Substance use & addiction journal最新文献

{"title":"Rural-Urban Inequalities in Lifetime Tobacco Consumption Among Middle-Aged and Older Adults in India: A Decomposition Analysis Using Survey-Weighted National Data.","authors":"Pritam Halder, Divya Sharma, Sukhmeen Kaur, Sonu Goel, Pradeep Sharma, Tanvi Kiran","doi":"10.1177/29767342261436545","DOIUrl":"https://doi.org/10.1177/29767342261436545","url":null,"abstract":"<p><p>IntroductionTobacco consumption was leading global risk factor for mortality in 2023. This study aimed to assess rural-urban inequalities in lifetime tobacco consumption among Indian adults aged 45 years and above, alongside socioeconomic inequalities.</p><p><strong>Methods: </strong>Data from the Longitudinal Ageing Study in India (2017-18, Wave-1) were analyzed, focusing on participants aged >45 years. Weighted prevalence estimates and chi-squared tests were utilized to compare tobacco use across groups. Socioeconomic disparities were examined using the concentration index, and multivariate decomposition analysis identified the contribution of socioeconomic, demographic, health-related, and behavioral factors to rural-urban differences in tobacco consumption.</p><p><strong>Results: </strong>Overall, 36.78% of middle-aged and older adults (45 years and above) reported tobacco use, with a rural-urban gap of 17.72%. Smokeless tobacco (19.88%) was more prevalent than smoking (13.92%), and 2.98% used both forms. The rural-urban gap was greater for smokeless tobacco (9.54%) than for smoking (6.06%). The Northeast region showed the highest prevalence of any tobacco use (54.29%), smokeless (36.65%), and dual use (5.88%), while the North had the highest smoking rates (24.56%). Socioeconomic disparities were more pronounced in urban areas, with higher tobacco use among poorer groups. Compositional factors explained 58% of the rural-urban difference, primarily driven by education (24.74%), region (17.43%), and alcohol use (11.30%). This indicates that if urban and rural areas had the same educational characteristics, regional distribution and prevalence of alcohol consumption, the difference tobacco consumption would decrease by 53.47%.</p><p><strong>Conclusion: </strong>Tobacco consumption is more prevalent in rural and economically disadvantaged populations. Strengthening National Tobacco Control Program (NTCP) implementation, particularly in rural and Northeastern regions, and addressing socioeconomic determinants are crucial to reducing tobacco use and narrowing rural-urban disparities.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342261436545"},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overdose Prevention Education and Medication for Opioid Use Disorder in School-Based Health Centers: A Qualitative Exploration.","authors":"Cala M Renehan, Abdul Mureed Alim, Ally Cogan, Moriah Wiggins, Emma Weinberger, Brittany L Carney, Justin Alves, Alicia S Ventura, Máireád Day Lopes, Sarah M Bagley","doi":"10.1177/29767342261442454","DOIUrl":"https://doi.org/10.1177/29767342261442454","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to explore attitudes and beliefs of school-based health center (SBHC) staff about overdose prevention education and medication for opioid use disorder (MOUD) in SBHCs.</p><p><strong>Methods: </strong>We interviewed 13 SBHC staff using a semi-structured interview guide covering the following: youth substance use training, beliefs in and attitudes about overdose prevention, providing MOUD, and interactions with students' families. A hybrid deductive and inductive approach was used to conduct thematic analysis.</p><p><strong>Results: </strong>Four themes emerged: (1) limited experience in providing care or education on opioids and overdose, (2) barriers to implementation of education and MOUD including school administration and operational concerns, (3) overdose prevention and treatment is consistent with existing practices, and (4) confidentiality as a facilitator and barrier of overdose prevention education and MOUD provision.</p><p><strong>Conclusion: </strong>SBHCs are uniquely positioned to provide overdose prevention education and MOUD. Developing, testing, and implementing both interventions should be made in collaboration with youth and SBHC staff.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342261442454"},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Prolonged Suffering Have to Be a Part of the Process? Methadone Initiations in the Fentanyl Era: A Lived Experience Narrative, Evidence Review, and Call to Action.","authors":"Brooke Jackson, Patricia Liu, David Lawrence","doi":"10.1177/29767342261442052","DOIUrl":"https://doi.org/10.1177/29767342261442052","url":null,"abstract":"<p><p>In a drug landscape dominated by the highly potent synthetic opioid fentanyl, traditional methadone initiation protocols increasingly fail people with opioid use disorder (OUD). While \"low\" initial dose selection and \"slow\" dose adjustment rates reduce risk for methadone-associated toxicity, they also result in weeks to months of unrelieved withdrawal symptoms and cravings, especially for people with high opioid tolerance from routine fentanyl use. For this growing population, \"low-and-slow\" forces a choice between 3 poor options: suffer weeks to months of withdrawal, self-manage withdrawal through non-prescribed substance use, or give up on treatment. Our commentary combines a Peer Support Specialist's lived experiences with methadone initiation and evidence from the peer-reviewed literature to illustrate this problem and the role of one potential solution: rapid methadone initiation (RMI), defined here as reaching a methadone dose of 80 mg or more within the first 7 days of treatment. For appropriately selected patients, RMI is associated with positive outcomes, including improved patient satisfaction, reduced readmission rates, and increased retention in care. Though regulations permit and growing evidence supports RMI, adoption remains limited. Our commentary, therefore, concludes by sharing frameworks to support providers in implementing RMI as a potential treatment option for people with OUD across applicable care settings. Methadone's life-saving potential depends on dosing that matches the physiological reality of fentanyl use. Collectively, addiction clinicians define the community standard of care. In the face of a transformed drug landscape, it is time for that standard to evolve to ensure that the option for rapid and effective relief becomes the rule, rather than the exception.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342261442052"},"PeriodicalIF":0.0,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147794159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Cannabis Vaping Advertising Messages and Warnings Among US Young Adults.","authors":"Cassidy R LoParco, Matthew E Rossheim, Julia Chen-Sankey, Kayla K Tillett, Shriya Thakkar, Morgan Speer, Yuxian Cui, Miranda Johnson, Patricia A Cavazos-Rehg, Carla J Berg","doi":"10.1177/29767342261429618","DOIUrl":"https://doi.org/10.1177/29767342261429618","url":null,"abstract":"<p><strong>Background: </strong>Cannabis vaping prevalence and marketing has increased, but limited research has assessed effects of specific advertising messages, warnings, or their combinations on young adults' perceptions. This study aimed to advance this research.</p><p><strong>Methods: </strong>In 2024, 3581 US young adults aged 18 to 34 (40.8% reporting past-month use) participated in an online survey-based experiment using a 2 × 4 factorial design (advertising message: psychological effects vs flavors; warning: none, adult-use, intoxication, vape-specific) and then reported on 5 perception outcomes: addictiveness, harm, cautiousness, appeal, and interest (0 = not at all to 7 = extremely). Multivariable regression assessed advertising message, warning, and message-by-warning interactions in relation to outcomes, overall and by past-month use status.</p><p><strong>Results: </strong>Among the total sample and among participants reporting no cannabis use, there were no main or interaction effects of advertising message or warning conditions. Among participants reporting use, adult-use (vs no) warning exposure was associated with lower addictiveness and cautiousness; intoxication (vs no) warning exposure was associated with lower harm. A significant interaction indicated that participants reporting use who were exposed to both psychological effects (vs flavors) advertising messages and intoxication (vs no) warnings reported greater appeal, whereas those exposed to both flavors (vs effects) advertising messages and intoxication (vs no) warnings reported lower appeal.</p><p><strong>Conclusions: </strong>These findings highlight the importance of understanding how advertising messages may affect how warnings are interpreted (or vice versa), strengthening the evidence base informing advertising restrictions and warning requirements, and elucidating the mechanisms driving the differences among young adults who use versus do not use cannabis.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342261429618"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RAMP-UP: Pharmacist-Led Methadone Titration for Hospitalized Patients With Opioid Use Disorder.","authors":"Emily R Casey, Tanya Uritsky, Liana Soyfer, Lin Xu, Kevin G Lynch, Samantha Zwiebel, Margaret Lowenstein, Ashish Thakrar","doi":"10.1177/29767342261433344","DOIUrl":"https://doi.org/10.1177/29767342261433344","url":null,"abstract":"<p><strong>Background: </strong>Hospitals increasingly start methadone treatment for opioid use disorder (OUD). Rapid methadone titration has been described in hospitals with addiction consult teams; however, most hospitals lack these specialty services. We evaluated whether a pharmacist-led rapid methadone titration protocol (\"RAMP-UP\") increased the proportion of hospitalizations that reached a minimally therapeutic dose of methadone (≥60 mg) before discharge.</p><p><strong>Methods: </strong>We conducted a retrospective, quasi-experimental, pre-post study comparing outcomes 7 months before versus 7 months after the implementation of RAMP-UP. The study included all adults admitted to a large academic medical center between March 2022 and April 2023 who newly initiated methadone for OUD. We used multivariable regression with generalized estimating equations to evaluate the primary outcome of achieving a total daily methadone dose of at least 60 mg by hospital discharge. Secondary outcomes included days to therapeutic dose, total daily methadone dose, and opioid-related safety events.</p><p><strong>Results: </strong>We identified n = 155 admissions, 55 pre-intervention and 100 post-intervention, among 124 unique patients with OUD. After RAMP-UP, a higher proportion of encounters reached ≥60 mg total daily dose (TDD) of methadone, but this difference was not significant in adjusted analyses (45.5% pre-implementation vs 60.0% post-implementation, <i>P</i> = .06). Post-implementation encounters had higher methadone TDD on discharge (62 vs 55 mg; <i>P</i> = .04) and, among those who reached 60 mg TDD, achieved this dose faster (9.0 vs 4.0 days, <i>P</i> < .001). Safety events were uncommon and similar (11.0% vs 12.7%; <i>P</i> = .80).</p><p><strong>Conclusions: </strong>Pharmacist-guided rapid titration accelerated attainment of therapeutic methadone doses and did not increase adverse events. Although the adjusted increase in the proportion achieving ≥60 mg TDD by discharge was not statistically significant, these findings demonstrate how inpatient clinical pharmacists can modernize inpatient OUD care.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342261433344"},"PeriodicalIF":0.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Attitudes on Recovery Residence Acceptance and Use of Medication for Opioid Use Disorder.","authors":"Cynthia Nichols","doi":"10.1177/29767342261426117","DOIUrl":"https://doi.org/10.1177/29767342261426117","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the relationship between medications for opioid use disorder (MOUD) attitudes and MOUD use in recovery residences (RRs). It was hypothesized that RR leaders with positive attitudes about MOUD will report more types of MOUD accepted in their RR, and greater MOUD use among their residents, than leaders with negative attitudes.</p><p><strong>Method: </strong>Data for this study were collected through an online survey of RR owners, operators, and managers in 20 states in the United States (n = 128). MOUD attitudes were assessed with 2 scales developed for this study. Both ideological (α = .90) and logistical (α = .77) attitudes scales showed good internal reliability. Poisson and ordinary least squares (OLS) regression were used to examine the association between MOUD attitudes, and the number of medications accepted and used in RRs, holding constant participant's time in role, RR level, proportion of non-white residents, bed number, whether the RR accepts females, and state.</p><p><strong>Results: </strong>Most participants reported that their RR accepted MOUD (92%) and a little under half preferred certain types of MOUD (46%). The Poisson and OLS regression revealed that more positive ideology toward MOUD was significantly associated with increases in both the total number of medications accepted in the RR and the extent of MOUD use among residents.</p><p><strong>Implications: </strong>Attitudes of RR leadership relate to MOUD practices among RR residents. Changing leaders' attitudes could influence the integration of MOUD use in RRs.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342261426117"},"PeriodicalIF":0.0,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-Urban Disparities in Inpatient Outcomes for Opioid Overdose: A Nationwide Analysis.","authors":"Muhammad Ahmad Nadeem, Mohammed A Quazi, Abdullah Khan, Tristen A Adams, Abdul Rafeh Awan, Amir H Sohail, Adeel Nasrullah, Abu Baker Sheikh","doi":"10.1177/29767342251370455","DOIUrl":"10.1177/29767342251370455","url":null,"abstract":"<p><strong>Objectives: </strong>Substantial gaps in clinical outcomes exist in rural and urban hospitals in the United States. Our findings highlight the impact of geographic location on hospital care, guiding targeted interventions to improve opioid-related outcomes in rural and urban areas.</p><p><strong>Methods: </strong>We used the National Inpatient Sample to examine trends in hospitalizations, in-hospital mortality, length of stay, and inflation-adjusted cost of adults admitted for an opioid overdose between 2016 and 2021.</p><p><strong>Results: </strong>Between 2016 and 2021, age-adjusted hospitalizations consistently declined across urban, rural, and overall populations. Urban hospitalization rates decreased from 700 to 500 per 100 000, while rural rates fell from 150 to under 100 per 100 000. Strong negative correlations indicated significant downward trends in hospitalizations across all groups (urban and total: τ = -0.99, <i>P</i> = .008; rural: τ = -0.99, <i>P</i> = .009). Rural patients had higher odds of in-hospital mortality (OR [95% CI]: 1.24 [1.1-1.4], <i>P</i> < .001), requiring invasive mechanical ventilation (OR [95% CI]: 1.46 [1.37-1.56], <i>P</i> < .001), and hemodialysis (OR [95% CI]: 1.64 [1.42-1.89], <i>P</i> < .001), with similar findings in propensity-matched cohorts. Additionally, rural patients were more likely to develop venous thromboembolism (VTE) (OR [95% CI]: 1.20 [1.00-1.43], <i>P</i> = .045), anoxic brain damage (OR [95% CI]: 1.15 [1.02-1.30], <i>P</i> = .025), and acute liver failure (OR [95% CI]: 1.34 [1.18-1.53], <i>P</i> < .001), although VTE did not reach significance in matched cohorts (<i>P</i> = .120). Rural hospitalizations incurred lower inflation-adjusted costs by $1367.89 (<i>P</i> < .001) and had a shorter adjusted length of stay by 0.49 days (<i>P</i> < .001) compared to urban settings.</p><p><strong>Conclusion: </strong>In conclusion, significant disparities in outcomes for opioid overdose patients highlight challenges in rural health care, including higher in-hospital mortality and complications. Continued healthcare policy reforms are warranted to alleviate the disparities in rural-urban cardiovascular outcomes.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"384-397"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Test of Multiple Risk and Protective Factor Domains for Early Substance Use Onset: Implications for Primary Prevention Policy and Practice.","authors":"Alfgeir L Kristjansson, Christa L Lilly, Michael J Mann, Megan L Smith, Steven M Kogan","doi":"10.1177/29767342251392695","DOIUrl":"10.1177/29767342251392695","url":null,"abstract":"<p><strong>Background: </strong>Primary prevention research rarely include measures for multiple risk and protective factor domains for youth alcohol, tobacco, and other drug (ATOD) use onset simultaneously within the same prospective study. The aim of this study is to test the simultaneous longitudinal relationships between risk and protective factors within these 5 domains and ATOD onset among early adolescents.</p><p><strong>Methods: </strong>Analyses are based on waves 1 to 6 from the Young Mountaineer Health Study cohort that was conducted every ~6 months over a 3-year period between 2020 and 2023 in 20 diverse schools in West Virginia in the United States. For the present analysis, 2916 sets of student data were included from all 6 waves. Longitudinal analyses were conducted using best linear unbiased predictors for all domain exposure variables across the 6 time points using high-performance linear mixed modeling in conjunction with logistic regression.</p><p><strong>Results: </strong>Risk and protective factors within the 5 exposure domains of parents/caregivers, peers, school, leisure time, and community were simultaneously related to odds of substance use onset among early adolescents.</p><p><strong>Conclusions: </strong>Our findings underscore the need for both basic and prevention research guided by systems-based approaches versus a focus on a limited set of etiological factors.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"521-530"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145644501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Perspectives of Peer Recovery Specialists: Needs for Training, Support, and Professional Development.","authors":"Margaret Lowenstein, Kathryn Gallagher, Nicole O'Donnell, Aminata Jalloh, Selena Suhail-Sindhu, M Holliday Davis, Jeanmarie Perrone","doi":"10.1177/29767342251372319","DOIUrl":"10.1177/29767342251372319","url":null,"abstract":"<p><strong>Background: </strong>Peer recovery specialists (PRSs) are professionals with lived experience in substance use and recovery, playing an important and growing role in the substance use care workforce. However, there is limited guidance on best practices for integrating PRSs into health care settings and supporting their well-being and career development. This study explores the perspectives experienced PRSs across diverse clinical settings regarding training, support, and professional development.</p><p><strong>Methods: </strong>Between September 2021 and February 2022, we conducted semi-structured interviews with 15 PRSs from the Philadelphia area who participated in a virtual PRS support group. The interviews focused on barriers, facilitators, and unmet needs in their roles. Interviews were recorded, transcribed, and analyzed using thematic content analysis.</p><p><strong>Results: </strong>Most participants were female (53%) and white (93%) (Table 1), with 80% having 4 or more years of work experience. Participants worked in a variety of settings, including community-based programs (47%), outpatient specialty substance use disorder treatment (27%), and primary care (20%). Key interview themes included : (1) Motivation and satisfaction: Participants found meaning in client successes and peer support, emphasizing relationships and teamwork; (2) Burnout and role challenges: Many experienced high stress due to role ambiguity, excessive caseloads, and secondary trauma; (3) Supportive workplace factors: structured supervision, professional networks, and feeling valued within care teams were crucial supports; and (4) Professional development needs: Participants identified gaps in training, system navigation, and career advancement opportunities.</p><p><strong>Conclusion: </strong>PRSs are vital in substance use care but face significant challenges related to burnout, ambiguous role expectations, and inadequate job training. Establishing structured models for PRS training, supervision, and professional development may enhance their effectiveness within health systems.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"398-408"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Among Minority Stress, Relaxation and Tension-Reduction Motives, and Cannabis Use Among a Sample of Sexual and Gender Minority Adults in Oklahoma.","authors":"Nadine Sikora, Katelyn F Romm, Michael A Smith, Amy M Cohn","doi":"10.1177/29767342251374755","DOIUrl":"10.1177/29767342251374755","url":null,"abstract":"<p><strong>Introduction: </strong>Despite well-documented cannabis use disparities among sexual and gender minority (SGM; vs heterosexual and/or cisgender) adults, less is known regarding associations of minority stressors, cannabis use motives, and cannabis use outcomes among SGM individuals.</p><p><strong>Methods: </strong>Data were from a repeated online cross-sectional survey of SGM-identifying adults in Oklahoma (n = 430; 67% female). Multivariable regressions examined associations of: (1) minority stressors (ie, discrimination, internalized stigma, community acceptance/safety, time spent in SGM spaces) with relaxation/tension-reduction cannabis use motives; and (2) minority stress factors and relaxation/tension-reduction motives with cannabis use behaviors (ie, past-month use, daily/near-daily use, possible cannabis use disorder [CUD]) among females and males, separately.</p><p><strong>Results: </strong>Among female SGM adults, discrimination was associated with more relaxation/tension-reduction motives, which were associated with higher odds of daily/near-daily use and possible CUD. Among male SGM adults, time spent in SGM spaces was associated with more relaxation/tension-reduction motives, which were associated with higher odds of daily/near-daily use and possible CUD.</p><p><strong>Conclusion: </strong>Findings elucidate associations of discrimination (for female SGM adults) and time spent in SGM spaces (for male SGM adults) with more relaxation/tension-reduction cannabis use motives and associations of relaxation/tension-reduction use motives with worse cannabis use outcomes. Findings provide preliminary insights into the potential need for community-level interventions aimed at reducing discrimination and individual-level interventions aimed at promoting healthier coping behaviors in response to stress for SGM adults.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":"47 2","pages":"326-336"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}