Self-reported Substance Use Research Articles

Substance Use and Adverse Mental Health Disparities Between Heterosexual and Sexual Minority Service Members in the U.S. Military.

Nationally representative studies have shown that lesbian, gay, and bisexual adults have higher levels of substance use than heterosexual adults. In the military, substance use is often associated with adverse mental health outcomes and is often comorbid with other mental health conditions and adverse or harmful behaviors. Few military studies to date have comprehensively examined the relationship between sexual orientation, mental health, and substance use. Data from the 2018 Health-Related Behaviors Survey (n = 17,166) were used. Univariate and multivariable logistic regression models were used to examine the association between sexual orientation and substance use. Regression models were also used to examine whether measures of mental health moderate the relationship between sexual orientation and substance use. Compared to heterosexual individuals, lesbian and gay individuals were more likely to engage in illicit drug use (adjusted odds ratio = 3.27; 95% CI, 1.45 to 7.36). Bisexual individuals were more likely to binge drink (adjusted odds ratio = 1.37; 95% CI, 1.08 to 1.74). Individuals with moderate or serious psychological distress were more likely to report binge drinking or smoking tobacco. Individuals with serious psychological distress were more likely to use illicit drugs. None of the interactions tested in this study were statistically significant. Substance use in the military was more likely among sexual minority individuals compared to heterosexual individuals. These findings reflect the patterns of substance use seen in the general population. Increased levels of psychological distress were associated with both the lesbian, gay, and bisexual population in this study and self-reported substance use behaviors. Further investigation of health disparities by sexual orientation may inform more efficacious treatment and prevention programs.

Detection and Characterization of Online Substance Use Discussions Among Gamers: Qualitative Retrospective Analysis of Reddit r/StopGaming Data.

Video games have rapidly become mainstream in recent decades, with over half of the US population involved in some form of digital gaming. However, concerns regarding the potential harms of excessive, disordered gaming have also risen. Internet gaming disorder (IGD) has been proposed as a tentative psychiatric disorder that requires further study by the American Psychological Association (APA) and is recognized as a behavioral addiction by the World Health Organization. Substance use among gamers has also become a concern, with caffeinated or energy drinks and prescription stimulants commonly used for performance enhancement. This study aimed to identify substance use patterns and health-related concerns among gamers among a population of Reddit users. We used the public streaming Reddit application programming interface to collect and analyze all posts from the popular subreddit, r/StopGaming. From this corpus of posts, we filtered the dataset for keywords associated with common substances that may be used to enhance gaming performance. We then applied an inductive coding approach to characterize substance use behaviors, gaming genres, and physical and mental health concerns. Potential disordered gaming behavior was also identified using the tentative IGD guidelines proposed by the APA. A chi-square test of independence was used to assess the association between gaming disorder and substance use characteristics, and multivariable logistic regression was used to analyze whether mental health discussion or the mention of any substance with sufficient sample size was significantly associated with IGD. In total, 10,551 posts were collected from Reddit from June 2017 to December 2022. After filtering the dataset for substance-related keywords, 1057 were included for further analysis, of which 286 mentioned both gaming and the use of ≥1 substances. Among the 286 posts that discussed both gaming and substance use, the most mentioned substances were alcohol (n=132), cannabis (n=104), and nicotine (n=48), while the most mentioned genres were role-playing games (n=120), shooters (n=90), and multiplayer online battle arenas (n=43). Self-reported behavior that aligned with the tentative guidelines for IGD was identified in 66.8% (191/286) posts. More than half, 62.9% (180/286) of the posts, discussed a health issue, with the majority (n=144) cited mental health concerns. Common mental health concerns discussed were depression and anxiety. There was a significant association between IGD and substance use (P<.001; chi-square test), and there were significantly increased odds of IGD among those who self-reported substance use (odds ratio 2.29, P<.001) and those who discussed mental health (odds ratio 1.64, P<.03). As gaming increasingly becomes highly prevalent among various age groups and demographics, a better understanding of the interplay and convergence among disordered gaming, substance use, and negative health impacts can inform the development of interventions to mitigate risks and promote healthier gaming habits.

Substance use by homeless clinic attenders in Sydney.

Describe patterns of substance use and comorbid conditions among clinic attenders in homeless shelters in Sydney. Retrospective cohort study of 2498 people who attended a psychiatric clinic at one of three homeless hostels between February 2008 and May 2020. Multivariable logistic regression was used to identify factors associated with self-reported substance use, psychiatric diagnosis and measures of social function. A total of 2041 of the 2498 (81.7%) reported the harmful use of at least one substance, with alcohol (61.8%), cannabis (50.9%) and stimulant drugs (34.9%) the three most common. Those reporting the regular use of two or more substances (1466, 58.7%) were more likely to have a history of early life and adult trauma, a diagnosis of personality disorder, a criminal conviction, receive the Disability Support Pension, be chronically homeless and sleep in the open. The study found a high rate of polysubstance use among homeless clinic attenders in Sydney, and an increase in the prevalence of substance use compared to previous studies. Substance use is both a cause and a consequence of homelessness, and services to address substance use have to be part of any program to reduce homelessness and sleeping in the open.

Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020.

The aim of the study is to assess associations between substance use and menopausal symptoms among US people living with and without HIV in a longitudinal cohort. We analyzed self-reported menopausal symptoms and substance use from biannual Women's Interagency HIV Study (WIHS) visits from 2008-2020. Substance use since the last visit or lifetime cumulative use included tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression quantified associations between each substance use and menopausal symptom frequency (vasomotor, mood, and musculoskeletal), adjusting for other substance use, HIV status, demographics, comorbidities, and trauma. A total of 1,949 participants contributed early perimenopausal, late perimenopausal, or postmenopausal study visits. Across reproductive-aging stages, based on menstrual history, and among participants with and without HIV, participants reported frequent vasomotor (range 22-43%), mood (18-28%), and musculoskeletal (25-34%) symptoms. Many reported ever using tobacco (72%), heavy alcohol (75%), marijuana (73%), crack (50%), and opioids (31%). Current heavy alcohol use (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.10-1.37), cumulative marijuana use (OR: 1.15, 95% CI: 1.01-1.32), and cumulative tobacco use (OR: 1.06, 95% CI: 1.01-1.12) were associated with a higher frequency of vasomotor symptoms; current heavy alcohol use (OR: 1.20, 95% CI: 1.04-1.39) and current opioid use (OR: 1.13; 95% CI: 1.01-1.25) were associated with mood symptoms; and current opioid use (OR: 1.11, 95% CI: 1.00-1.23) was associated with musculoskeletal symptoms. All other associations were found to be null. Current and prior substance use may independently affect symptoms experienced during the menopausal transition and may indicate potential to benefit from additional intervention and referral to menopause specialty care.

LOTUS: Protocol for a double-blind placebo controlled randomized trial of hemp-derived cannabidiol for the treatment of cannabis use disorder.

As cannabis legalization continues to spread across the United States, average Δ9-tetrahydrocannabinol concentrations in recreational products have significantly increased, and no prior study has evaluated effective treatments to reduce cannabis use among high potency cannabis users. Some research has found that the non-intoxicating cannabinoid cannabidiol reduces cannabis use and cannabis use disorder-related symptoms, such as affective disturbance and withdrawal. Results of these studies are promising but limited to synthetic or isolated forms of cannabidiol. Conduct a placebo-controlled randomized control trial comparing the effects of hemp-derived cannabidiol on reducing Δ9-tetrahydrocannabinol use in concentrate users with cannabis use disorder. Design. Double-blind, three-arm randomized placebo-controlled trial. Setting. University in the Denver-Boulder, CO, USA area. Study population. Community members who are heavy, stable cannabis concentrate users that meet criteria for at least moderate cannabis use disorder and are seeking to decrease or stop cannabis use. Data. Self-report demographics, substance use, and mental health characteristics, blood and urine based biomarkers and anthropometrics. Outcomes. Affective, physiological, and physical withdrawal symptoms, Δ9-tetrahydrocannabinol use. Analysis. Three-group ANOVAs and χ2 tests will be used to compare baseline variables between groups. Characteristics that differ between groups will be evaluated as potential covariates in subsequent analyses. A multilevel modeling framework will be used for primary outcome analysis to account for the repeated observations nested within participants over time. Pairwise post-hoc simple effects tests will be conducted to confirm patterns of differences. ClinicalTrials.gov NCT06107062.

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.

Firearm violence and associated factors among young adults presenting to emergency departments in three cities: Baseline results from Project SPARK

ObjectiveRecent shifts in U.S. violence dynamics call for updated violence epidemiology among general emergency department (ED) samples of young adults. Using baseline data from a multi-site longitudinal study of firearm violence prediction, we describe violence rates and associated factors. MethodsStaff approached age 18–24 entrants to Level-1 trauma centers in three cities (Flint, Seattle, Philadelphia; 7/2021–5/2023). Consenting participants completed a survey including validated measures of violence experience, firearm-related behaviors, substance use, mental health symptoms, peer/parental/familial behaviors, community violence, and attitudes/norms. We described the sample and examined factors associated with firearm assault (victimization/aggression, including threats). ResultsAcross sites, 1506 participants enrolled (41.7. % Black; 33.6 % White; 61.4. % female). Half of participants self-reported past-six-month violent victimization and/or aggression; non-partner violence, and violent victimization were most common. Over half of participants self-reported high-risk substance use, and over half screened positive for post-traumatic stress disorder, depression, and/or anxiety. About 14.4 % self-reported past-six-month firearm assault, and 5.9 % self-reported firearm violence (excluding threats). Adjusted analysis showed community violence exposure was most strongly associated with firearm assault; each one-point-increase corresponded to a 13.7 % (95 %CI: 10.4 %–16.9 %) absolute increase in firearm assault prevalence. Drug misuse, mental health symptoms, firearm carrying, retaliatory attitudes, prosocial attitudes, and family conflict were also associated with firearm assault. ConclusionsViolence, including firearm assault, is common among young adults entering urban EDs, and is associated with several psychosocial factors. High rates of substance use and mental health symptoms underscore this as a high-need population. Leveraging this information could help tailor interventions and optimize resource allocation.

Relating distractor suppression to problematic drinking behavior

BackgroundImpaired cognitive control has been linked to weakened self-regulatory processes underlying compulsive substance intake. Previous research has provided evidence for impaired task performance in substance-abusing groups during Stroop and Go/No-Go tasks. Mechanisms of distractor suppression in visual search might also involve overlapping regulatory components that support goal-directed behavior by resolving the attentional competition between distractors and the target of search. However, the efficiency of learning-dependent distractor suppression has not been examined in the context of drug abuse and a direct comparison between cognitive control and distractor suppression is lacking. MethodA total of 84 participants were assigned either to the heavy drinking group (ALC, n = 42) or the control group (CTL, n = 42) based on self-reported substance use. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) and Barratt Impulsiveness Scale (BIS). After that, participants completed a computerized version of the Stroop task, Go/No-go task, and a visual search task measuring learning-dependent distractor suppression. ResultsThe Stroop effect and the frequency of no-go errors did not differ between groups. However, learned distractor suppression was significantly blunted in the ALC group compared to the control group. Across participants, performance on the Stroop and Go/No-go task were correlated, while the magnitude of distractor suppression was related to neither. ConclusionsOur findings support a divergence of mechanistic processes underlying cognitive control and attentional control, and demonstrate impaired learning-dependent distractor suppression in heavy drinkers relative to a control group. Impaired distractor suppression offers new insight into why drug cues can be difficult to ignore.

Concurrent substance use among cancer patients with and without a history of cannabis use since cancer diagnosis at an NCI-Designated Cancer Center in Florida.

Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent substance use with cannabis among cancer patients. Our objective was to examine predictors of concurrent substance use with cannabis among cancer patients since their cancer diagnosis and explore perceptions of cannabis among these patients. Patients treated at a National Cancer Institute-designated comprehensive cancer center were invited to participate in an electronic survey regarding medical cannabis from August to November 2021. Survey data were linked to internal data resources including electronic health records and patient intake forms to obtain history of substance use (defined as within at least 3 months of cancer diagnosis) of cigarettes, injection drugs, high levels of alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent substance users were defined as those with any reported substance use and cannabis use at the time of cancer diagnosis. We used descriptive statistics (χ2 or exact tests) to compare groups and estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to identify predictors of substance use among users and nonusers of cannabis. Approximately 45% (n = 489) of the sample reported cannabis use since their cancer diagnosis. Of patients who reported using cannabis, 20% self-reported concurrent polysubstance use, while 8% of cannabis nonusers reported substance use (P < .001). Among patients who use cannabis, those who reported 2 or more self-reported treatment-related symptoms (eg, pain, fatigue) were more likely to have self-reported concurrent substance use (AOR = 3.15, 95% CI = 1.07 to 9.27) compared with those without any symptoms. Among nonusers, those with lower educational background were more likely to have a history of concurrent substance use (AOR = 3.74, 95% CI = 1.57 to 8.92). Patients who use cannabis with concurrent substance use were more likely to report improved sleep (P = .04), increased appetite (P = .03), and treatment of additional medical conditions (P = .04) as perceived benefits of cannabis use. High symptom burden may be associated with concurrent substance use with cannabis among cancer patients.

Diagnostic and Statistical Manual of Mental Disorders, fifth edition, personality disorders and the alternative model: Prediction of naturalistically observed behavior, interpersonal functioning, and psychiatric symptoms, 1 year later.

Traditional personality disorders (PDs; e.g., Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] Section II PDs), as well as dimensional traits (e.g., alternative model for PD [AMPD]), offer unique advantages in personality pathology assessment. However, very little is known about how these systems compare in predicting observable behavior. This study compares self-report ratings of PD symptoms (i.e., Structured Clinical Interview for DSM-IV PD) with self-reports of AMPD traits (i.e., Personality Inventory for DSM-5) in predicting clinical outcomes, 1 year later, via three different methods: (a) naturalistically observed psychosocial functioning (i.e., electronically activated recorder [EAR]), (b) informant-reported interpersonal functioning (i.e., Inventory of Interpersonal Problems-32), and (c) self-reported suicidality (SI), depression, anxiety, and substance use symptoms (i.e., Psychiatric Diagnostic Screening Questionnaire). Data were analyzed from 72 individuals in current or recent psychiatric treatment meeting diagnosis for at least one PD. Results showed that DSM Section II PD and AMPD ratings yielded meaningful and comparable predictions of naturalistically observed EAR variables and informant-rated interpersonal functioning. The AMPD appeared to offer slight advantages in the prediction of EAR-observed negative affect, hostile words, and informant-rated interpersonal functioning, with clearer advantages at the facet level. Overall, these results provide tentative evidence that both DSM Section II PD and AMPD systems show meaningful links with clinical outcomes measured via multiple methods 1 year later, but with clearer advantages for the AMPD at the facet level. Moreover, results show that the EAR is a viable method for capturing naturalistically observed clinically meaningful, in vivo behavior of individuals exhibiting maladaptive personality patterns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Using umbilical cord tissue to identify prenatal ethanol exposure and co-exposure to other commonly misused substances.

Substance misuse during pregnancy can result in a variety of poor pregnancy outcomes. Objective data reporting the prevalence of neonates born with ethanol metabolites (evidence of prenatal ethanol exposure) in their fluids or tissues are limited. A secondary analysis of umbilical cord tissue specimens received for routine toxicological analysis was conducted. Prevalences of ethyl glucuronide (EtG), a long-term direct ethanol biomarker, were determined using a new laboratory tool, LDTD-MSMS. Additionally, other commonly misused substances were determined using routine procedures. Of 12,995 specimens, 238 (1.8%) specimens contained EtG. Concentrations of EtG ranged from 5 ng/g to 6679 ng/g (median 47 ng/mg; IQR: 16 ng/g, 203 ng/g). Of those 238 EtG-positive specimens, nearly 58% (N = 138) contained additional substances or metabolites. Self-report of substance use during pregnancy is under-reported. We have demonstrated co-exposure of substances with ethanol is higher than previous reports.

Implementation of universal screening for substance use in pregnancy in a public healthcare system

ObjectiveScreening questionnaires are one option for identification of at-risk substance use and substance use disorder (SUD) during pregnancy. We report the experience of a single institution following universal implementation of a brief screening tool for self-reported substance use at the first prenatal encounter. Study DesignThis is a prospective implementation study evaluating screening for substance use in pregnancy in a large safety net healthcare system. Universal screening with the National Institute of Drug Abuse (NIDA) Quick Screen V1.0 was integrated into the electronic medical record (EMR) and administered at the first point of contact with the healthcare system. SUD was identified initially with diagnosis within the EMR by a healthcare provider and was confirmed with toxicology (maternal or neonatal) results corroborating a pattern of substance use and maternal and neonatal ICD-10 codes for SUD. Patients identified with SUD were then classified as moderate or severe SUD based on criteria established by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. We measured rates of NIDA implementation across different healthcare settings, evaluated NIDA concordance with ascertainment of SUD, and compared adverse pregnancy outcomes associated with moderate and severe SUD. ResultsFrom July 28, 2021, through June 25, 2022, 14,634 unique pregnant individuals accessed care at ambulatory and acute care sites. Universal implementation of the NIDA Quick Screen identified at-risk substance use in 2146 (14.7%) of those who accessed our system, or 17.1% of 12,550 screened across the system, with greater screen completion in ambulatory over acute care settings. SUD was identified in 256 (1.7%) of 14,634 individuals and moderate or severe SUD was identified in 184 (1.3%). Among those with moderate or severe SUD, 90 (48.9%) were NIDA positive, 22 (12.0%) NIDA negative, and 72 (39.1%) unscreened. Of 94 individuals with NIDA discordance or who were unscreened 76 (81%) accessed initial care through an acute care setting. Of 96 individuals with opioid use disorder, 68 (70.8%) were treated with medication-assisted therapy, and 56 (58.3%) were screened with the NIDA Quick Screen. Among delivered individuals with available outcomes, those with moderate or severe SUD were less likely to seek prenatal care (71 (76%) vs 9852 (98%), <0.001)) and more likely to deliver before 37 weeks, (18 (20%) vs 909 (9%), RR (95% CI) 2.13 (1.40, 3.24)) compared to individuals without SUD. Neonates exposed to moderate or severe SUD were more likely to have birth weight <10th centile for gestational age (20 (22%) vs 1147 (12%), RR (95% CI) 1.92 (1.29, 2.85)) and require admission to the neonatal intensive care unit (NICU) (19 (21%) vs 964 (10%), RR (95%) 1.95 (1.30, 2.93)). ConclusionUniversal screening was implemented across a large public healthcare system at a high rate, with higher rates of implementation in ambulatory settings. NIDA successfully identified at-risk substance use in 17% of the SUD cohort but failed to identify more than 50% of patients with moderate or severe SUD. Patients with moderate and severe SUD accessed care primarily through the emergency department and experienced higher rates of adverse obstetric and neonatal outcomes. Future efforts to identify, engage, and retain this highest-risk group are needed.

T30 - Prevalence and Correlates of Self-Reported Novel Psychoactive Substance Use Among Adults in 13 US Cities, 2021–2022: Results From National Drug Early Warning System (NDEWS) Surveillance

T30 - Prevalence and Correlates of Self-Reported Novel Psychoactive Substance Use Among Adults in 13 US Cities, 2021–2022: Results From National Drug Early Warning System (NDEWS) Surveillance

A Scoping Review: Associations Between Drugs of Abuse and Toxoplasma Gondii Infection

Toxoplasma gondii (T. gondii) is one of the most common parasites that infect humans. The parasite exists in approximately 40 million people in the United States. Latent infections are frequently associated with tissue cysts of T. gondii in the skeletal muscle and brain tissue that can lead to mental disorders, congenital disorders, and vision dysfunction. Furthermore, self-directed violence, impulsivity, and aggression are associated with T. gondii infection. Dopamine is associated with human behaviors including pleasure, aggression, memory, and substance use disorder; however, the studies on the association of T. gondii infection and drugs of abuse are not well understood. The frequency of substance use may be associated with substance-induced modification of dopamine-receptor densities and basal dopaminergic activity. Likewise, T. gondii can directly or indirectly influence dopaminergic activity in infected cells. The current scoping review aimed to review peer-reviewed literature and identify gaps to evaluate the association between drugs of abuse and T. gondii infection. Articles for review were included if published between the 1st of January 1970 and to the 30th of December 2022. Different key words and phrases were adopted: “T. gondii infection”, “Toxoplasmosis”, “T. gondii and drug use”, “T. gondii infection and dopamine”, “T. gondii infection and drugs of abuse”, “drugs of abuse”, “T. gondii infection and alcohol”, “SUD”, “Toxoplasmosis and SUD” and “Substance abuse and inflammation”. Articles that did not match and/or were published outside of history range were excluded. Databases utilized to generate results included PubMed, Web of Science, and Scopus. One hundred and nine articles or resources were generated and deemed appropriate for reference in this review. Results indicate that individuals infected with T. gondii display increased risky behavior, such as excessive alcohol consumption. T. gondii seropositive subjects had a reduced likelihood of self-reported substance use compared to T. gondii seronegative subjects which confirms that SUD is a potential risk factor for behavioral and psychiatric complications associated with T. gondii infection. Therefore, it is necessary to conduct further research characterizing the mechanisms associated with dopamine metabolism of drug dependence and withdrawal in the context of a T. gondii infection, evaluating the role of inflammation, and identifying potential drug-and-sex specific underpinnings of these associations

The Effect of Bully Victimization on Self-Reported Delinquency and Substance Use Using the General Strain Theory Framework: Sex, Race, and Ethnicity Differences

ABSTRACT Young people who are bullied in school are more likely to skip school and engage in antisocial behavior than those who are not bullied. Through Agnew’s general strain theory (GST), bully victimization is considered an experienced strain, and deviant behavior may be one reaction to such strain. In contrast, skipping school can allow young people who are being bullied at school the chance to avoid victimization and is representative of what Agnew refers to as anticipated strain. The current study assesses whether bully victimization and skipping school due to bully victimization are associated with self-reported delinquency and substance use and whether these effects vary by the demographics of participants (e.g. sex, race, and ethnicity). Using data from the 2022 Florida Youth Substance Abuse Survey, results indicate that only experienced measures of physical bully victimization and cyberbully victimization are associated with a greater variety of delinquency and substance use but verbal abuse was related to lower variety of substance use in the overall sample. While results largely suggest that the effects of strain on these outcomes do not significantly differ between males and females, there is evidence that some of these effects differ between races and ethnicities.

Frequency of Cannabis Use and Female Infertility: A Cross-Sectional Analysis [ID 2683566

INTRODUCTION: With expanding cannabis legalization in the United States, the prevalence of cannabis use is growing. Literature describing the effect of cannabis use on fertility is limited. The purpose of this study is to investigate the association between frequency of cannabis use and infertility. METHODS: This study utilized cross-sectional data from the 2013–2018 cycles of the National Health and Nutrition Examination Study (NHANES) for women aged 20–49. We used multivariable logistic regression models to examine the association between frequency of cannabis use (never used, irregular use, regular use) and infertility (inability to conceive within 1 year), adjusting for self-reported sociodemographics and use of other substances. Regular cannabis use was defined as monthly use or more for at least a year. All analyses were conducted using R, version 2022.07.2. RESULTS: Of the 3,166 women included, 12.5% reported infertility, with the prevalence of infertility ranging from 10.8% among irregular cannabis users to 15.4% among regular cannabis users. Compared to women who reported never using cannabis, women who reported regular use had 47% greater odds of infertility (adjusted odds ratio [aOR] 1.47; 95% CI, 0.88, 2.45) and women who reported irregular use had 17% lower odds of infertility (aOR 0.83; 95% CI, 0.54, 1.30). CONCLUSION: Our results contribute to a small, but growing body of evidence that regular cannabis use could have a small to moderate association with infertility, signaling that further research is necessary to better characterize the risk to prospective parents.

Beyond Maternal Health: Examining the Effect of Birth Complications on Unmarried Fathers' Postpartum Well-Being [ID 2683609

INTRODUCTION: Birth complications (BCs) are known risk factors for maternal postpartum depression, but their effect on paternal postpartum depression (PPD), especially among unmarried fathers, remains understudied. METHODS: In this cross-sectional study, we analyzed data from The Future of Families and Child Wellbeing longitudinal birth cohort, focusing on unmarried fathers who were present at their child’s birth (n=1,484). Paternal PPD was assessed using a 12-item CES-D scale, dichotomized into depression present versus absent. Maternal medical records identified seven conditions constituting BC, including excessive bleeding, placental abruption, placenta previa, emergency c-section, seizure during delivery, cord prolapse, or fetal distress. Logistic regression models were estimated, adjusting for parents' demographics, self-reported health status, cohabitation, poverty, substance use, relationship quality, and prior fatherhood experience. RESULTS: Postpartum depression affected 132 fathers (9%), while BC occurred in 602 mothers (41%). In the unadjusted model, BC was associated with 42% increased odds of paternal PPD compared to uncomplicated births (95% CI, 1.00–2.04). In multivariable analysis, BC was significantly linked to paternal PPD (aOR 1.46; 95% CI, 1.00–2.12). Fathers in great/very good health had 37% lower paternal PPD odds than those in good/fair/poor health (95% CI, 0.43–0.96), while interparental conflict was linked to higher paternal PPD odds (aOR 2.38; 95% CI, 1.61–3.52). CONCLUSION: Our study found birth complications to be associated with increased odds of paternal postpartum depression. Further research is needed to explore how maternal birth experiences affect paternal well-being, particularly among unmarried fathers, and identify novel ways to incorporate fathers into perinatal support systems and interventions.

Examining Parental Alcohol Use and Peer Relationships as Predictors of Substance Use Severity

In the United States, issues with substance use among adolescents has grown in its prevalence, and past research has shown a continuity in substance use amongst children with substance involved parents. In adolescence, young men tend to report higher rates of alcohol use when compared to young women. As such, we were interested in examining gender as a moderating factor on the relationship between parental alcohol use and substance use severity. Amazon’s MTurk was used to recruit 185 participants with a history of substance use to complete a series of surveys. Participants reported parental alcohol use during childhood and involvement with pro-social peers. Results revealed gender did not moderate the relationship between parental substance use and respondents’ self-reported substance use. However, there were strong correlations among substance use severity, parental alcohol use, and involvement with pro-social peers. Specifically, respondents who were the child of a mother who experienced problems with alcohol were 3.12 times more likely to have a severe SUD. This effect was not observed when paternal alcohol use was examined as a predictor of substance use severity (p=0.651). Respondents involved with pro-social peers are less likely to have a severe substance use disorder (p less than 0.001). Together, children whose mothers struggled with alcohol use were more likely to develop a severe substance use disorder. In contrast, having a father who struggled with alcohol use did not affect respondents’ involvement with substance use. Furthermore, having a peer support system reduces subsequent substance use, regardless of parental alcohol use.

347 Short-Term Pain Outcomes and Pain Medication Utilization Among Urine Toxicology-Identified Opioid and Marijuana Users Following Elective Spine Surgery

INTRODUCTION: Postoperative pain outcomes may be influenced by preoperative substance use, which is often underreported due to associated stigma. METHODS: Patients undergoing elective spinal surgery between September 2020 and May 2022 were recruited for this prospective cohort study. Detailed chart review was completed to collect demographic, urine toxicology, VAS, and pain medication regimen data. Comparisons between self-reported and urine toxicology-identified substance use, pre- and post-operative VAS ratings, and postoperative pain medication use were made using χ2 tests, student’s t-tests, and logistic regression, respectively. Models were adjusted for age, sex, and race. RESULTS: Among 111 participants (mean age 58 years, 59% female, 95% with &gt;1 comorbidity), urine toxicology overestimated drug use (47% vs 16%, p &lt; 0.001) and underestimated alcohol use (16% vs 56%, p &lt; 0.001) at preoperative baseline relative to patient reports. Two-weeks postoperatively, participants on preoperative opioids as determined by urine toxicology reported no significant improvements in pain from baseline (6.67 preop vs 5.92 postop, p = 0.288) unlike non-users (6.56 preop vs 4.61 postop, p &lt; 0.001). They also had worse postoperative VAS (5.92 vs 4.61, p = 0.030) and heavier reliance on opioid medications (OR = 3.09, 95% CI = 1.21-7.89, p = 0.019). Conversely, participants on preoperative marijuana reported similar improvements in pain from baseline (users: 6.88 preop vs 4.36 postop, p = 0.001; non-users: 6.49 preop vs 5.07 postop, p = 0.001), similar postoperative pain (4.36 vs 5.07, p = 0.238), and similar postoperative reliance on opioid medications (OR = 0.96, 95% CI = 0.38-2.44, p = 0.928). CONCLUSIONS: While urine toxicology-identified preoperative opioid use was associated with poor postoperative pain relief and continued reliance on postoperative opioids for pain management following elective spinal surgery, preoperative marijuana use was not. Preoperative marijuana use, hence, should not delay or be a contraindication to elective spinal surgery.

Covid 19’s Social Quarantine-Moderated Self-Reported Mental Health and Substance Use Among US Adults

In 2019 the novel coronavirus spread quickly throughout the world. It was easily transmitted, resulting in a sudden increase in infection and death rates that overwhelmed hospitals. This sudden pandemic resulted in government and health officials mandating physical and social quarantines to decrease the spread of COVID-19. All these unexpected factors induced traumatic stress across the world. The impact of this trauma is seen to date, as many studies reported adverse mental health effects in an array of populations and researchers speculate these effects will continue long after COVID-19. The role of social quarantine as a moderating factor to these adverse mental health symptoms was assessed in a Qualtrics sample of 596 US adults. Participants completed a demographic survey, Adverse Childhood Experiences (ACEs) Questionnaire, COVID-19 Pandemic Mental Health Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, International Trauma Questionnaire, Brief Resiliency Scale, and the Tobacco, Alcohol, Prescription Medication and Other Substances Tool. Hierarchical regressions with demographic and risk factors as predictors assessed the role of social quarantine as a moderator in predicting mental health symptoms. ACEs and risk factors were stronger predictors of mental health symptoms, but social quarantine added significant incremental variance in self-reported anxiety, depression, PTSD, complex PTSD, and substance use; β&lt;em&gt; &lt;/em&gt;ranged for 0.24 to 0.30. Quarantine had a significant adverse impact on mental health symptoms among these adults. Fostering resilience and distress tolerance is a proposed clinical intervention.