Czarina N. Behrends , Don C. Des Jarlais , Winston Luhur , Xinlin Lu , Grace J. Corry , Sara N. Glick , Shashi N. Kapadia , David C. Perlman , Bruce R. Schackman
{"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 , Don C. Des Jarlais , Winston Luhur , Xinlin Lu , Grace J. Corry , Sara N. Glick , Shashi N. Kapadia , David C. Perlman , 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}
Daniel Blumenthal , Nathaniel Stevens , Frank T. Leone , Anna-Marika Bauer , E. Paul Wileyto , Casey Foster , Spencer Schwartz , Julia Villasenor , Brian P. Jenssen , Helen Koenig , Judith O’Donnell , Robert Gross , Robert Schnoll
{"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 , Nathaniel Stevens , Frank T. Leone , Anna-Marika Bauer , E. Paul Wileyto , Casey Foster , Spencer Schwartz , Julia Villasenor , Brian P. Jenssen , Helen Koenig , Judith O’Donnell , Robert Gross , 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 > 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><sup>2</sup>[3]=24.79, <u>p</u> < 0.001) and clinicians (<u>χ</u><sup>2</sup>[3]=33.85<u>, p</u> < 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 , Ben Jacoby , 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}
Lindy K. Howe , Lauren Micalizzi , Mary Ellen Fernandez Goyette , Elizabeth R. Aston , Rachel L. Gunn
{"title":"Online conversations on perceived stigma among pregnant individuals who use cannabis","authors":"Lindy K. Howe , Lauren Micalizzi , Mary Ellen Fernandez Goyette , Elizabeth R. Aston , 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}
Chrystal Vergara-Lopez , George D. Papandonatos , Margaret H. Bublitz , Alicia M. Allen , Laura R. Stroud
{"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 , George D. Papandonatos , Margaret H. Bublitz , Alicia M. Allen , 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><sub><em>age</em></sub>=22) and 7 participants using OCs (M<sub>age</sub>=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}
Rachel J. Smith , Vanessa M. McMahan , Nicole C. McCann , Sarah Kosakowski , Sarah Brennan , Xochitl Luna Marti , Alexander Y. Walley , Phillip O. Coffin
{"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 , Vanessa M. McMahan , Nicole C. McCann , Sarah Kosakowski , Sarah Brennan , Xochitl Luna Marti , Alexander Y. Walley , 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}
Sabrina Gaiazov , William Mullen , Ann Wheeler , Swapna Munnangi , Yifan Gu , Mitch DeKoven , Robert Dunne
{"title":"Factors associated with emergency room visits among patients with opioid use disorder: A study of buprenorphine-treated and untreated patients","authors":"Sabrina Gaiazov , William Mullen , Ann Wheeler , Swapna Munnangi , Yifan Gu , Mitch DeKoven , Robert Dunne","doi":"10.1016/j.dadr.2025.100349","DOIUrl":"10.1016/j.dadr.2025.100349","url":null,"abstract":"<div><h3>Objective</h3><div>Identify factors associated with 6-month emergency room (ER) outcomes in patients with opioid use disorder (OUD) and/or treated with buprenorphine (extended-release [BUP-XR] or transmucosal [BUP-TM]). Compare baseline characteristics and 6-month ER visits and healthcare resource utilization (HCRU) across treatment groups.</div></div><div><h3>Methods</h3><div>Patient claims data from September 2017– March 2022 were analyzed for patients diagnosed with OUD and/or treated with buprenorphine. Adjusted logistic regression models were used to identify factors associated with ER visits 6-months post-index.</div></div><div><h3>Results</h3><div>543 patients initiating BUP-XR, 52,569 BUP-TM and 57,125 patients with OUD diagnosis but no-medications for opioid use disorder (MOUD) were identified.</div><div>Patients who received BUP-XR (OR: 0.43, 95 % CI: 0.36–0.53) or BUP-TM (OR: 0.78; CI: 0.76–0.81) had lower odds for an all-cause post-index ER visit compared to those with no MOUD treatment.</div><div>Patients with later index years or those who had an opioid overdose ER visit in the baseline period had higher odds of post-index all-cause and opioid overdose ER visits.</div><div>1.2 % in BUP-TM cohort and 1 % in the no MOUD cohort had an opioid overdose ER visit, compared to 0 % in the BUP-XR cohort. The BUP-XR cohort had lower rates of inpatient stays, ER visits, and outpatient physician office visits compared to the BUP-TM and no MOUD cohorts but incurred higher pharmacy costs.</div></div><div><h3>Conclusions</h3><div>This study found that any buprenorphine treatment, particularly BUP-XR, was associated with lower odds of all-cause ER visits compared to patients with no MOUD, and highlighted potential risk factors that could help reduce the demand on ER services.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100349"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291117","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}
Natasha A. Sokol , Eva Sharma , Janet O. Joseph , Janet A.J. Johnson , Laura R. Stroud
{"title":"Changes in prenatal cannabis use and perceptions during the COVID-19 pandemic","authors":"Natasha A. Sokol , Eva Sharma , Janet O. Joseph , Janet A.J. Johnson , Laura R. Stroud","doi":"10.1016/j.dadr.2025.100348","DOIUrl":"10.1016/j.dadr.2025.100348","url":null,"abstract":"<div><h3>Purpose</h3><div>To understand the observed increase in prenatal cannabis use during the COVID-19 pandemic, this study compared differences in prenatal cannabis perceptions among pregnant people who used cannabis before versus during the pandemic.</div></div><div><h3>Method</h3><div>From 2018–2022, participants who ever used cannabis during pregnancy (N = 136, M<sub>age</sub> = 27.0 years, 29.9 % white) were recruited in their first trimester and surveyed during their first and second trimesters. Participants responded to the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory, Reasons for Using Marijuana measure, and Marijuana Perceptions Questionnaire.</div></div><div><h3>Results</h3><div>Compared to those responding before the pandemic, those responding during the pandemic were more likely to use cannabis to manage physical and psychological symptoms, including vomiting, depressed mood, chronic illness, pain, sleep, and appetite (RR’s > 2.0, p’s ≤ 0.020). Among those who reported medical use, participants responding during the pandemic were more likely to report physician-recommended use (RR=2.2, p = 0.075). Participants responding during the pandemic were more likely to use edibles (RR=1.72, p = 0.023), and less likely to smoke cannabis mixed with tobacco (RR=0.69, p = 0.009), and they were more likely to have attempted to quit or reduce use (RR=1.14, p = 0.047).</div></div><div><h3>Conclusions</h3><div>The shift in cannabis use to treat pregnancy and pandemic-related symptoms during the pandemic underscores the necessity of enhancing prenatal support systems for managing physical and mental health symptoms in times of significant disruption to routine prenatal care and daily life. This may be particularly important given projected increases in the frequency of epidemics and pandemics.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100348"},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242733","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}
Thye Peng Ngo , Salomeh Keyhani , Samuel Leonard , Katherine J. Hoggatt
{"title":"Substance use and use disorders among Veterans on long-term opioid therapy","authors":"Thye Peng Ngo , Salomeh Keyhani , Samuel Leonard , Katherine J. Hoggatt","doi":"10.1016/j.dadr.2025.100347","DOIUrl":"10.1016/j.dadr.2025.100347","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have reported on the prevalence and health risks associated with substance use and substance use disorder (SU/SUD) in Veterans who use long-term opioid therapy (LTOT). We leveraged health record data to estimate SU/SUD prevalence and its association with mortality among Veterans on LTOT.</div></div><div><h3>Methods</h3><div>We conducted a secondary analysis of cohort data for Veterans on LTOT within Veterans Health Administration outpatient settings (2014–2019). SU/SUD was defined as a positive screen for risky alcohol use; a positive urine drug screen for cannabis, benzodiazepines, or stimulants; or a documented SUD diagnosis. We fit Cox models for all-cause mortality, fatal overdose, and traumatic deaths, comparing Veterans on LTOT with SU/SUD vs. LTOT-only.</div></div><div><h3>Results</h3><div>One in four (25.0 %) Veterans on LTOT have risky alcohol use, tested positive for other substances, or had a diagnosed SUD. Alcohol was the most common SU/SUD (9.8 %), followed by sedative (8.1 %), cannabis (6.6 %), and stimulant (0.6 %). Relative to Veterans on LTOT only, mortality rates were higher for Veterans on LTOT with cannabis (HR=1.16, 95 % CI=1.03, 1.30), sedative (HR=1.29, 95 % CI=1.10, 1.52), or stimulant SU/SUD (HR=1.54, 95 % CI=1.17, 2.02). Fatal overdose rates were higher for LTOT with alcohol (HR=1.43, 95 % CI=1.10, 1.86), sedatives (HR=1.40, 95 % CI=1.04, 1.91), or stimulant SU/SUD (HR=3.29, 95 % CI=1.60, 6.77). LTOT with sedative SU/SUD was associated with traumatic death rates (HR=1.30, 95 % CI=1.05, 1.61).</div></div><div><h3>Conclusion</h3><div>Substance co-use is common among Veterans on LTOT and is associated with elevated mortality and overdose risks. Comprehensive screening and targeted interventions may be needed.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100347"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178318","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}
Ayesha C. Sujan , Natalie E. Slama , Brian T. Bateman , Deborah Ansley , Carley Castellanos , Kelly C. Young-Wolff
{"title":"Substance use and mental health characteristics among pregnant individuals with medical and non-medical benzodiazepine use early in pregnancy","authors":"Ayesha C. Sujan , Natalie E. Slama , Brian T. Bateman , Deborah Ansley , Carley Castellanos , Kelly C. Young-Wolff","doi":"10.1016/j.dadr.2025.100345","DOIUrl":"10.1016/j.dadr.2025.100345","url":null,"abstract":"<div><h3>Background</h3><div>Research to date evaluating the safety of benzodizapine use during pregnancy has shown mixed results and has relied on self-report or filled prescription data, which are unlikely to capture non-medical use and, consequently, could bias results. Therefore, research on non-medical benzodiazepine use during pregnancy is needed.</div></div><div><h3>Methods</h3><div>The present study used data from a large, healthcare system with universal screening for prenatal substance use via urine toxicology tests and information on filled prescriptions. We first evaluated the prevalence of pregnancies with non-medical benzodiazepine use (positive urine toxicology test and no filled prescriptions in the past year) and medical benzodiazepine use (positive urine toxicology test and <u>></u>1 filled prescription in the past year). We also evaluated the presence of co-occurrence of substance use and mental health conditions among these pregnancies.</div></div><div><h3>Results</h3><div>Our results showed that benzodiazepine use during early pregnancy was rare (<1 % had a positive toxicology test). However, more than one-third of those with a positive toxicology test did not have a filled prescription (i.e., had non-medical use) We also found similar rates of substance use and mental health conditions among pregnancies with medical and non-medical benzodiazepine use.</div></div><div><h3>Conclusion</h3><div>Our results suggest that research relying on prescription data alone and the medical system may be missing pregnant individuals using benzodiazepines. This points to a need for additional measures and screenings (e.g., urine toxicology tests) in both research and clinical settings. Our findings also underscore a need for additional services for pregnant individuals with both medical and non-medical benzodiazepine use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"15 ","pages":"Article 100345"},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124189","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}