Types Of Substance Use Research Articles

Alcohol, Tobacco, and Marijuana use Among Individuals Receiving Prescription Opioids for Pain Management.

Substance use among individuals receiving prescription opioids for pain may be associated with poorer functioning. The purpose was to examine whether use of substances (i.e., alcohol, marijuana, or tobacco) among individuals prescribed opioids for pain management was associated with pain, psychiatric disorders, and opioid misuse. Patients with non-cancer pain and a new opioid prescription were recruited from two health systems. Participants (N= 827) completed measures regarding pain severity, pain interference, psychiatric symptoms, and substance use. Substance use was common with 58.0%, 26.2%, and 28.9% reporting alcohol, tobacco, and marijuana use, respectively. Use of tobacco or marijuana was associated with poorer functioning. Those with tobacco use had greater pain severity, interference, number of pain sites, and concern for opioid misuse, and were more likely to have probable depression, anxiety, and PTSD. Participants reporting marijuana use were more likely to have higher concern for opioid misuse scores and probable depression, anxiety, and PTSD. Use of alcohol was associated with lower pain severity and interference and fewer number of pain sites. Substance use is common among individuals receiving prescription opioids. Some types of substance use may be related to poorer opioid, pain, and psychiatric functioning. Clinicians prescribing opioids for pain management should assess for substance use, including tobacco, and be aware of the association with poorer functioning. Interventions could target pain, psychiatric symptoms, and substance use simultaneously to optimize outcomes for individuals with pain and substance use.

Leisure activities, substance use and psychological health among Hungarian adolescents

ABSTRACT During the past several decades, adolescents’ leisure has undergone several important changes due to, for example, alternative modes of entertainment, such as video gaming and social media which have had a significant influence on their well-being. The aim of this study was to examine the relationships of adolescents’ leisure activities to their substance use and psychological health. Participants were middle and high school students (N = 2,239, aged between 12 and 18 years, M = 14.61 years, SD = 1.71; 51.8% females) using data drawn from the Szeged Youth Study 2022, Hungary. Peer-based leisure was positively associated with all types of substance use. Playing and gaming leisure showed a negative relationship with psychosomatic and depressive symptomatology. Aesthetic-sophisticated and family-based leisure proved the most beneficial for psychological health and health behaviour, and it was also the strongest predictor of adolescents’ life satisfaction. Arts, hobbies and internet use played a beneficial role.

Examining the pathways from adverse childhood experiences to substance use

BackgroundAdverse childhood experiences (ACEs) are traumatic events that occur early in life and can have lasting effects on health and well-being. Previous research has linked ACEs to substance use in adulthood, but there is limited research on the underlying mechanisms or pathways of this relationship. This study explores whether depression mediates the relationship between ACEs and current substance use among U.S. adults. MethodsData were obtained from the 2021 Behavioral Risk Factor Surveillance System (n = 30,978). Generalized Structural Equation Modeling was used to examine the links between ACEs, cigarette, e-cigarette, and marijuana use while adjusting for sociodemographic characteristics. ResultsApproximately 71 % of respondents reported experiencing at least one ACE. The findings show that depressive disorders mediate the relationship between ACEs and current substance use among U.S. adults. There was a significant indirect effect of ACEs on current cigarette use (OR = 1.13, 95 % CI [1.10, 1.16]), e-cigarette use (OR = 1.17, 95 % CI [1.12–1.22]), and marijuana use (OR = 1.22, 95 % CI [1.13, 1.33]) through the mediator of depressive disorders. Additionally, the most pronounced effects were found among those aged 18–24 years for cigarette use (OR = 1.32, 95 % CI [1.11, 1.56]), e-cigarette use (OR = 1.22 [1.09, 1.36]), and especially marijuana use (OR = 1.52 [1.18, 1.96]). ConclusionThese findings suggest that depression may be a key pathway from negative experiences during childhood to certain types of substance use in adulthood, particularly among young adults.

Explaining Substance Use among Puerto Rican Older Adults: Impact of Perceived Discrimination, Perceived Stress, and Social Activities

Background: Despite Puerto Ricans having one of the highest rates of substance use among Hispanic groups in the United States, limited research has focused on the impact of perceived discrimination and stress on substance use among older adults. Individuals who experience stressful events are inclined to engage in harmful behaviors as a coping mechanism. Objectives: Based on the propositions of the General Strain Theory, the current study explores the relationship between perceived discrimination, perceived stress, social activities, and the use of alcohol and cigarettes. Methods: Baseline data from the Boston Puerto Rican Health Study collected in 2014 was used to conduct a logistic regression analysis. Results: The findings reveal that while perceived discrimination is significantly linked to both types of substance use, social activities may serve as a protective factor for cigarette use. Conclusion/Importance: Our study findings emphasize the need to examine perceived discrimination as a stressor impacting the health and well-being of Puerto Ricans in later adulthood. Policy implications for reducing substance use and directions for future research are discussed

Prevalence of psychosis and its relationship with substance use disorder in patients with bipolar disorder in Iran

BackgroundThe correlation between psychosis and bipolar disorder is a crucial and complex matter that requires attention and study. In this study, researchers examined the relationship between the current episode status, substance use disorder, different types of substance use, and psychotic symptoms in inpatients with bipolar disorder. MethodsThe study included 150 patients who were diagnosed with bipolar disorder based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). These patients were referred to the emergency department of Roozbeh Psychiatric Hospital in Iran between November 2019 and February 2020. The Structured Clinical Interview for the DSM-5 (SCID-5) questionnaire was used to diagnose the patient's bipolar disorder, including episodes of depression and mania, as well as their substance use disorder. The type of substance used and the pattern of its use were also evaluated using this questionnaire. Additionally, a faculty member of the psychiatry department at Tehran University of Medical Sciences carefully evaluated the patient's condition for the presence of psychotic symptoms using a psychiatric diagnostic interview. ResultsOut of 150 inpatients diagnosed with bipolar disorder, 89 (59.3 %) had comorbid substance use disorder. Among these 89 patients, 42 (47.2 %) had psychotic symptoms, whereas 79 (52.7 %) of the total 150 inpatients had psychotic symptoms. There was no significant relationship between substance use disorder (p-value=0.86), the type of substance used in a recent episode (p-value=0.93), and the current episode type (p-value=0.69) with psychotic symptoms. LimitationsThe study's generalizability is limited to hospital patients with bipolar disorder. Additionally, since it was a cross-sectional study, causal interpretation was not possible. ConclusionsThe study suggests a primary link between bipolar disorder and psychosis, independent of substance use. Longitudinal multicenter studies with larger sample sizes are recommended.

Prevalence, correlates, and reasons for substance use among adolescents aged 10–17 in Ghana: a cross-sectional convergent parallel mixed-method study

BackgroundSubstance use among adolescents poses significant risks to their health, wellbeing, and development, particularly in low- and middle-income countries, including Ghana. However, little is known about the outlets and reasons for substance use among Ghanaian adolescents. This study examined the prevalence, correlates, reasons for substance use, and outlets of these substances among adolescents aged 10–17 in Ghana.MethodsData were obtained from the Department of Children, Ministry of Gender, Children, and Social Protection, Ghana, which employed a cross-sectional convergent parallel mixed-methods technique to collect quantitative and qualitative data from children aged 8–17, parents or legal guardians and officials of state institutions responsible for the promotion and protection of children’s rights and wellbeing. Overall, 4144 adolescents aged 10–17 were interviewed for the quantitative data, while 92 adolescents participated in 10 focus group discussions. Descriptive statistics, Pearson’s chi-square test, and multivariable binary logistic regression were used to analyse the quantitative data, while the qualitative data was analysed thematically.ResultsThe prevalence of substance use was 12.3%. Regarding the types of substance use, alcohol (56.9%) and cigarettes (26.4%) were the most common substances. Being a male and currently working are significant risk factors, whereas being aged 10–13, and residing in the Middle- and Northern-ecological belts of Ghana are significant protective factors of substance use. Peers, household members who use substances, drug stores, and drug peddlers are the major outlets. The reasons for substance use were fun, substance as an aphrodisiac, boosting self-confidence, dealing with anxiety, and improved social status.ConclusionsThere is a relatively high substance use among adolescents in Ghana, and this calls for a multi-sectoral approach to addressing substance use by providing risk-behaviour counselling, parental control, and effective implementation of substance use laws and regulations.

The Impact of Childhood Mental Health and Substance Use on Methylation Aging Into Adulthood

To test whether childhood mental health symptoms, substance use, and early adversity accelerate the rate of DNA methylation (DNAm) aging from adolescence to adulthood. DNAm was assayed from blood samples in 381 participants in both adolescence (mean [SD] age= 13.9 [1.6] years) and adulthood (mean [SD] age= 25.9 [2.7] years). Structured diagnostic interviews were completed with participants and their parents at multiple childhood observations (1,950 total) to assess symptoms of common mental health disorders (attention-deficit/hyperactivity disorder, oppositional defiant disorder, conduct disorder, anxiety, and depression) and common types of substance use (alcohol, cannabis, nicotine) and early adversities. Neither childhood mental health symptoms nor substance use variables were associated with DNAm aging cross-sectionally. In contrast, the following mental health symptoms and substance variables were associated with accelerated DNAm aging from adolescence to adulthood: depressive symptoms (b= 0.314, SE= 0.127, p= .014), internalizing symptoms (b= 0.108, SE= 0.049, p= .029), weekly cannabis use (b=1.665, SE= 0.591, p= .005), and years of weekly cannabis use (b= 0.718, SE= 0.283, p= .012). In models testing all individual variables simultaneously, the combined effect of the variables was equivalent to a potential difference of 3.17 to 3.76 years in DNAm aging. A final model tested a variable assessing cumulative exposure to mental health symptoms, substance use, and early adversities. This cumulative variable was strongly associated with accelerated aging (b= 0.126, SE= 0.044, p= .005). Mental health symptoms and substance use accelerated DNAm aging into adulthood in a manner consistent with a shared risk mechanism. Using data from 381 participants in the Great Smoky Mountains Study, the authors examined whether childhood mental health symptoms, substance use, and early adversity accelerate biological aging, as measured by DNA methylation age, from adolescence to adulthood. Depressive symptoms and cannabis use were found to significantly accelerate biological aging. Models that tested the combined effect of mental health symptoms, substance use, and early adversity demonstrated that there was a shared effect across these types of childhood problems on accelerated aging.

Using a Syndemic Framework and Structural Equation Modeling to Assess the Co-occurrence and Mutual Impact of Violence Experiences and Substance Use Behaviors Among Adolescents.

Adolescents are at particular risk for multiple violence experiences and substance use behaviors. The extent to which the two clusters of experiences correlate with each other remains unclear. The purpose of this study is to assess the co-occurrence and mutual impact of violence experiences and substance use behaviors in adolescents using structural equation modeling (SEM) based on syndemic theory. This study utilized data collected by 2019 Youth Risk Behavior Survey from a nationally representative sample (N = 13,677). Bivariate associations and correlations between four forms of violence experiences (weapon threats, sexual violence, dating violence, and bullying) and three types of substance use behaviors (e-cigarette smoking, alcohol drinking, and marijuana use) were examined. Two SEM models were built to measure the correlation between the two clusters of variables. The results showed that 36.8% of adolescents experienced at least one form of violence in the past year (22.0% one form, 8.9% two forms, and 5.9% three or more forms) and 42.4% reported one or more types of substance use in the past month (16.3% one type, 14.0% two types, and 12.1% three types). Youths with multiple violence experiences were three to four times more likely to report substance use, and those using three types of substances were two to six times more likely to report violence victimization. All examined associations and correlations between violence experiences and substance use behaviors were statistically significant. In the final SEM model, the four violence variables indicated a syndemic factor and the three substance use variables indicated another syndemic factor. The two syndemic factors were positively correlated (β = .43, p < .05), with 19% of variance being explained by each other. Findings in this study highlight the needs for comprehensive prevention efforts to address the co-occurring and mutually reinforced situation between violence experiences and substance use behaviors in the youth population. Targeted intervention programs and mental health services are needed for adolescents with multiple violence experiences and concurrent substance use behaviors.

Movement disorders associated with substance use in adults living in precarious housing or homelessness

ObjectiveMany individuals living in precarious housing or homelessness have multimorbid illnesses, including substance use, psychiatric, and neurological disorders. Movement disorders (MDs) associated substance use are amongst the poorly studied subtopics of drug-induced MDs. The aim of the present study was, therefore, to determine the proportion affected and severity of different signs of MDs, as well as their associations with substance use in a community-based sample of precariously housed and homeless individuals. MethodsParticipants were recruited from an impoverished urban neighborhood and were assessed for substance dependence and self-reported substance use (alcohol, cannabis, cocaine, methamphetamine, nicotine, and opioids), as well as for the severity of signs of MDs (akathisia, dyskinesia, dystonia, and parkinsonism). Adjusted regression models were used to estimate the associations of the severity of signs with the frequency of substance use over the past 4 weeks and with the baseline diagnosis of substance dependence. ResultsThe proportion of the sample with clinically relevant signs of MDs in any of the four categories was 18.6% (n = 401), and these participants demonstrated lower levels of functioning than those without signs. Of the different types of substance use, only methamphetamine (its frequency of use and dependence) was significantly associated with greater severity of overall signs of MDs. Frequency of methamphetamine use significantly interacted with age and sex, whereby older female participants exhibited the greatest overall severity with increased methamphetamine use. Of the different signs of MDs, methamphetamine use frequency was positively associated with the severity of trunk/limb dyskinesia and hypokinetic parkinsonism. Relative to no use, concurrent use of antipsychotics demonstrated lower severity of trunk/limb dyskinesia and greater severity of hypokinetic parkinsonism with methamphetamine use, and greater severity of dystonia with cocaine use. ConclusionsOur study found a high proportion of MDs in a relatively young sample, and their severity was consistently associated with methamphetamine use, moderated by participant demographics and antipsychotic use. These disabling sequelae represent an important and understudied neurological condition that may affect quality of life and will require further study.

Escape or activate? Pathways of work stress on substance use.

Research on the spillover effects of work stress on substance use have mainly focused on the concept of escapist substance. Building on the concept of self-endangering work behavior, we expand this stress-theoretic view with a presenteeism path of work-induced substance use. Contrary to emotion-based disengaging coping strategies associated with escapist use, we argue that high job demands may also promote problem-focused engagement coping, where substances are used for activation. A structural equation model was used to analyze both assumed pathways of stress-induced substance use with survey data from a random sample of n = 411 employees. We confirmed that high job demands are directly related to escapist substance use, but indirectly related to activating substance use, mediated by presenteeism behavior. Both types of substance use are reduced in organizations with high psychosocial safety climate, but increase with higher competitive climate. Social support is related to reduced activating substance use. Males show a stronger tendency for the escapist path, whereas the presenteeism path is more prevalent in women. Work stress may not only induce substance use as a disengaging emotional coping strategy, but also as an active problem-focused coping strategy, where employees engage in substance use to continue their efforts necessary for work-related goal attainment. A psychosocial safety climate may provide opportunities for intervening on the "cause of causes" of substance use. Moreover, due to the higher prevalence for activating substance use in female workers, previous research may have underestimated women's risks for work-induced substance use.

Peer Crowds and Tobacco Product Use in Hawai'i: A Qualitative Study.

Young adults often derive self-identity from affiliation with peer crowds, which may be defined as reputation-based peer groups centered around characterizable lifestyle norms. Little is known about peer crowds prevalent among Asian American, Native Hawaiian, and other Pacific Islander (AANHPI) populations and the peer crowds' normative tobacco and other substance use behavior. To address this gap in knowledge, this study conducted focus groups with young adult community college students. Focus group discussions were conducted with a convenience sample of 42 young adults (Mean age = 21.5, SD = 2.7) recruited across community colleges on O'ahu, Hawai'i. The participants represented 60% women, 55% NHPI, and 29% Asian American. Results indicated the presence of a wide range of peer crowds in the population, which may be classified into the following seven categories prevalent in the literature: Regular, Academic, Alternative, Athlete, Geek, High Risk, and Popular. Several peer crowds within the Alternative, Athlete, Geek, High Risk, and Popular categories appeared to represent subcultures relevant for NHPI young adults. High-risk peer crowds were reported to be vulnerable to different types of substance use. Tobacco product use, particularly e-cigarette use or vaping, was noted to be characteristically present among Popular crowds and certain Athlete crowds. Tobacco and other substance use prevention interventions, such as mass media campaigns, may benefit from targeting high-risk peer crowds, especially those relevant for NHPI young adults, who are at high risk for tobacco and other substance use. E-cigarette use prevention interventions may benefit from paying close attention to vulnerable Popular and Athlete groups.

SEROPREVALENCE OF HBsAg, Anti-HBs, Anti-HCV, and Anti-HIV IN PATIENTS WITH ALCOHOL AND SUBSTANCE ABUSE IN AN AMATEM CLINIC IN EASTERN TURKIYE: A SIX-YEAR RETROSPECTIVE EVALUATION

Aim&#x0D; Substance abuse and concomitant infections are important causes of morbidity and mortality. Yet, the number of epidemiological studies regarding infectious diseases in people with substance abuse are limited in our country. In this study, the aim was to investigate the frequency of illegal alcohol and substance use in an Alcohol and Drug Research, Treatment and Training Centres (AMATEM) clinic in Turkey as well as the HBsAg, anti-HBs, anti-HCV, and anti-HIV parameters between the years of 2016-2021. &#x0D; Material and Method&#x0D; HBsAg, anti-HBs, anti-HCV, and anti-HIV tests were conducted using the ELISA technique in 6881 alcohol and substance use disorder (ASUD). Urine samples from ASUD’s were analyzed for alcohol, cannabis, and cocaine metabolites. The results were evaluated retrospectively. &#x0D; Results&#x0D; All of the 6881 ASUD’s were male with a mean age of 32.18±9.66 years. Of the 6881 ASUD’s included in the study, 4107 (59.7%) were opioid addicts; 1479 (21.5%) were mixed drug addicts; 897 (13%) were alcohol addicts; and the rest were addicts with other types of substance use. The mean age of the alcohol users was 45.33±13.03 and the mean age of opioid users was 29.90±7.13. The percentage of opioid addiction in 2016 was 71.2% which dropped to 28.7% in 2021. Meanwhile, the percentage of alcohol addiction was 13.6% in 2016 and increased to 21.4% in 2021; and the percentage of mixed drug use was 8.7% in 2016 and increased to 36.8% in 2021. HBsAg-positivity in opioid users (56.7%) was higher compared to cannabis users (2.6%) and mixed drug users (22.3%). Anti-HCV positivity of opioid users (69.4%) was found to be higher compared to alcohol (9.4%), cannabis (2%), and mixed drug (16.2%) users, and this finding was statistically significant (p=0.0001). Anti-HBs positivity of opioid users (63.1%) was found to be higher compared to alcohol (9.9%), cannabis (3%), and mixed drug (21%) users, and this finding was statistically significant (p=0.0001). Anti-HIV was determined negative in all ASUD’s. The highest rates of HBsAg, anti-HCV and anti-HBs positivity were found in the 26-30 years of age. &#x0D; Conclusion&#x0D; These findings indicate a high prevalence of intravenous substance abuse in the 26-30 years age group in our region as well as the high HBV and HCV rates in this patient group.

Acute Consequences Associated With Co-use of Alcohol and Cannabis: A Daily Survey Analysis.

Co-use of alcohol and cannabis has been associated with more total negative consequences than single-substance use, but results have been mixed depending on whether the single substance was alcohol or cannabis. The present study used within-person analyses to examine whether co-use increased the risk for experiencing specific acute negative consequences. College students who were co-users of alcohol and cannabis (N = 341; M age = 19.8 years; 51.3% female; 74.8% White) completed 56 days of five daily surveys across two bursts. We used generalized linear mixed effects models to examine the effects of type of substance use day on specific negative consequences, controlling for consumption and covariates. Relative to both alcohol-only and co-use days, cannabis-only days were associated with decreased likelihood of experiencing hangover, blackout, nausea/vomiting, injury, rude/aggressive behavior, and unwanted sex. Relative to alcohol-only days, cannabis-only and co-use days were associated with an increased likelihood of driving high/drunk. Finally, there was an increased likelihood of hangovers on alcohol-only days compared with co-use days. Days with different types of substance use differed in specific consequences. Most of the negative co-use consequences investigated here appear to be driven by alcohol consumption rather than cannabis use. The results also indicated that these young adults were more likely to endorse driving under the influence of cannabis than alcohol. Interventions for co-use should target alcohol consumption to reduce negative consequences such as blackout, injury, rude/aggressive behavior, and unwanted sex and highlight the dangers of driving under the influence of cannabis.

Differentiating Patterns of Vaping, Alcohol, and Cannabis Use Among Early Adolescents

The current study assessed whether risk factors associated with vaping were distinct from risk factors associated with other substance use (e.g., alcohol, cannabis) during adolescence. Participants ( N = 848, ages 10–16 years) completed a self-report survey to assess frequency and age of onset of substance use, risk perceptions of use, risk factors (depressive symptoms, sensation seeking, and parent-reported factors), and vape nicotine content. Groups were created to differentiate types of substance use, and frequency of substance use. Overall, adolescents who only vaped had lower depressive symptoms and indicated less nicotine vape use than adolescents who vaped and used other substances. Experimental vapers perceived other substances (but not vaping) as risky and endorsed vaping nicotine less often than regular vapers. Early initiation of vaping was not associated with polysubstance use. Taken together, our findings offer important implications for how vaping can be differentiated from other substance use during adolescence.

Religiosity and Substance Use Among Youth in Southeast Europe: The Importance of God as the Strongest Protective Religious Dimension

Using a large sample of youth ( N = 10,398) from 10 countries of Southeast Europe, the present study analyzed the effects of different dimensions of religiosity on various types of substance use across three different religions. The results, based on risk ratios and binary logistic regression, indicated that belief in the importance of God is generally a much stronger protective factor against substance use than church attendance or personal prayer. At the level of the entire sample, risk ratios revealed that finding God to be highly important reduced the likelihood of using hard drugs by as much as 69% and the likelihood of using soft drugs by 74%. In the case of alcohol use, the effect was weaker and less robust. Overall, the results of this study results point to the high relative importance of belief in God as a factor strengthening an individual’s ability to refrain from substance use.

Prevalence and associates of non-fatal overdose among people who inject drugs in Saveh, Iran

BackgroundAs a public health issue, non-fatal overdose (NFOD) is highly prevalent among people who inject drugs (PWID). This can lead to an elevated risk of future overdose, causing various harms including possible death. It is essential to improve knowledge concerning this problem and its associated risk factors to inform overdose prevention and assistance programs. The primary aim of the present study was to determine the prevalence of NFOD and associated risk factors among PWID in Saveh, Iran.MethodsIn the present cross-sectional study, 272 PWID living in Saveh, Iran were interviewed face-to-face using a structured survey. Data concerning socio-demographics, substance use, risky behaviors, and services utilization data were collected. The outcome variable (i.e., NFOD) was assessed by answering “Yes” to the question: “In the past three months, have you ever overdosed (at least once) by accident?”ResultsThe prevalence of NFOD among PWID in the past three months was 54%. The characteristics and behaviors that were associated with an increased risk of experiencing NFOD in the past three months were being of older age (AOR = 5.2, p < 0.05), drug use initiation under the age of 22 years (AOR = 7.8, p < 0.05), being an alcohol user (AOR = 3.0, p < 0.05), and being a simultaneous multiple drug user (AOR = 5.8, p < 0.05). Also, more recent initiates to injecting (< 2 years) had an increased risk of experiencing a non-fatal overdose in the past three months. Findings also indicated that those who (i) attended a needle and syringe program (AOR: 0.3, p < 0.05), (ii) were visited by a general practitioner (AOR: 0.03, p < 0.05), and (iii) received a psychosocial intervention (AOR: 0.1, p < 0.05) were 0.3, 0.03 and 0.1 times less likely to report non-fatal overdosing than other participants, respectively.ConclusionsThe results indicate that intervention and prevention initiatives seeking to reduce NFOD among PWID should not only be focused on the primary drug used but also the use of alcohol and polysubstance use. Specific and tailored psychological interventions combined with pharmacotherapy may be highly beneficial for PWID who experience more severe types of substance use, including alcohol use disorders and/or polysubstance abuse.

Daily diary study of loneliness, alcohol, and drug use during the COVID-19 Pandemic.

Research conducted during the COVID-19 Pandemic has identified two co-occurring public health concerns: loneliness and substance use. Findings from research conducted prior to the pandemic are inconclusive as to the links between loneliness and substance use. This study aimed to measure associations of loneliness with three different types of substance use during COVID-19: daily number of alcoholic drinks, cannabis use, and non-cannabis drug use. Data were obtained between October 2020 and May 2021 from 2,648 US adults (Mage =38.76, 65.4% women) diverse with respect to race and ethnicity using online recruitment. Participants completed baseline surveys and daily assessments for 30 days. A daily loneliness measure was recoded into separate within- and between-person predictor variables. Daily outcome measures included the number of alcoholic drinks consumed and dichotomous cannabis and non-cannabis drug use variables. Generalized linear multilevel models (GLMLM) were used to examine within- and between-person associations between loneliness and substance use. The unconditional means model indicated that 59.0% of the variance in the daily number of alcoholic drinks was due to within-person variability. GLMLM analyses revealed that, overall, people drank more on days when they felt a particularly high or particularly low degree of loneliness (positive quadratic effect). There was a negative and significant within-person association between daily loneliness and the likelihood of cannabis use. There was also a positive and significant within-person association between daily loneliness and the likelihood of non-cannabis drug use. Associations between loneliness and substance use vary with substance type and whether within- or between-person differences are assessed. These findings are relevant to the persistence of substance use disorders and thus of potential clinical importance. Individuals who do not experience severe loneliness at intake but who show daily increases in loneliness above baseline levels are at heightened risk of alcohol and non-cannabis drug use. Future research could profitably examine just-in-time adaptive interventions that assess fluctuations in loneliness to prevent the development or exacerbation of substance use disorders.

Interpersonal Violence, PTSD, and Substance Use Types among Women Receiving Substance Use Treatment

Objective: Many women receiving substance use treatment report histories of interpersonal violence (IV) victimization, including physical and sexual assault. IV is a risk factor for mental and behavioral health difficulties such as posttraumatic stress disorder (PTSD) and substance use disorder (SUD). Consistent with the self-medication hypothesis, PTSD may explain elevated SUD among IV survivors. Yet, few studies have investigated whether PTSD may have differential mediating effects for different substances, which has significant treatment implications. Methods: In 124 women (M age = 35.37, SD = 11.90) in substance use treatment, we examined PTSD symptoms as a mediator between IV and severity of different types of substance use, including alcohol, cannabis, cocaine, and opioid use. Participants completed self-report measures including the ASSIST, PCL-5, and LEC-5. Data were analyzed using path analysis in Mplus 8.3. Both dichotomous and continuous outcomes of problematic substance use outcomes were examined. Results: Most women (53.3%) reported problematic substance use with at least one substance, including opioids (39.7%), cocaine (13.0%), alcohol (9.6%), and cannabis (5.6%). Most (83.2%) of the sample reported at least one IV incident. On average, women reported clinically significant PTSD symptom severity. When problematic substance use was examined dichotomously, findings revealed significant indirect effects from IV exposure to opioid (β = 0.10, p = .010) and cocaine use (β = 0.07, p = .039) via elevated PTSD symptoms. There were no significant indirect effects for problematic alcohol (β = 0.03, p = .260) or cannabis use (β = 0.02, p = .562). When substance use was examined continuously, results revealed significant indirect effects from IV exposure to opioid (β = 0.09, p = .017), cocaine use (β = 0.09, p = .015), and alcohol use (β = 0.08, p = .020) via elevated PTSD symptoms. Indirect effects for cannabis use remained nonsignificant (β = 0.05, p = .100). Conclusions: IV survivors may be particularly at risk for opioid and cocaine misuse because of elevated PTSD symptoms. Treatments that integrate PTSD and SUD are needed to simultaneously target traumatic stress and substance use. Women with opioid and cocaine misuse may particularly benefit from trauma-focused exposure-based psychotherapy to reduce symptoms of PTSD, and thus, decrease opioid and cocaine misuse.

Substance Use Behaviors Among LGBTQ+ Youth of Color: Identification of the Populations Bearing the Greatest Burden in Three Large Samples

PurposeResearch has identified persistent disparities in alcohol, e-cigarette, and marijuana use, by sexual orientation, gender identity, and race/ethnicity. Using an intersectionality framework, the present study analyzes three large datasets to identify intersecting social positions bearing the highest burden of substance use. MethodsData from adolescents in grades 9–12 in three samples (2019 Minnesota Student Survey, 2017–2019 California Healthy Kids Survey, and 2017 National Teen Survey) were harmonized for an analysis (N = 602,470). A Chi-squared Automatic Interaction Detection analysis compared the prevalence of four types of substance use across all combinations of four social positions (six racial/ethnic identities, five sexual orientations, three gender identities, and two sexes assigned at birth). For each substance, 10 intersectional groups with the highest prevalence of use were examined. ResultsIn the full sample, 12%–14% of participants reported past 30-day alcohol, e-cigarette, or marijuana use and 7% reported past 30-day binge drinking. Several intersecting marginalized social positions were consistently found to bear a high burden of substance use. For example, transgender and gender diverse (TGD) Latina/x/o young people, particularly those assigned male at birth, were in the high prevalence groups for alcohol use, binge drinking, and marijuana use. Black TGD or gender-questioning youth were commonly in the high prevalence groups. DiscussionFindings suggest that support, resources, and structural changes specifically tailored to youth with multiple marginalized identities (especially TGD) may be needed. The results argue for intersectional efforts that explicitly address racial/ethnic and cultural differences, while also integrating awareness and understanding of sexual and gender diversity.

Association of Cannabis Use and At-Risk Alcohol Use With Intimate Partner Violence in an Urban ED Sample

IntroductionUrban ED patients have elevated rates of substance use and intimate partner violence. The purpose of this study is to describe the risk profiles for intimate partner violence among urban ED patients who report at-risk alcohol use only, cannabis use only, or both types of substance use. MethodsCross-sectional survey data were collected from study participants (N = 1037; 53% female; ages 18-50) following informed consent. We measured participants’ past-year at-risk drinking (women/men who had 4+/5+ drinks in a day), cannabis use, psychosocial and demographic characteristics, and past-year physical intimate partner violence (assessed with the Revised Conflict Tactics Scale). We used bivariate analysis to assess whether rates of intimate partner violence perpetration and victimization differed by type of substance use behavior. Multivariate logistic regression models were estimated for each intimate partner violence outcome. All analyses were stratified by gender. ResultsRates of intimate partner violence differed significantly by type of substance use behavior and were highest among those who reported both at-risk drinking and cannabis use. Multivariate analysis showed that women who reported at-risk drinking only, cannabis use only, or both types of substance use had increased odds for intimate partner violence perpetration and victimization compared with women who reported neither type of substance use. Men’s at-risk drinking and cannabis use were not associated with elevated odds of intimate partner violence perpetration or victimization. DiscussionBrief screening of patients’ at-risk drinking and cannabis use behaviors may help identify those at greater risk for intimate partner violence and those in need of referral to treatment.