National Survey Of Drug Use And Health Research Articles

Religion, Psychedelics, Risky Behavior, and Violence

ABSTRACT Research has found that psychedelic use is associated with positive behavioral changes, however research has yet to explore the relationship between socio-cultural conditions on this relationship. This paper intends to fill this gap by testing the effects of religious participation and beliefs on the relationship between psychedelic use and behaviors. This study examines the relationship between Lifetime Classic Psychedelic Use (LCPU), different aspects of religion (such as salience and attendance), and the likelihood of committing a violent assault. The analysis uses pooled data from the National Survey of Drug Use and Health (NSDUH) from 2015 to 2019, with a sample size of 282,768. Binary logistic regression models conducted in Stata 17 reveal that LCPU and religion (salience and influence) are independently associated with reduced violence. Additionally, two-way interactions indicate that the association between risky behavior and violence is smaller among individuals with high levels of religious salience. Furthermore, a three-way interaction suggests that the association between risky behavior and violence is smaller for those who have used psychedelics, with the largest effect observed among individuals with high religious salience. These results show that religious factors can influence the relationship between psychedelic use and behaviors, with both attendance and salience operating simultaneously.

Diminished psychedelic returns on distress: Marital status and household size.

Although the use of psychedelics to impact health has seen growth, little research has tested the effects of culture conditions on the relationship. More specifically, how does marital status and family size affect the relationship between psychedelics and health? This study tests the relationship between Lifetime Classic Psychedelic Use (LCPU), marital status, and household size (number of people living in a household) on levels of psychological distress in the past 30 days. This project uses pooled data from the National Survey of Drug Use and Health (NSDUH) (2010 to 2018) (N = 674,521). The Final sample size is determined by the dependent variable, psychological distress in the past month (n = 158,633). The analysis includes a series of nested logistic regression models conducted in Stata 17. Results indicate that LCPU is independently associated with better health, but the association between LCPU and health varies across levels of household size. Larger households are associated with higher levels of distress, which are then exacerbated among psychedelics users. Furthermore, three-way interactions reveal that the negative association between household size and distress gets larger among psychedelic users who are married, divorced, and widowed. Overall, results suggest that household size negatively impacts the association between LCPU and health, with those who are married, divorced, and widowed experiencing the worst outcomes.

Minorities’ diminished psychedelic returns: Cardio-metabolic health

Although there is a growing support for the protective factor of psychedelics to improve mental and physical health, these effects may differ across racial and ethnic groups. Race differences remain a critically understudied gap in psychedelic literature. Recent empirical research into Minority Diminished Psychedelic Returns suggests that Black Americans may gain little health benefits from psychedelic use. This study tests race differences in the association between Lifetime Classic Psychedelic Use and multiple indicators of cardio-metabolic health including cardiovascular disease, hypertension, and Body Mass Index. This project uses pooled data of Black and White adults respondents from the National Survey of Drug Use and Health (NSDUH) (2005 to 2019) (N = 421,477). The analysis includes a series of logistic and ordinary least square regression models conducted in Stata 18. Results demonstrate that Lifetime Psychedelic Use is associated with better cardio-metabolic health. However, regression models by race find that there is no association between LCPU and cardio metabolic health for Black people, while the positive associations remain significant for white people. Overall, results lend support for the MPDR theory.

Characteristics associated with blindness or visual impairment within the adolescent demographic: a national cohort analysis

BackgroundPsychosocial metrics associated with self-reported blindness or visual impairment for adolescents in the National Survey of Drug Use and Health (NSDUH) have not been fully characterized. This retrospective cohort analysis of the latest NSDUH aimed to determine novel characteristics associated with self-reported visual loss among adolescents in the United States. MethodsData from the NSDUH2020, a publicly available, federally validated database, were analyzed. Self-reported severe visual impairment or blindness was defined as being truly blind or having serious difficulty seeing even when wearing corrective lenses (s-rSVI). Inclusion criteria were all cases of s-rSVI in adolescents aged 12-17 years. NSDUH weights were used to accommodate complex survey design, nonresponse rates, and population variance. Weighted percentages, asymptotic two-sided Rao-Scott χ2 analyses, and multivariable binary logistic regression were performed. Statistical significance was considered reached at P < 0.05. ResultsA total of 5,667 adolescents aged 12-17 years were surveyed, and s-rSVI occurred in 236 cases (weighted percentage, 3.48%). Within our final risk model, characteristics associated with enhanced odds of s-rSVI based on multivariable logistic regression analysis were female sex, Asian and Latino race/ethnicity (relative to non-Hispanic White), and self-reported serious difficulty hearing and concentrating (all P < 0.05). ConclusionsThis national retrospective cohort analysis highlights risk factors associated with s-rSVI for adolescents within the 2020 NSDUH. Clinicians and policymakers should consider at-risk demographics for s-rSVI during development and enhancement of screening programs, population health initiatives, and healthcare policy issues.

Opioid Misuse and Associated Health Risks among Adults on Probation and Parole: Prevalence and Correlates 2015–2020

Background As state legislatures work to reduce prison populations and increase the use of community-based alternatives, limited knowledge exists about the service needs of those under criminal justice supervision in the community. Preliminary research indicates unusually high rates of disease, disability, and death. Health risks for this population include opioid misuse, a form of substance misuse that has reached epidemic proportions in the U.S. Evidence indicates this may be one of multiple epidemics this population experiences, complicating intervention. Methods Our study included 5154 individuals on probation or parole. Using 2015–2020 data from the National Survey of Drug Use and Health (NSDUH), we conducted a series of logistic regressions examining associations between opioid misuse and a range of health risks, controlling for sociodemographic variables and survey year. Results Approximately 17% of those on probation or parole indicated past-year opioid misuse, a rate 4 times higher than in the general population. Compared to those on probation and parole who did not misuse opioids, it was associated with higher odds of other health risk behaviors and mental health problems. For example, the odds of marijuana and cocaine use were 4-6 times higher and the odds of substance use disorder were 10 times higher. Similarly, the odds of experiencing major depressive episodes and serious psychological distress were 2–3 times higher. Conclusions Our findings reveal a markedly high risk for opioid misuse within this population along with associated risks for behavioral and mental health problems. The complex treatment needs of this population require greater policy attention and further research.

Psychedelics and workplace harm.

This study aims to understand the relationship between Lifetime Classic Psychedelic Use (LCPU), employment status, and weekly work hours on levels of psychological distress. The data used for this analysis is pooled from the National Survey of Drug Use and Health (NSDUH) from 2008-2019 and includes a sample size of 484,732 individuals. The findings suggest that LCPU and being employed are independently associated with better health. Additionally, the results indicate that psychedelic use is associated with lower distress for those who are employed, volunteer, retired, or permanently disabled. However, those who are unemployed, full-time students, or homemakers may experience higher levels of distress with psychedelic use. Interestingly, the analysis also suggests that those who use psychedelics are working longer hours per week before experiencing an increase in stress. Overall, the study suggests that psychedelics are not likely to have a negative impact on employment outcomes.

The Utilization Profiles of Comprehensive School Mental and Behavioral Health Needs Among Adolescents.

Schools have become a primary access point for mental health services to cover the gap between need and service utilization that has long existed, particularly among vulnerable populations. This study aims to identify the profiles of comprehensive school mental and behavioral health system (CSMBHS) needs and examine related characteristics. We used the 2019 National Survey of Drug Use and Health (NSDUH) collected from a nationally representative sample in the United States. The sample included 6th through 12th-grade adolescents who had received CSMBHS services in the last 12 months (N=1346). The study conducted latent class analysis and multinomial logistic regression using Vermunt's 3-step approach. The analysis identified 3 profiles of student CSMBHS service need: depression needs (42%), multiple endorsements in most needs (depressed, friend, and school problems; 6.5%), and low endorsement (51.4%). Findings suggest that the profiles differed by age, a lifetime major depressive episode, family income, and use of other mental health services. Emphasis should be placed on proactively identifying student needs and advocating for appropriate interventions based on student needs. The study reveals important information regarding how schools best support students in need and in seeking services.

The association between cannabis use and subjective memory complaints in older adults in the United States.

The U.S. population is aging and increasing numbers of older adults are using cannabis. Cognitive decline is common in older age and subjective memory complaints (SMC) have been associated with increased risk for dementia. While residual cognitive effects of cannabis use at younger ages are well understood, the links between cannabis use and cognition in older adults is less clear. The present study represents the first population-level analysis of cannabis use and SMC in older adults in the U.S. We used the National Survey of Drug Use and Health (NSDUH) dataset to evaluate SMC in respondents over age 50 (N = 26,399) according to past-year cannabis use. Results revealed that 13.2% (95%CI: 11.5%-15.0%) of those who reported cannabis use also reported SMC, compared to 6.4% (95%CI: 6.1%-6.8%) among individuals with no cannabis use. Logistic regression revealed a two-fold increase (OR = 2.21, 95%CI: 1.88-2.60) of reporting SMC in respondents who had used cannabis in the past year, which was attenuated (OR = 1.38, 95%CI: 1.10-1.72) when controlling for additional factors. Other covariates, including physical health conditions, misuse of other substances, and mental illness also significantly contributed to SMC outcomes. Cannabis use represents a modifiable lifestyle factor that has potential for both risk and protective properties that may impact the trajectory of cognitive decline in older age. These hypothesis generating results are important for characterizing and contextualizing population-level trends related to cannabis use and SMC in older adults.

Systematic mining of patterns of polysubstance use in a nationwide population survey

Objectives:To identify patterns of association and transition in polysubstance use based on National Survey of Drug Use and Health (NSDUH) in the United States. Methods:We developed a new computational platform for PolySubstance Use data Mining for Associations and Transitions (PSUMAnT). It is based on the computation of weighted support, a measure of popularity, for the use of every combination of one or more substances, termed as a drugset, over a period of 5 decades (1965–2014) based on NSDUH data. It uses an efficient bitstring representation with exact and approximate string matching capabilities to search for patterns of association between drugsets and demographics of user groups at different time-intervals. Moreover, it introduces a quantitative definition of a rule of transition between pairs of substances used within a given time-interval, and provides a function for mining them. Results:We identified the frequent drugsets from individual substance use database, and determined their representation among different demographic groups at different intervals. An interesting pattern of use of pain relievers and tranquilizers was detected for the age-group of 26–34 years. In addition, transition rules for heroin use in the last decade (2004–2015) of the given data were mined. Conclusions:Computation of weighted supports over time for every possible combination of substances in the survey, and their association with specific user groups, allows PSUMAnT to generate and test novel, interesting hypotheses in polysubstance use. PSUMAnT can be used for mining combinations of substances used among diverse demographic groups including those that have received less attention in this problem.

Racial and ethnic differences in suicidal behavior and mental health service use among US adults, 2009-2020.

While suicide rates have recently declined for White individuals, rates among Black and Hispanic individuals have increased. Yet, little is known about racial/ethnic differences in precursors to suicide, including suicidal ideation (SI) and suicide attempts (SA). Data from 2009-2020 National Survey of Drug Use and Health (NSDUH) consisted of non-institutionalized US civilians aged ⩾18 (n = 426 008). We compared proportions of White, Black, and Hispanics among adults reporting no past-year suicidal thoughts/behavior, SI, and SA. Multivariable-adjusted analyses were used to evaluate the independence of observed racial/ethnic differences in past-year SI, SA, and mental health service use. In the entire sample, 20 791 (4.9%) reported past-year SI only and 3661 (0.9%) reported a SA. Compared to White individuals, Black and Hispanic individuals were significantly less likely to report past-year SI [OR 0.73 (95% CI 0.69-0.77); OR 0.75 (95% CI 0.71-0.79), respectively], but more likely to report a past-year SA [OR 1.45 (95% CI 1.28-1.64); OR 1.19 (95% CI 1.04-1.37), respectively] even after multivariable adjustment. Black and Hispanic individuals were significantly less likely to use mental health services, but the lack of significant interactions between race/ethnicity and SI/SA in association with service use suggests differences in service use do not account for differences in SI or SA. Black and Hispanic individuals are significantly less likely than White individuals to report SI but more likely to report SAs, suggesting differences in suicidal behavior across race/ethnicity that may be impacted by socio-culturally acceptable expressions of distress and structural racism in the healthcare system.

Licit and illicit drug use across trimesters in pregnant women endorsing past-year substance use: Results from National Survey on Drug Use and Health (2009-2019).

Given the health consequences, perinatal substance use is a significant public health concern, especially as substance use rates increase among women; ongoing data regarding the rates of substance use across trimesters of pregnancy is needed. The present study utilized cross-sectional population-based data from the National Survey of Drug Use and Health (NSDUH) between 2009 and 2019. We aimed to explore both licit and illicit substance use assessed within each trimester among women endorsing past-year substance use. The NSDUH sample included 8,530 pregnant women. Perinatal substance use was less prevalent among women in later trimesters; however, past-month substance use was observed for all substances across trimesters. The prevalence of past-month licit substance use among pregnant women ranged from 5.77 to 22.50% and past-month illicit substance use ranged from 4.67 to 14.81%. In the second trimester, lower odds of past-month substance use were observed across tobacco, alcohol, and marijuana (odds ratios [ORs] ranging from 0.29 to 0.47), when compared to the first trimester. A similar lower rate of past-month substance use was observed in the third trimester compared to the first trimester, across tobacco, alcohol, and marijuana use, as well as cocaine, prescription pain medication, and tranquilizer use (ORs ranging from 0.02 to 0.42). The likelihood of polysubstance use was lower among women in the second and third trimesters compared to the first trimester (ORs ranging from 0.09 to 0.46). Findings indicate that a minority of women continue to use substances across all trimesters. This is especially true among women using licit substances and marijuana. These results highlight the need for improved interventions and improved access to treatment for these women.

Suicide Attempts Rise, Yet Many Do Not Receive MH Services

Back to table of contents Previous article Next article Clinical & ResearchFull AccessSuicide Attempts Rise, Yet Many Do Not Receive MH ServicesTerri D'ArrigoTerri D'ArrigoSearch for more papers by this authorPublished Online:25 Apr 2022https://doi.org/10.1176/appi.pn.2022.05.4.4AbstractLogistical and financial barriers stand between patients who attempt suicide and the care they need.Between 2008 and 2019, the annual rate of suicide attempts per 100,000 adults in the United States rose from 481.2 to 563.9, yet the rate at which individuals who attempt suicide receive mental health services has not kept pace, according to a study in JAMA Psychiatry.Policies that improve the social conditions in which people live can help curb the rise in suicide, says Tanner Bommersbach, M.D., M.P.H.Yale School of Medicine/Robert A. LisakTanner Bommersbach, M.D., M.P.H., a psychiatry resident at Yale School of Medicine, and colleagues analyzed data from 484,732 adults who participated in the National Survey of Drug Use and Health (NSDUH) from 2008 to 2019. They defined suicide attempts as self-reported efforts to kill one’s self in the past 12 months and examined trends in past-year use of mental health services among participants who reported past-year suicide attempts. They also analyzed data about the participants’ reasons why they did not receive care.Among adults who attempted suicide, 34.8% (2010 to 2011) to 45.5% (2018 to 2019) reported needing mental health services but did not obtain them. From 2008 to 2019 there were no significant changes in the likelihood of having any mental health outpatient, inpatient, or medication services or changes in the use of substance use treatment services. The number of participants who reported not knowing where to go for treatment, lacking transportation, or reporting that services were too far away increased over the course of the study.Bommersbach told Psychiatric News that the results demonstrate a need for broad efforts to address mental health. “While access to care for individuals at high-risk is critical, mental health services alone are unlikely to curb the rise in suicide,” Bommersbach said. “We must also focus on community-based interventions and broad social policies that improve the social conditions in which people are living.”Study researcher Taeho Greg Rhee, Ph.D., an assistant professor adjunct of psychiatry at Yale School of Medicine, added that it is important for health professionals to step up in helping patients get the care they need. “Improving access to care and addressing unmet psychiatric and medical needs among individuals with suicidal ideation or suicide attempts should be clinical goals across diverse settings,” Rhee said. “We need to engage with and educate patients more actively so that they can get the help they need when they face a crisis, including suicidal ideation or suicide attempts.”Maria A. Oquendo, M.D., Ph.D., suggests partnering with schools and communities to offer education about mental health.David HathcoxAlthough there is a shortage of psychiatrists and mental health professionals, psychiatrists among the APA membership can play a role in community outreach, said suicide expert Maria A. Oquendo, M.D., Ph.D., the Ruth Meltzer Professor and Chair of Psychiatry at the Perelman School of Medicine at the University of Pennsylvania and past president of APA, who was not involved in the research.“Organizing district branches to partner with schools and communities to offer educational sessions about mental health and how to access care in the community would be useful,” Oquendo said.Social media campaigns, initiatives on college campuses, unemployment benefit programs, and financial supports may offer other ways for reaching high-risk populations, Bommersbach and colleagues wrote. Continued expansion of telehealth-based interventions for substance use, especially for medications for opioid use disorder in rural areas, may also present a way to engage more people in treatment, they added.The researchers wrote that the results underscore the importance of efforts to improve access to insurance and enforcement of mental health parity.Oquendo explained that a lack of parity serves as a barrier to care, even when patients do have insurance.“Despite being a law, many insurers still have discriminatory policies that result in mental health clinicians not being paid for their work, thus deterring [these professionals] from accepting insurance,” Oquendo said.This study was supported by the National Institute on Aging; the National Institute of Mental Health; and the Institute for Collaboration on Health, Intervention, and Policy of the University of Connecticut. ■“National Trends of Mental Health Care Among U.S. Adults Who Attempted Suicide in the Past 12 Months.” ISSUES NewArchived

Associations of employment status with opioid misuse: Evidence from a nationally representative survey in the U.S.

The opioid crisis in the United States (U.S.) is widespread and increasing in severity, and psychosocial exposures have been identified as potential risk factors. We examined associations of employment status with opioid misuse in a large, nationally representative, population-based sample in the U.S. Data were from the 2019 National Survey of Drug Use and Health (NSDUH), an annual cross-sectional survey. The association of employment status with opioid misuse in 40,143 participants was examined by multivariable logistic regression, adjusting for age, sex, race/ethnicity, marital status, household income, educational attainment, medical insurance status, physical health conditions and depression. Analyses were weighted to represent a nationally representative sample of adults in the U.S. In NSDUH 2019, 3.82% of American individuals reported past-year opioid misuse. After taking relevant variables into account, compared to workers who were employed with normal working hours (35–40 h/week), those who were currently unemployed had higher odds of opioid misuse (fully adjusted odds ratio and 95% confidence interval were 1.40 [1.09, 1.79]). Compared to workers employed with normal working hours, those who were in school/training or retired had lower odds of opioid misuse. Short or long working hours were not associated with opioid misuse. Government and employer policy interventions may benefit from emphasizing stable employment as a major social determinant of health in the context of the opioid crisis.

Epidemiological association of cannabinoid- and drug- exposures and sociodemographic factors with limb reduction defects across USA 1989–2016: A geotemporospatial study

BackgroundReports of major limb defects after prenatal cannabis exposure (PCE) in animals and of human populations in Hawaii, Europe and Australia raise the question of whether the increasing use of cannabis in USA might be spatiotemporally associated with limb reduction rates (LRR) across USA. MethodsCongenital anomaly data was from the National Birth Defects Prevention Network, drug use data was taken from the National Survey of Drug Use and Health (NSDUH), cannabinoid concentration was estimated from Federal seizure data and ethnicity and income data were from the US Census bureau. Geotemporospatial analysis was conducted in R. Results436 LRR datapoints were obtained. LRR was significantly associated with cannabis use and tetrahydrocannabinol (THC) exposure and demonstrated prominent cannabis-use quintile effects. A sharp increase in LRR occurred from the fourth to fifth quintiles of cannabis exposure (mean ± S.E.M 3.78 ± 0.38 to 6.66 ± 0.56/10,000 live births, P = 5.22 × 10−9). In final lagged geospatial models adjusted for ethnicity and income interactive terms including cannabinoids were highly significant and robust to adjustment. States in which cannabis was not legalized had a lower LRR (4.28 v 5.01/10,000 live births, relative risk reduction = −0.15, (95%C.I. −0.25, −0.02), P = 0.021). Internationally 37–63% of cases are estimated to not be born alive. Their inclusion in these analyzes uniformly intensified the identified effects and the significance of the effect of the cannabis legalization paradigm rose from P = 0.0256 to P = 0.0146 to P = 0.0048 with silent factors of 0%, 36% and 63%, respectively. ConclusionTherefore a spatiotemporal and dose-dependent association between several cannabinoids including THC and cannabigerol and LRR is reported, is robust to adjustment, is consistent with pathophysiological and preclinical studies, accords with findings elsewhere, is markedly exacerbated in higher exposure quintiles, is exacerbated by cannabis legalization and evidences dose-related intergenerational sequaelae.

National Trends of Mental Health Care Among US Adults Who Attempted Suicide in the Past 12 Months

Although suicide attempts remain the strongest risk factor for future suicide, little is known about recent trends in the prevalence of and risk factors for suicide attempts and past-year use of services among adults who attempted suicide. To estimate annual rates of suicide attempts and use of mental health services among US adults from 2008 to 2019. This US nationally representative cross-sectional study used the National Survey of Drug Use and Health (NSDUH) from 2008 through 2019. Participants included noninstitutionalized US civilians 18 years or older (n = 484 732). The overall annual rates of suicide attempts per 100 000 adults in the general population and national trends from 2008 to 2019 were estimated, with suicide attempts defined as self-reported efforts to kill one's self in the past 12 months. Subgroup analyses were also performed by demographic characteristics and clinical conditions. The trends in past-year use of mental health services among those who reported past-year suicide attempts were then examined. Data were analyzed from October to December 2021. Rate of suicide attempts from 2008 to 2019. Multivariate-adjusted logistic regression analyses were used to determine whether adjusting for sociodemographic and clinical factors associated with past-year suicide attempts could account for the change within the study period. Of 484 732 survey participants, most were 35 years or younger (69.8%), women (51.8%), and non-Hispanic White individuals (65.7%). From 2008 to 2019, the weighted unadjusted suicide attempt rate per 100 000 population increased from 481.2 to 563.9 (odds ratio [OR], 1.17 [95% CI, 1.01-1.36]; P = .04) and remained significant after controlling for sociodemographic characteristics (adjusted OR [aOR], 1.23 [95% CI, 1.05-1.44]; P = .01). Rates of suicide attempt increased particularly among young adults aged 18 to 25 years (aOR, 1.81 [95% CI, 1.52-2.16]; P < .001), women (aOR, 1.33 [95% CI, 1.09-1.62]; P = .005), those who were unemployed (aOR, 2.22 [95% CI, 1.58-3.12]; P < .001) or never married (aOR, 1.60 [95% CI, 1.31-1.96]; P < .001), and individuals who used substances (aOR, 1.44 [95% CI, 1.19-1.75]; P < .001). In multivariate analyses, the temporal trend of increasing suicide attempts remained significant even after controlling for other significant sociodemographic and clinical factors (aOR, 1.36 [95% CI, 1.16-1.60]; P < .001). Several sociodemographic and clinical subgroups remained independently associated with suicide attempts, especially those with serious psychological distress (aOR, 7.51 [95% CI, 6.49-8.68]; P < .001), major depressive episodes (aOR, 2.90 [95% CI, 2.57-3.27]; P < .001), and alcohol use disorder (aOR, 1.81 [95%CI, 1.61-2.04]; P< .001) as well as individuals who reported being divorced or separated (aOR, 1.65 [95% CI, 1.35-2.02]; P < .001) or being unemployed (aOR, 1.47 [95% CI, 1.27-1.70]; P< .001) and those who identified as Black (aOR, 1.41 [95% CI, 1.24-1.60]; P < .001) or American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander (aOR, 1.56 [95% CI, 1.26-1.93]; P < .001). Among adults with a suicide attempt, there was no significant change in the likelihood of receiving past-year mental health or substance-related services. During the study period, 34.8% to 45.5% reported needing services but did not receive them, with no significant change from 2008 to 2019. Although suicide attempts appear to be increasing, use of services among those who attempted suicide has not increased, suggesting a need to expand service accessibility and/or acceptability, as well as population-wide prevention efforts.

Depression and mental health service use among 12–17 year old U.S. adolescents: Associations with current parental and sibling military service

ObjectiveTo examine whether having a parent and/or a sibling currently serving in the military is associated with major depression and use of mental health services among 12–17 year old adolescents in the United States. MethodDescriptive and multivariate logistic regression analyses are conducted using pooled data from the 2016–2019 National Survey of Drug Use and Health (NSDUH). Analyses are weighted and standard errors are adjusted for the complex sampling design. ResultsAdolescents are more likely to have a sibling than a parent currently serving in the military. Having a sibling currently in the military increases the likelihood of having a lifetime and a past-year major depressive episode (MDE), but not a past-year MDE with severe role impairment or use of mental health services. Having a parent in the military is not associated with any measure of MDE, but increases use of specialty outpatient, specialty inpatient/residential, and non-specialty mental health services net of MDE and sociodemographic controls. ConclusionConsiderable attention has focused on risk and resilience among the dependent children of current service members. A better understanding of how the current military service experiences of siblings, as well as parents, influences related adolescents’ mental health, mental health care service use, substance use, and health behaviors has the potential to contribute to programs and interventions that can enhance the well-being of youth with intra-generational, as well as inter-generational, connections to the military. Adolescents who have a sibling currently serving in the military are an at-risk population for MDE and potentially other mental and behavioral health problems.

Predicting Mental Health Treatment Access Among Adolescents With Elevated Depressive Symptoms: Machine Learning Approaches.

A large proportion of adolescents experiencing depression never access treatment. To increase access to effective mental health care, it is critical to understand factors associated with increased versus decreased odds of adolescent treatment access. This study used individual depression symptoms and sociodemographic variables to predict whether and where adolescents with depression accessed mental health treatments. We performed a pre-registered, secondary analysis of data from the 2017 National Survey of Drug Use and Health (NSDUH), a nationally representative sample of non-institutionalized civilians in the United States. Using four cross-validated random forest models, we predicted whether adolescents with elevated past-year depressive symptoms (N = 1,671; ages 12-17years) accessed specific mental health treatments in the previous 12months ("yes/no" for inpatient, outpatient, school, any). 53.38% of adolescents with elevated depressive symptoms accessed treatment of any kind. Even with depressive symptoms and sociodemographic factors included as predictors, pre-registered random forests explained < 0.00% of pseudo out-of-sample deviance in adolescent access to inpatient, outpatient, school, or overall treatments. Exploratory elastic net models explained 0.80-2.50% of pseudo out-of-sample deviance in adolescent treatment access across all four treatment types. Neither individual depressive symptoms nor any socioeconomic variables meaningfully predicted specific or overall mental health treatment access in adolescents with elevated past-year symptoms. This study highlights substantial limitations in our capacity to predict whether and where adolescents access mental health treatment and underscores the broader need for more accessible, scalable adolescent depression treatments.

Optimal control of alcoholism spreading through awareness over multiplex network

This paper proposes the SISRS epidemic model to represent alcohol addiction among people. The spreading of alcohol addiction is controlled by creating awareness among the people and also by treating them to overcome it. Multiplex network is used to study the dynamics of addiction. Alcoholism spreads over the physical contact layer and follows the SISRS process whereas human awareness spreads over the virtual contact layer and follows the UAU process. Based on the Microscopic Markov Chain Approach competing dynamics of spreading of alcohol addiction and human awareness diffusion are studied. Necessary conditions for the existence of an alcohol-free population are found. An optimal control problem using a suitable cost index is formulated to reduce the alcohol addicts and the optimal control strategy using Pontryagin’s Minimum Principle is determined. Numerical results are developed to find the effect of various parameters and to analyze the effects of different control strategies. The results obtained from this model are closer to the data collected in the National Survey of Drug Use and Health (NSDUH) from 2002 to 2018.

Adolescent Marijuana Dependence: The Role of Social Bonds and Social Learning Theory

ABSTRACT Using the 2017 National Survey of Drug Use and Health (NSDUH) data, this research examines the extent to which social bonds and social learning theory predict adolescent marijuana dependence. Full information maximum likelihood (FIML) for logistic regression analyses were conducted in four models to test the competing theories. The results revealed partial support for both theories, such that adolescents with stronger parental bonds and negative definitions of substance use were less likely to be dependent on marijuana, while adolescents who associated with substance using peers were more likely to be dependent on marijuana. The multi-theoretical model suggested that only the social learning theory concepts of differential association and negative definitions were significant theoretical predictors of adolescent marijuana dependence. Additional analyses revealed that first using marijuana at 14 or 15 years old was also significantly related to adolescent marijuana dependence. Implications for future research and risk prevention programs are discussed.

Predictive model of multiple emergency department visits among adults: analysis of the data from the National Survey of Drug Use and Health (NSDUH)

BackgroundIn this methodological paper, we use a novel, predictive approach to examine how demographics, substance use, mental and other health indicators predict multiple visits (≥3) to emergency departments (ED) within a year.MethodsState-of-the-art predictive methods were used to evaluate predictive ability and factors predicting multiple visits to ED within a year and to identify factors that influenced the strength of the prediction. The analysis used public-use datasets from the 2015–2018 National Surveys on Drug Use and Health (NSDUH), which used the same questionnaire on the variables of interest. Analysis focused on adults aged ≥18 years. Several predictive models (regressions, trees, and random forests) were validated and compared on independent datasets.ResultsPredictive ability on a test set for multiple ED visits (≥3 times within a year) measured as the area under the receiver operating characteristic (ROC) reached 0.8, which is good for a national survey. Models revealed consistency in predictive factors across the 4 survey years. The most influential variables for predicting ≥3 ED visits per year were fair/poor self-rated health, being nervous or restless/fidgety, having a lower income, asthma, heart condition/disease, having chronic obstructive pulmonary disease (COPD), nicotine dependence, African-American race, female sex, having diabetes, and being of younger age (18–20).ConclusionsThe findings reveal the need to address behavioral and mental health contributors to ED visits and reinforce the importance of developing integrated care models in primary care settings to improve mental health for medically vulnerable patients. The presented modeling approach can be broadly applied to national and other large surveys.