Drug and alcohol dependence最新文献

{"title":"Sex disparities in outcome of medication-assisted therapy of opioid use disorder: Nationally representative outpatient clinic data.","authors":"Eduardo R Butelman, Yuefeng Huang, Alicia McFarlane, Carolann Slattery, Rita Z Goldstein, Nora D Volkow, Nelly Alia-Klein","doi":"10.1016/j.drugalcdep.2024.112535","DOIUrl":"https://doi.org/10.1016/j.drugalcdep.2024.112535","url":null,"abstract":"<p><strong>Question: </strong>The opioid epidemic causes massive morbidity, and males have substantially greater overdose mortality rates than females. It is unclear whether there are sex-related disparities at different stages in the trajectory of opioid use disorders (OUD), from large samples in the community.</p><p><strong>Goal: </strong>To determine sex disparities in non-medical opioid use (NMOU) at the end of treatment with medications for opioid use disorder (MOUD), using national data.</p><p><strong>Design: </strong>Observational study of outpatient MOUD programs in the \"Treatment episode data set-discharges\" (TEDS-D) for 2019.</p><p><strong>Participants: </strong>Persons aged ≥ 18 in their first treatment episode, in outpatient MOUD-based therapy for heroin or other opioids (N = 10,065). The binary outcome was presence/absence of NMOU in the month prior to discharge.</p><p><strong>Results: </strong>In univariate analyses, males had higher odds of NMOU compared to females (odds ratio=1.22; p = 6.84 ×10^-5 after Bonferroni correction). A multivariable logistic regression detected a relatively small male>female odds ratio of 1.14 (p = 0.0039), surviving adjustment for demographic variables and social determinants of health. Several specific conditions were revealed in which males had greater odds of NMOU compared to females (e.g., if they were in the white racial category, and were not of hispanic ethnicity). Also, using by smoking, inhalation or injection routes (versus oral) was associated with greater odds of NMOU, irrespective of sex.</p><p><strong>Conclusions: </strong>This national community sample shows that males overall have greater odds of NMOU in their first treatment episode with MOUD, a potential indicator of more unfavorable outcomes. Further analyses should examine the underpinnings of this disparity, including clinical severity features.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"267 ","pages":"112535"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960472","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 novel prolonged exposure therapy protocol for improving therapy session attendance and PTSD symptoms among adults receiving buprenorphine or methadone treatment.","authors":"Kelly R Peck, Jillian Giannini, Gary J Badger, Rebecca Cole, Stacey C Sigmon","doi":"10.1016/j.drugalcdep.2024.112507","DOIUrl":"10.1016/j.drugalcdep.2024.112507","url":null,"abstract":"<p><strong>Background: </strong>Among individuals with opioid use disorder (OUD), the prevalence of posttraumatic stress disorder (PTSD) is higher than in the general population. Prolonged exposure (PE) therapy is highly efficacious for improving PTSD symptoms. However, few studies have evaluated PE in individuals receiving medications for OUD (MOUD) and treatment completion rates have been low. This randomized trial evaluated the efficacy of a novel protocol for improving PE attendance and PTSD symptoms among adults receiving buprenorphine or methadone treatment.</p><p><strong>Methods: </strong>Eligible participants (n=52) were randomized to one of three 12-week experimental conditions: (a) continued MOUD treatment as usual (TAU; n=17), (b) Prolonged Exposure Therapy (PE; n=17), or (c) PE with financial incentives contingent upon PE session attendance (PE+; n=18). Primary outcomes included percent of PE sessions attended and Clinician Administered PTSD Scale for DSM-5 (CAPS-5).</p><p><strong>Results: </strong>PE+ participants attended significantly more therapy sessions than PE participants (88 % vs 33 %; p<.001). All three groups reported significant (p<.05) improvements in CAPS-5 scores between intake and week 12, with no significant group differences. However, PE+ participants achieved significantly greater improvements in self-reported PTSD symptoms (p=.02) than TAU participants, as well as higher rates of diagnostic remission compared to TAU and PE participants (p<.001). Participants in the two PE groups did not exhibit an increase in non-prescribed drug use.</p><p><strong>Conclusions: </strong>In this study of adults receiving MOUD treatment, PE+ was efficacious for increasing PE attendance. Our findings also provide promising support for the efficacy of PE+ for improving PTSD symptoms without exacerbating substance use.</p><p><strong>Clinical trial number: </strong>NCT04104022.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112507"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793028","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 e-cigarettes as a smoking cessation treatment: A critical umbrella review analysis.","authors":"Renée O'Leary, Giusy Rita Maria La Rosa, Riccardo Polosa","doi":"10.1016/j.drugalcdep.2024.112520","DOIUrl":"10.1016/j.drugalcdep.2024.112520","url":null,"abstract":"<p><strong>Introduction: </strong>This umbrella review identified the current high-quality systematic reviews on e-cigarettes as a smoking cessation aid. What is the comparative effectiveness of e-cigarettes compared to other cessation treatments or approaches? We also investigated the systematic reviews for reporting biases.</p><p><strong>Methods: </strong>This umbrella review was based on the Methods for Overviews of Reviews (MOoR) framework and the Preferred Reporting Items for Overviews of Reviews (PRIOR). The search was conducted in six databases and grey literature searches in four sources, plus four secondary searches. A Vote Counting Direction of Effect was selected for the analysis method because of high heterogeneity among the primary studies and the potential overweighting of data from two primary studies.</p><p><strong>Results: </strong>Sixteen systematic reviews were retrieved. Eight with an AMSTAR2 rating of moderate or high confidence were included, encompassing 24 randomized controlled trials. The analysis found that in 8 of 11 comparisons, e-cigarettes were more effective, and 3 of 11 comparisons reported no statistically significant difference. No reviews concluded that e-cigarettes were significantly less effective than any treatment or no treatment.</p><p><strong>Conclusions: </strong>Our analysis indicated that e-cigarettes are more effective than other treatments for smoking cessation. For ENDS compared solely to NRT, the evidence was mixed and still favored the effectiveness of ENDS. In any case, the success rates for cessation with ENDS was 10 % - 12 % at 6 months to one year, and the effect of relapse has not been sufficiently studied. New treatments and approaches are urgently needed.</p><p><strong>Registration: </strong>PROSPERO CRD42023406165; International Registered Report Identifier (IRRID): PRR1-10.2196/47711.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112520"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815337","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":"Patient and provider experiences with opioid use disorder care delivered via telehealth: A systematic mixed-studies review.","authors":"Shoshana V Aronowitz, Naomi Zucker, Morgan Thompson, Richard James, Justin Clapp, David Mandell","doi":"10.1016/j.drugalcdep.2024.112522","DOIUrl":"10.1016/j.drugalcdep.2024.112522","url":null,"abstract":"<p><strong>Introduction: </strong>Since the onset of the COVID-19 pandemic and loosening of some opioid use disorder (OUD) treatment regulations in the U.S. and Canada, there has been a rapid rise in the use of telehealth for buprenorphine induction, maintenance, and counseling (tele-bupe). Previous reviews highlight that tele-bupe can expand access to OUD care and improve treatment retention, but none to date have synthesized patient and clinician experiences with and perceptions of this care.</p><p><strong>Objective: </strong>This review synthesized findings from quantitative, qualitative, and mixed-methods studies that examined patient and provider experiences with tele-bupe. We assessed the perceived effectiveness and acceptability of this treatment modality.</p><p><strong>Methods: </strong>Our systematic review followed PRISMA 2020 guidelines. In July 2023, we searched six databases using keywords 'telehealth AND opioid use disorder' (and related terms) for papers published in English. Papers were eligible for inclusion if they reported findings about patient or provider experiences. Two reviewers screened studies for inclusion; 40 studies were included. We used a data-based convergent synthesis design to extract and synthesize findings, and the Mixed-Methods Appraisal Tool to appraise studies.</p><p><strong>Results: </strong>Patients and providers hold generally positive views of tele-bupe and most support its continued use in some form, citing multiple benefits, including accessibility and convenience. Most studies also identified barriers to tele-bupe, including technological challenges. Patients and providers differed in how they thought telehealth affects the clinical relationship, with providers expressing more concern about rapport-building and patients stating that being in their own environments during visits facilitated comfort and openness. The findings also suggest that providers are conflicted about when and for whom tele-bupe is appropriate.</p><p><strong>Conclusion: </strong>Overall, both patients and providers view tele-bupe favorably; however, providers are conflicted about the patients and situations for which it is appropriate, which may lead to inequities in who is offered this form of care.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112522"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815344","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":"Divergence in cannabis and alcohol use disorder prevalence trends from 2002 to 2019.","authors":"Samuel F Acuff, Justin C Strickland","doi":"10.1016/j.drugalcdep.2024.112521","DOIUrl":"10.1016/j.drugalcdep.2024.112521","url":null,"abstract":"<p><strong>Introduction: </strong>Despite increases in the availability, potency, and consumption of cannabis, epidemiological data suggest decreases in the prevalence of cannabis use disorder (CUD) in some groups. Understanding mechanisms for these changes may help improve diagnostic tools for identifying disordered use. This analysis evaluates changes in CUD compared to a substance with comparably stable social and environmental context (alcohol use disorder [AUD]) as well as treatment engagement and need from 2002 to 2019.</p><p><strong>Methods: </strong>Data were from the National Survey on Drug Use and Health. Outcomes included CUD and AUD symptoms, treatment engagement, and perceived need. Temporal trends and average annual rate of change [AARC] were computed.</p><p><strong>Results: </strong>Between 2002 and 2019, daily cannabis use prevalence increased by 94 % (AARC=11.68 %), whereas CUD prevalence among those using cannabis daily reduced by 47.9 % (AARC=-10.30 %). Daily alcohol use prevalence decreased by 10.86 % (AARC=-1.90 %), and AUD prevalence among those using alcohol daily reduced by 3.9 % (AARC=-0.67 %). Prevalence of individual 12-month CUD criteria among those using cannabis daily decreased (-13.4 to -59.6 % change; AARC = -2.4 % to -14 %). Among those using cannabis daily, trends in prevalence of individual AUD criteria varied, with some criteria increasing in prevalence and others decreasing (-30.2-24.6 % change; AARC = -5.82-3.7 %). Treatment engagement and perceived need decreased for cannabis, whereas treatment engagement increased and perceived need decreased for alcohol.</p><p><strong>Conclusion: </strong>These results suggest that CUD and AUD criteria may be determined within the cultural context dictating the definition of harm which has changed for cannabis, but not alcohol, from 2002 to 2019.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112521"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808896","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":"Dose by design: How limits on nicotine flux and puff duration affect the abuse liability of electronic nicotine delivery systems.","authors":"Rose S Bono, Augustus M White, Rabia Imran, Gabrielle T Maldonado, Thokozeni Lipato, Andrew J Barnes, Caroline O Cobb","doi":"10.1016/j.drugalcdep.2024.112508","DOIUrl":"10.1016/j.drugalcdep.2024.112508","url":null,"abstract":"<p><strong>Introduction: </strong>Electronic nicotine delivery system (ENDS) product standards for nicotine flux (nicotine emitted/second), combined with limiting puff duration, could control nicotine dose and support ENDS regulations. We assessed behavioral and subjective abuse liability indices for ENDS varying in nicotine flux with fixed puff duration among people who smoke.</p><p><strong>Methods: </strong>This within-subjects study included 32 adults who smoked cigarettes. Own-brand cigarettes (OB) and four unflavored ENDS were evaluated: no-flux (0μg/s), low-flux (36.01μg/s), cigarette-like-flux (90.03μg/s), and high-flux (180.06μg/s), with ENDS puff duration limited to 2s. Outcomes from behavioral economic choice tasks included demand intensity (drug purchase task [DPT]), cross-price elasticity (cross-product DPT), puffs earned (progressive ratio task [PRT]), and breakpoint (cross-product PRT). Subjective effects were nicotine abstinence symptoms (NAS), aversive effects, product liking, and sensation. Condition differences were analyzed using linear mixed models.</p><p><strong>Results: </strong>All ENDS were associated with significantly lower demand intensity, puffs earned, NAS suppression, and liking compared to OB, yet would serve as OB substitutes. Low-flux ENDS were a significantly stronger OB substitute than cigarette-like-flux ENDS, and were associated with more puffs earned than no and high-flux ENDS. Compared with other ENDS, high-flux ENDS generally reduced NAS more, were less pleasant, tasted worse and produced more intense harshness/irritancy and throat hit.</p><p><strong>Conclusions: </strong>ENDS abuse liability and substitution potential varies by nicotine dose, which could be controlled via product standards integrating nicotine flux and puff duration. ENDS that exceed a cigarette nicotine dose may not be necessary to encourage transition from cigarettes to ENDS.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112508"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808900","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":"Protecting historically marginalized groups or targeted marketing? A computational analysis of individuals engaging with public and protected cigar-branded tweets.","authors":"Jiaxi Wu, Lynsie R Ranker, Juan Manuel Origgi, Jianqi Ma, Deyan Hao, Emelia J Benjamin, Jennifer Cornacchione Ross, Ziming Xuan, Derry Wijaya, Jessica L Fetterman, Traci Hong","doi":"10.1016/j.drugalcdep.2024.112516","DOIUrl":"10.1016/j.drugalcdep.2024.112516","url":null,"abstract":"<p><strong>Introduction: </strong>Swisher Sweets, a leading brand of little cigars and cigarillos in the United States, switched its Twitter account to protected status, limiting access to its tweets. This study examines how the protected status of Swisher Sweets tweets influences post engagement, aiming to inform regulatory strategies for branded tobacco promotions on social media.</p><p><strong>Method: </strong>Using natural language processing, we predicted the demographics of individuals replying to Swisher Sweets' public and protected tweets. Engagement with public versus protected tweets was compared using a Mann-Whitney U test, and a mixed-effects logistic regression assessed the likelihood of different demographics replying to each tweet type. Chi-square analyses examined word frequencies related to any flavor, concept flavors, and characterizing flavor in replies to public and protected tweets.</p><p><strong>Results: </strong>Overall, 16 % of individuals replying to Swisher Sweets' tweets were predicted to be under 21, and 65 % were Black. No significant difference was found in average reply counts to public versus protected tweets (p = .78). Black individuals were 2.61 times more likely than White individuals to engage with protected tweets after the status change (OR = 2.61, 95 % CI [1.36, 5.06], p = .004). Replies to protected tweets contained more words related to any flavor (adjusted p < .001) and concept flavors (adjusted p < .001) compared to public tweet replies.</p><p><strong>Conclusions: </strong>Our study suggests that the protected status on Twitter was ineffective in preventing underage engagement with Swisher Sweets' branded tweets and may facilitate targeted marketing among Black individuals.</p><p><strong>Implications: </strong>More stringent age verification procedures and promotional regulatory measures are needed to prevent targeted tobacco brand marketing on social media.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112516"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848734","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 wearable alcohol biosensor: Exploring the accuracy of transdermal drinking detection.","authors":"Catharine E Fairbairn, Jiaxu Han, Eddie P Caumiant, Aaron S Benjamin, Nigel Bosch","doi":"10.1016/j.drugalcdep.2024.112519","DOIUrl":"10.1016/j.drugalcdep.2024.112519","url":null,"abstract":"<p><strong>Background: </strong>Trace amounts of consumed alcohol are detectable within sweat and insensible perspiration. However, the relationship between ingested and transdermally emitted alcohol is complex, varying across environmental conditions and involving a degree of lag. As such, the feasibility of real-time drinking detection across diverse environments has been unclear. In the current research we revisit sensor performance using new tools, exploring the accuracy of a new generation of rapid-sampling transdermal biosensor for contemporaneous drinking detection across diverse environments via machine learning.</p><p><strong>Methods: </strong>Regular drinkers (N = 100) attended three laboratory sessions involving the experimental manipulation of alcohol dose, rate of consumption, and environmental dosing conditions. Participants further supplied breath alcohol concentration (BAC) readings in the field over 14 days. Participants wore compact wrist sensors capable of rapid sampling (20sec intervals). Transdermal sensor data was translated into alcohol use estimates using machine learning, integrating only transdermal data collected prior to the point of BAC assessment.</p><p><strong>Results: </strong>A total of 5.39 million transdermal readings (28,615hours) and 12,699 BAC readings were collected for this research. Models indicated strong transdermal sensor accuracy for real-time drinking detection across both laboratory and field contexts (AUROC, 0.966, 95 % CI, 0.956-0.972; Sensitivity, 89.8 %; Specificity, 90.6 %). Models aimed at differentiating high-risk (≥0.08 %) drinking levels yielded intermediate (AUROC, 0.738; 95 % CI, 0.698-0.777; only drinking episodes) to strong (AUROC, 0.941, 95 % CI, 0.929-0.954; all data) accuracy levels.</p><p><strong>Conclusions: </strong>Results indicate a range of useful future applications for transdermal alcohol sensors including long-term health tracking, medical monitoring, and just-in-time relapse prevention.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112519"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873666","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":"Vaping nicotine and cannabis on the same occasion is linked to increased vaping consumption among young adults: A smartphone-based daily diary study.","authors":"Nhung Nguyen, Salomeh Keyhani, Gregory M Marcus, Vuong V Do, Deanna M Halliday, Ellen D Herbst, Pamela M Ling","doi":"10.1016/j.drugalcdep.2024.112517","DOIUrl":"10.1016/j.drugalcdep.2024.112517","url":null,"abstract":"<p><strong>Significance: </strong>Vaping both nicotine and cannabis in the past 30 days (co-vaping) is common among young adults. It is unclear which co-vaping patterns may increase substance use and dependence. We examined day-level associations between vaping patterns with vaping quantity.</p><p><strong>Method: </strong>Daily assessments of vaping behaviors were collected via smartphone for 30 consecutive days among 111 young adults (aged 18-29, vaping nicotine/cannabis at least 20 days during the past month) in California, US, in 2023-2024. Participants reported daily use of nicotine/tobacco (e.g., e-cigarettes, cigarettes) and cannabis products (e.g., vaporized/combustible cannabis). Vaping intensities were the number of times a participant vaped nicotine/cannabis in an entire day. Vaping patterns on a given day were categorized into non-vaping, single-substance vaping, same-day different-occasion co-vaping, and same-occasion co-vaping. Generalized linear mixed-effect models examined day-level associations between these patterns and vaping intensity outcomes, controlling for covariates.</p><p><strong>Results: </strong>Of the participants, 84.7 % reported co-vaping and 15.3 % reported single-substance vaping in the past 30 days. Of the 2522 daily assessments, 42.7 % were nicotine-only vaping, 9.7 % cannabis-only vaping, 16.5 % same-day different-occasion co-vaping, and 16.9 % same-occasion co-vaping. Participants reported a greater intensity of vaping nicotine and cannabis on days with same-occasion co-vaping compared to days with other vaping patterns. Vaping intensities on days with same-day different-occasion co-vaping were greater than on days with single-substance vaping or non-vaping.</p><p><strong>Conclusions: </strong>Closer temporal proximity of co-vaping was associated with greater intensities of vaping nicotine and cannabis. Same-occasion co-vaping is linked to the greatest increase in vaping intensity. Interventions addressing this high-risk pattern are warranted.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112517"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793037","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":"MOUD use among Hispanic clients increased post-ACA, yet differed by heritage and geographic location.","authors":"Carolina-Nicole Herrera, Sugy Choi, Natrina L Johnson","doi":"10.1016/j.drugalcdep.2024.112509","DOIUrl":"10.1016/j.drugalcdep.2024.112509","url":null,"abstract":"<p><strong>Background: </strong>Overdose death rates for Hispanic people rose 2010-2022. Opioid overdose rates grew faster among Hispanic people than non-Hispanic White people (\"White\"). Medication for opioid use disorder (MOUD) is an effective but underutilized intervention for decreasing overdose risk. The Affordable Care Act (\"ACA\") should have increased MOUD use, but insurance and behavioral health reforms differed by state. We examined to what extent MOUD use increased post-ACA implementation and differed for Hispanic people (overall and by heritage group) compared to White people who used opioids (\"clients\").</p><p><strong>Methods: </strong>We analyzed first annual ambulatory care episodes (TEDS-A, 2009-2019) for working-age Hispanic (N= 76,591) and White (N=444,753) clients. We categorized Hispanic clients by heritage group (Puerto Rican, Mexican, or Other Hispanic). We grouped states by Medicaid expansion status (California, Other Expansion States, and Non-Expansion States). We used logistic regression to compare the odds of MOUD use pre/post ACA within racial/heritage groups, and, separately, between racial/heritage groups using pre-ACA White clients as a reference group. We used linear probability difference-in-differences to confirm changes in MOUD use between Hispanic and White clients.</p><p><strong>Results: </strong>Among Hispanic clients in ambulatory care, MOUD use was lowest in the Non-Expansion States and highest in California. Nationally, only Puerto Rican and Other Hispanic heritage clients had higher odds of MOUD post-ACA compared to pre-ACA. Nationally and in Other Expansion States, Hispanic and White clients had similar increases in MOUD use post-ACA.</p><p><strong>Conclusions: </strong>MOUD use among Hispanic clients rose post-ACA, but differences remained between Hispanic heritage groups and between states.</p>","PeriodicalId":93983,"journal":{"name":"Drug and alcohol dependence","volume":"266 ","pages":"112509"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808909","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}