Drug and alcohol dependence最新文献

{"title":"The ACA Medicaid expansions and the supply of substance use disorder treatment services in Spanish","authors":"Agustina Laurito ,&nbsp;Jonathan Cantor","doi":"10.1016/j.drugalcdep.2024.112468","DOIUrl":"10.1016/j.drugalcdep.2024.112468","url":null,"abstract":"<div><h3>Background</h3><div>Given persistent disparities in substance use disorder (SUD) treatment for Spanish speakers, it is important to understand whether major health policy changes may improve access to linguistically competent services. We estimate changes in the supply of SUD treatment facilities that both accept Medicaid as payment and offer services in Spanish after the Medicaid expansions under the Affordable Care Act.</div></div><div><h3>Methods</h3><div>We use data from the Mental Health and Addiction Treatment Tracking Repository for years 2010–2020 to calculate the number of facilities per 100 that offered both services in Spanish and accepted Medicaid as payment, facilities per 100 that accepted Medicaid as a form of payment overall, and facilities per 100 that offered Spanish language services overall. We use a difference-in-differences strategy exploiting variation in the timing of the Medicaid expansions across states, and county-level variation in the share of Spanish speaking Latinos across and within states.</div></div><div><h3>Results</h3><div>We find that treatment facilities that both accepted Medicaid as a form of payment and offered Spanish language services increased by roughly 2–3 per 100, on average, in counties with the highest shares of Spanish speakers compared to counties with low to medium shares. This increase may be explained by more facilities accepting Medicaid as a form of payment.</div></div><div><h3>Conclusion</h3><div>The Medicaid expansions under the ACA produced a modest increase in the supply of SUD treatment facilities that both accepted Medicaid as payment and provided services in Spanish in areas with highest shares of Spanish speakers.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112468"},"PeriodicalIF":3.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between gender diversity and substance use experimentation in early adolescents","authors":"Iris Y. Shao ,&nbsp;Patrick Low ,&nbsp;Shirley Sui ,&nbsp;Christopher D. Otmar ,&nbsp;Kyle T. Ganson ,&nbsp;Alexander Testa ,&nbsp;Glenn-Milo Santos ,&nbsp;Jinbo He ,&nbsp;Fiona C. Baker ,&nbsp;Jason M. Nagata","doi":"10.1016/j.drugalcdep.2024.112473","DOIUrl":"10.1016/j.drugalcdep.2024.112473","url":null,"abstract":"<div><h3>Background</h3><div>Gender diversity, encompassing gender identity beyond traditional binary frameworks, has been associated with substance use during adolescence. However, there is a paucity of studies that consider different dimensions of gender diversity. This study investigates associations between multiple dimensions of gender diversity and substance experimentation in early adolescents.</div></div><div><h3>Methods</h3><div>Data from 10,092 adolescents aged 12–13 years from the Adolescent Brain Cognitive Development (ABCD) study were used to assess the relationship between gender diversity and substance experimentation. Gender diversity was measured using multiple dimensions, including identity (transgender), felt gender (congruence between gender identity and assigned sex), gender non-contentedness (dissatisfaction with one’s gender), gender expression (adherence to gender expression norms), and place on the gender spectrum (masculine to feminine). Substance use was evaluated using self-reported lifetime and new experimentation (past year) of alcohol, nicotine, and cannabis use. Logistic regression models adjusted for sociodemographic factors were analyzed.</div></div><div><h3>Results</h3><div>More gender-diverse responses for felt gender, gender non-contentedness, gender expression, and gender spectrum were associated with higher odds of lifetime alcohol experimentation. More gender-diverse responses for gender identity and gender non-contentedness were associated with higher odds of new nicotine experimentation, and more gender-diverse responses for gender identity, felt gender, gender non-contentedness, and gender expression were associated with higher odds of lifetime and new cannabis experimentation.</div></div><div><h3>Conclusion</h3><div>Gender diversity is differentially associated with new and lifetime substance experimentation in early adolescence. Different dimensions of gender diversity may be uniquely associated with substance use behaviors, highlighting the need for targeted interventions in gender-diverse adolescents.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112473"},"PeriodicalIF":3.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An examination of Black-White disparities in repeat nonfatal opioid overdose incidents, fatal drug overdose, and all-cause mortality in Detroit, Michigan","authors":"Grant Victor ,&nbsp;Catherine Zettner ,&nbsp;Guijin Lee","doi":"10.1016/j.drugalcdep.2024.112488","DOIUrl":"10.1016/j.drugalcdep.2024.112488","url":null,"abstract":"<div><h3>Background</h3><div>There has been an approximately 38 percent increase in overdose deaths for Black men since 2015 yet estimates vary between major metropolitan areas. It is crucial to examine local data to inform community-driven harm reduction and overdose prevention services. We used administrative data to examine the effect of demographic characteristics and repeated nonfatal opioid overdoses (NFOO) on drug-related and all-cause mortality.</div></div><div><h3>Methods</h3><div>Emergency medical services (EMS) data were linked to vital records to determine fatal drug overdose and all-cause mortality. Demographic measures included age, race (Black/White), and sex (male/female). Binary logistic regression modeling was used to assess the relative influence of each of these factors on the odds of a fatal drug overdose.</div></div><div><h3>Results</h3><div>Among decedents, 27.0 % (n=47) experienced at least one additional NFOO prior to death. After controlling demographic characteristics, the odds of a fatal drug overdose increased by 17 % for each additional NFOO. Compared to White individuals, Black individuals were 60 % less likely to experience a fatal drug overdose, despite experiencing a significantly greater number of NFOO. All-cause mortality among Black individuals was approximately double that experienced by White individuals following a nonfatal opioid overdose.</div></div><div><h3>Conclusion</h3><div>There is a high risk of fatal drug overdose in the two-years following a nonfatal opioid overdose, and a greater risk of repeated NFOO. Black individuals’ mortality was associated with non-overdose causes, despite being associated with experiencing a significantly greater number of nonfatal overdoses. Widespread implementation of overdose prevention and general medical care is warranted to curb NFOO and allcause mortality.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112488"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood demographics in relation to marketing and regulation-related factors among cannabis retailers in 5 US cities","authors":"Carla J. Berg ,&nbsp;Nina C. Schleicher ,&nbsp;Patricia A. Cavazos-Rehg ,&nbsp;Katelyn F. Romm ,&nbsp;Cassidy R. LoParco ,&nbsp;Yuxian Cui ,&nbsp;Yan Wang ,&nbsp;Darcey M. McCready ,&nbsp;Rishika Chakraborty ,&nbsp;Lisa Henriksen","doi":"10.1016/j.drugalcdep.2024.112471","DOIUrl":"10.1016/j.drugalcdep.2024.112471","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assessed differences in cannabis retailer practices by neighborhood sociodemographics, which can inform disparity-relevant interventions.</div></div><div><h3>Methods</h3><div>Multilevel multivariable logistic regressions examined retailers’ census tract demographics (percent &lt;21 years-old; non-Hispanic White, Black, or other race, Hispanic; median household income [MHHI]) in relation to 2022 audit data regarding marketing (youth-oriented signs, health-claims, exterior ads, price specials, membership programs, delivery/pick-up) and regulatory compliance (pregnancy and health-risk warning signage, exterior minimum-age signage) among 150 randomly-selected retailers in 5 US cities/states (Denver, Colorado; Seattle, Washington; Portland, Oregon; Las Vegas, Nevada; Los Angeles, California).</div></div><div><h3>Results</h3><div>20.7 % had youth-oriented signage, 28.7 % health-claim signage, 27.3 % exterior ads, 75.3 % price specials, 39.3 % membership programs, 28.0 % delivery/pick-up, 72.0 % pregnancy warnings, 38.0 % health-risk warnings, and 64.0 % minimum-age signage. Retailers in tracts with higher percent &lt;21 and non-Hispanic White had lower odds of youth-oriented signage. Higher MHHI had higher odds of health-claims; higher percent Hispanic had lower odds of health-claims. Higher MHHI had lower odds of exterior ads. Higher percent &lt;21 had lower odds of price specials. Higher percent non-Hispanic White had higher odds of membership programs. Higher percent non-Hispanic White, other race, and Hispanic had higher odds of delivery/pick-up; higher MHHI had lower odds of delivery/pick-up. Higher percent non-Hispanic White had higher odds of pregnancy warnings. Higher percent &lt;21 had lowers odds of health-risk warnings. Demographics were unrelated to minimum-age signage.</div></div><div><h3>Conclusions</h3><div>Given key findings (e.g., less regulation-related signage in racial/ethnic minority communities), cannabis retail could exacerbate disparities, underscoring the need for related regulatory and prevention efforts.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112471"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An updated view on the influence of initial opioid prescription characteristics on long-term opioid use among opioid naïve patients","authors":"Allen M. Smith ,&nbsp;Anuj Shah ,&nbsp;Bradley C. Martin","doi":"10.1016/j.drugalcdep.2024.112463","DOIUrl":"10.1016/j.drugalcdep.2024.112463","url":null,"abstract":"<div><h3>Objectives</h3><div>This retrospective cohort study provides an updated view on the association between the likelihood of long-term opioid use (LTOU) and characteristics of the initial opioid prescription (dose, opioid type) and initial opioid prescription episode (days’ supplied) among opioid-naïve patients utilizing IQVIA PharMetrics®Plus for Academics database representative of commercially insured patients in the US.</div></div><div><h3>Methods</h3><div>Kaplan-Meier estimates were used to determine opioid continuation likelihood at 365 days stratified by the characteristics of the initial opioid prescription and initial opioid prescription episode. Cox-proportional hazard models were estimated to determine the strength of association between initial opioid prescription characteristics and opioid continuation.</div></div><div><h3>Results</h3><div>A total of 578,403 cancer-free, SUD-free, opioid-naïve subjects aged ≥14 years that filled ≥1 opioid prescriptions between April 13, 2016 and April 18, 2020 were identified and categorized based on time to opioid discontinuation. After accounting for censoring, 5.05 % of persons continued opioid use for ≥365 days. Compared to a 1–2 days’ supply (DS), the likelihood of opioid discontinuation was consistently lower with higher DS [HRs (CIs): 3–4 days' supply = 0.66 (0.65–0.66); 5–7 DS = 0.41 (0.41–0.41); 8–10 DS = 0.33 (0.33–0.34); 11–14 DS = 0.30 (0.29–0.31); 15–21 DS = 0.26 (0.26–0.27); ≥22 DS = 0.17 (0.17–0.18)]. These associations between increased DS and decreased likelihood of discontinuing opioid remained consistent across different pain etiologies.</div></div><div><h3>Conclusions</h3><div>In this era of more conservative opioid prescribing, increases in DS remains the strongest factor associated with a higher likelihood of LTOU.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112463"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of discomfort intolerance, discomfort avoidance, and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for opioid use disorder","authors":"Danielle F. Haley ,&nbsp;Michael D. Stein ,&nbsp;Sally Bendiks ,&nbsp;Skylar Karzhevsky ,&nbsp;Claire Pierce ,&nbsp;Ana Dunn ,&nbsp;Debra S. Herman ,&nbsp;Bradley Anderson ,&nbsp;Risa B. Weisberg","doi":"10.1016/j.drugalcdep.2024.112472","DOIUrl":"10.1016/j.drugalcdep.2024.112472","url":null,"abstract":"<div><h3>Background</h3><div>Chronic pain and non-prescribed substance use are associated with lower retention in opioid use disorder (OUD) treatment. We examined the associations of perceived capacity to tolerate uncomfortable physical sensations (discomfort intolerance and discomfort avoidance) and cannabis and alcohol use among persons with chronic pain receiving prescription buprenorphine for OUD.</div></div><div><h3>Methods</h3><div>This study utilizes baseline data from 163 persons with chronic pain receiving prescription buprenorphine for OUD enrolled in the Treating Opioid use, Persistent Pain, and Sadness (TOPPS) intervention trial. We used negative-binomial regression models, adjusted for age, education, gender, race/ethnicity, pain interference, depression, generalized anxiety disorder, and average cigarettes smoked/day to estimate the associations of discomfort tolerance and discomfort avoidance with frequency of cannabis and alcohol use.</div></div><div><h3>Results</h3><div>Participants (n=163) were on average 45 years old (standard deviation=10.6) and predominantly White (86 %, n=141). Forty-one percent (n=66) used cannabis and 24 % (n=30) used alcohol use in the past 30 days. In adjusted models, discomfort intolerance was positively associated with days of cannabis use (IRR = 1.11, p =.016) and days of alcohol use (IRR = 1.14, p =.022). Discomfort avoidance was not associated with cannabis or alcohol use.</div></div><div><h3>Conclusion</h3><div>Individuals with chronic pain receiving prescribed buprenorphine for treatment of OUD with lower tolerance for physical discomfort may augment pain management with cannabis and alcohol. Given the intersections between substance use and retention in care for OUD, future work should extend this preliminary work by exploring these relationships over time and in experimental settings.</div><div><strong>Clinical Trial #</strong> NCT03698669</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112472"},"PeriodicalIF":3.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minority stress mediates associations of sexual minority state policies and tobacco use among US sexual minority young adults","authors":"Katelyn F. Romm ,&nbsp;Erin A. Vogel ,&nbsp;Christina Dyar ,&nbsp;Laurie A. Drabble ,&nbsp;Patricia A. Cavazos-Rehg ,&nbsp;Carla J. Berg","doi":"10.1016/j.drugalcdep.2024.112477","DOIUrl":"10.1016/j.drugalcdep.2024.112477","url":null,"abstract":"<div><h3>Introduction</h3><div>State policies surrounding sexual minority (SM) rights are associated with tobacco use among SM individuals. Research is scant regarding the role of distinct SM policy categories on SM young adults’ (SMYAs) tobacco use and mechanisms explaining these associations.</div></div><div><h3>Methods</h3><div>We analyzed 2023 survey data from 1100 SMYAs (ages 18–34; 14.2 % gender minority; 66.1 % bisexual+, 29.1 % monosexual; 53.2 % racial/ethnic minority) with representation across 45 US states and DC. Regression-based models examined: 1) direct associations of residing in states with negative and limited (vs. comprehensive) SM state policies with respect to 7 policy categories (relationship/parent recognition, nondiscrimination, religious exemptions, LGBTQ youth, healthcare, criminal justice, gender identity documents) with minority stress (mental health, internalized stigma, community connectedness); 2) direct associations of policy categories and minority stress with tobacco use (past-month cigarette, e-cigarette, any tobacco use, number of products used); and 3) indirect associations of policy categories with tobacco use through minority stress.</div></div><div><h3>Results</h3><div>Relative to residing in states with comprehensive policies, residing in states with limited relationship/parent recognition policies indirectly predicted higher odds of e-cigarette use through mental health; weaker nondiscrimination policies indirectly predicted using more tobacco products through internalized stigma; and negative healthcare policies indirectly predicted higher odds of cigarette and any tobacco use through community connectedness.</div></div><div><h3>Conclusions</h3><div>These novel findings regarding associations among distinct SM policy categories, minority stress mediators, and tobacco use outcomes warrant further examination to better understand these distinct mechanisms, ultimately to inform SM-related policy and advocacy efforts, as well as tobacco prevention and cessation efforts.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112477"},"PeriodicalIF":3.9,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142579029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does sex moderate the effects of early life stress on peripheral inflammation in alcohol use disorder? A preliminary investigation","authors":"Dylan E. Kirsch ,&nbsp;Erica N. Grodin ,&nbsp;Artha J. Gillis ,&nbsp;Karen Miotto ,&nbsp;Lara A. Ray","doi":"10.1016/j.drugalcdep.2024.112474","DOIUrl":"10.1016/j.drugalcdep.2024.112474","url":null,"abstract":"<div><h3>Introduction</h3><div>Early life stress (ELS) increases risk for many medical and psychiatric illnesses, including alcohol use disorder (AUD). Females appear to be more vulnerable than males to adverse ELS-related health outcomes, including heavy alcohol use. The biological processes underlying sex differences in ELS-related drinking outcomes are not well understood. Inflammation is one biological mechanism linking ELS to adult alcohol use. This study tested whether biological sex moderates the relationship between ELS and peripheral inflammation in adults with AUD.</div></div><div><h3>Methods</h3><div>Treatment-seeking males (N=60) and females (N=38) with AUD completed the Adverse Childhood Experiences (ACE) questionnaire and provided blood samples for measures of peripheral C-reactive protein (CRP) and cytokines (TNF-α, IFN-γ, IL-6, IL-8, IL-10). Participants were classified as having “no/moderate-ELS” (ACE=0–3) or “high-ELS” (ACE=4+). A composite cytokine score was calculated using principal component analysis to capture general immune system activation. We tested ELS by sex interactions on CRP and cytokine levels using univariate ANOVA.</div></div><div><h3>Results</h3><div>The no/moderate-ELS group included 37 males and 22 females; the high-ELS group included 23 males and 16 females. There was an ELS group by sex interaction on CRP (p=0.02) and composite cytokine levels (p=0.02). Females in the high-ELS group exhibited greater CRP (p=0.003) and composite cytokine levels (p=0.01) than females in the no/moderate ELS group. There were no ELS group differences in CRP (p=0.9) or composite cytokine levels (p=0.6) in males.</div></div><div><h3>Conclusion</h3><div>Results suggest that sex moderates the effects of ELS on peripheral inflammation in adults with AUD; females with AUD may be more vulnerable to the ELS-related adaptations to the immune system, potentially resulting in a proinflammatory state in adulthood.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112474"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlates of post-hospitalization naltrexone adherence for alcohol use disorder","authors":"Eden Y.Bernstein ,&nbsp;Kara M. Magane ,&nbsp;Kimberly A. Dukes ,&nbsp;Tibor P. Palfai ,&nbsp;Joo H. Lee ,&nbsp;Richard Saitz ,&nbsp;Jeffrey H. Samet","doi":"10.1016/j.drugalcdep.2024.112470","DOIUrl":"10.1016/j.drugalcdep.2024.112470","url":null,"abstract":"<div><h3>Introduction</h3><div>Hospitalizations present an opportunity to initiate naltrexone for patients with alcohol use disorder (AUD). Understanding factors associated with post-hospitalization adherence could inform practice.</div></div><div><h3>Methods</h3><div>This study is a secondary analysis of a clinical trial in which patients with AUD were randomized to oral (PO) versus long-acting injectable (LAI) naltrexone at hospital discharge. The outcome of this secondary analysis was naltrexone adherence 3 months after discharge, defined as receipt of at least 2 out of 3 monthly injections or the equivalent days of self-reported PO medication use (60 out of 90). We used baseline socio-demographics, substance use history, health status, healthcare utilization, and randomization arm to construct multivariable logistic regression models to identify correlates of adherence.</div></div><div><h3>Results</h3><div>We evaluated patients who initiated naltrexone treatment, 124 randomized to PO and 120 to LAI (overall mean age 49 years, 80 % male, 51 % Black, 47 % unhoused, and 91 % with severe AUD). At 3 months, 50 % of patients were adherent. LAI naltrexone (aOR 3.88; 95 % CI 2.17–7.13), recent office visit (aOR 2.01; 95 % CI 1.10–3.72), and age (aOR per 10-year increase 1.37; 95 % CI 1.02–1.88) were associated with increased odds of adherence. Unhoused status (aOR 0.54; 95 % CI 0.30–0.98) and cocaine use (aOR 0.35; 95 % CI 0.17–0.71) were associated with decreased odds of adherence.</div></div><div><h3>Conclusions</h3><div>LAI naltrexone for AUD at hospital discharge was associated with better adherence at 3 months vs PO. Access to LAI naltrexone and targeted interventions for patients with cocaine use or who are unhoused hold potential to improve naltrexone adherence.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112470"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of tobacco price-minimization strategies among public housing residents compared to U.S. low-income adults","authors":"Craig T. Dearfield ,&nbsp;Kasra Zarei ,&nbsp;Kelvin Choi ,&nbsp;Debra H. Bernat","doi":"10.1016/j.drugalcdep.2024.112476","DOIUrl":"10.1016/j.drugalcdep.2024.112476","url":null,"abstract":"<div><h3>Background</h3><div>Price minimization strategies (PMS) are ways for people to save money on tobacco purchases especially among those of lower socioeconomic status. This study assesses PMS and coupon receipt among public housing residents compared to U.S. low-income adults.</div></div><div><h3>Methods</h3><div>Data were from adults who currently use tobacco and live in District of Columbia Housing Authority (DCHA) public housing (n=270) and a US nationally representative sample of low-income adults who currently use tobacco (n=820). We examined the prevalence of PMS use across demographic characteristics and smoking behaviors, and qualitatively compared them across the two datasets.</div></div><div><h3>Results</h3><div>Most DCHA resident participants (84.2 %) and US low-income adults who currently use tobacco (91.5 %) recently used at least one PMS to save money on tobacco. The top-three most common strategies among DCHA residents were saving cigarettes to finish later (35.6 %), smoking fewer cigarettes (32.2 %), and finding cheaper places to buy cigarettes (30.4 %), while among U.S. low-income adults these strategies were using coupons or promotions (62.7 %), purchasing by bulk (55.5 %), and finding cheaper places to buy tobacco products (53.6 %). People who lightly smoke in DCHA were more likely than people who heavily smoke to use PMS in general (25.0 % vs. 13.7 %) and smoke fewer cigarettes to save money (35.8 % vs. 19.2 %). US low-income people who lightly smoke were more likely than people who heavily smoke to cut back on tobacco use (61.9 % vs. 39.8 %).</div></div><div><h3>Conclusion</h3><div>Most U.S. low-income individuals and DCHA residents who smoke engaged in PMS. Regulating these strategies while supporting tobacco use cessation may reduce the impact of tobacco in these populations.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"265 ","pages":"Article 112476"},"PeriodicalIF":3.9,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}