Kratom is a plant with partial opioid agonist effects, and its use has become popular to ameliorate symptoms of opioid withdrawal. However, use has been linked to thousands of poisonings, although ...most have involved use of other drugs. Little is known regarding prevalence and correlates of use in the general U.S. population.
Data were examined from the 2019 National Survey on Drug Use and Health, a nationally representative probability sample of non-institutionalized individuals aged ≥12 years in the U.S. (N=56,136). Prevalence and correlates of past-year kratom use were estimated. Data were analyzed in 2020.
An estimated 0.7% (95% CI=0.6, 0.8) of individuals in the U.S. have used kratom in the past year. Past-year proxy diagnosis of prescription opioid use disorder was associated with increased odds for kratom use (AOR=3.20, 95% CI=1.38, 7.41), with 10.4% (95% CI=6.7, 15.9) of those with use disorder reporting use. Opioid misuse not accompanied with use disorder was not associated with kratom use. Those reporting past-year cannabis use both with (AOR=4.33, 95% CI=2.61, 7.19) and without (AOR=4.57, 95% CI=3.29, 6.35) use disorder and those reporting past-year cocaine use (AOR=1.69, 95% CI=1.06, 2.69) and prescription stimulant misuse (AOR=2.10, 95% CI=1.44, 3.05) not accompanied with use disorder were at higher odds for kratom use.
Kratom use is particularly prevalent among those with prescription opioid use disorder, but it is also prevalent among people who use other drugs. Research is needed to determine reasons for use and potential dangers associated with adding kratom to drug repertoires.
Although morbidity and mortality related to synthetic opioids such as illicitly manufactured fentanyl are monitored in the U.S., there has been a lack of national survey data focusing on use. Survey ...data are important because self-report can help estimate prevalence of use among living persons.
Data were examined from the 2022 National Survey on Drug Use and Health, a nationally representative probability sample of non-institutionalized individuals aged ≥12 years in the U.S. (N=59,069). Prevalence and correlates of past-year use of illicitly manufactured fentanyl were estimated. Data were analyzed in 2024.
The estimated prevalence of past-year illicitly manufactured fentanyl use was 0.23% (95% CI=0.17, 0.31). Compared with no past-year use, individuals were at increased odds for illicitly manufactured fentanyl use if proxy diagnosed with use disorder involving use of cannabis (AOR=3.72, 95% CI=1.34, 10.32), cocaine (AOR=11.96, 95% CI=4.78, 29.93), methamphetamine (AOR=5.60, 95% CI=1.65, 19.02), heroin (AOR=20.56, 95% CI=8.90, 47.52), and/or prescription opioids (AOR=10.65, 95% CI=3.54, 32.03). (Mis)use without use disorder was only significant for prescription opioids (AOR=5.77, 95% CI=2.55, 13.06). Those receiving treatment for substance use in the past year were also at increased odds for use (AOR=5.79, 95% CI=2.58, 13.00).
Prevalence of illicitly manufactured fentanyl use is rare in the general U.S. population. Whereas past-year (mis)use of other drugs (without use disorder) was not consistently associated with illicitly manufactured fentanyl use, cannabis, cocaine, methamphetamine, heroin, and prescription opioid use disorder was associated with higher odds of illicitly manufactured fentanyl use, suggesting that more severe use of various drugs is more of a risk factor than use.
People who attend nightclubs and dance festivals—particularly those that feature electronic dance music (EDM), are at high risk for use of cocaine and other party drugs. Given that cocaine is now ...sometimes adulterated with fentanyl, this study examines trends in people's knowledge about such risk of adulteration to inform prevention and harm reduction efforts. Adults were surveyed entering randomly selected EDM events (including dance festivals) in New York City in 2018, 2019, 2021, and 2022 (n = 2107). They were asked whether they agree that some dealers sell cocaine containing fentanyl, and trends in agreement were estimated. Prevalence of agreement that cocaine can be adulterated increased from 42.1% (95% CI: 36.8–47.6) in 2018 to 65.6% (95% CI: 54.1–75.4) in 2022—a 55.8% increase (p < .001). Between 2018 and 2022, particular increases occurred among those not reporting past‐year cocaine use (by 61.6%, p < .001), among White individuals (by 68.1%, p < .001), those with some college (by 68.5%, p = .021), and those age ≥26 (by 83.8%, p = .001). Awareness that cocaine can contain fentanyl is increasing in this high‐risk population. Continued education is needed for high‐risk populations regarding both opioid overdose response and test strips that can test drugs for the presence of fentanyl.
Studies have examined trends in cannabis vaping, but research is needed to examine trends in more frequent use as this may increase risk for adverse health outcomes.
Data were from 12,561 high school ...seniors participating in the Monitoring the Future national study. Prevalence of self-reported frequent vaping of cannabis (defined as using ≥10 times in the past month) was compared between 2018 and 2019 cohorts.
Frequent vaping of cannabis significantly increased from 2.1% to 4.9%, a 131.4% increase. This increase was larger than the increase for any vaping of cannabis (which increased 85.9%). Notable significant increases occurred among students aged ≥18 years (a 154.9% increase), female students (a 183.5% increase), those who go out 4–7 evenings per week (a 163.0% increase), and those reporting past-year nonmedical prescription opioid use (a 184.7% increase).
Frequent vaping of cannabis is increasing among adolescents in the United States, particularly among selected subgroups.
Highlights • No studies have reported recent trends in alcohol use among older adults. • Binge drinking and alcohol use disorders are increasing among older adults in the United States (US). • Older ...women reported large increases in binge drinking and alcohol use disorders in the US. • Older binge drinkers reported significant increases in chronic disease in the US.
A drug concoction called tusi has emerged in Latin America and in Europe and is now beginning to acquire popularity in the United States. "Tusi" is a phonetic translation of "2C," a series of ...psychedelic phenethylamines. The concoction is also sometimes referred to as "pink cocaine" as it typically comes in the form of pink powder. However, despite its name, the concoction rarely contains 2C series drugs. Multiple drug checking studies have found that the majority of tusi samples contain ketamine, often combined with 3,4-methylenedioxymethamphetamine (MDMA), methamphetamine, cocaine, opioids, and/or new psychoactive substances. The tusi phenomenon complicates the drug landscape because it has the potential to confuse both people who use it and researchers alike. People using may think the drug is 2C/2C-B, and they may also be unaware that the concoction tends to consist of ketamine and a wide variety of other drugs. Unintentional exposure to its contents can lead to increased risk of adverse effects. The tusi phenomenon also has the potential to complicate drug research as unknown exposure to drugs like ketamine and MDMA will lead to underreporting of use. A combination of self-report and toxicological testing may be needed to inform the most accurate estimates of use. Both researchers and people at risk for use need to be informed about this new concoction. Drug researchers need to be cognizant about the way they query use, and people at risk for using need to be educated about the possible contents of tusi and associated dangers.
Introduction
It is largely unknown whether adverse effects experienced from recreational drug use affect willingness to use again. This study determined whether adverse effects from select party ...drugs affect reported willingness to use again in the next month among a high‐risk population—people who attend electronic dance music parties at nightclubs or dance festivals.
Methods
Adults (age ≥ 18) entering nightclubs/festivals were surveyed in New York City in 2018–2022 (n = 2981). Participants were asked about past‐month use of common party drugs (cocaine, ecstasy, lysergic acid diethylamide LSD and ketamine), whether they had experienced a harmful or very unpleasant effect after use in the past 30 days, and whether they intend to use again in the next 30 days if offered by a friend. The relationship between having experienced an adverse outcome and willingness to use again was examined in a bivariable and multivariable manner.
Results
Experiencing an adverse effect after past‐month cocaine (adjusted prevalence ratio aPR = 0.58, 95% confidence interval CI 0.35–0.95) or ecstasy use (aPR = 0.45, 95% CI 0.25–0.80) was associated with lower risk for willingness to use again. Adverse effects related to LSD use were related to lower risk of being willing to use again in the bivariable model, but in multivariable models, risk was not attenuated for willingness to use LSD or ketamine again.
Discussion and Conclusions
Personally experienced adverse effects can deter willingness to use certain party drugs again in this high‐risk population. Interventions targeting cessation of recreational party drug use can likely benefit from focusing on deleterious effects of use that have been experienced.
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