Substance Use

The use or misuse of substances such as alcohol, tobacco, cannabis (marijuana), stimulants, hallucinogens, and opioids.

Adolescent E-Cigarette Onset And Escalation: Associations With Internalizing And Externalizing Symptoms

Nov. 3, 2020

Janet Audrain-McGovern, Daniel Rodriguez, Shannon Testa, Emily Alexander, Stephen Pianin

Abstract [from journal]

Purpose: We sought to evaluate if internalizing symptoms (i.e., anxiety and depression) and/or externalizing symptoms (i.e., impulsivity, sensation seeking, and substance use) were risk factors for the onset of 30-day e-cigarette use and escalation in the number of days used across the following 30 months among adolescents.

Methods: Adolescents (N = 1,808) from public high schools outside Philadelphia, PA, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-

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A Toxic Blend: Assessing The Effects Of Cross-Source Media Coverage Of Flavored E-Cigarettes On Youth And Young Adult Perceptions

Robert C. Hornik, PhD
Oct. 26, 2020

Ava Kikut, Sharon Williams, Robert Hornik

Abstract [from journal]

Flavored e-cigarettes have received high attention across social and news media. How does exposure to e-cigarette flavors across multiple sources in the media environment influence youth e-cigarette perceptions? To address this question, we identified e-cigarette flavor mentions on 24.3 million Twitter posts and 11,691 longform texts (newspapers, broadcast news, and websites) disseminated over 3 years (2014-2017). During the same period, we measured e-cigarette beliefs through a nationally representative randomly sampled rolling

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These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity

Sep. 17, 2020

[Original post: Utsha Khatri, Corey S. Davis, Noa Krawczyk, Michael Lynch, Justin Berk, Elizabeth A. Samuels, These Key Telehealth Policy Changes Would Improve Buprenorphine Access While Advancing Health Equity, Health Affairs Blog, September 11, 2020. https://www.healthaffairs.org/do/10.1377/hblog20200910.498716/full/. Copyright ©2020 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.]

Gaps in the Use of Long-Acting Opioids Within Intervals of Consecutive Days Among Cancer Outpatients Using Electronic Pill Caps

Salima Meghani, RN, PhD, Penn Nursing School researcher
Sep. 16, 2020

Salimah H. Meghani, Amelia L. Persico, Jeffrey Fudin, George J. Knafl

Abstract [from journal]

Objective: This study describes individual cancer patients’ nonuse of extended-release or long-acting (ER/LA) opioids, including periods of gap between opioid doses taken.

Design: Secondary analysis of a three-month observational study of prescribed ER/LA opioids monitored using electronic pill caps.

Setting: Two outpatient oncology clinics of a large health system in the Mid-Atlantic region.

Participants: Inclusion was based on self-identified African Americans and...

HIV and Suicide Risk

Sep. 14, 2020

In recent years, remarkable achievements in HIV testing and antiretroviral therapies have improved the detection, management, and care of persons living with HIV (PLWH). In the 1980s and 90s, patients with HIV infection faced a devastating prognosis. But now, with proper medications and support, PLWH can enjoy long and fulfilling lives. Thus, when the topic of suicide among PLWH is raised, many physicians are surprised. They often ask me, “wasn’t suicide an issue of a time before we had access to antiretroviral therapies?”

The Impact Of Socially Stigmatized Preexisting Conditions On Outcomes After Injury

Sep. 8, 2020

Lucy W. Ma, Elinore J. Kaufman, Justin S. Hatchimonji, Ruiying Xiong, Dane R. Scantling, Jordan B. Stoecker, Daniel N. Holena

Abstract [from journal]

Background: Socially stigmatized preexisting conditions (SSPECs), including alcohol use disorder (AUD), drug use disorder (DUD), and major psychiatric illness, may lead to provider minimization of patient symptoms and have been associated with negative outcomes. However, the impact of SSPECs on failure to rescue (FTR) has not been evaluated. We hypothesized that SSPEC patients would have increased probability of complications, mortality, and FTR.

Materials and methods: We performed a

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Prevalence Of Psychotropic And Opioid Prescription Fills Among Community-Dwelling Older Adults With Dementia In The U.S.

Aug. 18, 2020

Donovan T. Maust, Julie Strominger, Julie P. W. Bynum, Kenneth M. Langa, Lauren B. Gerlach, Kara Zivin, Steven C. Marcus

Abstract [from journal]

This pharmacoepidemiology study uses Medicare data to estimate US prescription fills for antidepressants, anxiolytics, antipsychotics, opioids, and antiepileptics among community-dwelling older adults with dementia in 2014-2015, and identifies the most commonly prescribed medications.

Screening To Identify Signals Of Opioid Drug Interactions Leading To Unintentional Traumatic Injury

Jul. 30, 2020

Charles E. Leonard, Colleen M. Brensinger, Thanh Phuong Pham Nguyen, John R. Horn, Sophie Chung, Warren B. Bilker, Sascha Dublin, Samantha E. Soprano, Ghadeer K. Dawwas, David W. Oslin, Douglas J. Wiebe, Sean Hennessy

Abstract [from journal]

Background: Efforts to minimize harms from opioid drug interactions may be hampered by limited evidence on which drugs, when taken concomitantly with opioids, result in adverse clinical outcomes.

Objective: To identify signals of opioid drug interactions by identifying concomitant medications (precipitant drugs) taken with individual opioids (object drugs) that are associated with unintentional traumatic injury DESIGN: We conducted pharmacoepidemiologic screening of Optum Clinformatics Data

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Hepatitis C and The Layering of Disease-Related Stigma

Jul. 28, 2020
“That's exactly how I feel like they look at you. Like, ‘You on drugs, you dirty, you homeless, you don't got nowhere to take yourself, staying yourself and take yourself.’ Why should they try to help you and give you the best care possible? For what? They could save it for somebody else that's doing all the right things versus give it to the people that's doing all the wrong things.” – HIV/HCV-coinfected study participant

Trends in Muscle Relaxant Prescribing

Jul. 21, 2020

As the opioid epidemic rages on, clinicians are looking towards safer medication alternatives for patients with acute and chronic pain. Skeletal Muscle Relaxers (SMRs) are a common opioid substitute for patients with musculoskeletal conditions. Although their use has grown at a rate similar to that of opioids, little is known about their safety and efficacy in treating long-term, chronic pain, particularly for older patients and patients with simultaneous opioid use.

Association Between Mothers' Postoperative Opioid Prescriptions and Opioid-Related Events in their Children: A Population-Based Cohort Study

Jul. 15, 2020

Jennifer Bethell, Mark D. Neuman, Brian T. Bateman, Karim S. Ladha, Andrea Hill, Guohua Li, Duminda N. Wijeysundera, Hannah Wunsch

Abstract [from journal]

Background: Postoperative opioid prescriptions may be associated with risks of unintentional poisoning and drug diversion in other household members. The objective of this study was to explore the association between mothers' postoperative opioid prescriptions and incidence of opioid-related events in their children (aged 1 to 24 years).

Data and methods: This retrospective cohort study used individually linked administrative health data from Ontario, Canada. A population-based sample of 170,

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