Journal: Journal of Medical Internet Research, 2025, doi: 10.2196/55621
Authors: Rachel Chernick, Amanda Sy, Sarah Dauber, Lindsey Vuolo, Bennett Allen, & Fred Muench
Abstract:
Background: Concerned significant others (CSOs) play a significant role in supporting individuals with substance use disorders. There is a lack of tailored support services for these CSOs, despite their substantial contributions to the well-being of their loved ones (LOs). The emergence of helplines as a potential avenue for CSO support is outlined, culminating in the focus on the Partnership to End Addiction’s helpline service, an innovative public health intervention aimed at aiding CSOs concerned about an LO’s substance use.
Objective: The article analyzes the demographics and use patterns of the Partnership to End Addiction’s helpline service, highlighting the critical role of such services, and advocating for expanded, tailored support models.
Methods: This observational study draws data from 8 data platforms spanning April 2011 to December 2021, encompassing 24,096 client records. Surveys were completed by helpline specialists during synchronous telephone calls or self-reported by CSOs before helpline engagement. Collected information encompasses demographics, interaction language, substance of concern, CSO-LO relationship, and the LO’s “use state,” that is, their location on the continuum of substance use.
Results: CSOs primarily comprised women (13,980/18,373, 76.1%) seeking support for their children (1062/1542, 68.9%). LOs were mostly male (1090/1738, 62.7%), aged 18-25 years (2380/7208, 33%), with primary substance concerns being cannabis (5266/12,817, 40.9%), opioids (2445/12,817, 19%), and stimulants (1563/12,817, 12.1%). CSOs primarily sought aid for LOs struggling with substances who were not in treatment (1102/1753, 62.9%). The majority of CSOs were looking for support in English (14,738/17,920, 82.2%), while the rest (3182/17,920, 17.8%) preferred to communicate in Spanish. Spanish-speaking CSOs were significantly more likely to call about cannabis (n=963, 53.7% vs n=4026, 38.6%) and stimulants (n=304, 16.9% vs n=1185, 11.3%) than English-speaking CSOs (P<.001). On the other hand, English-speaking CSOs were more likely to be concerned about opioids than Spanish-speaking CSOs (n=2215, 21.3% vs n=94, 5.2%; P<.001).
Conclusions: The study illuminates the helpline’s pioneering role in aiding CSOs grappling with an LO’s substance use. It highlights helplines as crucial resources for CSOs, revealing key demographic, substance-related, and use-state trends. The dominant presence of women among users aligns with other helpline patterns and reflects traditional caregiving roles. While parents form a significant percentage of those reaching out, support is also sought by siblings, friends, and other family members, emphasizing the need for assistance for other members of an LO’s social network. Spanish-speaking individuals’ significant outreach underscores the necessity for bilingual support services. Substance concerns revolve around cannabis, opioids, and stimulants, influenced by age and language preferences. The helpline serves as an essential intermediary for CSOs, filling a gap between acute crisis intervention services and formalized health care and treatment services. Overall, the study highlights this helpline’s crucial role in aiding CSOs with tailored, accessible support services.
To read the full text of the article, please visit the publisher’s website.
Journal: JAMA Network Open, 2025, doi: 10.1001/jamanetworkopen .2025.2728
Authors: Kechna Cadet, Bianca D. Smith, & Silvia S. Martin
Abstract:
Importance: There are several apparent research gaps based on the intersectional sociodemographic dimensions of drug-related mortality disparities. Relatively marginal evidence exists on the potential roles of intersecting forms of race and sexual marginalization on the disparities across drug-related mortality.
Objective: To examine intersectional sex-specific White and Black racial disparities in drug poisoning mortality across states from 2010 to 2020.
Design, Setting, and Participants: This cross-sectional study used unintentional fatal drug poisoning mortality data from the Centers for Disease Control and Prevention’s Web-Based Injury Statistics Query and Reporting System. Trends from 2010 through 2020 were analyzed by Black men, Black women, White men, and White women across states. One-sided Mann-Kendall trend analysis was used to examine statistically significant increasing or decreasing trends in age-adjusted mortality rates. Statistical analysis was performed from June to July 2024.
Exposures: White and Black groups intersecting with male and female sex.
Main Outcomes and Measures: Analysis of age-adjusted mortality rates, excess years of potential life lost (reference group: White men), years of potential life lost ratios (reference group: White men), and percentage change to highlight state differences.
Results: From a total sample of 518 724 unintentional fatal drug poisoning deaths (9.0% in Black men, 3.9% in Black women, 29.0% in White women, and 58.1% in White men), 11 820 781 years of potential life lost were recorded. Black men had the highest mean (SD) age-adjusted mortality rate (23.25 [22.65]), followed by White men (22.49 [14.32]), with lower rates for White women (11.71 [5.96]) and Black women (9.01 [8.04]) (P < .001). Compared with White men, both Black men (τ = 0.298, slope = 0.002, intercept = 0.381, P < .001) and Black women (τ = 0.157, slope = 0.0004, intercept = 0.271, P < .001) had worsening YPLL over time, while White women (τ = -0.146, slope = -0.0003, intercept = 0.5252, P < .001) showed improvement in their YPLL over time compared with White men. At the state level, there was a disproportionate burden of deaths due to drug poisonings, with Maryland showing the highest increase in mortality rates among Black men (485.4%), while decreases were observed for White women in states such as Alaska (-23.0%).
Conclusions and Relevance: In this cross-sectional study of overdose deaths, disparities in overdose mortality were evident, with Black men and Black women experiencing a pronounced and increasing burden of mortality compared with their White counterparts. Addressing these disparities will require a multipronged approach targeting the social, physical, economic, and policy risk environments.
To read the full text of the article, please visit the publisher’s website.
Journal: Canadian Journal of Physiology & Pharmacology, 2025, doi: 10.1139/cjpp-2024-0281
Authors: James M. Duerksen, Matthew Ramjiawan, Julia Witt, Shirley Fitzpatrick-Wong, Paramjit S. Tappia, Bram Ramjiawan, … Erin Knight
Abstract:
The growing epidemic of opioid misuse presents numerous challenges for healthcare practitioners and patients alike as friction exists between ease of use and efficacy, and potential for overuse and addiction. With over 82 000 deaths related to opioid overdose in North America in 2020, it is imperative to gain a better understanding of the underlying mechanisms behind the addiction process, as well as the current methods being used in the arsenal against this disease. The current best pharmacological approaches for mediating opioid use disorder are methadone, buprenorphine, naltrexone, and naloxone, which act on opioid receptors to produce diverse effects based upon the patients’ needs. The variety of effects that these drugs produce, which include removing opioid withdrawal, reversing overdose effects, and blocking opioid properties, makes this arsenal of therapeutics a global necessity in addressing the opioid use epidemic. Accordingly, this narrative review provides a summary of the available data regarding the physiological processes by which opioid addiction takes place and discusses the current and future potential of interventional methods used to mitigate opioid use disorder. The mechanisms of action and subsequent functional outcomes must be understood to reduce the number of opioid-related deaths worldwide.
To read the full text of the article, please visit the publisher’s website.
Journal: The Lancet: Regional Health Americas, 2025, doi: 10.1016/j.lana.2025.101075
Authors: Santiago Escobar, Neil J. MacKinnon, Preshit Ambade, Zach Hoffman, & Diego F. Cuadros
Abstract:
Background: The escalating substance use disorder (SUD) crisis in the contiguous United States (US), with rising mortality since 1999, necessitates a spatiotemporal analysis to identify high-risk areas and vulnerable populations. This study examines the geospatial distribution and clustering patterns of SUD mortality, assessing disparities by race and urban-rural status.
Methods: We analyzed county-level ecological data on SUD-related deaths from the Centers for Disease Control and Prevention (CDC) from 2005 to 2020. Using spatial scan statistics, we identified significant clusters of elevated SUD mortality and assessed shifts over time. The analysis stratified results by race (White and Black subpopulations) and urban-rural classification to explore disparities.
Findings: Among 3142 U.S. counties, we identified 27 significant spatiotemporal clusters of elevated SUD mortality, primarily emerging post-2013 and persisting until 2020. The epidemic’s epicenter shifted from the western to the eastern U.S. around 2016. Clusters in the White population (n = 26) had an estimated mortality rate of 28.42 per 100,000 person-years (95% confidence interval [CI]: 28.30-28.54), compared to 14.83 per 100,000 person-years (95% CI: 14.74-14.92) outside clusters. For the Black population (n = 17), the mortality rate was 33.16 per 100,000 person-years (95% CI: 32.80-33.51) within clusters, versus 13.36 per 100,000 person-years (95% CI: 13.14-13.59) outside. Clusters in the Black population emerged later, mostly after 2013, while White clusters followed a pattern similar to the general population. The urban SUD mortality rate was 1.30 per 10,000 per year, while the rural mortality rate was 1.03 per 10,000 per year. Within clusters, urban counties had a mortality rate of 1.61 per 10,000, compared to 0.97 per 10,000 outside. Rural counties had 1.43 per 10,000 in clusters, while non-clustered rural areas had 0.81 per 10,000.
Interpretation: The shifting geographic and racial patterns of SUD mortality underscore the need for targeted, region-specific interventions. The increasing impact on Black populations and urban centers in the East highlights the importance of equitable access to treatment and harm reduction services. Real-time surveillance and tailored urban-rural strategies are essential to mitigate the evolving crisis.
To read the full text of the article, please visit the publisher’s website.
Journal: Scientific Reports, 2025, doi: 10.1038/s41598-025-98153-2
Authors: Lakshmi Kumar, Kasey G. Creswell, Kirk W. Brown, Greta Lyons, & Brooke C. Feeney
Abstract:
Alcohol intoxication can lead to both positive and negative social outcomes, and recent research suggests that alcohol-induced changes in emotion recognition and empathy may underlie these consequences. However, methodological limitations of prior studies make drawing firm conclusions difficult. This study addresses some of these limitations by investigating the acute effects of alcohol on emotion recognition and empathy in a large sample of young adults, using an intoxicating alcohol dose and more ecologically valid tasks. Participants (N = 156, mean age = 22.51 ± 2.16, 31.41% female, 72.44% White) were randomly assigned to groups of 3 unacquainted persons; each group was randomly assigned to drink an alcoholic or placebo beverage together. Participants then completed measures of emotion recognition and empathy. Alcohol (vs. placebo) participants showed impaired recognition of anger (B = -0.18, p < 0.01) but no other specific emotions. They additionally reported higher affective empathy (i.e., how well participants related to another participant) in response to direct interactions with other participants (B = 0.31, p < 0.05). Alcohol and placebo participants did not differ on perceived empathy assessed by a traditional third-person empathy task using static images. These effects held when controlling for covariates. Findings suggest alcohol worsens anger recognition and increases perceptions of relating to another. Results also highlight the importance of considering the nature and reliability of social cognition assessments when examining alcohol intoxication effects.
To read the full text of the article, please visit the publisher’s website.