Impact Of Substance Use Research Articles

Stability and Change in Men's Intimate Partner Violence and Substance Use in Early Adulthood.

Despite substantial evidence of the role of substance use in intimate partner violence (IPV), little is known about the impact of substance use on stability and change in the experience of IPV as both a perpetrator and a victim. Using an ethnically diverse sample of 232 men in early adulthood (mean age = 29.1, SD = 0.91), this study defined typologies of IPV based on men's reports of both perpetration and victimization; examined the potential impact of substance use, including alcohol and marijuana use, on IPV typologies over two measurement occasions; and quantified stability and change in these typologies over time. Patterns of IPV were characterized by three classes at each time point: no IPV, psychological aggression, and physical aggression. Men's regular marijuana use was associated with physical aggression contemporaneously and prospectively. Partner's problem alcohol use was associated with psychological aggression contemporaneously, suggesting that women's problem alcohol use could be a risk factor for their own and their partner's IPV perpetration. IPV appeared to remain somewhat stable over time with 67% of men remaining in the same IPV class. Among those who did transition from one typology to another, it was most often to a less severe IPV typology. Regular marijuana users were more likely to be in the physical aggression typology rather than the no IPV typology, with a higher probability of transitioning to a more severe IPV typology than nonusers. The present study has implications for prevention and intervention efforts by its ability to identify men who are at greatest risk for continued or increased violence and underscores that men's marijuana use may exacerbate IPV.

Substance Use and Healthcare Utilization Across the Pre-Exposure Prophylaxis (PrEP) Care Cascade among Black and Latino Men Who Have Sex with Men

Background: Despite the documented efficacy of pre-exposure prophylaxis (PrEP) for HIV prevention, large disparities in uptake and adherence exist among Black and Latino/Hispanic men who have sex with men (BLMSM). Limited data exists among BLMSM on the impact of substance use at different stages of the PrEP Care Cascade. We examined the ways substance (alcohol, cannabis, other drug) use is related to PrEP experiences across the PrEP Care Cascade (PrEP aware/no use; PrEP use/discontinuation; PrEP use/adherent). Methods: We utilized data from a national sample of 908 BLMSM (Mage = 25.17, range: 18–29), collected between February and October 2020. Results: We found that heavier alcohol use, more other drug (e.g., cocaine) use, more participant healthcare utilization, and higher number of partners across all measures of substance use were separately associated with a lower likelihood of being aware of PrEP. These same factors were also associated with a higher likelihood of PrEP adherence. Conversely, only cannabis use was associated with discontinuation of PrEP use. Conclusions: While we confirm some earlier findings (i.e., alcohol use is associated with both PrEP discontinuation and PrEP use), we newly identify cannabis as a barrier to the adherence of PrEP. Our findings highlight the need for improved PrEP interventions to increase awareness among BLMSM with substance use who are among the most at-risk for HIV infection.

Alcohol and cannabis co-use and longitudinal gray matter volumetric changes in early and late adolescence.

Previous studies have characterized the impact of substance use on cerebral structure and function in adolescents. Yet, the great majority of prior studies employed a small sample, presented cross-sectional findings, and omitted potential sex differences. Using data based on 724 adolescents (370 females) curated from the NCANDA study, we investigated how gray matter volumes (GMVs) decline longitudinally as a result of alcohol and cannabis use. The impacts of alcohol and cannabis co-use and how these vary across assigned sex at birth and age were examined. Brain imaging data comprised the GMVs of 34 regions of interest and the results were evaluated with a Bonferroni correction. Mixed-effects modeling showed faster volumetric declines in the caudal middle frontal cortex, fusiform, inferior frontal, superior temporal (STG), and supramarginal (SMG) gyri, at -0.046 to -0.138 cm3 /year in individuals with prior-year alcohol and cannabis co-use, but not those engaged in alcohol or cannabis use only. These findings cannot be explained by more severe alcohol use among co-users. Further, alcohol and cannabis co-use in early versus late adolescence predicted faster volumetric decline in the STG and SMG across assigned sex at birth. Findings highlight the longitudinal impact of alcohol and cannabis co-use on brain development, especially among youth reporting early adolescent onset of use. The volumetric decline was noted in cortical regions in support of attention, memory, executive control, and social cognition, suggesting the pervasive effect of alcohol and cannabis co-use on brain development.

Prevalence and hospital resource usage associated with substance use disorder among hospitalized adolescents in the United States

We sought to determine common characteristics of SUD-related hospitalizations and patterns of discharge diagnoses among adolescents in the United States. Using the 2016 KID, a cross-sectional study was conducted to identify discharge records associated with ICD-10-CM diagnostic codes for SUD. Adolescents between the ages of 13 and 19 were included. SUD and non-SUD groups were compared using the Student’s t-test for continuous variables and the χ2 test for categorical variables. A total of 6.7 million hospital discharges were analyzed. A uniform and a standardized coding system were used to identify cases. Subgroup comparative analysis for length of stay, hospital charge, and common discharge diagnoses was performed. A weighted estimate of 94,732 adolescents associated with SUD was discharged from the U.S. hospitals during the study year. Teens with SUD accounted for 510,268 days of inpatient days in the U.S. community hospitals accounting for a total charge of $3,070,948,580. The average LOS for all SUD teens in the U.S. was 5.4 days with a mean charge per discharge of $32,754, indicating higher LOS but a significantly lower mean charge compared to non-SUD teens (4.1 days; $39,657). In 2016, more than 88% of SUD patients had ≥ 3 diagnoses compared to non-SUD patients (76%) (P < 0.0001 for all). The most frequently observed diagnosis associated with teens with SUD was psychoses, depressive neuroses, and alcohol use disorder. With one in ten teenagers found with an SUD, early substance initiation still appears to be an important public health issue. Unfortunately, the health and economic impact of substance use in adolescence on society are huge requiring effective strategies targeted to this population. The concerning data and literature identify a significant need to address prevention, treatment, and recovery services for adolescents throughout the United States.

Sex-specific and generational effects of alcohol and tobacco use on epigenetic age acceleration in the Michigan longitudinal study

BackgroundExcessive alcohol and tobacco use are risk factors for poor health in both men and women, but use patterns and relationships with diseases and mortality differ between sexes. The impact of substance use on the epigenome, including DNA methylation profiles, may also differ by sex. It is also unknown whether parental substance use during childhood is associated with epigenetic changes that persist into adulthood. This study assessed the sex-specific effects of individuals’ alcohol and tobacco use, as well as paternal alcohol and paternal/maternal tobacco use, on offspring's cellular aging as measured by epigenetic age acceleration. MethodsFour measures of epigenetic age acceleration (HorvathAA, HannumAA, PhenoAA, and GrimAA), the difference between chronological age and inferred age based on DNA methylation, were estimated from saliva samples. Linear mixed models tested associations between alcohol/tobacco use and epigenetic age acceleration in parents and offspring. ResultsCurrent tobacco smoking was associated with a 4.61-year increase in GrimAA, and former tobacco smoking was associated with a 3.60-year increase in HannumAA after accounting for multiple testing (p < 0.0125). In males only, current tobacco smoking was nominally associated with a 2.19-year increase in HannumAA (p < 0.05), and this effect was significantly different than the female-specific effect (p < 0.0125). Paternal heavy alcohol use when the offspring was 12 or younger was associated with a 4.43-year increase in GrimAA among offspring (p < 0.0125). ConclusionsThis study found evidence of sex-specific effects of alcohol and tobacco use, as well as paternal heavy alcohol use, on epigenetic age acceleration.

Event-level associations among minority stress, coping motives, and substance use among sexual minority women and gender diverse individuals

BackgroundSexual minority women and gender diverse individuals (SMWGD) are at heightened risk for alcohol and cannabis use disorders compared to heterosexual and cisgender individuals, and their heightened risk has been attributed to minority stress. However, few longitudinal studies have examined mechanisms through which minority stress may impact substance use, and none have done so at the event-level. MethodsWe utilized data from a 30-day ecological momentary assessment study of 429 SMWGD who used alcohol or cannabis regularly to test a mechanistic process in which minority stress predicts alcohol and cannabis use via coping motives for use at the event-level. ResultsWhen individuals experienced more enacted stigma (e.g., microaggressions) than usual during one assessment, they were more likely to use cannabis to cope during the next. In turn, occasions when cannabis was used to cope were marked by more sessions of cannabis use, longer intoxication, higher subjective intoxication, and more cannabis consequences. Indirect effects of enacted stigma on cannabis use via coping motives were significant. However, only one of internalized stigma’s indirect effects was significant, with internalized stigma predicting cannabis consequences via daily coping motives. No indirect effects predicting alcohol use were significant. ConclusionsFindings provide robust evidence that using to cope is a mechanism through which enacted stigma predicts cannabis use and internalized stigma predicts cannabis consequences. Results did not provide evidence for similar associations for alcohol. Our findings suggest that interventions designed to reduce cannabis use among SMWGD should attend to their minority stress experiences and cannabis use motives and teach alternative coping strategies.

Investigating differences of medications in hospitalized schizophrenia and schizoaffective disorder patients: impact of substance use

ABSTRACT Background Substance use is a clinical comorbidity resulting in poor prognosis, non-adherence and increased admissions in schizophrenia and related disorders. This study investigated differences in treatment preferences in hospitalized schizophrenia and schizoaffective disorder patients with or without substance use. Method Retrospective recordings regarding patients hospitalized between July 2017 and July 2018 were obtained from a mental health hospital database. Results Younger people and males were prevalent in those reporting substance use. Total and involuntary hospitalization numbers were similar across groups. Admission to a psychiatry unit due to forensic issues was higher in substance users. Electroconvulsive therapy (ECT), long-acting injection antipsychotics (LAI APs) and clozapine use were more frequent in substance non-users. Total and involuntary hospitalization numbers predicted LAI AP use, while younger age, total hospitalization and illness duration predicted clozapine use. Substance use was predictive for clozapine use. Conclusions Substance use should be monitored in young, male cases with schizophrenia spectrum disorders. LAI AP, clozapine, and ECT use should be investigated more comprehensively in this group.

Social exclusion and substance use among African immigrants: The role of discrimination

ABSTRACT Due to their racialized identity and immigrant status, African immigrants face increased risk for social exclusion and other negative outcomes. Research indicates that discrimination, social and economic disadvantage increase risk for substance use among Black populations in the United States. While emerging studies on African immigrants have explored consequences of social exclusion on psychological health, little is known about how these conditions impact substance use patterns. This study examined the effects of social exclusion on alcohol and/or other drug use, and non-medical use of prescription drugs among African immigrants, and explored whether perceived discrimination mediated this relationship. Data were collected between 2019 and 2020 from a cross-sectional survey examining experiences of first and second-generation African immigrants across the United States (N = 597). The majority of the sample identified as female (71%) and Black (82%). Structural equation modeling was conducted with probit regression paths to examine the direct and indirect effects of three dimensions of social exclusion (sociocultural, economic, and structural) on alcohol and/or other drug use and non-medical use of prescription drugs, with perceived discrimination as the mediator. Increased sociocultural and structural exclusion significantly increased the likelihood of alcohol and/or other drug use and non-medical use of prescription drugs through the perceived discrimination pathway. Structural exclusion also had direct effects on substance use. Findings highlight the importance of examining social stressors when exploring risk for substance use, and point to the need for prevention efforts that reduce negative attitudes and promote inclusivity of this marginalized population.

Patients' perspectives of medications for addiction treatment in HIV clinics: A qualitative study

BackgroundWhile substance use disorders (SUD) disproportionately impact people with HIV (PWH), HIV clinics inconsistently provide evidence-based medications for addiction treatment (MAT). Patient receptivity to MAT is critical to enhance addiction treatment in these settings. However, we know little from patients about how to best integrate MAT into HIV clinics. MethodsThis qualitative study used four focus groups informed by the Promoting Action on Research Implementation in Health Services framework to identify barriers and facilitators to receiving opioid, alcohol, and tobacco use disorder care in HIV clinics. The study population included 28 patients with HIV and SUD receiving care at one of four HIV clinics in the northeastern United States. Focus groups were recorded and transcribed for content analysis. The study also performed a brief survey assessing demographics and behaviors. ResultsFocus groups revealed several major themes related to MAT in HIV clinics. Barriers included stigma around MAT, knowledge deficits about available MAT options and the impact of substance use on PWH, concerns about medication side effects, substance use screening without adequate clinician follow-up, and peers who discouraged MAT. Facilitators included recognition of substance use as a threat to overall health, integrated care from HIV clinicians, and support for addiction treatment from peers with lived experience. ConclusionsEfforts to enhance MAT in HIV clinics should include patient education to help them recognize addiction as a chronic disease with available medication treatment options; clinician and staff training to promote integrated, multidisciplinary screening and treatment; and thoughtful inclusion of peers with lived experience.

Self-reported changes in alcohol and tobacco use during COVID-19: findings from the eastern part of WHO European Region.

BackgroundThe COVID-19 pandemic might impact substance use behaviours around the globe. In this study, we investigate changes in alcohol and tobacco use in the second half of 2020 in countries of the eastern part of the WHO European Region.MethodsSelf-reported changes in alcohol and tobacco use among 11 295 adults from 18 countries in the eastern part of the WHO European Region were collected between August 2020 and January 2021. The non-probabilistic sample was weighted for age, gender and education. For each country, proportions of respondents reporting a decrease, no change or increase in substance use over the past 3 months were examined, and multinomial regression models were used to test associations with age, gender and past-year alcohol use.ResultsIn most countries, about half of the respondents indicating past-year alcohol or tobacco use reported no change in their substance use. Of those alcohol users who reported changes in their alcohol use, a larger proportion reported a decrease than an increase in most countries. The opposite was true for tobacco use. Women, young adults and past-year harmful alcohol users were identified as being more likely to change their substance use behaviour.ConclusionWe found diverging overall trends for alcohol and tobacco use in the second half of 2020. The patterns of change vary according to age, gender and past-year substance use. Individuals at risk to increase their substance use during the COVID-19 pandemic require most policy considerations.

Programs to address substance use in U.S. children’s hospitals: Untapped potential for expanding community prevention and treatment resources

ObjectiveSubstance use affects Americans across the life course and there is need to understand how pediatric health care organizations implement new programs to address this need. The aim of this study was to understand what programs are currently offered and the institutional and community factors that predict hospitals undertaking this work. MethodsWe analyzed children’s hospitals’ community health needs assessments (CHNAs) and implementation strategies (2015–2019) to identify which hospitals were addressing substance use and categorized the programs they implemented. We conducted bivariate descriptive comparisons of hospitals that did or did not address substance use based on institutional, county-level, and community-benefit spending characteristics and calculated a logistic regression model to assess whether the extent of local need was associated with hospital service provision, independent of covariates. ResultsOnly 13% of children’s hospitals addressed substance use in their CHNA implementation strategies and of the 151 programs adopted, only 11 were pediatric-specific. The most common strategies hospitals outlined to address substance use included access to formal treatment and community outreach and education efforts. Children’s hospitals who did not address substance use in their communities were more likely to have worked independently on their community benefit plan and to work in counties with greater economic needs. The level of substance use needs in the community was not associated with hospital programs. Analysis of community benefit filings to the IRS confirmed that children’s hospitals not addressing substance use also spent fewer community benefit dollars on population health-related activities suggesting that overall spending may overlap with willingness to invest in complex behavioral health needs. ConclusionsFew children’s hospitals address substance use as a community health need, suggesting that these organizations are an underutilized resource for preventing and addressing the profound impact of substance use across the life course.

Electronic screening and brief interventions

Screening and brief interventions are among the evidence-based recommended practices to reduce the negative impact of substance use on the population. The digitization of these interventions makes it possible to disseminate them widely and to circumvent some of the barriers to the implementation of face-to-face interventions. Current evidence shows that electronic screening and brief interventions are effective in reducing alcohol and tobacco consumption. For other substances and for gambling, current evidence is more limited but promising and additional research is needed. These interventions can represent an alternative to face-to-face interventions.

Food insecurity and substance use in people with HIV infection and substance use disorder

Background Food insecurity and substance use are common among people living with HIV (PLWH). Substance use may help people cope with hunger and thus be associated with food insecurity, but the association is uncertain. This study assessed whether, in PLWH and substance dependence, if there was an association between food insecurity and substance use. Methods: We studied adults with HIV and current substance dependence or ever injection drug use interviewed at 12 and 24 months after enrollment in a prospective cohort study. The presence of food insecurity (insufficient food quantity or quality, or anxiety about its availability) was assessed using the Household Food Insecurity Assessment Scale questionnaire (HFIAS). Unhealthy alcohol use was assessed with the Alcohol Use Disorder Identification Test – Consumption (AUDIT-C) and past 30-day other drug use with the Addiction Severity Index. Associations using repeat cross-sectional data from each of two time-points, 12 months apart, from the same participants were tested using generalized estimating equations logistic regressions. Results: The 233 participants had a mean age of 50 years and 65% were male. At the first interview, 44% reported food insecurity, 40% unhealthy alcohol use, 25% past 30-day cocaine use, and 17% past 30-day illicit opioid use. In analyses adjusted for demographics, social factors, physical and mental health function, and substance use related variables, there was no significant association between food insecurity and unhealthy alcohol use (adjusted odds ratio (aOR) = 1.06 (95% CI: 0.59, 1.87)). Those with food insecurity had higher odds of illicit opioid use (aOR = 2.5 (95% CI: 1.12, 5.58)) and cocaine use (aOR = 1.95 (CI 95%: 1.00, 3.81)). Conclusion: Food insecurity was not associated with unhealthy alcohol use but was associated with cocaine and illicit opioid use. Given the prevalence and impact substance use has on PLWH, food insecurity should be identified and addressed.

Individual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort

BackgroundWe analyzed the association between substance use (SU) and condomless sex (CS) among HIV-negative adults reporting heterosexual sex in the Seek, Test, Treat, and Retain (STTR) consortium. We describe the impact of SU as well as person/partner and context-related factors on CS, identifying combinations of factors that indicate the highest likelihood of CS.MethodsWe analyzed data from four US-based STTR studies to examine the effect of SU on CS using two SU exposures: 1) recent SU (within 3 months) and 2) SU before/during sex. Behavioral data were collected via 1:1 or self-administered computerized interviews. Adjusted individual-study, multivariable relative risk regression was used to examine the relationship between CS and SU. We also examined interactions with type of sex and partner HIV status. Pooled effect estimates were calculated using traditional fixed-effects meta-analysis. We analyzed data for recent SU (n = 6781; 82% men, median age = 33 years) and SU before/during sex (n = 2915; 69% men, median age = 40 years).ResultsFor both exposure classifications, any SU other than cannabis increased the likelihood of CS relative to non-SU (8–16%, p-values< 0.001). In the recent SU group, however, polysubstance use did not increase the likelihood of CS compared to single-substance use. Cannabis use did not increase the likelihood of CS, regardless of frequency of use. Type of sex was associated with CS; those reporting vaginal and anal sex had a higher likelihood of CS compared to vaginal sex only for both exposure classifications (18–21%, p < 0.001). Recent SU increased likelihood of CS among those reporting vaginal sex only (9–10%, p < 0.001); results were similar for those reporting vaginal and anal sex (5–8%, p < 0.01). SU before/during sex increased the likelihood of CS among those reporting vaginal sex only (20%; p < 0.001) and among those reporting vaginal and anal sex (7%; p = 0.002). Single- and poly-SU before/during sex increased the likelihood of CS for those with exclusively HIV-negative partners (7–8%, p ≤ 0.02), and for those reporting HIV-negative and HIV-status unknown partners (9–13%, p ≤ 0.03).ConclusionExcept for cannabis, any SU increased the likelihood of CS. CS was associated with having perceived HIV-negative partners and with having had both anal/vaginal sex.

Examining an In-Home Behavioral Parent Training Protocol Among Parents Who Use Substances Involved Child Welfare: Effectiveness of SafeCare.

Given the detrimental impact of substance use (SU) on both parent and child outcomes including child maltreatment, research and service efforts have focused on incorporating parenting resources into integrated SU treatment programs. While promising, it is imperative to examine and test parenting programs in a variety of settings. This study examined whether SU moderated the relationship between treatment condition and parenting outcomes among parents who participated in SafeCare, and parent ratings of engagement, service satisfaction, and perceived cultural competency of services. Results indicated that SU did not moderate the relationship between treatment condition and abuse potential, but did moderate this relationship for depression and parental distress such that parents with higher levels of SU reported less improvement in depression and parental distress. Results underscore that SU problems may impact the effectiveness of SC on specific risk factors, such as depression and parental distress, potentially indicating unique treatment needs and the need to adapt interventions to ensure treatment success. In addition, this study found that SafeCare was not found to be beneficial for parents with SU problems above and beyond the treatment as usual condition. Finally, results indicated that parents with SU concerns and without SU concerns engaged very similarly in SafeCare.

Substance use behaviours and the UK furlough scheme: evidence from eight longitudinal population surveys

Disruptions to economic activity such as job loss can impact substance use behaviours. During the COVID-19 pandemic many countries implemented a furlough scheme to prevent job loss. We examine how furlough was associated with respondents' substance use behaviours in the initial stages of the pandemic in the UK. Data were from over 27,000 participants in eight adult longitudinal surveys. Participants self-reported economic activity (furlough or job loss vs stable employment) and smoking (any current), vaping (any current) and drinking alcohol (>4 days/week or 5+ drinks per typical occasion) both before and during the initial stages of the pandemic. Changes in frequency/quantity of substance use were also examined. Risk ratios were estimated within each study using modified Poisson regression, adjusting for a range of potential confounders, including pre-pandemic behaviour (though this was excluded in analyses of behaviour change). Findings were synthesised using a random effects meta-analysis. Compared to stable employment, participation in the furlough scheme was associated with smoking (risk ratio: 1.24 [95% CI: 1.08-1.42]; I2=0%) while job loss was associated with vaping (1.72 [1.10-2.71]; I2=25%) and heavier drinking (1.21 [1.02-1.43]; I2=2%), but these associations were largely accounted for by confounders (adjusted risk ratios: smoking: 1.06 [0.96-1.16]; I2=8%; vaping: 1.55 [0.93-2.56]; I2=42%; and drinking: 1.03 [0.89-1.20]; I2=35%). Furlough was associated with drinking more than before the pandemic (adjusted risk ratio: 1.15 [1.00-1.33]; I2=70%), and with increases in vaping behaviour (1.54 [1.14-2.07]; I2=0%). Increased drinking associated with furlough is concerning, while increased vaping likely represents moves to reduce smoking and may be positive.

"With a PICC line, you never miss": The role of peripherally inserted central catheters in hospital care for people living with HIV/HCV who use drugs.

People who use drugs (PWUD), and especially those who inject drugs, are at increased risk of acquiring bloodborne infections (e.g., HIV and HCV), experiencing drug-related harms (e.g., abscesses and overdose), and being hospitalized and requiring inpatient parenteral antibiotic therapy delivered through a peripherally inserted central catheter (PICC). The use of PICC lines with PWUD is understood to be a source of tension in hospital settings but has not been well researched. Drawing on theoretical and analytic insights from "new materialism," we consider the assemblage of sociomaterial elements that inform the use of PICCs. This paper draws on n=50 interviews conducted across two related qualitative research projects within a program of research about the impact of substance use on hospital admissions from the perspective of healthcare providers (HCPs) and people living with HIV/HCV who use drugs. This paper focuses on data about PICC lines collected in both studies. The decision to provide, maintain, or remove a PICC is based on a complex assemblage of factors (e.g., infections, bodies, drugs, memories, relations, spaces, temporalities, and contingencies) beyond whether parenteral intravenous antibiotic therapy is clinically indicated. HCPs expressed concerns about the risk posed by past, current, and future drug use, and contact with non-clinical spaces (e.g., patient's homes and the surrounding community), with some opting for second-line treatments and removing PICCs. The majority of PWUD described being subjected to threats of discharge and increased monitoring despite being too ill to use their PICC lines during past hospital admissions. A subset of PWUD reported using their PICC lines to inject drugs as a harm reduction strategy, and a subset of HCPs reported providing harm reduction-centred care. Our analysis has implications for theorizing the role of PICC lines in the care of PWUD and identifies practical guidance for engaging them in productive and non-judgemental discussions about the risks of injecting into a PICC line, how to do it safely, and about medically supported alternatives.

Motives for prescription opioid use: The role of alexithymia and distress tolerance.

Prescription opioid (PO) use disorder is a national public health crisis. Distress tolerance and alexithymia are two separate but related components of emotion regulation that are known to impact substance use disorders. No studies to date, however, have examined the role of distress tolerance and alexithymia in PO use disorder. Thus, the current study examined the association between distress tolerance, alexithymia, and specific motivations for PO use. Participants were non-treatment-seekingindividuals with current PO use disorder (N = 81; average age = 35.0). Assessments included the Distress Tolerance Scale, Toronto Alexithymia Scale, and the Inventory of Drug Taking Situations. The findings indicate that distress tolerance mediated the association between alexithymia and PO use in negative situations. Specifically, distress tolerance mediated the association between alexithymia and unpleasant emotions, testing personal control, and conflict with others. The results provide novel information regarding emotional states that may contribute to PO use and are malleable intervention targets. Additionally, this study adds to existing literature exploring the relationship between distress tolerance and substance use and is the first to expand upon the connection between alexithymia and distress tolerance in an opioid-using population. Implications for clinical practice and future research are discussed.

Substance use and HIV stage at entry into care among people with HIV

BackgroundInformation regarding the impact of substance use on the timing of entry into HIV care is lacking. Better understanding of this relationship can help guide approaches and policies to improve HIV testing and linkage.MethodsWe examined the effect of specific substances on stage of HIV disease at entry into care in over 5000 persons with HIV (PWH) newly enrolling in care. Substance use was obtained from the AUDIT-C and ASSIST instruments. We examined the association between early entry into care and substance use (high-risk alcohol, methamphetamine, cocaine/crack, illicit opioids, marijuana) using logistic and relative risk regression models adjusting for demographic factors, mental health symptoms and diagnoses, and clinical site.ResultsWe found that current methamphetamine use, past and current cocaine and marijuana use was associated with earlier entry into care compared with individuals who reported no use of these substances.ConclusionEarly entry into care among those with substance use suggests that HIV testing may be differentially offered to people with known HIV risk factors, and that individuals with substances use disorders may be more likely to be tested and linked to care due to increased interactions with the healthcare system.

Substance use patterns in 9-10 year olds: Baseline findings from the adolescent brain cognitive development (ABCD) study

BackgroundThe Adolescent Brain Cognitive Development ™ Study (ABCD Study®) is an open-science, multi-site, prospective, longitudinal study following over 11,800 9- and 10-year-old youth into early adulthood. The ABCD Study aims to prospectively examine the impact of substance use (SU) on neurocognitive and health outcomes. Although SU initiation typically occurs during teen years, relatively little is known about patterns of SU in children younger than 12. MethodsThis study aims to report the detailed ABCD Study® SU patterns at baseline (n = 11,875) in order to inform the greater scientific community about cohort’s early SU. Along with a detailed description of SU, we ran mixed effects regression models to examine the association between early caffeine and alcohol sipping with demographic factors, externalizing symptoms and parental history of alcohol and substance use disorders (AUD/SUD). Primary ResultsAt baseline, the majority of youth had used caffeine (67.6 %) and 22.5 % reported sipping alcohol (22.5 %). There was little to no reported use of other drug categories (0.2 % full alcohol drink, 0.7 % used nicotine, <0.1 % used any other drug of abuse). Analyses revealed that total caffeine use and early alcohol sipping were associated with demographic variables (p’s<.05), externalizing symptoms (caffeine p = 0002; sipping p = .0003), and parental history of AUD (sipping p = .03). ConclusionsABCD Study participants aged 9–10 years old reported caffeine use and alcohol sipping experimentation, but very rare other SU. Variables linked with early childhood alcohol sipping and caffeine use should be examined as contributing factors in future longitudinal analyses examining escalating trajectories of SU in the ABCD Study cohort.