We sought to estimate the prevalence of synthetic cannabinoid use and characteristics of people who use in the US general population.

Dependence on addictive substances is indicated by impaired control, strong desires/craving, withdrawal symptoms with abstinence, challenges with quitting, etc. Most measures of dependence are substance-specific, which inhibits comparisons across substances. In light of increasing prevalence of cannabis and tobacco co-use, we aimed to adapt indicators of tobacco dependence to assess cannabis dependence (CD).

We have shown that environmental enrichment (EE) can effectively reduce reinstatement and facilitate true abstinence in animal models of drug use. Here, we investigated whether EE is effective against reinstatement of heroin seeking in long access (LA) model, which has been argued to capture the compulsive features of human drug addiction. We also explored the neurobiology by which EE produces its anti-drug addiction effects. In particular, we focused here on the ghrelin system, which is known for its involvement in reward-motivated behaviors and upregulation following intravenous drug self-administration. Following LA to heroin, rats were housed in either non-EE or EE conditions. During extinction and cue-induced reinstatement test, EE rats showed a significant reduction in active lever responding compared to non-EE rats, suggesting that EE facilitates extinction of drug seeking and reduces the capacity of drug-associated stimuli to elicit and maintain drug seeking. Using Western Blotting, we found that rats with LA to heroin IVSA showed a significant increase in ghrelin receptor (GHS-R1a) expression in the ventral tegmental area and nucleus accumbens, the brain regions implicated in resumption of drug use . Exposure to EE attenuated heroin-induced upregulation of GHS-R1a receptor in these regions but produced no significant changes other brain regions. Our findings suggest that EE can be an effective behavioral approach to diminish drug seeking even following LA to heroin. Compulsive drug taking and seeking seem to be correlated with an upregulation of GHS-R1a expression in the limbic regions, and EE can reverse these neuroadaptations, potentially contributing to a reduction in drug seeking.

Describe buprenorphine treatment gaps across the care cascade by race, ethnicity, age, sex and key clinical characteristics.

Integrating patient navigation (PN) interventions in hepatitis C virus (HCV) elimination efforts enhances HCV treatment cascade outcomes from screening to cure. Nonetheless, little is known about how the patient-navigator working alliance influences the effectiveness of PN interventions. This study among persons who inject drugs (PWID) living with HCV aimed to assess the association between patient-navigator working alliance and HCV treatment cascade outcomes.

Over 60 % of individuals with alcohol use disorder (AUD) resume hazardous drinking within 6 months post-treatment, necessitating the development of more efficacious interventions. Accumulating evidence suggests transcranial magnetic stimulation (TMS) is a promising intervention for AUD. This randomized, double-blind, placebo-controlled trial assessed the efficacy of intermittent theta burst (iTBS), a form of TMS, as an adjunct treatment for AUD.

Simultaneous alcohol and cannabis use is prevalent among adults who drink alcohol and is associated with more negative consequences than use of either substance alone. Understanding reinforcement processes that maintain simultaneous versus single-substance use will highlight intervention targets specific to this pattern of use. In individuals' daily lives, we tested whether simultaneous use moments are associated with more affectively reinforcing outcomes compared to single use moments.

Harnessing technology for delivery of behavioral health interventions to reduce alcohol use and aggression may reduce morbidity among youth. This paper describes the outcomes from a sequential, multiple assignment, randomized trial (SMART) testing interventions for youth (ages 14-20) in the emergency department (ED).

Incarcerated individuals with opioid use disorder experience high rates of opioid-related mortality upon release. Buprenorphine and methadone are effective at reducing mortality rates in this population, but evidence for extended-release naltrexone is mixed. We evaluated a comprehensive jail-based program in Massachusetts (MATADOR 2.0), which combined extended-release naltrexone and recovery navigator support before and after release.

Medications for opioid use disorder (MOUD) are key to preventing opioid overdose. Despite the high risk of opioid overdose among recently incarcerated people who use drugs, missed opportunities for engagement in MOUD treatment persist in this population. We examined the association between unmet need for MOUD and non-fatal opioid overdose among recently incarcerated people who inject drugs (PWID) and assessed prevalence of non-fatal opioid overdose by selected characteristics.

The objective of the current study was to assess the relationships between perceived racial discrimination, symptoms of depression, and tobacco and cannabis use in a sample of pregnant Black Americans. We collected data from 668 pregnant participants, in Atlanta, GA, once at 8- to 14- weeks' gestation and again at 24- to 30-weeks' gestation. We administered the Timeline Follow-back Interview to assess self-reported tobacco and cannabis use and measured metabolites of nicotine (cotinine) and cannabis (11-nor-9-carboxy-Δ9-tetrahydrocannabinol) from urine samples. Participants described depressive symptoms using the Edinburgh Postnatal Depression Scale. They also reported instances of racial discrimination throughout their lifetimes via the Krieger Experiences of Discrimination scale. Self-perceived racial discrimination was significantly related to increased tobacco use and urinary cotinine levels during pregnancy, while controlling for potential confounds. Race-based discrimination also impacted self-reported tobacco and cannabis use later in pregnancy through increased depressive symptoms. To our knowledge, this study is the first to investigate whether depressive symptoms mediate the influence of racial discrimination on substance use among pregnant Black people. Our findings have significant implications for smoking-cessation interventions, which should account for the interconnection between racial stress and mental health.

Deaths from opioid overdose are increasing in the United States (US) and distribution of the opioid antagonist naloxone is one key strategy to reduce mortality. In this cross-sectional survey, we assess the association of high-risk behaviors with possession of naloxone and knowledge of where to find it.

The prevalence of tobacco use among people with mental health and substance use disorders in the US is high. State- and facility-level factors could be associated with the provision of tobacco treatment and tobacco-free grounds policy in mental health and substance use treatment facilities. We estimated the latest prevalence of, and factors associated with tobacco treatment provision and tobacco-free grounds policies in these facilities.

Little is known about acute subjective and physiological responses to alcohol in individuals with alcohol use disorder (AUD), particularly as it pertains to the spectrum of AUD severity. This study examined acute biphasic alcohol response phenotypes in participants with mild, moderate, and severe AUD.

The current phase of the US opioid overdose epidemic is marked by growing racial inequities, driven in part by unequal access to medications for opioid use disorder (MOUD) including buprenorphine. This report provides a much needed update on the racialized patterns of treatment uptake in an evolving drug use and treatment landscape.

Adolescent substance use typically occurs within peer contexts and is influenced by characteristics of neighborhoods and the cultural environments of the schools adolescents attend. This study aimed to (i) examine variation in cocaine use among adolescents in Oslo, Norway, based on neighborhood of residence and high school affiliation; (ii) assess the significance of school-based party cultures; and (iii) identify individual-level correlates.

Limited prospective research has evaluated the health benefits associated with changing levels of drug use, aside from complete abstinence. This study determined whether lower levels of cocaine use impacted physiological indices (e.g., mean arterial pressure) and biomarkers (e.g., stromal cell derived factor-1a [SDF-1a], soluble intercellular adhesion molecule-1 [ICAM-1], neutrophil activating peptide-2 [CXCL7]) of cardiovascular health.

Substance and opioid use disorder (SUD/OUD) treatment remains limited in rural communities. This paper examines rural telehealth use, its impact on medication for opioid use disorder (MOUD) provision, and issues that require attention for sustainment.

Daily rewarding experiences not involving drugs are complex and may differentially support recovery from addiction. Rarely has nondrug reward, and its multiple facets (i.e. anticipation, meaning etc.), been examined in daily life-this could uncover the acute benefits of different components of nondrug reward on daily recovery outcomes.

The care that people with opioid use disorder (OUD) receive during hospitalizations for opioid overdoses present opportunities for support, yet initiation of opioid agonist treatment (OAT) remains low. Therefore, we sought to determine factors associated with treatment initiation following hospitalization for an opioid overdose.

Substance use and its related disorders represent a significant global health concern. Risk propensity has been identified as a factor influencing substance use.

This study applied a network analysis approach to the study of individual self-reported alcohol-related harms (ARHs) across four waves of data.

Variations in inter-individual response to opioid medications has not been well-investigated in prospective, empirical designs or in persons who have no learned experience with opioids or current pain conditions. These analyses categorized response to opioids during rigorous human laboratory experimental conditions. Healthy individuals (N = 75) with little to no prior opioid exposure completed a 5-day residential study wherein they received triple-blinded doses of placebo or oral hydromorphone (2mg, 4mg, 8mg). Outcomes included a series of general and specific visual analog scale (VAS) ratings completed by participants and blinded observers, physiological endpoints, and analgesic responses to laboratory-evoked pain. The lowest dose at which participants endorsed > 20 point change in self-reported "Drug Effect" VAS ratings from baseline was used to define the following opioid sensitivity thresholds: 2mg ("Low Threshold", N = 9), 4mg ("Medium"; N = 29), and 8mg ("High", N = 14); a "No Threshold" group (N = 31) did not endorse any effects at any dose. Main effects of sensitivity threshold existed for most participant-reported responses and conformed to threshold categories in dose-dependent ways. In contrast, no main effects of sensitivity threshold were observed for blinded observer ratings, physiological endpoints, or evoked analgesic responses, such that hydromorphone produced dose-dependent opioid agonist effects for all participants that diverged from their self-reported experience. These data provide the most granular assessment of inter-individual differences in opioid response among persons with little or no lifetime opioid exposure or existing pain condition. All participants experienced dose-dependent changes in opioid agonist responses, yet their self-awareness of these effects varied and 30 % of participants endorsed no awareness of opioid exposure at any dose. These data demonstrate a consistent and reliable divergence between the subjective experience of opioids from rigorously-assessed physiological, observable, and analgesic responses. Testable implications of these outcomes are discussed.

United States military veterans face heightened vulnerability to sleep disturbances due to factors such as irregular sleep schedules, combat-related stress, and co-occurring mental health disorders. These sleep disturbances are often exacerbated by substance use, including alcohol and cannabis, as veterans may rely on these substances to self-medicate for stress and sleep issues. However, the interplay between sleep quality, substance use, and perceived stress remains poorly understood, particularly on a day-to-day basis. This study aimed to explore the dynamic associations between these factors using daily diary data collected over three months from 74 veterans with elevated PTSD symptoms and problematic cannabis use. Data from this study are secondary analysis. Dynamic structural equation modeling (DSEM) was employed to examine both within-day and day-to-day lagged associations between sleep quality, perceived stress, and substance use (alcohol and cannabis). Results showed that worse sleep quality was associated with higher perceived stress the next day, which in turn predicted greater alcohol consumption. Additionally, stress mediated the relationship between poor sleep quality and increased alcohol use. For cannabis, while no day-to-day lagged effects were observed, within-day analyses revealed that higher cannabis use was associated with lower stress and better sleep quality that same night. These results highlight the complex and bidirectional relationships between sleep, stress, and substance use among veterans, underscoring the need for interventions that address these dynamics holistically. Future research should further explore these interactions using real-time data to inform tailored interventions for improving sleep and mental health outcomes in this population.

We tested effects of a culturally adapted version of the Keepin' it REAL (KiR) prevention program on longitudinal patterns of polysubstance use among Mexican adolescents.

The standard of care for treating opioid use disorder (OUD) during pregnancy includes either buprenorphine or methadone. Although buprenorphine-naloxone presents an alternative due to the reduced risk of misuse , evidence regarding its impact on pregnancy and infant health remains limited. This systematic review and meta-analysis aims to compare buprenorphine-naloxone vs buprenorphine alone for OUD during pregnancy, assessing gestational and neonatal outcomes.

Benzodiazepine adulteration in British Columbia's (BC) unregulated opioid supply has risen. Given the health risks associated with co-ingestion of opioids and benzodiazepines, accurate detection of benzodiazepines using point-of-care drug checking technologies is critical. This study aimed to validate the use of Fourier-transform infrared spectroscopy (FTIR) and benzodiazepine immunoassay strips compared to gold standard laboratory technologies.

Understanding the role of non-nicotine constituents in tobacco use disorder (TUD) could inform the development of more effective treatments for TUD and tobacco control policies. Cigarette smoke contains considerable levels of various volatile organic compounds (VOCs) including acetaldehyde, toluene, and benzene. While acetaldehyde and toluene can have substance use disorder (SUD)-related effects and/or potentiate the TUD-related effects of nicotine in some preclinical models, their role in TUD is not fully understood, and effects of benzene have not been evaluated in any preclinical model of SUDs. This study evaluated the SUD-related effects of parenteral (s.c.) administration of these VOCs in an intracranial self-stimulation (ICSS) model in male and female rats. The ability of acetaldehyde and benzene to influence nicotine's effects on ICSS was also examined.

As the overdose crisis continues to spiral, high volume and intensity of drug poisoning calls are impacting first responders' mental health. This study examined burnout and attitudes towards mental health help-seeking among first responders in Missouri. The study included 3059 participants, of which 76.4 % were law enforcement officers (LEO) and 23.6 % were emergency medical services personnel/firefighters (EMS/FF). Participants mainly comprised of men (80 %), and a majority had witnessed an overdose fatality (53 %). A descriptive analysis and Structured Equation Model (SEM) of field experience, mental health help-seeking, and burnout indicate that [1] emotional exhaustion and depersonalization levels were higher among LEO than EMS/FF (β= 0.25 and β = 0.28, respectively, p < .001), [2] EMS/FF had higher personal accomplishment scores than LEO (β = -0.10, p = .046), [3] higher levels of depersonalization and emotional exhaustion were associated with lower levels of mental health help-seeking (β = 0.27 and β = 0.50, respectively, p < .001), [4] higher levels of personal accomplishment was associated with higher levels of mental health help-seeking (β = -0.37, p < .001), and 5) there was lower burnout among EMS/FF than LEO. This study highlights important differences in burnout within and across first responder professions. Additionally, this study sets the foundation for targeted research to focus on how burnout manifests itself within these individuals, how it affects their work, and how work environments are impacted. Moving forward, research and practice should prioritize exploring how mental-health help seeking influences burnout.