Addiction最新文献

{"title":"Professionalism, professional identity and community pharmacy culture: The context of substance dependency through the lens of student and early career pharmacists.","authors":"Natalie Weir, Emma Dunlop, Adrian MacKenzie, Thomas Byrne, Katie Johnston, Alice O'Hagan, Zohaib Rehman, Holly Richardson, Aalia Shah, Gemma Wilson, Andrew Radley","doi":"10.1111/add.70180","DOIUrl":"https://doi.org/10.1111/add.70180","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to explore the reflections of student and newly qualified pharmacists (NQPs) surrounding community pharmacy culture around substance dependency. This study explored professionalism and professional identity formation, and the possibility that a fragmented professional identity may impact behaviours and the provision of compassionate care.</p><p><strong>Design: </strong>Qualitative study: semi-structured interviews were conducted with student and exploring stigma within community pharmacy environments in relation to people with substance dependency, the community pharmacy culture and their own ideas of professionalism and their professional identity formation. Interviews were undertaken by six pharmacy student researchers, under the supervision of two experienced researchers.</p><p><strong>Setting: </strong>Community pharmacies across Scotland.</p><p><strong>Participants: </strong>Twenty-eight participants were recruited, including undergraduates based at Scottish Schools of Pharmacy (n = 20); Foundation Year Pharmacy students (n = 2) and NQPs (n = 6). Recruitment utilised university networks and social media platforms.</p><p><strong>Measurements: </strong>Interviews were conducted between September and November 2023 on Microsoft Teams®, each lasting 17-60 minutes. Data underwent inductive thematic analysis via NVivo® through data familiarisation, initial coding, theme searching, reviewing and defining and reporting.</p><p><strong>Findings: </strong>Stigmatisation of people with substance dependency attending a pharmacy was a prominent observation. This included negative stereotyping, adverse treatment because of judgements made about substance use and structural stigma relating to barriers to accessing care. Positive care provision in pharmacies was evident. Pharmacy staff who were empathetic, respectful, professional and who formed long-term relationships with people with substance dependency were valuable role models for students and influenced their professional identify formation. Students appreciated the exposure to practice and the opportunity to make judgements that would mould the type of pharmacist they aspired to become. A number of participants reported that their university course poorly prepared them for the reality of supporting people with substance dependency.</p><p><strong>Conclusions: </strong>Pharmacy practice in Scotland appears to be characterised by stigma and lack of professionalism towards people with substance dependency, although there are examples of compassionate care. Observing staff in practice allowed participants of this study to develop their own professional identity and attitudes, yet there is a need to better prepare students in undergraduate curricula.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structure and stability of internet gaming disorder from childhood to late adolescence: A 5-wave birth cohort study.","authors":"Lars Wichstrøm, Beate W Hygen, Daria J Kuss, Vasileios Stavropoulos, Věra Skalická, Rubén Rodríguez-Cano, Ane-Kristine Øien, Frode Stenseng, Silje Steinsbekk","doi":"10.1111/add.70195","DOIUrl":"https://doi.org/10.1111/add.70195","url":null,"abstract":"<p><strong>Background and aims: </strong>The natural course and longer-term stability of internet gaming disorder (IGD) and its symptoms are largely unknown, yet such knowledge is essential to aid prevention, treatment and policy development. This study therefore examined four aspects of IGD symptom stability: of form, at the group level, rank-order and of within-person changes.</p><p><strong>Design: </strong>Birth-cohort study.</p><p><strong>Setting: </strong>Trondheim, Norway.</p><p><strong>Participants: </strong>A stratified sample (n = 812, 50.9% girls) of the 2003/2004 birth cohorts was examined biennially over five waves from age 10 to 18 (n = 3236 observations).</p><p><strong>Measurements: </strong>IGD was assessed through a semi-structured clinical interview. Latent growth curves were employed to assess the stability of symptoms at the group level, and random intercept cross-lagged models were used to determine how changes in symptoms predicted subsequent changes in symptoms at the within-person level.</p><p><strong>Findings: </strong>IGD symptoms loaded on two factors, termed 'Heavy involvement' and 'Negative consequences,' consistently across ages and sex. Strong measurement invariance was partly achieved across ages. The point prevalence of IGD diagnosis varied between 1.1%-2.2%, and 5.6% [95% confidence interval (CI) = 4.0-7.3) had an IGD diagnosis at least once across ages 10-18 (boys: 10.2%, CI = 6.9-13.5; girls: 1.6%, CI = 0.5-2.7). Symptoms capturing Heavy involvement increased slightly from age 10-16 and then declined sharply at age 18, whereas symptoms representing Negative consequences remained stable. Regarding stability relative to the group, moderate two-year stability was observed (Heavy involvement r = 0.33 to 0.56, P < 0.001; Negative consequences r = 0.19, P < 0.01 to 0.37, P < 0.001) with increasing stability with age. The stability from age 10-16 and 10-18 was weak for Heavy involvement (r = 0.14 and 0.17, P < 0.05) and absent for Negative consequences (r = 0.09 to 0.11, P > 0.05). Increases in Heavy involvement predicted further increases in Heavy involvement two years later (β = 0.17, P < 0.01 to 0.39, P < 0.001) and increased Negative consequences at ages 14 and 18 (β = 0.29 and 0.28, P < 0.001).</p><p><strong>Conclusions: </strong>Although the point prevalence of internet gaming disorder (IGD) diagnosis in the 2003/2004 birth cohorts of Trondheim, Norway, was low, 10% of boys fulfilled the criteria for a diagnosis at least once during preadolescence and adolescence. IGD symptoms at age 10 were only weakly related to IGD symptoms in mid- and late adolescence. However, as Heavy involvement symptoms predicted later increases in Negative consequences symptoms from age 12 onwards, early adolescence may offer a window of opportunity for when interventions might intersect a development toward a full-blown IGD diagnosis before symptoms become more intertwined with additional problems and resistant to change.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psilocybin-assisted psychotherapy for methamphetamine use disorder: A pilot open-label safety and feasibility study.","authors":"Elizabeth Knock, Krista J Siefried, Gill Bedi, Steven Albert, Richard O Day, Nadine Ezard, Margaret Ross, Paul Liknaitzky, Jonathan Brett","doi":"10.1111/add.70187","DOIUrl":"https://doi.org/10.1111/add.70187","url":null,"abstract":"<p><strong>Background & aims: </strong>There are few effective treatments for methamphetamine use disorder, despite increasing global demand. Here, we assessed the safety and feasibility of outpatient psilocybin-assisted psychotherapy for methamphetamine use disorder.</p><p><strong>Design: </strong>Single arm, open label pilot study.</p><p><strong>Setting: </strong>Outpatient public stimulant treatment program at St. Vincent's Hospital, Sydney, Australia.</p><p><strong>Participants: </strong>We recruited 15 participants that were ≥25 years old, seeking treatment for methamphetamine use, using methamphetamine ≥4 days/month at screening, and without serious mental illness or contraindicated medical conditions or medications.</p><p><strong>Intervention: </strong>Participants received three preparatory psychotherapy sessions over two weeks before a single psilocybin dosing session (25 mg oral), followed by two integration psychotherapy sessions over one week. Psychotherapy included elements of motivational enhancement and acceptance and commitment therapy. Participants were followed for 90 days post psilocybin-assisted psychotherapy session.</p><p><strong>Measurements: </strong>Primary endpoints were safety (as measured by adverse events over the trial and vital signs during psilocybin dosing) and feasibility (as measured by enrolment and dropout rates), and secondary endpoints included measuring self-reported methamphetamine and other illicit drug use, drug craving, depression, anxiety, stress and quality of life measures.</p><p><strong>Findings: </strong>Of 56 participants pre-screened, 15 were eligible and enrolled, 14 completed the intervention and 13 completed 90-day post-dose follow-up.\". No serious adverse events (AEs) occurred, and the seven treatment related AEs were self-limiting and mild to moderate in severity. AEs included hypertension during the dosing session and headache (n = 4), nausea (n = 1) and noise sensitivity (n = 1) within the week following the dose. Methamphetamine use (over the prior 28 days) was observed to be lower at screening (median 12 days, IQR 7-16, n = 15) relative to day 28 (median 0 days, IQR 0-2, n = 13) and 90 (median 2 days, IQR 1-4, n = 14) post psilocybin. Methamphetamine craving was also observed to be lower while quality of life, depression, anxiety, and stress were observed to be higher at days 28 and 90 follow-up relative to baseline.</p><p><strong>Conclusions: </strong>Psilocybin assisted psychotherapy for methamphetamine use disorder was feasible to implement in an outpatient setting and did not appear to generate safety concerns. A larger randomised controlled trial is required to confirm efficacy and safety.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of drug-related deaths among individuals identified as LGBTQ+ in the United Kingdom, 1997-2024.","authors":"Emmert Roberts, Miriam Hillyard, Caroline Copeland","doi":"10.1111/add.70198","DOIUrl":"https://doi.org/10.1111/add.70198","url":null,"abstract":"<p><strong>Background and aims: </strong>Individuals from sexual and gender minorities (LGBTQ+) are understudied and at increased and differential risk of experiencing drug-related harms when compared with the general population. We aimed to determine the case characteristics, circumstances of death and type of implicated drugs among LGBTQ+ individuals dying due to drug-related causes. We also aimed to assess any differences between deaths occurring in the context of sexualised vs. non-sexualised drug use.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Coronial records submitted to the National Programme on Substance Use Mortality (NPSUM) in the United Kingdom (UK), 1997-2024.</p><p><strong>Cases: </strong>Decedents identified as LGBTQ+.</p><p><strong>Measurements: </strong>Information was available on decedent sociodemographics, characteristics of death and drugs implicated in death.</p><p><strong>Findings: </strong>A total of 83 decedents were identified as LGBTQ+. Forty-six were identified as cis men (55.4%), four as trans men (4.8%), two as cis women (2.4%) and 31 as trans women (37.3%). Forty-five were identified as gay, including 44 gay men (53.0%) and one gay woman (1.2%), with three identified as bisexual (3.6%). Decedents were predominantly of White ethnicity (n = 68, 81.9%) with a mean age of 38.2 years (standard deviation 12.1; range 16-84). Overall, 16 (19.8%) cases were deemed intentional. Poisoning was the main disease or condition that was certified as the underlying cause of death (n = 46, 55.4%). The median number of drugs implicated in death was 2 [Interquartile range (IQR) 1, 2] with multiple drug toxicity implicated in the majority of cases (n = 42, 50.6%). The two most common drug groups implicated in death were opioids (n = 31, 37.3%) and gamma-hydroxybutyrate (GHB) and related compounds (n = 14, 16.9%). Death occurred in the context of sexualised drug use in 21 cases (25.3%). There were statistically significantly fewer cases in which any opioid (33.9% vs. 4.8%, P = 0.009) or any benzodiazepine (21.0% vs. 0.0%, P = 0.02) were implicated when compared with cases of non-sexualised drug use.</p><p><strong>Conclusions: </strong>Over the last three decades in the United Kingdom there have been consistent numbers of drug-related deaths each year in which individuals were identified as LGBTQ+, results likely representing conservative estimates. A minority of drug-related deaths occurred in the context of sexualised drug use.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145090817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thresholds for adjunctive medication usage and probability of initiating injectable naltrexone.","authors":"Kara E Rudolph, Shodai Inose, Nicholas T Williams, Iván Díaz, Rachael K Ross, Adam Bisaga, Matisyahu Shulman","doi":"10.1111/add.70189","DOIUrl":"10.1111/add.70189","url":null,"abstract":"<p><strong>Aims: </strong>To estimate the effectiveness of different thresholds for administering opioid withdrawal medications (clonidine and clonazepam) on the probability of successfully initiating extended-release naltrexone (XR-NTX) among participants with opioid use disorder (OUD) during medically managed withdrawal.</p><p><strong>Design: </strong>Secondary analysis of a multisite clinical trial comparing a rapid vs. standard approach for XR-NTX initiation, 2021-2022.</p><p><strong>Setting: </strong>Six community inpatient addiction treatment units in the United States.</p><p><strong>Participants: </strong>English-speaking adults seeking treatment for DSM-5 OUD and expressing interest in XR-NTX treatment (n = 415).</p><p><strong>Measurements: </strong>We estimated the extent to which the following thresholds for adjunctive medication administration would affect the probability of initiating XR-NTX over time: 1) where adjunctive medications were given in response to at mild-to-moderate withdrawal symptoms or greater [Clinical Opiate Withdrawal Scale (COWS) score ≥ 5), 2) where adjunctive medications were given in response to minimal withdrawal symptoms or greater (COWS score ≥ 3) and 3) where adjunctive medications were given regardless of withdrawal symptoms. Using a longitudinal sequentially doubly robust estimator, we estimated the cumulative probability of XR-NTX initiation under each of these three treatment regimes while accounting for dropout and initiation of other medications as competing events.</p><p><strong>Findings: </strong>The estimated probability of initiating XR-NTX by day 14 was 50.4% [95% confidence interval (CI) = 41.8-58.9) under the no-threshold regime, 43.9% (95% CI = 39.1-48.7) under the regime of waiting for minimal withdrawal symptoms and 38.5% (95% CI = 34.3-42.6) under the regime of waiting for mild-to-moderate withdrawal symptoms. Probability of XR-NTX initiation was a statistically significant 11.9 percentage points higher (95% CI = 3.6-20.2) under the no-threshold regime versus the mild-to-moderate threshold regime, and a non-statistically significant 6.4 percentage points (95% CI = -0.8 to 13.7) higher under the no-threshold regime versus the minimal threshold regime.</p><p><strong>Conclusions: </strong>Providing clonidine and clonazepam daily during the first five days of medically managed opioid withdrawal appears to statistically significantly increase the likelihood of initiating extended-release naltrexone treatment compared with waiting for mild-to-moderate withdrawal symptoms to administer adjunctive medications. To improve initiation rates, providers may consider lowering the threshold at which they provide adjunctive medications, giving these medications preemptively or to manage even minimal withdrawal symptoms.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Describing the alcohol harm paradox: 20 years of data from Victoria, Australia.","authors":"Michael Livingston, Nic Taylor, Sarah Callinan, Yvette Mojica-Perez, Alexandra Torney, Gabriel Caluzzi, Klaudia Kepa, Amy Pennay","doi":"10.1111/add.70194","DOIUrl":"https://doi.org/10.1111/add.70194","url":null,"abstract":"<p><strong>Background and aims: </strong>Internationally, rates of harm from alcohol tend to be higher in lower socio-economic groups, even while drinking is lower. This is known as the alcohol harm paradox. There are very little Australian data published on socio-economic disparities in alcohol consumption and harm, and none that has examined changes over time. This paper aimed to describe trends in socio-economic inequalities in key measures of alcohol consumption and alcohol-related harm over 21 years in Victoria, Australia.</p><p><strong>Design: </strong>Trend analysis of population rates of separate data on hospital, emergency department and drinking behaviour.</p><p><strong>Setting: </strong>Victoria, Australia, between 2000 and 2020.</p><p><strong>Participants/cases: </strong>Survey data from 37 422 respondents plus 841 792 hospital admissions and 591 824 emergency department presentations.</p><p><strong>Measurements: </strong>Socio-economic status was measured using an area-based index based on postcode of residence, divided into quintiles. Two measures of drinking were assessed based on survey responses: annual volume of drinking and frequency of risky (50 g or more) drinking occasions. Chronic harms were measured via hospital admissions for alcohol-related liver disease and acute harms via emergency department presentations for alcohol-related disorders. Differences in drinking and harm rates across quintiles were assessed using negative binomial regression, with interactions to examine whether the social gradients changed over time.</p><p><strong>Findings: </strong>For men, there were no statistically significant differences in either total volume of drinking or frequency of episodic risky drinking between socio-economic quintiles. For women, volume of drinking was generally higher for those living in more advantaged neighbourhoods [e.g. Incident Rate Ratio (IRR) = 1.60, 95% confidence interval (CI) = 1.32-1.95 for women in the most advantaged compared with most disadvantaged], while frequency of episodic risky drinking did not differ statistically significantly. Trends in drinking on either measure did not differ by socio-economic status for men or women. Alcohol-related harms were higher for people living in disadvantaged neighbourhoods for most outcomes and sub-groups analysed. For example, male rates of alcohol-related liver disease were nearly twice as high in the most disadvantaged quintile as in the least disadvantaged quintile (IRR = 0.54, CI = 0.50-0.58). On some measures there was evidence that the gap between socio-economic groups had widened over time.</p><p><strong>Conclusions: </strong>Despite similar or lower levels of alcohol consumption, people living in more disadvantaged socio-economic areas of Victoria, Australia, appear to experience much higher rates of alcohol-related harm than those in more advantaged areas, with some disparities widening over time.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining cause of death attribution among opioid, opioid-stimulant and stimulant acute toxicity deaths.","authors":"Yi-Shin Grace Chang, Nora Anderson, Kyna Long, Ciaran Murphy, Vanessa M McMahan, Luke N Rodda, Alex H Kral, Phillip O Coffin","doi":"10.1111/add.70190","DOIUrl":"https://doi.org/10.1111/add.70190","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Deaths attributed to a combination of opioids and stimulants have risen dramatically in recent years, largely attributed to fentanyl, yet little is understood about which drug class is primarily responsible. Attributing death to acute substance toxicity is complex and lacks clear standards. We aimed to determine whether additional causes of death and other significant conditions among deaths attributed to fentanyl were similar regardless of stimulant involvement, and distinct from deaths involving stimulants without opioids.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Cross-sectional analysis using records from the California Electronic Death Registration System.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and cases: &lt;/strong&gt;Unintentional acute toxicity deaths involving fentanyl or stimulants (methamphetamine or cocaine) occurring in San Francisco, USA, during 2013-2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;We compared demographic characteristics and causes of death or other significant conditions (cardiovascular, cerebrovascular, other medical cause, or no other additional cause) among five mutually exclusive groups of deaths: stimulants without opioids (stimulant-only), fentanyl with stimulants (fentanyl-stimulant), fentanyl without stimulants (fentanyl-only), other opioids (e.g., heroin, oxycodone) with stimulants (\"other opioid-stimulant\"), and other opioids without stimulants (\"other opioids-only\"). We conducted separate unadjusted and adjusted multivariable logistic regression models for each outcome (cardiovascular, cerebrovascular, other medical, or no additional cause). The primary analysis included results for the fentanyl groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Of 4475 deaths attributed to acute opioid and/or stimulant toxicity, 24% involved stimulants-only, 45% fentanyl-stimulants, and 12% fentanyl-only; the remaining 20% involved other opioids. Stimulant-only decedents were the oldest (mean age 54 years), followed by fentanyl-stimulant (47 years) and fentanyl-only (44 years; p &lt; 0.001 for all). The adjusted odds of having cardiovascular, cerebrovascular, or other medical causes of death (adjusted odds ratios [aORs] from 0.03 to 0.52, with 95% confidence intervals [CIs] from 0.01 to 0.68) were lower and the odds of no additional cause of death (aORs from 2.53 to 3.31, with 95% CIs from 2.00 to 3.40) were higher for both groups of deaths involving fentanyl compared with deaths attributed to stimulants-only. There were no statistically significant differences in causes of death when comparing fentanyl-only with fentanyl-stimulant deaths. Findings were similar for other opioid deaths.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In San Francisco, USA, causes of death and other significant condition characteristics among deaths attributed to fentanyl appear to be similar regardless of the involvement of stimulants, but are markedly different from deaths involving stimulants without opioids. When reporting on drug-related mortality and devel","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersectionality in cigarette smoking cessation: A latent class analysis to predict 12-month cessation in a randomized controlled trial.","authors":"Margarita Santiago-Torres, Kristin E Mull, Dingjing Shi, Adam C Alexander, Nicole L Nollen, Brianna M Sullivan, Michael J Zvolensky, Jonathan B Bricker","doi":"10.1111/add.70185","DOIUrl":"10.1111/add.70185","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aims: &lt;/strong&gt;Currently, smoking cessation intervention research on marginalized populations focuses on a single attribute (e.g. race). However, these attributes intersect and research on this intersectionality has been rare. This study applied latent class analysis (LCA) to examine how multiple theory-driven baseline factors interact and predict 12-month 30-day point prevalence abstinence from cigarette smoking in 2415 adult participants in a digital smoking cessation intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Theory-based analysis of a randomized trial with 12-month smoking cessation follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;United States (US).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;A total of 2415 adults who smoke that were recruited from all 50 US states and enrolled in the trial between May 2017 and September 2018.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention and comparator: &lt;/strong&gt;In the parent RCT, participants were randomized to receive iCanQuit, an Acceptance and Commitment Therapy-based smartphone smoking cessation app (n = 1214) or QuitGuide, a US Clinical Practice Guidelines-based smoking cessation app (n = 1201) for 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Measurements: &lt;/strong&gt;Guided by Sheffer et al.,six theory-based factors were examined, including social identities: gender, race and ethnicity, marital status, sexual and gender minority (SGM) identity and socio-economic status (SES; education, income, employment); and lived experiences: positive screen for experiencing depression symptoms. Social identity and lived experiences data were collected via baseline questionnaires. The primary smoking cessation outcome was self-reported complete-case 30-day point prevalence abstinence at 12 months. SAS PROC LCA was used to identify classes based on the six selected factors and to predict 12-month smoking cessation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;A 4-class model showed the best goodness-of-fit statistics and interpretability. Participants in class 1 (n = 352, 14.6%) were more likely to be women, individuals of Black race and those with single marital status. Participants in class 2 (n = 322, 13.3%) were more likely to be men, SGM individuals and socioeconomically advantaged, as indicated by higher education, higher income or employment. Participants in class 3 (n = 368, 15.2%) were socioeconomically disadvantaged and screened positive for experiencing depression symptoms at baseline (CES-D &lt;math&gt; &lt;semantics&gt;&lt;mrow&gt;&lt;mo&gt;≥&lt;/mo&gt;&lt;/mrow&gt; &lt;annotation&gt;$$ ge $$&lt;/annotation&gt;&lt;/semantics&gt; &lt;/math&gt; 16). Finally, participants in class 4 (n = 1373, 56.9%) were more likely to be women, individuals of White race and married. Class 2 had the highest smoking cessation rate (32.8%) at 12 months, followed by class 1 (27.3%), class 4 (24.2%) and class 3 (15.4%). Compared with class 2, class 3 had 63% lower odds of quitting smoking (odds ratio = 0.37; 95% confidence interval = 0.20-0.71, P = 0.016).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;People with both socioeconomi","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between Problem Gambling Severity Index scores and suicidality: Results of a 9-year cohort study of young United Kingdom adults.","authors":"Oliver Bastiani, Jasmine Khouja, Anya Skatova, Philip Newall","doi":"10.1111/add.70156","DOIUrl":"https://doi.org/10.1111/add.70156","url":null,"abstract":"<p><strong>Background and aims: </strong>Previous studies report cross-sectional associations between harmful gambling and suicidality. Longitudinal evidence is less common, but among young adults in the United Kingdom (UK), current longitudinal evidence highlights the specific association between increases in harmful gambling and subsequent suicidality. In a young UK adult cohort, we aimed to investigate whether harmful gambling, as measured by the Problem Gambling Severity Index (PGSI), would be associated with concurrent and future suicide attempts (at intervals of one, four and five years). Furthermore, the four-year window was used to observe whether PGSI increases were a unique risk factor for suicidality, as has been observed before. In all instances, hierarchical logistic regression models explored whether associations were robust to controls for adolescent suicidality and relevant confounders.</p><p><strong>Design: </strong>A birth cohort study of the UK general population.</p><p><strong>Setting: </strong>Avon, UK.</p><p><strong>Participants: </strong>n = 2801 (62.4% female) participants with data for suicidality at 24 years from the Avon Longitudinal Study of Parents and Children (ALSPAC).</p><p><strong>Measurements: </strong>Past-year non-fatal suicide attempt prevalence was self-reported at 24 and 25 years (in 2017-2018). PGSI was measured at 20 and 24 years. Measured confounders were sex, maternal education, economic activity (employment/education status), hyperactivity, alcohol disorder likelihood and adolescent suicidality.</p><p><strong>Findings: </strong>Past-year suicide attempt prevalence was 2.57% at 24 years, and 1.86% at 25 years. Confounder-adjusted models found that PGSI predicted suicide attempts at 24 years [odds ratio (OR) = 1.13, 95% confidence interval (CI) = 1.05-1.21, P = 0.001], and predicted future suicide attempts over one-year (OR = 1.15, 95% CI = 1.06-1.25, P = 0.001) and four-year timespans (OR = 1.20, 95% CI = 1.08-1.34, P < 0.001), but there was inconclusive evidence of this association over five years (OR = 1.14, 95% CI = 0.995-1.31, P = 0.058). There was inconclusive evidence that increases in PGSI scores between 20 and 24 years predict suicide attempts at 24 years (OR = 1.69, 95% CI = 0.72-3.99, P = 0.230).</p><p><strong>Conclusions: </strong>Among young adults in the United Kingdom, harmful gambling appears to be associated with suicide attempts; however, this association may be more complex long-term, and increases in harmful gambling during adulthood may not be an important factor.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and characteristics of prenatal cannabis use in Michigan, USA: A statewide population-based pregnancy cohort.","authors":"Ban Al-Sahab, Jean M Kerver, Omayma Alshaarawy, Kipling M Bohnert, Michael R Elliott, Hongxiang Qiu, Audriyana Jaber, Harish Neelam, Nigel Paneth","doi":"10.1111/add.70188","DOIUrl":"https://doi.org/10.1111/add.70188","url":null,"abstract":"<p><strong>Aims: </strong>To estimate the prevalence of prenatal cannabis use in Michigan, USA, using self-reports and urine toxicology and to examine factors associated with use.</p><p><strong>Design: </strong>Observational study using data from the Michigan Archive for Research on Child Health (MARCH) cohort, part of the National Institutes of Health's Environmental influences on Child Health Outcomes (ECHO) program. It is a prospective statewide pregnancy cohort recruited in 2017-2023 using births as a sampling frame.</p><p><strong>Setting: </strong>A three-stage stratified cluster sample design that randomly selected hospitals, prenatal clinics and mothers across the lower peninsula of Michigan, where 97% of Michigan hospital births take place.</p><p><strong>Participants: </strong>Pregnant individuals recruited at their first prenatal visit primarily from 20 clinics serving 11 hospitals. Of 1105 eligible pregnant participants, 1092 (98.8%) had information on cannabis use either from self-reports (n = 999), urine toxicology (n = 1028) or both (n = 945). Study participants had a median age of 29.3 years (interquartile range = 7.6).</p><p><strong>Measurements: </strong>Cannabis use was self-reported by interviewer-administered phone surveys twice during pregnancy and further ascertained by measuring tetrahydrocannabinol (THC) metabolites in up to two urine samples collected during pregnancy. The prevalence of cannabis use was estimated using sampling weights and clustering by sampled hospital to account for the complex survey design.</p><p><strong>Findings: </strong>The weighted prevalence of prenatal cannabis use was 16.8% [95% confidence interval (CI) = 8.0%-25.7%] based on either self-report or urinalysis. Prevalence based on self-report alone was 12.3% (95% CI = 6.1%-18.6%) and from urinalysis alone was 13.3% (95% CI = 5.1%-21.6%). Adjusted for creatinine concentrations, levels of 11-nor-9-carboxy-tetrahydrocannabinol (THC-COOH) in positive samples ranged from 5.43 to 4694.89 ng/mg with a median of 122.00 ng/mg. Multivariate analysis revealed that participants who were single [adjusted prevalence rate ratio (aPRR) = 2.08, 95% CI = 1.15-3.78], had lower educational attainment (aPRR = 3.76, 95% CI = 1.23-11.53 for some college education and aPRR = 3.15, 95% CI = 0.97-10.25 for high school education as compared with undergraduate education or above), reported symptoms of depression (aPRR = 1.72, 95% CI = 1.19-2.48) and had a history of adverse childhood events (ACEs; aPRR = 2.04, 95% CI = 1.21-3.45 for ACEs ≥ 3 and aPRR = 1.64, 95% CI = 1.07-2.52 for 1-2 ACEs as compared to 0 ACEs) were more likely to use cannabis prenatally.</p><p><strong>Conclusions: </strong>Cannabis use is estimated to have occurred in one of six pregnancies in a population-based sample in Michigan, USA.</p>","PeriodicalId":109,"journal":{"name":"Addiction","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}