American Journal on Addictions最新文献

{"title":"Brief report: Meth, tranq, gas station heroin & other drugs complicating addiction treatment","authors":"Erin L. Winstanley PhD,&nbsp;Jane M. Liebschutz MD, MPH,&nbsp;Cristina Murray-Krezan PhD,&nbsp;Galen E. Switzer PhD,&nbsp;Samantha Nash BA,&nbsp;Sarah Kawasaki MD","doi":"10.1111/ajad.70151","DOIUrl":"10.1111/ajad.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Patients using fentanyl have worse treatment outcomes; however, little is known about other drugs that complicate treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A national survey (<i>n</i> = 396) was conducted using a random sample of clinicians waivered to prescribe buprenorphine in the United States. This study reports the results of a single survey item on clinicians' perceptions of other drugs, besides IMF, complicating treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinicians reported methamphetamine (86.4%), synthetic cannabinoids (42.7%), and xylazine (41.4%) were complicating treatment; reports varied by geographic region.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Scientific Significance</h3>\u0000 \u0000 <p>Rapid clinician surveys can provide real-time data on changing patterns of drug use's impact treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":"543-546"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147300951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring outcomes of substance use disorder among healthcare professionals in Utah: A retrospective study of the professionals health program","authors":"Mubo O. Olufemi MSc,&nbsp;Lisa J. Merlo PhD, MPE,&nbsp;Melissa Cheng MD, MOH,&nbsp;Hongwei Zhao ScD,&nbsp;Justin Yang MD, MPH,&nbsp;Matthew S. Thiese PhD, MSPH","doi":"10.1111/ajad.70106","DOIUrl":"10.1111/ajad.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Substance use disorders (SUD) among healthcare professionals threaten both patient safety and workforce stability. Professional health programs (PHPs) aim to support recovery and safe practice reentry, yet outcomes for non-physician professionals remain underexplored. This study assessed return to use and professional outcomes among healthcare professionals monitored through the Utah Professionals Health Program (UPHP), a cohort predominantly composed of non-physician participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study used data from 183 UPHP participants with SUD (60.7% nurses) enrolled between 2013 and 2024. The primary outcome was return to use, defined by positive toxicology results or self-report. Logistic regression was used to identify predictors of return to use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Return to use occurred in 48.6% of participants, with the highest incidence (33.9%) in year one. By year five, 81.4% had completed monitoring, and 55.9% were working full-time in healthcare. In adjusted models, age (OR = 0.93 per year, <i>p</i> = .039), duration of SUD before UPHP enrollment (OR = 1.14 per year, <i>p</i> = .004), and injury history (OR = 0.23, <i>p</i> = .017) were significantly associated with return to use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>This non-physician dominant cohort highlights need for early recovery support and profession-specific care. Return to use was most frequent in year one, underscoring the need for intensive early-phase monitoring. Tailored support for injury-related substance use, along with peer support and employment services may improve outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>Findings provide novel insight into recovery outcomes for non-physician healthcare professionals in a PHP, a group underrepresented in addiction research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":"480-488"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary care's most pressing needs to address opioid use disorder: A qualitative study","authors":"Elise A. Robertson MA,&nbsp;Kaitlyn K. Frick,&nbsp;Cory B. Lutgen MHA,&nbsp;Elisabeth F. Callen PhD, PStat,&nbsp;Tarin L. Clay,&nbsp;Gabriela Gaona Villarreal MPH,&nbsp;Kathryn Cates-Wessel BA,&nbsp;Joshua A. Smith MD, MPH,&nbsp;Melissa K. Filippi PhD, MPH","doi":"10.1111/ajad.70152","DOIUrl":"10.1111/ajad.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Although buprenorphine is effective and approved for treating opioid use disorder (OUD), it remains underutilized in primary care settings. This study's objective was to explore what primary care teams need to overcome barriers in treating OUD, and to assess whether those needs change after receiving education on OUD treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The American Academy of Family Physicians hosted a 12-month Project ECHO® educational series on OUD for primary care teams. Thematic analysis was conducted on participant responses pre- and post-series to the survey item “Please list your most pressing needs related to OUD” (<i>N</i> = 92).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two participants from 25 primary care practices from the US and Canada responded to the pressing needs item across both surveys. The most prevalent need reported at baseline was Education and Training, which became second to Health System Resources at endpoint. Respondents cited organizational protocols for OUD treatment as a pressing need among other Health System Resources such as support for reimbursement. Needs relating to transportation and housing; engaging patients to start and continue in OUD treatment; and addressing stigma within the community and health system were indicative of overlapping barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Responses from primary care teams echo previous studies on barriers to OUD treatment and provide specific, actionable insight to addressing these barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>Actionable insights, for example, implementing health system-level OUD protocols and guidelines and promoting availability of OUD treatment and education, are ways that primary care teams could increase treatment of patients with OUD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":"525-533"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying clinical correlates of drinking clusters during treatment for alcohol use disorder","authors":"Robert J. Kohler PhD,&nbsp;Hang Zhou PhD,&nbsp;Yasmin Zakiniaeiz PhD,&nbsp;Terril L. Verplaetse PhD,&nbsp;Vernon Garcia-Rivas PhD,&nbsp;MacKenzie R. Peltier PhD,&nbsp;Bubu A. Banini MD, PhD,&nbsp;Sherry A. McKee PhD,&nbsp;Walter Roberts PhD","doi":"10.1111/ajad.70132","DOIUrl":"10.1111/ajad.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Despite the availability of treatments for alcohol use disorder (AUD), relapse prevalence and health-related consequences associated with AUD remains high. Using data-driven approaches that enhance generalizability can help elucidate relationships between treatment outcomes and alcohol consumption, aiding in the discovery of novel treatment targets for AUD subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We merged data (<i>n</i> = 2045) across four Phase 2 randomized clinical trials affiliated with the NIAAA Clinical Investigations Group and a Phase 3 trial (NIAAA Sponsored). Participants were clustered based on self-reported drinking during treatment maintenance. A gradient boosted machine learning model with end-of-treatment clinical features was used to predict the clusters we identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified a three-cluster solution corresponding to low (<i>M</i>_{Standard Drinking Units (SDU)} = 1.68, <i>n</i> = 1677), moderate (<i>M</i>_SDU = 6.70, <i>n</i> = 253), and high (<i>M</i>_SDU = 12.92, <i>n</i> = 115) clusters of alcohol consumption during treatment maintenance. We achieved modest prediction of the clusters (Accuracy_Train= 71.0%; AUC_Train = 0.79) using demographics and end-of-treatment clinical and biological assessments. Between-cluster differences were observed between low and high clusters on measures of depression and anxiety (<i>M</i>_Difference= 0.49, SE = 0.13, <i>p</i> = .004), drinking consequences (<i>M</i>_Difference= 1.02, SE = 0.13, <i>p</i> &lt; .001) and liver functioning (0.39 ≤ <i>M</i>_Difference ≤ 0.52, 0.12 ≤ SE ≤ 0.13, 0.001 ≤ <i>p</i> ≤ .005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>These findings suggest that generalizable clusters of alcohol consumption exist across these clinical trials characterized by core demographics, clinical, and biological phenotypes, irrespective of the treatment received. We further show that some assessments may not be useful in distinguishing between higher levels of consumption.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>Identifying predictive features of AUD subtypes, across different phases of treatment, can assist clinicians in identifying individuals who require additional support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":"471-479"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis cessation and neurocognitive recovery: Patterns, predictors, and clinical implications—a systematic review","authors":"Valerio Ricci MD, PhD,&nbsp;Thomas Fraccalini MD,&nbsp;Giovanni Martinotti MD, PhD,&nbsp;Giuseppe Maina MD, PhD","doi":"10.1111/ajad.70156","DOIUrl":"10.1111/ajad.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Cannabis use disorder affects millions globally, with growing interest in neurocognitive recovery following cessation. The reversibility of cannabis-induced neuroadaptations remains critical for clinicians, given increasing cannabis potency and early initiation. This systematic review examines neurocognitive recovery patterns and biomarker changes following cannabis cessation, focusing on clinical implications and factors influencing recovery trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted using PubMed, EMBASE, PsycINFO, and Cochrane databases (2000–2025). Studies examining neurocognitive recovery following cannabis cessation were included, with abstinence periods ranging from acute (≥72 h) to extended (months to years). Primary outcomes included neuroimaging changes, cognitive performance, and biomarker recovery patterns. Study quality was assessed using Newcastle-Ottawa Scale and Cochrane Risk of Bias tools. Narrative synthesis was employed due to heterogeneity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six studies met the inclusion criteria. Neuroimaging demonstrated CB1 receptor normalization within 4 weeks and cognitive improvements within the first week of cessation. Recovery patterns varied by age of onset and use intensity. Adolescent-onset users showed less complete recovery than adult-onset users; heavy users required extended recovery periods. Cognitive deficits in attention and executive function persisted beyond acute cessation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Cannabis cessation produces substantial neurocognitive recovery, particularly within the first year. However, recovery requires extended clinical support, age-stratified approaches, and systematic cognitive monitoring. Current evidence challenges assumptions about permanent cannabis-related brain damage while highlighting vulnerabilities in adolescent populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>These findings provide evidence-based guidance for treatment duration, realistic expectation-setting, and individualized prognosis determination in cannabis use disorder recovery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":"451-470"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147502812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Opioid-related disorders increase patient-directed discharge in admissions for hemorrhagic or ischemic stroke","authors":"Rohan M. Shah BA,&nbsp;Shiv Patel BA,&nbsp;Brent Schnipke MD,&nbsp;Brandon Hamm MD, MS","doi":"10.1111/ajad.70157","DOIUrl":"10.1111/ajad.70157","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>Opioid use has been linked to increased stroke incidence and severity; however, data on effects during acute stroke hospitalization are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the 2016–2020 National Inpatient Sample to evaluate the effects of opioid disorders on patient-directed discharge (PDD) and length of stay (LOS) in 3,101,545 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>On multivariate analysis, opioid disorders were independently associated with discharge AMA (aOR: 2.29; 95% CI: 1.98–2.65) and longer LOS (β: 1.5, SE: 0.138; <i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Opioid disorders may predispose PDD and prolonged hospital courses in stroke admissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Scientific Significance</h3>\u0000 \u0000 <p>Opioid disorders may warrant targeted inpatient management and health system planning in stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":"547-550"},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DISCOVER MEMPHIS: Use this handy guide to plan your free time at the Annual Meeting","authors":"","doi":"10.1111/ajad.70182","DOIUrl":"https://doi.org/10.1111/ajad.70182","url":null,"abstract":"<p>Click on the PDF file for live links</p><p></p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148269031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REGISTRATION OPEN: Don't miss out on next year's Annual Meeting, held in Memphis, TN!","authors":"","doi":"10.1111/ajad.70183","DOIUrl":"https://doi.org/10.1111/ajad.70183","url":null,"abstract":"<p>Click on the PDF file for live links</p><p></p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":"35 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajad.70183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148269212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social media use and health outcomes as moderated by rurality among sexual minority young adults.","authors":"Erin A Vogel, McKenna K Nhem, Mahalaxmi K Das, Katelyn F Romm","doi":"10.1111/ajad.70086","DOIUrl":"10.1111/ajad.70086","url":null,"abstract":"<p><strong>Background and objectives: </strong>Social media use may influence substance use and mental health symptoms differently for urban versus rural sexual minority young adults (SMYAs).</p><p><strong>Methods: </strong>SMYAs aged 18-25 in Oklahoma and surrounding states were recruited via social media for a two-wave online survey study in 2023-2024. Among participants reporting any social media use, multivariable logistic regressions examined associations of social media use variables and rural-urban residence with health outcomes. Multiple group regressions examined whether associations varied for rural- versus urban-residing participants.</p><p><strong>Results: </strong>The sample (N = 493; M_age = 21.68 [SD = 2.15]) was 35.7% rural-residing, 72.1% female sex, 47.1% gender-minoritized, and 41.6% racially and/or ethnically minoritized. Most participants (61.9%) had moderate-to-severe depressive and/or anxiety symptoms; 39.8% reported current tobacco use (49.7% cannabis, 74.6% alcohol). Rural-urban residence moderated associations between social media use and substance use. Among urban participants only, social media use frequency was associated with tobacco and alcohol use. Among rural participants, community connectedness was associated with lower odds of mental health symptoms, tobacco use, and cannabis use and social media-based social support was associated with lower odds of cannabis use.</p><p><strong>Discussion and conclusions: </strong>Urban SMYAs may experience negative effects of social media use, including increased risk of substance use. Rural SMYAs may benefit from supportive connection from SMYA peers on social media, reducing their substance use risk.</p><p><strong>Scientific significance: </strong>Prior research has identified benefits (e.g., social support) and harms (e.g., substance use) of social media use. This study found that associations of social media use with substance use among SMYAs differed by urbanicity.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"387-395"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance use and sexual orientation among adolescents: Differences by age group and sex in the 2023 National Survey of Drug Use and Health.","authors":"Timothy J Grigsby, Rachel Hoopsick, Dylan Barker, Elise Devier, Amber Amis, R Andrew Yockey","doi":"10.1111/ajad.70087","DOIUrl":"10.1111/ajad.70087","url":null,"abstract":"<p><strong>Background and objectives: </strong>Adolescent substance use is a critical public health concern with significant long-term consequences, yet research on disparities by sexual orientation remains limited. Despite the unique stressors faced by sexual minority youth-particularly bisexual individuals-that increase their risk for substance use, most studies investigate disparities among older adolescents and adults. Using recent national data, this study aims to fill this gap and inform targeted prevention and intervention efforts for sexual minority youth.</p><p><strong>Methods: </strong>We leveraged data from the 2023 National Survey on Drug Use and Health from youth aged 12-17 (N = 10,361). Using weighted logistic regression models, we examined the separate relationships between sexual orientation and past-year substance use (i.e., tobacco, marijuana, and alcohol) stratified by age and sex assigned at birth.</p><p><strong>Results: </strong>Among adolescents, 4.73% reported tobacco use, 11.2% reported marijuana use, and 17.2% reported alcohol use. Logistic regression models indicated that, compared to heterosexual youth, bisexual youth had higher odds of using tobacco (OR = 2.00, 95% CI = 1.37-2.90), marijuana (OR = 1.85, 95% CI = 1.43-2.40), and alcohol (OR = 1.32, 95% CI = 1.02-1.69), while gay/lesbian youth had lower odds of tobacco use (OR = 0.47, 95% CI = 0.24-0.94), but higher odds of alcohol (OR = 1.60, 95% CI = 1.06-2.44). Notable differences were observed across sex and age.</p><p><strong>Conclusions and scientific significance: </strong>Findings from the current study highlight significant disparities in substance use among youth based on sexual orientation, particularly among bisexual adolescents. We recommend that prevention and intervention efforts incorporate age-specific and gender-sensitive approaches to address the unique stressors faced by sexual minority youth.</p>","PeriodicalId":7762,"journal":{"name":"American Journal on Addictions","volume":" ","pages":"396-403"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145063409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}