effects of cannabis extract on exploratory behavior in rats","authors":"Felipe I. Varas , Gonzalo Miguez , Vanetza E. Quezada-Scholz , Esperanza Ibáñez-Jiménez , Camila Aguilar , Simón Ramírez , Jonathan Badilla , Felipe Alfaro , Francisca Bertin , Javier Bustamante , Rocío Angulo , José A. Fuentealba , Alvaro Vergés , Mario A. Laborda","doi":"10.1016/j.dadr.2025.100344","DOIUrl":"10.1016/j.dadr.2025.100344","url":null,"abstract":"<div><div>Experimental evaluation of cannabis tolerance has lacked an associative learning approach, focusing primarily on physiological variables. The present study assessed acute effects, chronic tolerance, and contextual specificity, exploring a potential associative component underlying cannabis tolerance. Sixteen adult Sprague-Dawley rats of both sexes were assigned to two groups, one receiving vaporized administrations of cannabis and the other receiving the vehicle substance, in two different counterbalanced contexts. An initial measurement was performed to assess acute effects, followed by four measurements to evaluate the development of chronic tolerance, and a final measurement to test the context specificity of tolerance, comparing the responses to the usual administration context and a novel context. Ten behaviors were analyzed in an open field. Acute effects were observed in seven indicators, corresponding to greater exploration activity in the group that received the drug compared to the control group. In five of these, the data also showed the development of chronic tolerance to the effects of cannabis on exploration, which was indicated by a progressive decrease in exploratory activity in the drug group. However, no evidence of context specificity was found in any variables in which chronic tolerance was observed. We discuss factors that may be related to the lack of contextual specificity of cannabis tolerance. Together, our findings show that a single administration of cannabis induces acute effects, and repeated exposure leads to chronic tolerance, ultimately reducing exploratory behavior.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100344"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948267","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}
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