Journal: Addictive Behaviors Reports, 2026, doi: 10.1016/j.abrep.2026 .100668
Authors: Nathan A. Silver, Brenda Dimaya, Elexis C. Kierstead, Madison Iskra, Maeh Al-Shawaf, Michael A. Tynan, & Jessica M. Rath
Abstract:
Introduction: Streaming platforms have changed the way we watch television. Although previous research has established a causal relationship between tobacco exposure on-screen and tobacco use, it’s unclear whether changes in the media environment brought about by streaming have altered this process. We hypothesize that youth and young adult’s intentions to use cigarettes and e-cigarettes in the future will be positively associated with greater exposure to tobacco imagery in streaming television.
Methods: A content analysis identifying the amount of tobacco imagery in 60 popular streaming shows with a new season airing between 2019–2022 and an online survey of 1032 15–24-year-olds were conducted to examine the relationship between exposure to tobacco imagery in streaming television and intentions to use.
Results: Compared to those with low exposure to tobacco imagery, moderate and high exposure was associated with 61% and 176% respectively higher odds of increased intentions to use e-cigarettes, and 104% and 168% respectively higher odds of increased intentions to smoke cigarettes. Significant interactions indicate that the relationship between high exposure and intentions to use e-cigarettes and cigarettes was weaker among those who had used a tobacco or nicotine product in the past 30 days.
Conclusion: The relationship between exposure to tobacco imagery and intentions to use tobacco or nicotine products in the future endures on streaming media. Future research is needed to parse differential influences on initiation versus cessation and better understand what kinds of depictions drive these relationships.
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Journal: Drug and Alcohol Dependence, 2026, doi: 10.1016/j.drugalcdep .2026 .113043
Authors: Rachel L. Gunn, Alexander W. Sokolovsky, Lindy K. Howe, Nancy P. Barnett, Kristina M. Jackson, Sharon Lipperman-Kreda, Robert Miranda, Timothy Trull, & Jane Metrik
Abstract:
Background: Alcohol and cannabis are commonly used substances for young adults, and person-level co-use (i.e., concurrent or simultaneous use of both) is associated with increased likelihood of experiencing positive and negative alcohol-related consequences. However, findings regarding within-person effects (i.e.,day-level) co-use on consequences are mixed, possibly due to inconsistency in including alcohol quantity (i.e., total number of standard drinks consumed) when examining the association between co-use and consequences. In the present study, we examined whether the number of drinks mediates the association between co-use and positive or negative alcohol consequences at the day level.
Methods: Data from morning reports in a 28-day field-based study of young adults reporting frequent past 60-day alcohol and cannabis use (N = 115) were used to test multilevel mediation models.
Results: We found significant mediation for both positive and negative alcohol consequences; consuming more alcoholic drinks on co-use days, relative to alcohol-only days, was associated with a higher likelihood of experiencing negative consequences and a lower likelihood of positive consequences. These results suggest that daily number of drinks is a significant driver of the relationship between co-use and alcohol-related consequences at the day-level.
Conclusions: In the context of increased cannabis use among young adults, this finding provides critical information for prevention and intervention efforts aimed at reducing the alcohol-related consequences associated with co-use days. Overall, reducing total alcohol consumption remains a prominent harm-reduction strategy among this population.
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Journal: Addictive Behaviors Reports, 2026, doi: 10.1016/j.abrep .2025.100664
Authors: Shelley Alyse Gresko, Robin P. Corley, Erik G. Willcutt, Michael C. Stallings, Christian J. Hopfer, & Soo Hyun Rhee
Abstract:
Background: Subjective effects (SEs) are positively associated with substance use disorders in clinical samples. However, the etiology of these associations remains unclear. The present study utilized a clinical sample selected for elevated polysubstance use disorder (SUD) criteria to address the following questions: Are positive and negative polysubstance SEs and SUD criteria associated? Are cross-sectional and longitudinal results consistent? Is there evidence for common genetic influences between SEs and SUDs?
Methods: Cross-sectional and longitudinal analyses using the Defries Fulker regression method were conducted in clinical probands (n = 476) and their full (n = 557) and half siblings (n = 65). SEs were assessed in adolescence and SUD criteria were assessed once in adolescence and twice in adulthood.
Results: SEs were correlated with SUD criteria from adolescence to adulthood in clinical probands (r = 0.12–0.40) and during adolescence (r = 0.36–0.39) in full siblings of clinical probands. Results were inconsistent with common genetic influences between elevated SUDs and SEs.
Conclusions: Elevated SUDs and SEs were mostly explained by familial influences independent of genetics. There was little support for common genetic influences on elevated SUDs and SEs, possibly due to low power. Future research should focus on individual factors driving associations between these constructs.
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Journal: Harm Reduction Journal, 2026, doi: 10.1186/s12954-025-01378-7
Authors: Nicholas P. Iacobelli, Liberty Estrella, Mandy D. Owens, Elenore P. Bhatraju, Alexander J. Gojic, Devin Kennedy, Geetanjali Chander, & Judith I. Tsui
Abstract:
Background: People who co-use opioids and methamphetamine have high rates of incarceration. The criminal legal system is therefore increasingly tasked with providing substance use disorder treatment, including medications for opioid use disorder (MOUD). Unfortunately, treatment in carceral settings remains inconsistent and little is known about how people who co-use experience these treatment pathways. This qualitative study addresses this gap by analyzing how people navigate these overlapping systems of punishment and care.
Methods: We conducted in-depth, semi-structured interviews with 20 hospitalized patients in Washington State initiating MOUD with recent methamphetamine use and past-year criminal legal involvement. Interviews explored substance use trajectories, legal system contact, and treatment experiences. Using thematic analysis grounded in ethnographic principles, we identified common strategies and challenges participants faced in accessing and engaging with treatment.
Results: Participants described legal system involvement as stigmatizing, unpredictable, and difficult to escape. Metaphors like “entrapment” and “contagious” were used to make sense of the legal system’s disruptive role and to show how social and structural factors increased people’s vulnerability to the legal system itself, sometimes in substance-dependent ways. To navigate this legal environment, participants adopted strategies of both compliance and non-compliance, toggling between them to minimize risk of harm and maintain autonomy. These same strategies were carried over into carceral treatment, which was often experienced as an extension of punishment and ill equipped to meaningfully capture polysubstance use.
Conclusions: This study contributes to the literature on carceral treatment, detailing the lived experience of people who co-use opioids and methamphetamine with treatment access and legal system involvement as the two become more tightly linked. Mandated treatment often replicates carceral control and fails to accommodate the realities of polysubstance use. People who co-use developed adaptive strategies to navigate these systems, reflecting the need for treatment models that respect autonomy and reduce harm rather than criminalize. Our findings thus support the need for policies that provide consistent access to care and disentangle treatment from coercive legal oversight.
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Journal: JAMA Health Forum, 2026, doi:10.1001/jamahealthforum .2025.6286
Authors: Alex Dahlen, Frederick Lei, Kofi Agyabeng, Runhan Chen, Christian E. Johnson, Gabriel Amaro, … Tilda M. Farhat
Abstract:
Importance: The monthly opioid overdose death rate in the US has declined by 50% from its peak in the summer of 2023 through fall of 2024, and the factors associated with this decline are not fully understood.
Objective: To examine the association between the proportion of fentanyl reports in illicit drug seizures and opioid overdose deaths during periods of rising and falling mortality.
Design and Setting: This secondary analysis of state-month level panel data from the National Forensic Laboratory Information System and US Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) was conducted from January 2018 to September 2024 and included all 50 US states and Washington, DC. CDC WONDER data were collected from recorded death certificates; National Forensic Laboratory Information System data were obtained from drug reports submitted by forensic laboratories. The data were analyzed from July to August 2025.
Exposure: Percentage of illicit drug seizures that contained fentanyl or fentanyl-related compounds. Illicit drug seizures were defined as seizures that contained any of the following: fentanyl or fentanyl-related compounds, heroin, methamphetamine, cocaine, and xylazine.
Main Outcomes and Measures: The monthly count of opioid overdose deaths, given by uniform claim descriptor codes X40 to 44, X60 to 64, X85, and Y10 to Y14, with additional multiple cause of death codes of T40.0 to 4 and T40.6. Death rates were calculated using yearly population estimates from the American Community Survey.
Results: From a peak in the summer of 2023 through the fall of 2024, the monthly opioid overdose death rate declined by 50%, from 2.2 to 1.1 per 100 000. This decline was accompanied by a decline in the fentanyl reports as a proportion of total illicit drug seizures from 28.8% to 23.2%. In a 2-way, fixed-effects model, a 1–percentage point reduction in fentanyl prevalence was associated with 0.018 fewer overdose deaths per 100 000 population per month (95% CI, 0.016-0.019; P < .001). There was evidence that the strength of this association has decreased over time.
Conclusions and Relevance: The study results suggest that current decline in the proportion of fentanyl reports in illicit drug seizures is associated with 9.2% of the total observed decline in mortality. Additional contributing factors may include other shifts in the drug supply not captured by fentanyl prevalence in illicit drug seizures, shifts in drug use behavior, and the effect of public health programs, interventions, and policies.
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