Substance Abuse Research Articles

Enhancing adolescent mental health through cognitive and social support: Insights from study on depression in Chinese adolescents

Adolescent depression is a growing global health concern, affecting 14% of adolescents and leading to severe consequences such as academic failure, substance abuse, and suicidal ideation. The study by Yu et al , investigates the cognitive and social factors influencing depression in 795 Chinese adolescents. Findings reveal that negative life events (NLEs) and dysfunctional attitudes are strongly associated with depressive symptoms, while social support moderates the impact of NLEs but not dysfunctional attitudes. The study highlights the need for cognitive-behavioural interventions targeting perfectionism and autonomy, and the importance of strengthening social support systems in schools and communities. Culturally sensitive, holistic approaches to adolescent mental health are crucial for addressing both the internal vulnerabilities and external pressures contributing to depression. Further research is needed to explore the roles of peer and parental support and the long-term effects of these factors across diverse cultural contexts.

Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use

Introduction There is an urgent need to improve the identification of psychosocial vulnerabilities in clinical practice (eg, stress, unstable living conditions) and examine their contribution to prenatal substance use, especially for legal substances such as alcohol, tobacco, and recently, cannabis. Methods We conducted a retrospective chart review of 1842 patients who completed the PROMOTE screening instrument during their first prenatal visit to outpatient clinics of a New York State health system in 6/2019–11/2020. The PROMOTE includes 18 core items to assess psychosocial vulnerabilities including the NIDA Quick Screen assessing past year substance use. Outcomes were tobacco, cannabis, and alcohol use during pregnancy based on electronic medical record abstraction including clinical notes, self-report, or urine toxicology. Results A total of 188 (10.2%) patients used at least 1 substance prenatally, including 132 (7.2%) tobacco, 50 (2.7%) cannabis, and 45 (2.4%) alcohol. Two of the NIDA Quick Screen items (past year tobacco use and past year illegal drug use) were associated in the bivariate analysis with greater use risk of all 3 substances. Additional risk factors uniquely associated with specific prenatal substance use variables include low education predicting tobacco use (adjusted odds ratio [AOR] = 2.74, 95% confidence interval [CI] = 1.43–5.23), being unpartnered predicting cannabis use (AOR = 3.37, 95% CI = 1.21–9.39), and major life events predicting alcohol use (AOR = 3.25, 95% CI = 1.439–7.38). Conclusions Utilizing brief psychosocial self-screening instruments such as the PROMOTE can help identify and refer at-risk patients to appropriate care. Particular attention should be paid to life context including partner support, emotional health, stress, and past year substance use.

Teaching Note—Positioned for Success at a PWI: A Minority Fellow Narrative

ABSTRACT The Council on Social Work Education’s Minority Fellowship Program (MFP) supports the mission of the Substance Abuse and Mental Health Services Administration to increase the number of individuals who are trained to work with underrepresented and underserved persons with or at risk for mental health or substance abuse disorders. This teaching note is a critical autoethnographic investigation of a doctoral MFP alum reflecting and sharing her journey to overcome barriers to advance her nontraditional social work research agenda in a predominantly White institution. It is the intention that this teaching note provides suggestions of how to maintain a research agenda in a teaching university. Discussion of the author’s MFP affiliation, career trajectory, community effect, research findings, and remarks regarding the necessity of MFP will be provided.

SAMHSA: Substance use by teens across sexual identities

A new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) has found that LGB+ youth are more likely than straight youth to have major depression and serious thoughts of suicide. But patterns of substance use by sexual identity were nuanced.

USO INDISCRIMINADO DOS OPIOIDES POR PROFISSIONAIS DE SAÚDE: UMA REVISÃO INTEGRATIVA

Introduction: The opioid epidemic is a global public health crisis that affects several regions, including one that is not always highlighted: health professionals. General objective: to analyze the complexity of the indiscriminate use of opioids by health professionals. Method: This is an integrative literature review, following five stages with a search in the LILACS, BDENF, MEDLINE, and SciELO databases from 2019 to 2024. Results: 109 articles were found; 06 articles were used to prepare the study. Discussion: According to the Brazilian guidelines on opioid abuse, patients with chronic pain and healthcare professionals are among the groups most at risk of acquiring opioid dependence. Concern about the abuse of psychoactive substances by healthcare professionals is not new. Historically, the population of doctors and other healthcare workers has been more exposed to the risk of abusing psychoactive substances, including prescription drugs such as benzodiazepines, opiates and amphetamines. Conclusion: The disordered use of opioids by healthcare professionals is a multifaceted problem that requires a comprehensive and collaborative approach to combat. Healthcare institutions, regulatory bodies and society in general have an important role to play in promoting a safer and more supportive working environment. Emphasizing the importance of the mental health and well-being of healthcare professionals, as well as implementing preventive measures and effective interventions, is essential to reducing opioid use and ensuring that these professionals can continue to provide quality care while protecting their own health and safety.

A SYSTEMATIC REVIEW ON ADHERENCE TO ORAL ANTIDIABETIC DRUGS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Type 2 diabetes mellitus (DM) is a chronic metabolic disorder in which prevalence has been increasing steadily all over the world and one of the main reason for this is poor adherence to oral anti-diabetic drugs, which can lead to therapy failure and increase risk of complications. So we planned this systematic review with an aim to get an adherence estimation to oral anti-diabetic drugs in type 2 diabetes mellitus patients for which a literature search was performed in pubmed, Google Scholar, scopus, and central databases to find observational studies on therapeutic adherence in users of oral anti-diabetic drugs. Our analyses showed that adherence rate to oral anti-diabetic drugs therapy ranged from 23 to 90%. This review confirms that many patients for whom diabetes medication was prescribed were poor compliers with treatment of oral anti-diabetic drugs.

In Case You Haven't Heard…

National Institute on Drug Abuse director Nora Volkow, M.D. published a blog last week calling for community involvement in addiction science, and this means “[i]ncluding people with experience of substance use and addiction in the scientific workforce — and making sure they feel safe and recognized as valuable members of the research team…” Their perspectives, she wrote, “are invaluable in making sure that the right research questions are asked.” For the blog, go to https://nida.nih.gov/about‐nida/noras‐blog/2024/11/improving‐community‐engagement‐in‐addiction‐science

Women, gender and drugs: between research and action.

This article is part of Harm Reduction Journal's special issue on harm reduction research in the francophone context and specifically the Harm Reduction Network (HARENE). After highlighting the history and current context of harm reduction for women in France, we present the results of four research studies addressing the links between gender and drugs which were presented in the book Espaces genrés des drogues. Parcours dans la fête, l'intimité et la réduction des risques ('Gendered Spaces of Drugs. A journey of intimacy, party and harm reduction'). This article is divided into three parts, each addressing a specific space: the space of institutional care, the intimate marital space, and the urban festive space. We begin by describing gender inequalities within harm reduction and care structures, by demonstrating how single-sex spaces facilitate the care of women, and how care professionals can perpetuate unequal gender norms in their relationship with a woman in a situation of addiction expressing a desire for pregnancy. Concerning the marital space, we highlight the reproduction of gender norms within socially included heterosexual couples who use drugs and are socially included, particularly concerning the choice of the intimate partner, the distribution of tasks linked to the purchase and sale of drugs, and parenthood. Finally, concerning the festive space, the article highlights the differentiated strategies of men and women in urban festive places, and the maintenance of a gendered order of festive places and drug consumption. This leads us to discuss the current issues of stigmatization of women drug users, and the initiatives put in place in the French context to promote harm reduction for women who use drugs.

Idiographic Family Assessment Method for Substance Users

ABSTRACT With the aim of identifying the family systemic factors associated with substance use, the Idiographic Family Assessment Method for Substance Users was designed. The Method was applied in an outpatient counseling center for drug users in a city in central Mexico. Fifteen families were included in the study, totaling 34 participants. From a poststructuralist stance, a bridge was created between clinical practice and science, through an idiographic inquiry. The Method can be utilized with other populations. The research methodology was predominantly qualitative, phenomenological, and interpretative, with grounded theory for content analysis of in‐depth interviews, and complementary quantitative techniques, including a self‐report instrument. Findings subsumed: Structure, Dynamic, and trigenerational Family History aspects for each case. All dimensions were interrelated, and differences in perception between the user and his family member(s) were identified in most cases. Risk and protective factors were distinguished, and some hypotheses were formulated. Protective factors were rooted in Mexican traditional family values.

The Heterogeneous Effects of College Education on Outcomes Related to Deaths of Despair.

College education features prominently in research on determinants of deaths from substance use disorders and self-harm-outcomes collectively referred to as "deaths of despair" (DoD). Limited attention has been given to whether the protective effects of college education on indicators of despair vary by individuals' likelihood of college completion. We use data from the National Longitudinal Study of Adolescent to Adult Health for 6,145 individuals to test whether the protective effects of college completion on precursors to DoD vary according to individuals' propensity to attain a college degree. Understanding whether the benefits of college education differ depending on the propensity to complete it is important for designing effective educational policies. Using the heterogeneous treatment effects approach, we find that individuals with a relatively low propensity for graduating from college but who complete it have a lower likelihood of depressive symptoms, binge drinking, prescription drug abuse, and hard drug use.

The effect of cognitive control on addiction relapse

Background and Aims When entering substance abuse treatment centers, some individuals with substance use disorder relapse whilst others do not. Predicting who is likely to relapse or not would enable for more effective treatment by targeting those who are at increased risk. Previous research would indicate that aspects related to cognitive control including cognitive bias, inhibitory control, and working memory may all be strong indicators of relapse likelihood. Therefore, this paper explores whether aspects of cognitive control can predict relapse likelihood. Method Participants were patients in substance treatment centers who were abstaining. They were tested on measures of cognitive bias (REsT), inhibitory control (go/no-go), and working memory (nBack). A follow-up survey was then issued after a twelve-week period to ascertain whether participants had remained abstinent or if they had relapsed. Results Relative to abstainers, individuals who relapsed had shown significant impairments in working memory and inhibitory control at baseline. They had also demonstrated increased preoccupation with substance-related stimuli as indicated by the cognitive bias measure. Conclusions These findings demonstrate that deficits in cognitive control contribute to the maintenance of substance use disorder and substance usage. The results indicate that inhibitory and working memory deficits may contribute to initial engagement in substance abuse, followed by an increase in cognitive bias and further deficits in inhibitory control and WM contributing to an increased likelihood of relapse. This suggests that decreased cognitive control may increase relapse likelihood.

Child Protection Responses to Domestic Violence Exposure: Co-Occurring Safety Concerns and Investigation Outcomes.

Childhood exposure to domestic violence (CEDV) poses significant risks to children's safety and wellbeing, yet its prevalence and impact on child protection outcomes remains understudied. This study examined administrative data for child protection investigations in Los Angeles County, California between January 2018 and March 2021 to determine the prevalence of CEDV safety concerns, associated case characteristics, and child protection outcomes (case openings and foster care placements). Results indicated that 5.9% of investigations had CEDV concerns and CEDV investigations represented 17.9% of placements. Investigations with CEDV concerns had higher co-occurring indicated safety concerns than investigations without, including substance abuse (31.1%) and mental health (14.2%). Investigation outcomes for those with CEDV concerns included the substantiation of more than one individual (36.6%), while 28.4% resulted in case openings (without placement) and 30.2% resulted in placements. The study underscores the importance of moving beyond punitive frameworks and exploring the use evidence-based service planning to address the complex needs of families affected by CEDV.

Evaluating the human abuse potential of concurrent use of electronic cigarettes and low nicotine cigarettes among adults who smoke.

The U.S. Food and Drug Administration has stated its intention to reduce the nicotine content of combustible cigarettes to render them less addictive. This study evaluated the impact of providing adults who smoke with both very low nicotine content cigarettes (VLNCCs) and electronic cigarettes (ECs) of varying nicotine content on measures of human abuse potential. Participants (n = 213) were adult combustible cigarette users. They smoked their usual brand cigarettes (UBCs) during Phase 1 (baseline; week 1) and were provided with and encouraged to exclusively use VLNCCs during Phase 2 (weeks 2-4). During dual-product Phases 3 (weeks 5-7) and 4 (weeks 8-10), participants received both VLNCCs and ECs (assigned to one of two EC devices in higher or lower nicotine concentrations and choice of flavor), with instructions to use them freely in Phases 3 and 4. Assessments included product use, exposure, acceptability, risk perception, and withdrawal-related measures. Results indicated that participants used significantly fewer UBCs during the VLNCC and dual-product phases and smoked fewer VLNCCs during the dual-product phases than the VLNCC-only phase. Neither EC liquid nicotine concentration nor flavor influenced product use. The three study product phases resulted in less product liking and more withdrawal symptoms than the UBC phase. These results suggest that adults who smoke are able to switch much of their tobacco product use from UBCs to VLNCCs and will substitute combustible UBCs and VLNCCs with noncombustible nicotine-containing ECs, but most remain dual users, at least in the short term. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Intersection of Traumatic Brain Injury, Substance Abuse, and Mental Health Disorders in Incarcerated Women Addressing Intergenerational Trauma through Neuropsychological Rehabilitation

The intersection of traumatic brain injury (TBI), substance abuse, and mental health disorders presents a significant challenge within the incarcerated female population, where rates of these conditions are alarmingly high. This paper explores the multifaceted relationships among TBI, substance abuse, and mental health disorders, emphasizing the impact of intergenerational trauma on this vulnerable group. Women in correctional facilities often experience a history of trauma, exacerbating their mental health challenges and increasing the likelihood of substance use as a maladaptive coping mechanism. The cumulative effects of TBI can further complicate their psychological and emotional well-being, leading to a cycle of trauma that is perpetuated across generations. Through a review of current literature and case studies, this paper advocates for the implementation of neuropsychological rehabilitation programs that address the unique needs of incarcerated women. Such interventions are crucial not only for improving individual outcomes but also for breaking the cycle of trauma that affects families and communities. Recommendations for policy reforms and future research directions are provided to enhance the efficacy of rehabilitation efforts and support the reintegration of these women into society.

The impact of cyberbullying on mental health outcomes amongst university students: A systematic review

Cyberbullying is increasingly prevalent globally, particularly among young individuals. Cybervictims may be at an increased risk of adverse psychological outcomes. This systematic review aims to summarize the mental health effects of cyberbullying among college and university students. A systematic search of PubMed, Cochrane, and Embase databases was performed to identify studies reporting mental health effects of cybervictimization among college/university students until April 15, 2023. Risk of bias assessment was conducted using the National Institute of Health (NIH) tool. The review is registered on PROSPERO (CRD42023429187). Thirty-two studies involving 29,593 students were included. Depression showed a significant association with cyber-victimization in 16/20 studies (prevalence: 15–73%). Anxiety was significant in 12/15 studies (27–84.1%), stress in 3/3 studies (32–75.2%), and suicidal behavior in 4/9 studies (2–29.9%). Cybervictimization weakly but significantly correlated with lower self-esteem in 4 out of 6 studies (r = -0.152 to -0.399). Fear of perpetrators was reported in 2 out of 2 studies (12.8–16%), while decreased academic concentration/productivity was found in two studies (9–18%). Cybervictims were more likely to engage in substance abuse (adjusted odds ratio: 2.37 [95% confidence interval: 1.02–5.49]; p = 0.044). The majority of articles were of good quality (22/32). This review demonstrates a high prevalence of adverse mental health outcomes among cybervictims, including depression, anxiety, stress, and suicidal behavior. Based on these findings, we recommend that institutions of higher education worldwide introduce zero tolerance policies against cyberbullying, implement screening processes to identify affected students, and provide psychological therapy within their institutions.

Tramadol use for chronic pain management: A thorough analysis of safety, effectiveness, and clinical recommendations

Chronic pain, especially arthritis-related pain, represents a significant medical challenge worldwide. Tramadol, a centrally acting analgesic, has emerged as a valuable treatment option for managing chronic arthritis pain. This review article provides a comprehensive analysis of tramadol’s role in chronic pain management, emphasizing its safety, effectiveness, and clinical guidelines. Literature indicates that tramadol, whether used alone or in combination therapies, effectively treats various types of arthritis-related pain, such as musculoskeletal pain, osteoarthritis, and rheumatoid arthritis. While some clinical guidelines recommend tramadol as a first-line option for persistent knee or hip osteoarthritis, others urge caution due to concerns over potential abuse and negative effects. Tramadol’s mechanism of action involves, among other things, stimulation of opioid receptors and inhibition of serotonin and norepinephrine reuptake, contributing to its analgesic effects while attempting to minimize the side effects associated with traditional opioids. However, tramadol is not without side effects, including nausea, vomiting, constipation, respiratory depression, and withdrawal symptoms if it is suddenly discontinued. Despite these challenges, tramadol remains a valuable component in managing chronic pain, especially in patients with concurrent conditions and comorbidities. Further research is necessary to determine the optimal use of tramadol and to establish its risk-benefit profile across diverse patient populations.

Clearing the air: Heightened perception of harm from secondhand cannabis smoke exposure is associated with no in-home cannabis smoking in a 21-country convenience sample.

As countries adopt more lenient cannabis use policies, perception of harm from secondhand cannabis smoke (SHCS) exposure is decreasing and most cannabis smoking is taking place at home. We quantified the relationship of reported in-home cannabis smoking with perceived harm from SHCS exposure. The analytic sample comprised 28,154 adult respondents, from 21 countries, to the annual cross-sectional Global Drug Survey (2021) of users of licit or illicit drugs. Respondents reported perception of harm to non-smoking residents from SHCS exposure and past 30-day cannabis smoking in the home by anyone. Logistic regression estimated covariate-adjusted odds ratios and 95 % confidence intervals of in-home cannabis smoking (yes/no). The association between harm perception and in-home cannabis smoking by country of residence was also quantified. Sixty-one percent reported no in-home cannabis smoking in the last 30 days; mean perception of harm of SHCS exposure on a 10-point scale was 5.2. Those at the 75th (vs 25th) percentile of perceived harm had 70 % higher odds (OR = 1.7, 95 % CI = 1.6-1.8) of no in-home cannabis smoking. In all countries of residence, higher perception of harm was associated with reporting no in-home cannabis smoking, although not all were statistically significant. The strongest association was seen in Sweden (OR = 3.9, 95 % CI = 1.5-11.9) and New Zealand (OR = 2.3, 95 % CI = 2.0-2.7). Respondents who perceived SHCS as harmful were less likely to report in-home cannabis smoking. If this association subsequently proves causal, increasing awareness of the harms associated with SHCS exposure could substantially reduce residential cannabis secondhand smoke exposure.

An Analysis of the Food and Drug Administration Manufacturer and User Facility Device Experience Database for MAGnetic Expansion Control Spinal Rods.

MAGnetic Expansion Control (MAGEC) rods can prevent repeated lengthening operations for scoliosis patients. However, there have been several Field Safety Notices issued, including a worldwide product recall due to actuator endcap separation. We aimed to review adverse events reported to the Food and Drug Administration (FDA) regarding MAGEC rods, focusing on MAGEC X. Reports submitted to the Manufacturer and User Facility Device Experience database in relation to MAGEC devices were accessed and analysed using R Statistical Software. Exclusion criteria included duplicate and literature review reports (n = 54). Free-text data were analysed using inductive content analysis. 1016 adverse events were reported to 11/30/2023. 99.0% (1006) were submitted by the manufacturer. Reports primarily arose from the UK (465, 45.8%) or US (421, 41.4%). From free-text data the most frequent adverse events were distraction mechanism failure (573), device wear (272), and actuator seal damage (180). Rod fracture (n = 48) was not significantly associated with rod diameter (≤ 5.0mm or > 5.0mm), p = 0.736. 234 reports referenced MAGEC X devices; actuator endcap separation was identified in 41.9% (99). Other events include failure of distraction (63), surface damage (31), and rod fracture (15). On 06/30/2020 MAGEC X2 received FDA approval. Twenty reports reference devices manufactured after this date, seven describe distraction mechanism failure; notably there are no reports of endcap separation. These data represent the largest series of adverse events reported for MAGEC rods, including significant new data regarding MAGEC X. As well as endcap separation, failure of distraction, surface damage, and rod fracture were reported.

Effects of sex and estrous cycle on extended-access oxycodone self-administration and cue-induced drug seeking behavior

IntroductionIncreasing evidence indicates that sex is a factor that impacts the abuse liability and relapse vulnerability of prescription opioids like oxycodone. However, while women are more likely than men to be prescribed and to use these drugs, the impact of sex and ovarian hormones on prescription opioid use and relapse vulnerability remains unclear. Accurately assessing these measures is complicated by the fact that chronic opioid exposure can lower ovarian hormone levels and cause cycle irregularities.MethodsAdult male and female Sprague–Dawley rats self-administered oxycodone (0.1 mg/kg/infusion) under extended-access conditions (6 h/day, 10 days) followed by forced abstinence. Separate groups of animals received cue-induced seeking tests in a drug-free state during early (1–2 days) or later periods of abstinence (43–45 days). To track estrous cycle stage, animals were regularly vaginally swabbed throughout the study.ResultsWe observed oxycodone-induced estrous cycle dysregulation in the majority (~60%) of the animals during both self-administration and the first month of abstinence. In animals whose cycles were not dysregulated, we found a reduction in oxycodone intake during estrus compared to all other cycle stages (non-estrus). We also found that males but not females showed a time-dependent intensification or incubation of cue-induced oxycodone craving over the first 6 weeks of abstinence. This sex difference was estrous cycle-dependent, driven by a selective reduction in drug seeking during estrus.DiscussionThese findings highlight the importance of tracking drug-induced estrous cyclicity and identify a clear impact of ovarian hormones on oxycodone taking and seeking behavior.

Abstract 4140185: The Burden Of Substance Abuse And Mental Health Disorders In Patients Admitted With Stress Cardiomyopathy

Introduction: Several studies have linked mental health disorders and substance abuse as risk factors for stress cardiomyopathy (SC). However, the true burden of these disorders amongst patients with stress cardiomyopathy remains unknown. Methods: We used the 2016-2020 National Inpatient Sample database to identify hospitalizations for SC who underwent diagnostic catheterization. We assessed the proportion of patients diagnosed with a substance abuse or mental health disorder. Subsequently, the association of these disorders in SC compared to patients admitted for myocardial infarction (MI) was assessed using the chi-square test. Results: From 2016 to 2020, there were 33,075 hospitalizations for stress cardiomyopathy who were diagnosed by cardiac catheterization. Of these patients, 5,920 (17.9 %) had depression, 8,500 (25.7 %) had anxiety, 1058 (3.2 %) had severe stress reactions, and 16,372 (49.5 %) were diagnosed with a mental health disorder. 9,955 (30.1 %) were smokers, 5,358 (16.2%) abused hallucinogens, 5,457 (16.5 %) abused cocaine, 5,457 (16.5%) abused sedatives, 6,019 (18.2 %) abused cannabis, 5,920 (17.9%) abused opioids, 6,416 (19.4 %) abused alcohol. Subsequently, the association of stress cardiomyopathy with mental and substance abuse disorder was compared with patients admitted with myocardial infarction See Table 1. Conclusion: Mental health and substance abuse disorders are common in patients diagnosed with SC. These disorders are more commonly present in SC compared to MI. Further research is needed to assess the significance of these findings.