American Journal of Drug and Alcohol Abuse最新文献

Background: Alcohol-induced hypertension (HTN) is linked to a 2.3-fold increase in cardiovascular-related death.Objective: We aimed to identify temporal trends in alcohol-induced HTN mortality among United States (US) adults stratified by year, sex, age, race, and region.Methods: Data on alcohol-induced HTN mortality among adults (≥25 years) in the US from 1999 to 2020 were extracted from the CDC WONDER database, utilizing ICD-10 codes. Crude (CMRs) and age-adjusted mortality rates (AAMRs) were calculated. Temporal trends in AAMRs were assessed using Joinpoint regression. Mortality forecasts through 2030 were generated using the ARIMA model in STATA software (version 17.0).Results: From 1999 to 2020, 50,793 alcohol-induced HTN-related deaths were recorded in the US, with an overall AAMR of 0.858 per 100,000. The AAMR increased from 0.279 (95% CI: 0.257-0.302) in 1999 to 1.348 (95% CI: 1.305-1.390) in 2018, rising further to 2.014 (95% CI: 1.963-2.066) in 2020. Mortality was higher in males (AAMR 2.16) than in females (0.55). The highest burden occurred among American Indians/Alaska Natives (AAMR 2.392), while the lowest was observed in Asians/Pacific Islanders (0.206). The Western region had the highest AAMR (1.116). CMR peaked among individuals aged 55-64 years (2.416), with slightly higher rates in rural areas. Forecast analysis projected the overall AAMR to increase from 2.01 in 2020 to 4.18 by 2030.Conclusion: Rising mortality from alcohol-induced HTN highlights an urgent need for strengthened control policies for alcohol use, early identification of hazardous drinking, and integrated management of hypertension and alcohol use to reduce preventable cardiovascular mortality in the US.

Background: The primary psychoactive ingredient in cannabis interacts with the endocannabinoid system, which declines with age and may alter cannabis-related effects in older adults. Animal studies suggest age-related differences in cannabis responses, though findings are mixed. Importantly, biological sex modifies the endocannabinoid system, which complicates interpreting age-related effects.Objective: This study examined how age and sex jointly influence cannabis-related outcomes in middle-aged and older adults.Methods: Self-reported measures of cannabis use behaviors, memory, mental and physical health, cannabis use disorder (CUD) symptom severity, and sleep quality were collected from 107 adults (age range = 35-78, 54 females) who use cannabis. Partial correlations examined associations between age and outcomes controlling for years of use. Self-reported biological sex was assessed as a moderator.Results: Regression analyses revealed a significant age × sex interaction for both CUD symptoms and mental health scores. Among females, CUD symptom severity decreased with age (b = -0.20, p = .03), and mental health scores improved (b = 0.59, p = .04); these age-related effects were not observed in males. Sensitivity analyses suggested that participants reporting medical-only cannabis use may exhibit a steeper age-related decline in CUD symptom severity than those reporting recreational-only use (b = 1.31, 95% CrI: -1.99 to 4.54) or hybrid use (b = 0.62, 95% CrI: -2.76 to 3.98).Conclusions: These findings suggest that factors such as sex and reason for cannabis use may be important for understanding cannabis safety profiles in aging populations and may inform individualized clinical care.

Background: Black persons who smoke are a recognized tobacco disparities group in the United States. Although past research indicates racial/ethnic discrimination is important to smoking among this group, less attention has been focused on anticipatory stress characterized by race-related vigilance, which is heightened awareness and preparation for potential discriminatory encounters.Objectives: The current study examined the role of race-related vigilance on smoking cessation outcomes, including severity of problems when quitting, perceived barriers for smoking cessation, as well as smoking abstinence expectancies related to negative mood, somatic symptoms, harmful consequences, and positive consequences among Black adults who smoke combustible cigarettes.Methods: The present sample consisted of 498 Black adults who reported daily use of combustible cigarettes (M_age = 45.37, SD = 14.68, age range: 18-73 years; 51.4% female).Results: Race-related vigilance was associated with several smoking-related constructs, including severity of problems when trying to quit (b = .02, p = .01), perceived barriers for smoking cessation (b = .28, p = .009), and expectations concerning the effects of smoking abstinence (i.e. negative mood [b = .49, p < .001], positive consequences [b = .20, p = .021]) even after accounting for sociodemographic factors and perceived racial/ethnic discrimination.Conclusions: These results provide novel evidence that race-related vigilance represents an important, yet understudied element involved in smoking behavior among Black adults, warranting further examination regarding its application to minority stress models of smoking behavior. Addressing race-related vigilance may be a critical component in developing more effective, culturally responsive cessation interventions.

Background: Neurodegenerative diseases including Alzheimer's disease (AD), Parkinson's disease (PD), Amyotrophic lateral sclerosis (ALS), and Huntington's disease (HD) represent a significant global public health problem. Alcohol consumption is a common lifestyle factor that has been implicated as both a risk factor and potential modifier of disease progression.Objectives: This review integrates evidence from human and experimental studies to characterize the effects of alcohol consumption on the onset and progression of major neurodegenerative diseases.Methods: A narrative review was undertaken examining the pathophysiological effects of alcohol on the brain and its disease-specific effects on neurodegenerative disorders, integrating findings from human cohort studies and mechanistic investigations in preclinical models.Results: Experimental evidence indicates that chronic alcohol consumption exacerbates neurodegeneration through multiple converging mechanisms, including oxidative stress, mitochondrial dysfunction, lipid peroxidation, inflammatory signaling, disruption of neurotrophic pathways, impairment of dopaminergic neurotransmission, and alcohol-induced gut microbiota dysbiosis with blood-brain barrier compromise. Epidemiological data suggest dose-dependent and disease-specific associations, with heavy and sustained consumption more consistently linked to increased risk or accelerated progression of AD and PD, while evidence in ALS and HD remains inconsistent.Conclusion: Alcohol exerts a multifaceted and context-dependent influence on neurodegenerative diseases. Accumulating evidence supports that long-term heavy alcohol consumption is associated with enhanced neurodegeneration. Minimizing alcohol consumption may present a pragmatic opportunity to reduce neurodegenerative risk.

Background: Research exploring social support and length of stay within sober living environments can be essential in understanding factors related to confidence in abstinence (abstinence self-efficacy).Objectives: This study examined whether length of stay mediated the relationship between social support and abstinence self-efficacy, and whether sex differences occurred between social support and length of stay.Methods: Oxford House residents from various recovery homes (N = 352, age range 18-70, (M = 37.54, SD = 10.74), 52% male, 48% female) participated in this study. A moderated mediation analysis assessed whether sex altered the relationship of length of stay and social support within the indirect pathway of social support and abstinence self-efficacy.Results: Social support significantly predicted length of stay (b = 1.05, SE = .35, p = .003) and length of stay predicted abstinence self-efficacy (b = .08, SE = .04, p = .05). Social support did not predict abstinence self-efficacy (b = .15, SE = .09, p = .10). Sex did not moderate social support and length of stay (index = -.03, BootSE = .03, 95% CI [-.09, .006]). Thus, results did not confirm a mediating or moderating effect. However, sex was a significant covariate on length of stay (b = -.39, SE = .13, p = .002) where males (M = 1.49, SD = 1.21) demonstrated longer stays than females (M = 1.11, SD = 1.22).Conclusions: Findings support the importance of bolstering length of stay among all residents within recovery housing programs, as results indicated similar outcomes across sex.

Background: East and Southeast Asia face a severe drug epidemic. A detailed analysis of specific drug use disorders (DUDs) is urgently needed to inform targeted interventions.Objective: To quantify trends in the burden of four DUDs in East and Southeast Asia from 1990 to 2021.Methods: Using Global Burden of Disease Study 2021 data, we analyzed trends (1990-2021) in incidence, prevalence, and DALYs for four DUDs across 20 countries/territories. Estimated annual percentage changes and age-period-cohort models assessed trends and independent effects.Results: Significant disparities were observed. Amphetamine DALYs were higher in East Asia (41-79 per 100,000), while cocaine DALYs peaked in high-income Asia-Pacific (15-16 per 100,000). Amphetamine-related DALYs declined sharply in East Asia (net drift: -3.08%; 95% CI: -3.20 to -2.95, p < .001) but increased in Southeast Asia (0.16%; 0.11 to 0.22, p < .001). Cannabis-related DALYs rose in East Asia (0.27%; 0.2 to 0.35, p < .001). Cocaine-related DALYs fell markedly (-3.81%; -3.95 to -3.68, p < .001). Age effects peaked at 15-34 years.Conclusions: The patterns of drug prevalence and their changing trends in East Asia and Southeast Asia show regional characteristics. The proliferation of amphetamines is becoming increasingly severe in Southeast Asia, while in East Asia, although some success has been achieved in controlling other drugs, risks related to cannabis are continuously rising. Public health strategies must focus on subregional interventions, prioritizing the growing problem of amphetamines in Southeast Asia and the emerging trend of cannabis use among young people.

Background: Methadone administration for opioid use disorder (OUD) has historically been in liquid formulations.Objectives: Evaluate how persons with OUD experience methadone dispensed in tablet versus conventional liquid formulation for the treatment of OUD.Methods: Persons (N = 48) receiving methadone for OUD were transitioned from liquid to a tablet formulation. Within-subject quantitative and qualitative reports of experience following each formulation were compared and descriptively summarized, respectively.Results: Participants were significantly more likely to describe tablet methadone as equal or better than liquid methadone (85.4% vs. 69.8%, p = .048, φ = .20). More participants endorsed benefits from tablet versus liquid methadone (66.7% vs. 37.8%, p = .005, φ = .29), including improved taste of the tablet, convenience in transporting medication, lower feelings of stigma, improved sleep, reduced cravings for sweet foods, and improved energy. No significant differences in formulations were evident with regards to bowel movements/constipation, sedation, and withdrawal suppression, with 81.5% of participants noting tablet methadone was equal or better at managing withdrawal compared to liquid. Participants found tablet methadone satisfactory, with 91.7% willing to recommend tablet methadone to their family/friends and 91.7% willing to use it again.Conclusion: Most participants experienced tablet methadone as neutral or advantageous compared to liquid methadone. Several qualitative potential benefits of tablet versus liquid methadone were raised. Approximately 80% of participants felt their opioid withdrawal was as good or better managed with tablet versus liquid methadone. These data may be used by clinics to explore tablet methadone dosing strategy and support advancement in the use of methadone for OUD.

Background: People who are unhoused have higher rates of alcohol use disorder (AUD). Understanding the contexts associated with alcohol avoidance motivation may inform interventions to increase motivation for behavior change within this population.Objectives: Aim 1 examined daily variations in motivation among people who were unhoused with probable AUD. Aim 2 examined if motivation was associated with alcohol urge, negative affect (NA), positive affect (PA), and social situations with/without alcohol. Aim 3 examined if morning motivation, urge, NA, PA, and social situation predicted later alcohol use.Methods: Secondary analyses from a clinical trial of adults with unstable housing and probable AUD (N = 70; n_male = 58, n_female = 12) were conducted (NCT03746808). Participants completed ecological momentary assessments assessing motivation, urge, NA, PA, social situation, and alcohol use for 4 weeks. Multilevel models examined daily variability in motivation, as well as the between- and within-person effects of urge, NA, PA, and social situation on motivation and alcohol use.Results: On average, participants rated their motivation to avoid alcohol as "Neutral" which remained stable within day (mean = 3.23). At the between-person level, higher average alcohol avoidance motivation was associated with lower average urge (CI: -0.70 to -0.22) and with lower odds of alcohol use (CI: 0.15 to 0.78). At the within-person level, higher alcohol avoidance motivation was associated with lower urge (CI: -0.18 to -0.06), higher NA (CI: 0.05 to 0.21), and higher PA (CI: 0.07 to 0.20).Conclusions: This study identified situations that may be conducive to encouraging alcohol use change among people who are unhoused. Targeting in-the-moment affective and craving fluctuations may be keys to enhancing and maintaining motivation to avoid alcohol among people experiencing unstable housing.

Background: Kratom's rise in popularity during multiple overlapping drug use crises is potentially driving poor mental health outcomes and straining health systems.Objective: To investigate temporal changes in the compounding effect of kratom on serious mental illness (SMI) when co-used with other drugs.Methods: We used the National Survey of Drug Use and Health (2021-2023; N = 139,524; male n = 61,926; female n = 77,598) to identify SMI, a range of drug use disorders (SUD), and kratom use. Our focal predictor was whether an individual had 1) no SUD and no kratom use, 2) an SUD without kratom, 3) kratom use without an SUD, or 4) both an SUD and kratom use. We used multiple logistic regression to model whether SMI is associated with SUD/kratom status, year, and their interactions.Results: Roughly 6% of adults met the criteria for SMI. We found that the increase in SMI over 3 years was fastest and markedly different among those with both OUD and kratom use, such that the predicted SMI prevalence went from 20% in 2021 to 50% by 2023 (interaction p = .01), whereas SMI remained relatively stable for other drug combinations, including those with OUD without kratom use, kratom without OUD, and neither OUD nor kratom.Conclusion: Over a short period of 3 years, SMI more than doubled among those with concurrent kratom use and OUD. At a time of strained US treatment systems, high overdose rates, and a mental health crisis, we stress the multiplicative association between kratom, opioid use disorder, and SMI.

Background: The drug landscape in the US is rapidly shifting, and alternate methods of drug surveillance that do not involve human subjects may help overcome limitations of current methods. In this study, we focus on nightclubs, where use of cocaine, ketamine, and 3,4-methylenedioxymethamphetamine (MDMA) is prevalent.Objectives: In this proof-of-concept study, we assessed the feasibility of surface swabbing in nightclub venues in New York City as an environmental method for monitoring the presence of commonly used party drugs, and we compared findings from swabs collected from non-nightclub public settings.Methods: Swabbing was conducted inside 9 nightclub venues on 15 nights in 2025, yielding 46 separate surface samples. For comparison, 16 additional swabs were collected from non-nightclub public environments we considered "controls." Samples were analyzed via liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS).Results: Cocaine and ketamine were detected at every nightclub on every night. Across all nightclub swabs, cocaine was most often detected (83%), followed by ketamine (78%), and MDMA (26%). We also detected lidocaine (11%), levamisole (4%), phenacetin (4%), 2-methylmethcathinone (4%), 4-methylmethcathinone (4%), bis(2,2,6,6-tetramethyl-4-piperidyl) sebacate (BTMPS; 4%), and quinine (4%). Detection of cocaine, ketamine, and MDMA was relatively consistent within the same night, and detection was also consistent by venue across nights with some variation in number of swabs testing positive. Among non-nightclub comparison swabs, cocaine and ketamine were detected on 44% and 13% of surfaces, respectively.Conclusions: This study demonstrated that surface swabbing can possibly serve as a useful method for drug monitoring at such venues.