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Reasons for E-Cigarette Use and Responses to the FDA Nicotine Addiction E-Cigarette Warning among Young Adults Who Use E-Cigarettes
Journal: Addictive Behaviors, 2026, doi: 10.1016/j.addbeh.2026.108784
Authors: Renee E. Magnan, Linda D. Cameron, & Anna V. Song
Abstract:
Purpose: To test the relationships between reasons for using e-cigarettes and responses to the FDA nicotine addiction warning and explore differences in associations by exclusive e-cigarette use versus dual use of e-cigarettes and cigarettes.
Methods: In a within-subjects experiment, young adults who currently used e-cigarettes (N = 353) evaluated 11 e-cigarette advertisements that included the U.S. FDA text addiction warning on a range of cognitive and affective outcomes such as worry about health harms, discouragement to use e-cigarettes, and perceptions of e-cigarettes as a healthy alternative to cigarettes; and they answered questions about their reasons for using e-cigarettes.
Results: Those who dual use reported stronger reasons to reduce cigarettes relative to those using e-cigarettes exclusively. The two groups did not differ on social context or sensory experience reasons for using e-cigarettes. Stronger endorsement of any reason for use was associated positively with higher cognitive and emotional responses across most responses to the FDA e-cigarette warning, and this was most consistent for social context reasons to use. Use group moderated this relationship, particularly for endorsement of social context reasons, such that those who exclusively used had stronger responses to the warning.
Discussion: Use motivations could be helpful in tailoring health communications for youth and young adults so that they help mitigate e-cigarette marketing strategies that target this vulnerable population.
Implications and contribution statement: Young adults who use e-cigarettes do so for a number of reasons. Reasons for using e-cigarettes may contribute to how young adults who use e-cigarettes respond to e-cigarette health warnings. Consideration of reasons to use e-cigarettes could contribute to approaches to educate and inform about health harms of e-cigarettes.
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Pharmacokinetics of Xylazine and Fentanyl in Patients Presenting to the Emergency Department after Non-Fatal Opioid Overdose
Journal: Drug and Alcohol Dependence, 2026, doi: 10.1016/j.drugalcdep. 2026.113228
Authors: Alex J. Krotulski, Michael H. Baumann, Brittany P. Chapman, Patricia Mae E. Martinez, John P. Broach, … & Kavita M. Babu
Abstract:
Background: Xylazine is an alpha-2 agonist found as an adulterant in illicitly-manufactured fentanyl. Little information is available about its pharmacokinetics in humans. We conducted a naturalistic study with thirteen adult patients presenting to two urban, tertiary care emergency departments for suspected opioid overdose and concomitant xylazine exposure.
Methods: This study was conducted at two US emergency departments in Worcester, MA. Serial blood specimens were collected over 4h at 30-60min intervals for pharmacokinetic analyses. We developed a quantitative analytical method to measure the blood concentration of xylazine and its metabolites, fentanyl and its metabolite, and medetomidine and its metabolite.
Results: All thirteen participants had detectable concentrations of xylazine and fentanyl in their blood; five participants also had medetomidine present. Initial blood concentrations (mean±SD, ng/mL) were 47 ± 53 for xylazine, 14 ± 15 for fentanyl, 23 ± 19 for norfentanyl, and 25 ± 24 for medetomidine. Data from a subset of eight participants were used to calculate drug half-lives (t1/2) (mean±SD, min): 345 ± 145 for xylazine and 537 ± 451 for fentanyl.
Conclusion: The elimination t1/2 of xylazine in these opioid overdose participants was considerably longer than predicted from veterinary data. The fentanyl t1/2 values were within the upper range reported in the literature. Understanding the pharmacokinetics of xylazine is vital for projecting outcomes of xylazine exposed patients and could allow for improved interpretation in forensic analyses. The quantitative assay we developed for xylazine and its metabolites is suitable for clinical research.
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Geographic Availability and Use of Medications for Opioid Use Disorder Among Medicaid Enrollees
Journal: JAMA Health Forum, 2026, doi: 10.1001/jamahealthfom.2026.1934
Authors: Coleman Drake, Michael Sharbaugh, Dylan Nagy, Joo Yeon Kim, Crystal Zang, Katherine A. Ahrens, … & Julie M. Donohue
Abstract:
Importance: There are large racial and ethnic differences in the use of medications for opioid use disorder (MOUD). Whether differences in geographic availability of MOUD providers (defined in this study as buprenorphine prescribers, methadone dispensing opioid treatment programs, and naltrexone prescribers) contribute to these differences in Medicaid is unknown.
Objective: To examine differential geographic availability of MOUD in Medicaid and whether it is associated with MOUD use.
Design, setting, and participants: This cross-sectional study analyzed the geographic availability of Medicaid prescribers of MOUD in 2021, spanning 10 states (Delaware, Kentucky, Maryland, Maine, Michigan, North Carolina, Pennsylvania, Tennessee, Virginia, and West Virginia) in the Medicaid Outcomes Distributed Research Network. The study population included Medicaid enrollees aged 18 to 64 not enrolled in Medicare and their MOUD providers. The data analysis was conducted from December 2022 to April 2026.
Exposures: Geographic availability was measured at the zip code level (number of MOUD providers available in Medicaid within a 15-minute drive time per 100 Medicaid enrollees).
Main outcomes and measures: Main outcomes included the probability of buprenorphine, methadone, and naltrexone use as a function of enrollee race and ethnicity, whether they had above-median geographic availability, and interactions between above-median geographic availability and race and ethnicity.
Results: The sample included 8 081 899 Medicaid enrollees; 472 409 (5.8%) had an OUD diagnosis. The population was 58.7% female and 41.3% male. Among the study population, 11.7% were aged 18 to 20 years, 39.5% were aged 21 to 34 years, 21.4% were aged 35 to 44 years, 14.5% were aged 45 to 54 years, and 12.9% were aged 55 to 64 years. Overall, 7.3% of the sample were Hispanic enrollees, 27.4% were non-Hispanic Black enrollees, 56.2% were non-Hispanic White enrollees, and 7.2% were enrollees from other racial and ethnic groups. Overall, 13 575 buprenorphine prescribers, 516 methadone dispensers, and 4801 naltrexone prescribers billed Medicaid. Median Medicaid MOUD providers available within a 15-minute drive were 0.89 per 100 enrollees for buprenorphine, 0.03 for methadone, and 0.32 for naltrexone. Above-median geographic availability of methadone was associated with a 0.99 (95% CI, 0.54-1.42)-percentage point increase in methadone use for non-Hispanic White enrollees; there was no such increase for non-Hispanic Black or Hispanic enrollees. Evidence of similar differences was limited for naltrexone. Above-median availability of buprenorphine was not associated with increased use of MOUD for any racial or ethnic group.
Conclusions and relevance: In this cross-sectional study of 10 state Medicaid programs, greater geographic availability of MOUD was associated with increased use only for methadone and, to a lesser extent, naltrexone. No racial and ethnic groups experienced gains in use associated with improved access. Additional strategies beyond addressing geographic access may be needed to close racial and ethnic gaps in MOUD.
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Changes in Exposures of US Children Ages 12 and Under to Cannabis from 2000 to 2024
Journal: Journal of Addiction Medicine, 2026, doi: 10.1097/ADM.000000 0000001720
Authors: Raymond E. Bertino, Ryan Feldman, & Jerrold B. Leikin
Abstract:
Objectives: In the United States, significant federal cannabis policy changes occurred in 2009, 2013, and in 2018. This study reviews trends in reported cannabis exposures to children in light of those policy changes.
Methods: Retrospective descriptive observational time-trend analysis. Secondary analysis of annual data from US poison centers. Participants were cases reported to US poison centers and entered in the National Poison Data System from 2000 to 2024. Rates of pediatric cannabis exposures reported to America’s Poison Centers are given, along with trends in those exposures.
Results: Reported pediatric exposures of the under-6-year age group to cannabis were stable from 2000 to 2009. Starting in 2010, exposures began to increase, with the rise continuing to 2024, the most recent year of data availability. Between 2009 and 2024, such exposures increased by 6386% from 132 to a total of 8430 exposures. Cannabis exposures in the 6-12 age group also increased during the same period (increase from 21 to 2894; 13,781%).
Conclusions: There was an increase of more than 6000% in reported pediatric exposures to cannabis in the United States between 2009 and 2024 in both the under-6 and the 6-12 years age groups. This rise is temporally associated with changes in federal cannabis policy that began in 2009. Because of the negative effects on children’s health, public health policy adjustments are warranted.
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Results from a Peer Recovery Coach-Delivered Future Orientation Intervention for Returning Citizens in Substance Use Treatment: Feasibility and Preliminary Outcomes
Journal: Health Justice, 2026, doi: 10.1186/s40352-026-00427-y
Authors: Salam Sulaiman, Richard Yi, Jennifer E. Johnson, Andre Johnson, Ashley Kucera, Jaclyn M. Johnson, … & Julia W. Felton
Abstract:
Introduction: Returning citizens with substance use disorders (SUD) make numerous decisions that involve engaging in behaviors with short-term, immediate rewards (i.e. the pleasurable effects of returning to use) relative to those with longer-term, but delayed, benefits (i.e. engaging in treatment), often in the context of resource-poor and unstable environments. Successful navigation of the reentry period may require making future-oriented decisions; yet previous research suggests that incarcerated individuals and those with SUD evidence steeper rates of delay discounting, or tendency to devalue something as a function of the delay of its receipt. Episodic future thinking has been shown to reduce delay discounting and improve decision-making, suggesting it may be particularly well-suited to support healthy decision-making among justice-involved populations. The current study evaluated the implementation potential and preliminary effectiveness of an episodic future thinking intervention adapted for individuals during the reentry period to reduce delay discounting and improve related clinical outcomes.
Method: Returning citizens (n = 40) who identified as in recovery from SUD and had experienced incarceration within 12 months prior to enrollment were recruited to participate in a randomized controlled trial. Participants received either a brief (60-min) adapted episodic future thinking intervention or a control intervention that did not activate future thinking. Both interventions were administered by a peer recovery coach in a community setting. Participants then completed weekly check-ins for up to four weeks and were assessed one month after the intervention.
Results: Findings suggest that peer-delivered episodic future thinking was feasible and acceptable, and could be delivered with fidelity. Additionally, participants in the active condition experienced significant decreases in delay discounting, significant increases in considerations of future consequences, and increases in the presence of protective factors that may support longer-term recovery. Participants in the control condition did not experience changes in clinically-relevant outcomes.
Conclusion: Results of this study provide preliminary support for the implementation potential and effectiveness of brief, peer-delivered intervention focused on improving decision-making during the reentry period.
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Published
July 2026