National Survey On Drug Use And Health Research Articles

Impact of intrinsic and extrinsic religiosity on cannabis use in adolescents: A structural equation modelling approach to data from the National Survey on Drug Use and Health (NSDUH) 2015–2019

IntroductionReligiosity is believed to be a factor that may reduce the risk of addiction and substance use both in adults and in young people. It is a complex construct that is neither measurable nor objectifiable, thus it must be estimated from proxy characteristics. For this purpose, researchers differentiate between subjective religiosity (i.e., individual religious experience) and extrinsic religiosity, that is, participation to religious services (extrinsic-personal subtype) or to social activities consistent with religion-based principles (extrinsic-social subtype).Objectives This work aimed at exploring the role of different facets of religiosity – intrinsic (subjective), extrinsic-personal (service attendance), and extrinsic-social (church-based social activities) – in terms of deterring cannabis use among adolescents.Methods Aggregated data of NSDUH (2015-2019) on 68,263 adolescents between 12 and 17 years of age were analysed using a structural equation modelling (SEM) to determine pathways of intrinsic and extrinsic components of religiosity in cannabis use. Several covariates were considered in the analyses, including comorbid depression and civil volunteering activities.Results About 15% of participants admitted cannabis use in the previous year. Intrinsic and extrinsic-personal religiosity was reported by 66% and 25% of the sample, respectively. A percentage of fifty-seven of participants were involved in at least one faith-based activity, while 74% reported participation in secular community activities. Both intrinsic and extrinsic-personal religious components were likely to reduce cannabis use at the SEM regression model analysis controlling for putative confounders (cannabis use coeff.: -0.065, p=0.001; coeff.: -0.176, p<0.001, respectively). Considering the joint contribution of relevant covariates (community-based activities, lifetime MDE, sex, and poverty status), the outputs were similar. Cannabis use was not influenced by extrinsic-social component of religiosity, even though the involvement in non-faith based volunteering activities was protectively associated.ConclusionsFrom a policy-makers perspective, the reduction of cannabis use among young people may be obtained by supporting secular volunteering programs, which seem to be a cost-effective strategy. Moreover, whilst promoting religiosity is beyond the scope of any preventive programs, religious practices should be considered relevant protective factors.Disclosure of InterestNone Declared

Relationships of Self-reported Opioid Use and Misuse and Pain Severity With Probable Major Depression Among Participants With Spinal Cord Injury

ObjectivesTo examine the relations of pain intensity, opioid use, and opioid misuse with depressive symptom severity and probable major depression (PMD) among participants with spinal cord injuries (SCI), controlling for demographic, injury, and socioeconomic characteristics. Study DesignCohort study. SettingMedical University in the Southeastern United States (US). ParticipantsParticipants (N=918) were identified from 1 of 2 sources including a specialty hospital and a state-based surveillance system in the Southeastern US. Participants were a minimum of 18 years old at enrollment and had SCI with non-complete recovery. Participants were on average 57.5 years old at the time of the study and an average of 24.4 years post SCI onset. InterventionsNot applicable. Main Outcome MeasuresParticipants completed a self-report assessment that included frequency of prescription opioid use and misuse, based on the National Survey on Drug Use and Health (NSDUH), and the PHQ – 9 to measure depressive symptom severity and PMD. ResultsOpioid use, opioid misuse, and pain intensity were related to elevated depressive symptom severity and higher odds of PMD. Non-Hispanic Blacks had fewer depressive symptoms and lower odds of PMD, as did those with higher incomes. Veterans had lower risk of PMD, whereas ambulatory participants had a higher risk of PMD. Age at SCI onset had a mixed pattern of significance, whereas years of education and years since injury were not significant. ConclusionsThe relation between pain intensity with depressive symptom severity and PMD was profound, consistent with the biopsychosocial model of pain. The greater risk of PMD and higher depressive symptom severity among those using opioids and misusing opioids raises further concern about long-term prescription opioid use. Alternative treatments are needed.

Codeine and promethazine: Exploratory study on "lean" or "sizzurp"using national survey data and an online forum.

The concoction known as "lean" containing codeine and promethazine, holds a prominent cultural presence and is often referenced in mass media platforms (e.g., music and social media). Surprisingly, there's a scarcity of national data characterizing the use of lean. Therefore, the current study investigated the use of lean using national survey data and online forum participant input, and focused on identifying concurrent substance use, exploring co-administration with other substances (e.g., alcohol, cannabis), and determining lean-related experiences. We analyzed data from the National Survey on Drug Use and Health (NSDUH) spanning 2007-2019, identifying persons who used lean (weighted N = 42,275). Additionally, we conducted a Reddit-based study to gather insights about lean consumtion (N = 192). The NSDUH data indicated that lean use was most prevalent among teenagers and young adults (ages 13-21), accounting for 66% of the sample. This trend was more pronounced in male respondents (75%) compared to females. Additionally, the use was predominantly observed among Black/African American (29%), Hispanic (28%), and White (33%) populations, with these groups also reporting higher levels of concurrent alcohol and cannabis use. Similarly, findings from Reddit showed that individuals who used lean were predominantly male (67%) and exhibited elevated concurrent rates of alcohol (83%) and cannabis (46%) use in the past 30 days. Moreover, approximately 66% of respondents met criteria for severe lean use disorder, and 37% acknowledged driving under its influence. The NSDUH data found that mostly young adult males reported consuming lean in the past twelve months, though the racial/ethnic breakdown of persons who used lean was diverse. The Reddit data found that most individuals in the sample met the criteria for a substance use disorder pertaining to their lean consumption. These findings underscore the clinical significance and necessity for further controlled research on lean.

Differences in the relation of binge drinking and prescription drug misuse to suicide ideation and attempts between college-aged adults and adults above the age of 25: Findings from the 2015–2019 National Survey on Drug Use and Health (NSDUH)

ObjectiveTo clarify the role of age in risk associated with drug misuse and binge drinking, this study examines the differential relations of binge drinking and prescription drug misuse to risk of suicidal ideation and attempts in young adults of college age (18–24) compared to those above the age of 25. MethodsWe used data from the National Survey on Drug Use and Health (NSDUH) for the years 2015 through 2019 (N = 269,078). ResultsThe study found that, for adults above college age, the presence of any past-month binge drinking was associated with a higher likelihood of past-year suicide ideation (b = 0.427, OR = 1.532, 95%CI [1.388, 1.692]) and attempts (b = 0.637, OR = 1.891, 95%CI [1.271, 2.813]) compared to college-aged adults. Similarly, past-month prescription drug misuse showed stronger associations with past-year suicide ideation (b = 0.831, OR = 2.297, 95%CI [1.952, 2.701]) and attempts (b = 0.539, OR = 1.715, 95%CI [1.264, 2.327]) in adults above college age. ConclusionThese findings highlight that binge drinking and prescription drug misuse appears to become more strongly associated with suicide ideation and attempts after adults age beyond young adulthood.

Understanding the Behavioral Health Risk Factors that African American and Latinx Women Experience within a National Context

ABSTRACT In an effort to address social determinants of health and to reduce barriers to care, there have been increased attempts to understand and mitigate public health concerns in ethnic minority communities. As knowledge increases regarding the impact of health disparities on ethnic minority communities, social workers practice knowledge must expand to include intersectional approaches and methods that are inclusive of mechanisms that address inconsistencies in access to health care. Using the 2018 National Survey on Drug Use and Health (NSDUH), this study examined behavioral health and psychosocial risk factors that African American and Latinx women (n = 7008) experienced and identified how these factors are associated with self-reported overall health. Results indicated that overall health and wellbeing is linked to psychosocial risk factors, such as depression, substance use, and even age for African American and Latinx women.

Multiple risk factors of substance use among lesbian, gay, bisexual (LGB) adults: A comparison study

ABSTRACT The aim of this study was to identify and compare risk factors of substance use between heterosexual and LGB adults. Using data from the 2020 National Survey on Drug Use and Health (NSDUH), Chi-square, t-test, and standard multiple regressions were employed to analyze the data. The findings showed that LGB participants had significantly higher experiences with substances and initiated substance use earlier than heterosexual participants. Some risk factors were related to experiences with substance use for both groups (i.e. depression, emotional distress, age of first alcohol and marijuana use), but these factors accounted for more of the variance for LGB participants. Additionally, overall health was uniquely associated with experiences with substance use for LGB participants. These results have important implications for the design of culturally appropriate substance use prevention and intervention services for LGB individuals.

Substance addictions and suicidal thoughts and behaviors: Evidence from a multi-wave epidemiological study

Substance addiction (SA) is a risk factor of suicidal thoughts and behaviors (STB), although it is still unclear which SAs are reliably associated with increased risk for suicidal ideation, planning, and attempt. The current study aimed to meet this goal using data from the National Survey on Drug Use and Health (NSDUH) referring to years from 2008 to 2020. The information extracted included sociodemographic and contextual information, eleven SAs (e.g., nicotine, alcohol, marijuana, cocaine, pain relievers, heroin, inhalants, hallucinogens, sedatives, stimulants, and tranquillizers), and STB. The analysis revealed that SAs for alcohol, pain relievers, marijuana, and cocaine were stable and reliable predictors for STB (e.g., suicidal ideation, planning, and attempt), while cocaine was not a stable predictor for suicide attempt. The selected SAs model showed a greater predictive accuracy than only sociodemographic and contextual factors as well as not selected SAs. Moreover, selected SAs showed comparable predictive accuracy to the full model. Furthermore, SA to alcohol showed to be an extremely effective predictor of STB, having a comparable predictive accuracy to all the other ten SAs together. In conclusion, SAs to pain relievers, alcohol, marijuana, and cocaine can be considered as important risk factors for concurrent STB.

Self-Reported Prescription Opioid Use Among Participants with Chronic Spinal Cord Injury.

Individuals with spinal cord injuries (SCI) experience high rates of prescription opioid use, yet there is limited data on frequency of opioid use and specific medications being taken. To examine the frequency of self-reported prescription opioid use among participants with SCI and the relationship with demographic, injury, and socioeconomic characteristics. A cohort study of 918 adults with SCI of at least 1-year duration completed a self-report assessment (SRA) that indicated frequency of specific prescription opioid use based on the National Survey on Drug Use and Health (NSDUH). Forty-seven percent of the participants used at least one prescription opioid over the last year; the most frequently used was hydrocodone (22.1%). Nearly 30% used a minimum of one opioid at least weekly. Lower odds of use of at least one opioid over the past year was observed for Veterans (odds ratio [OR] = 0.60, 95% CI = 0.38, 0.96) and those with a bachelor's degree or higher (OR = 0.63, 95% CI = 0.44, 0.91). When restricting the analysis to use of at least one substance daily or weekly, lower odds of use was observed for those with a bachelor's degree or higher and those with income ranging from $25,000 to $75,000+. None of the demographic or SCI variables were significantly related to prescription opioid use. Despite the widely established risks, prescription opioids were used daily or weekly by more than 28% of the participants. Usage was only related to Veteran status and socioeconomic status indicators, which were protective of use. Alternative treatments are needed for those with the heaviest, most regular usage.

LSD use in the United States: Examining user demographics and their evolution from 2015–2019

AbstractBackgroundLysergic acid diethylamide (LSD) use has risen in the United States in recent years amid increased interest in therapeutic applications of psychedelics. Despite this, contemporary epidemiological investigations of LSD users are few. To expand the literature on this topic, we sought to characterize past-year LSD users in the United States and investigate recent demographic evolution within this population.MethodsUsing National Survey on Drug Use and Health (NSDUH) data from 2015–2019, we investigated correlates of past-year LSD use and associated changes over the study period.ResultsPast-year LSD use increased by 47% from 2015 to 2019 (0.59%–0.87%). However, among people reporting past-year hallucinogen use disorder there was no significant proportional increase in LSD users. Notable correlates of LSD use on multivariable analysis were: increased LSD access, lower perceived risk of trying LSD, low income, fewer children in the home, being approached by someone selling drugs in the past month, and past-year suicide attempt among people age 18 and older. We found no associations with unemployment, arrest history, or past-year psychological distress. From 2015 to 2019, the proportion of respondents reporting past-year LSD use who were age 26–34 and married increased. Past-year LSD use among lifetime users of methamphetamine also rose.ConclusionsThough still uncommonly used in the United States, LSD's societal acceptance may be increasing. Overall, LSD does not appear to contribute significantly to the country's public health problems.

Opioid misuse among people with HIV: results from the National Survey on Drug Use and Health (NSDUH) 2015-2019.

Aim: Pain is a major challenge in the management of HIV/AIDS. This research analyzed the prevalence of substance use and opioid misuse among people with HIV (PWH) and those without (PWoH) in the USA. Methods: Using data from the 2015-2019 National Survey on Drug Use and Health, the study assessed misuse of pain relievers and opioids in 279,025 individuals. Results: PWH were about 1.88-times more likely to misuse pain relievers and 1.85-times to misuse opioids than PWoH, with a notable rise in hydrocodone and tramadol misuse. Conclusion: The data highlights an imperative for interventions targeting substance misuse among PWH, addressing the complex nexus of HIV, chronic pain and opioid use.

Why Are Adolescent Cannabis Use Disorder Treatment Admissions Declining in the US? The Mediated Pathway of State Treatment Admissions Rates before and after Recreational Cannabis Legalization

Purpose: State-level prevalence data are used to investigate whether recreational cannabis legalization moderates the mediated pathway from the perception of low risk of harm, to cannabis use, to cannabis use disorder (CUD) treatment admissions, among adolescents (age 12–17) in the US. Methods: Annual state prevalence measures of perception of low risk, cannabis use, and CUD treatment admissions between 2008 and 2019 (N = 542 state-year observations) were collected from the National Survey on Drug Use and Health (NSDUH) and the Treatment Episode Dataset – Admissions (TEDS-A). A two-way fixed effects (state and year) moderated mediation model was used to test whether recreational legalization moderated the indirect effect of perception of low risk on treatment admissions via cannabis use. Results: A positive indirect effect of perceiving cannabis as low risk on CUD treatment admissions via cannabis use was observed prior to legalization but not afterwards. After legalization, the positive association of perceiving cannabis as low risk with cannabis use was strengthened, and the positive association of cannabis use with treatment admissions was suppressed, as compared to before legalization. Discussion: Recreational legalization may alter the social acceptability and medical self-administration of cannabis, potentially leading to CUD treatment utilization decline among adolescents even as risk factors for CUD increase. Linking recreational cannabis legalization to advancing awareness of the health risks associated with adolescent cannabis use and promoting adolescent CUD treatment engagement through mHealth approaches and primary care providers are key to addressing potential adolescent health challenges brought about by expanding cannabis legalization.

The association between depression and alcohol use among pregnant adults in the USA

BackgroundThe prevalence of alcohol use among pregnant women aged 18–44 years old increased in recent years. The influence of mental health issues on an individual’s likelihood to use alcohol during pregnancy has not been thoroughly investigated. This study will examine the association between experiencing a major depressive episode (MDE) in the past year and past-month alcohol use among pregnant women using the 2011–2020 National Survey on Drug Use and Health (NSDUH).MethodsPregnant women between the ages of 18 and 44 years old were included in the study for analysis. Multivariable logistic regression analysis was used to examine the association between past-year MDE and past-month alcohol use adjusting for age, race/ethnicity, marital status, and employment status. Additional logistic regression analysis was performed to investigate whether this relationship differed by trimester of pregnancy.ResultsA total of 6745 participants were included in the analytic sample. The prevalence of past-year MDE and past-month alcohol use was 7.67% and 9.15% respectively. Logistic regression analysis showed past-year MDE was significantly associated with past-month alcohol use in pregnant women adjusting for age, race/ethnicity, marital status, and employment status (aOR = 1.96; 95% CI, 1.34–2.87). This relationship became stronger in second and third trimesters of pregnancy.ConclusionsThis study showed a positive association between MDE and past-month alcohol use among pregnant women, with strongest effect estimates in the third trimester. These findings may inform approaches for improved screening guidelines and health education for individuals who may be at higher risk of prenatal alcohol use.

Mental health disparities in young adults with arrest history: a survey-based, cross-sectional analysis

BackgroundOver 4.53 million arrests were made in 2021 in the United States. People under 26 years of age were more likely to be arrested than older people. Although mental health disparities are prominent in the incarcerated population, the subject has not been closely examined among young adults specifically.ObjectivesThis study examines how criminal justice involvement, specifically arrests, affects the mental health of adults between 18 and 25 years of age.MethodsWe analyzed secondary data using the 2021 National Survey on Drug Use and Health (NSDUH). The study used a subsample of 13,494 people aged 18 to 25 years, including 7,330 women and 6,164 men. History of arrest was the key independent variable. Depression, serious mental illness (SMI), substance use, suicidal ideation, and suicide attempt were the outcome variables. We performed five multivariate logistic regression models for each outcome variable, controlling for race/ethnicity, income, and education level for men and women separately.ResultsOf 13,494 respondents, 6.63% had a history of arrest. Among young women, a history of arrest was associated with significantly higher adjusted odds ratios for all mental health concerns. Most notably, a history of arrest increased the likelihood of substance use by a factor of 15.19, suicide attempts by 2.27, SMI by 1.79, suicidal ideation by 1.75, and depression by 1.52. Among young men, a history of arrest was associated with increased adjusted odds ratios (AORs) for substance use (AOR, 13.37; p < .001), suicidal ideation (AOR, 1.45; p = .011), and suicide attempt (AOR, 1.82; p = .044).ConclusionsWe found a strong relationship between young people having an arrest history and mental health concerns. More specifically, a history of arrest was associated with all mental health concerns among young women, while it was associated with only substance use and suicide among young men. Providing arrestees with appropriate mental health care would benefit them and the criminal justice system by decreasing the odds of recidivism.

Identifying factors, such as low sleep quality, that predict suicidal thoughts using machine learning

Every year, around 800,000 people die by suicide worldwide, and it is the second leading cause of death for individuals aged 15-24 years. The National Survey on Drug Use and Health (NSDUH) is conducted annually to ask the general United States population aged 12 years and older questions about mental health, substance use, and suicidal thoughts. Some of the factors the survey considers are substance use, including need for treatment and disorders, and mental health topics, including major depressive episodes, suicidal ideation and attempts, and mental illness. In our research, we sought to identify associations between suicidal ideation and relevant variables, such as sleep quality, hopelessness, and anxious behavior, by analyzing survey responses from the 2020 NSDUH. Due to the density of the survey and no obvious direct relationship between any variables with suicidal ideation, through our research we aimed to clearly find and display any association. We hypothesized that frequent anxious thoughts and behavior (such as fidgeting and restlessness), feelings of sadness, and/or low sleep quality would be the factors most predictive of having suicidal thoughts. Using a random forest classifier, we found that sleep problems were highly predictive of suicidal ideation. Professionals and clinicians should keep these findings in mind when developing suicide prevention efforts, such as identifying and supporting people potentially at risk, intervening to improve sleep quality, and teaching coping skills.

Correlates of Adolescent Depression in 2021 in the United States

The aim of this research paper is to explore the potential links between various factors (socioeconomic, empirical and contextual factors), as well as the likelihood of adolescents experiencing major depressive episodes according to datasets reported in the 2021 National Survey on Drug Use and Health (NSDUH). This paper uses secondary data analysis method, where some variables of interests are compared: demographics, school experiences, adult-involvements, peer-involvements, extracurricular, and incomes. The results shows that both contextual factors around adult and peer involvement played a significant role in this research process. In influencing adolescents experiencing major depressive emotions during their growth. During this period, the influence of adult figures become a main object in shaping adolescents emotional health. However, with the frequency of parental arguments, the results show an adverse association, which underscores how the role of family dynamics influence adolescent mental health. Meanwhile, in terms of peer behaviors and related peer pressures, individuals are shaped by their choices and perceptions which also affect mental health of these adolescence.

Cannabis use and the prevalence of current asthma among adolescents and adults in the United States

ObjectivesCannabis use has increased among adolescents and adults in the United States (US) in recent years. Few data are available on the prevalence of asthma by frequency of cannabis use. This study aimed to estimate the prevalence of asthma by frequency of past 30-day cannabis use among US individuals. MethodsData were drawn from the 2020 National Survey on Drug Use and Health (NSDUH), a nationally representative, annual cross-sectional survey of US individuals aged 12 and older in the United States (N = 32,893). Logistic regression models were used to examine the relationship between frequency of any cannabis and/or blunt (i.e., cannabis smoked in a hollowed-out cigar) use in the past 30 days and current asthma, adjusting for demographics and current cigarette smoking. ResultsCurrent asthma was more common among US individuals who reported cannabis use in the past 30-days, relative to those who did not (9.8% vs. 7.4%, p < 0.0001). The odds of asthma was significantly greater among individuals reporting cannabis use 20–30 days/month (Adjusted Odds Ratio [AOR] = 1.67, 95% CI:1.21, 2.31), blunt use 6–15 and 20–30 days/month (AOR = 1.9, 95% CI:1.1, 3.2; AOR = 2.2, 95% CI:1.4, 3.6), respectively, than among those without. A positive linear relationship was observed between frequency of a) cannabis use (p < 0.0001) and b) blunt use (p < 0.0001) and current asthma prevalence. ConclusionsFindings suggest a dose-response relationship between frequency of current cannabis use and the prevalence of current asthma in the US individuals.

NSDUH finds substance use, depression, suicidality high among youth

Last fall's release of the federal 2022 National Survey on Drug Use and Health (NSDUH) found that substance use, suicidal thoughts, and depression are high among adolescents and young adults. Highlights are below.

Abstract A108: Perceived negative effects of COVID-19 on mental health based on a history of cancer

Abstract Background: The COVID-19 pandemic had profound effects on cancer care and healthcare in general, including access and delays in receiving care. However, while the perceived negative effects of COVID-19 on mental health have been widely acknowledged, it remains unclear whether individuals with a history of cancer are at a higher risk of experiencing mental health issues as a result of the pandemic. Methods: We used the 2021 cross-sectional epidemiological data from the National Survey on Drug Use and Health (NSDUH) in the United States. Our outcome of interest was based on a single-item question in the 2021 data that elicited perception of the COVID-19 pandemic's negative effect on emotional or mental health. We examined the association between a history of cancer and our outcome of interest, using a multivariable logistic regression to estimate the odds of perceiving negative mental health effect due to COVID-19 based on a history of cancer. A secondary analysis examined demographic factors associated with perceived negative mental health effect of COVID-19 among individuals with a history of cancer. Results: Our analysis included a total of 15,959 individuals aged ≥18 years, 12.7% of which had a history of cancer (n = 2,030). After adjusting for age, race/ethnicity, and sex, compared to individuals without a history of cancer, those with a history of cancer had higher odds of perceived negative mental health due to the pandemic (aOR = 1.23; 95% CI 1.01, 1.49). Within the subgroup of individuals with a history of cancer, compared to individuals who were ≥65 years, individuals aged 35 – 49 had higher odds of perceived negative mental health due to COVID-19 (aOR = 1.73; 95% CI = 1.04, 2.88). Additionally, individuals who were non-Hispanic Others (Asians, Native American Indian/Alaskan Natives, Native Hawaiian/other Pacific Islanders, and mixed races) had higher odds of perceived negative mental health due to COVID-19, when compared to non-Hispanic white individuals (aOR = 2.75; 95% CI = 1.29 - 5.87). Conclusion: Individuals with a history of cancer may have perceived being more negatively impacted mentally by the COVID-19 pandemic compared to those without a history of cancer, especially certain age groups and minoritized populations. As cancer care emerges into a post-COVID era, it is imperative to prioritize mental health to ensure a better quality of life during cancer survivorship. Citation Format: Meng Chen, Dina K. Abouelella, Melissa C. White, Rong Jiang, Oluwole A. Babtunde, Eric Adjei Boakye, Tammara L. Watts, Nosayaba Osazuwa-Peters. Perceived negative effects of COVID-19 on mental health based on a history of cancer [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A108.

Abstract A002: Alcohol use patterns and patient-provider discussions about alcohol use among cancer survivors: Differences by race and ethnicity in the National Survey of Drug Use and Health

Abstract Background: Alcohol is a leading modifiable risk factor for cancer risk and recurrence. The American Cancer Society recommends abstaining from alcohol for cancer prevention and advises that those who choose to drink should limit their intake. Healthcare providers are uniquely positioned to counsel cancer survivors about alcohol’s harms. Prior research has revealed stark differences in heavy drinking among cancer survivors by race and ethnicity. We build on this work by examining the prevalence of multiple alcohol use patterns, alcohol screening, and patient-provider discussions about alcohol by race and ethnicity among a cancer survivor population. Methods: We conducted a cross-sectional study using data from the National Survey on Drug Use and Health (NSDUH) 2015-2019. Eligible respondents included adults (18+ years) who reported a prior cancer diagnosis. Outcomes included alcohol use patterns (lifetime abstention, alcohol use and binge drinking in the past 30 days), alcohol screening in the past year, and report of an in-person alcohol discussion with a healthcare provider in the past year. We estimated the adjusted prevalence of these outcomes by race and ethnicity from marginal effects of logistic regression models that accounted for sociodemographic characteristics (i.e., age, gender, educational attainment, household income) and health insurance type. Models included cluster, strata, and weight variables to account for the complex survey design and nonresponse bias. Results: The unweighted analytic sample size included 6,240 cancer survivors – 431 identified as Black, Non-Hispanic; 461 identified as Hispanic, and 5,348 identified as White, Non-Hispanic. Though not statistically significant, adjusted binge drinking prevalence was highest among Black, Non-Hispanic survivors (17.3% [95% CI: 11.6 – 23.0]) followed by White survivors (13.4% [95% CI: 12.2 – 14.6]) and Hispanic survivors (13.1% [95% CI: 9.8 – 16.4]). Significant differences in adjusted binge drinking prevalence by race and ethnicity were found for binge drinking among current drinkers – Black (41.4% [95% CI: 30.7 – 52.1]), Hispanic (31.7% [95% CI: 22.6 – 40.8]), White (26.7% [95% CI: 24.6 – 28.8]). No significant differences were found for alcohol screening prevalence by race and ethnicity. Black (44.7% [955 CI: 36.4 – 53.0]) and Hispanic (48.8% [95% CI: 40.1 – 57.6%]) cancer survivors were less likely than White survivors (56.9% [95% CI: 54.9 – 59.0]) to report an in-person provider discussion about alcohol. Conclusions: There is a significant racial disparity in problematic drinking between Black, Hispanic, and White cancer survivors, with higher proportions of Black and Hispanic survivors reporting binge drinking than their White peers. Yet, Black and Hispanic cancer survivors are less likely to have an in-person discussion with a provider about alcohol use compared with White cancer survivors. Black and Hispanic cancer survivors may not be receiving important messages about alcohol’s harms from their providers, who could be important sources of this information. Citation Format: Naomi K. Greene, David Dean Jr. Alcohol use patterns and patient-provider discussions about alcohol use among cancer survivors: Differences by race and ethnicity in the National Survey of Drug Use and Health [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A002.

Phosphatidylethanol as a biomarker to assess alcohol exposure in women of reproductive age using retrospective data from a reference laboratory

Abstract Alcohol consumption during pregnancy may cause fetal alcohol spectrum disorder (FASD), which is a preventable disorder. Prenatal alcohol exposure during the first trimester of pregnancy is deemed most disruptive to the developing fetus. Pregnant women may be screened for alcohol use through self-reported measures. These subjective methods are known to underreport drug use. Therefore, a reliable method to detect and monitor alcohol use during pregnancy is needed. Phosphatidylethanol (PEth) is a specific biomarker associated with alcohol consumption that can be used to differentiate social drinking from heavy alcohol use. The predominant PEth homologues are PEth 16:0/18:1 (POPEth) and PEth 16:0/18:2 (PLPEth), which account for 37-46% and 26-28% of the total PEth homologues, respectively. PEth can reflect alcohol intake up to several days to weeks after consumption. The aim of this study is to investigate the prevalence of positive PEth samples in women of reproductive age to determine whether testing for PEth should be assessed in a three-month checkup in pregnant women. The first objective is to perform a retrospective study on the direct alcohol biomarker, PEth, to evaluate the true positivity rates of alcohol use in females and in women of reproductive age (14 - 44 years old) using retrospective data analysis from a reference laboratory. The initial data analysis demonstrated the positivity rate of PEth in females (N = 66,306) to be 32% for POPEth and 28% for PLPEth. Further retrospective data analysis of PEth in women of reproductive age (N = 19,366) was performed and the positivity rate of PEth in this population was quite similar between the ages of 27 to 40 years old, at around 35%. The data shows that the positivity rate of PEth in women of reproductive age (~35%) is slightly above the positivity rate for all females (~30%). These percentages are significantly higher than what is reported in the 2020 National Survey on Drug Use and Health (NSDUH). The NSDUH reported that 10.6% of pregnant women used alcohol in the past month. The second objective is to conduct a laboratory study where we will measure PEth concentrations by mass spectrometry using residual whole blood specimens from females in an OB/GYN clinic and compare the positivity rates to those determined by the retrospective analysis. This study will provide the opportunity to educate women of reproductive age on drinking during pregnancy and the long-term effects of alcohol use.