Drug and alcohol dependence reports最新文献

{"title":"Characteristics associated with adult non-fatal opioid and stimulant overdose and substance use disorder emergency department visits in Michigan","authors":"Olivia Martin ,&nbsp;Harriet Bird ,&nbsp;Sarah Nechuta","doi":"10.1016/j.dadr.2024.100290","DOIUrl":"10.1016/j.dadr.2024.100290","url":null,"abstract":"<div><h3>Background</h3><div>Understanding risk factors for emergency department (ED) visits for overdose and substance use disorder (SUD) can inform prevention efforts. Few studies have considered non-fatal opioid overdoses, stimulant overdoses and SUD, and limited data exists by overdose intentionality and by sex.</div></div><div><h3>Methods</h3><div>We conducted a serial cross-sectional study with Healthcare Cost and Utilization Project Michigan (MI) 2019–2020 ED discharge data (<em>n</em>=5,716,716). Primary outcomes included non-fatal opioid overdoses, non-fatal stimulant overdoses, and SUD primary diagnoses in a single ED visit. We examined demographic and socioeconomic factors associated with study outcomes using binary and multinomial logistic regression (for overdose intentionality) models, which estimated adjusted odds ratios (AOR) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>Among all MI discharges, 13,908, 1,379, and 23,462 were nonfatal opioid, stimulant, or SUD overdose visits, respectively. Lower median household income (vs. higher income), male sex (vs. female), metropolitan county of residence (vs. small urban/rural), and Medicaid (vs. private insurance) were associated with increased odds of all outcomes. For example, ORs(95 % CIs) for Medicaid were 4.41(4.18,4.65), 2.25(1.95,2.60), and 2.80(2.70,2.91) for opioid overdoses, stimulant overdoses, and SUD, respectively. All outcomes had the highest increased odds in ages 28–32 years compared to 18–22 years. Stratification by sex and non-fatal overdose intentionality modified some associations, with the strongest associations observed for non-fatal opioid overdoses.</div></div><div><h3>Conclusions</h3><div>Male sex, Medicaid, and race/ethnicity were consistently associated with all outcomes similarly, but other characteristics varied in patterns, strengths of association, and statistical significance by outcome groups, sex, and non-fatal opioid or stimulant overdose intentionality.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100290"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142552741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement in substance use disorder treatment after an emergency department visit among persons at high risk of opioid overdose: A prediction analysis","authors":"Fiona Bhondoekhan ,&nbsp;Yu Li ,&nbsp;Benjamin D. Hallowell ,&nbsp;Linda Mahoney ,&nbsp;Mackenzie M. Daly ,&nbsp;Jamieson Goulet ,&nbsp;Francesca L. Beaudoin ,&nbsp;Laura C. Chambers ,&nbsp;Brandon D.L. Marshall","doi":"10.1016/j.dadr.2024.100287","DOIUrl":"10.1016/j.dadr.2024.100287","url":null,"abstract":"<div><h3>Background</h3><div>Certified peer recovery specialists (CPRS) and licensed clinical social workers (LCSWs) can facilitate substance use disorder (SUD) treatment engagement for emergency department (ED) patients at risk for overdose. Predictors of treatment engagement after such behavioral services are unknown.</div></div><div><h3>Methods</h3><div>This secondary analysis included Rhode Island ED patients at high risk for opioid overdose participating in a randomized controlled trial comparing the effectiveness of CPRS and LCSWs services (2018–2021). SUD treatment engagement within 90 days post-discharge was identified using statewide administrative data. Potential predictors were obtained from baseline questionnaires. Classification and regression trees (CART) were used to identify predictors of treatment engagement.</div></div><div><h3>Results</h3><div>In the ED, 323 and 325 participants received CPRS and LCSWs services, respectively, among whom 141 (43.7 %) and 137 (42.2 %) engaged in SUD treatment within 90 days post-discharge. For the CPRS group, predictors of treatment engagement included unhealthy alcohol use, prescription opioid or benzodiazepine use in past 6 months, and lifetime history of: unstable housing, barriers to treatment, bipolar disorder diagnosis, addiction treatment, and recovery services. In the LCSW group, predictors included health insurance, current pain, opioid overdose in past year, and lifetime history of anxiety disorder diagnosis and mental illness treatment. However, CART had low predictive accuracy (CPRS: 60.9 %, LCSW: 54.8 %).</div></div><div><h3>Conclusions</h3><div>Among ED patients at high risk of opioid overdose receiving behavioral services, 90-day SUD treatment engagement was high. Sociobehavioral and clinical patient characteristics did not accurately predict treatment engagement. Behavioral services should be offered to all ED patients at high risk of opioid overdose.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of cannabidiol use and correlates in U.S. adults","authors":"Namkee G. Choi ,&nbsp;C. Nathan Marti ,&nbsp;Bryan Y. Choi","doi":"10.1016/j.dadr.2024.100289","DOIUrl":"10.1016/j.dadr.2024.100289","url":null,"abstract":"<div><h3>Background</h3><div>Cannabidiol (CBD) use has been increasing for its putative therapeutic potential for various health conditions. Research using a nationally representative sample is needed to examine characteristics of CBD users.</div></div><div><h3>Methods</h3><div>Data came from the adult sample (N=47,100) of the 2022 U.S. National Survey on Drug Use and Health. We fitted generalized linear models to examine the sociodemographic, health, other substance use, and cannabis risk perception as correlates of CBD-only use and CBD-cannabis co-use, compared to cannabis-only use.</div></div><div><h3>Results</h3><div>In 2022, 20.6 % and 23.0 % of U.S. adults reported using CBD and cannabis, respectively, in the preceding 12 months, and 63 % of CBD users also used cannabis. CBD use was significantly higher among women (CBD-only vs. cannabis-only use: IRR=1.43, 95 % CI=1.31–1.57), but significantly lower among Black and Hispanic individuals compared to non-Hispanic White individuals (CBD-only vs. cannabis-only use: IRR=0.71, 95 % CI=0.60–0.85 for Black individuals; IRR=0.79, 95 % CI=0.65–0.96 for Hispanic individuals). Older ages, higher SES, chronic medical conditions, mental illness, and high cannabis risk perception were also associated with higher likelihood of CBD-only use versus cannabis-only use. CBD-cannabis co-users were at most risk in terms of chronic illness, mental illness, cannabis use disorder, and other substance use problems.</div></div><div><h3>Conclusions</h3><div>The high prevalence of self-reported CBD use among those with physical and mental health problems warrants public health warnings about potential side effects and drug interactions. The high CBD-cannabis co-use rate also calls for more research on potential benefits and negative effects of the co-use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100289"},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of HIV pre-exposure prophylaxis (PrEP) indication, HIV risk perception and unwillingness to use PrEP among people who inject drugs in Baltimore, MD","authors":"Tarfa Verinumbe ,&nbsp;Gregory M. Lucas ,&nbsp;Katie Zook ,&nbsp;Brian Weir ,&nbsp;Miles Landry ,&nbsp;Kathleen R. Page ,&nbsp;Susan G. Sherman ,&nbsp;Oluwaseun Falade-Nwulia","doi":"10.1016/j.dadr.2024.100288","DOIUrl":"10.1016/j.dadr.2024.100288","url":null,"abstract":"<div><h3>Background</h3><div>Perceived HIV risk may impact willingness to initiate PrEP among people who inject drugs (PWID).</div></div><div><h3>Methods</h3><div>We analyzed baseline data from PrEP eligible PWID in Baltimore, MD. Risk perception was assessed by PWID relative to the average risk of their age group categorized as: higher-than, lower-than, or about average. Participants were informed of PrEP for HIV prevention and asked about their willingness to use daily PrEP. Associations of PrEP indication (categorized as injection risk only vs any sexual risk), perceived HIV risk and non-willingness to use PrEP was assessed using generalized linear models.</div></div><div><h3>Results</h3><div>Among 489 participants, 61 % were male, 66 % were Black and mean age was 46 years. One-third (35 %) of the participants were aware of PrEP and &lt;1 % had used PrEP in the prior 30 days. Overall, 30 % of PWID reported lower-than-average perceived HIV risk and 18 % reported non-willingness to use PrEP. Participants with injection risk only were more likely (aOR: 2.75; 95 %CI: 1.60 – 4.73) to report having lower-than-average perceived HIV risk compared to those with any sexual risk. Participants with lower-than-average perceived risk were more likely to report non-willingness to use PrEP compared to those with higher perceived risk (adjusted PR: 1.91; 95 %CI: 1.18 – 3.10).</div></div><div><h3>Conclusion</h3><div>A considerable proportion of PWID eligible for PrEP reported having low risk of HIV acquisition despite being eligible for PrEP. Consistent and tailored PrEP messaging that addresses drug use HIV risk perception may be critical to increasing PrEP uptake among PWID.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining naloxone access and interest in secondary naloxone distribution on an American Indian Reservation in the Northern Midwest of the United States","authors":"Kristin E. Schneider ,&nbsp;Sean T. Allen ,&nbsp;Allison O’Rourke ,&nbsp;Molly C. Reid ,&nbsp;Maisie Conrad ,&nbsp;Pam Hughes ,&nbsp;Laura Palombi ,&nbsp;Toni Wakemup,&nbsp;Andrea Medley ,&nbsp;Melissa Walls","doi":"10.1016/j.dadr.2024.100285","DOIUrl":"10.1016/j.dadr.2024.100285","url":null,"abstract":"<div><h3>Background</h3><div>Indigenous communities in the United States experience disproportionate rates of overdose morbidity and mortality due to a range of historical traumas and ongoing oppression. Limited health and harm reduction service access on some Tribal lands exacerbate these challenges. To date, little is known about naloxone access on tribal reservation lands.</div></div><div><h3>Methods</h3><div>We used cross-sectional survey data from community members on the reservation lands of a northern Midwest Tribe in the United States. We explored the prevalence and correlates of recent (past 6-month) naloxone receipt and interest in secondary naloxone distribution among all participants and people who used drugs (PWUD) recently. Correlates included sociodemographics, cultural identity and spirituality, witnessing overdoses, stigma, and drug use characteristics.</div></div><div><h3>Results</h3><div>Among 227 Indigenous participants, the average age was 45, 62 % were women, 53 % were single, 29 % were not working, 29 % had experienced recent hunger, and 8 % considered themselves homeless. 91 % said that Indigenous spiritual values were important to them. Sixteen percent had witnessed a recent non-fatal overdose, and 6 % had witnessed a fatal one. Twenty-four percent of the overall sample had recently received naloxone, and 40 % of PWUD had received it. Witnessing both fatal (p&lt;0.001) and nonfatal overdoses (p=0.001) were associated with receiving naloxone. Further, 63 % of participants were willing to distribute naloxone.</div></div><div><h3>Conclusions</h3><div>Innovative strategies to expand naloxone access that are culturally relevant and responsive are needed in Indigenous communities. Cultural connectedness and shared identity are key strengths of Indigenous communities that can potentially be leveraged to implement secondary naloxone distribution programs.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100285"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142445807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of future overdose among people who inject drugs in Baltimore, Maryland","authors":"Michael P. Ramirez ,&nbsp;Gregory M. Lucas ,&nbsp;Kathleen R. Page ,&nbsp;Katie Zook ,&nbsp;Miles Landry ,&nbsp;Amanda Rosecrans ,&nbsp;Robert Harris ,&nbsp;Suzanne M. Grieb ,&nbsp;Oluwaseun Falade-Nwulia ,&nbsp;William Clarke ,&nbsp;Susan G. Sherman ,&nbsp;Brian W. Weir","doi":"10.1016/j.dadr.2024.100286","DOIUrl":"10.1016/j.dadr.2024.100286","url":null,"abstract":"<div><h3>Background</h3><div>Longitudinal studies of future overdose risk among people who inject drugs (PWID) are needed to inform planning of targeted overdose preventions in the United States.</div></div><div><h3>Methods</h3><div>The Integrating Services to Improve Treatment and Engagement (INSITE) study followed 720 PWID between June 2018 and August 2019 to evaluate the delivery of mobilized healthcare services in Baltimore, Maryland. The present analyses used logistic regression to identify baseline characteristics predictive of non-fatal or fatal overdose during the 6-month follow-up among 507 participants with overdose information. Non-fatal overdoses were self-reported and fatal overdoses were identified through the National Death Index.</div></div><div><h3>Results</h3><div>At baseline, 121 (23 %) reported an overdose in the prior 6 months. Between baseline and follow-up, 66 (13 %) participants reported a non-fatal overdose and 6 (1 %) experienced a fatal overdose. Overdose during follow-up was positively associated with overdose in the 6 months prior to baseline (6.70 aOR; 95 % CI: 3.51, 12.78) and more than 6 months prior to baseline (2.49 aOR; 95 % CI: 1.52, 4.08) versus no prior overdose. Overdose during follow-up was also positively associated with buprenorphine treatment (2.37 aOR; CI: 1.08, 5.21) and negatively associated with non-prescribed methadone at baseline (0.59 aOR; 0.38, 0.93).</div></div><div><h3>Conclusions</h3><div>Identifying and intervening with PWID who experienced a recent overdose could reduce short-term elevated risk of future overdose. However, as other PWID reported never experiencing an overdose at baseline nonetheless experienced an overdose during follow-up, targeted approaches should be complemented with population-level interventions. Overdose risk implications of buprenorphine treatment and non-prescribed methadone are also discussed.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covid-19 vaccination status and beliefs of individuals with co-occurring serious mental illness and alcohol use disorder","authors":"Mohammad Keshtkar ,&nbsp;Diana Tyutyunnyk ,&nbsp;Paige King ,&nbsp;Katharine Palmer ,&nbsp;Mariah Brigman ,&nbsp;Julianne D. Jett ,&nbsp;Rachael Beck ,&nbsp;Sara C. Parent ,&nbsp;Richard Ries ,&nbsp;Sterling M. McPherson ,&nbsp;Naomi S. Chaytor ,&nbsp;John M. Roll ,&nbsp;Douglas L. Weeks ,&nbsp;Michael G. McDonell","doi":"10.1016/j.dadr.2024.100284","DOIUrl":"10.1016/j.dadr.2024.100284","url":null,"abstract":"<div><h3>Objective</h3><div>The study objective was to determine factors associated with obtaining COVID-19 vaccination in people with co-occurring alcohol use disorder (AUD) and serious mental illness (SMI).</div></div><div><h3>Methods</h3><div>Survey responses were obtained from 135 adults with SMI seeking community-based AUD treatment about their primary series vaccination status, COVID-19 preventative practices, vaccination motivators, reasons for vaccine hesitancy, and strategies to increase vaccination uptake. Vaccinated and unvaccinated groups were compared. Responses to survey items with nominal or Likert scales were analyzed with chi-square tests of association. Logistic regression was employed to determine predictors of vaccine status.</div></div><div><h3>Results</h3><div>Seventy-nine percent (n=107) of participants reported they were vaccinated. A higher proportion of vaccinated participants believed COVID-19 was a serious disease. While both groups adopted preventative hygiene practices at similar rates (e.g., washing hands), vaccinated participants engaged in more interpersonal practices directly involving others (e.g., wearing masks and avoiding crowds). The strongest vaccine motivator was protecting personal health, while the primary reason for hesitancy was potential side effects. Most unvaccinated participants endorsed increased safety information availability (61.1 %) and living with a high-risk-for-severe-infection individual (55.6 %) as reasons to overcome hesitancy.</div></div><div><h3>Conclusions</h3><div>Vaccination rates, motivators, and hesitancy reasons were similar to the general United States population. Strategies to increase vaccination in this high-risk population should include education on vaccine safety and side effects and the impacts of COVID-19 and other respiratory illnesses on others.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100284"},"PeriodicalIF":0.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal cannabis exposure in the clinic and laboratory: What do we know and where do we need to go?","authors":"Lani Cupo ,&nbsp;Karen A. Dominguez-Cancino ,&nbsp;José Ignacio Nazif-Munoz ,&nbsp;M. Mallar Chakravarty","doi":"10.1016/j.dadr.2024.100282","DOIUrl":"10.1016/j.dadr.2024.100282","url":null,"abstract":"<div><div>Coincident with the legalisation of cannabis in many nations, rates of cannabis use during pregnancy have increased. Like prior investigations on smoking and alcohol, understanding how prenatal cannabis exposure (PCE) impacts offspring outcomes across the lifespan will be critical for informing choices for pregnant people, clinicians, and policy makers alike. A thorough characterization of the life-long impacts is especially urgent for supporting all of these stakeholders in the decision-making process. While studies in humans bring forth the most direct information, it can be difficult to parse the impact of PCE from confounding variables. Laboratory studies in animal models can provide experimental designs that allow for causal inferences to be drawn, however there can be challenges in designing experiments with external validity in mirroring real-world exposure, as well as challenges translating results from the laboratory back to the clinic. In this literature review, we first highlight what is known about patterns of cannabis use during pregnancy. We then seek to lay out updates to the current understanding of the impact of PCE on offspring development informed by both human and nonhuman animal experiments. Finally we highlight opportunities for information exchange among the laboratory, clinic, and policy, identifying gaps to be filled by future research.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"13 ","pages":"Article 100282"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142424524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How substance use preferences and practices relate to fentanyl exposure among people who use drugs in Rhode Island, USA","authors":"Leah C. Shaw ,&nbsp;Katie B. Biello ,&nbsp;Jane A. Buxton ,&nbsp;Jacqueline E. Goldman ,&nbsp;Scott E. Hadland ,&nbsp;Susan G. Sherman ,&nbsp;Yu Li ,&nbsp;Alexandria Macmadu ,&nbsp;Brandon D.L. Marshall","doi":"10.1016/j.dadr.2024.100280","DOIUrl":"10.1016/j.dadr.2024.100280","url":null,"abstract":"<div><h3>Background</h3><p>Over 107,000 people died in the United States (U.S.) from drug overdose in 2022, with over one million overdose deaths since 1999. The U.S. drug market is characterized by a highly toxic, unregulated, and rapidly changing supply. Understanding the extent of exposure to fentanyl among people who use drugs (PWUD) will guide public health interventions aimed to decrease overdose.</p></div><div><h3>Methods</h3><p>We utilized baseline data from the Rhode Island Prescription and Illicit Drug Study, a randomized controlled trial of harm reduction-oriented interventions for PWUD in Rhode Island from 2020 to 2023. We evaluated sociodemographic and drug use-related covariates and examined fentanyl presence in urine drug testing (UDT). We built a classification and regression tree (CART) model to identify subpopulations with the highest likelihood of fentanyl presence in UDT.</p></div><div><h3>Results</h3><p>Among 446 participants, those with fentanyl present in UDT tended to be younger, non-Hispanic white, and had recently injected drugs (<em>p</em>&lt;0.05 for all). The CART analysis demonstrated a large variation in sample sub-groups’ likelihood of fentanyl presence in UDT, from an estimated probability of 0.09 to 0.90. Expected recent fentanyl exposure was the most important predictor of fentanyl in UDT.</p></div><div><h3>Conclusions</h3><p>Univariate analyses and CART modeling showed substantial variation in the presence of fentanyl in UDT among PWUD. Harm reduction services for people actively injecting drugs and drug checking programs based on capacity-building, empowerment, and targeted towards those not yet engaged in services are urgently needed to support PWUD in navigating the current volatile drug supply.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100280"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000647/pdfft?md5=cee48821cca3b11f8a75f4a762818160&pid=1-s2.0-S2772724624000647-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-risk use of prescription opioids among patients treated for alcohol problems in New York State. A repeated cross-sectional study, 2005–2018","authors":"Tzu-Yin Kuo ,&nbsp;Chi-Hua Lu ,&nbsp;Zackary Falls ,&nbsp;Gail Jette ,&nbsp;Walter Gibson ,&nbsp;Peter L. Elkin ,&nbsp;Kenneth E. Leonard ,&nbsp;Edward M. Bednarczyk ,&nbsp;David M. Jacobs","doi":"10.1016/j.dadr.2024.100278","DOIUrl":"10.1016/j.dadr.2024.100278","url":null,"abstract":"<div><h3>Background</h3><p>Patients with alcohol use disorder (AUD) and high-risk opioid use are at risk of serious complications. The purpose of this study was to estimate the prevalence of and factors associated with high-risk opioid use in patients with an alcohol use problem from 2005 to 2018.</p></div><div><h3>Methods</h3><p>This repeated cross-sectional study analyzed data from first admissions for alcohol treatment (2005–2018) to the NYS Office of Addiction Services and Supports merged with Medicaid Claims Data. High-risk opioid use was defined as opioid dose ≥50 morphine mg equivalents (MME) per day; opioid prescriptions overlapping ≥7 days; opioids for chronic pain &gt;90 days or opioids for acute pain &gt;7 days.</p></div><div><h3>Results</h3><p>Patients receiving ≥50 MME increased from 690 to 3226 from 2005 to 2010; then decreased to 2330 in 2018. From 2005–2011, patients with opioid prescriptions overlapping ≥7 days increased from 226 to 1594 then decreased to 892 in 2018. From 2005–2010, opioid use &gt;7 days for acute pain increased from 133 to 970 and plateaued after 2010. From 2005–2018, patients who received opioids &gt;90 days for chronic pain trended from 186 to 1655. White patients, females, age 36–55, patients with chronic and acute pain diagnoses had the highest rates of high-risk use.</p></div><div><h3>Conclusions</h3><p>The prevalence of high-risk opioid use in patients with alcohol use problems increased from 2005 to 2011, and generally decreased after 2010. However, prevalence of opioids &gt;90 days for chronic pain trended up from 2005 to 2018. High-risk opioid use among patients with AUD emphasizes the need to develop interventional strategies to improve patient care.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100278"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000623/pdfft?md5=aa208a02fe548f757344954bdfaaecfc&pid=1-s2.0-S2772724624000623-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142129787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}