Drug and alcohol dependence reports最新文献

{"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":"2025-09-01","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":"2025-09-01","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":"Changes in prenatal cannabis use and perceptions during the COVID-19 pandemic","authors":"Natasha A. Sokol ,&nbsp;Eva Sharma ,&nbsp;Janet O. Joseph ,&nbsp;Janet A.J. Johnson ,&nbsp;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_age = 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 &gt; 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":"2025-09-01","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}

{"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":"2025-09-01","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":"2025-09-01","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":"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":"2025-09-01","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":"A preliminary investigation of tobacco co-use on endocannabinoid activity in people with cannabis use","authors":"Rachel A. Rabin ,&nbsp;Joseph Farrugia ,&nbsp;Ranjini Garani ,&nbsp;Romina Mizrahi ,&nbsp;Pablo Rusjan","doi":"10.1016/j.dadr.2025.100369","DOIUrl":"10.1016/j.dadr.2025.100369","url":null,"abstract":"<div><div>Tobacco is commonly co-used with cannabis. This is unfortunate because tobacco co-use exacerbates select clinical consequences associated with cannabis use. Evidence demonstrates that low levels of anandamide, a prominent endocannabinoid, correlate with worse clinical outcomes. Fatty acid amide hydrolase (FAAH) degrades anandamide, and greater FAAH levels may underlie poorer clinical outcomes in people who co-use relative to those who use only cannabis. Therefore, we tested whether tobacco co-use increases FAAH levels beyond those associated with cannabis use alone. Cannabis-using participants (N = 13) were parsed into individuals with daily tobacco use (CT, n = 5) and no current tobacco use (CAN, n = 8). We evaluated group differences in FAAH, quantified using positron emission tomography and [¹¹C]CURB, while controlling for sex and FAAH genotype in the prefrontal cortex, hippocampus, thalamus, sensorimotor striatum, substantia nigra, and cerebellum. A significant group x ROI interaction for [¹¹C]CURB λk₃ [F(5, 45)= 3.15, p = 0.016] emerged. Bonferroni-corrected post-hoc tests indicated greater FAAH levels in CT compared to CAN in the substantia nigra (p = 0.023, d=1.54) and cerebellum (p = 0.003, d=1.76), while a trend emerged in the sensorimotor striatum (p = 0.054, d=1.33). Preliminary findings suggest that tobacco co-use is associated with elevated FAAH activity relative to cannabis-only use, which may underlie poorer clinical outcomes associated with co-use.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100369"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756840","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 humanized monoclonal antibody attenuates carfentanil self-administration in nonhuman primates","authors":"Lindsey K. Galbo-Thomma ,&nbsp;Carly Baehr ,&nbsp;Elaine A. Gay ,&nbsp;Scott Runyon ,&nbsp;Marco Pravetoni ,&nbsp;Charles P. France","doi":"10.1016/j.dadr.2025.100365","DOIUrl":"10.1016/j.dadr.2025.100365","url":null,"abstract":"<div><div>Approximately 70 % of fatal drug overdoses in the United States are attributed to fentanyl and fentanyl analogs. Current medications for reversing overdose and treating opioid use disorder might not be as effective against fentanyl and fentanyl analogs compared with other opioids, possibly due to their lipophilicity and high potency at the <em>mu</em>-opioid receptor (MOR). Hence, fentanyl and fentanyl analog-targeting monoclonal antibodies (mAb) could be an alternative treatment. The humanized (h) mAb hHY6-F9 has high relative affinity for fentanyl and decreases intravenous (i.v.) fentanyl self-administration in monkeys. hHY6-F9 has lower affinity for fentanyl analogs, including carfentanil; however, the effects of hHY6-F9 on fentanyl analogs <em>in vivo</em> have not been characterized. This study examined the effects of hHY6-F9 on i.v. carfentanil self-administration. hHY6-F9 was administered to two male rhesus monkeys self-administering carfentanil, heroin, cocaine, or fentanyl during twice daily sessions. Based on prior <em>in vitro</em> and <em>in vivo</em> findings, hHY6-F9 was hypothesized to attenuate fentanyl but not carfentanil, heroin, or cocaine self-administration. However, hHY6-F9 significantly decreased carfentanil self-administration for up to 5 weeks while having little or no effect on heroin, cocaine, or fentanyl self-administration. A cell-based pharmacological assay of carfentanil-induced MOR activation supported the carfentanil self-administration findings, showing that murine HY6-F9 reduced the effects of carfentanil. The ability of hHY6-F9 to attenuate the effects of an ultra-potent fentanyl analog could be advantageous for treating opioid use disorder or overdose given the unpredictability of the unregulated opioid supply.</div></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"16 ","pages":"Article 100365"},"PeriodicalIF":2.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724436","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":"2025-09-01","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}

{"title":"Substance use and use disorders among Veterans on long-term opioid therapy","authors":"Thye Peng Ngo ,&nbsp;Salomeh Keyhani ,&nbsp;Samuel Leonard ,&nbsp;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":"2025-09-01","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}