Journal: Journal of Public Health, 2025, doi: 10.1007/s10389-025-02532-y
Authors: Jamie V. Saunt, & Carina N. Montoya
Abstract:
Background: The intersection of substance use disorder (SUD) among pregnant and parenting women (PPW) and the child welfare system is a topic that spans multiple systems, including child welfare, public health, and SUD treatment. Some components of this multi-systemic issue have been addressed through various research initiatives, but they are siloed in their approaches. This article provides an overarching summary of existing research by reviewing the literature on PPW with SUD and how current policies impact their experiences within the child welfare system. This scoping review identifies key patterns, challenges, and outcomes faced by this vulnerable population, highlighting the profound implications for both mothers and their children.
Methods: Searching in five databases yielded 93 studies for inclusion, broken down into general categories of systems involvement, removal, treatment and relapse risk, and marijuana/alcohol in pregnancy.
Results: Findings indicate that substance use significantly exacerbates legal, social, and moral challenges for women, leading to high rates of child removal and placement in out-of-home care. In addition, the complexities of managing SUD during pregnancy while navigating multiple systems with inherent structural stigma are explored.
Conclusion: This review underscores the necessity for targeted interventions and support systems to mitigate adverse outcomes for both mothers and children. Through identification of both systemic intersections and personal experiences, this review provides essential insights and recommendations for future practice, policy, and research to better support PPW with SUD within the child welfare systems framework.
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Journal: Journal of Primary Care & Community Health, 2025, doi: 10.1177/21501319 251346102
Authors: Sunday Azagba, Galappaththige S. R. de Silva, & Todd Ebling
Abstract:
Adverse childhood experiences (ACEs) can have lasting effects into adulthood. This study examines the relationship between ACEs and the frequency of substance use among high school students in the United States. Data were drawn from the 2023 Youth Risk Behavior Survey, a nationally representative survey of high school students. A cumulative ACE score was calculated based on 8 self-reported lifetime experiences. Multinomial logistic regression models were used to analyze the association between cumulative ACEs and substance use (alcohol, binge drinking, cannabis, and e-cigarettes). A significant positive association was found between cumulative ACEs and substance use. Higher ACE scores were associated with greater odds of substance use across all categories. Specifically, cumulative ACEs were associated with more frequent alcohol use (OR = 1.89, 95% CI = 1.48, 2.43), binge drinking (OR = 1.69, 95% CI = 1.40, 2.05), cannabis use (OR = 1.81, 95% CI = 1.65, 1.99), and e-cigarette use (OR = 1.89, 95% CI = 1.78, 2.00). Similar results were observed for occasional alcohol use (OR = 1.47, 95% CI = 1.31-1.66), binge drinking (OR = 1.53, 95% CI = 1.36-1.72), cannabis use (OR = 1.26, 95% CI = 1.01-1.57), and e-cigarette use (OR = 1.60, 95% CI = 1.32-1.94). This study highlights the significant associations between ACEs and substance use behaviors among adolescents. Addressing ACEs through comprehensive strategies, such as fostering supportive relationships, may be beneficial and promote healthier development.
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Journal: Addictive Behaviors, 2025, doi: 10.1016/j.addbeh.2025.108400
Authors: Veronica Szpak, Joji Suzuki, Reinout W. Wiers, & René Freichel
Abstract:
Background: Opioid use disorder (OUD) is a complex diagnosis characterized by symptoms such as craving, tolerance, withdrawal, and impaired social, occupational, or recreational activities. However, there is a lack of data about the interconnectedness of these symptoms, in particular the links between withdrawal symptoms and psychosocial impairment. The present study uses symptom network analysis to better understand these associations surrounding heroin use.
Methods: We used data from individuals who reported heroin use during the past 12 months in the National Survey on Drug Use and Health (NSDUH) (year 2021, n = 207). We estimated a cross-sectional network that included heroin use-related aspects, including coping and withdrawal symptoms, consequences, loss of control, craving, and dependence symptoms. To examine key ‘bridge nodes’ that connect these different clusters, we computed a measure of bridge expected influence for each node.
Results: The network model revealed several symptom connections within and between clusters. The withdrawal symptom, sleep problems, had the strongest bridge centrality. The dependence symptom “increased use for an effect”, was a key bridge node connecting to withdrawal symptoms and consequences. Craving was connected with two withdrawal symptoms (depressed mood and sweating). Additional symptom connections emerged between the loss of control and other dependence symptom nodes.
Conclusions: Our network analysis model provides additional insight into how heroin use symptoms and relevant characteristics are interconnected. Craving and loss of control (time spent using, amount of use) map onto specific withdrawal symptoms.
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Journal: Social Science & Medicine, 2025, doi: 10.1016/j.socscimed.2025 .118196
Authors: Cynthia M. Lakon, Cheng Wang, John R. Hipp, & Carter T. Butts
Abstract:
Social network-based adolescent substance use interventions have demonstrated potential for reducing adolescent cigarette smoking. This approach is premised upon leveraging youths’ social networks for the diffusion of peer influence. Determining which adolescents to select in network interventions for reducing smoking is a major consideration. We utilize a simulation approach that first estimates Stochastic Actor-Oriented models (SAOM) of adolescent smoking using data from two of the largest schools from the longitudinal saturation sample of the National Study of Adolescent to Adult Health (Add Health) (n = 3,154). We then conduct Agent-Based Simulation models which mimic the consequences of intervention strategies selecting adolescents in network positions and structures that are salient for smoking and the diffusion of peer influence within school-based networks, and we select adolescents smoking at different levels. Our findings indicate that selecting adolescents occupying central network positions yielded the greatest reductions in the number of smokers in a school, one year post intervention. Moreover, our findings indicate that in the school with the higher smoking prevalence, there was a beneficial network multiplier effect one year later, which resulted in more non-smokers than those smokers initially intervened upon. When examining the effects of varying the magnitude of peer influence, we find that targeting central positions in networks led to even greater decreases in smoking in schools with higher levels of peer influence. Our findings highlight interdependence and sensitivity of peer influence to network position and have implications for informing school-based network interventions for adolescent smoking.
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