American Journal of Drug and Alcohol Abuse最新文献

{"title":"Levels of support and consumer perceptions of cannabis regulations in Canada.","authors":"Anastasia Marquette, David Hammond","doi":"10.1080/00952990.2025.2479152","DOIUrl":"https://doi.org/10.1080/00952990.2025.2479152","url":null,"abstract":"<p><p><i>Background:</i> Canada legalized cannabis for adult (recreational) use in 2018, alongside regulations on the sale, use, and possession of cannabis. To date, there is little evidence on consumer perceptions and support of cannabis regulations.<i>Objectives:</i> This study examined perceptions of nine cannabis regulatory policies, including differences by cannabis consumption and provincial policy.<i>Methods:</i> National survey data were analyzed from Wave 5 of the International Cannabis Policy Study conducted online in 2022 with 16,812 Canadians aged 16+ years, 62% of which were assigned female-at-birth. Weighted logistic regression models examined support for nine policy variables.<i>Results:</i> Support among Canadians was greatest for health warnings on cannabis products (62.6%), legalization for adult use (58.5%), and retail store window-coverings (49.2%), followed by a vaping/extract THC limit (40.1%), retail store density (35.5%), government-only store models (34.6%), the THC limit on edibles (32.3%), and advertising restrictions (31.8%). The 30 g purchasing limit had the least consumer support (10.1%). As consumption increased, opposition generally increased, although support remained high among consumers. Compared to non-consumers, daily consumers were more likely to oppose window-coverings (OR = 1.43, CI95 = 1.16-1.75, <i>p</i> = .001). Where policies differed provincially, few differences in support were observed. No differences in support for THC limits on vaping/extracts were observed between Newfoundland, Nova Scotia, and Quebec versus the rest of Canada, despite stronger vaping/extract regulations (OR = 1.05, CI95 = 0.87-1.28, <i>p</i> = .597).<i>Conclusion:</i> Canadians generally support existing cannabis regulations that were implemented to support public health. The high level of support among consumers suggests that the comprehensive regulations may not undermine transitions to legal retail sources.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-17"},"PeriodicalIF":2.7,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"American Indian women's perceptions of perinatal cannabis use.","authors":"Celestina Barbosa-Leiker, Olivia Brooks, Crystal Lederhos Smith, Shayla C Reid, Gusti Lulu Fatima, Katherine A Hirchak, Randi Arias-Losado, Margaret Cabell","doi":"10.1080/00952990.2025.2473399","DOIUrl":"10.1080/00952990.2025.2473399","url":null,"abstract":"<p><p><i>Background:</i> Cannabis use during pregnancy continues to rise, yet research examining cannabis use in perinatal American Indian women is lacking. Structural injustices have led to health inequities for American Indian people, including higher prevalence of past-month cannabis use and lower prevalence of receiving mental health treatment, compared to other racial and ethnic groups.<i>Objective:</i> To describe perceptions of risks and benefits of perinatal cannabis use in a sample of American Indian perinatal women who report regularly using cannabis while pregnant.<i>Method:</i> A qualitative descriptive study was conducted with 10 American Indian perinatal women who reported using cannabis at least weekly while pregnant or postpartum. Participants were from three states where cannabis use is legal for adults (Washington, Oregon, and California). Themes were generated from implicit and explicit participant responses and principles of Indigenous research frameworks were utilized.<i>Results:</i> Four themes were derived from the data: 1) Perinatal cannabis use as better than other substances, 2) Medicinal use and perceived therapeutic effects of prenatal cannabis, 3) Unsure if cannabis use while breastfeeding impacts the baby, and 4) Minimal responses from healthcare providers perceived as approval.<i>Conclusions:</i> Cannabis was used for health-related issues and was perceived to be a safer option for than use of methamphetamine, heroin, alcohol, and prescription pharmaceuticals. With a focus on other substance use issues within participants' communities, minimal discussion about cannabis use by healthcare providers was perceived as endorsement of use, highlighting the need for additional training for healthcare providers.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-9"},"PeriodicalIF":2.7,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How adolescent tobacco use has responded to state tobacco 21 laws and flavor restrictions.","authors":"Summer Sherburne Hawkins, Rebekah Levine Coley, Lindsay Lanteri, Christopher F Baum","doi":"10.1080/00952990.2024.2444567","DOIUrl":"https://doi.org/10.1080/00952990.2024.2444567","url":null,"abstract":"<p><p><i>Background:</i> Tobacco 21 (T21) laws (prohibiting tobacco sales under age 21) and flavor restrictions have recently been enacted, yet little is known about the extent to which these policies shifted adolescent tobacco use.<i>Objectives:</i> To examine the associations between state-level T21 laws and flavor restrictions with adolescent tobacco use overall and by age.<i>Methods:</i> We linked state-level T21 laws and flavor restrictions with individual-level data on self-reported levels of cigarette, cigar, and electronic nicotine delivery systems (ENDS) use among 979,477 (500,205 female/479,272 male) 14-18+-year-olds from the 2011-2021 Youth Risk Behavior Surveys. We estimated adjusted zero-inflated negative binomial regression models to predict the likelihood of zero use and frequency of use among users and calculated total predicted use, with year and state fixed effects.<i>Results:</i> There were no associations between flavor restrictions and cigarette, cigar, or ENDS use. There also were no associations between T21 laws and cigarette use; however, when categorized based on the laws' policy components, strong T21 laws were associated with lower cigarette use (total marginal effect estimate: -0.34; -0.59, -0.09; <i>p</i> = .009, showing a 0.34 day/month decline). T21 laws were associated with higher ENDS use (total marginal effect estimate: 0.36; 0.11, 0.60; <i>p</i> = .004, showing a 0.36 day/month increase). Policy effects did not vary by age.<i>Conclusion:</i> Current state policies aimed at reducing access to tobacco products have not curbed adolescent tobacco use. Our findings suggest that more comprehensive state laws, including T21 laws with strong policy components, are needed to fill gaps in federal age and flavor restrictions.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent stress avoidance influences cue-induced heroin seeking and chaperonin gene expression in the dorsal striatum of adult female rats.","authors":"Kassandra Looschen, Ann Jeffers, Songjukta Chakraborty, Colin Salisbury, Anastasia Dodge, Mason Hochstetler, Swarup Mitra","doi":"10.1080/00952990.2025.2469793","DOIUrl":"https://doi.org/10.1080/00952990.2025.2469793","url":null,"abstract":"<p><p><i>Background:</i> Females remain underrepresented in opioid use disorder (OUD) research, particularly regarding dorsal striatal neuroadaptations. Chaperonins seem to play a role in opioid-induced neural plasticity, yet their contribution to OUD-related changes in the dorsal striatum (DS) remains poorly understood. Given known sex differences in opioid sensitivity, it is important to determine how chaperonin expression contributes to OUD-related adaptations in females.<i>Objective:</i> To investigate how stressor controllability during adolescence influences heroin self-administration (SA) and responses to drug-paired cues in adult female rats, focusing on differential gene expression of chaperonins in the DS.<i>Methods:</i> Female rats were exposed to stress avoidance training during adolescence. These rats underwent, in adulthood, heroin SA followed by cue-induced seeking tests after early and prolonged abstinence.<i>Results:</i> Heroin intake during SA was similar between stress-avoiding and stress-naïve females (<i>n</i> = 8/group, <i>p</i> = .89). However, stress-avoiding females exhibited reduced drug-seeking behavior in response to drug cues at 14 days of abstinence compared to controls (<i>p</i> < .05; d = 0.99), suggesting a protective effect of stressor controllability. qPCR showed that the gene expression of Hspa5, a heat shock protein, was elevated in the dorsolateral striatum (DLS) of stress-avoiding females (<i>p</i> < .05; Cohen d > 1.0). Hspb1 gene expression was upregulated in the dorsomedial striatum (DMS) of stress-avoiding females (<i>p</i> < .05; d > 1.0).<i>Conclusion:</i> These findings suggest that chaperonin dysregulation links opioid exposure and stress avoidance conditions. Increased Hspa5 in the DLS and Hspb1 in the DMS may contribute to the observed behavioral differences supporting further preclinical investigation with clinical implications for stress and OUD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-9"},"PeriodicalIF":2.7,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonfatal pediatric fentanyl exposures reported to US poison centers, 2015-2023.","authors":"Joseph J Palamar, Linda B Cottler, Joshua C Black","doi":"10.1080/00952990.2025.2457481","DOIUrl":"10.1080/00952990.2025.2457481","url":null,"abstract":"<p><p><i>Background:</i> The opioid crisis, driven by fentanyl use, continues to worsen in the US and there has been a lack of focus on nonfatal overdose and how pediatric populations are being affected.<i>Objectives:</i> We determined the prevalence of nonfatal pediatric fentanyl exposures and associated characteristics and delineated how such characteristics are associated with major (life-threatening) outcomes.<i>Methods:</i> This repeated cross-sectional study examined characteristics of pediatric nonfatal fentanyl exposures (aged 0-19 years) reported to poison centers in 49 US states from 2015 through 2023.<i>Results:</i> 3,009 nonfatal pediatric exposures (41.5% female) were reported to poison centers-58.9% aged 13-19 and 41.1% aged 0-12. The number of exposures increased overall from 69 in 2015 to 893 in 2023 (a 1,194.2% increase, <i>p</i> < .001). Exposures increased by 924.3% among those aged 0-12 (<i>p</i> < .001) and by 1,506.3% among those aged 13-19 (<i>p</i> < .001). Ingestion-only use was the most prevalent route of administration by those aged 0-12 (76.9%) and 13-19 (54.1%). Prevalence of ingestion-only use increased from 44.1% of exposures in 2015 to 67.9% in 2023 (<i>p</i> < .001). The majority of patients aged 0-12 were exposed unintentionally (81.7%, vs. 1.0% among patients aged 13-19) while the majority of patients aged 13-19 misused or \"abused\" fentanyl (65.7% vs. 1.8%). The plurality of exposures (41.0%) resulted in a major (life-threatening) effect.<i>Conclusions:</i> Pediatric exposures to fentanyl are increasing and over one-third of cases are unintentional and/or had documented life-threatening effects. Prevention and harm reduction efforts need to include efforts for youth, particularly as counterfeit pills containing fentanyl flood the illicit market.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-10"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost-effectiveness of long-term post-treatment peer recovery support services in the United States.","authors":"Sierra Castedo de Martell, Margaret Brannon Moore, Hannah Wang, Lori Holleran Steiker, J Michael Wilkerson, Nalini Ranjit, Sheryl A McCurdy, H Shelton Brown","doi":"10.1080/00952990.2024.2406251","DOIUrl":"10.1080/00952990.2024.2406251","url":null,"abstract":"<p><p><i>Background:</i> Peer recovery support services (PRSS) have been widely adopted across a variety of settings, but little is known about their economic impact.<i>Objectives:</i> To conduct a cost-effectiveness analysis of long-term, PRSS delivered after specialty substance use disorder (SUD) treatment (post-treatment), and to describe the development of a free, web-based cost-effectiveness calculator based on this analysis.<i>Methods:</i> Using publicly available data from a variety of sources, post-treatment PRSS were compared to specialty SUD treatment from the societal (broad perspective including costs like participant time) and health systems perspectives (only costs borne by health system), and in terms of quality-adjusted life years (QALYs) added and people in recovery. Whenever possible, 2019 data were used to avoid the impacts of COVID-19. Standard willingness-to-pay thresholds and additional treatment episode cost ($17,203.74) were used. One-way and probabilistic sensitivity analyses were conducted. Two recovery community organizations (RCOs) were involved in model refinement and calculator development in 2022.<i>Results:</i> Post-treatment PRSS were cost-effective to all thresholds and perspectives: $5,898.60 per QALY and $10,562.08 per person in recovery from the health system perspective, and $3,421.58 per QALY and $6,126.72 per person in recovery from the societal perspective, and post-treatment PRSS remained cost-effective across a variety of conditions in the sensitivity analyses. A cost-effectiveness calculator was developed from the analysis and is available at https://go.uth.edu/cea.<i>Conclusions:</i> In light of finding PRSS cost-effective, the expansion of PRSS across the US should continue, and may be aided by using the cost-effectiveness calculator to estimate tailored results for a specific program.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-11"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer recovery support services: an under-explored policy tool in the substance use crisis.","authors":"Carol Xu, Zachary Sturman","doi":"10.1080/00952990.2025.2469087","DOIUrl":"https://doi.org/10.1080/00952990.2025.2469087","url":null,"abstract":"","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-3"},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Day-to-day discrimination and substance use treatment motivation among justice-involved adults experiencing homelessness.","authors":"Priya B Thomas, Jamie M Gajos, Jennifer M Reingle Gonzalez, Rebecca Molsberry Marcolina, Karen L Cropsey, Sydney Gilmer, Rodolfo A Perez, Michael S Businelle","doi":"10.1080/00952990.2025.2466188","DOIUrl":"https://doi.org/10.1080/00952990.2025.2466188","url":null,"abstract":"<p><p><i>Background:</i> Adults experiencing homelessness (AEH) disproportionately suffer from substance use disorders (SUD) and under-utilize SUD treatments compared with the general population. AEH with a recent history of justice involvement (AEH+J) face additional treatment barriers related to discrimination and criminal history.<i>Objective:</i> To describe types of discrimination that AEH+J experience and assess whether the type of discrimination experienced impacts motivation for SUD treatment by SUD severity.<i>Methods:</i> We analyzed data from 164 AEH+J (85% male, 54% non-Hispanic Black) from the Link2Care cohort. ANOVA and linear regression analyses tested for associations between discrimination type, SUD treatment motivation, and SUD severity. Multivariable linear regression models examined associations between discrimination types and SUD treatment motivation by SUD severity level.<i>Results:</i> The majority of AEH+J experienced discrimination (90%), primarily due to homeless status (27%) and race (27%). AEH+J with severe SUD had a significantly greater motivation for SUD treatment than those with mild/moderate disorders (mean difference: 7.34, <i>p</i> < .0001). Discrimination type was not directly associated with SUD severity or treatment motivation. However, among participants with severe SUD, AEH+J who experienced race-related discrimination had lower treatment motivation than those who did not experience discrimination (β = -6.17, <i>p</i> = .03).<i>Conclusion:</i> Results support allocating scarce publicly available SUD treatment resources to AEH+J with the greatest need and motivation to receive treatment. Results also highlight the importance of screening for discriminatory experiences, especially to those who primarily experience race-related discrimination, to improve motivation for SUD treatment among AEH+J with severe SUD.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-10"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age patterns and predictors of cannabis initiation among biracial and monoracial U.S. youth.","authors":"Ai Bo, Alejandro Martinez, Jieni Zhou, Daniel Bauer, Patrece L Joseph, Trenette Clark Goings","doi":"10.1080/00952990.2025.2461520","DOIUrl":"https://doi.org/10.1080/00952990.2025.2461520","url":null,"abstract":"<p><p><i>Background:</i> Understanding cannabis initiation is essential for effective prevention but remains understudied, especially for biracial youth who are disproportionately affected by substance use.<i>Objectives:</i> This study examined age patterns and predictors of cannabis initiation across eight monoracial and biracial groups and explored whether predictor effects varied by age, racialized group, and sex.<i>Methods:</i> Add Health data (<i>n</i> = 12,941, 50% male, baseline mean age = 15.5) were analyzed using discrete-time survival analyses to estimate cannabis initiation probabilities from ages 10-24 by age, racialized group, and other predictors.<i>Results:</i> Cannabis initiation probability followed a quadratic age pattern, increasing from age 10-16 and declining thereafter, with differences by racialized group (<i>p</i> < .05). The highest probabilities of new initiations (at age 16) ranged from lowest to highest as follows: Asian (0.08), Black (0.10), Hispanic (White) (0.12), White (0.15), Biracial White-Indigenous (0.16), Indigenous (0.18), Biracial White-Black (0.19), and Biracial White-Asian (0.25). Age- and race-varying effects were found for peer substance use and parental control (joint Wald test, <i>p</i> < .05). Specifically, peer substance use was positively associated with cannabis initiation during adolescence, peaking in mid-adolescence, with stronger effects for Biracial White-Black and Biracial White-Asian youth than their monoracial peers. The effects of parental control showed complex, group-specific patterns. Family support and religiosity slightly lowered cannabis initiation across racialized groups.<i>Conclusion:</i> These findings highlight distinct cannabis initiation patterns across racialized groups, along with variations in the effects of peer substance use and parental control by age and racialized group.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-12"},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using digitally delivered measurement-based care in substance use disorder treatment: qualitative analysis of patients' perspectives.","authors":"Tessa Frohe, Eliza B Cohn, Madeline C Frost, Tascha R Johnson, Kevin A Hallgren","doi":"10.1080/00952990.2025.2458626","DOIUrl":"https://doi.org/10.1080/00952990.2025.2458626","url":null,"abstract":"<p><p><i>Background:</i> Measurement-based care (MBC) is a clinical practice where patients complete standardized outcome measures throughout treatment to monitor clinical progress and inform clinical decision-making. However, MBC is rarely adopted in routine substance use disorder (SUD) treatment. We developed a digital MBC system and pilot tested it in an outpatient adult community SUD treatment setting.<i>Objectives:</i> The current study aims to characterize qualitative feedback from the pilot participants about their experiences using the MBC system in SUD treatment, focusing on perceived benefits, drawbacks, and suggestions for improvement.<i>Methods:</i> Participants (<i>N</i> = 30; <i>n</i> = 11 female 37%) completed weekly MBC questionnaires via smartphone for 6 months and completed structured interviews at 6-, 12-, and 24-weeks. Themes were identified using a combination of inductive/deductive thematic analysis.<i>Results:</i> Participants highlighted several benefits of using the digital MBC system, including improved self-reflection (e.g. goal clarification, noticing changes over time), treatment enhancement (e.g. improving patient-clinician communication, extending the reach of treatment beyond scheduled sessions), and ease-of-use (e.g. brief, understandable questions). Drawbacks were less frequently expressed and included limited integration with clinical care, repetitiveness of questionnaires, and some questions being difficult to answer. Suggestions included making elements more personalized and improving interactivity with the digital interface.<i>Conclusion:</i> Patients report several benefits of integrating digitally delivered MBC into SUD treatment, along with recommendations that may improve its usability and usefulness. Integrating MBC technology into SUD treatment may potentially aid patients by enhancing self-reflection, facilitating more efficient communication with clinicians, and extending the reach of treatment beyond scheduled treatment sessions.</p>","PeriodicalId":48957,"journal":{"name":"American Journal of Drug and Alcohol Abuse","volume":" ","pages":"1-11"},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}