Highlights • This trial included emergency department patients with risky opioid medication use. • The intervention used a motivational interviewing framework and a computer aid. • The intervention ...reduced overdose risk behaviors more than enhanced usual care. • The approach is feasible and potentially effective for promoting safer opioid use
Abstract Background The abuse of synthetic cannabinoids has emerged as a public health concern over the past few years, yet little data exist characterizing the use of synthetic cannabinoids, ...particularly among patients seeking substance use disorder (SUD) treatment. In a sample of patients entering residential SUD treatment, we examined the prevalence of and motivations for synthetic cannabinoid use, and examined relationships of synthetic cannabinoid use with other substance use and demographic characteristics. Methods Patients ( N = 396; 67% male, 75% White, Mage = 34.8) completed self-report screening surveys about lifetime prevalence of synthetic cannabinoid use, route of administration, and motives for use. Results A total of 150 patients (38%) reported using synthetic cannabinoids in their lifetimes, primarily by smoking (91%). Participants chose multiple motives for use and the most commonly endorsed included curiosity (91%), feeling good/getting high (89%), relaxation (71%), and getting high without having a positive drug test (71%). Demographically, those who used synthetic cannabinoids were younger and more were White. They had higher rates of other substance use and higher scores on measures of depression and psychiatric distress. Conclusions Lifetime synthetic cannabinoid use was relatively common in SUD patients and many of those who used it reported doing so because they believed it would not result in a positive drug test. Further research is needed to characterize the extent of synthetic cannabinoid use among SUD treatment samples, and to establish understanding of the longitudinal trajectories of synthetic cannabinoid use in combination with other substance use, psychiatric distress, and treatment outcomes.
Objective: To examine the relationship between COVID-19-related distress and mental health among first-year college students. Participants: Data for this longitudinal study (n = 727) were collected ...before the school year (August 2019), end of fall semester (December 2019), and soon after the university suspended in-person instruction (April 2020). Methods: We used multivariable log-linear and logistic regressions to examine continuous and dichotomous outcomes on the 9-item Patient Health Questionnaire and the 7-item Generalized Anxiety Disorder scale. Results: The most consistent predictor of during-pandemic mental health was feeling extremely isolated (versus not at all), which was associated with increased symptom severity of depression (proportional change95% CI = 2.431.87, 3.15) and anxiety (2.021.50, 2.73) and greater odds of new moderate depression (OR95% CI = 14.833.00, 73.41) and anxiety (24.742.91, 210.00). Greater COVID-19-related concern was also related to increased mental health symptoms. Conclusions: Results highlight the need for mental health services during crises that lead to social isolation.
•We examined naloxone access of people who inject drugs (PWID) in Southeast Michigan.•Overall self-reported naloxone access was: 24.9 %.•PWID naloxone access by location were: 18.3 %, urban; 41.9 %, ...suburban/rural.•Naloxone access is associated with race/ethnicity, social economic status (e.g. insurance coverage) and recent homelessness.•No age or gender differences in naloxone access.
Given the rising incidence of opioid overdose in the United States, naloxone access is critical for high-risk populations, such as persons who inject drugs (PWID). Yet not all PWID have access to this life-saving antidote. With PWID in Michigan recruited via respondent driven sampling in 2017, after the 2016 standing order expanding naloxone availability through local pharmacies, we explored possible access disparities.
With 46 seeds recruited from agencies serving local PWID communities, we obtained a sample of N = 410 PWID from Southeast Michigan (n = 285 form urban Detroit, and 125 for suburban/rural areas outside Detroit). Participants completed questionnaires detailing socio-demographics, health history, substance use and treatment access, including naloxone. We used multiple logistic regression to examine the predictors of self-reported naloxone access based on participant characteristics (e.g., demographics, health status) and geography (urban vs. suburban/rural).
Self-reported naloxone access differed significantly by location (urban = 18.3 %; suburban/rural = 41.9 %). In multivariable analyses, naloxone access was significantly associated with race, household income, employment, health insurance, recent homelessness, prescription opioid usage, Hepatitis A and C status, Hepatitis A vaccination, Hepatitis C testing, access to drug treatment and services, and hospital as the usual place of care.
Despite recent policies to expand access, our results indicate that naloxone access among high-risk PWID is low. This warrants future research to identify effective channels to reduce barriers and increase naloxone access.
Efforts to intervene with subgroups at particularly high risk for alcohol use require information on factors that differentiate drinking intensity levels. This article summarizes existing research ...and provides new findings on sociodemographics and risk factors that differentiate high-intensity drinking (HID) to provide context for developing and delivering interventions for the highest-risk drinkers. Cross-sectional data were obtained in 2019 from participants who reported past 30-day alcohol use in 2018 as part of the nationally representative 12th grade Monitoring the Future study. Among past 2-week drinkers in 2019 (N = 601; modal age 19; 57.0% male; 67.4% non-Hispanic White), bivariate associations between drinking intensity (moderate drinking 1-4 drinks for women/1-5 drinks for men, binge-only drinking 4-7/5-9 drinks, and HID 8+/10+ drinks) and a range of sociodemographic characteristics, risk factors, and alcohol-related consequences were examined. Results showed binge-drinking norms, social and enhancement drinking motives, nicotine vaping, and use of limiting/stopping drinking and manner of drinking protective behavioral strategies differentiated all drinking intensity levels, lending support to HID and binge-only drinking having an overlapping risk profile. However, there were also risk factors uniquely associated with HID, including sex, college attendance, employment, HID norms, use of serious harm reduction protective behavioral strategies, family history of drinking problems, any cigarette or drug use other than marijuana, and depression symptoms. Therefore, risk factors differentiate young adult drinking intensity. These results can inform efforts to adapt interventions for young adults who report HID.
Public Health Significance Statement
This study indicates that young adults who report high-intensity drinking have higher social and enhancement drinking motives than young adults who engage in drinking at binge levels below high-intensity drinking thresholds. Young adults who report high-intensity drinking are more likely to have a family history of drinking problems and to report more depression symptoms than young adults who engage in drinking at binge or moderate-intensity levels. The results from the present study suggest that brief interventions targeting HID likely need to address unique risks, including other substance use, depression symptoms, fewer protective behavioral strategies, and negative alcohol consequences.
Central to measuring the impact of the COVID-19 pandemic on HIV is understanding the role of loss of access to essential HIV prevention and care services created by clinic and community-based ...organization closures. In this paper, we use a comprehensive list of HIV prevention services in four corridors of the US heavily impacted by HIV, developed as part of a large RCT, to illustrate the potential impact of service closure on LGBTQ+ youth.
We identified and mapped LGBTQ+ friendly services offering at least one of the following HIV-related services: HIV testing; STI testing; PrEP/PEP; HIV treatment and care; and other HIV-related services in 109 counties across four major interstate corridors heavily affected by HIV US Census regions: Pacific (San Francisco, CA to San Diego, CA); South-Atlantic (Washington, DC to Atlanta, GA); East-North-Central (Chicago, IL to Detroit, MI); and East-South-Central (Memphis, TN to New Orleans, LA).
There were a total of 831 LGBTQ+ youth-friendly HIV service providers across the 109 counties. There was a range of LGBTQ+ youth-friendly HIV-service provider availability across counties (range: 0-14.33 per 10,000 youth aged 13-24 (IQR: 2.13), median: 1.09); 9 (8.26%) analyzed counties did not have any LGBTQ+ youth-friendly HIV service providers. The Pearson correlation coefficient for the correlation between county HIV prevalence and LGBTQ+ youth-friendly HIV service provider density was 0.16 (p = 0.09), suggesting only a small, non-statistically significant linear relationship between a county's available LGBTQ+ youth-friendly HIV service providers and their HIV burden.
As the COVID-19 pandemic continues, we must find novel, affordable ways to continue to provide sexual health, mental health and other support services to LGBTQ+ youth.
•Beyond disease transmission, COVID-19 is impacting other health behaviors.•Students at college campuses typically have high rates of binge drinking (BD).•Students reported on their BD frequency pre- ...and post-campus shutdown due to COVID-19.•Post-shutdown, most students reported no change in BD frequency.•Many students reported less BD post-shutdown; few reported more BD.
The COVID-19 pandemic is associated with reports of increased substance use. College students are a population of concern for high risk binge drinking and their behavior may be particularly impacted by COVID-19 campus closures. Therefore, we examine first-year college students’ binge drinking soon after their university’s pandemic-related suspension of in-person operations.
Students from a single campus (N = 741; age: M = 18.05, SD = 0.22) completed one assessment in April-May 2020 post-campus closure (March 2020) including theoretically-informed measures (e.g., drinking motives, norms) and two items of self-reported pre- and post-closure binge drinking frequency, the focus of these analyses.
About half of students consistently reported not binge drinking pre- and post-closure; 6.75% reported a consistent frequency of binge drinking pre- and post-closure. Many (39.41%) reported lower 30-day binge drinking post-campus closure compared to their pre-closure reports; few (4.18%) reported higher 30-day binge drinking frequency post-campus closure. Students reporting lower binge drinking post-closure showed differences in coping, social, and enhancement drinking motives and isolation. Students reporting greater post-closure binge drinking reported higher perceived drinking norms and were more likely to be in Greek life.
This study demonstrates self-reported patterns in binge drinking among first-year college students at the point of COVID-19 campus closures. Pandemic-related college closures may have been a temporary environmental intervention on this high-risk behavior for some students. Although many students were not binge drinking, some continued binge drinking after closure and may benefit from preventive interventions.
PDF
