Effectiveness of Remote Intensive Counseling Versus Outpatient Counseling in Substance Use Disorders: A Retrospective Cohort Study

Journal: Cureus, 2022, doi: 10.7759/cureus.24167

Authors: Armand Ntchana & Ricky Daley

Abstract:

Background: Substance use disorders are a serious and persistent U.S. public health problem. Although a number of therapy modalities exist, few studies assessed the comparative effectiveness of specific therapies. This study empirically evaluated whether remote intensive counseling (RIC) is more effective than outpatient therapy (OT) in relapse prevention over the period of nine months in patients aged 18-45 years with a history of substance use.

Methods: The current study utilized a retrospective correlational cross-sectional cohort quantitative research design with multiple between-group comparisons and fixed effects. The sample (n=296) included adults of both sexes, of diverse racial/ethnic backgrounds, and of socioeconomic status (SES) between 18-45 years of age who had been using an illicit addictive substance(s) for at least six months prior and had never participated in any treatment program previously. Individuals with alcohol and/or nicotine co-dependence were excluded.

Result and conclusion: Remote intensive counseling (RIC) is more effective for patients aged 18-45 years with a history of substance use than outpatient therapy (OT). RIC works better for single or never married females younger than 30-year-old with higher education. The use of RIC for other age and racial/ethnic groups should be guided by whether patients belong to a younger age cohort and/or a specific race/ethnicity.

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Adverse Childhood Experiences and Comorbidity in a Cohort of People who Have Injected Drugs

Journal: BMC Public Health, 2022, doi: 10.1186/s12889-022-13369-5

Authors: David W. Sosnowski, Kenneth A. Feder, Jacquie Astemborski, Becky L. Genberg, Elizabeth J. Letourneau, Rashelle J. Musci, Ramin Mojtabai, Lisa McCall, Eileen Hollander, Lynnet Loving, Brion S. Maher, Gregory D. Kirk, Shruti H. Mehta & Jing Sun

Abstract:

Background: Childhood adversity is associated with the onset of harmful adult substance use and related health problems, but most research on adversity has been conducted in general population samples. This study describes the prevalence of adverse childhood experiences in a cohort of people who have injected drugs and examines the association of these adverse experiences with medical comorbidities in adulthood.

Methods: Six hundred fifty three adults were recruited from a 30-year cohort study on the health of people who have injected drugs living in and around Baltimore, Maryland (Median age = 47.5, Interquartile Range = 42.3-52.3 years; 67.3% male, 81.1% Black). Adverse childhood experiences were assessed retrospectively in 2018 via self-report interview. Lifetime medical comorbidities were ascertained via self-report of a provider diagnosis. Multinomial logistic regression with generalized estimating equations was used to examine the association between adversity and comorbid conditions, controlling for potential confounders.

Results: Two hundred twelve participants (32.9%) reported 0-1 adverse childhood experiences, 215 (33.3%) reported 2-4, 145 (22.5%) reported 5-9, and 72 (11.1%) reported ≥10. Neighborhood violence was the most commonly reported adversity (48.5%). Individuals with ≥10 adverse childhood experiences had higher odds for reporting ≥3 comorbidities (Adjusted Odds Ratio = 2.9, 95% CI = 1.2 – 6.8, p = .01).

Conclusions: Among people who have injected drugs, adverse childhood experiences were common and associated with increased occurrence of self-reported medical comorbidities. Findings highlight the persistent importance of adversity for physical health even in a population where all members have used drugs and there is a high burden of comorbidity.

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Risky Health Behaviors during the COVID-19 Pandemic: Evidence from the Expenditures on Alcohol, Non-Alcoholic Beverages, and Tobacco Products

Journal: PLoS One, 2022, doi: 10.1371/journal.pone.0268068

Authors: Binod Acharya & Chandra Dhakal

Abstract:

Background: The COVID-19 pandemic has increased mental stress among the population and, at the same time, has lowered consumer income. Alcohol, non-alcoholic beverages, and tobacco consumption are associated with multiple health conditions but the information on how the consumption pattern of these goods shifted during the pandemic remains limited.

Objective: To examine the consumer spending on alcohol, non-alcoholic beverages, and tobacco products during the COVID-19 pandemic compared to the pre-pandemic period.

Design: An observational study utilizing the expenditures data on alcohol, non-alcoholic beverages, and tobacco between 2017 and 2020 obtained from the US Consumer Expenditure Diary Survey.

Participants: 18,808 respondents aged ≥ 21 years who answered the Consumer Expenditure Diary Survey. Main Outcome Measure(s): Bi-weekly expenditure on alcohol, non-alcoholic beverages, and tobacco products.

Analysis: Multivariable linear regression models.

Results: A total of 18,808 respondents (mean [SD] age = 52.5[16.9] years; 53.8% females) were included. Compared to the pre-pandemic levels, household expenditures on alcohol, non-alcoholic beverages, and tobacco products significantly decreased during the pandemic period by 28.6%, 7.9%, and 15.5%, respectively, after controlling for the state-, individual-, and household-level characteristics. Individual age, race/ethnicity, income, and education were significant predictors of spending. Heterogeneities in expenditures were evident across subgroups, with less educated and low-income households cutting their alcohol expenses while the wealthy and more educated consumers spent more during the pandemic.

Conclusions and implications: Household expenditures on alcohol, non-alcoholic beverages, and tobacco products significantly decreased. The results might be beneficial in understanding consumer spending habits concerning risky health behaviors during the period of economic disruption.

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Electronic Nicotine Delivery System (ENDS) Device Types and Flavors Used by Youth in the PATH Study, 2016-2019

Journal: International Journal of Environmental Research & Public Health, 2022, doi: 10.3390/ijerph19095236

Authors: Lisa D. Gardner, Sherry T. Liu, Haijun Xiao, Gabriella M. Anic, Karin A. Kasza, Eva Sharma & Andrew J. Hyland

Abstract:

The evolving electronic nicotine delivery system (ENDS) marketplace and recent regulatory actions may influence youth ENDS device preferences. Using data from Waves (W) 4, 4.5, and 5 (2016-2019) of the nationally representative Population Assessment of Tobacco and Health (PATH) Study, this study estimated the prevalence of open and closed system primary ENDS use by youth (12-17 years) current (past 30-day) ENDS users, and compared demographics, tobacco use characteristics, and patterns of ENDS use, including flavors, by device type. Among current ENDS users, closed system use was significantly higher than open system use in W4.5 (68.3% vs. 31.7%) and W5 (60.5% vs. 39.5%). In W5, closed system users were more likely to have a regular ENDS brand, believe their ENDS had nicotine, and use tobacco and mint or menthol flavors in the past 30 days compared to open system users. In W5, users of closed systems were less likely to use fruit, non-alcoholic drink, and candy, desserts, or other sweets flavors in the past 30 days than users of open systems. Youth were more likely to use closed over open system ENDS in 2017-2019. Differences were observed between device types, particularly with flavor use, reflecting recent changes in flavored product availability.

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Change in College Student Health and Well-Being Profiles as a Function of the COVID-19 Pandemic

Journal: PLoS One, 2022, doi: 10.1371/journal.pone.0267724

Authors: Stephanie T. Lanza, Courtney A. Whetzel, Ashley N. Linden-Carmichael & Craig J. Newschaffer

Abstract:

Objective: The COVID-19 pandemic has potential for long-lasting effects on college students’ well-being. We examine changes from just before to during the pandemic in indicators of health and well-being and comprehensive profiles of health and well-being, along with links between covariates and profiles during the pandemic.

Participants: 1,004 students participated in a longitudinal study that began in November 2019.

Methods: Latent class analysis identified health and well-being profiles at both waves; covariates were included in relation to class membership.

Results: Mental health problems increased, whereas substance use, sexual behavior, physical inactivity, and food insecurity decreased. Six well-being classes were identified at each wave. Baseline class membership, sociodemographic characteristics, living situation, ethnicity, coping strategies, and belongingness were associated with profile membership at follow-up.

Conclusions: COVID-19 has had significant and differential impacts on today’s students; their health and well-being should be considered holistically when understanding and addressing long-term effects of this pandemic.

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