Journal: Frontiers in Public Health, 2025, doi: 10.3389/fpubh.2025.1512529
Authors: Nicole P Porter, Sean Dunnsue, Cori Hammond, Molly Bobek, Alexandra MacLean, Mari Watkins, Craig E. Henderson, & Aaron Hogue
Abstract:
Introduction: Research, clinical wisdom, and government policy recommend family involvement in services for young adult (YA) opioid use disorder (OUD) to improve treatment outcomes. Moreover, research suggests YAs believe that family involvement is essential to OUD treatment and prefer greater involvement of their concerned significant others (CSOs), such as family members, romantic partners, and family-of-choice members in their care. Yet, CSOs are not routinely involved in OUD services for YAs. The main aim of this qualitative study is to learn from CSOs and YAs directly about their thoughts, beliefs, attitudes, and experiences with family-involved services.
Method: We used convenience sampling to recruit 10 YAs (ages 24-36 years) who were in treatment for OUD and their CSOs (5 mothers, 2 grandmothers, 2 partners, 1 aunt) from two urban treatment centers. Using semi-structured interview guides, we conducted qualitative interviews with YAs and their CSOs to explore their experiences, feelings, and attitudes toward family involvement in services. Thematic content analysis started with deductive-dominant group consensus coding followed by matrix analysis to analyze themes in the context of CSO-YA dyads.
Results: We identified five main themes: (1) CSO-YA relationships were resilient and motivated treatment and recovery, (2) CSOs believed in the importance of family involvement in services and experienced personal benefits by participating, (3) CSO involvement occurred on a continuum from facilitating treatment entry to systemic family therapy, (4) YAs identified CSOs who were supportive and encouraging of treatment even in the face of CSO barriers and challenges, and (5) YAs held accurate perceptions of their CSOs’ MOUD attitudes and beliefs.
Discussion: In this qualitative study we learned from YAs and CSOs themselves about the individual and relational benefits of family integration in services and replicated findings from previous research highlighting preferences for greater family involvement in OUD services. Clinical implications and recommendations for challenging barriers to relationship-oriented services and recovery planning for OUD are discussed.
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Journal: Maternal Health, Neonatology and Perinatology, 2025,
doi: 10.1186/s40748- 025-00216-9
Authors: Katelyn Sainz, Hollie Ulibarri, Amanda Arroyo, Daniela Gonzalez Herrera, Brooke Hamilton, Kate Ruffley, McKenna Robinson & Greg J. Marchand
Abstract:
Importance: Following expansive legalization of cannabis in many parts of the United States, cannabis use in pregnancy has increased several fold. There is a pressing need to understand the maternal and neonatal outcomes associated with this exposure.
Objective: To quantify the maternal and neonatal outcomes of mothers using cannabis during pregnancy.
Data sources: We searched five databases for all relevant observational studies, from each database’s inception until March 1st 2024.
Study selection: Two reviewers separately screened the studies in duplicate. Our initial search yielded 5184 studies, of which 51 (0.98%) were included in our qualitative synthesis.
Data extraction and synthesis: Our study adhered to PRISMA guidelines and independent extraction by two researchers was utilized. We used a 95% confidence interval and the random effects model, as there was significant heterogeneity between studies.
Results: The 51 included studies yielded a total population of 7,920,383 pregnant women. Cannabis consumption was associated with increased risks of low birth weight (RR = 1.69,95% CI = (1.34,2.14),P < 0.0001), small for gestational age (RR = 1.79,95% CI = (1.52, 2.1),P < 0.00001), major anomalies (RR = 1.81,95% CI = (1.48, 2.23),P < 0.00001), decreased head circumference (MD = -0.34,95% CI = (-0.57,-0.11),P = 0.004), birth weight (MD = -177.81,95% CI = (-224.72,-130.91),P < 0.00001), birth length (MD = -0.87,95% CI = (-1.15,-0.59),P < 0.00001), gestational age (MD = -0.21,95% CI = (-0.35,-0.08),P = 0.002), NICU admission (RR = 1.55,95% CI = (1.36,1.78),P < 0.00001), perinatal mortality (RR = 1.72,95% CI = (1.09,2.71),P = 0.02), and preterm delivery (RR = 1.39,95% CI = (1.23,1.56),P < 0.00001). Cannabis use was also associated with a decreased risk of gestational diabetes in pregnancy (RR = 0.64,95% CI = (0.55,0.75),P < 0.00001).
Conclusions: Inclusion of the latest published data continues to show worse maternal and neonatal outcomes for mothers using cannabis in pregnancy.
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Journal: BMC Psychiatry, 2025, doi: 10.1186/s12888-025-07132-4
Authors: Mandy D. Owens, Addy Adwell, Samyukta Singh, Karen Osilla, Megan Tweedy, & Judith Tsui
Abstract:
Background: Medications for opioid use disorder (MOUD) are frontline treatments for opioid use disorder, but retention is low. Community Reinforcement and Family Training (CRAFT) is an evidence-based intervention with concerned significant others (CSOs; family, friends) that improves treatment engagement among people with substance use disorder, but is rarely available. This study aimed to assess the interest in and preferences for a CRAFT-based intervention among CSOs of patients receiving MOUD.
Methods: Patients receiving MOUD were recruited from outpatient clinics to complete a brief survey to identify CSOs who might be willing to give feedback on a CRAFT-based group. CSOs who agreed to participate were interviewed virtually using a semi-structured guide assessing preferences for a group intervention.
Results: Over half of patient participants (n = 28/48; 58%) listed a CSO. Of n = 36 CSOs contacted, fourteen (39%) completed interviews. Interviews were transcribed and coded using thematic analysis on reasons for participating and preferences for the group. All interviewed CSOs were interested in doing the group, with the most common reasons being to learn skills, get evidence-based education, and interact with others in similar situations. Most CSOs preferred doing a virtual group in the evenings or on weekends.
Conclusions: Among patients receiving MOUD, a third had a CSO willing to engage in a group intervention for their family/friend. Findings will inform a pilot study of a CRAFT-based group intervention delivered by an MOUD nurse care manager. The current and future studies add to ongoing efforts to involve CSOs and to improve outcomes among individuals on MOUD.
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Journal: JAMA Health Forum, 2025, doi: 10.1001/jamahealthforum .2025.2654
Authors: Cole Jurecka, Joella Adams, Pranav Padmanabhan, Jason Glanz, Paul Christine, Xiaoyu Guan, Danielle Kline, Ingrid Binswanger, & Joshua Barocas
Abstract:
Importance: In 2022, Colorado passed legislation making possession of small amounts of fentanyl, a high-potency synthetic opioid, a felony. Whether the Colorado law affected opioid overdose fatalities and whether those effects differed by racial and ethnic subgroups is unknown.
Objective: To estimate the association between the change in criminal penalties for fentanyl possession with opioid-related overdose deaths (OODs) in Colorado.
Design, setting, and population: Serial cross-sectional study comparing OODs among adults (≥18 years) who died of an overdose and population estimates before and after Colorado House Bill (HB) 22-1326 was enacted in July 2022 (January 2018-November 2023) using autoregressive integrated moving averages (ARIMA) model time series forecasting. Monthly OOD rates per 100 000 residents were calculated using state population estimates from the American Community Survey 5-Year Data and the Colorado Department of Local Affairs State Demography Office. Overdose death rates were calculated separately by racial and ethnic group (Hispanic, non-Hispanic Black, and non-Hispanic White). Data were analyzed from January 2018 to 2023.
Exposure: Enactment of HB 22-1326 changed the legal penalty for possession of any drug weighing 1 g to 4 g that contained any amount of fentanyl from a misdemeanor to a level-4 drug felony punishable by up to 180 days in jail and up to 2 years of probation.
Main outcome: The difference between expected and observed OOD rates following the enactment of increased criminal penalties.
Results: A total of 7099 OODs were analyzed (1798 Hispanic [25.3%], 451 Non-Hispanic Black [6.4%], and 4170 Non-Hispanic White [58.7%], 680 other [9.5%] and not included in the race and ethnicity categories). OODs increased across the study period in Colorado from 20.46 per 100 000 adults in January 2018 to 37.78 per 100 000 adults in November 2023. Among different racial and ethnic groups, the non-Hispanic Black population had the highest increase in OODs (9.3 per 100 000 in 2018 to 56.9 per 100 000 in 2023) followed by the Hispanic population. There was no difference between the observed and expect overdose deaths for the overall population following the enactment of HB 22-1326. However, there were significant increases in 4 of 13 months after policy implementation among the non-Hispanic Black population.
Conclusions and relevance: The results of this serial cross-sectional study suggest that increased criminal penalties for fentanyl possession did not change preexisting trends of OODs in Colorado and may have been associated with an increase in opioid overdoses in the Black population. These results should be interpreted in light of increasing opioid overdose rates in Black populations nationally during the study period.
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Journal: Digital Health, 2025, doi: 10.1177/20552076251360919
Authors: Danielle Downie, Alina Patel, Michael Corman, Claire de Oliveira, Esha Jain, Michelle Patterson, … & Lena C. Quilty
Abstract:
Objective: The aim of this study was: (1) to investigate changes in CBT related skills, quality of life, and SUD severity in adults completing a CBT4CBT intervention, and (2) to explore the participant experience of CBT4CBT in a tertiary hospital specializing in mental health and substance use health in Canada.
Methods: Participants included 51 adults seeking treatment for SUD. Participants received access to CBT4CBT over 8 weeks. Measures assessing CBT skills and associated constructs (distress tolerance, change assessment, drug-taking confidence, and change strategies inventory), substance use outcomes, and quality of life were collected at baseline and post-treatment. A qualitative interview was conducted with 26 participants post-treatment. Statistical analysis was conducted using a series of linear mixed effects models examining changes from week 0 to week 8 across all measures.
Results: Significant effects of time were found for SUD symptoms, change strategies, distress tolerance, and quality of life. Qualitative analysis found that participants reported the skills modules on managing triggers and dealing with cravings to be the most helpful. Further, participants found the convenience and relatability of the program scenarios most beneficial. Participants suggested that a live connection to a researcher or a practitioner and some technology enhancements would improve the program.
Conclusion: The results suggest that CBT4CBT is linked with a reduction in SUD symptoms and an increase in CBT skills, including change strategies and distress tolerance, as well as improved quality of life.
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