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Co-occurring use (co-use) of nicotine and cannabis is common, and represents a broad range of use behaviors, including concurrent use, sequential use, and co-administration. Co-use has primarily been examined through the lens of smoked tobacco and cannabis. Little is known about those who co-use vaped nicotine and cannabis, and the degree to which specific co-use behaviors are associated, based on mode of use and/or substance. We conducted an online pilot survey on use behaviors related to inhaled modes of nicotine and cannabis. The survey was administered to 112 concurrent vapers of these substances. Descriptive analyses examined sample characteristics and co-administered vaping and smoking behaviors. Logistic regressions examined associations in use behaviors by mode and substance. Participants who vaped nicotine and cannabis monthly also reported monthly smoking of cannabis (100%), and cigarettes (58%). Most exhibited moderate-to-high degrees of mental health and substance use problems requiring clinical intervention. Monthly concurrent use exhibited more differences by mode, and more similarities by substance. Specific sequential use practices showed mode-specific associations; with greater frequency of cigarette smoking and nicotine vaping. Co-administration was associated with more frequent tobacco and cannabis smoking. Those who regularly vape nicotine and cannabis tend to engage in some form of smoking. Different subsets of nicotine and cannabis co-use behaviors showed different associations with patterns of use and modes of drug delivery. Findings underscore the diversity of nicotine and cannabis use behaviors among co-users, and the importance of considering associations by both substance and mode of use. [ABSTRACT FROM AUTHOR]

Background: The legal status of cannabis is rapidly evolving, outpacing systematic research and educational efforts. Aims: We investigated knowledge of cannabinoid content and dosages among frequent cannabis users. A brief survey was administered in April 2019 (N = 472) at a cannabis advocacy event in a state with legal medical and recreational adult cannabis use. Most participants (67%) used cannabis every day, 85% used cannabis for health or medical purposes. Knowledge of cannabis was mostly from participants' own experiences (78%), with some receiving information from a medical cannabis caregiver or dispensary (23%) or their primary care provider (18%). The majority reported not knowing the effective dosages of THC (53% of participants) or CBD (68% of participants), other participants gave average estimates of 91 mg and 177 mg, respectively. Participants' average estimates for high-THC (52%) and high-CBD (53%) as well as low-THC (28%), and low-CBD (30%) strains of cannabis were considerably higher than currently accepted definitions. Men, European Americans, and participants who had medical cannabis cards were more accurate in cannabinoid concentration estimates. Frequent cannabis users reported low knowledge of and substantially overestimated cannabinoid content. The importance of education and research on cannabinoid dosages grows with increasing cannabis accessibility. [ABSTRACT FROM AUTHOR]

Recently implemented New York State policy allows police and fire to administer intranasal naloxone when responding to opioid overdoses. This work describes the geographic distribution of naloxone administration (NlxnA) by police and fire when responding to opioid overdoses in Erie County, NY, an area of approximately 920,000 people including the City of Buffalo. Data are from opioid overdose reports (N = 800) filed with the Erie County Department of Health (July 2014-June 2016) by police/fire and include the overdose ZIP code, reported drug(s) used, and NlxnA. ZIP code data were geocoded and mapped to examine spatial patterns of NlxnA. The highest NlxnA rates (range: 0.01-84.3 per 10,000 population) were concentrated within the city and first-ring suburbs. Within 3 min 27.3% responded to NlxnA and 81.6% survived the overdose. The average individual was male (70.3%) and 31.4 years old (SD = 10.3). Further work is needed to better understand NlxnA and overdose, including exploring how the neighborhood environment creates a context for drug use, and how this context influences naloxone use and overdose experiences. [ABSTRACT FROM AUTHOR]

Background: Daily process research can help distinguish causal relationships between substance use and sexual risk behaviors in high-risk groups, such as urban emerging adults. We employed text messaging to assess 18-25 year-olds' daily substance use and sexual risk behaviors over 28 days. We describe the implementation of this method, attitudes regarding the daily surveys, and correlates of survey completion. Method: We recruited 111 emerging adults from an urban Emergency Department in a resource-limited area who reported recent drug use and unprotected sex (Mage=22.0; 53.2% female; 45.1% African American; 43.2% receiving public assistance). Results: Respondents completed M=18.0 (SD=8.7) of 28 daily surveys (27 items each). Participants completing a 1-month follow-up found the surveys not at all/only a little annoying (90.3%) and were comfortable with questions about drugs/alcohol (97.9%) and sex (94.6%). Completion was higher on weekdays versus weekends, and earlier in the study. Daily survey completion was unrelated to sameday substance use measured by the Timeline Follow Back at follow-up; polysubstance use and drinks consumed were associated with lower odds of next-day completion. School enrollment, public assistance, unlimited texting plan, lower baseline alcohol use, and depression symptoms at follow-up were associated with higher completion. Technology difficulties were commonly mentioned barriers to completion. Conclusions: Participants in this urban, resource-constrained sample found the daily text message methodology acceptable for reporting sensitive information. With rapid advancements in technologies and increased accessibility, text messaging remains a promising methodology for the study of daily processes in substance use and HIV risk behaviors. [ABSTRACT FROM AUTHOR]

To inform ethical procedures for human subjects research using mobile health (mHealth), we examined perceived risks and benefits of study participation among emerging adults (N = 54) with drug use who completed text message assessments of substance use and sexual behaviors. Most participants reported comfort with participation and some reported perceived benefits, such as improved relationships. Perceived risks were infrequently reported, including negative emotions and legal or financial concerns. In conclusion, participants from a vulnerable population reported few perceived harms of participation in longitudinal mHealth assessments of sensitive behaviors. Researchers should continue characterizing participants' perspectives on ethical aspects of mHealth research. [ABSTRACT FROM AUTHOR]

Abstract: Underage drinkers typically have not developed regular patterns of drinking and so are likely to exhibit situational variation in alcohol intake, including binge drinking. Information about such variation is not well captured by quantity/frequency (QF) measures, which require that drinkers blend information over time to derive a representative estimate of “typical” drinking. The Timeline Followback (TLFB) method is designed to retrospectively capture situational variations in drinking during a specific period of time. We compared our newly-developed Self-administered TLFB (STLFB) measure to a QF measure for reporting alcohol intake. Our sample of 429 (men=204; women=225) underage (i.e., age 18–20 years) drinkers completed the two drinking measures and reported on alcohol problems. The STLFB and QF measures converged in assessing typical daily intake, but the STLFB provided more information about situational variations in alcohol use and better identification of regular versus intermittent binge drinkers. Regular binge drinkers reported more alcohol problems. The STLFB is an easy-to-administer measure of variations in alcohol intake, which can be useful for understanding drinking behavior. [Copyright &y& Elsevier]

This article is a summary of a symposium presented at the 2005 Research Society on Alcoholism annual conference organized by Dan J. Neal and chaired by William R. Corbin. Event-level data, wherein each “event” (e.g., day) is captured as its own data point, capture the complex patterns of drinking and other high-risk behaviors in ways that the typical aggregate approach cannot. Because of their richness, methodologies that incorporate event-level data are becoming more common in alcohol research. At least 3 distinct forms of event-level data can be gathered: retrospective data (those collected on a single occasion, using memory aids to help each participant reconstruct all drinking events over a specific period of time), daily monitoring data (reporting on all events for that day), and momentary assessment (those recorded immediately following a drinking event or in response to a prompt from researchers). The goal of this symposium was to address many issues associated with event-level methodology, as well as demonstrate projects that are currently implementing such innovative data collection. The 4 presentations included in this symposium were “Realizing the Promise and Avoiding the Pitfalls of Retrospective Daily Estimation Assessments of Alcohol Use” by Frances K. Del Boca; “Using Interactive Voice Response Technology to Assess the Alcohol-Victimization Link” by Kathleen Parks, Linda King, and Ann Pardi; “Methodological Issues in Using Personal Data Assistants to Self-monitor Alcohol Consumption” by R. Lorraine Collins, Mark Muraven, and Charlene Vetter; and “Collecting Event-level Data Using the World Wide Web” by Dan J. Neal and Kim Fromme. [ABSTRACT FROM AUTHOR]

Presents information on a study which examined the alcohol use of women in various non-European ethnic groups in the U.S. Review of related literature; Characteristics of the participants; Methodology; Findings and conclusion.

Purpose: To compare cannabis enthusiasts' knowledge about cannabis risks and effectiveness in treating medical conditions with existing empirical evidence.Design: A brief survey assessed cannabis use, information sources, and knowledge about risks and effectiveness.Setting: A cannabis advocacy event in April 2019 in a state with legal medical and recreational cannabis.Participants: Demographically diverse adults (N = 472) who frequently used cannabis; 85% used cannabis for health or medical purposes.Measures: Participants reported the sources of their cannabis information, health conditions they thought cannabis was effective in treating (n = 10), and health risks increased by cannabis (n = 6). Conditions and risks were based on ratings of evidence (ie, from substantial to insufficient) for therapeutic effects and risks identified in a review by The National Academies of Sciences, Engineering, and Medicine (NASEM, 2017).Analyses: Chi-square tests examined the correspondence between participants' knowledge and NASEM conclusions.Results: Most participants' (95% confidence interval [CI]: 74%-81%) knowledge of cannabis was from their own experiences; 18% (95% CI: 14%-21%) received information from primary care providers. On average, participants' beliefs matched NASEM conclusions for half of effectiveness (95% CI: 50%-53%) and risk items (95% CI: 55%-57%). Many (95% CI: 38%-42%) thought that cannabis use did not increase any risk. Contrary to NASEM conclusions, many thought cannabis was effective in treating cancer (76%), depressive symptoms (72%), and epilepsy (68%). Those who received cannabis information from their primary care providers had better knowledge of medical effectiveness. Medicinal cannabis use frequency inversely predicted knowledge of medical effectiveness and increased risks of adverse events.Conclusion: There were considerable discrepancies between cannabis users' knowledge and available evidence, highlighting the need for more research and education (by physicians, caregivers, and dispensaries) on effectiveness and health risks, especially for users with specific health issues such as pregnant women and people with depression. [ABSTRACT FROM AUTHOR]

Objective: We designed the current study to assess the rates of risky sexual behavior among women bar drinkers, as well as differences in predictors of risky sexual behavior, based on partner type-new or regular. Method: We conducted comprehensive, in-person interviews with 241 young women who reported weekly drinking in bars. Several constructs (e.g., individual characteristics, social and sexual behavior, substance use) that we hypothesized would predict risky sexual behavior were assessed in two separate hierarchical regression models for new and regular sexual partners. Results: Rates of risky sexual behavior were significantly higher with regular partners compared with new partners. Increased risky sexual behavior with new partners was significantly associated with having had a riskier regular partner in the past 6 months, lower sexually transmitted disease (STD)/pregnancy prevention assertiveness, increased expectations of sexual disinhibition when drinking, a greater history of prior sexual risk taking, and more frequent drinking in bars. Increased risky sexual behavior with a regular partner was significantly associated with being older, the use of oral contraceptives, lower assertiveness for STD/pregnancy prevention, a greater history of prior sexual risk taking, and increased drug use. Conclusions: Among young women who regularly drink in bars, sexual risk taking was significantly higher with regular partners than with new partners. The predictors of risky sexual behavior differed based on partner type. These findings have implications for including information about the role of alcohol, drinking context, and drug use, as well as individual difference characteristics and partner type in targeted prevention strategies to reduce sexual risk taking. [ABSTRACT FROM AUTHOR]

Background: The past decade has seen over a four-fold increase in deaths from opioid overdose in the United States. To address this growing epidemic, many localities initiated policies to expand access to naloxone (a drug that reverses the effects of opioids); however, little is known how naloxone access affects opioid use behaviours.Methods: The present qualitative study used semi-structured, in-depth interviews with inpatients at a substance use treatment centre. All patients who met study inclusion criteria (in treatment for opioid use, between the ages of 18 and 40, able to speak and understand English, and had not previously completed an interview with the research team) were invited to participate. Interviews were conducted until thematic saturation was reached (N=20) and covered the participant's naloxone knowledge, access, and attitudes, as well as experience(s) with opioid use and opioid overdose, and their naloxone use in the context of opioid overdose. Thematic content analysis was used to analyze interview transcripts.Results: Five main themes were uncovered during analysis; first, awareness about naloxone, including, content knowledge and source information for naloxone. Naloxone awareness was very common among opioid users; however, depth of knowledge varied; some participants did not make any efforts to have naloxone available, and others felt that it was "just as important as a clean needle." The second theme explored how naloxone access intersects with drug selling. The third theme explored naloxone availability while using, including attitudes about naloxone, occasions with no naloxone availability, when naloxone is "good to have," and when naloxone is a priority for users. The fourth theme examined changes in opioid use behaviours associated with naloxone access. Primarily, participants discussed changing how much heroin they used in a given situation to achieve a bigger high. The final theme explored naloxone behaviours that alter overdose mortality risk, such as how users distinguish when to use naloxone, dis-incentives to naloxone use, and solo opioid use.Conclusion: Results indicate that though naloxone awareness was high, there was great variation in the associated attitudes and practices. Participants generally described naloxone as an important resource, but not all were inclined to carry or use it appropriately. Future research needs to examine why different groups of opioid users access naloxone differently, particularly to identify those at risk for experimental opioid use while carrying naloxone. [ABSTRACT FROM AUTHOR]