Substance Use & Misuse最新文献

{"title":"Suggestions from Clinicians and Harm Reduction Specialists to Mitigate the Impact of Xylazine on People Who Use Opioids.","authors":"Megan K Reed, Karla Martin González, Kristin L Rising, Julianna LeNoir, Traci C Green","doi":"10.1080/10826084.2026.2723590","DOIUrl":"https://doi.org/10.1080/10826084.2026.2723590","url":null,"abstract":"<p><strong>Background: </strong>Xylazine is rapidly spreading across the US and is associated with several adverse outcomes. This work focused on engaging content experts (e.g., harm reduction direct service staff, wound care nurses) to explore experiences with and responses to xylazine adulteration of the opioid supply.</p><p><strong>Materials and methods: </strong>Twenty interviews were conducted with xylazine content experts in Philadelphia, PA and other areas impacted by xylazine between June-July 2023. We explored the challenges of xylazine spread in the region as well as opportunities for intervention. Interviews were analyzed using a content analysis approach.</p><p><strong>Results: </strong>Among 20 participants, the average years of experience working directly with people who use opioids (PWUO) was 11.4 years. Content experts named wounds, withdrawal, and sedation as challenges exacerbated by xylazine alongside several interventions they believed could help address harms associated with xylazine adulteration. These included individual-level (i.e., overdose response, wound care prevention and treatment) and structural-level (i.e., housing, safer supply options) interventions.</p><p><strong>Conclusions: </strong>Content experts with longitudinal experience with PWUO identified interventions to mitigate impacts of xylazine in the drug supply. However, these interventions will be limited without structural changes to more effectively prevent xylazine related harms.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Punitive Responses to Underage Marijuana Use in the Era of Legalization: Insights from an Online Survey.","authors":"Linda Richter, Brandie Pugh, Krista Davy, Robyn Oster, Lindsey Vuolo","doi":"10.1080/10826084.2026.2722321","DOIUrl":"https://doi.org/10.1080/10826084.2026.2722321","url":null,"abstract":"<p><strong>Background: </strong>As adult nonmedical marijuana use becomes legal in many U.S. states, policymakers have adopted a range of responses to underage marijuana-related behaviors, often emphasizing punitive consequences. The extent to which these approaches align with public preferences remains unclear.</p><p><strong>Methods: </strong>Data were drawn from an online survey of 1502 U.S. registered voters recruited from a national opt-in online panel. Analyses assessed support for a range of consequences for underage marijuana-related behaviors (i.e., possession, use, sale, and use of false identification), with selected bivariate comparisons across demographic groups.</p><p><strong>Results: </strong>Respondents supported penalties for using false identification (89%) and selling marijuana (84%); fewer supported penalties for possession (59%) or use (57%). For attempted purchases, parental notification (79%), community service (64%), and drug education (58%) were more commonly endorsed than jail time (18%). Several differences by age, sex, race/ethnicity, and parent status were observed.</p><p><strong>Conclusions: </strong>Respondents generally expressed greater support for parental notification, community service, and education as a response to underage violations of marijuana laws than for punitive responses. Policies that emphasize supportive, health-oriented responses, alongside stronger adult and industry accountability, may be more consistent with public attitudes and more effective than punitive responses in advancing youth protection goals in legalized contexts.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-6"},"PeriodicalIF":1.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building and Sustaining Cross-Sector Collaboration: A Commentary on Cannabis Packaging and Labeling Research, Policy, and Coordination.","authors":"Sarah A Okey, Kristen N Haley, Sarah Ross-Viles, Jessica Fitts Willoughby, Stacey J T Hust","doi":"10.1080/10826084.2026.2710349","DOIUrl":"https://doi.org/10.1080/10826084.2026.2710349","url":null,"abstract":"<p><strong>Introduction: </strong>In the rapidly evolving legal cannabis market, product packaging and labeling serve as powerful health communication tools that influence consumer behavior and safety perceptions. No single entity can effectively address these complexities in isolation.</p><p><strong>Methods: </strong>This commentary describes a cross-sector partnership established between local public health professionals, academic researchers, and a regulatory body in Washington State. This collaboration bridged distinct stakeholder goals related to cannabis packaging and labeling, addressed a shared public health challenge of limiting youth- appealing packaging, and developed actionable solutions.</p><p><strong>Results: </strong>Research stemming from this collaboration revealed certain design elements on cannabis products continue to appeal to youth. Notably, these elements were found to be in full compliance with state regulations, indicating a gap between existing legal frameworks and effective public health protections against both accidental and intentional exposure. From this collaboration, an initial framework was developed to inform future collaborations to further policy solutions.</p><p><strong>Conclusions: </strong>Authors of this commentary underscore a need for expanded evidence-based research to refine packaging and labeling standards and outline three themes for future research. Establishing and sustaining cross-sector collaborations is essential to developing comprehensive regulations that protect youth while supporting the responsible operation of the legal cannabis industry.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis and Prediction Study on the Burden of Drug Use Disorders in China from 1990 to 2023: A Systematic Analysis From the Global Burden of Disease Study 2023.","authors":"Enda Xia, Gang Chen, Jinjuan Duan","doi":"10.1080/10826084.2026.2716890","DOIUrl":"https://doi.org/10.1080/10826084.2026.2716890","url":null,"abstract":"<p><strong>Introduction: </strong>Drug use disorders, including amphetamine use disorder (AMD), cocaine use disorder (COD), cannabis use disorder (CAD), opioid use disorder (OPD), and other drug use disorder (OTD), have become a serious global public health issue. However, there are limited systematic reviews and studies on drug use disorders in China.</p><p><strong>Methods: </strong>The Joinpoint regression method was used to comprehensively evaluate the changes in the burden of drug use disorders in China from 1990 to 2023. The systematic analysis was conducted by stratifying by gender and age group, and the future burden of drug use disorders in China was predicted based on the difference autoregressive moving average model (ARIMA).</p><p><strong>Results: </strong>In 2023, the prevalence of AMD, COD, CAD, OPD, and OTD were 218.45, 162.13, 4.22, 109.27, and 21.31 per 100,000 in China, respectively. From 1990 to 2023, the burden of AMD, COD, OPD, and OTD in China all showed a downward trend, while the burden of CAD remained relatively stable. Additionally, from 1990 to 2023, the burden of AMD, COD, and CAD among Chinese males was significantly higher than that among females, while the gender differences in the burden of OPD and OTD varied in different periods. In terms of age stratification, the disease burden of different drug use disorders varies significantly among different age groups. Moreover, the prevalence and DALYs rate of drug use disorders decreased with increasing age. However, it is necessary to be vigilant that the proportions of OPD and AMD are constantly increasing among the elderly. The prediction results indicate that in the next 15 years, the disease burden of AMD, COD, OPD, and OTD in China will further decrease, while the disease burden of CAD will remain relatively stable.</p><p><strong>Conclusions: </strong>The disease burden of drug use disorders in China remains significant, and there are notable differences among different genders and age groups. In the future, more targeted prevention measures should be developed based on the current situation and the characteristics of gender and age stratification, in order to effectively reduce the disease burden of corresponding drug use disorders.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-cigarette use and nicotine dependence among hospitalized youth: influence of nicotine metabolism and <i>CYP2A6</i> variability.","authors":"Stephani L Stancil, Delwyn Catley, Nikki Nollen, Andrea Gaedigk, Erin Boone, Wendy Wang, Paul Toren, Shelbie Wooten, John Tumberger, Anna Burns, Hung-Wen Yeh, Abbey R Masonbrink","doi":"10.1080/10826084.2026.2716845","DOIUrl":"https://doi.org/10.1080/10826084.2026.2716845","url":null,"abstract":"<p><strong>Background: </strong>Youth e-cigarette use is a public health concern, yet cessation approaches remain suboptimal. In adults, faster nicotine metabolism is linked with better cessation outcomes with varenicline compared to nicotine replacement therapy (NRT). This remains unexplored in youth, for whom NRT is first-line treatment. This study examined whether nicotine metabolism is associated with nicotine dependence among hospitalized youth aged 14-21 who currently use e-cigarettes.</p><p><strong>Methods: </strong>This cross-sectional study assessed e-cigarette use, nicotine dependence, saliva nicotine metabolism ratio (NMR) (slow [1^st quartile], normal [2^nd-4^th quartile]), and <i>CYP2A6</i> genetic variation. Activity score (AS) was used for <i>CYP2A6</i> genotype-predicted phenotype (slow metabolizers, AS ≤ 1.5, normal metabolizers, AS > 1.5). Analyses included Fisher's exact, Wilcoxon rank-sum, and logistic regression.</p><p><strong>Results: </strong>Among 106 hospitalized youth (mean age 16 ± 1.3), 38% reported near-daily e-cigarette use and 50% had medium-to-high nicotine dependence. Dependence varied by e-cigarette use (<i>p</i> < 0.001) and nicotine metabolism (<i>p</i> = 0.027), with 87% of dependent youth classified as fast metabolizers. <i>CYP2A6</i> phenotype was associated with NMR (<i>p</i> < 0.001) but not with dependence or use.</p><p><strong>Conclusion: </strong>Nicotine dependence in youth using e-cigarettes was linked to nicotine metabolism. The predominance of fast metabolizers among dependent youth suggests varenicline may be more appropriate than NRT as first-line treatment. Future work should evaluate metabolism-informed cessation treatment for youth.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Moderate Risk Cannabis Use Threshold Among a Sample of U.S. Military Veterans with Chronic Pain Who Report Medical Cannabis Use.","authors":"Daniel Schriemer, Travis I Lovejoy, Natassja Pal, Steven K Dobscha, Benjamin J Morasco","doi":"10.1080/10826084.2026.2715771","DOIUrl":"10.1080/10826084.2026.2715771","url":null,"abstract":"<p><strong>Background: </strong>The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) is widely used for substance use screening. However, its established risk cutoffs may not be appropriate for people who use cannabis for medical reasons. This study sought to determine an optimal moderate-risk cannabis use cutoff for this population.</p><p><strong>Methods: </strong>A sample of 501 U.S. military veterans who reported using cannabis for medical reasons and were prescribed long-term opioid therapy were administered the ASSIST and Cannabis Use Disorder Identification Test - Revised (CUDIT-R). Receiver operating characteristic (ROC) curves compared the performance of the ASSIST to the CUDIT-R.</p><p><strong>Results: </strong>The currently recommended cutoff of 4 demonstrated poor performance (Area Under the Curve [AUC] = 52.8). A cutoff of 7 maximized AUC (66.2). However, this cutoff resulted in low sensitivity (59.9). A cutoff of 6 improved sensitivity (94.7), with a reduced AUC of 59.8.</p><p><strong>Conclusions: </strong>Among this population, raising the ASSIST cutoff to 7 to detect moderate cannabis risk may be appropriate for ongoing patient monitoring, while a cutoff of 6 may be preferable for screening. However, there remain significant problems with the ASSIST as a measure for detecting risk for cannabis-related harms among this population. Development of population-specific screening tools is needed.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for Ecological Momentary Assessments in Alcohol Use: A Narrative Review.","authors":"Vaibhavi Venkataramanan, M Windy McNerney, Donna E Murray, Sindhuja Narayanan Krishna, Martin S Mumenthaler","doi":"10.1080/10826084.2026.2715773","DOIUrl":"https://doi.org/10.1080/10826084.2026.2715773","url":null,"abstract":"<p><p><i>Background:</i> Ecological Momentary Assessments (EMAs), a newer method assessing alcohol use, present advantages over Timeline Follow Back (TLFB). EMAs have progressed from telephone calls to smartphone applications, providing opportunities for growth in a naturalistic assessment. This narrative review provides an overview of smartphone-based EMAs in alcohol clinical trials showing strengths/weaknesses, implications of designs, assessment durations, validity, and compliance. <i>Methods:</i> A literature review was conducted from March 2020 to April 2025, with no limitations on article time frame as EMAs are newer. PubMed, PsycINFO, EMBASE, and Web of Science were searched for English peer-reviewed articles. <i>Results:</i> 100 final articles were included. EMAs can collect real-time data, resulting in nuanced alcohol use data, often revealing that TLFB underreports alcohol consumption due to recall bias. EMA validity is influenced by design, intoxication while reporting, and increased awareness of drinking patterns. EMA compliance increases if the study design avoids participant burden, provides incentives, and accounts for participants who react to EMAs by changing their alcohol use patterns. However, this narrative review is limited to focusing on breadth due to research on a high number of different EMAs with few being investigated repeatedly. <i>Conclusions:</i> Additional clinical trials with the same EMAs are needed to continue to establish their validity and refine existing protocols for researchers and clinical trial specialists. EMAs offer advantages including fine-grained/real-time data on alcohol use, avoiding recall bias, and a higher external validity. EMA recommendations include providing drink options, training participants on platform usage, and designing studies based on specific aims.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-18"},"PeriodicalIF":1.7,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recreational Substance Use is Linked to Deficits in Recall, but Not Recognition Memory.","authors":"Adnan Levent, Eddy J Davelaar","doi":"10.1080/10826084.2026.2718448","DOIUrl":"10.1080/10826084.2026.2718448","url":null,"abstract":"<p><strong>Background: </strong>Recreational substance use is thought to disrupt neurotransmitter systems involved in memory. While prior research consistently reports recall impairments among people with a history of substance use, findings on recognition memory remain mixed. Importantly, most studies relied on single-task assessments, limiting the ability to capture a comprehensive picture of memory performance in this population. This study assessed various memory processes (i.e., free recall, cued recall, item recognition, and source recognition) in individuals with and without a history of recreational substance use to identify which aspects of memory are more vulnerable to substance use.</p><p><strong>Method: </strong>The sample consisted of 100 subjects: 47 people without a history of illicit substance use (27 females, age range from 18 to 50+) and 53 with a history of illicit substance use (21 females, age range from 18 to 50+). Participants completed self-report questionnaires and lab-based memory tasks.</p><p><strong>Results: </strong>Individuals with a history of substance use performed significantly worse than those without a history of substance use in the California Verbal Learning test. Moreover, higher frequencies of substance use were associated with poorer performance, suggesting a dose-response relationship between substance use and verbal learning. On the contrary, there were no significant differences between the groups in the Source Memory, False Memory and Verbal Paired Associates tests. Most results remained significant after adjusting for covariates (e.g., general health, sleep routine, alcohol use and age).</p><p><strong>Conclusions: </strong>This study provides compelling evidence that recreational substance use has a detrimental effect on memory, particularly impacting free recall abilities, while recognition memory remains relatively unaffected.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking Risks on Skiing and Airplanes: Exploring and Confirming the Factor Structure of the S-UPPS-P in an Australian Alcohol and Other Drug Treatment Context.","authors":"Nicholas Kerswell, Grace Shuttleworth, Georgia Dellosa, Benjamin Bonenti, Kris Crane, Xan Dangaard, Timothy Piatkowski","doi":"10.1080/10826084.2026.2704625","DOIUrl":"https://doi.org/10.1080/10826084.2026.2704625","url":null,"abstract":"<p><strong>Introduction: </strong>Despite its growing use in Australian AOD clinical settings, limited local psychometric evidence is available for the Short UPPS-P in treatment-seeking populations. This study aimed to evaluate the factor structure and reliability of the Short UPPS-P to determine its clinical utility as a multidimensional measure of impulsivity in an Australian AOD treatment setting.</p><p><strong>Methods: </strong>De-identified baseline outcome measure data were obtained from clients accessing a large Australian non-government AOD treatment provider (<i>N</i> = 18,786). Confirmatory factor analysis (CFA) was conducted in R using weighted least squares mean and variance-adjusted estimation (WLSMV), treating S-UPPS-P items as ordered categorical indicators. Internal consistency and latent factor correlations were also examined.</p><p><strong>Results: </strong>The theorized five-factor structure of the S-UPPS-P was broadly supported. Model fit indices demonstrated acceptable comparative fit (CFI = 0.938, TLI = 0.927, SRMR = 0.084), though RMSEA was elevated (0.103). Negative urgency, positive urgency, and lack of premeditation demonstrated strong and consistent factor loadings and internal reliability (<i>α</i> = 0.76-0.80). By contrast, lack of perseverance and sensation seeking demonstrated weaker loadings and lower internal consistency (<i>α</i> = 0.65 and 0.63, respectively). Latent factor correlations were theoretically coherent and consistent with multidimensional models of impulsivity.</p><p><strong>Discussion and conclusions: </strong>Findings provide support for the broad applicability of the five-factor S-UPPS-P structure within an Australian AOD treatment context when analyzed using appropriate ordinal psychometric methods. However, weaker psychometric performance within the lack of perseverance and sensation seeking domains suggests some items may function less optimally in this clinical population. These findings support continued refinement and contextual adaptation of impulsivity measures for Australian AOD settings.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol Consumption Typologies Among Colombian Adults: A Latent Class Analysis of AUDIT Indicators.","authors":"Gabriela Sequeda, Carlos H Contreras-Pizarro, Juan Luis Huayhua-Velez, Jairk E Sanchez-Villanueva, Salvador-Mateo Castillo-Calderon, Pablo D Valencia","doi":"10.1080/10826084.2026.2716304","DOIUrl":"https://doi.org/10.1080/10826084.2026.2716304","url":null,"abstract":"<p><p>ABSTACTAlcohol consumption remains a major public health challenge and a leading preventable cause of morbidity and mortality worldwide. Although the Alcohol Use Disorders Identification Test (AUDIT) is widely used to identify hazardous alcohol use, reliance on total scores may obscure clinically meaningful heterogeneity in drinking behaviors. This study aimed to identify latent alcohol consumption typologies among Colombian adults using AUDIT response patterns and to examine their sociodemographic and psychosocial correlates. Latent class analysis (LCA) was conducted using ten dichotomized AUDIT items from 14,131 adults who reported alcohol consumption during the previous 30 days in the 2019 Colombian National Survey of Psychoactive Substance Use. Competing models were evaluated according to statistical fit, parsimony, classification accuracy, and interpretability. A three-class solution was selected, comprising Low Risk (50.7%), Hazardous Binge Drinking (38.5%), and Harmful/Dependence (10.8%) profiles. Although the two higher-risk classes showed similarly high probabilities of heavy episodic drinking, the Harmful/Dependence profile was characterized by substantially greater probabilities of dependence symptoms and alcohol-related consequences. Early alcohol initiation, peer heavy drinking, and depressive symptoms were associated with more severe profiles, whereas female sex and higher socioeconomic status were protective. These findings highlight the value of person-centered approaches for identifying heterogeneous alcohol use patterns and informing targeted prevention, screening, and intervention strategies.</p>","PeriodicalId":22088,"journal":{"name":"Substance Use & Misuse","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}