Objective: This study examines the differential predictive value of baseline characteristics of clients being treated for an alcohol problem with respect to the development of an opioid use disorder (OUD) or opioid overdose (OD) within 1 year, between 1 and 4 years, and beyond 4 years after treatment. Method: A cohort of 87,172 patients treated for an alcohol use problem within state treatment centers was examined. We extracted the first OUD/OD diagnosis event within 1 year of, between 1 and 4 years of, and more than 4 years after the patient’s first admission to the Office of Addiction Services and Supports. We calculated odds ratios for all predictors and control variables with respect to OUD/OD events and compared the predictive values of these variables for the different periods. Results: Both sociodemographic and clinical factors predicted an OUD/OD overall and in most specific follow-up periods. Sociodemographic factors were more strongly associated with OUD/OD during follow-ups beyond 4 years, perhaps because of the increasing availability of opioids over time. Mental health and alcohol use severity factors were more strongly associated with OUD in the 1-year and 1-to 4-year periods, suggesting a rapid progression to OUD/OD. Conclusions: Both sociodemographic and clinical factors were predictive of a diagnosis of OUD/OD within a brief period; however, they were only predictive of approximately 40% of those who would develop OUD/OD within any specific period. These findings highlight the need for a more formal assessment of opioid use at treatment entry, and for the implementation of harm reduction measures throughout treatment.

Objective: Veterans experience high rates of co-occurring anxiety disorders, posttraumatic stress disorder (PTSD), and unhealthy alcohol use. The goal of this study was to improve the understanding of...

Objective: The purpose of this study was to investigate the experiences of a novel adjunctive medical cannabis (MC) intervention within a residential substance use recovery program. Method: This quali...

Objective: The internalizing (e.g., depression/anxiety) pathway to substance use is a prominent hypothesis, but its evidence has been critiqued for neglecting correlated dimensions of mental health such as externalizing (e.g., aggressive, rule-breaking) and attention-deficit/hyperactivity problems. Furthermore, most research has been conducted in predominantly White samples, limiting generalizability. We examine associations between substance use and psychopathology symptoms across intersectional race/ethnicity and gender identities. Method: Participants (N = 1,187; 16.26% Black women, 17.61% Latina women, 15.67% White women, 16.68% Black men, 17.10% Latino men, and 16.68% White men) ages 18–26 completed online surveys. Alcohol and cannabis factors were indicated by six pattern-of-use items (e.g., frequency/quantity) and psychopathology symptoms via the Adult Self-Report. Differential item functioning was tested before making comparisons in univariate and multivariate models. Results: Differential item functioning was detected; the degree of bias was modeled via partial metric invariance, allowing for latent inferences. At the univariate level, externalizing symptoms predicted alcohol and cannabis across all groups except Black and Latino men, whereas internalizing and attention-deficit/hyperactivity symptoms predicted cannabis use in White women and White men only. In a multivariate model, internalizing symptoms inversely predicted alcohol use for White women and White men, externalizing symptoms predicted alcohol use in all groups except Latino men, and externalizing symptoms predicted cannabis use in all groups except Black women and Latino men. Attention-deficit/hyperactivity showed no significant associations in the multivariate model. Conclusions: The conceptualized structure of mental health has implications for research on substance use. Intersectionality-minded methods may provide a more generalizable scientific base.

Objective: Chronic heavy alcohol use increases the risk for developing alcohol use disorder (AUD), leading to adverse health outcomes. Evidence suggests that patient demographics are used to make treatment decisions, which contributes to barriers to AUD treatment experienced by Hispanic and Latino/a/x individuals. This study characterized the use of ethnicity in alcohol use assessment and treatment referral among medical trainees and dental trainees. Method: Current medical trainees (n = 54) and dental trainees (n = 59) reviewed 32 vignettes varying systematically in sex, age, ethnicity, and alcohol concern cues. Trainees used 0–100 visual analog scales (VASs) to rate the likelihood of discussing the patient’s alcohol use (VAS1), the likelihood that the patient has AUD (VAS2), comfort discussing alcohol use with the patient (VAS3), and the likelihood of referring to AUD-related treatment (VAS4). Idiographic regressions characterized individuals’ decision-making policies. Group-level analysis determined the influence of trainee ethnicity and trainee type on patient ethnicity cue use. Results: Almost all (96%–100%) trainees reliably used the alcohol concern cue when providing ratings. About 25%–56% of trainees used ethnicity as a cue. Trainee ethnicity did not significantly affect ethnicity cue use when evaluating vignettes (t < 1.37, p > .17; d < 0.56). Analyses indicated that medical trainees weighed the alcohol concern cue more heavily than dental trainees for VAS1. Conclusions: Results suggested that a substantial proportion of trainees reliably used patient ethnicity to make alcohol treatment-related decisions, consistently to the potential detriment of Hispanic and Latino/a/x patients. Finally, the lower weighting of alcohol concern among dental trainees than medical trainees in all but one judgment suggests that dental trainees may not view alcohol screening as part of their professional role as strongly as medical trainees.

Objective: Lower education is a risk factor for alcohol-related deaths, but it is unknown if the impact of education varies by race/ethnicity. We evaluated the interaction between education and race/ethnicity on the odds of alcohol use disorder (AUD) and the significance of employment and poverty as potential mediators. Method: The 2016–2019 National Survey on Drug Use and Health was used to obtain the weighted prevalence of AUD in participants 26 years and older. Using AUD as the outcome, multivariable logistic regression analyses were performed, stratified by four levels of education, ranging from less than high school to 4-year college+; odds ratios (ORs) for each race/ethnicity were compared across models for interaction. The second model included employment and poverty as covariates; changes in ORs were calculated to assess for >|10%| change implying significant mediating or confounding effects. Results: AUD prevalence was highest among American Indian/Alaskan Natives (AI/ANs) (8.06%) and similar among non-Hispanic Whites (5.37%) and Blacks (5.09%). When stratified by education, the odds of AUD among Blacks and AI/ANs increased with decreasing education (OR = 1.45, 95% CI [1.07, 1.96]) for Blacks versus Whites with less than high school, compared with 0.55 [0.46, 0.67] for Blacks versus Whites with 4-year college+; 2.55 [1.53, 4.24] for AI/ANs versus Whites with less than high school versus 1.01 [0.45, 2.28] for AI/ANs versus Whites with 4-year college+. Including employment and poverty resulted in <|10%| change in ORs. Conclusions: Lower education significantly increased the odds of AUD among Blacks and AI/ANs. Employment and poverty did not significantly change the association, implying that there are likely other mechanisms accounting for racial/ethnic disparities in AUD.

Objective: This study investigated associations between social network characteristics and alcohol and cannabis use among non–reservation-living American Indian/Alaska Native (AI/AN) emerging adults (18–25 years old), with a focus on the potential protective influence of AI/AN traditional practices (e.g., dancing, storytelling, beading). Method: The study used a multilevel, multivariable dyadic approach to analyze personal network composition and network connectivity (centrality and density) from 470 AI/AN emerging adults living in nonreservation areas across the United States. Eligible participants completed an online survey, which included questions about social networks and alcohol and cannabis use. Results: Findings indicated that network members who were similar in age, perceived to be friends, and lived nearby were more likely to be alcohol and cannabis use partners. Network members who shared AI/AN identity but did not engage in traditional practices were more likely to be alcohol and cannabis use partners than non-AI/AN network members. Analysis of network density demonstrated that having highly connected networks was associated with lower odds of respondents engaging in alcohol and cannabis use with members of their networks. However, highly central network members had higher odds of alcohol and cannabis use with respondents than those who were less central. Findings were robust when controlling for respondent and network alcohol and cannabis use. Conclusions: The study underscores the significance of the network context of alcohol and cannabis use for nonreservation AI/AN emerging adults. The protective role of traditional AI/AN practices highlights the importance of strength-based intervention approaches that promote healthy social connections and traditional practices. Future research should test hypotheses longitudinally to inform more effective prevention strategies.

Objective: The term fetal alcohol spectrum disorder (FASD) refers to a variety of negative consequences that may develop in children born to women who have consumed alcohol during pregnancy. Anxiety disorders are common in FASD. Animals exposed to alcohol exhibit anxiety-like traits. Erythropoietin (EPO) is produced by the kidneys and liver. The synthesis of EPO by immature neurons also plays a crucial role in the embryonic stage. In addition, EPO inhibits astrogliosis and cell death while increasing the number of brain-derived neurotrophic factor (BDNF)-positive cells, which is linked to reductions in anxiety-like behavior and neuronal damage. This study investigated the protective effects of EPO on ethanol-induced neurotoxicity in the hippocampus of rat pups. Method: The intubation of the total daily dose of ethanol (5/27 g/kg/day) was started from Postnatal Day 2 (PD2) to PD10 (corresponding to the third trimester of pregnancy in humans). After intubation, 1,000 and 2,000 U/kg EPO were injected subcutaneously. The elevated plus maze was performed 39 days after the birth of the pups to determine the levels of anxiety. Immunohistochemical staining was then performed to determine GFAP and BDNF levels 40 days after birth. Nissl staining was done to measure necrotic cell death. Results: EPO administration significantly improved the anxious behavior associated with FASD (p < .001). EPO significantly increased BDNF levels (p < .001), decreased glial fibrillary acidic protein expression (p < .001), and attenuated alcohol neurotoxicity-induced necrotic cell death (p < .001). Conclusions: EPO treatment provides protection against ethanol neurotoxicity, which consequently leads to lower anxiety levels.

Objective: We investigated offspring alcohol use outcomes as a function of unremitted and remitted parental alcohol use disorder (AUD). Method: Self-report data of participants in the Collaborative Study on the Genetics of Alcoholism (COGA) were used. Offspring (n = 2,244, mean age 16.3 years at baseline, 26.9 years at follow-up, 50.8% female) were linked to parental data. Time-varying associations of parental AUD and remission with offspring age at first drink, years from first drink to AUD onset, and years from AUD onset to first remission were tested in Cox models adjusted for polygenic risk for problematic alcohol use (PGSPAU). Analyses were stratified by genetically inferred continental groups of European Americans (EA; 65.9%) and African Americans (AA; 34.1%) because of sociocultural factors that can contribute to differences in alcohol use and problems. Results: In EA, maternal remission was associated with increased risk for offspring AUD; neither maternal nor paternal remission was associated with other outcomes. In AA, maternal and paternal remission were associated with an increased likelihood of early drinking; the association with maternal drinking varied as a function of whom offspring lived with during adolescence. Paternal, but not maternal, remission was associated with a heightened risk for AUD onset. Parental status had no association with offspring remission in EA or AA. Conclusions: Evidence that parental remission can help mitigate the risk associated with parental AUD and increase the likelihood of remission in affected offspring was limited and mixed based on continental group and sex. These nuanced outcomes highlight the complex interplay of parental AUD status and offspring’s alcohol-related behaviors.

Objective: Increasing engagement in evidence-based treatment for opioid use disorder during pregnancy is pressing. Generative artificial intelligence large language model conversational agents may sup...

Objective: Heavy drinking is common among men who have sex with men (MSM) and significantly increases HIV acquisition risk. MSM who report heavy drinking also report higher cannabis use, which has also been associated with sexual behaviors known to elevate HIV transmission risk. Despite evidence of associations at the between-subjects level, the effects of alcohol and cannabis use on sexual risk behavior among MSM who engage in heavy drinking are largely unknown. The current study used ecological momentary assessment to examine the between- and within-subject associations of heavy drinking, cannabis use, and sexual behavior. Method: This is a secondary data analysis of a study on alcohol intoxication and sexual decision making that included 115 MSM who reported cannabis use and were not using pre-exposure prophylaxis (PrEP) at baseline. Participants reported daily alcohol and cannabis use and sexual activities over 6 weeks. Multilevel multinomial regression was used to evaluate how alcohol and cannabis use were associated with sexual behaviors. Results: Higher alcohol use was associated with higher rates of intercourse at the between-persons level and a higher likelihood of all sexual behaviors at the event level. In contrast, cannabis use at the between-person level was associated with an increased rate of condomless anal intercourse relative to both anal intercourse with a condom as well as no sex. At the within-person level, cannabis was associated with an increased likelihood of anal sex with or without a condom relative to no sex. Conclusions: Cannabis and alcohol may have independent effects on sexual risk behavior among MSM. Interventions addressing sexual health among MSM who engage in heavy drinking should also consider the additive risks of cannabis use.

Objective: Numerous studies have reported associations between child maltreatment and drug use and abuse. We ask whether internalizing and externalizing symptoms during young adulthood mediate the rel...

Objective: Media alcohol exposure is a modifiable environmental risk factor for adolescent drinking behavior. Shifts in teen media use have made social media engagement nearly ubiquitous among this population. TikTok, a short video-sharing social media platform, is the fastest-growing platform among teens. A total of 98% of the most viewed videos tagged “#alcohol” on TikTok portray alcohol positively. TikTok also offers a search function that provides algorithmically identified “Top Videos,” for which alcohol-related content has yet to be characterized. Alcohol-naive and curious youth may be more susceptible to encountering content this way. Method: A Python script using a newly created account was used to download the 100 “Top Videos” for five alcohol-related search terms: #alcohol, #beer, #wine, #vodka, #tequila. Videos were qualitatively coded for context, setting, and positive/negative sentiment of alcohol depiction. Twenty percent of videos were double coded, with a total percent agreement of 95.8% (Cohen’s kappa = .81). Results: For terms related to specific alcohol types (e.g., #beer), videos were overwhelmingly alcohol positive (96.9%), rarely depicted alcohol problems, and frequently were humorous and depicted alcohol recipes and games. For the “#alcohol” search term, nearly half of videos (41.8%) were identified as being alcohol negative and more often depicted alcohol problems and dependence. Conclusions: In contrast with the most viewed videos on TikTok for “#alcohol,” videos returned via the search function included significantly more alcohol-negative content. Content returned by all other search terms remained alcohol positive. Understanding content delivery algorithms may be beneficial for mitigating the risk of alcohol exposure on digital/social media platforms.

Objective: The purpose of this study was to investigate factors contributing to the decline in the number of passengers riding with alcohol-impaired drivers involved in fatal crashes since 1982 and to examine the impact of simulated interventions on this group through 2050. Method: Historical data were obtained from the Fatality Analysis Reporting System. We applied linear regression to analyze changes in the average numbers of passengers per alcohol-impaired young driver involved in fatal crashes between 1982 and 2020 by age and sex. We also extended our existing system dynamics simulation model developed to examine driving-while-impaired (DWI) behaviors of U.S. male and female drivers ages 15 to 24 and explored riding-with-an-impaired-driver (RWI) behaviors and corresponding interventions. We conducted sensitivity analyses to examine the likely trajectories of alcohol-impaired drivers’ passengers in fatal crashes across multiple scenarios through 2050. Results: Our findings show that the decline in passengers of alcohol-impaired drivers in fatal crashes primarily stems from a decrease in the number of impaired drivers rather than a change in the average number of passengers per impaired driver. The simulation model replicated historical trends from 1982 to 2020, and the sensitivity analyses show that the policies reducing DWI trips also decrease RWI trips. Conclusions: Wide adoption of a comprehensive strategy combining increased enforcement, an alcohol truth campaign, the provision of alternative transportation, and the enactment of a new DWI restrictive law could significantly reduce the number of passengers in fatal crashes involving alcohol-impaired drivers while minimizing possible unintended consequences.

Objective: Buprenorphine is a high affinity partial agonist that can displace full opioid agonists and could be used to reverse opioid induced respiratory depression. There is scant evidence to suppor...

Objective: Latino/as comprise nearly 20% of the US population; 25% report past month binge drinking, and disparities in care persist. Culturally adapted interventions may improve outcomes and access. ...

Journal of Studies on Alcohol and Drugs, 86(5), 834–841 (2025). http://dx.doi.org/10.15288/jsad.24-00463 -->

Objective: This pilot micro-randomized trial (MRT) evaluated feasibility of the MRT design and compared acceptability and preliminary impacts of drinking-focused and maternal-focused text messages to ...