Substance Abuse Treatment, Prevention, and Policy最新文献

{"title":"Using illicit drugs alone in Vancouver, Canada: a gender-based analysis.","authors":"Kat Gallant, Kanna Hayashi, Eric C Sayre, JinCheol Choi, Manal Mansoor, Thomas Kerr","doi":"10.1186/s13011-025-00637-x","DOIUrl":"10.1186/s13011-025-00637-x","url":null,"abstract":"<p><strong>Objectives: </strong>Canada continues to experience an epidemic of toxic drug-related overdose deaths. Public health messaging emphasizes the dangers of using drugs alone as it restricts timely overdose response or renders it impossible, yet this practice remains prevalent among people who use drugs. While drug use practices and associated harms are known to be highly gendered, little is known about how factors shaping solitary drug use may differ across genders (including cisgender men, cisgender women, transgender women, Two-Spirit people and gender diverse people). Thus, we sought to explore solitary drug use practices according to gender in Vancouver, Canada.</p><p><strong>Methods: </strong>Data were collected through Vancouver Injection Drug Users Study, a prospective cohort study between June 2019 and May 2023. We used gender-stratified multivariable generalized estimating equation models to identify factors associated with using drugs alone.</p><p><strong>Results: </strong>Among the 697 participants, 297 (42.6%) reported using drugs alone in the previous 6 months at baseline. In multivariable analyses, we found that being in a relationship was negatively associated with using alone for both cisgender men and cisgender women (adjusted odds ratio [AOR] = 0.25 and 0.34, respectively), while homelessness was negatively associated for cisgender men only (AOR = 0.45). Factors positively associated for cisgender men included daily illicit stimulant use (AOR = 1.90), and binge drug use (AOR = 2.18). For cisgender women, only depression was positively associated with using drugs alone (AOR = 2.16). All p-values < 0.05. While unable to conduct a multivariable analysis on transgender, Two-Spirit and gender diverse people due to small sample sizes, bivariate analyses showed larger impact of depression on using alone for Two-Spirit (OR = 8.00) and gender diverse people (OR = 5.05) compared to others, and only gender diverse people's risk was impacted by experiences of violence (OR = 9.63). All p-values < 0.05.</p><p><strong>Conclusion: </strong>The findings of this study suggest significant heterogeneity in gender-specific factors associated with using drugs alone. Factors exclusively impacting cisgender men's risk included homelessness and daily stimulant use, and depression having a significant impact on cisgender women's, but not cisgender men's, risk. Ultimately, gender-specific factors must be recognized in public health messaging, and in developing policies and harm reduction measures to address the risks associated with using alone.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"9"},"PeriodicalIF":3.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers to traditional care delivery and pharmacy challenges: a qualitative study of buprenorphine, telehealth, and a digital therapeutic for opioid use disorder.","authors":"Laura B Monico, Megan Eastlick, Darcy Michero, Peyton Pielsticker, Suzette Glasner","doi":"10.1186/s13011-024-00631-9","DOIUrl":"10.1186/s13011-024-00631-9","url":null,"abstract":"<p><strong>Background: </strong>The opioid epidemic contributes to increasing morbidity and mortality due to drug overdoses in the US, but barriers to traditional opioid use disorder (OUD) treatment prevent a vast majority of patients from accessing quality care and medications for opioid use disorder (MOUDs). Public Health Emergency (PHE) provisions during the COVID-19 pandemic relaxed in-person evaluation requirements for buprenorphine inductions, allowing for the expansion of telehealth care to OUD populations. This qualitative study explores patients' experiences with a novel digital therapeutic telehealth program with buprenorphine for OUD.</p><p><strong>Method: </strong>Semi-structured qualitative interviews were conducted with a sub-sample (n = 15) of participants from a larger feasibility and acceptability pilot. Interviews explored participants' opioid use, OUD treatment history, previous MOUD experience, barriers to previous treatment attempts, medication adherence, counseling experience, treatment satisfaction, and comparisons between current and previous treatments.</p><p><strong>Results: </strong>Barriers to care in previous OUD treatment episodes included logistical and program related inconveniences (program attendance requirements, commute distances, transportation, appointment wait times, and clinic patient volumes), financial strain, unreliable access to prescribers, residential program experiences, and the availability of detox-only based treatments. Participants with previous treatment experiences contrasted these barriers with the virtual delivery study setting and reported that the characteristics of telehealth OUD care facilitated improved engagement and retention by overcoming many of these barriers through: no transportation requirements, open and flexible appointment scheduling, appointment times confined to care team meetings only, absence of provider availability concerns, and the ability to receive buprenorphine maintenance care from home. The primary barrier noted for virtual care delivery was the fulfillment of buprenorphine prescriptions from local pharmacies.</p><p><strong>Conclusion: </strong>A novel digital therapeutic telehealth program was reported to overcome almost all of the barriers encountered by participants during previous traditional OUD treatment episodes, contributing to a growing body of evidence supporting the permanency of current PHE expansions for OUD telehealth care. Findings also emphasize the importance of coming to workable policy solutions for buprenorphine supply threshold constraints on local pharmacies that unintentionally constrict access for telehealth and other OUD patients.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"8"},"PeriodicalIF":3.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the alcohol use disorders identification test in a Danish hospital setting.","authors":"Peter Næsborg Schøler, Max Benjamin Andersen, Kjeld Andersen, Ulrik Becker, Maja Thiele, Anette Søgaard Nielsen","doi":"10.1186/s13011-025-00638-w","DOIUrl":"10.1186/s13011-025-00638-w","url":null,"abstract":"<p><strong>Background: </strong>Early identification of potential alcohol-problems is central for timely intervention and treatment referral. The Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) serve as globally recognized and validated screening tools for this purpose. We aimed to evaluate the diagnostic validity of internationally recommended AUDIT cut-off scores ≥ 8, ≥16, ≥ 20, and AUDIT-C cut-off scores ≥ 4, ≥5 using the Danish language versions of questionnaires in a hospital setting.</p><p><strong>Methods: </strong>Questionnaire data were collected from 2/15/2023, to 4/27/2023 at the Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark. We tested the World Health Organization's recommended AUDIT cut-offs: ≥8 for hazardous use, ≥ 16 suggestive of dependence, ≥ 20 high likelihood of dependence, along with AUDIT-C ≥ 4 and ≥ 5 using the following reference standard: Danish low-risk drinking guidelines (≤ 10 standard drinks/week) for hazardous use and self-reported ICD-10 alcohol dependence criteria for alcohol dependence. Analyses included ROC curves, AUC, sensitivity, specificity, predictive values, and agreement.</p><p><strong>Results: </strong>Three hundred patients participated, mean age 52 years (SD 17.4, median 54) and 51.3% males. Mean AUDIT score was 4.5 (SD 5.8, median 3) with fourteen (4.7%) meeting at least three self-reported ICD-10 criteria for alcohol dependence. The prevalence of hazardous use was 10.7%. AUDIT ≥ 8 exhibited a sensitivity of 56% (95% CI 40.6-73.6) and specificity 91% (95% CI 87.8-94.5) for detecting hazardous use. Against at least three self-reported ICD-10 criteria for alcohol dependence, AUDIT cut-off ≥ 16 showed a sensitivity of 85% (95% CI 66.1-98.2) with 97% specificity (95% CI 96.0-99.2), while cut-off ≥ 20 had a sensitivity of 71% (95% CI 49.2-91.6) with 99% specificity (95% CI 98.1-99.9). The AUDIT-C cut-offs ≥ 4 and ≥ 5 exhibited low positive predictive values in detecting hazardous use (30.8% for ≥ 4 and 36.8% for ≥ 5) and dependence (13.5% for ≥ 4 and 18.4% for ≥ 5) and demonstrated a specificity ranging from 68.5 to 82.1% with negative predictive values from 98.2 to 100%.</p><p><strong>Conclusion: </strong>In Danish gastroenterology and hepatology departments, the AUDIT and AUDIT-C may be used to identify patients who are unlikely to have an alcohol problem, while positive screen results should be carefully considered and followed by more exhaustive assessment.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"7"},"PeriodicalIF":3.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative pilot study exploring the acceptability of a peer provider delivered substance use brief intervention from the perspective of youth in Kenya.","authors":"Florence Jaguga, Matthew C Aalsma, Leslie A Enane, Matthew Turissini, Edith Kamaru Kwobah, Edith Apondi, Julius Barasa, Gilliane Kosgei, Yvonne Olando, Mary A Ott","doi":"10.1186/s13011-025-00639-9","DOIUrl":"10.1186/s13011-025-00639-9","url":null,"abstract":"<p><strong>Background: </strong>Substance use disorders are prevalent among youth in sub-Saharan Africa (SSA), yet treatment resources are scarce. Peer provider delivered brief interventions (BIs) represent an affordable and potentially scalable strategy for addressing youth substance use disorders. The goal of this study is to assess the acceptability of a peer provider delivered substance use BI from the perspective of youth in Kenya.</p><p><strong>Methods: </strong>We conducted qualitative semi-structured interviews with youth participants (n = 25) to explore acceptability of a substance use BI. Youth were participants in a two-arm mixed-methods pilot randomized controlled trial (RCT) investigating the feasibility of a peer provider delivered single-session substance use BI for youth aged 15-24 years with moderate-risk substance use. The semi-structured interviews were conducted three months after the BI was delivered and were guided by the Theoretical Framework of Acceptability (TFA). Qualitative data were analyzed through thematic analysis.</p><p><strong>Results: </strong>We interviewed 25 of 38 participants in the BI arm, 18 males and 7 females; 15 were ages 18-24 years, and 10 ages 15-17 years. Affective attitude: Most youth reported that they enjoyed the session content and enjoyed interacting with the peer provider. Burden: Most youth felt that it was easy to understand the session and participate in it. Perceived effectiveness: Most of the youth perceived the intervention to be effective in helping them reduce substance use and improve their well-being. Ethicality: All youth perceived that the counselling session fit in with their goals and values. Intervention coherence: Most youth understood the overall goal of the intervention. They reported that the goal of the intervention was to help youth stop substance use, and to bring about behavior change. Opportunity costs: Some youth reported that they had to forgo other activities to attend the session, such as work, school, sports, gaming, visiting family, or house chores. Self-efficacy: Most youth felt confident about being able to cut down or stop using substances following the intervention.</p><p><strong>Conclusion and recommendations: </strong>Our findings indicate that the peer provider delivered single-session substance use BI was acceptable to youth. The youth recommended that follow-up sessions be provided to ensure sustained behavior change. This study supports the utility of the TFA in exploring acceptability of a substance use intervention from the perspective of young people.</p><p><strong>Trial registration: </strong>NCT05545904 Registration date 16/09/2022 Registry ClinicalTrials.gov https//clinicaltrials.gov/study/NCT05545904.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"6"},"PeriodicalIF":3.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating mortality attributable to alcohol or tobacco - a cohort study from Germany.","authors":"Ulrich John, Hans-Jürgen Rumpf, Monika Hanke, Christian Meyer","doi":"10.1186/s13011-025-00633-1","DOIUrl":"10.1186/s13011-025-00633-1","url":null,"abstract":"<p><strong>Background: </strong>Little is known about mortality from four disorder combinations: fully attributable to alcohol or tobacco, partly attributable to both alcohol and tobacco, to tobacco only, to alcohol only.</p><p><strong>Aim: </strong>To analyze whether residents who had disclosed risky alcohol drinking or daily tobacco smoking had a shorter time to death than non-risky drinkers and never daily smokers twenty years later according to the disorder combinations.</p><p><strong>Methods: </strong>A random adult general population sample (4,075 study participants) of a northern German area had been interviewed in the years 1996-1997. Vital status and death certificate data were gathered 2017-2018. The data analysis included estimates of alcohol- or tobacco-attributable mortality using all conditions given in the death certificate and alternatively the underlying cause of death only.</p><p><strong>Results: </strong>Among 573 deaths, 71.9-94.1% had any alcohol- or tobacco-attributable disorder depending on the estimate. Risky alcohol consumption and daily tobacco smoking at baseline were related to disorders in the death certificate according to the combinations. Deaths with an alcohol- and tobacco-attributable disorder were related to risky alcohol consumption (subhazard ratio 1.57; 95% confidence interval 1.25-1.98) and to daily tobacco smoking at baseline (subhazard ratio 1.85; 95% confidence interval 1.42-2.41).</p><p><strong>Conclusion: </strong>First, more than 70% of the deceased persons had one or more alcohol- or tobacco-attributable disorders. This finding suggests that total mortality seems to be the suitable outcome if potential effects of alcohol or tobacco consumption in a general population are to be estimated. Second, the relations of risky alcohol consumption and tobacco smoking with time to death speak in favor of the validity of alcohol- and of tobacco-attributable disorders in death certificates and of considering both alcohol consumption and tobacco smoking if attributable deaths are to be estimated.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"5"},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of alternative payment models for substance use disorder prevention in the United States: development of a conceptual framework.","authors":"Elian Rosenfeld, Sarah Potter, Jennifer Caputo, Sushmita Shoma Ghose, Nelia Nadal, Christopher M Jones, Margaret R Kuklinski, Andrew D Carlo, D Max Crowley, Lisa Clemans-Cope, Michael T French","doi":"10.1186/s13011-025-00635-z","DOIUrl":"10.1186/s13011-025-00635-z","url":null,"abstract":"<p><strong>Background: </strong>Alternative payment models (APMs) are methods through which insurers reimburse health care providers and are widely used to improve the quality and value of health care. While there is a growing movement to utilize APMs for substance use disorder (SUD) treatment services, they have rarely included SUD prevention strategies. Challenges to using APMs for SUD prevention include underdeveloped program outcome measures, inadequate SUD prevention funding, and lack of clarity regarding what prevention strategies might fit within the scope of APMs.</p><p><strong>Methods: </strong>In November 2023, the Substance Abuse and Mental Health Services Administration (SAMHSA), through a contract with Westat, convened an expert panel to refine a preliminary conceptual framework developed for utilizing APMs for SUD prevention and to identify strategies to encourage their adoption.</p><p><strong>Results: </strong>The conceptual framework agreed upon by the panel provides expert consensus on how APMs could finance a variety of prevention programs across diverse populations and settings. Additional efforts are needed to accelerate the support for and adoption of APMs for SUD prevention, and the principles of health equity and community engagement should underpin these efforts. Opportunities to increase the use of APMs for SUD prevention include educating key groups, expanding and promoting the SUD prevention workforce, establishing funding for pilot studies, identifying evidence-based core components of SUD prevention, analyzing the cost effectiveness of APMs for SUD prevention, and aligning funding across federal agencies.</p><p><strong>Conclusion: </strong>Given that the use of APMs for SUD prevention is a new practice, additional research, education, and resources are needed. The conceptual framework and strategies generated by the expert panel offer a path for future research. SUD health care stakeholders should consider ways that SUD prevention can be effectively and equitably implemented within APMs.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"4"},"PeriodicalIF":3.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician's perceptions and experiences with tobacco treatment in people who use cannabis: a qualitative study.","authors":"Cristina Martínez, Marga Pla, Ariadna Feliu, Marta Enríquez, Judith Saura, Carmen Cabezas, Joan Colom, Josep M Suelves, Sílvia Mondon, Pablo Barrio, Magalí Andreu, Antònia Raich, Jordi Bernabeu, Xavier Roca, Maite Narváez, Esteve Fernández","doi":"10.1186/s13011-024-00632-8","DOIUrl":"10.1186/s13011-024-00632-8","url":null,"abstract":"<p><strong>Introduction: </strong>Global demand for the treatment of cannabis use disorder has increased significantly, prompting a need to understand effective strategies for addressing concurrent cannabis and tobacco use. This study focuses on clinicians' experiences and perceptions in delivering tobacco cessation services to people who use cannabis.</p><p><strong>Methods: </strong>Fifteen participants (12 females, 3 males) participated in three homogenous focus groups, including two groups with extensive experience in providing tobacco cessation among the substance use population in Catalonia, Spain, and one group of clinicians without such experience. Thematic analysis was conducted to identify key patterns and insights in their discourse, focusing on shared themes and divergences across groups.</p><p><strong>Results: </strong>Five main themes and 17 subthemes emerged: Individual characteristics, Clinician characteristics, Models of intervention, Organizational healthcare models, and Health policies. Clinicians stressed the importance of intervention models and the active role of professionals in addressing tobacco use within routine care, as tobacco cessation could mitigate social and chronic stigma among people who use cannabis, especially those engaged in polydrug use.</p><p><strong>Discussion and conclusions: </strong>Recommendations included integrating tobacco cessation into all services, reducing healthcare service fragmentation, improving resource accessibility, enhancing clinical documentation, and advocating for stronger population-level tobacco control policies.</p><p><strong>Trial registration: </strong>The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"3"},"PeriodicalIF":3.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community pharmacy's role in dispensing androgens and supporting harm reduction amid current policy dilemmas.","authors":"Timothy Piatkowski, Lkhagvadulam Ayurzana, Michelle King, Laetitia Hattingh, Sara McMillan","doi":"10.1186/s13011-025-00636-y","DOIUrl":"10.1186/s13011-025-00636-y","url":null,"abstract":"<p><strong>Background: </strong>Legitimate androgen use, such as testosterone replacement therapy, requires a legal prescription. Off-label use for reasons like wellness and aesthetics continues to grow. Recent regulatory changes in Australia aim to curb non-prescribed androgen use, potentially intensifying stigma, however seeking prescriptions through legal channels persists. This study aimed to explore community pharmacists' knowledge, attitudes, and practices regarding individuals who use androgens.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 15 community pharmacists, to explore knowledge and experiences related to the dispensing of androgens. The data analysis followed an iterative process, developing a codebook for thematic analysis and aligning findings with relevant literature.</p><p><strong>Results: </strong>Pharmacists face challenges when meeting the needs of individuals using androgens. They often made judgments based on appearance, leading to stigmatisation and potential refusal of prescription supply. However, this is tempered by the complex environment that pharmacists work in with respect to professional and legal requirements. Limited knowledge about androgens and varying exposure to people who use androgens were evident, prompting a unanimous desire for tailored training, especially in communication skills and interaction strategies.</p><p><strong>Conclusions: </strong>Facilitating androgen use within regulated healthcare settings, under professional medical supervision, is crucial to mitigating health risks. Varied pharmacist knowledge underscores the urgent need for targeted training, emphasising education initiatives to address structural stigma and inform healthcare policies globally.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"2"},"PeriodicalIF":3.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis use characteristics and associations with problematic use outcomes, quitting-related factors, and mental health among US young adults.","authors":"Carla J Berg, Cassidy R LoParco, Katelyn F Romm, Yuxian Cui, Darcey M McCready, Yan Wang, Y Tony Yang, Hannah S Szlyk, Erin Kasson, Rishika Chakraborty, Patricia A Cavazos-Rehg","doi":"10.1186/s13011-025-00634-0","DOIUrl":"10.1186/s13011-025-00634-0","url":null,"abstract":"<p><strong>Objective: </strong>Given the changes in trends of cannabis use (e.g., product types), this study examined latent classes of young adult use and associations with use-related outcomes.</p><p><strong>Methods: </strong>We analyzed 2023 survey data among 4,031 US young adults (M_age=26.29, 59.4% female, 19.0% Hispanic, 13.5% Black, 13.6% Asian). Among those reporting past-month use (48.8%), latent class analysis (LCA) indicators included: days used (1-5; 6-20; 21-30), use/day (1; 2-4; ≥5), and type usually used (herb/flower; edibles; oils/vape; concentrates/other). Multivariable regressions examined class in relation to problematic use, quitting-related factors, and mental health, controlling for sociodemographics and state non-medical cannabis laws.</p><p><strong>Results: </strong>LCA identified 4 classes of cannabis use frequency and types used: 'infrequent-herb/edibles' (41.4%), 'frequent-herb' (16.8%), 'moderate-herb' (28.0%), and 'moderate-oil/other' (13.8%). In multivariable analyses (referent group: 'moderate-herb' class), 'frequent-herb' reported less problematic use (B=-0.18, 95%CI=-0.30, -0.07), while 'moderate-oil/other' reported greater (B = 0.39, 95%CI = 0.27, 0.51). 'Infrequent-herb/edibles' had lower odds of driving post-use of cannabis (aOR = 0.28, 95%CI = 0.22, 0.37) and cannabis/alcohol (aOR = 0.52, 95%CI = 0.35, 0.76), whereas 'frequent-herb' (aOR = 1.52, 95%CI = 1.02, 2.28) and 'moderate-oil/other' (aOR = 3.98, 95%CI = 2.72, 5.82) reported greater odds of driving post-cannabis/alcohol use. 'Moderate-oil/other' reported higher quitting importance (B = 0.59, 95%CI = 0.17, 1.01), while 'frequent-herb' reported lower (B=-0.33, 95%CI=-0.99, -0.18). 'Infrequent-herb/edibles' reported higher quitting confidence (B = 0.56, 95%CI = 0.20, 0.92), whereas 'frequent-herb' (B=-1.01, 95%CI=-1.45, -0.57) and 'moderate-oil/other' (B=-1.27, 95%CI=-1.74, -0.81) reported lower. 'Infrequent-herb/edibles' reported fewer mental health symptoms (B=-0.55, 95%CI=-0.93, -0.17), while 'moderate-oil/other' reported more (B = 1.03, 95%CI = 0.53, 1.52).</p><p><strong>Conclusions: </strong>Preventing frequent and moderate use of cannabis, particularly of oils/concentrates, is crucial given the potential negative implications for problematic use, quitting, and mental health.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"20 1","pages":"1"},"PeriodicalIF":3.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the needs for cultural adaptation of DARE-keepin' it REAL among Brazilian students: strategies to improve implementation.","authors":"Juliana Y Valente, Bianca Franciosi, Rodrigo Garcia-Cerde, Tania Pietrobon, Zila M Sanchez","doi":"10.1186/s13011-024-00630-w","DOIUrl":"10.1186/s13011-024-00630-w","url":null,"abstract":"<p><strong>Background: </strong>The widely implemented prevention program in Brazil, PROERD (a translated version of the DARE-kiR program), showed no evidence of effect in preventing drug use in a recent trial. The lack of cultural adaptation and instructors' deviations from the curriculum were identified as potential reasons for its ineffectiveness. This study aims to identify points of inadequacy of the PROERD program for the Brazilian culture, suggesting strategies for revising the curriculum to improve implementation.</p><p><strong>Methods: </strong>We triangulated data obtained from three different groups of study participants: semi-structured interviews with the law enforcement officer who implemented the program, focus groups with students who participated in the program, and questionnaires completed by external experts in the prevention field who evaluated the program's manuals. Data was analyzed using thematic analysis based on the Ecological Validity Model theory, which encompasses three main axes: methodology, content, and language to identify the main points for cultural adaptation.</p><p><strong>Results: </strong>Regarding the program's methodology, there is an excess of activities with little interactivity involving literacy skills that do not match Brazilian students' cognitive development and require equipment unavailable in Brazilian public schools. Regarding content, activities were considered appropriate for evidence-based prevention; however, there were some contradictions related to the drug content. The language presented in the program's manuals was considered inappropriate for the culture of Brazilian youth (vocabulary, examples, and images).</p><p><strong>Conclusions: </strong>In conclusion, this study strongly recommends revising the PROERD curriculum Caindo na Real, ensuring it will align with the international prevention standards and Brazilian Culture.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"19 1","pages":"48"},"PeriodicalIF":3.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}