JOURNAL OF DRUG ISSUES

Cannabis Consumption Among Adults Aged 55-65 in Canada, 2018-2021
Wadsworth E, Cristiano N, Gabrys R, Renard J and Hammond D
Cannabis consumption among aging adults in Canada is increasing. The aims of the study were to examine cannabis consumption patterns before and after non-medical cannabis legalization and assess whether these patterns differ between men and women. Data were analyzed from Canadian respondents in a repeat cross-sectional survey conducted in 2018-2021. Analyses were conducted among adults aged 55-65 ( = 18,177) who had consumed cannabis in the past 12-month ( = 4119). Past 12-month cannabis consumption significantly increased among 55-65-year-olds from 2018 (19.3%) to the first-year post-legalization in 2019 (24.5%; < .001), but remained stable thereafter (24.3%, and 25.6% in 2020 and 2021). More men reported past 12-month consumption than women (28.4% vs. 21.4%; < .001). A substantial number of cannabis consumers consumed to manage a physical or mental health condition. Targeted messaging might be beneficial for this age group, including possible interactions with other medications. This research may be helpful for informing age-adapted cannabis education.
Police officer Perspectives on a Pre-booking Diversion Program for People who use Drugs in Philadelphia
Shefner RT, Johnson J, Shofer FS and Anderson ED
Pre-booking diversion enables police officers to divert individuals to supportive services in lieu of prosecution for minor crimes related to substance use. We surveyed 204 Philadelphia Police Department officers authorized to initiate pre-booking diversions. We used bivariate x tests and multivariate logistic regression to examine differences in respondent perspectives. 78% agreed that pre-booking diversion provides important services to people who use drugs, 69% wanted to expand the geographic score of programming, and 52% wanted to expand eligibility. Yet 59% questioned whether diversion is "what police should be doing", and only 27% believed that it will improve public safety. In logistic regression, the perceived value that the police department places on referrals correlated with agreement that PAD improves safety, provides important services for people who use drugs, and fits within officers' role. Tension between beliefs that the program provides important services but may not improve safety reflects both potential value and inherent challenges of pre-booking diversion models.
Adolescent substance use outcomes in response to social consequences of use: the role of empathy
Winters DE, Massey SH and Sakai JT
Evidence suggests empathy deficits have a temporal relationship with substance use severity by late adolescence theorized to decrease use via recognition of social consequences. However, this has yet to be tested empirically along with differences in cognitive and affective empathy. Adolescents admitted to substance use treatment (n= 3,382) were followed through treatment and 12 months after treatment. Variable trajectories were fit using growth curve models; and cross-lagged effects of cognitive and affective empathy on response to social consequences of use were tested along with how response to social consequences affected the mean trajectory of substance use. Results indicate higher cognitive empathy predicted greater response to social consequences of use and response to these consequences at the end of treatment predicted a steeper decrease in substance use. This evidence highlights the importance of cognitive empathy for responding to social consequences of use for motivating less substance use in adolescents.
"I Like the Vibes it Gives": Adolescent Perspectives on Cannabis Billboards and Print Advertising in Nevada
Drake CS, Sloan K, Anderson M, Clements-Nolle KD and Pearson JL
An influx of laws permitting recreational cannabis sales in the US has allowed for increased advertising. The purpose of this study was to describe how adolescents perceive outdoor and print cannabis advertising and to identify aspects of advertising that are appealing or eye-catching, focusing on five themes: price promotion, sex appeal, wellness, party, and text-only. We recruited adolescents ages 11-17 to participate in seven focus groups (44 participants) from 2019 to 2020. Participants viewed cannabis advertisements and responses were summarized using deductive thematic analysis. The party-themed advertisements were the most salient to participants, who desired to emulate the behaviors shown. Participants favored ads featuring young people and containing multiple colors. Participants disliked advertisements perceived to portray misleading or contradictory messages, such as the promotion of physical activity or use of sex appeal, and ads perceived to lack authenticity. Identification of youth appealing features can help inform cannabis advertising regulations.
Who Persists and Who Desists? A Prospective Study of Prescription Stimulant Misuse in College Graduates
Holt LJ, Langdon SW and Feinn RS
Prescription stimulant misuse (PSM) has been studied extensively in college populations, but few studies have examined how PSM changes after graduation. We used a longitudinal design to follow individuals at risk for PSM two years after college graduation to document PSM prevalence, motives, and predictors of PSM persistence. Participants from two small, private colleges completed online surveys focused on intrapersonal, interpersonal, and sociocultural predictors of PSM. Overall, PSM declined over time. Lack of premeditation, perceived peer norms, positive expectancies, media exposure, and other substance use were associated with continued PSM; however, only lack of premeditation, descriptive norms, and other substance use predicted PSM in a multivariate model. This preliminary study suggests dispositional and behavioral risk factors may help to explain why PSM persists after college. Interventions that enhance decision-making skills, correct misperceptions about peers' PSM, and reduce polysubstance use may be effective in curbing PSM in college graduates.
Screening Incarcerated Women for Opioid Use Disorder
Staton M, Tillson M, Levi MM, Webster M, Oser C and Leukefeld C
The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree of correlation between street opioid misuse and other high-risk drug indicators (overdose and injection practices). These findings underscore the importance of outreach, screening, and intervention in real-world settings, including jails, in order to increase access to OUD treatment among this vulnerable sample of women.
Examining Gender Differences in the Relationship Between School Bonding and Opioid Misuse Among Justice-Involved Adolescents
Vroom EB, Johnson ME, Akbari Z, Frederick Z and Bristol SC
Justice-involved adolescents (JIAs) have an increased risk for opioid use disorder and overdose related to opioid misuse (OM). Consequences of untreated OM include recidivism and poor educational outcomes, which can be harsher for female JIA. Therefore, identifying relevant factors and settings that reduce the risk for OM is critical. Schools are a central institution in adolescent development. Drawing on social control theory, JIA with higher levels of school bonding was hypothesized to attenuate risk for OM. Cross-sectional data on 79,960 JIA from the Florida Department of Juvenile Justice were examined. Multivariate and stratified logistic regression analyses were employed. On average, for every one-unit increase in school bonding, JIA had 22%, female JIA had 23%, and male JIA had 22% lower odds of OM. Results suggest school bonding and the school context should be considered in treatment and how this setting may impact OM intervention outcomes among JIA.
Prevalence and Predictors of Substance Use Support Programming Among U.S. Religious Congregations
Torres VN, Fulton BR, Wong EC and Derose KP
Experiences Administering Naloxone Among People in Different Social Roles: People Who Use Opioids and Family Members and Friends
Urmanche AA and Harocopos A
Unintentional drug overdose deaths continue to be a critical public health issue. Naloxone, a nonscheduled, safe, and effective drug that reverses opioid-involved overdoses is available to non-medically trained individuals ("lay people"), but there is scant information about how people in different social roles experience naloxone administration. We conducted 24 in-depth interviews with people who use opioids (PWUO; = 15) and family members and friends of people who use opioids (FF; = 9) who had administered naloxone in response to an opioid overdose. Compared with PWUO, members of the FF group were less reticent to administer naloxone in response to an overdose. PWUO and FF had different perspectives of law enforcement and demonstrated varied knowledge of the Good Samaritan Law. While PWUO found that having and administering naloxone was empowering, FF took a more pragmatic approach, reporting the need for naloxone as an unfortunate reality of their loved one's drug use.
Pandemic Procedures: Adapting Problem-Solving Court (PSC) Operations and Treatment Protocols During COVID-19
Smith LR, Faragó F, Witte JC, Blue T, Gordon MS and Taxman FS
With an ongoing pandemic claiming hundreds of lives a day, it is unclear how COVID-19 has affected court operations, particularly problem-solving courts (PSCs) which have goals rooted in rehabilitation for participants in their programs. Even with practical recommendations from national organizations directing courts on how to manage COVID-19, whether and how PSCs met the needs of PSC participants during this time is underexplored. This study, drawn from a larger national study using a survey of PSC coordinators, examines the COVID-19 responses of PSCs to remain safely operational for participants. A sub-sample of survey respondents (n = 82 PSC coordinators) detailed how the COVID-19 pandemic led to changes to their court and treatment operations amidst the constraints of the pandemic. The courts' shifts in policy and practice have important impacts for court participants' treatment retention and success in the PSC program, and these shifts need more in-depth research in the future.
COVID-19 Vaccine Uptake and Attitudes Within Two Cohorts of Younger Adult Cannabis Users
Fedorova EV, Wong CF, Conn BM, Ataiants J and Lankenau SE
It is crucial to understand COVID-19 vaccine uptake and attitudes among young adult cannabis users given the lowest vaccination rates among young adults and negative association between cannabis use and willingness to get vaccinated. 18-21-year-old and 26-33-year-old cohorts of cannabis users, recruited in California, were surveyed about the COVID-19 vaccine uptake/attitudes between March-August 2021. Cannabis use/demographic differences were investigated by vaccination status. Vaccine attitudes data were categorized and presented descriptively. 44.4% of the older and 71.8% of the younger cohorts were vaccinated. Non-Hispanic Black/African American race/ethnicity, lack of health insurance, and medicinal orientation towards cannabis use were negatively associated with vaccine receipt within the older cohort. For both cohorts, top reasons for vaccine hesitancy and rejection were concerns about speed of development, potential side effects, natural immunity, and lack of trust of vaccines. Our results highlight greater vaccine hesitance/rejection and need for targeted interventions among mid-20's-early-30's cannabis users.
Medication-Assisted Treatment in Problem-solving Courts: A National Survey of State and Local Court Coordinators
Farago F, Blue TR, Smith LR, Witte JC, Gordon M and Taxman FS
Problem-solving courts (PSCs) are a critical part of a societal effort to mitigate the opioid epidemic's devastating consequences. This paper reports on a national survey of PSCs (N = 42 state-wide court coordinators; N = 849 local court coordinators) and examines the structural factors that could explain the likelihood of a local PSC authorizing medication-assisted treatment (MAT) and MAT utilization. Results of the analyses indicate that MAT availability at the county level was a significant predictor of the likelihood of local courts authorizing MAT. The court's location in a Medicaid expansion state was also a significant predictor of local courts allowing buprenorphine and methadone, but not naltrexone. Problem-solving courts are in the early stages of supporting the use of medications, even when funding is available through Medicaid expansion policies. Adoption and use of treatment innovations like MAT are affected by coordinators' perceptions of MAT as well as structural factors such as the availability of the medications in the community and funding resources. The study has important implications for researchers, policymakers, and practitioners.
Social Network Ties and Responses to COVID-19 Among E-Cigarette Users
Kelly BC, Pawson M and Vuolo M
Social networks can enhance behavioral changes or entrench existing patterns of behavior. We aimed to identify how network ties to other e-cigarette users shaped responses to the pandemic and e-cigarette considerations. A national U.S. survey of 562 e-cigarette users was conducted during April 2020. Participants self-reported network ties to other e-cigarette users and pandemic outcomes: receiving expressions of concern about vaping, risk for a bad COVID outcome, changes in e-cigarette risk perceptions, and considerations of quitting. Each additional e-cigarette user tie was associated with a 0.014 unit increase in expressions of concern ( < 0.001), a 0.034 unit increase in perceived risk of a bad outcome ( < 0.05), and 3.9% higher odds of quit considerations (OR = 1.039; < 0.01). Family ties to e-cigarette users were particularly important. Additional e-cigarette users within a network shaped risk perceptions in response to COVID-19. Network ties to other e-cigarette users have implications for cessation or reduction of e-cigarette use.
Supervisor Undermining, Social Isolation and Subordinates' Problematic Drinking: The Role of Depression and Perceived Drinking Norms
Montal-Rosenberg R, Bamberger PA, Nahum-Shani I, Wang M, Larimer M and Bacharach SB
Findings regarding the mechanism underlying the impact of supervisor incivility on subordinate alcohol misuse remain equivocal. Specifically, some studies indicate that stress mediates the impact of supervisor incivility on subordinate alcohol misuse, while others, find no evidence for such an effect, suggesting the need to investigate other mechanisms. Extending Conservation of Resource (COR) theory and employing a longitudinal study design, this study examines two alternative mechanisms grounded on social isolation. The first suggests drinking as a resource-mobilizing response, with social isolation eliciting the perception of more permissive injunctive drinking norms, thus facilitating problematic drinking. The second suggests problematic drinking as a mode of coping with a negative emotional state elicited by social isolation, namely depression. Findings indicate that supervisor undermining's association with subsequent subordinate problematic drinking is serially mediated by social isolation and depression, with no support found for the first mechanism. Implications for research, practice and policy are discussed.
Are we Truly "Safer-At-Home"? A Test of Contextual Effects on Mental Health and Drug Overdose Incidents During the COVID-19 Pandemic
Konkel RH, Harris MN and Hoffman CY
This study examined whether the social restrictions stemming from COVID-19 impacted the locations of mental health and drug overdose incidents, while controlling for immediate and community contextual indices. Addresses for mental health/overdose calls to law enforcement or emergency medical services between January 1, 2018 and August 13, 2020 were collected from one police department in the Midwestern United States. Businesses and previous victimization/offending were joined with parcels (level-1; N = 20,019), whereas local services and socioeconomic indicators were joined with block groups (level-2; N = 32), to allow for a multi-level (HLM7) examination of context on mental health/overdose incidents. Event Rate Ratios (ERR) revealed the greatest contextual effects took place following social distancing mandates. Findings highlight the importance of allocating to areas with the highest likelihood of reporting incidents and suggest that parcels with a history of sex offenses, drug offenses, and prior mental health calls may benefit the greatest from preventative resources.
Perceived Normalization of Drug Trafficking and Adolescent Substance Use on the US-Mexico Border
Valdez ES, Obeng-Kusi M, Brady B, MacPherson AH, Bell ML and DeRose K
Historically marginalized youth are at risk for daily substance use. Daily use may be associated with social and environmental factors.
COVID-19's Impact on Substance Use and Well-Being of Younger Adult Cannabis Users in California: A Mixed Methods Inquiry
Fedorova EV, Wong CF, Conn BM, Ataiants J, Iverson E and Lankenau SE
Few qualitative studies have examined the impact of COVID-19 on cannabis and alcohol use, and overall well-being among cannabis users. Cannabis users (aged 26-32) were surveyed quantitatively (n=158) and interviewed qualitatively (n=29) in April 2020-May 2021 in Los Angeles. 63.3% of the quantitative sample reported increasing use of either cannabis (29.1%) or alcohol (15.2%) or both (19.0%) following the COVID-19 outbreak. Qualitative data revealed that increases in cannabis and alcohol use were largely attributed to changes in employment and staying at home resulting in fewer impediments and boredom. Themes of loneliness and utilization of various coping strategies were more pronounced among those who increased cannabis and/or alcohol use. For some, increases in cannabis/alcohol use were temporary until participants adjusted to "a new normal" or embraced more adaptive coping strategies. Results suggest monitoring cannabis/alcohol use trends and identifying coping strategies to reduce the pandemic's impact on substance use and mental health.
Primary Purpose for Committing a Crime and Past-30 Day Opioid Misuse: A Statewide Sample of Justice-Involved Children
Shaw DJ and Johnson ME
The prevalence of opioid misuse (OM) among justice-involved children (JIC) is significantly higher than children in the general population, yet little research has examined the predictors of OM among JIC. Goldstein's "economic compulsive model" hypothesizes that JIC who commit crimes for material gain will have a higher likelihood of meeting past-30 day (P30D) OM criteria. The data in this study were cross-sectional and represented 79,960 Florida JIC. To test the hypothesis, logistic regression analyses were utilized. Over 2000 JIC (2.67%) met P30D OM criteria and JIC who committed crimes for material gain were 2.55 times as likely to meet P30D OM criteria. Findings indicate that children may be incarcerated due to an inability to afford their addiction, contributing to the criminalization of mental health. JIC could benefit from the increased utilization of drug courts and the implementation of a cascade of care model.
Cannabis Use Among Mental Health Professionals: A Qualitative Study of Cannabis-Related Risk Perceptions
Ghelani A
Perceptions of cannabis-related risk are changing, and many are viewing cannabis as harmless despite the biopsychosocial risks. Perceptions of risk have an impact on behavior as individuals who are less likely to view cannabis as risky are more likely to use it problematically.
Characterizing symptoms of cannabis use disorder in a sample of college students
Pellegrino AJ, Duck KD, Kriescher DPJ, Shrake ME, Phillips MM, Lalonde TL and Phillips KT
Since legalization of marijuana in several U.S. states in 2012, there has been concern about increases in the development of cannabis use disorder (CUD). The current study examined rates of CUD in Colorado college students who reported regular marijuana use and assessed a range of factors associated with CUD symptoms, including coping motives, concentrate/dab use, mental health concerns (depression, anxiety), age of regular marijuana use, and alcohol use. College students were recruited from a mid-sized university and completed a baseline assessment that included a marijuana urine screen. Participants reported a median of five CUD symptoms and 90% met criteria for CUD. After adjusting for covariates, age of regular marijuana use was negatively associated with number of CUD symptoms, while average daily alcohol drinks was positively associated with number of symptoms. Prevention and intervention efforts at the university level should be increased to reduce negative outcomes associated with problem marijuana use.
Prescription stimulant diversion on a college campus: Intrapersonal, interpersonal and environmental correlates
Lam C, Figueroa W, Yomogida K and Bavarian N
Prescription stimulant diversion is a behavior that increases the availability and accessibility of prescription stimulants for purposes such as misuse. As such, we aimed to develop a theory-guided understanding of diversion correlates.