•~73% of patients with OUD evidenced co-occurring substance use confirmed via urine toxicology.•Benzodiazepines (~57%) and cannabis (~53%) were the most common co-occurring substances.•Co-occurring ...substance users were younger than those who were positive for opioids alone.•Higher prevalence of co-occurring substance users were HCV + than those using opioids alone.•Rate of co-occurring opioid and amphetamine use increased from ~12% in 2014 to ~47% in 2018.
Funding to address the current opioid epidemic has focused on treatment of opioid use disorder (OUD); however, rates of other substance use disorders (SUDs) remain high and non-opioid related overdoses account for nearly 30% of overdoses. This study assesses the prevalence of co-occurring substance use in West Virginia (WV) to inform treatment strategies. The objective of this study was to assess the prevalence of, and demographic and clinical characteristics (including age, gender, hepatitis C virus (HCV) status) associated with, co-occurring substance use among patients with OUD in WV.
This retrospective study utilized the West Virginia Clinical and Translation Science Institute Integrated Data Repository, comprised of Electronic Medical Record (EMR) data from West Virginia University Medicine. Deidentified data were extracted from inpatient psychiatric admissions and emergency department (ED) healthcare encounters between 2009 and 2018. Eligible patients were those with OUD who had a positive urine toxicology screen for opioids at the time of their initial encounter with the healthcare system. Extracted data included results of comprehensive urine toxicology testing during the study timeframe.
3,127 patients met the inclusion criteria of whom 72.8% had co-occurring substance use. Of those who were positive for opioids and at least one additional substance, benzodiazepines were the most common co-occurring substances (57.4% of patients yielded a positive urine toxicology screen for both substances), followed by cannabis (53.1%), cocaine (24.5%) and amphetamine (21.6%). Individuals who used co-occurring substances were younger than those who were positive for opioids alone (P < 0.001). There was a higher prevalence of individuals who used co-occurring substances that were HCV positive in comparison to those who used opioids alone (P < 0.001). There were limited gender differences noted between individuals who used co-occurring substances and those who used opioids alone. Among ED admissions who were positive for opioids, 264 were diagnosed with substance toxicity/overdose, 78.4% of whom had co-occurring substance use (benzodiazepines: 65.2%; cannabis: 44.4%; cocaine: 28.5%; amphetamine: 15.5%). Across the 10-year timespan, the greatest increase for the entire sample was in the rate of co-occurring amphetamine and opioid use (from 12.6% in 2014 to 47.8% in 2018).
These data demonstrate that the current substance use epidemic extends well beyond opioids, suggesting that comprehensive SUD prevention and treatment strategies are needed, especially for those substances which do not yet have any evidence-based and/or medication treatments available.
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Drawing upon media framing theory and the concept of cognitive scripts, this article provides a new interpretation of the context in which the famous World War II photograph ‘Raising the Flag on Iwo ...Jima’ appeared. This interpretation is based primarily on an examination of American newspaper and newsreel coverage from the Pacific island battles prior to Iwo Jima. The coverage – especially the pictorial coverage – often followed a three-step sequence that showed US forces proceeding from a landing to a series of skirmishes, then culminating with a flag-raising image. This created a predictable cognitive script. That script, combined with other framing devices found in the news coverage (such as metaphors and catchphrases), conveyed the misleading message that the Allies’ final victory over Japan was imminent in early 1945. The Iwo Jima photo drove home that message more emphatically than anything else. This circumstance had profound implications for government policy at the time and, in retrospect, it illustrates the potency of media framing – particularly in times of crisis or war.
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This article presents a study of the rhetorical dynamics of patriarchal advertising in the United States during World War II. The analysis scrutinizes a series of War Advertising Council (WAC) ads ...that targeted a wide swath of women on the home front, doing so through the depiction of negative and positive role models. The essay concludes that in these sorts of appeals WAC tacitly relied on rhetorical norms, which acted as a gendered means of patriarchal control in the face of the increased wartime autonomy that was enjoyed by many women during the war years.
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This essay investigates the authenticity of Geraldine Hoff Doyle’s widely accepted status as the model for the World War II–era “We Can Do It!” poster. After considering the rhetorical nature of the ...so-called woozle effect, the analysis endeavors to counter this particular woozle by plotting a reverse narrative. Taking the form of a quest that moves backward through a metaphorical forest of visual rhetoric, the essay initially traces the sources of Doyle’s tale into the recent past and, subsequently, into the original visual context. At length, it debunks Doyle’s claim while identifying Naomi Parker as a previously unknown figure in the controversy surrounding the poster.
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This essay argues against the prevailing historical conception that George Strock’s graphic photograph of three lifeless Marines—published by Life magazine on September 20, 1943—was the definitive ...point when domestic U.S. propaganda began to portray increasingly grisly images of dead American soldiers. After considering how the visual culture of the home front made the photo’s publication a dubious prospect for the government, I examine a series of predecessor images that arguably helped construct a rhetorical space in which such graphic depictions could gradually gain public acceptance and that, ultimately, ushered in a transformation of the home front’s visual culture.
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This article draws on the concepts of narrative interactivity and closure to investigate three World War II-era print media characters. The analysis details how Al Parker's Mary & Jane and Norman ...Rockwell's Willie Gillis developed a perceived authenticity that invited fans to envision the propaganda drawings as having lives beyond their artistic origins. The essay concludes that the narrative arcs of these characters prefigured the imagined relationships that subsequent generations developed with televised characters.
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Kimble examines the U.S. Treasury's eight war bond drives that raised over $185 billion-the largest single domestic propaganda campaign known to that time. The campaign enlisted such figures as Judy ...Garland, Norman Rockwell, Irving Berlin, and Donald Duck to cultivate national morale and convince Americans to buy war bonds.
In the wake of Pearl Harbor, President Roosevelt called for the largest arms buildup in our nation's history. A shortage of steel, however, quickly slowed the program's momentum, and arms production ...fell dangerously behind schedule. The country needed scrap metal. Henry Doorly, publisher of theOmaha World-Herald, had the solution.Prairie Forgetells the story of the great Nebraska scrap drive of 1942-a campaign that swept the nation and yieldedfive million tonsof scrap metal, literally salvaging the war effort itself.
James J. Kimble chronicles Doorly's conception of a fierce competition pitting county against county, business against business, and, in schools across the state, class against class-inspiring Nebraskans to gather 67,000 tons of scrap metal in only three weeks. This astounding feat provided the template for a national drive. A tale of plowshares turned into arms,Prairie Forgegives the first full account of how home became home front for so many civilians.
...his consistent public depictions of the United States "as one large neighborhood" (p. 2) facilitated an attractive vision of national unity throughout some of the country's bleakest years, ...allowing him to tout particular values and to argue forcefully for bolstering the benign power of the federal government. Stuckey traces the founding ideals of the United Nations back to his portrayal of "a global neighborhood" that featured "equality among states, noninterference in domestic matters, free and open trade, and peace through democratic capitalism" (p. 204).
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