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• US young adults face a heavy student loan burden & socioeconomic instability. • We tested if they were linked to problematic drinking & mental health symptoms. • Positive links between instability and drinking, anxiety and stress were found. • Relationships were stronger at higher levels of perceived socioeconomic instability. U.S. young adults face the largest student loan burden in history, rising income inequality, and economic uncertainty. Personal debt and other financial stressors have been associated with problematic drinking and mental health symptoms. In this paper, we investigated whether student loan debt was more strongly linked to problem drinking and mental health symptoms among those in lower positions of socioeconomic status (SES) and those who perceived greater [in]stability in their SES (SES-instability). Using data from a larger study of college graduates, we investigated SES, SES-instability, student debt, and their 2-way interactions on problematic drinking and mental health symptoms. College graduates (N = 331), who were two years post-graduation, completed measures assessing student debt, perceived SES, SES-instability, problematic drinking, and mental health symptoms (depression, anxiety, and stress). The hypotheses and data analysis plan were registered prior to conducting analyses. The expected unique, positive associations of SES-instability with problematic drinking and mental health symptoms were supported. SES was uniquely linked with problematic drinking only and in the opposite direction as predicted. Student debt was uniquely and positively linked to stress only. The expected interactions were largely supported for SES-instability and student debt—i.e., the associations of student debt with problematic drinking, anxiety, and stress were stronger (more positive) for those with greater SES-instability. The expected interactions for SES and student debt were null. Though data are cross-sectional and come from an educationally-privileged group, study findings provide preliminary evidence of links between young adult student loan debt, greater SES-instability, and their drinking/mental health. [ABSTRACT FROM AUTHOR]

Background and Aims: The volatile and 24/7 nature of the cryptocurrency market allows traders to engage in speculative trading patterns closely resembling gambling. Its potential for harm and financial loss warrant investigation from a public health perspective. Therefore, we summarized the emerging literature on cryptocurrency trading and its link to problematic gambling and other mental health outcomes such as depression and anxiety. We also examined demographic or psychological factors associated with cryptocurrency trading.Methods: We searched PubMed, Scopus, and Embase for published, original studies investigating associations with cryptocurrency trading behavior. We also conducted supplementary searches using Google Scholar.Results: Eight papers were included after eligibility screening. Our scoping review revealed associations between problem gambling symptoms and cryptocurrency trading engagement and intensity. Furthermore, we found cryptocurrency traders share similar demographic and personality characteristics with share-traders and problem gamblers. Studies on cryptocurrency trading and mental health produced mixed results.Discussions and Conclusions: Our scoping review indicates a likely relationship between problem gambling and cryptocurrency trading. Findings also suggest overlap with high-risk stock traders, with similarities in gambling behaviors, demographics, and personality traits. These findings justify further research into problem cryptocurrency trading behaviors and their potential for harm, especially concerning mental health. To assess what behaviors are problematic, future research should also look to explore differences between long-term investors and short-term traders of cryptocurrency. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Alcohol use disorders affect millions, but few utilize medications. This paper examines factors contributing to the use of long-acting injectable depot naltrexone (LADN) in a large patient population. Methods: Bivariate analysis, stepwise multivariate logistic regression, and multivariate logistic regression analysis were used. Results: The sample had 101,026 patients of whom 3180 (3.1%) received any form of naltrexone and 240 (0.24%) received LADN. Of those who received naltrexone, only 7.5% (240/3180) received LADN. The LADN group was more likely to have outpatient mental health service use and a mental health inpatient admission. The LADN group was more likely to have a co-morbid Axis 1 psychiatric disorder and to fill a psychotropic prescription. Conclusion: In order to better serve and understand the implications of LADN treatment for the patient population that uses and may benefit from it, more research is needed on the effectiveness of this medication in the dually-diagnosed and high service use population. [Copyright &y& Elsevier]

Abstract: This paper presents an overview of substance use patterns of recent veterans returning to low-income predominately minority communities over four periods of the military–veteran career. Respondent driven sampling (RDS) was used so that unbiased estimates could be obtained for the characteristics of the target population. The majority of participants had used marijuana but no other illegal drugs. In the military, marijuana use was substantially lower and alcohol was the drug of choice; the majority were binge drinkers and nearly half were heavy drinkers. While deployed, alcohol and marijuana use were both lower, though some participants (6%) initiated the misuse of prescription painkillers. After separating from the military and returning to civilian life, heavy drinking was much lower, marijuana use increased, and some veterans misused prescription painkillers (7%). Further research based on these data will examine these distinct periods of substance use, contexts of use, related substance and mental health problems, treatment use and avoidance, and civilian reintegration. [Copyright &y& Elsevier]

Abstract: Military personnel and veterans smoke at higher rates than the general population, compromising physical performance readiness and health (Committee on Smoking Cessation in Military and Veteran Populations & Institute of Medicine, 2009). While efforts are being made within both the Department of Defense and the Veterans' Administration (VA) hospitals to prevent onset, change the smoking culture, and promote smoking cessation; smoking rates are increasing among combat deployed service members, and smoking rates are particularly high among veterans with mental health and other substance use disorders (McFall, 2006). Recent research supports making smoking cessation widely available and integrated with other forms of care (Gierisch et al., 2012; McFall et al., 2010). This paper describes the efforts of one VA substance use disorder (SUD) treatment program to integrate smoking cessation in routine care, including assessment of tobacco use and motivation and intention to quit via the proposed Nic-BAM assessment. Our team was 100% successful in incorporating the Nic-BAM into our regular assessment of treatment program participants. This suggests that staff members are amenable to assessing for tobacco addiction alongside other substance addictions. Although smoking did not decrease according to the Nic-BAM, an increase in the use of nicotine-replacement products suggests that participants are willing to initiate a quit attempt during SUD treatment. The availability of new evidence-based approaches for integration of tobacco cessation with mental health and SUD treatment may help to enhance programmatic efforts. Environmental changes are needed to fully incorporate tobacco recovery into SUD programming, and additional resources may include peer support specialists. [Copyright &y& Elsevier]

Abstract: Introduction: The aim of this paper was to examine the association between exposure to second-hand smoke (SHS) among non-smokers, in the home and the vehicle, and poor mental health outcomes (mood disorder, anxiety disorder, poor/fair mental health, and high stress). Methods: Data were drawn from the 2010 Canadian Community Health Survey, a representative sample of 62,909 Canadians 12years and older. Measures of SHS exposure are drawn from self-reported daily or near daily exposure in the home or in the vehicle. Mental health indicators include self-reported diagnosed mood and anxiety disorders, and self-report measures of overall mental health and experiences of stress. Associations between SHS exposure and poor mental health among non-smokers were examined in a series of logistic regression models. Additional analyses stratified on respondent''s smoking status, physical health, and gender. Results: Analyses revealed that SHS exposure among non-smokers was associated with increased anxiety disorders, poor/fair mental health, and high stress, with no association to mood disorders. Stratified analyses demonstrated that associations between SHS and poor mental health are contextualized by respondent''s gender, physical health, and smoking status. Conclusions: Beyond changes to physical health, SHS exposure in private spaces was negatively associated with the mental health of non-smokers. Public health efforts to reduce SHS exposure in private spaces are warranted. Findings also reveal additional targets for decreasing and eliminating the societal burden of mental health disorders. Further research is needed to examine causality and to explore associations between SHS exposure and specific mental health outcomes. [Copyright &y& Elsevier]

Background: This paper examines the health status and functioning of an aging cohort of individuals with a history of heroin dependence with a focus on gender differences. Method: Study subjects were originally sampled from methadone maintenance clinics in California in the 1970s and completed follow-up interviews in 2005–09. Out of the original study sample (N=914), 343 participants (44.3% female) were interviewed (70.6% of those not deceased). Bivariate analyses examined gender differences in participants'' overall health status and physical and mental health problems. Scores on SF-36 scales were compared with general population norms by gender and age, as well as between participants in the study sample who did and did not report past-year drug use. Results: Average age of the study sample was 58.3 (SD=4.9) years for males and 55.0 (SD=4.1) years for females. There were no significant gender differences in past-year drug use (38% of sample) or injection drug use (19%). Women reported significantly more chronic health problems and psychological distress compared with men, and overall poorer health and functioning compared with general population norms. Men under 65 had poorer physical health and social functioning compared with population norms. Men in the study sample reporting past-year substance use had poorer physical functioning, but less bodily pain, than non-users, whereas women with past-year substance use had poorer mental health than other women. Conclusion: Individuals with a history of heroin dependence have poorer health and functioning than their counterparts in the general population. At a younger age, women reported poorer overall health status and more chronic health and mental health problems than men. Study findings may inform interventions for this population, particularly related to gender-specific treatment needs. [Copyright &y& Elsevier]

Abstract: This review reports on the results of a comprehensive literature search of studies examining the physical and mental health characteristics of older adults in the United States who use heroin. Multiple databases were searched for papers meeting the inclusion criteria of heroin users who were age 50years or older. A total of 14 articles covering 9 different studies met the review inclusion criteria. All of the studies were convenience samples, and seven of the nine studies (77.8%) were entirely drawn from substance abuse treatment programs, primarily methadone maintenance programs. Findings from the qualitative studies suggest that the marginalization of older heroin users was a predominant experience that impacted the intent to seek treatment as well as treatment retention. While articles reported high levels of physical and psychological/psychiatric comorbidities with substance misuse, research on heroin use and methadone treatment among older adults is scant and the quantitative findings are inconsistent. The articles reviewed in this study demonstrate that the needs of this population will be significant, yet the development of appropriate interventions and treatment for older adult heroin users will be contingent on empirical research that adequately describes mental and physical health problems. [Copyright &y& Elsevier]

Abstract: This paper explores gender and mental health influences on alcohol, tobacco, and illicit drug use among late adolescent urban youths. Specifically, we examine whether rates of substance use differ by gender, whether mental health indices differ by gender and are predictive of substance use, and whether gender moderates the relationship between mental health and substance use. Data from our non-clinical sample of 400 youths were collected primarily online. Analysis of cross-sectional data revealed no differences in substance use by gender. Indices of mental health differed by gender, with girls reporting greater symptoms of depression and anxiety. Ratings of hostility were similar for boys and girls. Alcohol, tobacco, and drug use were associated with greater symptoms of depression, anxiety, and hostility; this relationship, however, was not moderated by gender. Study findings provide evidence that among late adolescent youths living in urban areas, poorer mental health status is associated with increased substance use. Evidence of a moderating effect of gender on the relationship between mental health and substance use was not significant. [Copyright &y& Elsevier]

Tobacco dependence among individuals with a mental illness or an addiction is a tremendous problem that goes largely ignored. Studies of genetics, neuroimaging, and nicotinic receptors support a neurobiological link between tobacco use and alcohol dependence, drug dependence, schizophrenia, depression, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders. This paper summarizes the recent literature on this topic and discusses how treatment for tobacco can no longer be ignored in mental-health and addiction-treatment settings. More research is needed as well as a national organized effort to address tobacco in this large segment of smokers. [Copyright &y& Elsevier]

Insight refers to a person's understanding of themselves and the world around them. Recent literature has explored people's insight into their substance use disorder (SUD) and how this is linked to treatment adherence, abstinence rates, and comorbid mental health symptoms. The aim of this systematic review was to synthesise and critically examine the existing literature on insight in SUD. Five academic databases (Medline, PsychINFO, SCOPUS, CINAHL, Web of Science) were searched for key terms related to insight and substance use. Included studies were on humans aged 18 years or over with SUD that examined the relationship between substance use and insight using a quantifiable measure of insight. Of 10,067 identified papers, 20 met the inclusion criteria, employing 13 different measures of insight. The most commonly used measure was the Hanil Alcohol Insight Scale (HAIS) which was the only measure designed for a substance use population and was specific to alcohol use. Based on a pooled sample from five studies (n = 585), 57% of participants had poor insight, 36% had fair insight, and 7% had good insight on the HAIS. Better insight was generally related to negative consequences from substance use, better treatment adherence and maintaining abstinence. Insight appears to be an important factor to consider within SUD. Exploring the most appropriate way to measure insight and assess its role in SUD has implications for intervention design, and engaging and maintaining people with SUD in treatment. [ABSTRACT FROM AUTHOR]