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Background and Aims: Increasing numbers of school‐based drug surveys are transitioning data collection to electronic tablets from paper‐and‐pencil, which may produce a survey mode effect and consequent discontinuity in time trends for population estimates of drug prevalence. This study tested whether (a) overall, self‐reported drug use prevalence is higher on electronic tablets versus paper‐and‐pencil surveys, (b) socio‐demographics moderate survey mode effects and (c) levels of missing data are lower for electronic tablet versus paper‐and‐pencil modes. Design A randomized controlled experiment. Setting: Results are nationally representative of students in the contiguous United States. Participants: A total of 41 866 8th, 10th and 12th grade students who participated in the 2019 Monitoring the Future school‐based survey administration. Intervention and comparator: Surveys were administered to students in a randomly selected half of schools with electronic tablets (intervention) and with paper‐and‐pencil format (comparator) for the other half. Measurements Primary outcome was the total number of positive drug use responses. Secondary outcomes were the percentage of respondents completing all drug questions, percentage of drug questions unanswered and mean number of missing drug items. Findings The relative risk (RR) for total number of positive drug use responses for electronic tablets versus paper‐and‐pencil surveys were small and their 95% confidence intervals (CI) included the value of one for reporting intervals of life‐time (RR = 1.03; 95% CI, 0.93–1.14), past 12 months (RR = 1.01; 95% CI, 0.91–1.11), past 30 days (RR = 1.05; 95% CI, 0.93–1.20) and for heavy use (RR = 1.10; 95% CI, 0.93–1.29). Multiplicative interaction tests indicated no moderation of these relative risks by race (white versus non‐white), population density, census region, public/private school, year of school participation, survey version or non‐complete drug responses. Levels of missing data were significantly lower for electronic tablets versus paper‐and‐pencil surveys. Conclusions: Adolescent drug prevalence estimates in the United States differed little across electronic tablet versus paper‐and‐pencil survey modes, and showed little to no effect modification by socio‐demographics. Levels of missing data were lower for electronic tablets. [ABSTRACT FROM AUTHOR]

The article presents abstracts on the American Psychosocial Oncology Society's (APOS) 9th Annual Conference which include cancer survivors' quality of life, national policy changes for cancer survivors and substance use in cancer survivors.

The number of citations a peer-reviewed article receives is often used as a measure of its importance and scientific impact. This paper identifies, describes and categorizes the highly cited papers in addiction research on cannabis, heroin, cocaine and psychostimulants. Highly cited papers were identified in the Web of Science Core Collection database. Several bibliometric indicators were calculated. Social network analysis was applied to draw groups of authors and institutions with the greatest number of collaborations and co-words. The number of citations for the top 100 cited articles ranged from 649 to 4,672. The articles were published in 40 journals. The subject category Substance Abuse included 10 papers. The United States was the most productive country (79 papers), followed by the United Kingdom (9). The main funding institutions were the National Institutes of Health in the United States. The network of collaboration between authors distributes the 352 researchers into 53 groups. The three most cited works address the neural basis of drug craving as an incentive-sensitization theory of addiction, the clinical and research uses of the Addiction Severity Index, and the neurocircuitry of addiction. Scientific literature on addictions is widely dispersed both in multidisciplinary and specific journals of neurology, psychiatry and addictions, with relatively few publications providing most of the citations. An ongoing challenge for this field is the concentration of highly cited papers coming from a select number of countries, with the United States being the research hub of the world, with the highest volume of publications and total citations. [ABSTRACT FROM AUTHOR]

This paper examines the issues surrounding low-income immigrants in the U.S. and the ways they shape the educational experiences of their young children. Using a multidisciplinary lens including sociology, family studies, education, and mental health, the authors analyse multiple perspectives towards the educational experiences of children in low-income immigrant families. After providing a sample case study focusing on the educational experiences of Burmese refugee parents with early elementary education (Grades K through 3) in the Midwestern United States, the authors frame desirable responses from policy and practice that would best support the educational experiences of young children in low-income immigrant families including (a) understanding cultural strengths, (b) creating a positive and inclusive classroom environment, (c) supporting bilingual and bicultural competencies, (d) providing immigrant families with leadership opportunities, (e) teacher professional development on mental health and poverty, and (f) building integrated supports for the family.

Background: Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Conclusions: Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children. [ABSTRACT FROM AUTHOR]

Purpose: Evidence from the USA/Australia suggests whole-school interventions designed to increase social inclusion/engagement can reduce substance use. Completeness of implementation varies but contextual determinants have not been fully explored. Informed by previous interventions, the paper aims to examine these topics in an English pilot of the Healthy School Ethos intervention. Design/methodology/approach: This intervention, like previous interventions, balanced standardization of inputs/process (external facilitator, manual, needs-survey and staff-training delivered over one year to enable schools to convene action-teams) with local flexibility regarding actions to improve social inclusion. Evaluation was via a pilot trial comprising: baseline/follow-up surveys with year-7 students in two intervention/comparison schools; semi-structured interviews with staff, students and facilitators; and observations. Findings: The intervention was delivered as intended with components implemented as in the USA/Australian studies. The external facilitator enabled schools to convene an action-team involving staff/students. Inputs were feasible and acceptable and enabled similar actions in both schools. Locally determined actions (e.g. peer-mediators) were generally more feasible/acceptable than pre-set actions (e.g. modified pastoral care). Implementation was facilitated where it built on aspects of schools' baseline ethos (e.g. a focus on engaging all students, formalized student participation in decisions) and where senior staff led actions. Student awareness of the intervention was high. Originality/value: Key factors affecting feasibility were: flexibility to allow local innovation, but structure to ensure consistency; intervention aims resonating with at least some aspects of school baseline ethos; and involvement of staff with the capacity to deliver. The intervention should be refined and its health/educational outcomes evaluated. (Contains 3 tables.)

Steroid use in professional sports continues to receive much media attention in the United States. The predominant response to the use of steroids in professional sports is negative. Much of the opposition to steroid use focuses on the critical importance of fair play in American society. To the degree that steroids provide some players with an unfair advantage, the use of steroids is said to undermine fair play. This paper provides an analogical analysis of SAT (Scholastic Assessment Test) coaching services, and the manner in which these services similarly undermine "fair play" in college admissions competition. Ultimately, our national commitment to fair play is context-specific. If one looks closely, it further reveals the troubling possibility that fair play as a core value is not a core value at all, but little more than an empty mantra.

Background: Few methodologically rigorous international comparisons of student-reported antisocial behavior have been conducted. This paper examines whether there are differences in the frequency of both antisocial behavior and societal responses to antisocial behavior in Victoria, Australia and Washington State, United States. These 2 states were chosen due to their similarities on sociodemographic characteristics and their differences in policy frameworks around problem behavior including antisocial behavior and substance use. Methods: State representative samples of students (N = 5769) in school grades 5, 7, and 9 in Victoria and Washington State completed a modified version of the "Communities That Care" self-report survey of behavior and societal responses to behavior. Chi-square analyses compared frequencies of antisocial behavior, school suspensions, and police arrests in the 2 states. Multivariate logistic regression analyses were conducted for each outcome measure to examine the effect of state, controlling for sample design, clustering of students within schools, age, socioeconomic status, and urbanicity. Results: Few state differences in student-reported antisocial behavior were found, although frequencies varied across behavior type and grade level. Differences in societal responses were observed across grade levels with grade 5 Washington students reporting higher rates of school suspension. Older Washington students reported more arrests. Conclusions: Rates of student antisocial behavior appear similar in these 2 states in Australia and the United States. However, youth in the United States relative to Australia may experience greater societal consequences for problem behavior. Further research is required to examine the impact of these consequences on subsequent behavior. (Contains 4 tables.)

The Ohio Substance Abuse Monitoring Network (OSAM) is designed to provide accurate, timely, qualitatively-oriented epidemiologic descriptions of substance abuse trends and emerging problems in the state's major urban and rural areas. Use of qualitative methods in identifying and assessing substance abuse practices in local communities is one of the main assets of OSAM Network. Qualitative methods are sensitive to local contextual variability, flexible enough to capture emergent trends, and can be implemented with limited financial resources. This paper describes how qualitative epidemiologic methods, like those used by the OSAM Network, could be applied to inform substance abuse prevention activities, particularly those directed at adolescents.

Stigma toward people taking medication for opioid use disorder (MOUD) is prevalent, harmful to the health and well-being of this population, and impedes MOUD treatment resource provision, help-seeking, and engagement in care. In recent years, clinicians have implemented new models of MOUD-based treatment in parts of the United States that integrate buprenorphine initiation into emergency departments and other acute general medical settings, with post-discharge linkage to office-based treatment. These service models increase access to MOUD and they have potential to mitigate stigma toward opioid use and MOUD. However, the empirical literature connecting these emerging service delivery models to stigma outcomes remains underdeveloped. This paper aims to bridge the stigma and health service literatures via a conceptual model delineating how elements of emerging MOUD service models can reduce stigma and increase behavior in pursuit of life goals. Specifically, we outline how new approaches to three key processes can counter structural, public, and self-stigma for this population: (1) community outreach with peer-to-peer influence, (2) clinical evaluation and induction of MOUD in acute care settings, and (3) transition to outpatient maintenance care and early recovery. Emerging service models that target these three processes can, in turn, foster patient empowerment and pursuit of life goals. There is great potential to increase the well-being of people who use opioids by reducing stigma against MOUD via these structural changes. [ABSTRACT FROM AUTHOR]

Tobacco use is the leading cause of death in the United States and youth prevention is key to reducing tobacco use. American Indian/Alaska Native (AI/AN) individuals have a higher prevalence of tobacco use compared to other populations. This paper aims to evaluate the prevalence of tobacco products among youth within the Cherokee Nation reservation. Data from the 2019 Cherokee Nation Youth Risk Behavior Survey (YRBS) was used to analyze the prevalence of tobacco use (cigarettes, smokeless tobacco, electronic cigarettes, cigars, and ≥ 2 products) among students within Cherokee Nation. Weighted frequency and percentages were obtained for variables and 95% confidence intervals were computed using Taylor linearization variance estimators. Binary associations between variables were examined using the Rao-Scott Chi-square test. There were 1475 high students who participated in the 2019 Cherokee Nation YRBS. Males were more likely to report the use of smokeless tobacco and ≥ 2 products than females. Twelfth graders had a higher prevalence of reported e-cigarette use compared to lower grades. AI/AN students had a higher prevalence of current use of cigarettes and ≥ 2 products compared to other groups. The use of marijuana and alcohol was positively associated with the use of all tobacco products. Depression was also positively associated with the use of all products excluding smokeless tobacco. Grade, age, depression, and current use of other tobacco products, marijuana, and alcohol were associated with greater electronic cigarette intensity levels. Using the results, tribal and local organizations can promote evidence-based interventions that focus on reducing tobacco use among youth. [ABSTRACT FROM AUTHOR]

Despite significant social efforts to reduce substance-related imprisonment, the United States prison population continues to have high percentages of individuals who suffer from substance use disorders. This already marginalized group continues to make up substantial portions of the incarcerated population. This perspective paper overviews the Alcohol Severity Index (ASI) and its use within incarcerated populations. It highlights several shortcomings of the assessment, including validity, time of the assessment, the window of detection, and individual inmate consequences due to high assessment scores. In addition, it advocates for change within the assessment process of substance use disorders within the prison population that would navigate toward better outcomes for both inmates and the prison system. [ABSTRACT FROM AUTHOR]

Mental health challenges have been recognized as one of the most prevalent issues impacting children and families within the United States. Children and families of color are disproportionately affected by this due to lack of access to preventative and ongoing supports, and programs that can help address their overall well-being. These issues are even more severe for those that are at risk or interact with the child welfare system. Social workers use various clinical modalities to assess and support them. In the recent years, child welfare agencies have turned to Evidence based programs (EBPs) as a best practice to meet the needs of children and families. The Title IV-E Prevention Services Clearinghouse, established by the Administration of Children and Families is a landmark effort to review and promote such EBP's that prevents foster care placements, including mental health programs. While the Clearinghouse has reviewed 141 programs and services, out of which 71 have been rated as promising, supported, or well-supported, there is a dearth of culturally responsive programs that have met the Clearinghouse criteria. Given the overrepresentation of African American and Native American Families in the child welfare system, and the critical role of the Clearinghouse in reviewing and promoting EBPs, this paper highlights the philosophical, administrative, cultural and logistical barriers for culturally relevant programs to be accepted into the Clearinghouse. It also provides specific recommendations on how the Clearinghouse and researchers can build EBPs that account for the intersection between mental health, social location and cultural identities of the children and families that social workers serve. [ABSTRACT FROM AUTHOR]

As First Lady of the United States, Laura Bush is leading the Helping America's Youth initiative of the federal government. She articulates the goal of enlisting public and volunteer resources to foster healthy growth by early intervention and mentoring of youngsters at risk. Helping America's Youth will benefit children and teenagers by emphasizing action in three key areas: family, school, and community. The initiative highlights the importance in every child's life of a loving, caring adult, whether that is a parent, a grandparent, a teacher, a coach, a pastor, or a mentor. This fall, they will convene a White House Summit on Helping America's Youth. Researchers, policy experts, educators, parents, and community leaders will discuss the best ways to help our children avoid risky behaviors so they can build successful lives. Researchers will identify the causes of problems and suggest the best practices to overcome them. The conference will introduce a new assessment tool that will allow communities across the country to identify the challenges that they face and the services that they already have that help young people, and then where there are gaps. Local leaders can then build off existing government programs, as well as volunteer faith-based or community programs, to create seamless efforts to help their local children.

In response to the rapidly evolving coronavirus disease 2019 (COVID-19) pandemic, the All of Us Research Program longitudinal cohort study developed the COVID-19 Participant Experience (COPE) survey to better understand the pandemic experiences and health impacts of COVID-19 on diverse populations within the United States. Six survey versions were deployed between May 2020 and March 2021, covering mental health, loneliness, activity, substance use, and discrimination, as well as COVID-19 symptoms, testing, treatment, and vaccination. A total of 104,910 All of Us Research Program participants, of whom over 73% were from communities traditionally underrepresented in biomedical research, completed 275,201 surveys; 9,693 completed all 6 surveys. Response rates varied widely among demographic groups and were lower among participants from certain racial and ethnic minority populations, participants with low income or educational attainment, and participants with a Spanish language preference. Survey modifications improved participant response rates between the first and last surveys (13.9% to 16.1%, P  < 0.001). This paper describes a data set with longitudinal COVID-19 survey data in a large, diverse population that will enable researchers to address important questions related to the pandemic, a data set that is of additional scientific value when combined with the program's other data sources. [ABSTRACT FROM AUTHOR]

Background: Adequate housing is a basic human right. The many millions of people experiencing homelessness (PEH) have a lower life expectancy and more physical and mental health problems. Practical and effective interventions to provide appropriate housing are a public health priority. Objectives: To summarise the best available evidence relating to the components of case‐management interventions for PEH via a mixed methods review that explored both the effectiveness of interventions and factors that may influence its impact. Search Methods: We searched 10 bibliographic databases from 1990 to March 2021. We also included studies from Campbell Collaboration Evidence and Gap Maps and searched 28 web sites. Reference lists of included papers and systematic reviews were examined and experts contacted for additional studies. Selection Criteria: We included all randomised and non‐randomised study designs exploring case management interventions where a comparison group was used. The primary outcome of interest was homelessness. Secondary outcomes included health, wellbeing, employment and costs. We also included all studies where data were collected on views and experiences that may impact on implementation. Data Collection and Analysis: We assessed risk of bias using tools developed by the Campbell Collaboration. We conducted meta‐analyses of the intervention studies where possible and carried out a framework synthesis of a set of implementation studies identified by purposive sampling to represent the most 'rich' and 'thick' data. Main Results: We included 64 intervention studies and 41 implementation studies. The evidence base was dominated by studies from the USA and Canada. Participants were largely (though not exclusively) people who were literally homeless, that is, living on the streets or in shelters, and who had additional support needs. Many studies were assessed as having a medium or high risk of bias. However, there was some consistency in outcomes across studies that improved confidence in the main findings. Case Management and Housing Outcomes: Case management of any description was superior to usual care for homelessness outcomes (standardised mean difference [SMD] = −0.51 [95% confidence interval [CI]: −0.71, −0.30]; p < 0.01). For studies included in the meta‐analyses, Housing First had the largest observed impact, followed by Assertive Community Treatment, Critical Time Intervention and Intensive Case Management. The only statistically significant difference was between Housing First and Intensive Case Management (SMD = −0.6 [–1.1, −0.1]; p = 0.03) at ≥12 months. There was not enough evidence to compare the above approaches with standard case management within the meta‐analyses. A narrative comparison across all studies was inconclusive, though suggestive of a trend in favour of more intensive approaches. Case Management and Mental Health Outcomes: The overall evidence suggested that case management of any description was not more or less effective compared to usual care for an individual's mental health (SMD = 0.02 [−0.15, 0.18]; p = 0.817). Case Management and Other Outcomes: Based on meta‐analyses, case management was superior to usual care for capability and wellbeing outcomes up to 1 year (an improvement of around one‐third of an SMD; p < 0.01) but was not statistically significantly different for substance use outcomes, physical health, and employment. Case Management Components: For homelessness outcomes, there was a non‐significant trend for benefits to be greater in the medium term (≤3 years) compared to long term (>3 years) (SMD = −0.64 [−1.04, −0.24] vs. −0.27 [−0.53, 0]; p = 0.16) and for in‐person meetings in comparison to mixed (in‐person and remote) approaches (SMD = −0.73 [−1.25,−0.21]) versus −0.26 [−0.5,−0.02]; p = 0.13). There was no evidence from meta‐analyses to suggest that an individual case manager led to better outcomes then a team, and interventions with no dedicated case manager may have better outcomes than those with a named case manager (SMD = −0.36 [−0.55, −0.18] vs. −1.00 [−2.00, 0.00]; p = 0.02). There was not enough evidence from meta‐analysis to assess whether the case manager should have a professional qualification, or if frequency of contact, case manager availability or conditionality (barriers due to conditions attached to service provision) influenced outcomes. However, the main theme from implementation studies concerned barriers where conditions were attached to services. Characteristics of Persons Experiencing Homelessness: No conclusions could be drawn from meta‐analysis other than a trend for greater reductions in homelessness for persons with high complexity of need (two or more support needs in addition to homelessness) as compared to those with medium complexity of need (one additional support need); effect sizes were SMD = −0.61 [−0.91, −0.31] versus −0.36 [−0.68, −0.05]; p = 0.3. The Broader Context of Delivery of Case Management Programmes: Other major themes from the implementation studies included the importance of interagency partnership; provision for non‐housing support and training needs of PEH (such as independent living skills), intensive community support following the move to new housing; emotional support and training needs of case managers; and an emphasis on housing safety, security and choice. Cost Effectiveness: The 12 studies with cost data provided contrasting results and no clear conclusions. Some case management costs may be largely off‐set by reductions in the use of other services. Cost estimates from three North American studies were $45–52 for each additional day housed. Authors' Conclusions: Case management interventions improve housing outcomes for PEH with one or more additional support needs, with more intense interventions leading to greater benefits. Those with greater support needs may gain greater benefit. There is also evidence for improvements to capabilities and wellbeing. Current approaches do not appear to lead to mental health benefits. In terms of case management components, there is evidence in support of a team approach and in‐person meetings and, from the implementation evidence, that conditions associated with service provision should be minimised. The approach within Housing First could explain the finding that overall benefits may be greater than for other types of case management. Four of its principles were identified as key themes within the implementation studies: No conditionality, offer choice, provide an individualised approach and support community building. Recommendations for further research include an expansion of the research base outside North America and further exploration of case management components and intervention cost‐effectiveness. [ABSTRACT FROM AUTHOR]

Racism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated. [ABSTRACT FROM AUTHOR]

This summer, the Hazelden Betty Ford Foundation released a research paper embracing the concept of civil commitment for substance use disorders (SUDs). The driving force is similar to that for suicidality: saving the life of a possible overdose victim. In issuing this paper, called 'Involuntary Commitment for Substance Use Disorders,' Hazelden Betty Ford has opened a national dialogue among treatment providers on this controversial issue. [ABSTRACT FROM AUTHOR]

Mental health and drug treatment courts have a substantially positive effect on instances of recidivism in non-violent offenders in the criminal justice system. A significant portion of the prison population in the United States suffers from serious mental illness (SMI); due to the deinstitutionalization of mental health treatment, prisons often end up being the only treatment option for people with SMI or substance abuse disorders. Policy is needed to treat the issues surrounding mental illness instead of punishing them. Incarceration is not the answer for people with mental health problems. Instead of punishment, a restorative model of justice can be implemented in the form of alternative courts that reduce recidivism for non-violent offenders with mental illness. The policy which could accomplish this is the expansion of mental health and drug treatment courts. To argue this point, this policy paper will provide a brief history of mental illness deinstitutionalization and explore the basic problems of mental health and substance abuse for people in the criminal justice system. The paper will summarize the basics of mental health court (MHC) functions and examples of MHCs in action are detailed alongside evidence of their efficacy. Potential opposition and drawbacks are explored, and additional policy recommendations for supplementing MHC programs are presented. [ABSTRACT FROM AUTHOR]

Précis: Despite significant scholarship, research, and funding dedicated to implementing criminal diversion programs over the past two decades, persons with serious mental illness and substance use disorders remain substantially overrepresented in United States jails and prisons. Why are so many U.S. adults with behavioral health problems incarcerated instead of receiving treatment and other support to recover in the community? In this paper, we explore this persistent problem within the context of "relentless unmet need" in U.S. behavioral health (Alegría et al., 2021). [ABSTRACT FROM AUTHOR]

A perennial talking point of politicians and scientists, since the time of the Greeks, is to lament how American youth are sliding into moral decrepitude, lawlessness, and poor mental health. Indeed, to hear some observers talk, particularly in this election year, young people in the United States are being battered by a coarsened culture that celebrates violence and irresponsible sexuality, placing them at greater risk than ever before of a wide variety of social maladies. Though compelling, this narrative of decline is false. In this article, the author contends that according to several significant indicators, today's youth are actually faring much better than did other recent generations: They are less violent, less suicidal, less likely to use drugs and alcohol, and less likely to experience teen pregnancy (despite a small increase in teen pregnancies in 2006, they remain much lower than in 1991).

This paper explores how poor health outcomes in the HIV/AIDS and opioid epidemics in the United States are undergirded by iatrogenesis. Data are drawn from two projects in Southern California: one among men who have sex with men (MSM) engaging with pre-exposure prophylaxis to HIV (PrEP) and the other in a public hospital system encountering patients with chronic pain and opioid use disorder (OUD). Ethnographic evidence demonstrates how efforts to minimize risk via PrEP and opioid prescription regulation paradoxically generate new forms of risk. Biomedical risk management paradigms engaged across the paper's two ethnographic field sites hinge on the production and governance of deserving patienthood, which is defined by providers and experienced by patients through moral judgments about risk underlying both increased surveillance and abandonment. This paper argues that the logic of deservingness disconnects clinical evaluations of risk from patients' lived, intersectional experiences of race, class, gender, and sexuality. This paper's analysis thus re-locates patients in the context of broader historical and sociopolitical trajectories to highlight how notions of clinical risk designed to protect patients can in fact imperil them. Misalignment between official, clinical constructions of risk and the embodied experience of risk borne by patients produces iatrogenesis. [ABSTRACT FROM AUTHOR]

Millions of Americans suffer from opioid use disorder (OUD) in the United States, resulting in thousands of deaths. The ongoing opioid crisis necessitates novel approaches to reduce the morbidity and mortality associated with misusing opioids. Studies using peer support models show success in engaging persons living with OUD in initiating treatment and decreasing relapse. Although most studies have focused on patients in clinical settings, community studies integrating peer community leaders also show promise. This viewpoint paper explores the use of peer coaches in online interventions in the community setting. [ABSTRACT FROM AUTHOR]

A recent report from the National Academies of Sciences, Engineering, and Medicine (NASEM) highlights rising rates of working-age mortality in the United States, portending troubling population health trends for this group as they age. The Health and Retirement Study (HRS) is an invaluable resource for researchers studying health and aging dynamics among Americans ages 50 and above and has strong potential to be used by researchers to provide insights about the drivers of rising U.S. mortality rates. This paper assesses the strengths and limitations of HRS data for identifying drivers of rising mortality rates in the U.S. and provides recommendations to enhance the utility of the HRS in this regard. Among our many recommendations, we encourage the HRS to prioritize the following: link cause of death information to respondents; reduce the age of eligibility for inclusion in the sample; increase the rural sample size; enhance the existing HRS Contextual Data Resource by incorporating longitudinal measures of structural determinants of health; develop additional data linkages to capture residential settings and characteristics across the life course; and add measures that capture drug use, gun ownership, and social media use. [ABSTRACT FROM AUTHOR]

The number of sexual crimes committed against women in the United States is high, and the prevalence of these crimes is on the rise. Although these crimes are heinous and have severe consequences on survivors, they are highly excused in U.S. society, and the responsibility for the assault is often shifted from the perpetrators to the survivors. In this paper, we will review the influence of willing substance use and race and ethnicity on the attribution of blame and responsibility in rape crimes. More specific cally, we will present the results of an analysis of variance (N = 316) of (a) the willing use of alcohol, marijuana, and heroin and (b) race and ethnicity (Black, Hispanic, and White) on blame attribution in rape crimes. Additionally, we will review the findings on the influence of participants' demographics. Our results provide support for previous findings regarding the impact of alcohol and introduce new insight about the influence of race and ethnicity. [ABSTRACT FROM AUTHOR]

Syndemic theory hypothesises that observed clusters of diseases are the result of harmful social conditions. Critiques of syndemics present the theory as ambiguous and lacking empirical evidence. Syndemics are evidenced through qualitative assessments drawing on observations, epidemiology, and biomedical evidence to explain bio-bio and bio-social interactions. Quantitative syndemic studies commonly apply a summative approach, whereby the outcome is a result of the cumulative effect of the individual elements. More recently, quantitative studies apply analyses to assess mechanical interactions among conditions. This paper applies a synergy factor analysis to measure synergy – the enhancement of the effect of one element on the effect of the others. Data from the canonical quantitative syndemic analysis study was reanalysed to assess synergy among the elements of the SAVA syndemic (substance ab/use, violence, HIV/AIDS). Contrary to original study findings, which applied a summative approach, no synergy was measured. Synergistic interactions were confirmed among a subset of the study population; the effects of substance ab/use and violence on HIV were more than two times greater in White MSM than the predicted joint effect (SF = 2·32, 95%CI 1·02–5·11, p = 0·044), indicating synergy. Synergy factor analysis presents an accessible tool to measure syndemic interactions and facilitate timely global health responses. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To conduct a systematic review and meta‐analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past‐month marijuana use prevalence among adolescents. Methods: A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta‐analyzed. Estimates of MML effects on any past‐month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non‐MML states over comparable time‐periods. These estimates were standardized and entered into a meta‐analysis model with fixed‐effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F‐test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results: None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non‐MML states for marijuana use prevalence among adolescents. The meta‐analysis yielded a non‐significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non‐MML states on pre‐MML differences and all found higher rates of past‐month marijuana use in MML states pre‐MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non‐significant results, although limited heterogeneity may warrant further study. Conclusions: Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions. [ABSTRACT FROM AUTHOR]

There is a dearth of research on the intersection of incarceration and psychological distress among men who have sex with men including African American (AAMSM) and Latino MSM (LMSM), populations which bear a large burden of HIV in the U.S. Recent incarceration is an important context to examine psychological distress given the critical implications it has on health outcomes. Using baseline data from the Latino and African American Men's Project (LAAMP), a multi-site randomized HIV behavioral intervention trial, this paper examined the association between previous incarceration within the past three months (i.e., recent incarceration) and psychological distress in the past four weeks, assessed by the Kessler Psychological Distress Scale (K10). Among 1482 AAMSM and LMSM (AAMSM: 911, LMSM: 571), we found 768 (52%) were previously incarcerated, but not in past three months and 138 (9.3%) had been recently incarcerated. After adjusting for race, education, access to resources, current living arrangement, HIV status, and substance use, participants who had been recently incarcerated were more likely to have mild psychological distress i.e., K10 score 20–24 (aRRR:1.43, 95% CI 1.20, 1.71) or severe psychological distress, i.e., K10 score > 30 (aRRR: 1.89, 95% CI 1.22, 2.93) in the past four weeks than those never incarcerated and those previously incarcerated, but not in past three months. Our findings have implications for mental health and HIV prevention services for AAMSM and LMSM with previous incarceration within the past three months. [ABSTRACT FROM AUTHOR]

This paper provides a personal memoir of historical work at the Addiction Research Unit, in particular the genesis of the book Opium and the People. This topic had policy significance for US drug policy and a competing US study was funded. The development of the substance use history field is surveyed, and its expansion in recent times through a focused professional association and a critical mass of researchers in the area, covering a wide range of topics. The politics of using history in this area can be problematic. History now sits at the policy table more easily, but there is still a tendency for professionals in the field to use (and misuse) it, rather than calling on the interpretive and challenging approach they would obtain from professional historians. The paper calls for historians and others to move beyond a substance specific focus and to avoid the tendency for 'naive history' implicit in using only digitized industry archives as the sole source. [ABSTRACT FROM AUTHOR]

Black adolescents in the United States have experienced an increase in suicidal thoughts and behaviors (STBs). Since Black adolescents are overrepresented in the youth punishment system, more research is needed to investigate correlates of STBs for this population. The purpose of this paper is to explore and establish correlates of individual, family, and community risk and protective factors and their relationship to lifetime STBs in a national sample of Black youth with arrest histories. Guided by an intersectional eco-behavioral lens, we investigated individual, family and contextual risk and protective factors for STBs among a national sample of justice-involved Black youth aged 12–17 with a history of arrest (n = 513). We used logistic regression models to test risk and protective factors for STBs. Among the sample, 9.78% endorsed suicidal ideation, and 7.17% endorsed a previous suicide attempt. Further, gender (female) and depression severity were risk factors for STBs, while positive parenting and religiosity were protective factors for STBs. School engagement was associated with lower levels of suicidal ideation. The findings suggest suicide prevention and intervention efforts should identify developmentally salient risk and protective factors to reduce mental health burden associated with STBs and concurrent alleged law-breaking activity of Black youth. [ABSTRACT FROM AUTHOR]

Tobacco use is associated with an annual global economic cost of two trillion dollars and mortality of half of its regular users. Tobacco leaf cultivation is the starting point of the tobacco cycle. Tobacco farming employs millions of small-scale tobacco farmers around the globe, most of whom are out growers who rely on the tobacco industry. This paper aims to map the regions of greatest tobacco production globally (i.e., the US, Brazil, China, Indonesia, India, and Zambia) and tobacco use rates in these locations. Smoking rates were higher in those areas, except for India, where important population subgroups reported an upward trend for tobacco smoking. In general, there was a relationship between tobacco farming and tobacco smoking. Tobacco farming may lead to a higher risk of tobacco use and lower adherence to tobacco control policies. Therefore, promoting viable alternative livelihoods for tobacco farmers must have dual benefits. Additionally, specific health prevention policies might be necessary for those populations reporting higher tobacco use and lower perception of tobacco-related health risks. [ABSTRACT FROM AUTHOR]

Background: As a result of the intergenerational trauma impact and experience, Native Americans continue to exhibit trauma-related issues such as high rates of substance use. After leaving high school, the pressures and stress of continuing an education, finding work/employment, and the responsibilities related to family and tribal community obligations result in the Native American young adult being more vulnerable to substance use. Objective: The purpose of this paper is to report findings of the Talking Circle intervention impact on the outcome variables of Native-Reliance, substance use, stress, and behavioural health, depression, and cumulative trauma. Methods: Native-Reliance was the theoretical underpinning for the study, demonstrating culturally safe research. A pre-test/post-test one-group design was utilised to examine how the Talking Circle intervention influenced the outcome variables. In total, 75 Native American participants, ages 18–24, participated in the Talking Circle intervention sessions. Baseline pre-intervention measures were completed and were repeated at 6-month post-intervention. Results: At 6-month post-intervention, Native-Reliance significantly revealed an increase of 40.55 (t = 22.13, p <.001), sources of stress (SS) revealed a significant decline of 3.68 (t = −18.39, p <.001), behavioural health issues (BH) showed a significant decline of 3.63 (t = −15.36, p <.001), substance-related issues (SR) showed a significant decline of 3.57 (t = −15.24, p <.001), depression (PHQ-9) showed a significant decline of 4.85 (t = −17.02, p <.001), and cumulative trauma revealed a significant decline of 2.77 (t = −13.39, p <.001). Conclusions: The use of a culturally safe Talking Circle intervention evidenced a research approach that resulted in a positive impact on reducing substance use and increasing the well-being of young Native American young adults. Impact Statement: Culturally safer intervention environments are conducive to results in outcomes that are positive and effective. [ABSTRACT FROM AUTHOR]