搜索结果：Substance use & misuse

This study aimed to describe the prevalence and characteristics (sources, motivations, perceived health risks, accessibility) of medical use and misuse of addictive prescription drugs (APDs), and the prevalence of poor mental wellbeing and self-harm among adolescents in Estonia. In addition, this study examined associations between APD use status (non-use, medical use, misuse) and mental health indicators (mental wellbeing, self-harm). Data came from the nationally representative 2024 European School Survey Project on Alcohol and Other Drugs (ESPAD) survey of 15-16-year-olds in Estonia (n = 2,019). Respondents were classified as non-users, medical users, or misusers based on lifetime APD use. Motivations, sources, perceived health risks, accessibility, mental wellbeing, and self-harm were assessed. Multivariable logistic regression examined associations between APD use status and mental health indicators. Overall, 27.8% of adolescents reported APD medical use and 18.3% misuse, with higher prevalence among girls. Sedatives and sleeping pills were the most commonly medically used and misused APDs. Most misused APDs were obtained from home, and self-treatment motives predominated. Poor mental wellbeing (44.4%) and self-harm (17.6%) were most prevalent among misusers. APD misuse (. non-use) was associated with poor mental wellbeing, self-harm and female gender; misuse (vs. medical use) with self-harm; and APD medical use (vs. non-use) with self-harm and female gender. The strongest association was found between APD misuse (vs. non-use) and self-harm (adjusted odds ratio = 2.78). APD medical use and misuse are common among Estonian adolescents. APD misuse co-occurred with poor mental wellbeing and self-harm, highlighting the importance of integrating APD misuse prevention into broader adolescent mental health and substance use strategies.

To examine the prevalence of categorical self-reported opioid misuse and compare it to a post hoc corrected indicator in the general Mexican population. We used data from the 2025 Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco. We constructed indicators from self-reported categorical heroin/fentanyl use, prescription opioids misuse and opioid misuse and post hoc corrected versions based on the review of open-ended follow up questions by two experts. We estimated the prevalence from categorical self-report responses and compared it with the post hoc corrected indicators. The prevalence of self-reported prescription opioid misuse was 1 948.3 per 100 000 people, which decreased to 1 242.4 after correction. Self-reported heroin or fentanyl use was 370.7 per 100 000 people, with a corrected prevalence of 326.2. Self-reported opioid misuse had a prevalence of 2 229.6 per 100 000 people, which decreased to 1 482.3 after correction. Misclassification was more frequent for prescription opioid misuse than for illicit opioid use. Simple categorical questions performed well for measuring illicit opioid use, but they moderately overestimated prescription and overall opioid misuse.

Adolescents and young adults (AYAs) who are at risk for harms related to substance use are often not the focus of harm reduction strategies. There is a need for AYA-responsive digital health communication strategies that reflect how they consume information and make decisions about substance use. While social media can contribute to the perpetuation of stigma and normalization of substance use behaviors, it also holds potential to improve health literacy, reduce stigma, and promote effective harm reduction interventions. This commentary is based on a structured literature review conducted using PubMed. Search terms included "social media", "TikTok", "Twitter", "Instagram", "substance use disorder", "addiction", "evidence-based medicine", "social stigma", "stigma reduction", "youth", "adolescents", and "young adults". Articles were selected based on their relevance to social media use, substance use behaviors, stigma, public perception, and health communication among AYAs. Additional references were identified through manual review of citations in selected articles. Prior research has highlighted the promise of social media to disseminate accurate public health-related information, while mitigating the spread of misinformation. Additionally, interventions that leverage social media influencers to spread health-based information have demonstrated efficacy in promoting evidence-based mental health messaging. Developing a deeper understanding of how AYAs engage with social media-and how it shapes their behaviors, perceptions, and attitudes toward substance use-may provide valuable insight for developing evidence-based messaging regarding substance use to educate youth about risk and treatment. Social media may be leveraged to disseminate credible information about substance use, promote harm reduction strategies, and increase awareness of available treatments.

Simultaneous alcohol and cannabis use is a common type of polysubstance use among young adults. Depending on the substance used first, the amount of alcohol consumed might vary. Coping or enhancement motives endorsed on simultaneous use days might also impact alcohol consumption differently. This study examined whether alcohol use differed on alcohol-only versus simultaneous use days, and whether using alcohol versus cannabis first on a simultaneous use day predicted heavier alcohol consumption. We also examined whether differences in alcohol consumption depended on daily levels of coping or enhancement motives. Undergraduate students (n = 370; Mage=20.8; SD = 1.5) completed a 14-weekend daily diary study in Fall 2021. Surveys administered Friday to Sunday mornings measured alcohol use, cannabis use, their order of use, number of drinks consumed, and motives for simultaneous use. Analyses were restricted to alcohol-only and simultaneous use days (n = 2826/9017; 31.3%). Multilevel models showed that students consumed more alcohol on simultaneous use days (Mdrinks=5.08) than alcohol-only days (Mdrinks=4.23). Students also consumed about 1.4 fewer drinks when cannabis was used first compared to when alcohol was used first on simultaneous use days. However, the effect of order of use on alcohol consumption did not depend on daily levels of coping or enhancement motives. Using cannabis first on simultaneous use days was associated with less drinking, an effect not apparently linked to situational drinking motives. Contextual factors associated with cannabis use such as affect (e.g., negative or positive) and setting (e.g., alone or with others) may explain lighter drinking on cannabis-first simultaneous use days.

This study explored substance use and harm reduction service utilization among rural lesbian, gay, and bisexual (LGB) individuals. A survey explored substance use patterns, history of abuse and stigma, and treatment and support group utilization, with subsequent interviews providing contextual and thematic data. Participants were recruited January to July 2023 in southern Illinois. All completed the survey, and a subset were interviewed. Chi-square and independent samples t-test analyses were conducted on the quantitative data, and Interpretative Phenomenological Analysis was used for the interviews (n&#x2009;=&#x2009;9). LGB survey participants (n&#x2009;=&#x2009;17) had similar rates of substance use versus their heterosexual peers (n&#x2009;=&#x2009;128), but increased frequency of reported adverse childhood experiences (score of 6.71 vs. 3.69; p&#x2009;<&#x2009;0.001) and post-traumatic stress disorder (score 3.65 vs. 2.44; p&#x2009;=&#x2009;0.006). Thematically, substance use risk factors included homophobic/biphobic environment(s), childhood trauma/abuse, familial histories of abuse, and mental health disorders. Barriers to treatment and harm reduction service utilization included stigma from clinic staff and police, addiction to treatment medication, long treatment waitlisting, and lack of rehabilitation services. Rural LGB individuals may experience substance use, mental health issues, homonegativity, adverse family histories, and harm reduction barriers, which is reflective of non-LGB rural people who use substances except for homonegativity.

Chronic pain is a prevalent and costly public health issue in the United States. Prescription opioids remain a common treatment but carry significant risks. Medical cannabis has emerged as a potential alternative, though access and use may vary by state medical cannabis laws. Prior research using 2015-2019 National Survey on Drug Use and Health data found that appropriate use and misuse of prescription pain relievers were associated with increased odds of medical cannabis use. We extend this work using 2022-2023 data. To assess the prevalence of past-year medical cannabis use among United States adults, both in all states and in states without legalized medical cannabis use, and to examine associations with prescription pain reliever use and demographic, substance use, and psychiatric characteristics. We analyzed pooled 2022-2023 National Survey on Drug Use and Health data. The outcome was past-year medical cannabis use and the primary predictor was past-year prescription pain reliever use. Survey-weighted Rao-Scott chi-square tests and multivariable logistic regression examined associations with covariates. Among 256 million U.S. adults, 3.9% reported past-year medical cannabis use. Appropriate prescription pain reliever use (OR = 1.76, CI = 1.53-2.03, p&#x2009;<&#x2009;0.001) and misuse (OR = 1.94, CI = 1.49-2.51, p&#x2009;<&#x2009;0.001) were associated with higher odds of medical cannabis use after adjustment. Medical cannabis use remains stable overall but more prevalent among adults using prescription pain relievers, suggesting co-use rather than substitution and a need for updated clinical guidance on medical cannabis for pain management.

Northwest Nigeria is highly vulnerable to climate variability and heavily dependent on rain-fed agriculture, which exacerbates existing socioeconomic vulnerabilities. This study aimed to explore the link among climate-induced stress, poverty, and mental health outcomes, particularly substance use as a maladaptive coping mechanism, in this region. The study was conducted in Kano, Kaduna, and Katsina in Northwest Nigeria. A cross-sectional study was conducted among 20 000 adults aged &#x2265; 18 years from 40 randomly selected communities. Data were collected using validated instruments: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Kessler Psychological Distress Scale (K10), the Coping Strategies Inventory-Short Form (CSI-SF), and a Multidimensional Poverty Index Questionnaire. Robust statistical analyses, including multivariable logistic regression with cluster-robust standard errors, were employed. The prevalence of high-risk substance use (ASSIST &#x2265; 27) was 18.5% (n = 3700). Cannabis was the most commonly misused substance (12.4%, n = 2480), followed by prescription opioids (9.1%, n = 1820) and alcohol (7.8%, n = 1560). High psychological distress (K10 &#x2265; 20) was identified in 45.2% (n = 9040). Over 85% (n = 17 000) were multidimensionally poor. Maladaptive coping strategies were strongly correlated with both poverty (odds ratio [OR]: 3.12, 95% confidence interval [CI]: 2.85-3.42) and high psychological distress (OR: 4.85, 95% CI: 4.48-5.25). This study reveals a concerning syndemic of climate-related stress, profound poverty, poor mental health, and substance use in Northwest Nigeria. Associations suggest substance use may function as a maladaptive coping mechanism in the context of climate-induced economic hardship, though causal inference is limited by the cross-sectional design. Findings underscore the critical need for integrated public health interventions that address mental health and substance use disorders within the context of climate adaptation and poverty reduction strategies.

People with spinal cord injury (SCI) have an elevated risk of secondary health conditions, including pain, which is often treated with prescription opioids, depression, and suicide. Our purpose was to compare opioid use and misuse between Former Service Members (FSMs) and non-FSMs with SCI, identify risk factors, and assess the differential relationships of opioid use and misuse with suicide ideation (SI). Data were collected from 1,253 participants with SCI. Using logistic regression, risk factors for SI were evaluated, including interactions between FSM status, opioid misuse, and multiple opioid prescriptions. SI was measured using the patient health questionnaire-9. SI was reported by 9% of FSMs and 13% of non-FSMs. It was related to self-reported misuse of opioids among non-FSMs, intermittent use of 2 or more prescription opioids among FSMs, and 3 or more prescription opioids for both FSMs and non-FSMs. Risk of SI was also associated with more painful days, probable major depression (PMD), and more severe SCI. Non-FSMs who reported misusing their prescription opioids had 4.01 (95% CI&#x2009;=&#x2009;2.14, 7.52) greater odds of SI, while FSMs did not have greater odds of SI. However, FSMs prescribed 2 or more opioids had 3.91 (95% CI 1.27, 12.08) greater odds of SI, while non-FSMs did not have a statistically significant effect. Both FSMs OR&#x2009;=&#x2009;10.30 (95% CI 2.42, 43.97) and non-FSMs OR&#x2009;=&#x2009;2.52 (95% CI 1.12, 5.70) receiving 3 or more prescription opioids had greater odds of SI, with FSMs having over 3 times the odds of non-FSMs. FSMs appear to have a particularly greater risk of SI when using two or more types of opioids, despite no relationship between self-reported misuse and SI. Closely monitoring prescription opioids is essential for minimizing SI and the risk of suicide among FSMs and non-FSMs with SCI.

Alcohol use disorder (AUD) is a prevalent, relapsing condition. Despite well-documented links between alcohol misuse and adverse health outcomes, the role of AUD in orthopaedic surgery is underexplored, and systematic screening remains uncommon. The aim of this study was to examine the incidence of alcohol use and potential misuse among orthopaedic patients and assessed whether patients flagged for risk engaged in documented discussions about alcohol use with their care teams. We retrospectively reviewed intake data from orthopaedic trauma, spine, bone health, and general registries between May 2020 and April 2025. Alcohol use was initially assessed with a nonstandardized intake questionnaire and later with the validated Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) tool. Patients meeting thresholds for possible misuse were flagged. Clinical notes were reviewed to determine whether flagged patients had alcohol use discussed by their orthopaedic team. Among 99,269 patients screened, 67.9% reported some alcohol use, and 2.5% reported a personal history of AUD. Of 1040 patients completing the AUDIT-C, 29.2% screened positive for potential misuse; 11.1% of bone health patients also met criteria for at-risk drinking. Only 80 of 718 flagged patients (11.1%) had a documented alcohol-related discussion, with higher rates in bone health registries and among older patients. Alcohol use and misuse are common among orthopaedic patients, yet systematic screening and discussion are infrequent. Integrating validated screeners such as AUDIT-C into routine intake and supporting clinicians with training and referral pathways represent critical opportunities to improve patient safety and orthopaedic outcomes.

Background: Posttraumatic stress disorder (PTSD) symptoms are associated with increased substance misuse, including cigarettes and opioids. People who use opioids often report a desire to quit cigarettes, but little research has explored concurrent reductions in opioid and cigarette use in treatments for PTSD and substance use disorders.Objective: This exploratory study examined changes in cigarette use in a pilot study of an integrated psychotherapy for co-occurring opioid use disorder (OUD) and PTSD.Method: Daily cigarette use was measured using the Timeline Followback at 30 days before baseline, during weekly intervention sessions, and at 1-month follow-up. Bootstrapped linear mixed effect models tested for self-reported reductions in cigarette use across a subsample (n=4) who reported using cigarettes at baseline.Results: Results showed reductions in the average number of cigarettes used per day (CPD) between baseline and 1-month follow-up (B=-.93, SE=.41, p=.04) from an average of 17.06 (SD=15.32) CPD at baseline to an average of 8.07 (SD=9.28) CPD at follow-up. Additionally, participants reported high satisfaction with the intervention, with a mean score of 28.33 (SD=2.78) on the Client Satisfaction Questionnaire and all participants completed the intervention.Conclusions: Exploratory findings suggest that the integrated treatment for OUD/PTSD may have assisted in reductions of co-occurring cigarette use. Notable limitations include the study's small sample size, lack of a control group, and lack of nicotine product-specific self-report and biological measures. Although exploratory, observed changes suggest future work should explore concurrent reductions in opioid and cigarette use in randomized clinical trials for OUD/PTSD. This study explored reductions in cigarette use in HOPE, an integrated psychosocial intervention for opioid use disorder and PTSD.Participants showed reductions in the average number of cigarettes smoked per day from baseline to 1-month follow-up.More research is needed on the relationship between co-occurring opioid and tobacco use and their relation to PTSD.

BACKGROUND Drug abuse is a global public health concern with substantial medical, psychological, and social consequences. Drug abuse monitoring (DAM) systems help identify patterns of substance misuse and support regulatory interventions. Current monitoring systems mainly rely on fixed-point reporting from addiction treatment centers, detention facilities, and compulsory detoxification institutions, which can lead to delayed detection and incomplete data coverage. Additionally, there is increasing misuse of prescription medications, over-the-counter drugs, and emerging psychoactive substances in medical settings. Therefore, establishment of a structured DAM approach within medical institutions is important to improve early detection and reporting of drug abuse. MATERIAL AND METHODS A single-center retrospective observational study was conducted at Wuxi Mental Health Centre to monitor patients diagnosed with drug/substance abuse between September 2020 and December 2024. A DAM research group was established to standardize reporting procedures, define staff responsibilities, and implement monitoring protocols linked to the national reporting system. RESULTS In total, 146 patients with drug/substance abuse were monitored: 41 male individuals (28.08%) and 105 female individuals (71.92%). Nineteen drugs or substances across 5 categories were identified. Sedative-hypnotic drugs represented the largest proportion of cases (98.63%). Antipyretic and analgesic drugs containing caffeine were abused in 4.11% of cases; dextromethorphan or Yumei tablets were involved in 3.42% of cases. Nitrous oxide abuse was identified in 2.05% of all monitored cases; affected patients were aged 17 to 25 years. CONCLUSIONS The proposed DAM approach was successfully implemented in a hospital setting and demonstrated feasibility for systematic monitoring of drug abuse in medical institutions.

Tackling the global burden of mental health conditions and substance misuse is an international priority. In recent years, strategic work has begun to develop mental health services in Ethiopia and strengthen human rights protection for people with mental health conditions. To inform mental health service planning in the Somali region of Ethiopia, the extent of mental health conditions and substance misuse requires quantification. We aimed to investigate associations between problematic khat use and mental health conditions in Ethiopia's Somali Regional State (SRS). We carried out a quantitative household survey of 844 randomly selected residences in two cities in Ethiopia's SRS: the regional capital, Jigjiga (55.1%, n=465), and third largest city, Kabridahar (44.9%, n=379). We used the culturally validated Problematic Khat Use Screening Test and Mini International Neuropsychiatric Inventory to assess the prevalence and factors associated with mental health conditions and problematic khat use. Out of 844 participants, 18.6% (n=156) met criteria for major depression, 11.1% (n=92) met criteria for post-traumatic stress disorder (PTSD) and 5.7% (n=48) expressed suicidal ideation. The combined prevalence of these mental health conditions was 21.8% (n=186). Men reported more aggregated mental health conditions than women (30.6%, n=97&#x2009;vs 16.9%, n=89). Adjusted regression analyses showed that people with problematic khat use had more than twice the prevalence of major depression (prevalence ratio (PR) 2.5, 95% CI 1.7 to 3.5), recurrent depression (PR 2.8, CI 1.8 to 4.4), suicidal ideation (PR 2.4&#x2009;CI 1.9 to 5.3), PTSD (PR 3.1, CI 1.9 to 5.3)&#x2009;and any mental health condition (PR 2.4, CI 1.7 to 3.4) compared with people without problematic khat use. This study provides the first data regarding population mental health needs and harms associated with problematic khat use in the SRS, to inform the design, development and prioritisation of mental health services and substance regulation and policy. Associations between problematic khat use and a range of poor mental health outcomes demonstrate the importance of targeted services for this population. Further research is needed to explore causal pathways underlying these associations.

The present study focuses on the extent to which individual political orientation and political school climate are related to the use of alcohol, cannabis, cigarettes, and e-cigarettes. We sampled 11,114 Belgian (Dutch-speaking) students from 44 secondary schools in the four highest grades (age 14-18). Left-wing orientation predicted lower substance use, while radical-right orientation predicted higher use. No main effect of left-wing school climate emerged, but several cross-level interactions showed that individual political orientation effects depend on school context. A noteworthy finding was that radical-right orientation predicted greater substance use most strongly in radical-right climates. The present findings highlight the contextual nature of political orientation: individual-level effects are moderated by the school-level political climate. Given the elevated levels of substance use among radical right-wing individuals in radical right school climates, we suggest that policy efforts should foster adolescents' critical reasoning about science versus pseudoscience.

Work-related mental disorders comprise conditions of psychological distress in which causal factors are associated with elements of the work environment. These disorders impose substantial economic and social burdens on affected workers and are frequently associated with alcohol consumption and the use of other psychoactive substances. To conduct an epidemiological analysis of reported cases of work-related mental disorders in Brazil between 2012 and 2021, investigating their association with alcohol and other drug misuse. This analytical, quantitative study was based on notification data obtained from the Department of Informatics of the Brazilian Unified Health System. Sociodemographic characteristics, work-related conditions, and information on alcohol consumption and the use of other drugs were collected. Data were analyzed using statistical tests and multivariate analytical techniques. Work-related mental disorders predominantly affected women, individuals with higher educational attainment, and those who self-identified as White or Brown. Alcohol consumption and the use of other drugs showed limited statistical significance as factors associated with the reported cases. Strategies aimed at improving working conditions, expanding access to psychological support, and preventing substance misuse are essential to address work-related mental disorders, a major public health concern in Brazil. Identifying risk factors associated with these disorders may inform more effective interventions and promote improved work organization, thereby reducing their impact on the health of the working population and on the national economy.

Misuse of noncontrolled prescription medications (NCPMs) is often overlooked with the emphasis on opioids and stimulants. We provide a definition of misuse and describe common categories of NCPMs commonly misused, and through case-based examples we discuss select medications, motives and context for misuse and provide some basic information on clinical management. We also discuss the importance of flexibility in working with these patients and in prescribing or deprescribing NCPMs.

Losses that remain unaddressed can serve as a barrier to positive substance use treatment outcomes. Adults who misuse opioids face various barriers to substance use treatment and may also be navigating different forms of losses, including non-death loss. Due to the obscure nature of non-death losses, the support typically provided during a distinct loss is not made available, leading to the disenfranchisement of one's grief. Lacking social support and having a reduced capacity to cope can be harmful to the grieving and drug recovery process, contributing to an increased risk of relapse. Understanding participants' experiences of non-death loss and its impact on their well-being and drug misuse is imperative to promote recovery. Using a sample of 41 Black adults who reported opioid misuse, researchers employed reflexive thematic analysis to examine themes in participants' experiences of loss. Identified themes were: (1) pre-addiction loss, childhood trauma, (2) loss during/because of addiction, idealized adulthood, and (3) loss during remission, recovery capital, interpersonal relationships, and stability. Findings provide evidence that non-death losses affected participants' drug use, whether it was the initiation of their use, the duration of their use, or their remission or relapse. Researchers discuss implications for providers who work with people who use drugs (PWUD), who may experience adverse life events that could be framed as loss. Results of this study suggest that viewing clients' non-death losses as moments of loss can help to explore their grief and ultimately address their drug use as a coping mechanism.

Background: Transgender women and travestis (TWT) in Brazil have a disproportionately high prevalence of psychoactive substance use, contributing to increased vulnerability to sexually transmitted infections (STI). The use of substances before or during sex has been linked to risky sexual behaviors but remains understudied among TWT in Latin America. Objective: To investigate the association between the use of cannabis, cocaine, or crack before or during sex and inconsistent condom use with casual partners among TWT. Methods: We analyzed data from 533 TWT in the TransOdara study (2019-2021), who reported penetrative sex with casual partners in the past six months. In the previous year, 47.8% used cannabis, 37.3% cocaine, and 8.1% crack - mostly before or during sex. Inconsistent condom use was reported by 48.9%. Cocaine (PR: 1.40; 95% CI: 1.16-1.70) and crack (PR: 1.42; 95% CI: 1.06-1.91) use during sex were associated with higher inconsistent condom use, while cannabis showed no association. Discussion and Conclusions: These findings underscore the need for targeted public health interventions that address the intersection of substance use and sexual health risks among TWT in Brazil. In particular, drug use specifically before or during sex should be prioritized in research on sexual behavior.

Cannabis use in the United States has become increasingly diverse following widespread legalization, with multiple consumption modalities differing in potency, pharmacokinetics, and health effects. Understanding how psychological distress relates to specific cannabis use modalities is essential for targeted public health surveillance. To examine the association between past-month serious psychological distress (SPD) and cannabis use modalities among U.S. adults. We analyzed 33,404 adults aged &#x2265;18&#x2009;years from the 2023 National Survey on Drug Use and Health (NSDUH). Survey-weighted logistic regression models were used to examine associations between SPD and past-month cannabis use modalities, adjusting for sociodemographic characteristics, substance use behaviors, and mental health treatment. Each cannabis modality was modeled separately as a binary outcome. Overall, 8.9% of adults reported SPD. Cannabis use was more prevalent among adults with SPD than those without (26.8 vs. 12.3%). In adjusted analyses, SPD was associated with higher odds of multiple cannabis modalities, including smoking (AOR = 1.72, 95% CI: 1.47-2.01), vaping (AOR = 1.84, 95% CI: 1.44-2.34), dabbing (AOR = 1.68, 95% CI: 1.29-2.20), blunt use (AOR = 2.06, 95% CI: 1.69-2.50), topical use (AOR = 1.99, 95% CI: 1.26-3.13), and drops/strips (AOR = 2.41, 95% CI: 1.48-3.93). Edible cannabis use was also significantly associated with SPD (AOR = 1.45, 95% CI: 1.14-1.84), whereas associations with pill use were not statistically significant. Psychological distress is associated with increased likelihood of using multiple cannabis modalities among U.S. adults, with variation across product types. These findings highlight the importance of considering mental health status in cannabis surveillance and the need for modality-specific approaches in prevention and clinical care.