Drug and alcohol dependence reports最新文献

{"title":"Perceptions of structural and provider-based substance use stigma interventions among primary care professionals","authors":"Erin Fanning Madden ,&nbsp;Felicia Frabis ,&nbsp;Jonathan Cohn ,&nbsp;Fares Qeadan ,&nbsp;Christopher RC Mann ,&nbsp;Mark K. Greenwald","doi":"10.1016/j.dadr.2024.100259","DOIUrl":"10.1016/j.dadr.2024.100259","url":null,"abstract":"<div><h3>Background</h3><p>Stigma enacted in primary care settings remains a barrier to care for people who use drugs (PWUD). Little is known about the acceptability of potential stigma interventions to target structural drivers of stigma affecting the organizational- or provider-level.</p></div><div><h3>Methods</h3><p>In-depth interview data were collected from 21 individuals working in Michigan primary care facilities. Participants included clinical (e.g., physicians, nurses) and non-clinical (e.g., administrators, receptionists) staff. Interviews explored perceptions of stigma toward PWUD and the acceptability of interventions to mitigate such stigma. Thematic analysis was used to identify stigma themes.</p></div><div><h3>Results</h3><p>Participants largely reported substance-use stigma as a matter of individual attitudes or knowledge limitations and described such stigma as rarely occurring during interpersonal interactions. Participants were still acutely aware of upstream societal and organizational factors creating structural barriers to care and/or worsening outcomes among PWUD, but seldom labeled these as stigma. Some provider and structural stigma reduction interventions were enthusiastically supported because they address participant ideas of substance-use stigma drivers (e.g., lack of knowledge) or provide resources that could improve care quality or provide resources for PWUD. Conversely, participants opposed some potential stigma interventions, e.g., less-frequent urine drug testing and increasing clinical visit time, deemed infeasible because of outside forces like insurers or regulators.</p></div><div><h3>Conclusions</h3><p>Although most participants conceptualized substance-use stigma as an individual or interpersonal process best addressed with training, their awareness of social determinants of health seemed to fuel an openness to some structural interventions to reduce organizational and provider stigma toward PWUD in primary care settings.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277272462400043X/pdfft?md5=5e843f9030f109a6474fbef140b3be8b&pid=1-s2.0-S277272462400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630538","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":"Association of economic and racial segregation with restricted buprenorphine dispensing in U.S. community pharmacies","authors":"Kyle J. Moon ,&nbsp;Sabriya L. Linton ,&nbsp;Neda J. Kazerouni ,&nbsp;Ximena A. Levander ,&nbsp;Adriane N. Irwin ,&nbsp;Daniel M. Hartung","doi":"10.1016/j.dadr.2024.100255","DOIUrl":"10.1016/j.dadr.2024.100255","url":null,"abstract":"<div><h3>Background</h3><p>Timely and reliable dispensing of buprenorphine is critical to accessing treatment for opioid use disorder (OUD). Racial and ethnic inequities in OUD treatment access are well described, but it remains unclear if inequities persist at the point of dispensing.</p></div><div><h3>Methods</h3><p>We analyzed data from a U.S. telephone audit that measured restricted buprenorphine dispensing in community pharmacies, defined as inability to fill a buprenorphine prescription requested by a “secret shopper.” Using the Index of Concentration at the Extremes (ICE), we constructed county-level measures of racial, ethnic, economic, and racialized economic (joint racial and economic segregation) segregation. Logistic regression models evaluated the association of ICE measures and restricted buprenorphine dispensing, adjusting for county type (urban vs. rural) and pharmacy type (chain vs. independent).</p></div><div><h3>Results</h3><p>Among 858 pharmacies surveyed in 473 counties, pharmacies in the most ethnically segregated and economically deprived counties had 2.66 times the odds (95 % CI: 1.41, 5.17) of restricting buprenorphine dispensing, compared to pharmacies in the most privileged counties after adjustment. Pharmacies in counties with high racialized economic segregation (quintile 2 and 3) also had higher odds of restricting buprenorphine dispensing (aOR 3.09 [95 % CI 1.7, 5.59]; aOR 2.11 [95 % CI 1.17, 3.98]). Similar associations were observed for economic segregation (aOR: 2.18 [95 % CI: 1.21, 3.99]), but not ethnic (0.59 [0.34, 1.05]) or racial (0.61 [0.35, 1.07]) segregation alone.</p></div><div><h3>Conclusions</h3><p>Restricted buprenorphine dispensing was most pronounced in socially and economically disadvantaged communities, potentially exacerbating gaps in OUD treatment access. Policy interventions should target both prescribing and dispensing capacity to advance pharmacoequity.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000398/pdfft?md5=36e0c271c0d6d4c2e784e8baa8ac8011&pid=1-s2.0-S2772724624000398-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141630539","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":"“He’s used drugs - he’s biased! He’s not a drug user - what would he know!”: A cross-sectional, online study of drug researchers’ experiential knowledge of drug use and disclosure","authors":"Danielle C. Ompad ,&nbsp;Cho-Hee Shrader ,&nbsp;Kyle M. Snyder ,&nbsp;Jules Netherland ,&nbsp;Sheila P. Vakharia ,&nbsp;Ingrid Walker","doi":"10.1016/j.dadr.2024.100256","DOIUrl":"10.1016/j.dadr.2024.100256","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite the recognized value of experiential knowledge, drug use and disclosure of drug use within the drug research community is rarely discussed or studied.</p></div><div><h3>Methods</h3><p>We distributed a cross-sectional online survey using targeted recruitment. Researchers provided information on drug use, disclosure of use (or abstinence) professionally, and their impact via write-in text boxes. We used the general inductive approach to analyze the data.</p></div><div><h3>Results</h3><p>Of the sample (n=669, 43 countries), 52 % were cisgender women, 89 % had post-graduate education, and 79 % worked in academia. Most (86 %) reported lifetime drug use and 47 % past 3-month use. Among 557 researchers who used drugs, 59 % disclosed their use to institutional colleagues, 59 % to colleagues outside their institution, 25 % to research participants, and 11 % in their research/scholarship. Themes included frequency; context; meaning of drug use disclosure personally, professionally, and socially; and how drug use experience and disclosure informs research. Respondents connected their concerns about disclosure in research with issues of social identity, professional risk, and the role of stigma related to lived experience. Some respondents felt that such concerns reinforce a vacuum, noting that the inability to disclose drug use limits research questions and the knowledge base overall.</p></div><div><h3>Discussion</h3><p>Our findings support the dichotomy of thought surrounding the lived experience of drug use: “[They’ve] used drugs- [they’re] biased!” and “[They’re] not a drug user-what would [they] know!” Our findings provide an opportunity to reflect upon our positionality and the impact researchers’ own drug use may have on the field.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100256"},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000404/pdfft?md5=023eb75e9f637e4fc727adf8628ec25d&pid=1-s2.0-S2772724624000404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141637210","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":"Trends in drug overdose deaths among adults 65 years of age and older in Canada (2000–2022)","authors":"Sameer Imtiaz ,&nbsp;Farihah Ali ,&nbsp;Nat Kaminski ,&nbsp;Cayley Russell ,&nbsp;Jürgen Rehm","doi":"10.1016/j.dadr.2024.100254","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100254","url":null,"abstract":"<div><h3>Background</h3><p>Although young adults and middle-aged adults have borne the brunt of the drug overdose crisis in Canada, older adults are also at an increased risk of harms. We examined trends in drug overdose deaths and opioid overdose deaths among adults 65 years of age and older.</p></div><div><h3>Methods</h3><p>Age-standardized rates of drug overdose deaths in Canada (2000–2022) and of opioid overdose deaths in Ontario (2003–2021) were computed. Drug overdose deaths were based on vital statistics registries, while opioid overdose deaths were based on toxicologic testing. Trends were characterized using joinpoint regression.</p></div><div><h3>Results</h3><p>Drug overdose deaths among adults 65 years of age and older in Canada rose from 4.3 to 9.9 deaths per million in the entire population between 2000 and 2022 (Average Annual Percentage Change [AAPC; 95 % CI]: 3.1 % [2.6 %-3.6 %]). Increases were observed in males (AAPC [95 % CI]: 4.0 % [3.1 %-4.9 %]), females (2.1 % [1.0 %-3.2 %]) and unintentional deaths (6.0 % [1.0 %-11.3 %]) after stratification by sex and manner of death. Opioid overdose deaths among adults 65 years of age and older in Ontario increased from 1.5 to 5.2 deaths per million in the entire population between 2003 and 2021 (AAPC [95 % CI]: 7.5 % [4.5 %-10.5 %]).</p></div><div><h3>Conclusions</h3><p>Drug overdose deaths more than doubled in Canada and opioid overdose deaths more than tripled in Ontario among adults 65 years of age and older during the past two decades. These findings indicate a need for education of patients, prioritization of harm reduction interventions, screening, intervention and treatment and adherence to prescribing guidelines.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000386/pdfft?md5=5c38c7eb8915275f590234af42c40817&pid=1-s2.0-S2772724624000386-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141596085","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":"Simultaneous use of alcohol and cannabis and attenuated age-related declines in alcohol and cannabis use disorder symptoms across young adulthood","authors":"Scott Graupensperger ,&nbsp;Brian H. Calhoun ,&nbsp;Anne M. Fairlie ,&nbsp;Katherine Walukevich-Dienst ,&nbsp;Megan E. Patrick ,&nbsp;Christine M. Lee","doi":"10.1016/j.dadr.2024.100252","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100252","url":null,"abstract":"<div><p>Most young adults naturally mature out of high-risk substance use patterns, but it is important to identify factors that may impede normative declines. Use of alcohol and cannabis simultaneously (i.e., simultaneous alcohol and marijuana/cannabis [SAM]) is cross-sectionally associated with alcohol and cannabis concerns, and SAM use increases acute risks at the daily level. However, less is known about long-term risks of SAM use and, specifically, how SAM use relates to maturing out of alcohol and cannabis use. Using four consecutive years of survey data from young adults who reported SAM use (<em>N</em>=409; 1636 responses; aged 18–25 at baseline), we first estimated age-related changes in symptoms of alcohol and cannabis use disorder (AUD/CUD) using multilevel growth modeling. Findings supported a maturing out process, as both AUD and CUD symptom severity significantly declined across young adulthood, on average (4 % and 5 % per year respectively, with significant acceleration). Cross-level interactions tested whether participants’ mean SAM use frequency across all four timepoints moderated age-related trajectories in AUD/CUD symptom severity. Significant interactions indicated that, relative to less-frequent SAM use, participants with more frequent SAM use showed less steep declines in AUD (1 % decrease per year vs. 6 % per year) and CUD symptoms (0 % decrease per year vs. 7 % per year); thus, SAM frequency was associated with slower/delayed maturing out of hazardous alcohol and cannabis use. Findings highlight that SAM use may be a correlate or risk-factor for prolonged high-risk substance use during young adulthood that relates to deviations from maturing out processes.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100252"},"PeriodicalIF":0.0,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000362/pdfft?md5=0d9e754725c5055fd3fb6bfcba2564ab&pid=1-s2.0-S2772724624000362-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141541882","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":"Psychometric evaluation of the Self-Report Habit Index for assessing habitual e-cigarette use behavior in high school adolescents","authors":"Meghan E. Morean ,&nbsp;Danielle R. Davis ,&nbsp;Grace Kong ,&nbsp;Krysten W. Bold ,&nbsp;Amelia Talley ,&nbsp;Suchitra Krishnan-Sarin","doi":"10.1016/j.dadr.2024.100251","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100251","url":null,"abstract":"<div><h3>Background</h3><p>E-cigarettes are the most-used nicotine product among adolescents, but limited psychometrically-sound, e-cigarette-relevant measures exist for adolescents. We examined psychometric properties of the Self-Report Habit Index (SRHI) for assessing adolescents’ habitual e-cigarette use.</p></div><div><h3>Methods</h3><p>During Fall 2022, 4855 students from eight Connecticut high schools completed an anonymous survey. The analytic sample comprised 491 students who reported past-month e-cigarette use and completed the SRHI (Age M=15.94, SD=1.24 years, 56 % female, 37.1 % Hispanic, 57.6 % White). We examined the SRHI’s latent factor structure; internal reliability; measurement invariance and between-groups differences (e.g., nicotine vs. nicotine-free vaping); and associations with total e-cigarette flavors used in the past month, past-30-day vaping frequency, and e-cigarette dependence.</p></div><div><h3>Results</h3><p>The SRHI’s 6-item, 1-factor structure was confirmed. Internal reliability was excellent. The SRHI was scalar invariant for all subgroups tested. Nicotine (vs. nicotine-free) and daily (vs. non-daily) e-cigarette use were associated with greater habitual e-cigarette use behavior. In adjusted models, habitual e-cigarette use was associated with using more e-cigarette flavors, vaping more frequently, and greater e-cigarette dependence. Habitual e-cigarette use incrementally accounted for variance in past-month flavors used and vaping frequency beyond dependence.</p></div><div><h3>Conclusions</h3><p>The SRHI evidenced solid psychometric properties for assessing habitual e-cigarette use behavior among high school students. Relationships between habitual use and frequency of use, e-cigarette flavors, and dependence might be expected as these constructs are associated with the three characterizing features of habitual behaviors: frequent repetition, cue-driven elicitation, and automaticity. Future prospective research can clarify the temporal ordering of habitual e-cigarette use and dependence in adolescents.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100251"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000350/pdfft?md5=e94573654c3222cd8f467d5f5cb93bec&pid=1-s2.0-S2772724624000350-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483529","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 and trends in current cannabis use among US youth and adults, 2013–2022","authors":"Delvon T. Mattingly ,&nbsp;Maggie K. Richardson ,&nbsp;Joy L. Hart","doi":"10.1016/j.dadr.2024.100253","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100253","url":null,"abstract":"<div><h3>Introduction</h3><p>Cannabis use is increasing due to several factors including the adoption of laws legalizing its use across the United States (US). We examined changes in current cannabis use among US youth and adults and by key sociodemographic groups.</p></div><div><h3>Methods</h3><p>Using data from the 2013–2022 National Survey on Drug Use and Health (n=543,195), we estimated the prevalence of (2013–2019, 2020, 2021–2022) and trends in (2013–2019, 2021–2022) current (i.e., past 30-day) cannabis use among US youth (aged 12–17) and adults (aged 18+) overall and by age, gender, race and ethnicity, educational attainment, and total annual family income. We also examined sociodemographic factors associated with use from 2013 to 2019, in 2020, and from 2021 to 2022.</p></div><div><h3>Results</h3><p>Cannabis use increased from 7.59 % to 11.48 % in 2013–2019, was 11.54 % in 2020, and increased again from 13.13 % to 15.11 % in 2021–2022. Among youth, cannabis use remained constant from 2013 to 2019 and 2021–2022. In 2022, use was highest among aged 18–34, male, non-Hispanic multiracial, and generally lower SES adults. From 2021–2022, cannabis use increased among several groups such as adults who were aged 35–49 (14.25–17.23 %), female (11.21–13.00 %), and Hispanic (10.42–13.50 %). Adults who were aged 18–25, male, non-Hispanic multiracial, some college educated, and of lower annual family income had consistently higher odds of current cannabis use from 2013 to 2019, in 2020, and from 2021 to 2022.</p></div><div><h3>Conclusions</h3><p>Cannabis use is increasing overall and among certain sociodemographic groups. Our findings inform prevention and harm reduction efforts aimed at mitigating the prevalence of cannabis use in the US.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100253"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000374/pdfft?md5=b59ea96d246fd01a366cf4db70ee5259&pid=1-s2.0-S2772724624000374-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141541883","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":"Assessing the accuracy of substance use disorder treatment search tools: A cross-sectional analysis of national and state-level directories","authors":"Sean R. Riley ,&nbsp;Leslie P.M. Brouwer ,&nbsp;Daniel E. Jonas","doi":"10.1016/j.dadr.2024.100249","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100249","url":null,"abstract":"<div><h3>Background</h3><p>Addressing the critical public health crisis of substance use disorder (SUD), this study evaluates the accuracy of SUD treatment search tools, such as FindTreatment.gov, to connect patients with appropriate care.</p></div><div><h3>Methods</h3><p>To ensure geographic diversity, we randomly selected one state from four distinct US regions (Arizona, Florida, Massachusetts, Ohio) and then randomly selected counties of varying sizes (one large, two medium, three small) within each state using a random number generator. Contact information for practices was extracted from the tools and validated through phone calls. The primary outcome measures were exact accuracy rate (wherein all information was accurate) and functional accuracy rate (wherein enough information was provided to facilitate care establishment).</p></div><div><h3>Results</h3><p>A total of 697 practices from within ten SUD treatment search tools were assessed. Accuracy of the ten SUD treatment search tools varied considerably, with exact accuracy rates ranging from 9.1 % to 76.0 % (mean: 56.0 %) and functional accuracy rates from 50.0 % to 92.0 % (mean: 82.8 %). National tools exhibited higher accuracy for both exact accuracy rate (66.3 % v. 49.0 %; p = 0.2864) and functional accuracy rate (83.8 % v. 82.2 %; p = 0.9148) than state tools, while privately funded tools demonstrated higher accuracy for both exact accuracy rates (66.8 % v. 48.9 %; p = 0.2008) and functional accuracy rates (83.8 % v. 82.2 %; p = 0.9148), but none of these differences were statistically significant.</p></div><div><h3>Conclusions</h3><p>This study found that SUD treatment search tools commonly list inaccurate information, underscoring the need for systematic improvements in data management and validation practices.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100249"},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000337/pdfft?md5=09cb0c47ef507d00a8268efe58180b86&pid=1-s2.0-S2772724624000337-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483530","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":"“If everyone knew about this, how many lives could we save?”: Do drug suppliers have a role in reducing overdose risk?","authors":"Bethany Hedden-Clayton ,&nbsp;Jes Cochran ,&nbsp;Jennifer J. Carroll ,&nbsp;Alex H. Kral ,&nbsp;Grant Victor ,&nbsp;Erin Comartin ,&nbsp;Bradley Ray","doi":"10.1016/j.dadr.2024.100250","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100250","url":null,"abstract":"<div><h3>Introduction</h3><p>An unpredictable illicit drug supply is driving high levels of overdose death in North America. Prior research has demonstrated the importance of involving people who use drugs in harm reduction intervention design and implementation. The inclusion of people who supply drugs in these efforts has been scant. We explore this possibility by interviewing persons targeted by a harm reduction educational program designed specifically for people who supply drugs.</p></div><div><h3>Methods</h3><p>In-person interviews with people who use drugs were conducted in 2022 in Indianapolis, Indiana. We conducted a thematic analysis of data from six interviews with people who were either primarily or secondarily trained through this harm reduction training for people who supply drugs,</p></div><div><h3>Results</h3><p>Participants described a diverse array of harm reduction strategies, some gained through the targeted education program, which they regularly practiced as they consumed and/or supplied drugs to others. People who supply drugs were regularly identified as key actors capable of widely reducing risk across drug networks. Participants described being motivated by a moral imperative to protect community members, tying the previous loss of friends and loved ones to overdose to their commitments to the safety of others.</p></div><div><h3>Conclusion</h3><p>This article contributes to the scholarship on the role of people who supply drugs in implementing harm reduction interventions and reducing overdose risk. Better enabling grassroots harm reduction organizations to provide people who supply drugs with harm reduction training and access to harm reduction resources may help to reduce drug-related harms.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100250"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000349/pdfft?md5=9d1ace09c78ad3b657885a7c4ddf4295&pid=1-s2.0-S2772724624000349-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141539771","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":"Contraceptive uptake in postpartum people with and without opioid use disorder and opioid use with co-occurring substance use","authors":"Jennifer K. Bello ,&nbsp;Kevin Y. Xu ,&nbsp;Joanne Salas ,&nbsp;Jeannie Kelly ,&nbsp;Richard A. Grucza","doi":"10.1016/j.dadr.2024.100248","DOIUrl":"https://doi.org/10.1016/j.dadr.2024.100248","url":null,"abstract":"<div><h3>Background</h3><p>Using contraception to delay pregnancy allows people with opioid use disorder (OUD) to choose when they are ready to continue their families. Yet, postpartum contraceptive uptake among people with OUD has not been well characterized.</p></div><div><h3>Methods</h3><p>Analyses used 73,811 pregnancy episodes among 61,221 people (2016–2021) from the St. Louis University-SSM Virtual Data Warehouse. OUD was defined from the year prior and through pregnancy. Contraceptive uptake was defined within 90-days after delivery. We used Generalized Estimating Equations-type multinomial logit models to assess association of OUD +/- co-occurring substance use disorders (SUDs) with any contraception (yes/no) and type of contraception (effective – pills, patch, ring, injection; or highly effective – long-acting reversible, LARC methods [intrauterine device, implant] and sterilization).</p></div><div><h3>Results</h3><p>The sample was 66.0 % white and average age was 27.7 years (±5.6). 32.5 % of pregnancies were followed by contraception initiation, 2.3 % had an OUD diagnosis, and 1.3 % OUD with co-occurring SUD. There was no association between OUD and postpartum contraception receipt, but OUD was associated with decreased highly effective compared to effective method initiation (aOR=0.76; 95 % CI: [0.64–0.91]). OUD plus co-occurring SUD was associated with decreased uptake across all contraception types (aOR=0.81[0.70–0.93]), specifically, highly-effective methods (aOR=0.48[0.38–0.61]).</p></div><div><h3>Conclusions</h3><p>Overall postpartum contraception uptake among people with OUD is comparable to uptake in the non-OUD population. People with OUD plus co-occurring SUDs are particularly unlikely to receive contraception. The reasons people choose contraceptive methods are complex and may differ by SUD severity. More information is needed to understand factors that impact postpartum contraception initiation.</p></div>","PeriodicalId":72841,"journal":{"name":"Drug and alcohol dependence reports","volume":"12 ","pages":"Article 100248"},"PeriodicalIF":0.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772724624000325/pdfft?md5=e714e8d53c208e096b43cfab5eb1b575&pid=1-s2.0-S2772724624000325-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141483531","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}