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    Research News Roundup: November 30, 2023

    Factors Associated with Indirect Exposure to and Knowledge of Fentanyl Among Youth

    Journal: Journal of Adolescent Health, 2023, doi: 10.1016/j.jadohealth.2023.08.040

    Authors: Jennifer I. Manuel, Daniel Baslock, Tania DeBarros, Teresa Halliday, Pam Pietruszewski, Alexandra Plante, … Victoria Stanhope


    Purpose: Using data from an online assessment of youth in the United States, this study examined factors associated with youth’s indirect exposure to fentanyl; factors related to youth’s level of knowledge of fentanyl; and sources of substance use information obtained by youth.

    Methods: This is a secondary analysis of data from a cross-sectional online assessment of youth ages 13 to 18 in the United States in 2022. Participants self-reported on substance use knowledge and concerns, indirect exposure to substance use, access to substance use information and resources, the extent to which youth discussed drug use harms with someone, and COVID-related stress.

    Results: Analyses revealed that most youth did not have knowledge of fentanyl even though they reported indirect likely exposure to fentanyl. Youth concerned about alcohol or drug use in their own life were less likely to have knowledge of fentanyl and more likely to know someone who, if using drugs, would likely be exposed to fentanyl. A significant risk factor of indirect likely exposure to fentanyl was COVID-related stress. Prevalent sources of information included the internet, social media, friends or peers, and school classes.

    Discussion: While youth may have close proximity to fentanyl exposure and a degree of understanding of fentanyl, there is a general lack of knowledge of the substance, a critical gap that future substance use prevention initiatives could fill.

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

    Accelerating Solutions for the Overdose Crisis: An Effectiveness-Implementation Hybrid Protocol for the HEAL Prevention Cooperative

    Journal: Prevention Science, 2023, doi: 10.1007/s11121-022-01465-2

    Authors: S. V. Patel, J. D. Cance, E. E. Bonar, P. M. Carter, D. L. Dickerson, L. E. Fiellin, C. S. F. Fernandes, … B. H. Lambdin


    Given increasing opioid overdose mortality rates in the USA over the past 20 years, accelerating the implementation of prevention interventions found to be effective is critical. The Helping End Addiction Long-Term (HEAL) Prevention Cooperative (HPC) is a consortium of research projects funded to implement and test interventions designed to prevent the onset or escalation of opioid misuse among youth and young adults. The HPC offers a unique opportunity to synthesize and share lessons learned from participating research projects’ varied implementation experiences, which can facilitate quicker integration of effective prevention interventions into practice. This protocol paper describes our hybrid approach to collecting and analyzing information about the implementation experiences of nine of the HPC research projects while they maintain their focus on assessing the effectiveness and cost-effectiveness of prevention interventions. To better understand implementation within this context, we will address five research questions: (1) What were the context and approach for implementing the prevention interventions, and how was the overall implementation experience? (2) How representative of the target population are the participants who were enrolled and retained in the research projects’ effectiveness trials? (3) For what purposes and how were stakeholders engaged by the research projects? (4) What are the adaptable components of the prevention interventions? And finally, (5) how might implementation of the prevention interventions vary for non-trial implementation? This work will result in intervention-specific and general practical dissemination resources that can help potential adopters and deliverers of opioid misuse prevention make adoption decisions and prepare for successful implementation.

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

    Chronic Disease as a Risk Factor for Cigarette and E-Cigarette Use from Young Adulthood to Adulthood

    Journal: Preventive Medicine Reports, 2023, doi: 10.1016/j.pmedr.2023.102473

    Authors: Marshall K. Cheney, Hairong Song, Shristi Bhochhibhoya, & Yu Lu


    Chronic disease prevalence in young adults is increasing with 15-20 % reporting 1 or more chronic diseases. This study examined cross-sectional and prospective relationships between chronic disease and e-cigarette/cigarette use from young adulthood to adulthood utilizing the U.S.- based National Longitudinal Study of Adolescent to Adult Health (Add Health). Add Health Study wave 3 (2001-2002; ages 18-26), wave 4 (2008; ages 24-34), and wave 5 (2016-2018; ages 33-44) were used. Past 30-day cigarette use at waves 3-5 and past 30-day e-cigarette use at wave 5 were assessed. Two measures of chronic disease were used: asthma (yes/no) and non-asthmatic chronic disease (yes/no) composed of 7 additional chronic diseases (diabetes, migraine, heart problem, hepatitis B/C, high blood pressure, epilepsy, and cancer). Weighted multilevel logistic regression (controlling for age, race/ethnicity, gender, and education) was used to assess cross-sectional associations at wave 3, and then prospective associations of wave 3 chronic disease (asthma and non-asthmatic) with waves 4 and 5 cigarette and wave 5 e-cigarette use. Logistic regressions showed no significant cross-sectional or prospective relationships between asthma and cigarette and e-cigarette use. However, wave 3 non-asthmatic chronic disease was significantly associated with wave 4 cigarette use (aOR 1.38, p <.001, 95 % CI: 1.15, 1.65) and with wave 5 cigarette use (aOR 1.49, p <.001, 95 % CI: 1.21, 1.84) but not e-cigarette use. The association between chronic disease in young adulthood and tobacco use in adulthood differed by type of chronic disease and tobacco product, indicating the need for targeted interventions.

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

    Mindfulness and Clinical Correlates in Methamphetamine Use Disorder

    Journal: Drug and Alcohol Dependence, 2023, doi: 10.1016/j.drugalcdep.2023.111029

    Authors: Olivia Jarrett, Edythe D. London, Tarannom Mahmoudie, Jaymee Suh, Dara Ghahremani, & Andy C. Dean


    Background: Mindfulness-based interventions are increasingly used for the treatment of substance use disorders, including methamphetamine use disorder (MUD). Literature indicates that trait mindfulness may play a key role in the effectiveness of these treatments on therapeutic outcome, yet no prior studies have tested for differences in trait mindfulness between individuals with MUD and healthy control participants. Such differences are important for treatment implementation.

    Objectives: The goals of this study were to evaluate trait mindfulness and to determine its clinical correlates in individuals with MUD.

    Methods: A group of participants with MUD at varying lengths of abstinence from methamphetamine (< 1 h to 90 days; mean 5.4 ± 12.5 days; N=95, 53 female, 42 male) and a healthy control group (N=65, 30 female, 35 male) completed the Mindfulness Attention Awareness Scale (MAAS). Group differences and relationships between trait mindfulness and several measures of drug use and psychiatric symptoms were evaluated.

    Results: In participants with MUD, trait mindfulness was 10% lower than in healthy controls (p < 0.001), but it was not significantly correlated with measures of drug use or craving. Across both groups, trait mindfulness was negatively correlated with state anxiety, depression, emotional dysregulation, impulsivity, and a history of childhood trauma, while it was positively correlated with self-compassion (ps < 0.001).

    Conclusion: The deficit in trait mindfulness in MUD presents a capacity that can be targeted for improved treatment outcome with mindfulness-based therapies. Trait mindfulness is inversely related to mood dysregulation.

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

    Prevalence of Fentanyl in Methamphetamine and Cocaine Samples Collected by Community-Based Drug Checking Services

    Journal: Drug and Alcohol Dependence, 2023, doi: 10.1016/j.drugalcdep.2023.110985

    Authors: Karla D. Wagner, Phillip Fiuty, Kimberly Page, Erin C. Tracy, Maryalice Nocera, Colin W. Miller, Lina J. Tarhuni, & Nabarun Dasgupta


    Background: Overdose deaths involving stimulants and opioids simultaneously have raised the specter of widespread contamination of the stimulant supply with fentanyl.

    Methods: We quantified prevalence of fentanyl in street methamphetamine and cocaine, stratified by crystalline texture, analyzing samples sent voluntarily to a public mail-in drug checking service (May 2021-June 2023). Samples from 77 harm reduction programs and clinics originated in 25 US states. Sample donors reported expected drug and physical descriptions. Substances were identified by gas chromatography-mass spectrometry. Negative binomial models were used to calculate fentanyl prevalence, adjusting for potential confounders related to sample selection. We also examined if xylazine changed donors’ accuracy of detecting fentanyl.

    Results: We analyzed 718 lab-confirmed samples of methamphetamine (64%) and cocaine (36%). The adjusted prevalence of fentanyl was 12.5% (95% CI: 2.2%, 22.9%) in powder methamphetamine and 14.8% (2.3%, 27.2%) in powder cocaine, with notable geographic variation. Crystalline forms of both methamphetamine (Chisq=57, p<0.001) and cocaine (Chisq=18, p<0.001) were less likely to contain fentanyl: less than 1% of crystal methamphetamine (2/276) and no crack cocaine (0/53). Heroin was present in 6.6% of powder cocaine samples. Xylazine reduced donors’ ability to detect fentanyl, with correct classification dropping from 92% to 42%.

    Conclusions: Fentanyl was detected primarily in powder forms of methamphetamine and cocaine. Recommended interventions include expanding community-based drug checking, naloxone and fentanyl test strip distribution for people who use stimulants, and supervised drug consumption sites. New strategies to dampen variability in street drug composition are needed to reduce inadvertent fentanyl exposure.

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


    November 2023