Sarah Ashrafian MPharm, Elena Ahrens Cand. Med., Luca J. Wachtendorf MD, Ricardo Munoz-Acuna MD, Denys Shay MD, Aiman Suleiman MD, MSc, Simone Redaelli MD, Dario von Wedel Cand. Med., Guanqing Chen PhD, Georg Wolff MD, Kevin P. Hill MD, MHS, Maximilian S. Schaefer MD, PhD
Background and Objectives
Previous studies reported a predisposition to major adverse cardiovascular or cerebrovascular events (MACCE) in patients consuming cannabis, which might be exacerbated by interventional or surgical procedures. This study investigated the association of nonmedical cannabis use with MACCE after interventional procedures or surgery.
Methods
288,923 adult patients undergoing noncardiac surgery between 2008 and 2020 at a tertiary academic hospital in Massachusetts, United States, were included. The exposure was nonmedical use of cannabis, differentiated into ongoing self-reported recreational use or a diagnosis of cannabis use disorder. The primary outcome was MACCE, defined as ischemic stroke, cardiac arrest, acute heart failure, myocardial infarction, or revascularization within 1 year.
Results
Patients with a diagnosis of cannabis use disorder had a higher risk of MACCE (adjusted odds ratio 1.26; 95%CI 1.05–1.51; p = .02). For recreational users, this was dependent on the patient's baseline cardiac risk, based on the revised cardiac risk index (RCRI) class: among patients at high cardiac risk (RCRI class III/IV), recreational cannabis use was associated with increased risk (adjusted odds ratio 1.41; 1.15–1.74; p = .001), while there was no association among patients with a low RCRI class (I/II; adjusted odds ratio 0.87; 0.75–1.02; p = .09).
Discussion and Conclusions
Patients with a diagnosed cannabis use disorder are at increased risk of post-procedural MACCE, while for recreational users, this association was dependent on patients' baseline cardiac risk.
Scientific Significance
This study demonstrates the association between cannabis use and MACCE differentiated by type of use and depending on baseline cardiac risk.
{"title":"Association of cannabis use with major cardiovascular and cerebrovascular events after surgery or interventional procedures","authors":"Sarah Ashrafian MPharm, Elena Ahrens Cand. Med., Luca J. Wachtendorf MD, Ricardo Munoz-Acuna MD, Denys Shay MD, Aiman Suleiman MD, MSc, Simone Redaelli MD, Dario von Wedel Cand. Med., Guanqing Chen PhD, Georg Wolff MD, Kevin P. Hill MD, MHS, Maximilian S. Schaefer MD, PhD","doi":"10.1111/ajad.70029","DOIUrl":"10.1111/ajad.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Previous studies reported a predisposition to major adverse cardiovascular or cerebrovascular events (MACCE) in patients consuming cannabis, which might be exacerbated by interventional or surgical procedures. This study investigated the association of nonmedical cannabis use with MACCE after interventional procedures or surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>288,923 adult patients undergoing noncardiac surgery between 2008 and 2020 at a tertiary academic hospital in Massachusetts, United States, were included. The exposure was nonmedical use of cannabis, differentiated into ongoing self-reported recreational use or a diagnosis of cannabis use disorder. The primary outcome was MACCE, defined as ischemic stroke, cardiac arrest, acute heart failure, myocardial infarction, or revascularization within 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with a diagnosis of cannabis use disorder had a higher risk of MACCE (adjusted odds ratio 1.26; 95%CI 1.05–1.51; <i>p</i> = .02). For recreational users, this was dependent on the patient's baseline cardiac risk, based on the revised cardiac risk index (RCRI) class: among patients at high cardiac risk (RCRI class III/IV), recreational cannabis use was associated with increased risk (adjusted odds ratio 1.41; 1.15–1.74; <i>p</i> = .001), while there was no association among patients with a low RCRI class (I/II; adjusted odds ratio 0.87; 0.75–1.02; <i>p</i> = .09).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Patients with a diagnosed cannabis use disorder are at increased risk of post-procedural MACCE, while for recreational users, this association was dependent on patients' baseline cardiac risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>This study demonstrates the association between cannabis use and MACCE differentiated by type of use and depending on baseline cardiac risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 5","pages":"517-527"},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Megan F. Dickson PhD, Shawn M. Jamison, J. Matthew Webster PhD, Martha Tillson PhD, Carrie B. Oser PhD, Jaxin Annett MS, Michele Staton PhD
Background and Objectives
Despite elevated overdose risk in rural communities, rural/urban differences in overdose risk factors are understudied among women with criminal legal system involvement. This study examines substance use and overdose among incarcerated women.
Methods
Women (N = 900) were randomly selected from nine Kentucky jails, screened, and interviewed as part of a larger study. Bivariate analyses were used to identify group differences.
Results
Rural women were less likely to report pre-incarceration overdose and to receive emergency services post-overdose. Substance use also varied.
Conclusions and Scientific Significance
Results underscore the importance of Opioid Overdose Education and Naloxone Distribution in rural communities.
{"title":"A descriptive analysis of rural-urban overdose experiences among incarcerated women with opioid use disorder","authors":"Megan F. Dickson PhD, Shawn M. Jamison, J. Matthew Webster PhD, Martha Tillson PhD, Carrie B. Oser PhD, Jaxin Annett MS, Michele Staton PhD","doi":"10.1111/ajad.70025","DOIUrl":"10.1111/ajad.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Despite elevated overdose risk in rural communities, rural/urban differences in overdose risk factors are understudied among women with criminal legal system involvement. This study examines substance use and overdose among incarcerated women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women (<i>N</i> = 900) were randomly selected from nine Kentucky jails, screened, and interviewed as part of a larger study. Bivariate analyses were used to identify group differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Rural women were less likely to report pre-incarceration overdose and to receive emergency services post-overdose. Substance use also varied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Scientific Significance</h3>\u0000 \u0000 <p>Results underscore the importance of Opioid Overdose Education and Naloxone Distribution in rural communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 4","pages":"460-464"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Opioid toxicity remains a significant public health issue in the United States, with naloxone serving as a key intervention to reverse toxicity effects. This study aims to identify demographic predictors across the naloxone cascade—a framework comprising awareness, beliefs, access, availability, and possession of naloxone—among U.S. adults, using data from the National Center for Health Statistics Rapid Survey System.
Methods
We conducted a cross-sectional survey of U.S. adults aged 18 and older (n = 7046, weighted total = 257,926,944 representing the U.S. adult population) between October to November 2023. Multivariable logistic regression analyses identified predictors across each naloxone cascade, adjusted for age, sex, education, race, and poverty status.
Results
Awareness of naloxone was high (75.1%), but only 53.2% were aware of its availability over-the-counter, and 5.6% reported carrying it. Female participants showed higher awareness (OR: 1.29; 95% CI: 1.12–1.48), while participants aged 60 years and over were significantly less likely to carry naloxone (OR: 0.55; 95% CI: 0.32–0.94). Significant disparities observed across racial and socioeconomic groups, with Non-Hispanic Blacks and Hispanics had lower awareness levels than Non-Hispanic Whites.
Discussion and Conclusions
Despite high awareness, naloxone possession remains low, especially among older adults and racial minorities. Tailored public health interventions are needed to improve naloxone distribution and accessibility in underserved populations.
Scientific Significance
This study identified important demographic predictors and gaps in naloxone possession across U.S. adult populations, offering insights to inform public health strategies to reduce opioid toxicity deaths.
{"title":"Knowledge, access, and possession of naloxone (Narcan) among U.S. adults: A nationwide survey 2023","authors":"Akshaya Srikanth Bhagavathula PhD, Tadesse Melaku Abegaz PhD, Jagdish Khubchandani PhD, Bong-Jin Choi PhD","doi":"10.1111/ajad.70031","DOIUrl":"10.1111/ajad.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Opioid toxicity remains a significant public health issue in the United States, with naloxone serving as a key intervention to reverse toxicity effects. This study aims to identify demographic predictors across the naloxone cascade—a framework comprising awareness, beliefs, access, availability, and possession of naloxone—among U.S. adults, using data from the National Center for Health Statistics Rapid Survey System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional survey of U.S. adults aged 18 and older (<i>n</i> = 7046, weighted total = 257,926,944 representing the U.S. adult population) between October to November 2023. Multivariable logistic regression analyses identified predictors across each naloxone cascade, adjusted for age, sex, education, race, and poverty status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Awareness of naloxone was high (75.1%), but only 53.2% were aware of its availability over-the-counter, and 5.6% reported carrying it. Female participants showed higher awareness (OR: 1.29; 95% CI: 1.12–1.48), while participants aged 60 years and over were significantly less likely to carry naloxone (OR: 0.55; 95% CI: 0.32–0.94). Significant disparities observed across racial and socioeconomic groups, with Non-Hispanic Blacks and Hispanics had lower awareness levels than Non-Hispanic Whites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Despite high awareness, naloxone possession remains low, especially among older adults and racial minorities. Tailored public health interventions are needed to improve naloxone distribution and accessibility in underserved populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>This study identified important demographic predictors and gaps in naloxone possession across U.S. adult populations, offering insights to inform public health strategies to reduce opioid toxicity deaths.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 4","pages":"450-459"},"PeriodicalIF":2.5,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medetomidine is a sedative approved by the FDA for veterinary use, but it is not authorized for human use. Its increasing presence alongside illegal opioids like fentanyl contributes to a rise in fatal overdoses across the U.S. While it is more potent than xylazine, knowledge surrounding medetomidine's role as an adulterant remains limited. This review investigates existing human data regarding its illicit use and overdose symptoms and highlights the evolving issue.
Methods
This review compiles case reports, law enforcement findings, and human studies to assess the role of medetomidine in opioid overdoses. We emphasize overdose symptoms, treatment challenges, and clinical outcomes, drawing from cases in U.S. cities experiencing rising overdose rates associated with this sedative.
Results
The review reveals a troubling trend of increasing fatalities related to medetomidine adulteration, particularly in urban areas. Medetomidine's sedative effects complicate the management of opioid overdoses, often leaving many cases unrecognized due to the overlap of symptoms. The rising incidents of seizures and deaths underscore the urgent need for public health action.
Discussion and Conclusions
The growing use of medetomidine as an opioid adulterant calls for further research, increased awareness among healthcare professionals and emergency responders, and enhanced diagnostic screening methods. Specific treatment protocols for medetomidine overdoses are crucial, and laboratory testing should be expanded to identify this substance.
Scientific Significance
This review highlights the growing prevalence of medetomidine, which has surpassed xylazine also in some areas, and advocates for strengthened public health efforts to address this emerging crisis.
{"title":"Rise of illicit medetomidine use: A worrisome trend","authors":"Nikhil Sood MD","doi":"10.1111/ajad.70030","DOIUrl":"10.1111/ajad.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Medetomidine is a sedative approved by the FDA for veterinary use, but it is not authorized for human use. Its increasing presence alongside illegal opioids like fentanyl contributes to a rise in fatal overdoses across the U.S. While it is more potent than xylazine, knowledge surrounding medetomidine's role as an adulterant remains limited. This review investigates existing human data regarding its illicit use and overdose symptoms and highlights the evolving issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review compiles case reports, law enforcement findings, and human studies to assess the role of medetomidine in opioid overdoses. We emphasize overdose symptoms, treatment challenges, and clinical outcomes, drawing from cases in U.S. cities experiencing rising overdose rates associated with this sedative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The review reveals a troubling trend of increasing fatalities related to medetomidine adulteration, particularly in urban areas. Medetomidine's sedative effects complicate the management of opioid overdoses, often leaving many cases unrecognized due to the overlap of symptoms. The rising incidents of seizures and deaths underscore the urgent need for public health action.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>The growing use of medetomidine as an opioid adulterant calls for further research, increased awareness among healthcare professionals and emergency responders, and enhanced diagnostic screening methods. Specific treatment protocols for medetomidine overdoses are crucial, and laboratory testing should be expanded to identify this substance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>This review highlights the growing prevalence of medetomidine, which has surpassed xylazine also in some areas, and advocates for strengthened public health efforts to address this emerging crisis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 5","pages":"558-561"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carol A. Lee PhD, Devin C. Tomlinson PhD, Kipling M. Bohnert PhD, Erin E. Bonar PhD, Lara N. Coughlin PhD, Mark A. Ilgen PhD
Background and Objectives
Cannabis use is increasing in the United States, and, on average, those consuming medical cannabis report more frequent cannabis use than those who use recreationally. The present analyses focus on the prevalence and correlates of working under the influence of cannabis (WUIC) amongst individuals with chronic pain who use cannabis medically.
Methods
Adults were recruited from medical cannabis certification clinics in Michigan and individuals who were employed in the past 6 months were included in the analytic sample (N = 362). Unadjusted and adjusted logistic regressions were estimated to examine factors associated with WUIC. Descriptive analyses examined WUIC by types of employment.
Results
WUIC was reported by 34% (n = 123) of employed medical cannabis patients. After adjusting for other factors, older age and having episodes of 6+ drinks were significantly associated with lower odds of WUIC. History of driving under the influence of cannabis, reporting three+ hours high on cannabis per day, and using 0.5 oz+ of cannabis per week were all significantly associated with higher odds of WUIC.
Discussion and Conclusions
Amongst individuals who use cannabis for pain and are in the workforce, WUIC is relatively common. This may be particularly concerning in jobs that are safety-sensitive. Prevention efforts for WUIC might focus on those who use cannabis several times per day and might consider how to balance the needs for pain management with workplace-related roles.
Scientific Significance
The current study extends knowledge around the prevalence and characteristics of individuals using medical cannabis who engage in WUIC.
{"title":"Working under the influence of cannabis amongst medical cannabis patients with chronic pain","authors":"Carol A. Lee PhD, Devin C. Tomlinson PhD, Kipling M. Bohnert PhD, Erin E. Bonar PhD, Lara N. Coughlin PhD, Mark A. Ilgen PhD","doi":"10.1111/ajad.70028","DOIUrl":"10.1111/ajad.70028","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Cannabis use is increasing in the United States, and, on average, those consuming medical cannabis report more frequent cannabis use than those who use recreationally. The present analyses focus on the prevalence and correlates of working under the influence of cannabis (WUIC) amongst individuals with chronic pain who use cannabis medically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults were recruited from medical cannabis certification clinics in Michigan and individuals who were employed in the past 6 months were included in the analytic sample (<i>N</i> = 362). Unadjusted and adjusted logistic regressions were estimated to examine factors associated with WUIC. Descriptive analyses examined WUIC by types of employment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>WUIC was reported by 34% (<i>n</i> = 123) of employed medical cannabis patients. After adjusting for other factors, older age and having episodes of 6+ drinks were significantly associated with lower odds of WUIC. History of driving under the influence of cannabis, reporting three+ hours high on cannabis per day, and using 0.5 oz+ of cannabis per week were all significantly associated with higher odds of WUIC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Amongst individuals who use cannabis for pain and are in the workforce, WUIC is relatively common. This may be particularly concerning in jobs that are safety-sensitive. Prevention efforts for WUIC might focus on those who use cannabis several times per day and might consider how to balance the needs for pain management with workplace-related roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>The current study extends knowledge around the prevalence and characteristics of individuals using medical cannabis who engage in WUIC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 4","pages":"415-421"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Max Spaderna MD, Elana Rosenthal MD, Sun Jung Kang PhD, Rahwa Eyasu MSN, FNP, Emade Ebah MPH, Onyinyechi Ogbumbadiugha MPH, Phyllis Bijole MA, Amelia Cover CRNP, Ashley Davis CRNP, Meredith Zoltick MSN, MPH, Sita Kottilil, Julia Mount BS, Catherine Gannon BA, Jasmine Stevens BS, Grace Garrett BS, Meghan Derenoncourt BS, Tina Liu AB, Lisa Horowitz PhD, MPH, Maryland Pao MD, Sarah Kattakuzhy MD, MPH
Background and Objectives
Few studies have longitudinally investigated suicide risk (SR) in opioid use disorder (OUD). This investigation administered three screening tools to individuals with OUD to compare rates of and variables associated with SR over 12 months.
Methods
121 individuals meeting criteria for OUD within the past 3 years were administered Item #9 of Patient Health Questionnaire-9 (PHQ-Item-9), the twelfth item of DSM-5-TR Self-Rated Level 1 Cross-Cutting Measure (CCSM-Item-12), and the Ask Suicide-Screening Questions (ASQ) to detect SR at Day 0 and Months 6 and 12. A partitioned generalized methods of moment (GMM) model identified variables associated with SR.
Results
At Day 0, screen-positive rates for SR were 30% for ASQ, 12.4% for PHQ-Item-9, and 4.1% for CCSM-Item-12. Rates were similar at Months 6 and 12. Variables significantly associated with SR by PHQ-Item-9 were intentional overdose history (p < .001), poor sleep (p < .001), meeting criteria for psychosis (p < .001), and meeting criteria for mania (p = .005). Variables significantly associated with SR by ASQ were intentional overdose history (p < .001), female gender (p = .003), meeting criteria for psychosis (p = .001), and total PHQ-9 score (p = .032). Too few participants endorsed SR by CCSM-Item-12 to be included.
Discussion and Conclusions
In the OUD population, screening positive for SR was unchanged over 1 year, but detection rates varied by screening tool. History of intentional opioid overdose is independently associated with screening positive for SR.
Scientific Significance
This is the first study to evaluate SR in the OUD population using more than one screening tool, and to show an association of history of intentional opioid overdose with SR.
{"title":"Elevated rate of suicide risk in individuals with opioid use disorder","authors":"Max Spaderna MD, Elana Rosenthal MD, Sun Jung Kang PhD, Rahwa Eyasu MSN, FNP, Emade Ebah MPH, Onyinyechi Ogbumbadiugha MPH, Phyllis Bijole MA, Amelia Cover CRNP, Ashley Davis CRNP, Meredith Zoltick MSN, MPH, Sita Kottilil, Julia Mount BS, Catherine Gannon BA, Jasmine Stevens BS, Grace Garrett BS, Meghan Derenoncourt BS, Tina Liu AB, Lisa Horowitz PhD, MPH, Maryland Pao MD, Sarah Kattakuzhy MD, MPH","doi":"10.1111/ajad.70027","DOIUrl":"10.1111/ajad.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Few studies have longitudinally investigated suicide risk (SR) in opioid use disorder (OUD). This investigation administered three screening tools to individuals with OUD to compare rates of and variables associated with SR over 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>121 individuals meeting criteria for OUD within the past 3 years were administered Item #9 of Patient Health Questionnaire-9 (PHQ-Item-9), the twelfth item of DSM-5-TR Self-Rated Level 1 Cross-Cutting Measure (CCSM-Item-12), and the Ask Suicide-Screening Questions (ASQ) to detect SR at Day 0 and Months 6 and 12. A partitioned generalized methods of moment (GMM) model identified variables associated with SR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At Day 0, screen-positive rates for SR were 30% for ASQ, 12.4% for PHQ-Item-9, and 4.1% for CCSM-Item-12. Rates were similar at Months 6 and 12. Variables significantly associated with SR by PHQ-Item-9 were intentional overdose history (<i>p</i> < .001), poor sleep (<i>p</i> < .001), meeting criteria for psychosis (<i>p</i> < .001), and meeting criteria for mania (<i>p</i> = .005). Variables significantly associated with SR by ASQ were intentional overdose history (<i>p</i> < .001), female gender (<i>p</i> = .003), meeting criteria for psychosis (<i>p</i> = .001), and total PHQ-9 score (<i>p</i> = .032). Too few participants endorsed SR by CCSM-Item-12 to be included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>In the OUD population, screening positive for SR was unchanged over 1 year, but detection rates varied by screening tool. History of intentional opioid overdose is independently associated with screening positive for SR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>This is the first study to evaluate SR in the OUD population using more than one screening tool, and to show an association of history of intentional opioid overdose with SR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 4","pages":"440-449"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The United States has been experiencing a deadly epidemic of fatal drug overdose (OD), including among emerging/young adults. We aimed to examine intentional OD (IOD) among young adults receiving methadone maintenance treatment for opioid use disorders (OUD).
Method
Thirty-three participants (18–26 years old) with OUD completed measures of drug use, OD, depression, and suicidal behavior. Between-group differences were analyzed using independent samples t-test and χ² test for continuous and dichotomous data, respectively. Regression analysis was employed to predict the magnitude of intent to die before the most recent OD.
Results
Forty-two percent of the sample had a history of a suicide attempt (SA). Of those, 78% reported >1 IOD. Participants with SA history had a significantly higher depression severity (p = .01), were younger at the onset of opioid use (p = .04) and were less likely to be Hispanic (p = .03) relative to those without SA history. The magnitude of intent to die before the most recent OD was predicted by (a) number of lifetime SAs (p < .001), (b) likelihood that participant thought they would OD before their most recent OD (p = .009), and (c) number of days using illicit opioids in the last 30 (p = .02).
Conclusions and Scientific Significance
These findings indicate a high prevalence of IOD among young adults enrolled in clinical services. Awareness of suicidal intent as a predictor of OD would improve prevention-intervention methods for the reduction of morbidity and mortality among them. This is the first reported study to examine IOD among emerging/young adults with OUD.
{"title":"Drug overdose and suicidal intentionality among young adults in methadone treatment","authors":"Yifrah Kaminer MD, Simon Zhornitsky PhD","doi":"10.1111/ajad.70026","DOIUrl":"10.1111/ajad.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>The United States has been experiencing a deadly epidemic of fatal drug overdose (OD), including among emerging/young adults. We aimed to examine intentional OD (IOD) among young adults receiving methadone maintenance treatment for opioid use disorders (OUD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Thirty-three participants (18–26 years old) with OUD completed measures of drug use, OD, depression, and suicidal behavior. Between-group differences were analyzed using independent samples <i>t</i>-test and χ² test for continuous and dichotomous data, respectively. Regression analysis was employed to predict the magnitude of intent to die before the most recent OD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two percent of the sample had a history of a suicide attempt (SA). Of those, 78% reported >1 IOD. Participants with SA history had a significantly higher depression severity (<i>p</i> = .01), were younger at the onset of opioid use (<i>p</i> = .04) and were less likely to be Hispanic (<i>p</i> = .03) relative to those without SA history. The magnitude of intent to die before the most recent OD was predicted by (a) number of lifetime SAs (<i>p</i> < .001), (b) likelihood that participant thought they would OD before their most recent OD (<i>p</i> = .009), and (c) number of days using illicit opioids in the last 30 (<i>p</i> = .02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Scientific Significance</h3>\u0000 \u0000 <p>These findings indicate a high prevalence of IOD among young adults enrolled in clinical services. Awareness of suicidal intent as a predictor of OD would improve prevention-intervention methods for the reduction of morbidity and mortality among them. This is the first reported study to examine IOD among emerging/young adults with OUD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 4","pages":"433-439"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Become a AAAP Member","authors":"","doi":"10.1111/ajad.70024","DOIUrl":"https://doi.org/10.1111/ajad.70024","url":null,"abstract":"<p>Click on the PDF file for live links</p><p></p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"34 2","pages":"267"},"PeriodicalIF":2.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143581616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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