Journal: Developmental Cognitive Neuroscience, 2025, doi: 10.1016/j.dcn .2025 .101639
Authors: Yixin Wang, Robbie Fraser, Laika Aguinaldo, Tam T. Nguyen-Louie, Fiona C. Baker, Susan F. Tapert, & Kilian M. Pohl
Abstract: Early cannabis initiation during youth is associated with elevated risk for harmful substance use, mental disorders, and cognitive impairments. To account for the complexity behind cannabis use initiation, we performed a data-driven analysis across 151 measurements spanning seven domains from the individual, microsystem, and exosystem level of influences: biobehavior, cognition, brain MRI, family, peer, neighborhood and legal factors. Data were from 450 cannabis-naïve youths from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) (baseline age: 12-21 years). Within an 8-year period, 292 transitioned to first use and 163 to weekly use of cannabis. Random Survival Forest predicted age of first onset (C-index = 0.68; 95% CI: [0.65,0.71]) and weekly onset (C-index = 0.69; 95% CI: [0.67 to 0.71]) with an accuracy significantly higher than chance (i.e., C-index = 0.5). Its prediction patterns consisted of factors from all three levels of influence. The predictive pattern of first onset comprised 13 factors across six domains including lower positive thinking during stress coping, which correlated with earlier use (R²=0.023, p=0.0090). Three variables were shared with the predictive pattern of weekly use onset: cannabis outlet density, access to alcohol at home, and more positive social expectations of alcohol use forecasting earlier onset (Initial Use: R²=0.031, p=0.0027; Weekly Use: R²=0.023, p=0.0090). Weekly use onset was predicted by only four factors suggesting that while many influences contribute to a youth trying cannabis, only a few key factors appear to facilitate escalation to habitual use, some of which represent promising targets for prevention programs.
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Journal: Addictive Behaviors Reports, 2025, doi.org/10.1016/j.abrep. 2025.100639
Authors: Ayodeji Iyanda, Richard Adeleke, & Omowunmi Iyanda
Abstract:
Background: Emergency room (ER) use reflects acute healthcare burden, but the roles of chronic health conditions (CHCs), substance use disorders (SUDs), drug use disorders (DUDs), and mental health conditions (MHCs) remain underexplored across populations.
Methods: Using nationally representative survey data (N = 226,838; weighted = 1,243,120,763), we applied survey-weighted logistic regression to examine predictors of ER visits. Covariates included CHCs, SUDs, DUDs, severity levels, MHCs, race/ethnicity, education, employment, residence, and body mass index.
Results: Adults with ≥ 1 CHC were more likely to visit the ER (OR = 1.72; 95 % CI: 1.60–1.85). DUD significantly increased ER use (OR = 1.70; 95 % CI: 1.54–1.88), while overall SUD was not significant after adjustment (OR = 1.05; 95 % CI: 0.98–1.12). Severe SUD elevated ER use even without CHCs (OR = 1.89; 95 % CI: 1.67–2.13). African Americans had higher odds of ER visits (OR = 1.28; 95 % CI: 1.21–1.36), and Native American/Alaska Natives were more likely to report DUD (OR = 1.55; 95 % CI: 1.31–1.82). Lower educational attainment (OR = 1.22; 95 % CI: 1.16–1.28) and unemployment (OR = 1.34; 95 % CI: 1.25–1.43) were linked to higher risks. MHCs predicted ER use (OR = 1.63; 95 % CI: 1.53–1.74) and substance-related disorders.
Conclusions: CHCs, DUD severity, and MHCs are strong predictors of ER utilization. Disparities among African Americans and Native American/Alaska Natives highlight the need for integrated care addressing chronic illness, behavioral health, and substance use—particularly for socioeconomically and racially marginalized groups.
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Journal: Addictive Behaviors, 2025, doi: 10.1016/j.addbeh.2025.108538
Authors: Jesse S. Boggis, Thadryan Sweeney, Lisa A. Marsch, Wesley J. Marrero, Kenneth A. Feder, & Erika L. Moen
Abstract:
Background: Professional societies recommend that adolescents with opioid use disorder (OUD) receive medication for opioid use disorder (MOUD). This cross-sectional study examined the association between adolescent specialty treatment episodes for OUD with planned MOUD use compared to adults over time.
Methods: We used data on first episodes of specialty treatment for OUD (n = 671,183) from the Treatment Episode Data Set – Admissions, a national database of publicly funded treatment programs in the U.S. Admissions occurred between 1/2017–12/2022. The primary exposure was being adolescent (15–17 years). The main outcome was planned MOUD use, defined as having MOUD in a treatment plan.
Results: Adolescent specialty treatment episodes for OUD were significantly less likely to have planned MOUD use than adults (aOR 0.05, 95% CI, 0.02–0.09). Linear combination tests of the interaction between age group and year confirmed that adolescent episodes were significantly less likely to have planned MOUD use than adults across all years. In 2021 and 2022 this disparity narrowed slightly. In 2021, adolescent episodes had 10% of the adjusted odds of planned MOUD use compared to adults in 2017 (95% CI, 0.07–0.15). In 2022, adolescent episodes had 9% of the adjusted odds of planned MOUD use compared to adults in 2017 (95% CI, 0.06–0.11).
Conclusion: Adolescents entering specialty treatment for OUD had significantly lower odds of planned MOUD use than adults. The relatively smaller difference between adolescents and adults in recent years suggests a potential trend toward greater MOUD access, though future research is needed to understand access barriers.
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Journal: Journal of Primary Care & Community Health, 2025, doi:10.1177/21501 319251375393
Authors: Anna R. Morgan-Barsamian, Sanae El Ibrahimi, Michelle A. Hendricks, Kendra L. Blalock, Erin Stack, Richard Wyss, … Michael A. Fischer
Abstract:
Objectives: The PINPOINT (PaIn aNd oPiOId maNagemenT) intervention in Oregon aimed to support primary care clinics in applying evidence-based guidelines for pain management and opioid use disorder treatment. We evaluated the impact of this intervention on opioid use disorder treatment and overdose outcomes.
Methods: Data from the voluntary Oregon All Payer All Claims datasets were integrated with several administrative datasets to create the Provider Results of Opioid Management and Prescribing Training dataset, which tracks clinical and prescribing activities at the provider level. We employed difference-in-differences models to assess the impact of PaIn aNd oPiOId maNagemenT enrollment on changes in opioid use disorder treatment and overdose outcomes. The intervention sample consisted of 289 primary care providers from clinics participating in PaIn aNd oPiOId maNagemenT, compared with 2000 control providers identified through administrative claims.
Results: The difference-in-differences models indicated statistically significant associations between intervention enrollment and treatment with medications for opioid use disorder (incidence rate ratio [IRR] = 1.214, 95% confidence interval [CI] = 1.100-1.340), any substance use disorder treatment (IRR = 1.120, 95% CI = 1.070-1.172), and any outpatient opioid use disorder treatment (IRR = 1.102, 95% CI = 1.034-1.175) compared to controls. No statistically significant changes were observed in overall non-fatal drug overdoses, non-fatal opioid overdoses, and naloxone overdose reversals, though absolute event rates were low.
Conclusions: We found that multi-faceted, evidence-based approaches to improve clinical practice in primary care settings were associated with increased treatment for opioid use disorder, however differences in overdose outcomes were not observed. Further research is needed to assess the scalability and clinical impact of these interventions across diverse care environments.
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Journal: Journal of Adolescent Health, 2025, doi: 10.1016/j.jadohealth. 2025.07.004
Authors: Richard Miech, Megan E. Patrick, & Adam M. Leventhal
Abstract:
Purpose: To document recent, national trends in vaping and use of flavored vaping solutions among US adolescents who use marijuana.
Methods: Data come from Monitoring the Future, which conducted annual, cross-sectional, nationally-representative surveys from 2021 to 2024 of eighth, 10th, and 12th grade students.
Results: Among adolescents who used marijuana in the past 12 months, the percentage who vaped it increased over the study period from 48% to 57% in eighth grade (p < .05), 60%-66% in 10th grade (p = .07), and 58%-67% in 12th grade (p < .01). The percentage of adolescents who used a flavored solution when vaping marijuana switched from a minority to a majority over the study period, from 47% to 63% (p < .01) in eighth grade, 41%-53% (p < .01) in 10th grade, and 36%-50% (p < .01) in 12th grade. The percentage of all adolescents who vaped a flavored marijuana solution in the past 12 months over the study period increased from 2% to 4% (p < .01) in eighth grade, 5%-6% in 10th grade (p = .25), and 7%-9% in 12th grade (p < .01).
Discussion: The percentage of US adolescents who vaped flavored marijuana solutions increased from 2021 to 2024, one of very few drug outcomes that increased since the pandemic onset. With this increase, adolescents who used flavors to vape marijuana shifted from a minority to a majority and vaping became more common among adolescents who used marijuana. These results point to flavored marijuana vaping solutions as an increasingly important target for research and policy on adolescent marijuana use.
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