Research News Roundup: February 6, 2025

Journal: Addictive Behaviors, 2025, doi: 10.1016/j.addbeh.2025.108259

Authors: Jad Hamaoui, Nina Pocuca, Mikaela Ditoma, Camille Héguy, Cléa Simard, Raphael Aubin, Anastasia Lucic, & Natalie Castellanos-Ryan

Abstract:

Background: The association between the age of cannabis use (CU) onset and substance use (SU) problems has been extensively studied, yet findings remain inconsistent.

Aims: This systematic review aimed to examine prospective studies on the association between age of CU onset and later SU problems, controlling for key individual, social, and SU-related risk factors.

Methods: PsycINFO, Web of Science and PubMed were searched for studies published between January 2000 and December 2024. Studies were included if they: 1) were prospective; 2) measured CU onset during adolescence; 3) measured CU or SU problems after CU onset, 4) examined whole plant or phytocannabinoids. Studies were excluded if they exclusively focused on high-risk samples. Risk of bias was assessed using the Risk of Bias in Non-randomised Studies-of Interventions tool. The review was registered with PROSPERO, number CRD42022332092.

Results: Sixteen studies met eligibility criteria. Earlier age of CU onset was associated with CU disorder (CUD) and CU negative consequences, with mixed findings for other SU problems (e.g., alcohol). CU frequency accounted for a significant portion of the risk for CU negative consequences, but the association with CUD remained independent of frequency. Only one study had low risk of bias, while seven had some concerns, and eight had a high or very high risk of bias.

Conclusions: Findings suggest that early age of CU onset is a specific risk factor in the development of CUD, but not other SU problems. Prevention approaches should aim to delay the onset and reduce the frequency of CU among youth to reduce risk of the development of CUD.

To read the full text of the article, please visit the publisher’s website.

Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen .2024.56253

Authors: Leslie W. Suen, Amy Y. Chiang, Benjamin L. H. Jones, Christine S. Soran, Michelle Geier, Hannah R. Snyder, … Phillip O. Coffin

Abstract:

Importance: The rise of high-potency opioids such as fentanyl makes buprenorphine initiation challenging due to the risks of precipitated withdrawal, prompting the exploration of strategies, such as low-dose initiation (LDI) of buprenorphine. However, no comparative studies on LDI outcomes exist.

Objective: To evaluate outpatient outcomes associated with 2 LDI protocols of buprenorphine among individuals with opioid use disorder (OUD) using fentanyl.

Design, Setting, and Participants: This cohort study analyzed data on adults with OUD who self-reported daily fentanyl use and underwent buprenorphine initiation using LDI. Data were extracted from the electronic health records of 2 substance use disorder treatment clinics using a specialty behavioral health pharmacy in San Francisco, California, from May 2021 to November 2022.

Exposures: Type of LDI protocol selected by individuals: 4-day or 7-day protocol.

Main Outcomes and Measures: The primary outcome was successful buprenorphine initiation, defined as self-reported LDI completion and pickup of a refill maintenance prescription, and buprenorphine retention. Logistic regression with generalized estimating equations assessed associations between LDI protocol (4-day vs 7-day) and successful initiation, adjusting for multiple attempts, age, gender identity, race and ethnicity, and housing status. Kaplan-Meier survival curves were used to estimate buprenorphine retention, and survival curves were adjusted using a fitted Cox proportional hazards regression model.

Results: A total of 126 individuals (median [IQR] age, 35 [29-44] years; 90 identified as men [71%]; 26 [21%] identified as Black or African American, 20 [16%] as Latine, and 66 [52%] as White individuals) with 175 initiation attempts were included. Across attempts, 72 (41%) had a 4-day LDI protocol and 103 (59%) had a 7-day protocol. Initiation was successful in 60 attempts (34%), including 27 (38%) among 4-day protocol and 29 (28%) among 7-day protocol attempts. Buprenorphine retention rate at 28 days was 21% for a 4-day protocol and 18% for a 7-day protocol. Logistic regression found no significant differences between LDI protocols and successful initiation, while repeated LDI attempts had lower odds of success (second attempt: adjusted odds ratio [AOR], 0.30 [95% CI, 0.14-0.66]; third or more attempt: AOR, 0.22 [95% CI, 0.09-0.53]). Unadjusted and adjusted survival models did not detect a significant difference in retention between LDI protocol types.

Conclusions and Relevance: This cohort study found that among people with OUD using fentanyl and attempting outpatient LDI of buprenorphine, successful buprenorphine initiation and retention rates were low. Future studies should examine interventions to improve LDI success and increase buprenorphine uptake and retention.

To read the full text of the article, please visit the publisher’s website.

Journal: Journal of the American Academy of Child & Adolescent Psychiatry, 2025, doi: 10.1016/j.jaacop.2025.01.002

Authors: Zachary W. Adams, Trey V. Dellucci, Jon Agley, Kristina Bixler, Maggie Sullivan, Jesse D. Hinckley, & Leslie A. Hulvershorn

Abstract:

Objective: Substance use disorders (SUDs) often develop during adolescence, forecasting myriad health problems across the lifespan. Implementing responsive clinical services requires information about the prevalence of SUDs by age, substance class, and severity. However, no reports have summarized those data using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.

Method: Using 2022 National Survey on Drug Use and Health (NSDUH) data from participants aged 12-25 years (n = 26,276), the prevalence and severity of DSM-5 SUDs was estimated across age cohorts (ages: 12-13, 14-15, 16-17, 18-20, 21-25) via χ2 tests of independence. Cramer’s V (φc) was also calculated for each outcome to approximate the effect size between age group and substance use outcome.

Results: Although past year rates for alcohol and cannabis use were higher overall as age cohort increased, the prevalence of disordered use and proportional distribution of SUD severity (mild, moderate, severe) did not differ across age cohorts among those who used alcohol (φc = .04) and cannabis (φc = .04) in the past year. Conversely, the prevalence and severity of SUDs generally varied across age groups among those who reported past year use of less commonly used substances (heroin, methamphetamine).

Conclusion: Meeting criteria for an SUD was common among youth with past-year substance use. Allocation of developmentally appropriate prevention and treatment resources should account for the distribution of mild to severe SUDs across adolescence. The field will likely benefit from further study of these issues in diverse samples.

To read the full text of the article, please visit the publisher’s website.