Background: High substance use among Ethiopian high school students has been reported in localized studies, yet key contributing factors such as parental substance use, school policies, and environmental influences remain under-researched, particularly in Jimma. Identifying the prevalence and contributing factors specific to this setting is essential for developing targeted prevention strategies and guiding school and community-level interventions. Methods: This cross-sectional study assessed substance use prevalence and the associated factors among 206 high school students (Grades 9–12) in Jimma Town, Jimma, Ethiopia. Participants were selected using multistage random sampling from two schools. Self-administered questionnaires, including an adapted Brief Screener for Tobacco, Alcohol, and other drugs, were used to screen participants. Data were entered in Epi-Data 3.1 and analyzed using SPSS 27; bivariate and multivariate logistic regression analyses identified associated factors, and statistical significance was determined at a 95% confidence level, P value (.05). Results: Among 202 participants, the prevalence of substance use was 27.2% (95% CI: 21.1–33.3). The most common substances used were Khat 48.5% (95% CI: 1.75–1.96), followed by alcohol 26.7% (95%CI: 1.27–1.56), and tobacco products 8.9% (95% CI: 1.23–1.52). Living with parents (AOR = 9.245, 95% CI: 0.96–88.94, P = .045), parents’ neutral opinion on substance use prevention (AOR = 2.762, 95% CI: 1.09, 6.94, P = .031), students’ lack of information on substance use (AOR = 0.343 95% CI: 0.15, 0.77, P = .010), and peer substance use especially chewing Khat (AOR = 16.512, 95% CI: 6.68–40.80, P < .001) significantly increased odds of substance use. Conclusions: The high prevalence of substance use among high school students necessitates a collaborative approach involving all stakeholders to foster a safer and more supportive educational environment. Schools should mandate comprehensive substance use prevention programs, establish clear prevention-focused policies, and engage parents and the community to build a cohesive support network.

Abstract Purpose The present study described associations between profile membership, based on lifetime experiences of intimate partner violence (IPV) and three conceptually relevant groups of variables hypothesized to facilitate vulnerability to IPV among emerging adults: Risky substance use, lifetime experiences of adversity, and dysfunctional relationship characteristics. Methods An ethnically and racially diverse sample of U.S. transgender adults ( N = 248, age M = 22.61 years) were surveyed using the CloudResearch participant recruitment platform. Latent profile analysis (LPA) was used to model the optimum number of underlying groups of participants, based on their self-reported lifetime experiences of psychological control, physical violence, and sexual violence by romantic or sexual partners. Results Four profiles were identified: High All IPV Scales, Low All IPV Scales, High Psychological/Physical IPV, and High Sexual IPV. Significant between-profile differences in dependent variables varied by variable domain. However, members of the small High All IPV Scales profile reported the highest mean scores for all indicators of risky substance use and lifetime adversity and very high mean scores for relational aggression and relational victimization. Conclusions There was substantial heterogeneity in transgender emerging adults’ experiences of IPV. More complex patterns of lifetime IPV were significantly associated with more severe patterns of risky substance use, lifetime adversity and forms of conflict in intimate relationships. The information generated in this descriptive study may be used to inform tailored counseling interventions for transgender emerging adults by integrating into IPV risk reduction initiatives detailed information regarding factors that facilitate client vulnerability to IPV.

Nicotine and cannabis use are increasingly relevant in surgical planning, but their effects on postoperative complications following ankle fracture open reduction and internal fixation (ORIF) remain unclear. This study evaluates associations between recent substance use and postoperative complications across multiple time points. We queried a nationwide database, TriNetX, for patients aged ≥18 years who underwent ORIF for ankle fractures between 2011 and 2023. Five independent 1:1 propensity-matched cohort analyses were performed based on substance use in the year prior to surgery: (1) dual use vs neither, (2) nicotine use vs neither, (3) cannabis use vs neither, (4) dual vs cannabis use, and (5) dual vs nicotine use. Patients with overlapping exposures were excluded from single-substance groups. Groups were 1:1 propensity score matched. Primary outcomes included 90-day wound disruption, surgical site infection (SSI), and hardware removal at 1 and 3 years. Nicotine use was associated with higher 90-day wound disruption (odds ratio [OR] 1.4 [1.2-1.6]) and SSI (OR 1.4 [1.2-1.6]) compared to nonusers. Dual users also showed increased SSI vs neither-use (OR 1.6 [1.1-2.3]), whereas wound disruption trended higher (OR 1.4 [0.99-2.0]). Cannabis use alone was not associated with higher complication rates (all P > .05). Compared to cannabis-only users, dual users had higher 90-day wound disruption (OR 2.0 [1.1-3.4]) and SSI (OR 1.7 [1.01-2.8]), though outcomes were similar between dual and nicotine-only users (all P > .05). Hardware removal rates did not differ across groups (all P > .05). Nicotine use was associated with increased postoperative complications after ankle fracture ORIF, whereas cannabis use alone was not. When evaluating dual substance users, complication rates were largely comparable to nicotine-only users. Further studies are needed to clarify the isolated and combined perioperative effects of cannabis and nicotine.

Within the framework of the Barcelona Health in the Neighborhoods strategy, an intervention was implemented in disadvantaged neighborhoods of the city to promote healthy leisure activities, training, and work experiences for adolescents. This study aimed to evaluate the effects of this intervention on emotional well-being, self-esteem, social relationships, substance use, and access to the labor market.We conducted a non-experimental pre-post mixed-methods evaluation of the intervention. A questionnaire was administered between 2017 and 2020 to participants at three time points: before the intervention (pre, N = 252), after completing Phase 2 training (post-1, N = 142), and after the first employment experience (post-2, N = 81). In 2021, qualitative interviews were conducted with both participants and program educators who had taken part in the intervention between 2019 and 2021. A total of 27 individuals (participants and educators) took part in the interviews. We collected data on emotional well-being and employment as primary outcomes, and on resilience, substance use, perceived health, self-esteem, social support, and program satisfaction as secondary outcomes. Quantitative data were analyzed using univariate and bivariate analyses, and qualitative information underwent thematic analysis.Our findings showed improved well-being and higher employment rates among participants, as well as greater perseverance and trust. The program also contributed to enhanced practical knowledge, social skills, and interpersonal relationships. In contrast, tobacco and alcohol use increased after the intervention.This study suggests that healthy leisure and labor insertion interventions for young people might facilitate workforce entry and improve young people's well-being and overall quality of life.

Supplemental Material for Borderline Personality Disorder Does Not Predict Treatment Outcome in a Partial Hospital Program Independent of Internalizing and Harmful Substance Use Dimensions

Study DesignUmbrella systematic review.ObjectiveTo qualitatively synthesise systematic reviews evaluating the prevalence, correlates, and outcomes of mental illnesses in individuals with traumatic spinal cord injury (tSCI).MethodsSystematic reviews reporting on depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorders (SUD), cognitive impairment, and related psychological outcomes in tSCI populations were identified and synthesized as per PRISMA guidelines. Data on prevalence, risk factors, assessment tools, and interventions were extracted. Methodological quality was appraised using AMSTAR 2, and primary study overlap was assessed.ResultsTwenty systematic reviews published between 2005 and 2025 were included. Depression was the most frequently studied condition (n = 16), followed by anxiety (n = 10), PTSD (n = 6), and SUD (n = 4), with several reviews addressing multiple conditions. Primary study sample sizes ranged from 3152 to over 50000 participants, with wide variation in injury characteristics, study design, and outcome measures. Pooled prevalence estimates indicated a substantial burden: depression affected up to 43% of community-dwelling individuals, anxiety symptoms around 27%, PTSD up to 62%, and hazardous alcohol use ≥50% in some cohorts. Common risk factors included pain, injury severity, incomplete injury, low social support, maladaptive coping, and co-occurring psychological symptoms. Evidence for effective interventions was limited, and few studies used standardised, validated tools across settings.ConclusionsMental health conditions are highly prevalent in the tSCI population, yet intervention research remains limited. Standardised assessment, longitudinal designs, and targeted, evidence-based interventions are urgently needed to address this critical but under-recognised aspect of tSCI care.

Introduction: Adverse Childhood Experiences (ACEs) refer to traumatic events occurring before the age of 18 that can negatively impact physical and mental health, often disrupting development. Numerous studies have shown associations between ACEs and the onset or severity of psychotic disorders. The aim of this study was to assess the prevalence of ACEs among patients with psychotic disorders and to examine an association between ACEs and the sociodemographic and clinical characteristics of psychosis. Material and Methods: The study was conducted at the Center for Mental Health and the Psychiatric Clinic of the University Clinical Center Nis, from March to July 2025. The sample included adult patients of both sexes diagnosed with psychotic spectrum disorders based on ICD-10 criteria. The Adverse Childhood Experiences Questionnaire (ACE-Q), along with sociodemographic and clinical data from medical records, was used. Results: The sample included 60 patients, with a mean age of 36.7 years. The average ACE-Q score was 2.57 ± 1.98, with one-third of patients reporting high exposure (≥4 ACEs) to childhood adversity. Patients with high ACEs exposure (≥4 ACEs) differed significantly from those with low to moderate or no exposure (<4 ACEs) in terms of economic status, family history of psychiatric disorders, substance use, and treatment adherence. Conclusion: Despite the small sample size, our results point to a potential link between childhood adversity and certain sociodemographic and clinical characteristics in patients with psychotic disorders. Integrating systematic assessments of trauma history into routine clinical practice may support the development of more effective treatment strategies.

Assessing the prevalence, determinants, and health impact of substance use among university students in Bangladesh

Trends of Adolescent Substance Use by Type of Victimization: COVID-19 Interaction Effects in the United States Youth Risk Behavior Survey (2013–2023)

To estimate the risk of death after hospitalisation with non-fatal intentional self-poisoning in New South Wales, and to estimate the associated number of years of life lost. Retrospective observational study; analysis of Poisoning And enVenomation Linkage to evaluate Outcomes and clinical Variation in Australia (PAVLOVA) study data. All index admissions to New South Wales public and private hospitals of people after non-fatal intentional self-poisoning (ie, were discharged from the index admission alive), 1 January 2011 - 30 September 2020. Standardised mortality ratio (compared with general population mortality rate; SMR), overall, and by cause of death (data available only for 2011-2018); years of life lost (YLL) overall, and by cause of death (2011-2018), age group, and sex. Index admissions of people with non-fatal intentional self-poisoning were identified for 48 951 people; their median age was 32.8 years (interquartile range [IQR], 20.8-47.5 years), 30 274 were girls or women (61.8%), and 3449 died during follow-up (median, 4.9 years; IQR, 2.7-7.3 years). The all-cause SMR was 3.1 (95% confidence interval [CI], 3.0-3.2); by cause of death, the SMR was highest for external cause deaths (16.8; 95% CI, 15.9-17.8), including accidental poisoning (30.3; 95% CI, 27.4-33.2) and suicide deaths (25.1; 95% CI, 23.2-27.1). Among natural causes of death, the SMR was highest for infectious and parasitic diseases (5.4; 95% CI, 3.9-6.8), digestive diseases (4.2; 95% CI, 3.4-5.0), and respiratory diseases (3.0; 95% CI, 2.5-3.4). The estimated overall premature mortality burden was 110 301.4 YLL; the median value per death was similar for women (31.1 YLL; IQR, 15.0-43.0 YLL) and men (33.2 YLL; IQR, 19.7-44.9 YLL). During 2011-2018, the total mortality burden was 79 821.6 YLL; by cause of death, the major contributors were deaths from suicide (26 945.2 YLL; 33.8%), accidental poisoning (17 436.1 YLL; 21.8%), other injuries (6026.8 YLL; 7.5%), and natural causes (29 413.5 years; 36.8%). The risk of death is markedly higher after hospitalisation with intentional self-poisoning than for the general population, but suicide deaths only cause about one-third of the mortality burden in terms of lost years of life; deaths from accidental poisoning and natural causes are also major contributors. Referrals to specialist psychiatric and physical health care and brief interventions for treating psychiatric and substance use conditions are appropriate after hospitalisation with intentional self-poisoning.

The COVID-19 pandemic disrupted schooling for many during the middle-to-high school transition, a critical period for initiation of substance use. This study examines how reduced in-school peer exposure was associated with substance use patterns among ninth and tenth graders before and after the pandemic. To examine the relationship between differential in-school peer exposure to substance use patterns among ninth and tenth graders before and after the pandemic. We conducted a repeated cross-sectional study of ninth and tenth graders (total N = 2,024) from a large US high school, using annual in-school survey data from 2017-2019 (N = 1,550) and 2023 (N = 474). We compared substance use prevalence and risk factors pre- and post-pandemic. The pre-pandemic sample was 48% boys and the post-pandemic sample was 57% boys. Ninth graders (one year less exposure to in-school peers) had significant declines pre- to post-pandemic in 30-day alcohol use (13% to 7%), 30-day e-cigarette use (12% to 7%), lifetime alcohol use (31% to 20%), lifetime marijuana use (18% to 10%), and lifetime e-cigarette use(23% to 13%). Tenth graders (one additional year of in-school peer exposure) did not experience similar declines. Perceived substance use accessibility increased among ninth graders pre- to post-pandemic (mean risk perception score: 3.18 to 3.33, p < 0.05). Less in-school peer exposure during a critical developmental period was associated with reduced substance use initiation and progression. These findings highlight the importance of in-school exposure to peers in adolescent substance use trajectories. Future research should investigate specific mechanisms of peer influence-such as substance availability on campus-to inform targeted prevention and early intervention strategies.

This study validates the Spanish version of the Brief-COPE in the Colombian context. This tool assesses 14 different coping strategies, including positive coping, planning, emotional support, instrumental support, substance use, and religion, among others. The structural validations of this tool in Latin America, Europe, North America, and Asia yielded heterogeneous results, with validations in Latin America often having limitations in their data analysis methodologies and sample size. This study aims to address these limitations and provide methodologically sound evidence on the structural validity, reliability, and convergent and divergent validity of the instrument for adults in Colombia. A total of 762 participants completed the Brief-COPE along with the ERQ, the Wellbeing Index, the HSCL-25, the PCL-C, and the Kessler 6. Categorical Confirmatory Factor Analysis (CFA) was employed to assess the fit of 12 different theory and data-driven models. After identifying the best-fitting model, reliability, divergent, and convergent validity were assessed for the resulting factors. The best-fitting CFA model for the Brief-COPE had 11 factors: active coping, social support, acceptance, venting, self-distraction, behavioral disengagement, denial, self-blame, humor, religion, and substance use. Substance use, active coping, religion, social support, humor, self-blame, denial, and behavioral disengagement demonstrated good reliability (Omega > = .7), whereas the remaining subscales demonstrated insufficient reliability (Omega > .6 and Omega < .7). Maladaptive coping strategies were found to positively correlate with distress measures, while adaptive strategies exhibited negative correlations, as expected. However, social support and humor presented significant positive associations with PCL-C and HSCL. This study provides evidence supporting an 11-factor structure for the Brief-COPE in Colombian adults, with most factors demonstrating satisfactory reliability. Researchers should use caution when interpreting subscales with lower reliability. The results also underscore the influence of cultural context on coping patterns, given the heterogeneous factor structures found in other validations. Future studies should recruit more diverse samples to enhance generalizability and further investigate the predictive validity of this adapted tool.

The recognition of poor sleep quality is a significant health issue since there is a paucity of comprehensive data on sleep quality in women and the previous studies that have no providing a holistic understanding of the issue across different stages of women's lives. Therefore, conducting a systematic review and meta-analysis of poor sleep quality and associated factors among women in Ethiopia is an essential to provide actionable insights for healthcare providers and policymakers. A systematic review and meta-analysis of 11 studies among 6038 women of the exact heterogeneity of (I² = 99%) with a comprehensive search using electronic databases (PubMed, Cochrane Library, Google Scholar, and African Journal Online) was performed covering articles indexed through June 2000 to 1,August 2025. The quality of the included studies was evaluated using the Joanna Briggs Institute (JBI) Epidemiological Data Research Institute Critical Appraisal Checklist which studies scoring above 75% were considered for inclusion in the meta-analysis. The inter-rater reliability between the two reviewers for the JBI quality assessment was substantial (Cohen's κ = 0.82; 95% CI: 0.73-0.91), indicating good consistency in scoring across studies. The I2 test statistics were used to examine the heterogeneity of the studies. A random-effects meta-analysis was performed to estimate the prevalence of the poor sleep quality, and the results are reported in a forest plot. The pooled prevalence of poor sleep quality among 6038 women was 42.25% (95 CI: 30.80, 53.7). In this review, having depressed (AOR = 3.7, 95%CI: 2.82, 4.8), substance use (AOR = 2.00, 95%CI: 1.6, 2.6), Intimate Partners Violence (IPV) (AOR = 3.20, 95%CI: 1.95, 5.3), stress 2.50, 95%CI: 1.82, 3.43), and low social support (AOR = 4.2, 95%CI: 2.700, 6.60) were significantly associated with poor sleep quality. Poor sleep quality is affecting over 40% of women in Ethiopia. Depression, substance use, intimate partner violence, stress, and low social support are statistically associated with poor sleep quality. Therefore, targeting mental health and social support, alongside public education and policy integration, are essential to improve sleep quality.

The COVID-19 pandemic and its measures have profoundly affected adolescents' lives, including their health behaviors. As a host of research indicates that adolescent health behaviors cluster together and that adolescents can respond differently to the pandemic, we examined adolescents' changes in clusters of health behaviors and its correlates during different phases of the pandemic. A total of 710 Dutch adolescents (53% female; at pre-pandemic: Mage = 14.37; SDage = 0.65; age range = 12.72 to 17.06years) completed questionnaires on health behaviors (i.e., nicotine use, alcohol use, unhealthy food intake, and physical inactivity) before the pandemic (spring 2019) and during different phases of the pandemic (lockdown 1 (spring 2020), reopening 1 (fall 2020), lockdown 2 (spring 2021), reopening 2 (fall 2021)). We used a person-centered technique to explore how health behaviors clustered in latent classes before and during different phases of the pandemic, and whether adolescents transitioned to different classes during different phases. Adolescent demographics (i.e., age, educational type, and sex) and parental health behaviors were tested as covariates of class membership and transitions. The Latent Transition Analysis (LTA) identified three classes before the pandemic: one class characterized by health-risk substance use and food intake, one class characterized by health-protective versions of these behaviors, and a medium health-risk class. During the pandemic phases, two classes were identified: most adolescents in the health-risk or health-protective class transitioned to a class with similar health-risk and health-protective behaviors. The third, medium health-risk, class was split into a health-protective and a health-risk class during the pandemic, with most adolescents transitioning to the health-risk class. Age, educational type, sex, and parental food intake behavior were related to latent class membership at some, but not all, time points. Some parental health behaviors, but not adolescent demographic factors, were related to the transition from the medium health-risk to the health-risk class. Adolescents at-risk for unhealthy behaviors may remain so during the pandemic. Adolescent demographics and parental (food intake) behaviors are relevant to consider as forms of screening adolescents who may be more at risk to show health-risk behaviors. Larger studies are needed to corroborate these findings.

Calls for service (CFS) to 911 are one way to assess both community safety and public health needs. While an abundance of literature demonstrates that conditions within the neighborhood environment may contribute to violent- and property-related CFS, limited research is available on the association between neighborhood environment and non-crime related CFS, which constitute the majority of 911 calls and present avoidable risks due to police intervention. Furthermore, many studies fail to distinguish between police-initiated and public-initiated CFS, despite public-initiated calls theoretically representing a recognized need from residents rather than what is observed by policing alone. The current study therefore seeks to improve our understanding of how community needs align with neighborhood resource allocation by examining spatiotemporal associations between non-violent, public-initiated CFS and neighborhood characteristics in Durham, North Carolina. Using publicly-available data from the Durham Open Portal, we analyzed approximately 640,000 public-initiated CFS data aggregated to the census block group between 2015 and 2021. Non-violent, public-initiated CFS were aggregated into the following groups: alarm, disturbance, sound of gunshots, medical assistance, mental health, lost and found persons, noise complaint, other (panhandling, prostitution, gambling), property, public assistance, substance use, and suspicious activity/behavior. Census block group level evictions from 2015-2021 and poverty and unemployment from 2015-2019 were assessed as neighborhood characteristics. We assessed correlations between call groups and neighborhood characteristics. Neighborhood eviction density, poverty rate, and unemployment rate were examined cross-sectionally in relation to public-initiated CFS, adjusting for education, race, sex, and age. Public-initiated CFS were moderately to strongly correlated with evictions and poverty rate. Similarly, non-violent, public-initiated CFS exhibited significantly positive associations with levels of evictions and poverty. Unemployment rate, however, was not associated with non-violent, public-initiated CFS. This work provides important insights into the neighborhood conditions associated with a greater demand for public safety resources via 911 call centers. More research is needed, qualitative and quantitative, to understand public safety funding that best aligns with community needs.

Tracking functional recovery in a community-based substance use disorder program: a five-year descriptive evaluation using the brief addiction monitor.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder that often persists into adulthood and is associated with an elevated risk of substance use disorders. Benzodiazepines (BDZs), frequently prescribed for anxiety and sleep-related symptoms, carry a high potential for misuse and dependence. Preliminary evidence suggests that individuals with ADHD may be particularly vulnerable to problematic BDZ use, yet this association has not been systematically reviewed or quantitatively assessed. This review aimed to systematically examine the association between ADHD and BDZ misuse or dependence in adult populations, and to quantify this relationship through meta-analytic synthesis of observational data. A systematic literature search was conducted in PubMed, Scopus, and ScienceDirect for relevant observational studies published up to April 30, 2025. Inclusion criteria focused on original research reporting BDZ misuse or dependence in adults with a clinical diagnosis of ADHD. A random-effects meta-analysis was performed to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Risk of bias was assessed using the Joanna Briggs Institute checklist for analytical cross-sectional and cohort studies. Four studies met the inclusion criteria, each contributing one independent effect estimate. The pooled OR indicated a significant association between ADHD and BDZ misuse or dependence (OR = 1.94; 95% CI: 1.31-2.89), with moderate heterogeneity observed (I2 ≈ 42%). Patterns of misuse included high-dose intake, intravenous/intranasal administration, and prolonged BDZ use. Adults with ADHD demonstrate a significantly increased risk for BDZ misuse and dependence. These findings emphasize the need for targeted screening and cautious prescribing practices in this population.

Healthcare access and perceived value of liver screening among people experiencing homelessness and substance use disorders: a qualitative study.

Identifying target-specific drugs remains a challenge in pharmacology, especially for highly homologous proteins such as dopamine receptors D2R and D3R. Differences in target-specific cryptic druggable sites for such receptors arise from the distinct conformational ensembles underlying their dynamic behavior. While Molecular Dynamics (MD) simulations has emerged as a powerful tool for dissecting protein dynamics, the sheer volume of MD data requires scalable and unbiased data analysis strategies to pinpoint residue communities regulating conformational state ensembles. We present the Dynamically Resolved Universal Model for BayEsiAn network Tracking (DRUMBEAT) interpretable machine learning algorithm and validate it by identifying residue communities that enable the deactivation of the β2-adrenergic receptor. Further, upon analyzing dopamine receptor dynamics we identify distinct and non-conserved residue communities around the contacts F1704.62_F172ECL2 and S1464.38_G14134.56 that are specific to D3R conformational transitions compared to D2R. This information can be tapped to design subtype-specific drugs for neuropsychiatric and substance use disorders.

Strong information delay as a driver of epidemic waves: Mathematical modeling for drug trends and epidemic bio-preparedness.