Research News Roundup: August 14, 2025

Journal: American Journal of Preventive Medicine, 2025, doi: 10.1016/j.amepre .2025.108033

Authors: Rebecca J. Evans-Polce, Jessica M. Mongilio, Sean Esteban McCabe, & Phil T. Veliz

Introduction: Nicotine, tobacco, and cannabis use continues to evolve in the US with new forms of use (e.g., oral nicotine, cannabis edibles) emerging and increasing. It is critical to understand how these substances are being used and co-used. This study identified subgroups of adolescents and younger adults ages 12 to 34 years based on nicotine, tobacco, and cannabis use using recent nationally-representative data.

Methods: Cross-sectional data from the Population Assessment of Tobacco and Health Wave 7 (2022/23) was used. Analyses focused on those ages 12-34 years who reported any past 30-day nicotine, tobacco, or cannabis use (n=8,722). Latent class analysis was conducted using eight indicators: combustible tobacco use, nicotine vaping, oral nicotine product use, other noncombustible tobacco use (e.g., snus/chew), blunt use, cannabis smoking, cannabis vaping, and cannabis edibles. Differences were examined by sex, age, race, ethnicity, and region.

Results: On average, individuals reported use of approximately two products in the past 30 days (M=2.08). Six subgroups of nicotine, tobacco, and cannabis use were identified: Combustible Tobacco (30.77%), Multimodal Cannabis (26.72%), Vaping Nicotine (18.37%), Multimodal Co-Use (13.87%), Cannabis Edibles (5.31%), and Multimodal Nicotine/Tobacco (4.95%). Sociodemographic characteristics were associated with class membership.

Conclusions: There is substantial heterogeneity in nicotine, tobacco, and cannabis use among US adolescents and younger adults. Of particular concern is that most of the sample reported combustible use, including three subgroups that reported multiple modes of use. Continued surveillance of nicotine, tobacco, and cannabis use is needed, particularly as the products and their regulation continue to evolve.

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Journal: BMC Primary Care, 2025, doi: 10.1186/s12875-025-02947-2

Authors: Lauren Kelly, Grace M. Hindmarch, Katherine E. Watkins, Colleen M. McCullough, Beth Ann Griffin, Lisa S. Meredith, Sapna Mendon-Plasek, Miriam Komaromy, & Sarah B. Hunter

Abstract:

Background: Opioid use disorder, mental health conditions, and housing instability are frequently intertwined and have a profound impact on health outcomes. While past research has focused on the opioid use and mental health of people experiencing homelessness, less is known about those experiencing housing instability. We examined the cross-sectional associations between housing status (currently unhoused, unstably housed, and stably housed) and mental health and substance use severity among primary care patients with co-occurring disorders.

Methods: Data are from a randomized controlled trial, Collaboration Leading to Addiction Treatment and Recovery from other Stresses, which tests the Collaborative Care Model for primary care patients with opioid use disorder and co-occurring depression and/or post-traumatic stress disorder (PTSD). We defined being unhoused as not living in stable housing in the past 3 months and being unstably housed as living in stable housing but being worried or concerned about loss of housing in the next 3 months. We assessed differences in baseline characteristics across the housing groups using ANOVA for continuous variables and chi-squared tests for categorical and binary measures. Adjusted linear regression models were used to assess associations between housing status and mental health and substance use symptom severity scores.

Results: Among the 797 patients randomized, 13% of the sample was currently unhoused, 24% was unstably housed, and 63% was stably housed. Individuals who were unhoused were on average younger, received less education, never married, and had not used prescribed medications for opioid use disorder (MOUD) in the past 30 days. The adjusted regression results showed that both being unhoused and being unstably housed were significantly associated with higher PTSD symptom severity, depression symptom severity, opioid use severity, and opioid overdose risk behaviors compared to being stably housed.

Conclusion: Primary care patients with co-occurring disorders who were either unhoused or unstably housed have worse mental health and substance use symptom severity when compared with stably housed individuals. This suggests primary care providers should screen patients with co-occurring disorders not only for being unhoused but also for unstable housing. Addressing housing instability in primary care settings could lead to improved health outcomes and reduced healthcare costs.

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Journal: Addiction Science & Clinical Practice, 2025, doi: 10.1186/s13722-025-00590-x

Authors: Kathleen M. Ward, Adam W. Carrico, Daniel Vader, Reneé H. Moore, K. Rivet Amico, Allison K. Groves, … & Alexis M. Roth

Abstract:

Background: Contingency management (CM) is an effective intervention that provides financial incentives as positive reinforcement for reducing opioid or stimulant use. However, it has not been tested in populations of women who inject drugs (WWID) engaging in polysubstance use.

Methods: We aimed to compare the feasibility of two CM protocols designed to encourage illicit stimulant and opioid abstinence among WWID participating in an ongoing HIV prevention trial. Participants completed a 3-month CM period during which they submitted thrice weekly urine toxicology screenings (UTOX). In the ‘abstinence from stimulants and opioids’ protocol, participants received a $5 USD incentive when metabolites of stimulants and opioids were not detected in urine. In the ‘partial-abstinence protocol’, they received a $5 USD incentive when metabolites of stimulants or opioids were not detected, thus doubling the potential incentive obtained each visit. Women also received scaling bonuses after three consecutive negative UTOX ($5-$15 USD). We used descriptive statistics to summarize the total number of (1) UTOXs completed and (2) bonuses distributed. Rates of engagement per person per month were calculated (i.e., total number of completed UTOX/3 months*24 participants). Rates of engagement were compared by CM protocol period.

Results: Participants were primarily White women (67%) with an average age of 47 years. Self-reported polysubstance use was common (96%) with women reporting injecting an average of 5 times daily (Interquartile Range: 2–7). Participants (N = 24) collectively submitted 177 UTOX during their 3-month CM periods. Rates of non-reactive UTOX results were slightly higher in the partial-abstinence protocol compared to the abstinence from stimulants and opioids protocol (2.9 per month versus 1.0 per month). More bonuses were earned in the partial-abstinence protocol (0.50 bonuses per participant per month) compared to the abstinence from stimulants and opioids protocol (none). There were no study related adverse events in either protocol group during the CM period.

Conclusions: Findings demonstrate the feasibility of a CM protocol that provided financial incentives for partial abstinence, periods with documented stimulant or opioid abstinence, as well as abstinence to both, without the occurrence of iatrogenic effects. Future research focusing on CM protocols with more flexible incentive structures remains critical.

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Journal: Addiction Research & Theory, 2025, doi: 10.1080/16066359.2025 .2530997

Authors: Lois S. Sadler, Sangchoon Jeon, Ahmad Ibrahim, Declan Barry, Uzoji Nwananji-Enwerem, Dustin Scheinost, Henry Yaggi, & Nancy S. Redeker

Abstract:

Objectives: Opioid use disorder (OUD) and its treatment (MOUD) are associated with altered sleep health. The purposes are to (1) describe profiles of sleep health among adults using medication for opioid use disorder (MOUD) and (2) examine the associations between multi-level individual, family, neighborhood, and social characteristics and sleep profiles. We hypothesized that poor quality of life, adverse life experiences, addiction behavior, dysfunctional family and social interactions, and negative neighborhood characteristics are associated with negative profiles of sleep health.

Methods: This study comprised baseline analyses of the NIH/HEAL-funded CLOUDS study (Collaboration Linking Opioid Use Disorder and Sleep). We obtained self-report measures of sleep health and indicators of multi-level individual, family, and neighborhood factors. We identified sleep health profiles with K-means cluster analysis and examined the associations between these multi-level factors and sleep health profiles.

Results: The sample included 165 participants (M age = 42, SD =11.4 years; N = 73/42.2% female; N = 37/22.4% Black or more than one race). We identified four sleep health profiles: Healthy sleep (Profile A; 30.3%); mild insomnia/late sleep timing (Profile B: 20%); clinical insomnia/long sleep (Profile C: 25.5%); and insomnia with excessive daytime sleepiness (Profile D: 23.6%). There were statistically significant differences across sleep profiles in physical and psychological health, addiction use and risk, family function, neighborhood esthetic quality, and perceptions of community support, with more adverse factors associated with poorer sleep health.

Conclusions: Research is needed to understand the causal directions of these relationships and promote multi-level interventions to promote sleep health.

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