Drug and alcohol dependence最新文献

{"title":"Spatial epidemiology of nonfatal overdose in a community-based cohort of marginalized women in Vancouver, British Columbia (2014–2022)","authors":"Shira Goldenberg ,&nbsp;Esteban J. Valencia ,&nbsp;Ofer Amram ,&nbsp;Kate Shannon ,&nbsp;Kirstin Kielhold ,&nbsp;Charlie (Haouxan) Zhou ,&nbsp;Kathleen Deering","doi":"10.1016/j.drugalcdep.2025.112670","DOIUrl":"10.1016/j.drugalcdep.2025.112670","url":null,"abstract":"<div><h3>Background</h3><div>Given limited data regarding the spatial epidemiology of overdose among women amid the current overdose crisis, we evaluated (1) changes in spatiotemporal clustering of overdose over time, (2) the association between residential proximity to overdose clusters and recent nonfatal overdose, and (3) the association between ‘risk environment’ features and residential proximity to overdose clusters.</div></div><div><h3>Methods</h3><div>Questionnaire data were from a merged community-based cohort of marginalized women who use drugs in Vancouver, Canada (09/2014–08/2022). Emerging hotspot analysis was used to classify residential proximity to spatiotemporal clusters of nonfatal overdose and kernel density estimation was used to visualize the spatiotemporal distribution of nonfatal overdose clustering over the 8-year study. Statistical analyses drew on bivariate and multivariable logistic regression using generalized estimating equations (GEE).</div></div><div><h3>Findings</h3><div>Over eight years, among 650 participants (3461 observations), 37·2 % experienced a nonfatal overdose at least once. Annual period prevalence of nonfatal overdose increased from 9·1 % in 2014–15 to 25·6 % in 2021–2022. The highest-density clusters were in Vancouver’s Downtown Eastside/Strathcona neighborhoods, where clusters became larger and more dispersed from 2016-onwards. Residential proximity to overdose clusters was associated with higher odds of recent nonfatal overdose. ‘Risk environment’ features of unstable housing, unsafe sleeping environments, and physical violence were associated with elevated odds of residential proximity to overdose clusters.</div></div><div><h3>Interpretation</h3><div>Marginalized women face a high and rising burden of nonfatal overdose, which is influenced by the ‘risk environments’ in which they reside. Scale-up of geographically tailored overdose prevention services, harm reduction, and programs addressing violence and housing are needed.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112670"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070746","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":"Thematic analysis of medical examiner narratives to understand the socio-spatial context, recency of drug use, and likely mechanism of stimulant toxicity deaths","authors":"Finn Black ,&nbsp;Vanessa M. McMahan ,&nbsp;Yi-Shin G. Chang ,&nbsp;Luke N. Rodda ,&nbsp;Phillip O. Coffin","doi":"10.1016/j.drugalcdep.2025.112700","DOIUrl":"10.1016/j.drugalcdep.2025.112700","url":null,"abstract":"<div><h3>Background</h3><div>Drug toxicity as a cause of death is challenging to establish and may be based on limited evidence, especially in deaths attributed to stimulants. We developed a method for characterizing stimulant deaths, focusing on potential mechanisms and opportunities for intervention.</div></div><div><h3>Methods</h3><div>We used medical examiner case narratives and medical records from a mixed methods study of fatal acute stimulant toxicity in San Francisco. We coded case narratives for circumstances surrounding death events, including physical location, bystander presence, decedent disposition, and evidence of recent street drug use; medical records provided data on potential mechanism of death when not present in case narratives.</div></div><div><h3>Results</h3><div>Of 101 deaths (70 stimulants-no-opioids, 31 stimulants-fentanyl), 85 were unwitnessed, including 69 unwitnessed deaths in spaces inaccessible to bystanders. Drug use was observed before collapse in 1 of 14 witnessed stimulant-no-opioid and 1 of 2 witnessed stimulant-fentanyl deaths. Among unwitnessed events, scene evidence of drug use was found in 36 of 56 stimulant-no-opioid and 25 of 29 stimulant-fentanyl deaths. Twelve of 14 witnessed stimulant-no-opioid deaths and none of two witnessed stimulant-fentanyl deaths included an apparent cardiovascular or cerebrovascular event.</div></div><div><h3>Conclusions</h3><div>Deaths occurred in physically and socially isolated contexts, limiting opportunities for bystander intervention. Compared to stimulant-fentanyl deaths, stimulant-no-opioid deaths may be more likely to be witnessed and involve a cardiovascular event, and less likely to involve recent drug use. Applying a thematic analysis of medical examiner records to a larger sample, including other opioid deaths, could guide prevention strategies.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112700"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904333","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":"Development and preliminary testing of a secure large language model-based chatbot for brief alcohol counseling in young adults","authors":"Brian Suffoletto ,&nbsp;Duncan B. Clark ,&nbsp;Christine Lee ,&nbsp;Michael Mason ,&nbsp;Jordan Schultz ,&nbsp;Irvin Szeto ,&nbsp;Denise Walker","doi":"10.1016/j.drugalcdep.2025.112697","DOIUrl":"10.1016/j.drugalcdep.2025.112697","url":null,"abstract":"<div><h3>Objective</h3><div>Young adults face elevated risks from alcohol use yet encounter significant barriers to accessing evidence-based interventions. Large language models (LLMs) represent a promising advancement for delivering personalized behavioral interventions, but their application to alcohol counseling remains unexplored. This study evaluated the development and preliminary outcomes of a Secure GPT-4-powered text-based Motivational Interviewing Conversational Agent (MICA).</div></div><div><h3>Method</h3><div>Using a prospective single-arm pilot design, we evaluated MICA across two phases (Phase I: n = 8; Phase II: n = 37), editing the LLM prompts between Phases. Participants aged 18–25 who reported consuming ≥ 10 standard alcohol units weekly completed a counseling session with MICA. We evaluated safety and compared MI fidelity (relational and technical sub-scales of the Client Evaluation of MI [CEMI]) and usability (System Usability Scale) between Phases. We also explored surrogate measures of effectiveness (i.e. proportion of change talk to sustain talk from session logs) and qualitative feedback themes.</div></div><div><h3>Results</h3><div>No unsafe responses were observed. MI fidelity improved significantly in the CEMI relational sub-scale from Phase I to II (67.2 % to 82.6 %, p = 0.03). Usability remained consistently high across phases (Phase I: 85.4; Phase II: 80.9; p = 0.45). The proportion of within-session change talk was also consistently high (Phase I: 65.2 %; Phase II: 75.8 %; p = 0.10).</div></div><div><h3>Conclusions</h3><div>This study provides preliminary evidence that LLM-based chatbots can deliver MI-adherent alcohol interventions that are both acceptable to young adults and maintain high MI fidelity. Future research should employ randomized controlled designs with longer follow-up periods to evaluate impact on drinking outcomes.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112697"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907661","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":"Patient characteristics associated with receipt of contingency management for stimulant use disorder in the Veterans Health Administration","authors":"Madeline C. Frost ,&nbsp;Lara N. Coughlin ,&nbsp;Lan Zhang ,&nbsp;Devin C. Tomlinson ,&nbsp;Lewei (Allison) Lin","doi":"10.1016/j.drugalcdep.2025.112683","DOIUrl":"10.1016/j.drugalcdep.2025.112683","url":null,"abstract":"<div><h3>Background</h3><div>Contingency management (CM) is the most effective available treatment for stimulant use disorder (StUD). The Department of Veterans Affairs (VA) rolled out the largest national CM implementation effort to date, but ongoing efforts are needed to increase CM receipt. To inform these efforts, it is important to understand the reach of CM implementation across patient characteristics. This exploratory analysis examined whether patient characteristics are associated with CM receipt among VA patients with StUD.</div></div><div><h3>Methods</h3><div>We extracted electronic health record data for patients with diagnosed StUD who received care 10/1/20–9/30/22 at VA facilities that had begun CM implementation (N = 93,960); CM receipt was measured during the year following patients’ index visit (first visit during 10/1/20–9/30/22). We examined whether sociodemographic characteristics, comorbidities, and prior non-CM StUD treatment utilization were associated with likelihood of receiving CM using multivariable logistic regression.</div></div><div><h3>Results</h3><div>Only 1 % (n = 1113) of the sample received CM. Patients were more likely to receive CM if they were age 30–64 (compared to age 18–29), Black (compared to White), service connected, experiencing homelessness/housing instability, had alcohol, opioid or other drug use disorders, or had more prior non-CM StUD psychotherapy visits or more prior StUD medication management visits. Patients were less likely to receive CM if they lived in rural areas, had posttraumatic stress disorder, or had ≥ 3 Elixhauser comorbidity conditions.</div></div><div><h3>Conclusions</h3><div>Ongoing efforts to increase CM receipt are needed, including increasing access for patients in rural areas and further work to understand specific barriers for patients with PTSD or a higher number of comorbidities.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112683"},"PeriodicalIF":3.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911645","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":"Using a loose-leaf vaporizer to study tobacco-cannabis co-administration: A proof-of-concept study","authors":"Gideon St.Helen,&nbsp;Christopher Havel,&nbsp;Newton Addo,&nbsp;Nickole Criner,&nbsp;Peyton Jacob III,&nbsp;Neal Benowitz","doi":"10.1016/j.drugalcdep.2025.112678","DOIUrl":"10.1016/j.drugalcdep.2025.112678","url":null,"abstract":"<div><h3>Objective</h3><div>We examined differences in Δ-9-tetrahydrocannabinol (THC) and nicotine intake, pharmacokinetics, subjective and physiologic effects from use of cannabis only, tobacco only, and a mixture of cannabis and tobacco using a PAX-3 vaporizer.</div></div><div><h3>Methods</h3><div>Eight (7<!--> <!-->M, 1<!--> <!-->F) healthy adults who use both cannabis and tobacco participated in a 3-arm, within-subject study. Participants were administered 3 standardized puffs of cannabis only, tobacco only, or a 50–50 mixture with a PAX-3. Blood was collected and questionnaires were administered before and after the last puff.</div></div><div><h3>Results</h3><div>Average maximum plasma THC concentration (C_max) and area under the plasma THC concentration-time curve (AUC) were significantly higher after vaping the mixture compared to cannabis only [C_max: 25.7 ± 14.0<!--> <!-->ng/mL vs. 9.7 ± 6.5<!--> <!-->ng/mL, p &lt; 0.04 (mean±SD); AUC: 590 ± 555<!--> <!-->ng/mL•min vs. 306 ± 258<!--> <!-->ng/mL•min, p &lt; 0.02]. Similarly, plasma nicotine C_max and AUC_(0→360) were significantly higher after vaping the mixture compared to tobacco only [C_max: 1.6 ± 0.71<!--> <!-->ng/mL vs. 0.55 ± 0.32<!--> <!-->ng/mL, p &lt; 0.02; AUC: 135 ± 35.7<!--> <!-->ng/mL•min vs. 63.1 ± 25.4<!--> <!-->ng/mL•min, p &lt; 0.01]. Although elevated from use of the mixture, heart rate changes were not significantly different across study conditions. Subjective effects generally did not differ across study conditions, but this may have been due to the small sample size of the study.</div></div><div><h3>Conclusion</h3><div>Vaping cannabis and tobacco together leads to greater exposure to THC and nicotine than the substances by themselves. Despite differences in THC exposure, subjective effects and heart rate were not different between the mixture and cannabis only, indicating potential attenuation of THC-related effects by nicotine.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112678"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907802","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":"Substance-induced mental disorders and discontinuation of medication for opioid use disorder","authors":"Alyssa Shell Tilhou ,&nbsp;Richard A. Grucza ,&nbsp;Kevin Y. Xu","doi":"10.1016/j.drugalcdep.2025.112685","DOIUrl":"10.1016/j.drugalcdep.2025.112685","url":null,"abstract":"<div><h3>Background</h3><div>People with opioid use disorder (OUD) often exhibit psychiatric symptoms representing primary (PMD) and substance induced mental disorders (SIMD). PMD are associated with increased discontinuation of medications for OUD (MOUD). It is unknown if this relationship holds for SIMD.</div></div><div><h3>Objective</h3><div>To examine the association between SIMD and time to MOUD discontinuation.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study using the Merative™ MarketScan® Commercial and Multi-State Medicaid insurance claims Databases (2015–2019), we identified individuals initiating MOUD (buprenorphine, methadone, and extended-release naltrexone) following a 180-day pre-period of continuous enrollment without MOUD. Episodes were classified based on <u>&gt;</u> 1 SIMD diagnosis in this pre-period. We estimated days to MOUD discontinuation using stepwise multivariable Cox regression, adjusting for age, sex, insurance type (Medicaid or Commercial), Charlson Comorbidity Index, MOUD at initiation, co-occurring substance use disorders (SUD), and PMD.</div></div><div><h3>Results</h3><div>Of 31,134 MOUD initiation episodes, 3.5 % exhibited SIMD. Episodes with SIMD demonstrated a higher prevalence (p &lt; .001 for all) of mood and psychotic disorders (42.8 vs 16.4 %; 4.0 % vs 0.7 % respectively) but lower prevalence of anxiety-related disorders (51.3 % vs 59.9 %) relative to episodes without SIMD. Unadjusted models illustrated a 44 % (95 %CI:1.34–1.55) increased hazard of MOUD discontinuation associated with SIMD. After adjusting for all covariates but PMD, SIMD retained a 13 % increased hazard of MOUD discontinuation (95 %CI:1.05–1.21). Adjusting for PMD eliminated this association.</div></div><div><h3>Conclusion</h3><div>SIMD is associated with reduced time to MOUD discontinuation, which may be accounted for by PMD. Further research on SIMD treatment among individuals with OUD is needed to improve OUD treatment outcomes.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112685"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898955","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":"Patterns of past month cannabis consumption and cannabis use disorder – Insights from a nationally representative survey","authors":"Alexandra F. Kritikos ,&nbsp;Bruce Taylor ,&nbsp;Phoebe Lamuda ,&nbsp;Harold Pollack ,&nbsp;John A. Schneider","doi":"10.1016/j.drugalcdep.2025.112680","DOIUrl":"10.1016/j.drugalcdep.2025.112680","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;As cannabis usage continues to surge in the United States, understanding the nuances between medical and recreational use, as well as the frequency of past-month consumption, is critical for public health. The need to differentiate these patterns and assess their implications for Cannabis Use Disorder (CUD) is important for both clinical care and health policy in the United States.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This study utilized data from the AmeriSpeak® web-based panel, a nationally representative sample of U.S. households. Participants (n = 1719) were adults aged 18 and older who completed a self-report survey in December 2023 or January 2024 and reported past-month cannabis use. The Cannabis Use Disorder Identification Test (CUDIT) was employed to measure usage frequency and identify CUD risk, with scores of 8 or more indicating hazardous use and scores of 12 or more indicating possible CUD. Multinomial logistic regressions were conducted to explore associations between sociodemographic characteristics and cannabis dependence, further segmented by past-month frequency of medical and recreational use.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Approximately 10 % of adults reported past-month medical cannabis use and 17 % reported recreational use. Any past-month medical cannabis use was associated with a 26 % CUD rate (95 % CI: 19.8–30.4) and hazardous use rate of 25 % (95 % CI: 18.5–31.2). When broken down by frequency, CUD rates ranged from 16 % to 34 % for people who use cannabis for medical purposes : occasional use (19 %, 95 % CI: 13.7–24.3), moderate use (24 %, 95 % CI: 17.5–30.5), and daily or near-daily use (31 %, 95 % CI: 24.1–38.3). People who use cannabis for non-medical (recreational) reasons showed a 21 % overall CUD rate (95 % CI: 17.7–25.2), with segmented rates by frequency indicating 10 % for occasional use (95 % CI: 6.2–13.8), 24 % for moderate use (95 % CI: 18.1–29.9), and 32 % for daily or near-daily use (95 % CI: 25.3–38.7). Younger adults (18−29) and males were identified as the most at-risk groups, exhibiting the highest CUD scores across both medical and recreational categories.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Discussion&lt;/h3&gt;&lt;div&gt;Over a quarter of people who use cannabis meet the criteria for CUD, underscoring the importance of more precise assessments of cannabis use patterns. While no significant differences between medical and recreational cannabis use were observed, the nuances in usage patterns become obscured when grouping all individuals who use cannabis in the past-month together, potentially masking important differences in risk levels. Integrating frequency and quantity metrics into clinical assessments, similar to practices in alcohol consumption research, is imperative. This approach allows healthcare providers to gain a comprehensive understanding of cannabis use behaviors and associated CUD risks, providing crucial insights for developing targeted interventions, support services, and str","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112680"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899037","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":"The prevalence and correlates of dual diagnosis among adults in custody: A systematic review and meta-analysis","authors":"Niamh Taggart ,&nbsp;Stuart A. Kinner ,&nbsp;Jesse T. Young","doi":"10.1016/j.drugalcdep.2025.112675","DOIUrl":"10.1016/j.drugalcdep.2025.112675","url":null,"abstract":"<div><h3>Background</h3><div>Incarcerated individuals experience mental illness (MI), substance use disorders (SUD), and their co-occurrence – dual diagnosis – at higher rates than the general population. By systematically reviewing the literature on dual diagnosis in custody, we aimed to (1) estimate the pooled prevalence of dual diagnosis among adults in custody, and (2) identify the psychosocial, health-related, and criminal justice correlates of dual diagnosis.</div></div><div><h3>Method</h3><div>We searched CINAHL, CINCH, Embase, Medline, PsycINFO, and Web of Science for studies investigating dual diagnosis among adults in custody. We also conducted backward citation chaining of a previous systematic review of dual diagnosis in Australian prisons. We used random-effects meta-analysis to generate a pooled prevalence estimate of dual diagnosis and conducted a narrative synthesis of the identified correlates of dual diagnosis in the literature.</div></div><div><h3>Results</h3><div>Twenty-five studies met the inclusion criteria; 20 had sufficient data for meta-analysis. The pooled prevalence estimate of dual diagnosis among adults in custody was 25.3 % [95 %CI: 18.6, 32.7]. Correlates of dual diagnosis included illicit substance use before 15 years old, living with someone who used substances before incarceration, violence victimisation, increased suicide risk, and a lifetime history of multiple convictions.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that approximately one out of every four adults in custody have a dual diagnosis, highlighting the need for coordinated mental health and alcohol and other drug services for justice-involved individuals. It is crucial that correctional healthcare providers have the capacity and resources necessary to address the complex needs of adults with dual diagnosis in custody.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112675"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911634","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":"A within-subject cross-over trial comparing the acute effects of vaporized delta-8-tetrahydrocannabinol and delta-9-tetrahydrocannabinol in healthy adults","authors":"Tory R. Spindle ,&nbsp;C. Austin Zamarripa ,&nbsp;Destiny Schriefer ,&nbsp;Edward J. Cone ,&nbsp;Ruth Winecker ,&nbsp;Ronald Flegel ,&nbsp;Eugene Hayes ,&nbsp;Lisa S. Davis ,&nbsp;David Kuntz ,&nbsp;Ryan Vandrey","doi":"10.1016/j.drugalcdep.2025.112684","DOIUrl":"10.1016/j.drugalcdep.2025.112684","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence and accessibility of Δ8-tetrahydrocannabinol (Δ8-THC), a chemical isomer of Δ9-tetrahydrocannabinol (Δ9-THC), has increased drastically, yet no controlled studies have directly compared the effects of vaporized Δ8-THC and Δ9-THC .</div></div><div><h3>Methods</h3><div>Twenty healthy adults with no past-month cannabis exposure completed five randomized outpatient sessions in a within-subjects, double-blind, crossover design. Participants inhaled Δ8-THC (10, 20, 40<!--> <!-->mg), Δ9-THC (20<!--> <!-->mg), or placebo (distilled water) using the Mighty Medic vaporizer. Measures included subjective drug effects, cognitive/psychomotor performance, puff topography, vital signs, and whole blood concentrations of Δ8-THC, Δ9-THC, and their metabolites.</div></div><div><h3>Results</h3><div>All Δ8-THC doses and Δ9-THC produced subjective drug effects that differed from placebo. 20<!--> <!-->mg Δ9-THC elicited stronger ratings of “drug effect” and “unpleasant” than 10<!--> <!-->mg Δ8-THC; no other subjective effects differed between Δ8-THC and Δ9-THC. 20<!--> <!-->mg Δ9-THC impaired DRUID performance compared with placebo; no other significant differences were observed between conditions on cognitive/psychomotor measures. Few pharmacodynamic differences were observed between Δ8-THC doses. Evidence of compensatory puffing emerged, with longer/larger puffs at lower Δ8-THC doses and placebo. Blood cannabinoid concentrations revealed that Δ8-THC metabolism differed from Δ9-THC, with less psychoactive 11-OH metabolite formed after Δ8-THC exposure.</div></div><div><h3>Conclusion</h3><div>Various doses of vaporized Δ8-THC elicited comparable psychoactive effects as vaporized Δ9-THC, which is noteworthy considering Δ8-THC is less potent and generally perceived as less harmful/intoxicating than Δ9-THC. The magnitude of effects from cannabinoids is dictated by several factors including dose, route of administration, and, for inhaled methods, puffing behaviors. These data should be considered in future drug policy and public education initiatives.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112684"},"PeriodicalIF":3.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907803","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":"Harm reduction interventions for AYA who use opioids: A scoping review","authors":"Elizabeth Noyes ,&nbsp;Elizabeth Hausman ,&nbsp;Ellis J. Yeo ,&nbsp;Paul A. Bain ,&nbsp;Maxwell Bannister ,&nbsp;Irving Barrera Lopez ,&nbsp;Brammy Rajakumar ,&nbsp;Grace Wang ,&nbsp;Avik Chatterjee","doi":"10.1016/j.drugalcdep.2025.112677","DOIUrl":"10.1016/j.drugalcdep.2025.112677","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents and young adults (AYA) are highly vulnerable to substance use and substance use-related harms. Existing harm reduction programs do not optimally serve AYA, and there is minimal data regarding harm reduction interventions specific to AYA.</div></div><div><h3>Methods</h3><div>We conducted a preliminary search in MEDLINE (Ovid) to identify names used to describe harm reduction interventions to include in the final search. We performed a scoping review of electronic bibliographic databases MEDLINE (Ovid), Embase (Elsevier), PsycINFO (EBSCO), and Web of Science (Clarivate). We included studies that discussed any harm reduction interventions specific to adolescents and young adults. We performed thematic analysis of included studies and used a narrative synthesis approach to consolidate and present findings.</div></div><div><h3>Results</h3><div>We included 58 studies in our review. AYA demonstrated different patterns of substance use and engagement with harm reduction compared to adults. AYA are open to harm reduction practices and engage in forms of harm reduction informally. A variety of harm reduction interventions were effective among AYA, including naloxone training, fentanyl test strips, and safe injection facilities. AYA respond well to programs that are convenient, private, and emphasize longitudinal relationship building with community and providers. They may uniquely benefit from virtual programming, telehealth, and delivery services.</div></div><div><h3>Conclusions</h3><div>We must better serve AYA with youth-centered programs that prioritize privacy, safety, and convenience; offer a wide variety of services relevant to AYA substance use patterns; offer mobile and virtual options; and focus on building and leveraging community and networks.</div></div>","PeriodicalId":11322,"journal":{"name":"Drug and alcohol dependence","volume":"272 ","pages":"Article 112677"},"PeriodicalIF":3.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911730","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}