Drug and alcohol dependence reports最新文献

{"title":"Fortifying alcoholic beverages with thiamine: Lessons from history and future opportunities","authors":"Thomas Jedamzik,&nbsp;Georg Juckel","doi":"10.1016/j.dadr.2025.100358","DOIUrl":"10.1016/j.dadr.2025.100358","url":null,"abstract":"<div><div>Thiamine deficiency remains a significant risk for individuals with chronic alcohol use and is a major contributing factor in the development of Wernicke encephalopathy and Korsakoff syndrome. While clinical guidelines recommend targeted thiamine supplementation in at-risk patients, strategies for prevention at the population level remain limited and underutilized. Among the more unconventional proposals discussed in past decades was the fortification of alcoholic beverages with thiamine. This idea received particular attention in Australia in the 1980s, where high prevalence rates of Wernicke encephalopathy and Korsakoff syndrome led to a broader public health debate. Although fortification was ultimately limited to flour and cereals, the discussion raised important questions about feasibility, effectiveness, and ethical considerations, many of which remain unresolved. This commentary revisits the history of this debate, drawing on empirical studies, review articles, and opinion-based contributions published in scientific journals from the 1940s to the present. Particular attention is given to the counterarguments raised against beverage fortification, including concerns about thiamine absorption, the potential behavioral implications of such a measure, and doubts about its political and regulatory feasibility. These arguments are examined in their historical context, including how they evolved over time, what types of evidence they were based on, and how they were discussed across clinical disciplines and scientific forums. By tracing the development of this largely overlooked policy proposal, this article aims to clarify the central points of contention and encourage a more nuanced understanding of the rationale, limitations, and potential of thiamine fortification in the context of alcohol-related health risks.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100358"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580828","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":"Psychosocial consequences of xylazine and implications for harm reduction services","authors":"Marina Plesons ,&nbsp;William H. Eger ,&nbsp;Erika L. Crable ,&nbsp;Maia H. Hauschild ,&nbsp;Corbin C. McElrath ,&nbsp;Cyrus Owens ,&nbsp;David W. Forrest ,&nbsp;Angela R. Bazzi ,&nbsp;Naida De Los Santos ,&nbsp;Hansel E. Tookes ,&nbsp;Tyler S. Bartholomew","doi":"10.1016/j.dadr.2025.100357","DOIUrl":"10.1016/j.dadr.2025.100357","url":null,"abstract":"<div><h3>Introduction</h3><div>Xylazine, a veterinary tranquilizer not approved for human use, has increasingly contaminated the unregulated drug supply in the United States and is a key driver of an increasingly synthetic, polysubstance overdose crisis. While research has focused on xylazine’s toxicologic and physiologic effects, less is known about its psychosocial consequences for people who use drugs (PWUD) and their implications for harm reduction services.</div></div><div><h3>Methods</h3><div>We conducted semi-structured qualitative interviews with 17 PWUD and 8 staff at a syringe services program in Miami, FL from June–July 2023. Emergent codes in the transcripts were identified using inductive memos. Final themes were established through team-based thematic analysis and validated through member-checking.</div></div><div><h3>Results</h3><div>Participants reported that xylazine intensified five key psychosocial harms that exacerbated existing challenges for PWUD, including 1) keeping oneself and others alive; 2) protecting oneself and one’s possessions; (3) curbing withdrawal; (4) entering and remaining in addiction recovery; and (5) fitting into society.</div></div><div><h3>Discussion</h3><div>Xylazine’s emergence has compounded existing harms for PWUD and introduced new challenges for harm reduction services. This study underscores the need for novel and expanded harm reduction services that go beyond traditional opioid-focused approaches to encompass the complexity of polysubstance use and the unique features of xylazine dependence. This includes additional drug-checking services for xylazine detection, updated clinical protocols for xylazine-related wound care and substance use disorder treatment complicated by xylazine dependence and polysubstance use, and expanded social and psychological support—for PWUD and the frontline harm reduction staff who care for them.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100357"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595512","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":"High-risk alcohol consumption is associated with mitochondrial damage-associated molecular patterns in people living with HIV","authors":"Shannon R. Gilstrap ,&nbsp;Micheal D. Ho ,&nbsp;Joanna M. Hobson ,&nbsp;Dyan M. White-Gilliam ,&nbsp;Khalid Freij ,&nbsp;Michael A. Owens ,&nbsp;Shameka L. Cody ,&nbsp;S. Justin Thomas ,&nbsp;Robert E. Sorge ,&nbsp;Burel R. Goodin","doi":"10.1016/j.dadr.2025.100359","DOIUrl":"10.1016/j.dadr.2025.100359","url":null,"abstract":"<div><div>Alcohol (i.e., ethanol; EtOH) use disorders are common in people with HIV (PWH) and are associated with poor health outcomes. One potential reason for these poor health outcomes in PWH is that alcohol use is associated with mitochondrial damage and dysfunction, potentially leading to cell death. However, the link between alcohol use and mitochondrial functioning in PWH remains unclear. This study specifically investigated the relationship between high-risk alcohol consumption and mitochondrial damage-associated molecular patterns (mDAMPs) in PWH and people without HIV. We analyzed mDAMPs in 122 participants (51 HIV, 71 HIV-) before and after exposure to experimental pain testing to examine mDAMPs reactivity in response to noxious stress. Mitochondrial DAMPs were quantified from serum samples using real-time polymerase chain reaction, providing two variables: ND1 and ND6. High-risk alcohol consumption was assessed using the Alcohol Use Disorders Identification Test – C (AUDIT-C) questionnaire. In this study, we tested whether HIV status influenced the relationship between high-risk alcohol use and mitochondrial damage. Our findings revealed that PWH who engaged in high-risk alcohol consumption exhibited significantly increased mDAMPs following exposure to experimental pain testing for both ND1 (p = 0.045) and ND6 (p = 0.047). These results suggest that the effects of alcohol consumption on mitochondrial damage and dysfunction may be exacerbated by HIV infection. This study highlights the risk of high-risk alcohol consumption on mitochondrial health for PWH.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100359"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580827","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":"Early life outcomes of prenatal exposure to alcohol and synthetic cannabinoids in mice","authors":"Siara K. Rouzer,&nbsp;McKay Domen,&nbsp;Aisley George,&nbsp;Abigail Bowring,&nbsp;Rajesh C. Miranda","doi":"10.1016/j.dadr.2025.100356","DOIUrl":"10.1016/j.dadr.2025.100356","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated the effects of prenatal co-exposure to alcohol and synthetic cannabinoids on offspring viability, physical development, and neurobehavioral outcomes in young adulthood. The goal of this investigation was to determine whether prenatal co-exposure produced distinct outcomes from single-drug exposures, including sex-specific vulnerabilities in motor coordination and exploratory behaviors.</div></div><div><h3>Methods</h3><div>Pregnant C57Bl/6<!--> <!-->J mice were randomly assigned to one of four treatment groups: drug-free controls, alcohol (ALC)-exposed, cannabinoid (CP-55,940, CB)-exposed or ALC+CB-exposed, with drug exposure occurring between Gestational Days 12–15. Offspring viability, physical malformations, and developmental delays were first assessed at birth. Then, behavioral evaluations, including rotarod and open field tests, were conducted on young adult offspring (Postnatal Days 100–120).</div></div><div><h3>Results</h3><div>ALC+CB exposure significantly decreased litter survival (<em>p</em> = 0.006) and offspring viability compared to controls. Non-viable offspring exhibited craniofacial abnormalities, limb malformations, and developmental delays. Assessments of rotarod performance revealed that all exposures reduced motor coordination in males compared to controls (<em>p</em> &lt; 0.05), while ALC and CB exposures alone produced this outcome in females. Open field tests indicated that ALC+CB exposure reduced time in the center of the arena in male offspring exclusively, while this same exposure increased hyperactivity compared to single-drug and control groups, independent of sex (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Prenatal co-exposure to alcohol and synthetic cannabinoids exacerbated offspring mortality and induced sex-specific deficits in neurobehavioral motor outcomes. These findings highlight the distinct risks of polysubstance exposure during pregnancy and underscore the need for targeted interventions to mitigate the effects of prenatal polysubstance exposure on offspring health outcomes.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100356"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605153","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":"On-site health service delivery models at syringe services programs in the United States: Results of a national cross-sectional survey","authors":"Czarina N. Behrends ,&nbsp;Don C. Des Jarlais ,&nbsp;Winston Luhur ,&nbsp;Xinlin Lu ,&nbsp;Grace J. Corry ,&nbsp;Sara N. Glick ,&nbsp;Shashi N. Kapadia ,&nbsp;David C. Perlman ,&nbsp;Bruce R. Schackman","doi":"10.1016/j.dadr.2025.100355","DOIUrl":"10.1016/j.dadr.2025.100355","url":null,"abstract":"<div><h3>Background</h3><div>People who inject drugs (PWID) have many needs for health services, but frequently lack access to and/or do not utilize those services. Syringe services programs (SSPs) are low-stigma environments where health services can be provided, but are not well described.</div></div><div><h3>Objective</h3><div>We characterized types of health services delivery available at syringe services programs (SSPs) nationally and assess SSP characteristics associated with them.</div></div><div><h3>Methods</h3><div>Using a national survey of SSPs on services provided in 2019 (N = 153), we conducted latent class analysis to determine the best fit model for health service delivery types. We examined the association between health delivery types and SSP organizational characteristics using multinomial logistic regression.</div></div><div><h3>Results</h3><div>A 3-class model was best fit and included 1) a comprehensive care model that had a high probability of offering multiple health services (11 %), 2) a testing and wound care model that offers mostly HIV/HCV testing and wound care (57 %), and 3) a minimal or no health services model that predominantly do no offer medical services (32 %). Comprehensive care and HIV/HCV testing and wound care SSPs were significantly more likely to have ≥ 50 % of their funding from public sources (OR=13.7 and OR=18.0), be a larger program (4th quartile in syringe distribution, OR=25.2 and OR=4.7), and less likely to be a grassroots program (OR=0.1 for both) compared to minimal care SSPs.</div></div><div><h3>Conclusions</h3><div>With 11 % of SSPs providing comprehensive care and one-third providing minimal services, there is an opportunity to expand health care services at SSPs with further public funding investments.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100355"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563663","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":"A formative study to develop nudges informed by behavioral economics to increase engagement with tobacco treatment among people who smoke receiving care for HIV","authors":"Daniel Blumenthal ,&nbsp;Nathaniel Stevens ,&nbsp;Frank T. Leone ,&nbsp;Anna-Marika Bauer ,&nbsp;E. Paul Wileyto ,&nbsp;Casey Foster ,&nbsp;Spencer Schwartz ,&nbsp;Julia Villasenor ,&nbsp;Brian P. Jenssen ,&nbsp;Helen Koenig ,&nbsp;Judith O’Donnell ,&nbsp;Robert Gross ,&nbsp;Robert Schnoll","doi":"10.1016/j.dadr.2025.100354","DOIUrl":"10.1016/j.dadr.2025.100354","url":null,"abstract":"<div><h3>Background</h3><div>The rate of tobacco use among people with HIV (PWH) is &gt; 2 fold higher vs. the general population and accounts for more life years lost than the virus. Yet, evidence-based tobacco treatments are uncommonly offered by clinicians or used by PWH. Biases informed by behavioral economics concerning tobacco treatments may drive this practice gap.</div></div><div><h3>Methods</h3><div>This formative study tested nudges in the form of messages that target four behavioral economic biases – status quo, availability, omission, and focusing effect – to determine which message would be most strongly associated with PWH willingness to use or clinician referral for tobacco treatment; 19 clinicians and 75 PWH assessed pair-wise comparisons of the four messages with instructions to select the message that, if sent via text or a patient portal, or via the electronic medical record (EMR) at a clinic visit, would increase willingness to use or provide a referral for tobacco treatment.</div></div><div><h3>Results</h3><div>There were significant differences in reported preference across the messages among PWH <u>(χ</u>²[3]=24.79, <u>p</u> &lt; 0.001) and clinicians (<u>χ</u>²[3]=33.85<u>, p</u> &lt; 0.001). The message that addressed focusing effect bias was most preferred for increasing use and referral for tobacco treatment among PWH (29 %) and clinicians (38 %).</div></div><div><h3>Conclusions</h3><div>A message that addressed focusing effect bias was associated with greater interest in the use of or referral for tobacco treatment within HIV care. These results can help design a clinical trial to test the effectiveness of these messages within the clinical workflow for their effects on actual use of and referral for tobacco treatment for PWH.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100354"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563751","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":"Synaptic signatures of perinatal cannabinoids: A systematic review of rodent hippocampal synaptic plasticity, learning, and memory","authors":"Rebecca Przy ,&nbsp;Ben Jacoby ,&nbsp;Brian R. Christie","doi":"10.1016/j.dadr.2025.100353","DOIUrl":"10.1016/j.dadr.2025.100353","url":null,"abstract":"<div><div>The expanding legalization of cannabis raises significant public health concerns about its use during pregnancy, particularly due to the limited understanding of its impact on neurodevelopment. Existing research suggests that perinatal cannabis or cannabinoid exposure may impair learning and memory; however, variations in study design hinder the ability to draw generalizable conclusions. Clinical studies are limited in their observational nature and the lack of insight into neural or cellular mechanisms underlying cognitive changes, underscoring the importance of preclinical studies to explore the effects of perinatal cannabinoids in greater detail. The objective of this systematic review is to consolidate findings from existing preclinical research that investigates the effects of perinatal cannabinoid exposure on learning and memory and the putative mechanism of learning and memory, hippocampal synaptic plasticity, in rodents. This review summarizes studies on hippocampal synaptic plasticity (n = 2), spatial/visual memory (n = 13), working memory (n = 6), recognition memory (n = 12), and associative memory (n = 7). Perinatal cannabinoid-induced impairments were reported in the two synaptic plasticity studies, and in 24 out of 30 studies that examined learning and memory, with spatial memory tasks showing the most consistent deficits. While the existing evidence converges on the notion that perinatal cannabinoid exposure negatively impacts hippocampal physiology and associated memory functions, further research is needed to disentangle the influence of various methodological factors, including offspring sex and age, cannabinoid type, time of gestational exposure, and method of administration.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100353"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549353","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":"Online conversations on perceived stigma among pregnant individuals who use cannabis","authors":"Lindy K. Howe ,&nbsp;Lauren Micalizzi ,&nbsp;Mary Ellen Fernandez Goyette ,&nbsp;Elizabeth R. Aston ,&nbsp;Rachel L. Gunn","doi":"10.1016/j.dadr.2025.100352","DOIUrl":"10.1016/j.dadr.2025.100352","url":null,"abstract":"<div><div>Perinatal cannabis use (PCU) is a controversial topic, as it is associated with negative neonatal and maternal outcomes. However, PCU persists, often reported in the context of perceived symptom management, and those who engage in PCU can face significant stigma. Such stigma can deter individuals from discussing their cannabis use with support persons, potentially exacerbating negative health outcomes for the parent and child. The current study explores how PCU stigma manifests and is navigated in online communities, focusing on discussions within an online space for individuals who use cannabis during pregnancy. First, a random sample of 10 threads per month from June 2020 to May 2021 were extracted from a cannabis-focused forum on a pregnancy and parenting website. Next, analyses involved a two-cycle coding process (i.e., topical followed by conceptual) to identify key themes surrounding stigma in the context of PCU. Three primary themes were identified: 1) experiencing stigma (e.g., familial and societal sources of judgment, emotional responses such as guilt and frustration); 2) contradictions in substance stigma, highlighting the contrast between societal attitudes and expectations towards cannabis versus alcohol or tobacco use during pregnancy; and 3) challenging stigma, in which participants actively provide support, share personal experiences, and offer evidence to counteract stigma. Online communities may play a critical role in combating stigma, offering a platform for connection, support, and education. Results emphasize that a nonjudgmental approach to information dissemination may be more effective. Understanding stigma is essential for developing effective interventions and reducing the harms of PCU.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100352"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330165","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":"Electronic nicotine delivery systems (ENDS) use across the menstrual cycle and oral contraceptive regimen: A proof-of-concept intensive longitudinal study","authors":"Chrystal Vergara-Lopez ,&nbsp;George D. Papandonatos ,&nbsp;Margaret H. Bublitz ,&nbsp;Alicia M. Allen ,&nbsp;Laura R. Stroud","doi":"10.1016/j.dadr.2025.100350","DOIUrl":"10.1016/j.dadr.2025.100350","url":null,"abstract":"<div><h3>Introduction</h3><div>Exogenous and endogenous ovarian hormones (e.g., estradiol, progesterone) may influence nicotine use. Prior research has focused on combustible cigarettes and yielded mixed results, which may be due to a lack of granular assessment of nicotine use across the menstrual cycle or oral contraceptive (OC) regimen. We conducted a small proof-of-concept study on Electronic Nicotine Delivery Systems (ENDS). Our goals were to examine the utility of intensive longitudinal methods to assess ENDS use in a ~month long protocol, and explore ENDS use levels and variability among naturally cycling (NC) individuals and those using OCs.</div></div><div><h3>Methods</h3><div>There were 12 NC participants (<em>M</em>_<em>age</em>=22) and 7 participants using OCs (M_age=21). ENDS occasions were assessed 4 times a day across the protocol.</div></div><div><h3>Results</h3><div>On average, the NC group completed 77 % and the OC group completed 86 % of ENDS assessments. The average number of missing data was 2.2 days (<em>SD</em>=2.9). Time-Varying Effect Modeling (TVEM) examine changes in links between variables over time. TVEM revealed increases in ENDS use coinciding with rises in estradiol across the menstrual cycle. In contrast, ENDS use was consistent in the OC group.</div></div><div><h3>Conclusions</h3><div>Preliminary evidence indicates that ENDS use among NC individuals varies as a function of natural fluctuations in ovarian hormones while OCs appear to lower and stabilize ENDS use. Despite the small sample, this study suggests that intensive longitudinal methods are useful for examining links between the menstrual cycle, OCs, and ENDS use. This proof-of-concept research may galvanize mechanistic and intervention research on ovarian hormones and ENDS use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100350"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330166","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":"Emergency medical system response, emergency department visits, and hospital admissions in response to non-fatal opioid overdoses reported by a cohort of overdose survivors in San Francisco and Boston, 2019 – 2022","authors":"Rachel J. Smith ,&nbsp;Vanessa M. McMahan ,&nbsp;Nicole C. McCann ,&nbsp;Sarah Kosakowski ,&nbsp;Sarah Brennan ,&nbsp;Xochitl Luna Marti ,&nbsp;Alexander Y. Walley ,&nbsp;Phillip O. Coffin","doi":"10.1016/j.dadr.2025.100351","DOIUrl":"10.1016/j.dadr.2025.100351","url":null,"abstract":"<div><h3>Background</h3><div>Non-fatal opioid overdoses that do not result in an emergency medical system (EMS), emergency department or hospital encounter are not tracked. We aimed to understand the proportion of non-fatal overdoses with and without a healthcare encounter.</div></div><div><h3>Methods</h3><div>We used data from the REpeated-dose Behavioral intervention to reduce Opioid Overdose inTervention (REBOOT) trial among opioid overdose survivors in San Francisco and Boston. Participants reported the number of non-fatal overdoses over the prior 4-months at baseline and follow-up visits over 16 months. We asked details about the three most recent overdoses, including naloxone administration, EMS attendance, transport to an emergency department, or hospitalization.</div></div><div><h3>Results</h3><div>A total of 268 individuals completed 1163 assessments. Across the assessments, 150 participants reported a total of 504 overdoses. Complete details were collected for 384 of the overdose events. Naloxone was administered at 306 out of 384 (80 %) overdose events. EMS attended the scene in 177 out of 384 (46 %) of events, with naloxone administration occurring in 159 of these events (90 %); 130 of the 384 (34 %) events resulted in transportation to the emergency department, and only 18 (5 %) led to hospital admission.</div></div><div><h3>Conclusions</h3><div>Among opioid overdose survivors in urban settings, EMS were present at less than half of self-reported overdoses, emergency department visits occurred in about one third, and admission to the hospital occurred in one of twenty overdoses. Most overdoses involved naloxone administration, frequently by lay responders. Estimating non-fatal overdose prevalence should not rely solely on measures of EMS attendance, emergency department or hospital admissions.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100351"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306209","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}