Substance use & addiction journal最新文献

{"title":"Study Protocol for Implementation of Pharmacist-Led Interventions to Increase Access to Medications for Opioid Use Disorder for Incarcerated Individuals (PLI-MOUD Study).","authors":"Meghan Breckling, Holly Handley, Jennifer Shuler, Michael Mancino, Azizi Ray","doi":"10.1177/29767342251333241","DOIUrl":"10.1177/29767342251333241","url":null,"abstract":"<p><p>Illicit opioid use and opioid use disorder (OUD) are public health crises that often lead individuals to encounter the criminal justice system. Illegally manufactured fentanyl contaminates much of the illicit drug supply, including opioids and stimulants, leading to unintentional drug overdoses. Access to evidence-based treatment with medications for opioid use disorder (MOUD) and an opioid overdose reversal agent (OORA) is paramount to preventing overdose deaths. However, few jails or prisons in the state of Arkansas currently provide access to or education about these evidence-based medications. One strategy to increase evidence-based medication utilization within a carceral setting is to engage pharmacists, who are under-utilized healthcare professionals and who have considerable expertise in MOUD and OORA. There is currently limited evidence to support pharmacists' roles within a jail setting. With federal and state opioid response funding, we are conducting the Pharmacist-Led Interventions to Increase Access to Medications for Opioid Use Disorder (PLI-MOUD) study. This randomized controlled study evaluated the preliminary efficacy of pharmacist-led interventions to expand knowledge and access to MOUD among individuals identified with a history of symptoms suggestive of OUD. In addition, it aims to assess knowledge and confidence in OORA among individuals with a history of symptoms suggestive of stimulant use disorder alone or in combination with OUD, who are currently incarcerated and enrolled in an established Re-Entry program within a single county regional detention facility. The three aims of the study include (1) assessment of the prevalence of OUD symptoms and racial/ethnic differences within this unique study setting, (2) comparison of the effectiveness of a naloxone administration training intervention delivered by a pharmacist versus an Alcohol and Drug Counselor (ADC), and (3) compare the effectiveness of two pharmacist-delivered MOUD education interventions, Brief Intervention and Referral to Treatment versus standard medication counseling.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"1034-1039"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063928","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":"Protocol Commentary for the SUCCESS (Successful Recruitment and Retention in a Randomized Controlled Trial of Pregnant Participants with Opioid Use Disorder) Study.","authors":"Ashley M Snyder, Sanila Math, Kristine Campbell, Davida M Schiff, Alexindra Wheeler, Kristi Carlston, Adam J Gordon, T John Winhusen, Gerald Cochran, Marcela C Smid","doi":"10.1177/29767342251334490","DOIUrl":"10.1177/29767342251334490","url":null,"abstract":"<p><p>Opioid use disorder (OUD) and resulting opioid-related overdoses are significant contributors to maternal morbidity and mortality. Yet very few clinical trials focus on evaluating the efficacy of medications for OUD among pregnant populations. Understanding challenges to the recruitment and retention of pregnant participants with OUD in clinical trials and identifying effective strategies to overcome these barriers are urgently needed to help improve outcomes. The SUCCESSful recruitment and retention in a randomized controlled trial of pregnant participants with opioid use disorder (SUCCESS) study was conceptualized and designed by researchers from the Medication treatment for Opioid use disorder in expectant Mothers (MOMs) trial (NIH NIDA NCT03918850). The objective of the SUCCESS study is to identify strategies, facilitators, and barriers to recruiting and retaining pregnant and postpartum participants with OUD in the MOMs trial. The SUCCESS study entails (1) semi-structured interviews with researchers from all 13 MOMs sites, (2) focus groups with MOMs trial participants, and (3) a modified Delphi process to develop data-driven guidance for future clinical trials. This commentary describes the motivation to conduct this study, presents our conceptual framework and critical decision points in protocol development, and describes the proposed product of this study.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"1040-1046"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610821","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":"Collaborating Across the Globe: The Yale-University of Jordan International Interprofessional Addiction Education Program.","authors":"Srinivas B Muvvala, Rebecca Minahan-Rowley, Yara Al-Khateeb, Rana Abu-Dahab, Kaveh Khoshnood, Mayyada Wazaify, Jeanette M Tetrault","doi":"10.1177/29767342251331389","DOIUrl":"https://doi.org/10.1177/29767342251331389","url":null,"abstract":"<p><strong>Background: </strong>Substance use is a major global public health challenge. A well-trained health care workforce is needed to prevent, address, and treat substance use disorders (SUD) internationally.</p><p><strong>Methods: </strong>In September 2021, the Yale Schools of Medicine (YSM) and Public Health (YSPH) and the University of Jordan (UJ) collaborated to establish the Yale-UJ Joint Training Program in Addiction Medicine. The curriculum was developed using the six-step Kern Model. The program aimed to create opportunities for cross-cultural, interprofessional education in addiction medicine to address education and treatment gaps.</p><p><strong>Results: </strong>The two-year program led to novel learning, training, and research opportunities in addiction medicine for faculty, staff, and students at YSM, YSPH, and UJ. The program implemented 16 lectures, a live in-person training workshop, three student-led discussion events, a student-led exchange network, a novel elective course, two cross-institutional research projects, and resulted in three published peer reviewed articles, two international conference presentations, three elective training opportunities, and one postdoctoral training. The program was well received by students and faculty and resulted in SUD treatment stakeholder collaboration in both countries.</p><p><strong>Conclusions: </strong>Establishment of a cross-national, interprofessional joint training program creates opportunities to implement novel education, research, and mentorship to prepare a culturally informed workforce.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":"46 4","pages":"1013-1018"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007016","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":"Understanding How Persons With Maternal Opioid Use Disorder Experience Public Food Assistance Programs WIC and SNAP.","authors":"Meghan Gannon, Kimberly McLaughlin, Vanessa Short, Trami Nguyen, Dennis J Hand, Diane J Abatemarco","doi":"10.1177/29767342251336041","DOIUrl":"10.1177/29767342251336041","url":null,"abstract":"<p><strong>Background: </strong>The current opioid epidemic persists in tandem with the food insecurity crisis, especially among pregnant persons and parents with opioid use disorder (OUD). Limited research exists examining the experience of pregnant persons and parents with OUD and their engagement in federal food assistance programs. This understanding is imperative to address service gaps, destigmatize practices, and ensure food assistance programs are culturally relevant and acceptable. Therefore, the aim of this study were (1) to understand food access and nutrition needs among pregnant persons and parents in OUD treatment and (2) to describe challenges and limitations associated with current food assistance benefits among pregnant persons and parents in OUD treatment.</p><p><strong>Methods: </strong>This qualitative study conducted at an OUD treatment program utilized focus group discussions to elicit feedback from participants. A total of 24 participants (≥18 years of age, parent, recipient of food assistance program and OUD treatment) participated.</p><p><strong>Results: </strong>The average age of participants was 40 years (SD = 7.4), all received outpatient OUD services, and all participants received Medicaid benefits. All but one (95.8%) reported receiving medication for OUD (ie, methadone). A total of 7 major themes were identified from the data including the following: (1) risky behaviors to access food, (2) Breastfeeding Concerns and Women, Infants, and Children (WIC), (3) Challenges with end of Emergency Allotments payments, (4) WIC/Supplemental Nutrition Assistance Program Enrollment and Support, (5) The impact of food insecurity on maternal and family health, (6) Complexity of food shopping with limited resources, and (7) Impact of food insecurity on recovery domains.</p><p><strong>Conclusions: </strong>Despite 2 long-standing federal programs aimed at increasing nutrition and food security for families with children, families affected by maternal OUD continue to face significant barriers to nutritional equity. This study provided context to the additive challenges that families affected by OUD experience in the face of food insecurity, and how they have important implications for the family's health.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"950-959"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060216","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":"Feasibility and Acceptability of Restroom Motion Sensors for Detecting Overdoses.","authors":"Ju Nyeong Park, Haley McKee, Susan E Ramsey, Josiah D Rich, Traci C Green, Hannah E Frank, Avik Chatterjee, Joseph G Rosen","doi":"10.1177/29767342251370822","DOIUrl":"https://doi.org/10.1177/29767342251370822","url":null,"abstract":"<p><strong>Background: </strong>Most US drug use events that lead to a fatal overdose are unwitnessed. Given the scale of the overdose crisis, interventions to help detect and respond to overdoses in community settings are urgently needed. Overdose detection technologies (ODT), including reverse-motion restroom sensors, are a promising set of interventions that are underutilized. This study explored the perspectives of frontline harm reduction workers, clinicians, housing shelter staff, and their clients on restroom sensors.</p><p><strong>Methods: </strong>Staff and program client focus groups conducted between December 2022 and January 2024 discussed prior experiences of responding to overdoses and existing organizational overdose policies and procedures. A verbal and visual description of restroom sensors was given and supplemented with brief captioned educational videos to assess the feasibility and acceptability of restroom sensor implementation.</p><p><strong>Results: </strong>We conducted N = 8 discussions (n = 40 participants total). Staff described the anxiety and cognitive burden of monitoring client restrooms and the trauma of witnessing and responding to overdoses. Sites varied in their safety procedures, ranging from manual door knocks every 5 minutes to every 24 hours. Participants embraced the prospect of restroom sensor implementation in community drop-in centers, housing programs, and public restrooms (eg, food service). Perceived benefits of restroom sensors, in addition to saving lives, included the low-threshold and automated nature of the technologies and potential reductions in stress, anxiety, and trauma. However, participants shared concerns surrounding data confidentiality, potential legal repercussions of being found onsite after overdosing (eg, loss of housing, job, children, freedom), stigmatizing attitudes among first responders, reactions to ODTs among clients who mistrust technologies, corporations, and the government, staff fatigue, and technology maintenance.</p><p><strong>Conclusion: </strong>Our findings demonstrated high acceptability of ODTs among staff and patients but revealed several programmatic and policy considerations that could support future implementation efforts.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251370822"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180825","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":"Associations Between Violence and Unsafe Living Situations With Cannabis Use During Early Pregnancy.","authors":"Shannon N Ogden, Carey R Watson, Sara R Adams, Deborah Ansley, Carley Castellanos, Kelly C Young-Wolff","doi":"10.1177/29767342251371802","DOIUrl":"https://doi.org/10.1177/29767342251371802","url":null,"abstract":"<p><strong>Background: </strong>Maternal and child health are adversely impacted by experiences of violence, unstable living situations, and cannabis use during pregnancy. Women who experience intimate partner violence (IPV) are more likely to use cannabis than those who do not experience IPV. However, IPV can be difficult to identify as patients may not be ready to disclose. As IPV is associated with prior experiences of violence and unsafe/unstable housing, this study aimed to estimate the associations between experiences of current IPV, any past-year violence, and unsafe or unstable living situations with cannabis use during early pregnancy. This study used a large, diverse sample to further our understanding of the relationship between violent experiences and prenatal cannabis use.</p><p><strong>Methods: </strong>Using data from 303 178 pregnancies in California from 2014 to 2023, we used chi-square tests and modified Poisson regression models to estimate associations between experiences of current IPV, past-year violence, and unsafe/unstable living situations with cannabis use during early pregnancy.</p><p><strong>Results: </strong>Individuals endorsed current IPV or any past-year violence in <1% of the pregnancies (n = 324 [0.1%] and n = 979 [0.3%], respectively), and about 2% (n = 6284) reported having unsafe/unstable living situations. Over two-thirds (69.1%) of the pregnancies where patients endorsed current IPV also endorsed past-year physical violence or unsafe/unstable living situation. Individuals used cannabis during 7.2% (n = 21 868) of the pregnancies. In unadjusted analyses, current IPV, past-year violence, and unsafe/unstable living situations were associated with higher prenatal cannabis use. In adjusted analyses, past-year violence and unsafe/unstable living situations were associated with higher prenatal cannabis use.</p><p><strong>Conclusions: </strong>It is crucial for experiences of violence and unsafe living situations to be concurrently assessed and addressed with cannabis use. Interventions that incorporate education, advocacy, and connections to mental health and IPV services could help reduce cannabis use and recurrent violence and improve pregnancy-related outcomes and patient safety.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251371802"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180857","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":"Culturally Engaged REcovery - MOms connected through Native CommunitY (CEREMONY): An Implementation Study to Evaluate the Adaptation and Implementation of an Integrated Perinatal SUD Clinical Model for Pregnant and Postpartum Native People.","authors":"Michelle P Debbink, Heather Tanana, Jennifer L Murray, Priscilla Blosser, Lorena Horse, Carissa Monroy, Saskia Spiess, Jasmin E Charles, David K Turok, Marcela C Smid, Amanda A Allshouse, Justin D Smith, Susanna R Cohen, Erin Phinney Johnson, Torri D Metz, Adam J Gordon","doi":"10.1177/29767342251336550","DOIUrl":"https://doi.org/10.1177/29767342251336550","url":null,"abstract":"<p><p>Deaths related to substance use disorders and mental health concerns are leading causes of maternal mortality, particularly in the postpartum period. Integrated perinatal substance use care that streamlines substance use disorders (SUD) treatment and prenatal care into a single setting improves perinatal outcomes, including postpartum follow-up and engagement in treatment for SUD, which may ultimately reduce maternal mortality. Native pregnant and postpartum people have identified a lack of culturally responsive care, as well as stigma, bias, and racism, as barriers to entry into SUD care and prenatal care. Through a partnership between the University of Utah Health and Sacred Circle Healthcare, the Culturally Engaged Recovery - MOms connected through Native communitY (CEREMONY) project aims to adapt and test the clinical and implementation effectiveness of integrated perinatal SUD care for Native pregnant people. The protocol for this 7-year, NIH-funded project centers on a bidirectional partnership and acknowledges Native sovereignty, data safety, and ethics of research with Native and Indigenous communities. Within this ethical and community-engaged framework, we rely on the ADAPT-ITT model, human-centered design, and the Implementation Research Logic Model to map the adaptation and iteration of a culturally responsive integrated perinatal SUD care model. Following adaptation, our protocol outlines a Hybrid Type 1 implementation science study to evaluate the clinical and implementation effectiveness of the adapted intervention. The work of CEREMONY has the potential to create implementation protocols for use in other settings as well as to reduce maternal morbidity among Native pregnant people in Utah.The CEREMONY study is registered in ClinicalTrials.Gov under NCT06747442.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251336550"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071515","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":"The ELEVATE Maternal Health Center of Excellence: A Program to Reduce Maternal Morbidity From Substance Use Disorder in Utah.","authors":"Erin P Johnson, Marcela C Smid, Susanna R Cohen, Melissa H Watt, Michelle P Debbink, Adam J Gordon, Justin D Smith, David K Turok, Jasmin E Charles, Elisabeth Parker, Tom H Greene, Torri D Metz","doi":"10.1177/29767342251336860","DOIUrl":"https://doi.org/10.1177/29767342251336860","url":null,"abstract":"<p><p>Substance use (SU) and mental health disorders are the leading cause of maternal deaths in the United States, and individuals living in rural communities and those who identify as Native American or Alaska Native are disproportionately affected. The new ELEVATE Maternal Health Center of Excellence brings together an interdisciplinary team and strong community partnerships to help address these concerns by rigorously developing and evaluating interventions to improve the care of, and reduce mortality and morbidity for, pregnant patients with SU disorder (SUD) with a focus on rural and Native populations. ELEVATE is comprised of a Community Engagement Core, a Training Core, an Implementation Integration Core, and 2 large-scale research projects focused on reducing maternal morbidity from SUD. ELEVATE members are actively engaged with community partners across the state with interests in Native health, minority health, rural health, and SUD through Community Advisory Board meetings and bidirectional communication. The 2 research projects focus on (1) adaptation of a culturally sensitive clinical program for Native mothers with SUD in the perinatal time period and (2) development of a healthcare provider training to reduce stigma and improve evidence-based care for patients with SUD who are giving birth. Information gleaned from these projects will be disseminated across Utah, and nationally, to improve outcomes for pregnant and postpartum people with SUD and ultimately help eliminate preventable maternal deaths. The multipronged approach of the ELEVATE Center will reduce maternal morbidity from SU in Utah while training the next generation of scientists focused on morbidity reduction.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251336860"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071583","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":"Protocol for the INSPIRE Study: A Training Package for the Intrapartum Team to Promote Respectful and Non-stigmatizing Care for Patients with Substance Use Disorder.","authors":"Susanna R Cohen, Assumpta Nantume, Jami Baayd, Olivia R Hanson, Marcela C Smid, Rebecca Simmons, Erin P Johnson, Karen W Tao, Torri D Metz, Alexandra Gero, Justin D Smith, Connie Wilson, Melissa H Watt","doi":"10.1177/29767342251333641","DOIUrl":"https://doi.org/10.1177/29767342251333641","url":null,"abstract":"<p><p>Individuals with substance use disorders (SUD) often encounter challenges in healthcare, including provider attitudes, stigma, and gaps in clinical education. For pregnant and birthing individuals with SUD, these challenges are further compounded by moral blame, judgment, clinician burnout, and limited institutional support. Each of the aforementioned factors are barrier to evidence-based, person-centered care, and contributes to adverse outcomes for both birthing individuals and newborns. This study aims to address those barriers by designing and implementing a stigma-reduction and clinical empathy training package tailored for the intrapartum healthcare workforce. Focusing on the in-patient labor and delivery period, the intervention aims to foster institutional change, grow clinician confidence, and promote a culture of empathy and understanding. The proposed intervention, <i>Interprofessional Simulation Program for Clinical Resilience and Empathy</i> (INPSIRE), will include multi-component training modules and an adaptive intervention designed to address provider clinical knowledge, stigma, and burnout among clinicians and will promote the use of practical tools for demonstrating clinical empathy and support. In developing the intervention, the study will examine quality and stigma in intrapartum care from clinician and patient perspectives through focus group discussions, key informant interviews, restorative justice story circles, and postpartum patient interviews. Drawing insights from these qualitative methods, the INSPIRE intervention will then be co-designed with stakeholders to ensure relevance and effectiveness. The impact of the INSPIRE intervention will be evaluated using a quasi-experimental design, assessing its effects on healthcare team outcomes, patient outcomes, and scalability. Through self-directed online learning and in-person team simulation, the INSPIRE intervention aims to enhance provider skills, promote respectful care, and ultimately improve maternal health outcomes for individuals with SUD.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251333641"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071564","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":"Stacking the Risks: Fatal Consequences of Anabolic Steroid Misuse and Stacked Substance Use in FAERS Data.","authors":"Ji Won Heo, Jung Doo Yang, Sun Kyoung Yum, Kyung Min Joo, Sun Young Yum","doi":"10.1177/29767342251360872","DOIUrl":"https://doi.org/10.1177/29767342251360872","url":null,"abstract":"<p><strong>Background: </strong>Misuse of anabolic-androgenic steroids (AAS), especially through \"stacking\" multiple substances, poses significant health risks. This study leverages data from the FDA's Adverse Event Reporting System (FAERS) to assess these risks and identify factors predicting severe outcomes.</p><p><strong>Methods: </strong>We analyzed 286 FAERS reports of intentional AAS misuse. After removing duplicates, the final dataset included 218 unique cases involving men, 7 involving women, and 14 cases with unspecified sex. Drugs, adverse drug reactions (ADRs), and demographic data were categorized. Statistical analyses, including logistic regression, evaluated associations between substance combinations and serious outcomes.</p><p><strong>Results: </strong>Serious cases constituted 46.8% of the total among men, with cardiovascular, endocrine, and psychological ADRs being most frequent. Stacking other drugs on top of AAS was highly associated with serious outcomes (<i>P</i> < .001). Stacking central nervous system (CNS) depressants (<i>P</i> = 3.50 × 10^-8), fat-burning agents (<i>P</i> = 1.51 × 10^-10), endocrine modulators (<i>P</i> = 6.26 × 10^-6), and other CNS-active substances (<i>P</i> = 3.34 × 10^-5) were strongly associated with serious outcomes. Logistic regression revealed younger age (<i>P</i> = .0188, negative coefficient -0.117) and higher drug count (<i>P</i> = .0458, positive coefficient 0.991) and recent report year (<i>P</i> = .0006, negative coefficient -0.467) as significant predictors of life-threatening events.</p><p><strong>Conclusions: </strong>AAS misuse, especially through high-risk stacking, significantly elevates the risk of serious health outcomes, particularly in younger individuals. Public health interventions-including targeted outreach, harm reduction, and enhanced healthcare provider awareness training-are necessary to educate on and mitigate these risks.</p>","PeriodicalId":516535,"journal":{"name":"Substance use & addiction journal","volume":" ","pages":"29767342251360872"},"PeriodicalIF":0.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002406","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}