Drug and alcohol dependence reports最新文献

{"title":"Distinguishing a drug use disorder from drug use in a high-risk sample of youth: A random forest classification and explanatory analysis","authors":"Lauren M. Berny ,&nbsp;Anwesha Guha ,&nbsp;Emily E. Tanner-Smith","doi":"10.1016/j.dadr.2026.100412","DOIUrl":"10.1016/j.dadr.2026.100412","url":null,"abstract":"<div><div>Although many adolescents and young adults experiment with drugs, a subset may develop a drug use disorder (DUD). Few studies have used machine learning to identify risk and protective factors associated with DUDs, and to the best of our knowledge, none have been conducted with a high-risk youth sample or incorporated explanatory analyses to understand <em>how</em> such factors influence model predictions. We sought to address these gaps by estimating a random forest to identify salient risk and protective factors that differentiate youth with a DUD from their peers who use drugs but do not meet diagnostic criteria for a DUD. We extend traditional supervised learning methods by conducting explanatory model analyses to unpack what the model learned from the data, allowing for better interpretation of how influential factors may affect DUD risk at both the sample and case levels. Cross-sectional data were analyzed from a sample of 600 youth aged 14–24 with past 6-month illicit drug use (59 % male, 58 % Black; 57 % meeting DUD criteria). Global assessments revealed that risk factors aligned with deviance proneness and stress/negative affect were associated with higher likelihoods of a DUD, whereas academic achievement and later drug use initiation were associated with lower likelihoods. Local assessment methods highlighted how these broad predictive patterns can be applied to individual risk and protective factor profiles to inform precision-based preventive strategies. Overall, these analytic approaches and findings may help inform the development of indicated preventive interventions for DUDs in adolescent and young adult populations.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100412"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173410","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":"Rurality weakens the positive association between the COVID-19 pandemic and substance use treatment involving medications for opioid use disorder","authors":"Ryan J. Lofaro ,&nbsp;Leanne M. Confer ,&nbsp;Robert M. Bohler ,&nbsp;Jessica S. Schwind","doi":"10.1016/j.dadr.2026.100408","DOIUrl":"10.1016/j.dadr.2026.100408","url":null,"abstract":"<div><h3>Introduction</h3><div>During the COVID-19 pandemic, policies and practices were adopted to increase access to medications for opioid use disorder (MOUD), an evidence-based treatment that has lower utilization rates in rural areas compared to urban regions. However, limited attention has been given to rural-urban differences in MOUD use associated with pandemic policy and practice changes. We examine associations between the pandemic, rurality, and MOUD use in residential and outpatient treatment programs in the United States.</div></div><div><h3>Methods</h3><div>Using 2018–2022 Treatment Episode Data Set Admissions (TEDS-A) data from residential short-term (RST), residential long-term (RLT), and outpatient treatment centers, we explored bivariate associations between MOUD as part of a treatment plan as the outcome variable and rurality and the pandemic as key independent variables. We then employed logistic regression, adjusting for multiple factors to analyze base and moderation models.</div></div><div><h3>Results</h3><div>Findings indicated MOUD use increased across all treatment modalities in the post-COVID period with the strongest association in RLT treatment (OR = 2.298). In all treatment modalities, rurality reduced the strength of the positive relationship between the pandemic and MOUD use (interaction term ORs ranged from .441 to .91). Rural areas experienced a sharp drop in MOUD use from 2021 to 2022 in RLT and outpatient treatment.</div></div><div><h3>Conclusions</h3><div>Gains in the use of MOUD post-pandemic appeared short-lived in rural areas, ultimately widening urban-rural disparities. Providers, policymakers, and other stakeholders should work together to sustain policies and practices that promote MOUD, particularly in rural areas.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100408"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925579","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":"Morbidity, mortality, and health outcomes following emergency department visits for fentanyl-related overdoses: A retrospective cohort study","authors":"Lyn Yuen Choo ,&nbsp;Samantha Nash ,&nbsp;Baylee Farmer ,&nbsp;Zebulun Mallow ,&nbsp;Liv E. Miller ,&nbsp;E. Ashley Six-Workman ,&nbsp;James J. Mahoney III ,&nbsp;Erin L. Winstanley","doi":"10.1016/j.dadr.2025.100405","DOIUrl":"10.1016/j.dadr.2025.100405","url":null,"abstract":"<div><h3>Background</h3><div>Overdose (OD)-related mortality has been extensively studied; however, less is known about OD-related morbidity beyond neurocognitive impairments (NCI). The purpose of this study is to systematically describe morbidity, mortality, and health outcomes following a fentanyl-related OD treated in the emergency department (ED).</div></div><div><h3>Methods</h3><div>A retrospective cohort study (n = 205) was conducted using electronic medical record (EMR) data of patients who presented to an ED for a suspected or confirmed fentanyl-related OD within a rural health system that includes 25 hospitals across 4 states. Eligible events occurred between November 1, 2021 and October 31, 2022.</div></div><div><h3>Results</h3><div>A third (32 %) of patients were discharged the same day, 6 % were hospitalized for 10 +  days, 34 % were transferred to the intensive care unit (ICU) and 8 % died during their hospitalization. Twenty-three patients had ongoing health conditions that necessitated transfer to another inpatient hospital or a skilled nursing facility. Among the 633 diagnoses recorded, the majority (64 %) were categorized as related to the OD and specifically 20 % of patients had amnesia or memory loss. Diagnoses were also categorized as mental health (17 %) and medical conditions (11 %). A third of patients were administered naloxone in the hospital and other medication administered included gastrointestinal agents, central nervous system agents and analgesics.</div></div><div><h3>Conclusion</h3><div>Patients treated in the ED for a non-fatal OD had significant hospital service utilization and had complex morbidity suggesting the need for coordinated aftercare, as well as screening for NCI.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100405"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925581","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":"Development and validation of a fentanyl quantification model for drug checking services","authors":"Samuel Tobias ,&nbsp;Sara M. Guzman ,&nbsp;Jason E. Hein ,&nbsp;Lianping Ti","doi":"10.1016/j.dadr.2026.100415","DOIUrl":"10.1016/j.dadr.2026.100415","url":null,"abstract":"<div><h3>Background</h3><div>Drug checking services are becoming increasingly popular. Despite the significant variability in fentanyl concentrations observed in the unregulated opioid supply, quantifying fentanyl concentrations using community drug checking technologies remains challenging. This study reports the development of the first machine learning model to classify and quantify multiple fentanyl analogues in community drug checking samples, using data from British Columbia, Canada.</div></div><div><h3>Methods</h3><div>Drug checking samples from harm reduction sites using Fourier-transform infrared spectroscopy were forwarded for laboratory analysis at Health Canada’s Drug Analysis Service. Using gold-standard quantitative nuclear magnetic resonance results, we developed a machine learning pipeline to classify and quantify fentanyl and fluorofentanyl in unregulated drug samples.</div></div><div><h3>Results</h3><div>Over a nearly six-year period, 131,096 drug checks occurred at British Columbia harm reduction sites and 2032 unique drug samples were forwarded for laboratory analysis. A total of 974 training samples were used, each containing varying amounts of fentanyl or fluorofentanyl. Model performance depended on sample composition: ridge regression produced the most accurate fentanyl estimates in absence of fluorofentanyl, while random forest performed better in mixed-analogue samples. A screening model allowed us to combine these into a hybrid pipeline, improving estimates for both fentanyl (mean average error=3.74; R²=0.94) and fluorofentanyl (mean average error=1.22; R²=0.97).</div></div><div><h3>Discussion</h3><div>Our study shows that machine learning models for fentanyl quantification can be used to augment traditional community drug checking technologies. However, any practical use as a point-of-care tool should be accompanied by clear communication of uncertainty to ensure predictions support, rather than unintentionally undermine, harm reduction goals.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100415"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173411","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":"Sexualized alcohol and drug use among men who have sex with men and the PrEP retention in Thailand","authors":"Awirut Oon-arom ,&nbsp;David J. Grelotti ,&nbsp;Kriengkrai Srithanaviboonchai ,&nbsp;Chaisiri Angurawaranon ,&nbsp;Sherry Larkins ,&nbsp;Sung-Jae Lee ,&nbsp;Wichuda Jiraporncharoen","doi":"10.1016/j.dadr.2025.100402","DOIUrl":"10.1016/j.dadr.2025.100402","url":null,"abstract":"<div><h3>Introduction</h3><div>Sexualized alcohol use (SAU) and sexualized drug use (SDU) involve the use of alcohol and/or drugs in sexual contexts, which may impact the HIV pre-exposure prophylaxis (PrEP) continuum of care. This study examines associations between SAU, SDU, and PrEP retention among Thai men who have sex with men (MSM), and explores the acceptability of mobile health interventions.</div></div><div><h3>Methods</h3><div>A quantitative study with embedded qualitative data was employed, with one hundred MSM recruited from a community clinic to complete a survey assessing SAU, SDU, and other health risks. The psychosocial syndemic count was calculated based on symptoms of alcohol and drug use, depression, anxiety, and experiences of physical or sexual trauma. Factors associated with PrEP retention were analyzed using multivariable logistic regression. Additionally, thirty participants who reported SAU and SDU participated in semi-structured qualitative interviews. Rapid thematic analysis was performed to assess the acceptability of mobile health interventions aimed at improving the PrEP continuum.</div></div><div><h3>Results</h3><div>In the sample, 27 % reported SAU only, 12 % SDU only, and 23 % combining SAU and SDU. SDU included alkyl nitrite (51.6 %), Cannabis (14.5 %), and stimulants (9.7 %). PrEP retention was not associated with syndemic count or SDU, but was associated with SAU and experiences of sexual violence. Qualitative interviews indicated enthusiasm for mobile health interventions, particularly those offering PrEP reminders, incentives for healthy behaviors, and improved PrEP access.</div></div><div><h3>Conclusion</h3><div>SAU and sexual violence were identified as barriers to PrEP retention among MSM in Thailand, while SDU was not. Mobile health interventions emphasizing pro-health incentives and harm reduction may enhance PrEP adherence in this population.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100402"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791037","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":"Characterizing patterns of opioid and stimulant use by route and associations with non-fatal overdose and xylazine use in people who have injected drugs from Baltimore, MD, 2023–2024","authors":"Jacqueline E. Rudolph ,&nbsp;Liz M. Martinez-Ocasio ,&nbsp;Kenneth A. Feder ,&nbsp;Catherine Tomko ,&nbsp;Javier A. Cepeda ,&nbsp;Gregory D. Kirk ,&nbsp;Shruti H. Mehta ,&nbsp;Danielle German ,&nbsp;Becky L. Genberg","doi":"10.1016/j.dadr.2025.100403","DOIUrl":"10.1016/j.dadr.2025.100403","url":null,"abstract":"<div><h3>Background</h3><div>The fourth wave of the overdose epidemic in the United States (US) is characterized by deaths involving fentanyl with stimulants. Understanding patterns of substance use as novel drugs continue to emerge is critical to inform overdose prevention. Among people with a history of injection drug use in Baltimore, MD, we examined opioid-stimulant use by route and the association of injection with non-fatal overdose and xylazine use.</div></div><div><h3>Methods</h3><div>We included 1132 participants in the AIDS Linked to the IntraVenous Experience cohort with a study visit in 2023–2024. We characterized participants by self-reported past-six-month use of any opioid and any stimulant by route using descriptive statistics. Adjusted associations were estimated using targeted minimum loss-based estimation.</div></div><div><h3>Results</h3><div>Most participants were Black (68 %), male (67 %), and older (median: 56 years). 53 % reported using both opioids and stimulants; these participants were more likely to report using other substances, non-fatal overdose, depressive symptoms, and homelessness. Among participants using both, those injecting both were more likely to report non-fatal overdose and xylazine use than those using by non-injection (overdose: PD = 22.3 %, 95 % CI= 17.2 %-27.5 %; xylazine: PD = 13.3 %, 95 % CI = 4.7 %-21.9 %).</div></div><div><h3>Conclusions</h3><div>We provide one of the most comprehensive summaries of substance use during the fourth wave in Baltimore, a city with the highest rate of fatal overdose in the US during the study period. Use of multiple substances was common, and many participants reported injection. Overdose prevention should be targeted to those injecting both drugs as this pattern had heightened overdose risk.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100403"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737614","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":"Special issue: The harms and benefits of cannabis and cannabinoids in women and men and effects on their progeny","authors":"Rachel A. Rabin","doi":"10.1016/j.dadr.2026.100409","DOIUrl":"10.1016/j.dadr.2026.100409","url":null,"abstract":"","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"18 ","pages":"Article 100409"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147395470","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":"Corrigendum to “Relationship between Medicaid coverage design and receipt of medication for alcohol use disorder (MAUD): Probability of receipt increases based on comprehensiveness of plan” [Drug Alcohol Depend. Rep. 16 (2025) 100374]","authors":"Miguel Antonio Garcia Estrada ,&nbsp;Shelby R. Steuart ,&nbsp;Christina M. Andrews ,&nbsp;Colleen M. Grogan ,&nbsp;Olivia M. Hinds ,&nbsp;Emily C. Lawler ,&nbsp;Felipe Lozano-Rojas ,&nbsp;Melissa A. Westlake ,&nbsp;Lauren Peterson ,&nbsp;Coady Wing ,&nbsp;Amanda J. Abraham","doi":"10.1016/j.dadr.2025.100382","DOIUrl":"10.1016/j.dadr.2025.100382","url":null,"abstract":"","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100382"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145684578","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":"Substance use, stigma, and coping in treatment: A qualitative study of participant perspectives","authors":"Kaylia Carroll ,&nbsp;Charles Ashley Warnock ,&nbsp;Ashlin Ondrusek ,&nbsp;Frances J. Griffith ,&nbsp;Adam Viera ,&nbsp;Noah Hopkins ,&nbsp;Carmen Muniz-Almaguer ,&nbsp;Cathy Jian ,&nbsp;Carson F. Ferrara ,&nbsp;Jessica Muilenburg ,&nbsp;Trace Kershaw","doi":"10.1016/j.dadr.2025.100380","DOIUrl":"10.1016/j.dadr.2025.100380","url":null,"abstract":"<div><h3>Background</h3><div>This study explores experiences of stigma in substance use treatment, coping strategies, and the contexts in which individuals feel stigmatized due to current or past substance use. Semi-structured interviews were conducted with 55 individuals enrolled in substance use treatment programs within two distinct geographical areas of the U.S., Northeast and Southeast. Data were collected from February to October 2023. Themes were organized by the Health Stigma and Discrimination Framework. Five themes were identified: 1.) <strong>Interpersonal drivers of stigma</strong> participants described feeling stigmatized by treatment staff, healthcare practitioners, and family; 2.) <strong>Substance- and method-specific stigmatization:</strong> participants reported feeling greater stigma from the use of criminalized substances and substances used intravenously, compared to non-criminalized substances and non-injection use methods; 3.) <strong>Coping approaches:</strong> participants identified active (e.g., prayer, meditation, exercise) and avoidant (e.g., laughing it off) strategies to manage stigmatizing experiences; 4.) <strong>Rejection of stereotypes:</strong> participants described empathetic views of people who use substances, even as they acknowledged that treatment environments often reinforce stigmatizing practices; 5.) <strong>Recovery-oriented care:</strong> participants felt less stigmatized and more comfortable with treatment providers with lived experience. Data for this study did not indicate differences by study site. Recommendations include prioritizing providers with lived experience, training healthcare workers in culturally responsive care, and integrating coping strategies and harm reduction into treatment to reduce stigma.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100380"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109624","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":"Intersecting stigma of substance use and child welfare system involvement: Understanding stigma drivers, experiences, and outcomes from a socioecological perspective","authors":"Allyson L. Dir ,&nbsp;Brielle L. Batch ,&nbsp;Matthew C. Aalsma","doi":"10.1016/j.dadr.2025.100386","DOIUrl":"10.1016/j.dadr.2025.100386","url":null,"abstract":"<div><h3>Background</h3><div>Substance use in parents is a common reason for child welfare system involvement (CWS). Stigma associated with substance use and disorders (SU/D) continues to negatively impact individuals; however, less is understood about the intersecting stigma of CWS involvement and SU/D. The current study seeks to understand parents’ experiences of stigma related to SU/D and CWS involvement as well as the drivers and consequences of stigma at multiple socioecological levels using the Health Stigma and Discrimination Framework.</div></div><div><h3>Methods</h3><div>Qualitative data analysis was conducted on semi-structured interviews with N = 31 Child Welfare System (CWS) personnel (90.3 % female; 96.8 % White, Non-Hispanic), N = 28 SU/D service providers (85.7 % female; 67.9 % White; 89.3 % Non-Hispanic), and N = 28 parents (89.3 % female; 78.6 % White; 89.3 % Non-Hispanic) with a current or recent CWS case due to SU/D.</div></div><div><h3>Results</h3><div>Stigma drivers included a lack of understanding of SU/D at interpersonal, community, and organizational levels; negative stereotypes of parents with SU/D involved in CWS (seen as dishonest, unmotivated, poor parents); community neglect of SU/D; negative attitudes towards SU/D medications and harm reduction; and CWS policies unsupportive of SU/D. Parents described experiences of stigma by CWS and the healthcare system, their communities, and loved ones, leading to social isolation and hesitancy to engage in services. Consequently, stigma impacted SU/D service availability, housing/employment policies, and CWS practices, further negatively impacting parents.</div></div><div><h3>Conclusion</h3><div>Parents with SU/D and involved in CWS have unique experiences of stigmatization related to both SU/D and CWS involvement. Findings point to multiple targets for stigma reduction at different socioecological levels.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"17 ","pages":"Article 100386"},"PeriodicalIF":2.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267048","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}