Substance Abuse Treatment, Prevention, and Policy最新文献

{"title":"Substance use and treatment utilization patterns of working-age American men who were not in employment, education, or training (NEET) during the COVID-19 pandemic.","authors":"Wayne Kepner, Keith Humphreys","doi":"10.1186/s13011-026-00733-6","DOIUrl":"10.1186/s13011-026-00733-6","url":null,"abstract":"<p><strong>Background: </strong>A growing population of working-aged men are not in employment, education, or training (NEET). The COVID-19 pandemic has been associated with changes in rates of substance use disorders (SUDs) and treatment seeking in the general population, but COVID-era substance use patterns among NEET men are unknown.</p><p><strong>Methods: </strong>We estimated the prevalence and correlates of NEET status among working-aged (18-64) men using data from the 2022 National Survey on Drug Use and Health, a nationally representative survey of non-institutionalized individuals in the United States. We developed logistic regression models to examine associations between NEET status and substance use behaviors and treatment engagement, adjusted for sociodemographic factors.</p><p><strong>Results: </strong>An estimated 11.1% of working-aged men were NEET in 2022 representing 10.6 million individuals. Compared to non-NEET men, NEET men were significantly overrepresented among older age groups, lower income brackets, unmarried individuals, those with lower educational attainment, and Non-Hispanic Black men. After adjusting for sociodemographic factors, NEET status was significantly associated with higher odds of prescription tranquilizer/sedative use disorder (aOR = 3.54, 95% CI: 1.97-6.37), methamphetamine use disorder (aOR = 3.10, 95% CI: 1.82-5.28), and prescription pain‑reliever use disorder (aOR = 2.88, 95% CI: 1.82-4.53), while being inversely associated with alcohol use disorder (aOR = 0.68, 95% CI: 0.54-0.85).</p><p><strong>Conclusion: </strong>More than 1 in 10 working-aged men were NEET in 2022. Adjusted models showed higher odds of past-year SUDs but lower odds of alcohol use disorder. Targeted interventions should include age-appropriate, culturally tailored, and substance-specific treatment programs to improve public health.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006751","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 community-based systematic review of economic evaluations of overdose prevention sites for people who use drugs: a study protocol.","authors":"Ehsan Jozaghi","doi":"10.1186/s13011-025-00668-4","DOIUrl":"10.1186/s13011-025-00668-4","url":null,"abstract":"<p><strong>Background: </strong>Over 100 overdose prevention sites (OPS) operate in various jurisdictions, including Australia, Canada, the United States, and several European countries. However, despite the increasing prevalence of people who use illegal drugs, including those who inject drugs, no such facility currently operates in Africa, Asia, the Middle East, the Caribbean, or Central and South America. Except for Canada and a few sites in the US, no sanctioned facility currently operates in Mexico.</p><p><strong>Methods: </strong>This systematic review will identify peer-reviewed studies, reports, and theses that evaluate the cost and benefits of OPS, relying on five electronic databases (ECONLIT, Google Scholar, Medline, PubMed, and Web of Science). A search strategy based on the PRESS approach will guide the initial search for articles. Based on the PRISMA, community researchers will screen titles and abstracts using the specified inclusion criteria in EndNote X20, and the results will be uploaded into Covidence. Community reviewers using Covidence will examine the complete text, including the title and abstract. All articles reported through the initial search will be further screened based on Cheers and Drummond criteria to identify weaknesses in the research while extracting additional information and data related to costs, benefits, programs, or services. The final data analysis will include the range of cumulative benefits, costs, and ratios associated with operating OPS.</p><p><strong>Discussion: </strong>This review has the potential to provide evidence-based knowledge through a community-based research approach on the cost savings of public health interventions implemented through harm reduction philosophy for underserved populations.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"21 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13188599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975663","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":"Alcohol and mental health care integration in traumatically injured patients with elevated BAC: a retrospective chart review.","authors":"Nicholas R Schumann, Madeline R Marks, Devi Jayan, Jorian Greenwood, Sydney C Timmer-Murillo, Timothy J Geier, Claire M Bird, Andrew T Schramm, Sacha A McBain","doi":"10.1186/s13011-026-00736-3","DOIUrl":"10.1186/s13011-026-00736-3","url":null,"abstract":"<p><strong>Background: </strong>Alcohol is a well-documented risk factor for motor vehicle collisions (MVCs) and may also heighten post-trauma psychological symptoms. Given the frequent co-occurrence of MVC injury, alcohol use, and post-injury mental health sequelae, coordinated post-injury care is critical to support long-term psychological and physical recovery. The American College of Surgeons Committee on Trauma requires screening for and intervention on risky alcohol use and, more recently, to conduct mental health risk screening and referral. However, little is known about how established alcohol screening and intervention workflows interface with mental health services in routine practice.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults (≥ 18 years) with traumatic injuries at a Level I Trauma Center in the U.S. Midwest from 2017 to 2022. Data were pulled from the trauma registry and electronic medical record. A chart review was completed on a subset of patients who were legally intoxicated at the time of admission to assess engagement with services using a structured abstraction template.</p><p><strong>Results: </strong>From January 2017 to December 2022, 198 patients were admitted after MVC. Of the 154 patients tested for blood alcohol concentration (BAC), 78% were legally intoxicated (≥ 0.08 g/dL). 58% screened at high risk for PTSD or depression on the Injured Trauma Survivor Screen (ITSS). Of the patients legally intoxicated, 25 received at least one visit from trauma psychology. Alcohol use was discussed in 60% of these encounters, primarily regarding frequency and quantity. Eleven patients (45.8%) had alcohol use explicitly addressed and were provided resources by social work.</p><p><strong>Conclusions: </strong>These findings suggest that alcohol use, despite its significance in this high-risk population, was minimally addressed across specialty services.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13422042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983344","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":"Determining adverse childhood experiences and their association with substance use among young adults in universities and colleges in Mombasa County, Kenya.","authors":"Merab Odero, Richelle W Kihoro, Phoeby W Mbogo, Safari Agure, Erastus Muniu, James Muttunga, Zackary Kwena, Susan Njoroge, Collins Okoyo","doi":"10.1186/s13011-026-00734-5","DOIUrl":"10.1186/s13011-026-00734-5","url":null,"abstract":"<p><strong>Background: </strong>Substance use and adverse childhood experiences (ACEs) remain major risk factors for health, education, and social relationships, with the effects of ACEs persisting into adulthood. This study aimed to investigate the association between substance use (alcohol, tobacco and tobacco products, and illicit drugs) and ACEs among young adults in higher learning institutions in Mombasa County, Kenya.</p><p><strong>Methods: </strong>The analytical cross-sectional study collected data on having ever experienced any form of ACEs and substance use (alcohol, tobacco and tobacco products, and illicit drugs). A total of 849 participants were randomly sampled from 11 higher leaning institutions in the county. Questionnaires collected information on ACEs and substance use, with ACEs scores used to assess association with the three substances. Descriptive statistics were used for exploratory data analysis, while Chi-square tests and logistic regression assessed the relationship between ACEs and the use of the three substances.</p><p><strong>Results: </strong>The overall ACEs prevalence was 88.1% (95%CI: 86.0%-90.3%). Among the three substances, alcohol had the highest prevalence at 45.6% (95%CI: 42.4%-49.1%). Exposure to physical abuse (adjusted odds ratio (aOR) = 1.8 (95% CI: 1.0-3.1), p = 0.044), emotional neglect (aOR = 1.6 (95% CI: 1.2-2.2), p = 0.002), emotional abuse (aOR = 2.0 (95% CI: 1.1-3.5), p = 0.019), sexual abuse (aOR = 2.2 (95% CI: 1.3-3.8), p = 0.003) and parent/guardian alcoholic (aOR = 1.8 (95% CI: 1.3-2.5), p < 0.001) was significantly associated with higher prevalence of alcohol use. Exposure to emotional neglect (aOR = 1.5 (95% CI: 1.0-2.1), p = 0.039) and collective violence (aOR = 2.0 (95% CI: 1.3-3.2), p = 0.001) was significantly associated with higher prevalence of tobacco and tobacco products use. The use of illicit drugs was significantly associated among those who had experienced emotional abuse (aOR = 1.9 (95% CI: 1.1-3.3), p = 0.019) and those who had a household member imprisoned (aOR = 1.6 (95% CI: 1.1-2.3), p = 0.024).</p><p><strong>Conclusion: </strong>This study found that most young adults in colleges and universities had experienced at least one ACE and reported substance use, with prevalence higher among those exposed to ACEs. This emphasizes the need for targeted approaches within higher learning institutions supporting early detection and prevention of ACEs and their associated consequences such as adult substance use.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975634","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":"Startup activities and challenges implementing an integrated care model for pregnant and postpartum individuals with substance use disorders: a qualitative study.","authors":"Jennifer D Hall, Maria N Danna, Viviane Cahen, Andrea Baron, Camille C Cioffi, Deborah J Cohen","doi":"10.1186/s13011-026-00731-8","DOIUrl":"10.1186/s13011-026-00731-8","url":null,"abstract":"<p><strong>Background: </strong>Substance use has increased among pregnant and postpartum people in the last decade, yet few pregnant individuals receive prenatal care and treatment for substance use disorder (SUD). The Nurture Oregon model aims to integrate medical care with SUD treatment and provide destigmatized care through regular visits in an integrated care setting. We studied one family medicine, one behavioral health, and two SUD treatment organizations in rural counties with high SUD rates and limited resources that were funded to implement the model.</p><p><strong>Methods: </strong>To examine the startup and early implementation phases of Nurture Oregon, we used a prospective, observational design to appreciate the effort from multiple perspectives. We observed program development meetings, team operations, and conducted semi-structured interviews with organization leaders, team members, and community partners. We used an inductive and comparative approach to identify sites' startup and early implementation activities and challenges.</p><p><strong>Results: </strong>Each site started with different program elements at baseline. This influenced the model elements each organization worked on during startup and the implementation challenges they experienced. The SUD and behavioral health organizations did not fully integrate care due to difficulty developing partnerships with medical organizations; they leveraged peers and doulas to provide cohesion for patients. The family medicine site was the only site that fully implemented the model, but they experienced barriers to financially supporting their peer workforce due to licensing and reimbursement policy constraints. All sites experienced challenges collaborating with hospital labor and delivery departments, and they all took steps to address patient housing needs by connecting patients to housing resources or acquiring housing units.</p><p><strong>Conclusions: </strong>Implementing a care model to integrate medical and SUD treatment for pregnant individuals is difficult to accomplish but has the potential to make a significant difference in maternal and child health outcomes, recovery success, and prevention of foster care placement. Experiences during the startup and early implementation phases can shape the entire trajectory of a program and determine its long-term success. Our work shows the early challenges that need to be addressed to build an integrated program.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949484","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":"Brief Addiction Monitor-Taiwan version as a simple tool for the measurement-based care of people who use drugs in the era of harm reduction: predictive validity in prospective follow-ups of patients nationwide.","authors":"Chen-Ping Lin, Shang-Chi Wu, Tzu-Yu Chen, Ming-Chyi Huang, Kuen-Hong Wu, Chun-Hung Lee, Chieh-Liang Huang, Chi-Yen Chen, Hung-Chi Wu, Yao-Wen Liu, Yen-Tyng Chen, Lian-Yu Chen, Wei J Chen","doi":"10.1186/s13011-026-00737-2","DOIUrl":"10.1186/s13011-026-00737-2","url":null,"abstract":"<p><strong>Background: </strong>The Brief Addiction Monitor (BAM) is a simple tool for the periodic assessment of substance use disorders, but whether it can be applied in non-US settings is unknown. This study aimed to evaluate the reliability of a translated version of the BAM, named the BAM-Taiwan (BAM-T), and examine whether the baseline BAM-T score was associated with being lost to follow-up or with changes in the score at 3 months and 6 months, respectively.</p><p><strong>Methods: </strong>A total of 2336 participants recruited from people who use drugs enrolled in treatment programs nationwide were followed up at 3 months and 6 months. Within this cohort, intraclass correlation reliability (ICCR) of interview responses was used to assess interrater reliability in 127 participants and test-retest reliability in 102 participants. To evaluate predictive validity, we examined associations between baseline BAM-T total score and follow-up outcomes, including loss to follow-up and subsequent BAM-T severity, using multivariable regression models. To account for informative loss to follow-up, stabilized inverse probability-weighted (IPW) linear regression models were applied.</p><p><strong>Results: </strong>The BAM-T total score demonstrated excellent interrater (ICCR = 0.855) and 1-week test-retest reliability (ICCR = 0.789). Higher baseline BAM-T total score was associated with increased odds of loss to follow-up and with higher BAM-T total scores at both 3-month and 6-month follow-up. These associations remained robust in IPW-weighted analyses accounting for informative loss to follow-up. Each 1-SD increase in baseline BAM-T total score (7.9 points) was associated with a 5.21-point (robust SE = 0.18) higher BAM-T total score at 3 months (95% CI, 4.85-5.57; p < 0.0001) and a 4.95-point (robust SE = 0.21) higher score at 6 months (95% CI, 4.54-5.36; p < 0.0001) after adjustment for key sociodemographic and clinical covariates.</p><p><strong>Conclusions: </strong>Our results provide empirical support for the utility of BAM-T as a simple tool for the measurement-based care of patients who use various types of drugs.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942945","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":"Inpatient utilization among Medicaid members with substance use disorder in Oregon.","authors":"Daniel J Fish, Megan Holtorf, Kristen A Lacijan, Benjamin Gronowski, Graham Bouldin, Andrew Mendenhall, Hannah Cohen-Cline, Taylor Doren, Catherine J Livingston","doi":"10.1186/s13011-026-00732-7","DOIUrl":"10.1186/s13011-026-00732-7","url":null,"abstract":"<p><strong>Background: </strong>In the United States, substance use disorders (SUDs) remain a critical public health concern with significant morbidity and mortality. Oregon exemplifies this crisis with high rates of illicit drug use and overdose deaths, compounded by systemic challenges like behavioral health workforce shortages. This study's objective is to characterize patterns of acute care utilization and ED visit and admission reasons among Medicaid enrollees with opioid use disorder, stimulant use disorder, and/or unintentional substance overdoses in the Portland metro area.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 2023 Medicaid enrollment and claims data from Health Share of Oregon, a coordinated care organization. The study included adult Medicaid members (aged 18 to 65) enrolled in Health Share of Oregon for at least six months during 2023, categorized into cohorts based on ICD-10-CM diagnosis codes for opioid use disorder, stimulant use disorder, and unintentional substance overdoses. Members without these diagnoses served as a comparison group. Measures included rates per 1,000 member months, frequencies, and proportions of emergency department (ED) visits, avoidable ED visits, inpatient admissions, length of stay, readmissions, and hospitalizations for ambulatory care sensitive conditions, as well as reasons for ED visits and inpatient admissions.</p><p><strong>Results: </strong>Compared to non-cohort members, individuals in the cohorts had significantly higher emergency department and inpatient utilization rates. Those with unintentional substance overdoses exhibited the highest rates. Cohort members had longer hospital stays, higher rates of 30-day readmissions, and increased avoidable ED visits and hospitalizations for ambulatory care sensitive conditions. Infection was identified as the most common reason for admission among cohort members.</p><p><strong>Conclusions: </strong>Medicaid enrollees with substance use disorders exhibit substantial acute care needs and face systemic challenges. Addressing these needs requires enhanced access to evidence-based SUD treatments across multiple care settings. These findings underscore the need for clinical and policy interventions to mitigate the intertwined crises of SUD and acute care conditions in vulnerable populations.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869514","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":"Comparing the effectiveness of in-person vs. virtual intensive group interventions for healthcare professionals with substance use disorders.","authors":"Enric Llavayol, Regina Santiago, Gemma Nieva, Sílvia Torrent, Carmen Buenaventura, Sergi Valero, Constanza Daigre, Xulián Mozo, Josep Antoni Ramos-Quiroga, María Dolores Braquehais","doi":"10.1186/s13011-026-00723-8","DOIUrl":"10.1186/s13011-026-00723-8","url":null,"abstract":"<p><strong>Background: </strong>Virtual interventions for patients with substance use disorders (SUDs), including intensive outpatient treatment, were developed during the COVID-19 pandemic and later maintained in some clinical settings. However, the effectiveness of this type of intervention in healthcare professionals (HPs) has not been studied so far.</p><p><strong>Methods: </strong>This is a quasi-experimental cohort study with both retrospective and prospective data comparing the main treatment outcomes of HPs in treatment for SUDs: (1) 29 patients following a 40-hour synchronous virtual group intervention; and, (2) 31 patients following a an 80-hour in-person group psychotherapy. They both underwent in-person psychiatric and psychological individual treatment as well as addictive drug use monitoring. Logistic regression analyses were performed to find predictors of abstinence from addictive substances and of working status. A Cox proportional hazards regression was used to compare time to first lapse (positive addictive drug use monitoring). Satisfaction rates at the end of each intervention were also compared in both groups using a non-parametric test.</p><p><strong>Results: </strong>The sample consisted of 60 HPs, with a mean age of 49.5 years (range: 30-67). Of these, 53.3% (n = 32) were women. Physicians represented 53.3% of all patients. Patients in the virtual group were more likely to be working during the intervention compared with those in the in-person group. At one-year follow-up, 55% of the sample remained abstinent from addictive substances. After multivariate analysis, the type of intervention did not predict abstinence when controlling for other variables, although having dual diagnosis was inversely correlated with remaining abstinent (OR: 0.24; 95% CI: 0.07-0.85). HPs receiving in-person intervention were more likely to be working one year after the treatment (OR = 8.3; 95% CI: 2.1-33.3). Time to first lapse was similar between groups, although the in-person sample showed a more heterogeneous distribution. Satisfaction rates were similar in both groups.</p><p><strong>Conclusions: </strong>Virtual interventions may be an effective alternative to in-person interventions for HPs with SUDs. More studies are needed to more deeply analyze these preliminary findings.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857235","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":"Health insurance type moderates the association between substance use disorders and cardiovascular multimorbidity among U.S. adults - Results from the 2023 National Survey on Drug use and Health.","authors":"Kevin M Ball, Elizabeth C Prom-Wormley, Jonathan L Wells, Anika L Hines","doi":"10.1186/s13011-026-00705-w","DOIUrl":"10.1186/s13011-026-00705-w","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular multimorbidity (CVD MM), defined as two or more cardiovascular conditions, poses a significant public health challenge. Substance use disorders (SUDs) may elevate CVD MM risk, and health insurance disparities could exacerbate this relationship. We examined if insurance type moderates the association between SUDs and CVD MM.</p><p><strong>Methods: </strong>We analyzed cross-sectional data from 45,133 US adults in the 2023 National Survey on Drug Use and Health (NSDUH). CVD MM was defined as two or more specific cardiovascular conditions. SUDs included illicit drugs and cannabis, excluding nicotine dependence and alcohol use disorder. Logistic regression models examined the SUDs-CVD MM relationship and tested for an interaction between insurance type and SUDs, adjusting for covariates.</p><p><strong>Results: </strong>Individuals in the representative sample of US adults were 60.8% privately insured, 17.4% with Medicaid, 9.1% with Medicare, 8.7% uninsured, and 4.0% with other types of insurance. CVD MM (12.7% Uninsured to 47.7% Medicare; p < 0.0001) and SUDs (2.8% Medicare to 8.3% Medicaid; p < 0.0001) prevalence varied significantly by insurance type. In adjusted models, SUDs were not associated with CVD MM; however, Medicaid enrollees had higher odds of CVD MM than those privately insured. In interaction models, insurance type was a statistically significant moderator of the SUDs-CVD MM association (p = 0.0146). Stratified models showed uninsured adults with SUDs had higher odds of CVD MM (aOR:2.25, 95% CI:1.28,3.93) compared to uninsured counterparts without SUDs. No significant association was found among privately insured, Medicaid, or other insured individuals.</p><p><strong>Conclusions: </strong>Uninsured individuals with SUDs face an elevated risk of CVD MM. Interventions improving access to care for this vulnerable population are crucial for reducing cardiovascular health disparities.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":"21 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842905","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":"Kava (Piper methysticum) consumption patterns and conceptualizations: results from an online survey.","authors":"Katherine Hill, Cianna Piercey, Hollis C Karoly, Kirsten E Smith","doi":"10.1186/s13011-026-00728-3","DOIUrl":"10.1186/s13011-026-00728-3","url":null,"abstract":"<p><strong>Background: </strong>'Kava,' or 'kava kava,' (Piper methysticum) is a psychoactive plant indigenous to the Pacific Islands. Historical consumption is reported to provide anxiolytic and sedating effects. In regions where kava is native, it has been used in religious and cultural practices, as well as for medicinal purposes. The mechanisms by which kavalactones - the best studied psychoactive constituent of kava - may mediate pharmacological effects include enhancing the GABA_A receptor, blocking of sodium and calcium channels, blocking reuptake of norepinephrine dopamine, and inhibiting MAO-B. In the United States, products containing kava have proliferated in recent years alongside the rise of ethnobotanical tea bars serving kava preparations.</p><p><strong>Methods: </strong>Between December-July 2024, an anonymous online survey on legal psychoactive products was conducted using convenience sampling. Eligible individuals had to be ≥ 18 years old and endorse lifetime use of kratom, kava, tianeptine, and/or akuamma seed.</p><p><strong>Results: </strong>Of the 368 participants, almost half (n = 180, 48.9%) had used kava during their lifetime. Those who reported lifetime use of kava were younger on average (p = 0.001), more racially diverse (p = 0.041), and had a higher proportion of being employed or in school (p = 0.012) than those where did not use kava in their lifetime. Kava was purchased online (40.6%) or in ethnobotanical tea bars (31.7%). Many reported infrequent consumption (average = 4.4 months/year and 9.1 days/30 days). Lifetime use of alcohol, kratom, and cannabis was common. Approximately one-third of participants had consumed kava more than 100 times, with commonly reported perceived effects from kava experienced in the minutes and hours after consumption included reduced general anxiety (33.7%), improved mood (32.9%), reduced social anxiety (25.5%), and sedation (23.4%). Most respondents had favorable conceptualizations of kava, with only 11.7% characterizing that kava alone as habit-forming. Many (51.7%) conceptualized kava as an alcohol replacement with 18.3% and 16.7% using kava as a short- and/or long-term substitute for alcohol, respectively.</p><p><strong>Conclusions: </strong>Kava use practices are diverse, though perceived kava effects appear mostly mild. The proliferation and diversification of kava products pre-mixed with other psychoactive botanicals requires study as the benefit-risk profile may change. Clinicians should be aware of kava use for harm-reduction and other purposes.</p>","PeriodicalId":22041,"journal":{"name":"Substance Abuse Treatment, Prevention, and Policy","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842886","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}