Partner Substance Research Articles

Deployment and combat experiences and their impact on partner substance use

Despite burgeoning evidence of the negative effects of service experiences on service members’ spouses/partners, limited research has examined these effects in the context of substance use. Additionally, a strong literature demonstrates the protective role relationship satisfaction can play for health-related outcomes. The goal of the present research is to examine relations between service experiences (e.g., deployment, combat exposure) and partner substance use, as well as how relationship satisfaction may buffer these effects. Data from 275 civilian partners were drawn from Operation: SAFETY (Soldiers And Families Excelling Through the Years), a longitudinal study examining health among U.S. Army Reserve/National Guard (USAR/NG) soldiers and partners. Analyses examined relations between soldier service history (baseline) and civilian partner alcohol/drug use (2-year follow-up), as well as interactions with relationship satisfaction. Models controlled for civilian partner sex and age and soldiers’ self-reported posttraumatic stress disorder symptoms and substance use. Results revealed interactions between service experiences and partner satisfaction for models predicting alcohol consumption and heavy drinking. Greater relationship satisfaction mitigated overall alcohol consumption and heavy drinking frequency among partners of soldiers with two or more deployments and among partners of soldiers with greater combat exposure. Soldier service experiences were unrelated to civilian partner drug use. The effects of deployment and combat exposure extend beyond the service member to negatively influence civilian partner alcohol consumption and heavy drinking, with relationship satisfaction buffering these risks. Interventions that assist USAR/NG soldiers and spouses in strengthening their relationships may also help protect against spouse substance use related to soldier service experiences.

Continuity and Change in Substance Use Patterns During the Transition from Adolescence to Young Adulthood: Examining Changes in Social Roles

AbstractThis study offers a model for using multidimensional growth mixture models to identify polysubstance use trajectories by examining transitions among conjoint substance use trajectories from adolescence to young adulthood and exploring potential moderators that may facilitate transitions towards healthier substance use trajectories in young adulthood. Longitudinal mixture modeling was used to examine six waves of data collected during adolescence (ages 13, 14, 15) and young adulthood (ages 25, 29, 31) in Seattle, Washington. Data were drawn from the International Youth Development Study, a longitudinal, cross-national study examining the life course patterns of substance use and development among youth. Participants (N = 961) completed questionnaires on six occasions that assessed demographics (sex, race, highest parent education), suspension and expulsion, individual substance use, partner substance use, and social role transitions (education, marriage, childbearing, employment). Four substance use classes were identified in adolescence and included low use (n = 572, 59.6%), alcohol dominant (n = 177, 18.4%), increasing use (n = 103, 10.7%), and poly-use (n = 109, 11.3%). Five substance use classes were identified in young adulthood and included low use (n = 134, 15.3%), alcohol only (n = 349, 39.8%), alcohol and tobacco (n = 97, 11.0%), alcohol and cannabis (n = 162, 18.5%), and poly-use (n = 135, 15.4%). The transition from adolescence to young adulthood showed the strongest continuity in the poly-use class and the weakest in the low use class, with a general trend toward adding substances rather than reducing them. College graduation moderated the transition in substance use patterns from adolescence to young adulthood for low use and alcohol dominant adolescent classes but not for the poly-use class. Delays in adult role assumptions were not consistently associated with substance use classes during this transition. However, where significant, delayed marriage and parenthood acted as protective factors against the progression of substance use leading into young adulthood. The findings underscore the need for early detection and tailored prevention efforts among adolescents. By identifying pivotal periods and specific substance use patterns, these findings inform the timing and focus of targeted interventions designed to reduce the escalation of substance use leading into young adulthood.

Discordant and Concordant Substance Use and Daily Partner Violence in Adolescent and Young Adult Relationships With Baseline Dating Violence

PurposeIntimate partner violence (IPV) and substance use in adolescents and young adults (AYAs) are significant public health issues in the United States. Together, they can harm emotional regulation and romantic relationship functioning. This study examines the role of concordant and discordant substance use on IPV within AYA relationships. MethodsA prospective cohort of community-recruited AYA women in a heterosexual dating relationship with past-month IPV completed four months of daily surveys via a cell phone. Each day, participants reported any IPV perpetration and/or victimization, their alcohol and drug use, and observed partner substance use. Concordant substance use was coded when the participant and partner used drugs or alcohol on the same day. Discordant use was coded when only the participant or partner used drugs or alcohol on a given day. Alcohol and drug use were modeled separately. Generalized estimating equations accounted for the correlation of repeated measures. ResultsParticipants (N = 143) were 18.2 (1.1) years old, 93% African American race. Discordant alcohol and drug use was associated with same-day victimization, perpetration, and co-occurring violence compared to concordant nonuse. Similarly, concordant alcohol use, drug use, and alcohol/drug use were associated with increased odds of victimization, perpetration, and co-occurring violence compared to concordant nonuse. DiscussionDaily data illustrated that dyadic patterns of substance use are associated with IPV. These findings may facilitate the development of effective and developmentally appropriate IPV intervention programs for AYA that also integrate strategies to reduce substance use.

Factors Associated With Domestic Violence Against Peri- and Postmenopausal Women.

The goal of the study was to determine factors associated with domestic violence in menopausal women. This was a cross-sectional study that 350 menopausal women participated. Data gathering used a World Health Organization's violence against women instrument. Emotional violence was recognized as one of the most experienced types of domestic violence (48%). According to the multivariate logistic regression model, the status of exposure to sexual violence (before marriage) and the partner's substance abuse was the most robust risk factors for domestic violence, while factors such as employment of women and satisfaction of income were protective against domestic violence. This study has highlighted the factors associated with domestic violence that health program managers need to address.

Traumatic Life Events and Stressors: Associations With Substance Use Problems of Men Under Community Supervision.

This study aims to determine associations between sources of stress and substance use problems among men under community supervision programs. We used ordinary least squares regression models to test the hypotheses that the traumatic life events and stressors of men under community supervision and their partners, respectively, were associated with the substance use problems of men under community supervision. The sample included 230 men involved in community supervision programs in New York City and 230 women who were their intimate partners. We found that the traumatic events and the depression and anxiety of men under community supervision and partner's substance use problems were associated with the substance use problems of the men. These findings underscore the importance of addressing trauma in substance use treatment for men under community supervision. Future research can explore how stressful events impact substance use, sources of coping for couples, and the association between racism, traumatic events, stress, and substance use. Clinical Trial Registration: NCT01690494.

The COVID-19 pandemic and parental substance use: a cross-sectional survey of substance use among pregnant and post-partum individuals and their partners

ABSTRACT Background This study was designed to investigate patterns and risk factors for substance use among obstetrical patients who gave birth during the early period of the pandemic, and their partners. Methods Cross-sectional survey of obstetrical patients between March 17th and June 16th, 2020, at The Ottawa Hospital, Ottawa, Canada. Substance use was a composite measure of any alcohol, tobacco, or cannabis use since COVID-19 began. Four outcomes included: any participant substance use or increase in substance use, any partner substance use or increase in substance use. Adjusted risk ratios (ARR) and 95% confidence intervals (CI) are presented. Findings Of 216 participants, 113 (52.3%) and 15 (6.9%) obstetrical patients reported substance use and increased use, respectively. Those born in Canada (ARR: 2.03; 95% CI: 1.27–3.23) and those with lower household income (ARR: 1.38; 95% CI: 1.04–1.85) had higher risk of substance use. Those with postpartum depression (ARR: 5.78; 95%CI: 2.22–15.05) had the highest risk of increased substance use. Families affected by school/daycare closure reported a higher risk of increased partner substance use (ARR: 2.46; 95% CI:1.38–4.39). Conclusion This study found that risk factors for substance use included demographics (i.e., being born in Canada, income), mental health (postpartum depression), and school/childcare closures.

Khat use and associated factors during pregnancy in eastern Ethiopia: A community-based cross-sectional study.

Women of reproductive age are increasingly using khat. The use of khat is associated with prelabor rupture of membranes, anemia among pregnant women, and other problems related to motherhood and infanthood. Most of the previous studies performed at the facility level revealed that different factors were associated with khat use among pregnant women. Lower educational status, low wealth index, and the age of the mother were the factors significantly associated with maternal khat use. Partner substance use also has a significant association with maternal khat use. However, there is limited information about khat use and its associated factors among pregnant women in the study area. This study aims at assessing the prevalence of khat use and associated factors among pregnant women in Kersa and Haramaya Health and Demographic Surveillance System Sites, eastern Ethiopia. A community-based cross-sectional study design was employed among randomly selected 1,015 pregnant women from an open cohort from Kersa and Haramaya Health and Demographic Surveillance System Sites in Ethiopia. Data were collected through face-to-face interviews from January 30 to April 30, 2021, using Open Data Kit (ODK) software and analyzed using SPSS v-26. Descriptive statistics were used to summarize the characteristics of pregnant women. Factors associated with khat use were identified by bivariate and multivariable logistic regression analyses; an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated. Statistical significance was declared at p < 0.05. The prevalence of khat use among pregnant women was 15.5% (95% CI, 13.3-17.7). Age of the pregnant women; being in the age group between 25 and 35years (AOR = 2.27, 95% CI, 1.33-4.89) and 35years and greater (AOR = 2.33, 95% CI, 1.29-4.20); having a chronic medical illness (AOR = 3.28, 95% CI, 1.27-8.48); and having a history of abortion (AOR = 2.87 95% CI, 1.73-4.76) significantly increased the likelihood of khat use among pregnant women. The current study revealed a relatively high magnitude of khat use in pregnant women as compared with previous studies. The age of the pregnant women, history of medical illness, and history of abortion were significantly associated with khat use during pregnancy.

Perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021: A cross-sectional study.

Objective:This study aimed to assess the prevalence of perinatal intimate partner violence during COVID-19 and its associated factors among postpartum mothers attending newborn immunization in southern Ethiopia, 2021.Method:A facility-based cross-sectional study was conducted among 657 postpartum mothers from 1 to 30 March 2021 in southern Ethiopia. All postpartum mothers who visited the selected hospitals or health centers for newborn immunization and met the inclusion criteria were included in this study. Data were cleaned, coded, entered into Epidata manager version 4.2 and then exported into SPSS version 26 for analysis. Binary and multivariate logistic regression analysis was used.Results:The prevalence of perinatal intimate partner violence was 62.4%. In this study, income loss due to COVID-19 (adjusted odds ratio: 12.00, 95% confidence interval: 5.60, 25.71, p < 0.001) was the strongest factor associated with perinatal intimate partner violence. Young age women (adjusted odds ratio: 5.82, 95% confidence interval: 2.72, 12.46, p < 0.001), partner alcohol use (adjusted odds ratio: 2.21, 95% confidence interval: 1.37, 3.56, p = 0.001), partner substance use (adjusted odds ratio: 2.07, 95% confidence interval: 1.12, 3.83, p = 0.021), and partner relationships (cohabited) (adjusted odds ratio: 1.88, 95% confidence interval: 1.06, 3.34, p = 0.032) were also strongly associated with perinatal intimate partner violence.Conclusion:The prevalence of perinatal intimate partner violence was relatively high. The health of the women should be maintained through empowerment of women and provision of health education in order to minimize prevalence of perinatal intimate partner violence associated with low income, young age, substance use, and cohabited marital status. Future qualitative studies are required to identify the underlying multifactorial reasons for intimate partner violence.

Prenatal smoking, alcohol and caffeine exposure and maternal-reported attention deficit hyperactivity disorder symptoms in childhood: triangulation of evidence using negative control and polygenic risk score analyses.

Studies have indicated that maternal prenatal substance use may be associated with offspring attention deficit hyperactivity disorder (ADHD) via intrauterine effects. We measured associations between prenatal smoking, alcohol and caffeine consumption with childhood ADHD symptoms accounting for shared familial factors. First, we used a negative control design comparing maternal and paternal substance use. Three models were used for negative control analyses: unadjusted (without confounders), adjusted (including confounders) and mutually adjusted (including confounders and partner's substance use). The results were meta-analysed across the cohorts. Secondly, we used polygenic risk scores (PRS) as proxies for exposures. Maternal PRS for smoking, alcohol and coffee consumption were regressed against ADHD symptoms. We triangulated the results across the two approaches to infer causality. We used data from three longitudinal pregnancy cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom, Generation R study (GenR) in the Netherlands and Norwegian Mother, Father and Child Cohort study (MoBa) in Norway. Phenotype data available for children were: NALSPAC = 5455-7751; NGENR = 1537-3119; NMOBA = 28 053-42 206. Genotype data available for mothers was: NALSPAC = 7074; NMOBA = 14 583. A measure of offspring ADHD symptoms at age 7-8years was derived by dichotomizing scores from questionnaires and parental self-reported prenatal substance use was measured at the second pregnancy trimester. The pooled estimate for maternal prenatal substance use showed an association with total ADHD symptoms [odds ratio (OR)SMOKING = 1.11, 95% confidence interval (CI) = 1.00-1.23; ORALCOHOL = 1.27, 95% CI = 1.08-1.49; ORCAFFEINE = 1.05, 95% CI = 1.00-1.11], while not for fathers (ORSMOKING = 1.03, 95% CI = 0.95-1.13; ORALCOHOL = 0.83, 95% CI = 0.47-1.48; ORCAFFEINE = 1.02, 95% CI = 0.97-1.07). However, maternal associations did not persist in sensitivity analyses (substance use before pregnancy, adjustment for maternal ADHD symptoms in MoBa). The PRS analyses were inconclusive for an association in ALSPAC or MoBa. There appears to be no causal intrauterine effect of maternal prenatal substance use on offspring attention deficit hyperactivity disorder symptoms.

Prevalence and associated factors of antenatal depression of women attending antenatal clinics in two tertiary care maternity hospitals in Sri Lanka

AimsTo determine the prevalence of depression among antenatal mothers in two tertiary care maternity hospitals in Colombo and associated factors of antenatal depression.MethodA descriptive cross-sectional study was conducted in antenatal clinics in two tertiary care maternity hospitals in Sri Lanka. Every second woman attending the clinic was recruited using systematic sampling until the calculated sample size was obtained. A structured questionnaire and Edinburgh Postnatal Depression Scale (EPDS) were used for data collection. Data were analysed using SPSS.ResultA total of 536 pregnant women were participated in the study. Around one third (180, 33.6%) of pregnant women had depression according to the EPDS score (Mean = 7.66, SD = 5.17). The mean age was 29.65(SD = 9.30) years and among them 387(74.3%) had at least secondary education. The majority lived with parents or in-laws (329, 61.4%) in addition to nuclear family members and 266(49.6%) were in their third trimester. Most women were in first pregnancy (149, 39.5%) and 11 (2.1%) had a history of psychiatric illness. Sixty (11.2%) women and 156(29.1%) of partners used psychoactive substances. Verbal abuse and physical abuse were reported by 5(0.9%) and 3(0.6%) respectively. Sixty one (11.4%) women have reported inadequate family support, and 226 (42.2%) had only support of the partner. Among them 346 (64.6%) reported excellent support from partner. One third (186, 34.7%) of pregnancies were unplanned, 328(61.2%) women reported a very good relationship with their partner. Complications were experienced by 123(22.9%) of women during this pregnancy and commonest was gestational diabetes. The presence of depression was significantly associated with living with extended family (p = 0.033) and in-laws(p = 0.014). Multi parity (&gt;2 children) (p = 0.008), partner's substance use (p = 0.002), inadequate family support (p = 0.024), inadequate partner's support (p = 0.003), unsatisfactory relationship with partner (p = 0.000) and unplanned pregnancies (p = 0.001) were also associated with depression. Logistic regression analysis indicated a significant association between depression with partner's substance use, unavailability of family support and poor relationship with the partner.ConclusionAround one-third of mothers were having antenatal depression. Several spouse related factors and unsatisfactory family support were associated with depression among antenatal mothers.

Drug and sexual HIV-risk behaviors among adolescents and young adults with opioid use disorder

Opioid use disorder (OUD) among adolescents and young adults (youth) is associated with drug use and sexual HIV-related risk behaviors and opioid overdose. This mixed methods analysis assesses risk behaviors among a sample of 15–21-year-olds (N = 288) who were being treated for OUD in a residential drug treatment program in Baltimore, Maryland. Participants were enrolled in a parent study in which they received either extended-release naltrexone (XR-NTX) or Treatment as Usual (TAU), consisting of outpatient counseling with or without buprenorphine, prior to discharge. At baseline, participants were administered the HIV-Risk Assessment Battery (RAB), and clinical intake records were reviewed to determine participants' history of sexual, physical, or other abuse, as well as parental and partner substance use. A sub-sample of study participants completed semi-structured qualitative interviews (N = 35) at baseline, three-, and six-month follow-up periods. This analysis identified gender (e.g., female IRR = 1.63, CI 1.10–2.42, p = .014), the experience of dependence (e.g., previous detoxification IRR = 1.08, CI 1.01–1.15, p = .033) and withdrawal (e.g., severe withdrawal symptoms IRR = 1.41, CI 1.08–1.84, p = .012), and the role of relationships (e.g., using with partner IRR = 2.45, CI 1.15–5.22, p = .021) as influencing high-risk substance use behaviors. Similarly, high-risk sex was influenced by gender (e.g., female IRR = 1.43, CI 1.28–1.59, p < .001), and the role of relationships (e.g., using with partner IRR = 0.78, CI 0.62–0.98, p = .036). These are key targets for future prevention, treatment, and intervention.

Partner influence as a factor in maternal alcohol consumption and depressive symptoms, and maternal effects on infant neurodevelopmental outcomes.

Few studies have investigated the partner's influence on risk factors such as alcohol consumption and depression during pregnancy. Partner substance use and lower relationship satisfaction predict higher maternal alcohol use and depressive symptoms. Because prenatal alcohol use and maternal depression affect infant outcomes, it is imperative to examine how the partner affects these maternal risk factors. The current study examined the effect of a latent construct of partner influence on maternal alcohol use and depressive symptoms, and the effects on infant development of these maternal factors. Participants were 246 pregnant women from 2 sites in Western Ukraine from whom longitudinal data were collected as part of a multisite study. In the first trimester, mothers reported on relationship satisfaction, partner substance use, and socioeconomic status (SES). In the third trimester, they reported on alcohol use and depressive symptoms. Infants were assessed using the Bayley Scale of Infant Development (average age=6.93months). A latent construct titled partner influence was formed using partner substance use and measures of relationship satisfaction, including the frequency of quarreling, happiness in the relationship, and the ease of talking with the partner. Using structural equation modeling, a model was specified in which partner influence and SES predicted maternal alcohol use and depressive symptoms, which in turn predicted infant neurodevelopmental outcomes. Higher partner influence significantly predicted lower prenatal alcohol use and lower depressive symptoms, controlling for the effect of SES. Higher maternal prenatal alcohol use significantly predicted lower infant mental and psychomotor development. Maternal depressive symptoms did not predict infant development over and above the effect of alcohol use. Partner influence is an important contributor to prenatal alcohol use and maternal depressive symptoms, over and above the effect of SES. The significant paths from prenatal alcohol exposure to infant neurodevelopmental outcomes underscore the importance of partner influence during pregnancy.

COVID-19 and perinatal intimate partner violence: a cross-sectional survey of pregnant and postpartum individuals in the early stages of the COVID-19 pandemic

ObjectiveThe objectives of this study were to: (1) document violent and controlling behaviours within intimate partnerships during the perinatal period; and (2) determine individual, interpersonal and household-level factors influencing the...

Magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of eastern Ethiopia

BackgroundUse of substances like alcohol, tobacco and khat during pregnancy can bring miscarriage, prematurity, neurodevelopmental problems, sudden infant death syndrome and others. There are limited studies on the magnitude and associated factors of substance use among pregnant women in Eastern Ethiopia. Therefore, the aim of this study was to assess the magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of Easttern Ethiopia, 2019.MethodHospital based cross-sectional study was employed on 510 pregnant women attending ANC at public hospitals of Eastern Ethiopia (Jigjiga, Dire Dawa and Harar towns). Data were collected from the study participants that were selected using systematic sampling method from each public hospital. The data were collected through interviewer administered structured questionnaire. Binary logistic regressions with 95% confidence interval were used to determine the degree of association between covariates and outcome variable. Multicollinearity between independent variables by using the standard error was checked. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests.ResultsOut of 526 participants, a total of 510 study participants were involved in this study thereby making a response rate of 96.9%. In this study, the magnitude of substance use among pregnant women attending ANC was 26.5% (95% CI: 22.7, 30.6%). Among the overall pregnant mothers, 100 (19.6%) chewed khat, 48 (9.4%) drank alcohol, 12 (2.4%) used tobacco products and 28(20.7%) were dual substance users. Pre pregnancy substance use (AOR = 27.25, CI: 14.107–52.66), partner substance use (AOR = 3.704 CI: 1.839–7.464), family substance use (AOR = 3.447 CI: 1.69–7.031) and the amount of monthly household income (AOR = 3.397, 95% CI: 1.316–8.766) were found to be statistically significant and positively associated with substance use during pregnancy.ConclusionThe magnitude of antenatal substance use in the study area was 26.5%. Pre- pregnancy substance use, partner substance use, monthly house hold income and family substance use were found to be positively associated with substance use during pregnancy. Therefore, health education which is inclusive of child bearing age women with their partner and family may be helpful to decrease antenatal substance use during pregnancy.

Gender and Age Moderate the Effects of Partner Substance Use on Problem Drinking in Adulthood

The current study examined whether partner substance use problems predict problem drinking and how gender and age moderate this relationship. Problem drinking refers to alcohol use resulting in alcohol dependence or health and social consequences. Participants were adults (n=2142, 53% female, mean age=54, range= 33-83) from Wave 2 of the Midlife Development in the United States (MIDUS) Study. Participants reported on both past 12-month problem drinking (e.g., emotional problems from drinking, urges to drink, month or “much time” drinking, drinking more to get effects, drinking more than intended, and alcohol-related role interference) and partner substance use problems. Results indicated that 22.2% of the sample reported at least one problem drinking behavior in the past year. Multiple linear regression analysis revealed a significant interaction between gender and partner substance use problems (b=0.05, p=0.01) such that for males having a partner with substance use problems was a risk factor for their own problem drinking. However, a three-way interaction with gender, age, and partner substance use problems (b=-0.41, p<0.01) indicated that partner substance use problems might have both gender and age-specific effects on problem drinking. Exploratory analyses of this interaction indicated that with age partner substance use problems might no longer promote risk for male problem drinking. Older adults are especially sensitive to the effects of alcohol for reasons such as lower tolerance, medication interaction, and health conditions. There is thus a need for identifying age-relevant factors associated with these drinking behaviors for intervention and prevention efforts.

Structural and syndemic barriers to PrEP adoption among Black women at high risk for HIV: a qualitative exploration

In the USA, Black women are at disproportionately higher risk for HIV compared to women of other races/ethnicities, which can be explained by the Substance Abuse, Violence and AIDS (SAVA) syndemic. Disparities in HIV, substance use and violence are driven by multiple influences, including structural factors (e.g. housing and poverty), which exacerbate social- and individual-level factors leading to more sex partners, engaging in unprotected sex, having sex for money, experiencing forced sex from an intimate partner or increased substance use, all of which increase HIV risk. Pre-exposure prophylaxis (PrEP), a pill that can prevent HIV, is a discreet and underutilised method that Black women experiencing syndemics can use to decrease their risk. This study explored Black women’s interest in, and barriers to adopting PrEP over 6 months. Thirty Black women (age M = 32.2) who experienced multiple substance use, violence and HIV-related syndemic factors were interviewed four times over a 6-month period. Results demonstrated that experiencing intimate partner violence, substance use, community violence and other structural factors (poor access to social services, transport and childcare) all acted as barriers to PrEP adoption. Future research should consider multi-level interventions that include methods such as media campaigns, providing PrEP or referrals where women who experience syndemic and structural factors seek help, and implement a PrEP adherence programmes and interventions in support group settings.

Predictors of Opioid and Alcohol Pharmacotherapy Initiation at Hospital Discharge Among Patients Seen by an Inpatient Addiction Consult Service.

Medications for opioid use disorder (MOUD) and alcohol use disorder (MAUD) are effective and under-prescribed. Hospital-based addiction consult services can engage out-of-treatment adults in addictions care. Understanding which patients are most likely to initiate MOUD and MAUD can inform interventions and deepen understanding of hospitals' role in addressing substance use disorders (SUD). Determine patient- and consult-service level characteristics associated with MOUD/MAUD initiation during hospitalization. We analyzed data from a study of the Improving Addiction Care Team (IMPACT), an interprofessional hospital-based addiction consult service at an academic medical center. Researchers collected patient surveys and clinical data from September 2015 to May 2018. We used logistic regression to identify characteristics associated with medication initiation among participants with OUD, AUD, or both. Candidate variables included patient demographics, social determinants, and treatment-related factors. Three hundred thirty-nine participants had moderate to severe OUD, AUD, or both and were not engaged in MOUD/MAUD care at admission. Past methadone maintenance treatment (aOR 2.07, 95%CI (1.17, 3.66)), homelessness (aOR 2.63, 95%CI (1.52, 4.53)), and partner substance use (aOR 2.05, 95%CI (1.12, 3.76) were associated with MOUD/MAUD initiation. Concurrent methamphetamine use disorder (aOR 0.32, 95%CI (0.18, 0.56)) was negatively associated with MOUD/MAUD initiation. The association of MOUD/MAUD initiation with homelessness and partner substance use suggests that hospitalization may be an opportunity to reach highly-vulnerable people, further underscoring the need to provide hospital-based addictions care as a health-system strategy. Methamphetamine's negative association with MOUD/MAUD warrants further study.

The protective roles of ethnic identity and community cohesion on substance use among Black women experiencing adversity

This study employs a strengths-based approach to explore associations of ethnic identity and community cohesion with substance use among Black women experiencing adversity. Black women (N = 107; Mage = 34.2, SD = 7.7) completed interviews about their sociodemographics, HIV status, intimate partner violence exposure, ethnic identity, community connectedness, and substance use. Hierarchical linear regression analysis was used to examine associations of ethnic identity and community cohesion with substance use, accounting for age and socioeconomic status. The overall model was significant, with greater ethnic identity (β = −.25, p < .01) and more community cohesion (β = −.29, p < .01) associated with lower substance use. Findings highlight the value of contextual factors in substance use prevention among Black women.

Prenatal Substance Use and Perceptions of Parent and Partner Use Using the 4P's Plus Screener.

Background Prenatal substance use screening is recommended. The 4 P's Plus screener includes questions on perceived problematic substance use in parents and partner that are not considered in risk stratification. Objectives This research examined the: (1) prevalence of self-reported problematic parental and partner substance use and associations with biochemically-verified prenatal substance use; (2) utility of self-reported perceptions of parent/partner substance use as proxies for prenatal substance use; and (3) degree to which the sensitivity of the 4P's Plus can be augmented with consideration of parent/partner questions in risk stratification. Methods A convenience sample of 500 pregnant women was recruited between January 2017 and January 2018. Participants completed the 4P's Plus and provided urine for drug testing. Diagnostic utility of problematic parent/partner substance use questions was assessed, then compared to the 4P's Plus used as designed, and to the 4P's Plus used with these 2 questions included in risk stratification. Results Half (51%) of respondents reported either partner or parental problematic substance use. When partner or parent problematic substance use were considered as proxies for prenatal substance use, sensitivity was 65% and specificity was 55%. When used as intended, sensitivity was 94% and specificity was 29%. Including partner/parent questions increased sensitivity to 96% but lowered specificity (19%). Partner substance use and combined partner/parent use were associated with prenatal substance use [adjusted odds ratio (aOR): 2.0 (1.2, 2.4; p = 0.006); aOR = 1.6 (1.1, 2.5, p = 0.04)]. Conclusions for Practice Sensitivity of the 4P's Plus may improve with inclusion of self-reported problematic partner/parent substance use items in risk stratification.

HIV Testing in Women in Relation to Intimate Partner Violence and Substance Use: A Systematic Review

Background: Low-income racial/ethnic minority women are disproportionately represented in substance use and intimate partner violence (IPV) among those who are at risk for or live with HIV– collectively called the SAVA syndemic. Little is known about how IPV exposure and substance use impact HIV testing uptake among low-income racial/ethnic minority women. Aim: The objective of the current study is to conduct systematic literature review of SAVA syndemic on HIV testing among women. Design/Methods: A systematic literature review was conducted between February and September 2016 using databases of PubMed, Ovid/Medline, PsychINFO, Embase, and CINHAL/Nursing. Quantitative and qualitative peer-reviewed studies published in English that covered the topics of HIV testing, women, IPV, and substance use were reviewed. Study contents were summarized and reviewed to identify the gap in studying the impact of substance use and IPV on HIV testing in women. Results: Among women at risk for substance use and IPV (N = 6,259), HIV testing was perceived to be a priority especially if they were injecting drugs and engaging in risky sexual practice; however, barriers were also identified including stigma, privacy issue, convenience, and fear of receiving an HIV-positive result. Conclusions: Findings were informative in meeting the needs of HIV testing and counseling for women at risk for substance use and IPV while addressing the potential barriers to increase access to the service.